Knee replacement turns two, and ‘Obamacare’ is still law of the land

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Still proud of myself for ‘re-purposing’ the bicycle seat that served me for 28 years as a wedding gift.

Having started with Affordable Care Act coverage when legally mandated in 2015, I’m proud to announce that the replacement knee that made me physically whole again after a dozen years as ‘a gimp’ and restored my personal confidence levels, turned two yesterday.

A physical game changer at 60, replacement was the most anticipated gift I’d ever received.

After asking my doctor if I could possibly get the surgery in December, 2017, the scheduling person said, “You’re in luck. Two cancellations means one spot has opened up. The doctor is booked on the 18th, Christmas is the 25th, and after that its a new program year. You can have surgery this Monday, but you have to tell me,” and she literally looked at her watch, “now.”

After a difficult economic 2016 as a new real estate broker, getting a knee that was totally shot at the end of 2017  fixed as a long-term negative was far from a given. In the final accounting, the numbers turned out super-doable: “Obamacare” meant my maximum out of pocket – on an insurance breakdown with a $28,700 top line was $600.  The $20 a session for physical therapy – seven weeks, twice a week – was money extremely well spent.

Thankfulness has abounded since, and I have no reason to listen to anyone knock the ACA. This past weekend I popped off an 18 mile ride without any protest or strain from “Lefty,” and while a second day of Christmas tree selling brought a minor ache, two beers watching the LSU game took care of that.

I’m a happy camper about the knee, and have said so in every survey they sent me.

Rehabbing is definitely a challenge, nothing fun

When you catch a major break like the timing and cost factors I had, you owe the Universe your very best effort in return. Whatever other exercises Amanda and Becka came up with, knowing how important a factor an ERMI was in my progress, I worked the hell out of it.

ermimachinie

A significant extra from having Dr. Robert McBride (OrthoCarolina) as my surgeon was getting that ERMI (Extended Range of Motion Improvement) machine as a 30 day ‘loaner.’ It’s not kidding to say, with your heel in a foot-scoop, “You pull the pneumatic lever until the bend is uncomfortable, then give it another little tug, and keep that position for ten minutes.”

After taking a break, the system calls for coming back for ten more minutes and doing that twice a day. In physical therapy for knees, they quantify your progress in range of degrees, and at least for me, clicking that lever another line or three while in the ERMI saddle and channel-surfing hit an “I got this” machismo.

I believe that *every*little*bit*more*I*do* goes directly to helping the strength and functions of my knee-quad-whatever. (What I told my PT person, Amanda, often, and strangers in grocery stores even more frequently)

Its a process, and goals help

My initial, somewhat whimsical goal for being “better” involved planting my left foot without pain and being able to hit a tree with a snowball. The last time I’d tried on a trip to NY, I literally couldn’t hit the broad side of a barn. Charlotte doesn’t get snow that often, so it was a touch of luck that a decent skim appeared in late February to help fulfill that “leveling up” affirmation.

By the end of May, with the help of regular, mostly flatter 8-10 mile bicycle rides for training, I could handle my favorite urban route, one that features a three-mile stretch with several long rises about the mid-point. Thumping a forehand up the alley in tennis as an opponent flails at its passage still hasn’t been put on the official scoreboard, but I’ve killed a nearby wall.

In a captain’s choice golf event before Memorial Day 2018, I played amazingly well off the tees, STRAIGHT drives that located well and allowed better players to shoot for higher risk options. For years that knee clicked and wobbled at exactly the point I settled into an optimal swing position, which was more than just distracting. When my balance was restored, wow! Without that constant niggling, my swing came through smoothly.

That old joke about, “Will I be able to play the piano after surgery, I never could before,” that’s what solid drives felt like.

My bike ride is a working antique, a 12-speed Miyata with gears on the up-angle from my pedals instead of in the middle of the handlebars. I bought ‘Clyde’ for $125 in 1990, refurbished it for $185 many years ago, and finally bought a more ergonomically friendly seat vs. the slab of leather (see photo at top) that lasted 28 years. Riding Clyde was a saving grace, what allowed my staying in shape because it was really the only physical thing that *didn’t* abuse the knee, and biking is an almost year-round possibility in Charlotte.

