Knee Surgery

Dressing for the hospital

So, Thursday. I had my knee "done", as we say.  I had a torn meniscus, and also have significant arthritis in all my joints, so success is uncertain. But it was limiting me. I could walk, it didn't hurt when I was just sitting around, but it was limiting me. I couldn't run. I couldn't go down very many stairs. I couldn't drive a spade with my foot. So I did it.

My brother-in-law dropped me off at the hospital and remained on-call to pick me up for this out-patient procedure. Everyone was so nice!  They kept asking how I was, and chuckled as I whined about my dreadful no-coffee headache. Within an hour of walking through the door, I was in the operating room and going under. The plan, which apparently worked out, was to trim the torn meniscus, smooth out the arthritis-roughened areas, with just four little incisions at the corners of my knee.

The next thing I remember was the recovery room, where there was a very rough few minutes - absolutely no idea how long. My knee hurt like hell. They pumped drugs into my IV, and asked every few minutes for a number to describe the pain (a 9 to start!) and pumped in more. I tried and couldn't focus enough to meditate, but I still thing the attempt was useful. In the meantime, I remember through a haze the surgeon came by - and I remember him saying "no surprises" but nothing else - and the nurse started up a conversation. How come I'm so healthy? Why is is that despite my (apparently advanced) age (and, unsaid, heavy body) I have no co-morbitities? I'm a runner? That must explain my low heart rate. She hopped on the phone to the nurse in the next stage to say "Bringing in a 63 year old knee patient. Don't worry about her heart rate. and blood pressure. She's a runner.". I got wheeled into the next room as my nurse from the previous stage was writing down the name of my trainer at the gym.

As long as he doesn't touch the actual knee, it's nice

Amusingly, the next nurse took it up right at the same place and also wrote down the trainer's info. By then, I was in a happy haze from the drugs, and finally got an actual cup of coffee, with apple juice, water, and graham crackers. I called my brother-in-law, got dressed, and was wheeled out to the car clutching my percoset from the hospital pharmacy and my ice bag.

I walked into my house, with my brother-in-law propping me up. Ensconsed on the couch, I visited with him, looked at the internet on my phone, and remembered the admonition to not sign any legal documents for 24 hours after anesthesthia. I felt fine, but decided the admonition pretty much should also apply to social media.

Later that day, my niece came over to stay for a couple of days. The night and the next day are a haze of disordered thinking and weird dreams, with no great pains as long as I didn't move wrong unconsciously. I hated the haze, but I had been warned by knee surgery veterans to not let the pain get ahead of the drugs. I kept a log on the white board on the fridge in my kitchen: when I took the perc, did the math for soonest I could take the next one, and wrote that down as well. The night of the surgery I got up in the middle of the night to take the next one on the dot, turning on the kitchen light, double-checking the written-down time against the clock, reading the pill bottle label to verify the right thing before taking it. But, by mid-afternoon I was stretching the percoset out. The drug has tylenol in it, so I didn't want to jump into tylenol without a taper on the perc since I'm hyper about tylenol and liver damage.  Mid-afternoon of the day after the surgery, just over 24 hours from the operating room, I walked around the block. SO slowly, but still. I used hiking sticks (actually, a hiking stick as a cane), which helped both steady me and take pressure off the knee. I did this for the ability to be able to move - I needed to move! Even though it was raining, the fresh air and the sense of accomplishment were fabulous. Ice every hour while sitting still. My niece and I spent time with movies and TV. I got 4,000 steps for the day! I had laid in supplies of both vegan and non-vegan comfort foods, and we each prepared our own, relying heavily on the microwave.

Size of a volleyball

The next day, yesterday I guess it was, the big move was taking off the bandage. It had effectively immobilized the knee joint itself - I could walk but not bend. Tight when it went on, it was loose and droopy because swelling had gone down. I have the impression the knee plus bandage was basketball sized when I left the hospital, and was down to a volleyball size when I unwrapped it. SHOWER and then four little bandaids over my four little incisions is the only dressing I have. Crazy. Still swollen and visibly bruised.

Tylenol and ice. A trip with my niece to my new basement gym (slow on the stairs, "down with the bad, up with the good", each step with two feet on it). Besides the prescribed exercises, back exercises and some upper body. Five minutes on the treadmill, at two miles an hour.

I can't drive until I'm comfortable bending and flexing the knee - it's my right leg - so we took a Lyft to downtown SS and had a late lunch at the diner. I had thoughts of walking around, but it was pouring and I thought better of it, so we swung into a pharmacy for bandaids and took the ride home. (I did shuffle around the block again when home.) Another movie (willing to rent from prime to catch up on things I missed in the theater) and an early bedtime because I had no nap. Never needed the percoset all day. The surface stings, the underneath aches, but it all feels better for moving and with tylenol and ice it's certainly tolerable. The big thrill was with my bandage off, I was able to roll over onto my side to sleep. Hard to describe the comfort and joy that gave me, after two nights wedged on my back with pillows under my knee and elevating my foot. I got 4,500 steps for the day.

