The Arthroplasty Chronicles

Whoa! Another Year Goes By!

2011-05-31T12:30:00.000-07:00

And it's been an awesome one. The knees continue to perform better than expected. If I overdo things, I will get achy but it disappears within a day. I continue to bike long distances and work out in the gym. I can do yoga except not on my knees.

I would do this again in a heartbeat.

And a year has past . . .

2010-01-09T10:14:00.001-08:00

It's so very hard to believe that on January 27 my knees will celebrate their 1 year anniversary. They continue to be one of the greatest gifts I've ever received.

Let me start by saying that somewhere around month 6, I stopped noticing limitations. I still had some, and still do today, but the limitations were so minimal that I stopped thinking about them. For example, I returned to aerobics classes and found that a few side moves were hard to do, but not enough to make me think about dropping the class. And I still can't, and won't, kneel on on the replacements--it just feels wrong. Plus it isn't good for them.

I have learned to adapt my yoga routine so that table position (on knees and hands) is not required to complete certain other positions, like Cat and Cow. I do these seated now, they work fine. My biking capacity has returned to normal (my training has NOT, but that's not because of the knees, it's because I got lazy. I'm working on returning to training). I am now walking up and down multiple flights of steps, doing some easy jogging with the dogs, and once again can play in the snow. I don't stop before trying new things because it will be fine.

My back issues continue to plague me and I'm quite certain that I'll be having that fusion sometime in the next year--probably after my center grant is submitted. But this chapter on the knee replacement is coming to a close. Starting today, I have turned on comment moderation so that I know if someone asks for information--and I am still happy to talk to you if you are contemplating arthroplasty in the future. I will come back and post updates if anything changes, but otherwise . . . so long! And thanks for taking this trip with me.

Seven months post op

2009-09-01T10:04:00.000-07:00

I celebrated my 7 month post op anniversary on vacation in the Rockies-- this photo was taken during a hike in the Grand Tetons. So, as an update to how things are going, I guess you could say I am nearly returned to normal at this point. I was able to easily spend all day, every day for 18 days, hiking, climbing, chasing the dogs, and sightseeing.

Those of you contemplating surgery or who are on the mend should note that I'm still taking pain meds for my back, which continues to cause me problems. The back issues are also caused by arthritis, but are in no way related to my knees. I mention this because I may be having some knee pain, but it is blocked because of these meds. If you are still experiencing some knee pain, I believe this is normal and should respond well to ibuprofen--if not, I would have a talk with your surgeon if you are beyond the 6 month point.

Other things that remain and probably will always remain--I do not kneel, I do not wish to kneel, and if I forget and kneel, it hurts. The joints are very vulnerable when they are flexed into the kneeling position, so people with artificial knees should avoid kneeling anyway. I took an aerobic dance class this past summer, and some of the side-to-side motions were clunky. I am doing more side-to-side activity in my workout routine now, and that seems to help strengthen those lateral muscles.

I have days on end when I forget that these are not "real" knees. I remain thankful for the replacements and would repeat the surgery in a heartbeat.

Six months and holding

2009-07-30T17:18:00.000-07:00

At six months post-op, I am doing the following:

walking 3-5 miles without pain
biking 2-3 hours without problems
attending spinning classes twice a week
attending aerobic dance class twice a week
keeping up with yoga
this past weekend, I bounded up and down the sand dunes with Stella--no pain, no after effects

Things I can't do:

kneel
move my legs sideways quickly or easily (affects my ability to do some dance steps)
sleep with my knees together (that's where the little memory foam pillow comes in)

That's about it. It has become my new "normal."

Four months post-op

2009-05-27T08:38:00.000-07:00

I'm gradually returning to normal activity. This past weekend was spent doing yard work--the intensive, bend-plant-pull-chop-dragstuffupthehill activity. And this went on for three days. Sure, I was sore by the end of the weekend, but the knees are doing fine. It was that feel-good-because-you-worked-too-hard hurt.

I have signed up for a cardio dance/pilates class that will start in June, meeting on Tuesdays and Thursdays. I have signed up for my Wednesday yoga class (which starts today at noon). I am walking more than 10,000 steps a day on most days, and walking for up to an hour when the mood suits me. I am working on a plan to return to spinning class at least 2 days a week, maybe by next week.

The only thing I can't do is bend the way I did before. I was one of those hyper-flexible people, so my bending looks an awful lot like Millard's bending, and he's never had his knees replaced.

All in all, I'm learning to manage the back pain so my focus has now completely shifted back to weight loss and fitness. It's been a very good journey.

I am still happy to discuss my process, or yours, if you are contemplating this surgery. Just send me an email.

--Violet

Day 100 Post-op; A Time to Move On

2009-05-07T21:39:00.000-07:00

And here we are, 100 days since my surgery. Time for an overall update.

Range: Full on both sides
Flexion: 130 degrees on right; 122 degrees on left
Extension: 0% (full) on both sides

Steps, up: Easy
Steps, down: Easier, foot-over-foot, with some caution

Distance: Able to walk 30-60 minutes without pain.
Standing: Up to 45 minutes so far without pain
Bending: Well, no full lotus positions for me for a while. But better all the time.

Pain: Never. I have had not had pain since about 4 weeks post-op.

Scars: Still highly visible and not pretty, but I love them. They represent a tremendous amount of new-found freedom for me. I work on them with vitamin E oil, every day, and they are smoothing out nicely. But I really don't care if they don't fade. I wear them proudly, like battle scars.

Several things are going to happen now that I've reached this point. I will post less frequently; probably when things change enough to warrant updating. This blog will remain public as a source of information for people contemplating arthroplasty. I would encourage those of you to contact me with questions, I'm happy to help out.

Starting some time in the future, I will create a new Fluffy blog that will focus on my activities, travel, and fun stuff. I will post a link on this blog for those of you who want to keep up.

All in all, even with the back pain that I'm still dealing with, things are looking good.

Take care.
Violet

Day 94

2009-05-01T12:27:00.000-07:00

Well . . . I see the back surgeon next Tuesday, until then I'm on hold. I was so frustrated yesterday that I worked out at PT. I figured that if I'm hurting I'll take the drugs. But to just be waiting . . . it's killing me. I am going to do at least some of the exercises from now on. Bring it on.

The knees continue to be amazing. I am able to walk up and down stairs, foot over foot, with no pain. As my muscles get stronger, I can do this faster and faster. I am able to walk for 30-45 minutes without tiring. I can walk the dogs. I also found out this past weekend that I can RUN for short bursts. Stella was sitting in the car, with the hatch open, while I was trying to put a bicycle on the roof of the car. She saw another dog and LAUNCHED out of the car, snarling, to attack it. I put the bike down and bolted over to her, getting her under control before she caused any damage. Then I realized that I RAN--and I smiled.

I'll post again after I see the neurosurgeon on Tuesday.

Day 87: The Challenges Continue

2009-04-24T09:19:00.000-07:00

I have good news, and bad news. The good news is two-fold. The knees continue to amaze me. There is simply no pain, ever. The muscles around them still need strengthening, but other than a reduction in stamina, I feel like I have real knees and not huge hunks of metal. I am grateful for them every single day.

The bad news, which is also good news when you put it into perspective, is that the MRI I had last week showed a 7 cm synovial cyst on my lumbar spine. This cyst is totally benign, but large enough to pinch off the nerves and cause the pain and numbness in my left leg. That leg is getting weaker by the day. The cyst will have to be removed, so I will be having more surgery soon. Which I am NOT looking forward to doing.

The good news is that we know what is wrong with my back, after nearly a year of treatment. For many back injuries, the cause is never completely identified and as a result, surgeries fail to provide relief for nearly half of all patients. I was really worried about having surgery when we were dealing with a "pinched nerve," but now that I know I have a fluid-filled cyst causing the problem, I am anxious to get it out of there.

By the way, this condition and set-back is NOT related to the knee surgery at all. It's just a very inconvenient coincidence.

Day 73: The Problem with Balance

2009-04-10T06:21:00.000-07:00

So, it all comes down to balance. The muscles on my left side remain weaker than the muscles on my right side, and the imbalance causes all the muscle problems on the left.

This morning in PT I discussed this revelation with Kristin, and she agreed that we needed to do more targeted work on the left side. We tested the differential on the leg press machine. While the right leg could press 95 pounds with great ease, the left struggled to press 65. I simply must bring the left leg closer to the strength in the right leg if I want my progress to continue.

The instructions for this weekend are core strengthening, hamstring strenthening on the left side, and lots of walks with Stella.

Atrophy 101

2009-04-05T14:19:00.000-07:00

Sigh. In my heart of hearts, I knew it was coming.

When I got up this morning, the newest issue of Bicycling magazine was on the coffee table, opened to this ad. My bike sat quietly by the fireplace, casting judgment. I can't blame her. She has been more than patient.

Over the past week, as I've struggled to come to grips with the back pain, it has become pretty evident that I'm dealing with plain, old, unsexy muscle atrophy. When I'm taking the pain meds, I can push myself really well, but my back muscles are doing more of the work than I realize. The only way to deal with it, long term, is to stay off the drugs and be happy with achieving much less.

So, yesterday I rode my bike for (sigh) 20 minutes, then walked the dog for 35 minutes. Today I've been too tired and sore to do much else.

To quote my favorite Bonnie Raitt line, "I will not be broken." Humbled, yes.

Day 64

2009-04-01T12:32:00.000-07:00

Well, I'm still dinking around with back problems. The muscles in question are the quadratus lumborum (QL), a huge, deep, vertical muscle that runs alongside the spine with the job of keeping us upright; and the iliopsoas ("psoas"), a vertical muscle that runs vertically alongside the spine deep within in the lower abdomen. The two connect somewhere around L5, which can cause sciatica and leg numbness, and the two have the ability to stress each other, thus keeping up the dynamic of the dysfunctional relationship.

I awaken in the morning feeling pretty good, until I walk a few steps. Then the muscle spasms begin. It takes a great deal of time on the heating pad, along with popping pills, to get everything settled down. On PT days I don't take the pain meds, and I suffer through the session, which involves deep pressure point massage and exercises. I am trying to pay close attention to the exercises that hurt--and there are a few of them that I can't do right now. Needless to say, I am resentful and angry because my knees are practically shouting to GO! DO STUFF!!! But the rest of me is just not strong enough. Yet.

What causes injury to these muscles? Well, sitting without lumbar support is one; habitual overuse of the muscles will cause "knots" (adhesions) that must be worked out over time. The iliopsoas becomes shortened with too much sitting, and of course, I was in bed for how many weeks? So it all makes sense. It's just frustrating.

Knees are great. They make this little "clucking" noise when I bend them, but there is no pain, no weakness, no buckling, no problems. I'm thrilled with their recovery.

Week 8 Rehab Report

2009-03-24T09:38:00.000-07:00

OK, don't freak out. My current battle with back pain is not a new development in my recovery. If you go back to last fall in this very blog, you will see my reports of back pain; it was the back pain that landed me in rehab before the surgery. I had a rip-roaring case of sciatica that improved with rehab, but never got fully resolved. We decided that until my gait was normal, there was no chance of fixing it. So I worked on overall strength, pain control, and waited for surgery.

While on the heavy meds for the first 5-6 weeks post-op, I forgot about the back pain. The drugs did a great job of masking problems and I was able to focus on my recovery process. IT WAS GREAT!!! About 3 weeks ago I transitioned off the Oxycontin (my choice, my plan, nobody made me do it) and then I started phasing out the Percocets (once again, my plan). Well, over the past week the pain has come back, first gradually, then with a vengeance. So much so that I'm having problems functioning and sleeping. Today I went running to my primary care doctor for help.

She listened to me rant about the unfairness of it all, and then said, "Maybe you need to be a little more patient." ME? Patient??? OK, maybe a little impatient. She then explained that most people opt to be on some form of pain control for up to 6 months following knee surgery, because the "alignment problems" can take as much as the whole first year to resolve.

My doctor went on to explain that we could pursue 3 different types of treatment. I could go back on a low dose pain drug, continue working out hard and improving my overall fitness, and then work on transitioning off the drug in a few more months. She wasn't worried about my forming a dependency. The second option was to see an anesthesiologist for an injection of pain meds right into the spine. This requires an MRI and carries some risk. The third is surgery. We discussed the fact that some large percentage (like 40%) of spinal surgeries do not succeed in removing the pain and in some cases cause even more damage.

So, with prescription for 10 mg. of Oxycontin in my hand, I returned to work. I have scheduled a follow up appointment with her, to determine if I am improving. And if I've learned to be more patient.

Day 46, Post Op

2009-03-14T12:51:00.000-07:00

Some significant things have happened in the last week. First, the swelling my knees dropped a bit, which seems to be responsible for my being able to feel the metal and the "clicking" of the joint for the first time. This is normal and expected, and it will go away at some point this year. The second thing is that I'm back to work, up to 25 hours per week, until April 1. On April 1 I return to work full time. Third, I saw the surgeon ("Old Cranky Pants") on Thursday and he said that I was where he expected me to be--at SIX MONTHS POST OP! He's happy with my progress. I am able to climb steps foot-over-foot, and sometimes go down them foot-over-foot, although I still use the old one-foot-at-time for descending most of the time.

I'm completely off the Oxycontin now, and using Percocets only for PT when necessary.

PT continues to focus on scar reduction, stretching and flexing the knees, and lots and lots of strengthening exercises. I am up to 25 minutes of cardio (on the bike or NuStep) at one time, and I'm using 95 pounds on the leg press, for presses and calf raises.

Tomorrow is our anniversary--Mr. Fluffy and I have been together for (gulp) 35 years!!! We are debating about going out or not.

Day 38 Post Op Report

2009-03-06T07:36:00.000-08:00

This week I returned to work for 12 hours--three half-days. The results were mixed; on Tuesday I was so exhausted that I went to bed and pretty much stayed until the next morning, Wednesday and Thursday went fine and I finished a number of projects. So far, so good. I see the surgeon next week and will encourage him to bump me up to 20 hours a week, with a gradual return to full time by April 1. I think that might be do-able.

Physical therapy continues to produce improvements. My left knee is now at 116 degrees of flexion; the right knee is 125, which is considered normal. Extension is now a bit more difficult, for reasons I can't articulate. It might be because I'm fairly well weaned off the narcotics and can just feel more pain when the PT is forcing them down.

I have been able to ride the bike for 10-20 minutes at a time, although with minimal resistance. The left knee is still "catching" and not entirely comfortable with the rotation. But this is also getting better with each attempt.

All in all, I still think I'm way ahead of schedule.

Day 32, HALLELUJAH!!!!

2009-02-28T16:49:00.000-08:00

Yesterday at PT I got clearance to start riding my bike!!! I am allowed to bike 10 minutes twice a day, morning and evening, as "see how it goes."

I love my bike. Many of you have heard me say that before, but I'll tell you why. This is a Specialized Ruby Expert custom build, women's geometry, it fits me perfectly. It is outfitted with Shimano Ultegra components that shift and break like heaven. Because the bike is completely constructed of carbon fiber, it deflects stress away from my mostly-painful joints. It also has a compact double crankshaft, which gives me the gear ratios I need for hills without the added weight and clunkiness of a third gear. I love the compact double; I don't know why anyone would consider a triple gear on a new bike, given this option.

I love this bike. And not riding it much over the past year has absolutely KILLED ME. Now that she (Ursula) is sitting in my living room on the CycleOps trainer, I am feeling like I'm really coming back from the nightmare that has been this 4-year decline into disability.

I'm back, baby!

