Tweedle Beetle Tri-Atheletle

Scoggins Valley Tri

2010-12-16T14:47:00.000-08:00

Alright, alright...

I have been terribly negligent. I haven't posted in months and actual raced two more tri's at the end of the summer. The final one, I actually placed second!

Yes it took puking all over the shoes of some poor person who stood too close to the finish corral (sorry but I barely could keep putting one foot in front of the other) and then puking again on the finishing mat.

All said and done though, I left it all out there and I finally feel like I am back in form!

My second place run!

2010 Amica Mid-Summer Olympic Distance Triathlon

2010-08-10T13:35:00.000-07:00

	Blue Lake Olympic 6/6/10	Hagg Lake Olympic 7/10/10	Amica Mid-Summer Olympic 8/1/10
PLACE (OVERALL):	178 / 406	64 / 203	54 / 186
NAME:	H, JENSEN	H, JENSEN	H, Jensen
AGE:	33	33	33
SEX:	M	M	M
TIME:	2:35:03	2:42:17	2:25:58
BRACKET PLACE:	25 / 41	13 / 25	11 / 21
SWIM TIME:	0:32:13	0:30:53	0:28:35
SWIM 100 YD:	1:58	1:53	1:45
PLACE AFTER SWIM:	318	126	84
TRASITION 1:	3:58	3:27	3:24
BIKE TIME:	1:09:22	1:15:25	1:06:48
AVE MPH:	21.11 MPH	19.77 MPH	21.42 MPH
BIKE RANK:	162	52	54
PLACE AFTER BIKE	224	77	61
TRASITION 2:	2:57	2:40	2:02
RUN TIME:	0:46:33	49.52	0:45:09
AVE MILE SPLIT:	7:29	8:02	7:16
RUN RANK	125	60	49
PLACE AFTER RUN:	178	64	54

***http://www.racecenter.com/results/

Waiting for my wave while the sprinters were getting
warmed up.

There are a few times in ones career when everything seems to fall into place, to come together into a perfect day, perfect presentation, perfect work of art or perfect race. These days are not just for the rich, the artisans or athletic pros - they are for all of us and while they don't happen very often, rest assured they do happen. August 1st, 2010 was one of those days for me.

Waking at 5:15 the alarm was just loud enough to not waking up the wife and kids. My steps were soft enough as I got ready as to continue this trend and leave everyone in the house smiling in their sleep - rather than grumpy with Dad for waking them. Everything was just as I had left it the night before and with a perfect cup of coffee in my hands, I rolled out of the drive way. Getting to Blue Lake at about 6:30 gave me plenty of time to realize my first and only mistake of the day... (my complete lack of bug spray). In true spirit of the triathlon community, it only took me about 45 seconds before I found someone totally willing to lend me theirs.

The comradely of the event, of which you only have to be a present to experience didn't stop at the bug spray. I have really only been doing this for about 6 months but in that time, I have made good friends and make new friends at every race. Amica was not exception. Within minutes of finding my place on the rack in the transition area a conversation had begun between a couple and I. Both were down from Seattle and I must admit, I was a bit startled when the husband began pulling not just running shoes and bike shoes out of the duffel bag but a true carbon running leg, biking leg and swimming leg! A leg for each event. I truly was inspired, especially after I learned that he will be participating in the Lake Steven's Half Iron man.

With my wave just about to start, I was trying not to focus on
burning sensation on the inside of my left bicep... oh, and the
3" teeth about to tear into my lower abdomen.

My wave was set to start at 8:37 AM. A few fellows and I sauntered down to the waters edge as we started on what now has become a pre-race ritual of pulling on our wet-suit tops and helping each other with finding the "perfect" zipper pull placement. As I pulled the suit up I felt a sharp burning sensation on the inside of my left bicep, as I jerked the suit down again to look at what had impaled me - I was not to happy to find a bee stinger handing out of me, pumping away. While this was an annoyance, I decided to take the Lance Armstrong approach and just let it piss me off so I would be motivated to go faster.

Jeremy Wade (of River Monsters) holds
his prise Tiger Fish on the shores of the
Congo River in Africa.

Aside from bee sting anger, I picked up yet a new source of motivation. A few nights ago, while on the floor stretching as I watched Animal Planet. I was lucky enough to find myself engrossed in a new episode of "River Monsters". In this episode our fearless fisherman (note the use of fearless and also the fact that he generally remains safely on the shore) was hunting the "Demon Fish" or better know as the Tiger fish. Well, while it hadn't occurred to me that this "fish" may have made its way out of the Congo to the shores of Blue Lake Oregon, as I watched the show - it did occur to me that it was a near certainty - as I stood waist deep putting on my swim-cap and goggles. I decided that the slowest swimmers were most certainly the prime target of such a carnivore and I scared my way into a new 28:35 PR!

Turning Right onto Marine Dr (Approximately 1/2 mile from
Transition Area)

With the exception of a slight debachle in the Swim to Bike Transition area (where I literally fell over my bike) - the ride was smooth. I felt powerful through the entire ride where as in June, I felt a fade in the last 6 miles. There were a few instances where I had to break my aerodynamic position to stretch my butt and lower back but overall I I was able to hold a fairly constant 21 to 22 mph. Recently I have been working on "explosive power" - the ability to reach the foot of a short hill or in process of climbing, explode with a burst of power. In theory, this will allow me to both maintain my speed when I encounter a short hill or pull away from drafting competitors (or simply make a strong pass where I firmly plant in my competitors brain... "I can't keep up that pace" and allow me to pass unchallenged). I felt successful on both accounts. There are two short, shallow hills on Blue Lake Bike course which tend to slow the pace of the riders. On both hills I passed 6 to 8 competitors and while I brought my HR up to the 190s was able to get it back down once I settled a comfortable 30 yards past them. I was very happy about this performance and will continue this additive into my endurance program.

8 Miles in to the 40K TT.

The transition from Bike to Run was smooth and fast. Again, I felt the need to pee upon exiting the transition area and had to burn up 30 seconds in the bushes. I am not sure how to avoid this. I can only imagine that being dehydrated and not peeing would result in a substantial drop in performance (much more than my 30 sec pee). That said, I still kept my first mile under an 8 min/mile pace and continued to average 7:16 s through the rest of the run.

One of my absolute mental pet peeves is that guy who settles in behind you and uses your pace to pull him along. Not that there is anything morally or ethically wrong with the practice - just hearing the constant footfalls behind me and the breathing, increases my anxiety and prevents me from racing with a clear head. While this is probably something I need to "shift" my thoughts around, I wasn't in the right frame of mind on this run to do it. I do believe that I mastered my thoughts and was successful at developing a plan to use this annoyance to my advantage. As we neared the overpass on mile 4 I planned my last and potentially fatal burst on the uphill side of the overpass and then a stride out on the way down - trying to put some distance between me and my two pace leaches. It was successful to a point. For Mile 4 I posted a 6:26 split, a 50 second increase in pace. I maintained it until mile 5.5 (about 3/4 mile to go) at which point I couldn't hold it and my paced slowed significantly to 7:45 for the last mile or so. Due to the slackened pace my two friends caught me and passed me (grrrr). Hind sight being 20/20, I should have waited 1 mile to surge and maintain the surge through the finish. 2 1/2 miles at 6:30 was simply too much.

While the racing was great, the outstanding energy of the event was fantastic - what meant the most to me on this day was the fact that my wife and two boys had come out to support me. The night before as I put my son down, he gave me a red, white and blue silicone wristband that he got for being the "Star Student" at his school, so that I would remember him during the race. This was so touching that no less than a dozen times, I looked down at my wrist and felt a surge of energy to increase my pace. It really, really meant something to me and then to have that reinforced as I came out of the transition and have him give me a "high-five" made me feel so blessed.

My wife told me a little story after the race... As they were waiting for me to arrive on the bike, she said something to the effect of "Is that Daddy?", upon further investigation - it wasn't me but Aidan then piped up with "No, it is probably Lance Armstrong".

New Team Kit for North Lake Physical Therapy Tri Team

2010-07-25T16:00:00.000-07:00

I love this!!!

My "real" job is to work with various corporations and help them spread and grow their brand equity via promotional items. I recently worked on a project for Google where we did a Chrome Cycling Kit and a Maps Cycling Kit. I used this same vendor to create a two piece Tri Suite for North Lake Physical Therapy Triathlon team.

Hopefully we will have it by the end of the season!!!

