Denouement

 No crying streak broken last night when I had to make the call whether to workout this morning or not.  I decided not to, I was in some serious pain (perhaps a 7 by bedtime), and the good news is I am still upset about not working out.  My legs may be getting flabby, but I am still thinking like an athlete :)

Pain 3-4 in morning, about a 3 now, superpainful at PT when trying to lift leg, rotate, etc on the tables.

PT:  longer e-stim because I have been hurting,  then ultrasound, then megalong massage by intern (hey I wasn't going to stop her), then hamstring stretch, ankle press exercise, and pelvic exercise (I asked Steve the name of this sucker but it was hopelessly too long for me to remember).  Then Steve started to work on me, and brought the MRI report to me.  At first blush it looked like a stress fracture, but in their details it seems to indicate something short of that (exerpt:  There is an increased signal involving the bones on both sides of hte right sacroiliac jiont, more prominently on the sacrum side of hte joint than on the iliac side of hte joint.  NO increased signal is noted within the joint itself.  While there is a subtle low signal linear density crosssing the right aspect of the sacrum at th emargin of this increased T2 signal, a similar and symmetric structures seen on the left sisde so I do not believe this represents an acute stress fracture. . .These findings a re suggestive of stress reaction.)  Total mumbo jumbo to me.  Steve's having me rest, and on Monday we'll consult with Dr. McLane, since she asked the radiologist to call her while he was reading it, she will have some insight.  So do I have a stress fracture, or perhaps something just short of one????

Steve said assuming its a stress fracture, that I need 7-10 days in a row with no pain, then I can start incorporating cross training.  So it might take 5 days to get to consistent no pain, but we'll see. 

Holy freaking pain!  Pain shot up to 8ish by late evening, pain with every step, every movement, pain while riding as passenger home from date.  I held Paul's arm for support as I walked, close to buying crutches. I will not curse about this, I will not curse about this.

Pain around a 3 at waking up, 2-5 through 1pm.

Pain gradually increased to just below yesterday.  Walking around like a ninety year old.  

Pain very much the same.  Lots of back tightness too from bracing for pain (had that yesterday too).

PM: back started to tighten greatly late afternoon and pain was about a 5, so I took a muscle relaxant at 5pm, which actually helped quite a lot.  My pain was more mellow last night, pain of 2-3 with straight walking, and twists, getting out of car, etc still hurt up to 5-6, but not nearly as bad as the last two nights (thank heaven). 

Confirmed stress reaction, just short of a stress fracture (no fracture line yet).

 I got to see my MRI pictures, very interesting to see yourself in slices.

Crutches for three weeks to keep weight off, should decrease healing time.

Bone stimulator should come in the next couple of days.

TENS machine so I can get electric stimulation to my heart's desire (also does IFC).

Muscle relaxants, a pain reliever (non addicting she says) in case I need it.  I am getting sick of reading, but I guess I can work at my desk. 

I can walk in the pool if it doesn't hurt, may start swimming arms only with my scuba mask and breathing thing, once I go crazy. 

Oh man, Benji got some type of break in his leg.  Apparently a piece chipped off in Feb when he got his initial injury, but we thought it was just a sprain.  Today was his second time reinjuring it, and it turns out he is on crutches!  I thought he'd be my designated mopper and gopher, but I just had a chat with rascal #2 about being a big boy and helping us all out while we are waylaid.  Two people on crutches in my house in one day!  Its like a bad sitcom.

Pain about a 1-2 early morning, 0-1 during the day.  Pain in back started around 11am, took a muscle relaxant around noon, will take another around 7pm (I can feel the lower back soreness coming back).  Pain in SI still around a 1, but I tripped on my chair (clumsy with crutches) and felt a stab of pain in SI.  

Did reach over exercise with weight on my good leg today with no ill effect.  I've been told by Dr. McLane and Steve I can walk in the pool or swim with just arms, but I am going to wait for another day at least.  I don't want any more false starts.

During my nap I dreamt Adam Lambert got kicked off American Idol, must have been post-traumatic stress from last week.  He is soooo good and rather fine when he wears his eyeliner :)

Pain in bed still when rotating, or if I trip in my crutches like a clutz, and a 1 otherwise.  Pain up to a 2 by evening, forgot to use crutches twice when getting up from couch, and leg felt fine both times.

