28 Days

Today marks four weeks since my arthroscopic hip surgery. Before going in for surgery, I researched the procedures and recoveries pretty extensively. I talked to other patients. I saw a few surgeons. I talked to others in the medical profession. I knew I had to be committed to doing things properly and being in the recovery for the long haul and not the short term pain and frustration. This is not easy for any athlete, but it can be especially challenging for someone who is used to engaging in their sport of choice every single day. And let’s face it: people who run stupidly long distances are not entirely right in the head. Moderation and restraint are probably not things we embrace.

Like many women, I have a lifelong history of body image issues. I have been an every single day exerciser since I was 13-years-old. I have written about body image previously (particularly HERE). As the mother of two daughters and as someone who has struggled with how I feel about my appearance, it is an issue of utmost importance to me. Running freed me from a lot of concerns I held about not being ‘enough’: ‘not thin enough, not muscular enough, not hot enough, not pretty enough…just ‘not enough’. Running was something that made me feel not only ‘good enough’ but just plain old ‘good’.

tonia running CM 50k

2016 Cheyenne Mountain 50K with Tracey: I had one of my worst races due to injury, but like sex and pizza, even when running is bad, it’s good.

This is a Test

I worried a lot going into this surgery that months of not running would make my body and self-esteem take a nose dive. I guess that is one thing about being in survival mode…suddenly the size of your ass seems much less important than just making it through each day. I learned that during my cancer treatments, of course, but we humans have short memories. We forget a lot of important lessons we learn over our lives and sometimes we need to go through a hardship again to relearn them. This recovery period is a test of how well I learned certain lessons the first time around.

Of course, I have not been inactive at all. Since the night of surgery, I have been working very, very hard at my rehabilitation. I do my Physical Therapy exercises twice each day. I spin on the bike for two 20-minute sessions each day. I have been going to the pool and swimming, water jogging and doing my aqua therapy exercises 3-4 times each week. It isn’t running on trails, of course, but it is something and I am diligent about doing it.

There are No Shortcuts

I promised myself before doing this surgery that if I lost muscle or gained weight, I would not engage in self-loathing. I promised myself that I would approach this like I do a race and look at each phase as vitally important in reaching my goals. In training for ultras, I wanted to embrace the entire process, start to finish, the good, bad and the ugly. I did not seek shortcuts then and I am not seeking them now. I want to do this properly or I would not have signed up to do it at all.

Ingredients for Recovery

Right now I need two things to heal properly: rest and good food. This includes lots of veggies, fruits, lean meats and sometimes cookies because a little indulgence is good for my mental health, too. So far, I have been kind to myself and not judgmental towards my body. This is progress.

I Don’t Hate you because you Can Run and I Can’t

I am actually proud of the fact that over the last four weeks I have not once felt sorry for myself because I cannot run. I have not felt jealous of my running friends. I am still able to look at people’s running joys and accomplishments on Facebook and think how genuinely happy I am for them. I am so glad I can celebrate along with people who are still fulfilling running goals and dreams. I hoped I wouldn’t feel pathetically sorry for myself following my surgery, but you just don’t know how things will impact you until you experience them personally.

So those are the things I really feel good about and have even gone better than I thought. But there are also things which are harder than I believed they would be and some things I had no idea would be an issue at all.

I Knew this Would Be Difficult…

I really miss being independent. Not being able to drive myself frustrates me still, but I know it is temporary and I am grateful for help. I could never have done this without my mom here.

mom driving us

My mommy has to drive me everywhere still.

Trying to sleep in the CPM is just so difficult for me and lack of sleep for four weeks is really hard to deal with. I will be shedding the CPM this week, so this too is temporary.

CPM leg bed

Hooked up to the CPM, NICE machine and  DVT calf sleeve

Sitting up causes a great deal of pain- more pain than I thought it would. I was in so much pain last night after working on stuff at my computer for several hours that I wanted to cry. I wanted to cry but I couldn’t cry because I was in too much pain and just too tired. All I could do was lay down on ice for the rest of the evening and pray I would feel better in the morning.

Didn’t See THAT Coming

In many ways, the hardest part has been the stuff I was not able to plan ahead for. I did not anticipate was that I would be on medications (not pain meds) for a month which would make me very sick to my stomach and dizzy. For 28 days, I have felt like I have morning sickness that lasts all day. Aside from PT, I am spending a whole lot of time laying down on ice and just feeling ill. I am far from resuming my normal life.

After beginning to progress towards weight-bearing, things that didn’t hurt at all before are now quite unhappy. My adductor muscles are very angry and so is my IT band. This is to be expected, but I was doing so well at first I believed maybe I would escape with no pain at all.

