Tag Archives: orthopedic

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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Plasma!

Three weeks ago, I received my platelet-rich plasma (PRP) injection into my relentlessly injured hamstring. This came nearly on the day of nine months since the injury. It still unnerves my mind to consider all of these months of constant pain sprung from one split second of lifting my hands as I was doing the splits. Yet, after so little change so many months, this procedure was hope.

As a recap, a PRP injection includes removing the patient’s (my) blood, spinning it down to the platelet-rich plasma, and injecting that mixture directly into the injury. This is said to stimulate the body’s own natural healing. The procedure itself is brief and out patient.

The procedure was uncomfortable, as advertised. I bent over an exam table, a hole strategically cut in my awful paper shorts. My doctor’s assistant dug the ultrasound wand into the flesh of my buttcheek as the doctor struggled to make the tip of needle appear in the field. He did not find it quickly or easily. Zings and flares flashed over my nerves as he moved the needle side to side and poked it deeper into my joint.

I just breathed and tried not to focus on the pain. The pain snapping at my spine, riding my synapses in waves. My body flinched and jerked involuntarily. I tried not to focus on the detached way the doctor worked on me like an inanimate pig carcass and his assistant called me sweetie to compensate.

The pressure increased as the small amount of spun down plasma was deposited directly in my injury. Then it was over. Of the variety of medical procedures I have had, this was definitely not the most painful. Unpleasant for sure but at least brief.

The worst part of the whole experience was trying to extract information from my doctor. Throughout his minimal appearances in my treatment, his (and his assistant’s) bedside manor have been lacking. Or I have failed to communicate my symptoms, like, at all.

I initially sought treatment because of my pain level. I was functioning fine, still able to be active. It was the pain. I told that to my primary care doctor then this orthopedic. I told them the persistence of the pain was affecting my personality and causing negative behaviors like yelling at my children too much.

And yet, this orthopedic treated me with the passing attention I would expect if I came with a mild ankle sprain. I had to fight to explain my symptoms. I had to nag to get any information on recommendations on recovery or activity. I had to get pain medication from my other doctor. He just seemed to not really take me seriously, either because he thought I was exaggerating or because he thought my injury was trivial.

In either case, it made the treatment and interactions in the office unpleasant and less fruitful. However, I was willing to indulge his medical expertise. He seemed knowledgeable enough, and it would have cost months to get a different referral for my insurance.

When I initially researched PRP injections (I had to Google on my own since my doctor provided zero information or expectations), I learned that the procedure actually stimulates inflammation in the injury to inspire your body to heal it. And since inflammation is the source of most pain, the information forecast a pretty miserable couple weeks after the injection.

However, I did not live up to that prophecy. It hurt, yes. I was exceptionally uncomfortable for a couple days but neither as much as I expected nor more than I had grown accustomed. Plus there were finally pain meds to take that miserable edge off.

But did it work?

I have just completed my two weeks of rest. Two weeks of zero activity. It was rough mentally. But, over the weekend, I was able to begin gently moving again. I have gone for a walk. I have taken a barre class.

And it is feeling better. Day by day, very slowly and incrementally, it is feeling better. I am not cured or fixed, by any means, yet the pain is retreating. I have pain medication that I am not even taking. I still have aches and zings and soreness, but I am not crying from the severity. I am not miserable and bitchy all day long.

I can feel myself starting to surface again under this injury.

I wish it was just cured. I was wish I was just fixed. I feel like I have earned it after this long. Yet it is happening painfully slow for my lack of patience.

Now the challenge is to temper myself. Every day it hurts less, I want to go run a half marathon (and I did not want to run another after I ran my first). So, prior to being liberated, I laid out a gradual plan to return to my normal activity level. I had to make it up myself since my doctor provided absolutely no post-procedure instructions. I had to interrogate his assistant for the slightest guidance then still just guess for myself.

I am on week 2. Two gentle workouts. A couple days ago, I went to barre for the first time. The origin of this entire mess.

I have not been active for really a month. In that month, I have put on about 10 pounds. Yes, emotional eating as I pouted over being inactive played a large role. Yet, it turns out that all my obsessive working out did serve a purpose; it was showing. I just did not notice until I stopped. Now I have to do all that work again, without being fanatical, without reinjuring myself. I am hoping that challenge will teach me to be more accepting of myself, to live with more balance.

My recovery starts over now. Not the nine months of suffering behind me. It starts over right now.

Right now, things are improving. Right now, I can get back on track with my eating and start easing back into activity. I can start fresh and maybe find some sort of sustainable balance this time. I wish I did not have to go back to trying to slim down again, but maybe this time I will appreciate where I was.

I am SO looking forward to getting back to running. It will be short and slow to start, but it will be far better than the nothing I am at right now. I want that time back. I want that sanity back. I want to feel like myself again.

Christina Bergling

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The Next Level of Failing Recovery

What I would not give to finally be able to write a damn post about running! For a running blog, this has been a sad string of whiny rants about not running for the better part of the last year.

