A Surprise in Thailand

Let me give you a little background.  

Steve and Connie Bright have been great friends for over 20 years.   Steve and I work together at the Cherokee facility, where he is the Director of Fitness.   He's also my mentor and most frequent companion on the back of a bicycle.   Although we're not related, he is my brother.

Steve and Connie's daughter April (growing up, she was known as "Mooch") and her family moved to Thailand in July where they serve as missionaries.  Last week, April gave birth to her second child.  Two days ago, Steve and Connie flew to Thailand to visit the family.  April had no idea they were coming.

The following is one of the most touching videos ever posted.   Maybe it hits me more because of my relationship with the family but I think you will surely shed a tear when April keeps screaming "my Momma, my Momma!"

http://www.youtube.com/watch?v=IZ_Q4-aoRjQ

And you might find the following video interesting if not amusing.   Penny McIntosh, personal trainer extraordinaire, followed me around for a couple of days and then came up with this.

http://www.youtube.com/watch?v=C87sBTyx1tg

jb

This one may be too much information....

I'm gonna share today.   It may be too much information:   You can stop reading now if you already know too much about me.

I had a colonoscopy on Wednesday.   That's a procedure where they....well, you'll just have to look that part up. 

Everyone (everyone) should consider colonoscopy beginning at age 50.  If you have a family history of colon cancer or any of the risk factors, you should consider colonoscopy at 40.

I started having these things at 40.   I have a rather profound family history of colon cancer and so I was strongly encouraged to start then.   My grandmother died of colon cancer.  My mom had most of her large intestine removed because of it.  I have cousins that have had colon cancer or who have had pre-cancerous polyps removed.

According to the American Cancer Society, in 2011 about 148,000 people in this country will be diagnosed with colon cancer.  It is the fourth most common cancer in both men and women.  About 1 person in 20 will develop colon cancer during their lifetime.

A lot of other cancers started in the colon and move (metastasize) to other places.  That's one reason why it is so incredibly important to pay attention to colon cancer.

Yet, colon cancer is one of the most preventable cancers known.  Early detection gives it an almost 100% success rate.   Two tools are important in that process:  the Fecal Occult Blood Test  and the colonoscopy.

A Fecal Occult Blood Test as part of my annual physical with my primary care physician revealed a very small amount of blood in my stool. 

Polyps (small growths in the colon that can be a precursor to cancer) and cancers in the colon can bleed.    So although it wasn't quite time for my every-5-years colonoscopy, I called to make an appointment with Dr. Ed Brown, my gastroenterologist.

I have had colon polyps (small growths that can be a precursor to cancer) removed before but my last colonoscopy revealed none so I was put on a 5 year cycle for a repeat colonoscopy.  But now it was time for another.

A lot of jokes can be made about a colonoscopy.  My favorite is from comedian Jerry Clower, who said "if you hear the word 'procto,' gather your split-tail gown around you and go hide in the swamp."

It really isn't that bad.  The bad part is the clear liquids that you have to drink for 24 hours before the colonoscopy and the cleansing process.  On Tuesday, I craved solid food.  Anything.  I've never been more tired of bullion and jello.

The colonoscope itself is a long, flexible instrument with what is essentially a camera at its end.  The doctor administering the test is able to examine the entire length of the colon.  But you don't care because you're asleep.   It really only sounds bad.  Like I said, the bad part is the cleaning out.  

On Wednesday, Dr. Brown removed three polyps which means that I'm back on a 3 year cycle.  That's OK.  I'll do whatever it takes. 

                                                                        

Changing approach to Total Joint Replacements

It really started when I heard that a couple of buddies from high school were discussing their total knee replacements.  David "Tree" Birkholz was a standout basketball player at my high school and Hank Evans and I played football together there.

I've not really seen much of either of them since so it seems like they should still be in their 20's.   I just can't think of them as 57 and 56 and having a surgery that most people think is only for senior citizens.   Goodness, they're both younger than me!

I had my first knee surgery in 1972 and met my first physical therapist, Ray Patterson, when I was sent for rehab.   As I have done numerous times since then, Dr. Patterson asked me what my major was.

At that time, as a college sophomore, it was Wildlife Biology.  I thought that meant you got to hunt and fish all the time (two activities which are surprisingly absent from my adult life considering that I had a gun, rod, or bow in my hand from age 6 to 22).  But I had discovered that jobs were few and far between in that field so I was looking around for a new career.

As odd as it sounds, I was trying to decide whether to be a football coach or a doctor.   Ray Patterson, in his wisdom, replied "great...you're going to be a physical therapist.  It's the perfect marriage of both of those."

