Finding Patience as a Patient

Those who know me, like really know me, will tell you I am not patient. Unfortunately, my podcast co-host and triathlon Coach, Liz, finally caught a glimpse of it the other day and called me out. She told me I was being a "pill" - I think that was a generous way of putting it. 

I try to keep a lid on that personality flaw, but sometimes, it escapes. Usually, it's when I am waiting in a line - a virtual or real one - when I am behind the wheel, and definitely when I become a patient! 

The first question I get from an injured athlete is when can I (fill in the blank). Most of the time, I can approximate the typical rehab times for specific injuries, but that doesn't consider all the factors and variables that come with humans. We are different; our lifestyles, health histories, and other health-related factors are varied and impact or can delay recovery. What we eat, how we sleep, whether we do our exercises, our age, whether we were strong and stable before the injury…The list is really long. 

I empathize with patients - I know how agonizing it is to not do what you want to do - whether it is a beloved sport like running or not. It's torture, the waiting. "Trust the process," I tell my patients. And I believe it when I say it, but when I have to hear it, I want to jump out of my skin. But for the first time in my running injury history, I demonstrated patience as a patient, and it paid off. 

My knee surgery was on August 1, 2023. I am happy to report that I finally feel back to normal after 5 months (12+ months since the tear and knee pain began). I can run, bike, and strength train at the intensity and volume I consider my new norm, and I can go up and down the stairs. I am still determining exactly why I was patient this time around. Perhaps it's because I didn't have the energy to fight and resist. It was easier to take one day at a time and not look too far ahead. 

There are a few things I did that helped. First, I did not subscribe to a timeline. I accepted an open-ended, "it will happen when it happens" approach. I participated actively in my recovery, but I didn't worry about the time it was taking to get through the steps. 

Second, I made no commitments to myself or anyone else to do this thing or that - like sign up for a race or event - even if it was far out in the future. I'm still not ready to do that. 

And lastly, I was also honest with myself every single step of the way - listening to my body carefully and accepting what it could do on any given day. Some days were good, and others weren't.

I also filled my time with other things to keep me busy. During group runs, when I'd typically run long distances with my friends, I found something else I could accomplish physically - besides laying on the couch and feeling sorry for myself - which was what I really wanted to do sometimes! 

While recovery was a long road and considerably longer than what the research suggests is a typical timeline, it doesn't seem like it, and I think that's because I was patient with it. Now, if only I could find that patience with other aspects of my life…

Welcome Aboard My Rehab Coaster

"We're gonna take you up really high, drop you really low, and you'll go really fast!" - Roller Coaster Operator

On my way to physical therapy today, I must've passed ten runners taking advantage of the cooler temperatures this morning and experienced an equal variety of emotions from jealousy, inspiration, joy, hope, worry, trepidation, resentment, frustration, and excitement to determination. Phew, that's a lot for a commute on a Tuesday morning! 

I wanted to be on the road pushing the ground away behind me, enjoying the occasional spray from lawn sprinklers, the smells of fresh-cut grass, and the "good mornings" from other runners. My yearning quickly took a turn into jealousy.

But just as suddenly, this jealousy dissolved into inspiration to remain determined and focused on rehabilitation. Chick, chick, chick uphill in my brain, I visualized a triumphant return to running, filling me with joy and excitement.

Then the image took a steep dive into worry. What if? What if the surgery isn't successful, no matter what I do or how hard I work? Or what if it is a success but not enough to run again? Science doesn't back that up, but this autoimmune disease may stop me. Resentment and frustration toward my body burbled to the surface. How dare my body fail me! How dare it give up! 

Welcome aboard my rehab coaster. It's a wild ride that makes my stomach drop. Sometimes I feel happy and raise my hands; other times, I feel scared and grip the seat belt. 

Fortunately, I'm not alone on this ride. I have my friends and family for emotional support and my physical therapy colleague, Sam, to hold me accountable. 

