12:15am stream of consciousness... was angry the past few nights about not eing able to run. I thought i was ok, and had accepted it due to my health, even told someone last night that once I found out about my osteoporosis I didnt care about running anymore ...
that's not true.
some nights i just want to throw my phone in anger, reading about running, and running quotes, and motivation ... when God damn it I'm already motivated... I never needed the "just do it" and "never give up" speeches because i just loved to be out there running... and now i can't.
BUT. I dont want to be injured again. working everyday on crutches or a scooter is annoying. who the hell wants to go through this again.
better thoughts...
cant wait to go on our Disney cruise! then WDW!
Wednesday, January 30, 2013
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:
labs:
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
Differentials?
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.
workup:
24 hr urine calcium, to be followed by fasting labs the next morning (estrogen, etc). Also MRI pituitary.
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:
labs:
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
Differentials?
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.
workup:
24 hr urine calcium, to be followed by fasting labs the next morning (estrogen, etc). Also MRI pituitary.
Wednesday, January 23, 2013
Baby steps ... AGAIN
Quick update on my status ... (mainly for my own documentation really)
I got some labwork done this morning -- LH, FSH, ACE, prolactin, testosterone, and endomysial antibodies. I already got CBC, CMP, Ca, PTH, Vitamin D, SPEP, and UPEP. My endocrinologist is just trying to rule out secondary causes of osteoporosis, given that I'm a 39 year old male!
I just saw my orthopedic podiatrist ... he says there is good healing on the MRI and ankle Xray of my tibial stress fracture, and now I can partially weight bear!
Yay! but what does that mean? Well, I can put 40-50 pounds of weight on my ankle (I tried it on a scale to get a feel, as the doctor prescribed) for 2 weeks, then on to full weight bearing during the 3rd week.
That means I still need the scooter and crutches. I'm working with no day off for the next 2-3 weeks (including weekends), and am on call this weekend. I was hoping to be walking fully this weekend, but this is actually okay, I'd rather use the scooter than crutches anyway. I can just practice my partial weight bearing at home.
That being said, I have to be realistic about the races I had registered for.
There is the Allstate 13.1 Marathon in New York City on March 23, 2013. Even if I was running (and I'm not), that would only give me 8 weeks to train. Doable, but I'm only partial weight bearing. I was planning on walking it anyway, but even then, even if and when I am full weight bearing in 3 weeks, that gives me 5 weeks to train.
C'mon now. I'm positive, and optimistic, but I have to be realistic, and NOT FRIGGIN HURT MYSELF AGAIN. So I'll back out of the Allstate Half, maybe defer till next year.
Now ... I am also registered of the NJ Half Marathon (Long Branch Half) on May 5, 2013. now that's certainly interesting. If and when I'm full weight bearing in 3 weeks, I can do a walking program and train to walk the Half in 11-12 weeks. That sounds doable. It will be great rehab.
So that's my short term goal for now.
(yes, Goofy is still in my sights for 2014).
I am seeing my endocrinologist on Friday (2 days from now), so we'll see what transpires then, based on some of the labwork that was done today.
I got some labwork done this morning -- LH, FSH, ACE, prolactin, testosterone, and endomysial antibodies. I already got CBC, CMP, Ca, PTH, Vitamin D, SPEP, and UPEP. My endocrinologist is just trying to rule out secondary causes of osteoporosis, given that I'm a 39 year old male!
I just saw my orthopedic podiatrist ... he says there is good healing on the MRI and ankle Xray of my tibial stress fracture, and now I can partially weight bear!
Yay! but what does that mean? Well, I can put 40-50 pounds of weight on my ankle (I tried it on a scale to get a feel, as the doctor prescribed) for 2 weeks, then on to full weight bearing during the 3rd week.
That means I still need the scooter and crutches. I'm working with no day off for the next 2-3 weeks (including weekends), and am on call this weekend. I was hoping to be walking fully this weekend, but this is actually okay, I'd rather use the scooter than crutches anyway. I can just practice my partial weight bearing at home.
That being said, I have to be realistic about the races I had registered for.
