Back to normal...

It has been 3 weeks since my last post - it has been a busy and productive few weeks. The semester is now in full swing and despite teaching just one class, I am buried in meetings and the occasional opportunity to get some research done. The research I have gotten done has mainly focused on student's research. Post-tenure, this is definitely more of my focus. Its not that I didn't involve students in my work before, but I would drag them along to completion whether they fully understood what we were doing or not at each step of the process. Now I am trying to let them drive the ideas more and especially direct the writing and presenting of material. It is better for them and now that I don't have a deadline looming, I am more than happy to let them take the lead. This led to having two students present their work at the Montana Chapter of the American Statistical Association Fall Meeting. This is actually the first time any of my students presented there and it was really fun to see them do well. I think both are making excellent progress on their projects and heading towards publishable results.

My rehabilitation process has moved from getting normal function to getting full function in my leg. I am walking normally or at least close to normally and have even done some long distance walks. Last Tuesday, I walked close to 4 miles, most of that at the end of the day, and felt great the next day. I am now working on hopping and skipping to start to build up some of the explosive power in injured leg. I have been tempted to do that around campus, but have restricted it to in the house at this point. The rehab is now about getting my leg ready for ski season, which seems to be rapidly approaching as we feel the first chilly nights. I could start jogging now, but am waiting until the hopping and skipping get to be easy before I start asking Teresa to go for a run with me.


We have been remodeling our kitchen recently and that has proved to be a slower process than we had hoped. We have faced a couple of setbacks with a damaged base cabinet and then the counter-top installers are backed up on other projects. We are still a couple of weeks out to getting our kitchen back so the 3-4 week project will be 6-7 weeks, maybe more. So we continue to cook in my work room and do dishes in a laundry sink. Not really that bad, as we have a toaster oven, microwave,  two burner cooktop, and a dorm fridge there. It just lacks a bit in counter space. And now we get to have a family visit without a kitchen. We also get to complete our two large tasks in the project - getting the flooring in and then eventually tiling the backsplash. We've never done either before but hopefully all our years of watching HGTV will pay off.

Starting a neighborhood association

In addition to all my other responsibilities at work, the beginning of a new semester, continuing my rehab, and starting a kitchen remodel, I have taken on trying to organize a neighborhood association (Midtown North Neighborhood Association at http://midtownnorthneighborhoodassociation.blogspot.com/). When I look at it in that context, I wonder what I was thinking. That regularly happens to me when I am at work and I wonder why I promised so much work for my collaborators. The neighborhood association idea has happened because it is always a well received idea with neighbors when it comes up, and then nothing happens. I have entirely more experience organizing and leading meetings than I expected as part of being a faculty member. I am also starting to serve on faculty senate, chairing my departmental awards committee, on the departmental promotion and tenure committee, and then there are all the graduate student committees that I serve on. Service is a part of my job description, but most of us don't get into academia for the committees.

I sometimes think that my midwestern lutheran upbringing was excellent training for being a faculty member - lots of activities, everyone chipping in to make things happen regardless of how important the things might be, and being reliable about attending and eventually organizing those events. I noticed that as a graduate student I was always helping out and it was second nature. And it wasn't second nature for all the students... That desire to be involved got me positions as student representative on various committees. The point of all this is that I am comfortable being the driver of the initial organization of the neighborhood association.

I discovered that I am a little less comfortable going up to neighbors I have never met and discussing this. The moment I did this, I started to feel like a politician. But I think I will get over that soon. I am mainly interested in spreading the word about what I've done to this point so people who are interested can get involved. I have tried to create an electronic footprint for the association, with a FB page and a companion page on my blog. Trying to get noticed by the google search engine has been slower than I expected - they own blogspot so one would think they can access it pretty quickly.

In terms of my rehab, it has possibly been slowed a little by my recent efforts related to our kitchen work. Maybe it is rehab to scrape floors and paint ceilings and walls? I suspect I could have focused my exercises more and gotten a little more benefit. On the plus side, I have gotten noticeably stronger recently. So maybe construction is good rehab... The net result is that at around 12 weeks (odd how it is hard to remember the count now and it used to be so easy) I am finally starting to walk without a limp. My pedaling motion is also getting smoother on the bike. My PT has become more dynamic including lunges and moving from a squat to being on my toes. That last one makes me think about jumping even though I am still a bit from doing that. It was really exciting to able to move the leg press sled with 10 lbs of weight (plus the sled and my body weight) on it with my left calf at the end of my last session.

Smells like... a new semester

As fall begins to hint at its return and coats become mandatory for the ride to work, familiar smells return to remind me that fall is here. Around the MSU campus, these smells seem to be those of weed-killing chemicals and road construction this week. The building has a nice neutral odor. In two weeks that all changes.

The last few weeks have been a little frustrating since the two main conduits into campus from the north have been closed (S. 8th and S. 11th). This has put all the traffic into my biking path on S. 9th and S. 10th. I did "inspect" the new roundabout on my way home recently and I think it will actually be reasonable to use on a bicycle or as a pedestrian. The roundabout is not open because the lights were back-ordered. I have two issues with this. First, you don't start construction until all the "appliances" have arrived - we got this advice over and over again on our upcoming kitchen project. Second, why can't they have it open during daylight hours and close it at dark?

I have been working on starting a neighborhood association for our neighborhood. It has a temporary home as a blog at http://midtownnorthneighborhoodassociation.blogspot.com/. More on this later...


