Starting Over

Well once again it has been a long time since I've written any kind of an update.  The excuses are many, but mostly due to a lack of activity in sport.  Without going back to read where I actually left off, the short version is that I had an un-diagnosed injury to my back/hip/leg on my left side. 

Well, that was quite some time ago.  In fact I think the injury first began to surface about 5 years ago.  2009 sounds about right.  I suffered through seeing about a dozen doctors, chiropractors and PT’s never really finding the answer.  I was able to live with it for a couple years and even raced somewhat successfully despite the injury, but never reaching my potential. 

My last race was the IM 70.3 World Championships in Vegas where I suffered several setbacks.  And while simply being at that race was an accomplishment, it was also the last time I was able to toe the starting line. 

The years following 2012 were challenging in several ways.  My job at the time was easily the most stressful job I've ever had.  It got so bad my Crohn’s became a regular issue requiring me to go through several CT scans and be on prednisone multiple times.  It had gotten bad enough for the doctor to consider surgical options.  There is a difference between the doctor considering surgery and me considering surgery, but for him to even mention it as an option is alarming.

The unfortunate truth is that had you asked me 3-4 years ago if I’d need another surgery in my life I’d have said probably not.  I was doing well, stress was under control, and the Crohns was well controlled.  As I sit here today I’d have to say there is an 80% chance I’ll need to do it again.  On a normal day I feel fine, but the dietary restrictions have me at a point where I can’t eat an apple without having issues.  Raw fruits and vegetables are not really an option for me at this point in time. 

On the brighter side, I am finally starting to make some progress with my hip.  In the past I’d been diagnosed with hamstring tears, bulging discs, and various other issues like SI joint arthritis, etc.  I never really believed those diagnosis because they didn't fit the type of pain I was constantly feeling.  I always felt like this was due to some type of imbalance combined with something I was doing every day to make the issue worse…every day.  Something in my everyday life had to be a contributor.

Well, over the summer I decided to go back to the doctor as I wasn't willing to just live with constant pain any longer.  Through that process I saw a PT at the spine center who started taking a look at the muscles around my lower spine and had me do a few balancing exercises.  Within about 3 days my day-to-day pain vanished.

Unfortunately, that was about as far as that PT got with me.  It was around that time that my sister and brother-in-law were in town.  He was racing at USAT Nationals.  In one of our discussions I brought up the injury and the types of issues I was having.  As it turns out, he’d had something similar and saw a PT in Austin, TX.  The PT essentially specialized in posture and proper movement.  I briefly spoke with that PT via email and he directed me to his instructor who is on the north side of Chicago.

Long story short, I’m all kinds of screwed up.  The muscles in my hips, low back, and legs are all kinds of imbalanced.  I've seen David Foo (new PT) twice now and have already seen a dramatic improvement.  I first saw him back in early September and he gave me a set of 4 breathing and posture exercises.  After about a week of those I was able/willing to get back on the bike and start running as well.  Overall getting back into shape hurts a lot more than I remember.  But my back is doing a lot better.  While the pain is occasionally still there, it is much less severe.  In fact, if the pain had stayed at this level back in 2012, I would have never stopped training/racing. 

I saw David again last week and got a few more hip/back/leg specific exercises, and saw another dramatic improvement.  I’m now at a point where I am biking 4-5 times per week and running 5-6 times.  Granted, I am taking things very easy.  Rides are all under 60min and generally Z2.  But I have started into slightly higher quality workouts as of last week.  (Managed 2x5' @300w on Tuesday!) My runs will stay at an easy 9-9:10 pace for now.  While it’s slow, it’s still much more than I was doing.  And for the first time in a really long time, I have actual hope of being able to train and compete again.  The speeds will improve as I begin to drop the 40lbs that I put on in my stressed out un-athletic Crohns induced depression.

