Sunday was a trip down memory lane. Thirty three years ago, I did my first ocean swim, in an event that hadn’t been going all that long, the Palm Beach to Whale Beach ocean swim. I wasn’t much of a swimmer back then but decided to give it a go. Years later on a hot Sunday morning, I’m heading up to Palm Beach in a chartered bus with about 30 colleagues from the Balmoral Beach Club.What this has to do with recovering from tibial plateau fracture and surgery I don’t know. It’s better than sitting in the gym pounding away on the bicycle of death or doing endless leg presses which I’ve been studiously avoiding of late. I’m a bit apprehensive. I have lost a lot of confidence in the surf and while I used to revel in getting out through big waves at Palm Beach and tearing off around the headland to Whaley, 2.8km away, I no longer relish the prospect. I’ve never done it with the snorkel of shame either. Never mind. It looks like a calm, flat day in the ocean and the company on the bus is very jolly

Well that wasn’t so bad. No swell, fairly glassy conditions, no wind and no blue bottles. In fact, at 45m 43s ,it’s the fastest I’ve ever done the 2.8 km course. Surprised myself. Must be the snorkel. I had a lot riding on it.  I bet Denise Elder a bottle of wine that I would beat her. This is usually not a sound bet. To my surprise, and her horror, I won by 1m 34s. It was a beautiful swim water very clean and warm. The hardest part was hanging around for a couple of hours at Palm Beach before the start trying to avoid being sunburnt. Barry Feyder hosted me for lunch afterwards as we planned our upcoming Palm Beach to Manly swim which is an adventure of considerably greater magnitude, now planned for May this year. Hopefully. No injuries.

The afternoon found me sound asleep in bed – a couple of hours to just completely zone out. Boy I was tired. All the the swimming training and rehab training is now joined by apprehension about the upcoming skiing trip. I leave in two weeks. I can’t do this if I break my leg again on the trip to Montana and Idaho . I have been really slack over the last fortnight with my rehab training and my knee is starting to ache a bit. Swimming and working is just making me too tired.

The results:

Swimmer	Time	Category Place	Gender Place
Oliver KING (927)	0:45:41	30-39 Years  (77)	Male  (381)
Derek HEATH (1250)	0:45:42	50-59 Years  (82)	Male  (382)
Richard CAVANAGH (1335)	0:45:42	50-59 Years  (83)	Male  (383)
Kieran KELLY (1432)	0:45:43	60-69 Years  (23)	Male  (384)
Matthew MORTIMER (1056)	0:45:44	40-49 Years  (100)	Male  (385)

And so a year has rolled around. It’s Tuesday, 19 January 2016. A year ago I was lying flat on my back in the snow at Revelstoke in Canada, in the first half hour of a dream heli-skiing holiday that had suddenly gone pear-shaped. I had skied off a small cliff in low visibility and fractured my tibial plateau – in layman’s terms I’d broken my leg.

How do you celebrate 12 months of surgery and rehab? Well, I guess you go to the gym. Tomorrow, Wednesday would be my normal appointment with Belinda – she who must be obeyed – but she is leaving tomorrow to get married. We decided to do a session today which developed into long, involved, gym purgatory. She had me doing more of the extraordinarily peculiar exercises of late. I don’t know how many times I climbed up on the box and jumped off it but it was a lot. I was also doing a lot of sideways sprints, walking lunges – which seems to be a favourite of hers – and Kettlebell lifts. This was done with a 20 kg bell which I think was a bad idea. My back was very stiff and sore by the end. I don’t think I’ll do any more Kettlebell lifts. It’s a bridge too far. Luckily, we also did a lot of stretches.

Anyway, I now have only two more sessions of gym work before I go skiing. For the first time in my life I’m not really excited about going to the mountains. I first saw snow a Perisher Valley as a 21-year-old on my first ever holiday. Was I excited? You bet.  And I’ve been excited ever since. Until now. Now I’m just apprehensive.

