Friday, January 25, 2013

I can't run right now ... and it's okay.

It's amazing what perspective can do.

I saw an endocrinologist today, in regards to my osteoporosis, specifically why a 39 year old otherwise healthy male would have low bone density (thus the cause of my stress fractures).

Without going into too much detail right now, I do have a hormonal imbalance, and more workup is needed.  Just for the sake of asking, I said, "so I can't run?" And he said, "No, you have the bones of a 70 year old."

And, to my surprise, my feeling after being told that I can't run? I'm okay with that.

Really.  The whole purpose of this blog, and my own personal fitness and success goal this past year and half has been to train myself to complete the Walt Disney World Goofy Challenge ... to run a Marathon and a Half.  And maybe I will someday.  Who knows.  My doctor didn't say don't run ever.  But no matter.  As of right now, my health is important to me.  I can still hold that goal ... and I will walk it next year.

I'm okay with the answer because my DOCTOR advised me not to run right now.  My doctor.  Not because my coworkers told me not to run.  Not because random people, especially nonrunners, are telling me "find another sport," and "you gotta stop this running stuff," and "when are you going to stop."  Not fellow runners, not random people who I run into who don't know my health, who don't know medicine, who don't have my health as a priority.  I take advice from my doctor.  And I'm content with that.

But I want to go through this workup, and figure out why my hormones are so out of balance.  And fix it.

Wow.  I didn't think I would have this reaction.  I thought that I would be devastated to hear that I can't run.  And maybe I will feel it tomorrow.  In fact, on my drive on the way to my doctor, I listed to the WDW Today Podcast, and the episode was about the Walt Disney World Marathon.  And I really wished I could run it.  And I still do.  But right now, let me just get healthy first..

I'm okay with that.


The following will be more technical for my own documentation and notes.  This should not be construed as medical advice and should not, in any circumstance, be a substitute for any reader's own physician's history, physical exam, and clinical judgement.
Endocrinologist visit notes:
Low testosterone and low free testosterone for my age, but ok.
Low LH, normal FSH
LH --> estrogen, FSH-->sperm.  men should produce estrogen for bone growth.  testosterone converts to estrogen
No celiac disease, no sarcoid (normal ACE)
prolactin low, which is good
previous results: ionized Ca, PTH, SPEP, UPEP ok.  Vitamin D mild low.  would like Vit D level to be 40, but can't give too much right now bc of h/o nephrolithiasis

Hypercalciuria (idiopathic) -- potential Tx thiazides, to retain Ca
other low estrogen producing
if negative workup, think bone disease, including Marfan's?  (less likely given arm span and no other fracture hx other than my recent stress fractures). Mastocytoma?
not varicocele bc would destroy testosterone in which case LH and FSH would be elevated.

24 hr urine calcium, to be followed by fasting labs the next morning (estrogen, etc).  Also MRI pituitary.

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