All The Times I Have Been to the Emergency Room

Yesterday, I was at Marin General and it made me start reminiscing about all the times I’ve been to the hospital/emergency room. Here are all my personal trips to the ER (not counting when I accompanied someone else), as I can think of them:

  • Shattering my teeth in the mall parking lot (a classic, obviously)
  • Biting through my lip when I accidentally slammed a weight-lifting bar into my face — which was also a key part of my Best Week Ever
  • Knocking out my front tooth in college at a pick-up soccer game
  • Hitting a curb and my bike in my first-ever mini-practice triathlon, which caused a concussion and a not-a-seizure
  • Passing out in the training room in high school, after getting hit in the face with a medicine ball, and having a not-a-seizure
  • (I can’t remember if we actually went to the emergency room or just to the doctor either 1. the time I slept-walked in the middle of the night in high school and dove off my bed into my bookshelf and then went back to sleep, or 2. the time I passed out from some weird combination of cold winter running/hot tub/shower, and hit my head on the kitchen floor when I fell. I do know that all those times prompted a whole rash of tests and visits to the Children’s Hospital.)
  • Falling off the slide in 5th grade (I think) and having a not-a-seizure
  • When they thought I had appendicitis in 3rd grade and were all set to take out my appendix, but then I mysteriously got better; memorable because we took a cab to the emergency room, which was the first time I’d ever been in a cab and it was quite exciting
  • Getting my thumb slammed in a door as a kid, and we weren’t sure if it was broken or not
  • Jumping off a pool backwards and slamming my chin into the cement — also the only time I’ve had to get stitches (which got infected and then I had to get more stitches)

I feel like I’m missing one and, obviously, there were plenty of other accidents and injuries that didn’t warrant an emergency room visit. But, as you can see, when I say I don’t need to go to the ER and it would be pointless, I know of what I speak.

What is Vasovagal Syncope and Why Does It Suck So Hard

I wrote this on facebook last night:

facebook

A vasovagal episode is the official name for the weird thing I have where my heart goes nuts and I sometimes pass out. At least that’s officially what the super fancy specialist at UCSF said — and also that there’s not much to do about it. It just is what it is; some people pass out. Don’t hit your head. Studies say that the only thing that really stops you from passing out is when you feel it coming on you have to do this thing where you sit down and cross your arms and legs, because that forces the blood pressure to rise. So.

Traditionally, this has only happened to me after something big caused my heartrate to skyrocket and then drop, like I would pass out after crashing my bike or I’d have trouble after a really hard race — always after, after sitting up and being ok, after the immediate problem, once I realized I was fine and the whole adrenaline or whatever stopped, then my heart would go nuts and I’d pass out. Fun times. I’m pretty much screwed if I ever get in an actual car crash or have a huge emergency. You can guarantee as soon as I’m safe, I’ll pass out.

The last two times, though, it’s happened during a run with other people. We’d be doing something moderately hard, because of the efforts or the sun or whatever, and we’d stop, stand around and talk for a few minutes, and then suddenly I would be reeling. It happened in July and it happened yesterday after hill repeats with the high school kids. Abruptly, as we were waiting for all the kids to finish, I had to sit down and focus on things not going black and my heart was echoing in my ears and I couldn’t breathe. Needless to say, this is always super fun to explain to people (especially high school kids and especially when you really can’t talk right in the moment).

This time, like the time in July, it took FOREVER for my heartrate to get back to normal. After 5′ or so, I was able to shuffle/jog the mile back to school. But, I still felt not great. And, back at the school, I started to feel disoriented again and like I was going to fall over from the pressure on my head and the light, agh the light, always goes bright and then dark. It took maybe 15-20′ from when it initially started to feel totally ok. This is new. Traditionally, once I passed out I was fine or once it came on it would go away within a minute or two. I even once had to lay down on the track in between intervals to wait for things to stop and then I finished the intervals. That was not happening yesterday.

Yesterday, as is often true when these episodes happen, I was done for the day. I had to bike very, very slowly home. And, then I couldn’t do anything but lay on the couch the rest of the night. I’m still pretty exhausted today — though that may just be from the hill repeats (plus other training) and not from what happened after the hill repeats.

There’s nothing to do. I’ve been to the best specialist doctors and I’ve had all the tests done. There’s no danger to these episodes, they say, even if I did pass out (as long as I don’t get another concussion). It’s just part of my life, whatever. The UCSF doctor did refer me to a specialist cardiologist two years ago, though, because with how my heart speeds up instead of slows down it seems likely I have an arrhythmia too. But, that doctor said the next step is to do this thing where they go up through a vein in my leg to explore my heart and possibly close off (is that the right term?) the arrhythmia. And, I said, ‘yeah, no’ to that.

