Six Month Checkup

It’s been six months since I had my knee replacement surgery so I thought I would catch you up a bit. I get a lot of questions about how it is doing.  Many of those questions are from people who are considering knee replacement themselves.


Let me just say this: If you think you need a knee replacement, you probably do. I’ll tell you what I have heard patients tell me hundreds of times—“I wish I had done this a long time ago.”


Let me explain my situation. Prior to knee replacement, I had three surgeries on my right knee, dating back to when I was a teenager. All were successful and I continued an active lifestyle, playing basketball until I was 59. Really.


Even in recent years, my knee didn’t hurt much. Oh, I took more than my share of ibuprofen and only when I went without anti-inflammatories did I get an inkling of what was going on in my knee.


It’s been a long time since I could run. That was OK. I could still ride a bike without any problem whatsoever. And I could hike. For years, my wife I have taken an annual fall hiking trip, visiting some really great places. Not in 2019. I knew that my knee wouldn’t hold up to it.


About the only time I had to run was on the football field to check an injured player. In recent years, that got harder and harder and I got slower and slower. It finally got to where I didn’t even try and run. This past fall, I heard an official tell an injured athlete “Joe’s coming” as I walked as fast as I could onto the field.


I rehabbed hard and tried to force my knee to allow me to run, thinking that maybe I wasn’t tough enough. I knew it was bad but I didn’t know how bad. Then I saw my own X-ray.


What a mess! It is no exaggeration to say that my own x-ray was about the worst I had ever seen. But I knew that I had to get through the football season so I limped along. Literally.


There were days when the pain was pretty bad…days when I wanted to find an orthopedist and an operating room and fix it right then. But I got through it and on the first Wednesday after the state championship game, I was admitted for surgery.


Jump ahead to today. My knee feels great. It’s a little stiff but that’s because of the extensive damage to my knee and the fact that I waited about 10 years too long to have it fixed.


I’m biking hard. I climbed Lookout Mountain on consecutive days recently. I’ve been mountain biking a bunch, even wrecking (without injury) a couple of times. I’m ready to start hiking again. Thank you Dr. Justin Jones for taking a mess and giving me a good knee.


My best advice? If your knee is changing your lifestyle, if there are things that you can’t do that you want to do because of your knee, get it replaced.


Like I said, I wish I had done it a long time ago.

What Lessons Will We Teach?

I turned to a family member this week for ideas for this space. She told me “well, you haven’t written about your newest grandchild yet.” Well, I sort of did. Right after she was born. Talking about experiences in the Children’s Hospital NICU.


Number seven. A blue eyed beauty that shares my name. Born prematurely in January, she is now healthy and robust and though lacking in understandable vocabulary, is quite the Talker.


But what kind of world are we bringing her into? Will she be judged by her gender? By the color of her skin? Will she experience hate and prejudice? Parents and grandparents worry about those things. Especially these days.


So, what can we do for her? What can we do to make the world a better place for her? When all this turmoil is over, I would really like to think that her world will be more accepting, more loving, more tolerant.


As her grandfather, I want to show her love…unconditional love. To make sure she knows that I will love her as long as I’m around. That there is absolutely nothing that she can do to change that one bit.


I want to teach her the value of being physically active. If needed, I will teach her how to ride a bike, play in the trees, and swim like a fish.


I want her to respect her body and mind, understanding that those are hers and hers alone—that it is her job to take care of both of them. Maybe that means eating good, whole food but sometimes a girl just has to have a burger, fries, and a milkshake.


And that means that she accepts her body, whatever shape it takes. Tall or short. Thick or thin. I want her to love herself, to love the person that she sees reflected in my eyes.


I want her to learn the importance of being outside. Of walks in the woods. Of the mysteries to be found in a creek bed. That bugs aren’t creepy but necessary.


I want her to recognize the fox, the deer, the bear, the bunny, even the lowly possum. The Robin, the Mockingbird, the Eastern Bluebird. The fish in the sea. That she is a part of nature just like all those creatures. Even snakes.


