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Photo by Jason DeVarennes

Sunday, July 9, 2017

How Deep is My Well of Resilience?

I decided to really step out of my comfort zone during my second semester of college by signing up for a world literature course. I had taken the standard American Fiction literature class in my first term and thoroughly enjoyed it. I recall spending a couple of hours a week reading various short stories and poems, and then an hour a day in 3 weekly lectures, where the professor pointed out all the intricacies and hidden meanings that I had failed to grasp while reading my assignments. It was pretty cool for me to both be exposed to such a variety of fiction, and to start to learn to see deeper meaning and really gain a better understanding of what I was reading. That's what college is mostly about, right? Learning how to learn!

What made this world literature course so different from my American literature class was that it involved a great many more hours of reading some pretty intense compositions. We would only meet once a week for a 3 hour lecture on Monday evenings from 6PM to 9PM, but these lectures turned out to be seriously exhausting for me, both mentally and physically.  The professor had a reputation for being quite tough. After a relatively easy course load during my first semester, I may have been a bit naive about exactly how challenging this particular class would be. When I first scanned through the syllabus, it appeared our first week's assignment was to read the Old Testament! Fortunately it turned out that we didn't have to read the entire Old Testament in a week, but had a long list of selected passages, one of which was the complete Book of Job. This would be the subject of the first lecture. This was many years ago, before computers were ubiquitous and one could easily access summaries and analyses of anything online from sites like wikipedia. At that time, buying printed Cliff Notes was the only real source of this kind of info for the various novels and short stories in my assignments. However, my budget was already stretched quite thin, and I don't think I had spare money to buy Cliff Notes for this class.  I also remember having almost no free time that spring, spending hours and hours every day reading, with barely anytime left to do my calculus homework. Fortunately for me, math was easy!

Building bridges isn't easy and it takes a long time!
Want to know what's really hard. Building bridges!


Now I'll admit today that I honestly don't remember many details of what I actually learned in college (from any subject). It was a long time ago and, like anything, if you don't use it every day, you'll likely forget it.  I do remember reading many of the classics and some translations of more obscure prose and poetry, but I don't actually recall the plot or details of most of the things I read for this class, aside from the very first lecture on the Book of Job. This one made quite the impression.

My professor gave a lecture on a work of literature, not a book of the Bible. He talked about the characters of Yahweh and Satan and Job. This wasn't Sunday School. This wasn't about religion. This was pure literature. Lots of religious scholars talk about the Book of Job as a way of discussing how an omnipotent God allows bad things happen to good people. Some of Job's colleagues tried to convince Job that he'd done something wrong or wasn't pious enough. Job defended himself to his friends, while he struggled, but maintained his faith in his God through all his bad fortune. In the lecture my professor talked about how the character Satan tricked the character God into torturing his most loyal and faithful follower, Job, and how clever the character Satan was and how easily tricked the character God was. I will never forget stumbling out of that lecture, in awe of my professor and how he'd gone past this as scripture and had delved into it as pure literature, with a lecture on characters and plot. Given that I was attending a church affiliated college at the time, it seemed especially bold.  If lightning didn't strike in the lecture hall that night, surely the president of the college would take offense and condemn my professor. But none of that happened. And this wasn't the last time in college that I would learn to see things in a way that challenged my previous beliefs and shed more scales from my eyes.

Over the course of my 4 years attending (2) liberal arts colleges, I took a number of classes in philosophy, history, religions of the world, and political science. As it turned out, the more I learned about these things, the more cynical I became. As a freshman, I started out planning to major in political science and eventually going to law school. But at some point I realized the system rarely seemed fair and to quote the musician, Richard Thompson, "good things happen to bad people."

I went on to graduate with a Bachelor of Science in Computer Science and Mathematics. Math and Computer Languages were well defined and worked in a very predictable way and just suited my analytical brain better.

Now I've made no secret of my belief in science and research and that I hold little regard for religious dogma. In my post about my cancer diagnosis a couple of years ago, I stated that a positive attitude would help me not to be miserable while science healed me. I don't think people get sick because they are bad, or get healed because they are good. There's genetics and bad luck and yes you can certainly contribute to your own bad fortune with poor choices. But I survived a broken back because a great surgeon was on call and knew how to repair me. I survived cancer because generous people had funded dedicated researchers who found a way to treat my condition.

I am by no means Job, a pious individual with great faith. And I don't compare my experiences over the last 4 years to his or the real tragedies of anyone else. But at some point this spring I really decided I was tired of exploring the depths of my well of resilience.

As a cyclist, I know how to suffer. No... wait... I love cycling and I ride my bike for pure pleasure. Cycling isn't about suffering!

