Squats

Another day working out. It feels so good to be back. I'm weaker but that's ok. I'm just having fun for a while, maybe a year. 

I worked up to 175# 1RM front squat today. It was heavy but I made it and will slowly improve. 

So today:

45' PT

Iron scap

5x 250m Row sprints

Fastest at 1:48 split

5-5-5-3-3-3-2-2-1-1 

Working up to 1RM front squat 

Ended with 175#

3-3-3-2-2-1

Working up to heavy overhead squat

Failed at 100#

5-5-2-2-1-1

Working up to heavy bench

Failed at 95#

Superset 3-3-3-3-3

Push-ups 

Banded strict pull ups

Mobi

Nutrition Team Challenge - Day 1

I decided to do a nutrition and performance challenge at my gym. It started yesterday with a pre-WOD. 

Still in e brace I had to modify it of course: 

3RM deadlift and Fight Gone Bad

I hit 125 and 207 reps with a 6# ball and 35# bar. 

It was pretty exhausting but SOOOO much fun to be back. 

I started working out a bit more since Wednesday when I was cleared to do so by my PT guy. 

I am concerned a little bit about some pain in my shoulder. I may need to get that checked out again to rule out anything else. 

But my scar is healing well.

The challenge started well, although I didn't gain any bonuses for great performance. I hope I'll improve by the end of it. 

We had measurements and pictures taken.

My weight was at 147# with 115 LBM. 

My goal is to lose some fat and gain some more LBM. So ideally, I'll stay around 145#.

We have a 30 day strict paleo rule after which we can add in dairy and some other items. I think the 30 days will be challenging but today went surprisingly well and I am pretty stoked about cleanigg up my diet and getting back into even better shape than before my surgery! 

Here is to health and fitness! 

10 Days post-op Posterior Cervical Foraminotomy/Discectomy

Today I had my 10-day post-op follow-up doctor's visit. 
He pulled the sutures and the staple and said it looked really good. 
I don't need the hard brace any longer, but have a soft one, for another week or so. 
I can start driving, but haven't given i a try just yet. I think I will start slow/short distances. 
Though, Tuesday I need to drive down to South Denver, so that will be the first "test"- leaving early to make sure :)

I will be able to start PT in a week, so I will call Monday to maybe get my first appointment set for Friday. From there, I will slowly ease back into more strenuous activities. 
I have been walking 5-10km/day so far and will up it to 20-30km/day this coming week.
I am trying to walk sub 10min/km. I've been around 10:30-11min/km which is fine, but I feel good. Adding in some air squats and lunges as well. 

Also, today I did not have any notable pain in my arm or shoulder and the doctor reassured me that my nerves had plenty of room now, and were just irritated from the procedure. So, once the swelling goes down, I should be as good as new, and obviously, the muscles in my neck need to heal up.

At least I can say I am off pain meds, that is narcotics and muscles relaxants, and only need ibuprofen or bromelain every now and then.
So, all in all, everything went well and I am doing good. 

I am SO ready to go back to lifting. 
I know the first couple of months will be tough... and I will have a battle scar, but in a few years I am sure even this will be gone.

Here, is a picture of what my scar looks like Day 1 post-op versus day 10 post-op. 

1 day post-op

10 days post-op

Wednesday PT and ModWOD

Just another day before surgery! 

30 PT with ultrasound, scap/back/shoulder massage and neck/head traction

Ion scap

Mobi

1k row in 4:05

5rds 

500m row

15 kb Russians @35#

10/10 pistols 

5rds

10/10 ghd

1' acc. Lsit 

1' acc. plank

Getting old stinks: Mental vs. Physical Strength

Please excuse me, if you find this post to be a bit messy. There are just a lot of confusing feelings and thoughts that I am trying to navigate, plus all the physical pain, and ups and downs...

Indeed, I have been feeling a bit better - disc-wise a - since Germany won the World Cup 10 days ago. My pain has decreased but the strength and range of motion in my left arm - which now is also visibly smaller than my right - is still at about 40%. Biceps, internal and external rotator, shoulder ROM and grip especially.

