30 June 2009

A Moral Victory?

The month will pass without me swimming to the buoy. I'm still going to act as if I did it. I've been ready. Ria even agreed to paddle next to me as I swam. Everything was in place. Until I got to the beach. Damn board-breaking south swell closeouts! I don't want any of that when I'm surfing. Why would I try to take that on with only a wetsuit and a smile? Screw that. I'm not crazy. Both Ria and I laughed about envisioning both of us paddling in on her surfboard. The conditions weren't right for a swim . . . even with a good knee. I'll get to it when the swell calms down.

I recognize that I'm beginning to get on with my life. I've chucked the handicapped parking placard. I've stopped smoking the marijuana (although it would have come in handy last night—I'll get back to that). I want to feel normal again. Not that I'm suggesting I was ever normal. (I'll be here all week! Is this thing on?) As I begin to feel better, I'm no longer forced to consider my knee with every decision I make.

With that said, I still ain't got no flexion, dammit! It bends, yes, but it's not enough. Now, I know there's still a lot of healing going on in the joint. My knee continues to be quite warm to the touch. Yesterday, I got a massage specifically to break up the scar tissue. Doesn't sound fun does it? Well, it was not. Fun. Enjoyable. Delighftul. Or easy. It was rather painful, to say the least. Two hours later, I went to physical therapy. So I spent two hours being tortured yesterday. Please, sir, may I have another! At this point, I will do everything within my power to bring this knee back to the point where it does what I need it to do. Most knee replacement patients simply want to live without pain. I want to play without pain. I also want a joint that allows me to do what I do. I'm willing to put up with the pain and the expense of this knee replacement and the recovery in order to get my life back.

28 June 2009

Fair Weather Swimmer

The sun was out when we left our house heading to the beach. The end of the month is upon me. I've yet to do my ocean swim. If I don't get 'er done by the end of the month, I won't start trippin'. I know I've been capable of doing it for about a week. Nevertheless, I want to put my money where my goal is.

Suffice it to say, I got to the home break only to find gray skies and wind. Not quite what I had in mind as the setting for my first post-knee replacement goal. I will go back to check it on Tuesday.

Good things are happening, by the way. I awoke to much less pain than usual. Once I decided not to do the swim, I came home to sit on my bike. I've been getting the pedals around for the last week or two, but I've not been able to do so in my cycling shoes. This is big. Cycling shoes lock your foot into place. Your knee has no option but to bend the required amount in order to do a full revolution. I've been pedaling in normal shoes since they allow my foot to slide up and down the pedal, thus giving my knee an easier angle when necessary. Today seemed like the day when I might be able to return to the shoes I'd wear were I to ride the bike outside.

Well, you would have thought I'd won the Tour de France. I was that elated when I was able to get the pedals all the way around. Don't get me wrong. It hurt. I'm still at the point where most things hurt. It doesn't matter. You're going to hurt as you recover. If, like me, you've had previous operations on your joint, it will probably hurt even more. The battle against scar tissue wasn't won in a day.

Tomorrow I go to see a massage therapist who specializes in releasing scar tissue. I'd found him long before I knew I'd be dealing with scar tissue issues. I just figured the massage was a good idea because they cut through muscle when doing knee replacements. I assumed that would be the only scar tissue I'd have to worry about.

I'm still looking at August as the month I get back on a board.

25 June 2009

They Drop in Threes!

I've heard that my entire life. I was born, raised and continue to live in Los Angeles. This city, if nothing else, revolves around the rich and famous of Hollywood. When a famous person dies, it was said, expect two others to quickly follow. So when Ed McMahon died, I was waiting to see if the supersition would come true again. And it has!!

Ed McMahon

Farrah Fawcett

Michael Jackson

How twisted is fate that it takes them out three at a time?

24 June 2009

My Bipolar Bionic Knee

On Monday and Tuesday, I was in teeth-clenching pain, right? Today? I feel fine. The knee hurts, but it feels like the intense pain disappeared overnight, leaving vague reminders of days past. Oh, how poetic. In other words, I feel pretty damn good today. My swim didn't even make the knee feel worse. I've felt good all the livelong day. Amen.

