Lows and Highs - Independence Day for Celiacs...

With marathon training season upon us in Houston, this Celiac was feeling a little down as I tried to schedule my July 20 appointment for post operation review. Every time I had, the scheduling screen did not show up, leading to delays while the clinic staff consulted with the tech support, etc. I told them that not running was absolutely killing me (see my post on the Ironman).

Finally, the answer was that the doctor was going on vacation, until the 29th. Three hours of "Oh no..." and then - "If you can come in tommorrow, he'll see you." Sweet - please pray I get cleared for at least jogging.

In other big developments - The rumor is that Jason's Deli will roll out gluten free bread system wide! This weekend! I'm so excited - the only thing is that you have to ask for the special prep area. Happy July 4th.

Knee exercises for physical therapy

This list is what I have been doing 3 times a week (not everything every time). If you have knee issues, there's probably an exercise in here for you.

All of these exercises should be done fluidly and reasonably slowly, in control.

• Prone TKE
• T-Band Stand TKE
• Standing Hamstring Curl
• Leg Press
• Heel-Toe walk
• Single leg balance
• LAQ
• Ball bridge
• Ball hamstring curl
• NMES SAQ (isometrically sqeeze quad)
• NMES SLR (isometrically squeeze quad while raising leg straight)
• NMES Quad Set (put something under knee and isometrically squeeze quad while raising leg straight)
• Stool scoots
• Sideways-hip abduct
• Mini Squats
• Step up – forward and lateral
• Standing calf – raise single leg
• Lunges
• Elliptical machine forward and back
• Bike machine

…and don’t hold your breath while you do them…

Other things I have found helpful:

• Epsom salt bath at night
• Ice, ice and more ice
• Anti-inflammatories
• Carbonated apple juice to combat nausea
• Early bedtime and lots of sleep
  

I found a lot of these exercises (but not all) explained at

http://www.athensorthopedicclinic.com/docs/Basic_Knee_Exercises.pdf

Progress and measurement

Well, yesterday was good news and new news for my recovery. I actually spiked out a 140 rpm on the recumbent bicycle they have at the PT place. That's faster than I have ever spun a crankshaft. The new news was that they measured my quads and calves. I've lost an inch and a half of muscle around my right quad, which they say extrapolates to about 25 weeks before my legs 'even out' -- almost 6 months.

It is a very humbling experience.

I think I'm wired to always be looking at the area that needs improvement. Friends who see me occasionally say that I'm doing much better, that I'm moving around better and that I look "normal." Those are nice comments to have, because they remind me of the progress I am making.

Almost Straight...

It's been exactly a month since the surgery and my knee is almost back to being able to be straight. That's important, because if my knee can be straight, it can lock and support my weight through the skeleton instead of using my weak muscles.

The trend is generally very good. Tiredness is no longer a general concept. There's upper body (rare), lower body (more frequent), hurt leg (pretty frequent) and supporting muscles (very frequent). Bicycling seems to help a lot

The surgeon cleared me Friday to be in the pool (yay) and do aquajogging (yay, but he did give me a funny look on that question). I have just six little cuts/holes around my knee, and all the steri-strips are off now. The worst thing on Friday was that he reiterated the four months to jogging on the street/trails. That would have me waiting to be on the road until July 25.

I've really eased off the Tylenol - none so far today in fact.

My body has put on a few pounds, which I anticipated because of my solution to the nausea, but now would like to see melt away. Of course, nothing "melts away" - so it's diet and exercise for me. I really miss exercising outdoors. I was built to move, and this approach lacks camaraderie and actual moving through space. Maybe that yearning will ease up when I start swimming again.

M Resort doing great job with Celiac diet

The Celiac diet is always a concern when traveling. I've been at the M Resort in Las Vegas for a conference, and they are doing a great job taking care of my meal needs. Usually, I give a report on the athletic facilities and so on. I can say that the ice machine always seems to be full enough for me to take the provided shoe bag and make really big ice packs for my knee. Usually, I don't like to be close to the ice machine or elevators, but this trip I made an exception. It's worked out pretty well.

