Category: Injuries

BSRD4 – The Work Begins

images (4)Today was a tough day.

Physically I am paying the price for deciding to quit the percocet before it gets it’s grip too tightly on me. I’m sweating for no reason, I am nervous, anxious and feeling really on edge. As the day wore on, it got better, but I was a real basket case this morning. It was a rainy day here so I was resigned to trying to walk on the treadmill which was unimpressive. Unfortunately it’s just not up to the task of running with me on it at such low speeds. It was jerking around like crazy and the walk was therefore a total bust as far as being emotionally uplifting. I did try out the bench just to see what the position was like and for future reference if it was even possible to keep the weight off my back as I lifted. The test went well, if I brace my legs just a little I can carry all the bench weight across my shoulders and my back is almost completely protected. I didn’t go too far with it, just a kind of see what happens session and it did lift my spirits a little.

The big news of the day is that Lightning is home again, his numbers (creatinine) went from 1000 down to 355 which is basically a manageable number. We do have to give him subcutaneous fluids which will no doubt be an adventure but for the time being it looks like he has dodged a bullet. Hopefully this will give us another couple of years at least with him regardless of his bum leg and his obesity.

By the evening, I felt so much better that I decided to go to the gym to see the girls and have them explain in their own words what happened at competition. All I can say is that is went badly. Very very badly. A hard to swallow end to a very challenging day.

 

BSRD3 – Pain Tolerance

percocet-abuse-help-infoI went for a 2km walk early this morning, but it was apparent as soon as I started that trying to stop taking Percocet today may have been a mistake. Before I even got to the end of the street my shins were on fire on my right leg. Strangely I cannot get rid of the pain by stretching as per normal and the pain didn’t get any worse as I went along, then again I am not sure what is worse than excruciating so….

Anyway, the good news is that it was a long walk all in one go and that my pace was up slightly from the last couple of days. I have gone from 26 minutes per km the first time out to around 20 yesterday but today was a lightning quick 17 minutes per km. I suppose it is a good reflection of the progress, not only the increase in exercise time and distance walked but also the increase in pace. I am not sure which of these will become the best indicator of my recovery so for the time being I will continue to report them all. As noted above I have tried to quit the Percocet at this time. I had to take some at 5 this morning to get back to sleep but I am hoping that I will be able to make it through the whole day without them, after all, a day filled with back pain is normal for me. I find that the pills make me foggy, restless and disinterested in almost everything. I remember from last time what a devastating effect it can be trying to come off them cold turkey if you are on them too long and so this time I will try to get away ASAP. I figure if I can come down to 2 a day today and tomorrow and then quit completely for the rest of the week that should be good progress.

Today I am missing my girls compete for the first time in my coaching career. I have never had to miss a competition and it’s killing me not being there. However, I understand fully that missing this day will enable me to be there the rest of the year, a short term sacrifice for long term gain, but the guilt is killing me.

Cat update – He apparently is a little better, and although he is on the road to recovery, it is not clear exactly how far he is going to be able to come back. Apparently he was mere days away from being too far gone so although we are keeping our fingers crossed, we just don’t know.

 

Back Surgery Recovery Day 2 (BSRD2) – Summer is finally here!?

Today was a wonderful day weather wise which is so much better for rehab than the dead of a Canadian winter. I was able to get out and walk twice again today for a total of 1.6km or so, slightly ahead of my projected goal of 1.5k. I will try for 2k tomorrow but I think that I should stick with that for a few days, my leg was sore, I had some hip pain and the speed was noticeably diminished at the end of the walk.

Also I have noticed a certain physical difference. I have always know that the mass I lost off my right leg was at the top of the outer quadricep muscle. After the most recent nerve impingement I lost the ability to control my foot lift but also the ability to flex the outer quad down to the knee (the vastus lateralis). I just noticed this evening that I am starting to get an overdevelopment of the sartorius which is actually very pronounced but on BOTH legs not just one. This is puzzling to me since I believed the overdevelopment was due to the lack of nerve messaging and not a compensatory development of some kind. I will look into this some more but I think it is pretty interesting that I have compensatory muscular development in the leg with what I believed was no neural involvement. I suppose this could mean that I actually did have some neural effects on my left side, but it could also mean that my gait has been altered by such a degree that the effects are being felt on both sides, but not only that, in equal places on both sides. Very weird. Also on the physical side, in addition to my hip pain alternating from side to side today I also gained enough strength back in my foot to pull open one of the doors in the kitchen cabinets that we have taken the handles off as a childproofing measure. This is pretty significant and although I still can’t lift the ball of my foot while standing, it’s a move in the right direction.

