Monday, April 4, 2011

Home Again.

And with consistent Internet access!  Brace yourself for a long blog post.  I arrived home from Florida yesterday afternoon.  I had planned to blog on the plane on the way home.  However, I sometimes suffer from severe motion sickness, as does Amelia.  In the last half hour of my flight on the way to Florida, I was hit with some of the worst motion sickness I've ever had.  I have the type that causes me to vomit, but the vomiting doesn't make me feel any better.  I didn't want to chance it on the way back, so I took a Dramamine (which I carry with me at all times).  And it makes me very sleepy.  So I slept the entire flight.

I have so much to report on, but let me first say a few things I learned about traveling. I've done a lot of traveling to conferences, but usually all the transportation is arranged and I'm with other people.  This was my first time traveling by myself, and organizing everything by myself.  Some things I learned:

-It is very, very, very beneficial to have a rental car.  It is also very, very, very beneficial to ask on Facebook about what you should/shouldn't buy when renting a car.  I posed this question and was told that I didn't need the extra insurance coverage they provided, and that I should not pre-pay fuel.  Sure enough, they tried to push this stuff on me.  I didn't do it, and I saved a lot of money.  Thank you, Facebook pals.

-The GPS I rented to go in the rental car saved my life while I was there.  Totally worth the $11/day.  I have GPS on my iPhone, but it's too dangerous to look at it while driving.  I actually now really want a Garmin GPS for my own car.

-Bring your own Splenda.  I had, for the first time, a Starbucks barista refuse to put 11 splenda in my cappuccino.  Yes, she refused.  Luckily, I had some emergency ones in my purse.

-Cheap hotels can be just as good/better than the expensive ones.  You'll find out more about this if you keep reading.

-Always take your Dramamine.  See above.

I landed in Tamp around 7:30 on Wednesday night.  I picked up my car (a Nissan Versa hatchback, with which I fell in love).   I had to make the 30 minute drive to St. Pete Beach.  The drive went well, except it was storming and I didn't have the foresight to learn how to use the Versa's wipers prior to getting on the interstate.  I couldn't figure them out, and suddenly I couldn't see anything.  I had to pull over on the interstate to find them.  Other than that, I loved the car.

I arrived at where I would be staying--Dirse Motel and Apartments.  It is right next to the biggest (and pinkest) hotel on the beach, the LeCesar Beach Resort.  The owner of the Dirse Motel, Jeanie, is a friend of Al's (the robot guy), and he had arranged for me to stay in an apartment that is part of her private residence.  I had spoken with her on the phone, and knew that she was Lithuanian.  I pulled up to her house, and I saw the shadow of a very round lady sitting on the porch.  She hurried over to my car and looked genuinely excited to see me.  "Velcome, velcome!"  I got out of the car.  "Oh, you is so small.  So small, like little girl.  Come in, come in!"  I told her I would drop my stuff and then needed to get some dinner.  She would have none of that.  She was like a character right out of a novel.  At 76, Jeanie is no spring chicken.  But she is one of those women who just never stops.  I went into her house and found a HUGE, and I mean HUGE, dinner waiting for me.  An entire loaf of bread.  Steak, salad, rice, papaya, and tea.

I can eat a lot.  I run a lot, and I love to eat.  I could not keep up with Jeanie.  Each time my plate got near empty, she instantly refilled it.  When I told her I was full, she pushed the plate toward me and said "You eat, no?"  She is one of the nicest people I've ever met.  And so I ate.  And ate.  Until finally she had mercy on me.  While I ate, she told me about how she runs this motel (which is actually 4 cottages) all by herself.  She does all the cleaning, all the bookkeeping.  Jeanie has never physically seen a computer.  I showed her a video of Rowan on my iPhone, and she was genuinely freaked out.  "How da baby get in de phone?!  Make happen again, make happen again!"  After I ate and amazed her with my iPhone, she told me that one of the other guests had left, so I could stay in one of the cottages.