Still moving slow

It's been about 10 days, and my knee is doing very well, in my opinion. Most of the swelling has gone, and I have been walking on it for nearly a week now and I've been off prescription painkillers for a week. It is not back to "pre-operation" mobility or strength yet.

It can turn revolutions on the bicycle stand now, but the right toe needs to be pointed down for it to work.

I have ups and downs. Usually lying down for a half hour will revive me. I'm sleeping about an hour past the tail end of my meds. When I'm awake, I started "feeling it" about two hours before the end, but now it's closer to an hour/forty-five minutes.

Still having issues with nausea. Coke and peanut M&Ms help, but those are not long-term solutions.

I have a business trip and have ordered a wheelchair. I just can't see myself walking through an airport yet.

Out of Surgery today, still a bit groggy

Well, it doesn't appear that being a Celiac affects surgery for an ACL much, but I did find out quite a bit about the medical process. Every step of the way, I've told every medical professional and coordinator about my vitamins/supplements and that I was a Celiac. (. I wore my Awareness run t-shirt more than once). It must have been at least 10-15 people. Low and behold, I'm being prepped for surgery, I am doing one last review and Celiac is not in my surgery records! We fixed that.

Probably all well and good as things went fine, but what if they had to transfer me to a hospital?

Anyway, at least my anesthesiologist had a sense of humor and said, "I promise I won't feed you bread while you're asleep."

I wanted to publicly thank all those who prayed for me and had me in your thoughts. Given the amount of damage my surgeon saw in my MRIs that first week, I am doing much better than average. Please keep it up, maybe these nerve blockers will wear off and I will be able to feel my leg again soon!

Another two weeks of wait and see

I went to the orthopedist today. The swelling, while much better, is not to a point where it makes sense to operate yet. Of course, one big question was about whether being a Celiac affects this at all. Celiac doesn't seem to bear much on the issue, as there isn't much to worry about from a donor tendon in the way of rejection for the autoimmune side. On the medication side, I will need to talk to the anesthesiologist, but again, no expected issues there. I was really glad for my wife's moral support and for writing my questions down.

I did leave the surgeon with the first few pages of the Celiac medical package from our local support group, which he scanned with some interest.

He did authorize me to again try to gently cycle on my computrainer, so I may try some of that again this weekend to see how it goes. He suggested mucking with the seat height to give some gentle encouragement to the knee flexibility. At first I thought it would mess up my setup, but upon reflection I think the move would be for the greater good.

Thanks to everyone for your kind comments as I work through this.

I tore my ACL

Well, no posts for a while usually means things are going really well, or really poorly. This time around it is really poorly.

I was out playing "driveway tennis" with my son when my foot caught up in the tree roots at the back of the driveway. Man, did that hurt. I have never wanted to get away from a body part so badly. Thing is, the part (and the pain) comes with you.

Well, an xray and MRI told me what I already knew from the popping noise. I've spent the last two weeks trying to keep up at work (not so successful), and manage the swelling (not so successful).

When you lose a functional knee and are in constant pain, it is amazing how your focus changes to getting out of pain and figuring out how to do really basic things like putting on a sock and personal hygiene. It's really nice to have two young, homeschooled kids to run around and carry things for me.

Never mind that moving around on crutches is a workout all by itself. I haven't done a proper "workout" since the fateful day. Saturday I said to myself, "It's been two weeks, get on that bicycle and stop feeling sorry for yourself." So I pumped up the tires, laboriously pulled on my cycling shoes, clipped in left foot, gingerly swung my right leg over and clipped in. Success!

Then I tried pedaling. Of course my left foot worked just fine, but my right knee didn't want to bend. So I tried backwards, then forwards. Each time my knee bent a hair more and with heavy exhalations I managed a full rotation. After about 20 I was done. Or so I thought. I couldn't clip out! Laughing at myself, I had to call one of my kids up to loosen my foot strap so I could slide my foot out and escape. Maybe next time I'll bring a crowbar...

Anway, I have some truly spectacular pictures of the swelling and bruising, which I may post at some point. I'll keep intermittent posts on how the rehab progresses.

