My first Half Ironman - overcoming adversity

I just finished my first Half Ironman at Amelia Island this last weekend.  I had double hip replacement surgery 1 1/2 years ago.  Before my surgery I was in constant pain, could hardly walk, had a limp, no range of motion, had to give up running and the last few months before surgery had to give up bicycling.  No one can gaurantee the outcome of surgery but I did my homework, got a good doctor and physical therapist and did what I needed to do to get he best outcome I could.  It took me 6 months before I felt like my hips were mine, supported me and I was getting stronger than I was before surgery.  Don't get me wrong, I was up walking right after surgery and I did a sprint triathlon (relay, someone else ran for me) 3 months after surgery.  I think most people would be happy with that.  My doctor said I could get even better results so I worked with my physical therapist to get them.  It was hard work but I did it.

I've done Sprint triathlons over the last 5 years or so but never thought or had the inclination to do a Half Ironman.  All I know is some of my friends were doing this one, I had the time to do the training and I had people that believed that I could do it.  So I signed up.  Did the training, have one or two panic attacks, wondering what the heck had I gotten myself into.  It seems so big, something other people do.  Got over my panic quickly because even though I did question my sanity I was going to give it my best. 

I had two of my friends going up with me, Rose decided to do the Sprint tri while she was there and Bianca decided she would do the Olympic tri while she was there.  We went up Friday, looked over the couse and relaxed.  Saturday morning got up and were in the ocean at 7:30 swimming so we would know what it would be like the following day, followed by quick easy bike and short run.  Just a warm up for the race.  We were ready!

Sunday morning, before the crack of dawn, we were up getting our transition area set up.  This was the most organized friendly race I've been too.  Race staff and volunteers were knowledgable, enthusiastic and extremely helpful.  No waiting in lines, everyone was calm and organzied.  Loved it!

It's now race time!  Half Ironman get to go first.  I thought the swim course was very well marked with huge buoys you could see from shore.  Although the farthest one out (1/4 mile out) looked really tiny and really far away, didn't dwell on that.  So my wave is off.  I love the swim part, even though it can be a challenge in the ocean, it's my favorite part of a tri.  I would even swim longer and shorten the run (I know, blaspemy, sorry).  I did great in the swim, don't really have to use arms for much else in the race so use them up in the swim!

I was in top third of my group out of the water, 44 minutes.  There was a current and waves as we got farther away from shore.  Coming in it felt like the shore took forever to get closer.  Still I loved the swim.  On to the bike.  The bike course was beautiful, not a lot of intersections but we had a few roundabouts. 

With volunteers and police holding traffic for us it was never an issue.  I felt prety safe the whole way.  One big bridge in the first 15 miles, no problem, I just tuck in and go.  We did have wind picking up.  I always felt like it was a cross wind or against me.  Not often did I feel like it was behind me pushing.  Then in the last 10 miles was a flat bridge where I did have the wind behind me going, yea got to go really fast for a short period.  But I saw the look on bikers faces coming the other way, not good.  On the way back over the flat bridge was the hardest.  Head on winds with cross winds thrown in.  Not fun, but again, just tucked in and kept telling myself, it's not forever, it will end, just through it, and I did.

I enjoyed the bike, grinning the whole way, no great discomfort, but at the end I was looking forward to the run.  Which I couldn't believe, I hate running, I've never felt the runners high, still looking for it, I think runners are pulling my leg or it's at mile 28 which I will probably never see.  Anyway, I was looking forward to the run, ok.  It's odd, since I had never done a Half Ironman I had no idea what I would feel like towards the end of the 13.1 mile run.  I knew I had the swim, no problem.  I knew I could do the 56 on the bike after the swim decently.  Not sure how I would hold up on the long run after the long bike.  It's kind of strange to go into something that was such a big unknown for me.  I did the training, I had confidence I could do it, but I did know that things may not go as planned.  I did a great run for me, did not stop once!

On the last 4 miles, my muscles in my lower legs and feet started to cramp.  I was still grinning and saying to myself, you have to be kidding me!  I've come this far and on the last 4 miles, now you act up?  Stop it!  I made sure to drink some electrolytes which helped delay the cramps some but I could tell they were on the verge.  But I made it!  Finished in 6 hours 48 minutes.

Of course looking back I know I could do better and even before I finshed knew I would do another one.   I can't believe I'm saying it.  I used to sign up for 5k or triathlons so I would do the training to help keep me in shape.  I never liked the actual race, too stressfull.  I've changed a lot this last 6-7 months.  My running has improved greatly, I thoroghly enjoyed a race.  I've met wonderful people that I hope will be friends for life.

I've come so far from when my hips first started deteriorating.  Everyone has diversity in there life, some much more extreme than others.  In fact part of the proceeds of this event went to help physically challenged people.  There were quite a few in wheelchairs competing in the Sprint and Olympic races.  I can only hope I would be as inspirational as they are in the same circumstances.  I am a firm believer in looking at what you can do and not concentrating on what you can't.

It's funny, completing a Half Ironman is a great accomplishment.  But anyone can do it.  You just have to believe in yourself and then put the work in.  Such a huge thanks to my friends who were with me every step of the way.  Without their support, not only would my training not have been as fun, but they made the whole process and race even more wonderful for me.  Plus I am fortunate to have one of my friends as an incredible tri coach.  Without Shelly I don't think I would have done as well as I did and I know I would have been much more stressed over it all.  She gave me great advice, coaching, plans, you name it she helped, and always with a smile. 

On to the next challenge!  Olympic Triathlon (piece of cake, right?) in Key West beginning of December.  Bring it on! 

Going Home After the Surgery - What to expect

I originally thought it would be no big deal coming home and doing things for myself after surgery.  I even told my husband not to get the tall toilet seat with handles, I wasn't going to need it.  Ha!  You have no hip flexibility.  You can't bend at the hips and even if you could they don't want you to for a while.  Try reaching down for something without bending at the hip, you are lucky if you can reach your knee.  If something falls on the floor then it's just going to have to stay there.  Actually there is a reacher/pincher tool that is extremely helpful.  That and the hook/shoehorn to help get socks, shoes and shorts on and off.  You will have to have someone there to help you, I don't know how else you could manage and I'm pretty self sufficient.  I was told I could not drive for a month either.  I am so darn independent it was hard to rely on someone else for everything, but you do what you have to do.

