Another Doc, A New Idea

15 Mar


So, my new routine goes a little something like this:  wake up at 5, leave house by 5:20, get on train at 5:30, get to Flywheel for 6 AM class, take said class, walk to work, do 15 minutes on TM (that involves 2 minutes of running followed by 1 minute of walking, for 15 minutes total) shower, and be at my desk by around 8:15.  This is neither convenient nor particularly fun, but I’ve gotten sort of used to it.

However, getting up routinely at 5 AM may just be killing me.  I am so tired.  So very tired.  All the livelong day.  A lot of my friends have been popping out babies lately and I simply cannot fathom that brand of tired.  I try and think of them when I am feeling very sorry for myself and wanting to nap under my desk a la George Costanza around 2 PM.

I'd rather not divulge how many times a day I consider following his lead....

Anyhow… I’ve had a few days this week where my foot pain was nil (which was exciting!) or very low.  However, just when I think the pain is gone, I get a little gnawing reminder of it.  It’s not incapacitating and never has been, actually, but at this point, I just want it to go away completely so I can feel 100% confident about running and not having the PF rear its ugly head and end my running days for good.  I’m trying very hard to be smart and cautious and I’m hoping it will pay off in the long run.  (“long run”– so punny.)  I’ve read some horror stories about runners who persisted in running while they had PF and I do not want that.

My PT has me working on strengthening my hips, ankles, and core.  My right ankle is a big part of the problem, as its range of motion is very low (but has gotten much better!)  My calves are and always have “the tightest calves ever.”  (quote from PT.)  I’m working to loosen them up.  I’m seeing some results (slowly.)  But the foot issue persists.  And I know that despite how little pain I am in currently, it would come raging back if I chose to do a run longer than 20 minutes or so.  I can just tell.

Since I’ve been going to PT so much and reading so much about PF, I’ve formed an opinion that the issue (at least in my case) is not so much with my FOOT,  as it is with my running mechanics– the aforementioned ankle weakness, calf tightness, etc.  By the way, I think my PT is awesome and if anyone is looking for a recommendation, please hit me up.  I like that he takes a holistic approach to it and wants to fix the mechanics issues, rather than just focusing on my foot.  Anyhow, this belief is why I have balked at the notion of expensive orthotics (which obviously focus on the foot) and cortisone injections (which, more times than not, it seems to me, ease the pain, but not the issue.)  I am not interested in easing any pain, since, as I’ve said before, it’s more than bearable right now.  I am interested in getting rid of the PF completely and never seeing it return.

Now that I’ve given this long and rambling introduction… I saw a new doctor yesterday.  I really liked him, as he sat down and asked me a bunch of questions, listened to me, and took a long look at my feet.  He acknowledged that I had been very good about doing pretty much everything they consider to be a conservative treatment– not running, PT, sleeping in the splint, etc.  He then explained that he was fairly certain I had progressed from plantar fasciitis to plantar fasciosis.  That basically means, from what I understand, that my plantar fascia have progressed (or regressed, I guess?) from a point of inflammation to one of degeneration.  No one wants to hear that something is “degenerating” on one’s body and he acknowledged that it sounded scary, but it was very common– especially in runners.  He then did an ultrasound where he confirmed that I was indeed dealing with a case of fasciosis.  He showed me where the tendons had started to degenerate.  Then he told me how he likes to deal with this problem…

He suggested giving me a PRP injection.  PRP stands for Platelet Rich Plasma.  Basically, he would draw blood from my arm, spin it in a centrifuge to isolate the platelets, then inject the blood into my foot.  OK, I’m not a scientist, I don’t really get it.  Also, when I hear that he is going to be DRAWING BLOOD (eeeeek needles) and then INJECTING ME (eeeeeek more needles) I don’t really hear anything else.  Even though T and I love Intervention, I can no longer watch the ones about heroin because seeing needles gives me the willies.  One of my loved ones has to have blood drawn regularly and our family has come to refer to it as a “sparkle test” because too much talk of blood being drawn makes me ill.  (BTW, my code for anything icky or uncomfortable is sparkles and unicorns– picturing those things makes me happy ’cause I’m a girl and stuff.)