Pray for surf for yourselves. Pray for more virtually pain-free days for yours truly.

22 June 2009

On Surfing, Joint Replacement and Vampires

I watched True Blood last night even though, in its second season, I'm beginning to lose interest. I watched this series from its inception last year not because I'm fascinated by vampires or humans who have sex with vampires or humans who use vampire blood as their illicit drug of choice. All of that is kind of weird. I actually appreciated the writing and the characters who are surprisingly three-dimensional. The men in the cast aren't exactly hard on the eyes either. However, that is not my point.

My point is that last night's episode prompted me to wonder why people find this vampire thing so appealing. Those pale, blood drinking stiffs can't even show their faces during the day. Are you kidding me? What fun is that if you can't even surf while the sun is out? Then I remembered that the vampires on the show easily find their way everywhere in the dark. I suppose that means they can see in the dark. That's when I decided that the vampire thing might not be as bad as I first thought, aside from the bloodlust problem. Think about it, if you can see in the dark, you can surf in the dark!! In a place like L.A., that's the only way you're going to get a wave to yourself. Imagine surfing Malibu with everyone politely pulling back and out of your way when you have priority. I know! I can't imagine that either. But that must be what it would be like were you to surf in the dark. Malibu. Peeling nicely. You. In the dark. Alone. Taking any wave you want. The only problem with the night time surfing would be if your friends were all human. Although I love surfing alone, I also enjoy surfing with my friends. If I'm a vampire and my friends are all still human, I'd never get to surf with them. I'd end up only surfing with other vampires. With my luck, some damn greedy vampire would start selling pop-out boards that sported resin made from blood. Then the night time lineups would be choked with a bunch of vampire kooks who are as bad as the human kooks. If that's the case, and I'm sure it would be, I'd rather take my chances with the human lineups.

Last night's episode also showed the aftermath of the hurtin' a vampire put on one of the humans who tried to get slick and attack him (the vampire, a hot one) with silver. When I say "hurtin'," I mean literally ripped to shreds. Long story short, the dead guy's limbs were scattered all over the place. The audience at home and one of the humans can see some metal sticking out of a body part. It turns out it was part of the dead guy's bionic hip. I knew what it was immediately. And I was amused. The vampire tore this guy to pieces . . . but that bionic joint was still intact. Right! I've lost my mind. I agree. Just remember that I'm in the midst of this joint replacement battle. (Fuck this "journey" stuff that people like to say. This is a battle!) I'm back to being hardly amused by this long, painful recovery. The fact that bionic body parts easily withstood the wrath of a vampire gave me a nice laugh.

What to say about this knee? It hurts. And it doesn't. The pain is related to how hard I push myself in my workouts. That's where it starts. Then my physical therapist ups the ante. I'm fighting what I often feel is a losing battle against my existing scar tissue. I know I'm improving. I'm simply tired of being in pain. I've finally decided to pursue the medical marijuana avenue. Much to my surprise, I easily qualify for it. And I need something for the pain. I don't intend to slow down my workouts. The physical therapist and the doctor do not feel I'm doing too much. I don't either. However, my knee is not happy, especially after a day like today; I swam this morning and then went to physical therapy in the afternoon. Apparently, many people at this stage are almost pain-free. Those are the people who don't have scar tissue issues. They have surgery. They regain range of motion. They're done. It's not that easy for those of us who've had surgery before. Your fitness and youth aren't going to make you heal faster than other people who have relatively little scar tissue. Now that I understand this, I recognize what I have to do to keep improving. Since I refuse to take prescription meds or OTC meds, I'm recognizing that cannabis is effective for medical issues. I always believed it was, but never thought I'd learn firsthand that this was the case. Now that I have, I must admit that I've developed some damn fine joint-rolling skills.

