Wednesday, January 16, 2013

Bicycle vs Car (Final Thoughts)

There are times in your life when you have an opportunity to stop and think about where you are and how you got there.  

This is one of those times.  I've taken up competitive recumbent spin-biking.  I'm sitting on the trusty steed, far to the right, against the wall.  I've decided to put the machine through its paces today.  No sling to notify my competitors of my injury.  I look like I really want to be there.  My training partner is a middle-aged obese woman who's cranking out the watts on level 1, at what looks like 50 rpm.

You have to be sneaky to get more than a 30 minute workout.  If other competitors are waiting, its almost impossible.  On this day, though, with two sweat puddles already on each side of me, I dial up another 30 minute block to do some additional cadence work.  
I start my spin-ups at 95 rpm and go to 120, each one lasting 30 seconds.  Landing back at 95, I wait for my heart-rate to stabilize for 30 seconds before hitting it again.  
This is what my workouts have become.  No barking dogs.  No potholes.... and definitely no cars!

I'm happy to be home.  It's around 4:30 in the afternoon.
My wife has to run out to fill my narcotic prescriptions and pick up some additional supplies for the next phase of my convalescence.  I don't think I'll need the strong pain medication but she heads out just in case.  My arm is strapped to my body with a sling but when I move, it flops around like a broken wing on a bird because the nerve block has silenced my brain-to-arm control signals.
To keep things simple, I find my resting place in a sturdy, upright leather chair in the living room.  I'm able to position myself so there's no pressure on my arm or shoulder.  As the evening wears on, I start to feel a little tingling in my fingers.  It's around midnight.   As instructed, I take 1 pain pill.

2:00 AM: My world has been reduced to feeling like I'm at the edge of a cliff, looking over with the expectation that I'm going to jump, while hopping up and down on a bed of loose broken glass.

The block has completely worn off.  I'm sweating, nauseous and don't know if I should scream, cry or throw up!  Looking at the pain bottle, it says "1 pill every 6 hours".  I'm already nervous about taking these stupid things because of the addictive qualities but I consider taking more.  It doesn't take long before I relent and take another.

8:00 AM: By now, my pain is relatively managed.  With a call in to the doctor to confirm the adjustment of the dosage, I drift off to sleep a while.

Two magic pills are required to take the sharpest edge off of the pain.  They don't work immediately so I have to make sure that I take them before the effect of the previous dose wanes.  They call this, "getting ahead of the pain".  While at the height of its assistance, the pain drug turns me into a babbling, drooling half-wit.  On the back-slope, I'm slightly more lucid, but I become impatient and restless, pacing back and forth from room to room.  My wife-turned-nurse notices my behavioral changes and prompts me to get ahead of the pain.

Aside from pain management, I can do less with my arm than before the surgery.  I can't even pull my socks up over my feet.  I guess I'm a typical guy and don't like asking for help.  Especially in this case, where I can't really dress myself, I resist asking, for fear that I may seem even more helpless than I feel.

My wife offers her assistance.  Occasionally, she demands it.  I'm grateful that she doesn't stand down when I fire off one of my many declarations of independence...

"I can do it myself!"

Sitting on the bed, struggling to get the first sock on my foot with one arm, she walks around the bed and pushes my hand away to relieve me of the task.  Bowing my head in defeat, I have no choice but to allow it.

The following few days feel like weeks.  Each day, we reduce the amount of pain drug by a fraction, until it's the lowest possible, a half of one pill, right before I want to try and sleep.  Sleeping isn't really possible without timing it exactly right with the apex of the opiate's tentacle.... that and my nurse's discovery that there's a relaxation trigger by rubbing the bottom of my feet.  Once again, she proves indispensable.  I've moved from sleeping in the chair to sleeping on the couch, pillows stacked behind me to keep me mostly upright.

With the weekly follow-up with Dr. Falcons out of the way, I'm back to work and even sleeping in my own bed, next to my now-part time nurse wife, surviving on over the counter pain meds and that one glorious half that I can relish right before I drift off to a place where its the reality and this is just the bad dream.

