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Thursday, August 25, 2016

If I was a Horse they'd just shoot Me!

So let me start this post by saying I'm in Texas!

Yep - my old Stomping Grounds.... my old Money Making Grounds.....

And my Old Medical Find Out What the Fuck's Up Grounds!

So What the Fuck's Up!

Well - in a Nutshell....

I'm Fucked Up!

Or should I say.....

Worn out!

I know I hear all the moderate intellectual overweight, let life pass me by individuals out there saying....

"Ha! I told you so.... I knew it.... Yeah you thought you were such a Bad Ass and now all that working out and shit talking has got you where?"

To which I say in a polite manner.....

"Better to Live One Day as a Lion than a Lifetime as a Lamb."

And in not so polite a manner....

"FUCK YOU!"

Ok.... enough of the attitude and expletives.

Let's get down to data, information, experiences and learnings.

And that's the most important thing about this post and this blog in general....

What can you take away from the information you get here?

What can you learn to do to better your life?

What can you learn NOT to do to better your life?

So let's take it one body part at a time.

First of all, as most of those who know me and / or read this blog regularly know, I had a left knee replacement on April 4th and it is doing wonderfully..... Way beyond my highest expectations.  It is way better than the God-given knee I had for the last 5 years and even though the orthopedic guys tell me otherwise, I can't tell it's not better than the knee God gave me from the beginning so 2 thumbs up and Gold-colored stars on the Left Knee Replacement.

Now let's talk about the rest of the God-given parts.

First of all, as a matter of information, I had all of these exams / evaluations done at the Fondren Orthopedic Group in Houston Tx.  


As far as I am concerned and know, this is the best group of orthopedic doctors in the World and if Humpty Dumpty ever fell off a wall, I would take him there to have him put together again.

So let's begin the list of Body Part All Stars with a guy I have known for over 30 years who has done 4 surgeries on my left knee - G. William Woods.


And this is the X-ray of my Right Knee - Yep the God-given knee.  I've had some pain from it especially when sitting for a while or hiking downhill and every once in a while when a make a clockwise rotation with the upper leg relative to the lower leg I can feel a sharp pain that feels like a meniscus tear or rough area.

So I had the G-Man take a look at it and, surprisingly, it's not that bad.  There's still plenty of meniscus / cartilage left and the wear is relatively even.  There is one bone spur visible on the inside of the lower joint visible on the x-ray on the left but that's about it.  

Dr. Woods recommendations -

Stop squats, lunges and all weight exercises for the legs.... Just hike, bike and swim..... Been hearing this for 30 years.

So I showed him how I do squats and lunges where I keep my shin / lower leg completely vertical, i.e. no knee movement past vertical, keeping a 90 degree angles between the upper and lower leg.....

And Dr. Woods goes.... "Hmmmm..... Never seen that before.  That will make a difference." 

I didn't convince him to let me do squats but I did make a point.

Lifting technique makes a huge difference in the stress that is put on the knee joint or any other joint for that matter.

He also told me that the NSAID (Non-Steroidal Anti-Inflammatory Drug) that I am taking, Dicloflenac, is one of the strongest NSAIDs available and was probably instrumental in masking the pain and inhibiting the inflammation to the extent that I could continue to rock the CrossFit Rx WODs as an example to which I thought "No Shit Sherlock.... that's why I'm taking it".

Anyway, he prescribed me a milder NSAID as a way of limiting my ability to work out as much because I would be in more pain.

Huh?  Go to a doctor and he reduces your meds so you can be in more pain? 

Now that's a new approach.

Anyway..... we'll see how it works out.  I think most of the Pain Relief comes from working out and keeping the muscles around the affected joints strong but that seems to be counter to modern medicine so WTF do I know.

So bottom line, unlike the other body parts, the knee is the knee of a 54 year old.  

So that's the good news first.....

And where the good news ends!















The next body part giving me problems is my lower back and for this evaluation I went to J. Bryan Williamson at the Fondren Orthopedic Group.


His PA, Darren, came in to see me first and did a simple drawing of what he saw on the X-rays, a condition called spondylolisthesis -


It's a fancy way of saying that one vertebra has displaced forward relative to its neighbor because there's no more cartilage / disc left to keep it in place.

In my case, this has happened in the disc below L5 on this drawing.



You can see it clearly in the bottom right X-ray.

Also note how little gap there is at this vertebra compared to the ones above it.



















And you can really see the forward displacement on this next X-ray.

So in a nutshell, the lower back is pretty bad, as I suspected.

And of course the recommendation is No More Weight bearing exercises including squats, deadlifts and especially military presses - 3 of the most basic strength and muscle building exercises.

I asked Dr. Williamson about the benefit of keeping the muscles around the spine - the spinal erectors - very strong to support the structurally degraded spine and he grudgingly admitted that was probably the reason I was still as mobile as I am.

