Beginning a New Chapter

Brett, Rogue, Colt and I are about to begin a new chapter in our lives…and I’m very excited about it. Change can be difficult, but I’m ready for it. A few days ago I gave notice to PowerBar that I would be leaving on July 15th. It was a hard decision because I love PowerBar, my co-workers and the fact that I get to do a job I love. It’s pretty awesome getting to go to endurance events, represent a brand you believe in, and teach sports nutrition to fellow athletes. I won’t say it was all fun and games; being on the road for days at a time can be hard, in addition to not seeing Brett as often as I wanted. You get used to staying in hotels and learn where you can find the best choices for nutrition. But nothing beats your own bed, and your own food.

It was a dream job, and I’m so thankful to have had it. Thank you PowerBar! I currently have two other dream jobs, and I’m soon hoping for two more. Currently I coach a small number of awesome triathletes, consult with athletes on proper sports nutrition, and I’m excited to:

1. Start a family (soon)

2. Launch a new nutrition website, geared towards assisting athletes make the best meal choices they can. More on this later.

Yesterday marked Brett’s last day of classes, and he’s now a newly minted geologist. It’s been quite a journey for him going from the Army, to Oregon State, and then eventually finishing his degree at Towson. I know how much he loves geology, and he’s excited to get to put his education to use. Yes, envision a rock hammer, magnifying glass and plaid shirts with hiking boots. The whole nine yards.

So now that he’s done, we can get the house packed up. I have a few more events with PowerBar, so I’m not done just yet. But after Tri Rock Philly last weekend, it’s all smooth sailing and downhill.

You might be wondering where we’re going after Baltimore. Good question. We’re headed to…Texas! That’s right, hot, hot Texas. I’m so excited, even though I’ll admit I’m a bit nervous about the heat. I can’t say I’m a true Texan, especially since I put beans in my chili, my hair isn’t that big, I don’t wear cowboy boots and I don’t ride horses. Those might be stereotypes (except the beans), but I’m looking forward to seeing that for myself. I also might have to develop an accent.

In addition to Texas being a hot bed for geologists, I also have the ability to finish my master’s degree there. The cost of living is great, the people are friendly and there are a lot of multisport athletes. Our thought is Dallas, but we might be open to elsewhere. Especially if Brett’s company needs him in a different location. One of the benefits of our situation is that we are open to just about anywhere. We don’t have kids who need to be in a specific location or school district and we are both very flexible. I’ll be working from home, so I don’t need to be in a specific area.

While Texas is our final destination, for the next month or two we’ll be in upstate NY. This will give us the opportunity to see family and friends, and to have just a bit of R&R before our move. The triathlon team I coach with Valor Triathlon Project is based in Rochester, so I’ll be able to see athletes, and get to go cheer at some local races.

I’m going to keep an air of mystery around the new nutrition site I’ve been working on. But just a teaser, I’ve spent the last year (since laying in bed after surgery) refining a concept and implementing it with the help of a design team and software team. We are close to being done, but not just yet. I’m making a few changes and until I’m ready to release it, I don’t want to say too much. If you’re interested, please find my new Facebook page for Fueled and Focused and “like” it. Eventually that will become part of the HQ for the site, and new info will be updated there. In addition I’ll do some launch deals with the site that I’ll post there.

And as you all know, I can be sporadic with my blogging. This will not be the case moving forward. Since my 9-5 job (or actually 11-8pm or 5am-1pm, etc.) is ending, my focus will be 100% on my coaching, nutrition counseling and the new site.

Stay tuned for more…And thanks for being apart of my blogging life. I don’t think I’ve really said that. But to everyone that reads this, a big heartfelt thank you.

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Healing through Nutrition, Pre and Post Surgical Recommendations

As most of you know, I am a sports nutritionist. I spend most days assisting athletes with their endurance training and sports nutrition. I am a firm believer in you are what you eat, crap in, crap out and think about food as fuel for your body. In order to perform the best, you need to put good things in your body. Everything in moderation of course, but on a whole, nutritious veggies, fruits, grains, lean meats, nuts, legumes, etc. Meat isn’t needed, but I’m not giving it totally up. You can if you’re so inclined though. Eat everything that provides the proper macronutrients, micronutrients, antioxidants and more. So if the proper nutrition can fuel your everyday life and athletic endeavors, why can’t it help you heal? In fact it can.

