(no subject)
Part rant and part questions. Bear with me through the background info, which many of you have probably already heard. I swear almost all of it will become relevant by the end of this post, and my questions are good, running-related questions that many of you may be interested in, however I feel that giving my personal context for asking is also neccessary for me to get answers relevant to my particular case from the only people I think might know more about it than me: you guys! :)
I'll put the actual questions in bold for those of you who will classify this as TLDR so you can just skim down to them.
This was originally written for a post in the runners community, BTW.
Going on two years ago, I hurt my ankle pretty badly in a horseracing accident. The emergency room doctor said that there were no visible fractures in the X-rays and that it was probably just a bad sprain, but if the swelling didn't start to go down in three to four days to come back for an MRI. After that time, the swelling had started to come down, although not as fast as it usually does (I have sprained my ankles lots and lots of times) so I assumed he was right about the sprain and never went back for the MRI. I spent two weeks on crutches, then rode seven or eight more races before the end of the meet, and drove to Texas to try riding some more only to realize I'd given good ol' Arapahoe Park the only copy of my pre-injury physical stating that I was fit to ride, which of course there was no way to get ahold of because everyone to do with that track vaporizes at the end of the meet, and would need to have a new one for Texas, which I knew I couldn't pass.
I tried for two weeks to support myself as an exercise rider, but found that I couldn't walk from barn to barn fast enough to get on enough horses during training hours to pay the outlandish weekly rent at an extended stay motel across San Antonio (the only one I could find that would take dogs, (after the one I'd reserved changed their pet-policy in the meantime, failed to notify me, and then refused to refund my deposit because I hadn't given them 48 hours notice of my cancellation) who were tearing up the joint on account of me not being able to walk them) to say nothing of what the commute was costing me in gas (I drive a 1976 F-250) and feeding myself. I ended up holing up with my sister in Oklahaoma for a few months, then with a guy I met while working at a gas station in Elmore City (the actual town from the movie Footloose, who just yesterday finally lifted the ban on dancing). I found a trainer near there and galloped some horses for awhile, but it turned out that my ankle still wouldn't take it, plus I was getting fed up with the boyfriend so I hustled back to Denver to stay with Daddy-dearest until good ol' Arapahoe Park opened again, and here I sit. I rode part of the meet here last summer before a horse broke down on me resulting in a compressed vertebrae for me and a Pentosol injection for the horse.
I had decided after my horrible first impression of Texas to not travel anymore until I could afford to buy a camper trailer (most tracks have a small RV park attached to them for all the horsemen who come to the race meet from out of town needing a convenient and affordable place to stay) and needless to say, the fourteen weeks of work I missed due this more recent injury left a gaping hole in my budget for that goal. By the time I got medical clearance, I was too broke to leave town (seriously, renting is one of the worst financial decisions you can make) and spent the winter here dancin for dollas. I finally bought a trailer in January with ambitions of going to Oaklawn, a nice track in Hot Springs, Arkansas, to ride there while I've got my apprentice allowance, but it turns out that getting all the lights working on my truck was a bigger project than I imagined, so that didn't happen, and now I'm galloping horses close to home, getting ready for the start of good ol' Arapahoe Park Memorial Day weekend, where I have no ambitions of race-riding because I seem to be jinxed at this track, but rather kill the summer exercise riding and doing some other things I've been wanting to that a jockey-level committment doesn't allow, hopefully let my body finish healing and get strong, save some money, ride some bush meets in the fall, and try for Oaklawn again in Januray.
I have, since coming up with this revised plan, found out that tracks are not in the habit of giving trailer spaces to exercise riders. This has pretty much been the pattern of my life for the last four years. Just cannot catch a frickin break, and every.single.time. anything even remotely good starts to happen for me, something really bad will happen to offset it. I must have done something really terrible in my previous life, but if that life was anything like this one, who could blame me? Asshole. *shakes fist at sky*
Anyway, my back has healed as much as I imagine it's going to, which is really pretty good considering the fall I took, but the ankle is still defective. In hindisght, I probably should have spent two months on crutches instead of two weeks, which maybe would've let it heal or maybe would've given me enough time to figure out that it wasn't healing so that my dumb ass might have sought treatment. But the way it is now is what I have to work with. Over the winter when all I was doing was stripping and going to the gym to lift weights and use the elliptical machines, it felt ok. If I was lucky, I could even go jog a couple miles every four to ten days without being totally crippled for days afterward. I call this being lucky because, even though it's like, a tenth of the running I used to do, it's a huge improvement over hobbling around.
