Live by the sword, die by the sword

Did you hear about the auto mechanic whose car is broken down, or the botanist whose own garden is dead, or even the financial advisor who’s broke? Or what about the running coach crippled with injuries? Well that last person would be me…

I really don’t like writing about my own predicaments, but in this case I just want to put some thoughts down in words as somewhat of a ‘therapy’. To cut a long story short, in a running context, I’m in some pretty deep sh*t, with many months ahead until I’ll be running again in any shape or form. How did it happen? What’s the prognosis? How do I feel? – those answers are kind of what this blog post is about.

Suffice to say, I love running. I always have, since school, when I’d go for training runs around the country roads around our farm. I remember when I first realised I could run quite well when I popped up out of nowhere to win the Ballarat Grammar School senior lap-of-the-lake in about Year 9 or 10 (in reality, I was just lucky the school was bereft of good runners!!). Running gave way to triathlons after school, filling my desire for a bigger, harder challenge than the single-sport of running could offer.

In my late teens / early twenties I was pretty gung-ho, training hard and racing hard which led to all kinds of problems, some of which included injuries. From my knees down seemed to cop the worst of it – knees, shins and ankles – which began my introduction to occasional cortisone injections (which is a great drug when used at the right time in the right circumstances). Nonetheless, I pushed on always in hope of fulfilling an endless desire to push myself…until the wheels fell off. In particular my left heel.

Over the course of about 18 months (in about 1991-92, I think) I had two operations on my left heel – one to remove a troublesome bursar and another to clear ‘adhesions’ between the Achilles tendon and the surrounding sheath. In hindsight I wish they’d been combined the two procedures. These operations were both a great success and left a fantastic scar about 10cm long on the inside of my heel!!!

At the time I thought these were like visits to the crash repairer, who fixes them up and off you go, good as new. I now realise these operations – and the subsequent scar tissue that’s built up inside my heel over nearly 20 years – has come back to haunt me.

Throughout my life I’ve taken the attitude of living by my actions; planning ahead and then dealing with whatever happens…all the while not looking for any sympathy. I am – and always have been – my own toughest critic. The thoughts and sentiments of others cannot come close to my own, very honest, self-appraisal…for better or worse. Live by the sword, die by the sword.

Fast-forward to recent times and my body has held up remarkably well, albeit with some hiccups at times, and performed quite well through it all. I was looking forward to more great competition ahead, and exhilarated by the thought of it. Then in April my left heel started hurting, again.

At first I thought it was recurrence of the bursitis from about 20 years ago, which was odd since I thought it was meant to be removed in one of those operations. The doctor agreed, although sent me for an ultrasound and cortisone injection. Interestingly, the ultrasound report described the problem as something quite different – a hernia of the fat pad that sits behind the Achilles, putting pressure on the tendon…hence the pain...plus some tendinopathy (aka tendonitis).

The cortisone was partly successful, but the pain still existed although on advice of the doctor and a physio the symptoms still seemed to just indicate some residual inflammation in the area, and that running is OK although we may need to review that if the pain continued. It did, so a visit to another doctor resulted in another cortisone injection in the inflamed area, which was successful in addressing the inflammation. A further doctor appointment (up to my third doctor by now!!) confirmed that I was going in the right direction, and with some more rest things should be OK…based on the symptoms and previous diagnosis.

In hindsight, more attention should have been given to the ultrasound report, and the problems it described, which included some issues that were being skimmed over. Nonetheless, it was me doing the running and me who should have been taking ultimate responsibility for my actions, and listening to my own commonsense. I was riding a roller-coaster of emotions throughout, hope mixed with disappointment and frustration, and lots of other feelings. The prevailing theme was hope, that I was on track to get better.

At the time a friend expressed relief that I wasn’t “locking myself in a dark room listening to Coldplay…”, as a metaphor to describe absolute despair. In context – and as always – things could be a lot worse.

So after much resting, and with everything seeming to be good, it was time to go for a run again. Fail. I couldn’t even make it through 30mins without symptoms, which now included heightened awareness of the Achilles problem mentioned in the ultrasound report (but skimmed over). My reaction was a bit (or a lot) stubborn. I was over it, and kept running thinking, believing and hoping that it was just some more inflammation, and just being ignorant of the fact the pain this time was much more centred around my Achilles, and getting worse. I also had this awful feeling of inevitability about the situation, and that it was heading towards being worst-case…

So I made an appointment with my fourth doctor, this time with someone I knew to be an excellent practitioner with a wealth of experience with elite runners (of which I’m very much not!!), and a network of contacts that opens doors most people find firmly shut. I wish I’d seen Dr. Karen Holzer in the first place.

Dr. Holzer is a woman of action, and made amazing things happen all in the space of a few days last week. It went like this:
5:30pm Wednesday – First appointment. Dr. Holzer manages to book me in for an MRI scan the following day, bypassing the multi-day queues!!
3pm Thursday – MRI scan. I look at the scans myself that evening even I can see the situation looks awful.
12pm Friday – Second appointment with Dr. Holzer. She tells me the situation and pulls more strings for me to see a specialist next Tuesday.

I can’t thank Dr. Holzer enough for her help.

So the diagnosis is of severe tendinopathy (aka tendonitis) in the area around the Achilles tendon, including in the sheath surrounding the tendon, plus a small tear of the Achilles tendon. There’s also a whole lot of scar tissue built up over years from the previous operations, which is/are new fibres created by the body which are not as functional as the original tissue – just like the scar left from a cut on your skin. Scar tissue can also cause problems over time, as in my case, in that it has hindered the function of the Achilles and got to a point where it is perhaps the root cause of my heel problems this time.

Apart from the small tear, I think the Achilles tendon itself is generally OK…which might be akin to saying that apart from a heart attack, the patient is quite well!!!! See, I’m still trying to be a little bit positive…

So I’m off to see a specialist next Tuesday at 11:30am, and not sure what he’ll recommend. My overriding objective is to ensure the long-term health of my Achilles is top priority. If he suggests surgery, I’ll hop into a theatre gown right there and suggest he gets on with it!! Achilles problems are serious, long-term injuries, so however long it takes, whatever it involves then I’m up for it…not that I really have a choice!!

How do I feel?? Well, the feeling of inevitability has come home to roost (so to speak). At least the picture it getting clearer rather than just guessing, hoping, praying. Once I know the full story after Tuesday it will give me something to aim for. Right now I’m resigned to the worst-case scenario, and feeling rather empty.

The worst moment was on Friday afternoon, after picking up a "Cam boot" (like a ski boot, which holds my foot/ankle very rigid) and sitting on a step beside Lennox St in Richmond. This was an external, very visible label of what I’d done to myself, and I really, really, really didn’t like what it was saying.

But I think (hope?) that I’m an inherently positive person, and that is slowly rising up. I’ve had enough of feeling down. Obstacles exist to challenge us to continue, and that I will with as much hope and optimism as I can, not just for myself but for the people nearest to me. We all need each other’s support all the time.

"Tough times don't last but tough people do."
A.C. Green, Retired NBA Basketball Player