So, good times.

Do you have episodes like this?

Why I Hate Doctors — Especially ‘Sports Doctors’

The first doctor I went to for my mysterious foot injury (who was highly recommended) told me it was just inflamed, rest it. When that didn’t totally work, she referred me to another doctor in her office for a cortisone shot. That doctor said it’s a bone spur, you’ll need surgery. So, I went to a running specific doctor, who said here are some inserts to correct the problem, keep running.

Those are very different diagnoses.

If I had gone to three random people on the street and asked what was wrong with my foot, then I would have deserved whatever I got. But, these were all professionals, whose opinions I paid for. And, the part that’s really terrible was that each diagnoses was delivered with 100% confidence and an assurance that they had it figured out.

This past weekend I went to Urgent Care. Four weeks ago, when we were in Hawaii, I got a crazy bite on my side, which turned into a red rash/ring that spread across my side. It mostly has gone away (though not entirely), but there was a lot of concern that it might be a tick, or whatever the equivalent is to Lyme Disease in Hawaii. Then, Friday morning I woke up with another weird bite on my arm and by Saturday morning there was a giant red rash/ring that had spread across my bicep. For extra fun, I also had debilitating weakness in my arm that day.

That’s weird. So, I went to Urgent Care, which is like 10′ away. Because it happened twice now, I was concerned. What if I picked up some parasite in the waterfall pool in Hawaii? What if I was bit by something not good?

At Urgent Care, I sat and waited and waited and answered all the nurse’s questions and then the doctor came in and said, “So, I heard you have some kind of a rash” — while carrying my chart, which would have answered that question.

Before I finished my first sentence, he said, “Did you see a tick?”

Well, no, I did think that far ahead before coming in. Him: I don’t see a tick.

Gee, thanks. Him: I don’t know then.

And, then he started to prescribe me antibiotics and I asked how can you prescribe antibiotics if you don’t know what it is? How do you know that will even help or that it’s a bacteria? Are you just prescribing a generic antibiotic that will kill everything?

And, he laughed and said, hah, not everything.

Um.

I tried to explain that the rash was a symptom of the problem, not the problem. That I’m not concerned about it itching, but about what caused it to itch. And, he asked like what? I said, like a tick, but whatever other parasite like a tick there might be in Hawaii. And, he said, well, I could prescribe you an antibiotic that’s also for ticks if that’ll make you feel better. And, I said, but we don’t think it’s a tick. And, he said, no. And, I said, so, that won’t make me feel better.

When he left (after asking four more times if I smoke but not asking if I’d been feeling sick or had a fever or muscle aches or where I’d been recently) and I waited some more, a different nurse came in to ask if I have any questions. I was feeling super bitchy by then, so I said, “Tons, but you guys don’t seem to have any answers.” She wanted to know what my questions were, so I said the same stuff again and how I’m concerned about what’s causing this. And, she looked it over and said, “It looks like an insect bite.”

Yes. Well.

The problem isn’t that doctors are people. It’s that they think they’re better than regular people. We bestow on them this mantle, but forget that information doesn’t equal knowledge. Every kid in my dorm in college wanted to be a doctor. And, if they stuck with it long enough, most of them are now. But that  still doesn’t mean I want them doling out advice to me, particularly about things they don’t know about — and why would most general practitioners have any specific knowledge about your specific problem.

Steve had a back/hip injury at one point and went to the doctor, who was nominally supposed to be a “sports doctor.” She told him to rest (or something), but that he could still swim. Only she must have been thinking water aerobics, because when he asked about kicking, she was like oh no, no kicking. Which obviously makes swimming hard, unless you pull all the time. So, then, she suggested swimming with a kickboard under your stomach for support.

Does that even make sense? Is that even a thing?

Is My Foot Better?

Yes. No. Maybe. I don’t know.

I first hurt my foot in March. It was weird. Over the course of one track workout, the base joint of my big toe on my left foot became so debilitating I walked home. I was told it was inflammed and to rest, but you know for all that someone telling me that had Dr. in front of their name it might as well have been a random person saying it. Who knows. Some rest didn’t make it better. More rest only made it sort of better. Ice, rest, water run, rest. AHHHHHHHHHH

Oddly, most pictures of people being "frustrated" are of people getting angry with their computers. So, there you go.
Oddly, most pictures of people being “frustrated” are of people getting angry with their computers. So, there you go.