I went to bed exhausted, bloated, and full of anticipation.  I couldn't wait to see Al.  He is an expert in muscles.  If you want to read about his story, and how he came to invent the robot, you can read about it here. I would have 3 days with him.  First, though, Jeanie cornered me and made me eat breakfast.  She had prepared, for me alone, two breakfast burritos, oatmeal, two bananas, toast, papaya, coffee, milk, and orange juice.  I did the best I could to eat, but only managed to eat a little less than half of it.

Day 1:
It was storming.  Badly.  And it was supposed to get a lot worse.  I arrived at the clinic at 8:00 am.  I met Al, and his assistant George, as soon as I got there.  Al was larger in stature than I'd anticipated, but other than that he was pretty much as I had imagined him.  He immediately began his assessment.  He had me stand, sit, lie down, bend over.  He kept mentioning things for George, his assistant, to note.  I heard the names of muscles, but other than that I was kind of unsure what was happening. 

Next, while I was lying on the robot table (basically like a massage table with a robot over it), he measured where my heels hit.  My left leg was longer.  I've always kind of known that, since as a teenager I remember having to cuff the left leg of my jeans under because it always appeared longer than the right.  Al explained to me that my left leg, as far as the bones in it, is not actually longer.  No--the muscles on the right side of my body are so contracted that they are, in effect, shortening that leg.  He found major tightness in the right iliacus, psoas, diaphragm, rib cage (between two of my ribs the intercostal space has completely disappeared), right popliteal muscle (behind the knee), and pectoralis major and minor.  Basically, the right side is a train wreck.  On the left, all he could find was a slight issue with the top of my quad.

But wait a second here.  Hold the phone.  My overuse injuries have been, 100% of the time, on my left side.  My left leg/ankle/foot are always causing me grief.  Why is it the normal side?  Because, Al said, that side has
 been forced to take a lot of extra load since my right side has been in a constant state of contraction.  "We'll fix that," he said.  Okay, now what about my abdominal pain?  He said that the abdominal pain must be as a result of the heightened state of contraction on the right side, and it was causing the psoas to spasm.  Okay, I'll buy that.

Then we started in with the robot.  It's not the R2D2 kind of thing you might be imagining.  Basically, you lie on a hydraulic massage table, and a robotic arm is positioned over you.  On the clinic model, there is a computer attached to the top of it.  Al programs it so it can travel along a muscle.  We started with my right psoas, and he set it to travel on it from my right iliacus up to where the psoas meets the diaphragm.  I lay there, and the probe began to come down into my psoas.  I cannot describe what it felt like other than to say that it was extremely painful.  It holds that constant pressure there a few seconds, recalculates something or other, and then goes in a bit deeper.  It does this over and over.  I was very uncomfortable the first minute or two, but it changed over time from pain to discomfort, then to pressure....despite the probe pressing harder and more deeply each time.

We did this routine on the above-mentioned muscles on my right side.  This took pretty much all morning.  Then we measured my legs again.  EQUAL.  You can't deny an objective measurement.  By lengthening the muscles on my right side, we got my left and right legs to match.  I was so impressed.  I left for lunch, and couldn't wait to get back.  However, during lunch, I got a little worried.  I still had my usual pain. He had turned that right psoas into puddy, and as I was walking from the car to the restaurant and back...I felt my normal ache.  Shouldn't it be gone?  Or at least better?

When I returned to the clinic, it was time for more treatment of the right-sided muscles.  I immediately told Al that the pain was still there.  He had me lie down and he felt my psoas--he could feel the stringy knot over it (which I've been feeling for months).  As much as he tried, he couldn't identify what that string was.  He thought maybe it was the psoas minor adhering to the psoas major.  Whatever it was, it wouldn't budge.  Not from his hands, nor the robot.  In order to keep me from being anxious, Al said to me "Give us more than one day.  We can fix this."  Everyone I've seen, apart from Dr. Kaeser, has told me they can fix me.  No one has.  And so, when someone tells me that, I certainly don't believe it.  But I was willing to keep trying.

