2 Weeks

It been two weeks since my knee operation. I guess everything is going OK. I added a picture of someone's knee I found on the web to give everyone a reference for the procedure. I know I didn't know I had a fat pad in my knee before I got part of it removed. My knee is starting to look like a knee again. The swelling is still present but is concentrated at the lower part of my knee near the operation site. The pain isn't too bad. Most of the day I don't notice it. However, if I walk around in a brace for too long it will start to hurt. Walking in the brace is definitely a skill. I have to roll one foot and bounce to keep from pointing my foot out.

I have started taking the brace off when I sleep. On the bright side sleeping is easier, on the down side, if I get up I have to break out the crutches to keep the weight off. I am starting to get some mobility back but in general the only time I get to move my leg is when I am at PT. I can move up to just over 90 degrees but my knee is really tight. The range of Motion should return once I can flex the leg but right now I am no where near normal.

I have started to workout again. No, I can't ride, run or even swim yet, however, I have found the weight room. I am doing rehab work with a straight leg and brace. Additionally, I have started to lift with my upper body and left leg. It's great to be moving again. Of course, maneuvering my leg/brace around as I go from machine to machine is constant learning experience.

Post Op 1

After 6 days, I had a day full of medical visits with a bit work tossed in the middle. The day started with my first post-op appointment. I was looking forward to it as it was my first chance to get the full story on what happened and an explanation of the pictures I have been staring at for the past few days. So what was really done? The fat pad (I think anterior?) was inflamed and removed. Scary but true, I also got a CD with a video of it being cut and ripped out (ouch). The fiber near the attachment site was trimmed. If you look at the circular probe in the pictures, it turns like a drill and appears to have roto-rottered the loose fibers away. The cartilage in my knee was soft; however, this could be genetic and didn't appear to be arthritic. The cartilage doesn't appear to be worn down or show any other signs of degradation. My ACL and MCL look great. Finally, the star of my procedure, a Topaz device was utilized to coblated/removed with radio frequency radiation--death by radio, several small holes in my patellar tendon near the attachment site of the inferior pole.

Once again, the concept behind the operation is to remove some of the damaged area and stimulate the tendon to grown again in a controlled healthy way. The general message was everything looked good and was healing.

My recovery program got a little more structure. I was told I could lose the crutches after 7 days. I will still need a brace for another two weeks but no crutches is great news. I can start swimming when the stitches disappeared. He guessed it would be another 7 to 10 days. The hidden good news is that I can start getting the area wet in another day. Until now, I took a few sponge baths, not fun, and more recently used some Nathan Power Shower wipes--way better, to get clean. I can't wait for a shower. Back to the rehab plan. When I return to the pool, it will be with my feet tied and a pull buoy. No kicking for 12 weeks. I was told, to delay getting on the bike another 3 weeks, 4 weeks total. On the bright side, I can bend my knee as much as I can as long as I don't but weight on it. My PT gal temporary took that freedom away later in the day. She suggested it would be best if I let her move it and I only stay get happy with my brace.

As for pain, it's not too bad. I still have a lot of tightness in my quad and my knee doesn't have anywhere near a full range of motion, up to 90 degrees after a little help. I was told my quad hurt because I was lifting my leg with it more and adding stress to it. Of course, combine that with some operation stress and you get sore quads. My biggest problem is actually keeping the brace all the way up on my leg. My quads are too dang skinny to fill out the top of the brace. Come on, why can't we use something big like my butt as a reference point. Nope, they use my skinny quads and I have to take the Velcro all the way to the side of the brace and not the designed point. Think of having to make your hole in a belt to get it to fit.

Later at work, we had a health screening. Other than being the guy hobbling around on crutches all went well. I have a good cholesterol level, blood pressure, sugar level etc.... Now if my knee heals life would be perfect!

To finish off the trifecta of medical fun, I had my second PT appointment. We discussed the full rehab process and started a lot of basic movements. It feels great to have my leg out of the brace and moving. Ok, I am not moving it but to have someone moving it is nice. I did a few simple leg strengthening exercises but all with a straight leg to keep the pressure off my knee. Simple rotations, lifts on different angles etc... Then we worked a little bit on using one crutch. I am not transferring weight to my right, injured leg. After a few reminders, I was doing better. I have to admit, I am still really nervous to put any stress on my right leg. I just don't have any confidence in it. I should trust the brace but easy to say and hard to do after a night of screaming in pain. Oh well, that's all from me.