Monday, January 14, 2013

Bicycle vs. Car (Part 4)

I am writing these blog entries, as recommended by family and friends, to help me articulate my experiences that lead me to the present.  These accounts are true to my own memory and I've left out names, for obvious reasons.

I have learned to do many of life's tasks with one arm.  Some things are easier than others.  Pulling up pants?  Manageable after some practice.  Shaving?  Too dangerous to do with the opposite hand.  Washing hair?  With some contortion, doable.  Tying shoes?  Totally impossible.

My PT asks me what my immediate goals are.  I tell him that I would like to sleep better, wash my hair with two hands and get on my bike as soon as possible.  Our sessions start out slowly.  Heat first.  PT-assisted stretching next (this is the really painful part).  Then, self-directed stretches exercises.  Finally, the glorious ice packs.

Today's stretches were painful.  Topical conversation is not distracting me from the discomfort.  My pain equals sweat connection is in full force but I've finally stopped apologizing for it.  This is what progress feels like and I'm eager to do more.  All the enthusiasm is reduced to a grumble when the 1 lb dumbbell is almost too much weight for me to accomplish the current instruction.

After going through an accident, an ambulance ride and hours in a Level 1 trauma center, it seems weird that I'm just sitting in the passenger seat of my wife's car, 11:30 at night, driving home.  I'm still wearing what's left of my cycling team uniform.  I can almost relate it to the times where she's had to rescue me from breakdowns or that one torrential rain and sleet storm south of town.  It feels too normal.

My wife is the queen of research.  She can nearly accomplish any amount of information gathering with the use of her phone, an iPad or her laptop.  We dispatch post-haste to find the preeminent shoulder expert within driving distance of our home.  It doesn't take us long to narrow the possibilities.  Reaching out to friends, we then look for personal recommendations.

The following day, a Friday, I had to come to work to gather some things so I can work from home.  I have a swollen left eye-socket, a cut under my eye and an arm in a sling.  Everyone thought I had been in a fight.

After discussing my current condition with some friends in the medical field, we decide to put my care in the hands of Emory Sports Medicine.  I had experience with them in the past.  They treated my ankle injury.  They don't just let you see THE guy.  You have to get through a first evaluation with the non-surgical guy.

There are some things you're cool with when going to teaching hospitals and clinics.    You know there will be less experienced staff doing things or observing while you're there.  When I took my shirt off to show the non-surgical guy what we were dealing with, he quickly summoned a larger group of people to take a look.  We quickly realized that whatever my current condition was, it wasn't something they see very often in their practice.  After a quick flick of the ultrasound wand, THE guy was summoned.

Meet Dr. Falcons.  Dr. Falcons gave us the final diagnosis - 5th degree AC Separation.  Being quite the confident advocate for one particular type of repair, he went through some options and let us know about some studies he had published or was about to publish on the procedure he recommended for me.  Not having been too familiar with it, we opt to leave without making a decision to give us time to do our own research.

It didn't take long to make the decision.  The following day, I called back and scheduled my surgery for the next available opportunity.  I was told that Dr. Falcons normally doesn't do surgery on Mondays but, in my case, time was of the essence so they set me up for the next Monday afternoon.  I was scheduled to get a clavicular hook plate to repair my busted-up AC joint.

I'm told not to eat or drink anything after midnight.  My surgery scheduled for early afternoon, I'm not very pleased by this advice.  Other than that, I was very eager to get things going.

We arrive at the surgery center by 11am as instructed.  Everything rolls smoothly and I'm escorted through two solid doors to the pre-surgery area.  I have to get the nurse to help me remove my shirt.  I've let go a little of the embarrassment from having to ask for help to do some of these small everyday things.

Once in the gown, little booties and hair net, I'm relaxing on the bed while being visited by several different residents.  First is the RN who does my IV.  Her skill and experience is evident.  Since I haven't had any fluids in over 12 hours, the veins in my hand aren't exactly standing proud.  She easily inserts the IV needle without any fuss.

