Weight Loss During Pregnancy

So it’s safe to say that pregnancy hasn’t been anything like what I expected it to be. I’m not going to harp on about the gory details of severe morning sickness that lasts for 40 weeks because it’s very rare and most people will never experience the ‘joy’ of it, at least for that length of time. What I will focus on, is how amazing the human body is. And how little control you have over this whole amazing journey of creating a human from scratch.

The Dude or Dudette's room, finally ready to go.

The Dude or Dudette’s room, finally ready to go.

In the first trimester, I lost weight. No surprises there, I was vomiting so much I was hospitalised. In the second trimester, my body really came into its own: I gained weight like a trooper, with an aim to eat as much nutritious food as I could get down and keep down, and my baby grew like a little champion. In the third trimester, the vomiting and nausea returned with a vengeance and I have been losing weight again. Remarkably, the baby continues to gain weight – proof that the human body is simply incredible in just “knowing” what to do throughout this whole process. It’s now officially “baby month” as the baby is due to arrive any day now….something which is extremely exciting and equally frustrating for a control freak like me!

WHEN is “D-Day?” Such a simple little question. Thoughts race through my head about when it could be, where I will be (hopefully not at work taking a Pilates class!), what it will be like. I can handle the excitement of not knowing the sex of our little bubba, but not knowing when it will arrive is a huge challenge for me. I feel like I’m in the final days of preparation for an Ironman, only I don’t know which day I’m actually going to have to pull it all together to perform….

Control freak aside, I know I will cope with whatever labour throws at me when the time does come; know after everything I’ve been through that I am strong enough for that. I can’t wait to become a “mother”, and to meet this little person who’s shared the toughest 9 months of my life with me.

Birthday Cake: despite my nausea, I couldn't break my annual tradition of making myself a cake and eating some of it.  It wasn't much, but that's a win!

Birthday Cake: despite my nausea, I couldn’t break my annual tradition of making myself a cake and eating some of it. It wasn’t much, but that’s a win!

What scares me is the presence of Ana, ever there perched on my shoulder and nattering away its useless voice. Every time you get weighed at the Obstetrician’s office. And you’ve lost weight. Or gained weight. Every time you think about life after pregnancy – returning to racing, eating (normally, without vomiting…), running. Breastfeeding. Every time you see your body in its ever-changing state (why aren’t there any stretch marks there? Is that even possible?!). And of course, all the unknowns about how you and your body will be afterward. I put a lot of the uncertainty down to being so sick for so long, which invariably makes you dread eating food but forcing yourself to do it anyway. In some ways, it’s like being in recovery all over again. And then when you LOSE weight despite all the effort to keep some nutrition down, it’s like an extra factor messing with your head.

I am all too aware that statistically, the postpartum period is a high risk one for ED relapse. And that those of us who have had ED’s are also at higher risk of postpartum depression and anxiety. I’m concerned that I hear the little voices of Ana already planning “when the baby is out we’ll….[insert damaging behaviour here]”. I guess I somehow thought that by being all-absorbed with the love for the little person inside of me, there would be no room left for those thoughts. I was wrong.

I feel like pregnancy does make you strong enough to fight those thoughts and do everything in your ability to nurture the child within; my question is, what happens to that force once you are no longer carrying the baby inside of your body?

My hope is that the strength will carry over. Ultimately, that little person, whether inside of me or out in the big wide world, is relying on me and only me to be its whole world – at least for the start of its life. It’s still me who has to feed it, love it, care for it. And I can’t do the best possible job of that if Ana is taking up any significant real estate in my head. I also like to tell myself that after everything I have been through in the past few years, if major relapse was going to happen, it would have happened already: if major foot surgery, 18 months away from my beloved running, and 3 miscarriages doesn’t push you over the edge I think you can stand tall and be proud of where you have gotten in your recovery.

