Monday, February 28, 2011

"I know it hurts. I can feel them."

Yesterday, during my 20-miler, the pain level really started to increase around the 10 mile mark.  I wanted to stop.  I wanted to stop, stomp my feet, pull my hair, and scream.  I suppressed my desire to throw a tantrum and I kept running.  And I kept thinking--"Only 10 more miles, then I get help."  And a mile later, "Only 9 more miles, and I get help" all the way until I got back to my front porch.

Last night, after Rowan went to bed, Tim and I got packing.  We shared a suitcase.  Rowan's stuff, however, took up the entire back seat and the back of our Yukon.  You wouldn't believe how much stuff a 19-pound person requires.  Well, he does.  Two strollers (the normal and the running one), three bags, toys, diapers, etc.  Our car looked like we were going camping in a remote area for at least a week.  I went to bed nervous.  I'm not sure why.  I guess I was nervous they wouldn't find anything.  That I'd get there and they'd say..."Well, sorry, we don't know either."

We got up early, and Tim, Rowan, Rowan's large amount of luggage, and I were off and on our way to Chicago at about 7:30.  Rowan has never been on  a trip this long, and I was a bit concerned about how he'd do.  In addition, he's been coughing.  He's never been sick before, and I wondered if the mix of that with the first long travel might make the trip an utter nightmare.  Thankfully, he did wonderfully.  He slept about an hour and a half and was wide awake and pleasant the rest of the time.  He didn't even poop!  What a good boy.  We only stopped a couple of times, and we arrived in Chicago with plenty of time to spare.

We got slightly lost in downtown Chicago, but Tim realized it quickly so we didn't lose too much time.  We checked into our hotel, which was only a few blocks from the Sears Tower, where the chiropractic office is (thanks for the info, Pete!), changed Rowan's diaper, and headed to see Dr. Kaeser.  We got there early, so we had time for some lunch.  Rowan was doing so well...had not fussed at all.  But I knew that he needed a nap.  He naps three times a day at home, and has usually had two by the time we were finishing lunch.  He was getting tired and fussy just as we headed to the office.

The office was not as I expected.  It is behind some glass doors at the end of a hallway.  I expected something larger, more imposing.  I went in to the desk and told her my name.  She looked at her list and didn't see it.  Surely I didn't dream all this up?  Maybe.  Except, when I told her I was there to see Dr. Kaeser, she knew who I was.   I had to fill out quite a bit of paper work.  Meanwhile, Tim got Rowan to sleep.  After a few moments, Dr. Kaeser came out.  I recognized his voice.

He was utterly hospitable.  He apologized that we had to begin in a massage room, as we were waiting for one of the larger exam rooms.  He commented on how beautiful Rowan is and made sure we were comfortable.  I have never been treated this way by any care provider--no doctor, physical therapist, etc.  There he was, on his day off, crammed in a massage room with me, my baby, and my husband.  And he was on a mission.  We sat down to get started.  I gave him all my records, and also a time line I had drafted, which depicts the whole history of my pain (as the runners will know, we write everything down, so I was aware exactly when it started, when the intensity changed, etc.) as well as all the doctors I'd seen, tests that had been run, etc.  He pulled out my blog posts, which he had printed off.  I knew he had been studying them.  They looked like the articles I have my undergrads read--painted with yellow highlighter, stars, underlines, notes in the margins.  It was at that point I became comfortable.  This guy cared. 

He asked me to go through the time line with him, which I did.  He was able to connect some of the time line to the blog posts.  He made notes on the time line and had me point to where my pain started initially and where it is now.  This took probably 20 minutes.  We then--stroller and all--moved into a larger exam room.  I can't begin to tell you everything he did, but this is the most thorough physical examination I've ever had.  He started by listening to my heart, given the left shoulder pain I have.  Then he had me lie down on my back.  And he found them.

By "them" I mean the spots that rip/tear/pull/stab at me while I run.  The spots on my abdomen that I literally want to rip out and toss on the side of the road.  He went right to them.  And he'd say "That hurts."  He'd say that before I told him.  He pressed on the left side where it hurts so much, and I told him so.  He said, "I know it hurts.  I can feel them."  I knew that he believed me about my pain.  He kept pressing, and he'd say "Ooo...that hurts."  And every single time, he was right.  It DID hurt.  He was digging deep and reproducing the pain I have while I run.  I nearly came off the table in pain, but I was so ecstatic.  He found them!

He went lower, to my pelvis, and found nothing.  Nothing has ever hurt there, so I wasn't surprised.  Then he went up to my right rib cage.  He found another spot.  "That hurts, doesn't it?"  YES!  Yes, you wonderful man, it does hurt.  And I've told every doctor I've seen how much that hurts, and no one would listen to me.  He went up my rib cage, to my breast bone, and pressed in my intercostal spaces.  Ouch! was my response to some of them.  When I say ouch, I mean it was exquisitely tender.  Like electric shock waves going through me.  He followed the paths of those all the way to my shoulder tips, where I often get pain while running.

I flipped onto my abdomen and he worked on my back.  He found one spot--T4--which was incredibly tender.  I could hardly stand him to press on it at all.  He explained to me that the nerves innervated there wrap around the rib cage.  It was interesting to hear him work.  He started predicting things.  "Now, I bet I know where it will hurt up here."  He'd press something, I'd tell him it hurt, and that's what he had guessed.  In my mind, as he poked and prodded, I was thinking, "He's doing it.  He's figuring it out."  It was like putting a puzzle together.  Every pain led him somewhere else, which led him even somewhere else, and so on.  At one point, he pressed down on my shoulders/spine which caused the right-sided pain.  He watched me walk, he watched me run.  He checked everything.  I could tell he was satisfied with what he found.  He knew he was on to something.  He left to go chat with the other chiropractor and physical therapist to get their opinions.

Tim had to leave with Rowan, as Rowan had to take another nap, so he missed this next part.  The other chiropractor, who was also extremely inviting, was interested in my diaphragm.  He examined me, and told me that my diaphragm was high, as it is when it's prone to spasm.  And then it clicked.  He made the pregnancy connection.  When I was pregnant, my diaphragm clearly was smushed.  What's more, I ran with my diaphragm like that.  So, when Rowan was born, my diaphragm should have gone back to normal within two weeks.  It didn't.  It's still in the pregnancy position. And it's irritable.  Want to know how I know?  He palpated it.  OUCH.  And he hypothesizes that the weight bearing associated with running is making it even more irritable, so it spasms badly during that and aches all the time.  He manipulated it, and it felt immediately not as tight.  He did the left side, which wasn't as bad, as well.  He later showed Tim how he could work on my diaphragm at home.  He let us know it should only be done 2-3 times/week.  It's a good thing--I'd have had Tim doing it constantly.  But the premise is we have to get it "calmed down."  It may take time, but it should work.

Then they took a chest x-ray.  My ribs and everything else are fine.  The pain I'm feeling in my right rib is due to intercostal radicular neuralgia--which means a nerve between my ribs is causing pain that radiates.  That has likely happened because of the diaphragm irritating the intercostal muscles.  The diaphragm is the main culprit.  I must give credit to Dr. Wiedenbener, who long ago suspected as much.  Next, Dr. Kaeser worked on the adhesions in my abdomen.  Why do I have them?  We don't know.  I've never had abdominal surgery or any known abdominal trauma.  The only thing I can recall is a car accident when I was 17.  I had some bruised ribs, but that was pretty much it.  He says that's enough to form adhesions, and that these things have probably been "cooking" inside for quite some time.  Pregnancy has a way of bringing things out.  And again, my high level of activity during pregnancy probably really stirred the hornets' nest.

He did deep tissue work on my abdomen.  Man, it hurt.  But I've not been that happy in a long time.  He kept saying "This might hurt."  I don't care!!  I asked him if I'd need surgery for the adhesions.  He wouldn't promise me no...but said that there's a very good chance he can take care of them this way.  The problem with surgery is that it can cause additional adhesions, especially in people prone to them ( fascia has been described as "cardboard-like"). 

Next it was my back--that pinched nerve is painful, and as he manipulated it I could feel the symptoms I usually get while running.  How could I possibly have all these problems?  I have not one problem, but four (actually five--but the additional one has nothing to do with this pain).  I technically have diaphragmatic spasms (caused from Rowan living in there and me running while he did so...and these have set off the whole chain of events), intercostal radicular neuralgia (radiating nerve pain that originates between the ribs, and stemmed from the diaphragm issue), abdominal adhesions (4 large and 2 smaller, not sure where these came from), and a pinched nerve at T4 (pinched nerve in the back which causes radiating nerve pain around the abdomen with compression, which obviously happens during running--this is likely a result of pregnancy).

At this point, I'd been there for three hours receiving constant care.  Next, I saw the PT, who gave me some exercises to strengthen my core.  However, I have to be very careful--no crunches for now, as anything putting pressure on my diaphragm is not good.  I have to sit up straight.  Oh, and I'm supposed to limit sugar, as those make adhesions worse.

