Health

With lots of time to think, rather than ride, work on the house, or work in the yard, lots of random stuff tends to zip around through the cerebral synapses. Of course the question remains how much will be remembered once the bones, tendons, ligaments, and skin have finished healing.

One thread in the milieu of thoughts has been of goals, short-term and long-term. The accident has had a great impact on many short-term goals and objectives. All remaining racing related goals for the year were immediately pushed into the mental bin marked ‘unattainable’, at least for this year. Who knows about next year. The Wife and I had a goal of doing some riding outside the US this year and had been planning on some MTB riding in South America to meet that goal. That, too, was swept into the ‘unattainable’ bin. Many more things will be pushed off this year’s calendar or seriously delayed. What comes back onto the calendar for next year remains to be seen and will be determined, in part, by how well the recovery is coming but also, in part, by considering and weighing the risk factors.

The long term goal thread has been dominated by concern about how accidents like this might impact what I want to do in the future. At some point in time, probably at the time I drop out of the day-to-day workforce, I want to take a few months and just meander across the country sampling a bit of the craziness that exists in this nation. Might want to try a couple of others, too. But to do so I must be healthy enough and able to physically stand the daily grind of pedaling many tens of miles. Got some other long term goals on the mind, too, and in general I need to be healthy to meet them.

So now I am sitting here with some work stuff cranking and waiting to finish so I am musing on how to balance staying active, doing what I would like to do, but staying healthy enough to continue to work towards what I want to achieve both now and down the (cronological) road. No answers at time, just part of what ye olde brain is trying to sort out at the moment.

We watched the Michael Moore documentary on healthcare, Sicko, on Friday.  It was rather timely since the bills for my crash last month just started appearing in the mailbox.   Moore is always over the top, but he usually puts some light on the craziness in our society, and the healthcare industry in this country definitely is out of whack in many ways.

The first bill I have received is from the hospital for my treatment in the ER (but not for the trauma doctors, all billing separately), the operation (but not the surgeon), and my 61 +/- hour stay.   The total is tickling, hard, the six figure range and some of the charges seem a bit excessive.  The 30 min or less with PT on my second day, basically them watching me get up and hobble on a walker then crutches, comes in at a bit over $500.  The OT person who followed along but did not really do much other than say ‘good job’ is apparently worth almost $700.  The PT person the next day, the one who took me for one lap of the floor and a couple of steps, is charged at $600.   There is a full body CT scan at $25K, and a separate head CT scan at $5K.  Isn’t the head part of the body?  Couldn’t they do it all at once for one price?

The craziest part of it all is how the numbers change due to my insurance.  There is a ‘contractual adjustment’ to the near six figure price, an adjustment that deducts 80% of the price from the total, with the remainder being allocated to the insurance carrier and to me.   Which is a bit scary; if I am John Doe without insurance I would be on the hook for nearly $100K just for the hospital, but since I have insurance yours truly and the insurance company together only have to come up with 20% of that amount.  Now that is truly ‘Sicko’.   And it really points to the need for healthcare/insurance reform with universal coverage.

The right side of my body seems to take the brunt of all my mishaps.  The way I am going it might not be long before every major joint on the right side of my body has had to be reconstructed.  The list:

• Ankle: pretty much destroyed in one of those ball sports back around ‘67, reconstructed in ‘68.
• Knee: off and on damage over the years, possibly more in the latest incident.  Will have X-rays and an assessment made in a couple of weeks.
• Hip: in the recent accident the hip end of the femur needed to be reconstructed using traction and a ‘box of hardware’ according to the orthopedic surgeon.  Interested to see the X-rays next week.
• Shoulder: definitely messed up after the recent accident.  So far the orthopedic surgeon has ruled out rotator cuff damage, but nothing else.
• Elbow: hey, no damage.  Yeah!
• Wrist: pretty messed up  when I was presumably drop-kicked by a car in 2002.  Have an “L” shaped titanium plate and 6 screws holding it together.

The left side has been relatively free of damage.  Some minor damage to the knee, and broken ribs from a car accident, but no joint reconstruction.  Perhaps I need to add additional padding and protective material to my right side?

And that will not start to convey all the gratitude I feel and debt I owe to those who have assisted me over the past few days.

