Friday, July 20, 2012

Injuredville

If you read this blog regularly, you'll notice all my photos went away yesterday evening.  This is because I am NOT a technological genius and messed around with my Picasa albums.  Including the one labeled "Blogger."  And will have to replace my blog photos.  All of them.  One by one. 

I'll save that for the weekend, when I get a few free minutes.

Over the last six days I've enjoyed the return to life in the Land of the Two-Handed after ditching my sling for good last Friday.

This Wednesday I had a great day. I followed up with Dr. Getzin, who said my shoulder had improved much faster than he expected. After agreeing on our exceeded expections we discussed continued increased activity, how to know when I've done too much and what to do about it, and we agreed on physical therapy-which he said would certainly recommend. He brought it up as if he thought he'd have to talk me into it. Not me.  Ready, willing, able.  I'd have started immediately except I wanted to see the particular physical therapist LiLynn had recommended.  I have my first appointment on July 31st.
After such an upbeat and mostly pain-free Wednesday I left the doctor's office walking on clouds and enjoying the prospect of leaving Injuredville behind so soon. Except I haven't yet.

Thursday morning I woke up in the wee hours of the morning in pain.  This pain continued and  bounced back and forth all day between mild and moderate.  Tolerable, yet remarkably tiring.
The pain continued this morning and afternoon after causing uneasy dreams about doctors, hospitals and surgery last night.  My shoulder hurts more when it rains.  Seriously. 
These two days reminded me the recovery process isn't over.   A week ago I experienced such pain I emailed Dr. Getzin to ask about it. He "wasn't surprised to hear I had episodic pain" and said to expect the shoulder to hurt for a month but with gradually decreasing frequency and intensity.  So I'm just having an episode now. 

Of course I won't race at the NYS TT Championships this weekend.  So I won't resolve my unfinished business with that race after last year's mid-race flat.  I had ONE flat on the road last year, and that was IT.  Next year, I guess.
And I don't get to enjoy the women's team slumber party beforehand at a certain teammate's house either. 

I know, I know.  Buy some cheese to go with that WHINE instead of crying myself a river. 

After this temporary speed bump in the road I plan to go ride outside this weekend as much as I can.  That may not occupy much time, but it will keep life optimistic. 

With luck, I may get to race a mountain bike one more time this summer.  I'll be 100% before CROSS season, and 100% motivated too.
The best way to find yourself really wanting something?  Remove all possibility of having it, just for a little while.

There's no bike racing in Injuredville.

Thanks for reading.



Wednesday, July 18, 2012

Halfway Back. Maybe.

Saturday marked two weeks gone by since I flew over my mountain bike handlebars, shoulderplanted and temporarily redefined myself (injured).
Not having had an injury before, I expected a slow, drawn-out recovery.  Instead it's moved forward REALLY quickly.
In the first few days I unconsciously divided normal activities into categories:  Things I CAN'T Do and Things I CAN Do.  When there are a lot of Things You CAN'T do, you learn to really appreciate the Things You CAN Do.
For instance, you CAN take a hot shower and start off your day clean.  [Never underestimate the potential of showers for making you feel human again.]
 You CAN use your right hand to scrub your left armpit-so you CAN keep it clean (forget about shaving it for a little while).
You CAN put a short-sleeved stretchy top or tank top but you CAN'T put on a sports bra.
You CAN take off the sling to slice up ingredients for dinner but forget about picking up watermelons.
You get the idea.
So that's how the first week went by.  Do what you can, don't worry about what you can't.  Bob helped me get dressed for a couple of days.  The shoulder got painful here and there.  Between that and difficulty sleeping in the sling, I didn't go to work for a week.  Napping helped.  NBC Sports' live streaming coverage of the Tour de France also helped.  Phil and Paul would lull me into a snooze discussing local French history and architecture in their Brit accents, then start shouting when something happened, which woke me up handily so I didn't miss anything important.