Operation Day

So the operation happen a couple days ago and my goal is to document the process and my post operation experience so that others can learn from my experience.

The procedure was outpatient and I was scheduled to arrive in the morning. The facility was only a mile away from I live so I decided to walk. I knew it would be the last time I could walk for a few weeks so why not. I arrived with plenty of time to spare and relaxed in the waiting room. After a short wait, I was called back, filled-out some papers, and got dressed for the operation. On the bright side, I didn't get one of those thin gowns. Instead, they had these insulated ones with an attachment for and air hose to help stay warm.

After a short period of time, my doctor and anesthesiologist stopped by and I knew it about to be show time. I walked into the operating room and I was out pretty quickly.

I awoke about 90 min later in the post op room and was told my ride would be here soon and that everything went well. Sure enough, within a few minutes, my ride was there and I changed and was loaded into a car for the way home. Seeing as I didn't know what the next few days would hold, my friend volunteered for me to stay at their place and mentioned they would help out if I needed anything.

For the first few hours I felt great. Ok, I was walking with crutches and with a big leg brace but everything felt not too bad. I was told to move around and then hold my leg up. I did both throughout the night but in general was thinking this isn't going to be too bad. Well, I was a bit to optimistic.

After dinner, I felt a little bit of pain and started to take my pain meds, Norco. I took two and new I was going to take a sleeping pill in a couple hours and that would knock me out for the night. I made it up the stairs to my room, took an ambient and then read a few pages as I anticipated falling asleep soon. The entire process started around 10 and by 10:30 PM. I was hoping to fall asleep. I tried but just could get comfortable. My doctor mentioned I could take the brace off when I sleep if that helped so I tried that and couldn't get comfortable. Even worse, now my knee was starting to really hurt! I spent the next 2 hours changing positions and putting my brace off and on in hopes of getting comfortable and falling asleep. Unfortunately, it wasn't happening. I took two more pain pills and hoped they would kick in and kill the pain. No such luck. By 1AM I was screaming in pain into my pillow and hoping/praying anything would change. It didn't.

In my desperation, I thought I needed ice and maybe that would be the silver bullet. When I started down the stairs, my friend say me and innocently asked, "do you need some help?" I said, "Yes." I was truly suffering and hadn't anticipated it. I We made it down stairs, she gabbed some ice and helped me get onto the couch.

After seeing all the pain I was in, she called the doctor to ask for help. He said he couldn't do much because increasing my meds required special triplicate forms and it just wasn't going to happen. He did ask where the pain was and said the pain being all around my knee was from swelling and I had to get it down or the pain wouldn't stop. We prompted my leg up with 5 pillows and then placed ice everywhere. My friend was honest with me and told want I needed to hear. The pain will lessen but not anytime soon and you are just going to have to deal with it. Let's turn on the TV and it will help to pass time.

Somehow, when we turned on the TV, it was on Comedy Central and was showing a preview for Jackass in 3D. It brought a smile to my face. The pain returned but I knew I just had to find a way to make it through the next few hours. I told my friend to go back to bed because there was nothing she could do. If anything happened, I would wake her up and she could help. A few minutes later, she brought over a piece of bread to eat with the next pain pill and walked upstairs to go to sleep.

I spent the rest of the night, watching bad TV and wishing I could get some sleep. By 3 AM the pain had decreased enough for me to get a few minutes of sleep, 15 min, and then I would awake in pain. I repeated that a few times and by 5 was able to extend to 30 minutes before waking up.

The next morning came and she came down I was doing better. The blood had left my foot and the swelling as going down and my body was adjusting to the pain. It still hurt but it was not the screaming pain of the night before. We talked for a bit and it passed time before she took-off for work.

I called the doctor and got my medication increased. I still couldn't sleep more than 30 min and it was getting old. They doubled the pain killer and after a couple doses I was able to sleep for up to 60 min before the pain took over. By that evening, I was doing better but felt really bad between the lack of sleep and pain. After dinner, I stayed downstairs this night and had keep my leg elevated almost all day to reduce the swelling. To heck with the nurse telling me to move around, I needed the pain to go away.

