Pain Cycles

Today, I was about to count it day 5 of feeling fairly good. On the scale system, I think I have been on a 5-6/7. Then it started flaring up again in the evening to a 7/8. Not sure what aggravated it. My pain is characterized by wandering sharp and pulsing pain either in my shoulder, shoulder blade or upper arm (bi/tri, though c6/c7 is not affected by the herniation...) and forarm, elbow, wrist. Sometimes it feels more like stabbing sometimes it's just dull and achy. My neck barely hurts, neither does my head. But I do get a stiff neck from all the muscle tension every now and again. My thumb and forearm numbness comes and goes as well along with tingling and pins and needles pain usually down my arm and in my hand. Ugh. Right now it's pulsing and sharp pain in my elbow and wrist, a little but in my shoulder blade area... It's gotten worse over the course of the day. Let's hope I'll get some decent rest with just a few ibuprofen and 1 oxy.

I broke out in a rash that I am not sure of where it comes from so I am trying to not use too much medication.

The PT session on Monday left me sore for the next day; Wednesday I had a dental procedure that took over 2 hours. It's more than possible that the sitting in the dentist chair caused some of the worsening that I am feeling today.

I also took the dogs for walks yesterday and today. They didn't pull too much though so I don't think that was it.

Maybe doing backsquats, planks, and core work at the gym? Or getting on the airdyne? I am not sure... But I needed to do it to not go crazy... I need to ask my doc again about what physical activity he thinks I can or should do.

I only back squatted 210# - so about 25# below my pr and it felt kind of hard. It's truly frustrating to witness my own strength loss. I can't do a real push-up anymore. I do not have the strength in my left arm. It just gives in.

Seeing everyone else pr and sweat isn't easy either but I want to be supportive, even if it's hard and sometimes feels like I am lying to myself; however, I need to have faith in the process and remember that it will be ok.

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

GERMANY is WELTMEISTER

Wir sind Weltmeister. After years of hard work, smart coaching, physical and mental training, Germany has finally made it: Winning the FIFA World Cup. Athletes and fans alike know how good winning can feel. Endorphines basically replace adrenaline or couple up, I guess. I am not an expert on hormones, but the emotions I felt when Götze shot that one and only goal during the second half of overtime, were intense. I made my dogs go crazy as I screamed "Jaaaaaa!" and jumped off of my chair. Unbelievable. Simply wunderbar.
My posture will be fixed for at least the next couple of days, as I carry myself with an extra touch of pride...

But, at the other end, we all were shocked to see Kramer go down, keep playing, but then a bit later - surprisingly still walking - going off the field. Head injuries are not uncommon in soccer or any other contact sports for that matter. I hope that 23 year old Christoph will only have suffered a concussion as the TZ reported, but I also hope they will take x-rays of his neck. Just in case. Pereira (player for Uruguay) was knocked out during their game against England. Although he was unconscious, he kept playing. According to sources such as die Zeit, FIFPro is calling for "more" head protection. That's great, but they will keep happening, so discussing the measures that should be taken during a game, seems just as important to me. I'm sure FIFPro is considering that as well, but I am just saying. 
 
It certainly reminded me of my own spinal problems, the pain, and the thoughts of recovery,and fear of being able to perform at the gym again the way one did pre-injury. I sure am no star soccer player, but it does not matter who you are and it does not matter why you got injured in the first place. It is important, however, to address the cause and to be proactive and optimistic about recovery. My body is telling me with the pain it sends down my arm, that I have to do something. Change something. And I am. Never have I been more focussed on form and core strength. Maybe this will play out in my advantage in the long run, even if it will take me longer to get back to where I was pre-injury.

Tomorrow, I will see another specialist to get a second opinion on surgery and all. 
For now, I am happy to be Weltmeister and hope the best for all head-injured players of the 2014 FIFA World Cup, which has been one of the best I've seen - not only because we made it.

By the way, if you haven't read my "About me" blurb: I am German. 

Gute Nacht - tonight without narcotics! Woohoo!

Back to Blogging about Crossfit

I am back. Over a year later, I decided to really do a blog :)

Long story short, CrossFit changed my life. For the better. I am likely to write more about how and why in other posts. So here are my reasons, why I decided to blog about my experience as a female crossfitter.

First of all, I am a writer. I just finished my dissertation and should be drafting proposals for conferences and publications, however, life got in the way and the only form of typing I can do currently is using my iPhone. I guess, I could try writing proposals with my iPhone, but honestly - and despite the fact that it's pretty much impossible - I don't even have the mental space for that right now.

Brings me to the second reason. I want to share my current journey of being an injured crossfitter who was just getting stronger than ever, dreaming and working towards making it to Regionals in 2015. I'm not saying this dream is crushed, because that's not how my competitive brain works, but I have encountered obstacles that need some more care and caution than just doing some extra credit work at the gym.

I have been diagnosed with a C5/C6 disk herniation, cervical radiculopathy, and foraminal cervical stenosis and as a consequence - my muscles trying to work around this - a kyphotic deformation of my neck vertebrae (loss of cervical lordosis). To sum up

My symptoms: numbness and tingling down my left arm into my thumb, pain in my wrist, elbow, shoulder, tri and biceps, loss of range god motion, grip strength, reflexes, and motor skills. And some neck and back pain. But that's nothing compared to the pain felt in my shoulder and arm. Luckily NO headaches!

While analyzing the causes of my neck problems, I can go far back into my childhood. I was dropped and injured my neck as a toddler, then injured my neck jumping rope (yes, jumping rope) in 4th grade, and passed out one time cleaning up my room ( trying to get my head under the bed) while in high school. I also suffered several whiplash accidents (two during horseback riding, two during snowboarding and two in car accidents). Rest was the prescribed treatment for all of these incidents. I don't think ever had they taken X-rays. All this occurred while still back in Germany.

At any rate, the first time it really became an issue - besides episodes of stiff neck every now and then - was when I became more and more active at CrossFit. Note, that sitting in front of the computer with suboptimal posture for the majority of hours per day added to my already harmed neck.

So, to keep it rather short today, I will follow up soon to let you all know how it all got worse, what I have been trying to "heal" it and what will be ahead on my road to recovery, and on my path to becoming a competitive CrossFitter.

In the meantime, let's cheer for Germany to win the World Cup today!

----

"People will keep saying something is impossible until someone shows them that it is possible."

Measurements and Baseline

Baseline WOD


400m Run
40 Air Squats
30 Situps
20 Push-Ups
10 Pull-Ups

Time: 4 minutes 51 seconds

May 1 before working out, I had my measurements taken.

Weight: 142Ibs / 64.5kg

Chest: 35.5in / 90cm
Waist: 28.5in / 72.5cm
Hips: 38.5in / 98cm
Thigh: 21in / 53.5cm

BodyFat%: 18.8

So, I guess I should be setting a goal.
I want to improve in one month.
If I could do the WOD in 3 minutes, that would be great. I am better on 10min+ WODs but that's ok. I am already doing RX on most WODs though. inch-wise I think I can lose around the hips, possibly thigh and waist but I think my chest is not goign to get smaller, rather bigger. Similarly, I am barely in the athletic range for body fat, but 15% would be pretty awesome. Weight-wise I have no idea. But 135 would be great, yet, I really don't care about my weight.

I have no idea if any of these are realistic but let's say these are my goals:

Performance Time: 3 minutes (1minute 50 seconds)

Chest: 35in / 90cm (0.5in)
Waist: 25.5in / 65cm (3in)
Hips: 35in / 90cm (3.5in)
Thigh: 19in / 48.5cm (2in)

BodyFat%: 15

Weight: 135Ibs / 61.5kg