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Tuesday, February 26, 2019

My story, in reverse

   I didn't even commit to any sort of imaging until January.  Argentina had turned into another disaster of an Ironman, sure, but I couldn't blame the left-sided sacral and proximal hamstring pain that had been a part of my life the entire season-halfway between finishing off the best training block I'd had all year and the race, my HR spiked 10-15 beats throughout everything I did, while my energy (and motivation) dropped.  Quite simply, I had overreached, and couldn't bring myself back in time.  But, whatever, the blood work checked out fine, any major underlying problem got ruled out, and I wasn't in any major rush anyways, figuring I'd need a few weeks to properly rest and rehab that ass pain to pull it back under control.  Unlike previous bouts, though, that pain wasn't coming back under control, but instead falling further out of it-once a week, I'd try a little ~20min test jog, with each becoming worse than the previous.  My main concern was something bone-related; in the back of my mind, my prior history of a sacral stress reaction and a stress fracture at the hamstring attachment loomed.  Not wanting to start up again, working through the pain, only to have it take me down entirely in, say, March, with race season around the corner, vs the middle of winter, I finally mustered up the courage (because I loathe asking for things) to email my hip doctor about the situation.  Within a few weeks that felt longer than the months I'd been actively ignoring the pain, the MRI was done, and I was in the office, awaiting my fate.

   Give it five minutes.  I told myself that at the start of runs more times than I can count this past season, as my body struggled to figure out how to make a normal run motion, my left ass protesting and guarding its way up the street.  And, sure enough, five minutes would pass, and I'd have compensated my way into a normal pace and passable gait pattern.  The bike wasn't great, either, but I could ignore that, too.  The more I managed to push through it all, the more I was able to convince myself that nothing could be that wrong.  The thing was, all along, on paper, I looked fine.  I cut some swim shorts because of a cranky shoulder, occasionally had a wonky knee limit me, and of course I just had some days where I felt awful overall and couldn't hack it, but the ass?  Not once did I give in solely because that hurt.  Sure, I did worry that their might be something wrong, but then I'd go out and put forth another solid run, and I'd be able to reassure myself that I was fine.  I can't pinpoint when the pain started this time around.  I remember it protesting the day after Eagleman when I went for a jog between travel bouts, but that seemed normal.  It locked up on me once during my longest ride prior to IM Lake Placid, but then it calmed down, let me finish out six hours, and I happily ran 20 miles the following day.  I remember the pain increasing leading into Placid, but justifying that with the taper, race, and recovery, I'd be fine.  When the ass hurt during the race, which is uncharacteristic for my injuries, as usually race adrenaline overrides all,  I justified that it was just because I'd had a bad run, and had been feeling all of the bad things.  When the ass hurt even more with starting up training again the next weekend, I justified that it was just because I'd been lazy, and needed to get moving again.  I got serious about rehab in August, and actually, it did begin to feel better. I think that September gave me a reprieve, but I was also riding that Wisconsin high into my Taiwan ambitions, and the mind can be pretty darn powerful at times like those.  During the marathon in Taiwan, I remember thinking to myself that I was glad that that was it for the season, because I needed to get a little more serious about taking care of my ass.  Then, even after a very long and uncomfortable flight, I got home, and decided I didn't want to be done-I had a score to settle (ha, on how that one worked out) with Argentina, and I was really quite enjoying training.  My ass had made it through the year to that point, so what were a couple more months?  Despite those limp up the street run starts, soreness afterwards, and nights spent awake with something throbbing, though, I legitimately did enjoy training all fall, until the wheels fell off at the very end.  I was consistent, fit, in a good mental space with it all.  Sure, it didn't work out, but I don't regret those months.  Plain and simple, I was satisfied, happy, despite the growing pain.

   It wasn't like I didn't have precedence for looking the other way.  That left ass hurt in the summer of 2017, but it was after I'd gotten back from Australia, where I'd spent the better part of the month of June doing absolutely nothing.  The more I got back into training, the better it felt-like it just needed to get going again.  The flare I'd had earlier that spring had been pacified with some cortisone injections and a few easy days.  When, after almost two years of strictly right-sided problems, the left side first started to hurt in the fall of 2016, I did have some pause, as an MRI to check on my right-sided pain the previous winter had shown a left-sided sacral stress reaction that hadn't even felt like much of anything.  But, despite my inclination that if I'd had damage with no major symptoms, major symptoms=damage, that fall MRI proved me wrong, and, at the time (until the pain kept recurring), we thought that it might have been related to the softball of a uterine fibroid I ended up having removed a couple of months later, anyways.  Regardless, the old standby of self-rehab got it better, anyways. 