I am writing this while I am sending a loop code off to create vectors of 1.8 million observations. I really don't need or want to do an analysis with 1.8 million observations (over 100 years of monthly observations at over 1200 weather stations), but I want to see if I can do it. First I have to get it formatted the way I want, then I need to see if I can fit the models that I  would want to use for it. I guess this is a little like trying to climbing a mountain because it is there but not really planning to tell anyone about it unless you succeed and find a new route to the top. That is the danger of blogging, I guess, sharing your work before it is completely ready to be shared. I guess I've always known that research is rarely a linear process from initial ideas to final results, but it is even more obvious to me now that I've seen a few projects from beginning to end.

We always write up our research as if it was a direct process from beginning to end. It usually takes knowing someone pretty well or a couple of beers to share the trials, tribulations, and nonlinearities that were encountered between the initiation of the project and its completion. Some people are just repeating other work or sometimes publishing the same thing in multiple places - that is a linear research process until a reviewer finds the redundancy, which happens less often than it should.

As I've gotten more experienced doing research, I have been able to see the upcoming hurdles and either bypass them or be prepared to jump over them. When I am really engaged in my research, I have ideas bouncing around, some good and some bad, so much that I have trouble just working on one project at a time. I have a wall full of ideas for research topics and know some will never get worked on. Some of my great ideas have been found in articles that appeared after I had the idea but before I could even have started working on it. Some of my ideas have been so specific to my collaborative projects that some aspect of the research had to be publishable, sometimes it was even novel and useful in general. The best research is based on accomplishing things that initially looked to be un-accomplishable or maybe it is better to say that they have no direct solution to the problem at first glance.

For those wanting updates on my ruptured achilles, things progress well. I am trying to be rigorous with doing my PT exercises. I have had to face the weakness of the leg as I isolate it in various exercises. It amazes me that I can't lift my body up on my injured foot yet but I am getting close. My gait gets better every day and I have minimal pain as I work the area. I managed to walk to the store this week, which adds to the list of accomplishments on the path to getting back to normal. I haven't told Teresa yet, but I did climb the ladder to clean the gutter. And I've been commuting around town on my bike pushing harder every day. It is a long process but I am managing it well.

Boot off, learning to walk again...

I got cleared on my 8 week from surgery checkup to start walking without the boot. I am using an aircast ankle brace to prevent an ankle sprain since the ankle is so weak. The surgeons assistant was really happy with my progress and strength. I didn't mention that I had been walking around indoors for the week prior to her visit. When I mentioned that I had been biking for more than 2 weeks, she was surprised. I tried to clarify that I had been commuting not mountain biking, but got the feeling that this was not recommended. I re-read my original protocol and noticed that this is something for weeks 10-12 and I started in week 7 - oops. But I would have gone crazy without getting out on my bike when I did. 


Despite not being able to play much with them this summer, I felt a strong bond with my summer league team. Maybe it was more imagined than real but I will not forget this summer. They were gracious in having me around the couple of times I made it out, especially given that many of the players were older than me and seeing me reminded them of the risks of playing at their ages. And most have young kids, so being incapacitated would be even more challenging for them than for me. Buster (our dog) wonders why I haven't gone out with him for a walk all summer, but Teresa has had great fun with him this summer so he has barely noticed my absence.

I am loving this new phase of PT. I am getting to stretch my calf (oh how I missed my morning calf stretches) and do standing calf raises while standing on a step.This is the first time I am moving from being uncomfortable to real muscle soreness. Getting to push my muscles again is great. Biking without the boot has been great fun even though I can feel my weakness on every push with my left leg. My gait is still uneven but is improving daily

It is interesting how the body compensates for injuries. When I first was doing standing calf raises my therapist told me that I should keep my knee straight. I thought I was until I looked down and saw my knee at an angle. That cheating was allowing me to use the range of motion where I had strength and avoid the range where I was weak. And it all happened without my conscious knowledge.

I have managed to keep my weight in check during this period of reduced activity, only putting on a couple of pounds, coming close to 160 when I was closer to 150 before the injury. Even though my weight didn't change much, its locations have changed a little and I get to start working on that as the fall moves along. I had made some progress in this direction in the spring and feel like I am starting over at my winter weight just as winter is approaching. I guess I need a couple more pairs of "fat pants" for the fall if I don't start seeing some changes.

I did do something this week I am not proud of. I missed an acupuncture appointment. I forgot to put it on my google calendar the day I scheduled it, then left for a conference, and never remembered it. I pride myself on being organized and early for all my meetings (and especially showing up at them). I should have been more attentive to this as I moved from co-scheduling everything with Teresa to managing my own appointments.

Joint Statistical Meetings in Miami Beach

I recently attended the Joint Statistical Meetings that were held in Miami Beach. This is the largest statistical conference in the US each year, held the first week in August, and rotated around different large cities. It had attendance of around 4800 and often has more attendees when it is in better places. I have to rate this as the worst JSM I have ever attended (includes '99 and 2006-2011). My perceptions were colored by the state of my recovery to some degree. But I wasn't alone in my evaluations. On the last day of the conference, I was in a meeting where it was noted that Miami Beach was not in consideration for any future meetings. There was a round of applause, the only one I've ever been a part of in a meeting like that. It was too spread out, expensive, and with little to do other than sit on the beach (for me at least).


The night before I left for the conference I got as grumpy as I've been in a long time. I don't know if it was the heat, being tired, or just the looming day of travel. Teresa was sweet as ever and eventually it faded a bit. The conference required quite a bit of walking and standing, all of which I did in my walking boot. I also had too many meetings to attend, which combined to allow me very little time to attend presentations. I had to fight that same feeling of grumpiness every day as I used up what little walking I could do. I'm not sure I completely succeeded, but I tried.

The Miami Beach convention center is extremely large and has its set of presentation rooms on east and west wings of the building with what seemed like about 5 or 6 football fields between the wings that you had to navigate via a sky walk sort of thing. The administrative meetings and mixers were at the Loews hotel near the beach and not very close to the convention center (maybe around 3/4 mile?).