Overall things are looking up.  I have a new job that is both challenging and a lot of fun.  I work with a lot of really talented people and the stress levels are much better.  We’re in the same building as a Gold’s Gym, so I’m able to work out at lunch making things a lot easier on my schedule.  At the same time I’m left with the bad...A VERY poor diet has left me 40lbs north of where I was when racing.  There’s not sugar-coating my state of fatness.  40lbs is a lot even on a 6'2" frame that hides it pretty well.  Simply put there are no excuses...I put myself in this mess and I have to get myself out of it.  I knew I wasn't working out and ate as if I was...that's a really bad mix for an endurance athlete used to burning at least 4,000 calories per day.  Weight loss is generally a simple equation and I ate more calories than I burned.  Now I need to go the opposite direction.

At the end of the day, I’m left with several things to focus on.

First, I have to make sure I remain healthy.  This includes both the Crohns and my back.  If I don’t focus on getting healthy in both regards, none of this matters.  Fortunately for me, working out again should help me with stress management and the Crohns.  At the same time, I need to continue with, and stay focused on the muscle imbalances that led to my hip/back issues.  I need to get those corrected so I can move forward.  I see David again next week and hope to continue making good progress.

Second, I need to get a basic level of fitness and endurance back.  If my back and hip continue to improve I need to get myself to some longer bike rides so I can burn calories without the impact of running.  The reason that’s important is that I don’t want to do too much long distance running until I've dropped around 20lbs.  That will help both my speed, but my durability as well.  I'll still run, but I'll likely keep it to a consistent 30min 6x per week instead of building to 90min runs.

Lastly, once I have some basic fitness, I can start to really focus on the weight-loss.  I’m at a point right now where dropping the 40lbs will have a far greater impact on speed than quality speed workouts would.  So it makes sense to hold off on harder workouts and focus on some longer endurance workouts that I can repeat day in and day out.  In order to do that, I’ll probably need to add swimming into the mix in the next several weeks.  I just don’t want to add swimming back in until I’m really sure my hip/back are going to get better.  Too many false starts with this injury have left me a bit deflated emotionally.  I don’t want to get my hopes back up only to be left in pain and unable to work out again.  So I’ll be taking it somewhat slow.

And that, as they say, is the rest of the story.

No Consistency

Well, it's been a while and a lot has been going on.

Work has been extremely busy for the last several months.  I have a rather large project in the works, really its more like a program with two big projects under that umbrella.  Working 7-5 with no lunch is not uncommon plus a little on the weekends. 

Fortunately the project and the people are fun helping alleviate a lot of the typical stress that would come with a bigger effort.  But that has certainly had an impact on training.  It's been so hectic that Aimee and I decided to postpone our yearly pilgrimage to Mexico (anniversary) as well.

As for the training itself, it's been okay at best.  Post-foot surgery and recuperation, I've been feeling pretty good.  My foot is 100%.  My shoulder seems to have bounced back with the rest and I'm able to swim again.  I have a new bike fit with some technique changes that appear to be helping my hip, so all in all, things are going well.  However consistency has been lacking.  As a result I always feel like I am starting from scratch.

The unfortunate reality of my current situation is that if work doesn't interfere with training, the crohns does.  Lately it would seem that my guts are just not cooperating.  Just when I feel like training is going well, I'll get another bout that forces a few days off.  Even worse, lately it seems like I need a whole week off to bounce back. 

Overall I'm not 100% sure what the problem is.  It starts with the typical cramping, etc.  But the prednisone hasn't been as effective.  For obvious reasons that is alarming.  Once prednisone loses effectiveness there are only a couple options, surgery being the primary option.  I did that once and don't care to repeat it. 

Interesting thing is that I've done a battery of tests recently.  CT scan, colonoscopy, etc.  None are showing signs of active crohns.  They are however showing signs of constipation.  I've been struggling to believe that diagnosis because the pain is so severe, but also exactly the same in nature as the crohns.  I really just can't believe how much that hurt.  I wasn't in the fetal position all last weekend...but I was pretty incapacitated.  I've had worse crohns attacks, some that hospitalized me, but they weren't much worse.  The only thing that stopped an ER visit was that I could tell (feel) food moving and I never tossed a meal.  Vomiting tends to mean a full obstruction = trip to ER, and I never had that.  I guess my glass is half full after all!