The second night was infinitely better. I was able to sleep in 60 min segments all night long. I would only be awake for 15 to 20 min and then I was back asleep. The human body is an amazing thing. By morning I felt great! OK, the pain was present but after some sleep the world looked much better.

It was Friday and I was scheduled for physical therapy. I made it to my PT place. I was a little late but not too bad. The therapist was a little surprised I was there two days post operation but I was. After a few strengthening exercises, I underwent some electrostim and I was set to go home.

We stopped at Rubio's on the way home hoping a burrito would cure everything. It tasted great going down. However, the stronger meds had killed my stomach. After 3 hrs it was still sitting in my stomach and it come out. Not good! I ate soup and some yogurt that evening and couldn't even hold it done. I hate pain meds. They didn't help me when the pain was bad and now they had totalled fried my gut. On the bright side, I sleep great Fri night....I will get some images up soon so have patience...

a bad Right Knee

A couple weeks after I finished Ironman, Kona, I started feeling some minor pains around me kneecap. I was just coming off a nice break and wanted to get going for the upcoming 2010 season. I went to the weight room and when I tried to do leg extensions with my right leg I could barely lift the bar! I stayed away from running and went to my primary care physician who diagnosed it as runner's knee. I took anti-inflammatory drugs for 4 weeks and stayed off it but it just never felt right.
I stayed away from running until Jan and after a week new something was wrong and went to a specialist. I got an MRI that found a 5% tear of my patellar tendon. My doctor gave me a cortisone shot and said I would be fine if I would take a month off running and take it easy. I did but it didn't heal much. I never noticed and difference and was tired of waiting around. I returned to training and spent the full 2010 season trying to make up for lost training time. It never happened.
On the way back from a work trip, my knee was pounding in pain after sitting in a plane for several hours. I was really for a change and went to a different specialist, Dr. Daniel Keefe. Keep in mind, I could run/ride/swim with little to no pain but I couldn't stay seated for more than 30 minutes without pain.
Dr Keefe looked at my MRI and discussed several treatment options. I had already tried 2 months of physical therapy, 3 months of Graston therapy, gone to two chiropractors, one ART person and was working with the Wolf Studio. I felt confident I had exhausted all non-surgical options. He agreed. He suggested a new procedure call Topaz microabblation. I had never heard of it so I looked into it. The operation involves opening up the knee and burning a series of small holes in the tendon near the damaged region. The idea being destroy the damaged area and then stimulate new tendon growth in the holey region under post-op conditions.
I found a pretty high success rate for tennis elbow so I agreed to give it a shot. Yes a patellar tendon is different but from what I can tell my injury is rare. Most people either completely tear it off or have tendonitis. A partial tear is less common. I was informed to think about it because the small tear I have shouldn't effect my triathlon ability but I knew it was affecting my quality of life so I scheduled the procedure to occur 3 days after my last race of the year, Austin 70.3

Training with Ian and Kevin

Last in San Diego was the big surf monkey race that Rock and Huddle put on. As a result, many of my training partners decided to compete in it and avoid the traditional big Sat ironman training ride. However, I didn’t really have an interest in racing the aquathon and thought my training would be better spent getting some miles. I contacted Kevin and Thurs and he mentioned he was going up to LA for a big weekend with Ian Mikelson---crazy strong triathlete who is having a great season.
Since Ian has made a few trips to SD, I thought I would call him to see what was on tap. He mentioned Sat would be 5 hrs of riding through some hills near his home, Sat night a long run and then Sun a massive 7 hr ride up the coast. Definitely some big days and sounded better than Surf Money. Yes, there is something wrong with me. However, I still wasn’t sold because I just didn’t think the riding in LA would be that great. Well, after talking to Kevin again I was in.
So, Kevin and I met up, we loaded up my Honda Element and we drove up to Ian’s parent’s house in Torrance for a IM training weekend to remember. We got Fri night and after being off a block managed to find his house. We couldn’t see the street signs but knew the house with the loud stereo and college kids drinking in the front yard wasn’t it.
On Sat morning, we awoke and knocked out a good breakfast---lots of bananas and peanut butter. The weekend theme. We got rolling around 7 and managed to make several loops around Palos Verdes. Ian had this random connection of roads that made two loops. An outer loop, flatter with more signal lights and an inner loop with a nice climb. Other than losing a bottle after 4 hr, we had a great 5 hr ride for 95 miles!