2010 HAGG LAKE OLYMPIC DISTANCE TRIATHLON

2010-07-25T15:09:00.000-07:00

	Blue Lake Olympic 6/6/10	Hagg Lake Olympic 7/10/10
PLACE (OVERALL):	178 / 406	64 / 203
NAME:	H, JENSEN	H, JENSEN
AGE:	33	33
SEX:	M	M
TIME:	2:35:03	2:42:17
BRACKET PLACE:	25 / 41	13 / 25
SWIM TIME:	0:32:13	0:30:53
SWIM 100 YD:	1:58	1:53
PLACE AFTER SWIM:	318	126
TRASITION 1:	3:58	3:27
BIKE TIME:	1:09:22	1:15:25
AVE MPH:	21.11 MPH	19.77 MPH
BIKE RANK:	162	52
PLACE AFTER BIKE	224	77
TRASITION 2:	2:57	2:40
RUN TIME:	0:46:33	49.52
AVE MILE SPLIT:	7:29	8:02
RUN RANK	125	60
PLACE AFTER RUN:	178	64

***http://www.racecenter.com/results/

*** PLEASE NOTE CORRECTIONS TO BLUE LAKE OLYMPIC DISTANCE (I READ THE RESULTS WRONG...) WHOOPS! ***

The day started in stark contrast to Blue Lake Triathlon just a little more than one month ago. The sky was blue, I pulled on my shorts and drove (enjoyed the windows rolled down the entire drive) out to Hagg Lake. I arrived early and things went as smooth as they possibly could - I even had time for some meditation and visualization.

We were in the water at 8:00 AM sharp my my wave was second at 8:01. The water was brilliantly warm and the toughest part of the swim was the elbow which clipped my nose about 3/4 of the way out to the first buoy. I felt strong throughout the swim, although hindsight being 20/20 - I should have pushed it a bit harder. I swear there was a current... somebody mentioned it but I can't be sure.

My "imaginary" Hagg lake.

Okay... the bike leg..
That was really hard...really, really hard.. I feel like I did well but... DAMN!!! That was really hard! Lets remember that "Hard" is relative and I suppose that being "relative" it has to be compared to a reference point. Lets call this my "expectation". Compared to my expectation, Hagg Lake was really, really hard. The course was described to me as rolling hills (the start of my reference point troubles). This is how "I" expect rolling hills to look.

I sort of pictured grassy plains with, well... rolling hills, maybe 50 or so feet of elevation change - maybe even a hundred feet. The kind of ride where you stand up to peddle and maintain your speed, but for the most part, maybe even the entire part, you are locked onto your aerobars, cranking out 20+MPH speeds, mile after joyful miles. Let me be very clear... THIS IS NOT HAGG LAKE.

Stage 8 Tour de France

Brutal climbs...
Leg and Lung punishing accents...
Terrifyingly fast descents....
Riders and runners dropping like flies in the heat of a blistering summer day...

Okay, Okay.... this is actually the profile for stage 8 of the 2010 Tour de France. Sorry Lance, I know you are reading this and I hate to bring up bad memories. I guess the good news is my ride was MUCH better than yours. It really looked like this from my vantage point!!! Honestly... It did!

Actually, what the bike leg really look like with this:

For the Olympic Distance the race was two loops around the lake with a bit of a dog leg mid way. Total distance was nearly exactly 24 miles. Personally, I went out too strong - finding myself really having to push on the second loop and then struggling through the run especially on the uphill sections.

On the first loop, after crossing over the damn, there was a hard right hand turn which I nearly went down on as I came into the turn way too fast. It is one thing to be sliding sideways on a mountain bike and something entirely different to be sliding sideways on a road bike with 120 psi tires chattering through the corner. After a quick and very lucky recovery I reentered the group, nearly colliding with a rider who saw an advantage and went to take it on my right side (I was a bit annoyed by this) whom I never expected to be there. I got back on the bars fairly quickly but was seriously shaken - if my heart rate wasn't already at 180 - it quickly found its way there during the slide and it was tough to get it back down to where I needed it. The race wasn't without a bit of blood though - one woman went down hard and required the use of emergency medical (fire and paramedic). Lets hope she was all right! The rest of the bike leg was without event and I finished with a decent time of 1:15:25 and average speed of 19.77 mph.

The run leg of the course was a 3.125 miles out, 3.125 miles back on road course. The same course as the bike leg (yup, this was hilly too!). I was stiff coming off the bike and felt like it took forever for the gels to kick in that I scarfed down at the bike to run transition. Each hill seemed to slow me more (even though my splits were within seconds of each other). Where I felt like I struggled was both legging it out and recovering on the downhill section. This has always been a strength of mine and a strategy (shorten my stride and grind a consistent pace on the uphill side, then maintaining the same cadence - lengthen my stride, increasing my speed on the downhill). Not being able to do this really shows that I should have slowed things down on the bike so I could take advantage of my best leg (the run). My run time was 49:52 with ave mileage splits of 8:02. This is really where I am looking for improvement at Scoggins Valley Olympic Distance next month.

Did I do well? Ya, I think I did. I have to keep reminding myself that when the race was ran (July 10, 2010) I was less than 6 months out of spine surgery. There is really no question though that this race was really special to me because it was to be the first opportunity for my two boys and my wife to watch me race. I can't describe the feeling of passing the three people you love the most in the world, hearing them cheer you on as you run or cycling past them. The feeling of picking up my two boys after crossing the finish line. Its really amazing and makes me feel so grateful.

Thanks North Lake Physical Therapy for sponsoring my involvement in the race, but most of all - thank you to my wife, Shannon for sitting on the side of the road, breaking up fights between our two toddlers in 80 degree temperatures for 2:42:17. She gets first place for dealing with a much tougher race than I had!

SPONSORSHIP!

2010-06-23T07:20:00.000-07:00

North Lake Physical Therapy and Rehabilitation has agreed to provide me sponsorship for the 2010 Triathlon season!

Setting the Stage - The timeline:

Last December, 2009 - I made the decision that I was going to begin my training for the Pacific Crest 1/2 Iron Man in Sunriver Oregon.

December 19th, 2009 - Beautiful December day - 20 mile light ride. Tingling in my left hand.

December 21st, 2009 - Woke up to the most intense pain ever radiating down my left arm. (http://tweedlebeetletriatheletle.blogspot.com/2009/12/locked-up.html)

January 21st, 2010 - Complete Artificial Disk Replacement surgery, to replace the badly herniated Disk between C6/7.

Febuary, 2010 - Cheryl Kosta agrees to ignore my ridiculous insurance and provide to me the very best in physical therapy. Thank you!!!!

The Badly Herniated Disk between C-6 and C-7.

The Group:

The North Lake Group, lead by Physical Therapist and North Lake founder Cheryl Kosta, took me under their healing wing back in February 2010 - after my C6/7 artificial disk replacement surgery. This surgery corrected my badly herniated disk which resulted in excruciating pain, muscle waisting on my left shoulder, pectoral, bicep and triceps, numbness in my left hand and paralysis in my left triceps.

What They Did:

Rather than just rehabbing my cervical spine and shoulder area, the group took on a holistic approach - viewing the body and a system of interconnected subsystems. I completed my rehab with two sets of ortohotics (one for daily use - the other for running/cycling), a professional and complete bike fit, and I am ecstatic to report that I have made a complete recovery. The orthotics are designed to not only align my bone structure preventing some of my most chronic injuries (Achilles Tendinitis and IT Band Tendinitis) but also increasing performance! By aligning my structure I increase efficiency and power transfer.

Post Surgery - Notice the artificial disk between C-6
and C-7.

The Result:

On May 15t,h 2010 (less than 4 months after my spine surgery), I returned to competing at the Pole Pedal Paddle. (http://tweedlebeetletriatheletle.blogspot.com
/2010/06/first-race-of-year-2010-us-bank-pole.html)

On June 6th, 2010 I competing in my first Olympic Distance Triathlon at Blue Lake, finishing 125th out of 405 finishers.
(http://tweedlebeetletriatheletle.blogspot.com/
2010/06/2010-blue-lake-olympic-distance.html)

My Sincerest Thank You!

There is no question that North Lake's direction during my recovery not only helped my physical recovery from my spinal injury but also returned me to a stronger, more limber and faster place.

To Cheryl and everyone at North Lake, thank you for your guidance, your support and your financial assistance!

Happy Fathers Day!

2010-06-20T09:33:00.000-07:00

My Wife Shannon, gave me the two greatest gifts a man could ever receive, my two boys - Aidan and Brodie.

To my wife - Thank you. To my two boys, I love you more than anything in the world.

To All of you Dads out there, Happy Fathers Day.

To my Dad, Happy Fathers Day.

To my other Dad, Happy Fathers Day.

I love you both - Thanks for everything.

Jensen

2010 BLUE LAKE OLYMPIC DISTANCE TRIATHLON

2010-06-16T10:26:00.000-07:00

2010 BLUE LAKE OLYMPIC DISTANCE TRIATHLON

PLACE: 125

NAME: H, Jensen

AGE: 33

SEX: M

TIME: 2:35:03

BRACKET PLACE: 25

SWIM TIME: 0:32:13
SWIM 100YD: 1:58

PLACE AFTER SWIM:318

TRANSITION 1: 3:58

BIKE: 1:09:22
AVE MPH: 21.11 MPH

BIKE RANK: 162

TRANSITION 2: 2:57

PLACE AFTER BIKE:224

RUN TIME: 0:46:33
AVE MILE SPLIT: 7:29

PLACE AFTER RUN: 124

** http://racecenter.com/results/RCNW_results.htm

I wake up - 5:30 AM, and look outside to the utterly disgusting weather. Rolling my eyes, I wander downstairs to get my oatmeal cooking and shiver as I look out the window. This was one of those mornings where you can't quite see out the window, its a layer of glass and a layer of rippling water. Its obviously raining and raining hard.