In any case, it certainly is plausible as when I have a crohns attack one of the first things to leave my diet is fiber.  Fiber and roughage tend to make things worse.  As I've been dealing with repeated issues for almost a year, it is possible that when this first started up I reacted by eliminating most fiber and never started up again...causing a larger issue.

In any case, I'm on a much higher dose of fiber as well as a couple other things to keep things moving.  (More info than most of you wanted I'm sure).  So far so good.  As the issues tend to present themselves every 4-6 weeks, we'll see how I'm doing in another month or so.

As for the training, I'm doing the best I can in between issues and work.  I recently started back into swimming and that is starting to come around.  I do struggle to stay motivated in the water.  Swimming more than 45min or so is just brutal at this point.  I think I need to start bringing sets to the pool instead of just winging it.  That way I have something to focus on.

Biking is okay.  The changes I've made have all been in the last 3 weeks.  So its too early to tell, but my hip does seem to be improving.  My left leg has a tendency to swing out on the upstroke, I have to really focus on not doing that.  It may be causing my issues.  That is taking some time to get used to.  On the bright side, I started watching the Walking Dead on Netflix...that's giving me new motivation to get on the bike.

Running is fine.  I'm not fast right now, and I'm not really doing much speed work.  Just trying to run 6-7 days a week.  That's been a real struggle with the crohns issues.  On the bright side, I am pretty close to running my typical 30-60-90 program.  So the endurance seems to be returning.  Once I'm ready a little speed work and threshold running will get me back up to speed.

As for racing, I haven't made up my mind.  I'd like to go back to Kansas 70.3, but that will depend on my health.  I have been tossing around the idea of a stand-alone marathon.  I've never done one and would be interested to see what I can do.  But I don't think that would happen until next fall.

Until next time.

Getting back into shape...

Let me start this posting by commenting on how much it sucks to get out of shape.  The problem is that I remember where I was, and in starting to workout again, I think its an easy thing to just start with those workouts.  You'd think that my muscles screaming at me would be an indicator to back off, but that would make sense. 

In any case, from an injury standpoint, things are going well.  My foot is on the mend and I am able to run again.  In fact, I started some very light running about 2 weeks ago, about 7 weeks post surgery.  Since then I've been able to build up to 3-4 mile runs with some walking mixed in because I'm fat and out of shape.  Having said that, despite some disappointment at the fitness I'm in (as compared to the fitness I want to be in or was in) I'm doing pretty well.

Swim:
I am out of shape.  No way around that.  I took a few months off and am paying the price.  Fortunately for me, swim fitness will come back quick.  I've been in the water a grand total of 5 times and can already feel things coming back.  My wind isn't there yet, but my stroke feels reasonable.  I just need to keep on keepin' on and I'll be back to myself.
Unfortunately my swim partner Scott has recently been told that he is an under-achiever in the water.  In fact, he has been for the last several years.  This of course means that I have been an under-achiever as well.  His sets are considerably faster than when I left the pool, this makes me sad.

Bike:
Overall I am in better shape on the bike than anywhere else.  I was able to start riding about 2-3 weeks post surgery.  Just easy stuff, but everything helps.
The hip/glute/piriformis/sciatic injury is starting to get under control.  Over the last few months it has become clear that this is entirely a bike fit issue. 
Years ago my first professional bike fit put my seat height at 79.5cm.  That was when I first started to see some of these issues.  I made some modifications myself, and ultimately started having real major issues that appeared to be my hamstring.

After some major time away and rehab, I came back to the sport with a new bike fit.  My PT had me at roughly 74cm on the bike seat.  That is a MAJOR difference.  And it worked, the injury was fine and did not resurface.  It did lead to other issues such as a lack of power and cramping quads.  So I went for a retul fit and they promptly raised my seat back up.

