My daughter hurt her knee in the soccer game last night. After blowing through our flexible spending account paying for a surgery we paid off our deductible and are working towards our out-of-pocket maximum.
Whenever patients reach this point in their insurance plan, their incentives flip? Can I come three times a week? How many visit do I have remaining in my plan?
If once a week was appropriate before hitting that point, once a week is still appropriate.
Did I hesitate to have an orthopedist look at her knee? Nope. She needs to have her knee examined. Will I hesitate to have my daughter’s knee MRI’d? Not for a second. Making certain her meniscus and ACL are intact is important information to have. The cost is not a huge issue now.
These are the rules to the game they laid out. I am just playing their game.
While touring Depauw this past weekend, I learned that the dining hall is open from 9 to 11 PM for fourth meal. They serve french fries, onion rings, burgers, and I assume pizza.
I have so many unanswered questions. Is it part of the meal plan or replace breakfast? Does fourth meal mean the freshman 15 becomes the freshman 50? Is the ice cream machine working during fourth meal?
I studied at the Barnes Hospital cafeteria during the evenings of my first year at PT school. I didn’t eat much. It just gave me a table, some background noise, and the ability to pace and move to think and learn.
Would I weight 350 pounds if I had access to a fourth meal when stressed and studying?
I have carried a bias that a microdiscectomy meant my failure as a physical therapist. Microdiscectomy was appropriate when the patient had loss of arm or leg strength or reflexes. I now am adding a third criteria: when you have longstanding intractable pain.
I don’t have this bias when somebody has a fracture or a ligament tear.
I think this bias comes from physical therapy school but I cannot nail its origin.
When everything else has failed you, and anatomy is causing the problem, we need to change anatomy with surgery.
The challenge then is restoring full strength, motion, and tissue health in physical therapy.
I have used the same weight belt for the past twenty years. It is a lever belt that locks tight with a flip of the lever. To adjust the size I need to take a penny or screwdriver to two screws. Each placement of the lever leaves a mark on the suede leather. Over twenty years and a roller coaster of fifty pounds I have moved the belt tighter and looser.
The waist size on my pants is one metric of my weight, body composition, health, and fitness. The weightlifting belt is a more strict and harsher judge.
I am six inches from the narrowest the weight belt has ever been and one or two inches in pants size.
I am going to reward myself for moving in two more inches on the weight belt by getting a Dexa scan body composition test this summer.
I need to get past the critics the twin critics of my belts first.
I was training the car push on my street with my wife at the wheel. The incline of our street was a bit much for me. I moved the car about 6 inches before it rolled back at me.
Neighbors were out walking and walking their dogs. A friendly neighbor was coming by with his Great Dane.
“Is it not moving? If you can wait a minute I can be back here with my truck and help.”
“Actually, I am training for a strongman contest where I have to push three cars.”
There was along ten second pause before he responded, “Wait. You’re serious?”
“Unfortunately, I am.”
I am building a new kitchen table out of walnut. It will be 56.5 inches round with a lazy susan on top. I needed to cut the panel into a circle. I reached out to somebody with more extensive woodworking experience but did not hear back. How was I going to make this cut and not blow ours of works and a few hundred dollars of walnut?
To get the job done, I went to the ultimate instructor: YouTube. It is just amazing that a site started as a dating site, failed completely at that goal, has now become an indispensable resource for sharing knowledge.
Twenty years ago if you wanted to learn how to Olympic lift, or joint two boards, fix something on your clothes dryer, or paint shoes, you might find something online but probably not. Now you have a number of instructors sharing their life experience and knowledge to help you complete tasks, learn software, or figure out how to correctly install a battery in your new toy.
Most people are not monetized but uploaded something just to help other people out. If the world and Google were a little bit nicer, and micropayments were easier to process with lower fees, we could thank somebody with a spare buck or two in a tip jar. Until then, when you see a video that helps you get the job done, click the thumbs up button and leave a “Thanks” in the comments. It might help motivate them to make another video in the future to help somebody else earn something new.
One weekend, a week after a snow, I was training with a group at my office. The parking lot was clear and dry except for a ring of ice around the periphery from the plows. We were in the parking lot doing prowler pushes. Chaz brought a friend and the friend wanted to make an impression. One of the unspoken rules of survival for training was to do what you could do, find a bit of challenge, and call it a win. When somebody joined the group with a background of being one of the stronger people at their gym, they usually failed to understand that rule. They wanted to win that event and every event. They definitely needed to outdo everybody smaller than them much less smaller and older.
We were pushing the prowler sled about 100 feet. The new guy made his mark by pushing it twice that.
He made his mark because he was done for the day after that. His blood sugar and blood pressure went nuts. Nausea downed him like a tidal wave. If there was blood in his digestive system it got pushed to his working muscles. Blood pressure spikes to keep pumping blood through working muscles and then plummets when you stop. Your body struggles with trying to figure out where blood and oxygen need to go.
A better description would be he made his mark by vomiting three or four times around the edge of the parking lot burning a hole in the ice with the contents of his stomach and some stomach acid.
I would have understood if we never saw him again after that. But he did not give up. He did not come back for a few weeks but he did come back. That is how he truly made his mark.
When I trained for strongman at the warehouse, the training group would talk about the White Buffalo. After some event training, tire flips and sled drags in particular, when you pushed too hard, your vision would get cloudy with a white haze. You were light headed and nauseous. You were done for the day. You were seeing the White Buffalo. A mystical creature would run through your visual field in the fog and haze you were experiencing.
I did car pushes today getting ready for the three car push on May 2nd. It did not go as well as last time. Maybe I held my breath too much. Maybe it was because it was 7 pm instead of 10 am. Whatever the reason, I am sitting here an hour later and still see fringes of fog and the familiar nausea of the White Buffalo.
I need to get my work capacity up and my tolerance for time under tension increased to better survive this event. I want to finish the event without vomiting. Finishing it without nausea would be even better.
I want to avoid the White Buffalo.
Since my friend and I are fully vaccinated, we restarted working out together. It has only been two workouts but it is great to get back in the routine.
This weekend it hit home when he provided a reassuringly-there-but-not-helping spot with my last set of squats.
I can get a spot from my family but it is often an accountability spot instead of a save my butt spot. The accountability spot is “If I say I am doing three reps, stare at me disapprovingly if I do fewer than three reps.” The moment of shame helps me not quit in the moment. It doesn’t help me if I need that nudge through a sticking point to complete a rep.
It is nice to push harder with a degree of safety and support. It is great to have a spotter again.
Patients tell me numerous times a day that I have strong hands. I smile and say thank you. I have some grip strength but the real grip strength people are light years ahead.
I had some grip strength when I was doing farmer’s walks, frame carries, and holds on a regular basis. That has been a few years.
I have a Hercules Hold on May 2nd. I will grab two handles with weights trying to split me in half. Think Captain America with the helicopter but with only his hands hanging on the entire time.
After talking with a friend I have added one arm hip lift and holds. I have weight on a loading pin with a revolving cable crossover handle. I pick up the weight a few inches and hold it for as long as I can. The results were a bit depressing this morning.
I will train it avoiding failure until the week before the competition and let rest, prayer, and positive thinking help me in the event. It can only get better. If I can get 50 or 75 pounds more with each hand for 30 seconds, that would be great. If I can get 25 pounds more for 20 seconds, hopefully I will not be embarrassed.