Yes, I am in great shape. And no, I am not in great shape.

Years of cycling have made an incredible difference in my overall condition. I have lost a lot of weight and, more importantly, I have maintained my weight. However, I have struggled with lower back pain for many, many years. Although I approached cycling with a high degree of intensity, I did nothing around the cycling work to build up my core strength. Nor did I do anything to stretch my muscles.

At this time, the major leg muscles — calves, thighs, quads, glutes — are rock solid. So are the forearms, biceps, triceps and shoulders. No surprise as these are the muscle groups that do most of the work when riding.

Midsection? Flabby. No surprise there either. I just haven’t performed any conditioning for the midsection.

Several weeks back, significant back pain emerged. Different class of back pain from previous years. Lower right side with a numbing pain traversing down my right side from the hip to around the knee. Really painful first thing in the morning. I am not able to sit for any length of time and it is really difficult to drive a car for much longer than an hour. Really difficult.

Although it is hard to say with certainty, I suspect this happened due to an aggressive cycling program and misalignment of my pedal cleats.

What my muscles are doing, in effect, twists my body out of shape. The muscles are so tight and the midsection so underdeveloped that I am experiencing pain when I do simple things like walking, sitting or raising my right leg off the floor.

Nino from Door2Door Fitness came over last night and took me through a series of routines to assess the current state. Bottom line: very tight, limited flexibility, and imbalanced development of muscle strength.

I have signed up for 16 sessions to start the process of core conditioning. That, along with a refit on the bike, should help to address the lower back pain issues. I hope. I may need to get things checked out to rule out any other contributing factor.

Nino said that I won’t need a lot of coaching: “You strike me as a highly self-motivated and very disciplined person.”

My wife thought that was an understatement.

Being busy allows a different, healthier focus to emerge. And I need to re-focus.

Cycling makes a big difference. Unfortunately, I did something to my lower right back, or hip, when cycling last week and I have had to take a bit of time off the bike to make sure whatever happened gets a chance to heal. I might also have to revisit my fit on the bike in case I have something like a leg-length discrepancy — which is what I think I am experiencing.

Cycling has a way of making things seem better. I hope to be riding again on Sunday. Weather forecast for Sunday looks mixed right now but maybe the sun will be out.

I could really use the ride.

What is different for me this time around compared to when the tinnitus first emerged three years ago? I do not have the same intensity of emotional response to the condition. Is the condition challenging? At times, you bet it is. Last night, I awoke around 3am and I was shocked at the intensity of the ringing noise in my head. However, I was able to control the “fight or flight” response and I resumed sleeping. Three years ago, I would have been overcome with anxiety and nausea. Three years ago, I did not sleep at night.

The process of habituating to the condition seems to be going faster this time as well.

No question that it has been a setback in terms of quality of life. It is hard to describe just how terrible the condition can be when it is present in the conscious mind.

But for those who did write to me, I am doing fine and I am coping much better these days.

My last post on the subject was here. I was pretty proud of how I had adapted to the tinnitus. It no longer impacted my life and I did not notice it most of the time.

Until this week. On Tuesday, something happened and the tinnitus roared back into my left side. Although I did not have the same degree of emotional response as when it had first emerged, the symptoms of intense nausea, headache, stress, lethargy, discomfort and despondency all merrily jumped in. In a way, I was hoping that I had come down with a flu. Despite experiencing some severe nausea, no other flu symptoms emerged.

The intense ringing is back. Overshadowing life.

I suppose I am most upset because I did not think that the tinnitus would re-emerge. I am not the only one to have it return with a vengeance. And I have to be optimistic that I can re-adjust to the perception of the sound. It took about six months to adapt the last time it emerged. I’ll just have to accept it and learn to deal with it again.

I have had several people ask me about the battle with tinnitus. And, although it is certainly always there, it is never really there. In other words, I do not notice it most of the time. And for the times that I do notice it, I do not have any emotional response. To me, when I do perceive tinnitus, it is a bit like the noise of a computer fan. Present but not really noticeable.

