I was supposed to go back to school today, BUT, the little storm in the Northeast gave us our first snow day today.  I have a feeling my Christmas vacation will extend until tomorrow. It feels like a whole other vacation.  :)

I would like to just be in denial that this vacation will never end, but I also got another denial this week.  My insurance company denied the authorization for my surgery.  Hooray...NOT!  Not entirely unexpected, but just another challenge to overcome.  This happened even with the referral to go see the specialist in Boston.  The insurance company did a "peer-to-peer" where the insurance company doctor calls my doctor and they have a nice little chat about why I need the medical treatment I do.  The first time was successful, hopefully the second will be as well.  

Other than my ongoing knee issues, which are temporarily band-aided by some futuristic hardware that seriously hampers my lower body fashion choices.  The upside is that my students say it makes me look a little "bad-ass."  Unexpected benefit.  

I recently cashed in my credit card rewards points and I selected a Home Depot gift card.  This card will allow me to purchase....wait for it....a Kreg jig!  Woohoo.  I have been eyeing it on lots of blogs and DIY sites.  My dad taught me to biscuit joints, but I HATE the time it takes to measure, line it up, glue, clamp, wait and repeat several times.  So now, I will build in an afternoon versus a weekend or two.  Score.  Thanks Capital One!

Time to finish my grading to be ready for school on Monday.  At least I am keeping my fingers crossed.  Clearly, I am still in denial about Christmas vacation coming to an end. 

I was really good since my arthroscopic surgery -- I stayed on my crutches while walking the entire week.  My PT's - Jared and Noah - said I had to stay on crutches for one week until the synovial fluid in my knee regenerated, which takes takes about a week.  I started walking and teaching on Tuesday.  While I KNOW I am hypersensitive about each little twinge, tweak and minor catch -- it just seemed like my knee still wasn't right.

Each little weight shift caused my knee to tweak a little.  Not pain exactly, but pressure that just makes you stop and hold your breath.  All Tuesday, Wednesday and Thursday I felt like I was on the verge of a major catch. I could literally feel the inside of my knee with every step.  While I don't ever let my knee keep moving in a position when it is tweaking, it feels like my kneecap could just crack in two. Very bizarre.

It's been difficult to tell if all of this pressure is due to having surgery a little over a week ago OR because my knee is just messed up and will remain so forever.....

My follow-up with my orthopedic surgeon, Dr. Brown of OA, yielded some unsettling information.  

The microfracture site is indeed failing.  I have really cool intra-operative photos that show some jagged, frayed cartilage that Dr. Brown had to scrape away.  It's kind of liken a little defect in a piece of wood that you sand away to make smooth.  If you don't sand it -- it would will catch your clothing, stab you with splinters or just break off.  It's exactly the same inside your knee.  It catches, makes me stop and feels like it is going to break away.  Dr. Brown carefully sanded it down to make it smoother.  However, the cartilage is only about 1-4mm thick normally, so shaving it makes it even thinner.  AND it isn't even smooth.  There are a LOT of rough edges.  

I appear to be depressed.  Well....of course I am depressed about this....but I am not depressed with any other part of my life.  While I was shocked that Dr. B suggested this, I did take some time to think about if indeed I am.  Yes, I was emotional in the office, but I am facing the end of my life as a triathlete.  I am facing the end of running for the rest of my life.  I am facing the end of anything athletic that requires impact or forceful movements.  Geez.  So, in thinking about a possible depression I contemplated whether or not the one afflicted is the last one to know?  Could I be in denial?  I asked my husband. I asked my colleagues.  I asked my high school classes.  The resounding answer was, "NO!"  I'll go with that.  While my athletic life is super important to me, it's not the end all-be all of my life.  I have tons of stuff that makes me super happy - my family, diy projects, teaching, reading, etc... So, maybe I have selective depression.  I can be depressed about a certain compartment of my life and I need to give attention to that depression.  I'll take medication before I go into the doctor's office; I will think happy thoughts there; I'll bring a support system.  Geez.

Dr. B thinks I need to go to Boston for the consult for an ACI.  After counseling me for about 45 minutes and talking about my expectations, hopes and shattered dreams this year -- he thinks I DO need to have an ACI.  He even shared that many of his patients that he has referred for ACI have even returned to running.  I think my jaw may have dropped when he said this.  It was the first tiny little seed of hope I have had in a month.  So many times over the past year, I had thought that "this" surgery was going to fix things and I would be able to throw myself back into training.  And so many times, I have been profoundly disappointed.  I am not going to hold that as my expectation (return to running), but it is my "reach" goal.  KInd of like that "reach school" when you are applying to college.  I'll be happy to be able to be pain-free and forget that I have had knee problems and absolutely ECSTATIC if I can cross another finish line after a run.  

Dr. B suggested I go on a low-carb diet.  While the depression comment was shocking, I was blown away by this one.  Not that I don't think he has a point -- any extra weight I carry puts additional stress on my knee.  But the fact that he was so specific with the type of eating program -- that just threw me. BTW--the only way I seem to lose weight is by eating low-carb.  I am very familiar with the science behind it and how it changes your insulin dependency and how you metabolize fat, but I was shocked to hear a doctor actually recommend it.  He shared his own story about switching to low-carb last year, the research he did, the medical journals and articles he read and the cardiologists he consulted.  He recommended books for me and challenged me to come back in four weeks with some changes.  Whoah.  He is right.  I wish he wasn't.  Since all this knee crap began, I am not an endurance athlete anymore.  I used to work-out 1-2 hours each day running, swimming and biking which controlled my weight easily.  Take those things away -- the pounds DO creep back on.  Immediately following the appointment, I drove to Books A Million and bought the New Atkins.  Tomorrow: I grocery shop.  Tonight: I had my last carb-infested dinner with Texas Roadhouse buttered rolls, BBQ pulled pork and honey mustard drenched salad.  

