How Do You Begin...Again?

July 2011 with my 2 boys and my baby girl

Sorry I'm late to the party. But allow me to explain myself. You see, I sit and stare. I stare at the blank screen. The cursor flashes at me like a red light at an intersection in a small midwestern town at 3 in the morning. I’ve got my hands gripped tightly on the wheel, there’s not a soul to be seen and yet I don’t make a move. I watch the tumbleweed roll across the intersection, but I’m paralyzed. As I stare at the cursor I am convinced I can hear it tic and toc like an old grandfather clock reminding me that time is passing me by. Eventually, it is as if the cursor speaks to me in short bursts in rhythm with it’s flashing. At first, with encouragement, “C’mon, let’s go.” “You can do this.” Then with a tone of irritation, “You agreed to do this, the boys are counting on you.” Finally, I hear the drill sergeant “Get off your ass and get started!” “LET’S GO!” I try to make the connection between my head, my heart, my fingers and the keyboard, but I just sit and stare. My wife, my kids, the cat, even the four 1 week old kittens we are fostering and bottle feeding (don’t ask) are asleep. Finally, I slowly push down on the gas pedal, I try to type, I try to express myself, but I cannot get this unrelenting mantra out of my head. It is marching around my brain like a goose-stepping fascist military parade “How do you start? Where do you begin?” “Where do you begin? How do you start?” And then it hits me. “Maybe I don’t want to start?” I have tried to start this blog nearly a half a dozen times and I failed. I could give you a laundry list of reasons why I haven’t written my introduction. But maybe the honest truth is that it is easier to sit here, stare and do nothing. You see I am not just starting, I am starting again.

I am a 37-year-old husband and father of 3 living in Boston (yup home to the granddaddy of them all, this year’s 150^th running of the Boston Marathon). I have struggled with my weight my whole life, spending most of it straddling the fence between overweight and obese. Like most people who struggle with obesity my weight has gone up and down more than the price of gas. But also like the price of gas, despite the ups and downs, the trend was clearly upward. I am a veterinarian. Actually, I am a veterinary cardiologist (yes that’s right a dog and cat heart doc) and I spent the most potentially athletic years of my life (18-30) in college, veterinary school, an internship and residency. At the time, I felt as though I had no money to eat well and no time for exercise. As a working husband and father of three little ones, I now understand that I actually had plenty of time to exercise and enough resources to eat well. But it is what it is, I am where I am now and I cannot change the past. I really started to pack on the pounds during my residency in veterinary cardiology at the Animal Medical Center in New York City (2001-2004). Yup, NYC, home of the Macy’s Thanksgiving Day Parade. With each passing year I looked more and more like the blimps that floated through Times Square on the 3^rd Thursday of each November. I left the residency and NYC in 2004 for the suburbs in NJ. My wife gave birth to our baby girl in 2004. We ultimately moved back to my wife’s hometown – Boston, MA – in 2007.

June 2008

When I began my first “real job” after my residency at the age of 30, I was working hard, yes, but there was plenty of time for exercise. But much like this blog post, I didn’t know where to begin. I felt like Jane from the Jane’s Addiction song “Jane Says” “I’m gonna start tomorrow / I’m gonna kick tomorrow / Gonna kick tomorrow.” I was Jane and my addition was food. With the constant over eating and absolute lack of exercise, I was being walked ever so slowly to an early grave. It may have been a longer walk than the inmates on death row, but there is no question I was a dead man walking. The “Tomorrow” Jane speaks of finally came in January of 2009. This is when I had my moment of enlightenment, my moment of clarity.

January 2009, 270lbs of love! Ugh.

My wife has a wonderful memory and remembers so many details from her past, I, on the other hand do not. My wife remembers the color of shirt she wore on the 4^th day of 3^rd grade. I cannot remember what I ate for dinner last night. But I will remember this moment for the all eternity. I was in the YMCA locker room just finishing “open swim” with my then 5-year-old daughter, 3 and 1 year old sons. As we were changing I caught a truly unflattering view of myself in the mirror and I literally thought, “Oh, my God. Is that really what I look like?” I avoided looking in mirrors as much as possible during those years, but I could not escape this image. I was obese and horribly unfit. I had a BMI of 36, I touched 270lbs on the scale and I was so sad with what had become of me.