On the medication front I have cut down to 5 percocet a day, mostly after walking when the pain is more and at night when it seems to be worse. I am on target to be done with the things under the 30 that I was given so I am happy about that. There is nothing I fear more than the addictive properties of pain killers. As for the cat, apparently they have found that he has a heart murmur now as well as his kidney failure and it is starting to look more and more like his time may be close to the end. I really hope we can get a few more years out of him, I think he has a pretty good life here and he deserves to go out with a little dignity rather than be forced out due to failing kidneys. We will find out more on Monday until then he is in good, albeit very, VERY expensive hands.

Recovery Day 1 – Friday April 26 2013. Plus sugar free BBQ sauce.

tumblr_m4o2eqCLmu1r8v6q9o1_500Bed was surprisingly comfortable however I still was woken up regularly by the pain and had to take pills to manage getting back to sleep. Fortunately Nicole was up early to take Elyse to daycare and I was afforded the luxury of sleeping in. Once awake, I thought it best to try to restore whatever semblance of normality I could back into my life. I was unable to shower, since I have to take 3 days off, but I tried to make it through brushing my teeth, hitting the big hole in the toilet and washing my hands and face as normally as possible. This meant standing without my cane, making sure my posture was good, not leaning over the sink and paying close attention to the distribution of weight between my two legs. I managed to make it downstairs OK, toothpaste stains and all and for the first time in a few weeks had a little bacon and egg for breakfast. My day (and for the next 3 days at least) comprised mostly of wandering doing various menial tasks around the house and then hitting the couch once my leg or back started to hurt. In fact, it was not my back that hurt at all but rather various parts of my lower body. When the urge struck me, I went outside for a walk, which happened twice. I had a goal of 1km walking today, and after both my walks I had reached a grand total of 1280m. I actually downloaded Nike+ that I had on my old iPhone so that I can keep track of my walking since the physio and EVERYONE I spoke to told me that recovery from back surgery is all about staying mobile and above all… walking. The fact that I can keep track of my walking online with Nike+ is a huge bonus too, since statistics and monitoring is one of the things I love about working out. My Nike+ account can be monitored here for those with obviously very little else to do. It’s actually pretty sad that my walking pace after back surgery is not that far off my pace when I used to walk at lunch during work…

Apart from the walking and the sleeping I was also able to make some pork in the crock pot and come up with a pretty good base for a sugar free BBQ sauce. If you add to it your favourite spice mix (of which there are many) you can come up with a pretty damn good sauce:

1 large can of tomato paste
1 400g can of crushed pineapple in juice (no sugar added obviously)
200ml of pineapple or apple juice
150g of pitted dates
Your favourite spice

Getting the pineapple and tomato paste mixed is easy, but getting the dates to cooperate is harder. I opted to put mine in the Vitamix and be done with it. You mix everything together, but make sure that you leave the mixture to sit for a while since using powdered spices takes time to dissipate the flavour. For the spice mix I have 2 that I use, both from the Bulk Barn. Once is called BBQ spice and the other is called Pulled Pork Spice. I find the pork spice to be more salty but both make equally good sauces.

On a related note, a few weeks ago Bob brought a protein bar into work that he and his wife had made and it was magnificent, I have since been playing with the recipe a little to try and get the calories down a little and to jazz it up a bit but once again, getting the dates to behave is proving problematic. You see, the recipe calls for almonds, almond butter and flax meal however I found that if I added dates, it would be tastier, less caloric and you could add pure cocoa chocolate to it for a nice chocolatey kick without the sugar. So, here  is my recipe for protein bars with dates. I find the best thing to do when preparing this is to mix the dates with the coconut oil on the stove then vitamix it. Otherwise you get a very sticky ball of dates in the food mixer. I can’t actually remember the original recipe so this will have to do.

