One Day at a Time

So here we are.

I went to the foot doctor on Monday, expecting some good news, but alas, none was to come.  He asked how my foot felt, I said "fine".  He said it wasn't swollen.  I said, "Yeah...that could be because I am taking 2400 mg of motrin a day for Costochondritis.  He nodded his head, asked how I got Costo and empathized with my pain.  Then he took an X-ray.

When he came back he looked a bit baffled.  "Still not healed.  These suckers take a long time...how about we put screws in your foot?"

They look like drywall screws...are you kidding?

WHAT?!?!

Okay....so a month ago you said 4-6 weeks in the boot no problem....now you want to put screws in?  No effin way!

So I looked at him and simply said, "You are not putting any screws in my foot."  I healed from a Jones Fracture in 12 weeks, I will heal from this too.

And so, he sent me on my way with another appointment in 4 weeks.

In the meantime I started to think about all of the motrin I have been taking (and trying to wean from).  Hmmmmm....I had a hunch so I googled "Motrin effects bone healing".  Isn't google great?

What do you know??  Motrin (or any NSAID) slows bone healing.  In fact, they give it to people when they DON'T want a bone to grow back.

FABULOUS!

I have been trying to wean myself off of the motrin for two weeks now.  Sunday and Monday were pretty much costochondritis symptom free.

HAPPY HAPPY JOY JOY

Anyone who has experienced the pain associated with costochondritis will understand my expression of joy.

And it's back

So I went down to 1800mg of motrin on Tuesday and Wednesday.  By 1:00 on Wednesday afternoon, it was back.  Full force!  Like a sucker punch, bam...there it was.

So back up to 2400mg I go.  Slow bone healing I have to accept.

I made an appointment with a Sports Medicine Doctor for this afternoon.  I am feeling very confused around this whole thing.  I'm not sure what I should be doing, could be doing or absolutely should not be doing in order to make this chest pain go away.

I exercised Sunday, Monday, Tuesday and Wednesday.  Mostly on the bike but I also did light resistance with arms and shoulders and some core stuff.  Could that have triggered a relapse in symptoms??  Should I lay off all resistance, or will resistance actually help the healing?  Is the motrin really effecting the healing time of my foot?  Is there an alternative anti-inflammatory?  How long can I expect this to last?

Oy, so many questions.  Hopefully today I will get some answers!  Stay tuned. :)

Unbearable Pain and Cycling..Where Did The Week Go?

Sorry for the lack of posts this past week.  I suppose I haven't had much to say, but I have also been a bit distracted.  I am writing now for any folks who are reading this relating to either a broken foot or costochondritis.  

Similar to the boot I am wearing.

Bike on a trainer.

This past week was really tough.  The pain associated with costochondritis has been unbearable at times, making it difficult to function or get anything done.  Last weekend I did finally get on my bike (using the trainer).  Big black boot and all.  If you have a broken foot and are allowed to put any weight on it, I highly recommend a stationary bike for cardio.  I rode for 25 minutes on Sat and 30 minutes on Sunday and then I iced my chest.  Interestingly enough, my chest did not hurt at all during the workout or directly after.  Icing it either made it worse or didn't do anything though, because both days were pretty torturous.

On Monday and Tuesday there were actually moments when I wasn't thinking about my chest.   I decided to start weaning off the motrin and took my dose down to 600mg 3x/day instead of 800.  By Friday I felt just as bad as I did the previous weekend.  Back up to 800mg....ugh!  As of yesterday I also added a Zantac and if it is really hurting...I take tylenol too.  So far today has been a GREAT day.  I feel halfway human.  Just not sure what the other half is yet..

Halfway human...although imagine it with only one foot.

In the meantime, I have been walking just the tiniest bit on my foot without the boot in the morning and at night.  Mostly to get back and forth to the bathroom, because using the crutches hurts my chest to much.  The GOOD news is that I don't feel any pain in my foot!

So, either my chest hurts so badly that it is completely masking any pain in my foot, or maybe it is the 800mg of motrin I am taking 3x/day....or it could be that the break is pretty close to being healed!!

