Platelet-Rich Plasma Therapy

Warning: If you can not handle the sight of blood, you probably won’t want to read this because, yes, you will see some blood.

I really wasn’t sure what to expect when I went to the clinic for my PRP injection.   How long will it take?  Will it hurt?   How long will my recovery be?  Will this be my only injection?  And, most importantly: will it work?

The “blood-sucker” introduced herself, took me into a room and proceeded to withdraw 30 cc of blood from my arm.  “Whoa!  That’s a big syringe!” I said when I saw it, and I didn’t look at it again until after she had finished taking my blood. “Wow! That’s really purple!”  I had forgotten that blood can look purple too,

One Platelet-Rich Plasma Cocktail in the making.
My layered blood.

Dr. Bentley, then, put my blood into the centrifuge to spin it around.  It only took seconds to see the blood start to separate into its layers: red blood cells on the bottom, then white bloods cells, and the platelets on top.  After a minute, the 30 cc that I had given him had been reduced to much less. After that, I really didn’t see much more as I was getting ready for the injection.  I caught of glimpse of what I think was a very long needle (the length of a pencil) as Dr. Bentley filled a syringe with my platelets to inject into my hamstring tendon.   I lay on the table, face-down and in a quasi-prone position, trying to relax.

Dr. Bentley poked with his finger at my upper hamstring to find the location of the tear before he started using the ultrasound.  I wasn’t able to feel any discomfort at first and that made me nervous.  “What if there really isn’t a problem?” I thought, only to be followed by my verbalizing, “That’s where it is.”  Dr. Bentley started to use the ultrasound and I heard him say to his student “That’s the tear, right there.”  I suddenly felt a bit of assurance.

“Get ready for a poke,” he said and that was all I really felt.   At one point, I felt like I was in a dentist’s chair as he asked how I was doing a few times.  I was fine.  “I’m just telling myself that this isn’t going to hurt that much because my legs are so muscular – ha!”  There was no real sensation of pain; it was more of a tightening.  I later described it to Dr. Bentley as an elastic tightening around your arm until you have a constant throbbing.  He replied that the blood being injected into a tendon has no where else to go so it would create that same kind of feeling.  As we finished up, he told me that it would feel like I was sitting on a golf ball for a few days.

On the way home, I was glad that Dave drove me to my appointment.   Moving my foot from the pedal to the brake and back to the pedal would have been difficult.  We hadn’t even left Hamilton when I said to him “I feel like my leg is having a baby.”  Painful, but not terrible, and knowing that it would end with something good.

A few hours later, I was able to drive.  I took my 13 year old to referee a soccer game and I happily stood for an hour to watch.  Walking was difficult and sitting was impossible, so standing had become the position of choice.   I could tell that it was going to be for the few days but I had a feeling that it would be worth it.

 

 

 

 

 

 

 

Stress Test

Last week, after 15 months of heart tests,  I was finally given a thumbs-up.  Everything is fine.

The fact that doctors thought there was something wrong with my heart was an enigma. In November 2017, days before I was running Nationals cross-country, an 8k distance, I was scheduled for a routine asthma test at the hospital.  During one of the baseline tests, the respirologist stopped the test.  “We can’t do it,” she said.  “Your heart rate isn’t normal.”

I was completely dumbfounded.  How was that even possible?  At that point in 2017, I had logged almost 2000 miles for the year and I was racing fast enough to call myself a competitive runner.

Cross Country Nationals 2017

How could I possibly have something wrong with my heart?  But during the baseline test, my heart rate dropped (spiked down, as she said) so that it was dangerous to proceed with the test.  After answering what felt like a gazillion questions (Do you smoke?  Do you drink?  Do you workout?  What do you do for exercise? and so on) and meeting with a cardiologist, they decided that it was safe for me to continue the asthma test.  “It’s okay.  There is a cardiologist next door if something goes wrong.”

Over the next 6 months, I had bloodwork, an echocardiogram, and an ultrasound of my heart.  In simplest words, results showed that my outtake valve is thinner than my intake valve; the valves, by the way, are only 1mm thick, which I find absolutely remarkable.  So running is good for me, but it meant that I needed to be monitored.

