Monday, September 29, 2014

Daily Supplements

I guess it's worth noting as a factor of recovery, what supplements I'm taking on a daily basis - as is what I'm eating, but I'm not logging that right now. (I have in the past and it may not be a bad idea to start the fool log / journal again, but I haven't yet.)

I've been taking regular supplements for years now. There is some variation, but what I'm listing here is the base and at times I will add others based on my exercise level and intensity. I take a morning and evening dose and will label them with AM and PM respectively. Over the years I've preferred to choose individual items over the blends available as they often share many of the same ingredients.

  • Super B-Complex - AM, PM
  • Performance Multi - PM
  • Magnesium 400 mg - AM
  • CoQ10 300 mg - AM
  • Flaxseed Oil 1400 mg - AM
  • Glucosamine 1500mg w/ MSM 1500 mg - AM, PM
  • Calcium 600 mg - AM, PM
  • Vitamin C 1000 mg - AM, PM
  • Taurine 1000 mg - AM
  • Fish Oil 1000 mg - PM
  • Milk Thistle 175 mg - PM

I've never had a hair sample, but my over all health has been very good for many years. Until taking time for my knee surgery, I used 2 sick days about 2 years ago and none for over 2 1/2 years before that. When I feel sick, I will typically go for a run or ride and let my body do what it does best ... kill the invaders!

I guess the bottom line is "quality of life". This is part of my routine to keep mine.

Sunday, September 28, 2014

4 Wks Post Meniscus Repair - still no weight bearing...

I saw my physical therapist this at 4 weeks and a day after surgery. The range of motion (ROM) was 5 - 105 degrees. I've been doing my 'assigned' exercises and stretches daily and have even added some core exercises that I was told to drop: bent knee situps (old style) and the basic plank. Both, I was told, can put stress / pressure on the knee. I also learned that you shouldn't ask your therapist if there is more you can do; because there are always more exercises or the addition of an ankle weight or a ball under your foot ... needless to say, I actually worked up a sweat doing my 'enhanced' exercises at therapy!

It is difficult to not put a little weight on it here and there: in the kitchen, in the bath room, when I'm sitting and my foot is resting on the floor, ... but, I am trying to not put my weight on my left leg / foot. There are only 2 more weeks. I will see the Dr at 1 PM and then go to therapy at 2 PM with the expectation to be worked hard: which will include weight bearing, cycling, and I don't know what else.

I still have little waves of discomfort in my knee. Usually at the end of the day and sometimes at the end of a nights rest. My normal routine is to do a full set of exercises as soon as the kids are off to school so I can get everything stretched out and going for the day.

I've seen several articles, but not conclusive evidence supporting the conservative recovery program that has me waiting 6 weeks before I put weight on my knee, compared to the more aggressive that may start at week 3 or 4. I feel like my body is ready, but I am choosing to honor my Dr's instruction to wait until 6 weeks.

Not much else to report. Still doing my exercises. Once I locate an ankle weight I'll continue with some 'enhanced' exercises too. I've watched several seasons of several series on Netflix... often while I'm doing my exercises. There's some funny and interesting stuff out there.

Saturday, September 20, 2014

3 Weeks of, Post Knee Surgery, Physical Therapy completed / Sudoku Solver

Three Weeks of, Post Knee Surgery, Physical Therapy completed .. how many more??

Compared to my entry before this, my first page of record keeping is full and today started a new page. And the photo of my knee .. not a whole lot different (no stitches now, maybe just a little less swelling).

At two weeks, the Dr removed the stitches and said it looked good. I was told that some of the swelling that is still present will likely stay until I'm able to put weight on my leg and start using the muscles - which will work the fluid out of the area. The first 2 weeks I was seeing the Physical Therapist twice a week, but now it will be 10 days when I visit again. (Part of that is insurance related - they only cover a limited number of visits, and the visits once I can put weight on are more important than now as long as I continue doing what I've been told to do).

I currently have a routine that takes about 60 minutes. That formal routine I like to do twice a day, with various other informal exercises sprinkled throughout. My normal routine is:
  1. - heal prop for 5 minutes (can and sometimes do for longer)
  2. - calf stretches (6 sets of 16 seconds with 5 seconds rest [6x16,5r])
  3. - hamstring stretches (6x16,5r)
  4. - front leg raises, squeezing the knee with quad muscles (6x16,5r)
  5. - side leg raises, squeezing the knee with quad muscles (6x16,5r)
  6. - hip raises (6x16,5r)
  7. - passive stretching (letting leg hang over table and go through 0-90 range) (5 minutes)
  8. - using a green band around my foot, working the foot in all 4 directions (20 each dir)
  9. - standing leg raises (move left leg front, side, back)(20 reps, 2 sets)
  10. - electrical stimulation on quad muscles while heel propped  (10 minutes)
  11. - ice treatment (10-15+ minutes)
I am able to remove my brace when I sleep now, that helps, but sleeping is still not always very restful. I've driven myself in our mini-van to a few places, so I can drive when necessary.

