Doing it all the hard way...

Saturday, November 30, 2013

It is miserable outside; isn’t that wonderful?

 The richest man in the world.
After my visit with the orthopedic surgeon a couple weeks back I was optimistic that my recovery would not require surgery.  As I mentioned when last I blabbed about my knee it seems to have ups and downs.  After an extended string of downs and seeing no improvement for a long time I came to the depressing conclusion that my path to healing probably included surgery, accordingly I scheduled a MRI.

I met with the doctor yesterday and got the results of my MRI. After close examination of both my knee and the MRI of my knee it turns out that there is more going on than we first thought.  I won't jump into all the details, but there is a combo of MCL, PCL, Meniscus and Mystery Meat that have combined to slow Davo down. He was able to confirm that I wasn't a whiner and in fact something was indeed weird. No one thing is bad enough to warrant surgery but the combo will heal slower than we thought.  My goal is to be in shape in time for the road racing season and that looks to be intact.

Like a grey haired manager patting the outgoing pitcher on the butt, the doctor told me to buckle up, fake some patience and ride out my slow recovery.  I'll see him again in the new year, but for now I get to ride, I just shouldn't race (either with a number or in a throw down).

My rides of late aren’t fast or hard but I am not complaining.
 The Brotherhood of the Brown
Just as George Bailey kissed the loose newel cap (awesome word, look it up) that he had cursed only hours before, so too does Evo savor the cold gloriously miserable miles that he might have condemned had circumstances not been altered on a cold October night Thrilla.
We went far enough that even KB was eating

My knee has been healing slower than I expected and my return to riding is correspondingly gradual.  The path I am on is that as I am able to do more I increase my riding whilst still doing less than my maximum to avoid slowing the healing process. If you had trouble following that sentence fragment just imagine me chasing an imaginary line with the goal of getting as close as I can without touching it. I touched it a couple weeks ago and I felt like my knee had been slammed with a sledge hammer.  Aleve can only do so much.

My knee still feels weird and weak, and I am glad I now know why, but it does seem the improvement is painfully slow (deliberate word selection).  The most dangerous thing I do is strain it in my sleep by laying on my right (and historically favorite) side. I can walk straight and essentially forget about it.  Then I turn or lean wrong and I am reminded in no uncertain terms something isn’t right.  I can almost straighten it all the way, but my range of motion the other way has some real limitations (Meniscus and mystery meat).
Matthew is sooo into Miley Cyrus he can't stop watching her videos on his smart phone

Because we do not see things as they really are, but as we think they really are, I keep trying to put my injury and recovery in the context of my past experiences.  My recoveries from arthroscopic knee surgeries have been pretty straight forward. Once the swelling and other trauma of a (minimally) invasive surgery have subsided, I was pretty much on my way.  Based on my experience that transition was markedly sharp and this gradual healing is wearing on my patience. 

Because the healing is so slow, it catches me by surprise. Instead of looking for improvement I just assume it to be unchanged day to day and then when something does NOT hurt my reaction is along the lines of “Hmm, that didn’t hurt.  I must be healing”. 
Every cyclist with a bladder knows where I took this photo

Delving into why we value something more following the threat of losing it may be the subject of another post, but for now let’s just say that I am really enjoying being able to ride.

Monday, November 25, 2013

How stupid are we ?

Baby's got back
George Carlin mocked us for eating Jumbo shrimp and for using a hot water heater instead of a cold water heater and we all laughed.  I smirked earlier this month when my TV asked me to honor those who served this past Veteran's Day buy buying new tires.  I had to laugh out loud when the computer was promoting "Plus size Skinny jeans!"

There is nothing like Irony to bring out the dumbest in all of us.

I know we're all far to wrapped up in body image.  I'll jump in and agree that is way unhealthy.  Maybe it is the curse of old age, but I would like to THINK it is okay not to dress like anorexic models.  As a devout capitalist, I do believe that if people have money they want to spend, we should strive to take it from them. Even so, plus size skinny jeans ?  Really ?

