Water running, swim, bike sprint trial w/ the offloader

 Two days ago, I hit the lake and did a set of water running, and a swim.  Pretty good workout.

Water running

60 (R/L) steps x 6 w/ 1 min rest

Max HR 158

Avg HR 129

Lake swim -  340 yds

I was happy to have the lake by myself. ... since a casual visitor to the lake who would see me water running might think I was struggling, maybe drowning. lol

This morning I tried 'strict' pullups - all from full extension, only 18.  Definitely different than the 'near full extension' pullups I normally do.

Today, I got the DonJoy OA Nano offloader brace today, free with my insurance.  I looked it up, it generally sells for over $600 new.  I tried it out on a bike sprint with some brief standing hills.  Yea, it works.  It seems to prevent 180º full extension - maybe allowing up to just few degrees short of full extension, and corrects the valgus/varus angle, shifting load off the vulnerable compartment.  It has to be worn tight or it doesn't work.  Unlike the Ossur offloader, this one seems pretty solid and doesn't slip.  I think it could even be affixed more securely with K-tape.  Not really super comfortable to be worn for hours.  

I did the usual bike sprint and even though I didn't time it or measure HR, that first hill where I'm standing for 30 - 35 R/L strokes is FAR more engaging to the cardio vascular system than anything I could do in a similar stretch sitting on the saddle.  (True, Joe).  Knee felt great afterward, but I'm not going to dive into standing bike sprints right away.  A little at a time.  

The pretty young nurse that fitted me with the brace just graduated from Auburn and is a friend of  Ja'Kobe Tharp, new world record holder in the 110H, and Adidas track pro.  It was fun talking track.  

I'm definitely eventually going to try running with this thing at some point.  

Still really light, mid 141s this morning.  Meeting postponed so my next blood work postponed til Mon.  

I joined this popular FB group called the "Great Cholesterol Conspiracy" and wow, the debate continues.   Seems to me when you have research tools like Claude AI,  people shouldn't have so much belief in unscientific notions.  More on that next post.  

Dr. visit, long swim, police

I prepared a lot for the Dr's visit and it was pretty short and inconsequential.  Drove 95 min, he was nearly 90 min late, had to cancel my blood work appt.  He spent maybe 10 min with me.  Despite coming with pre and post op MRI reports, surgical report, laptop with images, he blew all that off and I had to get radiated again with their Xrays.  The ones I had from just weeks ago, they couldn't download.  

The only thing he looked at was the surgical report, he commented that "Justin's work is amazing" and this repair was far more involved than the LaPrade repair on my right, which I knew, but he emphasized it.  He said I had some arthritis and due to my bow legged alignment / running form, running L turns, etc... my medial side is susceptible and he showed me xrays that showed 1/2 the joint space on the medial vs the lateral knee compartment.   It was still not bone on bone.  Bottom line, he thinks there is a chance to recover the knee with the goal of limited running, and seemed more than happy to do injections as needed, which I would only do as last resort.   I got measured for an offloader brace which will help recovery.  He seemed to think that biking, rowing, and weights were ok.  I'm not so sure, but will return to seated only biking.  Generally, not a great impression, and a guy I will likely not see again. 

So, I got home after meeting with a contractor at my house and took a brief nap.  Got on the motorcycle and went to the lake.   Just as I crossed the lake, I looked back to the opposite shore and saw 3 police trucks and a small swarm of uniformed police standing around my motorcycle.  I took off and swam a half mile down the lake.  Back stroke, I can swim forever.  When I was out of sight, I came ashore and and walked to the near shore opposite of the bank where I parked.  I was thinking they'd just get tired of waiting and leave.  They didn't leave.  I reasoned that I'd better not keep them waiting any longer and swam back to face the music.  

Well, it went ok.  I just had happened to go around the gate when Nate the forestry chief was driving by.  Just bad luck.   He was there with a couple cops.   The old cop gave me a stern warning and asserted the strict no motor vehicle policy on Sewanee protected areas.    I told them I had been doing this for more than a decade and several times just this past week, and I how I've cleaned up this place and picked up garbage.  It was fine.  No citation.   I could have been cited for multiple things - bike hasn't been registered in 6 yrs, uninsured, violation of protected property, etc... since it's a small friendly town, we just chatted.... about how great this place is, about motorcycles, E-bikes, etc... Nate knew my name and that I'm a professor.  This is really the end of an era, I've been doing this more than a decade without any issues.  It is literally the only place I ever go with my motorcycles.  So it's quite significant.   I wish I had thought to have gotten a group photo before I drove off.   They did bring up an interesting issue... very gray area between an electric motorcycle and an electric bike.  (E-bikes are ok on trail but must be below a certain wattage)
. 

water running, guitar

4th day in a row at the lake.  After dodging strong storms all day that kept the temperature just perfect, there was an evening break and the lake was surreal, quiet, smooth.

