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Photo by Jason DeVarennes

Wednesday, April 25, 2018

There is no such thing as fate, so stop tempting it

I often talk about superstitions  - the ones that you can't say out loud what you fear... or it will happen. But let me just state that I firmly believe in science. (It's sad that one actually has to state that these days!) I don't believe in fate and I know that I can't tempt fate by saying something out loud - or typing it - or even thinking it.

Despite all that, I have threatened to ban people from my rides because they insist saying something silly like, "At least it's not raining." Despite all scientific evidence that this cannot possibly cause us to suddenly get soaked, it almost always does. As a result, I practically forbid ride companions from evening uttering the R-word. See what I did there: cause and effect. You talk about rain... it rains... causing me to not want to ride with you again.

So given my reputation for this weather superstition, readers must have noticed me tempting fate by vowing not to write about yet another injury/recovery. Well, here we go again... I do promise to post way more about rides and tours, but humor me now as I write about my latest adventure.

In January of 2017, I was out riding my new fat bike and let's just say that I found myself in conditions beyond my skill level.  I recognized this relatively quickly and turned back. I was inching my way back down the icy rutted track and almost within sight of the end of the dodgy part, I found myself on the ground with a busted collarbone. It wasn't too bad. I walked most of the rest of the way back to where we started. I saw a surgeon and had it repaired with a plate and was back riding within a month. Eleven months later, the plate was bothering me so much that I had it taken out. Then three weeks after that I was reaching overhead to adjust a heat vent and it re-broke in the same spot. The surgeon who took the plate out was adamant that it had healed properly and that we couldn't do anything else until the screw holes fully healed. A second opinion suggested otherwise and after more downtime than I'd prefer, I got it repaired again, this time with a bone graft from my hip. A rubbery fibrous joint had formed at the original fracture site. This was cleaned out and bone and barrow from the iliac crest were packed in to form a basis for healing. The new surgeon put in a plate across the full length of the collarbone, and now we just get to watch it heal.

I had hoped to go home the same day, but woke in so much pain that I agreed to stay the night at the hospital, just so they could give me strong pain meds. While the donor site, the iliac crest is not weight bearing, it was extremely painful and I could barely stand up. I'm sure the surgeon had warned me that it would hurt, but I didn't realize just quite how much.

In the last five years I have broken my left collarbone three times. I fractured 4 vertebrae and crushed a fifth. I also broke 6 ribs. I have been treated for breast cancer, complete with a year of infusions and a bilateral mastectomy. Then last spring the osteoarthritis in my right shoulder resulted in me having no cartilage left at all, so I had a total shoulder replacement. 

When I got the shoulder prognosis, I bought a recumbent trike to enable me to ride without any stress on the shoulder. The trike was handy because it allowed me to safely ride through my recovery. While it was fun like a go-cart, it was also very hard work and I was thrilled after a couple of months to get back on my regular bike so I could keep up with friends and ride my beloved dirt roads and trails.

Maybe it's superstition talking, but I'd just packed the trike away in the basement when I re-broke my collarbone.

Needless to say, there has a lot of pain in the last 5 years, and my pain scale has been adjusted accordingly. I've also become way too familiar with pain medication.

But the current climate is one that is unfavorable for prescription painkillers. So despite the fact that I have some amount of pain everyday, I am completely off all painkillers and anti-inflammatories. 

Shortly after my latest surgery, a friend, who is also an anesthesiologist, sent me a link to an article about the experience of American woman in Germany, who had just given birth, and was told to simply take OTC Tylenol. The thinking there is that pain should be a guide/limiter. You should rest and recover.

The problem I have is that a lot of my pain is a result of weakness and I need to do some strength training to rebuild muscle. But those activities are painful. So where is the point that I let pain stop me, versus pushing through. 

The big problem for me is guilt. I can't rest. I have to ride or walk or something, because otherwise I'm just being lazy. I'm also not a spring chicken and after so much trauma in the last 5 years, each recovery is harder and harder, and each comeback fails to bring me to the level I was before. Do I accept it or push harder?

I'm still trying to find that balance. 




