Learning to “Hurry Slowly”

Nothing like Melbourne's best espresso to help one hurry slowly.  Brunetti's, amaze.....

Nothing like Melbourne’s best espresso to help one hurry slowly. Brunetti’s, amaze…..

“You can’t calm the storm, so stop trying. What you can do is calm yourself; the storm will pass” – Timber Hawkeye

Hurrying Slowly

This phrase has always immensely annoyed me as I find it very hard to get my head around the concept that sometimes, less is more. I am an intelligent and logical person and I can see how the concept is supposed to work; indeed I spend large proportion of my waking hours explaining its importance to my injured athletes (patients) so that their bodies can heal in due course. However, as with a lot of things in life, applying it to oneself has remained a challenge for me.

The first time I encountered it was from the man who moulded most of my triathlon ‘career’ to date, my coach. He used to annoy the hell out of me by responding to my long rants about how impatient or fatigued I was at any given time with the simple response: “we hurry slowly”. “I don’t do anything slowly!”, I would retort, and as it turns out this was to be my ultimate “fail” as I sit here recovering from foot surgery essentially because of my inability to stop when needed and not push the boundaries of the amazing human body (combined with a large proportion of congenital biomechanical predisposition to developing a sesamoid dysfunction). Lesson learned.

So the way I see it, the Universe has given me another shot at learning to “hurry slowly” and this time, I am listening up. It’s been a huge challenge for me, but it helps that the human body is pretty clear about things in a post-operative state: you do too much, you get pain. You get too busy, the foot swells. It’s not rocket science. But it is a great chance to practice the concept of listening to one’s body and pacing oneself. And I am hoping that by developing these skills, I will have a more successful shot at applying the ‘hurry slowly’ concept to my life when I am back in full swing – working full time and training full time. This is when the real challenge surfaces, as the vague rumblings of a body that is overstressed can be easier to ignore – the churning stomach, the over-racing mind, the lack of appetite, the niggles that pop up with routine training, the fatigue that slowly creeps up over days or weeks, the loss of patience for life’s little annoyances. These are all important signs to look out for and they should be respected even more than the clear-cut objectivity of post-operative pain and swelling.

Because, ultimately, a foot will heal as the amazing human body turns over its bone cells in a cycle roughly every 6-8 weeks.

But our health – mind and body? That is forever. We only have one body, and one life. And we can’t do a simple operation to “fix” it. So instead, we must take great care of it; listen to it, treasure it, and learn to go with its natural flow.

Hurrying Slowly.

K xo

Sesamoid Fractures

D10 Post Op Review
Day 13 post-Op

“Your journey has moulded you for your greater good, and it was exactly what it needed to be. Don’t think that you’ve lost time. It took each and every situation you have encountered to bring you to the now. And now is right on time.”

So it will be two weeks tomorrow since my foot surgery, what a whirlwind of a fortnight. This is going to sound like stating the obvious but I just cannot wrap my head around how much it has taken out of me – I mean, I can do an Ironman and run 3 days later, but this surgery thing is in a whole different ball park! Even as a physio, I am constantly amazed at how exhausted I am and how little it takes to get fatigued or to swell up the foot…..but I am learning, often the hard way, and trying to be very patient with myself (doesn’t come easily!). I guess I figured that I was super fit going into the surgery and I had done so much “pre-hab” that I would just breeze through it – ah, close but no cigar! As promised, for the medical nerds out there I’ll go into the juicy details; if you’re not into it then feel free to let your eyes glaze over momentarily while you fast-forward past this section.

