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.

 

 

 

 

 

 

 

Do I Laugh or Cry?

“There is value in learning to accept gracefully those things that cannot be changed.”

This were the first words that I read in my son’s psychology text on the weekend.  He had rushed off to work and left his book on the kitchen table, open to a section on anger and frustration.  Being a psych major, I couldn’t help but look at what he was studying and, somewhat appropriately, these words jumped out at me.

The past few months have been a test of my mental strength.  How much frustration and disappointment of being injured (July), re-injured (October) and learning that it was way worse than anyone originally thought (January) can I handle?  I like to think of myself as a positive person, one who looks for an upside, thinks happy thoughts and believes that “things happen for a reason.” The upside of my hamstring tear is it has given me more time at home with my 13 year old and let me watch him grow as a student, an athlete, and a person.  But I am now in my sixth month of healing, almost 3 seasons later, and while I have accepted my injury, my frustration is still there.

Good news! Or so I thought.

I had a glimmer of hope that my weeks of being side-lined are coming to an end when I finally got an appointment date for a PRP injection: April 16th @ 12:00PM DURING HIS LUNCH.  I had no idea what was meant by “during his lunch.”  Am I suppose to feel extra grateful that he is seeing me at 12:00 rather than make me wait another week or two?  Is this a underlying message that I better not be late?  Or he is so busy that he is likely to be behind and I better not dare complain because he is seeing me “during his lunch.”  Or maybe, just maybe, it is a subtle hint to bring him a coffee, a snack or even a lunch.  Well, I am grateful that he is seeing me at this time rather than have me wait for another appointment at a later date so I happily confirmed it, I won’t complain if he is behind and maybe, just maybe, I’ll stop at Tim’s to bring him a snack.  I could only laugh.

However, when I called to confirm, I learned that this is not my appointment for the injection; it is a consultation.  Since 1 in 10 people are turned away, I have to meet with the doctor first and go in later for the actual injection.  I wanted to cry.   If my injection is at the end of April, I can assume that I will be off for another 6 to 8 weeks, which means that I still won’t be running until the end of June.  And that is only if I need one PRP shot.  If I need another, it will obviously be even longer.

This whole process has been frustrating beyond belief and it is now being overshadowed but the occasional fear.  What if I am that one in ten?  What if I can’t run again.  What if?  What if?   I hate the “what if?” game.  “Stay positive.  Look for the upside,” I tell myself.

Last night after yoga, I spoke my about thoughts with Kelly-Lynne and I found the positive again.  I realized how much fitter I have become in the past 6 months.   My leg strength is coming back; I can feel it when I cycle, and I can sit for longer periods of time without being in pain.  My core is firm, I can do a lowboat again and my upper body is stronger than it has been in years.  I threw myself back into the deep end when I came out of my comfort zone and started swimming.   When all things are said and done, I feel like I am in better shape than I have been in years.  So even though I still am not running and am quite unhappy about it, I can accept the delay.  If it means that my hamstrings are going to be that much stronger and I am going to be that much healthier, then I can absolutely wait a few more weeks.

Many years ago, when making a group decision at work, we voted for acceptance.  “Can you live with it?” was the question asked.  At school, I teach my students that you don’t have to always like something, but you have to be able to accept it; my Grade 7’s understand that.  Well, I do not like this time to heal and this waiting game one little bit, but I can live with it.  I have accepted it and, one day, I hope, that will make me a better athlete.

 

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.

 

 

 

Oh, What a Feeling!

After finally being able to run consistently, every other day, for the past 3 weeks, I have a renewed energy.   I can’t get too excited since running still hurts, but it isn’t the “Ow, I am broken” kind of hurt that I had all fall; nor is it the “I’m so out of shape” feeling that we often get when we have been off for a while.  It’s a stiffness, a type of knot, a sensation that I really can’t describe.   I like to think of it as a “healing pain” to remind me of Tammy and Izzy, my unruly tenants who moved in during the summer and fall, and of all the work that I have been doing to evict them.  It’s a message to not push myself just yet – to be careful.

At my chiropractic visit on Saturday, Sandy asked how my legs and hips were feeling.  “It’s just my glutes,” I told him, “and the very top of the back of my thigh.  I feel like I have gone for circle.”  In July,  I went for a massage because those were the two areas that were bugging me, but that treatment led to a chain reaction of a tightness, pain and tears.  “That’s it?” he replied.  “That’s good.”   “Well, my quads were killing me earlier in the week, but that’s because I am an idiot.”

