I’m tired.  I’m really tired.  Unfortunately, I haven’t been able to sleep very well lately.  Part of it is the ankle.  If I have to get up in the middle of the night, it aches for a while after I lay back down.  A second part is also the ankle.  Not knowing what’s going on with it and why it still hurts is bugging me.  Third, it’s Christmas time.  Stress is always here around Christmas.  Between the money literally flying out of my hands and the PTSD it’s tough to sleep.

  I’m going back to the doc again in about 12 hours.  Something just isn’t right with my ankle.  It’s tight, which I expected.  But, I still can’t stretch it out.  See, when I try to stretch it burns.  It burns on the inside of my ankle from my medial malleolus (the bump on the inside of the ankle) all the way to the back and bottom of my ankle.  Imagine drawing a square over that area and that’s where it hurts.

  I know I have tendonitis, but this doesn’t feel like tendonitis pain.  I think one of the ligaments healed inside the joint, or I have part of the posterior tibial tendon caught in the joint, or I have a pinched nerve.  I’m going to ask the doc to send me for a second MRI.  I don’t think he’ll disagree.  I just need the answer and if I need surgery, I need to get it scheduled.

  I think another reason I’m not sleeping is that I’m not exercising.  Usually I can get some exercise in during the week and expend some of this energy and stress.  Ok, yes, you’re right, I could still workout.  And, I need to do it.  I guess I need to start hitting the cross trainer and hope that it helps me get back on track.

  As for a marathon in the spring.  It’s not going to happen.  In fact, I don’t know if I’ll even be ready for  a half marathon.  I hope to be able to at least run the half, but I just don’t know.

  In case you’re wondering, the CFF marathon team here in Cincinnati, Team for Life, needs members.  The fundraising goal is $1000.  I know, that sounds like a lot of money.  Trust me, it’s easy to raise.  If you’re reading this and are interested in running in the Flying Pig (Marathon, Half Marathon, or 4 person relay), please leave me a comment.  With the economy, the CF Foundation is hurting too.  My life and the lives of 30,000 other CF patients are directly affected by the work and fundraising the foundation does.  I truly appreciate anyone that runs with the team.  We are not just raising money, we’re practicing sacrificial giving, as Coach Wheeler says.  Time to try to get some more sleep.

  Yesterday was my second follow-up appointment with my podiatrist.  It was a good appointment, but I should explain my Physical Therapy appointment first. 

  Therapy was at 8 AM.  I got there about 40 minutes early, so I hit the cross-trainer for some cardio first.  I ended up going 20 minutes at 190 strides per minute.  It was far from easy, but I really needed to push myself.  My ankle hurt, but not too much.  The range of motion on the cross trainer isn’t that large.  I then proceeded to do all of my leg work.  I did the leg press, toe raise, and “running” exercises on the reformer.  I also did lunges, squats, and step ups on the evil bosu.  Then a few other balance and proprioception exercises.

  Jamie, my therapist, also wanted to work on my stairs.  See, I can’t go down them very well.  I typically point my toe and land on the ball of my foot when coming down stairs.  I explained to her that the inside of my ankle hurts when I do that.  Honestly, I thought it was my deltoid.  After some discussion and prodding, we located the source of the pain.  It wasn’t the deltoid, it was the posterior tibial tendon.  I had tendonitis.  I had all of the classic symptoms: pain on the medial side of the foot, fatigue after minimal activity, and pain when rising on the ball of the foot.  Jamie wrote a quick note to my doc and I took it to him.

  So, at the doc’s I handed him the note.  He read it and said that he figured that’s what I had.  He said that dealing with this injury is like peeling an onion.  Last time we treated the joint line of my ankle, as that was the most painful at the time.  Yesterday, he gave me another shot to address the tendonitis.  He gave it to me under ultrasound and did a great job.  He hit the trigger point of the tendon exactly, as my the tendon fired almost immediately upon the injection of the med.