However now that I'm working again, things are not so peachy. Work, for me, is six days a week, galloping six to nine horses every morning which will go up to nine to twelve when the track opens, and then in the afternoons either pulling manes, trimming hooves, giving vaccines and dewormer, or most recently, moving eight tons of hay, by hand, over the course of six days. The girl I have helping me with this isn't completely useless. It definitely beats doing it by myself, but being Betty Badass like I am, the nickname bestowed on me by my helper, one of my top three favorite nicknames ever, I end up with the hardest portions of stacking hay. For example, when loading it on the trailer, it's ineveitable that the highest bales on the haystack end up being the bottom bales on your trailer, and the lower you get down the stack, the higher you have to throw the bales onto the growing stack on your trailer. Getting it up there is my job, and then my sidekick, Allie, arranges it on the stack. I am a 5'4" 23yo 124lb girl, which happens to be about 15 pounds heavier than the weight I need to be at to race-ride with my weight allowance, just damn-near clean-and-pressing 40-60lb bales up to about eye level. We'd go one row higher but it seems like too much for the truck.
That amount of work this last week is what has exacerbated my ankle troubles to the point that I am begging for your help. I've sprained them enough times that I ought to know everything there is to know about ankles, but nothing seems to help it heal beyond a certain point. Not even (God forbid) resting it. It will take so much and is tolerably ok about it, but as soon as I cross that workload threshold it goes right back to being so bad I can barely walk around. It has been TWO YEARS and I am fed the f*ck up with fighting this injury. Not only has it taken running, one of the primary joys in my life, away from me, but now it is affecting my ability to work and therefore jacking with my money, which has historically always been Last Straw territory for me.
I am worn out. I feel like this is going to defeat me. I can not take any more. I have hated my life because of it for the last two years, and I am out of ways to make myself feel better and stay optimistic about it. Furthermore, I have lost so much time to injury in the last two years that I now have weight problems, something I never had to contend with before, and I don't see how I am going to solve this if I can't run. I hate the pool. I hate the stationary bike. And I hate the elliptical machines. So not only can I not run, but it looks like I'm not gonna be able to be a jockey anymore, either, which is a dream I've been chasing since I was eleven years old. It's the only thing I've ever really wanted to do, the only thing that's ever held my interest for more than a few months that I could actually make a living at, and I don't know what else I'm going to do that could ever compare to this if it turns out that I can't do it anymore. I'm desperate. I'm finally on the brink of going completely crazy.
When Betty Badass is reduced to a hysterical weeping puddle of goo, you know it's bad.
Clearly the first thing I need to do is get an MRI to find out exactly what I'm dealing with. It's possible I'm having bone problems in addition to ligament problems because I could have had a hairline fracture too small to show up in the initial X-Rays that became worse as a result of me being told there was probably nothing really wrong with it outside of a bad sprain, so when the compromised ligaments get overworked some other structure gets turned/doesn't get help up/straight and compresses something in such a way that it bothers some bone-scarring or between-bone-connective tissue/bursa scarring. Or anything else. I'd say there's a 60% chance that surgery will be in order.
I saw an article in the January issue of Runner's World about new treatments for Plantar Fascitis including dry-needling, shock-wave therapy, and concentrated blood-platelet plasma injections, and since connective tissue is pretty much connective tissue, I figured they would probably also work for ankle ligaments and such. The first two are supposed to break up scar tissue, are cheap ($150-200/session) and may be covered by the track's insurance policy. The third basically floods the injury site with nutrients and other growth factors to stimulate healing, which would probably require some form of reinjury first because I've let it go for so long, but it's expensive ($1-2,000 per treatment) and is probably not covered.
Have any of you heard of/tried/known someone who tried any of these treatments and what was the outcome?
In case it matters, the specific parts of my ankle that hurt/cause gait problems are, I think, according to the illustration in Gray's Anatomy, 1) the Posterior Calcaneo-Astragalus Ligament. Calcaneous is your heel bone. Astragalus, more commonly known as the talus, is the bone that forms your ankle joint with your tibia/shin, and kind of straddles the calcaneous like it's on the saddle of that bone's back, as well as some of your other tarsals, thereby transferring your weight to the ground via your heel and down your arch (tarsals and metatarsals) to the ball of your foot. The ligament in question, if you could bisect the achilles tendon to look at the actual framework of bones deeper in the ankle, is extremely short top-to-bottom and wraps around the back of the heel, holding the top of your heel bone to the bottom of your talus/astragalus at the rear. 2) some aspect of the External Lateral Ligament, which exists in three parts, and are the part on the outside of your ankle most commonly sprained. So imagine what hurts when you twist your ankle. And/or the External Calcano-Astragalus Ligament, which is in the same region and assists with the same function. And maybe 3) the Superior Calcaneo-Navicular Ligament and/or the Superior Calcaneo-Cuboid Ligament, which are located just forward and down on your foot from the stuff you think of when you think of an ankle-sprain. Also, my achilles tendon is annoyed right where it inserts on the heel bone because of either the way I've been taping this other stuff to it to get through work which pulls on it laterally and makes it work askew, or because I do not land/load/break over my foot correctly anymore, which is also beginning to bother my knee.