Oh hey! Look at that! It's a unicorn! This image has basically nothing to do with the subject matter, but I was getting a bit uncomfortable with all the blood talk, plus I've got a hella huge block of text going on here.

Anyhow, the doc said he had seen some really good results from this.  He said he saw me having a long running life ahead of me.  I asked him what his thoughts were on shockwave therapy and he said, “That’s a really good question.”  He seemed pretty impressed in general with my knowledge of PF and its treatment options and I kind of wanted to say, “Bro, I am OBSESSED with fixing this ish!”  Anyhow, he told me that shockwave therapy was the same idea as PRP in that it also re-injured the area in order to re-inflame it, (again, I’m paraphrasing and have basically no clue what I’m talking about) but that shockwave therapy was done in a series of sessions, where PRP is one injection, maybe two (nooooo), maybe three, (hail noooooo) and in the case of one runner he had done, four.  (For the love of G-d.)  Anyhow, he encouraged me to see another doc and look into it if that was something I was interested in, and I really appreciated his candor.

So, I found out that the injection is not covered by insurance.  And it is, um, expensive.  Not prohibitively expensive, but “Ouch, that’s more than I’d like to spend anywhere but Bloomingdales” expensive.  But I set up an appointment for next week.

Then I obsessively began reading about PRP.  I’m still obsessively reading about PRP.  If you’re curious, this is a good article about it.  It definitely clearly states the pros and cons and the research.  But it’s a year old, so I’m still looking for more research…

But I think I’m gonna do it.  I woke up Sunday morning and it was beautiful outside– warm and sunny and perfect.  I had the entire day stretching ahead of me and I was beside my sweetie.  Life was good.

And I cried.

Because ALL I WANTED TO DO in the entire world was run.  I knew it was ridiculous.  I laughed through my tears.  But I just felt so frustrated and tired of doing everything I’m supposed to do and not seeing results.

I woke up this morning, removed my Strassburg Sock (much easier to sleep in than the boot) and my foot didn’t hurt.  I felt encouraged and thought, “Maybe I won’t do this wack needle thing after all.”  But as the day progressed, the usual dull and irritating pain developed in my foot.  Same as usual.  The difference is that instead of immense, overpowering frustration, now I almost feel like there is a light at the end of the tunnel with this option of PRP.

So I think I’m going to do it.

Thoughts and opinions are very welcome, and congratulations if you’ve made it through this ridiculously long and dry post.

*Oh and in case I don’t get another post in before–  I’m watching Lori and Cheryl run the NYC Half on Sunday and hoping I catch a glimpse of Josie, too!  Good luck to them, and everyone else running!  And GOOD LUCK to my buddy Sara, who is running her first half this weekend– the National Half in DC!!! :)*

17 Responses to “Another Doc, A New Idea”

  1. Celia March 15, 2012 at 12:52 pm #

    If he saw signs of degeneration (scary!) then it seems logical that what you are doing isn’t going to make the problem go away. I would do it. Especially since it seems like there can’t be bad side effects (again I am not that well versed. really just as well versed as I could be from reading what you wrote) but they are injecting you with parts of YOU not some sketchy drug!! Seems safe! Good luck!!

    • Katie March 15, 2012 at 5:38 pm #

      Thanks, Celia!

  2. Kimra March 15, 2012 at 1:13 pm #

    The only thing I know about PRP is that I think Tiger Woods did it. And I don’t even know why I know that, because I don’t like golf.

    But anyway.

    It seems like if rest and PT aren’t fixing the issue, there must be something else that will. I’m with you on being opposed to cortisone, but this doesn’t sound like “pain relief” — it sounds like actually helping with restoring blood flow, which I know is a big issue with lower-leg tendons (and maybe all tendons? so not a doctor over here).

    Good luck with whatever you decide!

    • Katie March 15, 2012 at 5:40 pm #

      Well, Tiger and I have a lot in common in that I also love cheesy cocktail waitresses, so it only seems logical I should follow his lead here… 😉 Ha, kidding, obvs, but thanks for the encouragement!

