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.