I know what the problem is – I’m frightened of getting hurt again and having to go through surgery and doctors and physios and personal trainers and gym work and on and on. It’s such a lonely endeavour. The last year has drained all the stamina out of me. The self-confidence went out the door with it. I couldn’t do this again. I’ve spent part of this rehabilitation year reading the Greek philosophers, Epicurus in particular. He was a ruthless dude. Epicurus believed that we live in an indifferent, materialistic universe, one that has natural laws, but no divine plan. Whether God exists or not – and Epicurus believed he didn’t – God can’t change these natural laws. Human beings are but tiny specks in an impossibly vast universe and are of little significance. Neither do they have any meaning.

There is no essential justice to the universe. That’s what frightens me. I could easily go away skiing this year and break my leg in the first hour just as I did last year. God and the universe would be indifferent to my plight.  We are always confounded how the innocent suffer and the wicked often prosper in life.  Epicurus thought these were irrelevant, human, value judgements and human concerns with no universal application. It would cause me great suffering and would be an injustice if I got injured again but Epicurus would say that suffering and injustice are unavoidable and have no essential meaning.

He was a really miserable sod in some ways and in others he was a great optimist who has shaped our Western way of life. Epicurus believes that we should cultivate material pleasures, be moderate in doing so, try to enjoy life while it lasts and not fear death or suffering. That’s pretty positive and a large part of Western society lives that way but I have grown to fear suffering because, unlike Epicurus, I just don’t understand why it is necessary or even why it exists. I wouldn’t have made a very good Greek philosopher.

Tonight I celebrate the passing of a year I would rather forget. I pulled out my metal leg brace and tried it on. It took me 15 to 20 minutes to figure it out which is amazing. At one point I used to sleep with it next to me and could get up at night and put it on, entirely by feel. I was amazed how hot it is. It has neoprene rubber straps wrapping horizontally around the leg in four different places. They are hot and sweaty. I had forgotten this aspect or maybe the pain was so great I didn’t even notice it before. I decided I’d get the crutches and go for a burn around my apartment. While it was a trip down memory lane there is nothing much to recommend leg braces or crutches and even less to recommend wheelchairs. I feel for all the people out there who have to endure them as a permanent part of their lives. They were my lot for only a short period. The courage of people who are permanently injured, is one of the great revelations to me over the last year. At least, in that, it has been a positive experience.

It has been a hectic couple of days.

With the stock market crashing I decided to take my staff to see The Big Short on Friday night. It was an excellent Michael Lewis book but I was curious to see how it could be turned into a movie. Amelia, Bergin and Catherine joined Ryan, Sarah, Aditi Grover and myself, so we took up a row at the Dendy at Circular Quay. Sirius FM was shouting.

The film was replete with CDO’s, Credit Default Swaps and Real Estate Mortgage Bonds and I’m sure the average movie goer would not have a clue what it was about. Margot Robbie, in the bath explaining shorting, was profoundly arresting (I have a weakness for Margot Robbie. She could sell me any piece of Wall St crap, especially if we were both sitting in the bath) but sadly for the punters, she was uninformative as she had no idea what shorting is. It brought back so many memories of 2008 and 2009 when the world was collapsing around me and I got all the clients through without anyone losing a cent. Don’t know how I did it in hindsight. I know I wasn’t in the bath with Margot drinking champagne and getting a back rub, while she gave me stock tips. Unfortunately! I was younger then and investing is a young man’s business. Saw John Parker in the foyer, after the film. He is an old client who was exposing his grandson to the wilds of Wall St. We had some laughs reminiscing about our investing experiences.

Got back to Manly late in the evening to find I’d left my car and house keys in the office. Car had to stay in the Manly council car park for the evening.

Saturday was another double at Manly. Balmoral still too dirty to swim. Launched into the grey dawn at 6am. Getting very tired. Marg Carney drove me to town after breakfast to pick up my keys from the office. No way could I do the Saturday gym. Too tired. Slept for most of the afternoon. My left ear is bleeding from the Aldara. Pillow covered in blood this morning when I awoke. I think its starting to effect my sleeping as I’m getting really tired again like I was with the gut bugs.

