Decision Time

Posted on October 8, 2019 by Jonah Soolman

Shortly after midnight on Saturday, April 14, 2018, I had a dream in which I was at the staging area for that morning’s Newport marathon, but I had not yet checked in for the race or stored my belongings even though it was 7:13 AM, just 17 minute shy of race time. Frantic, I was trying to figure out how I was going to take care of these logistical to-do items and get to the starting line on schedule. Then I woke up.

Approximately seven hours later, I was at the staging area down in Newport for the actual marathon. The truck containing the mobile locker I had rented in advance was mysteriously not there yet. Confused and anxious, I wondered what I was going to do with all of the gear I had planned on locking up, including my wallet, keys, phone, clothes, and post-race snacks. Standing there feeling somewhat paralyzed by uncertainty, I took out my phone and checked the time. It was 7:15 AM. (Premonitions allow for a two-minute margin of error, no?)

Midnight clairvoyance and the subsequent inauspicious sunrise set the tone for the rest of my day. Eventually, I got in line for gear check, an unsecured area for runners to leave their belongings, for I could no longer wait for the mobile lockers to arrive. Good thing I did not hold out for them either, as I found out later that the driver overslept and did not arrive with the lockers until well after my race began.

As I was standing in a long line comprised mainly of runners competing in the 5K and half marathon events that were commencing later in the morning, I heard the national anthem and then saw my fellow marathoners starting down the road. After several minutes, I got the attention of a volunteer and stammered, “I don’t know what I’m doing and my race just started without me.” He told me to drop my bag, that he would take care of it, and from there I hurried to the course and crossed the starting line well after the rest of the field.

While I prepare meticulously for race-day logistics, my pre-race plans went out the window due to the chaos that ensued from the mobile lockers’ absence. About a mile down the road, I realized I had accidentally left two of my three anti-nausea medicines in the bag I checked with the volunteer. Such a mistake was quite concerning, as nausea tends to be my limiting factor in marathons, even more than muscle soreness or general fatigue.

Not having my medication only compounded problems that began with a poor training cycle due to a herniated disc in my lower back, an abdominal hernia for which surgery was scheduled six days after the marathon, and a couple of other medical hindrances. Things were not looking good already, and yet they got worse.

Quickly, my fellow runners and I discovered that hydration was going to be a problem. Unlike most marathons that offer both water and sports drinks regularly along the course, most of the beverage stations on this course featured only water. Moreover, the cups were maybe a quarter full. Subtract from that the fluid that splashed out during the drinking process, and the net amount that made it down my throat was not nearly enough to keep me hydrated. The stations that did offer a beverage other than water had a low-calorie electrolyte drink, woefully insufficient to replenish the carbohydrates expended during such an endeavor.

Despite these challenges, I was inexplicably on pace for my all-time best marathon through mile 18, but by then things were getting ridiculous. We had not had a beverage station since mile 13, no electrolyte drink since probably mile 11, and the course was in the midst of a miles-long uphill stretch that felt more challenging to me than Boston’s Heartbreak Hill ever has.

The nausea, which had been building slowly, was pronounced enough where I felt like the time was right to use the one anti-nausea medication that I remembered to bring out on the course with me. In keeping with the theme of the day, the pills promptly fell out of my Ziploc bag onto the road. The quiet tick of the medication hitting the pavement was likely inaudible to anybody else, but to me it was the thunder of my last hope for a great marathon finish crashing down.

Limited by nausea and dehydration-induced muscle cramping, my pace slowed significantly over the final miles. Around mile 25, a blister that I did not know I had burst on the bottom of my right foot, altering my gait and slowing me even further. Hobbled, I kept running and crossed the finish line limping.

Somehow, out of the day’s nonsense sprang my fastest marathon time in 15 years, but this is less a story of resolve and more a tale of someone struggling in real time to weigh the pros and cons of disregarding or honoring his body’s signals, which in this case were clearly telling me to drop out of the race.

The course was essentially a figure eight with the start, midpoint, and finish all at the center. If I was going to call it a day early, hitting the eject button at the midpoint made the most sense, so I took stock of the situation as I neared the 13.1-mile mark. Inadequate fluids, dehydration and cramping that were already setting in, insufficient medication, and memories of my 2004 Boston marathon – which ended with an ambulance ride to the emergency room – all suggested that dropping out was the sensible and safest play.

