Saturday, August 27, 2011

Caution - Construction Zone


Taking my time, being patient, and putting the finishing touches on my foundation. One of the reasons I feel my recovery has been going so incredibly well, is I am paying very close attention to building the foundation correctly. One stone at a time, one course at a time, one corner at a time. I am nearing the completion of the foundation, and am happy to report the structure is sound. Having a strong and solidly built foundation is the key to an equally strong and solidly built training program. I'm excited to report that I have picked my debut race. I can't wait to get back in the rhythm of training to race. I have also just learned that my training partner has met two incredible women who are training for the Umstead 100, that I will be meeting for the first time at the race I have signed up for. Potential partner opportunities for me!

Sunday, August 7, 2011

Mid Life Crisis

This is the story about how I came to be bionic. I am posting now as part of the background to an upcoming article I am working on about the psychology of injury. Before you read on, I want to give a quick update on the arm. Last week in yoga class, I was able to do my first one arm plank on that arm, much to my squealing delight.

Mid Life Crisis


Not the kind you think, either, so don't go thinking I bought a new sports car or went out parachuting. This was the kind of mid-life crisis that was a bonafide crisis that was totally unanticipated, unwelcome, life altering, soul seeking, wake-my-ass-up from complacency knock-you-down-and-step-on-your-trachea crisis. I've waited until I was almost recovered so I could write a proper story, from beginning to middle to the end. Well, it's been ten weeks since the accident, and I'm ready to tell the tale.

It's funny (well maybe not in retrospect) how you can be living your life in relative peace and quiet and calm one minute, and the next minute have something happen that turns your life upside down. I've relived the accident a thousand times to try to figure out what happened, and more importantly, how to not let it happen to me again. Each time, it gets clearer and clearer and I can almost see myself in the seconds before and the moments after with great clarity. It's an effort to slow it down in my mind’s eye and examine every detail to understand the messages and lessons so rudely handed to me that morning.

September 13, 2009 was a beautiful day for a run. Gorgeous morning. Ramesh, Lori and I had been training for a half marathon coming up in November. Ramesh happened to be in Vancouver, Canada, for his best friend's wedding, and wasn't able to join us that day. I was excited though to run with someone new that day. One of Angie's friends (Tessa) was looking to run long in preparation for her first marathon in Washington, DC. You know me, I love to run with new runners and I was excited to not only meet her, but run with her. In that spirit, we all set out for our long run. Chatting, laughing, enjoying the company, having a great time as we made our way around the course that Ramesh had laid out for us. Just past mile 9, we made our way up on to Six Forks Road, a flat stretch with a slight downhill to it. A great place to catch our breath and stretch it out a bit. We were running down the sidewalk, me on the right, Lori on my left, and Tessa behind us both. I was in super fun chat mode and made a serious mistake. I took my eyes off the ground, and glanced over my left shoulder to say something to the gals. In an instant, life changed. I caught my left toe on a crack in the sidewalk, and was hurled forward towards the ground with lightning speed. I tried in vain to get my legs under me. It only took a nano-second for me to realize I was going to hit the ground, and hard. As I saw the ground coming towards my face, I made a split second decision to save my dental work and rolled (rather threw) my body to the left. My left hand found the ground first, followed by my right knee, and then my body weight all fell on to my right arm as I rolled on to that side to avoid smashing my face on the ground. I slid down the sidewalk until I came to a stop. Life altering moment number one.

OK, I thought I could be injured, so I lay still for a few minutes and calmly told the gals to give me a minute to see what may have happened. I sat up. My knee was bleeding, having removed the flesh down to the bone on it. I grabbed my water bottle and washed it off. That's when I noticed the rice crispy crunch in my right elbow. Oh, that's not good I thought to myself. Still being as calm as I could be, I said to Lori that I thought it could be broken. Odd, it did not hurt at all. It was simply crunchy when I bent it. Hmmmm, should probably get it x-rayed. I stood up, and it was decided that Lori and Tessa would run back to the house (we were about 1.5 miles from the house) to get Lori's car, come back and collect me, and then we would head to urgent care for an x-ray. I started to walk back alone. I tried to run, but for some reason the energy just wasn't there, so I hooked my right hand in my water belt and walked. I was a bit surprised later on that none of the dozen cars that passed me in the neighborhood stopped to ask if I was alright. I had blood streaming down my leg, my arm was obviously gorked, and I was alone. Later, I told my entire family if they ever see anyone in this condition to stop and render aid. I was nearly back when Lori arrived and helped me in the car. We went back to Angie's house. This is where the fun started.

I can testify that the kid friendly antiseptic works great. Angie dressed my knee and called Rick. "Mom fell and she may have broken her arm". "What? Doesn't she watch where she's going?" This was just the beginning of many marital stressing statements from Rick. (Just so you know, he did finally "get it", but it was a long few weeks until he did) Angie handed me a breakfast bar, and off we went to urgent care. Thank goodness for Lori who was in instant help mode, and did everything she could to make the next part as easy as possible for me.