Did a set of water running but no significant swimming, as the thunder was rumbling in the distance.   I really needed to burn some calories.  My diet has been bad.  Yesterday, just wasa crackers, fig jam, a banana sandwich and tea.  Today only slightly better, sardines, spring mix lettuce, wasa crackers, Royo bagel w/ almond butter and honey.  

Water running

6 x 60 strides with 1 min rest

Max HR 143

Spent 80 min at the cathedral practicing after midnight.  It was actually pretty taxing.  Got home, fell asleep in a chair and slept straight until 8 am.  Got up, did my usual bedtime regime and went back to bed for 90 min. 

I love the sound and the feel of playing music but, to pull off a concert of virtuoso repertoire, it takes an enormous amount of time and commitment, and even then, rarely is a performance perfect.  Not to mention the stress involved.  At this stage of my career, there actually seems to be more to lose than gain in some ways.   The stress involved, the risk of a substandard performance.   I never perform 'badly' but sometimes have had mistakes, memory slips, etc... and like a car wreck in an auto race, that's what people remember the most.  That's why I wonder sometimes if I should even do it.   Some of my colleagues have stopped or scaled back performing.   Years past there were rewards involving academic standing, tenure, money, career, etc... but now none of those things are at stake or an issue.  It's all personal.  Making video recordings for Youtube is actually a better way to reach the public instead of giving a guitar recital.  Rarely have I played a guitar recital for more than 80 people or so, typically it's like 40-50.  Social media reaches so many more.  But, to be a teacher and proponent of the rare art of solo classical guitar performance, since I can do it, I should do it.  I need to set an example and attempt to inspire students.  20+ yrs ago, I inspired a bright kid from East TN who was a heavy metal shredder.   Years later he was performing in Carnegie Hall and playing for ambassadors, now recognized as one of the best guitarists in the world. 

Been working on the Rameau variations again.   No one in the world played this piece but me until just the last few yrs, now a few have. Probably the single most important and unique piece I've ever played, but I stopped playing it in concerts about 15 yrs ago because of the difficulty.   I'm fairly sure I will perform it this fall.  Taking a fresh look at it.  Fingers are still working.  

Like racing a 400m... we do these things, not because they are easy, but because they are hard.   Beautiful and expressive as well.  

Back to the cathedral tonight.    

380 yd swim

Just an evening swim at the lake.   Beautiful.  22 pullups this morning.  

Hanging around 143 lbs.

Finally they got a day of competition in at Masters Nationals.  Moved everything indoors because of air quality.   What a situation!    M65 hasn't been impressively competitive this yr.  Happy to see people who've never won medals get them.  Ron won the 400m easily in 61.02, and the 100m in 12.99.   Dale got Bronze in 65.25.   Happy for him.  Silver was 63.31.   

Sour grapes for me, since I was running 62 back in Nov with less than 2 mo training.   Oh well.   Also, ran 13.8 in trainers for a 100m after not running for 2 mo.   My bronze medal time in of 57.59 in '23 would have won Gold this year in M60.  That was one incredibly competitive yr.  

Going to the cathedral to practice tonight at midnight.  Love it.  

Same workout as yesterday

Beautiful day at the lake.  Had the place to myself for most of the time.   About 85º, water temperature 88º. 

Same exact workout as yesterday.

Water running 6 x 60 (R/L) strides w/ 60 sec rest

Max HR 144, Avg HR 118

This workout seems to really get the hip flexors and is more fatiguing than the HR would indicate.  After a rest I swam across the lake and back.  Each rep without stopping.

Lake swim

2 x 160 yds  ~ 90 strokes

Max HR 129, Avg HR 118

Started the day with 21 pullups, ab wheel, and 40 pushups.

Now time to practice.   

At the lake, water running / swim

Love this time of year.  Had the lake to myself and did a decent workout.

