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Sunday, August 23, 2015

When you think of love, do you think of pain?

  I read an article while sitting at the border last weekend in one of the running magazines that Dave found some slickdeals (not surprisingly, his favorite website) deal on that we get.  The article talked about perfectionism in runners, and optimism vs. pessimism.  The gist was that runners who are too perfectionist are never happy enough; made sense.  Conversely, though, too much optimism isn't a recipe for success, either.  The "too positive" thinkers who "strongly fantasized" desired outcomes, the article stated, "tended to invest so much of their effort into positive-thinking their way to success that they forgot to do the real work".  Interesting stuff.  The week after surgery, oddly enough, I laid on the couch most of the time, and I coped by thinking about outcomes.  I haven't crossed a long course finish line in almost 11 months now, and it digs at me daily.  Without any evidence of how out of shape I was becoming, it was easy for me to delude myself with crazy thoughts and fantasies of races and finish chutes.  I reveled in the small stuff-my range of motion was good, I could put weight through my leg, I was almost at my normal recovery wattage range, the doctor said I could progress more quickly than most, etc, etc.  Small victories were large victories; the well-wished poured in and I felt sort of justified in lamenting over how little I could do for myself.  Eventually, though, that began to wear off, and I began to regain my independence and was given permission to add more activity here and there.  With that, though, comes a stark realization of how not exactly in shape I actually am, and how much work it takes to get there.  Yikes.

   Which brings me to where I am now, stuck at the intersection of "look how far you've come" and "look how far you are from where you want to be".  Laying on the couch imagining stuff is physically easy.  Heavy training with a clear goal in mind, when the daily battle is waged between fitness and fatigue is physically hard.  It's also mentally hard, but it's a time when mind can be placed over matter, and the ability to both embrace and mitigate pain, to overcome it, is incredibly rewarding.  Right now, though, is just foreign and strange to me.  When I had acute fractures this winter, the PA had told me that if I overdid it, I'd just be sore, I wouldn't negatively impact the bone healing.  I don't know if she necessarily understood that sore to an IM athlete is a way of life, and a normal, sort of cozy feeling to be embraced.  Post-op, though, is a different ball game-soreness is normal but pain needs to be heeded and listened to and understood.  How much should I take?  This is my judgement call-according to my aquatic PT, the surgeon said that part of me being allowed to push (fairly far) ahead of protocol was that I have to be completely honest about it, and not ignore or deny pain because I'm trying to be tough or stubborn or whatever.  Argh.  As objective as I try to be as a PT and a coach, policing myself is an entirely different ballgame.

   Stay patient, be smart.  Sometimes, I'm pretty damn optimistic and positive.  The hip feels ok, I'm able to look and see that hey, a 4k "swim" (well, pull these days), a 60-90min easy-lower end aerobic bike a day, and a fairly normal gait pattern 3.5 weeks post-op is actually sort of active, and I'm in better shape than a good majority of the population.  Then the pessimist cuts in.  I'm not even using my legs in the pool, my arms are tired, my shoulder is getting sore again.  I'm riding 30-40W lower than normal.  Running is a distant memory.  I'm sick of carrying around an extra 10 lbs.  When I feel something from my hip, I start to question am I doing too much or can I do more, what's the line?  Beating myself up over the lost training and fitness becomes far too easy, as it stares me in the face, and this time there's some frustration knowing that I have to wait before I'm able to put in the type of work that I need to put in.  That's healing.  I can't rush that.  But then again, I switch back to thinking about all of the good stuff, and I then start being myself up over feeling bad about the bad stuff-at this point, even to me, it just seems like petty whining to both myself and everyone around me.  Many would kill to be in my shoes.

  But really, is this a bad thing?  Context goes two ways.  I can't wallow in self-pity, because I'm actually doing quite well for where I am now.  Feeling sorry for myself gets me nowhere but miserable.  But, at the same time, I know where I want to be, and if I was content and patting my back over every small accomplishment now, I'd never get to where I'm truly happy with it all.  Training to get the most out of yourself, no matter what level, takes freaking hard work.  Period.  We were up watching/coaching at IM Mont Tremblant last weekend, and I thought back to what had turned into a pretty awesome training weekend for me there last year, when Dave had been racing.  The day we left, I had put in a 5k swim, a 3hr tempo ride, and then a set of 5x1 mile all out repeats on the track.  Our drive up there that evening had been slightly delayed by Dave having to wait for me to unfurl and start moving again afterwards.  I had a swim and a recovery ride the next day, nothing major, but had followed that up with a 6hr ride finishing over IM effort and one of the best ~6 mile  transition runs of my life on Saturday, and then had somehow squeezed in another 2hr ride, 15mi run (a test of pure will on toasted legs), and a cold, lonely swim surrounded by chop and some sketchy water plane landings nearby while making it to every major course checkpoint to spectate Dave and two athletes.  So basically, leaps and bounds away from the "training" I'm doing now.