Steve O sent me three articles about sacral stress fractures and they were like reading diary.  These injuries are so rare that misdiagnosis and false starts with treatment are inevitable.  If only it could have been diagnosed in Feb, but it wasn't because of faulty medical care, rather a lack of medical clairevoyance, and I'll have to forgive my various caregivers and most of all myself for that shortcoming :)

The articles suggest I could be on land running in 4-8 weeks, so I will likely be doing the 8 week plan.  Even though I have a "stress reaction" by diagnosis, I am going to treat it like a stress fracture, because it very well could be and just wasn't picked up strong enough (too many layers of fat to image through ;) ). 

Found out in articles amenorrhea was a potential cause of bone density loss. I just thought it was one of the many perks of being a serious runner :)  My last two were 4.67 months apart, so perhaps this is a risk for me.  I need to figure out calcium supplements and how to test for bone density/bone loss.

One week of no activity, then slow increase of cross training sounds like the plan.  I haven't done any cross training since Thursday, but I had extreme pain through last Saturday, and even Sunday wasn't that good, so should I wait until next Monday to start crosstraining?  My start will be walking in the pool and swimming with my arms.  All needs to be pain free.  So I could try it Friday and just see if its pain free.

Used new home e-stim unit, 2.5 hours on SI, 1 hr on back.  It's not as sturdy as the models at Dr. Bradys, or Steve O's offices, so I hope I don't wear the sucker out.

I can't stand sleeping on my right side any more!  Laying flat on my back causes a dull pain, and I can feel the SI when I shift legs in bed, or sleep on stomach too, but that's how I ended up.  I'll know I've won the battle with this thing when I can roll around in bed to my hearts content.

I feel like such a slug.  I have fallen out of love with food, feel semi-nauseous alot and undeserving of eating, since I so sedentary.  Eating none the less.  There's the female athlete triad that contributes to bone injuries:  1) disordered eating, 2) amenorrhea and 3) osteoporosis.  I have #2, perhaps #3 but not #1.  I don't always eat as well as I should, but I eat plenty (as demonstrated by my 10# weight gain so far) and try to eat right. 

No pain getting in or out of the car (I was keeping legs parallel like a granny, but still progress).

 My back got tired by the end of the day, but no steady tightening/pain like days past, so that is progress.

1.5 hr of e-stim on SI

1.5 hr of e-stim on lower back

.5 hr of e-stim on SI

I read that e-stim can actually help the bone rebuild.  Has anyone else heard that?

When I woke up I got on my left side (I think I've been saying my right side this whole time, but its my left I am on to relieve the right side) and I lifted my right leg, which traditionally caused pain, but no pain.

Laid on my back for 1 hour last night and felt no pain, some pressure on my bone but when I paid attention, that pressure is also on the left, just the weight of my body!  I gingerly rolled to the left and there was no pain! I don't dare roll to the right, that is where I am very likely to feel pain.  I guess I'll test that side in a few days if I feel like there's more healing progress.

Feeling happy with my progress!  Here's to another crutchy day.

Update - work was so hard!  I had to go up and down the stairs many times, never though my desk job had so much moving around.

Went to the elem school's fair in the evening, so more crutching around.  No real pain but can feel my SI just a tad. Big knot in my upper right back.

I dared to roll over to my right side for the first time in over a week this morning and there was no pain.

Lounged around the house.  

Went out in the evening and it wiped me out.  Its a 35 min drive to Provo.

Paul got us into Chili's without waiting by saying something about his wife being in crutches (I was in the car waiting to see if the wait time was too long for us).

By mid movie my tailbone was sore, probably too much sitting throughout the day.

Had 60 minutes in the car on the way home, wiped out by the time we got home.  No pain above just feeling like the right felt differently than the left.  And tired and back sore.

I love mother's day! 

I am making Paul make a turkey, you should have seen his face as he took the giblets and turkey neck out of its cavity.  He is so afraid of semonila and it just grossed him out.  He made a cake and frosting from scratch.  He's so domestic!!!

I got a big symphony bar and between the 5 of us (mostly me, but I shared) its gone!

My back massager I got as a gift is missing some pieces, so I need to take it back :(  Next year I am getting my own MRI machine :P  It'll be way useful for early detection of stress fractures.