On the other hand, my speed was inexplicably fast up to that point and I did not want to take for granted that I would ever have a shot at a marathon personal best again. While I reserve the right to change my mind, I went into this race figuring it was probably my last marathon. While I enjoy the training and racing, impending parenthood had me looking at the situation from a different perspective. Long training runs take a lot out of me, so much so that I am pretty much useless the rest of the day, and I do not think it is fair to put our daughter in a position where daddy cannot play, or go to the playground, or go for a walk, or do pretty much anything at all because he ran far and needs to rest.

Even if I do decide to train for another marathon someday, who knows, I could wake up sick on race day, or sprain my ankle on a Baby Einstein guitar while heading out the door to the starting line, or suffer any item on a tremendously long list of inflictions or mishaps beyond my control that could throw the whole endeavor out the window at any point in my training cycle or at the very last instant.

As I neared the half, I was cognizant of the reality that being 13 miles into a marathon with a chance for a personal best might never happen again. For as much had gone wrong, a lot had also gone right to allow me to be in such a position. Having weighed the pros and cons, I decided to continue on with the race despite all of the reasons to stop.

Disregarding my body’s cues eventually caught up with me. A few minutes after I crossed the finish line, the nausea worsened, I was shivering (a symptom of dehydration) despite the warm temperatures, and my breathing was abnormally rapid. Laying face up in the sun while wearing a hooded sweatshirt and winter jacket did not help. With my condition deteriorating, I made my way to the medical tent.

The paramedics took my blood pressure, which was sky high compared to my norm, and I was having trouble answering their questions. While I have a history of occasionally feeling miserable after long runs, this was worse than my norm. The scariest part to me was that I was aware of my incoherence, yet I could not do anything about it. They asked me what medications I take, but I could not put together an articulate response. In my mind, I was like, “Come on, dude, you know what meds you take, just tell them,” but I was incapable of getting the words out.

The paramedics wrapped me in blankets, put me in the back of an ambulance, and cranked the heat to warm me. They gave me oxygen and placed leads to monitor my pulse, heart rhythm, and oxygen saturation. After two hours of laying on the gurney getting rehydrated and warmed, we agreed that I was well enough – but albeit still far from 100% – to leave the ambulance and make my way back to my car.

Stepping out of the ambulance, I was startled to discover that the finish area was virtually deserted, as the spectators, volunteers, race organizers, and my fellow runners had pretty much all gone home. Watching the few remaining workers disassemble the food tent and the final handful of artifacts from a post-race party that had presumably been so happy and festive just a short time earlier, I felt an eerie and unsettling sensation: loneliness.

Later that evening, Joanne commented over dinner that I looked sad. She was right. Ending up in an ambulance with a health scare is no way to conclude an event. Finishing a marathon normally yields a significant sense of accomplishment, but this time I felt conflicted and somewhat hollow. Even though completing the course was a triumph of sorts, I had mixed feelings for having put myself in unnecessary jeopardy.

Like I tell my patients who are working on listening to and honoring their internal cues: assessing hunger and fullness levels, sorting through matching criteria, checking for humming and beckoning, and utilizing other intuitive eating tools are never meant to be leading questions, and there are no such things as absolute right answers. Decisions made regarding what, when, and how much to eat matter much less than having utilized a thoughtful process to reach them.

Similarly, having considered all of the pros and cons of the options available to me at the moment I had to make a choice, I feel like continuing to run was the best course of action for me despite my body’s cues suggesting that I stop. Ultimately, I am glad I finished the race even if I did pay a price for my decision.

Just after crossing the finish line. Am I having fun or what?

Pineapple

Posted on October 9, 2017 by Jonah Soolman

My right hamstring was cramping up before I even left the house yesterday morning for the Newport marathon. How does that even happen? Nerves, probably. Marathons always make me anxious, but this year I went in with expectations, which compounded the anxiety.

My training went so well that I thought I had a shot at setting my all-time personal marathon best. No, it was more than that; I thought I had it in the bag, and it would have meant a lot to me to achieve a personal best after everything I went through with the surgeries.

