Weekly Log 29-Jul to 4-Aug-2019: A Step in the Right Direction?

Monday:  0 run, 1 walk
Much better than yesterday.  Night and day getting out of bed.  Shoulders in pain all day, and limped most of the day, but I was up and moving.  The glass is half full.  No running, but Brady took Jana and I out for an evening neighborhood walk.  Yay!

Back in Black:
black dog in a black car

What's wrong with this mirror?  (Other than it's no longer attached to a car)
I was initially ticked with Mark when he came home late one night last week with the Volvo mirror busted
in above pic, with glass gone and components behind the mirror broken and gone.
Apparently he didn't even know it and it got hit while he was parked.
I was quoted $500 to professionally replace it.
---------
Since I no longer run, I find other senses of accomplishment.  In this case
I bought a used mirror for $130 off eBay, and installed it tonight.  Despite having to take
the door apart to make the electrical connections, it worked!

Tuesday:  0 run, 1 walk

AM:  7th doctor visit on my current health ailment.  My medication runs out next week, and since I'm no closer to getting a rheumatologist appointment and my PCP previously indicated he wouldn't renew the prescription, I was ready for a fight.  Luckily, there wasn't any and this time my PCP was very agreeable.  Fortunately I was not having a good morning physically as I came in limping and unable to move my right arm as well.  Why fortunately?  Because he can see how I really am suffering.  The doc said I'm not looking very stable (uh, yeah, that's what I've been telling you for two months now).

He now agrees with my orthopedic doc that Polymyalgia Rheumatica ("PMR") is the most likely diagnosis, and was shocked that I still haven't been able to get the rheumatology appointment despite repeated calls.  He had his office manager call, and when she got the same results as me (none), he was clearly upset with the broken process.  Good!  He issued two more referrals, one in Newport, and one in Pawtucket, and I'll go to whichever comes up first.  Meanwhile, he gave me a steroid injection (the kind legal in running, not anabolic steroids) to fight the inflammation quickly, and not only gave me another prescription of Prednisone, but based on some of my morning setbacks, doubled my dosage from 5mg to 10mg each morning.  Based on what I have read on PMR case studies and reputable medical websites, all of those steps sound correct.  Yay!

Doubling my daily drug dosage quickly turned out to be a godsend.

Nighttime neighborhood walk redux with Brady and Jana.  No limping tonight!!

Wednesday:  3
Fun Run week #9.  Last Fun Run of the year for me.  I ran the first mile with Chris, who humored me by a pedestrian pace for him of 6:15, while I gasped and wheezed.  He picked it up after Mile 1, and I slowed it down to a more manageable pace of high 6s for the next two miles.

Thursday:  0 run, 1 walk

Day 3 on the double drug dosage:  It's a miracle!  I can get out of bed without any issue,
and I can walk without any limping!
(No, I can't quite walk on water yet, but based on my progress,
I'm pretty sure that's next.)

Friday:  2
Evening run with Brady at Wahaneeta.  The Wahaneeta 5K is coming up in two weeks now, and as I'll be away all next week, went here for an assessment on what's needed.  Fortunately, the trails are really in good shape and could pass without any maintenance, but I'll probably try to do some minor trimming on the perimeter trail pre-race.

Saturday:  0
Long drive from Westerly to St John, New Brunswick, arriving in the evening.

Sunday:  4 run, 1 walk
AM:  Rockwood Park, St. John, NB.
Trail run with Matthew and Brady.  That's right - a MORNING run!  Hallelujah!!  Haven't been able to walk right in the mornings in a while, never mind run.  Very clean park with manicured trails around lakes and through the woods.

Post-run, back at the hotel, Matthew and I played on the waterslide before breakfast.
I thought it would be kind of a lame "kiddy slide", but it was actually pretty neat
and you got going reasonably fast in the spiral loops (there was one spiral above this that
you can't see in pic due to ceiling in the way) before being jettisoned into the pool.

PM:  Halifax, NS

York Redoubt National Historic Site
Not as impressive as it looks here

The color of the water doesn't look like Nova Scotia, right?

If I had half of his energy and speed ...

Crystal Crescent Beach Provincial Park:
Now this place was both scenic and fun!  If you're ever in the Halifax
area, I highly recommend.

Weekly mileage:  10 run, 4 walk

Weekly synopsis:  Despite the paltry numbers above, this was a great week for me!  While my previous Prednisone dosage was giving me some relief in the afternoon and evening, it clearly wasn't enough as my mornings were downright miserable to the point that I couldn't physically exercise at all and some mornings had physical issues getting out of bed.  With the new dosage, this is a game changer with just some minor morning shoulder pain and otherwise all is good.  Optimism!

Weekly highlight:  In any normal healthy week, it would clearly be the fun romping on Crystal Crescent Beach (full disclosure:  I wimped out and didn't swim in the frigid water like Matthew and Brady did).  However, the highlight for me was the immediate game-changer in my mobility and pain levels that the double drug dosage is providing me, especially just at the start of our family vacation.