We worked on my iliacus, and actually managed to get the right leg longer than the left (we fixed that by balancing the left).  But every time I'd just get up to use the bathroom, etc. the pain was still there.  Al said I must be stressed, and that was my stress point.  It was at that point that I began to get discouraged.  What is wrong with me is not caused by stress.  Now, I'm not saying Al is not good at what he does, or that he's some kind of quack.  He's not at all.  But he couldn't figure it out, but he wouldn't just come out and say it.  I tried to keep faith--maybe it wouldn't hurt when I ran.  The day came to an end, and I left.  I had planned to run 10 miles on the miles and miles of paved trails there.  However, the storm was now horrendous.  There was lightning, 50 mph winds, and hail.  I couldn't run in that.

I began to get angry.  I HAD to run.  Jeanie's place didn't have a treadmill, and it was potentially lethal to run outside.  I talked to Tim, and he told me to look for a YMCA.  I searched via my GPS, and I found one--21 miles away.  So I drove, through what the locals called the worst storm in 30 years, to this Y.  I was hoping they had an indoor track, but they didn't.  So I paid $10 to run on a treadmill.  I began my run with so much anticipation.  Would this be it?  The first time I could finally say--I'm pain free!  Well, it wasn't.  It was bad, actually, by the 2 mile mark.  I wanted to stop out of sheer frustration.  There I was, in a strange place, in the middle of a storm, surrounded by strangers who were enjoying their exercise, and I was about to explode.  Somehow, I kept running.  But I was, emotionally, at my lowest point since all this started.  I could see my face in the reflection from the TV screen attached to the treadmill.  I thought about how the people around me had no idea of the horror through which I was currently going.  I stared at myself.  And I became angry.  I hated looking at myself.  At that moment, I did not want to be aware of my own reality.  I wanted to escape and not experience this moment of utter disappointment, loss, and hopelessness.  But I kept running.

The pain spread to the left.  Then into my left shoulder.  I was so unbelievably angry.  Livid.  I began asking all the "Why me?" questions.  I indulged myself in catastrophic thinking for a few moments.  I'll never be able to run like other people.  I'll never be able to compete again.  I'll never maximize my potential or realize my running talent.  I might as well just quit.  Just stop right now.  It's over.  Hopeless.  No one will ever figure this out.  You are doomed.  But I kept going anyway.  I made it to 8 miles, and decided that was good enough.  I got off the treadmill in a daze.  I got into my car, completely unaware and unconcerned with the heinous storm around me.  And I bawled my eyes out.

I drove back to Jeanie's.  She met me with a smile.  It was all I could do not to break down.  She offered me food, which I declined.  I retreated to my cottage and immediately called Tim.  I so much needed him with me.  I have discovered, through this process, how emotionally dependent I am on him (which I guess is okay, since he's my husband).  He suggested I call Al.  I did, but had to leave a message.  I spoke again with Tim, with Wes, and my mom.  I was in utter despair, but they managed to calm me down.  I went straight to bed and the storm, symbolically, raged on.

Day 2:
Another huge breakfast with Jeanie, and off again.  Al was all smiles when I arrived at the clinic.  I know he expected that I had had a great run, and I also knew he hadn't yet heard my message.  "Well?" he asked, with great anticipation.  I kept my composure.  I began by telling him that my legs felt amazing (and they had...for the first time in over a year, my left ankle was not sore at all while I ran, and my toes didn't bang up against my shoes, as I was heel striking versus my usual toe striking).  Then I told him that I still had the pain.  He briefly showed a look of confusion, then had me hop up on the table.  "Your psoas, ilacus, and everything is tight again.  When you run, it must tighten up."  He worked quickly, and released them all again with the robot.  He was incredibly pleased with the results.  "So, you have to make sure you release these before you run, and after.  Who cares if you tighten up while you run, as long as you can loosen it back up after the run?"  I explained to him that, as it's so-called tightening during the run, that it hurts very, very badly.  And that is keeping me from being able to run the way I want to.  "Just stop during your run and treat it."  But what about races?  "You can stop and treat it during a race, just have a robot on the course."  I wanted to kick and scream.  Al knows muscles, but he wasn't getting this.  I explained again that what I needed was for that pain that occurred while running to go away.

