The good kind of sore

I was talking recently with a fellow spine sufferer about the differences between good and bad sore. Good sore are muscles fatigued from exercise. Bad sore are angry nerves, torn ligaments, strained soft tissue, basically anything that prevents you from moving the way you would normally move.

All I've experienced for the past seven months has been the bad sore, the limiting sore, the 'when is this gonna end' sore. So you can imagine how good it feels to finally feel my muscles working again! My calves and quads are tingling with delight after another workout on the Santa Monica stairs. Three laps and I had plenty in the tank for more, but I chose to play it safe and live to fight another day. I've come to appreciate the smallest of victories.

View from the top of the stairs

My back is tight, the SI joints are a little en fuego, and I can 'feel' the disc in my back. It's hard to explain what I mean by 'feeling' the disc. My mind knows it's there, and my body can sense it, but I'm not sure if the mind or body is in charge of this particular sensation right now. My legs and glutes are beginning to wake up and remember how to function properly. It's still difficult to sometimes distinguish between a healthy burn in my glutes and a precursor to real pain, but thus far the real pain hasn't reappeared for a couple weeks.

This week I'm back in the pool and will start doing some hikes in the Santa Monica mountains. Get ready to burn!

I sneezed

And it didn't hurt!

That is all.  Carry on.

Week 4 post op - It's just a jump to the left...

...And then a step to the right.

Week four was interesting. Things started off well, took a dip, then picked back up. I had a rough few days last week. I maintained my five miles a day on foot and continued stretching each day, but my low back started to get especially cranky, which made me jittery. A persistent burning sensation set in, followed by a familiar tightness that I was hoping I had left behind in Germany. But I calmed down and reminded myself that this recovery won't always be a march forward. Sometimes a lateral move isn't necessarily a bad thing, especially if new pains replace old pains.

I hit the Santa Monica stairs again this morning and was able to actually push hard enough that I was winded half way up. I'm sticking to two laps per day for this week so I don't overwhelm my quads and hamstrings, which haven't seen any real action in so long they had all but closed shop for the winter. I've increased my daily output to six miles for this week, and finally picked up a decent pair of trail running shoes which have helped tremendously! 

My tolerance for sitting and standing hasn't increased much, but my comfort levels have. I'm good for about 20 minutes in a restaurant before I need to stand up and walk around. But I don't stand in one spot for too long. I'm constantly bobbing and weaving to keep things loose. Fly like a butterfly, sting like a bee! Basically, I feel better when I'm moving, so I guess I can't stop moving. I'm like a Great White shark - If I stop, I die!

Where I notice marked improvements are while doing routine motions. Two weeks ago I had to hold onto the car door and gently lower myself into the seat, making sure not to twist. Last night I nonchalantly stepped into my car, and it wasn't until I turned the key in the ignition that I realized I hadn't braced myself before getting in. Another positive sign is the sneeze test. Two weeks ago even the hint of a sneeze left me petrified. But I sneezed not two minutes ago, and the laser like sharp pain has been replaced by mild discomfort.

So, four weeks out and I'm feeling OK. I stopped taking any pain meds before I left Germany and haven't reached for so much as an Ibuprofen since my return. Pain levels continue to fluctuate, but are definitely moving in the right direction. Mechanical pain seems to be decreasing, and remaining active helps keep my back and hips relaxed. I'm still limited in my movements, but slowly regaining my flexibility. My left hammy and groin still aren't quite as loose as the right, but it's getting close.

Again, I'm guarded, but optimistic!

Gettin' Rowdy

I managed two laps on the Santa Monica stairs today. I could have done more, but I know if I pushed it my hamstrings and quads would have been useless for the next week. After only two laps I'm sure I'll feel it tomorrow. My back didn't feel too bad while climbing the stairs, but going down I took very light steps. The back was tight, but no serous pain. It was the first time I've raised my heart rate above 130 since last summer, and I actually got a little light headed near the top. Nice to finally activate my glutes, too!

It's rare to hit the SM stairs and not run into a celebrity or two. Normally you see a lot of character actors and pro athletes on weekends. Today, UFC champ Rowdy Ronda Rousey was training at the stairs. That is one solid woman. She fights at 135, but she easily walks around 20 pounds heavier, and she wears it well. And no, I didn't take any pictures. Only tourists who aren't used to seeing the occasional celebrity reach for their cell phones at the first sight of someone famous.

