Shoulder Surgery

This time my left shoulder got a repair job. My right shoulder was repaired in 2008.

 October 20th

Carrie dropping me off. She can't come in because of COVID protocol.

I'm getting used to structural repairs.

(repair list here)

October 23rd

Bandage removal, nasty!

Nice to be married to a retired nurse.

Not so bad. Only five holes.

November 24th

Arthroscopic holes healed up

"Popeye" muscle after surgery on left arm.

A cosmetic deformity that can occur after a Tenodesis. The bicep tends to bunch up because the damaged section of the long head bicep tendon is cut and the shorten tendon is relocated from the Glenoid and reattaches lower down to the Humerus. 

Normal muscle right arm.

The details;

1. Rotator cuff repair

2. Bicep tenodesis (reallocation of bicep tendon)

3. Munford procedure

4. Debridement labrum

5. Decompression paralabral cyst

Where and who;

1. Southern California Orthopedic Institute (SCOI)

2. Dr. Mark Getelman

At home care provided by nurse Carrie, my beautiful wife.

Cane

I keep a carbon fiber cane in my pannier. 

Watching the Tokyo Paralympics gave me a WTF reality check. So I need a cane to stabilize my wonky legs. So what? Is that all I have to complain about? Up until now I was embarrassed to pull the cane out of my pannier and have to use it. I don't give a shit anymore. I'm just being my best and enjoying life.  

So what gives?

I have nerve damage to my lower legs and feet caused by either years of back problems and back surgeries but more likely from bi-lateral hip replacements. The timeline suggests the butcher job the surgeon did on my hips not only caused nerve damage but also left me with a scared and chronically inflamed Piriformis muscles and sciatic nerve entanglement in the scar tissue. Also Heterotopic Ossification in my right hip (more here) and an uneven pelvis. 

Slowly over the years, after my hip replacements, my calves muscles (particularly the Gastrocnemius) have weaken to the point where I can't stand on my toes, My right leg is worse. The medial head of the  Gastrocnemius has totally atrophied. Try getting around with weak calve muscles. I feel like a drunken cow if I'm not using a cane. I would not pass a sobriety test walking a straight line. So I use a cane to stabilize my walking because my calves aren't helping much. 

When riding my trike clipping into my pedals helps to stabilize my calves but then I have to deal with lower leg numbness which starts in my feet. When I ride the more I climb and the longer I ride pressure builds on the small compromised Piriformis muscles that are adjacent to the sciatic nerve. And the lower leg numbness sets in and I have to take a short break and stretch. 

And I have some other minor nerve damage issues to my legs that are not worth complaining about. 

And to top it all off the weakness in my legs makes me prone to uncomfortable muscle tightening and occasional full blown cramps. A couple of small muscles in my right leg, the Gracilis (inner thigh) and the Tibialis (shin), are forced in some way to compensate for my wonky calves and they'll cramp if I get off the trike to fast or make sudden cycling movements after I've been riding for awhile. I just have to be aware of this and be careful. I can go for months without a cramp and then I eventually do something stupid like hurry off the trike after a long ride. 

I've kept my upper body strong so maybe time to add a handcycle to my cycling routine.

I'm done...time to look forward.

 

Piriformis Syndrome

WARNING ... Boring medical stuff about Piriformis Syndrome.

I always suspected I had Piriformis Syndrome but held off confirming it until I was on Medicare. I'm now on Medicare and I'm no longer paying $1,200 a month for shitty health insurance with a $7,000 deductible that forced me to think twice about seeing doctors. 

Before dealing with the Piriformis I got my back repaired as to not confuse the symptoms of the Piriformis issue with the back issue The back surgery was done a back in February.

An ultrasound confirmed that my Piriformis is inflamed and there is also a layer of scar tissue on the Piriformis from my hip replacements in 2013. The stiff scar tissue is most likely binding up my Piriformis and not allowing it to smoothly move thus the inflammation. Along with always having some degree of discomfort and sometimes pain (if I twist my leg wrong) it also causes occasional foot numbness as the ultrasound showed the Sciatic nerve to be "entangled" in the mess that is my scarred Piriformis. 

When I ride my scared Piriformis requires that I stretch every 10 to 15 miles during a ride as the Piriformis tightens up with use. I usually feel no pain from the Piriformis while riding but I do feel the onset of numb feet (my form of recumbent foot). The function of the Piriformis is the lateral rotation of the hip joint and other stability functions. Being clipped into pedals helps to stabilize the hip joint while riding. However once off the trike I generally feel some discomfort. Pain on occasion.

