RT_Nomad, How Do You Train?

Bigger Stronger Leaner
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My last day at the gym was the day before my dermatologist told me I had dermatomyositis. I had since then lost at least 40lbs of muscle, maybe more. I have a moon face caused by Medrol induced Cushing’s Syndrome. In a few months short of 2 years, I look like a completely different person. Only a couple of my fellow lifters have seen me since my last day at the gym. While I want to get back in the gym, I hate to see the shock in the eyes of those who know me, even if they never talked with me.

My first day back went as I expected as far as how I was received by the gym members. Some were outgoing, welcoming me back, wishing me the best. Some just looked with interest. I did feel self conscious as there were plenty of mirrors to remind me that I was no longer the man I once was, not even close. A lifter who was becoming a friend before my illness gave me the most encouragement. His name was Charles Bailey. I will talk about him in later posts.

I started very light, because I know my bones are much more brittle. Plus, I am very weak. It is still very hard climbing any stairs, and a flight of stairs is out of the question. I started a 4 day per week lifting program. Upper body/lower body split. I did deadlifts on lower body day. I did five sets of 10 reps on every exercise, definitely no where close to failure by choice, though some exercises did seem to tire sooner than I would have expected. I omitted squats for now, because it was hard enough to stand up from a seated position.

I tired very quickly. But it felt good doing what was the core of who I was. I brought my protein intake up to at least 150gms/day. I am hoping to stop the embrittlement of my bones. It seemed that my bones needed to support more weight. I was hoping that I helped more than I hurt my cause. Time would tell…

It was absolutely discouraging how weak I was.

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My doctor has set up another 2 month IVIG treatment period for me. Though I had not told my doctor, I am continuing to lift weights (though still real light weight) and take creatine. The treatments went well. The nurses welcomed me back. They are very compassionate. Most of them were all the same with only one or two new faces. Jerry Springer was still the favorite show. I have my own cynical take on the show’s popularity.

This time, before starting the treatments I ask my pharmacist, whom now knew me well. I said I wanted to hydrate after treatments so I could go to the gym under the best possible situation. I said I was looking for an electrolyte formula like Pedialyte, but without the sugar. He said they had some packets of electrolyte formula without sugar. I bought a case of 12 from him. I was treated every Monday, which was also a workout day. At the end of my treatment I would add water and ice to a container and start sipping it on my way to the gym. I don’t know if it was any benefit, but I always felt good by the time I got to the gym. It tasted like sweat, but I never cared much about taste when it came to improving my physique. It went down easy.

My strength at the gym was improving, though it was slow, which is probably good considering my bone density being in question. I decided to add squats, but with just the bar, 3 sets of 10 reps. It felt very heavy, but at least I could stand up.

At the end of my 2 month IVIG treatment my CPK was below 500, and everything felt good. My Medrol was down to 12mgs. I had added a prescription for 2mg Medrol tablets to my arsenal so I could reduce the dosage at a slower rate. But once I dropped to 8mg of Medrol per day, the next blood test had my CPK above 1,000. It seemed pretty obvious that I was on the vicious cycle for dropping the inflammation with steroids, and it returning as the steroid dosage dropped below 10mg per day. My immune system did not seem to want to reset to normal.

I am caught on the cycle…

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I will take a break in the time sequence and discuss how I dealt with the loss of the essence of who I was:

I wasn’t too many weeks into my diagnosis of dermatomyositis before I was looking for an outlet to redirect my energy to accomplish something that fulfilled the hole that bodybuilding left behind. I nearly immediately returned to my childhood interests that could be participated as an adult. My first hobby of interest was model railroading. I had started as a very young child in O gauge (Lionel) and converted to a more realistic model railroading that HO offered. I had a 4’ by 8’ layout.

As I looked into this I noticed that O gauge offered more scale items. You should know these are fairly expensive in the late 1990’s. For those of you who have competed in bodybuilding and the use of AAS’s to get a competitive edge, you know this can become quite expensive. I suppose I was dedicating well over $5K a year. Now I wasn’t spending that $5K. Model railroading took a big bite into that, and quickly. I expanded further into G gauge, which consumed more money. These things took my mind off what I had lost, except for any mirror I passed that was a repeated reminder that has never ceased.

While talking with some of my fellow workers about my reversion back to a childhood hobby, one of them mentioned the fun they had building and flying Estes model rockets. I too had done that and actually did a science fair project using Estes model rockets. That got my interest and I started to see what was available in model rocketry. I found high power model rocketry. That really got my attention and I found a high power model rocketry club in town and contacted them. They flew rockets on a sod farm about an hour and a half south of where I lived. I found this a real challenge, as certification was required to fly more powerful propellants. There were three levels of certification. I set out to get the top certification: Level 3.