So, today felt promising. Being sedentary feels worse than moving around. I still can't stand in one spot for more than a few minutes and sitting for more than 20 is difficult, as well. But climbing stairs feels pretty good...so far.

Nice rack

I've been unable to ride any one of my five neglected bikes since last July. Actually, I haven't been able to even look at them. I thought of removing the bike rack from the Mighty Fit, but each time I consider this it feels like I'm giving up. So I left the rack in place to serve as a bumper guard for now and also as an incentive for getting healthy again so I can get back to pedaling.

Today is March 21, exactly three months from the summer solstice, which I have penciled in as my return to cycling. My ultimate goal is to be back on a mountain, any mountain, crushing climbs and descents on my single speed, but that's much further into the future. For my immediate plans I'll settle for tarmac.

As for my current status, the past few days haven't produced any real big changes. A fairly strong, constant ache has taken root in my low back, but the sharp pains have almost gone away.  Not exactly progress as I've swapped one pain for another, but it's not a step backwards either, so I'll take it.

The tightness in my groin and hips is fading thanks to the massage work, and my downward dog is getting easier to slip in to. My goal for this weekend is to tackle the Santa Monica stairs. 180 steps. Easy peasy.

3 weeks post-op

Well, it's been three weeks since I had Marlene (my new disc) installed. If I'm being completely honest about my recovery so far, I have to admit that I'm pleased with the direction things are going, knock on wood. I'm cautiously optimistic and don't want to jinx anything, but I'm feeling a little better each day.

When I returned home last Monday I was in a world of hurt after the plane ride from hell. I attempted a two mile walk the following morning, then paid for it dearly for the rest of the day. Now I'm walking about 5 miles a day without aggravating my back too much. I'm able to move more naturally and my stomach muscles are coming back. I can rise from a horizontal position using only my stomach, which is a huge step forward.

I credit much of my progress to the regular chiropractic treatments I've been getting. I cannot stress enough how important it is for anyone undergoing this type of surgery to incorporate massage and chiropractic into your recovery. And I'm not talking some 'snap, crackle, and pop' jockey. This is the last type of treatment any disc replacement patient needs. What you should research is called, 'Sacro Occipital Technique, or SOT: http://www.sotousa.com/wp/?page_id=14959

After disc replacement surgery your pelvis is likely to be both rotated and tilted, causing among other things, leg length discrepancies. All of the muscles and connective tissue in your back and groin area are basically locked, which can cause severe misalignment. In my case, one leg was almost an inch longer than the other, forcing my joints to take on an unequal load. I basically walked around the hospital like a pirate with a peg leg.

In the past week my chiropractor has been able to align my pelvis, so now there is no longer any leg length discrepancy and I'm able to walk normally. I'm still limited and move slowly, but my gate has almost returned to normal.

The pain in my low back has been tolerable, but I still can't stand for more than a few minutes in one spot without it starting to act up. The pain in my left groin area is tight, but improving with each stretch. My SI joints still burn at times, but this too is getting better. I can sit at a table and eat a meal without wanting to jump out of my skin, and sleep is slowly creeping back into my nightly routine. I've been adding different stretches to my repertoire and started doing face-down leg lifts in order to start stabilizing my SI joints.

A few days after surgery I was honestly scared that my life was over. But I trusted in the doctors who said I'd improve, and damn if they weren't right. Still a long way to go, but it feels like I can actually see a faint glimmer of the finish line ahead.

Onward and Forward!

10k per day

I downloaded a pedometer app to track my steps so I can monitor my progress. I managed a bit over 10,000 steps today, not counting puttering around the house. Based on some statistic I read, 2000 steps comes out to around a mile, assuming the average person's stride is 2.5 feet. So I racked up around 5 miles today. My goal is to maintain a minimum of 10k steps a day for the next week, depending on how I'm feeling. And each week I'll increase that number by 2k steps until I'm up to 20k.

My distaste for Los Angeles isn't exactly a secret. But I guess there could be worse places to recuperate from major surgery than Santa Monica. Next weekend I'll tackle the world famous 'Santa Monica Stairs' and rub shoulders with all the celebrities getting in shape.

