I don't think it worked.

So it's been eight days since my steroid injection, and I have disappointing news.

In the days following the shot, I wasn't quite sure it was working.  I woke up Saturday a little sore, but that was mostly from the shot itself, and not from my injury. (Apparently a very large needle was used and it makes you sore for a few days...  I hadn't seen how big it was when I was injected).  Sunday and Monday I woke up with no soreness at all, which I thought was good since I had been waking up feeling pain in my hamstring/butt before the shot.  Then Monday afternoon, I took a little bike ride--just like five miles or so to keep Dane company while he ran--and I could barely feel the injury.  Monday evening, as Dane and I were eating dinner at the delicious Langosta Lounge in Asbury Park, I started feeling the tight/tingly sensation that I always feel when I sit down for long periods of time.  I had to sit with my leg crossed over my knee for most of the meal.  Tuesday, on the bus ride back to NYC, I had trouble sitting down for the whole ride and found myself constantly adjusting my legs.

The doctor said it would take about a week for the steroid to have its full effect, so I kept a positive outlook.  Thursday was the 2 x 2 relay.  I figured it would be fine to do since it was about a week after the shot.  My butt actually felt fine during the run itself, although the rest of me felt completely out of shape.  It was my first time running at all in almost two weeks, and it felt that way.

Bernd was my partner for the relay.  We were Team "Muffin Hunters," named after the prize muffins VCTC gives out to all the age group winners.  Bernd took the first leg and I took the second.  When I went out, Daniel from FRNY was about 100 yards ahead of me.  I think I let the my competitive instinct make me go out too fast, though, as I set my sight on him from the very beginning and tried to close the gap between us.  I ended up catching up to him in about a half mile, but as soon as I did I knew I wasn't going to be able to maintain it.  Sure 'nuff, halfway up Cemetery Hill, I ran out of gas, and Daniel left me in the dust.  I always forget how tough that hill is until I'm wheezing to get over it.  I spent the last 3/4 mile trying to recover.  In the end, I did the two miler in about 13:38.  Considering my lack of running over the prior two weeks, I was pretty satisfied, despite the ego-crushing.

It is now Saturday night, though, and I spent all of Friday and most of today limping around.  The pain I felt was maybe the worst post-running pain I felt since my injury began, although now I feel like it might be more in the middle of my hamstring than in my butt.  This isn't good.

I have an appointment to see Dr. Metzl again this coming Friday.  I don't know what he's going to suggest we do now.  But I think I'm coming to accept that it's time for me to take some time off from running.   I'm thinking this means no fall marathon, and no Reach the Beach this year.  Maybe a couple of months of really no running.  I'm hopeful, though, that I'll be able to at least bike and swim.  (Last Wednesday, Rachel, Zander and I biked a few loops of Central Park during the FRNY Fun Run.  I think if I can keep biking with the runners, it'll make the time go by faster...).

Tonight I'm in New Jersey, getting ready for my one-mile ocean swim tomorrow.  Chris, Jeff, Josh and I tested out the waters a little bit, and the waves were really big and rough.  It was actually kind of scary.  It took me a few tries before I was able to swim past the crashing waves to where the water was more calm.  Tomorrow's swim is going to be interesting...  I'm definitely going to be wearing a wetsuit, even though the water temperature is around 75 degrees.  My goal is just to finish and hopefully not freak out.  I'm excited and nervous.  I'll let you know how it goes!

"Your Butt Is Much Stronger Now"

It's amazing what a few hours and a new medical opinion can do.  This morning, I was feeling pretty down about the prospect of not running through the summer and fall.  Over lunch, I went to my appointment with Dr. Jordan Metzl.  Those of you who are regular readers will remember that Dr. Metzl was the one who diagnosed me in November as having a "weak butt."  I was, at the time, disappointed with his seemingly cursory examination, and got a second opinion with Dr. Babiy.

Well, I went back to him today, this time armed with my three MRI results. After examining me, he told me I no longer have a weak butt.  But, based on the MRIs and his examination, he thinks I have piriformis syndrome, which is where the piriformis muscle impinges on the sciatic nerve in the leg.  I thought this was what I had in OCTOBER--but the various doctors had me convinced that, instead, I had  (in chronological order): a weak butt, a herniated disk, a tear in the hip labrum, and a tear in the hamstring by the ischial tuberosity.  I don't believe it's taken eight months of doctor examinations, MRIs, X-rays and physical therapy to to get me to what I thought I had before I even started seeing anyone.  This is beyond frustrating.

Dr. Metzl had some good news, though:

1.  It can be treated.  Dr. Metzl scheduled me for an ultrasound-guided steroid injection into the sciatic notch at HSS for July 2nd.  From some online research I've done (here and here), it seems that this injection is used to both diagnose and treat the piriformis syndrome.  If the pain goes away, then it'll confirm that an inflamed piriformis muscle was impinging on the nerve.  In some cases, the shot itself is all that is needed for the pain to go away permanently.  In other cases, however, the pain goes away and comes back, which may mean surgery is required to release the piriformis and decompress the nerve.  Hopefully that's not what I'll need.

2.  I can still run!  Dr. Metzl noted that in eight months, the pain hasn't really gotten any worse.  Because of that, he told me to "keep doing what you're doing"--which to me means I can still run, although I will stay away from speed and hill workouts, and not go crazy on the races.  I do still plan to do as much swimming and biking as I can, since those don't cause as much pain as running does.  But it's good to know that I now have a doctor's OK to keep running.  I think I may be able salvage a decent summer and fall running season after all.  :-)

5 Weeks Till Boston; 6 Weeks Without a Kitchen

I've been cautiously trying to ramp up my running as I near the peak of my training for Boston, which is now less than five weeks away.  I usually try to peak at around 45-50 miles a week when training for a marathon, but this time I think my highest weeks are going to be closer to 35 miles.  I'm hoping, though, that my cross-training (swimming, biking, yoga) will make up for some of my lost miles.

One thing I've decided not to do anymore is speed workouts.  Two weeks ago, I went to my first speed workout since November.  I had been running pretty consistently, and figured that if I didn't push myself too hard, I would be able to get a good workout without further injuring myself.  The workout that night was 5 x 1mile (first 1000m @ 10k pace, last 600m faster), with a 3 minute rest / 1 lap jog between sets.