And well, fuck. It’s only about to get worse.

The hamstring saga continues, unfortunately. I have failed spectacularly at physical therapy.

So injury in August. Initial doctor in January. My insurance company rejected the request for an MRI, so I was sent to the orthopedic in January. I almost immediately started physical therapy and went once or twice a week until the end of March, when my therapist and I agreed that I was making no progress if not deteriorating further. So I was sent back to the orthopedic who requested an MRI that my insurance company decided to bless this time.

Last week, I went for my first-ever MRI. Even as they were just imaging my hips and pelvis, leaving the crown of my head outside the torturous and constricting tube, it was a remarkably unpleasant experience. I do not like confined spaces, particularly those that restrict my arms. I would not call it claustrophobia. Perhaps a manageable discomfort. I also do not do super well holding still, much less utterly and completely still.

So I lay in the tiny tube, where it felt like I could headbutt the top of it. I breathed through my discomfort and the constricted feeling steadily climbing my limbs. As I held still longer and longer, I lost feeling in my hands. I had to peek through the bottom of my eyes to assure myself they remained folded on my chest. Yet even through the unrelenting slamming noise of the machine, I kept dozing off. Yet I could not be trusted to remain still while I slept, so I kept wrenching myself out of the twisted nightmares reaching up over me.

(not my MRI image)

The half hour dragged on in a shapeless and oppressive blur. Thankfully, my tech was very communicative. Between each set of images, he informed me of the duration of the next set and the total time remaining. That gave me landmarks back into reality. I held completely still, bobbed up and down on the sea of my subconscious, and made it.

The MRI revealed that I have a partial hamstring tear. (Pause for my complete and utter lack of surprise. Wait a moment for me to scream how I said this in August. And December. And January.) My doctor told me they would like to try plasma-rich platelet (PRP) injections as the course of treatment.

(definitely NOT my hamstring)

I had never heard of PRP (and my doctor and assistants are relatively terrible at communication), so I have done a fair amount of research online. To summarize, they will draw some of my blood, spin it down, and inject the platelet-rich layer directly into the hamstring injury. This should cause inflammation to go into overdrive and Wolverine up my body’s healing measures. It’s also supposed to hurt like holy hell for the first two weeks due to how inflamed it will be.

I read mixed reviews online. Studies that confirmed it accelerated healing and recovery effectiveness. Studies that claimed it does absolutely nothing compared to other therapies. People who swear by it and worship the results. People who scoff at or hate it. Thanks, Internet, for your reliable ambiguity.

Yet, at this point, I will try about anything. The pain is near constant and continues to interfere with my life, as simply as restricting activity and as grandly as influencing my behavior and personality. It has been almost 9 months with minimal improvement; I am over it. Depression is starting to creep in, flood and blur the edges, capitalize and take over. I feel it taking root in my brain, planting its awful seed in all the fissures the pain have created.

Besides, my doctor informs me the only other measure we can try involves completely severing the hamstring and reattaching it. I want no part of that very major surgery.

So the PRP injection is the next step. Once my insurance blesses it. Even if they do not, I may just pay for it. I need some sliver of hope.

What I have not been able to ascertain from my doctors or physical therapist are rules, boundaries, suggestions, advice, ANYTHING at all about what activities I should or should not be doing. The answer has been consistently vague.

“Don’t aggravate it.”

“Don’t do anything that hurts it.”

Aside from the fact that by personality defect alone I will push right through both aggravation and pain, activity has not hurt this entire time. It has felt fine to be active during the activity. If not much better than rest. Yet, clearly, that was not the case. I just want some definite answers. I get the liability portion; I get the variability between patients. But come on! Give me something.

So I stepped outside the therapeutic relationships and sought wisdom elsewhere.

Running has felt pretty good all along. No hamstring pain, no twinges, just perhaps extra pain after. Yet my logical brain has snagged on how it could be good or even ok for the injury. Besides, for all those months, I didn’t know what was really wrong. Yet now, running is off the table. NO RUNNING until it recovers.

I have trouble even typing that because I do not know how I am going to do it. It sounds silly to be so attached to an activity, but it has been my lifeline to sanity for so many years now. Even though my fitness has diversified over the past couple years, running has always been there; it has always been my guaranteed hit of endorphins.

No yoga either. The other activity I have used almost exclusively for the effects on the mind rather than the body.

SHIT. How am I going to hold my shit together?

I have been given permission to walk (in short strides) and dance (minus specific movements) and maybe barre (skipping key exercises). It is better than nothing, but I just do not know how I am going to maintain the balance I have cultivated through exercise when I am not allowed to push myself past my edge. My sanity is created by completely exerting myself, completely wasting myself in a workout to leave only the high.

I do not know how to moderate. In life.

I mean I’m grateful that it is not more restrictive or that my injury is not worse. Initially, I thought I would be 12 weeks with zero activity after the injection. That idea nearly sent me into a panic attack.

