Sunday, November 25, 2018

14 Weeks to Napa Valley Marathon

This bird is eyeballing me carefully, but didn't fly away 
This was a good week: 41 miles.

After dealing with many lost days of running due to all the bad smoke in the bay area, I changed my thanksgiving flight, at Toni's suggestion, to Sunday the 18th and "Got out of (smoky) Dodge".

A bonus is that I was able to attend the birthday of my brilliant, hardworking, science-loving niece, Louse. (Louise is also this year's Rose Queen of the Rose Parade)

You'll notice she's got her glasses on in these photos and videos. She's the first Rose Queen to do that...making me ultra-proud.....Brainy girls rule!

I was also able on Monday to get in a 13 mile run in the clean Pasadena air.  (Has anybody ever uttered those words before? 😆)

I had 3 more runs in Pasa before we returned home on Saturday....after some great Thanksgiving food and festivities. The air at home had been made squeaky clean by the rain that came midweek so I took a rest day Saturday and did a 15 mile run on Sunday.  

A lot of this running in Pasa and home was done on roads, nor soft dirt: I need to toughen up my legs for road running. 

The 15 miler took the starch out of me but my right side glutes held up pretty well for the whole run. I slowed down from a 10:30 average during the last 3 miles..and ran about 11:30 min/miles. 

I have been noodling on what my marathon pace will be. Obviously it depends on the next 14 weeks of training.  My pace 10 years ago was about 10:08 min/mile and I had no fade. Age grading puts that pace at 11:00 min/mile. If I look at my training at the time I logged a ton of miles, including some 50 mile weeks (!). 

So it's all a bit unclear. My overarching goal is to finish the marathon at stretch goal is to run a 10:30 min/mile pace.  Right now, I think I would  start at 11:00m/m for the first half and see how it goes from there.

Sunday, July 29, 2018

First 30+ mile week (post new hip)

This week managed 5 runs for a total 34.9 miles with the Sunday long run being 14 miles. Gradually getting back marathon grade fitness, but still have a way to go.

My right glute (operative side) is still a tad weaker than the left but I've made some good progress:  

The plot below shows my "Ground Contact Time Balance", reported from my Garmin watch (with running dynamics pod.) 

i.e. This is the ratio of time each foot spends in contact with the ground. The graph timeline shows one full year. The green dot on the left for August of last year,  is before my hip started crapping out and shows 50/50 balance, i.e. normal.

Then you have 4 months of no dots: could not run and then in Nov got the new hip. 

Finally, running again in January and you can see my right leg was really off with a L/R balance of 45/55%.  Then you can see that each month it gradually gets more and more toward 50/50 until, FINALLY, this month we have green again!

I did today's 14 miler by getting up at 6am and hitting the trails while the skies were foggy and cool. Lots of birds out early when it's still foggy:

This coming week will be a step-back week. Probably ~25 miles.

Sunday, June 17, 2018

Rundown: Race for Literacy Half Marathon 2018

First Half Marathon, ~ 6 months post THR

The Race for Literacy, is a small, local race that starts and ends in the Sunnyvale Baylands park. It runs on the San Tomas Aquino bike path as well as the Bay  (a part I run on from work all the time!). It's a charity race that helps bring reading to the poorest areas of India.

There were about 700 people running the 5k / 10k: only 64 people ran the half marathon which makes it very small and personal.

Nice green tech shirts given...I like them. The start was very informal and off we went at 8am. The 10k and 5k races were staggered later, and did not create any problems for us. Nice!

The weather was good: cloudy and 60F with some wind. I decided on a 9:30 m/m pace as I had run a 10 miler a few weeks ago and thought I could probably hold that pace.

After we all got sorted out by pace (the usual crazy people running ahead then walking, etc.) I settled in to my 9:30 pace....I thought about pushing harder but decided that was a bad idea...instead I would wait until the halfway point (6.5 miles) and see how I felt.

We turned onto the San Tomas Aquino bike path at about mile 2 and passed the Levi stadium with the turn around shortly after.

At mile 5 we turned back on the bay trail and they shortly onto dirt to get on the water's edge bay trail (this is where I run from work many times per week). After this point, I was not passed but I did pass 3-4 other runners during this time. 