I am still thinking to go to the pool Monday for walking in the pool and swimming with just my arms, but will keep it short.

I have no pain, but some slight soreness if I rotate on a bed, trip with my crutches (sorry this still happens) and otherwise can just feel a slight difference between the two sides, but perhaps thats just the muscle atrophy. (muscle atrophy being my favorite phrase right now).  My right side (unused side) is also slightly discolored (pink, sometimes purple) but I can get it the same color after flexing and relaxing the calve for a few minutes.

To the Legacy Center!  I swam 10 minutes with my snorkle mask and breath-tube in so I could freestyle the whole time.  Had to take brief breaks to drain nose section which wasn't staying water tight.  HR 108 at the end, not bad.  No pain or SI discomfort, I did not kick them.

then 10 minutes walking in the pool.  It felt foreign to walk with both feet.  Felt slight discomfort in the pool at one step, and just kind of weird on the rest.

I felt like I could have done more swimming with no negative effects.  The 10 minutes of walking felt like plenty.  Not really a work out but felt like some dormant muscles were waking up. 

I left my snorkle gear and my running belt by the side of the pool on accident--dang it!  I hope they are there tomorrow.

I felt into the door with my right hip as I exited the dressing rooms, and that caused a pain in my SI of 2-3 which did not linger. 

PT:  e-stim on back, back ultrasound and massage, then Steve came in and did some light gluteal massage, back massage and some hamstring massage and rotational exercises.  He wants me to do some rotational exercises that aren't weight bearing.  I'll go in again Friday.

I am feeling good so far today.  My back is sore from being at work and on crutches, but no apparent negative effects from the workout.  I haven't taken a muscle relaxant yet, but I think I will right now.

I called last night and they had my snorkle mask, but the worker must have set it aside because they couldn't find it this morning and the worker this morning said she saw it last night too.  She said it was probably in the main office, which was locked.  So I'll call again tonight.

 They had wire basket full of running belts just like mine, so I convinced them to give me one my size, since they found my snorkle equipment but probably put the belt away, thinking it was the pools.  I was honest but persuasive :)

I had to swim the old fashioned way, turning my head to the side to breathe, just wearing my normal goggles, but I did the freestyle for the most length ever today:  400m.  It was almost straight through, though I would hang by the side and take a couple of breaths at each turn.  I did them nice and slow so as to not drown, I completed that in about 12 minutes.  Then I did 100m backstroke to get to 15 minutes of swimming.  My HR was 90 after the freestyle.  I then walked in the pool for 10 min.

I woke up this morning at 3:38 after having a dream that Marion had walked into our home the middle of the night into our bedroom and woke me up and started talking to me, but Paul was trying to sleep and I was trying to get her to be quiet so that he wouldn't be disturbed.  Talk about invading our bedroom :)

I couldn't get back to sleep after that.  I had pain which I thought was in my SI at first and was very distressed, but then figured out it was lower back pain.  I can deal with that.  I was very tired driving to the pool.  I hope I can take a nap today.  I sure roll around at night, I am noticing.  When I had pain when I moved, I was motivated to get on my left side and stay put.  I slept every which way last night, even on my right side (with no SI pain- first time in weeks).

PM: Went to dr regarding supplements/bone density test.  She said I need to be on calcium, magnesium, potasium, vitamin D and Glucosamine/chondroitin.  She said that our body absorbs 90% of calcium from milk, and 30% from supplements, so I need to continue to focus on getting my nutrients from my diet.  She ordered a DexaScan, and I thought it was awesome I was able to go right over and get one.  After I got it I wasn't so sure. 

The table was metal with a pad on top of it, and laying on it caused my good old SI pain to flare up.  It hurt while on that table (I had to move around into a handful of different positions).  Afterward I got off the table I felt like normal (that was 2pm), until 6:45 when my SI pain crept back, in the 2-5 range (two while doing nothing, 5 being the sharp pains when I move the wrong way).  I had pain when moving in bed last night.  I can't be positive it was just the table.  My pain tends to come also when there is an accumulation of excess use, so perhaps the walking in the pool the last two days also contributed.  I will do nothing until the pain is gone, then I'll walk in the pool again and see if it is the cause of the flare up.

Coughed before going to bed and I felt a pop in my SI area.  I was turned toward Paul and I was shocked and panicked.  But pain felt no different before or after.  I can feel every sneeze and cough in that area.  Weird.

