Training: Crescent City Classic 10k

Here's a question for you:
How do you train for a 10k when you're 10 weeks post-op, and the race is in a little over 5 weeks?
It's a good question. I had a better answer a month and a half ago, before I got really sick. I'd carefully created a training plan, starting with low-resistance biking, progressing to pool running and elliptical, and ending with a running build-up. It wasn't a recipe for a PR, but it would probably get me through the Crescent City Classic 10k without walking.
Now, I've scaled back my expectations somewhat. During my last PT appointment, I talked to Christian about the race, and we discussed workouts to make it possible. We unfortunately cut out a lot of strength work until my ribs heal, so I am curently omitting the original short strength or core workout I would do daily. I can still do lower body, but that's about it. Here's what my new plan looks like:

Every day: PT routine; strength or core (15 min) if no pain.
Week 1: Cardio five days a week for 45 minutes, with one session increased intensity and one day alternating walk/run. One rest day (PT day) and one strength day (only if no ribcage pain, or modified). Cardio options: elliptical, pool running, exercise bike, outdoor bike, stairclimber. Can do up to two hours on the weekend. HAHAHAHAHA. That has not happened, and it never will.
Week 2: Same as week 1, but may increase walk/running to two days. Not to exceed 3 miles total with running portion less than half.
Week 3: (Cleared to run!). Up to three days a week, walk-run, do not exceed 1 mile running at a time. No two days in a row. Otherwise, same as week 1.
Week 4: Same as week 3, but may increase to 3 miles at a time and total distance 5 miles.
Week 5: Same as week 4, but may increase to 5 miles at a time and total distance 7 miles. Still just three days a week, interspersed with other cardio.
Week 5.5: Easy jogging as tolerated.
Race!

This build-up is totally different from last time - last time I worked on more days of running before I added distance. But this time I need to get the distance in so I can make it 6 miles without dropping dead.
Notably lacking: Any speed work, obviously. The goal here is just to finish with both hips intact. And I think that won't be a problem - my hips are feeling really good. I can't believe how strong the right hip feels! Even after skipping out on a ton of PT work while sick. I'm pretty excited to get back to normal activity soon.

Weekend: Sunshine, music, paint and the Oscars

Saturday we finally had warmer weather and some sun, and I was bad and went running. So worth it just for the Vitamin D!
Like most Saturdays, I spent much of the day cleaning the house and doing other chores, but that evening we went out for dinner and the symphony. We have been doing happy hour food specials before the symphony (we have a 8-ticket assortment for the season), but didn't plan this right; we wanted to go to the Swizzle Stick Bar in the Loews Hotel, but it was packed. We ended up getting appetizers at Cafe Adelaide, the restaurant also in the hotel, before heading to the Mahalia Jackson theater. It was a guest conductor, and we had good seats this time - B of the first level off the floor, on a row configured with leg room! The selection was Debussy's Prelude to the Afternoon of a Faun (heard it a million times), a Ravel symphony (performed well; first time I'd heard it, but I didn't love it - not a fan of the excessive bassoon), and Rachmaninoff's symphonic dances, which the symphony really mastered. They play a LOT of Rachmaninoff, for whatever reason, but they're good at it. We were still hungry after, so we stopped for late-night sushi at the ever-speedy and reliable Sushi Brothers.

Sunday was another beautiful day. We walked to church - which I missed last week - and I volunteered at the visitor's table, where I quickly met several really interesting people. Our church attracts the most fascinating, accomplished mix of humans. I don't know how, but there's not a boring soul in the congregation.

In the afternoon, David and I walked to the park. I set up my easel and paints while he ran a few loops in the park; I only had a about two hours including set-up and clean-up, so I didn't get a lot of painting done, but I got a decent start. I am practicing a loose, Cezanne-like brush stroke.
Then we quickly cleaned up and headed to our pastor's Oscar party.

The gloves were a prop for photos. I stole them for most of the night. 

"Red-carpet attire optional," read the invitation. That's all I needed to hear. I happened to have a gown I was about to toss - it didn't survive the wash well at all, emerging with stitches undone, dye faded, and terminal wrinkles. I did an outrageous top-knot, nude lips, heavy gray smoky eyes, and topped it all off with loops of fake pearls from Mardi Gras.

