A ReNewed You's Year End Reflection

I was going going to write one of those kitschzy year end posts about all I have learned this year and everything I hope for in the year to come.  But it all seemed too droll and pathetic.  It all seemed too selfish and self-centered and too, me, me, me.  And while I am no saint, I like to think I am at least somewhat genuine.  And a post about my rough year and better times to come would just be the literary equivalent of flinging bullshit.  Because when I think about it, I really don't anything to complain about.  I really don't.  Yes, I had a bad accident, but in the grand scheme of things, what happened to me was relatively minor.  And I was inspired by some folks in a much worse position than me.

This got me thinking about the various levels of injury-illness and their corresponding recovery.  Now these aren't scientific, medical, or even tested.  They are just how I view and categorize how likely people are to return to 100%.  Here goes:

1. Bad accident or injury but 100% recovery probable.  This is where I fall in.  These are the younger folks with ACL surgeries or rotator cuff surgery or even a bout with cancer that was caught early.  It could even be a broken hip or pelvis but either age, genetics or determination will deliver them back to 100%.
2. Possible return to 100%.  This is hip replacement or knee replacement that requires a lot of time, effort and luck to get back to 100%.  It might happen; it might not.  Age plays a big part but diet and other inexplicable factors are at play too.  This also includes those unlucky folks who fix one knee, only to blow another.  Or fix both knees, get in great shape, and then blow out a shoulder.  The odds keep getting stacked against them.  This could even be heart attack survivors who decide to make serious changes.  Or a cancer survivor who was able to able to be treated back to complete health.
3. No chance of a return to 100% but not immediately fatal.  These are the Multiple Sclerosis (MS)  patients or sufferers any other chronic disease. 
4. Illness or injury is fatal and time left is unknown.  Pick your disease but I think you get the idea.  Cancer seems to be the most publicized one one but there are many others.

In thinking about this post, I realized I made a lot of assumptions about recovery.  There are some people that want to recover but can't.  I have spend a lot of my time writing to and about people in levels 1 & 2.  And I did so because that's what I knew and that, frankly, is who I am.  I can't write intimately and personally about levels 3 & 4.   But I can write about what I have seen and perhaps, from the outside, what I might do if I was ever in their shoes.

As I have written before, recovery is as much a mental game as anything.  And the desire to keep living when you have something that is whittling away at you, has to be the biggest battle of wills.  In level 4, your timeline is uncertain but your fate certainly is.  In level 3, your timeline is longer but everyday you might get beaten down a little more, a little more life sucked from you.  So what do you do? 

I suppose there are several approaches.  You could booze and party and live like it doesn't matter.  But because the timeline could be long, I suppose that would get old and, in the end, not very satisfying.  I suppose a better option is to get as healthy as possible and beat the disease as far into the corner as possible.  Magic Johnson comes to mind as someone who has done this and as a result limited the impact of HIV on his body.  Another person close to me who has MS recently lost 50 pounds.  Now a 50 pound weight loss for anyone is inspiring but for someone with MS is even more impressive.  To me, it says that she wants to live and that she is not her disease and that as long as you keep fighting, you keep living.

Now the 4th level is, well, the heart breaking one.  You might not be able to do anything to survive or improve.   The disease has you in the corner and you are taking punches everyday.  You feel like Gerry Cooney, day after day after day.  I would hate to go out like that.  Just kill me with a heart attack in my sleep when I am 95.  The metal and emotional anguish of never knowing but knowing it is soon would be more than I could stand.  These are the true tough guys and gals.  Forget about sports.  Try and live like you are dying.  Tougher than anything.

So for the 3rd level, thanks for showing us to keep bailing water when there is a hole in the boat.  Thanks for showing that you can live perfectly imperfect.  Thanks for still smiling and laughing when you fall and can't get out of the snow.  Thanks for inspiring us and reminding us that while a hip fracture with 3 screws seems big, it could be worse.

And for the 4th level, thanks for showing us true grit.  Thanks for caring about everyone but yourself.  Thanks for getting up everyday and doing what you have to do even though it may not help.  And to the big guy in Cedarburg, WI, thanks for introducing me to Vince Lombardi, that picture is forever burned in my memory.  For you I wish love, peace, and hope - and really only one thing in 2013: a Packers Super Bowl win.  You know Vince wants the trophy back home.

Happy New Year to all.

Thanks for reading...

Do Dogs Create Big or Small Piles of Shit?

What do these things have in common?

• Broke hip
• Daughter had Pneumonia
• Wife had surgery while husband was on crutches
• Someone shattered car window and stole wife's purse
• Had a property dispute with new neighbor
• Toilet didn't work in new house
• Refrigerator smelled in new house
• Bike was stolen from work

The only thing they have in common is that they happened to me this year.  And I am not putting it out there to get some sort of sympathy or for everyone to feel sorry for me.  I am putting it out there to make a point and dispel a common held belief. 

I believe most people believe in the notion that we have bad days and bad weeks and bad years.  And these bad periods of time are made up of a series of connected "bad" events.  Somehow the world conspired against us and we are stuck in a runt where no matter what positive we do, something negative is going to happen and continue to happen to us.  Everyone has had them.  The kids get sick and then the dishwasher breaks and then you are low on money and then you can't take a vacation and then and then and then and then.

To me that is just non sense.  It is true that sometimes that things happen in succession or in 3s, just like deaths - as my grandmother said.  And when coupled together they become the bad days, months, or years.  In reality, there is no good luck or bad luck.  Yes some people are more or less fortunate than others but good luck in terms of success is more based on hard work than anything else.

If you take the things that happened to me, they all probably would have happened with or without the other.  With or without my hip injury, my wife still needs surgery.  With or without any of our surgeries, we still would have had the challenges with the house as we had our offer accepted before.  Those challenges were waiting for us.  My bike was stolen because I happened to have ridden to work that day.  And before the accident it would have been even more likely because I rode more frequently.

So you have an accident or are struck down with illness and then have a series of unexpected events occur after, don't mentally pile them on top of what you are going through.  Mentally and emotionally separate them and take some (strange) comfort that they would have happened with or with out your injury.

