RED-S, osteopenia and me

This is hard to write. But I want to get it down and be completely honest about it. I’m at home now, complete with a pair of crutches, a diagnosis of osteopenia, and stress reactions in both my left tibia and fibula. How did I get here? That isn’t a straightforward story and it involves plenty of cognitive dissonance, denial, and disordered thinking.

I wanted to be fast. I love to run, to be fit and strong and cover long distances with ease. I wanted to look like a runner, light and lithe. I didn’t want to eat extra calories unless I deemed them absolutely necessary. 13 miles on the trails and hills wasn’t *quite* enough to justify the recovery drink I’d packed because 250 calories was a bit *excessive*, surely? Maybe if I’d done 20 miles, then I would have it. But *other runners* run that on water or nothing, and I ate a gel half way round so *surely* I don’t really need those extra calories?

After all, I look heavier than other runners, don’t I? I only ran 10 miles in the morning so better have a small lunch, only two rice crackers with your salad- don’t want to be a pig. Feeling hungry- why? You had a huge bowl of oats for breakfast (at 5 am, it’s now 12 and you’ve run for 90 mins and done a gym session) why on earth would you be hungry? Clearly you’ve got a problem with food, no self control, too much appetite. Eat a bowl of olives before dinner, then an entire pack of stir fried vegetables. Why do you eat so much? Why can’t you just eat normally like other women? It can’t have anything to do with the fact that you’ve run 80 miles plus 6 hours in the gym this week …. but other women do so much more, you’re just making excuses…surely?

I felt happy running not least because it allowed me to feel I could eat a bit more, and I love to eat. And I wasn’t thin, I’m not underweight. What’s the fuss about?

I missed a few periods – so what? It’s just a bit of stress. I’m not thin, it can’t be that, I’m not thin enough for it to be a real issue.

I’m feeling fast, but I’m tired. I’m getting a strange numbness in my feet when I run and I’m always cold. Just a few more runs and I’ll take a day off. That day comes and I rest but the guilt comes flooding in – why am I hungry? I’ve done nothing. I’m so tired I slept instead of cross training; why am I so lazy? I don’t need that food, I haven’t earned it and besides, I’m not thin so I can’t afford to eat like that.

The pain in my leg wakes me at night. I recognise it, like a snake bite aching across my lower leg, throbbing at 3am. A phone call from the sports medicine specialist asking me to come in for a talk about my DEXA scan. I admit the pain and get sent for an X-ray. There, both bones, shadowed and bowed like a line that has been erased clumsily and been redrawn with a crayon.

You need to maintain a BMI of 22. He tells me this, when I felt big at 19. You need to offload your leg completely and eat 2g per kilo body weight of protein per day minimum, plus as much calcium as you can get down.

Everywhere else in January the message is lose weight, cut back, trim down. Messages about how society is getting fatter abound. I know I can eat a huge bowl of cauliflower for half the calories than in a small portion of pasta; I like the volume, the feeling of abundance so I go for the vegetable, but feel guilty anyway for eating all of it.

But I’m tired of it. I’m fed up with running in pain, fed up of the tiredness, of the guilt and the criticism. I’ll come to terms with having to be bigger and maybe I’ll recover well and not injure myself again. I’ll allow myself the recovery and the nutrition and the rest and maybe, just maybe, I’ll finally be the athlete I’ve been preventing myself from being, because I’ve been trying so hard to run the most, train the hardest, be the fittest.

Don’t be like me. Osteopenia is not fun. Stress fractures really fucking hurt. But what hurts the most is I knew it; I know all about RED-S; I’ve read the articles, listened to the podcasts, gone to the seminars. I *know* that amenorrhea is a waving red flag; but deep down I felt it was a badge of honour – “look how hard I train!” I thought I was special, my body would cope. Nope. I’m just as weak as I always feared, just not in the way I assumed.

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