Bleeding Painful

My buddy and blood brother, Jeff, recently recommended that I… Well, let me share his words:

"If you don't mind, Vaughn, I know that a few members would appreciate hearing a little more about your hip bleed, treatment, recovery, etc. A few of our younger bleeder siblings are going through them right now so insight into recovery and management would be welcome."

It just so happens that I healed and recovered from a pretty major hip bleed in the same way I have recovered from maybe one hundred bleeds over the last forty-eight years. However, I’ve perfected my technique over the last twenty or so years… This blog article will discuss what I did. Before starting, let me tell you what I mean by bleed… As most of you already know, I’m a type A mild hemophiliac. That means that my body does not produce an adequate amount of the clotting protein, factor eight (written factor VIII). Because of this I get bleeds that normally manifest themselves in my joints after an accident during one of my adventures.

One other thing…

WARNING: Exercise, stretching, sports, and other fitness related activities can be dangerous. You can be seriously injured, crippled, or killed. The opinions, stories, and ideas presented here are my own and do not constitute a recommendation of or endorsement for any particular or general use. I strongly recommend getting a complete physical and doctor’s approval before starting any type of strenuous activity. Especially if you are over the age of 40 or have high blood pressure, genetic heart problems or conditions, or elevated cholesterol levels. If you choose to workout, you do so at your own risk. In addition, working out requires patience, diligence, and above all else, using good form. Never bounce or over strain! Most important: listen to your body…

Let’s dive into my latest hemophilia experience and how I dealt with it. On June 14th I had an accident on my skateboard while performing a stunt of sorts on a vert wall (think half-pipe). Before you say it… Yes… I know that hemophiliacs shouldn’t ride skateboards. Today’s post isn’t to figure out what’s wrong or right for a crazy hemophiliac to do. Rather, how I handle the agony of defeat.

During the wreck, I felt each and every one of my forty-eight years… Suffice it to say that it hurt… Bad. I got up, brushed myself off (after laying there for a few minutes), and promptly read my body. It told me that I was having a bleed. You read that write… I read my body. You see, all of us have an innate ability to communicate directly with our bodies. As a hemophiliac this comes in very handy as I can always determine a bleed before going in to the hospital. This is the first part of today’s lesson. As an easy bleeder (person living with a bleeding disorder), you must learn to listen properly to your body.

This may sound a little crazy, but I also self medicate with deep solitude and meditation. I spend time controlling my breathing and drawing into myself. I use the power of my brain to help with the healing. Crazy as it sounds, I believe it works.

Step two was RICEFFU; which stands for Rest, Ice, Compression, Elevate, and Factor the Eff Up! In other words, I got home, laid on my sofa with ice on my hip and gave myself an intravenous injection of factor VIII. I continued this step for eight days, because this was a major bleed. For lesser bleeds I will only dose four days. Experience has taught me that the bad bleeds will slowly leak if I stop after four days… So, I did eight days of RICEFFU.

The first two steps (recognition and medication) are the most important and must not be skipped if you really want to utilize the full extent of your recovery and produce the best outcome in the shortest amount of time. After decades of doing this part wrong, I now know how to shut a bleed down quickly and with the least amount of problems.

Step three is an evaluation and extended rest period. At this point, I stop the factor, and stop the RICE. I take about one week and simply rest… No workouts. During this time I also carefully listen to my body and the joint in question. I assess and determine if I’m ready to move to step four; which is where the active recovery begins.

By the way, it is imperative that you don’t workout or stretch during the initial healing period. PERIOD.

With my medicine done, and my bleed completely stopped I move on to step four. This step is gently, but physical. I start gently stretching and getting motion into the joint. After about two days of this, and ensuring that the bleed is absolutely done, I throw in hot Epsom baths. That’s right, each day I fill a tub with hot (pretty dang hot) water and pour in Epsom Salts. Remember to never get into a hot bath if you think you are still having any bleeding, as this will only bring your injury back. Along with the hot bath and gentle stretches I do some soft pinpointed massaging.

Each week I increase the depth and pressure of the stretches and massage. I also keep up the baths. This continues until I feel my range of motion is returning and the pain from the bleed is going away. Sometimes this step can take two weeks, other times it can last two+ months! This last time was in the two+ months category because of how damaging it was.

Next comes body weight exercises, continued stretching, and baths. I also add my tai chi workout; which really helps on a mental level too.

