03 July 2013

Not Guilty

Nearly a month has passed since last my twisted thoughts graced your screen.  Hey, if I’m not running, how presumptuous would I need to be to think you’d want to hear periodic whining on the progress, or lack thereof, of the pesky injury that finally brought me to what many have stated is a well-deserved break.  I don’t agree, as the phase “well-deserved break” implies getting away from something you don’t want, whereas I miss my miles significantly.  But still, there just hasn’t been much to talk about.

I’m past the grouchy stage, I’m past the annoyance of inching toward a normal, rather than slightly emaciated weight, and I’m past the grief over the death of both the every-day streak (seven hundred and fifty, R.I.P.) as well the two-hundred-mile-month streak (twenty-seven, ditto).  I’m simply waiting around, trying to figure out when to pull the trigger again.  As Tom Petty (and the Heartbreakers) sang way back in 1981, the waiting is the hardest part.  When is healed really healed?  When can I go back?  Gently?  When can I hammer it?  How long before I cry, “Uncle!” and seek professional help?

After a week’s break with no big improvement, I worried not; after all, it was only a week.  The following week brought a bit of a science experiment.  It was bad enough to not be running while on our annual trek to Acadia – the carriage roads are simply divine for wonderful miles – but not hiking was entirely out of the question, so hike we did.  All that walking up steeply slanted slabs of granite, stretching Mr. Achilles, which I hoped would have a positive effect, sadly didn’t bring on any improvement either.  The following week, looking at three straight, with my log feeling lonely, the “To Doctor or Not To Doctor question, which had been percolating for weeks if not months prior, reached the tipping point.  I declared the emergency, broke the glass, and phoned up Dr. Foot Doctor.

Lesson to America’s youth:  make friends with your doctor.  The difference between, “He’ll see you in three weeks” and, “We can slide you in tomorrow” is more valuable than gold.  And it found me in his office, catching up on the latest in our respective adventures shortly thereafter.

That which we believe is normal may not be, and Dr. Foot Doctor showed visible alarm at the somewhat misshapen appearance, let alone the tenderness of my battered Achilles, both of which I’d simply grown to live with.  Concerned over the possibility of a potential vertical tear, which is not even in the league of severity compared to my severed foot tendon years back but still falls into the category of “simply won’t heal by itself and might need minor surgery”, he sent me packing for the restful donut of our local MRI machine, restful that is if you like construction sites, noisy plumbing, automotive backfires, war, and other similarly quiet entities. After the unreasonably early Saturday imaging appointment, I took defiant delight in leaving the hospital on foot for an easy jog with my local club, knowing they were about to pass by anyway.  But I’m a bit ahead of myself.

Seemingly indescribable topic change:  My employer, like many large companies, insists that we all endure mindless ethics training.  The most value anyone gets out of it is the fun of deriding the inane videos and certification tests over the modem version of the water cooler.  After all, if you didn’t have a moral compass before, no web-based video is going to instill one in you, and if you weren’t smart enough to know not to collaborate with the competition, take bribes, or play Edward Snowden with company secrets, well, you were pretty much a basket case anyway.

But it’s not to say that ethics aren’t important, because they are.  It’s just that simple training can’t prepare you for when the questions get hard.  And ethics are hard precisely when, well, they’re hard.  Like when you’ve been struggling with an injury for over a year and your doctor recommends that you hit it with some oral steroids, because the alternative might well be surgery, and though you know they aren’t the kind of steroids everyone talks about – in fact, you’ve checked this out to be certain because you have to be certain – you’re still somewhat worried as to whether these are within the rules.  And these are rules that aren’t just there to catch the modern version of East German Amazon Women, but rules that are based in the ethics of fair play.  And you’re close to both of these reasons, because you race on a well-known team with a stellar reputation that you cannot afford to sully no matter how obscure the chances, and because you personally feel disgust at society’s craze to bulk up, diet down, and keep your manliness with testosterone underarm roll-ons that will grow hair on your wife if she comes within twelve feet of you.  It’s just not right.

But you’re not doing this to keep your manliness or improve performance, you’re only looking at a short-term therapy to heal an injury.  Medical care.  Then again, it’s an overuse injury, so does healing it, which allows resumption of training, translate to improving performance?  Some might say so, but so do eating, sleeping, ibuprofen, and Band-Aids to stem the flow of errant bodily fluids also allow resumption, or continuation, of training.  Where does this gray line lay?

It took a little research to allay my fears, if that’s not giving away more of the punch line than the title of this post already did.  The common “dose pak” of oral steroids, the ones where you take six the first day, and slide down to one six days later so as not to collapse in a hormonal crisis, are in fact glucocorticosteroids, and in fact are on the World Anti-Doping Agency’s list of banned substances.  Ouch!  Worry danced through my walnut-sized noggin.

But there’s a big distinction that I missed the first time through.  The list is broken into substance banned at all times, and those banned in competition.  These common yet magical chemicals in question fall into the latter category.  Relief, at least somewhat.  My feelings, of, “How can a few days of treatment for a medical condition constitute a grievous violation?” began to subside.

More research turned up some insight into why these are listed as such.  While everyone has heard of Sammy Sosa and Roger Clemens style accusations of abuse of anabolic steroids for bulking up muscle, apparently there are those who also misuse the gluco versions for their own special reasons, using them for long periods in high doses.  Knowing very personally that one risk of steroids of any sort is the possibility of weakening of tendons, I can’t fathom why you’d want to take that risk, but some do, and thus the rule, and it’s a good rule.

Still I fretted to a level that Dearest Spouse found puzzling until I related to her that any foolish mistake on my part could have nasty repercussions on my club and beyond.  Would I need to apply for a Therapeutic Use Exemption, or TUE, granted when medical needs require the use of otherwise banned substances?  A TUE which is supposed to be applied for twenty-one days in advance, which, when adding administrative time, would make trying this route to a healing rather meaningless?

More research brought closure to my fears.  According to the U.S. Anti-Doping Agency, those of us who are competitive but not God-like don’t need to worry about stuff like this that is banned only in competition, not in general (see http://www.usada.org/tue-determine/ and the embedded image).  And if through some unfathomable combination of events one were to be tested and have something like this turn up, implying use in competition, the process is educational, not harsh.  So in short, even though I expect (and insist) that this stuff will be long gone from my system well before I race again, a freak combination of unlikely events won’t bring shame upon my family for a generation.

I’m probably overeacting to all this, but I consider this stuff extremely important, both because it is, and because I want the guy racing next to me to feel the same so that we’re racing on a level playing field.  After all, fair is fair.  Now work that into your corporate ethics course!

Verdict:  Not Guilty, playing within the rules.  I’m glad for that not only because it stands on its own merit, but also because I came home from that MRI, played doctor, examined the images (I always ask for, and they always provide for me a copy on CD, what fun!), and in my highly non-professional opinion, I can’t see anything torn that can be surgically fixed.  Conveniently, nice images of torn Achilles are available on the web and mine happily looks nothing like them.  Since Dr. Foot Doctor had by then headed out on vacation, I won’t know for sure for another week, but it appears that non-invasive healing appears is the only option. So bring it on, let’s make it happen and get back on the roads.  Fairly.

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