Friday, August 19, 2011

Catch Up: School, Running, Dr. Casey, and High Rock

Yikes.  What a negligent blogger I am.  If I haven't lost you, my audience, let me try to play catch up.

Let's start with school.  That's why I've been negligent.  I'm working on--no, I'm finishing--my dissertation.  The study I was doing for my dissertation is done.  I've interviewed all my participants and I've pored over the data for the last couple of months.  Now it's just time to write it up.  The first three chapters are finished (more or less--waiting for comments on chapter three).  I'm in the midst of writing chapter four.

I just realized you may not be familiar with dissertation chapters.  Let me fill you in.  There are five chapters.  The first is an introduction.  The second is a review of the literature (a very long chapter).  The third describes the methodology used in carrying out the study (how did you get your participants, what did you do with them, etc.).  The fourth chapter contains the results of your analysis.  And chapter five is the discussion chapter--what do your findings mean in the context of existing scientific literature?

Chapter five is the most difficult.  I say that even though I have not yet written it.  I have it outlined, but not written.  It is in this chapter that you must compare/contrast your findings to those of other scientists.  And you must demonstrate what your findings mean and what should be done based on them.  Basically, you have to convince a lot of smart people that what you did mattered.

My dissertation must be finished by Sept. 27 so that I can defend Oct. 27.  I will do it.  And then I'm going to Disney World.

Okay...running.  Running has been going well.  I'm up to 72 (maybe 75, depending on how the weekend goes) miles for this week, and I'm not injured.  I have little aches and pains, but they go away.  I've not done any kind of speed or pace work this week, but I did a 6 mile pace run last week with Wes.  I averaged 7:02 for the six miles, and it didn't feel difficult.  My marathon pace is 7:15, so it should feel even easier at the beginning of the race.  I felt like I could hold the 7:00 pace for 13 miles...I could have kept going another 7 or 8.  It's after 22 or so that I ran into (very minor) problems in Eugene.  That's an endurance problem, not a speed one.

I have been doing a TON of long runs, including a weekly 20, this cycle.  My legs are good and tired but I feel like I could run forever.  I'm hoping this strategy pays off in October.  We'll see. to the meat of the post (took me a while to get there, huh?).  If you remember, Dr. Casey ordered an MRI of my spine, which was normal.  She then went to the scientific literature (bravo!) and thought that maybe I had something called abdominal cutaneous nerve entrapment syndrome--a rare condition in which a nerve or nerves in the abdomen becomes "stuck" in the fascia over the muscle or in the cutaneous tissue.  The only way to diagnose it, though, is via a musculoskeletal ultrasound.

These are not done just anywhere.  She was sure someone in Indy probably did them, but she wanted to be there for the test and also wanted me to see Dr. Grant--a specialist at Northwestern who is the guru of this type of ultrasound.  So, this Wednesday, Tim and I headed up to Northwestern.

Whenever I go get these tests done, I feel famous.  They're all waiting for me and have all heard of me.  Everyone wants to be the one to figure out what the heck is wrong with me.  Dr. Grant was no different.  He couldn't wait to get that ultrasound probe on my belly.  Dr. Casey joined us (she doesn't even work there--she came over just to watch) and they began searching for some glaring problem.

There wasn't one.  There was no large nerve branch entrapped.  There was, however, a small area of abnormality located in the same line as my pain.  My pain is not just in one spot. It is sort of in a line...up and down.  This abnormality was in the middle of this line.  They assume it must be a nerve, but neither of them could figure out which nerve it was.

Dr. Grant injected the area with Lidocaine.  And then they sent me off to run.  I ran two miles and never had ANY right-sided pain (where the injection was).  I mean...none.  At all.  The injection worked.  But I still had pain on the left.  He hadn't seen anything on the left, but feels that whatever it is might be too small to see on ultrasound, as the one on the right was barely visible.

So it appears that I do have the rare condition of abdominal cutaneous nerve entrapment syndrome.  It is usually caused by trauma to the abdomen or post-surgically when a nerve gets tied up into an incision.  In my case, it was pregnancy.  This is not documented in the literature.  But I'm sure it will be now.

The plan is to try injecting a steroid into the area and see if that relief lasts longer.  But Dr. Grant is the only one who can do it, and he's 5 hours away.  Another option is surgery to free the entrapped nerves.  This would be a permanent solution, and much like my compartment syndrome surgery.  The surgeon would go in, clear away the fascia from the affected nerve(s), and it should never bother me again.  I'm waiting for Dr. Casey's opinion on that.

So that's where I am right now.  I am so thankful for Dr. Casey, and I feel as though I have been led to her.  She is a wonderful, caring person who has taken an interest in me.  Only Dr. Kaeser shares her compassion.  Interesting that they're both in Chicago.

Oh, another thing I forgot to mention---Tim and I have begun attending High Rock church in Bloomington.  My friend Rachel goes there and that's how I heard about it.  It is an amazing place with wonderful people.  The teaching is intellectual with a mix of spirituality--it's perfect for an analytical mind like mine.  And, I must say, my life has improved since I've become committed to going there.  If you live in the Bloomington area, you should check it out.  Scott Joseph is the lead pastor and he teaches in a way I've never experienced.  All I can say is...he makes it all make sense.

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