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Friday, March 20, 2020

The problem with blogging...

By the time I get around to putting all my wayward thoughts together, the entire world has changed!
I started and erased this post half a dozen times already, but I have a quiet minute now to collect myself and put up some updates. So here goes!

COVID19
Here in NOLA we're a hot spot, no doubt thanks to Mardi Gras, which brought travelers, germs, and crowds together for weeks. But at this point, most of the country has adopted the restrictions that were so stringent to me a few days ago. Our community is doing its best, but in addition to a very rapid transmission rate, we are financially hurting. This crisis will truly cripple New Orleans: we rely heavily on tourism and the service industry. Everything New Orleans is famous for is banned now!

How I've modified work:
jeans day every day! 
How we're working: I am still at work, in fact I'm busy. Most of my week was spent trying to convince insurance companies to pay for costly oral chemotherapy. With our hospitals treating COVID19 patients, they're no longer safe places for high-risk cancer patients, and our goal was to discharge them on oral treatments that most closely match their current chemotherapy. A lot of this was off-label, and I had to work hard to get our patients covered. This is all new territory, so insurance companies don't have guidelines in place for when a patient has to be treated at home because they're immunocompromised and our hospital has COVID19 positive patients. Nor are we sure we're even making the best choices for these patients. I admire how much faith they have in us, and how creative the healthcare team has been in making sure these most-vulnerable patients are safe and treated!
David is working from home four out of five workdays, and the baby is still at daycare, which has stayed open to serve healthcare workers.
Still getting super sweaty in the park
(it has been in the 80's here)

How we're worshiping: Our church will livestream Sunday's service. Bible study was via Zoom, and church is posting daily prayers and liturgy on Youtube. It's not the same, but I admit the Zoom was not bad at all! A little hard to converse, but we made it work!

How we're socializing: Besides social media, we are:
Spending more time on the porch. Our house is raised, so we're well over 6 feet from any passers-by!
Using FaceTime. I never got into FaceTime, usually because I am driving when I call people, but I like the extra humanity it provides right now.
Checking in more often. Everyone feels isolated, so I am making sure to call or text friends more often than normal.
I plan to also arrange for a neighborhood porch dinner - we can all socialize over dinner from somewhat afar. Our houses are close enough together to make this work!

How we're running: The only thing that has changed is the lack of group workout. We are too large of a group to be legal! I definitely miss that, but I do love still having the park available to get my running in. Actually, the park is packed lately. Maybe we will all be more fit when this is all under control!

I hope you and your family stay safe and healthy through this crisis, and that you have the emotional support you need to stay sane. Be well!


Friday, March 6, 2020

February running

You don't get a recap of January running, because you know what I was doing in January? Three things: being miserably overdue, having a baby, and then recovering from said baby. Yeah, I ran some scattered miles, but they were mental health miles! (There were some standout runs in January, though: running 1.5 miles while in labor, 48 hours before he was finally born, and a 3 miler 13 days after he was born - an early, but much-needed, run!)

Honestly, February wasn't much better. The first few weeks to months of a baby's life are just so full of changes, it's hard to get a schedule down. Our little guy struggled with eating and gaining weight at first, too (he is fine now - he did PT with the sweetest physical therapist ever and learned how to suck!) so that monopolized a lot of my time. I had to breastfeed, pump, bottle feed every single time he ate, so that took up a good part of my day (also - I hated it; I wanted to be cuddling my baby but I had to toss him on a boppy and pump constantly!). So running took a back seat.
car pump life (on the way to track)

I ran 98 miles in February, and that included:

- My longest run, ten miles with the stroller
- My first workout back on the track, which was as bad as I expected. I modified the workout, and ended up with 8x400 at 5k pace with 400 jog. I ran an average of 1:35, although it was clear I was out of touch with my pacing, as I ranged from 1:32 to 1:39.
- LOTS of short, 3 mile runs
- Several big breaks, including while on a business trip (handling a baby on a business trip was tough enough; I didn't think I could also exercise, but as it turned out I probably could have. David came with me to watch baby, and they were both angels!).