Make-up job and pearl-wrapped hair

We left before the prediction ballots were completed, but not before I picked up my well-earned Best Dressed trophy.

Tearfully accepting my award

It pays to have heaps of ball gowns in your closets.

Testing, testing

While I was sick for weeks, it was freezing cold here (well, I mean, 30's, but remember that we have no insulation in our house) and our heater was broken. Thursday night it miraculously came on, just in time for a heat wave on Friday. I didn't care. I basked in the 90 degree kitchen and thawed my frozen rib cage out (the heat really did help it).
But Saturday morning I woke up to warm, humid breezes, an overcast sky, and a park begging me to run through it.

Selfie attempt abandoned after one mis-timed shot because
the garbage men came up the street and I felt silly. And yes!
Our road, although not paved yet, is clear enough for the
garbage truck to get down it!

Now, don't get mad. I just alternated running and walking block by block to the park. I ran on the streetcar tracks, so it was a soft surface. Really I just wanted to get out of the house, but I rationalized it by telling myself that I wanted to test my hip and see what exactly still needed work. Like, if my hip flexors felt tight, that's what I'd focus on for the next few weeks.

I got to the park, walked the 2-mile loop, did some form drills, then repeated my walk-run on the way back.
Report: I felt pretty good. I could definitely feel work done on that hip, but no pain. Range of motion while running felt equal. After I got home, I had some hip snapping on the right. My psoas tendon is probably inflamed and irritated; this can continue post-surgery for awhile because the tendon and muscle catch on the enlarged/scarred joint area. Once the surgical area returns to normal, this lessens and hopefully goes away.
Something I didn't expect was the rib pain while running! It was pretty terrible! But I was only going a block, so I dealt with it; and after I got back, my ribs actually felt a little better. A little motion is probably good for them. If they don't heal up, however, I will not be running in 2 weeks: it hurts too much right now for more than a block at a time.

Ths s s frstratng!

Or so I would have posted earlier this week. My keyboard has been broken, and I just replaced it with a really loud industrial keyboard that is sure to drive my husband crazy. I have gone through two sleek blue tooth Apple keyboards, and I'm done with them - they keep dying. The keys go out row by row, starting at the top right.
I actually wrote my last post from my phone, with the help of Siri taking my dictation. Siri and I get along very well. I text for work a lot - I have a technician on the hospital floor, and the most reliable and discreet way to communicate is to text (I don't want her on her phone in patient rooms, and if she's busy she can get the text when she has time). Since I am typing prescriptions most of the day, I can dictate to Siri while I type something else. That is how rote my job has become - I can type directions for one drug while talking about another drug to Siri. Boring. But good old Siri has mastered the names and spellings of countless drugs and insurance companies, and I almost never have to correct her.
Nevertheless, it's great to have a loud, clicking keyboard back!

Thanks for the well-wishes as I get well. I feel like I'm actually on the mend from my whooping cough. I looked up the CDC's pertussis stats, and there were close to 19,000 cases in 2011, so I am definitely not alone (although it's pretty lonely on the adult side of the graph). The pertussis component of the Tdap vaccine I received in 2007 generally offers 80% protection, with a decrease in severity for those who do contract the disease despite being vaccinated. Sorry, it still felt pretty crappy! But since I was also recovering from surgery, no doubt my immune system was a little weak. I was also eating nothing but junk (thanks, Carnival season) and that probably played a part in my inability to combat the bacteria.

And of course, the antibiotic I took early in the course was not fully active against B. pertussis, which is why I felt a little better, then got sick again.

Meanwhile, back at the ranch, my hips...? I don't know. I haven't thought about my hips at all. I've been too busy thinking about how I'm supposed to get any oxygen when I can't stop coughing. I suppose they are fine, almost better, but I have been terribly negligent about my PT and any exercise at all. I've basically done nothing for the past four weeks, with a sporadic trip to the gym or set of squats when I was feeling a little more well. Today I went back to the gym and used the elliptical, with great success; thanks to a little cough suppressant I didn't have a single coughing fit. Oh, and of course I'm no longer contagious, or I'd keep my gross self at home (I already went through the embarrassing process of contacting anyone I exposed to the disease before I had a diagnosis, and basically they all have small, unvaccinated children. Luckily no one has a cough!). But it's just a touch over two and a half weeks until I am allowed to run again, so I expect to have more updates soon! And my first "race" back is only six weeks away. I'm just hoping my ribs are healed by then.