I ran the first set at 4:10 (1st 1000) / 6:30 (total).  It was the fastest mile I had run since probably September or October.  It felt exhilarating--every time I run on the track I feel like I am pushing myself to go as fast as I could go, and with each step, I feel like I want to go faster and faster.  That was a mistake.  By the end of the mile, I felt like I wanted to die.  I had forgotten how nasty and stale the air was inside the armory.  More significantly, I had forgotten that pretty much all of my running over the past several months had been in the 7:45 minute pace or slower.  The fast boys doing the workout (Mikey B, Stephan, Peter Macari, Timmy and Matt) sucked me into their vortex.  But I couldn't keep up with them, and I felt like I was killing myself trying.  Although my butt felt fine, I didn't think there was any way I could maintain that pace for the other four sets.

So for the next set, I decided to let the boys do their own thing while I paced off of Kerstin, who said she was doing 7 minute miles.  It felt much better running with her.  At first, I felt like I was holding myself back, but I quickly settled into her pace, and figured that this would leave me with enough juice to be able to do the last 600 faster.  About the third or fourth lap, she ended up pulling off because of a shoelace issue or something, and all of a sudden I was left without a pacer.  And I suck at pacing myself.  I ended up running the rest of that set way too fast (4:17 / 6:42), felt like crap, and had to sit the next set out to catch my breath.  Ugh.

The last two sets I ended up, again, pushing myself harder than I should have: 4:09/6:33, and 4:10/6:30.  Of course, at the time, I was very pleased that my last set was the exact same time as my first set.  But for the next FOUR DAYS, I couldn't walk without limping, and I couldn't sit without feeling the intense pain in my butt.  I decided then and there that I wasn't going to do another speed workout.

It's funny, though... the four miles of fast running made my butt feel so bad, but four days after that, I did a twenty miler, and I ended up feeling fine afterwards.  The 20-mile run itself, though, was bruuutal.  The plan was to go from Chris's house in Washington Heights, across the GW Bridge, and into the Palisades Park in NJ.  It's a really pretty run, but there's no water, and the hills make Harlem Hill seem puny in comparison.  On the day of our run, though, everything but the very Southernmost portion of the park was closed due to all of the trees that had fallen into the road from Snowpocalypse the week before.  Even the part that wasn't closed was icy and littered with fallen trees. 

We ended up all turning back at around mile 5.5.  Most of the group went to do loops around Fort Tryon Park, but Mikey had a good idea of running North on the Hudson River Greenway, into the Bronx, turning around at the Tortoise and Hare Statue.  I had never done that route before, so I was excited.  Although not as bad as the Palisades Park, this route was pretty hilly too.  And my legs were just about worn out after the heavy climbs and steep descents of the park, even though we only ran about 6 miles in it.  But one of the lighter moments of the run came when, shortly after Mikey and I crossed the bridge into the Bronx, a teenage girl saw us in our skimpy running clothes and shouted out to us: "Work it, Girls!"  Haha, I love the Bronx.

Mikey said that run took us 3 hours and 1 minute, which works out to about 20 miles at 9 minutes per mile.  Considering that six months ago I ran 26 miles in 3:09, I was a little disappointed with our run.  But the good thing about the run was that it made me realize I need to do a lot more hill training before Boston.  Because of the weather this winter, most of our long runs have along the Hudson River or Eastside Greenways, which are both pretty much pancake flat.  But if I'm going to avoid crashing and burning at Boston, I'm gonna need to better train for Heartbreak Hill.

I felt pretty good the day after the 20-miler, although, when I woke up, I was sore, tired, and lazy, and ended up deciding to skip the Coogan's 5k.  I felt bad, since this was the first points race of the year.  It would not have been a pretty run, though.  And I did end up making it to the FRNY brunch at Patrick and Johnny's house afterwards.  :-)

The following days, I felt really good.  So I decided I would give the Armory workout another try.  It was another 5 x 1mile workout, this time with 800 @ 10k pace, and 800 faster.  I paced off of Cenk for most of the sets, except the 3rd (which I sat out because of stomach issues) and the 5th (when he made me go in front).  This time, I felt much better cardiovascularly, and was really happy with my times and how I felt afterwards.  However, starting from my second set, I could feel my hamstring/butt issue acting up, and I knew that wasn't a good sign.  Nevertheless, I completed the workout, which I admit was probably not the best idea.  Here are the splits:
1:  3:22 (1st 800) / 6:22 (total)
2:  3:20 / 6:30
3:  um, quick trip to the men's room.
4:  3:21 / 6:24
5:  3:07 / 6:14
So with my fifth set, when Cenk made me go in front, I didn't have anyone to pace off of, and ended up going out way too fast, and I couldn't go "faster" for the last 800.  Nevertheless, I was happy that I had it in me to do a 6:14.

The next few days meant more limping and more butt pain.  Not good.  So, after that workout, I REALLY decided that I'm not doing any more Armory workouts.  Tonight, though, is the FRNY Track Meet, at the Armory.  I'm only planning on doing one event, the Distance Medley Relay, with Anthony, Da and Tsing (the four gaysians...  we're team "Joy Luck Club").  The DMR is a four-person relay with a 1200, 800, 400 and mile.  I'm doing the 1200...and I'm a little nervous, but I'm not going to push it too hard.

Sunday is the New York City Half Marathon, which I'm signed up for.  I really like this race because you get to run through Times Square, which is closed off to traffic.  And although the first half is in Central Park, the second half is down the Westside Highway, which is flat and fast.  My PR is on this course 2 years ago, although at the time I was a little disappointed with my performance...  I got a 1:31:30, way off my goal of sub-1:30.  I KNOW that I have it in me to do a sub 1:30 sometime; I just have to get back in shape and wait for this damn butt issue to go away.  But for Sunday, I'll be satisfied with a 7:30 pace (1:38:19) if I feel good afterwards.  I'm thinking maybe I'll start there and ramp it if I can, once I get out of the park.  I'll be delighted if I can get a bit faster than that, we'll have to see what happens.