Post-replacement and therapy, I honestly never expected to become the long-distance shooting threat in hoops I sort of recall being a dozen years before, when I started needing a bracier brace. Having stopped playing even 4-on-4 games six years ago – I sure didn’t want to be the guy *anybody* can drive on and they want to guard – I just wanted to move naturally. I continued catch and shoot hoops by myself over the years, but having to WALK after misses, that didn’t really square with the inner athlete.

Not having to skip across the street so I didn’t get run over made having that knee replacement a simple decision.

This October, after declining to play the previous week, I tried “going easy” for a short game to seven, shooting 4-5 with three long shots, and an assist. I’ve been back four times since, even though my doctor says, “You’re playing basketball?” with concern in his voice. (No sweat doc, I’m playing with old, broken down guys…) I resisted for over a year, I swear I know my limitations, but running after misses because I can, is another reason for thanks.

When doing a content copy writing gig for a CBD manufacturer early last year, I did several articles about how CBD’s effect on the endocannaboid system (ECS) can help with anxiety and depression.  Other research, regarding physical activity as a good overall tool on those fronts, echoed a personal mantra, and that Forever Young Boomer inside me does seem to respond well to CBD’s “focus factor,” having both going for me is terrific.

In my humble opinion, when your moment comes to pull the trigger, do it. The physical therapy is going to hurt, but do it – and then do a little bit more. Happy second birthdays depend on it.

CBD oil as health care resource for Baby Boomers struck a useful chord early

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When searching for results, if you find a product that works, keep it around.

If you consider the early years of Boomers with Daniel Boone hats and hoola-hoop “fads,” CBD is more like Beatles-level important. The 70 million strong ‘Baby Boomer’ generation (1946-1964) will be overtaken by Millennials (1981-1996) soon, but Boomers accepted documentation and showed a personal willingness early to experience this non-drug and the many physical things it seemed to benefit without the buzz.

CBD oil became a health care star quickly in 2019, beginning with the passage of 2018 Farm Bill (Senate Bill 2667) just before the government shut down in December.  An essential change was redefining CBD as “all parts of the Cannabis sativa plant that do not exceed 0.3% delta-9 THC by dry weight, including “derivatives,” “extracts,” and “cannabinoids.”

Boomers are aware that Reefer Madness scare tactics and criminalized marijuana (Controlled Substances Act, 1971) use were bogus in a lot of ways, but few will deny the scary aspects of opioids like codeine, fentanyl, and hydrocodone addiction. That singular aspect makes CBD’s all-natural aspect even more appealing to those who have more liberal views on what may be good or bad for them.

With a market projected at $22 billion by 2022, Boomers can consider CBD kind of like Coca-Cola as the Real Thing.

Because they’re often caregivers, Boomers have significant first hand knowledge about upcoming senior care issues, including expensive medications with known, negative side effects. Their “Forever Young” group attitude has always valued health issues (racketball, jogging, aerobics) and their top priorities at sixty-plus years are now inflammation, pain management, and as a sleeping aid, areas where CBD has shown documented strength and results.

While it’s got a great reputation regarding arthritis inflammation, CBD is actively marketed for a plethora of medical concerns, like ADHD, multiple sclerosis, chronic pain, as a multi-vitamin, for blood pressure, hormone regulation, even PTSD. Most people don’t care whether indiscriminate use blurs previous medical boundaries, more an increased ability to control personal wellness programs being an easily followed path.

How does CBD affect the body?

In an absolute bottom line report from WHO (World Health Organization), they stated that “In humans, CBD exhibits no effects indicative of any abuse or dependence potential,” which is a positive, 180 degree alternative to the opioids addiction crisis.

While everyone knows they have a central nervous system (right?), you may not be cognizant of your endocannabinoid system (ECS), which is something that will be constantly referenced in everything you read about CBD. I’ll suggest this as a starting point to learn about its important physical regulatory roles.

