less is more … fitness

04.02.15 less is more ... fitness

Less than a year ago, I wrote about how I had become a “gym person,” waking up at obscenely early hours to get my workouts in every day. But I neglected to pen the follow-up post detailing how I later opted out of gym-person-card-carrying status, probably because I felt somewhat less proud of my slide back into middle-aged, chair-bound sessility. But there you have it – after about 6 months of previously unparalleled commitment to working myself into top-flight shape, I reverted back to the more gelatinous form of humanity depicted in WALL-E.

The transition to endormorph began when I started experiencing persistent pain in my Achilles tendon shortly after I would start running. I went from running 3-4 days a week to having difficulty walking because of stiffness and pain in my tendon. Since I stubbornly refused to engage in any other form of cardio, that left me with nothing to do at the gym except lift weights. While staring at myself in a mirror for an hour a day (surprisingly) didn’t make me nauseous, I found my tendency to want to wear tighter tee shirts profoundly disturbing. While I can’t clinically prove it, I’m reasonably certain that my IQ dropped by a solid 10-15 points for every pound of muscle mass I gained. Intent on preserving my mental acuity – and, perhaps not coincidentally, bored out of my ever-loving skull – I soon let the weight sessions fall by the wayside as well. Before I knew it, I was catching an extra hour of sleep every day and not missing the gym at all.

By last October, I was perfecting my 12-hour consecutive sitting technique while rediscovering my love of ice cream with willfully reckless abandon. I blame that on Caroline. It has always been “our thing” to eat a pint of Ben & Jerry’s Chocolate Fudge Brownie together. In order to maintain those strong father-daughter bonds, I made sure those pints found their way into our freezer with increasing regularity. After all, they seemed to have no effect on Caroline, though that could have something to do with her thrice weekly workouts of 3 hours each at the local gymnastics center. But hey, I was at the same gym with her a few times a week (albeit in a chair, watching her practice), so I figured what works for her would work for me.

My descent towards total physical dissolution continued through the winter. My only exercise from December through February consisted of shoveling snow. I didn’t take Cara’s regular warnings that “people die all the time shoveling snow” as a positive referendum on my overall physical condition. The requisite upsizing of clothes followed soon thereafter.

And then, as I wrote about in my last post, my friend Phil died of a stroke.

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When I first became an amputee, Phil taught me that I needed to train like an athlete – intensively and regularly. This wasn’t so I could try to qualify for Nationals and compete in the Paralympics; it was so I could merely live an average life, doing things like walking from a parking garage to the Brooklyn County Courthouse or across a soccer field to watch my kids play youth sports.

One of the unanticipated results of Phil’s passing is that it allowed me to reconnect with an old mutual acquaintance of ours. This friend – Dave – is a PT who has spent a good portion of his professional life donating time free of charge to amputees ranging from first-time walkers to Paralympians. We sat over dinner last week, reminiscing about Phil and talking about amputee rehabilitation, fitness and prosthetic components. Finally, he looked at me and asked, “So, what are you doing now for exercise?” I said, “You’re pretty much looking at it,” and gave him my recent fitness history, starting from the high point last year when I was running regularly and lifting weights at the gym up until the present.

“How’s your back?”

“Not great,” I replied.

“What are you doing for it?”

“What am I doing for it …” I repeated, gazing into the distance before locking my eyes back on Dave. “What I’m doing is experiencing regular back spasms whenever I try to get out of my car or a chair. I wait for them to pass, trapped in anywhere from 3-5 seconds of agonizing pain, bent over, before I can straighten my spine. That’s what I’m doing for it,” I finished triumphantly, a cynical smile on my face.

Dave laughed but immediately turned serious and poked my chest: “You’ve got to take care of yourself,” he said. “If you’re like this today, what do you think it’s going to be like at 60 or 65? If you want to be moving then, you’ve got to deal with it now,” and he reminded me about the need to train like an athlete, just as Phil had told me when I first became an amputee.