  Today, my ankle feels about 80%.  It’s not perfect, but it’s to the point were I can work on range of motion and flexibility much easier.  I’ve very happy about that, although I think I’ll need another shot in a couple of weeks just to make it 100%. 

  I’m sad to say that I’ll be missing the 100th running of the Cincinnati Thanksgiving Day Race tomorrow.  I was really looking forward to running it, but my ankle is nowhere near ready to run.

  It’s been a long time since I’ve posted so I’ll do a quick recap.  On October 27th I went back to my podiatrist for a follow-up on my ankle.  At that point, my doc told me that I was allowed to begin bearing weight on it.  It was a slow process, but about 10 days later I was “walking” on it without the crutches.

  Since then I’ve been to Physical Therapy twice a week.  We’ve been working on Range Of Motion, stretching, strengthening, and proprioception.  I’d love to tell you which I need the most work on, but I think it’s all of them.  I’ve made some progress, but am still limited by the swelling in my ankle.  This swelling is causing me pain when I try to increase my range of motion.

  Today, I got to go see my doc again.  He was very happy with the stability of my ankle and feels confident that the ligaments are healing correctly and are not in the joint.  So, that means no surgery.  I did discuss my limited range of motion due to the pain.  I also mentioned my plantar faciitis, which is to be expected after not moving it over a month. 

  The good news is that he shot me up.  That’s right, more of the MLB players fix for what ails you….steriods.  Kenalog in fact.  He gave me the shot in the medial side of the ankle, right near my deltoid ligament.  Within about 2 seconds a tingle shot up my foot and it was completely numb in about 30 seconds.  Of course, I did joke around that I wouldn’t be able to drive home.  Oh, and I should note, I took him about 20 of my world-famous Chocolate Chip cookies.  He wanted a lemon meringue pie, but those don’t travel too well.

  My next stop was at Physical Therapy.  I went there immediately afterwards so that I could get in some of the beating while I couldn’t feel the foot.  I did more today that I have any other day.  Of course there is the reformer and the calf board stretches.  But, I also did some work on the flat side of the Bosu.  Balance, squats, throwing and catching a medicine ball, and generally any other torture they could think of while I was on there.  I also did 30 modified lunges (I’m really feeling those right now!)  and then Jamie massaged my plantar fascia as well as my entire ankle.  We finished up with ice and stim, which felt great. 

  I’ll be interested to see how it feels tomorrow but it’s kinda sore right now.  I’m hoping to be back to running within a few more weeks.  There are no promises, but I’m going to keep working toward that.  All in all, I’m back to most of my activities but still no running.  Stairs are still a small issue due to the proprioception.  And, I really have almost no lateral strength in the ankle yet.  But, it’s getting better every day.

Just a bunch of random thoughts tonight. 

Health Care Reform

  Ok, I don’t know anything about politics and I don’t claim too.  I know that something needs to be done, however.  I just found out that my health insurance premiums for next year are going to go up 50%.  That’s bad, but I’ve good insurance so I’ll take that.

  But, as a CF patient, I have enough medical expense.  Let’s list out the meds alone.  Albuterol $10, Pulmozyme $40, Tobi $40, Ultrase $20, Synthroid $20, Mirapex $20, Nasonex $20, Azythromycin $10, Flovent $20, Patanol $20.  So, that’s $210 per month, just for meds.  And, of course, most of those will go to $40 next year (just my guess).  This doesn’t include the doc visits.  And of course my wife and kids have bills too.  It’s crazy.  I know that’s not what needs to be fixed, but it’s the part that I see each and every day.

Shock to the System

  My new friend Tara is going through a very tough time.  She’s 34 and a former elite tri-athlete.  On September 1, she was diagnosed with CF.  I can’t imagine what she’s going through.  She I don’t know life without CF.  She did and I guess still remembers it.  Well, Tara, when you read this, things will get better.  You once said you were pondering the meaning of your life now. Well, I can tell you what I think it should be.  You should use your experiences and physical talents to inspire the rest of the CF patients out there.  Even though you now you have CF now, you also had it when you were winning tri’s.  Use that to show people what they can do to overcome challenges.  That’s just my opinion.  BTW, I’m still going to push you to come run The Pig with me.

