My L5-S1 Disc Explosion Pt II

Continued from Part I So after bucket-loads of pills, rest, e-stim, physical therapy, decompression treatment, chiropractic adjustments, and acupuncture I was still a mess. My pain had only gotten worse over the course of 6-7 months. What was the next step?

Steroids

I was referred to another doctor, this time a pain management specialist. I gave him the story that I’ve been repeating over and over to the other health care professionals. He took notes, reviewed my MRI and my treatment history, and decided the next step was to try an oral steroid treatment. Before you shake your head in disappointment and disdain, understand that we aren’t talking about anabolic steroids (I doubt those would have helped me much). The treatment consisted of 10 days of a corticosteroid drug, specifically Prednisone, in a hardcore attempt to kill the inflammation in my spine. The doc was straight up with me and told me that there’s a chance it will help but it’s a far cry from a guarantee. He wrote me the prescription and warned me of the side effects:

-High blood glucose

-Fluid retention

-Insomnia

-Anxiety

-Weight gain

-Severe facial swelling

-Fatigue and weakness

-Mental confusion

-Steroid dementia syndrome

-Infection

-Joint pain

-Blurred vision

-Acne

-Depression, mania, or psychosis (wait… what?!?!)

I followed the directions closely and took the pills everyday for ten days. The dosage started high and tapered down throughout the duration. I can’t say I felt much of a difference throughout that time. The pills didn’t make me feel better at all, but I didn’t get any noticeable side effects either.

So soon after that I’m back in the doctor’s office to see what the next step is. We agree that something more invasive needs to be done, but not surgery… yet. He suggests an epidural steroid injection. An epidural injection does not “fix” the issue of the blown up intervertebral disc, but can provide lasting relief for anywhere from a few weeks to a year or more. In combination with a solid rehabilitation program, many patients have had great success with these injections.

A few weeks after the oral steroid treatment, I’m in the doctor’s office ready for my first injection. It was definitely a scary thought, the idea of an enormous needle driven right into your lower back, but I was a desperate man ready to take desperate measures.

They provided some local anesthetic to my lumbar region, and proceeded to stab me in the spine with a Super Soaker of a syringe. They warned me that it would hurt, and it did. I felt an extreme sense of pressure in my lower back, as if an elephant stepped on it, followed by intense pressure down my left leg. When I got off the table to stand up I almost collapsed, because my left leg was still numb. They told me this was normal and that I should regain the feeling in my leg in a couple hours.

The pain in my back and down the leg at this time wasn’t completely gone, but it was significantly dulled. I remember feeling a sense of hope, that I was FINALLY on the path to recovery. The dulled pain continued for a few days, but then slowly started creeping back. I called the doctor with concern, but he let me know that sometimes it actually takes a couple weeks for the drugs to kick in 100%, so I should give it time.

Over the next two weeks I remember trying to ignore the fact that the pain was coming back, but after a few days of waking up to the full blast pain that I felt before, I went back to the doctor. He recommended a second injection. The second injection was just as pleasant as the first one, and left me numb for a day. This time the doctor also wrote me a prescription for Cymbalta.

“An anti-depressant?!” I asked. I mean this injury is depressing for sure but c’mon doc.

He explained to me that the drug is a seratonin-norepinephrine reuptake inhibitor (SNRI) and that yes, it is used to treat clinical depression but also to treat peripheral nerve pain. Reluctantly I took the prescription and took about a weeks worth. I quit after that first week because I felt like it wasn’t helping and I was becoming paranoid about the dictionary-sized list of associated mental side effects.

The dulled pain lasted about three days this time and immediately returned. After another couple weeks I came back for injection round three. The limit for these injections is three per year, and I reached this limit within a couple months. These injections definitely aren’t child’s play and you can’t haphazardly just shoot them up into your spine whenever you want to. With each injection you run the risk of infection, dural puncture, nerve damage, and even joint degeneration in the long run!

This time the doctor wrote me a prescription for Gabapentin as well. Gabapentin, also known as neurontin, is a drug used to treat epilepsy but has been successful in treating neuropathy as well. Apparently it’s also a popular recreational drug because of its potential psychoactive effects. What is this doctor feeding me?!

Anyways, after three injections and a bunch of sketchy drugs, I was back to square one. No relief. When I came back to the doctor I already knew what they were going to tell me: “We’ve exhausted all of our options and it may be time to consider surgery.”

The Surgeon

My girlfriend, who works at INOVA, did some digging on several reputable orthopaedic surgeons in the area. After consultations with three different surgeons, I decided to go with Dr. Thomas Schuler of Virginia Spine Institute.