Injuries are tough enough on their own.  Don't make them heavier by placing a bunch of non sense on top.  Yes shit happens but dogs don't always shit in one spot.  They usually spread it all over the yard.  Thus your injury is just one pile.  Perhaps it is the biggest pile but the others have nothing to do with that big pile.

Sorry for a long winded metaphor but I think you get the point.  Deal with your injury and deal with everything else.  Just because you have an injury doesn't make you ill fated for the rest of your life.  Instead keep a positive outlook, do your daily gratitude, and roll with with it.  Go Zen.  Go Christian.  Go with whatever makes you happy.  And take peace with that is how life is: sometimes it is great and sometimes it sucks.  And then it is great and then it sucks.

If you take the right attitude, however, you'll know that shit happens.  And if you roll peacefully down the river, you'll know sooner or later the shit is just going to float on by.

Thanks for reading...

Gimme Something (or Someone) to Believe in

Aside from my own experience with a hip fracture, one of the inspirations for this blog has been my mother.  And it is not one of those my-mom-raised-me-and-9-siblings-on-her-own stories.  Instead, she is one of us; she is one of the bruised and battered.

After years of suffering from knee pain, my mom finally had knee replacement surgery last year.  But even after a year that included a few months of PT, she wasn't walking any better than before the surgery.  In fact, she may have been walking worse.  On the bright side, her knee pain was better - but her hip mobility was awful, her legs ached, and she was wobbling around on cane like a woman 20 years her senior.

After my positive experience with Pilates, I suggested she find an instructor in her area.  And somewhat to my surprise, she did.  Even more, she has stuck with it for the past 4 months and seen incremental improvements in strength, mobility, and pain.  What she really gained is something more than I would have anticipated - and perhaps something she needed more than what physically Pilates can give you.  Now I can tout the value of Pilates or any other form of exercise until the cows come home and I can say how much better you will feel but only an interpersonal relationship between two human beings can describe what my mother has gotten out of Pilates.

Her real benefit: someone who believes in her.  As we all know, recovery is a long, lonely road.  Even for those of us who have lots of friends and family, we can feel like strangers in our own homes because of what we are going through.  No one really understands.  They don't really understand what progress means to us and what a lack thereof does to set us back mentally and emotionally.  My mom, now, has someone who remembers what she could do when she first started and what she can do now.  She has someone who gets excited when she reaches a milestone.  And those are all very important things.

The most important, however, is the confidence it brings her.  Recovery, by my own experience, has a way of bringing about a serious crisis of confidence.  My mom suffered from bad knees for more than 10 years so her confidence, and true belief, in her ability to really get better was probably very, very low.  Now she has a friend who believes she can get better, she can recover, and she can live a better life.  And that is what someone like her Pilates instructor can give.

So I know we can't all afford private trainers but if you can find one or two people to aid in your journey, the mental and emotional benefits will be enormous.  If nothing more, you can use them as resources to answer questions and help you along.  For me, my Pilates instructor and massage therapist has been a great help to me.  Not only has she helped me recover but she has become a friend.  There have also been a few others who I have nothing more than an email relationship.  But it is these big and small touches with humanity that keep us going and help us believe.  We humans are resilient and it is really the interaction we other caring individuals who will carry us through.

So do your best to find someone.  If you are in Minneapolis-St. Paul area, email me and I can make some recommendations.  Or heck I will do it myself.  I am willing to help anyone who is recovering and even just needs someone to lend an ear...

Thanks for reading....

Treat the Pain You Can Treat

I think my lack of recovery days put my immune system in  a difficult position and now I have a cold.  It has been a strange one, kind of up and down.  As soon as I think I am better, the next day I am worse.  Today I was able to rest for a while so hopefully I am beginning to mend.  I really don't want to be sick for the holidays.  Been there, done that - and it is no fun. 

One of things I notice when I get a cold or any flu like symptoms, is how much my nagging little aches and pains tend to get more achy and painful.  All in all after suffering an injury such as mine, I have been pretty fortunate to the overall amount of pain I have.  By and large, my hip does not hurt very often.  I have some soreness on the inside of my leg but even that comes and goes.  My low back will get stiff but only after long bouts sitting in a car or a meeting.  And my only other area of pain is my elbows, in particular my right one.  I have written about this briefly before, as it was caused by doing daily pull ups and dips while on crutches.  I have been off crutches for almost six months now and haven't done any pull ups since, but the elbow is still aggravated. 

I don't think I can do much about the hip and leg pain beyond what I am already doing.  The strength training and massage have the hip and leg improving so I am not overly concerned.  The back will continue to get better and get less stiff as the leg and the rest of the core get better.  The elbow, however, is where I have made some dumb mistakes.  In order for it to heal, I really need to rest it and lay off any exercises that aggravate it.

I have continued to to do heavy presses and this has put some strain on the elbow.  It doesn't hurt when I press but it bugs me a bit the next day.  And this is just plain silly.  I need to avoid any exercises that strain the elbow and work around it.  It is pain that I don't need to have and can reduce stress on the body.  I can't entirely control when the hip and back will get better and in some regards I can't I control when the elbow will get better but I can control doing activities that will make it worse.

And I am sure I am not the first person to make these counter-productive decisions.  How many have run on a bum knee or sore ankle or lifted with a bad shoulder?  And just because we can't miss a workout or are afraid to gain weight or getting out of shape.  But letting injuries that linger for months become more of a liability to resurface when we get older. 

That's the thing about pain, it may never really be over.  You can get it better but the longer the pain existed in the first place, the better chance it has in coming back as you age.  Thus, if you have pain, treat it right away and try and help it heal as quickly as you can.  Remember, in the end most of us aren't professionally athletes but all of us are going to grow old so if something is painful when 20, 30, or 40, it is going to hurt like hell when you are 70.

So if you have pain in the form of a "bum" knee or "bad" ankle or whaetever it may be, take the steps you can to make it better.  You will thank yourself years down the road.  The goal is not to set athletic records but to live a long healthy life with energies devoted to our work and our loved ones.  So don't make the mistakes I made.  And I am going to lay off the presses for a while and maybe in a few months I hope I will have one less nagging injury.

