October 1, 2014

Andrea: Athletic Pubalgia Surgery Post-Op Rehab Weeks 0-2

I am now two weeks out from surgery. I spent the first six days in Philadelphia, working with a physical therapist (Nicole) at Vincera Rehab and checking in with Dr. Meyers. My dad was nice enough to take a few days off from work and keep me company, as I would have gone crazy from boredom without him.

I traveled back to Salt Lake City after six days, and the traveling day was hard on me. Over eight hours of sitting in an airplane is not easy after abdominal surgery! I had increased swelling and pain the following day, but it returned to previous levels after another day.

Throughout the second week, my pain level remained about the same, if not slightly increased. I have been consistent with my physical therapy exercises and walking prescribed by Nicole. I started seeing PT Danny at Canyon Sports Therapy in Salt Lake City, and he has been great so far - he even contacted Nicole to discuss my surgery and the appropriate rehab program for me.

At 11 days post-op I noticed an accumulation of fluid in the lower right abdominal area. Dr. Meyers told me it was called a seroma and was related to the extensiveness of the tissue dissection on that side. Jake and I call it my "pooch" - let's just say it does not make my stomach look attractive!

Other things to note: I went back to work after 7 days but limited my time there to only a few hours and worked from home the rest of the second week post-op. I also lost 3 lbs since surgery (good-bye muscle) and needed 10 hours of sleep at night plus a 2 hour nap during the day!

Here are the PT exercises that I have been doing -

250m walking
4x25m side steps
4x25m backward walking
2x10 bird dog – arms only, lead with thumb - then progress to both arms and legs
3x10 posture shoulder exercise (arms at right angle and rotate out) with 3s hold
3x10 clams with 5s hold
1x30 transverse abdominis isometric contraction with 5s hold
2x10 bent knee adductor squeeze with 5s hold
2x10 bent knee abduction against resistance with 5s hold
3x10 bridges with 5s hold - then progress with both a band around knees and ball b/w knees
1x5 extended leg lift and resisted adduction with 3s hold
1x30 back flexion and extension
3x10 side leg lift at 120 degrees (targeting glute medius) with 3s hold
250m walking
2x25m side steps
2x25m backward walking
Heat and ice several times a day
Massage starting at 10 days.

Icing after a round of morning PT exercises

I feel like I've gotten better and worse at the same time. The exercises are becoming easier for me, but I'm also having more pain than I anticipated after how well the first week went. I'm also an emotional rollercoaster - super optimistic one minute and then convinced that I'm never going to be pain-free the next. Jake really enjoys dealing with the mood swings on a daily basis! :)

September 30, 2014

Big Trees, Sea Lions, and a Wedding in the Forest

Andrea in the redwoods at Henry Cowell State Park

A quick set of photos from our trip to California for our friends' wedding - the wedding was in Saratoga, and then we headed to Santa Cruz from there...

The Santa Cruz coast - Wilder Ranch State Park

The rest of these are kind of in order. First up - a hike in Big Basin Redwoods State Park...




Banana Slug

Next up was Mike and Rossini's wedding at Saratoga Springs...





From there, Santa Cruz...


Lazy, fat sea lions
This is what makes humans fat and lazy!

On Monday the sun was out in full force. We took advantage with a nice hike along the coast...


More lazy sea lions

And then we finished out the trip with another afternoon in the redwood forest...

September 22, 2014

Andrea: Athletic Pubalgia Surgery #2

She's back - this is Andrea's first post on Wasatch and Beyond in 2014! 

Dr. William C. Meyers
Last week I went to see Dr. William C. Meyers of Vincera Institute, the expert in the field of core muscle injuries (aka sports hernia, athletic pubalgia, etc). This has been a long time coming as it has been 16 months since I had an unsuccessful surgery with Dr. Brown in May of 2013. I tried many, many types of rehabilitation over the past year to recover from the chronic pain that intensified after the first procedure, but finally came to the realization that there was nothing more that I could do.



What I really liked about the Vincera Institute is that it comes as a whole package - the imaging, doctor's office, surgery center, and rehabilitation are all in the same place and are focused on the same patient. Unfortunately, the monetary cost is quite hefty due to the "experimental" distinction of this surgery by most insurance companies. One thing I have learned in the past two years is that my health and well-being are worth a LOT!

After MRI imaging, Dr. Meyers discussed my injury with me and did a thorough evaluation. He then brought in the radiologist to discuss my pain and ensure that all pain areas were examined on the MRI. He confirmed the critical areas that need repair by having 5 diagnostic/steroid injections done in my hip and groin. Based on all of these findings, Dr. Meyers recommended that surgery was my best option and scheduled it for the following day.

This is a very complicated area!!

Here is a summary of the surgery:

1) Left adductor compartment release
2) Left surgical reattachment of the rectus abdominis muscle to the pubis
2) Both sides psoas tendon release
3) Right adductor longus reattachment
4) Right re-repair and release of abdominal tissue

I have three incisions from the procedure. As he re-repaired the right side, there was a lot of excess blood/fluid so Dr. Meyers put me on a drain to wear for 4 days (gross). Because of the extensive nature of my surgery, he also recommended that I stay in Philadelphia for a week so that I could see him a few more times and also start rehabilitation immediately.

I honestly can't believe how different the recovery has been already from this surgery. I took pain medication as instructed but have really not felt much worse than before surgery. Definitely nothing compared to the pain from the first surgery (which makes me believe that something went very wrong there). I was able to walk a mile without difficulty the day after surgery and able to sit/stand/lay down mostly on my own. I  had a bit of nausea/sickness but food and drink helped - apparently you burn a lot of calories after surgery!

