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.

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!

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!

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!

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!

Some updates

This pregnancy has had its fair share of complications, and I wanted to update readers quickly. August and September were a little stressful!
I had my routine anatomy scan ultrasound in August, and while we didn't get ANY cute pictures, because this kid NEVER stops moving, we did find out that he or she has pyelectasis, a kidney problem fairly common in fetuses. This is a "watch-out", and may require surgery after birth if it doesn't resolve on its own. However, it's also a Down Syndrome marker. I pulled my other anatomy measurements and, plugging my age and all the date into a reliable risk calculator, realized this baby had a 1 in 64 chance of having the condition. I decided it would be prudent to have a non-invasive blood test to screen.
Now, let me be very clear: I do not consider news that a baby has Down Syndrome to be bad news. It's just news. I absolutely value the lives of those living with Down Syndrome, and we would be happy to welcome a baby with this disease. But it is smart to be prepared for the upcoming challenges, were this the case, so we decided to get the test anyway. It came back negative, which was a relief - despite my willingness to parent a child with Down Syndrome, I feel wholly inadequate to do so! But we still had to schedule follow up for the kidneys, and to try to get a better anatomy scan - baby was moving so much that we missed about half the measurements.

We had the next scan a month later, and now that baby is more crowded and can't really swim away, getting images was easier, so we were able to complete all the important measurements. Unfortunately, the kidneys did not improve, so we're still keeping an eye on that.

More concerning is that the uterine mass that started this whole thing, that has been causing me so much pain and grief for over a year now, grew significantly since my last ultrasound. It's not a good situation: it now takes up the entire uterine wall and bulges into the amniotic space, so there is a concern for fetal growth restriction (right now baby's size is fine). The other concern is that its growth rate, appearance, and perfusion are not typical for a fibroid, and are what you would see in a malignancy. This was the original concern that sent me to the OR back in May, where I found out I was pregnant!
Maternal Fetal Medicine is on board - I still have my regular OB, but they are following me for the mass, the other fibroids, and baby's kidneys - and they recommended an MRI for better imaging due to the concern for cancer. I had the MRI, but it was inconclusive. It ruled out a few (benign) diagnoses, but left us with two potential diagnoses: a degenerating (and atypical) fibroid, versus a leiomyosarcoma. The appearance could be either; my symptoms actually match neither. The first is benign and can certainly be addressed post-partum; the second is a very rare but very aggressive cancer with a poor prognosis. Finally, I was referred to another specialist and got him to read my MRI and his report is positive - he doesn't think the appearance is malignant. We're still watching it - I'll have frequent ultrasounds and additional MRIs if the appearance changes or it continues to grow - but for now there are no plans to deliver early for treatment.

I'm glad to finally have a little peace. At every single doctor's appointment or ultrasound I've had, I've gotten potential bad news, so to finally only have a few minor concerns on the radar is a relief. I am pretty confident baby's kidneys will be normal at birth, as they are only very slightly out of normal range, and as long as baby can continue to grow, I think all will be well. Sure, we still have to take this mass out at some point, but that was already the plan originally! We will cross that bridge when we come to it, and just try to ride out these last two months with minimal drama!

Jazz Half Marathon 2019 race recap

I signed up for the Jazz half with a discount code before I knew I was pregnant, and as the day grew closer I kind of wondered how it would work out: racing a half marathon in the third trimester! But I figured that if I could still complete long runs of 10-12 miles, I'd be fine.
I went into this race really banged up. A surge of the hormone relaxin has wreaked absolute havoc on my feet and legs: my normally strong arches are lax and I cycled rapidly through achilles tendinitis, plantar fasciitis, and now arch-ankle-leg pain so bad I'm limping. I've been experimenting with compression wraps and things, but race day still had me in a lot of pain.