My doctor scheduled a physical therapist to come the week after I got home, I was ready to get going.  They do give you exercises to do in the hospital and to do when you get home, very basic but trust me, nothing is easy at this point.  They also schedule nurses to come change bandages.  When the nurses came they said something about giving me a shot or meds for some reason.  I said they need to make sure they had the right patient because I wasn't supposed to be taking anything.  They had the wrong records.  So make sure they are looking at the right paperwork.  Never be afraid to ask or insist, specially about medications.  Even in the hospital I had orders for pain meds but didn't take them because I really had no pain.  The nurses were very insistent, if it's written they want you to take it.  And yes, if you have pain, you need to take it.  I always ask what are they giving me and why.  I think the nurses only had to come out twice, after that it was easy for my husband to help clean the incisions. 

The incisions looked horrible (at least to me) in the beginning, big and purple.  My hips also swelled up to about four times their normal size, wow!  It was actually funny to try and put on sweatpants or shorts, nothing fit right.  My doctor also had me wear the compression tights for over a month.  Very tough to look fashionable in them.  Was extremely glad to see them go.  The incisions will get better, mine are probably 4-5" long and no one ever notices them and I'm in a bathing suit a lot.

Finally my physical therapist comes for our first appointment.  Yea!  To me that means I'm on the road back to recovery.  She went over all the basic exercises and did some extra ones with me too.  Most were way too easy and then a couple were way advanced for my recovery stage.  So I called my doctor and got a prescription for therapy with a physical therapist I'd worked with before who is one of the best.  I had to get someone to drive me there but it was worth it.

Your doctor you pick is extremely important.  Just as important is your physical therapist.  I can't stress that enough.  That's the other have of the equation to getting good results.  I went 3 days a week for 1-2 hours.  I love my physical therapist, although at the time it was love/hate.  It was not easy.  Some of the things were extremely boring and tedious while other things were extremely challenging.  You also need to listen to your therapist about what you can and cannot do.  They have their reasons.  You may feel like you could do more or harder but depending on your healing stage it might not be appropriate yet.  Tell your physical therapist what you want to do and they'll tell you if you should or not or even a variation that might be better for you.  I'll say it again, LISTEN TO YOUR THERAPIST!!!

I did physical therapy for almost 3 months.  You are up and walking and really mobile after 1 month but I had goals.  I wanted everything back and then some.  I wanted as much hip flexion as my doctor said I could have safely.  At first my progress was steady but after the first 2 or 3 weeks my hip flexion hadn't improved so my therapist had to come up with other ways to get it to move.  After my warm up and most of the workout I would lay on a table and he would strap one leg down.  Then he would do an active stretch with the other leg.  He would get behind my leg and I would push against him and he pushed my leg.  It was hard and so not fun but I was determined.  Every week we made progress and eventually got where my doctor said I could be.

Now my doctor tells me I have no limitations, I can do the splits if I want, just don't cross the legs.  I have noticed my hip flexion improving all the time.  I am very active and that has to help.

Be smart, get good doctors and physical therapists and then listen to what they say.  They know more than you do.

Life after surgery gets better and better

Today I was supposed to compete in a sprint triathlon.  I'm actually training for a half ironman in October and this would have been a training race.  Monday I ate something bad and got salmonella poisoning.  Talk about bad timing!  So I've been curled up in a ball praying to not throw up or praying to throw up, you are very conflicted when your stomach hurts that bad.  So not only no training this week but I had to miss my first race of the year, in my back yard no less, with all my friends.  :(  Oh well, such is life, not the end of the world.  Actually as I type this they should be finishing up, can't wait to hear how everyone did.  Monday I'll be back to training, although I probably won't be quite as strong as the week before but at least I'll get back to it.

Since my hip surgery last year I've gotten stronger and stronger.  My hips now support me and that's huge.  You may not realize how much your hips do for you in almost every movement.  I'm back running, while not super fast, faster than I was even 2 years before my surgery.  My biking is getting better too.  I look at my bike times from races before surgery and after and can see improvements, very satisfying.

At the moment my plan is to do an Olympic tri in Sept (part of my training) and then the half ironman in October.  Then for fun another Olympic tri in Key West the first week of December.  Ironically the Key West tri was my big goal for the year.  I wanted to complete an Olympic tri this year and how can you beat one in Key West?  I have a lot of people signed up to do it with me so how could it not be fun?  Then one of my friends kind of talked me into the half ironman in October.  What the heck, I have time this year to train (it is a commitment of time) and I have some really great people to train with this year as well.  So, I signed up and immediately had anxiety attacks.

What was thinking!?!  I know I can do the swim, 1.2 miles.  I swim with the local master's 3-4 days a week and swim in the ocean at least 1-2 times a week.  To me that's the easiest part, but it's also the shortest part of the race.  The bike is 56 miles and I was worried my neck couldn't handle it.  I have arthritis in my left shoulder and my neck will stiffen up on the bike ride and spasm.  But with some minor changes to my bike I'm confident that I can do 56 miles without a problem.  Much thanks to Matt and Julie from On Your Mark Performance Center in North Palm Beach, Florida.  The run is a whole other matter.

I have NEVER liked running, in fact disliked intensely is probably appropriate to how I feel about running.  I really only started running because I wanted to complete a triathlon years ago.  I've come to enjoy certain aspects of running.  I do love running at sunrise along the beach where I live.  It's beautiful to watch the sunrise and you never know what your are going to see, from baby turtles hatching, amazing shells and sharks in the surf.  When we travel I've found the most amazing trails to run all around the world.  It's much easier to run when traveling than find a place to swim.

But to run for running's sake I have to do mental gymnastics to get me through it and I have to run 13.2 miles after I swim and bike.  Yea, gonna love it!  I can do it, I know I can!  But then I may hang up my running shoes except for shorter races.  I would love it if I could compete in Aquadu's, just the swim and bike.  There are a few out there but not many.

Life is what you make of it, no matter what adversity's you may encounter.  I see people all the time on the news that have far worse problems than mine and have not only a great attitude but help others.  Why would you want to be more of a burden to people you love by having a bad attitude or being unpleasant to be around.  Some things you can't change, deal with it, figure out how to move on around it.  Whatever that may be.  Life can be good, it is good, enjoy it.

Double Hip Replacement Surgery - What to expect.

