Tag Archives: therapy

On Recovery Running

Calm down.

You cannot sprint off into the pace and distances you left before the injury.

Calm down.

You cannot run like the past weeks, months, and pounds never happened.

Calm down.

It is OK to be winded and weak and dying. It is OK for the pain to still crawl up the back of your leg and nestle firmly in the root of your hamstring.

Calm down.

You are still recovering.

Calm down.

Do not make it worse.

Breathe. Just run. Gently. Just enjoying being able to run. A little.

You’ll get back, just like you have before. Running will still be there.

Calm down.

Baby steps. Baby little zombie turtle wogs.

Take what you can get. You will find the float again some day. You will sprint again some day.

Today, calm down.

 

***

 

I am trying to be good. I am trying SO HARD to be good. I am trying to run infrequently, short distances, and slowly. I am trying to modify barre classes to avoid the exercises that aggravate my hamstring. I am trying to not work out every day or twice a day.

I am trying to temper myself. So far, I think I am managing to tame my obsession, but I am struggling on the mental side of it.

I feel that itchy, uncomfortable anticipation experienced in the race chute all the time. Those terrible last seconds before the start gun. Those wretched little pregnant eternities. Yet I feel that all the time. Restrained, held back, contained. Like I’m coming out of my skin.

Getting back to some exercise has helped, but babying the leg still gives me this trapped feeling. The benefits I glean from exercise come from pushing myself to my brink, from making it hurt until the endorphins wash over my brain. I can’t do that yet, so I’m just left feeling perpetually unconsummated.

I’m trying to think of this as an investment in my body. I am trying to process it as purchasing health on the other side of this injury. Yet, with my mental balance in free fall, I am finding it challenging to sell these ideas to myself.

Patience. Breathe. Calm down.

 

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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Exercise: The Bipolar Hack

I think I have come to accept that my obsessive, demanding fitness regime has simply become a way of life. Initially, after having my son, I told myself that I was killing myself just to recover from him. I told myself that I was dial back the effort once I was back to maintaining. Even as I fixated on my shallow pursuit, I think I always knew, deep down, that was not true.

At some recent point, I remembered who I am on multiple levels. I remembered that I do not care about being skinny enough or a certain size; I remembered that it is not really my priority. Instead, I care about sanity. And I remembered that I need this, that obsession, fixation, and self-abuse are at my core. Channeled addiction, directed negative energy.

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I was diagnosed as bipolar when I was 19 years old. By the point I finally sought help and a diagnosis, I was scarcely functional, and my self-mutilation escalated to an alarming degree. What I would later learn were my symptoms emerged when I was 17 yet I can remember hints back into my childhood. I remember feeling so much and never being able to adequately explain or understand it.

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Like most, I railed against my diagnosis, alarmed by the permanence of the idea of being defective or broken. I resisted what it meant, fought what I needed to do, and continued to be a self-destructive mess for a long time. Making peace with what I am, with the way my brain is was probably the hardest point of growth in my life. The idea of who I am, how I identified being defective or undesirable was a difficult pill to swallow.

I tried medication once. And by once, I do not mean one kind of medication; I mean one pill, one time. The experience was horrendous. I was unconscious for over 12 hours, borderline catatonic for the entire next day, then suicidal for two more. I vowed to never attempt medication again, so I had to find an alternative method to deal.

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I did not want to hide in pharmaceuticals, but the chemical component of my disorder is undeniable. I cannot ignore it without it tearing apart my life. I cannot control the structure of my brain. I cannot affect the way my neurotransmitter receptors react to chemicals or the natural levels of serotonin or norepinephrine. However, I learned I can control two things: 1. The chemicals and activities that change my brain chemistry and subsequently moods, and 2. How I react to and process the moods I experience.

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Therapy handled learning how to react and process better. After I got past the resistance to what my diagnosis meant and entailed, sessions could actually be productive. By the end, I learned to suck any fraction of worth from 50 minutes out of a paid hour like a vampire. A reduction in alcohol intake and elimination of detrimental chemicals tamed the peaks of my extremes. Enter exercise as my medication.

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All my self-destructive behaviors included trying to eat and drink myself to death, so when I surfaced from the depths of my depression, I initially started exercising to lose weight. That shift, in itself, was a change from self-destruction to self-care. Instead of trying to kill myself slowly in every way possible, I made one step in the direction of taking care of myself, of deciding my body and my health was worth the investment. Then it was habit and routine to maintain the loss. It took years, but I discovered the mentally therapeutic benefits of fitness when I began dancing and running. When there was a high.

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The high is the key, which is why exercises like dancing and running are more effective for me than walking or weight lifting. I am chasing that wave of euphoric endorphins. Like a true bipolar, I am at home in extremes. Like a true recovered masochist, I always want to push until I hurt myself a little. That high can extract me from depression or level out the waves of my cycles (fun fact: Monster energy drinks also serve the same short term purpose but too much can lead to flirting with psychotic mania). So regular high intensity cardio exercise both helps keep me level and helps level me out when I do cycle.

This realization and practice, nearly a decade of bipolaring in the making, has changed everything for me. I did not have to wean off of medication or forego breastfeeding when I had my babies. I do not have to worry about side effects, the ones I experienced with my one dabbling or others like excessive weight gain associated with psychoactive drugs. I am unshackled. Unchained yet also completely and solely responsible for my own functioning. I’m even off the therapy leash these past few years.

However, this approach is definitely more demanding than popping a pill. Usually, I exercise 8-12 hours per week. Balanced between a full time job, two young children, writing, and a social life with my family stretches me pretty thin (and not in the aesthetic way).

This much self-care requires me to be selfish at times I probably should not be; it makes my relationships inequitable at times. I have to make sure to go run when I should be with my children. My partner has to consider me and make sure I can take care of myself before himself. It is often gravely unfair, but doesn’t my condition need to be considered and attended? Does my neuroatypical brain not require different things than the typical ones around me? Don’t I have to take care of myself to be worth anything to anyone else? These are hard questions to answer, and I do not think the answers are always the same.

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Neuroatypical is a new word to me. So much more comfortable than crazy or broken.

This concept, my way of dealing, has been weighing on my mind with extra heft lately. Recently, additional snippets of family history have been revealed about breakdowns and hospitalizations. The history always just feels like a damning roadmap of my future. But I want to be different.

I already am different. I am living my life out in the open. Part of me hesitated to publish this mental history lesson publicly under my real name, but this is who I am. I am bipolar. And if anyone can benefit from the lessons I have suffered to learn, I am willing to put them out there. I am not hiding or denying, like past generations had to. I have cultivated a support system who are familiar with my challenges and are able to support me through them.

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I am being proactive. If working myself out to the bone is what keeps me sane, I am committing to this fitness lifestyle. It’s a hell of a better reason to do so than just trying to be some kind of skinny.

 

Christina Bergling

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