Next I'm seen by the anesthesia resident and his boss.  We discuss the virtues and practical risks of not only the general anesthesia but also the nerve block I'm about to receive.  I'm on track to get two nerve blocks, each contributing to my entire arm and shoulder area being numb for 12 hours or longer.

Without much pause, these guys leave and then return with an ultrasound cart and a HANDFUL of needles!  Not that I'm nervous about needles but these are going to be inserted into my neck.  Shaky a little, the resident is instructed to source the nerve with the ultrasound wand.  We're all watching the monitor while he moves the wand left to right, a little up and then down.  The DR tells him then to INJECT!  I feel just a little pressure but nothing near what I was afraid of.  Next, the trainee hits a button on the display and then moves the want to seek out his next target.  With a little more direction from the DR, he spots the location and then, without much pause, inserts the larger needle into my neck.  This one feels a bit more uncomfortable due to the volume injected, but, it also wasn't something I'd call painful.  When a doctor tells you that you're about to get two injections into the nerves in your neck, naturally, you'd be a little worried.  Not a piece of cake... but nothing to be afraid of in the future.

My wife's escorted in and we have a little laugh about the booties and the hair net.  I can already feel my shoulder going numb as well as some tingling in my fingers.

Our next visitor was one of Dr Falcons' fellows.  He's a relatively familiar face and puts a mark on my left shoulder.  It doesn't take long for Dr Falcons himself to pop in.  He gives us the same spiel he recited in his office.  We nod in agreement and we're all set to get this thing going!

A kiss to my wife and off I go through another set of doors and into the operating room.  Once again, I have to transfer myself onto another table.  This time, I'm wearing a gown with an open back.  It's all a challenge.

Peeking over my head is a new white coat who says she's about to give me a little sedative.  Then she says she's going for the same propofol from Michael Jackson fame.  I think the reference is a bit weird considering the setting.  My hand stings a bit from the drug.  Another white coat from my other side lays a mask over my face and says to breathe deeply.  Several deep breaths later, someone asks if I'm getting drowsy, I give a bit of a shrug and then another hit is administered into my hand.  This one stings less but is obviously more effective.  It's the last thing I remember before waking up in the recovery room.

This is what the fluoroscopy shot looks like immediately after the install.

Waking up, I see my wife on one side and the recovery nurse on the other.  They're asking me questions about feeling nauseous.  I'm alert enough to give them a nod and motion for a sip of water.  I really don't feel anything other than really having to pee.  My arm "feels" heavy.  I say that in quotes because I couldn't feel a thing.  I could feel the weight of my arm but that is about it.  I get permission to head over to the restroom but they won't just let me walk over there without pants.  So, between my wife, the nurse and the one-armed bandit, we wrestle my pants on and head over for some relief.

Back to the bed for some last bit of instructions and we're ready to leave for the next chapter of my recovery.

The wheelchair ride to the car is uneventful along with the ride home.  I'm glad we opt not to stop along the way. There's no pain but having my completely numb arm strapped into my body, slightly swinging about because I can't control any movement is an odd sensation, to say the least.

In the last entry, I will finally describe what it means to get ahead of the pain, the sweats and how to say thank you when your wife has to put your socks on for you.

Friday, January 11, 2013

Bicycle vs. Car (Part 3)

I am writing these blog entries, as recommended by family and friends, to help me articulate my experiences that lead me to the present.  These accounts are true to my own memory and I've left out names, for obvious reasons.

Laying on the training table waiting for PT to move my arm and shoulder into positions neither has seen in 3 months, I allow myself to wonder what might have been.  Would I have returned to fitness as I was attempting to do?  Cyclocross season was upon us and I was targeting my return to cyclocross at the closer races in Conyers and N. Atlanta.  Could I have made the upgrade to the next category?  I should feel fortunate I wasn't hurt more severely.  Don't feel sorry for your soft, sorry self.

