Next Up: Physical Therapy

I returned to my Orthopedic Surgeon this past Friday to have the cast removed from my leg.  It had been 15 days since I broke my leg, and ankle, on a morning run, and 11 days since my ankle was operated on.  From both a mental, and emotional standpoint, I was really looking forward to having the cast removed.

I arrived at the office, was shuttled back into the office pretty quickly, and a Medical Tech had the cast off in no time.

Wait, staples?  I knew there would be stitches, but not staples.  And surely not 16 of them.  You can't see them all here - but on the lateral side of my ankle is what looks like big zipper.  I'll come back to that later.  In the meantime I checked out the old ankle and it didn't look as bad as I had anticipated.  There was some bruising, but nothing that made it look like a prop from a bad horror movie.  And the swelling was no worse than the day I went in for the surgery.  Next it was off to X-Ray for a scan:

Very cool indeed!  A plate, 2 screws, faint shadows where the doc drilled through both bones, and "buttons" where the bone sutures were anchored.  My Orthopedist said everything looked great and we were moving on to next steps.

Initially, physical therapy will be non-weight bearing for the first week.  The focus will be on stretching and flexibility.  Week two will then introduce weight bearing exercises to start building up strength.  The really good news is that I can start swimming and water walking as soon as I'm ready.  That was quite exciting to hear.

My obvious first question for the Orthopedist: "So, am I swimming with these staples, or is something else going to happen here?" 

Yes, the staples were removed

Once we begin to introduce weight bearing exercises I can get back on my bike trainer and spin with minimal resistance.  The flexing of the ankle will be good and I'll start to use my calf muscles again.  However, like everything that's good for you, moderation is key.  If the ankle swells up and becomes painful, well, I'll need to pull things back a notch or two.

I'm set to head back to the Orthopedist in 4 weeks for a follow up consult.  At that time he'll decide how much longer I need to keep the boot on.  Maybe an additional two weeks - it all depends on how quickly things progress in physical therapy.

So, I'm making headway.  Things feel better every day, and I was quite happy to sleep without a cast or walking boot last night.  I'm well past feeling sorry for myself.  Not that I don't long to be outside running or cycling, but things are moving along quicker than I expected.  Tomorrow I'll schedule my physical therapy and start getting the strength and flexibility back. 

Not knowing anyone who has gone through something like this, I'm dealing with the learning curve of this adventure with no real knowledge base.  However, just this morning I discovered an individual who went through a very similar experience.  After reading about her injury, and how she worked through it, Cortney certainly registers as pretty tough in my book.  The recovery bar has been set pretty high.

From Running to Triathlons

As I was saying in my previous post, things snowballed quickly and the running thing really took off in my house.  My wife JL and I were eating better (thank you, JL, for seeing that we were indeed in need of a dietary makeover) and we both benefited from losing a lot of extra weight.  We thrived, and still do, with this new active lifestyle.

I became totally engrossed with running.  I still am.  I love to run.  It's what gets me out of bed in the morning (well, the coffee maker actually does that).  It gives me energy, and makes me feel great.  Running the trails with my good friends Tom, Mark, and Matt is always a highlight of any given weekend.

The club that JL and I joined - the Sound Shore Running and Multisport Club has a regular Saturday club run that we used to attend on a religious basis.  On one particular Saturday, 5 or 6 years ago, a few of us were chatting it up, talking about what we did - in regards to athletics - back in the day.  At some point the conversation came around to me and I mentioned that I swam through high school and into college.  Someone then immediately asked: "Do you own a bike?"  I didn't, and their immediate response was:  Why not?  I can't recall who it was that said this, but the conversation flowed into how I would have two of the three legs of a triathlon down pretty well, there were numerous cyclists that belong to the club to help get me started, and maybe it was maybe worth thinking about.

A little time went by, and JL and I were out to lunch on some random Saturday.  At that time we had actually been toying with the idea of buying a couple of kayaks, as a friend of ours had recently taken us out into Long Island Sound and we had really enjoyed it.  We thought that it would be an interesting way to continue to be active and to be outdoors.  I then mentioned the discussion that took place on my run the previous week, and our conversation soon turned to focus on bikes and triathlons.

Well, 2 glasses of wine later we were at a bike shop near our town browsing and asking questions.  After an endless litany of questions, and a few test rides, and we had purchased road bikes, shoes, helmets, shorts, gloves, and were heading home.

