Category: health


Progress

I’m a bit astonished that it has been over two months since my last post but it really should be no surprise to me since I’ve had little to say about my leg injury or my weight loss (and that’s really all that’s consumed my personal life the past few months). It feels like I haven’t had much progress in either area. I’ve been feeling very much like a little hamster on a hamster wheel but sometimes that in itself is progress.

I finished physical therapy earlier this month. Even though I was still having the same symptoms in my left leg (and sometimes in my right leg), my PT didn’t think there was much more that they could do for me in terms of physical therapy. He felt that the best thing to do right now would be to continue doing my stretches and PT exercises at home. He gave me the OK to get back to doing whatever I want exercise-wise and to start running again. He also watched me run and felt some adjustments to my gait might help with the pain. I have a tendency to push off and land on my toes and ideally I should be landing on my heel.

I’ve been running the past couple of weeks, trying hard to adjust my gait and to stick to soft surfaces. I also picked up some orthotics that a a podiatrist recommended. For now, I’m going to try to limit my running to 2 – 3 times a week and only for about an hour. I still have a sharp tight pain in my left thigh but it seems worst during the first mile/mile and a half of a run. After that, the pain subsides and it just feels a bit sore. I’ve been making sure to stretch my legs pretty well before and after runs, along with icing my leg after a run and massaging my leg with a foam roller everyday. Doing all of those things has certainly helped with the pain when I’m not exercising but it does not seem to be preventing the pain when I’m running. My gut feeling right now is that my back wasn’t the cause of my symptoms but that a tight IT band might be the real culprit. I haven’t had any back pain since I started running and it seems like the only time I had severe back pain was usually after some sort of medical appointment (usually after something a doctor, chiro, or PT would make me do).

It has been really amazing to get back to running. Nothing else makes me feel so physically empowered and capable. I’ve really missed that feeling most of this past year.

Despite my excitement about running, I can’t help but feel angry and disappointed that I’ve been so unsuccessful in getting my leg treated. I feel like much of the past year has been wasted. Wasted seeing specialists. Wasted getting my hopes up. Wasted being frustrated. Wasted trying this or that treatment. Wasted going to physical therapy. Wasted not getting a real solution. Wasted not losing weight.

Given how much time and effort I’ve spent in 2009 trying to get this issue resolved, I’ve decided to give up on it for now and learn to live with it. Trying to get this injury treated really slowed down my weight loss – I didn’t have as much time to exercise or prepare food, was limited in the exercises that I could do, and felt pretty bad about the whole situation. I really could use a break right now from medical treatments (especially unsuccessful ones) and I think not having to worry about all of that will help kickstart my weight loss once again. I also feel that I haven’t had very much luck getting my injury treated simply because I’m fat and don’t look athletic. I think most doctors and specialists I saw didn’t take me very seriously and didn’t understand how important it was for me to get back to running as soon as possible. I’m hoping that my leg will heal itself eventually but that if it doesn’t that I will be thin enough at some point to get proper medical attention.

When it comes to my weight, I’ve been maintaining it at around the 68 – 70 pound mark. I was really hoping that I’d get to 80 pounds by the end of the year but that just didn’t happen. As I feared when I joined Weight Watchers a few months ago, I really couldn’t stick to it. Their program (which is a diet, regardless of what they say) was just too restrictive. I know people can lose weight doing Weight Watchers and I really envy those people who can stick to a plan and steadily lose a pound or two every week. But for whatever reason, I’m not wired that way and I seem to take a lot of missteps before I eventually move forward.

I’m now back to writing down my food in a paper food journal, monitoring my appetite, and trying to only eat when I’m truly hungry. I was really hoping that I could get to 90 or 100 pounds by the time I turned 30. Right now, I think I’d be happy with 75 or 80.

