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Wednesday, April 20, 2016

Dear Diary: being injured kinda sucks

   Ok.  Therapy time.  So, I think it's now safe to say that I've been hurt for a bit of time.  Just a bit.  I think that I've used this blog to vent and be pretty honest about it all along the way, but as time has progressed, I've started to notice more and more common themes and feelings along this bumpy, weird, twisted path.  When injured, I feel like I've often wanted to try to emphasize the good side of things, to convince both others and myself that I'm ok, and I can be a good sport with a solid perspective on this.  And this is very true.  I thoroughly recognize that my problems are super small in the realm of real world problems-it's freaking IM racing, a total luxury.  Nothing is THAT wrong with me.  Others have had far worse medical problems for far longer than I have.  I know all too well how much worse the results of my bike crash could have been.  I'd had time to do other stuff that I'd never have gotten a chance to do otherwise.  My family still loves me.  I still have a few friends that don't think I'm nuts.  The sun still rises.  But, there's another side to injury that just undeniably sucks.  No matter how hard I try to rationalize with myself, I can't not feel feelings.  That's not how it works.  In talking to various friends and teammates that have all taken turns riding the injury struggle bus with me or existing in the stupid valley that won't let me out, I've come to realize that I'm not as alone as I might have thought with these pesky feelings and experiences and what not.  Because of that (and because the frustration levels are rather high right now), I wanted to take the time to just get a bunch of somewhat personal, somewhat whiny and overly angst-y seeming stuff off of my chest that's come up throughout the past 1.5 years of being sidelined.  Maybe someone can relate.  Maybe no one can relate and I'm just being like a dramatic 13 year old.  Maybe no one will even finish reading all of this.  Maybe everyone who does will think I'm a little nuts and I need to go find myself a real problem, because that's likely the case, too.  But still, it makes me feel better to present the real side of injury, not just the sugar-coated find good in everything part, so here goes.
Nailed it.

What does this creepy picture of my high school clarinet lesson teacher have to do with anything?  When I was injured once in high school-spring of senior year, he told me that I could use the extra time to practice my clarinet more.  This remains the #1 worst piece of advice that anyone has ever offered me for dealing with injury.
(Random aside: I had originally started to write about my experiences with PRP and all that went into that, but it was kind of boring me.  Not that this is interesting, but at least it gives me stuff to unload.  As for the PRP, I'm about 4 weeks out.  The actual process was VERY painful.  I still have to give it more time to kick in fully to judge the results.)

   Mood swings.  Holy mood swings.  Now, for the most part, I hope that I've appeared more stable on the outside than I've felt on the inside to most people.  If you've been blessed with my injury presence, I'm still the exact same person, only perhaps a bit more sarcastic and slightly more profane.  I'm not walking around randomly throwing tantrums on supermarket floors, or bursting into tears if someone says the words "ischial tuberosity", "adductor pain", or "Mexican vacation" to me.  I think there are probably only a handful of people out there who I've really taken down with me on this one.  But, mood swings from high to low have been intricately linked with this whole thing all along.  I don't always have warning or control over it, either.  I can be doing the exact same thing, and sometimes be in a good mood and happy, and other times just feel sort of overwhelmed and sad and cranky.  If anyone had my car miked for the past 1.5 years, I'd be in trouble with some of that creative language (seriously, though, use blinkers to change lanes.  And use the left lane to PASS, not drive the speed limit).  I've had plenty of times where my rational side has thought to myself, why do you feel like you want to cry right now?  This is completely irrational, the only thing wrong with your life is that you can't triathlon.  Stop being dramatic about your first world problems.  Generally speaking, though, this results in my irrational side responding with, shut up, asshole.  Everything sucks and is awful.  Stop being mean to me.  Let me feel bad, and don't make me feel like a jerk because I feel bad.  But, thankfully for me, even without the endorphins of exercise, I've always been able to pull myself up (or...text or email friends sarcasm and bitterness and profanity, because getting that in return is how I'm encouraged).  So, by now, I know that I can't escape the irrational periods of storm clouding.  But, I know that they won't last, I know how to weather them and start to reverse them, and during those couple months last winter when I was able to train three sports consistently, they were gone pretty much entirely.  With that, I will say that although I haven't gotten to the point where I've had to seek out professional help in the form of a sports psychologist (or the like), I have gotten to points where I have thought about it somewhat seriously (particularly before getting back on the bike last spring, when fear was a major issue).  I wanted to say here that there shouldn't be any stigma attached if someone does decide to take that route-I don't see my mood swings as a sign of mental weakness, they're just a part of injury.  I've talked to injured teammates, and have learned that I'm far from alone on this one.
Ok, it's profane, but again...basically.
   Weight of the matter  Like many female endurance athletes, I've had my share of body image issues and struggles with weight and food.  I've never even been close to having an actual eating disorder, and I definitely can't claim that I'm unique in this regard.  I've never really gotten into details on it, because it's something that's a sensitive subject, but I that there are probably many out there who can relate, so I'll share a bit.  I've always been naturally a little bit more muscular, so I've never had that runner "look" (which I don't buy-if you run, you look like a runner, period).  When it comes to body fat percentage, I've fallen into the gray zone where I do struggle to get body fat off, but not so much that I have to go to extreme measures to do so, so I often feel like I should be more lean than I am.  If we want numbers, I'm 5'4".  I've cycled up and down between 115 (ended with a stress fracture)-135 (end result of injury in college) since reaching that height.  Now, when training and not making too much of an effort to lose, I can sit relatively comfortably in the 123-125 range.  I'm allegedly supposed to race at 118-120, but I've never actually gotten there.  Usually I end up at around 121-122 before the balance starts to shift too far towards low energy, major hunger and cravings, and an inability to get through training sessions (especially since those 5 IMs I did in the course of a year...thanks, KPR and 35 women to Kona..).  I'd be lying if I said that this hasn't been on my mind, for better or worse, every IM I've done, but this is all another story.  My run splits and my ability to be properly fueled are more important on race day than what the scale says.