So now I'm on my own, more-or-less back in my right mind (no wise-cracks, please) and aiming at even more exercise and activity today. In fact, while yesterday involved watching movies and reading books, I think today may involve turning my attention to productive pursuits - like enhancing my paltry prep for Christmas. They are not expecting me back at work until Wednesday. I may Uber in, but I'll put in an appearance at the office then. Also likely to sign on work computer and review emails tomorrow or Tuesday, and perhaps Uber out to see my mother tomorrow (based on pouring rain, I'm begging off today). I'm focusing on me and getting better, but frankly it isn't that time consuming and I'm just a bit bored. The most difficult thing I'm doing is trying to satisfy my fitbit that I am moving sufficiently every hour of the day - getting up and taking about 250 steps, which usually leads to other waving of arms and bending of knees before I sit down again.

I'm looking forward to being able to do lunges and squats. Quite a ways off, but part of my goals.

Not-so-Silent Retreat: The Hikes

We went on one or two "hikes" every day. Real hikers would perhaps scoff - we didn't rack up much mileage. But the trails were rocky, dusty, vertical, and sometimes directly through streams. I thought it was a great balance of activity and chilling. I need both.

The first afternoon, we took a stroll through a canyon where the highlight was a chance to climb on a rock wall above a waterfall. It was also my first exposure to how life is experienced when social media is not just for fun, but how one earns a living. Our professional photographer - and all of us - had to capture all kinds of moments to be used in posts that included tags for various sponsors. This was not annoying, just different. I'm getting more used to the fact that without pics it didn't happen, but in this case, it was not solely for fun - but it was always fun.  When we got to the rock climbing part, not everyone went up the wall, but I did. The difficulty was minimal, though as always the challenge is some transition in balance from using my arms to relying on my legs to hold me up.

The stream was mostly dry

I did that too

Social media life

The next day was a much more challenging slot canyon with a much taller waterfall.  It was truly scary, but we all did the climb at the end. First, however, we ascended a canyon with a very cold stream running through it, often forced to walk through the water directly. We had loaner hiking boots from one of the sponsors, Merrell. We also had hiking sticks (like ski poles) which I used for the first time. I have been reluctant to use poles because I think they look nerdy. But, balancing on rocks in a swiftly moving stream, I welcomed the extra help in balancing. I also found them useful for taking pressure off my knee when going up or down big steps.

The path is only through the water

Trying to improve my selfie technique - remember to smile!

Bits of sunlight changed the temperature

Gaining confidence

Slow shutter speed

Steep sides

Claiming it as my own

Yes, we did a bra shot

After chilling back at the house for some hours, we headed out to a place with big rocks for yoga at sunset. No pictures of the actual yoga, as I was doing it. Just the big rocks and big sky.

The next morning was literally up well before dawn to go into Zion National Park, climbing in the dark to a scenic overlook to watch the sun rise. This was absolutely the most amazing time. We had the spot mostly to ourselves, because of being early birds. There was a huge backup to get into the park we saw on our way out.

Not quite light

I could actually see the line of the sun move on the hills

Feeling on top of the world

This was pretty high up

The light is about to come

Everything is fabulous

More light

More yoga was done

Great spot for a pose - always paying attention

After dawn, we made one other stop in Zion to see some petroglyphs.

That evening, post chilling and before dinner, we did a trail run just a couple of miles from the house. My knee didn't actually let me run for more than five minutes. (I've got to get that fixed.)  Mirna the ultra-runner gave us tips and coaching. Since I didn't run much, I also spent time admiring the plants.

Trail

There was a very steep hill at the end

Datura

The last full day was extraordinary in a different way. We were going up a very steep canyon. It involved giant steps up rocks, requiring hands for me, and my knee simply couldn't do it. I said I was going to turn around, but due to a slight fear of thunderstorms causing a flash flood, everyone came with me. After the shorter-than-planned hike, we drove through the home of the FLDS (the splinter group of polygamists and pedophiles who think the LDS, Mormons, are not conservative enough. Since a series of arrests and trials, the world has come to this place, and it is slowly opening to the world. We did not actually see many people, perhaps because it was Sunday, perhaps because it was hot.

Enjoying the moment

A random arch

Apparently one is required to strike this pose when wearing this shirt

Perhaps the most brilliant day

 We headed in the cars towards a scenic overlook that required less climbing and that would be above any floods. But we stopped before reaching the spot, because the road was rough and it appeared there was a serious rescue of a mountain biker underway, involving many high speed vehicles. This random desert moment proved surprisingly emotional.

This patch of desert is the back door to Zion

We felt the end of our time coming soon

Community

Better selfie?