As one of the top 100 spinal surgeons and specialists in the country, recognized among the top 1% of physicians in his specialty, and top 10 spinal surgeons for the NFL, his reputation preceded him. Being the spine specialists for the Washington Redskins had nothing to do with my decision… I think…

IMG_0897

During the consultation at his office, he and his assistants spent almost two hours of dedicated time with me, running me through a myriad of tests, looking through my records, performing another x-ray on my spine, and analyzing my MRIs.

When it was all said and done, he was confident that a microdiscectomy would be the way to go.

A micro-what now?

The plan was to perform a “micro-surgery” that was relatively minimally invasive: The doc would slice into my lower back, push the erectors out of the way, cut some bone away from the lamina of the vertebrae, find that insidious piece of disc that was pushing on my sciatic nerve and ruining my life, decapitate the herniation, and stitch me back together.

Terrifying… I thought. “Let’s do it,” I said. My consultation was on a Thursday, and the operation was scheduling for the following Monday.

The Surgery

Like almost everything in life, the operation came with a bunch of paperwork. I filled out all my papers, signed a will (yeah, really), and they sent me home with my pre-op packet filled with instructions.

There wasn’t much to do from my end pre-op. I couldn’t eat or drink anything the night before and had to shower with a special soap.

The next day I showed up at the hospital, checked in, and waited in the waiting room with a number of other poor souls like myself that were about to get cut open. When I was called up they prepped me up in a gown and surgical socks and rolled me away on a bed to the anesthesiologists.

The anesthesiologist prepared the IV and stuck it into my arm. She explained that she would soon inject the drug and I would fall into a deep sleep. I remember her asking me where I went to school, to which I replied “George Masgfughabluhhhhhhh…” BAM! I was out like a light!

After what seemed like a minute or two, I slowly woke up, very hazy. One eye half-open, I looked up at a nurse and asked “when are they taking me to surgery?” She chuckled and replied “Oh honey, you’ve been out of surgery for hours.  It went perfectly!” I didn’t want to argue so I went back to sleep.

316395_10150283021360974_1035511306_n

The second time I woke up I was in the recovery room with my girlfriend and family. After the blur started to wear off I realized that the intense pain in my back and left leg were gone. I was so happy I could’ve cried. Pain had become such a huge part of my life that I forgot what it was like to not be in agony. I was definitely sore from the flesh wound I now had in my back but it was merely a slight discomfort compared to how I’d been living that past year.

I spent the night there, still in a daze from the morphine and eating French toast while watching The Simpsons. It was definitely one of the most joyous days of my life.

Stay tuned for Part III!

Colorado Dreamin’

Last week I had an awesome opportunity to spend a few days snowboarding, relaxing, and getting beat up by trees in Winter Park, Colorado.  Having spent most of my time here on the East Coast it was amazing to witness the breathtaking scenery and culture out in Winter Park.  If you like snow and want to get away, I definitely recommend visiting! The Mountains are Huge… Like Really Huge

Growing up I’ve frequently visited the local mountains within a few hours of Northern Virginia, and they now seem like mole hills in comparison to the mountains out west.  In the handful of days that I was there I did my best to explore as much of the mountain as I could, but despite my efforts the last day of my trip came and I realized I only hit a tiny fraction of the skiable terrain (which turned out to be over 3,000 acres).

Altitude is No Joke

I’m by no means an elite level athlete, but I feel like I’m in decent shape.  So when I began walking up a flight of stairs and started breathing heavy I couldn’t help but think… “HUH!?”

The base of Winter Park is about 9,000ft above sea level, with the highest peak being 12,060ft.  Compare this to Northern VA’s ~500ish ft above sea level.

I could almost FEEL the decreased oxygen levels in the air, which is a big reason for some endurance athletes using altitude training to improve performance when competing at lower elevations.  The idea is that the body will start to acclimatize to the thin air and adaptations will occur, such as naturally increased erythropoietin (leading to increased red blood cells), increased number of blood vessels, and increased buffering capacity.  In other words, improving the body’s oxygen delivery system.  It is still a controversial training method and I cannot say from dedicated experience that it “works” (I was there for five days and I doubt my mile time improved).

If you’re planning a trip to a location of high altitude I’ll pass along the advice that the locals told me: “Drink a ton of water and don’t overexert yourself.”

Elbow Dislocations are a Rare but Awful Injury

Like other sports and activities, injuries are just an unfortunate slice of the snowboarding pie.  A friend of mine took a hard fall while bombing down a hill at probably 45 mph, and didn’t get up as quickly as I’d hoped.  During the tumble his shoulder ended up locked into internal rotation with his forearm trapped between his back and the ground, all while skidding across the snow.

