Rawhide Part One

Skin infection on residual

A couple of weeks before Memorial Day weekend I noticed a red spot forming along the incision line on the front of my residual. I am very conscientious about keeping my liners clean, using antibacterial soap, and immediately attending to any skin issues like the occasional pinched skin break. This wasn't an abrasion, so I knew I had to be careful.

"Good good good lookin' out our back door" (S&L Photography)

We had been to Devil's Fork State Park where Jennifer had grabbed a great deal for a villa by staying up to midnight earlier in the year to snag it. We had a restful weekend, and did a little hiking at Oconee Station to Station Cove Falls. It was rather warm though not yet as hot as will be in another month. With my new walking prosthesis and the Renegade AT foot, I was enjoying the ease I could traverse the hills and uneven ground. With my old arthritic ankle, I could have not done this without a great deal of pain if at all; now I look for roots and rocks to walk over it because it does not hurt anymore. I never get tired of doing this!

Station Cove Falls (S&L Photography)

Anyhow I was sweating in my liner, not unusual and less than I have in the past, but still not the best environment for what was already starting on my skin. Despite applying a topical antibiotic to the spot, it continued to get bigger, and more red spots radiated from it. Follicultis? When we got home I noted things were degenerating, and was able to see my MD on Tuesday afternoon. He treated my previous infection with an antibiotic that quickly cleared it up; this time he used a different one that I began that evening.

I continued to run, not wanting to lose the microscopic fitness gains I have made since my knee surgery. This is obviously slowing the healing process so I am taking time off until the infection clears up. I'm also looking into changing my cleaning protocol, sterilizing my liners more often, and asking my amp running friends what they do to help prevent the problem from occurring in the first place. I don't want this to become a chronic condition or worse.

It is couch surfing season again, something I have done through my surgeries and other bumps in the road on this new running journey. I am hoping to heal in the next week as we have a race on June 14 at Charles Towne Landing. This is a Thursday evening event I choose because it could serve as a tempo run for me, since my racing speed, such as it is, will not return for many more months. With a few more workouts I should be able to run without someone mistaking me for a static park display.

Come to think of it, I ran my middle-aged PR at this location many years ago...it will be a nice reunion with the old me there, to see how far we have come and how far we will go. A little older, a little slower, but more thankful than ever, that...I...can...still...fly.

Red wing and all.

*******

Update: One of my CPs believe this may be fungal so some athlete's foot type medication may clear it up and be an excellent preventative.

The Greatest

The Heart of the Champion

I had known about the life of Jason Pisano for only weeks. And on a Tuesday morning, the first of May, I learned he had died the previous day, the result of a choking incident robbing his body of life. In so short of a time I feel I have lost a best friend, yet we never met; although I recently friended him on Facebook, we had not yet corresponded.

How brief, how fragile, how tenuous is our grip on life here. Indeed, a blink of an eye. Yet in this small speck of time, we are able to live, to love, to do.

"I run marathons not because I have Cerebral Palsy, but because I'm an athlete." 

- Jason Pisano

Bid me run, and I will strive with things impossible.

*******

Shortly after the 2012 Boston Marathon was in the books, I was looking for videos of the race when I came across the one below.* I watched it over and over and over, often having to stop, overcome by emotion. I then searched and watched a number of videos, along with discovering Jason and Team Pisano's blog here and website here.

* The video I originally linked to has been made private and therefore not accessible. So I am linking to a different one than the one I mentioned above. Sorry this was done but out of my control. This video below was done by Kim Gulko, a great friend and supporter of Jay's.

“A race is a work of art that people can look at and be affected in as many ways they're capable of understanding.”

 - Pre

I read all of the blog posts, following links and searching for tidbits of information. The more I learned, the higher the mountain of awe rose. I know what it is to run a marathon, as an able-bodied athlete and as a mobility impaired runner. Without this reference, it would have been nearly impossible to know the extent of his accomplishments. With it, I would learn the words Jay had tatted across his shoulders: Impossible Is Nothing.

