BSRD12 – The Swing Of Things

Changing-prioriteis-198x300So I guess I am into a kind of routine, walking during the day, mostly earlier in the day so I can eat after I am done. If not, then later in the day so I can have dinner right after. I am finding that I am not eating much at all, which is to be expected since I am not doing very much and my weight is relatively stable. Here’s an update on how the rest of the things are going and an insight into my next week.

Diet
Sticking with paleo obviously, trying to add more fruit and veg where possible, drinking coconut water where I can instead of coffee. I have smoked more ribs this week, the pork ones turned out spectacular but the beef ribs were a bitter disappointment. Also, the eye of round didn’t come out well either, but if I had some Au Jus it would have been acceptable on a bun.

Exercise
Walking is going OK, I took it easy last Saturday and took Sunday off, that meant that my hips have been much better the last couple of days. I find that when I walk I still get the shin pain in my right leg and I am still unable to heel walk on my right leg. However I am able to walk 2,5km like I did today at a decent pace. I still take my cane just in case but it’s a bit redundant so far. As far as other working out, I am restricted to limited bench, I haven’t even tried doing any pushups yet. I will be trying to expand my workout a little to get some shoulder work done and some bands work for my back, very limited since that it the biggest concern post surgery. I am also going to drop in some air squats so that I can work a little on my leg range of motion and strength to start getting back up to speed.

Pain
The surgery site is still very tender and the steri strips have not come off yet. I have very limited movement forward and that is when it’s most painful. My hips are better than they were, but they may go back to being very painful again after a couple of days walking we will have to see. The shins are much better, in fact no pain in my left leg at all but still some pain about 2 minutes in on my right leg. The pain seems to go away after a while, in fact once I have been walking for a while the hip pain also disappears but that it replaced by a feeling of fatigue that so far is preventing me from walking any further than about 30 minutes. I do still spend an inordinate amount of time laying down however, it’s a pain to stand for too long and too stressful on my back to sit. I am hoping that sitting will become easier so that I can return to a more normal life of standing and sitting, and saving the laying down for bedtime.
EDIT – I also wanted to comment on the hip and upper shin pain on my left leg which should  be unrelated to the back surgery. I get a quite sharp and intense pain in the very top part of my shin almost at my knee on the exterior side. It’s a real discomfort and I can initiate the pain severely if I lay on my back and stretch my left leg straight above my body stressing the hamstring and pulling the whole anterior chain into effect. For some reason that gives me excruciating pain in my shin, and I realize that it’s probably a ITB thing tying into the low back which hasn’t been stretched and is antagonizing the hamstring and thereby pulling on the knee but when it happens, it really doesn’t seem to make a whole lot of sense.

Other
Nicole’s truck cost $1000 to fix but drives like new. It still could use another $2000 in various repairs and I think for that reason it’s about time we parted ways. With the limited kms on her schedule a lease would be much more sensible and would enable her to be covered under warranty 100% of the time. Nowadays places even throw in oil change schedules as well.
Lightning is much better, although still not exactly a frisky feline. We spent a week giving him fluids under his skin twice a day and it seems to have worked to some degree. He is going for more blood tests Thursday so we will know exactly just how well it worked then.
The weather has been just great for being outside, the mid to high 20s during the day so at least that’s one plus. People ask me all the time how I am doing, and I guess the appropriate response is that I am doing better and I think that is the truth. Each day brings it’s own challenges and pains but I think in the general scheme that I am on the upswing, and that’s the best I can expect at the moment. I do have to admit that it’s been better than I imagined, only because of the nightmare that happened last time. Still, it’s not something I would recommend as a fun time…

 

 

 

 

 

 

 

BSRD9 – The Weekend Is Here

I just wrote several paragraphs that got lost due to the inexplicable frailty of the ridiculous Bell internet service we have. I am not going to repeat the effort, so here are the basics.

