24 Hours after Bicep Tendon Surgery

Structure of the Shoulder 2

Yesterday I finally had my bicep tendon surgery. After 18 months of on and off physical therapy and 4 cortisone shots, this was the next step. As I wrote in a previous post, I see this procedure as regular maintenance–just as I would do for a car. As long as I take care of my body, I hope that it will last me a long time.

Over the next few weeks, I’ll talk to you about my progress so it might be of some use to others who may be in need of similar surgery.

On Wednesday, I got a phone call to arrive at the surgery center at 11 AM. I would estimate that surgery actually began around 12:30. Once the anesthesiologist got involved, there isn’t a whole lot that I remember. The last thing I can recall is getting some Versed, after which the doctor began to do an ultrasound of my neck to figure out the right spot in which to do the nerve block. I remember eating some graham crackers in recovery; I remember getting into a wheelchair to be wheeled out to the car; I have zero recollection of the ride home or how I changed into my pajamas or how I got into my bed… Which is, frankly, how I prefer it.

I will admit that I am not exactly sure what the procedure entailed. It is called bicep tenodesis. I tried to watch a video on YouTube, but after about 20 seconds, I decided it was probably a better idea to just let the doctor do his thing. What I do know is that my rotator cuff was in good condition and required no attention.

And now, the recovery. I have a sling that I have to wear for 2 weeks; on top of that sling is an ice pack that I will need to use for the next 24 hours or so. I have to wear compression hose for 2 weeks to prevent blood clots; let me assure you, it is quite a look. No shower until Sunday morning (ugh!). On Monday afternoon, I have physical therapy with my favorite therapist, Megan, at the Cleveland Clinic. Originally I thought I would be missing one week of work, although now it appears it could be 2 weeks. I won’t be able to do any lifting with that arm with anything heavier than a coffee cup for the next 6 weeks.

The real challenge is learning to do the things that are necessary for daily living with my left hand when I am righty. Believe it or not, I found a way to dictate text on my laptop and that is how I wrote this blog post.

Of course, this is not the best way to spend my summer, but I am confident that in the long run, the pain will be worth the gain. I would rather have this taken care of now so that I can continue to enjoy an active lifestyle and be the best personal trainer that I can be.

In the mean time, wishing everybody Shabbat Shalom, and a good weekend! I will keep you posted on my progress.

Falling Apart?

Broken Robot

They say that aging is not for the faint of heart.

Each year, it seems, my body surprises me with something else. Last year I had an emergency appendectomy–not fun at all and with a harder recovery than I expected. Three months later, I finally took care of a long-standing issue with Plantar Fasciitis that led to another surgery–also not the least bit enjoyable with an even harder recovery.

In the midst of COVID-29–which, thank God, I have avoided thus far–I have had a skin cancer with surgery (about which I blogged earlier). I will be having shoulder surgery in the not-too-distant future to resolve bicep tendonosis. And did I mention that some of my labs came back “funky” and I’ll need some more evaluations?

Definitely not for the faint of heart.

There are times when I do feel like I’m falling apart, like I am a broken robot whose circuits and switches are malfunctioning. The weird thing, though, is that I am still running (thanks to the surgery on my foot last year), am still working as a personal trainer, go for long bike rides a couple of times each week, can hike, and do the other activities that I enjoy. It is all relative. I sometimes see pictures of others my age and think that I’m actually doing pretty well, if not excellent. Others who see me tell me how great I look and ask how I keep in such good shape. And yet, there are days where I feel like I’m simply holding on with toothpicks and glue.

My attitude has evolved into the following. My father lived until he was 85. He had a lot of health issues including diabetes, heart disease and Parkinson’s, and did not always take the best care of himself. If I manage to make it to 85 that means I have another 28 years to go (God willing). I plan to do all the maintenance and repairs so that my body will help me to do all the things I want to do as I age. It is kind of like taking care of a car; as long as we are faithful with the upkeep, the car should last a good long while…and may even become a classic!

I know that this is not the end of the surprises. I am sure that other parts will fail me every now and again. I am fortunate that I have access to health insurance and can deal with my issues in a planned way rather than at the ER when the situation becomes critical. I do worry about so many others who do not have the same privileges that I do. This too is part of the social protest movements that are going on.

The main thing is to listen to our bodies, to care for them, to keep them well-nourished, well-exercised and well-rested. We cannot control everything that will happen, but we can keep ourselves as strong as possible so that when parts fail, we are better able to address the issue.

That is my strategy as I make my way into territory that is not for the faint of heart.

What I Hadn’t Counted on After Surgery

Scales

It has been 9 weeks since my surgeries on my leg and foot. The recovery has been more arduous and painful than I expected. And I have learned a lot.