I am a big evidence based/scientific research first nutritionist. Before I will really dive head first into something, I like to at first research the food, diet, way of eating, then try it on myself. Kind of an n=1 experiment. I’ve done this with the high carb diets ( 1990’s),  The Zone diet (early 2000’s) the Paleo diet (mid-2000’s), Intermittent fasting (late 2000’s) and finally, just basic good nutrition focusing on whole foods. In addition, using spices and herbs to supplement my diet.

Before surgery I was under a lot of stress. Between the nerves of the actual surgery, wondering if it would work, worrying about nerve damage, thinking I wouldn’t be myself for a year, that I actually didn’t do a good job at preparing myself from a nutritional standpoint. I was eating a mostly vegetarian whole plant-based diet, with occasional lean meats, fish and healthy fats, however I didn’t focus enough on what I should have been doing. So now I’m here to share this, so if you’re going to have surgery or just had surgery, read on. Also, if you’re just looking for an anti-inflammatory diet (that still includes grains and dairy-these cause inflammation if you have issues digesting them. If not, you are fine with whole grains and dairy and I will continue to teach to use them) read on.

Exercise, especially vigorous or strenuous exercise causes physical stress on the body. We actually need some of that stress to adapt to exercise, and to make us better. It’s one reason I don’t advocate mega dosing with antioxidants. In addition, there are other stressors that can create both hormonal and immunological responses that are similar to exercise. When scientists study inflammation, they generally look at an increase in inflammatory cytokines (IL-1, and TNF-a production among others). These can be increased following surgery or trauma as well.

So, knowing that surgery creates more inflammation, how can we do about it. Below I’ve listed some of the things that I do daily, weekly or have tried. When I started writing this blog I realized it would take me hours to speak on each one. So instead I thought I’d start by listing them, then writing on them one by one. I’ve already written on Omega 3’s, which can be found here. This is not a complete list, and by no means do every one of them have 100% definite evidence that they will assist you. It’s more that they have some good evidence that they might help you, with little risk of toxicity. So, other than money, why not try them.

Here is what I supplement my daily/weekly diet with:

  1. Curcumin/Tumeric (daily, 1000mg mixed with pepperine/black pepper)
  2.  Omega 3 Fatty Acids (daily, 800mg EPA, 400mg DHA)
  3. Tart Cherry Juice Concentrate (daily, 2 tbsp)
  4. Ground chia/flax seed (daily, 2 tbsp)
  5.  Ginger (weekly, 1 tsp fresh)
  6.  Cinnamon (weekly, 1 tsp ground)
  7.  Collagen/Gelatine (weekly, 2g of gelatine, however I might switch to daily soon-there’s some cool new  research out)
  8. Bromelain (weekly, 1 cup of pineapple in a smoothie)
  9. Garlic (daily-weekly-I could with it almost daily, but don’t go out of my way to supplement)

In addition to all of that (which Brett jokingly says I’m a pill popper for doing), the right nutrition will provide anti-inflammatory benefits. I’m a big believer in the Mediterranean Diet, which emphasizes whole grains, beans, legumes, vegetables, fruit, healthy fats (like olive oil) and small amounts of meat, mainly fish. This diet has been known to be very beneficial to reducing inflammation, one reason being the heart healthy fats, whole grains, fruits and vegetables. Things like processed foods, white sugar (unless you’re training for long distance events), and certain types of saturated fats can increase inflammation.

What about Glucosamine/Chondroitin? There is pretty strong evidence that it isn’t beneficial to humans, however I have heard anecdotal evidence. So, if you’d like to try it, there isn’t a great risk.

How about Matcha? Matcha is a ground green tea powder. It is loaded with antioxidants and I’ve been tempted to try it in a morning smoothie. I’m not a coffee drinker, however a caffeine boost in the morning can be a good thing.

Fermented Foods? Well, fermented foods are awesome probiotics. And they have been known to reduce inflammation of the gut/GI tract. This isn’t exactly what we want for surgical inflammation, however it’s great if you are having GI issues, or just want the benefit from probiotics. I wrote about that here.