On the way over to pick up James, my Tri Coach and friend - I groan at the classic February Oregon downpour and feel a twinge of annoyance as I realize its June. Even worse, the day before we enjoyed 76 and sunny! COME ON OREGON!!! WHAT THE HELL??? I have been in this weather enough to know very well that I am going to feel very cold, very wet and very uncomfortable by the end of the day.

Showing up at Blue Lake park, the weather seamed to only get worse... Here is a photo of a couple of kids who tried to run from one tent to another.

A couple of spectators when they mistakingly stepped
out of the shelter of the vendor's booth.

I elect to get the wet-suit on before doing anything else, like a switch - my body wakes up from the solid shot of adrenaline and nerves (finally realizing why I drove out here), creating a malicious grin which spreads across my face as I realize how much I miss competing - especially in such conditions.

I look out across the transition area and laugh at myself and my fellow athletes as we slip, slide and sink into what should be a grass field... It now looks something akin to a bog.

Transition area - Blue Lake... OK, OK, so its not but it looked like it!

I really couldn't believe the fact that in a blink of an eye, I found myself neck deep in Blue Lake surrounded by a rainbow of different colored swim caps. I had no idea what to expect, except for the fact that I would finish... well, I would finish as long as I got though the swim... I don't even remember a gun... or an announcer or any indication that we should all start swimming but soon enough, I realized that I was avoiding feet and hands as we all attempted to swim towards a great big floating green buoy. I remember, after settling into a rhythm, thinking of my boys and Finding Nemo, as I sang... over and over and over... "just keep swimming, swimming, swimming... just keep swimming, swimming, swimming."

Dorie and Nemo keeping me company through the swim.

Well, guess what happens when you follow Dorie's advice... eventually, fast or slow - you get there. After 33 minutes, I got there - slipping and sliding into the transition area, stripping off my wet-suit, plopping down in the mud, donning my soaked bike shoes, helmet and "sun" glasses. I grabbed my bike and trudged through to the first sign of pavement and mounted up.

Me coming out of the transition area...

I felt really strong on the bike and actually enjoyed the rain for the first 16 miles or so. At about mile 17, it became quite a pain in the ass... no really, my butt hurt! You will be glad to know this was a first for me on the bike - somewhere deep between my right glute and right hamstring a muscle was screaming at me and really cramping up. I finished the leg strong but overall average speed suffered during the last few miles or so. Hind sight being 20/20 I should have realized that I was failing at hydrating properly. Who needs to drink when you are surrounded and covered in sheets of water??? I guess I did :). The transition area - as mucky, sloppy and slippery as it was, looked like an oasis.

Parking the bike, I took a quick look at my race flats and socks that were already getting soaked. What would be worse??? Soggy Socks or no socks at all? My split second decision was to go without socks, my first footfall out of the tradition area would make me regret that decision for the next 6.24 miles. That footfall landed directly in a 6" deep puddle - the gravel immediately infiltrated my shoe and I knew I was in for bloody feet by the end of the day. I turned my brain off and after a quick pee of the side of the road (causing me to have a 8:30 first mile), I was able to crank out 7:15s for the rest of the 10K. That felt great and boosted my overall standing to 124.

OK so these are not my feet, and really my blisters were
no where near this bad... But this is how they felt!!!

Overall, after taking in everything - the rain, the blisters, the metacarpal hamstring pull, the really slow swim, the incessant shivering after the race, the 4" deep muck in the transition area - I LOVED IT!!!!

I am so motivated to better my times, as there is so much room for more fun... for more improvement.

Stay tuned for the rest of the 2010 Season!

Special thanks to James Williams at Zing 3 Coaching / Club Sport for coming out and guiding me through my first Tri Experience.

Special thanks to Cheryl at North Lake Physical Therapy for helping me recover and get back to racing condition.

Especially, Super Dooooper Special thanks to my wife Shannon for supporting my passion and forgiving me for disappearing (phone got lost in the back of the car - she thought I died...) after the race... I love you Hon!

First Race of the Year! 2010 US Bank Pole Peddle Paddle

2010-06-07T15:38:00.000-07:00

2010 US BANK PPP

SNOWBOARD
XC SKI
BIKE
RUN
PADDLE
SPRINT

The 2010 US Bank Pole Peddle Paddle was a banner year! Did we win? Nope. Were we top 3 in our bracket? Not even close... Well OK, from a competitive side, we are not looking to go pro any time soon but each of us on the team tacked a PR up on the wall at the end of the day!

Near the inception of our disheveled and bedraggled team of misfits, a question was asked... Who knows how to cross country ski? I answered with a very confident (Confident that I would not be chosen as the one...), "I haven't cross country skied since I was 8!". Their unanimous response was, "Great! You're our guy!". Two months and a few days later - just one hour before our race start, I found myself asking anyone who would answer me, "How do I clip these on my feet?" Fifteen minutes after that, I found myself asking anyone who even smiled in my direction, "Can you teach me how to do this?" Forty Five minutes later, I found myself struggling through 50 min and 10K of cornmeal. I have included some footage below of my final climb into the finish shoot and a visual description of what happens when you ask lots of the right questions but fail to ask them all.... "How do I get these skis off when I am done?"

My second leg was the 20 mile bike from Bachelor to Bend. For this, I felt fantastic - regardless of my 50 min energy burn on skis just before. Given it was mostly downhill (there were two short climbs) I felt I posted a solid time.

Dis: 19.8 mi

Time: 41.5 min

Ave Speed: 28.9 mph

Ave HR: 178 bpm

Overall, a total blast!

Then it was our magic marathoner, Adam's turn at the wheel. Once we found each other at the transition (what a few minutes in a race?) - he set off at top speed! Adam, what was it? 6 minute miles???? Anyway, Adam rocked the course tagging Eric our pro kayak expert.

On a lighter note, our professional paddler forgot... didn't know... or maybe just wanted to look supper macho by leaving the plug out of the kayak and having to dump the water 3 times during the paddle portion of the race. Needless to say, he still posted the best time of the day - for him :). He also managed to say, "To hell with the man, and purposely drowned his Blackberry in the process. Way to go Eric - you are an inspiration to all of us chained to our cells.

Adam, Eric... Great job gentlemen... Can't wait to kill it again next year!

Although next year, I will try to get out there before 1:00 AM in the morning...

P.S. Favorite Quote of the day...

"I am pretty sure I was still buzzed when I woke up this morning..." - Adam

Body Molding... The Orthodontics Of The Skeletal System

2010-04-01T15:23:00.000-07:00

YOU ARE NOT STUCK WITH WHAT GOD GAVE YOU!!!

No, I am not talking about getting a larger chest or shaving unwanted pounds off your mid section with a lypo-hose. I am talking about designing a workout routine which will change the structure of how your bones fit together, changing the way we stand, the way we sit, the way that we live to increase performance and decrease the chances of injury. Actually investing both TIME and ENERGY (the two basic ingredients into anything worth while) - applied under the watchful eye of a professional, yields incredible results. I am absolutely giddy with all that I am learning.

10 weeks ago, I walked into my PT (Physical Therapist). She asked me to remove my shirt and my shoes and simply stand. The first words out of her mouth after her critical eye passed over my body was - "You struggle with IT band and Achilles Injuries." By the way, it wasn't a question but a statement of fact - one that I had to smile at because it couldn't be more close to the truth.

Today I feel as if I have nearly come full circle. I am not as fast as I was 10 weeks ago, nor as strong but I feel like my PT has been able to set a foundation to get even stronger, even faster and with less chance of injury.

Thank you to everyone at North Lake Physical Therapy - I came to you hoping for a stronger neck and you gave me a stronger body.

www.northlakephysicaltherapy.com

The Ride Of a Lifetime

2010-02-28T09:38:00.000-08:00

Some of us ride to train.
Some of us ride for general health.
Some of us ride to get from home to work and/or from work to home..
Some of us ride for our significant others, fathers, mothers or brothers.
Some of us ride because we can't drive, for one reason or another.
Some of us ride because it is hard... really hard, depending on how hard you want it be.

Others, a lucky few, ride because every once and a while - it allows us the capacity to capture an experience which is worth remembering. Experiences like these can take place any-day, anytime, anywhere or with anyone. My experience today though, took place on a beautiful February Day, about 60 degrees and sunny. Cold enough to wear a sweatshirt but not cold enough for a jacket.