And that’s why losing weight (naturally) is so fucking incredibly hard. It takes a lot of time and energy. It takes months of losing and gaining the same five pounds. It takes a lot of readjusting and shifting. What worked for me three years ago, may not work for me today. I wish it was faster, mostly because I’m tired of having worked so hard and come so far and yet not being there yet. Even though I do sometimes feel like a little hamster on her little hamster wheel, I have to remind me myself that just being on the wheel is better than not being on it. I’ve managed to maintain my weight loss for three years. I exercise several times a week. I eat mostly healthy food. I’ve managed to lose and maintain an amount of weight that most people can’t lose or maintain. I’m down 4 – 5 sizes. I’m the lowest weight I’ve ever been as an adult.

And for now that’s something to be proud of.

second opinion

Yesterday afternoon, I went and saw a doctor at PAMF to get a second opinion on my back/leg injury and a referral for a PAMF physiatrist (since at PAMF you have to see a GP first before you see a specialist). I have no idea if the physiatrists at PAMF are any good but I’ve had pretty good luck with specialists there so I figured it was worth a shot.

The GP whom I saw felt that all the necessary steps have been taken in my treatment so far. Given my age, she said that conservative treatments (e.g. rest, Advil, chiro, PT) would be employed first. She also said that back injuries do tend to take a long time to heal so my current progress isn’t atypical. She did confirm that the results of my MRI are not bad, there is no serious damage to my spinal cord/nerves so it seems pretty mild. She felt that looking at the MRI report she couldn’t see me needing surgery (yay). She did prescribe an anti-inflammatory medication (from my understanding, something similar to Advil but stronger) in hopes that taking that on a daily basis for a month will reduce the inflammation in my sciatic nerves (and so reduce the pain/tingling in my legs). I’m hoping that the new medication plus another month of PT will resolve the issue. She also did give me a referral for a physiatrist and I scheduled an appointment for early October.

So after that experience, I have some renewed optimism (and renewed faith in my primary GP’s course of treatment, although not so much in her referrals :)) about the problem, although I can’t say that I have any more patience (but I’m really trying to be).

update on my injury

Earlier this month, I saw a physiatrist about my back/leg injury. I can’t say that I was too impressed with him since I found him dismissive and rushed. And he told me to exercise – somehow the “I noticed this sharp pain in my leg when I was RUNNING” and “I try to workout everyday” didn’t register with him. He did order an MRI of my lumbar spine, which revealed that three of my discs are mildly herniated. My L5 disc (the one at the bottom of my spine and the one most people injure) is off to the left side, which is pinching my sciatic nerve (hence the sharp pain in my left leg when I run and the constant tingling in my left leg). I’m not sure if the other two discs are of much concern (perhaps I would know had he spent longer than 5 minutes reviewing my MRI with me) and I’m not sure that they’re causing any of the off and on throbbing pain in my lower back (apparently you could have bulging discs in your back and not even have any symptoms). He prescribed physical therapy for a couple of months and did manage to refer me to an awesome physical therapy place.

The physical therapy is pretty time consuming, which has been stressful. The PT appointments range from 1.5 to 2.5 hours, twice a week (and the only reason they’ve been 1.5 hours is because I’ve had to rush them because I needed to get back to work!). I also have to do some stretching and strengthening exercises at home and those tend to take me about one to two hours to do. The PT place is really nice, down the street from my office, and seems to have a very sports medicine approach (which I especially appreciate). They’re a million times better than the first PT I had tried way back in June. They did a very thorough evaluation of my condition during the first visit and seem to always work with how I’m feeling that day. There have been a few times during the past couple of weeks where things we did in PT flared up my back or leg and when that’s happened, we’ve adjusted my exercises. When that happened with the last PT, she seemed to always blame me instead of actually taking responsibility for her treatment (one time she was convinced that I had been crossing my legs at work hence causing more tingling in my leg, which is funny because I NEVER cross my legs). Given the time commitment, I’m really hoping that the PT will work but it is hard to say since I’ve yet to see any improvement.