I want her to understand that we are custodians of the planet Earth and it is our responsibility to take care of her, to nurture her, to protect her. The air that we breathe. The streams and creeks and rivers.


I want her to be less dependent on digital devices than I am, to understand that real conversation is important, that human contact is essential.


I want her to experience the joy of family. That her siblings are the best friends that she will ever have. That her cousins are the best people she will ever know.


I want her to play a sport—any sport. I want her to find something that she is passionate about and pursues it with vigor. I believe essential life lessons are learned on our playing fields. But let it be her sport and her choice. From that, she will discover the joy of movement.


I want her to know that there is a world outside her four walls, outside her hometown, outside her family and that she has a responsibility to that world. Yes, I want her to go change the world. It’s what she was brought into this world to do.

What does Joe Black eat?

I received a note from a reader this week, mostly appreciating what I didn’t have to say about Covid-19. But she did add, “tell us this—what does Joe Black eat?” 

Ooooh…I don’t know. Does anyone really want to know? Should I be worried? Can I be completely honest? How specific do I get?


OK. Here goes. Judge me as you will. But go back. Way back. 

For most of my life, I have followed what we were told was a heart healthy diet. Low fat. High carbs. Lots of fruit and vegetables. If anyone wanted to lose weight, they were told to avoid bread and potatoes (which maybe should have told us something).


About eight years ago, it was discovered that I had a significant level of atherosclerosis. Hardening of the arteries. Further testing indicated that my coronary arteries are probably doing their job so I’m not likely to have a heart attack but I will fight blood pressure issues for the rest of my life.


At about the same time, a friend of mine introduced me to research clearly indicating that we had it all wrong—that carbs were the culprit. And I was a carb-fed animal. Carbs for breakfast. Carbs for lunch. Carbs on my bike rides. More carbs with dinner. I ate but I was hungry all the time.


That friend also introduced me to Whole30, basically 30 days without carbs. I can tell you that for a couple of weeks, it wasn’t too bad. Then it hit me—it was tough. My energy levels were zero. My performance on the bicycle was awful. I got dropped in the parking lot.


But by the end of the 30 days, I felt pretty good. I lost weight. I wasn’t hungry all the time. My problems with hypoglycemia (low blood sugar) went away.


Don’t get me wrong…you can’t exist without carbs. As a biker, I need more than most, especially on a 3-4 hour ride. But it should be complex carbs. And you don’t need as much as you think. I will follow a low carb diet for the rest of my life. I am convinced it is the most heart-healthy approach out there.


And about that low fat. We now know that there are good fats and that a diet totally avoiding fats has problems of its own. We just have to seek out the good ones.


The other thing that I have changed is how I shop. I’ve always read labels but now what I’m looking for is simplicity. Most of the items in my grocery cart have one name, easily understood. Broccoli. Spinach. Salmon. Eggs. Milk. Various fruits. My friend, the late Sam Beall of Blackberry Farm, taught me why butter was better than margarine (check the ingredients). Simplicity.


So what is a typical Joe Black meal? It trends toward sameness. When I find something I like, I stick with it until I get tired of it. Here’s what I had yesterday.


Breakfast: Two eggs, almond milk, almond flour pancakes, maple syrup. Lunch: Chicken salad, carrots, fruit, coconut water. Dinner: Grilled chicken, asparagus, Jasmine rice, pumpkin pie.


I drink a Kombucha every day and snack on Pistachios. I have a distinct weakness for Benton’s bacon, Haagen-Dazs ice cream, Fritos, dark chocolate, and hot dogs with chili and slaw. A late night snack is likely to be tart cherry juice and a handful of Cheetos (don’t ask me to explain that one…I can’t). I believe that we need to enjoy our food and I’m not afraid of desserts.