Yes, we're big fans of immediate gratification.

I fell in love with cycling.  I loved the speed, I loved being outdoors, and this was opening up new doors for for both of us.  We started to ride with the cycling group within the club on a regular basis.  I had thought I was pretty fit, but I was struggling to keep up with these guys.  They pushed me, and drove me to get stronger on the bike.  More importantly, they taught me the in's and out's of road cycling. 

Soon after, we signed up for our first triathlon.  That was the whole point of this exercise anyway.  It was coming up at the end of the summer - a sprint triathlon - and a few folks from the club regularly raced it.  I borrowed some clip-on aero bars for my road bike and started to get used to them.  JL and I went to another local sprint tri a few weeks before-hand to look at the transition area and to see how everything goes down on race day.  Yes, we're a bit OCD.

Long story short, race day came, and it was awesome.  I finished in the middle of the pack but had an absolute blast.  I was hooked.  It didn't take long for the type-A personality to set in, however. The next season I was determined to run the same race faster than before.  They hold multiple triathlons on this course throughout the spring and summer, and low and behold I came in 3rd in my age-group in the June early season race.  Well, that sealed the deal.  I started working harder, started getting more AG podium finishes, started doing Olympic distance tri's.....  Yeah, I had the bug, and bad.

And it helped that my wife was hooked as well.  Weekends were soon devoted to long runs and rides.  And there was no guilt from either party when the other headed out for 2+ hours on a Saturday or Sunday morning.  This was really working out well.

Soon, my wife (very smartly) suggested that I start training with the Westchester Triathon Club.  Our friend Rich heads it up, and he had been inviting me to join them for their Saturday rides and Sunday runs for quite some time.  I finally joined them on a Saturday morning group long ride and promptly had my ass handed to me.  These guys (and girls) were tough.  But, over time, I became stronger and faster.  My endurance improved.  I was training with some big-dogs (this past year alone, 4 folks from the club qualified for Kona) and it was paying off.  I never dreamed that I'd be regularly getting age-group podium finishes and placing in the top 10 overall at competitive tri-state races.  But it's amazing what happens when you train with people that are stronger, faster, and just plain better than you.  You raise your game up a notch.

Well, just like with running, this too snowballed into a completely engrossing endeavor.  My road bike (well, my upgraded road bike) is still in the basement, right next to JL's upgraded roadie and my Time Trial rig for racing.  We now do more laundry that contains racing and workout gear than we do regular clothes.  We joke on the weekends that we not only do our regular grocery shopping, but we now hit our favorite running and triathlon store, Westchester Road Runner, for gels, bars, drink mixes and supplements - we call it our 'real' grocery shopping for the week.

The triathlon community is great.  The people that I met are wonderful and all just as addicted to a healthy lifestyle, being fit, and racing hard.

So here I am:  My leg up on pillows (still), my ankle in a cast, waiting to get back out there.  I realize I have a lot of physical therapy to do before I'm back on the roads, but I really miss training and am going to miss racing the early season races I had on the calendar even more.

As my wife says: Have patience.

How it started: How I Became A Runner

As I sit here with my leg propped up on some pillows, waiting patiently for Friday to arrive so I can have this damned cast removed from my leg and start rehabbing my ankle, I was thinking back to how all this running and triathlon stuff started.   As I get in the 'way-back' machine and think back to 2001, I wasn't fit at all.  I sat behind a desk all day (still do) but wasn't active in the true sense of the word.  I was about 35-40 pounds heavier than I am now, I ate like crap, and my fitness routine was a once a week football (soccer) game on Sunday mornings. 

I began to run (well, jog) as a way to get ready for Sunday League football (soccer).  Sorry for the Euro-phile phrasing, but as this league was composed mostly French guys, along with some Germans, Brits, Spaniards, and Turks, it was called football.  I figured I'd hit the treadmill at the local gym and get "in shape" for the upcoming spring and summer Sunday morning run-arounds.  I think I might have run about 3/4 of a mile on my first attempt.  I was destroyed.  My wife said I look like I was going to die - my eyes were sunk in and I had the complexion of non-fat milk.  But I kept at it.  Once or twice a week I would torture myself on the treadmill and I was proud of the accomplishments, albeit small ones, I was making.  So much so, that I started to talk about my forays into running with a friend of mine at work.  I knew he ran - at least I knew he ran more than I did - and we started to bond.