I hope everyone got some of the south swell. This is the second June in a row that I've missed a decent swell. Last year, while I was taking a break from the blog, I was out with an injury to my other knee. That's my first and only injury to that knee. Somehow, I believe it was fate's way of preparing me for this knee replacement battle. I was surprisingly patient last year when I couldn't surf. I stayed in the pool as I let the knee heal. That knee injury allowed me to see how patient I am when I'm injured. I don't rush my return to the water. I paddled out when I thought the knee could handle it. I will do the same with the bionic knee. I won't be back on a board until I know this knee is ready to party.

17 June 2009

Two Months and Two Days (Continued)

After I finished the previous post, I realized I was a bit lax in my self-imposed duty to provide details for those who are contemplating or preparing for knee replacement. I feel the need to be more specific about certain things.

Sleeping is still a problem. I tend to toss and turn in an effort to find a comfortable position. All of this is related to pain. I've not smoked any marijuana of late. Truthfully, I ran out and then decided not to use it anymore for the pain. Of course, I subsequently had a few days when the pain was substantial enough to make me wish for a joint. But I survived those days. I've since gotten more weed. I'm in no rush to use it. I'm feeling pain as I type this. That swim this morning beat up on me. I guess there was no good reason to do 100 yards of kicking on my back. Nevertheless, the pain is an irritation more than anything else. And I did it to myself. I don't take the shortest route from Point A to Point B when I workout. I take the long way home. I've always been like that. I see no reason to stop just because I've got a new joint (Ha! I made a marijuana pun!) that hasn't fully integrated itself into my body. When I know I'm going to have trouble sleeping, I drink some wine. It works well enough; I slept about five hours last night.

If I had a job to which I could return, I'd be able to work a desk job now. There's no pain when I'm simply sitting. There's still stiffness and a little pain once I stand up. It's nothing I can't handle. I probably could have comfortably returned to a desk job a few weeks ago.

My limp became less pronounced over the last few days. It seemed to happen overnight actually. One day the leg was stiff. The next day I was walking with an almost normal gait. For two months, my 78 year old mother and her prosthetic knees have walked slowly when with me because I couldn't move much faster than a slug. Last week she was shocked when she couldn't keep up with me.

I could probably drive a manual shift car if I were so inclined.

The joint is no longer hot to the touch. There remains some swelling. That won't abate for a few months.

The worst is behind me now. Thanks again to everyone for the kind words, good karma, food, clay fin, dog sitting and care package. All of you helped me hold it together at a time when I badly needed the help.

Knee Replacement: Two Months and Two Days Later

I saw my orthopedist yesterday for my two month check-up. He assured me that all is well with the knee. When I brought up my concerns about range of motion, he explained that the soft tissue around my knee will probably recover more slowly than that of someone who hadn't had previous knee surgeries. My knee has been operated on twice before. Therefore, there's already scar tissue around the joint. This surgery has added to that. So, he believes my recovery plateau may take a few more months. That makes perfect sense to me. I see improvements each week. I cannot deny that. However, there is still a good amount of swelling and heat at the joint. I still can't turn the pedals over on my road bike. Once I can do that, I will stop worrying about every little thing. I realize I'm now only 10 degrees shy of the flexion (i.e., bend) I had prior to surgery.

What can I do? Well, I surprised myself a few days ago when I broke out in a spontaneous dance party for one. There was surgical pain. There was no osteoarthritis pain at all. The surgical pain was minimal. It appears that I can start compiling a list of things I'm able to do (as opposed to my pre-surgery ever-growing list of things I was no longer able to do). I swim with abandon now. I feel great while I'm doing it. I'm still doing mainly freestyle. I've found that, of the strokes I'm able to do, backstroke taxes the knee the most. I think it's the fact that one must really straighten the knee if the kick is going to have any power behind it. At this point, I don't worry about the pain it causes. I can tell that swimming is helping. My limp is almost gone now. I thank the swimming for forcing the knee to loosen up.

Look what I got for my birthday? Bet you can't guess what this is?

No, it's not a little pocket defibrillator. It's a sweet little waterproof MP3 player. Score!! Swimming is much more enjoyable with music. The thing doesn't even go in your ears. You simply rest it on your cheekbones. Somehow, the music is conducted to your ears. I love this gadget. It works so well that I actually had to turn it down today; the music was way too loud. Truly amazing!