My pace was fine until about mile 10 where I was really working hard to hold...ran a 9:40 and at mile 11 a 9:56...oops! 

Mile 13 was much better: back at 9:20.

Overall: 29/64
Male: 20/53
55-98 age group: 4/6

Time 2:05:29
Pace: 9:34 m/m

Not bad! Next step is up the mileage and start marathon training for the Napa Valley Marathon as my first post THR full. That race was my first marathon so I decided it was time to do it again.

Saturday, May 05, 2018

Pathways 10k trail run

My first official race post hip-replacement.


The weather was perfect: 55-60F and the trails were dry. 
Very hilly, about 1000' of climbing, according to Mr. Garmin.

Cinco del Mayo so a Mexican band!

The crowd at the start:

Me and running friend Gail...she told me about this race:

I took a wrong turn and actually ran one loop of the race twice, racking up 6.9 miles instead of 6.2.......pace around 11:30-ish (some time spent head scratching ;)

Operative leg and hip felt great!  Still out of shape (especially for hill running) but almost perfect 50-50 left/right ground contact time the entire race: the right leg is getting stronger.

Next up: a half marathon. 
Which one?

Wednesday, May 02, 2018

10K this weekend!

It's been about half a year since my hip replacement. (181 days)
goats munching grass near the bay

I've been running several months now ...started up in January a bit and now for the last couple of months have gotten up to 20-26 miles per week. This is not bad, but I need to get up to ~35 mpw for a decent marathon training.

I've been running in the 10:00 - 11:00 range and my HR is higher than it used to be for the same paceThis is due to my running economy being lower from not running for a few months and also because I'm about 5lbs heavier and of course because my right leg is still weak compared to my left leg.

But it's getting better week by week. I caught a bad cold which set me back about 10 days but now since then I have two 10 mile runs at about a 10:30 m/m pace and it was a push but felt really good to do 8).  Mostly I run 3 to 7 miles.

Other changes in my life: I am completely off caffeine. Gradually it has become more and more powerful to my body and jangling the heck out of me. My sleep in the early morning hours was becoming very fitful. My stomach also doesn't like it.  

So, it took a while but now the only caffeine I get is from GUs 8). The small amount there take when running doesn't seem to effect me.

I have a target first post-op marathon in sight now: Napa Valley Marathon. This is the first weekend in Feb and was where I had my first marathon! It's a beautiful run. It will be more than a year post-op: I'll have a couple more months to get ready. Need to do some half marathons (1-2) between now and then.

This Saturday is my first post-op race: the Los Altos Pathways's a trail race and single track with lots of people, so hard to go really fast but thats okaaaay, I'm not really fast.

Today I did about 6 hill sprints and 3 miles...tomorrow I'll do an easy few and then I'll rest on Friday.

Wish me luck!

Friday, February 23, 2018

16 weeks post THR: Call me Steve.

I've run outdoors a number of times now, with a max distance of 4.5 miles!  Yes, puny by old standards but liberating now 8)

Over the Presidents weekend I had a chance to do a 3.5 mile hike in Yosemite 2500' up to view of upper Yosemite falls. A really good workout doing lots of rock 'stair stepping' up and down.. 

So, gradually, with lots of effort, the right leg is getting stronger. Today's run (3.2 miles) had a ground-contact-balance very close to 50-50 (see the green, which is good..)

I'm still pretty inefficient running. If I run at what I consider a 'decent' pace of 10:30 m/m my HR climbs up to 135+ which is not appropriate for what should be an 'easy pace'.  I have to slow down or do some walking to bring it down. (My max HR is about 160 bpm)

But, it's already noticeably better than just a few weeks ago. There's a reason why they call you a 'patient': you need to be patient. 

Physical Therapy

Once  a week, Sonja Kranzfelder has been my therapist and she has done a great job, 
She has pushed me to improve my range of motion as well as my strength in the 
operative leg with a farrago of exercises. 

I may have the potential to be ergonomically better than I was before the THR. 

Gentlemen, we can rebuild him. We have the technology. We have the capability to make the world's first bionic man. Paul will be that man. Better than he was before. Better...stronger...faster." 