I love good restaurants and avoid the chains. If the chef and the owner are the same person, that’s my kind of place. I love seafood of all kinds and a really great steak, cooked medium rare, is heavenly.


So, there you have it. I’m not going to try and tell you what to eat-I’m not a nutritionist. This is what works for me. Do your research and eat what’s right for you but avoid white sugar and white flour whatever you do. 

Your heart will thank you for it.

Noticing The Little Things

I will not write about Covid-19. I will not write about Covid-19. I will NOT write about Covid-19.

There. Got that out of my system. But since we aren’t doing much in the way of sports and this is the Sports Section, what’s left? What lessons can I teach? What wisdom can I impart?

Well, maybe not much. My world is very singular now. And most of my inspiration comes from experiences—things I do, see, or hear. Right now, my life is work, eat, sleep, repeat, so I’m finding far less inspiration.

So, I went outside. Sat out on the back of the building where I work, having a snack. The sky was what the meteorologists call “partly cloudy.” Not the big Cumulus clouds that you can use your imagination on. Plain, normal clouds. And a light breeze. A little cool. Perfect weather, really.

I’ve seen a rabbit in our parking lot for a while but while snacking, I saw the squirrel that had left signs that he was hereabouts. He was on the side of the one little Maple tree beside where I usually park for work. Twitchy as they all are, he didn’t like my presence. I was in his world.

When I stopped to look, I noticed birds everywhere. They didn’t seem to be practicing social distancing. My curiosity up, I walked down to the small creek that runs behind our office and splits the Maryville Little League Park.

It seems like I’ve been around that little creek for half my life, first with my kids playing ball on those fields and for nearly 20 years, in an office nearby. I never thought much about it. It was just someplace where kids liked to throw rocks and sometimes fall in.

I never thought of it as a life form but as I gazed into the waters, I noticed lots of life. 

So I took off my shoes and crept down into the creek. The water was cold but after I got used to it, I started exploring. I noticed tiny fish everywhere and several different kinds of aquatic plants. On close inspection, it was teeming with life. Never noticed any of that.

I stopped to listen and could hear the creek gurgling, the birds singing. It didn’t seem like there was as much road noise. Maybe traffic is down because people are staying home more. I could even hear kids playing nearby.

By now my senses were on full alert. I stopped, inhaled, and smelled…nothing. I’ve been in big cities and there is a constant odor, usually rather unpleasant. I grew up in an industrial town that smelled of rotten eggs.

But then I picked up just a hint of something sweet. Honeysuckle was in bloom not too far away and when I really focused, I could distinguish that particularly nice smell. Just because I’m an inquisitive sort, I put on the mask that I had in my pocket to see if it filtered the honeysuckle odor out. I was pleasantly surprised that it did not.

I looked at that little Maple that I’ve written about a few times. Just a stick when first planted, I would say it is now a teenager. One thing I like about it is how it reflects the seasons. Bare in winter. Budded in spring, full bloom in summer. Bright colors in fall. I try to make it a metaphor for life sometimes, but that’s just the poet in me. In all of us.

Is there a point to all this? Yes. Despite the pandemic, the sun will still shine. Regardless of the masks, there are smells to be smelled, sounds to be heard, wonders to be noticed.

I'm Positive That...

Coronavirus. Doom and gloom. Fear the Beast. I’ve done my part on the scare tactics. I’ve filled this space with warnings and dire predictions.


So what’s a guy to do? Shut out the world? Hide in the mountains until this is all over? I’ve just about quit watching the news—something about the body count (the number dead from the Coronavirus) that is just too much. It’s reminiscent of the news from the Vietnam era that I grew up in.


I can’t ignore the fact that it seems like a lot of people are just ignoring this thing, going on about their lives like there is nothing to be concerned about. Some people seem to have interpreted “Safer at Home” to mean “stores are open-let’s go shopping!”