My friend at work, Brian, was great.  He was supportive and kept egging me on.  "...just run for 5 minutes longer next time.   You can do anything for 5 minutes"  This continued for a while, and I was soon pushing 2 - 2.5 miles on the treadmill.  I thought this was great.  Then came his next challenge: Get off the treadmill and run outside.

That changed things.  Running was much harder.  Wind, elevation changes, concrete.  This was terrible.  But I kept at it - always trying to run just 5 more minutes on my Sunday "long runs".  I hurt more than I did on the treadmill, but I still ventured outside 3 or 4 days a week.

What I wasn't aware of is that Brian not only ran, but he ran a lot.  Marathons?  Check.  Ultra's?  Check.  Why didn't he share this with me before?  I would have been a bit more cautious in what directions I took from him.

Finally, one weekend I ran 6 miles.  Then a few weeks later I ran 8.  Slow, but 8 miles none-the-less.  That apparently sealed the deal for Brian.  The next thing I know, with Brian looking over my shoulder in my office, I'm on the NYC Marathon web page and I'm registering for the New York Marathon lottery.  I was also instructed to sign up for the Marine Corps Marathon, as a backup, just in case I didn't get into NY.  Whoa.  How did I get here!?

Low and behold - I got into New York.  Now, mind you, I'd never run a 'race' before.  Ever.  Not even a 5K.  Now I have to train for a marathon.  I promptly went to the running store and got some better shoes.  The ones I had been wearing were 3 year old running shoes that I bought because they looked cool at the time.  I got a beginner's training plan from Runners World Magazine and plotted out my training schedule.  I can't remember how many months I had to get ready - it seemed like a long time, but it flew by.

My training for this first marathon, first race, wasn't good by any stretch of the imagination.  There was no speedwork involved.  I didn't know what that was.  I ran the same speed - every day, every run.  I just assumed that the "marathon miracle" would occur and I would somehow just be faster on race day.  I still ate like crap but figured since I was running, I could.  Nutrition and hydration on long runs?  Both inadequate I'm sure.  If there was a public service announcement on how not to train for a marathon, I would have been the poster boy.

Cut to race day.  It's mostly a blur as I think back.  But a few things do stick out, and I have memories of certain things that oddly seem quite vivid:

I remember the surreal atmosphere at Fort Wadsworth waiting for the race to start.  So many people there that looked very serious and I hadn't a clue what I was doing.  It took me a while to figure out why the roads were always sticky after passing a water station.  I vaguely remember entering Central Park and people yelling "..you're almost there".  I remember thinking that they should just be quiet because I really hurt, and 4 miles to go really isn't "almost there".  It took a lot of effort to keep running the last 6 or 7 miles.  Math was impossible.  I remember seeing the 22 mile mark and saying to myself, "okay, just 4 more miles....wait, is it four?  23, 24, 25, 26 (visualize me counting on my fingers)...is that really 4?"

I finished in over 5 hours.  But I finished.  My legs were just solid knots, and walking took much more effort than it should have.  I took the subway back to Grand Central Terminal to catch a train home.  I had no long pants, or dry clothes to change into in my gear bag - I wasn't prepared.  I had no thought of packing clothes for after the race.  I was wrapped in a post-race heat blanket the entire trip home.

My wife JL picked me up at our train station.  I limped to the car and whimpered my way into the front seat. That night I swore I wouldn't do that again.  Well, we all know how that goes.  I ran a handful more marathons.  I worked my marathon PR down to a respectable 3:30-ish (I honestly can't remember what the exact time is off the top of my head).  Things snowballed from there.  JL started to run.  We joined the Sound Shore Runners and Multisport Club to get involved with the local running community.  I was introduced to speedwork thanks to my good friend and first running coach , Joe G.  I started running more races: 5 milers, 5K's, 10K's, 15K's, 1/2 Marathons.  We started eating better at home.  My race times started dropping - I started to get faster. Things really took off. 

I then discovered the drug that is triathlons.  I'll cover that in my next post.

Recovery, Rehab, and Thoughts on the ER

Allow me to preface this post with an apology.  It's very possible I'm in a bit of a Percocet and Toradol haze.  As my editor isn't available at this moment, there might be a typo or disjointed sentence (or 4) floating around somewhere.