For those not keeping up, I took a spill at Hellyer Velodrome on Wednesday night, leaving a fair amount of skin behind (nose, upper lip, both knees, both elbows), getting bit of bruising (right ribs, shoulder, and knee), and breaking the end of the right femur. The femur has a metallic rod added on Thursday. I am one messed up guy.

The biggest thanks has to go to The Wife who has been doing yeoman’s duty helping out under what are, for her, difficult circumstances. She has such a tenderness to her heart and soul that it is hard for her to help me at times since helping causes some momentary pain. She fights through and has been solid in doing what she can, and more, to help me get around for now and repair so i can become independent again. I can tell how hard it is, and sometimes my pain may come across as grumpiness, but I can assure her that I appreciate all she does and I am working to keep my comments to myself. Thanks sweetie!! I can never repay in full, but I will work on that debt later.

Also a big thanks to those who helped at Hellyer and assisted in getting us to the hospital. I was pretty much out of it; I remember the start of the race (BxC points race) and I remember someone telling me to wait for the ambulance, but other than that my memory banks are blank until such time I was in the CT machine being scraped along the wall. Major thanks to Rick Adams, and to Michael and Sabine who helped to gather my stuff and get it to the Toaster along with the the newlyweds Erika and Linda who continued to help transporting the toaster to the hospital for the wife, learning my full legal name in the process.

A big thanks to the staff of Regional Medical Center who worked fast to get humpty-dumpty together to the point that I was able to go home about 64 hours post accident. And to the dozens of folks whose calls, e-mails, and blog posts have conveyed good wishes.

And a special thank you to the friends who have taken some of the burden off The Wife by offerering to plan, prepare, and drop off meals to keep us nourished, thereby relieving The Wife of that extra task

If I do not get a chance to extend the thanks in person, know that I want to and I greatly appreciate the tasks of the many.

Not me. Not even close to being retired, semi or otherwise. No, it is my thumb splint, my constant companion of the past 25 days that has been put into semi-retirement. I saw the orthopedic surgeon yesterday who, after taking a couple of photos and doing some poking and prodding, pronounced that the thumb was healing well and it was time to let it out of the splint during ‘normal activities’. He warned I should wear it if I engaged in activities where it was likely I could take an impact to the thumb (if taken literally that is anything for a klutz like me), so I took that to mean that most of the time I can live without that hard plastic shell. Yippee!

Yesterday evening I took a fast 20 mile loop up into the Los Altos Hills to give the thumb a test. Still cannot shift the thumb lever on the right side, so Wente RR is now officially off the table, though unofficially I had been resigned to it being unrealistic for the past 10-12 days. The goal now is to work towards being ready for the EBC crit two weeks from tomorrow (10 May 2008).

Madera Madness

Wow, sometimes by ignoring on-line discussions you miss out on some good cat-fights. There was some real head butting about the Madera Stage race over on the ncncaracing list. Some folks get fairly dogmatic that they have seen the truth and cannot understand when others do not agree. Sheesh. Oh well, hopefully now that the full moon has come and gone that little battle is finished.

Last Saturday I was at a birthday celebration for Mintie Linsey, who finished 3rd in the GC for the Women 4 at Madera, and I was asked when the photos I had taken at Madera would be on-line. Ooops, apologies to Mason and others who have been waiting. I finally retrieved the camera from the bag last night and will now go through them and post some to the gallery RSN (Real Soon Now).

A quick scan of the photos provided some evidence of what I had suspected. Not long after The Wife completed her ITT I noted that the rear wheel was flat. That raised questions about if it was going flat during her event which would have increased rolling resistance. No longer supposition; it is clear that as she crossed the finish the part of the tire beyond the tan sidewall is compressed down and barely visible. The replacement tires will be glued onto those wheels this weekend so The Wife can get accustomed to them before the Women’s Stage Race at Kern in three weeks.

Saturday ridin’

I decided to test out riding with the damaged thumb on Saturday but I was not quite ready to tackle the thumb lever of the Campy shifters. So I grabbed the TT bike, with the bar end shifters, and headed to the west. I found it easy to operate the right shifter with a combination of two fingers and the hand. After a nice warmup in the flatlands I made my way into the Los Altos Hills and started some VO2Max intervals, and I was feeling good. I put in a bit over two hours with no problems whatsoever.

