Rotator Cuff Update

I had surgery on my left shoulder back in January. I thought I'd post an update in the hope that it might help some other middle aged person who's facing a similar situation.

I hinted at the problem in my 2013 retrospective. I did my best to manage it as a chronic condition. I even went back to swimming, albeit at a greatly reduced effort, frequency, and intensity. But by the time my surgery date approached, I noticed that the muscles behind my left scapula felt markedly worse. I was grateful to be on the surgical calendar.

It was the first time I've ever been under the knife. I tried to remain calm, but when they took my heart rate and blood pressure on arrival at the surgery center both were sky high. The anesthesiologist put some valium in the solution when they prepared me for the nerve block "to take the edge off". I found out later that I had fibrillation again when they intubated me. They were worried enough to send me to a cardiologist for an echo cardiogram after I returned home. All was well. It was fear!

I was wheeled into surgery at 11:15 am. I believe it was 3:30 pm when I woke up in the recovery area. They found out that I had a bone spur on my collarbone that was abrading my labrum. Some time with power tools took care of everything. The nerve block worked wonders for 36 hours - I had no pain at all. I took the pain medication to stay ahead of it, but I hate taking pills. I weaned myself down to one at a time, then off completely after a few days. I never experienced any pain at all.

I was in physical therapy the day after surgery. The exercises were little more than moving and stretching, but they were key for avoiding excessive scar tissue buildup and stiffness. I went to physical therapy faithfully three times a week and did the exercises on my own at home. At first they were difficult and frustrating. One of the worst was the 1 kg medicine ball. I had to put it on a spot on the wall at shoulder height, then rotate the ball about that point ten times in each direction, three times each. Those small muscles in my shoulder needed to control the ball simply weren't firing. I could barely keep the ball on the spot, and just a few reps left my shoulder exhausted. But I stayed with it, going so far as to order a ball of my own so I could do those exercises at home along with the hand weights.

The physical therapist was terrific. He said there's a controversy in the field over when to start physical therapy. If the surgeon lacks confidence in his repair s/he's likely to recommend remaining in a sling and immobile for up to five weeks. The typical repair technique calls for drilling two holes in shoulder bone and inserting pins to hold the stitch and muscle to the bone. Pulling the pins out is catastrophic. My surgeon drilled all the way through the bone and looped the stitch through the holes. The only way to pull it out is to destroy the shoulder. The more reliable attachment, combined with arthroscopic minimally invasive cuts, made it possible to start on therapy right away.

The therapy room was always filled. Old and young: the former because of long use and the latter from sports injuries. One afternoon I was doing my exercises next to a man my age who was struggling with a range of motion exercise that I'd endured eight weeks earlier. "What are you here for?" I asked. He'd had his elbow repaired. When I told him I'd had my rotator cuff fixed, he said "I had that done last year by another surgeon. I was in a sling for five weeks; I couldn't drive for five weeks; I slept in a recliner for five weeks. I started physical therapy after discarding the sling and endured it for six months, and it's still not right. You look like you're doing pretty well." His eyes popped out of his head when I told him I'd had my procedure just eight weeks ago.

I was in a sling for ten days. I was driving once I left it behind. I started on physical therapy the day after. Seven weeks after surgery did my first lengths in a pool. I was discharged after eleven weeks and feel almost 100%. I'm still doing the exercises on my own at home once or twice a day. I'm working my way back to regular swimming, including Masters. I'm back out on the road running and feeling good.

So if you're reading this and considering a procedure, take heart. It's possible to come back. I'm on my way.

Running

It's almost halfway through 2011. We've passed the summer solstice, the happiest day of the year. This was what I was longing for back in January when there were ice dams on my roof that wouldn't yield to repeated blows from a steel hammer.

2010 was far and away my best swimming year ever - an absolute blow-out in yardage totals, attendance, and every other measure you can think of.

2011 will not top it. By the end of Jun 2010 I had 318,100 yards under my belt. Right now, my total for the year is only 158,100 yards. Half the total!

The reason is easy to see: poorer attendance and effort. Five of the first six months in 2010 were "best monthly yardage totals." This year I fell short in January and never caught up. I haven't been regular about making it to Masters workouts. My standard morning workout was 2500 yards last year. This year I've put in 2000-2400 yards a day, rarely reaching that 2500 yard mark. Those small differences accumulate over time.

I had two bouts of poor health. There was a feverish weekend back in March that left me flat on my back. But I went back to my swimming regimen as soon as I finished the course of antibiotics and recovered sufficient strength. I don't think I was fully recovered. When the trees popped in May, spewing pollen everywhere, my health collapsed. I couldn't breathe, couldn't stop coughing. I was able to recover thanks to extreme measures, a smart doctor and wonderful health coverage.

But I found myself back at square one when it came to fitness. I've always been lung-limited while swimming. Now I had to figure out how to get it back. I had to do something different.

Swimming and biking are great, but there's nothing like running to tax the lungs and expand capacity. I decided that I had to learn how to run again.