This resulted in the bones in his elbow (humerus, radius, and ulna) separating from eachother.  Despite the severe pain and gross looking elbow he handled it like a champ and we were able to get him to ski patrol.

According to a veteran in the ski patrol department, an elbow dislocation is one of the highest ranked injuries purely from a pain scale perspective.  Apparently it is a very rare injury as well, at least on the slopes.  With close to 40 years of ski patrolling under his belt, he has only seen two elbow dislocations during his career.

Pizza and Honey is a Match Made in Heaven

After a hard day of riding we went to get some food and ended up at the resort’s pizza parlor.  When I walked inside I noticed something strange: there was a bottle of honey at the tables.

Confused and afraid, I demanded answers.  The response was simply “Um… to put on your pizza? Duh.”  I drizzled some honey on my pizza and was very pleasantly surprised at how delicious it was.  It was even better with honey+sriracha.

My friend’s injury was a bummer, but otherwise I had a great time in Winter Park.  The community is extremely friendly (no one locks their doors!), the food is great, the mountain is amazing, and the scenery is really out of this world.  I definitely cannot wait to visit again!

Lessons of the Jaw: A Few Thoughts on the Body's Intradependence

As you read this, I'm either in surgery or in the recovery room. For those who don't know, I am having lower jaw surgery to correct a severe over (also called "open bite") and cross bite. That being said, blogging might be a bit spotty (more so than usual) over the next couple weeks, but I'm going to do my best. Seeing as this surgery has been on the forefront of my mind for quite a while, I thought I'd share a bit of the physiology connections I've learned over the past year or so. It's actually pretty interesting how dependent the body is on it's collective parts. So dependent that something up in my face affects the rest of my body rather dramatically.  We'll do bullet points because I really like them.

Lesson 1: Pain is sneaky. Sometimes the origin and/or cause is not where you think.

I've known I would need this corrective surgery at some point for quite a while now. About 3 years ago, I experienced severe and prolonged pain in my tempromandibular joint (TMJ), the hinge joint of your jaw that connects the lower to the upper. I didn't have the means to have surgery at the time and the pain receded a bit, so I put it on the back burner. Just over a year ago, I started having migraine/severe headaches in the front of my head that would last for days, even weeks. Medications didn't help. Then I started to have shoulder pain on my right side. This made me think something else was going on since I knew I wasn't doing anything that would aggravate my shoulder.

I popped over to this site and discovered that a tight sternocledomastoid can cause both pain in the head and shoulder. Sure enough, I had knots the size of marbles all along these muscles. Guess what? The SCM connects right up behind the ear, near the TMJ, thus a misaligned jaw (being used for thousands of reps per day) will definitely cause some tension in the poor ol' SCM.

Lesson 2: The suboccipital muscles are really, really important.

I also had pain in the base of my skull on a regular basis, thanks to irritated suboccipital muscles. I trolled around to find some information and perhaps home treatment to help manage the pain symptoms. I came across fellow strength coach, Patrick Ward's post here. Readit, seriously, it applies to everyone. It'll blow your mind how important those little muscles are to your overall health.  Patrick Ward goes into the implications of tight suboccipitals and their effect down the stream, such as posture in general and neural control over postural muscles. I found it interesting that "voluntary trunk control" was one of the muscle functions affected. Guess what? I struggle with bracing my right side. I know that sounds weird, but I can not get as "tight" on the right side without really thinking about it. Might be why I have a collapsed disc to the right side?...

Lesson 3: It's seriously all connected.

Then I came across this paper (you don't have to read the whole thing unless you're super-into-science and research papers) that linked symptoms of TMJ dysfunction and jaw pain with the suboccipital muscles. Check out pages 13 (yup, I have all those symptoms, including impaired vision) I should also note that I've suffered from vertigo since I was 13, so perhaps, once my jaw/bite is corrected and those muscles are no longer strained, I might see a decrease in symptoms.  Page 15 which connects hypertonic (too tight) neck muscles with TMJ muscles dysfunction and pain, and 17 describing short cervical muscles and posture and how they research has found correlations... craziness. Upper cross syndrome, a posture <--- description used by those in the health field, is either a creator of tight neck muscles or the result of tight suboccipitals. It's a bit of chicken-egg questions, but either way, they tend to coexist. So, if you have a hunched posture, try massaging the base of your skull, that might help loosen some things up!

