Yesterday I was talked with my sister who is 2 1/2 years younger than me. She said she’s having back pain. She does not read my blog. I asked her to describe it.
Pain in the outside of her lower left leg. Pain when walking that is reduced when she leans forward or leans against something like a grocery cart. Pain that kicks in after about 50 yards. She can’t trust her left leg; it feels like it’s going to give out.
Gregor Mendel, phone home.
MRI Report
My MRI report confirms that my spine is FUBAR. Most of the pathology doesn’t seem to be causing me pain. I have moderate disc bulging and thinning here and there. And there is some stenosis in various places in my mid to upper spine. Mostly this seems to be the cause of mild discomfort as well as numbness in my feet and hands from time to time. My lower back gets achy when I stand or walk for long periods but muscle spasms are rare.
Near my 4th and 5th lumbar vertebrae, however, the report said:
There is severe left foraminal stenosis with indentation of exiting left L4 nerve root. The right foramen is moderately to severely stenotic with indentation of exiting right L4 nerve root.
This is consistent with my recent left leg problems. My guess is that’s where the epidural will go.
The same MRI center had a record of my 2014 scan. The report noted that a disc extrusion (i.e., bulge) found back then no longer exists. This is one reason why back patients are told to give it time. Many of these abnormalities resolve on their own, as did my 2014 problem.
A Clarification
In yesterday’s post, I described a conversation with my friend Julie who is a Rolfer. I may have given the impression that she is reckless or aggressive in her methods. If I did, I apologize to her and want to clarify.
Recapping: a Thai massage therapist skipped past my thighs when I indicated that the therapist had hit a sensitive nerve. What Julie meant when she said she’d “dig right in” to nerve pain was that ignoring the problem as the massage therapist did is unhelpful. The objective of massage is to grant short term relief and reduce tension. Oversimplifying, the objective of Rolfing (and for that matter Feldenkrais) is to reduce pain and stress in the long term by improving how body parts interact. Rolfing focuses on connective tissue called fascia that wraps around muscles and nerves. The end result should be pain and stress reduction on an on-going basis.
For now, I am focused on getting the offending nerve to calm down. Once I get the pain under control, I can consider how to deal with the situation longer term. My guess is that I’ll be doing some combination of yoga, PT, massage, Feldenkrais, and Rolfing.
For the last several days I’ve been staying off my feet and taking over-the-counter pain medication. When I walk, I generally use a cane (if I haven’t left it somewhere). As a result, my pain level has been greatly reduced. I have no intention of sitting around for the rest of my days, however.
I am still riding but the arrival of winter has nudged me into dialing back the mileage and intensity. On Saturday, I rode Big Nellie in the basement for 80 minutes. It’s a nice change of pace and infinitely preferable to riding while anxiously looking for icy patches on the pavement. Yesterday, I rode the CrossCheck outside. Temperatures declined into the 30s and winds picked up with each passing mile so I cut the ride short at 17 miles.
As I may have said earlier, I quit PT and Feldenkrais, at least until I give the pain doctor a shot (so to speak) at my problem. My friend Julie (a Rolfer, jewelry maker, proud momma, and Alaska backcountry bad ass hiker) said that I should give Structural Integration a try. (This should not be confused with Functional Intergration which is the basis of Feldenkrais.) In my current physical state, I will have to take a pass on her advice; Rolfing (one method of Structural Integration) can involve rather aggressive manipulation of body parts (in contrast to Feldenkrais which more closely resembles Reiki).
Julie’s Rolfing suggestion follows up on part of the conversation we had in Astoria, Oregon at the end of my cross country tour. I mentioned to her that a few years ago I had a problem with sharp pain in my right leg. While having a Thai massage, the therapist hit the problematic nerve in my inner right thigh and I flinched in pain. The therapist decided to skip over that part of my body. Julie said that if it had been her she would have dug right in.
It’s interesting that massage, Feldenkrais, Rolfing, and, for that matter, chiropractic, all profess to address the same body problems. Whether one method works probably depends on the pathology involved. At the moment, I know from x-rays that my back is showing numerous signs of age-related deterioration, complicated by my genetic make up, a previous back surgery, and a whole lot of wear and tear. Hopefully, tonight’s MRI will give an better view of what is causing the specific pain that I’ve been dealing with.
In a few weeks, I may be able to ramp up my activity level without pain.
I met Julie the day after I reached the Pacific coast on my 2018 bucket list cross country bike tour. I was feeling what I called afterglow. I want to feel that way again.
