Sunday, April 28, 2013

Keep moving

"To me, if life boils down to one thing, it's movement. To live is to keep moving." Jerry Seinfeld
It has been awhile since I have provided anything like an update. Well, here we go! I am pleased to share that, overall, it was a banner week for 'into the thermosphere'.

Tuesday: The love of my life, Linds Sanders, accompanied me on my 50th summit of Mount Sentinel in 2013. This milestone marks the halfway point of the Mount Sentinel challenge.

Wednesday: I sought redemption on Mount Sentinel with my mountain bike. My goal is to bike without stopping to the summit via crooked trail/crazy canyon road. I have improved significantly since previous attempts, biking all but 20 feet without stopping (round trip from house-to-house 1 hour and 30 minutes). I can't wait to get back up there and muscle up those 20 feet!

Friday: Fueled by the adrenaline of a completed work week, Diet Coke and AWOLNATION, I had a go at my University Mountain/Mount Sentinel double-dip personal record (PR). This PR route follows the ridge route directly up Mount Sentinel, then heads down to the University/Sentinel saddle, then up to the summit of University Mountain. The route then reverses itself descending back to the saddle and back up Mount Sentinel and down the ridge route (~3,250 vertical feet total). My PR sat at 1 hour 35 minutes round trip (in January), but included running descents. The goal on Friday was to establish a new PR in which not a step was run. Equipped with trekking poles and a light pack, I power hiked the ascents and descents and established my new hiking PR on the route at 1 hour and 42 minutes. I am very pleased with this.

Saturday: I took my bike up the Main Trail in the Rattlesnake. I made it a solid 10 miles in before snow prevented further passage. Unfortunately, no wildlife sightings (save for a snake that I didn't see until my front wheel was on top of it - still feeling awful about that).

I wish I had better news regarding progress toward the magic '500,000 foot' line that I established as the goal of the 'Into the Thermosphere' project. It's not happening. Four months into the challenge, I am sitting at 141,775 feet, well off the pace to 500,000 feet for the year. At this stage my pace is honest and within the realm of what is reasonable. Any increase in intensity and I would be back where I was in February: injured. I have finally locked into a pace that includes adequate rest and cross-training and will remain there as long as I am able.

The upshot: the thermosphere technically begins at ~264,000 feet! Within reason for 2013! The 500,000 foot mark will come, but not until 2014 (perhaps on Denali?). 

All right, full disclosure, this blog post is a bad news sandwich (good news, bad news, good news). Highlights are 'good', falling short of a goal is presumably 'bad' and having my inflammation controlled for 5 months is better than 'good', it is extraordinarily encouraging!  

At my routine bi-monthly check-up - blood work and physical exam  - with the rhuematologist, we fell victim to collective surprise at the results of my most recent blood work. My current pharmaceutical regimen - beginning December 2012 - has effectively brought the level of active inflammation in my body into the normal range (after 3+ years 10x or more of normal). The doc alluded to a possible tapering of some of the medications if my labs remain stable through the next two months. This is the best sort of news you can get with RA!

The best part of all of this - the highlights, botched goals and promising labs - is the quality of life that I have been provided. Save for unrelated knee problems (which are steadily improving), I have been feeling like a million bucks. Keep moving!

Onward and upward!


Monday, April 22, 2013

Sunday, April 7, 2013

My Least Favorite Questions

"Mountains are the means, the man is the end. The goal is not to reach the tops of mountains, but to improve the man." - Walter Bonatti
The last several weeks have been something of a drought creatively. I won't pretend to have found a century spring or the like, but I have discovered something like a dripping faucet that, drip-by-drip, will satiate for the time being.

Since my last post, "Disappointment, Resilience" x2, I have done my darnedest to keep resilience at the fore by taking positive steps towards healing. I immediately made an appointment with a physician's assistant (PA) at Missoula Bone and Joint to have a look at my knees. He said the pain I was experiencing in both knees was likely associated with pressure created from the rheumatoid arthritis. The PA went on to give me a shot of cortisone in each knee to ease the pressure and sent me on my way with a referral to a physical therapist. 

To physical therapy!

After a brief knee exam, the physical therapist asked me what has become my second-least favorite question (least favorite to come): "Have you tried biking?" My heart sank. Not because of any ill-will toward biking, but because I have so much love for bi-pedal locomotion. Ambling, hiking, sauntering, running, jogging, sprinting, strolling, loping, walking, sashaying, mountaineering, striding and straight-up walking: all of these forms of two-legged travel - even sashaying! - are near and dear to my heart and, given the ability, I would perform combinations of these movements every waking hour. 

Back to the exam… She went on to describe how biking is not only easier on the knee joints - something we all know!,  but in many ways, healthier for them. When activated, the synovial fluid - the lubricant in the knee - heats up and provides nourishment for the meniscus and various cartilage in and around the knee joint. Running, hiking and power walking, on the other hand, provide the additional element of downward force on the cartilage, tearing, grinding and outright destruction of the precious padding in an unhealthy knee. 

After describing the science of knee joint impact through competing dyads (running vs. walking, walking vs. biking), the physical therapist went on to explain the value of cross-training. She mentioned that two to three hikes a week is within the realm of what is reasonable given the amount of cartilage I have remaining in both knee joints. She then asked me what has become my least favorite question: "What are your exercise and physical goals?" The reason I dislike this question lies in the fact that my goals are always unreasonable. Examples of previous exercise and physical goals: win a marathon; place top-three in a 50-mile running race; 100 miles on a stationary bike in under four hours; run Pikes Peak round-trip in five to six hours; run a half-marathon in the morning and a 50k in the afternoon. The challenge, the chase, the insurmountable nature of the goal is exactly what makes it so tantalizing. It is in the pursuit of excellence that I feel most human, most alive. Invariably, when asked the question, I couch my reply, responding with what I think my rheumatologist, PA or physical therapist considers to be the upper limit of what is reasonable. In short, I lie. 

A few more minutes of discussing my ostensible goal - to hike 4-5 times a week, ha! - my reception to the news of biking began to warm, consequently changing my attitude and tone. I begin to ask the 'real' questions, the honest questions that reflected the reality of the condition of my knees and what lie in the realm of the reasonable. "Hiking two to three times a week, with days of biking in between to maintain your cardiovascular health will keep you fit", she said. Although I may not be a genius, I am not an idiot. I know these things she tells me! But how hard it is to accept hard truths, truths that we can intellectually acquiesce, repeat and believe! 

All right. So that is my story: I visited a PA, he gave me shots of cortisone; and then I visited a physical therapist and she asked me two of my least favorite questions. 

My honest answers the questions?

Have you tried biking? After a soul-searching chat with my buddy Dave over a cup of coffee, the idea of biking as a sport became real. I purchased a mountain bike last week and will begin supplementing my hikes and climbs with mountain biking.

What are your exercise and physical goals? At this stage, to climb Mount McKinley in 2014. All else is secondary. The goal of 500,000 feet and 100 summits of Mount Sentinel in 2013 is a means to an end (a means that will need to be amended to the realm of what is reasonable).

This week, I will be telling my physical therapist the truth. Her support, coaching and encouragement is only as good as my honesty. I am doing myself no favors by couching my dreams. If my goal is to make the unreasonable reasonable, the unreasonable must become reasonable. The unreasonable - the dreams! - must be shared with friends, family and, in this case, medical professionals that can provide proper nourishment for the mind, body and soul that can explain away the doubt.