My surgery was scheduled for Monday on my right hip because it was slightly worse than my left.  Why that was a deciding factor on which hip they did first I have no idea.  Off I go to the hospital at the crack of dawn.  The surgery didn't take long and when I woke up I was not in pain.  Of course you know something major has been done to you but I didn't hurt like I thought I would.  I was afraid to move though, you just aren't sure what's ok to move and what isn't.  The next day they did get me up and moving a few steps.  Very weird, your leg feels like it's not part of you and I was very dizzy.

Wednesday they did surgery on my left hip, again when I woke up still no pain.  That's a huge plus of course, pain can be debilitating and hamper your recovery.  I never had to take any pain meds.  They wanted to give them to me though.  If I had been in any pain I would have taken them but there really wasn't any pain.  I couldn't really move but no pain. 

Since I had both hips done I had to rely on my arms to move me around, legs are now pretty much useless.  This is why they do not do double hips replacements on older people.  I consider myself fairly strong and it was a struggle to move even to the end of the bed.  You take it slowly, inch by inch.  They want you up and moving as soon as possible.

I had a problem, whenever I sat up, let alone stood up, I had a blinding headache and got so dizzy I would pass out.  My head killed me.  I could not even walk two steps because of this.  The headache and dizziness went away when I lay back down but returned the minute I sat up.  Very frustrating.  So I was not able to get up and walk Wednesday or Thursday.  If everything had gone well I could have gone home Friday.

By Thursday I still could not get up and walk and I started physically feeling really bad.  Finally one of the doctors figured out I had a punctured spinal column from the first surgery on Monday.   They did a spinal anesthesia for the surgery like they do when you give birth and it had punctured my spinal column so spinal fluid was leaking.  No fun!

The fix, in very layman terms, is to plug it.  So back I went down to the anasthesiologist and they fixed it.  What a difference, no headache!  Unfortunately my blood level was extremely low so I still got dizzy and gray around the edges when I stood up.  So I got a liter of blood. 

Very important, if your doctor does not suggest it, ask about donating your own blood ahead of time.  I guess it's not uncommon to need blood after this type of surgery.  Some procedures are bloodier than others, words from a doctor.

So finally, I was up and walking (with a walker) and even got out my hospital room door to the corridor.  That was such a huge achievement for me.  I'd been in that hospital room since Monday and it was so nice to see outside the room!  Other than the blood loss and spinal problem, the actual surgery went really well.  No pain!  And I could get up and walk, finally.  I was discharged Sunday, and I was so ready to get out of there, although it's scary to think about going home and managing yourself. 

I had anxiety about moving the wrong way and having the hip come out of the socket.  Everyone loves to tell you horror stories, even the nurses in the hospital while you are laying there trying not to worry about it.  Even getting in the car to go home is scary, what if?  Of course your doctor will give you a list of what you can and can't do.  Plus your hip range of motion is zero, you have no flexibility, you can't even reach your knees.  Amazing how limited you are when you can't bend over.

Next time I'll talk about recovery.  surgery was easy compared to rehab.

1 Year Anniversary of my Double Hip Replacement

Yes, today is the 1 year anniversary of my right hip replacement, then on Thursday (2 days after) they did my left hip.  They didn't want to do them both on the same day.  My doctor said he got better results if they had a couple of days before making me lie on the side they just did surgery on.

Obviously I decided to go ahead with the surgery.  I talked to at least 6 orthopedic doctors, I talked to the rep for the implant parts and I talked to at least 5 people that had done the surgery, 3 with the doctor I decided on and 1 of them with a double hip replacement.  It's very tedious to find peoples contact info and to actually talk with them and time consuming.  Plus, what questions should you ask?

What to ask the doctor:  How many of these do you do?  What technique do you use and how long have you used this technique.  What should you expect for your recovery?  Are there other options he might suggest?  What limitations will you have, if any?

What to ask other people that have had the surgery?  How old were they when they had surgery?  What doctor performed the operation?  What was their recovery like?  Are they happy with the results?  What are their limitations, if any?

No matter what take a couple days or even weeks and let all the information percolate.  Don't rush into any decision, think it thru so you can decide what is the best course of action for you.  It may be to postpone surgery or maybe by the time you need it they have more options available.

One of my doctors talked about a partial hip for my right side but the results for females in particular didn't look very good.  Maybe I would have been one of the lucky ones but I wasn't willing to take the chance.  They are also making progress with different injections for the hip such as hyarulonic acid which was not approved for the hip when I needed it.  There is also some other process that does something with other substances injected that a physical therapist told me about.  All may be things you can try.  Since my hips were so bad I didn't think what was available to me helped.  I did get cortisone shots in each hip.  Which was not any different then the MRI with contrast, it was shots without the MRI.  the shots are uncomfortable but I thought my doctor did an excellent job and it really wasn't that bad.

While I was in the office for my first shot, Dara Torres (the Olympic swimmer) happened to be there in physical therapy.  My doctor operated on her shoulder just after the Olympics.  I really wanted to meet her but after I got my first shot of cortisone in my hip I passed out cold.  Don't know why, sometimes when I get a major shot - out I go.  I'm not afraid of needles, most of the time I'm fine.  Needless to say I didn't get to meet Dara at that point.  I was lucky enough to get to meet her at a later date though.  The next time I got a cortisone shot in my hip I was fine.

The cortisone shots did nothing for my hips.  I thought they might because I've had a cortisone shot in my shoulder, years ago, and I got back full use of my shoulder and it's still good.  Some things you have to try, specially if there is no down side to the procedure.

I've exhausted all options and I've interviewed everyone I could possibly find to ask questions to.  I decided the time had come for surgery.  I also did the research on doing both hips at once.  Since both of mine were really bad, what did I have to lose.  The recovery isn't any longer, you just have to spend a couple of extra days in the hospital.  I find rehab and recovery such a tedious and boring process.  I understand how necessary it is but boy does it take mental discipline to get through it.  It's another reason I decided on doing both hips at the same time.  I didn't want to spend 6 months recovering then go through it all again.

I picked the doctor I wanted to do my surgery and made the appointment.  I thought I was ready and as informed as I could be.  Next I'll walk you through the surgery and hospital stay.  Such fun!