Post Op Report, Week 4

2009-02-24T16:32:00.000-08:00

My surgery was 4 weeks ago today. I've been thinking a lot about the first week post op, and after reading what I wrote, I have to say that I didn't do a good job describing the pain in those early days. It really was hell, an all-consuming pain that left no energy for anything else. I wasn't able to cope with normal daily things and was forced to rely on my family and caregivers for even basic support. Bone pain has got to be the worst of it.

Still, following those 6-7 days of hell, I woke up about a week later feeling hugely better. My body was able to rebound quite well. So, for anyone contemplating this surgery, even doing one joint at a time, let me say that the week in hell will be well worth it. Take the drugs and just do it.

I continue to be better every day. My flexion gets about 5 degrees better every 3-4 days. I have not used a walker or cane for 2 weeks now. I can walk 4-5 blocks without pain or tiredness. On Monday, following a dental appointment, I stopped in at work for 3 hours. By the time I went home I was absolutely demolished, but I'm going to start going in to work next week, for a few hours at a time.

I can't drive yet, and probably won't be driving for another 2 weeks or so. That sucks.

I am down to about 1/3 of the medication I was taking in rehab, and I am actively weaning myself off the Oxycontin. I will continue to use Percosets to get through physical therapy. PT has become a routine. I arrive around 2:30 for my 3:00 appointment (Jess drops me off on her way to work), and get onto the NuStep machine for 30 minutes, to warm up. I then suffer through 30 minutes of Kristin's stretching, prodding, and bending, followed by 30 minutes of exercises (lunges, squats, leg press, balance ball, weights, calf raises). The last 1/2 hour is devoted to electrostimulation and icing. I get picked up around 4:30, go home and hit the recliner for a much-deserved nap.

I seem to be losing weight, about a pound a week. I'm not restricting calories, but I am eating well and don't seem to need to overeat. The chronic pain is no longer here, just some acute episodes that are easily handled by rest, ice, or drugs.

My goals for the next month include a gradual return to full time employment and being able to ride my bike. It's all good.

Post Op Report, Day 23

2009-02-19T07:52:00.001-08:00

I am happy to report that my convalescence is not getting in the way of the dogs' important daily naps. Ho-hum.

Yesterday's PT was more of the same, working on the scars, which are sticking to the underlying muscles in a few places; I have now been reassigned the dreaded wall squats, I can't seem to get away from them. I received more electrostimulation and then spent 10 minutes on the recumbent bike. The upper arc was quite difficult on the left leg, but I managed to do it.

At this point, my flexion is 117 degrees on the right leg and 104 degrees on the left, and my extension is perfect on both legs, at zero degrees.

Post Op Report, Week 3

2009-02-16T15:27:00.000-08:00

Well, here they are. Still very swollen, but healing nicely. I am grateful.

Tomorrow will be the three-week anniversary of my surgery, and I'm doing better all the time. I am able to use Tylenol for pain part of the time now, reserving the hard stuff for severe pain (usually when I overdo it) or for physical therapy.

Today I started back at physical therapy with my folks at Probility, and it was great. Kristin worked on my scar for a while, breaking up the adhesions, and then also worked on scar tissue in the connecting tendons. The bulk of the work is in the left leg. She is thrilled with my flexion and extension. After she did this work, I was "treated" to 20 minutes of electrostimulation and ice. I then spent the last 20 minutes on the NuStep, waiting for my ride. I've been chilling in the chair ever since. I'm whipped!

I also worked about 2 hours today. That felt pretty good.

Post Op Report, Day 17

2009-02-13T07:07:00.000-08:00

I have been home now for three days and I've learned a few things. The first is that the drugs really make a big difference--you have much more energy when you are not investing any of it in pain management. The problem with taking the drugs is that chronically hyper-active people like me do too much. Somehow, over the past few days, my prescribed 10 minutes of activity + 50 minutes of rest per hour got reversed. The end result was that I was completely laid out last night. All I could do is sit in the recliner and feel bad for myself.

Today the goal is to rest every single hour, for at least half of it. So far I've managed, although my mind keeps racing along. I started the day with my PT exercises and I can see that I am still gaining strength in both legs, so I've lost no ground there.

I am scheduled to return to outpatient rehab on Monday, 3x a week. Rehab will be grueling because the first order of business will be to break up the scar tissue in both knees so that I become more flexible. I'm not looking forward to it, but I'm resolved to doing whatever is necessary to keep moving up on the functionality scale.

FYI, I met with my surgeon on Wednesday ("He of Few Words") and he says I'm weeks ahead of schedule, healing wise. My plan is to start back to work (from home) next week for possibly a few hours a day--we'll see how things go.

Two Weeks Post Op: And I'm Home!!!

2009-02-10T11:04:00.000-08:00

I am now firmly planted in my recliner, in proximity to two very happy dogs, typing away on my laptop while I try to catch up on the universe for the past two weeks. Tomorrow I see my surgeon for follow up. I already know that he is going to be ecstatic about my recovery so far--I certainly am.

The plan going forward will be to start back to outpatient physical therapy, probably 3 times a week, until I have balanced functional muscle strength and can transition to a regular exercise program. I am also in process of transitioning from the heavier pain meds to Motrin or Tylenol, except for therapy sessions or if I need it to sleep. I'm looking foward to being a little less numb.

What a trip that has been! I'm not hurting much. And words cannot express how wonderful it feel to walk without my joints sliding all over the place.

Post Op Report, Day 11

2009-02-09T11:00:00.000-08:00

I have come through one of the last (I hope) great pain hurdles for this recovery—forcing those last few degrees in my range of motion. This exercise involves my sitting on the edge of a chair while my therapist pushes my ankle backwards beyond 90 degrees. The right knee has been largely cooperative, but the left remains somewhat frozen and moves in fits and starts. I am happy to report that I still remember my Lamaze breathing exercises from 30+ years ago, which is a skill well-suited to these these circumstances. Today the left leg finally capitulated, and I can now report, after 4 hours and a number of ice packs, that it is bending more freely at last.

I am still taking pain medication on schedule. The combination that works best for me is 30 mg of Oxycontin twice day, 12 hours apart, augmented by 40 mg of Percoset taken on a 4-hour schedule, around the clock. You would think that I would be walking into walls with this narcotic load, but I’ve actually needed it in order to work through the therapy as aggressively as I wanted. My plan is to substitute 800 mg. of ibuprofen for the Percosets as soon as I get home, especially on those days where my activity will be less or I’m feeling particularly well. I will continue to take the Percosets right before physical therapy, because scar tissue work will be ongoing for the next month. I equate this experience with having how it would feel to have a root canal without drugs. You can get through it, but you don’t enjoy the trip. I will need to be totally off the drugs before I can return to work, and certainly before I will be able to drive again. And for the record, my typing ability is terrible while under the influence.

I am scheduled to leave rehab mid-day Tuesday, February 10. My family has the house set up in “barrier-free” mode and we are working on a transportation plan so that I can get back and forth to physical therapy without placing undue burden on my caregivers. I plan to not post on the blog again until I get home and settled. I am looking forward to spending some quality couch time with the dogs!

First Week Report

2009-02-04T06:11:00.000-08:00

At this time last week, I was being wheeled into my room at St. Joe’s following my surgery. A lot has happened in this first week.

My knee swelling is less than half of what I experienced in those first few days. I am now on a very good “cocktail” of pain meds that keep my pain manageable—not gone, by any means—but in traumatic surgeries like these, we aim for manageable. I get around fairly well on my own via walker and a few awesome assist devices. This has caused a few problems since I keep jumping the shower line by going ahead of my scheduled day and time. They can’t catch me in time to stop me!

One of my goals for the new year was to learn to say focused in the moment, and this surgery has certainly given me lots of practice. There simply isn’t any energy to deal with what is happening in the world, at home, at work, or even in the next room. Every day is a focused experiment in making individual muscles work a little bit harder. It doesn’t feel good, but one is driven by necessity to do it anyway.

I have learned, in this one week, how much I have taken for granted as it concerns my legs. Never again will I take such precious gifts for granted. I have learned that when you are sick you do not want to hear about others’ problems, and you certainly don’t want to hear about how easy your process is from someone who hasn’t done it. I call these “third-party referrals.” It doesn’t matter how someone else did, each of us approach and experience the healing process in a very individual matter. We also don’t share the real truth of the ordeal with others because we believe that having working knees is still better than knees that don’t work, and the pain will be worth the effort.

Today in physical therapy I was working when one of the techs wheeled another knee replacement patient up to me. She had also had bilateral and wanted to know how mine was going. She was shocked to see what I could do. Her own surgery was 5 days before mine, and she still couldn’t get up and use the walker. Part of it was her age and weight, but it really doesn’t matter. It’s not a one-size-fits-all process, which is why no surgeon wants to give you a hard timeline.

So, a the end of week one, I have 104 degrees of flexion and extension in my right knee, and 90 degrees in the left. I will try to keep these updates coming about every 2-3 days. More often if good stuff starts to happen.

Post-op Days 5 and 6

2009-02-02T15:32:00.000-08:00

Well, the rehab center has been no picnic for the past few days. I learned the very important way of asking the question “Do you include memory loss patients with the general population”, which yielded the response “We make every attempt to treat our memory loss patients in a cohesive program that includes dedicated space for that population.” I should have asked, “On average, how often do you house a memory loss patient with the general population.” That would have yielded different information.

On Saturday and Sunday night, nobody on my unit got any sleep because the darker it became the more agitated Dorothy became. She is 92 years, completely deaf, and in late stage dementia. She managed to scream and moan 4-8 times per hour all night. Today I told the admissions manager that I was going home tonight if Dorothy was not transferred upstairs. Fortunately that has occurred.

I continue to need heavy pain medications which I take round the clock. I am taking 20 mg of oxycontin at 12 hour intervals, kicked up a notch by 40 mg of percoset every 4 hours. This does not “control” the pain—the pain is always present—but it does help me to manage the stress of it. I have finally learned what that 1-10 pain scale means to me:

10—producing a dead faint
9—nausea/gagging/vomiting
8—uncontrollable sobbing
7---teeth gritting
6—root canal territory
5---bearable but present pain that reminds me that the injury is serious
4-1 I’ll let you know when I experience it

There is no therapy on the weekends, in general, but on Saturday I had my intake assessment. I was given some very awesome tools to help me move around. These included a pole with a loop on the end, to move my most painful foot around; a sock assistant, you put the sock on the assistant then use the ropes to pull it up onto your foot; a “reaching device” to grab for things out of reach.

Yesterday Millard and I broke the rules here and I had an unauthorized shower. It basically involved him scoping out the shower room, helping to gather up the materials, and then helping me to shower. The whole thing took 20 minutes. I had found out that my “shower night” was Saturday and I found this out on Sunday morning. It had to be done.

My incisions still look horrific, but they are healing and my legs are working pretty well. So far, so good. I will probably go home on Friday.

Day of surgery, January 27 2009

2009-01-31T15:52:00.000-08:00

On Tuesday morning I woke up feeling mostly calm and focused. My time was largely structured for me by my surgical team—two cups of black coffee and routine meds before 8 am; followed by a full-body shower at 9 a.m. At 9:45 I was to start the antiseptic scrub—first round was the whole leg, and then the area directly above and below each knee.

I made the last phone call at 10:30 a.m., to my friend and partner-in-crime, Susanne. She’s had every single joint replaced in her body at this point, and her last words were the only ones I really wanted to hear. She wished me luck, told me “TAKE THE PAIN MEDS,” and sent me on my way. We arrived at St. Joe’s at 11:22 for intake and pre-op.

It all gets pretty sketchy at this time. I don’t ever remember being nervous or having any pain. I was just on autopilot. I remember seeing my surgeon, who looked me in the eyes and said “It’s all going to be good.” I remember the epidural and my anesthesiologist, and talking about the good old days of natural childbirth. But mostly I remember a blur, a transfer onto the operating table, and then emerging from the darkness in recovery. I was still blocked from the spinal. My surgeon was telling me that the joints were terrible, far worse than he had anticipated, but he thought he has been able to straighten them nonetheless. He predicted that I would be happy with the results.

I was transferred to the 2^nd floor of the old hospital, a general surgery unit, because my surgeon wanted me monitored. This was the biggest pain in the butt possible. Besides having every kind of wire and tube strung over and into every body part, the nurses were not informed or equipped to deal with orthopedic surgery patients. I had the required Foley catheter, a drain in each knee joint that were attached to two hemovac pumps that would filter and spin my drainage to produce a dense fluid of red blood cells that would be put back into my body (so, yes, Fluffy has been blood doping, notify the French press) two access IV’s, antibiotics, normal saline fluids, and a PCA pump to deliver pain meds directly into my spine via the surgical epidural lines. I was the Bionic Woman.

The rest of that evening was low key—I remember drinking broth and being left alone, mostly. Pain was not a problem because the spinal took another day to wear off.

Day 1, January 28 2009

At 12 hours postop, reality started to filter in. I was told that I would remain on floor two until I could manage my pain and the catheter was removed. Day 1 was also the day when the geniuses on the floor decided that I needed to walk. Bear in mind that nobody was quite sure why I was getting up, if there was a protocol for getting a bilateral joint recipient up on the first day, or the best way to accomplish it. But stand I did, and FAINT I nearly did—the world went black for a moment and I was bathed in cold sweat. To say the word “pain” and have it cover the entire spectrum of what I experienced somehow falls short. Let me say that the type of pain that comes to mind, several days later, is the pain you feel during a particularly bad root canal experience—when every tooth in your mouth is going through it at the same time, if you can imagine that. It’s simply too much pain for our little brains to process.

I am happy to report that cursing out a particularly inept nursing staff is still well within the scope of my skills set, irregardless of pain.

Day 2, January 29, 2009

Oh happy day, today I am transferring to the Ortho floor on level 5. The nursing staff on 5 GET IT. They understand pain control, why certain body parts need to be kept horizontal or vertical during forward motion, and why any any effort at this point has the capacity to exhaust me for hours on end. It’s not that I don’t appreciate the things that people do for me. It’s just that if you haven’t experienced this process you cannot understand what it means, and your feeble attempts to explain it to me just convince me that you are totally inept, and right now, because of how much every motion or activity hurts, I need to believe that you know what you are doing.

I am now transferring from the bed to the walker to the toilet and back, and spend a chunk of time every day in the chair in my room. I also spent 4 hours today in a continuous passive motion machine (CPM), which basically raises, rotates, and lowers my leg to attempt to loosen the muscles. It should reduce the freezing and stiffness. An after-the-fact observation is that the upper body arm and back muscle work I did several months pre-op has been well worth it. I have the strength to haul my body around on my arms, after all.

Day 3, January 30, 2009

I may or may not be moving to rehab today. My orthopedic surgeon and primary care doctor are having a disagreement over the seriousness of my anemia on the latest blood draw. My PC thinks I should stay an additional day and get a grip on things; my surgeon thinks we should let rehab deal with it. The staff on floor five are taking bets largely in favor of the surgeon.

After 3-1/2 hours strapped inside the CPM, the nurse came in to announce that I needed to be ready for discharge in about 2 hours. And this is when I realized that the whole concept of “rushing to get ready” really requires muscles that can respond completely when called upon to do so. Not to mention a person with a car who is there and ready to go. I’m not sure how all this fell through the cracks as it did, but I suspect it has something to do with the dim-wit social worker assigned to my case. Somehow we managed to get me and my stuff to the entrance to the hospital, then over to Glacier Hills, where my arrival was NOT anticipated, hence we got to watch them scramble for a while to find a bed and get me into it. But by the end of day 3, I was safely snuggled in my bed with plenty of tools that would help to get me back on my feet. I am so glad to be in rehab (although the Amy Whinehouse song keeps playing over and over in my mind, I say no no no). I think it gets better from here. I HOPE it gets better from here.

