Waiting. 

Waiting in the ER as a family member is boring and nerve-wracking. Waiting as a family member and a physician, watching your parent wince in pain is excruciating.  

When I arrived he was seated in a wheelchair in the “Green Zone”, where the sprains and strains are waiting. He looked pale and sweaty and his heartrate was about 110. (Normal is 60-80). I found the nurse, explained who I was (daughter, not doctor) told her in medical terms what I had found when I saw him.  She did an ECG (normal except for the fast rate) and moved him into the main ER. And two hours later we are still waiting to see a doctor. He is triaged as “back pain” and so we wait. 

I finally couldn’t take it anymore watching him wince in pain and asked a nurse if we could get him something for pain and moved to a bed.  About twenty minutes later the doctor shows up and my dad is lying down in a bed. He’s still sweaty and in pain. He also says he’s a bit winded and has a bit of chest discomfort. 

The squeaky wheel gets the grease. 

Percocet on board and labs drawn. 

More waiting. 

And the worst of it? I was supposed to be with my daughter and Aunt watching a live production of Cinderella. 

A Pain in the Eye

Day 6 – National Blog Posting Month.

All day my eye was bothering me. Between patients I’d go to the bathroom with a saline spray and remove my contact lens to clean it. My eye would feel better after a while but then the irritation would return. It felt like a grain of sand or dust was in my eye. I thought I might be getting a stye. By the end of the day I felt like scratching my eye out.

I had some fluorescein stain at home so I put a few drops in my eye and used the blue light of my ophthalmoscope to look at my eye. Yellow and blue make green. A corneal scratch or abrasion will light up green.

http://www.rcemlearning.co.uk/references/corneal-injuries/

Above photo credit: http://www.rcemlearning.co.uk/references/corneal-injuries/

I was a little surprised to actually see that I indeed had a few scratches on my cornea. Suddenly the pain got worse (psychosomatic?). I called for my two older kids to come to the bathroom so I could show them.

Needless to say they thought it was pretty cool. I had to wear my glasses for the rest of the evening. They have lenses from 2006. They haven’t been updated and my eyes have gotten worse. I really need to get the lenses updated.

Corneal abrasions hurt. Wow. Do they ever hurt. I woke up with a brutal migraine today and I still want to scratch my eye out. It’s going to be a great day.

Vice Grip.

The piercing pain on the right side of my head woke me up.

Here we go again, I thought.

“Maaaaama! Poo-poo bum! I hugry. Want bekfast”

“Ugh ….”, I moaned.

I got out of bed, stumbled on a toy which made my head feel like it was going to explode. As I walked by his room, he held out his sippy cup and I took it. I made it down the stairs, to the kitchen, where I filled his cup with milk.  Giving it back to him at the gate of his door, I patted him on the head and turned on his light just a little bit.

“Mommy going to take a shower, you stay here and play quietly.”

I fumbled in the dark for the shower curtain and pulled it aside as I took off my clothes. The water’s coolness on my hand caused me to shiver and as turned the shower heads on, I stepped in to the cold rain on my head.  I started shivering immediately and sat down under the stream of water.  I hugged my knees and rocked back and forth waiting for the pain to subside.  Eventually I felt it lift a bit and turned the temperature of the water up.  The shivers stopped.  My head felt better. I could hear squealing and laughing coming from the hallway.  Everyone was up.

I lay back down in the bathtub.

Five more minutes, kids.

Mommy needs just five more minutes.

The Agony of Accomplishment

I hurt today.

I knew it would hurt to get out of bed the moment I stretched out my legs.

My left knee at the fibula where the IT band inserts.

Both calf muscles and the Achilles’ tendons.

The right lateral thigh along the entire length of the IT band.

My deep, deep core muscles.

They were all mad at me for what I put them through yesterday.

