I Think I've Spent All My Bile

Some more general thoughts about illness and injury . . . 

1.  If something hurts then try to manipulate that thing to keep the pain in the forefront.  This is particularly helpful when you've reached a steady state where you can't actually feel the pain but that you have a sneaking fucking suspicion that the pain is still there, lurking just under the surface, ready to spring into action if you apply the correct force, torque, or pressure to the injured thing.

You can do it.  You know you can.  Find your inner discomfort.   FOCUS on it!

Practical Example: Sore tooth.  You have 32 teeth so if you have 1 sore tooth that means you have 31 teeth that aren't sore.   Use your tongue to probe the sore tooth repeatedly, whether it hurts or not.  More force is recommended.  If it doesn't hurt don't get discouraged - come back a little later and try, try again until the pain is reactivated.  The tooth has not healed - no, never.  The pain is simply dormant, hibernating, waiting to spring back into action.

“I don't see why there should be a point where everyone decides you're too old.  I'm not too old, and until I decide I'm too old I'll never be too fucking old.”  Lenny Kilmister of Motorhead

2.  If you injure yourself or get sick it's important to remember the Never/Forever Rule.  It will Never heal and you will feel like this Forever.  Always is also a good word to keep in mind.  And in this general milleau it's helpful to understand that YOU are the ONLY person who has ever had a difficulty like this and NO ONE ELSE understands what you're going through.  You are very, very special.

I'd like to add that the Never/Forever/Always Rule can be effectively applied to almost anything that you really like or really don't like.  As we say often around the Seaweed household: Nobody knows the trouble I've seen . . . 

There is no difference between an old man and a young man as long as they are both sitting down."  Mark Twain

3.  Complaining is important.  It makes you feel better and it makes you popular with others.  Don't you enjoy being around people who are always bitching about this or that?

I'd like to note that I complained about my knee with my neighbor who is going in for knee REPLACEMENT surgery.  My chutzpah knows no bounds.

Admission

Admit:  To concede as true or valid; confess to be true or to be the case, typically with reluctance.

(Ed. Note:  the italics are mine.  I love that the definition indicates that an admission is a begrudged concession, not an easy, willing action.  You are giving something up that you don't want to give up.  You are holding onto something that you should release).

We admitted we were powerless . . . 

"OK, whatever, I'm fucking powerless.  There, you happy?" This is roughly how I admit to anything that has a stranglehold on me.

( I'm going to digress way, way off the path for a minute.  There's this lyric by Ted Nugent which I was compelled to look up because I used the word stranglehold: "Got you in a stranglehold, baby, you best get out of the way" always confused the hell out of me.  How can you get out of the way if you're in a stranglehold, by definition a grip or control so strong as to make escape impossible?  Makes no sense at all.  Pretty good song, though.  I took a short break to listen to it on YouTube even though Ted is an asshole.)

When god closes one door he always opens another, but it sure can be dark in the hallway.

Maybe I'm grudgingly moving forward.  I'm getting tired of writing about all this, that's for sure.  I don't think there are any more words for me to look up in Step 1 and this is saying something because I like words, mostly because they help me avoid writing about what's really on my mind.  I'm at the atomic, elemental level of my vocabulary research unless I want to research words like "were" and "and."

Remember: It's always the darkest right before it goes totally black.

Pessimism:  Tending to see the worst aspect of things or believe that the worst will happen.  (Synonyms include gloomy, negative, defeatist, cynical, bleak, fatalistic, dark, black, despairing, and hopeless.  Ed. Note: These would ALL be EXCELLENT names for a hard rock band or at least the stage names for the musicians themselves . . . "and on guitar please welcome Despairing . . .")

Optimism:  Hopefulness and confidence about the future or the successful outcome of something.

Also, apropos of nothing, pessimisties is how you say pessimism in Afrikaans.  Never know - might come in handy some day.

I hate optimistic people: cheery, upbeat people who always have a big smile on their face and a sense of unbridled optimism.  I would honestly rather share an office with an ax murderer - an active ax murderer who is currently murdering people with his ax - than one of those cheery people.  These people bring to mind the true meaning of the phrase "Scourge of The Earth."

Scourge:  A person or thing that causes great suffering.  

