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post #61 of 173 Old 09-17-2019
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Wink Re: Sailing as a senior

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Originally Posted by pdqaltair View Post
Even for those off us with no pathology, this is a big deal. I thought sailing and writing were keeping me sharp. Then I took on a large engineering consulting project and learned just how much I had slid both in speed and project organization. Within a few months I was up to speed, but there is no substitute for constantly challenging the mind. Of course, there is the stress. But the difference is it's not a career job that I have to sweat loosing. It's "good" stress, like exercise.
100% wha I’ve noticed in friends and what gives me pause on retiring yet without a way to contribute or keep myself sharp intellectually. It’s one thing to read and another to engage with others .

I work with many generations of managers and line employees. Being around a diverse group age wise as well as experience wise has both challenged me to keep up intellectually and even physically.


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post #62 of 173 Old 09-17-2019
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Re: Sailing as a senior

I've had low back problems ever since I broke a disc slipping on ice, on my way out the front door on a sunny day. (I had to laugh when I realized those two feet framing the Sun were mine! Then crawl back to safety ). . . . I said "no, thanks" to surgery because a side effect was possible paralysis. It took at least a decade, but I cured the problem by rowing. I used a recumbent rowing machine in my office building after hours. After a few weeks my back pain was gone.

I had ankle problems, too, from bad running shoes. Slow progress on a treadmill mostly fixed it after about 20 years.

My routine now is every other day lifting weights, not too much. Alternate days on a stair climber for intervals (sprint, recover) 8 x in 14 minutes, plus two sets each of push-ups, sit-ups, what I call "leg raises" to strengthen the core, and pull-ups if I can. Stretching after each workout, and one day of rest.

When I keep it up I feel great and can accomplish a lot. When, like now, my workout room is being renovated and got ignored for summer chores, I'm starting to hurt.

Whatever works, regular exercise of some kind, even light to moderate, helps tremendously.
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Re: Sailing as a senior

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Have single on first two reefs. Double on third. Single is a PIA. Have expensive blocks sewn into sail. Dyneema lines. Fancy dan turning blocks on deck. Everything to reduce friction.friction is very low and you can pull the lines by hand alone. But as line comes down from block on luff of sail it catches on the sail near the boom. Sometimes you need to go forward to clear it. Takes a second but in wind means changing you change your clip to the jack line to do it. Takes longer to do that then the job.
I've got single line on both of my reefs. If I keep pulling in all of the slack in the reef line while I lower the main the line doesn't catch on the sail.
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Re: Sailing as a senior

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I've had low back problems ever since I broke a disc slipping on ice, on my way out the front door on a sunny day. (I had to laugh when I realized those two feet framing the Sun were mine! Then crawl back to safety ). . . . I said "no, thanks" to surgery because a side effect was possible paralysis. It took at least a decade, but I cured the problem by rowing. I used a recumbent rowing machine in my office building after hours. After a few weeks my back pain was gone.

I had ankle problems, too, from bad running shoes. Slow progress on a treadmill mostly fixed it after about 20 years.

My routine now is every other day lifting weights, not too much. Alternate days on a stair climber for intervals (sprint, recover) 8 x in 14 minutes, plus two sets each of push-ups, sit-ups, what I call "leg raises" to strengthen the core, and pull-ups if I can. Stretching after each workout, and one day of rest.

When I keep it up I feel great and can accomplish a lot. When, like now, my workout room is being renovated and got ignored for summer chores, I'm starting to hurt.

Whatever works, regular exercise of some kind, even light to moderate, helps tremendously.
My rotator cuffs were so bad I couldn’t reach my wallet!

Seriously.

Arthritis specialist wanted to give me steroids.

Surgeon wanted to operate.

I insisted on seeing a sports specialist, that appointment was 6 months out.

So I bought this book, “The 7 Minute Rotator Cuff Solution”, and I did the exercises - D.A. specified. What a PITA.

When I went to make the appt. with the sports Dr. I was cured. He looked at the book, which I had brought along, and said that with one minor adjustment it was exactly what he would recommend.

So if you have a Rotator Cuff problem I highly recommend it. But you gotta do what it says. PITA.

https://www.amazon.com/7-Minute-Rota.../dp/0944831257
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post #65 of 173 Old 09-18-2019
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Re: Sailing as a senior