I was tempted to swim to the buoy at the home break on Sunday. I'm more than fit enough for that swim. I said my goal was to do it at the end of the month. Well, I'm ready to do it now. Luckily, I know I'm still nursing a joint that's not ready to fight the shorepound. There's no way my knee could have withstood the shorepound out there on Sunday. One tends to forget that the ocean is not a pool. You don't just jump in and swim. You fight the waves, the current, the water temperature, what have you. I'll be ready at the end of the month, but I've decided not to do the swim unless it's flat. Then the only work my knee has to do is swim.

When do I think I'll be back on a surfboard? Probably August if things continue to improve at their current rate.

13 June 2009

The Saturday Morning Blues

(sigh) I want to surf. I want to feel better than I feel. I want a knee that bends more than it does.

Oh, health insurance would be nice too. And peace on earth.

11 June 2009

On Physical Therapy and Knee Replacement

You have to go into it knowing you won't get back on a surfboard unless you face down the pain. I've given my physical therapist carte blanche to bring as much pain as I can stand. When she knows I'm at my limit, wanting her to stop, she'll say, "You want to get back on that surfboard, don't you?" Works every single time.

At the beginning of the physical therapy aspect of this knee replacement process, everything was difficult. Doing leg extensions while seated was impossible. I'd sit there willing my foot to lift, exhorting my quads to get to work. Nothing. I'd get my foot to move maybe an inch or two. That was it. Now, I do them easily on the machine with about 25 pounds.

There's no law that says you have to follow your physical therapist's directions to the letter. Now, I don't mean you throw caution to the wind. I'm reminded, instead, of El Hefe telling me to listen to what my therapist said and then do a little more. I followed his advice. In fact, I probably would have done that anyway, but El Hefe's words allowed me to do push the envelope without feeling guilty about it. In the end, if you listen closely to your body, you'll recognize your limitations.

The best thing about being almost eight weeks removed from surgery is that I can now return to my Woman Cave.

I had to make changes prior to surgery: take all of the surfboards out, move the bicycle and stationery trainer in. The squat rack will probably be sold. I don't know that I'm supposed to be doing squats with a prosthetic knee. I stopped putting heavy weight on the bar years ago as the knee got progressively worse. Of late, I used the squat rack for shallow squats with lighter weight as well as for calf raises. The rowing machine, which was bought for Soul Brother #2 (who, of course, ignores it entirely), is something I cannot use at this point. I don't have enough bend in my knee to comfortably row. However, it did occur to me that I could use it for flexibility. I simply sit on the seat, going forward and back, trying to push the knee a little each time I go forward. The Bowflex allows me to work everything. I started using it again two weeks after surgery in order to maintain my upper body strength. Now I use it for both upper and lower body.

The pool is your friend no matter what joint you have replaced (except your shoulder). I feel little to no pain in the pool. I'm not a great swimmer by any means. I didn't learn to swim until I was in my 20's. I'm not particularly fast. I'm not exactly slow. I just swim.

It's not like I got in the pool and started swimming the first day the doctor told me I could get the incision wet. The thing people need to understand is how much work your body does to repair itself. The first few weeks after knee replacement are not easy; you won't want to do much other than physical therapy. I think this is the first week that I've actually felt like myself, like the person I was prior to surgery: athletic, energetic and happy all at the same time. Yesterday I swam in the morning and lifted weights later in the day. By last night, I was in a world of hurt. The knee ached enough to make me consider taking something for the pain. All I did was consider. I ended up being so tired from the double workouts that I fell asleep on the pain. Mindful of what I put my body through yesterday, I did nothing today but allow my body to rest. My body spoke. I listened.

I'll be back in the pool tomorrow.

09 June 2009

From CNN.com

Ocean trash problem 'far from being solved,' U.N. says

By John D. Sutter

(CNN) -- The world's oceans are full of trash, causing "tremendous" negative impacts on coastal life and ecology, according to a U.N. report released Monday.

The oceans will continue to fill up with junk discarded from cities and boats without urgent action to address this buildup of marine debris, the United Nations Environment Programme says in a report titled "Marine Litter: A Global Challenge."