Goodbye old friends.  It's time to break up.  I am headed to Boston to see if I can get back my finish line......

Miles to go b4 i sleep....

I've blogged before - not very successfully.  But recently, I have found that I have more to say than what I feel comfortable posting on Facebook.  I always feel like I am bragging/boasting/imposing myself on the Facebook crowd.  Don't get me wrong.  I don't think ill of any of my FB friends who share their lives in that format.  In fact, I am sort of envious that they can just put it all out there and not care about the comments people inevitably think but not post. I overanalyze.  I hope that this blog is read by people who DON'T know me personally.  Is that weird?  Whatever.

I can't run anymore.  

How can I be a triathlete without running?  Tri means three and now I can only do two: swimming and biking.  Waa, waa.  There are so many other people out there that can't do any of those things. I get it.  I really do.  But when you spend the last five years battling with a sport that concludes with a hellish, pain-induced, fighting-for-every-inch run at the end to get to a sweet, gratifying, can't-believe-I-did-it finish line -- it feels like you lost a friend.  

Sure, it's a friend of which I had a love/hate relationship.  But at least I could choose to hate it or love it.  Now, I have no choice at all.  It's like a break-up you knew was going to happen--even wanted to happen--but when it happened, you actually wanted to go back and change things.  

Elizabeth Kubler Ross coined the five stages of grief: Denial, Anger, Bargaining, Depression and Acceptance.  Am I mourning running?

Denial -- occurred all summer when I ignored the pressure on the inside of the knee and attributed it to scar tissue.

Anger -- I get sort of angry that I can't sign up for a full triathlon anymore.  I get angry when I see what seems like the ENTIRE freaking neighborhood running by my house on their easy Saturday morning jogs.  I get angry that every freaking ad on Facebook has to do with new sneakers, new Garmins, new training plans.  I get angry because so many take it for granted that they can run.  I get angry because I did too - until I couldn't anymore.

Bargaining -- I tried to make deals with myself -- I'll only do sprint tris.  I only walk/jog the run. I'll eat really well.  I'll never complain about run workouts again.  There are no more deals to be made.

Depression -- I go in and out of this one.  I am fine until I see pictures of my friends at the end of a 5k on Facebook.  I am fine until I see my $170 Hoka one one's mocking me from their spot near the door.  They were only bought because I had a bad knee and it was going to help me to keep running.  I am fine until I realize that I will probably never cross another finish line. And then I am not fine.

Acceptance -- I'm not there yet.  

I am four days into recovery from my third knee surgery.  :(  My right knee can't seem to hold onto its cartilage.  After a tempo run last August (of 2012), my knee felt stiff, swollen and seemed to "catch" when I moved from side-to-side in certain positions.  I was convinced it was a meniscus tear and just needed a little snip, snip and I would be good as new.  It turned out to be a bit more serious.  The articular cartilage, in a weight-bearing area between my femur and tibia/fibula, had broken down and there was damage all the way to the bone.  I had  micro-fracture surgery last August and spent the fall on crutches with strict instructions to put NO weight on that leg.  Yikes.  I was in physical therapy from October until May with varying levels of success. Some days would feel great and other days were miserable with feeling something "not right" within my knee.   I became quite hypersensitive to any twinge, tweak or catch.  

The month of May hit and my orthopedic surgeon didn't like what was going on....hence...the second surgery.  This was a diagnostic-let's look inside-see what's going on type of surgery.  The micro-fracture looked great but there was some other cartilage that was floating around that needed cleaning up.  Hooray!  I could run again.  My PT's got me on a run progression and I spent the summer running slowly in a pair of ugly-orthopedic Hoka One-Ones. I've grown to like them, but we are NOT in love yet.  I didn't feel any pain running - just pressure.  Then I upped my speed in order to actually make my body run faster than the 10 - 11 minute mile it was quite happy sustaining.  On direction of my PT, I added some faster intervals of 9:30; 9:00; 8:30; and 8:00 minute paces of 30 seconds each to my regular run.  

It was awesome.  Tough, but I finally felt like my old self.  If you are a triathlete, there is a certain amount of pain expected with training and I hadn't felt that "aerobic pain" in a long, long time.  My knee didn't hurt - my lungs did.  

Not an hour later, something didn't feel right.  It just felt like something--my patella--something just felt "off."  Back into PT I went, where they worked on getting my form back into line.  I ran on the track with no pain and was ready to get back out there.  The next day, as I was finishing a climbing a small set of stairs and rounding a corner, my knee "caught."  I felt instant sharp internal joint pain and knew something inside was terribly wrong.  

A week later, the MRI confirmed some more articular cartilage damage in the same spot as my micro-fracture and under the knife I went again.  

This time the news is not so great.  The micro fracture is failing and I need to "wait and see" if I need to go to Boston for a consult for an ACI.  This is a much more serious operation that could potentially give me back a brand new knee.  We are talking about a small spot of 1 cm of cartilage that is wreaking HAVOC on my life. I can't dance.  I can't play volleyball.  I have trouble moving side-to-side in my kitchen emptying the dishwasher or cooking.  

It's time to accept the reality.  It's time to stop choosing to try and run.  It's time to choose my everyday life. 

Is this acceptance? 

miles to go b4 i sleep.....