Jean: Bootless!

She came to the evening WOD tonight boot free. Forgot to get a picture...

Nat: It's all over but the whining!

Yesterday (November 8th) marked six weeks since my right hernia repair
surgery was performed, it sure seems longer ago, far more than just the
forty-three days signify.  As a re-cap I was diagnosed with the hernia
at least eight weeks before my surgery, I had my pre-op visit with the
surgeon six weeks prior to the surgery (over all those weeks I was
scaling back my workout loads, but still working out, right up until the
day prior to my surgery).  After the surgery (literally once I got home
from Denver) I began walking, three days after the surgery I was back at
the gym participating with trail walking and stair climbing during my
two weeks of rest/ten pound lifting limit.  After these two weeks I was
allowed to ramp up my work-outs while "being smart"?

The first week back Tim kept the reigns pretty tight on what weight he
allowed me to use and what movements were permissible....and I will tell
you it did not take but an attempt or two at: a higher box, or heavier
weight, or too row, before I backed down quickly all on my own!  It was
fairly clear what movements and weights did and did not feel
comfortable.  That was week three after my surgery - I surely thought I
would be able to do a lot more, but after a couple of workouts I was
fine with just mildly pushing the envelope.  I added back in The Ground
Floor the following week (week four after surgery), I bailed on my
attempt to add the GF on Wednesday of that week - hate to play the age
card once again, but I felt that my body was and still is requiring more
rest than normal.  I have been able to stick to my four WOD's per week
plus one to two Ground Floor visits per week since my lifting limits
were lifted.

Each day that went by, the irritation at the incision area as well as
the tack pain has been diminishing - to the point last week (week five
post-surgery) all the irritation went away for a few days...then came
Competition Night followed by a tough Saturday WOD and Ground Floor, and
the irritation returned - but each time it recurs it is at a lesser and
lesser threshold, which tells me the tack issues are resolving
themselves and hopefully very very soon I will not have any more
irritation.  There are still certain movements that cause me more mental
anguish and some pain - those being burpees, box jumps, kipping pull-ups
and sit-ups.  If I am opening up my hips properly while lifting this can
also cause some irritation - especially sumo dead lift high pulls and
snatches (which my WODS and GF's have had a lot of lately!).

I would say I am over any issues/recovery concerns at this point, so
it's all over but the whining I am doing as I start to regain my
conditioning!  This surgery went so well, so much better than even I
imagined - and I imagined a very easy surgery and recovery.  Again I
would like to review the reasons why this was such a successful surgery
- first and foremost I was in really good condition - the best ever for
me, I stayed on my regular Crossfit schedule up to the day before my
surgery (my 52nd Birthday), I got moving (two walks that evening - 1/2
mile) as soon as I got home from surgery (the anti-nausea drugs were a
big plus), got off the narc's immediately (the evening of the surgery) -
I felt so much better without the narcs and was able to deal with the
pain with x-strength Tylenol (the only drawback here was what was called
an anesthetic hangover - which made life at work hard, but did not
affect my recovery)  I got back to the gym three days after surgery -
and the support and encouragement from all of my fellow Crossfitters
along with the heavy handed coaching really kept me on track!  And then
getting right back in to my normal routine (scaling back heavily!) as
soon as my restrictions were lifted has helped to continue my speedy
recovery.  I still have a ways to go to get back my pre-diagnosis
conditioning, but the past two days the sweat has been pouring out of my
body to the degree it used to so I know I am getting my performance back
up comparatively. So at this point I'll call my re-hab a wrap and right
now I have to head back to the box for my second workout of the day -
that being a hour in ground floor.  Thanks to everyone, staying
connected with Crossfit made  this a non-event in my life, now let's see
if I can start lifting some real weight!

Nat: two weeks out

My post-op visit was last Friday (10/07/11), ten days after my surgery. I met with my surgeon early in the morning prior to a day of meetings in Denver.  He reviewed his surgical notes with me and I recapped my ten days of recovery:

I let the Doctor know I was on the oxycodone the day of the surgery only, followed by two days of Extra Strength Tylenol (OTC) - he felt I was a bit over-zealous getting off the pain medication - but really it wasn't that bad at all and as I've said before, a little pain helped tremendously in keeping my impatient attitude in check.  And trust me, had I been hurting too bad I would have been taking something for the pain, I'm still a pussy after all, not like my surgery changed that!

