Thank you all for being so excited for me and my new gig writing for NBC New York! Yesterday, my second post went up!
Dori’s Quest: The Refine Method is a review of Refine Method, the workout I have been obsessed with for the last few months. This review is the first in a series I will be working on at NBC New York called Dori’s Quest – all about my quest to find the perfect workout in New York City. I will review different classes, trainers, trends and more. Expect to find these articles on Mondays. I am so happy that Refine got to be my first in this series; especially timely since they just won NY Magazine’s Best New Workout of 2011.
Back to business.
It is no secret that I am frustrated with the health care system in this country. I’ve mentioned my GI illness on here before but I don’t know if you know that I haven’t actually been to a doctor about it in almost a year and a half. I saw so many doctors and in the end they all told me there was nothing they could do, and sent me off to a surgeon. I ended up seeing two surgeons who both recommended major surgery that would essentially destroy my life.
Not good. Not necessary.
So it was a nice surprise to find an orthopedist who specializes in hips who I really liked. As I discussed in My Hip Injury: Part 1 and Part 2, the doctor sent me for an MRI — it showed a labral tear — as well as a cortisone injection and physical therapy. His goal was to get the areas surrounding my hip nice and strong to take the stress off my hip and, if I improve enough, be able to try and start training for the NYC Marathon by June.
I received a few aggressive — but well-meaning — comments in response to this idea.
I have a labrum tear and FAI and there is nothing that physical therapy, injections, rest can do to heal this injury . . . you should just have surgery and get it out of the way. Surgery is the only thing that will ever get rid of a labrum tear . . . Frankly, I think that your physician and therapists are misleading you to believe that your injury will allow you to run a marathon. By all means it is your body but the more complicated the tear the more complicated the surgery and the more complicated the recovery process and the less chance of a full and complete recovery . . . I always like to remember that A-Rod had a torn labrum in 2009 and was playing baseball 2 months later. If they labrum would heal itself with time then why did surgeons opt to fix him before the season instead of letting it heal or waiting until December for surgery?
Dori, while I think it’s great you are trying to do everything you can and you are seeing a reduction in pain I have to agree with the [above comment]. You could get a second opinion on your MRI but if you really have a labral tear, it will not go away on its own. If your labrum is already trying to heal, this sort of workload will surely do serious damage . . . Trust me I’ve been through all the self-talk, telling myself “Oh if I’m better by this date…” and I’ve come to learn, your body does not work by your brain’s deadlines. Your body does what it wants to do and you can only do so much. I don’t want to scare you but if there’s anything I could tell past me it’s to go easy and pay attention to your body.
I know the commenters were trying to be helpful. However, everyone’s situation is different and because the commenters are not physicians, I decided to make another appointment with my doctor. It was time for a follow-up anyway.
He stretched me this way and that and asked about my pain. I told him that since my cortisone injection in the middle of January, I haven’t felt that same sharp pain. And my thickened tendon that caused the swelling (and the majority of my pain) completely disappeared.
“That is excellent!” the doctor told me. “I often have patients who get the cortisone, and then two weeks later they are in pain again. Those are the patients I recommend surgery to. It is a very good sign that your pain hasn’t returned.”
Happy with this news, but still concerned (after all, one of the commenters said my doctor was misleading me!) I brought up the fact of labral tears never actually healing.
“If I MRI’d a group of people off the street,” the doctor explained, “a bunch of them would show labral tears.” It turns out that labral tears are extremely common, but are often asymptomatic so people do all sorts of activities without even knowing they have a tear. I felt my injury because of the inflamed tendon, and my acupuncturist felt hers because of a cyst that developed in the area — but for many people, the tear is so deep inside they never know it is there. And if that is just random people off the street, imagine how much more prevalent this is likely to be in the running community.
This means that many people do in fact run marathons with labral tears. While some bad cases would need surgery, a person can run a marathon without it. This doesn’t mean that I will definitely be able to run, but it also doesn’t mean I won’t.
My doctor — who, by the way, is one of a very small group of doctors in the city who specializes in hip arthroscopy — said that there is no reason someone as young as me, who is not currently experiencing pain, to need surgery. As for the comment comparing my situation to A-Rod, well that is apples to oranges. Not only does he um, lift heavy weights and do much more intense workouts, he also has (as my doctor made a point to explain) 10 years on me. And a baseball career. And not all labral tears are the same.
I am young. I have the luxury of time. If I can’t run the marathon, I don’t need to. Just because A-Rod needed surgery for a labral tear does not mean I can’t achieve my goals without the same surgery. Different degree of injury, different goals, different needs. The claim that his doctors are better than mine for not “letting him heal or waiting until December” is silly because his situation is totally different.
My doctor never told me the labrum would “heal itself” as that commenter implied. What he did tell me is that it is possible to work around a torn labrum since many people do this every day. As for a sabotaging my “complete and full recovery” — that commenter seemed to contradict herself, after just saying recovery was not possible. And while the tear is forever, some people can continue with their lives without getting surgery.