All in all, there is a ton of foods, herbs, spices, etc that have great healing properties. I don’t think we should overlook them and solely rely on Western drugs. I am a big believer in Western medicine, don’t get me wrong. I just believe that we can receive benefit from other areas as well.

While I may be an herbal pill popper, my goal is complete recovery. Some days it seems farther away then others, but I know I will get there. So I’ll continue my journey and continue to provide you with what I’m learning. And there is a lot to learn.

Coming up soon I’ll touch on each of the supplements I’m taking, and the evidence with them. I do have some exciting personal news that I’m getting ready to share…maybe tomorrow. And no, I’m not pregnant…yet 🙂

 

 

 

 

 

 

 

Hamstring Surgery…My Journey, One Year Later

This post has been a long time in the making…one year in fact. And it’s been quite the journey. I’ve had many ups and many downs too. Sitting here writing this I’d thought I’d be in a different place now than where I actually am today. If you had told me I’d still not be able to train, I’d still be dealing with post surgery complications I’d have been pretty bummed.

And after the past two years, bummed might be an understatement. But this post isn’t philosophical, it’s not spiritual, it’s not inspirational and it’s not depressing (at least I hope not). My goal of writing this is very similar to why I started this blog. The blog has taken on some different turns,  and manifested into something new, however when I started it, it was to share this surgery experience. And that is why I write this today. From more of a “I’ve been through it, here’s what happens.” It’s my story, and yours might be different. However when I started this, I couldn’t find anything on it. And my hope and goal is that if you are going through this, you’ve found this and it can help. In addition, I had a chronic issue. If your issue is acute, or you don’t have a complete repair, your recovery timeline might look different. Heck, every doctor is different and I know Dr. Wolff is conservative. But this was my timeline and if yours is shorter, at least you were prepared for the worst!

My absolutely amazing physiatrist Dr. Victor Ibrahim encouraged me to start this. He could tell how anxious, scared and depressed I was. No one could figure out what was wrong, and he was the first doctor to give me hope and insight into what turned out to be Proximal Hamstring Syndrome. A condition which many doctors don’t believe in, although I’m not sure why. It is extremely challenging to diagnose, and most of us with it go for several years without a diagnosis. In short Hamstring Syndrome is (British Medical Journal):

A gluteal sciatic pain, in which posttraumatic or congenital hard fibrotic bands irritate sciatic nerve at the insertion site of hamstring muscles to ischial tuberosity. Traction, mechanical compression and impingement of the sciatic nerve may occur in certain anatomopathological situations at the origin of the hamstrings on the ischial tuberosity. The symptoms include local pain at the ischial tuberosity irradiating to the posterior thigh which appears with the cyclic stress of running, after physical exercise, and typically during sitting. Hamstring syndrome diagnosis is basically done according to typical symptoms and finding. Differential diagnosis is required from piriformis syndrome, ischiogluteal bursitis, posterior femoral muscle compartment pain, scars in hamstring muscles and back originated symptoms. MRI is the best examination to detect abnormality at the ischial tuberosity area. The majority of the athletes with hamstring syndrome respond positively to conservative therapy but in the refractory cases the hamstring syndrome can be treated surgically by dividing the compressing band and by performing the sciatic neurolysis.

This is what I had, in addition to a torn hamstring. So not only did I need to have the hamstring re-attached, I had to have the nerve surgically removed from the hamstring. So whether you are going through Hamstring Syndrome, or have torn your Hamstring and need surgery, the same or similar progression will occur. Now this is my story and everyone’s will be different. But this is my timeline, so you have a better understanding. (If you’re not interested in the gory details, stop reading now). Dr.  Wolff said initially the surgery recovery was 6-9 months. As you now know, mine took longer. In his defense, I was his first surgery of this kind and while that might seem a bit crazy, not very many doctors will perform it. And he is one of the best surgeons in the country. In addition, I had the nerve component. If you don’t, yours shouldn’t take as long.

Day 1 surgery– 4 hours in surgery, a few hours in recovery, and back home

*You’ll be high, on crutches and not able to help yourself. Brett and my next door neighbor had to carry me upstairs. For the next 3 days you’ll lay in bed, getting up to use the bathroom, taking pain meds, anti inflammatories and using your ice machine. You won’t have much of an appetite, but must you must eat. Going to the bathroom will be very challenging as your leg is strapped into a large leg brace, and you will be in immense pain. You won’t be able to sit on the toilet, but will have to hover-this is very hard.