There is the Allstate 13.1 Marathon in New York City on March 23, 2013. Even if I was running (and I'm not), that would only give me 8 weeks to train. Doable, but I'm only partial weight bearing. I was planning on walking it anyway, but even then, even if and when I am full weight bearing in 3 weeks, that gives me 5 weeks to train.
C'mon now. I'm positive, and optimistic, but I have to be realistic, and NOT FRIGGIN HURT MYSELF AGAIN. So I'll back out of the Allstate Half, maybe defer till next year.
Now ... I am also registered of the NJ Half Marathon (Long Branch Half) on May 5, 2013. now that's certainly interesting. If and when I'm full weight bearing in 3 weeks, I can do a walking program and train to walk the Half in 11-12 weeks. That sounds doable. It will be great rehab.
So that's my short term goal for now.
(yes, Goofy is still in my sights for 2014).
I am seeing my endocrinologist on Friday (2 days from now), so we'll see what transpires then, based on some of the labwork that was done today.
Monday, January 21, 2013
Selfish?
Those who know me may describe me as generally positive person, quick to smile and offer warm words (I think, anyway) ... but not today.
I woke up at 5:30am as I have been for the past couple of weeks, not to go to the gym or to run like I had looked forward to in the past, but to get up and go to work. I looked at the daily affirmation this early, dark, morning, "I love to get up in the morning and greet a new day," and said, "YEAH RIGHT!"
There was something about today ... maybe I was just in a bad mood ... the whole osteoporosis thing is gnawing at me, hitting me in weird ways. Being non-weight bearing, getting around work -- rushing around, mind you -- is just getting old. The jokes and comments are getting old. I understand and appreciate everyone's concern about me. To be truthful, I'm sure it's more curiosity. Look at that scooter! Scooter boy! How much longer do you have to be on that thing?
It's not their fault. They're curious. I'm just getting tired of everything.
I know there are worse things, and many people are dealing with worse illnesses and circumstances.
I'm guessing others would be jealous of my circumstance:
Heck, I'm married to a wonderful, beautiful, and loving wife, have an awesome healthy son, have a great career which pays well, own and live in my dream home in a great community ... and look, even with all of this I'm just so focused on running again. But now what? I get hit with this osteoporosis diagnosis and all of a sudden I'm living in uncertainty and doubt.
But full confession, I'm jealous of others:
When I see runners outside, I get jealous. Whenever I drive past my old running routes, the reservoir, or whatever, I wish I was there. When I look on Facebook and see other runners' posting pics of recent races, or PR's, I get jealous, and I get frustrated to no end to see that my own PR's weren't that bad. I don't think I was bad for a 39 year old beginner/recreational runner, or at least a less-than-one-year runner.
5k PR: 23:48, 7:40 pace (official)
Half marathon PR (in training): 2:04:23, 9:30pace
Not by any means elite, and still a ways to go from the front corrals, but, hey, I think I could hang with an average 39 year old recreational runner.
But hey, I really enjoy (enjoyED?) running. It gave me joy, made me feel good.
I'll be getting some bloodwork (testosterone level) done tomorrow, will see my orthopedic podiatrist on Wednesday, and an endocrinologist on Friday.
In the meantime, I'm free to speculate, read, worry (or not), or whatever. I did read that beers have the OSA form of silicon, which is bone building, especially the India Pale Ale kind!!
http://www.telegraph.co.uk/health/healthnews/7168666/Beer-boosts-bones-and-fends-off-osteoporosis.html
So hey, why not? I just enjoyed a Founders Centenial IPA:
So, we'll see. So many thoughts all at once, so many things to figure out ...
Why do I have osteoporosis? Not sure if I want a reason or not ... hopefully it's correctable, hopefully it's curable ... I want to run ...Can I run again? Will I be able to run again? How about walking? yeah, I can walk ... bought Chi Walking, I'll look at that, we'll see ... oh man I have the Allstate 13.1 Half Marathon in March! I can walk that, right? Can I train in that short of time? Wait, what the hell? I'm still nonweighbearing!! I'm so selfish. But c'mon, I want to run. There are a bunch of runners with osteoporosis that I see online. I can be like them, right?!?! God, just slow down. Why, oh why, do I want to run so much.