For the next 3 weeks, I've kind of got the routine that I need to follow down, with possible changes when I see my physical therapist this Friday.

What have I been doing with all this time at home and not really able to 'do' anything that requires walking of carrying anything? Well ... as a long time software developer ... I'm drawn back to writing software. My wife has become quite the Sudoku Master, so I'll do games with her occasionally on her Kindle, but have found myself writing a Sudoku solver. So far what I've got written will solve all the puzzles I've thrown at it.

Today I looked for very difficult puzzles and found one that my solver didn't solve. It turns out this puzzle requires the use of a technique called XY-Wing. I think I understand the concept now, but, the difficult part in this program, isn't just understanding different solving techniques, but in the ability to understand it well enough to be able to come up with logic and data structures to duplicate what we so easily process in our mind. As time allows, I will be adding some logic to handle this technique and then hope to be back up to 100% on my solve rate. (If you've got a puzzle for me to solve - send it my way. :-) Currently the program runs on my Windows desktop, but I am considering porting it from C# to Java and putting it on my Android phone, ... we'll see. I like the Android environment and have considered writing software again for it specifically. Just need to come up with the 'killer' app!

It's important to keep my mind active ... even if my body is not!

Monday, September 8, 2014

Physical Therapy: Good, Bad, .... Ugly!?

Physical Therapy: Good, Bad, .... Ugly!?

Physical Therapy: for those who have been 'broken' by this word, we all share a journey of healing, through a path of perseverance, mercy, help, discomfort, pain and time. It's a great option to have.

Photo1: It's been 3 days now since we've put up an old table in the front room, where I spend most of my time now. This table is kind of like my office, for my exercises that I'm doing for my therapy. It's a sturdy table that I can lay on and move around on and can hang my legs off for passive exercises as well. [On the table is a mat, the remove for the stereo, the home phone, my cell phone for timing exercises, my strap, my drink, and a place for me to elevate my foot for the most painful exercise of them all - the heal prop: where my foot is propped on the stool and foam roll with gravity providing sufficient force on my knee to cause discomfort/pain as I stay still. Today I did 10 min's and 11 min on my second set - a PR (Personal Record).]

Photo 2: this is my log book for my Physical Therapy. I like to record everything - it helps me be motivated and also encourages me as I can look back and see progress and perseverance. This log started on Friday: 1 wk and 1 day after surgery (2 weeks after my injury).

Photo 3: it hasn't been that long, but it looks like I'm already seeing some entropy of my left leg. I'm also having trouble firing the muscles of my left thigh. It is getting a little better, but still not in complete control. My therapist has suggested that I get an electro something that I attach to my muscles and it stimulates via electrical signals. My son has some device that kind-of looks like an ipod and I've been using that in the interim and it makes my muscles fire. It doesn't quite hurt, but it's in the grey between discomfort and pain.

So the Good, Bad and Ugly:
- the good would have to be that I was able to do my heal prop twice today for a time of 10 minutes - which is the suggested amount of time and its the first time I've been able to do it that long.
- the bad would have to be being at home and not able to do the things I enjoy (cycling, mountain biking, lifting weights, golfing, projects and tasks around the home, walks, ... etc).
- and the ugly would be my left leg ... wasting away....

Thursday, September 4, 2014

First day of Physical Therapy

Yesterday was my first trip and first time ever to physical therapy. It wasn't as bad as I was expecting ("I was expecting to be forced though painful exercises"), but instead found myself forcing myself to do these simple but painful exercises! (Pretty clever, having me torture myself.) The range of motion of my knee is what were working on now. Still not allowed to stand on it or have any weight on it .. for another 5 wks.

