Archive for the 'Injuries and Physical therapy' Category

The Quest for Breath

You could almost make an entirely separate blog to chronicle the issues and idiocies that I endured trying to find out why I couldn’t breathe normally last summer. The lung fail was intermittent, never seemed to happen when I actually was at the doctors’, and, apparently, was considered to just be “weird.” My first visits weren’t very useful, and with work and training taking up so much time… I kinda got lazy about following up with the docs. After the OLH failure though, I got serious about finding out what the hell was going on with my chest, called the Kaiser urgent care line and gave the dude on the phone the rundown:

Randomly occurring chest tightness that kept me from being able to get “over the top” when trying to pull in a deep breath. Food, allergens, stress, work and exercise do not seem to have a direct correlation. Occurs at any time of the day without warning.

This description quickly spawned a battery of increasingly ridiculous (and ultimately useless) tests with freakishly normal results.

  • Assigned on a whim inhalers: Worthless. Given as a result of basically no testing, and, other than fueling one fairly awesome climb, had no impact on anything (other than a weird feeling on my teeth).
  • Chest xray: clear. No pneumonia or other terribleness.
  • Skin-stab allergy test: I am allergic to nothing.
  • Sub-cutaneous (stick shit UNDER your skin) allergy test: I am still allergic to nothing. Except histamine. But everyone’s allergic to that.
  • Pulmonary function test: I have “a really gorgeous set of lungs.” Yep. Someone actually said that to me, and it was exactly as creepy as it sounds. Lung tech may or may not have asked me to do extra breaths just so he could see results in the 90th-plus percentile again. Must be sad to only ever test old people.
  • Weird stretching exercises to expand my chest muscles: good for me (as I’m terribly inflexy), but offered no measurable result for breathing.

In the end, the doctors never figured anything out, and my issues eventually (weeks later) subsided. Personally, I think I strained my chest wall in a core class and noticed tightness issues whenever I really thought about taking in a deep breath.  My mom swears I was having panic attacks (a theory on which I still call bullshit! Other than the one day with ashes, I never even came close to hyperventilating!). I can say, for sure, that the breathing problems made most of last summer season’s rides challenging. Some were better than others, but none were great — which was a really tough pill to swallow in my first season as team support. I muddled through the best I could though, “taking one for the team” to hang back with anyone having a bad day — and did successfully complete most rides.

Speaking of, is anyone else ready to get back to the ride posts? Me too. On it!

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HMB hates me

Dear Half Moon Bay:

I’m sorry. Really. I have no idea what on earth I might have done to offend you (especially considering that I’ve never really come to see you save on rides… actually maybe that’s it? Lack of attention?), but I swear I didn’t mean it. I’ll be good from now on, I promise. I’ll visit as often as you want. Or at least at some interval that’s reasonable. I’ll invite friends to see you. Throw a party for you. Take pretty pictures with the doggies on your beach. Or not. Just, for the love of Pete… tell me what I need to do to get you to stop randomly injuring parts of my body!

Best,

That chick who’s calf you spazzed out on that 7/11 ride

So, in case you didn’t catch the drift… my version of the team’s 50(ish) mile Half Moon Bay ride (two Saturdays ago) was a bit less than ideal. The day started off well enough. The weather was a bit cold and drizzly, but our quick “still feeling fresh first thing in the morning” pace was enough to get the engines revved up. By the time we hit the first mini-climb, I was glad that I’d left the leg warmers behind (the arm coolers were totally still a good call). After minor mechanical difficulty (Brent had some flat-tire issues), we regrouped and rolled down for a nice descent into the valley.

And thus the first 18ish miles passed almost without incident. We joked, laughed, took our turns pulling, and just generally enjoyed the scenery. The coastal views and mountain/valley action are really quite gorgeous. You still listening HMB?! I complimented you there!! Somewhere along that stretch we did end up leaving Brent and Geoff behind (HMB is a tough ride to start back on after a couple weeks out of training), but the rest of the team maintained a great line all the way up to the first actual climb (not a bump!).

