“We’re going to have to stop meeting like this.”

 

For the second time this year, I’ve gone under the knife. You might recall that back in the summer that I had a mountain bike wreck that broke some ribs and collapsed a lung. A chest tube and hospitalization followed that.

Well, last week, I had a double hernia repair. Be warned that this may contain more information than you want to hear, but I promise it will be all PG.

A couple of weeks ago, I had a hard workout on Monday, a mountain bike ride on Tuesday, and had just finished an early hour on the stationary bike when I jumped in the shower to get ready for my work day. As I showered, let’s say, “down there,” I felt this ping pong ball in my right groin.

Being the worry-wart that I am and having a primary care physician (Dr. Kevin Turner) that is accommodating and understands me, I went immediately to his office where he declared “Joe, that’s the easiest diagnosis I’ll have today—you have a hernia.”

OK. So be it. What followed the next week were lab studies, a contrast CT, and a visit with surgeon Dr. Stephen Pacifico. About Dr. Pacifico:  He played linebacker for us at MHS and has made a fine surgeon. I have all the confidence in the world in him.

Yep, it was a hernia. And yep, I needed surgery, which was scheduled for the following week. Oh, and there was a hernia on the other side too.

Back up a bit to the why. Dr. Pacifico and I agreed that while I might have the muscles of a 30 year old, I have the connective tissue of a 70 year old. And I do lift heavy stuff from time to time. I lift heavy weights, sometimes assist with transfers of heavy patients, and I work hard on the farm. Not to mention the 99 V-ups that I did in that Monday workout.

Hernias don’t just happen to old people like me either. I’ve had younger athletes that have had them. They can happen to any active individual, although they happen to men more than women.

So, now it’s time for the fix. On Dr. Pacifico’s recommendation, I chose a laparoscopic procedure, with both hernias being repaired through the same small holes. On that Wednesday, now a week and a half ago, I reported to Blount Memorial Outpatient Surgery. After check in, Scott the RN took me back and pretty much stayed with me until they took me back for surgery.

Thorough and friendly, Scott has been a traveling nurse for the last few years and has been to some cool places. I’m not using last names here because frankly, I don’t remember them. Keep in mind, the sedation process had already started.

Nurse anaesthetist Lakosha (spelling?) was next and was super. One of the nurses that took me back was Christy and she was friendly and memorable. I don’t remember the other nurse’s name but Christy was the one holding my hand when they finished sedating me.

About that moment. I’m human. I was pretty cool about the whole thing up until that moment. My BP was still good but I was admittedly anxious at that point. The entire surgical team, Christy, the other nurse that took me back, the two scrub nurses, Lakosha, and the anaesthesiologist (I can’t remember her name either but she was good) gathered around me and told me “we are going to take really good care of you.”

I remember that! And the next thing I know, I’m waking up with a sore belly and another nurse that I’ve known for a while, Montana.  She was a student trainer at Heritage High School and Maryville College, and while at MC was the recipient of the Carl H. Black Outstanding Student Trainer Award, named after my dad.

Needless to say, it was awesome to see her. I know that she is the best. Oh, and Dr. Pacifico had filled my wife in on the surgery. It was way more complicated than he had expected but it all went well.

To wind this story down, I’m fine. I’m back at work. I’m being a good patient. And I won’t be doing V-ups for a while. But my experience through all this has been what health care should be all about.

Every day: back pain

It has been estimated that 80% of adults have an episode of significant low back pain in their lifetime. If you think you are in that 20% that hasn’t, then you better be doing everything you can to protect your back—the odds are stacked against you.

I suppose everyone that lives long enough will have some sort of back pain. I think I’m in that 20% but I’ve had an achy back from time to time, mostly when I’ve overdone it.

I had one of those man-on-the-street encounters last week that my wife has learned to tolerate as part of being my wife of over 47 years. We were in this fellow’s place of business when he asked if I had any advice for him in dealing with his back pain.

More specifically, he asked me if there were any stretches that he could do to help his back. I have no idea how many times I’ve been asked that exact question.

It doesn’t matter what body part it is, a lot folks think that the only physical therapy strategy for dealing with their physical complaints lies in a couple of stretching exercises.

Back to this guy—he’s a super nice guy who works too much. And part of his job is lifting heavy objects from time to time. So we chatted about how his pain behaves and what he has done in the past to control it—that sort of thing. Back to him in a minute.

I get stopped a lot and usually the conversation starts with “I know you must get tired of people asking you about their complaints, but…”

As soon as I can get a word in edgewise, I assure them that I don’t mind at all. I’m flattered that anyone wants my opinion at all (except maybe about religion and politics—two things I avoid discussing) but especially about their health.

My wife long ago figured out that this was part of makes me me. I’m still doing this stuff well into my senior years (I’ve been a physical therapist for 46 years now) because I love it. And most of that is helping people. It’s also part of what makes a physical therapist a physical therapist.

Anyway, it is rarely about stretching. Sure, tight joints and muscles can be a part of the problem but that is rarely the basis of the problem. For this fellow, his biggest problem is his core strength. That’s just not something many people pay much attention to.

What happens is that our life gets in the way of regular exercise and then we help our neighbor move or stack firewood or something else that we don’t do regularly and the next thing you know--BAM!--back pain.

My first aid formula for most injuries is the same. Ice and ibuprofen. Most of the time, it pays to keep moving. Curled up in a hot tub or bedrest and doing nothing is rarely a good idea.

To know what to do next, the best thing is to consult a spinal care expert, like a physical therapist. But that option is not always available. The best advice that I can give if that’s the case is to keep moving.

To prevent it from happening, you’ve got to develop good core strength and learn good body mechanics. Plank. Bird dog. Cat and Cow. Have someone that knows what they’re doing to watch your lifting techniques.