You see, I am running but it isn’t enough – in terms of distance or intensity.  I need more of both. While I love that I am back on the road and running, I don’t feel like I am getting much out of that time healthwise, so I am keeping up with the lunges, bridges, planks, cycling (windtrainer) and yoga that I have committed through the fall.   Somehow, through my determination to get stronger and a touch of bad planning, I somehow managed to do everything within 24 hours.

On Monday night, I hit yoga class (warmed up with my bridge routine) at 6:00 and rode on my windtrainer after that.  Tuesday morning, I did my 360 lunges at school, ran 5K after school and had a chiropractic treatment at 6:00, 24 hours after my Monday night yoga class.  Then, to top it off, I rode for an hour before going to bed because it seemed like a good idea at the time.   When I woke up the next morning, my legs were sore!  But it was a good kind of sore, the kind you get when your muscles have been pushed and are tired, the kind of sore that feels better as you move around through the day, the kind of sore that feels great!

I haven’t had that feeling in months.   Sandy laughed after he heard my insane description, especially with the treatment details in the middle.  “You are obviously doing everything you can to get stronger and that’s okay.  It’s okay to feel sore.  Just overdo it.”

I don’t think there is a chance that I could ever repeat that Monday/Tuesday- at least, not in the near future.  But the satisfaction of thinking about what I did makes me smile.  It’s made me realize how far I have come in my overall fitness in the past 7 months and it gives me hope for chasing dreams and crushing previous times.   It makes me feel great!  So I won’t say “never again.”  We’ll see how long it takes me to lose my mind again.

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.

 

 

Two Steps Forward, One Step Back

I cried today.  It has been the first time I cried since my training for Chicago has been sidelined.  Heck, it is the first time that I have cried in I don’t know how long.  But I do know that since Tammy started acting up, the uncertainty of whether I will be able to run the Chicago Marathon has left me feeling blue.  Last week, I only ran on Monday,  when I realized that Tammy the Hamstring needed attention, so I turned to yoga and spinning on my wind trainer for the rest of the week.  The rest helped; I noticed that the range of motion in my right leg improved over the seven days as did my strength and balance.

Success! Three miles done!

This past Monday, I was cleared by my physiotherapist to try some shorter distances so I ran 3 miles that afternoon.  Tammy was still tight, but she wasn’t sore like she was the week before and I felt fine the next day.  On Wednesday, I was starting to feel normal; my hips felt like they were opening up again and I seemed to be walking properly.   At my physio appointment the next morning, I was told that the puffiness on the back of my thigh was down and the weird bruising, which started to surface when we taped my leg the week before, was disappearing.  Things seemed to be progressing and I was encouraged, so I ran again on Thursday night; this time I covered 4 miles.

This morning, everything changed.   I headed out for an easy 3 mile run and Tammy decided to start kicking me in the butt.  At the one mile mark, I stopped my watch, walked home and cried.  I have been doing everything right: my exercises, my warm-ups, rest, sleep, physio…but it hasn’t been enough for Tammy.  She obviously needs more time.

Today was the first time that I have cried since my training for Chicago came to a halt.  In the past two weeks, I have played the “what if” scenarios, including not starting.  I have toyed with the idea of walking the 26.2 miles but that is not what I set out to do; I want to run the course, not walk it.  I have thought about running part of the course and walking the rest, which I would be okay with if that becomes the plan, and I’ve considered running part and dropping out.  But not once during the “what if” games that my mind played did I cry.  Until today.

This afternoon, I decided that I am not going to run until Tammy is in better shape.  I feel that my trying to run is like playing Russian Roulette; how much more can I push Tammy until she has had enough and really bites me in the butt?  I looked into pool running as a way to supplement my training and was ready to buy a belt, but I don’t want to pool run.  When I put things in perspective, I reminded myself that running Chicago is suppose to be fun, so I don’t need to torture myself with things that I don’t want to do.  Instead, I will continue to ride on my wind trainer and go to yoga; I’m even willing to start swimming again.  If I don’t start in Chicago, so be it.  There is always another marathon.  As I walked with my youngest in the late afternoon and felt Tammy’s presence again, I realized that taking a step back like this is the best thing for me.

I am trying to stay positive but there will likely be more tears between now and October 7th while I figure out what exactly Tammy has planned for me.  Who knows?  Maybe I will be able to pull a miracle out of my butt and I’ll be able to chase my dreams sooner than I think.   Only time can tell.