This past fall, at another asthma appointment with my respirologist, she asked whether I had been showing any symptoms?  “Of what?” I asked.  “I really don’t know what I am looking for.”  My waking up and gasping for air in the middle of the night could be asthma-related, or it could be a symptom of a heart problem.  So could the dizziness that I sometimes have during the day (which is likely attributed to a low heart rate).   My doctor wanted to “cross the t’s and dot the i’s) so she referred me to a cardiologist. Continue reading “Stress Test”

One Day At A Time

A few weeks ago, I finally picked up a training journal.  I had just started to run again and I wanted to get back to tracking my running on pen and paper.  Five days after buying it, before I had even opened it, I was pulled from running and was told that it will probably be 3-6 months until I can run again.  Since my MRI was at the beginning of January, this week marks the end of my first month.

At my physio appointment on Friday, Tammy’s power and flexibility were good; I am feeling much stronger in general.  The only indicator that I am not ready to run is my butt aches when I sit down.  Looking back, though, I realize that it has been sore when sitting for the past two or three years, maybe longer, which indicates that my hamstring issue may have been brewing for a long time and I just didn’t recognize it as a problem; instead, I attributed my sore sitbones to a skinnier tush.

These days, I am encouraged by the almost normal feeling that I have.  “Does it really take 3 to 6 months for a hamstring to heal?” I asked my physiotherapist.  “No” was the fast reply.  “It takes 6-8 weeks.”  I laughed. “Then, by the time I have my PRP injection, I should practically be healed.”

In mid-January, Dr. Elliott submitted the referral for me to see the hip specialist but I don’t even have an appoinment yet.  “They’re probably still getting over the backlog from the holidays” was suggested as a reason, which is fine, but I really want to know when I am going to see the doctor.  Will it be a consultation with a second appointment for the actual treatment, or will it all be done at once?  How many treatments does he think I’ll need?  And what about the labrum?  Do I need to worry about surgical repairs?

As the days pass, I get more and more frustrated that I haven’t had my PRP injection, nor any kind of communication from the doctor’s office.   But I am starting to believe that I may be back on the road in the spring as my hamstring seems to healing on its own and the injection will only strengthen it.

Fingers crossed, hopeful thoughts, and dreaming of running again….Believe.

Feeling Like a Rock Star

Every now and then, out of the blue, someone makes me feel special.  I end up carrying those feelings with me for days or weeks, maybe even longer, and they end up driving my energy.

On Thursday, as a group of Grade 7’s was leaving my Math class, one of the boys stopped, looked at me in the eye and said, “Thanks, Mrs. O’H.” I was caught off guard because he doesn’t usually talk to me at all.  But what came next was even more of a surprise.  “You’re a good Math teacher.  Ya.  So thanks.”  And off he went.

I really don’t know where that comment came from.  He isn’t a top student and he never comes in for extra help but he works hard.   I guess Math is starting to click for him.   Regardless, he made me feel great and, let’s face it, I’ve been feeling down in the dumps since I got my MRI results back so I needed  this “feel good” moment.

My second rockstar moment came on Saturday when I went for my ultrasound.  The technician looked at my history before she started so that she knew exactly what images she needed.  “How did you tear your tuberosity?” she asked.  “It’s a running related injury,” I answered, only to find out that she had the a similar injury and is just starting to run again after being off for a year.   So, of course, during the ultrasound, she spoke about her running, cross-training, and rebuilding – and she suddenly stopped.  “I’m so sorry,” she said.  “I should be focussing on you.  I mean, you’re here for your ultrasound and I’m busy talking about me.”  I insisted that I didn’t mind; I love to talk about running.  Besides, it took my mind off the whole procedure.  But she continued anyway.  “You look really fit and fast.  How far were you running each week?”  I could only laugh.

