Tuesday, February 26, 2013

The Injured Athlete: Why it took me so long to write this

Today is Tuesday, February 26th.  29 days ago, on Monday January 28th, I had a Back Attack.

I was baking a quiche in my kitchen after a super basic evening of 60 minutes of steady-state elliptical cardio at the gym.  It was a completely non-descript day; I did biceps, triceps and shoulders in the AM, worked all day, then cardio before I went home to do my customary monday evening meal prep.  I even remember having "I Shouldn't Be Alive" playing on Netflix on my computer as cooked, watching someone's harrowing ordeal and being thankful I was healthy and well.

That's when I noticed the pinchy tightness hitting my left glute.  I couldn't stretch it out, and it nagged at me.  I figured I was having a cramp.  I took 2 advil and tried to ignore it.

Two hours later, as I was just lying in bed to sleep, that growing achey pinchy cramp finally seized into a brain numbing pain shooting through my left glute, around my hip flexor and down my leg.  I immediately thought what I thought was the worst - that I was having a flare up of Piriformis Syndrome, which I had been shoddily diagnosed with twice before in my past.  Both times took MONTHS to recover from, and I laid in bed in a blinding panic, especially since I had done nothing to provoke this.

The next day, the pain was gone.  I felt pretty ok.  I took Tuesday as a rest day, and when Wednesday came around, I decided to have at it and see if the pain came back.  I ran 7 miles, did lower body weights, and ended it with a course of yoga.

Brilliant, aren't I?

Thursday was the true beginning of a horror story I am still not even near being out of.  The pain which seemed to grow stronger and stronger each hour, each day, the aches, the nerve pain, the impossibility of getting into a position to alleviate the pain…. it was maddening.

I survived to Monday, February 4th, when I saw a Chiropractor for the first time.  He immediately said I had sprained my L4/L5 disc, that I was a pretty textbook case, and that I shouldn't worry; the pain would subside, and they'd help me learn how to prevent this in the future.  But… disc injury?  He might as well have told me I had cancer, to be honest.  I knew what back injury meant.  I had seen my brother suffer chronic pain from it, saw it sideline many people I knew in my life.  It was the first disability I had ever been diagnosed with, and the pain was blinding.  I couldn't sit, I couldn't lay down, I couldn't drive, I couldn't work.  The instability of my spine was always constant, the nerve pain was unresponsive to any quantity of drugs I took.  One night I was so desperate I took three 200mg Advils, one Advil PM, and 5mg of Flexeril.  Not a single change in the pain.

What ensued was a heart-defeating dance of having a couple "ok" hours, and then spasm.  A day or two of tolerability, and then suddenly days of cramps and nerve pain of varying, inconsistent degrees.  Some mornings I would wake up fine, others I would begin my day with awful cramps through my left quad and down the side of my calf.  Usually between 11a and 2p I would have such intense nerve pain focused around my sacrum and radiating to each of my hips, that I would break down sobbing in the lobby of my work.  People would stare, some had the decency to ask me if I needed an ambulance.  All I could do was just say I was in a great deal of pain that nothing but time could alleviate.  I would call my mom who unfailing absorbed all of my inconsolable tears, who with patience and a love only a mother could emit, showered understanding, reason, sympathy, and options we had to help me find healing.  Even if it meant steroids and percocet, she would remind me we hadn't exhausted all the options, that there was a way to escape the pain if I really needed it that badly.  Part of me admittedly didn't ask for steroids or hefty pain killers from my doctor for fear that they wouldn't work either, and I don't think I could face that defeat.  It was comforting enough just to know there were other options that might still work.

Amidst the physical pain, was the pain of being told I obviously couldn't work out.  Weekends were the worst.  Seeing my minifeed full of people getting in their 20 mile trail runs before 7am, people hiking, cycling, hitting the gym….All my friends were out playing volleyball and I couldn't even be near it, the depression and jealousy and anxiety would consume me. It still does.  It brought back nightmares -- literal nightmares -- of the time I tore some tendons in my knee and had to retire from soccer.  But at least then, I was still allowed to lift, still allowed to swim and cycle until my knee healed.  I couldn't sit or lay down for the pain due to this back injury, but I wasn't allowed to work out or do anything that I loved that would take my mind off of the misery, and all of my friends were out doing athletic things that I couldn't participate in.  The first 3 weeks were a blur of unending tears, anxiety, and massive amounts of depression.  The weekend of President's Day I spent indoors with the blinds drawn, my phone shut off, and went between bouts of pain-induced tears, depression-induced tears, and complete mental breakdowns before exhaustion would consume me and I'd fall asleep for 3 - 4 hours.  I would wake up, realize I was trapped in a nightmare, and continue the cycle.

