Between L4 and L5

In heartrate terms, Level 1 (L1) is easy aerobic training. L3 is medium. The upper end of L3, right where it meets L4, is one’s anaerobic threshold, the point at which the body's ability to prevent the build-up of lactate (lactic acid) seriously deteriorates. One can sustain threshold for about an hour, so L4 is essentially race pace for shorter races. L5 is the heartrate and pace you can sustain for a few hundred meters. It’s reserved for hard intervals, the end of races, and, if you're a guy, when you're about to be “chicked,” aka passed by a woman. (Look, most guys in endurance sports are pretty progressive; please forgive us this one misogynistic term when used in a friendly manner.) Für mich, being on the L4/L5 border is bliss. My body is tripping on endorphins, and although I know the last stretch is about to suck, I also know the post-race beer and fun with friends is just around the corner, the endorphin high will linger, and the traditional race-day whiskey nightcap is just a few hours away. 

I hope I get back there soon.
 
L4/L5 also refers to our lowest two vertebrae, and, unfortunately, I’ve been diagnosed with a problem between then. More specifically, it looks like I have Spondylolysis, which, as Wikipedia puts it bluntly, "is a defect of the vertebrae." Even more specifically, my L4 and L5 are not fused correctly, and I was likely born this way.

According to the Cleveland Clinic,“Spondylolysis is a specific defect in the connection between vertebrae, the bones that make up the spinal column. This defect can lead to small stress fractures (breaks) in the vertebrae that can weaken the bones so much that one slips out of place, a condition called spondylolisthesis.” And according to the good Priv.-Doz. Dr. med. A. Badke Stellv. Ärztlicher Direktor (have I mentioned that Germans like titles?, and more on him in a moment), I have said spondylolisthesis.

Luckily I do not have Spondylosis -- seriously, this is a third term and condition (basically a form of degenerative arthritis). The similarity of the words is Kafka-esque. I have spondylolysis and spondylolisthesis but not spondylosis. Ready for the quiz? I thought about posting the x-ray here, but really the spine is grossing me out at the moment.

So what do an improperly fused spine, stress fractures, and slipping bones mean in the long term? As Kristin and Jason's doctor friend just put it to me, "The good news is that you have had this your whole life, the bad news is that it is now symptomatic." It’s funny that I recently wrote here that my goal remains a marathon p.r.; I guess I should scrub that line from the blog. I hope to remain a moderate runner, and maybe do shorter races (one question I'll ask whatever doctor I see back in the states: will this increase the chances of being in a wheelchair when I’m 70?). My sister got all the swimming genes in the family (I literally can kick for about three strokes), so I guess the way to make lemonade out of rotten limes here is to finally take up swimming. Anyone want to go in on adult swim lessons? The good news, according to Kris Freeman, is that swimming makes you a faster skier. Indeed, I hope above all that I’ll still be able to x-c as much as I want.

But there’s no doubt about it: this is disappointing news, given that running has become a passion -- and running is pretty much the worst thing you can do with this condition. And apparently lifting weights may not be ideal either. My question for the ex-theologians and psychologists who read this blog: if one is cancer-free; not in a Syrian refugee camp; in the SES not getting completely screwed by our nation's anti-statist fetish, record inequality, and stupid turn toward austerity; and devoid of a true disability, how much is one allowed to be depressed about simply not being able to do as much of what ones loves to do? And I am allowed to be feel sorry for myself if this condition actually starts affecting my ability to walk for Eis or to wear a backpack, as it seems to be at the moment?

In the short term, I decided to take one out of the Washington Nationals’ playbook and completely shut down. I stopped everything for two weeks ... and did learn you really can read a lot of history when you don’t have to worry about workouts (and you’ve finally met a 17-year-old goal of getting your inbox to zero). I lifted a couple days ago, and so, of course, the pain returned this morning walking J to the train station towing a suitcase. Argh. Of course, then I felt like a complete jerk getting mad about it after we passed a woman with elephantiasis. ... but in any event, it looks like I’m back on the IR. Maybe at this point, instead of admitting that I’m in athletic limbo, I’ll pretend to be a serious athlete ironically describing the difficulty of finding things to do on recovery days. 

Although the news was not great, Betty and Ella and I had fun at the hospital. Here I am waiting for the x-rays after getting a number.

After this image, you might expect a paragraph on the terrible waiting and rationing inherent in the German health care system. Sorry to disappoint. My visit to the hospital indeed brought the contrast between the European and American models into sharper focus … and made me mad once again that the Dems caved in on the public option. I first had back pain more than a year ago, but then I waited several months to see my doctor, and even then -- on a tight insurance-company leash -- he sent me to a personal trainer instead of a back specialist, and did not ask for x-rays. I don't want to even think about how the trainer twisted me like a Bretzel not knowing my condition. Here in Germany, the doctor was motivated by the novel idea of finding out what was wrong with me, and, wholla, I finally got the simple diagnosis. Oh, and the wait for x-rays took about 10 minutes. 

It turns out that Priv.Doz. Dr. med A. Badke’s son has the same condition. I think we really bonded.