I started swimming back when I was 21 because I wanted to avoid the toll that pounding the roads would take on my ankles, shins, knees, and hips. That was prescient - no replacement surgery for me. I ran every day then, but I haven't since. I'm lucky if I run the Manchester Race on Thanksgiving Day and hit the road half a dozen other times in a year.

There's a speed limit sign exactly a half mile from my driveway. I started running half-mile repeats, with a two-minute rest in-between. The key is to be regular and focused. I want to run four times a week. Don't take days off. Don't be shy about two workouts in a day. Keep working my lungs, getting a sweat on, and building my metabolism and lung capacity up.

It's worked out well this week. I swam at noon on Monday, squeezing in 1500 yards that included some nice 100 repeats. I had a yoga class at the grammar school just up the street after work. I measured the distance from my driveway to the school: 1.3 miles. A run to yoga would be doable. I persuaded my youngest daughter to join me. It was fun to have a running partner.

We had a 90 minute yoga class that felt great. I felt strong and loose. Wouldn't a run home complete the day? My daughter was game, so we ran home in the dusk followed by clouds of fireflies. It was a beautiful experience.

I'm not trying to run marathons. I don't want to race or be competitive. I just want to get my lungs back and feel fit again. I've learned the hard way that running is the only way. I've neglected this activity for too long. If this week is any indication, it's like seeing an old friend again after many years.

One Hundred Pushups

I'm already obsessively tracking my swim progress each and every year. While my yardage totals and performance in the water would not be impressive for a trained swimmer, I've been pleased enough with my old guy efforts.

One of the joys of swimming is also a problem: buoyancy. The water holds me up when I'm swimming. It's gentle on joints - knees, ankles, and hips don't take the pounding that something like running or basketball would dish out. But you don't get the benefit of a weight-bearing activity.

We all lose muscle mass as we age. I've been thinking for a while that I need to mix some strength training into my routine. I've never been a machine or weight lifting kind of guy. The place where I swim today offers a lot of interesting alternatives besides swimming, but I'm not sure that they fit into my day as nicely as the early morning, before work swim does.

So what's my solution? I'm trying a regimen that I Stumbled Upon: One Hundred Pushups. The idea is to build strength by working your way up to 100 good push-ups per day over a six week period.

I like it, because it can fit into any day, it doesn't use machines, and I don't have to go to a special place in order to do it. I can also work it in with yoga, so I'd have all three legs of the fitness stool: aerobics, strength, and flexibility.

Today was my first day. I know, the web site says to work on Mon-Wed-Fri with weekends off, but I swam last night and wasn't up to doing pushups when I returned home. I did the test on Wed and found that I was average for a guy my age. So I'm starting at the beginning at Week 1.

I'm hoping that having a routine laid out will help me stay with it. I'll be tracking it in my Excel spreadsheet. I'll report back on my progress in six weeks.

First Ride Of 2010

It's a spectacular late winter Sunday. Temperatures are up above 50 F/10 C and skies are cloudless and blue.

I usually don't get on my bike until spring is well under way. I didn't take my first ride last year until 19-Apr-2009. Sand and pavement broken by ice and snowplows usually combine to scare me off, but I couldn't resist this year. I pumped up my tires and headed out to circle the lake in Marlborough, a modest ride of 15.9 miles.

I was dressed for colder conditions. I had a new pair of fingered gloves that kept my hands nice and toasty. I wore a hat under my helmet so my ears wouldn't go numb. I had tights, a sweatshirt, and a windbreaker on. I worked my way to a good sweat by the time I was done.

I think the extra 500 yards I've tacked onto my daily swims is paying dividends. I felt fit today. There are three decent climbs on this ride, including
Jones Hollow Road in Marlborough. I downshifted and kept my seat the whole way up instead of standing on the pedals and rocking the bike. My heart, lungs, and legs all felt good. I've been doing more kicking with a board lately during my swim workouts. My legs were up to the task today.

I had no problems with sand or pavement. My brakes were squealing loudly when I left the house, but once the pads and rim warmed up the noise went away.

My equipment was in fine shape. I replaced my pedals last year. A chronic problem with flat rear tires was corrected with a new rubber seal on the spokes. I added a strobe light that hangs off my seat post, at the cost of having to remove the carrier I used to bring my clothes to work. It'll help to keep me safer in the morning if I start riding to work again in April. I'll have to find another way to transport my clothes. Perhaps a backpack will do the trick....

I loved being back on my bike again. It means that winter is on its way out, that spring isn't far away, that I'll be back on the road to work with my friend Michael again soon. Of course I tracked my riding last year in the same spreadsheet that I used to track my swimming totals. I'm starting earlier than last year. If I could work my way up to two rides to work per week on average I'd have no problem besting the 625 mile total that I accumulated last season. Maybe I can break the 1,000 mile barrier this summer.

If only I could translate this goal and metric oriented thinking to my entire life. I'd accomplish far more than I have to date if I could only figure out how.