PowerMill fitness tests

Just over 1 year since being hospitalised, I'm back in the gym preparing for a family ski holiday. Having had 6 months completely booze free whilst I was on the Warfarin and recovering I must say I felt pretty good and was looking forward to getting back to normality.

In Sept / Oct, I ended up doing very little exercise and in November I ended up flying 3 weeks out of 4. In December I enjoyed the festivities as usual and in January I'm back up to 90kg and feeling like shit. Fitness levels have plummeted dramatically, apple watch VO2 max score dipped back down below 40 and I'm not sleeping well - had a cold that seemed to go on forever and the drip into the back of my throat when I was lying down nearly drowning me, despite it being almost unnoticeable when I was up & about.

Only one thing to do, get back in the saddle. Build up the legs with squats and lunges and get some cardio done.

Up until now I've had treated Cardio machine fitness test assessments with some skepticism, as I don't think I've ever scored less than well above average - even when I've felt distinctly average. First effort on the Powermill and you enter usual, age, weight etc and then a estimated fitness level between 1-20. I thought less than half is about right so went with 9. Managed to do 2 minutes 37 seconds, before the machine stopped the test - seems like it didn't like when my pulse went above 157...

2nd time, I tought I'd better go conservative, so set the Fitness level to 2. Felt like it was barely moving, completed the test, but score was 0 - Very low...

3rd time, I'm not sure what's going on, but if I increase the fitness level at least this might count as a warm up, so increased to 4. Score 10 - Very Low

4th time, Tried fitness level=5, felt like a nice warm-up actually. Score 10 - Very Low.

OK, so probably need to use FItness level 5, maybe 6 and see how it goes. Very Low - Things can only get better !

EU health care - true story

Bit of a strange one, but here we go. I am now on long term, prophylactic, anti-coagulation medication. I take 2.5mg of Apixaban twice per day to prevent the reoccurrence of potentially fatal blood clots. I've been pretty well disciplined in my medications since being hospitalised with this condition, but as a result of some catastrophic preparation, I found myself arriving in Hamburg yesterday afternoon for a 4 day workshop without my medicine.

Calm head required, My first thought was that I should get to a pharmacy and simply buy the drug, I doubt that's possible in Germany - they tend to be quite strict about these kinds of things, but lets see how that goes.

I started to google the cost of the drug in question using my phone in the taxi, expecting that I might be getting hit for 40-50 Euros.

Shat myself... Immediately started thinking about whether I should just run the risk of going without.
Interesting topic that - can you afford to go without life saving medication, food, water, shelter???? Indeed, why do progressive governments think that medication should be available to all as a matter of priority?

Anyway, there was the worst case scenario, maybe up to 500 Euros as a reminder not to be a twat, or possibly just die and avoid any embarrassment...

At 17:40 I presented myself at an Apotheke to explain in my very unreliable German the situation I was in. Massively in my favour was the fact that the drug comes with a wallet card explaining your status and dosage, however it's still a prescription drug in Germany - in the UK, for some drugs it is possible that a pharmacist can offer a short term fix in emergency situations. Through some limited conversation with the Phamarcist, I learned that it was exactly as the case in the UK, this was a prescription only drug, but no emergency procedures available to me. She kindly directed me to the nearest Medical practice, thankfully on other side of the road, where after some form filling and presentation of my EHIC (thankfully having taken time to put my 'Patient Alert card' in my wallet, I also remembered to pack my European Health Insurance Card) I was invited to sit in the waiting room. A few more laughs with the receptionist and I found myself meeting Dr. Maas who very quickly produced a prescription - No Charge!

Rushed down to the Pharmacy at 18:20, with it closing at 18:30. Presented the script only to be told it wasn't in stock. So I raced down the street to the next pharmacy where I was also informed they would need to order the drug. "Shit!" thinks I, this place closes at 18:30 and I need to be in a workshop a long way from here at 08:30 tomorrow morning. But, lo, I've misunderstood, I just need to come back around 21:00 when the drug will have been delivered and the pharmacy will open for me if I have the correct papers - how do I get these I wonder? - she prints them for me - how much does it cost?  - 5 Euros please -  For the papers?  - Just for the drugs. - How much for the emergency Service? - What? - the emergency Service, how much? - we don't charge if you need medicine... - of course...

If I was English, I'd be asking my MPs what the fuck they think they're playing at?