Day 4-21-

*You’ll slowly start to get used to the crutches and having to hover over the toilet. You won’t have the ability to sit on the toilet for 3 weeks, and you won’t have a bowel movement for at least the first 2 weeks (at least I didn’t, and I eat a lot of veggies). Even with the correct meds. The pain will be almost unbearable. As an athlete, you’re used to pain. This is a different pain, and pain meds did not help. The only thing that helped was my ice machine. It said not to sleep with it, but  I did. At least I didn’t have to take too many pain narcotics, since they didn’t help.

*In addition, you will need help. I would try to find a family member or friend who works from home, is retired or doesn’t work. You will need a lot of help from getting out of bed, going to the bathroom, showering, eating, getting dressed, moving around the house, pretty much anything you can think of. I thought, I’m an athlete, I can do it, but no I couldn’t. And thankfully for me, my mom is retired and since Brett was in school, I stayed with my parents during this time.

*Get ready to sleep and lay with 4-5 pillows. You’ll need them to put under your leg, and the entire side of your body. Be prepared to wear clothes are that very easy to put on, and get around in. Think elastic waist shorts and tank tops. The leg brace is very hot, and you will sweat. It is not a straight brace, so for weeks your leg will be bent. It’s not horrible, but you’ll wonder what it’s like to have a straight leg.

Week 3-8-

*I was off the pain meds by now, and started to wean off the ice machine. I held on because I was still in a lot of pain. But by now you’re moving around.

*Buy a squishy cushion/seat to sit on. You won’t be able to sit well, and you’ll want to lay down the whole time. But this will get you prepped for when you have to sit in a chair. And yes you’ll feel stupid, but you’ll need it.

*Around week 6 you’ll go to the PT. Don’t get excited, they will just be taking measurements. For example, they will measure your quads to see how much they atrophy. The brace should still be bent, and you won’t be able to stretch out your leg.

*You’ll be getting around fine on crutches, but you’ll work hard. Don’t be tempted to use your leg. They might have you start to put weight down, but don’t push it.

Weeks 8-12-

*PT really starts, and you’ll begin with stretches and manual massage to the surgery site. You might start to re-strengthen your hips, and even do some basic quad exercises.

*The brace will be slowly straitened, but you’ll still be on crutches. You can put a bit more weight down, but not a lot.

*I didn’t wear the brace in the house, just used the crutches. Outside you’ll need it to minimize the risk if you fall.

*You’ll start to feel like you’re going crazy, and finally you’ll be cleared to drive (yes, with the brace on).

Weeks 12-20-

*Back to work around the 3 month mark. I thought I’d be back at the 2 month mark, but I’m glad I had the medical leave with work (Thanks PowerBar) as I wouldn’t have been able to work.

*I started to drive at the 3 month mark, and even though still on crutches, I could do the grocery shopping, etc.

*You’ll start by switching to one crutch. You’ll do this for a few weeks. Then you’ll wean off the one crutch, and you’ll start to walk. It won’t look or feel like a walk. You’ll be in pain with each step, and it felt like my hamstring was going to rip off. Don’t push it. I was walking 25-30min miles. I started at 1 min, then 5, then 7, then 10. Each day going a bit further. I could walk 1 mile with rest.

*At PT you’ll start using bands and very light weights. If you have an awesome PT with an Alter G, you can walk on this. It’s awesome as it takes your body weight away, and it supports you=less pain.

*This is also where I started nerve glides and tensioners. Google or youtube these. Even if you don’t start with nerve pain, having hamstring surgery can cause nerve issues. So please start these to prevent nerve issues down the road.

Weeks 20-24-

*You’re walking without crutches or a brace and you’re able to walk normal for short distances. I would start off very slow, but could make it 2 miles. Towards the end you might limp a bit, but try not to.

*At PT you’ll be using weights and doing body weight exercises. You’ll start to feel like an athlete again.

*This is the time that I could start back to the pool. I wasn’t kicking much, but did push lightly off the wall.