Thursday, November 14, 2013

Update: The Kneed for speed



Jens is so tough color photos of him come out in black and white.

I visited the ortho specialist this week.  Those moments of solitude sitting in an exam room waiting for the doctor are a fertile ground for self doubt. The silence, the memories of past injuries; the magazines with obnoxiously happy people on the covers all conspire to depress me.  Soon I will get to explain how riding exceptionally fast at night, with headlamps, on loose gravel trails covered with wet leaves whilst wearing spandex wasn’t stupid. To be honest, I’ve done crazy things to win bets that were more logical than that ride.  

The medical charts on the wall, the plastic knee joint sitting on the counter as a visual aid; I’d seen them all before.  I should know better.  I do know better. Yet here I am. 

In a few minutes the Doctor arrived and poked, prodded, pushed, pulled, twisted and bent my leg. Before long his experienced touch had yielded the “money spot” on the inside of my left knee.

At this point my appointment resembled an eye exam.
“Does it hurt here?” he asked.
“Oh yeah”
“But not here?”
“Not so much”
“Right here?” He queried.
“Yes, yes.” I confirmed.
“Not here?”
“Nope.” It was getting repetitious.
“This is the spot?” He asked one final time pushing hard with his index finger.
I am not sure if my butt actually lifted off the exam table, but I do believe I did jump.
“Shit…..Yeah!” I answered, my voice cracking. 

He confirmed the initial diagnosis of an injured MCL which was not a surprise.  What I came for was to discover what the next steps would be.  I had my calendar ready to schedule the MRI.

He then said I should continue my current treatment of not doing much, icing and anti-inflammatory medication. He told me MCL injuries heal slowly, usually four to eight weeks. He continued and instructed me that in two to three more weeks if I’m not seeing improvement, then schedule a MRI and amp up the dread.  Okay the dread part was my poetic license, which by the way, I need to renew that license before the end of the year… thanks for the reminder. 

Once he floated the no surgery option my mind set off on its own mission of perpetual motion. I really have no idea what else he said.  I would like to think I heard everything else, but in reality I would fail if you tested me.  In my daydreaming state I didn’t ask the questions I should have, such as what would surgery entail and what would the recovery be, or how about a PRP injection to help me along ? 

I left his office with a spring in my step and had a pretty good night. 

The next morning I woke up and the knee was hurting more than it had been in a week which kept the worry fires burning.   I started doing the math and making guesses about recovery time that had no basis in fact whatsoever.  

Just to keep the pendulum swinging, the day after that, my knee felt pretty good.


In the end, “wait and see” is far better news than, “you’re screwed,” but it lacked the finality I was seeking.  My profession is connecting the dots and mapping the path from today to success.  As such, I hate unknowns.  Right now, the future of my knee is unknown.   When the path is uncertain, I get a little antsy.  In my work I like to say bad news is far better than no news. While I didn’t get a final answer, and I didn't get bad news, what I did get is better than no news.

For now, I'll take it.

Monday, November 4, 2013

Coffee and Lies #44 Entropy


As my loyal followers know, I am currently on injured reserve.  While it is one thing not to ride, it is quite another to not be able to ride.  When on vacation or travel if I can’t ride I can always console myself that when I get back I will go at it with gusto and make up for lost time.  When you can’t ride you feel like you are a passenger in a car, not in control, helplessly watching at your fitness erodes.

My cyclical cycling training train isn’t totally off the tracks. Impressive wordplay eh? I had planned a post-Cyclocross rest period, but my season wasn’t supposed to be over just yet.  McWoodie suggested I treat my physical therapy (that will be coming one way or another) as off season strength training. There is some validity to this idea as I am skilled at both denial and make-believe. 

Physical therapy (PT) is one of the most misunderstood aspects of the medical world.  We visualize a patient reclined on a padded table getting a localized massage.  In fact you are sweating and grimacing as you work sore joints.  This weight workout from hell is typically punctuated by the therapist flexing your body beyond where you think it is supposed to go.  It is essentially torture preceded by a prescription from a doctor.