Sunday was the 2400m Ben Remfrey handicap race at BBC. I was tired half way though the endless circuit of the bay but kept going. Ended up second on handicap – I almost won. I haven’t won a trophy in years. Then walked home to Manly along the harbour foreshore. 14km on a hot day guiding a group from BBC women who are going on a girl’s bushwalk in Tasmania. Unfortunately, no time for breakfast. Did it on an empty stomach. Carried 10kgs. Excellent workout for my leg. Doing the Jatbula Track and all the training involved was an inspired decision in hindsight. Walking with a heavy backpack is one of the best ways to recover from tibial plateau fracture surgery. Gee I was hungry at the end. The machine says I’m too fat so maybe it’s good for me.

So Tuesday is the 12 month anniversary of breaking my leg. What a year. I am Parsifal’s Magpie. I shall yet make merry (as long as my ear doesn’t fall off. Then I’ll be a deaf Magpie)

One of the hardest things to determine when undergoing rehabilitation after surgery for a broken leg is the rate of recovery. Where am I 12 months after surgery? How much recovery has there been in my broken leg? How strong is the broken leg compared to the unbroken leg. Today I got the chance to find out.

After our normal Wednesday session Belinda – She who must be obeyed – announced, “Ok, It’s time for you to go on the machine. I haven’t done this before as I didn’t want you to get discouraged, but I think you are ready for it now.”

“Shit, what could this possibly involve? I’ve been on just about every bloody machine in the joint. There are no machines I haven’t been on.”

I looked around like a cornered ferret. I imagined some gym Bastinado which would rip me limb from limb. How had I had missed it?

“I wonder what she’d do if I just turned around and pissed off and hid in the men’s locker room?” I thought. Male pride wouldn’t let me do that and I meekly followed Her Indoors, to a far wall of the gym previously unvisited.

It turned out to be an InBody machine which measures the structure or composition of a human body. In short
• My right (broken) leg now has more muscle mass than the unbroken left leg.
• I have more skeletal body muscle than most people my age
• I’m about 3 kgs over-weight. I weigh 83kgs and should be 80kgs.

The stuff on muscle mass in my leg is easy to understand as I’ve been concentrating on it. The overweight bit is a strange gig. I was 80kgs when I left school in 1970. 83kgs now doesn’t seem too bad.

I recommend everyone incorporate this machine into rehab if you can. If you are doing surgical rehab it will be progressive ie the experts will try and get you to do progressively more difficult exercises to improve

• Muscle bulk
• Coordination
• Flexibility
• Joint mobility
• Recruitment of nerves and
• Muscle strength.

The problem has been all along: How do you measure progress? This can be:

• Visual ie you can see the muscle bulk in your broken leg coming back
• Bio-mechanical eg I can stand on the broken leg and do a one legged squat where I couldn’t six months ago or
• Mechanical using machines eg I can leg press 90kgs where six months ago I could only do 15kgs.

This is all a bit hit and miss and an Inbody machine is excellent for more objective results. Also if you stand on one at the begging it gives you a baseline to work from. I wish I had stood on it at the start and I could have monitored it once a month. The full report is reproduced below.

I don’t like machines that tell me I’m fat.

Bit of a sad day today. News last night that David Bowie had passed away aged 69. All the memories came flooding back. I bought my first car in 1972, my second year at university. A brand-new, 25-year-old, Humber Snipe, with a very loud sound system and a very dodgy gearbox. It cost me the princely sum of $900.  The only thing that worked properly with the car was the radio. The songs playing through that radio, when I went to pick up a girl for the first time, were Ben, by Michael Jackson, On the wings of an eagle, by Russell Morris and three songs by a dude, who I thought at the time, was one of the strangest individuals I had ever seen . Hey okay, I had just arrived in Sydney from the country, give me a break. That person was David Bowie and the songs were Ziggy Stardust, Suffragette City and Starman.

