Friday, February 25, 2011

All In

Very rarely in life are we faced with the decision to go all in or save the chips for later. If you were to really think about your life, most of life's defining moments allow you to still hold on to some chips: an emergency fund, Plan B, or a safety net.

While running a marathon is not akin to the birth of a child, or my wedding day, or accepting my first professional job...it's still up there. Perhaps it's the meaning I myself have attached to the miles and the accomplishment. Whatever the explanation, possessing the ability to run long distances holds a certain significance in my life.

While it has never been mentioned in my blog before (mostly because I didn't see its relevance until now), I was born with a bone disorder that caused some significant problems in my legs as a child. I developed tibial torsion, and my right tibia was reconstructed when I was 13. I spent that entire summer unable to walk, but returned to swimming almost as soon as I was recovered. Two summers later, the plate and hardware were removed from my leg and I went on with my life. Never used it as an excuse. Never really even disclosed it to anyone or spoke of it at all. I pushed it far back in my mind and plowed ahead with my life, the only evidence of struggle a fairly large scar on my shin.

I had absolutely no issues with this leg when I started running half marathons. It was only natural to move into the full marathon distance, so I just went for it. I truly forgot about my limitations; that I do not have the same capabilities as everyone else.

While I endured a stress fracture on my tibia before, I started to feel more discomfort within the last week or so, and the excrutiating pain had begun to shoot up my shin, into my knee, and even my hip. On Monday, the physical therapist focused entirely on pain management, and urged a doctor to get me in on Wednesday for some x-rays and evaluation.

While meeting with the doctor, I was told that I have about 30 miles left on my leg in its current condition. The previous stress fracture remains, as well as evidence of some smaller ones in other areas. Continuing on in this state for too much longer is putting me at risk of a break. A true break on the tibia, given my history, would require a rod be placed in my leg to reset it.

From a purely medical standpoint, according to the doctor, running the marathon in 9 days will probably not cause anymore damage that what is already present. Considering my recent mileage, running 26.2 miles is just another drop in the bucket.

But my mind started going...30 miles minus 26.2...leaves 3.8 miles to spare...

"You have about that left on it...it's just going to hurt like hell," And in his words "the large majority of doctors would tell you not to run on this at all..."

Then the real bomb...The inside of my tibia will always be at risk of fracture due to its poor alignment, no matter what we do. For this reason, the road marathon is an extremely high-risk pursuit for me in the future.

I can be a runner again...after what the doctor and physical therapist call "some serious work" involving biomechanic adjustments and orthotics and perhaps some more reconstruction. But I cannot be a marathon runner.

Unfortunately, that's precisely what I wanted to be.

I didn't think when I registered for this marathon that it would be both my first and last. I didn't question my ability to finish it or even my ability to hit my goal time (which was a bit of a lofty goal for a first-timer..but within reach). I saw this race as an entry point into a string of races that would eventually lead me to qualify for the great Boston Marathon, lots of finisher's medals, and colorful stories to share. The stuff marathon runners live for.

As the doctor put it earlier this week: I can think of these 30 miles as poker chips at my disposal.

I can go all in now and endure the pain...knowing this is the closest I may ever get to completing a road 26.2.

I can save the chips for later...knowing I may never get to use them in the future due to the risk involved.

When I left the sports medicine center that morning a few days ago, I was crying. A lot. I couldn't process the information and it didn't seem real. Sure, it's just running. But running has grown to mean a lot to me. And running full marathons...well, I think I've made it quite clear what that means to me too.

Mama K was my first and only phone call that day. I braced myself for what I was certain was coming: "M., this is just ridiculous now, it's not worth it. Just throw in the towel, it's okay. You don't need this accomplishment."

Instead she quietly listened, thought for a moment, and finally just said: "I think this might just be one of those times you have to go all in."

I'm not going to say Mama K's response was what gave me the willpower to forge ahead with this (stupid) race. But I realized her voice was just confirming my own thoughts, giving the reassurance I needed to give this goal a shot...even when the chips are seriously stacked against me.

I saw Dr. Joe last night for an appointment and filled him in. Another person who tends to err on the "cautious" side, I was anticipating that he would try to talk me down off this ledge with his patient and completely rational voice. Instead, he looked at me with somewhat sobering and very genuine eyes and said "M., I am very, very sorry. I know how much running future marathons meant to you."