I had hoped to use the city bus since it ran from the convention center to very close to my hotel but it was somewhat poorly labeled and after one adventurous ride I wanted very little to do with it. I got on the bus one day hoping to head south to my hotel. After waiting a few minutes, the bus pulled up. I hopped on, paid my $0.25, and settled in. I wondered why the bus was pretty empty but figured it was just an under-used resource. At the first intersection, it turned when I wanted it to go straight. And then it turned again and started to head north. I had researched it online a bit and knew the bus route had some odd loops in the north section and figured I would ride it around and one way or another I would get close to my hotel (it generally runs on a loop). And then the bus pulled over and I was told to get off. I was told to find a bus near the Publix a block away. Fortunately, I found one of the areas 'Decobikes' rental spots. So I grabbed one of those and started riding. I really didn't know where I was or which direction my hotel was. After a few blocks and a couple of turns, I found a road I recognized and knew how to get home. I found out that locals even get caught with this problem with the bus route and I didn't try the bus again.

I mainly used the decobikes to get around. This had its own issues. You rent them for $4 for 30 minutes and can leave them at any of their automated parking areas. A little pricey to use for commuting and you can't buy a pass unless you are a resident, but in general they are a decent idea. In retrospect, I should have just rented a bike for my time there (that would have been $15 a day) and could have parked really close to each place I needed to visit. I did enjoy biking along the beach and the exercise was nice. One time I got to my desired station that was full and the parking locations were a bit sparse near the hotels, which would seem to be an important place to have lots of spots. I guess the network is only 2 months old and maybe it will be improved in the future.

In terms of my recovery, it wasn't a great week. I was so tired each night that I didn't do a good job with my PT. I walked so much that I wore out the padding in the my boot in the heal and started to worry about doing some damage because of that. Flying was also an issue. On my flight to Miami, I was able to manage my swelling because of a long layover between flights, getting an exit row, and having an empty seat next to me. On the way back, I barely made my connection (almost had to run in Minneapolis because there were no golf carts even though I requested  one) and was wedged into the wall on the flight from Miami to Minneapolis by someone that was close to needing 2 seats. The stewardess gave her a seatbelt extender on her way into the flight, if that is an indication of what I enjoyed. One positive feature was that I wasn't cold on that flight at all. The net result of my trip back was that my ankle was the largest it has been in weeks, maybe even more than a month. On a positive note, the swelling is now gone and I am getting stronger and starting to walk a little around the house. I will hopefully get cleared to begin walking without the boot on Monday morning when I see the surgeon for my 8 week check-up. I can't wait!

Preparing for a new semester

My strength and fitness are improving daily with my rides to campus. Last monday night, I went to watch my summer league team play. They had 1 sub to begin with but then he had to leave and another player may have broken a bone in his hand, leaving them with only six players. It was so windy as a storm blew through at the beginning of the game, that I thought about trying to play a little. If I could safely huck (which I can't yet), I was thinking that I could walk around the field, and be available to huck the disk and then let my team play a 6-person zone. Fortunately, the wind calmed down and those crazy thoughts passed. I can't waste 7 weeks of work just because I feel a little better.

I got the slightly frustrating news today that I will be in the boot for another week. Really a week and a half since I see the surgeon again on Monday of the following week at exactly 8 weeks after surgery. I was hoping to be ahead of schedule enough to get some boot-free walking in, but the PT is not cleared to make that sort of decision. As I note above, I have to avoid being stupid at this point. I am at 6 weeks and 3 days post surgery and that is just not enough time to get out of the boot...

In between the hectic preparations of a poster for a conference, an accelerated search for a position for this fall, and trying to get a new course proposal ready for submission, I have been thinking about my fall class. It is a senior level undergraduate course in mixed models. Basically it involves statistical methods for correlated data that might come from measuring the same person repeatedly or students in the same classroom or spatially, temporally, or spatio-temporally correlated observations.

I try to let my teaching be influenced by recent experiences, be they research or life experiences. I got a push in sharing my life with my students by Tim Robinson at the University of Wyoming. We team-taught an engineering stats course and he had an almost folksy presentation style (in a good way) with his Virginia accent and stories about his family and his research projects permeating lectures. This made a class 80 students feel like a much smaller class setting. When I took over the class, I wasn't ready to bring that familiarity into my teaching but have slowly gotten more relaxed when I am teaching and more willing to share what I am up to with my students. My classes are heavy on my research projects as examples of hard learned lessons in various areas. But I am also willing to let students see that we all try to balance work, family, and fun - letting them know that sometimes when I am not in my office I am out hiking, biking or skiing. I am in my office enough hours with my door open to also try to set a strong example for how much work is required to do this job. This fall, my achilles tendon rupture and rehab will be a prominent part of my class and discussions.

During my surgery, I discovered the "new" infra-red based technology to get body temperature readings non-invasively. It uses the temperature of the blood vessels in the temple area. I looked around and discovered that you can get them relatively cheaply ($30 for a decently rated one, $10 for one "fresh" from China) and even more cheap is the hardware version of the tool - a laser-based temperature gauge ($10). I am yet to get a reasonable body temperature reading from the laser temperature gauge but it may be possible; the "real" gauge seems to work well although I haven't bothered with the rectal temperature calibration test. Regardless, I am going to try to integrate the real and alternative temperature gauges into my class in the fall. I am hoping to use them and the idea of doing a study of body temperatures to motivate some of the big issues in the class during the first few lectures. I plan to have them design, collect, and analyze a study using the different gauges. I have a few different ideas that would be fun but am trying to remain open to whatever ideas they might come up with in class.