It took a couple years to get there, and a couple fairly long trips to get certified. To get my Level 3 Certification I had to travel to south Florida. I built a 15 foot rocket that was 11 1/2’ diameter. I added a 5lb lead ingot to the nose cone to assure that the center of gravity was a body diameter in front of the center of pressure. The total weight of the rocket was 95lbs. The motor that held the propellant cost $500. The propellant (ammonium perchlorate) cost $500. I had to purchase at the launch site from a dealer with a BATF license and he was there to assure it was spent, or back in his possession. They had to call the FAA for clearance to launch. The rocket cost $1,000 for the airframe, fins, electronics, and parachutes. That moment of the launch was the single biggest rush I have ever had. It went 4,200 feet in the air (altimeter reading at apex). Both chute opened properly. The flight was a success. I received my Level 3 Certification! ( I left out a number of details)

Another distraction was getting involved with cars, and car shows. I bought a 1999 Plymouth Prowler and began adding my personal touch to make it mine:

Prowler2
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And last, but certainly not least, my faith, which had been growing since 1993. I had become a student of the Bible.

As I began making progress in the gym, model rocketry went to the wayside. I still enjoy model railroading to this day. I had a Lionel EMD SD40-2 custom painted AWVR #1206 of the movie Unstoppable:

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I will be back on track with my quest to get as healthy as possible using that which had grown to be who I was…

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I had been making steady, but slow progress in strength, all the time considering my “brittle” bones. With the cooperation of my doctor, we decided that 16mg/day of Medrol was sufficient to bring down my CPK when it rose above 1,000. That was good news. I was taking less of that “poison.” The winter of 2002/03 I had tried another IVIG treatment, which failed to normalize my immune system. It was looking like I would be managing my dermatomyositis with Medrol going forward.

The skin on my forearms had thinned greatly. Also the skin on my lower legs was likewise very thin. So much so, that twice I bumped against a weight tree stand prong and got skin tears on the front of my lower leg. Those required an extensive recovery period, because the skin is too thin to hold sutures. They just attempted to pull the loose skin and flesh back in place and hold with bandages. On one trip doing IVIG, when the nurse removed the adhesive that held my IV in place, it pulled the thin layer of skin from my forearm. From then on they used bandages that stuck to themselves and not my skin. Those are very nice indeed. The Medrol was the major culprit in thinning my skin. At least I had managed to lower my highest dosage of Medrol to 16mg/day.

My doctor had noticed that I was seeming to be getting better and had added some muscle. He asked what I was doing. I then told him I had been lifting weights and had added 5g/day of creatine monohydrate to my diet. He looked interested, as most of his patients were getting steadily worse, instead of improving. IMO, most of his patients had succumbed to the disease, and not fought against it. Dermatomyositis may have taken me out of competitive bodybuilding, but it didn’t take the gym from me.

I also got some vary bad news about my rheumatologist. He had bone cancer.

There are times that I believe that the disease might have saved my life, at least extended my life. I was taking too much AAS’s to be adding another decade of organ stress. I was competing more because I felt people expected me to, than because I was driven to do so. Sure, I would have liked a shot at the Over 50 Master’s Nationals. But somehow there was quite a bit of satisfaction making improvement conquering dermatomyositis.

Things are getting better continuously…

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Quite the conundrum: brittle bones make lifting (potentially) more risky, yet resistance training is among the most effective interventions for strengthening bone. Of course, this was going on some 20 years ago… Perhaps if you presented with the same issues today, Doctors would be more encouraging of strength training?

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Being fairly weak you would think I would be injury free, apart from concern of brittle bones. But that was not so. I was doing dumbbell bench flies with 20lb dumbbells. I was doing it more to feel the contraction, than just trying to get the weight up. I had planned on 4 sets of 10 reps. When I had finished the 3rd set as I was returning the dumbbells back to my sides as I sat up, I felt the left shoulder twitch forward and then back. It was the most injured shoulder of all the years I lifted.

I finished the workout after stopping at that 3rd set of flies. The remaining part of the workout went fairly easy accompanied with some pain in the shoulder. It was two days and I realized that I had a pretty severe rotator cuff tear. I considered surgery for a moment, but my better senses said I didn’t need to push my luck on Medrol and fear of another blood clot while being immobile. Whether it was the right decision, or not, I question that to this day.

The shoulder injury didn’t affect most of my workout apart from overhead and bench press. There was no pain doing anything else (of the exercises I was doing.) I didn’t miss a workout. I just worked around the injury.