  That weekend last year, I had suffered pretty hard on many occasions physically and mentally.  Halfway through the long ride (which I had done on the trainer-it was cold, what can I say), I had found myself standing at the fridge, eating cold leftover pancakes from Dave's earlier breakfast, pondering the meaning of life.  I whined on the couch afterwards, forcing my pre-race husband to cook me dinner, too.  On the run the next day, all I'd wanted to do was stop where the aide stations were being set up and chug an entire bottle of coke to try to revive myself.  The swim-I really did not want to be in the water the entire time I was in it.  Trekking back to the condo after the race, I think I was every bit as happy as Dave when a shuttle bus let us in to drive us up the giant hill, bike and all.  So, on the surface, it seems as if this year's experience should have been more enjoyable.  I only swam a little bit, I went to a team breakfast, I hung around the condo, I slept more, I relaxed, we hung out by the pool a little, I never wanted to lay down by the side of a path or barf, I never wondered if I was in some kind of time warp making one bike minute seem like 17 regular minutes.

   But even though the training hurts and sometimes picking weeds out from between the pavers of our back patio while eating ice cream sounds more pleasurable than sitting on my bike seat for 3 more hours, when I'm in those time periods where everything is shot and the workouts are relentless, I'm at my happiest.  A few years ago, after the San Juan 70.3, Dave and I had been sitting behind our hotel, looking out over the water.  He was reading, I was typing out a race report and trying to saw into a mango the size of my head with a plastic knife (I miss those mangoes).  We watched some others who looked to be around our age by the pool, drinking and laughing with each other.  We could have come here and not raced, Dave had commented, and done that instead.  Remember real vacations?  We kept talking, though, and quickly decided that actually, we were happier with our trip.  Were we loving life at, say, mile 10 of that half marathon?  Probably not (Dave especially in that race).  Was riding a stationary bike and swimming in the 15m hotel pool before heading out to explore the next day sort of time-consuming and tedious?  Well, yes, it was.  But, neither of us would have had it any other way.  Training and racing are their own rewards, and that's what we've chosen.  I probably don't need to explain this to anyone who's actually taking the time to read this, after all.  Comments I heard from mile ~25 of the Tremblant run course last weekend included, "Ironman is insane", "why am I doing this again?", "I'm too old for this", and variations of "uuuunnnnnhhhhhhh"-but yet, all of those people had chosen to do that race, even if I was more comfortable sitting on the curb at the time.

  I've also read that we block out memories of the unpleasant stuff and remember the finish line, which is why we do these things again.  That's probably the case, but somehow watching others suffer has somehow confirmed with me how much I want to get back to that position.  If I was never able to race again, I'd find a way to make life go on and be happy about it, for sure.  That article from earlier?  It also mentioned being forced to "deal with the reality of whether you have the time, energy, or talent to actually do what you want".  The deep tightening in my chest and stomach when I really think about racing, the twinges of jealousy,  the total melodramatic meltdown I'd had on the trainer a week ago hearing the cannon shoot off the pro women, and the fact that I voluntarily swam, like, 22k with actual intervals with no one making me in my first week back in the pool tells me that my heart is still in it.  The article's solution for that whole overly positive vs. overly perfectionist thing?  Think about the end goal, but then break it down into the steps along the way that need to be done before it can be reached, and find some satisfaction in reaching them.   Allow yourself to fantasize about that finish line, but then shift and think about the obstacles in the way and the steps that need to be taken to overcome them.  For me, right now, this sounds like the perfect compromise.  