Balance work

No, this isn't a post about balancing hip recovery, whooping cough, fitness, and a busy work schedule. Honestly, that balance is going great, since my rib cage pain and my bad cough mean that I can't really work out or do physical therapy at all. So basically that means that I have a whole lot of extra free time for myself. Or Walgreens. Whoever claims it first. 

Instead, I remembered that I wanted to share some of the at-home moves I've been doing to improve the small muscles used to help you balance.

1. Towel slides. These are so fun. I just put each foot on a soft cloth or towel and basically skate across my wooden floors. I would never have done anything this dangerous early on in hip recovery, but right now it's a good way to work out all those little muscles that your body uses to stop forward and side motion.

2. Bed planks. Want to make your planks harder? In case you're wondering, no, I do not. I am actually pretty bad at planks. But if you are superhuman, and planks are too easy for you, try doing planks on your bed. It's a lot harder when you don't have a soft surface to brace against.you end up recruiting auxiliary muscles.

3. Cushion squats. I stand on large throw pillows to do squats. This is especially effective for one-legged squats.

4.  Cushion deadlifts. Same idea, except I do one-legged deadlifts with a light weight dumbbell while standing on a cushion.

Hope you find some of these helpful, whether or not you're recovering from surgery, because I do think that working on balance is important for runners. I'm trying to remember all these little things I'm doing during recovery, so I will do them once I'm back to running, too.

You're kidding me, right?

After being sick for 26 days, and failing one course of antibiotics, costochondritis finally sent me to the emergency room.
Friday night, after canceling our Valentine's plans, I started feeling sharp pain in my ribs when I coughed. I ended  awake all night, in so much pain coughing that I certainly couldn't sleep. It didn't improve all day Saturday, and overnight I was starting to have labored breathing as well, so Sunday I snuck off to the ER. I had to sneak because David was riding in a parade, and I didn't want to... I guess rain on his parade, har har. Once he left, early Sunday morning, I drove to Ochsner, even though I work at Tulane, because I didn't want to get stuck in downtown parade traffic. I didn't have to wait, but I ended  being there for three hours for:

- a breathing treatment
- a chest x-ray
- a Toradol injection (to help with the inflammation of the rib-cage - and it has helped enormously)
- a nasal swab for pertussis

But obviously it's not pertussis , because I am fully vaccinated, having received the booster in 2007 before my clinical rotations started.

Except it is pertussis. The PCR came back positive. Huh?!
At this point, its too late to treat the infection, so I am just waiting it out. I got a cough syrup  with codeine for night, so hopefully  I can sleep , and I am taking antiinflammatories for the ribs. And now I am wondering how effective this vaccine really is. There is no way ALL the whooping cough cases are in or due to the unvaccinated. It is certainly unsettling.  I wonder if we are overestimating the duration of immune memory engendered by the vaccine? 

New doctor: hello and good-bye

My hip surgeon cruelly left me in January, moving to Florida to open a private practice. He transitioned all his patients to another doctor in the practice, who also does hips (although I think he's more of a knee guy). I met Dr. Heard for my final post-op appointment.
The appointment was really brief. I don't have any complaints, and the things that cause me pain are exactly as expected. He wrote me a prescription to continue PT, and told me not to come back, so I guess that's that!
I reconfirmed with him the return-to-running date Dr. Van Sice had set - 12 weeks post-op. Dr. Heard is actually more conservative (I don't even see how that's possible) than Dr. Van Sice, and said he usually has patients back at 4 months, not 3, but he gave me the go-ahead. He said his choice of dates is mostly based on patients' reported pain, so just don't run if it hurts too much (but he reminded me again that it will hurt a little. Yep, I know!).
I did clear with him running the Crescent City Classic in April, and he said that was fine, too; he just made me promise to walk if it hurt.

The next thing on my recovery agenda is to start working on range of motion. I delayed that a lot, waiting for my internal stitches to heal, but it's time. I am pretty stiff and the ends of my range of motion cause pain - and I definitely want that taken care of before I return to running. I don't want ROM limitations to affect my form. I know it's going to hurt, but it's got to be done. Time to be friends with the stretching strap again!

