Weeks 4 & 5: Joy

You can tell that I'm struggling more keeping up with this class than with CS161, when I flipped that -- I have not been able to blog regularly, because I spend pretty much every waking moment working on the course (or frantically doing the other administrivia required of faculty and every once in awhile I get to talk to my students and pretend to do research and file NSF reports). You might be tempted to assume that it's the scale of the course that is making this more difficult, but it turns out that that is not the case. This course is taking so much more time, because it's a course I've never taught before When I flipped CS161, I'd taught the course many, many times over the past 20 years; I knew the material; I knew what was difficult; I had lecture notes. In that case, my efforts in flipping turned into recording audio tracks for slides that already existed and designing in-class exercises. In contrast, this year, I'm developing the notes from which to record the pre-class videos and the in-class exercises and the pre- and post-class surveys. Thankfully, I am not preparing new problem sets, because I have inherited a terrific collection of problem sets from previous years. (We're designing one new assignment.) Also, I am extraordinarily grateful to the folks who've taught the course before me -- from one I have an amazing collection of slides -- while I don't copy them, they provide an excellent source of inspiration and data from which to design my own. From the other, I have inherited a huge array of programs that can be turned into the right in-class exercises. Without these two sources, I do not think I could do this in real time -- that is, I could not keep up with the pace of the class. I think this is a HUGE point, so I want to summarize the different ways one might be tempted to flip a class:

• Flip a class that you've already been teaching: This is definitely doable and rewarding. You probably already know the patter that you have with every slide in your slide deck and recording will take time, but it won't panic you. You will learn just how sloppy you can become while lecturing and will spend time trying to become more precise in your patter. You may also spend time breaking long lectures down into smaller, bite-sized topics. And you will also spend a lot of time developing in-class exercises. For programming courses, this requires both intellectual investment as well as programming, debugging, clarifying, etc.
• Flip a class that you've not taught but for which you can inherit a lot of material: This is also doable and rewarding, but requires an enormous amount of effort. I suppose that if you are comfortable lecturing off someone else's slides (or in this case preparing videos off of someone else's slides), then you can reduce the work. But, it takes a lot of time to figure out exactly what exercises in class connect the videos to the problem sets.
• Designing a new class from scratch: I personally could not do this in real time. That is, I would need at least half the course completely done before the semester started. Your mileage may vary, but I find it intellectually challenging (albeit rewarding) to coherently design videos, pre-class surveys, in-class activities, and problem sets. Coherence is really the key. If the in-class exercises do not connect (especially to the problem sets), students quickly become frustrated and lose interest.

Lest you think this experience has turned me off flipping, that's definitely not the case. I still love it and remain convinced that it's the more effective way to teach certain subjects (programming and systems for sure). I've gone into numerous reasons before, but perhaps the most compelling one is the one I just noticed last week: the joy that I see in my students when they are working in class. They are actually happy! They are having fun. When one lectures (at least when I lecture), there may be a few students who look at least mildly interested, but there aren't a lot who look genuinely happy. As I and the staff wander about the room, talking with students, answering questions, pushing them to dig in, everyone, both students and staff, look genuinely happy!

I come away from class both invigorated and exhausted -- it's hard work. You want every student to have a positive experience, and you have a real way of observing very directly if they are. When things go wrong, it's rough. We had one unfortunate incident this week where I didn't fully think through the ramifications of exactly how I had asked students to do an exercise. The end result was that their Makefiles were spitting out errors that confused them. The fact that the Makefile errors were irrelevant; they were distracting to the learning we wanted to happen. Little things matter, and making everything that is not directly relevant to the learning, is a detraction (except candy). It's important to remember that and make every experience as seamless as possible. The only silver lining is that since the college students finish several hours before the extension students have their web conferences, we can fix things for extension. That's critical as the technology and distance pose a sufficient hurdle that technical difficulties with something as mundane as a Makefile would be a real demoralizer. So, what' coming up next? Assignment 3 (adding a cache to a simple, unbuffered standard IO library) is due and then we have a midterm! That's always stress inducing on the students -- but it's also a good indicator for us about whether we are successfully teaching the students what we think they should be learning! Until next time.

Week 3: Gulping water ...

If I thought I was barely making it last week, this week is even worse in terms of material preparation. And my attempt at weekly updates is lacking.

That said, it seems that the course is running well. The students seem happy and engaged in class; they did very well on Assignment 1 (due this past Friday). My TFs continue to dazzle and amaze me. The extension students are working hard and doing well too.

Sometimes technology is just amazing: I had a quick trip to California last week (my niece got married Friday in San Diego), but I managed to Skype in to kick class off, which was kind of cool. Then I skyped in for staff meeting and that worked OK as well. And, because extension office hours are remote anyway, I was able to do those as well. And thanks to airplane wifi, I spent the flight home fighting with our grading server and getting the next assignment ready to go.

The biggest challenge we're facing this week is providing a good experience for our extension students. These students fall into a couple of categories:

• Local students who come to classes -- these folks seem to be doing quite well.
• Local students who cannot come to classes -- we're doing "OK" by these folks -- our schedule is such that these are at convenient times, so they can tune in for web conferences, sections, and office hours. That said, and as I'll discuss below, the web conferences are not as effective as we might like.
• Remote students who are in timezones that make the sessions we schedule feasible (i.e., US) -- these folks are in a situation similar to the local students who cannot come to classes, but the timing isn't quite as good.
• Remote students in Europe, Africa, Asia -- what we've scheduled simply doesn't work for these folks. I hold morning office hours on the weekend, hoping to be available for them and we've now added some additional teaching fellow office hours for them too, but the sections and web conferences will never be convenient for them. The real-time interactive nature of the pedagogy in this course makes this a real challenge, so we'll talk about that next.

Let me talk about the different parts of a flipped course and how I see them fitting together.

• Pre-class videos are for first presentation of information -- they cover material similar to what can be found in a text, but are more biased towards precisely the concepts that I think are important -- both in general and for the problem sets. Additionally, I've been able to incorporate a more dynamic experience than a text through audio-annotated screen captures and scribbling on slides, drawing pictures, highlighting things, etc.
• Pre-class web work is a high level check that the students have gotten the key concepts. They are not intended to be challenging, but they highlight to me areas where students have confusion so we can discuss them at the beginning of classes.
• Classes let me address confusion in the pre-class work but are largely designed for small-group work. The key here is that these exercises connect the concepts in the pre-class work to the problem sets in a way that is supposed to help students know how to tackle assignments. My sense is that this is working well for the students who are present in class, but not well for the students trying to have this experience via web conference.

So, our current challenge is figuring out how to provide the best experience we can for the remote students. We're going to try a slightly different version of the web conferences, walking students through the in-class exercises rather than having them work individually in small break out groups. While the technology supports these small breakout groups, it's difficult to know where you (an instructor) should be at any time. You can spend all your time hopping room to room trying to figure out which group could most benefit from your presence. Additionally, the students are at vastly different levels and degrees of preparation and that makes for challenging group work. I am still convinced that while students can work alone through the exercises, they get so much more from having someone else at a comparable level with whom they can puzzle things out, bounce ideas back and forth, and share "aha" moments. Trying to produce that via a distance experience is challenging.

I'm going to get this posted now and will try to write more this weekend.

Week 2 -- Barely Keeping my Head Above Water

Here we are Monday of week 3 and I haven't blogged last week. That should give you some indication of how things are going -- busy, busy, busy. However, most of the business is due to logistical setup -- getting everyone accounts on our custom grading server -- and getting the students through their first "submission" (a check-in on assignment one which is really due next week).

So, how are things going?

I'd say they are going well. We've dealt with some of the issues surrounding our new classroom:

• I tried writing on a small whiteboard for the first class -- it was totally invisible to the back of the room. So now I bring my tablet (my nifty new surface), hook it up to the projection system, fire up Bluebeam (a terrific PDF editor), and use that to scribble.
• Running one handheld microphone among 132 students (that's the registration number for the college; it will change a bit over the next few weeks) doesn't work. I've gotten the OK to buy 4-5 more microphones, which should solve the problem.
• Everyone likes it so much, they want to use it other times! We've gotten OK to hold office hours there after class -- that's pretty cool (and exactly what I predicted).

So what were the big issues this week?

Timing

As I've not done this class before nor has it ever been flipped, I really don't have a good sense of how much material the students will get through in a class. I've designed the first few days' exercises so that if we didn't finish them, it would be OK, but students still stress if A) they don't finish everything and B) they feel as if others are doing "better" because they got through more. I'm working to produce exercises everyone can get through, but it's quite challenging. I've taken to writing up "answers" after the fact so that students who didn't finished can go back and check what they missed. Of course, that takes time away from preparing the pre-class videos and in-class exercises. I spent almost all my waking moments on the course (when I'm not producing NIH formatted biosketches): preparing slides, recording audio/video/screen capture, designing in-class exercises, designing pre-class surveys, creating accounts on various servers, reading Piazza, answering Piazza, replying to email, holding web conferences. I'd forgotten what it means to do a large course (132 Harvard College plus 60 Harvard Extension). If you don't hear from me this semester, you'll know why!