At my 1 year anniversary I swam this morning with the master's and then when I got home at 7 am my husband was waiting for me because the surf was up!  So we went surfing for 3 hours, great waves, lots of fun.  Was going to go for a run with the local running club but too tired from both swimming and surfing.  Tomorrow I'll do stairs with my friends.  We run up and down the stairs at one of the bridges that crosses the intracoastal.  We do it for about 20-30 minutes and it's an intense workout.


Having the surgery when I did was perfect timing for me.  I am so very glad I had it done and could not be doing any better.  I still need to work on my hip flexion range of motion but my doctor said it's up to me, whatever I want to achieve as long as I don't cross my legs I'm good to go.  I am still seeing improvements in my hip flexibility and if I actually dedicated time to it I know I could get my flexibility where I want it.  That will be my next fitness goal.

After athroscopic surgery to fix my hip labral tear

The surgery to fix my labral tear in my hip helped for a little while.  I really thought I'd get back to running and feeling like it did before.  The small amount of arthritis pain was manageable.  But it never really got back to what it was.  I think it just kept deteriorating and quickly.  The pain got worse, on cold days I would sit on the couch with a heating pad wrapped around my hips.  Anyone who has arthritis knows of the deep ache you can get.  I don't know what I would have done without the anti-inflammatory medicine my rhuematologist gave me.  Unfortunately you have to be very careful and have your liver tested every 3 months.  I was only on this medicine for 6-8 months.  The pain is one thing, I could have dealt with the arthritis if it was just the pain.  Osteoarthritis eats away at the joint and my hip would not support me doing every day things.  I could walk but I had a limp.  I was a fitness director and personal trainer, try demonstrating a lunge or squat when your hip will not support you.  It's physics, you can't make it do something if the structure is no longer there.  I did try though.  I think it was extremely quick how fast my hips deteriorated.  My doctors kept saying maybe a hip replacement within the next 10 years. 

My range of motion declined dramatically.  I could not widen my stance more than maybe 15 inches.  Stepping up or over anything was a challenge.  Ok, don't laugh, but getting up from the toilet was impossible without pushing myself up with my hands.  I broke 2 flush levers before I figured out I was putting my full body weight on it to help me stand up.  My hips/legs would not support any weight bearing activities.  Very frustrating.

So I have choices, there are always choices.  Go after every new injection to see if it will postpone hip replacement or have the surgery?  I must have talked with at least 5 orthopedic surgeons.  One said partial only on my right hip.  Well the studies show very low percentage of it working and at worst I would fracture my femur and have to have a total hip replacement within the first 3 months.  If it worked it sounded awesome, very little down time,  a lot less bone taken away and use of the hip joint again.  You have to go home sleep on it and weigh everything out.  It always sounds like that's what you should do when your are in the doctors office and they seem the best person to do it.  Go home and let it all percolate for a few days before you decide.  Talk to other people about the procedure such as physical therapists.  They know with the outcome of most orthopedic surgeries are.

I decided I wanted 10-20 years of pain free, full range of motion activity as opposed to toughing it out for another 5 or 10 years.  Who knows what procedures they will have for hip replacement in 15-20 years.  What if I get hit by a bus in 3 years, I could have had an awesome 3 years with no pain and the ability to do the activities I love.  Then I talked to the doctors about my left hip as well.  It hurt but it didn't give me as many problems as my right hip.  It didn't catch and it was slightly stronger than my right side.  My doctors all said that the arthritis was just as bad in the left hip as the right and I would probably have to have it replaced within the next 6 months anyway.

So that leads to a whole other questions, do both hips at once or 6 months apart?  My doctor said the recovery would not be any longer if I did both hips at the same time.  I, of course, did research and talked to whoever I could find that had it done.  I decided to just do it and get it done with.  I made the appointment for surgery and off I go down the journey of a double hip replacement.  I talked with so many people but I don't think anyone can prepare you for something that big.  Although I did my very best to down play it to everyone.

So many decisions in the osteoarthritis journey, it's tough to know if you've made the best decision for you.  All I can say is do your homework!!!  Ask questions and then ask more and ask everyone.

Decisions, decisions. Labral tear and arthritis, what is the next step?

So I now know for sure I have a labral tear in my hip along with the arthritis.  A labral tear is a tear in the soft cartilage of the joint.  Used to be much more common in shoulders but now it's becoming very common in the hip.  I think it's because they have better tools to diagnose it.  My doctor says I have options.  Live with it and do nothing or arthroscopic surgery to fix it.

I decide to live with it even though I can't run anymore it's not limiting anything else and it's not that painful at the moment.  I first felt the pain in my hip in November of 2007.  After all the tests to figure out what the problem was it was well into December.  As the days went by my hip did get worse.  I started feeling it catch on the torn cartilage and that is not pleasant.  It was my busy season so I did live with it for a few months.  I asked my doctor for his referral to someone who does this surgery.  Again, at the time there were very few doctors that even did the surgery.  Luckily I found a really good doctor in Miami.  I would have gone wherever I needed to for a well qualified doctor.  I had found a couple that had done one or two but that is not enough for me.  This doctor originally trained under a Canadian doctor that pioneered the technique and had done thousands.  Of course I talked to his nurses and physical therapy staff beforehand too.  It's amazing what they will tell you, they are a great source of information. 

My doctor said that I had some bone spurs and lots of arthritis he could clean up while he was in there.  He would repair the tear, clean off the head of the humerus and poke small holes to stimulate blood flow to grow a different type of cartilage.  You can't regrow the original, but this was supposed to be better than nothing.  It was arthroscopic so minimally invasive and an out patient procedure.  I would have to be on crutches for a while.  I decided to go ahead with it.

The surgery itself was no big deal.  Three tiny scars on my upper thigh and in and out the same day.  Rehab was another matter.  Not much pain but I could not put any weight on it at all.  None.  They were very adamant about it.  For five weeks.  Crutches for 5 weeks.  And you get to use the automatic joint movement machine they use for knee replacements.  You get to set it to a certain range of motion for your leg and you get to lay there while it goes up and down in slow motions for 30 minutes to an hour once or twice a day.  After so many days you get to increase your range of motion.  It was incredibly boring so I got a lot of reading and napping done.