The plague is back

The very next morning after I completed my antibiotics for my revolting throat infection, my symptoms returned with a vengeance. I'm just as sick, if not worse, than before. I'm sure my paltry little amoxicillin prescription couldn't put up enough of a fight against whatever vicious, resistant, super-bug bacteria I picked up at the hospital.
Here I am, sick as a dog, going on two and a half weeks - and we have so many plans and guests for Mardi Gras. Great.
My big plan this year was to create a savory king cake to bring to a parade party, but I don't think anyone wants to eat anything I've touched unless I have a sudden recovery (But don't steal my idea. It's happening next year, promise). I was also going to make a bacon and brown sugar king cake for my bacon-loving hipster church friends. My church is full of hipsters. They all wear plaid, ride bikes, drink Pabst Blue Ribbon, grow beards, and like bacon in non-bacon-appropriate places. They'll be disappointed.

Heading upstairs with a mystery/crime novel. It's pretty good, although the language is atrocious. 

Tonight we were supposed to bike down St. Charles to the Nyx parade, but I just don't feel well enough. Instead I'm going to bed with a cup of tea and a good book.

Week 8 post-op: hip physical therapy

I thought I'd share with you my daily PT now that I'm able to extend my range of motion a little (I'll be at week 8 in two more days). Today, it looks like this (reps vary based on time constraints):

1. Planks. Front, left side, right side (about 1 min each).
2. Quadruped series: On hands and knees. Leg lifts straight, then knee bent at 90 degrees, then fire hydrants, then hurdles (10 - 30 of each, each side).
3. Squats - usually 25 or 50; sometimes wall squats; sometimes one-legged if I'm feeling ambitious.
4. Bulgarian split squats (I put my back leg up on the second stair step - 10 each side).
5. Walking lunges: the length of the house and back (it's 34 total. My house is 17 lunges long).

Just walking through the house.

6. Monster walks with resistance band - length of the house and back with band around calves and then thighs while squatting. I didn't count these.

7. Clams series: with resistance band, then with extension. Twenty - thirty each.
8. Bridges series: with resistance band (abduct at top of bridge), then one-legged. Thirty each.
9. Leg lift series: side lying, with toe neutral, pointed up, then pointed down; front leg lifts. Ten each.

I do more when I'm actually at PT (he has the cool toys, like ankle weights, exercise balls, kettle bells, straps) but this is a nice, short series I can manage in the mornings before the gym.

Parading

If you are in the middle of winter, I'm sorry that I am about to show you pictures of the sun filtering through oak tree branches out of a cloudless blue sky on a 70 degree day.

Really, incredible weather for a day of parading. We hung out with friends, had some beer, and did what New Orleanians do best - run into people we know. That's kind of how you do Mardi Gras: you share your food and drinks with whoever you end up seeing.

We stayed for two and a half parades, then ducked out so David could make it home in time for mass. I went home to wash my hair - I got my bell rung by a huge bag a beads that clocked me on the forehead, and I had blood in my hair (those throws are dangerous!).

But it's not a good parade without a little blood, right?

The fellow turned forty

I gave my husband explicit instructions to not turn 40, but his big birthday rolled around anyway. David is about eight years older than I am, a fact that I discovered accidentally several months into our dating relationship. I had been talking to a friend who was weighing the pros and cons of attending her high school reunion.
Me: "I don't know what to tell her, David. Do you think you'll go to your ten-year reunion?"
David: "Huh? I already went."
Me: "HOW OLD ARE YOU?!"
And that's how I found out that the man that little 21-year-old me was dating was 29, going on 30 pretty soon. It's not a big age difference now, but when he was a successful 30 year old lawyer and I was 22 and hadn't even started graduate school yet, it was.
David is lucky, because no one ever guesses his age: he looks very, very young. He had maybe three gray hairs by now (my fault entirely, I own it), but he's wrinkle-free and still pretty adorable in my opinion. So we can still pass for a young couple.

And to prove it, I made David take this picture, just woken up and deathly ill. 

I threw him a big party at Phillip's for the occasion, and as luck would have it, became deathly ill right before that weekend. I'm afraid I wasn't much of a hostess, and to top it all off, my gift to David was my bad cold. It was still a nice party - it was so easy to have Phillip's do everything (I talked to them just once - we go there all the time, I trust the owners, and I just gave a check and they handled everything). And it was lovely to see a lot of old friends.
No pictures, because we were too busy partying! And my phone stayed in my purse, which was a really cute textured purple clutch. I don't love purple, but just a tiny accent piece works well (the rest of my outfit was black).