My riding partner for the day saddled up on his bike looking particular fast - a red skateboarding helmet, partially sliding off the back of his head because of the stocking cap being worn underneath, his Velcro-shoes, strapped stylishly in a "X". I donned my more "stylish" Old Navy jeans, tucked strategically into my socks. Instead of my Specialized bike shoes, I elected to go with a less common high top converse (old school style).

They ride was typical. We covered rolling terrain, made especially tricky by the allowance of driveways gently greeting the pavement of the street. For a bit it was stop and go, as we checked both ways before moving from one side walk to the other. Our stats were also typical - 1 mile covered, 40 min of ride time, Average Speed of 4.2 mph... oh and a stop at the slides and a loop around the basketball court.

This ride was not special because of the sights seen, the weather, the speed or distance. It wasn't special because my heart rate was in the "target range" for 80% of the ride or that I lead the pack for more than my fair share. It was incredibly special because it was with my son - my very first ride with my 4 year old son. In a life which is so unpredictable, so fleeting - these experiences are gifts, and these gifts are the reason why I ride. Today's gift was unexpected, this experience was one to remember and document. Today was certainly a ride of a lifetime - and I am grateful.

Why do you ride?

Setting The Stage - My Very First Blog... With a Point.

2010-02-10T14:34:00.000-08:00

First - let me tell you all, that this blog has been exceptional for me. In many ways, over the last 5 weeks - I feel like for the first time in many years, I have a passion. I really enjoy writing, it keeps me present and allows me to share all that I enjoy, whether it is stories about my family, incredible physical pain, new additions to my spine or (To get back to the ORIGINAL point of this Blog) to discuss my training for Triathlons. I am even considering branching out into authoring and submitting articles for publication in running/cycling/fitness related periodicals.

So lets set the stage for my very first artilic (yes, artilic is a word, my word, look it up in my blog) attempt. Upon starting my physical therapy/recovery from my surgery, I have felt the need to track my training and look at how my overall performance is affected by my training schedule. I hope that this effort will yield much better gains over a shorter amount of time. All athletes, regardless of discipline or level could benefit from tracking and evaluating their performance and nutrition, to become more competitive.

There are LOTS of various ways to track performance and many of these require some sort of financial investment in order for you to take advantage of their attributes. Well, as much as I wish I could afford to invest in some of these amazing applications, I can't! I have a wife and kids and my money goes towards them (or a new Tri/TT bike)... Needless to say, I have other priorities that take precedence over a training log. For that reason, in my search - my first condition was that the application needs to be free (or very close to being free). My second criteria required the training log to do more than just running, or weightlifting, or cycling, or swimming, or physical therapy, or ..., or .... It needed to be able to do all of it and more. It needed to be customizable and reasonably easy to use. My last criteria was that I would be somehow showcasing the application here on Tweedle Beetle Tri-Atheletle for you, my readers. I have to assume that other out there are looking to document their training as well and are looking for an educated place to start!

Well, I selected three applications to trial. I will be devoting time to each, in parallel and evaluate each application - so that you can make the best decision for yourself. Upon selecting the "winner", I will continue to use the application, documenting my training and results here at Tweedle Beetle Tri-Atheletle. Here are the three programs I am going evaluate:

1) http://www.elevationfit.com/

2) http://www.beginnertriathlete.com/

3) Triathlete's 2010 Triathlon Training Log Template By Doug Clark

I will be going over each of these applications in detail over the next week or so.

I will be evaluating each of these applications by use of the following criteria.

1) Easy Factor: How easy is it to use?

2) Programmer Factor: Do you have to have any previous computing knowledge to use it?

3) Custom-ability Factor: Does it have limits to how much custom-ability the program offers?

4) Cheep Factor: How much (if any) does it or will it cost in the future?

5) Speed Factor: How fast can you enter in data after a workout?

6) Analysis Factor: Does it offer the user the ability to evaluate based on good data analysis tools?

Each will be rated on a 1-10 with a solid description of why.

I will be evaluating for 2 months before making a decision - the final results will post the first week in April.

Keep healthy.

2 Weeks After - New Photos

2010-02-03T16:00:00.000-08:00

Hi All,

Just had my 2 week follow up X-Rays... Here they are. I will have my follow up appointment tomorrow (I assume all is well!

Before...

After...

All in all... I feel fantastic! I had a great workout today on the Recumbent Bike at the gym and actually really worked hard.

As a preview - I have begun keeping track of my workouts both in recovery from the surgery as well as overall training for the race season coming up. I am going to be logging data via 3 different pieces of web-based training logs. After 1 month, I will make a choice between them and provide you all with which was the best and why!

More to come!

Cool Mod!

2010-01-29T12:09:00.000-08:00

Hello All,

I thought I would throw up a quick post with the after shots of my new spinal modification!

For those of you techy people out there - here are the details on the device itself:

Name: Prodisc-C Total Disk Replacement
http://us.synthesprodisc.com/EN-US/
Description:

The Prodisc-C total disc replacement has been determined to be safe and effective in the treatment of symptomatic cervical degenerative disc disease. The Prodisc-C total disc replacement surgery is intended to:

–	Remove the diseased disc
–	Decompress the neurological structures
–	Restore normal disc height
–	Preserve motion in affected vertebral segment
–	Improve patient function

Since December 2007 the Prodisc-C total disc replacement is approved for use in the US by the FDA after an IDE clinical study.

Photo:

My Photos:

My Results Thus Far: Wow!!! Exactly one week after surgery, the radiating pain down my arm is gone and has stayed gone. I am back to work and plan on starting into PT early next week. The soreness around the surgical site was always minimal but has improved substantially from that. My range of motion has improved significantly but I am still stiff. God, thank you, I can finally sleep at night... and in any position I want!!!! I preyed for a really good outcome of the procedure and thus far, the outcome is exceeding my expectations significantly. I am going to continue to be conservative and stick with the "Don't pick up anything more than a coffee cup" philosophy until the doctor gives me clearance (regardless if I think I "could" go for a run). If anyone is considering this procedure, I welcome you contacting me and asking questions but know that as long as your doctors see you as a good fit for the surgery and you trust them - I have no complaints!
What I learned from all of this:

Take your health into your own hands! Do not let anyone (Doctors especially) tell you how you are feeling. You have the right to call them time after time after time to try and get in and see them. If they tell you their first availability is in two weeks - take it and call back that afternoon to see if there has been a cancellation. Call back EVERY day until they say "Yes, we have an opening!". Your your disk was anything like mine, the impingement is killing your nerve and atrophying your muscles. You are responsible for protecting yourself.
This surgery was not that painful - the drugs afterward were worse. If I have to do this again I will tell them up front - in writing that I do not want anything more than Tylenol with Codeine.
Have a good support network before the surgery. My Dad, Step mom, Mother In Law, Step dad, Friends from my wifes Moms Club and friends made this such an easy time to take care of my self.

Sleeping in...

2010-01-26T11:53:00.000-08:00

Oh to sleep again!!!

That's right, I went to bed at 11:00 PM and slept in until 7:00 AM. Eight hours, haha! I feel like I am on vacation. Overall, I feel so much better today. The pain in my throat has decreased substantially (although I am not eating any Nature Valley Granola Bars). I am still stiff but really feel improved.

Now all I need is to... GET OUT OF THIS HOUSE!!!

I really do like my work but I would be lying if I said that I was running out the door every morning to get to the office. Now I can't wait for my conservative half day tomorrow. My associate Judy has been holding down the fort for me and I really feel bad about all the stuff she has been doing on my behalf.

Anyway, I am really looking forward to getting back to life.

Whoa!!! Where did that truck come from???

2010-01-24T21:25:00.000-08:00

“Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever.” - Lance Armstrong

Lance Armstrong before surgery on his broken right collarbone.

Photo: AP

OK, OK...

I think I got a little ahead of myself in thinking I was out of the woods. This morning I woke up feeling like I had just been pulled out from under a Mac Truck. My esophagus felt like it had swollen substantially, my neck felt like it had been cemented into place and the muscles surrounding the incision were sore, sore, sore. I was told to expect this but I was a bit spoiled yesterday as I felt very little pain. Maybe the remaining adrenaline and other shock related hormones that came after the surgery helped in the 24 hrs after? Regardless... it hurts now.

That said, I do believe it is time to reevaluate some of my fitness goals and acknowledge what the next 6 months are really going to look like. For one, I think it prudent to rethink the Pacific Crest long course triathlon - and maybe target a long course triathlon later in the year.

OK - here are how things look:

Jan 21st - Recovery from surgery begins.
Feb 4th - Follow up with surgeon - hopefully relieved from "coffee cup lifting limit". Start back into cardio training on recline (granny) stationary bike. Start physical therapy to regain strength in tricep and maintain/increase range of motion safely. Start water running.
March 4th - 6 week mark - hopefully relieved from "milk jug lifting limit". Get started back into Spin (stationary bike) bike and road trainer. Start back into swim training. Start light running.
April 4th - 10 week mark - hopefully relieved to full duty. Ease back into full training and begin racing.
May 15th - Run 10K at Pole Pedal Paddle (Defend title with the "Innovators") PR - 35:42.