Lesson 4: Pain eventually conquers proprioception

We recently had an in-service where we learned about the neuromuscular implications of injuries in regards to training athletes. The main point I retained was, if muscle tissue is acutely damaged, such as a sprain, or chronically irritated, such as repeated spraining of said ankle, the muscle spindles, which reside in the tendons, will no longer respond accordingly, much like Ariel responding to her father's command to stay away from land... Poorly.

Muscle spindles are proprioceptive organs that control the stretch-reflex, for example when the doctor taps your knee and your leg kicks forward a bit, the muscle spindles are rapidly stretched (when the mallet hits your patella tendon) and they respond by sending a signal to your brain to flex the quads (thus, pulling your knee into a bit of extension).

So, damaged muscle tissue, specifically the muscle spindles and especially chronically damaged tissue ("damaged" doesn't necessarily mean an acute injury, but a chronic posture, like your shoulders slumping and your neck protruding forward as you peer at the computer screen) tend to lose their ability to provide valuable feedback to the body in the form of proprioception (where your body is in space i.e. balance). Instead, pain signals are sent. This is bad on two fronts: 1) it hurts 2) lack of proprioception means loss of muscular control, be it voluntary or involuntary.

I don't know too much on how to restore muscle spindles and transfer them back to being proprioceptive and not pain oriented, but I do know that a) removing the irritaing stimulus (in my case, setting my jaw in the correct alignment) b) improving tissue quality through manual therapy (professional or at home) and c) retraining the muscles to move how they should (i.e. standing up straight instead of slouching, or going back to the ankle example, walking without a limp or favoring the ankle).

Lesson 5: Implications for training.

Another random fact, there's a correlation with a cross bite and scapular winging (the shoulder blade sticking up instead of laying flat on the rib cage). Winging impairs overhead movement, messes up the rhythm of the humerus and shoulder girdle and makes picking and lifting heavy things a bit problematic. I've done just about every exercise under the sun to fix my wing, to no avail... maybe surgery?

Anyway, as a coach, just by looking at my own situation helps me work with our athletes here at SAPT. If at first the basic, usual cues don't fix a problem, like "pulling yourself to the floor" during a push up to fix a winging scapula or "crack a walnut" to prevent knee pain during the squat, then, maybe there's an underlying issue that demands a different approach. Maybe some dedicated soft tissue work is in order to correct a nagging pain or it might be severe enough to refer out to a physical therapist or doctor. Whatever the case, if after working with an athlete diligently doesn't solve the problem, probably time to delve a bit deeper. (and check their bite! Kidding.)

10 Things I'd like to Share from 2012

As I opened my computer this morning, it didn't take long to realize I had a list of non sequiturs running around my brain. As 2012 is drawing to a close, why not allow them to run around on paper, forming a random thoughts post. Here are 10 things I either remembered, learned, or simply felt like sharing from the past year: 1. Taking the time to teach an athlete to "sit into the hip" during the foundational phases of jump training in the frontal and transverse planes will do wonders for their athletic development, as they progress onward to more "advanced" stages of change-of-direction training and force transfer outside of the sagittal plane.

Notice how in the video above, I use a "soft knee" during each landing and and push my hips back to decelerate. This displays the proper utilization of the glutes and other active restraints of the hip to create "tri-planar"  stability: eccentrially controlling flexion, internal rotation, and adduction of the femur upon each ground contact.

However, the video below shows how you'll typically see people perform lateral hurdle (or cone) hops. Note how I rely much more heavily on the passive supports of my body - namely, ligaments, menisci, and other joint structures - to decelerate each landing.

Many athletes will land with a "double step," or even fall over, when learning how to decelerate correctly for the first time. Investing ample time in mastering this entry-level progression will pay huge dividends later on within the realm of injury risk reduction, change-of-direction speed, and rotational power on the field.

2. I love coffee, and, as a result, one of the best parts of my day (other than a good poop) is preparing and enjoying a quality brew early in the morning. Either that, or visiting my favorite local coffee shop, Caffe Amouri, where I settle down to do computer work alongside my faithful squire, Aragorn.

caffe amouri aragorn

The best decision I made this past year to enhance the morning experience of home-brewing coffee was to purchase a Clever Dripper to prepare my morning elixir. Some of you may recognize it as the "pour over" or "hand pour" method.

With it, you receive all the benefits of a french press - full extraction of the flavors and sugars of the bean - but without the "mud" that typically resides at the bottom of a the mug. The Clever Dripper also WAY easier to clean than a french press.

clever dripper sapt

I highly recommend it for you coffee-lovers in the crowd.