I had a coffee mug once that said: "Have a Nice Day Elsewhere."

Remember: the light you see at the end of the tunnel may be the locomotive coming straight at you.

Living The Life In Seaweed World

So more irritating things have made themselves know.  I feel like I'm in a seance talking to a poltergeist that I can actually see.  It would be great if things made themselves known at the beginning and all at once.  This discovery crap, this uncovering of hidden truths . . . very annoying.  I would say I wish I was a finished product, one that didn't require so much detailing, but the product obviously needs a bunch more finishing.

Let's recap:
Mom and dad made me mad.  Which I did not know.
I am powerless over my health and my body.  Which I cannot admit.

And now, completing the Trifecta of Irritation, is the realization that my exercising has also reached the unmanageable stage.  And the out of control plateau.  I don't need to exercise as much as I do especially given the fact that I've been suffering from more and more overuse injuries: back, wrists, elbows, knees.  So I'm also powerless over my exercising.  I want to exercise, I need to exercise, I MUST exercise.

Here's an example, no doubt obvious to you, gentle observer, but opaque to me: I have this swimming style where I mostly pull with my arms and kind of let my legs drag along behind me, like so much useless ballast.  I guess I'm naturally buoyant so I've never felt the need to kick and flay about with my legs.  A few weeks ago I decided that it would be a good idea to work on my legs so I started kicking a little bit.  Not a lot of kicking but more than the none I was doing before.

"Oh," winced SuperK.  "I don't try new things anymore.  Kicking your legs like that has to be hard on your knees."

Where are all of these smart people when I'm doing all of these dumb things?

I've tried to use this down time to learn some stuff.  All of the time I've been able to devote to my writing has been great.  I've also done a lot of studying about these issues that are upsetting me: pain awareness, mommy syndrome, the effects of aging, etc.  There are lot of smart people out there, did I mention that?  Anyway, much research has been done on the effects of aging on the body and how best to respond to it, and I've found that if you pay attention to the source of the information that the advice becomes remarkably consistent.  Of course, if you're reading obscure blog posts written by people with no qualifications to be commenting on whatever area of expertise you're researching then you're going to see the data points start to veer off the path but, all in all, good research leads to consistent results.  Many experts begin to use 40 or 50 as a marker for when the body begins to respond differently and should be treated with more kindness.  Blew right by those mileposts without changing a fucking thing.

I have exercised literally almost every day for 20 years.  This is ridiculous.  There is no need for this.  Excessive is what this is.  This is not salutary behavior.

I still have a definite outcome in my mind.

I should be thankful for improvement, however slow and incremental.

I should at least add the qualifier "if it be thy will" to my inflexible demands to have things work out the way I want them to work out.

Maybe this knee thing is a metaphor for my life.  As in, act your age: you aren't 75 and you aren't 35.  Maybe the down time is a big Taser, trying to jolt me into some semblance of reality. I should hire someone to walk around with me and slap my face whenever I drift into Seaweed World.  Perhaps I am seeing that I'm really lost without exercise.  Perhaps the fact that I'm not having to burn off sugar calories is helping me to eat less of them.

Reality:  The state of actually being, existing, or occurring; not imaginary or fictional.

And then there's this: when something that is upsetting me is removed or ameliorated to my satisfaction I feel better.  Happier.  I'm not sure that this is turning it over.  This seems more like getting what I want.  I know my health and my knee and my exercising are unmanageable but am I powerless?  Maybe flushing a trip is an example of powerlessness . . ..  

Maybe it's just that concrete.

This Is Really Not Fair

Agog:  (Chiefly of eyes) Wide open; in a state of high anticipation, excitement, or interest.

Several years ago I told SuperK that I had recently learned that people began to feel more aches and pains as they got older.   I was under the impression that you just got slower.  Lost a step.  Your 40 yard dash times went down and you weren't quite as good in man-to-man coverage.  I honestly, no-shit did not even consider the possibility that there was physical discomfort involved.

Agog is the word that comes to mind when I recall the look on her face.

"You are unbelievable," she said.

"How did I get stuck with you?"  she said, much more recently, recalling the conversation.  "You are a weirdo."

