Two Blood Tests, 6 Months Apart with InsideTracker

In August of last year, I was obviously at a low point. I was in a boot while what felt like the entire city of Chicago was barreling toward peak week in preparation for the marathon in October. I was confined to 6 weeks in a boot and begrudgingly found new ways of cross-training through my injury. My doctor gave me these initial steps to take when we confirmed that I had a stress fracture in a metatarsal in my left foot:

  1. MRI Monday, August 17th – confirmed stress fracture, possible neuroma in between 2-3 metatarsals
  2. Began wearing Aircast Tuesday, August 18th
  3. Bone density scan conducted Wednesday August 19th – confirmed healthy
  4. Began taking 600 mg calcium 2 x a day, 2000 IUs vitamin D 1 x a day on Thursday, August 19
  5. Blood test (Vit D & Ultimate Panel from InsideTracker) scheduled Wednesday, August 26th

I researched InsideTracker a bit before after seeing Julia Webb’s post on her experience. So when they saw my updates on Twitter about my stress fracture and reached out offering a free test, I couldn’t say no (especially because I was so down in the dumps then and wanted to figure out why this darn injury happened).

For anyone that isn’t familiar with the service, InsideTracker provides blood test analytics personalized for you, based on your lifestyle and nutrition factors. I’ve had blood tests in the past but it always seems to fall short — so much of a blood test and its entire process depends on your relationship with your primary doctor and the recommendations he or she may be able to give you based on the results. I’ve independently taken blood tests in the middle of training cycles just to make sure I’m doing everything I can to stay healthy. But I always felt like I needed help to figure out what steps I could take to optimize markers that were either too high or too low. And the recommendations for a runner can often be very different, as compared to an athlete in another sport or a person that doesn’t exercise regularly. (For example, runners often need to pay specific attention to their iron/ferritin levels –and the recommendations for a ‘normal person’ don’t cut it for long distance runners.)

Enter InsideTracker. 

  • Purchase a test.
  • Schedule a blood draw at a local Quest Diagnostics (so quick and easy to do online).
  • Wait 3-5 days for your results to pop up in your InsideTracker account.
  • Implement the recommendations they give you!

….So freaking simple.

Here’s an example of what you will see on your personal dashboard after your results have been received.

Screenshot 2016-03-29 15.46.49

I like the InnerAge component. Based on results for the test I had done in August 2015, I had 6 factors that needed work and 3 that were at risk. The main markers my doctor was interested in and that were specific to my stress fracture were calcium and vitamin D.

Screenshot 2016-03-29 16.10.20

You’ll notice that there are two readings for Vitamin D. I took a second blood test a few weeks ago, so the tests were just over 6 months apart. My Vitamin D is considered to be high both times. My doctor was comfortable with my result in August, so we were able to rule out this deficiency as a factor of my injury. This winter, I consistently supplemented with vitamin D but it appears I was probably overdoing it. Just as InsideTracker recommends, I’ll be reducing the frequency of this supplement (even more so now that my chances of seeing the sun in the morning and evening is higher!)

Screenshot 2016-03-29 16.10.30

My calcium result surprised me. I had only begun to take 600 mg of calcium 2 x a day the week prior to this August blood test. The second test I had done this month did not include Calcium as a biomarker, so I’ll be curious to see where this is at when I do another full panel.

There’s a lot to be said for a service that makes the most important part of the blood testing process extremely simple. I’ve chosen two main goals for optimizing my results: I want to sleep better and boost my energy throughout the day. Based on these goals and the markers that need work, InsideTracker tells me that I should eat more lentils and chia seeds, supplement with garlic and berberine to lower my cholesterol, consume more nuts and drink green tea. These are all things that I feel like I can do. It’s easy to complicate the ways we choose to take care of ourselves. It’s nice to have a solution that dumbs it down for you as an athlete.

And the best news is that they have a new panel that’s designed specifically for endurance athletes: the High Performance Panel. My latest test, this month, was this panel. It includes markers specific to rest, recovery, strength, power and endurance — basically, anything that could help you determine how to improve your running. Out of these markers, I can personally work on optimizing:
  • cortisol
  • vitamin D
  • vit B12
  • Ferritin
  • hs-CRP

I find these factors interesting and I also wonder if the timing of this blood test impacted my blood test results. On Sunday, March 13th, I ran 20 miles. And my blood test was the next afternoon. I’m wondering if specific endurance and inflammation factors would have had different results if I had waited a few days. Something to look into!