I also starting to find some interesting articles related to achilles tendon problems for my class in the fall. One is here which contains a summary of possibly more interesting studies but with statistical methods that might not be as good a fit with the class. I like this one because it has nice graphics and is a simple repeated measures analysis with a single(sort-of) quantitative explanatory variable. It also illustrates why researchers might be interested in taking repeated measures instead of one measure per "subject" - they are working with cadaver's legs. There are a couple of issues with how things are reported and the model but I'll leave that for my students to sort out on their homeworks...

I was also entertained to find an achilles related data set in R in the repolr package. It is a repeated measures, ordinal response data set with a 3-level response of level of recovery. I have been working in this area and looked at that package last spring, prior to my injury, and didn't think too much of the data set back then. I will definitely be revisiting it later.

I find that I am struggling a bit to write this to whatever audience I have - maybe I should split my posts into different topic areas. I mix my life and work up together, but maybe my posts should have more separation. I am beginning to think that blogging is as much for yourself as it is for other people... it certainly was in my first days post-surgery.

Transportation Independence...

When I first saw the surgeon, he was happy for me because I hurt my left foot and could drive sooner than if it was my right foot. Unfortunately, we have a manual transmission so I still haven't driven since June 5th. Usually, we bike or walk around town and it has been wearing on me (and Teresa) that we have been driving everywhere. Friday, I got permission from the PT to use my commuter bike while I am wearing my boot.

So I pulled my bike out of the bike trainer stand the second I came home and used it to ride to campus. My commute is almost exactly a mile with a small climb at the edge of campus. I took off not expecting too much even though I had been riding for 10 minutes straight in the bike trainer, which is about how long it usually takes to ride to my office. I discovered that my boot makes it a little cumbersome when starting up and it can get caught on my fender when I turn right, but the biking is pretty natural. I took it a little slower than normal and had more traffic than normal to deal with, but found the ride easy and climb at the end pretty manageable.

The north end of campus at Montana State is a mess with construction. At the corner of 11th and College, we are getting a roundabout. That should be interesting when students come back to campus in the fall. 8th street is also torn up with new water lines being installed. So traffic is getting pushed into 9th and 10th streets from both sides and those are the streets I use to commute to campus. Surprisingly, riding with a boot gets you no sympathy from drivers that have been diverted by construction. At one intersection, I tied with the car coming the opposite direction at a stop sign. I came to a momentary stop and since her turn signal was not on and she saw me, I proceeded forward. She started to turn and gave me a dirty look! Even without a boot, I would have been mad about this. With a boot, wouldn't you be a little more patient with someone on a bike (even though I didn't need it)? I get so tired of people with cell phones stuck to their ears driving around and nearly hitting me, especially when I am on a bike and behaving legally - following the traffic laws.

Next week looks to be much easier for both of us since Teresa no longer needs to take me everywhere. We can return to our old schedule and routines of biking to campus and one of us biking home to let Buster out during lunch. My appointments next week will no longer require complicated logistics to get me there and back home. And I start to regain some of my fitness as part of my daily routine.

I had a replacement physical therapist last week and she was really impressed with my recovery at this point. I am getting close to walking without my boot. I am still nervous about that as I feel like I am still pretty weak, but at some point I have to get back to full weight bearing without protection. One of my PT upgrades to get me back to walking has been balancing on one foot with my eyes closed. Try this sometime. Even with full functioning legs, it is challenging to hold for 30 second to a minute. I do this sort of exercise in the winter to improve my balance and glide on skate skis, but had always kept my eyes open. This is definitely a level higher.

Returning to normalcy...

I am daily feeling gains in strength in my injured leg, both in terms of balancing in my boot and walking with more strength. The PT is getting more adventurous as I improve as well.

One aspect of that is scar tissue remobilization. I am just at the beginning of that process but for now it involves gentle massage of the incision site. Some spots feel good to have this treatment, but a couple of areas, especially near the top of the incision are less enjoyable. I have heard this gets more intense and less comfortable sometime in the future.

In general, I am progressing quickly and should be starting to do some work outside my boot in the next weeks. I sneaked standing on my injured leg without the boot a couple of times and found it to be strong and comfortable. Not trying to roll forward on it yet but I think that is coming soon. My therapist described the next weeks as a series of levels to reach and then I get to move to the next level. Everyone's timeline is different at this point, but once you can do something, then you can try the next. For example, I have been one-legged biking with a bike trainer I borrowed from a friend the last couple of days. Now that I can balance on my injured leg in the boot I can add the second pedal. I will still be biking in the boot, but can have a more natural biking experience. Once this gets comfortable, I think elliptical training will be next but will wait until later this week to find out about that.

I have tried two different massages in the last two weeks. Somehow our insurance is more in favor of massage than acupuncture so I wanted to see what benefits I could get from massage on top of my other treatments. Last week, I got more of a relaxing massage except for some deep tissue work on my shoulders. It probably was good because it helped me break some defenses down after the surgery but really wasn't terribly therapeutic in any way. This weekend, I went to see Katie Cook Massage and got an entirely different sort of treatment. Her thoughtfulness and methods were completely different from the previous weekend. She seemed to work on fixing function of parts of my body and my posture, and doing this by manipulating soft tissue. I can't say it was enjoyable (it actually was near my upper pain threshold frequently) but I can already feel some changes. My neck and shoulders are moving better. She tried to fix the alignment in my hips that has been messed up by walking in the boot - the difference in heights is somewhat unavoidable. This morning, I noticed that I was walking on my tip-toes on my right foot. Amazingly, my hips wanted to stay at the same height instead of twist to accommodate the differences. I'm sure I will reverse this with more walking in the boot, but it shows what she can do for me once I am out of the boot. It was such an interesting experience, I think I bored Teresa with stories from my treatment by telling so many but I was fascinated by what she did. There are stops that she pressed on that I didn't know could be sore. I think both Teresa and I will be using her services to keep us running smoothly as we escalate our exercise intensities into the future. I would recommend her even if she wasn't our neighbor and friend!