We chatted some more, mostly about the Chilly Half Marathon and Around the Bay.  We both really want to run Around the Bay this year because it’s the 125th anniversary, but her mileage isn’t high enough yet and I’m just not running.  I asked if she thought about walking the 30 kilometres instead and her face lit up.  “I never even thought about that!  I can do that!  I’m sure I can!”  I suggested that she try walking the Chilly Half Marathon in Burlington at the beginning of March and, if it went well, then she would still have time to register to walk Around the Bay at the end of the month.

As we were finishing up, the technician asked, “Should I know you? I mean, are you famous?”  I just laughed. “Only in my dreams,” I replied.  “Well, you are so motivational.  I am so happy to have met you today.  I really hope that you are going to be running soon.”  And that was that.  We parted without exchanging digits or handles, but as two runners who found a commonality and connected.

Meeting this technician was a gentle reminder of how supportive the running community is and how much I need to be a part of it.   It’s made me realize that, despite everything, I still need to get involved with the running scene either as a volunteer or a coach (or both) as I work my way back to being a healthy runner.

Until that happens, though, I am going to continue to bask in magical moments like these that leave me feeling like a rockstar.

 

 

 

When the Wind Changes Direction

Don’t you love that feeling when you are out for a run and, after fighting the wind for miles, you turn around and let the wind blow you back home?   Other times, we aren’t quite so lucky and turn around to find that the wind that we thought we were running into was the tailwind, which means that running back is going to be that much harder.

Emotions can be like that too.  Almost anyone who lives with a teen has experienced the noise which can follow them home from school, similar to the sounds of an explosion after a 747 has crash landed in your living room.  As adults, we are better at controlling our emotions.  We can run with the feeling of the wind being on our back for months or years on end until, without any warning, a plane crashes into our home and leaves us feeling broken.

Last night, I got my results from the MRI of my hip.   This was requested months ago, at the end of October, and I finally had imaging done at the beginning for January.    Since I had started running again, I thought about cancelling it, but my husband and son both said, “Why not?  It’s only going to give you more information.”  So I went ahead with it, hoping that I would find out exactly why it still hurts when I run.

I got what I wanted – and more.   First, I learned something new; there is a tear in the labrum.  The doctor says I don’t need to worry about that because it isn’t an area that is bothering me.  Secondly, I got more information about my old friend, Izzy.  While I thought that Izzy had moved out, she is lying low and creating havoc.  There is inflammation between the gluteal insertion at the tuberosity, which is diagnosed as enthescopathy.  This seems to be caused by osteo-arthritis, which is starting to show in the hip, and by overuse from running.   And, even though I thought I was getting better, the tendon at the ischial tuberosity is still partially torn.  It involves less than 50% of the tendon which, to me, sound like it is between 25-50%, or the results would read “less than 25%.”  So, in a nutshell, my hip is a bit of a mess.

It isn’t the hip results, though, that are weighing on me.  I also got some unexpected results.  A round structure was found in an organ.  I’m not ready to talk about it yet, other than to say a more detailed ultrasound is in the near future.

Dr. Elliott and I looked at a treatment plan for my hip.  First, I am off running, and he thinks it will be another 3 to 6 months before I will be able to again.  We decided to go ahead with Platelet-Rich Plasma Therapy to strengthen the hamstrings so he sent in a referral to the specialist at McMaster Hospital.  Hopefully, I can get an appointment soon.

This was a lot of information to digest.  In some ways, I am not surprised by the hip results.  I feel better knowing  why running has been  hurting, why it doesn’t feel right, and why I have been so hesitant to push myself.  It’s not because my muscles are waking up; it’s because there are some structural weaknesses.  I’m glad that I followed through with the MRI as now I have a concrete plan to correct the aches and pains that we know about and, I hope, eliminate the other concern.

Last night was the first night that I crawled into bed before 10:00 in a long time.  I needed a quiet spot, a place to rest, a place to think.  Like the plane before it crashes, I felt myself start to shake while fighting to maintain control.  And then I cried.  By the time I got out of bed this morning, I was over it.  For now, I will salvage what I can and do what I am able.