I'm moving forward with having the situation reviewed by a doctor to two. The expected game plan is for targeted physical therapy to soften the scar tissue and ease the fascia between muscles to get the area moving smoothly again to hopefully ease the problems associated with the Piriformis. The worse case option would be surgery, if even possible. 

Such a little muscle but it can cause so much pain.

Staying Healthy Takes Work

When I recently went in for my Carpal Tunnel surgery the pre-op nurse asked me a bunch of the usual questions. When she asked if I have had any previous surgeries I started laughing. It hit me at that moment that I have had a bunch of surgeries. And they just keep adding up. Yay for medicare and medicare supplement as of last year. No more $10,000 deductible and co-pays. No more waiting to get my body repaired due to cost or timing a surgery around the start of a new annual deductible. 

I've lived a physical life and leverage and gravity conspire to break down my 6'1" frame. However I am very fortunate that nothing has been life threatening  (except for a little heart attack in 2011). I think of those unfortunate souls who are dealing with serious life threatening and quality of life issue conditions and it helps me put my issues in perspective. I realize that at 66 shit is going to happen and I'm thankful it's shit that I can manage. I may be paying the price for lifting too many stones in my younger days and poor genetics but I wouldn't change anything. Well maybe a better diet in my younger years could have helped me avoid a heart attach. But the plumbing seems to be in good order now.

I hate going to doctor offices but I've learned to accept at 66 years old it's a reality of my life. It plays havoc with my "white coat" hypertension. I keep a record of my "at home" blood pressure readings so I don't have to listen to the high pressure lecture when I visit a doctors office. 

Don't need a fancy gym.

Staying active and maintaining my quality of life doesn't come easy for me. Exercise is a daily routine. I'm not genetically blessed, more like cursed. I work hard at keeping myself moving so I can enjoy life and family. Cycling 200 to 350 miles a month, regular exercise with weights, and a lot of stretching. Old muscles tighten up fast. Also a healthy vegetarian diet (really more like a sushitarian diet, I enjoy Sushi but no other fish). The most I ever weighed was 227 some 30 years ago.  In the last 15 or so years I've kept my weight between 185 and 190.

A life well lived is better than a life long lived.

I have 15 reasons to stay healthy...

9 grandkids,

5 grown kids, 

and waking up next to my beautiful wife every morning.

_________________________________________

Haha...this is what it has come down to, a list of surgeries so I don't have to stress my brain when filling out a new patient form. I'll be adding my left Wrist Carpal Tunnel release to the list in a couple of months. 

Surgeries - Mark Rackow

Knee right arthroscopic 

Knee right arthroscopic...again

2008 Shoulder right rotator cuff repair

2009 Back L4, L5 - Foraminotomy

2009 Back T5, T6 - Foraminotomy

2011 Heart 2 stents LAD

2012 Hip left arthroscopic

2012 Hip right arthroscopic 

2013 Hip left replaced

2013 Hip right replaced

2020 Back  L1 to L5 and S1 - Foraminotomy, partial  

         laminectomy, Discectomy, Coflex clip L4,L5

2020 Wrist right - carpal tunnel release

2020 Wrist left - Carpal tunnel release

Titanium Hips Post Op

I went to the doctor today for a post op visit. Everything is good. It's been six months since my right hip replacement and three since the left one was replaced. Now I need to spend the next few months working out the stiffness (and soreness especially after a ride) caused by scar tissue. I'm told that scar tissue is a good thing. Muscle and tendon are soft and stretch while scar tissue is tough and holds things in place well.

The soreness (nothing that a little Ibuprofen can't help)  after a ride is diminishing. As long as I avoid steep climbs on my 700 (not geared for steep climbs) I can end a ride with minimal soreness. Soon I'll start taking the Expedition out more with it's 16 gear inch low end and ride some of the hills around home

 Photos from today's visit to the doctors office. 

Doing Laps

My left hip was replaced exactly four weeks from today. Time for my first ride on the road...well I should say on the pavement. I took advantage of the holiday to take some laps in the school parking lot. I went around and around for 3.2 miles. I've lost a lot of strength in my legs. On the positive side, both hips are now replaced and I only get stronger from here. I've been told to expect eight to twelve months for total recovery. This new year will be dedicated to settling in the new hips and building up my strength. Oh the sweet pain of recovery. Ride on!!

MLK Day and the school parking lot is all mine.

Feels good to be moving on my 700.

Carrie waits for me to do a few more laps around the lot and then give me a ride back home. It's to soon to attempt the grind up our hill.