At that moment, I'm snapped back to the present where I'm dripping sweat down the sides of my face while PT has my arm above my head, pushing it cautiously to it's new-found limit.  

Pain makes me sweat.  I don't know what it does to other people but, for me, it makes me schvitz, as my Jewish grandmother used to say.

There are a lot of things that happen to you while you're suspended in an immobile position.  You try to focus your spidey senses to make up for the things you can't see.  You try to listen more closely to the footsteps.  Are they coming toward you?  Are the voices getting louder?  Will someone soon cover my half-naked body with a blanket?

I don't have to wait terribly long before a nurse stops and asks me if the doctors have cleared my spine and neck.  I, of course, say no since I'm still in a cervical collar, head taped to a board, body strapped down like a patient who's gone 5150.  She summons some white coats and they roll me to the right while pressing on my spine, asking me each step of the way if I feel any pain or numbness.  (Ed note - how do you feel numbness?) I promise myself now is not the time to be a smart-ass so I go along with these tests.  They roll me off the board and remove the c-collar.

Now there I lay in the hallway -- no shirt, my bib shorts cut and somewhat lowered to a semi-revealing level... still wearing my cycling shoes and gloves.  I still can't move my left arm.  They have my elbow resting on the cushion with my hand on my stomach.  I reach down and remove the glove off my left hand.  Just the smallest amount of tugging pressure sends lightning bolts through my body.  Is my shoulder dislocated or do I have some other injury? ..and why can't someone cover me with a damn sheet or something?

Dr. ER swoops in and asks me a few questions about allergies and within 10 minutes, I'm greeted by Mr. ER nurse who injects something into my hand that stings more than a hornet's fury.  Thankfully, it's short lived and a warming rush of pleasant relief comes over me.  The edge of the pain has been smoothed.  I can still feel the pressure on my left side.  I can still feel the grumpiness of my obvious shoulder deformity.  I am able to take deeper breathes though.  I start to calm down.

My next thought is that I need to call my wife because I'm sure she's freaking out.  I need to tell her that I'm ok.  I am OK.  I know she's going to immediately reflect back on the terror we all felt during the few hours after the car vs. bike accident of a good friend of mine.  The next time the white coat walks by, I ask if I can borrow a phone to call my wife.  He hands me a cordless phone and I get in touch with her.  The tenor of her voice lets me know she's scared and worried.  I let her know I'm ok and that I'm in the hallway in the Trauma unit at Grady.... she's already enroute.

It's easily 45 minutes since anyone has come by to check on me.  I've become the patient everyone looks at with curiosity as they walk by.  I have become a spectacle.

Then I hear a voice.  She sounds like she's around the corner, her heels clicking on a hospital floor getting louder.... She found me.  My wife's first look at me, important to both of us, had two different reactions.  First, she is upset because I must look hurt... then relief, partly because she's found me and I must not look that hurt.  She gingerly leans over to kiss me.  It's nice to see her.  Now I know everyone's in for it as well... the next most impatient, tenacious person I know besides myself is my wife.  Look out!  Here we come!  ... I finally get a blanket.

Soon after her arrival, we're off to get some x-rays.  Dr. ER and another white coat discuss the pictures he wants to see and, after looking at my swollen left eye socket, mumbles something about a head CT.

The x-ray attendant wheels me into a much darker, older part of the hospital.  The tile walls look like they've seen many years of service.  This is in stark contrast to the area they wheeled me from, which was bright and modern-looking.  Once in the x-ray room, I am challenged with having to transfer myself from the mobile bed I had been on to a cold, stainless slab of metal.  First, I'm STILL half naked and it's remarkably colder in this room.  Second, I can't move my left arm.  "Scoot this way.  Move that way."  All of these commands are difficult to comply with when you only have one arm to assist.