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I’m choosing to focus on my “strategies” and all the positive things to come, rather than the fear of relapse and Ana returning. Those strategies include having races pencilled in, so that I can feel like “myself” again in the not too distant future (it has been the longest time since I have raced an Ironman, fit and healthy, and I cannot wait to do it as a ‘Mum’ with my husband and baby cheering me on). And focusing on new friendships: up until this point in my life, I feel like I have friends who knew me as anorexic, then when we moved here 5 years ago, I formed a heap of new friendships with a clean slate – mostly triathlon-related friendships, and those people have no idea about how much of my life Ana took up. And I like it that way. But I have been missing spending time with a lot of those people with the reduced training that comes with surgery then pregnancy. I am excited to meet yet another bunch of friends through mother’s groups etc, and to start the next chapter in my life. I’m excited to blend that with my return to racing and hopefully have the best of both worlds: new mum, and Ironman comeback Queen. I’m blessed enough to have had a number of amazing women pave the way before me (see previous post on elite athletes and motherhood) and show me that not only can it be done, but you can actually come back even stronger.

Bring on 2015: New baby, new (stronger) body, and a long-awaited return to Ironman!

Happy Training,

K xoxo

My gluten-free Iced Vovos...presentation was a fail but I am assured they tasted amazing!

My gluten-free Iced Vovos…presentation was a fail but I am assured they tasted amazing!

Racing Weight

So yesterday I had a revelation. It’s only been, hhmmm, 18 years coming.

I was looking through some race results from a recent track meet and they had accompanying photos. One photo in particular really set me off – I felt a deep pang of ?yearning? to suddenly stop eating and to run a really long way. To look like that. ASAP.

I won't put the triggering photo up for obvious reasons.  Instead, here's a bunch of awesome, fit healthy chicks at the New Balance Games.

I won’t put the triggering photo up for obvious reasons. Instead, here’s a bunch of awesome, fit healthy chicks at the New Balance Games.

Ever since I started restricting calories at age 12, I have always been very easily triggered by certain people – for me, mainly athletes of the very lean, tanned, blonde and hot description. I most definitely have a “type”. For the longest time it was Anna Kournikova. I remember as a 12 year old looking up her height (same as mine – I was tall at 12. Incidentally, I never grew after that….amazing what starvation can do to the human skeleton) and weight. That was ground zero. Only, once I got to her weight, of course the ED/Ana was in full flight and I couldn’t stop there. I may have had the long blonde hair, the sports trophies, the tan….but I didn’t look like Anna Kournikova, because, well….she looks healthy. She glows. I had some grey death staring out my eyes to match the grey shades under them, and a bony back to boot.

Anna Kournikova in full flight.

Anna Kournikova in full flight.

Over the years the role models have evolved, and as I’ve talked about in previous posts, I now tend to look up to healthier athletes as a matter of requirement. I am simply too easily set off by the former. And of course a swap to a sport that suits my genetic make-up to a tee has helped as well: as a distance runner, being lean and super light was always an uphill battle, whereas I build the endurance and strength needed for long course triathlon almost by mistake, it happens so easily.

Anyway back to the point. To give you some context, my body at the moment is not at racing fitness and after being “Ironman fit” for the preceding 3 years straight, that’s a hard thing to get used to. I was as fit as I’ve ever been going into my foot surgery in July last year. But 3 months in a cast and non-weight bearing on crutches, when all I could do was core and upper body gym work and then after that, swimming….well for someone who builds muscle easily, I suddenly developed upper body muscles. Throw into the mix a couple of pregnancies then miscarriages in that period and well, needless to say, my body has changed. So I’m in the prime target zone of being affected by such triggers and constantly fighting the urge to overexercise and undereat, when in reality my body needs to be loved in every way in order to repair right now.

Only yesterday, for the first time ever, a shocking thing happened. I’m not even sure it was my brain producing the thought process, so foreign was that thought process. I suspect perhaps my psychologist or dietician found a way of tapping into my brain waves and altering them. For when I saw the picture, I yearned to starve and go run 35km. But then the next thought that followed was astounding: “yeah, if you want to be skinny-fat and unhealthy. If you want to get back to that level of fitness, you know what you need to do. You need to commit to training hard, and eating. A lot. Of really high quality food.” Sigh. Wait – whoah!! What just happened?!!!! Was that my head talking?

New, healthier role models: Caroline Steffen aka "Xena", 2nd fastest female Ironman athlete in the world.  Machine.

New, healthier role models: Caroline Steffen aka “Xena”, 2nd fastest female Ironman athlete in the world. Machine.