I am just trying to process how I am going to do this, what all it is going to mean. Ultimately, I will do just about anything to recover, to make the daily constant pain go away. Yet, a very nagging part of me is still lamenting what it is going to cost.

So expect even more posts not about running but more about not being able to run.

The saga continues…

Christina Bergling

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At the Mercy of the Hammy

The hamstring saga continues…

The last time I updated this topic, I had just come off Prednisone, and the pain was returning but manageable. Oh, how things have changed again.

This week, things culminated to a new peak of pain. The discomfort had steadily returned since the end of the anti-inflammatories. Then it started to get worse, hearkening back to the onset of the injury. Until one morning I could not walk, could not move on my own for an alarming amount of time.

My insurance denied the claim for the referral for the MRI in December, so I never did get scanned. Instead, they sent me to an orthopedic then physical therapy before they would entertain the idea of payment for scans.

So I went to the orthopedic. The visit was rushed and abbreviated. Both the doctor and his assistant asked a few questions and did not wait for an elaborations on the answers. I do not think I ever got to accurately articulate the full issue. Yet I was willing to trust. I was willing to try just about anything to change the situation and, especially, lessen the pain.

Then it was a steroid shot into my hamstring and a referral to physical therapy. I did not want to jump straight to a steroid shot, but again, I would take anything. I resolved to just go with it and give it a chance.

I had optimism in the shot, yet it did nothing. I know it could take weeks, but I guess I dreamed of the instant effect of the pills. Then things seemed to get worse. I doubt it was a result of the shot, but I do not know what changed. I did not notice any tweak that made it worse. I had not really changed my routine. Yet suddenly so much more pain. Like falling backward into the start of the injury.

The pain appeared more often and was called up by more movements and activities. Then that one morning where I could not walk.

Thankfully, so far, that degree of pain has only been reserved for that one instant and the first day of the injury. It really did reach levels that called up childbirth memories. Yet I now live in fear of it. Every catch and tweak, I wonder if it will fade. I worry I will be trapped like a whimpering turtle again. In that pain, I thought that was just how it was going to be, what my injury had become, and I think that hopelessness fueled the majority of my tears.

My orthopedic’s assistant did not seem at all concerned by my hellish morning, so I continued on to start physical therapy this week. Instead of mobility training or gentle exercises, I was there for one treatment: dry needling.

Dry Needling

I had never heard of dry needling, definitely never experienced. In short, the practitioner takes an acupuncture needle and stabs the muscle in a trigger point until it hypercontracts. That contraction is meant to reset the muscle, work out the knots, encourage healing.

Despite my extensive tattooing, I was nervous. Something about the idea of a needle being plunged into the sweet meat of my inner thigh. Yet it was not as bad as I had feared. The initial pierce of the needle was barely noticeable, and the muscle stabbing was also relatively minute. The pain came from the muscle contractions. The harder and more effective the contraction, the more painful. The sensation paled in comparison to that of the actual injury, so I just breathed through it.

The physical therapy has at least given me hope. Mostly because I liked my therapist. There seems to be a minute improvement since the needling. The pain remains just as intense, but the frequency and duration have lightened a bit. It would make sense to be from the treatment. Or it could be from starting to sleep with it wrapped or from taking a couple rest days.

I hesitate to think it is getting better because, in the past months, every time I do, it immediately regresses and gets much worse. The injury reminds me that I am at its mercy; then I am just crushed by the defeat.

Even as things have improved physically, I find myself struggling mentally and emotionally this week. I can feel the pain changing me, affecting my personality and reactions, and I do not want it to. That terrible, immobile morning has shaken me. It has made me gun-shy and paranoid, and it has also deflated my hope. I find myself frustrated and bitter all over again, as if my leg owes me something, as if I’m promised permanent functionality.

Then, at some point in my pathetic wallowing and pointless bitching, I realized that the pain is not the root of my mental discontent; it’s the restriction. And I think it is less not being able to do the activities I want and more not being able to reap the benefits of doing them. The injury simultaneous puts me in this nagging pain then limits my coping mechanisms to deal with it (and all the normal things).

I use exercise to deal, to manage. I rely on endorphins to tame my bipolar. I leverage time spent exercising as alone time and time to mentally process. It is a huge part of my routine and my balance. Which is a large part of the reason I have been pushing through the injury to continue the activities.

An amplification in pain was more to deal with but also took away the crutch. Add to that the fact that I am doing the Whole30 diet, and I am also missing my beloved consolations of alcohol and food that I actually enjoy. Not to mention the void of those things alters the chemistry in my brain. I cannot even use my Monster energy drink hack.

Basically, I have stripped myself bare, removed all safety pads, and left myself alone with life in general and this injury in specific. I find that I am terribly weak solo, without all my tricks and tools. And I am getting my ass kicked. It is all sloppy and just sad. I feel like a mess.

The realization helps, tames the beast a bit. As always, I find the true break is in my mind. And I am the only one who can fix that.