My doctor is a surgeon. He makes money from surgery. If a surgeon talks you OUT of surgery, don’t you think he has a good reason for that? It is in his best interest to cut me open. But he seems to be looking out for mine. Also, this surgery is new. Hip arthroscopy is only 5-10 years old in the United States. My doctor told me that the surgery technique this year is far better than it was last year. Next year, he explained, the surgery will be even better. Every year is another year this surgery has been around, and another year of knowledge. If there is no rush and I can function, why get surgery now when it will be better next year?
And he would not perform surgery on someone who is not in pain. He told me that as long as I am not hurting, I could try to start to slowly build up with my running. A slow mile, see how I do. Stop if I feel any pain at all. Increase. Repeat.
Obviously this is the news I wanted to hear, and my doctor was logical and made complete sense.
But because I don’t intend to take my situation lightly, I made an appointment for a second opinion with another hip specialist at the Hospital for Special Surgery. I brought my MRI images to show him.
When the doctor came into the room, he stretched my leg a few different ways, saying “So you hurt yourself training for the marathon?”
“No,” I replied. “I didn’t start to train yet, but I would like to this year.”
“But you were supposed to run the marathon last year.”
Where did he get this from? “No, I am supposed to run it this year.”
“Why didn’t you run it last year?”
“Because I didn’t get into it last year.”
This visit was off to a strange start. The doctor sat down on a wheeling stool, looked at directly at me and asked me if I am healthy.
“Yes, very healthy,” I told the doctor. He looked at me doubtfully.
“Do you eat meat?”
“Do you drink milk?”
“Then you are not healthy.”
And he said it with a smirk. If there is one thing that bothers me, it is a misinformed doctor. Even more than that, a misinformed, arrogant doctor.
(There are plenty of ways to be healthy without eating meat — in fact, there is a great deal of evidence that avoiding animal products is the best way to prevent cancer, heart disease, diabetes and many other illnesses. Brendan Brazier’s Thrive: The Vegan Nutrition Guide to Optimal Performance in Sports and Life offers incredible resources for athletes. And then there is Scott Jurek, the vegan ultramarathoner. He’s doing pretty well if you ask me. I am a vegetarian, and while I am not vegan, I do try to avoid animal products as often as possible. With my GI illness, this has helped me immensely.)
I told the doctor that I am, in fact, very healthy and that I have done a lots research about this — and had blood tests. He smugly shook his head. Then:
“You are too fragile and pale to run a marathon. Some people will never be able to run a marathon and you are one of them.”
I was confounded. First, by fragile I can only assume he means thin. Yes, I am a relatively small person. I have small bones. I know that he thinks I am only small because I don’t eat meat or drink milk, but when I used to do those things I looked exactly the same as I do now.
I am strong. I work out hard. And in theory, wouldn’t being smaller make me a better runner? I don’t know, but his claim still sounded ridiculous. Maybe plausible?
I didn’t take the morning off work and trek all the way to the East River to talk about my porcelain skin tone. I was there to hear what he had to say about my MRI and whether he agreed with my other doctor that I could try to slowly build up my running.
“You are fragile and pale. You are clearly lacking Vitamin D and calcium. You are going to get a stress fracture. I see many stress fractures, and every woman looks exactly like you.”
Whoa. Whoa whoa whoa. First, I didn’t go to the doctor to ask if I would one day get a stress fracture due to my “unhealthy” diet, pale skin and small frame.
Next, since when does the shade of one’s skin have any effect on their athletic ability? That is absurd! Yes, I am pale. I was born with pale skin. I heard it has to do with some newfangled scientific theory, something called genetics? Heard of that? Apparently we inherit traits from our family, and we, like, look like them or something. Crazy! Answers a lot of questions I had about my fro, though.
The doctor told me to get plenty of sun. When it is nice out, I do! But, I do not get tan. I get freckles. I will always be pale. Light skin does NOT indicate a Vitamin D or calcium or any other type of deficiency. At least not if you looked like this your entire life.
Dismissing his ridiculous claims, I turned the conversation to the reason I was there: just how bad is this tear and is my other doctor right in telling me I can try to run?
“Almost every MRI will show a labral tear,” he said. “It means nothing. Yes, yours shows a tear, but we can’t know for sure you really have a tear unless we open you up and look inside.”
Despite the fact that this doctor was . . . lacking . . . he did say the exact same thing as my other doctor about the general population and labral tears. Lots of people are walking around with possible tears, the MRIs of random people will show this, and it does not necessarily indicate a serious problem when there is no pain.
“Can I try to slowly build up my running?”
“Sure. But stop if you feel pain because you are going to get a stress fracture.”
Fine. Done. I can try to run. I will stop when I feel pain, which I would have done anyway, having learned my lesson the hard way about ignoring symptoms, getting myself into this situation in the first place. That is what I was there to hear.
I am nervous. I am scared. I will give running a try. I actually started last week and felt fine, but I am taking it really slowly and paying close attention to any signs of pain.
All I can say is — I am so happy that this was not the first doctor I went to about my hip.
Did a doctor ever tell you something ridiculous?