the true cost

This is hard to write about but in order to chart my progress and convince myself I am healthy enough to attempt to run later today, I need to see how far we’ve come. I have health insurance. This is not a life-threatening injury or illness, yet the cost of medical care for a middle income American is hard to ignore.

The following is one account of a runners return to running after a work place event resulted in a pubic ramus stress fracture.

March 21: injury trigger

March 22: injury felt and manifest

March 22: Sports massage $108

March 23: PT appointment & initial injury diagnosed as groin strain $74

March 26: PT appointment $74

April 1st: Sports massage $108

April 15 - 3 weeks post first run try

April 17 - try to run again

April 20 - Chiropractor appointment $150

April 27 - Chiropractor appointment $75

April 30 - MRI $606.39

May 1 - Diagnosed as pubic rami stress fracture

May 3 - DEXA Scan $49.32

May 10 - Sports Doctor Appointment $657.17 + X-Ray $27.87

May 13 - Blood work & urine sample $275.63

May 17 - Sports Doctor Appointment $657.17 + supplements ordered $35.97

May 31 - First attempt to run

Total: $2897.52

Screenshot of my insurance medical claims:

I have been through it.

When we believed it was a groin strain, my coach and I maintained training at the same level of intensity thinking it would be a few weeks of rest and that I’d be back to it. I could feel the healing and actually tried to run a few times, each of which was achy. We attributed that to normal return to run muscle and tendon fatigue. However, something felt incorrect to me so I saw a chiropractor. He did some adjustments (my left hip drops significantly) but suggested getting an MRI would be helpful to at least put my mind at ease. During this period I was not sleeping well. I got the MRI and was diagnosed with a pubic rami stress fracture. My chiropractor then suggested I get a DEXA scan to make sure my bones are ok. We then found out they are, to put it mildly, less than ideal for someone my age.

After the stress fracture diagnosis and DEXA scan, I felt my body give up. I was simply spent. I was tired of fighting with my body when inside it had the structure of a sand castle just waiting to disintegrate. I was scared to do anything. I stopped training hard. I stopped looking for a comeback. I gave into the demands my body has been yelling for but I did not hear. I had a few panic attacks a day for a week until I got in to the a sports doctor at CU medical center. He ordered tests, bloodwork and a 24 hour urine collection. Though I immediately attributed my nagging injuries to poor nutrition in adolescence, it was the doctor and my dietician who started asking about my whole life. What I attributed to “I just eat a lot of fiber” is actually stress-induced IBS and poor nutrient absorption. What I thought was just a part of a normal adult job is an anxiety so deep that I don’t notice I have it because I am so used to it. I am not alone in the hospitality industry as most managers and chefs will tell you, the responsibilities of a thankless job build up and manifest in myriad ways. Some chefs drink themselves to death. Other managers use weed to get to sleep. I hold stress inside of myself so hard my bones weaken, my tendons stay inflammed and I do not absorb the nutrients I need to run at the level I do. After my diagnosis, I finally stopped holding it in. Damn it was painful. My body ached. My soul felt so heavy inside. I stopped caring about training for performance and wondered if I would be able to be a mobile senior citizen. I shamed myself for being so stupid, for ignoring my health needs, for not seeing a doctor.

It was my dietician who really help me through this. I expected her to shame me for knowing so much about nutrition and performance yet neglecting my own because I appear healthy. She did the opposite. What did I expect, she wondered, when for the first 10 years of my adult life I did not have medical care and was in a survival job working to pay rent and stay alive. Of course I was not thinking about my irregular period, that simply meant I had more money for basic necessities instead of tampons. After being this way for so long, I forgot about it. I felt and appear healthy, my eating disorder thankfully a distant memory, my lack of regular bleeding was not concerning to me because that was my normal. Like my IBS symptoms, I assumed most people who ate vegetables and were active had a regular movement. My ignorance could only last for so long, my body is done.

The past three weeks have been life changing to say the least. After the panic and crying, my team and I have a plan in place. I started to move just enough for my enjoyment and stop when it felt like I should. I don’t think of it as training so much as making me feel human. My body likes to move, I just know I don’t need to move as much as I did right now because training is on the very far back burner. Move enough to feel like myself, stop when the joy stops. I am putting on some weight to help regulate my hormones and make my period regular without the use of drugs. I have changed the composition of my diet to reflect the nutrients needed to build and maintain bone and muscle. I go to sleep when I want and nap when it comes to me, even if it’s still bright out. I say my body gave up, but I really think I am actually leaning in to what it wants, consciously letting it guide how I will strengthen it. That has been a good start, I feel fresh rather than bogged down. The last piece of this puzzle that I am figuring out is the stress that comes with where I work. The problem is, I love my job and it brings me so much joy. The issue with that love, is that the stress I feel goes unnoticed most of the time. What that means is I do not notice how it is affecting me inside because the stress can often times be excitement after getting through a lunch rush or solving a scheduling problem. It is the laughter that comes after another person is sick and Aaron and I look at each other and put our heads in our hands. I love the bad as much as I love the good because it makes me appreciate what we do so much. Who am I without that really?

To be honest, I am still figuring that part out. I have the support of my bosses and Aaron at Skratch to take care of myself. I am choosing to let go for now. To take full days away and not check my phone or email. I hired some more help. I work a few less hours for now so I can nap or read. That feels kind of hard to say, but honestly my performance only improves when I take time for myself. Maybe if I do this, like how I taught the staff to eat lunch, others will too.

This is a lot to write and there so much more I could say. If anyone reading this needs support or to know if the aches or feelings they are feeling are normal, please reach out.

You will be ok. Just cry a little bit first.