After deep consideration, I’m fairly certain it was me. I’m impressed. And when I analyse it, it’s true – the only times in my life I have been super race-fit, lean, healthy and glowing (and incidentally injury-free) have been when I’ve been able to train well and at a high intensity, and when I’ve been able to eat a lot of food to support that. For many of the other times, I may have been clocking in at my desired “racing weight” – for distance running, not triathlon – but I was far from glowing, and the fake tan and smiles were barely hiding a very frail skeleton with 10+ stress fractures in their short history.

As we all know a little too well, it’s far easier for us to undereat and overexercise. It’s comfy, predictable, safe, not scary. Eating like an athlete is frightening, uncomfortable, requires planning, and a lot of mental strength – and not just for a day, but for months. But when all is said and done, it’s always more rewarding doing something challenging than sticking to the same well-worn path. I don’t want to be a skinny-fat distance runner anymore; I will stand proud as an athlete. Glowing, too.

Bring it.

xoxo

My hand-made Easter chocolates for the family.  Happy Easter everyone! xoxo

My hand-made Easter chocolates for the family. Happy Easter everyone! xoxo

Our Body Responds to the Messages We Give It

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I have a friend in Brisbane who has just taken up Ironmans, which I am over the moon about. At first glance, she has all the right ingredients to make a solid long course athlete: she’s tall, muscular, mentally pretty tough and she has the support of her family – her husband also does Ironman triathlons. And boy does she like to train.

Before her first Ironman she was understandably nervous, and wanted to skype with me to pick my brains about a few things; I was more than happy to help out. I had a lot of fellow Ironman athletes take me under their wing when I first started out, and along with my coach I felt extremely well prepared going into my first race and subsequently had a great time. I was excited to be able to do the same for her, and so I wrote down some key nutrition, pacing and training concepts that work well for me (mainly female-specific things).
So you can understand my shock when no more than 5 minutes into said skype date, she blurts out “well of course I’m only doing Ironman to keep my weight under control – for the same reason you and every other girl does it!” she laughed. I was not laughing. I was actually trying not to choke on my espresso.

SAY WHAAAAATT??!!

Firstly, let me get this off my chest. Ironman is sacred. It is a place where you go to search the depths of your soul, to find out what you’re really made of in a way that daily life just doesn’t allow for. It is a celebration of the human body and mind, of the incredible things it can achieve. It is a magical place with a finish line that feels better than ecstasy. And when all is said and done – the months of discipline, the long, long rides with fellow athletes who become friends, the many memories made, the body chiselled and honed, the mind strengthened and the self-confidence firmly built one brick at a time – you become part of the “Ironman Family”. And THAT is what Ironman is about. Nothing short of a celebration of life in all its glory. Amen to that.

My second thought was “oh boy you are going to crash and burn in a big way, you’re doing it for all the wrong reasons”. (I didn’t say that out loud….). I do Ironman to celebrate my recovery, and to be around a couple of thousand people who don’t make excuses about why they can’t do things, they find a way to do things and be happy and loving and I am addicted to the joy and self-confidence that Ironman has brought to my life. I now respect my body for what it can do, NOT what it looks like or what the number on the scale is. It’s not an exaggeration to say that it has saved my life, by taking me away from Ana and onto richer pastures. I can’t believe how amazing this body now is, and also feel mortified sorry for the things I have done to it in the past.

final Arpil 14

The third thought – and this is where the scientific nerd within kicked in – was “you’re not going to lose weight by doing what you’re doing, if that is your goal….”. She refused to take any nutrition other than water during any training sessions, scared that it would make her gain weight. Then she would try to restrict her calories during the day as well, to try to cut more corners. (Subsequently I am sure) she hated long rides because….well….she probably felt like crap, running on empty! Not surprisingly, she had a few niggles that she couldn’t settle and she wasn’t able to push the training up to the next level.