Sunday ridin’

If one day of riding is good, two is better. The Wife was heading out to lead a team workout and asked if I wanted to carpool northward to ride in that area. Sure, but what bike? I had torn down the TT bike to clean and prep for Madera this coming weekend and did not have time to get it together. So I threw the Colnago in the Toaster and headed out to Woodside. While The Wife and her teammates did their review of what was ahead I did some loops of the parking lot and found I could use the finger next to the thumb to shift the thumb lever, just not smoothly or quickly. I did a warmup then cruised north on Cañada road for a fast tempo ride. There was heavy drizzle and stiff headwinds, but I did not care. The legs felt great and I rode hard, minimizing gear changes. I got in a big gear and powered up, doing 22-25MPH even on the uphill sections, all the while keeping the cadence above 95 rpms. I was shooting past groups of riders, the only one’s who were matching me were two guys in DBC kits. If I had felt that good, and had that much drive, last Sunday then I think I would have been in the front group all day. Maybe the extra rest did me good, or maybe the somewhat hard workout on Saturday. Need to sort that out, but it was fun and I was feeling it.

Glue and tape

One of my teammates had a tubular tire roll of the rear rim while he was cruising for an almost certain 2nd place at the Rondee von Brisbeen crit a week ago. The race official noted there was very little glue on either the tire or the rim. The teammate says that the tire was mounted by a local bike shop owner, one whom some folks claim tell them that they use too much glue when mounting tubulars. I do not know about that, but that shop owner has told me that I should be able to swap tubulars faster than I can repair a flat clincher. Never been able to, mostly due to the time it takes me to peel the old tire off the rim; maybe if I used less glue I could peel them off faster.

The incident has led to a lot of on-line chatter about gluing techniques, etc. Basically it is a religious war as to whether to glue or tape, if glue which one, etc. With Madera a week away, and The Wife wanting to ride the TT with the high zoot carbon trispokes, with tubulars, I decided to peel and remount the tires just to make sure they were on well. I glued on the front, using the Continental glue. For the rear I tried Tufo tape. When picking up the tape I did a quick check: regular or extreme? Extreme is for ‘extreme’ conditions of low or high temperatures, with the ‘extreme high’ meaning above 74 degrees F! Where is the world is it that 74 degrees F is an extreme high? Antarctica? I know Tufo is a Czech company, but the Czech Republic is not that moderate in their temperature range. Upshot is I went for the ‘Extreme’ stuff. While I was at it, I got a new tubular spare and needed to stretch that. All I can say is that gluing tires and stretching new tires onto rims really calls for having two good thumbs. I got it all done, but it was not easy.

New track wheels

While looking at the website of the manufacturer of the carbon trispokes for gluing recommendations I found that they sell a road to track kit for the wheels. For a couple of bills I can get the parts so I can swap them back and forth between road/TT duty and use at the track. Sweet! A lot more friendly on the budget than a new set of wheels.

I had my date with the orthopedic hand specialist and now I understand what the folks at Urgent Care were not telling me.  My rather enormous thumb has two breaks.  One is a rather standard, straight across the bone type and that gets and ‘oh well’ reaction from the doc.  The second is a smaller break, but it is where the flexor tendon inserts on the distal phalanx (say that 3 times fast) so the concern was that bending (flexing) the thumb might be compromised.   Apparently not, so I was sent home to let it heal naturally.  And the humongous wrist to mid-thumb splint that was functionally inadequate but impressive looking has been downgraded to a  flesh colored plastic thumb cozy in the largest size available.   Word is 3-4 weeks to heal with the advice that I can ride but should not race during that period.  So no racing at Madera, but Wente Vineyards Road Race in just over 3 weeks might be possible.  I have a followup with the doc 2 days before Wente.   Time to start prepping!

Now I know a bit of what the REI dividend will fund. I am in serious need of some pants that fit the new, somewhat lighter version of yours truly. I loaded up on some pants at the end of last summer thinking that would do me for a year or so (I hate shopping so I concentrate my buying in a few, short periods of intense activity). Gravity can take those pants down to my ankles if I remove my belt now that I dropped a few pounds this past fall/early winter. I, like Jared, will have to make room in the closet for skinny pants to reside alongside the fat pants.