Compounding my problems is the track's insurance company. I will spare you the cussing storm that usually accompanies any mention of this subject because I have finally concluded that there are simply no words bad enough to do it justice. Here is where current events become relevant to us injury plagued runners, although in my case the injury was not running-induced. I'm actually more of a wannabe runner now thanks to it.
As a licensed jockey, I have always been under the impression that if I get hurt at the track, my medical expenses are supposed to be covered 100% no-questions-asked by the insurance the track is required to have to cover jockeys. I think that some of the better tracks actually cover, or did cover before our industry crashed thanks to the yearling and 2-year-old sales practices, (which remarkably foreshadowed the sub-prime real-estate crash leading to a global recession) anyone with a license, so grooms and trainers and exercise riders and even owners are, or were, covered if they had a horse-related accident on the backside. But, insurance companies being insurance companies, and Arapahoe Park being Arapahoe Park, and my dumb ass self being my dumb ass self, predictably, I have had problems. Somehow or another, when I hurt my ankle, the insurance company never got the accident report. Turns out the EMTs on call at the track had given me the only copy to take with me to the emergency room. It said right on the front of it to fax it to the insurance company, but, silly me, I thought that was the track's responsibility. Then when I broke my back the following year and was transported by ambulance (there is no excuse for those things not having softer suspension, seriously) I had no insurance info with me whatsoever. I guess I'm supposed to get a little business card with all that crap on it from the licensing office at the time I get licensed, which I had no way of knowing never having been told, nor had anything placed in front of me to sign that had anything to do with my track coverage (lucky for me I had my accident report with me the year before) and whoever was supposed to have known apparently forgot. So when they start asking for my billing information I'm all like, "Uummmmm....call the track?" which predictably caused me problems with trying to get discharged. So the year I hurt my ankle was a f*cking circle-jerk trying to figure out what was supposed to happen, cuz the insurance company never had a claim filed with them, and you can imagine how confused and outraged I was when the bills started getting kicked back to me instead. Seriously, when I got home from Oklahoma, there were probably a dozen Scary Red Envelopes waiting for me at the house about something I had no reason to think wasn't long since taken care of. Imagine the panic and opposition this immediately arouses in someone who is broke, out of work and debtophobic. That finally got sorted out.
Then after I broke my back, they started kicking bills back to me again, this time with statements from the insurance company about how they had already paid their portion of it. Some of them got paid after I wrote them an outraged letter explaining to their uncommunicative asses that there were in fact two ambulances that attended to me at the track, the one on site during training and racing hours for life threatening emergencies, and the one they send for for transport for non-life threatening emergencies, therefore there were two legitimate, identical bills for the same day. But some of the bills are still getting kicked back to me anyway. Apparently they only repay what is "reasonable and customary" which in laymens terms means that the hospital inflates their prices to get all of the people who actually pay their bills to offset the cost of all the people who DON'T pay their bills. They charge what they feel like, and the insurance only pays what it's worth, which ensures that both parties make unreasonable and uncustomary and downright unjust amounts of money, meanwhile sodomizing you and me, the people they are supposed to be helping, who have already paid unreasonable amounts of money for the so-called "security" of insurance that doesn't actually insure shit, because rather than being there for you when you need them, they immediately begin searching for any excuse NOT to pay. I wrote a letter to the hospital informing them that if the insurance company knows what is a reasonable amount to charge for a service and has already covered that amount, I am under no circumstances going to pay one cent above that, and if they don't like it then they can take it up with the insurance company. The bills are now in collections and I answer less than half of my phone calls.
And this Helthcare Reform Act that just got passed plans to begin fining us taxpaying citizens in 2014 if we don't have health insurance. So the hospitals will still charge what they feel like, the insurance companies still won't cover all of it, and they'll be able to charge whatever they feel like for their spotty coverage and we will be forced to pay it. And it insures coverage for the unemployed but not for the working poor, effectively making it better to live on what I'm calling the Expanded Welfare Act with coverage than to have a job without. Keeps getting better and better, huh?
I received 14 weeks of disability after I broke my back even though the effects, thanks to the timing, lasted a LONG time past the date of my medical clearance. By all rights, I should have been claiming it on my ankle since July 10, 2008, but I'm the type to push through it, and tried to go on working after the injury, and I didn't want to abuse my coverage. I reapeat: I did not want to take advantage of them. I felt it would be bad karma or something. Go figure.