Thanks, Julie, for your suggestion. One of these days I hope to meet again. Come to think of it, I haven’t ridden a bike in Alaska yet.
Rain. Cold rain. On a Friday morning when most retirees stay in bed. I got up and hit the road a little after 6:30. The rain, blown by a northeast headwind, spit on my face. And I rode. I arrived at Friday Coffee Club (yes, we capitalize it) around 8. The crowd was predictably small, given the crummy weather: Ed, Ricky, Andrea, Jeff, and a player to be named later. (Sorry, I didn’t catch your name.) Ed and Andrea were discussing a 400 kilometer randoneuring event they are participating in tomorrow. (Ed is riding. Andrea is volunteering.) That’s 248 miles (plus 5 because the course designer is a sadist.) In one day or so. I can’t even.
Ed brought a lightly used Brooks Flyer saddle with fancy copper rivets. I bought it from him for my tour. It has lots of room for tension adjustments. My tush should be a happy camper.
After Andrea, Ricky, and the PTBNL left, Ultrarunnergirl made her first appearance of 2018. Yay! I haven’t seen my biking-hiking-baseball-flaming drinks buddy in a very long time. Hugs and smiles. She took the bus because she is nursing a messed up hip. We must get her well for future adventures.
After I left FCC, I rode to the gym and went all Hulk for 40 minutes. Next, I did 20 minutes of physical therapy at home. Then, I went to an acupuncturist down the street.
I had a hard time tuning my ears to my acupuncturist’s heavy Korean accent but with some forbearabce, we managed to get the gist of my problem understood. He examined my tongue and poked various parts of my body. Mostly this was painless, but a couple of pokes in my feet caused sharp pain. (A similar discomfort shortened a Thai massage a few years ago.)
As I lay on my back, He pinned me in my upper left arm and at various other points all over my body. After about 15 minutes, he flipped me over and repeated the process. Acupuncture is rather hocus pocus to me but I have had success with it in the past. I have to say that my arm does feel better this evening. I’ll wait a day or two before declaring the trip a success.
At the end of the appointment, he placed small stickers on spots on my hands. This mark points that I should prod and massage to help my shoulder heal.
When I got home I ordered two new maps from Adventure Cycling. Over coffee, Ed has made the road west out of Missoula sound like bicycle heaven. He said there is a 90 mile gradual downhill that follows a river through the mountains. I stumbled across a blog online that described the shortcut to the Cascades in less than glowing terms. I will use the maps to work out itineraries for both routes.
One of the maps contains a small surprise, a short cut to Missoula from the east. I’ll have to give that a closer look at that. (It probably involves a climb of horrific proportions.)
I think the only way to properly plan for this trip is to go with the flow and see how I feel when I get to Montana.
What a beautiful Saturday. I could have gone for a hike but I had things to do. Eight things to be exact.
Thing 1
I rode my bike to the government center down the street and I voted. I could vote early because I will be out of town on election day. The only down side to voting early is that other voters don’t get to see me bike to the polls. Oh well, at least I got a new sticker.
I bike and I vote
Thing 2
Next up, I rode to the drug store to score some drugs. Okay, it was asthma medicine which isn’t all that exciting until I don’t have it when I need it.
Thing 3
I rode the Mount Vernon Trail to the farmer’s market it Old Town Alexandria. The place was packed. There were apples. LOTS of apples. I didn’t buy any. I was just people watching. There were people. LOTS of people. I didn’t know any.
Thing 4
Next up was a Thai massage. After all the biking I’ve been doing, it was time to cash in the gift card that Mrs. Rootchopper gave me on my birthday in August. It was for a one-hour session including a foot bath. I’d never had a foot bath like this before. The therapist kneaded my feet. I laughed through the whole thing except when it hurt. I have tender puppies. So it hurt quite a lot. When it was over, it felt pretty awesome. If you are a runner, you should have a soaking foot massage.
Thai massage place in Old Town
Then the message happened. Dang are my muscles tight. After 20 minutes, I asked to extend my message for an extra 30 minutes. This was going to take some time. My massage therapist was Dau. She did a great job. Some of it hurt but I told her to keep working on the sore parts anyway. It differed from the other Thai massage I had last year. For one thing, I was on a massage table instead of on a cushion on the floor. This gave Dau a different angle on manipulating my body. Another difference is that, although my legs were tight, I did not have numbness in my right leg. Last time the therapist had to limit the work on my thighs.