   Besides, it didn't take some complex mathematical equation to get me to accept that some degree of pain on that side might be something I'd just have to deal with.  I smashed it onto hard-packed dirt in Cozumel four years ago.  It took the impact.  That left SI joint has shown signs of being widened on CT scans.  It likes to crack and pop all on its own with residual instability.  Some overuse injuries at that proximal hamstring attachment actually drove me into triathlon in the first place way back when, too.  It might have been problematic long-term even if it had been my bad side at first.  But, it wasn't.  My fractures, hip damage, etc, were all on the right.  I relied on the left for a good portion of 2015, as I pushed every recovery from everything to, and sometimes beyond, the limit.  In 2016 and 2017, my body started to figure out ways to keep all of those damaged areas on the right quiet.  If, for example, I shifted my right ass off of my bike saddle, the bone spur that resulted from that fracture healing wouldn't hurt.  After two years of right-sided pain, which finally went away in early 2017 after a long, slow rehab from my two late 2016 surgeries (the fibroid removal and the sports hernia repair), the left-sided issues seemed just like irritating noise that I was going to have to deal with from compensating from some structural imperfections on to an imperfect side.  At times, I almost felt comforted by the fact that my right side, which had seemed hopeless for so long, felt fine.  As long as I was functional, training, competing, I was happy, even with some pain.  I could accept that I try to do a sort of unnatural activity at a high level on an imperfect pelvis.  I don't expect no pain.  It is what it is.       

   The day I went down, 11/30/14, I was racing with powdered aminos in the bottle I carried on my down tube for the first time, something I'd tried in training lead up until that race.  I was worried that some might have settled out to the bottom of the solution, so I wanted to make sure it was completely emptied into my front aero bottle, so I got them all out.  The throw bottle collapsed in on itself as I squeezed its contents into the aero bottle, leaving some liquid at the bottom.  I laughed to myself as I blew some air into the bottle in order to reinflate it to get that last bit of fluid out-in high school, my teammate had coined the term, "giving the bottle a blow job", which was obviously hilarious at the time, and somehow, maturely, still amusing during an IM a decade and a half later.  I started to finish the refill.  Then, I started to feel my bike swerving beneath me.  It took a moment to register what was going on, but I had time to think, this isn't how it's supposed to end.  Instead of just taking the fall, a run of the mill skid on my side, I tried to correct, and made the situation worse.  I don't know exactly what happened next, but I felt an impact against the entire left side of my body, and I found myself laying on the downward sloped, hard packed dirt between the road and the bike path, my bike strewn beside me, with evidence suggesting it had done a perfect flip, landing exactly upside down. 
I'm sure the impact hurt, but I've blocked that from my memory.  My first instinct was to get started again.  My bike seemed ok, although the aero bottle holder had broken, and it was hanging upside down, so I couldn't see my bike garmin.  I thought to turn on my garmin watch, so I'd have something to look at.  The left side of my pelvis throbbed, but my heart rate was where it should be, at least for the time being.  I debated pulling the flopping around aero bottle off, putting the garmin into my back pocket, and tossing the bottle at the next aide station, but figured I shouldn't waste equipment.  Eventually, the pain began to push the denial aside.  My HR was dropping, my power kicked back in and was 30W low, and as I sat up to navigate a turn in town, my loosened (unbeknownst to me) aerobars dropped.  After having another, am I going down again? moment, I stopped, stood up, and was immediately greeted with stabbing pains on my right side of my pelvis-the opposite side from what had taken the impact.  I thought I probably wouldn't be able to run with that.  And then I was surrounded by spectators and medics, and it was over.  Or, just beginning, really.

   What if I'd just gone down when I first started to lose control?  Would I have landed safely on my side, with road rash and bruises, but nothing major?  What if I hadn't been so worried about those final couple of ounces of fluid?  What if the wind had blown in that moment at just a slightly different angle?  What if I hadn't mistaken some water safety personnel for a buoy and swam past the turn into the swim exit-would I have been at a slightly different place in the road in that moment, where I might have kept control?  If my first tooth implant had taken, I never would have missed training, and I would have raced IM Arizona, instead of opting for the extra week of training.  What if I'd never even been born with whatever tiny genetic variant kept me from having two adult teeth, and I'd never needed that implant in the first place?  What if my brake had been just a fraction of a centimeter, in Coeur d'Alene earlier that year, keeping it from rubbing-would I have been content to have finished my season earlier then?  What if I'd never picked up some microscopic bacteria in Florida, leading to me getting sick at camp, eventually withdrawing from IM Los Cabos, and ending up racing Coeur d'Alene?  What if all of these tiny little flaps of the butterfly's wings had never happened?  Would I have ended up on the ground that day?  Would I be here, over four years later, writing this, analyzing how my current situation is so intimately linked into that one dumb, stupid moment, that moment that changed the trajectory of a large part of my life, that has reminded me it occurred via some sort of bodily pain every day since?  I'm not going to deny that these what-ifs haunt me sometimes.  When I'm able to train through the pain, not so much-then, I can override the pain and shut those little gnawing thoughts right up.  But in down times, like now, they get their chance to taunt me.  In plain terms, it sucks. 