The High Performance Panel is half the cost of the Ultimate Panel and specific to markers that endurance athletes should care about. I’m excited about it because the lower price point will allow me to test more often – instead of when I feel like training isn’t going well or when I feel fatigued or low energy.

Screenshot 2016-03-29 16.20.24
If you’re interested in giving InsideTracker a shot, you can use “HPJENNY” when you checkout for the chance to win a free Ultimate panel as a follow-up (It’s worth $499 — and included 30 total biomarkers!) 
– JP
Advertisements

Back to Running Post-Fracture!

I….have…returned. 🙂

I mean, ‘returned’ in the sense that I can now run 50 min straight pain-free and I’m starting to build up my endurance again. After 6 weeks in the boot and 8 weeks on a return to running program that started very conservatively, I’m so happy to be back at it.

2015-10-02 12.50.40

As this was my first stress fracture (and hopefully my last), this was all new territory for me. I tried not to have any expectations about what running might feel like or how fast/slow I would be running. I think one of the biggest surprises was that, even after the boot came off for good, I didn’t have much motivation to actually go running. :gasp!: I put my run/walks on my calendar just like I had with my cross-training sessions all summer, but when it came time to actually lace up my shoes and head out the door, I’d kind of stall. I think that happened for a few reasons. First, I was scared. Scared for mostly nonsensical reasons, but the most legitimate being that I thought I’d injure myself again. I think most runners feel this way after any injury, not just stress fractures. Second, running does NOT feel good when you’re not in shape. Seriously, this was a revelation for me. I think we (the Royal ‘we’ of runners) take for granted the periods when we’re in shape and running feels like meditation. Because getting back to running, even in 5 minute segments with a walk break, can be really tough. On one hand you’re so happy to be *able* to run, but sad that it doesn’t feel the way you remember it. It takes patience and time.

My first run/walk was 2 x 5 minutes the week of September 28th. I took a few days after my doctor cleared me to just get used to walking around in a PAIR of regular shoes. I’m glad my doctor recommended this to me – even my hips had to get used to walking like a normal person.

2015-10-02 12.52.58-1

Running for 10 minutes total had me smiling literally the rest of the day. It was weird and glorious and awkward and amazing.

I couldn’t believe how weird running felt on that first run. Within the first minute, I thought, “Does running normally feel like this? Do I pound the ground like this all the time?”. It’s a really disorienting experience when you haven’t done it in awhile. I realized that there’s a reason why so many people say they “gave running a shot once” and didn’t like it! Despite the amount of cross-training I did, returning to running wasn’t as glorious as I thought it would be. But I took it day by day, stuck to the schedule, and tried to stay patient.

I really like the plan I followed. I don’t think I would have had much fun trying to run even 1 mile straight the week that I was cleared by my doctor. I’m glad I eased into it and took my time (and that I’m still doing that). The plan started with 1 run, followed by 2 rest days. Then, it was a run every other day. Then it was 2 runs, followed by 1 rest day. You get the idea!

Screenshot 2015-11-23 16.02.54

Feel free to click on the image for a closer view. 

The first few weeks, I continued with a decent amount of cross-training. I had been doing 5-7 hours of cross-training while recovering and it helped keep me sane. I still needed that dose of sanity while starting the run/walk program.  I also had the opportunity to connect with an ElliptiGO rep, Chuck (now friend!) a few times to cross-train that way and honestly, I was so giddy to be OUTSIDE exercising and getting a great workout. Being injured in the summer while everyone trains for fall marthons was maddening at times, so having an opportunity to get out of the gym and exercise outside meant a lot to me. [If anyone has any questions about the ElliptiGO, I’m happy to answer or to connect you with Chuck!]

2015-10-25 13.32.59 2015-10-25 09.36.38 2015-10-25 09.02.39

All of my runs, so far, have been time-based as opposed to mileage-based. Some days, 35 minutes straight of running would feel effortless and others it felt so.darn.long. And sometimes a 3 hour long run during a marathon training cycle feels worlds away from what I’ve been doing. But I think, ultimately, a time-based schedule forced me to just get out the door and not focus on the mileage — just to get moving was important.

I’ve had some really, really great runs too. My first tempo effort was 3 x 5 minutes tempo a few weeks ago (note: I waited 6 weeks until I did anything up tempo.) I was ecstatic when I got home from that run. Tempo pace felt so smooooooooth and my stride felt like it had come back. Each week, I feel like the little pieces are starting to fall into place. My second tempo was 3 x 1 mile and it felt just as great. It’s a good feeling to do 20ish minutes of work!

So, what’s happening now?