Web Conferencing

Well, we did our first web conference for the extension students. The good news is that it feels very similar to what goes on in class -- some of the small groups work well; some have slightly bigger discrepancies in skill set, but the same interactions and questions seem to come up. The bad news is that working these "rooms" is really challenging. Two of us did the first one and I was completely exhausted afterwards. There is just a lot to keep track of (it's especially problematic if people have poor connectivity -- they keep popping out of their breakout rooms and you have to manually put them back). That said, we had about half the class show up (the timing is bad for those in Europe and Asia).

I've also been using the web conference for office hours and I like that a great deal. (We're using Adobe Connect.) I can "hang out" in the room and students show up and I can talk with them; if they need privacy we can jump into a breakout room, otherwise, everyone gets to benefit from each other's questions. So far, so good.

Post-Class Statistics

After every class, we ask for a bit of feedback about how useful the class and exercises were. It seems that most people find them pretty handy (I wonder if this would change if we stopped asking for email address -- I think I'll try that)? Only a handful (2-3) people hate working with their peers and felt that the exercises didn't help them. In general, 80% and above find them useful and/or enjoyable. I'm pretty good with that.

A Picture

I got a request for a photo of the new space!

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Find all posts about flipping this course here.

At it again ....

About three years ago I did a series of posts reporting on my experience flipping my operating systems class. Well, I'm baaaaack.

Whereas the big challenge I experienced last time was avoiding overloading the students with pre-class preparation while they were in the midst of implementing large, complex, challenging assignments, this time the key challenge is scale. CS61 is one of our introductory courses and has been running about 150 students. And, just in case that didn't pose enough of a challenge, it's also been part of the certificate program offered through the extension school -- so I have students flung around the globe taking this same class I'm trying to flip. Well, I do hope you'll join me on this adventure. As I did before, I will try very hard to write weekly posts, revealing the good, the bad, and the ugly -- all in the service of education science!

Let me launch the series with a little bit of what's been happening behind the scenes.

Hiring Staff

Having taught large introductory courses before, I knew that I was going to have to start early recruiting teaching fellows (TFs) (teaching assistants in other schools). I got started a bit later than I intended, but I did manage to advertise for TFs and interview people last spring. There were, however, a few obstacles.

1. Most of our students have never taken a flipped class, so while I can tell them all about it and point them to my blog, they don't really know what they are getting into. Maybe this is good.
2. Now that CS50 is the largest course in the college, a very large number of our undergraduates (who often make outstanding teaching fellows for introductory courses) are already involved in CS50.
3. I did not realize how much attrition there would be over the summer. This is perhaps fodder for another post, but I have had more students this summer consider taking a year off to join a startup than ever before.
4. I didn't realize that I could have hired a teaching fellow for the entire spring semester to help me prepare. That would have been amazingly helpful.

Enough whining -- I am happy to report that I have assembled an awesome collection of teaching fellows. They are sharp, enthusiastic, and best of all, they seem to have bought into my vision of the course and the idea that we're going to support our students in learning a bunch of really cool stuff!

Space

It might not be the final frontier, but where the heck do you flip a class of 150 students? The beautiful classroom we have that is used for flipping holds about 60 officially and perhaps 75 in a pinch. That's way shy of 150.

I had my eyes on a large open space in the basement of one of our newish buildings (amusingly, this is called the Northwest building and while it is, in fact, north of most of campus, it's actually not west of much). The space was officially event space, but it looked just about the right size to fill with tables and white boards and hold a humungous flipped classroom.

It took the better part of the summer, but I am pleased to report that pedagogy won out and I was given the space, the school purchased new furniture, and they replaced doors on the adjacent rooms to help with soundproofing. In fact, everyone was terrific about making this happen. It took while to all come together though, and so I put off preparing materials until I knew that this fantasy of mine was going to come to fruition. That made for a rather hectic end of August and will make for a pretty frantic semester, but c'est la vie.

Technology

In my OS course, I kept things very low tech: audio annotated powerpoint. I recorded individual slide clips using Audacity, converted to video using moyea and then made the videos smaller using handbrake. It was a bit of a nuisance, because Moyea only runs on Windows and I do everything else on my Mac. In February, I was in a Microsoft store and saw Office Mix -- a way to incorporate Q&A, screen shot, recording, etc into a nice powerpoint video. I thought this would be the ideal tool to prepare my video clips, so I wanted to test it. Alas, it doesn't run on Mac. It also doesn't run on my ThinkPad Tablet II. So I contacted IT to see if I could borrow a machine (for just a few hours) to give the thing a run before buying a machine. After multiple weeks of being told "any day now" I was informed that they could get me a machine one week before classes started. I freaked. I ordered a Surface 3.

I am happy to report that it was worth it. I really like the capabilities that Mix provides. There are, however, a few things that I would love to see fixed:

1. If you want the interactive Q&A, you have to run it on Microsoft's servers. Sad. I want to host everything locally.
2. If I want identified per-student data on the questions, I have to have students create Microsoft accounts. I'm not excited about requiring that.
3. You can really only fit one question on a slide -- I'd really like a more compact presentation so I could have a list of questions on a slide.
4. I would love some global operators (make all my audio clips start automatically).

After bugging my teaching fellows and trying all sorts of different ways of presenting material, I decided that I would embed some Q&A in the videos, but not the "pre-class work" that I keep track of as part of participation. Instead, I would continue to use google forms for that (even though the Mix analytics are much better). In this way, I can host the videos on the MS servers, but do not need to require a login. If you're interested in the technology, you can check it out here. (Select any of the pre-class videos.)

Extension School

Here's the real conundrum: how do you teach a flipped class via distance learning? The students are used to watching videos of live lecture and then having sections, but recording a live flipped classroom doesn't actually make all that much sense now does it?

Fortunately, my colleague, Harry Lewis, has been offering his flipped class via extension. One of our former graduates has been his teaching assistant and is regarded as the guru of flipped distance ed. So, I lured her over to the house one weekend (since I still couldn't drive; see previous blog series on total hip replacement) to talk flipping and eat homemade biscotti. She assured me that you could run good interactive sessions using the extension school's web conferencing software. So, that's what we're doing.

We will try to record some of the class time and make it available, but the extension students can tune in for a live, instructor guided, web conference to go through the in-class exercises. We will have live streaming of section, but I'm not going to require attendance there, since I think the web conferences will be more important and I didn't want to ask them to do three days per week. We'll have to see how this all works out.

Off and Running

Other than the hours I've spent watching last year's lectures, making pre-class materials, developing in-class exercises, and figuring out the infrastructure that the previous instructor developed, that's about it! Tomorrow is our first class -- our goal: make sure students understand what they are getting themselves into!

Until next week!

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Find all posts about flipping this course here.

Week 6: Mobile at last!

I have been officially discharged from home PT, and I got the "all clear" from my surgeon (or more precisely, his PA). That means I can pretty much do anything I want except run (and by extension, I'm going to include soccer in that). And I can now legally drive again! That was very exciting (of course, the day after I was allowed to start driving, our family found ourselves with another licensed driver, but that's definitely material for a different post!). The next major milestone will be 6 months post-op when I see the surgeon and we discuss "the future" (what I can and cannot reasonably do). The X-ray was pretty cool -- the part looks great (so much better than a normal hip). I will continue with PT to rebuild muscle, which I think is really addressing the year and a half I spent in pain and limping more than any post-surgical residue. So, 6 weeks post op, status is:

• I can walk 4+ miles at a 16 minute pace.
• I can (finally) work hard enough on the elliptical to get a heart rate up to 75-80% of max (which for me is way higher than any of the charts say). It feels good to be able to work up a real sweat (exercising as opposed to hot flashing).
• Range of motion is quite close to normal.
• Every once in a while I can tell that the abductor isn't 100% there on the right.
• My walking posture is almost normal (I have to concentrate on walking straight, but this is left over from the pre-surgical mess I was).
• Quad is still a tad weak (only noticeable if I'm thinking about it going upstairs), but we're getting there.

Overall, I am thrilled -- so much happier than pre-surgery.

Week 5: Definitely wrapping up here

I take it as a good sign that there is less to report each week. Again, changes happen, but are not as dramatic. So, this week's milestones were:

• Wednesday: went for a walk in the woods. I wasn't up to climbing over felled trees (we had a hailstorm on Tuesday), but I was fine with the uneven ground and carried my cane, but didn't use it.
• Thursday: So, based upon the walk in the woods, I shed the cane!
• Friday: I hit the 3-mile mark on my walk.
• Saturday: I hit 13,000 steps.
• Monday: I upped my pace from Friday's 19 min/mile to 18 min/mile.

Tomorrow is my Xray and post-op appointment and next week's post will be my last!