It was a whirlwind.  There is no immediate fix, it will take time and additional treatments.  I'm seeing them again tomorrow and will likely be making another few treks up here.  I won't complain about that at all.  They are trying to find someone in Bloomington who can do the same sort of treatments on me closer to home.  I don't say things like this lightly...but Dr. Kaeser and the other chiropractors/PTs at Meridian Chiropractic in Chicago are wonderful physicians and some of the most caring people I've ever met.  I do not know why, and I dare not question, but they want to help me.  And they are.  I'm running 12 miles in the morning--they tell me it may still hurt.  That's okay, as long as I know what it is and that we're treating it.  I told them that the next race I run pain free...their names shall be on my singlet.  They laughed...but I'm seriously not joking.  Pete's name will be there too.

Sunday, February 27, 2011

And the Winner is....Bill?

Ah, Sunday long run.  I didn't have as much trouble getting myself out the door today, as I knew this was my last run before I (hopefully) get some help.  Our group was smaller today.  Emily and Kathy are out of town, as is Magnus (in London--lucky!).  Wes and Scott were being trail snobs.  That left me, Tim, dad, and Bill to run the rough roads of Lawrence county.  The weather was very nice, and actually a bit too warm for such a long run.  But I'm not complaining.  Tim, Bill, and I were planning 20.  Dad wasn't sure if he'd do 20 or peel off at 17.  All were in shorts this week, and the Truebloods/Millers were in singlets.  Bill, being a bit cold natured, had on short sleeves.

The run started out well, and at a relaxed pace.  I noticed the right-sided pain really kicking in around the second mile, but it wasn't too bad.  Until we got to the I street hill.  Sometimes, when I exert myself beyond very easy running, my pain gets a lot worse.  That happened on this hill.  So I was the caboose on that one.  After that, though, it settled down quite a bit.  I'd say it was a 4/10...and, sad to say, that's pretty good for me at this point.  This is about when we started playing the game.  What game, you ask?  Bill's waving game.  We were introduced to it last week, but this week we got serious about it.  Here's how it works.  You wave at oncoming cars, and if the person waves back at you, you get a point.  If the person doesn't wave back at you, you lose a point.  If the person flips you off, you get FIVE points.  And the same if you get a high five.

At first, Bill was getting most of the points.  Dad got a few, too.  Then Tim decided he'd just run in front of all of us and get everyone to wave at him.  Well into the run, I decided to challenge him.  Every time we heard a car up, I'd bolt in front of him.  As long as I got my arm in front of him, as well as a wave back, I got a point.  I racked up a ton of points, and Tim had a lot too.  Bill slid into third, and dad was a distant fourth.

Around the 10 mile mark, my left side started hurting.  For some reason, when the left side hurts, it hurts badly.  It was sharp.  I distracted myself with racking up as many points as I could.  Before I knew it, we were at the base of Slaughter House Hill--just two miles from home.  I think Tim and I were pretty much tied for first at this point.  But Bill hadn't given up.  As we got back into town, he started playing dirty.

We went past Bill's house, and there happened to be his wife, Leisa, outside.  He got a WAVE, a HIGH FIVE, and a KISS from her!  No fair.  Then, as we did a little loop around N Street, he yelled out "Hey, Kids!" to a group of kids playing outside.  They all, like it was a reflex, turned and waved at him.  Crap!  My sides were hurting so bad but somehow I was having fun with this game.  We dropped dad off at the house (it turned out 17 was all he wanted, and he was calling the horses the last couple of miles).  Then the three of us headed out for 3 more miles.

My legs felt great.  A little stiff at this point, but not at all a problem.  I could pick it up if I wanted (were it not for the pain), and that's a good feeling that far into a 20.  Anyway, Tim and I knew that our only opportunity to pass up Bill would be on Lincoln Avenue.  Tim got several points, but there were also a lot of people who wouldn't wave at him.  So I took over.  And no one, and I mean NO ONE, would wave at me.  I got myself into a hole.  I was trying everything.  Bill hypothesized that men driving in cars with their wives wouldn't dare wave at a female runner.  Then he wanted us to conduct an experiment--we moved to the side walk instead of the road.  Perhaps the lack of waves was due to irritation about us being in the road?  Well, he was right.  I got considerably more waves running on the sidewalk...but never enough to pass Bill.  I'm not sure what the final score was, but what with using his wife and the neighborhood kids to boost his score, I think Bill won.

We finished up.  We averaged an 8:20 pace, which may look slow but really isn't given the terrain we were on.  My sides were really hurting after the run, and they still do.  That happens sometimes--when it gets bad at the end of the run (and the last two miles of this run were the worst), it will hurt for hours afterward, even to the touch.  Heading to Chicago in the morning.  I hope to be able to give you an epic blog post when I get home.  Thank you all for pulling for me--I can feel it.

Saturday, February 26, 2011

It Takes a Village

When I talked to Dr. Kaeser on Thursday night, he told me he'd be calling me the next day, around the same time, to let me know the time to come in and see him on Monday.  I was surprised when my phone rang yesterday, displaying his phone number, at 11:00 a.m. (10:00 a.m. Chicago time).  I had a brief moment of panic, thinking "Well, he's changed his mind.  He read my blog again and wants not a thing to do with this."

My worries were short-lived, as he exclaimed:  "1:00 on Monday!"  I told him we'd be there.  He let me know that I shouldn't worry if I'm running late, that he's got the room reserved for me.  (Trust me, I'll be there early).  He also asked if I minded if some other doctors/practitioners took a look at me.  He'd spoken with some, and there is another chiropractor, a physical therapist, a pain management doctor, etc., etc. who would like to help as well.  Would I mind?  "Pack 'em in!" was my word-for-word response to him.  Just a little bit of Bedford coming out of me there.  He told me they'd start by doing some x-rays--of my chest, back, etc.  No one has even looked at my back or my chest.  I asked if I should bring my abdominal/pelvic CT scan that I had done about three weeks ago.  His word-for-word response to that was "Bring anything you can get your hands on."

So, Rowan and I hopped in the car (Tim's car, actually, as mine is messed up right now--strangely, I don't even care) and headed to Bloomington to get what we could get our hands on.  The first stop was the hospital.  That's where I had the CT.  I carried him in (as an aside--that kid is HEAVY) and we went to the medical records department.  On our way, we saw two of my students (there for clinicals) eating lunch.  They got to meet Rowan after hearing me reference him and Amelia so much while I teach.  Anyway--you'd think that you could get your own medical records without too much trouble.  They're yours, right?  They depict something about you, your body, or your health.  Well, let me tell you, they've got them on lock down.  I had to show a picture ID, give them my SSN, sign 15 papers, then sign something else, then swear I wouldn't sue them, etc., etc.  I even had a cute, smiley baby in my arms and they acted like I was trying to rob the joint.  The worst part came when they asked if I was a minor, as I would need my mother or my father to sign for me if I was.  Now I know I didn't look great yesterday, and I get constant threats from Amelia and my husband about being nominated for TLC's "What Not to Wear," but I can't imagine why they asked me THAT.  Finally I was given the CT results.  I had to walk to an entirely different part of the hospital to get the actual CD of the scan (like I said, Rowan is HEAVY).  In the end, though, I got them. 

Got Rowan back in the car, as we had to go to two additional places (IMA gastroenterology and SIRA) to get the colonoscopy, abdominal ultrasound, and HIDA scan results.  I had to sign in blood there, too.  The only thing I didn't manage to get were my labs.  In all of this, I've only had one lab drawn:  my liver function tests.  They were normal.  But, honestly, could we maybe check a sed-rate, a CBC with differential, anything?  No one has done that yet, and I'm not sure why.  I got Rowan back in the car again and finally headed home.  I felt victorious.  Before pulling out of the parking lot, I decided to read my records.  As a nurse, I know that what doctors dictate does not usually match what they tell patients.  The CT scan actually revealed an ovarian cyst on the right side, as well as an enlarged liver.  The abdominal ultrasound I knew showed an enlarged liver, but the HIDA scan did as well.  I had not been told a lick (the Bedford in me is glaring today) about the cyst or the liver showing up anywhere but on the ultrasound.  Now, I know that ovarian cysts are pretty normal for a woman my age.  But it's on the right side, where my pain is--maybe someone should have mentioned this?  What I'm getting at is....whenever you're going through something like this, a situation where no one seems to know what's wrong with you, take the day off (it'll take you that long), bring your fingerprints, bank account numbers, license, passport, DNA sample, and your first (or second) born child and go fetch your own test results.  I should note that the colonoscopy report was actually just as Dr. Spier had explained it to me.  I knew I liked him.

So, I ran today.  10 miles.  Tim asked me how it went.  "Same as usual."  "You survived," he said.  Yes, I did.  And I have to insert something here that I mentioned yesterday.  But, at least for my sake, it bears repeating:

"When I am disturbed, it is because I find some person, place, thing, or situation--some fact of my life--unacceptable to me, and I can find no serenity until I accept that situation as being exactly the way it is supposed to be at this moment.  Nothing, absolutely nothing, happens in God's world by mistake."