Lo and behold, he was right.  That knee injury has given me a career that I have loved and which certainly seems to have been a good fit for the gifts I was given. 

Since then, Dr. Ken Bell of Maryville Orthopedic Clinic has operated on both of my knees and has kept me quite active but due to no small amount of abuse, I don't have the healthiest knee joints around.  It really isn't a question of "if" I will have to have my knees replaced.  It's "when."

Total Rehabilitation employee, Alcoa High Head Athletic Trainer, and unofficial daughter Peggy Bratt had her right knee replaced at age 41.   She went from struggling to run on the field to take care of one of her athletes to half-court basketball and an essentially pain-free knee.  

So I talked to Dr. Bell and here's what he told me.   He said they're replacing knees and hips in people that are younger and younger.   That they're getting better long term results than any of us dreamed possible.  (Dr. Bell, who has a total hip replacement, is an aggressive mountain biker--I know--I often chase him down a rocky hill that he rides easily and I white-knuckle all the way down.)  

He attributes most of those advances to the improvement in materials that they are using.  He said that the materials being used now are more than ten times more durable than materials used as recently as 10 years ago.   And the prediction on those older models was that they would last 20+ years.  10 times better than they used to be and the older models would last at least 20...hmmm...you can do the math on that one.

Folks that avoided joint replacement surgery in fear of having to have it again in 20 years really don't have much to fear.  We don't know exactly how long these things will last but it isn't likely that you will wear it out any time soon.

So instead of putting off getting joint replacement surgery as long as you can, maybe you should consider it if your joint pain is affecting your lifestyle. In other words, if you can't do the things that you want to do, joint replacement surgery might just let you get back to the things you love.

I'm not scheduling knee surgery any time soon but it's good to know that when the time comes, the prospects are good.

Disconnections

Sometimes we have to disconnect to reconnect.

In early September, I spent a week camping, canoeing, and fishing in Canada's Quetico Provincial Park, which is due north of Minnesota and consists of 2 million acres of lakes, trails, and streams.

And no motors.  Which means that if you are in Quetico, you got there under your own power.    With lakes everywhere, canoes are the only practical form of transportation.

Imagine a place where there are no roads, no vehicles...where the only sounds you hear are those made by nature and each other. 

A place for listening to loons, whose call is beautiful yet haunting.  Making new friends.  The simple joy of paddling.  Camping, cooking, and sitting by the fire.

Have you ever gazed at a night sky when the nearest artificial light might be 30 miles away?  The stars are so bright you can reach out and touch them.  I would often awake in the middle of the night, when the moon had set, and see more stars than you can count in a lifetime.

Solitude so absolute it could be disconcerting.  Isolation so deep it can both enhance the experience and scare the beejeebuss out of you. 

It is a fisherman's paradise but lest you think this kind of trip is for everybody, let me tell you about a little thing called "portages."  On a portage, you pick up everything you brought and carry it between the lakes.

Often through mud bogs, across fallen logs, and up steep hills, all while traversing fields of rocks.  On one memorable trail, I sunk up to my hip in mud with a canoe and a backpack on my shoulders.  It probably took 20 minutes to dig me out.

Did I tell you there was no electricity, no running water, and no "facilities?"  With that said, I'd do it again in a minute.  It was wonderful and amazing and breathtaking.

But before you go, you've got to disconnect.   Disconnect from the internet, turn off your cell phone, and tell your family that they won't see you or hear from you for a while.

At first, it's strange.  For the first couple of days, I felt for that familiar buzz on my right hip that indicates a message or call coming in on my cell phone.  I was sure there was an e-mail that required my immediate attention or an important decision that needed my input. 

But about the 3rd day, the wilderness started working its magic.  I forgot about meetings, appointments, and alarm clocks.  Frustrations?  Gone.  Problems?  On vacation.  When day-to-day existence is reduced to the very basics, you start to appreciate what is really important.

Like family and home and good food and toilets.  I'm glad I went.  I'm glad I'm home.

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National Physical Therapy Month

I am both a physical therapist and an athletic trainer.   Maybe you knew that already. 

I spend my days in the where I have my physical therapist hat on most of the time.  I've been practicing (now that's a strange use of the word) physical therapy for almost 34 years now and I really don't have any plans to do anything else anytime soon.  Retirement is for somebody else--somebody that doesn't enjoy their work as much as I do.

I am still thrilled to walk into the room of someone I might not know, examine them, decide how I as a physical therapist might help them, and then set into place a treatment program.  Part scientist, part teacher, part coach, I am only as good as my ability to get you better. 

October is National Physical Therapy Month and in telling you a bit about me, maybe you will learn more about physical therapy.