I did not expect what a toll this would take on my mental faculties. I apparently am not the only one, because a friend of mine who had a very similar surgery also commented to me that her brain was not firing at 100% either. There are a lot of things from the last month that are a bit foggy, and since I am not on pain medications, I cannot attribute it to that. It must just be the stress on the body and lack of sleep. Whatever it is, it is real.

Yay! Phase Two is Here

So, phase one of recovery comes to a close now and I move on to phase two. I can start to say goodbye to the CPM, the DVT calf sleeves, the ice and hopefully the crutches shortly and begin working towards full weight bearing.

The goals for me for now are to maintain my (mostly) good attitude and continue to adhere to PT protocols even when I am feeling poorly. Equally importantly, I hope to continue focusing on my end goals and recognize that each moment, especially the hard ones, are what will help me get there. I will be patient. I will be smart. I will be kind to myself. I will move forward slowly and surely.

 

 

 

 

 

My Hippie Life

March 30th, 2017 marks the day I officially became a hippie. On that day, somewhere shortly after noon, I had hip surgery at the Vail Valley Surgery Center with Dr. Marc Philippon.

Hip History

My hip gave me some trouble several years ago. In 2009, I turned 40 and my ass fell off. Maybe that is a bit of an exaggeration, but, I trained really hard and ran a couple of good (for me) races, culminating with an 8th place finish at the American Discovery Trail Marathon. I won a little cash and enjoyed the race tremendously.

Tonia ADTM awards

I went home, very sore and spent the rest of the day reclining on the couch. The next day, I could not stand up straight. I was bent over like a 132-year-old person. Imagine my surprise when I saw my picture gracing the front of our local newspaper’s sport section (photo courtesy of the Gazette).

Tonia ADTM Gazette

How on earth did I go from feeling good and running well to being 132 years old?

An Eternity in the Pool

After ADTM, I spent months seeking a firm diagnosis on what was wrong, but doctors could not seem to agree.  ‘Maybe’ it was a labrum tear. I definitely had a stress reaction or hairline fracture to the pelvis. Some soft tissue damage. The possibility of labrum surgery was introduced at that point in time, but after doing a lot of research on the procedure, I decided I really needed to spend a long time trying to recover and rehab. I could not put my body through a procedure with an extremely long recovery without knowing for sure if the labrum was torn.

No Love at First Sight

I spent the next 9 months not running a step. I decided I would swim for recovery. I am not a swimmer. Sure, I can keep myself afloat long enough that I will not drown, but I have no technical swimming ability under my belt.

I hated every minute of swimming. The pool was cold and I was miserable every single time I got in the water. As much as I hated it. I never gave up. Over the course of 9 months, I swam nearly every day. Sticking with it paid off in spades when I got back into running. Becoming a terrible but committed swimmer kept me in great shape. When I started running again, I was grateful I had spent all of those months in the pool.

Eventually I got back into running, then racing and ultrarunning.  I never went back to the pool. I never thought I would need to.

Groin Pain or Hip Pain?

While the outside of my hip did not bother me, I occasionally developed what I thought was ‘groin pain’. As it turns out, ‘groin pain’ can actually be hip pain. For months following Run Rabbit Run, I did all I could to get better, but the pain never went away. Sometimes it was more or less intense than others, but it was always there.

Hip Surgery

After consulting with several medical professionals, I decided it was ‘now or never’ time. The labrum was now definitely torn and I needed to get it fixed soon or it might never happen. Results for this surgery seem to depend upon multiple factors, including the surgeon, the rehab work after surgery and the joint itself. If there is too much arthritis, the outcome of a labrum repair will not be good.

Fortunately for me, Dr. Philippon at the Steadman Clinic in Vail was willing to take me as a patient. (Read about the Steadman Clinic HERE) When his clinic contacted me and said he was willing to take me as a patient, I was thrilled. He is a pioneer in hip arthroscopic surgeries and has worked on many professional and elite amateur athletes. (Read more about Dr. Philippon HERE) Though he has strict criteria/requirements for his surgical patients and their recoveries (patients must stay in Vail for Physical Therapy for 4-5 days minimum post-op), I felt that going to Vail would give me the best shot for coming back to running.

I received excellent care in Vail and cannot say enough good things about the Steadman Clinic and Howard Head Sports Medicine. Within hours of my surgery, a physical therapist visited me in the hospital and got me on an exercise bike. (Visit Howard Head HERE)

Vail hospital Bike

I went to physical therapy twice per day for four days after surgery. On the fifth day, I went to morning PT and then all the hip patients went to the Avon Rec Center for a session in the pool.

hip class

How Did I End Up Here?

