Light at the End of the Tunnel

DISCLAIMER: I’m going to preface this post by stating a few things; First things first, I am not a doctor, nor would I ever give out medical advice. What I’m about to discuss is highly personal medical information as it pertains to me and I am sharing it with you with the sole purpose of bringing to light information I thought might help inform and/or possibly encourage anyone who might be dealing with something similar to ask questions should they ever find themselves in my shoes. More so, I want to prevent anyone from ever finding themselves in my shoes to begin with. Second, if you’re a dude you might not want to read this entire post and I’ll warn you when to look away.

As most of you know today I had my follow up appointment with my sports medicine doctor, it has been four weeks since my last visit wherein he fitted me for Das Boot. In that time two seemingly unrelated things have occurred that have shed new light on the what, why, and how of this whole stress fracture debacle. These things while separately are cause enough for concern, when combined are a recipe for disaster, or rather, a guaranteed stress fracture.

Your typical stress fracture takes about 6-8 weeks to heal and is usually a result of over-training. I don’t doubt that there were those of you who thought this was precisely the case when this all first happened, just as my sport medicine doctor did upon first seeing me. It has been fourteen weeks since that fateful day in March but I have never felt like this was the case. To me, this whole thing never added up, but unfortunately I didn’t have insurance at the time to dig any deeper. Instead I followed the sports doctors’ instructions and continued not to see any progress.

Last month I finally had enough and purchased personal medical insurance. It was a huge fiasco with my preexisting condition but I was finally able to get it squared away and was able to start making appointments. The first was with the sports doc for follow up x-rays since I was not seeing any improvement and the second was to an internist to get a full blood panel run to check for deficiencies.

*DUDES – Unless you have a medical interest, I recommend you skip the next two paragraphs. You’ve been warned.*

In the meantime, about two weeks after Das Boot I got my period. I have not had a period in over four years. Between my birth control and my heightened activity level from marathon training I became amenorrheic, a fairly common occurrence in female athletes. (Those of you who are familiar with Meghann from Meals and Miles, might recall this post she wrote last year about this very subject.) To date it has never been a cause for concern to any of my doctors and I have not given it a second thought. Until it came. Obviously I talked to my OB/GYN and she gave me some insight on the matter:

Its reappearance is a result of two things: 1.) I am under a significant amount of stress having been dealing with all of this over the last few months and 2.) The inactivity of the last few months has resulted in my muscle mass deteriorating and my body finally having enough fat to produce enough estrogen to maintain a normal cycle. FACT: Estrogen helps transport calcium through the blood. When you’re low in Estrogen (i.e. not having periods), you’re not transporting calcium as well and therefore have a heightened chance of developing stress fractures if you are active. Furthermore, bone density decreases when estrogen levels are low, due to the hormone not being there to transport the calcium. Taking calcium/vitamin D supplements alone, without addressing the hormone deficiency means the two minerals won't be absorbed efficiently. (And y'all know I've been taking it like candy since this all went down!)

*DUDES - RESUME READING HERE*

Friday just before I left for Florida, my internist called to discuss my blood panel results and it seems my thyroid levels came in low. This is cause for concern for an overactive thyroid or hyperthyroidism and I was to come in for T3 & T4 tests (thyroid specific blood tests) upon return. FACT: Your thyroid is linked to calcium regulation.

Do you see the pieces of the puzzle coming together here? Well my sports doc sure did this morning when I clued him in to all of this. As I stated above, while separately they are cause enough for concern, together are a recipe for disaster. He actually apologized for not asking about my cycle or insisting on a blood panel, something he typically reserves for “repeat offenders” i.e. someone who has a history of stress fractures. He applauded my determination and was relieved that we finally have a reason for all of this. Not that it’s great that all of this has happened mind you, but he admitted he was beyond perplexed that I was having such a rough go with it. For all intents and purposes I am the picture of health otherwise so I am glad I went with my gut on this one.

After our discussion of all of this we finally took at look at my new round of x-rays and found that while I am showing healing I am not healed. He prescribed three more weeks in Das Boot to remain conservative, but I can ditch it when I am at home or doing things that do not require significant amounts of walking. I can begin weaning myself out of it an hour at a time each day until my next appointment and I can resume swimming, aqua jogging, and flat road/no resistance cycling so long as there is no pain. He is confident that after my internist figures out my thyroid situation I should get the all clear at my next appointment at which time I’ll be sent to a nutritionist to be enlightened on what I will need to do to stay on top of keeping myself balanced going forward. He closed by saying I was his best patient with the worst luck.

So, there is a light at the end of the tunnel, at long last, I just have a little bit further to go before I reach it.

At least I make this look good... right? :)

Now I know this a lot of information to digest, so please feel free to ask questions in the comments below and/or share your stories. I will do my best to respond to all of you or if there are enough questions I will just answer them all in a follow up post.

Special thanks goes out to Heather for letting me bounce a lot of this off on her as she has knowledge on the subject. Thanks also to Adam for giving me a dudes opinion on whether or not I'd loose all my guy readers for talking about my period. (He seems to think I won't so please don't prove him wrong!) Continued thanks to all of you for your continued support and encouragement, it's been a rough few months and I appreciate y'all not giving up on me! It's looking very hopeful that July will {FINALLY} produce some actual running related content! Stay tuned!