The second week I tried harder to DO more with my left arm and found that all of a sudden, a whole lot of Things I CAN'T Do became Things I CAN Do.  I had a few outbreaks of serious pain here and there but the range of motion really started coming back.  The sling came off more and more.  I put my road bike back on the trainer and started pedaling.  I ordered a new brace to use for riding outside and began shopping for a new helmet.  I stopped using the sling completely as soon I could stand to.  Which forced improvement to come even faster.  Obviously, using the arm as soon as possible, as much as possible does more to help the shoulder improve strength and range of motion, then keeping it immobilized.

Friday the 13th my new shoulder brace arrived.  Saturday I borrowed Katie's 650B mountain bike (higher handlebars are easier to hold) and ventured outside with Bob.  We rode on the dirt roads in the Connecticut Hill area, and even toodled around on some fairly soft trails for about 15 minutes.  I could only manage an hour of riding total but felt pretty thrilled about that. 
My shoulder does not tolerate rocks or tree roots well. 
If I forget to ride with soft hands, relaxed wrists and bent elbows...it hurts. 
If I ride too slowly some bumps feel bigger.  That hurts. 
If I go too fast I can't avoid as many bumps.  Ow.
If I brake too hard or too suddenly and my body wants to go forward when the bike stops?  It compresses my shoulder.  That HURTS.

I think most most mountain bikers would agree that having soft hands, relaxed wrists and bent elbows, keeping continuous speed and momentum, staying off the brakes, standing whenever possible (more bumps when sitting) and being smooth as possible on the bike are all good things to practice.  And receiving immediate feedback via pain is one way to learn.  Although I don't plan on undertaking more prolonged "learning" until the shoulder in question gets a little stronger.  At present the lessons hurt a bit too much.

For now I'm happy to ride the road bike on trainer indoors, and the mountain bike outdoors.  Hopefully next weekend I may try to ride the road or cross bike outside, depending on how my ability to hold drop bars improves on the trainer.
Sunday I took out the 650B bike for an hour and 45 minutes.  My legs started waking up and my shoulder felt initially stiff, sore and "rusty" but once I warmed up it felt better than the day before.   I joined up temporarily with LiLynn and a group ride containing several of the usual suspects (Jack, Ernie, Sara, Bill, Bob!) who were engaged in an 80-mile dirt/road ride on cross bikes led by Andy Goodell and Matt DeLisa.   I rode along with them for a half hour then turned for home once the shoulder started saying it'd had enough.

Ernie accused me of "bringing a bazooka to a gun fight" by showing up on a mountain bike.  I also sported my new armored gladiator shoulder brace.  Which must have really looked like overkill.




Wearing this thing, I feel prepared for just about anything.






Including another two to four weeks of working on my shoulder.  My goal is to build up flexibility and strength back to normal levels.  Or at least as close to normal as humanly possible.
And I really need to decide on which new helmet to buy.  Today.

Thanks for reading.

Wednesday, July 11, 2012

Wiggo the Rubber Chicken



Right now I can't do much bicycle riding.  So I've spent significantly more time watching and following the Tour de France than I normally would.
I am sort of pulling for Wiggo to win.  I liked the way he conducted himself on camera the day he ended up in yellow.  And yes I felt sort of horrified to find out how foul-mouthed he was (although maybe that's somewhat endearing-I haven't decided yet).
But the impression that Wiggo gave me two days ago during his time trial..well, I can't shake it off.  I won't say anything more because a picture is worth a thousand words.  So I'm going to share with you a piece of original artwork.
Here you go.











Sunday, July 8, 2012

Separated

"Are you OK?" asked somebody.  I think it was Georgia Gould.
I grunted, then mumbled "Ah...I think so."  It was surprisingly difficult to form words.   I lay face-down and helmet embedded in dirt, partly on and partly off the trail at the bottom of "Miniwall" on the World Cup cross-country MTB course at Windham.  I heard tires skidding, male voice yelling, gravel flying, and bike chain bouncing against a frame.  Another yell came, and the sound of what might have been another crash.
Overheard:  "We need to move off the trail.  Can you get up?"
I could.  I rolled over and sat up, wiping more dirt into my mouth with my glove instead of wiping it off.  Gritty.  Grit in my teeth too.   Actually I was red-brown all over.  Catskills dirt here is red.  I got up but in the process found something very wrong with my left shoulder when I tried to use my left arm.  Pain.  Big time.  I got my dirt-covered carcass off the trail and the Luna riders with me got organized finding help.  One person left to find the medical staff.  I gave them Bob's number as my emergency contact and knew he wasn't far away since he had planned to ride some of the course with Garrett.