   Going back to the current times of injury, it's obviously no secret to anyone who has seen me that I've been up and down plenty.  When it comes to my relationship with food...I like it.  Food tastes good.  But I also have never liked feeling like the big runner or the not totally pro lean triathlete.  So, it's complicated, in a word, and something that I've struggled with, like many others in a relatively body-conscious sport with spandex everywhere.  One of the nice perks that comes along with the training I do is that it has allowed me to have a healthier relationship with food, even if some body image issues have remained.  When I'm in periods of heavy training, I like eating food that's both tasty and healthy to nourish my body, and I also like having a little bit of leeway to enjoy treats here and there.  And eating unadulterated amounts of crap the day post-IM is one of the great joys of life to me-judge if you want to, but I enjoy guilt-free fries and donuts with the best of them.  But, injury has been tough for me in this regard.  I know that some people are able to use times of injury to focus on nutrition and not gain weight, but I'm not among them.  Maybe this is a flaw, but it's also something that I know I'm again not alone with-it's just one of those things that people aren't going to necessarily want to advertise.  When I went through my initial period with the fractures, I basically ate whatever I wanted to (it was the holiday season, I didn't anticipate how long I was going to be out, and I was coming off of a long season of careful eating).  Ten plus pounds went on very easily, and I think I peaked around 135.  I didn't like it, but I had other issues to deal with then.  After I started running again, I got down to about 126.  Then my labrum presented itself, and I was unable to run again.  With swimming and biking until surgery, I kept the damage to a minimum, only gaining another pound or two back before surgery.  After my surgery, though, despite the fact that I was being more careful than I had been after the fractures, I still got back up to 133 thanks to a greatly reduced activity level.

   At that point (mid-September), I finally took charge, tracking and monitoring everything.  Once I was able to run again, the weight loss came more easily (although, at what expense I still don't know, given that I ended up injured again).  I was able to get back to the 121-122 range, and felt good.  I gained a couple of pounds when I couldn't run anymore, but no big deal.  Since the PRP, though, I gained a few more, and have gotten back up to that 127ish range.  Is this the end of the world?  Well, no, not really.  I still fit into my normal clothes, they're just tighter than I'd like them to be.  At no point in any of this process have I been anything even close to overweight in anything other than my mind, which is mired in the pro triathlete world.  But, I don't like how I feel here necessarily, and I'm a bit disappointed in myself for letting go of the reins enough after doing the work to get to a point where I was happy with myself in that regard.  All of this gets compounded by a social media culture where we often see pictures of super fit athletes and ripped bodies, especially as the triathlon season kicks off in earnest.  My heaviest time post-op also coincided with the period just before Kona, where everyone was very active.  I'm not blaming anyone for posting these kind of pictures-I'm more than guilty of it myself when I'm happy with what my body is doing for me (#narcissist).  People have every right to post whatever they want, provided it's not some direct personal attack on someone else-judge-y articles about what not to post because someone's feelings might get indirectly hurt often bug me.  But, it all plays into the whole mindset thing-I've already had my daily endorphin dose yanked from me, I can't say that I love the body I'm in, and then I find myself with my hand in the box of peanut butter Puffins, mindlessly snacking because I have time and I'm bored and vegetables don't sound as good as they do when I'm training a lot and need the nutrients.  Truth of the matter is, without, say, 1000-3000 calories burned from exercise a day, adjusting the eating habits to NOT gain weight is difficult for me, and probably for others in my situation.  We hear so much about how good it is to try to maintain when injured, but for some people, such as myself, this is easier said than done.  I beat myself up over it plenty and have difficulty not feeling guilty about food these days, so hopefully by sharing this, someone else will know that he or she isn't alone, and that really, it's ok.  A few pounds of injury weight doesn't make me a bad or weak person, even if it's not the greatest thing in the world for my hip.  It's just a part of it all.
Pretty close to my heaviest last winter.  Again, I'm far from being overweight here, but this picture did not make the internet.