Week 4: Slow and Steady

It's pretty clear that there is less big news to report this week, but progress continues. It seems that the major milestones this week have been:

• Walking without the cane pretty much all the time except for long walks.
• Long walks are approaching 2.5 miles (with the uphills and downhills of Tower Road).
• The last day of week four I did about 3/4 of the walk carrying the cane as opposed to using the cane.
• I can regularly hit 10,000 steps and have hit a max of 13,000.
• PT is feeling more like a workout -- it's all about rebuilding muscle strength.

I'm thinking that there will be only two more posts in this series, as the beginning of week six will bring me to my post-surgical appointment, and I expect to be pretty much fully functional. And anyway, I will need to start on my next blog series: flipping a classroom of 150 students!

Week 3: Look Ma, No Hands!

It was another big week on the recovery front. Wednesday I had my last visit from the nurse and was discharged and, more importantly, relieved of having to wear dorky socks! Yippee!!!!! This also means I can now fully dress myself -- a wonderful feeling. Putting on socks is still a bit tricky, but doable.

At my Friday PT session, I discovered that I can actually use the brand new spiffy elliptical that my wonderful husband swapped in for the treadmill (since I really should not be running on a treadmill but I can go as hard as I want on the no/low-impact elliptical). I can also do the spin bike! Yeay -- I can start working out again -- my physical therapist doesn't want me doing either with resistance, but it's a start.

Also at PT I discovered that I can now lay on my good side and lift up the leg with the new hip -- this is a huge step forward for the muscles on the outside of the hip, which were pretty much non existent last week. It turns out that phyiscal therapists rate strength on a Five point scale. prior to this week, the muscles in that direction were somewhere between a 1 and a 2; now they are a solid 3!

But perhaps the biggest shock was that spontaneously on Friday I could suddenly walk reasonably well without the cane. I was in my office and suddenly just felt stable and able to walk without a limp. Absolutely amazing!

Saturday, I went out for a 1+ mile walk and brought the two crutches as I'd been doing, but never actually used the second -- I did the whole walk with only one crutch, so Sunday, I both lengthened the walk (about 1.5 miles) and used the cane. And then Monday, I lengthened my morning walk to about 1.75 miles and over the course of the day hit 10,000 steps for the first time since surgery.

Today wraps up week 3 and PT was great -- we're focusing on building up the strength in the few muscles that are still weak, continuing to stretch the hip flexors, and beginning to start stretching the quads. All great news.

So, my week 3 summary is:

• I can walk for 40 minutes at a shot.
• I can now walk a couple of miles without stopping.
• I can walk without a cane (way better than I was pre-surgery). I can't do this yet for my long walks, but around the house/office I'm good.
• Strength is coming back.
• I can do an elliptical for 30 minutes.
• No more dorky socks!

Week 2: Big Strides!

It's been a fantastic week!

It started on Tuesday with a visit from the nurse, who removed my bandage, which warrants a bit of discussion. Every surgeon seems to have his/her own preferred method of closing you up: stitches, staples, steri-strips -- I've had them all. However, my surgeon used something I'd never seen before: glue and an aquaseal. The glue seals the wound and the aquaseal is a large (and I mean large) gel bandage that covers it. Among its most wonderful properties is that it's waterproof! This meant that I was able to shower from the day I got home (as opposed to the week or ten days I'd been quoted by others). I don't know about you, but showering is one of life's simple pleasures, and especially after a stint in the hospital, sitting in a nice warm shower is really high on my list.

Anyway, she removed my aquaseal, and we cleaned off a lot of the gluey, gummy adhesive to reveal my fine, six-inch scar.

Everything else looked good, so we left things that she'd come one more time, but we guessed that would be her last visit. Yeay -- everything looking good medically.

Then later that day, my PT showed up and we did a little bit of walking with only one crutch. I probably don't want to do that all the time, but I can, and that's exciting.

The next day (Wednesday), I ventured out for one of my short, but slow, walks all by myself. I now feel stable enough getting around that it doesn't concern me. This is another major milestone! We celebrated by going out for sushi that night -- I felt almost like a real person.

Thursday's big news was that I was able to lay flat for a full 15 minutes. Now, this might not seem like much to you, but one of the tightest muscles I have right now is my hip flexor, making it extraordinarily painful to simply lie in a flat position. In theory, I'm supposed to do this three times a day for 30 minutes; in practice, after about 10 minutes I want to curl up in a ball and cry. A long walk prior to the stretch helps a lot.

Ah yes, one other topic I haven't mentioned yet -- the dorky socks! A lot of post-surgical attention goes to avoiding blood clots (which I admit is a good thing to avoid). In my case, the avoidance protocols involve daily shots of blood thinner (which are getting pretty tedious about now) and what I fondly call, "The dorky socks." These are knee-high compression socks that have all the great features of a) looking ridiculous, b) being uncomfortable, and c) being really hot.

If it weren't for the dorky socks, I think I'd be able to dress and undress myself, but I still need help getting them on/off, because they are so tight, and I'm not quite flexible enough on the right side to deal with them. I am guardedly optimistic that they are about to become a thing of the past after my next/final nurse visit!

By Thursday, I also realized that the vast majority of the swelling was gone! I had been pretty bummed when I weighed myself coming home from the hospital -- I'd spent the past two weeks, eating lightly, and prior to surgery, walking a lot -- 15,000 - 20,000 steps per day, so I had expected to be a bit lighter than when I'd left for "Canada -- Part II" But the scale said that I was three pounds heavier, which was devastating. However, on Thursday, I ventured on the scale again -- 9 days post-op -- and I was a full ten pounds lighter than my "coming home" weight. Ok, I was much happier.

While I'd been off pain-killers (including tylenol) for the past week, I was still using ice at night to go to sleep, but Thursday night was also the first night where I never put the ice pack on! Things just keep getting better!

But Friday was the big day! During PT, she let me try a cane, rather than one or two crutches, and we walked around outside on bumpy ground, and it was OK. So, I've been promoted to a) a cane, and b) reciprocol stair walking (i.e., "walking stairs like a big girl"). This is huge as a cane means I have a free hand and can actually carry things! This means I can do things, which is rather exciting!

I also managed a 30 minute walk (still with the crutches), but probably over did it a bit during the weekend between insisting on making dinner Sunday evening and walking too much. I need to give the muscles more time to get stronger, but it's such a relief to be able to do stuff.

So the report after two weeks is pretty darned amazing.

• I can comfortably walk for 30 minutes (albeit with crutches and slowly).
• I can get up and down stairs pretty normally using the cane lightly to give added strength to the leg with the new hip.
• My sleep is better than it was pre-surgery; I'm probably sleeping better than I have in a year and a half.
• I'm no longer napping at all.
• Pain level is pretty much always sub-3, unless I just do something I shouldn't or am doing a couple of the exercises that are still challenging.
• Bruising is pretty much gone:
  Last Wednesday (8 days post-op):
  
  Monday (13 days post-op):
  
  

Total Hip Replacement: Surgery and the First Week

Warning: amazing bruise pictures below.
Everything went pretty much according to plan. There were a few slight hiccups -- I tested positive for Staph, so they put me on an antibiotic for five days coupled with daily Hibiclens showers. In my experience, Hibiclens is pretty standard for the three days prior to surgery, so this just meant a longer run.

Pre-Surgical Appointment

This was mostly routine, although it was my first experience with NEBH so it was kind of interesting to compare and contrast (I have now had surgeries at St. Elizabeth's, Emerson Hospital, MGH, the Brigham, and NEBH.)
NEBH was the farthest ahead electronically (or at least relative to what I'd seen other places, which was admittedly a few years old now). Every document was shown to you on paper, but you provided an electronic signature, so they had the entire file digitized, including things like your Health Care Proxy. So, no searching for random pieces of paper at future moments. Other than that, checkin was pretty typical -- sign lots of forms.
If you are "of a certain age" (over 50), then you also get the bonus ECG (they would like to make sure that you're not going to keel over during surgery). So we did that, we drew some blood, I met with physical therapy, I think we may have taken another Xray (although I am not entirely sure), and (new to me), they did nasal swabs to test for both MRSA and Staph. I don't know if this is NEBH standard for everything or something special for joint replacements. It is pretty clear that infection is a huge concern for hip replacements (e.g., from here on out, before every dental appointment, I need to get prophylactic antibiotics. Who knew?), so this might be standard everywhere; I don't know.