I am hoping to gain some consistency in March. I don't want to jinx myself by putting it in writing, but our schedule has stabilized now that baby is sleeping through the night! When he turned seven weeks old, he started daycare (I went back to work at six weeks, but we were traveling for my trip that first week, and the other days David kept him so we wouldn't have to pay a full month for just a few days). I don't know if daycare just exhausts him (he takes short naps there!) or if it's related to his improved eating, or if it's just related to his age, but he is now sleeping 9pm to 6am. Actually, it's really about 7:30 to 6, but I force him to wake up and eat at 9. He wouldn't wake if I didn't get him up, and getting him awake enough to eat is a challenge! He will (cutely) look up at me and smile before promptly falling back asleep.

With this lovely new schedule - and it is indeed lovely! - we have some flexibility in our schedule again. The 6am wake up is a little restrictive, as I have to either be back from my run by then to feed him, or leave after he eats (which only gives me about an hour to run, even if I am totally ready to go before he gets up). But I can't complain at all. This week we have been doing feed at 6, then I go running at around 6:40, and David takes baby in the jogging stroller. So far it has worked out great! He loves the stroller, and usually falls asleep near the end up the run, just in time for his first nap of the day. And I can get a quality run in while he's with his dad. I'm crossing my fingers that his night schedule sticks: he's been at it all week now, so I hope it's not a fluke!





Thursday, February 20, 2020

Welcome, baby

He's finally here - my little miracle baby! We had a little boy five weeks ago, a full week and a half late (oooooof). The labor and delivery was a little tricky with some serious complications, but we both emerged healthy at the end. I will require surgery for the uterine mass later, but we already knew that, right? The good news is that I had an MRI immediately post-delivery, and not only does it now appear to be a fibroid (not cancer), but also stable enough that we can delay surgery until perfusion to the site has reduced (assuming it does, otherwise, yikes).
Baby is healthy, except for a watch-and-wait kidney condition which seems pretty mild to me, and of course his total inability to eat! He just doesn't breastfeed well, so we've been doing a combination of breastfeeding, pumping, and bottle feeding. Phew! It's exhausting!

Now anyway. On to the stuff that matters: running!
I will confess that I returned to running early, at 13 days postpartum, actually. I needed to get out of the house and clear my head! And I felt good. Well, weak and very anemic, but that was to be expected. Since then, I've been only able to run some short miles, mostly due to a not-so-stable baby schedule plus just being plain old tired. I've now been officially cleared to run, but honestly, I think that is more a personal decision than something a healthcare provider can tell you. I was most worried about pelvic floor issues, but I have had no such problems at all, thankfully.
Heading out for my first run back since baby!

Running since baby:

Distance: The furthest I have run is 8 miles so far. I've mostly been doing a 4.5 mile route.
Pace: My easy pace is still in the 10's. I did one stroller run and pace was 9:53, which was actually a pleasant surprise since it felt like 13's!
Mileage: I've run 90 miles since having the baby 5 weeks ago, so - averaging a whopping 18 miles per week. But since actually returning to running, it's been about 25 miles per week.
Injuries: During pregnancy, I tore my posterior tibialis tendon. That is mostly healed, although still sore on occasion. It just took time. I also had excruciating lower back pain at the end of the pregnancy that totally vanished as soon as I gave birth! I also had a painful SI joint, but that is almost totally gone, too (once in a long while it feels stiff, but it hasn't bothered me running). My hips do not feel 100%, but...they never really do. I am carving out time for hip exercises to maintain some strength as my pelvis settles back in to semi-normal shape.
Races: You know, I haven't signed up for anything, and I think that was the right decision for now. First I need to navigate the return to work! Then I can look more closely at the upcoming race schedule. Right now I need to slowly regain my strength, anyway.