Like I tell my patients, rehab is not a perfect trajectory to the end goal. There are ups and downs, both physical and mental. And I suppose if I dish out that advice, I better take it. So while on this rehab coaster, I will try to keep my hands, feet, and, most of all, my head inside the ride “at all times.“

Waking Up on Jupiter

I woke up on Jupiter this morning, where the gravity is 2.5 times that of Earth. My 120-pound body felt like 300 pounds. It was hard to lift my arms and legs. And then, I realized, I was still on my home planet; no one stole all the oxygen; this was a sudden fatigue attack and a hallmark symptom of my autoimmune disease.

Fatigue can come on suddenly. For me, it starts with ringing in the ears and then an overwhelming feeling of heaviness. In the past, I've experienced normal fatigue from lack of sleep, dehydration, stress, or the result of training, but this feels different - it is overwhelming and uncontrollable exhaustion. The cause is increased inflammation in the body.

Did I do something wrong? Did I do too much yesterday? Was it all that time in the sun? Was it the wine I drank last night or because I rebelled and didn't take my supplements? Maybe it was that sugary bread pudding. It was probably all the things. But that is frustrating because I want to be able to do it all. I want to rebel sometimes; I want to paddle board with my friend during the day and go to dinner to celebrate events with my family and not pay such a hefty price.

As I explain to my athletes and patients, the answer to wellness and success is to strike a balance; it will take some time to figure out the recipe that works for me. But it won't change today. What can I do about today? What if I feel like this tomorrow and must go to work?

That's when I got to thinking. The brain is powerful. When I suddenly find myself on Jupiter, what if I visualize that I am instead on the moon? Maybe I am a helium balloon. Does this change the chemistry in my body? Will it help the inflammation that is causing the fatigue? Maybe! The conscious mind is powerful. It can partially control how much oxygen is delivered to the musculoskeletal system by regulating the heart rate, blood pressure, and respiration. Wow, right?

More studies are needed to examine the effects of mindfulness on the immune system. But, regardless of the physiological impact, it is worth trying if it can even slightly alter my perception. So, with that in mind, off I go, on the moon in my space suit today, taking one small step into my new reality.

Rebel With A Cause

First Triathlon

I'm a rebel. Behind this smile lurks a devil of a girl who stamps her feet and throws tantrums against convention- a lot! That may surprise most people, but probably not my family (especially on game night).

If you tell me what to do or demand I do something, chances are, I won't do it, and if you suggest I'm unable or not allowed to do something, that acts as a catalyst for me to do that very thing. 

In her book, The Four Tendencies, Gretchen Ruben defines a rebel as resisting all outer and inner expectations. Rebels do what they want, in their way and in their own time, and if someone asks or tells them to do something, they resist.

A rebel then would be highly unproductive, right? Not necessarily! Rebels often own and operate successful businesses and meet goals like training for and completing a triathlon. 

Presented with a choice and a challenge, I will act. Sprinkle in doubt from others and perhaps a little self-doubt too, and you've started the engine. 

There are countless examples and experiences throughout my life where doubt from others motivated me...

In high school, my coach did not select me as a co-captain of the cross-country team, which only bothered me once he pointed it out and explained why. But later, I wondered, do I not have leadership qualities? That seed of self-doubt certainly contributed to my success in operating two businesses and as a coach of runners worldwide. 

Teachers told my parents at conferences, "She is flighty, an air-head" #dumb! - This fueled my dedication to studying and achieving a pre-med degree in human biology and a master's of science in physical therapy. 

Recently, I was learning a new card game and lost hand after hand after hand. And with each loss, my ugly temper grew so much so that my husband said, "Maybe we should stop playing." I was ready to call it quits, but after that statement, I responded, "Not until I win." I'm sure hubby wanted to keep playing and knew this would keep me in the game. 

The pitfall of being a rebel is the tendency to rebel against the self - the inner expectations. So, even when choosing a self-imposed goal, like, "Let's not eat gluten," I may follow through for a long time, like eight years, only to stop with total agency inflammation be damned. Like Forest Gump, when one day he ceases running and says, "I'm pretty tired. I think I will go home now." 

Now, I face a new challenge that will require positively directed rebellion. I was recently diagnosed with an autoimmune disease. It affects everything I do, from endurance training to working and simply functioning daily- but I will not let it take over. I will not cave to it. I will revolt. 

Go on, tell me I can't...