Well this is confusing

 From my MRI report:

There is a non-displaced fracture involving the third metatarsal neck. There is no acute bone marrow or soft tissue edema. The findings may reflect a fracture nonunion. 

From my x-ray report a week later (and I promise you nothing has changed in my foot):

A band of sclerosis is present involving the distal diaphysis of the third metatarsal. This is felt to represent a healed stress fracture.

Those are pretty different diagnoses. I've got a note into the super duper specialist (the one who actually ordered this x-ray last week) to see which one is accurate. Because honestly if the x-ray findings are accurate, not only will I be ecstatic I'll also go running. 

Bonus kitty picture to spice things up.

And here's the reply from Dr. R's nurse:

I spoke with Dr. R and he said the xray is what gives us the most up to date information. So I would say the Xray is gospel!  He said basically you are producing a band of sclerosis in that area which is your body's way of trying to heal the stress fracture.  He said that this could be an area of what is called hyperostotic non-union or is an area of bone formation in the face of a non-union.  He explained that typically those situation do go on to heal but they may require surgical intervention.  He encourages you to keep your appointment with the foot specialist.  

DNS so clearly DNF

On Friday, the window closes to submit marathon results for the Grandma’s Marathon this year (which is all virtual).

What to do with this?

I, of course, will have nothing to submit thanks to my broken right foot.

This is the first race I’ve not started, let alone not finished and this is hard for me.

I had a lot of meaning and significance invested in this race: the end of active cancer treatment, finally healed up from the fractured pelvis, also I’m 60 this year and that sort of seemed appropriate, to run my first marathon the year I turned 60.

Well that’s not happening. It’s hard to stay with the feelings, because they mostly suck and are centered on loss, failure, and fear that I will never be able to get back to the running I love so much.

So here I am, seven months after paying the fee to run that marathon, looking at a jacket I will never wear. I didn’t earn it and I would always feel like a fraud. Honestly, I'm not sure what to do with it.

DNS—did not start
DNF—did not finish

Where I am

Me for another 23 days

I saw the orthopedist last Tuesday, and the news was not at all what I hoped for. While this isn’t a bad break, he’s said I need to wear the boot until my next appointment—that’s not until June 23.

At first, he said no exercise at all but then relented and said anything that didn’t put weight on the foot was OK. Rowing is not OK, even though I told him I was pushing from my heels. That’s because he said it would be too easy to start pushing with the whole foot. So I have no aerobic exercise option right now because walking is also off the table. Well other than getting around the house.

At my next appointment, assuming things are healing well, he said he’ll put me in a carbon plate orthodic insert and I will be able to walk. I’m hoping rowing will be allowed then too. Running is prohibited for at least two months and more likely three months.

Long story still not so short, I can’t run the Grandma’s Marathon this summer and I won’t be able to rebuild my running in time to run a marathon this year. I’ve suspended my coaching, which hurts because I was making so much progress with him. I told him I will be back assuming I heal OK and remain gainfully employed, and he should look for me again in late July or early August. My goal at that point will be to regain my running fitness and look to run Grandma’s Marathon next June.

(this is related, bear with me)
I’ve been seeing a psychologist through the breast cancer center because having the breast cancer diagnosis and all the various treatments retriggered the post-traumatic stress disorder I have from being a childhood sexual abuse survivor. I met with her two days after I broke my foot and was pretty clearly distraught about this situation. We stopped the cognitive behavior treatment and instead she’s had me focus on staying with my grief, anger and despair over this. That’s very difficult, it’s so much easier to stuff those things back in the closet and slam the door shut. But that’s also not the way to peace and healing for me.

I’ve been writing what I feel and this weekend realized that this is yet another loss on top of already losing things that matter to me. While I haven’t actually lost running, I am concerned that a second bone has just broken while doing the sport I love. Sure, my pelvis fracture was due to too heavy a running load. I don’t deny that. But this foot bone was not. I’ve trained safely and sanely and paid strict attention to any niggles or pain in my body. I had no warning from my foot, not a twinge, at least not until the bone just broke.

