Thursday, May 26, 2011
First I apologize for being the crazy emotional rollercoaster for the last few weeks. I may be experiencing hormonal issues. Everything makes me cry. Every thing. And I am so not like that. I never cry. Now it's a daily thing. I can't watch the news without something causing the waterworks. The last few Biggest Loser episodes. Kirstie Ally on Dancing with the Stars. Seriously?!? I occasionally get mushy the week before TOM, but this is all the time and frankly it is getting old. Maybe the stress of being injured and not really seeing any progress is getting to me. No exercise = no stress relief. And the weight going up is really bumming me out. So I'm not sure which is the chicken and which is the egg, but it's all wrapped up together somehow.
Last weekend I went shopping with my DD and really scored at TJMaxx and Marshall. I came home with 3 casual dresses, white capris, a few cute tops, a tankini (OMG I technically bought a 2 piece), a running skirt and sexy new pj's. Ha, I say sexy but they are really just cute -no crazy cut outs, see-thrus or anything slutty. A couple of weeks ago I bought some microfiber undies and loved them. Saw the pj's in the same microfiber and LOVE them. I feel naked (in a good way). And I am a natural fiber kind of girl so this a stretch for me. Anyway, before I digressed into not so slutty pj's.... I have been replenishing my wardrobe since I have absolutely nothing to wear. The things I bought for winter A. do not work for summer and B. no longer fit anyway. As I shrunk out of things I put them on the other side of the closet and started making a pile on the floor. It now amounts to everything that is more than 6 months old. I have a huge pile to donate and all of the nice things are going on Ebay -that's a lot of work to photo and upload! And holy cow!! I can't believe how huge these clothes are!! I was looking at them and thinking there's no way that fit me. Eek it did. So out with the fat lady clothes -- I need to recoup some cash to fund my continued purchasing!! And btw... everything I bought last weekend is a 12 or Large. Can you believe?!? That's quite a difference from my 22's.
Today I had a chiro appt and discussed my minimal progress for the anguishing week of total rest. I expected a lot more. Like total healing would have been nice. I communicated that the residual pain is only when I raise my leg while bending at the knee as in taking a step up or stepping into pants. It is only the act of engaging muscles to lift the bent leg. Not the pressure of raising my body up the step. I have full range of motion. I'm still consistent with Patellafemoral Pain Syndrome, but he is very intrigued that I can do one-legged squats without any pain. It isn't the weight bearing. It's only the motion of lifting my leg, but that isn't consistent -that's hip flexor and it shouldn't cause pain inside the knee. So Dr Paul is doing some research over the weekend, I am getting back in the pool (with his approval) and we will reconvene next week to see if we should do anything differently. Just keep swimming, swimming, swimming... I'll take whatever smidgeon of positive I can find!
Added a visual aid!
22... NOT 22!!
PS: Notice I'm wearing my running shoes, haha.
Sunday, May 22, 2011
My journey to a healthy me started a year ago. I joined Biggest Loser online and committed to exercising 30 minutes a day, 5 days a week and eating within my recommended calorie range. I immersed myself in books absorbing everything I could (without formal education or training) about exercise physiology, macronutrients and the keys to healthy weight loss. Within a month I had a new daily routine and was on my way -never looking back. My life was forever changed.
I found Sparkpeople in September and soon after dropped BLC after realizing that I had learned all there was to learn there and didn't want to continue the subscription just to log my food when SP actually offered so much more in the way of networking. I found the C25K team and started running. And it was a glorious thing! I love running and the miles felt good.