Monday, December 30, 2019

The end.

It looks like running is over for me for the foreseeable future! About two weeks before my due date, I started having really bad SI joint and lower back pain. Running doesn't help it at all, so it's on the shelf!
After the pain started, I did try one short 3 mile run/walk. It wasn't the worse pain in the world, but it just didn't seem like a good idea to me, so I decided against future runs (most annoying part of this run is that I planned to just enjoy one last excursion in the park, sort of saying "farewell for now" before many weeks off...and instead ran into an acquaintance who talked my ear off the whole time and made dire predictions about my running future postpartum).
So that's the end of running. I ran about 1550 miles pregnant, most of which were frankly miserable, and I do hope I can exercise some self-control when  I come back so I don't permanently damage my pelvic floor.
Speaking of which, I can get a referral to a pelvic floor specialist who can help me rehab and return to running with a personalized timeline, so that's the plan!

I've avoided registering for any 2020 races so far, but the bug to race is definitely there - I'm thinking the Crescent City Classic in April would be a nice comeback race. It's just 10k so I should be able to swing it!

Thursday, December 19, 2019

Running clothes for pregnancy

I had to do some wardrobe updates to keep running while pregnant. I wasn't happy about it (you know I'm cheap!), but I had no choice.

First trimester:
I actually lost weight in my first trimester because I was very, very sick. However, I still needed to size up in bras! I started out by buying some slightly larger size smalls: I find that Champion's most basic bras are not only really cheap (I got some for $3.99!), they also tend to be roomy. The Champion Absolute in my usual size worked for the first trimester. Other than that, I didn't need new clothes, even though I was already showing (due to my incarcerated uterus, I had a visible baby bump at seven weeks....yeah, that was stupid). Luckily, few of my running tops were fitted, all my shorts have some stretch, and as the weather warmed up, I usually just ran in a bra, anyway.

Second trimester:
Bam, weight gain. Between weeks 10 and 28, I gained THIRTY pounds (total - just 20 net thanks to weight loss early - but still, that's a lot of weight gain!). By the end of the second trimester, I was definitely too big for some of my old clothes.

  • Bras: I now had to size up to mediums. I bought a few basic Nike Pro sports bras on Ebay because they have comfortable tape bands across the rib cage. I also was given two Brooks bras that were 34C and they fit, too, although the band actually felt tight!
  • Tops: Ugh, nothing fit. I had a few flowy tops I could wear, but they were snug in the chest. I mostly ran shirtless since my second trimester was in the heat of summer anyway.
  • Shorts: At first, I was able to switch to some of my drawstring-waist shorts and loosen up the tie. But my shorts size changed - I tend to gain weight in my butt anyway, and add to that an expanding pelvis - well, soon most of my shorts were too tight. I bought a pair of new shorts I thought might work, since rumor has it they are stretchy and run large: these. They were also cheap...but they didn't work. The waist was too tight to stretch over the bump, and they chafed. I bought a few mediums, but they had too much extra fabric in the front. I ended up sticking with my all-time favorite shorts, the Coeur Sports run short, which are stretchy and roomy. I could tuck the waistband under my stomach with no problem. I just wore my regular size - no need to buy anything new.
  • Shoes: I had a ton of swelling in my legs and feet starting in my second trimester. It was the worst after standing all day or sleeping all night - so, you know, early morning or after work, the two times I run. Naturally. I was able to accommodate the swelling by re-lacing, and my shoe size didn't change.
Tights under the belly...shirt stretched within an
inch of its life. Eight months here. 

Third Trimester: 
I didn't run all that much in the third trimester, because I had a freak pregnancy tendon injury. Once I figured out how to tape it for stability, I started to run again, but then my SI joints started giving me hip pain. I finally got that under control, only to immediately get a terrible cold. In the last three months of pregnancy, I've run 291 miles to date. That's less than I ran in the single month of March! But when I did run, clothes got complicated. The weather got colder, and I got bigger, and not a lot fit! 
When it was still warm enough, I ran in shorts, and my Coeur Sports shorts still fit. But for colder weather, I tried to wear my regular tights pushed under my belly and ended up with a cold strip of stomach. My long-sleeved running shirts were tight and too short. But by now I am not about to buy some larger clothes, so I am just muscling through, even though I look ridiculous! 

