Description

An admitted shoe geek waxes philosophical about running, triathlon, and life in general.
Comments welcome!


Sunday, June 21, 2020

I'm Back....


I’ve got my spine
I’ve got my Orange Crush
REM, “Orange Crush”

“Get back,
Get back to where you once belonged.”
The Beatles, “Get Back”




A sneeze changed the course of history.

Well, I guess it didn’t quite change everything, but it changed a lot, related to my spine. Buckle up, this might get long…

So let’s back up (see what I did there?) to last year, winter, February 2019. It was a cold day, but not so cold… It had not rained, or snowed, but the driveway had iced up overnight, and the area in front of my garage, being in shade all day, remained icy through the day. When I came home from work, stepping out of the F-150, my left foot slid out from under me. I caught myself before the hard landing, but my left hamstring felt… off. Like I’d pulled a muscle.

That persisted throughout the spring, slowly getting worse through the summer. I tried stretching, some roller-work, self massage… It kept getting slowly worse. I just wanted to get through some cycling events in late summer, and then I was going to give it some rest and maybe seek professional intervention if it didn’t respond. So that gets me to August, where I aced my main event on the 12th, chopping a good 35 minutes from my previous best time on the ride up Windy Ridge (Mt St Helens). And then I started some tae kwon do classes with my young daughter. In the second class, it came to a head during some sprint warm-ups. Chiro, then PT, a MRI, and it was confirmed – herniated disc at L5-S1 (the bottom-most lumbar vertebra where it causes the most frequent complaint of “sciatica”).
The 9-30-2019 MRI revealed a significant
L5-S1 Herniation.

There was more following, a lengthy process to get a cortisone injection that lasted all of 2 days before all the pain came right back. I returned to the pain management clinic (who did the cortisone injection), and they suggested two courses of treatment: another cortisone injection involving the L5-S1 AND the L4-L5 discs, or going with a microdiscectomy. For those not familiar with that procedure, basically they open up access to the spinal column and use a slurpee spoon to suck out the offending portion of the gelatinous disc material, with the idea that the fibrous outer perimeter can heal. I decided I wasn’t going to mess around with another very likely ineffective injection and go straight to the surgery route.

And that was right as the COVID-19 lock-down hit. No non-essential procedures at the hospital. I was in a holding pattern.

Finally, near the middle of May I got a surgery date of June 29th. There was light at the end of the tunnel.

All this time I’ve been working from home. The company I work for has (wisely, I think) kept those who can work from home doing so. But the desk chair I’d been using was pretty miserable (it has since been replaced). One early morning while sitting in from of the computer, I happened to sneeze. That was about May 20th. I immediately felt like I’d pulled a muscle in my back. Rather uncomfortable, but not debilitating. But it persisted, and on the night of May 30th it was excruciating. I couldn’t sleep most of the night because of the pain.

Sunday morning, sitting at my dining room table next to my young daughter, as she was finishing breakfast, I stood up. As I side-stepped to exit from my chair, my left leg moved as normal, but my right leg felt like it was caught on something. I pulled harder, and it slowly came out… And there was nothing there. Hmm… As I stepped away, I almost fell over because my right leg kept kicking out to the side. I shambled around for a little bit, then finally went to lie down. Along the way, I discovered that the pain in my back was gone…

In many ways, having the pains down the back of my left leg, but the muscles for the most part are functioning well, is much less disconcerting than no pain with muscles not functioning properly.

My mind was thinking of the possibilities – stroke? MS? Or…?? I went through my own little F.A.S.T. test, and while it was encouraging I knew it wasn’t definitive that I hadn’t suffered a stroke. But still… My wife made a quick appointment with the local Urgent Care doctor’s office, but they couldn’t do much in the way of testing, so they sent me to the local ER. Still no definitive answers, but they eliminated stroke as a possibility, and felt that likely I had another disc issue.

Lovely.

I had my pre-op appointment with the surgeon (the PA, actually, but he’s the proxy for the surgeon in the pre- and post-op meetings) on the 16th, but I didn’t want to wait that long. I scheduled another appointment to talk about this new development. We met on the 2nd, the outcome being that it was likely true I had another disc issue, but that the normal course of action would be the “conservative” approach which had landed me in a now-9-month-plus ordeal with my left leg. I kind of insisted on at least an MRI, which they agreed to order. On the 12th I got the MRI, and the results arrived to me the morning of my pre-op: significant herniation of the L3-L4 disc, causing displacement of the nerve.
The 6-12-2020 MRI showed a severe
L3-L4 Herniation.

At my pre-op appointment, I basically just asked the question of “if surgery is a suggested course of action, wouldn’t it make sense to do it at the same time as the L5-S1 discectomy? Even on the insurance end?” The PA wanted to talk with the surgeon… Within 5 minutes it was decided that, yes, this would be a good course of action, and it was all put in place. Assuming my insurance agrees, I’ll be having both locations sucked out on the 29th.

But the L3-L4 discectomy is a little more involved, because of how it has herniated – it might well entail removing part of the vertebra, the “fin” portion that protrudes backwards and shows as that ridge in the back when flexed forward. And recovery will likely be a bit longer.

So, a sneeze. Kind of ridiculous.