This is a new day, filled with questions and hope and I am reminded of the words “Focus on the things you can control, not on what you can’t.” Today, I will focus on me, my thoughts and my actions.  I will focus on finding inner strength and moving forward – one day at a time.

 

 

 

Gratitude

Yesterday morning, I was visiting my chiropractor and the topic of mental health came up.  “When I have competitive athletes,” Sandy said, “I have to watch their mental health.  If they stop running me and they aren’t doing anything else, I worry because that is when they can fall into depression.”

I have seen it.  Years ago, a close friend of mine was injured and flat out refused to go for a walk, come to yoga, start swimming with me (and if I am willing to get back into the pool, you know that I am trying everything to get him active again)….All he wanted to do was run and depression took over.

Ironically, Kelly-Lynne and I were talking about how runners deal with injuries just before Tammy the Hamstring started to complain.  “I’m pretty sure that I would find something else to do,” she said.   I was sure of my reaction.  “I know I would.  After watching my friend suffer….I don’t want to go through that.”

As much as I miss running, I have accepted whatever injury I have and that I need the time off.  When my forced break began, I could barely walk without being in pain, but I looked for things that I could do – or try to do – and, week by week, I find that I can keep adding something else to my list of can’s.  This week, I feel especially grateful for the things that are a part of my healing.

I am grateful to be able to do:

Bridge: so good for the gluteus.

a. Yoga.  For weeks, this was my only outlet.  At the beginning of October, I could not get into a Warrior One pose; now I can.  Two weeks ago, I still couldn’t move into a Crescent Moon, but I did a few on Friday for the first time; I had to work to hold it, but I got into the position and that is progress.  Yoga sets a bar for me and I get excited when I find that I can suddenly do something that I couldn’t in the class before.  I am committed to going three times a week, which I will continue once I am back in my running shoes.

Lunges: 6 x 60 various types of lunges twice a week.

b. Lunges.  Three weeks ago, when the temperature dropped, I didn’t want to do my lunge drill outside because it was too cold; I worried that the cold could be detrimental and I could end up doing more damage to the same muscle group that I have been trying to rehabilitate.  So I turned indoors.  Twice a week, after dropping off my son, I head to school before almost everyone else and stretch and strengthen through the hallways before my work day begins.

c. Planking.  This started off as a bar to measure my strength but it has evolved into a personal challenge.  Two minutes, every day, and anywhere: no problem.  We’ll see how high that number can climb.

d. Indoor Cycling.  I use to ride a lot: I commuted through Toronto by bike; somedays, I felt like I lived on a lifecycle at the gym; Dave and I covered a lot of miles on our rode bikes.  But that was before kids and when the roads were less busy and less dangerous.  Somehow in the past few years, cycling of any kind has become a part of my past.  But my windtrainer is still in the basement.  I walk past it every time I have to hang up laundry and, every time, I tell myself that I need to start spinning the wheels again.  Three weeks ago, as soon as my leg was strong enough, I got back into the saddle.  For now, it is my only form of cardio and it can be as boring as heck, but I am glad to have it.

Boring, yes, but it is saving my cardio.

And I have more options to look forward to: weights, rowing, swimming….As soon as I know exactly what I am dealing with, I can introduce other ways to build and maintain as I transition back to running.  I can’t worry about what I can’t control, but I can focus on the things I can.

 

Tammy Goes To The Doctor

After getting back from Chicago, I knew that Tammy the Hamstring needed to see a Sports Medicine specialist.   But getting an appointment wasn’t easy.   I had to go through my GP, which was a two week wait.  Then, I had to wait another 10 days before I could see the sports doc.  I joked that by the time I would actually see him, I would be almost healed.

Tammy and I drove to Burlington on Friday to see Dr. Elliott at his sports medicine clinic to try to find out what is setting her off and turning her a real pain in the butt.  While waiting, another patient recognized me.  “Cynthia?” she asked.  “It’s—.  So  how is retirement treating you?”

“Ummmm…I am not retired.”  It’s a week later and I still don’t have a good comeback.