Suggestions: 
  • Senita makes inexpensive maternity wear that would have been a good purchase early in my pregnancy. By the time I discovered them, I didn't feel it was worth it. They do also have some nursing tops and bras - good to know! 
  • Depending on where and how you gain weight, you might be able to swing your regular clothes, at least for trimesters one and two!
  • Except bras...you'll probably want new bras...I bought most of my sized-up bras used to save money, since I don't know what size I will end up. 
  • Many people say that your shoe size will change during pregnancy, so it's probably a good idea to get re-sized at a running store. Mine didn't, however. Unless it changes in the last few weeks here!
  • I did not use a belly support band, even though many people suggested it. I never felt I needed one, but I did buy one early on. I have NO IDEA how you are supposed to run or workout in these things. They're uncomfortable and have a weird, restrictive fit - like I am not sure how you could run at all with one on; they sit across your hips which you'll be trying to move, I assume! This is the one I got, and now I need to sell it on Ebay (which is where I bought it to begin with)! 
  • I chafed in weird places, like my waistband, where I normally wouldn't. Be careful!


Wednesday, December 4, 2019

Turkey Day "race' 2019...in which I managed to finish 5 miles

With a posterior tibial tendon tear, wonky hips, and almost 8 months of pregnancy, running Turkey Day would be a bad idea for me. BUT. I had already registered, and I really hated the thought of missing that race. Even though this is almost always a bad race for me (including last year's water contamination disaster!), I love seeing so many friends on Thanksgiving morning. This race is big, and the whole city comes out to run or walk, it seems.

I've been in physical therapy for my tendon, but healing is progressing very, very slowly. It's like my body is building something new instead of repairing, haha. I've been injured for over a month, and the pain is only slightly less at rest and still the same with activity. The area remains swollen and discolored, as well. My doctor pointed out that the etiology of the tear was probably my constant calf cramps as I sleep: combined with a tendon weakened by relaxin, the tear was unavoidable. That would explain how I woke up with this injury, and also part of the reason why it won't heal: my calves continue to cramp all night!

Despite my minimal progress, my therapist suggested I tape my ankle if I really wanted to race. I have been doing just a minute or two on the treadmill in PT to test the tendon, and if I run with it taped, it really doesn't hurt that much. I've actually gradually moved to athletic tape plus an elastic arch wrap instead of a boot or brace. It's a lot less cumbersome, and I think it's about the same support as the brace and much better than the boot, which I can't get tight enough to support the tendon.

So on race day, I went ahead and taped my ankle and got my stuff together, including a dead Garmin that I had to charge in the car! We found parking and headed to the start pretty late, since no way was I going to warm up: I hadn't been running, my ankle was injured, and my hips and SI joints have been killing me. Five miles would be MORE than enough! Every time I've raced pregnant, I've moved further and further back from the start. On Thanksgiving I slunk back to the row containing people-who-run-races-in-sweatpants, which is about my speed these days (side note: this row also contains people-who-don't-wear-deodorant).

