Surgical Options

Now looks like a good time to start over. Again. It seems like I have done nothing but physically start over for the past four years, and (if I’m honest with myself) I think I’m having a small adult tantrum about it.

When I was violently ill through my entire pregnancy, I thought it would get better when it was over. When the birth was rough, I thought it would be fine after I recovered. When recovery stretched out into years, I thought it would normalize eventually. When I pulled my hip, I thought I could run through it and get better. When I tore my hamstring (and apparently my labrum), I thought I would suffer the couple months and be back to normal. When my hamstring finally healed after 18 months and two PRP injections, I thought it might finally be over.

Yet here we are.

Nothing has been debilitating or unbearable, just an endless string of discomfort and inconvenience, of tasting recovery or “normal” just to be shoved back to square one. And perhaps the root of my suffering is the resistance to the idea that this is my new normal, my foolish attachment to how I should be after all these changes.

Maybe this chapter of my life is about a series of physical recoveries, rather than the mental and emotional recoveries in the previous chapter. Maybe life is all just a series of events and recoveries.

Or maybe I’m just whining.

I went to my orthopedic for my steroid injection follow up today. At my previous appointment, they injected steroids into my hip joint to troubleshoot my continued pain. Though my hamstring showed healed, the pain continued as an unusual presentation for a labral tear. The shot helped. A lot. For about a week before its effectiveness started to fade.

Since the shot seemed to indicate the root of the pain, we discussed options. I could do nothing and live with the current discomfort level. I could do maintenance steroid injections until they lost effectiveness. I could do PRP or stem cells to stimulate healing, despite the lack of evidence that the labrum can heal itself. Or I could have laparoscopic surgery.

I found myself torn between the extremes, as always. Nothing or surgery.

Typing it out, my logic does not make any sense, but my instinct was to do nothing. To just continue to deal with it. It seems ridiculous after lamenting the issue for nearly the past two years. It seems like it should be an easy answer to finally fix it. Yet it was the idea of recovery that tempted me to stay with the pain. Though I am known to develop Stockholm Syndrome type attachment to my pain.

I didn’t want to face another lapse, another step back after it took this long to regain this ground, after how many times I already had to retread. Spoiled complaints of the mostly functional. Yet beneath that is the fear.

Exercise and endorphins are the foundation of my precarious little balance on life. It sounds silly to say that two weeks on crutches could be unbearable, but… I know that if I don’t exercise hard enough in 2-3 days, the depression starts to swell and my thoughts begin to twist and contort. I know that it’s just one step back towards that darkness. So the idea unnerves me, and my self-preserving instinct is to just not. To just run through it.

Truthfully, I still want to do that now. Just keep running and tell myself the nerves will give up.

More superficially, I am frustrated to release the progress I’ve made. I’m reluctant to go back to adding miles and shaving off seconds, to rebuilding the muscles and conditioning that abandon me so immediately. I finally got back to where I thought I left. I even just said, foolishly aloud, that I was finally almost there so it must be time for something to send me backward.

With this injury, the universe takes what I say way too fucking literally.

However, after being scolded by at least three people, I know that all of this is my stupid, irrational fear and obsessions clouding an easy and obvious decision.

So, next step, surgery…

 

Christina Bergling

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Healed

It has been a while since I posted! Honestly, I was exhausted of posting the same thing (plus I was painfully busy). Trying and failing to lose weight. Trying and failing to recover from my hamstring injury. The same circle for over a year and a half. It had to be as mundane to read as it was frustrating to endure.

However, I can finally say with some measure of confidence that I have progress on both fronts!

Following my latest PRP injection several weeks ago, I returned to my orthopedic for a follow up. While my injury was definitely improved, the pain lingered. My doctor offered further injections, but I requested an updated MRI to see where we were and if any progress was being made. Last week, I had the MRI with additional contrast this time (which I mostly slept through), and today, I got my results.

The MRI revealed that, compared to my previous MRI over a year ago, my left hamstring appears NORMAL. Meaning I have actually healed!

My two hamstrings looked the same on the MRI. All the time and pain and resting and injections have ultimately done something. I had a mini celebration when my doctor told me and then had to struggle to focus on the rest.

So why am I still in pain? The MRI also revealed a tear and some other issues in my labrum. However, I do not present with labral tear symptoms. The pain should be in my groin rather than at my hamstring attachment. So we did a steroid injection into my hip joint as troubleshooting. If it has an effect, it must be an odd presentation of the labral tear. If not, perhaps to physical therapy to work out the last of the pain.