I stopped - gutted as some say - recalling my own post of my second race as an amputee, when, as I began to struggle late in the race, these words came up from within: Nothing is impossible.

Nothing Is Impossible...Impossible Is Nothing

How I regret not meeting Jason in Hopkinton this year. Yet, had I been there, would I have the same understanding, more to the nature of enlightenment, as I do now?

It is a question that cannot be answered.

********

At Jay's first Boston, he was not allowed to finish the race. We all know the prejudice against women and how, only through courage and a bit of deceit, that was overcome. What Bobbi Gibb and  Kathrine Switzer would do for women, so would Jason help do for the disabled.

I have given much thought to Jason's initial Boston effort. At first I was deeply angered; angered and hurt because of the history of discrimination and denying him the crossing of the finish line. How could human beings treat other human beings so shabbily?

Jay was, by necessity, not choice, participating as a bandit. I never cared for those sorts as an able-bodied runner; usually these were jackasses too cheap to pay for a race entry fee, in effect stealing from those who paid for all of the race services.

Coming from the planet of the able-bodied, it could be understood why bandits must be escorted from the course. But after the black eye of sex discrimination, you would think that a disabled person, asking for entry, would at least be treated as a human being. Jason had little use of his arms, so the standard wheelchair divisions did not fit his disability. What he was wanted to do was...impossible.

With his friends being his dedicated guides:

'"...he started the race in Hopkinton, Mass., before sunup. He labored for 9.5 hours over the hilly, agonizing terrain but didn't complete the course -- not because he couldn't. ``They pulled me off the track a half-mile before the finish to let the lead runners go through and they wouldn't let me finish,'' Pisano says."'

"The BAA officials refused to recognize me for my accomplishment, but I felt great and fulfilled. The small crowd at the finish line cheered loudly. As Randy (Spellman) was helping me out of the racing chair and into my other chair, a race official came up to us and said, ``You are going to have to get out of here, only athletes are permitted in this area.'' When Randy tried to explain that I had just finished the race, he replied, ``Sure he did, buddy.'' We wanted to punch the guy in the face. I had just finished nine of the hardest hours of my life and I was not even recognized as an athlete. We decided that it wasn't worth it to let the guy ruin what I had accomplished, and we went home, but I knew that I would be back."

To be kind, I suppose the disbelief that Jay had run the marathon by pushing himself backwards in a wheelchair using only his left foot could be understood. In fact, that is the very thought we should understand. What he did was impossible. It could not be done. Get out of our race.

Impossible Is Nothing.

With the knowledge this athlete had done the impossible, an extraordinary amount of national attention and due respect was paid to Jay. I now know why one day I may run Boston as a mobility impaired athlete; also why there is an early start and a more inclusive qualifying time as well:

'"In 1995 you set your sights on the granddaddy of all marathons, The Boston Marathon. The Race Organizer refuses to give you an answer about your eligibility, as it has never been run “backwards.”

"WWJPD (What Would Jason Pisano Do?) Jason would “unofficially” run one of the hilliest courses in America with his own support team. The stir created by his accomplishment would lead to the creation of one of the most popular race classes in the Boston Marathon."'

From the Team Pisano blog, something for all of us to consider:

It makes you wonder what the purpose of the Boston Marathon is.

I understand that they want to limit the impact of the marathon on the towns along the route and also maintain their high qualification standards by keeping the race as short as possible, but the cost may be the very founding spirit of the marathon.

Legend says the when Pheidippides burst into the senate after his journey from Marathon to Athens, he exclaimed "Νενικήκαμεν", which translates to "We have won"."We have won", not "I have won". We.

There are maybe a handful of people of the many thousands that run a marathon with hopes of the fastest time, and so it must follow that the winning is - not who comes in first, but something all together different.

No light, no fanfare, no cheering, no banner awaited Pheidppides on that first of marathons. And so it is with Jason Pisano.

What is your message when you burst throguh the doors of the senate? The message that has driven you the long hard journey, step by step, driven through pain and suffering with only your will to keep you going?