Aside from the amount of time I’m spending on physical therapy, I’ve also been pretty frustrated with the limitations that have been put on my exercise. I can’t run. I can’t ride a bike. I can’t do spinning or kick boxing. I can’t go on a strenuous hike (I can go hiking as long as the trail is pretty flat, which sort of defeats the purpose of hiking). I can do the elliptical, stairmaster (although I can’t seem to do it for longer than 15 minutes since the sharp pain in my leg starts after about 20 minutes), stationary bike, swim, and walk (I’m not so sure about the walking since it does seem to cause the same type of pain as running). I haven’t been doing any resistance training since I don’t really have the time to do it anymore and it also seems to flare up the pain in my back.

As I’ve mentioned before, this injury has been really hard on me. I can’t do the activities that I really enjoy and I can’t seem to lose any more weight without those strenuous activities. I came to the conclusion last week that I may just have to focus on maintaining the 65 pounds I’ve lost so far and healing my back/leg. Even though I know maintaining my weight loss during an injury is a pretty big deal, it is still pretty hard for me to accept that that may be as much as I can do right now.

another one bites the dust

As much as I like the chiropractor I’ve been seeing the past few weeks, I’ve come to the conclusion that chiropractic care does not seem to be healing my leg injury. The chiropractor’s adjustments have been very helpful in temporarily healing my back, although it seems that any wrong move brings back the back pain (e.g. a resistance training workout on Sunday meant that my lower back was throbbing most of yesterday). This has led me to believe that there is some underlying issue that is not being solved. I have no idea if my back issues are related to my leg but it does appear to be a possibility.

I have an appointment tomorrow morning with a physiatrist. I’ve never heard of the field so I really have no idea what to expect – this is just the next step that my doctor outlined (if seeing a chiropractor didn’t help).

So this new specialist will be medical person #4 that I’ve seen to try to solve this problem (first my doctor, then the physical therapist, then the chiropractor). I’m really really really hoping that this guy knows what he’s doing, takes my issue seriously, accurately diagnoses it, comes up with a concrete treatment plan, gives me a solid time line for recovery, and finally heals my pesky leg! But given my track record so far, I’m trying not to get my hopes up. If he ends up being a jerk (an unfortunate reality in my experiences with doctors – likely due to my weight and their preconceived notions about what that means about me) or doesn’t figure out how to heal my injury, I’m giving up on my doctor’s plan for healing this injury. I’m now thinking my next steps after this guy will be to see somebody in sports medicine at PAMF or Stanford. I’ll probably try PAMF first since my old doctor used to be there and I’ve seen specialists there (and I really have no idea how easy/hard it would be to see somebody at Stanford and if I’d need a referral).

In so many ways, this experience has led me to objectively question my doctor’s judgment, whom I only started seeing last fall (after an awful experience with the doctor I had for a couple of years at PAMF). I really don’t want to switch doctors yet again but I’m having a hard time justifying seeing a doctor who is out of network (meaning I pay some out of pocket costs and have to file all the messy insurance paperwork myself) when she can’t help me quickly and efficiently heal an injury. It sucks because I really liked her – she seemed very thorough, personable, smart, patient, caring, and encouraging. But none of that really matters right now – I just want somebody to help me get back to my normal active self. Aside from the physical pain, this has been an emotionally devastating experience for me. I really miss hiking and running. And I miss feeling so great about myself. :( I wish I can find a specialist who really gets how important this is for me.

the last two months

A friend of mine emailed me this morning wondering how I could possibly not have updated my blog since May 15th?!? She even started to wonder if her Blackberry had it wrong.

Her Blackberry didn’t have it wrong – I just haven’t had much to say lately. I wake up, I weigh myself, I get frustrated when my weight hasn’t gone down, I do stretches that are supposed to help my injury, I go to work, I attempt to workout given the limitations of my injury, I see specialists about my injury, I get frustrated about the lack of progress in the healing of my injury, I read vampire novels, I go to bed. And then I repeat the whole cycle the next day.

Being injured has sucked. I don’t have a clear diagnosis of what is really wrong with me – I have some sciatica-like symptoms in my left thigh. I have a constant tingling in my thigh, which most of the time I don’t even think about. When I do go running, I have a fairly severe pulling pain in my thigh and sometimes in my butt. Depending on who you ask, this pain might be a pinched nerve due to tightness in my glutes and other muscles in my butt (did you know that you butt does a lot of work when you’re running or hiking?). Or it might be a herniated disk that is inflaming/pinching the nerve. Or it might be a compensation injury due to an imbalance in my form. I also sometimes have pain in my lower back or tail bone but that seems to be more sporadic.