And Dr. Joe, a runner himself, proceeded to coach me on how to give myself the best shot of completing my one and only marathon.

26.2 miles that I honestly don't know if I will be able to finish. 26.2 miles even the doctor isn't sure I will be able to finish, no matter how much grit and willpower I have. The pain may be too great.

In the end....this is one of life's "all in" moments. I am given one shot at something I want. Regardless of what happens, I'm all in.

It just means that much too me. Whether it should or not. It just does.

Thursday, February 24, 2011

Next Up: Tackling Body Dysmorphia

Body Dysmorphia: Failing to see your body as it truly is. Painful body image. Distortion.

One of the benefits of becoming my former dietitian's favorite-client-turned-friend is my newfound access to one of her former colleagues, JN. Welcome to the team, JN. Unfortunately for JN, I cannot afford to dish out sign-on bonuses. Although LA, Dr. K., and Dr. Joe may come knocking if the new chick collected one while I was essentially dropped in their laps with a host of serious issues in tow.

JN can best be described as a dietitian with a twist. As a wellness coach, she blends nutritional guidance, yoga, and body image counseling to help girls like me who, well, have no idea what they look like and really need to cut the "I hate my body" crap in order to fully recover from disordered eating.

JN and LA know each other from their work at an outpatient eating disorder clinic about 30 minutes north of here. Dr. K also knows JN and perked up a little when I reported that I would be working with her on some body image issues, as she is probably waiting for the day she no longer has to waste energy trying to conceal my weight during office visits.

Tonight's meeting with JN was actually the second. About two weeks ago, LA drove me to my first appointment with JN (which, for them, was like a little reunion), and the three of us discussed my treatment thus far, my lingering food issues, and why I can't just love my freakin' body already. Unlike the first time I met with LA, I actually opened up to JN with ease, probably because:

1. I am eating and no longer brain-starved, so therefore was coherent (unlike my first meeting with LA back in the day).

2. LA was there. I have major trust issues (duh...we know this), but knowing LA trusted New Girl helped me actually form meaningful sentences. I am convinced I would have sat with my arms crossed had LA not been there to telepathically coax me along.

3. I genuinely want the help. I know the body dysmorphia- while the hardest to overcome- is the like the eating disorder's obnoxious twin. Not seeing my body clearly and not wanting to eat are a package deal; one leads to the other and vice verse.

Tonight, I flew solo to JN's office and talked to her myself like the mature, 28-year old that I (sometimes) claim to be. Given the injury issues, I have been slapped in the face with the eating disorder yet again, and while trying to resist, have skimped a little on the food this week. When I realized I may have to back off from running, I instinctively snipped away at my daily food intake to "compensate" (normal people can do this, I cannot). Out went the second waffle I normally eat every morning, the cheese that goes with my morning apple, the hummus that accompanies my raw vegetables. I was gently reminded by JN that I need to stick to the plan.

Tomorrow, I'll eat two waffles again, re-introduce hummus to my veggies (I'm sure they missed one another) and chomp on some cheese. I get it. I remembered why I have to do that. My bad.

In addition to the food piece (which is never ending, really), part of my work with JN includes some yoga principles and body awareness. Think: the "my body is a temple" kind of stuff my "I love pain and cardio and competition!" mind generally doesn't handle well.

But I need it. I know this.

At least every other day I have a mini-meltdown related to what I see in the mirror or how I "feel" inside my body. I tend to always feel sloppy, lazy, "soft", pudgy...you name it. It's very black and white. For example, yesterday I wore a pair of my "sick" pants (worn while at my lowest weight) to work. They still fit, but are a little more snug than I would typically wear my pants.

The pants are a size zero Tall. They are from a store that does vanity sizing...but still, a zero nontheless (those things used to matter to me). However, because they were snug, I immediately thought to myself: "well, here we are...you knew this day was coming sooner or later. You are now a size 14 and can no longer fit into anything. Congrats. You suck."

If I had truly become a size 14 overnight...could I really have even fit into the zeros? Um...NO. Hel-lo distortion.

Likewise, JN caught a glimpse of this distortion last evening while in her yoga room. When asked to "place my feet hip's width apart", I instinctively spread 'em quite widely.