But I have ridden some tough events over the years, both short and intense and long and challenging. So indeed some times there has been Type-2 fun. Type-2 fun is the type that isn't fun at the time, but looking back might still not seem like fun, but it is certainly rewarding. That's Type-2 fun! And the amount of Type-2 fun I've incorporated into my life may suggest that I have a reasonable threshold of pain.

A day or two after I was hit and broke my back, the PT at the hospital came and got me out of bed for a walk. I walked so far that day that I no longer qualified for PT! I continued to walk over the next few months, and managed to keep myself in reasonable shape, walking up to 8 and 10 miles a day. Once freed from the back brace and allowed to ride, I came back with a vengeance. I still had a lot of pain and eventually had hardware removed and faced another long recovery. Then came cancer, which slowed me a little, but again I kind of lived in denial that this could hurt me and rode my bike to chemo. Then last summer, as if to prove I was again strong and healthy, I toured 5000kms around Ireland in a little under two months.

A few months after completing that tour, as if I jinxed myself by making more big plans, I crashed and broke a collarbone in January. However 10 days after surgery, against doctors' suggestions, I was back on my bike. Then in April, just as John was ramping up his training for a big race, he crashed and broke his collarbone.

A few weeks later, while he was still convalescing, I headed out on a longish ride with a friend. My shoulder and arm began to throb. I've had shoulder issues ever since I broke my first collarbone back in 1996.  I've known for a while that I have pretty bad osteoarthritis in that shoulder. I've had a few cortisone injections and done quite a bit of PT to try and maintain range of motion. I've even had minor surgery for a debridement and to remove some of the broken off bits of cartilage.

There is supposed to be a gap between those bones!


When I saw the orthopedic doctor this past spring, he talked about more extreme options. I joked, "Oh, like a handlebar bag?" Since I could no longer rotate my arm around to get stuff out of jersey pockets, I've been relying on a 'bar bag for all the things I used to stuff in jersey pockets. But  he was really talking about the extreme of a total shoulder replacement. I looked at the literature and said that I had too many plans for the summer. Maybe later... John's job was coming to an end in June and we had big plans to spend a large part of the summer cycling in Spain.

But then the pain got so intense over the next few weeks that my rides grew shorter and shorter and I almost stopped riding. Pain meds weren't helping. Ice didn't help. Heat didn't help. E-Stim didn't help. And then I couldn't sleep.

"This is not fair!" I screamed out to the universe. I don't even use my shoulder. I don't play tennis or baseball. I'm not a carpenter, hammering away all day. I'm just a cyclist, who needs the shoulder to get my hair in a ponytail. What was even worse was that no previous injury or illness had caused me pain like this! My 1-10 scale had to be altered again! The doctor ordered more images and the reports showed I basically had no cartilage left and it was now just bone rubbing against bone. And he told me that I had exhausted all the options. Injections wouldn't help. Debridement wouldn't help. Removing those giant loose pieces of cartilage wouldn't help. He would have to go in and pull back my rotator cuff, cut off the top of my arm and insert a metal ball and replace the socket with plastic. There would be pain initially and a long recovery, but then the pain would go away. And I'd be pain free again and might even be able to use jersey pockets again.
 
So I finally gave in and scheduled the surgery. We then cancelled our summer plans. For the first time in years, John had an extended break from work and sadly we wouldn't be able to take advantage. But I really and truly had no other option.

So if you were wondering why the blog has been so quiet...

The next thing the surgeon told me was "No cycling!" He said I'd be in a sling for 6 weeks and would have serious restrictions on my right arm for a long time. He told me I could do desk work, and then described the box I could move within. I would be able to straighten and dangle my arm, bend at the elbow and rotate in. Not back, not out to the side, not to the back and not overhead.

I asked if I could walk outside. He said OK. But I'm not sure he realized what I had done before and what I had in mind.

But he repeated, "No cycling!"

So, naturally, I came home and started researching recumbent trikes. I found a dealer nearby and despite an attitude I interpreted as the shop owner's best effort to run himself out of business, I brought home a cute baby 'bent tricycle. (His shop must be a front for something nefarious.)

For my first ride, a month before surgery, I headed home from the shop a somewhat indirect way, over something called Mountain Road. I wasn't sure the trike would fit in the car, so I had ridden over on a bike that I would retrieve later with the car.  The next day I did a  longer ride and each ride after was longer and hillier and I didn't hesitate to do dirt. Admittedly, I did order some wider tires to provide a bit more suspension on dirt. And it was fun, hard, but oh so fun. Go-cart fun. Silly, fast, leaning hard into corners, descending with a grin-fun. Sure the leg press climbs were more Type-2 fun. But seriously, it is fun, with a capital F. Yes F'ing fun!