When it was over I walked out feeling totally relaxed. My thighs were so relaxed. I had no idea how tight they were. And my back felt like new.
I am not a massage kind of guy. I usually feel like I have better things to do with my time. This was different. It was definitely worth the time and money.
Thing 5
Mrs. Rootchopper does the grocery shopping after her Saturday morning Pilates class. I forgot to tell her that we needed coffee and raisins. So I swung by the grocery store to get some. They fit nicely in my Carradice saddle bag.
Thing 6
After I got home, I mowed the lawn. During summer our back lawn grows much faster than the front. In autumn, the front grows faster. Either way, it’s much easier to mow the lawn when it’s not 95 degrees outside.
Thing 7
I read the paper. Two hours later I woke up. This is primo napping weather. Resistance is futile.
Thing 8
I bought tickets for my daughter to fly home for Thanksgiving. Free. Boy am I glad Southwest flies into National Airport.
The year began with a paper lantern rising in the post-midnight sky over Old Town Alexandria. I hoped it was a sign of good things to come. Here in no particular order are the highlights of what followed:
Around the World in 19 Days: When your kids move to the other side of the world, you have a perfectly good excuse to go visit them. We flew via LAX to Sydney to meet up with our daughter who was studying abroad at Macquarie University. We explored Sydney, Uluru, and Melbourne in Australia and Rotorua in New Zealand. Then we flew to Thailand where our son now lives, teaching English at a school in Phuket. We flew back via Abu Dhabi and JFK, completing our trip around the world. Speaking of travel….
Six Days without a Plan: I did my first bike tour in ten years, riding 370 miles from Pittsburgh to home, nearly entirely off road in six days. Kevin and Ryan made for good company. The Meth Man not so much. Earl and Anne, two friends from my years in Boston, met up with us for Mothers Day brunch. And we saw the Pirates execute a triple play at PNC Park in Pittsburgh. Speaking of baseball….
Where’s My Ring?: I pretty much went all in as a Washington Nationals fan this year. I attended 8 or 9 games (one was a rainout) and watched dozens more on the tube. In the process I discovered the wonderful bike valet service at the ballpark, bottles of ice water (mostly ice) sold outside the stadium, and SeatGeek, a web service for cheap seats. Sadly, the Nats completely fell apart in August and September ending with the sad display of a bad apple reliever choking the eventual league Most Valuable Player. Speaking of things surly…
Getting Surly: My bikes were getting old. And so was I. So I decided to buy a new one, just for riding events and such. I bought a Surly Cross Check on the enthusiastic recommendation of a half dozen friends who own one or wish they did. I’m still working on giving it a name. My fleet of now four bikes carried me over 7,000 miles this year. Speaking of mileage….
Turning the Odometer: I hit 60 in August. My brain still can’t believe it but my body does. Denial only gets you so far in life. I celebrated by hiking Old Rag. My advice is to do this hike long before your 60th birthday. Mrs RC made me with a quilt from my old running t-shirts. This totally surprised me with it even though she made the thing right in front of me. Still, turning 60 was inescapably depressing. Speaking of depressing…
Goodbye Blue Mondays: I started the year dealing with rather severe depression, not the “I’m sad” kind but the clinical kind. It’s a drag just thinking about it. I forced myself to socialize (see below), ate vitamin D supplements (I had a severe deficiency), and began daily meditation at the repeated suggestion of a friend. You could say that when it was over I had become comfortably numb. Speaking of numbness…
My Right Foot: I also started the year with a mysteriously numb right foot. I saw a neurologist who was incredibly enthusiastic, competent, and beautiful about my case. She sent me to a physical therapist who gave me a set of exercises including bird dogs, side planks, and nerve flossing that I still do every other day. On a whim, I went for a Thai massage. It didn’t do a thing for my foot but it was just about the most relaxing 90 minutes I can recall. “Use your third eye, John.” I also went to an acupuncturist who didn’t do a thing for my foot either. He did fix a pain in my upper arm and recommended some orthotics for my shoes. Speaking of shoes….