Long term anti-coagullation

I finished a 6 month course of Warfarin therapy in July and honestly felt better than I have done in years. Besides the fact that I'd torn my hamstring, my cardiovascular fitness was returning and a lot of minor aches and pains I've endured over the last few years seemed to have disappeared. I was ecstatic and couldn't wait to get back to 'normal' living.

6 weeks later and having enjoyed a few weekend parties - my contemporaries all seem to be turning 50 this year - I really started to feel like I was heading back down the same road that led me to hospitalisation. Without having anything too specific, I simply wasn't feeling the same way that I had done. The only empirical evidence I have for this is that my apple watch estimated VO2 max dropped from 43 ml/(kg-min) to 38 ml/(kg-min) over a few days and stayed down at that level, having not been so low since I was just out of hospital.

With a bit more digging into my family history it's become very clear that there is an issue on our male side. I knew that we had suffered too many sudden young deaths, but I hadn't appreciated that other 'healthy' relatives had also suffered strokes too, so the basis on which I'd had my 'end of therapy' review was probably void.

Back to the doctor and one week of using even just a prophylactic anti-coagulant, I'm already feeling better again and the VO2 max score is climbing steadily once more.

I don't want to be on long term medication, but this is the right decision. Perhaps I was starting to clot again or perhaps it was psychosomatic? Perhaps starting to enjoy alcohol again is detrimental to my overall health and actually I now suffer week long hangovers? Perhaps the fact that I had not taken care to make sure I was getting a 30 minute daily walk done was a factor? In the end, the risks are a little bit too severe for my liking - take a wee pill every day or drop dead suddenly with the possibility of just having a heart attack or a stroke as the lighter alternatives. I'm on long term anti-coagulants now and my ambitions to train in Tae-Kwon-Do or play some masters rugby are parked.

UKCC Level 2 - Scottish Rugby

Accepting that my future involvement in rugby is much more likely to be from the sidelines, I embarked upon the Scottish Rugby UKCC Level 2 course with some like minded fellows down at Kilmarnock RFC last weekend.

First impressions are that the SRU have made a considerable investment into the support for coaches and coach development. 2 very fine rugby 'educators' were on hand to take us through some rudimentary rugby concepts and to understand the SRU blueprint. We discussed coaching techniques and how the SRU see the game being played from a top level down. The emphasis very much on Mini-Rugby being fun for all and Youth rugby being a developmental game; not one for coaches and clubs to simply hunt for trophy glory but for the much greater ideal of player capture, development and retention.

I have to say that the volume of resource available is incredible, almost daunting, but the Scottish rugby portal on Hive hosts a wonderful array of coaching video and self-learning cards for coaches.

Further to what the SRU have been up to World rugby also have created a 'passport' site where coaches can manage their learning, with superb resources for First-Aid training, Concussion management, Protecting rugby from gambling problems, coaching, officiating and generally understanding the game better. The passport site allows a coach to self-learn and work towards certificates, some of which are mandatory homework for the UKCC Level 2.

I've spent at least 12 hours doing online homework for this and will be back down at Kilmarnock on Sunday for another practical coaching session, where I will need to demonstrate that I've found a way to address the critique I received for last Sunday's practical session. I don't expect to fail, but my goodness I'm impressed with the level of detail in the course and the level to which we're expected to understand Strength & Conditioning, psychology and player development. It's a long way from the 3 laps around the pitch warmup and endless passing drills I endured as a kid.

Very impressed.

Hamstrung by stupidity

Fuck Fuck Fuckity Fucking Fuck!!!!!!

Was really starting to feel great. Genuinely benefitting from a wonderful break in Sardinia, chilling with the family, catching plenty of rays, dipping into the pool daily and even getting up for some early morning Body Balance - very cool class that is a mix of Yoga, Pilates & Callanetics with a very chilled out set of background tracks to work to. Doing it from a shelter just after sunrise looking out to sea added to the tranquility.

All of this tranquility and peace may explain why when the lovely Rachel asked if one of the parents could join in the football to even up the teams I reluctantly stuck my hand up and took my place in goals... Of course it could have been the tranquility, but it wasn't was it! Bloody stupid ego of a man who should know better is much closer to the truth... 2 stunning saves later and I'm dreaming of a comeback... Here they come... Change of direction, attempt at acceleration, foot slipping on uneven surface... Twang!

Just like that, another 6 weeks of rehab and the echoes of a doctor's voice in the distance reminding me that after 6 months rest, I shouldn't expect my body to be as it was before I was ill...

