Monday, July 11, 2011

Freaking out your local doc

I went to a walk-in clinic for some dull aches in the outside of my foot, just below my ankle. I wanted to check whether it was a sprain or a dislocation (or, gulp, a stress fracture in the works) and get an idea of what I need to do to fix it.

They had a triage room where they take your temperature, blood pressure, and pulse with a single, nifty electronic device that uploads it to the computer. You can actually watch the real-time graphs on the screen! Side note: they had iPads in the office you could toy with while you waited. This was a pretty cool clinic.

Anyway, my blood pressure came out as 102/50, and my pulse was hovering around 41. The tech was really nervous, and he asked me if I was light-headed. "No, I'm feeling pretty normal now." "I'm not letting you leave here until you can get your heart rate elevated." "I run long distances, I'm pretty sure it's just that." "How long is long?" "100 miles." "They really need to train us to handle people like you."

Because we're such a handful, right?

I get this a lot whenever I see a new doctor or assistant. For the general population, a heart rate that low usually is a warning sign, as is a low diastolic pressure.

Am I bragging here? Absolutely. But I think it's a combination of genetics, which is completely an accident-of-birth thing, and some endurance training that has given me low blood pressure and a low heart rate. In high school, we did maximum heart rate testing every year. At our Winthrop running camp, we'd sprint up a 400 meter hill multiple times after a long run and take our pulse at the top. I was never able to get my heart rate above 185, and despite my own and my coach's attempts to find another method to elevate my pulse, I always hit that brick wall. It's not that I'm not working hard when I run with an aerobic heart rate of 135 - it's still 75% of my max!

Back to my current predicament, it looks like an acute injury from a rough landing - the ligaments and joint between and around the calcaneous and talus are inflamed and weakened, so it looks like a minor grade 1 sprain from an ankle inversion. The tendon and nerve bundle that runs through the area is inflamed, as well, so they either sustained damage during the inversion or they've become damaged from a change in gait over the past few weeks. Either way, I've got some Vicodin to take the inflammation down and will be icing for a week. She said that it looks pretty minor, and I can probably resume running in a week or two.

The doctor highly doubted that it was a stress fracture, although she said that it would probably still be too early for a bone scan, let alone standard radiography, to get a good reading. It might be a stress reaction (the buildup to a fracture), but a week or two off running is generally enough to nip that in the bud, anyway.

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