Pain in the morning about a 1-2, not as good as during the last week, but not as bad as last night.

Pain increased in evening, very much the same as Tuesday night :(

Well the good news is I am getting lots of sleep. 

Pain 1-2 in the morning, lower during the day than yesterday, and some pain during nap, but shooting pain less intense and frequent than last night. 

So there is improvement today, not enough to satisfy, but enough to keep hysteria at bay :)

Pain got a little worse in the evening today than yesterday, a dull soreness in the SI area at a solid 2 by the end of the day, another pop in the SI when I sneezed, slight soreness when I lay on back, some pain when rotating in bed. 

PT: e-stim and heat, ultrasound, massage on lower back, lightly on RT SI area, then Steve worked on my back, ham and my left hip (IT band) since it gets sore when I am on my feet too long.  Then my e-stim and ice.

Good news, I got a bone stimulator today and used it for the first time.

Day 12 crutches

Day 1 bone stimulator

Day 13 crutches

Day 2 stimulator

Felt just a tad better than yesterday.  No pain when walking, some feeling/pain when I change clothes, bend down, lay on my back, twist, etc.

SNL was so awesome today, I laughed so hard it made my SI hurt.  Oh well.  And Green Day is awesome!

I was excited for my friends running Ogden, but sad when it ended poorly for Allie.  I also had a hard time seeing people compete and to not be able to, though I reminded myself that I didn't have this race on my race schedule anyway. 

Very much the same.  I am getting sick of explaining my injury to all my acquaintenances.  I know they mean well, but explaining it over and over is like pouring salt in my wounds.

On a positive note I think I am coming to grips with losing all fitness and with perhaps never being as good as I was in 2008.  It was a great ride.  I hope to be able to return, but I need to find peace with the path God has placed in front of me and worship the running idol no more.  I've got to keep it all in perspective.  It would be nice to get my health back so I can be a functional mother, but even that is not up to me.  I have something to learn yet from this and I resolve to learn it ;)

PT appt this morning. e stim, very lower back ;), then ultrasound, massage, Steve maasage and discussion, then more bum e stim and icing.  Plan is to walk10 min really easy in the pool on Wed and swim with my arms.  Then take Thursday off, then Friday do 10 min spin with no resistance if I don't get a negative reaction to Wednesday.

I saw KellieS at the grocery store when shopping with my family and I was in a wheel chair (the jazzy was in use).  My first reaction was mortification, being caught in a wheel chair at the grocery store.  But then we had a really nice chat.  Thats the difference real friends make.  They help you feel at ease and accept you however ridiculous you are.  It was like a ray of sunshine and it made me realize how starved I am for interaction beyond my tight circle of home-work-doctor.  Thanks for not laughing at me Kellie :)

Temple this afternoon, wow they have a whole row of handicap spaces and I can't use them.  It is hard crutching up that hill, and hard to put on the brakes going down the hill.   So I did get my workout today :)  Feeling spiritually in the zone.  Rediscovered K-LOVE (I always stop listening when there's pledge drive, I do this with NPR too).  Too much repetition, but definitely positive and uplifting.

Went to KellieS and TylerS' home for tevoing of American Idol (I invited myself over and they graciously agreed).  

I drive up and there's a bright blue handicap sign on the front door, a hilarious touch.  It was fun to hang out with them and dispute who should be the next AI, edgy boy or sweet meek boy (I vote edgy).  Then we had a nice chat.  They tried to fatten me up through various snacks but I was strong :)

Pain was really nonexistant today.  Lower back soreness right from morning straight through the day.  Funny how when my SI pain goes lower back pain emerges.  I could feel some slightish dull pain by late night (about a 1).  I am very encouraged!!!!

About 14 minutes of swimming with arms, scuba mask, and running belt around waist.  I look choice, especially when you add in the crutches while getting in the pool.  The good thing is people hardly ever ask to share the lane with me.  I look too odd.  500m total freestyle, first 400m in 10:07.  I was taking it pretty easy, but got heartrate up to 108 by the end.  This is the longest I have used the scuba gear while swimming.  My mouth got so dry from breathing into that pipe, noticable after 10 min.  

