Author: Sara Puotinen

A Recap of the Week

• Still not able to run.
• Swam on Monday.
• Biked to the State Fair and walked around it all day, then came home, not-so-smartly walked the dog without my leg brace and felt something pop again on Tuesday.
• Biked to the lake, ripped my wetsuit as I was putting it on, took it off and swam around the buoys by the big beach anyway, then went to physical therapy and was told that my knee was still pissed and that we’d give it one more week and if it wasn’t better, I’d need to see the doctor again and probably get an MRI and maybe have knee surgery on Wednesday.
• Took the dog on 2 walks, mowed the lawn, cleaned the house, went for dinner with my dad and his wife on Thursday.
• Biking to the fair and then walking around it again today.

When the physical therapist mentioned an MRI, my first response was: will I have to be fully enclosed? I’ve never had an MRI and for years it has been on my list of things I never want to do because they will freak me out. Being trapped, unable to move, in a confined space? No thanks. But not being able to run again or to walk without my knee popping out is not an option, so if I need an MRI, I’ll get an MRI. To prepare myself for this possibility, I decided to derange the MRI, to take away some of the power of the letters to haunt and terrify me by rethinking the acronym.

MRI officially stands for Magnetic Resonance Imaging. But, it might also stand for:

Must Read Incessantly
Magical Realism Included
Musty Rusty Incubators
Mile Runs Impress
Mighty Rosie Inspires
Maybe risk injures?
More restored instruments
Myopic readers irritate
Must resist incumbents
Must resist injury!
Miniature Rhinos Incite
Monster Roosters Incant
Moody Radicals Impinge
Mustard Relish Infusion
Muffin Roll Invasion
Moldy Reed Infirmary
Musk Rat Infatuation
Minneapolis Re-evaluates Infrastructure
Mississippi River Island (Rosie’s suggestion)
Massive Recalls Impending
Mauve = red + indigo (Scott’s suggestion)
miffed redneck implodes
Multiple raisins ingested
Made really irate
Mountain rappelling Idiot
Mutant rats infiltrate

A note about mutant rats: this acronym was inspired by Scott’s story about how warmer weather is allowing rats to have longer breeding seasons and to produce bigger rats that could grow to the size of infants. Rats the size of infants? This will surely haunt my dreams sometime soon.

swim: 1100 yards
bike: 8.5 miles

Swam at the lake in the afternoon while the kids were finishing up their first day of school. I’ll only be able to swim outside a few more times this year. It will start getting colder and, after next Monday (or sooner?), they’ll remove the buoys. Too soon.

Worked on turning my injury log into a non-linear story. A collage? I need to review my notes on the different forms to determine its form. I’m tentatively titling it, Subluxation, 16 Emotions. It’s a combination of lines of poetry, taken from the poems I memorized while recovering and fragments from my injury log.

swim: 1450 yards
bike: 8.5 miles

No running at all this week, so I’m biking and swimming instead. What a beautiful morning to be at the lake! Swam in my wetsuit and my knee didn’t bother me. I love swimming in the lake. I will miss it, when it’s over, which is soon.

Here’s something I’m working as part of my recovery through poetry project. It’s a Cento, combining lines from many of the poems I’ve memorized over the past few weeks. I’m using Simone Weil’s essay “Attention and Will” as a way to frame it.

UNMIXED ATTENTION IS NOT WILL


UNMIXED ATTENTION is prayer is belief is faith is love is a million unopened fountains is obedience to a mystery is sweet scented stuff when the breeze draws across it is pausing to attend to the goldfinches who have gathered in a field for a musical battle is touching the face of every blossom, not choosing this blossom or that blossom is heeding the call, harsh and exciting, of the wild geese and the world is swimming one day in August is going down to the sea for the deepening and the quieting of the spirit is walking into words that have been waiting for us to enter is listening at his heart—little, less, nothing is grieving over golden grove unleaving is counting five mountain ranges, one behind the other is thinking of a sheep knitting a sweater is not clenched jaws is not stiffening muscles is not pride is not a miracle just beyond our heavy-headed grasp is not imagining that trees just stand and look like they look when we’re looking when we’re not looking is not walking, on your knees, for a hundred miles through the desert, repenting is not telling one’s name—the livelong June, to an admiring bog is not seeing all spoiled is not praising this but not that, loving this but not that and IS NOT WILL.

And something else I liked, that I read this morning, by Wendell Berry:

Accept what comes from silence.
Make the best you can of it.
Of the little words that come
out of silences, like prayers
prayed back to the ones who prayed,
make a poem that does not disturb
the silence from which it came.

And a few words I wrote down in my journal to describe the wind, which I listened to–did I, as Mary Oliver entreats, “listen convivially”?–yesterday.