Hug Me!

  Ok, not literally.  My ankle needs it.  I go back to the doc on Tuesday and hope to be able to walk again.  I’m not holding my breath however.  Well, I think there’s a chance.  See, my ankle has been hurting lately.  It’s my deltoid ligament, on the inside of my ankle.  It’s only when I sleep and I think it’s because I move it too much when I sleep.  It feels much better when I keep it wrapped.  So, I guess until Tuesday, it’s going to stay wrapped as much as I can bear.  Like I said, I just need a hug.

Good Luck Kelby

  My friend Kelby is running her first full marathon tomorrow.  She’s running the Marine Corps Marathon in DC.  I won’t tell you what her goal is, in case she doesn’t make it.  If she does, however, I’ll sing her praises here on my next post.  Good luck tomorrow Kelby.  Remember, it’s not the 26 miles that kills you, it’s the 0.2 at the end.  Also, remember to have fun.  There’s nothing like finishing you’re first full.

  Yesterday afternoon I began replying to “How are you?” with “I’ve had better days.”  Both the kids woke up sick yesterday morning and my wife Kristen was also sick.  I went about trying to help them all feel better, take some care of the dog, and get ready for work.  All this while on crutches.

  By about 9 AM, Michael had spiked a fever to around 101F.  Kristen and I decided that a trip to the doctor was in order.  So we took them both together.  They asked that she and the kids wear masks, and I grabbed one also.  After an exam, a nasal swab, and about 15 minutes we learned that both kids tested positive for the H1N1 virus. 

  Now, this didn’t surprise us at all.  In fact, we were concerned that they had it.  We needed to know so I could get TamiFlu.  Michael is also on TamiFlu, as he has asthma.  Kristen didn’t is assumed to have H1N1, but was not tested.  They all have a nasty cough, headache, sore throat, and significant fatigue.  Interestingly, Kristen doesn’t have a fever.  The CDC says that 30% of H1N1 cases are without fever.

  So, for the next few days, it’s going to be lots of liquids, tylenol, advil, and rest for the three of them.  And, I’ll hope that the TamiFlu keeps me from getting this. 

  Oh, and I do have to complain a bit here.  My insurance plan through work (H@#$#A) sucks.  They have TamiFlu as a Tier 3 drug.  So, we threw away $40 for each of the Rx of TamiFlu.  I’m sorry, but in a year that they know there’s going to be a high demand for a drug they make sure that it’s the highest Tier.  They’ve also been taking all of my CF related meds to Tier 3 also.  About 1-2 per year.  I can’t wait to see what happens next year with the insurance.

  Damnit!  It’s fall in the Greater Cincinnati area and the stupid walnuts are falling too.

  This morning my friend Jamie and I went out for a short run.  Well, “long” for me, short for her.  She’s going to be running a half marathon on Sunday.  We thought that she could use this as her last run before the race, and I could use it to get back into shape. 

  I met her at her house, we walked to the top of her hill and then turned right.  We had decided to go on a bit of a hilly route on Grand Avenue.  So, we go about a quarter of  a mile and turn left at the light.  Grand is a windy course with a rolling elevation.  I was thinking that I had to be careful on the first left hand curve, as there are some oak trees that hang over the sidewalk and they tend to drop acorns.  I’ve had move than a few run-ins with the acorns.  Nothing serious.

  Jamie and I had run about 3 houses toward that curve when I suddenly felt my right ankle step on something, it turned and I was on the ground.  Then I felt the pain!!!!  I grabbed my right ankle yelling something along the line of “I broke it!”  My ankle didn’t feel right, felt like it was sticking out.   Then I felt a pop…it was dislocated and popped back into place.