And I'm afraid that if I actually go ahead and get this stupid ankle treated, because it's been two years and I have worked on it and I have run on it, they're gonna find some loophole to deny responsibility and I'm gonna get saddled with the bills. The MRI alone is gonna be six grand, bare-ass minimum, guaranteed. That's diagnostics, not even treatment, for a procedure that probably costs them .20 to do, if you divide the cost of the equipment and the technician and the electricty it takes to run it by the number of images that machine will probably take in it's lifetime. Assholes.
I can't afford it. Bottom line. The insurance company and hospital have already shown an inclination to stick their noses up and threaten me with legal action when I inquire about my rights or even ask to see my policy from the track. What's gonna happen when I try to bring up another ten grand in charges on a two-year-old claim with a bankrupt company? If I could afford a lawyer, I would've gone that route long ago. The one I've contacted won't even talk to me without seeing a copy of the policy which they are withholding from me. Withholding my own god-damned insurance policy! And even if I do swallow my damned fool pride and accept the bills on my own shoulders, is it gonna be worth it? I don't even know if my stupid ankle is fixable at this point. From a moral standpoint, this is not something I should have to pay, and then I'm gonna be a bitter old hag about it forever, cuz nothing is more abrasive than being the victim of senseless injustice. I am angry. And I feel helpless, which makes me even more angry.
It occurs to me that our own culture has us living in terror more so than the actual foreign terrorists do. If the world as we know it actually ends in 2012, I wouldn't be opposed. I'm fairly confident, as I'm sure everyone is, that I would be in one of the little pockets of survivors, and then I could live how I want to, the earth restored to it's natural fertile state, and this oppressive civilization vaporized. Who would Jesus bomb? It is little wonder that "radical extremists" want to put an end to our way of life, cuz it clearly doesn't work for a really high percentage of the population. They are probably just outraged people who have felt victimized themselves and feel they have no other means to take back their personal power. But I digress.
My other question today has to do with integrated heartrate monitors and GPS distance/pace trackers, a subject which is probably getting old in here, but maybe I can put a fresh spin on it.
As a result of my ankle I've been limited to cross-training pretty much exclusively. Most recently has been the P90X home fitness program, which is a freakishly awesome program that includes a really sound eating plan. My problem is that the overly-simplistic formula they give you for determining your daily calorie burn, based only on your bodyweight, isn't calibrated for the amount of activity in my day, which ineveitably led to a big crash after 3 weeks of great workouts from too much of a caloric deficit. So what I really want is a heartrate monitor that will track my calorie burn, however this concept seems flawed to me for the same reason as P90Xs formula: it's overly simplistic. If I, a 5'4", 23yo, 124lb female and a 6'5", 19yo, 220lb male both have a resting heartrate of 40bpm and a max HR of 210bpm, guaranteed that guy is gonna burn more calories than me at any activity, be it sleeping or running Badwater. It just takes less energy to run a smaller person at any percentage of exertion. So the computer software that accompanies whichever monitor I settle on has to account for this when you plug in your workout data or it's gonna skew my results weightloss-wise. This precision is essential because as a jockey, weight-management is a Very Big Deal to me. Back when I could run it was never a problem but now it is.
I also would like something that will do graphs. Like a line graph of my HR over the course of a day so that I can have an easy visual of which activities get me the biggest burn, be it galloping or hiking or whatever workout I do, and where I can zoom in to look at a given hour, down to the minute, (P90Xs workout DVD's feature a countdown clock on the screen all the time, and I swear I'm not an ad exec for them) to determine exactly which move or interval gave me the desired spike as compared with my notes about how I felt at that point in the workout. Or bar graphs of daily and weekly distance totals for side-by-side comparison. Line graphs for pace...and I don't suppose any of them will do altitude??? Although I can't run much, I do hike a lot, and have Big Plans for this summer for which such data would be relevant. I'm also interested in blood pressure and respiration rates not only during exertion and at altitude but also when under stress, like when I'm stitting in the jocks room waiting for my race, but it's not really required, plus I think a chest strap would bug me.
And obviously a distance tracker, since I hike and have ambitions of being able run again some day, and I do spend a little leisure/errand time on an outdoor bike although I don't really consider it training.
Also, I am thinking of getting a Mac when I get my laptop, but I don't know about software cross-compatability? Like if it's written for Windows, will it not work on a Mac? If that's going to be a problem I need to know cuz it'll affect the computer purchase, too.
So.. Garmin? Nike+? Other?