If you've ever been on crutches you know how much fun that is.  Everything you do takes three times as long.  Luckily I could drive myself around after the first week.  So I went to physical therapy three times a week, along with the leg machine at home and all the exercises I did at home my physical therapist gave me.  All very tedious and boring because I could not put any weight on my hip.  All my exercises were done laying down, for five weeks.  Ironically I was the Fitness Director at one of the local country clubs.  And I was still training clients.  How does it look to have your trainer come in on crutches?  Or to see your Fitness Director hobbling around on crutches?  You really have to keep your sense of humor.  As with anything you get through it and it could always be worse.

One of the happiest days of my life was when the doctors said I could get rid of the crutches.  Although my physical therapist said not so fast.  I could get rid of one of them.  I had to use one for a week and then wean myself off the one so many hours a day over the second week.  I did what he said, he knows his stuff.  After you go through any surgery do what your physical therapist tells you.  Make sure he's good though.  I have had some that just followed a cookie cutter outline and it didn't really apply to my circumstances.  You want one that takes your specifics into consideration, what kind of shape are you in, pain, range of motion, so many other things.  You want to get the best results possible from your surgery so do what your physical therapist tells you.  It's hard, you may feel like you can do more or your are bored.  Don't do it unless you talk to them first.  I always asked for more and when can I do certain things. 

I had a friend of mine go through the same thing.  She was younger and didn't have arthritis but had the labral tear.  Had the surgery and then didn't listen to her physical therapist and did too much and the wrong things.  She had a lot of pain and was slow in recovering.  You don't want to undo what you just had the surgery for.  I can't say it enough.  Find a good physical therapist and then do what they say.  It's ok to question them, they usually have good reasons.  It's ok to tell them you want more.  Just make sure you listen to what they say.

The surgery did help, my hip did not catch anymore and it did feel better.  Unfortunately is didn't cure it, I still had arthritis.  My doctor did say it wouldn't fix everything but might put off a hip replacement 5-10 years.  Still couldn't run, I mean I could but it didn't feel good so I didn't.  I took up swimming instead.  Life throws you curve balls it's how you deal with it that matters.  I wasn't happy about giving up running.  Even if running wasn't my favorite thing no one likes it when something is dictated to you and it's not your choice.  That's the tough part.  I did shed a tear or two over it but then moved on.  Turns out I love swimming!  It's amazing what good things come out of bad situations if you keep an open mind and try.

How it all started - A pain in the hip

It's funny, after I started having problems with my hip, and even more so later when I had to have a double hip replacement, I can't tell you how many people asked me if it was because I was so active or from running.  You have to stop and really think about that question.  Because if that were the case than almost everyone I know would need a hip replacement at a young age.  I am an active person but I am in no way what I consider as active as athletes are or anyone who runs marathons or competes in major triathlons.  In fact I never even ran until about 6 years ago, and I only started because I signed up for a sprint triathlon.  About 2 months before the race I figured I should start running.  Needless to say I wasn't a very fast runner by race time but I finished my first triathlon at the age of 46.  Then I swore I would never do another one.

I even told my husband that there was no way I would ever say I liked running.  I did kind of keep it up and much to my amazement actually looked forward to certain aspects of running.  I am lucky to live next to the beach in Florida so I would get up and run at sunrise.  I would run along the water where the sand is harder packed but it's a challenge.  You never knew what you would see, baby turtles hatching, sharks in the surf, crabs on the beach and sometimes some amazing shells, just to name a few things.  The sunrises were always beautiful and it was a great way to start the day.  And being Florida I could do this pretty much year round, I love where I live.

One of the other things I grew to love about running was that when I traveled I would scout out places to run.  One time in Lime Rock, Connecticut, next to the race track there, is an offroad trail my husband found.  Lots of elevation changes and beautiful scenery.  My husband is a sports car endurance race car driver and we often ran the race tracks he competed on, always fun.  My husband races all over the world and I found some amazing places to run in France, along the river in parks.  So when I had to give up running I actually missed it.

I am a Personal Trainer and I used to be the Fitness Director as well at a local country club.  I don't usually teach group classes but for Thanksgiving one year I did a boot camp that morning.  My hips had always ached after running but I took Advil and it wasn't that bad.  After I did the high energy boot camp my right hip really hurt and didn't get better.  In fact got worse with time and I had to stop running.  So off to the orthopedic doctor I go.

Right off the bat he tells me I may have osteoporosis, a fracture, or a labral tear.  I, of course, tell him that none of those options are probable, he's crazy.  He kept asking if I'd been in an accident or had some incident that might cause the fracture or labral tear.  I had not even fallen so it just couldn't be those two issues.  I had a bone scan and my bones where great.  X-rays didn't show anything, some arthritis but nothing major.  I go for an MRI and it doesn't show anything.  All of this takes time, it's not like you schedule all the tests in one day.  You do one of the tests then schedule back with the doctor, schedule the next test, schedule back with the doctor.  All along he kept asking if I felt something catching or could hear any clicking.  At the time I didn't so I was very skeptical about what he was suggesting.  If he hadn't come highly recommended by multiple people I would have gone elsewhere. 

I had made friends with a physical therapist, Rett, that had worked on my husband years ago.  Rett is one of the best I believe in the country.  So I introduced myself so I could ask him questions about clients and also refer clients to him.  I won't refer people to anyone I don't know or who I don't think is one of the best in their field.  Rett had recommended this doctor highly so I stuck it out.  Looking back I laugh because I really though he was so far off the mark but from day one he had it pegged exactly what it was.
Finally he sent me for an MRI with contrast.  So fun, they stick a ginormous needle in your hip joint and inject dye.  It wasn't the worst thing in the world but not fun.  Then they do the MRI.  Well son of a gun!  It showed clear as day a labral tear in my hip joint.  At the time this was relatively rare unless you had been in a car accident or older.  Labral tears in the shoulder were very common, specially with baseball players and other athletes.  My doctor says my options are arthroscopic surgery or live with it.  I decided to live with it, which lasted all of 3 months.  I started limping and it started catching.

A labral tear is in the soft cartilage of your joint, doesn't matter if it's the shoulder or hip it's the same thing.  The cartilage tears and you have a piece of bone sticking up which will then catch as the joint is used.  Obviously not good in the hip as you use your hips to walk, sit and just about everything you do in life.  Long story short, I had osteoarthritis in my hip which produced bone spurs and when I moved a certain way with force it tore my cartilage.  Of course I tried to ignore it, isn't that always the first recourse to problems?  As I said, that didn't last long as it just kept getting worse.