3. Here's an important classification I like to use for differentiating between main lifts in and accessory lifts in program design: Any main movement can also used as an accessory movement, but not all accessory movements can necessarily be a main movement.

SAPT bench press chains

It may sound simple and borderline obvious, but it bears repeating for those that are unsure of how to set up their programs.

4. The wrong and right way to hip hinge during a squat. Be careful of overemphasizing the familiar "hips back" cue too much when either squatting yourself or teaching someone else how to squat, especially if an anterior-loaded squat pattern like a goblet squat or barbell front squat is being performed.

If you push your butt back too much at the start, then your body has nowhere to go but forward on the way down in order to find its center of gravity with respect to the bar position. I think it goes without saying that this is unfavorable, with regards to both safety and that whole getting stronger thing.

See the video above for a brief demonstration of what I'm referring to. The first two reps show what happens when you overdo the hip hinge at the start, and the third and fourth rep show how to properly push your hips back as you descend to the bottom.

5. I read through the Harry Potter series this year (yes, admittedly it was fantastic), and jotted down some memorable lines as I went along. Here are a few of them:

- "Indifference and neglect often do much more damage than outright dislike." ~ Dumbledore

- "If you want to know what a man's like, take a good look at how he treats his inferiors, not his equals" ~Sirius Black

- "It does not do to dwell on dreams, and forget to live." ~ Dumbledore

6. Speaking of literature, I'm currently reading A Game of Thrones, and it is spectacular, to say the least. The author, George R.R. Martin, does a phenomenal job of reeling you into the story relatively quickly, and the world he creates is a different than most fantasy stories in that he veers away from the typical character archetypes (few are totally good or wholly evil, you don't have the classic hero who overcomes impossible odds and is immune to corruption, etc.) and he breaks many of the "rules" of stereotypical fantasy.

Hint: Don't read it if you're afraid of your favorite and/or likeable characters to die.

Not to mention, Martin is an absolute master of metaphors, description, and overall wordplay. Read it, and thank me later.

And, while I've heard good things about the HBO series, it still doesn't count. Sorry. However, that still doesn't mean this picture is not awesome:

7. One of the most rewarding parts of my job, by far, is helping people to train around injuries. It's extremely humbling to have the opportunity to help countless individuals - be they just coming out of surgery or simply dealing with a "tweaked" ankle or knee - continue to get stronger despite an injury they recently received.

Below is a video of Conrad, a 64-year-old who recently underwent not his first, but SECOND, total knee replacement surgery within the past year. Instead of wallowing in misery over the fact he couldn't do lower body training for a while, he barged through the doors of SAPT, with a battering ram, asking us to prepare him for a powerlifting meet. Keep in mind this was just weeks after his total knee replacement.

We put him on a bench-specialization program, and the end result was him hitting a bench PR in an official meet.

He serves as such a great example to those - way younger than 64 years of age, mind you - who make excuses as to why they seemingly can't take time to care for their bodies.

8. The Hobbit was an excellent film. I honestly don't see how Peter Jackson, or anyone for that matter, could have possibly done a better job with it. Yeah, people are upset he's splitting it up into three parts, but to me that just shows how Jackson pays attention to detail, and wants to ensure they leave no stone unturned during the film. It also means we still have two more excellent experiences in the theater to look forward to around Christmastime.

thehobbit

I didn't want to read any of the reviews before I saw it, so I looked at them a couple days after seeing the movie. Upon reading just a few of them, it confirmed my notion that the opinions of movie critics are worthless and overrated.

9. When you set up for the basic plank (and its variations), choosing to go from the "bottom up" vs. the "top down" actually has significant impact on how much iliopsoas is recruited. Considering that heavy recruitment of the iliopsoas is generally unfavorable in core stability exercises, try setting up from the bottom up rather than the top down.

Plank SAPT

10. An admittedly strange and ungrounded pet peeve of mine is when people use the words "jealous" and "envy" interchangeably in conversation. They don't mean the same thing! 

To clear the air: Envy generally implies a sense of covetousness or a desire for something that someone else has. Jealousy, on the other hand, relates to a sense of resentment due to rivalry or the fear of being replaced.

I readily admit I don't have grounds from which to stand upon this sense of annoyance, as I am far from a grammar expert myself, and I make grammatical errors all.the.time. but for whatever reason I can't get this one out of my head.

Note: If you enjoyed this list format, feel free to check out this post or this post that I wrote in 2011. 

From the Hills of Ireland into the Mountains of Switzerland

I spent the middle seventeen days of October backpacking around Europe, and am finally settled back into things here in Northern Virginia. I took the trip with my good friend, Jason, and it was one of the more epic adventures I've partaken in during my life, to say the least.