Day 4, January 31, 2009

Met with my physical therapist (Nikolina) and occupational therapist (Jean) who hooked me up with all kinds of cool tools, like the hand extender, the sock assistant (it is so cool, can pull up your socks for you) and a scrubby extended for getting my lower back. I love tools! I am such a primate!!!

I am able to bend my right knee by almost 90 degrees, a little less bend on the left. I am able to extend my right foot to nearly 180 degrees but can extend the left almost NOTHING—as in, start from no baseline at all. Talk about a humbling experience! My brain is screaming “lift these muscles” and my quad muscles are humming “nobody is home.”

More of the same tomorrow.

THIS JUST IN

2009-01-26T14:24:00.001-08:00

They gotta have the final say, after all! My surgery has been moved from 1:30 to 12:30 p.m. I'm hoping that is the last change. Sigh.

To-morrow, and to-morrow, and to-morrow . . .

2009-01-26T11:42:00.000-08:00

. . . Creeps in this petty pace from day to day . . . or so sayeth the Bard.

I am at work, on very little sleep (crazy, anxiety dreams all night), trying to tidy up my desk and delegate out last-minute projects. People have been enormously supportive. We have several layers of dog-walking volunteers, ready to go; Millard has his Blackberry mapped into my Yahoo mail so that he can forward messages to friends and family; my bags are packed; bills are paid and taxes are all finished.

Now, we wait. I just ate the last solid food I will have (grilled chicken and green beans). Tonight will be soup, and then nothing solid after midnight. I am permitted two cups of black coffee before 9 a.m. (hallelujah!!!) and that is all. I check into the hospital at 11:30; surgery at 1:30 p.m.

Unless I am subject to a last-minute cancellation/rescheduling, this will be the last blog entry until I am able to do my post-op report.

Thank you, thank you everyone who has wished me well, put me on their prayer lists, and have offered support. There are tons of you, and I am totally humbled by your goodness.

Now let's get this party started.

And Then, There Were Five

2009-01-22T10:18:00.000-08:00

Days, that is. Days until surgery. And now it's getting hard. Besides the emotional/fear factors of facing such a daunting task as having no legs for while, I have been off most of my anti-inflammatory and pain meds for a week now, plus no supplements, and I'm hurting. All. The. Time. Tylenol doesn't do much for the bone pain, and it does nothing for the tendonitis. I'm having problems sleeping, I'm doing too much comfort eating again, and the urge to raid the liquor cabinet and just drink until I pass out is strong and constant.

I'm not going to do that, of course, but I can see that by the time Tuesday rolls around I'll be jumping with joy (metaphorically--I'm a low-impact kind of gal from here on). If there was ever a motivating force for me, it's being inconvenienced at this level. See previous note about working on patience.

At this point I'm still playing phone tag with one of the rehab centers, I have clearance for rehab by my insurance company, I have the proverbial to-do list in process, and I've pretty much cleaned up my job enough for now. So by the end of the weekend I will be "ready," whatever that means.

Rehab Central

2009-01-19T09:57:00.000-08:00

With 8 days to go, I have determined which two rehab centers will be acceptable if I need one. My first choice is Glacier Hills; second is the Evangelical Home in Saline. I am still hoping to go home, but not if going home will result in less progress.

I've had good input from the Knee Geeks website as a result of posting about my upcoming surgery. This group will be a great resource for me post-op; they will be able to keep me reality-based about my progress and pain control.

Moving on . . .

Post-Disney Report

2009-01-14T09:34:00.000-08:00

So, on Thursday Millard and I left for Walt Disney World in Orlando, Florida. We were meeting up with friends and family to spend 5 days in the sun and warm. A number of our party would run the half marathon on Saturday.

This trip was planned about a year in advance, at a time when I didn't realize that I would be having bilateral knee replacement in January; at a time when I could still walk. In order to deal with the walking issue, an employee of mine graciously recommended Buena Vista Scooters, which dropped off a snappy little battery-power model on Friday before 7 am, and picked it up Sunday a midnight. They could not have been more accommodating and the price/day was less than half what Disney was charging for their big clunky models.

The trip was wonderful and terrible at the same time. The wonderful was warm, sunny weather on all days except the last one, as we were preparing to depart; it was tons of very excited, happy children who were more than happy to share their joy with us; it was an opportunity to have fun with some of my favorite cousins--Al, Rita and Patrick--and reconnect with Buddy and meet his new wife, Vickie. It was a chance to catch up with Karen at the race expo, and to talk with people from all over the world who had come to run either the half marathon, full marathon, or BOTH! These crazy people got "Goofy" medals and I think that is fully appropriate! And finally, it was a chance to see Millard set a goal for his race and beat it, after several years of very non-committed running.

The terrible was really about being hit in the face with my limitations. This experience has changed me forever, and given me a new respect for people who live their lives without leg power. On Thursday night we rented a wheelchair and Millard pushed me around Magic Kingdom--this was an awful experience. In addition to feeling like a burden on him, people simply DID NOT SEE ME. I was stepped on, bumped into, and was largely ignored by everyone around me. The switch to the power scooter over the next few days was somewhat better--I could navigate myself--but people still didn't acknowledge my presence, and some were outright irritated that it took time to load me onto the bus or that I got special treatment in the lines. As I said before--this was a total eye-opening experience!

Before we left for WDW, I was starting to feel fearful about the surgery. But now I am looking forward to it. And once I have new knees, I will take care of them so that I am never back in this condition. I have the power to do this right. That's something.

Medical Update

2009-01-13T13:00:00.000-08:00

On January 7 I met with my orthopedic surgeon, who, true to form, was in a hurry and arrogant as usual. I went in with my list and made him answer my questions. Unlike my mom (and most other older women), I am NOT charmed by his handsome looks! I want him to do a good job. I asked him what types of knees I would be getting (Zimmer female-specific titanium), if he would replace my kneecaps (only if he can't resurface the old ones), how long he expected me to be in surgery (2-3 hours), and if he planned to try to straighten my legs (yes). He told me that he performs about 500 replacements a year, and that St. Joe's is one of the top hospitals for knee replacements. I do know that outcomes have more to do with the quality of the surgeon and the hospital than any other issue, so this is probably as good as it can get.

Yesterday I met with the nurse practitioner for about an hour, for labs, physical exam, and instructions on when to stop supplements (now), ibuprofen (the 17th) and how to prep for surgery. I then met up with Millard for 1-1/2 hours of education with a group of patients. I was the only one under the age of 60; the only one under 200 pounds; the only one doing both knees at one time.

I am feeling much, much more confident about the procedures. I also know that I will feel pretty good for the first few days (because they leave the epidural in place), and that the real pain work will begin on day 3.

Onward and upward.

2009-01-01T14:15:00.000-08:00

So, here we go. A brave new year, with a new direction in government, a new set of knees for me, new careers for Jess & Dom, and all the good things that life throws at us. I'm ready.

We spent a quiet, fun time last night with Dick and Julie, and managed to MISS midnight, we were totally engrossed in back episodes of My Name is Earl. Yeah, I know, not very highbrow. We slept late and spent the day playing with dogs, making chili, and taking down decorations. It's been a lazy, wonderful way to start the new year.

I did my PT stretches this morning and have been working on going up and down the steps, forward and backwards. Later this evening I will do my dreaded wall squats and dynaband exercises. Tomorrow is the gym for weight work, Saturday will be pool work.

Tomorrow is also my last PT session until after the surgery. I will miss these guys, but I am ready--more than ready--to go it alone.

I expect these last 26 days to go quickly. We leave for Orlando on the 8th and return on the 12th. My first consult with the surgeon is the 7th; post-op physical and labs, followed by the group training session, is the 13th. And my leg waxing is the 25th--you don't expect me to deal with hairy legs for a few weeks post-op, do you?

Happy new year to all, with love and prayers from a very grateful Fluffy.

The Year in Review

2008-12-29T09:59:00.000-08:00

I don't think that 2008 will go down as the most fun time I've ever had, but it certainly was a year of change, and I'm hoping that change is for the better as time goes on. My recap, in a nutshell:

2008 saw the end of my knee function. It became so bad that by early spring I had already sworn off spinning class, walking for exercise, the elliptical trainer, and finally, long bike rides. My workout routine became an unending series of upper body weight workouts. As a result of the cardio deprivation, my heart health began to show signs of wear and tear.
As a result of the lack of exercise, my metabolism ground to a halt. I've had to struggle on a daily basis to just hold even.
In late March, Millard and I moved closer to our retirement dream by purchasing a 2004 Fleetwood Flair motorhome. Although circumstances prevented us from traveling as much as we wanted, we did manage to have some really good times in it, and plan to have even more good times this coming year.
Our son finished school and moved back to Michigan. It's good to have him closer.
Our daughter finally quit complaining about her crappy job and went back to school to train for her CNA certification so that she can start to accrue the health care experience she needs to apply to physician assistant programs. She also started back on science requirements, since she's been out of her undergrad for too long.
Following a long stretch of illness, my mom agreed to move into assisted living. My sister spent a huge part of her summer and early fall helping to facilitate this transition, and it's gone amazingly well.
I finally gave up on the toxic boss and found a better job. One with people who actually care about me and want to work with me.
After flunking out of obedience training, Stella has slowly learned to listen to some commands and chew things less than she had been. However, she is now obsessed with the rocks on one of the plants. This proves that Cesar Millan is correct when he says "You might not get the dog you want, but you always get the dog you need." I am working on becoming more patient.
And Dexter is still the dog from Heaven. He is 110 pounds of loving protector. We are blessed to have such a good friend.
My favorite cousins, Al & Rita, were finally able to adopt their foster kid, Patrick, who now gets to fit into this crazy family. It's so much fun to get to know him

Should I not check back in until January--happy new year to all. I'm looking forward to yet another wild ride in 2009.

On the Eve of Christmas

2008-12-24T09:13:00.000-08:00

So, at 2 pm I am sending the staff home, and then I will head home to begin 11 days of vacation time. I have tons of household projects to do over the holidays, plus preparation for the long stretch off after surgery, but I'm ready to tackle it all.

I plan to hit the gym for a very limited, modified workout and also do some pool running or swimming over the holidays. I have physical therapy on Friday, then twice next week, then I'm done until I'm post-op. I plan to eat tons of vegetables, take my vitamins, drink plenty of water, and meditate every day. I have only 3 weeks of work left with lots to do and I know that time will pass quickly.

This morning Jess learned that her friend Aaron was involved in a serious accident on I-75 last night, near Saginaw, so she is headed north as I type this. If you are reading this post, please say a prayer that Aaron will be OK. He's a good guy; he was trying to hook up chains to his car, which had slid off the road, when another vehicle slammed into him.

A safe and peaceful Christmas to all.

Tuesday PT Report

2008-12-23T06:30:00.000-08:00

Today we added leg presses and WALL SQUATS!!! I HATE WALL SQUATS!!!

Onward and upward.

Monday Update

2008-12-22T09:18:00.000-08:00

Well, I spent the weekend taking it easy, and except for a nagging cough, I seem to be well on the mend from the past two weeks of flu, followed by a bacterial infection of my sinuses and lungs. I am sleeping better and my appetite is back.

I went to see my chiropractor on Saturday and got adjusted; I am scheduled to resume acupuncture later today. Tomorrow I'm back to PT, thank heavens! And my exercises this morning went well, no new sore spots. In fact, the act of lying around for the past two weeks seems to have made my muscles feel a lot better.

One issue that became very clear this past weekend is that I have absolutely no hamstring strength. While helping Millard bring a large package into the house, I found myself in the position of having to take a step up onto the porch, backwards, while holding on to this item. The item wasn't heavy, but I simply could not find those muscles. I couldn't make them move. Jess had to retrieve the package so that I could turn around and mount the step in a forward position.

Lots of work to do before next month! I'm looking forward to the holiday break (12/24-1/4) to have more time to maybe increase my efforts to twice a day, plus do some swimming.

An Off-Topic, Inapppropriate Political Rant

2008-12-18T09:33:00.000-08:00

OK, so I agree with the majority of the people in this great country that the U. S. automakers have mismanaged their businesses. I agree that they failed to anticipate the need for more fuel efficient autos. But does this economy REALLY NEED a few million more working people on unemployment? If we can give hundred of billions to AIG, with no strings attached, and no visible benefit to any of the problems in this fragile economy, why are we are not stepping in to help keep people employed? Employed people pay taxes, which you need if you are going to keep handing your banker friends hundreds of millions with no strings attached.

If the people in this country really think that Michigan is that expendable, please sell us to Canada--we like Canadians, we know them well, and maybe the Detroit Lions would do better in the Canadian Football League. Then my taxes would go to a government that is at least supporting some of things I want and NOT fighting useless, purposeless wars while good working people lose their houses and go hungry. Canada, by the way, is propping up their auto industry, as are most of the countries in Europe and Japan.

Back on the Rails

2008-12-16T09:55:00.000-08:00

So I went back to PT today, after about a week off. We focused on mostly on stretches and working me back into the strength exercises. One of the benefits of spending the last week in the recliner? My hip and back muscles are EXCELLENT, no tightness or pain at all. If only there wasn't that "walking" thing, I'd be fine.

Catching Up

2008-12-15T09:11:00.000-08:00

OK, now I get it. The reason I felt so lousy last Tuesday was because I was coming down with the flu--it had nothing to do with my rehab progress. So, after almost a week of lying around sipping tea and coughing my fool head off, I'm heading to the doctor this afternoon for what looks to be a case of residual bronchitis. I've not been back to PT, or acupuncture, or anything else for the last week.

The good news--after 6 days of very limited activity, my knees, hip, and back feel pretty good.

Tuesday Update

2008-12-09T06:06:00.001-08:00

Owwwwwwwwwwwwwwwwwww. High pain day. It's cold and wet outside, freezing rain, so that might have something to do with it. I have to lead a senior staff meeting at 10, and then have a meeting with our computing core at 11, and then I might go home and curl up with dogs. PT was minimal today because I felt so bad.

PT Update, Thursday

2008-12-04T08:56:00.001-08:00

Another good morning in PT. I've been using the ice packs this morning (sat through an entire interview with one on my knee) but no hard drugs . . . yet.

I see 2 people each time I go in: Kristin is my physiotherapist and does the actual manipulation, traction, and other hands-on therapy. Sarah is a PT tech (a student in training, I think) who works with me on strengthening exercises. Some of them require me to balance on a wobble board or ball while holding onto a Dynaband that Sarah is jerking or pulling. Anyway this team works great together and I'm in really great hands, I think. They are becoming like family, I see them so often.

Today Sarah and I were talking about her life, and I realized that she is engaged to one of our UM football players. She said that he has signed with an agent and will be training with the Cleveland Browns this year--which is sad, because it means he will go into the draft before he graduates. Michigan's team has been in the gutter all year and it's sad to lose what little existing talent we have.

And the Good Follows Bad

2008-12-02T07:12:00.001-08:00

Yup, a good morning in PT. Still some problem spots in my iliopsoas, piriformis, QL's and IT band, but some slow and steady progress is becoming more and more apparent. Back to some of the upper body strengthening exercises and more ball work for balance and core strengthening. I arrived at work before 9, iced my back and IT band for 30 minutes, and now I'm prepping for meetings the rest of the day.

I have an acupuncture appointment later this afternoon, and nothing planned for after work. YAY!!!