Well, I’m going to slowly build my mileage through December. I’ve put a plan together that should help bridge between where I’m at right now (20-25 mpw) and the beginning of a 16-week spring training cycle in January. I’m registered for the Shamrock Half in Virginia Beach and honestly can’t help but think about how much fun that weekend will be with Corey, Liz, and Chanthana. It’s doubtful that I’ll be in shape for a PR in the half by then but I have a feeling it’s going to be a great chance to get to a start line again. It will be my best shot at a good effort before racing the Carmel Marathon near Indianapolis in April. I ran the half at Carmel in 2012 in 1:36:08. [I seriously feel like that was 5-6 years ago…so much seems to have happened!] I’m looking forward to the ‘hometown feel’ of Carmel, just as I did at Monumental 2014.

2015 was a poor year of training and racing for me. Looking forward to a fresh start in 2016!

 

 

 

Recovering From a Stress Fracture: My Experience & A Guide for Others

Today marks the beginning of the final & 6th week in #dasboot. To be honest, I kind of can’t believe I only have a week remaining in this thing. The day I first strapped it to my leg, I thought, “well, shit. This is going to be the worst 6 weeks everrrrrr.” I was pretty crushed that a fall marathon would be out of the picture (I’m not crazy enough to attempt 26.2 after 6 weeks off.) But I’m happy to report that with a little bit of consistency and a cross-training plan that felt oddly similar to a running training plan, I’m making it through just fine. A big mental boost was reaching the halfway 3-week point and thinking, “that wasn’t so bad. I can do it again.”

Recovering From a Stress Fracture: Life In the Boot

An attempt at making the boot look fancy.

I think one of the most frustrating things when I first found out that I had a stress fracture was that no one seemed to have information collected about what you can and cannot do while allowing a fracture to heal. Sure, there’s a LOT of information out there. But not all of it sounded wise to me and a lot of it just sounded entirely mind-numbing. [The only exception to this being Camille Herron’s blog. I devoured her posts about her own experiences with stress fractures and found them really helpful. I can see why more than a few people recommended them to me.]

So, I set about collecting information that seems reputable and trustworthy. I gathered it for myself at first, but I want to share everthing that I’ve done in the past 5-6 weeks so that anyone out there dealing with a stress fracture can get a good picture of what they can do while injured. I’m not the type of person to just sit on my a** for 6 weeks & hope to stay in some kind of shape. I wanted to do everything I could to stay fit so that getting back to running wouldn’t be a complete strugglefest. I realize I am *also* not a doctor or therapist authorized to give this advice. Everything I’ve done to recover has been 100% pain free. If my foot hurt or was uncomfortable, I would stop. I think it’s important to keep moving through an injury as long as you’re not experiencing pain.

So, the first step was obviously following doc’s orders.

Checking the vitals:

  1. MRI – confirmed stress fracture in 2nd metetarsal on the left foot, possible neuroma in between 2-3 metatarsals
  2. Began wearing Aircast (AKA #dasboot)- ordered for 6 weeks non-weightbearing – Approved exercise included seated-only spin, pool running, and mat-based pilates.
  3. Bone density scan – completely normal result [This was more a precaution than anything – I have no history of female athlete triad problems, but checking bone density was a smart step to take.]
  4. Began taking 600 mg calcium 2 x a day, 1000 IUs vitamin D 1 x a day
  5. Blood test (Vit D & Ultimate Panel from InsideTracker) – more on this in a future post, but Vit D and calcium levels found to be in healthy range. [Note: If you’re interested in giving Inside Tracker a try, they’re giving my connections the best discount possible only through December 1, 2015! Use this code when checking out: “BFRJENNY”]

Next, I made a list of things I *could* do instead of thinking about the one thing that I couldn’t. So, I decided to …

GivE Pool Running A Shot:

I decided that in addition to spinning (only seated; standing was ruled out because it’s weight-bearing), I wanted to give pool running a try. I’d never done it before and from everything I read, it was an activity that would keep my running-specific muscles in shape without impact on my foot. My first trip to the pool was pretty comical. It was a gorgeous Chicago summer day. The public pool in my neighborhood was fairly busy in the later afternoon. While the shallow end was full of kids splashing around, the ‘grown up’ area in the deep end was …completely empty. Adults were sunbathing on the pool deck and I sauntered in wearing my boot and carrying an AquaJogger a friend let me borrrow (thanks Lynton!). I’m fairly certain that at least 70% of the pool goers thought that I couldn’t swim and actually needed the AquaJogger to enjoy the deep end. In fact, I am able to swim. 🙂

2015-09-15 15.50.45-1

I wrapped my iPod cord around my ponytail and clipped it to my hairband. Works wonders for pool running!