In any field a little knowledge can get you in big trouble. In other words you need to know what you don’t know. Now much care is provided by nurse practitioners, or physician assistants or primary care. When done right it’s a boon. Better care at less expense. When done wrong it’s a disaster. I can see overall the floor has been raised considerably but the the ceiling lowered. Best practices imposed and quality of care monitored. Significant disincentives to consult and for the consultants disincentives to go beyond generic care.
I was a consultant to a insurance company for awhile. I believe in their thinking there are three groups. Paying premiums receiving no care or very inexpensive care. Paying premiums receiving care who’s cost is far in excess of that. Not paying premiums (dead). Not costing anything. The dead and no or little care are not revenue negative. The patient needing detailed care is. Where do think this ends up?
When I started practicing I got more patients, delivered better care, and made more money if I used my expertise to figure out the correct diagnosis and give the most effective care. I left medicine when that was no longer the case. If I spent more money going through a decision matrix eliminating common ills first but then proceeded to rare diseases the insurance companies punished both me and the patient. I lost the “pay for performance “ bump being a expensive provider. The patient would end up with a higher co pay. The result was as I continued to try to do the best when there was a difficult diagnostic case they were referred to me which confounded the issue. The time spent with each patient increased so number of patients seen in a given time decreased. Time spent talking and in physical exam is much cheaper than shotgunning a lot of testing but you aren’t paid more for doing it. You are paid a fixed amount for a consult. Follow ups are tiered to mild extent. It became given worse on the treatment side. A constant battle for pre approvals and fights to get people the therapies or interventions that were most likely to help them. Two support people doing nothing but fighting with insurance. The breaking point for me was with a lady with intractable epilepsy. It took two surgeries and years of medication manipulation to get her under control. She went from multiple seizures per day to seizure free. Once seizure free she could drive, finish school, get a good job, require no financial support and generally have a life. Because she was seizure free for several years her allowed visits were decreased. Care turned over to her primary care with me alway available to the pcp. Several of her drugs were extremely expensive and she did better on brand name for the more common ones in her program. She and the primary decided in response to the costs to her to change her drug program. She had a seizure (inferred from other drivers observations) while driving crashed and died. Her husband called me to thank me for her care. It broke my heart. This guy thanking me when our medical system failed her leading to her death. It was one of several cases in a short amount of time with either a bad outcome or a death not due to lousy physicians nor inadequate science but rather the system. It was the straw that broke me.
It’s a impossible problem. You can’t figure things out in a 15 minute visit. The primary care providers are faced with a huge burden. For the consultants you can’t spend every last dollar on one person when that money might save hundreds or lives. The consultants understand that but, if human, their hearts break as they heard or see that one person die knowing they could have done something. It’s a cruel fact it’s about the money honey. Perhaps get rid of the obscene millions paid to administration would help. Or the huge drug company profits. I don’t know. Perhaps as AI eliminates many bad decisions costs will come down. I don’t know. Continue to read and think about this problem but know so many physicians who have burnt out. Think burn out more likely when you care about people which makes the whole thing worst. Still when you complain about your docs think about the obstacles they face.

s/v Hippocampus
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Last edited by outbound; 09-18-2019 at 09:26 AM.
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post #66 of 173 Old 09-18-2019
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Quote:
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My rotator cuffs were so bad I couldn’t reach my wallet! [IMG class=inlineimg]/forums/images/SailNet_Toucan/smilies/tango_face_grin.png[/IMG]

Seriously.

Arthritis specialist wanted to give me steroids.

Surgeon wanted to operate.

So I bought this book, “The 7 Minute Rotator Cuff Solution”, and I did the exercises - D.A. specified. What a PITA.

When I went to make the appt. with the sports Dr. I was cured. He looked at the book, which I had brought along, and said that with one minor adjustment it was exactly what he would recommend.

So if you have a Rotator Cuff problem I highly recommend it. But you gotta do what it says. PITA.

https://www.amazon.com/7-Minute-Rota.../dp/0944831257

What was the one minor adjustment that the sports physician offered regarding the book?

The book sounds great, and I will check it out. I would like to also tell people to not be afraid of rotator cuff surgical repair. I have had both shoulders done now and have come back strong. I'm 65.

Both of my surgeries were done laparoscopically. I had a few small incisions the size of my little finger. My recovery time was pretty good, and complete.

My left one was done three years ago. My injury didn't feel that bad and wasn't terribly limiting, but I had some joint discomfort, that I was able to treat with ibuprofen. I noticed some loss of strength in that arm, though.

It is interesting to me, how specific different muscles and tendons can be. The first diagnostic approach the old doctor used, was to check my ability for weight-bearing out to the side. I could easily reach my arm directly in front of me to lift heavy objects. Out to the side, the doctor was able to easily push my arm down to my side with two of his fingers. A MRI revealed that my rotator cuff tendon was completely dedetached.

The Acromion bone on the clavical had developed some calcification and bone spurs that were slowly abrading my tendons at the top of the humerus. It was much like your anchor rode getting chafed by the toe rail.

Through the small laparoscopic incisions, he ground back the bone spurs and reattach the tendon with some cord (from the surgical photos, it looked like blue and white dyneema).

My recovery took a few months but I got good strength back, no discomfort, and I had to work at getting back my full range of motion, which I have accomplished.

A year ago, I started experiencing a lot of pain in my right shoulder and forearm. Then, on a January 2019 sailing trip to the Gulf, I spent six hours out on the water and really tore up the shoulder with a day of cranking winches. I had to abandon the second day of sailing because it hurts so bad.

My insurance company didn't want to pay for a MRI, so ordered two months of Physical Therapy first. It did not get better. My doctor was considering a steroid shot but ordered a MRI first. That revealed a number of torn tendons, including my rotator cuff tendon, and my bicep tendon. This doctor also did laparoscopic surgery, ground back the bone spurs on the Acromion, and reattached all torn tendons.