Versions of the Wind

• shimmering
• sizzling
• shshshshshshing or shushing
• whooshing
• swirling
• coming in waves, swelling up and down, rolling over the trees
• undulating in the air
• agitating the air, stirring up the dust
• a natural white noise machine
• crackling, electric
• wafting

Physical Therapy

Some things I learned today at my physical therapy appointment:

• I have a high tolerance for pain, according to my therapist.
• I am particularly proud of the fact that I have a high tolerance for pain and I’m not totally sure why or if I should be proud.
• I have an extra bony anatomy which makes me prone to subluxation of the kneecap.
• My kneecap will probably be partially and temporarily dislocated again. And maybe again after that.
• My first injury almost 2 years ago, was probably not the result of a bone spur, but a subluxation.
• I should not run for the rest of the week.
• I should not run through pain, even though my doctor told me I should.
• My doctor and physical therapist have very different approaches.
• My kneecap is pissed off at me right now. Strangely, I am not pissed at my kneecap. I’m not sure what I feel towards my kneecap. Concern? Love? Acceptance?
• It typically takes about a month to recover from a subluxation of the kneecap.
• Right now, I’m at two and a half weeks. If I have to wait a full month to run again, that would be September 4th, just four weeks before the marathon.
• I might still be able to do the marathon. I might not.

Subluxation: partial dislocation
dislocation of the patella/kneecap
sub (nearly, slightly, partly)

dislocation: disruption, disturbance, disengagement, disconnection

A new fear introduced: subluxation. It could come back, you know. It’s possible this episode was not even the first. Perhaps my injury, a year and a half ago, was two injuries, two separate instances of subluxation?

Subluxation.
A sub par performance with no
sub-8 minute miles.
A substitution: speed out, stability in.
Now subject to more delays and derailments.
Submitting to the will of an extra bony anatomy.
Subliminal arguments between my right kneecap and the running path.
Subtraction and Addition: less grip and more gripe.
A subdued soul,
A submerged spirit.

A partial and temporary dislocation.
Out of the groove. The patellofemoral groove.
The fall to leap more groove.
The let a flap or a mole groove.
The poor tall female groove.
The fall poem or tale groove.
The tell a floor map groove.
The late morale flop groove.
The poet, leaf or mall groove.
The located on your femur bone between two bumps (femoral condyles) groove.

Recovery mode.

Day Sixteen

Swim: 2750 yards
Bike: 8.5 miles

I biked to open swim and then swam 2 loops (2400 yards) with a wetsuit and then an extra 350 yards without one. I was even able to kick with my right leg! A week ago, I never would have imagined that I’d be able to swim again this summer. I feel such gratitude.

Sunday open swims are tough because you have the sun in your eyes when you’re swimming out to the little beach, where there aren’t any big landmarks. Today, I swam blind for probably 200-300 yards. By blind, I mean that I couldn’t see anything but water. No big orange buoys. No sandy shore of the little beach. Just blue-gray water and an endless tree line. But I was fine. I didn’t panic or get upset or stop and try to get my bearings. I just swam straight, like I knew that I could, and eventually I saw the orange buoy, 20 feet ahead of me.

Was able to lift my straight leg off of the ground a few times. Very hard.

Recovery mode.

Day Fourteen

Now that I know it’s okay to feel pain, I’m okay pushing myself more. I’m realizing that sometimes I’m too cautious. I was so afraid that I would injure it more that I wasn’t willing to push it at all. Pushing through the fear is such a good thing for me. I don’t mind feeling pain, pain I can handle, as long as I believe that it’s not damaging me and that it will go away. Random: I use the word “that” a lot in my writing. I’m noticing it as I memorize poems by Mary Oliver. She hardly ever uses “that” but I frequently insert it in her lines as I recite them from memory. I want to eliminate unnecessary thats.

Repeat, minus the “thats”

I know it’s okay to feel pain now, so I’m okay pushing myself more. I’m realizing sometimes I’m too cautious. So afraid to injure it more, I was unwilling to push it at all. Pushing through the fear is such a good thing for me. I don’t mind feeling pain, pain I can handle, as long as I believe it’s not damaging me and it will go away.

Repeat, more refinement

It’s okay to feel pain. I know this now. So I’ll push myself more. I’m too cautious, too afraid, too unwilling to push past what’s seems safe. Pushing through fear is good for me. Pain is good for me, as long as I believe it’s not damaging, I believe it won’t stay forever.

Repeat

Pain is okay, sometimes. Like now. My pain doesn’t signal an injury, but muscles complaining as they wake up again. I won’t be afraid of it or tiptoe around it. I’ll embrace it, work though it, live with it. Pain is a part of living; it will end eventually.