Turkey Report

2008-12-01T10:42:00.000-08:00

Well, Al, Rita and Patrick are safely back at home. By some miracle, I gained just 2 pounds and was able to keep up with my exercises all weekend. I was expecting much worse news when I hopped on the scale. I'm back on my eating plan, which includes no alcohol for the next two months. I'm trying to get my immune function as high as possible before surgery.

Today I got the clearance to start swimming again--so I am looking for a pool that has hours that will work with my hectic schedule. I am to start with just 10 minutes (hardly worth the effort of changing clothes twice and taking a shower, but it's a start) and we will assess as we go.

More Progress

2008-11-23T12:42:00.000-08:00

It's been tough work in physical therapy this week. On Tuesday, I showed up at 7:30 only to realize that my appointment was not until 8:00 a.m. But my PT noticed that I came in early and told me to get started on my exercises. So after a 30 minute period where I not only did my stretches, but a number of strengthening exercises on the ball and with Dynabands, I had my treatment. For the next 30 minutes my PT did deep massage and manipulation of the IT band in an attempt to break up scar tissue. This involved her getting her fingers UNDER the IT band and manually separating it from the muscle tissue below, where it was stuck.

This is one of my least favorite activities in PT, but it is absolutely essential to making sure that the muscles around my knees are ready to work once I have the surgery. I cannot afford to lose any rehab time. The recovery I have seen after the first 3 months post-op will set the level of recovery I will be capable of having, forever. So I bear the pain and even pay people to do it. (Go figure.) Following the treatment, she sent me back to the exercise area to do yet another 30 minutes of strengthening.

After my session on Tuesday, I spent the day at work with my leg wrapped in ice packs, popping Motrin and Vicodin like candy. I slept moderately well on Tuesday night, but by Wednesday night the pain was escalating. By Thursday morning, I was in bad shape. I barely got to PT at 8 a.m. and my therapist, Kristin, knew by how I was moving. She termed it "a minor setback."

My treatment on Thursday was really just gentle adjusting and massage, and then stretching. I did only stretching on Friday and Saturday, and then again today. Tomorrow I have PT again, and I think I'm ready to add back the strengthening exercises.

Sometimes it feels like I'm getting nowhere, but I am walking straighter and my back no longer hurts--the pain is isolated down around the knee joint and muscles, which is where it belongs. On the other hand, I was trying to do a yoga plank to determine the strength in my core muscles--holding the pose for anything over 30 seconds is considered good--and couldn't even get into the position, much less hold it for any length of time. So that tells me we have a LONG way to go!

Onward and upward.

How Progress Happens

2008-11-13T10:02:00.001-08:00

So, over the past few days I've had some ups and downs with the back problems. After PT on Tuesday I felt OK but later in the day starting to have a radiating pain on the side of my leg, the kind that sends lightening bolts of numbness down to the ankle. After a bit of icing and a bunch of Motrin, I felt better. On Wednesday morning I felt fine, and worked through my exercises. When I got to the one that involves putting a Dynaband around my ankles and side-stepping across the room, the pain came back very quickly. Eureka! The culprit has been discovered.

Last night I had a deep tissue massage with the Wonderful Judi (who has been my massage therapist for more than a decade now). She worked for an hour on my left IT band, which she said was stuck to the muscles by scar tissue. This was incredibly painful work, but today I am moving much more freely.

When I arrived at PT this morning, I relayed the massage treatment to my therapist, and she had me stop doing the side steps altogether. Since I was already using a yellow Dynaband (the easiest level), I am clearly not healed enough to be doing them. She has instead substituted a few others that are working much better. She also spent a good deal of time on my left IT band. The good news? The fact that pain is now isolating in an area outside of my back means that I am healing, and healing quickly.

Onward and upward.

BREAKTHROUGH!!!

2008-11-10T09:21:00.000-08:00

TODAY I AM NOT IN PAIN!!!!

At some point in time yesterday my body turned the corner and the physical therapy exercises started to work. By "started to work," I mean that I did not feel worse after finishing them. I am even feeling a little stronger today than yesterday. I have a huge amount of energy and I'm getting a ton of work done this morning--my staff are in shock, to be perfectly honest. They have never seen this version of me, since I arrived at this job 6 months ago already in pain.

The secret is that I simply cannot do more than my PT assigns to me. Even if I feel good when doing extra things, the injury shows up later. I have to be patient, build up very slowly, and be stronger than I am now, but not as strong as I want to be, when I have the surgery in January.

Which, by the way, happens in 77 days.

Recovering from Election Night

2008-11-06T09:21:00.000-08:00

Well, I am truly feeling every one of my 55 years. After a late night on Tuesday, and sleeping a great deal yesterday, I am still dragging butt. One night of disrupted sleep and I'm chronically out of whack. If that isn't a sure fire sign of aging, I don't know what is.

Physical therapy continues to be a challenge. Yesterday I worked with dynabands and ended up with pain and numbness shooting down my left leg, for the rest of the day. Today we made some adjustments and I'm feeling better.

I really look forward to having all of my energy back. Even with the massage, the acupuncture, the PT, the extra sleep, and lots and lots of moral support from friends and family, I am TIRED all the time. That's probably the very worst thing about living with chronic pain.

Physical Therapy Report

2008-11-04T09:10:00.000-08:00

I am on week 2 of my fall physical therapy. I am seeing a physiotherapist (that's a combination massage therapist/physical therapist) two times a week for an hour before I head in to work. Although it means getting up at butt crack of dawn, it works out in the long run. I'm much more limber and my pain is lessened with the exercises.

What has happened over the past six months is that I have seriously compromised my lower back alignment. This happens when you walk with a limp, and when you favor one leg over another. The muscles in my abdomen and lumbar area, on the left side, have become much weaker than those of the right side. The result is a great deal of pain, on both sides, since muscle atrophy hurts on the left, and the right side is just tired from doing the left side's work.

The sessions start with deep trigger point massage of the iliopsoas muscle in my abdomen. This isn't really all that much fun; the muscle is very tight and very angry and not very forgiving at this point. She then works on my lumbar muscles, particularly the insertion points on the piriformis.

Each day I get more and more exercises added to an ever-growing corpus. More and more, I am getting to do some strength-building, and this feels awesome. It also hurts afterwards, but I am starting to move with much more ease.

Also, I have continued with the acupuncture sessions and they are awesome. The needle insertion really does help to interrupt the pain feedback loops in which my body is caught, plus the level of relaxation it creates is simply wonderful. I leave each session a bit clearer-headed. I'm grateful that I added this treatment to my wellness plan.

Just 83 days until surgery . . .

2008-10-31T08:28:00.000-07:00

Ah, autumn!!! It is so beautiful around here this time of the year. I wish I were riding my bike, with the cold air on my face and the smell of musty leaves around me. Alas, my bike riding is now confined to occasion bouts on the stationary at the gym. I am experiencing the fall through the eyes of a sitting, complacent non-participant. Sigh. Big deep sigh.

Still, things are moving along. I started back to physical therapy this week. I will see a physiotherapist two times a week for an hour and leave each time with a prescription for the exercise I must do for the next few days. The goal of this session, which lasts until the Christmas break, is to get strong enough to do the PT as soon as I can following surgery.

I've been battling a nuisance rash on my left ankle for the past two months, and I'm starting to worry that this thing could be a show stopper in January. At first my internal medicine doctor thought it might be some form of shingles. She sent me to a dermatologist, who diagnosed a fungal infection and gave me some cream. Well, two weeks later it's still erupting new blisters and the pain is deep and boring. It's enough to keep me up at night. On the positive side, it no longer itches, so that's a great improvement from the early days.

The other thing that is troublesome is my lack of energy. I get exhausted very quickly, and many of the physical tasks I would normally do (cleaning up the yard for winter, gutters, etc.) must be delegated to Mr. Fluffy. This has put him in a state of chronic overload, and I am incredibly guilty over it. I know that this is how couples support each other, but I don't make a very good patient. Nor do I have patience.

All in all, my days are spent mostly looking forward to a time when I can move freely, and quickly, once again.

An Update

2008-10-10T10:02:00.000-07:00

This is my new cane. Yes, as in hobbling-old-woman. After a few scarey falls I decided that the added stability would be good. And because you don't buy a walking stick every day of your life, I opted for a carbon one, decorated in butterflies. Very light, very pretty. Still not all that much fun to walk with.

So, since my last update, I've finished the SynVisc shots and my knees are much less painful. For that I am grateful. However, the rest of my body is terribly out of balance, as a result of the wobbly way I walk. A week ago I managed to rupture a disc in my lumbar (no motor nerves were involved, thank heavens), so now I'm weaning myself off the Vicodin. Next week I go back to physical therapy (third time this year, for the record) to let them show me how to get my strength back and ease back into an exercise routine without further injury.

That's probably the worst part of the knee deterioration. Everything in our bodies is in balance with other parts of our bodies, and when something as structurally integral as the knees go, there is a kind of domino effect that follows. So far this year I've dealt with a number of spinal and feet issues, to say nothing of an increasing battle with not gaining weight. Forget losing--I'm down to eating less than 1200 calories a day just to maintain. At least I like vegetables.

My latest experiment has been to see an accupuncturist. It's been an amazing experience, although I can't really say why. Yesterday she was working in the center of my back when a bright, hot light seemed to fly across the muscles in that area. After that, the sciatica in my hip just stopped hurting. It was freaky.

Tonight I have a deep tissue massage. Tomorrow, spinal adjustment with my chiropracter. Monday starts PT. I have become incredibly high maintenance!

All in all, I'm feeling very positive about my surgery, which is scheduled for January 27. After everything I've been through, I just am not worried about the rehab. It will feel great to get on with it.

Just Shoot Me

2008-09-08T10:00:00.001-07:00

What a difference one shot of Synvisc makes!!! I am walking so much better, and my knee pain has gone from an 8 to a 3. I have two more sets of these to go. Unfortunately, I will not be able to have any more of these injections before the surgery in January. The last set wore off in less than 4 months, but the substance is not approved for injection more than every 6 months.

As before, the left knee is responding much better than the right. The left knee is pretty much pain free (it still slips a lot, though) while the right one is somewhat painful. This difference is probably attributable to the different wear patterns; my deterioration is not the same in both knees. But still . . . even "mildly better" is better than nowhere!

Getting Focused

2008-08-12T09:46:00.001-07:00

On my knee surgery, that is.

The pain is back with a vengeance, of course a whole month before my insurance will pay for Synvisc shots again. I've been hobbling about with a cane (a very pretty carbon model, complete with butterflies) and taking left-over root canal Vicodin to sleep at night. I'm scheduled to have the first set of shots on August 28, and I'm hoping they are as effective as they were back in February.

In 2005 Jane Brody published an essay about her bilateral replacement, where she spoke candidly about the problems of functionality and pain control. She took a lot of flak from orthopedic surgeons around the globe, who accused her of being too negative. However, having witnessed my mom's replacement ordeal last year, I think that Jane did a good job of describing how the body deals with the outrage of being dissected and reassembled. I don't expect this journey to be easy, to say the least.

Anyway, I wondered what Jane has said most recently about the new knees, and I was delighted to read an update from June 2008, three years post-op. This gives me hope that I won't be out of work forever when I have my procedure done in January, but even better, that I can return to some semblence of an active life at some point in time. Bad knees on a person with chronic hyperactivity disorder is some sort of cruel cosmic joke.

Speaking of which--my tentative surgery date is January 13; backup date is January 19, a very good(?) way to start 2009. Off we go . . .

Tuesday Night Workout

2008-07-30T14:41:00.000-07:00

I have given up trying to get to the gym in the morning. I am in too much pain, much too stiff, to face getting out in the morning and then getting to work.

Yesterday I packed my gym clothes and went straight to the gym following work, and it was great! I not only managed to work out a great deal of work stress, but I had more energy when I got home and was able to move much better since the endorphin high lasted for a few hours. I ate less for dinner also.

The gym was hot and crowded (the down side), but I was able to spend 30 minutes on the elliptical trainer and then do my weight workouts without much of wait for machines. My only complaint was that the guy on the elliptical next to mine controlled the TV, and had the ESPN Sport Center on for the entire time. And the entire time (all 30 minutes that I was there) was devoted to the fact that somebody's NASCAR car had tires that did not hold up in the Brickyard race last weekend, and oh the horrors, and how could you do this to the fans, and I watched a series of old guys basically say the same things over and over again, with the same shots of torn up fenders and melted tires, for the 30 minutes I was on the machine. The show was still going on for the following half hour.

Now, I have no problem with people getting excited about NASCAR, but who wants to talk about an engineering problem, over and over again, for an hour? Well, besides my engineer friends? And it worried me a lot the guy next to me was so into it.

But then again, I still don't understand the excitement about golf either.

Spain Times Three

2008-07-27T14:45:00.000-07:00

Yup, I watched all 21 days again this year. For the third year in a row, Spain claims a win for the Tour de France. Carlos Sastre kicked ass.

The 2007 winner, Alberto Contador, was not permitted to compete this year simply because he signed up to ride on Team Astana. After last year's debacle, the Astana sponsors fired everyone, hired Johann Bruyneel (who successfully coached Armstrong for a number of years). It was Bruyneel who hired Contador, among other riders, all of whom thought they would be able to compete since the doping culture had been completely expunged from Astana, from the coaches down. A month before the start of the Tour Bruyneel got the bad news. I don't think this was at all fair.

At any rate, in 2006, following Floyd Landis' fall from grace, Oscar Pereiro was unceremoniously awarded the yellow jersey. No Arc de Triomphe, no flowers, stuffed lion, and kisses for him. In fact, he didn't really get the title until nearly a year later. And this year he quit the race mid-stage after sustaining a serious leg fracture.

Until a few hours ago, there were 3 riders dismissed from the Tour for doping this year--much better than the horde from last year. However, sadly, I noted that just a moment ago the Dmitriy Fofonov of Team Credit Agricole was dismissed having tested positive for an asthma drug he never reported. At least they busted someone from a French team for a change.

Still, you gotta admit--Spain is on a streak. Good for Carlos Sastre and Team CSC! They put on a spectacular show for those of us who just had to watch. I'll be watching again next year.

Weekend Update

2008-07-27T12:38:00.000-07:00

Saw an awesome physical medicine doctor on Friday, who diagnosed the back/butt pain as an inflamed sacro-iliac ligament (caused by the imbalance created by my pronounced limp); he gave me a cortisone shot, adapted my workout plan, and I'm already feeling better.

Saturday's workout was 30 minutes (2.5 miles) on the elliptical trainer, followed by 45 minutes of weight lifting, eliminating some machines and adding a few new ones, per his instructions. So far today I feel great.

Today we did our A2-Dexter ride and back on our bikes, for a total riding time of about 80 minutes. Tomorrow is yoga.

Oh yeah, on Friday I got my new cane and I'm practicing using it, for high-pain days. Jeez.

BFFs Forever

2008-07-23T12:16:00.000-07:00

So, last weekend we headed north in hopes of doing some mileage at the annual Ride Around Torch (RAT), only to be rained out. HOWEVER, in between the rain we had many opportunites to play in Lake Michigan with the dogs. Although Dexter is a great swimmer and has been swimming for three years, Stella has never been swimming, so it was fun to watch the little bit of labrador retriever in her come forward.

Of course, the pit bull stubbornness made for some trouble, especially when the tennis ball became punctured and SUNK . . . Dexter refused to come in without it, and Stella eventually had to be retrieved from the deeper water because she would rather drown than leave Dexter's side.