Surgery

Then I went gallavanting off to Canada knowing that some time between 4:30 and 8:30 PM on the 6th, I would get a phone call with my surgery time. So, I'm sitting on the runway in Denver, waiting for them to close the door and my phone rings. My surgery is scheduled for 7:30 AM with a checkin time of 5:45 AM. Oh yeay; I land at 10:00 PM. My wonderful husband books a hotel room about 15 minutes away from the hospital, picks me up at the airport, and spends the night before surgery with me (isn't he a great guy?).
I show up at 5:45 expecting a pretty quiet/empty place, but au contraire -- there are already a dozen people in registration when I get there (and what time did they get there?). Checkin is reasonably efficient and then a nurse comes to get me for pre-op.
Pre-op is an interesting experience -- a (long) parade of doctors and nurses come by, introduce themselves, tell you what their role in your surgery is, and get on with their business. I'm sure I will leave out a bunch of folks, but I remember: pre-op nurse, surgical nurse, anesthesiologist, hematologist, a second anesthesiologist, and, of course, my surgeon. Everyone is pretty friendly and chipper. You get used to stating your name, date of birth, and what procedure you're having -- a lot! And, in good form, the surgeon initials the hip on which he's working. You may think this double checking is excessive, but I still remember being wheeled into the OR at MGH and seeing the board displaying RIGHT ACHILLES REPAIR. Only problem was, I had a LEFT ruptured achilles. I pointed this out pretty adamantly and they assured me they knew which side was having surgery, but let's say that the error on the sign did not instill great confidence.
I get my IV and I have to admit that I don't even remember being wheeled out of pre-op and into surgery. It seems that they must have left me under for quite some time, because I went in for surgery at 7:30 (in theory) and while I have a few vague recollections from post-op, my first real recollection was getting taken to my room right around noon. And here is the truly amazing thing: they handed me a pair of crutches and I walked, bearing weight on my brand spanking new hip from the stretcher to my bed. How totally unbelievable is that?

In-hospital Rehab

The plan was to put me on accelerated rehab so I could go home the next day instead of staying a second night. (Part of accelerated rehab is the walking to bed thing.) So they got me settled and before the afternoon was out, I had Laura, the physical therapist come by and take me for a walk. This rebah was the oddest thing I had ever experienced. While I could walk on the thing, it was still remarkably difficult to move it around and get myself into and out of bed. It's a rather different experience from any of my prior injuries.
Keith and Teagan came by that afternoon/evening to visit, which was quite nice. Mary Riendeau also came by with a bunch of balloons and a bucket of goodies. I think I was pretty cognizant that evening, but I was, in fact, on narcotics, so who knows. I asked about food and almost miraculously a tray appeared moments later -- clear liquid diet. Yuck. I drank some bouillon and called it a meal. Unfortunately, this didn't actually settle terribly well and just as Mary was leaving, so did the boullion. Oops.
The night was the first I'd spent in a hospital since Teagan was born. And I was feeling pretty great then relative to this time (even with a C-section and a terrible close). So the night was rough. I got at least one shot of dilaudid (narcotic pain killer), but it was still a pretty rough night.
I felt much better the next morning. OT showed up early (before 8) and went through my stepping into/out of a shower, getting to the bathroom, etc. She cleared me to go home! PT showed up later in the morning (after another tray of clear liquid diet and another attempt at bouillon). We mastered the stairs -- I can't tell you how much easier crutches are when you're weight bearing. With non-weight bearing, stairs are always a bit terrifying. With weight bearing, they are a piece of cake. Cleared by PT. Unfortunately, on the way back from PT I got a bit nauseous again and I experienced the return of the morning's bouillon.
Then things got bad: they decided to give me reglan for the nausea. Unfortunately the reglan started giving me the shakes -- so bad that my muscles started clenching and I was in agony. In what seemed like forever, they tried some adavan to help relieve the shakes. Eventually I calmed down, but within a couple of hours, I felt the shakes starting to come back on again. I alerted the nursing staff, but it seemed like it took forever for anyone to do anything -- this time they tried demerol. Finally the shaking stopped and didn't come back.
But this ended up torpedoing any chance I had of going home that day. I would have been OK with the nausea if we could have skipped everything else!
Keith came by that evening to visit again, and we planned to get me out of there as early as possible the next day. I had one more PT session that evening, walking further, doing stairs again, etc. Hemotology signed off on my status. The surgeon came by and he seemed happy.
So, on day two post-op, I had one last PT session, another visit from the surgeon, another hemotology checkout, and then got myself cleaned up and dressed and went through the endless pile of paperwork. I think we finally got out of the hospital around 11:30 AM. The PT was completely accurate that the day right after surgery was the worst and that the second day after was considerably better. It may be that staying in the hospital both days was really all for the good.

Home Rehab

Part of the discharge process includes setting me up with both home nursing service and home PT. It seems that the home healthcare service spent a large part of Thursday trying to reach me, but they kept calling my cell, and I wasn't really paying attention to it (I also don't get great cell reception in the house). It turns out that I was going to be getting weekly visits from a nurse and PT three times a week for awhile and then twice after.
This bout of rehab has been rather different from anything else I've experienced. On one hand, I can walk -- I'm pretty much fully weight bearing and just using the crutches to make sure I'm balanced and I take fairly normal strides. Put another way, the goal is to make sure I don't develop any bad walking habits. So that is quite amazing. But then there are stupid little motions (sliding my right leg off to the side) that are exhausting and painful. The exercises I'm supposed to do seem so trivial, but man do they knock it out of me!
I took my last dose of narcotics just after midnight Thursday night and stopped all painkillers at that point. I hate how the narcotics make me feel, and the tylenol doesn't seem to do anything.
Friday was one of those days of sitting around, napping, not eating much, changing positions, napping, etc. Both the nurse and physical therapist came by around two and checked me out to make sure all was going well. Immediately after I had to do a qualifying exam via Skype. I was pretty good for the first hour, but could feel the fatigue setting in by the remaining half hour; after I just crashed for a couple hours of napping. I think the combination of 1) not feeling like eating much, 2) still recovering from surgery, and 3) the exertion required to move around was combining to make me extremely tired.
That night as I went to bed, Teagan commented on my bruising. It is all in the back of my leg, so I couldn't see it, but I decided to start photographing the progression of the bruising. We didn't save the Friday night pictures, but the Sunday night pictures looked like this:
Wow. I had no idea.
Saturday and Sunday were much of the same -- moving around, sitting around, icing, getting stiff, walking around, napping, etc. While the pain isn't too bad, I would also say that I'm pretty much constantly uncomfortable. At the same time, I can feel that things get just a touch easier each day. Another physical therapist came over on Sunday, and she pushed me through all my exercises and reminded me to get a few real walks in each day. So, I decided that I would make sure I did three sets of each of the three types of exercises I had and take three walks. Although my walks were slow, I was able to do a 5 minute walk, an 8 minute walk and a 12 minute walk. That felt pretty satisfying.
Unfortunately, the laying down exercises were so extraordinarily painful and difficult (the PT assured me that they'd be a lot easier if I were still doing painkillers) that they left me kind of whimpering by the time I went to bed (honest).
I decided to take it much easier on Sunday -- only a couple of sets of exercise and one 15 minute walk. But I did get a lot of work done around the house -- mostly paying bills. This ended up exhausting me in new and different ways! My back was really, really sore -- essentially, my hip flexors are super tight and this puts strain on the back. Stretching the hip flexors is the most painful thing I have to do, with abduction a close second.
Monday wrapped up my last day in the first week of surgery -- I managed to stay awake all day, until about 5:00, including a few sets of exercises and a 15 minute walk. My appetite had pretty much returned to normal (although I have no sweet tooth, which is OK with me). I'm trying to eat as much iron-rich food as possible in an effort to combat the fatique. In other situations, I've found it pretty effective.
So my week one summary would be something like this

• Walking is remarkably easy.
• Tightness in the hip flexor is the single biggest problem leading to stiffness and an unnatural gait.
• The muscles that got damaged in the surgery (hip abductors, in particular) are the most troubling in terms of what I can do. My guess is that this would not be the case for the anterior approach -- something I haven't discussed. The traditional hip replacement takes place from the rear buttock. There is a new approach that comes through the front. In theory, it's supposed to preserve more muscles. My experience is that the anterior is more common on the west coast; on the east coast, every surgeon I spoke with was much more comfortable with the posterior approach, particularly because it provides better visibility. The tradeoffs are nicely summarized here. In theory, the anterior approach leads to faster recovery, but the numbers I see and what I expect don't fully support this and to the best of my knowledge there are no conclusive studies.
• I was bathing independently by day 5; day 4 was mostly independent. That said, we have a walk-in shower with a built-in seat, which makes things easy. I have an extra chair next to it that mostly gets used for getting out of the shower, put also provides some leverage to keep that right buttock off the toilet.
• Appetite has pretty much returned to normal by day 6.
• By day 7 I was reasonably functional in terms of phone calls, conversations, balancing my checkbook, paying bills, etc.
• The bruising is really quite amazing.