This is me at my lightest point, trying to set up a full-body selfie to post on instagram after a run (coincidentally, the run where my butt REALLY started to hurt).  See?  Totally, completely guilty here.

Thennnnnn, this happened. 
   Sunday, bloody Sunday (hey, jealousy)  Sundays.  Oh, Sundays.  For years on end, Sundays were spent either closing out a training week with a bike/long run brick, finding strength that I didn't know existed on tired legs and a worn down body, or at a race, putting together everything that I had been working for all of that time.  Those were some of my favorite things in life.  Other than the maybe 3 months over the past 1.5 years I've had of almost normal training, my Sundays no longer contain long runs or races.  And it hurts.  Sundays now consist of swim practice, maybe a little biking if I'm lucky, and then alternately tracking races while still trying to distract my attention away from what I'm not doing.  At this point, anything I find for myself to do on a Sunday (or, a Saturday when not long riding, for that matter), is at best a pleasant diversion.  As happy as I may be to see my friends and acquaintances doing well, too, I'd be completely lying if I said I never had a thread or two of envy running through me.  Maybe jealousy is unbecoming, but when others have something that I want so very badly, as trivial as it may seem, it's an emotion that happens.  Sundays, at the moment, don't contain finish lines or medals, runs along the river boardwalk, or moments spent exhausted happy, doubled over in the back yard with the hose running down my back while I try to keep dogs from licking my sweaty face.  There are no smiling selfies of me, say, vacuuming the carpet, or special twitter congrats because I made it through another bummer day without flying off the hook and punching someone in the face (ok, I've never punched anyone in the face my entire life, but still).  So, while I spend a bunch of time trying to remind myself of what I have, I let Sunday be the reminder of what I don't have at the moment, and of the comeback attempts that haven't panned out yet.  It's like my cheat day away from sanity.
A Sunday this fall.  Probably alternating between saying that the leaves were pretty and complaining about how I would rather be running.
   The lull (between how it is, and how it should be)  I now consider myself to be in sort of the third "portion" of this injury process-there was the fracture portion, the surgery portion, and now the tendon/nerve/muscle dysfunction/PRP portion.  Each of these portions have started with testing and diagnoses (sort of, in the current case) and some sort of more acutely painful event, and then all that smoke clears and I'm left with the haze of the lull.  What I've found is that the most acutely painful part (which for the current portion I guess could be considered the PRP injections) isn't really the hardest part to get through.  During those times, others have basically held me up-there's never any shortage of kind words and get well soon wishes, and honestly, having a chance to just relax and unwind isn't always the worst thing in the world.  Pain decreases are actually somewhat steady, and regaining skills comes quickly and with gratitude.  This is when it's easy to seem strong and keep a sense of perspective, especially coming off of something like a bike crash, where gratitude to have all faculties intact displaces other concerns.

   But with a resumption of a relatively normal day to day life (minus exercise) comes the lull.  This is the time period where I start to be able to do some stuff resembling exercise, but it's still a far cry from what I once was able to do.  I feel like I should be grateful over how far I've come, but being sort of bummed about how far I have to go and not knowing how long it'll take often tries to overtake the gratitude.  Pain levels start to stall out, and I spend a bunch of time driving myself nuts over it-striking the balance between getting healthy injury-wise and getting in shape (and staying sane) becomes a battle of epic proportions that I have yet to win.  Those pesky feelings of isolation start to set in, because I'm removed from my normal lifestyle and those involved in it are going on without me.  I've likened the lull to mile 18-19 of an IM marathon before-that point in the race where I've come so far and in reality, I don't have that much more to go, but at the time, it seems absolutely insurmountable with the amount of discomfort and irrational thinking that's started to go down.  Usually, it's at some point in the course where not too many people are around, because all of the excitement and glory are at the start and the finish, and my supporters probably just want me to be done with it all, too.