Wednesday, August 12, 2015

Post-op update take II-random thoughts from the trenches

  Well, now that I'm nearing the two week post-op time frame, I figured that I'd throw together a random conglomerate (this is kind of going to be all over the place, but hey, that's the beauty of a personal blog vs. a college thesis) of thoughts and updates on how the process is going!  So far, I've been pleased with the overall progress, although I still have some battling to do.  So, read on for the details, for those who also are killing time :)

  The first few days post-op, when I'd last blogged, were mostly marked by trying to stay awake long enough to get work done (I might have made a few math mistakes on training schedules here and there...), as I tried to work through the fun effects of anesthesia, pain meds, and sleep that was disturbed by the combination of that horrible leg contraption thing and, well, crutch trips to the bathroom to get rid of the 10lbs of swelling in my body.  The "anti-rotation night brace" became the bane of my (and Dave's) nighttime existence.  I only had to wear it for a week, and I barely even made that.  Sleeping on my back (or trying to) is hard enough for me, so throw in having my feet strapped into some contraption, and I was NOT a happy camper.  Plus, the velcro on that thing was so industrial-grade that every 3am bathroom trip had to be preceded by rousing Dave up to release me (I would have had to bend my hip too much in order to reach it myself).  During the last few days, I kept managing to somehow subconsciously get my left leg free during the night, and I'd wake up with my right hip hurting anyways from trying to get it released as well.  I made it until 3am the final night before I completely ripped it off for good.  Anyways.  I was given Ambien for that time, which, although I'm not really a medication kind of person, was wonderful after months of having tons of trouble falling asleep.  The pain meds got old really fast, though, and I was off of those in just over 24hrs.
Where the night brace ended up after vacation-randomly thrown on the driveway.  I wanted to leave it there.

Gross stitches picture.  I'm still amazed at how small the incisions were.  They shaved bone through these!  The marvels of modern medicine.

Some attractive bruising.  Thankfully, I was also told yesterday that my thigh was still a bit swollen with post-surgical fluid, not just post-surgical inactivity :)

Princess band-aids and a get out of swimming note from athlete Paul!!!  Totally awesome.
   After the first few days, thing began to slowly improve in terms of mobility, function, ability to stay awake, comfort, etc.  At a week, I was allowed to bend my hip past 90 degrees, which was a big step in terms of being able to do things like get dressed and tie sneakers-it's the little things.  I actually haven't even gotten too bored yet-between coaching work, those continuing ed courses that I finally got around to, a couple of PT visits, and twice daily sessions of easy bike rides, rehab exercises, and some upper body band work to at least pretend like I cared about losing swim fitness, I kept fairly busy.  Last week, Dave and I were able to head out to Massachusetts for our annual Cape Cod vacation with my family.  Even though I couldn't really do too much other than lay on the beach while he trained, I was grateful to be able to unplug, get myself off of the couch and into the sunshine, and spend some time with my family.  I've been to the cape every year since I was not even two, so I wanted to be able to make it out there, surgery or no surgery.  I wasn't able to go into the water (no incision submersion for two weeks) and I definitely ached a little bit inside from time to time thinking about how much I've loved running out there in the past, but I still hobbled down the beach on crutches stuck my feet into the ocean on the final morning.  The last time I'd stood with my feet in salt water was back in Mexico two mornings after my crash, when I'd hobbled down to the shore with a cane, having no idea the extent of anything yet.  As I let the warm Atlantic waters lap at my ankles again Sunday morning, I was able to pretend as if somehow, in some strange way, all of the down times were being washed away, back out to sea as well.
There was a bunny!  He was my friend while I did my easy trainer spin one morning.  Dave wouldn't let me take him home, though.

On our final day, Dave met up with Ray and swam across a lake and back.  I watched a yellow lab play fetch, which was better than swimming.

At one point, Dave and I ended up in charge of  our just under 2 year old twin niece and nephew.  This happened.  #babysittersoftheyear
  Then...there are my feelings towards said crutches.  This is my fourth stint on crutches in my life.  I always used to think that crutches would be the greatest, most fun adventure ever when I was a little kid...NO.  The first time that I used them was for a couple of days when I sprained my ankle (on a track, thus starting my history with injuring myself on flat, smooth surfaces) back when I was 14.  I think that I used them for about two days, and it was mostly so I could take the elevator in school and feel special.  The second time, I had a stress fracture in college, and walking all over campus was preventing it from making much progress.  I remember not being a huge fan of navigating my way from the farthest student parking lots ever (thanks for not giving me any sort of special parking permit, UB doctor...I still remember) on them with 9000lbs of books in my bags (nerd), but when I was done for the day, I'd just leave the crutches in the car, and then walk normally around my apartment.  Then, I used them a little bit last winter when I was more acutely fractured, but mostly just for distances, and, in retrospect given how prolonged the healing had been then, definitely not as much as I should have ("as tolerated" is a slippery slope for anyone that trains day in and day out to override pain).  So really, this is the first time that I've actually HAD to use crutches to get around even short distances, and if nothing else, I now have a huge amount of appreciation for anyone that's stuck with them for a longer period of time.  Two weeks is basically nothing, and I've wanted to chuck them out the window and/or beat someone with them on many occasions.  At one point before my sister intervened, one of them was being used in a sword fight (along with a broom and a noodle) between my older nephews and another little boy while on vacation, and I was fine with letting that one happen.  Everything takes 17 times as long with crutches, and I never really appreciated my ability to carry stuff until I could no longer carry stuff.  They're also kind of gross, when I think about everything I touch before touching them.  I've used a lot of Clorox wipes on those handholds.  Very, VERY thankfully, yesterday I was given the a-ok to start weaning off of them a couple of days early.  This is also for the betterment of our house, which has been raised a level from its normal kind of gross state with my total inability to clean.  On the flip side of that, at least Dave had to admit that even my normal half-assed housecleaning is sort of helpful.  Also, I will say that I'm rather impressive with crutch skills.  Far better than my bike skills-not that that's saying much here.