It is frustrating because I’ve been dealing with this injury since February. I’ve seen my doctor, a physical therapist, and a chiropractor. We’ve tried a bunch of different things and so far nothing has healed my leg. I’m trying to stay positive about the chiropractor since I only started treatment with him a couple of weeks ago. If that doesn’t work, I’m supposed to see yet another specialist (I can’t remember the technical medical term but I believe it is a doctor who treats the back exclusively).

This injury has been a pretty major setback for me. I’m angry, disappointed, frustrated, and generally feeling helpless and like a total failure. It is one thing to get injured when you’re skinny. It is something else to get injured when you’re trying to lose weight. I’m actually surprised with how hard I’ve taken it. I knew I was starting to love running but I didn’t realize just how much it meant to me. Not only did it enable me to stay on track with my weight loss goals, I just really enjoyed it. Running makes me feel like I’m an athlete – it makes me feel like I can do the impossible. Sure, I’m pretty slow and I can’t run that far (4 – 5 miles is the longest distance I’ve run) but it still feels like I’m doing something I’m not supposed to be able to do at my size right now. Getting on the elliptical doesn’t excite me or give me the same feelings of self-worth that running does. Running helped me sort through the various emotional and mental junk floating around my mind. For whatever reason, I can’t seem to get the same sort of clarity from any other exercise I’ve tried.

I’ve been trying to see the silver lining to my current situation but that has been a struggle. I keep reminding myself that I’ve come a long way and accomplished something that most people can’t do. I’m at the lowest weight I’ve been in 11 years. And despite my injury, I’ve still managed to maintain my weight loss. All of those are very positive things but I can’t help but think that they’re excuses. At the end of the day, I’m left with overwhelming feelings of failure, anger, and disappointment.

And that’s really why I haven’t been blogging – nobody wants to read a whiny angry post.

In more positive (but unrelated) news, I just moved to a new apartment this weekend. I LOVE the new place so far (despite having a bunch of maintenance issues).

I have a lot to be grateful for in my life right now – I’m just struggling to see past this setback.

various fitness related updates

I don’t have much to report about my life so I figured a fitness update was in order (and there really isn’t much else going on):

  • When I increased the intensity of my running workouts a couple of months ago, I started noticing a sharp pain in my left thigh. The pain would usually only occur when I was running and go away after I stopped running. At first, I thought it was because I needed to get some new running shoes but my new shoes didn’t help. I then figured it was just normal soreness from challenging my body so I ignored it. The pain got so bad last week that it started lingering for a few hours after my running workouts. I decided that this couldn’t be normal so I took a break from running for a week hoping that it would heal on its own. When the pain didn’t go away after a week’s rest, I went and saw my doctor. It turns out that I have sciatica. The good news is that my doctor doesn’t think it is back/disc related and she seemed pretty optimistic that I’ll be back to my normal running workouts in a few weeks. From my understanding, it sounds like the cause of the problem might be lack of proper stretching. The muscles around my sciatic nerve are tight (which apparently happens when you exercise) so they’re causing pressure on the nerve. For now, I’m taking a week off from anything that triggers the pain – running, walking, hiking, and bike riding. I can still exercise but my options have been pretty limited this week – elliptical (not the crossramp kind since that also triggers the pain), swimming, and resistance training. I’m also supposed to take Advil 3 times a day (to alleviate the inflammation) and do the piriformis stretch. That stretch, by the way, is literally a pain in the ass – although it doesn’t seem as hard to do now as it did when I first tried doing it Monday night. Starting next week, I can get back to running (YAY) but I have to take it slow – I’m only supposed to do half of my usual workout for the first week or so. If the pain doesn’t go away after a few weeks, I have to go back to see my doctor for more intense treatment. I’m hoping that it’ll heal up sooner rather than later.
  • I’m back to taking swim lessons but with a new instructor. I’ve only had two lessons so far but I really like my new instructor. She seems to really know how to work with adults and I’m seeing a huge improvement in my skills. Her availability seems pretty limited, though, so I’m hoping I can continue to work with her over the spring and summer. I was started to get really down about my swimming skills – like I’m never going to get any better because I didn’t learn as a kid. It’s nice to be excited about swimming, again. And its been great timing since I can’t run right now.
  • After the whole sciatica thing, I started thinking that I really need to learn more about running. For the most part, I feel like I’ve been running blind. I knew enough to find a running plan online so that I could actually slowly progress to running a 5K and I knew enough to go to a running store and get proper running shoes for my feet but other than that, I really don’t know much else about it. I decided to buy a running book so that I could learn more about proper training and stretching. I looked through a number of books at Borders but settled on this one. Even though I’m not very far into it, I’m really loving reading this book! For one thing, since I can’t run right now, it is nice to at least think about running. The book is really positive and very encouraging. I looked at other books and some of them seemed to have a condescending tone – like spending a whole chapter lecturing you on how to get motivated. Umm . . . given what I’ve accomplished the past few years, I’m not sure motivation is my problem.