When I was in my early 30s, I had a career-ending injury—I was a musician (oboist) and developed a terrible case of tendonitis in my right thumb, which spread to my hand and up my arm to my elbow and shoulder. And when I say terrible case, I mean I couldn’t sign my name to a check kind of terrible. I went through six months of physical therapy and about six months later, tried to play again. The tendonitis immediately came back. I lost something that had been part of my life since I was 10 years old and completely shaped my identity. I don’t know that I ever acknowledged that loss or felt any of that grief, except on the inside.

That’s been my fear, that I will lose running—something I love, that leaves me feeling calm and relaxed and as though I’ve accomplished something.

People keep asking me

Is it a stress fracture?

Which is annoying me all out of proportion to the question. I know why people are asking, they’re genuinely concerned, that’s all. But I got the same question when I fractured my pelvis and so now for Broken Bone 2.0, it’s annoying. Plus I'm cranky because I'm in pain.

Also I didn’t know what the difference was between a stress fracture and an acute fracture. I mean the bone is broken either way, so what difference does it make? Still, I was curious so turned to Dr. Google.

From this article I learned the following:

• Stress fractures usually cause a progressive increase in pain that is worse with activity. This lines up with what happened when I fractured my pelvis. It started hurting a few weeks before that last race, and then boom, I could no longer walk. I think it was breaking for a couple of weeks.
• Acute fractures typically have a sudden onset, with swelling and ecchymosis (otherwise known as bruising). And this is what happened to me on Saturday. I had zero pain in my foot and then boom, I had a lot of pain. Once I got home and took off my shoe, my foot started swelling and it’s still swollen. Normally my feet are scrawny bony things but right now you can’t see a dang bone across where my toes come into my foot. It’s Puffyville all the way. 

There’s a potential for something called a Lisfranc injury of the foot. Two months ago, I went to Urgent Care because of pain and swelling on the top of my foot. It hasn’t fully resolved so who knows, maybe that’s going on too.

And May's running is over

Yesterday at about mile 6 of my planned 18-mile run, my right foot started hurting in the area where all your toe joints come into the foot. I’ve never felt that before, and I hadn’t fallen or tripped or anything. I wasn't sure what to think but honestly, you get little pains all the time while running and usually they just go away, they’re nothing. So I kept going.

But my foot kept hurting. Oddly it hurt more running uphill than down (I love running uphill), and by about mile 7.5 I thought well I’ll get to the house and see if it’s a muscle spasm (my route took me by my house at about mile 10 so I could get a sip of water if needed).

But by mile 9.5 I knew I wasn’t going to get all 18 miles in, I hurt too much. So I got home (which was just over 10 miles total), took off my shoes and started to gently massage the bottom of my foot only I couldn’t—it hurt so much that I gasped and got tears in my eyes. I knew I needed to get it checked so I took a painful shower (hard to take a shower on one leg but I’ve had a lot of experience doing that from when I broke my pelvis) and then Kent drove me to the orthopedic urgent care clinic, the same one I went to when I fractured my pelvis, talk about a bad deja vu.

Long story not so long, I broke my foot; specifically, the third metatarsal. The break was clearly visible on the x-ray and I was devastated because I knew what that meant. I asked anyway, how long do breaks like these take to heal? Six to eight weeks, she said. She put me in a boot, gave me discharge instructions (elevate the foot, ice, Tylenol as needed, the orthopedist will call with a follow up appointment in 10 to 14 days).

So. No Grandma’s Marathon this summer. No more running in May, probably not much in June, and once again I will need to rebuild my running stamina etc.

This weekend has been a real low point for me. I keep randomly tearing up because this marathon meant so much to me and I was making amazing progress. I hope this is just a freaky random fracture and means nothing in terms of the osteoporosis (which by the way, I have been taking meds for) or a possible metastasis to bone from the breast cancer.