I am a purist, an idealist, so I remain unmoved by the fanfare, the pomp and circumstance, the false and easy message of "I have won". It must be hard for people who carry that message to see Jason, so caught up in the "I", they see that they have no excuse for their whining, their complaining, or even perhaps they see their accomplishments are not so great as they believed them to be.

What they should see is that, yes, they don't have an excuse for whining and complaining. That what they've done is not all that it could be, that there are no limits.

That is the message of Pheidippides, of the Marathon, of Jason Pisano:"Νενικήκαμεν", WE have won.

*******

Pisano Strong

 

I have run a fraction of the number of marathons Jay has and only one as an amputee. Because of several issues, it took me nearly two hours longer than I had ever run before. It was hard. It was very hard. On that day I learned more about myself and my fellow last place finishers than I ever did a bit further up the ladder.

Jay ran with his arms bound so he would not accidentally strike another athlete. Think about that you upright runners. You can't wipe the sweat from your face or scratch an itch...or grab a cup of water or wave to a loved one in the crowd.

Jason's final Boston marathon took over 12 hours to complete. One foot, his left, shoving himself forward, his steady guides - his best friends, his true brothers-in-arms, kept him out of harm's way and on course. It is almost beyond comprehension, this magnificent display of the unbridled human spirit. How could any mortal man do such a thing, much less this spastic body moving a few feet or yards at a time with one foot?  

"Sure he did buddy."

Jay's racing was a thing of great beauty

Jay belongs on the winner's podium with the laurel wreath halo upon his head. He has done the impossible not once, but 52 times. Many, many men can run a sub 2:10 marathon. Yet who among them - or us - could take what would be a debilitating condition and, through the force of sheer will - create this miracle? Jason Pisano did, and he did so without complaint.

He did it with friends like Randy Spellman, who was his blood-brother. His beloved mother Michele Burdick, stepfather Ray, and grandmother Barbara Hindle-Pisano's support provided Jay with the guidance and inventive needs for his uncommon life. Jay dedicated what would be his final marathon to Barbara.

I put Jason Pisano's accomplishments among the greatest in any sport in history. I do not make that statement lightly. This man, this athlete, had the heart of a pure champion. Nothing could stop him except the very thing that will claim us all...as I write that I am still terribly touched by his loss, that I had not met him. I would have wanted to learn  from Jay; to share running tips and goals and dreams of what could be.

*******

I smile to dream that Sylvester Stallone might one day make a movie about Jay...to hear many of the Rocky themes and words echoing back through his life on the big screen, what a transcendental experience that would be.

*******

Way back, I read an article about Kelly Luckett, who I would later meet at the Getting2Tri camp and we would become friends. She mentioned someone who inspired her at Boston:

"But as inspiring as she is herself, Luckett was inspired in the Boston Marathon by another athlete, Jason Pisano, who has cerebral palsy. Luckett recalled, "Jason has completed several marathons, including many Bostons, by using his legs to push himself backwards in a wheelchair. I know how tough it is to run or even just walk those hills on the Boston course, so I can only imagine the training and perseverance he must have to push himself backwards up those hills!"

I had so hoped to be on the starting line of Boston this year, but that was not to be. And now I do not miss anything about the race other than not being able to help my friend Ashley Kurpiel and the IFOPA and, in a personal loss, missing meeting the greatest, the friend I would never know, Jay Pisano. Yet I know him now, and I believe others will come to see this brightest star, and in time I hope his legacy will be more widely known for what it is. 

For it is a life of impossible dreams, dreams that were reached not by a perfect human body but by one given impossible odds. Jason did not have courage; he was courage personified, and therefore the perfect athlete. Nothing on this living earth could stop him. He kept moving forward - citius, altius, fortius - toward that place where

Impossible Is Nothing.

Jason Pisano, January 25, 1972 - April 30, 2012

The Greatest.

Footnote: Boston did incorporate the Mobility Impaired Division the year following Jason's first race there. Someone knew what they were doing in setting up this category for those who would have never had the opportunity to participate in this historic race. We all make mistakes, it is how we make amends for them that matters. To those who helped bring this about, thank you for making a difference, and for understanding there are higher achievements to be reached while we may strive to do so in this life.