No, this isn't me...yet.

"I'll take the hammy on rye, extra tight."

I've always focused on flexibility, specifically my hamstrings, IT band and piriformis. As expected, all of the muscles and tissue leading into my pelvis and hips are tighter than a mosquito's sphincter. Prior to surgery I could easily bend at the waist and place the palms of my hands on the floor. Now I can't even get my legs close to a 90 degree angle while laying on my back.

There's a certain, satisfying burn you feel in your piriformis when you stretch it out. Like scalding hot water trickling down your spine.  Unfortunately, when I attempt to stretch, that burn feels more like a raging wildfire at the moment. My body is holding onto the area in my left hip and SI joint like a hub cap in the fast lane.

My right hammy isn't that bad. I can manage to get into downward facing dog without too much drama. But the left leg isn't very happy when I try to straighten it. However, this is progress, because a week ago downward dog was a pipe dream. I'm sure the regular chiropractor treatments are helping greatly by opening up my hips and allowing me to move more freely.

That being said, I just sneezed and #$!&@% that hurt! I managed to let all the air escape painlessly with the first sneeze, but the second one hit harder and caused a momentary full body seize. I've never been a sneezer. Seriously, why now!? I can't seem to get through the day without a couple sneezing episodes. Talk about bad timing. The worst part is anticipating the sneeze and bracing for the pain. Your mind says relax, but your body says contract. Mind, tell the body to shut up!

Anyways, I'm walking around a combined 2-3 miles a day and started doing some light stretching and core work. Pain levels continue to fluctuate and I haven't had what I'd consider to be a good day yet, but it feels like I'm moving in the right direction. The tingling and numbeness/weakness in my left leg comes and goes, but while walking to the beach and back this morning my hips did feel slightly less wobbly than a week ago. Another small victory!

Una cerveza por favor

After a trigger point massage followed by a chiropractic session, I felt halfway normal enough to hit a local mexican place, sit at the bar and enjoy a plate of enchiladas and a Dos Equis.

"I don't always drink beer, but when I do, I chase it with an Oxy."

Stay thirsty my friends!

Slow down, you move too fast

I've decided to dial it back a little on the activity. For someone who is used to covering hundreds of miles a week on his bike, admitting I can't even walk comfortably for a couple miles isn't easy. So it's short, frequent walks for now, with lots of rest in between.

My chiropractor said my SI joint is definitely not happy, but he can get me straightened out with some work. I still haven't been able to sleep much, even with some pharma help, so I'm walking around in a sleep haze. But I'd rather be hazy at home than a hotel 6,000 miles away.

It feels like I wobble a little less when I walk now, so I'll call that progress and do a little gimpy happy dance.

Lost faith

I finally made it home yesterday afternoon after a not-so-pleasant flight. The airline somehow 'lost' my reservation for an aisle seat, which I explained I needed because I would be forced to get up and walk several times an hour because I had back surgery. The agent apologized at the gate and said, "Enjoy your flight." Her smile grated across my skin like a belt sander.

Unfortunately, not one person on the plane would switch seats with me after a flight attendant made a plea for anyone with an aisle seat to change with a passenger (me) with a medical condition who needed to stand frequently. So I had to settle with a center seat and make due with painfully climbing over the asshole on the aisle who refused to switch with me because he said, "The aisle is more comfortable." No shit!

Halfway through the flight he started getting annoyed, which I responded to by telling him, "Deal with it." I quickly stopped asking him politely to get up so I could get out of my seat and simply told him to move. If not for the nice German lady sitting next to me who entertained me for the 12 painful hours in the air, I probably would have elbowed him in the larynx somewhere over the Atlantic. Let's just say my faith in the generosity of human kind was pushed to it's limits at 5000 feet, and I walked off that plane with a little less of it.

But I'm home, still tired, raw as hell and looking forward to a nice, hot almond milk latte. Today I meet with my chiropractor and begin my slow crawl back to normalcy.

Let the healing begin!

auf Wiedersehen, Germany

It seems like I waited forever to get this surgery, and now that it's over it feels like it flashed by in the blink of an eye. This trip has been surreal in more ways than I can describe. The second guessing, indecision, fear, hope...you name the emotion, I've experienced it.