Getting back to training on April 4th, gives me 10 weeks to be ready for the Pacific Crest Long Tri and looking at this realistically, I think it foolish and irresponsible to try and force my body into such a grueling race on such a short training schedule. I don't want to give up on the idea of racing though so I am revising my goal to compete in the Olympic Distance Triathalon on June 26th, so...

June 26th - Compete in the Pacific Crest Olympic Distance Triathalon

I will be adding some more events to the schedule but even more than all of this - I am simply looking forward to being a Dad again and a Husband. It kills me each time my son asks me, "Is your back feeling better Dad?" I am so excited to say - yep! and snatch him off his feet and tickle him as he dangles mid air from my shoulder...

Recovery... finally!

2010-01-23T09:37:00.000-08:00

The worst is over...

Overall, the surgery (Complete Cervical C6/7 Artificial Disk Replacement) was a complete success (at least 2 days later). After gowning up, it was simply a waiting game. The surgery before me was delayed by about an hour which in most circumstances would be a real bummer as you anticipate the worst. Actually, though - it gave me time to meditate and get centered before the procedure was done. I went in feeling very calm, collected and centered. Here are some of the before photos showing everyone in a nervous but good spirit...

It's not the camera that adds the extra 40 lbs - its the gown... terribly unflattering especially when they pump it full of warm air. That said, its like sitting in a sauna at the gym and a huge improvement over past surgeries where your nerves seam to turn you into an icicle. You also may notice my uncommonly unshaven face. I had a truly grand plan of shaving the morning of the surgery. I failed at reading the "pre-opp" direction which are fairly clear - no shaving two days before surgery as it may increase infection. I was stuck with the Itchiest face ever going into the procedure.

The procedure started at about 4:30 and I finally came out at about 6:30 and woke up around 8:00. I can't remember much except talking my wife's yoga class up to the recovery nurse. It was a long night - walking up every few hours and getting restless sleep between. Overall the effects of the surgery paled in comparison to the side effects of the drugs they were giving me in fairly high dosages. First they started me out on Dilaudid.

For you chemist friends of mine... here is what the little guy looks like (cool 3D image that takes me back Chemical Engineering).

(Adverse effects of hydromorphone are similar to those of other opioid analgesics, such as morphine. The major hazards of hydromorphone include dose-related respiratory depression and sometimes circulatory depression.^[4] More common side effects include light-headedness, dizziness, sedation, constipation, nausea, vomiting, and sweating.^[4] Massive overdoses are rarely observed in opioid tolerant individuals, but when they occur they may lead to circulatory system collapse. - From Good old www.wikipedia.org)

For me, the worst of my night started with my second dose of Dilaudid where it felt like my chest was being compressed with a 250 lb weight. It took all my focus to raise and lower my chest and it scared the crap out of me. While this effect eventually died off, it meant that the nurses hooked me up to all the machines again to send an alarm if I did go into respiratory arrest. Later, the nausea and vomiting kicked in. To combat this, at about 8:00 the next morning they gave me some sort of anti-nausea drug which brought on the worst of my recovery - I had uncontrollable twitching, leg muscle spasms and shaking. On top of that, I had the worst anxiety - I would have done anything to get out of that hospital bed. It was the worst feeling on the planet and one that I would never want to repeat again. I finally got relief with more drugs, some sort of anti-convulsion/anti-seizure drug and Valium which helped me sleep a bit more.

Finally they asked me if I was in pain and I flatly lied to them saying NOPE - I FEEL GREAT! In hopes that they wouldn't give me anything else to make me feel worst. The good news is that they then prescribed good old Tylenol which I have been on ever sense. Sometimes I think it better that you just endure the "real" pain as opposed to the more awful side effects of the drugs they give you to cover it up.

All the worst said, I am soooooo relieved at the outcome of the surgery. The radiating pain in my shoulder and arm is GONE. The numbness in my fingers has lessened and the strength in my triceps has increased substantially. Am I sore? Yes - especially the muscles around my incision on the front of my neck. Honestly though, I have been in worse pain after a solid lacrosse game. I really can't complain and feel so blessed that I could get this surgery as soon as I did. I am looking forward to a 100% complete recovery!!!

I spoke with the surgeon after the procedure and he said I was a text book example of the perfect surgery. The herniated disk was one of the top 3 largest that he had seen in the cervical spine and hernias of this size are usually reserved for the larger disks in the lower part of the back It really justified the amount of pain, numbness and paralysis that I was feeling. A very heart felt thank you to the expertise, caring and excellent skills of Dr. Keenen and Dr. Tatsumi of Oregon Spine Specialist (www.orspine.com).

My wife has been fantastic - she has been so strong through this and so caring. I couldn't be a luckier husband. My mother-in-law Susan, my Dad and Step Mom have all been out here spoiling my boys and keeping them from using their delicate daddy as a jungle gym. Thanks to all who send their thoughts and prayers during and after the surgery and the meals coming in from Shannon's friends at "Mom's Club". You have all made this difficult time so much easier to bare.

I am looking forward to taking my first shower after my surgery - although with my Dad's help, I did shave last night to great relief. It also made me feel good that "Dad Duties" don't ever end :).

The Day Of

2010-01-21T06:38:00.000-08:00

In all honesty, I am really looking forward to the surgery... well maybe a better way of saying it is that I am tired of being in pain and ideally, the surgery is going to fix the worst of the pain and hopefully cause less than I have now. This last month has been bloody awful, plagued with sleepless nights, constant fatigue, constant nerve pain, paralysis in my triceps and numbness in my fingers. I really feel for people who are struggling with cronic pain - without relief it really wears on a person.

My surgery today was bumped up from its original time of 6:00 PM to 3:30. I need to be at the hospital for preparations by 1:30 and hopefully I will be out by 5:30 PM. Most likely I will be discharged from the hospital the following day but I am planning on being a "slow" recovery so that I can be pampered for another day so :).

Dr. Keenen, a very experienced neurosurgeon (30 years) and Dr. Tatsumi (a neurosurgeon and an instructor for implantation of artificial disks and has done 100s of these) will be working on me for what should be 1.5 hrs or so.

During my recovery, my beautiful and wonderful wife will be keeping my blog up to date with my recovery status.

Check back to see how everything goes!

Its Official

2010-01-19T15:29:00.000-08:00

Well,

I am scheduled for a Cervical Disectomy and artificial disk implant on Thursday at 6:00 PM. I had my pre-opp appointment this morning with the doctor and really feel good about the procedure. As my current surgeon (Dr. Keenen) has only done 15 of these surgeries, he will be joined by his partner, Dr. Tatsumi (http://www.orspine.com/doctors.html) who has done over 50. I am hoping that this will help me over the long term to prevent other disk injury which could have been caused by a total vertebrae fusion.

I don't have much time now but wanted to share the following video as a way to describe the procedure.

Cut Me Where???

2010-01-17T14:49:00.000-08:00

I am not sure why... but I was totally prepared to schedule a surgery on this herniated disk. I had come to terms with it and was ready to move forward. I have to say though, I was taken by surprise when I was told that they would be cutting through my throat to access my spine from the front! It doesn't take a engineer to figure out the shortest distance between two points is a straight line and if you have two straight lines of different length, it is generally easy to figure out which of those straight lines is the shortest. Well... where is your spine??? On the the front of your neck? Nope - even I know this one, your spine runs down your back. It seems logical to me that to get to your spine, you should probably cut through the back not the front!!!

Enough sarcasm, here are the stats on what the Neurosurgeon says:

Severely herniated disk C6/7
Disk degeneration C6/7
Bulging disk C5/6
Disk degeneration C5/6
Bone spurs forming on C 5/6/7 (the body's natural way of fusing these joints to protect the spine).

Plan:

Cervical discectomy and fusion (C5/6 and C67)
Cut into the neck, through the throat to access the spine from the front.
Remove all of the disk material from C5/6 and C6/7 (maybe - but definitly C6/7)
Utilize a cadaver bone graph to facilitate bone generation and cervical vertebral fusion.
Attach a titanium plate to the two vertebrae to support the bone graph.
Surgery take 1.5 hrs and then overnight stay at the hospital for observation.
There are lots of good to gruesome videos out there (just Google the Cervical Discectomy and Fusion

Anterior Cervical Discectomy
Uploaded by mkohne. - Independent web videos.

Recovery:

Initially, things won't be fun with 4 or 5 days of local pain (at the surgical site and throat).
The Nerve pain should be gone but this will be replaced with the surgical pain.
The doctor suggests getting up and moving around in the first few days anything out of bed will require a C-Collar for neck suport.
For the first 2 weeks - picking up nothing heavier than a cup of coffee.
For 6 weeks nothing heavier than a milk jug (try this on for size when both of your toddlers are much heavier than a milk jug)
After the first couple of weeks, I should be able to get back to the gym and sit in the recline (granny) bike and peddle to keep my heart rate up.
After the first couple of weeks, I will be engaged in controlled physical therapy.
I should be back in business by 12 weeks (3 months) able to train for all of my endurance sports.