*                       *                        *

I got another MRI a few weeks ago, this time on my hip and pelvic region.  The results show that I have a "small superior right hip labral tear," "mild bilateral intertrochanteric bursitis," and a "mild stress reaction" at the "pubic symphysis." 

Seeing these results, Dr. Babiy referred me to Dr. Srino Bharam, a hip specialist.  Dr. Bharam stretched my leg in a bunch of different directions to put pressure on my hip joint, asking me if I felt any pain.  I did feel a little bit of a pinch in the joint when he put me in a certain position, which confirmed the MRI report's diagnosis of a small labral tear.  Dr. Bharam said he thinks that the the hamstring/butt issue that I have is related to the labral tear because of the way my running mechanics are changed as a result of it.  He said that ideally, I should stop running for a while.  But short of that, I should just be careful not to overtrain, and after Boston, he recommended that I take some time off of running.

To be quite honest, though, I think Dr. Bharam is just plain wrong.  My research online shows that labral tears occur in sports with twisting/pivoting motions, like golf or softball, or contact sports like football or hockey...  nothing about how it's a running injury.  The most common symptom of a labral tear is a clicking or catching sensation in the hip joint, which I don't have.

Dr. Degis thinks (and I tend to agree) that I have a tear/strain in my hamstring up by the tendons that attach the hamstring muscles to the sit bones of the pelvis (the "ischial tuberosity").  Because tendons receive less blood flow than muscles, it takes a long time for them to heal.  And because the tear is where it is, the pain occurs mostly when I am sitting, which stretches the tendon out and puts pressure on the exact spot where that tendon attaches to my pelvis.

If you do a Google search for "running ischial tuberosity," the very first result is a Runner's World forum discussion on ischial tuberosity pain syndrome, a discussion which has lasted 4 years with 142 responses.  The postings all sound like exactly my symptoms (pain while sitting/driving, no pain while running, pain while bending over, etc).  Virtually all of the postings make the outlook sound extremely bleak (suffering from the pain for 2, 5, 7 years; getting surgery that doesn't work; cortisone injections that don't do anything; running careers that ended, etc).  Dr. Degis, though, said he knows this condition very well, and he says that he is confident it will eventually go away.  I am currently just seeing him once a week.  He knows that I have the marathon coming up, and my sessions are mostly just to keep myself loose so my injury doesn't become worse.  After the marathon, he thinks I should cut down on my running, and go in 2-3 times a week to aggressively break down the scar tissue and rebuild my muscles in the area.  So that's the plan...after Boston, the running will be minimal, and I will do what I have to do to get rid of this pain in the butt.

Dr. Bharam, the hip specialist, also mentioned mention a treatment that I've been reading a lot about, platelet-rich plasma therapy.  Some of you might recall that Dr. Gallina, the ankle specialist, said this was a possible course of treatment to take if my ankle tendinitis didn't heal.  The New York Times says the following about PRP:

The method, which is strikingly straightforward and easy to perform, centers on injecting portions of a patient’s blood directly into the injured area, which catalyzes the body’s instincts to repair muscle, bone and other tissue. Most enticing, many doctors said, is that the technique appears to help regenerate ligament and tendon fibers, which could shorten rehabilitation time and possibly obviate surgery.

The problem with PRP is it that because it's still in the experimental stages, it isn't covered by insurance, and costs about two thousand dollars.  Still, it sounds promising, and if it means I can run without pain, maybe it's worth it.

*                       *                       *

As a way to cut down on my running, I've decided that this summer is going to be the summer of triathlons.  So far I'm registered for the following races:

5/16: Jersey Shore Sprint Triathlon

7/18: Metroman Tri (Intermediate) -- This was the race where I had my disastrous ocean swim last year.  Hopefully this year will be better.

10/2: Mightyman Half -- This will be my first Half Ironman...I'm excited and nervous!

I'm looking to do a couple more... maybe the Mighty Montauk in June, and something in August / September.

*                       *                          *

A few weeks ago, the Front Runners had its First Friday happy hour at RF Lounge, a swanky lesbian bar in the former, less fancy Rubyfruit Bar and Grill.  Afterwards, some of us went to Grand Sichuan Seventh Avenue in the Village.  I had a few drinks at RF Lounge, so I don't remember everything we ordered, but I did snap this photo of the whole fish with chili sauce.  It was very good.

*                        *                         *

I'm still working on renovating my kitchen.  It's been about six weeks, and it's starting to feel like the project that will never end.  Fortunately, I think I'm closing in on the finish.  These past couple of weeks, I've installed the oven and microwave, got an electrician to put in some new circuits, had the countertop put in, and did most of the plumbing except for the drain.

The electrician put in two new 20 amp circuits and carried the lines into my kitchen, where there will be two new outlets: one for the microwave/hood, and one under my sink for the disposal and instant hot water dispenser.  I was originally planning on doing the electrical work by myself, but then I got nervous and ended up calling for help.  But when I saw the electrician do it, I was kicking myself after seeing how easy it was...  All he did was run the wire through the five feet of wall between the kitchen and the breaker box, connect it to a breaker, and plug it into the box.  I had to patch up the holes in the wall myself.

With the electricity in, it meant I could install the microwave hood.  This, I really should have gotten help with.  I ended up having to lift the microwave, which weighed like 100 pounds, by myself, hold it up with one hand and a shoulder against a brace on the wall, and screw it in with the other hand into the top cabinet.  If I dropped it, it would have crushed my feet, and I would have said goodbye to my new microwave.  Luckily, it went up without incident. 

The most exciting thing about the microwave is that I installed a duct so that it would vent out the exhaust instead of recirculating it back to me.  I've always thought it was pointless for range hoods to spit the exhaust back into your face, but I think that's what most NYC apartments have.  Fortunately, I already have a vent in my kitchen, which wasn't really serving any purpose.  So I just got some ductwork to hook up and spit out all the exhaust into that vent.  Hopefully, it's not going to spit it out into someone else's apartment...