Do you remember this show? Ok so I put my name in there instead of Steve Austin 8) It was the "SIx Million Dollar Man". My THR was billed out at $143,000. (!) so I guess I'm a lot cheaper ;)

Sonja has pushed me to reduce the foot turnout,  something I would have never thought 
possible. It's difficult: I have a lifetime of soft tissue adaptation to the turnout, but 
perhaps (especially when running) I can learn to keep it in line.

Previously things were pretty funky: even with a lift in my left leg (almost 1/4") to try to match 
the right leg, the right leg was not doing as much...I'm not using any lift right
now. Dr Graw evened this out pretty well I think. 

When running, various people have offered up comments like "You look like you are about 
to sprain an ankle"  or "wow that's what I call pronation", etc.  (they meant duck-foot)
And we won't even talk about the taunting I got as a kid.

The turnout was pretty severe..check out  this posting if you haven't seen it already. 

Perhaps, just perhaps, I might get a bit of an edge from improving this and having my leg length matched better.. It's a fun thought. We shall see.

My goal: run a solid marathon (sub 5hr even pace) sometime on or around a year from my operation (Nov 1).

I'm not sure if that's actually practical but given my current rate of improvement it seems possible.  

Once I get back to being lean and mean running machine, I plan to put more non-impact bike and elliptical training back in the mix to reduce wear. But first I need to get fit again and running is by far and away the best way to do that.

NB: I ran a 4:42 marathon at Napa Valley, Mar. 3, 2018

Saturday, February 10, 2018

First run OUTDOORS!

Ready to run!

My last decent run (about 10 miles) was back in mid-August. After that,  the hip pain had a final flare-up and the running had to stop.  Post-THR with 12 weeks of recovery behind me,  I was cleared to run. My doc asked that I stick to soft surfaces as much as possible.

After that, I ran the treadmill 2 or 3 times per week for 3 weeks (as well as doing bike and elliptical)....and eventually it seem fairly good: I was itchy to get outside again...I decided I was strong enough.

My PT once a week has been super useful, with lots of special exercises to bring back the weak leg.

Saturday -> to my favorite Baylands!

It was a perfect blue sky day! Temps around 55F..also great. 

My pace was slowwww 11:xx m/m and my HR was way high for my pace. But man, it sure felt good.

I got a little teary eyed, having missed running, and running outdoors in my favorite places so, so much! 

I do not take it for granted.

I set a goal of 4 miles. This was about right the end I was getting pretty tired.

Even with some elliptical and stationary biking my legs are weaker and my cardio is way down from days of yore. But it will come back!

I run with the Garmin running dynamics pod, and it shows me what I already know: my right leg is weaker than my left:

Ideally if both legs are working equally, this should be a line right on the 50/50 scale mark and be all green...instead the red an orange dots show I have more ground contact (about 52% ) on the right leg. This is not surprising as it's weaker.

It's also varying all over the place. My right leg is still relearning all the new muscle firing patterns to suit the new pivot location. It will be interesting to track how this evolves...more on this to come. 

When I got back to the car I was feeling pretty tired in my right leg..but very happy. I have a long way to go to get back to as close as possible to where I was before. Runners that have been through this say: about 1 year....that's  about 9-10 months.  

You can bet I will be avidly doing my PT exercises! If you are a runner they're good idea even if you don't have a hip replacement


Wednesday, January 31, 2018

Paul gets a new hip!

What's new with Paul?

I haven't posted since the Oakland Marathon....which was quite a few  months ago .....and the reason is that I have been dealing with my right hip.

At the end of the Oakland marathon I noticed my right hip seemed pretty stiff. In retrospect I realized that some other feelings I was having earlier in the year (on and off) were probably due to it wearing out. I've always had a very turned out right foot, in fact I did a post about it in 2009 called "just ducky".  

In 2011 or so, my massage therapist...being very frustrated at my lack of flexibility in my right hip, suggested I get some X-rays and make sure things are ok. I did so, and the observation was: your hip is messed up and you are down to 1-2 mm of cartilage in the abnormal (right) hip. 

Being only 56, it was not going to last,  and that "I'd be back".  

It seemed congenital turnout (hip socket slightly rotated back on my pelvis at birth) was causing higher wear than normal and running was going to accelerate that, but I decided to gamble and not worry about it. 

The analogy is driving a car with a badly aligned tire that doesn't track straight wears faster. My front and back swing was not what a rotated back socket wants, and so the wear is high.