Total Hip Replacement: The History

When last you left this blogger, I was riding the high of the recent women's world cup championship. Good thing too -- I definitely needed something good before embarking on my next journey -- after flying home from Vancouver on Monday, I had to be at New England Baptist at 5:45 AM Tuesday morning to get a new (right) hip.
I suppose a bit of background is in order.
I've had pretty constant hip pain for about 16 months at this point, but being smarter than I was before, I'm guessing the hip problems started several years ago. Every once in awhile, perhaps every second or third game, I'd notice that my hip would spontaneously kind of buckle. It was a quick thing, not terribly painful, and it was fine immediately thereafter, so I ignored it. This may not have been my most clever move.
Then, starting early last year, the hip started getting sore after games. It wasn't unbearable, just annoying. I figured it was a sign of aging, but didn't think a lot about it. Then in the late spring I ran into a woman who had just returned from a hip replacement and I asked her about early warning signs. She pretty much described my buckling sensation. This got me pretty scared, but I had some other medical issues to attend to, so I ignored it for a bit longer.
Finally in November I sought medical attention. My normal orthopedist doesn't do hips, so they sent me to a specialty I'd never heard of: physiatry. Initial diagnosis was bursitis. That sounded pretty good! That would be treatable and completely fixable. The only problem was that the cortisone shot made things considerably worse. Next step: MRI and XRay.
The results of that showed a torn labrum, a 3 cm cyst, and "mild to moderate" arthritis. This was the end of my run in physiatry and I went off to the area specialist in minimally invasive hip repair (thinking that this torn labrum must be the culprit). However, within moments of seeing him (we're now at December 24), he said that the labrum and cyst were the least of my problems, but I had pretty severe arthritis (flattening or destruction of the cartilage) in the hip. It didn't take a trained expert to see what he meant -- a well functioning hip is a ball joint, nicely centered in the pelvic socket with a nice fat layer of cartilate between the two. My ball socket was only millimeters from the pelvic socket and definitely not comfortably surrounded by cartilage. He sent me off for a slow-acting shot of cortisone into the hip joint and then PT three weeks later.
My Physical Therapist, Clare Safran-Norton, at the Brigham is awesome! I'd been trying to find someone to help me figure out why I'd been having repeated injuries on the left side and no one would take a holistic view, but Clare did. She immediately started to work with me to bring some flexibility back into my spine (it had become practically flat after so many months of compensating for hip pain), she got me working out in the pool, but most of all, she treated me like a partner and we worked together to see how far I could get. If you need a PT, I can't say enough good things about her. She is just terrific.
By the time I had my follow up with the doctor/surgeon, I was still in pretty constant pain and he broke the news that a replacement was really my only option. I wasn't thrilled, but swallowed the answer. He gave me the number of his scheduler to schedule surgery, but when I finally got through to her, she said I had to come back for another appointment and XRay. When I found this second appointment almost an identical rehash of the previous appointment, I decided to shop around a bit more for doctors.
I worked my network and got recommendations, did a bunch of searching online and decided that I probably wanted to get this done at New England Baptist, because it's an orthopedic hospital and they do more of these than pretty much anywhere else. So I started looking for someone who was both a sports physician and a hip replacement surgeon. It turns out that several of the NEBH (New England Baptist Hospital) crew practice out of an organization called Pro Sports Orthopedics and that they see patients in Cambridge, Brighton, and Waltham -- three terrifically convenient locations.
So I narrowed my list and decided that I wanted to speak with Anthony Schena The good news is that I liked him a great deal; the bad news is that he doesn't actually do hip replacements. Oops -- turns out "Joint reconstruction" is fundamentally different from "Joint replacement. My bad. He directed me to his colleague, Michael Mason. Liked this guy a lot. Instead of, "Well, we'll have to see when we can get you in." I got, "Oh, early July? That should be no problem." He took the time to draw pictures of the pieces that went into a hip replacement. He gave me a good sense of where the technology is, what we know and also what we don't know (I find this trait particularly attractive in physicians; it is all too rare). He was encouraging, and he's clearly active both clinically and in research -- he has a herd of goats prancing around Scotland (I think) with artificial cartilage. The research is going to take a long time to complete, because for the next step, the FDA requires that the goats be slaughtered, and no one is keen to do that. And actually the clincher was when I asked him what brand he uses for replacements, he named two and said that he picked the one that fit me best. Very different from earlier interactions, which devolved down to, "I use this part."
OK, so the plan was set: I spend most of June in Canada (see previous blog sequence), during my trip home in the middle I do my pre-surgical appointment, and then I land on July 6 and get a new hip on July 7.

25 days and 13 games later: The USA vs Japan

The day arrived!

I had planned to do a boat trip up the Indian Arm this morning with Beth Martens (fellow chuck) and her family (Omar, Katie, and Cassie). I figured it would be a lovely and welcome distraction as we awaited the big game. It was a good plan -- I didn't start to get antsy until about the last 45 minutes of the trip.

But enough preamble -- the environment was everything you could expect -- overrun with Americans, it was almost entirely a pro-American crowd. It was a joyous, festive, albeit nervous, atmosphere. And unlike any of the other games, we had a bit of a pregame show -- Canadian Maple Leaves, the FIFA banner, mounties, and flags saluting all the teams who played in the tournament.

From the first moment, the USA made it clear -- they were out for redemption -- the heartbreaking PK loss four years ago was a bitter memory, and they were out to ensure there was no repeat this year. Japan started with the ball, passed it back, took a long kick, and the USA gained possession and immediately started pushing into the attacking third. And then, two and a half minutes in, Rapinoe sends a beautiful corner kick into the middle and Carli Lloyd runs in and just buries it in the back of the net! The stadium went completely wild!

And then, only two minutes later, it's Holiday taking a penalty from the same side. Julie Johnston flicks it on and again, Lloyd tips it in! USA 2-0 and we haven't even had five minutes of game time! The whole team ran over to hug their bench and the crowd cheered for a good solid minute.

Japan could not seem to muster the long sequence of passes that so characterizes their play -- they would make three or four good passes and then send a long ball to nowhere, kick it out of bounds, or otherwise lose possession. And when they did, the US attacked ... and attacked ... and attacked. In the 14th minute, Tobin Heath launched one into the box. The Japanese defender flicked it high in the air, but still in the box ... and this time, Lauren Holiday raced onto it and volleyed it into the back -- 3-0!!!!!

But perhaps the most stunning play of the game came just at the fifteen minute mark -- Carli stole the ball at midfield, the Japanese goalie is way off her line, and Lloyd sends the ball in from midfield just over the outstretched hand of the Japanese goalie. USA 4-0 and a hattrick for Lloyd in the first fifteen minutes!!!

In the 18th minute, Lloyd almost made it 5-0 off a beautiful cross from Klingenberg. At this point, Japan finally settled down a bit; their possession improved and they began controlling the ball. And when Japan does that, they are dangerous and one makes mistakes at their own peril. Sure enough, a misstep by Julie Johnston in the 27th minute gave Ogimi just the opening she needed to send the ball soaring into the corner of the goal past Solo's outstretched hand. USA 4-1.

This is about the time it's important to remember that in 2011, Japan came from behind not once, but twice, to take the game into overtime and PKs. So, even with a 4-1 lead, it's natural to become a bit nervous.

Perhaps an even more salient reminder of 2011 was the 32nd minute Japan substitution, bringing Homare Sawa into the midfield. Sawa is arguably the soul of the Nadeshiko in the same way that Abby Wambach is for the USA. She's a tad slower than in 2011, but her ability to calm the team down, establish order, give Japan hope, and attack the goal is unmatched. And that's exactly what she did.

In the 39th minute, surprisingly, Japan made its second substitution. This is somewhat unheard of -- using two subs before half time -- but Sasaki (the Japanese coach) clearly needed some tactical changes to avoid being completely thrashed. And that's how they ended the first half: USA 4-1 and Japan having used two of their three subs.

And then it was the second half!

Rookie Morgan Brian, who has played wonderfully as the holding midfielder, had a beautiful shot in the 50th minute that forced the Japanese goalkeeper to make a tipping save. And then in the 52nd minute, the US scored again -- unfortunately, it was an own goal, by Julie Johnston. As mentioned earlier -- the Japanese take advantage of every misstep; a slight defensive glitch gave them a shot on goal that Johnston tried to divert with a header, but instead of diverting it, she sent it into the corner of our own goal, just out of Solo's reach. USA 4-2 -- and those who remember 2011 are started to get a bit twitchy.

And then, just a minute later, a Holiday corner kick goes to the far post, where Morgan Brian is perfectly positioned to set it up into the middle where Heath redirects it into the goal: USA 5-2!

Before the 60th minute, Japan used its last sub, replacing forward Ohno with Iwabuchi, who scored Japan's only goal against Australia. And only moments later, the USA made its first sub: Rapinoe is subbed out to a standing ovation, replaced by Kelley O'Hara.

It's a bit sad to say, but the remaining excitement of the match was the entrance of the team's two senior members: Wambach for Heath in the 79th minute and Rampone for Morgan in the 83rd minute.

And then it was all over ... the USA were world champions and Japan was in tears. There is a lot of genuine respect between the USA and Japanese teams, but it's always difficult to lose and have to stand around waiting to get those silver medals.

And then, there is the golden ball -- to the best player in the tournament -- Carli Lloyd!

And the golden glove for the best goalie -- Hope Solo.

Then the Japanese get their silver medals.

And finally, the new World Champions take possession of the trophy!

It's been a great month. I can't wait for France 2019.