In any case, MY HAMSTRING IS HEALED!

As far as weight is concerned, I think fasting is my answer. I have been fasting (as described in The Obesity Code) since January-ish. I have lost 20 pounds with no rebound. I don’t think or obsess about food. In short, I feel like myself again, physically and mentally.

The fasting suits the binge and purge nature inherited from my eating disorder days but reapplies it in a way that it balances my body’s insulin rather than destroying my mind and body. It just works for me. It is so much simpler and easier than I thought. I am saving a shit ton of money on food, brain power on not having to plan, and soul on not torturing myself by counting the calories in every bite.

FREEDOM!

And it’s working. Slowly and steadily. To the point that I don’t care anymore. I’m just happy.

Some days, the fasts are not easy. Some days, I don’t succeed. But I just let those days fall away and try again the next week. I can have pizza and beer until I’m sated and know that my Monday morning fast will balance me back out.

I think this might be my solution. It was a long and maddening journey to get to both of these points, but I’m happy to finally see them.

PLUS I am running more and faster again. I might even be able to fully get back to that. This is a running blog after all…

Christina Bergling

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Doctor vs Doctor

It was been 19 months since I went into the splits and tore my hamstring. Yesterday, I went to a new orthopedic.

I began treatment with my first orthopedic about a year ago, last January. He gave me a steroid shot and sent me to physical therapy. After dry needling, massage, and strength training did nothing or potentially made it worse, he finally sent me for an MRI. He told me I had a minor tear with no details. He gave me a PRP injection then told me we were at the end of my treatment.

I had this initial PRP back in May. It cut my pain in half, so a vast improvement, but then it just plateaued. It was better but not recovered, improved but not healed. I was fine to deal with it. Besides, my doctor had given up on me and told me there was nothing more he could/would do for me. However, when the pain seemed to increase again and it was driving me from my bed at night, I decided it was time for an evaluation. If nothing else, to verify I wasn’t making it worse.

I understand that hamstring injuries are notoriously slow to heal. Yet the lack of any progress and appearance of regression concerned me. Also, my doctor’s treatment (or lack thereof) left me with so many questions. Was I doing something that could be making it worse? At what point should I be worried? I had to know, so I got the referral for a new doctor.

After just my one visit yesterday, I can say that my experience with this doctor is a night and day contrast to my previous orthopedic. I did not know the extent of my dissatisfaction with the first until receiving the superior treatment from the second. Allow me to compare the two experiences.

My first doctor and his nurse were very rushed and impersonal. They asked questions but did not seem to actually listen to the answers. I spent extended periods in the lobby and patient room, waiting. I told them in my first visit that I was there to resolve my pain. I then repeated this every visit, yet they never wanted to treat my pain. They only wanted to get me back to activity.

Conversely, this new doctor and his nurse were extremely friendly and attentive. At each stage, I waited for normal and reasonable amounts of time, yet they continually checked in on me to communicate a status update. They were so attentive that it was startling. They also both connected with me. They looked into my eyes when they spoke to me. They responded to the previous thing I said. They waited for me to speak as if they wanted my answers.

I felt so much more comfortable at the new office. I felt like I actually mattered instead of being dismissed and ignored.

When my first doctor got my MRI results, he told me I had a minor tear. That was it. Despite any queries, he only said that and also that the technician probably would have never seen something so insignificant had he not pointed it out. He and his nurse seemed to trivialize and minimize my injury at every appointment. Their dismissive demeanor made it feel like they either did not believe I was injured or doubted its severity.

I learned yesterday from my new doctor that this same MRI showed that I had a labural tear tear in the same hip. The outside of that hip also showed inflammation, most likely from the injury I had before the hamstring. He told me my hamstring had a partial tear, approximately 20%. However, he said, the tear was not on either edge, instead it was in the center of the hamstring, making it extra difficult to heal.

All information that would have been useful A YEAR AGO.

My first doctor told me I could have a steroid shot and gave me one. He told me I could have a PRP injection and gave me one. Then he terminated my treatment, deciding he was done and there was nothing else he could do for me (another indication to me that he did not consider me actually injured).