After all of these steps, I am ready to begin my real workouts (weight lifting, swimming, bike riding, and running) again. It is important to start out slowly and allow ample rest time. This will also help eliminate some of the pain that you will surely endure after having so much time off from training. Ramp the level of intensity up over a few weeks. Before you know it, you will be back stronger than ever. And, ready for the next bleed! …just kidding-sort of…

To prove what I’m talking about, I’m going to race 156 miles in the annual Hemophilia Federation of America’s Gears for Good race; which I’ve done every year since its inception. Checkout my page and consider donating to help my worth cause of helping those with hemophilia: The-Talented-Mr-Ripley-2015

Cheers,
Rip (no pun intended)

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Ankle Fitness

In the past we have done many health and fitness related articles. And, even though some of these discuss good routines for hemophiliacs, none have specialized or been pinpointed at easy bleeders. I recently decided to start a series of articles that are primarily based on people with bleeding disorders. All of these workouts will work for clotters (non-hemophiliacs), but they are a gentler way to strengthen your body, and will focus on specific joints.

Today we will tackle one of my target joints, and also one of the most popular joints for bleeds. The ankle. Like all joints, the ankle is complicated and consists of several large muscles, tendons, and ligaments. Because this joint is so easy to injure and start a bleed, it is imperative that we strengthen it when its healthy. A strong and flexible ankle is a fantastic foundation to avoid injuries and potential bleeds. That said, hemophiliacs and Von Willebrands sufferers need to strategically exercise these joints to carefully and slowly strengthen them over time.

WARNING: Exercise, stretching, sports, and other fitness related activities can be dangerous. You can be seriously injured, crippled, or killed. The opinions, stories, and ideas presented here are my own and do not constitute a recommendation of or endorsement for any particular or general use. I strongly recommend getting a complete physical and doctor’s approval before starting any type of strenuous activity. Especially if you are over the age of 40 or have high blood pressure, genetic heart problems or conditions, or elevated cholesterol levels. If you choose to workout, you do so at your own risk. In addition, working out requires patience, diligence, and above all else, using good form. Never bounce or over strain! Most important: listen to your body…

There are three primary muscles that are associated with flexing and securing the ankle joint. Most people think of only one and simply call it the calf muscle. However, the calf muscle is actually made up of two large muscles: Gastrocnemius and Soleus. The gastroc (short for gastrocnemius) is normally the muscle we refer to as the calf, because it is larger and more pronounced. But, the lesser known soleus is very important for ankle flex too. The difference comes mainly from the position (bend angle) of the knee. When the leg is straight (or fairly straight) the gastroc is the muscle that comes into play when standing on your toes. If your knee is bent, then the soleus is the one that flexes the toes (and foot) down.

You work the gastroc by doing the exercise known as standing calf raises. You work the soleus by doing the exercise known as seated calf raises. Both exercises are very important to strengthen the calf muscles and associated ligaments and tendons.

If you recall, I said there are three primary muscles… Well, there happens to be a muscle on the front side of the shin called the tibialis anterior; which is important for lifting the foot and toes upward (as opposed to pressing them down). Most people overlook this muscle entirely, because it doesn’t really add much bulk or “look” to the calves. However, hemophiliacs (and anyone interested in a stronger more supportive ankle), should not skip this important muscle. Every muscle in our body has an antagonist muscle or muscles. When we are strengthening a joint, it is important to hit the agonist (primary muscle) and the antagonist (opposite side the flexes the joint in an opposite direction). This is the secret to a health, strong, and supportive joint!

Since we listed the tib (tibialis anterior), let’s touch base on how to exercise it. The simplest way is to sit on a chair or bench, place some weight (light weight is more than ample for this weak muscle) on your toes and then do reps lifting your toes off the ground. You can (and should) add range of motion by placing something under your heel and lifting it a few inches off the ground.

Just like other muscles, your calves need rest, so do not exercise them everyday.

Once your muscles are good and warm from a workout, do some slow, deep stretches that you hold for 22 (or so) seconds. Never bounce or pop into a stretch. Instead you will gradually and carefully deepen a stretch during the 22 seconds. Also, make sure to stretch both calf muscles (gastroc and soleus) by stretching with your leg straight and bent. And, hit your tib by pointing your toes out and away from you as far as they’ll comfortably go.

One final note. There are generally three agreed upon types of weight training for muscles:
1. Strength (perform 5 to 8 reps of extra heavy weight failing on the last rep)
2. Bulk/hypertrophy (perform 8 to 12 reps of moderately heavy weight failing on the last rep)
3. Endurance (perform more than 12 reps of moderate weight without a real failure rep)

For hemophiliacs, we are trying to strengthen the joint without injury so I recommend not going to absolute failure. In other words, “leave one in the can.”