I told my surgeon I had been walking within a half hour of arriving home from my surgery, followed by a second walk that same evening. I walked about a half mile total that first night, I walked a mile each the next two days and Friday I was back at the gym where I walked the trail run and climbed twenty-four trips up and down the gym stairs.  The next day, Saturday, I walked the trail run again and this time I did thirty-five stair trips with five pound dumbbells.  I was back in on Monday walking and climbing stairs and Wednesday and Friday I walked and then did my own AMRAPS utilizing stair climbing, stair push-ups and rope rows.  Between my workout days I was walking a minimum of two miles per day. I took my surgery week off from work, so I would get-up and take a walk, nap, take a walk, nap, take a walk, go to bed, and do it all over the next day.

So after thinking I was a freak-show about the abbreviated use of pain relief, you can only imagine what my surgeon was thinking after I told him all of that!  After admonishing me for not taking it easy during these first ten days post-op and warning me about the last four days remaining of my 10 pound lifting limit,  I assured the Doc that I had been super diligent with the weight limit, only mistakenly lifting a couple of times and those times most likely did not surpass twenty pounds. And in my mind I should get an award!  And here's another good reason to get back to the gym quickly - Tim kept my dumb-butt in check when doing the stairs, or during my non-workout workouts. I'm sure you all heard him yelling "Havens I told you to walk the stairs not run them.", I'm so glad he only had to miss two days of yelling at me!

I will tell you walking and my pseudo-workouts made me feel so good, and it felt like my body was always craving the next walk.  I am sure that getting my body moving, beginning the night of the surgery, made a huge difference in my recovery - it was great for my: stomach/body for getting all the drugs out of my system, my three incisions and their swelling, my newly installed patch work, and my mind.  After my scolding about taking it easy, I can see that my desire to jog a few 275m's on various occasions during my first ten days post-op may have been overkill and I should have concentrated on resting and being satisfied with my daily walks - but I was not far off of that mark, and feel I certainly could have been doing a lot more as far as activity goes...but then again fourteen days of rest (with walks!) is not too horrific, and far smarter for my recovery!

During this post-op appointment my surgeon showed me in his notes where he noted that he wished all his patients were in my physical condition, it made the surgery very easy for him.  I also found out that I had major damage from my right lingual canal all the way down to my junk, far more than he had expected to find - but a condition which coincides with hereditary hernias. So I got the jumbo patch by default!

I found out about the extent of my inner damage when I told the Doc that I had only one spot where I still had pain/discomfort and since it was close to my hip bone I thought it could have nothing to do with my hernia repair - it was way too high, horizontally across from my belly button.  And to my surprise I found out that the pain was coming from the top of the patch, and the discomfort is from the tack that was installed to secure the patch in place.  This is when I learned about the first and only drawback of being lean and in good physical condition - I'm so lean that this upper tack is going through a couple layers of muscle and or dermis, so when I moved/twisted/stretched my body I would experience pain as a result. I did not process this explanation fully at the time because honestly I thought I had screwed up somehow on day one getting out of bed when I really felt a lot of pain in this area, so I compartmentalized this pain in my psyche and did not allow myself to feel it fully because I talked myself into believing it was just going to take longer to heal before the pain went away.  Well after my four hours of meetings and a couple hours of errands I was headed back to Fraser, so I had an hour and a half to think about this situation with the tack.  Anyone who knows me well is saying to themselves right now - oh that's not a good thing - Nat dwelling on possible problems, that's a disaster about to happen.

In that short hour and a half, the time it took me to drive home from Denver, I was able to totally destroy my positive mental attitude over this tack issue. I allowed my imagined fears to just decimate all the good I had been able to achieve - and my biggest fear of all was that I would no longer be able to participate in Crossfit - hey, it's my mind and that's how that crazy thing works!  I got a haircut before leaving Denver and decided to take a shower prior to hitting Comp Night at CFTA.  While showering I was actually able to push down on the tack area and actually see it pushing up through my skin, which caused a brief psychotic episode on my behalf!  I pounded my fist on the tack a couple of times and then tried to pull the layers of skin/muscle up an off of the tack, like I said it was a brief few seconds of spazing out until I got grossed out and stopped.  I did my own workout during Comp Night but I was still very depressed about the tack issue.  Saturday morning at the gym was even worse, my mental attitude had hit rock bottom, I ended up bailing from class and took Sampson out for a long walk in the woods.  I tried to contact my surgeon over the weekend to discuss the complication further, but unless I was willing to classify my condition as extremely serious I was left with the option of leaving a message for the surgeons assistant, which I did, asking the Doctor to call me on Monday.