Current efforts to address the problem are not working, and the issue is "far from being solved," the report says.

"There is an increasingly urgent need to approach the issue of marine litter through better enforcement of laws and regulations, expanded outreach and educational campaigns, and the employment of strong economic instruments and incentives," the report says.

"Although a number of countries have taken steps at the national level to deal with marine litter, the overall situation is not improving."

Scientists have been watching trash pile up in the world's oceans for about a half-century, when plastics came into widespread use. Since plastics don't biodegrade, or do so very slowly, the trash tends to remain in the ocean, where circling currents collect the material in several marine "garbage patches." See a map of the Great Pacific Garbage Patch »

One of these trashy areas is said to be roughly the size of Texas. The water in these at-sea landfills is thick like a plastic soup, oceanographers told CNN.

The trash patches are located in "very remote parts of the ocean where hardly anyone goes, except the occasional research vessel," said Peter Niiler, a distinguished researcher and oceanographer at the Scripps Institution of Oceanography.

Plastics and cigarette butts are the most common types of ocean litter, with plastic making up about 80 percent of the ocean trash collected in some areas of the world, a U.N. news release says.

The ocean litter is a problem for coastal communities, which rely on clean beaches for tourism dollars and to boost quality of life for their residents, the report says. Ocean trash also affects marine life and degrades human health.

Sea turtles, for example, think plastic grocery bags are jellyfish when the bags are floating in the ocean. An untold number of the turtles and other creatures, such as Hawaii's endangered monk seal, swallow the bags and suffocate, drown or starve, said Holly Bamford, director of the National Oceanic and Atmospheric Administration's marine debris program.

Birds face similar issues when they eat pieces of plastic out of the water. In the North Sea, a survey found 94 percent of fulmars, a type of seabird, had plastics in their stomachs, the U.N. report says. The birds, on average, had about 34 pieces of plastic in their stomachs.

A surprising amount of trash that ends up in the ocean starts on the land, the report says. In Australia, for instance, a survey found 80 percent of ocean trash starts on the land.

One of the key questions for people interested in ocean trash is how much of it is out there, but Monday's U.N. report does not solve that mystery.

The U.N. says little is known about the extent of litter in the oceans, and more data is needed for the problem to be adequately addressed.

"This deficiency, in combination with the lack of specific legislation, adequate law enforcement and funding, are the primary reasons why the problem of marine litter is far from being solved," the report says.

"Unless effective action is taken, the global marine litter problem will only continue to worsen in the years to come."

The report does suggest several solutions, among them:

* Countries and regions should adopt long-term plans to prevent litter from ending up in the oceans.

* Countries should monitor marine litter using international standards and methodologies.

* Ports should encourage fishing boats not to discard nets at sea.

* Efforts to reduce marine litter should get more funding.

Volunteer efforts try to address the issue now, and the Ocean Conservancy says it organizes the largest of these.

Last year, 400,000 volunteers from more than 100 countries picked up 6.8 million pounds of trash from beaches, preventing it from harming the ocean, said Tom McCann, a spokesman for the group.

"It's entirely preventable," he said of the problem. "It's something we can solve ourselves."

McCann said people can prevent trash from ending up in the ocean by making smarter choices about the products they buy.

Some of the Ocean Conservancy's recommendations include:

* Buy products with smart packaging that doesn't create excess waste.

* Use alternatives to plastic such as cloth grocery bags and reusable bottles.

o Don't litter. Trash can make its way from the interior of a continent into the oceans via rivers and the wind.

o Volunteer with the International Coastal Cleanup, held on September 19 this year.

08 June 2009

Knee Replacement: Seven Weeks Later

I swim. Sans pull buoy. I use the kickboard. Badly. I smile much more than I did seven weeks ago.

These days I'm trying to decide whether the knee is a pain or a nuisance. The god-awful excruciating pain is long gone. The pain that remains is more of a constant ache. My limp is almost non-existent. My hip distress, which threatened to overshadow what I was feeling in the prosthetic joint, is almost gone too. I'm at the point where you see the tunnel and wonder why someone is shining such a bright light at the end of it.