In one of my favorite episodes from Seinfeld the loser character George is brainstorming with Jerry about possible career paths to replace the job he just lost.  He's coming up with ridiculous options like talk show host or sports broadcaster, reminding Jerry that he always makes great comments when they're watching a game together.

Jerry says: "Yeah, you make great comments  . . . but normally they give those jobs to ex-ball players or people in . . . you know . . . broadcasting."

George stares at Jerry for a couple of beats: "Well, that's really not fair."

Yes.  Yes.  This Is Really Not Fair would look great on my headstone.

Step One Sticking In My Craw

Character:  Strength of mind; resolution; independence; individuality; moral strength.

So this writing bullshit is really starting to stick in my craw and - as you are well aware - my craw is packed with bullshit of all kinds.  I may have several craws, a whole array of craws or, perhaps, I have a grotesquely monstrous craw, as big as a Buick, based on all of the irritating things that I've managed to cramstick in there.  I'm always finding new things to be irritated about and right into the craw they go with nary a peep from any craw proprioceptors.  My proprioceptors are bored: "Keep the bullshit comin', Seaweed," they say, not even bothering to look up from their cell phones.

First, the inventory that I finally do on my mom and dad uncovers all kinds of carefully covered things, revelations that I'm finding very helpful.  Who knew?  Then, on my wife's recommendation, I'm working a formal 12 Step inventory on my unhealthy fascination with my health - not merely an inventory but the exercise where one starts at Step One and goes through the Steps, in order and one by one, the task complete only when Step Twelve is completed.

Perhaps some numerology will help clear this up . . . . 

And the LORD spake, saying: "First shalt thou take out the Holy Pin, then shalt thou count to three, no more, no less.  Three shall be the number thou shalt count, and the number of the counting shall be three.  Four shalt thou not count, neither count thou two, excepting that thou then proceed to three.  Five is right out!  Once the number three, being the third number, be reached, then lobbest thou thy Holy Hand Grenade of Antioch towards thy foe, who, being naughty in My sight, shall snuff it.

(If you're a true Python addict . . . the Latin lyrics that are being sung as the Holy Hand Grenade is being retrieved, under the watchful eye of Brother Maynard, are "Pie Jesu Domine, Dona Eis Requiem" which approximately translates into English as so: Compassionate Lord Jesus, Grant them Rest - and is part of many Catholic funeral liturgies).

This was such spectacular advice that I decided to take it.  I figured that I would quickly blow through One, Two, and Three, getting to the Step Four inventory that I had predetermined was at the heart of the solution.

The sounds you hear are the screeching tires of a Very Expensive Car coming to a full stop.

Step One shakes out so: I admitted that I'm powerless over my body, that my health is unmanageable.  I know this sounds kind of silly but my understanding of this process is that one substitutes the bothersome character defect in place of "alcohol."  I marvel at the work I've done on my character defects, at how so many of them were lifted out with a minimum of effort, a smaller number came out, more or less, with some more considerable amount of work, and then there are those troublesome few that are lodged in there sideways.

I again take solace in these words: "If we ask, god will forgive our derelictions.  But in no case does He render us white as snow and keep us that way without our cooperation. "

Sounds frustrating.  We are forgiven but not absolved of responsibility for our behavior and, even then, god is going to do whatever god wants to do.  God is not looking for feedback from me.  God has this.  There is nothing in there that god needs help with.

And here this is again, a concept that bears repeating: ". . . why then shouldn't we be able to achieve by the same means a perfect release from every other difficulty or defect?  This is a riddle of our existence, the full answer to which may be only in the mind of god."

God is not looking for my input.  The lines of communication may run both ways but there is no doubt who's in charge.

Anyway, I am totally, completely, unambiguously down with the fact that my health life is unmanageable.  Out of control.  Lost all perspective.  Balance is gone.  It is the only thing in my life that consistently upsets me and it's tireless in that regard.

Clearly I'm powerless.  I'm down with this.  No argument here.

Power:  Ability to coerce, influence, or control.

However, I'm still trying to manage the shit out of the situation.  I am trying to manage the outcome to control my health so that I fee the way I want to feel - good and definitely not bad.  This is outcome stuff, running directly counter to our suggestion that we do the work and leave the results up to god.  There is nothing anywhere to suggest that I'm going to get what I want.