As I began my run, I prayed for mercy.  Please just let this one not be as bad as the last.  And you know what?  It was bad, but it wasn't as bad as Thursday.  That's something to celebrate.  I tried to think of all the positive things in my life.  That did help take my mind off the pain.  I tried to vividly remember the days on which my children were born.  I thought about Amelia, when she was 3 or 4, dancing in the living room to a Shakira song.  I thought about how lucky I am to have such a kind-hearted soul for a daughter.  I thought about Rowan, and those last few, intense moments of my labor with him.  I thought about my husband, and how utterly lucky I am to have him.  Unfortunate events, for both of us, occurred in the time leading up to when we met.  Without those, however, I am 100% sure I would not even know Tim Miller at this point in my life.  I refer you again to the paragraph above.

Long run tomorrow.  Keeping the faith, knowing that there's an A-Team waiting for me in Chicago.

Friday, February 25, 2011

Leap of Faith

Last night, Tim, Amelia, and I had just sat down for dinner.  Rowan was watching us from his exersaucer (he'd already had his dinner of mixed veggies, berries, and bananas--he's going to be a big eater, let me tell you).  My cell phone rang, and I didn't recognize the number.  My students sometimes call my cell with questions, and so I almost didn't answer it, thinking I'd call the student back after dinner.  But, for some reason, I did.

It was a man on the other line, and I didn't recognize his voice.  He told me his name is Dr. Ken Kaeser, and he's a chiropractor from Chicago.  I actually have been expecting his call, but for some reason didn't imagine this was him calling.  So how does a chiropractor from Chicago know about little old me from Bedford, Indiana?  You can thank my friend, Pete Bochek, for that.  Pete is a reader of this blog, and he and I know each other from Hal Higdon's v-team web site (  He messaged me a couple of weeks back and told me that he wanted me to see his chiropractor in Chicago.  I'm five hours from Chicago, but told him that if I thought he could help me, I'd go.  Pete sent my blog posts to Dr. Kaeser's wife, who passed them on to her husband. 

Dr. Kaeser told me that he's been reading my blog.  I think he sold himself short--he's been STUDYING my blog.  He knew everything.  Most importantly, he wants to and thinks he can help me.  He knows a lot about ribs, and he thinks that might be the root of my problem.  If you remember, my right lower ribs are sore, but no one has been able to tell me if this is related to my pain.  Also, when I run, the pain becomes severe in my epigastrium area, which can occur if the intercostal nerve is involved.  All of these signs point to ribs.  At the least, the rib issue needs to be evaluated and ruled out.

So, we're going to Chicago on Monday.  I'm seeing Dr. Kaeser on that day, and then the following day.  That will give him two separate appointments with me.  My hope is that I'll come home on Tuesday feeling much better, or at least with some sort of diagnosis.  It may seem crazy to make a 5-hour (one way) trip to see someone who can maybe help me, but something is telling me to go.  And that feeling I cannot question.  I am lucky that Tim can take off a couple of days and go with me and Rowan.

Here is a passage given to me by my brother, Wes, that I am finding helpful right now:

"When I am disturbed, it is because I find some person, place, thing, or situation--some fact of my life--unacceptable to me, and I can find no serenity until I accept that situation as being exactly the way it is supposed to be at this moment.  Nothing, absolutely nothing, happens in God's world by mistake."

I'm going to Chicago realizing that this situation is completely out of my control, and that someone/something else will determine my fate.  But I think going there is supposed to be part of the journey.

This may all seem sort of outlandish to some people.  "Why don't you just stop running?"  I take comfort in knowing that the runners, at least, will understand.  I have a high pain tolerance, as do most distance runners.  We're conditioned to deal with pain.  I've also given birth completely naturally.  I've run in pain from a variety of injuries.  Never, however, have I run through something like this.  I'm digging deeper than I ever have--deeper than even in a race--to keep running.  I loathe every step of my runs, and I constantly play mental games to get through each mile.  I do this because I have faith that someone, somewhere (perhaps Dr. Kaeser) can fix me.

Thursday, February 24, 2011


I am an impatient person.  I'm one of those who'd rather drive an extra half hour to avoid construction just so I can be moving the whole time.  When I have a problem, I have to do something about it, even if that something will in no way change the outcome.  It's a pathology.

So, after my doctor informed me that he thought the inflammation in my colon could be causing my pain, and that I should see a vascular surgeon (whom I see next Thursday), I started to think.  I know a lot about physiology.  I teach it, as well as pathophysiology.  How could we possibly determine whether colonic ischemia is causing my pain?  For those of you who aren't physiology buffs, let me explain ischemia.  When you do any kind of high-impact sport, and especially in running given that it is a constant motion, your blood shunts to your legs.  There is an 80% reduction in blood flow to the GI organs to compensate for the extra oxygen demand needed in the legs.  This happens in anyone who runs.  My doctor is theorizing that, in my case, the amount of blood shunted away from my colon is excessive, causing ischemic pain (the kind of pain that results from lack of oxygen).  He has the idea of them giving me a medication that will vasoconstrict the vessels feeding my colon (a sort of induced ischemia) and then seeing if my symptoms occur.

There are two ways I can think of that would allow that to be done.  The first would be to give me some potent alpha agonist vasoconstrictor (excuse the pharmacology talk), such as Vasopressin.  Its action is direct and very powerful constriction of the arteries.  Problem is, it's not colon specific.  So if they gave me that, it'd constrict the vessels to my heart, my brain, etc.  Not sure I like that idea.  The other idea I had was that they could dilate my arteries, have me run, and see if my symptoms DIDN'T occur.  This could be done with a potent arterial dilator such as Nipride, which is often used in ICU patients in hypertensive crisis and those recovering from open heart surgery.  The problem, again, is that it wouldn't be vasodilation specific to my colon--all of my arteries would dilate and my blood pressure would go very low, making it difficult, if not impossible, to run.  Then I thought--hey, they could give me an IV fluid bolus with the Nipride while I'm running to keep my blood pressure up.  Then I thought--what doctor would ever actually do that?

So, since I'm waiting to see the vascular surgeon, and I can't bear the thought of waiting without DOING anything, I devised an experiment.  I completed it last night.  I came up with an indirect way to determine if (maybe) the pain I experience running is the result of ischemia or the result of impact.  The idea was to get on my bike (on the trainer), get my heart rate way up, and see if I had the pain.  If the problem is blood flow, then it should happen on the bike, right?  Realizing that more blood is shunted away from the colon in running than cycling due to the impact, I decided I needed to get my heart rate up REALLY high on the bike, as high as I could get it.  Surely, if ischemia is the problem, that ought to bring on the symptoms.

So I did it.  I haven't been on my bike since August.  I forgot how difficult it can be to get your heart rate up on the bike.  While running, my max is around 200--and so I think I'm probably around 180 or so on the bike.  I spun for five minutes and my HR was just around 120.  No pain yet.  I decided it was time to get my heart going.  I put it in the highest gear, came out of the saddle, and began "climbing."  I did this for a few minutes, and my heart rate was just 160.  But I was dying!  However, no belly pain.  I then spun another few minutes, and climbed again.  This time, I got my heart rate up to 170.  My legs were on fire, I was gasping for air, and all I wanted to do was stop.  But no belly pain.  I spun easily a few more minutes, and gave it one more go.  I actually got my heart rate up to 180.  And I held it for about two minutes.  It was awful, and my daughter Amelia became very concerned watching.  Throughout all of that--my abdomen never hurt.  At all.

So, signs were suggesting that the problem is impact rather than blood flow, but I still wasn't totally convinced.  I got on the treadmill.  I ran as slowly as I possibly could--at a 12 minute pace.  My heart rate barely cracked 100.  However, after half a mile of this, I started getting the abdominal pain.  By one mile, I had it on both sides.  By 1.25 miles, it was radiating around my back.  At a 12 minute pace, and an average heart rate of 110.  Just enough impact to bring it on.  I highly doubt that my heart rate of 110 caused any major ischemia to my colon.

So, what do I do with this information?  I don't really know.  I'm still going to see the vascular surgeon, but I think my experiment is a pretty good indication that we're not dealing with that kind of beast.  So, what is it?!  I have no idea, but it's not an overuse injury.  I have had plenty of those.  This one came on in the first run after a 3.5 month layoff.  It's literally like my organs "catch" on something as I run, causing this severe pain.

Oh, I also ran 11 miles today.  It hurt....both sides.  If anyone has any idea what this could possibly be, please tell me....I am a much better runner than cyclist.