I sat in the waiting room, eating my bar (thankful I did that...) until they called my name. They never looked at my knee, even though I asked them to a couple of times. Got x-rays of both arms, thinking holy shit, if I broke them both, what will I tell Rick? How will I eat? Crap, crap, crap. This was threatening to ruin my training. I had a nasty contusion on the left arm, and the x-rays showed I had indeed fractured my right arm. The original diagnosis was a fractured radial head, simple. I got a splint, a prescription for painkillers (never needed it), and instructions to see an orthopaedic specialist in the morning. Little did I know what was coming.

Monday morning at 8:00 found me in front of the computer, looking for an ortho specialist that could see me that day. I called practices in alphabetical order until I found someone who had an opening. Fate definitely delivered me to the right practice. Raleigh Ortho had an opening downtown, and could see me. Thinking I had a "simple" fracture, Rick drove me over there to get what I thought would be a cool cast that the grand kids could write their names on. Uhhhh that will teach me to think. The PA loaded up my x-rays on the computer, and hauled me out in the hallway to look at them. She had a very worried look on her face. She started to tell me all kinds of things that made me get a very worried look on my face. I heard myself ask for Rick, who was in the waiting room. I'm thinking I'm about to hear some bad news that I wasn't prepared for. She goes and gets a doctor (I was only supposed to be getting a cast...no doctor was supposed to be needed...so I grew concerned). Dr. A came in and started explaining that I have not only broken the radial head, I managed to shatter it. In my head, I'm thinking SHIT. Surgery? Dr. A gets this brilliant idea that maybe a little physical therapy, and things should be OK in a splint for 8 weeks. Oh...except for one small issue he wanted to deal with right then and there. What's that Dr. A? It seemed the joint was full of blood, which he was going to extract before I left with a 52 inch needle. (Just kidding...it was big, but not that big) Here, lay down, we'll fix you right up. I'm used to getting mentally prepared for procedures, not just going right from the chair to the table. No time to think about it. I won't give too many details except it was done without Novocain, it wasn't easy for him because of the bones all being shattered and he had to basically navigate around them, and it took him 15 minutes to get the blood out. So, a nice splint and less blood in the joint and off I went. It got worse.

On Wednesday, I got a call from the urgent care. They were very concerned about me. They sent my x-rays to a specialist to read, and he wanted me to know that I had shattered the radial head. Duh. Been there, done that, but thanks anyway for the follow-up call. I started physical therapy to try to coax my arm to heal itself. I transferred to an office closer to my house, which turned out to be the best decision of all. After 10 days of valiant efforts, I was getting worse. Pain began to haunt me, and I couldn't move the arm at all. I met Dr. T. I LOVE DR. T. He was very candid with me. He wondered what Dr. A was thinking. To Dr. T, I was the clearest candidate for surgery that he had seen all year. OK, to recap, I went from a simple fracture to a surgery in 10 days. See what I mean? It kept getting worse. Dr. T showed me better x-rays that clearly showed the problem. Dr. T is a runner, and we had a great chat about Ironman, running and all that goes with it. Did I mention I love Dr. T? Surgery was scheduled for Sept. 28th. Should only take 1-1/2 hours to put some screws in to stabilize the fracture, and all will be good again. It still kept getting worse.

I was up early the morning of the surgery. Rick and I made our way to the surgical center. Angie planned on joining Rick later on to be there when I woke up. I had hoped that I would still get the cool cast for the grand kids to write their names on. I was given a nerve block (pretty un-nerving...) and the best drugs on the planet, and wheeled in to the surgery. Piece of cake. I was awakened by the surgeon. He said "you probably won't remember any of this, but you were in surgery for 3 hours". 3 hours? Holy crap. Something must have gone wrong. He went on "I wasn't able to reattach the shattered pieces and after trying for an hour and a half, we had to replace your radial head". I mumbled something like "oh, OK", and slipped back in to my drug induced fog. Angie and Rick were there, and when he left, showed me the x-rays they had taken during the surgery with the prosthesis in it. It didn't hit me at all the gravity of what just happened. I came out of my fog, got dressed, and we made our way home. I had a huge dressing and a sling, and my arm was totally frozen from the nerve block. Too bad that nerve block didn't last long, because as it wore off, excruciating pain set in. I felt like I'd been dropped out of a 747 from 10,000 feet. Drugs. Give me drugs. I spent the first couple of day’s zombied out on the couch, alternating between the Percocet and the anti-nausea medication so I could take the Percocet. Miserable, I tell you. I had my computer at home, thinking I could work, but quickly discovered that was entirely out of the question. Two days later, and it hits me. A prosthesis? WTF? How did that happen? I called Angie and asked her this question "can you please explain to me how I went from a simple surgery to put some screws in my arm to having part of my bone cut away and replaced with a freaking fake elbow?" She calmly told me the story she had listened so intently to in the recovery room. Evidently, the damage was way worse when they opened up the elbow. The impact of the fall had compressed the radius severely, and I had broken the head of it in to 4 separate pieces. The surgeon was able to reattach 2 of them, but couldn't get 2 screws to stay put in the remaining 2 pieces because the compression had all but ruined the area he was trying to attach them to. So, after 1-1/2 hours of effort, he made the decision to remove the radial head, and insert a brand spanking new Acumed radial head. It was made of titanium, with a chrome polished cobalt head. Ooooooo, I'm bionic now. I told you it got worse. In retrospect, and after follow up discussions with both my physical therapist and my surgeon, I have concluded this was the one true correct solution. Screws would have plagued me in my later years, and are often the source of arthritis and other issues. This way, at least it is a clean replacement and should give me a lifetime of trouble free use.