Georgia, Katerina Nash and the local Luna Chix riders had been leading a course pre-ride for the female beginner, sport and expert riders racing next morning.  I'd spent the two days taking in great scenery at a World Cup cross-country and downhill race.  I'd helped work the feed zone for the men's race after hanging out at Kabush Falls watching the women's race.  Saturday night was the last chance to pre-ride the course before my race Sunday morning.

I'd decided to take the faster, straighter and steeper A line down MiniWall this time, since I'd taken the B line three times last year and twice so far this year.  All went smoothly til I hit the very bottom.  The course seemed twice as dry and dusty as it had been Friday night.   The loose dirt had become looser and deeper, the ruts more dug in from a few hundred World Cup racers ripping through.  I had dropped my eyes and lost my upper-body balance just enough when my front tire suddenly took a big drop and the hard track at the bottom came flying up at me way too fast.  I had no time to roll and my left shoulder took all the impact.

Joe Bender crash reenactment.


After 5 years (??) of racing bikes (and crashing a few times) without real injury, my number had finally come up.
'There are only two types of bike racers, those who have gotten hurt and those who are going to."  Everybody's heard THAT one before.
Yup.
Bob and Garrett arrived on scene just before the medical staff did in their ATVs.
I wasn't that upset.  Mostly I just felt resigned knowing I'd done real damage this time and had no delusions about continuing to ride.
Racing the next morning?  Out of the question.  No point getting too upset over that either.  The pain I felt really made everything else pretty insignificant by comparison.
The next logical steps:  go back down the hill, find an ER, start damage assessment.  Frankly it sucked.  Instead of having dinner and hanging out with the NoTubes crew plus a group of interesting bike people then racing the next day, I faced a long night of pain, sitting in an ER waiting to find out what I did and what I would need to eventually repair it.
Which is not to say I didn't get lucky.  I am DAMN lucky.  I destroyed my helmet but walked away.  No concussion.  No cracked vertebrae, broken neck, anything broken as far as I knew. My collarbone felt whole.  I had my head together.  Nothing else hurt except my shoulder-which began to demand attention very quickly.
Trust me, I know how trite it sounds to say "it could have been worse" but truth is truth.
The medical staff at Windham impressed both myself and Bob (a former EMT/ski patroller).  They quickly checked for concussion and then immobilized my shoulder with a field dressing and brace, tucked me snugly into a small off-road truck between the driver and EMT, and drove down the hill with painstaking care trying to minimize the bumps.
After some additional assessment, the head paramedic at Windham Mountain advised us about our ER choices. We had two options-Albany Medical Center or Catskill Regional.   "If it were me, I'd go to Albany Medical."
Bob and I dropped Garrett off at the condo-and then Bob and I took the hour trip to Albany Medical.  Once there, he hung out with me for the next four hours, with the patience of a saint-this after he had been on his feet all day working his butt off at the Stan's tent.  He also had to put up with my yelping every time we hit a bump in the road.  Poor Bob.  He's retrieved me from the hospital two times in the last couple of years after I've been put there by bee or wasp stings.  This third ER visit ended up more cut-and-dried than the usual.
But four hours is a pretty short amount of time to spend in a major trauma center ER on a Saturday night.
The ER seemed eerily quiet on arrival-the front desk staff booked me quickly and a male nurse named Anil took over.  He wore dark eyeliner, spoke affectionately, and moved faster than anyone else in the entire department.  In maybe a half hour I had an IV, a first round of drugs, and headed off to X-Ray.  Anil had to wash the dirt off half my arm before it was clean enough for an alcohol pad.  Bob also spent some time patiently cleaning the dirt off my face.