As I mentioned before, Teresa has been starting to run and enjoying it. Once I am free to go into the outdoors again, she will be running loops to get her cardio with me along. I don't mind but we are both preparing mentally for this role reversal. I think she is quite excited about leaving me in her dust...

Starting PT

Now the fun really begins! I had my first and second PT sessions last week and started walking with a boot and crutches and now can walk without support. I am using a cane to try to level out the walking a little but am walking enough to make my shin sore while everything else is feeling great.

The main focus of the PT is on strengthening and not on range of motion at this point. I didn't quite understand the therapists explanation of the mechanisms behind this (I was trying to spell the alphabet with my foot and somehow it took all my mental focus to do that) but the main concern is over-stretching the tendon. If that happens, it will be really hard to have strength in the range of motion required to push forward. So for now, building strength is the key. I could start doing some riding of my bike on a borrowed trainer but wasn't strong enough to change the pedals over the weekend. I will try again soon.

Last Wednesday after PT, 4 hours at work, and learning to walk again in the boot, I had an acupuncture treatment. Ever since the surgery, I have been extremely sensitive to the needles - much more than before. Part of this is that she can't "confuse" my nerves in my ankle area by pressing on them prior to inserting the needles because it would hurt too much to press that hard. Part of it is that my system is still a mess and needs some time to get back to normal. And some if it is due to the slight swelling I am still working on below the injured area. She has been focusing on getting things in better alignment, healing, and reducing swelling. I am also continuing to take a suite of chinese herbs to help with the swelling and keep my calves relaxed. As far as I can tell, all this is helping me. My most recent treatment was my most "normal" yet. She thinks that the herbs and treatments have me doing better than I was before the injury (except for my achilles of course). But my pre-surgery status was related mainly to trying to rebuild my body after the stress of the tenure process.

The tenure process is an interesting experience. You put every fiber and thought into getting as much done as possible before you have to send your packet out for review. You barely see family and friends, take on too many projects, and are always looking for one more paper. I really enjoyed the lag between submitting an article to a journal and hearing back because it meant I could focus on another project. I was working at a rate of submitting or re-submitting an article every month for the last year and a half of the process and was right at the upper limit of my productivity during that time. And some projects fell to the wayside and some surprised me to get done quickly. One surprise was a paper just recently accepted to the electronic journal of applied statistics (for statisticians, the acronym EJASA is not a coincidence).

The story behind it is not really all that typical: I was working with some Arctic researchers on other projects and they brought me a side project looking at presence or absence of certain microbes in different layers of ice cores. The data set wasn't conducive to inference, really it just needed a nice description of the patterns observed. I did a standard hierarchical cluster analysis but the reviewers wanted some revisions on the paper. I ran into a different type of clustering more suited to the binary nature of the data set and showed the results to them. They thought it was nice but that the plot was hard to interpret. So I made it better. And that application paper got accepted. And then I used the same method on a data set from the Examining Mathematics Coaching (EMC) project that I am funded on and showed it to those collaborators and they thought it was interesting as well. So I wrote a paper describing the method being used and why the graph I developed was useful, and suggested some different areas of interest for its application. I think it took me a week to write the paper although it was built on my previous work and feedback from great collaborators. The first reviews wanted more of a contrast between methods and I added that to it shortly after the semester ended. I am happily surprised about its subsequent acceptance but it shows that small novel ideas can get you publications without years of work. And sometimes years of work on a project barely gets you a publication. 

The main frustrations of last week have been hearing the recovery timeline re-iterated and some stiffness in my neck. My neck has improved, but I am still faced with the following. The surgeon says 6 months to fully unrestricted activity and the physical therapist said that I will struggle to recover my previous strength for up to around a year. So my week has included the excitement of walking, returning that awful scooter, starting my PT, getting an article accepted... and then thinking about a long time to getting back to where I was a month ago. But I feel like I have a good team around me - PT, acupuncturist, wife, and dog. And I will get to cross-country ski this winter so I can't wait for the snow.

4 weeks post injury, 3 weeks post surgery

Happy 4th of July weekend!

Recovery continues to progress well. I had a bit a swelling and discomfort the last few days as I have gotten more active and started trying to move my ankle around but it is enjoyable to get things working again. I expected some pain as I start to break the scar tissue up and form better tissues in the area. Being able to directly ice my ankle has provided some nice relief and kept the swelling down. I took an opportunity to explore some of the literature related to achilles tendon ruptures (ATR). There seems to be studies indicating no evidence of a difference with and without surgery after 6 months. Those studies might have ignored looking at differences in trajectories over time as they all seem to use relatively simple statistical analyses to compare different outcomes at fixed time points. I wonder if they are missing differences in recovery at earlier time points... More on this later when or if I find some studies I want to use in my class in the fall and really dig through the details.

I have been enjoying watching Teresa get into running in the last couple of weeks. It is early days for her doing this, but she seems quite taken with it. Before my injury, we would go for bike rides and I would often ride ahead and then loop back to ride with her for a bit. Whenever I get back to doing fun stuff, I suspect she will be giving me the same treatment. It will be a while before I get to going ahead of her again.