While I generally prefer to write about topics concerning the reason all of you visit this site daily - you know, subject matters like athletic performance enhancement, picking heavy things, getting faster and stronger, or anything involving The Lord of the Rings - I didn't think most of you would mind if I took today to share a few highlights from my trip. I thought it may help/interest some of you reading who have traveled to Europe, will travel to Europe, or maybe just simply enjoy reading this sort of thing.

I possess a certain affinity for lists and bullet points so, what follows is, in list format, some notes and tidbits from a few of the locations we visited. I can't promise to part company with prolixity during this synopsis (it's over 1,000 words), but I hope at least some of you get something out of it!

Switzerland (Interlaken, Grindelwald, and Murren)

- Talk about a decent view for a morning cup of coffee, huh? The photo above is from our stay in Grindelwald.

- Switzerland is, in a word: majestic, awe-inspiring, breathtaking, and paralyzingly-beautiful. Ok, maybe a few words.

- This was my favorite country of all the places we visited. Don't get me wrong, Ireland and Italy were incredible in their own right, but there's something about being surrounded by a panoramic view of the Swiss Alps no matter where you go. The very air you breathe is pure and crisp, the skies are perpetually blue, and the "menu items" for outdoor activities are virtually innumerable.

- I think it goes without saying, but the hikes in Switzerland are unreal. Extremely difficult (think 3,000 of elevation in a single short hike), yet euphoric. Imagine walking along, breathing in the sharp tang of pine needles mingled with the earthy scent of rotting leaves, feeling the cool mountain air blow on your face and filter through your lungs, and everywhere you look you see something like this:

During the mountain hikes we experienced, I felt as if I was slapped awake from a long, deep, fuzzy slumber that had encapsulated me for years in the cities and suburbs of Washington DC.

- CANYONING!!! This was arguably the coolest experience I had the entire trip. In fact, we enjoyed it so much that we decided to do it twice while in Switzerland. What exactly is canyoning, you ask? Aside from forcing you to abandon caution and question your sanity, canyoning is where you cliff jump, rock slide (yes, you go sliding down ROCKS), and repel, all within a water-carved canyon. We were taken right up into the heart of the alps, and then submersed ourselves into the beautiful canyon of Chli Schliere, in which we remained for 4+ hours.

To any of you who will travel to Switzerland, and are perhaps slightly mental: DO IT. You won't regret it, it's literally the experience of a lifetime.

Below is a video I threw together of a few of the jumps and slides my buddy Jason and I completed. The most asinine, what-would-Kelsey-do-to-me-if-she-saw-me-doing-this jumps where the ones where we had to jump off a cliff, then rotate in midair and back into a rock wall, sliding down the 30ft sheer drop into the water; you can see one of the ones we did at the 1:00 mark. Unbelievable. Keep in mind, I completely loathe heights, so this was a major step in quelling that fear, along with the reason for the occasional dubious expressions thrown in the video:

- The chocolate in Switzerland really is to die for. I'm not talking about chocolate from Switzerland, imported into the U.S. or wherever else you may be, but actually consumed in Switzerland. You know when cows who produce the milk for the chocolate are grass-fed from the lands of the Alps, it's gotta be good.

- My last recommendation for any of you who may travel to Switzerland is to head wayyy up to Schilthorn. Some of you may recognize it from the old James Bond movie, On Her Majesty's Secret Service, where part of the film was set. It's a revolving restaurant and viewing platform situated right up at 10,000 feet above sea level, and provides the most spectacular view I've EVER seen. You're literally on level with the highest peaks in Europe, and able to look down upon some of the mountains that appeared huge from the Swiss train station.

What was also really sweet was that I was the only one up there when I went, so I had a full hour and half by myself to relax, read, and take in the view. Yes, a complete dream for an introvert like me.

Pictures and video can't quite capture what it's like in person, but here's a video I shot while up there that I hope gives you a decent idea:

And yes, I pronounced "Schilthorn" incorrectly.

- Expensive, expensive, expensive. Switzerland's only downfall is that it's the most expensive country in Europe. It cost an average of 19 CHF (Swiss francs) for a BURGER - no, the burger wasn't made out of gold, or even filet mignon - and 4+ CHF  for a simple shot of espresso. Oh, and by the way, the US dollar is valued less than a franc, so that's over twenty bucks for a burger and over four bucks for a simple coffee. Let's not even go into the cost of a full course dinner. I even had to pay 2 francs to use a public restroom, and 15 francs to do a load of laundry! So yes, very expensive.

- Did I mention Switzerland is expensive?

