This is Canadian Masters Track legend Earl Fee. He broke the M95 400m record today (2:01.40). He already holds the 400m WRs in M85 and M90. He is the oldest man ever to run less than his age in the 400m, 89.15 at age 90.
I was fortunate enough to break his 34 yr old M60 400m meet record in Canada in '21 when I ran the WL M60 time of 56.23.
I'd be happy to be alive and to walk at 95.
Earl Fee - age 95, 400m WR.
Salute!
I won't even call it a workout but...
5 x 50 bicycle crunches w/ 30 sec rest
16 pullups
25 pushups
9 pullups
It actually peaked my HR at 157. Better than nothing.
Just thinking about how this lapse in training is affecting my immediate and possibly future health. If sprinting makes you young, not sprinting makes me old. It has to affect my CV health and contribute to a susceptibility to CVD. Due to my lipid profile, max HR sprint training was the only thing likely keeping me plaque free. However, I got through it once and ate worse than I'm eating now. I'm mostly vegan, the worst thing I eat is homemade granola bars. I'm back on heavy collagen supplements, 2 types of peptides and capsules. Eating about 22g day of collagen, couldn't hurt.
The change was so abrupt. I was struggling back after taking the summer off. By 12/13, I was probably 2 months away from being back to elite level, or close. Then, in one day, that Friday the 13th, my life changed, and maybe forever. Now, forced to take 2 consecutive spring/summer seasons off, doesn't bode well for ever getting to competition level again. I will likely start the same way, around the same time. Run once a week Sept, then ramp up. Sept would be 7 mo. I may wait even longer. This could take 9 mo to heal. I'll be good to bike and swim all summer so looking forward to that.
There is very very little data on 60+ meniscus repair, certainly long term. One small study of age 60+ with only 32 patients, showed a 78% success rate after 3 yrs, however only 13 of the 32 were body and horn repairs, the rest root repairs. Anyway, it's a rare surgery for a 64 yr old and the healing time is going to be long. Longer than last time.
I don't expect to be doing any significant PT for 6 weeks other than mobility and quad isometrics. I was really VERY happy to have found my PT protocol packet from the Steadman Clinic's Howard Head sports medicine institute! PT will undoubtedly be very important to the future health of this knee, but even more, an abundance of caution and most of all ... time.
PT protocol package from '19 -
Dr. Saliman explained a bit about the root repair and told me that after a week, "there is zero chance it has healed by now." Which is obvious, but I needed to hear it. It has changed my behavior. I am now wearing the soft brace all the time and being much more conservative with movements. He said that if that root repair gets loose, it may not heal. Definitely needed to hear that too. As he said, it was a "nasty tear."
The main radial tear was 1 cm from the native root site, my question was about how the root placement was handled. It was an unusual repair as the root tear was 1 cm from the attachment, the longest distance from the native root attachment which root repairs are normally made. On the diagram below, the tear was full width through the area at an oblique angle. The typical 'type 4' (LaPrade term) oblique tear shown below is closer to the root, mine was further but extending into the root. (diagram is approximate, of course). What made this repair unusual was that both sides of the tear, the long side and the root stump side were sutured and reattached to raw bone. Dr. Saliman said, "we usually don't do this."
Pulling the meniscus root(s) down to bone for healing
So, this was really a state of the art repair. There is definitely a risk of failure. I really want this to work so I'm going to be super cautious. He said 50% weight bearing ok, I'm going non-weight bearing like I did last time.
Tomorrow is the followup with Dr. Saliman. In advance, I received the surgical report. Here's an excerpt:
The medial compartment was evaluated carefully. The tibial-sided peripheral body region
tear was rasped to help stimulate healing, as was the radial root tear that was
approximately 10 mm away from the native root insertion site. A shaver was used to
debride some of the central edge tissue as was the biter. Middle third and peripheral
third tissue was not excised and instead was repaired back to the bone by creating a
tunnel through the tibia via an anterior tibial incision and a FlipCutter guide. A curette
was used to debride the cartilage from around the insertion site into the joint of the pin
to give a nice bony bed for the meniscus to heal into. The Smith and Nephew
NovoStitch device was then used to pass sutures which were shuttled out for 1.2 mm
mini-tape sutures and then passed within its own loop to create the locking loop
stitches. These were then pulled through the tibial tunnel and tied over a metal button.