We got home, ate a little bit of food and lounged around until 3:30. Now it was time to load up and head for the beach and an oceanfront run. The goal was 2hr 15 min out and back from Redondo Beach to whenever. It was flat on not too bad running along the bike path. The only bad part was the AVP tournament going on in Hermosa Beach. We had to zig-zag our way through a lot of people for a mile.
Surprisingly, the run went well. I tossed in 20 min of tempo at 1hr 45 min and it was painful. But other than that the run was a solid 19 miles. It was a great site to see Ian’s girlfriend “T” sitting on the beach after her long run. She was kind enough to go back to the car and pick-up our cooler with drinks.
We returned home and the feast began. Ian’s father Larry, made a trip to the store and had chicken and salmon. We tossed in a couple pizza’s as we prepped the food. I worked the grill and cooked the fish, chicken and some corn. About the time we started to eat, Ian friends Ryan and his girlfriend joined the group. Dinner was great and not having to go to the store was killer. BY now it was late and time to get to bed before Sunday’s adventure.
Sun was crazy long day. I awoke and ate as much food as I could before we left for a 7 hr tour up the coast. It took us a little bit more time to get going than we hoped. We got about 2 blocks away and Ian had a flat, so we turned back to fix it. About 20 min later we, we got rolling again. We wound our way through LA and up the coast and through Santa Monica and finally out to good riding. The rolling hills up the 1 were great. We cruised up the coast to Oxnard and grabbed some food/water and we headed home.
Once again, we got rolling just in time for Ryan to have a flat. We fixed it and started rolling. The wind getting back to the Malibu coast was strong. Kevin took a great a pull to give Ian a break and then we started working together. We were rolling and then Ryan got another flat. 3 flats in one day! We got rolling again and everything was great until this random cyclist hoped in and sat in the middle! We tried to talk to him but he blew us off. Eventually we reached Santa Monica and waited a bit for Ryan who stopped for water after being dropped. The ride was 5.5 hrs by then and I was starting to get tired. Unfortunately, the ride turned to city streets and the bike path and the ride went from great to bad for the last hour and a half. We rolled into the Mickelson mansion with 7 hr and 5 min of riding and 134 miles! Big day. We ate, loaded up the car and headed home to SD.

I arrived home around 8PM. I was dead tired and got nothing else done but some great training. I had 14 hrs of training with 19 miles of running and 229 miles of riding. Ian is a freaking freight train and his parents are great. If the riding was better, I could see myself making this trip a few more times. OK, that’s all from here.

The power of Food Inc

A couple weeks ago I watched the movie Food Inc. I highly recommend this to everyone. The movie describes how food goes from the farm to our table. While I had read both Fast Food Nation and The Food Revolution, something about seeing the processes described in those books just stood out. For example, chicken farms. I knew chickens grew faster and were all similar sizes to allow for assembly line cleaning. OK, breading . However, the consequences I had never thought about. The chickens grow so fast they can’t walk! The movie goes on to talk about the monopoly that Monsanto’s biotech has on crops and lack of labeling and power of the USDA. One of the important messages in the movie is you have the power to make changes by controlling your purchases. Something I thought about but never enough. Wal-Mart is placing a large effort on environment and organic foods. Does anyone thick this is because they want to support the environment and push a big green campaign? No, it’s because the market is growing and they want your cash. At the end of the day, you vote every time you make a purchase. Do you want free-range chickens or those that grow so fast and so close they can’t walk? Do you want hormones in your food? The choice is yours but I know my buying habits are changing.

