Day 10

We took another nice walk on the park’s grass trails today, a little farther and a little faster than before. What a nice day - 60 degrees and a cool breeze. 4.4 miles in 1:27, pace about 20 minutes per mile.

This is the 10th day after the hernia surgery, very little pain during the walk, but it’s certainly not healed yet. I haven’t tried to run more than a shuffling step or two, and won’t for a while. I’ll get more direction from the surgeon in our post-surgical evaluation on Monday, I hope.

I had my fourth session of acupuncture today too, treating the surgical incision and my chronic peripheral neuropathy. So far I can’t tell whether it’s helping; the neuropathy hasn’t improved much, but the surgery seems to be healing rapidly.

Every Day Is Better than the Last

Wednesday, March 28, 2012:

We three had never seen some of the park's new trails, so we had an enjoyable walk on grass trails on the other side of the park.

We walked for about 45 minutes, no telling the distance, but we weren’t moving very fast. I felt about the same as yesterday, not much pain and very happy to be out there. This is day 9 since the hernia surgery, and it feels better every day.

Tuesday, March 27:

A walk in the park. 3.6 miles in about 1:20, a very easy pace. I felt an ache in the gut once in a while, especially if I misstepped a bit and got a little jolt. Otherwise, this was an uneventful walk. Mostly cloudy, windy, and warm for March.

Monday, March 26:

Elliptical trainer, 2.5 "miles" in 30 minutes, 265 calories. I "ran" at a reduced pace and reduced resistance level, with no pain.

Those are cherries on top of the oatmeal:

No More Pain Meds

I’ve been taking naproxen sodium (Aleve), which I prefer to ibuprofen for a couple of reasons, but today I just didn’t need any medication for pain. Certain things are still a little difficult, like getting in and out of bed, but I can laugh, cough, sneeze, blow my nose, walk, climb up & down stairs, and even drive a car without pain or pain medication.

This is good news. After three and a half days, it seems that recovery from the sports hernia surgery is on schedule. There is still quite a bit of swelling, and numbness in the skin around the incision, but I understand that’s expected and will go away. There is no evidence of infection or internal bleeding. I feel good, full of energy, and I hope that the recovery continues to go well.

It’s a masterpiece!

Acupuncture

I took the sore abdomen to practitioner AO, a licensed acupuncturist and expert in Chinese Medicine, practicing in Stillwater. We discussed most of my health issues, not only the recovery from surgery but also the myeloma, the minor peripheral neuropathy in my hands and feet, and even the chronic runner’s knee. She asked about diet, sleep, medicines, and more.

She examined my tongue, top and bottom, pronounced it good, and felt my pulse for quite a while, not quite so happy about that. Looking at my legs, she said that I had good skin. Who knew.

She seemed a little concerned about the amount of swelling around the incision, but did allow that she is not an expert on that medical issue. I’ll wait a few days more before I call the surgeon about that.

Then, as I laid on my back, she placed needles around but not in the surgical field, in my ears, on my face, my hands, my legs, and my feet. Sometimes I could feel a little pinprick as she placed one, but usually I felt nothing. Maybe 25 needles in total were placed. Then she positioned infrared heat projectors near my abdomen, and left me to sleep, meditate, or just relax, but not move.

Twenty-five minutes later she came in and removed the needles. Results: She thought that the swelling might have gone down slightly, as well as the redness in the area. Now, a few hours later, I do think that the swelling is less, though I have also applied ice to the area one more time. The neuropathy in the fingers of my right hand seems to be less too, though the thumb on that hand and the whole left hand seem unimproved. Bottom line, any change prompted by the acupuncture treatment is small. I didn’t ask and don’t know if the benefits of the acupuncture treatment are likely to show up later.

Whatever, I’m going back soon.

Laughing Is Back

For the first two days after Monday morning’s hernia surgery it hurt to laugh, cough, sneeze, or blow my nose. This morning I can laugh again. Getting into bed was no problem last night, and even though getting out was still iffy, sleeping was far easier the second night after surgery than it was the first night. Life is great.

The first night I took one little percocet tablet, trying to get some sleep, and I did regret that yesterday. The first-listed side effect is constipation, and apparently just one little pill will do it. Better today though.

I called the surgeon, who returned the call on his lunch break. He told me that the surgery had gone well, and that he saw no reason why I should not recover to pain-free running. That’s the assurance I wanted, and I hope he’s right. I also reported some numbness around the surgical site and he said it was normal and would go away in a few months.

I did not quiz him about the unexpected and unwanted general anesthesia. We have a followup appointment in a couple weeks, and we will discuss it then.