Weekly lowlight:  Hmm.  It really was a good week.  I would say the two mornings of the week before the new dosage kicked in, but I really want to focus on the positive, of which there is much.

Blessing of the Fleet XVII

Narragansett, RI
Friday, July 26, 2019

Was originally going to meld this into my weekly log, as I knew it would be a slow race for me and this has certainly been a down summer for me for sure.  However, I'm trying to keep the glass half full and there were enough interesting facets of my race to merit its own post.

I signed up for this race with about as much enthusiasm as bantered about by some of my WTAC peers in group e-mails:

• “being a fat pig, I am not running”
• “I might even do something stupid like run it”
• “If this elderly broken down guy can finish it...”
• “It will be an ugly, shambling effort”
• “I will hate myself for doing it on Rte 108.  Death march to the finish.  Disappointing finishing time.”

Race day morning, friend Mike B and past Blessing runner reached out to me to offer good luck and some advice to take it easy and just have fun.  I was limping and having some trouble with stairs as he reached out to me, but was optimistic the daily low dose of Prednisone would kick in and limber me up for the afternoon and early evening as it has.

Indeed, by the time we left about 4:45pm (race start 6pm), the body was feeling looser.  Still, with my setbacks and inconsistencies running recently, when Jana asked in what time did I think I would cross the line, I said if I'm doing really really well out there, maybe 1:10, but otherwise more likely between 1:10 and 1:30.  (For reference, my median time over the past 5 years was 1:02:33.)

Race start:  After last year's slow time due to nerve injury, this was the first year in many that I was not awarded one of the coveted low-number two-digit bibs that allows you to enter the fast runner starting corral up front.  Accordingly, it took me twelve minutes after race start to get to the starting line.

The moron:  While it is true that I didn't cross the start line until 12 minutes after race start, and it's also true that I lost my low-number bib, that doesn't really explain why it took me a full 12 minutes (11:40 to be exact) to reach the start.  In fact, based on the chart below, there is a reasonable assumption that the starting line queue dissipated within the first three minutes:

Given my somewhat scientific assumption that the queue fully dissipated within three minutes
after the starting gun, it appears that I was in good company of a total
of 24 morons that arrived late to the race.
Not that I should take solace in that.

So what happened?  Well, the moron got all the way to SK (25 minutes from home, 5 minutes more to drive to race start) before realizing that his bib was still at home.  Six days earlier, I had put it on top of my bureau so I would remember to bring it.  Yeah, that worked out well.  Fortunately, Jana (my driver on the day and fervent supporter) took it all in good stride to turn around and drive back to Westerly, and then back again.  So Jana got as close as she could to the starting line, and when she got stuck in traffic at 6:10pm, I got out and ran to the start.  So much for a warm-up.  I got to the starting line, and the starting mats were already picked up as the road was now open to traffic.  However, the mats were on the side of the road and a timing official told me to make sure to run over the last mat and that would pick up my time.  Done!  He yelled me to confirm he got my start time.

The chase:  So for the next 1.5 miles I ran in the breakdown lane alongside backed up traffic spewing emissions.  A fair penalty.  I even waved to Jana as I re-passed her sitting in traffic.  Each time I came up on and passed another runner, I was thinking this person is the back of the pack.  Nope; just another late starting moron like me.

Easier running:  Finally, 1.5 miles in, on Ocean Road, I caught the trailing police cruiser, with his lights flashing.  THIS was finally the back of the pack, and once I passed the cruiser, it was a lot easier sailing, as ahead of him the road was closed and I was no longer punished for my stupidity by having to run in the breakdown lane while sucking down exhaust.

Unique experience:  Once I was past the cruiser, the running became fun again.  I was passing people left and right and I saw a few people that I knew running and made it a point to wave and say hi to them.  It's not like it really mattered what my finishing time would be, but rather only that I finished.  A few asked, "What are you doing way back here?", as did a state cop directing traffic at the intersection turning onto Route 108.

Proud uncle:  At about Mile 5, I spied my brother Kurt and his 9-year old daughter Lucy running.  (There was one other 9-year old running in the race, no 10-year olds.)  I asked Lucy to conserve her energy and not to talk to me while I talked to Kurt for a while.  Lucy was looking good, and after a 1/4 mile or so, I continued on and stopped bugging them.  Since my pace was about 7:30 or so, even in my lack of running and diseased condition, this still felt relatively easy for me and kind of "fun" instead of the usual hating running on Route 108.

Finishing:  The next few miles were really a blur.  Occasionally I would hear my name, but never really could tell who it was that was calling.  At about Mile 8, on South Pier Road, I heard some very motivating music from one of the runners I was passing, but I couldn't tell which one, so I just yelled out, "Keep the AC/DC coming!".  The retort back to me was, "You want some Dirty Deeds?!".  Oh, yeah!  I had fun along the way pointing at young children with super-soaker squirt guns and hoses and asking them to douse me.  They seemed to enjoy that as well.  As I turned the corner onto Kingstown Road at the Mile 9 marker, I picked it up and finished the final mile in sub-7.