This new doctor explained my six different options and quoted me the out of pocket price for anything not billed to insurance. I could:

  1. Get a new MRI
  2. Get one or more PRP injections
  3. Get stems cells from a donor
  4. Get stems cells harvested from me without anesthesia
  5. Get stem cells harvested from me with anesthesia
  6. Have the reattachment surgery

Not only did he provide me these options with price tags, he then walked through the pros, cons, and his experience with each choice. He told me that surgery would be his last resort because, with my injury, it could potentially sacrifice the 80% healthy hamstring to repair the 20% damaged. He told me he would prefer the biologic options (PRP, stem cells), but PRP has the most data and evidence behind it. If he did stem cells, he would recommend harvesting my own to eliminate risk of cross-contamination or rejection.

Then he encouraged me to ask questions and share what I thought I would like to try first. I opted to start with another PRP injection, which he then provided me at this same appointment. Then he set a follow up appointment to check how the PRP took and determine next steps.

Yet, with all this, the most glaring and important distinction between the two doctors and my experiences with them was the administration of my PRP injections.

At my first PRP injection, the nurse took my blood and spun it down in the room with me. When the doctor came in, he had me bend over the examination table. This aggravated my injury and felt very awkward. The nurse jabbed the ultrasound into my butt while the doctor stabbed the needle into my tendon. Afterward, he informed me this was all he could do for me. When I told him I really needed something for the pain, that the constant pain was affecting the rest of my life and making me short with my children, he reacted as if I had never mentioned pain and was drug seeking. He gave me Tramadol. As if being unconscious would solve my problem.

Yesterday, the nurse took my blood. While she was waiting for it to spin down, she checked in on me and told me how much longer I would be waiting. She set me up laying on the exam table on my stomach with a pillow. When the doctor came in, he covered me (as much as he could) with a paper blanket. He informed me he was going to start the ultrasound and placed it gently against me. He told before he marked for the injection and inserted the needle. He communicated each step before taking it. After, he sat down with me, and we discussed recovery and expectations and follow up appointments. He shook my hand before leaving. Then the nurse came in and set up my appointment before walking me out.

The two experiences of the exact same procedure were so different, so polarized. After the first one, I felt very uncomfortable and unnerved, generally unhappy. Being bent over the table, stabbed, and then dismissed so impersonally made me feel violated somehow. It never sat right with me and doused any hope I had that the injury pain might actually subside.

In contrast, I left yesterday’s appointment feeling optimistic. I felt like the doctor had actually heard me and I once again had options. And even if my circumstances do not change and the injury does not heal, I at least feel like someone gave a shit and tried. It was simple subtleties and seemingly insignificant details that made me feel violated and dismissed versus cared for and treated. I don’t think anything unethical or inappropriate happened at my first shot and I don’t necessarily doubt my original doctor’s medical knowledge, but I do see now how wholly unsatisfied I was with the treatment I received from him.

These experiences reminded me how individual doctors are and how unique a medical experience can be. Getting an injection is not just getting an injection. The circumstances, environment, and care are crucial factors. I am hoping a more favorable experience cultivates more favorable results as well.

For now, I will be on the couch, willing my body to heal itself.

 

Christina Bergling

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Back Again

I went for a run yesterday. A real run.

Embarrassingly, I have not gone for a real run in a long time. I have gone for runs, sure. Group runs at various paces for various distances. I have been content to jog and cut off miles, which is very uncharacteristic of me. I have even gone for solo runs. Yet I have been talking myself into keeping them short or slow.

I am not entirely sure what had been happening. I felt gun shy about running. In theory, I told myself I missed it and wanted to return to longer and harder running, yet I would permit myself the excuses for it not to happen. Again, not like myself.

I would say it was perhaps my perpetual hamstring injury, but that has not hindered me from running or exercising in the past 18 months, so why now?

I have definitely been distracted by other fitness pursuits. bodyboss was extremely time-consuming. Then there is barre. I have been practicing a lot of belly dance for an upcoming performance I’m traveling to next month. I also picked up a hip hop class (I am terrible, by the way). So maybe I have just been too distracted.

Whatever the bullshit reasons and excuses, I finally forced myself out for real yesterday. I didn’t permit myself the 2 mile or 3 mile I have been clinging too lately, even though they have come to feel like my comfort zone. I forced myself to do the 5 mile route, with the 2 horrible hills.