Waiting for my first round of x-rays.  It's easy to smile when they put
fentanyl into your IV.  You'll be pain-free and giddy.
For about 15 minutes.


Some time later a young resident showed up-she bossily told me to do excruciatingly painful things and disapproved of my failure to completely obey, then poked very hard right where it hurt the most.  After forcibly prodding a discolored swelling on my ribcage she decided I needed another round of x-rays to make sure I hadn't broken any ribs.  "But we'll get you some more painkillers first."
Unfortunately my nurse wasn't in charge of administering painkillers-and the person who had the keys to the IV narcotics wasn't as efficient as my nurse.  I took that second trip to X-Ray without painkillers. But the technician didn't want to torture me and skipped taking the one picture that required extremely painful movement.
Shortly after I got back the narc nurse returned with some morphine.  Which DID NOT work.  It left me feeling flat as roadkill, but the pain remained.  The nurse also left a barf bag in case of stomach side effects.  No problem there.  I hadn't eaten in nine hours.
The ER transformed in an hour or two to "Saturday night" busy.  Since Albany is a major trauma center, two or three LifeFlights and at least as many ambulances had come in since we'd arrived.
After a long long wait, one of the attendings showed up.  She said no broken bones but I'd likely separated my shoulder and that I needed to follow up with an orthopedist or sports medicine doc in the next couple of days.  Some other nurse came to give me a sling but couldn't figure out how to put it together.  Once he left, I took it off, put it together properly and put it back on.

Finally they discharged me.  Anil came flying in, whipped out the IV, gave me some discharge papers and a little box of Lortab and off we went, sometime after 1 am.  We found an open McDonald's, grabbed a snack and drove the hour back to the condo.  I still had my dirt-covered kit on and Bob had to help me pry everything off.  While he went to bed, I took a bath of sorts, hoping I wouldn't wake up the racers sleeping in the next room over.  Around 3 am I finally got to sleep-on a couch with just the right type of cushions to keep me wedged firmly on my right side.

Everyone staying at the condo was very kind the next morning. Mary McConneloug told me of similarly injuring her right shoulder-she has the same funny bump at the end of the collarbone as I do now.  She hasn't lost any functionality.  Kaila Hart and Cindy Koziatek made me breakfast.  Nina Baum told me that I should consider this injury an achievement.  "Why do you say that?"  I asked.
"Because it means you're pushing to that next level.  You don't get an injury like that unless you're really going for it."  I have to hand it to Nina. She actually managed to make me see this as accomplishment of sorts.  And she's right.  I was going for it.  Everybody knows that in bike racing that can have consequences.  I don't think I will "go for it" any less now that I've had an injury.  If anything I can't wait to ride and race again.

I followed up after a few days with Dr. Andy Getzin at Cayuga Sports Medicine.  He said it's a Grade 2 shoulder separation.  Which means I completely tore the top ligament attaching the end of my collarbone to another bone in the shoulder, and partially tore two of the bottom ligaments that run underneath the collarbone.   These will not repair themselves.  Total recovery will take 4-6 weeks.  I've been icing the shoulder and using ibuprofen.  But a week now post-injury I have some limited mobility coming back and can take the sling off for 10-15 minutes at a time.  The pain comes and goes.  Sometimes it gets a little out of control but I have drugs for that.  I've been tired and even napping in the daytime but expect to climb back on the trainer pretty soon.  After reading Krista Park's blog (she suffered a Grade 3 separation while pre-riding the World Cup course at Pietermaritzburg, South Africa) I plan to order the same brace she used to support her shoulder.  I'll use this to get back to riding outside.  Eventually.  Thanks for the input, Krista!  I'll pick your brain more about this soon.

I won't ride any more time trials this summer but I WILL be ready for CROSS season and will hop on my MTB too, as soon as I'm able.  I miss riding with everyone right now but as Margaret Thompson pointed out, one week of my 4-6 weeks has already gone by.  Now I'm down to 3-5 weeks.

See you all soon.  Thanks for reading.