DWP Appraisal Hell

I’ve not written (speech recognition of course) a blog for a while, mainly because I feel like I’ve had nothing to say, despite having plenty of things I’d like to write about. I got hit by severe depression in mid-October. Things have become better recently, but first a negative event I experienced.

A few days before Christmas I had a DWP appraisal, even though I’m not getting any money from benefits. The whole event was sickening, I don’t just mean metaphorically but also physically. I don’t think giving a detailed narrative is a worthwhile thing for me to do, and I imagine it would not be for anyone to read, but there are few things that stood out.

The first thing that struck me upon arriving at the site was how much like a prison the setup was, with a massive security fence and guards. The building entrance has a bizarre double door system, at least it had automated doors for those people that are really struggling physically, but the short corridor took up valuable room space, since the waiting area is split into two weird and quite small sections. Upon arrival people are informed that they are likely going to be waiting for over an hour, and given how they were already behind yet it was early morning, they could be waiting up to 2 hours. Given the uncomfortable claustrophobic waiting area that was quite unappealing.

bureaucracy

Upon arrival every person seems to be surprised by this information, and several people had to cancel their appointment due to time constraints. The receptionist repeated the same few statements to each person about how the system is not their fault, and that they appreciate that a person may have to leave and schedule a new appointment. A man in a wheelchair arrived and was even informed that his appointment had been cancelled, although no one had actually contacted him to explain this, and the reasons given were classic examples of bureaucratic mismanagement, along with repeated statements by the receptionist that it is not their fault. It is easy to accept/agree that it is not the receptionist’s fault, but the fact that they are acting like a dismissive robot is their fault. I guess this is a learned behaviour given their job, and I can appreciate they may be used to receiving nasty comments, but they should at least wait for some before being so defensive, and dismissive.

Since I had walked a mile to get there I was already feeling the physical impact, and added to this was the fact that I had not slept for over a day due to the usual severe pain. I suppose I could have asked to reschedule, but I didn’t see how the next time would be much different. Sitting for a length of time escalates my pain, and can result in an inability to even sit due to my nervous system demanding that I stop doing the thing that is causing my pain to spike, it’s a weird retracting pain, the urge to move away becomes overwhelming, but obviously I can’t move away from my own body. Standing up or lying down at least changes things for a while until they become deemed to be the enemy.

sleepdepr

Eventually I was seen by a physiotherapist, which was the first sign of trouble, since a key part of my problems, and long-term domino effects is sleep deprivation and thus the psychological impact of that should be considered, not just the physical. The interview proceeded to become a bizarre movie like style of being interrogated by stupid cop, who repeated the same questions, yet lacked any comprehension of what the answers meant. I was asked about my sleeping pattern, since I had written about it in my overview. I explained that I don’t have one due to the constant ongoing pain, which sometimes becomes unbearable and overrides even exhaustion, which over the last year and a half often resulted in missing huge chunks of sleep over the week so that I became so exhausted I could get a few hours sleep, and then probably not sleep for another day even though technically that means I’m down twelve hours. Then after a few weeks of this I would manage to get more sleep for a short-while, before the erratic sleep returned. I had to explain that I have had sleep deprivation problems continually, yet it still didn’t sink in, they then asked me what time I set my alarm for this day I explained I set it for nine but then highlighted that I hadn’t actually slept so they said “so you pattern is normally what nine then?” I genuinely had to resist the urge to scream at this person, instead I managed to yet again explain the situation using simple clear words. It was odd, instead of acknowledging this answer I was asked a bunch of weird questions about my how I use an alarm, and how I use a mobile phone. This then turned into further strange questions, which indicated the person didn’t believe what I was saying about not phoning people. This went on for quite some time, and towards the end I realised how much time jumping they had done in regards to trying to piece together a timeline, even though they had a detailed explanation written out in front of them from the four I had filled in previously.