   On another random note, I feel that the completion of that whole tooth implant thing deserves a shout out here.  As some background, because I think this is only something that's been frequently mentioned in passing but never fully explained, I was born with two baby molars with no adult teeth underneath.  Last summer (in July, as reminded by my facebook memories earlier this summer, which is my random daily entertainment), after numerous cavities and fillings, one of them finally reached the end of its reasonable life.  Sigh.  It was pulled (ok, it was really like, 2/3 of a tooth by that point).  After a few months, when enough healing had supposedly taken place, I went in for tooth implant attempt #1, three days after my last completed IM in Chattanooga, and several hours after talking to Jesse and deciding that I'd race IM Arizona that fall.  That implant caused tons of problems and pain, I missed more training than one could get away with when trying to pull off two IMs seven weeks apart, we decided that I'd do Coz instead, and then the damn implant fell out anyways, four weeks later.  It was probably trying to tell me something.  Then Coz happened.  I found out about the fractures (and my low vitamin D levels, a risk factor for dental implant failure) a few days before my next mouth check.  I wasn't healed enough yet to try again.  Dental implant #2 eventually went in, this time 3 days before I was originally cleared to run.  It was successful.  Eventually, I had one more step (getting it dug out of my gum and a new healing cap put on) before the final step of the whole process (getting the crown put on) in July.  As I was walking into the building for that appointment, my phone buzzed with my MRI results about the labral tear.  For whatever reason, the novocaine didn't seem to work as well as normal as I had my gum cut into that day, but I didn't even care about the pain right then.  Finally, Monday I crutched my fixed-up hip in, and happily laid down in the chair to get my mouth completed, once and for all.  Let's get this wrapped up, the dentist had said upon viewing the crutches and asking about the surgery, and get some good going in your life.  For whatever reason, I found myself staring at the butterflies on the ceiling, and feeling weirdly, unexpectedly emotional-but good, happy emotional-to be finishing off the whole tooth thing.  Like my hip these days, the tooth still feels a little bit weird in me-not quite mine yet, like I can't believe that it's supposed to be there and be ok, like it's too large for the space it's in (it's not, I've mirror verified plenty of times that it actually sits well within the bounds of the surrounding teeth), but I'm getting used to it.  Somehow, I feel like that whole thing ending means that the whole pelvis/hip thing is going to be over soon enough, too.   

   Otherwise, I had my post-op visit with Dr. Giordano yesterday.  I got to see cool pictures (anatomy nerd) of my stitched up labrum, cleaned up joint capsule, and shaved down bone.  The damage that was beyond the normal wear and tear of a 30 year old lifelong athlete was all consistent with trauma, which made me feel better about my long-term joint health.  So far so good with everything, and I was given permission (have to appreciate the doctor that understands the athlete-he even brought up something he did that should help me be able to ride in an aggressive position without pain down the line) to be able to push ahead of protocol a bit in certain areas (strength exercise progression, weight bearing, range of motion), but with plenty of warning to not push it in others (basically, anything that involves too much use of the hip flexor).  Scar tissue buildup now and tendonitis down the line are the biggest risks.  Naturally, a large part of me is saying, it's been long enough, let's go already!, but then the health care practitioner area of my brain that governs logic instead of just dreams is telling me to listen, because another setback would just NOT be fun anymore.  I remember last March hating my December self for not being smarter about everything, and I don't need to repeat that.  Athlete or not, my collagen needs time to build up and my tendons are just as prone to inflammation as anyone else's.  Right now, I'm up to 2x40min spins on the bike.  I'm able to handle about a "normal" recovery wattage as long as I sit up with my hands on the bar pads, but I'm not pushing it.  In a couple of days when the final scab has healed off of my incision (mmmm), I'll be allowed to get into the pool and do some pulling.  Next week, I start aquatic therapy, and I also was told that I can start a little bit of light elliptical work.  Somewhat mercifully, I'm actually not allowed to water run due to the resistance on the hip flexor.  I'm not upset about this.  So all in all, not too bad.