It's day 3 after my ankle surgery.  I have to admit it's not as bad as I thought it would be.  Granted, when the nerve block on my lower leg wore off the other night I was popping Percocet like they were Chicklets.  But it's manageable.  I'm not all smiles and full of cheer, to be sure, but I'm experiencing pretty much exactly what was explained to me.

There's pain and discomfort of course, and I do have periods of time where the discomfort is a bit troubling.  But I'm finding a groove, so to speak, in getting around the house and am getting the hang of navigating the kitchen with a cast and crutches.  Sleep is fitful, but depending on what meds I'm taking I nap enough through the day and 4-5 hours of sleep at night is about all I can muster. 

I really don't have room to complain too much.....really, I don't.  I'm very fortunate to be able to run, swim, and cycle - and compete in triathlons.  As a dear friend said to me yesterday, if this is the worst sports injury that I've had, then I should consider myself lucky.  If all goes well I'll be starting physical therapy in the next 2 to 3 weeks, and then it's just a question of how hard am I willing to work in conjunction with the healing process.

My wife JL has been great.  She makes sure that I have water, fruit, snacks, laptop, etc all ready to go on the coffee table in the living room before she heads to work.  She's been keeping an eye on me since the incident happened a week ago, and without her here at home I would have been in a spot of trouble for the first few days.  But I think a corner has been turned and the healing process is underway.  I'm now looking forward to getting the hard cast off and getting PT started.

I'd like to jump back a bit, and comment on our observations on the ER, the Orthopedist, and the care that was given throughout this wonderfully fun past handful of days. 

I'll start by saying that everyone in the ER was great.  We were checked in quickly, and I think we might have waited 10 minutes in the waiting area before being brought back into triage.  There was a bit of aloofness (for lack of a better word) at the beginning.  Not that the physicians assistant and the resident docs weren't friendly, competent, and direct.  But there wasn't any real urgency in moving things along as fast as I would have liked, or thought they should have been.  But I'll touch on that in just a moment.

The on-call Orthopedist for the ER was at her practice at the time, so we saw her there on the way home.  The next day I met with the Chief of foot and ankle surgery - with a sports medicine background - for that practice.  Both were great.  Very informative, and very to the point.  If we asked questions, they listened and gave answers.  This isn't to say there wasn't a little of the usual "quickness" in their answers, but follow-up queries were accepted without being talked over.  They both wanted to understand what my expectations were, and explained very clearly the time lines and process for recovery both with and without surgery.  Once it was decided that surgery was required, the Orthopedic surgeon rang me up and told me exactly what he was going to do and again listened to all my questions.

The day of surgery was very business-like.  I think that sums it up best.  The nurses in the prep area were all business and didn't mess around.  My attempts at joking with them fell mostly flat.   My surgeon, the Anesthesiologist, and physicians assistants were actually very upbeat, direct, and offered suggestions and input during the planning process for the day.  I was put at ease by their attitude.  No complaints at all.  I will say, however, that an improvement in communications while I was in the recovery room would have been helpful.  There were a few gaps where more information and communication to both my wife and I would have been helpful on a number of fronts.  In the end, nothing major.  If that's the biggest complaint we have for the day then so be it!

So, as I said, there was kind of a strange vibe going on in the ER when we first arrived.  I was in a hell of a lot of pain, and there was just a bit of a lackadaisical approach with the people we spoke with.  I just felt that, while competent and being thorough, nobody seemed to think things were all that bad. they kept talking about a 'bad sprain' in my ankle and that I'd 'be fine'.

It was shortly after the radiology results came back that we had our little epiphany (well, JL did - I wasn't thinking much at all at this point).  As soon as word got around the ER that I had one, possibly two fractures, the physician assistants, nurses, and ER docs who all saw me from the beginning (saying that it could be a bad sprain) all started to circle back and, with great surprise, state "...it's broken?  Wow, you really did it up right!" or "...oh my god, you broke you leg?"  We think, and this is just a guess, that they see so many weekend-warriors come in with sprains and muscle pulls that it was just assumed that I was another type-A, 40-something out trying to relive his childhood.  But when word got around that I really did screw things up, their tune changed a bit.  We could be reading into things, but in hindsight their attitude did go from somewhat aloof and indifferent to enthused and attentive.