Deep water running

6 x 60 (R/L) strides w/ 60 sec rest

Max HR - 160

Avg HR - 125

Lake swim

2 x 160 yds 

Was able to finally make it across the lake freestyle without stopping.   About 90x (R/L) strokes. 

Started the day with 23 pullups and some ab wheel... and a couple hrs of guitar practice.

Knee feels good and I think limiting leg activity to water and maybe occasional gentle seated bike might be what I need.  I don't know what to make of the comments on the last post.  A lot of ridiculous hyperbole, snide BS.    Bottom line, my knee is painless for daily activities, even when carrying significant weight up stairs.  The identified possible medial condyle defect ("emerging subfracture") is tiny, about 1/4" square.  I don't think it's unrecoverable for normal daily activities and may be recoverable with a significant healing period even for occasional running.   Dubious I'll be training for the 400m at the same level as before the injury, but that's ok.  Turf sprints once a week is really all I need + bike.  I don't think that is an unreasonable goal.   May try an under loader brace for biking, I'll ask the Dr.

Really light 141.3 lbs after workout.  12% bodyfat.  

Sympathy to my masters colleagues who had their first day of competition at USATF Masters Nationals canceled in OH due to air quality.  Fortunately, they have a 300m indoor track on site.  The air quality forecast for Friday is also not good.  That sucks, but they'll have to bring it indoors.  Not the first time.  It happened in '17 in LA when lightning forced us indoor at LSU on a 200m flat track for 200m semis. 

bike sprint, weights, water running, swim

Not keeping track of all my workouts but spent Sunday doing weights all day, several sets of upper body and core.  Finished with a brief swim.  

Tuesday did a bike sprint.  2nd fastest.

2.5 mile mountain bike sprint - Laurel Branch Trl

Time - 9:31

Avg speed - 14.3 mph

Max HR - 184

HR over 156 - 8:10

HR over 170 - 1:10

HR over 180 -  0:26 

Avg HR - 160 (inc 1 min recovery at end)

Today, water running, lake swim, weights, backward walking uphill.  I really felt the fatigue in my quads at first.  Any new activity gets new areas.  

water running:

6 x 60 strides w/ 1 min rest

Max HR - 160

Avg HR - 124

Lake swim:

345 yds

Max HR - 139

Avg HR - 124

Lake water temperature 90º according to my watch.
 

Interestingly, more confirmation there is no activity like sprinting... with just a few short sprints on Sat, my hamstrings were a little sore for 3 days.  Don't get that from slow running, drill, stairs, etc...  

Even though I haven't lost much weight, hanging around 142 -144, my body fat % is down 1% from when I first started measuring it, from 13.5% to 12.5%, according to the Hume pod.  Have added some hard fought muscle mass I think.

Hottest day of the year today, low 90's and super humid, dewpoint hit 80º today and heat index over 100ºF.  Early evening before we went to the gym, we walked up the Roark's cove rd. steep and that lush micro climate on the north side of the mountain was noticeably cooler (84ºF) than the area around my house, a south facing bluff which was over 90ºF.  I walked up the steeps backward.  Really felt it in my quads.  

Roya likes to walk with ankle weights while pumping light dumbells.  Looks kinda funny. 

Medical:

My MRI results showed very little.  Very scant detail, nothing concerning, pancreas cyst no change, perhaps even a mm smaller (7mm).  The radiologist has good creds (Harvard, J. Hopkins, BU) but is relatively young.  

Monday, I'm going for an MRI of my knee to assess the issues.  

Roya just had an Ezra full body scan.  No results yet.  

Tomorrow, we'll have heat indexes close to 100º.  I'm going to revel in it.  Going to the track and taking my weight harness, going to pull the 90 lbs weights across the field in the hottest part of the day.  Will be fun.  

Drinking tea again.  Flowers are loving this weather.

water running, short hills, resistance

Gorgeous summer like day on the mountain.  I just love it.  I went to the lake today and had the place to myself for almost 2 hrs.  Did a set of water running and it was harder than expected.  Also today, did some upper body and some 40m hill sprints.  

I definitely felt the pump in my quads after a few reps of water running.  I dd 4 sets of 60 (L+R) strides.  Each set takes about 80 sec, and 60 sec rest in between.   Then I did some short hill sprints.  Like with any type of running, some minor pain on the first 2 reps that goes away.  I do notice that paying attention to my form and keeping it aligned helps alleviate knee pain.  