Vineman 2009

Last weekend was vineman 70.3. Despite completing several vinemans I have never had a good race in Santa Rosa. However, I still really like the race. It normally draws a good field, the course is hard enough to break up the groups on the bike, it generally hot and the run in rolling. Best of all, a friend from grad school lives there and it gives me an excuse to visit her.
The only down side of vineman is there are a ton of waves and this year I was going off near the end. Over an hour and half after the first wave. It was a really strange feeling to be arriving in transition after the pro men had exited the water and I still had plenty of time.
The swim is a 1.2 miles out and back in the Russian river. I got out to a clean start and felt pretty strong. As the group thinned out, I didn’t see too many competitors in front and was swimming solo. The turn around at vineman is always interesting because the river gets so shallow I was touching the bottom. I exited the water in just over 30 min—about the same time as my other half IMs this season.
I got off onto the bike and settled in for what I knew was going to be an interesting bike ride. The early part of the bike course covers some winding narrow roads and there were a lot of competitors in front of me. I was maneuvering my way through the field when I saw I fire truck on the side of the road. Apparently, a tree branch had fallen and landed on a rider and taken 2 others down. The branch caused a bunch of chaos in the area but by the time I got there the road was clear and the athletes were off receiving medical care.
I road smooth for the first third and then gradually picked it up. About 1 mile later a truck pulled in front and slowed my down for mile and I was caught by another competitor. I road the middle segment going back and forth with Chris Geist. As we exited the hills, I cranked it up another notch. I dropped my riding partner and just before entering transition caught the one athlete who passed me in the first mile of the bike. I road 2hr 27 min and felt like I should have pushed more because I was really strong at the end.
The bike to run transition is at a different location from the swim. When I got off the bike, I felt great but as I entered the transition, somehow I got my handlebars caught on a flags guiding you into transition and it took my bike out from my hands. It crashed to the ground and took a couple chunks out of my hand. I gathered myself and ran into and tried to find my shoes. My cluelessness continued and I ran onto the wrong row. I ducked underneath the rack and found my shoes. By then my riding partner was in transition so I said nice bike and was off to the run.
As I exited the run, I was caught fellow tribuys.com athlete Jen Chalmers. She looked great and was on her way to winning her age-group. I felt great and ran out in control hoping to have a good run. While I didn’t feel hot, I knew the day before it was warm and might be later on the run so I took special care to pull in fluids/salt. I actually thought the weather was pretty comfortable but I enjoy warmer weather.
The unique part of the run was all the athletes are very spread out and I knew several competitors. The way out was a string of saying hi to several friends having great races—Ian 1st ag, Charisa 2nd ag and PR, Kevin 4th ag and PR, Susan PR..etc…
I rounded the winery and knew the course was predominately downhill from there and it was time to push hard. I felt great until mile 9 and then the next two miles were a little tough. At mile 11, a told myself, just 12 more hard min and you’re done and managed to get it rolling again. I knew I was doing well in my wave but with 2 other waves I didn’t know how I was doing overall so it was push all the way to the line. I crossed the line in 4:15:39 with a 1:15:54 run!
The prelim results had me listed as second in my age-group, I was nervous with two waves out on the course, but I was 4th amateur overall so I thought I could hold onto a podium finish. Fortunately, I maintained my position after all the 35-39 men had finished. After some food and conversation, I packed-up my stuff and road to Karen’s for a shower as Dave road back to the start to get the car. Dave conveniently forgot his backpack so I had to carry both our gear home. Nice cool down but man the backpack got heavy over the past few miles.
After a quick shower, I checked on the chickens and Charisa and other stopped by for a shower. Steven was kind enough to grab a burrito for me. We made it back to the finish line just in time for the awards ceremony. They started it early! When does that happen? We missed Ian getting his award and got Kevin there just after they announced his name. On the bright side, we got there just in time for Charisa to go up. Then another fun surprise happened. They announced the fastest time of the day at 4:11. Ian was saying how close he was and I was sure the original results had someone going 4:05 in my division. However, by the end, they must have had his time wrong because I won my age-group by over 6 min and was the 3rd amateur. It was a really nice surprise.
My goals going into the race were to get on the podium, 1st qualifies, and run under 1:20, 1:15:54 works. The race went well and everything seems to be progressing in time for Kona. I still need some serious help with my swim and to keep working on the bike but any time I win my age-group and finish in the top 5 overall I have no complaints.
I have a couple good Dave stories to tell in the coming days..