That day, I did 30 minutes of ‘easy pool running’ and it felt like I had gone for a long run of at least 90 minutes. It’s definitely not easy and it takes a little getting used to, but once you get your balance and your body gets used to the movement, it’s a great workout.

I was really looking forward to getting some fresh air while doing workouts at the outdoor pool, but it closed for the season on Labor Day. For a small fee, I added another one of my gym’s locations to my current membership in order to use their indoor pool. Logistically, it’s more difficult but well worth it.

*Note: an unexpected hassle of all of this cross-training is that I have to constantly work around the group fitness schedules for the spin room and the pool. I didn’t want to attend a spin class and be the only one seated for the duration (even though I’m sure the instructors would understand) and I don’t want to get in the way of others doing swim workouts in the pool. I put workouts on my calendar just as I would work meetings because of these conflicting schedules!

Here are some helpful pool running resources I found:

Cross-Training Plan:

The first few weeks, I struggled to find the motivation to actually commit to a cross-training and strength-training routine. I wallowed a little bit while I collected resources & tried to figure out what I wanted to do. Looking back on my training log, though, I’m actually surprised I dragged myself to the gym after just two days in the boot and then to the pool for my first pool running workout just two days after that. In the first week, I had my MRI & bone scan — and spent much of the rest of the week pretty bummed.

Here’s a short synopsis of the cross-training I’ve done the past 5 weeks:

Week 2: 
Monday – 1 hr spin

Tuesday – 45 min spin + 30 min Pilates abs DVD

Wednesday – 1 hour spin with 10 x 2 min sprints, 1 min RI + 25 min core & glute strength routines

Thursday – 36 min pool run – 2 x (6 x 1:30 hard, 30 sec RI) + 30 min glute & arm strength routines

Remainder of week – traveling to Copenhagen! 

Week 3: entire week in Copenhagen on vacation! No exercise

We spent at least 6-7 hours of each day walking around the city. Because I was on my feet so much (in the boot the whole time), I didn’t have much energy to workout in the hotel gym. I slept soundly, enjoyed every single delicious meal, and enjoyed time off.

This vacation had been on the calendar for months but I think having a getaway while injured is a great idea. Getting completely away did wonders for my mood & distracted me from thinking about how many more days I had left in the boot. Put fun things on the calendar if you can!

Week 4: Back to it!

Monday– Rest + jet lag

Tuesday– 80 min spin

Wednesday – 90 min spin + 30 min strength (core, arms, glutes/hips)

Thursday – 45 min strength (Pilates DVD + random YouTube videos – this channel is particularly challenging and has a lot of workouts that can be done while injured)

Friday – 60 min spin + 20 min core strength

Saturday– REST

Sunday – REST

Week 5:

Monday – 60 min spin with 12 x 2 min hard spints, 1 min RI

Tuesday – 45 min pool run (ladder workout) + 35 min strength (core, glutes/hips, arms)

Wednesday – 90 min spin endurance

Thursday– REST

Friday – *55 min pool run (8 x 2:30 hard, 1 min RI) + 90 min spin (endurance with 10 x 1 min sprints at finish) = 2 hours 25 min cross-training session!

Saturday – REST – so much fun with friends in town & spectating Corey’s tri + beer festival

Sunday – REST

*I made a point to do one longer cross-training session this week to replicate the feeling of a long run. Splitting it up between the pool and the spin room was nice. I listened to my iPod in the pool and to a few podcasts on the bike so that the time would pass quickly. I definitely left the pool feeling like I worked hard. And the next day my legs were sore for the first time in weeks. Success!

Week 6: 

Monday – 75 min spin inc. 10 x 3 min sprints, 2 min RI (almost almost almost felt like 10 x 800s!)

Tuesday – 55 min pool run (2 sets 8 x 1:30 hard, 0:30 sec RI) +

Wednesday* – 60 min spin + 30 min strength (core, hips/glutes, arms)

Thursday *– 60 min pool run including 45 min ‘steady’ + 30 min Pilates core DVD

Friday* – 60 min pool run (7 x 5 min hard, 1 min RI) + 90 min endurance spin

Saturday & Saturday – REST + fun plans!

*Wednesday-Friday = what I have planned the remainder of this week

Once I got into a routine, I found it pretty easy to do 5-6 hours of cross-training a week and commit to strength training.