Now, keep in mind, 'back in the day', I did not really track all my coordinates.  Fortunately my PT did track some of this so I know what range I need to be in.  I'd also add that I thought I had a torn hamstring which I rehabbed, so moving my seat back up made sense at the time.

In any case, today I am slowly working my way back down to a point where the seat height is not causing me issues.  I am currently sitting at 78cm and will probably move down another 5mm.  I may adjust the seats placement over the bottom bracket as well, i'm not 100% sure. 

The good news is that the changes appear to be working.  I did some really hard riding in the last week and a half and have not suffered any real consequences.  I've also added running, and no issues so far. 

Run:
The good news is I'm way ahead of schedule.  I had not planned to run until next week when I originally had the surgery.  As I was not in pain, I started running 2 weeks ago.  I'm running every other day at the moment 3-4miles per run. 

The bad news is that I am really out of shape.  I'm taking walk breaks and feel like death.  That's all I have to say about that.

Weight:
My weight is up.  That's what happens when you're used to burning 4,000-5,000 calories per day, eat accorndingly, and then stop working out.  I accept responsibility for my poor eating habits.  I put on 15lbs total.  I'm already down about 3 from the last few weeks.  Once I can really start hitting it, the weight should drop off pretty quickly.  I don't have to show much restraint when I'm burning high numbers.

Crohns:
I've actually been having some pretty significant issues.  As I look back over time, I've been ina little bit of denial about it too.  It seems like the last year and a half or so I've been having bouts as a regular occurance.  On the bright side I can control them with prednisone.  On the bad side, they keep returning. 

I spoke with doc, and I'm on a lengthy dose of prednison now that is ramping down in the next week.  It sucks, I hate it, and it kills my sleep.  But I need to get the cycle of inflammation down.  Hopefully a longer cycle of pred will knock this down and put it in remission for a while.

In any case, assuming things continue to progress well, I might do some real races this year.  I'm still keeping my eye on Pigman, so we'll see if that happens. 

A Little Ray of Sunshine

For a change of pace I have some good things to write about.

My foot appears to be healing just fine.  I get the pin out of my toe next week Wednesday.  Overall I am walking with no pain and in a normal shoe.  Although I don't know that I'm supposed to be in a normal shoe, I am doing so without any pain.  In fact, I'm walking better now, 3 weeks after surgery than I was before the surgery.  That can't be a bad thing.

I've been able to start biking again.  On the not so good front, my pirfiormis started acting up almost immediately.  However I saw the PT again and we may have uncovered the issue within my SI joint.  After a little manipulation and some specific rehab, its already feeling considerably better.  For a change, I'm actually pretty hopeful we've finally uncovered the root cause of my issue and can resolve it by the time my foot is good enough to run on.  So even that is good news.

My weight is not nearly as bad as I thought it would be.  I only put on about 10lbs with 2 weeks of no working out.  Changing my diet for those two weeks was never really an option...so it is what it is.  Once this week is out I'll be biking every day and watching what I eat a bit more so those pounds should fall off pretty quick.  Not helping matters was my Crohns.  It acted up a few times forcing me to a diet of cheese burgers and chocolate shakes.  They may be yummy, but healthy and nutritious they are not.  The grease lets everything slide right through, so that's helpful.

As things are starting to get a little better for me, I've begun to look towards the summer a little bit.  We might actually get some good whether in the near future...so biking outside would be great.  I won't while the pin is in my toe as I do enough stupid crap on accident...no need to do it on purpose. 

I'm hoping to start light running in June.  The earlier the better.  I'll start to think about potential races after that.  I'm really doubting it, but maybe Pigman in IA is an option before I go to Canada with a trip to the Austin 70.3 after that.  It will all depend on the foot as I'm not going to push it.

Allow me to leave everyone on this note:

Moving on

Before I begin with what will be a relatively normal posting, I'd like to spend a brief moment on what occured in Boston.

To start with, I'd like to offer my condolences to those who are either directly or indirectly impacted by this event.  I've thought about training for a stand alone marathon with the hopes of qualifying for Boston at some point, but I love triathlons too much to break from them for that long. 