By the end of our meal, Dave had volunteered to help oversee my return to a more active life. It started on Saturday with the purchase of a new pair of gel-soled Asics (“It’s all about protecting your sound side!”). I perform mandated crunches, back bridges and planks (“You have to have a strong core.”). I stretch my hamstrings and quad (singular) several times a day. I go on a mile-long walk every other day with a target of getting my heart rate up to a specific range (“No running till you’ve gotten your weight to 175!”). And on off-days it’s resistance bands for strength and flexibility.

Most interesting, Dave wants to make sure that I don’t overtrain: the goal is to get maximum value out of limited exercise time with a long-term view towards making sure that what I’m doing today to get in shape doesn’t destroy my knee, hips or spine by the time I’m in my 60’s. (It’s the less is more (!) approach to fitness.) As I text updates to Dave every day so that he knows I’m complying with his instructions, I’m reminded just how hard – perhaps impossible – it is to walk this one-legged path alone. And I find that comforting. Once again, my prosthesis has (re)connected me to someone. And that reminds me of how many important, amazing people I’ve met because I wear a prosthesis, not despite it.

catching up

catching up 1.15.15

Between the end-of-year holiday season and traveling for work I have been away from these e-pages for just over a month. A quick three-part recap of key events during that time period for your reading pleasure.

daughter’s gymnastics career 2: McGill home internal aesthetics 0

Three years ago we purchased Caroline a “Tumbl Trak.” It’s an inflatable pad that allows my daughter to practice back flips, handsprings, layouts etc. within the comfort of our home. Cara and I congratulated each other on being such wonderful parents, the excitement of offering our daughter the possibility of 24-7 home acrobatics center temporarily impairing our faculties.

Upon its arrival and much to our mutual chagrin, we realized that only one room was large enough to house this monstrosity: the den, which sits right off the kitchen and is the most natural place for the family to gather together. Walk into the room today and the dominant feature isn’t the brick fireplace, wood mantle, two couches or TV, but rather, what looks like a bright blue inflatable mattress for 14 people. We keep it tilted up against the wall, only dropping it onto the floor when Caroline actually uses it, but it’s still an eyesore, an ever-present reminder that you ignore the measurements of an item you purchase online at your own peril.

With that history behind us, you’d think we’d learn. We do not.

A “kip bar” has now joined the Tumbl Trak in the den. I lovingly assembled it on Christmas Eve, thrilled that I figured out how all the pieces fit together in less than 10 hours. Because of the force that Caroline generates when swinging on this new piece of equipment, I was forced to add an extra 6-8 feet to the base – “the extension package” – within days of her starting to use it. So now I have two enormous pieces of gymnastics-related gear swallowing up the best room in our house. I should charge Caroline a storage fee.

Totally unrelated aside, other than the fact that it involves Caroline: she has started calling herself, inexplicably and out of nowhere, “Bambles.” I’m afraid to even ask.

shoveling rocks: just as much fun as it sounds

We went up to Connecticut to visit my parents a few days after Christmas. Upon arriving, I learned that my dad was somewhere out on the property doing yard work. Knowing that he had just had a nerve block in his back for progressively worsening pain, I tossed on my coat and located him behind his garage. As I scanned the barren landscape that is northwest Connecticut in December, I realized that about a third of his stone driveway sat on the lawn, the result of snowplowing a month earlier.

After confirming with my dad that he in fact preferred the rocks on his driveway as opposed to in the vicinity of it, I began returning them to their natural habitat. I quickly determined that a plastic leaf rake was ineffective, as the rocks were simultaneously too small and too heavy to move with that piece of equipment. I opted instead for a metal garden rake turned upside down to pull the rocks into large piles, which I then tossed into the driveway using a shovel.