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The thing I take away from this interview is that it very much seemed like I was having to prove that I was innocent of committing fraud, that they were trying to trip me up by asking the same thing repeatedly, that they were desperate to find anything to latch onto to prove I was guilty of lying, such as the bizarre mobile phone questions. And then abruptly the interview ended and I was dismissed, at this stage the person had no interest in any further conversation, and was already trying to herd me out the door. Crucially there had been no questions about my psychological state, which given the symptoms should have been a key part of the interview. As I mentioned above, the gravitas of my situation finally hit me in October, the fact it been well over a year, and at this stage I had been suffering from depression for the last two months; it has been pointed out to me that my idea of depression and other people’s has a scale of difference, being fatalistically optimistic and the fact that I’ve had long-term pain of a different type for twenty years, I view depression as an inconvenience, and what I call depression others would categorise as major depression. Having a degree in psychology I am also academically aware of things, including the difficulty of self-diagnosis, and how our beliefs and biases influence our thoughts. I had been given medication to help with the sleep problem, and to help fight off depression, this was an area highlighted by my doctor; in hindsight I should have emphasised it.

If I had ticked the box regarding depression then I am sure I would have been allocated a doctor and not a physiotherapist for the interview, and some of the questions would have been about the psychological impact of my condition. I can at least acknowledge that my involvement is part of the reason why things went the way they did, of course considering I had written about being massively sleep deprived you’d think an assessor would highlight that issue.

Due to how physically demanding the whole event was, and the fact it lasted several hours, my pain levels later that day were a staggering fucking nine for several hours, before dropping back to my normally horrific six or seven. This is on top of the fact that I had not slept for what was approaching two days. Painkillers and alcohol didn’t do anything to the nine rating. I guess my body was flooded with cortisol both from the psychological interrogation as well as the scale of physicality I am not used to.

Miraculously four days later, on Christmas Day, I experienced several hours of a pain level of only one or two! Unfortunately that did not last, and even in to early January I was still probably averaging a six rating.

The shoulder and neck physiotherapy session have ended, I am still carrying out the exercises, and it does seem to have helped a lot. Having started physiotherapy for my stomach, back and hips it seems like the intense pain in my right midsection is starting to reduce a bit.

So once again my thoughts are flooded with daily ponderings about returning to exercise of a more tangible level, and even going back to martial arts in a few weeks, primarily BJJ. Realistically that goal is way off, even if things start improving faster, but it’s nice to have hopeful thoughts and even an anticipation of setting a simple goal. Next time something less depressing.

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When Pathetic is not Pathetic

Since leaving my job due to my health I have felt almost no stress (until I ponder things in the future, so I mostly don’t), and this has helped relax the pain in my neck and shoulder. Doing much of anything is still too much, and doctors have repeatedly emphasised complete rest is the most important thing, continuing my estimation game for when I can do more. Due to this I decided to not even force myself to finish a particular blog. This helpfully allows me to do something I enjoy: starting a whole load of things, mentally being happy with the direction, but not physically finishing them. Whilst I am financially paying for myself to rest, I decided that getting the most rest, to quicken healing, really is still the priority, because then I can return to actually doing some work.

As part of my continuing focus on resting, I have even avoided doing much dictation by speech recognition. I have a massive mental list of blog posts I have pondered writing for a while now:

  • role-playing articles
    • working at KJC Games
    • game design lessons
    • more gaming stories and the lessons I learned
    • my obsession with White Wolf
    • why GURPS is the best thing, yet I’ve never played
    • tidal force role-players
  • the difficulty of doing nothing,
  • energy levels and how to plan around them
  • chronic pain
  • martial arts
    • returning from injury
    • consideration of training partners when you cannot work at your old pace
  • NoobGrind articles
    • Various thoughts about gaming
    • Guild Wars 2
    • Path of Exile

There is an additional reason that I am avoiding finishing any blog posts, since I envisioned graphics that I feel really add to the articles. The problem being, whilst I can make art and graphs to at least an adequate level, they are not areas that I practice much, so it would take me a long-time to get things to a level I am satisfied with. This links to an issue of sitting at a computer for an extended period, I normally have pain in a variety of places, and thus it is not good for my body, nor is it me resting. Pathetic sounding, but it is the reality of my situation.

I’m also aware that my wanting to have graphics for a blog post, it is me entering into the dangerous territory of pushing these partially started articles towards needing to be near perfect. In a way this justifies me not having to do what I can, and then move on.

Graphics Needed
Well, it is still nice to have some graphics.