1 cup almonds
1/2 cup flax meal
150g dates
1/2 cup coconut oil
touch of honey
drop of vanilla
1 cup unsweetened coconut
a couple of pieces of pure cocoa

Blend all the dry ingredients in the vitamix and then add the wet stuff, press into a pan lined with foil and if you can get a small cake tin you should be able to get about 25 cubes of protein bar at about 150 calories each. And you know what’s in it! Thanks to Bob for the original recipe however don’t use carob since carob is in fact just sugar with a small amount of carob seed in it.

As for the updates as to how I am actually doing today here are the basics.

I walked 1280m today mostly without the use of the cane.
I an flick my toes against each other, a habit that Nicole finds incredibly annoying while we are watching TV but I couldn’t do it yesterday, That means my toes are getting stronger. I cannot however grasp anything with my toes on my right foot, there is still a long way to go.
I can lift my toes off the floor on my right foot if I stand neutrally, however I cannot raise the foot at all.
After walking today I got a pain my my left shin right at the knee. Also I find that my left hip is sore today. I do expect some odd soreness since I have to assume that my body will have to readjust constantly as my strength returns in my right side. In the mean time, my left side is struggling to compensate, something this is bound to lead to some soreness.
Sitting on the recliner is not as comfortable as I had hoped, this means I won’t be spending too much time here but it also means I have had to try and find a way to get onto and off the floor.

Tomorrow my goal is to walk 1500m. I don’t want to go too crazy so I will see how I feel. I promised no weights or bands or anything until Monday at the earliest.

I got my temporary disabled permit today, something I regret not doing last time. In fact, not having it almost caused me a serious fall last time around. I respect the institute and I do not plan on abusing the privilege.

Finally the cat went in to the vet and it doesn’t look good. Apparently his kidneys are pretty much shot and it seems like if he doesn’t improve over the weekend then it will be time for him to be reunited with his brother Thunder in the big litter box in the sky. Poor little fella has had an arthritic limp for a long time now and it seems like he is falling apart. The tough thing will be what to tell Elyse. I can’t imagine this will be easy.

 

 

 

 

 

 

 

Discharge

I am not one to fear hospitals, in fact the though of having someone else take care of everything while I sleep is something I find particularly attractive however, there are certain circumstances where even I just can’t wait to get out. Today was one of those situations. I awoke fairly mobile but unable to get out and walk due to the IV in my hand. I was therefore reduced to peeing into a bed bottle (something that is harder than you would imagine) and counting the hours until the nice nurse came on to shift to get the medieval torture device out of my arm. After what seemed like an eternity of medications, discharge documentation, visits from doctors, surgeons and physiotherapists I was finally told I could leave. I packed up my meagre possessions and limped out of the ward to my first real challenge, walking to the hotel, a mere 50 metres from the Hospital. I knew that the walk wouldn’t be as bad as the car ride and I was right. Sitting in my usually plush seats was excruciating for me, and as much as I love the drive up the DVP on a sunny day I was driven to distraction by what felt like my non-existent stitches ripping out of my scar one by one. We had to make quick stops for medication but we got to the house as quickly as possible where I was faced with what seemed like a pleasant choice pre-surgery. Was it to be the recliner or the bed? To my surprise I felt like the only solution was to take the memory foam topper off the mattress and use the bed. Since laying on the memory foam was incredibly painful it was actually a real treat to lay on a relatively firm mattress. Sure, it wasn’t the adjustable bed I had been used to over the last 48 hours but at least it was bearable. I spent the rest of the day (which by this time was actually the evening) trying to get more sleep and gauging just how well I could do without the Percocets.

The answer, surprisingly was that I could make it through on lack of sleep and one Perc every 4 hours.

When it rains…

Our Bell satellite TV is playing up, this evening in fact I can’t even boot the damn receiver any more. Lightning, our cat, has been sick the last few weeks and we finally decided to take him to the vet to find out what is wrong. We are still waiting for those results. Add my wife being sick in the one country in the world where you don’t want to get sick, ‘merica and you have what is turning out to be a rich tapestry of my life. I am sitting on the recliner, having been told that it’s the best place for me by my physio, down to 1 Percocet at a time and marvelling at what a massive contrast my last surgery was to this one.