I'm now shaking uncontrollably and sweating from the pain.  The attendant says, "Take a deep breath and don't move!"  Yeah - right!  He moves the contraption and swings over a bar that looks like a pull-up bar that's slightly higher than my head.  "Stand up and grab the bar with both hands."  I just laugh.  I'm still wearing my cycling shoes.  I haven't held up my own body weight since before leaving the scene of the accident.  I've been given some joy juice to take the edge off my troubles.  ...and my left arm moves like linguini.  I have to use my right hand to raise my left hand to grab the bar.  I do it slowly because I have no idea what's going on with my shoulder and every inch of movement makes the pain and pressure increase exponentially.  "Take a deep breath and don't move!"  Dude, I'm shaking uncontrollably and my obviously deformed shoulder does not like this position.

Half way back to the modern part of the facility, my wife mentions that the doctor asked for a head CT.  Back to the dungeness, dank, old x-ray wing for another picture we go.  Same drill.  A different attendant, without some much as eye-contact, motions for me to move myself from the rolling bed to the much narrower CT scanner bed.  After some wranging, I'm in position and she says, "Breathe normally but don't move!"

We come back to the modern wing and are dumped in a room with glass walls.

X-rays - check.  Diagnosis - missing.

As we wait for Dr. ER to return, Mr. Jovial ER nurse comes in to tell us we can leave soon.  As the patience wears thin, Dr. ER finally rolls by to say that my face is not broken, my nose is fine and shoulder is not dislocated at all.  All I have is a separated shoulder.  He hands me a few prescriptions and a referral to the Grady Orthopedist office.  He takes a final look at the cut on my face, grabs a gauze pad and gives it a tug and a wipe.  He recommends not stitching it up since it's relatively superficial.  He leaves so quickly we don't have any chance of asking him questions.

My face is wet.  Why is my face wet?  My wife grabs a paper towel and gives it to me.  My facial cut is open enough to be bleeding again.  No bandage?  No bandaid?

Mr. Jovial ER Nurse returns and I ask about getting a gown or some clothes to wear so we can leave.  He says he can track down a social worker to find me some clothes.  Social worker?  I don't want be a charity case!  I just want something to cover up my naked skin while I do the barefoot walk of shame out to the circle drive patient pick-up area.  No dice.

He and the wife discuss directions to the rendezvous location and she's off to get the car.  I'm escorted out of the glass room and through the doors to the public waiting area for the ER.  I have no shirt.  I'm wearing nothing more than my cycling socks and my bib shorts, one strap cut and dangling around my waist and a new white mesh sling, where my useless left arm is finally resting.

The discharge staff does it's business and I sign, what I'm sure is the first of many billing papers in my new reality, and head out beyond the metal detector, through the sliding door and onto the sidewalk to wait for my ride.

"What the heck happened to you, buddy?"

"Bike vs. Car"

"You look like crap!"


"Want to sell your prescription?"

In Part 4 - the final frontier... Meeting Dr Falcons and what it means to get ahead of the pain.

Thursday, January 10, 2013

Bicycle vs. Car (Part 2)

At this point, the paramedics have taken over my care completely.  I can hear the EKG monitor in the background.  Beep Beep.... Beep Beep.  The pressure in my shoulder has increased to an almost intolerable point.  My general pain level is quite high.

Before the door swings closed for the final time at the scene, there's a quick discussion about which hospital to take me to.  I'm given the choice between Atlanta Medical and Grady.  I ask about Emory or Dekalb but those are quickly ruled out because I'm considered a "trauma patient" and need to go to a Trauma Center.  When it comes to trauma, I figure there's no better place to be than Grady.

So we're off.  I wait for the driver to hit the sirens... no siren.  I ask the paramedic in the back of the ambulance whether the driver's going to light it up.  So far, no lights.

As we're moving along, I can't see out the window.  It's an odd and uncomfortable feeling not being able to look side to side to orient yourself, but also to simply see what's going on around you.   I'm trying to figure out which route the driver chose to get us to the hospital.

The pressure in my shoulder is serious business.  The paramedic and I go through a series of questions and answers.  He seems to be writing stuff down.  We get through all the typical questions about health history, finally landing on my current condition.

"You have a broken nose and an obvious deformity of your left shoulder.  There's some blood on your face and you have a two and a half centimeter lac on the left cheek."