And where does the power come from, to see the race to its end? From within.

- Ian Charleson as Eric Liddell, Chariots of Fire 

Eric Liddell, Paris Olympics 1924

 

 

 

21661

While running with Jennifer on Friday, I mentioned I had received an email from my friend Bruce who passed along the weather forecast for Boston this Monday. At that time it was going to be 80oF, quite warm for a marathon, where most runners prefer something south of 55o. I can acclimate to hot weather, since our climate is semi-tropical, but I am a poor hot weather runner even when I am use to it.

I thought out loud something like: "Well, if the running gods did not want me to run this year because of the heat, they could have chosen some other method than taking a bat to my knee." After a laugh I thought about it some more, I wondered what worse things could have happened and decided the present detour may have been the best. None of my past marathons with the exception of Myrtle Beach were run in hot weather, and the MB race was more warm and humid than hot. If I was at Boston and caught up in the excitement would I be smart enough to take the newly offered deferment option and run next year? I doubt it. Seriously doubt it.

As I write this the forecast is 59/87. This could put many runners into the broiler of heatstroke; and being among the toughest marathoners on this planet most will not think of not running. No doubt the book "Duel in the Sun" will be on some minds when Salazar and Beardsley slugged it out in high temperatures. This video is just truly awesome:

One thing I can say with a high degree of certainty is that I should not have run Boston this year. Even if I had been able to do enough pool running or perhaps had access to an Alter-G treadmill to be fit enough, I do not believe it would have been a wise move on my part to run a marathon on my surgically reshaped knee joint after 10 weeks.

We runners are a driven lot, and some will simply not back off when it is imperative to do so. I've done my share of those knuckleheaded decisions; fortunately I don't recall making any terrible mistakes like trying to run on a stress fracture or pushing through the pain of a sprained ankle...although I did do the latter when playing some hoops in my youth. The only thing worse is encouraging others to push through such injuries, to me that is a crime against the spirit of this great sport.

*******

I have three friends running Boston on Monday. Many times I thought of how it would feel to stand on the starting line with them, wearing bib number 21661, in a surreal world exceeding any dreams I ever had of running.

These friends are Kelly Luckett, Shariff Abdullah, and Scott Rigsby. They did the work to get themselves to the starting line. This will be Kelly's eighth Boston Marathon, a tremendous achievement for any runner, but on a prosthesis I can attest this is far beyond the norm. This diminutive runner is nothing but the will to persevere; her husband Brian is a talented ultrarunner as well and we are richer for knowing them.

Shariff, aka the Singapore Blade Runner (SBR), will be the first person from his country running in the MI classification. I met SBR through Facebook, and I so wanted to greet him in person at Boston. Today I awoke to this post of his:

At RPC on Friday evening and collected the number bib 21663; Race Date: Monday 16 April 2012 at 9am in USA Boston (9pm Singapore) I, Kelly Luckett and Scott Rigsby will be running the MI category and we will start the first wave to inspire the World.

We will dedicate this run to bro Richard Blalock. Wish you are here. — in Boston, MA.

Later I heard from Scott:

Very excited about heading to Boston. Wishing my good buddy and fellow amputee runner Richard Blalock was going. He will be there next year!

*******

These are the friends I have. Friends I would not have known had my life not taken this different road.

This is it.

Life.

Today is my ampiversary.

And whereas I miss one part of me, it in return gave me my life.


And that has made all the difference.

8 Plus 1

This past Saturday was the eight week mark since my knee surgery. On Sunday I ran 8 miles, and, for different reasons than the Seinfeld episode, it was spectacular...even with a single event.

My family has a history of heart disease. My grandfather died at 66, my dad at 62, and my brother just shy of 50. So when my cholesterol went north of 200, my doctor put me on a well-known statin.  These drugs do come with side-affects, but death is more, uh, dramatic and somewhat limiting to my running goals.