   The hardest part of the lull for me is that it's where I could probably use the most support, but I don't want to ask for it.  Asking for help ranks up there with making phone calls and small talk with strangers as "stuff that makes me ridiculously uncomfortable".  Plus, I don't even know what "help" looks like-half of the time, I'm just over talking about my stupid pelvis or hip or whatever, because I sick of it all.  By this point, I just feel kind of bad dragging people into my crap over and over again, especially when they've given me support all along the way.  There's probably a limit to how much I can make others listen to me without having much to offer in return.  Everyone has their own crap to deal with, and my issues are so small in the realm of real problems.  I mean, really, at some point, it just has to come across as whiny and trivial, especially when things are physically coming along (sort of).  But, with that, I've somehow still had individuals who have, again and again, let me commiserate and vent without judgement, or have let me know that they're experiencing the same sort of emotions that I am.  Whenever someone reaches out to me during the lull, when I'm just sort of existing between being acutely beat up and actually appearing to be an athlete again, I'm given a complete and total boost.  To feel cared about as a person, instead of just an injury and a once-was athlete, gets me by again and again.
Things that happen during the lull, surgery edition: the dog ends up in a peacock costume from Target

Things that happen during the lull, PRP/ass injury edition (aka, ,when Jennie no longer has money because of medical bills): the dog ends up in a camo bathing suit.  Bailey says, "I also despite the lull".

Things that obviously haven't happened during the lull: car maintenance.  Yep, that's a giant heat shield that fell off of my car, layered on top of crutches, with a random sheet, towel, and bike helmet in there, because the last time I drove somewhere to ride outdoors was July. #adulting

   Uncertainty.  Holy.  Freaking.  Geez.  The uncertainty.  The lack of answers.  The ambiguous "as you feel" instructions.  Unsure diagnoses.  Unsure timelines.  Pain, unrelenting pain, that increases and decreases and rarely goes away entirely, that moves around and sometimes taunts me one day, convincing me that it's going away, only to come back with a vengeance the next day.  If you were to ask me what makes it better or worse, I'd have no answer.  I don't know.  Google.  Freaking, freaking google.  There should be a way for google to ban people from entering their symptoms into its search bar.  I don't even want to think about how much time I've wasted re-reading the same articles from a google search that I last read a week ago, just in case I forgot some key detail and needed to drive it into my brain.  My deepest sympathies go out to those facing actual serious, life-altering diagnoses, because the diagnostic process for each of my steps along the way of all of this has been fairly agonizing.  I waited to see if one of the fractures extended into my hip joint.  I waited to see if the fractures were healing at every follow up.  When the labral pain started, I had x-rays, an MRI, and MRI with joint contrast, and a diagnostic lidocaine injection into the joint.  This time around, there were more x-rays, an MRI, and then time periods post-injections waiting to see if they'd work or not.  I've come to find that I don't handle the anxiety of these times well.  I was sick multiple times this summer while waiting on tests, and again this winter.  And again, this is just to find out if my bones and soft tissues are intact-nothing even that majorly serious.  Waiting, worrying, and uncertainty suck.