JN giggled. "Well, if that isn't an indicator body dysmorphia, I don't know what is! Um...your hips are not that wide."

I looked at my feet, set at least twelve inches to the outside of either hip. I laughed. I really thought that's where my hips were; a clear indication that I am not exactly experiencing my body as it truly is.

JN is going to attempt to help me just "be"...something I really never "am" (if that makes any sense at all). Now that I have restored some weight, learned to eat again, and have stopped trashing my body, it's now time for Step Two: minimizing the anxiety over trying to fix my body, trying to find peace with my natural weight "set point", and learning to be an intuitive eater.

And I should probably work to locate my hips, come to terms with that fact that I don't go from zero to 14 2.5 seconds after eating a piece of candy, and to see what I really look like with all the distortion stripped away.

And so I've turned down another street on this journey and added another eating disorder professional to my growing collection. But I like these people, and I eventually want to shed all of this crap...so I'm going to let them all stay just a little longer ;)

Tuesday, February 22, 2011

What 26.2 Means to Me

So I'm injured. Less than two weeks before my first full marathon- a goal I set for myself while lying in a hospital bed twenty-five pounds ago and vowed to complete regardless of the setbacks.

And maybe I was naive to think there wouldn't be any setbacks. I've struggled a lot in my life, but physical activity was the one area where I didnt generally encounter a lot of roadblocks. Sure, I had to work hard...but more often than not, working hard produced the results I wanted. Generally, the only variable involved in achieving physical accomplishments was the amount of effort I put forth. And given the unflinching determination that has somehow been woven into my psyche, I never really ran out of effort to give.

But now this is different, and an unexpected variable has been thrown in: structural injury. And quite honestly, I didn't know how to deal with it at first. I just kept pushing and pushing and biting into this goal like a dog with a bone.

So why hold on?

I'll tell you why. The marathon means something unique to each person who has put in the hours, the pain, and the commitment to complete it. Everyone has their reasons for wanting to endure such a mental and physical challenge, and no reason is less significant than the next. For this reason, it becomes very difficult to talk a runner out of pursuing a marathon once his or her eyes have been set on the finish line.

For me, running 26.2 represents accomplishment, coming back to life after a disorder that could have killed me without intervention, and strength in both mental and physical capacity. On July 19, The Mr. walked me into the hospital (a planned stay, strongly recommended by Dr. K) to start the process of becoming medically stable and starting to eat again. When we walked through those sliding glass doors, I had two books in my bag: "First Encounters With the Marathon" and "Ironman". The night before, I had purchased them at Borders. I knew I would have down time while lying there with an IV stuck in my arm...and I wanted to read something that would motivate me to do whatever it took to regain strength.

Lying there, my muscles weak and my ribs showing, my weight at nearly the lowest it had been since my high school swimming days, I started to realize that I was both wasting away and wasting my life. I realized, with fluids dripping into my veins and doctors monitoring my food intake, that I was so much stronger and better than all of it. If I had the mental strength to starve myself, ignore hunger, and not let go of the vision of "perfection" I had set in my mind...then I certainly had the strength to turn it all around and dump that energy into completing a marathon.

By that time, I was running 13-15 miles without issue (and also without food or fuel). I told myself that if I wanted to run a marathon and an ultramarathon, I would need to start eating. I would need to be okay with some weight gain. I would need to reframe my thinking related to food: it could no longer be the enemy. Food had to become what it is intended to be: a source of energy and fuel to power me through the physicality I would be putting my body through.

So pound by pound, I grew to accept the strength that was developing in me. I had moments of regression when I cried when I saw the number written in my charts (Dr. K never intended for me to see those). But in the back of my mind flashed the thought of running marathons, and that flash was generally enough to remind me that it was okay to see the number rise.

I started asking LA questions about proper fueling. I wanted to know more about nutrition for endurance athletes and ate and ate and ate. I delved into it, I learned about it. It propelled me. With time, I had shed the eating disorder and found new confidence, a new love and appreciation for my body and strength and grit.

Right or wrong (and I'm sure there are plenty who will judge), the marathon brought me back to life. Regardless of what happens this week and next related to the injury, physical therapy, and alternative workouts, 26.2 miles represents a hell of a lot more to me than just a medal or an athletic accomplishment.