I got a cortisone shot and was told by a different person with Dr. in front of their name that I had a bone spur. I was not told what that means. I tried to run Boston anyway. I couldn’t run, really, having not been running. My hamstrings and quads and knees and calves all gave out. Some more rest, ice, rest, trying to run and have even more crippling problems. 

In early May, a different doctor-type person gave me inserts and told me everything would be better, though I suppose he was really only talking about my foot and not general life issues. Sometimes my foot was better; sometimes it just hurt different. I ran the Dipsea anyway and thought I had put this all behind me.

But, no. No. The week after the Dipsea I started working full-time in the city – which I know everyone is sick of hearing about, but man, I am not a fan of three hours of commuting. Working in an office meant I went from wearing sweats and sitting on the couch most days to wearing dress shoes and walking from the train to the ferry to the bus to the office. My toe started to hurt again. But, different. Before it hurt on impact at the base of the joint. Now, it’s hurting on impact but also on push-off in the toe itself (not at the joint). And, there are distinct times I know it’s going to hurt — landing hard off a curb, running to BART in dress flats yesterday, stepping on a rock just so.

I took off from running completely. I changed shoes. I iced. I raged. Etc. In Hawaii, during one of our hikes/walks it would hurt shockingly painfully when I landed in certain spots, but then the pain went away. I started running again and it hurts, but then it goes away. It hasn’t gotten worse. It hasn’t gotten better.

So, on we go. 

Yeah, that is not flattering, am I right? Photo: Pam Wendall.
Yeah, that is not flattering, am I right? Photo: Pam Wendall.

I raced the mile this past weekend. The longest I’ve run in my two weeks since “starting training” again is 7 miles. Partially I know my foot isn’t going to stand up to more training or longer runs, especially those necessary to train for IMs, and I’m just waiting for everything to implode. But, it’s hanging in there now. And, with no real sense of what’s causing the problem, I guess that’s the best I can hope for?

Am I missing something obvious? Is just continuing the best option?

 

Are Shoe Inserts Going to Fix All My Problems?

Wednesday, I went to the doctor in an effort to solve some of my problems. The previous suggestion by the other doctor when I got the cortisone shot that “Oh, I have a bone spur in my foot and might have to get surgery” just didn’t sit real well with me. It didn’t make sense, it had little reasoning behind it, and, um, surgery??

This podiatrist, who’s actually a running doctor, had some more logic and reasoning, but my eyes tend to start to glaze over sometimes and what I retained was: ‘The way you land and the shape of your foot puts undue pressure on your big toe joint. That’s why you’re having a lot of problems.’

This is what is supposed to solve many of my problems:

Magic foam.
Magic foam.

I’m not 100% sold, because I generally believe that if you just stick an insert in your shoe then 1. you’re not solving the underlying problem in your body mechanics and 2. you’ll cause other problems.

But, the doctor watched me run and videotaped me running and said my body mechanics are ok, for the most part. I may just need this temporarily to take the strain off my toe, let it heal, and allow it to stop causing bone spurs with all the pressure of the rubbing joints together. Or something.

And, anyway, might as well try some pieces of foam before getting surgery.

The thing is, my toe has been causing me a lot of angst because I’m not sure if I should make plans or not, but it hasn’t actually been my biggest problem. Here is a list of problems I have been having when I try to workout or run:

– My toe/tendons in my feet are sore later
– My arches keep cramping up into knots so bad that it woke me up the other night
– This also makes it hurt when I’m running and makes the soles of my feet burn
– Mild IT band issues
– My left hamstring (and now both my hamstrings) feel like they’re ripping out of my ass after 30′ of running
– My left calf then decided to get in on that party, when I tried to run on Tuesday, and about 50′ in felt like it was ripping/locking up/knotting
– I appear to be very, very out of shape

Some of these are supposed to get better as my foot stops trying to compensate for the toe injury. Some of them are supposed to get better with time and strengthening and massage. But, some of them are mysterious.

I have been very, very out of shape before, like serious sat on the couch for three months out of shape. I really shouldn’t be that out of shape right now — I mean, come on, I’ve been doing stuff. This leads me to believe it must be partially in my head and a lack of motivation. It’s also been like 90 degrees at my house and when I walked outside to run yesterday I was actually blown back by the sudden wave of heat. This is not motivating. But, mostly, when my legs just hurt so much and revolt against the easiest of workouts, it’s hard to get excited about what sounds like a death march.