Anyway, by mile five (Five!) both of my legs were legit cramping up, but I still maintained my goal pace for the first 18 miles before everything fell apart over the last eight. While I still beat my time from last year – which I ran during Hurricane Matthew – by a half hour, I was well off my expectations and nowhere near a personal best.

While we tend to only post on social media when things go well, privately we understand that not every day is a great day, not every goal is accomplished, and not every dream gets fulfilled.

Historically, Newport sea captains placed pineapples outside their homes to signal that they had returned safely from their voyages. With that in mind, my finisher’s medal offers perspective; while the race certainly did not go as I had hoped or expected, worse outcomes were possible, and at least I made it back home.

“Good Shot”

Posted on June 12, 2017 by Jonah Soolman

“Learn to say ‘good shot,'” my physical therapist suggested as I prepared to return to competitive tennis last fall. Her advice had nothing to do with sportsmanship. Rather, it was a half-sarcastic quip that reflected her assumption that I would not be able to reach balls that I was capable of tracking down years ago and a note of caution that it might be in the best interests of my back to not even try for them if I had any doubt.

She had a point, but only to an extent. Charging forward towards a drop shot, watching the ball fall for its impending second bounce, inching the butt of the racquet handle further towards my finger tips to take advantage of whatever length I can muster, I often think to myself, “Why aren’t I there yet?” Sometimes I forget I am a 40-year-old with a bunch of titanium in my spine. Then reality hits: The ball – just out of my reach – takes its subsequent plop on the court, my physical therapist’s advice echoes in my mind, and I glance up at my opponent and offer, “Good shot.”

While my back does not directly limit my game, it has an indirect impact. Managing my back means exercising intuitively, paying attention to the feedback my body gives me, and doing my best to balance physical activity with rest. Not being able to practice and exercise as much as I once did means that my fitness level has taken a hit and my game is not quite as crisp, which consequently has affected my level of play. My second serve, for example, which used to be as consistent as the sunrise, sometimes lets me down now and I just have to accept that. The upside, however, is that my back feels so good that I never worry that I am endangering myself by trying for every ball.

Both of my tennis leagues began in October and recently concluded. My overall record between the two was an even .500, a far cry from the three-year winning streak I had from 2003 to 2006, but I have always figured that if someone more or less wins as many matches as he loses, then he is playing at the competitive level where he belongs.

My level of play was at least good enough for me to rejoin the Amherst-based team that I played for when I lived in western Massachusetts during my nutrition studies. Sports are about more than exercise and competition; they are social experiences and opportunities to hold on to an aspect of playfulness that can sometimes get lost with age. When the season wrapped up, I emailed my teammates, namechecked the guys who remained from my first stint with the club over a decade ago, and told them, “You have no idea how much I missed being part of this team.”

Returning to the team marked a milestone of sorts for me, which reminded me that we just passed the one-year anniversary of another moment of personal significance: my first time back on the court since my operations.

Tennis has always meant a lot to me, but I never quite realized just how much until I went through the prolonged period of not playing, the uncertainty of whether I ever would again, and then ultimately my return. See, the thing is, walks can be interesting, swimming is okay, lifting weights is cool sometimes, bike rides can be fun, and running is great – but tennis, that’s what I love.

January 7, 2017

One Week in October

Posted on October 25, 2016 by Jonah Soolman

October 15, 2016, Ludlow, Massachusetts

Exactly 941 days after my first spinal fusion and 472 days after my second, I drove west to play a match for my old Amherst-based United States Tennis Association (USTA) team for the first time in a decade.

Over those 10 years, and particularly in the last two as I recovered from my operations, I dreamed of reuniting with them and wondered if it would ever actually happen. Intellectually, I thought it might, as my surgeon was cautiously optimistic about my chances of playing competitively again. My physical therapist was more guarded, however, particularly because the failure of my 2014 surgery reinforced that medical outcomes are rarely guaranteed no matter how certain they may seem on paper. So while in my head I thought I might compete again, in my heart I never really let myself believe it for fear of crushing disappointment.

The team roster has undergone some turnover since I last played for them in 2006, but many men still remain from my first stint and it sure was great to see them again. “You haven’t changed at all!” one of them declared. Well, on one hand, I think of the transitions I have experienced in the last decade: no longer a student, now a licensed healthcare practitioner; no longer an apartment-dwelling bachelor, now a husband, homeowner, and business owner; no longer a spry 20-something, now a balding guy in the twilight of his 30s with three back surgeries under his belt.

