Procrastination

Well, the bright work project certainly was a distraction and it proved how adept I am at procrastination!  By end of August I had layed on seven coats of varnish and decided to call it good enough for this season.  Seven coats will keep the teak protected and so the bright work project is in a safe temporary holding pattern.  Next spring I’ll add an additional four coats and call it good. 

In September and the first two weeks of October---without the excuse of needing to drive so that I could get to the boat after work fresh enough and with enough time to make progress---I have returned to biking to work, and I am really feeling improvement.  I am able ride faster for longer, and I feel less muscle ache during the ride and afterward.  Also, I have discovered several short-cuts from the standard Burke Gilman Bike Trail route that shortens overall distance and eliminates several busy intersections, so there are only one or two spots where I might have to stop.

Also, I have continued working on left ankle range of motion, and it is frustrating how little progress I am making there.  Although I am able to bend it a considerable amount by leaning against a wall (first facing in and leaning far forward and then facing out and leaning far back), without the added pressure the ankle is still very stiff and doesn’t yet bend back and forth of it’s own accord.  

Thankfully, I am sensing gradual improvement in feeling in my left foot.  In addition to pins & needles I am now also feeling internal stinging & itching (which I suppose is a good thing), and now I am able to feel whether the foot has successfully slipped into a slipper when getting up out of bed at night with the light still off, which is more than I could do several months ago. 

The doctors indicated there’s typically a two-year window for repairing nerves and recovering feeling after an injury, so I still have eight more months of potential progress.  It is really important to have good sensation in your feet for technical rock climbing, because you have to be able to feel how well your foot is attached to the a particular placement on the rock (or climbing wall), so I have continued to hold off on climbing until I have better sensations my left foot.

No more procrastinating, . . . time to get back to hiking and the thrice weekly workout routine!

Distractions are OK, as long as they are kinetic.

So, . . . in addition to climbing and getting out into the Alpine, I love getting out on the water, and have owned a wonderful sailing craft for years.  Care & feeding of "Rhythm" is a labor of love, and requires countless hours of just "messing around on a boat." I will be testing my full-body convalescence with a big summer-time boat project requiring bending, stooping, kneeling, and crawling around all while applying significant "elbow grease."

Several weekends ago, with a sharp scraper and heat gun, I began peeling off Rhythm’s exterior varnish.  The ship’s log indicates it has been 10 years since last she was back to bare teak, so this is several years overdue.  Typically, the base varnish coat begins detaching from the wood substrate after seven or eight years depending on climate.  Teak is an oil-saturated wood which, on the one hand, protects it from deterioration due to the elements, but on the other hand, destines brightwork to a decade life-span at best.  It makes sense to “scratch & patch” the first tell-tale failure points, although the repaired areas are lighter in color than the rest.  Eventually after many patch jobs the brightwork looks mottled, and with new areas delaminating in increasing size & frequency, the daunting task of scraping off all the old, sanding to clear wood, and then building up a new varnish system, becomes unavoidable.

Getting to the point where I was ready to apply fresh varnish took over 100 hours of heavy duty sanding, working first with an orbital sander, then a hand block, then free-hand, and finally using small “invented” tools to work in tight corners.  What you see prior to laying on the first coat of varnish is what you’ll live with for the next 10 years, so the prep-work needs to be thorough.  Similar to varnishing, sanding requires multiple passes, first with 80 grit sandpaper (to clear the remaining old varnish and “shape” the wood), then 150 grit (to smooth the 80 grit surface and reveal the wood grain), and finally 220 grit (to increase resolution and beauty of the wood grain leaving a silky smooth surface).  Thinking through the routine now, there are eight unique passes over the wood before it’s ready for the varnish primer coat.

After sanding and detailing, you need to tape off the surrounding surfaces in preparation for applying the varnish primer coat; only professionals lay on varnish without masking tape that catches errant brush strokes, drips, etc.  It will take the rest of the summer to build up enough varnish coats to call it brightwork, . . . at least 220 hours to complete 12 coats @ 7 hrs to varnish and 9 hrs to sand after each new coat, plus un-taping and re-taping after every 3rd or 4th coat. 

Thankfully thus far no setbacks or accidents other than small burns from the heat gun and sanding off my finger prints.  I have had to change the security feature on my mobile phone that reads my fingerprint until they grow back.  Sometime, I’ll tell you about the time (10 years ago) when I picked up the heat gun by the wrong end, . . . now that caused some damage!

It's been a year (tomorrow)!

A close friend emailed me early this week wondering whether the anniversary date is getting close and I realized that yes, it is either June 30^th (this coming Saturday) or tomorrow (the last Thursday in June), . . . right around the corner in either case. 

Thursday morning feels like the more appropriate marker as it aligns with last year’s weekly routine, so I’ll drop by Vertical World tomorrow first thing for a moment of silent reflection and thanks giving.  If you haven't yet, you should visit Vertical World's website sometime to get a sense of their amazing climbing walls.

I have experienced further improvement in walking gate smoothness and speed in the last week or so after starting a very modest course of aspirin in the AM and PM.  I happened to be reading something that indicated aspirin is excellent for reducing inflammation and joint pain, and after restarting with it (and bumping up dosage slightly to AM &PM) I noticed immediate improvement.  My left ankle hasn’t looked this svelte in months, and I can step right through the ankle bend with nary a twinge.  Pretty cool.

Last week I had the last visit with the spine surgery team (one year hence), and they were all "your healed, get out of here!" They still warn that because fewer vertebra are carrying the bending/twisting load there's a likelihood that they will need to fuse the next one down in 10 years or so.  I asked, and they indicated that strong core muscles will slow the degradation, . . . 10-minute abs here I come!

