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Cross-training 101

September 12, 2009 in Friends, Health by CyclistRick | No comments

As stated earlier, I am attempting to rebuild my hip and get back to some form of normality by the end of the year. So it is cross-training season as I work on strength and flexibility, but most activities took a back seat this past week as I spent some time with The Wife. She is off for 10 days shepherding her parents on a little bike tour of the Olympic peninsula, so I wanted to ensure we had some time together before the period of separation. U.S. Highway 101 is the link between us now; our house is just off the highway, she is riding the northern end of the Highway several hundred miles north of here.

I had planned to get up early and do a longish bike ride today, but I was not sleeping well as it was then the light and sound show (lightning and thunder) started in earnest just before 4AM and that was all she wrote for my night of sleep. As I sat around trying to get motivated our friend Erika called to plan a ride, then as I was getting things together to go out she called back to ask for a change to a hike since it was raining at her place, and rationalized it on the basis of us both needing to work on bone density. We met up with another of her friends for a nice, but brisk, trek up Windy Hill from Portola Valley then looping back down. A very pleasant day, and something I should do more often. Now I need to get out tomorrow, and then possibly help to arrange for The Wife to get a spare tire since she had to use her’s today after getting a blowout early on her first day of her tour. Anyone going to Port Angeles area who can carry a 700×32 tire and deliver it to her?

Is the cure worse than the disease?

January 27, 2009 in Cycling, Health by CyclistRick | 8 comments

When I was working in Peru, as a field biologist, one of the guidelines we followed was to never camp near sandy river banks. Sandy areas attract sandflies, and sandflies in most of the tropical regions of the world carry leishmaniasis. One of my colleagues did contract the disease, and at that time the only available treatments involved antimony based chemicals. A tough position: live with ulcerous sores all over your body or ingest relatively large quantities of heavy-metal compounds. He and I used to joke about the cure being as bad as the disease, though he did go through with the treatment.

As part of the followup to my crash and injuries of last June the orthopedic surgeon ordered a DXA bone scan to check for bone density. I’ve had the results for 3 months, but her and I just had a chance to talk about them a couple of weeks ago. Bone density of my arms is normal (for a 30 year old male, the standard, so above normal for someone my age), the lumbar vertebrae are a bit below normal, but still OK, and the measurment of my left femur is in the realm of osteopenia. That last number is the one the orthopedic surgeon wants to concentrate her attention, and she has prescribed a three part regimen to deal with the ‘problem’:

Take calcium, lots of calcium (at least 1500-1800 mg/day) . Interestingly, she did not prescribe Vitamin D to go with it.
Walking, at least 30-40 min/day beyond normal ‘maintenance of life’ movement. Basically this is weight bearing, and the only weight bearing activity she wants me to undertake involving the legs/hip at this time.
A bisphosphonate drug for ‘osteoporosis’.

I can accept #1 and #2, but #3 is where I have a divergent opinion. I am not a big fan of pharmaceuticals in general, but the bisphosphonates are particularly troubling. There are high rates of ‘troubling’ side-effects, including but not limited to severe muscle and joint pain, gastric issues including esophogeal erosion, and upsetting the bodies electolyte balance. More troubling is the increasing association with necrosis of the jaw. The more one reads about these compounds the more it seems that they are likely worse than what they are meant to cure. I think I will pass on them.

That’s what they did

October 17, 2008 in Crash, Cycling, Health by CyclistRick | No comments

It is so good to be able to get out and ride again. Today I was actually able to do a bit of pedaling while standing. Another baby step on the road.

My leg is screwed

Last week when I visited with the orthopedic surgeon she gave me a bit more information on what she did, or more accurately what she inserted into my leg. I have a device called a ‘sliding compression screw device’ in my right femur. The ’screw’ helps to hold things together while limiting direction and speed of motion. Apparently one of the strange feelings I have from the leg is the compressive device limiting how fast parts move in relation to one another.