And sure enough, after her first Ironman, she didn’t enjoy the experience. She was too focused on trying to keep her weight under control, and stressing about not training in the couple of weeks after the race.
Here’s the thing. This may come as a revelation to non-athletes and to Anorexics, but our body responds to the messages we give it. If you starve yourself, it learns that food is scarce out there in the world and it better slow down its metabolism and store fat for the long cold winter (we still have the same DNA as our hunter-gatherer ancestors, remember). It learns that it better prioritise only the essential life-giving functions, like breathing and brain activity – so those niggles don’t heal and the muscles don’t repair from the hours of training. Minimal training adaptations occur, so you don’t really get fitter either, you just keep breaking down. Not to mention hating the training because, well, you never really feel good! In the short-term or if you get extreme about the starvation yes, you will lose weight (hello eating disorders). But eventually that weight loss slows down. And I can tell you from personal experience that after 10 years of it, your metabolism becomes very smart and very thrifty. I could go days on minimal food and not lose any weight. My body just knew it had to conserve to keep me alive.

On the flip side, if you train hard, and fuel your body, it will get the message that you want it to become fitter and stronger, and that since there is plenty of food around, it’s therefore safe to make those adaptations. You’ll lose fat, and gain bone density and muscle. Your mental health, sleep and mood will improve. You will have more energy through the day. And on race day, you will perform well and likely also enjoy yourself and the experience (which is the whole point, right?!).

Matching shoes and nails: check...

Matching shoes and nails: check…

And then the best part of all is the famous post-ironman “afterburn” phase, which lasts between 1-4 weeks depending on your metabolism and fitness and genetics. This is where you pretty much eat whatever you like, do minimal exercise, and lo and behold – you get leaner. It’s hilarious. Your body is working so hard to repair everything, and it’s still zooming from the 12-hour race, that if you feed it with A LOT of food, you will then set it up beautifully for the next phase of training and racing (or just life in general if you so choose). BUT if, like my friend, you decide to hardly eat anything at all after the race, you will actually halt that process and force your metabolism to really, really slow down. Your body is madly trying to repair and recoup, and if you don’t nourish it now, you will set it up for an ever slower metabolism and, unfortunately, you will likely actually lose muscle and gain fat. Which is what happened to my friend. And so the cycle continues, as she has signed up for the next race in order to “control her (now higher) weight”…..

I know it’s hard to get your head around the fact that eating more could result in losing weight. It certainly took me a long time to believe it. I tried it as a one-woman experiment and took all my measures weekly. Sure enough, over the course of 6-8 weeks I got leaner, stronger and my performance and recovery were better than ever (read: I was kicking my husband’s butt in training). The key is to keep the food as nutritious as possible, and to eat most when your body needs it most – before, during and after training. It still feels odd for me to do that, but it’s worth the mental discomfort in order to now feel like an athlete.

As a final disclaimer, I’m not saying that there aren’t people in Ironman who have eating disorders and abuse the system, and I’ve talked about this in previous posts. But they aren’t the ones succeeding in the long term. They’re the ones you see at one race, who look super fit and fast, but who end up walking the marathon because they have no fuel or endurance. They are the ones who, after 1 or if they’re lucky 2 years in the sport, you never see again. Or the ones who are one big chain of injuries one after the other – they never line up on race day 100% healthy. And they certainly aren’t the ones with the sparkle in their eyes, who will still be doing it when they’re 60 years old. Now those guys are the real superstars!

We all have one body in this life, and we all have a choice. We can nourish it and let it flourish to its true potential, or we can cut corners and watch it struggle.

I choose life!
Happy training.

K xo

When all else fails, Bake.

Hormones rule the World…ok I get it, I GET IT!

It’s been a pretty stressful last few months, which largely stems from the fact that I am once again faced with the ever-challenging issue of learning to trust my body.

After having a miscarriage 4 months ago, my body has decided that it’s going to do its own thing, regardless of whatever I am choosing to do. Despite zero change in my food or exercise, I have been battling an influx of hormones presumably stemming from the miscarriage. My previously flat stomach is now decidedly curved and my breasts have gone from a small B cup to a large C cup. Initially I thought that this would level off over time, but it seems they are here to stay – at least for the time being.

Tiffany's-inspired Chocolate Cupcakes.  I dare you not to feel uplifted!

Tiffany’s-inspired Chocolate Cupcakes. I dare you not to feel uplifted!

