Roid Rave

I just started steroids, and i feel great!

For the first time in what seems like an eternity, i woke up this morning with NO PAIN in my Achilles tendon, just a mild stiffness that quickly went away with some stretching.  It's probably from getting my Dexamethasone Iontophoresis yesterday afternoon.

To be more precise, my steroid is not the (alleged) Barry Bonds type of steroid, which would be more of the androgenic/anabolic kind, but rather a glucocorticoid, which fights inflammation and causes a host of other effects when taken systemically.  This is significant difference, as when people hear the word "steroid," it evokes plenty of (undeserved) negative connotations.  I myself actually grew up deathly afraid of steroids, having grown up with the phrase, "Naku, naka-steroids ka na!" ("Oh no, you're on steroids now!") from various sources whenever i got a severe asthma attack.  Only much later (in medical school) did i realize those people probably didn't - and maybe still don't - understand what steroids are and what they do.  Not all steroids make you big, beefy, and angry.  Used with a clearly defined indication, dose, and duration - they can actually provide significant relief of symptoms.

So i'm supposed to get around five to six treatments delivered locally through the iontophoresis patch, and if it works - perhaps another six.  I'm optimistic right now, but i'd like to see what happens when it wears off.  I'm also a tad bit skeptical because the treatment seems odd: Astym to promote inflammation, but steroids to calm it down?  Ummm...  But anyway, i am trusting my therapist to know what he's doing.  I personally know how annoying it can be to have your opinion questioned by somebody else in a semi-related medical field, so i'm trying hard not to be "that" patient.  Onward!

Ouch

So today i had my first PT session.  It overall wasn't too bad, mostly a lot of information-gathering on the therapist's part with some exercises thrown in for good measure.  The worst part was when "massaged" my left calf using a treatment called Astym.

That treatment is borderline horrendous - at least for me.  It essentially consists of mashing plastic implements deep enough into your skin to hit whatever's underneath, and then pushing said plastic implements along the direction of the muscle fibers.  As explained to me, the underlying principle is to stimulate the body's inflammatory response, hopefully promoting healing of the deeper tissues.

As far as stimulating an inflammatory response, i can attest to it somewhat because at times it truly felt like my leg was on fire.  I half-expected to find my calf skinned, raw, and bleeding at the end of the session.  Surprisingly, my Achilles was fine - it was every other nerve ending that was screaming out in pain.

Hopefully it gets better and i don't feel like i'm getting flayed the next time.  And even if i do - i'm willing to tough it out if the end justifies the means.  My therapist seems optimistic though, and thinks he can get me to finish a turkey trot next month.  We'll see.

The Source

In all honesty, things have not been right since the marathon.  Little aches and pains have been popping up here and there with annoying regularity.  But the worst has been my left Achilles tendon.  It first hit me in May, a little before the Riverbank Run.  Since then i've tried NSAIDs, ice, and prolonged (up to two weeks) rest, all to no avail.  Two weeks ago i finally relented and went back to see the Orthopedic surgeon.  He set me up for an MRI, and finally found Achilles tendinosis.

Not being an orthopod myself, i had to go look it up (do not click this link if you're squeamish, as it contains pictures of someone's ankle being dissected).  Apparently it's a chronic condition associated with gradual degeneration of the Achilles tendon, resulting from microtears related to overuse.  

It's more than a little disappointing to me, as i've previously speculated that i may just not be built for the activity that i've come to love - running.  Well, at least i don't have to have surgery (yet)... for now i'll be going to physical therapy, hopefully to rehab the injury away and get me back up and running (pun intended).  Maybe, just maybe - i'll be able to do the 25k in the spring before we move to Pittsburgh.  I'm keeping my fingers crossed.