If you’ve been reading this blog, following my flickr photos, or watching my steps on Walkertracker, you probably know that I’ve been working out pretty regularly for the past six months. I find gym culture to be fascinating. I enjoy observing how people workout, what they wear, who they interact with, and how much they actually know about fitness (evidenced by what they’re doing, how they’re stretching, and how much attention they’re paying to their workout). There’s a part of me that silently observes and judges people. I like to think that I’m more hardcore than other people at the gym – I’ve got the fancy running shoes, I wear a pedometer AND a heart rate monitor, I know my heart rate zones, and I *don’t* need to be distracted by a TV. This morning at the gym, I crossed over the hardcore line into the dumbass area. I was running on the treadmill, doing my usual pace, when all of the sudden my left knee was down on the actual track. I’m not sure what happened but I guess I must have tripped (or perhaps I was so exhausted, my leg decided to quit?). I tried to hold on and pull myself up but before I knew it, my right knee also went down on the track. All of this of course happened within a split of a second. While all of this is happening, the track is still running at 4 mph, which sounds slow but feels like 80 mph when you’re sitting on the track instead of running it. The voice inside my head tried to make sense of the situation, but failed – “WHOA! WHAT HAPPENED TO US! STOP! WE NEED TO HIT THE STOP BUTTON! MUST REACH THE STOP BUTTON! WE’RE GOING TO DIE! IS ANYBODY SEEING THIS? WHY ISN’T ANYBODY OVER HERE STOPPING IT! STOP!! AAAAAAHHHHHHHHHHH!!! WE’RE GOING TO DIE!!!! IT’S ALL YOUR FAULT!!! I TOLD YOU WE WERE TIRED BUT YOU WOULDN’T STOP!!! I KNEW YOU WEREN’T SMART ENOUGH TO CONTROL OUR BODY!” OK, the voice inside my head didn’t say that last part but you get the idea. While my brain was racing, I tried to reach over to the stop button but couldn’t reach it. Finally, my arms and head fell to the track, which bounced me off the treadmill and onto the floor. Not the best way to start your Thursday morning. As a result of the ordeal, I scraped both of my knees very badly. They hurt and burn and seem to like to send burn signals to the rest of the nerves in my legs. In an odd yet convenient coincidence, I had a follow-up appointment with my dermatologist scheduled this afternoon so I had her check it out while I was there. You know your injury is pretty bad when even the doctor shrieks and turns her head away. I didn’t think my injury was that bad (I figured a little Neosporin would do the trick) but apparently both of my scrapes are deep. She prescribed an antibiotic ointment (which I need to pick up tomorrow) and LOTS of bandaging supplies (gauze, paper tape, non-adhesive pads).  Oh, and I’m probably going to have scars on both of my knees.  Sweet.  I’m not sure what I’ve learned (if anything) from this whole thing, other than I’m more of a dumbass than hardcore when it comes to working out.

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