Almost Ready for the Road

I plan on getting out of the garage and back onto the road by the end of next week. It's been 19 days since my left hip replacement surgery and nearly four months since having my right hip replaced. I don't have any more hips to replace so it only gets better from here.

Riding the 700 in the garage is sooo much fun. The 700 is hooked up to a CycloOps and sits on top of a few bricks (high tech stuff). Raising the 700 off the ground makes it easier to get into the seat.

This is as far as I can rotate the crank...today. Everyday a little more. Moving the crank back and forth along with a few choice words not worthy of repeating here makes for a good stretch of the new hip. And yes...it hurts so good.

Titanium Hips

Both hips are now titanium!! As my daughter Leili says...hip...hip...hooray!
It only gets better from here.




Day 2. Relaxing in the hospital bed reading Adventure Cycling Magazine. Thinking of future cycling plans.

Get It Done

The hardest part of recovering from the replacement of my right hip is waiting for my other hip to be replaced. I just want to get it done so I can put the whole double hip replacement process behind me and kick recovery into high gear. Right now I'm in purgatory trying my best to stay active and get strong knowing that on December 23rd I get to go through the whole hip replacement process again on the left hip. But then it will be DONE and then I can put all my effort into getting strong. This in between surgeries is taking it's mental toll.

Game plan....hang tight until December 23rd, let Dr Yun have is way with me and from there on all the pain of recovery will be headed in a positive direction.  "Good pain". When the last hip is replaced the ice packs and the stiffness and pain after each ride will be acceptable. I'm giving myself six months from December 23rd to feel strong and to once again stroke my (soon to be) sixty year old ego passing the properly contoured Lance wannabes on my Catrike 700. I can feel their youthful energy now as I pass them on my tricycle and they tuck down a little lower and shift gears. It's petty but I still get a kick out of it. I also look forward to towing my ole girl Betzi around town on my Expedition.

Oh the triken life is right around the corner. I must master the art of patience and good things will unfold.

I'm done venting, time to stop complaining and ride on!

Easy Rides For Now

Yep...I'm riding but not pushing hard. Just taking easy rides on the flats. It's been two months since my right hip replacement. I'm still working on getting strong and working past the aches and pains that linger. It's hard to get motivated to push hard since I'll be having my left hip replaced on December 23rd. It's three days after my 60th birthday and right before Christmas. Happy birthday, Marry Christmas, Happy Holidays and whatever else. 

After December 23rd the hips will be done and then it'll be time to kick recovery into gear. For now I'm just enjoying the ride and trying to keep myself in reasonable shape.

Ahhh... the 700. It's light, fast and easy on the hips.

Road ID eCrumb

My second ride since my right hip replacement. RoadID's eCrumb provides proof of my whooping 3.9 mile ride. I've been doing a lot of spinning in the garage, it's good to feel the wind in my face.

The RoadID eCrumb is a nice, simple and free tracking app.

Back on the Road

First ride on the road since my hip replacement three weeks ago. Only 4.5 miles but it's a start.

Patience

It's been 18 days since hip replacement and how I miss being on the road. There's nothing more I want to do right then climb some hills and feel the wind on my face on a fast decent. I plan on taking a short level ride next week but for now I'll continue to stare at the back of my car as I spin in the garage. Patience ole man.

The view from my 700.

Focusing on the Future

Focus on the future and let the present take it's course.

Before taking the final steps to having my old hips replaced with shiny new titanium ones I adopted a mindset that I would not dwell on what I was missing over the next three months while undergoing two hip replacement surgeries and the ensuing recovery period. Instead I would look to the future and the promise of adventures to come. Adventures and rides I was reluctant to commit to because of lousy hips that previous surgeries never quite resolved.

Now as I sit here dealing with the pain of recovery and boredom of inactivity I remind myself of my commitment to the process of healing and immediately start pondering rides for next year on bionic hips.

I'm walking at least a quarter mile every day. In a few days I should be able to hop on my Catrike 700 with the CycleOps hooked up and start some real pedaling. As soon as the right hip is working well then I get started all over again with the replacement of the left hip. Oh well...just get it done.

For now I have a new Adventure Cycling Magazine to read.

First rainy day of the season. Resting my hip by the fire while checking the latest Adventure Cycling Magazine.

Stationary 700

Working it! Six days since right hip replacement and I'm taking my first ride on the 700...well kinda like a first ride thanks to the CycleOps on my rear wheel. I wasn't able to make a complete revolution of the crank so I just pedaled back and forth using my good leg to force a good stretch on the bump leg. 