Don’t get me wrong. There have been some days when the absolute LAST thing I want to do is go to the spin room at my gym or take the bus to the pool to run. I miss my favorite running routes and especially the lakefront, especially given that it’s been so nice out lately. But lacking motivation to work out isn’t far off from a normal training cycle, especially when training for a marathon. It’s not all going to feel good and you’re not always going to want to do the work.

Strength training:

I had to modify some of my strength routines slightly to be non-weightbearing. I cut my hip/glute strength routine down to just two simple exercises because the rest of them put pressure on my foot. I know that once I’m cleared for normal exercise, I need to vigilant about committing to that routine again. The core routine is pretty similar to what I was already doing but I swapped out a few exercises. (Example: hip bridges were swapped for other exercises because I normally do these on a single leg – and didn’t want to put all of my weight on my left, injured foot.)

MODIFIED CORE ROUTINE:
  1. Slow bicycle
  2. Side plank – on knees!
  3. Bird dogs
  4. Leg lifts
  5. Locust pose/ Superman
  6. Australian crawl – (swim freestyle on stomach)
  7. Donkey kicks – 15-20 each leg
  8. Pushups with bent knees
  9. Side crunches- obliques
  10. Crunches with knees up – chair or couch
  11. Long lever crunches
MODIFIED Hip/Glute Routine:
  1. Clamshells with resistance band
  2. Lateral leg lifts

“Return to Running” Plans:

This advice is completely premature, as I’m not out of the boot quite yet. That said, this return to running plan caught my eye. A lot of others I found didn’t seem suited for a somewhat competitive runner. This seems like a conservative plan that aims to get you back to a full hour of pain-free running in about 7 weeks.

Screenshot 2015-09-24 16.03.00

My list of RECOVERY SANITY TIPS:

  1. Do something OTHER than obsessing about not being able to run. I picked up 2-3 books that I’ve been meaning to read and enjoyed actually having the time to read them! We fill our time so much with running sometimes that we forget there are other ways to enjoy an evening. I also went to a concert, joined some friends at a beer festival, celebrated a friend’s engagement, and scheduled dinners with friends on nights when I’d normally be running. 6 weeks is a good mental and physical reset.
  2. Podcasts podcasts podcasts, music music music. I listened to music in the pool and podcasts on the bike. There’s endless entertainment to get through hours of cross-training.
  3. Drink beer. There’s really nothing more I should have to say about that!
  4. Especially if you’re wearing a boot, wear a shoe with a heel or higher stack height on the opposite foot. I attempted to wear flats for all of 2 days after I started wearing the boot and my back was already noticeably sore. If you wear a higher shoe on the opposite foot, your hips won’t be all out of wack. (I was tired after walking so much in Copenhagen but not nearly as much as I would have been had I’d worn a flat.) ALSO – if you’re using the standard Aircast, buy a cheap insole to stick in the bottom of it. The boot itself is completely flat, so my doctor advised me to buy an insole so that my arch didn’t become sore and cause other problems. 2015-09-25 12.54.31 2015-09-25 12.55.22
  5. Complain to people that love you – to a point. A group message with friends can really help your mood when you’re feeling down and out. I tried not to complain about my own situation but whenever I did, I felt like my friends were there to make me laugh and ultimately get through 6 weeks without going crazy.
  6. Think about what your next race might be but do NOT register for it. I’m reminding myself of this even more now that the boot is close to going in the trash :fingers crossed: At first, I thought, “Oh, well I can definitely run a half before the end of 2015!”. Now, I feel like the last thing I want to do is rush back into a training plan. I’m looking at a run/walk plan for the first 4 weeks that includes 1-2 rest days between every single run before I get back to a normal schedule again. I’ll register when I feel ready but I haven’t spent much time dreaming about racing lately.
  7. Know that a lot of other runners have ‘been there, done that’! I was surprised at the number of strangers that asked me what happened to my foot and had a story of their own to share. While I didn’t really welcome it at first, it gradually started to make me feel like I wasn’t alone and that 6 weeks isn’t an eternity. Know that your life will still carry on and there are so so so many more miles to run in the future.

In my last post, I wrote: “I figure I either have 6 weeks to get a 6 pack OR 6 weeks to drink a many 6 packzzzz. I have a feeling those goals are not simultaneously compatible, but I think I’m up for the challenge, as always.” I can’t say whether or not I have a 6 pack and I lost count of how many 6 packs I consumed in 6 weeks so… let’s just say I’m feeling much better about running and *enjoying it* the rest of this year.

I hope this post helps someone else recovering from a stress fracture!

-J