Max ran out shortly after this effort began to try to convince me to buy him tickets for Louis C.K. at Madison Square Garden. I declined and put him to work, a double whammy that will probably cause him to reconsider asking me for anything while in the state of Connecticut as long as he lives. (I cut him loose after 30 minutes. He must have complained to his mother, because Jackson got sent out shortly thereafter, no doubt instructed to help his back-pain riddled grandfather and one-legged dad.)

After roughly 90 minutes we had returned the majority of rocks back to the driveway. As I sweated in the sub-freezing weather, my arms and sound leg aching – when shoveling, I’ve learned that I put almost all my weight on my non-prosthetic side, a tendency that has distinct and immediate ramifications when lifting heavy things – I congratulated myself for being a good son and completing this rather large task. I declined at that time to wallow in the all-too-real probability that the next snowfall would redistribute the stones back onto the grass again, making me an actual Sisyphean character.

Phoenix Skyharbor Airport: still hate it

I had the misfortune of visiting the Phoenix airport not once but twice last week, as it was the layover point between New York and Cabo San Lucas, which is where our company had its annual sales meeting. Skyharbor holds the dubious distinction of being my least favorite airport in the country, as detailed in my highly scientific analysis here.

My previous criticisms of the airport have always been from the perspective of a traveler arriving there from within the U.S. But on my return from Mexico, I had the opportunity to experience Skyharbor from the international side of things.

It was not an improvement.

I got off the plane and walked a not-entirely-unreasonable distance (by Phoenix airport standards (i.e., less than 3 miles) to customs. There, I was greeted for the first time in all my worldly travels by new U.S. Customs kiosks. Looking similar to an ATM, these machines involve a two-step process. (1) You place the picture page of your passport in the machine, which then shows you that image on the main screen. (2) You stand in front of the machine while it takes your picture, placing that real-time image next to the older passport photo.

I heard several passengers exclaiming, “Wow, this is so efficient,” and “Isn’t this technology great?” I might have  agreed if these machines replaced actual human beings, thereby streamlining the customs experience. They do not. The kiosk spits out a boarding-pass size piece of paper with the two images side by side. You then get directed to go stand in line for a customs agent, just like on every other international flight. Word to my fellow kiosk-loving brethren: if the old way of clearing customs required one step and the new way requires two, the new way is not more efficient.

After getting waved through – only after a lengthy delay due to a guy who it appeared had knowingly traveled to Mexico with an expired passport – I then walked about 14 miles to the main terminal, followed by a relatively quick 5 mile jaunt to my gate. I’m thinking that the key consultants for the architectural firm creating Skyharbor were members of the Tarahumara tribe. Either that, or someone accidentally drew up the original plans in yards rather than feet.

Seriously, it’s crazy out there in Phoenix.

random thoughts

11.6.14 Random Thoughts

While I love the possibilities that modern medicine offers, I have to admit that I find the concept of osseointegrated prostheses creepy. The thought of having a piece of metal attached to my femur and sticking out the end of my leg so that I can clip into a prosthetic knee and foot reflexively fills me with mild revulsion. That may be irrational, but I can’t control it.

With this bias freely disclosed, I have to register my concern with a recent article I read about the first U.S. patient to receive an osseointegrated prosthesis. The piece read like one of those magazine inserts that looks like a real article but has the thin banner up top labeling it “advertising” that you only notice after reading for 30 seconds and then saying to yourself, “Hey, this seems a lot like a commercial for [insert topic].” Except here, you get that feeling, look for the banner and it isn’t there.

I’m happy for the woman who got the osseointegrated prosthesis – she seems satisfied with her decision. But at the same time, to trumpet the fact that she has walked 100,000 steps in 3 months as if that’s a major accomplishment – that’s an average of 1,111 steps a day – strikes me as ridiculous. She’s walking nearly 2/3rds fewer steps than the average amputee (see this post, which includes step data from a 2007 U. of Washington study of 77 amputees who averaged over 3,000 steps a day).

This doesn’t mean the surgery was a failure or doesn’t have a place for the right patient as the technique evolves. But let’s report on it with appropriate perspective rather than promote it without critical analysis. Ok, I’m done with my rant.