Wednesday, February 23, 2011

One Foot in Front of the Other

I continue to have the constant ache in my right side that wraps around my back.  I had visceral manipulation yesterday.  Kent found that my splenic flexure was not moving.  He fixed that, and also made sure that the nerves in my abdominal area were moving freely.  When I got home, it was time to run.  It was really hard to get out the door for this one.  It was cold and windy.  And I knew it was going to hurt.  It's really hard to make yourself get started when you know you're going to encounter pain.  And not effort-type pain that results from running hard, but nagging, unrelenting pain that won't stop no matter how slowly you go.  It might be moderate, it might be severe, but it will be there.  To what degree you never know til you get out there.  To be honest, I've started to dread my runs on account of knowing that I'm going to have this abdominal pain, to some degree, every time I get out there.  Eventually, I got myself out the door.

The weather wasn't as bad as I thought it might be.  Except in the wind--that was chilly.  The pain started about a half mile in on the right side.  It was there the whole time, though a bit better at the end.  On the left as well.  Again, another 12 miles survived.  I keep having to run more slowly to get these runs in, but at least I'm getting them in.  Today is a rest day, and I'm glad for that.

I just spoke with my GI doctor who did the colonoscopy--Dr. Spier.  I really like him.  He seems to understand my plight.  Not once has he said, "Well, then, just stop running."  He's baffled by my (interesting) case and really, I believe, genuinely wants to help me.  He was calling to tell me about the results of the biopsies.  He took biopsies throughout the colon--sigmoid, descending, transverse, and ascending.  That basically means he took them from the left side, the right side, and the middle.  The results were somewhat nonspecific, but basically indicated that there is inflammation throughout my colon that is "sub-acute" in nature.  Sub-acute means it's not chronic, and it wasn't actively happening....but that it happened sometime in the last 72 hours.  So, the biopsy results were not normal.  For some reason, my colon is inflamed.  I was surprised it was my entire colon, as I seem to have pain mostly in two or three spots.  So, what does this mean?  Well, this means that this inflammation could be as a result of ischemia, which could be causing my pain.  As in, maybe.  The fact that it's sub-acute, he said, makes it more likely that it is due to running, as I had run the two days before the colonoscopy (a total of 29 miles).  But, the question remains, is that the cause of the pain?  And another question, at least for me, is why on earth did this begin happening after my pregnancy? 

I suppose it's best to focus on the first question, and that's what Dr. Spier is doing.  He is referring me to a vascular surgeon in Indianapolis.  Which one, I don't know yet.  He has to find someone who can somehow determine if this is the cause of my pain.  Basically, he has "dreamed up" (his words) a test in which I can be given some kind of medication that would cause vasoconstriction of the vessels that feed my colon.  If my pain is reproduced, that's the problem.  If not, then I have inflammation in my colon but that's not causing this pain.  So IF we can find someone who can do that sort of test and IF that is the cause of the pain...what next?  He said the inflammation is throughout my entire colon.  Well, I'm not going to go and have my entire colon removed.  He said that we could have the two "water-shed" areas--where I seem to have the most pain--removed, and that would probably make me much, much more comfortable.  And he said the vascular surgeon might have ideas about how to improve blood flow via medications or some other kind of procedure.  So, that's the next step--seeing a vascular surgeon at the IU Medical Center.  I'm worried it will take a LONG time to get in.  I also mentioned that I'd like to see a pain specialist, as in an anesthesiologist.  There is a pain clinic here, and I've read about how they can perform certain nerve blocks to determine from where pain is coming.  If the pain gets better following the block, that's the cause of the pain.  So I'd like to try that.  He's referring me there.

I'll keep trying to figure out what's wrong with me.  For now, I'm taking it day by day.  One foot in front of the other, as long as I can take it.

Monday, February 21, 2011

Very Interesting...

Today was colonoscopy day.  I was up much of the night due to the "prep."  Ugh--that was horrific.  Anyway, Tim took the day off to take me for the procedure, which was bright and early at 8:00.  My mom kept Rowan.  I had to fill out paperwork and show my insurance card (for like the 60th time--do they throw away the copy they make each time?) and then wait for them to come and get me.

As a nurse, it's always weird to be on this end of things.  Even though I pretty much know exactly what's going on, I still find comfort from the nurse explaining it all to me.  I had to strip down and put on a hospital gown.  Luckily, there was a warm blanket.  The nurse who got me ready was great--her name was Ann.  She told me that she ran two miles yesterday for the first time in years.  When I told her I went 17 she gasped.  Dr. Spier had wanted me to run prior to the procedure...but 17?!  I decided not to explain to her that 17 is really not....that.....far.  She took my history and told me how interesting my case is.  And how much they all wished they could figure out what is wrong with me so that I could carry on running without pain.  At that point, Dr. Spier came in.  "Did you run yesterday?"  "Yes."  Ann interjected:  "17 miles!!"  He didn't seem fazed by it.  I was able to explain to him that my pain is now worse, and also on both sides.

I got rolled into the procedure room where THOSE nurses went on about how they couldn't believe I ran 17 miles yesterday.  I told them my husband ran those 17 miles and then rode his bike an hour.  That made me look less crazy.  I had great nurses.  And that's saying a lot, because I'm a tough critic.  They also told me how interesting my case is.  Dr. Spier came in and talked to me a bit...then he started asking me about jogging strollers.  He wanted to know which one we use, because he and his wife have a baby about Rowan's age and they're looking for one.  I told him about ours, and that it's purple.  Then I remember asking the nurse, "Did you just give me something?" as I was having trouble communicating about the stroller.  "100 of Fentanyl."  "Aw, man, I wanted to know about the stroller," Dr. Spier said.  That's the last thing I remember.  I do remember hearing him say "cut" once or twice during the procedure, and thinking that I should keep my eyes open so I could watch the screen.

Allegedly--since I have no memory of it--I was then taken back to the prep room.  Tim was there, though I don't remember seeing him.  I guess I was talking about hating Wal-Mart and also complaining that they didn't do the procedure.  And I was confused as to why the nurse was wearing a Starbucks apron and visor.  Tim actually videoed me, so I've seen myself in this stupor.  Dr. Spier then came in (again, allegedly) and explained the results.  Tim tells me that he showed us pictures, and that there is some redness/inflammation in some parts of the colon, mainly on the left side.  Not much on the right.  He biopsied throughout the colon, and did notice that when he did so there was significantly more bleeding than what he would have expected.  So what does this mean?  Well--he didn't see anything glaringly wrong, though there is some evidence that something has been going on in there, at least on the left.  The heavier-than-normal bleeding may indicate that those areas have developed collateral blood flow in order to help them heal.  So, we're awaiting biopsy results.  Those results will let us know if there has been ischemia to the colon.  Well, then what?   Well, I could try not running to see if it will heal.  But that doesn't make sense to me because, when it developed,  I hadn't run in over 3 months.  The other option is to remove the damaged parts of the colon, but we can't do that unless we're SURE that's causing my pain.  And how could we be sure?  Well, we'd have to do some sort of test that would show the blood flow to my colon while I'm running...some kind of angiogram.  He, and interventional radiologists he's spoken to, however, don't know how to do that.

I went home and slept.  And later I went to see a local chiropractor.  He did a very thorough examination, determined that my spine is tender where it "lines up" with my diaphragm, but ultimately said "I have no idea, but it's very interesting."  He did an adjustment and gave me some information on a laser treatment from which I might benefit.  But he's not sure--it's all just guessing.

I'm not sure where to go from here.  Alas, though, it is very interesting.

Sunday, February 20, 2011

Sunny? Not!

I survived another long run.  Actually, the first 12 miles of this run were the best I've had pain-wise in a LONG time.  The last five miles?  Not so much.  More on that later.  The weather website said that it would be around 50 degrees with sunshine this morning for our 10 am start time.  They were wrong.  It was 37, drizzling, windy, and cloudy.  Yuck. 

Wes, dad, Tim, Kathy, Bill, and I were all running together today.  We set out for the 17-mile Tunnelton/Buddha/Bedford loop.  The same one I ran last week (monster hills), only without the 3 tacked-on miles at the end.  Dad and Wes had on shorts and a t-shirt.  Tim and Kathy had on shorts and long sleeves. I had on capri tights, a t-shirt, and arm warmers.  Bill had on long tights, long sleeves, a jacket, and a hat.  With the exception of dad, we were all wearing gloves.  There was a lot of banter between the heavily- and lightly-dressed groups.  Bill warned the short sleeve wearers that they would freeze once the rain came in.  Those in short sleeves mocked that Bill would be burning up on the hills.  In the end, I was comfortable. I took my gloves and arm warmers on and off throughout, but was never miserable.

My right-sided pain was there from the get-go, but it was strangely less severe.  It didn't spread to my back.  Just a real focal spot at the bottom of my right rib cage.  Around the 12 mile mark, though, I began to notice I was having pain on the left, too.  It was in my upper abdomen at this point.  And this happens sometimes, but usually the right side gives me more grief.  By the 13 mile mark, the pain in the left had moved lower, almost where you'd expect the ovary is.  It was stabbing.  Gripping.  It was bad, and it slowed me down markedly.  At this point, I really couldn't feel the right-sided pain anymore.  I don't know if it left or if it was simply overshadowed by the intense, stabbing pain on the left.  The left-sided pain did not stop until I stopped running.  But, anyway, I survived. 