All told I probably knew 10-20 people that were at the race.  My childhood neighbors were posting pictures prior to the explosions.  Aside from the people I knew directly, endurance athletes share a common bond.  We see each other training on the popular trails and roads.  We talk to each other at the races.  We spectate together at races our friends are in, and we have a sense of community.  We've suffered through countless miles trying to achieve our goals. 

The Boston Marathon was, is, and will again be an awesome event.  It will carry on. 

In any case, tomorrow I get to see my foot for the first time.  It's been completely bandaged and wrapped for two whole weeks.  I've also been unable to wash my foot and its starting to get a little bit ripe.  So I do look forward to that. 

Overall my foot feels pretty good.  There is a giant pin in the toe, and that will hurt if I move my foot the wrong way.  Other than that it is mostly pain free.  We'll see how it feels with the bandages off and a little more mobility.  I am sure I'll have to be careful. 

What's funny is that even though I am walking in surgical boot...I think about walking far less than I used to.  Now that the pain is gone, I simply walk naturally....and that is a very good thing.  We'll see if I can do that without the bandages.

To the best of my knowlege, the pin stays in my foot for another 2 weeks.  Here is what they'll be doing:

It's pretty sweet.  I'm even tempted to do it myself, but I'm not sure I could get it at the proper angle.  I'm thinking about recording the event so everyone can see if I turn into a little baby and cry.  I've had several friends offer to come over with a pair of pliers and remove the pin for me.  As nice of an offer as that is, and I'm sure it would save my insurance provider a little money, I will pass.

Other than that, I am a little concerned about my piriformis syndrom.  Despite zero working out for the last two weeks, it still bothers me on occassion.  I had to cancel my follow-up appointment on this last week due to my foot.  I'm going to try to get in this week if there is an opening.

Other than that everything seems to be doing well.  Part of me is hoping I can start some light riding tomorrow.  Bike shoes have flat bottoms, so if I keep a nice steady pace and no cranking on the pedals I don't see what damage I can do.  We'll see what the doctor says.  The other problem will be the sciatic nerve/piriformis issue.  Biking seems to cause that issues as well.  So starting up may not be the best idea.

I have discovered that foam rolling and digging into that area with a ball seems to help in the short term, but make it a little worse in the long term.  I wonder if I accidentally dig into the nerve and need to move the ball onto the muscle more.

I have no doubt my weight is up.  That's the main reason for wanting to start biking now.  I need to burn calories as eating less appears to be totally out of the question.

Post Surgery Update

So as many of you know, and some do not, I had surgery on my right foot on Monday.

It came on very fast as things just seemed to line up properly.  First off the injury to my piriformis muscle was creating a number of issues.  My shoulder was hurting from all the swimming, and I was basically thinking of taking some time off.  Add that to the fact that my 2nd toe on my right foot had been bothering me for a number of years, and it was time to get that corrected.

Long story short, 10 years back (roughly) I had a bunion removed off of my right foot.  As a result the big toe was shortened and the 2nd toe was very long in comparison.  Over time that toe hammered and the tendon underneath became very tight.  Walking/running gave me this tearing sensation that would range in pain depending on the day.  But it was always there and always irritating.

I rarely mentioned it because I generally pushed through.  I knew what it was and there was no real reason to complain about it as I could choose to fix it any time.  Well, the time was right.

Surgery went really well and the doc thinks he fixed everything up for me.  I was hoping I could have him get a few pictures with my phone as he was taking the saw to my toe, but Aimee didn't think that would be a good idea.  Truly a shame, I know!

Right now recovery is roughly 2-3 months.  That is for running specifically.  I'm guessing that I'll be able to bike in 1 month.  Swimming will probably come shortly after that with running being added last.

The foot is weight bearing (to a point) right now.  So I am able to get around.  I took a couple days off of work and am able to work from home as well.  Tomorrow I'll be back in the office with some ice and a pillow.