*   *   *

I played bass guitar for Max’s band, One-Click Waiting, a few days ago when his bassist had an unavoidable last-minute conflict. That means that over the course of the last 18 months I’ve played drums, guitar, and bass at different times in support of my son’s musical career. Despite my involvement, the band continues to generate good buzz and grow its fan base. My final and definitive contribution to One-Click Waiting will be not singing for the band. Ever. You’re all welcome.

A related aside: carrying large amplifiers with a prosthesis – not fun.

*   *   *

Max has also obtained his driving permit and now jockeys with me for control of my car several times a day. I am going on the record here: I want Max to get his license as soon as possible … so he can drive his siblings everywhere. I’m also very proud of the fact that between his exposure to (1) my personal two-step with a Mazda nearly 18 years ago and (2) Louis C.K.’s comedy routine about cars as weapons, Max has approached his driving experience with an appropriate degree of conservatism. It’s a lot easier to teach your kids to treat the responsibility of driving with respect when you can simply lift up your pant leg to show them the consequences.

*   *   *

When I hear prosthetic experts opine that future prosthetic devices will give amputees abilities that exceed their biological limbs, I keep asking myself a simple question: what good is having a limb that allows you to do things that make you “super-abled” if your remaining (biological) limb can’t match it? Am I the only one who sees this as problematic? Am I also the only person who notices that the people making these kinds of headline-grabbing statements all happen to be bilateral amputees?

I’m not saying there’s anything particularly wrong with their hopes/vision – just that for the vast majority of amputees (i.e., individuals missing only 1 limb), I don’t think it’s all that practical.

And while I’m on the topic, can we first work on creating prosthetic joints that accurately replicate all aspects of their biological counterparts before we paint visions of amputees’ superhuman future? I work in the industry and even I wouldn’t argue that the fanciest, most sophisticated knee joints, feet, elbows, wrists, hands and fingers come close to their biological counterparts. The best devices do a nice job of approximating certain key elements of natural human anatomy, but the gap is still enormous.

But by all means, let’s talk about how the Paralympics will someday feature athletes running the 400M in 23 seconds. That’s a useful discussion.

*   *   *

At least once a month I read a human interest news story about an amputee who is appealing to the public for help locating the prosthesis that robbers stole from their automobile. I’m pretty sure I’ve written about this in the distant past, but if I didn’t, a word of advice: you can avoid this problem by not leaving your prosthesis in your car. Or let me rephrase that: do not leave your prosthesis in your parked car. Ever.

*   *   *

A (very large) guy at the gym asked me to spot him as he benched 100 lb dumbbells on Monday. I was wearing shorts, so he clearly knew my situation. Either he’s a fervent believer in the power of a prosthesis to return an amputee to full strength, or he spends his non-gym time jumping out of planes without parachutes just for the thrill of it. Of those two possibilities, given my overall physical appearance, the latter scenario is more plausible. (I did successfully help him lift the dumbbells over his head to start his set, so he avoided physical disaster.)

*   *   *

I would like a clothing manufacturer to have a special offer for lower extremity amputees that gives us discounted access to replacement pants. No matter what countermeasures I employ, carbon graphite and titanium always triumph over cotton and denim. Little rips start appearing in every new pair of pants roughly 6 weeks after I begin wearing them.

*   *   *

Non-limb-loss-related note: if you like music and you’re not watching Sonic Highways every Friday night on HBO, then you deserve to get trapped in a vehicle going cross country playing only Bryan Adams (Everything I Do) I Do it for You at max volume. On repeat.

Especially enjoyed last week’s installment, where we see Dave Grohl’s trip to Nashville to produce the Zac Brown Band for what later became The Grohl Sessions EP. Best moment is Grohl sitting in the studio and telling the Zac Brown Band that he had never – never – heard one of their songs before and the band members trying to figure out if he’s joking. (He wasn’t.)