The fracture to the medial sesamoid happened 8 months ago; because of the difficulty in diagnosing this injury and because it was literally Christmas time there was a 2 week delay in getting the MRI results and a definitive diagnosis, then getting into a boot to offload the bone. Sesamoids are well known for being very difficult to treat and even with 8-12 weeks in a boot, your chances of it healing are statistically about 50%. This is mainly due to the location of the bone (under the forefoot so it gets your full body weight with every single step), and the poor blood flow to it – which is usually only one small artery for supplying all the nutrients needed for healing. Often when it fractures, you either break the artery or the swelling compresses it, further limiting the blood flow. I’m sure the delay in diagnosis would not have helped nor – I’m sure in retrospect – would me working 40 hours a week on my feet while in the boot; lesson learnt and I would never let a patient of mine do that. (Got to love the benefit of hindsight) So long story short, 4 months after this I had another MRI that showed no healing through the bone despite the mandatory time the boot, and I found myself sitting in the very swish office of a well-known sports surgeon in a big city far away from home.
He explained that we had a few options, and after a lengthy chat and a lot of questions from me, we both decided that the best shot I had at competing in Ironmans in the long term was to operate. He planned to do a bone graft from the hip and screw it into the sesamoid, but also do a dorsiflexion osteotomy of the 1st metatarsal at the same time, which would effectively offload the sesamoid and hopefully prevent me from having this problem again in the future.
So far so good, but here’s the kicker: it was fairly major surgery. Two hours under the knife, overnight stay in hospital, 10 days in a backslab, 6 weeks in a cast non-weight-bearing, then a further 6-8 weeks in a boot partial weight-bearing and a grand total of 9-12 months before I start a return-to-run program. Gulp. I asked him how long we could put off the surgery – I needed time to think! – and he gave me a couple of months. I needed every bit of that time to process how I was going to handle the situation (mentally and physically, not to mention the logistics of work etc) and to most importantly psychologically prepare myself so that I would be able to maintain good nutrition for healing and not revert to old habits throughout this challenging time.

Which brings us to the now, 13 days post-op.

The surgery itself did not go to plan in that when he got in there, the fractured bone literally “fell apart like an eggshell” and so he set about salvaging what he could of it. No bone graft was done but he re-attached the ligaments to the new smoothed out bone and the outcome should remain as favourable as if the bone graft was done. The osteotomy went well, and when the backslab came off it felt like unwrapping a present to see two relatively big but very neat incision scars and everything coming along well. Surgeon’s happy means I’m happy. He didn’t let me leave without a 15 minute lecture on training and not overdoing it, but then he does work exclusively with athletes so I am thinking I was not alone on the receiving end of that spiel! My next review is in 5 weeks to get an XRay done and hopefully we can remove the cast and get into a boot shortly after. I am allowed to do upper body weights and Pilates as long as I do not put my right foot on the ground, but nothing else. I will hopefully get back into swimming and deep water running, plus cycling in the boot on the turbo trainer, once the cast is removed.

The things I have handled well include preparing work and home so that I can still be keeping my mind occupied – that is, running the business from home and still overseeing my junior staff treating my patients etc. That has been huge for me, because without running AND my work I go mad. Take away running – and Physio becomes my main crutch, excuse the pun. So the surgeon was happy to work with me on that one, I was upfront from the beginning and he has been brilliant with setting clear guidelines. As of next week I will go back to the clinic and see selected patients during half-days so that will be even better – the worst thing you can do in this situation is have only yourself to focus on! I was also lucky to have my closest friends around me throughout the whole process, as well as my husband’s family who I am closer to than my own. They all knew in advance that I would be in need of lots of laughs, some sense of “normality” and zero sympathy (I am NOT a good patient! Business as usual….well, as much as possible!). Anyone in my life that I thought would not be able to abide by those guidelines I haven’t spent much time with (yet). I need to make sure I have a strong support network around me and it has been worth its weight in gold; I would do the same for any of my friends. (Don’t be afraid to tell people what you need – your true friends will actually feel more comfortable as they will likely be upset seeing you so busted up as well! This was a lesson in life that took me a long time to learn but that has been invaluable). And of course, there has been plenty of baking coming from my kitchen (therapy for me and a great “thank you” gesture for said friends). Equally as important as anything else has been making sure I eat great quality food, regularly, and getting enough sleep – not as easy as it sounds with zero appetite after all that my body has been through. Of course, this is hard for me when I can’t train as the two remain inextricably linked for me (ironically I am healthiest food-wise when I am in full Ironman training mode), but having prepared mentally for it beforehand was very important. I have no intentions of gaining any weight during the next few months, but by the same token now is not the time to be depriving my body of any vital nutrients – the success of this surgery depends on it. My long-term running depends on it. And that, my friends, is non-negotiable!!
What I have found most challenging has been pacing myself – I am so used to going 100 miles an hour every waking moment of the day; obviously being in plaster non-weight bearing slows you down but having to stop and REST every hour or two is a HUGE ask for this little duck! The other complications couldn’t have really been predicted – I have low blood pressure normally (110/70) and a low resting HR (55) which I put down to being fit and possibly a bit of after-effects from the ED; but my body really struggled with the anaesthetic – the night after my BP went down to 70/40 and things got a bit hairy for a while there. But all is well now, onwards and upwards, time to rebuild this body!