People often ask why I adopted a pit bull mix, given the amount of time and energy it takes to train them into respectable citizens. Well, it's because Dexter loved her, right from the beginning. And although a nice little foofy lap dog would have been tremendously easier on me, his happiness translate to more happiness for me as well.

At any rate, it all comes back to me, eventally. There is nothing like a good fuzzy friend when it's raining out and you are cooped up in an RV for the weekend.

One Helluva (Wet) Ride

2008-07-13T15:52:00.000-07:00

Yesterday we rode the 40-miler. At 8:30 a.m. we met up with some friends and by 9 had started out on the familiar course; this was the third year we have done this particular ride. The temps were hot and muggy already at 8:30; we were supposed to have thunderstorms later in the day. We decided to go ahead and try it anyway.

This is the first real long ride I've done all season, so I was a bit worried about how well my back and knees would hold up. I needn't have worried, if anything, I'm stronger than I've been.

We reached the lunch spot at Portage Lake State Park around 10 am. Lunch was great, as usual--lots of good sandwich fixings, whole wheat bread and pita, wonderful fresh fruit (grapes, plums, bananas), cookies and pretzels. However, while we chowed down under a tent, dark clouds rolled in and in a matter of moments we were watching a torrential downpour. The rain did not let up for nearly an hour. By then, the entire parking lot was flooded and the rain, although lighter, continued.

Some of our party had tickets to the Tiger's game later that afternoon, so we decided to press on in the rain. By the time we got back we were wet, cold, and mud splattered. A hot shower never felt so good!

On to the Ride Around Torch next week.

Tuesday Workout Report

2008-07-08T07:27:00.000-07:00

Today I did one mile on the elliptical trainer, 7 miles on the stationary bike, and a full upper and lower body weight circuit.

I had a revelation this morning. My hamstrings are much, much weaker than my quadriceps. This makes perfect sense if you remember that for the past few years my main mode of exercise has been cycling, which develops the quads quite nicely. Of course, the penalty for weak hamstrings and strong quads is a nasty malalignment syndrome that leads to back problems. Hence the issues I've suffered with over the past winter.

From now on, I will alternate between bike workouts and workouts that use the hamstrings. For a person with two advanced degrees, I can be really dumb sometimes . . .

Weekend Update

2008-07-06T15:05:00.000-07:00

Isn't he wonderful? This is a 200-pound Bullmastiff. I just think he's beautiful.

My mom has been in the hospital battling pneumonia this past week, which has not given me much time, but I have managed to work out three days in a row (almost: workout #3 will be in another hour or so, I'm going to the pool). On Friday I spent 90 minutes in the gym. I did a mile on the elliptical trainer, 10 miles on the stationary bike, and then a full set of upper and lower body weights. Yesterday we biked out to the Dexter coffee shop and back; a trip of 18 miles, in 80 minutes plus stop time. So far I feel fine.

Next Saturday is the One Helluva Ride. Instead of 63, we are going to bike the 40 miler. I need to ramp up much more slowly than I had anticipated. But this is one of my favorite rides, so it will be enjoyable.

Onward and upward.

Here's a Good Resource

2008-06-23T14:09:00.000-07:00

I have learned a lot, and gained a great deal of courage, from reading this blog. He seems to be someone nearer to my own level of fitness and determination.

This resource is also very helpful.

Blick Wechsel

2008-06-22T11:11:00.000-07:00

No, no, it's still Fluffy here. The title of this entry, from my favorite Christa Wolf novel, mean's "change of view." More loosely translated, a change of perspective.

Winter 2007-08 was not good to me in terms of the battle I wage against osteoarthritis. My left knee cartledge has been long gone, but over the course of the winter the RIGHT knee decided that it was not getting enough attention and joined the ranks of the chronically sore and slipping. Add to that a couple of good falls, and you have a good picture of my downward spiral into Weeblehood. (Weeblehood, for those of you who are not familiar with the little round-bottomed people from toys of yesterday, is a term I use to describe how one hobbles around without knees that bend properly.)

At any rate, following a trip to Jamaica in February, where I could not climb Dunns River Falls with the rest of our group, and then a trip to San Francisco where walking up and down the hills was torturous, and then again just last month, when I was not able to ride the Zoo-de-Mack, I started to rethink my 5-year plan for having the knees replaced. In April I started the job of my dreams, which came with an opportunity to work with the outgoing person for 3 months. And over the course of those three months, she mentioned that she wished she had opted for phased retirement so that she would not need to pay for her benefits until she reached 62. After some discussion, we realized that we could appoint her at 5% effort, thus maintaining her employment status, consolidate the time into a 4-6 week period, and have her come back to cover for me during medical leave. Presto-chango! We are now targeting January 2009 for surgery, with the retiring administrator stepping in to ensure that work occurs without interuption. Talk about your win-win!

In March, I saw my orthopedic surgeon and had updated xrays that confirmed my suspicions. Dr. O. said that they were bad enough to replace "as soon as you are ready." I asked him about bilateral replacement and after discussion he said that I'm young enough for him to consider it, pending the OK from my internal med doc. A few weeks ago I went through a battery of cardiac testing, including EKGs, blood work, and a stress echocardiogram, and I've been pronounced fit enough for the added strain of having both done at once. So I'll go back to Dr. O. in August, have a comprehensive discussion with him (with Mr. Fluffy present), and get on his schedule for January surgery, if possible.

The view change is really about wellness, about shifting my focus from performance or weight loss to just being as healthy as I can. I am working with a dietitian to learn how to eat without viewing food as a drug or an enemy. I will continue to work with a physiotherapist to incorporate exercise in such a way as to not punish my body. In the interim, I will lose a little more weight, but I'm already close enough and my health markers are good. I will lose 10-20 pounds following the surgery, so going into it too thin is not a good strategy.

Whew! I hope you can hang in there with me. Having never had major surgery of any kind, I need this space to organize my thoughts, my fears, and my preparation.

San Francisco Report

2008-04-16T16:12:00.000-07:00

On Friday, I flew to SFO to meet Millard (Mr. Fluffy) following a week long conference that he attended in San Jose. It was the first time I've been to SFO, and I loved it. HOWEVER, I had no idea that there were so many hills! A few years ago, when I was running, I would have loved having so many places on which to do hill repeats. The first picture was taken from the highest point in the city.

The mighty Golden Gate Bridge, which is a very awesome structure. However, I could not help but notice that it was not nearly as magnificent as our own Mackinac Bridge, which is 3 miles longer and much, much higher up. On the other hand, this bridge is accessible--pedestrians can walk on one side, and bikes can ride on the other. Try that on the Mighty Mack, especially during a high-wind day!!!

The best thing about the trip was getting back on a bicycle. And even though these rentals were clunky hybrids, it felt great to pedal along. We biked for about 3 hours, including a trip across the bridge, and back.

And, as you can see, it was a beautiful, clear, HOT day!!! SF'ers were complaining about the heat, but as an escapee of the perpetual Michigan winter, we loved it.

Fluffy and Mr. Fluffy, going on 35 years of marriage??? How is this possible?

Our son's friends, Ben and Miranda (with their trusted hound, Muddy Waters) spent the midday with us, drivingt us everywhere and showing us the coolest stuff in town. We never would have seen most of it if it weren't for their hospitality. (Note to all three of you: Come and visit us any time.)

Here's a question for my sister, Mittens. What are these? I'm thinking they are delphiniums on steroids?

And Now, the Movie, Folks!!!

2008-03-30T14:15:00.000-07:00

OK, so most of you know that we have been toying with the idea of buying a motorhome and eventually spending part of the year in it, for some time now. Well, I'm happy to report that as of this writing, I am the proud owner of 34 foot, double-slide 2004 Fleetwood Flair.

We have named it "Urge," after the 1961 VW microbus in the stories of Devine Right and his lady Estelle, as written in the Last Whole Earth Catalog many years ago. We plan to take our first trip (with dogs, of course) in early May, when we will drive north to meet friends of ours and camp for two days in a local park (sort of like a "shake down cruise" in the Navy). This morning I took it out and drove it. Except for a few close calls while turning right (my big challenge--I kept clipping the curb) it was really a lot of fun.

In the pictures that follow, you can see the overall size of Urge, with the slides not extended. The internal space will be three feet wider when the slides are out. Since Urge takes up half of our little association's street width, I thought putting the slides out would be most unkind to my neighbors, who have done a magnificent job of looking the other way and not reminding us of the "no RV" rule on our books!

For now, Urge lives in a very nice storage space about 8 miles from home. More reports from the road will certainly follow!

Oh yeah, I start the new job tomorrow. Life is good.

One more thing--the last picture has nothing to do with the RV, but I thought that you all would like to see a picture of Xena, our old lady, curled up in her favorite chair.

WHAT THE @#$%^&&?????

2008-03-28T06:59:00.000-07:00

Not really what you could call "biking weather" yet . . . .

Workout Notes as Spring Approaches

2008-03-04T09:10:00.001-08:00

Yes, it's still my bike and yes, I still love it.

I’m back to working out on a regular schedule, thank heavens. I’ve had three shots of Synvisc in both knees, which has helped a great deal. I’ve continued with the Saturday yoga class and my flexibility and posture are really beginning to improve, so much so that I’m going to add yoga on Wednesdays to my routine.

My spinal problems are improving also. I had a new scan performed last week that shows good nerve impulse transport except for somewhere up around C3. Although I had not perceived any problem there, I quickly discovered, as I returned to weight lifting, that I have pinched nerve that is impairing my left arm’s ability to lift effectively. Which confirms what the doc has been telling me all along—just because you don’t hurt doesn’t mean there is no problem! Only a small percentage of the nerve is dedicated to pain, the rest is dedicated to function.

Today’s workout was 30 minutes at high cardio (90-95% of max, which for me is in the upper 150’s or lower 160’s) at 90 rpm. This was the strongest I’ve felt in a long time and it felt really good to sweat buckets. With a new job on the horizon (I start on March 31) and a focus on the first long ride of the season (Zoo-de-Mackinaw on May 17), I feel like my fitness program is coming together. Or is coming together AGAIN, after a winter of many false starts.

Think spring. Think dry, warmer weather. Think biking from Ann Arbor to Dexter and back for coffee. We can do this. In the meantime, I’ll be spending time at the gym or on the trainer in the basement. At least the cats are amused by it.

Welcome Back, From the Other Side

2008-02-14T11:50:00.000-08:00

So, where I have been for 6 weeks? Not in hell, really, but not in a very nice place. Nice to be emerging from the darkness.

It started in mid-January, while I was taking a yoga class taught by my friend Lois. The class was not too rigorous, it was really quite lovely, but my left knee started to hurt quite a bit. And then the swelling starting, culminating with the rupture of the Baker's cyst behind the knee. This dumped tons of synovial fluid down into my calf. The condition, known as a "nuisance" complication of osteoarthritis of the knee, causes debilitating pain nonetheless, which in turn rendered me almost bound to my chair.

Those of you who know me know that inactivity is the worst sort of hell for me. This hell coincided with a complete breakdown in the relationship with my boss (otherwise known as The Boss From Hell) and my realization that I had to go onto the job search quickly, for my own sanity.

So that's what I've been doing for the past six weeks; working to get my knees back in working order (more on that later), and looking for a new job. A good prospect is in the works, and I'll talk about it if it pans out.

We spent 5 days in Jamaica and got back on Tuesday. We went for a friend's wedding, and it was wonderful. I loved swimming in the ocean and sitting on our balcony at night, listening to the waves. The weather was heavenly, 85 degrees. We returned home to zero degree temps and 8" of new snow--but the break has really paid off, because even the snow and cold are not bothering me.

Today I saw my orthopedic surgeon. I am receiving Synvisc injections to help the knee pain, but this is only a temporary fix. I will need both joints replaced in the next two years.

Moving along . . . .

HAPPY NEW YEAR!!!!!

2008-01-01T06:43:00.000-08:00

New Year's Resolutions . . .

2007-12-30T11:19:00.000-08:00

. . . or not. I don't intend to post a list of all the things I'm going to do better in a few days. I believe that 2008 is going to be another year of gradual improvements for me, just like 2007. Another year of getting my priorities straight, another year of losing a few more pounds, another year of fighting off the ravages of age.

I've been terrible about posting lately, mostly due to the fact that I've been sick, for weeks, really. Another sinus infection. But we've had a wonderful, low-key holiday break, and I'm beginning to feel like a human being again. Other things I've been up to:

WEIGHT: Well, I've gained a few pounds over the past few weeks but I'm not freaking out about it. I decided that I'm going to allow myself to be human when faced with holidays and loved ones. And one of the things we did a bunch of this holiday time was have dinner and good conversation with a number of friends and family members. It has been a very relaxed, happy time for us. A few pounds is a suitable price for such simple joy.

EXERCISE: The Treadclimber is still great, except that I have to watch my feet because I don't trust my clutzy self to fly off the back of it. But it really builds your muscles quickly, and also works my heart really well. It was a good investment. My bike--what can I say? I love my bike, and getting to ride it inside has been fantastic. (Note to file: I love this bike. Did I say I love my bike? I love my bike.) And the gym is still a warm and welcoming place for me, where I can take a spinning class when the mood suits me, and use the weight machines. I have a good handle on exercise. I promise to start posting more often. However, it's seems so routine to me now. Maybe I'll talk about spring training.

GOALS: We have set some goals--big goals. A small cabin in our 5 acres of hardwood forest in northern Michigan, probably in another 2-3 years. A motor home--this year. Millard staying in the workforce until some key bills are resolved, and then into retirement so that he can do the general contracting on the cabin. I am planning a two-week road trip some time in March. This will be to Austin, Las Cruces, and a few other places to visit friends. The bikes will be on top of the car and go with me; Millard will fly into Albuquerque and spend a few days biking and visiting with me, David and Donna in their new home. I've already put a number of long bike rides on the schedule. Back this year: Zoo-de-Mack, One Helluva Ride, Ride Around Torch, Hancock Horizontal Hundred, Leelanau Harvest Tour. New possibilities for this year: Amish Lands, Sea Gull Century. And I'm going to stay up all night on November 15 so that I can register us for the Death Valley Century in March 2009. I'M GOING THIS TIME. And a trip in the RV (with the dogs) to Glacier-Yellowstone-Grand Tetons in September.

It's been a good break. And a nice wrap up to a complicated but happy year.

Thursday's Time Waster

2007-12-20T14:58:00.000-08:00

Become an Ultrasound technician

Tuesday Spinal Update

2007-12-04T12:16:00.000-08:00

So, I've been seeing my chiropracter for almost three weeks. We reviewed my xrays last week and it was truly enlightening. For one thing, my scoliosis is much worse than I had believed. And unlike most cases of the deformity, where the curve in one area results in an opposite curve in another area of the spine, I have a pronounced curve to the right in my lower lumbar region, but the rest of the spine is completely straight from my waist to my neck. This creates a tremendous amount of imbalance for me, and is certainly one of the reasons I have worn out the cartledge on the outter aspect of both knees.

The doc is adjusting me three times a week, so I'm tender most of the time. However, I'm already seeing some improvement to the pinched sciatic nerve and I think I'm somewhat straighter. The real problem area is actually not the lower back, but the upper spine, in my neck, where I have several instances of fusion happening already. The goal is to get those discs operating more efficiently before it is too late.

This morning I was just too sore to lift, so I did an hour of yoga instead. It was awesome, even with the "dog helpers" who felt that my face needed washed on a regular basis. I've been using Rodney Yee's Yoga for Athletes DVD and I like it a lot.

Tomorrow will be weights and cardio at the gym.