And it felt great. It felt just like it always did. It sucked; it hurt; I wanted to die. Then it was the amazing high. It was all so familiar, so comforting, so exactly how I left it. I even ran faster than I have been lately. I even managed to improve after such neglect.

That was comforting. Now, I remember why I need it. I recall it’s place in my life and my fitness routine. There may not always be time to satisfy it, but at least now I can keep in mind why I should try and prioritize it.

After reading The Obesity Code and recovering from mild surgery, I find my exercise addiction tempered. Finally, it is not the end of the world if I can’t fit in a workout every day. Finally, I am not doubling down on workouts multiple times a week. Finally, I am allowing myself rest days. It feels foreign and awkward but also like a relief. I have no intentions of falling off the fitness wagon entirely, so I am hoping this reduction is actually healthy.

In all my questing for the next time and the answer, I am hoping this is actually it. I might have just needed a good run for it to feel right.

Christina Bergling

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bodyboss: My Review

I made it. I completed the bodyboss program. I even completed it on an accelerated schedule to finish before I had minor surgery, which may or may not have hindered the results. Either way, DONE! Now, for my review.

I HATED bodyboss, every single damn workout. To be fair, I hate strength training, particularly high intensity interval training (HIIT). And most of all, I loathe jumping. That pretty much defines bodyboss as a workout program.

It touts being just 24 minutes a day, 3 days a week. Lies. With warm up and cool down, it was an hour per workout. Plus the program included additional workouts for all the non-bodyboss days. So, in truth, it is about an hour a day, 6 days a week like any other workout program. I ended up skimming it down to just the meat of the bodyboss workouts so I could fit it in with my running, dancing, and barre workout schedule.

The program is divided into 4 3-week cycles. The first 2 cycles were manageable and built on each other nicely. Aside from the very annoying limitations of my hamstring injury (which bodyboss aggravated perhaps even worse that barre), it was acceptable.

Then week 7 hit. The program escalated drastically. It started included box exercises. I do not have a box and had zero desire to find a reasonable facsimile.  The number of exercises also increases from 6 to 8 and the reps climb to obscene numbers like 50. I never got to the point of being able to do 50 reps of 8 exercises in 8 minutes. The pain in my hamstring was too great to push through so many reps of exercises that made it angry, so I had to modify the program. Again, I’m not sure if that hindered results.

The workouts continued to build. More reps. More stupid jumping. I just pressed on. I just did what I could do as hard as I could do it. Frustrating, yes. Disheartening, yes. I wanted to quit before every damn workout, but I did it anyway because I was more than halfway there and I said I was going to finish.

If you asked me if I thought bodyboss worked for me before the numbers, I would have said absolutely not. I would have said it was complete bullshit and a waste of time. However, the numbers present a different case.

Final results:
Pounds lost: 5
Body fat percentage lost: 1%
Inches lost
Bust: 2
Waist: 1.5
Hips: 2

Challenge time
Before: 6:47
After: 3:49

The pounds and fat lost are negligible, but the inches and time on the challenge are relatively significant.

So, how do I feel about it when comparing experience to results? The results definitely temper some of my negative feelings because they make the suffering somewhat worth it. I have zero issues suffering, if it does something. The entire program, it felt like it was doing absolutely nothing. That turned out to not be the case.

So would I do it again? Honestly, maybe. It all comes down to the hamstring. I absolutely would not attempt it if I had any continued hamstring pain. At all. However, if my pain was actually alleviated, if my injury actually recovered, I would actually like to retry it. Both to see if I could do better and to see how my hamstring was actually impacting my progress.

Alas, for now, the hamstring injury continues to be never ending. So for now, there will be no second round of bodyboss. Instead, I am recovering from my laparoscopic surgery then getting back to running, dancing, and barre. It will all be so much simpler without cramming bodyboss in there.

The journey continues.

Christina Bergling

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The Next Thing

The last three years have seen me attempt diet after diet, exercise routine after fad. They all begin the same, with such hope, motivation, and optimism. However, after the infatuation wears off, they all have fallen into the same disappointing pattern. I rarely fail at them, but they consistently fail to deliver me results.

I have tried traditional calorie counting, low glycemic, Whole30, near ketosis. I have joined a gym, run constantly, started barre, used a personal trainer, done bodyboss. I am sure I have forgotten multiple tangents and detours.

Nothing.