At that point, though he didn't acknowledge it, I think Al understood what I was saying, as I could see the wheels turn in his head.  His robot did what it was supposed to do.  It did lengthen my muscles.  But it didn't stop the pain.

The second day was my training day.  I had decided to buy a robot (a much less expensive one) to take home with me so I could treat myself, and they had to train me to treat all of my problem areas.  We did it for about three hours, and it was very frustrating at first.  I had difficulty getting right on the muscles.  Al made it look so easy, but it wasn't.  Eventually, though, I felt comfortable.  After lunch, Al worked again on my right side, and a little on my left to make sure I was all evened out.

Then he wanted to watch me run.  I went outside and ran while he watched.  "Oh, look at that!" he said.  He explained that he saw two major flaws.  The first was that I wasn't using a cross arm motion--my left arm was going forward as my left leg did, when it should have been the opposite.  Second, my right elbow was crossing the center line.  At that moment, he was convinced that my running form, and particularly the right elbow crossing center, was the cause of my pain.  "That's putting torque on your psoas and diaphragm," he said.

We went inside and I was confused--if it's my running form, then why did it only happen right after my pregnancy?  Al says that's coincidence.  I've been running like that long enough that my psoas and diaphragm finally went into spasm.  It had nothing to do with the pregnancy.  But that's a problem--because I know it was caused by my pregnancy.  But Al was not convinced of that.  He is an expert (and he truly is) in muscles--he found glaring muscle abnormalities, he found problems with my running form that irritated those muscles, the pain happens while running--that must be the cause.

But it's not.  It's just not.  I've been running this way for a long time.  It may not be perfect, but most runners don't have perfect form.  And they don't feel as though they're being stabbed while they run.  I think he was thinking that my pain was of an overuse nature.  I have run through many, many, many overuse injuries.  I know what they feel like.  Now, they can hurt, but not like this.  I also had tried to explain to him that, when I press on the pain, and hold it, it diminishes greatly.  He said that's because I'm stretching the muscle.  But I think it's because I'm taking away the effects of gravity.  It aches all the time, but the impact of running brings out the beast.  And trails make it better--less impact.  But he could not see past his diagnosis.

And that's probably okay, because I don't think it was within the realm of possibility for him to take away my pain.  He knows his stuff.  My stuff just isn't his stuff.  Well, in part it is--I have a lot of muscle imbalances.  And there's a reason this is my first marathon--I keep getting horrible injuries.  I think what he found answers a lot of the question as far as why that kept happening to me.

I went back to Jeanie's and decided to run a few miles to see how I felt.  Maybe he was right.  I ran 4 miles, and they were some of the most painful I've had since this started.  The pain was worse.  Even though I half-expected it, I was devastated.  All of this was compounded by a deep missing of my husband and kids.  I called Tim and was hardly able to talk.  I wanted him there...I NEEDED him there.  I called my mom and asked her to please come to St. Pete Beach.  I needed someone with me when I went back to the clinic.  I was hysterical.  It was a new low.  In the end, I calmed down, and no one bought a plane ticket.  

The next day, I would only see Al briefly, as I was just picking up my robot.  Tim told me that, when I saw him again, I should try once more to explain how I was feeling.

Day 3
I wasn't supposed to see Al until 3 pm, so I slept in.   By 9 am I was headed to Fort de Soto park for a run.  It was hot and sunny.  10 miles were scheduled, but I had done 4 miles the day before.  That made up for the two miles I skipped Thursday and meant I only had to do 8 today.  I wasn't sure if I'd do 10 or 8.  As I was just about to start running, my phone rang and it was Al.  He wanted to come watch me run.  Obviously, he was still trying to figure all this out.  He was calling me on a Saturday morning to come watch me run again.