I have continued on the bike every other day for the last week.  I am still steering clear of any strength training, however I am considering working my arms tomorrow.  By the way, a great resource for cardio workouts is a website called motiontraxx.com

You can download workout music for free.  The cool thing is that you get tracks that set your pace.  Some even do intervals for you.   Currently there is a series of cycling mixes.  AWESOMENESS!

Tomorrow I go to the foot doctor.  There is a possibility that I will be able to get rid of the boot.  Which would be great for many reasons, one of which is the fact that it is FUNKY from sweating my ass off on the bike. 

Stay posted for updates...and thanks for reading!

Survivor, Game Theory and Life

Here it is...my post on Survivor the annoyingly addictive reality TV game show, game theory and how it relates to life...kind of.  

This most recent season of Survivor was probably one of the most fun to watch.  Why?  Because it really couldn't have been better if it was scripted.  Boston Rob, a seasoned player knew exactly what he needed to do and he did it, playing "as close to a perfect game as anyone has played on Survivor".

How?  Game Theory coupled with a little bit of charm, hard work and self admittedly, a little bit of luck.

So here is the thing.  If anyone watched the season, you would know that Rob completely dominated his tribe and they pretty much did whatever he wanted them to do.  It looked pretty easy from our vantage point, but a lot of work went into having that much control over that many people.

According to Game Theory...simplified of course....if you concede just enough to give someone what they want/need, they will in turn give you what you want/need resulting in shared benefits for everyone.  The catch however, is that you have to be willing to give up something.  The Prisoners Dilemma is the most popular example of this.

On Survivor, Rob was able to make each person feel as though he had their best interests in mind.  He promised each one that he would take them to the end and they believed him.  Therefor none of them even considered voting him off until it was to late.  This took a huge amount of insight, a lot of manipulation and a certain amount of mathematical prowess that allowed him to predict the behavior of others.

How does this play out in real life though?  In many instances, people don't cooperate even though the outcome would be best all around if they did.  Why?  Because quite often people have their own interests in mind.  We see this play out in economics and social policy all the time.

We can expect that people are going to do what they believe is best for themselves.  However, if everyone does what is best for themselves, nobody wins.  If people cooperate with each other each individual may not get what they consider to be the "best case scenario" but will ultimately be better off than if they acted upon their selfishness.

Kind of hard to wrap your brain around if you are not use to thinking this way, but fascinating nonetheless.

In Survivor, there can only be one winner, so in the end pretty much everyone but Rob got screwed anyway.  Unless you count all the "life lessons" and getting "closer to God" crap they all spouted at the end.

Real life is much more complicated and "winning" means different things to different people.  It is fascinating though.  Pay attention to what people want, give it to them, and in return...if the theory is correct....you will get what you need.  So simple, yet so incredibly complicated.

No Pain, No Pain

It's been five days since I last exercised...FIVE!  I haven't gone that long since I gave birth to my youngest....and even then I could at least take a walk.   If I wasn't so freakin uncomfortable I would probably be climbing the walls by now.

This is really what it feels like!

What is it they say about the best laid plans and good intentions???  Oh yes, "Sometimes life gets in the way of life."

My original intention with this blog was to write about life with a broken foot, how to continue to exercise and get through each day with a positive attitude (with a few social work related commentaries thrown in)...yet where do I end up???

See pic right.

Struggling to get through each day, feeling like an elephant is sitting on my chest, not being able to exercise, and still hobbling around in a big black boot recovering from a broken foot.
  
I will say, yesterday was a better day.  The pain wasn't quite as intense and when it peaked it didn't last for as long as it had in days past.  I was able to eat pizza and wings for dinner without dying after wards.  I even had a glass of wine.  I went to sleep hoping for an even better day today.

I awoke an hour later with such intense pain in my chest that all I could do was lay there and breathe.  What made it worse was that I couldn't even get downstairs to take my ibuprofen because I would need to use the crutches...which was absolutely NOT happening in that moment.