I never stopped getting stronger, though I sure wasn’t moving very much weight. After about 6 months and I could do bench press and overhead press, but my left shoulder gave out way before my right shoulder would have. That is an odd feeling that I became accustomed to dealing.

Next Charles Bailey asks about competitive powerlifting, and begins to open a new perspective about my weight training…

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I believe it the summer of 2003 that Charles Bailey asked me about competitive powerlifting. I explained the rules that were in existence when I powerlifted competitively. Since then there have been a few federations added with their own set of rules.

Charles had competed in bodybuilding for a few years as a light-heavyweight. He was very symmetrical. And he was strong. For income he was a personal trainer. But most of all he was always thinking of better ways of exercising and knew his own body better than anyone I had ever known. He was quick to search the internet and mentioned to me the concept of accommodating resistance. I told him I didn’t know what he was talking about. Charles mentioned chains.

At work I ordered a set of 25lb, 3/4" chains, that arrived at our storeroom a couple days later. I took them to the gym and Charles used some cord the maximum length needed to use for squats and bench press. I then ordered 2 sets of 20lb, 5/8" chains. We now had 130lbs of accommodating resistance. Charles then bought 3 sets of 20lb, 5/8" chains making our total of accommodating resistance 250lbs. Over the next few months I ordered 1 set of 30lb, 7/8" chains, making our accommodating resistance 310lbs.

Then Charles ordered blue and green resistance bands, and added a bunch of mini bands.

What I discovered which I believe is the safest, and best bicep developer was using chains on the Scott curl bench, where the angle is steeper than typically made. I put a dumbbell set vertical under the back of the Scott curl bench to make the angle close to 75 or 80 degrees (where vertical is 90 degrees). I used a curl bar that used Olympic plates, with fairly light weight, initially a 10lb on each end. I then wrapped the cord from a set of chains until a chain link was off the ground. Doing the full range of movement the chain went from a link off the ground to nearly all the links off the ground. You don’t want all the links off the ground because the weight will swing at the top (very unstable).

My deadlift was improving but felt weak coming off the floor. I use the traditional deadlift. We had two power racks, so I began doing deadlifts with reverse bands from the top so that I took about 155lbs to get the bar to touch the ground. That is, almost no effort to start 155lbs, but as the bands began to shorten the load increased. The feel was exceptionally comfortable. As I progressed I added more bands and more weight. At the best I accomplished I was using enough bands that it took the bar to be loaded to 315lbs for it to touch the ground, but it got heavy very quickly. Weight lifting was getting fun again.

I was still “cycling” my steroids, or I should say Medrol. But it seemed as though my bones were not brittle, at least, so much that they broke.

(If you hadn’t heard of Charles Bailey, he was very successful as a 275lber with a best squat of 1,100lbs and a total of 2,500lbs, and he didn’t start powerlifting until he was 40.)

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Two medication events occurred during 2003 and 2004:

In early 2003 I decided that a family doctor was in order to keep tabs on medical conditions that might need immediate action. I friend suggested one and I took her advise and scheduled a visit. After some tests my new family doctor noted my total testosterone was 272. She prescribed 200mg of testosterone cypionate every 10 days. (we later changed that to 100mg every 5 days.) One time we did blood tests and I tested at 1300 total testosterone. She said that was too high. I realized I had my blood drawn two days after my last 200mg injection. I then decided to make sure my blood tests were on the morning before my next injection (that I did at night.)

Going forward my total testosterone has been in the mid 500’s, all taken in the trough of the half-life curve. I started a lot of screening tests. My liver enzymes have always been high. She had me get a liver ultrasound. She had me set up on a colonoscopy 5 year test program. And I liked to brag that my doctor’s small fingers made yearly physicals much more pleasant.

I should note that I never felt different after starting TRT. But I did feel confident it would make putting on muscle easier.

In 2004 my rheumatologist died of bone cancer. He was such a nice guy. I sure missed him. But I had a new doctor at the oncology and hematology clinic, who took over the treatment of my dermatomyositis. In mid summer he came into the examining room with a smile on his face, saying that he had a new drug to treat my dermatomyositis. (Now I had quit my subscription of the support group magazine as I felt it was of no benefit, so I wasn’t aware of any new “hopeful” drugs for a cure.)

He said that he had a new drug that should fix the problem of my continuous cycling with Medrol. But it had one side effect. It was outrageously expensive, and he slapped his hip where he had his wallet. He then explained that he felt sure he could get me in an experimental trial group.