My labrum tore due to Femoroacetabular Impingement, a condition where excess bone on the hip socket (pincer type) and/or femoral head (cam type) causes damage to the labrum and cartilage. I had both types of impingement, so I ended up having the femoral head reshaped and excess bone cut off the socket. In addition, Dr. Philippon repaired the labrum and fixed several other problematic areas.

The Aftermath

The post-operative pain has been surprisingly manageable. I will be on crutches for approximately six weeks. I must use a ‘Continuous Passive Motion’ machine for 6-8 hours per day. The recommendation is to use it while you sleep, but that just doesn’t seem to work well for me. I do what I can and then make up the rest of the time during the day.

CPM

I am back visiting Kevin at Synergy Manual Physical Therapy in Colorado Springs. (Visit Synergy HERE). I ride a stationary bike and do my PT exercises twice per day, three or four days per week. On the other days, I am swimming/deep water running in addition to doing the PT exercises. So far, recovery feels like I am doing two-a-day training sessions for an ultra. In a way, I am.

incisions

It is amazing to me what surgeons can do arthroscopically these days. All I have are three small scars and a big bruise (not shown).

Lessons Learned…Looking Ahead

The good news is surgery went well. Dr. Philippon and the PTs at Howard Head believe I will be able to do whatever I want to do in time. The recovery from labrum surgery can be long and at 48-years-old my body does not bounce back from trauma the way it used to. I am trying to keep things in perspective and rely on my ultra marathon mentality to get me through the long road ahead.

I have already learned a few things in the last week-and-a-half:

  1. I hate being dependent upon other people. I knew this, but it has become even more apparent this past week-and-a-half. Since I am on crutches, I feel essentially helpless. I can’t carry anything. I can’t do laundry. I can’t fix dinner. I can’t carry a cup of coffee across the house. I need to ask for help with pretty much everything and it really bothers me. Why hasn’t anyone created crutches with robot hands? I would definitely buy them.
  2. Sometimes when you try something the second time around (or even third), you find you like it better…or at least you don’t hate it anymore. It was like that with running for me. I didn’t fall in love with running until the third time I tried to make it a habit. This is the second time around with the pool for me and I actually have been really grateful to have it as an outlet. I am thrilled to get real exercise and get my  heart rate up. I come home thinking, “I am tired and calm and that actually didn’t suck.”
  3. The pool feels warmer when you aren’t as skinny as you used to be. Also, swimming is hard work. Neither of these are bad things.
  4. Using crutches and wearing a brace makes everything take way longer than you think it will.
  5. As much as I hate it, sometimes I really have to rely on others for help. My mom, my husband, other school and volleyball parents have been life savers. I am grateful for their help.
  6. As much as I love running, I won’t die if I have to take some time off. I learned this already, but I am relearning it. Life will go on. I miss seeing my running friends. I will miss certain events this year. But, I will get back to it.
  7. It is good to have goals during recovery. Dr. Philippon and the PTs have all talked to me about my goals and I already have some in mind.
  8. I want to run again. I thought I would be doing Run Rabbit Run 100 again this year. Clearly I won’t be. But I believe I will run again.
  9. I also want to do some other things. Maybe I will take swim lessons. Maybe I will learn to rock climb when my hip is better. Maybe I will hike the Colorado Trail. I want to run but I hope to also discover joy in some new activities.
  10. I sometimes believe the universe is giving me signs. The gentleman who had hip surgery immediately following mine and who I spent lots of time chatting with at PT lives in Steamboat Springs and can see the Run Rabbit Run course from his house.
  11. I could live in a one room cabin with my husband and be happy.

For now, I am focused on getting through these next 4-6 weeks of crutches and equipment. While I know some days will be difficult, I am pretty at peace with the process for the moment. I don’t have a choice, so I may as well make the best of it. The mountains are still calling and I will be there…in time.

Seven Bridges selfie

 

 

 

 

 

 

 

What if this is ‘The End’?

When I ran Run Rabbit Run 100 in September, 2016, I had no idea that it would likely be my last 100 mile race. I was blissfully unaware that my little 100+ mile jaunt through the mountains in and around Steamboat Springs might be my final ultra or possibly even the conclusion of my running ‘career’.