Then came the granite countertop.  I ordered the countertop from E Stone, Inc. in Brooklyn, which I highly recommended since it was about a third cheaper than Home Depot or even Ikea, and also quite a bit faster (less than 1 week turnaround versus 2-3 weeks) since they did all of the cutting on the premises.  Here's the guys installing the countertop:

And here's the final product:

What do you guys think about the faucet?  I love the commercial kitchen look to it, but it's a little big for the space.  I think the sprayer is going to hit up against the bottom of the wall cabinet every time I use it, which could be annoying.  On the other hand, I think it looks kinda sexy.

With the countertop in, I turned to installing the stove.  This ended up being a really annoying project.  In order for the stove to sit flush up against the back wall, there's a little recessed area in the back of the stove where the gas line coming out of the wall is supposed to fit into.  Unfortunately, my gas pipe missed the recess by about 6 inches, so the stove ended up sitting away from the back wall by about two inches (the depth of the gas pipe).  To fix this, I ended up having to cut a hole in the back panel of the stove to accommodate the gas pipe, and then thread the gas connector through the inside of the stove.  It's hard to explain, but there are electrical wires in the area where I threaded the gas connector, so I don't think there's any risk of that area getting too hot for the gas line.

Anyway, here's a picture of the cutout I made into the back panel:

And here's me connecting the gas line:

But after all that, I actually got the stove to work!  And all without a gas or electrical explosion, haha!

Next up: connecting the dishwasher and putting in a new drain for the double-basin sink.  Then I just have the moldings and trim left....  almost there!

New Year's Run (and Rum)

Holiday Rum Balls

These rum balls are a favorite during the holidays and new year.  I love them because they're easy to make and require no baking.  People always think they're loaded with booze, but there's only a half cup of rum for about 50 balls.  So you'd have to eat about 12 of them to get just one shot. 

1 box of vanilla wafers
1 1/2 cups chopped walnuts or pecans
3/4 cup powdered sugar
1/4 cup Dutch process cocoa
1/2 cup dark rum (I use Myer's)
3 Tbsp light corn syrup
powdered sugar

Crush/chop the vanilla wafers into a fine crumbs.  Combine all of the dry ingredients and add the rum and corn syrup.  Blend well.  Shape into one inch balls, and roll in powdered sugar.  Best if made the night before so flavors can develop.

*                      *                     *

I've been trying to get back into running.  Different doctors have told me different things, and rather than sit and sulk about not being able to run, I've decided to run just twice a week at the fun runs.  So I ran five on Saturday and six on Wednesday.

Saturday's run was fine and pretty uneventful.  In the last mile, I started to feel a tingle in my ankle, but it wasn't too bad, and I finished without any pain, and without any change in my stride.  No significant butt/hamstring issue at all.  Saturday evening, though, I realized that I was limping because of the pain in my hamstring.  It wasn't debilitating or anything, just an achiness that felt like it needed to be massaged out.  But when I tried to massage it, I couldn't really pinpoint where the pain was coming from.  Frustrating.

I thought maybe some yoga would help out, so I went on Sunday, Monday and Tuesday.  I think all of the warrior poses did help my hamstring, but I realized that every time I do a forward fold, I felt the pain moving into my butt.  I've also discovered, although I'm not sure if this is new or not, that when I lean to the left, I feel a tightness/strain in my right hip that is not in my left hip.  So it's my hip, butt and hamstring that's all giving me problems.

I also went on a run on Wednesday.  Six miles.  Not sure if this was the smartest move.  Pretty early on, I felt my hamstring acting up.  It has never really bothered me on my runs before (just afterwards) and although it wasn't a terrible pain, the fact that it existed at all concerns me a bit.

Tuesday I got an MRI on my lower back.  This was my second MRI in a month (the first one was on my ankle), so I thought I knew what to expect.  But this time it was completely different.  Instead of going feet-first into the machine, and leaving my upper body exposed, I went in head-first.  So for about half an hour, I was stuck in a little coffin-like enclosure.  I had ear plugs on to block the jet-engine noise and sirens emitting from the machine.  The top of the opening was about 2 or 3 inches from my face.  I've never really been claustrophobic, but this was a little too much for me to handle.  I realized it was much more bearable if I closed my eyes and tried to let my mind wander.  To my surprise, the next thing I knew, I woke up to the technician pulling me out of the machine.  I ended up sleeping through the whole MRI experience.  Thank goodness--it would have torture to have to be awake the whole time.

Tuesday's MRI is making me extra sensitive about my back.  Perhaps I'm just being a hypochondriac, but I feel like I'm noticing some new aches and pains there.  I went back to yoga yesterday (Thursday).  Several times during the session, my lower back felt uncomfortable as I was transitioning from upward dog to downward dog.  So now I'm all paranoid that something is really wrong.

Today (Friday), my hamstring still feels a little achey from Wednesday's run, and I have a tightness in my ankle that started yesterday.  Mikey and some others wanted to go on a ten-miler tomorrow.  I tentatively said that I would join them, but I'm wondering if I need some more rest.  There's also a five-mile fun run on Sunday that the club is doing.  The Under Armour store on West 57th Street is sponsoring it, and apparently they've custom printed FRNY shirts for us all to wear.  I've decided to skip the NYRR Fred Lebow Classic 5-miler tomorrow, which is particularly disappointing because it was the first NYRR race I ever ran, back in 2006.

My appointment with Dr. Babiy to get the results of my MRI is not until next Thursday.  I'll try on Monday to see if I can get her to talk to me over the phone.  Chris Stoia recommended that I see his doctor, Eric Degis.  I have an appointment with him next Wednesday. 

I'm about to head out to a FRNY Happy Hour at Vlada.  Maybe then I'll decide if I'm running tomorrow.

Last Run of the Year

1310 miles in 2009.  Not bad.  Although it would have been closer to 1500 if it weren't for this damn butt issue.  And judging from last night's 5-mile test run, I don't think it's going to go away anytime soon.

The run felt OK at first.  I did feel some achy joints, but it was mostly just the result of not running for 27 days.  Initially, I also felt some achiness in my right butt/hip.  I couldn't tell if this was related to my injury or not, but it eventually went away as I warmed up.