By January (7 months) I had lost 60 pounds. And then something went awry. I had been continuously on track for 7 months. Even through the holidays I had lost weight. Yes, I was doing more than my original goals of 30 minutes a day. I was burning more calories, racking up more fitness minutes and trying to adjust my calories to match the recommendation for my activity level. But I wasn't hungry and as crazy as that sounds, I was struggling to eat enough calories. I was at 1500 every day. February I lost 3 pounds. March 1. How was this possible? I had enough calorie deficit to lose at least 2 every week. I blogged about the significance of losing 60 pounds and how I had noticed many people saying they had hit a plateau at that point and nothing they did could budge the scale. I was determined that wasn't going to be me. I began reading Sports Nutrition by Nancy Clark and the first thing I learned was that endurance athletes should consume no less than 1800 calories otherwise you are starving your body and your metabolism shuts down. I was way short on that and bumped my calories to 1650. Two weeks and no loss. 1700 and I finally lost 1 pound. Then my knee imploded and I had to stop running. I stayed at 1700 and lost another pound over two more weeks. I continue to read everything I can find about plateaus, what can cause them, how to bust them...and the losses are coming so frustratingly slow. Some people lose nothing for months. I averaged 1/2 pound a week for 3 months. A few people said if I'm losing that much then it isn't a plateau. That sucks in my book considering what I should be losing for the effort. Especially when it wasn't due to complacency, binging, sampling or any other off-track failures. For 12 months I have been on it. Absolutely, without fail - ON IT. I have weighed and measured, logged every bit of food and killed it at the gym doing strength training 3x week in addition to cardio 6x. Regarding the Dr Phil-ing to learn about nutrition, be focused, put in the effort -you clearly don't know me, but I appreciate your soap boxing because I have given that speech plenty of times to people that were making a piddling attempt and whining that they weren't losing.
Thursday I had a chiro appt and something he said hit home. I was sick with a cold last weekend so no exercise. At my Monday appt the swelling was down (for once) and pain was minimal. Thursday the swelling was back and a little pain. I had returned to exercise T, W &Th. Dr Paul said "Ok, no exercise for the next week. Zero. Not even swimming. You've got to give that knee a rest." I sat silent for a second. I had just started to lose weight again with a 2 pound loss for the week. My brain was spinning. My expression clearly said it all because the next thing he said was "You're not going to die if you don't exercise. Hear me? You're freaking out about this and I'm telling you that you have to rest. You're overtrained, you're injured, you're sick -your body needs a break." And there it was. I had read it time and again, but it didn't click because I didn't recognize the signs of overtraining. I didn't feel drained or burned out. I had enough energy to do two hours of running. But I also wasn't hungry and that's a problem. A few weeks ago I became hungry. REALLY hungry. It was surprising when it happened. And this was after I boosted my calories and stopped running.
It makes sense now. I have read that when you lose a significant percentage of weight, the body will stop and regroup before moving forward. There are recommendations to go on 2 weeks of maintenance after 4-6 months to give the body a rest and to reset metabolism. I've gone 12 months asking more and more from my body. I've lost 67 pounds. 25 to go to hit my "reassessment point" and figure out how much more to go from there. Even though I only lost 7 pounds while plateaud, I did lose 7" during that time. Being forced on an exercise break is probably the best thing for me. Maybe not psychologically, but physically. The last few months have been a mental struggle between training for a half marathon, being injured and not losing as expected. Last week I finally felt like I was getting a handle on finding a way to make all of it work together without overdoing and killing my metabolism again. It will be interesting to see what happens with zero calories burned and further reduced intake. Let the freak out begin!!
Monday, May 16, 2011
Friday was a major downer. The radiologist's report on the MRI indicated I have the "beginnings of osteoarthritis". When the chiro broke the news I was a bit stunned. Arthritis? Seriously? I'm 45. And that's a dream crusher for a runner!! So I had myself a little meltdown and then did my usual... I started reading everything I could find about osteoarthritis/knees/running. And the more I read the more I became convinced that OA is not the cause of my knee pain. The symptoms don't match at all. OA develops gradually over years as a wearing down of the cartilage. This was sudden with noticeable pain, not "morning stiffness with achiness after use" which is typical for arthritis. One article mentioned that arthritis is commonly misdiagnosed for Patellofemoral Pain Syndrome (Runner's Knee). That took me on a new Googleventure. PFPS is pain caused by the kneecap tracking incorrectly due to a domino effect of over-pronation contributing to IT band tightness which pulls the knee outward causing a strain on the MCL which then allows looseness in the knee joint. Loose ligaments/tendons allow the tibia and/or fibula to rotate and the patella to track improperly irritating the cartilage causing swelling within the joint. And there you have it. A total match with my symptoms. I'm not a doctor and since I can't read an MRI, I'm not denying the radiologist's diagnosis of "beginning of OA". But after reading so much about OA, I'm certain that is not the problem. So today I went back to my therapy appt at the chiro with a bucket full of questions about the OA diagnosis and PFPS.
