Surgery tomorrow

Well surgery is in the morning and I'm pretty anxious. I spent all day cleaning again to keep my mind occupied but that didn't work all that well. I am more worried about this procedure than any of the previous surgeries that I have had. Strange.
Well I'll post as I begin my recovery and who knows..... maybe some pics to go along!

The date has been set

Surgery is going to be Friday December 11. I will be taking time off from work until February 10th.
Well fall is officially here with heavy rains and winds for the last couple of days and heavy mountain snows. I really don't mind if it is storming but when it becomes constantly gray and dreary I wonder if we will ever move away.
Jake is coming home for Christmas this year! It is always nice when he comes to visit us. I think he might be helping me out a bit more than what he thinks. hee hee.
I have been playing my guitars more and am currently working on writting some new songs. My writting has become rusty but I think it will shine again with some more practice. It sure is nice to have my music and to play and sing all of the types of songs that I like.
Cheers!

We Have the technology to rebuild him.....

WARNING: NOT FOR THE SQUEAMISH!!!! But I know you will look!!!

It is tough getting older but I am thankful for modern medicine! I have medial osteoarthritis in my left knee. My last surgery removed the damaged meniscus and scar tissue from the inside portion of my knee. As time has gone the pain in my knee has steadily increased from my femur rubbing against my tibia. Walking and standing is very painful. Physical therapy hasn't helped and it won't so the next step is to have a high tibial open wedge ostotomy with a donor graft. Sorry for the length of the following but it explains the scenario:

In patients with degenerative arthritis, or osteoarthritis, of the knee joint, deformities of the knee are common. These deformities include a bow-legged or knock-kneed appearance. More technically, these deformities are called genu varum (bow-legged) or genu valgum (knock-kneed).

What causes a bow-legged or knock-kneed deformity? As arthritis progresses, the cartilage of the joint wears thin. The meniscus, or joint cushions, are also damaged and wear away. If the damage is more on one side of the joint than the other, as is usually the case, then the knee will take on a deformed appearance. When the inside, or medial side, of the joint is worn thin, a varus deformity (bow-legged) will result. When the outside, or lateral side, of the joint wears thin, a valgus deformity results (knock-knees).

What is the problem with this type of deformity? When the knee is worn more on one side, the forces transmitted across the joint are altered. When the inside (medial side) wears thin, the force of your body weight becomes more centered on the worn out part of the joint. Therefore, the healthier part of the knee is spared the burden of your body weight, and the damaged portion gets the brunt of your weight. This becomes a vicious cycle that leads to progression of the arthritis.

How does an osteotomy of the knee help? The idea of an osteotomy is to shift the weight-bearing forces to "unload" the worn out side of the joint, and place the forces on the healthier side of the joint.

Who is an ideal candidate for a knee osteotomy surgery? The problem with knee osteotomies is that finding the right patient is very difficult. Knee replacement surgery is very successful, and unless there is a good reason not to perform a replacement the total knee replacement is usually favored. Some patients, however, are not good candidates for knee replacement, especially patients who are young. Because knee replacements wear out over time, younger patients should be evaluated for alternative procedures.

The ideal patient for a knee osteotomy is a young, active person, who has arthritis limited to one side of the knee joint. The patient must have significant pain and disability such that surgery is warranted. The patient must understand that rehabilitation from this surgery is lengthy and difficult. Finally, osteotomies around the knee, tend to last less than one decade--then something more, usually a knee replacement, needs to be done. Some patients may find lasting relief with an osteotomy, but the majority of patients use a knee osteotomy surgery as a means to delay eventual knee replacement surgery.

Good candidates for this surgery must fit the following criteria:
Significant pain and disability
X-rays showing involvement of only one side of the knee joint
The ability to cooperate with physical therapy and rehabilitation

Who is not a good candidate for a knee osteotomy? Unfortunately, performing this surgery in the wrong patient can have poor outcomes. Therefore, you should discuss with your doctor the potential risks of this surgery. While many people want to avoid knee replacement surgery, the knee osteotomy is not right for everyone.

Patients generally should not consider this surgery if they have:
Widespread arthritis of the knee (not confined to one side)
Instability of the knee or tibial subluxation
Significant limitations of knee motion
Such a significant deformity it would be difficult to correct
Inflammatory arthritis (such as rheumatoid arthritis)

How is an osteotomy done? An osteotomy uses a procedure where the surgeon cuts the bone and then reorients the bone. There are two basic types of osteotomies: closing wedge, where a wedge of bone is removed to change the alignment of the bone; and, opening wedge, where bone is gapped open on one side to realign the bone. Depending on the type of deformity and the location of your osteotomy, your surgeon will choose one of these options.

Once the bone is cut and subsequently realigned, your surgeon may choose to use a metal plate and screws to hold the bones in the new position.

How long is the recovery from a knee osteotomy? The recovery from a knee osteotomy can be difficult. Because the bone is cut, it needs time to heal. The total healing time is at least 8 weeks, and can take longer. Most patients need physical therapy to regain their knee motion.

What are the complications of knee osteotomy surgery? The most common problem with this surgery is that it almost always fails over time. Now, if you can feel better for nearly a decade, and delay knee replacement surgery, it may be well worth it. However, it is not uncommon for patients to require conversion to knee replacement within a few years of the surgery.

Orthopedic surgeons also face the problem of performing the surgery in a manner that will not make a subsequent knee replacement surgery more difficult. Finding a doctor experienced in this procedure is a good idea.

Other potential complications include problems with healing of the osteotomy (a nonunion), continued pain from arthritis, blood clots, and infection.

How successful is this surgery? When done in the right patients, knee osteotomies are usually successful at decreasing pain caused by arthritis. They surgery tends to last about 8 to 10 years, and after that time, many patients will require total knee replacement. In a large group of patients, knee osteotomy gives good to excellent results in about:
· 80% of patients for 5 years
· 50% of patients for 10 years
· 30% of patients for 20 years
Because of this, knee osteotomy is generally reserved for young, active patients, who want to delay the time until knee replacement.

Now for the pictures. WARNING WARNING WARNING

The surgeon uses a plain X-ray film to find the preoperative anatomical alignment of the knee. Lines are drawn on the film with a ruler and protractor to estimate the size of the corrective wedge.

In the operating room a pair of guide wires are drilled from the lateral side to the medial side, ideally forming a perfect triangle

A conventional oscillating saw is run along the guide wires, the bulk of the wedge is removed, and the "hinge" of cortical bone is refined by osteoclasis or chiselling.

This is what my knee will look like when the surgery is over only on my left knee.

Surgery length: 2-2 1/2 hours. Overnight stay at hospital with possible second night stay.I will be off work 6-8 weeks with no weight bearing for 4 weeks minimum. I am now in the process of strengthening my body to be ready for surgery. I invite you all to please stay in touch with me.

Patience and perseverance have a magical effect before which difficulties disappear and obstacles vanish

"October's colors are flaming torches lighting the way to winter."

Clear nights and Harvest moons. The fog lifts and what wonderful days are bestowed upon us. Everyone should take time to sit and watch the leaves turn.

It is days like this that I put into my memory so that I can get through the winter.

Cedar Creek Gristmill, Battleground Washington

It's Fall

Just a quick update on life. My knee is on the mend and I have been able to run a few times with no knee pain. However, my muscles are weak and get very sore. It will just take some time to strengthen them. Next month I will have my surgeons evaluation on where I am at after PT and what to expect before my next surgery.
Angela's Gallblader surgery went great and hopefuly now she won't be in pain anymore. How nice that will be!

I hope that after the past 15 months our health will return back to normal. It has been a very tough road to be on and we are looking forward to getting back to what we love to do.

Surgery date

Surgery will be in 11 days on the 17th. This past week has been really difficult for me walking. I am constantly feeling and hearing things in my knee going "crunch". By the end of the day it takes a great effort to walk. This surgery can't come soon enough and I am positive that Dr. DaSilva will make my knee better.

Great news, Jake and Suzzanne will be visiting us this Friday and we all are heading to Seaside for 3 days. Jessi and Colin will be joing us too so it will be a great time! The weather report is showing nice weather for the coast this weekend so we will bring along our rain gear and sweatshirts! Hah!

Arthroscopic knee surgery

I had my follow up visit with Dr DaSilva and it has been determined that I have worn down cartilage and bone on the inside of my left knee. I will be having arthoscopic surgery in a few weeks where the Dr. will determine what damage there is. The possible procedure(s) that will be done will be a meniscectomy and microfracture.

If a meniscetomy is done the damaged tissue will be taken away and donor tissue will be added however if the damage is too much the tissue will only be removed with no implant. A microfracture is where the doctor will drill small holes into the damaged bone to get the bone to bleed and expell marrow out to begin regrowth of the bone. Again if there is too much damage then a bone graft will be placed with pins.

Now the big question: How will this affect my running.? Dr. DaSilva told me that I will probably not run again and that I should focus on my biking and swimming. I explained to him that I have overcome some pretty big challenges in my life and we will just have to wait and see how the surgery turns out. I guess the bottom line is that what ever happens will happen. No problem.

More to come.........

The Return

"For every dark night there is a brighter day "

Has it really been almost a month? Time flies! Well since my last 2 posts I am happy to say that I am starting to feel like my old self again. I am so thankful that I did what I had to do to get better even though it was one of the most frightening things I have been through.

So what is new with me is that I am rebuilding myself from my base. I injured my left knee while running back in March, had an MRI and am currently in physical therapy. With the inactivity from surgery and the medications I put on 35 pounds (yes I weigh 205 lbs right now) which wasn't good for my knee or for my over all fitness. My physical therapist says that he is much more optimistic than my Orthopedist and should be back running soon. In the meantime I am biking and about to start open water swimming again. I am going to set a goal for myself to do some late event in the season so I have something to train for. I just don't know what it will be.

A good friend of mine asked me the other day if I was planning on any more Ironmans and I told her that if I can physicaly train for it I don't see myself stopping that distant race anytime soon. I am thinking next up will either be Ironman Canada of Ironman Florida. It is fantastic to be able to say that.

Everything is impermanent, everything has its "course" to run, some short, some long, some momentarily, some for our life....no matter how much we fight it, when the end comes-(in anything)- we must let go...

It is so good to be back my friends

Just as the catapillar must die in his cacoon, so shall I........but...ON the other side Is the flight of the butterfly! I will be free to fly once again! Now that is amazing!

Only when its darkest out, are you able to see the stars..........................

April 20 2009

I am entering the hospital tomorrow to finish my opiate dependency. 10 months is long enough and this is what I need to get better. I should be reporting soon on my success. Treatment will last from 4-7 days. It is really too bad that I can't recover back on the island with some Bob Marley playing and the waves lapping at my toes. Soon though, soon.

Getting the help that I need

I am about to start my detoxification from the opiates that I have been on for the last 9 months. The Acupuncture is a wonderful thing that is helping a lot. I have been on Dilaudid now for 2 months because of the Oxycodone shortage. The drawback to this opiate is that it only lasts about 3 hours and then I begin all of the withdrawl symptoms. Just think of a junkie on the street and that is what I begin to go through. Shakes, paranoia, anxiety,tremors, sweats etc. I now have a new medicine that helps with the withdrawls which is a blessing but it tends to affect my cordination a bit and it also chills me out quite a bit because of the anti anxiety med that I take along with it. So...... let me sum this up because it helps me by sharing what I am going through.

MEDICINES: 2 mg Dilaudid 5 times per day for pain and because my body is addicted to it.

1 mg Xanax 4 times per day for anxiety.

60 mg Cymbalta for my depression. Once per day

.1 mg Clonidine for withdrawl symptoms and to lower my blood pressure 3x daily.

50-100 mg Trazodone to get the sleep that I need. I don't have restful sleeps.

10 herb pills twice a day to help mellow me out.

WHO I AM SEEING: Brad Whisnant, certified Acupuncturist/herbalist. Provides good "JuJu"

Shelly La France who is a nurse practitioner. Medicine prescriber.

Kurt Swensen, Certified addiction specialist. Counselor for my depression,anxiety and my PTSD.

Each day for the time being I am in pain, depressed, have high anxiety, suffer paranoia, have difficulty falling or staying asleep, irritability, hyper vigilance and feeling jumpy and easily startled. I feel like I have let myself down by still being on the opiates, gaining weight and not being where I want to be physically. I stepped down today from my marathon coaching job but I will continue with the program as an assistant coach and head of the route committee. So as you can see by reading this I am not in too good of a place in my life right now. I can see that I will have some major challenges ahead of me and know that with really hard work I will be able to overcome them. I just wish that I could see the light at the end of the tunnel.

बल श्रद्धा आशा

Strength Faith Hope

Good bye to a freind

I lost one of my friends this week. Alex Christy was a young 37 years old and I have worked with him about 10 years. Alex's humor was always witty and as colorful as mine can get.

I believe that upon death we will be asked two questions and our answers will determine whether we can continue our journey in the afterlife. The first question is, "Did you bring joy?" The second is, "Did you find joy?"

I know that Alex will have answered a resounding "Yes!" to each.

Travel safely Alex and we will again see one another.

Palm Springs

Just a quick report about our trip. Highs were 75-80 just right for proper "basting" by the pool. Angela and I spent one entire day out in the Joshua Tree National Forest. As I said to Angela, this is my Sanctuary, Cathedral or church for that matter. Take a look at some of the photos that we took at http://www.flickr.com/photos/rcwells/

Well I am training for my first race of the season. I will be doing this with Rick so I guess I have brought him to "the Dark Side" The event is a DUathlon which will be run a 5k, bike 15 miles and then run another 5k. This is a great event each year and should be a blast doing it with Rick!

Accupuncture continues to help along with my meds. I will be seeing my Dr. March 23 and we will discuss where I am at and what will be the next step. Send me a line and say hi and I'll be posting some more pictures on my Flikr site.

Chasing the Sun

Just a quick update. Angela and I are going to Palm Springs to soak up the sun and have some fun just sitting by a pool and laying in the sun for 6 days! I better start some more tanning at the fake and bake!

My new meds seem to be helping with my depression and anxiety but I still have my moments (don't we all) but I'm able to get through them. My acupuncture begins again this Thursday and I will be doing that 3 times a week. It really helps me and I would recommend it to anyone.

I went for a "long" run of 3.2 miles yesterday which would be my longest run since August. The weather here was in the low 50's and a very bright sun. Perfect weather for running although I did overdress for the run. My time was slow and my heart rate was higher than I would want it to be but I know it will drop along with my time. Baby steps. Baby steps. Baby steps. One day at a time. One day at a time. It sounds just like I am entering sobriety again.

Find peace and love in your heart each day and live strong through your faith and beliefs. Everything happens for a reason whatever it might be.

Sam Elliott

Sam shops in my store when he is in town and I was able to finaly get my picture with him. He is the most approachable, kind, good humored and what I would call a true gentleman and a good human being. Everything that I have seen him in has been great.

And so it begins

First I need to tell you about the new header picture. I took this in December 2006 when Angela and I were in the BVI's(British Virgin Islands) celebrating our 25th anniversary. This is Cooper Island where there is no electricity, roads, stores, TVs etc etc. There is a beach club with 10 units and a restaurant and 3 houses to rent. We have stayed here twice now in "our" pink house. The first time we stayed a week and the last time we were there I think it was 16 days. It is perfect. Pic of the house and the view from the deck.

Well I have officially started back training. I was able to run comfortably for 2 miles on the treadmill. I sure have some weight to lose but I have begun to eat correctly again and with the exercise it will come off soon. I have my 2009 race season 90% firmed up and it looks like the following will be my goals: Spring Duathlon in April. Olympic distance Triathlon in June. Hood to Coast relay in August. Half Ironman in September and to finish the year off the Portland Marathon in October. Here's to healthy and safe training!

Do you need a exercise schedule tailored to fit your goals or diet suggestions to help lose weight? I'm here to help. Now use me darnit!

Adios Amigos

A new year and new journeys

There will be no recapping of 2008. For those of you who followed along with my blog you know my goals, accomplishments and failures too. Feel free to look back at my older blogs and know that I found in my life exactly what I put into it. I hope that you all did too.

New journeys and new beginnings. I find that exciting! I am going to work on returning to my love of triathlons and know that my healing will continue to take time and to have patience. I need to keep reminding myself "that patience and perseverance have a magical effect before which difficulties disappear and obstacles vanish". I was told the other day by a close friend that smiling and good humor come with ease to me and that I should continue to humor myself with kindness and hope. That I will have my fitness return to me. "You've inspired me to take on running again". To hear that I have inspired someone again gives me the hope and the courage to return to my former self and continue to help and inspire those wherever they need it.

Live with intention

Walk to the edge.

Dare. Listen hard.

Practice wellness. Laugh.

Continue to learn.

Play with abandon.

Appreciate your friends.

Do what you love.

Live as if this is all there is.