When the answer is not clear

I have what may be competing goals:

• Run one (just one) marathon successfully
• Break no more bones

And I’m not sure how to decide. Normally I’d run off and ask my medical care team only here’s something I’ve noticed. I’m not sure if this is age or gender bias or a lack of common ground (because 99% of my medical care team clearly aren’t as into fitness as I am), but what I’ve heard since fracturing my pelvis in 2018, then struggling with side effects from radiation that affected my fitness and then breaking my foot goes something like this:

• Why don’t you just take a long walk?
• You just run to stay fit, right? So find another workout.
• How about some yoga?

To which the answers are:

• A long walk is beyond boring. Seriously boring. I would rather put that energy into mastering riding my bike.
• I run to compete, not just to stay fit. So screw that noise.
• I already do yoga. And Crossfit. And biking. 

I do have one doctor who’s as into fitness as I am: my endocrinologist. He's an avid mountain biker, totally loves it. And that he's my endocrinologist is also good because he’s the one who keeps an eye on my bone health. So I’ve thought about emailing him through the patient portal and asking his take on this. 

Because I really, really would like to run just one marathon.

Another anniversary

A year ago, I was out running a planned 18 mile run in training for a marathon. Only at mile 6, my foot broke (I didn’t know that’s what that pain was) and I was 4 miles from home. That ended my marathon training, of course, and I started the rehab process again.

Today, Kent and I volunteered at the Kansas City Triathlon as running marshals. Unfortunately, Kansas City had torrential rain today, and the triathlon was changed to a duathlon: 1 mile run, 20 mile bike, then a 20k run. 

Kent and I were put in separate spots, I couldn’t see him or any other marshals and there were no spectators where we were. So, I stood alone in the rain and waited and waited for the first runners to appear. Let me tell you, those elite athletes were really moving! 

I made it a point to cheer for every runner as they passed—my thinking was that I’ve always done better when someone cheers me on at a race and even if I’m not yet in racing condition, I can sure return the favor. So many of them thanked me for cheering them on, for being there, and boy that was humbling. Yes, it was miserable weather and I was cold and wet even with my running rain jacket on. But I also hadn’t run a mile, biked another 20 and then been running another 12ish miles in that weather.

This was a good way to mark a not great anniversary. Next up, I’m going to be talking with a personal trainer in the Kansas City area. I’m ready to gear up my training for the marathon I missed last year. I want to be in my best possible shape for that (and NO broken bones).

Turns out I am just silly

 I shared that the cool bag Radius provided didn't fit the Tymlos pen. Wendy suggested contacting them so I did, shared that the bag didn't seem to be made to fit the pen I actually use. Readers, that same day they called me back!

Turns out that you really are intended to shove that pen down in the opening. As Pierre said, it's supposed to be very snug. So I present to you the fully filled bag with a pen that isn't going anywhere. I think I could drop this off a tall building and nothing would break.

Thanks, Pierre!

Deja vu

 In both collages, the photo on the left is the new bone growth stimulator for my broken foot. The one on the right is the one I used for my fractured pelvis. 

Otherwise, the drill is the same. I wear the device for 30 minutes each day, the clock resets at midnight Pacific time, and it's a use it or lose it device. I've got 270 doses and once I started the device, the count down clock started. In another 265 days, this device will become trash (no recycling which stinks).

Insurance covered this 100%, probably because the claim is later in our benefits year. I was pretty annoyed by the medical rep who brought it by. He came to the door without a mask on so I said (in my own mask) "where's your mask?" Oh, he said, out in my car. Yeah go get it. Jerk. 

Signs of the times or is 2020 over yet?

I now have a sharps disposal container to hold my used needle from each day's injection.

We have a big assortment of masks.

I think Wally is over this year too. Or maybe I'm projecting. 

About my foot—an update

I broke the third metatarsal on May 16 (the break is in the foot, not the toe but it’s the third metatarsal). It broke clean through and as I wrote then, my orthopedist put me in a walking boot and continued following up with me.