Very cool to see musicians from totally different musical backgrounds come together like that. If you want to hear the results of that collaboration, check out Day for the Dead from The Grohl Sessions, Vol. 1. I’d listen to country music all day long if it always sounded like that.

beware the patients redux

patient beware redux 10.2.14

Several weeks ago I wrote about the world-class service provided by a physician seeing my kids for the first time. Here’s an update describing the follow-up visit, as well as a very different experience while accompanying Cara to her doctor a few days later.

the kids

We arrived at the office a few minutes before the scheduled 11:45 AM appointment. I walked to the front desk where a youngish woman didn’t look up as I signed the boys in, focused instead with a grim intensity on applying white-out to printed forms in front of her. Between the time we sat down and finally got called into the patient room I (1) started and finished Gravity’s Rainbow, (2) researched and authored a treatise on the parallels between nihilism and the feelings evoked when I listen to anything by Coldplay, and (3) watched Jackson visibly grow half an inch.

We received the magic invitation to the office’s inner sanctum roughly 35 minutes after arriving. The boys’ boredom quickly escalated as follows:

12:20 – Silence broken by increasingly hostile verbal horseplay between Max and Jackson.

12:25 – Through some unspoken, magical mental alignment, both simultaneously decide that the world’s new coolest game is “Find Inane Ways to Annoy Dad While He Tries to Read.” Favored techniques: funny voices; facial contortions; invading dad’s body space.

12:32 – Boys experiment with rolling stools. Key elements: creating movement without using their feet; elevating and decreasing stool height, preferably while making noises consistent with the vertical space traveled.

12:40 – Boys lie stomach-first atop rolling stools and repeatedly launch themselves across the room. Bonus points for doing it in close proximity to the door where the doctor will presumably enter at some point before the sun sets.

12:45 – Physician graces us with his presence.

Having learned from my prior visit to this office, I declined to stand up or otherwise do anything that would suggest I’m a human being capable of communication. The doctor has taught me well – I know that I’m nothing more than the guy with the insurance card that allows him to bill for the two boys whose names he doesn’t know unless he reads the chart. (And even then … )

The appointment for both boys takes less than 10 minutes. With limited exceptions, the physician avoids eye contact with any of us. He disappears out the door with Usain Bolt-like quickness. He’s in his late 30’s but I swear the guy has the fastest first 3 steps of any human I’ve ever encountered.

I walk back to the front desk to schedule our next visit to this Kafka-esque setting. The receptionist still sits there whiting out forms, still not acknowledging the existence of any person near her. I’m thinking the only task that could simultaneously involve such concentration and barrels of white out involves altering patient experience surveys that link directly to said employee’s compensation structure. I leave, happy to be gone.

the wife

We arrive at the office exactly at the scheduled time. Parking is tight, so I drop Cara off while I search for a space. When I get into the office 3 minutes later, Cara’s engaged in a smile-filled conversation with the receptionist. The billing person, sitting next to her, smiles and says hello as I walk in. Cara introduces me to the receptionist, who has built a friendly relationship with her over the phone in the weeks leading up to this visit. We talk for the next 8 minutes at which point we’re escorted into the patient room.

Less than 5 minutes later the doctor comes in and has (gasp!) an actual conversation with my wife. He explains what he’s going to do. She asks questions. He answers them. One specific query gets lost in the mix and I raise it again. He answers it.

This is a strange experience.

Nothing has prepared me for something approaching normal human interaction in a medical setting. Before the physician leaves the room he mentions to Cara that he’d appreciate it if she filled out online rating systems describing her experience at the office. He tells her that the receptionist will give her information about the relevant websites before we leave. I feel like an anthropologist watching an heretofore undiscovered tribe, desperately wanting to record everything I see and hear but fearing I’ll miss something earth shattering in the process.