Finishing up.

Final results:  1:14:32 (chip time), 1:26:12 (gun time), pace 7:27.  Full results here.

Apres-race:  I passed literally more than thousand runners (since I started behind the back-of-the-packers, and finished 251st out of 2,148.  That was fun and motivating.  Only one person passed me the whole time; a 20-something that all of a sudden sprinted at the end.  I felt really good!  Until I stopped.  And then everything stiffened up quickly.  We waited (not long) for Kurt and Lucy to finish, and then went to Lucy's grandparents (Kurt's in-laws) for an ice-cream celebration.  Leaving their house, I tried not to make a scene, as today was about Lucy, not me, but unfortunately, I was hobbling in pain.

I'm not sure what's with the goofy face,
but I'm happy I'm done

And here's my hero:  my 9-year old niece Lucy,
having finished 10 miles

Celebrating Lucy's victory
(I'm behind my Mom and between Lucy's parents)

Unfortunately, I did not catch up with any of my WTAC brethren, as they were all home, showered, had dinner, and were in bed fast asleep by the time I crossed the finish line.  Oh well.  This was my longest run since mid-May, before my PMR symptoms started.  How much was due to the PMR and how due to lack of running and training?  I guess I'll never know.  But the glass is half-full, and I'm proud to have finished my 17th consecutive Blessing of the Fleet 10-Mile Road Race.  My Mom and her friend Bob were at the finish line, and Bob asked me if I would try to keep running the race to make it 20 years in a row.  In fact, I hope to go for as long as I can, but given my current unknown recovery and treatment, yes, I'll say 20 years is a good goal for now.

Weekly Log 22-Jul to 28-Jul-2019: Zig Zag

Miscellaneous Ramblings:

• I must be naive, as I never realized until now the band name "The Doobie Brothers" was chosen for their penchant for, well, doobies.  I thought they were just brothers in a band, like, "The Allman Brothers Band".  Yeah, I guess the surname "Doobie" sounds a little suspicious, but I never put it together.  Crazy!
• A planned fall marathon is out the window for me.  I was hoping to run either Steamtown or Mohawk Hudson, but I have to be realistic at present on my limitations and lack of running.  So glad I got in the Myrtle Beach Marathon in the spring this year.

Monday:  4
As soon as I got up and hobbled downstairs in pain, I knew any running was out the window.  Like yesterday morning, I was very creaky and again couldn't lift my right arm.  Took my morning dose of Prednisone with breakfast while pondering that I just don't foresee I'll be able to run in the mornings anytime soon, and I'll have to change up my routine.  Fortunately, there are plenty of runs and races in the evenings in the summer, and hopefully (?) by the end of the summer things will improve.

As usual, I feel much better in the afternoon and evening.  Went with Matthew (with his own set of ailments) and Brady to Ninigret Park after dinner.  Ran mostly grass at Ninigret.  Started off with sharp pain in the shoulders, but that dissipated as I ran further.  Felt good overall.

Tuesday:  0

Wednesday:  2 walk, 3 run
Worked in MA today.  Was hoping for a run/walk before work.  Avoided the trails as deerflies are really bad, especially if you're walking.  Went to the track and walked two miles.  Tried several times to at least jog for short spurts, but just not possible.  I'm glad nobody talked to me, as I was in a pretty foul mood and needed to give myself a good talking to, in over to avoid sulking at work.

In front of the Wellesley, MA office is busy and ugly I-95.
In back of the office is beautiful trails with this view of the Charles River.

In the evening back in RI, I ran most of the Fun Run with Muddy.  Shoulder pain yes, but pretty mild, and felt quite loosened up running.  About a 6:40 pace.  Yes, I was breathing like a dinosaur, but still pretty happy with that.

Thursday:  0
Runs just take too much out of me lately, so while I always like to have a shakeout before a race (Blessing is tomorrow), since tomorrow is truly just about finishing, I'll save my energy.

Friday:  10
It seems like every day is something different.  This morning it's trouble walking up and down the stairs, with a lot of pain.  Come on Prednisone, kick in before tonight's Blessing and limber me up again.  Thank God (or whomever) that Blessing is an evening race.

Please, no more stairs.  Too painful.
(At Westerly Town Hall, awaiting my number to be
called for DMV, before I realized there's also an elevator.)

See separate write-up on Blessing.

Saturday:  0
Very sore in the morning, then surprisingly felt good in the afternoon and was able to attend an annual family seafood bake / pool party.

Sunday:  0

What I intended to do:  Go for a coastal bike ride with the guys and hopefully a stop at a coffee shop.  As a back-up plan, if this didn't work, I also got an invite from my cousins to meet up and go to the beach (they come to RI but once per year, and some of them just once every few years).