Don't get me wrong - I'm absolutely not knocking the nurses, PA's and doc's that were in the ER.  They were great.  And I'm sure that, if I had been in their shoes, I would have had the same initial attitude:  Some knucklehead 40+ year old out running in 20 degree, icy, miserable, weather?  Really?

Plates, Screws, and Bone Sutures. Oh My

Yesterday was quite the day.  Surgery day on my ankle.  Looking back on it now, it was quite the surreal experience.

We arrived at the hospital in the late morning for check-in / registration and waited around for about 90 minutes to be called up.  All the usual stuff here - some additional forms to fill out, gown on backwards, useless booties on the feet, IV put in, and another hour of waiting.  My Orthopedist came in, and we discussed what he was going to do:

An incision would be made on the outside of my left ankle - a plate would then be put on my fibula.  Two small incisions on the inside of my ankle would be made, where he would go in to thread bone sutures with the tibula from the plate.  He was, again, very upbeat and straightforward and told me in no minced words what the procedure entailed and what I could expect in the days to come.  We had another in-depth discussion around the topic of anesthesia and pain management.  While the Anesthesiologist hadn't yet arrived, my doc suggested, should it be offered (and he said it would be), that I get a spinal.  His rationale?  By doing this - and being numb from the waist down - it would require less sedative in the OR, and my recovery afterward would be easier as I would become awake and alert quicker.  I was a little apprehensive to be honest.  I can be a bit of a hamster at times like these.  More to the point, I'm sure it was more a mental fear of the unknown.

My wife Jerri Lynn was there with me as I was getting prepped.  While I was having these discussions with my Orthopedist, she could clearly see that I was getting a little overwhelmed.  We chatted a bit when everyone had come and gone and she talked me off the roof, so to speak. The reality of what was going on had really set in.  Everything had happened so fast over the past handful of days that, as I lay there, I was coming to grips with the fact that I was going to have a fairly significant procedure to fix a pretty significant injury.  All the fears that you can imagine were running through my head: What if it's worse than the doc thinks?  What if they can only do so much and my ankle will never be the same?  But, as I said, my awesome wife - always the voice of reason - kept me as cool and calm as she could.  She's a rock-star.

Anyway, it's all a haze from when I left the prep area to when I hit the OR.  They started doping me up in the prep area and I could feel it kick in pretty much immediately.  I remember getting the spinal in the OR (bizarre!) and then remember them start to put the tourniquet high up on my thigh - then that's it.  I drifted in and out at times, and they had a screen up so I couldn't really see what was going on (thank goodness).  I started to come around when they were finishing up the cast but only saw that for a moment or two.  I came to, officially, in the recovery room, and it was a bit disconcerting to not be able to move my legs at all.  They said it would take a couple of hours for the spinal to wear off - but in reality it took over 5! 

After about an hour in recovery, the "pain doc" who I met to discuss my earlier spinal, came by to do what my Orthopedist had suggested we do post-op.  Similar to the spinal, he was going to block the nerves in my lower left leg to allow for maximum comfort for the next 24 - 36 hours.  As I type this I still can't feel my ankle or foot, nor can I move my toes.  I have control of my left knee and the muscles above, but it's a tad weird.

My legs (well, right leg) finally began to tingle and come around shortly afterward.  I could start moving my toes and legs and was feeling okay.  But, in the interest of full disclosure, overall this was a bit of a humbling experience.  All the feelings and reactions that your body deals with as a spinal wears off can be odd and off-putting.  Even though all the nurses in the recovery room said that everything I was experiencing was completely normal and to be expected it was a very strange, and sometimes humiliating, 5 hours.  Finally, everything worked itself out, and I was discharged.  We started the day arriving at the hospital around 1030a ET and arrived home around 830p ET.  A long and crazy day.

I head back to the Orthopedist in two weeks to have the hard cast removed (originally one week, but now two....Hrmph) and then things speed up.  PT starting sometime in week three.  Swimming as soon as the surgical wounds heal (but no pushing off with the left leg for a while).  And cycling on the trainer (no resistance) in 3-4 weeks.  I'm told that my ankle will "blow up and be painful" through all this, of course, but the sooner I get back to strengthening things up the better.

So, I sit here on the couch - with my leg elevated up on pillows - trying to keep up with work.....sort of.  Mostly I'm surfing through bad daytime television programming, and managing discomfort from cast pressure points and pain from now returning feeling in my leg and ankle.  I have 4 prescription bottles lined up on the coffee table, along with a Sigg bottle of water, my mobile phone, iPad, MacBook, remote controls, Kindle, and - again in the interest of full disclosure - an apple core, a bag of nuts to munch on, an empty bowl of soup, and one very nosey cat.