The first 3 or 4 miles went really well.  I was running with Mike and John, and although they were running pretty slowly, in retrospect it was probably a little fast for me on my first run back.  The last time I ran in the park, I started getting ankle pains around mile 2, and ended up jogging/walking the rest of a disappointing 4 miler.  So I considered it a success that I did not feel any ankle issue even up until I turned off at the 102nd Street transverse (3 miles).  Just to be safe, though, I slowed down for the last two miles.  Around West 86th Street, I did feel the tendinitis coming back in my ankle.  It wasn't so bad to be debilitating, but it was definitely noticeable.  I slowed down a little bit more, but never felt the need to walk.  Although it's disappointing that the issue is still there, I feel like I just need a few more weeks of taking it easy and my ankle will be back to normal.

The butt, though, is a different story.  My butt has never really bothered me while running; it's always afterwards or the next day that I feel the pain.  Well, after the run, we went to Big Nick's Burger and Pizza Joint (on 75th and Broadway) for dinner.  It was the first time I went to Big Nick's.  They have a massive 28 page menu, which includes everything from Greek food to burgers to pizza and more.  I got a chicken souvlaki pita (pictured below), which was pretty good. 

In contrast to their huge menu, though, the area inside Big Nick's is tiny.  As we were standing in the entryway waiting for our table, some of us had to exit the restaurant whenever someone needed to walk by.  They packed five of us into a table crammed into the back of a narrow room.  Needless to say, I didn't have much legroom.  Halfway through my chicken souvlaki, I was needing to stretch my legs, but felt like I was trapped in this tiny restaurant with nowhere to go.  By the time we paid our check, pain was running from my right butt almost down to my knee.  I was trying to discreetly massage my hamstring during dinner, but I couldn't get in deep enough.  I was glad to get up when we finally left.

As I slept last night, I woke up a few times feeling that the pain in my hamstring was still there.  And at work today, I've had to get up several times to stretch my legs.  It's disheartening, and I know this means I should take it easy.  But I still want to run.

Happy New Year!

Six weeks off...

I have not run for two weeks now, and I learned this week that it's going to be quite a while longer.

Last Friday, I went back to Dr. Babiy.  The purpose of the visit was to look at the x-rays on my ankle and determine the next steps, as well as to get my electromyogram (EMG) on my butt.  The x-ray came back negative for a fracture.  However, it did show some signs of "cortical thickening," which I guess means that the outer layer of my tibia bone had grown thicker than usual.  She said this was probably the result of my running--as the muscles pull on the bone, they cause stress on it and make the cortex thicker.  She said this was probably not a huge deal, but told me to get an MRI just in case.

The EMG is a test used to record the electrical activity of muscles.  It can be used to detect muscle abnormalities, such as when there is a pinched nerve.  The purpose of the test was to see if I had problems with the sciatic nerve, since I had reported a "pins and needles" sensation to her.

The test was sort of like the rubber mallet reflex test that doctors do, only more high-tech, and much more painful.  The doctor places these electrodes up and down my leg.  She would administer a little shock here and there to basically see how much my leg reacted.  By my foot, where the sciatic nerve is at its smallest, I would feel what amounted to a little electrical pinprick.  But as she moved up my leg, the shocks felt more and more intense, and my reflexive reaction got bigger and bigger.  When she got to my butt, it felt like I got hit with a stun gun, and my leg let out a huge uncontrollable kick.  It was kind of funny and painful at the same time.  The EMG showed that there was nothing wrong with my sciatic nerve, so it turns out that my butt issue is just a muscle problem, like a pulled hamstring or something. 

Later, at physical therapy, my PT Marina (funny, both Dr. Babiy's and my PT's first names are Marina) confirmed that the problem area was not, as I had believed, my piriformis muscle.  She did this by isolating my piriformis muscle: I lay on the table on my left, bent my right leg and raised my right leg up, while her hand applied downward pressure.  This maneuver apparently isolates the piriformis muscle, which ends up flexing out of the butt.  She poked around at that muscle, and I didn't feel anything abnormal.  The area where I felt tenderness was further outside--my glute.  So I guess Dr. Metzl was right, I just have a weak butt. 

So I've been working some exercises to strengthen it, although some of them don't really seem to be butt exercises at all.  One of them is a "pushup" where I lie on the floor and push my chest up while keeping my legs and hips on the floor, kind of like an Upward Facing Dog in yoga.  My favorite part of physical therapy is when she attaches the electrodes to my butt.  The electrodes make a tingling sensation, nothing like the EMG shocks.  She sets the machine for ten minutes, and I usually end up taking a quick nap while it makes my butt feel all warm and fuzzy.  Here's the machine:

The next day, Saturday, I went to get my MRI on my ankle.  I have to say, as great a doctor as Dr. Babiy is, the places she sends me to get imaging done are the worst.  For my x-rays, I went to a place on 17th Street, where I had to sit in the waiting room for an hour and a half!  This was during my lunch break so I thought I was going to get fired.  For my MRI, Dr. Babiy sent me to Union Square Diagnostic Imaging.  I appreciated how this place had evening and weekend appointments.  They were able to fit me in the day after I called them, for a Saturday evening appointment at 7:30 (yes, I was planning to spend Saturday night getting a magnetic image of my ankle).  Around 2:00 they called me and told me they were running ahead of schedule, and asked if I could come in at 5:30.  I gladly obliged.

Well, I got to the waiting room, and ended up waiting for an hour and forty-five minutes.  I was like, ripsh-t.  I mean, like, they f-cking tell me to get to my appointment two hours early only to wait in the f-cking waiting room for two f-cking hours to watch f-cking Animal Planet on the f-cking TV?!?!  I went like apesh-t at the poor receptionist there, who was the one who told me to come early.  Not one of my proudest moments.

The MRI itself went off without much incident.  Despite the completely unnecessary noise (like an ambulance siren combined with a tractor truck's backup beeps), I managed to fall asleep during the half hour long process.

Wednesday, I had another physical therapy appointment.  And although I did not have a separate appointment that day with Dr. Babiy, she agreed to see me after my PT to discuss my MRI results with me.  It's things like this that make Dr. Babiy such a remarkable sports medicine doc.  I can't imagine another doctor taking time out of their busy day to have an unscheduled meeting with me.  So here's another plug for her.