   Finally, there's that whole pesky mental state part of it all.  Physical pain doesn’t phase me too much these days; it’s there but I can deal with it, and after 8.5 months of some sort of pain daily, I feel like I'm working towards the end of it.  The fractures were far worse, and if it starts to get sore, I just head over to the couch and stick my leg out until it fades.  How I feel has little to do with what's going on with few inches of space between my femur and my lumbar spine these days, and more to do with what's going on in the few inches between my ears.  I keep thinking back to this winter, because that's all I know.  One minute I'm happy and encouraged because I'm already ahead of the game compared to where I was back then, and at least my upper body is intact and I'm not terrified of my bike anymore.  But, then the next minute I'm just angry at myself, angry that one stupid moment of fumbling with a water bottle, something that took me so long to master but had become so second nature could cost me this year that I was so well set up for, angry that I just had to screw around with it trying to get, what, a couple ounces of fluid that were left out, angry about the moment I first started to lose control and tried to correct, because all I did was send myself flying off of the road instead of possibly just ending up with some road rash, angry that all of that battling back I did throughout the frozen winter that was in vain, because more was lurking.  Why didn't you see Dr. Giordano then??  Why didn't you know to suspect anything else?, I've been chastising myself, even though all logic tells me that I had no way of having any clue.  I'm angry that I can't compete, and angry at the jealousy that keeps sneaking into me when I watch others doing so-plenty of others have been or are in my shoes or worse, after all.  When it comes to running...I'm empty.  Fact of the matter is, in 18 years of running competitively, this is the longest period of time that I've ever gone without being able to consistently run.  Plain and simple, after running ~20-25mi/week for one little month out of the past 8.5, I think it's ok to ache a little bit for it by now.  I can work at maintaining fitness in other ways, but there's no substitute that's going to fill that hole for now.  There just isn't.

   Really, though, I'm fine and happy enough and encouraged enough the vast majority of the time.  Of course I have my moments when I fire off an an upset email, feel that anger and bitterness, or simply slip away into myself for a little bit; I think that makes me human.  Race pictures, people out running, driving down Titus and imagining myself running, frustration when I can't just put on a pair of shorts normally, certain songs, anything that makes me think about where I want to be right now can trigger me.  I've learned not to fight it-I let the tide pass, it never takes long, but not before I bottle a little bit of it up first.  Whenever I make it to mile 20 of an IM marathon again, to that point in every single marathon I've ever run off the bike where my HR starts its little dip until mile 24 when I wake the heck back up, I want to be able to look back on this particular type of hurt, to remind myself that whatever suck I'm feeling in the race pales in comparison to this suck.  The healthy, training, running, racing version of myself owes it to the post-crash, post-op, post-whatever I am now version of myself to deal with it.  And, like in an IM, the low moments always do pass quickly enough, as soon as I get back to focusing on what's right and gratitude and everything that's still pretty awesome about my life, which is basically everything other than one stupid joint.  I haven't let any low times prevent me from getting whatever I can do that's productive and moves me towards the end goal done.  So, overall, all is good.  Almost two weeks out now, and I'm glad that I had this done and got it over with!  For now, I'll take what my hip gives me, and I'll keep looking forward to getting back out there :)

The Bailey is also looking forward to this summer being over.  Summer=loud scary noises from the sky and sheepish hiding in the basement.
    

Saturday, August 1, 2015

Post-op update: give me back my broken parts

   Well, I had a good 30 year run of no major dental work, no acutely broken bones, no surgeries, and never even taking painkillers for anything.  I guess that's a good enough track record, given that I've spent ~25 years in organized sports of some sort.  Then I turned 30 on 9/29.  On 10/1, dental implant #1 went in; on 10/29, it fell out (1+29=30).  11/30 was my crash.  I was sick on 12/30.  Dental implant #2 went in on 3/30.  5/30 was the last long bike/run I did before the ominous hip pain started.  Then, yesterday, 7/30, I had my hip scoped.  Thankfully, there's only one more 30 in a month before I turn 31 (which gives me a little pause, because Dave is racing Muskoka that day-hopefully he'll turn this stretch around).