On the other hand, I felt at home again, just as I had before, that much was constant, and I think my teammate could see it in my face. If anything, I felt even more confident walking onto the court now than I did back in the day. Just returning to the team was in itself a victory, so whatever else I happened to achieve in the match was a bonus.

Confident and relaxed, I took advantage of an opportunity a decade in the making and destroyed my opponent 6-1, 6-0. As I quipped to my team captain, “Those 10 years of rest really helped!” Most importantly, my back felt great before, during, and after the match, which was particularly noteworthy considering what my body went through just six days earlier.

October 9, 2016, Newport, Rhode Island

My surgeon cleared me to resume running in January and I quickly ramped up my training enough to complete a 10-mile race in late February, but subsequent pain suggested that sticking to shorter distances was probably in my best interest. As the spring progressed, however, I was able to comfortably go for some longer jogs, which had me wondering if running the Newport Marathon in October might be possible. In July, my surgeon reversed his stance on long-distance running, gave me his blessing, and told me to go for it.

Go for it, I almost did not, as I nearly backed out several times on the morning of the race. As recently as two days earlier, I was excited for the event and did not feel the slightest bit nervous, but in the final hours I was sad and anxious, eerily similar to how I felt on the mornings of my surgeries. Driving south on route 24 before dawn, I thought about how easy it would be to take an exit, any exit, turn around, head north, and crawl back into bed. Just continue on to Newport, I told myself. Do not make a decision about the race yet, just drive to Newport, park, and reevaluate.

The parking lot near the starting line was still pitch black when I arrived, and torrential rain and raging winds, the extension of Hurricane Matthew that reached New England, pummeled me as soon as I stepped out of my car. Retreating to my vehicle, I considered pulling out of my space and driving home. Instead, I paused to take a deeper look at my anxieties, which mostly centered around getting sick or injured, and reminded myself of the strategies I had formulated to avoid disaster and maximize my chances of a great race.

Most importantly, I remembered other instances in my life when I felt similarly stressed and apprehensive before significant events, most notably my transcontinental bicycle ride a decade ago, only to be happy that I had followed through. In the early morning hours of June 1, 2006, my best friend drove me to a Seattle beach, my bicycle and backpack in the trunk. Sometimes he reminds me just how petrified I looked as we sat there waiting for the other riders to arrive. Indeed, part of me wanted to curl up in the fetal position in his passenger seat and ask him to drive me back to Seattle-Tacoma International Airport. Out of the 4,024 miles I traveled between Seattle and Boston, the most difficult span was the step out of his car, but I am so glad I took it.

“If you get out and run,” I told myself, as I remembered my bike trip, “in about six hours you are going to sit back down in this car seat with a medal and a tremendous sense of accomplishment.” So that’s what I did: I got out and ran. Around mile 24, I passed by my car and thought about the pep talk I had given myself early that morning. Soaking wet from the storm but excited and still full of energy, I finished the course with the fastest two miles of my entire race.

As was the case regarding my aforementioned tennis match, my back held up just fine during the marathon. “I don’t know if you fully appreciate how impressive that is after all you have been through in the past few years with your back and the surgeries,” my physical therapist wrote in an email. She may be right, as she can speak better regarding typical clinical outcomes than I can, but by no means did I take being able to complete a marathon for granted. Finishing was emotional, not just because of how close I came to backing out of the race that morning, but because for a long time I thought I would never cross another marathon finish line again.

Three days after the race, I returned to my surgeon’s office for a routine follow-up appointment. “I brought something to show you,” I told him, as I reached into my jacket pocket and retrieved my finisher’s medal. “Wow,” he laughed, “That’s amazing!” Back in March, he had gently told me my days of running marathons were probably over. He was right; they probably were.

October 8, 2016, Boston, Massachusetts

Walking from the Hynes Convention Center subway stop to its namesake for the final day of the Cardiometabolic Health Congress, I remembered limping the same route three years earlier, physically unable to continually walk the two blocks without pausing for my back pain to die down.