*The hard part of this phase is that you’ll look normal, but your body won’t feel normal. So people will ask what your season is looking like, or why aren’t you racing. It’s very frustrating, challenging, depressing, anger inducing and just about every other emotion. You’ll want to scream out, or wear a large sign that says, “I look fine, but my body is healing.” It’s nice they care enough to ask, but it can make things worse. Be prepared for the mental toll.

Weeks 24-36-

*This will be very personal. Some of you might be able to start riding a bike, jogging, swimming, etc. In fact, I hope this is where you can. I couldn’t, I still had too much inflammation and nerve issues.

*This is also the time where my positivity from the surgery started to wane. How could surgery still be successful when I was still in this much pain? Well, it can, and I hope you don’t have to go through it.

Where I am, 1 year later-

*I progressed on the Alter G, and my PT said it was time to start to run. This was the 9mon mark. I tried for :30 of jogging, but the pain was terrible. I know that there would be pain, but this wasn’t a good pain. So I went back to Dr. Victor.

*Dr. Victor said I had too much scar tissue built up around the surgery site. So while I did everything I was supposed to, a bit of scaring is normal. But unfortunately it was causing inflammation and pain. So he took a large needle and stabbed at the scar tissue, breaking it up. He also extracted some scar tissue and injected an anti-inflammatory. He said to wait a few weeks and try to run.

*So I waited and went for a run. And while the ischial tuberosity pain was gone, I had this terrible internal, adductor pain. So, back to Dr. Victor for another ultrasound. This time he said that I had inflammation of the Adductor Enthesis: Enthesis is the tendon/ligament insertion into the bone. So he did another round of injections. He said to wait and we’ll do a re-eval in 2 weeks.

*So here we are, another 2 weeks after. I’m going in for another injection. And while I feel 75% better, I still have sciatic pain. I’ve been doing an anti-inflammatory compound cream, and nerve glides several times a day. I feel confident that Dr. Victor will be able to heal me, so next Wednesday I go back.

I am hoping to close the door on this journey, and to be able to start to get to train again. But one thing I really want to emphasize, is that everyone is different and you have to be patient. You can’t will your body to get better faster, and while you might keep pushing to get back, if you just slow down and realize your body will heal at its own rate, you will save yourself a lot of stress and heart-break. This is a long, long, long journey. Very few people will actually understand the mental and physical pain you go through. I wouldn’t wish this on my worst enemy (thankfully I don’t have too many I don’t think) and it will take a lot to get through this. When people try to tell you how they had to take 8-12 weeks off for a fracture, or this, or that, listen politely and nod. They mean well, but they don’t understand it will just make you feel worse. Or at least it did me. 2-3 months off is nothing and you’ll wish that was you. But don’t go down that road as it only leads to you feeling sorry for yourself. You don’t want to do that. You must stay positive the best you can. If you need to, just say you don’t really want to talk about it, and suggest a different topic.

I don’t have any great pearls of wisdom like do this, and magically you’ll be healed, you’ll have a great outlook, you’ll know how to react to people, etc. I don’t. All I can say is trust your body, take care of yourself, go very slowly back-be conservative and don’t listen to others. This is your body, and do what you think is best. You and your doctor that is. Good luck and I hope you all have speedy recoveries.

Regaining my Faith

Last weekend was our Valor Triathlon Lake Placid training camp. This is an annual camp where we all gather for 4 days of training and team camaraderie. I’ve always loved Lake Placid (first IM was here), and I’ve been coming here since I was young. The Adirondacks might not be the Rockies or Sierra’s, but they are still beautiful and magnificent in their own right.

Mirror Lake

Mirror Lake

As a coach, my role is setting up workouts, making sure the athletes are taken care of, they know what they are doing and providing SAG. Since my surgery (hamstring and sciatic nerve), my training is very limited. I was able to swim (3x in 4 days) and stand up paddle board (3x in 4 days) while we were up there. I was the safety SUP while the team swam making sure everyone was ok and no panic attacks were had (everyone did great). I love supping and it was actually pretty cool that my hamstring felt better after. I’m chalking that up to the balance and isometric work on the board.