Water running

4 x 60 (L+R) strides w/ 1 min rest

Hill sprints 

3 x 20m

5 x 40m

Also have been trying to develop my core and doing various resistance exercises.   My most recent measurements on the Hume pod show a slight increase in muscle mass and decrease in body fat despite being heavier, about 145 lbs. 

Definitely living in paradise.  It reached 84º here in Sewanee.  By contrast it was 98º with a heat index of 108º down the mtn in Murfreesboro.  

My almost 40 yr old motorcycle gets me there.  

 

Bike sprint PR, swim and water running

Another PR for the 2.5 mile bike sprint on gravel with the mtn bike.  

2.5 mile mountain bike sprint - Laurel Branch Trl

Time - 9:38

Avg speed - 14.0 mph

Max HR - 175

HR over 160 - 7:32 

HR over 170 - 2:01

Avg HR - 161

Beat my previous PR by 6 sec.  It was hard.  

Going to go to the lake later and do some water running.   Forecast to be 86º today but the only rain storm in the state happened to be over my house this morning and has kept temps in the mid - upper 70ºs. 

Yesterday, did some pullups and some squats.  Back slid a little in weight.  144 lbs, still 13% bodyfat

Update:

Went to the lake today, did a little water running and a 370 yd swim.  Beautiful.  Water still cool, 81º at the surface.  

Water running

First time in the lake this season.  I did a set of water running and, being a new exercise, it felt actually pretty challenging.  Not that it raised my HR super high, but I definitely felt it in my hip flexors.  Not really 'warm' but certainly swimable.  I estimate about 76º

Water running

4 x 60 (R-L) strokes w/ 1 min rest

Definitely a good training exercise for future running.  

Still hanging at 143 -144 lbs.   Losing that last 4-5 lbs is the toughest.  The body really wants to hang on to it.

The Sherpa that gets me to the lake turns 25 this yr.

warmest day of the yr so far.

93º today in Sewanee.  Had this pristine lake to myself for the 2 hrs I was there.  Swam about 400 yds.  

 

Bike climb, swim

Busy day, bike climb in the heat of the afternoon... and it was hot due to a dewpoint in the mid 70ºs, the heat index was in the mid to probably upper 90ºs, especially at the bottom of the mountain.  After that, ran a lot of errands and then swam about a quarter mile leisurely and did a few reps of water running.

The bike climb was hard on the misery and HR index but it broke my string of PRs, 22:59.  My third fastest climb up Roark's cove rd.  HR higher on this one compared to previous.

Here's the data: 

Max HR - 182 

 HR over 170 - 15:51

 HR over 180 - 3:53 

 Avg HR - 168

 Avg speed - 6.0 mph 

 Total climb time - 22:59

It was Roya's birthday so after the swim, I made dinner and had guests over.   I was real hungry but only had a tiny piece of birthday cake since I'm getting blood work tomorrow.  I was 141.0 lbs before dinner, close to the lowest this yr.  

Felt really tired today, low energy.   Just going to do some pullups, pushups, and abs.  Tomorrow, having a lipid check and an A1C, so I'm fasting.  I expect I'm probably prediabetic.  Lower back still bothering me, not severe though.  I may try running a few stadium stairs.  

Here's our annual birthday month photo at the lake... Roya's 64th, my 65th earlier this month.  

 

Friday bike sprints, Sat. water running and swimming

Band work and drills at the track before bike sprints on Friday, then some water running and swimming at the lake on Sat.  Weather has been lovely, 80ºs day, 68º at night.   

Bike sprints weren't quite as fast as last time.  This time I used my Gymboss to precisely time the 2:30 rest interval.

4 x 420m w/ 2:30 rest - max speed: 28.2, 28.4, 28.3, 28.2 mph

 Max HR 169 

Avg HR - 138

It's hard to not do anything with the legs on a day but I need to take some recovery days where I don't do any legs.  

Although I've lost only a little weight, I do think I've lost fat.  Been between 143 and 145.

The water running was a little more than I usually do.  

Water running:

120 strides x 7 w/  1 min rest

Max HR - 136

Avg HR - 111

I then did my open water swim which is about 170 yds each way.  I try to do it without stopping but I often only make it about 70 (R+L=1) strokes before I have to coast on my back.  It's about 90 strokes all the way across.  Not an aerobic issue, a muscle fatigue issue.  My HR stays under 120.   