Not a real threat? Look no further than the nursing home in nearby Etowah. Talk to the children of those nursing home residents in Maine or in Kentucky. Talk to anybody in New York City. 
I have a friend at a hospital in New Haven, Connecticut that last week was filled with Coronavirus patients. Literally filled. The threat is very real and is still out there.


Agree or not, we’re beginning the move back to some degree of normalcy, although I would insist that we’re going to find a “new normal” out there. Some things can never go back to the way they were. Stores, restaurants, and other non-essential businesses are opening although there are a lot of rules that must be followed. Masks, social distancing, and counting heads at the door will be the rule of business for most of the summer.


“Safer At Home” is no longer a mandate but is still a good idea. I saw a meme this week that said “I’m going to come out of this thing a Hunk, a Chunk, or a Drunk.” There’s a lot of truth in that.


There are obviously some negative coping mechanisms being employed. And believe me, you will employ coping mechanisms. You probably already are. But I would like to suggest that you seek out positive coping mechanisms.


Like exercise. You’ve got more free time. Take advantage of that. We also know that regular exercise will help keep you healthier and maybe make you less susceptible to the Coronavirus.


This should be a time to eat better. More time to plan meals. More time to cook. Although the lines at the fast food places are long, I think that’s just folks finally getting out and wanting something, anything that isn’t in their own freezer or cupboard.


Put away the digital devices and get to know your family better. Yeah, I said it. Mr. Hooked-to-his-phone. They’re great and I crave that FaceTime with the grandkids that I don’t get to be around but sitting in front of the computer or TV for hours on end is simply a bad idea. Find alternatives.


Sleep more. I know I have. Not getting enough sleep is probably my biggest health mistake. There isn’t a study out there (that I’ve been able to find) that tells you anything but that you should get adequate sleep. Like 7-9 hours.


Get in touch with important people in your life that you haven’t talked to in forever. Give them a call. Send them a note. Tell them what they mean to you. That book you’ve been wanting to finally read? Now’s the time.


Work in the dirt. It helps. Plants something. Anything. Then watch it grow. There are few things more satisfying that being able to eat straight from your own garden. Whatever you do, look for the positives. 

Or wake me when this thing is over.

The Beast is Still With Us

Just this week, Governor Lee announced that the Safer At Home order will expire on April 30^th, allowing the reopening of businesses across the state. This will be a “phased reopening,” details of which are steadily emerging.


I don’t expect schools to reopen and the spring sports seasons have already been abandoned. There is lots of speculation about fall sports. I think we just need to wait and see. But things will be changed. Lots of folks will be reluctant to get in the middle of a crowd of people for a long time.


This doesn’t mean that we’ve beat this thing. We haven’t. The things we’ve done (hand washing, social distancing, businesses closing) have just slowed it down. Slowed it down so that hospitals could prepare. Slowed it down so that hospitals wouldn’t be overwhelmed by the huge surge in Coronavirus cases that has happened all around the globe.


As the world has dealt with this pandemic, we have learned a few things. We have learned that it has hit hardest in densely populated areas. We have learned that it is most dangerous for those that are physically or medically vulnerable.


I must say that I’m SO proud of our local hospital for the rapid preparations that they made to get ready. And I’m equally proud of our community that stepped up to help the hospital prepare and to help their neighbors. Stories of food sharing and drive by birthday parties abound.


The Governor weighed the need for getting people back on the job with the impact on our healthcare delivery system and potential risk for those affected by the Coronavirus. It’s not an easy decision and there are passionate folks on both sides of the discussion. I’m not here to take sides or to convince you that either side is right or wrong. People are hurting. Now is not the time to judge.


But here’s the thing—you can expect an increase in the cases, and yes, the deaths, from Coronavirus as rules are relaxed. That’s anticipated. That’s why it is SO important that we continue to follow all the guidelines that we’ve been under for the past few weeks.


