Day 366

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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.

Day 67: Marathon

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Boston Marathon starting line, Hopkinton

Selfie of my feet at the Boston Marathon starting line, Hopkinton

A little over a month ago, my surgeon gave me permission to slowly ride the recumbent exercise bike and perform basic upper-body resistance movements with light hand-held weights. The doctor’s clearance for new exercises is mandatory, but so is my body giving me positive feedback in response to said activities. Unfortunately, I only had one of the two. After a few times of giving these exercises a try, my back pain seemed to worsen, so I put the bike and weights on hold and returned to exclusively walking.

Because several walks in the range of 12 to 16 miles felt fine and left me feeling like I could have done more, I decided to go a bit farther today. Early this morning, my back brace and I took the first commuter rail train of the day out to Ashland, where I met the taxi that then dropped me off in Hopkinton, right at the starting line of the Boston Marathon. 7:28 later, I walked across the finish line in Copley Square.

Boston Marathon finish line, Copley Square

Boston Marathon finish line, Copley Square (Photo courtesy of a tourist who was nice enough to take my picture after I told her I had just finished walking the entire route)

Day 26: Mindful Movement

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This morning I went for a 14-mile walk, which was miles farther than I had intended when I left home. Carrying my MBTA pass with me, my plan was to walk from station to station in Newton and then take the green line home whenever I got tired. But the fatigue never came, so I ended up walking home instead.

This afternoon, I called my surgeon’s office just to make sure it is okay that I am walking that kind of distance at this point in my recovery. They told me that 14 miles has to be some sort of record for this soon after major back surgery, but as long as I am feeling good (which I am) then they see no problem with it.

Joanne and I talk about mindful eating with our patients, but the concept of mindfulness extends beyond just dietary habits. Adjusting mode, frequency, duration, and intensity of physical activity yields all sorts of permutations of movements, and our bodies are great at giving us feedback regarding which ones work for us. We just need to make sure we listen.

Approaching physical activity with a spirit of mindfulness means paying attention to and honoring the feedback that our bodies give us in response to our movement choices. Today, for example, I was fully prepared to end my walk as soon as my body told me it was time to stop, but instead I felt great so I honored that and kept going. Yesterday, in contrast, I was hoping to go for a long walk, but my left heel felt uncomfortable just a couple of blocks from home, so I turned around and called it a day. Although I was disappointed to go home early, better to nip whatever it was in the bud and let it heal immediately, rather than push it and risk a long-term injury.

Besides injuries, other consequences can arise from not being mindful with our movements. We risk increased stress, overtraining, undertraining, burnout, and simply not enjoying ourselves. Although I was never the type of personal trainer to push my clients past the point where their bodies were telling them to stop, holding myself to the same standard and listening to my own body’s feedback has been a challenge at times, and I have paid the price via overuse injuries and getting sick of activities I once enjoyed. Moving our bodies can, and should, be fun.

Given my personal challenges, I consider yesterday’s aborted walk a greater accomplishment than today’s 14-mile trek. By listening to my body and honoring its signals, even as it was telling me something I did not want to hear, I put myself in a position that made today’s walk possible.

Day 15: Acceleration

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A few years ago, I spoke with a woman at the gym about the time she had to take off from work for cancer treatment. Upon her return, some of her co-workers treated her as if she had been on vacation, which infuriated her. As she explained to me, and I know first-hand, there is a big difference between using vacation time and going on medical leave.

Spending all day on the couch watching television might be fun and relaxing when you do it by choice, but being forced into it because there is virtually nothing else you are capable of doing is an entirely different matter. My first week home from the hospital was the slowest seven-day span I can remember.

As that first week came to a close, I made the decision to focus less on what I could not do and to instead emphasize the small indicators of progress that came with each passing day. Each evening right before going to bed, I wrote myself a quick note about what I had accomplished that day.

My whole perspective shifted. Powered by a more positive outlook, I have nudged myself to do just a little bit more each and every day, and the results have come at a rate so accelerated that I never would have expected it. Just one week ago, for example, I went outside for the first time after my operation and slowly shuffled around the block with Joanne’s help. Today, I walked six miles by myself.

Yesterday was my first post-operative appointment with my surgical team and they could not believe how well I am doing. They were floored that (1) I am already off of all of my pain medications, and (2) that I have been off of them for a week already. My baseline fitness going into the operation and my generally-healthy diet, they said, are likely significant factors into why I am recuperating so quickly.

That is probably true, but I like to think that my resolve to get off the couch and do something productive with my days also has something to do with it.