The fact that it was so bad on the left, and so low, makes me wonder if a slipping rib could cause something like that.  The pain on the right fits with that perfectly, but I'm confused about my left-sided pain.  Anyway--I'll have my colonoscopy tomorrow, and that will be at least one step closer to finding out what's wrong.

A word of advice:  running a 17 miler while also taking laxatives in preparation for a colonoscopy is probably not a very good idea.  My apologies to all those trees.

Saturday, February 19, 2011

What a Slip Up

Last night, my friend Scott Breeden posted something on my Facebook wall.  He posted a link and said "Don't know why I didn't mention this to you earlier..."  The link was for information on a condition known as floating/slipping rib syndrome.  I'd never heard of it.  It almost sounded fake.  I read the link he sent me, and continued to Google it.  Susan Kuijken, a former FSU cross country and track standout, had this condition.  It greatly affected her running.  Her complaint was a frequent, severe right-sided "stitch."  Stabbing pain that came on no matter how slowly she went.  After several cortisone injections in the area, which did help, she ultimately had the slipping rib removed.  She runs pain free now. 

Slipping rib syndrome is quite uncommon and occurs in the 10th-12th ribs.  These are the ribs that are either "false" or "floating" in that they are not connected directly to the sternum.  Rather, the false ribs are connected via loose connective tissue, and the floating ones aren't connected to anything.  These ribs don't do well under extreme stress, and can become dislocated.  The 10th rib is usually the culprit.  Once dislocated from its connective tissue, the rib "slips" up and over the rib above it.  In doing so, it can also catch the diaphragm and the costal nerve.  The main symptoms are chest/upper abdominal pain and radiating lower back pain.  It's on the right side 70% of the time.  If severe, it can cause referred left shoulder pain.  The pain is dull/aching at rest and severe during exercise, especially high-impact sports.

Sound familiar?  It did to me.  But I haven't had any trauma.  Except--pregnancy is a cause.  Further, a rapid delivery is another cause.  Rowan was born in 3 hours.  As you can imagine, carrying a baby certainly puts a ton of stress on your ribs.  And I'm guessing that if you run through your pregnancy, there's even more.  I did both.

I'm not saying I have this.  I'm just saying this is the first thing I can read about and say "Oh, yeah, that's like what I have!"  I'm kind of baffled that no one has mentioned it to me.  It definitely needs to be investigated.  And guess what?  It's hard to diagnose.  Figures.  It won't show up on standard x-ray/CT scan.  It generally has to be diagnosed by a practitioner who is familiar with the rib cage and what position the ribs are supposed to be in.  Chiropractors and thoracic surgeons usually make the diagnosis.  Conservative treatment involves rest and nerve blocks.  The only cure is surgery.  If I have this--they can go ahead and sign me up for the surgery.  I'll be looking into finding a chiropractor to see in the next week.

I ran 12 today.  I was in a lot of pain during, as well as after.  But I survived.  17 tomorrow.

Friday, February 18, 2011

No Idea.

After my run yesterday, I continued to have quite a bit of abdominal/lower back pain throughout the evening.  It's a little better today, but still there.  I have seen several doctors about this.  First my GP, then my sports medicine doctor, and now the GI specialist.  When I initially saw my sports medicine doctor Dr. Weidenbener (hereafter "Dr. W"), he agreed my problem was probably pregnancy-related.  He's the one who hooked me up with Kent.  He scheduled me for a 3-week follow-up, and that was today.

Initially, I didn't know if I should even go.  I thought maybe I should wait until the colonoscopy.  But, at the last minute, I decided to go.  Rowan and I arrived there about 12:55 and my appointment was at 1:00.  The parking lot was EMPTY.  I've never seen it that way.  I sort of thought that was strange, but went in anyway.  The waiting room was also empty, and the secretary gave me a very strange look.  I told her who I was and that I was here to see Dr. W.  She told me that my appointment had been at 10:45, not 1:00.  And that the doctors don't see patients after noon on Fridays.  Great.  Perfect.  Then she told me to hang on a second.  She left and came back to tell me that he was still there dictating and that he'd see me.  So I got right in.

Dr. W and I go way back.  He's taken care of me a lot.  We don't always agree about my training, but he's always tried to help me.  What's more, he understands my mentality.  He knows that I get very anxious and that I suffer from catastrophic thinking.  When I saw him today, he was all smiles.  He commented on how cute Rowan is (and who can blame him), and said "So, are you feeling better?"  I had to tell him that, while I initially had a ton of relief from seeing Kent, the problem now seemed worse.  That it radiates around my back, between my shoulders, to the front of my left shoulder, and that it occurs with rest.  He was very surprised, as most people who see Kent get 100% better (and I still might).  He examined me.  He palpated my liver and it was VERY tender.  Then we just talked.  I vented my frustration.  He said that, if the colonoscopy is normal, we need to do a CT of the chest.  That's the one area we haven't investigated and it's possible that I'm getting referred pain from there, particularly since it's sometimes so intense right under the ribs.  There is a very, very, VERY small possibility that I could have something like a thoracic aortic aneurysm--but why all the sudden?  It would have to be congenital, as I don't have hypertension.  He also mentioned that the left shoulder pain is classic for diaphragm injury/irritation.  And the liver is right underneath it.  Could there be something going on there?  I know that Kent has focused on those areas a lot.

His final diagnosis was:  "I have no idea."  But he promises we'll find out.  He promised that before I could start crying and saying "I'll never run again!" as he probably expected.  "It might take time, but we'll find out.  And we'll fix it." 

He is going on vacation next week and said that he'll do some searching online to see what he can come up with.  He also wants my colonoscopy results faxed to his nurse, who can relay them to him while he's on vacation.  If my GI doesn't order the chest CT, he will (from New Mexico, where he'll be skiing).  And he thinks I should continue to see Kent.  And I agree--I don't think I should stop until he can't find anything.

I have 12 miles tomorrow and 17 on Sunday.  Not worried about pace at all.  Just need to survive the miles.

Thursday, February 17, 2011


I saw Kent, my PT, this morning for some more visceral manipulation.  If you remember--when I first saw Kent, I had IMMEDIATE and substantial relief from my pain.  Then it began to come back.  Every time I see him, something else is out of whack.  Today, it was my duodenum.

The duodenum is the segment of the small intestine that stems off the stomach.  It is also connected to the gallbladder, as the gallbladder secretes bile directly into the duodenum.  Kent found that the duodenum was somewhat stuck.  And he doesn't find that very often.  In fact, it's so rare that Kent had to go look up how to adjust it.  So he did that.  And while he did it, his hands were on the EXACT spot of my pain.  He remarked that he's had to adjust everything except the duodenum in me, so maybe this is "it."  The underlying problem of it all.  After that, he also found that my ileocecal valve was going the wrong way (again) and he fixed that.

I couldn't wait to run.  Tim and I went out for 10 miles, and Tim was going to be doing some speed work (fartlek workout while pushing a stroller).  My right side/back were still hurting, even after I'd seen Kent, but I didn't know how it'd go on the run.  It started okay and then got MUCH worse.  Right around 1.5 miles, the right side started.  By 2 miles, I was getting the intense referred left shoulder pain that I've had before.  By 3 miles, it was both sides, my right lower back, and the left shoulder.  I was in agony.  It literally felt like someone or something was attacking me while I ran.  I kept running, though.  Then, it got a bit better.  The shoulder let up, and it was just the right side.  It became tolerable.  Then, right around 5 miles, I had a stabbing pain in the right side that stopped me in my tracks.  We pulled to the side of the road and I pressed on the spot that hurt--it was right beneath my rib and it was extremely tender to the touch.  It subsided, I kept going.  It happened again around mile 8.  Subsided, and then stayed pretty mellow the last two miles.

So, the duodenum must not have been "it."  The way it works is that Kent will stop when he finds nothing abnormal--that's how we know we're done.  But every time I go, it' something else.  I'm hoping that some day soon I will go and that will be the adjustment that does it.  For now, I'm sentenced to run in pain.  In fact, I'm in pain all the time.  And I get sharp pains that radiate around the side and back even when I'm sitting on the couch.  It's bizarre, but something is definitely wrong with me.

Oh, I forgot to mention the wind during the run--20 mph headwind with 30 mph gusts.  Talk about adding insult to injury!

Wednesday, February 16, 2011


Today is Wednesday, and Wednesdays are my long days.  I teach every Wednesday morning for three hours, and every other Wednesday I head to Indianapolis immediately after to meet with my fellowship group at IUPUI.  Today was one of the every others.  I had to arrive to campus early this morning, an hour before the class I teach begins, because I was being interviewed for the IDS (Indiana Daily Student).