I am awaiting the actual surgical scheduling but should know more on Monday. I will keep you all posted!

Just Say NO - Train Your Brain

2010-01-13T13:36:00.000-08:00

Hi All,

Well it has been a long week since my last post where I was officially diagnosed with the herniated disk. I am so glad to know what I am dealing with - and that I now know it is not some strange inflammation that takes years to recover from and no one can treat. That said, I am also feeling frustrated and impatient with our wonderful world of Western Medicine. In this world, you can get seriously addictive drugs at the snap of a finger to treat the symptoms, but it takes weeks (if not months) to actually determine and treat the true cause.

It will have taken me a full month to finally get an appointment with a Neurosurgeon and maybe longer to get the issue addressed and fixed. During this time, I have been prescribed everything from Steroids to Percocet - but nothing has been done to actually get me back on track with recovery... AND I AM A BLOODY PAIN IN THE ASS!!! I call my doctors daily because if I don't, it may be a week before they get to me in their pile of patients...

One word of advice to other who are beginning this process - BE YOUR OWN DOCTOR, the internet is available to us all and don't let a doctor (who doesn't really care about you) tell you about your body. Second, BE A PAIN IN THE ASS. I have found that in this world, the squeaky wheel gets the grease and I have been screaming like a worn fan belt.

Well, I also refuse to become a pain med addict, I refuse to habituate to muscle relaxers and I refuse to carrode my Kidneys and Liver dealing with the pain. So what I have I done (or am beginning to do) - train my brain.

Time to get honest - three nights ago, I realize that I was inappropriately using my muscle relaxers to get some sleep. I would take two before bed (regardless of whether or not my muscles were cramping) just for the narcotic effect. The pain didn't diminish - I just didn't care about it as much. This would ware off at about 4:00 AM anyway and I would wake up getting only 4 hrs of sleep. What did I do? I quit!

The first night was brutal - I was wide awake until about 4:30 (watched "We Were Soldiers"). I woke up again at 5:30 and felt like a zombie the rest of the day. I did allot of mediation that night but to no avail, my body (in just 3 weeks) had become habituated to the drug.

The next night I took things seriously and spent an hour mediating before bed and got to sleep at 10:30, waking at 5:30 - this was like sleeping in for me at this point and I was ecstatic. Last night I did the same, adapting a mediation technique I read about from a book by Deepak Chopra. This technique was called (or is referred to as) the So Hum Mantra Meditation. It was absolutely amazing!!! Further research today into the mantra reviled that it geared to the Spine Chackra - here is some instruction:

The traditional method from what I understand incorporates 108 repetitions of So Hum mantra in about 17 minutes of meditation practice, at a rate of about 6 1/2 breaths per minute, which is extremely relaxing both for meditation and reducing stress in the autonomic nervous system. The Hummmm... sound is intentionally somewhat longer than the Sooooo... sound, as this increases the effect of the relaxation and meditation by releasing the autonomic nervous system.

Inhale silently with Sooooo...
Exhale silently with Hummmm...

Click here for more info on Sohum

I slept last night for 7 hours - much longer than I have slept in the past 3 weeks with drugs. The pain I am experiencing has not decreased or abated.

The feeling of freedom from the prescription drugs is so liberating - I am so terribly excited about this new found tool to not only control pain but decrease stress, quiet my mind, get present in my life and eventually (once I am through my recover of this) adapt my meditation to my training and competing.

If you are a doctor out there - please consider the power of Eastern meditation and homeopathic ways of healing. If your a patient - please know, there are other alternatives that allow you to deal with pain/sleep/stress without the little understood but terribly powerful world of pharmacological treatments.

Note - I am still on the anti-inflammatory (non-steroidal). These really do seem to decrease the amount of constriction on the nerve, minimizing the paralysis in my triceps and the amount of radiating "fire" pain down my arm.

MRI Results

2010-01-07T14:41:00.000-08:00

OK... I DID IT!!!!

Through focused meditation and visualization... oh and 2 Percocet, 500 mg Naprocin and a muscle relaxer - I was able to grit through 20 min of real pain. The meds took a bit of the edge off but it still really sucked. The good news is that we got good images which at this point confirm that this IS NOT BRACHIAL NEURITIS!!! Unfortunately, it is not my imagination either :). It looks to be a herniated disk and by the looks of it a "huge one". I quote an orthopedic surgeon who is a family member of mine.

Here are the MRI images:

Photo 1

Photo2

Photo 3:

Both photo 2 and 3 show the tell tale signs of a herniated disk and I guess it is fairly large which does correspond to the fairly large amount of pain I have been feeling!

Here is what I have learned thus far about Cervical Radiculopathy (Herniated disk)...

All of the information below was accessed from (http://www.spine-health.com and was written by:

By: Richard Staehler, MD)

Arm pain from a cervical herniated disc is one of the more common cervical spine conditions treated by spine specialists. It usually develops in the 30 - 50 year old age group. Although a cervical herniated disc may originate from some sort of trauma or injury to the cervical spine, the symptoms, including arm pain, commonly start spontaneously.

The arm pain from a cervical herniated disc results because the herniated disc material “pinches” or presses on a cervical nerve, causing pain to radiate along the nerve pathway down the arm. Along with the arm pain, numbness and tingling can be present down the arm and into the fingertips. Muscle weakness may also be present due to a cervical herniated disc.

Fig. 1: Disc herniation of the cervical spine

The two most common levels in the cervical spine to herniate are the C5 - C6 level (cervical 5 and cervical 6) and the C6 -C7 level. The next most common is the C4 - C5 level, and rarely the C7 - T1 level may herniate.
The nerve that is affected by the cervical disc herniation is the one exiting the spine at that level, so at the C5-C6 level it is the C6 nerve root that is affected.

Symptoms of a Cervical Herniated Disc

A cervical herniated disc will typically cause pain patterns and neurological deficits as follows:

C6 - C7 (C7 nerve root) - Can cause weakness in the triceps (muscles in the back of the upper arm and extending to the forearm) and the finger extensor muscles. Numbness and tingling along with pain can radiate down the triceps and into the middle finger. This is also one of the most common levels for a cervical disc herniation (see Figure 1).

It is important to note that the above list comprises typical pain patterns associated with a cervical disc herniation, but they are not absolute. Some people are simply wired up differently than others, and therefore their arm pain and other symptoms will be different.
Since there is not a lot of disc material between the vertebral bodies in the cervical spine, the discs are usually not very large. However, the space available for the nerves is also not that great, which means that even a small cervical disc herniation may impinge on the nerve and cause significant pain. The arm pain is usually most severe as the nerve first becomes pinched.

Treatments for a Cervical Herniated Disc

The majority of the time, the arm pain from a cervical herniated disc can be controlled with medication, and conservative (non-surgical) treatments alone are enough to resolve the condition.

Once the arm pain does start to improve it is unlikely to return, although it may take longer for the weakness and numbness/tingling to improve. If the arm pain gets better it is acceptable to continue with conservative treatment, as there really is no literature that supports the theory that surgery for cervical disc herniation helps the nerve root heal quicker.

All treatments for a cervical herniated disc are essentially designed to help resolve the arm pain, and usually the weakness and numbness/tingling will resolve with time.

First line of treatment for a cervical herniated disc

When the initial pain from a cervical herniated disc hits, anti-inflammatory medications (NSAIDs) such as ibuprofen (e.g. Advil, Nuprin, Motrin) or COX-2 inhibitors (e.g. Celebrex) can help reduce the pain.
The pain caused by a cervical herniated disc is caused by a combination of:

pinching of the nerve root, and;
inflammation associated with the disc material itself.
Therefore, taking anti-inflammatory medications to remove some of the inflammation can reduce this component of the pain while the pressure component (pinching of the nerve root) resolves.

For patients with severe pain from a herniated disc, oral steroids (such as Predisone or a Medrol Dose Pak) may give even better pain relief. However, these medications can only be used for a short period of time (one week).

