My first mainly sedentary week has been hard mentally. I wish so much that I could go for a hike or run, but just walking around the grocery store makes my hip throb with pain, so that is not going to be a reality any time soon. I went swimming at the gym and did an upper-body weight workout. Both of those activities went okay, but it feels like all the amazing progress I made working out with my personal trainer is going to slip away.
When sadness and anxiety start to take over and I can’t deal with the stress using exercise, I often turn to my nature journal to lift my spirits. Somewhere in those moments when I am looking closely at the pattern of veins in a leaf, and my pen is moving over paper recording what I see, my mind finds peace. Expect to see many drawings in the weeks ahead!
For the past three days, I have been nervously awaiting my appointment with an orthopedic surgeon to find out about the injury I mentioned in my last blog post. I am so used to going to the doctor for digestive- and colon-related issues. It felt a bit unsettling to go in for something entirely new like a bone problem. And I was even more anxious because the pain had gotten a little worse over the past couple of days. It had been especially intense at night — even keeping me awake for several hours.
At the clinic, the orthopedic surgeon looked at my x-rays and examined the area of my injury. He thought the stress fracture was small enough that I could ditch the crutches (unless I was having pain) and just take it easy. He said soon I could try some light exercise such as swimming or maybe easy biking, and to listen to my body and stop something if it causes any discomfort. However, because I have been experiencing the worsening pain at night, he wants me to get an MRI in 7-10 days to rule out a few things that could be more serious.
I was so ecstatic as I walked out of the doctor’s office sans crutches. I have a huge appreciation for those who have dealt with them for long periods of time. Using crutches is incredibly tiring, and it was difficult to rely on others to constantly carry my stuff or bring me things. It is next to impossible to have anything in your hands with crutches. My coworkers joked that they were going to get me a cowbell to ring every time I needed help. Thanks goodness I won’t be needing that.
So I am relieved with the circumstances for now and will cross my fingers that nothing strange shows up on the MRI. I know I will still have to cancel some activities in the upcoming month or so as I heal up, but I am confident that the plans I made for later in the summer will stay intact even if I have to tone them down a notch.
For this weekend, sitting in the grass with my sketchbook still sounds just about right.
In my last post I wrote: Sitting in the stadium on my 40th birthday, I realized that I still had no idea what was around the corner. Well, today I witnessed how true this statement indeed is.
In mid-March, I started to experience some mild hip pain. It came out of nowhere during one of my most sedentary weeks. I hadn’t been running or hiking much and had mainly been swimming, doing Zumba and doing the workouts my trainer had recommended. I had gone snowboarding a few days prior, but had not pushed it because it was icy and I did not want to fall. I really don’t remember if I took any tumbles on that day–if I did they were insignificant. I thought maybe I had just stressed a hip muscle doing side planks at the gym. In a few days the pain was gone and I did my 5K run. My hip was sore enough to limp after the race, but the next day the joint felt perfectly fine. I took it easy for the next six days doing one aerobics class, yoga, stretches, core work and light weights. The next weekend I was feeling good enough to go on a five-mile trail run, but found that my hip hurt again afterwards. Due to my history of prednisone use and the osteopenia it caused, I decided to schedule an appointment in a week’s time with my doctor to have the hip looked at. I just wanted to be sure nothing strange was going on. I had also been dealing with some knee pain in the opposite leg and figured I would get that looked at too.
In the week or so waiting for my appointment, the hip pain completely disappeared. I went for a mellow three-mile trail run with no soreness afterwards. In fact, thinking whatever had been bugging me had healed up, I even considered cancelling my appointment. As luck would have it, a really busy work load last week left me too exhausted to head to the gym much except for some short core and upper body workouts.
On Monday, I finally got in to see the doctor, and she decided to order some x-rays. At the time she thought it would be okay to stick with my workouts until the results came back the next day as long as I didn’t do anything crazy. I was actually heading to Zumba class when her call must have come in telling me the results of the x-ray. Due to a glitch in my cell phone service, the message she left did not show up on my phone. It was only when I got to work the next morning and saw messages on my work phone and then finally showing up on my cell phone that I got a panicked feeling. I knew if the x-rays had shown nothing, she would not be trying to reach me so many times.
My stomach knotted up as I dialed in to get the various messages. As I heard my doctor’s words, that knot traveled up into my throat and turned into a lump: the x-rays showed a pelvic fracture. She told me to get some crutches as soon as possible and to put no weight on my left leg until I could get in to see an orthopedist later in the week. I cringed when I thought of all the jumping I had done in Zumba the night before… and all the other workouts I had done in the weeks since the subtle pain had begun. And then the tears came as I thought of all the plans that this news so swiftly destroyed and all the progress it had immediately halted. I knew this injury would take a lot of time to heal. My mind raced to all the unknowns and I found myself swallowed by that familiar feeling of being overwhelmed.