Last week, I did a handful of short/easy runs and some Crossfit and one longer bike ride. This week I tried to step it up and went for a longer run and my calf felt like it was tearing. So, I’m back to the drawing board. Either rest and do nothing for multiple days/week OR race a 5K this Sunday and see if racing myself into shape is a good solution?

 

Do Cortisone Shots Work?

The number one thing people have been searching to get to this site lately is “cortisone shots” (or, as someone wrote it, “cortizone shoots”), which apparently directs them to a post I wrote about why I got a cortisone shot in my foot. It seemed appropriate, then, that I should update these visitors on if it worked or not.

In short: yes, the cortisone shot worked.

The day of the shot my entire leg hurt and I didn’t do anything except sit around. The next day, my foot was still sore and slightly swollen, but I could water run. And, by two days after I was able to do a test run, which went fine, and then a slightly longer test run the next day, which was when I realized it wasn’t my foot that was going to hurt me during the marathon.

So, yes, it sort of worked. My foot hurting is not why I dropped out of Boston. But, a cortisone shot doesn’t solve all your other problems, which have come about as a result of whatever is the reason you need to get a cortisone shot, so it’s only sort of a cure-all.

In theory, now, the cortisone should last for a few months, but after our daily 4-5 miles of walking around Boston my toe started to feel sore. (We had to walk a mile each way to get to the train station, through neighborhoods full of some creepy-ass East Coast big houses.) My toe has been on and off sore-like for the last week, meaning I can usually run a few miles, but I’m never sure if I’ll be able to. This leads me to believe one of two things: either the shot isn’t as effective as purported or the problem is not necessarily inflammation as much as it is some other bone-type issue, like a fracture.

Both of those scenarios mean one thing: doctors suck.

In Today’s Things That Suck: Water Running

It’s official: I hurt my foot.

According to the sports ortho doctor woman, the joint at the base of my big toe is inflamed. According to the sports ortho doctor woman, it’s unclear how that happened. It happened all of a sudden in one workout last week and it’s not like I did anything wrong or overtrained or recovered poorly or wore shitty shoes or the billions of other things you can fuck up training for a marathon. (I mean, obviously, I probably did one of them or several, but there’s nothing that points to a specific poor decision on my part.) It just happened.

She said there wasn’t anything to do but rest it. I asked for how long and she said three to four weeks. To which my response was: Yeah….about that.

Seeing as Boston is in less than four weeks now (ahhhhhh), the revised plan is: rest from running, throw every anti-inflammatory at it, ice ice ice until I lose the nerves in my other toes, and do lots of biking if it doesn’t hurt, Alter-G running (which I had totally forgotten about, but am now hoping will solve all my problems), mild panic attacking, and water running. I’m not completely sold on this plan. I’m pretty sure my foot is slightly more sore today than yesterday, but it’s like staring at the sun and trying to decide if it’s more bright or less bright than before — also a good idea. Since there’s not another better plan, though, this is the one we’re sticking with.

Yesterday, I went to the YMCA to water run. It was just like this, minus the smiling:

I should probably just give up running and get into water aerobics. They look happier.
I should probably just give up running and get into water aerobics. They look happier.

What is water running?

Water running suffers from the fact that it looks an awful lot like what those guys who used to wear gold chains in the pool at the 24 Hour Fitness did, until someone had a heart attack and they had to shut that pool down.

Water running is actually supposed to be running — not walking or jumping or waving your arms around — with the same mechanics of running as much as possible. But in water. The idea is to simulate running without impact so you can train through injury (ahhh) or train high mileage pre-injury. It is boring and it sucks. It is also highly effective, because if done correctly it mimics running and keeps you aerobically in shape to run.

(While I was going back and forth in the deep end of the pool yesterday, I was trying to decide why exactly it sucks so much more than either running or swimming. I have not yet come up with an answer. Any insight will be appreciated as something to think about during my next session.)

How do you water run?

You do it in deep water, first off. Your feet shouldn’t touch the ground.

Maintain running form, which is hard, but don’t bend too much over — a slight lean, I think, is how most people operate — and don’t overextend your legs. I found it’s really easy to accidentally start treading water shittily, waving your hands around and doing a type of scissor kick.

It’s particularly easy to lose form if you don’t wear an Aquajogger belt. Lots of people think it’s harder without a belt, which is true — it is harder not to drown. But, I’m of the belief that your body then focuses on not drowning instead of focusing on maintaining running form.