What I actually did:  After a fitful, tough night, woke up to the alarm at 6:15am to get ready for our 7am ride.  I was actually scared as I found out I could not physically raise either of my legs.  This PMR thing does not take a linear progression, as my previously frozen right arm was functioning just fine today.  But without leg control, it's really hard to get out of bed.  It took me a long time, but with a lot of effort and pain and grabbing onto things, I was able to do it.  Stayed out of bed only long enough to visit the bathroom and tell the guys I'd have to take a raincheck, then reversed the painful process of getting back into bed.  There's no way I could get on a bike, or play and swim at the beach.  Ugh!  Frustrating is an understatement, as I started thinking about my own mortality, the lack of quality in my life of late, and the fear of one day soon I won't be able to get out of bed at all.  I've got to stop that thinking and realize there are plenty of people worse off, but it's hard.

After spending the entire beautiful Sunday summer morning lying supine in bed and on the couch, I got up about Noon time and with the aid of Prednisone, was finally able to walk a bit with a minimal of limping and pain.  By early afternoon, I was once again able to lift both legs and was feeling reasonably better as I got out and mowed the lawn and then went to dinner at Sea Goose with some of the cousins that were still in RI vacationing.

Weekly mileage:  17 run, 2 walk

Weekly highlight:  Finishing my 17th consecutive Blessing.

Weekly lowlight:  Scary pain and lack of mobility on Sunday morning.  I'm dreading tonight as the Prednisone wears off and I return to my crippled state.  I'm also nervous about tomorrow, as so far the neurologist hasn't even reviewed my case and thus I can't get an appointment, so I'll have to reach out to my PCP again as my prescription will run out soon and he said no more.  This will make for an interesting discussion.  At least my orthopedic doctor seems to be backing me, so I have a second option while I wait out the ridiculous delays in even getting an appointment to be scheduled.

Weekly Log 15-Jul to 21-Jul-2019: Heat Wave and a Return of Brady

Monday:  0
Planned total rest day.  Actually fairly sore from what I thought was a pretty easy ride and then run yesterday.

Tuesday:  5
Flew to NC in afternoon.  $34 from Providence!  Very hot run (95 degrees) in Durham, NC.  And that was at 6pm!  As I was running, I was thinking that this weather reinforces that turning down the job move here in 2014 was the right thing to do.  I'm just not a heat person.

After I got off the main road, the path I ran on
gave at least some shade and protection.

Felt like jumping in here.

I know I'm cheap, but suggesting a 30% tip?!  Really?

Wednesday:  3
Long drive back from NC, where I met up with Mark and Brady halfway on their trek home from Tampa.  The car A/C is broken.  Ugh.  So the entire ride back was in the 90s with hot air blowing in through open windows.   Did I mention that I'm not a heat person?

My old Volvo wagon, which I gave to Mark,
is still in great condition and running at 206K miles.
(We got the A/C fixed upon return to RI.)
Brady, in foreground, is home for a 5-week visit.

Stopping at this busy rest area along I-95,
I asked Mark for Brady's leash, and he's said it's
packed in the back and I didn't need it.
OK.  So I let Brady out of the car, and sure enough he just stayed right
with me, even when leashed dogs went past and barked at him.

I ended up driving the whole way back to RI, because I somehow didn't get tired.  I was home about 15 minutes, when it was time for the Fun Run.  So many people thanked me for helping to put on the Fun Runs and said they had fun, and that it made it all worth it.  Personally, I ran with Mike B for the whole 5K route and enjoyed conversing with him.  Mostly, it was two old guys whining about their old age ailments.

Thursday:  0
I am really sore today.  I'm hoping it's only because of sitting in the car for 12+ hours yesterday, and not an easy paced 5K.

Friday:  6 run, 2 walk
Another year.  Double Nickel.  55.  I feel very old.

Took Brady with me to Burlingame picnic area, and we ran 6 miles of trails.  My stiff shoulder seemed to loosen up as I ran.  The last two miles he was dragging a bit.  Both of us cooled off in Watchaug Pond at the end of the run.

A random screw, completely screwed in.  How on earth could that
happen?

We started out with a strict rule of dog not allowed on any
furniture, and certainly not a wet dog just back from swimming in
Watchaug Pond.  Yeah, I'm way too soft in my old age.

In the evening, Jana suggested we take Brady for a walk in Watch Hill.  OK, sounds good.  Brady seemed to enjoy it, and I know we did as well.

Brady in Watch Hill

Man's best friend

Saturday:  0

Four cars home now for the rest of the summer.
If shuffling cars around in the driveway is the worst downside
of having everyone home, then it's a non-issue for me.

This is just disgusting.  Here in Westerly along the coast,
some years the temp never hits 90 degrees.  Today reached the low 90s
even in Westerly, and close to 100F in Providence.  Ugh.