It is only since I began physical therapy exercises a couple of weeks ago that i finally began to see progress in my mobility and levels of pain. As a personal trainer, I am on my feet a lot; after a month of putting no weight on my foot, the shock of doing that again was dramatic. After having been off pain medications, I went back on again for a short time. I’m still taking Ibuprofen and Tylenol–although a lot less now. It has only been in the last week that I finally have been able to go through a large part of the day without pain.

To those of you doing PT…listen to the instructions and do what you are told! It makes a difference. PTs are amazing skilled health professionals and I am really impressed with their ability to spot (diagnose) issues and recommend the appropriate exercises. I even “borrow” some of them for clients who have similar complaints.

Here is what I really did not expect. I put on quite a bit of weight–about a 5% gain. This is due to a number of issues. I was forced to be sedentary. Medications (especially pain meds) messed with my system. I did not eat as I normally did since I was sitting around with little to do but…snack. My exercise regimen was interrupted.

I have been trying for over 6 weeks to get back to my pre-surgery weight and really been finding it difficult. I finally turned to a subscription weight-loss app. Too soon to say if I am making progress, but the tracking of calories is scary as hell and definitely showing me where I am making mistakes. I will let you know if it works.

It is noteworthy that weight gain is quite common after many different kinds of surgery. It is also notable that few doctors warn their patients that this is a possibility and to prepare for it–physically and emotionally. I wish I had known; not that it would necessarily have made a difference, but I believe that knowledge is power.

My big takeaway? With regard to both the pain and weight gain after surgery, patience is required. Others who have had foot surgery have told me to not give up hope or get anxious; it takes a while for recovery. This is true of nearly any surgery. I now see a pain-free light at the end of the tunnel, but it took me longer to get here than I thought it would. With regard to the weight, I am also learning that what took 8 weeks to come on will not come off in 8 days. Slow and steady wins the race.

At some point, most of us will have to undergo some kind of surgery; in my experience, I never felt like I adequately understood what the recovery would be like (if we did, would we ever agree to the procedure?!?). If there is a next time, I will ask more questions, adjust my expectations, and remember that there is a reason why we are called patients!

Getting back to the Gym after Surgery

The cast finally comes off!

Surgery was just over three weeks ago. I have one more week of non-weight-bearing, and three more weeks wearing the boot.

This means that next week I can get back to training others at the JCC. Last night I taught a small group class, but could not participate–it was a weird feeling.

Since I began my fitness journey I have had a few surgeries: Bunionectomy, double-hernia correction, emergency appendectomy (this past January) and now the surgery on my foot.

What I have learned from my past experiences:

  1. Listen to your doctor…but also listen to your body. Doctors set guidelines for how we should “ease” back into our fitness routine, but that does not work for everyone. I have seen people have the same surgery performed by the same doctor for the same condition; one was back to work in 2 days, the other was out for 3 weeks. We all respond differently; some have surgery that is 100% successful, while others experience less success. So while a doctor may tell us that we should be able to do something (run, lift weights, etc.) we must listen to our body too. If we feel that we are nowhere near the progress we and/or the doctor expected, we must be sure to communicate with him/her.
  2. Go slow. I do not expect to be running long distances for a while (even a mile). I will start with walking on the track, then little by little adding a couple of laps on the track (1/12 of a mile) each time. When I had my hernia surgery, I had completed a half-marathon 10 days earlier; I was in tip-top shape. I tried to hop back into running with both feet and it was big mistake. I actually pushed myself too hard and too quickly, setting me back further and causing greater pain. It was about a year until I felt full recovered. This does not mean that we shouldn’t push ourselves (see point 1), but caution is our ally.
  3. Try to have some goals and a plan about how to get there. This is true with any kind of fitness plan, but all the more so after an enforced break. Before heading back to the gym, have a plan of how frequently and for what duration it makes sense to be doing which exercises (what weight, how many reps, how many sets, cardio or resistance). Putting it on paper gives perspective; does it look like too much, or not enough?
  4. Don’t get impatient or give up hope. I remember after my hernia surgery thinking that I was washed up and would never recover. The reality is that I did my best work after that surgery; easily beat my half-marathon time, ran obstacle course races, won to 5ks, and became a personal trainer. Keeping a positive outlook and knowing that we are on a journey (that isn’t necessarily linear) helps our sense of progress.
  5. Do some research. I’ve been poking around the internet and found several good articles on recovery after surgery. They all contain several common themes. Best of all, they help to set appropriate expectations. The more we set appropriate expectations, the less likely we are to be disappointed. The less we are disappointed, the more positive we are. The more positive we are, the more progress we make.

I will keep you posted on my recovery with insights I develop through the process. Let’s see how the 5 points above really play out.

In the meantime, glad the cast is off!

The Mental Work of Working through Physical Recovery

It has been one week since my foot surgery and hopefully only another three until I can walk again.
The physical recovery has not been as difficult as dealing with emotional issues that come along with an injury/illness. The first few days after surgery were not that tough; the block on my lower leg meant that I did not feel anything below the knee–especially pain. Once that wore off, I began to feel the discomfort. I really wanted to avoid taking pain meds since I don’t like the side effects, so I’ve been icing and trying to take it easy with several doses of acetaminophen daily. Today I wanted to go to morning minyan (prayer services); I got up, showered, got dressed, but was in too much discomfort to go. Big bummer.

The past several days have been difficult since I am so accustomed to doing a lot of the work to prepare for Passover. For those unfamiliar, imagine two Thanksgiving Dinners two nights in a row, but having to start with all new ingredients. In the past, I did a huge amount of the work and my wife pitched in with some sides and desserts. We were so excited to be doing all the preparation for the Seders together this year, but it ended up being all her. I tried to help where I could, but I felt kind of useless.

That feeling was made worse when I started receiving all the emails from the gym that all my clients were being cancelled for the entire month. That is a tough situation for anyone, but when you are just starting out in the industry and trying to build your client base, it feels devastating (even if the real effect may be much less). Since I don’t know what my recovery will be like and whether I will ever be back to where I was nine months ago before the pain began, there is an added level of anxiety. Will I be able to get back to training as quickly as I want? Will I have restrictions? Can I be successful at this new endeavor in my life? All questions swirling in my head.

It is always nice to have an objective party to discuss these issues with, and I did that today. I have in my mind that these four weeks are just a total write-off, but I can use this time productively. I will spend the week studying and hopefully obtaining my Functional Aging Specialization. Getting ready for that basically requires me to sit on my butt and read…I think I can do that this week. I also have to take things one at a time; I think we can all sometimes get into a downward spiral and follow a rabbit hole into the worst-case scenarios. I have to stop myself and let things unfold as they do without getting ahead of myself.

What has surprised me is just how much this recovery from surgery is emotional as well as physical. I have to deal with not working out, which is my usual stress reliever. I have to consider the possibility that my body may not fully recover. I have to face the fact that I am aging; this doesn’t mean that I’m all washed up, but rather that I have to change my approach. Hopefully, that awareness will make me a better Personal Trainer in the long run–especially as I train those in my peer group.

Wishing everyone a Happy Passover, belated Happy Easter, and all the best in whatever you celebrate. I also celebrate the process of healing–physically and emotionally. But it is hard work!

Learning from our Challenges, and Applying it to the Work We Do

The dog trying taking care of me

I am used to being very active–at the gym every day except for Shabbat training and working out. For the last 8 years or so I’ve been a runner: 3 half-marathons, more 5k races than I can count, several obstacle course races. So the thought of having to not WALK for four weeks is killing me!

I started having heel pain (most likely Plantar Fasciitis) back in late September when I was training for the Columbus 1/2 Marathon; it was a few weeks before the race so I couldn’t quit. Besides, it didn’t hurt when I ran…only afterwards. I finished the race (with my personal best time) but within a few days I knew I had a problem. I went to my podiatrist and we went through the usual conservative steps: new orthotics, stretching exercises, cutting down on the running. I even had a boot to wear at night that was supposed to flex my foot, but that was more annoying than the foot pain. Finally, I spent the last 5 weeks in a boot that went up to my knee. Unfortunately, while it improved at first, when I tried to walk for one hour without the boot, the pain was back.

Yesterday was surgery: stretching the Achilles Tendon was part 1, thinning out the plantar fascia was the part 2. Today I got my knee scooter so I can begin to get around again. Still, it is unclear how much or whether I’ll be able to train for the next month. I’ll need clearance from my doctor before I can go back to being on the Fitness Center Floor.

I am being forced to take a break–for a while at least. It makes me nervous. I rely on my workouts to ease stress, keep in shape, and for the social element as well. Training also helps to pay the mortgage. If I am unable to train, perhaps I will see if I can work at the Welcome Desk so I still feel a part of things.

Here is my real concern. All along I’ve told my doctor that I just want to be able to run again. We all have met people who tell us “I used to be a runner until….” I’ve also met folks who have said, “I was told I would never _____ again, but I did not give up.” I’d like to think I will be in the second category, but I hope I don’t have to make the choice.

When I am “fully recovered,” I hope I’ll understand what this all means. In the meantime, I now have a greater understanding and empathy for my clients who have had injuries or surgeries that have limited their ability to do the things they are accustomed to doing. When we talk about “Activities of Daily Living,” I now have a better sense of what that means.

When I am met with challenges, I always try to learn from them and then apply them to the work that I do–as a rabbi and as a personal trainer. This time will be no different. I will keep you posted on my progress.