Fuck Fuck Fuckity Fucking Fuck!!!

6 Months later

Nice review meeting with a hospital consultant this morning. Under normal circumstances I think we would have just stopped the Warfarin, shook hands and parted our ways, but with the sudden death of my brother last year and no post-mortem, there remains a concern that this could be some genetic condition at play.

Warfarin days are over though, so that's the good news.

Next stage is to return to hospital in 4 weeks time, to allow system to be cleared of Warfarin, and get some more blood tests (D-Dimer) which will further inform the decision as to whether I need to adapt a prophylactic medical regime or can return to unmedicated status - which is my preferred option, of course.

Still, that been 6 months sans-alcohol. I've not really missed it to be honest, and with my new found knowledge of Alcohol-free beers, could this become a lifestyle choice???

Regrets... I’ve had a few

5 months since being hospitalised with Multi-Focal Pulmonary Emboli I’m back into an exercise program. I left hospital bursting with vim & vigour and was somewhat surprised when the Doctor insisted that I take 3 weeks off work then a staged return to work. I really couldn’t believe I was that ill... Actually if you’d told me 2 months earlier I might have believed you, but by the time we realised what was wrong the blog clot was splitting and I’m eternally grateful that the fragments lodged in fairly benign places rather than taking the opportunities for mischief that they had.

It didn’t take long for it to sink in though that there had been a significant hit on my health. Everyday life was wearying - possibly a wee bit psychology involved in that too? Up in the morning and ready to take on the day very quickly dulled into tired afternoons. I tried to lose some weight and took to walking, which was wonderful. For some reason Spring came to Scotland exceedingly early this year, February was fabulous and I made the most of it. The outcome of which was that I quickly escalated my walks too much and ended up with a spot of Plantar Fasciitis.

Regret 1 - Should have invested in better shoes for walking.

For all that the heel pain of P.F. Makes the mornings a bit miserable, it’s actually fine once you’re up and about and just requires a bit of stretching and taking care of your feet - I had the time, so no problem.

Having previously played rugby for too many years, I have a few wee niggles here and there that will always be with me. I’m missing a ligament in my shoulder that means I need to keep it conditioned so that the muscles provide the necessary stability. Those muscles have a habit of atrophying more quickly than the others and if I don’t maintain it, I end up with an unstable and painful shoulder. It really doesn’t take much to maintain them either, but as I was in complete rest, I didn’t...

Regret 2 - Should have added a daily movement routine to my schedule. Just running the joints through a sequence of moves designed to ensure the stability was maintained. No need to view it or manage it as ‘exercise’; no need to get tired or stressed (physically) by it, just keep things ticking over by moving those joints, maybe even tai-chi style... think that's what I might recommend rather than anything even as stressful as Yoga.

Regret 3 - Whilst doing that sequence of joint mobility exercises should have introduced some moves to make me less right sided. See the above comment on tai-chi, damn! Should have thought of that, it always seemed a bit of a weird thing to be doing, but actually kicking myself now that I didn't do that.

The move I’m using just now to return my shoulder to form is a bit like Saturday night Fever dance move. The Physio calls it ‘drawing sword from scabbard’ but I’m definitely more John Travolta than Braveheart, so ‘Staying Alive’ it is. She’s given me one of those rubber bands to add resistance, but honestly, just doing the move on it’s own and twisting the hand at the end so that the palm faces upwards is enough.

See a video version of it here

Most of the problems I had with it in the first instance I’m sure are to do with the fact that my brain didn’t know which order the muscles should be firing in. Getting there though.

Regret 4 - See all of above but apply it to the left knee, which is only slightly less damaged than the left shoulder

Regret 5 - Should have learned to juggle

Regret 6 - Should have played more guitar

Regret 7 - Didn’t make enough use of my Busuu account to practise languages

Regret 8 - Should have played more guitar

But here we are. Nothing to be done about what I didn’t do. I’m now back on the machines at the gym (cross trainer is nice and easy, rowing machine a brute) and I’ve been in the pool getting a few lengths done, so we're well on the way to recovery.

In the interest of balance, I don't regret stopping the booze for the last 5 months. It was pretty easy for the first couple of months as I felt so shitty anyway. After that it just seemed to come down to reminding myself that I didn't drink when people offered - which is more difficult than you might imagine, but with the negative impact of a bang on the head when on Warfarin, the internal debate doesn't take long to reach a conclusion.