All posts by Mike

Injury update report

Yikes, didn’t realize it’s been so long since writing! My normal writing “cycle” is determined by… bike rides. No bike rides, and the cycle breaks. And there will be no cycling for a while.

The accident was a week ago, Tuesday morning. Spent that morning in the ER with Kevin, but Kevin just banged up an elbow and has nothing interesting to report. He’s fully functional and back at work. My story quite different. Wednesday, Thursday, Friday & Saturday I was stuck at home, barely mobile, not enjoying life. Sleep was a concept; just no way to get comfortable. Sunday was my first outing into the real world, heading out for a couple of errands with my Karen (my wife). Got a blood test at Kaiser (for my bone marrow issue), picked up some coffee pods at Bed Bath & Beyond, and stumbled into Starbucks for coffee. Sunday was actually the first attempt at forcing the return of normalcy in routine; it would have been easy to reschedule a doctor’s appointment on Monday with my hemo/oncologist until I felt better. No; it was time to make a choice and prove life on crutches was possible.

The sleeping thing… any little micro-movements have the potential to send these incredibly-sharp pains through my left leg. I don’t know how anyone could take much of that. Nor do I know how much of that could be deadened if you took enough heavy-duty narcotics, but something strong enough to operate at that level would have to be doing a much bigger number on your system than you’d want, because those pain spikes are pretty brief but you’d be medicating as if they’re constant. This is a very long way of saying that I did have a prescription for Norco (Vicodin), was in enough pain at one point to try one, and decided a: I didn’t like the way it made me feel and b: the pain was still there anyway. There are those who say you have to “stay ahead of the pain” but given that this could be weeks and weeks of feeling like this, that didn’t seem practical without running the risk of finding something that actually worked, and there’s no way something that actually worked could be safe taken for that long a period of time.

OK, Monday’s doctor appointment. New hemo/oncologist; my original had moved on. Nice guy, he’d obviously studied my history and understood the advantages I have over most of my peeps (those with Essential Thrombocythemia, a bone marrow cancer that causes your body to product too many platelets), such that it wasn’t as critical to keep my platelet count really low as it is for most. This is significant because the medication used to reduce my platelets (Hydroxyurea) also reduced by red blood cell count, dropping my Hematocrit level. What’s the hematocrit level all about? Think cycling, the “Lance” years, and the doping they did to become stronger cyclists. They took drugs that increased their hematocrit, allowing their blood to carry more oxygen. The stuff I take does the opposite. As a serious cyclist who enjoys climbing, I watch my hematocrit carefully and want to take as little of the blood-bashing med as possible. He (the doctor) gets that. And he agrees that the spike in my platelet count on my recent blood test is probably a result of the inflammation from my injury. Platelets rise in response to inflammation because they think they might have work to do, helping to stem blood flowing from damaged organs or capillaries.

So I survive, but you gotta do more than just survive right? You gotta push limits. So instead of getting a ride back from Kaiser to the bike shop, I walk. With crutches. No strava, no proof, right? I’ve got the strava to prove it. Sure seemed like more than .7 miles though! Gained new respect for what some of our older citizens face trying to cross a wide street because suddenly I was completely without any ability to get out of the way of cross traffic. I had to use the “push to walk” buttons and even then, worry there might not be enough time to make it across 6 lanes (2 parking plus 4 traffic). But, I made it.

And now we’re at Tuesday, one full week post-accident, finally meeting with someone in the Ortho department at Kaiser. I learn that I have not one fracture of the pelvis, but two. One high, one low on the pubis rami (or something like that). Fortunately, whether one or two doesn’t change recovery time. Best guess is something between 4-8 weeks recovery time. The doctor knows I’m going to try and get back on a bike sooner than I should and suggested that a wider saddle might be a good way to start. I was also given a cane to supplement my crutches. It seems that a cane is an “upgrade” over crutches, but frankly, I associate crutches with someone who is going to be getting better and a cane with someone elderly and feeble. Clearly I still have some growing up to do!

For the next few weeks, it’s going to be all about dealing with pain and the frustration of things I want to do, but can’t. It’s also going to be a losing battle with the scale.

If pain is weakness leaving the body, I’m going to end up very strong when I’m back on the bike

On the right you can see how nicely things started, with Sundays’ ride to Pescadero. On the left, mis-matched socks and an r-rated x-ray.
It’s odd, doing a post when there’s no cycling involved, when the time until I get back onto the bike is long enough that the most-interesting question is why, at this moment, am I not severely depressed. My mobility is extremely limited; I’m typing this from home instead of being at the shop and trust me, I really want to be at the shop helping people. Last night I realized how much I enjoy the time I spend washing the dishes with my wife, because I couldn’t. Today I had to call my oncologist’s office to consider rescheduling my Monday appointment because I wouldn’t be able to get a blood test today. It just didn’t seem reasonable to try and hobble in to the lab, when I’d have to do the standing, then sitting to wait, then back up and over to the lab to get it drawn, with the phlebotomist wondering whether my wincing was fear of the needle of the pain I feel getting up and sitting down. Once sitting, I’m fine, and once moving, I’m fine. But that process in-between, not so fine.

And there’s that thing where, sitting here, I honestly have no indication that anything’s amiss. None at all. Except that I’m sitting here at 4:32pm, possibly the busiest time of the day at the shop. And that when I have to get up for something, it’s going to hurt like heck for a few moments.

So yes, I’ve studied up extensively on my particular pelvic fracture, and have come to the conclusion that most of my pain might not be from the pelvis fracture or the bruising, but possibly an avulsion fracture where tendon or ligament has pulled away from the femur near the hip. Maybe. I’ll know for sure after Tuesday’s appointment with the Ortho doc.

In the meantime, there is some sense of not knowing what I’ve got till it’s gone. My Strava profile page shows a week gone bad. The photos from Sunday’s ride remind me how things started, how awesome it is to be out there on a bike. All that ended in an instant on Tuesday morning’s black ice. Maybe I’m not yet depressed because I’m in a state of shock. Guess my first milestone will be cleaning up after dinner.