I have been ramming my head into the same wall all these years, trapped at the same weight (or more) no matter how I work or starve myself. I am progressively dieting stricter and stricter, working out more and more regularly. I have worked myself into multiple injuries. Deeper and deeper into the obsession.

Nothing.

I have felt completely crazy. I have spent far too much time fixated on something I do not want to run my life. But here we go again, onto the next thing. Or things in this case. Two things.

First, I have been working with my therapist, who also happens to be an integrative medicine specialist focusing in eating disorders, through this struggle. With her advice, I went to my primary care doctor to have my hormone levels tested. My estrogen (and iron) came back high, while my testosterone was nonexistent. Quite possibly, I could be experiencing estrogen dominance from my hormonal IUD. So I went to discuss with my OB/GYN, and she immediately removed it to allow my body to self regulate.

Hopefully, normal hormone levels will balance my weight, as well as my mood and energy. Having a monthly cycle should also level out the iron level in my blood. So I am going back to being natural. And getting my tubes tied in a couple weeks.

Second, I have shifted to yet another diet/exercise program. I am still doing barre and running. I am still finishing bodyboss (nearly two thirds of the way through it now). However, my coworker introduced me to a new app to try for food tracking and planning.

The app is called noom and is ultimately not much different than MapMyFitness or MyFitnessPal or Spark People or anything I have tried previously. The main divergences are that the program is psychology-centric (which works for me on multiple levels) and that it includes an individual couch who messages you and an online support group (hence why it costs money).

My experience so far has been positive, but don’t go holding your breath just yet; we’re scarcely out of the honeymoon phase. I have seen some results then seen them mildly undone by Christmas. The psychological approach to the app is pretty transparent to me, both because they are transparent about it and because I’ve been in eating disorder counseling periodically for years. However, that does not prevent it from working on me. I know the compliment every time I log a work out is a manipulation, but it makes me feel good nonetheless, so the manipulation works. Same with the coach and the group, though my group is pretty inactive and lame. It is an extra layer of accountability without the pressure of real interaction.

I have noticed improvement in my thought patterns and emotional reactions, if nothing else, which is surprising since all that counseling over the years has done shit against the same problems. The app does not tell me much I do not already know, but for some reason, things appear to be clicking now. I hope it is not some false sense of enlightenment meant to lull me into complacency to then fall into old patterns again, but a girl can dream.

I hope one of these things is the answer. I’m ready to have an answer, any answer. Yeah, it would be great to fit into all my pants and be my pre-pregnancies weight again, but more than that, I want my body to be healthy. My blood sugar finally came down; I want it to stay that way. More than anything, I want to not think about this bullshit all the time. I want it to not be 10 hours out of my week. I want it to not be tormenting me every meal and every workout. I want to just be.

So, here we go on these next things. Fingers crossed.

Oh, and by the way, my hamstring is still torn. bodyboss aggravates it greatly. I’m headed to a new orthopedic to see what the hell is still going on next month. Maybe that problem needs another next thing too.

Christina Bergling

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bodyboss

I have started a new fitness program.

I know. I wait for your unmitigated shock to pass…

A friend and running mate decided to try bodyboss, so we, her running club, decided to go down with her.

bodyboss is a exercise program delivered via a booklet (physical or online) heavily pushed on Facebook. Most simply, the program is high intensity interval training (HIIT). It advertises as a quick 30 minute workout 3 days a week. What it neglects to mention is the 10 minute warmup and cooldown that bump it up to pretty much an hour.

The entire deal is 12 weeks long, and I am about 2 and a half into the process. So I have done enough to taste the workouts but not enough to truly gauge the whole system.

With this much of a taste, I can say that it fucking sucks.

I hate interval training. I also hate jumping and planks. That is literally what these workouts are. Almost all the are. 7 minutes seems like such an innocuous commitment, yet during the intervals, it turns into a damn eternity. I sweat and struggle and swear so much. There is no high; there is no rush. There is only pain.

Like barre, nearly all of the exercises also irritate my hamstring. After a year and a half, every twinge just stirs a rage of frustration and hopelessness. I have to modify many things, just to continue to acquiesce to the injury.

And so far, I feel no results. I have been working out daily and doing barre multiple times a week, so while I struggle with the workouts, it is not a huge difference to do them. I get sore sometimes but not often. If anything (despite also tightening my diet), I feel fatter.

But it has only been two weeks.

Stay tuned to see what I have to say after 12!

 

Christina Bergling

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