May 28, 2013

Mt. Hood Wedding

Not a bad backdrop for a wedding, huh?

Our friends Hannah and Pete got married on an organic farm near the base of Mt. Hood over Memorial Day weekend. Fortunately, a rainy morning turned into a sunny(ish) afternoon, and it was simply a gorgeous setting for their big day.

Andrea and I really thought this area of Oregon was spectacular, and immediately started plotting out how to make another trip back (sooner rather than later)...

Hannah and her parents

Reception Building
Fanciest POPs ever
Slick way of organizing the tables - by ski area!
View from the reception area
We dress up 1-3 times per year :-)
Goodnight, Mt. Hood

Columbia River Gorge

Columbia River

We spent Memorial Day weekend in Oregon, as a couple of our friends we getting married in Hood River. After flying into Portland on Saturday morning, we decided to drive out to Hood River via the Columbia Gorge scenic byway, which is full of amazing waterfalls and beautiful viewpoints of the gorge. We got lucky, and had a partly sunny day with no rain!

Vista House
Another shot of the gorge from the women's forum viewpoint

Latourell Falls
Bridal Veil Falls
Upper Multnomah Falls
Multnomah Falls

Hood River Waterfront Park
Hood River waterfront

May 24, 2013

A less intense blog post

The last post, with Andrea's surgery recap/images, was probably a little too intense...

She is bouncing back - able to walk a little further and do a little more almost every day. It will take some time, one step at a time.

My race plans for this spring were altered a bit. I was originally planning to run the USA 25K Championship, but due to my hamstring that didn't happen. I decided to back off the intensity for a while and get back to base training. I'm still going to run the USA Half-Marathon Championships in Duluth next month, but that will end up being more of a "see where I'm at" race instead of a peak performance.

I was lucky enough to spend a few days in Boston earlier this week, hanging out with the team at Saucony and previewing the new shoes/apparel for 2014. The product line is amazing. The company is full of so many passionate, innovative, and smart people, and what you are going to see from them in the upcoming months/year is going to convert you to Saucony if you haven't already!

While I was in Boston I did a long run on the marathon course, running the Newton hills section of the route twice. It really ignited my fire to get back there in 2014. And on that note, Saucony is still selling their #BostonStrong lace medallions - all of the sales go to the One Fund Boston. I ordered a couple pairs... its a great fundraiser.

May 14, 2013

Andrea's Athletic Pubalgia Surgery

[Update: Please read Andrea's Athletic Pubalgia Surgery #2. I highly recommend NOT seeing Dr. Brown as his surgery was unsuccessful and resulted in more complications.]

This could potentially be a long post, so I'm going to try and keep it as concise as possible, and summarize some of the information Andrea has been posting on her training log. I'll link to more detailed information when possible, and as always - if you have more questions, we are happy to answer whatever we can.

As most readers of this blog know, Andrea has been injured for a long time - she's basically been on the sidelines since the end of July 2012. Some of her updates on Wasatch and Beyond since that time:

September 2012 - Injury Pains
November 2012 - Still on the sidelines...
January 2013 - Injury Update

She was hurt (with no diagnosis) and unable to run from September through November, then made a bit of progress in December and January (even ran a 5K race), but then in February/March things fell apart again. If you read through those blog posts, you'll see that she was one of the most pro-active patients ever: she saw several MDs/PTs, went through multiple courses of physical therapy, tried no running, Alter-G running, backwards running, cross training, no exercise at all, etc etc etc. It was frustrating to say the least, especially with no diagnosis and no relief from the pain. Andrea did everything right for 9 months and nothing seemed to help. By April, the amount of walking needed to complete basic tasks (like going to the grocery store) were difficult and put her in a lot of pain. I felt awful for her and just wanted nothing more than for her to have some consistent relief.

Finally at the end of April she flew down to Nashville TN to see Dr. Thomas Byrd, who is one of the top hip surgeons in the world. He did a thorough evaluation, another MRI (#3!), and was able to rule out FAI and/or a labral tear as the source of her pain. This was good news, as those are difficult surgeries to recover from. I should note that about a month earlier, a local surgeon (Dr. Hickman, who I wouldn't let put a band-aid on me) told her that she definitely had FAI and needed surgery right away. Its SCARY how WRONG he was. Lesson is: don't settle for the first opinion, especially that of a junior surgeon. Dr. Byrd's feeling that FAI could be ruled out was also backed up by several expert radiologists that Andrea sent her imaging to.