Two weeks later his office called and scheduled an appointment for me. When the doctor came in he said that I was cleared for a trial that started in mid October 2004. The drug was Rituxan (rituximab). If I recall correctly the treatment was a 5 day week of infusions every 4 weeks for 3 months, but I was usually finished by noon each day. Much of the nursing staff was the same, with a few new nurses. I suppose “burnout” is pretty common on cancer treatment wards. It was nice to see some “ol’ friends”.

I was trying to cycle off Medrol when the treatments started and was down to 12mg/day at the start. By the end of the treatments I was down to 4mg/day. I was then scheduled for another 3 treatment weeks in April 2005.

I feared the return of elevated CPK, so stayed on 4mg/day. My CPK didn’t rise like it had before. Maybe, just maybe rituximab was the silver bullet. When April came around I was back for another round of rituximab. The treatments went well and my CPK stayed low, well… relatively low. And I stayed on 4mg/day of Medrol. Maybe I should have quit it entirely, but I couldn’t quit (at least not yet.)

My strength has been steadily increasing, though I am still fairly weak. I was now squating 135lbs for 3 sets of 10 reps.

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Allow me to describe the layout of the gym that I was now training. It was once a racket ball facility with 10 racket ball courts. As the fad of racket ball began to subside the owners began converting some of the racket ball courts to weight rooms on the ground floor. They put a second floor above the courts they removed. By the time I had joined the gym there were only two racket ball courts at the front of the gym.

When I first joined they sold beer in the lobby where there were glass walls on the lobby side of the two front racket ball courts. It had become to social go-to place at the beach for meeting the opposite sex. At the very back on the left side two courts were opened to accommodate the space for the free weight area. The other vacated racket ball courts were used for weight machines and two rooms for cardio equipment. The free weight area had the dumbbells and bench press and two power racks. Charles Bailey was given full authority by the owners to modify the area as he saw fit.

As Charles was trying to optimize his form at the powerlifts and learning how to get the most out of support gear, he found that a wider squat stance allowed him to lift more weight. He added wider platforms to both power racks to do very wide stance squats. one power rack had pins of solid cold roll with a rather thin disc welded to the end to keep the bar from rolling off. If you have ever attempted a very wide stance squat, you know that as the weight gets extremely heavy, you can only get just so wide with weight on your back. With a little practice you could learn to lean the bar off the pins. That way you could unrack the heaviest of weights (at your near max you might need a spotter to help you unrack the bar.) Do know that you will be lifting very close to the pins.

I recalled, years ago that widening my stance some improved the poundage I could squat. I decided why not widen more? And sure enough the weight started to rise. I had always squated in sets of 10 reps. I wanted to lift more weight so I did so with lower reps. I had no realistic expectation of ever being good enough to get on the stage again, so I focused much more on strength than size. I did mostly sets of 5.

I started at 185lbs for 5 sets of 5 reps. Plus some leg presses, leg extensions, and leg curls just to feel the muscle work. It wasn’t 3 months and I was doing 275lbs for 5 reps.

I felt a little loose in the hips at the bottom of the squat, so watching Charles using support gear and the results he was achieving, I decided to buy a single ply power pant from Inzer. Those suckers were a workout just getting them on. But the support at the bottom of the squat unbelievable. Back when I powerlifted no such support gear was available. It seemed odd that getting the correct depth with 135lb was next to impossible. My back was strong and my legs were getting stronger. I rationalized that I was more concerned with overloading my thighs than my hips, so the power pant was a more than acceptable crutch.

I started using chains for accommodating resistance. And it wasn’t long before I was squating 400lbs at the top of the squat. It sure was fun moving a bunch of weight. I was 56 years old at this time and decided my goal was to squat 10 times my age in pounds for a single. The pursuit was on…

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Charles had been competing mostly in the APF, which allowed gear and used a monolift for the squat. In around 2006 he had a welder fabricate a monolift contraption with some “pins” that fit one of the power racks. It was a heavy beast (the pair of them). But it worked exactly like a monolift.

My first experience using the “monolift” it seemed odd that when I went to unrack the bar where I must have pushed against the rack a little, because what happened first was the bar swung forward. It took me a little while to grow accustomed to lifting up only to unrack the bar. It became real easy being at a wide stance and not wasting any energy walking out the weight loaded bar. And when finished all you had to do was lean into the hooks. I needed no help reracking the bar, no matter how heavy it was.

I kept getting stronger…

Charles also had his welder weld a system at the bottom of that squat rack that would allow for the perfect placement of bands (as many as you wish). He also had pipe sleeves that nearly perfectly fit the Olympic plate diameter. That way the bands would adjust themselves to have equal stretch on both sides of the band. Squating against the resistance of bands is an experience all by itself. I had used reverse band squats, but that is band resistance that assists movement of the squat.