In my next post I'll talk about the next part of the journey.  It's all a process and I've learned you better be proactive about it if you want the best results.  No hiding under a rock!  No matter how much you would like to :)  It's your life, make it the best it can be.

Hip Replacement - What you need to know before and after

Arthritis, what a pain, literally.  Lucky me I inherited osteoarthritis.  I knew I had it in my left shoulder which I discovered in my mid-40's.  So far a cortisone shot has helped with that.  Then at the age of 49 I had a pain in my hip that caused me to start limping and stopped me from running.  I went to an orthopedic doctor who immediately said it was probably a torn labrum (lining inside your joint) or osteoporosis.  I pretty much told him he was crazy I was too young and had never been in an accident which, at the time, was usually the way you tore a hip labrum.  Shoulder labral tears are much more common.  So after a drawn out process of denial and MRI's it was confirmed that I had a labral tear and arthritis in both hips.  Well you have options, do nothing and live with it or hip resurfacing.  The do nothing option stinks because you can't walk right, it hurts all the time, you baby the injured side and compensate which in the long run will lead to back problems and other issues.  Basically a labral tear is a tear in your cartilage and it catches on the hip femur bone.  Not fun and painful.  So, two years later I decided to get the hip resurfacing.  Again, at the time, there were not many doctors that did it.  It's done othroscopically as an inpatient procedure, not a big deal but you have to be on crutches for 5 weeks!  No pressure on that leg for at least 5 weeks!  Now that was inconvenient.  What hey basically do is scrape off the bad cartilage of the femur and poke holes in it to stimulate blood flow to grow back what it can, it's not the same as the original catilage but better than nothing.  The doctor did tell me that this would not fix the problem but would put off hip replacement for a while and I should be able to walk better and should take care of the cartilage tear that was catching.

Now let me back up a bit.  When I found out I had a labral tear of the hip I tried to find out everything I could about it.  I asked physical therapists, friends, doctors, you name it I did it.  I searched the internet, whatever I could do to get information.  You are in charge of your health, don't let someone else make the decisions, get informed before making your own decision.  I've found that nurses, aides and physical therapists and athletes are a valuable and reliable source of information and referrals.  I then got referrals of doctors that did the procedure, there were not that many.  It's a hard thing to diagnose in the hip.  Luckily with technology it's easier now.  I found a doctor in Miami that was an expert on it.  Made an appointment and went down and interviewed him about the procedure.  Then did more research on the procedure.  What to expect for the operation, recovery and after.  Do your homework!!!  I know it's tedious and time consuming but this is your life and body, no one else is going to care as much as you do and you have to live with it.  I can't stress that enough.  Don't be afraid to ask people questions and ask a lot of people too.  So fully prepared I had the operation.

The operation itself was really a non-event.  Woke up fairly alert and not a lot of pain.  My husband drove me home (2 hours north) and by the time I got home I needed some pain killers, still not awful.  The hardest part is you can not put any weight on that hip for at least 5 weeks :(  that's rough but doable.  You figure it out.  Rehab is tedious, you are put on a leg movement machine like knee replacement patients get and you have to do that every day for what seems like forever.  After a couple weeks you can go to physical therapy but it's all very basic exercises, isometric for the leg that's operated on because you can't put any weight on it.  Finally after 5 weeks my doctor said I could walk on it and could get rid of the crutches.  Yea!!!  But, my physical therapist said not so fast.  He said I could get rid of one of my crutches and over the week work my way up to getting rid of it completely.

Here is the second most important thing you need to do besides your homework.  Find the absolute best physical therapist you can.  They will make all the difference from a bad or basic recovery to a phenomenal recovery.  And then listen to them and do what they say!  I know sometimes I told my physical therapist to hurry it up or I could do more or you have to be kidding, surely there is more I can do.  But he had his reasons and they were all sound and I was very glad I listened.  Don't mess up what you had fixed, do what your physical therapist says!  I know people who haven't and they end up worse than before their surgery, longer rehab, or they never get full range of motion back.  So why would you not listen to them.  I asked people to recommend a good physical therapist and then talked with the people that had used him. 

I'm lucky, the owner of our local running store/triathlon is an amazing athlete and knows lots of people that have orthopedic issues and therefore uses lots of doctors and physical therapists.  She always has excellent recommendations and has been very helpful to me.  I also ask around the local gyms.  Once I find some good referrals I make an appointment with them and interview them.  What's their education and background.  How familiar are they with my problem.  I've never had anyone get upset with me about it.  Years later they do tease me about it but usually anyone that is good appreciates the questions.  If they have a problem with you asking you don't want them.

So, had the hip resurfacing on my right hip.  Both hips had lots of arthritis but for whatever reason my right hip always hurt more and it was the one with the labral tear.  It did get better after the surgery but never back to what I thought it would.  Couldn't run so I started swimming and biking more.  LOVE the swimming, wow does it burn the calories.  Plus I like the water so it was a no brainer for me.  I'm a personal trainer (so imagine hobbling around on crutches for 5 weeks while training clients, such fun) and I continued with training clients and teaching spin classes.  I also did a couple triathlons, although I had someone else do the running, I did the swim and he bike.  Still fun and it gave me goals to help keep me in shape. 

I did everything I could to strengthen my hips and legs.  I still had arthritis and boy can it ache in the cold weather.  Good thing I live in Florida.  Everyone tells you to put off hip replacement for as long as you can, specially since I'm young.  And yes I consider myself young :)  Just the thought of having a hip replaced was huge to me.  To replace an entire joint in your body, how bizarre.  I didn't want to get rid of my body parts, it feels final and like the beginning of the end.  I found it strange to even think about.  I am an active person and hate limitations.  But, I do understand that if life throws something at you which changes what you can and can't do, figure it out.  Everyone thought for sure I'd get depressed or fat because I couldn't be as active.  I have to say I shed a few tears over not being able to run on the beach in the mornings or when I travel.  Who likes to be told they can't do something.  But you get over it if you are smart.  What are your options, keep crying about it and get depressed and fat or do something else.  I wish I had taken up swimming years ago.  I like it better than running.

Enough for now, I'll continue in my next entry.  So far, if nothing else remember these three things:
1) Do your homework on what your problem is
2) Get lots of referrals for the doctor
3) Get lots of referrals for a good physical therapist

Ask lots of questions and then ask them is there anything I forgot to ask?