Water is nice, 86º.   Roya approves...

Water running

 Glad I went to the lake yesterday morning because it rained all afternoon and was quite cool.  It was beautiful at the lake, I had it to myself.  No rain was predicted for yesterday, guess the NWS is failing. 

Did 6 sets of water running, 120 strides (about 75 sec) w/ 1 min rest.  It was good.  I needed to step back a bit because I felt some knee soreness after my Sunday workout.  Also have been feeling some lower back soreness after waking up, that goes away, thanks to the hot tub.  Indispensible. 

Deep water running 

6 x 120 strides (~75 sec) x 6 w/ 1 min rest 

core exercices 

Today, Wed., plan on going to the lake for some swimming and some bike later today.

If I were healthy, my first meet as an M65 would be about a week away.  Too bad.  Still not sure I'll return to competition.   If I can train like an elite, I will.

My birthday was saddened by the news that a good friend, gold medal winning relay partner in France, masters elite and many time world and national champion sprinter, often world #1 rank, has been diagnosed with an extremely rare debilitating neurological disorder, confirmed by genetic test.  He's also 65.   He was forced to retire but says he may run again with the time he has left.  This is the age where most disease appears or manifests itself.  Terrible situation.  Also for my brother who has not received any treatment or relief from his neurological disorder.

It was my 65 birthday, when I look around, happy to not look like most 65 yr olds here in TN where the life expectancy for males is 71-73 yrs depend on what source you look up.  

lake swim and water running

Gorgeous day, sunny and dry for a change.  Less humid and low 80º at noon at the lake.  Just some light exercise today.  After 2 days of bike sprints, today I did upper body, core and band work.  Swam across the lake and back then did a short set of water runs.

Lake swim - 2 x 200yds w/ 7 min rest in between

water running - 4 x 120 strides (70-80 sec) w/ 1 min rest

Nothing hard, max HR was 145 on the swim, 160 on the water running, I really pushed the last one.  Did feel a little soreness on the knees because I was on my feet last 2 days for several hours working around my house.  Also, lower back has been hurting when I wake up, but after coffee, hot tub, and some mobility exercises, feel fine.  Will probably return to doing something on the bike tomorrow and/or some lifting.  

144.5 after swim.   Last week as a non-senior citizen.  

Gorgeous, shady, and water is 86º

 

Gym, swim

This week, Tues I did gym including my first post op Stairmaster, and Wed, I swam across the lake and did some water running.   I've started doing 4 basic exercises every morning, body weight squats, pullups, pushups, and ab wheel.  In addition, reforming my diet.  

This was my gym session.  17 min on Stairmaster then some machines and core work.

Stairmaster 

17 min (20 min hill program no cool down level 12)

 

 

The water running and swimming was inaccurately measured using my watch.  Max HR was only 132.  

After swimming across the lake I did 3 x 120 strides of water running with 1 min rest.

Lake swim / water running

Across lake (~175 yd)

3 x 120 strides water running w/ 1 min rest

Back across lake (~175 yd)

Definitely feel that the fat is coming off but weight is generally in the 145s.

Thurs I spent all day trying to fix the way my gutters drain and probably did more harm than good.  Anyway, it ws exhausting and risky, up and down on the step ladder with a precarious step to the roof on and off the top step.  Lucky I didn't fall.  But I got it done, and I hope it will be ok as we enter a rainy period for the next week. 

pool, no word

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.  

pool

 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.  

Pool, still in limbo

Did the same pool workout tonight, intervals a little more even.  Good short workout, takes only about 10min.  HR higher tonight.  Stuck closer to my 1 min rest interval.

Pool

6 x 50yd  - 44, 43, 45, 47, 48, 49

Max HR - 164

HR 145 - 152 - 3:15

HR 153 - 163 - 1:00

 It was hard, but short and sweet.  I'm sure I could improve my times with an aggressive flip turn, but I'm only pushing off gingerly due to my knee.

Doesn't look like my surgery will happen on Thurs unless something big happens tomorrow.  The insurance company Drs have failed to timely confirm a meeting with my Dr. and as a result, I will likely lose $300 in a non-refundable airline ticket.   I may have an option to have surgery Mon, 2/3.  So crazy, the way I've been jerked around by this insurance company.  