So I decided to write the above stream of consciousness, at least then I am writing my intent in regards to what I will be blogging about soon, and I don’t need graphics. Whilst I could again use the word pathetic, that should only apply if I was healthy and avoiding doing work. If your best is barely anything, and you are still managing to get bits done, then that is not pathetic.

Health: Cortisone, Writing Motivation

The cortisone injection last week went well, with the doctor successfully injecting the area on the first attempt. The pain of the needle going in was not that bad, I was reading SuperBetter on my Kindle during the process, to help distract me from the pain, it did help a bit. Then as the injection of the fluid occurred the pain skyrocketed, it felt like a large object landing on the area; the doctor said that this could be a good sign, as it indicates that the injection had hit the right area due to how sensitive it was.

My body had an immediate reaction to the amount of pain, I started sweating a lot and nearly passed out. However, the experience sorting out my damaged right ear was far worse, so to anyone reading this due to worrying about their own cortisone injection I’d say yes it will be painful, but you will handle it. The pain experienced for the next two days was more like how the shoulder pain had been a few weeks ago, so not a big deal in the grand scheme of things.

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Example of shoulder injection

Writing & Motivation

Whilst things had improved a little bit I have still lacked motivation to do much, as well as still needing to prioritise doing nothing. So despite receiving positive feedback about the Kaizo Trap and Cyberpunk articles in particular, I have not finished any articles for a few weeks, and I had planned follow-ups on those previous articles. At least I have had time to think about them, but after making a few notes, I then don’t have the urge to continue. Considering I could ramble on using speech recognition whilst in bed it would seem easy enough, but I just didn’t want to, until today when I got so frustrated I decided to ramble a bit.

One of my coping mechanisms whilst resting up has been watching all sorts of videos, I have written a NoobGrind article about Gaming and Disability: Value of Video, which as per normal for me turned into a thousand word piece. I hope to be able to maintain motivation and get back to writing articles about role-playing games and my professional experiences.

What’s Next?

I have another doctor’s appointment today, and I will need a further sicknote extension for hopefully just a week or two, and then maybe the injection will prove to have been effective. As mobility has improved I have been at least able to do a tiny amount of yoga and tai chi, and I hope that this progress will help trigger further strengthening without interfering with the current healing by re-aggravating something. I am still having to hold off at attempting anything Brazilian Jiu Jitsu related.

As pain reduces and health improves, I expect (hope) motivation will return. I guess if things don’t improve then I will have to change mental gears anyway. SuperBetter is helping, but I will write about that another time.

superbetter-toolkit
SuperBetter by Jane McGonigal

Cortisone, Future Health & Physiotherapy

At the time of writing this I am a few hours away from having a cortisone injection in my left shoulder. The swelling from last year finally started to reduce a few weeks ago, and has nearly gone. The constant pain from the left shoulder, to back of the left shoulder blade, and then up my neck has only reduced a little bit. Although doing more than nothing still quickly increases this pain.

I received whiplash a few weeks ago during an emergency brake, even though it was not a particularly dramatic incident. It just shows how susceptible a person with a weakness is to injury.

My current sick-note is due to expire next Monday. It is hard to estimate whether the cortisone injection will give such a rapid improvement in 6 days, but hopefully it will.

I expect the injection to hurt, and whilst it may not help, I think it is worth trying at this stage. A few weeks ago I read a few articles and research papers on the subject, for example:  http://overhaultraining.com/cortisone-injections/

One of the things I kept reading was how key physiotherapy is, regardless of having cortisone or not. Since I desperately want to be able to exercise again, partly because I miss Brazilian Jiu Jitsu, and partly because I have put quite a lot of weight on, the sooner I can start exercising a lot more the better. I have been doing some very simple exercises, small shoulder and neck movements, as well as short works of a mile or two. However, I was advised by three doctors that doing more than this currently is not advised.

The trouble is determining when can I start to do more? Sensibly a few more weeks of basic movement is what I should stick to, and at the moment I am considering re-joining a local gym to get access to the swimming pool, sauna and spa. I am aware it is better to be sensible then do too much and quickly aggravate the injured area again.

40th Birthday

I recently celebrated my 40th birthday, which despite the chronic pain was still an enjoyable day, and it’s nice to write about something positive. I do not put any particular emphasis on specific days, since I try to treat every day as special, but I appreciate that some days are more special than others. I had a small family get-together; we enjoyed a tasty collection of Chinese food and a bit of cake. Technically this had been my breakfast since I had been up the previous night and slept most of the day, as once again my sleep cycle was out of sync.