Escaping the heat with Brady awkwardly wrapping himself around me in a
neighbor's pool (yes, they invited Brady in;
it's salt water, not chlorinated)

He just could not figure out how to get in the pool on his own

Sunday:  2
AM run fail.  Could barely reach down and touch my knees.  Could NOT lift my right arm one iota, not one inch.  Scary.  What is this fresh hell?  I tried running in the neighborhood, but didn't last one minute with the pain and awkward gait.  Walked home frustrated and depressed.

Got the lawn mowed (I can actually do that again) and a fair amount of yard work done, so I appreciated getting something accomplished at least.

In the evening, I was limber again as the meds had kicked in, and I took Brady out for a walk at North Camp (until we were consumed by deer flies and picked up the pace), then stopped by my brother Greg's house and Brady ran crazily in his back yard with Greg's two yellow labs as I caught up with my brother.

The black dog got temporary relief from the heat and the deerflies.

Brady, come back.  Where is he going?

Weekly mileage:  16 run, 2 walk

Weekly synopsis:  I'm certainly better than last week when I wasn't taking Prednisone at all.  This week I'm able to move with a lot more mobility, at least in the afternoons and evenings.  I'm looking forward to getting in to see the rheumatologist and getting a confirmation and a fresh look at the treatment and drug dosage, but I have yet to be able even to secure an appointment as the medical system moves so incredibly slowly.

Weekly highlight:  6-mile run and swim on Friday.  Most exercise all week.

Weekly lowlight:  Morning stiffness on Sunday morning.  I've read that's a symptom of PMR, and it was certainly evident, scary, and frustrating Sunday.

Weekly Log 8-Jul to 14-Jul: Potential DIAGNOSIS!

Miscellaneous rambling:

• This week, just around the corner from my house, an elderly out-of-state tourist with NY plates cut me off.  She screamed something at me that I didn't catch, except the last word:  "Stupid!"  I simply calmly told her that I had the right of way, not her, and she sped off.  The same exact thing happened to me last summer at the same intersection (Airport and Winnapaug), except that time I got luckier as a Westerly PD car was there, witnessed the event, and put on their lights and pulled over the offending driver.  Why don't people just take their time, relax, and calm down?  Especially presuming they're on vacation here.  Ugh.
• While biking along the shore, was shocked to see parking in Watch Hill is up to $40/day now, and at Misquamicut beach lots, $30/day.  I don't want to sound like my Dad telling tales of buying bread for a nickel a loaf in his day, but this is outrageous!

Monday:  0
Planned rest day from Loon.  1st day off the meds, and I'm starting to feel it, especially as the pain returns to the shoulders.

Tuesday:  0
Even worse than last week, I am having a very difficult time today, as all the symptoms have returned, and then some.  Had an extremely hard time and quite a while physically getting my carcass out of bed and standing up.  Could not put on my own socks, no matter how many times I tried nor how I varied the position leaning, sitting down, etc.  Had to have Jana put my socks on for me (is it time for "the home" as Mike B says?), and I didn't even bother to try to tie shoes and just went for the slip on variety.

I was thrilled I was able to get in to see my PCP same day, as I could not move my right arm more than a couple of inches in either direction, and couldn't even shift the car.  It was awkward starting the ignition and shifting my manual gearbox with my left hand, but got it done.  When the nurse brought me in, she commented on my limping right away.

I summarized my pathetic previous week for the doc, including my physical setbacks, going to South County Express Care while he was on vacation and getting predisone, which responded nicely, but now off the meds I'm set back again.  He said he'd get me referred to a rheumatologist, and gave me a second more-detailed set of lab tests, including the previous two rounds of tick-borne tests, muscle enzymes, inflammation, and a bunch of stuff I don't understand.  I asked if I can I get another prescription of Prednisone.  I couldn't believe he said no!  He said I can't live my life on Prednisone, but I said I can barely live my life at all now, told him about the difficulties I'm having, and I either need to get some relief until I can get in to see a rheumatologist (likely 1-2 months) or I probably can't continue working at the office and will be homebound requiring assistance.  I pleaded and begged to get more Prednisone, and in the end he capitulated with a very low dosage for 30 days, and said no more.

Ophelia (Jamie Lee Curtis) to Louis (Dan Aykroyd) in Trading Places:
"Come on baby, just a dime bag. 
I'll do all those things you like."
-------
That's the junkie I've become.  I was literally begging my doctor to give
me drugs against his judgment, as this is the only thing that's given me relief.

Getting my blood drawn, I was feeling really weak after a while.  I always look away because I'm squeamish like that, and when done, the person drawing my blood explained that they usually draw just one vial or sometimes two, but she had just taken eight vials out of me.  Yuck.

Wednesday:  0
Continued hobbling means I can barely walk and running or other exercise is out of the question.  Had to cancel working in MA and made up some excuses as there's no way I could drive there and spend the day.  Instead went home at lunch and crashed on the couch in pain.  I didn't think about how low the couch is, and had a tough time and took multiple attempts to get off the couch.  Pathetic.

Hobbled as I volunteered at the Fun Run in the evening.