Pain, drugs, and backing off the meds at Anderson House

Before Harbor View could discharge me to a skilled nursing center and free up a bed in their trauma center, I had to be off of intravenous pain meds and stable on oral meds.  This all seemed to be happening pretty quickly and it gave me concern as pain meds were definitely still required to maintain an even strain, but in the last couple days at Harborview I gained confidence meds could be administered effectively orally and leaving Harborview wouldn't result in a major set back.

Looking back on the transition from Harbor View to Anderson House, I can understand how cautious I felt about "change for the worse," but there's no question that Anderson House was a much better place to begin convalescence.  Harbor View is a place to get put back together, . . . not a place to mend over a longer period of time, . . . It's hectic, fast paced and staff are stressed, . . . it's like a war-time mash unit!  Regardless, I still ended up wanting to hang onto "the devil I knew" versus being cast off into the unknown.

In a much earlier post I indicated what a good living environment Anderson House provided for early convalescence.  Peace & quiet, helpful & friendly staff, a large private room, good food, encouraging & resourceful physical & occupational therapists, access to an shaded outdoor patio, . . . overall Anderson House put together an excellent program.  No skilled nursing center can fully meet expectations every minute of every day, but Anderson House came pretty close.

Naturally, there were times (usually around the meal hours) when assistant staff were heavily engaged getting people up and out of bed for meals, and so I needed to adjust expectations to account for these busy times.  On rare occasions, my needs would become unforeseen & urgent (think, I need a bed pan!) and there just wasn't anyone immediately available.  Oh well, . . . suppose there are worse things than dealing with these relatively minor consequences / inconveniences.

Anderson House nurse staff were almost always timely with meds and were uniformly friendly, helpful, compassionate, and looking out for my best interests.  Right off the bat it was apparent they were not as maniacal as Harbor View staff about reducing med levels, as they were not under the gun to discharge folks and free up beds.  We still did the "what's your level of pain" dance, but they were much easier to work with in making adjustments.  They instilled confidence that if we tried reducing meds and it wasn't working we could always readjust.  I was anxious to demonstrate zero dependence on pain meds and so we established plans to reduce first one prescription, then the next, and then the next.  Then we worked through each plan and celebrated being weaned off of each med. 

In retrospect, there were several comical / farcical episodes associated with coming off various drugs (Oxycontin, Dilaudid, and Gabapentin).  I weened from Dilaudid first and without memorable complication.  Although Oxycontin is a great pain med, it can be addictive and it definitely causes constipation.  So on the one hand, I had a choice of maintaining Oxy dosage at the risk of becoming dependent but also at the cost of frequent suppositories, and on the other hand, I could work down the Oxy and transition from suppositories to prunes.  Seems like a no brainer right?!  Yah, but you gotta' be careful about backing off of Oxy or you'll find yourself in a very uncomfortable state.  Looking back, it's comical to reflect on the fact that I initially leaned in favor of continuing suppositories!   There were definitely celebrations by all involved when I zeroed out the Oxy and was able to keep things moving with prunes and coffee!

The last med I was on was Gabapentin, and when I talked to the doctor about it she indicated it "just soothed nerve endings."  So later that day in a moment of hubris, I told the nurse to go ahead and zero out the dosage rather than go through a more gradual reduction regime.  Mistake!  Around bed-time it became apparent what Gabby was doing for me, . . . and what it felt like to go without. Going cold turkey off of Gabby resulted in turning up the thermostat in every square inch of skin to top-bench sauna temps. 

Holy fish cakes & mother of pearl, what an uncomfortable night!  Not "pain" per se, but incredible debilitating/maddening discomfort.  The next morning I had a "conversation" with nurses & doctors about the benefits of more gradually backing off of Gabby, and I didn't take the last pill of it until several weeks later, well after I was discharged from Anderson House and living at The Ballard Landmark assisted living center, the retirement home that housed me while I was still non-weight bearing and refined to either bed-rest or a wheel chair 24/7.

Since leaving the pain meds behind I have been on a daily regime of one aspirin, four Tums, and a drop of vitamin B, . . . the aspirin to keep blood a little thinner than usual to reduce the negligible odds of a blood clot breaking off of ongoing internal repair work going on in my shins/ankles/feet, Tums for calcium bone-building material, and vitamin B as a catalyst to absorb the calcium. 

Seems to be working, . . . the last time I visited the foot orthopedic team they were impressed with the amount of bone generation that has occurred since surgery.  They said I can do just about anything I want other than play basketball and sky dive!

Better living through orthotics

Can't believe I had been trying to walk distance without orthotics!  Wish I had looked into them much sooner; and it just shows what a stubborn cuss I can be.  Walking with and without them is a night and day difference, and at this point I wouldn't imagine going anywhere without them.  Miraculously, they totally smooth my walking gate, and it feels fantastic to be able to walk smoothly versus hitching along. 

The orthotics team made several sets for me, and I keep one set in shoes I leave at work (to save weight and volume in my backpack when biking/commuting) and another set remains at home.  It is easy to swap them in and out of whatever foot gear I am going with.  The orthotics aren't necessary or helpful while biking, and that's the only time I go without them.  The contrast between clumsily walking in non-adjusted bike shoes to & from the bike, compared with gracefully gliding along once on the bike, is poignant.

The jury is still out on the clam-shell brace.  It feels constricting, and it gets warm and, well clammy, inside, and that is something I'll just have to get used to.  Also, where my foot exits the brace there is an unavoidable lip / transition from the brace to my shoe that crosses the bottom section of my foot that is still recovering nerve sensation, and it is causing annoying discomfort after just a little bit of use.  Maybe I can lessen the sensation by adding a cushioning extension / transition.  In any case, I don't think it's going to do the job in it's current configuration.