The following exercises are what I'm to be doing:
- Hamstring Stretch: with my recovering leg out flat, lean forward until there is a gentle stretch in the back of my thigh and behind my knee: hold for 15 seconds, 6 reps, 2x / day
- Calf Stretch: with my leg flat and straight, put one hand on my thigh and the other using a strap, pull my toes toward me for a gentle stretch in my calf and behind my knee: hold for 15 seconds, 6 reps, 2x / day
- Heal Prop : (my most painful exercise right now) keeping my knee straight and my foot raised up on a foam roller, totally relax and let the weight of my leg pull my knee straight into extension. Keep leg propped up for 10 mins without interruption: 6x / day (can't make it the full 10 minutes yet due to pain in my knee.)
- Quad Set: tighten both quadriceps muscles for 5 seconds trying to get the back of my knee flat against the table during the muscle contraction: repeat 30x, several / day (I can't really do this one either. I seem to have little control over the flexing of my left thigh. Sometimes it does and sometimes it won't, I've never had a problem flexing or controlling muscles before.)
- Passive Knee Flexing Motion: Sit at the edge of a bed or high tale with recovering leg supported by the 'good' leg. Totally relax the recovery leg and use the other leg to bend the knee as much as possible . Repeat for 5 - 10 mins. 2 x / day. Preferable to bend knee up to 90 deg.
- Ice Therapy: elevate leg above heart and use ice machine for 20 mins every 2 hrs daily.

My bed is a little soft and the floor is to low (to hard to get down and up), so I'm still figuring out where and how to do these. But I am doing them as best as I can right now.  I will go back tomorrow as the Physical Therapist (PT) wanted me back soon for a check up. Hopefully there will be some progress over my first visit.

The photo captures my Grand daughter who was over this week, and developed a sympathetic pain in her right leg that required her to walk around the house with crutches! It was very sweet ...

The photo not here, is of me going to Costco with my wife, where I'm using one of the electric carts ... if you every want to be invisible, try using one of those. Wow, I'm still unwinding that experience...

Friday, August 29, 2014

Inner Knee Photo's

 These are photos from inside my knee taken yesterday during the repair of my Meniscus.

Post Surgery Report (large bucket handle tear of the medial meniscus)

Post Surgery Report
It's about 11 hours shy of being 2 weeks since that memorable experience of feeling like my left knee was going to explode! And it's about 20 hours since having the Meniscus tear repaired during surgery, rather than removed (something the Dr was not thinking would be the case, or at-least the percentages were telling him it wouldn't be).

Pre-Surgery work out: I haven't been able to do much these past 13 days aerobically, so I've done a few weight training work outs. This morning I did pullups, pull downs, neck/shoulder, biceps and forearms. What I could manage while keeping most of the weight on my right leg. As for the why, when I was told not to eat or drink anything starting at midnight the night before? The weight training is good for your bones, blood, ... I don't think I know all the benefits and maybe some of them are a placebo, but for me - they work. I felt like it was important for me to do to help the inside of my knee to be the best for healing it could be. I don't know when I'll get to work out next (I'm guessing the first 3 weeks will be no weight on my leg at all), then rehab will start...

Checking In: The time at the surgery center was excellent. My wife and I got there on time 10:00 AM, with maybe a dozen people in the large but nice waiting room. Before I was able to sit down with my clipboard, I was called up to the desk and sat in the chairs while the assistant helped me with the paper work - as the Dr was one his way and wanted to do the procedure as soon as I was ready. This process took maybe 10 minutes; and before I could get up they were calling my name from the door to go back in.

Behind the doors: Once in, the area looked similar to a hospital emergency, but with out all the noise, activity and people standing around. All the bays were curtained and once my wife was sat down, I was taken to the restroom and given instructions to 'change' into appropriate clothing: hair net, gown, underwear, grippy socks and a covering over my right knee that was used for pumping blood through my leg during the surgery.

Back in my bay, the nurse who checked me in was very nice and competent - as were all the people I came in contact with at this surgery center. Everybody I meet asked my my name and birth date, more questions from a second nurse, then she started shaving my knee which included about 3 inches of my thigh and the majority of my shin. While this was going on the first nurse put in the IV port with not to much pain - but it was the most I felt in the whole procedure, followed closely by the pain of pulling the hair out of my arm when it was removed before leaving.

I spoke with the Anesthesiologist: listening to him describe the process and then was able to ask him some questions, as well as letting him know I didn't want to take any narcotics for pain. The general Anesthesia was a narcotic which was fine. I was also given some type of gas during the surgery by a tube in my mouth (which only bothered me slightly last night).

[My reason for not wanting the narcotics is that when I was in my late teens, I broke the humerus in my left arm and was given a strong narcotic for pain and remember the feeling it gave me and the hallucinations ... not something I want to do again. It was almost like I had no control over my own thoughts and the hallucinations were dark and even frightening.]

One of my Pastors, and my friend, was there with my wife after I came out from changing and before they wheeled me off, he lead a prayer for all involved. I was then wheeled out and went into the surgery room. It was a larger room with lots of equipment on wheels so everything could be easily moved around. The anesthesiologist was the one talking to me in there: told me he was going to put a tube in my mouth and why, but I can't remember the details ...