That moment changed me forever. It was if someone had given me truth serum. I saw myself for what I was. I could see my world more clearly than ever. It had taken me 34 years to get there, but I finally realized that the winds of change were here. I had run out of excuses and now was time for a change. So I began to make more healthful food choices, I counted my calories and I started walking and exercising on the elliptical. Then eventually I began a run:walk routine (inspired by the ever amazing and gracious Jeff Galloway). Even though I had finally started to make a change, it was clear that it was not going to be easy. Going to the gym was always humbling and was often emotionally difficult. If you have ever been the “fat person” in the gym, you know what I mean. If you have not, count yourself fortunate. After about 3 weeks of exercise, I was on the treadmill and I kept catching this very attractive woman looking at me. At first I thought, “Hey, I’m making progress! ‘Looking good Billy Ray! Feeling good Louis!’ (“Trading Places” For those of you who missed it see video) I’m getting looks from the ladies!” Then I caught a glimpse of myself again in the dreaded mirror and quickly realized that I looked horrible. I was struggling and it looked like I was one French fry away from cardiac arrest. I realized the only reason the woman was staring at me was to try and figure out at just what moment should she call 911. Nonetheless, I persevered. I had the wonderful support of my wife and family. I continued to make progress. I started to participate in some local races. I walk/ran a local 5 miler, then my wife and I ran the Goffstown 5 miler in NH. 

Goffstown Gallop 5miler Summer 2009

Cailin and Josh Jan 2010 at 26.0 miles WDW Marathon

This was where we met our friends and AllEars Teammates Mike Scopa and Michelle Scribner-MacLean (Team AllEars is a team of people who compete in races during the Walt Disney World marathon weekend while raising money for breast cancer). At this point, I had my sights set on the Walt Disney World Marathon in Jan of 2010. Despite some orthopedic setbacks, my wife and I ran:walked the Walt Disney World marathon in Jan 2010 as part of Team AllEars. The WDW marathon was the race that fortified my addiction for endurance events.

Summer 2010 Boston Urban Epic Sprint Tri

Cailin, myself, JP and Jen after the Half WDW Marathon Weekend 2011

I won’t bore you with the details, but 2010 was a great year. I trained for and ran the Vermont City Marathon in Burlington, VT. In the summer I started training with the great Coach Jeff from Team PRSfit. I had a terrific summer. Coach Jeff guided me through the Falmouth Road Race, a couple of sprint and a couple of Olympic Distance triathlons. I was losing weight and gaining fitness. Mentally I was beginning to feel like an endurance athlete. I, “the slow fat kid”, was becoming an endurance athlete! I was having a great year and decided to train for the 2011 Disney’s Goofy Challenge – the half marathon on Saturday and the full marathon on Sunday. Again I did this as part of the wonderful Team AllEars. My wife ran the half marathon that weekend and I ran most of the half marathon with my closest of friends JP and Jen. I had a minor orthopedic setup back during the half, but I was able to run the full with great friends Dominic and Stan from Team AllEars and had the time of my life. During the full marathon, my wife was the best Sherpa! She always found me out on the course when I needed her most - a bottle of Hammer sports drink here, a banana there, a gel just when I needed it. She was my savior. Despite the distance (39.3mi in 48hrs), I can honestly say it was the greatest sense of accomplishment I have had as an endurance athlete.

Jamison and Josh Post Goofy WDW 2011

The 2010 racing season had ended on such a high note with the 2011 Goofy challenge and I was so excited to run Goofy again in 2012. But it was not to be. After Disney’s marathon weekend I began to focus on the upcoming summer tri season. I had thrown my hat into the ring for a June ½ iron distance tri (70.3mi). But while on vacation in Mexico in Feb 2011, it all came to a screeching halt. Everything I had gained I was about to lose and I never saw it coming. I was blind-sided. I herniated a disc in my back (L4-L5 on the right). I would spend the next 6 months on the sidelines trying to recover. Everyday was painful. There were times throughout each day when the pain was tolerable and other times during the day when I would have rather had my leg amputated. The pain was often immense. Most days, I could not make it through the shower without being in tears by the end. Standing and walking was tortuous.

So I tried to get well. I rested, I went to physical therapy, I did acupuncture, I went to see the chiropractor, and I had 3 steroid injections in my back. Nothing helped. So I ultimately ended up in the surgeon’s office. We scheduled the surgery for Aug 1 at 8am. I was so unbelievably scared of the anesthesia, the risks of surgery, everything. I was petrified. But I knew in my heart this was the right choice. I was put under general anesthesia and when I awoke, I was told everything went very well and that I should make a full recovery. The rest of that day I was on some great pain medications and I was euphoric. Fourteen hours after surgery they finally let me stand up. I was so excited. I even tweeted “I’m about to take my first steps in training for my 70.3!” But as soon as I stood up, I had the EXACT same radiating pain down my right leg that had me so incapacitated the months prior. The resident assured me that this was not that unusual “post-operative swelling/edema and inflammation” he said. But the pain persisted 1 day after surgery, 1 week after surgery, 2 weeks after surgery. At the recheck all the surgeon could say was, “Well, that was unexpected” The follow-up MRI demonstrated that my lesion had not changed! The disc was not fixed, the herniation was still present. I still had an anatomic reason for my pain! Another steroid epidural did very little. My surgeon clearly wanted nothing to do with me and he did not want to take me back to surgery. He told me there was nothing else to do but give it time and consider a spinal fusion in 4-6 months. Spinal fusion? When there was still a herniated disk present on the MRI? I couldn’t understand. I had 2 other “spinal physicians” tell me off the record that it looked like I needed another surgery. So I found another surgeon, a kind and compassionate man. It took me nearly 3 months to get an appointment and by the time I went into his office, I was in such extreme pain, I could not sit still for the physical exam, the repeat MRI or the 5^th epidural steroid injection. I was in so much pain, I would have opted for partial paralysis if it meant they could make my pain go away. 

