A Surprise Surgery and Unexpected Training Setback

Two years in a row toward the end of August I have had training derailed by a freak non-running issue. Last year it was the softball collision at home plate that sent me to a running retreat unable to run, and this year it was a surprise laparoscopic surgery.

I share this blog post not to lament by bad luck/timing but to actually raise awareness about a condition I didn’t know could occur and remind everyone to err on the side of caution when it comes to abnormal pain, and get it checked out! I know many of us runners are very stubborn and we are used to minor aches and pains—sometimes more serious pains that we try to waive off as minor—and self-remedy or just push through them. Well I learned a valuable lesson about that last week.

The Worst Pain I’ve Ever Experienced

So there I was at Boston Logan airport on Thursday, August 30th getting ready to board a flight to Denver. I was standing in line and suddenly started to feel an intense burning pain growing in my lower abdomen. I made my way onto the flight and by the time I got to my seat the pain had become excruciating. Breathing exercises didn’t help—the pain was so bad I kept unintentionally holding my breath and getting lightheaded. I expected it to pass and I was on an airplane, so what could I do?  Shortly after take-off that pain was accompanied by nausea, several trips to the airplane bathroom, and a failed attempt to drink some ginger ale. The level of pain decreased a little during the flight but the misery and nausea essentially lasted the entire time, and there were some silent tears.

When I got off the plane I honestly contemplated taking a voucher to fly to Boise the next day, just wanting to lay down and not suffer in public anymore. I decided to power through in case this was something serious—I didn’t want to end up in a hospital in Denver. I survived the next flight and by the time I landed in Boise and got my bags, around 1 a.m., the nausea was gone and the pain had become manageable. Jeremy took me home to try to sleep.

Around 3 a.m. I woke up to more excruciating pain but it had become focused on my lower right side. At that point it hit me “Oh my gosh it could be my appendix.” There in the dark I googled symptoms of appendicitis and what I had experienced was text book. Still, I tried to convince myself Web M.D. can’t be trusted and that I was overreacting and it would pass.

Time to Go to the Hospital

I slept restlessly until later that morning when I tried to eat for the first time since the pain began. The pain had ebbed so I was hopeful but as soon as I finished breakfast the pain came back and I felt nauseated again. At that point I decided to ask my mom what she thought. After describing the symptoms, she basically yelled at me through the phone to get my ass to the ER. Jeremy looked up appendicitis and also thought that’s what we were dealing with.

We went to the ER at Saint Luke’s in Boise. Even the ER doctor thought my symptoms were textbook appendicitis and after ruling out ectopic pregnancy or a UTI, expected the CT scan to confirm his thoughts. One nurse flippantly suggested it could be painful ovulation, and although I had my doubts I could only hope that was the case. We had a 16 mile run the next day and plans to go backpacking in the Sawtooths!

Fast forward to post-CT scan. The ER doc came in and said, “Well we know what it is now, and it is not appendicitis. It surprised me, and is not that common, but makes complete sense with the symptoms you experienced. You have an ovarian torsion.”

Before I could say “whaaa?” he explained that I had a softball-sized cyst on my right ovary (later during surgery would find out it was on my fallopian tube) that had caused my ovary to twist on itself and cut off the blood supply to my ovary.  The sudden intense pain I had felt was the torsion actually occurring.  The lack of blood flow begins to cause necrosis (death) of the ovary and if the blood supply is not returned in time, ultimately the ovary may need to be removed.  He told me the gynecologist was on her way and would confirm the requirement for surgery and explain further.

Operation Save the Ovary

After the ER doc left, Jeremy and I quickly Googled “ovarian torsion” and by the time the Gynecologist arrived, we realized we were definitely in for surgery and would be canceling all of our weekend plans.  Sure enough, Dr. Shrum came down and confirmed that ovarian torsion is considered an emergency and requires a same day operation. I would have a laparoscopic surgery, three tiny incisions in my abdomen, to untwist the ovary and remove or drain the cyst. She was confident my ovary could be saved.