We walk into the waiting room where the receptionist hands Cara a sheet of paper with the aforementioned web addresses of the ratings websites. Consistent with the doctor’s statements, she says that it would mean a lot to them if Cara took the time to evaluate them. They talk for another 3 minutes about the doctor’s instructions, the receptionist addressing Cara’s concerns and providing supportive feedback. We leave. My wife is visibly happier upon her departure than when we went in.

analysis

After reading “the kids” section of this post, you might reasonably ask, “Why are you still going to that idiot?” I have a three-pronged answer to that question: (1) I’ve been to enough doctors’ offices to know that this is the norm, not the exception; (2) the next-best physician who may offer a better user experience will necessarily work farther away from my house than Dr. Personality, so any savings in time I may enjoy from a more efficiently-run office will be lost in a longer commute anyway; and (3) medically he’s great, so I’ll tolerate monthly visits to hell with gritted teeth because it’s the best thing for my kids’ health (though not my sanity).

The most depressing aspect of this tale is the fact that I found the visit to Cara’s physician so remarkable. In any other service-related industry, what he and his staff do would be merely acceptable, not noteworthy. But put them in a medical setting and I react like they’ve solved a fundamental mystery of the universe.

my challenge to providers

As patients, we have to sign all kinds of documents when we go to medical facilities giving the practice the rights to our first-born in the event that we don’t live up to our payment obligations. So I’d like to counter with a proposal for those on the other side of the waiting room: how about whenever a new patient comes into a facility, the treating practitioners take the time to physically sign a written pledge that they’ll (a) see you on time, (b) contact you before you arrive at the office if you won’t be seen within 30 minutes of your scheduled appointment, (c) make a $25 donation – that’s about what they typically collect for your copay nowadays, no? – in your name to a charity of your choosing if they fail to comply with (b), and (d) compassionately and thoroughly answer your questions in language that’s easy to understand. Anyone brave enough to take that one on?

what if … you just kept your mouth shut?

less is more 04.01.14

What if the fact that you wore (or didn’t wear a prosthesis) inherently put you in situations where you had to make the difficult choice to either tee off on someone or hold your tongue? What if you chose the “right” answer and still ended up with a lousy result?

What if a business owner refused to let one of the hosts of this podcast – a pregnant, prosthetic-wearing individual – sit in his premises even though the nature of his business included bleachers designed for (gasp) people to sit on? What if I gave you a hint and told you that the aforementioned host of this podcast wasn’t me?

In this week’s Amp’d, listen to this sordid tale and feel the righteous indignation well up in your chest. As I and my co-host, Peggy, discussed before recording it, these kinds of stories make for a miserable individual experience but a compelling podcast. Enjoy.

what if … limb loss and holidays don’t mix well?

less is more 12.23.13

What if you geared up for the end-of-year holidays and you didn’t feel particularly upbeat? What if you felt that way normally and then had to deal with the loss of a limb?

What if two people had major amputation (or amputation-related) surgeries less than a month before Christmas? What if both of those people happened to also talk about it online?

In the final 2013 installment of both less is more and Amp’d, listen to an amusing podcast about how family (and medication) helped us survive our first Christmases as amputees. Click here to listen.

And thanks to all less is more readers for their continued support  and feedback this year! I hope you all have a wonderful holiday season and a happy and safe New Year! less is more will be back with a new post in 2014.

less is more’s summer break

less is more has decided to take a few weeks off for its summer vacation. Which leads to the question: what does a blog do when it’s not writing itself?

1. Reads Chuck Klosterman’s new book. (Simultaneously entertaining and disappointing.)

2. Reads World War Z by Max Brooks. (Same comment.)

3. Starts reading The Son, by Phillip Meyer. (Promising.)

4. Tries to meditate every day.

5. Tries to stay well hydrated in sweltering heat. And

6. Tries to work out every day.

What do I do while all of this is happening? Mostly admire the blog for its commitment to mental and physical recharging.

The blog looks forward to reconnecting with all of you on Tuesday, July 30.