Yesterday we left the house at 515am, tired child requesting timbits and the two of us bleary eyed trying to get to the Preop lounge at St. Mikes by 6am. And when I say lounge, this place looks like the setting for the opening scene of a Hitchcock movie which at that time of the day is a little bizarre. I had been dropped off, since there was really no use in having the whole family present while I waited around to be prepped for surgery, and after a relatively short stay in the boudoir of Madame  Surgerypants I was whisked off to have my gown strategically placed across parts of my body as I tried in vain to play twister with my bodyparts and a handkerchief. It wasn’t long before I was in the OR ready to go, I was told to take deep breaths and as I commented on the fact it was raining on my face in Chile I was out.

I awoke to an all too familiar feeling of what can only be described as a clothes iron being rolled slowly up and down my spine, pointy end first. To be honest, I was immediately aware of how much better I felt than I had that New Year’s Day in 2003.  I was groggy, my back and leg hurt like hell but I was acutely aware of exactly what was hurting and why. I was also able to move gently from side to side, almost like I did when my back used to go out and I would be trying to avoid the electrocution of my spine that came with making the wrong move. It was around 1130 when I woke in the PACU next to a guy who I remembered was in a wheelchair that morning in the Bunny Lounge. After a few minutes we struck up a conversation about our circumstances, our history and actually ended up having a very lengthy and interesting discussion about our lives. Now, anyone who knows me would agree that I am not that guy, I am not the one for friendly conversation and small talk but Jessie, the guy in the bed next to me, had such a similar story to mine and such an interesting history that talking to him was not only a great distraction but was also genuinely pleasant. After about an hour of entertaining the PACU with our war stories and our sporting endeavours we parted ways, I went to the 9th floor to the Neuro ICU and he went to the 4th floor. I had meant to try and check in with him as I left but unfortunately time and circumstances did not allow it. So if you know a Jessie who is a teacher in Ajax, had back surgery on April 24th 2013 and was once a pretty good volleyball player, say hi for me!

Once in the room, it was up to me to try and distinguish the pain from the medication and to figure out a way to plot my next move. It’s still pretty foggy to me, but I had a nice nurse, Joanne who was happy to encourage me to try and stand and get myself to the washroom. In fact, after the first time she assisted me (truth be told she was never going to catch me, but rather just be a soft landing for me) she left me to my own devices to get to the washroom and back which I did only a couple of hours later. As I drifted in and out of my Percocet dreams I strove to move as much as I could, to try and stand when I was able and to gauge just how capable I was. unfortunately there was a wrench in the works. My blood pressure had been dropping steadily since the surgery and hit an all time low of 96/53 at which point they sent in the butcher of Bakersfield to put another IV into my hand. It literally felt like she was ripping at my veins like Edward Scissorhands doing sutures and that pain was to stay with me until the IV came out as I left. Happily the BP started to rise and after just one bag I was fine again.

The most interesting part of the night was still to come as my roommate, who had been hit by a car on the sidewalk only a few days before, fracturing his neck, clavicle and upper back and was now part rod and screws, decided it would be cool to go and have a cigarette in the washroom. Now, I get it if you are an addict, it can be hard, but let’s remember he was harbouring an open flame in a room containing several under pressure gasses not least of all was the oxygen HE WAS ON! Thankfully we didn’t all die in a massive explosion, and I have to admin the nurses took a lot more notice of us after that!

I do have to say that although Joanne did a great job and had a wonderful bedside manner, the quality of the nursing left a great deal to be desired. I think it was mostly a timing thing, and that itself may also be a product of the lack of technology in use. If you can believe it, the nurses were recording medications and vitals on scraps of paper in their pockets and then transferring them into the computer system on computers located at several locations along the hallways. This could have explained why it took over an hour to get medication, or why after requesting washroom assistance for my second trip nobody ever came which is why I took it upon myself to go it alone. The quality of the surgery and the obvious skill of the surgical staff is undeniable, and the reputation of the organization is impressive however at the nursing level I am afraid there seems to be quite a way to go. Maybe I am spoiled but it would certainly serve some of our nursing staff well to come over to St Mike’s for a couple of days to make them realize just how lucky they are to work at an organization that supports them with such impressive technological advances.