Post Surgery: I woke up in a bay with a curtain around me (what turned out to be the North half of the initial area). I was told he repaired the Meniscus instead of the Menisectiamy (SP). My left leg was wrapped from high thigh to mid foot in ace bandage like material. Over that was a very stout knee brace that was locked in a slightly bent position. Just under my knee coming out from the ace bandage was a large blue tube that was hooked to a portable ice box. That is the modern replacement for an icepack. It works great as it circulates ice water from the cooler through some type of pad around my knee. It kind of reminds me of a bait tank aerator. The nurse removed my IV port and a few hairs from my arm. My wife helped me get dressed and then I was wheeled out to our vehicle by wheel chair.

My Leg: As for the incision and gauze and area immediately around the knee ... I don't know what's there or what it looks like. I suspect I'll see it today when I go in for a Post-Op meeting with the Surgeon this afternoon. I will also get to see pictures and maybe video of inside my knee.

The pain and discomfort has been not to bad, but my wife and Dr suggested I have the pain meds available just in case, which I do. At this point I would say in aches more than hurts.

I will update with photos if I get some today.

Bottom Line: All in all - I'm very thankful: for my family, for skilled professionals, for repair over removal, ... so much to be thankful for, especially to my God who is with me and promises to always be!

Thursday, August 21, 2014

A "Bucket Handle" tear of the Medial Meniscus

It's been almost 5 days now since I injured my left knee. After the weekend I've now had an MRI (with a diagnosis of a bucket handle tear of the medial meniscus), seen an Orthopedic Surgeon and now have a surgery date set for 1 week from today.

The following entries will be an attempt to document the process of healing and rehabilitation with the hope and intent of getting back to 'a life of training'.

I have stepped back from weight lifting which I will start back up again today since I am no longer able to get any aerobic exercise in my regular forms (mountain biking, road cycling, running, golf, ...).  The weight lifting will focus on strengthening of my upper body.

The recovery is dependent on so many factors:
  • what is done in the procedure (which won't be know for certain until during the surgery [removal or repair of the torn meniscus flap])
  • blood flow to the area
  • current damage to the meniscus
  • rehabilitation program
  • overall health
  • ... lots of other variables, some known - some not

It's a new path - but God is still God.

Tuesday, May 20, 2014

What a golf ball can do...

I regularly hit golf balls in my back yard, into a practice net designed to contain them ... or so it's supposed to. A few months ago I was hitting with my driver and I wacked one and then heard the trees in the back by the fence making noise like a golf ball was flying through them ... I never saw that ball again, nor did I hear it land. I repaired the hole in the net, but it happened again a week later and I decided that I could no longer hit my driver into the net ..  having a golf ball leave the yard like that is tooo scary!

Forward to today: I have the practice net in front of the wooden fence to serve as a stop for any balls that go through the net. I have sense made several repairs to the net. The dent left by a golf ball hit from a 3 iron leaves dimples on the fence that you can feel. Today, I found out a ball hit by my driver will do to the fence after it goes through the net ... break it. (My swing speed said the driver was swung at 115 mph, which is my normal driver speed.) So, I'm now thinking that the fence is not a good back stop and will hit shorter irons until I figure out another solution to keep balls in the back yard. I also have "Birdy Balls", which I've broken, but not the professional line of them. And I'll hit foam balls too. They're fun to hit, but can go over the fence's too; but they're not breaking anything.

On the Trails Again...

I have been casually looking for a used mountain bike (MTB) for several years now, something with at a minimum front suspension. The Diamondback Accent that I've been riding is a 7 speed x3, no suspension with standard brakes. My thoughts have been for a Cannondale Lefty. Why? I have a Cannondale R5000 road bike that I bought used that has served me well for years and thousands of miles through multiple states and from what I've read, the Lefty is a solid suspension (and strange with just a single shock tube up front). As is a pattern in my life, after waiting and waiting, three weeks ago I bought a used Cannondale RZ120 Lefty ... nice!! Thank you God - you always provide!
Cannondale RZ 120 Lefty

I've ridden it twice on the trails now and WOW, what a difference! Spots on the trail that would beat me up and rattle my brain before; now are just ridden over ... so smooth - I kind of feel like a little boy on Christmas morning when I ride it. To describe what it's like: it's taller, it rolls better, the brakes work better, it's smooth, it's fast, ... it feels like I'm cheating when I ride it compared to what my previous bike was like! I am very thankful.

That being said, I still need to get used to it: the front end is a little light on steep climbs so I'm having to focus to try to keep it on the trail and pointed in the right direction. I expect to make some updates as I start spending more time on the trails and get used to this nice MTB. I will post "Numbers" as in the past in future updates.

It's nice to be on the trails again. My RZ may not be new, but it's about 5 steps up from my last MTB. Now I need to work on getting my skills and fitness up.
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