But I can move and I am off narcotics. whoop whoop! Even took the dogs for walks a few times again. But then I developed a knot or cyst in my left palm. It's inflamed, too, I think, as it's pretty painful and causes tingly sensations. Tomorrow, I will need to have that checked out... Ugh... Getting old stinks. Ha, that reminds me: my doc today told me to pretend I'm still 29. LOL

But as I said, at least I can move, so here is what I was able to do at the gym this week. Taking off tomorrow to get that knot in my palm taken care of. It's quadrupled in size within 3 days... Gross, I know.

Monday

Worked up to heavy backsquat

Got to 210 - so 25# below my max

WOD 4T

10-1 Deadlift 125#

1-10 straight leg raises to bar

In 5:50

34 strict push-ups in 3'

Tuesday

Roll

Worked up to heavy frontsquat

got to 190 - so 20# below my max

Plank and push-ups in between lifts

Ironscap

WOD

3rds .5m airdyne 3rds 1.5m airdyne

22" tire step ups 10 each leg

10# each side weighted lunges 10 each

15#l/25#r dumb bell curls 10 each arm

Wednesday

1k row warm up 4:25

3 rds

Reverse L-sit tabata

15/15 GhD

Plank holds

WOD 5RFT

250m row

10 20# ball front squat

In 9:58

500m row cool down 2:20

Iron scap

Mobi

I also saw another doctor today - spine person who does not do surgery. Well,he suggested to give an epidural injection a try. I hope insurance will approve that quickly and I can get that done next week so that I can see if it helps before going under the knife.

At least this doctor knows the surgeon I decided to go with and also reassured me that both discectomy and fusion are good procedures that should bring me relief. And they said the surgeon was excellent.

On a side note: I'm tired of filling out the same papers at all these doctors. Wished there was a platform that stored it from which they can just pull it.

Anyway, his strength test also - non-surprisingly - showed a strong deficit in my left arm. And for the first time today I experienced strange headaches as well as more numbness in my left arm and hand. Oh and after rowing, also in my left foot. But let me ignore that for a change. Every time I pay attention to a tiny feeling of pain it has turned into something major.

Who knows maybe it is all mental? In my head. And then it manifests itself physically. Very possible. I mean I have had the most stressful years of my life and battled through them more or less scar-less on the surface. Yet, I just felt like everything was finally settling down, and getting better. I finished graduate school, got an adjunct job that allowed me more time to do lots of lifting and working out, as well as taking care of things at home. Although I have been stressing to find a full-time job in my field. And I really want to. I want a career. I have such strong work ethics, I'm a good team player, and leader... I've even begun to question that having done the PhD was the right thing... I'm basically overqualified but underexperienced. It's a mess.

But, maybe, the reason why I haven't been able to land a full-time position is because I have to take care of myself right now, because all this was going to happen and any "real" job, as other people describe it, would have been in the way and I would have lost it by now.

But, it's no fun to be a financial, physical, and mental burden to everyone close to me and especially to myself. And let's add another stressor, from today on, I only have 6 weeks left to make this right. Make my body heal. But maybe I need to heal my psyche. Which I wanted to do by traveling home. But I can't anymore. I miss Germany so much. I miss my family and my friends. I miss the culture. I just miss it all so much. And there is no one who can understand these feelings.

And to make things harder, I'm not a very patient person. This is definitely testing me mentally. A lot.

It is very difficult for me to stay positive right now and I feel depression and negative thoughts creeping up on me.

My diet is calorie-wise the way it was when I hit it hard at the gym, so I am also getting fat. Which brings up a whole other issue that I thought I had overcome. I think I even called myself recovered the other day. But I am not sure anymore. I've given serious thoughts to returning to ED. I know it would be wrong. If I was pregnant I could turn my attention to that but that whole trying to get pregnant thing is not working either.

It all boils down to "feeling like a failure" again. I feel bad for my husband and I wished again I was "just normal" - whatever that even means.

But nope, always something new that is pulling me down.

I keep telling myself and I do want to end this positively:

I will not give up and I will come out if this stronger.

I need to set goals.