IMG_6355

After a self-imposed rest of 3 days due to inclement weather and a broken furnace, I set out for a long run. I’ve been increasing my distance by 1 km every 2 weeks, so this week had me facing 13 km. With all the snow that fell I knew that only the major streets’ sidewalks would be clear enough to run on so I headed out and ran to the office. I tried to take it easy as this was supposed to be a LSD but after each kilometer clicked by it became clear that I was running at my 5km pace. (I can hardly believe I can even say that!). I reached the office and kept going for another 1.5 km. By the time I had to turn back I was getting pretty tired. I briefly considered hopping on transit but remembered I didn’t bring my wallet or any loose change. I allowed myself a few extra 100 meter walk breaks and thank goodness for traffic lights. I was able to catch my breath and stretch out the legs.

I made it home and felt like collapsing. My legs were jello and I was dripping in sweat. I drank a lot of water and made a cheese omelet even before I got all my gear off. I was starving. I stretched afterwards but obviously not enough considering how my legs felt this morning. A few hours later the dreaded migraine came on with a vengeance; a sign that I will need a water belt and gels for my next long run. I think I am going to wait another week before increasing my distance again. My legs definitely need a break. For the next few weeks I will stick to 5-10 km and work on getting my 5 km pace even faster.

Oh and just for fun here’s a shot of me as I ran by a storefront window. I’m pretty sure this was around 9 km. I’m surprised I’m not completely hunched forward!

IMG_6360

A Thousand Deaths

Day 3 – National Blog Posting Month

Doctors are not supposed to treat family members for a variety of reasons.  The main one I think is that doctors just can’t be objective when it comes to their loved ones.  I know I certainly am not objective.

Over the past few weeks, my brother had been complaining of a spot on the inside part of his left heel.  He sent me a picture and at first I thought it looked like a wart but was in a weird spot which wasn’t typical for plantar warts.  He called me on Hallowe’en and complained that he couldn’t put any weight on it at all. He sent me another picture and the more I looked at it, the more I started to worry it was something serious.  It looked like a melanoma. I know my brother thought the same thing as he’s had a friend who had melanoma (and is thankfully okay).  He joked how he was going to get his foot amputated like the old man in The Walking Dead. Husband and I looked up nodular melanoma and were worried all weekend.

This is the photo my brother sent me: photo 1

And here’s what nodular melanoma can look like:

So, you can see how I would start to get worried, right? Ugh. In the span of two days, I thought about all my brother would have to go through if it indeed was melanoma.

Anyway, he had an appointment booked today with a dermatologist who happens to work in my building, and yes, I may have asked the receptionist to move up the appointment when my brother told me  last week that it was getting worse.  He saw the dermatologist today. After scraping away at the site, he found something under the skin.

A foreign body.

A metal sliver.

photo 2

This weekend, my brother died a thousand deaths and I imagined them all.

Sandwiched.

photo(1)

The time has come. My parents are getting old.  My dad is going to be 80 next year, my mom is 74 this fall.  Both have been relatively healthy except for a few issues (hypertension and type II diabetes), but that is starting to change.

For as long as I can remember, my dad has suffered with back pain.  I remember him going to chiropractor appointments weekly for what seemed like years for chronic low back pain.  He was told many years ago that there is nothing that can be done about his back pain.  Well, now he’s finally had some imaging, and we saw a surgeon today.  But, unfortunately for my dad, surgery is not an option right now. Even though he has narrowing of his spinal canal (spinal stenosis), it isn’t producing enough leg symptoms to warrant surgery.  Sure, he could have it anyway, to open the canal up, but it may make his back pain worse in the long run.   You see, surgery doesn’t help back pain, it only helps leg symptoms (pain, numbness, tingling, etc).   And in my father’s case, his back pain is far more debilitating than his leg symptoms.  I know he was relieved to hear he wasn’t a candidate for surgery, and I think he finally heard that he needs to get up off his ass and start walking more.  He used to walk all.the.time.  He was very active when I was growing up – he’d go for walks in the evening and play golf in the spring/summer.  But all that gradually changed over the past ten years or so.  As his back pain became more pronounced, so did his excuses for why he couldn’t walk.  Well, that hopefully is about to change.  He was prescribed physiotherapy and exercises to start doing at home.  Even before his appointment, he told me he realized that he’s done nothing to help himself.  I really hope this was the wake up call he so desperately needs.