I did the straight leg raise! I did the straight leg raise! Damn, it was hard. Hard to believe, but it took all my effort. And it hurt. A lot. Not a sharp pain, but a steady, uncomfortable one. But I did it!

Did a 2 mile walk with Delia the dog—my new favorite way to write her name. Tried to walk as briskly as I could. The one mile I timed was 20 minutes, although probably slightly faster if you don’t count the stops at corners to cross and the few times I let Delia the dog sniff something. Still slow, but progress.

Did you know that elite race walkers, the women and men, can walk much faster than I can run? My best 5K time is 24:54/8 minute pace. While racing for 20K or 50K, their 5K splits are 19 (men) and 22 (women) minutes. Wow. I had no idea. I know I’m not that fast, but under 25 minutes for a 5K is not slow. Can you imagine running a race while they walked it and having them lap you? What a sight! I almost want to see that.

Pain will you return it
I’ll say it again – pain
Pain will you return it
I won’t say it again (Depeche Mode, Strangelove).

Other words for Pain:

• ache
• irritation
• discomfort
• soreness
• strain
• burn
• tenderness
• twinge
• crick
• distress
• pang
• annoyance

I like pain when it gives off a slight warmth, when your muscles ache from use. This type of pain is not irritating or unwelcome. I like it and long for it, when it’s missing. Swimming is the best way I’ve found, to achieve this sort of tender, gentle burn.

Thinking about pain and reading Eula Biss’s essay “The Pain Scale.” When I first started teaching, I’d ask my students at the beginning of class, “How are you feeling, on a scale from 1 to 10?” I stopped, after one student said, “Can we not do the 1 to 10 thing? It reminds me of when I was in the hospital and the nurse would ask me that every morning.” I can’t remember what, if anything, I did after that to gauge people’s moods. Maybe nothing. Maybe I shouldn’t have stopped.

When the doctor told me that fear of pain was preventing my brain from sending the proper signals to my quads to activate, my first reaction was “wow.” Mind blown. I never would have expected my brain, and not my knee, to be the real problem here. So much to think about in terms of the relationship between the mind, the brain and other parts of the body. At the outset of my Run! writing project, I wanted to experiment with how I imagine and experience the relationship between mind and body. I wonder where, if at all, the mind fits into my current quad problem? Is there a conscious element to the fear of pain and the brain? Or, is it unconscious? Is a lack of will the problem, at all?

“During your recovery period your brain has mapped out a new neural network for pain-free walking, which has become a habit.” Uh oh. Is that why my brain has done? Is that why I can’t lift my leg? I don’t want a new neural network, I want the old one!

“When you run your brain creates a ‘neural map’ that, through repetition, will dictate your ‘natural gait’.” There is nothing natural about my current gait, with my right leg that won’t quite bend (source).

Search words to use: “neural map running injury” “running injury body maps”
another source.

Neural map
/Body Maps (the virtual body): “When you practice a movement, the body map representing the physical body part involved grows in size. However, if you stop using a particular body part, e.g. when you are injured and/or in pain, the body map for that particular body part becomes ‘blurred’ (also referred to as ‘smudged’).”

Biked for 30 minutes in the front room then tried to lift my straight leg again. Did it, but just barely. So difficult! Not just pain, but something more. A strongly resistant body. I’m sweaty and out of breath from effort.

A few hours ago, I figured out when I swing my right leg forward, it’s not straight and the knees not locked, which is what it’s supposed to do when you walk. When you run, your knees are bent, but when you walk, they should be straight. I do not know this because I’ve noticed it when I walk. I know this because I researched the biomechanics of walking a few months ago. And because I watched a replay of the 2016 Olympics 20K race walk a few days ago and the announcers kept talking about how the swinging straight leg was critical for a legal gait. No straight leg earns you a penalty and, eventually, disqualification.

Took another walk with Delia the dog. Rosie joined us this time. Then drove over to the lake and swam half a mile. Then went shopping with Scott and Rosie and walked a lot. I’m tired and sore.

Before going to bed, tried to do raise my straight right leg off of the ground again. Almost did it once.

Knee injury.

Day Thirteen

Today is the day that I hopefully find out what is wrong with my knee and how much longer I will not be able to exercise. I’m really nervous.

To help with my nerves, decided to write a poem. Today I’m trying out a ballad. Before writing my own, started to memorize “Casey at the Bat.” Only made it through the first stanza:

“The outlook wasn’t brilliant for the Mudville nine that day.
The score stood four to two, with but one inning more to play
And then when Cooney died at first, and Barrows did the same,
A pall-like silence fell upon the patrons of the game.”