Well, the MRI results were not good.  I have a partial tear in my tibial tendon.  On top of that, a bone bruise cannot be ruled out.  Though she's not able to say for sure at this point, Dr. Babiy said that these types of injuries usually require about six weeks off from running.  I've already taken two, so four more to go...  Dr. Babiy also referred me to a foot and ankle specialist, Dr. Jessica Gallina, who will further evaluate and treat the condition.  She mentioned the possibility of wearing a boot.

What little information is available online about posterior tibial tendon tears does not give me great confidence.  It is also somewhat confusing.  This injury does not appear to be a common one in runners.  Instead, it usually occurs in sports that require a lot of lateral movement, such as basketball or tennis.  It could also result from a sprained ankle.  I vaguely remember twisting my ankle at some point after the NYC marathon.  But there's a possibility that I'm imagining it, or it could have been my other ankle, and I certainly don't remember it being particularly major.  My appointment with Dr. Gallina is on Monday, so I guess at this point, there's no real point to stressing over it.  It's worth mentioning that while all this is certainly bumming me out, I am glad I sought out Dr. Babiy for a second opinion after Dr. Metzl told me there was nothing wrong with my ankle.  I'll let you know what happens after my Monday exam.

Last week I went to yoga five times.  Yesterday, I realized that I need to get back to doing cardio, lest I continue to balloon up.  I went swimming for the first time in months.  Hopefully, by the end of six weeks, I'll at least be able to develop my stroke.

*                *                *

I made a couple of chicken dinners over the past week.  The first one was a five-spice braised chicken and daikon that I made in my pressure cooker.  I just threw the chicken and daikon in the pot, along with some scallions, ginger, garlic, soy sauce, rice wine, Manischewitz, five spice powder, star anise, and sugar.  In the picture below, the daikon looks a little like scallops.  I recently discovered that I can make brown rice in my rice cooker, so I'm making an effort to eat more brown rice instead of white rice.  And I've been on a collard greens kick of late, so that made a nice pairing.

The next night, I made pan-barbecued chicken.  For the barbecue sauce, I used ketchup, soy sauce, sesame oil, grated ginger, sugar and Worcestershire sauce.  My cast-iron skillet did a great job at giving the chicken a tasty caramelized crust.  I served it with a vinegar-based nappa cabbage coleslaw (I was excited to use, for the first time in my life, coriander seeds in this), and some not-so-homemade Bush's Baked Beans.  Oh, and some leftover brown rice and collard greens.  Dessert was a delicious Betty Crocker carrot cake with cream cheese frosting.  Mmmmm......

Foam rolling, running pants and dumplings

After Thanksgiving, I was eager to begin running again.  The Front Runners indoor track season started the week before Thanksgiving, and I was just starting to get into it.  Front Runners meets on Tuesdays and Thursday evenings at the Armory Track, a 200 meter indoor track in Washington Heights

Tuesday's workout was 6 x 800 meters, with 400 meters of jogging after each set.  Koach Kelsey divides the group into three or four smaller groups, roughly based on speed.  Although last year I generally ran in the "fast" group, I've been self-selecting the second group this year so as not to get sucked into the fast people's vortex and overstress my butt and ankle.  Plus, I think the fast group this year is quite a bit faster than the fast group last year (and I'm slower, haha). 

My first four 800s went pretty well.  I was wearing my brand-new racing flats that I had just bought earlier that day (the Brooks Racer ST 4).  It was my first time ever running in racing flats and my feet felt so light.  Peter and Stephan were in my group and we took the front of the group, taking turns at who among us would be in the lead.  First four sets: 3:14, 3:09, 3:09, 3:06.  On the third lap of the fifth set, I began to feel my left ankle acting up.  I let up a little bit on my last lap, finishing in 3:09.  As I started my recovery jog, I realized that I was limping.  After one loop, when the pain in my ankle didn't let up, I decided to call it a day.

I didn't really think much of it.  Having completed five of the six sets, I felt I had a pretty decent workout.  But as I sat and watched the rest of the group do their last set, I couldn't help but feel a bit left out.  It turned out, Peter and Stephan were probably holding back for the first five sets, and flew through their last set at around 2:50.  It looked so fun to be running that fast, and I really wished that I could have joined them.

I know it was a good idea, no matter how difficult, to sit out that last set.  The next night, I went to the Wednesday night fun run.  Two miles in, I got the pain in my ankle again.  I ended up just jogging/walking around the top of the reservoir--another disappointing four miles.  It's starting to get discouraging.

And because I was unwilling to admit defeat, I went to the Armory workout on Thursday too.  I actually did not feel any serious ankle or butt pain at all.  Then again, the workout was really short, and I was not running nearly as fast as I would have liked considering the distance--12 x 200.  My 39-41 second splits were fine, but I knew I could go quite a bit faster.  I started to wonder whether I needed to take some more time off.

I had scheduled an appointment on Friday morning to meet with a new sports medicine doctor.  I liked Dr. Metzl, but I just wanted someone else to take a look at me and tell me if anything was wrong.  I pretty much picked a new doctor at random, typing in "sports medicine new york 10011" into Google.  The first result was walking distance to my apartment, took my insurance, and could fit me in within a few days.  So I booked a date with Dr. Marina Babiy.

First off, Dr. Babiy spent at least 20-25 minutes analyzing me, compared with about five minutes for Dr. Metzl.  She she asked me 20 different questions about the pain I was experiencing, made me walk in front of her, tested my reflexes, had me press my leg against her hand in different directions in order to pinpoint the pain, and observed my back to see if the butt issue was linked to my spine (since the sciatic nerve going down the leg originates in the spine).  Dr. Metzl didn't do any of this.

At the end of the exam, she told me that although the pins and needles sensation that I felt could be indicative of sciatica, it was more likely that I had a muscle or tendon strain in my butt.  She scheduled me for an electromyogram (EMG) to rule out the sciatica.  Regarding the ankle, she said she did not see any major inflammation, so that it was probably a sprain as opposed to a stress fracture.  I didn't tell her that I had seen Dr. Metzl a few weeks earilier and he didn't see anything bone-related or serious.  Nonetheless, she ordered x-rays on my ankle.  She said that based on the EMG and x-rays, she will determine if more imaging is necessary.