Somewhere around two miles before we turned onto Haskins Hill, my right calf started feeling a bit… twingey. Yes, I realize that’s not really a word… but it’s the most accurate that I’ve got. Every few pedal strokes something seemed to pull back up feeling a little… well… wrong. Now, this wasn’t my first rodeo(ride?) or my first pulled muscle precursor. I knew something felt off and immediately took to pounding sport drink and chomping down some shot blocks every time I dropped to the back of the paceline. By the time we actually hit the base of our climb, I was pretty sure that I’d staved off any issues and wasn’t really worried about a thing (other than actually reaching the top). Shows how much I know.

I actually had a nice sit and spin ride up 99% of Haskins. Its a fairly long climb with a ton of little switchbacks and a few false summits… but it is also well shaded and is of a mostly gradual grade.  Having done this hill a couple times before, I actually had a pretty good idea as to when it would end (yay for recognizable landmarks), and started to pick up the cadence …or at least tried to… for the last couple curves.

And then, out of nowhere, my left calf gave one… two spasms… and (just as I crested the summit) it locked solid. And I mean solid. Screamingly so. The kind of cramp where you have to shout because it hurts so much. (And yes, for some unknown reason… for all the warning signs that I got from the right leg, it was the left that cramped. Who knows?!) I managed a miraculous one-legged unclip dismount, handed my bike off to our friendly neighborhood SAG (who was fortuitously/unfortunately positioned to see the whole thing), and hopped across the street to whimper and stretch. At least I made the top first, right?

By the time the rest of our ride group had reached the top and recovered, I decided to go ahead and keep rolling (or at least to attempt to do so). I didn’t want to leave the team entirely without ride support, and the rest stop was only another 10 miles in — how bad could it be? Pretty bad. The descent off Haskins went well enough; at least I remembered to keep feather-pedaling to keep from re-cramping too quickly cooled muscles. I really had to baby the left leg into the rest stop (I couldn’t pull up with it at all), but did manage to make it into the parking lot without further incident.

Knowing the likely culprits for muscle cramping (Potassium or salt deficiencies), I headed straight for the SAG table and snagged a whole banana and two roasted red potatoes, rolled in season salt – well the potatoes were, I mean. I refilled all my bottles, gulped down some more Cytomax, then went back to stretching (thanks to George for his help in targeting that darn calf muscle). By the time we rolled out, I was feeling… still tight but a bit better overall.

And then, just for extra bonus fun, we hit Stage Road. I’m sure you all remember how much I love that “little” stretch of pavement (2 broken bones ringing any bells here?). Well, for the record, I love it even *more* when I get to climb it with one gimped leg. No… really! Ok, ok. You caught me. Not really. The only positive note I can give for this series of climbs is that I did, in fact, manage to do them, fail left calf muscle notwithstanding. I also didn’t burst into tears (or even really consider doing so) when passing my accident spot this season. In fact, my Stage 1 descent was actually pretty darn smooth! You hear that HMB?? You haven’t crushed my soul yet!

By the end of the Stage 2 hill, I was pretty much toast. Everything felt off-kilter, as I was only push-pulling on one side… which tired me out darn quickly. The last stage climb back up to Hwy 1 was, well, rude. It’s actually not particularly steep or difficult, but (as I learned in my Tour de France coverage watching) placement in the ride matters. We hit the “final final” summit with only really 10 miles left to ride, and I think most of the group was feeling pretty beat up by that point. We did get some nice downhill action and some truly lovely views coming back down the highway (sadly, 30mph descents on a major thoroughfare… not the right place to bust out a camera), and finished, mostly intact in just under 4 hours. **Appeases the HMB with many compliments in a single blog post**

I dragged myself home after a quick burrito refill, and got to work on leg repair. I hot showered, iced, and IcyHot-ted before, ultimately, trusting its care to a professional. I was lucky enough to get a massage appointment in the same day, which helped a ton in relaxing all the terribly torn tissue. I did, once again, skip the Sunday recovery ride (I could barely walk… especially after an ill-advised bowling session late Saturday night) as well as Tuesday night hill repeats to allow for a bit more babying time.