  Then, there's my current situation.  Fact of the matter is, no one knows what's going on for sure.  It's frustrating, in a word.  Tendons, bursa, impinged nerves, overactive nerves, past fracture phantom pain, pelvic floor dysfunction-it's all been thrown out there, and it all boils down to a whole bunch of stuff hurts enough to prevent me from doing what I want to, because I spent a whole bunch of time doing more than I was supposed to.  All we can do is try different treatments while I keep up on my end of the deal, and see if things eventually start to turn the corner.  I went to Dave's ankle tendon follow-up with him today, where he was referred to a PT for a footwear evaluation.  When the doctor asked me if I knew who the PT was, it eventually dawned on me that I knew the name because my (eventual) surgeon had told me to get checked out by him 3 weeks after the fractures.  I'd (wrongly) assumed that I knew it all then, and that fractures would heal and I'd be back to normal after that-the first wrong turn of many.  I have days now when I question everything I did in the past.  I do believe that the PRP injections got at a good portion of the root of my problems at the moment, but it's still hard to say what I'm feeling right now is that vs. maybe some referral from a hip joint that was forced to do too much, too soon after a surgery, as the doctor and I discussed for a good deal of time today.  There's just no way to be certain.  Some days, I really, truly wonder if I'm ever going to be the same, and it's tough.  I've been given instructions at many times in the past to go as I feel, but having to make the determination on what's an acceptable vs an unacceptable amount of pain to work through is incredibly frustrating, and one I have yet to get right.  When it comes down to it, I know that I'm the one living in my body, and without anything majorly structurally wrong with me right now (just some tendons trying to heal from PRP still and a whole bunch of stuff that ambiguously didn't heal all that well), I'm the only one who can truly figure this out.  But it's hard.  So, so hard to be objective with a body that still hasn't figured it all out.
Patient intake form from before my PRP appointment.  I just wanted to put, "I don't know what's going on, and I've tried everything.  HELLLLPPPPP MMMEEEEEE."
   Blind faith.  With that, though, comes faith.  I don't know if or when I'll be better and running and training and racing again.  No one does.  I just have to trust that, well, since June when I decided to actually meet my eventual surgeon in person and listen to what he had to say instead of the not so in tune with athletes orthopedist who only looked at my x-rays and tested my vitamin D without trying to hold me back much last winter, I've been in the best possible hands.  I had a period of a couple of months where my body was handling a high level of training nicely, and my fitness was there, so although progression from there went too quickly and ended up poorly, I have to trust that I might be able to handle this again someday.  The athlete is still in me.  She hasn't left.  A couple of weekends ago, after spending some time out of the pool post-PRP and certainly not being 100% from that, I swam in a swim meet.  I set new best times in all 4 events, including breaking some barriers in 3 out of 4 of them that I've been chasing for years (which put me at the level of a mediocre varsity swimmer at a small school, but hey, I take what I can get).  For whatever reason, I felt just enough rekindling of the pure athletic accomplishment joy that's escaped me for so, so long, and I know it's just a hint of what I stand to feel should I ever be fortunate to be able to cross a triathlon finish line again.  At that meet, it dawned on me-you just don't quit, do you.  I guess I don't quit, and the reason that I haven't yet is that I really, truly believe deep down inside of me that I'm going to be ok when all is said and done, and that I'm going to eventually figure out why all of this had to happen some day.  I have to believe that, because I don't want to let go of my sport-related hopes and dreams.  I can't deny that I've had plenty of days in there where motivation waned and I simply went through the motions, but the fact of the matter is, a desire to keep going and pushing and trying and eventually competing has continued to win out.  Maybe I'm wrong, and maybe this will all turn out foolish and pointless, but for now, I'm going to keep holding on to the blind faith that it won't.
This.  Absolutely, positively 100% this.  No sarcasm on this one.
   So there we have it.  Some of the finer, more raw, arguably more negative, but 100% real parts of prolonged injury.  My point in writing is isn't to garner sympathy, or to make people feel bad for me.  I don't need that-there's nothing really, truly wrong with me; all of this is child's play compared to real problems in life.  I don't have incurable diseases or sick children.  I'm not alone, I have plenty of awesome people who love me and care about me.  I really, truly, don't need to be coddled or pitied.  But, still, this hasn't been an easy run for me in the context of my cushy life, and I think that it's ok to admit the human emotion side of it.  I have plenty in my toolbox to deal with all of these things that I've talked about by now, so really it just helps to feel like this is all normal and ok.  I'm flawed, and I can admit these weaknesses, the stuff beneath the surface that's not sexy to talk about, for fear of being judged negatively.  Writing this has been entirely therapeutic for me-to quote one of my angsty Pandora faves, "if I get it all down on paper, it's no longer in side of me, threatening the life it belongs to".  I know that for me, it's been infinitely helpful when people in periods of injury have admitted their own struggles, so hopefully, someone might be able to relate to some of this.  I'd like to think these things don't make me a worse human, they just make me a human with human emotions who feels things, even if they're related to something that just seems like a silly sport.  That's that-and I believe that I now have some PT exercises to attend to, so that the next time I feel compelled to blog, it comes with an entirely different, happier tone than this entry.  Until then, if anyone made it through my mess, continued thanks and gratitude for all of the love, support, and kindness I've received from the get go.  :)

Again.  Exactly.  Heart trumps logic sometimes. :)

And, some puppies in the woods.  For those who might have been hoping for a Moose kidney update rather than me dribbling on about myself, she's showing more signs of her disease (decreased appetite, mainly), but we're still taking things as they come.  For now, she's still enjoying walks in the woods, so we're doing that every day together.  Also, I thought that I should provide proof that I do nice things with the Bailey during the lull, other than dress her up ridiculously.