I will be posting updates on my recovery and rehabilitation. I am optimistic that this is the beginning of the end of this injury. There is still a small part of me that is afraid that this surgery won't work just like the last one, but I know that a positive attitude is critical to recovery. I will do everything I can to be pain-free again.

In good spirits :)

September 20, 2014

2014 Top of Utah Marathon

Final stretch of TOU 2014

I couldn't resist being at the 2014 Top of Utah Marathon one way or another. I won this race in 2012 and came in second last year. With Chicago only a few weeks away (21 days!), I had to be careful with my effort today - too fast, and I'd regret my decision to run TOU. On Friday I laid out my goals for the race: the aim was 2:30 +/- 2 minutes, and hopefully sneak into the top 3 and win a little cash in the process. This was at the end of another big mileage week, so I still have a lot of cumulative fatigue in the legs. I'm glad I continue to feel so strong despite (or probably because of) the big volume.


TOU Marathon - 2:28:14, 3rd place. Came through the first half in 1:14:24 and then ran the second half in 1:13:50. A controlled, even effort... stuck right to my plan. Mile splits were very consistent and not worth typing out.

Tylor Thatcher and Jason Holt took off at a quick pace, which ended up being a very good thing because it forced me to decide right away whether I was going to follow my plan or give chase. I ran most of the first 14 miles with Nate Hornock and Jon Heslop. Once we hit Hollow Road I pulled away a bit and ran the rest of the way solo. Overall it was a good effort and just what I needed today - a high quality long run that would continue to build fitness and not take anything out of the bank.

TOU always puts on the best races. I'm happy to add another moose trophy to the collection.

Andrea and Amiee were out on the second half of the course providing encouragement and giving me someone to briefly talk to every couple miles. All of these photos are from Amiee...



I took 5 gels today - PR! (I'm liking the liquid consistency of the Powerbar gels)

I also took a 20 minute ice bath afterwards - another PR!

Millville Hill



Our friend Devra won the women's race and got to wear the moose ears
"Good job not being stupid today" -Love, Andrea
The floppy hair is something new :-)

September 14, 2014

Chicago Training #4 - Biggest Week, One Month Out

I posted this on Twitter earlier in the week. Can I make the jump over the next month?
Previous training posts from this cycle:


Running at the Classic 10K last weekend
The Chicago Marathon is now exactly 4 weeks away, and I'm starting to really feel like my training and fitness are clicking. Today I capped off my biggest week of the buildup (160 miles, after back to back 145 mile weeks) with my staple 26.2K tempo run. Essentially this is the Hanson's "simulator" - but I make a few adjustments: 1) I don't run it at marathon goal pace... I aim for 10-15 seconds slower per mile. 2) I don't take any fuel or fluids. Today I averaged 5:31/mile, which is actually a touch faster than I ran this workout before CIM last year, and today was a very controlled effort. I made an effort to dial back the pace and make sure I wasn't dipping under 5:30 pace. I've found that if I run this workout closer to goal MP it takes a little too much out of you - especially mentally, when you are running it alone. You only have so much mental focus to use, and I think it's better to save the bulk of it for marathon day.

The rest of the week was standard - 14/8 doubles (with as much grass / dirt running as possible), 17 miles with a 10 mile progression on Thursday, and 10 x 30 second hill efforts (I can't call them sprints) on Saturday.
Workouts for the week of September 8th
I'm not as fast as I've been in the past (in terms of shorter workouts and 10K/HM races), but my aerobic strength is as good as it's ever been. I think that bodes well for the marathon. I've had an excellent stretch of long runs this summer (graphic below)... most of them at higher altitude and with a decent amount of hills. Today's run was almost completely flat, by design.

Over the next couple weeks I'll start to reign in my total volume, focus on a few quality longer efforts without trying to squeeze in too much now that I'm starting to feel "in shape." I'll save the magic for the streets of Chicago in four weeks. Ice bucket, protein bars, and massage will also be key elements of the next month!

First 8 long runs of the cycle
Fresh pair of Fastwitch for the next stretch of workouts

September 13, 2014

Southern Utah Trip #6 - Jeep Tour with Dan Mick

I want to upgrade to this jeep!

On the final morning of our trip, before Andrea and I drove back to Salt Lake City, we went on a jeep tour with Dan Mick. We were pretty tired after several days of hiking in the heat and wanted to do something a little different. We found Dan on TripAdvisor and almost couldn't believe his reviews were THAT GOOD. But I can tell you with 100% truthfulness that the tour was really that good. We spent the whole morning with Dan himself - he drove us up some incredible obstacles, took us to dinosaur tracks, and told great stories about the history of Moab. It was worth every penny and a lot of fun.

We didn't take any video during the tour, but this video gives you a very good idea of what it was like...



And a few photos we snapped...

Dan teaching us about the history of Moab. I love this kind of stuff.
Dinosaur footprints
Jeeps on the slickrock


A crowd waiting for us as we drove up Hell's Gate
It should be noted that around the time of this jeep tour, the White Wolf (my Jeep) busted a radiator...


I love this vehicle, but sometimes it gets the double middle finger anyways.
Luckily we got it fixed and we able to bring home several delicious Green River melons...

September 12, 2014

Southern Utah Trip #5 - Canyonlands Chesler Park


It seems fitting that I'm making this post on the exact 50th Anniversary of the creation of Canyonlands National Park. We've been to a lot of national parks, and this region is definitely a favorite. It's remote, rugged, diverse, and downright beautiful. The battle to protect the lands surrounding the park boundaries is still being fought.

We hiked out to Chesler Park on a very warm morning. Like any single day you spend in Canyonlands - you only get a taste of the landscape and it leaves you wanting to spend more time there. I definitely came away from this hike (and this whole trip) thankful that we have such a wonderful national parks system to explore and enjoy.



Hamburgers?
Don't step on the cryptobiotic soil!