I am definitely glad that I finished the ride, even though it meant doing 30 miles on a bum calf. I’m not sure why my Half Moon Bay karma is quite so terrible (did I ride over its invisible dog?!), but, thankfully, I won’t have to test my apology effectiveness letter for probably another year.

TNT Ride #5 HMB

Still Scarred, Albeit Smaller

As I mentioned before, the goals of my most recent surgery were twofold. The primary reason is obvious – get the evil, painful wires out. As a secondary benefit, the surgeon was going to try and make the massive ugly scar on my arm look a bit better. Apparently it is hard to get a clean scar on a road-rash covered elbow, so the marks on my arm after surgery one were pretty gnarly, at best. Plus, its hard to regrow skin on an elbow, since the cut goes right over the bend in your arm. Lots of stretching equals larger scarring. Yay fun! Since the skin was pretty well healed up this time around, the doc figured he could make the arm look at least a little better (mind you I would have gone in either way…those dang wires needed to come out!).

The surgery itself was pretty uneventful. Started relatively close to on time, got out the same day. Took pain meds for a few days, but overall this second round was much easier than the first. Not having a busted collarbone probably helped with that. They sent me home in an ace wrap and a sling (hooray for no plaster!), with strict orders to change the dressing in exactly four days. Good thing I’m an old pro at one-armed bandaging, right?

Two weeks after surgery, I was scheduled back into Kaiser to have my stitches taken out. Except when I get there I’m told that I have internal stitches and there’s nothing to remove. Sweet. Glad I had to give up an afternoon and receive several threatening (reminder) phone calls for that. (Seriously, I think the Kaiser appointment reminder people are mob-trained or something. They scare me!) On the bright side, my wound “looks great” and I was cleared to resume all activities without restriction …washing and lotioning included. Woohoo! All in all, a successful second surgery.

A Second Surgery

In case you haven’t heard, I’ll be headed back in for surgery on my elbow next Tuesday. The wires that they wrapped around my elbow have been driving me pretty much nuts; I can’t set my elbow on anything harder than a couch pillow without wincing in pain. So I called my surgeon up and asked him to take them out. He agreed. The good news is that my arm will be a lot less sensitive, and they may be able to remove some of the scar tissue from surgery one. Bad news is that I’m off the bike for about two weeks while the skin heals back up (faster recovery time than before at least!).

On top of that, I had to get a pre-op workup done this weekend, as the hospital anticipates “extremely high turnover” Tuesday so they won’t have time the day of. Not a huge deal, except I had to miss this morning’s ride to go verify that I’m not pregnant, hypertensive, anemic or any other random condition that might prevent surgery. You’d think I would have found this out before yesterday, but with only 5 days between my request and the surgery…apparently you have to adapt to last minute appointments. After a couple weeks off the bike due to the holidays (excepting spin class week), I’m hoping that I can manage not to fall too behind my teammates in training. Le sigh. Think I’m going to go out and hit the LGCT now to get a few miles in while I can!

5,000 Seconds

That is approximately how long it would take me to do every single exercise that my therapist has assigned me per day. Well, that’s how long it would take to do each exercise for 12 reps, holding for 10 seconds, with a 5 minute buffer in between categories, and a 30 second buffer between exercises. But that seems like a long time, right? That’s why I wrote it in seconds. 83 minutes isn’t actually all that impressive sounding. And yes, I really did do the math. If you didn’t know I was at least a little geeky by now, you haven’t been paying attention! Don’t believe me? Take a look:

Disclaimer: Yes, the following exercises all have technical names and were not simply invented by me. That said, I am not interested enough in being correct to go find the papers containing the titles. Plus my names probably give a better mental picture than “Shoulder Flexion (Assistive)” anyway.

Foam Noodle Fun (that surprisingly doesn’t involve hitting someone with said noodle, OR a pool…le sigh)

  • Climb the Rope
  • Shifty Arm Box – make a box with your arms, while laying on a noodle, and shift the box left and right. What would you call it?
  • Swing the Arm Triangle – same thing, only a triangle this time!
  • Rolling Pin Arm Desensitizer

Stretching with a Stick (again with the no hitting)

  • Lay flat, raise stick overhead – simple, right?
  • Lying Bicep Curl – oh, oh, I should have said “supine” like other people should know what that means!
  • Use stick to push arm out to the side. Cry.