Reporting from beautiful Vancouver, it's the Consolation Match: England versus Germany

England enters the match having never defeated Germany in 20 meetings. Germany enters the match having lost to the USA in the semifinal. And they're off!

The opeining 10-15 minutes saw Germany looking confident and dominating. They had opportunities in the box within minutes of the opening whistle. In contrast, England did not look so good. They were able to keep Germany off the scoreboard, but they just weren't smooth or organized -- they didn't look like the team who had deserved to win over Japan. Until, that is, they settled down. About fifteen minutes into the match, England settled down and we were in for a good tight game. Something about the English play made it seem like they wanted it more.

Germany was more precise and better at putting together the passes and combinations, but England were putting themselves out there in a way Germany wasn't. Nevertheless, the game was end to end and relatively evenly matched, with the Germans looking perhaps a bit stronger. They went into half time 0-0.

The came out of half time with renewed energy and Germany looked particularly dangerous. They threatened the English goal, regularly, but without success; England had fewer opportunities. In the 75th minute we saw perhaps the best opportunity of the game with Jill Scott pulling Nadine Angerer out of the box, but somehow the ball went backwards instead of into the goal. It had looked so promising.

The battle continued and the final whistle blew on a game still tied at 0-0! Into overtime.

The frenzied battle continued throughout the first 15-minute period with neither team successfully creating a threatening attack. Then we went into the second overtime. I did not want to see this game end in PK's. Both teams deserved better.

And then...it happened: Leanne Sanderson (former Boston Breaker) in the box; Tabbe Kemme appeared to have her around around Sanderson as she went down; was it? could it be? Holding in the box? Well, the referee did call it, awarding a PK to the English. The replay we could see on television was interesting. While still standing, it was pretty clear that Sanderson had grabbed Kemme. It was equally clear that Kemme did hold Sanderson, but it was almost as if Sanderson made it happen. I think without the replay, the call was completely valid; with the replay, it was much tougher to decide. I wouldn't say it was the wrong call, but I can't exactly say it was the right call either. I wonder if soccer will ever use instant reply to rule on these things?

Anyway, Fara Williams stepped up to the line and nailed it.

The rest is history. Germany lost a stunning two in a row; England had their best finish ever; this fan was exhausted!

Back in Edmonton: Japan versus England

It was a beautiful day in Edmonton as Japan and England met in the second semifinal match. Many of the Canadian fans had purchased tickets to this game, hoping it would be a Canadian match on Canada Day (the Canadian Fourth of July Equivalent, celebrated on the first of July). But, England squelched that plan, so it was an interesting crowd - a lot of Canadian jerseys, a lot of American jerseys, and many, many fewer English and Japanese jerseys (I wore my Boston Breakers Sameshima jersey). As the people behind me were overhead to say, "No one really cares who wins; they're just here to watch soccer." I was cheering for Japan, because I would like to see another USA / Japan final, with a different outcome than we saw in 2011.

The crowd was a bit larger than I expected (31,000). We only got 19,000 for the USA round of 16 game in Edmonton.

And our seats were quite nice.

Japan got off to a bit of a rough start -- they weren't connecting cleanly on their passes as we've come to expect from them. England, on the other hand, got a decent chance on their opening possession -- a rocket launched just left of the goal. Japan collected themselves somewhat, but I was shocked to see how different the 2015 Japan team was from 2011. In 2011, Japan connected passes like a pinball machine; amassing some ridiculously high pass completion rate. Today, they were missing passes, sending balls into wastelands of space, and simply not looking like Japan. And England was loving it! England seemed to have the speed advantage on both offense and defense. But they too struggled to put together a significant attack.

Then the game started feeling eerily familiar -- in the 31st minute Japan's Ariyoshi was fouled -- the referee called it in the box, awarding Japan a PK. And like last night's foul on the Americans, instant replay showed that the foul was just outside the box. Oops. Japan's captain, Miyama, struck net. Japan 1-0.

And again, eerily similar to the Germany USA match, less than ten minutes later, England's Houghton also drew a foul; Fara Williams nailed it, and we were back to a tie game (which seemed more apppropriate given the tenor of the game). The teams went into halftime at 1-1.

Only somewhat reminiscent of the previous evening's match, second half play continued with Japan dominating the possession game, but England dominating the attacking game. And still, this was not the Japan of yesteryear. The final ten minutes saw subs coming in, play becoming frantic, and when the clock reached 90, and the 4th official showed three minutes of extra time, most of us were anticipating another thirty minutes of soccer.

But then -- heartbreak for England. Japan raced towards goal and sent a low cross into the box; while trying to clear the ball, England's Laura Bassett knocked the ball into her own goal. Some of the crowd went wild, but most of us groaned, "No!" This was not how this game should have ended. England's losing the game seemed not quite right, but losing in that particular fashion was simply devastating. If ever I wanted a "do-over" this was it.

Third time's a charm: Back in Montreal

This is the big one -- the USA/Germany semi-final. Anticipating a large USA crowd, US Soccer arranged for two FanHQ events -- one the evening before the match and one the day of the match. I couldn't resist checking out the night before party (having spent most of the day enjoying the Montreal Jazz Festival -- I strongly recommend it). It reminded me a bit of a middle school mixer.

There were long lines outside and those of us who had RSVP'd got in quickly. I think the lines were partially to make one feel special -- the place still wasn't full when I left (8:15 from a party with a 7:00 PM start, but there were people still coming). The crowd was quite mixed: many families with kids, a few groups of teen age soccer players, lots of young adults -- most people came in groups. The locale was the bottom floor of the Telus Theatre, but it seemed more like a night club. There was a large dance floor with multiple bars, a raised area at the entrance with a bar and a few (very few) cocktail tables, and a stage where the DJ was set up.

For the first forty five minutes, nothing was actually happening, so people wandered in and tried to figure out what to do. The 14-year-old boy at the table next to me was wandering in circles around his family's table -- I could just tell that he had no idea what to do. But neither did anyone else. So, when in doubt, the adults bought booze. One rowdy teen age group from MA entered and tried to get the party started with some chanting of U - S - A, but it didn't really work.

It turns out that what we were missing was our cheerleader. And it turns out that DJs can double as cheerleaders. At least that's what DJ Spin Easy did. He was actually quite good. He worked on getting the crowd jazzed up and then played music and it basically turned into a dance party. Had I not been nursing a soon-to-be-replaced hip and had I been with a group of dancing friends, it would have been fun. Since I had neither, I headed home early.

And now the game!

Let me just say it was a match worthy of the top two teams in the world. Both teams played well and the outcome was really never quite certain, well perhaps around minute 84 it was, but a tremendous effort by both teams.

The stadium was packed -- the crowd practically all cheering for team USA. I felt a bit sorry for the few German fans. I haven't experienced such an atmosphere since the 2006 Men's World Cup game between USA and Italy in Germany.

There was a lot of speculation about the lineup, and I think many might have been surprised by it -- Carli Lloyd moved up top pairing with Alex Morgan, leaving Holiday and Morgan Brian in the middle and Tobin Heath and Megan Rapinoe on the wings. Controversial or not -- it worked. Brian was superb -- she worked well with the defense and connected with the offense. It was definitely the best I've seen her play, and it made a tremendous difference to the entire team play.

The opening ten to fifteen minutes saw Germany putting enormous pressure on our back line pretty much at the 18-yard line. However, the defense was, once again, rock solid. Germany dominated in possession, but when the US got the ball and started moving it upfield, their attacks were more threatening. There were at least three solid efforts in those opening minutes, but none found the back of the net. Still, forcing the goalie to make a save within the first two minutes of the game was a good thing.

Megan Rapinoe was having enormous success stripping the ball from her player, and the other Megan (Klingenberg) was both an offensive and defensive force. Germany still dominated in possession, but the USA began to do a better job in the second quarter of the match moving the ball around and possessing. The teams went into halftime 0-0, and it looked like it could stay that way for a very long time.

There were no personnel changes at halftime and the game continued largely as before, albeit perhaps even more balanced. And then things got interesting. Julie Johnston fouled German midfielder Alexandra Popp ... in the box! Ouch -- penalty kick to Germany. The noise when Sasic, the top scorer in this World Cup, missed the PK was earth-shattering. In a bizarre twist of fate, only 9 minutes later, Alex Morgan got fouled in the box by German defender, Annike Krahn. Unlike Sasic, Lloyd placed the ball in the net cleanly -- USA 1-0! Interestingly, she placed it in exactly the same spot she did against Colombia, but Angerer dove the wrong way.

Up 1-0, thus began the longest 22 minutes of a sportsfan's life. Kelly O'Hara came in for Tobin Heath around the 75th minute, and Abby Wambach replaced Megan Rapinoe in the 80th (moving Lloyd back to midfield). While several of our opportunities were lost because no one was crashing the far post, O'Hara fixed that. The first time, she didn't quite get there in time, but in the 84th minute, Carli Lloyd sent one zipping across the goal just out of Angerer's reach and O'Hara was there to drill it into the back of the net. USA 2-0!!! The fans went wild.