Not that it has been easy to rehabilitate, as it hasn't. The arm was useless and did nothing for the first couple of weeks. Rehab started when the surgical dressing came off. I couldn't hold a piece of paper in that hand. As part of my surgery, the surgeon had to remove the main ligament that holds the two halves of your arm together and then reconstruct it with a big honking screw. That has been the bigger problem to rehabilitate than the prosthesis. It's the same as if I tore the ligament from the bone, and has a very long healing time.

So, here I am, 9 weeks post-surgical and the arm is coming around. Like all life altering events, I have had to take a long, hard look at what I learned, and change some things in my life. We are all works in progress, and it's important to use these lessons to improve in areas where we are deficient. Certainly for me, this was a pivotal moment in my 54th year. I learned a few things, and came to a new realization about some other things. Things like:

1. It's true that the bigger you are, the harder you fall.
2. Concrete really is the hardest substance known to man.
3. The older you get, the harder it is to heal.
4. The worst part was losing my independence. I hated being dependent for nearly everything, even basic things like bathing and dressing oneself.
5. Family is everything. They jumped in and helped without hesitation. Ramesh traded cars with me so I could drive (his is automatic, mine is a 6 speed). Angie ferried me around and washed my hair when I couldn't. Rick tolerated me and eventually settled in to being extremely helpful over the long haul.
6. I was reminded I am a Buddhist, and I need to be more focused.
7. Never, ever take your eye off the ball. I don't care what it is you are doing. Driving a car, running, walking, doing dishes, cooking, sex, whatever. Be present with the task at hand, and with yourself. Never drop focus.
8. Patience is a virtue. I had to be reminded many times. An accident like this is a long process, and can't be hurried. I've been given the patience talk by my health care providers more than once.
9. I don't set off airport alarms. I found this out when we went to Spain.
10. People in Spain look at you funny when you are wearing a high tech splint like I had to wear. Evidently, this technology hasn't made its way in to socialized medicine countries.
11. I would be in financial straits without health insurance. The urgent care visit alone was almost a $1,000. The entire bill is going to be around $35,000. I don't know about you, but I don't happen to have that amount lying around the house. It pains me to know this country has so many individuals without health insurance. It's a freaking crime.
12. I've learned to be more humble. It's been hard to ask for help. I'm proud and independent. To ask for help was difficult for me. Now, I understand.
13. No, the arm doesn't make a cool swooshing noise like the bionic woman's did. Too bad. That would have been cool.
14. If you fall off a horse, or a bike, or splat on a sidewalk, it is imperative you get back on. Ramesh had me run right where the accident occurred on my first run back from surgery. Yeah, it was weird, and yeah, it was important to go back there. After all, it was just an accident.
15. Most of all live fully. Love life and live each day as if it were to be your last. You never know what can happen.

Dancing Again


I have two left feet. Really. My balance has always sucked, even before 4 foot surgeries. A couple of weeks ago, I joined an afternoon yoga class at work in an effort to bring a little flexibility and balance back in to my routine. Part of my rehabilitative exercise routine revolves around my ability to stay balanced. I loved yoga before the foot surgery, and jumped on the opportunity to bring it back in to my life.

Last week, my instructor coaxed me in to a Dancer's pose. I struggled with the pose, trying desperately to stay upright on one foot, especially my recently reconstructed left foot. The instructor walked over to me to help me out. She showed me and explained to me the importance of the pelvis, and how my feet are not what was holding me up. What she said really resonated with me. She said "your foot is not going anywhere....just try to move it". I could not. She demonstrated the power of the pelvis to me and had me tilt my pelvic forward, and sink in to the pose with my hips. What a pivotal moment! My body suddenly "got it", and I had a full minute of yoga enjoyment and exploration in this pose.

My trainer loved it too. He's been teaching me for years the value of strength in the core. He's happy I "got it" too.