Why this blog was born – and why we’re gimpy and grumpy!
My husband got me jogging when we married in 1981. For years we rose at dawn and set out on a morning run – first around our neighborhood in South Pasadena and then, after our move to northern California, from our home in Menlo Park, CA. This morning ritual was part and parcel to the fabric of our marriage – and our well being.
I started blogging about our morning jogs in February 2006 and very soon shifted to the third person, chronicling the outings of the Dawn Joggers. The male Dawn Jogger (Chris Gulker), who was once a professional photographer took the photos, the female Dawn Jogger (me), who began her career as a journalist and morphed into marketing and content development, wrote the accounts.
Stage 3 glioma – not a welcome diagnosis
The tandem jogging ended abruptly in October 2006 when the male Dawn Jogger was diagnosed with stage 3 glioma, the second most lethal form of brain cancer and began treatment at UCSF (one of the places you want to be if you have brain cancer – we were lucky it was up the road). His tumor was located on the motor strip in the right parietal lobe, which rendered it inoperable (due to almost certain paralysis if surgically removed). While the tumor had already started to limit functionality on his left side, a course of radiation therapy and the edema that’s common to brain cancer more severely limited his ability to use his left arm and leg. He could barely walk, let alone run.
The female Dawn Jogger began running solo – and became photog as well.
Trying to live normally with a life threatening disease
When people succumb to cancer, the obits often read that it was “after a [fill-in-the-number-of-years] battle with cancer.” At least from a caregiver perspective, the battle is as much about learning to live with a life-threatening disease and fighting to remain as normal as possible as it is with the disease itself.
After a course on the steroid Decadron (to reduce the edema), the male Dawn Jogger added severe muscle myopathy on his right side to the partial paralysis on his left. Hope arrived in the form of one very determined and knowledgeable physical therapist – Heidi Engel – who started working with the male DJ in August 2007 while he was being weaned from the steroids. The low point was reached in December of that year – he was physically weak both from the muscle atrophy and the fact that his adrenal glands were making very little cortisol on their own.
Inch by inch the male DJ fought his way back, increasing little by little the functionality of his left arm/hand and the mobility of his left leg/ankle/foot. By March of this year, while not jogging together, they enjoyed long walks all over the city of New Orleans; by April they were walking the Dish (local radio telescope on Stanford University land) together – a huge accomplishment.
First sign of trouble – a twinge in her heel
It was also in April that the female Dawn Jogger started feeling a twinge in the area just to the right of her heel on her left foot. It wasn’t constant and after taking a few mornings off where she walked instead of jogged, she went back to her running at dawn. It was still achy when the Dawn Joggers headed off to France in May, and the female DJ promised herself that she’d seek medical attention if there was still pain when she returned.
The only joy of leaving the male Dawn Jogger in France (where he stayed with their good friends) was being able to run the Dish again, which is exactly what she did the first morning after her return, all five miles, including three significant ups and downs. And that was it.
Her pain went from achy and cranky to barky and constant. She was unable to take a step even at a walking pace without moderate to severe pain. She immediately made an appointment with noted sports podiatrist Dr. Lawrence Oloff who had treated her successfully 7 years ago with the only other ‘injury’ in her almost 30 years of jogging, a bout of plantar fascitis. He ordered an MRI (done 5/29) and on the following Tuesday, 6/2 she got the news: Severe deterioration and partial tear of her left Achilles tendon – surgery necessary.
The radiologists summed up her diagnosis: “Severe insertional Achilles tendinopathy and tendonitis. Deep margin and interstitial partial tearing of the Achilles tendon at its insertion worse of the medial fibers and involving 50% tendon thickness. Extensive surround inflammatory change including retrocalcaneal bursitis and calcaneal osteitis.”
But just to be sure “the MRI was not over-exaggerating,” Oloff wanted an ultrasound done and was adamant that Dr. Kate Stevens do it. She, unfortunately was on vacation, so there was a lag of two weeks. While it took her a while to find the tear, find it indeed she did and her report to Oloff confirmed the MRI findings. Surgery was indeed looking inevitable.
Exploring ways to avoid surgery
But when you already live in a one gimp household, the thought of being restricted to non-weight bearing activities for a minimum of four weeks seemed a horrendous undertaking, even if curative. NWB means not only you can’t walk but your upper body is unavailable as it’s busy with crutches.
The concern was greater as an MRI of the male DJ’s brain in April had revealed a new shadow area surrounding his tumor. By the end of May, his ever-decreasing functionality on his left side, prompted him to ask his neuro-oncology team at UCSF to move up his next MRI. The verdict was the same – increased edema but no signs of tumor growth. But left arm functionality and left leg mobility continued to decrease.
So for due diligence sake for her own health – and increasing concerns about the the male DJ – the female DJ explored all possible alternatives to surgery and sought the counsel of credentialed trusted advisors. She read everything she could about Achilles tendon deterioration and partial tears. (For the record, a lot more exists about ruptures than tears.)
The most promising but still unproven alternative to surgery is Platelet Rich Plasma (PRP) which was “discovered” by a local orthopedic doctor who happened to be in her internist’s medical group. He was willing to do it and warned of the surgical complications: There’s an increased risk of infection for this kind of surgery as well as blood clots. But he also said that he “wished the deterioration/tear was a couple of centimeters higher” and that it would likely require two injections 5 months apart.
The male DJ helped her see that five more months of ‘wait and see’ was probably worse than biting the bullet and having the surgery. So it was settled and surgery – “repair/revision left Achilles tendon, possible bursectomy, possible exostectomy calcaneus” – was scheduled for Friday, July 24.
They’d be a two gimp household for awhile. Now the two Dawn Joggers could be officially transformed into the Dual Gs – gimpy and grouchy.
Linda Hubbard Gulker