After Oakland my leg felt better for a time. but around August it really started to hurt: X-rays confirmed I was done with my wonky hip. After interviewing some orthopedic doctors at my HMO, I scheduled a hip replacement for Nov 1st.

Note: My last decent run was in early August.

Ok, let's get a THR!

Meanwhile, online I discovered that hip replacements have come a long way, and there are thousands of runners continuing to run on them, some with BOTH hips replaced. 

I decided to get a so-called THR: total hip replacement. There is also something called a 'hip resurfacing' but this is usually done on people that really want to best range of motion (e.g. rock climbers, dancers, etc). The disadvantage of the resurfacing is that eventually you need to get a THR when it wears out. 

I don't need range of motion, but the next question is 'What kind of device'? It turns out that really the primary problem with hip replacements is wear, and this concern therefore tied to how old you are, i.e. how much longer do you think you are going to live?... much do you plan to use use that new hip?

This is a big issue for people with birth defects like hip dysplasia (shallow hip socket) that can wear out at very young ages: 20s and 30's even. If they get a replacement they ideally need it to last the rest of their lives.

In the early days of THR, the devices were metal on metal bearings, these had the problem that wear was high and the metal particles from the wear built up in the soft tissues and messed them up after 10-15 years.

Then they developed ceramic coatings: they have extremely low wear  but a problem is that in an accident the ceramic coating can shatter. The shards from this are impossible to remove cleanly. 

My doctor recommended the current preferred state of the art: "COP" or Ceramic on Polyethylene. The plastic is not just any plastic: it's a highly crosslinked version that is tough as nails. The plastic has really low wear but still has some 'give' in an accident and has the huge advance of being replaceable! 

If the total high replacement operation is defined to be a "10" in degree of recovery I'm told that to replace the plastic bearing is only a "2". This is wonderful for younger people that need the THR for many decades.

What's it like to have your hip wear out?

Literally, it's a pain. Real pain. Every time you need to move the bad leg (in and out of bed, putting on a sock, getting in/out of a car) it hurts. As you get really get down to bone on bone, it hurts all the time even without being moved.

Initially, you can't sleep on your bad side, and then eventually it hurts even on your back. The doctors are willing to give you opioids so you can sleep and this is better than nothing, but the drugs really don't allow for good dream-state sleeping, and they mess with your digestion. 

It's pretty horrible, frankly.  But the good news is that after the hip replacement, all that pain is GONE. Instantly. Yes, you have the wound pain from the operation (more on that below) but the hip itself no longer hurts.

One effect of having been through this is that when I see somebody walking... I can tell if they have a worn out hip. Older folks rocking side to side as they walk are a dead giveaway. I know they are hurting and need a new hip (or sometimes two).

What does an implant look like?

Here's an X-ray of my implant. There are two main parts: the part that goes in your hip and the part that goes inside your femur. 

The latter part has a spear that goes down inside your femur and replaces the 'femoral neck' i.e. the ball you used to have with the new ceramic ball.

The metal of the 'spear' going down into the leg bone has zillions of tiny nooks and crannies in it's called 'bone loving' metal 8)

Your femur grows into this metal and fuses with it. 

The upper part of the implant is the 'cup' or 'socket', it also has the plastic bearing locked into it (not possible to see details on the X-Ray)  The back of the metal cup is also bone-loving but to keep things solid for the first few weeks after the operation it has a couple of screws.

These screws become unneeded after your body fuses with implant, but they can't be removed and aren't harmful it seems so they stay there.  You do need to be careful for the first 6 weeks after the operation to not do moves with your leg that could pull the cup part out of your hip.  (This are called 'hip restrictions') 

After that the bone should be grown in pretty well.  Before I was allowed to start running my doctor asked me to wait another 6 weeks for more bone growth (total of 12 weeks)

Note: if you are older they may cement your implant in as bone growth may take too long to happen (or never happen). If you not very active the cement will do you just fine.

What's it like to get a total hip replacement operation?

There are two methods: anterior and posterior (from the front of the leg, or the back). The anterior approach is what I had and has faster recovery (doesn't involve cutting major muscles in the butt). Some doctors have not learned the anterior approach and are still doing posterior.