About a week before that day in 2013, I went to bed feeling fine, but in the morning I stood up from bed and almost fell over due to a sudden onset of severe pain radiating down my leg. Over the next few days, I hoped the symptoms would resolve as spontaneously as they arose, that I would similarly go to bed and wake up in the morning feeling back to normal. As I struggled to walk from the subway to the convention center, however, reality set in that a rapid recovery was not in the cards and I might be in serious trouble.

Thus began my three-year saga of doctors, injections, medicines, physical therapy, alternative treatments, surgical consults, operations, setbacks, and rehab that led to the present. This road has no end, as I will always have to be mindful of my back, take care of it as best I can, and live with the uncertainty that someday I may run into trouble with it again despite my efforts, but I am very happy and thankful to be where I am today.

Day 795/326: Tennis

Posted on May 25, 2016 by Jonah Soolman

Joanne and I are grateful for everybody who has recently joined us online by liking us on Facebook, following us on Twitter, and reading our blogs. Whether you have been with us for one day or several years, we thank all of you for being part of our virtual community.

For the new folks, let me get you up to speed on a theme that occasionally pops up in my writing: the three back surgeries I have undergone, including two in the last two years, and my ongoing recovery.

Generally speaking, I am pretty guarded when it comes to talking about my own life because self-disclosure can so easily do more harm than good. However, as I headed into my 2014 operation, I decided to make an exception and document my recovery because it can be helpful for patients to remember that while our specific challenges may differ, we are coping with similar themes:

weighing the pros and cons of imperfect treatment options,
coming to grips with the reality that health outcomes are never guaranteed and only partially in our hands despite our best efforts,
mourning abilities or characteristics once possessed that might be gone for good,
accepting our new identity and discovering new ways to thrive,
other story lines in human existence to which patients and practitioners alike can relate.

Those of you who have followed my recovery know that my ultimate goal is to play competitive tennis again. After playing for my high school and college teams and then in adult leagues, I have been unable to compete for nearly a decade.

On Sunday, 794 days after my second surgery and 325 days after my third, I took a significant step by returning to the tennis court for the first time in three years. Unsure of what my back could handle, Joanne and I began with gentle mini tennis, just tapping the ball back and forth as we each stood at our respective service lines. No pain, to my surprise, so we backed up a little bit more into no-man’s-land. All systems still a go. Five minutes after we got to the court, we were back at our baselines hammering ground strokes to each other almost as if I never had a layoff.

Muscle memory is a crazy thing, as is modern medicine. While Joanne and I exchanged forehands and backhands, my thoughts were with everybody who contributed to my recovery: my surgeon, Dr. Jean-Valery Charles-Emile Coumans, my outpatient physical therapist, Sue Bloom, the inpatient physical therapy and nursing staff at Massachusetts General Hospital (Sorry again for pooping in my gurney, guys!), my friends, and my family, including and especially my wife.

I cannot thank them enough for helping me to find my way back home.

Court

Healthcare For Some

Posted on February 29, 2016 by Jonah Soolman

Yesterday I ran the Five College Realtors 10-Miler, which was my first event since last summer’s surgery and my first road race since September 2013. My time was well off my personal record for this course, which I set the last time I ran it in 2007, but I have been through quite a lot in the last nine years so expecting to pick up where I left off would have been unrealistic. Besides, it was just great to be able to race again regardless of what the clock said.

As I have written before, I owe a debt of gratitude to everybody who has helped me recover over the last two-plus years, but at the same time I think others who do not receive the same level of care from their own support systems, including their medical teams.

When I went to my primary care doctor in late 2013 complaining of back pain, I received orders for x-rays, an MRI, and a CT scan, referrals to see a physical therapist, a physiatrist, and multiple surgeons, and a collaborative discussion about the pros and cons of complementary treatments, such as acupuncture, chiropractics, massage, and neuromuscular therapy. Subsequently, I received a topical medication, oral medicines, injections, and referrals to more surgeons. Ultimately I required an operation, and then another one, more scans, and physical therapy that continues to this day.

When my “overweight” patients go to their doctors complaining of back pain, more often than not they report receiving one intervention and one intervention only, one that research shows is only achievable for a tiny fraction of the people who attempt to attain it and may not improve their condition even if they do: a directive to lose weight.

Are we not all deserving of thorough, collaborative, evidence-based healthcare, or just those of us who are thin?