The final morning, the clouds and the rain were coming. We took a walk through cinders up the side of an ancient volcano. More yoga was done. Then were were done.

Early

Cholla cactus

Bye

Not-So-Silent Retreat, Part 1

I went off to a five day retreat in Utah. Immediately after signing up in July, I had cold feet. What did I know about this? Not much. A woman I read about in Runner's World, Mirna Valerio, and then followed on Instagram, and then joined her Facebook group, was the sponsor. But she wasn't the organizer. That was someone I'd never heard of. In early September, I got an email saying fewer people signed up than they hoped, there would only be three of us, but it would be fun and we should come anyway.

I hesitated a long time, before finally saying I'd come. I didn't want to go off with a strangers I'd have to talk to. The idea with the big group was that I'd be able to be lost in the crowd. With fewer, I might actually have to interact. But I really wanted to get away from work, and the thought of the desert was more than a little attractive after all the rain we've had. So I bought my airplane ticket and off I went.

I knew almost nothing about what was going to happen. I didn't really know where were staying. I had never met nor read much about the organizers, and certainly had no details about the other guests. I did have a cell phone number, an email address, an emailed shuttle ticket from Las Vegas airport to St. George Utah, and a promise that once I got to St. George, I would not need to do a thing for the rest of the week.

It was fabulous. The organizer, Shanti Hodges, had just bought a house in Utah, and her in-laws who live in Alaska had bought another house a couple of doors down. She and her husband were just starting a business of retreats and guiding, using their two new houses which would be Airbnbs between retreats and during trips. Between Shonti and Mirna, it was the perfect complete get-away from my current life.

Mirna is a writer, a professional ultra-runner, and a motivational speaker. Shonti is a writer with twenty years in the outdoor industry, the founder and head of a large non-profit hiking group, and compulsive community-builder. The other women on the retreat included a health care professional, a tech industry marketer, and a school counselor turned yoga instructor and closet organizer. Joining us for additional activities were a yoga instructor who is learning to code, a professional photographer, a nurse who is a major instagram hero, and a foot masseuse/reflexologist. We hiked, we ate, we hiked, we did yoga, we hiked, we had foot massages, we hiked, we sat around and talked, we ran, and we hiked. We took pictures. Lots of pictures. We checked in on our kids. With women coming and going and bonding, there was chatter, and jokes, and tears. We posted on social media, we had clinics in how to jazz up your instagram stories, we went out of cell coverage and took more pictures to share later. There was even silence, sometimes, as we soaked in the natural spirituality prompted by the desert landscapes.

More to come.

It Turns Out I Need Rules

My long struggle for mindful eating resulting in gaining a significant amount of weight!  Eating mindfully cannot mean eating impulsively. I need rules and planning or else the pounds pack on.

And yes, I care about those pounds packing on. I feel worse, I feel fat, my clothes don't fit, my knees and back go out. And yes, I can see it in the mirror or in photos.

So I'm back on a conscious plan to lose weight. This means a restricted set of food choices and lots of planning. My experiment with being an omnivore has not gone well. It's so much easier to eat what most of America eats, building a meal on bread, potatoes, pasta, or rice. Well, that really doesn't work well for me. I tried adding beans and more starchy vegetables such as sweet potatoes and winter squash into the mix, and that hasn't worked out so well either. The food tastes great! It's very filling. But, I'm hungry again too soon, and portion control goes out the window.

So back to basics on my menus. At least two meals a day have to be built around leafy greens, preferably all three. Meat in decent but not obscene portions (I just read - from Jane Brody, of all people - that older adults need much more protein than younger ones.) Cooking at home, and limited eating out.  This is the basics of Atkins. What I have found is when I actually do this, my appetite falls and so it becomes easier to stick to the plan. Less often do I have the cravings.

So it's been about a month, and I've arrested what is actually a three-year increase in my weight, since I hit my goal weight and allowed a bounce back up.  I can do a month; I've often done a big push for about a month. Then, I fall off the wagon and bounce back up. I'm at that falling off point now.

So that's where the mindfulness and other psychologically-based strategies come in. I still need to plan, I still need to focus on veggies and I still need to eschew starches. But I can't count on the diet to prevent all cravings. I also need to avoid an emotional feeling of being deprived, of feeling I'm missing out.

Here's some of what I'm doing:
I have a late afternoon slump in energy that has led to snacking on crappy chocolate candy at work in the afternoons. Physical problem: very real drop in energy, sometimes (but not always) genuinely hungry too. The mindful techniques I've learned include really checking in with my body to see if I'm hungry. Further, on days in the past when I've given in to the craving, staying in touch to find out, "what am I actually getting from this?". When I eat a bunch of candy, often it feels bad. However, when I eat one or two or three pieces, sometimes it just feels good- gives me energy. There is remorse, but no bodily bad feeling. After struggling with this for months, what has worked for the last couple of months are two new strategies: I bought a small Keurig coffeemaker for my office, and I'm careful to bring a really good, but appropriate, snack. I showed off a wide variety of snacks in a previous post, but that was when I was more omnivorous than I am now.  Now, it's usually macademia nuts, and sometimes guacamole. I've found that caffeine and fat and salt work. Cheese would also work, I bet.