Now that it's over I can think more objectively about where I'm at. But during the first few days after surgery the pain and disorientation caused me to doubt my decision. While laying in the hospital bed after the operation I panicked, feeling like I had made the biggest mistake of my life. The day after surgery as the physical therapists were helping me out of bed for my first steps was easily the scariest moment in my life. Would I be able to walk properly? Could I bear weight? Would my legs buckle like an accordion?

My rational mind knew I would be just fine. But I wasn't thinking rationally. My thoughts were all coming from a place of fear. Over twenty years of pain, all coming down to this moment. The sense of relief as I put one foot in front of the other, then another, and another, was overwhelming. I smiled, truly smiled, for the first time in far too long.

At the risk of sounding dramatic, the pain that followed over the course of my stay at Augusta Hospital was 'next level', meaning I've never experienced such intense pain in my life. Nothing could assuage my fear during that time. I was told that everything I was experiencing was common, and that in time the pain would diminish. Again, my rational mind wasn't buying it.

Every day I'd walk a little more, increasing my pace around the 6th floor, waving to the nurses with each lap. While the pain fluctuated, reaching white hot peaks, I continued to walk, take the stairs, and practice getting in and out of bed with all the dexterity of a moose doing the waltz . Fear and hope continued their tug of war, each staking their claim, neither declaring victory.

I've been advised to be patient by doctors and friends. Patience is a funny thing, and people sometimes mistake fear for impatience. I know that my pain will improve over time, and any frustration concerning my progress (or lack of progress) isn't an indication that I'm impatient with my recovery. My frustration is based in fear. Fear that I might not return to normal, or at least a close facsimile of normal. No one who has been in pain for decades expects immediate relief. But we hope for progress, and when progress seems stalled it invites fear to step in and trick us into believing for even a moment that, 'This is it. This is your life from now on'.

But as I sit here 12 days removed from surgery, my back feels slightly better today than it did a week ago. The pain is still far worse than before the surgery, but I have felt improvement since the operation. So I'm feeling optimistic that I'm progressing. A physical movement that required complete focus last week, feels almost natural today. I expect a very long rehab. In fact, I expect a lifelong course of rehabilitation. And I'm putting my faith and trust into the disc replacement patients who have come before me and the doctors who all tell me it's going to improve over time.

I want to thank Dr. Bierstedt for performing a flawless surgery. I'll be diligent in my recovery and make sure your work lasts as long as I do. Thanks also to Malte and the staff at ONZ and Medicos for all your help. This difficult trip was made much easier because of your hard work and dedication.

For those of you who have received email updates with each blog post, I'm going to remove your email addresses from the list. I'm going to continue to update my blog, but you can come visit on your own whenever you like. Thanks for following me along this trip. Being here alone was much easier to manage knowing you were along for the ride.

I'll be back in Los Angeles Monday afternoon. Fanny, on the way home we're hitting Killer Shrimp!

And the crowd goes wild!

There's a big soccer match going on at the arena right now.  The deafening roar of the crowd rolls along like a freight train. It's hard to tell if the home team has scored because the prolonged cheers never really drop below a deep thunder.

It's a nice way to complete my rehab. I've ended the physical recovery part of my stay at Medicos. Tomorrow is my last day in Germany and I'll be flying out bright and early Monday morning. I'm not quite ready to fly, but it's grin and bear it time. Sorry to leave so early, but really looking forward to getting home.

Poppa's got a new pair of shoes

It's official, I'll be setting off metal detectors at airports from now on.  All good pieces of engineering deserve a proper name, so in honor of my little trip to Germany I think I'll call my new disc, Marlene, after the mysterious and exotic, Marlene Dietrich.

Hallo, schön!

Love bite

Most of the swelling has gone down, aside from a small pouch around the scar. Still a little sensitive around the incision area and it burns slightly when I use my stomach muscles to sit up, but it's not too bad. Time to whip this flabby ass into shape again once I can really start moving. Hey mom, get ready for some training when I get back!

"I'm sorry, my English isn't so good..."