I’m going to see an acupuncturist this afternoon. The appointment was set up when I was going to try to heal the sports hernia by more natural means, but she may be able to reduce the pain and the swelling, and increase the speed of recovery. Who knows, maybe she can speed up recovery from the numbness. We’ll see what she says.

My appetite has been good throughout:

Too Late to Back Out Now

The "sports hernia" surgery is complete, and apparently went well. I say apparently because I wasn’t awake for it. Here are the boring details, as much as I can remember (I write this stuff for my own record, and post it on the blog in case anyone else cares, read at your own risk):

We woke at 4:00 am, left home at 5:10, and arrived Fairview at 6:00 am. I checked in and was soon paged to an admissions window in the area called "Same Day Surgery." We went to a "family waiting room," where Sunshine got a pager, and pretty soon a nurse took me away to a little office where she asked lots and lots of questions about my medical history. I changed into a gown - kind of a cool one that had portholes to allow a flow of warm air if necessary (they didn’t use them in my case).

Soon the anesthesiologist came in, and we had a discussion, then finally the surgeon appeared, describing the procedure to be done and marking the place on my abdomen where surgery was to be done. He asked me to confirm that it was the right place.

From there I walked to the operating room, already populated by at least four people all scrubbed and gowned. They did the final preparations, sterilizing and shaving the surgical site. At one point they did a "sound off," each person in turn reading my name, age, and the surgical procedure (abdominal exploration and repair), which I thought was an excellent precaution. They pulled a heavy cloth up in front of me, guaranteeing that I couldn’t see anything worth seeing, and then finally persuaded me to allow them to use a minimal amount of general anesthesia. Moments later, my lights were out for the duration. Apparently the surgery went well, but was finished long before I awoke.

Meantime, the surgeon was updating Sunshine. He said that some stomach muscles were injured by the running, and apparently that I wasn’t exactly a spring chicken in there any more, but we’re not exactly sure why he said that - he knew I was 71 when he encouraged me to have the surgery. He did not come to see me after I awoke.

They soon moved me to the recovery room., where several other people were recovering from their surgeries. The woman who moved me said that they had given me one unit (50 mcg) of Fentanyl. My lower right abdomen was still numb from the local anesthetic and I felt no pain at all.

After 30 or 40 minutes in recovery they put me in a wheelchair, took me back to get dressed, and a nice volunteer wheeled me out.

Tonight there is pain, especially when I cough, laugh, stand up, or sit down, but naproxen (Aleve) helps. I have something stronger if I need it, but then I couldn’t have my evening beer. There’s a reason for everything.

Here’s My Beef:

I know that I’m unusually sensitive to general anesthesia. I have examples, one time long ago when it took me days to recover, not minutes or hours, and other examples up to just three years ago. Anesthesiologists never believe me though.

I explained this to the first nurse, then to the anesthesiologist (at length), and again to everyone in the operating room. I also explained that I would prefer to be awake during the surgery, as the surgeon had said I could be, so that I could observe the process and talk to the surgeon. The anesthesiologist agreed to start with a minimal dose, which I could increase by asking for more. When the surgeon arrived, however, he said that I was a little too awake for his taste, and the nurse (or was she another anesthesiologist?) persuaded me to allow her to administer just a little Fentanyl, and that was it. Out I went, and I don’t know for how long. 60 minutes? 90 minutes? The whole process took three hours, so it could have been that long.

It seems to me that there are two possibilities:

• Either the surgical team deliberately ignored my wishes after assuring me that they would be honored, or
• They screwed up. They just didn’t believe me.

I’ll see the surgeon in a couple of weeks, and will certainly bring up this issue. Maybe I’ll call him tomorrow - depends if I’m still upset tomorrow. I wonder what would have happened to me if they had given me the amount of Fentanyl that they had planned to administer. Or maybe they did.

Anyway I’m safely home, and if the surgeon is half as good as he thinks he is, the recovery should be uneventful.

It’s a Walk in the Park

Thursday, Ides of March, 2012:

The sports hernia was still rather painful from yesterday’s run, so I walked with the girls, our usual 3.6-mile route on the paved trails. It hurt to walk, too, but that pain subsided somewhat during the walk and we had a good time, finishing together in 58 minutes.

Wednesday, March 14:

We were short on time today, and taking turns babysitting a sick cat, so I did a shorter run in the park. 3.6 miles in about 37 minutes, with a run/walk ratio of 3 to 1. The sports hernia hurt all the way, but I was so happy to be running anyway.