OK - obvious deformity?  He goes on to say that the good doctors at Grady will just reduce my dislocation and give me something for the pain.

Beep Beep... Beep Beep Beep... something behind me is going a little crazy with the beeping.  The paramedic gives the little blood oxygen meter that's clamped onto my right index finger a little attention.  He then asks me if I feel OK.  I get a little concerned but let him know that I feel the same.  The beeping hasn't stopped.  He finally lets me know that my blood ox has moved down to 96% and puts an oxygen mask over my face.  Urgh... Do I have broken ribs and a punctured lung after all?

I'm still amazed that we don't have sirens and a renewed interest in getting to our destination with any additional haste.   Bringing the subject back up to the paramedic, I grab the oxygen mask with my right hand, pull it down from my mouth and just simply say, "sirens?"

"Jeff - if your oxygen level gets under 95, we'll light it up and 'expedite'."

The roads of intown Atlanta are bumpy.  We're sitting in lines of traffic at every intersection.  Stop and Go... Stop and Go.  The jostling and moving around is made more uncomfortable by the fact that I can't brace myself while going over some of these big bumps.  My body presses against the straps as the ambulance shifts left to right and right to left.  Although secured to the backboard which is secured to the gurney, I can't escape the feeling that I'm going to get dumped off of this thing and onto the floor.

The paramedic calls up to the driver and says, "Let's pick it up!"  Awwwwl Raaaaght.

As we back into a spot in the Ambulance bay, my brain does a little trick on me.  I quickly see myself in a scene like in ER, where the doctors, along with their trusty residents come rushing to my side, do a quick triage and then wheel me into a room and do a lot of poking and prodding.  The thing I fear the most is a chest tube.  If I really have a collapsed/collapsing/punctured lung, I have to assume that's where things are headed.  I start shaking a little....

Doors swing open and I'm on the move.  We're greeted at the entrance by a police officer.  He looks over me, into my window of visibility and says, "Welcome to Grady!" while slapping some tracking sticker onto my side.  All I can think of to respond with is "Thank you!".

Once inside the sliding doors, my familiar ER scene comes to life.  Several white coats have surrounded me.  I am bombarded with questions about who I am, how I feel, where I think I am, what I think I'm doing there... all the stuff.... then a woman who's not wearing scrubs or a white coat hovers over me.  She's holding a clipboard.  She tries to hand me a pen and indicates I need to sign this paper before going further into the unit.  She puts a pen in my right hand.  Everyone assumes you're right handed.  I tell her I'm left handed and she then picks up my left arm to put the pen in my left hand and I yelp.... or bark... She drops my arm and says, "Oh, you're messed up? OK.   Put him over there against the wall.  Everyone's in 2 working that non-responsive battery patient."

Gotta love metro Atlanta.

In part 3... stolen phones, uncontrollable shaking and the final diagnosis.

Wednesday, January 9, 2013

Bicycle vs Car (Part 1)

It's been 2 years since my last physical therapy session.  I'm not really worried too much about the pain or discomfort from whatever the PT puts me through.  Whatever it is, it won't be like when the nerve block wore off after my recent shoulder surgery.  Plus, any increase in my range of motion will be welcomed.  I still can't touch my right shoulder.  Raising my hand behind my back only reaches the top of my left glute.  I'm told the PT at this Emory office is great with sports patients.   Let the rehab begin....

Sept 27, 2012... This is the last day I was on my bike outside.

While lying on the ground in the middle of the intersection, I couldn't believe what was happening.  Movie makers do this thing where they fade the background noise of a battle scene to a muffled level while zooming or focusing on the primary actor in the scene.  You think this must be what "shell shocked" feels like...  This is exactly how I felt.  This is exactly what I heard.  All the traffic noise, car engines and exhausts faded to the background.  I heard my own heartbeat.  I was laying on my right side, somewhat curled up into a ball.  My face was flat on the asphalt.  I was bleeding from somewhere.  My left shoulder really hurt.  The left side of my face was throbbing.  I was lying in the middle of the intersection.  There were cars all around.  No one was moving.