That’s all for today… Look for other joints, and hemophiliac related workouts in the near future.

Let’s work together and create Healthy Wealthy joints!!!

Cheers,
Rip

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How to Recover From an Injury

Let’s talk about injuries and how to get over them! Before we do that, let’s quickly get the painful stuff out of the way first.

WARNING: Exercise, stretching, sports, and other fitness related activities can be dangerous. You can be seriously injured, crippled, or killed. The opinions, stories, and ideas presented here are my own and do not constitute a recommendation of or endorsement for any particular or general use. I strongly recommend getting a complete physical and doctor’s approval before starting any type of strenuous activity. Especially if you are over the age of 40 or have high blood pressure, genetic heart problems or conditions, or elevated cholesterol levels. If you choose to workout, you do so at your own risk. In addition, working out requires patience, diligence, and above all else, using good form. Never bounce or over strain! Most important: listen to your body…

My first piece of advice in this article is how my disclaimer ends… Listen to your body! You might think that sounds more like a fantasy, then real life… However, I’m here to tell you that I am not only capable of listening to my body, but I literally communicate with it. Perhaps hemophilia is a gift, because I believe it’s the reason I can hear my body speaking. Most easy bleeders that I know are gifted with the ability to listen to their body. If you aren’t a hemophiliac or dealing with some other painful disease or problem, you might need to dig awful deep to hear your body talk. I recommend meditation for starters to get yourself in tune.

There is a very popular and silly saying: No pain, no gain! Well, that is just plain ridiculous. I would actually say: No gain comes from pain! Regardless of what you might think, there are some kinds of pain that are not good and it’s rarely a smart idea to workout when you’re experiencing this kind of pain. Keep this in mind the next time you are trying to exercise while your body is trying to heal.

I bring this up because we all know many active athletes (myself included) who not only complete races on injuries, but even train through them. Everyone thinks differently about this but I’ll share my thoughts. I believe in pushing myself despite injuries when I’m in an actual race or event… That said, I do not like to push my body through training when I’m injured. Do you guys see the difference? You need to talk to your body, listen, and then determine if you can workout or not.

Once you know you are injured and decide to skip a few workouts, you need to figure out what to do during the healing process. Certainly you guys all know what RICE stands for, but let me spell it out anyways:

Rest – Recovery requires sleep and downtime.
Ice – Cold helps with the healing process.
Compression – Wrap your injury.
Elevation – Raising the injury spot helps it heal too.

 

I made up my own mnemonic (I have a need to be different). I call it, the five I’s:
Injury = Ice, Ibuprofen, Interlude, and Invert.

Regardless of what you use, it’s important that you have your own process to follow during your healing phase of an injury.

Many folks like to alternate ice and heat on an injury… As a hemophiliac I sort of fear heat. So, I’m very careful to ensure the bleeding is not only stopped, but won’t recur before I apply heat.

Depending on the injury, you might want to do specific stretching too. Always do gentle smooth stretches and never bounce. This is true whether you have an injury or not. Carefully stretch injuries and slowly go until you get close to pain. Never stretch to the point of pain. As I’ve said over-and-over again, listen to your body. Focus on that painful injury area and slowly stretch. Listen. If you feel (hear) pain approaching, stop the stretch where you are. If possible, hold it. For the best results, hold this stretch for 22+ seconds and then slowly ease up and relax. Repeat a few times for a deeper and more invigorating stretch.

Once the damaging pain of an injury starts to subside (this can be a day or several months), I recommend starting to do some extremely light weight exercises that pinpoint the injury area. As I keep saying, take it easy and do not push yourself in the beginning. Over the next several days, carefully and slowly raise the weight and range of motion.

Normally you only need a day or two of rest between workouts… However, when dealing with an injury, you know what to do by now… That’s right… Talk to your body, and listen. If it tells you that it is ready to continue, then by all means… Continue.

Depending on how bad the injury was/is, go through several days to several weeks of gradual increases in stretching and lifting. Continue this until you have full range of motion and no pain before moving back into your “normal” workout routines.

I hope you never need the advice in this article… But, if you do, you can always lean on me and my experience.

Be well,
Rip

Please comment by clicking “Leave a Comment.” And, if you dig, share this article! Also, please type your email address into the “Subscribe” box up top to get updates each time I post a new blog article.

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