Pulley Exercises – yes, a real pulley is currently hooked to my front door

  • Generic alternating arm pull up – just like you do at the gym, only with zero weights involved.
  • Same thing, but out to the side
  • Freakish stretch arm behind your back and up between shoulder blades (aka oooow)

Everyone’s Favorite Stretchy “Not-Level-Zero” Rubber-band

  • Try to pull the arm straight – stand on the end of the rubber-band and let gravity (and some force) do the work. Apparently they aren’t working hard enough yet.
  • Side Pull downs
  • Standing Squeeze the shoulders together
  • Rotator Cuff stretch (front)
  • Rotator Cuff stretch (back)

No Cool Gadget to offset the pain for these Exercises (if you consider a pool noodle cool)

  • Quadraped Weight Shift – get on all fours and put your weight on your bad arm. HA!
  • Glenohemural Joint Greasing – drop your elbow to keep your shoulder lubricated (don’t ask me, I just follow directions)
  • Lift the soup can to the front – ok, technically this is “Lift the 1lb weight to the front” but I don’t own 1lb weights, so a soup can will have to suffice
  • Lift the soup can to the side (see above)
  • Lift the soup can behind you (you get the idea)

All told?
20 exercises x 12 reps x 10 seconds per exercise = 2400 seconds

20 exercises x 30 second break between types = 600 seconds

5 categories x 300 second break between categories for setup and “travel” time = 1500 seconds

Inevitable falling off of noodle at least once due to dog interference and therefore necessary “beat the dogs and reset” time = 240 seconds

Grand Total: 4740 seconds daily!

Add to this estimate “time stopped to fast-forward TiVo”, “spacing out while watching tv”, and “randomly necessary Charles interruptions” and you’re over 5k seconds in no time. Throw in a weekly 45 minute long therapist visit, and I’m not really sure that I have time to eat or sleep. I tried using therapy as an excuse to get out of work, but that hasn’t gone over well…yet. So, in case you were considering it, don’t break your collarbone and elbow unless you have a spare 5,000 seconds each day to dedicate to boring, and painful exercises.

All Clear on the Arm Front!

Well, mostly.

The short version: As of my doctor’s appointment yesterday, I am cleared to start riding, running, yoga or any number of other physical activities at my leisure. No heavy lifting for another 2-3 months, but all other restrictions are lifted. Hooray! Let’s bust out the road bike tonight, right?

The long version: While my bones appear to be fully healed, my muscles are still…well, wussy. Two months of utter inactivity has left me with pretty nasty tendinitis in the area around my rotator cuff, and my overall arm strength is “not bad, but could be better.” Unfortunately, there’s no magic cure – just physical therapy. Up to three more months of it. Le sigh…it could be worse.

In other news, the bumps in my arm that I thought were bruises are actually the flippin’ wires!!! Apparently, my skinny twig arms paired with a general lack of muscle covering the elbows on humans allows me to actually feel my more bionic parts. All together now….eeeeeeeewwwwwwwwww. I guess it’s good that I’m not still horribly bruised, but …*shudder*. Also, the sensitivity of my forearm is due to the surgery, is normal and will eventually go away. The best way to expedite it? Rolling it on the stupid foam thing or massage. Any arm-massage volunteers? As expected, I scored worst on arm-straightening (insert frowny face here). Theoretically I should be able to get it straight using my own force (ow?) in the next couple weeks (I’m really close!), but the doc is ordering a straightening brace just in case. You wear it at night and some spring-loaded rubberband thing pulls your arm straight in your sleep. Assuming you can actually sleep with it on. Oh well, I’m willing to give it a shot.