  Anyways.  That surgery thing.  As I mentioned in my last post, I'd had all of the hip imaging done, and was waiting on one final step to try to figure out if my pain was intra-articular or extra-articular.  I'll take a step back first, though, and sort of explain how I went from planning a season one second to on the operating table the next (well, trust me, it did not seem NEARLY that fast to me).  As I had previously mentioned, a few days before Keuka, I started feeling some deep, sharp pain in the front of my right hip/groin area after a run.  Had I had this type of pain before?  Well, yes, it mimicked the pain that I'd had with the acetabular fracture early on in this whole game.  The pain kept worsening, though.  It hurt with impact and stair climbing, and it got bad-bad to the point where I couldn't run a step without sharp pains, and bad to the point where I was again laying awake at night, worrying.  X-rays showed nothing.  A follow-up pelvic MRI showed that the fracture line at my ischial tuberosity was still there to some degree, but that didn't explain my newer pain.  Knowing that injury to the hip labrum and other joint structures wouldn't show up on a standard MRI, I wasn't satisfied that this was nothing, so off to the hip orthopedist I went.
Post-Keuka coach/athlete beer hand off.  Had I know what was going on with that hip, I would have finished the darn can instead of the cool down  Photo courtesy of Alex Tong.
  As the doctor had explained it, because my fractures were all on the non-impact side of my pelvis, they were caused by the ball of my hip joint smashing into the socket.  Before bone hit bone, it had to go through cartilage and labrum.  Therefore, a fairly significant chance of damage to those structures existed.  It could seem strange on the surface that the pain had taken so long to set in, but several factors went into that.  Early on, I would have had no way of distinguishing hip joint pain vs. fracture pain, and I'd been so immobile in that time, anyways.  Looking back, when I'd done some cross country skiing over the winter, that had been the main area that had bothered me afterwards, even though that was the first fracture pain to dissipate.  I'd felt pain there in my first few runs, before promptly hurting my foot and being away from running for another couple of weeks.  I then took lots of anti-inflammatories for the foot, which I had stopped taking about a week or two before the hip pain started in earnest.  I had just done my first 100mi ride outdoors in ages, and being down in the bars impinges the hip more.  Most notably, I was finally running somewhat consistently with a reasonable build, and I was getting into better shape and running a bit more quickly as a result.  Unfortunately, it all added up just a bit too well.
The moment in Mexico when I realized that the non-impact side didn't want to accept weight.  Oh, poor clueless Jennie.
  The longest, most torturous step of it all for me was waiting to get the MRI with contrast.  That suggested a labral tear, but things still weren't necessarily a clear-cut joint problem.  So, I went into the doctor's office soon after getting those results (lucked out with a cancellation on that one), and had lidocaine injected into my joint.  From there, I went over to the PT department to perform some "functional tasks"-running a bit, hopping, step downs, etc.  The criteria for surgery was 50% better.  If enough of my pain was relieved by in essence numbing up the joint, that would mean that a significant enough portion of my pain was due to joint damage.  So, functional testing it was.  Some of the tasks were a little hard for me to tell-I don't ever exactly hop around on one foot or do many cutting movements (as demonstrated by my coordination), so I had no basis for comparison.  Running felt ok, though-50% better from how it had felt earlier that day when I'd done a few 100-200m test jogs in the woods with the dogs that morning seemed about right.  Most telling was afterwards, though.  By that point, due to decreased training, my symptoms with walking, stairs, etc had calmed down somewhat, but I was still getting what I referred to as an "ice pick stabbing my groin" whenever I sat for more than a few minutes, especially after heavier activity.  After the injection, though, I went and sat doing work for a little while with absolutely no pain.  I then went home and hopped onto my bike for half an hour, hammering out some intensity in aero, standing, etc, and that was also significantly better.