Thursday:  0
Day 2 on the low dose Prednisone.  I'm still hobbling in pain, but starting to feel marginally better.  I've regained partial use of my right arm again.

In the afternoon I had a follow-up appointment with the orthopedic doctor looking into my original shoulder pain and mobility issue, before realizing that is all tied together.  As the symptoms have changed and spread to both shoulders and both hips, we know it's not a left shoulder specific injury or issue, so I actually thought about it cancelling and saving the $50 co-pay.  So glad I didn't!

This doc spent a lot of time with me today, reviewing my lab work, asking a lot of questions, poking and prodding, and having me perform a number of physical tests.  After that, he sat down and said with a reasonable degree of confidence and pending confirmation and review from a rheumatologist, he said he feels strongly that I have Polymyalgia Rheumatica, and explained in detail why he felt this way and why it wasn't other specific disorders, infections, or diseases.  I was so happy to have a medical professional, for the first time since this started in May, express what they felt to be a diagnosis!  Once you have a diagnosis, you can move to treatment.  So what is Polymyalgia Rheumatica?

Polymyalgia rheumatica (PMR) is a rare inflammatory disease that affects older adults, causing widespread muscle pain and stiffness, especially around the shoulders and hips. 

PMR primarily affects the shoulders, neck, hips, lower back, and thighs, with muscle pain and stiffness that is worse in the morning. A systemic disease (affecting the whole body), PMR also causes flu-like symptoms, such as fatigue and fever. 

The symptoms of PMR can come on suddenly, over a period of days or weeks. Corticosteroid medications such as prednisone are prescribed to reduce inflammation and pain. Patients usually respond quickly, within 24 to 48 hours, but most need to remain on treatment for a year or more. The disease typically runs its course in one to five years. However, even with effective treatment, relapses can occur, so ongoing medical follow-up is essential.

https://www.vasculitisfoundation.org/education/forms/polymyalgia-rheumatica/

So, now what?  Continue on the low-dose Prednisone until I can see the rheumatologist, and my orthopedic doctor will also make a call to see if he can accelerate that visit.

Remember this scene in the church from Blues Brothers?
I'm so happy to have a likely diagnosis, that I could do backflips.

Friday:  0
Day 3 on the low-dose Prednisone.  Gradual improvement.  For the first time since Monday, I was able to put on my own socks!  Ridiculous, I know, but I'm celebrating the small victories.

Saturday:  0
Continued improvement.  First full day this week of no limping at all!  Still near-constant pain in the shoulders, but again, I'll take the improvements.  Finally had enough mobility to attack some projects that had been sitting, including 1) rewiring the garage door safety sensors and thus getting the door to work again, and 2) changing the spark plug, air filter, and fuel filter on our tractor lawn mower, and thus getting that to run again.  It felt good to actually get something positive accomplished.

Enjoyed the afternoon at a friend's daughter's graduation party, and felt physically very comfortable the whole time.

Sunday:  15 bike, 5 run!
Decided to go for a solo easy bike ride along the local coast.  Stiff getting on the bike, and riding at first, but really felt good after that.  Towards the end of my ride, stopped for an iced coffee at the Weekapaug Inlet, and enjoyed some downtime and people watching.

Got back from riding and Matthew asked if I wanted to go for a run.  Hmm.  I actually feel up to it, but it was almost Noon now and he was planning to run Avondale, which I felt was too open in the hot sun for me.  When he suggested changing to Bluff Point State Park, I'm in!  We ran about 3 miles together at my pace for today (8:15) and then he went off while I continued at the pace back to the car.  Legs were stiff but manageable, and shoulders still painful, but they always are lately and that didn't impact my running.

Weekly mileage:  my Sunday activities only - 15 bike, 5 run

Weekly synopsis:  What started off again as a terrible and physically debilitating week was offset by getting a potential diagnosis on Thursday.  I really feel things will continue to improve from here, albeit gradually.

Weekly highlight:  The potential diagnosis received on Thursday, for sure.  Yes, it still needs to be confirmed, and assuming it is, it will likely require a year of more of taking drugs.  But just starting to get some answers is a huge relief, and my recent downward spiral into loss of mobility and constant pain was just robbing me of any quality of life and taking way my dignity.

Weekly lowlight:  Just like last week, having a really rough day on Tuesday and not knowing when or if this ever going to be resolved.

Loon Mountain Race 2019

Lincoln, NH
Sunday, July 7, 2019

Happy post:  This writing, for a change, is going to be a happy and upbeat blog post!  Because for today, I am pain-free and have near total mobility in my limbs!  (Yes, that's because of a temporary high dosage of prednisone, but let's relish the present.)  Because my attempt to complete the mountains series remains viable.  Because this will be my 3rd time running up Loon Mountain.  Because it's a well organized event in a beautiful location.  Because it's a feeling of accomplishment to have conquered the mountain and look down over the beautiful views of mountain ranges.  Because I feel alive!