As the day went on, I started to feel better once the shock of the situation wore off. My coworkers gave me hugs and made me tea to make me feel better. I called Doug and my Dad on the phone and they managed to cheer me up. I also found out more specifics from my doctor. The fracture is small. It is in the front of my pelvis near the symphysis pubis. Though I really won’t know anything until I see the orthopedist on Friday, from what I gather from the tiny amount of research I have done is that these injuries heal with rest and refraining from weighting the leg during the recovery time. Then there will likely be rehab exercises.
Already my mind is gearing up to get me through this. Now that the tears are out, it is reminding me of all the things I can do like draw, and write and watch the beauty around me even if while sitting under a tree instead of hiking down a trail. In my last post, I also wrote that uncertainty is okay. And you know what? It is. I will find the strength to get through this challenge just as I did during my healing period after ostomy surgery.
Realizing that today is the Winter Solstice and has the shortest daylight period of the year, it is a fitting time to write about my recent nighttime jogging adventures with Doug. Just about every evening after work, we have strapped our headlamps to our noggins and hit the wide dirt trail near our house. Running by headlamp is a unique experience. There was one night that we saw four glowing eyes in the distance, and I froze in my tracks thinking they belonged to a couple of mountain lions coming down from the mesa near our house. As the animals approached, I was relieved to see that they were happy canines out for an evening stroll with their owner. Another night we saw a coyote trot across the trail, forming a silhouette against the dusky sky. We went right over to examine the tracks he left in the snow. Last night I got dizzy as giant snowflakes were illuminated by my headlamp, giving me the feeling that I was moving forward through outer space. Whether the sky is moonlit or pitch-black, temperatures are balmy or frigid, or clouds are misting rain or dumping snow, we will be out there. Lately, running and other exercise has taken on a new importance.
A couple of months ago, I went for my yearly physical. Because of my prednisone use over the past few years, my physician scheduled me for a bone density test. Within a week, the results came back showing that I have osteopenia, which is weakening of the bones and can be a precursor to osteoporosis. My doctors at the hospital last fall had warned me that this would be a possibility since I had been on such high doses of steroids while trying to get my flare under control, so this news wasn’t a huge surprise to me. Still, it was not something an active person like myself wanted to hear.
I first discovered the amazing healing powers of prednisone about a year after being diagnosed with ulcerative colitis. A bad flare had led me to the ER where I was prescribed a 40mg taper of the steroid. I couldn’t believe how fast it worked. Within 4 days my symptoms completely cleared up. I was even able to climb the 14,255-foot Longs Peak two weeks later. However, foreshadowing what would happen when I took prednisone in the future, my symptoms returned when I got down to 10mg. My doctor added another tapering dose which finally ended the flare up. Over the years, it seemed like each time I needed prednisone, it became less and less effective. During my final flare, even high doses did little to control the severe ulcerative colitis.
As surreal as it can be to run the trail near my house a night, it is even crazier to think that such a small period of time on steroids could have had such a long-term effect on my body. I can’t remember the exact dosages and times I was on prednisone over the years, but the following list provides my best recollection:
July 2007- a 40mg taper over about a month’s time and then a few more weeks added when the flare returned
August 2008: a 40mg taper over about a month’s time
April 2009: a 20mg taper over two week’s time
August 2010: started a 40mg taper and ended up being on varying doses of oral and IV steroids for the next 3.5 months, with the highest dose being 80mg
After tallying these times up, it turns out that 6-7 months of my 39+ years of life was spent on varying dosages of steroids. It doesn’t seem like much in the grand scheme of things, but was enough to effect my bones. I know that each of those doses was necessary to get my disease under control at the time, but I am glad that, barring any other health issues, I will not need to take prednisone anymore.
This brings me back to the topic of running at night. Because I am no longer on steroids, my physician thinks that my osteopenia might be reversible with calcium and vitamin D supplementation as well as at least 30 minutes of daily weight-bearing exercise like running. In three years I will be tested again and hopefully it will show less bone weakness. In the middle of the winter when days are short, running at night provides a convenient way for me to get exercise. Though heading to the gym is also a possibility, I have always enjoyed the simplicity of grabbing my running shoes and heading right out my front door.
In years past, I would come up with all kinds of excuses as to why I couldn’t stick to my workout routine in the winter… it was too cold, too icy, too dark and my schedule too busy. But those rationalizations no longer sit well with me. Excuses do not strengthen bones.