I drifted off to sleep, however like clockwork after 3 hours I would awake, immediately aware that it was getting close to my medication time…

 

 

 

 

On the brink

Tomorrow is the day.

In fact, it’s 9pm here and I am due to check in at the OR tomorrow at 6am. Surgery is scheduled for 745am and after that I am guessing it will be 36-48 hours until I will be back home. Probably then another 24-48 until I could possibly be back here to post an update.

For today, I did go and do a brief bench workout in order to make sure that the bench is set up for my recovery. I have made sure everything I need is at hip height or above and that I have enough pulled pork and home made sugar free bbq sauce to tide me over for at least the next 5 days or so.

I have to admit that I am a little surprised at my nonchalance this time around. I suppose I could be mired in self-pity and anger as I have been in the past however it really wouldn’t do me any good. This time I am scheduled (which makes a difference) with a spinal neurosurgeon rather than being rushed into an emergency department, stuffed into an MRI like so much sausage meat and operated on by the nearest orthopedic surgeon they could find. I suppose I have a little more confidence in my own recovery this time also given my experience / maturity and vastly improved physical condition. As my gym kids told me last night via a very touching greeting card, I am one tough cookie and I suppose this new attitude is a reflection of that.

I will be back to comment some more, I am hoping my optimism will have proven accurate and I will be on the mend and able to post banal and monotonous updates rejoicing in the fact that I was able to make it all the way to the mailbox and back in one go!

Wish me luck…

Countdown to surgery

It’s Monday, I have spent the best part of the last week at home on the floor with a heating pad trying to get rid of the pain radiating from my back down my leg and through my hips. The initial pain that was in the right shin is gone, leaving a drop foot that I can only hope and pray isn’t permanent. The pain in the back is actually gone now however I can feel the near impingement almost every time I move. It’s as if the scar tissue that is apparently at fault is resting against the nerve just waiting to press against the root causing the familiar screaming pain. As far as trying to stay in shape before the surgery itself I have been able to do very little. Last week I managed to bench one day and do a small bicep workout another day. I have broken out the EMS unit I used back in early 2003 when I had my original surgery. Although my documentation of that time in my life is not great, I do have some information that I found:

What started out as a simple herniation of the disc creating pressure on the spinal nerves which causes an effect somewhat similar to Scoliosis developed into a severely displaced disc fragment that impacted the sciatic nerve. This caused excruciating pain down my right gluteus, into the quadriceps and terminating in the knee. When the cortisone injections into my spine did not help the situation, it was determined form both a CT and an MRI that surgery was going to be necessary to remove the portion of the annulus that was touching the nerve root. This was in preference to a discectomy that would have required removal of part of the nucleus of the disc in order to reduce the overall size of the disc. Most procedures that are available to patients with severe herniations are effective over time but require the procedure to be performed while the disc is healthy and normal. Even the newest and most promising procedure, referred to as “Percutaneous Microdecompressive endoscopic Spinal Discectomy with New laser Thermodiskoplasty for Non-Extruded Herniated Nucleus Polposus” as it’s name suggests requires that the disc be in a non-extruded state.So my options were limited, and under the trusted care of Dr. ****** I went in for surgery on New Year’s Eve 2002 at 4pm.
Since the surgery, I am glad to report that the localized pain is gone both in the spine and the thigh. However, there is still pain in the knee and much of the strength in my upper leg is gone. I left the hospital on crutches, unable to support any weight on my right leg. I am happy to report that I am now able to support myself without the use of crutches, however I am unable to climb even the smallest of steps. Much of the loss of feeling in my leg has also returned, however from the top of the knee I still have little or no tactile sensation. It is normal for this numbness to remain up to 9 months after sciatic nerve injury, and from what I have read, it is normally 6 to 8 weeks before the pain is completely gone and normal strength returns.Since walking requires very little bending of the knee, I am able to walk without crutches for short distances (a hundred feet or so), however any incline or decline which requires strength from the quadriceps is impossible to negotiate without crutches.