Thanks for reading...

Just Take It Easy...And Do Less

As my life has become busier and more complicated, I am astounded by the benefits of doing less.  And expecting less.  What I mean is that if you are recovering from an injury that it is just one more thing that you have to fit in a tight schedule.  You already (presumably) have a job and maybe a wife and kids, and other activities.  So to find time for PT appointments and doctors appointments and some exercise and figuring out how to change your diet and all the other things we need to recover, can be quite stressful.  In fact, it can be downright overwhelming. 

So, in response, we need to do less in other areas of our life.  We need to simplify anywhere and everywhere.  Below is a few things I have done.  Some may seem silly but they all focus on reducing stress and helping me find time to recover as well as continue to keep time spent with my family as my number 1 priority.

• Work From Home.  Immediately following my accident, I worked from home out of necessity.  I simply could not get into the office.  Even if I drove to work, the 2 blocks to get to the office on crutches were too much.  Towards the end of my period on crutches it was easier but I only did it when I absolutely had to.  Since then I have biked into the office 2 to 3 times a week but only when I want to.  If I feel tired or don't feel well, I stay home and make it easy on myself.  It also makes it easy if I have a massage appointment or am meeting with the doctor, or whatever I have to do.  I know this isn't a luxury everyone has and I feel very fortunate that my employer is very flexible.  But I do stress that trying to simply your commute is a great way to save time and money as well as take it easy on your body.  I can't imagine how stiff, tired, and moody I would feel if I had to sit in the car for 2 hours everyday.  It is not healthy for a normal person and it is hell for the bruised and battered.
• Do Less (PT) Exercises.  PTs, and some Pilates instructors, are know for taking us through a long battery of exercises and giving us several pages of print outs to do on our own time.  My philosophy is to find what exercises give us the biggest bang for our recovery buck and focus on those.  A long list of exercises is overwhelming and, in the end, not as beneficial as focusing on just a few.  Personally, I believe that, for me, at this stage in my recovery, kettlebell swings, Turkish Get Ups, and Goblet squats are really all I need, along with some mobility work and stretching.  And some biking for enjoyment.  More isn't always better.
• Focus on (Good ) Family and Friends.  I should preface this by saying that friends and family can be a blessing and a curse.  They can be helpful and bring all kinds of joy.  Or they can be a total pain in the ass.  When you are recovering, hang out with the easy ones.  Hang out with the mellow ones.  Hang out with the helpful ones.  Avoid the stressful, painful, annoying ones (as much as possible).  And you don't 15 different friends and have a party.  Just a couple good friends can be all you need.  For me I have found a few that I enjoy and we go and grab a movie or chat on the phone from time to time.
• Simplify Where Possible.  There are many things we can do to around the house to reduce stress.  A silly one I have done is to reduce the amount of clothing I have and focus on a few key items.  This way when I get up in the morning I don't have to "figure out' what I am going to wear.  I pretty much know.  I don't want promote getting back to the days of uniforms but combing through dozens of items and putting an outfit together is a lot less work when there are limited combinations.  Other ways to simplify are to clean out closets or storage, or even the car.  Give away stuff if you can.  It is an extremely cathartic experience.  Moreover, you can simplify your diet.  You only really need to eat fruits, vegetables, and some meats, so focus your meals around those 3.  the rest is just fluff.
• Park the Ego in the Garage.  I personally have felt the urge to make myself as great as possible in other areas of my life since my accident.  Until recently I have felt that moving my career forward and getting more and more responsibility would make me feel better about my hip.  I also have felt that if I can as lean as possible and look as good as possible would make me feel better about my hip.  And to some degree it has but in some ways it is just another stressor.  More responsibility is more stress.  Taking your diet to the extreme make you worry if you have a cookie or two.  Therefore what I am saying is that recovery is a job in and of itself and you don't have to make up for it in other ways.  It is okay to put some parts of your life on auto pilot.
• Keep a Clean House.  This is tough one, especially if you have kids.  But clutter creates stress so the more organized and picked up, the better you are going to feel.

I could keep going, probably, but I think you get the point.   Recovery takes attention and many of us don't have attention beyond our already stressful lives.  Thus we need to shrink the stress from other areas to allow us to focus on getting healthier.  If we don't, the stress of the recovery is going to build upon our already challenging lives and our recovery is going to be infinitely longer, more difficult, and more painful.

Thanks for reading...

Journaling, Global Warming, and Taking the Long View

One of the regrets I have is not starting this blog sooner. 

I should have started it right after the accident.  It is quite cathartic to put these things out there, even if read by a just a few.  Or, at least I should have kept a journal to describe how I am feeling on a daily basis.  Without it, now, I am subject to comparing how I feel today versus how I felt yesterday or the day before.  At the most, I can compare today to a week ago.  My memory just can't back far enough to know exactly how I was feeling any more than that.  I often end up feeling like I am stuck and I haven't made any progress at all.  Which isn't true.

My own situation, for some reason, makes me think about Global Warming.  Not to get political but sometimes I wonder if the planet warming is only a brief period of warming in the history of the planet and in 200 years we will be in another ice age.  Or something like that.  Another thing I think about is the stock market.  If we watch the line graph on one day the stock looks like a loser but it you spread out the graph over 5 years, the view is totally different.  The stock is continually up.  That one day was just small insignificant blip. 

What does this have to do with recovery?  It means that what really counts is the long term progress we make and not the fact that we have a bad day or week or month.  If we are progressing, then a slow, painful day doesn't really matter.  It is a just a day.

If we take the long view then the short term decline in our progress is just a short term decline.  It is temporary.  It doesn't mean anything.

And if I were new to an injury or about to get a knee replacement, I would start a journal right away.  It will help when several months out and you are having a bad day.  You will be able to see that you have made a ton of progress.  Because progress is never linear and it goes up and down.  But as long it is heading upwards, you have nothing to worry about.  It just takes time.

Just keep the long view and keep your eye on the prize.

Thanks for reading...

Gimme a Break!