Dr Paul asked if I was good over the weekend and I said "Very. I sat on my butt and other than the Thera-band exercises, did nothing". He said "No, really. Did you run?" "Seriously I had a cold and I didn't do anything. I promise!" Then I started in on him about the OA diagnosis not so much being wrong, but that the "cartilage irritation" was the result of PFPS because that was what fit with my symptoms and pain. He agreed and said the only reason he didn't diagnose it as PFPS is that he isn't an expert on it, but after more review of the MRI images he did some research on it over the weekend and felt that was more appropriate than OA as the radiologist diagnosed. In defense of the radiologist, he is strictly looking at pictures and not a patient history to consider so seeing swelling within the joint of an overweight middle-aged person with no meniscus damge gets an automatic OA diagnosis.
The bad of this is that PFPS can take 6 weeks to 6 months to recover and it can be recurring. The good is that we have already been following the best treatment protocal for the last 5 weeks (other than those two times I tried to run because it seemed I could, haha). And the really good is that once this is healed I can return to running. Even with recurrance, most runners are able to self-treat to recover because they quickly recognize it.
An NSV for today... Dr Paul gave my quads a "rock hard" label and said to keep pushing the Thera-band exercises -he wished all of his patients would work as hard and have that strength and definition. Maybe I should start using that thing on my butt?
Friday, May 13, 2011
Good news - no tears in the meniscus. (That means no surgery!) Bad news - strained ligaments allowing the Tibia to rotate and misalign with the Femur and that's why I feel it pounding when I run. More bad news... I have the beginnings of osteoarthritis. Not sure entirely what that means yet, but he said running is the worst idea. Yeah, I'm pretending I didn't hear that. Gotta get the knee healed before I can think about that. He said basically everybody has it to an extent and we wouldn't have known if it had not been for the MRI. That's probably not the root cause of the pain or swelling. So the treatment plan... absolutely no running or walking (for exercise) for at least two weeks. I can bike, spin, swim or elliptical. Continue my at home PT with the thera-bands and icing 4x a day. Twice weekly I will get neuromuscular electrical stimulation therapy and have my knee adjusted to keep it aligned. Hopefully this will reduce the joint inflammation and allow those ligaments to heal and hold everything in place.
So good news is no surgery, bad news is that this may take longer to heal than surgery and marathons are probably not in my future. There are worse outcomes than that so I'm not going to whine. (Although I reserve the right to whine and have a pity party at some point in the future).
I've been waiting to have the metabolic & VO2 max assessment because, with a test while running, I would get better info out of it that would also improve my running efficiency. I want to get this done for the metabolic info and since I can't do any kind of treadmill test now, I'm going to see if they have an elliptical or bike that we can use instead. Another week, another zero loss. I'm working my a$$ off and it is still there. I've got to get some answers before I reach maximum frustration. Since Feb 1 (15 weeks) I have only lost 7#. I work too hard at this to not see better results than that. And no, it doesn't make me feel any better that other people plateau 3 months with no loss at all. I can't compare because I don't know what they do or what they eat. I just know that I need answers! I'm tired of guessing and trying every different thing that everybody suggests worked for them. If a machine can spit out a perfect plan for me to follow and all it takes is an hour of my time and a chunk of my cash -I'm in. I have less than 30# to go and I want it GONE!!
Sorry to unload and rant about my frustrations! I suppose TOM doesn't help the situation. It's like the side mirror advisement... Caution: things may be ANGRIER than they seem. I only look calm, cool and collected when in reality I'm a volcano looking for a reason to blow. Unfortunately I have no way to get my endorphin high so I should probably wear a warning sign for a couple of days.
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