It’s a good thing that I have already established a relationship with Dr. Elliott from a previous injury years ago as my first interaction on Friday was with his resident.  When she called for me and I got up from the chair, I stumbled because my hip was sore after sitting while waiting.  She laughed at me and I felt put out.  I wasn’t clumsy; I just have something going on with the right side of my pelvis which is why I was there in the first place.  She took me into the examination room and began to ask questions, one of the first being  “Give me some examples of when it hurts.”  So I did until she cut cut me off: “Okay, I get it. You’re in pain.”  Somehow, I managed to bite my tongue.  After more discussion, she suggested a cortisone shot.  I was, again, taken aback, wondering why she would jump to an injection without examining me first.   When she got around to doing that, she commented “Wow, you are really skinny!  No, you are really skinny!”  I still can’t find the right words to explain how I felt: shocked, angry, upset, annoyed….None of them were positive.

My confidence was restored when Dr. Elliott walked into the room.  He wanted imaging – hooray! – and requisitioned an ultrasound of the entire right side of the pelvis.   As I expected, he wants to see what is going on inside so that we can proceed with treatment.  Meanwhile, he said, I have done all of the right things.

Dr. Elliott suggested that I may be dealing with bursitis, but there may also be a tear somewhere; hamstring tears, he told me, take about 3 months to heal.  Meanwhile, there is obviously a lot of inflammation so I walked away with a prescription for anti-inflammatories.

Getting closer to solving this puzzle has left me feeling positive.  The worst case scenario is a tear and, if so, I’m more than halfway to three months.  I am still not convinced that there isn’t a stress fracture, though, and I am waiting for an MRI.

The logo from the clinic sums up my feelings.

As crazy as it sounds, I am looking forward to racing in 2019.  I have already targeted Robbie Burns at the end of January, crossing fingers that I will be back on the road by mid-December.  Once I get the first set of results, I can decide if I should register.  Meanwhile, I’ll continue with yoga, increase my time on the windtrainer and, when I am feeling gutsy, get back into the pool.  Once this is all over, I should be ready to slowly rebuild my base and get back to chasing my dreams.

The Butt-nut

Since I have been injured, one of the hardest things to do (aside from running, which is still impossible) is driving.  My sitbone being crushed into the car seat can send an excruciating pain through my body.   But, unlike running, as a working mom with busy kids, I can’t just say “I’m not driving today.”  As the expression goes, I have places to go and things to do.

Last weekend, my son and his friends went to Wonderland for the Halloween Haunt and I won the task of driving them home.   That same afternoon, as I made a shorter 20 minute trip to Burlington and whined to myself about the havoc that Tammy the Hamstring was still causing, I started to think of supports and devices that might ease the agony of sitting in a car.  I lifted my butt, shifted positions, lifted my cheek again and had a “Eureka!” moment.  “I need a donut to lift my butt and surround the sit-bone so that it doesn’t dig into the car seat!”

After dinner, before venturing to Wonderland, I began my DIY butt-nut project.  I ripped strips of fabric from an old pillowcase, wound them into a donut shape, fastened it with duct tape and created my prototype.
Dave  could only laugh and walk away when I demonstrated how to use it properly.  But I was proud; my butt-nut felt good and seemed like it would help me survive the 60 minute drive.  The real test was about to happen.

In the car, it took a while for me to find the exact spot for my creation, and I did have to readjust it every now and then.   I waited for the 13 year old boy comments about it when my kiddo and his friends got in the car; what teen boy wouldn’t turn “butt-nut” into something?  But, instead, I got “That’s awesome!” or “You can go on Dragon’s Den and sell these!  You can retire!” If I can impress a crowd of critical teens with these, maybe I have come up with the next great Canadian invention.

When I got home, after a total of 2 1/2 hours of driving, I felt surprisingly good.  I was sore, yes, but no more sore than I was when I got in the car.  In fact, I felt the best after driving that I have in a long, long time.

So remember: you read about it here first.  The butt-nut, a donut with duct tape, personally fitted, designed for comfort.   What could be more Canadian?