A NOTE ABOUT DOCTORS TREATING OLDER PATIENTS:

My doctor was great, and did something that, I think not all doctors would do. He spent some time with me talking about my lifestyle, my commitment to rehab, and my goals for the remainder of my life.

My doctor is a sports medicine specialist and normally does repairs on much younger guys, many of whom are high school and college football quarterbacks, and baseball pitchers.

I told the doctor that I am semi-retired and wanting to begin some retirement activities, in which I expect to be more active than I have been in my days as an office worker and desk jockey. I told him that I want to do more bicycling, hiking, and sailing.

He was very good about discussing the options with me. He told me that the complete repair that he might do on younger athletes, would be more invasive and take more time and greater effort at rehabilitation after surgery, but would give a better and more complete outcome down the road.

He told me that there were simpler, less invasive approaches to treatment that would leave a person with some limitation in strength and range of motion, but would be fine for day-to-day household activities. He told me that, if I had told him that I was planning to retire to the couch and a life of TV, he would recommend the less invasive surgery. But, since I had impressed him with my desire for greater activity, and that I sounded like someone who would make the commitment to the long rehabilitation process, he was recommending the complete repair.

I was very impressed that he took the time to have that discussion with me. I think many doctors would not take that kind of time and consideration with an older patient.

So, at 65, I got the college quarterback repair package and I have been very pleased with the outcome. My recovery time has been longer with this surgery, than what I had done on the left shoulder. I had damaged a significant length of the bicep tendon. He completed a bicep tendonesis procedure, in which the damaged portion of my bicep tendon was cut away, shortening it, and the tendon was reattached to an attachment point that he created on a lower point on my humerus.

Because of the bicep tendonesis repair, I had to remain for 4 weeks in the arm sling before even passive range of motion PT work was started. This has caused the rehabilitation to take longer than it did with my left shoulder repair. I am now 5 months post-surgery and I'm still working on building back strength and full range of motion, but I am very pleased with the outcome.

The doctor did deliver some bad news to me, however. He told me that I will never pitch a 98 mile an hour fastball, and never be able to throw a football 50 yards. (And he calls himself a sports medicine specialist).
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post #67 of 173 Old 09-18-2019
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Re: Sailing as a senior

One of the most common failings I see in boats is either the absence of or overly tall steps. 7 1/2 inches is a step. Once I asked a group of potential buyers in the cockpit of a huge cat (boat show) how many either had a joint replacement or major knee surgery, or their spouse did. 2/3 of the hands went up. Then I asked them what they thought of the 16-inch steps leading out of the cockpit (they all said they were a bit tall), and then I asked the 30-something salesman pair what they though about that design and marketing error. They mumbled a lot.

I've added steps, both in the cabin and the cockpit. I'd like to do something in my F-24, but it's smaller than my cat and I'm struggling to find the space.

What about steps for smaller cockpits? Or larger cockpits. They seem lacking and are a big problem for many.
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Re: Sailing as a senior

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Originally Posted by pdqaltair View Post
One of the most common failings I see in boats is either the absence of or overly tall steps. 7 1/2 inches is a step. Once I asked a group of potential buyers in the cockpit of a huge cat (boat show) how many either had a joint replacement or major knee surgery, or their spouse did. 2/3 of the hands went up. Then I asked them what they thought of the 16-inch steps leading out of the cockpit (they all said they were a bit tall), and then I asked the 30-something salesman pair what they though about that design and marketing error. They mumbled a lot.

I've added steps, both in the cabin and the cockpit. I'd like to do something in my F-24, but it's smaller than my cat and I'm struggling to find the space.

What about steps for smaller cockpits? Or larger cockpits. They seem lacking and are a big problem for many.
Steps are important as is their spacing. I made a cheap boarding ladder extension out of PVC pipe back in 2006 to make boarding after a swim easier.
https://biankablog.blogspot.com/2007...extension.html
It is attached to boats boarding ladder by line that runs through the tubing. Last winter I took it off and put it back on in the spring. This year I found myself having trouble making the transition from the PVC part to the boat ladder after a swim. I just could not pull myself up enough to put my feet on the boat ladder. It was a painful struggle to pull myself up. I'm thinking I'm getting to old for this. Perhaps I need to install a $$ swim platform if I want to keep swimming off the boat. Then I thought I'd try and adjust the PVC ladder spacing to the bottom rung of the boat ladder by a few inches. It worked! I'm back to boarding easily again. Just a few inches adjustment was all it took.
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Re: Sailing as a senior

Step height and depth were invented by the Romans 2,000 years ago.
It's exact.
Absolutely exact. If yours are not exactly Roman height it gets difficult.
It's so important that architects learn it in their first semester, 1St year.
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Re: Sailing as a senior

7/11. OSHA gives you a considerable range, but some jurisdiction won't recognize a fraction off this. The OSHA range for ladders is 10-14 inches, but boat builders ignore this too.

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