Another Example of Why the Press Sucks

2007-12-03T10:10:00.001-08:00

I found this buried in the Bicycling.com site:

http://www.bicycling.com/article/1,6610,s1-3-9-16142-1,00.html

So, when you are accused of doping, you are guilty without trial or investigation, but when they finally absolve you of the sin, they are under no pressure to let the world know. Let alone make up the for the loss of income and opportunity to compete.

Sucks.

On another note, 30 minutes this morning on the Treadclimber, it is awesome and fun.

Regrouping

2007-12-02T15:54:00.000-08:00

So, thanks to Craiglist, I now own a fairly new Bowflex Treadclimber TC3000, for cheap. Jess is downstairs working out on it as I type. Following this weekend's ice storm, I'm more happy than ever that I did it.

We have a Cycleops fluid trainer, with computers for both bikes, and use that set up for "long" rides (Saturdays). We still hit the gym for cardio + weights three times a week; Sunday, Tuesday, Thursday. But I wanted another kind of cardio to use for cross training. The power walking was not a good option. My knees kill me afterwards, and with the amount of terrible weather we get around here, it's also not very feasible. Hence the Treadclimber. I will update everyone on how well it works; suffice to say, you sweat buckets after a few minutes on it. That might mean something good.

Speaking of weight workouts, I am still doing just one heavy set per machine, but I'm trying to concentrate on the NEGATIVE part of the rep and make that twice as slow and the exertion part. It's really much harder than I realized. Everything I've read suggests that for strength (which is my goal, not muscle building or even sculpting) one set of 10-12 reps as heavy as you can manage is the best. It certainly works well for me, especially when I stick to the "circuit" pattern that the gym has set up, which lets you do the exercises such that you work opposing muscle groups if you do them in order.

The weights really make a difference for weight control. Over the past month, I've picked up another 3 pounds, but my waist and hips have stayed the same size. This I credit to the extra muscle (although I need to get back on the weight loss plan. Enough, already).

Oh, by the way . . . THIS SUCKS!!!

2007-11-16T10:08:00.000-08:00

THIS FREAKIN' RIDE, WHICH I'VE BEEN PLANNING TO DO SINCE LAST YEAR, SOLD OUT IN TEN HOURS!!! AND THE EMAIL ANNOUNCEMENT THAT WOULD HAVE GIVEN ME A CHANCE TO REGISTER IN THOSE TEN HOURS WAS BLOCKED BY YAHOO MAIL! I'M PISSED!!!!!!

Now I have to find another century to do in March, maybe in New Mexico so that I can spend some time with David and Donna . . .

I HATE COMPUTERS!!!!

Friday, Already?

2007-11-16T10:01:00.000-08:00

Well, it's been an interesting week. On Monday, I did the usual Tuesday workout (30 minutes at max cardio on the bike, total body weights). On Wednesday, having spent an hour stretching and doing yoga and still not able to stop the numbness from traveling down my right leg, I called a chiropractor who could see me right away and high-tailed it over there. My massage therapist has been after me for years to get my back adjusted and I decided that I needed to do this. Routine exercise had become too difficult again and I was moving like an old woman (which I **am**, but not THAT old).

Anyway, I liked her a lot. They took xrays and did a electromyelogram on both sides of my spine, then put me on a heavenly table that moved rollers up and down my back. With steamy warm towels, no less. After that she adjusted my neck and back, and we scheduled me for more adjustments and a consultation on Monday, to go over my xrays and come up with a long-term approach to getting my spine healthy.

Last night I had a deep tissue massage that has left me rather . . . achey . . . and then today I went back for another adjustment. The massage table was still heavenly; the doctor did only a few manipulations because I was just too tender. We'll get back into it next week.

So, my exercise is off-kilter for the week, but I think this strategy is the best for long-term health so I'll be back in spinning class tomorrw.

Elinor Update

2007-11-10T13:48:00.001-08:00

You will remember my most awesome spinning instructor, Elinor, from my previous posts. Well, today we needed to ride 2 hours, and it was cold, so we threw outselves at the mercy of creative planning. We opted to arrive at the gym early and do 30 minutes on the stationary bike, then join the 75 minute endurance spin (which used to be taught by Elinor), and then finish up on the stationary to make the two hours.

We were pleasantly surprised to find that the new Saturday endurance ride instructor is none other than Melissa, who was a classmate of ours for the Saturday rides. And true to our Sensei Elinor's training, Melissa is going to do an awesome job of training us this winter.

When we asked what had happened to Elinor, Melissa gave us some devastating news. Elinor was diagnosed with breast cancer, which was revealed during surgery to be very extensive. Elinor had a radical mastectomy (both sides), and is home healing well, after which she will endure reconstructive surgery.

Melissa reported that Elinor has come to recognize that her workouts were overkill, and the state of over-training really did a number on her immune function. I've known for some time that this is true--all tests on major organ systems, following a marathon or long run, show that the body is in distress. The body does recover, but when an athlete pushes the envelope on a regular basis the time between recoveries becomes insufficient for proper balance--and immune distress will follow. Elinor has quit everything--teaching, running, biking--while she focuses on her recovery. And she says she will never return to her former pattern of teaching multiple classes a week, while training simultaenously for century races and marathons.

Elinor is 48, and a superb athlete. Not an ounce of flab, muscles everywhere, energy, exuberance. I have been reminded, once again, that when exercise becomes punishing, it crosses the line from healthy behavior to something that tears you down.

Hugs to you, Elinor--still teaching me.

Hump Day Report

2007-11-07T08:06:00.000-08:00

My god, I LOVE the time change! We were up and out of the house, to the gym, around 5:30 a.m. Plenty of time for a good workout and then home for breakfast, dog walking, lunch packing, and a plethora of other busy work that fills our mornings now that Millard is back to work.

This morning was a 45 minute cardiac challenge workout, the first 30 minutes on the stationary bike with resistance of 13 and cadence of 90 rpm. The goal was to keep my heart rate at 90% (up to 166 bpm) of max for the entire ride, and I was able to do this. I then transferred to the elliptical trainer for the remaining 15 minutes (mostly to give my arms a workout) and finished up with my heart rate on track. Cooled down, with my HR dropping like a rock, just like it's supposed to do.

SWEATED BUCKETS. One of those good, righteous sweats. I love it.

And Winter Arrives

2007-11-06T10:04:00.000-08:00

Well, well, well . . . woke up this morning to SNOW! Nothing that sticks, of course, but lots of little flurries everywhere. It’s days like these that I really appreciate my gym membership. The very thought of biking outdoors has now been retired until spring 2008. Found my trusty LLBean parka and wore that to work. Now to find the gloves and other paraphenalia that goes with staying warm in the Great North Woods.

For the record, I have designed our winter workout strategy that will let us train for a century ride in March. The schedule looks like this:

Sunday: Cardio, 30-45 minutes + full body weights
Monday: Pilates + walk at least 30 minutes (modified rest)
Tuesday: Cardio, 30-45 minutes + full body weights
Wednesday: Cardio on the bike trainer, 45-75 minutes
Thursday: Cardio, 30-45 minutes + full body weights
Friday: Yoga + walk at least 30 minutes (modified rest)
Saturday: LONG RIDE, 2 hours and up.

We will start with long rides of two hours and work up to long rides of 4 hours by the end of February. I also have the whole family on a new eating plan; this one incorporates all the stuff I know from years of study, and we have removed all the junk from the house, including “pseudo-healthy” things that reveal, upon closer inspection, a plethora of trans fats, high-fructose corn syrup, and “enriched” grain products.

I feel much more centered, now that I have a workout strategy. I used to lose my bearings when I ran marathons and then had no strategy for how to get back into training for the next race, and that’s what happened when the weather changed and I wasn’t ready to head indoors. The bike athlete needs a schedule as much as the running athlete did, I guess.

Note to file: Move south in a few years.

Men Not Allowed

2007-10-27T13:53:00.000-07:00

This is a post about my musings on the big "M"--no, not Michigan football, but rather, MENOPAUSE. (I am imagining the men who read this blog are high-tailing it to another URL about now). What does menopause have to do with fitness? Everything.

Everyone knows about the negatives. Hot flashes, mood swings, weight gain, and the worst thing--an escalation of the aging process. Well, there are plenty of a good things, if you don't let yourself get discouraged by the bad symptoms. For example, exercise goes from something you do because the doctors tell you to do it, to something you look forward to doing because it makes you feel so much better. The difference I feel when I leave the gym, compared to when I arrive, is absolutely amazing. Exercise is, without question, the proverbial Fountain of Youth.

Exercise mitigates the hot flashes. It took me a while to realize this, but I have the hot flashes while I'm working out. Sometimes it's pretty frightening; more than once I've looked up from the bike to see some guy looking at me in horror. I know why. My face is purple and I'm sweating BUCKETS. This is not an exaggeration. But once I cool down, go home and shower, and go on with the day, I am never bothered with hot flashes again, until the next morning when I force them to show up on my schedule.

Exercise mitigates the sleep problems. It really does, providing I don't eat terrible things before bed, or drink too much before bed, or get upset about something very big right before bed. My sense is that exercise stabilizes the body chemistry, allowing the body to shut down properly.

Exercise stops the weight gain. Even if you don't cut back on your calories, exercise will keep your weight fairly stable. Enough said on that.

Exercise slows down the aging process. I have great skin for a woman my age, and more energy, which makes people think I'm younger than I really am. This has made it easier for me to come to terms with the body parts that are starting to sag and the brown spots that seem to keep cropping up on my hands and forearms. Talk about sun damage . . .

The best thing about menopause is that I am gaining wisdom, now that the hormones are no longer keeping me crazy. I am calmer, less likely to respond emotionally, and see things far more deeply and spiritually now than I did just 5 years ago.

I don't know about you, but I've come to believe that youth is highly overrated.

Detroit Free Press Marathon, Revisited

2007-10-21T16:51:00.001-07:00

This morning we arose at 4:30 a.m., packed up the dogs and lots of dog treats, and Millard, Jess and I headed to downtown Detroit for the 30th Detroit Free Press Marathon (lovingly referred to around here as The Freep). Jess was running her very first half marathon, on not enough training.

Flashback: October 2000, Millard and I ran the full marathon and loved it. You leave somewhere downtown (the Renaissance Center and Hart Plaza, for our year; Cadillac Center for this year) and head to the Ambassador Bridge, where you run over the Detroit River into Windsor, Ontario. As in Canada. Yep, this is an international marathon experience, and the race has grown from about 3,000 runners in 2000 to this year's recordbreaker, around 20,000. After about 7 miles along the riverfront in Canada, you run through the Detroit-Windsor Tunnel, which goes UNDER the Detroit River, and arrive back in Detroit, where you finish with runs past the stadiums and around Belle Isle.

Our daughter Jess (shown above, at mile 9 where she has just emerged from the Windsor-Detroit tunnel, back in the U.S. after her run through Canada) had never run the half marathon, but I'm predicting that she'll run another. She had a blast, and looked amazing and strong at the end.

In the meantime, Millard and I walked over 7 miles, trying to catch her on the course. In the process of doing so we met some great people, and some butthead people. I was amazed at how much prejudice some people had against our puppy, Stella, because she is a pit bull. I was not happy with some of the near-sighted political discussions--the problem with the state of Michigan is not the regressive tax policies of the former governor who put them all into place before he retreated out of politics, but rather, our female governor, who inherited this huge mess. And it's her fault that the Detroit automakers have failed, once again, to get on board with the technology and quality that Americans want in their autos.

But I digress. The exercise note for the day was the miles and miles of walking, which have left my arthritic knees fairly swollen, and the joy of watching Jess lope across the finish line, high on the feeling of success. I remember that feeling; I miss not being out on that course. I feel a real connection to this fading city, having done my casework here many years ago. There are brilliant little pockets of culture and people amidst areas that are desolate and frightening.

Detroit is a patchwork quilt of contradictions, a city with a rich history and a dismal future. But this race brought out the best of her today.

(above) Jess finishing strong.

Why Flying is for the Birds, Period

2007-10-20T10:17:00.000-07:00

So I have not been working out much because I'm recovering from injuries. Why, you ask? Because of my wonderful, well-trained dogs. Dexter is a 2-1/2 year old mastiff-ridgeback mix, topping out over 100 pounds, and our newest edition, Stella, is 7 months of pit bull mix puppy power. They are very happy, non-aggressive animals. We have taken great care to keep them socialized with other dogs and people. And that has made them easy to be with . . . sort of. Well, temperament-wise, maybe. Dexter has also spent several years in progressive obedience training with an excellent trainer.

On Wednesday afternoon, I walked over to doggie daycare with Dexter, to pick up Stella. We take her there 3 days a week in order to wear her out, she has that much energy. As we walked back home, we lined up to cross the street to the park, as a man walking a yellow lab approached on the other side.

They liked the lab. They wanted to say "hi" to the lab. And I was busy watching traffic, and did not realize that they were gearing up for a launch. My neighbor Kim was walking towards us on the other side, and she said that she saw them go into the stance with perfect synchrony. They launched. I flew behind them, crashing down on the sidewalk on the other side.

The good news--they surrounded the lab and the three played just fine, allowing the guy to grab their leashes. Kim (a nurse, thank heavens) was with me in a moment. She said I was AIRBORN for a few seconds. I came down on the left side (you will remember that I crashed a month ago on my bike, coming down on my RIGHT side, so now I'm evened out in terms of scar tissue) and was bruised, abrasion-laden, but nothing was broken. My palms and the side of the my foot (which came out of my sandal) were hacked up and bleeding.

Kim walked home with us so that I had only one dog to handle. I went inside and washed my wounds, but over the past few days I've felt absolutely battered, with a case of whiplash on top of it. Yesterday I did pilates, mostly to be able to stretch, and today I was back in the gym, finally, for weights and biking. My bruised ego, however, still needs work.

Jeez.

Committing to Yoga

2007-10-09T13:32:00.000-07:00

Well . . . I keep threatening to do more yoga, but with the arrival of the Dog From Hell (OK, Stella, pit bull puppy, aged 8 months now) floor work has become increasingly more . . . challenging. By "challenging," I offer the latest example. While stretching out on the floor on Sunday, the stealth puppy crept up behind me, leaned over my face and BIT THE TIP OF MY NOSE. Just to see what it tasted like, I guess. She ran off before I could kill her.

Anyway, last year my boss' executive assistant, Lois, left here to open her own yoga studio. I've been meaning to go there and try one of her classes. Today the boss' NEW assistant, Denise, told me that she took a class at Lois' studio on Sunday, and loved it. She has convinced me that I should go a few times a week.

So, on Sunday, I'm going to attend "Better Backs" at Evolve Yoga in Canton. If it's good, I will schedule myself to take at least one other class during the week.

God knows, I need this! The biking and weight lifting are great, but without a good stretch and flexibility plan, fitness just stalls. I need to meditate more. And read more.

If only I could retire . . . before I'm 90.

Happy Oktoberfest!

2007-10-07T13:18:00.000-07:00

Well, for whatever it's worth, I'm back to exercising. Over the past week I've hit the gym three times for weights and cycling, and yesterday we biked 36 miles, to Chelsea and back. This morning I stretched and did pilates.

My current strategy is to do the 30 minutes of stationary biking and lift weights on Mondays, Wednesdays, and Fridays. I will bike long on Saturdays and Sundays for as long as the weather holds. For winter, we are looking at purchasing a bike trainer or a high-end training bike so that we can continue to bike long.

I haven't regained my weight. That's something.

Oh yeah, the bike repairs turned out to be nothing, once I took it to someone who knew what he was doing . . .