As hard as Run Rabbit Run was for me, I had an amazing time. (You can read more about my race experience HERE) Even though there were moments in time where I was really ready to be done, I knew without question I wanted to run another 100. In the immediate aftermath of my previous 100’s, I told myself I was finished with the distance. Only days, weeks or months later did I start entertaining the idea of running another one. At Run Rabbit Run, however, I knew before I even crossed the finish line that I would sign up for another one. Except now I think my days of toeing the line at ultras is over.

finish-rrr

Injury

It turns out the self-diagnosed ‘groin strain’ was something entirely different. I have a tear in the labrum of my right hip that is causing pain and making running difficult. While physical therapy can sometimes improve the symptoms of a labrum tear, the labrum will not actually heal on its own.

Complicating things a bit is my age. As we get older, we typically have signs of osteoarthritis in our joints. If there is too much arthritis in the hip joint, the surgery will not be successful.

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Soaking in the scenery (Photo courtesy of Tim Englund)

Debating Surgery

I have debated with myself whether to have surgery or not many times over since I first learned the nature of my injury.The recovery from hip labrum surgery is known to be very long and challenging.  If I don’t get the surgery, I might be able to keep running, with pain, for a while. Running in the hills puts extra strain on the injury, so that would be out. I could run short distances on flat trails to try to minimize the damage, but for how long? And would I be happy with that?

On the other hand, if the surgery is not successful, I may not be able to run again at all. What is the right thing to do? Take a chance on the surgery so that maybe, just maybe, I could get back to doing what I love? Or should I try to settle with what I consider to be a poor substitute for an unknown amount of time?  Do I take a chance on my passion and risk giving up running entirely? Or do I play it safe and hope to just be able to get in a couple of miles each day around the neighborhood?

Vermont 100

What would I have done if I knew it was the last time?

When I found out that I might not be racing or even running in the future, I was devastated. I thought about Run Rabbit Run and how I had absolutely no idea it was likely my final 100, my swan song. If I had known, I wondered, what would I have done differently? It was a race, after all, so maybe I would have tried harder, despite being injured, to turn in a faster finish time. Maybe.

I love competition and I get fired up by seeing how well I can do under any given set of circumstances. However, in this instance, I think I would have tried harder to soak up every second of the experience. I have wonderful and very fond memories of this experience, but I wish I could hold on to every second in my mind: the beautiful scenery, hugging my daughter at the Aid Stations, Larry’s amazing stories, the spectacular full moon that Laura made me take in, the sunrise with my husband and even those final hot and painful miles downhill to the finish line.

rrr-foliage

As we go through life and become acutely aware of how quickly time passes, we all seem to want the same thing- the ability to slow down time so we can savor the experiences. I have no regrets at this point about my running experiences. I have run many, many roads marathons, trail marathons and ultra marathons. I am three for three on 100 mile finishes.

Memories and Miles

Each race is special snapshot of a particular moment in the times of my life. I remember something from each experience which carries meaning for me. Sometimes those memories relate to where I was at a particular point in my life. Sometimes it is something as simple as the crowds at Boston or the scenery in the mountains. Either way, the memories the races evoke are incredibly special. I wouldn’t want to change the races where I ran as hard as I could. Still, all I can think when I recall Run Rabbit Run is how I wish I could replay the whole experience. I want to slow it down in the same way parents want to slow down time as their children grow.

More importantly, I carry running memories with me that have nothing to do with racing. I think back to how I started running with my dogs when I lived on the Gulf Coast. I remember the people I have run with over the years. I envision the beautiful trails I have spent so much time on since I have moved to Colorado. I have pushed my children in baby joggers and I have developed deep friendships on the roads and trails. My relationship with my husband has become richer and more rewarding as it has evolved over the years of running together. This is what makes running meaningful for me. It isn’t the races or the medals or the t-shirts. It is the all about the moments, the experiences, the time spent alone and the time engaged with others.

elk

I recently purged a bunch of my old race t-shirts. I even tossed an old Boston Marathon jacket I had. My husband was incredulous. He knew that jacket had once meant a great deal to me. At some point I realized, however, that it wasn’t the jacket that was important to me. The memories of the experience are what matter.

Who Am I if I am not a Runner?

In three weeks, if all goes well, I will have hip surgery. I hope to come back to running in time, but at this point I have no idea what the future holds. As with any major life change, it is frightening to have to give up something that has long been a big source of my own identity. I have now been ‘a runner’ for 20 years. Will I cease to exist as I once was? How will I see myself? How will others see me? Will I survive the long recovery period with my sanity intact? Will something else take the place running once filled in my life?

tonia run

Maybe I will come back to running, or maybe this will be the beginning of something new and undiscovered in my life. Either way, I cherish the memories I have built over these past 20 years. Push yourself. Run Hard. Run Fast. Run Long. But every once in a while, take the time to slow down and revel in the moment because you never know if it will be your last.