We have been dealing with fireworks "season" here in Bozeman, MT. In 2004, non-flying, non-concussive fireworks were legalized for July 3, 4, and 5th (I guess). This has lead to Bozeman sounding like a war-zone for about a week around the 4th. We tend to hide in our basement a few weeks to try to get some sleep and let our dog keep from overloading in adrenaline. Our personal problems with this vary depending on how much our close neighbors choose to violate the law. This year was one of the worst in recent memory... I like to think people are generally clueless about the actual laws here (Bozeman ordinance), the impacts on pets, babies, wildlife, the environment, and people that actually try to work in the mornings during this time of year. An interesting article about pollution from fireworks and a potential method of reducing it for professional shows is here. I think Bozeman's "real" show had fewer loud concussive fireworks and was much less jarring than previous years. I appreciate that change and wish all of our neighbors would read and obey the regulations. I also wish the city would ban all fireworks because most people seem to have missed (or outright disobey) the nuances in the current law.

I really like Bozeman but I do think the city council has missed the boat in their regulation of fireworks and the police in terms of trying to enforce the laws. I don't really blame the police, because I think they have many difficult laws to enforce at this time of year.

I will stop ranting about fireworks as I am headed out to the doctor to get fitted into my boot. It will be interesting to see how hard it is to walk now. My calf muscles now can contract and I am only lacking a few degrees of flexibility in the injured foot. I will be really happy to be free of crutches and scooters in the near future...

2 weeks post surgery

I had an exciting visit to the ortho today. They removed my splint and stitches and I passed a Thompson's test. The Thompson's test seems to the primary diagnostic for achilles function and seems to require little more than a squeeze on the calf when it is in a relaxed position. Passing this test, the healing of my stitches, and the general lack of swelling seemed to make the doctor (or nurse?) happy. We are a little frustrated with the lack of information about upcoming steps and appointments, but the surgery work seems to have top notch. We just would like better communication about the future so we can make our schedules work.

I have to admit that I was nervous about getting the stitches removed. They put a numbing spray on and it wasn't too bad. Teresa was there and that helped me through the process. Then I went to the connected rehab clinic to get a dynamic brace made. It is basically a custom molded plastic brace with an open back. Seeing my heel again is quite exciting. The picture below is what it looks like (sorry if you don't want to see the surgery area):

I am now allowed to step down on this but the angle it is fixed in doesn't make it very useful yet. And I can remove it to shower and even put a shoe on over this when I go out.

I don't know how much the herbs that I am taking have helped, but everyone seems to be impressed by how I am healing and they certainly haven't slowed me down.

I posted a review of my knee walker last week and here is the requested picture of it. Its interface with my new brace leaves a little to be desired but I think a little padding on the top where it hits my shin should make it manageable.

I decided to take not go to work today as I am adjusting to the new brace but am going to go out and watch some ultimate tonight. It is my 37th birthday on Tuesday and I guess we get to celebrate my excellent recovery so far. Teresa has a busy day at work but we are planning on going out for a fun dinner. For our anniversary last week, I wasn't ready to go out for dinner. I think we'll be double celebrating on Tuesday to make up for the last three weeks of stress and discomfort.

Hygiene and crutches

I have noticed that being on crutches or a knee walker creates an issue with hygiene. Unless you can reach the sink while sitting on the toilet, it is hard not to put unclean hands on support equipment to get in position to wash your hands. Washing your hands after that only partially mitigates this issue. So wiping the equipment has become an additional step in the process when possible, which is not always the case.

Completely unrelated to this, being semi-conscious at home last week and not having cable meant watching lots of internet tv from netflix and hulu. I got frustrated that the only way the writers seem to be able to create tension in thrillers is to have people do stuff that should get them into trouble, like cheating or stealing or abusing their jobs in some way. I guess you can't create a "taut thriller" without stupidity causing the problem. So we fell into watching more "period" movies where the drama comes from revealing an interesting set of events...

I am happy to report over 200 pageviews so far on my blog. I am hoping to make it more entertaining as I move from status updates on the injury into the rehab process and getting back to work concerns.

As an update on my recovery, I was doing great going into day 9 of recovery - starting to work and stopping pain meds. And then as I was heading outside to work and sit in the sun, I tripped, started to fall, and put weight on my injured foot. I am hoping I didn't do any real damage (it is hard to tell but I think it is just additionally sore/bruised) but feel like it took me backwards a couple of days in healing.

Shortly after that, I went for an acupuncture appointment. The treatment showed me how out of balance my system is after surgery. She explained that there are many meridians of energy flow that travel through the area that I and then surgeon messed up. I was extremely sensitive to some simple treatments and am hoping that she is helping me move along in my recovery quickly, at least when I don't cause my recovery to go backwards.  

Reviewing my Nova knee walker

I am starting to feel better and cut my pain med consumption down considerably. Having my body function more normally and my head clear up has let me see some hints of the length of the recovery process. Time has been moving really slowly so far and I have exhausted everything I want to watch on hulu and almost everything on netflix. The process will be more clear next week when I find out how much work I can do on my injured leg.

Thinking about other people and their injuries has put my injury in perspective. One of my students broke his leg and had to have surgery this weekend - we'll be having dueling crutches or walkers next time we meet. A friend broke his leg skiing two years ago and has had complications that are still causing problems. If this goes smoothly, I'll be putting weight on it in two weeks after injury. And so far the pain hasn't been as bad as I expected.

Now I would like to review my knee walker. It is a rental unit and has obviously seen some miles but wear and tear only applies to a couple of the issues. It seems to be a Nova four wheel model. A few of its components are "stolen" from bicycles but obviously this wasn't built with the best of bicycle technology in mind. While I am being critical of it, it has made a big difference in my independence but it could be much better...