Hint: Switzerland is expensive.

Galway, Western Ireland

- Amazing town that has tons of live music (awesome!) in most of the local pubs, every single night of the week. There's also a bunch of small restaurants & coffee shops, each unique in their own way.

- I was pleasantly surprised how many locals we saw and were able to interact with here. Maybe it was because we traveled in October, but the town didn't feel very touristy, and there were loads of local college students here.

- The Irish accent isn't very hard to understand so long as they speak slowly. If they get going fast though, heaven help you to try and understand them; they may as well be speaking Japanese.

- In general, the west coast of Ireland is much more scenic than the East side (where Dublin is). In contrast to the ragged, roaring splendor of Switzerland, the hills and landscape of Ireland possess a very gentle beauty that I've never quite experienced before. From Galway we would drive (we were brave or stupid enough, depending how you look at it, to rent a car in Ireland) north and south along the coast, stopping at random castles we found and enjoying the many rolling green hills and "midevil-like" countryside. The two most notable spots we visited were the Cliffs of Moher and Kylemore Abbey. The next three pics are from are from taken at these two locations, respectively; I think it'll be self-evident which is which.

Cliffs of Moher SAPT

Cliffs of Moher

DCIM100SPORT

- Sheep are ubiquitous in Ireland. This was a surprise to me. Makes for some pretty good lamb stew, though.

- Going back to that whole renting the car thing. Many of the roads are laughably narrow and windy, and the Irish drive extremely fast. You're also on the left side of the road, and the driver's seat is on the right side of the car. Fortunately for us, the drivers there are much better than Americans, so we walked away unscathed.

- The people of Galway, and Ireland in general, definitely know how to enjoy life, and take moments to "step back and smell the roses" during their work week. Such a stark contrast from the Northern Va mindset. I didn't hear a single car honk/beep, the restaurant servers never (even passively) rushed you out from your meal, people would take two-hour lunch breaks if they felt like it, and still finish their workday around 3pm,  and while waiting in line for coffee or food, people would, *gasp*, actually talk to one another rather than remain glued to their iphones. Not to mention, the bartenders would spend a full two minutes to perfectly craft each and every pint of Guinness they served.

- Yes, the legends are true: Guinness straight from a true Irish pub tastes better than it does in the U.S.

- I saw a 45 y/o man in a business suit run up and give an unsuspecting older gentleman, who was clearly a friend or co-worker, a firm butt slap as he danced past along the town streets of Galway, gleefully laughing as he continued to prance on down the road in the middle of his workday. That was entertaining.

Cinque Terre, Italy

cinque terre

- Cinque Terre, or "The Five Lands," is an 8-mile stretch along the coast in which the five  little villages are situated, each with their own unique feel.

- You can hike along the coast from village to village, enjoying a plethora of fine Italian cuisine. There seafood is especially good, no surprise due to their location right on the Mediterranean. When I ordered a sea bass, I was literally handed a full sea bass, head, bones, tail, and all. It was (wild) caught that very day however, and grilled to perfection, so who am I to complain.

- Many of the restaurants are right on the water, and since Cinque Terre is on the west coast this gives you quite the sunset view for dinner.

- I ordered an Americano in one of the caffes, and the picture below shows what I was provided. I thought it very cool how they served me the hot water in a separate container from the espresso, so that I could dilute it to my individual preference.

americano cinque terre

- Despite the "must sees" in Italy like Rome and Florence, I'll call you a fool if you travel to Italy and don't take a couple days to enjoy Cinque Terre. (Hint: Go there.)

DCIM100SPORT

Random Notes

- I've never missed Metamucil so much as I did while backpacking Europe. Yes, it can lend itself to quite the horror stories/memories, but boy was I glad to use it again upon returning home. 'Nuff said there.

-  Minimalism was key for this trip. I normally pack wayyy WAY too much for even a weekend getaway (just ask my wife...), so I was quite proud of myself for not packing more than necessary for the first time in Stevo's autobiography*. I only packed 2 pairs of underwear**, 3 t-shirts, 1 pair of jeans, 1 pair of hiking pants, 1 rain jacket, 3 pairs of smartwool socks, and 1 pullover jacket. Score.

- All the photos in this article were uploaded straight from our cameras.

- America needs to take a few notes from Europe's public transportation system.

- I dreamed of going to Ireland in 6th grade. I then started saving for this trip in high school, putting $5-$20 away into a separate account whenever I could from paychecks, Christmas cash, etc. This money wasn't allowed to be used for anything but traveling to Ireland.