Friday, December 6, 2019

Doing it right is more important than doing it fast

Words echo in my head as I listen to our tae kwon do instructor, Master Hubbard, impressing on the class to make their best effort on every move. It was a zen lesson I’d read many years ago, the actual story lost over the years, but the meaning stuck

How you do anything is how you do everything.

What does this mean? To me, it conveys an idea that your art is defined by your weakest link. That your real character is revealed by your lowest point, not your highest.

That probably sounds rather harsh. But read it again – how you do anything is how you do everything.

It doesn’t say you have to do everything perfectly. It doesn’t say you’re expected to hit the center of the target with every attempt. It does say, though, that you should approach every attempt with the intention of doing so.

When it comes to an art, applying yourself to the form is the goal. I’m reminded of a show I watched many years ago that was featuring the Japanese art of equestrian archery – yabusame. The targets for this art are quite small. But the part that struck me was when the narrator emphasized that the goal was not whether the archer hit the center of the target, but rather how the shot was made.

In weight lifting, form is everything. It’s what protects the lifter from (sometimes very serious) injury. Especially to a beginning lifter, form is WAY more important that how much weight is lifted. Develop the form with low resistance, make it as natural as blinking your eyes, and the weight will come.

In swimming, most speed issues are really form issues. One can grind out endless slow laps, but all that does is ingrain bad swim form and make the bad habits harder to break. I’ve been there. I spent several years in triathlon doing fairly well but playing a lot of catch-up once I got out of the water. I was “okay” at swimming, but not really good. I’d never been a competitive swimmer outside of triathlon. No one every took me aside to point out what I was doing wrong. I made an epiphany one day about my swim form, and my speed increased immediately. I was faster with less effort.

But the meaning spreads into life outside of any athletic endeavor. How do you approach your job? How do you interact with people? How do you drive?

In the more recent rendition of the movie The Karate Kid, Jackie Chan has an excellent line when finally revealing why he’s been having Jaden Smith pick up his jacket, hang it up, and then throw it back on the ground continuously for several days: Kung fu is in everything you do, and everything you do is kung fu.

The lesson in the tae kwon do class was this: Doing it correctly is more important than doing it quickly. Quickness will come.

There is no easy way, so stop bargaining with the effort of getting there. Especially when the prize is what you become along the way.

Wednesday, November 20, 2019

Looking back...


It’s been a tough couple months. Almost three months now, actually.

As I last posted, I had started a tae kwon do class with my young daughter in August. And I’ve enjoyed it thoroughly. I’m getting close to my first belt test for the “advanced white belt” – yeah, that means I’ll be an absolute oxymoron (some would say “minus the oxy”), an advanced beginner. But it’s been with some struggle, along with some time on the sidelines.

You see, I got injured.

My wife warned me. She cautioned me about not pushing myself. She said I need to really take it easy because these are all moves I am not accustomed to… And she’s completely right. But it wasn’t actually the tae kwon do that injured me.

It happened not long after my last post. As in just the day after I posted. My second class.

I knew that these first classes would have a lot of unconventional things in them, being that it was the week leading into the belt test for the students that were already in the class, so it included a lot of “fun” kind of things to unwind a bit. After just a few warm-ups, we went into some line sprints. On the second sprint I noticed that my left foot was dragging on the stride recovery. And on the third sprint I felt something “go” in my low back. My left hamstring locked up, and I hobbled in. I finished the class, with squats and roundhouse kicks and all, but was pushing down pain the whole time. It wasn’t debilitating, but certainly wasn’t comfy either.

And this started me down my current path of chiropractic treatment (ineffective), an MRI which revealed the issue, physical therapy (also ineffective), and to where I am now which is waiting out the insurance approvals for a “guided injection” that should happen in about 5 weeks.



But this really goes back MUCH further. February of 2019 was a cold month, and my driveway got pretty icy. On one of those icy days I was climbing out of my truck, just getting home from work, and my left foot slipped. I didn’t fall, but it was a comical contortion of catching myself on the door and nerf bar. My hamstring really felt it, and for a couple months after I suffered from a lot of hamstring cramps. I just figured I’d pulled the muscle, and it was being slow to heal. You know, being an old guy and all, recovery needs more time.

The stiffness in the left hamstring kept increasing, but it didn’t affect my riding, so I delayed having it checked out. I wanted to get through my events before looking at potential time off.

Looking back, though, it’s clear that these were the early symptoms of the issue that became suddenly much worse in that second tae kwon do class – a lumbar disc “extrusion” between the 5th lumbar vertebra and the 1st sacral vertebra (aka. L5-S1). This is compressing the sciatic nerve, and causing pain, loss of strength, and sometimes tingling and numbness down the gluteal muscle, between the ilio-tibial band and hamstring, and down into the calf, as well as weakness in dorsiflexion of the left foot (pulling the foot up).

The MRI revealed several degenerative issues in the lumbar spine, the official diagnosis being that my low back is "messed up". But most of those things are somewhat common in my age group, and aren't causing symptoms currently. The real concern is that L5-S1 disc extrusion.

I ended up taking over a month out of the tae kwon do classes, but I’ve been back in and doing everything my pain levels and mobility will allow. I’ll have enough classes to take the belt test in December, and I’ll only be a month behind my young daughter.

And that is about when the injection should happen. And while it won’t solve the underlying structural cause, I’m hoping that it solves the pain and flexibility issue.