As interesting as I am, no, they're not doing a story on me.  Rather, they're doing one on my brother, Wes.  And they are doing one on him because they were doing one on Scott (our friend) regarding his running and interviewed Wes to learn more about Scott.  The girl writing the story found Wes so interesting she decided to do a spin-off of Scott's story but make Wes the focus of it.  Whew--complicated.  Wes was asked by the interviewer to identify someone who probably knows most about him--past and present.  That'd be me.  So I met with the journalist at 8 am this morning at the Starbucks in the Union (where they seem to be chronically out of sugar free vanilla syrup...could someone fix this please?).  She asked me a rather open-ended question to start things off, which was "What do you think running has done for Wes?"  I had to think about that because, in my mind, Wes has had two running lives--when he was in junior high/high school and now (including the past few years).  Those two lives have been very different as far as his experiences with them.  As I'm sure Wes won't mind me sharing--Wes is a former drug addict.  He's been completely sober for 3+ years.  She was interested in how that phase of his life affected my family and my relationship with my brother.  Many people know others who've struggled with addiction, and it literally turns a person you know and love into someone you don't even recognize.  That's what happened to Wes.  He was not Wes at all for those few years.  It's hard to describe how it affected us, other than to say it was life-altering.  There were certainly moments of anger, hopelessness, and despair for me.

I haven't revisited those memories in a very long time.  Because Wes is BACK.  He's the most sober person I know, and we both help each other face reality.  It's not always easy, especially for control freaks like us.  One thing Wes has taught me is that addiction is not about drugs.  Or alcohol or food or whatever one's vice may be.  It's about the way you think.  Wes had to change his thinking.  And while he (and I) will always have some neuroses, he now knows how to deal.  So what does all that have to do with his running?  I'm not sure.  But, as I told her today, Wes is most himself when he's running.  I am so much like my older brother in some ways that it is frightening...and I am so different in so many other ways.  Even though I've never been an addict or even smoked a cigarette, I, on some level, understand what Wes experienced.  And I couldn't be more proud and privileged to have him as my older (yes, he's older) brother.  While it did take some time, I now trust my brother completely and he is my very best friend.  So--I guess what I'm getting at is that if you know someone with an addiction, don't give up on that person just yet.  And by that I do NOT mean enable him or her.  I had to basically stop speaking to Wes to get him to treatment.  And the day I dropped him off at an inpatient facility, knowing full well I wouldn't see or hear from him for months, I felt immeasurable relief.

Okay--onto MY running.  I ran 12 yesterday.  The weather was nice but my pain was pretty bad, especially early on in the run.  Both sides of my abdomen.  Today I was in quite a bit of pain all day, particularly on the right side.  And it wrapped around to my lower back.  This is the first time it's gotten this bad when I've done no running (today is a rest day).  I kept feeling the urge to pull over during my drive to Indy to "stretch it out," even though I know whatever IT is cannot be stretched.  It's a constant pain, and I'm getting fed up with it.  I have to get some answers.

Monday, February 14, 2011

The Results are In

Heard from my GI doctor today.  My CT was..."unremarkable," aka "normal."  While I'm glad nothing really serious showed up, I'll admit to being disappointed that I still don't have a solid answer for what's causing my pain.  I wanted it to show something.  But it didn't.  I'm glad we did the CT, as now we've at least ruled out any kind of mass, hernia, or cyst.  The doctor would like to do a colonoscopy, as he's convinced the pain is somehow related to my colon.  As much as I don't look forward to that procedure, I'm going to do it.  Next Monday.  He asked that I run the day before so that the inflammation would be more likely to show up during the procedure.  I'm running 17 on Sunday, so that should do the trick.  If I have what he suspects--exercise-induced ischemic colitis--the inner lining of the colon should present with some damage.  He hoped that it might show up on the CT scan as thickening, but nothing did.  He told me that if the CT was normal we'd do a colonoscopy.  And if the CT was abnormal we'd do a colonscopy.  So I should have seen this coming.

If the colonoscopy is normal, I'm not sure how next to proceed.  My pain is very real, unbelievably frustrating, and extraordinarily peculiar.  It's not a running injury (I do take a bit of comfort in that) and I don't appear to be sick in any way.  I'm eerily reminded of my experience with compartment syndrome.  I had these intense symptoms that would reproduce about 1.5 miles into my run.  This pain does the same, and it's a pulling/squeezing feeling just like the compartment syndrome.  Oh, and no one knows what it is either.  Every doctor I see just tells me how interesting it is.  Just like they did with the compartment syndrome.  I remember the day, after months of struggling with it, I finally got a diagnosis for that condition.  While I was hit with the fact that, if I ever wanted to run more than 2 miles, I'd have to have double fasciotomies, I was overcome by joy.  Finally, an answer.  I'm hoping I can get that same feeling with this.  But it appears that it's going to be a process.

I had visceral manipulation done today.  Kent was hoping that I had been pain free over the weekend.  Though I wasn't, I told him I did manage a decent 20 miler.  Today he worked on my rectum (via pressing on my abdomen--not in the way you might think).  He's done that once before.  Presses down with his fingers through my abdominal wall.  It is extraordinarily tender, and apparently it's not supposed to be.  I felt it release and the pain subsided.  My rectum and right kidney were the only two issues today, and he fixed both of them.  The right kidney makes sense with the back pain I've been having.  But I'm confused as to why nothing showed up on the left, as I've been having pain there too.  Anyway--I still have the nagging pain on my right upper abdomen, and it wraps around my side and into my back on occasion. 

Today is a rest day and I'm scheduled for 12 tomorrow.  I also have my pre-op visit for the colonoscopy, which I'm pretty sure will consist of them telling me how to clean out my colon prior to the procedure.  Nice.  Anyway--onward.

Sunday, February 13, 2011

Buddha 20

Whew, what a run today.  The weather was beautiful--perfect for me.  I wore shorts for the first time in a long time.  I was initially planning on 17, but Emily was planning on 20.  I wanted to finish up with her, so this became a 20-miler for me.  The gang was all here:  me, Tim, Wes, Scott, Emily, Magnus, Kathy, dad, and Bill.  Tim, Wes, Bill, Scott, and Magnus are on some kind of quest to find the hardest courses in existence.  They were planning to take on a new route today.  I've been on that route in a car.  And, trust me, if it looks bad from a car--it's going to be horrifically bad on one's legs.  I asked Emily what she wanted to do.  She said it didn't matter.  Well--I had told dad and Kathy we were going 17.  So I felt obliged to make sure we were coming by the house at 17.  I told Emily we'd just do our normal, plus a 5-mile Buddha loop.  She agreed, and I was happy. I ran a hard 10 yesterday and was not looking to commit suicide on the route they were running.

So Tim, Scott, Magnus, Wes, and Bill were studying their map.  Well, we knew our route, so I, Kathy, Emily, and dad set off.  Nice, slow pace.  I knew my legs were going to be tired.  I'd done a quick (around 8 minute pace--trust me, it's quick out there) 10 miles on this very terrain yesterday.  I would pay for it today.  We headed through town, up the infamous I street hill (which I had, until today, actually started to kind of like).  The headwind was brutal initially.  Then, when we turned away from it, we got overheated. 

I had my camelbak on, and I was constantly hydrating.  Being very well hydrated does seem to make my abdominal pain a bit better, or it at least keeps it from getting too much worse during a run.  I'm just getting used to taking gels, too.  I took three today.  Probably didn't need three, but I'm trying to practice with them since I've never taken them in a race.  I really like vanilla Accel gels and Carboom apple ones (apple pie!).  Today, though, I decided to try a jet blackberry Gu.  Oh, man.  Horrific.  I mean they had to work to make that thing taste that bad.  Never again.

So we did our usual around-the-airport loop, but when we got to the airport turn, we went the other way.  Into Buddha.  Yes, there is a town called Buddha right next to Bedford.  And, at least in my mind now, it is famous for hills.  Steep uphills followed by even steeper downhills.  There was one flat stretch, in the bottoms, that spanned about a quarter mile.  Other than that, we were going up and down, up and down.  The downs were killing me more than the ups.  We finally emerged from Buddha around the 12 mile mark, and I could tell my legs were toast.  With 8 more hilly miles to go.  I hung on, but suffered on the hills.  Again, mainly the downhills.  For once, the pain in my abdomen was trumped by the pain in my legs.  I kind of had to smile at that.

We got to the base of the last major hill, Slaughter House Hill, around the 15 mile mark.  This hill is always, always bad.  It's a category 5 climb.  Not that long--just under a quarter mile.  But it's a beast.  The last few times I've run on it, I've been able to sort of scoot up it.  Not today.  No, sir.  It was all I could do to keep myself moving forward.  I think everyone else was feeling the same way, too.  We were getting closer to town, and I heard dad calling the horses (a barking noise he makes when his legs are telling him that it's time to stop).  He had toyed with the idea of maybe going 20 with us.  Then he said "All the sudden it feels 90 degrees out here."  I figured he'd not be joining us for the final three miles.  But I asked him anyway.  "No.  I'm only moving one foot in front of the other now because I know I'm almost done."  Kathy was looking VERY strong, despite having run 22 (yes, 22) miles the day before.  So I thought she might join us for the last 3.