The day didn't start out well. A tropical storm hit New Orleans on Friday night, brining rain, wind, and storms. Its strength was completely unexpected, and took the city off guard. We lost power over and over throughout the morning, and when we got up at 5am, it was pitch black and we didn't have electricity. The storm was still going at this point, so as we groped around by candlelight for our race clothes, we wondered if the race would be cancelled. It was scheduled to start at 7, but my weather app showed the worst would be over at 7, so I guessed that it might just be postponed. I was right: as we headed to packet pickup, the rain and wind died down, and the race posted that the start would be delayed until 7:30. By the time the race started, the rain was a mist, and our biggest obstacles were fierce wind and a lot of debris on the course. The Jazz course is mostly on St. Charles avenue and through Audubon park, and all those oaks leave a lot of downed branches (sadly, Audubon lost one of its majestic oaks in the storm, actually).

I pushed myself back quite a bit from the start, knowing my limitations. Last year I ran this race in 1:27:04, which was a PR (and a surprise). This year the VDOT calculator predicted a 1:40 based on my recent two-miler. Although how accurate could that be? I was a lot more pregnant now! I decided to let my painful feet and legs decide how the race went. The race starts downtown, where GPS is useless, so my first "mile" beeped at 7:27...nowhere near the first mile marker. By mile two, I was really trying to let my feet warm up and maybe stop hurting so much, and I was mostly jog-limping. My GPS mile indicators were way, way off, as is typical, so I wasn't able to really on average pace readouts anyway. But by the time we got onto St. Charles Ave, I was starting to get a stride going, and at mile four I was at about a 7:50 pace (at some point, I rendered my Garmin splits totally useless by cleverly hitting "lap" at the mile marker. I was trying to get back on track so my autolap wasn't beeping so early. But I somehow also hit "stop" and didn't realize it for several tenths of a mile...eventually everything evened out what with GPS error and all, and by the finish my miles were *almost* on track, but basically my splits are useless!).

At the start

I run down St. Charles almost every week, so most of this race is very familiar to me. The only difference was that I was picking through a lot of branches on the ground this time. I got a chance to talk to teammate Paul, who came out to watch, and as I neared the park I got to see the leaders already coming back the other way. Power Milers were in second, third, and fourth for the men, and first and second for the women! I always like a chance to cheer my team on! Speaking of cheers, I was getting a lot of attention for running pregnant. It was really nice, because otherwise I was just another mid-pack runner. This gave me some motivation!

We reached the park after mile seven, and I love running through my park in a race. I was feeling a little better and started to pick it up. I passed two friends I'd seen at the start who had left me earlier in the race, and checked my time. A 1:40 was still doable, despite my slow start, but I'd have to pick it up. I was at 7:45 pace by the 7.1 marker (the relay exchange) and I'd need 7:37. There was Powerade on the course after the first few miles, so I grabbed some of that for some energy. And electrolytes - although it had cooled a lot since we got up - 78F to 65F by the race start! - it was still really humid from the storm.

I exited the park and headed back up St. Charles, trying not to think about taking a bathroom break (ugh!), and kept my pace up. I passed quite a few people in the second half: 35, actually, moving up from 97th to 62nd overall. It was definitely fun to hear the cheers then, because it's bad enough to be the pregnant runner, but the pregnant runner passing people? That gets A LOT of chatter! I can't really sprint anymore, but I did pass one more women right at mile 13, leaving me as 8th woman overall and 3rd in the 30-39 age group. I don't know how baby scored, but I did get two medals at the finish from the sweet and excited finish line volunteers...honestly, I rarely take medals anymore, but I took these so as not to be incredibly rude.

Getting a "Grace Thacker and company" from the announcer at the finish, ha! 

I finally got a bathroom break, but right away my ankle hurt too much to walk. Now that the race is over, I am on break to rest and heal. I don't plan for this to be a break all the way until the baby is born, but you never know. I just need to take enough time to readjust to all the changes that are creating all these injury situations and to let the inflammation die down!