While I don’t know if surgery is in my future or not, I am pretty darn sure there will be PT and PT equals pain.  I have the best PT guy in the world.  He is a great guy as well and I am already dreading seeing him.  If only the principle of commutation worked for PT.

I am still a week away from my appointment with the knee specialist.  Then add a week to get a MRI, another week for follow up when my screwedness is confirmed by reviewing the MRI followed by a week or two to schedule the surgery (I’m planning on the worst).  I figure I’m a month away from being on the path back. 

In the meantime I feel like my body is already going down the crapper.  As I lose muscle I also gain fat so while my weight hasn’t made any dramatic changes yet, bad things are happening already.  I estimate I burn 20 calories per kilometer and I have been averaging 200k per week which means I burn 4,000 calories per week riding.  Figure another thousand calories burned recovering from those efforts and that means I’m burning 5,000 less calories per week than I normally do.  
My future awaits..
BIBSHORTS EVEN !!
I’m already pinching fat and feeling disgusted with myself.  Everything that goes in my mouth is accompanied by the bitter taste of guilt. This is the week after Halloween and there are dishes with leftover candy everywhere I turn at home and work.  Lucky for me I’m not a big candy fan, but those little mini bars shouldn’t be called “fun size” they should be called, “easy to justify size.”
Check out Alexander's mouth
The copy of a copy
The original
I have not lost sight of the fact I have people who love me and my income isn’t dependent on the speed at which I can ride my bike. While I could debate the fine points of carbon, exotic metals and grams, I was most intrigued by seven and three quarter pounds of grandchild this past weekend.  To be honest, I forgot about my knee.

Saturday, November 2, 2013

Alexander

Wink if you want to tell me "Everthing is cool."

Remembering the wonder you felt when you held your tiny baby is only superseded by watching your tiny baby hold his tiny baby.

 

Thursday, October 31, 2013

Crash and burn and death and birth !


Crashing is part of the game..
Like many good stories; this one begins with the protagonist ignoring warnings of prudent origin.  El Chefe had cautioned me; riding the Thrilla loop backwards was almost pointless compared to riding it in the usual counter-clockwise direction.  “It just doesn’t flow; it doesn’t feel right,” he offered in a questioning tone. The awkward pause almost asking me to join him in a ride mutiny.  I let the moment slip away.

Geoff has been our faithful and kind leader on these journeys and he seemed to really want to ride it backwards.  I felt inclined to support him (or at least try it so I could know better in the future).  

With a scheduled evening departure we were all carrying powerful headlights. El Chefe and I were sporting the Maglia Bruno and Geoff was clad in his Roosterwear.  Doug’s attire reflected his apparent strong need for autonomy.  The backwards route starts off by climbing up heart attack hill three minutes after you leave your car. The short approach is beneficial because as soon as you see what you will be climbing you start to question yourself.  The climb ascends to the horizon at an alarming grade. There is a gate at the top that gives perspective to how steep the climb is.  Because the approach is so short, you find yourself riding up it before you were able to talk yourself out of it.

Like a poker hand containing four of a kind, we four idiots climbed the long, loose slippery grade which averages 18% without any of us stopping.  Your forward/upward momentum started and stopped with each pedal stroke. If your wheel spun out you would be doomed to climb the rest on foot.  I didn’t say walk because it is too steep to call it a walk.

At the top I likened the climb to the Zoo Hill climb in Issaquah; I can do it, but it isn’t fun.  The route continued up the somewhat monotonous Tolt power/pipeline trail.  The route would climb a hill and then gave back half of the elevation only to climb another hill and again give back a portion of that climb as well.  Continuing east we steadily gained elevation on the roller coaster road.  On one of the short descents we were creating a wake of leaves that flipped over like dominos as we passed.  It was the highlight of the day. This trail is fine in fulfilling its purpose of getting you back to Red Hook after doing the fun parts of the Thrilla, but on its own it wasn’t a party.  I was yet to be impressed. 