Ramping Up My Hiking: After each of my hikes last year, my back and knees were killing me. The second I put the orthotics in my shoes, my back felt better. I did ten hikes this year, most of them in Shenandoah National Park and a little further north on the Appalachian Trail. All but one were solo hikes. The exception came when Ultrarunnergirl kicked my ass all the way to the top of SNP and back. My knees and back hardly protested. Speaking of protests…
What’s a Park It?: Bike riders in DC had been getting hit by cars turning illegally through the Pennsylvania Avenue bike lanes. I attended a protest that was designed to bring awareness to the fact that new barriers called Park Its had not been installed on two blocks of the avenue. The protest was successful (the Park Its were installed a few months later) and was a great opportunity to get together with friends old and new. Speaking of new friends…
Do I Even Have a Fusiform Gyrus?: Three months after apparently meeting me at a December 2014 holiday party, a woman walked up at a post-ride reception and said “Hi John.” I had no idea who she was. She later said I needed to have my fusiform gyrus checked out. So began my improbable friendship with Katie Lee. A few days later we spent four hours in a booth in a downtown tavern. Two peas in a pod, pod people you might say, engaged in an incredibly intense conversation. I felt as if I had caught lightning in a bottle of Shiner Bock. On my way home for the first time in months the fog of my depression had lifted. Like a paper lantern. I know a sign when I see one. Thanks for showing me the score, KL.
Encore, you say?….
Sitting in the Lap of the North Wind: A year or so ago, Mrs RC bought me a CD of celtic sounding music by a Quebec folk group called Le Vent du Nord. As luck would have it, they played very small venues near DC twice this year. We were in the second row for both performances, practically in the lap of the foot drumming, song singing, fiddle player. Even though I studied French in high school and college I can’t really follow their lyrics but I have no trouble enjoying their hurdy gurdy fueled music. Tres bon.
A couple of days ago I was somewhat concerned that Thai massage, followed by snow shoveling, and a physical therapy session, all withing the space of 17 hours would wreck my body. As it turned out, I made it through the Trifecta of Pain with flying colors.
The Thai massage (with a bit of Reiki at the end), although painful at times, was a very soothing experience. I don’t normally pamper myself like this, but I am glad I gave this a go.
This morning we had three or so inches of wet snow. I pulled out the wovel and went at it. Each time I use this gizmo I am amazed. Snow shoveling is one of the most stressful things you can put your back and heart. Woveling is a piece of cake. It is actually not much harder than mowing the lawn. And it makes quick work of the snow.
Later in the morning I went to my physical therapy appointment. We worked on my balance. To my surprise, after some awkwardness, I did most of the exercises without losing my balance. I don’t know if this gets me anywhere with my numb foot but it helped my ego quiet a bit. The PT folks were curious to hear about the Thai massage. I mentioned the pain I had with my quadriceps and IT band and that became the focus of the session. We used a foam roller to massage both areas. This was incredibly painful, much, much more so than during the massage. Then we tried using a lacrosse ball to work out the tightness in my IT band. This was not as bad.
And so the Trifecta of Pain is over. It was not nearly as painful as I had expected.
I have only had one massage in my life. It came at the suggestion of my friend Paul. We had just completed our first century (100 miles) bike rides as part of the 1991 Bike Virginia event. Paul was about 3 weeks removed from breaking his collar bone (yes, Paul is an idgit) and I was amazed that he had done the whole distance. I suppose you would call what we had a sports massage. It only lasted 20 minutes but it felt so good I laughed my ass off for the entire thing. Despite the experience, I have never had a massage of any sort since.
A few years back (2011, I think), my Argentinian friend Florencia approached me in Meridian Hill Park on a lovely summer day. Stress was strewn across her normally cheerful face. She began to tell me of the oppressive weight of her unhappiness. She had a job, an apartment, tons of friends, more interesting activities than any ten people that I know, but she looked exhausted. “John, I am thinking of quitting my job and going to Thailand.” After a half hour of discussion, I could see that she had thought this through. I don’t know that my approval mattered much, but a short time later she was on a plane for Bangkok.
Her first excursion took her, among many places, to the Thai Massage School of Chiang Mai. Once I started reading of her times there, it became obvious that she had made the right choice. During her subsequent travels that year she also learned Reiki in Mumbai.
Ever since, whenever she was in DC, she has offered to give me a Thai massage and Reiki but I declined. Over the past four years I have had so many orthopedic and neurological issues that the thought of someone pressing into my muscles and nerves was a real turn off.
About a month ago, after spending summer in Argentina, she returned and announced that she would be giving Thai massage “with a Latin touch” and Reiki. (Flor knows marketing too.) With my back feeling better than it has in years and only minor other aches and pains, I signed up for a two-hour session.