Surgery next week - I can’t wait.


This photo was taken few days ago in the park. It's almost completely dry now. I hope to run on the grass trails this weekend:

Joyous Run

This was the first run since the marathon, and it felt wonderful. Until now I’d been trying to heal the sports hernia, but now I don’t care about it because the surgical fix is scheduled for next week. In the meantime I can run as much as I like. 5.76 miles on paved trails in the park, in 1:1:02:19, for a pace of 10:49. The temp was 63 degrees, and the trails were dry.

I started with a walk / run ratio of 1 to 1 for the first half of the distance, taking it easy, then switched to 1 to 3 for the second half. Overall pace for the first half was 11:22, and for the second half 10:17.

Whining: The sports hernia hurt a little most of the way, and the right knee spoke up a few times, but the pain was not a limiting factor and not really even a distraction. Who cares - I’ll be in rehab soon enough. It's a masterpiece.

Timing: 32:43, 29:36, total 1:02:19.

Second Surgery Consult

The first surgeon I saw was flatly opposed to surgery for an abdominal wall strain (sports hernia). It’s not really a hernia, nothing is actually broken, so why fix it? Just because it hurts? Suck it up, buddy. Run with pain or don’t run.

Today, Dr. BRP had a different view. He does a lot of sports hernia surgeries, probably more than any other doctor in Minnesota. He was recommended to me by my sports doctor and also by runners who have had this surgery done. According to Dr. BRP:

• It’s not really a hernia, of course, and he doesn’t like the name "sports hernia," but for convenience it’s the name we use.
  
• My case is quite typical, and he would do an open (not laparoscopic) surgery in a slit about 2 1/2 inches long, attaching a plastic mesh both above and below the strained abdominal muscles.
  
• He prefers open surgery because he can view the muscle structure and see what is wrong. Also, laparoscopy is in some ways more complicated. It requires general anesthesia, for example, while open surgery can be done with local anesthesia.
  
• It’s "minor" outpatient surgery, takes about 20 minutes, I walk in and walk out. Stitches dissolve.
  
• The probability of success is 85 to 90%. He considers it a failure when the pain is not resolved.
  
• In hundreds of these procedures, he has not yet had a serious complication. I believe he said that he does 150 sports hernia surgeries per year. I wonder if a serious complication would always get reported back to the surgeon.
  
• My little list of extra risk factors (weak immune system, allergy to penicillin and sulfa drugs, 71 years old, anti-angiogenic medication) did not impress him. He thinks I’m strong and I’ll heal OK. I do too.
  
• Usually, a person recovers for all normal activities in 3 - 4 weeks, and for sports in another 2 -3 weeks. My next marathon is 13 weeks away.
  
• He requires that I go off aspirin for five days prior to the surgery.
  
• Medicare covers it.
  

Dr. BRP is very positive about the surgery that he does so frequently (surprise!), and quite convincing. Despite his confidence, I am daunted by the realization that this is actual surgery and that it exposes me to risks that I don’t have to take. Nevertheless, I’m so tired of running in pain, or not running at all, that I have scheduled the surgery for next week. I keep telling myself that I can chicken out in the next few days if I want to, but I probably won’t.


You can actually see the oatmeal under there:

Walk, Don't Run

Sunday, March 11 2012:

63 degrees today in middle Minnesota, very unusual for March 11. We three went for a lovely walk in the park, 3.6 miles in about 1:04:00 which is a relatively easy pace of 17.8 minutes per mile, or about 3.4 mph. Not very fast, but there was no pain at all. I did my therapy first, seven different resistance exercises and five stretches, before we went for the walk.

Saturday, March 10:

St Croix Valley Runners, with more walkers than runners today. We walkers went about 2.5 miles in about 45 minutes, while the runners did their usual five miles, some of them in considerably less time. I felt the abdominal wall strain (sports hernia) a little, but I doubt that it was re-injured at all.

I’m intent on getting the sports hernia healed one way or another. Monday I have a consult with a highly-recommended surgeon, but may decide instead to continue with therapy, acupuncture, massage, walking, elliptical, bike, weight loss, and whatever else I can do to stay somewhat in shape while trying to heal the injury. We’ll see.


Proper nutrition is very important to a runner:

B & A Trail Marathon, Annapolis, MD

YAY! We three all finished, and I finished almost a half hour ahead of my target. I’m a happy marathoner. Marathon number 63, state number 44 (Annapolis, Maryland). It couldn’t have gone better.