Day 662/193: Collaboration

Posted on January 10, 2016 by Jonah Soolman

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Thanks to a great medical team, a supportive family, a generous bone donor, and a boatload of titanium, my spine is now the healthiest it has been in years. My surgeon gave me clearance last week to resume running. Not since 2013 have I been able to step outside and go for a jog.

In addition to expressing my gratitude for everybody who has aided me, I also want to thank myself for everything I have done to help my own cause. While doing so is admittedly not the most gracious of moves, danger exists in giving the impression that we are to solely look outside of ourselves for help. Although health outcomes are never guaranteed or entirely in our control to achieve, patients who come into my office, fold their arms, lean back in their chair, and direct “Just tell me what to eat” rarely do as well in the long run as those who collaborate and take a more active role in their own care. Nutrition may be my area of expertise, but my patients are the experts in their own lives, so the highest likelihood of success comes from working together.

Anyway, my two favorite races are the Mount Washington Road Race and the Five College Realtors 10-Miler, the latter of which is coming up late next month. The other day, I mentioned to my physical therapist that I am interested in running it this year. Given that she tends to be my foil, a voice of caution and conservatism who brings reason and sensibility to my ambitious ideas, I figured she would tell me that the 10-miler made more sense as a 2017 goal. Surprisingly, she thinks the likelihood of me being able to race it next month is high. Whoa. We talked about training for the event in the context of my continued surgical recovery and together we developed a plan. In other words, we collaborated.

Guarantees

Posted on July 14, 2015 by Jonah Soolman

Nearly two weeks ago, I checked into the hospital for what was supposed to be a relatively minor procedure to address an “extremely rare” complication related to last year’s spinal fusion.

When the surgeon got in there, he unexpectedly discovered that my body had reabsorbed the implanted bone grafts while the rods and screws were loose and moving around. This happens in 3% of cases, he said, and he has no idea why it happened to me, as I do not have any of the risk factors for poor healing. As he delivered the bad news to me upon my awakening, he expressed surprise that I was even able to walk around in that condition.

In response to the situation, he had to completely redo the fusion, making for a much longer recovery than we anticipated. One planned night in the hospital became four. One week of missed work will now likely be three. One month of taking it easy now becomes a season, at least.

Twice I fainted in the hospital, and my blood pressure and pulse dropped so low for no apparent reason that they ran tests to see if I had suffered a heart attack, but really the hardest part of the whole ordeal has been coming to grips with the reality that everything I went through last year I must now do again.

However, the situation has been made easier thanks to the help and support of friends, family, an excellent team of nurses and physical therapists at the hospital, and of course my wife, who is now picking up the slack for me in every facet of our life.

Just 12 days before the surgery, I ran the Mount Washington Road Race and we celebrated at the summit. We thought we were at the top; little did we know we were heading back to the beginning. The lesson: I will never take days like that for granted, as they are never guaranteed to come again.

Day 458: Mount Washington

Posted on June 24, 2015 by Jonah Soolman

In my mind’s eye, June 20, 2015 represented the end of an extensive journey back from a major operation. Long ago on the eleventh day of my recovery, I began keeping a log of the daily indicators of my progress, small steps all leading towards this late-springtime Saturday morning in New Hampshire when I would return to racing by competing in the Mount Washington Road Race and, upon reaching the summit, declare my recuperation complete.

Beginnings and endings make for nice stories, but they are sometimes just myths. Even as conditions improve and problems slip into the past, they still exist somewhere. Perhaps that is why alcoholics often still label themselves as such even after decades have past since their last drinks. My back will always demand my attention and vigilance, just as diabetics must continue to practice daily blood sugar management, as opposed to achieving their target A1C values and leaving their endocrinologists’ offices thinking they have wiped their hands clean of the disease. Not that I am complaining or feeling bad for myself; we all know that life could have dealt me a much worse hand.

Next week, I undergo a third back operation to correct what my surgeon terms an “extremely rare” complication related to last year’s procedure. Although I can run up the highest mountain in the northeastern United States, I cannot jog around the block or even go for a walk without significant pain. Go figure.