Finally, the brace works fine when walking on mostly flat terrain or when stepping up onto things like curbs, benches, rocks, stairs, etc., but because the brace restricts so much ankle motion, it is difficult to walk up simple, smooth, inclined grades, and the steeper the grade the more awkward it becomes.  It'd be no problem climbing a boulder field, or kicking steps up a snow slope, but walking up a steep trail may be a bit difficult.  Hmmm.  I'll do more testing.

Fine tuning.

All this biking, physical therapy stretching, calisthenics, stair climbing, and swimming has done wonders for my overall strength.  Still, my walking gate is far from smooth, and as I am learning through visits with the surgeons and orthotics' specialists, this has far more to do with bone & joint mechanics than muscle strength or even range of motion.

Based upon the physical clues mentioned in previous posts, it is clear that my right leg is shorter than my left leg, and my left foot is no longer flat but leans outward.  These two physical-structural-mechanical imbalances have caused a significant hitch in my stride.  It's as though I am walking along a railroad track, stepping up with my left foot on a rail that slants outward, and then stepping back down with my right to the bed of the track.  After observing my walk at a recent visit, the orthopedic surgeons gave me a referral to an orthotics' specialist who I visited last week.

We talked through the physical symptoms, they watched me walk, and they concluded a lift for my right foot and a wedge for outer portion of my left foot should help straighten things out.   Also, we talked about the ankle pain that has limited my walks to no more than six miles and/or two hours.  They suggested creating a custom-built clam-shell fiberglass ankle brace to hold my left ankle mostly motionless while walking, which would mimic fusing the ankle.  The braces straps will hold it firmly to my calf, so it will also transfer some of the impact load of walking from the heel/ankle to the upper calf.  This type of brace will fit inside a mountaineering boot, and fingers crossed, it will allow me to go further & longer.

At the follow-up appointment to create the caste for the brace and take accurate measurements for the lifts, the orthotics team determined my right foot needs a 5/8” heel lift and my left foot needs a 3/8” wedge on the outside edge to level it.  On a whim we measured the length of my feet, and it turns out my left foot has lost one-and-a-half shoe sizes!  Both feet used to be size 11.  Now my right foot is still an 11, but my left foot is a size 9.5. Crrrraaazzzy!! 

This will definitely improve my bragging rights when "comparing scars" with friends.

Gotta' love a bicycle, . . . and swimming pool!

These days I am biking to work just about every day (with a few exceptions) and I am loving it!  My body mechanics // chemistry thrive on cardio workouts, and I am so relieved to have found a ready source of physiological exercise that doesn’t cause debilitating pain in my ankles.  Gliding fast through beautiful outdoor scenery---akin to flying---is an added bonus.

It is interesting how quickly my psychology has shifted from finding rationales for driving to finding rationales for biking.  The same little voice inside that pushes me to achieve the summit of a climbing objective or accomplish one more lap during a workout now coaxes me to jump on the bike rather than strap on a car. 

When I first started biking, if the weather forecast indicated steady rain (with more than a ½ inch accumulation) then I may have reconsidered.  If I needed to stay especially late at The Mountaineers, I may have been tempted to drive instead.  If I needed to go somewhere after work, then shouldn’t I use a car?  Nope; all these impediments to biking are easily overcome.  Rain beads and slips off appropriate clothing.  It is easy to load a bike on the front of a Seattle Metro bus and commute home rather than riding in pitch black along the Burke Gilman Trail.  And usually there’s a decent bike route to any intermediate destination between The Mountaineers and home.

For example, last Friday afternoon after work I planned on commuting to REI in downtown Seattle to attend a conservation presentation about protecting The Methow River Headwaters region from a natural resource extraction project (a large open-pit copper mine).  Bad idea.  Anyway, in thinking through commute logistics, my first inclination was to drive to work, so that I could drive to REI, and afterward drive home to Ballard. 

Then the little voice began nagging, so I checked out Seattle Metro routes and determined I could bike to work, and then take Metro to REI and then home after the presentation.  The little voice continued to nag, so I checked out the bike route and distance between The Mountaineers and REI, and decided to bike the second leg as well, and then I could use Metro to get home.  But then after the presentation was over, there was still plenty of light, and the bike route and distance from REI to home was less than from The Mountaineers to REI, . . . so the little voice kicked in yet again, . . . and I biked home.  Yep, I am a glutton for cardio punishment!

So every weekday I bike to work which is a little more than twenty miles round trip.  Then, each morning, I spend twenty minutes on ankle range-of-motion physical therapy.  I stand next to a wall and lean forward as far as I can with legs straight and feet flat on the floor for 100 seconds, then I lean backward as far as I can for 100 seconds, and I do three reps of these stretches.  Then I do full rotations of my legs & upper body, circling through 360 degrees of ankle extension while keeping my feet flat on the floor.  Then I do knee bends, keeping my heels on the floor and lowering down as far as I can (last week I did full squats for the first time!).  I finish up with 40 toe raises, and finally I stay up on tip toes for 40 more seconds.  Ouch! 

That leaves Saturday & Sunday for my prior exercise routines.  On Saturdays I  do the full calisthenics workout (squats with heavy pack, pushups, and various other arm, core and leg exercises).  If the weather is nice I’ll bike to Golden Gardens beach and use a park picnic table as a workout platform (with an exercise mat for a little cushion comfort).  Working out with views Puget Sound, sunshine & blue skies, and budding spring cherry tree branches above is fantastic! 

On Sunday I do an hour of Golden Gardens Park stair climbing with heavy pack, and then afterward I go for a swim at the Ballard Community pool.  I try to get to the pool early enough to spend time in the hot tub with bubble jets playing on my back (aaahhh!) and my left ankle up and out of the hot water.  At this point I’m not really swimming, but doing what looks much more like an old-guy side-stroke or breast stroke, mostly because I don’t feel ready for full-out swimming just yet.  I do however, keep from touching the side or bottom of the pool for the hour that I swim, and that’s not too bad!