Apologies for the brain-dump. I consider it make-up for not posting daily about how my pinky toe hurts and the adorable thing my cat did. And if anyone has thoughts on how our culture has us living in terror more so than the actual terrorists do, or about anything you do to occupy yourself when you're laid up that's not sex or fattening that I might not have already thought of, or feel the need to blow off steam about insurance companies/the medical field, please feel free to talk about that, too. :)
I'll put the actual questions in bold for those of you who will classify this as TLDR so you can just skim down to them.
This was originally written for a post in the runners community, BTW.
Going on two years ago, I hurt my ankle pretty badly in a horseracing accident. The emergency room doctor said that there were no visible fractures in the X-rays and that it was probably just a bad sprain, but if the swelling didn't start to go down in three to four days to come back for an MRI. After that time, the swelling had started to come down, although not as fast as it usually does (I have sprained my ankles lots and lots of times) so I assumed he was right about the sprain and never went back for the MRI. I spent two weeks on crutches, then rode seven or eight more races before the end of the meet, and drove to Texas to try riding some more only to realize I'd given good ol' Arapahoe Park the only copy of my pre-injury physical stating that I was fit to ride, which of course there was no way to get ahold of because everyone to do with that track vaporizes at the end of the meet, and would need to have a new one for Texas, which I knew I couldn't pass.
I tried for two weeks to support myself as an exercise rider, but found that I couldn't walk from barn to barn fast enough to get on enough horses during training hours to pay the outlandish weekly rent at an extended stay motel across San Antonio (the only one I could find that would take dogs, (after the one I'd reserved changed their pet-policy in the meantime, failed to notify me, and then refused to refund my deposit because I hadn't given them 48 hours notice of my cancellation) who were tearing up the joint on account of me not being able to walk them) to say nothing of what the commute was costing me in gas (I drive a 1976 F-250) and feeding myself. I ended up holing up with my sister in Oklahaoma for a few months, then with a guy I met while working at a gas station in Elmore City (the actual town from the movie Footloose, who just yesterday finally lifted the ban on dancing). I found a trainer near there and galloped some horses for awhile, but it turned out that my ankle still wouldn't take it, plus I was getting fed up with the boyfriend so I hustled back to Denver to stay with Daddy-dearest until good ol' Arapahoe Park opened again, and here I sit. I rode part of the meet here last summer before a horse broke down on me resulting in a compressed vertebrae for me and a Pentosol injection for the horse.
I had decided after my horrible first impression of Texas to not travel anymore until I could afford to buy a camper trailer (most tracks have a small RV park attached to them for all the horsemen who come to the race meet from out of town needing a convenient and affordable place to stay) and needless to say, the fourteen weeks of work I missed due this more recent injury left a gaping hole in my budget for that goal. By the time I got medical clearance, I was too broke to leave town (seriously, renting is one of the worst financial decisions you can make) and spent the winter here dancin for dollas. I finally bought a trailer in January with ambitions of going to Oaklawn, a nice track in Hot Springs, Arkansas, to ride there while I've got my apprentice allowance, but it turns out that getting all the lights working on my truck was a bigger project than I imagined, so that didn't happen, and now I'm galloping horses close to home, getting ready for the start of good ol' Arapahoe Park Memorial Day weekend, where I have no ambitions of race-riding because I seem to be jinxed at this track, but rather kill the summer exercise riding and doing some other things I've been wanting to that a jockey-level committment doesn't allow, hopefully let my body finish healing and get strong, save some money, ride some bush meets in the fall, and try for Oaklawn again in Januray.
I have, since coming up with this revised plan, found out that tracks are not in the habit of giving trailer spaces to exercise riders. This has pretty much been the pattern of my life for the last four years. Just cannot catch a frickin break, and every.single.time. anything even remotely good starts to happen for me, something really bad will happen to offset it. I must have done something really terrible in my previous life, but if that life was anything like this one, who could blame me? Asshole. *shakes fist at sky*
Anyway, my back has healed as much as I imagine it's going to, which is really pretty good considering the fall I took, but the ankle is still defective. In hindisght, I probably should have spent two months on crutches instead of two weeks, which maybe would've let it heal or maybe would've given me enough time to figure out that it wasn't healing so that my dumb ass might have sought treatment. But the way it is now is what I have to work with. Over the winter when all I was doing was stripping and going to the gym to lift weights and use the elliptical machines, it felt ok. If I was lucky, I could even go jog a couple miles every four to ten days without being totally crippled for days afterward. I call this being lucky because, even though it's like, a tenth of the running I used to do, it's a huge improvement over hobbling around.