Now here's the weird thing (yes weirder than the last paragraph!) the pain began to subside in the tack region Saturday afternoon, and by the time I went to bed that night I no longer had the routine pain I had been experiencing for eleven days while trying to sleep?  The pain was still absent on Sunday as well, every once in a while I would feel a little discomfort in the area but nothing like it had been since the surgery.  I was still down in the mind on Monday - my surgeon was off on Monday and on Call on Tuesday - when I was told to expect a return phone call.  I did my own workout again on Monday night at the gym, and after two and a half days with very little pain from the tack area my attitude was slowly improving.  No phone call on Tuesday?  Wednesday I called again to find that my Doctor was off again, hoping to get a call tomorrow, on Thursday now.  On Tuesday of this week after I had an hour of being told I was a stupid idiot and to get my mind out of the gutter by he who shall not be named, I started getting my head straightened out.  That same individual wanted me to confirm that my surgeon said I had no weight limits after Tuesday evening - the Doctor told me to be smart and take four to six weeks to regain my strength and weight loads, but that I had no weight limits imposed.  No wonder Tim wanted me to confirm that!

Since I did not get my call on Wednesday prior to the 6pm WOD I could not confirm the Doctor's orders for Tim.  I did however participate with the class on a very scaled basis. For the WOD I carried a fifteen pound med-ball instead of the forty pound sand bag, and you guessed it I was not allowed to run, only walk the 400m's.  When Paul was doing his runs I was doing my thrusters with weighted PVC, I did 24 rope rows instead of the six rope climbs, and I stepped up on a twenty inch box instead of jumping the thirty inch box for men.  I tried my first 400m with a twenty five pound plate but found that weight too heavy, just as stepping a thirty inch box was too taxing on the patch area as well.  As mentioned above it's nice to have Tim keeping my stupid butt safe!  The workout went really well for me, I got "worked" by the rope rows the most, and left feeling really good - all over, and after the lecture the day before my mind was feeling far better about things too.  As I sit here typing this next chapter up, I notice no negative impacts from this evenings workout - my first real (albeit scaled) workout in two weeks since the surgery.  And as a reminder I was scaling back my workouts for five weeks prior to the surgery, not quite as scaled as tonight's workout but scaled nonetheless.

Other than my brief "mental complication" I would say that this surgery was almost a non-event in my life.  The surgery and return home went super smooth (always remember to ask for anti-nausea drugs if you are coming home over the pass the same day as your surgery), the laparoscopic procedure is so much easier on you than the "open" method. My goal of walking immediately after the surgery and every day following the surgery made a huge difference in shortening any negative side effects of the procedure.  And my positive mental attitude (not including my brief melt down) really determined my success.  That PMA had its founding from: first being in good physical condition, I'd say I was in the best condition of my life prior to the diagnosis of the hernia, secondly staying active prior to the surgery (I delayed my surgery so I could complete all my landscaping and fall and winter preparation projects at the Casa), I was at CFTA on my regular schedule doing scaled workouts but still pushing myself all the way up to the day of the surgery, and then finally walking on a daily basis post-surgery and then getting back to the gym three days after surgery and being back in my routine.  Perhaps some people think I was back too fast, but honestly it was really a non-event this surgery, and as I have said before I'm no hero, so if there was any pain I'd a been whining and would have wimped out far more than I did.  And the only problem I have really had is a temporarily weak mind, I can attest that that bowl of jello on my shoulders has been strengthened tremendously by 21 months at CFTA - it has a ways to go too, just as the rest of me does!  And I can say now that I've got my new patch I am ready to get back on the road to further improvements and accomplishments.  The hardest part of the two week post-op period has been being on the sidelines looking in at the gym, so glad to be back and a part of the normal workouts, I feel whole again (and no longer leaking my innards!).

With the help of the coaching staff I hope to be back close to my pre-diagnosis physical conditioning level by this time next month, or thereabouts!

n

Nat: The Morning After

This was yesterday, Wednesday, the morning after the surgery, the pain crept in late morning and subsided by the evening, I did not go back on the narc's but thought about it! Had two walks today, and trying to stay low, which is not too tough at this point. By taking just Tylenol I can tell where the pain is and that is aiding my lack of patience! Will be up in the morning for some stair walking and maybe a hill or two.

Nat: Photos of insides & patch

Nat suggested that these may be too "gory" for the website, but I put them in anyway. You clicked on Project Rehab, and we are showing you the real deal.

The first two show what the (failed) abdominal wall is trying to hold back, and the second two show the gortex patch that is going to fix the failure.

So now, when we give Nat the cue to "tighten up", we are also asking him to channel his goretex.

BTW, this was all done (both the surgery and pics) with a scope. Pretty cool!