Still, after reading a few articles about statins, I decided to try to control my propensity for high cholesterol by keeping closer tabs on my diet and by taking some supplements to fight this nasty fellow. No more statins for moi. I have to say I think this contributed to my good run on Sunday. Certainly I am stronger from PT and my running had a good base and is coming back, but I don't think these alone explain the sudden improvement I experienced.

I did two miles in the treadmill, then headed out for the remainder of my run. Almost immediately I found I needed to pull back from my pace, because I wanted to run 8 miles and didn't want to struggle at the end. Around 3.5 miles, I felt something like a bubble in my chest; I have felt this before and every time in the past when I checked my heart rate (HR) it was not higher or erratic in any way. Today it was going higher, from the around 140 bpm to 160 then 170...174...I have not seen these numbers since well before my first ankle surgery.

I stop. Two more beats higher. Somewhere, way over there, I think...could this be...then...

As quickly as it accelerated my HR drops, down in to the 120s and I start running again. This feels good...this is the why of why I run. Many people are out, I am struck by several children who say "Happy Easter!" I feel good. I see myself, outside of myself, running from above. Thinking about Boston. Of Santa Rosa. Of this great gift.

This runner is back...back from another test.

And ready for the next.

My Three Feet

My Rights - walking, running, convenience

On my prosthetic planet I typically have 3 different legs I wear in a 24 hour period. One is for walking, one is for running - you might note I run a little, and one is for backup/convenience. I am going to write about each one, with the new walking leg finally getting some press since I haven't talked about it much.

*******

The Prosthesis for Convenience aka "Old Paint"

My plastic slipper

This leg is from my previous prosthetist. I walked in it for perhaps a year or more as my everyday leg. With my longer residual limb, I do not have a suspension system employed in this leg, that is, nothing holds it on except the friction between the residual and the socket; there is no suction or even a sleeve required, just prosthetic socks to insure a snug fit.

The design is simple: thermoplastic socket and frame, an Ossur silicone liner, varying number of prosthetic socks, and the foot is a very good Freedom Innovations Renegade LP (low profile). It didn't need to be low profile, which has less energy return than full size, but that is another story. I ran some of my first races on this foot.

I can don (put it on) in less than a minute. If the house was on fire I could don it and escape. It's great for midnight kitchen raids or pit stops, and for walking around first thing in the morning before showering and dressing for the day. Also for travel it's great because in a tight airline seat my knees are jammed against the chair in front of me, and with this leg I can simply pull my residual out of it to have a little more room.

The downside is if I wear it for more than 30 minutes, sometimes less, I have to start adding prosthetic socks as my residual is squeezed like a tube of toothpaste; the fluid goes out of the anatomical leg and the volume decreases. The thing could fall off if I had to run or jump since it is only held on by friction. Lastly, the overall fit is not quite right. This is the same socket I ran some races in, and it irritates the fibula head if I wear it for several hours.

This is also why it and suspensions other than vacuum is less healthy for the limb; it is far less of a natural environment for the residual. Only vacuum systems like the Ohio WillowWood LimbLogic VS that I wear or the Otto Bock Harmony provide this outstanding feature.

Elevated vacuum does not work for all amputees, but for most transtibial (below the knee, aka BK or BTK) gimps like me it should be the suspension of choice in my opinion. It does take a dedicated CP to properly fit it, as considerations like keeping the system airtight is imperative in the prosthesis. The amputee must be educated to the advantages of elevated vacuum to offset what might be seen as inconveniences, particularly the longer donning/doffing processes.

These issues are largely solved by having a "convenience" prosthesis like Old Paint for times when donning/doffing the elevated vac is unreasonable, i.e. the aforementioned fire or the "I gotta go NOW!" 3 a.m. moment. Also if I am having my everyday leg worked on, I can wear this old thing and not lose my mobility.

I believe many who have other systems and particularly elevated vac need something like this that can be donned quickly. I did not have this prosthesis for a few weeks when I was first trying elevated vac and missed it every day. Now I have the best of both worlds and highly recommend this solution.