In the meantime, she prescribed 800mg of ibuprofen twice a day, physical therapy, and lots of icing.  She also said no running for two weeks, at the end of which we will reassess the situation.  I am bummed, but two weeks is not that long, and it's somewhat comforting to know that additional testing will be done.

The convenient thing about Dr. Babiy's office is that not only is it close to my house, but she also has a number of physical therapists on staff.  So I was able to go to physical therapy right after my doctor's appointment (and I only paid one copayment!).  The PT that I saw, Steven, taught me some stretches for my butt and had me use a foam roller.  He was surprised to hear that I don't own a foam roller, nor have I ever really used one.  I have to say, after trying it in physical therapy, I wondered how I could possibly have gone for so long without it.  It felt so good...like it was simultaneously soothing and intensifying my pain at the same time...  I had to buy my own the very next day at Jackrabbit.

*   *   *

A few weeks ago was John's MacConnell's birthday, so I had him and a small group of runners over for dumplings.  By the way, John's working of a new website, http://www.runningpantsinc.com/.  It's still a work in progress, but right now he's using it to show off his new running pants man / lightning bolt character.  Here he is:

The website also has an ever-changing running haiku of the day, and you can submit your own running haiku.  You can also request a running pants man temporary tattoo.  And my favorite part of the site is the area where readers post pictures of their body parts adorned with the running pants man tattoo.  Can you guess which body part is mine?

For John's birthday, I made chive-and-pork, and napa-cabbage-and-pork dumplings.  Both fillings also included shitake mushrooms, ginger, scallion, little dried shrimps, soy sauce, sesame oil and Franzia.  Here are the fillings:

I always have a good time stuffing dumplings with friends.  I think it's more fun to have a dinner party where everyone is helping out, rather than having one person stuck in the kitchen the whole time.  The dumplings below were made by me and John.  He made the fancy crimped ones in the midde, and mine were the pleated ones on the sides.  They tasted even better than they looked.  :-)

I am thankful for not rolling off the mountain

Around the Thanksgiving holiday, I decided to take some time off of running.  My butt and ankle were not getting any better, and I thought since I was going to be home for the holiday, it would be the perfect time to get some rest.  So I did not run for 11 days (November 20-30). 

The way I had scheduled things, I almost didn't really have an opportunity to miss running.  Saturday, November 21, I didn't go to the fun run.  Instead, I had registered to volunteer that day as part of my 9+1 volunteer race to qualify for next year's NYC Marathon.  When I signed up for a volunteer race, there weren't many more options available.  One of the few races with volunteer spots left was the Knickerbocker 60k--an 37.2 mile ultramarathon that includes 9 grueling loops around Central Park--so I signed up for it.  I was actually excited about volunteering at the Knickerbocker, despite my 5-hour long volunteer shift.  Six Front Runners ended up running the race, and armed with my cowbell, I got to cheer them on as they came round and round.  It was a small race by NYRR standards--only 187 total runners.  By the end of my volunteer shift, I recognized all of the runners, and felt like I could tell how each one was doing.  One of runners, a member of the Running Club Powered by Dim Sum, recognized me from the Asbury Park Relay Marathon.  The NYC running world is so small, haha.

[As I wrote this entry, I decided to see if I could figure out who this guy was.  After some brief results list cross referencing and a Google search, I found out that he is Hideki Kinoshita, and he set out to run 14 marathons in 13 weeks to raise money for pancreatic cancer.  You can donate to his cause, which benefits the Pancreatic Cancer Action Network, here.]

The next day was the Race to Deliver.  I had signed up for it, but decided not to run it because of my injuries.  It's too bad, since for a while, that race held my 4-miler PR (6:22 pace in 2007, which I beat in 2008 with a 6:17.  Hopefully one day before I die, I will break 6:15...).  Also, the race is germane to this blog (about running and food), since the money that's raised through running goes to benefit God's Love We Deliver, which prepares and delivers healthy meals to those who, because of HIV/AIDS and other illnesses, are unable to provide or prepare it themselves.

And on Tuesday, when I normally would have done the speed workout at the Armory, I instead flew to California to spend Thanksgiving with my parents in San Jose.  Although I didn't run during the time I was home, I did do the bike ride that I mentioned in an earlier post with my brother Tony.  To remind you, the ride was an 18.4 mile ride and 4300 foot climb of Mt. Hamilton Thanksgiving morning.  It was brutal.  I literally thought I was going to die.  I can't even explain how difficult it was.

My brother and I got there a few minutes after the bike ride officially begin.  As a result, we did not get to register, and our times weren't listed in the official results.  I think this was a good thing.  My time would have put me in last place, and by a pretty wide margin.  Actually, my brother would have been last, but more on that later.  Suffice it to say that I've run 18.4 miles faster than it took me to bike it.

Riding up Mt. Hamilton requires going up three separate hills, between 4-6 miles each, with a 4.7%-6% grade.  The last hill, at 6 miles and 6%, is both the longest and the steepest.  I was able to go up the first hill without much of a problem.  I wasn't really keeping track of my time or pace or anything, but I knew it took a long time.  When I got past the first hill, I took a little bit of a break.  Somehow my brother and I got separated at the beginning of the ride.  After a few minutes, he didn't show up.  I probably should have waited longer, but I figured I'd be slowing down soon, and he would catch up. 

The second hill was shorter and not as steep as the first, so it should have been easier.  But by this time, my legs were really feeling the weight of the constant pedaling, and I was already exhausted.  I had to pull over a couple of times on the ride in order to stretch my legs out and rest.  By the way, this wasn't like biking down the Westside Highway.  There are no water fountains, no shops to run into, or porta potties available.  I had brought plenty of water, but was wishing I had brought more along to eat than my single Clif Bar.  I felt like I was going to be completely zapped of any energy in a matter of moments.  I broke off a piece of my Clif Bar and pushed on.

By the third hill, I just had nothing else to give.  The six-mile, 2300 foot rise might has well have been a million miles.  I seriously could have walked faster than I biked.  And about once every mile, I had to stop and catch my breath and stretch my legs for a minute.  By the way, going reeeealllly slowly up a steeeeep hill with clipless pedals is kind of scary.  I started having thoughts that I would start rolling backwards and be unable to clip out of my pedals, flying off the cliff into a ravine. 