At the time I thought Bowie was just to show off but I’m still listening to his music all these years later. I’ve never forgotten those songs from those far-off years when everyone was young, the world was wide and the possibilities were endless. I associate David Bowie with being young, with taking out girls and dawn-filled, summer skies as I drove to Bilgola Beach to do Surf patrols

I, I wish you could swim
Like the dolphins, like dolphins can swim
We can be Heroes, just for one day
We can be us, just for one day
David Bowie Heroes 1977

Goodbye David Bowie. Like Amy Winehouse you gave so much pleasure to so many people.

Anyway, the living have to go on living and they have to get up and go for a swim. It is Wednesday after all. I rolled out of my apartment at 530 in the pre-dawn greyness. The 6am group, small though it was, were sheltering under the eaves of Manly Surf club. We did a quick belt over to Shelly in the gloom trying not to alert the sleeping sharks. The words and melody of Heroes rattled my brain. Back at the point at 630 the BBC crew were on their way out, heading for North Steyne. They had been driven to Manly once more by the ongoing dirty water at Balmoral caused by heavy rain. I decided to tag along. It’s amazing how much energy I have now that the gut bugs are gone, the pain in my leg has receded and I’m now getting some decent sleep. I did wake up this morning with my left ear stuck to my pillow from blood boozing from the wound caused by the Aldara treatment for the squamous cell carcinoma there. Walking around with a pillow stuck to my ear is nothing really. Doesn’t even register on the pain meter. This morning’s swim was 3.2 km all up. Not bad before work.

It’s Wednesday, so that means Belinda – she who must be obeyed. I fronted up as usual and it immediately became very weird. She had me doing sideways lunges/jumps 20 times across the gym, then back, then back once more. And once more becuase I’m tired. Then I had to stand up on the big box and jump off onto the floor, landing square on both feet, in a squat. I hadn’t done this before from this height and it was with considerable fear and trepidation that I launched the first time. I was just getting used to that and she said,

“Now we’re going to do some Bulgarian split squats.”

“WTF is that,” I thought. It turned out to be the height of weirdness. It’s essentially a one legged squat on your bad leg with one leg stuck up behind you. Only a Bulgarian could think of this! Please don’t try this unless you are under expert supervision or you are Bulgarian or both. We also did some deadlifts with the Kettlebell which I haven’t done for quite a few months. Thse are done with a straight back and are called Russian Deadlift. Hey, it’s all the Europeans.  Anyway nothing hurt. She seems to think I’m ready to head to the mountains. I’m not so sure.

Today I learned a lesson about rehab – If you are not going forward, you are going back.

Victor Kiam, the American business man put it another way: Even if you fall on your face, you’re still moving forward.

The day got off to a bright start at least. Since I’m sleeping better as I’m not in any pain I got up at 5am and went down to Manly early for the Monday morning swim. Went in with the 6am group. It was dark. I’ve never done this before. Didn’t know any of them. They are super quick. Pretty gloomy on the way to Shelly as sun only starting to come up. After short break at Shelly and return, I arrived back off the point at 6.30am just as the mob was coming out.  Jan, Gail and Marg where in the group so I turned around and swam back to Shelly with them. The “double,” as it’s called, is a pretty good swim. Takes me about 70 minutes – in at 6am out at 7.10am.

Day went downhill from there. I ducked the gym on the weekend and felt guilty so decided I’d have a Monday session. I hadn’t had a solid session in the gym, on the bike and leg press machines, for three weeks over Christmas and I was buggered today. I didn’t have to go back and start again but I have retreated a long way. I couldn’t get up to level 13 on the bike doing the sprints. I was exhausted at level 12. I also couldn’t get up to 90kgs on the leg press machine. I managed to get up to 80kgs and did one set – but that was it. It felt really heavy again.

I guess the lesson is at this age that if you stop rehab exercise you will immediately lose fitness whereas a younger person will hold onto it longer. The session could only be described as “perfunctory.”

Warm up on the bike: ………..5 mins on resistance 9, 10, 11,  and 12 – about 27 minutes. Sprinted to 100rpm, five times on levels 10, 11, and 12. too exhausted to go to level 13.