However now that I'm working again, things are not so peachy. Work, for me, is six days a week, galloping six to nine horses every morning which will go up to nine to twelve when the track opens, and then in the afternoons either pulling manes, trimming hooves, giving vaccines and dewormer, or most recently, moving eight tons of hay, by hand, over the course of six days. The girl I have helping me with this isn't completely useless. It definitely beats doing it by myself, but being Betty Badass like I am, the nickname bestowed on me by my helper, one of my top three favorite nicknames ever, I end up with the hardest portions of stacking hay. For example, when loading it on the trailer, it's ineveitable that the highest bales on the haystack end up being the bottom bales on your trailer, and the lower you get down the stack, the higher you have to throw the bales onto the growing stack on your trailer. Getting it up there is my job, and then my sidekick, Allie, arranges it on the stack. I am a 5'4" 23yo 124lb girl, which happens to be about 15 pounds heavier than the weight I need to be at to race-ride with my weight allowance, just damn-near clean-and-pressing 40-60lb bales up to about eye level. We'd go one row higher but it seems like too much for the truck.
That amount of work this last week is what has exacerbated my ankle troubles to the point that I am begging for your help. I've sprained them enough times that I ought to know everything there is to know about ankles, but nothing seems to help it heal beyond a certain point. Not even (God forbid) resting it. It will take so much and is tolerably ok about it, but as soon as I cross that workload threshold it goes right back to being so bad I can barely walk around. It has been TWO YEARS and I am fed the f*ck up with fighting this injury. Not only has it taken running, one of the primary joys in my life, away from me, but now it is affecting my ability to work and therefore jacking with my money, which has historically always been Last Straw territory for me.
I am worn out. I feel like this is going to defeat me. I can not take any more. I have hated my life because of it for the last two years, and I am out of ways to make myself feel better and stay optimistic about it. Furthermore, I have lost so much time to injury in the last two years that I now have weight problems, something I never had to contend with before, and I don't see how I am going to solve this if I can't run. I hate the pool. I hate the stationary bike. And I hate the elliptical machines. So not only can I not run, but it looks like I'm not gonna be able to be a jockey anymore, either, which is a dream I've been chasing since I was eleven years old. It's the only thing I've ever really wanted to do, the only thing that's ever held my interest for more than a few months that I could actually make a living at, and I don't know what else I'm going to do that could ever compare to this if it turns out that I can't do it anymore. I'm desperate. I'm finally on the brink of going completely crazy.
When Betty Badass is reduced to a hysterical weeping puddle of goo, you know it's bad.
Clearly the first thing I need to do is get an MRI to find out exactly what I'm dealing with. It's possible I'm having bone problems in addition to ligament problems because I could have had a hairline fracture too small to show up in the initial X-Rays that became worse as a result of me being told there was probably nothing really wrong with it outside of a bad sprain, so when the compromised ligaments get overworked some other structure gets turned/doesn't get help up/straight and compresses something in such a way that it bothers some bone-scarring or between-bone-connective tissue/bursa scarring. Or anything else. I'd say there's a 60% chance that surgery will be in order.
I saw an article in the January issue of Runner's World about new treatments for Plantar Fascitis including dry-needling, shock-wave therapy, and concentrated blood-platelet plasma injections, and since connective tissue is pretty much connective tissue, I figured they would probably also work for ankle ligaments and such. The first two are supposed to break up scar tissue, are cheap ($150-200/session) and may be covered by the track's insurance policy. The third basically floods the injury site with nutrients and other growth factors to stimulate healing, which would probably require some form of reinjury first because I've let it go for so long, but it's expensive ($1-2,000 per treatment) and is probably not covered.
Have any of you heard of/tried/known someone who tried any of these treatments and what was the outcome?
In case it matters, the specific parts of my ankle that hurt/cause gait problems are, I think, according to the illustration in Gray's Anatomy, 1) the Posterior Calcaneo-Astragalus Ligament. Calcaneous is your heel bone. Astragalus, more commonly known as the talus, is the bone that forms your ankle joint with your tibia/shin, and kind of straddles the calcaneous like it's on the saddle of that bone's back, as well as some of your other tarsals, thereby transferring your weight to the ground via your heel and down your arch (tarsals and metatarsals) to the ball of your foot. The ligament in question, if you could bisect the achilles tendon to look at the actual framework of bones deeper in the ankle, is extremely short top-to-bottom and wraps around the back of the heel, holding the top of your heel bone to the bottom of your talus/astragalus at the rear. 2) some aspect of the External Lateral Ligament, which exists in three parts, and are the part on the outside of your ankle most commonly sprained. So imagine what hurts when you twist your ankle. And/or the External Calcano-Astragalus Ligament, which is in the same region and assists with the same function. And maybe 3) the Superior Calcaneo-Navicular Ligament and/or the Superior Calcaneo-Cuboid Ligament, which are located just forward and down on your foot from the stuff you think of when you think of an ankle-sprain. Also, my achilles tendon is annoyed right where it inserts on the heel bone because of either the way I've been taping this other stuff to it to get through work which pulls on it laterally and makes it work askew, or because I do not land/load/break over my foot correctly anymore, which is also beginning to bother my knee.