Eventually I saw Lick Observatory, which marked the summit.  It was one of this times when you see something huge off in the distance and go and go and go and go but feel like you're never getting any closer.  But about three hours after I started, I finally reached the top.  It was a great sight.  Mt. Hamilton is the tallest mountain overlooking Silicon Valley, and I when was up there, I felt like I had conquered the impossible.

Tony arrived at the top about 10 minutes after me.  The reason he took so long?  I was riding his road bike, and he ended up taking a mountain bike.  Oh, and he had his three-year-old son strapped into a seat on the back.  Showoff.

I felt bad for going so far ahead of him, but I think in the end it worked out for the best.  He said he wanted to turn back after the second hill, and tried calling me to let me know.  Unfortunately, he couldn't get any cell phone signal, so he just kept riding.  Had I been with him, I would have all too gladly agreed to turn around.  But because I kept going, I got rewarded with a great feeling of accomplishment and a magnificent view to boot.

Here are some pictures of Thanksgiving dinner later that day.  Thanksgiving at my house is a combination of Chinese and American foods.  My favorite dish is the stuffing, which my mom makes out of sticky rice.  She adds Chinese sausage, dried shitake mushroom, dried shrimps, and some veggies.  It's so sticky and carby and savory and delicious, I love it.  Among with a bunch of other dishes, Mom also made a sea cucumber and scallop dish, a bean noodle and cucumber salad, and a ginger steamed shrimp, all pictured below.

 

Gone Fishing

My butt is still hurting.  I've decided that Dr. Metzl's diagnosis of a "weak butt" is not completely accurate.  My symptoms appear to be a textbook case of sciatica (minus the loss of bladder or bowel control).  I have a numbness / pins-and-needles sensation from the lower part of my back to right above the knee.  Sciatica is commonly caused by a herniated disk or piriformis syndrome.  I'm not completely sure what a herniated disk is, but it has something to do the the cartilage in the spine, and it can occur when engaging in heavy lifting with your back.

In playing back the last month or so in my head, and spending way too much time on mayoclinic.com, I had an "a-ha" moment.  The day before the Chicago Marathon, I had some pretty bad back pain.  I believe it came from lugging my carry-on bag from my house, on the subway and a bus to La Guardia, into the overhead compartment of the plane, and then onto another subway and bus to the hotel in Chicago.  The next day (Saturday), the back pain was so intense that I wondered if I'd be able to run on Sunday.  Fortunately, the pain subsided for the marathon.  But immediately after the marathon was when I started to feel the butt pain.  And now I wonder if that pain stems from a herniated disk that occurred when I was lifting my carry-on bag.  Damn me for being a cheapskate and taking public transportation everywhere that day.  The good news is that herniated disk/sciatica gets better on its own with some rest.  But still, I think an MRI would ease my mind a bit.  Can anyone recommend a doctor that I can go to for a quick MRI?

In addition, my left ankle is still giving me problems.  I don't think it's serious--probably a tendon issue.  But, while the butt issue is not debilitating, the ankle problem has really limited my running.  In the two weeks post-NYC marathon, I've run a total of 10 miles.  One upshot of this, though, is that I've gotten a chance to return to yoga, which has allowed me to both build up my butt muscles and stretch the problem areas.

Last Thursday, FaTai and Roberto came over for dinner.  I never really cook whole fish, but FaTai does frequently, and I love to eat it.  I stopped by Hong Kong Supermarket in Chinatown on the way home and I saw that they had live tilapia swimming in a tank, so I decided to get one.  Believe it or not, it was my first time ever buying a live fish, and the fishmonger's technique was a bit of a shock: first he scooped my fish out of the water with a net and put it into a plastic bag, then he took the bag with the flailing fish and hurled it against the wall.  The fish stopped flailing.  I think it was pretty much knocked out at this point, but just to be sure, he took the side of a cleaver and smacked it against the fish's head.  I have a feeling that fish had seen better days.

I also ended up buying some pork rib tips, tofu and a mystery leafy green vegetable.

Once home, I cooked up a batch of mapo tofu.  Mapo tofu is a traditional Sichuan dish with tofu and pork and lots of hot chili-bean sauce.  Literally translated, it means "pockmarked grandmother's tofu."  I always thought it was so named because the beans/chilis/pork resembled a grandmother's pockmarked face, but the references online appear to universally state that it was named after an old woman during the Qing dynasty who served this dish in her restaurant.  I guess it's more appetizing to have a dish served by a pockmarked old woman than to be eating her face.

The the leafy greens, which I just sauteed with garlic, came out pretty well.  I'm not sure what kind of greens they were, but the stems were a lot more tender than Chinese broccoli.

The pork rib tips were a bit of a mystery.  I didn't really know what I was going to do with them.  Fatai doubted me, saying that I would need 30-40 minutes to cook them well enough.   That immediately lit a lightbulb in my head, prompting me to pull out my new pressure cooker.  I first seared the pork a bit with some garlic, ginger and scallions, and then added some seasonings (soy sauce, fish sauce, sesame oil, Franzia), and sealed up the pressure cooker.  Eight minutes later, I ended up with delicious, tender, fall off the bone ribs.  A little Korean bulgogi sauce added some sweetness.  Yum.

The fish presented the biggest challenge.  I decided to "red cook" it, which means to braise it in a seasoned soy sauce base.  Fish is usually fried a little before braising to give it a moist but non-slimy texture.  I didn't feel like using a gallon of oil to fry it properly, so I kind of just pan-fried it a little in my wok.

After frying, I added some soy sauce, rice wine, star anise and of course Franzia, plus some leftover pot-roast juice for braising.  To make the most out of my braising liquid, I also added some shitake mushrooms, Chinese wood's ear mushrooms, dried lily flowers and tofu skin.  Here's the final product:

The fish itself came out really well.  I think pan frying it first helped it to develop its flavor.  The other stuff that I added to the braise (mushrooms, etc) could have used some extra time braising.  (The next day, I put it back in the pressure cooker for about three minutes, and it came out perfect).

We did a pretty good job on the fish, although none of us were brave enough for the head.  Good thing my parents weren't there...they would have been disappointed that we wasted a perfectly good fish face.