• First, the unit is very heavy. I mainly know this from watching Teresa carry it. I'm guessing the tubing is steel. This seems unnecessary as it only needs to support half a person. It is rated for 300lb people and maybe safety standards suggest some high level of overengineering. One would imagine an aluminum frame could be built for a similar cost that would cut the weight in half. There are other unnecessary additions such are both a seatpost collar and a bolt that goes through holes in the post. And the seat post looks like it is made out of a barbell type of material. The wheels are solid plastic which would likely be heavier than inflatable tires.
• Second, its handling and steering are weird. At any sort of speed it gets unstable. That would be forgivable if it had a tight turning radius that made it be too responsive, but its turning radius varies depending on which way you turn and is fairly minimal to the left. Neither direction seems to turn very quickly and I often end up lifting the front wheels off the ground to turn it - not exactly a safety feature.
• Third, the brakes are crap. The design is stupid, using brake pads on the rear wheels themselves. I think this is how they stop cable cars and the first bicycles. In my used unit, the brake actually only stops a single tire. Fortunately, the solid tires have no grip on carpet or wood floors, so this doesn't cause any instability. And if you don't have all your weight on the unit, the wheel locks up but it doesn't stop either. The brake lever looks like it came from a huffy from 1990 and has a hand lever that is large enough for big foot. As a safety feature, it does have a reflector on the handle, so if a car is approaching from the right, they might no run me over in my living room.
• Fourth, the solid tires are awful. As I noted, the handling and braking are poor probably due to the tires and the weight isn't helped either by them. I have to imagine there are inflatable tires out there that don't mar floors. The big thing this would provide is some ability to handle transitions between surfaces. I am not looking for a full suspension knee walker, but something that could role over a transition between rooms and grip a little along the way would be nice.
• Fifth, the grips are very thin. I don't plan on putting tons of miles on this, but the grips are extremely thin and provide no real cushioning and little grip. Again, bike grips have improved dramatically in relation to this in recent years and the worn out grips on this unit could be easily replaced.

Despite all my issues, the unit actually works just fine and the knee cushions so far seem to be the best part of the unit. It provides good stability as long as it is used cautiously. For the first time since my injury, I was writing on this blog to procrastinate doing some real work, which I am off to do now. Before, I was doing it because it was all I felt like I could do. With better weather coming soon, I'll be taking the knee walker out for a proper field test and might see some brilliance in the design, although I doubt it.

Recovery Days 3-4

I am happy to report that I am starting to feel better. The pain levels have dropped and I slept through the night last night without additional pain medication for the first time. I might even work a little bit before I want to nap today.

Yesterday had three bits of excitement - leaving the basement, showering, and visiting the acupuncturist. Later on in the recovery, this will seem pretty minor, but getting back to doing regular things and getting more mobile was exciting. Teresa went all out and bought us a safety show chair with a back on it. She thinks it is a good investment since we will start to need one more often now that we are getting older. The combination of my first activity for a few days and the treatment left me really tired yesterday afternoon. But resting combined with my best night sleep after surgery has sent me forward this morning feeling quite good.   

So another week of being careful not to damage the repaired area while I hopefully continue to feel better every day. The acupuncturist warned me that I may get a bit grumpy in the next week or two as my system tries to process the toxins from the surgery out of my system and I have to adjust to not having fun like I am used to. In the past few years, I've discovered that exercising is extremely important for my general health and feeling of well-being. For the short term, I need to obtain that without exercising.

I am quite happy to be feeling like I've turned a corner on the healing and now can start thinking about getting back to more of a normal mode of operation.

Recovery Day 2

Last night I finally started to feel some real pain. Not unexpected but not enjoyable either. I also got some deep sleep but my balance at 4 am was poor and I had to put some weight on my leg to avoid falling. I don't think I did any damage but the adrenaline spike kept me awake for a while last night.

Teresa often jokes about my habit of kicking in my sleep, especially after I watch soccer. This morning, even though I didn't watch the US-Guadalupe soccer game last night, I kicked with my injured leg in my sleep. What a wonderful way to wake up!


Buster has been extremely gentle around me and my injured leg. He is a border collie/ blue heeler mix and has tons of energy but seems to know that I am not 100% and is being very careful not to make it worse. 

I am beginning to see some direct impacts of the surgery on work, skipping a conference call on Thursday and having some work go stagnant because I am not able to function yet. I was optimistic yesterday about being able to get up to campus at the end of the week but now am thinking it might be the end of next week.

I see the acupuncturist on Thursday and maybe that will help me turn a corner on this and start to feel some heeling instead of feeling like I am mainly trying to avoid tearing my stitches.

Recovery Day 1

My surgery went well yesterday. The surgeon said that while it was ruptured, it wasn't as much of a mess as he usually sees and that it was an "easy" repair. Teresa joked later (not to the doctor) about asking for a discount on the surgery because it was easier than normal. My pain levels have been minimal but I didn't sleep well last night. I discovered sleeping on my stomach halfway through the night and that made it much nicer.

I chose to have a spinal anesthetic which created a few new experiences. The slow loss of feeling to lower extremities while they were positioning me was unusual. And then regaining feeling and the happiness that things were working again. While my gentleman's vegetables were still numb, I got an itch in that area that I couldn't seem to scratch. Eventually the feeling returned, but I've had some psycho-somatic itchiness from that experience. They did give me versed during the surgery so I don't remember any of it and am happy about that. I woke up and once the feeling returned, I felt good almost immediately. I am also taking a little aspirin to help to prevent blod clots that they observed as a rare complication here - not sure if that is related to living at higher elevation or not. I will also be starting to work with my acupuncturist this week to try to speed the recovery process.

I left the surgery in a splint which I have to wear for two weeks. Then onto a dynamic splint (the day before my birthday) and some weight bearing for the following two weeks. By four weeks, I will be in a walking boot and by eight I should be walking without support.

I have enjoyed all the emails, FB posts, phone calls and comments here supporting me in the recovery. It seems like a little thing to do that, but it is appreciated.

Waiting for surgery...