Lift weights. Stay in shape. Lose weight if you need to. Take the stairs. Park at the outer edge of the parking lot.

Above all else, keep moving.

ALS

 

ALS, or Amyotrophic Lateral Sclerosis, is also known as Lou Gherig’s Disease. ALS is not really a disease, but a progressive degenerative disorder of the nerves in the brain and spinal cord.

Lou Gherig was known as the Iron Horse of baseball, having played in 2,130 consecutive baseball games. When he was diagnosed in 1939, little was known about ALS.

On July 4^th, 1939, Gherig gave a speech that is one of the most memorable sports speeches in the history of sports. Knowing that he was going to die (he lived two more years) and knowing the horrors of ALS, he stood at home plate in Yankee Stadium and uttered the following words:

“For the past two weeks, you have been reading about a bad break. Yet today I consider myself the luckiest man on the face of the earth.”

For a small percentage (maybe 10%), it can be a genetic mutation. For those, it is known as Familial ALS. But for 90% of those that get ALS, there is no known reason. It hits men slightly more than women and onset falls into the range of 40-70 years of age.

ALS often starts in the hands and feet, with tingling and burning progressing to include weakness in the arms and legs. As it progresses, it encompasses any and all muscles, including the muscles used for swallowing, talking, and breathing. Cognitive functioning remains intact in most cases, which means that the person is fully aware of what is happening to their body.

ALS is not considered a sports injury, but there does appear to be a higher incidence of ALS in military veterans and athletes, particularly football players.

There is no cure for it. It is a devastating disorder, slowly robbing the person of all control.

No one knows why it affects one group more than others, but there are some similarities in combat veterans and football players. It has been speculated that repeated trauma might make a person more likely to get ALS, but we really have no idea about that. Life expectancy is 2-5 years and ALS progresses at different rates for different people.

In other words, we just don’t know much about it. But research is ongoing and hopefully a cure will be found one day. It’s an ugly, nasty disorder that slowly robs the person of their body.

Last week, I mentioned the best football player I ever played with. A gifted athlete at whatever he did, he was especially good at football. He was most definitely a “natural,” but he coupled that with a strong work ethic to become the best of the best.

On offense, give him the football and watch him go. On defense, he was one of those players that was always around the ball. We used to say people like that “have a nose for the football.” He definitely had that.

Maryville native and football coaching legend Ollie Keller recruited him to play at Memphis State but circumstances prevented that from happening. I have no doubt that he would have been a college star and maybe a career NFL player. He was really that good.

His name is J.L. Millsaps and he had ALS. He died this weekend.  In his last days, he could hardly move his once strong body. He spoke only in a whisper and was rarely able to even open his eyes. He knew the end was near, yet, his spirit and his faith remained rock solid. RIP JL.

 

Living Vicariously

 

Everybody wants their kid to be the star of the team. Everybody wants to be on the winning team. It’s just human nature. Everybody, meaning parents.

Interestingly, kids don’t think the same way. Oh, if you ask them what they want to do when they grow up, a fair number of them will say that they want to be a professional athlete in one sport or more.

But if you really dig into it, you will find that they just want to have fun and be with their friends. No doubt, winning is important to them but boiled down to its essence, they want to enjoy their sports.

You have no doubt heard about parents living “vicariously” through their kids. The earth may shake and the dead may roll over, but I’m here to tell you that isn’t always a bad thing.

I have seen a lot of parents who either were never athletes themselves or never had the opportunity to be an athlete. I remember one local athlete that was phenomenal, but when you look at her parents, you wonder how that could have happened.

Neither of them had an athletic bone in their body. But their daughter sure did.  Sometimes those things happen. I’m sure those parents enjoyed their daughter’s success.

Then there are the folks that didn’t have the opportunity. A lot of that is economic. Some kids have to hold down jobs to help the family. My dad dropped out of school after the 6^th grade when his own father died. He went to work in a hosiery mill and never went back to school.

Think about that. He was 11, maybe 12 years old, and already working in a factory alongside adults. His family needed that to survive. Child labor laws would prohibit that from happening these days, but you won’t have to go far to find a family that depends on the income from their 16 year old’s job.

I remember one young very promising athlete. He played three sports until he turned 16. Then he got a job and never played sports again. He had an old truck but his family couldn’t afford the insurance on it so he got a fast food job so he could drive and help transport his siblings.

It was sad really. Unfortunately, if you look at the high cost of participating in some sports, you will see that it can be cost prohibitive. If you want to be competitive, it seems like you need to take private lessons, work with a personal trainer, travel all around the country, and dedicate pretty much all of your spare time to it.

Golf and tennis come to mind immediately. Volleyball and basketball aren’t far behind. It is just more than some families can afford.

There are exceptions. In football, pretty much all of the equipment is provided. And in running, for the most part you just go run.

I will still insist that there is a place for just going out and playing, without all the “extra” stuff.  Some of the best basketball players I ever knew just played. You could always find them on a court somewhere. They were always in the gym shooting. Before school. After school. In their driveway.

The best football player that I ever played with didn’t play until high school, rarely lifted weights, wouldn’t know a personal trainer if one was standing in front of him, and didn’t need much in the way of coaching. He was a linebacker and all you had to do was tell him to go tackle the one with the ball.

I have to believe that if you are talented and work hard, good things will happen. Back when I played a little softball, the best player that I knew could throw a wicked curve with a softball. No one ever taught him how to throw a curve.

So, if you can’t do all those extracurricular things, don’t give up. Work hard and follow your dreams. And if those dreams are your parents’ dreams as well, so be it. Let them enjoy what you do. Let them live a bit through what you do. It’s OK.