Near misses past & present

Just wanted to share a quick “random” story related to a fantastic scramble of North Twin Sister last April before the fall. 

I had near miss on this trip.  We brought bicycles for the approach up and back down a long forest road.  My front brakes had become inoperable during our drive to the trailhead when they got hung up with another bike on the rack, so I was coming down the forest road with just my back brakes.  They got hot and eventually stopped working (!!) on a long, straight, narrow, steep down-grade.  I was unable to stop or slow down and could not help but accelerate down the road.  I was totally freaking out and thought I was about to be dead (or at least severely injured). 

Literally the only thing that saved me was that at the end of this long straight away was a wider than usual turn with fresh gravel spread liberally across the road. I was going fast at that point, but somehow as a last ditch last chance, I side-slipped and lay the bike down, and came down hard and fast on my leg, hip, fore-arm, elbow, shoulder and head (the bike helmet saved me as well).  I got up cautiously testing for breaks, but found only significant road rash on all parts (and miraculously the bike was on one piece as well)!  The bike was inoperable so I walked it the rest of the way, and thankfully I was close to the trailhead at that point so it didn’t take too long.  I was bleeding in a bunch of places, so when I got back to the cars I put on a coat and bandana so it wasn’t obvious (I was embarrassed about the accident --- and I was OK --- so I chose not worry everybody, . . . it had been such a cool trip and I didn't want to be a downer).      

The week after I got back to Seattle I fixed the front brakes and replaced both sets of brake pads, then did a quick test ride to make sure all systems were “go” before parking the bike in the garage.  It hadn’t been used again until this last weekend, when I rode it from Ballard to The Mountaineers Program Center and back.  I’ve been wanting to expand my workout routine, but needed to prove to myself that I could complete the round trip.  The weekend test ride was successful, so this morning I commuted to the Mountaineers for real and afterward brought the bike into the office (common staff-member practice) for the day.

This afternoon after returning from a meeting, people sitting close to my desk said they were surprised when my bike’s back tire exploded!  While replacing the innertube, I inspected the tire and discovered the tire-wall was worn thin and had finally given way in one place.  “Odd,” thought I, while adding just enough air pressure to ride on the tire from The Mountaineers to Recycled Cycles in Fremont.  I arrived at 6:58pm (they closed at 7pm), bought a new tire & innertube and had them install both on the rear rim.  While the technician was doing the work, we got to talking about how a tire might randomly explode like that, and he said I probably “hit something” or maybe "my back brakes may have been mis-aligned and were rubbing on the tire.” 

Hmmmm, . . . thinking back to when I last used the bike, it finally became obvious what happened.  Can you believe the tire held out for three trips between Ballard and The Mountaineers and finally gave out while sitting motionless by my desk?!  Had it blown this morning while riding at speed, I’d probably be back at Harborview right now!  Turns out that bike back tire saved me twice.

I am so lucky!

Pain, drugs, halucinations, and other facts of life at Harborview's trauma center

I am not an addictive personality, . . . haven't gone through periods of being obsessed by certain foods, music, or people.  From my teenage years through college, I drank socially, occasionally to excess, but never got hooked.  I smoked socially as well when out with friends, and never got hooked.  Thankfully, I hadn't been exposed to lots of heavy-duty medicines throughout my life.  Pretty much just over-the-counter pain meds (Tylenol, Ibuprofen, Asperin) for head-aches and muscle& joint pain.

Then this accident happened.  While at Harborview intensive care and going through numorous surgeries I was medicated intravenously with several strong & potentially addictive pain meds.  Finding the correct dosage seemed to be mostly trial and error.  The nurses and doctors would frequently ask "what is your pain level right now 1 to 10?"  and very soon it became apparent that my pain-level rating was different than most, in that most everyone else reported higher levels than me. 

I had to explain to the nurses & doctors that a “10” for me was so severe that I would use a weapon to end it.  A “9” was excruciating pain with uncontrollable writhing and being strongly tempted to use a weapon.   An “8” was extremely uncomfortable but with an ability to control physical movement, but likely with groaning/grunting/whining.  A “7” was very uncomfortable with control of both physical movement and utterances.  A “6” was uncomfortable and still very much needing pain management.  A “5” was uncomfortable with a preference for using some pain management.  A “4” was annoying and distracting but able to manage without pain management.  A “3” was distracting but manageable without pain management.  A “2” was noticeable.  And a “1” was virtually no pain.

Bottom line is that most people’s “8” is my “5” and so the nurses and doctors tended to under-prescribe pain meds for me.  The good news is I can count on one hand the number of times I was at an “8” (extremely uncomfortable but able to prevent writhing, but with groaning), but the bad news was I found myself in the “6” to “7” range too often.  There were only a couple of instances where I was over dosed on pain meds and had wild dreams and hallucinations.

Getting the right level of meds was often challenging.  Quickly you understand the hourly cycle time for each pain medication and you ensure the nurses are timely in providing the meds.  Most of the time the nurses arrived timely, but because Harborview is a trauma center and my bed was in the burn section there were times when the nurses were busy with more important/urgent activities, and hitting the nurse call button didn’t always result in a visit.  More frustrating was when the call button would slide to a position that I couldn’t reach (recall I was in restricting casts up to my shoulders and was instructed not to attempt to roll or twist to prevent back damage), and I had to wait for someone to walk by the room or drop in to check up on me.  Calling out for help into the void seemed so pathetic!

Also, when the prescription wasn’t working, going through the routine of explaining my pain levels took time, and the nurse would then need to convey the information to the doctors so they could adjust the prescription, and sometimes the doctors would need to come and talk with me in person, going through the same routine as with the nurses before they would change the prescription.