Then 10 min of walking in the pool with water about 4" shy of shoulders.  My weak leg is weak.  Go figure.  No pain.  Right side just feels different everywhere, but noticably in the bum, not pain, just a feeling that its different. 

Will do nothing tomorrow, see how body reacts to this, then will try to repeat Fri.  Steve wanted me to spin with no resistance Fri but I bowed out. Even without resistance I think the rotations are risky for my joint.  I'll give in and do it next week.  He is the PT after all.  I didn't even know what an SI joint was until Feb 2009. 

Felt pretty good, tired and allergies. 

pain/discomfort would occasionally come to SI area, 0-2, but mostly 0.

Did rotational exercises with no ill effect.

600yds swimming, first 400 in 9:28, and total in 14:30 hr 111 at the end.

10 min walking in pool--just feels wierd to do it.  I have some feeling in SI/bum/back area.  Its hard to know if its my joint/muscles getting used to movement again or if this even low level of activity is too much for it.

Have PT appt this morning.

PT says if I feel good throughout today that tomorrow I should walk holding up some of my weight on the arm rests on a treadmill for 5 minutes.  I feel like I am in Cinderella: 

Wicked stepsisters:  What you said Cinderella could go to the ball??

Wicke stepmother:  I said "IF".  (wicked cackle).

Well, I started having persistent if mild pain in the evening, up to a persistent 1-2 by bedtime, shifting in bed brought spikes pain up to 4 in pain and some tears too.  The bad thing is if I can't handle 10 minutes of walking in the water then what indication do I have that I am healing or that I'll ever get off these crutches?

Woke up with pain at a 3, then walking around its a 0-1, with pain of 2-3 if I bend, twist, or other such movements.  I am trying to keep my chin up and be grateful this trial is of a temporary and temporal nature. 

I am reading Uncle Tom's Cabin. For how much I love to read, there's so many influential books I haven't read.

Pain just a tad better than yesterday.

Pain 0-2 during the day, with spikes during nap, in bed at night spikes up to 5 (five is when grunting and involuntary moaning from pain happens). 

I had the worst night of sleep in a while (I didn't take ambien).  I tried sleeping on my right side, since my IT bank on my left side hurts from always sleeping on it.  It doesn't hurt being on that side, but it HURTS to change position.  I dreamt I ran a marathon very slowly, and Sasha and that red head dude in MikeMC's picture (can't remember his name) both saw me when they were in mile 22 and I was like at mile 13 and they were trying to cheer me up ("you're doing great! total time is only 2:19 so far!"). I kept taking detours.

Day 33 withouth running

Day 22 on crutches

Day 20 on

Day 10 on bone stimulator

Pain about the same as when I got on the crutches - highly irritating.  I have an appt with Dr. McLane.  My questions for her will be:

1) Can I be healing if I feel the same as when I got on crutches?

2) Can we see the health of the cartilage in the MRI images?

3) Are we missing something?

4) Can I sleep on my right side?

5) Should I be in a full body cast?

6) Should I get off crutches even if my pain is gone?

7) What can I do to stop atrophy (mention involuntary stretches of legs)?

8) Could my hamstring be causing issues (mention increase in hamstring symptoms with no activity)?

9) Should I stay away from mild massage in my glutteal area?

10) If this is just a stress reaction, shouldn't it be healed already?

Last night was better.  Some pain but not as bad.  Pain in ham higher than SI (4 vs 3).

Some pain getting out of bed and dressed (1-2).

No pain midday.

Walked 5 minutes on treadmill barefoot at 2:30pm, holding some of my weight with my arms, though that started to hurt my hands.  Worked up to 2.2 pace.  Gait highly uneven.  Some soreness in ham during but none in SI area, neither during nor up to now.  Also no pain getting in and out of bed (except in hamstring).

Answers from Dr. McLane below:

1) Can I be healing if I feel the same as when I got on crutches? Yes, they probably weren't ask helpful as we hoped but since my spikes in pain are decreasing with each inflammation cycle there is hope that I have healed some in the last three weeks.

2) Can we see the health of the cartilage in the MRI images? Not usually, she gave me a reference to a neurological surgeon, who will give me a consult, hopefully in a month, if I still am not mending.