Wait.
Why do I want to run? Why do I want to run a marathon? And the GOOFY for God's sakes? Why?
Selfish? Well ... because it will make me feel good. And isn't that what we all really want?
I woke up at 5:30am as I have been for the past couple of weeks, not to go to the gym or to run like I had looked forward to in the past, but to get up and go to work. I looked at the daily affirmation this early, dark, morning, "I love to get up in the morning and greet a new day," and said, "YEAH RIGHT!"
There was something about today ... maybe I was just in a bad mood ... the whole osteoporosis thing is gnawing at me, hitting me in weird ways. Being non-weight bearing, getting around work -- rushing around, mind you -- is just getting old. The jokes and comments are getting old. I understand and appreciate everyone's concern about me. To be truthful, I'm sure it's more curiosity. Look at that scooter! Scooter boy! How much longer do you have to be on that thing?
It's not their fault. They're curious. I'm just getting tired of everything.
I know there are worse things, and many people are dealing with worse illnesses and circumstances.
I'm guessing others would be jealous of my circumstance:
Heck, I'm married to a wonderful, beautiful, and loving wife, have an awesome healthy son, have a great career which pays well, own and live in my dream home in a great community ... and look, even with all of this I'm just so focused on running again. But now what? I get hit with this osteoporosis diagnosis and all of a sudden I'm living in uncertainty and doubt.
But full confession, I'm jealous of others:
When I see runners outside, I get jealous. Whenever I drive past my old running routes, the reservoir, or whatever, I wish I was there. When I look on Facebook and see other runners' posting pics of recent races, or PR's, I get jealous, and I get frustrated to no end to see that my own PR's weren't that bad. I don't think I was bad for a 39 year old beginner/recreational runner, or at least a less-than-one-year runner.
5k PR: 23:48, 7:40 pace (official)
Half marathon PR (in training): 2:04:23, 9:30pace
Not by any means elite, and still a ways to go from the front corrals, but, hey, I think I could hang with an average 39 year old recreational runner.
But hey, I really enjoy (enjoyED?) running. It gave me joy, made me feel good.
I'll be getting some bloodwork (testosterone level) done tomorrow, will see my orthopedic podiatrist on Wednesday, and an endocrinologist on Friday.
In the meantime, I'm free to speculate, read, worry (or not), or whatever. I did read that beers have the OSA form of silicon, which is bone building, especially the India Pale Ale kind!!
http://www.telegraph.co.uk/health/healthnews/7168666/Beer-boosts-bones-and-fends-off-osteoporosis.html
So hey, why not? I just enjoyed a Founders Centenial IPA:
Why do I have osteoporosis? Not sure if I want a reason or not ... hopefully it's correctable, hopefully it's curable ... I want to run ...Can I run again? Will I be able to run again? How about walking? yeah, I can walk ... bought Chi Walking, I'll look at that, we'll see ... oh man I have the Allstate 13.1 Half Marathon in March! I can walk that, right? Can I train in that short of time? Wait, what the hell? I'm still nonweighbearing!! I'm so selfish. But c'mon, I want to run. There are a bunch of runners with osteoporosis that I see online. I can be like them, right?!?! God, just slow down. Why, oh why, do I want to run so much.
Wait.
Why do I want to run? Why do I want to run a marathon? And the GOOFY for God's sakes? Why?
Selfish? Well ... because it will make me feel good. And isn't that what we all really want?
Sunday, January 20, 2013
Thank you, Coach Jay!
"Just get moving."
-Coach Jay Stephenson
A couple of weeks ago, (before I found out about my osteoporosis), I spoke with Jay Stephenson on the phone about my running injuries, and we discussed strategies for recovery and prevention. Jay Stephenson is the former head coach for cross country and distance track at Shorter University in Rome, Georgia. His wonderful website, www.gogorunning.com, is a wonderful resource for training and fitness plans, with load of informational videos on all things running -- training, races, nutrition, and more.
After I contacted him and explained my situation ... as you know, a 39 year old runner suffering a second stress fracture in 6 months, he graciously offered some time for further discussion and advice on the phone.