So 12 weeks after the 1^st surgery, I was back in the hospital for round 2. Again, surgery and anesthesia went very well. In recovery, I was 100% pain free. A feeling I had not had in over 10 months. It was as if someone had turned off the pain switch. I went home and was as happy as could be. Unbeknownst to me, it was still not over. 1 week after discharge from the hospital, I developed the worst headaches I have ever had. Upon standing, I would become uncontrollably nauseated. Within 30 seconds of being upright, I’d want to vomit. I’d go back to a prone position and the headaches would resolve. Another MRI revealed I had a torn dura and I was leaking CSF (cerebrospinal fluid - the fluid that surrounds and coats your spine and brain). This is a reported complication of the surgery. But it is reported in less than 0.5% of all disc surgeries. The CSF was leaking into the muscles and subcutaneous tissue around my incision. I had a palpable bump on my back over the sight of the incision. So back again to surgery we went. The day before Thanksgiving, I was taken back to surgery to repair the leak. Upon waking from the anesthesia, the headaches were gone.  I was finally on the path to recovery. The next day was Thanksgiving and, hospital food and all, I had never been never so thankful.

This is the palpable bump on my back from all the fluid.

It has been 4 months since my last surgery. I was told to wait 6 weeks before starting physical therapy. I started going to physical therapy in January, but honestly it was very difficult to make the time (3 hours a day 3 times a week). Business and family were very busy which made my visits inconsistent at best. Then we went away to Mexico again in February and I have not been back to PT since. The reasons I have stated for not going to PT are just excuses and I know that. The real reason is that it is hard, both physically and emotionally. Under the best of circumstances, it is painstakingly difficult to begin. I am finding out now, that it is even more difficult to begin again. I understand the work that is ahead of me in order to gain back my fitness and to lose the weight. I understand this now better than I did 3 years ago when I first began my journey. Yesterday I weighed in at 227 lbs. Although this is a far cry from the 270 I saw 3 years ago, it is still a flabby 21 lbs heavier than I was when I ran the Goofy Challenge a year ago. Having an understanding of the work I have to put in is overwhelming. It is paralyzing. I sit and stare at my calendar. I am once again Jane, “I’m gonna kick tomorrow.” But this time it’s different.

Post op 2011.  I've gotta long ways to go, but I'm ready.

Because I had the ability to swim, bike and run, taken away from me for over a year, I now understand how truly special it is. I understand the pain and frustration of the thousands of injured endurance athletes that would give anything to swim, bike and run, but due to circumstances beyond their control, they cannot. I know there are millions of permanently disabled people around the world who would trade all of their worldly possessions just to be able to walk down the street. I know there are millions of people who are weakened by radiation therapy or nauseated from chemotherapy who pray that someday they will be able to walk to the bathroom without an IV full of anti-nausea medication. I’ve had 3 back surgeries in less than 4 months. But that is in the past and I’m done feeling sorry for myself. I understand that what I went through, although tough, pales in comparison to the struggles of many. On Friday, I found out my mother has been diagnosed with breast cancer. She will be 61 in May and I cannot begin to imagine what she is going through emotionally and what will lie ahead of her physically. She has already fought and beaten lymphoma when she was in her 20s. But unfortunately the radiation therapy she had for the lymphoma left her with a predisposition for breast cancer. She is just at the beginning of her journey and we do not know what her treatment options are. While we do not know specifically what the treatments will be, there will be days, I am sure, when she will be exhausted from her treatments. There will be many a day I know when she will be emotionally spent. There will be days when she will want to go for a walk, but cannot. I may not be able to do the things I used to do 14 months ago, but I will not waste my second chance at health. I will do my PT for my mother. I will train and race for her. The time has come to begin again. I will swim, bike and run for all of those who cannot. My name is Josh and I am a triathlete and a marathoner, but I am just beginning…again.

Please join me and my friends on this blog and following our journeys.