When the doctor asked if I had any questions, I asked her what the timeline was for the day. She said “this is an emergency surgery, so as soon I leave here I’m changing into scrubs and you’re going to be prepped for the OR.” They didn’t waste any time. Operation Save the Ovary! Next, I asked “how long is the recovery?” and “how long do I have to abstain from physical activity?” Jeremy laughed and goes, “What she really wants to know is when can she run again?” Bingo.

She told me one week, no physical activity. Just walking. That wasn’t so bad! It would suck, but one week is nothing. Down to the Operating Room we went! I had very little anxiety thanks to some Dilaudid in my IV and extremely kind and informative nurses. Dr. Shrum made a few marks on my abdomen, they put a motion sickness patch behind my ear to control nausea, gave Jeremy some instructions, and wheeled me into surgery.

Recovery

The first three days were the toughest. My throat was sore and my voice was scratchy from the breathing tube, and my shoulders hurt because they had pumped me full of air and some of it got trapped in my diaphragm. I was very adamant about wanting to limit use of any opioids, so I took three 325mg hydrocodone from Friday to Saturday then quit cold turkey and moved on to Ibuprofen. The incisions were sore and I was bloated.

I went back to work on Wednesday and each day the bloating and swelling would increase throughout the day leaving my abdomen sore. I went in for my post-op follow-up this past Friday and the doc said I was healing right on schedule. She also showed me photos from the surgery, fascinating and a little disgusting at the same time. I’ll spare you those, anyone can use Google. I asked again if I was cleared to run, and she said I was. She said the bloating and swelling, and therefore discomfort, could last another week or two but that is just part of healing. I’ll go back in a few months for an ultrasound to make sure the cyst hasn’t returned.

Cleared to Run

I left feeling triumphant and ready to get back into training! I had that 16 mile run I didn’t get to do the week before. To be honest, 16 miles felt daunting after doing nothing for a week and I didn’t want to demand anything of my body. I had to adjust my expectations and be smart about getting back into training. I decided I would set out on my run and pay close attention to my body, stopping if necessary. Jeremy was right next to me slogging along at my 8:30-9:00 pace.

Around 9 miles things started to break down a bit. That pace is typically conversational but my breathing was labored and I had a hard time drawing deep breaths. Possibly a side effect of the air pumped into my abdomen during the surgery. I also just felt exhausted, I could tell my form was breaking down and I felt the muscles around my hips tightening up. At 11 miles I stopped for a stretch and walk break. I felt a little better after and ran on the Greenbelt to the next major crossroad where I told Jeremy that was it. My body had said enough, and I listened like I promised I would. 12.4 miles at 8:20 pace.

I thought back to a couple of things I learned during the RRCA coaching course that reinforced my decision. One being that I had run for over 90 minutes, so I had at least reached the time amount of time to experience some of the benefits of a true long run, and the second being that one workout does not define a marathon training cycle, it is the entire body of work.

Listening to my Body

I took a Lyft home while Jeremy ran the rest of the way with Bailey. After much stretching and foam rolling I was left with a ton of tightness in my TFL and glute med. Otherwise I felt okay. I had planned to finish up the last 3.6 miles the next day but when I woke up on Sunday I realized I needed to give myself another day. The run had taken a lot out of me, and as Jeremy bluntly reminded me “You had surgery one week ago, what did you expect?” So Sunday I rested, and scheduled a massage for later in the week 🙂

On Monday I ran 5 of my prescribed 4-6 at an effort level that felt like a 7:30 but ended up being an 8:20.

On Tuesday I ran last week’s missed 4×800 workout and ran on effort. The goal pace of 1:35 turned into a 1:38-1:40 and I was pretty ecstatic about that.

I had a few very smart and experienced running friends remind me that easing back in will not kill me, the fitness will come back quickly, and to continue to stay in tune with my body. I had a scary encounter that if not addressed early enough, could have resulted in losing an ovary and a recovery that may have stopped me from making it to the NYC Marathon starting line. The last thing I need to do now is rush back in and not make it to the starting line for a different reason. So onward I go training for NYC—easing back in, and still shooting for that 3:15 goal!

Final Note

I urge anyone who experiences sudden or prolonged abdominal pain to get it checked out! Whether it is an ovary, appendix, intestines or anything else the consequences can be dire. Even when we are hardwired to deal with and overcome pain, our body is telling us something. We need to give it credit and listen!

-Shaina