Mom Update

2007-09-30T13:09:00.000-07:00

So, I returned home from up north bruised and battered, to find that my mother was ill. Mom had her knee replaced on August 21, and the knee itself is healing wonderfully. However, she has been plagued with infections in other places as a result of the hospitalization.

When I returned on Monday, 9/17, she was experiencing fever and chills. Her doctor diagnosed a severe bladder infection and gave her antibiotics and something for pain. By the 9/19 she was running fevers of 104, so she was admitted to the hospital for 3 days, where they gave her IV fluids and antibiotics and tried to eliminate the infection, which had moved into her kidneys.

Mom was discharged on 9/19. My sister Amy announced that she was coming to town for two weeks to give us a break and take care of Mom. Amy arrived on 9/20. On 9/21, Mom was readmitted to the hospital, this time with a serious case of Clostridium difficile. She was discharged just days ago, to my sister's care. So far so good.

All of this is to say that I've been working out very little, and eating terribly. I'm trying to balance some difficult things at work with all this back and forth to the hospital.

The good thing that has come of this illness is that my siblings and I have been having good conversations on how to take care of Mom as she gets older. Hard conversations, but they need to happen now.

Leelanau Harvest Tour Report

2007-09-16T12:31:00.000-07:00

On Sunday, September 16, Donna, her sister Mary, and I rode in the Leelanau Harvest Tour. Mary intended to do just 25 miles, a conviction that became even stronger when we awoke to temps in the upper 30's (Mary is from Tucson). Donna and I decided to do the 45-miler and then I would add more miles at the end to do the 63 I wanted.

The first thing that went wrong was Donna's chain locking up, spilling her onto the parking lot pavement. After straightening out her chain and gears and checking her over for significant injuries, we were on our way, only to determine that Mary had gone in the wrong direction. I turned around and biked as hard as I could for about 5 miles, then gave up and called to David to track her down. By the time I made it back to Donna I had already biked more than 10 miles.

We caught up with Mary at Settler's Park, the first food stop, around 9:30 a.m. She was sitting in David's car, shivering hard. We sent her home for a hot shower and continued on. Donna and I labored up Inspiration Point Hill (a 2-mile 6% uphill grade) and then biked on to the halfway point, which is where the cars were parked. By then we were both hot and sweaty, so we decided to stop at the car and remove some layers.

At the parking lot things went according to plan, until I started out again. While pedalling slowly, concentrating on getting the left shoe clipped into the pedal, a pedestrian stepped out in front of me. I hit the brakes hard, and started to fall to the right. I tried to unclip the shoe to no avail. (I should stop now and note that the right clip had been giving me problems for months, but I procrastinated doing anything about it. My bad.) I hit the ground hard. Donna was there in an instant, having a cow.

A brief diversion in order to sing praises for wearing good gear. I invested in two pairs of high-end, carbon-padded biking gloves (one pair with fingers, one without) and they paid for themselves that day. I landed hard on my outstretched hand, hard enough to take chunks out of the padding. The palm of my hand was bruised, but the skin stayed intact. The chunks missing from the gloves would have been ME if I hadn't been wearing them.

I was bruised and battered. The area on the top of my shin bone was missing a deep hunk of flesh, and I was bleeding. The pedestrian was frantically apologetic. I checked my head, my joints (everything worked) and slowly climbed back onto the bike, determined to finish the ride.

But nobody told the bike about finishing. I couldn't shift the gears, and it became clear very quickly that I had smashed the crank, gear shift levers, and derraileur by failling on the right side. My new wonderful bike had been broken in, such that it needed maintenance in order to be ridable again.

Heartbroken, we packed up the bikes and headed home. My body is slowly healing; my ego is taking a bit longer.

Weekend Update

2007-09-08T07:40:00.000-07:00

Well, I broke my own rule and weighed myself. Just one more pound, but the flab is coming off quickly. I have far less back and waist fat, my clothes are fitting better, and I think I'm moving better. So I'm staying the course. I've added back some carbs: apples, raspberries, oatmeal, high fiber, low sugar cereal, popcorn. I even splurge and have a few semi-sweet chocolate chips or a glass or two of wine, from time to time. When I start to become hypoglycemic (I know this by sweating, trembling, feeling foggy) I have a good energy bar, like a Lara Bar or SoyJoy. I'm feeling very good on this regimine and think I can continue it going forward.

On a sad note: Elinor is not leading any spin classes for fall term. She might be back in the winter.

Today was 30 minutes of cadence work (90-110 rpm) on the stationary bike, followed by complete upper and lower body weights. Tomorrow we will venture to Findlay, Ohio to do 62 miles at the 37th Hancock Horizontal Hundred. It is supposed to rain, a lot.

Wednesday Workout Notes

2007-09-05T09:16:00.000-07:00

This morning was 30 minutes of speed intervals on the stationary bike, followed by upper body weights, and stretching.

Today was also the first time I put on one of my transitional weather suits, which I had not worn since last spring. I was pleasantly surprised by all the additional space in it! The urge to get on the scale is overwhelming, but so far I've resisted.

Exercise Update

2007-09-03T10:19:00.000-07:00

Thursday, 30 minutes stationary bike at 80% cardio, upper and lower weights.

Friday, pilates.

Saturday, 75-minute power spin without Elinor, interval training but most of the time in the fat-turning range, 122-138 bpm, followed by upper body weights.

Sunday, rest day due to sore knees.

Monday, 30 miles to Dexter and back, average pace 16 mph.

New weight plan--stay off the scale and use how my body feels, and how my clothes fit, as an indicator. When my clothes start feeling bigger, weigh myself to see what is happening. The goal is to develop a keener sense of how my body is feeling.

The good news is . . .

2007-09-01T16:55:00.000-07:00

. . . that since the football season is now officially over, we get our Saturdays back to do other stuff. Do I think they will now fire Lloyd Carr? Nope. Michigan is loyal to its faculty, no matter what. Sucks to be a fan right now.

By the way . . .

2007-08-27T11:22:00.001-07:00

. . . here is a really good article on insulin resistance (formerly known as "pre-diabetes").

Biking Long on No Glucose

2007-08-26T11:09:00.001-07:00

Ahhhh, Ursula, you are still the most awesome bike! I never get tired of riding you.

Anyway, even though we had a hard workout yesterday in spin class, the weather was just too great to not go out for a long ride this morning. One of our spinning classmates told us about a new route and we were anxious to try it.

The ride went south and west to Manchester and back, about 35 miles round trip. I was worried about how the glucose thing was going to work on a long, slow distance ride, but I didn't take Gatorade--dumb me.

Anyway, the first 10 miles were great. The route was rolling, but no killer hills, and the area was beautiful. We had several wildlife encounters, including a startled Great Blue heron that nearly flew right into me (she was sitting on the banks of the drainage ditch next to the road) and a close encounter with a giant snapping turtle. We also saw a number of sandhill cranes, on the ground and in flight, and that was magnificent. I love those birds, even though their presence indicates the arrival of fall.

At around 10 miles, I decided to move off the lower (big) gear to the smaller front gear to rest my knees. This meant going from a process of slower leg turnovers to faster ones. I was shocked to realize that I just couldn't do it, my fast-twitch muscles were completely exhausted from the previous day's workout. After about a mile of trying to keep up with Millard, I gave up and went back onto the big gear for the rest of the ride.

At mile 15, I signalled Millard that we needed to turn around and head back. With my mom in a rehab center and Millard returning to school tomorrow, we had too much to do to stay out more than 2 hours. So we headed back, again enjoying the beautiful farm country and the wildlife. About 3 miles from the car, I suddenly bonked. I had no more energy--I felt like I had after I gave birth! This came on very quickly. After working through a couple of rough intersections, Millard suggested that I stop at the local nursery and wait for him to come and get me with the car. I was grateful for the opportunity!

At the nursery I stretched, drank water, and looked at the plants for sale. I noted that my average heart rate was much higher. I ate a Lara Bar and felt much better in about 10 minutes. I will definitely take Gatorade with me from now on. Live and learn.

Millard picked me up, said that I had missed only a few miles of an extremely hilly ride, and we headed home. I'm fine now--I just played a rousing game of chase and retrieve the ball in the park with my 6-month old lab/pit bill mix, Stella, and we had great fun. Please note that at this moment, Stella is passed out on the kitchen floor, but I'm still going strong!

Tomorrow is back to the gym for 30 minutes of cardio and weights.

Spinning without Elinor

2007-08-25T10:37:00.000-07:00

Elinor has taken the month of August off in order to travel with her daughter, checking out colleges. After attending the first Saturday without her, where the very young instructor led a haphazard and disorganized 75-minute session that left us both hurting and tired, we decided to stick with outside biking until Elinor came back.

Well, the weather is not cooperating. On Friday we watched yet another wall of rain move towards us, and decided to take a chance and spin. The weather for Sunday looked better and we hoped that we could ride our bikes then.

On Saturday morning we showed up at the gym to find that the first instructor would not be leading the class, but rather, another of the instructors, Marie. Marie is very good and has been leading spinning classes at our gym for the past seven years. Her strategy is different than Elinor's, but she clearly puts a great deal of thought into her workout routines. Marie announced that we would be doing interval training. This was fine with me--interval training is an excellent way to work the fast-twitch muscles and improve your turnover.

This is the first heavy-duty workout I've done since I've been on the strict carb intake, so I paid close attention to my heart rate monitor and how I was feeling. I worked very hard to keep my heart between 132-145, my fat burning target. If I found myself bonking, I drank a little Gatorade to boost blood glucose, and that seemed to work. I was bathed in sweat by the end but felt good. And over the course of the day, I did not have problems with the severe blood sugar crashes that usually occurred.

Elinor comes back next week.

Water

2007-08-25T05:24:00.000-07:00

Rain, rain everywhere. Biking outside has become a dream. We are scheduled to ride 63 miles at the Hancock Horizontal Hundred in Findlay, Ohio on September 9; we are waiting to see if the flooded course will be clear in time for this to go forward.

Global warming . . . not a friend to outdoor enthusiasts. Unless you need an incentive to work on your backstroke . . . .

Diabetes 101

2007-08-24T10:49:00.000-07:00

OK, so here is what I'm doing. I'm giving my whole insulin/glucose system a rest by eating as little glucose-producing food as possible. This means paying close attention to how I am feeling. If your blood levels of glucose fall too low, the brain begins to get starved and you will pass out. Not good.

I'm eating lean proteins, nuts, low-fat cheeses, and low-sugar vegetables. I am not limiting myself. When I am hungry, I eat. When I'm feeling shaky, I have a high-fiber, no-added-sugar snack such as oatmeal, cereal, or a Lara Bar (made from nuts and dried fruit only). For day to day energy, this works fine. The secret is having snacks before you tank, and avoiding anything (whole food or not) that raises your blood sugar too high.

My family thinks that I'm starving myself or at least punishing myself, but the reality is that I feel great--better than I have in ages. I am no longer obsessed with thinking about food, I don't have those overwhelming cravings all the time. I'm a bit worried because this tactic runs counter to the American Heart Association's diet for lowering blood lipids--but their program was not helpful to me at all, in fact, my levels got worse.

As soon as I am confident that I can manage this, I will get a glucose monitor and start charting my levels pre- and post-meal. Then I will start introducing carbs back into my diet, noting the impact each one has on my levels. If a food is not good for me, I won't eat it, or much of it.

My colleage Marlene showed up for dinner a few weeks ago noticeably thinner. She's lost 60 pounds (with another 80 to go). When I asked her what her secret was, she said that she was recently diagnosed with diabetes. She went on to lament that for years her doctor had been warning her, but offered no information on what she should do except "lose weight." Marlene thought that it was sad that the medical and insurance practices would not intervene before things got bad. She wished she pushed for information and counseling earlier than she did.

Since I'm on the way to becoming a diabetic, I might as well embrace it and work the program before more damage occurs, right? And thanks to Marlene for giving me the kick in the butt I needed.

Endocrinology 101

2007-08-23T10:41:00.000-07:00

This is really complicated stuff. I will try to write down the Reader's Digest version, but it could get difficult. I may need to rewrite this blog entry a bunch of times to get it right. Bear with me.

One of the standing myths is that fat cells are basically inert material. They just sit around and take up space. This myth has been disproven by a number of pivotal studies, such that it is now taken as fact that fat cells are really individual endocrine factories; they create their own hormones and direct the chemistry of the body in concert with all the other endocrine factories. In the case of insulin resistance, they take over and run the place (well, that's my interpretation, any way).

Normal glucose/insulin systems should run something like this. When you consume a food that is converted to glucose, the glucose is carried into your blood stream. You need some glucose in the blood in order to run your organs, most importantly, the brain. However, too much glucose in the blood stream can cause all kinds of problems with your vascular system. That's where insulin comes in. Insulin is released from the pancreas' islet of Langerhans into the blood stream every time you eat, where it shuttles the excess glucose to the fat cell for storage. When your levels of glucose decline, the fat cell releases glucose and returns it to the blood stream. It is actually the gut's job to signal the release of glucagon, which triggers this process. Here is another good reason to keep your GI-tract healthy and high functioning!

In the meantime, in this normal situation, when the fat cells are becoming depleted of glucose (which happens when you diet), the fat cell itself releases a hormone that regulates leptin production. So in a normally-functioning system, glucose is shuttled back and forth within the system as needed, and, when the system starts to suffer a deficit, the fat cells release hormones that signal the brain to eat more glucose-producing food. This is why we crave sweets and high-glycemic carbs when we are overly-hungry.

What happens in insulin resistance? The fat cell decides to call the shots all the time. Or maybe it's just really confused and makes bad decisions, if that sounds less hostile. When an excess of glucose builds in the blood stream, the fat cell will not permit the insulin to deliver it. Insulin remains active for only 5 minutes at a time, and is triggered when you eat, so it only gets one short try before it is reabsorbed. In the meantime, the fat cell is convinced that it is starving for glucose, so it puts out more and more hormones, signalling the brain that the body is hungry.

What can create this situation? It generally starts with a hormonal imbalance of some sort. In the case of chronically overweight families, where a child is overweight from a very young age, the excess fat cells cause the imbalance by producing too many hormones (ever notice that overweight little boys and men have boobs?); however, conditions such as endocrine tumors or gestational diabetes can set the pattern in motion as well. In my case, I had severe gestational diabetes with my second child, and I've struggled with my weight ever since.

Without a way to convey a clear understanding of how the system should work and what is wrong, it is unfair to tell insulin resistant people to simply lose weight, and then blame their will power when they fail. The brain sabotages every attempt. Somehow, we need to find a way to educate a public that learns at the sixth grade level.

There are new drugs now that can help override the imbalances before diabetes becomes a reality, most commonly, metformin, but the drugs will only work in concert with more educated eating patterns and consistent exercise. Exercise can burn off some of the excess glucose in the blood, which is good. However, conquering the food issues--determining which foods set the dysfunction in motion, and which can be eaten without incident--is a very important part of this exercise. It forms the basis around which treatment takes place.

So, what am I doing? Stay tuned for a future entry called "Diabetes 101." I'm now worn out from this passage.

Catching Up

2007-08-21T10:19:00.000-07:00

Well, I've been fairly quiet on this blog for the past few months, but that's mainly because I've been busy. I've continued to bike as regularly as possible, including a weekend long ride (30-50 miles) usually to Dexter or Chelsea. Occasionally, to Hell and back (sorry, I just had to say it). I've been lifting weights, working on my abs, and trying to stretch well.