Germany didn't give up, but the US held fast. In extra time, Sydney Leroux replaced Alex Morgan and the crowd just cheered and cheered waiting for the final whistle.

Once again, our defense was purely spectacular. Germany barely got into the box -- our back line simply would not let them through. In the second half, they tried taking shots from outside the box, but the defenders were sufficiently well positioned that the shots rarely posed a challenge for Solo.

Tremendous effort by team USA! We're off to Edmonton tomorrow for Japan/England, and then off to Vancouver!

---

And for those of you who were perplexed by the idea of a zamboni-like device for watering the turf, here is our halftime friend!

Live from Ottawa -- It's the Quarter Finals

Posted from the train from Ottawa to Montreal!

Rounding out my World Cup Pentathelon, I hit the fifth of six cities hosting World Cup games late Friday morning, arriving in Ottawa. Becks arrived an hour later and we made it to our hotel, which boasted both a nice workout facility and a fantastic pool. I took to the pool for the exercises that I had not done in a very very long time.

France versus Germany

The USA game was at 7:30, but France was playing Germany at 4:00, so we wandered stadium-wards and found a restaurant/bar with decent food and a good TV and most importantly, a table right in front of the TV. My initial reaction to the game was, "I feel less bad about how the US is playing watching these two." I had been expecting excellence from both sides, but they both started out pretty weak. After the first ten minutes or so, France started putting together a nice controlled game, and, in my opinion, dominated the remaining 80 minutes. They controlled the pace of the game and had the better opportunities. And true to form, in minute 64, Necib found the back of the net -- France 1-0! For the next 20-ish minutes, I was convinced France had it, and then ... a French handball in the box, a penalty kick, and in minute 83 it was a tie game!

Sure enough, that tie persisted until the final whistle, leading to two 15 minute overtimes. The tides started turning a bit in overtime -- both teams were noticeably tired (who wouldn't be), and Germany started keeping better possession. One fifteen minute period... still 1-1. A second fifteen minute perios ... still 1-1. Oh no ... the worst way to end matches ever: a penalty kick shootout. What a terrible, terrible way to determine the outcome of a match.

Each team gets 5 kicks, alternating.
After first kicks, 1-1.
After second kicks, 2-2.
After third kick, 3-3.
(Are you seeing a pattern here?)
After the fourth kick, 4-4.
And after the fifth kick ... 5-4 ...
Germany!
I was sad; I thought Les Blues deserved to win.

USA v China

We hopped on a bus full of USA fans and headed to the stadium, where we had terrific seats about ten yards off of midfield. The crowd was largely American with several large Chinese contingents, including one behind us.

I don't think I've mentioned this before, but since the women are playing on turf (an entirely separate conversation; FIFA has been so sexist it's not even funny). Anyway, to cool the turf down, they have had these zamboni-like machines water the turf before the game and at half time. Well, it appears that Ottawa didn't warrant one of the zamboni-like machines, so before the game (and at half time), they had two lines of volunteers wielding enormous hoses with which they watered the field. It was adorable.

As you may recall, Lauren Holiday and Megan Rapinoe were out for the quarterfinal thanks to their second yellow cards against Colombia. So, the question on everyone's minds was, "Who plays where?" Coach Elis put Morgan Brian in at holding midfield (freeing Carli Lloyd to wander more), Kelly O'Hara at wing half (moving Tobin Heath to the left), and Amy Rodriguez up top, replacing Abby and giving us some real bursts of speed. From the opening whistle, it was a team quite different from the one we have seen so far in this tournament. The Chinese came out playing a controlled passing game; the USA came out running -- putting pressure on the ball, moving it up the field, connecting passes between the midfield and the forward line. O'Hara and Rodriguez seemed particularly in sync and Brian played significantly better than in her last game. It was exhilarating. Within the first couple of minutes, Rodriguez had a terrific opportunity that she took with the outside of her foot, sending it wide of the goal. After ten or fifteen minutes, the USA seemed to take the pressure off just a touch, but they continued to play well -- connecting all three lines of play and creating dangerous opportunities.

Although both teams were possessing well, the styles of the two teams couldn't be more different. The Chinese move the ball with passes -- usually short quick passes up the field. The USA moves the ball with individual dribbling effort. Both teams could improve by incorporating more of their opponent's tactics. The Chinese could use some dribblers and the Americans would do well to sometimes have their forwards play with their backs to the goal, passing back to the midfield who can then join in the attack. Our midfielders do this well with the back line, but the forwards do not seem to use the midfielders in the same way and I think they would be a bit more dangerous if they incorporated this into their play.

Although the USA seemed to have the game under their control, the scoreboard remained unpleasantly vacant -- 0-0 at halftime.

It seems that Abby Wambach gave the team strict instructions to score within the first ten minutes of the second half, and when Abby says, "Do," the team does. So two minutes into the second half, Julie Johnston set up a perfect play for Carli Lloyd who sent the ball into the back of the net with authority. The crowd went wild!

I was sure that there were more goals to follow, but there were not. Perhaps Abby should have been more clear, "Score a lot of goals; the first within the first ten minutes." There were subs -- Christen Press came in about 2/3 of the way through the match, replacing Kelly O'hara, in the 81st minute, Heather O'Reily came in (yeay! I'd been wearing her pink breaker's shirt to every game), pushing Press up top and replacing Alex Morgan, and in the 86th minute, Abby came in for Rodriguez, who I thought played a great game. It was a bit disheartening that all the cheers were for Abby coming in rather than the good game Rodriguez had.

And that was how we ended the game: 1-0 USA! Not a huge win in terms of number of goals, but a huge win, in terms of A) importance and B) quaity of play. Assuming our defense can continue to deliver, our midfielders remember how to play with the forwards, and our forwards place the ball in the net, I think we can beat Germany. They were not at their best against France, and they had a longer, tougher game. It should be a wonderful match in Montreal!

Japan versus Australia

Sunday, we headed out to a nearby sports bar to watch the next Quarterfinal match on a big screen. It took a solid five minutes for Japan to settle into its rhythm. But settle they did and while Japan played their hallmark short-passing controlled game, Australia did not seem to settle down into any sort of rhythm at all. While Japan created many opportunities, Australia had relatively few -- but those were more likely to be on frame. While Japan attacked with numbers, dribbling and passes, Australia attacked with long flanking runs. It was looking like another match was going to go into overtime until the 87th minute, a mad scramble in front of the goal, including a save that the goalie didn't hold onto, left Iwabuchi, the sub for Japan's striker Ohno, free to send a short ball into the net. It was Japan 1-0, with only a few minutes left. Australia wasn't any more successful in the final minutes than they'd been in the first 86, so the game concluded at 1-0 Japan. In my opinion, the right team won.

Canada versus England

This was England's first time in the Quarter finals and Canada's second, but first time since 2003. For the first ten minutes, I thought Canada had the upper hand -- they were moving the ball well, and Sinclair looked alive, creating opportunities. Tancredi had a beautiful opportunity in those opening minutes, but she sent it over the cross bar. This missed opportunity was going to come back and haunt them -- repeatedly! In the 11th minute, a defensive error by Sesselman, left Australia wide open in front of the goal, and McLeod didn't have a chance to stop the perfectly placed shot by Taylor.

This combination of a mistake and an opposing goal clearly flustered the Canadians. Only three minutes later, Bronze sent a parabolic ball into the net. McLeod immediately gathered her team together, and who knows what she said, but Canada settled down. Down two goals, they had a tough hill to climb.

Shortly after, Tancredi had another great opportunity off a Schmidt free kick, but once again, she put it over the cross bar. As the first half wound down, it looked like it was going to be a 2-0 halftime score, but a cross by Lawrence somehow escaped from the goalie's hands, and Sinclair pounced on the opportunity, sliding it past the keeper and into the net! Huge, huge, huge, huge goal to take the teams into halftime at 2-1 rather than 2-0.

Taylor continued to make McLeod earn her keep, and Tancredi continued to have reasonable opportunities in front of goal that she continued to shoot out of frame. It was frustrating. Canada could have tied it or even won the match, but it simply wasn't meant to be. While there were opportunities and several great opportunities, at the final whistle, it was still 2-1.

It is sad to see Canada leave the tournament -- this is, in many ways, their World Cup, and the crowds were looking forward to more games for them. I predict a pretty light and quiet crowd in Edmonton for the Japan/England semifinal. USA/Germany in Montreal will be quite different!

Live from Edmonton -- Round of 16 -- USA v Colombia

Repeat after me, "A win is a win, no matter how ugly."

While true, it does not bode well moving forward. I (as well as most of the soccer critics in the world) remain deeply concerned about the USA's chances moving forward if they continue to play the way they've been playing.

On the positive side: the US played more posession-oriented ball and looked comfortable knocking the ball around the backfield. And what a backfield: the combination of Krieger, Johnston, Sauerbrunn, Klingenberg, and Solo has been nothing short of spectacular. Just rock solid defense. And Sauerbrunn's ability to slide tackle the ball away from an attacking player without commiting a foul is exceptional -- every game she's had at least one of those, and each time it is executed flawlessly -- thank goodness!