Early rise:  The alarm went off in Westerly, RI at 4am.  Hit the snooze button but once, and then promptly got up at 4:09am.  Why exactly snooze alarms are almost universally set at exactly nine minute intervals is one of the greatest perplexing mysteries of the universe.  But I digress.  With what little I needed having already been laid out the night before, I was on the road by 4:25am.

Easy drive:  It's so rare and wonderful to have no traffic slowdowns at all.  I even drove right through Boston on I-93, because for once Google Maps showed that a quicker route northbound on I-93 than I-95.  I was originally on track for and hoped to watch the start of the women's race at 8am, but after stops for gas, food, and bathroom, I missed that opportunity and pulled into Loon Mountain Resort just minutes after 8am.  Took my time making my way over to the now familiar Governor's Lodge to pick up my bib, as the men's race start is at 9:15am.  Upon reaching the other registration, ran into confusion over two Jeff Walkers, and was told that Maine Jeff Walker had asked the registration personnel to relay a message for me to take it easy on him today!  The truth is that I have only ever beaten him once in a race, and the terrain was much different (Exeter Trail Race).  I certainly wasn't going to be remotely close to him today, but I appreciated his humility and gesture.

Boston may be ranked the 10th worst US city
for traffic, but this morning it is clear sailing!

Nice bibs as usual.
(Photo of last year's US mountain champ winner and trail master, Joe Gray)

The start:  After an easy warm-up, and catching up with Steve Brightman, I got myself lined up.  I stuck to my simple goals of 1) finish the race, and 2) have fun.  To help the odds of success and to ensure I went out easy, I lined up smack dab in the middle of the field.  Once the race started, it was apparent to me that the downside to my mid-packer approach was that I was stuck in a crowded field (523 men finished) with limited opportunities to pass.  I told myself to just relax and go with it.  After about 1/2 mile, the logjam cleared and I was able to pass with ease whenever I needed to for the remainder of the race.

A beautiful sunny day today.

Mid-packer observations:  With the disclaimer that none of the following bullets should be  construed in any way as pompous and those that know me well will often find me cheering just as vigorously for the person who finished last as first, I'm usually in the top 10% - 20% in any given race and my self-selected mid-packer position today put me in a position to take some interesting mental notes on the participants around me.  At the risk of painting too broad of a brush, and again with no intention of disrespect, here are some observations that I found unusual relative to my two previous LMRs:

• Some people start walking as early as 1/4 mile in (just past the lodge where the old starting line was, on the first significant incline).
• Can't believe how many wear headphones!  And physically carry a cell phone or music device!  While racing up a mountain?!  This despite the LMR headphone policy of "The use of personal music devices is strongly discouraged at this race. To enjoy all that our race has to offer and for the safety of all participants, acidotic RACING, LLC encourages a headphone-free environment during the running of the Loon Mountain Race.".
• Wearing cotton underwear (or to a lesser extent any underwear to me, but yeah that's probably TMI) in a warm and muggy mountain race has just got to be very uncomfortable, sweaty, and chafing.  (No, I wasn't checking out guys' underwear, but with a few shirtless guys with droopy shorts in front of me, it was kind of in my face.)
• Once we were on the only real "trail" section to me, I was astounded by how many ran weird inefficient back-and-forth across-the-trail trajectories in an apparent effort to avoid any wet ground at any cost.  I suppose that's their prerogative to a point, until they cut me off, as not surprisingly, I'm generally running a relatively straight tangent even if that means I have to run through muck or step through a stream.

Second half:  Coming out of the trail, we have a mile of mixed up and down hills in open terrain.  Right about 4 miles in is the usual place where I start to mix hiking and running, as this where we encounter slopes > 20%.  Today is no different.  At the end of power hiking the first such stretch, a guy says to me, "That last 0.1 miles was really hard.".  Perhaps I should have expressed more empathy, but I just shot back that's nothing compared to what's ahead.

Reaching Aid Station 2 at the gondola summit, I got water and heard my name called, but didn't realize until I was pulling away that it was Leslie handing me water.  Thanks Leslie!  Post summit, the race end is near, with about 1/2 mile of sharp downhill on Haulback before starting the punishing 40%+ climb up Upper Walking Boss.  Ran into a lot of women here, and it took me a bit to figure this was the tail end of the women's race.  I don't remember UWB being as excruciating as before, so I can only guess that being my 3rd time, I was better mentally prepared?  It's an uphill finish but with all the cheering and finish line in sight, I managed to break into a slow but sure jog across the line.  Done! 

Passing a couple of runners just before the finish line.

Great day out there.  I didn't know if I would be running 1 1/2 hours, but even with my slowdown, I still finished in 1:15.

Final results:  1:15:32.  Full results here.

Four down in the mountain race series, two to go.  Next up is Greylock on Labor Day weekend.  Good, time to get healthy.