Anyway, three months ago I got serious about losing the weight and getting back into shape. I set up my profile on FitDay.com and logged my meals with a level of precision that would make the most obsessive OCD proud; I gave up alcohol almost in its entirety (less than 1 drink per month); I exercised 4-6 days a week. All of these are within the American Diabetes Society and American Heart Association recommendations for warding off disease. My average daily caloric consumption was 1250-1600 calories, distributed as 50% carbs, 28% protein, and 22% fat. I met and exceeded my daily requirement for fiber (38-40 grams per day) and most of the foods I ate were whole and not processed. The result? I consistently lost and regained the same 7 pounds. Routine blood work in July revealed a decline in HDL (the good ones) and rise in LDL (the bad guy). My triglycerides are on the way up, and so is my C-reactive protein. I collapsed into a heap of defeat.

After a few weeks of my own private pity party, I decided to talk to the head of our obesity clinic. Please note that at this point, I am no where near being medically obese; I have about 15 pounds to lose in order to be in the "normal" range for my height. Dr. Chuck is really an endocrinologist by training, and he looked at my labs and didn't hesitate. "You are insulin resistant. You are on your way to becoming diabetic." How suddenly reality crashes in!

Now, those of you who know me know that I thrive on problem solving, especially if it requires a) lots of research and b) lots of learning opportunities. I dived into the subject matter with gusto. And what I've determined I will outline under a future blog entitled "Endocrinology 101." Basically, it's not quite as simple as just going on a diet. The diet that settles my chemistry will vary from the diet that settles the next person's. Finding out your own levels is part of the challenge. This requires monitoring glucose and collecting more data. Just the task for me!

Anyway, after 1 week on plan B, I am five pounds lighter. I've lost 3" from that mass of flab around my waist. I'm calmer, happier, and the cravings have stopped. More later.

Indiana Coast-to-Coast Bike Relay

2007-08-01T12:24:00.000-07:00

On Saturday and Sunday of this past weekend, Kecia, Millard, Mary D. and I (lovingly known as team "Fat Tire") biked the 322 mile stretch from the Ohio River in Evansville to Indiana Dunes State Park in Indiana. Following is my report.

FRIDAY

Drove to LaPorte, Indiana, in pouring rain, picked up Carol Schobert and drove to Brownsberg, Indiana, where we met up with Kecia, Wrayjean, and the rest of Carol's team. Redistributed bikes and people between the two cars and headed to Evansville, in the still-pouring rain.

Arrived at in Evansville, had dinner at a nice Italian place (Angelo’s), drove to registration, picked up packets, and headed to the hotel for the night. Still pouring rain.

SATURDAY: RACE DAY 1

Got up at 4 a.m. central time, had some food, packed up car, drove to starting line, got briefed on course and rules, got Millard set to go with the original peloton, witnessed the start, walked back to the car to take off for the next relay point, and the CAR WOULD NOT START.

Panicked.

Put Kecia and her bike in Carol’s vehicle and sent her ahead with that team (the “Racey Ladies”) so that she could relieve Millard at second relay point. Called Millard and told him the car was dead. Called AAA and waited for 20 minutes (not exaggerating) to talk to a human, who said she would dispatch a tow truck.

Waited 30 minutes for tow truck. When he arrived, he quickly determined that the problem was loose and corroded battery cables and connections (whew!). Cleaned them off and the car started right up. Got a lecture from the tow truck driver, then Mary, about maintaining the car, and informed them both that they need to talk to Millard; I’m not in charge of car repairs. Delegation skills come in handy sometimes.

Mary and I jumped in the car, drove like maniacs, and caught up with Kecia, Millard and the Racey Ladies. Kecia and Millard were alread through their second rotations, and tired.

Mary set off on her leg. Then me. The legs are 10 miles long and we quickly determined that distance was too long; we both finished tired. We strategized and shortened the legs. Millard goes. Kecia goes. Mary goes. Violet goes. We do that a bunch more times. We forget to hydrate. We forget to eat. It’s hot and humid, and we are facing 205 miles of HILLS. Nobody told us about the glacier!

By 4:00 p.m., we still have 70 miles to go, and Mary and Kecia are too tired. I bike my 7 miles, thinking about if Millard and I can manage the last 70 miles on our own, and I know that we can’t. I pull into the relay stop and Millard takes off. Mary, Kecia and I talk, then drive to the next relay stop, where we inform Millard that we are done, having completed just 132 miles of the 205-mile course. He doesn’t want to quit, but understands that it is time; plus, he’s outvoted. The race certainly did bring out his competitive spirit.

We tracked down the Racey Ladies and told them what we were doing, then drove to the finish line in Crawfordsville and informed the race director that we were officially disqualified. He told us it was OK to do day #2 anyway, and then fed us pizza. Not a bad outcome, all things considered.

We go to our “hotel” (which was a dive, but with the NASCAR Brickyard race in town that weekend, the best we could get), showered, and headed to the spaghetti dinner being hosted by Rotten Robbie’s Bike Shop. Hung out with the serious bikers and had a nice time, especially after the Racey Ladies showed up, having completed their 205 miles just as it turned dark. We were inspired by their tenacity.

Returned to hotel, slept like rocks until 6 a.m.

SUNDAY: DAY 2

Sent Millard off at 6 a.m. to get coffee for all of us. Sent Mary to Walmart for Gatorade, bread, Pringles, and tennis balls, packed the car, checked out, and headed to start line at Rotten Robbie’s. Millard was able to get a new tire to replace the one he cracked the day before (not flat yet, but probably would have been at some point). Kecia also had a mechanical problem that they fixed. It was good that we had the bike shop connection in Crawfordsville!

I was the designated starter for day 2, so I lined up with Racey Lady Pam, at the back of the peloton, and hit it hard when they gave us the checkered flag. Pam and I were dropped by the faster folks pretty quickly, but managed to pedal at a respectable 18-20 mph for a number of miles. My average pace for those 6+ miles was 16.8 mph. The good news: the terrain had flattened out considerably on day 2. The bad news: we were biking into a strong headwind, in addition to higher temps. The headwind would be with us for the rest of the day.

For the next 8 hours, we rotated at 4-7 mile intervals on schedule. This time we hydrated well, ate, stretched and massaged our muscles regularly (glad to have those tennis balls). There were some interesting intervals, mostly involving Mary, who got to bike through the worst stretch of construction ever, and also got stopped by a TRAIN and had to wait for it forever, but day 2 was a totally different day. The downside was the head wind, which was brutal in many stretches, sometimes reducing the average pace by 1-2 mph. We just kept plugging away until we finished.

Millard got the last leg and biked to the finish line faster than a speeding bullet, only to find that it was not marked and he had no idea of where to go. After driving around for 30 minutes, some of the Racey Ladies flagged us down and we finally connected with the rest of the group, in time to eat sandwiches, watermelon, brownies, and Cheetos (the puffed kind). We were given an award for first place in our “age group” (200+ years) and had our pictures taken. It had taken us 8 hours and 52 minutes to cover 122 miles. We were actually in last place, but it didn't seem to matter. I felt like we had conquered Mount Kilamanjaro.

At around 6 pm we packed up Kecia and the Anderson folks (Wrayjean, Debbie, and Pam) and sent them off to Brownsberg, while the rest of us, including Carol, went to Carol’s for quick showers and then hit the road for home. Arrived around 10:30 p.m. to find a very pathetic hound dog, transferred stuff to Mary’s car and said goodbye, and headed for bed.

MONDAY: DAY 1, POST-RACE

Moving OK. Very, very tired, but the muscles are surprisingly OK. Would I do it again? Yup—with better planning and more training!

Did I mention that I love that new bike?

By the way . . . .

2007-07-15T10:27:00.000-07:00

So, did you really think I was not watching this year? YUP, every single stage so far!!!! And it's just as much as fun as it has always been--maybe more so, now that I've become a more serious cyclist myself. ON TO PARIS!!!!

One Helluva Ride Report

2007-07-15T10:06:00.000-07:00

Yesterday Millard, Mary and I did the 31st One Helluva Ride tour that the Ann Arbor Bike Touring Society puts on every year. There were around 2,000 riders this year, up from last year, and it was a riot.

Millard and I were doing the 63-mile route, while Mary wanted to do the 39-mile route, so we agreed that Millard and I would start early and meet Mary at lunch at Portage Lake State Park. That would be 15 miles for her and 38 for us. We arrived at the Chelsea Fairgrounds by 7 a.m. to encounter an already-impressive group of riders; registered, got our maps, called Mary to confirm that we were leaving, and took off.

One of the reason for the early departure of so many riders was the weather forecast. Although Michigan has had a PERFECT summer so far--dry, not hot, sunshine--that was not to be the case for our ride day. The call was for thunderstorms and wind, at times gusting to 30 mph. Bike riders do not like rain, but we like wind less. The bad weather was scheduled to arrive around noon. Determined, we set out to do what we could do before it hit.

We had never done this particular loop before, and it was beautiful. We traveled very nice back roads with few vehicles that snaked through a number of little towns linked by pastures and woods. At mile 12 we stopped at the first refueling station and enjoyed bagels and peanut butter, fruit, pretzels, and of course lots of Gatorade and water. Refreshed, we set out again for the next leg, 20 miles. By the end of mile 20 my back and right IT band were starting to complain, so I was grateful to be at the lunch stop, and even more grateful that Mary was somewhat behind us in arrival. I had plenty of time to stretch and massage my sore muscles and get them ready for the final 25 miles. We enjoyed good deli sandwiches, more great fruit, pasta salad, pretzels, cookies, and the usual drinks before setting off. This tour always provides very nice food and drinks.

During lunch the rain set it in, but only spotty, random drops that seemed to blow over quickly. The winds, however, stayed with us for the remainder of the day, sometimes gusting so hard that the bike would wobble. Cycling into a headwind is none too fun, for the record.

Our average pace on the first 38 miles was 16 mph. We had a number of respectable distances with averages of 20 mph or higher. Millard and I both are starting to see performance improvements, and we are fairly evenly matched in terms of strength and endurance. It is really wonderful to have something to do together again.

For the last 25 miles, we would bike at Mary's slower pace, and this was a good thing because I was tired and sore. Both Millard and I practiced with some breakaways, but our average pace for this part of the ride was 13.7 mph. Given that Mary is 65+ years of age and riding a hybrid, we all felt that she did a great job on the ride. She's in fine shape for the relay in two weeks.

I love this ride; next year, we will do the 76-miler, or maybe the 100-miler, if training permits.

Recalibration #1: Six month recap

2007-07-07T09:54:00.000-07:00

OK, I've been offline for a while, dealing with medical issues, copious amounts of visitors, and general performance review madness at work. Over the visit of Al & Rita & Patrick & Buddy & Amy & John (which was great fun, by the way), I developed an ache in my jaw that finally isolated over one tooth--yup, a root canal. This one was particularly nasty, leaving me with a full-blown infection in my lower jaw bone. Needless to say, my exercise routine went to hell. I continued to ride the new bike, but every time I tried to do my 3x/weekly routine of 30 minutes of cardio followed by weights, I would be too nauseated and tired by the end of the cardio in order to continue. My heartrate skyrocketed in all activities. I'm still not back to my usual self, despite a long course of antibiotic treatment.

I'm still doing my best to train and get mentally ready for the Indiana Coast-to-Coast relay on July 28. With any luck, a rebound will happen soon.

Oh, yeah--the weight thing

2007-06-30T12:34:00.001-07:00

Just for the record, I did get down to a 9 pound loss before the Al & Rita weekend, but then put the weight back on. You expect me to LOSE weight when a box of 3 dozen 8" cookies, most of which are frosted and loaded with all kinds of fattening things like chunk chocolate and nuts, are sitting on the dining room table? Please! At least I didn't eat cheeseburgers . . .

Time Flies . . . .

2007-06-30T12:21:00.000-07:00

. . . when life gets moving too fast. So I haven't posted workouts for the past two weeks, but I will attempt to go back and reconstruct them.

Following the weekend of June 16-17, I continued with my weekday workouts involving two days of elliptical followed by weights, plus a real bike ride around town for about an hour. The new bike continues to be a great joy to me. During this week I started to feel tired at various times of the day, and the nighttime coughing came back.

The weekend of June 23-24 brought with it EIGHT house guests, and the pandemonium that usually ensues, especially when one of those guests is a 4-1/2 year old terror who instantly bonds with the 105-pound hound dog and spends the weekend tearing around the house and park at a full shriek. Enough said. On Saturday, we drove to Battle Creek where I walked the Cheetah Chase 5K in about an hour, in great pain and not entirely coherently. I was cold for most of the walk. On Sunday, before the household awoke, Millard and I sneaked out for a 2-hour long ride mostly around town, and it was wonderful, especially biking along the river. Later that day, my two lower, right-hand-side molars started to be sensitive to hot and cold.

On Monday, June 25, I called the dentist's office to ask if I could come and get the bottoms of those two teeth bonded again. I presumed that my receding gumline was the culprit. Within two hours the pain isolated in the bicuspid in front of the molars, and I called the dentist back to tell them that I was going straight to the endodontist. By the time I got there on Tuesday, the tooth was dead and the pain turned out to be a very large infection in my lower jaw and jawbone. We started yet another root canal and put me on massive antibiotics.

Needless to say, I didn't work out at all the past week, until Elinor's endurance spin this morning. Because I was still hacking up junk and still running mild fevers, I took it easy. I did manage to make it through the workout without any problems.

Tomorrow is a long ride, at least to Dexter and back. Then Ursula goes back to the bike shop for her shake-down tuneup.

Did I mention that I love love love this bike? Just checking . . .

The Arthroplasty Chronicles

Whoa! Another Year Goes By!

And a year has past . . .

Seven months post op

Six months and holding

Four months post-op

Day 100 Post-op; A Time to Move On

Day 94

Day 87: The Challenges Continue

Day 73: The Problem with Balance

Atrophy 101

Day 64

Week 8 Rehab Report

Day 46, Post Op

Day 38 Post Op Report

Day 32, HALLELUJAH!!!!

Post Op Report, Week 4

Post Op Report, Day 23

Post Op Report, Week 3

Post Op Report, Day 17

Two Weeks Post Op: And I'm Home!!!

Post Op Report, Day 11

First Week Report

Post-op Days 5 and 6

Day of surgery, January 27 2009

THIS JUST IN

To-morrow, and to-morrow, and to-morrow . . .

And Then, There Were Five

Rehab Central

Post-Disney Report

Medical Update

The Year in Review

On the Eve of Christmas

Tuesday PT Report

Monday Update

An Off-Topic, Inapppropriate Political Rant

Back on the Rails

Catching Up

Tuesday Update

PT Update, Thursday

And the Good Follows Bad

Turkey Report

More Progress

How Progress Happens

BREAKTHROUGH!!!

Recovering from Election Night

Physical Therapy Report

An Update

Just Shoot Me

Getting Focused

Tuesday Night Workout

Spain Times Three

Weekend Update

BFFs Forever

One Helluva (Wet) Ride

Tuesday Workout Report

Weekend Update

Here's a Good Resource

Blick Wechsel

San Francisco Report

And Now, the Movie, Folks!!!

WHAT THE @#$%^*&*&?????

Workout Notes as Spring Approaches

Welcome Back, From the Other Side

HAPPY NEW YEAR!!!!!

New Year's Resolutions . . .

Thursday's Time Waster

Tuesday Spinal Update

Another Example of Why the Press Sucks

Regrouping

Oh, by the way . . . THIS SUCKS!!!

Friday, Already?

Elinor Update

Hump Day Report

And Winter Arrives

Men Not Allowed

Detroit Free Press Marathon, Revisited

Why Flying is for the Birds, Period

Committing to Yoga

Happy Oktoberfest!

WHAT THE @#$%^&&?????