Today was an eye-opener for myself as well.  It was the first medical appointment I have ever attended with my dad. I stood in the room as his daughter first, but the physician in me knew from the questioning that surgery wasn’t going to happen.  Reading the MRI report is one thing, but hearing the story from the patient, my dad, was quite another.

Back in medical school, or maybe it was residency, I can’t really recall, we learned about the sandwich generation – becoming the caregiver for your own elderly parent while being a parent to one’s own children.

A study published in 2013 found that,

  • 20 per cent: Proportion of employed women and 17 per cent of men in the large survey which are part of the sandwich generation of Canadians.
  • 40 per cent: Portion of workers in the overall survey who report high levels of overload – both at work and at home.
  • 25 to 30 per cent: Portion of caregivers who cope with the pressures of work and family by bringing work home, giving up on sleep and trimming social activities on a daily basis – a response which raises the chance of employee burnout (and grumpy workers).
  • 20 per cent: Portion of male and female employees who are caregivers who turn down promotions because their plate is too full.
  • 63 per cent: Portion of caregivers who report emotional consequences of juggling work and looking after family, which includes stress, anxiety and frustration.

Add all of the above to a caregiver (me) who is also a physician? Oy.

Are you sandwiched?  Have you any advice? I’d love to hear it.

Doctor Heal Thyself

A few months ago, I saw a young woman in my office complaining of knee pain. She had just started running and after several 30-45 min straight runs developed anterior knee pain. Even before I examined her knee I knew she had developed patellofemoral pain syndrome (PFPS).

She had been a competitive swimmer in high school and hadn’t done any running before this. She just decided one day she was going to start running. I admired her.

Her knee examine was pretty straight forward. I was able to elicit pain along the inferomedial aspect of her patella; she had a very minor joint effusion, but otherwise the rest of her exam was normal.

I spent the rest of the visit counseling her on what PFPS is and how it happens. I spoke about imbalance in the muscles around the knee and showed her specific quadriceps strengthening exercises. I suggested she take a regular dose of an anti-inflammatory medication for at least a week if she was in pain. I advised her to get a proper gait assessment done for her running shoes and told her she had to stop running for a few weeks at minimum. She obviously didn’t like that last part but I reassured her that she would get back to her running if she listened to her body and took the proper steps to heal and strengthen her legs, particularly the quadricep muscles.

She returned to see me about six weeks later for a different reason. I asked how the running was going. She told me she took my advice and her knee feels great.

Remember that saying, “doctors make the worst patients”? It really is true. Ten days ago, at the first sign of knee pain, though I did “rest” I didn’t take any medication and I didn’t do the exercises. Granted I was on vacation with my family so having any time to myself to exercise was difficult. There were a few mornings I found myself alone on the deck so I did squats and yoga but it clearly wasn’t enough.

But, since the run two days ago, I have been faithfully doing my quad strengthening reps and taking acetaminophen for the pain. Normally I would be taking Ibuprofen but it’s been upsetting my stomach of late. I’d forgotten what a good painkiller acetaminophen can be; there have been moments when I think I could run again, my knee feels almost back to normal.  Gone is that annoying ache I experienced walking down the stairs! But I know that is the Acetaminophen working.  Not to worry, I told myself no running for another week, at minimum.

These particular quad sets, I find, are very helpful, but there are many more that are equally important.  Not only should I be strengthening the quadricep muscles, I also need to remember that the gluteus muscles and the hamstrings are key to a healthy knee as well.  I found this PDF to be particularly helpful. And just to prove that I am practising what I preach this time, here is a short video of me doing a quad set.  (And yes, that’s Katy Perry in the background and at the very end, my son demanding attention.)

 

 

Injured. Am I really a Runner now?