Bruise count

Training is going really well for me right now, but I've had some of those "out of training" accidents. I was moving the woodpile (for the third time!) to get it away from the house. The exterminator recommended it because a woodpile basically invites termites. So I trenched around the house and moved the woodpile. One of the pieces hit my foot and caused a big ole bruise on my foot/ankle. It doesn't hurt (much) and I can run on it, but it could have been worse.

That makes about three bruises (new and/or healing), plus the ones I haven't found yet.

Why bring this up? Well, training for big long distance events is different than shorter ones. With shorter ones, you get injured and say, "Oh well," you rehab, and you do an event a few weeks later after you heal. Big long distance events are riskier. They usually involve a lot of training time and some travel expense. If you miss one of these events due to a freak injury, you may have to wait a month or even a year to try again. "Moving the woodpile" should be added to the list of "don't do this right before a marathon/big tri."

Reading around the web, now this Celiac has a reason to avoid remodeling projects, too - possible gluten in the drywall! Thanks for sharing that one.

My treadmill exploded!

Remember last year how lightning struck nearby and a few things stopped working, including my treadmill? It was like losing an old friend, so I called the local treadmill repair shop for an appointment. The nice lady on the other end politely asked if the treadmill was plugged in and turned on. "I tried that already." I said as I quickly plugged the treadmill back in and bent down on my knees to flip the switch in the back. When I did, the treadmill belt shot forward about 4 feet, landing me flat on my stomach and shooting me back off the treadmill into my scale and some other stuff piled there. I politely told the lady good-bye and told her it looked like it was running.

My family, hearing a yelp and some crashing, had shown up at this point. I proudly announced that my treadmill was working. I put the kill switch back in and (on the sides of the treadmill this time), flipped the reset switch.

The fireworks started. Literally -- sparks were shooting out from the area under the foot guard about a foot from my face. I asked my wife to unplug it (she says I yelled) and get the fire extinguisher. Smoke was coming out between the belt and foot guard, but it stopped. The house smelled of ozone for a good five hours after that.

I called the nice lady at the the treadmill repair place back and made an appointment. It's a good thing it's taper time for the marathon.

Packet Pickup

I dropped by packet pickup today, and I had a discussion with another athlete. He said, "Well, maybe you'll be lucky and your toenail will fall off during the swim..." I think I'm just going to have to tough it out. I did a little math on the shoe tradeoff. I figure I can go 1 mph faster for the 10 miles, which roughly works out to about 2 minutes. It won't take me two minutes to swap shoes. In fact, I'll be surprised if it takes me two minutes for the whole transition area. So I'm sticking with using both bicycle shoes and running shoes. On top of all this, I think I caught a stomach bug my son had, which won't take me out of the race but will probably annoy me.


I also did some figuring on how fast I will be able to leave - and it's all about the slowest bicyclist from the last wave. I figure the earliest I will be able to lay my hands on my bicycle is 8:30, so that makes making the first service a pretty tight connection. We'll see. What drama.

The Blog lives!

Now that the superbusy-ness of the race has died down, I'm back to my workout. Tonight was an hour on the bicycle. I have to say that my toenail and riding don't mix well, and it's making me think about my options for the triathlon I'm doing this Sunday. It's short enough so that I'm thinking about biking in my running shoes. You see, I've cut half the toebox off one of my old painting shoes - and it works pretty good. Does anyone have any thoughts on the bicycle/running shoe tradeoff (improves transition time, but you are slower on the bike?)

First workout since the race

Having successfully directed my first race, I can now say with confidence that practically everything does happen in the last two weeks. As a consequence, all of my free time, including that for exercising, went to the Celiac Awareness Race (so it was for a good cause). I finally squeezed out 30 minutes for a run today. Ahhhhhh.

The only thing that really marred the weekend for me was that I dropped a picnic table on my big toe, which has been turning some rather unlovely shades of blue, black and purple. It's my first black toe from a running event, and somehow I always thought it would be a marathon and not this. Oh well. It didn't hurt too bad for the run, but it sure does bleed everywhere. Maybe I'll stick to cycling and swimming.