Compounding my problems is the track's insurance company. I will spare you the cussing storm that usually accompanies any mention of this subject because I have finally concluded that there are simply no words bad enough to do it justice. Here is where current events become relevant to us injury plagued runners, although in my case the injury was not running-induced. I'm actually more of a wannabe runner now thanks to it.
As a licensed jockey, I have always been under the impression that if I get hurt at the track, my medical expenses are supposed to be covered 100% no-questions-asked by the insurance the track is required to have to cover jockeys. I think that some of the better tracks actually cover, or did cover before our industry crashed thanks to the yearling and 2-year-old sales practices, (which remarkably foreshadowed the sub-prime real-estate crash leading to a global recession) anyone with a license, so grooms and trainers and exercise riders and even owners are, or were, covered if they had a horse-related accident on the backside. But, insurance companies being insurance companies, and Arapahoe Park being Arapahoe Park, and my dumb ass self being my dumb ass self, predictably, I have had problems. Somehow or another, when I hurt my ankle, the insurance company never got the accident report. Turns out the EMTs on call at the track had given me the only copy to take with me to the emergency room. It said right on the front of it to fax it to the insurance company, but, silly me, I thought that was the track's responsibility. Then when I broke my back the following year and was transported by ambulance (there is no excuse for those things not having softer suspension, seriously) I had no insurance info with me whatsoever. I guess I'm supposed to get a little business card with all that crap on it from the licensing office at the time I get licensed, which I had no way of knowing never having been told, nor had anything placed in front of me to sign that had anything to do with my track coverage (lucky for me I had my accident report with me the year before) and whoever was supposed to have known apparently forgot. So when they start asking for my billing information I'm all like, "Uummmmm....call the track?" which predictably caused me problems with trying to get discharged. So the year I hurt my ankle was a f*cking circle-jerk trying to figure out what was supposed to happen, cuz the insurance company never had a claim filed with them, and you can imagine how confused and outraged I was when the bills started getting kicked back to me instead. Seriously, when I got home from Oklahoma, there were probably a dozen Scary Red Envelopes waiting for me at the house about something I had no reason to think wasn't long since taken care of. Imagine the panic and opposition this immediately arouses in someone who is broke, out of work and debtophobic. That finally got sorted out.
Then after I broke my back, they started kicking bills back to me again, this time with statements from the insurance company about how they had already paid their portion of it. Some of them got paid after I wrote them an outraged letter explaining to their uncommunicative asses that there were in fact two ambulances that attended to me at the track, the one on site during training and racing hours for life threatening emergencies, and the one they send for for transport for non-life threatening emergencies, therefore there were two legitimate, identical bills for the same day. But some of the bills are still getting kicked back to me anyway. Apparently they only repay what is "reasonable and customary" which in laymens terms means that the hospital inflates their prices to get all of the people who actually pay their bills to offset the cost of all the people who DON'T pay their bills. They charge what they feel like, and the insurance only pays what it's worth, which ensures that both parties make unreasonable and uncustomary and downright unjust amounts of money, meanwhile sodomizing you and me, the people they are supposed to be helping, who have already paid unreasonable amounts of money for the so-called "security" of insurance that doesn't actually insure shit, because rather than being there for you when you need them, they immediately begin searching for any excuse NOT to pay. I wrote a letter to the hospital informing them that if the insurance company knows what is a reasonable amount to charge for a service and has already covered that amount, I am under no circumstances going to pay one cent above that, and if they don't like it then they can take it up with the insurance company. The bills are now in collections and I answer less than half of my phone calls.
And this Helthcare Reform Act that just got passed plans to begin fining us taxpaying citizens in 2014 if we don't have health insurance. So the hospitals will still charge what they feel like, the insurance companies still won't cover all of it, and they'll be able to charge whatever they feel like for their spotty coverage and we will be forced to pay it. And it insures coverage for the unemployed but not for the working poor, effectively making it better to live on what I'm calling the Expanded Welfare Act with coverage than to have a job without. Keeps getting better and better, huh?
I received 14 weeks of disability after I broke my back even though the effects, thanks to the timing, lasted a LONG time past the date of my medical clearance. By all rights, I should have been claiming it on my ankle since July 10, 2008, but I'm the type to push through it, and tried to go on working after the injury, and I didn't want to abuse my coverage. I reapeat: I did not want to take advantage of them. I felt it would be bad karma or something. Go figure.