  Turns out I stepped on stupid walnut.  (I’d rather use a stronger word, but this is a family blog).  Landed right on it!  My ankle turned completely.  So, Jamie ran back to her house and got her car.  She also woke her husband up to help me out.  Meanwhile, I waited, sitting on the sidewalk in the rain, bleeding like a stuck pig from my left knee.

  The ankle didn’t hurt that much, but I could feel it starting to swell.  I managed to stand up and attempted to put some weight on it.  That wasn’t a good idea.  Jamie and Joseph showed up after what seemed an hour.  It was really about 5 minutes.  I hobbled into her car and she drove me home.  They then helped me to the door and I sent them on their way.  Jamie and Joseph, thanks again for the help.  I’m glad Jamie was with me, I wouldn’t have been able to get home without you.

  I rang the doorbell, Michael opened it with Kristen behind him.  I said to her, “I don’t think  you’re going to work today.  We’re going to the ER.”  She saw my knee first and said something along the line of “What happened?”  I told her that I’d about broken my ankle and she said “well, you can drive yourself to the hospital, can’t you?”  Now, in her defense, work was going to be crazy today for her.  She’s working on the H1N1 vaccine studies at Children’s Hospital in Cincinnati.    I think they had 21 patients between 3-5 today. 

  So I showed her the bad ankle and she decided that maybe I couldn’t drive myself.  Well, we went to the University of Cincinnati Hospital ER.  They were great.  I was in and out in about 2 hours, which is amazing for an ER.  Now, I did contact my pulmonologist because I figured that they were going to get a call for the “what precautions do we need to take for surgery for him?”  Dr. Joseph called the ER and gave them the scoop on me.  I think I got in quicker because I needed respiratory isolation (due to the H1N1 flu crap). 

  The diagnosis: a severely sprained ankle.  Honestly, I can’t believe it.  I was sure that I had torn something in there.  The pop when I touched it was my clue.  I guess I’m not a doc after all.  I’ll be out of running for at least a couple of weeks.  I’m really not happy about this.  I was really looking forward to getting back into shape and improving my running.  Now I guess I’ll just be working on getting my ankle better.  I’ll still be at the Run Like Hell, but I probably won’t be running in it.

  The next week is going to be percocet, ibuprofen, and crutches.  We’ll see what happens after that.

  I hate stupid walnuts!!!!!!

  Ok, well maybe not normal, but within normal range.  Here’s the story.

  Yesterday I had an appointment with my pulmonologist and then an appointment to enroll into a research study.  I was at the pulmonologist for quite a while.  Most of it was just bad timing.  Before my appointment I had to do a Pulmonary Functions Test (PFT).  I have to do them every time I go see her, so this is nothing unusual. 

  I ended up blowing an FVC of 3.12 liters and an FEV1 of 2.57 liters.  Not my best and a little down from 4 months ago.  But that didn’t bother me at all.  I took almost all summer off from running, and my last numbers were right after marathon season, so I was in shape.  Dr. Joseph commented on it, but wasn’t concerned at all.

  Around 11 Am I went to Children’s Hospital to enroll in the study.  The study, AZLI vs. Tobi (two different antibiotics), has a requirement that you must be under 75% FEV1.  My number earlier was a 73%, so I figured I was in.

  Well, I get to the PFT lab at Children’s and start the test.  My first blow is always lower than the rest, just because I have to clear everything out of the airways.  In fact, my study nurse commented that I didn’t try that hard.  Well, I didn’t try hard, but I did blow my way out of the study.  You see, I blew a 2.81 (liters), which is 81% on their scale.  My nurse (whom I know very well) yelled at me for doing so well.  She was kidding, as she’s very happy that I’m so healthy.  But I had just finished telling her that I was a 73% at UC. 

  She also commented that my lungs are better than hers.  The RT that did the test said “You’re joking!”  She said that she can only blow a 75%.  Scary that a 38 year old Double Delta F508 CF Patient can still do that well.