The best counsel I can give to someone suffering from tinnitus is what I took from this website:

1. Don’t despair or Panic. The condition can be overcome. You will need to be patient and realize there will be setbacks, trials and tribulations as you move forward to your goal of habituating or no longer perceiving the Tinnitus. It is comforting to note that the vast majority of people who have Tinnitus are eventually able to habituate it. If there is no fear, anxiety, worry or negative emotion associated with Tinnitus sound then the autonomic and limbic system in the brain won’t perceive the sound in a negative light and the sound either goes away or is habituated (the sound is there but not noticed no longer perceived). If it is noticed it is no more annoying then your air conditioning fan or computer fan. In the beginning if there was no extreme physical or emotional stress the best course of action would be simply to ignore the sound and not to worry about it. For those that have had the condition for a longer period of time Auditory Habituation using sound therapy may be more appropriate.

2. Don’t believe all the negative literature, negative counseling and horror stories. When a physician tells you “You need to just live it” don’t believe it. There is a lot that can be done and there is a lot of reason for hope. The “wall of worry” followed by a negative emotional response is exactly what makes the condition worse. Unfortunately, many “Resources” out there don’t provide sufferers with much hope and practical suggestions. As a result the condition simply worsens.

3. Avoid trying so called “miracle cures” that are not supported by medical research. If a miracle cure fails your stress and anxiety levels will be increased. Again, the “wall of worry” followed by a negative emotional response is exactly what makes the condition worse.

4. Despite all the negative press more likely than not Tinnitus from a loud event (Disco Tinnitus) may go away as long as you don’t worry and develop a deep emotional response to it. Let it go its course and get plenty of rest and sleep. The worst case in most situations is that after treatment you will habituate or be able to ignore the Tinnitus. The noise may be there but most of the time you won’t notice it or perceive it as annoying. This is the subject of Tinnitus Retraining Therapy (TRT). See attached links if you wish to find a professional registered in this technique.

5. No regrets. Although it is good to understand the events leading up to the tinnitus don’t beat yourself up over the cause or whether you could have avoided it. Don’t beat yourself up over events in your control that you feel have made it worse. Practice a no regrets policy; it is all water under the bridge. These kinds of things happen and you would be surprised to find out how many people you know have been affected by Tinnitus in some way. It is good to determine what the cause was as this will allow you to understand the condition and move on. Was it a loud noise, severe emotional or physical stress, or an illness that led to the onset of the ear noise?

6. Early on, it is often better to avoid using ear plugs or other hearing protection unless you are in fact protecting yourself from expected loud noises especially if you are hypersensitive to sound (i.e. people talking, loud children). The continual use of earplugs may trigger hyper sensitive hearing or Hypercausis in some individuals. (Consult your physician)

7. Focus on the positive. Despite widespread literature to the contrary the worst case is that with treatment you will habituate the sound after a period of time. This means eventually most of the time you won’t notice it. Studies have shown this occurs despite the pitch of the sound or the volume level. The best case is that the sound simply goes away.

Yesterday my blood pressure was 113/61. My resting heart rate was 51 bpm. This site provides a chart for assessing healthy resting heart rates.

That is a lot of ibuprofen.

Never in my life have I taken so many Advils. The packaging on the extra strength Advil Liqui-Gels recommends no more than 3 a day and to consult a physician if symptoms persist longer than 5 days.

Side effects from taking too many Advils? Yes indeed.

Advil can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use Advil. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking Advil. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Do not take more of this medication than is recommended. An overdose of Advil can cause damage to your stomach or intestines. The maximum amount of Advil for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses). Use only the smallest amount of Advil needed to get relief from your pain, swelling, or fever.

Via.

I did consult with my surgeon to ensure that I was not overdoing the Advils. And today I have taken just one Advil. The pain is not as intense now and hopefully I can reduce my consumption of Advil to zero. The only side effects that I have noticed are problems with balance.