I have asked The Wife what she would like from REI, as I prepare to spend the spoils of being the buyer for my workplace. She has her eye on the latest in cycling footwear, the Keen Commuter cycling sandals. I am a big fan of cycling in sandals, as I blogged about last year. The Wife got a pair of cheap sandals a few years back but never got into riding in them. One of her concerns was lack of protection for the toes, and she maintained that if Keen’s ever made a cycling sandal it would be perfect. I think a pair of those will definitely make it in the shopping basket. Still looking at what else we might want or need from REI, especially that one item that will make maximum use of our “20% off one item” discount.

Some might read that this new shopping list indicates which way I decided to go on the data collection device decision (say that fast three times in a row). Not so fast. At this point in time the Garmin Edge is still the front-runner, but I realized that REI was not the place to purchase said device. The full kit (head, cadence/speed sensor, HR strap, cables, mount, software) is $359 at REI and is not eligible for the “20% off one item” discount. Other vendors sell the same package for $250. Even if it is ‘funny money’ (dividend) it seems silly to pay that much extra for one item.

Saturday I decided to test the lungs, the legs, the mucous producing machinery by doing a brief jaunt into the Los Altos Hills area. The legs were OK, not great, but the lungs were straining to find room for some air in between the resevoirs of mucous that had filled over the past two weeks. Even though I was riding tempo I kept the speed moderated, in part a concession to the lungs, in part to make sure I had control as I fired off countless ’snot rockets’. By the time I got home the throat was agitated, leading to a few good coughing fits through the rest of the day. Hmmm, perhaps it was a bit too soon to climb back into the saddle.

Did I learn my lesson and throttle back? You must be kidding! Sunday I got up ready to put myself out there in Early Bird #3, having missed #1 and #2 due to the combination of weather and the now infamous cold. But I needed to warmup first, right? And what better way to warmup for a few circuits of the industrial park than to ride 19 miles to the event? Little did I know what was in store.

The first surprise was rain; about 2 miles from home I entered the precipitation zone, light but steady, enough to get me and the bike thoroughly covered in that black, oily road run-off. At about mile 4 I seriously considered turning around and going back for the car, but was I smart enough to take the wise choice? Noooooo! Surprise #2 was a drive train problem, finally traced to debris that had gotten thrown up into the rear cassette. As the problem started I considered turning back and getting the car, but still I was not smart enough to follow my intuition. Surprise #3 was flooding on the approach to the Dumbarton bridge and the entrance to the bike lane on the bridge. I had to ford through water 2-3″ deep to get started on my way to cross the bridge, and by this time it was too late to consider turning back for the car. If that was not enough, right after crossing the bridge I realized my rear tire was going flat. When it rains, it pours, as they say.

By some miracle I did make it to the Early Bird with a few minutes to spare. And to add to the fun the first 7 miles of the trip back was straight into a stiff headwind. Mucous production seemed to have increased, and keeping that in check while riding in the pack was loads of fun; I am sure some of the other riders were amused at the long strands that kept dripping off the nose. And all that fun and games tweaked the throat even more, leading to more and longer coughing spells through the afternoon and evening. I am so ready to get back to my normal, healthy self. But moderate? What’s that?

Lex Luthor is always devising ways to be near kryptonite so that he cannot be defeated or harmed by SuperMan, who is severely weakened in the presence of the substance. I feel as though someone has found a kryptonite analog that weakens me and has hidden some of it near someplace I frequent. I rarely get ill, and on the rare occasions I do the illness is mild and I recover in a day or so. The past three months have proven to be an exception to the norm, with two long bouts with severe colds,  and I am trying to figure out why. The latest version has  lingered for 12 days. Tough to get out and do any time on the bike when you keep coughing up huge chunks of matter. To date I have missed, besides my own self-motivated rides, the fundraising points race at Hellyer last Saturday and the first two Early Bird clinics/crits. I am really itching to get out and do something this weekend, and right now the signs are looking positive.

On one of the days home from work due to the disease I did venture onto the scale. I avoid the scale for the most part, too easy to get obsessive. But I had dropped 14 lb since I blogged that I wanted to trim down a bit before the coming racing season. If I go down much more I will be near the lightest I have been as an adult, excluding the pathological 120 lb I hit when fighting malaria. With the weight down it is time to get in some good power development work. Hope to see folks on the road starting tomorrow!