What a weird random occurrence.  I mean I would rank this pain right up there with labor pains.  At least with labor though, there is a prize at the end.  What's the point here?

Woman in Excruciating Pain labor and/or
inflammation of the chest wall (hard to tell which)

Even worse, when I finally "breathed" myself to sleep (meditation is a fabulous thing), I was plagued by dreams of chasing a doctor who had just performed surgery on my chest around an exam room, all the while bleeding from wounds on my chest that he had carelessly forgotten to stitch back up.

Dear Subconscious:  Thank you for making it clear that I am experiencing intense pain, as if my waking brain could not figure it out on it's own.  Love and Kisses, J.

 Alas, here I sit...frustrated and uncomfortable.

Yet I remind myself that it is only a moment in time.

This too shall pass and one day soon I will feel "normal" again.

I hate it when life gets in the way.

The Moral Animal

I'm sitting in the exam room of my doctor's office with whom I reluctantly made an appointment because I told myself, if my chest still hurt by Monday I would go.  Given that I had my head on my desk and was practicing Lamaze breathing techniques by lunchtime, I thought I better hold true to my commitment.


The Nurse Practitioner walks in and the first thing she asks is, "What are you reading?"  Not exactly what I came there for, and since talking when you feel like an elephant is sitting on your chest takes more effort than one would think, I simply show her the cover of my book.  "The Moral Animal.  Why We Are The Way We Are"  

"For school?"  She asks.  "Nope."  I say..."For fun."

She gives me this sideways glance, as if to say, "What kind of  loser reads something like that for fun?"

Yes, I am weird in that way.  Granted, it has taken me 3 months to get through it, but this stuff is off the hook!!

Have you ever wondered....I mean REALLY wondered why we do the things we do?  I mean, there has to be a reason...right?  This is the stuff that keeps me up at night....again weirdness...I know.

Like, why do people "love" their siblings even if they don't "like" them?  Why are we inclined to help others?  What attracts us to a certain "type" of person?  Why is polygamy actually a better gig for women than it is for men?  What does game theory have to do with being successful in life? (This will be another post related to Survivor at some point I'm sure....cuz it's really cool stuff).

So much of this is hardwired into our brain...into our being...that it seems spiritual...or is it? 

From a Darwinian perspective, with a little bit of Freud thrown in, this book really forces one to rethink motives, responsibility and purpose.

Of course it's just a theory.

As far as my chest is concerned, the NP confirmed inflamed chest wall, probably as a result of over use of my chest muscles....duh!

Not quite sure how that would play into my "fitness" according to Darwin...other than perhaps my body is telling me to slow down.

Inflamed Chest Wall....Really??

I would think it was comical if it didn't hurt so freakin much! 

For the last three days my chest has been hurting.  Not the "Wow that was a great workout I'm gonna feel it in the morning" kind of hurting, but the "Something is seriously wrong with my chest, am I having a heart attack?" kind of hurting.

This can't be comfortable

WTF???

I don't want to seem like a hypochondriac or anything so I figure, whatever it is, it will pass.  But people keep asking me, "Are you ok?"  "What's wrong with your ribs?"  Apparently I keep touching my chest and wincing in pain.

No idea.  All I know is that I wake up in the morning and feel okay, but by 11:00am I feel like an elephant is sitting on my breastbone. 

Maybe it's reflux...I take an antacid...no dice.

My co-worker...who tends to be my go to person for bodily aches and pains mentions "inflamed chest wall".  So I GOOGLE:  "Inflamed Chest Wall"

Costochondritis is a condition that causes chest pain due to inflammation of the cartilage and bones in the chest wall. Also called Tietze's Syndrome, costochondritis occurs when there is inflammation at the junction of the rib bone and breastbone (sternum). At this junction, there is cartilage joining these bones. This cartilage can become irritated and inflamed. Depending on the extent of the inflammation, costochondritis can be quite painful.