1. Get the knot checked out/ taken care of.

2. Get the epidural injection and wait and see if it helps.

3. Get approval for discectomy surgery.

4. Keep doing what I can at the gym but not overdo it.

5. Stay positive and acknowledge feelings.

Recovery

Yes, I don't even have approval for surgery yet, but obviously, I am interested in recovery and all that comes along with it.
My doctor said if I have the surgery in the beginning/mid of August, I should count on 2 weeks in the soft brace, and be able to start work in September (I am a university professor, so no heavy lifting really). Then easing back into physical activity and doing PT, and after only 6 weeks I should be fine. Thus, I will be out for 2 months plus the 3+ months pre-op during which I already had to take it easy. This pause surely scares me. Basically, having to start over. I am telling myself though that all the core work and squats I am doing now and probably will be doing post-op for a while, will be beneficial in the long run. Eating a healthy diet has also become more important, so who knows what impact those "little" changes may bring as well.


Here is a great read about Peyton Manning and his road to recovery from the Washington Post, from October 2013. By no means do I compare  myself to him, ha, but I am pretty athletic and competitive, but this is encouraging and inspiring to say the least.

Spinal Surgeon #2

I went to another surgeon in South Denver today to get a second opinion. I liked this doctor much more than the first. He was more personable and professional, took his time to explain everything to me and my husband and did not rule out non-surgical options right away.

I still have another appointment set up but kind of feel it's not necessary anymore (nor do I have time to wait any longer). As I just implied the first surgeon I saw didn't take much time to explain or discuss my case, and didn't even consider non-surgical options.

So, surgeon #2 laid out the pros and cons of possible four options that my case would allow for - in his opinion.

(1) Epidural steroid injections

(2) Anterior cervical discectomy and fusion

(3) Anterior disc replacement

(4) Posterior cervical discectomy



We logically ruled out epidural steroid injections because of (a) failure of other conservative treatment including rest, meds (anti-inflammatories, steroids, narcotics for pain), physical therapy, dry needling, chiropractic manipulation, and (b) the location and size of the herniation.



Left with the remaining hree surgical options. But which one should I do? he compared my case to Peyton Manning and his fusion and showed me X-rays of successful fusions he did on athletes. Manning had (4) done but it didn't work out so (2) was his next step. While I was set on disc replacement over fusion after having done my own research - relying more on European studies than US-based research, I began to doubt this was really the right idea. Yet, I kind of excluded option (4)posterior cervical discectomy.



Nonetheless, this procedure actually shows high success rates, yet, it still may lead to one of the other options down the road (think Peyton Manning).

So should I go ahead and do (2) anterior cervical discectomy & fusion (Manning did this after (4) failed) or (3) anterior cervical instrumentation (aka replacement).



This surgeon worked with athletes, and said (2) was the standard procedure for elite athletes in high contact/impact sports. (3) However, lacks US-based research although it appears to be the preferred procedure in Europe and South America. and research has been promising.



Thinking it over and taking to my PT, reading yet a few more scholarly articles on the topic and some rational thinking made me second-guess going for a big surgery right away.



So, option (4) is what I decided and now the insurance approval battle has begun again.

Here are the titles and authors of some of he articles I've read and found helpful

In making my decision for the less invasive surgery:





(1) Early outcome of posterior cervical endoscopic discectomy: an alternative treatment choice for physically/socially active patients

by Kim, Chi Heon / Chung, Chun Kee / Kim, Hyun Jib / Jahng, Tae Ahn / Kim, Dong Gyu; 

Journal of Korean Medical Science



(2) Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. by Ruetten S, et al.
Spine (Phila Pa 1976). 2008 Apr 20;33(9):940-8. doi: 10.1097/BRS.0b013e31816c8b67



(3) Minimally invasive cervical microendoscopic foraminotomy; Initial clinical experience. 

by Fessler RG, Khoo LT 

Neurosurgery 51(Suppl 5):S37-S54, 2002.



(4) Advances in Spinal Stabilization. 

by Haid RW Jr, Subach BR, Rodts GE Jr (eds):

Prog Neurol Surg. Basel, Karger, 2003, vol 16, pp 251-265




(5) This one is open access: http://www.karger.com/Article/FullText/351887?hl=1&q=Cervical%20posterior

Long-Term Results of Anterior versus Posterior Operations for Herniated Cervical Discs: Analysis of 6,000 Patients by Dohrmann G.J. · Hsieh J.C.

Section of Neurosurgery, University of Chicago Medical Center



(6) Outcomes Following Nonoperative and Operative Treatment for Cervical Disc Herniations in National Football League Athletes

by Hsu, Wellington K. MD

Spine Issue: Volume 36(10), 01 May 2011, p 800–805