It’s brought all those recovery memories flooding back. The overwhelming feeling that you are drowning in a sea of change and you don’t know when the wave is going to stop pummelling your body against the floor of the ocean. It’s also a bitter pill to swallow: that I would not only lose my baby, but that I would lose control over my body as well. My doctor reassures me that it’s a good thing, that my body is trying to set itself up to become pregnant again (which is what I want more than the world). My psychologist says that I should focus on the positives, like having amazing breasts – my husband has certainly had less trouble than me focussing on this one – and that this will not last forever. But for me, it’s all been downright confusing. Just when you think you truly know your body, know what it likes, know where its set point is, have come to accept a certain size as being healthy for your frame….it all gets thrown to the wayside. I can almost hear God laughing.

Once again it has reminded me that hormones do, in fact, control the world. Or at least our sleep, mood, emotions, fat deposition, curves, weight, fatigue and ultimately, fertility…. So what to do? The only thing I know how to do: make sure I am taking the best possible care of my body and mind and trust that it will settle into itself, wherever it is supposed to be. Which means, for me, cutting out caffeine and alcohol, eating A LOT of fruit, vegetables, good quality protein, nuts, seeds, good fats, and of course steering clear of gluten (I have Coeliac disease, as an aside, which does put me at a higher risk of miscarriage along with a history of Anorexia. Oh the joys.). It also means focussing on nourishing my body with activity that brings me joy and relaxation, namely running, dance, Pilates, group rides and swim sessions with my husband. Not because I have to do a set session or hit a predetermined interval; simply because my body can and it makes me happy. That is an important distinction. It means getting at least 8 hours of good quality sleep a night, and actively trying to relax during the day – deep breaths at work, 5 minutes of meditation when I get the chance, and laughing a lot. And of course, when all else fails, it means baking – the cheapest and best therapy of all.

Death by Chocolate: Chocolate Mousse Layer Cake with Chocolate Ganache

Death by Chocolate: Chocolate Mousse Layer Cake with Chocolate Ganache

I’m not sure that I will ever be able to accept that I cannot control what is happening with my body. Ultimately, your body will change at various stages during your life, and there is very little that you can do to stop that – short of being unhealthy and falling back into eating disorders patterns, or conversely, saying “stuff it” and allowing yourself to become significantly overweight, which is not healthy either. It is well established in the research that your body has a “set point” – a range of about 5 kg, that it will defend at all odds. So just like in recovery, when you have to trust that you won’t keep gaining and gaining indefinitely; I too have to now trust that if I nourish my body and treat it well it will do what it needs to do to create the optimal environment for baby-making and health. I can’t change what that shape ends up looking like on me, but I can change how I react to it. I am faced with a choice – to reject the change and stick to everything I have known up to this point, or to embrace that I do not have control of what is happening and to learn to love my body, no matter what form it presents in. After all, I am still the same person inside.

It’s going to be a challenge, but I’m pretty good at overcoming those.
Keep on keeping on fighting the Good Fight. This one is going to be tough.

“When doubt seeps in, you got two roads, you can take either road. You can go to the left or you can go to the right and believe me, they’ll tell you failure is not an option. That is ridiculous. Failure is always an option. Failure is the most readily available option at all times, but it’s a choice. You can choose to fail or you can choose to succeed.” – Chael Sonnen

K xoxo

Show me how Big your Brave is

Reporters love asking celebrities what they would go back and tell their younger self. They reply with some warm fuzzy blurb along the lines of “things get better” or “be more confident”. If I could go back to my younger self – probably around age 15 – I would say: grow some balls and scream for help, scream so loud that no-one can ignore you, to hell with the fear….it may just save your life”.

Finally - the media doing something proactive towards body confidence

Finally – the media doing something proactive towards body confidence

There is inevitably those fleeting moments in the eating disorder journey where the inner You is strong enough that you could probably ask for help. But these moments are so few and so far between, that the fear quickly envelops the soul and again sets you back down the path to Ana. I can still think of the few times during my decade with Ana – count them on one hand, actually – that I would have accepted help without too much of a fight. Those moments you remember, with clarity when it was just too hard to fight any more. Broken, at last. When I do think back on those few times, it still makes me feel physically violently ill to my stomach and sets my heart pounding, even all these years later. The extent of the fear of ratting Ana out is unlike anything else. To simply say the words “I need help”, comes with a plethora of assumed baggage weighing enough to drown anyone.