A lot of thoughts crossed my mind during this time.  It's difficult for non-athletes to understand what it's like to suffer an injury that not only sidelines you, but drowns you in pain that nothing can alleviate.   I think of it as a brilliant mathematician being diagnosed with Alzheimers, or a guitarist getting into an accident and losing his hand.  Or Julie Andrews losing her ability to sing due to that vocal chord issue she had. When it wasn't physical pain, it was psychological warfare.  No matter who was around to make me feel better, to uplift me, to encourage me -- and believe me, I have had many angels through the darkest times of this! -- nothing was enough to give me any hope to cling to.  I thought of those survivors on I Shouldn't Be Alive and realized that if I was ever in a life-or-death predicament, I likely would not have the strength or the willpower to see myself through it.  

One time, when I was on a walk (which is all I am allowed to do), I was able to put my finger on why I was having so much anxiety and depression; after all, I had only been injured 3 weeks! I realized it was because I had put all my eggs into one basket.  Not only did I love being an athlete, and not only was I addicted to the high, the endorphins, the lifestyle, the sense of community, and all that came along with it, but it was my sole identity. I don't want kids, and I don't want marriage.  My career is mediocre at best, and I certainly am not climbing any corporate ladder any time soon.  My athletic activities defined me, they were everything my life was about.  If I had a bulging disc that prevented me from being the same ever again, then who was I?

In 2008, I suffered an awful heart break that I have never recovered from.  After enduring that pain, I came to my own personal conclusion that anything love had to offer, was not worth the risk or the pain.  All I needed was myself, my freedom, and I was perfectly content with that.  When I lost that relationship, the same thoughts flooded my mind; what is life worth, if the only person I ever loved was no longer in it?  What is there left to live for?  

Now, certainly these are dark thoughts we all experience during our darkest hour.  And we see it through, we learn, we grow, and we become better people for it.  But on my walk, when I was thinking the same thing for this injury as I was during heart break, I began to wonder if there was not anything in this life we can ever truly count on.  What is it all worth?  What is the one thing in life worth fighting for if you don't even have your own good health?  That is an open-ended question that I am on a quest to answer for my own self, in due time.  Surely there is so much to cherish and enjoy in this world besides athletic endeavors.  The problem really lies in how we view ourselves and where we fit in society.  If we lose our identity - whether it be to injury, loss, career obliteration, bankruptcy - if we lose the thing to which we've anchored our existence, then there is nothing left to keep us from floating away and being lost forever.

On President's Day (Monday), I had a chiropractor appointment.  I had been in spasm since the prior Thursday.  When my doctor saw me in such pain, after several weeks of treatment, I think he began to realize that he was dealing with a larger beast than he had once thought.  At first he suspected I'd be better in two weeks.  But then he felt scar tissue around my compromised vertebrae and told me that this was not my first rodeo -- that those times I had piriformis, where actually flare-ups of this same disc injury.  Which means I technically blew my back out first in 2008 when I was only 24, and again in 2010 when I was 26.  Here at 29, my third back injury.  A now chronic injury.

A later xray of my back would reveal a properly aligned spine with a slight narrowing of the L5/S1 vertebrae; this supported my therapists' diagnosis of soft tissue trauma and spinal sheering caused by pelvic strain placed on my spine as a result of imbalanced muscular development and misdiagnosis/poor rehabilitation of prior sports injuries.
The doctor worked to create space in my spine and then did deep tissue ART massage on my back erectors, which were as hard as concrete.  I spent the rest of the day in continued pain, which culminated in a full-scale, not even joking panic attack in the middle of Whole Foods with my mom and sister.  I stood absolutely frozen; I don't remember much, but I do remember going completely numb next to the Food Bar.  I heard a ringing in my ears and I started sweating and that's when I realized the panic was no longer in my head, it was taking over my body regardless of how I felt.  A searing dread came into me.  I was aware I was in a public place, and knew I needed to snap out of it and get agrip on myself, but there was this stillness in the eye of the storm that I was drawn to. It's like, my whole body was responding to this fear and dread and panic overcoming me, but the core of my mind was in this quiet, numb place that held me captive truly like a dear in the the headlights.