On every visit to the orthopedic surgeon she points out my arthritis. That is something I’ve known about for close to two decades. Perhaps the reason she is pointing it out is to prepare me for one possible side-effect of the injury repaired with the ’screw’: “over one third of patients w/ RA treated w/ a sliding hip screw (for intertroch frx) will sustain a major complication (AVN, nonunion, loss of fixation).” AVN is avascular necrosis, or for the benefit of cyclists we will just refer to it as ‘Floyd Landis syndrome’. Here’s hoping that I am in the under 2/3 of patients with RA who do not suffer these complications.

On the road again, just can’t wait to get on the road again

October 8, 2008 in Crash, Cycling, Health by CyclistRick | 5 comments

Apologies to Willie, but the orthopedic surgeon has just cleared me for take-off. The hip is healing, but not healed completely, the knee and shoulder are passing all the tests with no sign yet of anything that will require surgery, and progress is happening in strength and flexibility. The answer to the question as to what I should be doing was: ’swimming, cycling, and walking’. Watch out world, the bike is coming off the trainer!

Violating orders

September 3, 2008 in Crash, Health by CyclistRick | 9 comments

For much of my adult life I have been skeptical of physicians. It was a skepticism born of familiarity. My bachelors degree is in Biology from a large University where over 90% of the Biology and Chemistry majors I dealt with regularly were pre-med. Through the graduate school process, and afterwards as an instructor, I dealt with more of the pre-med and medical school students. There were some intelligent folks, but then there were a lot who were not so bright, and a few whose ethical compass I found scary. I am not sure how many of those last two groups got weeded out in the medical school process, but let’s say I am not thrilled to be doing a statistical sampling to find out.

Then there have been my own horror story experiences with doctors. When I contracted malaria I knew what I had, and I conveyed that to my primary care physician. The problem is he did not want to believe me and instead chased diagnoses of other exotic diseases (meningitis, encephalitis, and others) all the while failing to order the simple blood test that would determine whether or not I had malaria. That was close to being a fatal mistake. Finally my complaining resulted in a new primary care physician being assigned to me and within hours we had a confirmed diagnosis and treatment started. Then there is the case of my sensitivity to oats. I knew something was wrong and I conveyed the physical symptoms to the physician. He found anomalies in the blood tests, also, but did not want to consider that it all might be food related. Many, many tests later, looking for all sorts of exotic causes, the physician more or less gave up and told me to live with it. So I started my own ‘process of elimination’ food testing and eventually came to discover that oats were the culprit. As soon as I removed oats from my diet the physical symptoms went away and my blood composition returned to a more ‘normal’ state.

For the last few years I have been trying to put aside my past biases and to work with my physicians. And that is what I was doing with the orthopedic surgeon in regards to my hip. I have followed her orders, so far, to the letter. But now it is time for me to consider going outside those bounds. I was content until yesterday when I learned that she did not want to give me the extra leash I think I can use. All I asked for was a referral for Physical Therapy. I am progressing well, and think that I could use some help to guide my recovery. But the orthopedic surgeon says no, and that if she decides I should have PT that decision will come after my next visit … 5 weeks from today. Note that she may still decide against it, and from the tone of her message I take it that is a distinct probability.

So now it is time to go against doctors orders and to see about starting on a physical therapy plan. A friend who is a DPT suggested the exercise I did in the swimming pool on Monday, and she is coming by tonight to assess my ‘walk’ (as it is) and to determine what I need to work on to get to the goal of walking without aids (crutches/canes/etc.).

There are times to be compliant and follow directions. And there are times to decide that perhaps there are alternatives.

The long and the short of it

August 4, 2008 in Cycling, Health by CyclistRick | 7 comments

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.

Sicko

July 20, 2008 in Crash, Health, Movies by CyclistRick | 10 comments

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.

A ‘right’ mess

July 3, 2008 in Crash, Cycling, Health by CyclistRick | 9 comments

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?

A big thanks …

June 22, 2008 in Crash, Cycling, Friends, Health, Track by CyclistRick | 14 comments

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 a fair bit of bruising (right ribs, shoulder, and knee), and breaking the end of the right femur. The femur has a hip screw (large screw into the ball of the femur), two plates, and several additional screws that were 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 at Regional Medical Center being scraped along the wall of the device by incompetent techs. 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 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.

Semi-retired

April 25, 2008 in Cycle Racing, Cycle Training, Cycling, Health by CyclistRick | 7 comments

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.