Whilst I don’t expect presents from friends or family I do very much appreciate gifts. Although I am not much of an alcohol drink normally I have recently been using it for medicinal reasons, roughly one or two units a day, so it was nice to receive several different drinks. The wife bought me an amusing present, a collection of treats in a bin; I have mentioned needing a small bin for my new room. The nice secondary joke being that a large collection of sweets is rubbish for my diet, but at least I’m generally good at rationing out treats.

I have been contemplating upgrading my PC for a few years, and have received money towards this. Thankfully I have a powerful enough PC, and I have not needed to upgrade my CPU, memory, or motherboard for years. As the requirements for high-end PC games have lessened over the last few years, in part due to so many games being made for consoles, the hasn’t been a need to upgrade; yes there are games that demand more resources but I don’t particularly care about playing Crysis in maximum specs. Due to resting and avoiding computer use I don’t particularly need a more powerful system, but speech recognition software like Dragon NaturallySpeaking does benefit from having more system resources, so have recently been looking at a more powerful system.

To PC or not to PC.

About a year ago I had been contemplating having a big celebration; my sister had one when she turned forty, and that was a fun evening. I had pondered the idea of asking to use the ITC gym (Sukata), since a lot of the people I would have been inviting train martial arts there, in particular Brazilian jiu-jitsu (BJJ). Although I was not one of the club superstars, I do like to think that when I was healthier I was a good training partner, which is an invaluable asset for the more talented, healthier and dedicated practitioners. Hopefully I will be back training and healthy for my 41st birthday, and if so I can have a large party then.

Although I have read dismissive comments about how irrelevant or pathetic a Facebook or email message saying “Happy Birthday” is, I disagree. Even a short message takes time and effort for somebody to do, and whilst it is possible to set up a script to automate sending emails to people on the birthday, it is not something that the general person would do. This is why I appreciate the effort.

This blog post nearly ended up being about the placebo effect, but I decided to separate that information for a future post. In the end was more a collection of thoughts about how my life is not all bad.

This was written (dictated to) listening to the splendid new track by Leslie Wai, a cover of Modern Love but with some great tweaks. He is the wizard behind the Kaizo Trap music. I have blogged about Kaizo Trap before, and I wrote an article for NoobGrind about it.

RSI update: Shoulder and Sleeping

My medical situation in November deteriorated quite rapidly and I ended up pretty much bedridden for six weeks; despite my wish to return training as explained in Martial Arts and Disability: my situation. The RSI affecting my left arm had mostly subsided, however due to trying to use my left arm to compensate for the RSI in my right arm I developed RSI in my left shoulder. Due to the damage to my left hip, and the fact I have to sleep face down pinning it into place, this meant that I was also further antagonising my left shoulder. Taking a lot of pain medication did enable me to get sleep, however, as it was masking the problem I would usually wake up after only a few hours in a lot of pain and be unable to get back to sleep for a while. After a short while my neck had an intense pull on the left side, which then escalated as I had to adjust my sleep to my lower back being pulled out of alignment as my left shoulder and hip caused massive sleeping problems.

 

The pain I experienced over the last two months has been the worst in my life. I have had broken bones, the pain was extremely intense for a short duration, but thankfully improved over time. The pain from the RSI in both my arms could be somewhat tolerated by hugging myself, which changed the pressure in the arms. Obviously pain is a very subjective thing; different injuries have different effects, never mind the differences between people. For example the intense burning pain I had in my left arm from elbow damage, followed by a chemical reaction from Witch Hazel that I believe had seeped through a bit of tissue damage via my eczema, but was nothing in comparison to my left shoulder.

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Left elbow June 2015
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Left elbow June 2015 after Witch Hazel
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Left elbow June 2015 after Witch Hazel, massive swelling

 

Over the last few weeks I have radically altered my sleeping setup and managed to find new sleeping positions. The pain has reduced from agonising to the halfway level of ‘bloody annoying’. With the somewhat improved sleep and reduced pain my thinking has cleared up somewhat, and I feel like I can at least attempt things again. I walked a short distance into town tonight, had a meal out at a buffet and then walked home, this pathetic amount of exercise proved to be a bit of a challenge and my left shoulder and lower back particularly hurts at the moment, which is worrying since I returned to work in the morning!