But then the truck struck me.  I began feeling my hear racing, feeling the dizziness and nausea and that horrifying desire to run away from imminent danger and then becoming aware of huge muscle cramps and nerve pinches. I began to uncontrollably sob. I basically just gave up, and gave into it.  I gave into the pain, I gave into the fear that kept trying to squeeze the breath out of my lungs.  I surrendered all hope I had mustered in my "silver lining" attitude that in the end, this would all be worth it, that I would be a stronger athlete and a stronger person for all of this.  I was exhausted; I couldn't sleep for the pain, I hadn't eaten in at least 48 hours, and I had spent any remaining energy I had trying to push down the dread and the pain that kept coming closer and closer to engulfing my whole body, like a thick gray fog that veiled the whole world from me.  My mom rushed me out of the store as I began hyperventilating, and somehow managed to keep me on my feet when my sobbing turned to dry heaving and I thought for sure I was going to pass out.

Over-reacting?  I hope to god one day I can look back and say I was overreacting.  I hope to god one day I can look back in shame and say, "God, what a pussy I was about that one time when I had a back spasm!"  I hope to god one day I can look back with embarrassment for proving just how weak and vulnerable and impatient and soft I am.  I hope to god this was just an instance of weakness.  Because right now? 8 days after that episode?  I look back with horror thinking that that was one of the realest, most genuinely terrifying experiences I have ever gone through.  I remember that moment as being the closest to death I have ever come, to be honest.  I had never experienced a panic attack before, I have never had a near-death experience, I have never suffered from depression or anything like that.  With all of those intense sensations, all that pain (both in and out)… it was like, I had never been more aware of my existence than in that moment, and I had never been more aware of how fleeting it was, either.  

Since that day, I have made some improvements in my physical condition.  I still have the spasms (last Friday night I woke up to one so bad that I threw up).  But I am sitting better, lying better, am not in constant pain all the time, and have been allowed to lift light upper body weights which has saved me.  I struggle with anxiety and impatience and hopelessness still, and fear that I will never escape this pain (despite my doctors telling me I will surely recover).  After that last panic attack, I vowed to put as much of my energy as possible toward healing, and changing - both as a person, and as an athlete.  I have practiced meditation; taken long mineral salt baths with incense, music and candles; I've begun to read more, cook more, and strive to keep my mind and heart at peace.  Strangely, I think of Lance Armstrong a lot.   I think to myself what he must have gone through when he found out he had cancer.  Chemo, radiation, and the thought of not only losing his passion, but his career at the same time.  And he survived, and he came back.  Steroids be damned! I couldn't care less about that decision of his anymore.  I think about female athletes who get pregnant and have children and have to deal with - and rebound from - all the physical changes that procreation requires.  It's only been 29 days for me.  I am still in pain, still fragile, and still fearful…. but I can walk.  And I can maintain upper body.  And I can dream of the day I get better, and can finally hire my trainer and my nutritionist and start tackling my physique goals.  I may have to give up volleyball, but I've had to redefine myself as an athlete before; who knows, maybe triathlons are in my future?

But alas, I get ahead of myself.  The reason it took me so long to write this, is that it has taken me so long to stop hurting.  I haven't stopped hurting yet, but I realize that my experience may be consolation to people who come after me, and sharing all the dark and painful details that no one wants to talk about for fear that others will judge us as being hypersensitive or crazy might encourage others who find themselves in this dark place right now.  I've come across quotes and songs and such that I'd like to share as a part of expressing the experience of an injured athlete who is struggling with pain and identity crises, but I am tired so I will share those later.  For now, though, two quotes that I enjoy, which both convey trying to create opportunity in times of disadvantage:

"Every wall is my door." -- Ralph Waldo Emerson

"When the winds of change blow, some build walls while others build windmills."  -- Chinese Proverb

I am considering having the Emerson quote tattooed on my back once I heal from this injury :)