Pain management, as a sleep aid, and anxiety are high priorities, and negatives like 60,000-plus deaths a year from opioids compared to essentially none to date for CBD oil is not just something you missed on the news.

Bioavailability

After a friend asked, “Whats the best way to take it?” I suggested sub-lingually, meaning under the tongue, because outside of vaping – which has taken a fairly harsh hit (sorry…) recently – that provides the greatest payoff with dosage.

Using a 25 mg capsule as a standard dose, swallowing the capsule or gummie means it has to go through the liver for processing, and only about 6% of that is “available” in the bloodstream when all is done. Vaping gets 50-60% of that 25 mg. sample (about 15 mg) into the blood stream because of the surface area the inhaled vape is exposed to in the lungs.

The mouth is a large mucous gland, and holding the tincture in there for even 30 seconds allows absorption of up to 40% (10 mg) bioavailability, even though swallowing it still means it goes through the liver.

Topicals are a simple and effective use of CBD. While very little of the rubbed on content gets absorbed into the blood system, the “magic” in the application is that its already where its needed. While a 750 mg. 4-oz. tube (ie- Recover) is mathematically 190 mgs. per ounce, “liberal application” for a knee or muscle strain is noticeably helpful without using anywhere near that amount.

Dosing is something that has to be figured out. There is no RDA (required daily allowance) for CBD, or any height-weight algorithm for mgs. There is also a caveat about CBD oil and drug interaction, specifically being a “competitive inhibitor” with the CYP450 (cytochrome) liver enzyme, which metabolizes 60-80% of the meds that Americans take.

The “dog in the manger” example works here: The CBD and CYP450 enzymes deactivate each other, so the CYP450 enzymes in your system doesn’t break down the meds and make them release the benefits they’re supposed to in a timely manner. The “dog” (CBD) can’t eat the hay in the manger, but it doesn’t let the “cow” (CYP450) get to it either.

If you’ve heard an older aunt or family friend complain about not being able to enjoy grapefruit from their tree because of an interference with medications, this is probably what they mean.

Stress relief, pain management

Doctors still don’t get much training with CBD or natural cures; in 2016, only 13 percent of U.S. medical school did any kind of training.

“Anxiety” is a consideration that ranks very high for users, and how the ECS receptors are turned on by CBD to mitigate this area is worth reading about. While there is a significant amount of anecdotal information about relief on many, many fronts, pain management may be crucial as a “Quality of Life” concern, because CBD “amps” efficacy of other meds, which when known, can help reduce dosage levels.

All the hoo-ha over infusion of CBD (not legal according to FDA), its status as a nutritional supplement, or whether Boomers are going to turn its ability to “chill” situations across a range of what historically required ‘real’ pharmaceuticals, is still in growth stage.

Like CBD’s well-known THC “brother from the sativa mother” though, if it works so nice, maybe try it twice.

Take breaks to renew your mojo -Panthers pre-season, golf, a Sat. BBQ with pool

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This is actually the White Water Center, but the sense of easy going ambiance shouldn’t be lost, although of course it could become dramatically different. We didn’t live in fear after 9/11, we can’t allow that now.

Having done a quantity of “leadership thought” pieces recently, I also commented about how *a mother grizzly with cubs* – historically a kiss-your-ass goodbye! moment to avoid – treated the guy who saved her cubs better than Trumpster could hold it together for ten minutes into flight after visiting a hospital in Dayton.

Apples to apples comparison, one of those two did an excellent job with their PR.

In the week since those slaughters in Dayton and El Paso, TX, the over-whelming support for SOMETHING to change – by like 94% of everybody – has provided common cause, perhaps on the level of the Vietnam War protests I remember. That the recent violence was directed so specifically, that doesn’t represent the world I grew up in, so I and others will raise ours voices against it.

Does it feel like more jawing coming? Because while the NRA has clearly spoken to the Prez directly about their paid-for feelings, can even “Moscow Mitch” hold up something basic like background checks? How can this gun-racism tie in, after 18 months of barrage, still be inadequate to creating legislative changes? 