I never really got accustomed to squating against band resistance with only the squat bar. (Charles had bought 55lb Texas squat bars) With fairly strong bands (blue bands) there is very little dampening of the resistance. The bar seems to dance when you push. Within a year I was squating a few (3 or 4) reps with 415lbs and blue bands. I started with just the blue bands and added 45lb plates until I had loaded 415lbs on the bar.

Some workouts I would use a blue and a green band, or add another green or purple band. Sometimes I only used chains. And sometimes I mixed bands and chains, to the point there was very little resistance at the bottom and a freaky amount of resistance at the top. But most of all, it was FUN!

Next, doctors, not having any idea of what I was doing in the weight room, want me to get a follow-up bone density test…

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I have a buddy that is all about the sciency lifting stuff. His workouts don’t look fun at all. Having fun is an important aspect for me.

I have been using accommodating resistance in the form of chains on deadlifts. It seem to help my hips stay feeling good. I have also used them on bench and squats. I think the aspect of it being a bit easier on the hips for squat and deads, and shoulders for bench is often not recognized.

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I bought some shorter bands to do resistance banded deadlifts (plus weight) at the power rack Charles had designed for resistance bands. That is a freaky intense pull. It seemed to take a week to recover from them. I don’t recommend that deadlift variation at all. Reverse bands for the deadlift is very nice, though

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My gym has a platform that has pegs so you can do banded deadlifts. Here is what it looks like.

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I’ve only done them a few times, as I like chains better. The bands can be unstable, the chain pulls straight down. I also kinda enjoy the loudness of the chains. I guess with the deadlift, you don’t need more noise, but it’s still fun.

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Just in from my physical and blood test, for what its worth:

  • triglycerides: 81 mg/dL
  • cholesterol, total: 151 mg/dL
  • HDL cholesterol: 50 mg/dL
  • total testosterone: 608 ng/dL
  • free testosterone: 91.2 pg/mL
  • SHBG: 42 nmol/L
  • PSA, total: 1.01 ng/mL

All those were within range. Blood was drawn the morning before a test injection that night (100mg every 5 days).
I hadn’t done cardio in 9 months.

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In 2007 my family doctor decided to have my bone density tested to see how far my osteopenia had progressed. I went to the same facility where I got the original bone density test. I had a different technician. It was the same pics if I recall correctly. I asked what the results looked like. She said she just administers the procedure and that the doctor would determine the results. I countered, “You’ve done a lot of these. What do you think?” She said that she was to only administer and not to discuss the results. Her body language was hard to read. I then countered that when I got an ultrasound that found blood clots behind my knee that the technician said that I wasn’t to go anywhere except the hospital bed that was in the progress of being made available for me. She didn’t wait for the doctor to read the results. She then just smiled.

My doctors office contacted me the next week and said that I had no signs of any osteopenia, that my bones had normal density. I pretty much knew that anyway, considering the weight my skeletal structure was supporting in the gym.

Then sometime in 2008, I was referred to another doctor, but I can’t remember the reason. He obviously had my medical record. The first thing he said was that he had never seen anyone reverse osteopenia. Then he asked what I did. I told him, “Astronauts lose bone density in zero gravity fairly rapidly. I was doing the exact opposite of them. I was moving heavy weight.”

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Think back. I’ll bet the U/S tech didn’t explicitly say ‘You have a blood clot.’

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The technician actually turned the screen and showed me how the blood clot had restricted the blood flow behind my right knee. She then showed me the clot behind my left knee hadn’t advanced as much, yet was slowing the blood flow. She was very open with me once it was obvious that I had blood clots. I asked if there was a drug I could get from the pharmacy and I would just drive home. She laughed and said I was way past that option.

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Fair enough. But the bone-scan tech was correct–they’re not supposed to say anything.

My experience in this regard: Earlier this year I had pain behind my knee along with swelling below it. Naturally, DVT topped the differential, and I had an U/S post-haste. I asked the tech what she saw, and got the same non-answer as you: ‘Sorry, but I’m not allowed to say anything.’ When I politely pressed her, she said ‘OK, I can tell you this: If I saw a clot, I would not let you leave, and you’re free to go.’

Got the official result the next day: Ruptured Baker’s cyst.

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That pretty much explains why she was so quick to show me the screen.

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Even though machine based training is arguably safer for older folks, this is why I’m inclined to stick with load bearing free weight exercises like deadlifts, squats, standing overhead presses, etc. I view it as extra insurance, in the event that those exercises are better for preserving bone density…

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