By the time I reoriented myself, 3 bystanders were by my side.  I think there were two women on my left and a guy on my right.  I looked to my right and kept repeating "Get the license number!  Get the license number!"  He reassured me that the driver had stopped and to not worry.  I think I tried getting to my feet.  I thought if I could stand up, I would be able to yell at the driver.  I don't know for sure if I actually made it.  I do know I couldn't move my left arm.  I looked at it like it was a strange prosthetic that I didn't know I had.  I could move my hand but not my arm.  This guy put a shirt under my face so my head wasn't directly on the roadway.

In the distance I hear a siren.  It kept getting louder and louder.  A little part of me knew my first ambulance ride was imminent.  It was the police.  "We're shutting down the intersection!" I hear coming over someone's radio.

"What's your name?  Do you know where you are?"  I'm just keep pointing to my RoadID.  It's on my left wrist, laying there attached to a limp arm I can't move.  The pain and the pressure I feel on my left side is severe enough that it's taking my breath away.

"I need you to tell me your name.  What is your name?  Can you tell me what happened?"

I told the officer I had been hit by a car.  He insisted that I give him my personal information instead of discovering it for himself.  I assume it had something to do with gauging my lucidity.

A few more sirens were close-by.  Then I could hear someone giving a description of the scene.  "Bicycle vs Car.  Male cyclist.... Conscience...  Alert... "  THAT WAS ME!  Three firemen were next to me before I could really look up to watch all the commotion.  They're telling me to lay back down on my back and onto a backboard.

I'm no stranger to TV shows about this stuff.  I know what's about to happen.  I'm quickly moved to a backboard.  They put a cervical collar on me.  They tape my head down to the board.  They strap my legs and torso to the board as well.  My left arm gets some attention.  They add an additional strap to fix my left arm in a chicken-wing position, strapped to my already strapped torso.  I'm moved to the sidewalk.  At that moment, I'm thinking how awkward I feel since I'm not the lightest cyclist and there are 2 firemen, a firewoman and a policeman carrying my fat ass on a backboard over to the sidewalk.

At this point, I can't move my head and neck.  This collar is definitely doing its job.  I want to watch what's going on.  I'm frustrated that I can't.  

A fireman leans over me and asks where I was headed.  I told him I was going to the Pizza Ride in Avondale.   He then said "I figured that's where you were going.  I do that ride sometimes."  Cool!  One of the firemen is a cyclist!  I ask him how hurt I am.  He looks me over and says I have a dislocated shoulder and a broken nose and some road rash on my back and side.  I asked him to check my left collar bone.  He presses against my left collar bone and follows it down to my shoulder.  Since I'm not screaming in pain, I assume it's intact.  Amazing!

More sirens.... A guy with a blue shirt looks over me and starts cutting my jersey off of me.  I tell him it has a zipper but he's too fast with the scissors.  Next to go is my left bib strap.  I just got those bib shorts from my team and was upset they didn't just slip it over my shoulder.  He slaps some EKG leads on me and, with the help of the other blue shirt guy and a couple firemen, they pick me up and put me on a rolling gurney.   I'm rolled into the back of the ambulance and one of the paramedics tells me he's going to give me an IV.  I tell him to open it up full blast.  Hydration never comes that easy.

I ask the paramedic to give me my vitals.  He says "140 over 70, 65, 100 percent."  So my BP was a little high and my HR relatively low, all considering I just got hit by a car.  I was happy to know that 100% blood-ox meant the likelihood I had a punctured lung or something like that was almost zero.

The original cop leans in, asks me again if I know what happened.  I tell him that I was heading East on College and enter the intersection with a green light.  Next thing I know, a car coming from the opposite direction was turning through the intersection.  He then asks me for my wife's phone number and says he'll call her to let her know where I'm headed.  With a little relief that someone's going to call her, I realize that this will be the phone call she's always dreaded... a call from a police officer saying her husband has been hit by a car.

