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.

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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......

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.

Under Pressure

Sunday was a gorgeous day in NYC, sunny with a high of 68 degrees.
My ankle was still bothering me, so running was out of the question.  Dane and I instead decided to go on a bike ride.  It was a very leisurely 12-miler.  I took my mountain bike, and we rode from my house to Central Park for a loop.  Afterwards, we got a delicious Tasti-D-Lite.  I hope this beautiful fall weather lasts.

For dinner, I decided to bust out my new pressure cooker. I bought it a few weeks ago somewhat impulsively, although I had been thinking about getting one for a while. I have never been exposed to a pressure cooker in my entire life, but have always been intrigued by them.  I decided that my first meal in it would be a pot roast.  Brad and J. came over to act as my test subjects. 

I had another Groupon, this time for $35 to the Amish Market in Tribeca (which I got for $15) that I was going to use to buy the meat.  I always thought that the Amish Market was kind of an upscale market, but it wasn't nearly as nice as I had hoped.  They only had one roast there, and many of the vegetables there were past their prime (and overpriced).  You'd think since they were only a few blocks away from Whole Foods, they'd try a little harder to offer decent fruits and vegetables.  But I'm guessing more people go to Amish Market for their prepared foods than for their produce.  I got the one roast they had, a sirloin silver tip, but went back to the West Side Market in my neighborhood to get the vegatables for my pot roast.  Just the usual stuff...carrots, potatoes, onions, mushrooms.  I also got a few rutabagas for fun.

After searing the roast in the pressure cooker, I threw in some chicken stock, Franzia, onions, tomatoes, bay leaves, salt, pepper and paprika, and then sealed up the pot.  A few minutes later, steam starting spurting out of the air vent/cover lock, which rattled a little bit and then popped up, signaling that the cover pressure cooker was locked onto the the pot.  I was a little nervous.  Soon afterwards, a steady stream of steam began flowing from the pressure regulator.  I took this as a good sign, since the regulator ensures that the proper amount of pressure is in the pot (15 PSI), hopefully preventing it from exploding hot pot roast all over the kitchen.

After about 25 minutes, it was time to open up the pressure cooker and toss in the other veggies.  This requires releasing the pressure.  There are three ways to do so: (1) the "natural relsease" method, where you take the pot off the burner and just wait for the pressure to subside naturally; (2) the "cold water" method, where you run the pot under cold water to cool it down and release pressure quickly; and (3) the "quick release" method, where you turn a dial on the pot to get all the built-up pressure and steam in the pot to escape through a valve.  The quick release method sounded the easiest, so I did that.  It was pretty cool seeing all the steam rush out:

I threw in the carrots, potatoes, mushrooms and rutabagas, and sealed the thing back up again to cook for an additional five minutes.  It took the pot a lot longer this time to reach 15 PSI.  And because I had filled it up all the way with veggies, pot roast juice started sputtering out of the release valve along with the steam.  (Hidden somewhere in the instructions in very tiny print was a warning not to fill the pot past 2/3 full.)  After a quick 5 minutes of cooking, J. turned the quick release valve again to let the pressure out.  This caused a stream of pot roast juice to jet out of the valve like it was a Super Soaker, covering my countertop and floor (and J.) with the hot liquid.  Fortunately I got out of harm's way.  Sorry, J.

My first pressure cooker meal turned out pretty tasty, although I think I cooked everything for a bit too long.  The texture of the beef was a little bit stringier than I expected, and not as moist as I thought it was be.  After doing some research online, it seems like once you overcook meat in a pressure cooker, it gets really tough and dry, and you have to really overcook it in order to get it moist and tender again.  And even five minutes in the pressure cooker seemed too much time for the carrots, potatoes and rutabagas.  They came out way mushier than I would have liked.  The flavors, though, were pretty decent.  And to cook a pot roast the old fashioned way would have taken at least three hours.  I'm thinking that with a little more practice, I can get it just right.