Weekly Log 1-Jul to 7-Jul-2019: Setback & Change in Approach

Monday:  1/4 mile swim
Went to PT in the morning for my shoulder range of motion issue, and was advised that overall my joint condition appears to be worsening, and that I'm limping with hip issues, and I should get in to see a rheumatologist.  Called my PCP to discuss, only to get an answering machine announcement that his office was closed for the week.  Ugh.  Found and called a local rheumatologist for an appointment, only to be told that's not how it works, and I need to get a referral from my PCP, then after they receive the paperwork, they'll call me to schedule, but their scheduling is really backed up.  Ugh.  I'm in pain, and having a lot of trouble getting in and out of my car today.

Evening swim at Watchaug Pond.  Since I can't get my arms over my shoulders, the doc said no swimming (crawl), and I did what I could to breakstroke while Matthew swam a full 1/2 mile.

Tuesday:  0
Definitely the worst day of my medical issue thus far.  While trying to keep the blog positive, the reality is walking is painful, getting dressed and standing up difficult, and reaching into shelves in the refrigerator or cupboards impossible.  Is this what my life is reduced to?  54 years old, crippled, and chronic pain.

Perhaps overly dramatic,
but this is what I feel like.

Went to South County Hospital Urgent Care to seek some relief.  The doctor I eventually saw was kind and compassionate.  She recommended I see a rheumatologist (this is the 2nd professional in as many days to tell me this) and follow up next week with my PCP to get the needed referral.  In the meantime, she gave me a 6-day prescription for Prednisone to hopefully gain some temporary relief from inflammation.

Wednesday:  3
Woke up feeling like a new man.  Still pain in both shoulders, but walking is normal and I'm able to bend over and also reach my arms into the air.  Hallelujah!  Sounds ridiculous, but just don't take mobility for granted.

Felt even better by the evening, and decided to run in the weekly club summer fun run.  Far from 100%, but ran moderately easy at about 6:50 pace and felt good!

Thursday:  20 ride
Happy 4th of July!  Rode with Matthew out to watch the Quonnie 4 on the Fourth race.  Unlike last year, not many WTAC runners this year.

Friday:  6 run, 0.6 swim
AM solo beach run, before the mob of tourists take over the beach again.  The tide was coming in, but it was close enough to low tide that the sand near the water's edge was hard-packed and I didn't have to run in soft sand.  Felt great!

PM swim with Matthew.  Slow as molasses, but I did it.  Out to the buoy (1/4 mile) and back.  Goggles have had it as water was leaking in, but otherwise a good swim.

Saturday:  0
Calves sore from yesterday's 6-mile beach run.  Also, shoulder pain has returned.  Is that because I'm weaning off the Prednisone, or painful from yesterday's swim exertion?

I hemmed and hawed on whether to run Loon Mountain tomorrow.  At the beginning of the week, I had crossed it off in my mind, realizing that also means I won't be able to complete the mountain series, but feeling much better now and having much of my mobility restored, I'm going to go for it!  Last minute decision, which means it will be an early morning tomorrow driving up.

Sunday:  8
Loon Mountain Race.  Short, but separate, write-up to follow.

Weekly mileage:  17 run, 20 ride, 3/4 swim

Weekly synopsis:  All over the place in terms of mobility and pain this week.  Happy that the prednisone gave me a temporary improvement of quality of life, but need to get to the bottom of this.

Weekly highpoint:  It should be Loon, but just getting out and running the Fun Run temporarily pain-free was an amazing turnaround from just the day before.

Weekly lowpoint:  Tuesday was bad.  I was just about in tears from the pain, and embarrassed to have to ask others to do really simple tasks for me, like taking a bottle of juice out of the refrigerator when I just couldn't extend my arm to get it myself.

Books read:  Stealing a page here from BLS' blog.  I don't normally read books, but I picked up this assigned school book of Matthew's and found it interesting:

It's the story of a runaway slave from the Presidential Mansion in Philadelphia.  Back when the capital of our country was in Philadelphia, the slaves that George and Martha Washington brought up from Virginia got a taste for freedom when the vast majority of African-Americans in the state of PA were free.  As the approaching end of Washington's 2nd term meant a return to Virginia, a slave state, one of Martha's slaves, Ona Judge, escaped with help from the local free black community and traveled to Portsmouth, NH.  Overall this was a good read that kept me interested.   The downside to me was too much speculation on what people did or thought in the book (as opposed to what they actually did), but that might have been necessary on the author's part due to very little written information from slaves themselves.  For example, "Ona may have believed ..." or "we can only imagine ...".

One professional review on the back cover of the book states "No one who reads this book will think quite the same way about George and Martha Washington again.".  I do take exception with that statement.  Look, we all knew from a young age that the Washingtons kept slaves, right?  As did all of the early presidents that were from the south.  Playing Monday morning quarter-back, should they have kept slaves?  No, of course not; slavery is a terrible stain on this country.  But let's also not forget that George Washington did emancipate his slaves in his will, and let's not judge George Washington's 18th century life through 21st century lenses.