I also found the trike took all the pressure off the shoulder, as well as my lower back, and I was riding with much less pain than I have in almost 4 years. I experimented with riding one handed and theorized that I should be able to get back on the trike soon after surgery, much sooner than my doctor would prefer.

My surgeon is pretty conservative and cautious and said I could ride indoors, but he really didn't want me outdoors and risking falling. "But it's a trike - no falling over! Look at these photos.", I said as I pulled out my smart phone.



If you are a regular reader here, you know how important cycling is to me. It's how I define myself. I am a cyclist. It's what I do. It's my release valve. I need to cycle. I just need it. I freely admit that I'm an bike-aholic! And I am really tired of fate trying to intervene and cure my addiction!

Anyway, I rode the trike a lot in the month before the surgery and suddenly found myself using very different muscles. My calf muscles must be bigger now. We should have measured before. I still even managed to get out on my bike a couple of times, thanks to getting some relief from the trike, but each time I rode the bike it was made more and more clear that the warranty on my shoulder was well and truly expired. A quarter of a million miles is the limit! No more.

Then came surgery and then came even worse pain. I had opted to have the nerve block after surgery. When asked my level of pain on a scale of 1 to 10, I said 24. I really started to question the depths of my resilience. I was tired of bad news. I was tired of pain. I was tired of having to go to Plan B.




No one will be surprised that I managed to get out on the trike about 10 days after surgery. I had experimented a lot before with being able to ride one handed in the sling, but the sling wasn't even necessary and seemed to aggravate various muscles.  I sat down on the trike one day and confirmed that my position is one I am allowed. My arm is supported and within the box that the surgeon described. I'm really just reclining in an easy chair, one that moves because I push my feet against something.  I'm not using my shoulder muscles. This can be a challenge when the road goes up, but I just shift down with my left hand and spin it out. Once healed I can push back more and maybe some upper body muscles will be engaged, but not yet.

So John and I rode into town together to get coffee. I think it's a 3 mile round trip. That went well. Walking, OTOH, really wasn't going well. Sling or not, my arm and shoulder muscles would just go into spasm. So I finally decided that I just had to go for a ride.

I believe that the risks of being outside on a recumbent trike offset the risks of insanity - for both me and John. There have been many very stressful days of dealing with pain. And the current political environment unites both parties in a desire to restrict access to pain meds., because some small percentage of people are at risk of abuse or addiction. This denial of pain meds. to me started in the hospital within 24 hours of surgery. Because the pendulum has swung so far against the use of pain meds., it is becoming harder and harder for folks in legitimate need and without risk factor to get them. Folks who want to abuse them will still find a way, and it may be the restrictions that are leading more people to go to more dangerous street drugs. I've talked about this before here and may be at risk of sounding like a junkie... I'll just say there's got to be a better way than to treat everyone like a junkie, including someone fresh out of surgery.

Stress makes pain worse! And it snowballs and spirals out of control. Stress causes pain. Pain causes stress. Pain intensifies and if you don't get on top of the muscles spasms, they just won't go away.

Screw it, I'm going for a trike ride!


One night the pain got so bad that I went to the ER. I looked down into the well of resilience and saw my reflection. I thought this must be the bottom. Turns out it had been raining lots and was just filled with water. My well is much deeper!

I'm happy to say that I've worked out better pain control with my PCP and a pain specialist who does  acupuncture. I'm not clear of pain yet. I still have lots of trouble sleeping. I have a long recovery ahead, but I do feel like I'm pointed in in the right direction - just not downhill with a tailwind... yet.

And I've finally stepped back to look hard for hidden meanings, like I learned to do in my literature classes. I've adjusted my perspective about the meaning of Plan B and resilience. Sure, things have been hard for me, but I am still one lucky gal, who's too superstitious to say anything else.


But I will say it has gotten much easier to cross the railroad below thanks to this bridge!







5 comments:

  1. Always an inspiration and a reality check. Love your prose Pam.

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  2. You. Are. Amazing. This is all...

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  3. Enjoy the trike. I ride one to deal with carpal tunnel when it flares up. It's not the same as a bike but it beats being indoors. I hope your shoulder improves and stops causing you pain.

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  4. Thanks to all for the kind words, both here and direct. Exciting update... I saw the surgeon yesterday, 4 weeks + 1 day from surgery, and was granted freedom to move! Of course after not moving much for 4 weeks and a day, I'm pretty stiff and week, so I can barely lift my arm without assistance. Using pulleys this morning I managed to get it up to shoulder level. My first PT appt is next week. My PT is high demand, so it's really hard to get appt's. But forward progress! Very exciting!

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