Do Not Read This Post

Nobody needs to read this.  This is stuff nobody needs to read but me.  This is the output of all of the research I did on my knee, which is all that I'm concerned about right now.  If you're on fire and I have a bucket of water and a computer,  I'm going to be doing research on my knee, not dousing the flames.

The salient information for me is that if I take the time, visit competent sources, listen to trusted voices (www.you'regoingtodietoday.com is not a trusted voice) then I'm going to find a consensus, a balance, a median between reasonable extremes.  Facts begin to shake out.  Bullshit begins to fade.

The facts is the facts. 



A twisted knee is one of the most common way the joint gets injured.  This type of injury most commonly occurs during sports or by falling awkwardly.  Depending on how the knee twists, it places stress through different structures of the knee so accurate knee pain diagnosis is vital.

Most commonly, it is the ligaments or cartilage that get damaged when the knee over-twists.  Ligament injuries tend to cause ongoing problems with stability and the knee may frequently give way even months after the initial injury. 

Cartilage injuries tend to cause pain and swelling, may limit knee movement, and at times can cause the knee to get stuck.  In more serious injuries, multiple structures may be damaged.

• Grade 1 Recovery Time - If you have suffered a grade 1 MCL tear, recovery time is usually under two weeks. In fact, some people return to sports or exercise in one week.

• Grade 2 Recovery Time  - Grade 2 MCL tears take a little longer to heal.  One month is average, though this depends on your personal circumstances.  Some people make a full recovery from a grade 2 injury in two to three weeks. 

UCSD

Treating MCL Injuries

Treatment starts with rest, ice and elevation to ease pain and swelling.  In the next stage, you start exercises (physical therapy) to improve your knee’s range of motion, strength, and flexibility.  You may need a brace for weeks after your injury. Using crutches or a brace rests your joint, helping it to heal. 

The vast majority of MCL injuries heal well without surgery.

UCSF

Recovery times differ depending on the severity of the injury:

• A minor, or grade 1, MCL tear can take from a few days to a week and a half to heal sufficiently for you to return to normal activities, including sports.
• A grade 2 tear can take from two to four weeks to heal.
• A grade 3 tear usually takes from four to eight weeks to heal, unless it is associated with damage to the ACL, in which case the recovery time may be longer.

Mass General

 Rehabilitation after Injury to the Medial Collateral Ligament of the Knee Phase 1: The first six weeks after injury (grade 2 and 3) three weeks after injury (grade 1).  

The knee should be protected with a short-hinged brace for 3 to 6 weeks, depending upon the severity of the injury.  Crutches and restricted weight bearing may be needed, as instructed by the doctor.  Apply ice to control swelling.  Elevate the leg and use elastic stockings if the leg is swollen.  As the pain lessens and the swelling decreases, try to gradually regain knee motion.  Avoid pivoting or twisting the knee because it might be unstable and give out.  Be careful getting out of cars, or catching your toe on a rug.  When walking, bear weight according to your doctor’s instructions.  Progress to no crutch(es) or brace when you can walk without a limp and there is no pain (per doctor instructions).  Ice the knee if there is pain and swelling.  Place a towel or cloth between the skin and the ice to prevent skin injury. Ice for 20 minutes, three times a day.  At about two or three weeks following injury, the pain is usually subsiding and the swelling is lessened.  You can now try to stretch the knee to regain motion. Stationary cycle and swimming (flutter kick only) are recommended. 

HARVARD

• Grade I (mild) — This injury stretches the ligament, which causes microscopic tears in the ligament.  These tiny tears don't significantly affect the overall ability of the knee joint to support your weight.
• Grade II (moderate) — The ligament is partially torn, and there is some mild to moderate instability (or periodic giving out) of the knee while standing or walking.
• Grade III (severe) — The ligament is torn completely or separated at its end from the bone, and the knee is more unstable.

How long a knee sprain lasts depends on the type of knee sprain, the severity of your injury, your rehabilitation program, and the types of sports you play.  In general, milder Grade I and Grade II MCL or LCL sprains heal within 2 to 4 weeks, but other types of knee sprains may take 4 to 12 months.

How long will it take to recover?