We approached the house and, cruelly, we were a quarter mile short.  So dad would have to run past his car and around the block to get 17.  We did.  Kathy initially said she'd go with me and Emily for the final 3 miles but, after considering it for a moment, decided she better not push her luck.  I looked at Emily.  We were both tired.  "This is going to be a long three miles," she said.  I took that as a sign that she was just as beat as I was.  We decided to go slowly and simply get the miles in.  And these three miles we did in town, on the flatness.  For some reason, as soon as we started running on the flat stuff--my legs hurt WORSE.  Well, we made it.  20 done.  We finished up shortly after the guys did, and I was ever so glad we hadn't gone with them.  It sounded like a brutal course they were on.

We went to Casa Brava afterward to wash away the pain.  It worked.  Sort of.

Saturday, February 12, 2011

Sunshine and Survival

I have a really great husband.  And I'm not just saying that because Monday is Valentine's Day.  Our son, Rowan, sleeps from about 8:00 pm to 7:30 am.  Every weekend, Tim gets up with him at 7:30 and lets me sleep in.  Due to the seizure medication I take, coupled with training...I require a lot of sleep.  Sometimes hard to come by with two kids and a very busy schedule.  So, a public shout out to my husband for helping me get extra rest.

This morning, it was not too much extra rest, as I felt Rowan plop down beside me in bed at about 7:50.  Tim was going to run 12 miles with the group.  I would wait to do my run later.  We could have taken Rowan out in the stroller today, but Amelia was here too.  She slept to almost 10:00!

I had a great morning with my kids, and around 11:00 it was time to run.  Kathy was maybe going to join me, but Tim told me she was there for the group run and didn't contact me, so it didn't seem likely.  I headed out about 11:15 for ten miles.  As I left, I thought "That's short.  Just 10 miles?"  I love that feeling.  It was 37 degrees.  I wore capri tights and a long-sleeved shirt.  I was overdressed.  Two miles in, I was wishing I had on short sleeves.  Love that feeling, too.  The sun was vibrant.  The roads were dry.  It was not the gray, depressing, slushy atmosphere that I've become accustomed to as of late.

I headed out to do the county route--through town, out (or up) I-street, and then around a bunch of country (read:  hilly) roads.  Dealt with Mugsy the dog.  I've figured out he is actually a wimp.  If I just toss a rock his way he leaves me alone.  About a mile in the right-sided pain started.  It stayed with me the whole time, sometimes worse than others.  I felt a few twinges on the left, but it was pretty predominantly right-sided today.  Also went around my side and back.  I'd say it was a 5/10 today.  I really can't wait til we determine what this is.  It aches as I'm sitting here.  I know that running has not caused it, but it certainly exacerbates it.

I really love to run.  But being in consistent pain every time I'm out there has sucked the joy out of running for me.  I'm just surviving it for now.  It's extraordinarily frustrating because my legs--which have been my issue in the past--are completely healthy.  I'm training smart, I'm recovering.  I have no niggles.  And now this.  I'm not worried about speed.  I'm just trying to get the miles under me until I figure out what's going on.  It's definitely not a place I like being in, but it's the hand I've been dealt for right now.

I'm scheduled to go 17 tomorrow, but I think I might be doing 20.  Whatever the case, I'm looking forward to sleeping in a bit.

Friday, February 11, 2011

Double Waiting.

If you know me (or my older brother Wes), you know that there's one thing I (we) don't do very well.  That thing is waiting.  Now, we're not the types to flip out in a long check-out line or to jump you in line at a theme park.  We both can be very patient.  I have no problem spending a long time explaining something to a student.  Our impatience is distinct in that we're not total jerks when we have to wait for mundane things, or things that don't affect us personally.  However, if we, or something important to us, are threatened?  Look out.  We turn into instant gratification monsters.  Usually, the first thing that happens is that one of us (whichever is about to engage in catastrophic thinking) calls the other.  If there is no answer, the phone will ring incessantly for at least 20 minutes.  Frantic text messages will ensue.  If that doesn't work, our mom receives a pleading phone call ("Are you with Wes/Wendy, I need to talk to him/her!"), and she joins in trying to track down the other.  When the irrational thinker finally reaches his/her sibling, it goes something like this:  "Wes/Wendy, I'm dealing with a situation (which ALWAYS, ALWAYS has the characteristic of things simply not going my/his way in my/his timeframe).  Do you think my (life/running career/academic career/financial stability/relationship) is over?"  The one receiving the call knows the drill.  That one tells the other one that OF COURSE his/her life/running career/academic career/financial stability/relationship is not over and that everything will be okay.  All the while thinking "Whoa, I'm glad that's not happening to me.  I would FREAK OUT."  It's perfectly normal for this cycle to continue for several weeks over the exact same issue.  Well, my brother Wes has had quite a few phone calls lately about my running and my IRB troubles.  And despite the fact that I wish I had control over both those situations, I don't.  And that, my friends, drives this woman mad.

I had my CT scan yesterday, and they told me the results would be ready in 24 hours.  So, at 4:20 (I went 20 minutes past the 24-hour mark, thankyouverymuch), I called the doctor's office.  The results are in!  Except--my doctor is not.  And the nurse told me that he needs to go over the results with me.  Which means I have to wait until Monday to find out the results.   And to worry--I think she would have told me the results if they were normal.  However, that could just be their policy.  What if they lose my results?  What if my doctor gets sick and isn't in on Monday?  What if there's a fire?  Better call Wes.

I'm also waiting on the IRB situation.  My committee members are considering our next move.  I have a really good idea about how I think we can make them happy, which I emailed to my committee yesterday, but I haven't heard back.  So I can't DO anything about this situation.  I can stare at it, but I can't do anything.  And OF COURSE this happens over a weekend.  Their email inboxes will be so full of emails on Monday morning that they surely won't even read mine.  Wes?!

Lots of running this weekend--10 tomorrow, 17 on Sunday.

Thursday, February 10, 2011

Cold, Barium, and Frees

It's cold out today--did you notice?  My iPhone was displaying a whopping 2 degrees this morning.  Well, at least it wasn't windy.

I run twice on Thursdays, usually a total of 11-13 miles.  Today was 7 miles in the am, 4 in the pm.  I had to dress warm for this one.  Fleece-lined tights, running pants, warm running top, and my pink storm shelter jacket.  Ear wrap, hat, and my gloves.  Believe it or not, other than my face, I didn't get cold.  It was hard to blink toward the end, but that wasn't so bad. 

So, as of late, every time I head out the door to run my main thought and concern is "am I going to have that pain?"  I seem to always have it to some degree, but sometimes it's a lot more tolerable than others.  This morning was about as tolerable as it gets.  No left-sided pain, and on the right it wasn't too bad.  Funny thing, though--it moved.  Started in my abdomen and traveled around to my back.  It stayed put there for the duration.  As sad as it may sound, I'd have to say I prefer the back pain over the abdominal pain, though it's still very uncomfortable.

I had a CT scan today.  I went to see a GI specialist (was referred there after tests for my gallbladder showed zilch) earlier this week and he thinks that the pain I'm having may stem from my colon.  Some form of ischemic colon.  I'm not sold on that diagnosis, but I was happy to submit to a CT scan.  I know that there is SOMETHING going on inside of me, particularly on the right, and I really want to know what it is.  So I headed to Bloomington for that.  I had to drink two bottles of Barium prior.  As a nurse, I've administered a lot of Barium to a lot of patients.  Boy, do I feel guilty.  That was THE most disgusting thing I've ever ingested.  I love how the outside of the bottle says "Smooth, vanilla Barium milkshake."  Really?  Vanilla-flavored liquid concrete is more like it.  I felt nauseated immediately after finishing it, and I can tell you I never want to do that again.  The CT itself was quick.  I should have results by Monday, and hopefully by tomorrow.  Honestly, I hope it shows something.  I just need some closure on this.  It's been out of my control for a long time and, as a certified control-freak, I need to know what I'm dealing with.  My personal hell would be a bunch of personally-significant goings on over which I have no control.  Shudder.

I got home and had to quickly get ready to do my second run.  Was only 3.5 miles since I actually went 7.5 this morning.  The pain was much, much, MUCH worse during this run.  It was back to the stabbing, pulling, my-insides-are-being-squeezed pain.  Ugh.  3.5 miles of agony is what it was.  I got home and, to my surprise, the pain kept up that severely even AFTER I stopped running.  I was writhing on the floor, even.  It's better now, but I've never had it stick around beyond residual soreness.  I wonder if the Barium is responsible for that.