Probably the most frustrating medication problem while at Harborview was when I was prescribed a self-administered pain medication that would be effective for a couple of hours.  Great you say, self-administration means no pain, right?  Yes, that’s true, . . . until bed time and then you get to choose between sleep and staying awake to press the button, because if you don’t hit the button on time then you wake up extremely uncomfortable. 

Gaining an audience with the right set of doctors and convincing them that I wasn’t exaggerating my pain in order to feed a nascent drug habit took a great deal of constant hounding of the nurses to ensure the doctors would show up, and then a high degree of persistence in stating my case.  Even then the doctors were extremely reluctant to adjust dosages, and as a result, while at Harborview I never slept through the night, choosing to stay awake to ensure the proper doses of pain meds occurred on time.

What does one do to stay awake in a trauma center hospital bed in the middle of the night?  My sister gifted me a small portable Sony MP3 player, but because of the state of my hands it was too small to hold and the buttons were too small to manipulate, and I couldn’t reach my ears to press in the ear buds in any case.  She also purchased a Samsung tablet for me but I couldn’t keep it balanced at the right angle to see the screen and the on-screen buttons were too difficult to manipulate.  Another sister gifted me an Amazon Echo device“Alexa,” but it was such a new concept and I didn’t have the emotional/psychological resolve to have someone open the box and help me figure out how to set it up and use it.  Finally, there was no way I could use a notebook PC keyboard because my arms were fixed in place with casts.  All that left me was TV late night movies, . . . really bad TV late night movies, . . . and for that to work I had to have the TV remote taped to one hand so that I could reach it and adjust the channel and volume with the other.  Miserable!

About the only thing that allowed me to remain reasonably lucid while at Harborview was taking naps during the day while Marijane & Marie visited (they could rouse me just long enough to hit the pain med button), and when nothing else was going on like the never-ending series of x-rays, doctor & nurse visits, and other interactions with hospital staff.

I'll share one "G" rated (and yet bazaar) hallucination.  Coming out of a particularly deep anesthetization after yet another surgery, I was unable to rouse myself more than being aware of a completely blank white state/place.  Nothing. Zip.  Eventually I found I could barely move within the space, and so I very gradually crawled along until I arrived at a corner/edge where boundaries converged.  Sigh.  Can't go forward, . . . don't want to go back, . . . so I tried harder to discern anything other than blank white.  Looking very carefully, I noticed a slight variance in the blank white space closest to where the boundaries converged.  Looking closer still, I discerned small movements.  At this microscopic level I saw incredibly tiny "things" manipulating space/time to create something other than blank white.  I sat their transfixed as these things very gradually created just the tiniest beginnings of a reality.  It became apparent that these tiny things manipulated space/time in order to create entire realities that we experience.  I realized that scads of these tiny things do nothing other than constantly adjust space/time to seamlessy "stream" our reality.  As I continued to watch and comprehend, I learned that these things "specialized" in their space/time manipulations, . . . a gazillion of them combining their efforts to create the reality of one of the door knobs where you live, . . . and only that.  It goes on, but you get the picture.

More on de-escalating pain meds and consequences there of another time.

Fewer miles + More elevation (on stairs) = JOY!

Turns out that it is not necessarily walking time that is causing excessive joint pain but mileage. 

The longest walks (two laps around Green Lake at 5.8 miles with no elevation gain in two hours) are the most painful.  Long walks (four laps on the NE 74^th St Hill at 5.0 miles with 1,200 ft of elevation gain in two hours) are plenty painful.  Over the last couple of weeks my level of frustration and disappointment has been building because I've not been making further progress, with joint pain holding me back.  After these walks, I'm hobbled the rest of the day and much of the day after.  I've been dejected enough to begin contemplating punting on this whole rehab thing. 

Then, yesterday I returned to an old workout haunt, Golden Gardens Park, to climb the steps from the beach to the top of the stairs at the corner of NW 85^th St & 32^nd Ave NW.  I went four laps up & down for 2.8 miles (less miles) and 1,000 ft of elevation gain (similar) in two hours (the same amount of time), and it felt very good compared with walks of greater distance.

Rather than walking the longer trail I used for workouts before the accident, I stayed on the super long set of stairs leading a more direct and steeper path to the top, but as steps are easier for me to navigate at this point than a slanted trail, this ascent route felt much better.   Comparing yesterday’s workout with what I used to accomplish on the Golden Gardens Hill I am half as fast with less than half the pack weight.  Before, I was doing four laps per hour with a 50-pound pack for three hours, so a total of 12 laps, nine miles and +3,000 ft elevation gain.  Yesterday I did two laps per hour with a 15-pound pack for two hours, so a total of four laps, 2.8 miles and 1,000 ft elevation gain!   

The good news is that I purposefully took easy yesterday and because the joint pain wasn’t too bad, I anticipate being able to increase speed and pack weight over time.

After yesterday's workout I walked out on Golden Gardens Beach to the shoreline for the first time since the accident and enjoyed a fantastic view of a very high tide and calm winds making the Puget Sound look like a glassy smooth bathtub filled to overflowing.  It was just after sunset and the Olympic Range was clear on the horizon with a few clouds hovering over the peaks.  It was a perfect setting to be overwhelmed with thankfulness for the workout, my good fortune, and the beauty of the world, filling my heart as full as the Sound.  Quite often an interesting thing happens when I send up fervent thanks; I often sense a clear response encouraging me to get over the thankfulness (already) and to get busy living a life worthy of the good fortune that I’ve been allowed.  All right, all right, I respond, . . . just saying thanks!