With the belt and the floating of the water, it’s also easy then to go really easy. Most tips suggest keeping cadence high and doing harder efforts mixed in to get your heart rate up.

Don’t run into the women doing acqua-aerobics. Or small children.

This video is ok:

So, yesterday, I followed all these directions and went to the Y to do 50′ of water running with some 10 x 30″ pickups and 10 x 1′ pickups. Now, our YMCA isn’t like some other people’s YMCA, where apparently you can just get offered sponsorships while you’re swimming. (I sort of wish I went to Beth’s Y.) Our Y has the original weight machines, like from when weight lifting was invented as a thing with actual weights instead of just rocks. And our Y has a large and dedicated water jumping population. I don’t really know how else to describe the enthusiastic jumping and swinging arms and hanging on to the wall to do strange ballet-style kicking. It’s some kind of workout you must only learn about once you hit a certain age. Oh, and yeah, there were kids there too.

I’m being super judgemental obviously, which isn’t nice, but 1. I haven’t had the capacity to be nice in weeks and 2. I’m really just judging this one woman — who, as a side note, was creating a wake with her jumping routine — because she was probably about 50 years old and wearing a large pink headband that said “PRINCESS” in sparkles, which is about 46 years too old for anything you wear to say Princess unless you are actually a Princess, in which case leave us commoners to our fucking Y. Is nothing sacred.

I huffed and puffed and weaved and ducked and was dripping sweat — even though I was in a pool, I could tell it was sweat and not water. And, the people doing their insane jumping routines kept staring at me, since I was obviously the craziest one in the pool. Don’t I know water is for water sports, land is for running? Or, they may have just been looking at me because I turn bright red when I workout and look super awesome and refreshed, just like this:

This is how I always look after I go swimming.
This is how I always look after I go swimming.

What to Do about Running Injuries? A.R.T.

I don’t really like doctors. If you’ve gotten to know me at all, it shouldn’t be a surprise that I’ve gone through more than a few. I think they have a point, for certain emergency room visits, diseases, broken bones, but athletic injuries? No. You can only be useless so many times before it’s really my fault for still giving you my money.

At some point a few years ago, after I traipsed through yet one more office to listen to one more medical professional suggest that “perhaps I ice it” or “had I tried not running” or “I should only increase my mileage by 10% each week, so if I’m running 10 miles this week, then run 11 next week, or if I’m running 15 miles right now, don’t do more than 16.5 next week,” as if I didn’t understand the concept of 10%, that I told the doctor that for my $50 co-pay he was going to have to give me more insight than I could get from Runner’s World.

Since then, I have more or less stopped going to doctors for sports use injuries. And, since I have been to enough physical therapists to know what they’d say anyway, it has worked just fine.

For the IT band/hip issues I deal with regularly (as everyone does), I’ve learned to develop a strength program that keeps a lot of the underused muscles strong and helps prevent injury. I use the foam roller to get the knots out of my legs, ice baths when I know I’m going to be sore, rotate through a handful of different shoes — all of which I think has helped prevent most injuries. I get massages when I know I’m getting tight and it keeps things loose. And, when something starts to be a problem and I start freaking out, I go to one of the two doctors I trust: my A.R.T guy, Dr. Kyle, or my chiropractor, Chappy, who really is more of jack-of-all-trades with lasers and little metal tools and a thing that like hangs you upside down.

Yesterday, I went to Dr. Kyle and he jammed his thumb so hard into my ankle that it made my hamstring hurt.

If you’ve never been to A.R.T. (Active Release Technique), it feels like this — which is actually a knife holder for your kitchen I saw on The View one day:

cool-kitchen-appliance-and-accessories

All it really is is a guy poking your muscles with his fingers while you move your leg or your arm or whatever hurts. But, it’s amazing how sharp they can make their fingers.

Dr. Kyle stuck his fingers in the arch of my foot and the inside of my ankle and my heel and I could feel the nasty shit being forced out of the area, like an actual little knot in my nerve being scraped out. I don’t know the scientific explanation, exactly, without sounding like I’m bullshitting, so here’s my explanation: My ankle/heel/foot is all fucked. Muscles have really tightened up, as I tried to compensate for cramps in my foot and for things hurting. That has trapped all kinds of tendons and nerves and what have you. You gotta get that shit worked out or you are screwed.

So, hopefully, that’s what he did.

It seems a little better, but sore. I’m optimistic. And, if not, I’ll go to my other guy tomorrow and get some cold lasers to fix that up.

Have you tried A.R.T?