You can do it!  Whatever it is you can get through it.

How active do you need to be?

How active is active enough?  Her's the good news, you can do a lot in 20-30 minutes, 2 or 3 times per week.  I would say that's the minimum you need for your cardio.  It should not be a walk in the park, lolly-gagging along smelling the flowers.  You need to move and work your heart.  As always, you need to see a doctor before starting any exercise program.  If you are taking any medications that regulate your blood pressure or heart rate then you need to ask your doctor what a good working heart rate is for you.

There is a formula that gives you a general idea what your working heart rate range is but I like to go by perceived exertion.  Please feel free to use a heart rate monitor along with perceived exertion.  There is actually a scale for trainers to use.  Here's my version of it:

Level 1:   No effort, lounging on the couch or resting.

Level 2:   Very comfortable - can maintain all day.

Level 3:   Still comfortable, breathing a little harder, can carry on a conversation easily, 

                can go for hours.

Level 4:   Sweating a little, feel good, can talk easily but breathing harder.

Level 5:   Just above comfortable, sweating, can still talk but have to breathe after each sentence.

Level 6:   Slightly breathless, can still talk but have to breathe every 5-6 words.

Level 7:   Just below max effort, sweating heavily, breathing hard, have to breathe 

                after 3-4 words

Level 8:   Very strong +1, have to breather after every other word, can maintain 5-15 minutes.

Level 9:   Hard - have to breathe every 1-2 words, can maintain 2-5 minutes.

Level 10:  Extreme Max - can't talk, can maintain for only 30 seconds to 1 minute.

Pay attention to how hard you are breathing and how you feel.  You can feel good and be breathing hard.  Make sure you warm up for 5 minutes.  Everyone is different, some people may have a much higher working heart rate than others.  I can go hard for 1 hour at a heart rate of 170-176.  My husband would explode at that heart rate, his working heart rate is in the 150's.  That's why the perceived exertion works for most people. 

Ok, with all that said - Don't Be A Baby!!!  What I mean by that is, unless told otherwise by your doctor, it is ok to breathe hard and even get out of breath.  You don't have to work so hard you are totally out of breath but you do need to work your heart.  You should be working in the 4-7 range most of the time.  Depending on your goals you don't necessarily have to get up to the 8-10 range.  When I teach spin class I tell everyone what they should be feeling as far as breathing goes.  After a hard climb or high intensity I tell them they should be breathing harder and can't say a full sentence without having to take a breath.  There is always a few that immediately start talking as though they were at lunch.  If they can talk that easily they are not working hard enough.  Again it depends on your goals but don't be afraid to breathe harder.  You will surprise yourself what you can do if you put your mind to it, it's usually more than you initially thought you could.  Sometimes I think I've given it my all and I've got no more to give.  I tell myself not to stop and see where it takes me.  It will take you to the next level and it's very empowering to realize that you could do more than you thought.

Don't get discouraged if you initially tired after starting your cardio program.  It's normal and will not last forever.  After 2-3 weeks you will feel energized and your initial workout will be so much easier for you.  You'll feel like you could go longer and harder and still feel strong.

Here is the best part, besides the weight loss that will come with it, the powerful, strong, energized feeling will flow over to other aspects of your life.  You will figure out that you are in control of many things you didn't think you could control.  I have one client that is 75 and have worked with her for over 5 years, twice a week for 30 minutes each session.  After 3 or 4 weeks she could not believe how strong she felt and how much more energy she had.  She told me that it changed her outlook and positively influenced all other aspects of it.  You realize not only how good you feel but that you can accomplish anything you put your mind to.

Many people don't realize how bad they feel on a day to day basis.  Sleep, stress, food all affect our energy levels.  Most people don't realize how good they can feel every day.  I can tell big time if I don't get enough sleep or I make bad food choices.  Specially eating bad choices.  I feel tired, sluggish and I don't have the energy, speed, endurance I usually do.  I know if I eat ice cream on Thursday, my workout on Friday is going to suffer some.  Depends on how much and how often.  Since I can tell the difference and don't like to feel sluggish on a regular basis it's one of the things hat motivates me to make better choices.  I still eat junk food some times but I keep it smaller quantities and not as often.  Trust me, if I want to eat something I do, i just realize what the consequences are.

I think I'm making it sound easier than it is.  It's all a process and it evolves as you do.  Once step at a time.  Rome wasn't built in a day.  Perfect topic for my next post.  How to make changes you can live with and not overwhelm yourself.  It can be done.

Enjoy your life, it's the only one you have.

Finally! The secret to weight loss!!!

It's been right under our nose the entire time.  I wish it were a pill or something you could take to make it easier for everyone to lose weight.  What is the secret to weight loss?  It's simple math/physics:  How much you eat (yes, calories no matter what kind) - How much you burn off (activity) = How big you are.  Of course some people have metabolic issues which changes this equation but that's not true for most people.  I know you've heard that what type of calorie makes a different and you should cut out fats blah blah blah.  Well there is some truth to it but a calorie is a calorie is a calorie and it takes the same amount of energy to burn one calorie no matter what type of food you got it from.  Now, you will feel fuller with certain types of food than others, some foods are more nutritious, and if you choose your food wisely you can eat a lot throughout the day and not exceed your calorie goal.

Weight Watchers does a very good job of teaching you portion size along with their points system you can really eat what you want.  It helps you to realize that some foods come with a trade off.  You spend all your points on one serving of ice cream (or whatever is your weakness) then you have little if any points left throughout the day for other food.  You get hungry and you probably get a sugar crash from the ice cream as well.

Now anyone who knows me knows I am not one to deprive myself of what I want to eat.  I believe you should eat the foods you want, you just have to figure out how to do it in moderation and realize that if you do splurge it's going to cost you.  I do eat fairly healthy, I like the way I feel when I do and I have the energy to exercise or do the activities I enjoy throughout the week.  I do eat ice cream, desserts and other not so great things every now and then.  I enjoy them when I do, don't beat yourself up over it.  My husband loves to read me the calories and nutrition info on some things when I do eat badly.  I tell him to stop reading because I'm  going to eat it and I'm going to enjoy it.  I'm healthy, not overweight and have no cholesterol or blood pressure issues.  I do try not to over do, if you can manage it, everything is find in moderation.