Twice the distance (half the fun)

In the last two weeks I have increased my walking workouts (chart & graphs below):

   * distance from 3.2 miles to 5.6 miles
   * elevation gain from 150 ft to 1,200 ft (yes!)
   * time from 68 mintues to 124 minutes
   * pack weight from 5 lbs to 12 lbs

Yesterday, I found out what two laps around Green Lake feels like.  Four weeks prior, I had been very proud of accomplishing a single lap and I wanted to attempt twice the distance and set a new personal best.

Green Lake is a beautiful place to walk, especially in the late afternoon with golden light streaming over Phinney Ridge.  There are usually many other people there running, walking, skating, and biking so plenty of distraction and motivation.  If you time it right, you are done with your workout and can sit & recover while watching a spectacular sunset.

One downside of the Green Lake walk is there's no shortcut back to the starting point.  Once you commit to going about half-way around you have no choice but finish, . . . well I suppose you could call for an Uber, but get real.  My prior personal best was 5 miles (which was pretty tender), and just two weeks ago the farthest I'd gone was 3.2 miles, so although up for the challenge, I felt trepidation about the last mile of the Green Lake loop.

And for good reason!  Although I completed two laps in a little under two hours I was definitely not enjoying the sensations emanating from my feet, ankles and shins for the last 20 minutes.  Groan! Prior to the accident, I'd become inured to aches & pains associated scaling Pacific Northwest Peaks, and my misery index was calibrated higher than most.  It is a struggle to rebuild this capability, and whoever suggested I'd bounce back quickly needs to be set straight.   

Rebuilding the endurance of muscles throughout my lower appendages is flat out grueling, and after these workouts I wonder whether I'll meet the goals I've set and whether I'll ever again be on an alpine trail with heavy pack.  Patience I tell myself; one step at a time.  Regardless of these doubts, you can see in the charts below that I remain ahead of planned incremental improvements in distance, time, elevation, and pack weight.

It's time for a follow-up appointment with the Harborview Orthodpedic team and I'll be interested in hearing the doctors' responses to several questions about my convalescence:

1.  Am I pushing too hard?  When I described my walking routine to the scheduling nurse she indicated very few people do anything like that so soon after such extensive surgery, and that I should let my ability to manage pain & swelling guide frequency, distance, time, elevation, etc.

2.  Is my left leg longer than my right?  Given the amount of reconstruction the surgeons did on both ankles & shins it wouldn't surprise me if one leg ended up a different length than the other.  The doctors had one shot at this, and separate teams were working on each foot, so no telling how well they coordinated on finished leg length!  I sense that my left leg is a little longer, because when walking along a path with a slight cross-path slant my gate is much smoother when my left leg is on the "downhill" side of the path.  It could be that because I have less feeling in my left foot/ankle/shin (and less range of motion) I favor it (walking a little club footed) and that may accentuate the effect of the slight path slant.

3.  Is my left shin bowed?  Especially when wearing shoes, it appears as though that shin comes away from the ankle at a slight outward angle compared with the other foot.  It's like my left foot is attached a little off center (toward the inside of my stance).  It's less noticeable without shoes.  Have I caused this as a result of my walking routine?!

4.  Should I upgrade the compression in my compression socks?  Thankfully the doctors prescribed light compression socks to start with (which are difficult enough to get on by myself), but now I'm wondering whether "medium" or "stiff" compression might improve recovery after walks and reduce swelling.

Chart & graphs on my walking record thus far: 
           

Back to the scene of the crime

Because the spreadsheet recovery plan I put together several weeks ago (and that now controls my life!) calls for carrying gradually increasing weight and taking on gradual elevation gain, I have been modifying my walks. 

Initially, I remained on the 3.2 mile flat ground course in Magnuson Park and carried a day-pack loaded with five pounds worth of Velcro strap-on weight belts that I had used for arm exercises while bed & wheelchair ridden.  Although this measly amount of weight was hardly noticable, it added four minutes to my workout.  Next I found a street ascending a gentle hill at the edge of Magnuson Park and after nine-laps up & down, I had completed 3.4 miles and 400 feet elevation gain with a ten pound pack and this time it took an additional 13 minutes compared to the flat course with no weight.

I could see where this was going; in no time at all the weight belts wouldn't be enough.  It was time to use my old training pack, the same one I used in Louisiana for the Tunica Hills workout (last post), and prior to that for Seattle in-city workouts (more on those in a subsequent post).  It is a sleek & lightly constructed Dana running pack (no padding on the shoulder & hip straps) that I purchased for $5 at a neighborhood garage sale on a whim years & years ago.  It fits a 50 pound sack of sand with just enough extra room for a water bottle and a light puffy jacket.

In the early days while building up to carrying the fifty pound sack of sand on Seattle in-city workouts, I carried gradually increasing numbers of water & sand-filled Nalgene bottles (ten of which are the equivalent of the 50 pound sack of sand).  The water & sand bottles were on a shelf in our garage, but the Dana pack (still filled with the 50 pound sack of sand) was at Vertical World (made sense to keep it there for tread-mill and callisthenic workouts after the twice weekly wall-climb routine rather than humping it back & forth to the car every time).

I had not made it back to Vertical World since the fall.  While bed ridden at Harbor View and Anderson House Skilled Nursing Center it wasn't a possibility.  Then once mobile---but limited to the power wheel chair and Seattle Metro bus service---there wasn't a practical way to get there because it is far from any bus route and there are no sidewalks for the wheelchair.  Once I started walking short distances and driving a car it became practical to visit, but there wasn't a compelling reason.  Going back to the scene of the crime never made it onto the short-list of to-do items.

But now I needed that training pack, so I drove over and hobbled in. Initially, I focused on explaining my presence to the front desk folks, and then I went upstairs to the workout room to retrieve the pack.  While coming back down the stairs, I realized that on the way in I had walked right by the wall I fell from without stopping to look at it even for a moment.  It was as though I had purposefully avoided looking that way.  So on the way out I stopped for a quick glance.  Noticed the routes had changed (of course).  The wall was tall.  Where I fell from was way the heck up there.  It wasn't in me to stick around pondering the scene for any length of time.  Guess I'm not ready to get back on that horse just yet.