Moving Forward

The marathon can be one of the most frustrating road events.  I love the distance, the training that goes into it and the satisfaction from finishing.  For the first time in many years, I changed my focus in this last training cycle from a time goal to simply finishing.  I took on the “whatever it takes attitude” and I was winning.  I was ready.  Then the tides turned on me and derailed me during taper week, days before the Chicago marathon.  Even then, I made it to the start and felt I could finish, albeit slowly.  Instead, I finished one mile – one lousy mile.

I didn’t fail, but I didn’t do what I set out to do.  Was I upset?  Absolutely, and I was angry too, angry about the wasted time, effort and cost (in physio,  chiropractic and osteo treatments).  But I got over it, and now I move on.

Before I can do that, though, I have to get to the route of the problem.  My hip buckled under me when I ran during taper week, and it did again on Sunday morning.  This hasn’t happened before and it has become a cause for concern. Tammy the Hamstring may be playing her games again and partying it up with her friends, but my chiro suggested an x-ray to make sure that there isn’t a fracture.

On Friday night, Dave and I went to the hospital to learn that there isn’t an obvious fracture.  The doctor suggested Advil (3 times a day), physiotherapy and a bone scan. (Why do doctors always recommend nothing but Advil and physiotherapy?). On Saturday morning, my chiro agreed that I should have a bone scan to look for a possible stress fracture.  “With your high mileage, age, and frame,” he said, “I think it is a good idea.”

So now I wait.  I have an appointment with my GP on the 23rd and will, hopefully, get some imaging done a week later.  It’s frustrating as that means I probably won’t get results until a month after the first buckle.

In the meantime, I can continue to strengthen my muscles, try to get back on my bike and maybe, just maybe, get back into the pool.  I may not be able to run, but I can take advantage of the time off running to do other things that I love, as well as focus on what I can do and work towards improvement.

 

 

Chiropractic Care and Running Injuries

I use to have a chiropractor who helped me with running aches and pains, usually my left SI joint or my right hamstring.   When I had trouble with my back three years ago, though, he wasn’t able to help me at all; yet, he kept wanting me to go back for treatments.  I turned to a physiotherapist who had a different approach and it ended up being the right one.  I never did go back to that chiropractor.

This summer, I went through the reverse when Tammy the Hamstring acted up.  I started with physiotherapy which just didn’t seem to be making any difference in how I felt.  I called a friend to ask for her acupuncturist’s name, but she suggested that I see her chiropractor.  “He’s really good,” she said.  He knows muscles too.”  So I took his name, googled him, read that he specializes in running and hockey injuries and had treated some high profile athletes including an Olympian sprinter.  I picked up the phone and made an appointment to see him that week.

Lunging with company is always better.

That Friday, Sandy treated me and gave me orders to run over the weekend, with a long warm-up and a gazillion lunges.  And, since the run/walk combination had been too painful, he told me to just run very slowly.   After my third visit with Sandy, my husband decided that he would run with me that night but he watched while I did my 6 sets of 60 lunges.

A rare run together!

On the run home, Dave exclaimed, “Your form has completely changed!”  I waited for the negative comments to follow, about how sore and lop-sided I looked, but instead he said, “It’s unbelievable!  You are completely symmetrical!  You’ve lost your funny kick.  It’s absolutely incredible!  Whatever you’re doing, keep it up.”

“Even though I am so slow?” I asked.

“You look great!  It’s unreal!”

My husband is not one to hand out compliments, so I was shocked by his enthusiasm and support, as well as blown away by the almost instantaneous change that resulted from just a few chiropractic treatments.  It was clear that this was the right therapy for me.

In the past week, I have had a setback, but Sandy’s treatments and fitness plan for me have been effective.  I am in this for the long haul and am going to do whatever it takes to heal.  Between Sandy and my coach, I know that I will be able to come back stronger and faster than before.

To anyone with an injury, this is my advice: don’t fixate on one type of treatment.  What worked before may not another time so it is important to be open to new ideas.  I went in for my first visit with a “let’s see how it goes” attitude and, to my surprise, it was the right solution.  While I feel like I am back at square one, I have every confidence that chiropractic care will help me get to where I want to be.