By the time I left for my trip, I had over $4,000 saved up which allowed me to do things like travel to other countries as well, enjoy fine food each evening, go canyoning in Switzerland for two separate days (heck, just surviving the Swiss costs in general), or anything I wanted while I was over there, really. So to those of you youngsters who may be reading, you'd be surprised at what you can accomplish if you start saving, even a little bit, now.

- I really can't thank my wife, Kelsey, and co-workers (Sarah, Ryan, Tadashi) enough for allowing me to take this trip. Without you all, it wouldn't have been possible, and I thank you from the bottom of my heart for all you did before and during my trip.

*Soon to be a bestseller.

**I can't recommend Ex Officio highly enough for travel. I'd wash them with me in the shower at night and they're quick-dry so they'd be good to go by morning.

Band Geeks Need Strength Too!!

This past weekend I went to watch my brother, a tuba player in the Marching Virginians at Virginia Tech, play in the halftime show at football games (let's be honest, anyone who has met me quickly realizes that the band is the ONLY reason I go to football games. Blasphemous Hokie am I!) And if you're unfamiliar with the MVs and how AWESOME the tuba line is, here's a little sample:

(My brother is the one on the end closest to the camera.) Aren't they awesome? That's my bro-pod! Anyway, being the geek that I am (both a Band Geek and a Strength Geek...yup, I was in band all through high school and a bit in college!) as I watched the MVs perform I started thinking that they could really use some strength training. Not just the tuba's either! The WHOLE band would benefit from lifting heavy things that don't make music!

The MAIN point of this post (besides offering this piece of advice to my fellow band geeks: LIFT WEIGHTS!!) is that EVERYONE needs to be stronger no matter if you're an "athlete" or not. Read that again: EVERYONE NEEDS TO BE STRONGER!

Ahem, excuse me, I got a little carried away. Moving on, here are some exercises that I thought of while watching the MVs perform (and thinking back to my own marching days):

KB Swings:

Admit it, you knew I was going to say this. But seriously, this would be perfect for the tuba players doing the hokie pokie and sticking their heads in and out and shaking it all about. Check out the hip hinge (or rather, lack of) that tuba players need from the video above. Wouldn't a strong posterior chain make that easier? (especially on the 5th rendition of the Hokie Pokey)...

And then the swing:

Not only would this help make lugging the 25-45 pound tuba (technically sousaphone) up and down easier, it would prevent lower back injuries for over-enthusiastic hokie pokie-ing. Besides, swings improve cardiovascular fitness and who needs to be able to produce a lot of air without passing out more than a tuba player? (and the floutist. Fun fact: tuba players and flute players pass out more often from lack of air than any other instruments.) Every band member should swing; it'll improve their ability to make through the loooong Game Day of pre-game practice, marching and playing throughout the game. ANNND (one more thing) swings improve upper back strength and band members have to stand up straight throughout their performance, hence the need for a strong upper back.

Rows/Pullups/Chinups:

Speaking of strong upper backs, let's take a look at what the drum line has sitting on their chests:

I used to play drums and I can tell you, those instruments are NOT light! Rows, chins and pullups would be ideal to strengthen those muscles. By doing so, it will take the strain off the lower back because the upper back will be able to support the weight much more easily. (Cymbal players, I'm looking at you too! Those suckers are heavy, row/chins will also improve bicep strength which is needed in holding/clashing cymbals repeatedly.) Which leads me to my next exercise...

Planks/Anti-rotation presses/Anterior Core:

In junction with a strong upper back, a strong anterior (front side) core is CRUCIAL to preventing lower back injuries or aches while standing for long periods of time. This post highlights some exercises. I really like the landmine as there's a lot of dancing around in the bandstand so being able to resist rotation of the spine during wild cheering would be awesome!

And more anti-rotation:

Having a strong core is very, very (VERY! I'm not kidding!) important to band members who want to have a pain-free marching season.

Farmer Carrys:

This one should be obvious. Practice walking around with heavy things. Here's a post I wrote a while back about. Band geeks, read it!

And last but not least:

KB or Band-Resisted Dorsiflexion:

My high school band director used to say (or rather, shout): "I want to see 'HI MOM' written on the bottom of your shoes!!' meaning we had to march with our toes straight up to the sky (it looks nice...). Therefore, band geeks need super strong tibialis anteriors!

There are many more exercises I could list off (Pretty much everything in here) but I'll cut it here as I know band practice takes ALL of one's free time. However, I would encourage band geeks to squeeze in at least 30 minutes to improve there strength levels. And if a band geek can fit in time to get strong, then anyone can!

LET'S GO HOKIES!