With the training pack and water & sand bottles in the back of my car I'm fully ready to gradually increase carry weight on my walks.  This morning (Super Bowl Sunday) I tried a new venue, the road leading down to the West Point Lighthouse in Discovery Park on the Puget Sound.  In four laps up and down I completed 3.42 miles and 850 feet of elevation gain with a twelve pound pack in a little over 96 minutes, which is about 30 minutes longer than a similar distance (2/10's of a mile shorter) with very little elevation gain and no pack weight.  I can live with that!

Beating 24 minutes a lap on the West Point Lighthouse hill is something to shoot for.  It'll be nice when I'm doing eight laps, 1,700 ft and almost seven miles!

Setting ambitious goals, reminiscing on prior exercise routines, and personal bests

Two Saturdays ago, I completed a 2.9 mile lap around Green Lake in the heart of Seattle’s northern neighborhoods for the first time.  In the interim between this latest personal best and the two-mile trek the week before, I had completed an incremental walk of 2.5 miles, . . . just gradually increasing mileage with each walk.  The good news is that from two miles to three miles, it took the same amount of time, about 65 minutes, so my walking gate continues to smooth, lengthen, quicken.  The Green Lake walk occurred on the Saturday after the presidential inauguration and this being Seattle a protest run had started on the other side of the lake but in the opposite direction so I ended up weaving through many hundreds of runners wearing pink knitted caps!  On the following work-out day I increased the number of flights of stairs from 16 to 24 by moving from two circuits of my exercise routine to three circuits.  Since the Green Lake walk I’ve upped the distance to 3.2 miles, and soon it will make sense to re-join a gym so that I can increase workout intensity using gym equipment and weights.

I have been wanting to set more explicit goals for my recovery, and so yesterday I built a spreadsheet showing three-day increments throughout 2017, and starting at 0 miles, 0 minutes, 0 elevation gain, and 0 pack weight, and ending with 15 miles, 10 hrs, 6,000 ft elevation gain, and 50 lbs pack weight (an estimate of what I’d need to be capable of to successfully climb the nearby volcanoes).  As of the end of January, I am well ahead of distance and time targets, but will need to start carrying weight (only 5 lbs at this point) and begin taking on slight elevation gain, so I’ll be looking for neighborhood streets with gentle elevation gain.

Back in 2012 I moved to Louisiana for several years to take advantage of an interesting work assignment, and hence needed to get creative about staying in Mountaineering condition.  While there, I joined Anytime Fitness and used their facility twice weekly on weekdays and then hiked in the Tunica Hills (on the Louisiana / Mississippi border) on the weekends in the fall, winter, and spring.  In summertime, it was far too hot and humid to work out in the hills and so I would do an especially long Anytime Fitness workout on the weekends.  During the shoulder weekends of fall and spring (even with a pitch black 0400 start with headlamp and hand-held torch) it would become so uncomfortably hot & humid that after each lap I’d pull off my drenched and dripping shirt, underwear and socks to ring out the sweat.  So much sweat would run down my legs and collect in my boots that is was as though I had walked knee deep through a stream with my boots on.

The Tunica Hills exercise routine was closer to an intricate cross-country obstacle course than a hike.  I would strap on a 50-pound pack and walk/jog three laps around the five-mile circumference of The Thompson Creek Natural Area with enough hilly ups & downs (some very steep requiring veggie belays) to be the equivalent of 2,000 feet of elevation gain per lap.  Over the several years that I lived in Baton Rouge I made so many trips around the course that I knew every turn in the path, every step and every hand-hold.  I kept track of time on my trips, including measuring lap split times, and tested different strategies to improve my speed and endurance.  Also, depending on the amount of rain the prior week and the temperature, precipitation, and breeze forecast for the day of the workout, I could anticipate whether I had a chance at setting a new personal best time. 

The first attempt to complete the Tunica Hills workout took over eight hours (route finding issues) and my final personal best time was 5:48.  On the day of my final personal best, it hadn’t rained for a week so the trail was firm and the creeks were low, and it was cool and breezy, so I could move very quickly without overheating.  The most successful strategy for me turned out to be starting FAST and just trying to hang on to that pace going forward.  Taking Ibuprofen beforehand contributed to taking at least 10 minutes off my total time, as it reduced foot swelling, which reduced pain, resulting in less distraction and better foot placements.

The Tunica Hills workout was always great fun with lots of wildlife distractions along the way.  Most common were deer in the creek bottoms, armadillo rooting around in the leaves, raccoons & possums sharing the trail, turtles, tortoises, and the occasional flock of wild turkeys.  Startling turkeys always got my heart pumping because the entire flock would explode out of the understory and into the air all at once.  Somewhat less common and worth keeping a close eye out for were the cotton mouths and water moccasins, both goodly sized, aggressive & poisonous snakes.  Also, spicing things up a bit were the seasonally reoccurring waives of mosquitoes, biting flies, ticks (thankfully not carrying deer-tick disease, just an abundant nuisance), and (literally) huge spider webs with palm sized banana spiders in their centers.  These were the nephila clavipes of North America (not phoneutria of South America).  Although the varieties can be about the same size, they have dramatically different appearances, behaviors, and habitats. The North American type spins a web known for its incredible strength, and is shy and fairly harmless.  Walking / jogging into one of these super webs prior to sun up definitely gave me the creeps (where’d that spider go)!  The South American kind travels over the ground, hunts instead of making a web, is aggressive and has a potentially lethal bite (thank goodness there were none of these). 

Several weekends each year in early spring robins would visit in great flocks carpeting the forest floor, and they would ripple outward from my progress through the forest, a never ending flurry of wings.  Next, the cicadas would make their appearance, boring out of the dirt and working their way up the tree trunks to eventually emerge from their shells and remain stock still allowing their wings to dry. Then in the following weekends a seemingly infinite number of lightening bugs (fire flies) would make the forest a magical place before sunrise.  There was always something different to see / experience, including fantastically heavy rains and even the occasional snow fall!

Six hours of intense solitary workout in these abundantly verdant & vibrantly alive surroundings provided fertile ground for introspection, revelation, and creative imaginings.  Pretty certain I solved most of the world’s problems during these hikes!  After the workout, back at the trailhead parking lot, I’d pop open a frosty beverage and break into a bag of salty crunch and as often as not would answer questions from other park visitors about just what I was up to (training for Everest?!) because my boots, heavy pack, and rapid pace were definitely not the norm.  Eventually I made the acquaintance of the park ranger and became his eyes & ears on the park’s perimeter as he spent most of his time on the more frequented common trails through the park’s interior.  He asked for my mobile number and “deputized” me as an unofficial on-call emergency support person (SAR-lite) in case someone got lost or injured out there.   On several occasions, I did redirect turned-around hikers who had lost their way on the trail.

At this point in my recovery it is hard to imagine completing even one Tunica Hills lap as the trail is so steep and convoluted.   In any case, it's nice to recollect.  Of course, I could make it if I had to, . . . it’d just take forever!

A little farther & a little faster

During the first week of January I visited the side-opening doctors so they could evaluate that pesky bulge on the side of my abdomen.  Great news!  They are reasonably certain that it’s not a hernia but rather a flap of muscle that came loose from sutures somewhere along the way and is now bunched up and useless.  Turns out that muscle tissue is difficult to sew back together and hold fast, and now that this bit has separated there’s not much sense in going back in and sewing it back together again.  Instead overtime the non-functioning flap will atrophy and resolve itself, and underlying smooth muscle bands will bulk up and take on the job.  In the meantime, I’ve replaced casual slacks with Under-Armor work-out pants and their elastic waist bands nicely resolve the buttoning issue.  Now I can wear something other than rugby shirts (that are OK left untucked)!

I’ve held true to the three-day exercise routine for these last two weeks and have progress to show for it.  On the walk day, my new personal best is two miles in 65 minutes, and on the calisthenics day I’m doing 16 flights of steps up from eight.  My ankles/feet are still plenty tender afterward, but I’m sensing they are recovering faster.  Torso, butt, and leg muscles are always stiff and sore as they are under constant pressure to rebuild; they feel as they would after a typical weekend climb/scramble in the alpine but without the payoff of sublime views.   But you know, if I can walk two miles, then I should be able to walk four, and then eight, . . . we’ll see about that.

Rather than walking around the block at home, now I am walking at The Mountaineers, either at lunch-time (so I can ice for the rest of the afternoon while at my desk) or after work while the commute grinds along throughout Seattle (and then I’ll either stay late & ice while keeping up with work stuff or I’ll head home and ice while catching up on personal email / tasks).  The Mountaineers Program Center is situated on a Naval Air Station (now known as Magnuson Park) on the western shore of Lake Washington, and so there are great expanses of ideal, quiet park setting, sports fields, play grounds, etc., with paved or graveled flat trails to walk through. 

Tomorrow’s another walk day and this time I’ll use the Backcountry Navigator App on my phone to record a track and get a better fix on distance.   Those sports fields are tempting though as they present a perfect surface to safely build up speed, and now I’m thinking how wonderful it would (will?) be to sprint, kind of like the first time I stood up from the wheel chair.  

My pace is becoming somewhat less stilted and erratic although it remains no thing of beauty.  Because my left foot / ankle is still mostly asleep and less limber than my right side my reptile brain automatically wants to favor it (without nerves providing feedback, autonomous protective systems can’t confirm I’m not causing damage) and it takes focus to over-ride auto-pilot and force a smoother step.   It sure will be nice when (if) that left foot / ankle regains more sensory perception; all-in-all the left foot / ankle has me worried, as I just don’t know if it will be able to make the full recovery.  It won’t be for lack of effort.

Now that I’m walking distance it is making less and less sense to haul a portable collapsible wheel chair around in the back of my car (soon it will be time to pass this barely used convalescence aid on to goodwill) and the trekking poles have long since been stowed in the garage.  However, I remain thankful for the handicap placard displayed on my dashboard that allows for prime parking spots.

The power chair remains at my desk so that I can elevate my feet / ankles, but it moves less and less as the days progress.  Goodness, how indispensable it was in enabling Metro bus commutes from The Ballard Landmark to The Mountaineers, which remarkably ended just three weeks ago!

Thanking all my lucky stars, . . . 

I walked a mile!

Yesterday, it took about 40 minutes to complete two laps around our neighborhood block, so what I was doing looked far more like an old guy shuffle than a walk, but completing a full mile all in one go by the end of the year was a small goal I'd set for myself, so I just kept going and going and going.

Pretty sore this morning, so I went for a standard two-hour workout (hair of the dog so to speak) consisting of high-stepping back and forth across the exercise room multiple times, ascending flights of steps, completing a series of leg, arm, and torso calisthenics, and then stretching to increase range of motion in these thick and stiff ankles.

This afternoon I've had feet/ankles elevated and iced for a couple of hours to reduce pain and limit swelling.  I'll take the day off tomorrow to let things settle before going through the same drill again, and again, and again, . . .  walk one day, work-out the next day, recover the following day, . . . a little further, a little faster, more reps, etc.  At some point I'll add elevation and pack weight, but first I just need to develop a better/faster walking gate.

Huzzah!