I graduated from UT Health Science Center in Memphis in 1977 when it was the only physical therapy program in Tennessee.  There are now four others, Belmont, UT-Chattanooga, ETSU, and Tennessee State University. 

In the late 90's, the entry-level physical therapy degree became the doctoral degree.  In other words, everyone that graduates today receives the Doctor of Physical Therapy (DPT) degree.  In 2008, I got one of those too.  Yes, it's technically Dr. Black now but I usually insist that everyone calls me Joe (yet it usually turns out to be joeblack, one word-the curse of single syllable first and last names). 

There are a lot of specialty areas in physical therapy.  Pediatrics, primarily working with handicapped children.  Neurologic Physical Therapists who work with those having had strokes, spinal cord injuries, or head injuries.

There are those that focus on vestibular problems, balance issues, wounds, TMJ problems, lymphedema and the complications often accompanying cancer and cancer treatment. 

There are inpatient therapists that work in a hospital and outpatient therapists that work in clinics and others that work in home health, schools, skilled nursing facilities, and a variety of other settings.

Our biggest specialty area is orthopedics and even in that there are subspecialties.   I fall into one of those as I have specialized in extremity orthopedics and sports.   My day is pretty much filled with taking care of those with shoulder, knee, foot, and ankle problems.  Many of those are our athletes.

Other Orthopedic Physical Therapists specialize in taking care of those with spinal problems.  Over 31 million Americans will seek health care for low back pain this year.   Physical therapists are at the forefront of taking care of those problems, using exercise, education, and manual techniques based on evidence and research.  

We take care of those with minor sprains and those with catastrophic injuries.  We see people before surgery after surgery, and all the way to their return to full function. 

In a nutshell, physical therapists help you regain the life you want.   A life without disability or dysfunction.

I'm proud to be a physical therapist.  This profession has taken me places and provided me with opportunities that were beyond my wildest dreams.  That and I get to help people get and stay healthier.    

How lucky can one person be?

Politics as usual? I don't think so.

The recent budget crisis in the United States Congress was ugly.   It was partisan politics at its worst.   I saw a political cartoon recently that showed an elephant and a donkey in a little convertible driving straight toward a big transfer truck labeled "budget crisis."   The caption read "so, who's going to blink?"

So then the legislative branch (the House and Senate) and the executive branch (the President) finally got together and reached a compromise in which no one claimed victory.  Oh, they tried to spin it as a victory.  The Republicans feel that the reduced spending was a victory and the Democrats feel that raising the debt ceiling was a victory but hopefully, at the end of the day, the American people are the winners.

I mean, come on folks.   How can we keep spending more money than we take in?   Oh sure, it works for a while.  And then the bills come and sooner or later you've got to pay up.   So you can either spend less than you take in (reduce spending) and slowly pay off your debts or you can increase your income (in this case, raise taxes) and pay off your bills that way.   What the government seems to have done is to do both, which hopefully will work.

 After a fair amount of experience in politics, I can tell you that compromise is a necessary part of the legislative process.   When everybody goes away unhappy, it is likely good legislation.  Keep in mind that we often find completely opposite opinions on nearly every subject.   But instead of both being wrong, both are quite possibly right.  

There is not much "right" and "wrong" in political arguments (just different approaches or different perspectives) but way too much "I'm right, you're wrong."

I spend a lot of time in our state's capitol and I've grown to appreciate the political process at least as it related to a legislative agenda.  But getting legislation passed is like making sausage:  You don't want to watch it being made.   

The Preamble to the Constitution of the United States includes the provision that every citizen has the right to "life, liberty, and the pursuit of happiness."  I would like to propose legislation that would add that we should have "the pursuit of healthiness." 

I think life, liberty, and happiness are dependent in no small measure to healthiness.  I see very few unhealthy people that are happy. 

I'd like to see legislation passed that requires everybody to eat better (and by better, I mean healthier), to exercise daily, and to lead healthier lifestyles.   At the risk of stepping on individual liberties, I would like to see smoking ended, roads where no one drives impaired, and guns necessary only for recreational purposes.  

I'd like to see a world where no one goes to bed hungry (did you know that 925 million people in the world are hungry today?  And that 16,000 children will die of starvation today?).   I don't believe that "Universal health care" or "socialized medicine" is the answer but I do want to live in a country where the medical needs are provided for those that cannot provide them for themselves.

I wish I had all the answers.  What I do know is that I've never met anybody that didn't want to pursue life, liberty, happiness, or healthiness.   It's just that too many people think that it is their inherent right for somebody else to provide those things.

We don't "deserve" it, we've only got the right to "pursue" it.