The meniscus was probed and found to be securely repaired back to the bone. The
body region tibial-sided peripheral tearing was then fixed using the Smith and Nephew
NovoStitch device and spinal needle and a CHIA suture shuttle via 2 different
approaches in order to place circumferential compression stitches to adequately
capture the capsular side of the tibial tear. Revo knots were tied and cut in square
fashion. This tear came together much like a puzzle and required advanced training
and experience in order to anatomically reduce and uniformly compress the tear edges
adequate to hold them together during the 6 weeks it will take for this tear to heal.
Rachel S., a qualified physician assistant/associate provided crucial suture
management and intra- and extra-articular suture retrieval assistance throughout the
procedure, facilitating precise sewing and knot tying. This was particularly important
due to the complex nature of the patient's meniscus tears within the challenging
constraints of the peripheral and posterior knee compartments.
So, it seems the radial tear was close to the native root insertion site, that it became the 'new root.' Probably better that this tear was close enough to the root that it could be treated as a root repair. Pretty high tech surgery, virtuoso technique.
Bandage off. Still sore on medial side. Don't really need ice machine any more but using it once or twice a day for comfort.
Doesn't look too bad compared with some surgeries I've seen (especially out of the UK). In a few weeks, there will be no visible trace of surgery
Just kidding... but, I am absolutely stunned at how relatively painless this surgery has been and how quick the recovery is going. Haven't taken one pain pill and am sleeping ok.
I already have greater than 90ยบ flexion, naturally, not forced, no swelling, no Bakers cyst, nothing. I can actually do body weight heel raises (2 footed). Still cycling between hot tub and ice machine 2x / day. For 5 days out, this is amazing. Haven't work the brace at all, but I will when I eventually leave the 2nd floor of my house.
I am being extremely careful, crutches, pretty much non weight bearing except once in a while - some slight weight. I am exercising doing bicycle crunches (keeping surgical leg locked at an angle), pushups, pullups. However, can only get the HR up to just over 105. My first mini workout on Thurs, 3 days post surgery:
4 x 50 bicycle crunches w/ 30 sec rest
25 pushups
15 pullups
Not to say it is completely painless, but it's all relative to my previous experience. I still feel soreness on the medial side. I will likely take another week off to make sure of the healing.
Post op zoom meeting with Dr. on Tues.
One peripheral benefit from this lack of R leg weight bearing is that it's the same side as my arthritic foot. So, that may lead to some improvement.
Tonight's workout:
4 x 50 bicycle crunches w/ 30 sec rest
30 pushups
16 pullups
Max HR - 152
HR 128-144 - 3:15
HR 145-152 - 0:32
Interestingly the max HR was the pullups.
Dr. Saliman was a bit more liberal with his post op than my previous. His root repair protocol says "50% weight bearing for 6 six weeks". LaPrade was non-weight bearing for 6. I asked if there was any down side to being more conservative and he said, "I don't want you just laying around. Because that's how people get blood clots." Fair enough.
The whole experience was much easier that I expected it would be. Especially the return. However, it started off a little strange,,,
I took a $50 taxi ride to the surgery center at 5:15 am. My appointment was at 6:00, got there at 5:40, still dark. The front door to the facility was locked so I was walking the streets of W. Hollywood looking for a back door. Found a back door and a delivery guy said I had to go around and he'd tell them I was there. Waited 10 more min at the front door then called at 6:00 am. They said to come back to the same side door and enter through a different hallway. Finally found the surgery suite. For a while it felt like I was seeking a back ally abortion or something. After a bunch of paper work and interactions with some stunning beautiful Asian and Persian nurses, I got prepped for surgery. Surgery was supposed to be at 7am but Dr. Saliman came in about 8, reviewed the MRI, then met with me and diagramed out on paper what it looked like and strategies for repair, which he would decide on when he saw the extent of the issues. He was sharp, personable, and assuring. At 8:45, I actually walked from my recovery bed to the surgeons table with my IV tree. I was out in a few minutes. Surgery took about a 80-90 min.
I awoke with a stack of photos of the procedure on my bed . Dr. Saliman called me that night in my hotel to see how I was doing. We discussed the surgery and generally what he did. But I didn't have a list of questions prepared and I didn't ask him some things I meant to. I will meet with him again in a week via zoom so hopefully, he'll have notes from this surgery and my case file for our brief meeting.