In part 2, I'll describe the ambulance ride and my experience in the Grady Trauma Center.

Monday, May 24, 2010

It's a Long Road

For the last several months, I've been suffering from a mysterious ankle injury.  Resting off the bike through Jan and Feb did not resolve the pain in my right ankle.  Although I'm reluctant to see a doctor under most circumstances, I finally broke down and went to a highly respected Sports Medicine certified orthopedist.

My first visit, playing right into my initial fears, the doctor recommended a cortizone shot into the joint to resolve the persistent pain and swelling.  I agreed after some deliberation.  The doctor felt I had compressed the joint through my weightlifting or other activity and the joint just couldn't overcome the injury without some "assistance".  It seemed like a solid argument.  My newly injected ankle and I went on our way with a regimen of further rest and light self-rehab.  After 2 weeks, I revisited the same orthopedist who said everything was peachy and I could restart my activities, lightly at first.

After only two rides, my symptoms recurred.  I had a lot of discomfort on and off the bike.  Not thinking my initial care was aggressive enough, I sought out the premier ankle specialist in Atlanta.  A quick meeting and an MRI order later, I was ordered to not do any activities that involved my lower body until we had a reading from the MRI.  At this point, I was off the bike already for almost 7 weeks.

The MRI showed longitudinal tears of the peroneous longus and brevis tendons.  These tendons are involved in pretty much everything related to ankle motion.  The nature of these tears was not in line with surgical repair.  My only option, other than full immobilization and rest, was to undergo PRP (Platelet Rich Plasma) treatment directly into the tendons.  I've had this procedure before and was familiar with its efficacy.

Almost 3 weeks after the MRI-assisted diagnosis, I underwent PRP.  This was followed by another 5 weeks of full rest.

It's now almost 4 months since this whole saga started.  My next follow-up to gauge my progress is in two days.  The ankle feels stronger but still has intermittent sharp pain.  That not withstanding, I've been back in the gym working on core and upper body strength.  I've also been swimming again with a floatie between my legs to keep me from kicking.

On Saturday, I went for my first ride, even without the doctor's permission.  So far so good...

Sunday, January 24, 2010

Dripping Wet But Satisfied

The weather around here hasn't been cooperating so far this year.  Competing weather forecasts aside, I ventured out to the airport ride this AM.  I'm determined to get ready for the season, weather and ankle be damned!

I set out around 9:45 in a mist.  With the impending tsunami to the west, I expected the turnout to be weak. When I arrived at the start, there were only 5 other brave souls and 1 soulette.  Right before setting off, two of my teammates bravely rolled up.  Awesome!  So it was a quorum, 9 in total.  We set off and it was immediately clear it would be a death march.  The rooster tails off the wheels were almost as disruptive as the 20+ mph crosswind.  Compared to most, it was a low-paced airport ride.  With my current level of fitness and the weather challenges, it was quite difficult for me, especially after doing Tucker yesterday.

I'm pleased to have completed my first 150 mile week since October.  I feel pretty good overall.  The new kits look great.  The new bikes work really well.  I'll know more about the bike when our Zipp order is delivered in a few weeks.  I'm stoked to try the new 303's with my shiny new SL+ powertap.  That wheelset should bring the SL3 weight into the very low 14's.  With the wired 404's it's already sub-15.

Week Stats
146.8 mi
Peak 20min
185.4 lb

I just want to mention one thing. I hope CycleOps has worked on this since my era Powertap SL's. When it rains or it's damp and cold, the Powertaps refuse to work properly. I can't always ride in perfectly warm weather. I don't know what the root cause is but this has to get worked out. In order to get accurate data, I need a stable data collection device! More on this after the SL+ shows up. I'm particularly interested in the foul weather stability of the new hubs. In addition, I am eager to see if the Joule (if I ever get one) can show me cadence, power, HR and speed all on one display. In my opinion, it's critical for interval training to see any combination of these metrics simultaneously.