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Wednesday, March 7, 2018

Healing time: metatarsal stress fracture

I'm feeling 100% in my foot by now. I'm over 13 weeks out from injury at this point, but I didn't feel totally normal until almost 12 weeks.

Here's the breakdown of the healing process:

Week 1: Sudden onset of pain out of nowhere. Went to MD the next day. Was told it was not a fracture, but was metatarsalgia, so I did as I was told and loaded up on NSAIDs all week.
Week 2: Did test run as the doctor instructed me, but it was not good at all. I felt my foot pop, and limped home in incredible pain. Immediately, bruising spread across my arch. The top of my foot was quite swollen.When I reported this to my doctor, he said, "Hm, did you actually take the NSAIDs like I said?"
At this point I decided not to go back to my doctor. There were two reasons: one, I was certain it was a fracture and I was certain it would heal with rest; two, this is not the first time this doctor has insisted that I was not injured and should run on a serious injury. I just think we aren't a good doctor-patient fit.
Weeks 3 - 5: In the boot! I couldn't bear weight without pain, so I borrowed a friend's boot and stayed off my feet as much as possible. The swelling and discoloration remained. I could use the elliptical as long as I kept my feet completely flat, so I started light exercise again.
Weeks 6 - 8: I was able to transition to hard shoes (clogs) instead of the boot. Pain began improving daily; first, no pain at night in bed; then no pain at rest; finally, no pain with movement or palpation.
Week 9: Tentative, short run-walks. No bone pain, but the rest of my foot felt "off" - swollen, discolored, irritated. Ran four short days.
Week 10: Was able to start shortening and then eliminating walk breaks. Located source of irritation: my foot is simply a different shape now. Until the bone callous totally resorbs, it doesn't fit into shoes the same way. Re-tying a looser shoe helped a lot.
Week 11: Back to normal running. Inflammation decreased, then vanished.
Week 12: Able to add short, easy speed.

Some key points here:

  • This was a bad fracture. Extent of bruising at the site indicates depth of crack; if it bruises, you cracked all the way through the compact bone and into the marrow. No doubt the test run one week post-injury is what did it.
  • I wore a boot for about three weeks. I actually felt like a hard, wooden-soled shoe was more protective of my foot; the flat bottom of the boot had less arch support than my orthopedic swedish clogs. I found that when my foot muscles fatigued, the boot couldn't support them, and my muscles tugged on the bone.
  • I did not use a bone stimulator, which would have been great to reduce healing time. 
  • I did load up on calcium. I also ate normally (which includes indulging a lot!), so I gained some weight, but I never want to decrease calories while bone is healing!
  • I did not take any NSAIDS after the first week. NSAIDS are detrimental to bone growth, and taking them for a week probably significantly delayed my healing.
  • Left foot still swollen in January
  • I returned to activity before I was 100% healed. I am not recommending this: I would talk to your doctor, but I disagree with total rest of a fractured body part. Bone growth and calcium incorporation is stimulated by impact and loading, so once a callous starts to form, some level of weight bearing and muscle usage is a good idea. 
I wish I could offer some secret tips to reduce the healing time of a stress fracture, but in my case, it took the full amount of time the the literature suggests for a metatarsal fracture. And I don't have any amazing success stories about returning to run in prime fitness, thanks for my dedication to the pool or elliptical. I came back completely out of shape! But that's ok. I'm in comeback mode now, and I've done this before. Fitness comes back!

Wednesday, February 21, 2018

Lenten Valentine's Day

Here we are, going out to dinner after promising to have no alcohol and no sugar for six weeks. Poor planning!

In addition to giving things up, this year I'm trying to add some things in: specifically, a walk with David after dinner on nights when we don't have other obligations, and a little art in my free time. I tend to waste free time, and often put off large art projects until I have a big chunk of available time, like the weekend. For lent, I'm just working on small little low-stress projects, and it's been fun so far! I wonder how many I'll complete in six weeks?
Four pieces so far! 

I cut some bristol board into small 4 or 5 inch squares to ensure that the projects are small and doable on a week night.

If you practice lent, what are your plans?

Saturday, February 17, 2018

Welcome, nephew!

My little brother Joey welcomed his second child this week!

HIs wife required an emergency C-section at 37 weeks, so this was slightly unexpected, but thankfully mother and baby are both just fine.

I can't wait to meet this little guy - and his sister, who, I am ashamed to say, I have still never met in person (in my defense, excuse the pun, they're military and keep moving around). Isn't he a cutie?

Friday, February 16, 2018

Sure wish I had something exciting to post

Nothing going on here, just working my way back to running...
My foot is better, but not "better". It's doing that annoying thing where it doesn't behave completely normally, and I panic and assume it's double-broken.
But it's not. I have been able to run without pain, and of course there is no pain with daily activities, but at night the top of my arch grows discolored! I can't figure out if it's mild swelling and inflammation, or if it's from wearing a shoe all day. My healed bone actually developed a large callous that changed the shape of my foot - my instep is higher now, because of this lump of bone - so shoes rub the area. But either way, it's freaking me out enough to keep my comeback slow. I am terrified to add mileage and end up stranded at mile 8 with a throbbing foot.

I assume that my foot will look more normal soon, but in the meantime I'm feeling my time off in other ways. I have to be careful not to put to much stress on any of my bones, not just the fractured one, since I probably lost some bone density while I was not doing much impact. I actually have been feeling a little iffy in my RIGHT foot, which I have thought since December may have a mild fracture or stress reaction of its own. I hope not, but I'm babying everything anyway.