While eating disorders are rarely “silent” – those around you know there is something wrong – I would bet money on the fact that no one on this planet knows everything I did to myself during those years; the extent of the body abuse and the tricks that Ana played out. So while Ana may fool you into thinking “if it was that bad, someone would have intervened by now”; in reality, you and I both know that they have no idea what you are truly doing and what goes on in your mind. Looks can be incredibly deceiving.

My birthday cake.  Made by me, and yes, also eaten by me (well, one piece!  Baby steps)

My birthday cake. Made by me, and yes, also eaten by me (well, one piece! Baby steps)

But then the benefit of hindsight is that in all my wisdom, I can now look back with heartbreak, thinking “if only”. If only I had said to someone that I was unwell, and that I couldn’t stop myself. That I was so scared I wanted to vomit. That I thought I had control of this thing but that turns out to be the ultimate trickery. That I don’t want to fight anymore. I don’t want to “act” like Me anymore; I want to find Me. If only….

There were many people in my life that I could have asked for help. My immediate family were a huge part of my problem and chose to be incredibly ignorant about my condition, so even as a 12 year old, I knew that was not an option. But my Aunty, my best friends, my boyfriend, my coach, and later my resident mentor at college, or my doctor…..any of these people would have given heart and soul to help me – and God knows how much they all tried at various times – if only I’d let them in. It would have taken a huge amount of guts and four words to change my life: “help me, I’m ready”.

Instead, I let Ana rule the world for a decade, pretending I was in control, but knowing full well for the latter years of my illness that I was not. In a final bid for freedom – of myself, not Ana – I jumped on a plane to Canada and set myself free in the world. I was going to get better. Only just 2 weeks in, failing miserably, alone in a backpackers in Vancouver, I collapse on the stairs from a near-lethal combination of starvation and a vomiting bug. For the record, I don’t count medical help that was not given by choice but rather by dire circumstance as “asking” for help. Clearly, this was not going to be a one-woman effort. By that stage, Ana was so strong that it was going to take a lot more than that to break her down.

On returning to Australia, this time as an adult, I checked myself into help for the first time ever. It was my choice. I was scared shitless and felt so out of control of my life, but it was what it came to. It took years of mess and emotional rollercoasters and a lot of help from my friends following that to find health and most importantly, Me. But I got there.

And yet the mind wanders at times…..How would things be different, if I’d gotten help so much sooner?

“Maybe there’s a way out of the cage where you live
Maybe one of these days you can let the light in
Show me how big your brave is”

Help is scary, I know. But living alone with Ana is scarier. Just because it’s familiar, doesn’t mean it’s ok. Deep within every perfect little Anorexic is a voice that wants so desperately to stand up for You, for everything that should be yours and that you deserve just as much as everyone else in the world. Don’t let Ana fool you into thinking you don’t deserve it. Finding that inner voice and learning to use it is often the keystone to the mountain that is Recovery. It certainly was for me.

tattoo edited

Be brave. Kick and Scream. Beg for help. I know You can do it.

“Nothing’s gonna hurt you the way that words do
And they settle ‘neath your skin
Kept on the inside and no sunlight
Sometimes a shadow wins
But I wonder what would happen if you

Say what you wanna say
And let the words fall out
Honestly I wanna see you be brave….

Don’t run, stop holding your tongue
Maybe there’s a way out of the cage where you live
Maybe one of these days you can let the light in
Show me how big your brave is…

Honestly I wanna see you be brave”
– Sara Bareilles

K xoxo

The broken. A Survival Guide.

Part II:

So you’re fractured – body and brain. You want to scream at the world and pull your hair out and cry, simultaneously. I get it.

In the previous post I introduced the concept that perhaps it is essentially the mind that causes stress fractures in the large majority of athletes, moreso than just the body failing, as modern medicine would have us believe. Specifically, the sheer force of power that is that voice in your head that will not allow the body to stop, even when presented with increasing physical pain. We are a smart bunch; it’s not like we don’t know that something’s wrong and it’s getting worse. It’s just that stopping is infinitely harder than pushing through a little physical pain. Hell, sometimes the physical pain feels good – euphoric even – like you are fighting the beast in a different way. And yes, the pain of a stress fracture is “little” in comparison to running 35km after not eating much for a few days….there’s levels of relativity and most of you here have an abnormal sense of ‘perspective’ when it comes to matters of human suffering. I wish it wasn’t so, I really do.