I will continue to post some of the information I can find from last time, however the most significant difference this time is that I will be going in as a scheduled surgery with a neurosurgeon named Dr. Lo at St. Mike’s in Toronto rather than being admitted on an emergency basis screaming in pain and having to be rendered unconscious in order for the techs to get me into the MRI machine.

So what happened? I hear you ask. Well, it’s a long and as usual confusing story. I wrote about the initial effects already but it’s now days later and the foot drop is still there, in fact it seems worse than in the beginning. I had the MRI, I was then told I needed to go and see a neurosurgeon to get a professional opinion. Almost as soon as Dr Lo saw the MRI he knew it was going to require surgery. I asked about the disc replacement and also the idea of fusion however his indication was that since there is no misalignment of the spine that fusion is unnecessarily risky and that disc replacement surgery would be massive overkill. He told me that the success of the initial surgery is 90% but the success of follow up repeated surgery is only 75%. However, not having the surgery would almost certainly lead to permanent disability. So I am booked in for Wednesday, I have a 3-5 hour pre-op appointment for Tuesday and once that is done I should know a little more about what is to come.

 

 

 

 

 

 

Serious Injury Time

It’s that time of my life again. I am thoroughly petrified at the thought of having done serious damage to my body by another back injury. It was nothing of note, just some soreness and hip pain but after doing a cardio workout on Sunday my back felt very sore. That night I took Elyse to the bathroom and felt a painful twinge in my back. I took the next day off work and lay on a heating mat all day and took my pills. However, the end result once I was able to stand up was what seemed like massive shin splints in my right leg. However, I had lost about 75% of the lifting strength in my shin, causing my foot to droop. I am currently not able to walk properly, I can’t keep my foot elevated as I walk so my foot slaps against the ground as I walk. My doctor confirmed it is the same palsy as drop foot and did not give me any indication as to whether it would heal. Since I never recovered my thigh mass from the surgery and never recovered my hand feeling from my shoulder injury I am understandably scared that I may have a life long nerve damage that will cause me to limp for the rest of my life. The thought of never being able to run properly or maybe even do any kind of lower body work with any regularity makes me sick with worry. I know I am only on day 3 of this injury but the fact that I am still unable to walk properly is very frightening. This morning the pain was also back in my hip, I have to assume it’s part of whatever muscle thread was damaged by the pinch and the other muscles now are fighting to pick up the slack. I have a feeling I am in for a few weeks of pain and yet more lopsided lower body development.

This sucks. I really wish I had been fused the first time so that this pinch would have not had the ability to happen again. I am suposed to be going for an MRI and also to see a neurologist and a spinal surgeon. It may be time to go under the knife voluntarily this time to get this issue fixed for good.  I guess only time will tell but I can tell you that this time I will be pushing for a solution, not a band aid. My fear is that another spinal event could leave me with a paralyzed foot, or worse, some paralysis affecting my bladder or bowels. I know that disc replacement is common now where it was in it’s infancy when I had my original surgery and that alone gives me a little ray of hope from a surgery perspective.

Monday April 8

Abs and legs Crossfit style

20-30-40-30-20

Full crunch
VDSnap
Box jump
Squat
full situps
side crunch
1 leg squat
step switch

Wednesday April 10

Body Beast – Supervised not led

Biggest Loser – About To Commit Crimes Against Children??

It’ s all over the news about The Biggest Loser having kids between 11 and 17 on the show this season and while I am sure (at least I hope) that the approach will be radically different than that of the adults I still think that this is a very dangerous ratings grab. Much of my feeling is echoed by the following article but my overwhelming feeling is that these kids are going to be taught, purposefully or not, that exercise is something that takes work, dedication, pain and long term suffering. That’s simply not the message we should be sending. Although I agree that if these kids are obese and sedentary, they should be shown that there is a price to pay for their lifestyle, I am just not so sure that Ms. Michaels is the one to tell them. I am afraid that from a coaching perspective and someone who has coached kids 11-17 for many years that this could be TV’s next great trainwreck. Let’s hope for the kids’ sake it isn’t and that rather than using the treadmills and weights that these kids are out playing in the outdoors and having fun while learning that movement is preferable to watching TV. I would hate for the first exposure to exercise for a child would be a treadmill and a body bug.

http://www.athleticrevolutionsouthshore.com/biggest-loser-to-train-kids/