This condition is thought to be bost commonly due to repetitive microtrauma, or overuse. This means that activities are causing repeated damage to the cartilage of the chest wall leading to inflammation.

"Do your best and forget the rest"

Hello??  Perhaps I am overdoing it with the upper body workouts.

Repeated rows and push ups while also using crutches...hmmm.  Should have thought that through better.

I wonder what Tony Horton would have to say about this?

Of course I'm self diagnosing, but it does make the most sense.  Motrin seems to help and I have promised to lay off the push ups and rows for a little while.  I am wondering if trauma to any part of your body effects the rest of you.  Is my body less resilient in general because it is working to heal my foot??  

Luckily my girl hooked me up with her bike trainer so I can get my burn on.

Not so sure how it will work with the big black boot, but it's worth a try!


















  

Education and Poverty - Having Nothing to do With My Foot

Privatizing education in low-income areas so that the "whole" child can be addressed.  This totally makes sense to me.

I came across this article in the Wall Street Journal about a High School in Philadelphia that is going to be one of the "turnaround" schools in the city, meaning it will be owned by a private Charter School company with the hopes of effecting change, supporting children and their families and improving outcomes, something the School District of Philadelphia couldn't do on it's own.

The Charter School company is a non-profit that has obtained funding through a federal grant called Promise Neighborhoods which ties together housing, health care and additional supports in the community.  It looks like Promise Neighborhoods funds projects modeled after Harlems Children's Zone which began as a "one-block pilot program" in Harlem and has since expanded to 60 blocks.

THIS IS FREAKIN AWESOME!

"Our strategy is bold. We have created a unique, and uniquely successful paradigm: provide a pipeline of services that support children from birth through college graduation, and create a critical mass of engaged adults who understand what it takes to ensure a child succeeds"

HELLO!  Someone in Philly finally gets it.  I'm not dissing the School District of Philadelphia.  Some of my favorite people work there.  But the fact is, there is not enough money, resources or knowledge in the PA Department of Education to accomplish the daunting task of educating children who have so many additional needs.  Everything is funded through these silos.  Wake up people!!  Children do not operate in a silo!!

Having provided behavioral health services to children in the Philadelphia schools I know that when a child enters that school building, they don't leave the rest of their life at the door.  And no, therapy is not going to "fix" them.  A wise person (although I can't remember who) once said, "Toasters can be fixed, children can't".

Can Fix

Can't Fix

                              

The best way to impact a child, is to impact their environment.  How can we expect a child who is hungry and hyper vigilant to focus in school?  Stealing food and constantly moving around the classroom are survival skills in their world....a world that doesn't stop at the door step of their school.  How does "No Child Left Behind" account for that?

Harlem Children's Zone has figured out a way to address the multiple needs of children and their families who face generational poverty.  No solution is perfect, but at least this one is working.

Now, if we could just get funding streams on board...maybe we will make some progress.

Being Floppy

Picture that stuffed animal that isn't quite stuffed enough.  You know, the one you keep trying to sit up and it just flops over onto itself.  Yeah...that would be me.  My core has always been mushy, not matter how much Pilates and/or crunches I do.  Only made worse by a vertical c section (another blog all together) and a resulting diastasis recti.

Good thing my kid is cute.

Speaking of kids:  TIP - If your child is having trouble sitting still during circle time ask the teacher to sit him/her against a wall or in a chair.  It's unbelievable how long our kids are expected to sit unsupported.  Often teachers go right to a behavioral issue when in fact the child has poor trunk strength and can't sit up for long periods of time without support (see bunny above).

I was always active as a child, although I did not play many organized sports I remember staying outside late on warm summer nights playing Kickballl, King of the Hill and Hail Mary.  I also loved gymnastics, until I dislocated my elbow...twice.  Hey....do you see a pattern here?

What does any of the above have to do with anything?

Well my sister, who is an Occupational Therapist called the other day and asked, "Have you thought of getting inserts for your shoes?"  I know I overpronate...and yes...I have thought about inserts but it is one of those things I just never got around to doing.