There is no doubt I'll be surfing before the year is up. I'll probably paddle out before the summer is over. After lying on the floor for awhile the other day, I unconsciously popped up to my feet instead of just getting up off the floor. I still have the strength and speed for a quick pop-up. However, this leg doesn't bend enough for a decent pop-up. That is simply unacceptable. I'm gonna push to regain the flexion I had prior to surgery.

Don't get me wrong, there is pain. I'm not at the stage where you forget about your new joint. It won't let me put it out of my mind. It won't let me sleep comfortably. At least not yet. Still, for weeks there was indescribable pain that attacked my knee every time I stood up. It was agonizing. It didn't matter if I was getting out of bed, getting up from a chair, getting out of the car, getting off of the toilet. Didn't matter. I'd stand up and it felt like all of the pain in the universe migrated to my knee for about 30 seconds. Pain like that is the reason they made Vicodin, Percocet and all of those other drugs I refuse to take. I won't miss that pain. I don't wish it on anyone.

I figure the new knee gives me about 15 additional years of surfing. I know I may need to go back in for surgery during my lifetime. These prosthetic joints don't last forever, especially if you're active. I'm fine with that. My old knee, the one I was born with, was done. I don't know that I could have gutted out even another year with it. There was no way I was going to spend the rest of my life sitting on my ass in mind-numbing pain. I guess I was more afraid of that possibility than I was of the pain of joint replacement.

I'm not at the end of this joint replacement journey, but I am nearing the end of my blog posts about it. I just want to leave a paper trail for those who will follow.

05 June 2009

R.I.P. Pull Buoy

I just felt like it was time to let the knee do whatever work it can do in the pool. Three of my appendages work well enough to keep me from drowning. I decided to allow the left leg to do as much or as little as it wanted to do. I know that using it will strengthen the quads—which seem to have disappeared entirely—and perhaps get the knee accustomed to flexing easily.

There is a method to my painful madness. The sooner I can get this leg to kick well, the sooner I can get back in the ocean. My goal? To either swim out to the buoy and back or enjoy a session on my mat by the end of this month.

03 June 2009

Dance Party Wednesday!

I'm in a good mood! I've decided to start phasing out the pull buoy while I'm in the pool. Today I probably did 65% pull buoy and 35% swimming under my own power. Yeah, it hurt. So does getting hit by your board while you're getting worked.

This calls for a dance party!

01 June 2009

Knee Replacement: Six Weeks Later

And now for something completely different.

Today I swam. This afternoon I lifted. Somewhere in the interim I took the dog to the dog park. I also took the child to school and picked him up. Dinner was prepared. By me. There's a load of laundry working as I type. While the knee certainly isn't ready for a surfboard, it is improving. I did about 100 yards today without the pull buoy. Granted, I had to swim it in 25 yard segments. At times I thought I would sink since the leg wasn't doing as much work as I would have liked. I'm not mad. The leg did some work. That's a serious improvement. Now that I'm doing most of my own physical therapy, I've integrated light weightlifting for the left leg. The physical therapist gave me some exercises to do. I've added a little weight to them. In fact, I'm now making both legs hit the weights because there is the possibility that my right knee may pay a price for having done so much work over the last 29 years. Anyway, that's two workouts in one day. I could not even think about doing that a week ago.

Those workouts took their toll though. I'm barely awake enough to type this and my knee is more swollen than usual. However, I'm not in dire pain. I just know that I probably did too much.

At the six week mark, the pain is still constant. Thankfully, it no longer feels like I'm being attacked with a hacksaw. It's more of an ache with hacksaw moments. In fact, when I sit still there is no pain at all. It's only when I stand up that I start to wince and use what Spongebob would call "sentence enhancers".

People tell me I've lost weight. I don't see it. I don't know if the weight loss is the result of eating less, muscle loss, an increased metabolism from a body that's working hard to repair itself or none of the above. I'm not one of those women who is always trying to lose weight. I've been pretty much the same size for the last 20 years or so. My ultimate plan is to emerge from this time of forced inactivity with a stronger body and more focus.