So let me get this straight.....

Keeping your lower back muscles strong and built up through doing heavy weight bearing exercises such as squats and deadlifts is bad for the skeletal back but good for the muscles that support the back which is good for the skeletal back.

I'll get Back with you on this.



















Now for the worst news of all.... The Left Shoulder.

For this exam, I used Dr Hussein Elkousy at the Fondren Orthopedic Group - 




















Bottom line, the left shoulder is bone to bone best seen on the lower right X-ray.

No cartilage at all between the upper and lower bones.

And this joint has also displaced forward and formed a new "dish" in the lower bone causing what is labeled appropriately a "Biconcave" condition or a Biconcave glenoid.

Here's one very technical article explaining Biconcave (B2) Glenoid condition and Shoulder Replacement to fix it.


From this article:

The biconcave (B2) glenoid is characterized by asymmetric posterior bone loss and a posterior translated humeral head that is seated in a biconcave glenoid. 

And another link:


And from this article:

 The B2 glenoid is defined by asymmetric posterior bone loss with the development of a biconcavity and posterior translation of the humeral head. Progressive bone loss results in increasing glenoid retroversion, which must be corrected during anatomic shoulder arthroplasty.

Dr. Elkousy was the most pessimistic and adamant of the 3 doctors I visited about the future of the shoulder joint.  No more overhead weight bearing exercises at all.  Only curls and pulling movements.

Obviously, shoulder replacement is the end game and I asked him about that.

No weightlifting at all with a shoulder replacement. 

Then I asked him a question I had asked the other doctors and that reflects a holistic view and approach to life.

"What if I told you I didn't want to live to be 80 or 85?  That I only wanted to live to 70 but be active and do what I'm doing now all the way up to that point?"

In another words, fuck making this body last and living a diminished existence where you smile and wave at life like a lot of the Walking Zombies out there.  Just keep going wide open until body parts start flying off like a dragster engine blowing apart at 300 mph.

His reply -

If you had a shoulder replacement and do what you're doing now, it won't last 4 years.

And I looked at him and said these exact words....

"You mean to tell me that in 2016, they can't make a fucking shoulder joint that will allow you to lift a 50# sack of corn off the ground and put it on a shelf above your head!"

And he replied - "That's correct".

And I said..... "Well that's a bunch of bullshit".

I think the young doctor (the youngest of the 3) was talking a Safe Game to make sure that none of his patients put a bad mark on his record by wrecking one of his precious shoulder joints.

Regardless of what I think that was the info conveyed.

So we agreed to use the X-rays and observations from today as a benchmark / reference point and come back in 6 months and check everything again.

Those 2 data points should give us a trajectory of degradation which will roughly define the life of the shoulder.















So what was my takeaway from all this.

Well, first off, I already knew all this.  

I didn't need any X-rays or expert Doctor devaluation to tell me the aforementioned parts and joints were in bad condition..... the pain told me that.

Hell I can feel the shoulder joint grating bone on bone when I do handstand push-ups and side planks.  I could've drawn the X-ray of my left shoulder out on a piece of paper based on the way it felt.

And in knowing all this I have made adjustments.  I'm not working out near as much or as intensely as I was 2 years ago.  I don't do Les Mills Body Pump (High Rep all Body Part Weight Class) anymore.

I used to do a PIYO group exercise class in the morning AND a CrossFit class in the evening 3 times a week.  Now I just do the CrossFit class.

So I have made some changes.....

But Maybe I need to make some more.

I talked to my son about it and he recommended I do the Hershel Walker style workouts which is basically 1000 reps a day of bodyweight exercises - Squats, Pullups, Pushups, Situps.

I don't know about you but I don't want to do a thousand of anything.

Anyway, I'm gonna think about it and make adjustments as necessary based on the only reliable indicator I know.....

Pain.

Pain will make you change....

And Maybe it's time for a change.




Regardless of the condition of my deteriorated joints, I feel more

Awake and Alive 

Now than I ever have!




While in my old hometown of Lake Jackson Tx today, I had to stop by Brazos Mall and my favorite clothing store.



Next door, at Hot Topic, I saw this shirt that explains my view of Sarcasm and why I use it so much!


Pretty much come to the conclusion that I just have to embrace the Freak in Me and Live With It!



Am I Invincible?

Of course not.

But do you really have to Be Invincible or just....



How do you like my new blue mirrored John Lennon-esque Ray Bans?


Wheh ya going Wills?

Into the Sunset baby..... Into the Sunset.


Back at the worksite lodging and set up for...

Work!


And eating right!


And Working Out!


Aaaah..... and that too!


You know what?


In the end analysis, we are only on this Earth for a short while and we have to make the best of our time here.

However you define that.

For me, it's Wide Open from Can See to Can't See.

That's the Way I Live.....

And That's the Way I'll Die.

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