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No Air

I felt secure in my health. Invincible. I knew I was not immortal but I pictured a long, active, healthy life surrounded by people I love. I had a follow-up appointment scheduled with my doctor on a day when my husband had training for his job. He offered to change his training days, but I was so confident all would be fine that I told him not to bother. I would go alone. It would be fine. I would be fine.

As I  waited in the oncologist’s office, I had some mild pre-report jitters, which is normal.. The doctor came in and we engaged in a couple of minutes of idle chit-chat. I was waiting for the words, “Everything is fine. I will see you in three months.” But, instead, he opened his mouth and told me there was a lymph node near the celiac plexus that needed to be biopsied. As we looked through my scans together, he showed me another spot, this one on my liver. He emphasize that both could be nothing. However, he was recommending further testing to be sure.

As I listened to him, I kept a half-smile on my face, because I don’t want to show that I am rattled. But, I can feel the air leaving the room. I have a deja vu. I am back in 2013  when I first heard bad news about a tumor in my body that needed to be checked out further. I feel the same half-smile on my face, nodding in agreement to a voice that sounds a million miles away. No air. I hear the tumor board will discuss my case and let me know what will happen next. I think: I am alone. WHY did I come alone? Because I thought I was fine. I AM fine. But I thought I was fine in 2013, also. I don’t know what is real. I cannot trust my own instincts. I am afraid and so very alone.

I think, ‘What am I going to tell my daughters?’ I cannot tell them everything is fine, but I don’t want them to worry needlessly. After all,  I am going to be fine.

I leave and am, fortunately, able to speak to my husband. He sounds like I feel. A punch to the stomach. Fear. Disbelief. We are both desperate to be together, but are over 100 miles apart. I cry on a bench by the hospital elevator and I don’t care who sees me. I can’t drive. I can’t breathe. He has to return to class. I drag myself downstairs for the ride home but I just can’t do it yet. I sit on another bench and cry for 20 minutes, watching the rain pouring down outside. What am I going to tell my daughters?

Eventually, I pull it together enough to drive home. I talk to my parents. I talk with a couple of very close friends. I get home and sit on the floor, unable to move for 20 minutes. I am so thankful for Sadie, my Boston Terrier, who is licking my face. When my daughters come home, I tell them I need another test, but I do not elaborate. We have too little information. I am scared but I do not want to cause them unnecessary stress. There is no point. It seems cruel. They will know as soon as we know for sure one way or the other, good news or bad.

Sadie on my lap

The doctor calls the next day and says a biopsy is recommended. I vacillate between thinking I am totally fine and feeling fear that comes from seemingly nowhere. It consumes me on a visceral level. It does not seem to be triggered by anything in particular. I can only assume it is a response to the old wounds and fears coming back. One minute I am fine and the next I feel like the earth is swallowing me whole.

I cannot think about possible treatments. In fact, I don’t. I think about the test and just want to get through that. But when Stephen and I start discussing plans we have…races we have signed up for and trips we will take to see family, I become choked up. “But I have PLANS,” I think. “I have so much stuff that I want to do!”

The waiting is the hardest. Neither of us sleep well. We walk around, distracted zombies, trying to go through the motions and fulfill our daily duties and obligations. There is no time to emotionally deal with our personal crisis. We are so busy, we wish we had time to just sit and hold each other. When there is a moment of down time, our thoughts become our own worst enemies.

Steve & Tonia Santa Fe

I have the test. They biopsy enlarged lymph nodes. I go home and I wait and wait and wait. i try to figure out what it means. Why haven’t I heard anything? Is no news good news or does he not want to deliver bad news over the phone? I over analyze.

I actually think that I am healthy and fine. The logical side thinks I will be OK, but since I thought I was fine prior to my initial diagnosis, that leaves the door slightly open. Wednesday comes and I am supposed to see the doctor. A blizzard arrives, shutting down essentially every major road on the Colorado Front Range and I am stuck at home waiting to see if I will learn any news. I work and play games with my kids, but I am anxious and distracted. Finally, my phone rings and I get the news: I am fine. There is no sign of cancer in the lymph nodes.

There is relief and joy when I tell people, but after two-and-a-half weeks of living in some alternate universe, my own personal little time in hell, I am mentally exhausted. The news comes to me not as a surprise, but as a confirmation. I am fine. I knew it.

Today, as everything sinks in, I celebrate a new day of continued good health with a run. There is air. I can breathe again.

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