  3. Cheryl Allison James March 15, 2012 at 2:09 pm #

    Ugh, that sounds like my achilles! It just won’t get better, and finally I was told to get an MRI. 😦 Clearly I’m running Sunday on it anyway though! I hope the treatment works and you can run with me soon 🙂

    • Katie March 15, 2012 at 5:41 pm #

      Uhoh… crazy lady, we will discuss this over brunch after your victorious run! (Though now I feel I should dissuade you, if you’re injured!)

  4. Kristy March 15, 2012 at 5:25 pm #

    i would do it – i agree with celia…degeneration is a word i don’t like. it totally changes your game plan. you have done everything you were asked to and you are still not 100%. i think it’s time for something new and different. fingers, toes, and eyes crossed for you 🙂

    • Katie March 15, 2012 at 5:42 pm #

      Thanks, Kristy! I’m giggling, picturing you walking around with crossed eyes.

  5. Dorothy Starzak March 15, 2012 at 11:56 pm #

    Just checked your blog and thought I would put my two cents in again. Good sign that the pain is subsiding. Now you should definitely get the PRP injections to nip it in the bud. Like you said, if there is some degeneration (and in most chronic cases of plantar fasciitis there is), then you will just re aggravate when you start running again. The PRP injection will stimulate a healing response as it will bring a high concentration of platelets to an area that has poor blood supply. Also, just the act of injecting has positive benefits as it creates micro-tears which again stimulate healing. With regards to tendinopathies and anything ending in an “osis” (i.e. degeneration), PRP has had really good results. I say go for it for sure! Even if it is expensive – your physical and mental health is worth it. As for the pain….you run marathons…of course you can handle it 🙂

    • Katie March 16, 2012 at 9:57 am #

      Thanks for the input, Dorothy! You sound very knowledgeable; are you a doctor? Either way, I appreciate your comments. Thank you!

      • Dorothy Starzak March 22, 2012 at 8:17 pm #

        No, not a doctor – just a biologist 🙂 Hope you managed ok with the PRP injections…let the healing begin!

  6. Kelly March 16, 2012 at 8:39 am #

    It sounds like you’re making progress, Katie! That’s a good thing:) I’ve heard of PRP and it’s definitely intriguing. I’m really curious to see how it works for you – maybe it’s just what you need! I’d probably fork over the $$ for it too if I were you. It sounds like this new doc is really interested in getting you back to running, which I think is so important! Good luck 🙂

    • Katie March 16, 2012 at 9:58 am #

      Thanks Kelly! I hope to see you in CP some day soon! I also may visit you at work so you can help me pick out new shoes. 🙂

  7. Lori March 16, 2012 at 9:43 am #

    Wow, what a post. First of all, I’m still so sorry you are going through all of this. Unlike me, I know you love running…I still have a love/hate relationship with this thing. So I know that not being able to do something you love has been beyond painful for you. But I’m glad to hear you saw the second doctor and gave you some options. I’m quite impressed at all the research you have done too! Fingers crossed that you are truly on the road to recovery! And soon the tables will be turned, and I will be cheering you on at the next race!! Stay positive, Baber! xoxo

    • Katie March 16, 2012 at 10:00 am #

      Thanks, as always, for the support, Baber! Meantime, I’m looking forward to watching you crush the Half on Sunday!!!!!!

  8. Stephanie March 16, 2012 at 10:49 am #

    I had no idea you had a blog until just now! Good luck, sweetie. I think it’s worth all the money in the world to see you on your feet again, doing what you love. I definitely think you should try a proactive therapy like PRP or cortisone. My mother had cortisone treatments when her knee was inflamed, and it was definitely more than a pain relief treatment – it eradicated the swelling and allowed her joints to heal. She was able to walk normally again within weeks. She had a completely different problem, but it did prove that cortisone does have legitimate medical uses! No matter what you decide to do, I’m rooting for you! XOXO

  9. Josie March 19, 2012 at 11:14 am #

    Hey Katie! That sucks that your foot is still giving your hassles- but I guess its good that there are more options to try. I really think I am going to see you running in Central Park this spring and if not, for sure in the summer!! 🙂

    I didn’t see you in the park yesterday during the half but I imagined you were there! It was a great run so if you did come, thanks for cheering! 🙂

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: