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!

I'm home! With a small complication . . .

Last Saturday, twenty-four weeks since the fall, I moved back home from The Ballard Landmark Assisted Living Facility.  This was my first time back home, . . . it's been a while! 

Because our home has steps leading up from the sidewalk to the front yard and more steps to the front door (with similar obstacles approaching the back door) there was no way to make it wheel chair assessable and so returning home was dependent on safely traversing steps & stairs.  I am now doing this (carefully) in spades.  When I get up from my desk and head to the break room for coffee I tack on a couple laps up & down the indoor flight of steps to The Mountaineers top-floor meeting room.

Marijane moved my clothes and the other stuff that fit in boxes, and Dolly.com moved the bed, night stands, table, and chairs.  Thanks again Marijane!!  Dolly.com deserves a shout out as well.  If you haven't used them yet, it is like Uber for folks who own a truck and for folks who need a truck.  It was incredibly easy (and cost effective) to schedule a micro move, and the two helpers who did the "heavy lifting" were timely, friendly, and professional.  Couldn't ask for better.  If you need a truck and folks to move stuff for you, Dolly.com is a great way to go.

The complication has to do with one of the things I talked with the back doctors about at my six month visit last week.  Everything with the back is fine (and they were pleased with the most recent set of x-rays), but there is a lump/bulge on the side of my abdomen close to the 6" incision which allowed access to the blown out vertebra (so they could pull out the shards, and replace it with a titanium cage).  The bulge doesn't hurt at all, but it has altered the shape of my torso enough so that pant waists no longer fit. 

It could be that the nerves in the vicinity disturbed by the surgery aren't yet firing and so muscle tone isn't consistent across my abdomen, but more likely it is the result of me doing too much in-bed leg-lift physical therapy with leg casts which caused a hernia.  Yikes!  The back doctors gave me a referral to the side-opening doctors (interesting note, . . . as it turns out a different set of doctors actually opened me up and moved all the internals out of the way so the back doctors could do the vertebra replacement work) who are also familiar with hernia repair and I'll visit with them next week.  Once again under the knife!

It ain't over 'til its over . . .

The long ascent ahead

In the last several weeks at physical therapy I have moved from basic skills (walking, balance, stairs) to kinetic strength building (more sets and more reps), finally getting my heart pumping again with perspiration streaming down my face.  I can transition back and forth from standing upright to lying on the floor, so have increased the range of exercises I can accomplish.  Feels good! 

And not a moment too soon, . . . I've regained all the weight I'd lost during the first several weeks of surgery & convalescence, and there's no way that it is all muscle (although hardware remaining inside definitely contributes) so it must be chub and that just won't do.  No more desserts for Bill.

Doctors & PT folks encourage me to walk to tolerance, so I leave the power wheelchair at work and walk as much as possible while away from work.  The power chair allows me to keep my feet elevated for the majority of the day while at my desk, and I use it when traversing further distances around The Mountaineers Program Center.  My feet and ankles swell after PT and extended walking episodes so I've taken to icing them afterward, and because feeling is still limited throughout the damaged areas the cold doesn't really distract me.

That lack of feeling in my left ankle / foot is the biggest distraction at this point.  It feels very similar to the pins & needles sensations you get when a joint has gone to sleep after being restricted for too long and when you begin to move it again.  Rather than lasting a minute or so this feeling has been with me over these last several months and will be with me for many months more while nerves slowly mend (one millimeter per day or an inch per month).

Pain remains a minor distraction.  Feet & ankles are "tender" when walking, but in no way eye-watering. The back has never been anything other than stiff and maybe just a little sore.   Hands/wrists/forearms respond typically to PT range extension exercises (ouch) but during day-to-day activities they report just an occasional dull ache.  The doctors assure me that arthritis will be a constant friend going forward and the ache is likely a precursor.

Good news!  I've been able to remove tight compression socks by myself and with the help of a "sock donning device" I'm now able to put them on by myself as well (just five months after the accident).  Had worried that insufficient flexibility would forever limit my ability to dress myself!  This minor victory is especially satisfying, as it is the last vestige of being unable to fend for myself and it allows me to shower at my whim rather than scheduling assistance to remove and replace socks before and after showering.  (Thanks Marijane!!!)

Yesterday morning I dropped off all the other convalescence aids (slide boards, etc.) at Anderson House (the skilled nursing center I stayed at after departing Harborview) to assist others on their way to recovery.  Still holding onto a couple of walkers and a portable wheelchair just in case, but those will eventually find a new home as well.

From here on it's just a matter of remaining resolved to push hard and keep going, walking further and faster, increasing strength building reps, . . . typical Mountaineering stuff and Ashby protocol. 

Onward.