My operation took about 1.5 hours: I was given a spinal to cut off pain and also a narcotic to keep me knocked out while they did their thing. Basically, I just magically woke up in recovery and realized it was over! 

After my spinal wore off they had me stand up with a walker and just see how everything felt.  The incision was covered with a super nice humongous band-aid looking thing...the cut is about 6-7" long and the upper quad of my leg was fairly swollen and numb.

I was given IV painkillers (basically Tylenol and some opioids) and this made it really easy to sleep the first night. Which is good because basically people are waking you up all the time to check on your meds...and being able to go back to sleep in 30 seconds is excellent ;)

The next day I started PT...this was learning how to use crutches...walking up and down the hall, going over a list of some exercises to do, etc. I went home later the same day.  

I ended up buying a cheap cane at Walgreens on the way home and never used the crutches, and only used the cane intermittently for a few days.

Note: Its helps if you are younger and/or you are athletic  before you get a THR. Basically  the more surplus muscle you have,  the better off you will be during the recovery. For example, you will have a hard time getting up from a toilet because your operative leg can't bend very well right away: you have to extend it out in front if you. This makes getting up hard. I was still quite strong in my other leg and could press myself up with it..I only needed a light touch on the wall to steady myself. 

Being strong you can keep to the hip restrictions more easily: e.g. if I dropped something I could just kneel down on my good leg to reach it and then press back up. (Bending over would be bad)

The first week was the roughest: I took opioids for the pain and they had all the same downsides I mentioned before, but you really need them. I was able to gradually reduce the amount of them I needed each night (didn't need them during the day) and after a week I was DONE! 

The swelling and tenderness of the stitches require some care: you have to tape plastic over them if you want to shower. Your leg will feel 'hot' to the touch for quite a few days as things get over the trauma.

I went to work (by bus) a week after the op..for only a half day and then resumed my normal schedule.

Gradually the swelling went down and after two weeks my leg was strong enough that I was given the ok to drive. (If you get the left hip done and have an automatic car you would not have any problem driving right away)

During all this time your leg is 'recalibrating' ...basically everything has changed in there and so the particular nerve firings are a bit 'off': you can move and walk but you feel a bit clumsy in your operative leg.

This gradually fades way after 12 weeks I did my first run on the treadmill and it was ok. But they do say it takes up to a year before your leg really feels totally back to being your 'original' in strength and coordination and general feeling. Obviously athletes have a big advantage here.   

PT for the total hip replacement

After the surgery I was given some PT in the hospital, and for the first couple weeks I had a couple of visits by a PT and an OT (Occupational therapist). Mostly they looked around for dangerous stuff you might hurt yourself with at home and also provided more exercises to work on. 

I started going to the gym 4-5 times a week and gradually got my cardio back on the elliptical and stationary bike. I did the self PT for a while but after I got the hip restrictions lifted I signed up for a set of 8 once-a-week calibrations with a PT at my HMO.

These sessions are immensely valuable and bring back range of motion and strength. They take about 15-20 minutes 5 days a week to do. 

How do doctors feel about running with THRs?

It's a problem for doctors: they don't really have enough study data on wear to make blanket statements. Recently, a very small number studies coming out showing very low rates of wear for runners with the latest devices. 

My doctor says that I'm old enough that even running on my implant I will not need to have the bearing replaced and he says my left (normal) hip will be fine too. I will be getting check ups every now and then and the wear can be measured off the X-ray. I can compare the wear numbers with my activity (miles of high-impact sports) over that period and see how it goes and plan based on that.

I do intend to to do more of my hard interval work on the stationary bike and ellipticals. When I couldn't run I found I could do some pretty hard workouts (cardio-wise) and not feel very sore the next day. I could also read a book, which is nice. So this should reduce the wear some.

Right now, I'm planning on still running marathons, maybe only one or two a year rather than three or four.

Where am I now?

Summary: I had my hip replacement on Nov 1 and was cleared for running 12 weeks later. I have been very slowly increasing my treadmill running, having recently done 3 miles at one go with one mile at a 9:05 m/m pace. 

I have a long way to go to get my running economy back to where it was, as well as my range of motion,  and overall endurance.

But, I'm so super happy to be back to running! 

Thank you technology... (And Dr Graw and his team) for keeping me going!