Off the Deep End

Forty Days ago I had hip surgery. This past week I hit some major milestones. I am now cleared to drive my car.

driving

A driving selfie just because I was so darned happy to get to drive myself for a change!

I got to go on my first short walks with my husband and the dogs.

Sadie rolling

I am mostly weaned off of my crutches, only using them when my leg becomes very tired or sore.

I have been faithful to doing my physical therapy exercises. I go to the pool 3-4 times per week. I went from barely being able to swim for 5 minutes to now being able to swim a mile (using the buoy) with relative physical ease. I am still grateful for the ability to swim for exercise. If it weren’t for the pool, I would have no way to work my heart and lungs for the first twelve weeks post-op.

The Pool: The Depths of Sadness

Yet I still don’t love swimming. Every time I go to the pool I have to have a serious heart-to-heart talk with myself. It takes me several minutes to psych myself, first to the leave the house and then, when I get to the pool, to go in. There is something I find depressing about the pool.

At first I thought that it is because you can’t really talk to anyone while you are swimming, but then I realized it is more than that. The pool, for me, amplifies feelings of isolation. When I head to the pool, I convince myself it will be a time of solitude and reflection. But the pool seems to always be busy. Instead of relishing some time to be alone with my thoughts, I find myself surrounded by people, often in close proximity, but without being able to connect with anyone. There are cursory words, ‘hi, mind if we share this lane?’ But that is about as far as the conversation goes. There is a profound sense of isolation that comes from being surrounded by people without any real sense of connection.

Isolation Vs. Being Alone

It isn’t that I don’t like being alone. But the experience through running is different. I have spent countless miles and hours alone on the trails. I come away with a clearer head. On the trails, I can focus on the world around me, taking in the beauty of nature, while allowing my internal world to work through life’s problems. I come home feeling freer, lighter, calmer. The time on the trails gives me a perspective that is hard to reach in other situations.

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Being alone with one’s thoughts without traffic, noise, technology and other distractions is a rare gift these days. Several recent studies have shown how important time in nature is to our mental health and well-being. After spending nearly 6 weeks without a single excursion to the trails I love, I realize how important that time is for my own sense of mental and emotional peace. Being alone on the trails gives a sense of connection to the universe. Being in the pool surrounded by people I don’t know leaves me feeling empty.

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The Intimacy of the Trails

There is something else that sets swimming in the pool apart from running the trails. There is a sense of intimacy that comes from relationships built on the trails. I joke that running is a sort of ‘truth serum’ that causes you to share things with people that you might not every share otherwise. Run with a partner and you will soon know everything about that person. When I think of my closest friends, the image that comes to mind is often a particular conversation or snapshot in time on a trail. Topics we might never bring up in other circumstances become subjects of intense debate, scrutiny and mutual understanding on the run.

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The Things I Learn About Running from Not Running

I don’t crave large numbers of friends built on superficial relationships. I live for the few people with whom I enjoy deeper conversations and connection. I desire the closeness that comes with truly knowing others. I want the relationship where we love one another not despite our flaws and inner secrets, but because we trust one another enough to share them.

 

Those are the moments I miss right now. It isn’t training or racing or putting in big miles or tempo runs or hill repeats that I want at this point. I long for those moments of being purely alone in the mountains. I miss the quiet moments with one close friend. I yearn for feelings that cannot be quantified or measured, those moments and conversations that leave me both energized and grounded in a way nothing else does.

So for now, the pool leaves me feeling cold, both emotionally and physically. I will keep going because I know eventually it will pay off and allow me to return to what my heart and soul crave most. For the time being, I will try to envision the mountain vistas with each stroke and breath as I try to stay afloat, forever moving forward.

Tonia Jacks

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