I met her at her place and after spending 15 minutes inadequately catching up on each others lives (we’d need 15 hours), she went to work. First, we discussed any physical issues that she should be aware of. After reassuring her that I trusted her (not that she needed to hear it), she began. She put on some soothing music and began by gently massaging my face. It felt wonderful. Then she moved to rest of my head. Nice. Then my neck, firmly stroking in up and down along one line then another. We were in Nigel Hufnagle territory now. (On a scale of 1 to 10, the neck massage was an 11.)
She proceeded to work on my arms begining with each finger, gently but firmly pulling each one. Then she worked her way up each arm in a straight line mostly pressing in discrete spots along the line. Once she reached my shoulder she would go back to my hand and start anew on a different line. Eventually, my upper arms and shoulder blades were pushed this way and that. Each of these manipulations was gentle but firm. It was clear to me that she was carefully looking for signs of discomfort and tightness from me. At this point I was a happy camper. My eyes were closed as I just let her do her thing.
She moved to my feet and things got interesting. The bottoms of my feet are extremely sensitive. She pressed against the lines in the bottoms of my feet along the plantar fascia and OW! (This also happened with my acupuncturist so I wasn’t surprised.) She continued but backed off on the pressure. All was good. Next came my notoriously tight calves. Her manipulations and pressings were a bit uncomfortable but nothing too unpleasant. When she reached my thighs she found my true weakness. Each time she pressed it hurt. She later told me she wasn’t pressing hard at all but after tens of thousands of miles of biking and running my thighs are super tight and sensitive.
Along the way some of her manipulations were done with her feet. She would press her foot against the inside of my thigh and pull on my leg with her arms. It felt wonderful. She did a similar manipulation with her foot on my back and pulling on my arms. Ahhh! (I don’t think I would have realized this was what she was doing had I not watched a few videos. This looked scary in the videos but really felt great.)
Flor Giving a Massage in Thailand. Photo by Flor
She turned me over and massaged my back along my spine, kneading my back in small circles and moving from my head to the base of my spine, one line after the next. This felt great except for some minor discomfort when she was working near my old surgery incision (which I neglected to tell her about).
Next she gently laid her hands on my back and stopped just for a minute. By this time I was so mellowed out I don’t remember what came next. I eventually was lying on my back and her hands were gently placed on my forehead, then face, then chest, then stomach. She later told me that this was Reiki. Feeling her warm hands against my face after the Thai massage felt incredibly calming.
I had absolutely no idea how much time had passed. She said she stopped after 90 minutes. She decided that because of the discomfort in my legs that she would forgo some of the leg work that would take up about 30 minutes time. “Better to do too little than too much.” During the massage and Reiki we spoke hardly at all. “Just relax and meditate.”
Given the fact that my body is a bit of a train wreck, I’d say my first experience with Thai massage and Reiki was a resounding success.
I rarely see my friend Flor in a serious setting such as this. The vast majority of our times together have been at picnics and bike rides, casual events. To be honest, I had misgivings about having a friend in my personal space for as long as two hours. Flor put me completely at ease with her calm, caring, professional demeanor. I would recommend her Thai massage and Reiki to anyone.
After the massage, it was time for goodbyes. Flor is off to India in a few days for yoga training. As always, I will miss her, but I look forward to the next chapter in the life of my friend The Impermanent Resident.
My body does not do change well. When I went snowshoeing the other day, it seemed fine while I was out and about, but my little excursion, only 1 1/2 miles, followed by woveling snow and slush gave me a sore iliotibial band at my left hip. The iliotibial band was invented by Satan to stabilize man’s outer thigh. It starts just above the point of the hip and extends to the tibia just below the knee. When it gets inflamed it is hard to calm and can cause serious pain.
So tonight I go for my first ever Thai massage. In keeping with my style I signed up for a two-hour session. yes, i am an idiot. Sam and Jeff, two #fridaycoffeeclub regulars, had Thai massages from the same therapist earlier this week. Sam loved it. Jeff liked some aspects but not others.
During Thai massage the client remains fully clothed. The massage therapist manipulates body parts and muscles using his/her body and forearms and such. It actually looks quite a lot like some of the manipulations my physical therapist does.
So I fully expect to be a little sore tomorrow. This is just as well because we are expecting snow overnight and I will likely be woveling again during the day. By something of a coincidence, I have a late morning physical therapy appointment.
So by about 1 pm tomorrow, I expect to be sore in places I didn’t know I had. This may make evaluating the Thai massage somewhat problematic. Stay tuned.
A Few Spokes Shy of a Wheel 