We are indeed in stressful times, and while I was pre-occupied with becoming my mother’s primary care person two memorable Valentine’s Day ago, the slaughter at Stoneman-Douglas HS raised the guns- school shootings profile to a national awareness of ENOUGH!  As individuals frequently expressed over BBQ and beers this weekend, there’s an expectation that its time to wrestle with that bear, as long as its getting shoved in our faces anyway.

UGANDA is issuing travel advisories for *their* people going to the United States, in light of constant gunfire in US.  How’s that square with “winning,” our vaunted sense of superiority?

It’s not just amplified jive from the bots, or is it?

Rep. Nadler says this IS what impeachment proceedings look like, that its a process, whether anyone believes they’ve poked strongly enough to move a monumental effort through the courts or not. This is something to be hopeful about. We have the history of Watergate, a defining moment many others – first time voters, post Nixon –  political learning curves rely on, too. Yes, I became part of that huge increase in journalism majors in the late Seventies.

This is where many stop – “There’s nothing I can do”

“Don’t sweat those things you can’t affect,” or maybe the common “Stay in your lane, bro,” begs the question of how much caring and worrying we should individually and collectively give. Was it Covey who suggested we wasted an awful lot of time/energy worrying about events that – 95% of the time – either never come to pass, or will happen in spite of anything we can do?

That doesn’t mean you completely crap out on paying attention though. IMHO, you still have to call out what’s on the other side of Decency or Right (as in correct) line, and yes, results come from changing those things you can actually affect. Since Day One, I expected that the media would need to keep hot, bright, continuous lights on what this administration will go down in history as being, and 2018 was proof of that.

While its stunning that the graft-riddled Trump Administration is still afloat, we can still hope to make certain necessary changes in bringing back our national mojo. Calling for that mojo thing isn’t just a Woodstock flashback – and its really been 50 years since the ‘Miracle Mets’ and Tom Terrific and landing on the moon? –  but this isn’t the time for Boomers to go quietly into that good night.

Social Security is NOT an entitlement program, its a payoff I’ve built up since that first inside job at sixteen, when I asked, “What’s FICA?”

This isn’t the time for Boomers to go quietly into that good night.

With all due gravity to everyone affected – and the cannery workers round-up designed to incite greater fears as a chaser – I’m glad to watch a Panthers preseason game, have a chance to whack a pretty good bucket of golf balls, and be invited to a ribs + beers gathering with neighbors and their young and college age children on Saturday to gird myself for “More.”

Pace yourself, America

I acknowledge feeling safe there, although such a scene is as ripe as any other gathering for violent changes. Yes, should the worst happen at some point, “A good guy with a gun,” showing up like NRA/GOP always exclaims would be welcome.

Counting on Wonder Woman to deflect ordinance is a fallacy, but we’ve been closer to  putting some brakes on assault weapon killings before – and it worked, remember?20190630_141650

As we consumed saucy ribs, with intelligent persons representing a variety of nationalities and ages, my interviewer gene was tickled: So excellent to hear what our acquaintances FEEL on various topics instead of hearing cable TV percentages. It was gratifying to recognize the free flow of discourse compared to naysaying, negativity, and dogmatic reactions that often lower conversations with ‘others.’

The women I spoke with – that demographic everyone recognizes brings victory – I *never* heard anyone mention Hillary, and Trump won’t get their votes either.

There’s no denying the experts saying its going to be loud and bad right through Election Day next November, but I also relaxed, because I unplugged from political analysis from Thursday-Sunday.

Nicole Wallace’s DEADLINE: White House and Brian William’s 11th Hour have been my standards, they don’t do “alternative facts.” Williams’ humor and precise, well-articulated questions of experts is still the standard to hold high regarding the power of the free press. I respect Wallace because she was in the Bush White House on 9/11, and she KNOWS what disarray with staff and a national emergency both look like for real.

Like the soaps opera manipulations your friends used to fill you in about in college, you can miss a couple episodes with politics and pick things up quick in a 24/7 news cycle. Oh, Epstein committed suicide? What a surprise, but Barr is starting a probe…

You’re gonna have to pace yourself, America. Mueller’s report wasn’t as great a “movie” as many hoped, but I’ll support the on-going, Watergate-style job designated for Congress 243 years ago; ICE bullying and savage malfeasance, unqualified clowns considered for high positions, its more anxiety than CBD oil should be called on to negate.