I will listen to the doctor I will be seeing tomorrow (who I hear is pretty liberal and tends to lean to the "go ahead and run...just take painkillers!" side). I will follow directions. I will back off and save myself. I'll get in the pool and ice myself and retape. And if I'm given the green light to continue and to run the marathon, I'll be doing so driven by the fight that has gotten me this far.

Monday, February 21, 2011

Back to the Keyboard

Since the beginning, Dr. Joe has preached to me: "Progress, M., is not a straight line."

Absorbing this as just another -ism from a guy who earns $30 an hour to tell me what to do with my life, I used to brush it off with an eye roll (a leftover gesture from my youth that I rarely even bother to hide from the guy at this point). But having ridden the bumpy roller coaster otherwise known as "Life After the Worst is Over", I can attest to this fact: progress is more like the straight line someone tripping on acid may attempt to create.

About two months ago, I walked away from this blog and claimed to have closed a chapter. I was cocky and confident and sure that I was part of the small and exclusive group of "fully recovered", "formerly-known-as" eating disorder patients. I ate whatever I wanted for a little bit (within reason...some "food rules" still lingered), embraced my new healthy body, and started to wonder what on earth was the big deal about kicking this disorder?

Every time the eating disorder started to creep in, I was quick to shut the door. I threw it down into the dark basement of my life, gave it the middle finger, and turned my back. But gradually, it started to find other ways to make it back up the stairs: seeping through the cracks and creating other paths.

So it's right what they say about this disorder. It's like an addiction that will linger for life. Like any good post-recovery eating disorder patient, I had learned to turn my back on the temptation of familiarity. However, I made the rookie mistake of charging ahead without respecting the fact that the banished eating disorder could make its way back up the stairs when I'm not paying attention.

It would be a lie to say I've been living a perfectly blissful, balanced, ED-free existence since my last post. I'm honestly not sure why I never returned to the keyboard to explain the slips and falls and stumbles I've experienced in the last few months. Maybe it was my pride. Or lack of free time. Maybe I just didn't feel like putting it all into words again. Sometimes I just convinced myself no one really gave a fuck anymore and should just keep it to myself.

There was the Tuesday afternoon in January on which I had to call LA because I suddenly started bawling at the sight of my lunch. I should really be writing through this moment because this is totally insane and I need to remember what the hell got into me all of the sudden so it doesn't happen again.

There was the day several weeks ago when I stood frozen in the grocery store, paralyzed by the realization that the brown rice I had planned to purchase could only be found in a center aisle. I had just observed a trainer at the gym recommend that a client try to only shop the perimeter of the store and suddenly felt the advice applied to me as well. I should really be writing about this. There has got to be a humorous blog post buried deep in this completely irrational hysteria.

There was my most recent Dr. K appointment, during which I realized I'm only one pound under my self-imposed "weight limit" and secretly devised a plan to drop a few pounds without anyone noticing. I should really be writing about this because I just read an article about why my body is gaining weight while marathon training and it makes perfect physiological sense...yet I'd still rather hold my hand on a hotplate than gain another pound.

There was the day last week I went back and forth...purge. Don't purge. Purge. Don't purge. And ended up throwing up everything I ate after hours and hours and hours of obsessing. And the horrible guilt that set in when I realized I should probably tell LA I just broke Cardinal Rule #1 (that would be no throwing up) after nearly three months of digesting food like a normal person. I really should be writing through this. This is a relapse and people need to understand that it happens and life goes on.

Then there was today. As I lay on a cold table at the physical therapist's office with a giant ice pack and a stim therapy hook-up on my completely jacked-up right leg, my only obsessive thought was "this is it. I'm not eating until I can run again". I really should be writing about this...because if this is where my mind automatically goes, I still have some work to do...

The progress has been tremendous. Really, it has. But Dr. Joe is (unfortunately) right when he states that progress is not a straight line. There are peaks, and valleys; and while the valleys are becoming fewer and further between, they still exist and are deserving of my words.

And as I've learned throughout the biggest growth experience of my life (um, that would be this, actually)...nearly everything in life falls short of perfect.

So I've swallowed my pride, and I'm back. Stronger than before; more resilient. Happier, more secure, and with even more honesty than before...but picking up where I left off (almost) and telling the rest of the story.