Now what?!

Now what?!

If I were forced to claim a superpower, I would refer to my talent toward assisting individuals in the process of reframing their lives, their personal journey, in light of new, often unfavorable, circumstances; it is what I've been trained to do and why I'm "above average" (can you tell it's evaluation season?) in my job as a clinical chaplain. 

The ongoing joke is that my ultimate goal is to get to the level of Obi Wan Kenobi, in that classic scene of Star Wars: A New Hope (you only need to see the first few seconds of this clip). I try to practice this as much as I can and, as I'm sure you can imagine, I get mixed results. 

Unfortunately, it's a challenge for me to use my superpower on myself; it's lot more time consuming and not nearly as rewarding. Nevertheless, I've been expending a lot of energy toward this endeavor, over the past few weeks, and I think I'm making good progress.

I'll post more details later (history, the mechanism of injury, etc.) but, long story shortened, I have a partial tear of the conjoint tendon at the connection of the semitendinosus and biceps femoris to the ischeal tuberosity (sit bone, or butt bone) of the pelvis. The good news is that it's not completely torn away from the bone; the bad news is that this injury is complicated by the fact that the rest of that white matter, moving down toward the knee from the proximal (top) connection site, is extremely degenerated and weakened. In addition, I have a similar level of degeneration at the distal, or bottom, connection site, close to the knee. Boo. 


My first consultation resulted in the order for the MRI images (both of pelvis and left knee) that detected the tear and level of tendinosis in these areas; after having a difficult experience getting follow up information from this particular physician's nurse, I finally scheduled a follow up appointment for more answers. 

While I believe that this particular physician is top notch, his presentation of the options available left me feeling rather startled and depressed. Doesn't he watch Chef's Table? Even a tragic story deserves a good presentation! I've learned, through my work with patients and their families, that we actually retain very little when we are given information contradictory to what we'd like to hear. What stuck with me is that he said he was "unsure" whether any of these options would provide me with the outcome I was hoping for and was doubtful that I would be able to return to training for "distance events like marathons." He said, "you can still go out for a run, but it should be a secondary activity." Again, boo. 

I rarely appreciate cryptic social media posts, and try to avoid them, but I did not offer much information on the day that I was really struggling with this; I wasn't sure what I wanted to hear from others, even those with the best of intentions. How far would I really be willing to go to continue running? We treat surgery, these days, as though it's routine, in a very nonchalant manner, but I work too close to the source; complications are real and any elective surgery is just that...this is not a life-threatening condition and, I must add, I'm still waiting for that money tree to bloom in our back yard. 

After discussions with a few trusted folks, and generous suggestions and kind words from all-around badass Leah Thorvilson (who suffered a similiar injury toward the end of her running career), I decided to get a second opinion and saw a new physician this morning. 

Even though the message is generally the same, Dr. Smith provided me with a much more positive outlook. He has encouraged me (as did Leah) to try an ultrasound-guided platelet-rich plasma (PRP) injection; unfortunately, this therapy is still relatively new and there are not enough studies to determine its results, long term, so it is not covered by most insurance providers. It's definitely cheaper than surgery, though! 

Dr. Smith believes that, due to the level of degeneration and the continued presence of some fluid and inflammation in the area, I need to refrain from running for several more weeks, "maybe even months," in order to give the tendon time to "calm down." This is all subjective; everyone is different and so it's impossible for him to say how I will feel after six weeks, or eight weeks, or however many weeks of rest.

He said that cycling, swimming, eccentric strengthening exercises are all fine to do, and that it is preferable to remain active, but to avoid anything that might aggravate the tendon. In addition, he said that if the tendon calms down, especially with the help of PRP, I could cautiously begin a build up to running and "then see how it goes." 

He said that it might be a little unrealistic to expect to successfully train for and run a "goal" pace marathon, even with surgery (thanks to my stupid, ugly tendon), but that I could expect to get to a point where I could gradually add mileage back in as long as I create strong boundaries and step back immediately if I feel any aggravation. So, like I said, the message was essentially the same but he presented it in a much more compassionate manner and seemed to understand my position. Take note, future physicians! 

I'm learning so much through this process; I had no idea how tendons work (or don't work, in my case) and the fact that they don't heal like muscle tissue because they receive little, if any, blood flow. Like most who have been in this position, I would imagine, I wish I'd done more investigating sooner; nevertheless, both physicians reminded me that much of this is left up to genetics (family...the gift that keeps on giving). 

So, now what?!! Well, I'm riding in my first "organized" cycling event, a charity ride called Tour de Rock, this Saturday. In addition, I am already registered for the Yellowstone Half Marathon on Saturday, June 10, and I'm going to walk every step and take in the gorgeous views (beware - tons of pics to come!); after my return from vacation, I intend to suck it up and get the PRP injection. 

Like most things in life, reframing our expectations and goals takes practice; learning to accept what is, rather than fighting against it, is contrary to our nature. For now, I'm doing pretty well; my body still aches a little, and it's getting warmer each day, and I've only had ten consecutive non-running days. At this point, I don't feel overly anxious about the prospect of life without consistent running but I spend time each day preparing myself, mentally, for the challenges ahead. 

Right now, I am most thankful for the people that running has brought into my life and the support that I have received from so many; I'm treading into deep water, so I'll save more of these thoughts for another post. To be continued...




A (Temporary) Farewell

A (Temporary) Farewell

Reasons to Remember

Reasons to Remember