I am in the holding period waiting for surgery on Monday afternoon. I tried to do a little more on Friday wearing my walking boot, watering our raised gardens and making quite a few trips up and down the stairs. I now have grown a bit of a cankle and am seeing the rainbow of colors from yellow to black showing up below the injury. Teresa got me out of the house today and it was really enjoyable even though it wasn't a big adventure. We went to the museum of the rockies, saw the frog exhibit, and then did a little shopping, trying to anticipate post-surgery needs and wants. Mainly it was nice to get out of the house and spend time with her before I become really dependent on her next week. Being able to chat with some of the neighbors and friends we ran into while we were out was also nice.

Some of the ramifications of getting injured that you don't think about are the impacts on other people. We were going to remodel our kitchen at the end of June, but have moved that project to August at the earliest. My students aren't getting much attention as well as some of my other research projects that are just sitting still. I also see the impacts for Teresa because I have been her main exercise partner and she is having to take time off work next week to take care of me. She has signed up for some fun local mountain bike clinics and hopefully will link up with some (new) friends that are at her level for some further adventures this summer. It will be a bit of a role reversal for her to come back and tell me about her adventures in the next couple of months. And Buster (our dog) is getting lots of love but not as much exercise as normal.

We've been discussing how to modify my diet since my calorie consumption is going to drop. Probably the easiest thing to drop is beer, but I am reluctant on that one. I think I am more interested in smaller portions than that...

Post #2

I found reading blog posts (http://www.achillestendonblog.com/) about other peoples experiences with achilles tendon ruptures both scary and reassuring. The ortho appointment was interesting. It was a full rupture. I "failed" the Thompson's test and he noted that there is a gap in the tendon with possibly a few fibers still connecting it. The gap in it is really noticeable now. He thinks I will be a good candidate for a full recovery. I left the office with a walking boot and don't need crutches until after the surgery.

I have to admit that the exact dates for the different steps in the process flew by me in the conversations, but for the moment I just get to keep it comfortable and avoid further injury. He wants fibrin (?) to fill in the heads of the tendon so he can perform what is supposed to be a 20 minute surgery. Basically, he will stitch the two ends of the tendon back together and that will be it. The incision should only be an inch or two. Surgery will be sometime early next week. A couple of weeks and I get to start working it out again lightly. He thinks I should be walking by the Joint Statistical Meetings the first week in August.

I am feeling more positive about this today than yesterday. I know it will be a long process, but I will be more active sooner than I had expected. It was nice to get the splint off my leg and be able to do some icing again as my ankle was a bit swollen and starting to turn black and blue. I do love my garage sale polarcare 300 for icing - so much better and safer than ice or ice packs.

I have been fascinated that there are people looking at my blog. I have my work website and I know it gets some traffic but never know how much or who is looking  at it. If I knew how many people were looking at it, I would probably spend more time making it look nice.

I think I am finally getting an interest in working again. This week has mostly been lost for work and I hate that my recreation has cut into my work this much. I pride myself on keeping the two separate and using my recreation time to benefit my work. Usually I do this by either sorting out problems while doing fun stuff or having more energy when I am at work because of doing the fun stuff. In recent years, I have definitely recognized that if you are not healthy, you can only be productive for a short amount of time. Taking time to be healthy increases productivity, at least for me, except this week.  

First blog post...

I had never really been interested in creating my own blog, but I ruptured my achilles tendon on Monday, June 6 playing ultimate frisbee and facing months until I am back to normal has motivated my interest in having an additional outlet and distraction. I was recently tenured and promoted to associate professor of statistics at Montana State University and the change in pace and obligations also has encouraged me to consider this additional outlet.

First to the injury... I have been slowly easing back into playing ultimate and getting more fit this spring. The last few years have seen me playing ultimate sporadically compared to 1992-2004 where I played competitively at Luther College and the University of Wyoming. In those years, I played at least half a dozen tournaments a year, playing on college, open and coed teams. I was the player/captain/coach for both Luther and UW. Before that I played soccer competitively up until a back injury during training camp at Luther College in Fall 1992. All of that ultimate and then the tenure process took a bit of toll on my body, mainly my knees and my fitness levels. And I am now almost 37. So getting back to a fitness level where I can play ultimate, possibly competitively, has been a challenge this spring.

I had a good ski season, feeling stronger than I had in years. Then I started running a little as temperatures warmed a little, until I strained my left calf muscle about 2 months ago and had to take a couple of weeks off. Then I made it to a few pre-Bozofest practices and it wasn't pretty. But I didn't have any major injuries through that and started to feel my fitness improve. Then I started mixing in elliptical training and a few bike rides and really felt like I was turning a corner.

That brings me to monday. It was the first night of summer league. I did a nice warm up, stretched a bit, and then we started playing. It was the first time that my knee and all my muscles felt good. Fitness was still a little low on long points and my throwing was conservative or inaccurate on my one huck. I played around 4 or 5 points but was surprised with how good I felt (not great, but not as bad as I expected).

Then on a turnover near our endzone, I took off on a cut to lose my defender. It felt like someone stepped on my heel as I took off, holding it down as I tried to run. I had the oddest combination of tingling and numbness in the middle of my lower leg. It only hurt when I tried to walk off the field and was extremely weak. I later discovered that no one was near me when I was cutting. I think I knew I had hurt my achilles, but wanted to think it was a muscle strain/tear.

Thursday I go to the orthopedic surgeon and probably will have surgery to re-attach the tendon. I had seen discussions of 6-8 weeks for recovery but that is likely how long I will be in a boot or cast. Mayo clinic suggests 4-6 months for the complete recovery process. That takes me from August to between October and December. I hope to try to chronicle my recovery process here as well as taking time to discuss life as a statistics faculty member. Life always involves a balance between work and play, and it looks like my play time is over for the summer.