• A mild MCL injury or grade one sprain should take 3 to 6 weeks to make a full recovery.
• A more severe grade 2 or grade 3 injury may take 8 to 12 weeks.

When a Grade II sprain occurs, use of a weight-bearing brace or some supportive taping is common in early treatment. This helps to ease the pain and avoid stretching of the healing ligament. After a grade II injury, you can usually return to activity once the joint is stable and you are no longer having pain. This may take up to six weeks. Physiotherapy helps to hasten the healing process via electrical modalities, massage, strengthening and joint exercises to guide the direction that the ligament fibres heal. 

Recovery From An MCL Injury

Recovery from an MCL injury is very dependent on the grade of your MCL tear.  Recovery from a grade 1 MCL injury can be as short as a few weeks. Once your range of motion and strength have recovered most grade 1 MCL injuries can anticipate a full return to sports.  MCL injuries do tend to be painful so the pain from the injury might linger on for a month or two.

The recovery from a grade 2 MCL injury will take a while longer. A grade 2 injury might take between 2-3  months until you are comfortable, the knee is stable and your motion and strength have returned to normal.  Once you have sustained a grade 2 or 3 injury it is also very important to focus on sports specific rehabilitation and neuromuscular rehabilitation to make sure that your knee is ready to compete.

Why Do I Do Anything That I Do?

Defect:  A fault or malfunction.
Shortcoming: Deficiency.

SuperK and I had a free-ranging discussion about the tenacity of some of our defects -  shortcomings? -  and the best way to root them out.  We inevitably return to the The 12 Steps as a pretty effective starting point for correcting our flaws, even for those that we see as relatively minor.  Taking a good, honest look at a situation, doing some writing and talking about what we find, and then getting god involved is always a good place to start.

Ever defensive, I vigorously defended myself.  My theory is that the best defense is a BIG offense.  Whenever a baseball team is struggling I subscribe to BYL's stance that you need more hitters - that was always his solution to whatever woes were afflicting our team.  "More hitters," he would say dismissively.

"I'm working The Steps," I pointed out.  "I've been doing a ton of writing - a 4th Step inventory - and then talking to other alcoholics about it, including my sponsor.  I've also been asking my higher power to remove my unhealthy preoccupation with my health in my Quiet Time each day."

I stepped back, smugly self-satisfied.  Take that.

"That's great," she said.  "But that's an inventory - that's not working all of The Steps on whatever's bothering you."

Annoying sometimes, that woman.

She added this: "You've given the problem over to god - but are you ready for whatever happens next?  Remember that the defects are god's business and not yours.  They're removed - if they're removed, that is - at god's pleasure and on his time frame."

As luck would have it my Step Study meetings - I attend two of 'em - have been dissecting the 6th and 7th - the throw-away Steps.  The realization that I was trying to turn over this problem to my higher power without being ready to accept the answer struck me with a lot of force.  Humbly ask god to remove my shortcomings; make myself ready to have them removed if that's god's will.  I need to work on my humility and my willingness, my listening skills, instead of inserting additional notes in the margin of the workbook I'm putting together for god so that he knows exactly how to meet my daily demands.

"How did you fuck that up?" I ask god.  "I wrote it down for you."

Kenner used to remind me that I should pay attention whenever a sentence or paragraph was italicized: "That's Bill W shouting," he said.

Here are a few phrases that jumped out at me. . . . 

"Having been granted a perfect release from alcoholism, why then shouldn't we be able to achieve by the same means a perfect release from every other difficulty or defect?"  

Indeed.

"This is a riddle of our existence, the full answer to which may only be in the mind of god."

Well, that's hardly fair.

". . . any person capable of enough willingness and honesty to try repeatedly Step Six on all his faults - without any reservations whatever - has indeed come a long way spiritually."

I like the fact that Bill had to stick in the word "repeatedly."  It disabuses me of the notion that I do this once and then I'm done with it.  I also note the italics when the reservations are mentioned as well as the inclusion of the word "whatever."

Whatever:  No matter what; for any.

"If we ask, god will certainly forgive or derelictions.  But in no case does he render us white as snow and keep us that way without our cooperation.  That is something we are supposed to be willing to work toward ourselves."

Work?  Work?!  Fuck.