   So, as instructed, I contacted Dr. Giordano afterwards, and we agreed that it sounded like I was, in fact, a surgical candidate.  I should add that I have been very fortunate in getting in with the right doctor and medical team right off the bat here-Dr. Giordano is the go-to doctor around here for athletic hip injuries (working with several of the area local pro sports teams as well), and I have been impressed with not just his knowledge of the kind of injuries I had, but also his immediate understanding of the type of functional level I'm going for here.  He was to the point, and he gave me a pretty clear picture of what could be going on, and what recovery would entail, which was refreshing after all of the uncertainty of everything up to that point.  Given the overall timeline of my recovery last winter (three weeks away from everything, four or five weeks until I started easy recumbent biking, eight weeks until I got on a "real" bike, four months off of running, and strengthening/rehabbing the hip the entire time), I'd basically already done everything that could be done conservatively for a joint/labral injury.  If it was hurting to the point where I couldn't run after working up to 25mi/week and actually biking in aero here and there (something I couldn't do all winter due to sacral pain), full IM training without getting things fixed in there likely wasn't happening.  After all of this time, too, I was ok with that-I can concede this year, but I didn't want to risk bleeding this too far into next year.

  So, before I knew it, I was scheduling surgery.  Again, after eight months of being injured and in some degree of pain daily, I really just wanted to get it over with and get on the road to full recovery.  I told the receptionist that I wanted first available, and stood there and braced myself on the other end of the line, fully expecting to hear a date that would seem WAY too far in the future (I was thinking MAYBE late August), so when she said 7/30 (1.5 weeks from when I was called), I thanked my lucky stars and jumped on it, even though it meant that Dave and I had to rearrange some plans.  But, priority #1 was just getting the damn thing fixed as soon as I could.  Quite honestly, I was very much over everything.  I'd continued to swim and bike throughout the entire time of diagnosis and planning, but my efforts had been less than inspired, with more than just a little bit of going through the motions going on.  In a display of the effects of stress on the immune system, I'd picked up a couple of little infections along the way, and had really just lacked any sort of major mental fortitude to push through things like I normally would.  Still, I'd had a few days that suggested that there was some fitness left in my, so I felt ok enough going into surgery not really in great shape, but not totally out of shape, either.
I have to fill out this little health questionnaire every time I go in, and this question always makes me laugh a little bit.  According to my bank account after eight months of medical testing and no racing....hmm.

Sh!t got real.  I think the pre-op appointment people expected me to be a little more upset that I couldn't shower for a few days post-op.  Luckily, this is standard weekend fare for me.
  And, oh yeah, Dave had a little race in there-Ironman Lake Placid.  To be up in the place of some of my highest athletic highs at a fairly low pre-op point...well, I can't say that it was easy.  I had more than one emotional breakdown.  Thankfully, I had a crew up there, with Alexa in particular taking the award for the sarcastic friend that kept me laughing and distracted all weekend.  We even took a few hours on Saturday afternoon to decompress and hike up a mountain, which was a really fun way to enjoy the ability to be active for a few more days.  As for Dave?  Well, he swam reasonably (not as well as he wanted, but within a couple of minutes of that), performed his normal crushing of the bike course, and then, well, Dave hadn't been running much due to various foot/shin/hip/crash (we're awesome) injuries, so his run wasn't exactly pretty (GI issues included, as well).  He did give us a moment of excitement coming off of the bike in second overall and maintaining top 10-ish through halfway.  The good news there is that he's recovering well, should be able to get in some run training now, and has another shot at Muskoka in not much time, a course that plays nicely into his strengths as a strong cyclist who does better in normally cooler conditions.  Anyways.
Given I'm relying on him to carry absolutely everything for me right now, maybe I should have made an effort to actually push his bike to transition.  Nah.

Alexa and I at the top of Cascade!  

And a different view.  For the record, I found websites saying that experienced hikers should make it up in 1.5-2hrs.  We made it in 1:13, with my busted hip and both of our low grade infections to boot.

Rolling swim start!  First time I've actually gotten to watch one, pretty interesting stuff.

Dave in his element

Dave no longer in his element...but hey, at least one Hansen had a lead cyclist for a bit!
   So, back to Rochester and onto surgery week it was.  Maybe I use up all my nerves when it comes to racing, maybe I was just too numb to care anymore, maybe it was the memory of how much everything had hurt after Coz, maybe anger was taking over, or maybe it was just the level of comfort I had finally having some sort of more concrete timeline to recovery after months in limbo, but I stayed pretty calm heading in.  The whole surgery experience itself was fine.  The nurses were very nice (and skilled at IV placement), Dave hung out with me beforehand, the doctor came in and signed my leg, and (which is still bizarre to me) in what seemed like the next instant, I was waking up and people were telling me that I was done.  If I said anything embarrassing while being put under (which was a concern of mine), well, I don't know about it anyways.  Dr. Giordano popped in and told me that he had done a  labral repair (according to Dave, he said there was more than one tear), cleaned out some scar tissue and adhesions that had built up in my cartilage and joint capsule, and shaved down some impinging bone.  Being me, I'd had concerns going into surgery that absolutely nothing was wrong with my joint and that I was just insane because after almost two months off of running, it didn't hurt as badly anymore, so I was weirdly relieved to hear that I actually had been fixed up.  I'll find out a little more about what exactly went on in a little over a week when I go in for my post-op visit (including possible pictures and video, which excites me a little too much).
Hansen interactions remained entirely normal right up until the time of surgery
Drugged up thumbs-up for Dave, American edition.  Smile looks more defeated by this point.