In the month I've been back focused on actually dropping weight, I've had a few social engagements. I've been able to bend my rules, without throwing them completely out the window. I'm not one for more than one or two drinks, ever. So that's fine. When there is a dessert I want, I have some of it. Based on results so far, this limited indulgence has not derailed the actual weight loss.

Eight Dove squares last night

But last night was a problem. With all hatches battened down against a steady deluge, I was restless, bored, under exercised, and jazzed from reading a too exciting book too late into the night. I keep Dove chocolates in my refrigerator, and often have had one in the evening after supper. Sometimes, more than one, and that is a very slippery slope. I can't allow auto-pilot to just munch. I have to go get them one at a time, and ask myself, feel in my gut, each time: do I really want this? As I stayed awake to make sure our hero was going to come out ok, I kept making trips to the fridge and coming back with another Dove square. For accountability, I piled up all the wrappers. There were way too many this morning. I did in fact feel bad in my body before I went to bed - I knew I had messed up. But I was in the "I just don't care" mode. Sigh. What has gotten me in the past is sheer exhaustion, from thinking about this all the time.

I feel like I'm on the right track, but for how long? I beginning to think I'll never hit a weight balance where I can eat the diet I think is normally healthy, whole grains and beans and plenty of fruit as a regular part of my diet, unless I'm willing to weigh a lot more than I do now. I see lots of leafy greens in my future. Good thing I love salads.

Don't be a Cashew

I'm really obsessed with posture these days. I'm doing exercises to find and strengthen my neutral spine position. I walk, I sit, I ride my scooter, all with a mantra of "shoulders back and down, abs tight, chest proud". This is what I've learned from Back Forever, reinforced at the gym, and validated by how I feel as I do it. I learned this the first time I went through physical therapy for my back, more than a dozen years ago, and my sole yoga class had a session on mountain pose, with subtle points about my shoulders, my chest, my thighs, the crown of my head and my chin. A running clinic I took reinforced the posture further. Hold yourself right, and you can run all day.

Bending over is special. I heard back in February a piece on NPR about how Americans round our backs when bending over to the ground. Most other cultures around the world bend at the hips (hip hinge) and make their spine parallel to the ground, flat like a table. But, says the piece, Americans look like cashews when we bend over.  (My horrible back spasm in March happened when I bent over to tie my shoe. I'm certain I was a cashew then.)

"Shoulders back and down, hinge at the hips, brace that core..." was my mantra while working in the yard today. I spent a solid three hours pulling out English ivy from an area newly fenced and to be reclaimed as garden. "Don't be a cashew, don't be a cashew" was the short-cut.  Stand up, hip hinge, bend legs into a squat, grab and pull by straightening my legs while remaining bent at the hips but straight at the waist. Similar to some moves I do at the gym.

Now, the back clearly has been working hard today, but it's not terrible. I do my back exercises every single morning, just as Kim's friend Chris says to do, after the first cup of coffee but before the second. It starts with neutral spine march, not a lot of exhertion, but training my body to keep that core straight. Seven exercises in total, ten to twelve minutes depending on the reps. It's given me the strength to be able to bend over and stand up while pulling for three hours straight! 

Energy

Where does it come from? Where does it go?

It seems like I'm feeling more energy these past few weeks than in roughly forever. Why? What is the secret password that uncorked the bottle?

Does energy come from taking pills? Does it come from eating right? It takes energy to take pills, and even more to eat right. So which comes first? Enough energy comes from no-where as a gift, just enough to allow me to set things on a course that will start to generate energy?

Things I am doing that are helping grow the energy reserves:

• Taking vitamins (B12 and D3)
• Taking anti-inflammatory (celebrex)
• Eating right (low carb, my own cooking)
• Doing back exercises
• Going to the gym
• Meditating
• Brain training
• Sleeping lots
• Doing useful things at work
• Sailing
• Riding the Vespa
• Gardening and garden planning
• Spending more time with family

But I know I can't rise from the couch out of my funk and start doing these things all at once. So what has set off what is now seeming like a virtuous spiral?  Which of these is a cause and which a result?

Could it be the miraculous Curable app has miraculously fixed me after all? Despite my skepticism and only intermittent practice?

I'm enjoying the ride for now.

(And, of course, things don't just go one way. I had my first migraine in months this weekend, even when the pain was low it was like operating on half power. But I woke up this morning without it, and felt great!)