A week after her appointment with Dr. Byrd, Andrea and I found ourselves in Fremont, CA for a consultation with Dr. William Brown, a "sports hernia" specialist. Dr. Brown diagnosed Andrea with this condition, and she decided to have surgery the following morning.

The injury turned out to be pretty substantial. Here's the quick rundown of specifically what was wrong and the surgical fix:
  • external oblique aponeurosis tear, about 2 inches long, was sutured back together. 
  • internal oblique underneath that spot was damaged and about to tear, thicker portions of the muscle were sutured together across the compromised area. It had also separated from the conjoint tendon, and needed to be sutured back to that. 
  • 2 branches off the iloinguinal nerve were frayed; these were cut off. 
  • adductor longus was partially torn off the pubic bone and was attached to the adductor brevis in order to relieve some pressure from the pubic bone. 
He said it was the worst injury of this type he has ever seen in a female. He said something along the lines of "I dont know what in the world you did to cause this!" 

Andrea's daily log for May provides the day to day details of how all of this played out.

In one of her posts, Andrea explains a little more about this injury and process of diagnosis:

The injury I had is what is considered a "sports hernia" although it really isn't a "hernia" at all (somehow it got that name a name a long time ago because it occurs in roughly the same area as a regular hernia and happens to athletes). A better term to describe it is Athletic Pubalgia. Diagnosis is very difficult, because it basically occurs through process of elimination of all other groin/hip injuries. It is also rare (very rare in females), and a lot of doctors don't even know about it (for example, I had one surgeon in Utah tell me such an injury didn't even exist!). Matt Poulsen actually suggested this could be the problem all the way back in September, but he also knew it would take some trial and error to accurately reach this conclusion. He was right all along. Typically, people with this injury are encouraged to try several courses of physical therapy (along with ruling out FAI, labral tears, etc). I did all of those things and as you will see by the size of the tear, there was no way this was ever going to heal with PT or conservative treatment alone. The amount of surgeons who work with higher-level athletes and repair this injury can be counted on one hand. Dr. Brown was the closest to SLC and had excellent reviews; I'm very glad I chose him as my surgeon.
We have been very impressed with Dr. Brown throughout this entire process. In the weeks leading up to her appointment, he talked to Andrea several times on the phones and answered all of her e-mails quickly. In the first 48 hours after we left the surgery center, he called at least 6 times to check in on her. His concern was real, and we would both highly recommend him in the unfortunate case you ever have to deal with an injury like this.

Andrea is almost a week out from surgery at this point. She will post more about the recovery process (not easy!) in another post.

Now, I'm going to post some images from the surgery. Don't keep reading if you are squeamish or don't like seeing this kind of stuff...

This is the location of the injury, for reference:

This first photo is of the primary tear of the external oblique aponeurosis. The tear is 2-3 inches long and separated by a full thumb's width. The arrows show where the tissue should be attached. That entire area between the arrows is torn...
The second photo is another layer down, now looking at the internal oblique. This area wasn't torn, but the area outlined by the yellow box was very thin and barely being held together. It was at risk of tearing at any point. The internal oblique was also torn from the conjoint tendon (but we don't have a photo of that)...

The third photo is showing how Dr. Brown is pulling thicker/stronger portions of the internal oblique together over the thin/compromised area.

The fourth photo is Dr. Brown pulling the external oblique together (essentially attaching the ends separated by the yellow arrows in photo #1 back together)...

We don't have good photos of the adductor repair or the damaged nerves. Maybe that is a good thing!

May 6, 2013

Spring skiing and super-Garmin

I had to take a little time off after the SLC Half Marathon, as I yanked my hamstring a little in the latter miles of that race. In the meantime I've gotten some bonus days on the skis and somehow Andrea has gotten me excited about doing rehab exercises and stretching!

Here's some photos from some days in the mountains over the past two weekends, and scroll down to the bottom for super-Garmin...

For my birthday, a couple of our friend gave me the greatest gift ever: super-Garmin. (More here).