Just about every German health care professional I've come across at the hospital and rehab center has immediately apologized to me for speaking, in their opinion, poor English. Never mind the fact that, with the exception of a couple instances, I've been able to communicate just fine with every nurse, doctor and therapist. And when we were stuck on a word or phrase Google Translator was a great resource.

And not once have I been met with even the slightest tinge of impatience over the fact that I speak no German. This has been a humbling experience on several levels, not the least of which has been how gracious and kind everyone has been, from the doctors and nurses to the servers in the cafes.

Brightened my day

I received a special delivery from a special person. This made my day. Thanks!

Slurred lines

Well, I've crossed the threshold from merely half walking dead to flat out zombified. I've lost all track of time and can barely put two words together.  Good thing I've got an easy to follow schedule. Sleep, why do you taunt me so!

I found out today that people in Germany who get disc replacement recover at home for three weeks before beginning physical therapy so their backs have time to calm down. Which is why the doctor said I shouldn't be worried that I'm still mired in pain after starting PT one week after surgery. Five days until I'm scheduled to fly back to California. 13 hours sitting in a chair...in a confined space...sandwiched inside a tin can with 175 other happy travelers. Now that truly is hell in a steel hand basket.

It's gonna be tough to leave this place. Massage, PT, more massage, lunch, chat with the doc. If this is how professional athletes spend their days recovering from injury sign me up!

“I think insomnia is a sign that a person is interesting”

If that's the case I should be in those Dos Equis commercials.

I'm hanging on by my fingernails in the sleep deprivation department. I haven't quite been able to shut my eyes for more than a few hours and it's starting to feel like I'm in the 'Space Madness' episode of Ren and Stimpy. I'm off to tempt fate once more, but before I lay down here's a quick update.

I had a number of appointments today, including some bodywork. I needed a massage like Marlon Brando needed french fries. While it helped, it was short lived, and my back curled right back up into the unbreakable knot it's been for the past week. The pain is still refusing to let go, but I was able to move around a fair amount today. I also started some basic exercises in the gym, but I'm pretty limited at the moment, so walking will be my primary source of training for a while. The pain is a combination of joint, bone and muscle. I'll settle for one out of three taking a vacation.

I'm starting to put back some of the weight I lost, so hopefully I won't be a skeleton when I get home. One good sign is the pain in my stomach is subsiding and I can actually use my stomach muscles now without feeling like the wound is going to split wide open. This definitely helps with getting in and out of bed.

My doctor here is still confident things are going to start falling into place, so I'm putting my faith in his experience. One of the many things I like about this place is that many of the doctors walk around in regular clothes and leave the white lab coat in the closet. It helps to create a collaborative environment between health care professionals and goes a long way towards eliminating the hierarchical structure that US hospitals like to foster. 

Anyways, time to sleep. Or at least the illusion of sleep.

Goodnight!

Now this is rehab!

I know it's fashionable to bash the US while in Europe, but there is nothing like Medicos Health Center in the states. This place is an Orthopedist's Disneyland. The've got every possible angle covered, from physiotherapy to occupational therapy to massage to fitness, you name it. Medicos is the definition of comprehensive medical care.

I'm scheduled throughout each day for a variety of treatments. I visit with a doctor every day to monitor my progress, and I'm encouraged to knock on his door for any reason at any time. Seriously!? I have blood tests done to ensure there's no infections, lymph node massages, regular massages, electrotherapy treatments to reduce pain, exercise therapy...c'mon! And it's connected to my hotel!

There are cafes where people with various injuries hang out, sip coffee, eat pastries and the restaurant serves up some tasty dishes, including the homemade ratatouille I had for lunch. I've even got a reserved table specifically for patients of Dr. Bierstedt.

The place treats about 2000 people per day, with all manner of injuries, but it seems like most of them are knee related based on the high number of people walking around with canes. It's refreshing to see elderly people and professional athletes all receiving the same care. It feels like a huge, high-class gym with doctors and nurses.

One of the reasons I chose Dr. Bierstedt was because of the after care program they organized through Medicos. Needless to say, I was not disappointed. The doc at Medicos said that my incision is healing much better than normal and that swelling is low. I think the Wobenzym may have had something to do with that. He said about 50% of disc replacement patients experience increased pain after surgery due to soft tissue damage, which can take 2-3 weeks to heal. In the meantime his priority for me is to get the muscles in my low back and hips to relax and reduce the spasms. Bring on the massage!