While this past Saturday was not the metaphorical finish line that I anticipated, the occasion still carried a significance. As I neared the summit, I remembered that exactly 15 months earlier I laid in a hospital bed unable to do anything more than slowly shuffle about the unit with my walker and a back brace. The days that I thought I would actually make it back to competitive racing were vastly outnumbered by the days I felt in my heart that I never would, but I always kept working and accumulating small daily indicators that I was inching back towards my old self.

Effort alone, however, is not enough, and I never would have gotten to this point without the help of many people, including my surgeon, Dr. Jean-Valery Coumans, my physical therapist, Sue Bloom, and most of all my wife, Joanne, who has experienced this saga from spending sleepless nights on a couch in my hospital room to waiting for me at the summit. Literally and figuratively, it was a long way back to the top of that mountain, and I could not have gotten there alone. We got this far, and will go even farther, together.

Day 366

Posted on March 20, 2015 by Jonah Soolman

Today marks the one-year anniversary of my surgery. Because my spirits were so dismal in the days immediately following the operation, on day 11 I began writing a log of the small daily victories that marked my healing and recovery. While I was initially unsure how long I would keep it up, I have maintained the log to this day and have no plans to stop, not when I still have so far to go.

One year ago tomorrow, I strapped on my back brace, leaned on a walker, and shuffled slowly from my hospital room to the nurse’s station and back, flanked by my wife and a physical therapist. Due less to pain and more to my fear that the operation had not worked, I cried the whole way.

Going into the operation, I was under the impression that I would not need a brace. When I found out the surgeon was prescribing one, I angrily and defiantly informed the nurse that I refused to wear the contraption. Over time though, I became attached to it. While the brace was at first just a literal support, over time it took on a figurative role as well, sort of like my version of Wilson the volleyball. During the first two months of healing, my brace and I walked for hours and hours together, and during long walks when I was otherwise alone, unsteady on my feet, unsure of my present, and scared of an uncertain future, my brace was always there to keep me upright and give me the courage to keep moving forward.

On day 67, we walked the entire Boston Marathon route together. Shortly thereafter, my surgeon told me it was time to stop wearing the brace. Truth be told, I was sad to jettison my sidekick. Finding the brace by surprise in the house triggers a similar fondness to randomly running into an old friend in the grocery store.

My surgeon was astonished by how quickly I progressed in the first few months after the operation. “You will be back to your crazy workouts in no time,” my physical therapist told me last summer. Turned out she was way off. As I wrote on day 197, we are only somewhat in control of our destiny and life does not always unfold the way we might expect or wish for ourselves.

Setbacks have been plentiful. Activities that my surgeon said should be fine at the time, like swimming, remained intolerable until seasons after his timetable indicated. Some of the bone grafts were unusually slow to heal and for a couple of months we faced the legitimate possibility that they might never fuse. Once I got the green light to resume weight training, I hurt one shoulder, then the other, and had to leave the weight room once again while I rehabbed them. Raking leaves in the November twilight and rushing to finish before darkness, I swiftly walked into my leaf blower, broke my big toe, and ended up in a walking boot. My most recent MRI showed a bulging disk at the surgical site, a highly unusual complication, and the radiating pain down my leg has returned. What can I say, Robert Smith taught me a long time ago that life is neither fair nor unfair.

Before the surgery, I expected that my healing would plot out a linear trajectory with each week being better than the previous one, but quickly I realized that was unrealistic and a setup for disappointment. Real life has its downs, but thanks to good fortune, hard work, and help from many people, it also has its ups.

Although my ultimate goal remains to resume playing competitive tennis and I am working hard in a physical sense to make that happen, simultaneously I am doing my best to prepare myself emotionally for the possibility that it may never come to fruition. Although I remain light-years away from returning to the court, accepting the latter feels much harder – and much less likely – than ever achieving the former. Past opponents and fictitious foes have contract court time in my dreams and we battle it out several nights most weeks, and my wife does not know that I often tear up when I watch her own matches from the sidelines.

Recovery does not end once the surgical site heals. Despite all that has happened in the past twelve months, in some ways I feel like I am still at the beginning of the journey with a long and unmapped future ahead of me. One year ago, I was bawling on a hospital gurney awaiting my turn in the operating room. Today, I went for my first run outside in 18 months. It was slow, short, uncomfortable, and really, really difficult. And it was totally and completely awesome.