Rapinoe continued to be the offensive spark of the US side. Morgan and Wambach continue to look like they actually know each other on the field.

Now the negatives for which the US is being criticized: the midfield is totally ineffective. Holiday seemed to be a bit more involved than I've seen in past games, but her involvement, while important, is often defensive -- switching the side of the attack, interacting with the defenders, etc. I don't see her setting up forwards and being a playmaker. And once again, Carli Lloyd is largely absent. Yes, she stepped up to take a PK and put us up 2-0, but other than one nice shot on goal in the second half, I could have missed her presence on the field.

Well, that's all likely to change on Friday, since among other "interesting" things that happened during this game, both Holiday and Rapinoe earned yellow cards -- their second of the tournament, which means both will sit out the next match (against China). If every cloud has a silver lining, the silver lining is that the USA might be forced into a more dynamic, attacking midfield, and that would be wonderful.

So, let's see -- what actually happened? Well, the game started out well - the USA looked alive, stripped the ball away almost immediately and even got an early goal, called offsides against Wambach (didn't look it to me, but I will admit that I did not have the right angle on the play). But as it was in the opening few minutes, one might have thought that the US was back in form. But alas, it was not meant to be.

As I said earlier, the USA did retain possession - in the back third. But once again, they could not consistently break through the Colombian midfield. And some of the ball skills and fast break quick passes up the field by Colombia were breathtaking. In terms of, "wow" factor, that is, "Wow those women look great!" the Colombians had it and the US did not. Yes, the US had a bit more possession and yes they looked more threatening, but in terms of putting together strings of passes and moving the ball up and down the field, the Colombians had it and the US did not.

Now before going on too long about how awesome the Colombians were, it seemed that the excelled in one other less praise-worthy area -- they seemed to be diving ... a lot. There was some funny play they tried on their corners where one of their players would just dive into the ground -- literally. It wasn't even subtle. I suppose one could imagine she was removing herself from the play, but it looked more like she was trying to get a foul called in the box. But from our vantage point (which was actually quite good), it appeared that any time a US player touched a Colombian player, she was inclined to hit the ground and the ref was inclined to buy it and award the foul. Many of those were right outside the box, which was some cause for concern, but the two yellow cards to Rapinoe and Holiday are clearly the bigger concern. At the same time, it seemed that Colombia got a lot of free reign to push the Americans around. It was disheartening to watch.

Anyway, the teams left for half time at 0-0 - which felt like a defeat for the US and a pretty decent outcome for the Colombians. The crowd was actually quite well-balanced in terms of fan support, which was a welcome change after the lopsidedness of the Nigeria game.

The second half got off to a rather exciting start. Rapinoe set Alex Morgan loose on the left side for a 1v1 with the goalie (that would be the second string goalie, since the first string goalie was sitting this game out having gotten in card trouble). Alex had beaten the goalie, but the goalie tried to stop her, committing a foul, which is an automatic red card. The stadium went wild -- there was no question of what the call on the goalie had to be -- the rules are 100% clear on this -- a foul committed to stop a goal is an automatic red card. So, Colombia was about to lose their 2nd string goalie and play down a player the rest of the game. The only question was whether the foul happened inside or outside of the box. The ref called it inside the box!

Colombia subbed a field player for their third-string goalie, and Wambach stepped up to take the PK -- an assured goal, except ... she missed! This was so not what the USA fans (nor team) had in mind.

OK, even with a Wambach miss, you would think that with 10 players and a 3rd string goalie, the US might have enjoyed a bit of a goalfest. Well, that wasn't meant to be. Fortunately, just a few minutes later, Morgan did succeed in releasing a nice shot on goal that the goalie managed to deflect, but not enough to keep it out of the goal -- she got a light touch on it and redirected it upwards, but it hit the cross bar and fell into the goal. USA 1-0!

OK, now with a lead, that's when you expect the US to relax a little and start putting together some of that talent we keep talking about. Nope -- instead Colombia went on the attack -- and they looked good. But alas, the US back line shut them down ... repeatedly. The fouls started coming faster and more furiously -- on both sides, but usually called against the USA (sorry, that's what it looked like from the stands). But then, Rapinoe broke free and got tripped right in the box. Again, it was a call that left the ref little choice -- this time, Lloyd stepped up to take the kick and placed it perfectly. USA 2-0.

Shortly thereafter, coach Ellis clearly decided to start getting some experience with the lineup that was going to meet China on Friday. First, she pulled Wambach, pushed Holiday up top and placed Morgan Brian in the midfield. Next, Rapinoe came out, replaced by Christen Press. While I had not been impressed with either Press or Brian in the game against Sweden, both seemed to make an immediate and positive impact on the game. Brian is a nice ball handler, albeit somewhat predictable -- she receives the ball and spins. The spin is beautiful, but she needs to mix it up more. Press had some threatening moves and some beautiful sneaky passes to the front line, that would have been spectacular had there been a front line who understood what she was doing.

So that's how we ended the game -- 2-0 and a lot of work between now and Friday when I will complete my pentathalon of Women's World Cup soccer by blogging from Ottawa.

Live from Vancouver, it's the USA versus Nigeria

The US had destiny in its own hands: a win against Nigeria would put the US at the top of Group D and an entry into the Round of 16 against some 3rd place finisher.

The Nigerians had no interest in letting this happen. So, here I am in beautiful downtown Vancouver, where the typical person on the street has no idea what's taking place practically in the middle of their city. Other than the fact that the busses are running REALLY slow, you wouldn't know there was anything exciting about to happen. That is, until you get near the stadium and see the overwhelmingly American crowd sporting face paint, american flags, team jerseys, stars and stripes, and every other piece of "We are USA" screaming clothing imaginable. American fans practically filled BC Place Stadium, leaving only a tiny section for the underrepresented Nigerian team.

The teams who showed up on the field bore little resemblance to the teams I've watched play twice already. The Nigerians were not pressuing the back line -- instead, they staged an enormous midfield defense. And the US, well, they started off looking a bit more like the US that I have been hoping to see -- they controlled the ball, they passed it around and retained possession, and they had forwards breaking through the Nigerian defense on a regular basis. It appears that the Wambach/Morgan combination up top was what we needed. Or perhaps, it was Tobin Heath on a wide wing? Whatever it was, it looked good.

The US almost got out to an early lead with a Julie Johnston shot that was ruled offsides, but not before the 52,000 fans in the stadium went wild. Oops. For the first 10-15 minutes, the US firmly controlled the game -- everything, where the ball was, how quickly it was moving, etc. But then, they seemed to take a nap for about 15 minutes and suddenly Nigeria was controlling the game, braeking through the midfield, and putting our stalwart back line to the test. There were a few too many exciting moments for my aging heart, but the US weathered the storm. Once again, the back line of Sauerbrun and Johnston in the middle with Klingenberg and Krieger on the wings was outstanding. And once again, I found myself asking, Where's Carli?" Holiday seemed to be playing more of a holding midfielder role and she was able to send the ball around quite a bit, but once again, Lloyd seemed absent.

By about minute 30 or 35, the US came out of its lull and started shutting Nigeria down and attacking a bit more. At moments, they were really a thing of beauty - we just needed more of said moments. Wambach and Morgan seemed to be more in sync than any of the other forward pairs we've tried (and by now we've tried many). And then, finally, in minute 45, just seconds before the half ended, it all came together in an all too familiar way -- there was Rapinoe taking the corner kick, connecting with Abby, who buried the ball in the goal. USA 1-0! It was just what we needed coming into half time.

The second half began with a break through run from Morgan, shut down only by a solid save from Nigeria's keeper, Dede. Nigeria became a bit more frantic. Some of the time this resulted in a threatening attack, calling our back line and Solo into action. But frequently, this resulted in some sloppy play, which ultimately led to three yellow cards, two of which went to Sarah Nnodim, which became a red card, leading to Nigeria playing one man down for the last twenty minutes.

And in that ironic twist of fate that always seems to happen in this situation, playing a man down, NIgeria attacked more effectively than ever. The US bolstered its defense with substitutions: Boxx came in for Heath and Rampone came in for Rapinoe. On one hand, they were both good strategic substitutions -- Rampone provided a break for Rapinoe and made us a bit more defensive minded. Boxx provided a better holding instinct in our midfield and freed Lloyd up on the wing. And yet, I had to worry about a US World Cup team trying to sit on a 1-0 lead to ride out the rest of the game. Nigeria wondered too -- they attacked and attacked and attacked, and we repelled and repelled and repelled.

Ultimately, the defense won the 1-0 game - validated by Julie Johnston being recognized as the player of the match. There was some beautiful play by the US; Wambach and Morgan looked good up top, but the next four games are going to tell the tale, and the US, particularly the central midfield, is going to have to step up.

Next up, Edmonton on the 22nd.