By the way, the title is supposed to be sung.  And sung with all the enthusiasm that Nell Carter did. 

I say so because breaks from rehabbing an injury, exercise, work, or any routine activity are necessary.  Not only do we need weekends and days in between to recover but sometimes we need a longer period of time.  It is like a vacation from recovery.  I know I have been saying that the most important thing is to be consistent and stick with a program or routine but...

Sometimes a little rest is the best thing for us. 

Personally I don't think I have taken more than 3 days off since the day of my accident.  I spent 3 months crutching to the garage everyday to do pull ups and dips - and I ended up with a sore elbow and haven't done many pull ups and dips since.  A little more rest and I wouldn't have had a problem.  And since I was cleared to walk I doubt it has been more than 2 days off.  So between the kettlebells, Pilates, biking, and other activity I am beginning to feel tired and worn out.  I mentally and emotionally have the blahs as well.  I think I am also getting a cold.  Maybe not, I just know I woke up this morning feeling like could just go back to bed.

I know I need/should/must take 5-7 days (maybe even 10) off from everything.  And this time I will.  Even before my injury I was never very good with taking the right amount of rest.  Very often, I paid for it.  I would bonk and get hurt or sick.  Now, with my new found respect for my health, and an overarching goal to live pain free with my energies not dedicated to being superhuman in the gym or on the bike, but to my family, I think rest is the best thing for me.

Nevertheless, intuitively, it is a hard thing to do.  I want to keep pushing and pushing until I am 100% and I can show everyone how completely and quickly I have recovered.  So this will be a mental battle for me but one in which I will thank myself after the week is over.

The one thing that keeps coming to mind is the movie, What About Bob, where Bill Murrays' character says he is going to "take a vacation from his problems."  While recovering we need to do the same.  Remember, if we give ourselves more time, a week off is insignificant from recovery period perspective but it will make us feel better about the process and in the end may actually speed things up.  Rest, not just sleep, is the forgotten X factor.

So when you have been pushing for several months and you begin to feel drained, it is time to slow down and relax. 

You'll come back with enough energy to belt out a few high notes like Nell Carter... 

Or at least you'll feel better, even if you didn't spend the week at Lake Winnipesaukee...

Thanks for reading...

Decisions, Decisions, Decisions

As I have said before, one of my biggest learnings has been the fact that in order to recover from a major injury one has to actively manage their own care.  With that, I believe, comes the realization that many decisions, big and small, need to be made.  No longer can we sit back and have the doctor or PT dictate what we can and can't do on a daily basis.  We need to carry the burden of making our own decisions and be faced with the fact that sometimes we will make the wrong ones. 

Thus I have personally done a few things to take the pressure off myself to allow for the wrong decision.  As stated before I have given myself 2 years to recover.  In addition, I view every decision as a test, or experiment.  If the decision goes well, then I continue with it.  If the decision fails, then I tweak it and test again or scrap it altogether.  In order to test it, the decision must provide value to my recovery, fitness, or health, either mental or physical.  And lastly, I try and keep a long view.  I am only 37 years old and I want to be fit and nimble when I am 77 so decisions I make now can impact if I have my own hips 40 years from now and am active, upright, and walking.

In order to best explain my decision making process, let me outline some of the general rules by which I am confined.  At my 4 month appointment I was given 3 rules: don't run and don't jump.  And don't fall.  Everything else is acceptable. 

By and large I have followed that advice.  I haven't fallen - thank God - and the only running I do is with kids playing some pickup soccer, football, or basketball in the yard.  Aside from that, I dont' play basketball, I don't go out for runs, and don't do any exercises like burpees or rope jumping that would put extensive pressure or pounding on my hip. 

Now while I have no desire to run - 3 marathons pre-injury was enough - I do see value in the act of running on my recovery.  I philosophically don't believe that "going out for a run" is the best form of exercise for most of us - which is a post for another day, but I do think a once weekly sprint session or jump rope session is very valuable.  At 8 months into my recovery, I dont' think I could sprint even if I wanted to.  My pelvic alignment and leg strength aren't there yet.  And the pelvic alignment seems to cause some grabbing in my inner thigh, which would be further aggravated by running fast.  So I haven't even bothered to test it.  I think I already know the answer.

Jumping rope, though, could provide the benefits I desire.  The benefit gained, which running also provides, would be added bone density.  Continual pounding on the bones makes for stronger bones.  Cyclists have a reputation for week bones because cycling is effectively a non weight bearing activity.  Therefore, for example, I might try jumping rope in the near future given that the snow has fallen and biking has been limited.  So lately it has been on my mind as a test.  I haven't decided to test it yet but I may.

But this is just one decision, and some are big, some are small.  See a few others below.

• Can I bike? Tested.  It feels great, adds to hip mobility, and helps remind me that the injury was just a fluke thing.  But I no longer ride rode bikes.  The big tires make me feel safe.  It may be an illusion but  confidence has been built on a lot less than an illusion.
• Can I play golf?  Tested swing, too much twisting aggravates groin. Scrap
• Can I bowl?  Tested rolling the ball, a little pressure on the leg and feels a little awkward but no pain.  Keep but limit.
• Can I ski/snowboard?  No way.  Too much of chance of falling hard.
• Should I add more mobility work before my kettlebell workouts and stretching afterward?  Tested.  Yes it helps, I think.  Keep for now.
• Can I play football in the snow with my boys?  No way.  Too much of chance of falling hard.
• Can I bike in the snow/ice with the studded tires?  This is the decision I have been mulling over in my head for the week since we got a foot of snow here in St Paul.  I want to try it because I love it and I believe my gigantic studded tires would keep me upright but you never know.  I just can't gauge the risk factor.  And it becomes a bit like skiing or playing football, the snow and ice ups the chance of falling hard and setting my recovery back.  So far I have decided against it.  A season or two of not riding in the snow is worth the long term use of my "own" hip.
• Should I do more Feldenkrais on a daily basis?  Test.  Feels great. Eases pain.  Keep.