Winter Running - The Aftermath

The Orthopedic Surgeon gave me a call yesterday (Saturday) around noon, after reviewing my MRI.  Monty, what's behind curtain number 2?

A torn deltoid ligament, a cracked / broken syndesmotic joint, and most likely damage to another ligament (I have which one written down somewhere, but I just can't remember everything he rattled off to me at the moment.)  Bottom line he said that it's very unstable, and he'd be very reluctant to start any physical therapy on that ankle for at least 6 weeks.  His words as I remember them: "I wouldn't want anyone cranking on that joint for a while".  So, his suggestion was to stabilize the ankle with a plate and some screws to stabilize the joint and speed healing. 

The good news with this is that after a week of a hard cast, he'll remove that and I go back to a boot.  Then, a week or so after that, we start talking physical therapy.  If all goes well, 3 weeks after surgery I could start swimming (as soon as the wounds from surgery heal) so long as there's no discomfort in doing so.  Cycling on the bike trainer could happen shortly after that.  Running?  Not sure I remember exactly what he said, but it's certainly sooner than without going under the knife.

Will I be ready for my Half Iron triathlon in September?  Most likely not.  That could be pushing it.  But there's a lot of individual variance in recovery here.  I'm not setting my hopes on anything, but am hoping to be at least swimming and easy spinning on my bike trainer in a reasonable amount of time.  Hell, if I can walk comfortably (somewhat) in 6 weeks I'll be stoked.

Monday at noon I'm scheduled for the fun and games.  Should be home by dinner - which I'll sleep through I'm sure.  Tuesday, if all goes well, I'll be on conference calls for work from the comfort of my living room.  I'm sure that if I'm not liking this walking boot thing, that I'll most likely despise the hard cast.  But it's only a week of the hard cast, so that's not bad.

The Dangers of Winter Running - Part Deux

So, as I was saying, the Orthopedic surgeon was great.  He gave us a lot of detail yesterday.  And most importantly, he didn't pull any punches and was very to the point and up front.  He explained that my recovery time, without surgery, would yield 6 weeks before I could put any significant pressure on my leg and even think about swimming or cycling.  However, with the surgery, that time would be cut to 3 weeks before I could swim (individual results may vary), maybe cycle, and physical therapy would start after 2 weeks.  My knee-jerk reaction was, of course, then why aren't we just doing the surgery!?  But, my wife, the ever-logical one, jumped in stating that going into my ankle if the damage doesn't warrant it could very well be risking unnecessary complications.  * heavy sigh*   Anyway, as I wrote yesterday, an MRI was in order so the doc could make a fully informed decision.

So, I had the MRI last night (Friday).  I have the DVD of the images, but I of course have no idea what the hell I'm looking at.  The tech that did my MRI said he looked at them - I of course asked if it was truly a car wreck down in my ankle or what?  His response: "...I'm on a low-res display, and there so much fluid in there that it's all fuzzy".  Great.

Oh, and after he asked me what I did to myself, and how it happened, his retort was: "You should take up rowing".

I'm currently awaiting the Orthopedist to ring me up.  He said he'd call on Friday night or Saturday after he reviewed the MRI, and we'd talk about options.  In the meantime, the swelling in my ankle is out of control and there's really not any position now that is comfortable.  My wife has dubbed it the ankle that ate New York

   


Ironically, my wife - JL goes Vegan - had a guest post from Matt Frazier, of No Meat Athlete who wrote about  winter running tips on Friday morning.  I think JL received his post via email shortly after I arrived in the ER.

Again, more to come.......

The Dangers of Winter Running - Part I

Thursday morning was an interesting one.  It started out normal enough - up at 445a to get myself together for a usual morning run.  Depending on the day, the number of us running could be as many as 8 or 9, but yesterday it was just my good friend Tom and I.  We met at 530a at our usual spot and headed off on one of our regular running loops - about 6 miles total for me round trip.

Cut to: about 3 miles into the run, we came to a section that had a lot of piled snow.  It's in a section of a small subdivision that is bisected by creek - the snow is piled up around and on the bridge that lets us cross.  Again, this is one of our regular loops, so we knew it was coming, and started to navigate our way over it.  We got to the other side of the bridge (only 15 feet or so) and as we half jogged, half walked, over the snow section I hopped over the last small mound of snow to get back to clear roads. 