Anyone wanting more info about sesamoids and stress fractures can head to this brilliant site:
and of course I am happy to answer any questions on this tricky topic or with coping with injuries.
Happy training!
K xo

Separating the Wheat from the Chaff

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“Before you diagnose yourself with depression or low self-esteem, first make sure that you are not, in fact, simply surrounded by assholes” – William Gibson

“You are the average of the 5 people you spend the most time with”

There are a number of, shall we say, personality characteristics which strongly predispose a person to developing Anorexia. These are not usually enough to cause the full-blown illness, however, when combined with genetics and environment one can make a pretty lethal combination. One of these traits is the need or want to help other people to an almost pathological level; that is, to the expense of one’s own needs. To be perfect – the perfect athlete, friend, student, child, employee and so on.
Probably the single most important part of the recovery journey in my opinion, is learning to put oneself first. To put your health and wellbeing as the first priority. And in doing so, to truly understand that the only way we can be helpful to those around us is to be fully healthy and happy ourselves; this is where we get our strength. I say it to my patients all the time, and particularly to mothers, who love to put themselves last – it is imperative that you look after your own health and wellbeing first and foremost, so that you can be a pillar of strength for all those around you. In fact, not putting your own basic health and happiness needs first is the true form of selfishness, when you really think about it. I’m sure if you asked your friends and family would they prefer you to be a shining light of energy and health, or the ‘perfect’ person who always pleases others, deep down, you know they would want you to be your own person, imperfections and all.
Which brings me to the point of this blog. It has been 6 days since my foot surgery (more on that later), and it’s been an overwhelming 6 days in that it has highlighted a very important task in my recovery journey – having the strength to look after myself first; but as a part of this, surrounding myself only with the people who embrace me just as I am, no ‘perfection’ required. Task completed!
About 4 years ago, as I was getting on a roll with my recovery, something occurred to me – that some of the people in my life made me feel completely drained, stressed, or judged (ie relapse triggers!); while others made me feel happy and warm and most importantly, made me laugh and be “me”, crazy as I can be sometimes. I made a decision at that time which was one of the hardest choices I have ever made – to only foster those relationships which are 1) mutual and even (ie not me ‘giving’ all the time); and 2) supporting my recovery. I knew by then where I wanted to be with my life in the future (which is pretty much where I am now!), and I also knew deep down that some “friendships” and family members were holding me back from achieving that. As scary as it was, I decided to let go of the drainers and hope that the Universe would open new doors to new friendships in the near future (which it absolutely did, thanks Universe – you rock).
So, easier said than done, definitely stating the obvious. We can’t choose our family, and if yours are part of the problem, I strongly recommend talking to a professional about this as the core issues are different for everyone and it’s clearly an extremely sensitive area to deal with. My psychologist has been worth his weight in gold with making the hard decisions, as has my husband for helping to implement said changes over the years. As for friends, for me there was never a conversation or a set “end point” – it was just a matter of me stepping back and waiting to see what happened. Some reached out and stepped up and our friendships have become stronger for it; others I have not spoken to since, other than the odd social media interaction. I make it sound easy; it wasn’t. I lost my best friend through the process, however I had to acknowledge that our relationship was formed when we were both unwell and it was not able to evolve past that point (whereas others were). I also had to have some very confronting conversations with family, however over time it has meant we are all able to move forwards into much more functional, adult relationships.
And the upside? The short period of pseudo-loneliness and hard conversations was quickly replaced by stronger, more meaningful friendships that continue to evolve all the time. Many of my ‘new’ friends have no idea about the severity or extent of my ED history and that is fine with me, as it reinforces that fact that they value me for me, just as I am. Those friendships that I had from before have moved well beyond my ED era and I am sure many of them forget about it on a day-to-day basis, which is as it should be. It is part of my history, but it doesn’t define me – I am so much more than that. All of these people are my new “family”. And all of them have reinforced how much they mean to me over the last week and no doubt will continue to be looking out for me over the coming months, just as I would do for them.
My advice? Give it a shot: put yourself first. Set a trial period – for a month. And while you’re at it, notice how your friends and family react. Notice how you feel after seeing different people in your life – uplifted or drained? Stressed? Calm? Energetic? Embrace those relationships that make you feel great, and perhaps reconsider the ones that drain you. Above all else, don’t let fear hold you back – I have no doubt you are an amazing person, and losing a couple of “B” class relationships will most certainly open the door to a few more “A” class ones.
Life is too short to not be celebrating every day!