I know I can't have sweets, ice cream and other similar foods in the house.  It calls to me and I will snack on it without even thinking.  By not having it in the house I don't feel like I'm denying myself because most of the time I'm not craving it but if I see it I'll munch on it.  It's there, it's easy and usually no preparation is needed.  You have to figure out what works for you.  I have friends that can keep all the junk food in the world in their house and they never touch it.  Everyone is different.

I will tell you the minute someone or some diet tells me I can't have something, I want it.  I know, I sound like a kid, but it's true.  I find if I deny myself something then it builds until I eventually just gorge on it.  So if I want something I'll have a small amount of it and not every day.

The other main thing for me is to eat all day long.  If I don't snack I get hungry and if I get hungry I eat everything in site in large quantities.  So I eat a fairly big breakfast and then three hours later I have a snack, 2-3 hours later lunch, about 3 hours later another snack and then dinner.  Breakfast is probably my biggest meal.  I love breakfast.  Occasionally dinner will be big too, depends if we go out or what we are doing.

I eat out a lot too, you just have to make smart choices and I often take home half my meal.  Don't be afraid to ask for spray instead of butter, dry toast, whatever you want to make it healthier.  A little goes a long way in cutting calories in restaurant food.

Ok, how active are you?  I'll address this in my next entry.  It all goes together. 

Enjoy your life!

Don't Give It Away!

As we get older there are two things that are a given (besides death and taxes).  We lose muscle and balance, UNLESS you do something to prevent it.  That's the good news.  You don't have to lose your muscle or your balance.  It's simple, incorporate some type of weight training which should include balance training as well into your weekly routine.  A little goes a long way.  You can balance on 1 leg while alternating bicep curls with dumbbells.  Balancing on 1 leg is a heck of a leg workout while you are doing another upper body exercise.  If you are not comfortable balancing on 1 leg you can progress.  Most stable is a parallel stance shoulder width apart.  Then staggered stance but wide, about shoulder width.  Then a narrower staggered stance until you feel comfortable balance on 1 leg.  Here's a few tips to help you balance.  Slight break in the knees, neck relaxed, shoulders back and down, abs engaged and pelvis tilted up or slightly back.  This is a position of power, you would be hard to push over in this position.  Get your balance on 1 leg before your start the upper body exercise.  Pick a spot to look at that is fixed and block everything else out, this will help you balance as well.  As you improve you won't need to focus on a fixed spot, it does help a lot in the beginning.  One of my motivations to be active as far back in my 20's, was because I wanted to keep whatever mobility and independence I could for as long as I could.  Life throws curve balls at you all the time.  Who do you know that doesn't have some time of orthopedic or metabolic issue.  I am a firm believer in dealing with whatever issues life gives you and making the best of it.  Another great tip is to make your workouts fun.  That will be my next post, there are a lot of ways to make your workout something you look forward to or to get you to at least show up.

Fitness-You don't have to kill yourself to be fit & healthy

Hello and welcome to my blog!  I've always been fairly active.  I didn't play competitive sports but I roller skated, roller bladed, played tennis and racquetball, took aerobic classes and whatever other activities looked like it might be fun.  I tried running when I was younger and quickly found I did not like it one bit.  Ironically I started running in my late 40's because I wanted to participate in a sprint triathlon.  I actually got to like parts of the running, such as running on the beach at sunrise (I live in Florida, which helps) and when I get to travel it was always fun to find places to run wherever I was.  I found a wonderful off-road path in France.  Plus it's pretty easy to strap on running shoes and head out the door.  No equipment needed.  It took me many years to figure out that you don't have to kill yourself and exercise for hours a day 7 days a week to be fit and healthy.  What a revelation!  But it was hard to change my mindset.  Things have changed physically for me as I've gotten older.  I need more recovery time and I'm not willing to spend the time or the effort I used to, I would be exhausted all the time.  I am no less fit than I used to be.  Many people feel if they are going to do something they may as well give it their all.  I've also seen the other side of the coin, people just going thru the motions, but I still give them credit, something is better than nothing.  It really comes down to what your goals are.  Do you want to be the next Arnold Schwarzenegger, competitively compete in a sport or just be healthy?  Some of my hardest workouts are 20-40 minutes long.  Your body adapts quickly.  So if you do the same thing all the time the same way your body adapts and your don't get as much benefit or bang for the buck.  It's not too tough to change it up, if you do the treadmill then change to the elliptical or rowing machine or do 10 minutes on each.  The key is to just do it different.  You can change it every time, weekly or monthly, whatever works for you.  The other thing you need to do is change up how you do your cardio.  Do you go at the same pace for the same period of time?  Here are the 3 things you should integrate into your cardio workouts.  1) Steady State - 2) Tempo - 3) Interval.  1) Steady State:  Probably what most people do, keep the same pace for the entire workout, usually not a full out effort.  On a scale of 1-10 of perceived exertion you should be at about a 6-7, you can talk but you are still breathing heavy and you can go for an hour or more.  2) Tempo:  You have set intervals of higher intensity and then a recovery period.  Such as 5 minutes at a Perceived Exertion of 7-8, you can't talk without taking a breath every 4 or 5 words and you could probably go 10-20 minutes at this level.  You follow the 5 minutes with a period of recovery.  You can do this at a 1-1 ratio, 5 min at a higher level and 5 minutes at say a level 6 Perceived Exertion.  3) Interval:  This is High Interval Training (HIT)  This is hard and should kick your behind.  You do short intervals at a Perceived Exertion level of 9-10, that's all out huffing and puffing, can't talk.  The interval can be 15 seconds to 1 minute.  Recovery depends on your fitness level, you need to get your breath back to where you feel you are back to a Perceived Exertion level of 6 or 7.  You can get a heart rate monitor and figure out what your training heart rate is at these Perceived Exertion levels and when you do your recovery as soon as you hit your recovery heart rate you immediately go back to the higher intensity effort.  I find the HIT training is a love/hate thing for me.  It's hard!  When I first started doing it I was so tired too, but that only lasted a few days then you see yourself getting better and stronger.  I've barely scratched the surface but to get the biggest bang for your buck in your workouts change it up.  Mostly I talked about changing things in your cardio but you need to change it up in your weight workouts as well.  Try doing your weight training exercises in a different order or just try a different exercise for that body part each week, month or session.  Most of all tell yourself it's ok not to spend hours working out.  A little bit can go a long way.