   At the same time, in my moments of clarity and optimism, I see the good in everything that's transpired as a result of that moment.  I wouldn't have learned as much about resilience, fight, grit, etc, as I have otherwise.  I always trusted my ability to hurt, but I guess it's given me more evidence to support that.  The times I've gotten things right, those races I've nailed, have filled me with a greater joy than in previous years.  I'm not going to deny that I still take bad workouts and races to heart, because that's my personality, but I've come to appreciate good days and workouts for what they are in and of themselves, not merely as means to the end of a race.  The race doesn't always work out, so I sure as heck better be finding a deep satisfaction along the way.  Just because Argentina was total shit this year doesn't mean that I regret this fall, because I know how I felt working my way through that training.  Sure, I ended up overstepping it, but lessons were learned.  While, like many endurance athletes, I've always had a sense of wanting to make sure I did what I could to give myself the best chance of success on race day, having a race day end up in a Mexican hospital also gave me another perspective-if it doesn't work out, am I going to regret any decisions that I made along the way?  Shit's too uncertain to throw my entire life out for a dumb sport.  Sure, I'll still go to bed early so I can get up and swim (note: giving up the comfort of my bed to go embark upon an activity that allows me to work towards a goal that benefits me and me alone just is NOT a sacrifice), but if I want real ice cream and not mashed up frozen bananas here and there, so be it.  Additionally, maybe it goes without saying, but even in my worst moments, I can appreciate how small my issues actually are-I don't have a terminal or chronic disease, I don't have a sick child, my material needs are more than met, I'm in a happy marriage, I have the time and resources to train and compete around the world, my family is close by and loving, and overall, I'm happy in my situation in life.

  As for right now?  That MRI from last month showed some glute tendonitis, some asymptomatic, unrelated hip joint stuff, an "assault" stress reaction at the sacrum, whatever that means (I'm guessing "old and not important", since my doctor didn't really seem to think anything of it), and some partial tearing of my proximal hamstring tendon at the attachment, with related bone marrow edema.  That one required attention.  We opted to try PRP injections that in hopes that the tendon would heal up enough to get going again.  The surgical option sucks, not a really high success rate at returning to high-level sport even after a lengthy recovery period, so I'm not really about that.  I'm now four weeks post-injection.  If I'm being honest, at the moment, everything still hurts more than it did before the injection, with some right-sided stuff talking to me a bit again, as well.  I can swim, bike limited amounts, and elliptical a little bit, but running is a total no.  I haven't exactly been sunshine and rainbows lately.  Despite saying all of the right things prior to the injections about how smart I'd be, blah blah blah, I've had my share of moments lately of pushing into pain amounts that I know are not in my best interests in frustration.  It's dumb.  Really dumb.  Which is why I went about writing this-because maybe, just maybe, getting these thoughts, these dumb little what-ifs, out in writing will keep them from bouncing around in my head, leading to poor decision making on a physical nature. 

   So, I guess I should wrap this up here, since my dogs need a walk and I need to clean and pack and get some actual work done.  Fact of the matter is, it's easy to drive oneself nuts thinking about the tiny things that could have gone differently to result in a different outcome.  But, my cards have been dealt.  Instead of obsessing about how one more shuffle might have given me a better hand, I can make the most of the one I have, because guess what?  I still have a chance to do something with it.  Some people get truly shit hands, and don't get that shot.  I don't always have to want to celebrate a less than ideal hand, but being angry about it and throwing my cards across the table isn't going to solve a darn thing.  Instead, like throughout every other pelvic sequelae that's result from one tiny moment in time, when it comes down to it, I can pick up my cards, allow myself to have feelings about them, but smile, keep playing with whatever comes my way, do my best to make the most of it, and appreciate the hands that work out all the more.  That's life, and mine is pretty darn good no matter what.