Walking squats across gym…………..20

One legged squats off box (broken leg)…………..30 reps x 2

Leg Extension…………….20 x 30kg     both legs

Adductor…………………10 x 35kgs    …………20 x 40kgs

Leg Curl …………………..10 x 30kg        both legs

Leg Curl …………………..10 x 35kg        both legs

Leg Press………………….10 reps x 60kg, 70kg, 80kg both legs

Not much to be proud of here. Even though I’m falling on my face I’m still going somewhere.

So 2016 begins a bit like 2015 ended – going to the gym and also being attacked by a man wearing rubber gloves who then presents me with a large bill. Yes, its surgery time again. Yahoo!

Today was my first day back with Belinda at the Virgin Gym after a two week break over the Christmas/New Year period. Much has changed. I couldn’t do any of the exercises which was a surprise. We started with walking lunges, but my hamstrings were so tight Belinda was nervous that one of them would tear, so we had to desist. We then tried some two footed jumps onto and off a Bosu ball, one-legged hopping, side stepping and one-legged balancing on a Bosu ball. We then tried some two footed jumps across the gym landing on both feet which replicates a skiing turn – sort of. But through most of it my hamstrings really hurt so at the end I was reduced to doing stretches.

Belinda explained that the tight hamstrings were a product of swimming eight days consecutively and not doing any stretching afterwards. Doing rapid fire muscle exercise like a swim kick, in a weightless environment, just makes the hamstrings stiff and tight. I never stretch. Should do.

As I close in on the one year anniversary of surgery I can do most things except
1. Run
2. One legged squats on my broken leg
3. One legged hops on my broken leg.

I don’t think my leg is anywhere near strong enough to ski again but the experts don’t agree. We’ll see. Only one way to find out. Montana and Idaho, here I come.

In the afternoon, it was back to see the man with the rubber gloves, my friend Professor Jonathan Stretch, the prominent cancer surgeon. I have known him for some time. He removed the first melanoma that I suffered. As part of that process I asked that I read his thesis. He seemed surprised by this request but he gave it to me anyway. I read it and subsequently wrote a critique of it,  which I sent to him. Although he was surprised by both my interest in reading his thesis and my response to it, he called and offered to answer my questions. He very graciously gave me an hour one Friday afternoon, years ago, in his rooms at the Poche Institute to answer the questions raised by my thesis review. He tells people I am one of his most difficult patients.

This time was no different. I noticed that the pathology report on the biopsies taken on my face showed squamous cells on my cheek but also on the tip of my left ear.

It is described with the following weird words:

“L ear.” Hyperplastic Bowen’s disease/in situ squamous cell carcinoma. (Punch)

“R cheek.” Bowen’s disease with moderately differentiated squamous cell carcinoma. (Punch)

I don’t think the words in dermatological surgery are nearly as interesting or full of Greek and Latin pretension as those in orthopaedic surgery. Still they are trying. When you have a biopsy report that says your scalp contains, Eroded Acantholytic Bowenoid Actinic Keratosis,  you know they are having a go. The dermatologists are carting the ball up, but I don’t know if they are ready to play State of Origin against the literary giants of orthopaedic surgery.

I knew Jon was going to operate on the cancer on my cheek but not on the top of my ear. I asked why. With a sigh, he pulled out his pen and a bit of paper and we went through it. Plenty of diagrams. Prof Stretch is never stingy with his time. He will always happy keep going through it until I understand. He is a great communicator with patients and many of his peers should learn from him.

Anyway, an hour later, after getting several large horse needles, full of local anaesthetic, stuck in my face, he excised a sliver of me which was packed into an alcohol-filled, specimen jar and sent off for testing. I am basically disappearing bit by bit. At least in another 10 years there will be nothing left for the surgeons to operate on except my shoes. I’m not sure they’ll get much cash from slicing up leather. Mercifully, Jonathan Stretch is very pleasant and engaging company while he is chopping me up.

Long may you live, Professor. I don’t want you to retire as you and Dr Tanya Gilmore are probably keeping me alive. Also I need you to take the stitches out next week and tell me what the prognosis is from the excised skin.