  By the way, about the normal comment.  In the PFT world anything between 80% and 120% is considered the normal range.  So, like I said….I’m normal!  (Anyone that knows me will tell you that I am certainly not normal!)

  Hold on tight, this is an actual running related post. 

  Over the past 4-6 weeks I ‘ve decided to improve my running.  Well, I’ve decided to start running again…and improve what I’ve done in the past.  I really had to get back to the point where I missed it.  Well, I’m there.  Part of the improvement is loosing weight.  I’m down about 7 pounds, heading for 17.  The second part is actually improving the running.  I’ve been working on exercises from the book Explosive Runningby Dr. Michael Yessis.

  Dr. Yessis has a very interesting view on improving running.  The first section is about running form.  Honestly, I’m not tool concerned about form.  It’s not that mine is perfect, but I’ve got bigger problems.  The next three sections are on running specific stretching exercises, strengthening exercises, and explosive (plyometric) exercises.  His process is to perform these exercises within the movements of running.  It’s a little hard to imagine, but pick up the book if you’re interested.  I’ll warn you, it’s very technical, which is great for computer geek me.

  I’ve been working on the stretching and strengthening exercises for the past 5-6 weeks.  I’ve seen some decent results.  First of all, I can tell that I’m stronger than my cardiovascular system can handle.  Right now, it’s my lungs holding me back, not my legs.  That will get better as I run more.  Second, I’m recovering better after each run.  I’m only running every other day, but usually my shins are sore after a run.  Not at all right now.

  Today I had my first really interesting run after starting the exercises.  I started out to run three miles, which is my short, medium, and long distance right now.  My course had a couple of decent hills in it, but I didn’t really want to focus on them. Instead, I decided to try to focus on my pawback and toeing off for each step.  You know what, it really worked.  And, I was able to tell when I lost focus.  When I got to about 2.4 miles, back at my street, I decided that I’d go a whopping four miles.  So, I just did an out and back of 0.8 miles.  Up until now, I’ve been averaging about 11 minute miles.  Today, without really pushing I run all four miles in a 10:20 average.  Now, that’s not going to set any records, but 40 seconds per mile is pretty good in just a few weeks. 

  I’m hoping to continue the improvement, lose the rest of the weight, and be in good shape for marathon season.

  No, this isn’t about me.  It’s about my father, Earle.  It’s a new story that I heard this weekend.  I thought it was hilarious, hopefully you will too.

  When I was young, maybe 12 or so my brother Dave and sister Judy rented a house together.  It was an old three story house.  The top floor was turned into the perfect bar.  It already had a bar, they put in beer signs and a pool table, and gave it the perfect name: Busch’s Dive Bar.  The only thing it didn’t have was a refrigerator/freezer on the third floor.  I’m not sure why, but it had to go on the second floor.

  It was an old fridge, with a very small freezer inside the fridge.  The only problem was that the freezer didn’t have a door.  Well, my father the engineer, and english major mind you, decided to make a door.  He took some styrofoam and a piece of plexiglass and made a door.  It took him about 30 minutes. 

  Well, being the engineer that he was, he set out to layout the word freezer on the new freezer door.  He layed out the letters so that they would be evenly spaces.  He created nice block letters in perfect type with a sharpie.  He spent 2-3 hours working on the lettering.  At least that’s how my brother Pete tells it.  When he finished, Pete walks in an looks at the perfect lettering, etc. and says “What in the hell is a Feezer?”  Dad looks at it and says “Well, hell, I forgot the R!  Oh well, it will have to do.”

  My mother says that it was the funniest thing that he was an English Major that couldn’t spell.  She says that his spelling was horrible.  I can only imagine the people who moved in when they left asking “What idiot wrote Feezer on this door?”  I can’t stop laughing when I think about it.

  I miss my dad very much.  I miss his sense of humor and I miss hearing the crazy stories about his life.   Most of all, I just miss having him around.  But, it stories like this that will keep him in my heart forever.

  So now if someone asks, “Where’s the feezer?” I’ll have a clue what they are talking about.