There are 30 photos of the procedure and some are not really discernible. The photo above shows small circumferential stitches on the right for the complex repair, and the larger root repair fiber on the left. My main question is what was done with the main oblique tear? Was it close enough to the root that one end of the tear was drawn down to bone for healing? How much was trimmed?
Anyway, it seemed to have gone well, and I'm optimistic. Dr. says I'll be running again.
The trip back was great. Booked an extra leg room seat and with an empty seat next to me, it was one of the most comfortable flights I've been on. 3:40 hr flight went by fast. Got wheelchaired to the parking shuttle and was in my truck by 4:20ish. Best of all, no problem driving with my surgical right leg. Can pump the calf within no pain or problem. I was expecting it to take 3-4 hrs post landing to get home. It took 2 hrs. Coincidentally, I pulled in my driveway at the same time Roya was arriving from Atlanta.
Saliman is on the forefront of meniscus repair, taking on cases no one else will. I interacted with a fellow patient whose meniscus was so shredded he required 17 stitches. I think I had 4 or 5 beside the root repair. Dr. told him that he "turned chicken shit into chicken salad, no one else would have repaired it."
I'm certain that meniscus injuries are one of the most poorly and inconsistently treated of all orthopedic injuries, especially in the over 55 yr old age group. Since I joined a meniscus tear support group, I've seen some really ill conceived advice and primitive treatments and surgeries (especially from the UK).
I'm really happy with my decision and happy to get this done. I can still certainly exercise, can do pullups, core work like bicycle crunches, pushups off of one foot. Rehab starts now with active leg extension, patella mobility, isometric quads, leg raises.
My surgery was approved by my insurance company today, according to my physician's office.
I'm on for Monday, Feb 10. I should be hiking by wildflower season. Very happy to have cleared this hurdle.
Pool on Sat and tonight, Monday. Still no word on my pending surgery or final disposition from insurance. Very unsettling not knowing, although I have travel arrangements in place for a Mon surgery. This would be the 3rd surgery date they've given me but it's not confirmed yet. It would be nice to have a bottom line by Tues.
Sat pool:
6 x 50yd w/ 65 sec rest - 39, 42, 43, 46, 47, 48
Max HR - 157
Mon pool:
6 x 50yd w/ 62 sec rest - 39, 41, 43, 45, 47, 45
Mon was a bit better, both hard. Maintaining upper body strength, still able to do 22 cheater pullups (not full extension hang). Weight is ok, hanging around 142 lbs.
My father is disappointingly negative. He thinks I shouldn't endeavor to run, just use up my knee and go to a knee replacement like him when necessary. He was 71 when he got his knee. I'm not even close to bone on bone. He's also been relatively sedentary and overweight most of his last 30 yrs, while half that time I've been maintaining the training and competition schedule of an active college athlete. I respect he's almost 85, in decent health, but I don't want to live my life like him.
It gives me hope looking back at my recovery from the previous surgery. I was casual biking and light hiking in 8 weeks, hard effort biking in 10 weeks, light running in 5 mo, hill running in 6 mo, sprinting in 7 mo, and full scale training in 8 mo, and running a 62.5 400m in just 9 mo (Oct. '19). I was also battling plantar fasciitis during that fall so was hampered a bit, which kept me out of indoor season. Covid hit the following spring and there were no meets til late summer. The one and only 400m I ran in'20 was in late July and was an M60 WL - 57.49. I don't consider that completely legit due to covid, nevertheless, that was the start of me holding the WL for 2 yrs.
Same workout in the pool. Pretty much the same times. This set is always a good workout and brief.
Pool
6 x 50 yd w/ 1 min rest - 40, 42, 43, 45, 49, 50
HR max - 160 (40 sec after the last rep)
HR avg - 128 (including 12 min of getting dressed and walking out)
After dropping to 107 several min after the workout it went back up walking out and up the stairs. Surprised my HR stayed in the mid 120s for so long and got to peak after last rep. I can really feel the stroke efficiency suffering in the last 2.
I do like this workout, takes 10 min and it's hard. Feel really pumped afterward.
142 lbs after workout.