3) Are we missing something? There may be an unevenness in my legs, which haven't been clinically found.  She had me go to radiology and see if they can find a leg difference in imaging.  My right orthotic had a bigger heel than my left based off dynamic and static images of the pressure my feet put on a pad back in the spring of 08, then I started using the orthotics in June 08, and my hamstring and SI injuries ensued (but so did my highest training ever). I should get the results tomorrow.

4) Can I sleep on my right side? Yes, so long there's no pain I can sleep any which way.

5) Should I be in a full body cast? She laughed, though I don't see what's so funny.  I reiterated that I was ready for a full body cast if it would guarantee healing.  She said instead I need to go four weeks without any crosstraining.  So that's what I'll do.  Let the sloth and indolence continue.

6) Should I get off crutches even if my pain isn't gone? Yes, do the 5 minutes walking test to see what pain follows, then she was fine getting off the crutches cold turkey, but that sounds dangerous to me.  Since I am so conservative :) I will allow myself to go to toilet at night without crutches if I don't get a lot of pain tonight, then I'll allow myself to do short walking spells tomorrow without them.  Thursday night we have guests for dinner, so I'll do my longest stint without them during the dinner hour.

7) What can I do to stop atrophy (mention involuntary stretches of legs)? n/a will start using legs again, at least to walk around.

8) Could my hamstring be causing issues (mention increase in hamstring symptoms with no activity)? definitely, have Steve Orrock focus on trying to calm the ham down once and for all

9) Should I stay away from mild massage in my glutteal area? no, soft tissue work and even stretches should be fine, it shouldn't cause issues with healing.

10) If this is just a stress reaction, shouldn't it be healed already?I kind of knew the answer to this one already, because it's in an area of my body that is always being used (getting in and out of bed and the car, on and off the toilet).  Thus my argument for the full body cast.

So hopefully I'll be off the crutches by the end of the week, which would be a huge blessing.  To be able to carry toys, clothes, trash with me as I walk around the house.  To be able to cook and clean.  I don't like cleaning, but I will appreciate the ability to do it now (at least for a while).  Like I have said before--God has to use a big stick with me. 

No pain getting out of bed in morning, no pain in the middle of the day, with the exception of getting out of the car once, and when scooting on table when laying on my back at the PT.  No pain in bed during naptime. Pain in bed when went to bed, 3-4 level.  Dang.

PT: focused on hamstring and glute.  Discussed getting off crutches and Steve thinks I should get off gradually over the next week.  He gave me some exercises to do to help me get off my crutches since my attempts at walking demonstrate I am not ready to get rid of crutches cold turkey.   Exercises are doing a walking motion, right foot and crutches step forward and step back, gradually allowing my leg to have full weight.  Less jarring than just walking around my house.  Did each foot 15 times.  Did it again at night.  I did way too much cleaning in the afternoon, enough to make the bottom of my left foot positively ache.

last night(to/from kitchen-couch 4 times), show I am a total grampa.  My ham hurt when walking, felt stiff and like I had no power in right side. No pain in SI when walking.

No pain this morning, other than a spike of 1-2 getting out of bed (so far).  

Stepping exercises: morning, midday, evening, first set no pain in ham or anywhere else.  By evening some soreness in ham and right IT band by hip, and gluteal area (mild) but no sharp pains all day, nor at naptime, nor at night.  Encouraging.

Feeling golden.  Ham is feeling stronger.  I do little steps without crutches, have been all week, and today feels the most natural.  I will still be on crutches for all most all of the day.

Had a chat with the tens unit dealer, he guided me to program it for the best settings for my injury yesterday, so I started using it again yesterday again.

Day 37 - no running

Day 25 - Gluclosamine and calcium supplements

Day 15 Bone stimulator

Day 7 - no crosstraining

Stepping exercises: Morning and evening.

Walked to and from my printer at work 4 times, other small walking stints throughout the day. Felt some pain in my right hip area, on the outside, like an IT band issue. Able to roll in bed without pain, except soreness in IT band and right ham.

Man, I am struggling so well :)

Legs felt good when I woke up.  No pain.  Some really low level soreness in the whole area.  I hope to be off the crutches fully by Monday. 

Sunday, I felt fine, took small walks without crutches, but IT band area of right hip would start to hurt (this happened Sat night too from no crutches).  Did 3x walkthrough exercises on crutches.  Pain in bed up to a 2 on rotating in SI joint.  Dang it.