The B&A Marathon:

• Organization was almost perfect, the course was perfect, volunteers were better than perfect, even the weather was perfect (temp 40 to 47, partly cloudy). Nobody shut down anything until it was all over.
  
• The course is a lovely suburban trail, once a railroad bed. We started in the middle and went south 7 miles, then back to the middle and continued north 6 miles, returning to the middle for the finish. If you don’t like out-and-back courses, you wouldn’t like this, but I like to see the other runners and I got to see them all twice!
  
• The trail is almost entirely wooded, except at road crossings, of which there are few.
  
• Every crossing was manned by police or police volunteers.
  
• For some reason I had the impression that the trail was packed gravel, but it was blacktop the whole way. Nice clean blacktop. They had a serious rain the day before, a real soaker, but the trail was fine.
  
• The race was limited to about 1000 runners, and for the first mile or two it was on local streets, so by the time we got to the trail there was no crowding.
  
• Instead of yet another shirt, the race premium was running pants! Very nice ones, too. I will put these to good use right away.
  
• When I finished at five and a half hours, there was still plenty of food left. That doesn’t always happen in other races.
  
• There were plenty of aid stations, well stocked with whatever a marathoner would need. When I fished a gel out of my pocket, someone said “We have more of those if you need them.”
  
• Daffodils were in bloom. Songbirds conducted a symphony. We saw geese overhead, in formation. Frogs chirped in the marshes.
  
• The age-group awards are superb. Wooden plaques suitable for standing or hanging, with gold lettering describing the race, the date, and the exact award.
  
• Results are posted on their web site the afternoon of the race.
  
• They did run out of marathon medals, but will send one in the mail. That might matter more to a first-timer than it does to me.

My race:

• I had not been able to train since the Mississippi Blues marathon in January, because of a “sports hernia” (abdominal wall strain), and I was really a little worried about finishing this marathon. So I shot for six hours, the race time limit, but missed the first two mile markers and at mile three found myself a few minutes ahead of my plan. I felt good, though, so I kept going at that pace and finished in 5:32:45. Unfortunately, however, that was only good for third of three in my age group.
• Nevertheless, it was another marathon completed. Remaining marathons, in the order in which we hope to do them: Alaska, Vermont, West Virginia, New Hampshire, New Mexico, and Hawaii.
  
• My last three marathons have all finished within two minutes of the same time. I wonder if there’s a message there. It’s not a very good time, really. Interesting: In Mississippi that time got me third of eight in age group 70-74, but today I was third of three.
  
• The temperature was about 40 at the start, and got up to maybe 48 at the finish. That’s lovely! I wore shorts and a short-sleeved tech shirt over a long-sleeved tech shirt for 3/4 of the race, then took off the short sleeved shirt. Perfect for the weather.
  
• Six Clif Shot Mocha gels (w/caffeine), at least 8 salt tablets.

Whining:

• The sports hernia hurt all the way. About a three on a scale of zero to ten, maybe a four toward the end, where a five would be enough to make me slow down. It was never quite a limiting factor.
  
• The right hip flexors hurt too, but that’s happened before and it isn’t really an injury - it gets better within hours after the marathon is over. The left hip flexors hurt a little for a while too, but settled down again.
  
• The right hip flexors are close to the sports hernia, and some of the time it was difficult to distinguish between those two pains.
  
• Nothing else hurt. Not feet, knees, hips, back, nothing.
  
• My pace was not limited by pain, but by muscle strength and conditioning. I went about as fast as I could have. I should be able to finish a marathon an hour faster, but will need pain-free training to do it.
  
• We have a nice 14-week interval between now and the next race, and I’m trying to decide whether to try to heal the sports hernia by natural means (therapy and graduated running) or by surgery, then therapy and graduated running. I have a second-opinion consult in about a week.
  
• I own a heart rate monitor, but don’t like to wear it on a marathon. At mile 17 I timed my pulse and found that the rate was around 120 to 125. That's low, but I was breathing rather easily most of the way.

Splits: 37:22 (3 mi), 12:31, 11:43, 12:49, 28:44 (2 mi & major natural break), 12:23, 12:01, 16:02 (major natural break), 12:04, 12:20, 1:08 (0.1 mi,half marathon time 2:49:07), 11:07 (0.9 mi), 12:50, 12:20,11:37, 13:03, 12:14, 13:06, 12:35, 12:23, 12:22, 12:29, 12:33, 12:43, 2:13 (0.2 mi), total 5:32:45. First half 2:49:07, second half 2:43:38, actually a little faster than the first half, probably by about the time required for two major natural breaks in the first half, with none in the second.

Happy guy doing OK: