My Hip at One Year

This past Wednesday was the first anniversary of my hip replacement surgery. I can't really say it's back to normal, nor am i sure what normal is now. I don't have any pain bearing weight on it, but it's definitely weaker and i still have some difficulty lifting that leg. I'm not sure if my hip flexor needs more rehab, or if i'm dealing with an ongoing process of healing for muscles that were significantly traumatized.

I'm back to doing my martial arts training at a near full levels of effort, although i don't spar or grapple. I've done a lot of cycling, including another century ride; and i can even jog for short distances. On the other hand, i'm the heaviest i've been for years, and i've lost most of the substantial aerobic base i took years to build up.

I get asked fairly often if the surgery was worth it. I think so, but i don't think a year is long enough to say for sure. The deciding factors in the long run will be how close i can get to my previous physical condition (adjusted for age), and whether any radically better alternatives show up. I don't yet consider the lifetime of the prosthetic itself to be a factor, because i'm not convinced that in even a decade the methods of dealing with worn-out joints will be the same as they are now. There are so many younger people getting joint replacements now, that i think the demand for better, different solutions will increase dramatically.

47

It's hard to find good things to say about a year in which the chief memory is having major surgery. But all in all it was a relatively smooth year and if you subtract the hip replacement and the end of my running days, it wasn't bad. Though for some reason 47 seems much older than 46, much more on the verge of 50.

I did a decent birthday ride this year, about 80 miles up through Camp Pendleton and back with my friend Cathy. We got rained on riding through the community of Vista, which was actually kind of fun (especially since it eventually stopped). It's nice to ride through Pendleton, but they limit the roads you can ride on to just what you need to get through the base to parts north. When i drove on the base prior to the Hard Corps marathon in 2009, i saw much more of the base and i wish i could ride through it.

It was a pretty leisurely ride and we did a lot of chatting. Although i'm not in very good shape by the standards of some previous years, i'm in decent bike shape, since i've done more mileage this year than any in recent memory. So I had expected to ride 100+ miles, but we realized we were going to run out of daylight so we stopped in Rancho Santa Fe at the golf shop run by Cathy's significant other Tom.

Running was the unifying force in my life. I planned my days around it, and to some extent my year. It helped me sleep and eat better and helped me de-stress. I'm still trying to figure out what to replace that with. Biking, swimming, tai chi are options, but none of those have quite the same qualities of convenience and simplicity. I hope that by 48 i will have at least figured out this one aspect of my life.

My Hip At Six Months

Tomorrow is 6 months since my hip replacement surgery. I'd love to say that i am completely normal and good as new, but for the last month or so i've had some pain in the front or side of my hip that i hope is tendinitis. I can bear weight on my hip, i can ride my bike without pain, and i can swim without pain; but lifting my leg straight up as one would do in kicking outward or lifting your leg into a high seat (e.g., my truck) is painful. It seems to be getting slowly better, so i'm hopeful that all of my spare parts are still in place. Still, i wished to be essentially back to normal by this point, so i have to admit to some disappointment.

When i last visited my orthopedic surgeon, he said that i could "bike my brains out". He probably did not understand the license that gave me to overdo it. I now regularly ride 50+ miles at a time on the weekends, and i favor hills and other challenges. I also do regular tai chi and i've been testing my leg on kung fu forms. I suspect this is inappropriate behavior for a hip-replacement patient, but i'm not inclined to take it easy until forced to do so. At this point in my life this is what i have to live for, so i'm clinging to it with all the strength i can muster.

There are things of which I may not speak;    
There are dreams that cannot die;            
There are thoughts that make the strong heart weak,  
And bring a pallor into the cheek,    
And a mist before the eye.      
And the words of that fatal song      
Come over me like a chill:                
A boy's will is the wind's will,  
And the thoughts of youth are long, long thoughts.

Elephant Maintenance, Part I

Some images from my adventures in home improvement.

These are three nests that i removed from a bush near my garage that had grown out of control. Don't worry, they were long-since abandoned. I've been putting the debris from this bush in the greenery recycling for the last 3 weeks, but i still have about half of it left.

A couple of weeks ago, i put in a temporary section of PVC to patch an irrigation problem. Unfortunately, it didn't hold; but it did make this interesting looking inverse-crater thingy. Sadly, laying PVC for irrigation is one of the things that i'm good at. Imagine how badly the things that i'm bad at turn out.

The White Elephant Project

The origin of the term white elephant comes from southeast Asia, where receiving a white elephant as a gift often turned out to be a curse. They are expensive to keep but, because they are sacred, could not be used for labor or given away. So the expression means any thing that you can't get rid of, but you are obligated to take care of even at great expense.

That's a pretty good description of my house. It's a decent house in a good neighborhood, but in retrospect buying it seemed like a better idea at the time. We searched for a long time for a house that had a number of specific features. First, we wanted a fourth bedroom because we thought that our families would visit more often if we had a spare room. As it turned out, that extra room has been occupied maybe 20 nights during the 8+ years we've been here. Second, we (mostly i) wanted more lot space. I grew up on a farm, so our 1 acre lot is a compromise between rural and suburban. Third, we wanted an older neighborhood, or at least one that was not a completely uniform development where the choices were between beige stucco and gray stucco.

We found a place with those features at a fairly sane price by southern California standards. We knew it was a bit of a fixer-upper, but we had reasonable expectations of increasing equity and disposable income. In fact, those expectations were met until the economic meltdown of 2008. We made some minor home improvements, replaced the heating/air conditioning and the roof, renovated the pool, did a little landscaping and painting, etc. I put in grass on the back part of our lot (over 7000 sq. ft.), which was a blindly stupid thing to do in a place with no rain.

Any house requires more maintenance than you expect. A house that's almost 40 years old requires more. A 40 year-old house where the previous owner was an ambitious but unskilled DIY-er, where there are parts of the property you don't set foot on for months, where the trees grow faster than you can cut them down is a bloody, freakin' nightmare. It is a white elephant.

Technically, there is nothing sacred about this particular white elephant. My reluctance to sell it stems partially from the fact that my kids like this community, and partially from the reality that it's definitely not a seller's market. However, since i simply can't let it fall apart for the next five years while my sons finish up school, i've started to make some incremental fixes. In the cluttered bazaar that is my psyche, i call this the White Elephant Project.

The project is complicated by the fact that i have no money, so it is primarily a sweat equity sort of thing. The only real difference between me and the previous owner is that i am fully aware that i have no skill. I will probably limit my activity to cleaning, cutting, and the minor repairs that i've mastered over 25 years of home ownership. I am somewhat fortunate that my property can be improved significantly simply by removing things.

My first steps have involved trimming some of the runaway flora, and fixing some of the irrigation (there must be a mile of unused PVC under my ground). I got a pro to remove the more troublesome trees. This summer i hope to take down a rotting shed, fix some of the outdoor plumbing and electrical, and get some of the windows fixed. Probably the biggest challenge is figuring out what to do with all of the extra space. I'd really like to open it up to a sort of community garden thing, but i'm fairly sure my litigious neighbors would go apeshit.

I feel guilty at times that i have a sort of reverse American dream, by which i mean that traditionally the dream is to own one's home while mine is to unload the thing at the first opportunity. In a sense this place should seem sacred, since it is where my kids grew up; and fixing it should be a labor of love. Instead, it feels like a huge, festering symbol of every bad choice i've ever made.

Anyway, i will probably do periodic updates on the project as it proceeds.

Paleolithic Fitness

In my quest to find something to replace running as my primary fitness activity, i've come across material on the idea of paleolithic (and its cousin primal) fitness. The idea here is roughly that our early ancestors were (we assume) pretty fit even though they did not exercise in any methodical way. Rather, fitness was the consequence of needing to hunt for sustenance, being limited to only natural (often raw) food, and having little in the way of sedentary pastimes. It seems the case for this approach is often made on evolutionary grounds-- that the best exercise and food mimic the patterns of the earliest humans because those are the patterns that allowed us to survive when conditions were the most harsh for our species. I get the impression though that there's a bit of the Noble Savage mixed in too.

Most of the gurus eschew long-duration cardio exercise in favor of interval-like training, presumably to simulate chasing after prey (or being chased after by predators). That's a little strange to me, since it's fairly well established now that humans have evolved lungs and hearts that are remarkably good systems for endurance, but we didn't end up with a structure that's all that good for speed. On the other hand, i do believe in the benefits of interval training. When i was running, i found intervals to be the best way to get faster. There seems to be a lot of similarity between the paleo/primal approach and the functional fitness movement. Not much equipment, simplicity of exercises, more focus on full motion and less isolation. Strength training is mixed with endurance training and flexibility, and they avoid strict schedules and prescribed exercises. I think that's probably a great approach for general, base fitness; but i also suspect that it's insufficient for any specific sport.

Another aspect of the paleo approach is a tendency toward more protein and less carbs (that is to say, meat). At least one program i found completely eliminates grains, and discourages legumes (beans and stuff). That might explain why they don't care for endurance sports. I honestly don't know if cavemen really had meat-rich diets; or if that's a bias formed from things like the Lascaux cave paintings and the Flintstones. I suspect cavemen ate whatever did not kill them and they could digest. Again, i think this dietary approach works backwards from an idea of fitness that prefers to build muscle, get lean, and not do too much endurance exercise. I think it would probably be disastrous for Michael Phelps or the average Kenyan marathoner. Plus, to be honest, i'd rather have spaghetti than six-pack abs.

My Hip At Three Months

Today is three months since my hip replacement. I am probably a bit further in my recovery than average, but i'm not where i wish i were. I've been biking for a few weeks now without any pain, and i've been doing tai chi for the last two weeks. In general, regular motions are not too bad, but any sort of eccentric motion is both difficult and sometimes painful (twists, lateral steps). My left leg is still very weak compared to my right, and i find that i sometimes use my quads and calves to compensate for weak glutes and hip flexors, which puts pressure on my knee.

After a year of physical deterioration, i feel very impatient to get back into some sort of shape. I'm about 20 pounds heavier than i was when i was running regularly, and since i still have limited mobility i feel... old. I tried to come to terms with the things that i would not be able to do after the surgery, but i'm not quite over the psychological impact of going from being somebody who was in abnormally good shape to somebody who pretty much meets people's expectation of a 46 year-old man.

The only goal i have set at this point is to ride the Tour de Poway Century ride in early October. However, i also hope to get back to my normal weight by the end of summer, and get the strength back in my left leg. I'm trying to do Tabata-style training to compensate for the lack of hard cardio , but i find i'm not quite fit enough at the moment to get through the full sets for exercises like push-ups and pull-ups. I can do squats, however, i'm not sure that i'm working both legs equally.

At this point i'm still stubbornly convinced that i can get back to some physical level that will make both me and other people forget that i am an invalid. As i approach 50 i realize that most people's expectations will be lower, but i've spent the the last decade among people who were 50, 60, or 70 and still pushing the envelope. There will probably be a day when playing golf or taking walks will seem adequate, but i hope that day does not come soon.

Re-Reading

I've been re-reading a lot of old books, in part to save money and in part because i've begun to realize how poorly i can recall books that i remember liking the first time. It's a strange feeling to read a book that you read twenty years earlier and to find how little of the plot seems familiar. For example, i've been re-reading Saul Bellow's novel Humboldt's Gift. I remember most of the characters, even the names, but the plot is completely fresh. I'm about half way through and i honestly don't know how it's going to unfold (ironically, memory was a common theme in Bellow's later works).

What's even stranger is that i have a vivid memory of the circumstances surrounding my purchase of this book. While still in college my wife (then girlfriend) and i made a trip to Chicago while visiting my family in Indiana. We went to Stuart Brent's bookstore on Michigan Avenue and i picked up a pamphlet that listed 100 books that Brent considered essential. One was Humboldt's Gift. I had not even heard of Bellow at that point, but there was something about the title that appealed to me. I ended up buying it in mass-market paperback form at a chain bookstore in the mall in Fort Wayne, near where my parents lived.

I know that i liked the book and i ended up reading most of Bellow's novels at various points through my life. On re-reading it, it seems much more appropriate for someone my current age. The main character, Charlie Citrine, is a 50-something author in the middle of a nasty divorce and with a couple of young daughters. He is clinging to illusions of youth, what's left of his money and fame, and what dreams a middle-aged man can have. To my 20-ish self he must have seemed almost foreign; but now i see a character who, although he has had more success than most, has problems familiar to most middle-aged men.

That, i guess, is the benefit of re-reading. It's a bit like sampling a case of wine as it ages in that it's a different experience each time, but you're never sure until you're done with it which point was the best.

What To Expect After Total Hip Replacement

I see a lot of articles and forum posts that either try to set expectations for after THR surgery, or ask questions about what to expect. There are no correct answers, so i hope to provide one more data point. My facts:

• I had my surgery at the age of 46.
• I was very active until about a year prior to my surgery (marathon runner, black belt)
• Mine was a left total hip replacement necessitated by osteoarthritis.
• I had a posterior surgical procedure. My procedure was also "cement-less".
• My new hip is a Stryker model with ceramic surfaces.
• My surgery was on Monday afternoon, and i went home on Tuesday evening.
• My first time standing was the morning after my surgery. I walked three times with a walker on that day.
• I used a walker for the first week and a half after my surgery, and then i switched to a cane.
• I had at-home physical therapy for the first two weeks.
• I had to self-inject blood thinners for three weeks after my surgery. This sucks.
• I started driving about 2 weeks after the surgery.
• I returned to work after 2 weeks at home.
• At 4 weeks i could walk without a cane.
• I had outpatient physical therapy from 2-6 weeks (twice a week).
• At 6 weeks i started riding my bike trainer.
• At 10 weeks i started doing tai chi again. My left leg is still weak at this point, but not painful.

I'm at about 11 weeks now. For the last two weekends i've ridden my bike on the road, for almost 2 hours the last time. I can walk for about an hour, but i get some pain around my incision near the end of that.

Should you come across this via search engine or something, don't hesitate to ask questions.

The Beat

Went to see The English Beat yesterday at a place called the Canyon Club in Agora Hills, north of LA. It was primarily a party for my sister-in-law's 40th birthday, and to a lesser extent, my son's 16th birthday.

The English Beat (originally The Beat) is (are?) one of my favorite bands from my college years. Maybe a half-dozen of their songs are classics, and Save It For Later is one of my favorite songs (they also did a few General Public songs). The band still sounds great, and they are awesome live. They don't really have new material, so their show is a recap of their catalog from the 80s for the most part.

It was an all-ages show, so my kids and a few others were there, but most of the crowd was the band's original fans, which is to say, middle aged white people. I'm sure most of them were having fun, but as is my nature, i found the depressing essence at the core of it. For example, i learned that there is a uniform for middle-aged guys, which consists of "relaxed" jeans and a collared shirt worn un-tucked (except for the requisite dumb-ass wannabe hipsters with the soul-patches and black jackets). This outfit delivers the message "I am still cool, but i am also 25 pounds overweight". Sadly, i fit in a bit too well.

My wife hit the dance floor to hang with her sister, so i spent my time primarily keeping an eye on the kids, particularly Henry who was going back and forth into the crowd, and my older son's girlfriend Erin, for whom i felt particular responsibility among a crowd of hundreds of drunk adults. The club was a bit warm and i had too many layers on, so i spent much of the last hour of the set outside with the smokers. I got to look around the strip mall in which the club sits, and its odd juxtaposition of nightclubs and antique shops. Although, i guess it's not really that strange of a contrast in this case, since the band is effectively an antique.

It was a good show, but nostalgia is not my thing. Being reminded of a time when i was young and hopeful and had all my original parts doesn't appeal to me that much (it's probably significant also that on my own 40th birthday i did a two-day solo bike ride). If i had to repeat something, i'd much rather go see the Aquabats with my son and his friends again.