April was a good running month

As I’d shared with another blogger, I feel pretty fortunate that I’ve always preferred running alone and super early. That’s been useful during this pandemic—I don’t have to worry about social distancing (I see very few runners out when I go), and I didn't have to get used to running alone.

I’ve been working hard on my marathon training; my coach helps a lot and has been instrumental in me not getting injured. Case in point, I started having left knee pain a few weeks ago and I would have just blown it off, even though it was bad enough I cut short a long run. I shared it with him in the weekly check in (he has a section where I am to list any niggles, pain, etc.) and he immediately had me take a day off from running. Because of that, I got in to see my physical therapist (yes, my clinic is open) and we’ve been working on getting that all sorted out.

All of that to say that I hit several firsts for me: first time running 40 miles in a week, first time running 137 miles in a month and longest ever run of 16.3 miles. I still have doubts that I will actually be able to run this marathon, but that’s more about the mental side of running 26.2 miles all alone.

Last month I also ran the first of two planned virtual half marathons. This was for the Garmin half marathon, and I treated as a long run. I did one this last weekend too, which was for the Running with the Cows half marathon. I doubt I'll be a fan of virtual races after the pandemic is over (if that day ever comes), but these were good mental practice for me, running with no other runners, no support, no people cheering us on and no real finish line. Just my watch as it ticked over to 13.11 miles (I go the extra 0.01 so Garmin counts the damn run).

It's getting real

I’ve found a running coach (you can check out his website here), and I’ll be getting all the digital paperwork completed by the weekend. This will be a virtual coach, he's based in South Dakota.

I had a hour long video conference call with him on Sunday and felt very comfortable with him and his approach. He gave me a suggestion that he has his runners do, and honestly that tip was quite helpful. Basically, after a run he said to add in about 10-15 minutes of strength work to keep the heart rate up and get the body used to doing just a bit more. I did that this morning, and think that’s going to help a lot.

And yesterday, this came in the mail.

While I think it’s pretty hideous (does anyone look good in that lurid shade of orange sherbet?), and I won’t wear it until after the marathon, it did make the whole thing seem more real.

Some running stats and what’s next

I use Strava to track all my runs and workouts (Ben had suggested it to me, think of it as sort of Facebook for athletes). What I like about Strava is I can take a look at historical data to see how I’m doing and find any trends. Because of that historical data, I knew right away my heart rate spikes were so wildly out of normal for me last fall.

I took a look at my running totals since joining Strava in June 2017 and I was very surprised at what I found.

For 2017, the data only covers my runs since June, when I joined Strava.

Here's 2018. I ran fewer overall runs with longer mileage. And of course I broke my pelvis in May so I didn't run for several months after that:

But take a look at 2019. I would not have guessed I ran that much this year. For so much of the year, I felt as though I would never get back to my previous distances and times, or the overall total. And it’s true, I haven’t yet gotten there. But I sure ran more than I thought I did.

So what’s next? Well I did it. I signed up for a full marathon, my first ever. 

I had wanted to run the Garmin Marathon here in the Kansas City area. I liked the half marathon I did at that event in 2018 and I also like that it’s a local race. But the race date this year is April 18. I’m leaving the country on Saturday for most of January (a work trip) and that will no doubt crater my running. I’ll be in Manila, where it’s quite hot and humid and the air quality isn’t the best, not to mention I don’t know how safe it will be to run (thinking of traffic, not other kinds of safety as I’ll actually be in a really nice, safe part of the city). That was stressing me out, thinking of trying to somehow get the training miles in so I’d be prepared. 

So instead I’ve signed up for Grandma’s Marathon on June 20 in Duluth MN. This marathon has a great reputation for being very well organized and a whole lot of fun. I did crack up when registering because one of the questions asked if I were a grandma. Apparently the first grandma to cross the finish line gets a prize. Isn’t that hilarious?

I've got two training plans I'm evaluating for my training and ironically, the one I slightly prefer calls for a half marathon race on April 18. So I may end up running the Garmin Half Marathon this year!