A week later

July 20

Another week has gone by since my last blog. Life is resuming returning to normal post Ironman, post Tim's return to uber hours of work, and post move #2 for the year. I should be back up to uber hours of training or base building but I have bunked up my foot. Oops....apparently In the battle of Jenny vs. Mt Soledad .....Mt. Soledad won and I actually hurt my foot running uphill. Unless you all care to believe that the Hill Rom Total Care Sport bed ( carrying the 350 pound patient) that ran over my left foot during my last shift before I left for Ironman could be the culprit. It actually hurt at the time but the pain didn't linger. More than likely I think there is a definite lag between what you can do cardiovascular post Ironman and what your soft tissue can tolerate post Ironman. My form had been a touch off so I thought I would do the run at an easy pace wearing my racing flats to identify exactly wear I was striking my feet and I would clean up my form ........O.k. so this story is going from bad to worse.....Honestly though, there are readers of this blog who only run in racing flats. Maybe it was the best time to practice my form wearing racing flats..... (maybe that only works for Paul.....
so I was heading home going up Soledad and my foot started to hurt across the metatarsals. I was almost home and if I stopped it would be quitting on an uphill. That just didn't seem right....what's next asking for a ride to track practice????This is an inside joke with my family. The next few days I made it through my work shifts with a little discomfort and the next day I through on my bike shoes and the pain went away. That was until I got off my bike to do my first brick in preparation for IMAZ. I started to run and my foot started to hurt. This time I quit but stupidly refused to let Tim get the car so I was now reduced to walking up Soledad. The next few days I was either working or off work and lucky enough to be off work and riding with my friend Stacy. Magically my foot does not hurt at all while I am riding my bike. ( I think because the sole is stiff) It does hurt however when I stand on it at work. Hmmm. Imagine that sick call...."Yeah hi, this is Jennifer I can't come to work today because I am in pain and the only way to alleviate my discomfort is to ride my little pink bike all over the county".
Handy Tim examined my foot and said he didn't think it was a stress fracture but then C.Y.A'd himself and his future by saying but maybe you should have an x-ray.....it could be a stress fracture but it's probably soft tissue. I made an appointment at Coastal Sports Medicine because any non sports M.D. would think I have a psych disorder. When I told the Dr about my foot he laughed at me (in a nice way). He didn't x-ray it. He said Tim was probably right. Also that stress fx don't show up right away anyway and to come back next week if it wasn't better. He told me was impressed because a month after his first IM the bike was still in the box. I assumed he was riding his other bike. After I told him I was running up Soledad he stated......Jen.....the wetsuit was in the box with the bike.....ok so maybe he didn't ride the other bike. I explained to him that I had a 26.2 mile cool down because during the run my heart rate was only 130. I could breathe through my nose, talk, and eat while I "ran." He said the means the body has spoken..... it said you are done racing for today. He told me it's totally normal for my body to be malfunctioning right now and to expect to continue to do so for a while and that I'm inflamed everywhere. Hmmmp. Is Arizona too soon for me I asked. Nope..... he said, don't worry about it. Then he reminded me of Paula Newby winning IM after taking a long time off because of a stress fracture. I'm not Paula I thought, I actually need to prepare for this venue. I sheepishly kept my mouth shut this time.

I can only imagine the dictated H&P. It would read something like this:

31 year old well nourished, well developed Caucasian female complains of (L) foot pain s/p attempting to run up Mt. Soledad. She attempted this 21 day s/p Ironman. She denies use of recreational or performance enhancing drugs. She admits to supplementing with electrolytes while training and consuming protein recovery shakes prn. She is accompanied by three pairs of running shoes stated to be possible mechanisms of injuries. She confesses to cycling "toe down" at times. Her heart rate is 44 while sitting in the office but she admits to allowing it to climb to 181 during the Henshaw Loop.

Review of systems: Negative except exercise induced asthma. Skeletal: No hx of broken bones except (R)UE 3&4 th metacarpals suffered while alpine ski racing.

Differential Diagnosis:
Illusions of grandeur attempting AEB: running up mount Soledad vs.
(L) metatarsal stress fx vs.
Inflammation of plantar fascia at distal end vs.
Joint capsule inflammation

She has been advised to abstain from running for one week and return to office for x-ray in 1 week if no improvement of symptoms. Patient is highly suspicious for being non compliant with recommendations.

:)


For now my foot is too painful to think of running but on the flip side I guess I get to swim and ride more . Right????

3 comments:

Anonymous said...

If patient is suspected of being non-compliant on the next visit we will put her in a long leg cast. That'll teach her!

Anonymous said...

phantom pains from not training...you'll toughen up.

Jennifer Yake Neuschwander said...

It must be a psych disorder becuase my foot hurts unless it is in my bike shoe and spinning the pedals.