But since hope springs eternal, I went ahead and registered for the Crescent City Classic 10k in 6 weeks, which isn't even a race I like. As if I can race in 6 weeks! Ah, ever the optimist. It will give me a goal as I comeback!

Sunday, February 4, 2018

Test run

Comeback shorts: I saved my Christmas
present from David - new Coeur Sports
shorts - for my first run back. 
Today, I am officially 8 weeks out from my foot injury, and I decided it was time for a test run. David and I enjoyed dinner with a good friend last night, who just so happened to be the head of surgery at Tulane for decades, and anatomy professor for even longer. I discussed my injury with him, and he suggested trying out a run. He was pretty confident that, after eight weeks, a bone callous would have formed.
I haven't had any pain all week, either with walking, the hop test, or when pressing on the fracture site. So I thought it was probably safe (honestly, I had been planning to wait one more week, since I read somewhere that you should wait two weeks after it doesn't hurt to press the fracture area - but I bumped it up on his recommendation).

Yay! Three miles, including walking intervals, and no pain. Now, I'm trying not to be too excited, because maybe I'll be in pain again later in the day: that has happened to me before after a comeback, and I was so disappointed. But I'm pretty hopeful that today was the first step on the road to recovery.

The cool thing was, I ran into the Power Milers headed back from their Sunday morning long runs. Ah! I'll be back to join them soon!

Sunday, January 28, 2018

It's carnival time!

Sneaky calendar is sneaky, and Mardi Gras is already upon us! Here we are, just a few weeks from Thoth Sunday, the day of David's parade. Today was the Thoth open house, a family-oriented day in which the krewe opens their den and everyone gets a preview of the parade's floats.
Glossary (let's just get this out of the way):
Krewe: a paid club, invitation only, that celebrates Mardi Gras, usually with a parade (but some don't actually parade).
Den: the warehouse that stores the floats before the parade. Events are also held here sometimes, like meetings or things like this open house. The Thoth den was built over and around old brick slave's quarters in order to preserve their history.
David's brother and his three boys on David's float

We took our nephews to see the floats, and they had fun eating burgers, climbing all over floats, dancing to the live band, and even playing with a little petting zoo in the corner. The food was for sale, but it was cheap ($1 beer, $3 burgers, etc.) and proceeds went to the krewe's charity beneficiaries; the event was free. Riders' dues pay for things like this. Because, yes, you pay to be in a krewe, and you pay for all your throws. I'll never get over this.

More glossary:
Throws: the crap you throw off a float. Mostly beads. But beads are usually called...beads. One string is called a "bead", like, "I caught a bead from David!"

Anyway, the boys had fun, and it was nice to see the floats before the mayhem of the parade to appreciate the theme. Every parade has a theme each year; this year, Thoth's theme is "This is how we roll." I had a little more time to make sense of the theme without it rolling on by - and I needed it, since some of them were...a stretch. David's float is "bankroll" themed, but the one that is "rolls of wrapping paper"? I'm pretty sure they were just re-using a Christmas float from a prior year!

Sunday, January 21, 2018

The Great Freeze of 2018

Last week, New Orleans ground to a halt as the city iced over for more than two days. Don't laugh at us: it's a big deal! With almost no insulated homes, no de-icing equipment, and a population entirely unprepared for such weather, we were in dire straits.
On Wednesday morning, we awoke to a snow day! It was really more of an ice day in my neighborhood, but I wanted to enjoy it anyway, so I bundled up (tights, two long-sleeved shirts, light jacket, hat, gloves) and did a whole loop around Audubon Park, the most I've walked since my injury (3.2 miles). It was beautiful, and quite empty (except for Drew Brees out playing with his kids!). I did get pretty cold by the time I got back, though - it was only 20 degrees.

Work was silent. No one could travel - the interstate was closed, and there was ice on the roads, and I guess people are just scared to drive on ice. Only two of my employees came in at all! I actually got off early on Wednesday, and that was when the real work started: trying to keep warm. Our floor furnace has been on the fritz for years now, and the repair guys keep telling us it's the thermostat - except, three thermostats later, the problem  persists. Right now the secret trick is to stomp violently near the unit, which usually makes it wooosh on (not a great solution for someone with a broken foot). David and I spent all day Wednesday and Thursday rushing from our side of the house to our landlady's - she was out of town, and we had to keep her heat on, too. With no insulation and pipes exposed to freezing air, it was a balancing act to keep the pipes from freezing. We succeeded, but many of our friends weren't so lucky - people who were at work all day and didn't run water all had burst pipes, with one friend having to replace twenty burst pipes!

We survived the freeze with just a few dead plants, but the city had a rough time: the water pressure dropped so low after so many pipes leaking plus so many pipes being left to run, that the city had to issue a boil order. We live in a third world country, so this is actually a regular occurrence for us. I think we had three or four boil orders last year! As a matter of fact, as I type this, we're being threatened with another boil advisory, as water pressure is still very low. Ah, the joys of NOLA living.

We rarely get hard freezes in New Orleans, and I can't ever remember there being so MANY freeze days - we might get one day every other year, but we've had four or five already this winter. This has been a season of extreme weather! What crazy weather have you had in your area?