Leading into camp, I was a bit apprehensive on how I would feel watching our athletes biking, running and pushing their body’s to the limits. One awesome thing about a training camp is you can really push your body. There is no work or family responsibility, only you and what you’d like to do. Last year I was pre-surgery  at camp, and I longed for the chance to bike the IM course and run with the team. Last year I told myself that by this time, I’d be training with the team. Obviously this wasn’t the case, and I will admit at times, I got pretty down on myself at camp.

When I’m home in Baltimore, sometimes I get angry watching runners go by. It’s a combo of anger and envy in watching them push themselves and the just the freedom of being able to run. It’s been hard working for PowerBar because every week I’m at another endurance event. And each time I have to relax and tell myself to be patient, my time will come again. But I won’t lie, it’s been so hard to not get angry, stay positive and relax. So back to Lake Placid. I’ve worked hard to change my mindset and while I had little pangs of jealousy (no anger because I love our athletes) during the weekend, I felt great just being able to be in the midst of the group. A group passionate about a sport I love, and to feel apart of a team. Our team is pretty great too.

So while I was able to keep the jealousy  down, depression was a bit high. I try very hard to be a positive person, to find the brighter side of things and look forward not backward. It’s not always easy, especially when I feel like I’ve been through the wringer the past year or so. And right when I was feeling pretty low, God placed someone in my path who showed me what true inspiration is. I believe everything happens for a reason, and people are put in our path right when we need them.

I use the word inspiration very judiciously. It’s one of those words that I place great meaning in, and while I think many people have admirable qualities, to be a true inspiration is special (to me). I had just finished a SUP session and one of our other coaches wanted to try it out. So I promised to wait for him to finish, and sat by the edge of mirror lake, just thinking. A older gentleman walked over and we exchanged greetings. I asked him if he was training for IMLP. He said he was, and we spoke a bit about the swim, and training for it in general. Funny enough, we also spoke about the 2 escaped convicts from Plattsburgh who as of when I’m writing this, are still on the run.

My faith is of great importance to me, and holding onto it has really helped me through this experience. I’ll have to admit I do start to waiver in my faith when I get so low, but he helped me to change that around. I have renewed faith from him. Early in the conversation  he shared that he was Christian, but not the holier then thou crazy Baptists he said haha. I told him I knew what he meant, as I was the same. He shared how a few years ago, he almost didn’t finish LP and went on to tell this story. He was diagnosed with prostate cancer and  underwent multiple treatments. They preformed surgery, and he informed me that during surgery, you’re strapped to a table that tilts backwards, allowing the organs to move away from the prostate. When he was strapped to the table, his arms were locked in place for 11 hours. The surgery was successful, however when he awoke he couldn’t feel his arms-bilateral nerve damage from his arms being compressed too tightly.

This started the next year of re-learning how to use his arms. Just things like eating, putting on his clothes, wiping his butt (his most important one he said) and learning how to swim and ride again. 5 years later, he still doesn’t have complete use of his arms, and in fact he swims by engaging his deltoids and throwing his arms forward. He still swims a 1:30 IM swim! And on the bike he has special breaks so when he can’t feel his fingers he can still break. And he was able to do all of this the year after his surgery. I’m not sure what he finishing time was, but he finished. He also added that pre-cancer his wife would complain about his training time away. Now post cancer she loves the fact that he is out there training and racing. While it’s hard on families, she understands that he’s here and he’s doing what he loves. And there’s room for both a love of sport and family. I really respected what she had said, even if it’s through his words.

So here is a man, who has done IMLP 5 times after prostate cancer, and nerve injury, and there I was sitting there feeling sorry for myself. It didn’t feel right to share about my surgery or nerve injury, however what he gave me that day was really important. And while this year will be his last IMLP (10 I believe), I am so empowered by him. During this long recovery I’ll still have days that I’ll get down, and I’ll still have days that I’ll be angry, but I know that I need to have faith and belief that I can and will continue to be an athlete. It might take a few more months, or a few more injections, but I will do it. And I may or may not be at IMLP this year, but on that day where ever I am, I will be cheering for Tony S, as he attempts his 10th IMLP. If you happen to be there race morning, he’ll also be at the morning pre-swim prayer. I actually never knew this took place, but that’s pretty cool.

Good luck to Tony at IM, and thank you for sharing your story with me. I’m sure you have know idea how much it meant to me, but from here on out, when I start to lose faith, I’ll think of you.