As you can see it is a lot more art than science but it is all about progressing my recovery and not setting it back.  So in sum, I do things that help and avoid or delay anything that could set me back.  I take all activity an put it through an internal feedback loop employing advice as needed.  Typically that is my wife but sometimes it is a trainer, friend, or fellow cyclist.

I would encourage anyone in recovery - no matter a broken hip or bruised shoulder - to employ this approach.  It empowers you to own your recovery and make your own decisions.  Because in the end you are the only one accountable and your decisions are the only ones that really matter.

Thanks for reading....

A Hip Fracture...Dave Letterman Style

When I was in high school and college there were a handful of people who thought I looked like Dave Letterman.  There is still one guy to this day that if I saw him he would probably call me Dave.  Back then I had all my curly hair and the gap tooth.  Today I have much less hair and the gap tooth.  If I had to lose one, it wouldn't have been the hair. 

Therefore, I thought what better way to summarize my hip fracture than with a few Top 10 Lists.  I hope they give some insight into me, and others can find solace that they aren't alone in their recovery.

Here goes in no particular order:

Comical Moments

1. My boys using the crutches as guns.
2. My boys referring to my cane as a "walking stick".
3. My wife helping me take a shower and setting the water to cold.
4. The X-ray lady at my 4 week appointment who asked if I needed help undressing and I replied, "of all the fantasies I had about a woman undressing me, this isn't it."
5. Being unable to get interested in reading for 2 months after the surgery and getting inspired by the Motley Crue biography The Dirt.
6. Getting the "pat down" at the airport because I couldn't walk through security.
7. My wife needing to help discard my liquid waste for the first 2 weeks.
8. Deciding it would be easier to stop at a coffee shop for my daily constitutional than crutch up the stairs to the bathroom at our old house
9. The looks on people face when I tell them I am in pain and if they wouldn't mind massaging my hip.
10. A coworker stealing one of my crutches on the day I was told I only needed one.

Worst Moments

1. When the ER nurse adjusted my bed incorrectly by moving it down below parallel.
2. The ambulance ride.
3. The fall.
4. The day I came home from the hospital.
5. When the nurse came over and tried to help give me a shower and I couldn't lift my leg over the tub.
6. Having to be driven to my mother-in-laws for 2 weeks to take a shower until we moved.
7. My 4 week visit with the surgeon who did nothing but scare me.
8. Seeing the stress the injury caused my wife.
9. My middle child refusing to ride his bike all summer.
10. Moving to a new house and not being able to help.

Best Moments

1. Getting meals from friends and family
2. A coworker picking me up at the airport and shuttling me around for the whole trip.
3. My oldest putting a pillow under my foot for the first weeks every time I sat down.
4. Being able to work from home and spend time with my oldest and my niece who was nannying for him.
5. Getting a neighbor who is a doctor.  And telling me to fire the first surgeon.
6. Getting a great Pilates instructor and massage therapist.
7. Learning how to recover and knowing I am strong enough to do it.
8. My nephew moving our entire garage in one afternoon with me.  I drove the car.  He moved the stuff.
9. Being cleared to drive.
10. Figuring out how to be on crutches and carry two six packs.

What I am Thankful For

1. The two random strangers who put a jacket over me and held another over me like an umbrella.
2. The other random stranger who drove my bike and 2 others 20 miles back to St Paul.
3. How my wife thought to tell the ambulance to take me to United Hospital.
4. My new surgeon.
5. My friends.
6. My wife.  It wasn't easy being a single mom for 10 weeks.
7. My kids.
8. Walking.
9. My job.  Because of its flexibility I was able to work from home during the entire recovery period.
10. Walking.  I know it is in here twice.  But I took it for granted.  I never will again.

I hope Letterman would be proud.  They aren't as funny as his but they are from the heart.

Thanks for reading...

Bo Knows

I have certainly spent as much time as anyone lamenting over why at my age I could have suffered a fractured hip. 

I have gone over the details of the fall in my head many times. 

I shouldn't have ridden in the rain.

I should have called the ride quits at the half way point when my wife offered to come and pick me up. 

I should have ridden a different bike. 

I should have been riding slower. 

I should have gone over the railroad tracks on an angle. 

I should have...

I should have...

But in the end all this internal agonizing didn't do much good aside from cause me to lose sleep.  Sometimes, shit happens.  Sometimes freak accidents happen. 

And they happen to the best athletes in the world.  In a recent  ESPN 30 for 30 documentary about Bo Jackson called You Dont' Know Bo, the storytellers explain that when Bo Jackson was tackled and dislocated his hip, it only happened because he was so strong and such an extraordinarily, freakish athlete.  And that dislocation caused avascular necrosis which led to the decay of his hip socket.  Any other average NFL running back or average athlete would have been fine.  But Bo Jackson's career was ended because he was so strong. 

That might be the most freakish thing I have ever heard.  As an aside, I feel a certain kinship with Mr. Jackson because over the next 2 years I have about a 20-25% chance of avascular necrosis developing in my hip.

So if arguably the best athlete of all time can have a freak accident, so can us mere mortals.  Therefore, instead of beating ourselves up and asking why, why, why, we need to simply need to accept that there are things that happen.  And there are no reasons and we couldn't have avoided it.  It was our path.

We just need to turn the page and focus on recovery.  Worrying about the past is a waste of time.

Just ask Bo.  He knows.

Thanks for reading...

Are We There Yet?

I have spent the better part of the past 3 days feeling sorry for myself.  I am not walking perfectly.  My inner thigh is grabbing every now and again.  I can't play football in the snow with my boys.  I can't ride my bike in the snow because I am afraid of falling on my hip and setting my recovery back. 

I think I should be better by now.  I have done all this work for 8 months and I am not 100% better yet. 

Then I read an article last night a woman who took 4 years to recover from a car accident.  She recovered fully but it took her 4 years.  4 years!  This made me think about time and recovery.  Ask a doctor how it will take a 37 year old man to fully recover from a hip fracture and he will spout out some canned answer that is nothing more than a best guess.  Ask a PT and you get a different answer.  The real answer is that no one really knows how long it takes to recover from anything.  Every surgery is different, every body is different.