Additional conservative treatment options for a cervical herniated disc

In addition to anti-inflammatory medications, there are a number of non-surgical treatment options that can help alleviate the pain from a cervical herniated disk, such as:

Physical therapy and exercise. Just as in the lumbar spine, Mckenzie exercises can be used to help reduce the pain in the arm. In the initial period a physical therapist may also opt to use modalities, such as heat/ice or ultrasound, to help reduce muscle spasm.
Cervical traction. Traction on the head can help reduce pressure over the nerve root. It does not work for everyone but is easy to do, and if effective the patient can use a home traction device for pain from a cervical herniated disc.
Chiropractic manipulation. Gentle manipulation can help reduce the joint dysfunction that may be an added component of the pain. High velocity manipulations should be avoided as they can make the pain worse, or worsen any neurological damage.
Osteopathic medicine. Osteopathic manipulation and special techniques to restore normal joint motion can be helpful in reducing pain from a cervical herniated disc.
Activity modification. Some types of activities may tend to exacerbate the herniated disc pain and it is reasonable to avoid these activities to keep from irritating the nerve root. Such activities may include heavy lifting (over 50 pounds), activities that can cause increased vibration and compression to the cervical spine (boating, snowmobile riding, running, etc.), and overhead activities that require prolonged neck extension and/or rotation.
Bracing. In some instances a cervical collar or brace may be recommended to help provide some rest for the cervical spine.
Medications. In addition to the anti-inflammatory medications mentioned above, narcotic agents (pain killers) might be used on a temporary basis to help reduce the pain and discomfort from a cervical herniated disc. Also, muscle relaxants or certain anti-depressants may help reduce the nerve-type pain (neuropathic pain) and help restore normal sleep patterns.
Injections. Epidural steroid injections or selective nerve root blocks can be helpful to reduce inflammation in cases of severe pain from a cervical herniated disc, and can be very effective if accompanied by a comprehensive rehabilitation program that may involve a number of the above conservative treatments.

Physicians who provide the above treatments for a cervical herniated disc may include family practitioners, physiatrists (physical medicine and rehabilitation physicians), osteopathic physicians, neurologists, and orthopedic spine surgeons or neurosurgeons. Chiropractors and physical therapists may also provide some of the above treatments for a cervical herniated disc in their respective areas of specialization.

Spine Surgery for a Cervical Herniated Disc

Fig. 2: Bone graft

Fig 3:
Titanium plate and screw device

Most episodes of arm pain due to a cervical herniated disc will resolve over a period of weeks to a couple of months. However, if the pain lasts longer than 6 to 12 weeks, or if the pain and disability is severe, spine surgery may be a reasonable option.

Spine surgery for a cervical herniated disc is generally very reliable and can be done with a minimal amount of postoperative pain and morbidity (unwanted aftereffects).

With an experienced spine surgeon, the back surgery should carry a low risk of failure or complications. The success rate for back surgery for a cervical herniated disc is about 95 to 98% in terms of providing relief of arm pain.

The spine surgery for a cervical herniated disc can be done a number of different ways:

Anterior cervical discectomy and spine fusion. This is by far the most commonly preferred method among spine surgeons for most cervical herniated discs. In this surgery, the disc is removed through a small one-inch incision in the front of the neck.

After removing the disc, the disc space itself is fused (see Figure 2). A plate can be added in front of the graft for added stability and possibly a better fusion rate (see Figure 3). For more information, see Anterior cervical decompression (discectomy) back surgery

Anterior discectomy without spine fusion. This is basically the same procedure as above except after removing the disc the space is left open and no bone is added to get a fusion. The disc space will still often fuse even without a bone graft but the healing seems to be longer and when and if it does heal, it tends to heal in a deformed position.
For more information, see Anterior cervical decompression (discectomy) back surgery
Posterior cervical discectomy. This is similar to a posterior (from the back) lumbar discectomy, and for discs that occur laterally out in the neural foramen (the “tunnel” that the nerve travels through to exit the spinal canal) it is often a reasonable approach. However, it is technically more difficult than an anterior approach because there are a lot of veins in this area that can result in a lot of bleeding, and the bleeding limits visualization during the surgery. This approach also necessitates more manipulation to the spinal cord.

For more information, see Posterior cervical decompression (microdiscectomy) surgery

Potential risks and complications of spine surgery for a cervical herniated disc

Although any major surgery has possible risks and complications, with an experienced spine surgeon serious complications from cervical disc surgery should be rare.

Possible complications from spine surgery for a herniated disc include:

Damage to either the trachea/esophagus or one of the major blood vessels in the anterior spine (front of the neck). This should happen in less than 1 in 1,000 cases.
In about 1% of cases, retraction on the nerve to the voice box (recurrent laryngeal nerve) can cause hoarseness. The hoarseness usually resolves in two to three months.
Fusion rates run about 95%. Occasionally, there may be a postoperative nonunion that requires a re-fusion. Without a cervical plate there is a possibility (less than 1%) that the anterior bone graft will displace.
With either the anterior or posterior approach there is a 1 in 10,000 chance that there would be either nerve root or spinal cord damage.
Infection or cerebrospinal fluid leak happens less than 1% of the time.

Postoperative Care Following Spine Surgery for a Cervical Herniated Disc

For anterior surgery, there usually is not a great deal of postoperative pain. The surgery is done through a small incision in the front of the neck, and the spine can be accessed in between tissue planes that do not require cutting. This type of surgery usually can be done either outpatient (going home the same day as surgery) or with one overnight stay in the hospital.

The pain in the arm usually goes away fairly quickly, although it may take weeks to months for the arm weakness and numbness to subside. It is not uncommon to have some neck pain for a while.

Postoperatively, most spine surgeons prescribe a neck brace, although the type of brace and length of usage is variable. Also, most spine surgeons will ask their patients to limit their activities postoperatively, although the amount of restrictions and the length of time tend to vary. Ask your spine surgeon before the surgery what his or her usual protocol is regarding postoperative care.

Ya, lots and lots and lots of information, I know. Anyway, I hope this blog can be a resorce for others going through this. I will hear specifically from my doctor tomorrow and I will be seeking other opinions - I will fill you all in when this is done.

Thank you!

MRI - A painful failure

2010-01-05T14:12:00.000-08:00

Hello All,

Good news and frustrating news today. Yesterday, I was able to see a Neurologist. He confidently believes that my initial diagnosis of Brachial Neuritis was incorrect and I am actually struggling with a Cervical Radiculopathy (Herniated Disk). He described it to me this way... "In 25 years as a practicing Neurologist, I have seen one case of Brachial Neuritis whereas I have seen countless cases of herniated disks. We won't know definitivly until the MRI but if it quacks like a duck, looks like a duck and walks like a duck - it is most likely a duck."

Great! Phew... we can do something about that right?

I sceduled the MRI for the first available oportunity - this morning at 7:00 AM and I was right on time. After getting ready, I layed down on the sled and BLINDING PAIN begain coursing through my shoulder and arm... BLINDING... I honestly didn't appreciate that discriptor until today. Blinding pain is truely Blinding. Even thinking about it as I write this churns my stomach. I told myself, "OK - 12 min... I can do this..." Within 2 min I was whimpering like a baby, all the blood had left my face, bile begain to build in my throat and I was madly squeezing the little "GET ME THE F**K OUT OF HERE" ball that they give you for the truely panic stricken. There is a reason why I am still sleeping sitting up. Hell, laying down on a bed (down comforter and a pillow top matress) hurts me - the hard plastic sled they gave me today was worse than torture.

End result... I still don't know definitively what is wrong back there but if nothing else - this morning was a brilliantly painful reminder that something IS wrong. I have left three messages with my doctor to evaluate other options. As far as I am concerned, put a mask on my face and a IV in my arm because I can't do that again with any resemblance of consciousness.

Happy New Year!

2010-01-03T21:52:00.000-08:00

Hello Everyone,

Happy new year! I wish I was starting things out in a bit of a stronger way but I am telling myself, "I am getting the worst of the year over with in the very beginning." Today was a struggle for me - it started with a realization that that the paralysis is setting in in my left triceps. I am having trouble extending my left arm from the elbow when held over my head. This was a realization that this is real and it is not going to be like the rest of the injuries that I have worked through over the last 30 years. This was followed by shaking and tremors while trying to do simple things with my left hand (shuffling a deck of cards for instance). In all honesty, I am feeling scared.

I wasn't sure if the pain medication was working or not. The anti-inflammatory and muscle relaxant does allot to irritate my stomach but the pain didn't seem to have diminished. I thought I would try and entertain myself today and put it to a test - stopping the medicine and see how I was fairing towards the end of the day. The result was allot more pain which was frustrating in its own right.

Tomorrow I am looking forward to a appointment with a neurologist. I really am looking forward to it - maybe (I am preying) I will have an answer as to what is going on. While there has been a written diagnosis of Brachial Neuritis, no one can really confirm it without a MRI and Nerve Conduction Test. I am hoping that the neurolgist can make this happen for me quickly - confirming a diagnosis, giving me a prognosis (so I know what I am up against) and a agressive plan of attack to overcome this.

Lastly, the gift of feeling grateful for the rest of my life, and my family is still with me. I think of Pablo and his father Jeff everyday when I feel the frustration and doubt set in. I realize that I would live everyday with this pain if it meant that I could continue to be with my wife and children. Thank you Pablo.

May we all have a happy 2010.

Healing From Within

2009-12-30T22:19:00.000-08:00

A few things to note here...

I have only been dealing with this neck thing now for 2 weeks and I am already sick of doctors.
I have learned when they don't know whats wrong, they prescribe drugs.
I am sick of feeling doped up from the muscle relaxers.
I am sick of feeling buzzed from the steroids.
I am sick of worrying about my kidneys from the ibuprofen.
I am sick of not sleeping.
I am tired of booking appointments with specialists 2 weeks out, when I am in pain now.