5 comments:

  1. I hear ya, Pamela! I'm off pain killers completely but still struggle with shoulder year after surgery although WAY BETTER. It is a conundrum that one needs to strengthen wasted muscles and ligaments through rehab to get better but hitting the wall on pain can back flip you to lost ground. Doesn't seem that medicine has come up with a decent solution for chronic pain while rehabbing because of toxicity and side effects of meds. I've come to accept that shoulder injuries are agonizingly slow to heal but have made great progress from where I was a year ago prior to surgery and rehab. Rode my vintage bike today with its new semi-upright cockpit and hit some satisfying speed on short ride and pleased that I can ride two wheels again. This ride today is only second upright ride this year. Last 12 months hardly any riding including trike because of pain including cervical pain because neck muscles were grossly overloaded to assist shoulder movements. Surgery and rest and rehab have made a big difference and I'm lucky that I have running to fall back on during my cycling abstinence which would have been even harder without that fix. I'm experimenting with the new semi-upright cockpit to see whether this is a partial solution and if so may change out cockpits on other bikes. My takeaway from the past several years of fighting the shoulder pain is that the body is amazingly resilient but that shoulder injuries are excruciatingly slow to heal and will exact rest and recovery from me. I have made progress though but am coming to understand as you point out that there's a balance. For me, maybe a new normal. Still it's progress. You're still inspirational and I really feel for what you've gone through. Be kind to yourself! Jim Duncan

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    1. Jim,

      Thank you for the kind words. Shoulder stuff is brutal. As cyclists, we already have a hunched over posture from spending our days grasping drop handlebars. Combine that with a tendency to break collarbones and we are set back even more. I blame my first broken collarbone and lack of surgery, meaning 3 months of immobility for the frozen shoulder that morphed into osteoarthritis that resulted in my cyborg shoulder. Chemo and a year of cancer treatment wasted away a lot of muscle. Then the surgery went after more upper chest muscle. Not to pat myself of my sore back, but every time I see a new medical provider, they comment that my body has had more than its share of abuse. Yet at the same time, I know how lucky I am because things could have been much worse. This was driven home after the bone graft left me barely able to walk for a week. Now that was pure agony, couldn't ride, couldn't walk! That's when I realized what a motion junkie I am.

      I love that running is something you view positively. So it's great that you have it and enjoy it. But here's to better days for both of us going forward.

      Pamela

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  2. You are an inspiration, Pamela. From cycling crashes, I have fractured my pelvis in three places (still have a plate and four pins in my right ilium) and my jaw also in three places (in braces now after having it wired shut for awhile). I guess I should consider myself lucky compared to what you have been through! But pain is a constant companion, and like you, I have lost muscle and don't want to be on prescription painkillers. I am stubborn as I am still riding upright even when scar tissue from my pelvic fractures tell me I should probably be on a recumbent. After I broke my jaw last year from an endo, my 82-year old mother urged me to stop riding; she said that two bone-breaking injuries should be enough. On the one hand, I can understand how a non-cyclist would think that. It's completely logical. But as a cyclist for several decades now, it is hard to explain the impossibility of giving it up as long as I am still able to do it. I'm back at it and have over 1700 miles on the odometer so far this year. I hope and pray I am through with injuries for awhile -- and that you are too. And I also hope we can both find that balance you speak of. I love to read and cook and write and do other things besides cycling, but pedaling a bike is in my blood.

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    1. Hi Emily,

      Thank you for your kind words. You have had your fair share. Pedaling a bike is in our blood! Indeed!

      Pamela

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  3. You are one tough lady, to be sure. I have a shoulder that has gone from stuck, to just really painful. It takes 5 go 10 miles of riding these days for the pain to ease. I don't think it's a cycling-related injury, but I'm going to use you as inspiration when I get hit with a pang of pain.

    My wife and I have ridden the Prouty cancer fundraiser several times, and when when we're worn out, bucking a headwind with 75 miles down and 25 left to go, we start reminiscing about my sister Sue, whose active life was ended early, due to breast cancer. It's an instant tailwind to think about the energy and attitude that she brought to every challenge. There will be an extra yellow ribbon streaming from our bike this year, with your name on it.

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