We need to continue to wash our hands and keep our hands out of our mouths. We need to continue to practice social distancing. I expect those “non-essential” businesses to follow the same rules that the essential businesses have been following: Limiting the number of people admitted to a business, marking the floor at check-out lanes to ensure proper distancing, and providing screens between checkers and customers.


It’s easy to get complacent, as the number of new cases dwindles. Instead of assuming the worst is past, we should understand that this beast is still out there. I see far too many people not doing what they are supposed to. That’s a mistake. This thing is a monster. Talk to anyone in New York City.


I see young people that feel they are invulnerable and who ignore all the precautions.  Yes, it’s true that young healthy people will not likely die from this. But they can carry it to the old, the young, the weak. This thing is as sinister as anything we have faced in healthcare.


Those at risk should still stay at home. Those most vulnerable are our oldest, our youngest, those that are immunosuppressed, those with asthma, COPD, or other lung problems. Those with diabetes. Those with any medical conditions that compromise their ability to fight off disease.  STAY HOME!


The rest of us--respect others by wearing a mask in public places. Avoid crowds. It’s not yet time to return to stadiums or church pews. The best advice I’ve had is to pretend that you have it and do the things necessary to avoid passing it on to someone else. And pretend that everyone you encounter has it and do what you need to do to protect yourself. You never know.

TeleHealth Today

I struggled this week to find anything to write about that was NOT about the Coronavirus. That’s all anyone is talking about. In healthcare, it dominates every waking thought.


Something that you’re probably hearing more and more about is Telehealth. It has been around before we had ever heard about Covid-19, but this pandemic has certainly brought it to the public consciousness.


What is Telehealth? Most simply put, it is the delivery of healthcare when the provider and the patient are in different locations, usually using a computer or a cell phone to communicate.


Before Covid-19, it was most often discussed in really remote locations. Colleagues in Montana, where lots of people live many miles from the nearest neighbor and even further from health care providers, have been doing Telehealth for years.


It has been addressed in the Tennessee legislature in the past and would likely have come up this year if the legislature hadn’t been sent home early. Fortunately, Governor Lee has relaxed restrictions on Telehealth and opened doors that needed to be opened.


The Coronavirus pandemic has brought Telehealth up to an all new level. It has become an essential part of healthcare delivery. It is allowing those most vulnerable among us to get the care that they need without having to leave the safety of their homes.   


There’s a good chance that your Primary Care Physician (PCP) is utilizing Telehealth. I know the orthopedists are. In some ways, it is the only way to deliver much needed medical care. In physical therapy, we are using it to follow up with patients who can no longer come to our offices and to work with new patients without ever being in the same physical location as them.


Please understand that this is still healthcare and there is a charge for the service. For many practitioners, it is their only source of income. The state and federal governments have changed the rules about Telehealth reimbursement and there’s a good chance that your insurance will pay for Telehealth services.


On a different note, I saw something this week that resonated with me. This writer was asking people to be less judgmental. It hit home when someone I know was being critical of a man getting mulch at the local garden store. She thought it was unnecessary and irresponsible.


But this writer had a different opinion. He said that guy getting mulch might be an alcoholic who is stuck at home and has to keep busy with yardwork to avoid a relapse. Or the lady buying flowers who suffers from depression and working in her flower garden is what keeps her safe and sane.


You see, we can’t judge others in all this. I really struggled with stopping bike riding with a group. It is one of the things that keep me sane during a time when the Coronavirus has taken away a lot of the other things that keep me sane. But my concern for others means I now ride alone. I have friends that are still doing the group rides and that’s OK. I refuse to judge them.


I caught myself yesterday judging a grandfather and his grandson. They were in a store where the employees had taken very few precautions—no masks, no social distancing. And yet they were there, walking together, without masks. I had to stop and remind myself not to judge them. Was the grandfather not concerned about exposing his grandson to Coronavirus? That was hard.


It all boils down to the fact that we just need to love each other. Respect each other. Walk in somebody’s shoes before you criticize. But please, please, please do your part to stop this thing.