And so he arrived, after I'd run 3.5 miles, and I pointed right to where the pain was.  He immediately had me lie down on the ground and he palpated the spot (several people stopped to offer assistance--funny, neither he nor I considered how this might look).  "That," he said "is where the psoas fuses with the diaphragm."  The psoas and diaphragm are connected by a web of fascia, and actually become one muscle.  That's the worst spot of my pain.  We had a robot, so I treated my iliacus (which was tight again) and he watched me run.  Again, he could see that my right arm was crossing center.  And, again, he was convinced that it was causing the intense pain.  He gave me an assignment:  force myself to not allow the right arm to cross center while I run.  And he'd see me at 3.

So I did that.  I ran very slowly so that I could concentrate on my arm.  I didn't let it cross.  I even kept it at my side for a mile.  And still, I had pain.  If that arm is the cause, and I didn't even move it, then the pain should have been at least better.  I only went 8 miles.  It was really hot and I was just over it.  Then I bought a huge ice cream, sat on the beach, and waited to see Al again.

I went to pick up my robot (which I ended up shipping home because I didn't want to mess with the boxes...and it was cheaper to ship than to check the boxes as luggage).  Al watched me run once more.  He gave me another treatment.  He watched me run again.  He really, really, really wanted to be able to take the pain away.  He spent considerable time--much of it unpaid--trying to help me.  And he did, as I mentioned earlier.  But he couldn't get rid of the pain.  He says he's convinced if I fix my form the pain will go away.  Obviously, I don't think that's going to happen.  But I will use my robot faithfully.  It will allow me to run many more miles than I have been able to--it "undoes" all that running lots of miles does.

And that was the end of my visit.  The next morning, I bid farewell to the lovely Jeanie, and her lovely cottage on the beach for which she only charges $60/night.  Turned in the Versa, and headed home.  I returned home not under the circumstances I had envisioned.  I had imagined a celebration, and telling stories about how good I felt on my last run.  Instead, Tim and I had to come up with a plan as to what to try next.  

First, it is important for me to give up the notion that I could possibly be pain free by May 1.  That's just not feasible, and it stresses me out to have a deadline.  I will run Eugene.  I will wear my TENS and enjoy it as much as possible.  Beyond that, I can't plan anything for that race.  Second, I have an appointment with Dr. L (cortisone injection doctor) on Weds.  We obviously need to explore other options--a nerve block, possibly an injection into the diaphragm?  I don't know, but something.  Third, I need to see Dr. Steiner, another sports medicine doctor in Bloomington.  I've made an appointment for April 25th (he's good, so he's busy).  Finally, I think I'm at the point at which I want to see a surgeon.  Now, I'm not getting cut on before Eugene.  But, as my husband and brother can attest, I have always said "This will end with a cut."  And I'm more convinced of that now than ever.  Something has to be stuck to something else.  When I bounce, it hurts.  When I brace it, taking away the effects of gravity, it doesn't.  I hypothesize that my transverse colon, diaphragm, and psoas are somehow melded in a way they shouldn't be.  But this has gone on long enough.  Time to poke around in there and see what's up.  Because, I can assure you, something is very, very wrong.

For now I'm just going to finish up marathon training.  I will have my TENS on all my runs, just in case I need it, and it will certainly be with me on May 1.  Now begins the search for a VERY good surgeon.

Oh, and I did run yesterday when I got home.  17 miles in the heat and wind with Tim, Kathy, and Bill.  It wasn't too easy, but the pain was tolerable.  Bill had a very bad run (he sweats more than any human I've ever seen), but the rest of us finished strong, if tired.  22 miler next weekend and then--gasp--taper.  Onward.

No comments:

Post a Comment