As soon as my left foot went down, I knew I was in trouble.  It only took a second but it felt like forever.

I hit a patch of ice, and my left foot twisted and pronated in.  At the same time my leg twisted around the ankle - still underneath me - and all my weight came down on my left leg.  I had a flash in my mind of "oh, this is not good" and I went down hard.  I hadn't felt pain like that in a long, long, time.  I was on the ground, grabbing my lower left leg and trying to keep it from flexing and torquing in the middle of the shin / calf.  I calmed down enough to lay still, and could flex my foot - sort of - so I was beginning to think that it was just a bad sprain and in a few minutes the pain would start to go away.  My friend Tom had his hand on me, telling me to relax and take my time.  Eventually we tried to get me on my feet.  That was a short lived exercise.  As soon as I put weight on my left leg I went down again in just as much pain as before.  I remember Tom saying "oh my god" a few times and then we had to figure out what the heck we were going to do.

The pain was tremendous in my ankle, and strangely up high on my shin.  Hence, every time my leg would flex or torque, it would hurt everywhere. I had no idea what this meant at the time, but I was just happy to be able to flex my foot.

Tom did a nice 5K (roughly) sprint home to get his car.  I lay on the ground, in lovely 20F weather, and was just starting to get cold when he made it back.  I hopped into the front seat of his car and he got me to my house, and inside, and into a chair.  Tom told my wife JL,  what happened.  She hurriedly got her things together and we headed to the emergency room.  All this before JL had her 2nd cup of coffee!

It wasn't yet 700a when we got to the ER.  Check in was quick and everyone was great.  It took a bit of time to get me through the triage process and I sat in the hallway in a wheel chair waiting for radiology to come get me for some scans.

Waiting for the Radiologist

The radiology tech was great.  He was taking the scans, and being careful with my leg.  At one point, I was trying to convince myself that it was just a bad ankle and / or high ankle sprain.  You hear about some athletes getting these and it sounded good to me.  However, after one of scans, I realized he was on the phone talking to someone and I heard my name mentioned.  He came back to me and said he "saw something" higher up my leg, where half the pain was, and wants to rescan the ankle now to double-check something else.  The radiologist on-call came in, and they talked for a bit longer while I remained on the X-Ray table.

He then broke the news that he saw a fracture on my fibula and "something" in my ankle. 

The first words out of my mouth? "Oh, Fuc# me!"  I apologized for the outburst, to which he replied that he'd heard that one a few times before and not to worry.  I was wheeled back out to the hall in the ER where JL was holding station, and I sat and waited with an ice-pack on my ankle.  I told JL what he saw and said.  I was just beside myself.  The doc stopped by and said they were calling the Orthopedist on-call to review the scans.  She had office hours that morning, so shortly after 900a she called back - had looked at the scans - and asked that we should drive over to her office immediately.

So, with crutches and a lightweight ankle brace, we headed to the Orthopedist office.   Upon arrival it looked like a lot of the docs at this office are sports medicine docs.  That was comforting in some way.   Long story short here - more scans, and a bit of a more revealing diagnosis.

It looks like, most likely, the ankle twisting and pronating, combined with my leg twisting around it, snapped the tendon that holds the fibula and tibia together in the ankle.  This allowed the two bones to snap apart and causing a chain reaction up my leg that caused the fracture high up on my fibula just below my knee.  And tragically there was indeed a fracture in my ankle.

Lots of talk about "gaps" and "spaces" in my ankle.  Then the statement that I needed to come back tomorrow (well, today) to talk with one of the surgeons about the potential need to put a couple screws in there to get things back together.  Awesome.

Day 2: What, this isn't a normal ankle size?

So, we've been back to the Ortho to speak with the surgeon.  He didn't see enough "distance" in the gaps between some bones on my ankle X-Ray to be certain of next steps just yet.  And after torturing me on the table asking "does it hurt when I do this? (and then proceeding to twist my foot and ankle) he needed more information.  He ordered an MRI - stat - to determine if the ligaments and tendons (primarily the deltoid ligament) were damaged to the point of needing repair or if they're just stretched.