Sometimes the beast wins, and you find yourself in the doctor’s or physio’s office with a full-blown stress fracture or major overuse injury, which essentially you did to yourself. Yet another kick in the guts. Facing down the barrel of 6-12 weeks off your beloved sport, you feel the red rush of hot panic bubbling up from the fracture site and seeping into your heart. Staring at the image of a clear break on a clear scan, suddenly the pain feels so much worse.

What now?

Sesamoid IV

There are hundreds of well researched and accessible texts on gold standard treatment protocols for stress fractures, ranging from stopping running right through to the extreme of surgery, depending on the site and severity of your injury. But there are very few resources written on coping with the emotional and psychological backlash of injuries, much less if you also have an eating disorder or disordered eating and you are now faced with the removal of one crutch – running (emotional) and the replacement by another crutch (literal).

1) Take time to digest the news and go through the stages of grieving, so that you can recognise what you are dealing with. If possible, have a close friend or loved one with you to help with the support and to remember information. The average patient only retains 30% of what is said to them during a medical consultation. Even better – write it down. The doc won’t mind.

2) Embrace the “Athlete Mindset”. The fact that you are in this situation means that you are dedicated enough to your pursuit of excellence that you are already in the top minority of athletes. BUT….you need to learn when that line is approaching and how to not cross it in the future. Allow yourself to recognise your best traits (discipline, commitment, passion), but also to define what you would like to work on in the future (the strategies in part I – prevention; listening to your body; allowing yourself to rest and letting go of some of that perfectionism….). Your “training” now is recovery. That is no.1.

3) Get some Sun. It’ll help with the bone healing thanks to its Vitamin-D inducing properties. It will also assist with depression, appetite and most importantly it will get you outside into the fresh air.

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4) Ensure Social Contacts. It’s more important now than ever to make sure that you stay involved somehow – whether that be with group catch-ups after training, going to training or dance class and assisting the coach or teacher, keeping up with dance or running magazines. While it seems counterintuitive, this can actually help you to keep the “athlete mindset” and to help with staying on track in order to achieve bigger goals in the future.

5) Create a different outlet. Use your emotions as a guide. Do what makes you feel good; steer away from things or people that make you feel more down or frustrated. Be aware of being pulled towards bad habits – they can be strong and start sneakily. Tune into your emotional radar early when it’s slightly easier to resist.

6) Develop a nutrition plan. And stick to it. Most notably:

a. Avoid regular and diet sodas due to the bone-leeching phosphoric acid contained in these liquids.

b. Reduce caffeine intake, ideally to less than 2 cups a day. Caffeine also leeches the skeleton of calcium, critical when the bones are in healing mode.

c. Avoid alcohol, which can induce a pro-inflammatory environment and affect absorption of important nutrients in your food. Aside from this, it is a depressant so probably not helpful on the brain given the current situation.

d. Maximise sleep, as this is where your largest surge of growth hormone occurs – crucial for healing and mental health as well. Talk to your doctor about this if you are struggling, which is common when you are used to expending so much energy on a daily basis.

e. Most challenging of all….keep the focus on nourishing the body with high quality foods, now is not the time to diet or restrict food groups. Keep in mind that healing takes up a huge amount of energy. Accredited Sports Dieticians are very experienced in this field thanks to the high injury rate in elite athletes – and yes, you can totally book an appointment and request a meal plan to maintain your current weight while injured, whatever that weight may be. Even if they suspect you have a phobia of certain foods or a controlling personality, they will respect that and all information shared is legally confidential.

7) Most importantly, give yourself permission to rest and heal. If you cannot give it to yourself, ask your health professional – whether it be your dietician, psychologist, physio, doctor or even a friend or loved one. The most weighted words you can hear are “you are not allowed to exercise with this”. You have permission, to just heal. That is your number 1 job. There will be plenty of time once you’re back on your feet to concentrate on training; for now, the more you rest, the faster you will heal.