I most definitely have a bad case of Posterior Shin Splints, and now, the Anterior Shin Splints are making themselves known.

imagesshininjury

I had an x-ray and ultrasound of both my lower legs earlier in the week and not surprisingly, they tests were normal.  There is no obvious stress fracture, no periosteal reaction, the calf muscles looked pretty good (really good, actually) and there were no obvious tears seen.

Yet, I feel like I’m a mess.

The legs hurt more today than they did two days ago.

Oh, and I forgot to mention that I started riding my bike to and from work.  I need to keep exercising, I need to keep moving.  The bike ride is 20 minutes. About 5-6 km each way. It’s a great way to start the day.

But it’s not the same as running.

I see my physiotherapist on Friday.

I have to wonder how much of this is due to “too much too soon”, worn out shoes, the fact that I am almost 8 months postpartum and still carrying 15 lbs of extra weight.  Could the effects of those pregnancy hormones (to loosen ligaments) be making my legs weaker?

Am I just grasping at straws?

Do I need new shoes?  Do I need stability shoes or shoes with more cushion? Why do they make 500 kinds of shoes? Am I overpronating or supinating?

Why can’t this be easy?

Why can’t I just run without pain?

My girlfriend who runs told me I am likely going to need 6 weeks off running.

SIX WEEKS?????

She said I’m officially a runner now. Being injured is the badge of honor.

Great.

This sucks.

Injuries Can Suck It!

Last week, I ran almost 10km in two runs.  The first was just over 4km, the second was a run home from the office via a different route that took me to 6km.  That was on Thursday.  My legs ached a bit – that damn shin splint or soleus muscle strain or posterior tibialis stress syndrome – whatever it is, I don’t know for sure, but it ached the entire run.  I stretched and iced when I got home. Friday if felt okay, Saturday the same.  So, being the stubborn pain in the ass that I am, after I did 5km on the stationary bike, I decided to go out for a run.

I was forced to shut it down at 1.5km. Sharp, searing pain in the left calf/shin/whatever the fuck hurts.

Sorry for the curse words.

I am so, so frustrated with myself.  I have continued to run despite being injured.  I thought I was gaining some headway, taking rest days and icing even on days I didn’t run.

But no.  I have truly screwed myself this time.

It hurts now just to walk.  I carried the baby to the park in the Baby Bjorn and my lower legs are on fire now.  I don’t think I will be running again for quite some time.

I am the proverbial doctor who is a bad patient.

I am pretty sure I need either an x-ray to rule out bilateral stress fractures in the tibia, or an ultrasound to rule out tears in the soleus muscle. Or both. With my luck, both.

Is this what I get for running too soon after having a baby?  Are my ligaments and joints still in pregnancy mode?

What is going on????

I’m so defeated by this.  If I can’t run, I don’t know what I’ll do.  Sure, I can bike to and from work. I can get on the stationary bike at home and do my pilates and floor exercises to stay in shape. But that’s not the same as running. It’s just not.

Sorry for the debby downer post.  I am trying to look on the bright side here – but I’m not sure there is one.

Yesterday my husband, who is a fair-weather runner and hasn’t run in months, went out and ran 6km like it was nothing. Really?  I guess I just need to remember this:

On the Mend.

It’s been a crappy week, quite literally.

I got hit with a stomach virus earlier in the week.  The bright side is that I got to sleep 16 hours pretty much straight, but that was after a horrendous day at the office struggling to keep my shit together (pun intended).  I barely ate for three days and felt so incredibly weak. It was awful.

I really do hate being sick.

Today was the first day that I felt almost normal. So I decided I needed a run.  I didn’t think I’d be able to do more than 2.5-3 km so I was quite surprised when I reached 4.1 km and realized I could probably squeeze out the last kilometer and make it a 5km day.  That last kilometer hurt.  My calf/shin issue is still with me but it’s getting better, a little too slowly for my liking, but beggars can’t be choosers.

I had really hoped to start increasing my runs/week by now but that just isn’t happening yet thanks to the shin splint and this most recent bout of the stomach flu.  I can only hope that May will be a better month for running.