Although it sees less wear time than my other two legs, it definitely is a great convenience and I would miss not having it.

*******

The Prosthesis For Running aka "Jato"

My right wingman

Here is my cool friend Jato. In the current iteration, Jato consists of these major components:

• Freedom Innovations Nitro foot. 
• Ohio WillowWood LimbLogic elevated vac
• ProCare high tech proprietary socket and frame
• Otto Bock custom polyurethane liner
• Otto Bock Derma ProFlex sleeve

This incredible prosthesis was designed, fabricated, and fitted by the forward and innovative team at ProCare Prosthetics and Orthotics. With athletes and patients like Scott Rigsby, Jason Gunter, Cadie Jessup, Shea Taylor, Rajesh Durbal, Jarryd Wallace and many others, ProCare has the resources to help amputees achieve their dreams and open new horizons to others.

When I see other high level amputees using yesterday's technology because of other commitments like employment or because an organization requires them to use a particular prosthetist, well, that seems tragic to me. To settle for less than the best should not be the choice to make.

Is Jato perfect? No. No prosthesis is, but then again, neither is the anatomical body. The body remains the most incredible machine I know of, capable of healing itself from many injuries. Yet even the healing process may weaken it over time, or cause things like the very arthritis that rendered my old right foot deformed and painful.

I do know Stephen Schulte and his staff at ProCare never sit still, looking for ways to improve their products to help the disabled excel in life. And I am here to tell you now, my life has been richer since my amputation.

*******

The Prosthesis for Everyday

Freedom!

This is my current everyday prosthesis. Aside from the OWW LimbLogic VS pump, the brand new Freedom Innovations Renegade A•T All•Terrain prosthetic foot is the real star here.

Originally we tried an Otto Bock Harmony pump, but the length of my residual limb meant the prosthetic foot had to be very low profile. That foot that felt awkward, did not have the rollover characteristics of my old foot, and was uncomfortable. With the more compact LimbLogic electric pump, I was able to use the newly designed Renegade A•T and wear a full height foot on my everyday prosthesis.

Holy cow was I impressed!  For the first time I became UNAWARE of my prosthetic foot, the Renegade A•T is so natural and comfortable and a joy to wear. Rollover is entirely transparent to me; I remember thinking "if only my anatomical foot felt this good!" I believe this foot would be an excellent choice for running trails or other uneven surface where Jato is not as well suited to the terrain. I haven't tried this because the socket is not really designed for running.

As I've already mentioned, the elevated vacuum suspension system utilized in this prosthesis is key. Why is this so much better than any other suspension system? Because the residual limb is not squeezed, rather, uniformly pulled toward the socket, and as best I can tell, in similar position as a normal limb. An article appears here that discusses this giant step for amputees. 

My limb is in a healthy environment and I rarely (meaning nearly never) have to adjust my prosthetic socks.  Another huge plus is when set up properly, sweat can be removed from the prosthesis. In my old suction prosthesis this had been a huge issue for me. Now no more horrid Drysol or other anti-antiperspirants that made my skin far less healthy than normal. I have less issues like ingrown hair because the residual is not being compressed.

Socket comfort is usually outstanding, but after my recent meniscus surgery and subsequent return to running, I have felt some discomfort at the distal end of my fibula where the Ertl bone bridge is formed. This is in both my everyday and running prostheses. I believe the shape of my residual has changed some causing this, along with the fact there seems to be no specific loading on the end of my residual. Most "guillotine" amputees cannot tolerate load bearing in the end of their residuals;  Ertl amputees can because of the nature of the procedure. That said, I have contacted my CP and we'll see if an adjustment is in order.

*******

So there is my current lineup of right feet. These give me a life where I don't cringe at the thought of walking good dog Baxter to the field to play, or even to my vehicle to go to work. Prosthetics continue to evolve to improve the lives of people with limb loss. For me, running is a large part of my life, and that loss would be been the true tragic amputation.

I'm Baxman!

Day. dream.

What a beautiful day.

What a wonder to be alive.

From wonder folding into wonder

love this moment

together