And I'm afraid that if I actually go ahead and get this stupid ankle treated, because it's been two years and I have worked on it and I have run on it, they're gonna find some loophole to deny responsibility and I'm gonna get saddled with the bills. The MRI alone is gonna be six grand, bare-ass minimum, guaranteed. That's diagnostics, not even treatment, for a procedure that probably costs them .20 to do, if you divide the cost of the equipment and the technician and the electricty it takes to run it by the number of images that machine will probably take in it's lifetime. Assholes.
I can't afford it. Bottom line. The insurance company and hospital have already shown an inclination to stick their noses up and threaten me with legal action when I inquire about my rights or even ask to see my policy from the track. What's gonna happen when I try to bring up another ten grand in charges on a two-year-old claim with a bankrupt company? If I could afford a lawyer, I would've gone that route long ago. The one I've contacted won't even talk to me without seeing a copy of the policy which they are withholding from me. Withholding my own god-damned insurance policy! And even if I do swallow my damned fool pride and accept the bills on my own shoulders, is it gonna be worth it? I don't even know if my stupid ankle is fixable at this point. From a moral standpoint, this is not something I should have to pay, and then I'm gonna be a bitter old hag about it forever, cuz nothing is more abrasive than being the victim of senseless injustice. I am angry. And I feel helpless, which makes me even more angry.
It occurs to me that our own culture has us living in terror more so than the actual foreign terrorists do. If the world as we know it actually ends in 2012, I wouldn't be opposed. I'm fairly confident, as I'm sure everyone is, that I would be in one of the little pockets of survivors, and then I could live how I want to, the earth restored to it's natural fertile state, and this oppressive civilization vaporized. Who would Jesus bomb? It is little wonder that "radical extremists" want to put an end to our way of life, cuz it clearly doesn't work for a really high percentage of the population. They are probably just outraged people who have felt victimized themselves and feel they have no other means to take back their personal power. But I digress.
My other question today has to do with integrated heartrate monitors and GPS distance/pace trackers, a subject which is probably getting old in here, but maybe I can put a fresh spin on it.
As a result of my ankle I've been limited to cross-training pretty much exclusively. Most recently has been the P90X home fitness program, which is a freakishly awesome program that includes a really sound eating plan. My problem is that the overly-simplistic formula they give you for determining your daily calorie burn, based only on your bodyweight, isn't calibrated for the amount of activity in my day, which ineveitably led to a big crash after 3 weeks of great workouts from too much of a caloric deficit. So what I really want is a heartrate monitor that will track my calorie burn, however this concept seems flawed to me for the same reason as P90Xs formula: it's overly simplistic. If I, a 5'4", 23yo, 124lb female and a 6'5", 19yo, 220lb male both have a resting heartrate of 40bpm and a max HR of 210bpm, guaranteed that guy is gonna burn more calories than me at any activity, be it sleeping or running Badwater. It just takes less energy to run a smaller person at any percentage of exertion. So the computer software that accompanies whichever monitor I settle on has to account for this when you plug in your workout data or it's gonna skew my results weightloss-wise. This precision is essential because as a jockey, weight-management is a Very Big Deal to me. Back when I could run it was never a problem but now it is.
I also would like something that will do graphs. Like a line graph of my HR over the course of a day so that I can have an easy visual of which activities get me the biggest burn, be it galloping or hiking or whatever workout I do, and where I can zoom in to look at a given hour, down to the minute, (P90Xs workout DVD's feature a countdown clock on the screen all the time, and I swear I'm not an ad exec for them) to determine exactly which move or interval gave me the desired spike as compared with my notes about how I felt at that point in the workout. Or bar graphs of daily and weekly distance totals for side-by-side comparison. Line graphs for pace...and I don't suppose any of them will do altitude??? Although I can't run much, I do hike a lot, and have Big Plans for this summer for which such data would be relevant. I'm also interested in blood pressure and respiration rates not only during exertion and at altitude but also when under stress, like when I'm stitting in the jocks room waiting for my race, but it's not really required, plus I think a chest strap would bug me.
And obviously a distance tracker, since I hike and have ambitions of being able run again some day, and I do spend a little leisure/errand time on an outdoor bike although I don't really consider it training.
Also, I am thinking of getting a Mac when I get my laptop, but I don't know about software cross-compatability? Like if it's written for Windows, will it not work on a Mac? If that's going to be a problem I need to know cuz it'll affect the computer purchase, too.
So.. Garmin? Nike+? Other?
Apologies for the brain-dump. I consider it make-up for not posting daily about how my pinky toe hurts and the adorable thing my cat did. And if anyone has thoughts on how our culture has us living in terror more so than the actual terrorists do, or about anything you do to occupy yourself when you're laid up that's not sex or fattening that I might not have already thought of, or feel the need to blow off steam about insurance companies/the medical field, please feel free to talk about that, too. :)