The first question to answer was : "Why and how did I get injured?"
(please note that this was before my DEXA scan revealed osteoporosis, and the reason for that is still being investigated).
To answer this, he asked in detail what my running schedule was leading up to my injuries; he asked about my shoes, my form, and the surface I ran on. Here is my breakdown
Schedule: From November 2011 to May 2012, I started by completing a modified Couch to 5K Program, (modified because I skipped ahead a couple weeks when I felt good, something I should not have done) then had a rather irregular schedule because of work, but tried to stick with 3 maintenance runs of 3-5 miles during the week, and a long run on weekends from 6-13.1 miles, increasing each week. If I am to be honest, my schedule not regular at all, and I could go for a week without running, then would run several days in a row, and not really pay attention to increasing mileage.
Shoes: did a lot of experimenting. Video analysis at both a Foot Locker RUN store and Road Runner Sports showed that I have a neutral gait. Foot analysis at Road Runner Sports showed that I have a high arch. I played around with Nike Air Pegasus, Skechers GoRuns, Mizuno Wave Creation 13, Brooks Ghost 3, and Brooks Pure Flow 1. (man I loved the Pure Flow.)
Form: the Foot Locker Run store analysis showed heel strike, neutral gait (I was wearing shoes). In contrast, the Road runner sports analysis, showed that I had a forefoot strike and neutral PLUS gait (needed a little more support). (I was barefoot).
Personally I knew I was a heel striker, but tried hard to get onto midfoot (Chi Running) and forefoot. I wasn't always successful, but the concept of minimalism and form made sense to me, at the time anyway.
Great video on the basics of proper Chi Running form:
Cross training: none at that time.
Circumstances of my first injury: After a half marathon distance long run in training, 13.1 miles in my new Mizuno Wave Creation 13 with heel strike on pavement, I started to feels a nagging pain in my right groin that didn't go away. I kept running for a couple of weeks, and thus my femoral neck stress fracture.
So, what did I do then? I was on crutches and a cane for 5 months, I thought I learned my lesson, and then I tried to correct them when I got back to running October 2012 - December 2012.
This was my strategy:
-even more gradual acceleration -- I walked more, then did coach to 5 k, then tried Hal Higdon's Novice 1 marathon training program.
-I tried to change my form to a more forefoot strike.
-I varied my surface, and more regularly ran on treadmills and softer trails.
-I cross trained -- elliptical and bike
but --> I STILL GOT INJURED!!
In December 2012, I felt some left ankle pain after a short 3 mile trail run, so I stopped, then when it felt better, I ran 30-40 minutes on a soft treadmill, and then I found out I got my second stress fracture, a left distal tibial stress fracture.
Now, again, this was before my DEXA bone density showed osteoporosis, but his prescription in addition to a modified training schedule?
INCREASE BONE DENSITY!
He suggested increasing bone density with weight training:
2-3 times a week,
workout with moderate weights (not to bulk up, but to tone), 3 sets of 10.
both upper and lower body.
either free weights or machines, whatever keeps you motivated and consistent.
Little did I know two weeks ago how important and spot on this advice would be, now that I found out that my bone density is low. I haven't gotten to work out yet, I am still on crutches and a scooter. First things first, let's heal. My orthopedic podiatrist called my the other day and said to stay off of it, and he will see me this week, and probably well let me put some weight on my leg. And I am going to get a testosterone level this week and see an endocrinologist. Boy, this is turning our to be a roundabout way to get from Couch to Goofy. Let's do it right.
But, for giving me your generous time and advice, I thank you Coach Jay!!
Saturday, January 19, 2013
File under "Too much information"
I've been reading a lot today about osteoporosis. You know, because research is "me search." As a 39 year old otherwise healthy male, and not a postmenopausal woman , I should not have this low bone density disease ...
unless there's a secondary reason. Well, i can rule out: excessive alcohol use, glucocorticoid use, anti seizure medications ...
the question now is hormonal imbalance. Testing showed that my calcium and parathyroid hormone levels were ok, Vitamin D was mildly decreased, and my SPEP and UPEP (to check for mutliple myeloma) were fine.