So what do you do?  You give yourself time.  Take the ups and downs and give it time.  In a world of instant gratification, we have lost the concept of time.  Some things take longer than the time it takes to load a web page.  We aren't professional athletes with a host of resources at our fingertips.  So we need to give ourselves more time than we think.  And in that time frame we need to make steady incremental progress.  Find a recovery plan that works and stick with it.  Clean up your diet and stick with it.  Make sure you sleep enough.  Keep your stress in check.  And stick with it.

For me, I am going to give myself 2 years.  I believe in power of kettlebells to make me stronger.  I believe in the power of my massage therapist to work out the kinks and reduce the scar tissue.  I believe in my surgeon to give me good advice.  And I believe in myself to make the right decisions.  And I believe my body will recover.  In time.

And if it takes 2 years or 4 years, it doesn't matter.  Because as they say, "The only way you fail, is if you quit."

So don't quit.  Just give it time.

Thanks for reading...

Don't Find Comfort in Food...

For many pain is at its worst at night.  Dinner is over.  Kids are in bed.  And you start feeling pain and what you suspect is a hunger pang.  Your brain sends you a signal and you realize while you can't get rid of this pain in your hip/knee/back/shoulder/etc, you can EAT and that will provide some comfort and some relief.  You can feel something, anything else, other than the PAIN.

And what results is a few extra pounds.  And that puts more weight on your hip/knee/back/shoulder/etc and then you get hungry and you eat.  And what results is a few extra pounds...  It's a vicious cycle.

To avoid it, I say don't eat after dinner.  Make sure you eat just enough at dinner and then don't eat again until the next day.  To make sure this is easier said than done, try a few of these tricks:

• Brush your teeth.  This is an old dieters hack.  No one wants to eat after they brush their teeth.  And because we have become so accustomed to brushing teeth before bed, this should trick the mind into thinking its time for sleeping, not time for eating.
• Drink some tea.  I know, I have said this before but tea curbs hunger.  But avoid the high caffeine teas so you aren't tossing and turning all night.
• Drink a big glass of water.  This will make you feel full. 

So when you hurt, the last thing you should rely on is food.  Because in the end it will provide more pain and a whole lot less comfort.

Thanks for reading...

Who "Owns" Your Recovery?

When I think about doctors I am often reminded of that scene from the movie Malice, where actor Alec Baldwin goes into a tirade when asked if he has a "God Complex".  His rather lengthy response goes:

...The question is, "Do I have a God complex?" Which makes me wonder if this...lawyer, has any idea as to the kind of grades one must receive in college, to be accepted to a top medical school? Or if you have the vaguest clue about how talented someone must be to lead a surgical team? I have an M.D. from Harvard. I am board certified in cardiothorasic medicine and trauma surgery. I have been awarded citations from seven different medical boards in New England and I am never, ever sick at sea. So I ask you; when someone goes into that chapel and they fall on their knees and they pray to God that their wife doesn't miscarry or that their daughter doesn't bleed to death or that their mother doesn't suffer acute neural trauma from postoperative shock, who do you think they're praying to? Now you go ahead and read your bible-Dennis --and you go to your church and with any luck you might even win the annual raffle. But if you're looking for God, he was in operating room number two, on November 17, and he doesn't like being second guessed. You want to know if I have a God complex? Let me tell you something--I AM GOD...

While quite theatrical, this monologue gives us some food for thought.  Can doctors save our lives?  Yes.  Can doctors fix us?  Yes, mostly.  But can doctors heal us to to a point of 100% recovery?  Most definitively, No. 

The reasons I say that is because when it comes to matters of broken bones, hip replacements, knee replacements, ACL surgeries, and a battery of other injuries, doctors (and physical therapists, I might add) only get you part of the way there.  A doctor will get you maybe 50% of the way and then the PT might get you to 65%, maybe 70%, if you have a really good one.  But to get to 100%, that task falls upon ourselves.  And such is the reason that so many folks fail to fully recover, because they figure when the doctor or PT says you have recovered, that recovery is over.

To that I say doctors and PTs are only part of the picture.  They are only a piece of the pie.  The rest of it is yours to manage.  In fact, I think you should be managing the whole thing.  Don't like your doctor?  Get a new one.  Not getting results with your PT?  Get a new one or try something different like Pilates.

Doctors only have God Complexes because patients give them God Complexes.  In the end, we need to use doctors for what they are good at: surgeries, diagnosis, and serving an opinion to to the overall process.  They are simply ONE opinion.  But because there are so many factors like diet, exercise, and soft tissue repair, that simply aren't their expertise, we shouldn't allow them to manage our recovery.  Recovery is out of their wheelhouse.  They are the concrete guys of the process, they pour the foundation - which is very important, where all else is built upon.  But they aren't the general contractor - you are!

So the next time the doctor walks in the room and acts like he is charge, (kindly) remind him that he just a resource for your recovery and his worthwhile is based on the value of his advice, not for his ability to pretend he is God.

Here's the Stick...

A fellow member of the bruised and battered coalition recommended that I write about another item we can use for self-massage called "The Stick".  It is basically a stick with handles on each side and rolling pieces in between that move along your muscles to ease pain, promote bloodflow, and remove lactic acid.  I have tested it out a few times and it provides a good amount of relief, especially to the legs.  I have even seen a few guys in the NFL use them on the sideline.

A simple, cheap solution that you can use everyday.

Thanks for reading...

How We Eat = How We Heal

There is a saying among fitness professionals that says, "Bodies are made in the kitchen".  What they say after is usually something like, "80% of how you look is based on what you eat, and the other 20% is based on your exercise routine".  I think this is even more impactful for the bruised and battered like us.

If we are overweight, then amount of force coming down on the replaced knee or hip is going to hurt more and take more strength and recovery time to feel better.  Even more so, the right food choices can heal us.  Think about how good you feel after eating a piece of chicken and salad versus how you feel after a few slices of Pizza Hunt pizza or a few tacos from Taco Bell.