A good note about this run (must salvage something)--I wore my new 3.0 Frees for the first time.  I only wear Frees.  And when I say I only wear Frees...I mean I. Only. Wear. Frees.  I will run in nothing else.  Ever.  But, until now, I've never run in the 3.0s, which are the most minimalist Frees.  I haven't been able to find them, but the Indiana Running Company got some in last week, and I snatched a pair.  Well, I'm in love.  Even with stabbing, ripping abdominal pain I was getting a major crush on these shoes.  And over just 3.5 miles!  They are definitely more minimalist than the Free Runs, but they felt great.  I'll be easing them in slowly, though.

And I'm still at war with the IRB.  What else is new?

Wednesday, February 9, 2011

A Mixed Bag.

Parts of today were pretty great.  Other parts, not so much.

The good news first.  I gave my students their first major exam today.  I'm teaching a didactic critical care course at IU.  My students (60 total) are juniors.  I teach them all about the diseases that are encountered in critical care and, most importantly, medical and nursing interventions that should be used in caring for them.  It's not an easy course.  It requires an in-depth understanding of pathophysiology, medical interventions, and independent nursing practice.  The exam was hard.  I had succeeded in scaring the crap out of them about it two weeks ago.  They caught a break when IU closed last Wednesday, giving them an extra week to study.  Well, they must have.  The average was a solid B.  That is REALLY high for this exam and for this course in general.  I know the exam wasn't too easy.  They all looked dog tired, and now I know why...they studied their pants off.

After class, I had an appointment with my PT, Kent, who has been performing visceral manipulation on me.  Sound strange?  Yeah, it is.  I've been struggling with abdominal pain that feels similar to severe side stitches ever since having Rowan.  It's severe when I'm running and I feel it all the time (on the right) even when I'm not.  It's not my gallbladder, it's not a muscle idea what it is.  My sports med doc (Dr. Weidenbener of Bloomington Bone and Joint...he's awesome) referred me to Kent on the premise that maybe my internal organs got "messed up" during my pregnancy and have since become stuck that way.  What Kent does is very bizarre.  He "listens" to my organs with his hands.  Then he rearranges them based off of what he hears.  Believe me, I've never felt so desperate as a runner as I did the first time I was lying on that table and he was "listening" to my organs.  Boy, what I'll do to run.  I was a complete skeptic until I'd been a few times and my pain was about 90% gone.  Then, last weekend, out of nowhere, it came back.  So Kent's still working on me.  Today my stomach, liver, and cecum were out of whack.  I hope it works.  No running (or anything) today, but I have two runs tomorrow to test out Kent's latest work. 

The not-so-good news.  And it's not horrible, but disappointing.  My dissertation is a behavioral study.  Meaning it involves human subjects (well, I like to call them participants).  Which means that, before I can begin recruitment, my protocol has to be approved by the Institutional Review Board.  They're the people who make sure that things like Tuskegee don't happen all over again--that we researchers don't use and abuse people.  Well, they can be very difficult to deal with.  I had arranged the perfect recruitment strategy in collaboration with some physicians in Bloomington.  Flawless.  Well, IRB doesn't like it.  So this is going to mean considerable work/rearranging on my part.  And, if you know me, that's not good news.  Not the hard work part, but I'm a perfectionist and I absolutely LOATHE being delayed.  I ought to know better, though...just look at this blog title!   Anyway--my goal is to have that sorted out and resubmitted in a week.  Sigh.

The day ended at Starbucks (come to think of it--it started there, too).  I'm tutoring a PhD student from Salem.  He's having some difficulty in his research class and I'm helping to guide him through it.  So far, he's managing a solid A+.  I'm enjoying it.  Kids are in bed and Tim is off for a swim.  It's time to watch Supernanny.

Tuesday, February 8, 2011

Might as well...

"Girl, Interrupted" is the title of my running blog that I maintain via (plug for the V-Boards there).  However, most of my family and friends do not access the V-Boards, and thus I thought I'd make a hybrid blog which could be followed by one and all (or, as is more likely the case, hardly anyone!).  This will be a hybrid blog of sorts--training and life.  I think you'll find that training is a large part of my life.  I'm 28 years old and I have two children.  Amelia is 8 and a half and Rowan is 5 months.  I am a nurse--an RN with a Master's Degree (Clinical Nurse Specialist).  I'm finishing my PhD in nursing science and am scheduled to defend my dissertation in October of this year.  I teach part-time at the IU School of Nursing in Bloomington.  I love, love, LOVE teaching nursing students as well as conducting behavioral research.

This initial post will be mainly running-related, in order for those who don't know me well to get their bearings.  The title of this blog needs a bit of explanation.  While it refers to one of my favorite movies, it also refers to my sordid past with running.  I began running about 2.5 years ago.  I've always kept fit, but until I began getting chronic back injuries doing aerobics, I never ran.  Well, that's not totally true--I sprinted my junior year in high school.  Never put much effort into it.  I had gone to the cross country meeting that same year interested in joining the team, but was told by the coach that I was a sprinter and should run track, not cross.  So, I listened to her.  Big. Mistake.  For both of us.  Anyway--much later in my life I did a lot of aerobics.  My back didn't like that, though.  I was getting really frustrated being injured from the aerobics, so I decided to try something new.  Why not run?  Everyone else in my family does.  My dad has become somewhat of a local running legend (not for extreme speed--sorry dad--but because he's been actively racing in and around southern Indiana for many, many years), my brother Wes, and my brother Michael used to.  I joined a gym in Bedford.  They had a treadmill.  I started running 10 minutes at a time.  I remembered that I used to hear my dad talk about running an 8 minute pace on his easy days.  I vowed never to go more slowly than that.  I figured out what mph correlated to that, and set the treadmill to it.  7.5 mph for 10 minutes--nearly killed me the first few times.  I added time each week, until, only four weeks after I had begun the treadmill adventure, I was logging 50 miles a week on the thing.  50 quickly turned to 60...then to 70+ with speedwork.  I got fast.  My first ever 5K, after only having been running 5 weeks, was a 20:23.  Two months later I PR'd at the Persimmon Festival 5K with a 19:06.  And I won.  I won a few other 5Ks shortly after, but that's when the injuries hit.  Ruptured plantar fascia was the first big one.  Achilles tendonitis. I missed the Tecumseh Marathon in December of 2008 (would have been my first) due to these.  But what got me was bilateral exertional compartment syndrome.  Google it.  I developed this while training for the Indy Mini in late 2008.  The only fix is surgery--which I had in March of 2009.  Double fasciotomies to my lower extremities.  My pressures on the right were off the charts in terms of severity.

The fasciotomies worked.  Two months after surgery, I raced a grueling trail half marathon and, though it was slow for me, I won overall.  I was so excited to race again.  I set out to train for my first marathon, the 2009 Chicago marathon, four months after surgery.  I vowed to take a more moderate approach.  And I did, at first.  On my way to Chicago, I ran a 1:34:02 half in August quite comfortably as a pace run for Chicago (I was training at a 3:10 pace but planned to run 3:20).  Three weeks later, I suffered an overuse injury--a groin injury.  Long story short--it was a big one.  4 months of zero running before it was finally healed.  I did a lot of elliptical and a lot of spinning, but I didn't run Chicago.  I attended the race and watched my husband run an impressive 2:57.  But I had missed another marathon.  I was devastated--I had put my heart and soul into training and I was exceptionally fit.  I was in about 3:05-3:08 shape.  All down the drain.

After that injury, my husband (whom I will tell you about at some point, in case you don't know him) and I decided it was time for me to take time off from racing and to build what I certainly lacked--a base.  We were also planning, at some point in the near future, to have a baby.  This would be a good time, given that I wouldn't be doing any high-intensity training.  I ran through about 7 months of my pregnancy.  Completed a 10K (my first!), two half marathons, including the Indy Mini, and a trail relay.  In about my sixth month, I began having compartment syndrome symptoms in my right calf while running.  My right leg would cramp and go numb.  In the end, it ended up being completely pregnancy-related, but boy it scared me at the time.  After I stopped running while pregnant, I maintained fitness via about 12 hours of elliptical/spinning per week.  The day I delivered my son, Rowan, my resting heart rate was 39.  Lowest ever.

I resumed running about a month after his birth.  I'm training for the Eugene marathon in Eugene, Oregon on May 1.  Training is extremely conservative.  Relatively low mileage and absolutely no speed.  I'm injury free, but have some kind of internal condition that is causing some (often severe) abdominal pain while running.  It's gotten worse lately, and I'm getting it checked out.  It's extraordinarily frustrating...and I'll leave it at that.

Right now I'm running about 50 miles a week.  Most of it on the county roads of Lawrence County, which are a challenge.  But I'm learning to love them.  I ran 12 on them today.  I have a double run on Thursday (totaling 11 miles), 10 on Saturday, and a long of 17 on Sunday.  Most of my runs are alone, as Tim and I can't always run together.  We have a jogging stroller but it's far too cold right now to take the baby out. This Sunday I'm running with my friend Emily, and hoping that my other friend Kathy will join us.  My legendary dad might show up too.