When we finally turned and dove down into the forest it was completely black and our lights had been on since heart attack hill.  The flow was reversed and the portions that are a blast to ride as a curvy, flowy, gradual uphill now required braking and since we were travelling slightly downhill, the braking wasn’t as effective.  The trail was covered with huge golden brown leaves so the route itself wasn’t as obvious as normal. 

Can I again stress that we were riding it backwards (I prefer backwards to reverse because backwards implies there is a different, clearly superior, direction).  The turns required a little more care and we were wisely going slower than our usual throw-down speed.  The loose leaves and wet ground also made the corners a little more adventurous than usual.
                                       El Chefe' on the Volcanoes trip
El Chefe and I were zipping along and I went just a little wide on a left hand corner covered with yellow leaves. The leaves made it hard to judge where the edge of the trail was and what was off the trail. As my front wheel was about to be back on the “proper” trail the wheel and front of the bike unexpectedly dropped.  I could now see the trail had a buried plank of wood on the edge to prevent erosion and my wheel was on the wrong/downhill side of the plank.  The trail continued level across a small depression and my bike continued down the “off ramp” to the right.  My weight was now over the trail and my bike was on a divergent trajectory to the right.  The hinge point in this equation was my left knee against the edge of the plank. The bike didn’t lose traction in time (damn those awesome Clement MPX clinchers) and my knee bent in a direction it is not designed for.  If you imagine your left foot is supposed to hinge at the knee in the north and south directions; mine went west.

El Chefe was behind me when I rolled over in last Sunday’s race and I attribute this crash to him as well.  Why did he MAKE me crash AGAIN??  He was, however, perfect in coming to my aid.  He let me sit on the ground for a couple minutes while I went through the “WTF” phase and gathered myself. I tend to jump up and this time I was very content to sit still and wait.  With both hands I slowly took hold of my knee which hurt like hell.  It felt strange, like it wasn’t mine. It felt warm and cold at the same time. I ran my fingers up, down and around like I was feeling for something. Nothing was sticking out or bleeding.  Cautiously I held my knee and flexed my heel toward my butt. If you imagine getting hit from the side you would naturally bend your knees in to limit the side to side deflection which I had just experienced. Even though it was too late, I pulled my knee toward my chest and hoped everything would align.  Isn’t it funny how our minds work?
Oooooooohh   Shit !
After what seemed like several minutes, El Chefe helped me to my feet, commencing the “Okay, now what?” phase.  He offered to help me out of there and then offered to guide me back when I said I thought I could ride.  My leg could bear weight but flexing was another matter. I figured the route back was generally downhill with only minimal climbing so I decided I could make it. This really was more of a hope than a determination based in fact or logic. 
Our teammate "Hot Pants" out of gas in front of Casa de Chefe' last June
The crash had caused my wheel to move in the dropout and after realigning it the bike was ready to go.  Me; not so much. I stepped over and gingerly clipped in.   I started pedaling using my right leg for all the power and just having my left leg along for the ride. 
I should know better..
Then I entered the “Just how bad is it?” phase and decided to see how my left knee was working….

Light downward pressure on the pedals.  Left knee feels…….okay (I lied to myself).

Heavier downward pressure on the pedals….My whole knee hurt.  Everything from my lower quad to my calf muscles felt a burn.  Let’s stick with light downward peal pressure….

Then I thought I would try light pulling on the upward pedal stroke…Holy mother of shit!!  I felt a make-you-want-to-scream level of pain and all of it in one tiny spot.  That is not good.  That is way bad. Torn ACL was my first thought.  I’m not even sure that is where your ACL is, but that was the thought that was running through my head.
The blessed virgin had not blessed my bike or this ride..
I felt old.  I am a grandfather and I was riding fast, on wet gravel trails, in the dark, in cold weather.  What could be more stupid?  Why don’t I try it with a blindfold on?  I am lucky Hottie indulges my foolish priorities and allows me to pretend these things are relevant.  On the upside I am too old to spend much time in the “Regrets” phase and am quick to adjust to the “Acceptance” phase.