I saw him June 23, when he said I could ditch the boot and use the carbon plate, and then again on August 4. At that point he said I could stop wearing the plate but I wasn’t cleared to run for another three months. I'm to see him then.

I’ll admit I tried a couple of trots (cannot call them runs) and my foot hurt, so I stopped. Things improved and I thought great, this may take a lot longer than I want but I’m on the mend.

Except in the last few weeks, I’ve had a shooting burning pain on the top of my toe on the same foot. Basically, it hurts when I point my toe. So if I were in child’s pose, my toe would hurt like the dickens. Since that wasn’t a broken bone issue, I got an appointment with the podiatrist I saw a couple of years ago.

Unfortunately about four days ago, the broken spot in my foot started hurting again. Ugh.

I saw the podiatrist today and told her about both things, and about the weird pain I’d had on the top of that same foot way back in March right as lockdown started. She got an x-ray of my foot and yep, she said, you can clearly see the break.

She thinks that painful spot on the top of my foot may have been referred pain from the third metatarsal as it was in the process of breaking.

The burning pain, she said, is almost certainly nerve pain. The medial dorsal cutaneous nerve runs from that bony spot on the top of the foot to the big toe and the next toe--it splits and each toe gets a nerve. She said that nerve has probably been aggravated by all of this and by the micro adjustments I make when I walk due to the broken foot. And it's true, I'm not walking normally, I can tell.

What’s less clear is whether it’s healing properly or not. She said there’s a chance I have a delayed union, or possibly a nonunion fracture. Because I was diagnosed over three months ago with this broken bone, she said she can prescribe a bone growth stimulator for my foot.

Well I’ve been there before with my pelvis so I know the drill.

She also wanted the records from my orthopedist so I jumped through those hoops to get those over to her. Once she’s got the original x-ray and dx from May 16, she can prescribe the bone growth stimulator. I’ll see her in another month when we’ll get another x-ray. She said we may need an MRI to see what’s going on, but we aren’t there yet.

In the meantime, I’m still not running but she did say it would be OK to use our indoor rowing machine. Rowing is boring but if that's my only option, then I guess I will be bored.

Let me explain. No, there is too much. Let me sum up.

In looking back over my posts, I neglected to mention a couple of things about my bones.

First, I had all those tests run last July and as my endocrinologist thought, everything is great. So that means I don’t have an underlying reason for the bone issue. He recommended Prolia which is given once every six months by injection. I had the first injection in September with no issues.

In March, right as everything was getting locked down from COVID, I had the second injection. And the next day I had an allergic reaction around the injection site. It looked a lot like hives. Kent pushed me to get it checked out, although I didn't want to. So I compromised by calling the online nurse through my insurance company. Based on what I shared with that nurse, he recommended I get seen at Urgent Care so I did and sure enough. It was an allergic reaction.

Here’s the thing. I did a little research online and it turns out the housing mechanism Prolia comes in contains natural rubber which is closely related to latex  (see page 4, section 2.3 in this PDF). And I have a latex allergy. Apparently that was enough for me to have that reaction. So Prolia is off the table.

Today he and I talked through my options and there aren’t a lot. My number one goal is to stop breaking bones while running. So the treatment options are a drug that’s injected every day or one that’s given by infusion once a year. After talking through the pros and cons, I’ll be trying one of the daily injections.

He gave me a sample of Tymlos and recommended a trial run to make sure I don’t have an allergic reaction. Assuming I don’t, I’ll get started with the daily injections in September.

What cracked me up is this case he also gave me. It's actually for the other daily injection drug, Forteo (he didn't have any samples of that one). It’s made by Vera Bradley. I don’t know why that tickles me so much, after all Delta’s first-class amenities bag on international flights is by Tumi so it’s the same sort of thing. It just seems different for drugs.

Five needles per bag,
and there are six bags.

Designer baybee!