Any bets on if it will fall off?

Where'd that ball go?

Monday was a rest day for me, and anyone who knows me knows that I take my rest days as seriously as I take my workout days. I decided to take advantage of the time by "going long" at work and using my trigger point massage gizmos. After I'd worked over both legs, I hopped in bed and tried out the massage ball on my rib area - very gently. It seemed to help, and I wondered if it would do anything for my abs, too. I put the golf-ball-sized ball on my stomach and pushed and just started laughing because I couldn't see the ball anymore. I wondered how much faster I would go if I'd just lose 20 pounds or so.

Today I had a quick 30 minute run, which felt good, and a quick 30 minute swim, which was awful so I cut it short. It was tight around my rib and makes me wonder if I didn't hurt my pec muscle when I fell. I have a book that says I should go see a doctor if that happens, and my wife said, "You should go." I pointed out that I had seen a doctor last Monday, so I guess I'll just keep seeing how it feels.

On the Celiac front, my local newsletter reported on some studies that came out regarding thresholds. They only tested gluten at 10mg for a few weeks, and I feel that's too short a time to tell if there's long term damage. I think the study recommendations are too loose and any regulation based on them would give consumers a false sense of security. The cumulative effect of small amounts of gluten over long time periods was not studied.

Good Celiac PR + working out

I had a meeting with the group putting on the Austin Celiac Awareness race and someone said I was "famous." Evidently, I showed up in her Google tracker as a "runner story" for the Houston Marathon. It just makes me think again how small is the US Celiac world. It's good PR for Celiac Awareness, for sure!

This past week I needed a lot of medical attention, the sum of which is, "We can't tell you if you broke a rib or not." OK. Helpful. I can feel myself getting stronger, so either the rib is broken and it's no big deal, or it's not and it's no big deal. So I won't do anything risky, but I am doing my workouts.

Saturday (yesterday) was one of those days that just doesn't go right. I was helping my wife and told her I was going to lay down for a minute, and three hours later she was reminding me to take the boy to his Discovery Imagination meeting. I needed the sleep, but it was prime workout time.

Because I had family commitments, I decided to double up the workouts today. Now, before anyone goes nuts on me for over training, tomorrow's a rest day, so back off. It only totaled up to 90 minutes, anyway.

Mmmmm... Beer

The big news that hasn't made the blog yet is the introduction of Redbridge beer. It's a beer a Celiac can drink. In celebration of the nationally-issued product from the same folks that bring you Budweiser, I had my first post-marathon beer ever this year. It was good, and I couldn't tell you if it hurt or helped my recovery. Somebody needs to tell Anheuser-Busch that their "restaurant locator" needs to give at least one result, even if it's 50 miles away. I put my zip code in and it gave me no results. It might hurts sales, (but the word on the street is that the specialty liquor stores are selling out anyway.)

Today was the fourth day this week I've been in a medical office, and no, I don't work in one. I still don't have my lab results, so in true "what you don't know can't hurt you" mode, I've been exercising while waiting. I had a good ride. I think it may be the first time I was actually able to spin 100 rpms on the bicycle. The rib is feeling better today, so I must either be doing something right, or at least not making things worse. It doesn't feel good enough to go swimming yet, however.

About That Bruise...

For the uninitiated, there is a lot of pain associated with running a marathon. Your legs hurt during the marathon, and then after the marathon they hurt worse. For days.

I'm familiar with that pain, but this year I had more. The doctors at the finish line said that I should seek medical attention if my bruise hurt for more than four days and didn't get better. I called the nurse line today and they had me do a simple test --- press on my breast bone and see if my rib hurt. The answer was yes, so now I have an appointment on Monday to see the doctor. Personally, I think it's cracked, but I'll wait for the x-ray. There is a part of me that feels like these skeletal injuries are in part due to my previous bout with osteopenia, but my wife thinks I'm wrong on that point, and that I am just accident-prone lately.