Of course, it all sounds so practical and easy when it’s neatly typed out on a page. It won’t be – it’s going to be hard, much harder than the physical pain of the initial injury or the discipline of full training. But if there’s one thing that’s certain, it’s that with no plan at all, things will likely slip downhill fast on the sliperyslope to ED-land. You will have a much harder fight on your hands in the mental department during your down time, but it is worth fighting for and you will come through the other side a stronger, better, more passionate athlete. In my younger (Ana) darker days I had a tibia stress fracture which I couldn’t (mentally) stop running on, eventually I ended up in a cast. When the repeat XRays were done at 8 weeks there was zero evidence of healing, mainly because I had been stressing and severely restricting food during that time and had consequently lost a significant amount of weight. Yes, that can happen. Don’t muck around with it – the psychological setback is so much worse the longer it goes on.

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Stay strong, fight the good fight, and learn from your experience so that you can come out fighting.

K xo

The Importance of Nothingness

“Normal is an illusion. What is normal for the spider is chaos for the fly.”

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The Importance of Nothingness:

The ability to sit still with oneself in a non-anxious state
And truly be present in the Immediate Moment.

A heartbreakingly very difficult ability to learn, for us…

And yet perhaps the ultimate Yardstick to one’s true sense of Mental Health.

Can You be content in the company of You?

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K xo

Clarity

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High dive into frozen waves
Where the past comes back to life
Fight fear for the selfish pain….
It was worth it every time.

Hold still right before we crash,
‘Cause we both know how this ends
A clock ticks ’till it breaks your glass
And I drown in you again.

‘Cause you are the piece of me
I wish I didn’t need
Chasing, relentlessly
Still fight and I don’t know why.
Why are you my remedy?

– Clarity, ZEDD

Oh for the sensitive ones, the ones who love too much, feel too much, strive to be too perfect and fracture a little too easily. Even when pieced back together, ‘recovered’ for one of a better word, the fact remains: we feel what we feel, and we are the way we are. Different. And you still have to learn how to manage those emotions. Without that.

But the question remains. If you could change it, would you? Would you still be Ana you?

K xo

Ramblings of a Healing Heart

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We are all beautiful. It breaks my heart to see so many stunning, talented, inspirational and kind human beings walking the earth with their guarded self to the wind, scared of being hurt and lonely, and the saddest part is that by closing themselves up in such a way, they become the ones who are inflicting the self-harm, negative self-talk, and ultimately the self-destruction.

“IF you can keep your head when all about you
Are losing theirs and blaming it on you”…..

More often than not, these are not the people you suspect, as you all know too well, those of you who have been drawn here. I look around me at the amazing athletes who I have grown up with, laughed with, who have blossomed from scrawny little kids in to breathtaking women, the type that light up the whole room and inspire you to be a better person just with their presence.

“If you can meet with Triumph and Disaster
And treat those two impostors just the same”…..

Those are the blessed (cursed) few who the whole world holds up on a pedestal. For they are like the perfect rose – distracting the human eye with their breathtaking radiance all the while harbouring thorns with which they can too easily harm oneself. It breaks my heart to see such souls broken – spiritually, physically, psychologically.

“If you can make one heap of all your winnings
And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings
And never breathe a word about your loss”……

Often the physical trauma (injury, illness, starvation) is simply the final straw to the spiritual trauma that has been dwelling within. But the human spirit is strong, and the brighter the soul’s light in the world, the stronger the heart that lies within. Time and time again, I see these athletes get knocked down, shattered into a thousand pieces, and yet somehow clasp at the remnants of themselves and watch them slowly but surely build themselves back into a whole. Love can take you a long way, just as hate and manipulation can fracture you.

“If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: ‘Hold on!’”…….

Be smart about who you allow into your circle of life, and be strong in your love for yourself. You are so much more incredible than you allow yourself to believe, if only you could step outside your physical being and see yourself from others’ eyes.

Build on your strength, learn from your breaks, and foster self-love daily. Meditate on it. Visualise your life and self as beautiful. Reflect on your support and let the love in. Never forget, it is the thorns that allow the rose to hold its head so high to the world. It is the strong woody branches that allow the delicate rose to scaffold itself against the harsh conditions of its environment. Without that, the rose may be beautiful, but it is weak and easily damaged.

“If you can fill the unforgiving minute
With sixty seconds’ worth of distance run,
Yours is the Earth and everything that’s in it.”

Be strong.
You are amazing.

xoxo

– “If”, by Rudyard Kipling

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