 

Pool, crazy limbo

Here it is coming up on 2 days before I leave for LA for surgery and it's not going according to plan.  I did finally get back to the pool today amidst a hectic first week of classes where I've arranged to be gone the next 2 weeks from MTSU, but Sewanee is crazy ... huge turnout, biggest ever.  I have to teach 5 hrs without a break on the Tuesday before I leave Wednesday.  

My insurance company rejected authorization for my surgery pending a 'peer to peer' review with my surgeon that took place last Friday.   Generally, physicians are 90% successful in justifying surgery, after asking 2 that I know, one a thoracic and the other an orthopedic.  However, it could very well be denied and then, the cost out of pocket could be in the range price of a new car.  I'm talking $30k.   

I have no doubt that Dr. Saliman can make a convincing clinical case for surgery as he likely has these meetings all the time, but he doesn't have my medical records and doesn't know me and why I specifically am a good candidate for the surgery:  most convincingly that I rehabbed a similar previous surgery completely, demonstrated by elite level athletic performance and no reinjury.  Also, normal BMI.  Plus, the insurance covered it completely last time, and they are only obligated to cover 60% this time.  However, the facility and the anesthesiologist claim independently and may offer more coverage.  I should find out by end of day Monday.  And, here's one more crazy thing.  The person who files insurance and delivers cost estimates for the surgery center I was told she has been out sick since Wednesday.  This is nuts!

After 35 yrs under the TN State BCBS insurance plan, I have never had a claim denied.  Here was the verbiage for the initial denial:  

Denial Reason: Lack of sufficient clinical documentation Your records were carefully reviewed. The request to fix a torn cartilage cushion meniscus in your knee cannot be approved. More information is needed regarding your diagnosis and planned surgery. This needs to include your BMI height-weight measurement. Also surgery to fix the tear works better for those who are less than forty years old. It also works better for patients who are forty to fifty years old and very active. Your records do not show that this is the case for you. Please talk with your doctor about treatment options. A copy of this letter went to your doctor.

Yea, they ask about my BMI and say "your records were carefully reviewed."  I have never heard such a level of absolute bullshit.  For years, I've received the full $250 cash incentive awarded by this same company for, in part, keeping a normal BMI.  And.., hmmm, I'm "not active"???   When I chatted with a phone rep of BCBS, she said the decisions were made by their 'vendor' Turning Point Health.  She would not allow me the contact info for this decision maker (although their number is on their website) and was acting as an intermediary between me and them on the phone.  They said something incredibly stupid and ignorant to her about first trying "conservative treatments" before surgery.  Yea, conservative treatment to mask the pain so as to make my meniscus degenerate and become unrepairable.  Dumbasses.    

So, age being the biggest factor, Saliman has debunked that on his website and two studies state at least an 80% success rate of such repairs over age 60.  Due to my previous rehab experience, I would say I'd be closer to 90%+.  

Studies show, successful repair is obtained up to age 70 years.... age, as an independent factor, should not be considered a contraindication for meniscus repair: https://pmc.ncbi.nlm.nih.gov/articles/PMC9891740/ 

https://www.mdpi.com/2077-0383/12/21/6922

Anyway, the next phone call I get from them could be worth $20K either way.  I'll be pretty out of my mind if I don't find out definitively by tomorrow.  I am fortunate that I can afford to pay it, and there is both internal review appeals, and an external independent review process, and of course litigation.  I think I could compile a slam dunk case for an external review.  

Maybe this is a sign of the times.  

The general Republican MO in regard to healthcare, Big Pharma, the VA, etc… is to privatize, maximize profits at the expense of consumer, usually the sick and elderly.   The first things Trump did when he came into office was to eliminate price controls on pharmaceutical drugs for those on Medicare and Medicaid, freeze hiring for VA, stop all research and information sharing for the National Institute of Health (effectively halting cancer research), and for the CDC (in the midst of a severe bird flu pandemic), and withdrew from the WHO.  War on science and gifts to big pharma, CEOs, stockholders, etc...  

Anyway...

In the pool today, I did my usual interval workout and I was really winded but HR never got above 153.   Of course this is from my highly inaccurate watch.  Only 2:30 over 145.    I wonder if this time away from leg use and sprinting will lower my max HR?  

It was pretty much like the previous:

Pool

6 x 50 yd w/ 70 sec rest - 40, 41, 43, 46, 49, 50

I did feel pretty pumped when I finished.  I am quite light.  140.2 lbs.  Maybe losing muscle mass?