But, my testosterone wasn't checked, and I believe low testosterone is a common secondary cause of osteoporosis in young males.
Could I have low testosterone?
Then it hit me, (warning, TMI part coming up) ... as an adolescent I was diagnkawd with having a varicocele.
So ... varicocele --> low testosterone --> osteoporosis --> stress fracture!
Well, I still have to have testing next week and see my endocrinologist next week, but if this pans out ... then I have to thank RUNNING and my INJURIES for unveiling an otherwise hidden health problem.
Weird how things work out, and how there are reasons for events in your life.
unless there's a secondary reason. Well, i can rule out: excessive alcohol use, glucocorticoid use, anti seizure medications ...
the question now is hormonal imbalance. Testing showed that my calcium and parathyroid hormone levels were ok, Vitamin D was mildly decreased, and my SPEP and UPEP (to check for mutliple myeloma) were fine.
But, my testosterone wasn't checked, and I believe low testosterone is a common secondary cause of osteoporosis in young males.
Could I have low testosterone?
Then it hit me, (warning, TMI part coming up) ... as an adolescent I was diagnkawd with having a varicocele.
So ... varicocele --> low testosterone --> osteoporosis --> stress fracture!
Well, I still have to have testing next week and see my endocrinologist next week, but if this pans out ... then I have to thank RUNNING and my INJURIES for unveiling an otherwise hidden health problem.
Weird how things work out, and how there are reasons for events in your life.
Please
I'm so conflicted. I just want to run again. I want to run. That's it, that's all there is to it. I rationalize and explain that i want to be healthy, and I want to run safely ... but if I am to be honest, I just want to run. I don't want to walk.
I miss being outside, running down the boardwalk, the side streets, the reservoir path, the trails. I miss getting up really early in the morning, going for a run in the cold weather, and getting back home just as everyone is just getting up.
I miss being at work and looking forward to going home just to run. I miss being excited realizing that I had an afternoon off so I could squeeze in a run.
I miss doing a long run, feeling great that, wow, I actually ran that far, and that feeling of accomplishment. The distance, the time, the goal, running it nonstop -- that was a runner's high.
I even miss looking into new gear, new shoes, new whatever.
This is the weird part ... I now miss about 4-6 months ago, while recovering from my first stress fracture, when I KNEW I would be back to running ... then I even miss 2 weeks ago, during my second stress fracture, when even then I KNEW I would prove everyone wrong and would run again.
But now.
Now I know I have osteoporosis. And I just don't know. Everything I'm reading is contradictory -- weight bearing exercise is good, running ok, but not too much??
I will have to ask my doctors.
But I want to run.
Run.
Not walk.
I don't want to straggle in the back of the pack or worse during the races, during the Goofy. I don't want to be one of those. I know that might not be the right thing to say, and it is selfish, but that's how I feel right now.
Please let me run again.
Please.
I miss being outside, running down the boardwalk, the side streets, the reservoir path, the trails. I miss getting up really early in the morning, going for a run in the cold weather, and getting back home just as everyone is just getting up.
I miss being at work and looking forward to going home just to run. I miss being excited realizing that I had an afternoon off so I could squeeze in a run.
I miss doing a long run, feeling great that, wow, I actually ran that far, and that feeling of accomplishment. The distance, the time, the goal, running it nonstop -- that was a runner's high.
I even miss looking into new gear, new shoes, new whatever.
This is the weird part ... I now miss about 4-6 months ago, while recovering from my first stress fracture, when I KNEW I would be back to running ... then I even miss 2 weeks ago, during my second stress fracture, when even then I KNEW I would prove everyone wrong and would run again.
But now.
Now I know I have osteoporosis. And I just don't know. Everything I'm reading is contradictory -- weight bearing exercise is good, running ok, but not too much??
I will have to ask my doctors.
But I want to run.
Run.
Not walk.
I don't want to straggle in the back of the pack or worse during the races, during the Goofy. I don't want to be one of those. I know that might not be the right thing to say, and it is selfish, but that's how I feel right now.
Please let me run again.
Please.
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