In any case, my race schedule for the season is "kaput".  But that's okay as I had no real race goals anyway.  I'm hoping I can come back from the surgery fully rehabbed and ready to go. 

On a side note, I need to watch the calorie intake or else I'm gonna look like this in 4 weeks:

Anyway, I'll keep up with the updates as I progress.

Slacker-itis

So rehab is starting to make some progress.  Overall I think Piriformis was the issue.  I am now able to bike and run, although I am not able to do so with any intensity at this point.  That's the good news.  The not so good news is that all the extra swimming I did flared up some older shoulder issues from high school and college...so I have taken a little break from swimming.  And now I have a full blown case of swimmer slackeritis.  The idea of getting up in the morning to swim is so revolting I simply turn the alarm off in the mornings and roll over.  I'm not proud of that. 

Having said that I can fully justify my behavior by simply saying...who cares.  It's swimming.  I'll be one of the top swimmers no matter what.  That may sound arrogant as hell, but seriously, a few weeks off won't impact anything in the grand scheme.

On another note, the bad news is that I am considering another surgery.

Before I continue, allow me to difinitively say that I do not have Munchausen syndrome.  http://en.wikipedia.org/wiki/M%C3%BCnchausen_syndrome

I'm sure denial is an indicator for this disorder...and so maybe I do have it.  But I was once told that if you're able to question your own sanity...then you can't be insane.  I'm all good.

In any case, here is the deal.  Many years ago, probably close to 10, I have a rather large bunion removed from my right foot.  The surgical procedure ended up shortening my big toe, and not by an insignificant amount.  At the time I thought nothing of it as I wasn't terribly athletic yet...I had just started into triathlons.  I'd had the bunyon all my life, wearing dress shoes all the time for work and then starting to run caused a lot of problems.

Long story short, one of the potential problems that was not addressed with the bunion surgery is that my 2nd and 3rd toes are now too long.  And as I wear socks, my toes get bunched up.  Typically the big toe is strong enough to prevent that, but not in my case as the toe is too short.  That, over the years has led to hammer toes. 

Overall I'd say I've been dealing with this for at least 5-7 years.  I can't remember when it first started to surface.  At one point I had the tendon lengthened in my 2nd toe, and that seemed to help a lot.  But over time the problem has returned.  As things currently stand walking actually hurts worse than running.  Dress shoes tend to suck.  It's a giant pain...in my foot.

I haven't posted anything about this for a vareity of reasons, but the primary one was that I could ignore it.  As my regular readers, my natural tendency is to ignore the pain until it becomes a full-blown issue preventing me from doing what I want or even requiring a trip to the ER. 

I've tried orthotics and they helped a bit.  I tried a metatarsal pad, which I still use.  But that's been ineffective.  Lately I've been using a tape-job that essentially limits the toes range of motion.  For the most part, this is the most effective treatment I have.  And it is only 30-40% effective.  It only makes things a bit less painful.

As I was doing some rehab and thinking about the season I came to realize a few things:

First off, I know for a fact that I am favoring that foot.  And that could lead to a host of other problems...including an imbalance in my hips causing the piriformis syndrome.  Even if that isn't the cause, now that my glute pain is gone, I've noticed that my foot actually hurts.  That's not good considering how little I've been running.  It's generally sore with some sharp pain thrown in with every step.  I've also noticed that my right leg is generally sore in the foot/ankle/shin region.  That can't be a good thing.

But more than that, I have no real plans for this season.  I have no race to qualify for, and I don't even really care.  I've always known that my foot would require some work, and I've taken every half-measure possible at this point.  Perhaps the time for half-measures is at an end.  Especially since I'd like to train and race for the long-term, this may be the best overall option.

Last time I saw a foot doctor for this they did say that shortening my 2nd and 3rd toe should resolve this issue.  Recovery is around 3 months, so if I were to have this done in about a month from now, I'd be able to get back into some training after 2 months, running after 3 or so.  That puts me into July.  Not so bad. 

We'll see what the doctor says in early April.

In the mean time, rehab and working out will continue as if there are no issues.  Should be fun.