I am taking on a new intention. While I am not a doctor and I am not licensed to heal others, I truely believe that I have every right and every ability to heal myself. I believe that a true intention has power and if someone has the intention to heal themselves, they can.

Tonight I took action and turned away from work, the kids, TV and other distractions and sat quietly and meditated. I envisioned my body being filled with a toxic slag. Something looking similar to coal sludge - a dark, toxic black crud which is eating away at my body, literally stinking inside. This muck is synonymous with all of the negative thoughts, feelings and emotions I feel throughout the day. The anxieties over money, the impatience with the kids, the fear over my back and neck, the pain I feel, the lack of sleep.

While deep breathing, I imagined that my toes and fingertips were like screw on caps - unscrewed, this black sludge would flow out of me, slowly but steadily. While much of my inner self is left a healthy, life sustaining pink - there are other areas which have retained some of the sludge - dried up and caked on. These areas, corresponding with my most intense pain need be be scrubbed - even power washed of this toxic slime. Once every area is clean and the walls of my body look like that perfectly healthy pink of a babies lips - I fill myself back up.

The refill is done in the reverse, starting at my toes, creeping past my knees, my hips, my shoulders and eventually my cranium. The fluid is holy water, blessed by God for health and heeling - a pure fluid connection to my inner being, my soul.

This fluid represents health, peace and serenity. This fluid is ultimately conductive - allowing for the energy of my physical body to flow, unrestricted from my core to my limbs and back again.

I then visualize my energy flowing - a white electric light flowing through my conductive paths within this fluid medium. I visualize my body as the energy that it is and that the energy is moving without obstructions - especially in those places where I hurt, I am tight. This is especially easy now as the pain radiates down my nerve - the main pathway for electrical energy to travel throughout our bodies.

The end result - after the 45 min mediation, my pain had gone. The fire down the back of my arm had cooled. The numbness in my fingertips was still there but it was able to be embraced. I sat still for a few moments, relishing in the lightness that I felt.

Then, I moved - well the world is not perfect - and the pain flooded back in, but my mind was left in a better, more present place to deal with the pain. I was better able to be kind to my wife and had lost the low grade anxiety that lives within me.

Overall - a brilliant success, something I will continue to investigate and practice. By the way, I am still going to the neurologist on Monday but until then - maybe I can take some of this into my own hands instead of depending on a doctor who really doesn't care about me...

That's it for now... Happy New Years Eve!

MD MIA

2009-12-28T16:13:00.000-08:00

Hello All,

Well, the diagnosis has been narrowed down to two suspects with the most predominant being "Acute Brachial Neuritis, C6 and C7". The second being "Cervical Radiculopathy". There are significant differences in treatment but the symptoms are very similar.

Acute Brachial Neuritis:
Acute Brachial Neuritis or Brachial Neuritis (BN), also known as neuralgic amyotrophy, is a rare syndrome of unknown etiology affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. BN usually is characterized by the acute onset of excruciating unilateral shoulder pain, followed by flaccid paralysis of shoulder and parascapular muscles several days later. The syndrome can vary greatly in presentation and nerve involvement. (http://emedicine.medscape.com/article/315811-overview)

FIGURE 1. Acute brachial plexus neuritis usually involves the upper plexus, which supplies the shoulder and upper arm muscles. Weakness is frequently found in the rhomboideus major and minor muscles (dorsoscapular nerve), supraspinatus and infraspinatus muscles (suprascapular nerve), deltoid muscle (axillary nerve) and biceps muscle (musculocutaneous nerve). (http://www.aafp.org/afp/20001101/2067.html)

Symptoms:

Sudden onset of pain in shoulder
Arm
Neck or hand
Weakness in arm and shoulder
Difficulty moving arm and shoulder
Pins and needles
Numbness in arm
Shoulder and hand
Fatigue
Malaise
Headache
Muscle aches and pains
http://www.wrongdiagnosis.com/b/brachial_neuritis/symptoms.htm#symptom_list

Cervical Radiculopathy:
Cervical radiculopathy is a dysfunction of a nerve root of the cervical spine. The seventh (C7; 60%) and sixth (C6; 25%) cervical nerve roots are the most commonly affected. (http://emedicine.medscape.com/article/94118-overview)

Nerve root dysfunction, which is usually secondary to chronic pressure or invasion of the root, causes a radicular syndrome of pain and segmental neurologic deficit. Cervical (neck) disk syndrome involves pain, numbness and muscular spasm of the neck, radiating to the shoulders, caused by irritation and compression of the cervical nerve roots by a protruding intervertebral disk. (https://health.google.com/health/ref/Herniated+nucleus+pulposus).

(http://www.orthogate.org/patient-education/cervical-spine/cervical-radiculopathy.html)

(http://www.orthogate.org/patient-education/cervical-spine/cervical-radiculopathy.html)

Symptoms:

Arm muscle weakness
Deep pain near or over the shoulder blades on the affected side
Neck pain, especially in the back and sides
Increased pain when bending the neck or turning head to the side
Pain radiating to the shoulder, upper arm, forearm, and rarely the hand, fingers, or chest
Pain made worse with coughing, straining, or laughing
Spasm of the neck muscles
https://health.google.com/health/ref/Herniated+nucleus+pulposus

Comparison:

Graciously Stolen from (http://www.aafp.org/afp/20001101/2067.html)

TABLE 1
Comparison of Acute Brachial Plexus Neuritis and Cervical Radiculopathy

Condition	History	Examination	Tests and results	Treatment
Acute brachial plexus neuritis	Intense, burning pain begins in shoulder and upper arm. Pain is unaltered by neck or arm movements. Pain is spontaneous, often with no apparent cause. Gradual decrease in pain followed by marked weakness of upper arm.	Neurologic deficits indicate that more than one nerve is involved (i.e., lesion in the plexus).	Electromyography and nerve conduction studies obtained three to four weeks after symptom onset reveal abnormalities consistent with a brachial plexus lesion. MRI scan of the clinically weak muscles may reveal high signal intensity on T₂ images; these changes may appear within days following onset of symptoms.	Analgesics as needed for pain Physical therapy to maintain strength and mobility If deltoid muscle is profoundly weak, recommend a sling to avoid subluxation of humerus. Encourage patient that condition usually, but slowly, improves.
Cervical radiculopathy	Pain begins in neck and radiates down the arm for variable distances. Pain is aggravated by neck movements. Pain may begin spontaneously following physical exertion or trauma, but may have no apparent cause. Pain and muscle weakness occur simultaneously.	Weakness and numbness in the distribution of a single nerve root (contemporaneous with the neck and arm pain)	Cervical spine radiograph may reveal interspace narrowing and osteophytes. MRI scan or myelogram followed by computed tomographic scan may reveal osteophyte or herniated disc pulposus consistent with clinical findings.	Analgesics as needed for pain Steroid therapy may help decrease nerve root irritation. Muscle relaxants for muscle spasms Physical therapy Massage and cervical traction Anterior and posterior surgical procedures to decompress involved nerve roots

MRI = magnetic resonance imaging.

So, assuming that the good doctor is correct - the condition is a result of a viral infection at the nerve root of the cervical spine. What??? Really??? I guess the good news is that this won't kill me... The bad news is, no one can really tell me what caused this but my research has surfaced the fact that many people who come down with this afliction have also suffered another viral infection in the most recent history (preceeding few weeks) as I did when I came down with the flue just before Thanksgiving.

Even worse - and no the Dr. didn't say anything about this... here is the bloddy prognosis... After the pain goes away, the condition is charicterized by extreme weakness and muscle waisting. Ya, muscle waisting...

This isn't me... god please don't let this be me...

Speaking of the Doctor. Wow, I felt so lucky! I finally found a doctor that I really like. I met with Dr. Karl N Kaluza on Wednesday. I didn't realize this but this was his last day under Dr. Selby's roof. He has left the practice to places unknown and the bitch of this is that Dr. Selby's office (for fear that I might jump ship) won't give me his forwarding information so that I can inquire about the diagnosis he delivered! By the way, their fear is justified, I am tired of going to the Vicoden spiewing Dr. Selby. All he does is write scripts for Vicoden and each time I tell him that I don't need it. Haha, I got a vicoden sript for the flu! Note to all: Don't go see Dr. Selby.

Anyway, I finally find a Doctor that I really like and he has disapeared with all the answers to my questions!!! ARGUHHH!!! MY MD IS MIA!!!

I was feeling so stir crazy today, I had to get something which might resemble a workout... I hit the gym and decided that the pool would be the most gentil way of increasing my heart rate. Here is the extent to what I was able to accomplish (by the way, I am happy about this - 5 days ago, I was bound to the couch in physical agony).

* 50 M Pool running
* 50 M Kick board (this hurt as I had to hold my head up out of the water)
* 50 M Pool running
* Hot tub therapy
* Steam room therapy

... Well... its better than nothing!