Becoming my Mom’s primary care person that Valentines Day shooting, can you believe we’ve gotten to THIS POINT, again, in 18 months?  Standing on “Moscow Mitch’s” feet of lead in the Senate, that’s a significant, well-defined desire by the many.

Periodically unplugging and stopping to smell any flowers, really, watch ANY high school football game, or having ribs and beers with neighbors, that contemplation of peace and joy we praise in the Constitution is out there, keep pushing for a piece of peace.

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My Christmas Wish for Knee–Bazinga! In 32nd year of Christmas trees, you go guys!

When I mentioned a Christmas Wish on timing of long-time necessary knee replacement– because who know’s what health care will look like in 2018?– it was an acute surprise when scheduler said two cancellations would mean I could have surgery the following Monday, at least if I wanted friend and highly-regarded ‘cutter’, Dr. Robert McBride.

Doc is exactly who everyone should want in such situations, you immediately know where you stand. Its cool that he comes to our Christmas tree lot and does the sales thing: just one of the guys.  This  is our clubs biggest fundraiser of the year.

After six years of very gimpy knee, I’d set this year– at age 60, and in better than average physical shape– as the time to be ‘physically whole’  again in my mind. To be rehabbing a week later AND not being $1000s in debt, was only possible by ACA coverage through Blue Cross-Blue Shield.

The speed of x-ray appointment on Tuesday and ability to be rehabbing a week later was only made possible by ACA coverage through Blue Cross-Blue Shield. Give a shout out to those people, everything I needed to overcome two major physical problems, they handled it, like this life-changing new knee and after a bicycle accident two Memorial Days ago.

That accident would have been nearly $6800 in emergency assistance, and it came down to my $100 deductible plus $325 worth of ambulance. Getting crunched on a bike path isn’t even a consideration for many young-healthy people. Even under generous terms of ACA, they often see buying health care as something they might not use, so they rely on bad luck staying clear of them. That’s kinda called ‘skating’,  and  you should be considering  buying vs. alternative of NOT being all lucky.

How thankful am I NOT to be many thousands of dollars in debt from two bumps in the road, here at Christmas? Surgery meant losing last two weeks of temp assignment at UPS, but even overtime rates wouldn’t create better economics than my DOING IT NOW with surgery. I’m going to my 2nd PT session tomorrow, first session with physical therapist was about basic exercises to keep blood clots from forming.  I’ve heard about, and am not tingling with anticipation of constipation from oxy-whatever meds.

Everyone knows I’m going for surgery– at least 1/2 dozen in our club have used ‘Doc’ and nothing but praise. The next two weeks will likely be pain filled, because PT is about *getting you walking*, and they base their Success on getting that done. I’ve always been a good patient– Good, not ‘great’. In earlier times, I played in a rugby tournament five weeks after earlier injury– doc had said ‘at least 4 weeks’. The first time I tried a fake punt move, my knee buckled on me: 9:10, done for the day. I’m thinking more of the freedom to do whatever I used to choose now, nice for the walk vs. skip across street so I don’t get run over.

On Saturday our Men’s Club decided to extend the sale, and these guys are the troops. Do I feel guilty at not being there down the stretch for our 32nd year in tree selling? Not a problem– these are cagey veterans, they know about making decisions. They take pride in finishing off the event, I believe they won’t leave extra dollars around.  Of course, the knee is the culprit, but that’s changing as we write.

Lastly, at the end of November I submitted just over 50,000 words to NaNoRiMo, which they consider having written a book. I’m already several sessions  into editing for the follow up book about Marlena the Magnificent, ‘With Platinum Warrior Focus’.  Nailing  the sequel while working over-night shifts and an epic family Thanksgiving, I’ll take credit for the W because it was a goal, clearly 100% earned.  I’ve promised myself this won’t get tucked under my bed for three years like before.

Lots of social events coming, I’m looking forward to walking around to every one of them.