I was pretty hesitant when the gun went off, fearing instant pain in my ankle, but it wasn't too bad. Actually, my hips were the bigger problem! My left hip - which always gives me problems - just isn't right anymore, and I can't lift that leg well. I didn't plan on racing this race AT ALL, just running a comfortable pace, and I ran mile 1 in 8:14. I actually thought that was fast for the circumstances. I kept my pace pretty conversational, which was good, since plenty of people wanted to talk. People are VERY encouraging to pregnant runners! It felt weird to be running without racing, but I let the miles just tick by. I passed or was passed by many people I knew, so we talked a bit - I also had to tie my shoe twice, which was annoying (especially since tying my shoes is a bit more of an ordeal these days!). My hip remained very stiff and painful. My ankle was totally manageable, though. Due to construction, the course changed this year, so I wasn't able to look for familiar landmarks, just the mile markers: and the last mile came up fast. People started to speed up, so I did, too. The race finished in Tad Gormley stadium, and I had to chuckle at my awkward bumbling around the track to the finish line. I was extremely surprised to see 39:44 on the clock. I'd been running 8+ minute miles the whole way! I assumed the new course was short, but actually, it wasn't. Caught up in the fast last mile mood, I ran a 7-flat for mile five...which means that I am sure I could have run the whole thing a little faster. Oh well. I had other goals this year!

Post-race was just what I was looking for, and worth the rather painful run: we saw so many friends, including a good friend from out of town who was at the race with a friend; the Power Milers, who did really well (Paige won overall; Tyler and Casey were second and third); friends from the New Orleans Athletic Club, our gym, which puts on the race; runner friends and holiday heroes only. It was definitely my last race pregnant, and might well be my last RUN pregnant, and it was a fun way to take a bow!

Thursday, November 7, 2019

Posterior tibialis tendon tear!

Ooof. Cannot catch a break over here. I have been having weird foot and leg pains for a while now, things I never experienced before and attributed to Achilles tendinitis or plantar fasciitis. But then it all evolved into ankle and lower leg pain, and got bad enough that I was having a hard time putting weight on it. When the pain woke me up at night, I decided it was time to see a doctor. Luckily, Tulane recently opened an extended-hours sports medicine clinic geared toward student athletes and busy professionals who are at work or at class or practice from 9-5. I got a 6:30 appointment with the foot and ankle specialist: the same doctor I saw for my last stress reaction (gosh, I'm injury-prone). I really like him - he's the head of orthopedics here, and he is the one who recommended a carbon fiber plate in my shoe, which let me run through a stress reaction all the way to one of the best marathons of my life! (SARCASM, it was terrible in every way). I was happy to get in to see him so fast, and I'm a huge fan of the extended hours offered now!

He's one of those seen-it-all doctors, so as soon as he saw my foot he said, "posterior tibialis, right?" and confirmed the tendon tear by ultrasound. Dang. Diagnosis in ten minutes! Luckily, AS USUAL, I waited so long to see a doctor that I'm past the initial injury and into the healing stage. So the tendon is well on its way to repair. While I only noticed the sudden pain and bulge the last week of October, the damage was probably happening long before, only I was blaming all kinds of other conditions.

The body starts releasing relaxin in pregnancy, a hormone that relaxes pelvic ligaments in preparation for childbirth. Unfortunately, it affects other ligaments and tendons, too, by activating collagenase . This results in tendon laxity and lengthened tendons. In my case, my posterior tibialis tendon is already a mile long thanks to my super high arches, and all of a sudden it was flopping down like loose skin. Without the support of the tendon, my feet pronated inward, pressuring the attachment point and eventually inducing a slight tear of the tendon. This was the bulge and discoloration I noticed. Unfortunately, it's just one of those pregnancy things - and it could have happened even if I was mostly sedentary. The timing sucks, though, because I wish I could run right now: the weather is finally under 70 most mornings (although it's 84F today, bleah), and I have felt MUCH better running in the third trimester than the second trimester, where every step sucked.

By the way, thought I'd mention - women also release relaxin during the second half of the menstrual cycle, meaning that you may be more prone to tendon, ligament, or cartilage injuries at this time (all of which are affected by relaxin).

I'm currently in either a walking boot or ankle brace (my choice, and it depends on my day; if I'm biking to work I pick the ankle brace) plus PT. I don't have a timeline yet because my doctor isn't sure how my relaxing levels play into this. But I hope I can get over it before the baby gets here - get in a couple of runs at least before I have some forced time off!