My brain switched to survival mode.  The night was cold but we had dressed for it.  I was pretty sure that whenever I stopped pedaling my knee would stiffen up.  Already my range of motion was limited.  I knew that the adrenaline that was helping me would soon expire as well. “Don’t stop till you reach the car” I thought to myself.  As we emerged from the watershed, Geoff was stopped.  “I’m going to keep riding,” I muttered without looking toward him; I turned west toward my car and the end of the ride.
Cool French tombstone
El Chefe escorted me and I took a squirt of hammer gel. Man that apple cinnamon has some flavor!  A few minutes later Geoff who had ridden ahead was stopped to add some air to his rear tire which had a slow leak.  Once again I mumbled something as I rode past not even considering stopping.

My mind was racing. The adrenaline had to go somewhere. I guess my Cyclocross season is over. What was the name o f the guy who did Hottie’s knee surgery?  Man, my knee hurts. Aren’t El Chefe’s knees cold?  I’m going to hurt tonight.  I’m glad I don’t shave my legs. My knee hurts. I guess if it is tendon or ligament damage there isn’t any rush to get it treated tonight.  The air smells fresh.  Gawd my knee hurts.  My toes are cold.   El Chefe is a stud. My knee sure hurts.  I wonder if I should call my doctor tonight or wait until morning.  My knee feels okay when I’m coasting downhill. Maybe it is just a strain?  Here is a short hill.  Holy shit my knee hurts. I am so screwed.

Just before emerging from the hills onto the Sammamish River Trail there are some downhill gravel corners that aren’t all that sharp, but are pretty loose.  As I got out of the saddle my left leg feels….unstable.  I settled back in my saddle and ease around the corners.
I knew the right medication could help me.
Soon I am on the trail and without a word to the others I pedal northward toward the car.  I am alone for a bit and I look skyward at the moonless night.  I try and freeze the moment in my mind as I assume I won’t be riding again for a good while.

 My hands are cold and the grass on the side of the bike trail sparkles like a sea of diamonds, the beads of dew reflecting light from the beam of my headlight.  El Chefe pulls alongside and I thank him for his help.  He says it was nothing, but I know that he fully realizes that I needed help.  Geoff and Doug stayed away sensing that I was not feeling social tonight. 

At the car I load the bike in and angle myself into my seat without bending my leg.  Now that I can let down my guard my knee really throbs. I am distracted but make it home without killing anyone.  I tend to Hottie’s misbehaving bike and stupidly test ride it.  Her lower saddle increases my knee angle and it feels like an ice pick in my knee.  My injury doesn’t seem to be making me any smarter.

I shower, eat and begin my Aleve and ice treatment.  I can’t find a position that is comfortable for my knee.  My legs are sore from the heart attack hill climb which adds insult to injury (literally).  Once in bed it takes a while before I fall asleep and I wake often during the night.  Turning hurts more than when I had knee surgery.  This sucks.

The next day I saw my doctor who listens to my story and pokes and pushes with the care of a good friend and exceptional doctor.  In that very room he once told me the best way to avoid surgery is not to visit a surgeon.  After completing the exam he tells me to set up an appointment with an orthopedic surgeon.  It appears I have injured my medial collateral ligament (MCL).  I could be okay and not need surgery.   Time will tell.
Any post that includes an image like this is generally bad news

Today I called and made the appointment. 

Someone told me this morning that I “must be devastated.”  I’m not devastated.  Today is one of the best days of my life.  Today my oldest son and his wife welcomed their first born, Alexander Joseph, into the world.  You can keep calling me Grandpa, but I am still not ready to grow up.   
My oldest son Zach, and his oldest son, one hour old today..
Please say hello to Alexander Joseph !