Given my limited hip flexibility I had to use high tech methods to raise the ole 700 so I could get my sorry butt in and out of the saddle without help. Although I did have Carrie help me get my foot up to the pedal.

One Hip Down - One To Go

Right Hip Replacement (anterior method) 9/30/13 Doctor Andrew Yun, Saint Johns Hospital.

Recovering fast from hip replacement. No muscles or tenons are severed with the anterior method. No hip dislocation concerns after surgery  As soon as I'm ready to start riding again I'll have the other replaced...oh fun!! I had surgery on Monday and left the hospital Wednesday morning. As promised by Dr. Yun I left the hospital on a cane (actually it was a trekking pole that I use for hiking). 

Currently  20% of those doctors performing hip replacement use the anterior method. It involves a sizable equipment investment by the hospital and there is a learning curve for doctors. Dr. Yun has long ago passed the learning curve and is now performing the second largest number of hip replacements in the country. Patients fly in from around the country to have Dr. Yun install new hips. 

Goofing after surgery.

While my son Byron is in high school Leili and Carrie entertain me. My dancing girl Leili is home schooled so she was able to hang with me. 

Hamish a volunteer Border Collie came to visit. Dog lovers will understand how Hamish's visit made my day. Now I miss ma doggie Betzi.

Leili's artistic take on the pain symbols.

Day after surgery. Later the same day I started using my trekking pole and spent some time walking without the  "granny" walker or a trekking pole.

New Hip On It's Way

During my adult life I've put a lot of wear and tear on my body and being 6'1" doesn't help either, leverage and gravity take a toll on us tall folks. Time for a hip replacement.  Can't delay any longer, first the right hip followed a weeks later by the left. The right hip gets sliced and diced September 30th.

I had arthroscopic surgery to my left hip back in April of 2011 and my right hip in September of 2011. I was told that there was no guaranty that arthroscopic surgery would do the trick for the long run. It got me through the last two years without to much of a problem.

I've chosen Dr. Andrew Jun in Santa Monica, CA. to cut me up. When choosing a physician I look at patient reviews (Angie's List and other online reviews), methodology ( through research it's clear that anterior hip replacement is the way to go) and a doctor who has performed countless hip replacements. 

I've lost considerable strength in my legs due to my lousy hips. I'm looking forward to getting the replacements done and then start working on getting my strength back. Right before surgery I'll set up the CycleOps on my 700 and prepare for rehab.

The table (less the young lady) used for Anterior Hip Replacement...YIKES...put me to sleep fast!!

Fried Hips and Ducks

My poor  hips are fried. While figuring out how to repair or replace them I'll be taking shorter and easier rides. This morning's ride was back to the duck pond with a thermos of tea  Easy 10 miler with just a touch over 800 feet of gain.

My hips may be fried (one a little more then the other) and while hiking and assorted other activities are on hold I can still ride in comfort laid back on three wheels. You gotta love recumbent cycling, so easy on the body and yet so good for it. How sad it is that people can't break away from the herd and explore the world of recumbent cycling. Right now my trike is the only thing that's keeping me active and in good shape mentally and physically.

As long as I take it easy and pop some ibuprofen it looks like I'll be riding my "most excellent" trikes right up until the day my hips are sliced and diced and riding soon thereafter.

Tea time at the duck pond.

Starting to warm up, headed home via my favorite shortcut.

Mileage For August

I missed riding the last week of August...my hips are toast, especially the right side. Not only is my lousy hip sore but my doctor showed me beyond any doubt that my bad right hip is causing the muscles in my right leg to weaken. Depressing but it explains why the last few rides were less then inspiring.

Time to schedule a replacement of my right hip. More later...

Catrike 700 and a Chiropractor

Time to put my neck back on straight.

Last week I was riding my 700 through a construction zone and hit a nasty little elevation change at 25+ mph. The street was being ground down in preparation for an overlay. The sun was in my eyes and I didn't see the abrupt elevation change between the ground down road surface and the original surface. My front wheels (topped off at 140psi) hit first and popped into the air only to be to followed my another jolt from the back wheel. I felt like my spine was driven up into my skull.

I thought I could work my neck back into shape myself...wrong. After a week of discomfort I finally went to my chiropractor who said my neck was messed up. He put me right and I'm feeling better already. A couple more days, some more rounds of icing and some message from my beautiful wife and I'll be as good as new.

WARNING - If you ride a performance trike like a Catrike 700 or ICE Vortex make sure you know a good chiropractor.

On a positive note...if I were riding two wheels I probably would have needed more then a chiropractor to put me back together. Ohhh the fully suspended HPV Scorpion 26fs is looking good right now.