The following pictures show an experiment I tried using a massage table as a bed to help keep my left hip pinned. The idea was that I could help limit spine rotation by lying face down, plus pad the shoulder area. However, they are not comfortable things to lay on for extended periods.

Massage Bed 1
Massage Table experiment 2015

 

Massage Bed 2
Massage Table experiment 2015, screen beneath
Massage Bed 3
Massage Table experiment 2015, underneath showing monitor lying flat aimed at the face hole.

Exercise is going to be a tremendous challenge for the next few months. I have to fight the urge to do anything other than the few very basic physio exercises I have been instructed to do, because I am not even healed at the moment, but I do need to do something to help with the healing. The weight that I lost in 2014 and up until June of 2015 has since been put back on, so I also feel bloated, sluggish and my trousers don’t fit. So it looks like another month of no martial arts, although by the end of the month I should be able to do some sport specific exercises, and hope to do some very light Brazilian jujitsu training in February.

 

At least with my mind clearing my caged frustration can be channelled towards productive things. I will return to BJJ, but as long as I am sensible I can hopefully not have to immediately take another injury break!

Martial Arts and Disability: my situation

Despite barely doing anything physical today I am in a lot of pain and that’s even after taking my painkillers. So I decided to load up the Dragon speech recognition software and finally write an article about martial arts and disability, something I’ve been avoiding writing for a long time.

Firstly writing the following post proved quite difficult because I am apprehensive about referring to myself as disabled; I have repetitive strain injury in both arms, which I have had at a severe level since 1999. Although there are occasions when my wrists swell up so badly that other people notice, RSI is mostly a nonvisual disability. Therefore I appreciate why most people are normally confused when my medical situation becomes something I need to explain.

Secondly I consider the word disabled to be a very powerful and important one. I think it is fair to summarise that the average person considers a disability to be something massive and obvious, for example someone that has lost a limb. Without a medical breakthrough re-growing a limb is not going to happen, it is not a case of thinking positive or eating better. As with most things in life, the concept of disability includes a wide range of things from the obvious to see to nonvisual, but also the severity of conditions can vary greatly from minor to extreme. However, I have been told by doctors and physiotherapists that I have a condition that may never heal and that affects my day-to-day life, and since on really bad days I struggle to perform basic tasks whilst also being in constant pain it is a disability.

A summary of my background is that I started using computers extensively when I was six in 1982, and besides a lot of gaming I have also dabbled in programming. I started working in a call centre in 1996 doing a lot of data input. By 1998 I had started developing regular wrist pain, I was advised that it would go away, which it did, but it kept coming back. By the summer of 1999 I was signed off due to my wrist pain becoming so chronic. At the time I was a brown belt in Japanese Jujitsu, as well as practising other martial arts like Wado Ryu Karate and Nippon Kempo, so I had to stop training to allow myself time to heal. The trouble is I never really healed, instead the pain eventually diminished to a background level, but would spike up occasionally to a more severe level.

After a year’s break I was told to get back on with my life, so I returned to martial arts training but now I had to be careful. I had a whole list of worries about returning to training: I was still in pain, my skills had deteriorated, I was physically unfit and had gained weight, I had worries about my injuries getting worse. A major issue was the worry of embarrassment for me and my training partners in an awkward situation because with certain things I would need special considerations: no wrist locks, ever! Crucially my fear was proven true as I met people who thought I was pretending to have a disability to avoid committing to hard work.

Considering I had trained for years and put a lot of effort in, including even full contact fighting in armour, the idea that I was avoiding hard work was extremely disrespectful, never mind any suggestion that I was hiding behind a fake disability. I had learned to accept the fact that I was never going to be an exceptional martial artist, but I could still do things, and the whole point is you don’t give up.

Eventually I got my black belt in Japanese Jujitsu (JJ), but it doesn’t mean you are an expert just that you’ve learnt some things. I started assisting with teaching, and then running my own classes, it was often fun and I found I could learn by teaching. I returned to Karate, and also started training kung fu. The whole time I would have wrist problems, sometimes quite badly, but again I did my best to manage things and keep going. A few years later I got my 2nd dan in JJ.