This is the watch I got him.

Since it's the splurge birthday, I got David a nice watch- some Rolex that cost as much as a used car. Just kidding. He'd kill me. I got him a nice watch, but nowhere near that cost ballpark. It's understated and classic, just like him!
And on his real birthday, I bought him cough drops and Delsym. Sorry about that, babe.

Seven weeks post-op

I feel so much better after this surgery than the last one. I don't want to jinx myself by saying it, but I really think this surgery was quite successful and will heal with minimal lasting impact. Seven weeks after surgery on my left hip, I had a depressing visit with my doctor. I was in quite a lot of pain, and he wondered if the surgery had failed because the damage was so extensive prior to surgery. It turns out that I began feeling much better in a few weeks, but at the time I really didn't know if I'd made the right choice by having the surgery done.
This time, I just haven't had as many issues. I have had more stiffness and less mobility, because range of motion restrictions were extended due the repair rather than debridement of the labrum, but the joint doesn't really hurt very much.
Right around 6 weeks is when I would have been cleared to do a lot more activity, but unfortunately I haven't because I've been really sick for the past week. I actually went to the clinic and got an antibiotic, because my throat and tonsils were terribly infected (pus in your mouth. GROSS.). For the last week, I've done virtually nothing - no PT, no exercise bike, no strength, no core work. I was just too sick. But this morning I went to my PT appointment, and I ran 15 minutes at 70% of body weight on the Alter G. It felt pretty good, just about painless, and the plan is to do 75% next week, 80% the week after that, then 85%, 90%, then - cleared to start running.
Now that I'm starting to feel marginally better (and I'm not coughing so much), I will be heading back to the gym or at least exercising at home. I can now:
- Elliptical with no resistance or ramp restrictions
- Bike outdoors
- Add in a little range of motion work

I also have to get back on the PT/strength bandwagon, because my week off (plus general weakness from sickness) had me doing pretty poorly with my PT. He was totally making fun of my puny lack of strength. He wanted me doing 1:30 front planks x 3, and I am so serious when I say that I was about to collapse on the third one. And I was sweating buckets.
I better get on it this week. Christian is threatening me with a 3 minute plank.

Pool running vs. Alter G

In my last post, I explained what it feels like to run on the Alter G. I got a similar question from Cris (although I prefer Darkwave. She has a lot of aliases), who asked me to compare the Alter G to pool running. So here it goes:
1. Similarity to running:
Alter G: Very similar. Just like a regular treadmill.
Pool: You can mimic the motions, but without push-off and rebound, it's not very like running.
2. Effort required:
Alter G: Depends on the %weight setting, but obviously, there is less and less effort as you decrease weight. You feel like you're running, but not working out.
Pool: I've finally figured out how to get more out of pool running, so I'd say more effort required here. You're pushing against water, so that adds resistance.
3. Impact on body:
Alter G: Although this is dependent on your weight setting, your foot still strikes on the AlterG. There are plenty of injuries that I don't think it would be safe to rehab on the Alter G, at least not initially, like a broken foot.
Pool: No impact if you're deep-water running. Probably the safest rehab exercise, although you can stress soft tissue by pushing against water resistance. When I'm pool running after an injury, I eventually transition to running on the floor of the pool, and I would say that amount of impact is comparable to what I feel on the Alter G at 50% body weight.
4. Place in training:
Alter G: Because you can adjust the impact, you can use the Alter G anywhere along the rehab continuum, all the way from early rehab to back to racing. However, for most of us the Alter G is only appropriate for rehab, not regular training, since a. no one has regular access to one and b. there is so little effort that you are not really "exercising" - and unless you are a pro runner, I'm sure your time available to dedicate to running is limited and you don't want to waste hours without getting some cardiovascular/endurance benefit from it.

Pool: Although there are only two levels - deep water (no foot strike) or shallow water (foot strike), you can still use pool running in a variety of rehab and training scenarios. Actually, pool running is good cross-training, and I keep saying that I'll keep it in my schedule once I'm back running. I probably won't because I'm lazy, but it would be a low-impact alternative to running.