Over Extended Knee

 My knees also hyperextend which means other joints probably do the same.   I probably have ligamentous laxity (loose ligaments) and lower than typical muscle tone.  Keep in mind, muscle tone is not the same as muscle strength.  Muscle tone has more to do with the amount of tension in a muscle than how strong a muscle actually is (thus making one appear "floppy").

Who cares, right?

Apparently, according to my OT sister who can explain it much better than I can, this might have something to do with why I broke my feet.  I think it goes something like this, when my foot rolled the muscle in my leg responded by pulling on the bone.  My tendons and ligaments aren't strong enough to counteract the muscle, so "crack" there it is.

"But I thought it was just dumb luck", I said.  "Lot's of people step on shin guards and acorns," she responded, "not everyone breaks their foot."

Cool Orthopedic Shoes

Bio mechanically speaking, I'm probably just not built to endure high impact activities.  This doesn't mean I shouldn't do them, just that I should take precautions.  For example...I probably should not be doing plyometrics barefoot.

Needless to say, I won't be jumping on the barefoot running fad any time soon.
Hey....maybe I can get a pair of cool looing orthopedic shoes like these (see pic right)! 

In the meantime, I'll do the best with what I have and watch out for acorns, shin guards and other assorted things that may occupy the floor beneath my step.

Staying Motivated

Today is the day.  Not a cloud in the sky, nice cool breeze and  as I sit and write this I should be rounding City Hall in the Broad St. Run.  Sucks!!  There I said it.

Two years ago I was registered to run and I came down with a wicked chest cold 5 days prior.  I tried and tried to find supporting information that said, "Yes...go...run with a chest cold that is keeping you up at night and has you coughing up crap similar to the projectile vomit featured in the Exorcist"  But, alas, I could not.

I remember waking up early that morning, getting ready for the run, thinking it would be a "game time" decision.  It didn't help that it was raining and cold that day.  I decided not to run.  In some ways that decision was harder than dealing with this.  At least I don't have a choice this time   Although, don't think that I didn't consider trying to crutch my way through it!!

So, you might think I am one of those committed great athlete types.  One that runs every race, faces every physical challenge, competes in multiple competitions.  The fact is, nothing could be further from the truth.

For the most part, Broad St in the only consistent race I do.  Although I may challenge myself here and there, I don't particularly like competitive games and have never joined any type of league.

So, you might wonder..what keeps me motivated?  I think it is more about feeling good, physically, emotionally and spiritually.  The best advice I could ever give anyone about exercise is:   Don't do anything you don't enjoy.  It defeats the purpose.

Trail running is a great example of exercising for the soul.  I am lucky enough to live within 3 miles of Philadelphia's section of Fairmount Park known as Valley Green.  Valley Green not only has a bridal path that is great for running, but also multiple trails that wind up into the hills and back down into the valley as you cruise along parallel to the lower path.

Sometimes, when I am cruising up one of those hills, I feel like my legs are going to give out underneath me and my heart is going to beat right out of my chest...and then I get to the top.  I pick up my pace as I feel the sun on my face and look out over the valley below...I feel like I am flying. 

That is what keeps me motivated.  It is a feeling of being connected to your body in a way that only mindful physical activity can achieve.  It isn't about winning or losing or being better than someone else.  It is about connecting to yourself.

Since I won't be running any trails in the near future though...I am trying to find other things to maintain this connection. 

Yesterday I used the exercise ball.  If you have an injured foot or leg you can find some great exercises to do on the ball, especially for core and upper body work.  Today I plan to do P90x chest, shoulders and triceps with my husband.  Another upper body workout that I should be able to do with some modifications. 

In the end, the best motivation is knowing that whatever I do is going to make me feel good.  This is what kept me from running Broad St two years ago when I had the chest cold and this is what keeps me exercising on a regular basis.  Even with a broken foot.

By the way, don't you think that it is ironic that I run those trails, navigating rocks, snakes, trees and deer yet I break my foot stepping off a curb (18 months ago) and again stepping off a step??  Weird.