Unfortunately whilst training in Kung Fu I got an injury with my left hip that has never gone away. Despite a lot of physio and seeing specialists, the psoas minor muscle won’t heal properly and it has left the area weak. When I relax it wants to move out of alignment and is painful, I have to sleep in a certain position to avoid this problem; my RSI already often affects my sleep.

White belt, the joy of starting something new

For years I wanted to train Judo and Brazilian Jiu-Jitsu (BJJ), so despite the same apprehensions mentioned above, about having to explain my situation to a whole new bunch of people, I started training in these styles. After training in Judo for a short while I also started BJJ. My first lesson of BJJ was great, and although I was familiar with many of the basic concepts of ground fighting I had not done that much practice of it; knowing about a thing does not make you good at it. I was really impressed with the teaching of someone who was to become an important part of my life, Mr Gary Savage of Sukata MMA.

Unfortunately I had to take a break from Judo and BJJ due to how bad my hip became, as well as my wrists, but after two years of physio and my wrists getting a lot better I was able to return to training. I was welcomed back by Gary, being back training again was awesome, even though I could barely do a single push-up or sit up, and despite the small amount of knowledge in my head my body just didn’t react well to get even what I did know to work. Within a few weeks I was training more than one session a week, and by then I could do nearly 10 push-ups without my wrists complaining.

By 2014 I am training 8 to 9 hours a week. I am a 4 tag blue belt, doing some assistant teaching and even running my own little throwing session. My fitness was starting to approach what it had been before developing my major injuries. Then at the end of November 2014 something tore in my right bicep whilst lifting some boxes, this led to a few months of recovery. In the mean-time I had started developing a problem with my right elbow, which the doctor said was ‘tennis elbow’, I was given some exercises to help, it took a long-time to heal, but was still extremely weak.

In February 2015 I was able to go back training, and I had even lost weight due to changing my eating regime, so I actually felt good when returning to training. A few weeks later I badly banged my left elbow at home on a door frame (!*&!), and after applying some witch hazel it swelled up quite badly! Throughout the first half of 2015 I have only done a bit of light training, and very little BJJ rolling, but I have assisted with teaching beginners because it is better to turn up and do something, than nothing.

Amazingly Mario ‘Sukata’ Neto moved to Blackpool and is the head coach of our club, which is now called ITC. His teaching and technical knowledge is amazing, but I have barely been able to train under him. Since he doesn’t know me, and hasn’t seen me train properly I worried about having to explain my situation to Mario. My paranoid inner monologue returned to yet again given me many reasons to quit, suggesting that by discussing things.

Thoughts that I would appear weak, cowardly, pathetic and called out as a liar, that if I trained I would get really bad injured, that I would piss off my training partners for not being a poor training partner. Also that training under someone of Mario’s ability would be a disservice to him because he should be teaching people who want to be champions. Years early I’d had the same paranoid thoughts when I first went to Gary, and had to fight those demons then, I could do so again. Like Gary, of course Mario understands hard work and what it means to have bad injuries, so unsurprisingly in reality he was understanding and helpful. With my injuries slowly getting better I was starting to get optimistic, that soon I could fight my way back to the previous October’s level of fitness and health.

Then in July my RSI escalated from minor to severe level, my doctor said it was likely so bad due to the injuries with my arms. Additionally my shoulders have also become really painful, but we think we have figured out how to fix this, I’ll explain that in another post.

So it’s now November and overall things are a tiny bit better. Following on from a previous post I made about long-term injuries, or disability, eventually you have to get back on with your life as best as you can. I kept Gary up to date, and then I went to the gym to chat in person. Gary suggested I again assist with beginners, to turn up and do what I can, that as normal I would have support. Although I am once again unable to do more than a press-up due to muscle weakness and pain, and again I have put weight on, plus there are new people at the club and thus likely a whole bunch of awkwardness, but it’s about not giving up. Like so many others I have found BJJ is overall full of welcoming practitioners, that I have my long-time great instructor Gary, and another great instructor in Mario that I’d like to get to know more. I have gotten back on the mats so many times after small and big problems, I can do so again.

Life is for living, as best as you can. You don’t tap out to life, because if you do, you are dead!