With all this injury talk, I sure don't want to sound like a whiner, but for the purposes of this blog, I feel it's important to record significant events, feelings and training issues. So moving on, I'm in very good spirits. This feels like a minor setback in my training. Plus, I'll have a great story after I heal. "Yeah, I ran 20 miles with a cracked rib." Finally, today I got a massage for my legs. I always love that.

Another reason to be in good spirits is that I may have helped a friend of a friend with his ill wife. She said, "I know someone who knows about Celiac, I'll get you some information." So I passed that along today. I'll keep you posted.

Also on the celiac front, I asked the people at Saltstick if their electrolyte tabs contain gluten. They were able to tell me that "The capsules do not contain any added gluten as far as I know. The cellulose used as the capsule material is "hypromellose". The rest of the contents are salts. There is no added filler. Hope that helps! Race strong!" They had a nice PDF file on their website explaining the different components of the current top electrolyte pills. There were some pretty big differences between them. It makes me wonder where I can get an analysis of my perspiration...

Houston Marathon results...

Well, I continued on my trend for the year. (Having a good race marred by an unpleasantry)

Of course, the weather was perfect. The woman set a course record for the full marathon, and a new US record was set in the men's half marathon. I always joke that they put the average temperature on the literature to entice runners from other states, but that the weather has varied between hot and humid and arctic chill. Luckily, this year we managed to get the weather right in the middle. It could've been 10° cooler, but that would really be complaining.

My prerace training wasn't ideal because of my cruise and wrist. But having done 17 Houston marathons in a row, I had to toe the start line for number 18. Things were going brilliant until the 10K mark, when I hit a seam in the pavement. This time I fell down on my right side, hurting my hand, elbow, shoulder, and the back and front of my chest. The guy running next to me said, "Gosh, are you okay?" I said, "yeah" --- and after running about three steps, feeling the impact of my flying forward roll and seeing my bleeding hand, I revised that to, "No, I really hurt." I got patched up at the 7 mile medical tent and kept going, but I'll have to admit I was thinking that 20 miles was a long way to go at that point, especially after I missed my wife at our usual 8 mile rendezvous.

I ended up finishing strong at 4:55 (4:50 chip time) - just a one minute per mile fade off of my planned 10 minute pace over the last 20 miles. Medically, it's not that bad, but I did go to the post-race medical for only the second time in 18 marathons, and my chest hurts worse than my legs, if you can believe that. Still, the time was a twenty minute improvement over last year...

Funny story, I joined a training group and have consistently run at the very back of the pack at a 10 minute pace all year. I was the guy constantly cajoling the others to run the actual workout instead of speeding through. Some weekends, I would come in last, a half an hour behind the next closest guy. I passed two runners from the group two miles from the finish. I wonder if I should tease them a bit?

Good News, Bad news...

The last two weeks have been marked by a hectic week at work, followed by a hectic vacation to my parents (slowband connection = no posts), followed by a hectic week at work. I didn't train as much or as well as I would have liked, and I always felt "off my feed" as I was taking an oral vaccination for typhoid for a now-no-longer-upcoming trip.

All that aside, it was dark and early when I tromped to the local park office January 2nd to be one of the supplicants to reserve a spot for my first (annual) Celiac Awareness Race and race directing gig. Even though I was 19th in line, I was amazed at how fast the dates and locations disappeared. (A veteran reserver for the boy scouts took some 15 dates). Even so, I managed to secure the 19th of May (third choice), so there you have it. Even better, one of the local race directors said he would send me his checklists, which will obviously be like manna from heaven for a newbie race director like myself. Yippee! Now I just need to focus on logistics.

It's a good thing my marathon training is in the bag for the Houston Marathon on the 14th. Training this week has been awful. I went to do my interval workout yesterday on the treadmill and stepped off before the first repeat. Some days you just don't have it, and yesterday was such a day. I went to bed and promptly slept for 11 hours straight, so you know something was up. I probably have what my kids have.

I had good news from the doctor. I can take my wrist brace off. This is the first "two handed" typing I've done in over a month. I'm cleared for all my "tri" sports and just have to wear my brace while riding a bike. I'm pretty happy I don't have to have a cast or brace for the marathon.