Hips still very painful, intermittently so.
Will skip walking tomorrow to see if it helps.
Walked downtown yesterday, not impressed with it.
Some idiot St Mike’s employee stole my cable, but not the USB adapter.
The tenderloins were amazing, eye of round not.
Went to farmers market this morning, no brisket.
Back not really that painful any more, but hips seemingly not recovering or improving. Also not responding to heat. Confusing.
Nicole needs a new truck, hers is dying.

BSRD7 – Smoking meat

20130502_150416It’s day 7. Yesterday was unremarkable due to the fact that my walking was replaced by some shopping walking (30 mins) and a visit to my girls at gym which, I am very happy to announce, was far more pleasant than the last.

Today however I have discovered a couple of interesting things.

First, I can once again pick things up with my toes on my right foot. This is pretty major since I don’t always have my grabby tool with me when I need to pick something up. I can reach my bent leg on either side so now I am officially ambidextrous again with the foot grab.

Second, my foot is now strong enough that I can take my running shoes off without using my hands. This means I can lift my toe high enough and push hard enough to leverage off my left shoe with my right foot. Both good signs I think!

I spent some time trying to figure out a way to do curls without stressing my back. This is a tough one to do if I am trying to have zero impact. I can use the bench but the incline is too low and I am far from being able to raise the bench by myself. I may try out some bands but I still need some way of stabilizing and supporting my elbow to prevent the load from transferring to my spine. I am also mentally wrangling with how to do any kind of shoulder exercise and wondering how long it will be until I can do pullups again.

I walked to Blacks to get photos at lunchtime, it’s been beautiful weather here recently and the forecast is for another 7 days of sunny warmth. I may actually get a tan this year! The walk was only 2.2km but before I left I was having serious hip pains. They went away during the walk but after last night laying awake due to pain in both my hips I am starting to wonder exactly what is causing it. I took some tylenol but it seems that the best thing for the pain is more mobility. Unfortunately if that is what is causing the pain then I am in a real pickle!

I made some caramelized onions in the crock pot last night and some pork tenderloins and eye of round in the smoker today. The tenderloins were in for 1 hour of heat, 3 hours of smoke and 1 more hour of heat and came out amazing. The eye of round is still in the smoker after 5 hours getting one last hour of heat.

BSRD5 – Honeymoon Is Over

keep_calm_and_keep_going_by_forgedrains-d5fzp6n

I wondered when this would happen. And I suppose I knew that the answer would be linked to my stopping the painkillers. Now I am not some kind of masochist, but after the horrible side effects, both short term and lifelong from the last time I had my surgery I am more than a little concerned about the length of time I subject myself to oxycodone. I bought some tylenol today, or I should say Nicole went in and bought me some so to a degree things are a little better on the pain front but then again it’s a little like putting a bandaid on a severed hand given the amount of discomfort I am able to feel. What exactly is it that has happened? Well, it’s much like the weightloss plateau that people seem to run into after their first happy couple of weeks losing weight. It’s the inevitable knock back down that comes with having pulled yourself up onto unstable feet. It’s the predictable fall that comes after the first few baby steps. But not to worry, after all life has taught me that if there is one reaction that should be as predictable as hardship, it’s the heart to get back up and keep on going.

I walked again today, my longest yet to Tims and back a total of 2.2km. It was actually a real struggle for me since I have been feeling nauseated all day. The walking is not to hard, although I have to be super careful of my posture and not letting my right leg wander out of line as my shin starts to lose it’s effectiveness. However, the foot slap was gone for the duration of the walk which is progress. I didn’t have any ill effects from my bench testing yesterday which means I may try some tricep work tomorrow just to test out the equipment the way I have it set up.

I managed to get Lighting his subcutaneous fluids this morning, and with Nicole’s help again this evening. He seems listless but I am not really surprised given what he has been through. He is eating the low protein food they gave us for him so things certainly seem to be moving the right direction. I guess that is the best news of all for both of us, we are both moving in the right direction, sometimes quickly, sometimes slowly but the general movement seems to be positive in nature.

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…