Went to the doctor and I’m feeling much better. Got the best news I could hope for. I can start exercising right away. Swimming, biking and running. Yes, I can start running right now, as long as I can handle the pain. I begin physical therapy on Tuesday.

Decided to finish my ballad, combing stuff I wrote before and then after:

Before

She sat there in the waiting room, staring at her book,
wond’ring what would happen, when the doctor took a look.
Would he watch her as she entered, walking with her limp
and notice that her knee was swollen, blown up like a blimp?

Blimp is not quite true, I’d say, but swollen nonetheless.
Just enough to make it hard to walk without distress.
She would tell this when he asked, and others things as well
like all the times her knee gave out, and when she almost fell.

By all the times, I might add, she just means one or two
.
Sometimes when she tells a story, facts aren’t wholly true.
This happens when she’s nervous or is trying to make a rhyme.
Besides straight stories bore her, she hears them all the time.

Would he tell her to lay down and do the straight leg test?
Would she fail again and he’d say, “1 year of bed rest!”?
Oh, that dreaded straight leg test, haunter of her dreams!
Surely failing it cannot be as bad as seems?

After

She just met with the doctor, and could you even guess,
the outcome of the visit was almost pure success?
Her kneecap had slipped out, but then slipped back in place.
No lasting damage happened, she only needs a brace!

Things she heard were not all good, like the part about pain.
And how the quad’s not firing due to fear and the brain
refusing to send signals to tell the quad to move.
She’ll have to do lots of work to get it to improve.

She isn’t bothered by this news, she can take the pain.
All she cares is that the doctor told her she could train.
She won’t be running fast, or even every minute,
but, ‘bout the marathon, she still gets to be in it!

I swam a loop at open swim! I swam a loop at open swim! It was very windy and choppy. At one point, it felt like I was being lifted into the air. Pretty cool. I love swimming in rough water. Some day, I’ll have to swim in the ocean.

What I did today after finding out that my knee was okay and that any pain I felt was normal and not a warning of further injury:

• Took Delia the dog on 2 walks.
• Swam almost a mile.
• Walked up and down the steps at full speed, and without bracing myself on the railing.
• Walked over 4 miles total.

Answers to the questions I asked yesterday:

When can I start running again? NOW!
When can I start walking for more than a few blocks again? NOW!
When will I be able to swim again? NOW!
When will I be able to be outside again? NOW!
When can I walk my dog again? NOW!
When will I be able to stop reminding myself, every time that I get up from a chair or the couch: “nice and slow, Sara”? MAYBE NEVER, WELCOME TO 43 SARA.
When will I be able to write about more than injury or how stiff my leg is or how I failed the straight leg test again or about how long it’s been since I ran? NOW!
Is there any possibility, that if I walked most of it, that I could still do the marathon on Oct 1? YES!

Knee status: Much better. Feeling more pain because I’m pushing it harder.

Treatment: no RICE, just a brace and physical therapy starting next week.

Knee injury.

Day Twelve

Woke up a little sore, as usual, but managed to walk down the steps using both legs. Progress.

Had difficulty deciding which poem to memorize this morning, finally settled on the one I had intended, since yesterday evening in the car, to memorize: “Luke” by Mary Oliver. My method for memorizing is not to pick the most important poems ever!, but the ones that I want to keep. Tomorrow, I think I want to memorize another dog poem, this one by Jane Kenyon: “After an injury, walking the dog” (https://poetrying.wordpress.com/2011/05/27/after-an-illness-walking-the-dog-jane-kenyon/)

I love all of “Luke,” but especially:
and easily
she adored
every blossom,

not in the serious,
careful way
that we choose
this blossom, or that blossom—

the way we praise, or don’t praise—
the way we love
or don’t love—
but the way

we long to be—
that happy
in the heaven of earth—
that wild, that loving.

I have not run in 13 days.

Biked for 26 minutes. Felt pretty good. If I can’t run, hopefully I can keep biking.

Questions I’d like answered by my doctor, my body or both.

When can I start running again?
When can I start walking for more than a few blocks again?
When will I be able to swim again?
When will I be able to be outside again?
When can I walk my dog again?
When will I be able to stop reminding myself, every time that I get up from a chair or the couch: “nice and slow, Sara”?
When will I be able to write about more than injury or how stiff my leg is or how I failed the straight leg test again or about how long it’s been since I ran?
Is there any possibility, that if I walked most of it, that I could still do the marathon on Oct 1?

I’m hopeful that my drs appointment will go well tomorrow. My leg does seem to be getting better. What’s wrong with it, I wonder? Why can’t I pass the straight leg raise test? I’m sure it’s something that I couldn’t even imagine, something that I’ve never heard of or thought of.

Knee status: stiff, but better. can walk, mostly. failed straight leg test again.

Treatment: RICE