Oh, and I lost about 8 pounds while in the hospital. I guess living on clear soup every day for a week will do that.

Oleee ole ole oleeee

Up bright and early for my first day of rehab. The hotel is part of an athletic compound. It's connected to a health center, called Medicos, where athletes and us regular folk rehab injuries, among other things. The Veltins Arena is right next door and all of this sits up on a small hill overlooking the town. I've been told there are regular professional soccer matches and concerts held here, so I imagine the Marriot get's quite busy during these events. At the moment it's quiet as a church.

The restaurant in the hotel serves a mean breakfast buffet spread. Everything from your standard bacon and eggs, to raw seafood and exotic (buy American standards) cheese.

Everything here is already laid out, so all I need to do is give me name at various check-ins and strap in for the ride. I've been told I'll receive daily massages and exercise routines, so I'm looking forward to getting this recovery train on track.

Thanks Augusta!

I would be remiss If I didn't send a huge thanks to all of the fine people at Augusta Hospital in Hattingen. I ended up having to rush out of there today and regretfully didn't taken any photos of the incredibly supportive and hard working nurses. Every last one of them took excellent care of me.

Birgit, Sara, Julia, Jalil, Darius, Barbara, and everyone else.
Thanks to all of you!

Cab ride form hell!

I've arrived at the Marriot in Gelsenkerchen. The hotel is next to a huge soccer stadium and rehab center. It's pretty sweet. Unfortunately the ride from the hospital was an exercise in 'keeping my fists in check'.

The cabbie is from Turkey, and didn't speak English. But I don't speak Turkish, so it all evens out. When we got into Gelsenkirchen the Carnival parade was kicking off. It's a fairly big deal and several streets were closed to traffic. Apparently it's a family affair, and thousands of parents and their kids lined the streets. Rather than take the long way around the cabbie decided to drive up and down all the narrow, bumpy neighborhood streets so he could cross the parade route. With each dejection he got more and more agitated, which caused him to drive like a pissed-off yuppie during rush hour on the 405 in West LA.

With each slam of his brakes and stomp on the gas pedal my back started screaming! He kept looking at me, expressing his frustration and shrugging his shoulders as if I was commiserating. I told him, "Not my problem, figure it out. You're really causing me pain, so I don't care how angry you are, relax!" Of course it meant nothing to him.

So what should have been a pleasant 30 minute drive turned into a one hour joyride to Pain Town.

I did, however, find the Carnival costumes interesting. Unlike Brazil, or San Francisco Carnival parades where people don elaborate ensembles fit for a Las Vegas stage, the people of Germany dress up as clowns, superheroes, jailbirds...basically your average Halloween costume. I'm sure there's a reason for these outfits. And I shall investigate!

Anyways, I start rehab tomorrow. But tonight, I finally eat non hospital food!

The Longest Mile

I walked to downtown Hattingen this morning. Wish I was in better shape to move around because this is a great walking town. There are some cafes and pubs I would have liked to sample and some amazing architecture to check out. Unfortunately, all I could muster was about one mile before my back started shutting down. Wish I could report progress, but it feels like things are moving in the wrong direction. On a positive note, it's a beautiful day here, and Carnaval is in full swing. I didn't even know Carnaval was celebrated in Germany.

I'm not used to seeing empty streets on any given morning, but Sundays are for rest in Hattingen.

Struttin'

Went for my first walk outside since surgery. If I were taking it any slower I would've been walking backwards. The familiar numbness and tingling in my left leg and foot returned after about 15 minutes. A little disconcerting, but I'm not ready to get worried just yet.

It's a beautiful, crisp day in Hattingen. The hospital is situated in a quiet neighborhood, just outside downtown, which is a picturesque centuries-old village. I'm hoping to have the stamina to make it there tomorrow, but that might be a little optimistic based on my performance today.

I did come across a quaint cemetery near the hospital. Not a bad final resting place.

The frustrating part is I think most of my pain is coming from my SI joint at the moment. My sacrum is woefully out of balance. Which makes it difficult to determine how my lumbar area is feeling. My chiropractor will have his hands full when I get home.