Not quite as drugged up thumbs-up for Dave, throwback Mexican edition.  Smile was more optimistic here.  Again, poor clueless Jennie.

  For now, I'm a couple weeks on crutches with toe-down weight bearing, and I'm being a good PT patient, sticking to my post-op exercises, sleeping in some awful brace thing (it's mostly the sleeping on the back part, which I hate), and getting in my "tummy time" (as we called it at work, which normally results in napping).  If nothing else, I'm discovering that no, these exercises actually aren't too easy post-op-it's certainly a really interesting shift in perspective for me.  I was allowed onto the bike with minimal resistance just to move the leg around a bit today, which was nice.  I'm not supposed to bend my hip to more than 90 degrees, which makes moving around, dressing, etc interesting, if a bit frustrating at times, but luckily this is only a week-long restriction.  Dave is, of course, enjoying having to carry everything for me :).  Pain-wise, the first few hours post-op were a little rough, but since then I've been well-controlled (and off meds for almost a day now), which encourages me in terms of surgical success.  The swelling is currently putting any sort of post-IM fluid retention to shame (I'm up ~12lbs with a fantastically large thigh), but it's been just over two days, so I wouldn't expect anything different.  I've also been varying degrees of groggy/drowsy/uncharacteristically appetite-less, but again, two days isn't a whole lot of time to reset any of that, either.
This was before the swelling even peaked.  Attractive.

This has to be the least comfortable thing in the history of the universe to sleep in, especially because I DESPISE sleeping on my back.  Not to mention, I can't really get into or out of it independently with the hip ROM restrictions.  I made it until 5am this morning before busting out of it Forrest Gump style, coming downstairs, and promptly falling asleep on my stomach.   Whatever.  Tummy time.

~20W bike ride!
  In terms of "real" training-I'll have to let the incisions heal for a couple of weeks before I can get back into the pool (which is sort of ok with me, all of the swimming with no racing was starting to burn me out a bit), and I'll see with biking.  I'll start on the underwater treadmill in rehab after a couple of weeks.  Again, the timeline to return is actually shorter than what I dealt with this winter (I mean, I at least sat on my bike today!!), and although I never really got a chance to show it before being taken out again, I know that I was able to regain my fitness after that, so I'm trying to keep some semblance of optimism (although some may beg to differ with that statement...).  Is part of me pretty damn scared that I'm in essence about to go an entire year without running?   Do I worry what having zero run base to rely on at this point is going to do to me?  Well, of course I do.  But, I can't control that right now.  One step at a time.  Again, thanks to everyone who has sent me messages, likes, tweets, comments, emails, etc of support when going through this!!  I've read them all, even if I haven't been cognizant enough to respond to everything yet :).  It's been a longer road than I ever could have anticipated when I was in a Mexican hospital, still beating myself up over a DNF, and although I've had plenty of moments of doubting my ability to ever compete at a high level again, my desire to do so hasn't changed a bit, and I fully intend to do everything in my power to get back there.  At this point, I'll take things as they come, but at least I feel like I'm actually in the final step of this particular mess!  It's not all bad, at least I'm getting a chance to, well, fully relax, and Dave and I are spending more time together (for better or worse :) ) than we've gotten to in ages.  I understand that I need to resist my normal urge to work through pain, but I'm not going to baby myself over it all either.  Thanks for all of the continued support and belief from my family, friends, coach, teammates, "fans", etc-nothing is better than knowing that others aren't going to give up on me and kick me to the curb quite yet :)
We actually used to crochet a bunch on the xc/track bus in college (because we were awesome), so I figured I'd pick it back up in this time.  I made a penguin so far.   Highly skilled, and obviously very practical.


Obligatory dog conclusion picture.  The Moose looks cute when she begs.

The Bailey looks lazy when she begs, although it could be argued that she's 100% my current spirit animal in this picture