Now I am not going to get into what diet to recommend because that is just opening up Pandoras box.  There are just too many opinions in the diet industry.  What I will say is this, we need to focus on real foods with a diet high in vegetables, fruits, and, in my opinion, meats and fish.  There are some that say a vegan diet is the way to go and I won't argue with that either.  Whether your diet is Paleo, vegan, or just one based on moderation, it behooves you that while healing (and beyond), you are eating as well as possible.  Diet, others have said quite succinctly, is king.

This principle is highlighted in the documentary film, Forks Over Knives.  It is unfortunate that the film has somewhat become propaganda for the vegan diet because the title alone can teach something about how to care for ourselves.  "Forks" means that what you eat can prevent and heal injuries sometimes better and more successfully than surgery.

Now I am not trying to create a debate.  I am simply trying to emphasize that what put into our bodies has a HUGE impact on how we feel, heal, and live.  So if you are sick, tired, broken, or depressed, do your best to improve your diet.  It may not cure everything but it will make an impact and work harmoniously with all the other actions you are taking to heal.

Thanks for reading...

What Do Soft Tissue Damage and Male Orthopedic Surgeons Have in Common?

In the reading the Huffington Post article entitled Orthopedic Surgery: Women on the Rise in a Male-Dominated Field, I was struck by the fact that only 4.3 percent of board-certified orthopedic surgeons are female.  As the author points out, the reasons for such gender disparity are that a certain "amount of physical force is required to maneuver fractured or dislocated bones and joints back into place".  She goes on to say that is changing due an increased use in robots and other medical devices. 

That is is not, however, what caught my eye.  It is the simple fact that physical force is being used to move something around inside the body.  Or that such strain is require to reset our bones, joints, and ligaments.  The thought of it simply makes me cringe.  But it makes sense, given what aches and pains I have felt following my hip fracture surgery.  I now know they did a heck of a lot more than just reatttach two pieces of bone with three screws.

Coincidentally, my reading of this article quickly was shortly after my reading of a similar story to  mine when another gentleman had a hip fracture caused by a bike accident.  In this story he tells of his long struggle to heal and all the different types of treatment he has required to stop the pain and make himself healthy.  In one poignant part of the story, he states, that amount amount of soft tissue damage, or creation of scar tissue - caused by fixing a hip fracture or going through knee replacement surgery - simply cannot be understated.  In other words, our muscles, tendons, fascia, and nerves all take a beating when they are in there fixing our broken bones.

So what can we do about it?  What does all this mean for our recovery?  Short of not having the surgery, it means that we need to include soft tissue repair as part of our recovery plan. 

Soft tissue repair comes in many forms and I suggest you use them all to one degree or another. The most obvious is the use of Advil or any other anti-inflammatory.  But anti-inflammatories should be used on a limited basis due their side effects. 

Thus several other safer choices should be considered:

• Heat and Ice.  To promote blood flow to the area.
• Massage.  Ideally this would be with a proper massage therapist with experience in treating your specific injury.  But massage therapists are not cheap.  A less expensive, do-it-yourself approach would be to purchase a foam roll.  These can be be used on all parts of the body to apply pressure and relief the damaged area. 
• Proper Vitamin Intake.  Vitamins E, K, and C promote collagen that helps heal damaged tissue.

What ever you choose, or what ever works for you, don't forget that not matter how successful the surgery that the muscles and its surround components need treatment beyond just gaining strength.  They need to heal because in all types of surgeries sustain this collateral damage and failing to treat it will simply also pain and discomfort to linger.

I Overate (and I Can't Get Up)

For the first 3 weeks after my hip fracture surgery, I couldn't eat enough.  I felt like I was 15 again.  I would wake up so famished that I thought I was going to pass out.  I was eating and eating, and losing weight.

Then it stopped.  I remember the day like it was yesterday.  A friend brought me lunch, and she knew I was eating like a horse - so she brought me 2 Jimmy John's subs.  I was so happy to have pre lunch and post lunch.  So I scarfed down the first one.  And I expected to feel how I had been feeling: mostly satisfied but knowing I would have to eat again soon.  But instead I felt stuffed - stuffed beyond belief.  I felt like Thanksgiving dinner times five. 

So there I was, on crutches, unable to move, in pain, and stuffed to the gills.  Not a great feeling.  At the time, to deal with it, I went to the garage and did a ton of dips and pull ups.  Now while it probably helped, here is what he experts say one should do when after overeating.  These techniques can also help after eating junk food.

1. Drink a ton of water. Water helps promote digestion and flushes out your system
2. Drink tea.  It also helps with digestion and the caffeine will help you feel full so you don't eat too soon afterwards
3. Get plenty of sleep.  Loss of sleep acts as a stressor to the body and many compensate by eating.  Also a lack sleep depletes your body from the energy it needs to quickly digest.

Many experts also recommend going for a walk but I was out of luck given my situation.  Some also recommend fasting for a period afterwards.  In theory, not a bad idea but fasting can be a bit tricky when recovering from a major injury or when pregnant, for example.  Others also recommend taking a probiotic pill (or eating yogurt several hours later) to promote digestion. 

In the end, it was that last Jimmy John's sub that really signaled to me that I had to make some changes to my diet if I wasn't going to gain a ton of weight while recovering.  In fact, because I made diet changes, the opposite has occurred.  I have lost 20 pounds and am as lean as I was when I was 15.  But the body still won't let me eat like I am...  I guess age is more important than weight...when it comes to consumption.

Thanks for reading...

Contrast Your Bath...or Shower

In continuing with the minor relief theme, I wanted to bring up a simple technique that can help relax the body, ease pain, and promote healing.  It is called a contrast shower.  In technical terms, it is called contrast hydrotherapy.  The concept is pretty simple: alternating between hot and cold water while you are showering to stimulate your body to heat itself up and cool itself down, in order to bring recovery.  Blood rushes away from the extremities to protect the heart and then rushes back.  It is similar to the concept of contrasting a sprained angle with a heating pad and ice pack.