Given all that, what’s the plan? Will this blog ever have ride entries again? Yes…just not this week. With the tenderness that’s still present in my elbow, I’m pretty sure that jumping out onto the road immediately isn’t going to work. I just think about the jarring bumps on Willow Street and cringe (shooting elbow pains while driving are still pretty commonplace – I’m guessing these would be even worse on a bike). So for this week I’m going to get the bike up on the trainer and see how I respond to weight on my shoulder and elbow when leaning forward. Hopefully we’ll have everything hooked up tonight and I can make some assessments before this weekend. Assuming everything goes well, I should be ready to hit the road for real by early next week. I’ll have to keep the first couple rides tame (and likely short), I’m sure, but I’ll be back in the saddle! So exciting!! I’m nearly jumping out of my skin at work with anticipation. Of course, that could just be the caffeine. Whatever.

Cue *Back in the Saddle Again* music…

You Can’t Sleep in the Hospital Parking Lot

Last week I showed up 15 minutes late for my physical therapy appointment. Not surprisingly, the desk clerk quickly turned me away as my appointments only typically last 30 minutes. While I understand the concept – show up on time or don’t show up – morning traffic on 280 is nothing if not unpredictable, and I was more than a little irritated to make the drive to the hospital only to be crisply rebuffed. To compensate, this week I got up a full hour earlier and was out the door for my 8:30 appointment by seven sharp. This put me in the Kaiser parking lot by approximtely…7:15. (Remember what I said about the traffic?)

What’s a girl to do with a full hour plus to kill in a hospital parking lot? Knowing that the office didn’t take latecomers, I assumed the runes would be much the same for early-birds. With my luck, turning around and going home would likely net me the same result as last week. So, I went for the next best thing. Sleep in the car. Mind you, sleeping upright for me is a challenge. Sleeping upright with a broken collarbone is even more so. Sleeping upright, with a broken collarbone, in a tiny Beetle convertible? Nigh on impossible. (Oh, and let’s not forget the fact that the sun is out and shining?) But I had over an hour to kill and figured, with any luck, I could net a full 10-15 minutes of sleep when you account for the time it would take to get to sleep and the time it would take to walk into the office. I even set the alarm on my iPhone in anticipation.

Back support pillow in place, windows rolled up, head lolling to one side, I attempted the impossible. Car nap. I tossed and turned a bit – as much as is possible in the front seat of a Bug at least – and eventually found a comfortable-ish spot. I started to doze.

Taptaptap.

What the heck? Must be imagining things in my pseudo-sleep state. Grunt and turn head.

Taptaptaptap.

Open eyes…slooooooowly

And there he was. Hospital parking lot security guy. He seemed friendly enough. Something akin to my grandfather when he was young-ish. I cracked the window.

“What’s up?”

“Are you OK?”

*Checks self over* “Yeah, fine. Just catching a nap before my PT appointment at 8:30.”

“OK, I just had to check because…”

At this point he launches into a story about how someone died (or might have died. He can’t really give details) in the parking lot of the hospital. They’d come for help, but couldn’t get out and the guards just through the person was asleep and never checked. It was hours later… And now the policy states that… and so forth and so on. You get the idea. And while I was completely sympathetic to his plight at having to follow policy (and was utterly polite during the whole conversation. A huge feat for pre-eight am talks), I have to confess to being just a twinge annoyed that I somehow missed out again on the elusive experience that is car nap. I tried (unsuccessfully) to reclaim the sleep that I almost had, but eventually gave up in favor of watching Hospital Parking Lot Security Guy interrupt other people’s naps. It sorta made me feel better to know I wasn’t the only one suffering.

And this whole story prefaces what was an otherwise uneventful physical therapy appointment. I started strength training, which involves me standing in different positions and pulling on an over-large rubberband. And, for the record, I am on the level ONE rubberband, which is not the level zero, which makes me feel better. The physical therapist can’t clear me to ride, but she did say that my progress is excellent. My arm is straighter than ever, and hopefully the strength training will bring back enough stability that my arm raises start improving. Overall, good news, but uneventful. Hence my lesson for the day instead – you can’t sleep in the hospital parking lot.


What do we have here?

An often sarcastic, occasionally humorous journal of my training adventures in preparation for the Livestrong century ride. I took up cycling back in '07 in hopes of meeting new people, and, with the help of Team in Training, making my small positive difference in the world -- and haven't stopped spinning since. Follow along as my Trek road bike and I try and hash out our differences, hopefully with me upright and in the saddle.

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