Here is how I do it:

1. Get the water nice and hot
2. Get in the shower and warm up
3. Apply the soap and turn water to cold
4. Rinse off with the cold water and then turn back to hot
5. Put shampoo in hair and turn the water to cold
6. Rinse off with the cold water and then turn back to hot
7. Put conditioner in hair and turn the water to cold
8. Rinse off with the cold water and then turn back to hot
9. Shave in the hot water and then turn back to cold
10. One final rinse in the cold and then get out

When I get out out I feel relaxed and energetic.  For that reason, I like to use this technique when I am tired because I was up with one of the kids or sleeping in a hotel when on the road for business.  To focus on the energetic and get going with your day, end with the cold.  To focus on being relaxed and end your day or take a nap, end with the hot.

Like the Yamuna Foot Wakers, a contrast shower is something simple we can do everyday to promote healing and help our bodies recover.  Here are a few more resources to learn more:

http://www.vsnaturopathy.com/Shower.html

http://articles.elitefts.com/training-articles/rehabilitation/power-shower/

For an even more extreme method, try an ice bath.  It's a little too much work and too extreme for me but some might like it.  I know the guys in the NFL do...

Thanks for reading...

Wake Up Those Feet

Here is a simple little item you can buy that helps with recovery.  They are called Yamuna Foot Wakers.  These two little half rubber balls are a nice, simple way to massage your feet and relieve foot pain.  They also claim to help with gait and posture.  I can't say much for the gait and posture but they certainly haven't hurt my efforts to improve in that area.

Mostly I posted this product because they are relaxing.  When we are in recovery, our bodies are in constant state of stress.  We have scar tissue and we aren't moving correctly and then we worry about how we have scar tissue and aren't moving correctly.  It is a vicious cycle.  And finding ways to stop that cycle while in recovery is key.

Products like the Foot Wakers provide some respite while standing or hanging around.  You simply stand on them and move your feet backwards and side to side.  It is isn't a 90 minute massage but its something daily we can do to treat ourselves better.

Give them a try!

Thanks for reading...

The Cost of Recovery

I have been thinking a lot lately of writing post around all the aspects of recovery and how we individually have to manage our own recovery.  It was going to be about acting as our own project manager and not relying on the doctor, surgeon, or physical therapist to drive our our recovery.  And I think I will write it in the next few few days.  But I wanted to precede it with the cost of the recovery.

We all have the some of the same costs: insurance, co pays, out of pocket expenses.  And these expenses hurt - I know they hurt.  For most people that is where it ends.  I have seen it many times before. And because of the cost of health care, I totally understand why.

But we must be willing to continue spend to take our recovery to 100% and  keep ourselves healthy and age gracefully.  Surgery and traditional physical therapy (and insurance) will only get you so far.  You must be willing to dig deeper (into your pocket book) to save yourself from a life of pain

Personally I have spent several thousands of dollars on Pilates, Feldenkrais, massage, and chiropractors, and books of all kinds, among others.  To me these are worthwhile expenses - and they are worthwhile expenses now.  The reason I believe so is that the way we recover and rebuild our bodies 2 years after the injury will pay dividends on how how bodies feel 10 years from now.  It is just sound logic.  Father time is ticking and older age has a way of resurfacing injuries that weren't completely dealt with when we were younger.

Now I am fortunate that I can afford some money out of pocket to pay for my recovery.  And I have often paid for private lessons.  But you can do it on the cheap.  Take books out of the library.  Take a Pilate's class at the local community center or YMCA.  Go to a massage school and act as one of the test clients.  Spend what you have but invest in your body today so you can reap the rewards tomorrow.

All in all, it is that you have to spend some money beyond the co pays and out of pocket expenses to get yourself healed.  And you will need to do more self care to stay at 100%, whatever that is for you.  For me I am not there yet but I am only 8 months into my recovery.  That means I am going to invest heavily in myself over the next 12-16 months.  I'll keep you posted on the payoff.

Thanks for reading...

The Turkish Get Up (And Down)

If I had to pick one single exercise that I think has made the biggest impact (aside from Pilates) on my recovery, I would have to say it is the Kettlebell Turkish Get-Up (TGU).  There are hundreds of articles out there on the value of the get up so I wont regurgitate that here.  But it is the only exercise I know of that can build strength, coordination, and function all while serving as a way to identify your weakness, or leaks, as some trainers like to call them. 

It sum, the exercise is basically performed by you lying on the ground with a bell in one hand and the getting up while continuing to hold the bell overhead.  And then going all the way back down.  While it sounds simple, for most people it is difficult until either a) they really get the technique or b) they fix the leaks in their body.

See the below video by Steve Cotter, RKC:

The TGU has been hailed as a way to cure everything from shoulder problems to golfers elbow.  It is so useful that Geoff Neupert and Gray Cook each have programs where pieces and parts of the exercise are performed everyday.  Neupert's program can be found as part of his Kettlebell Express program.  It was the first strength based program I used after I was cleared to walk.  I used it conjunction with physcal therapy, massage, and pilates.  While I am not fully recovered, I believe it was this program that really gave my recovery a "kick start".  I continue to do it combined with a number of other kettlebell and bodyweight exercises.  Check out Gray Cook's Kettlbells From the Ground Up DVD for a similar program.  I don't have any direct experience with it but Gray Cook is a very well respected Physical Therapist and author, having written Movement and Athletic Body in Balance.

In the end, the TGU is one of the best exercises you can do because it both makes you stronger and shows you where you are weak. 

And all us bruised and battered are certainly weak in one way or another.

Thanks for reading...

Knees Up

I found an interesting exercise while searching some new ways to enhance my therapy using kettlebells.  It is  called kettlebell high knees.  It is not the high knees calisthenics exercise we often see in gym classes or boot camps.  In this case, it is performed by hooking your foot through the handle of a kettlebell and then lifting your knee upward.  See picture below:

One the reasons this exercise appealed to me - aside from its use of kettlebells - was the fact that it targets the gluteus medius muscle.  This muscle is often weakened in hip injuries and replacements.  Its weakness is also responsible for poor walking mechanics and a "hip hike" on the non weakened side - something I have suffered from since my accident.  It also has value to those recovering from knee injuries by assisting with the Tensor Fascia Latae muscle.

For more information, see the Physical Therapy Web Space site here.

Thanks for reading...