I'm booked for surgery on Monday, as he can get me in, and his opinion is that if it's needed, let's do it now.  He'll cancel it if need be based on the results of the MRI.  So, I'm scheduled for the MRI later today, and they've been instructed to call my Orthopedist as soon as it's done.  He said he'd call me later tonight or tomorrow and we'll make our final decisions.

More to come.......

Longing For The Good Pool

As I've been ranting and raving about recent swim workouts recently, I was thinking back to some of the better swims I've had over the past year.  I love open water swims with my triathlon club and once in a while get in a good pool workout at the local gym.  But last summer there were two great mornings that I recall fondly.

I was in Indianapolis last summer for work - just a few days, but enough to have to work training into the schedule.  Yep, the few days during the week was just enough for the old type-A / OCD to kick in and I began to worry about getting in my workouts.  The timing was pretty crappy, as I recall.  It was in early June, and I had two races coming up that month.  I can run almost anywhere, but where the heck was I going to get in a swim workout?  I went to Google Maps to locate my hotel, and saw that across the street was the NCAA Collegiate Athletic offices (cool), the NCAA Hall of Champions (still cool) and the National Institute for Fitness and Sport.  I didn't really know what the NIFS was, but it had to do with fitness and sport so I was thinking that this was getting cooler by the minute. Anyway, as I mapped what looked to be a good running route through the Indiana University campus, I stumbled across my savior for the upcoming week:

The IU Natatorium at IUPUI

Okay, the cool factor just went up a notch.  Time to pack the swimming gear.

I checked their hours for lap swimming, and the first morning I was in Indy, I walked the 10 minutes from my hotel to the pool.  Paid for a day pass, and headed to the lockers.  Interestingly, the locker rooms that were open to the public were fairly spartan - they reminded me of my high school swimming locker room.  I had to assume that the locker rooms for the IU team were a bit nicer! Anyway, not to worry I thought.  I'm here for the pool.  I hurriedly changed and got out to the deck.

I wasn't disappointed.

Oh, the joys of a long-course (50 meter) competition pool.   Deep all the way across (9-10 feet) and 8 lanes wide.  Waves were non-existant.  And while there were a fair number of people there, there was never more than 2 people a lane, and in a long-course pool you were never held up.

Cool water temps (they advertise that water being maintained at 72F at the time, but it felt cooler) meant you never felt overheated like I do at my local gym.  On top of that, they had an instructional pool (25 yards) in another area, and a full diving well with boards and platform tower. 

Man, this was great!

In the pool they have a wall covered with the names of all the swimmers who have set records in that pool: 101 American records and 15 World Records.  Walking back out side in the main hallway are photos of all the greats - too many to list, but needless to say I was a little late for work that morning (and the next!)

I write this having just come back from my local gym / pool.  Battling for lane space and grumbling about it to myself all morning.

The Transition Area

I read a post the other day from someone who, in one of their first longer distance triathlons, got to T1 and realized they had forgotten a few important items and had left them at home - HR monitor, nutrition.  I'm assuming it had to be pure oversight and a bag got left behind.  I suppose, similar to getting ready for ones first ever triathlon, that in your first long distance triathlon (a Half-Iron / 70.3 for instance), one might have their nerves a bit on edge.

My first triathlon ever had my nerves frazzled beyond belief.  The thought of just setting up my transition area was frightening.  As I recall, my wife and I went to a local triathlon a couple weeks before our race just to watch people come into T1 and T2.  It did help to see a transition area "live" and to realize that it's not rocket science.  But, I packed and re-packed my transition bag a dozen times before that first race.  And I'm pretty sure I brought waaaaay too much stuff for a sprint tri.

When I came out of the water and got to T1, I recall - not so fondly - a 'deer in the headlights' moment (or, four).  I stood there, frozen, staring at my transition area not knowing what to do first.  Looking back I'm surprised I actually found my way to my bike.  It's overwhelming the first couple of times you get into the transition area.  It's effectively a fenced in area of  controlled chaos.  People running in and out, bikes being un-racked and run to the "bike-out" area.  It can be intimidating for the first-timer - or even third-timer.  And heaven forbid you look up and see a veteran come in and out of T1. For the new triathlete, to see someone get in and out of the transition area as fast as some do can be shocking and humbling.

I've said many a time that I'm by no means an expert, but I've done this enough to know what works - for me at least - and I've found over the years that it has gotten easier to pack for my transition area on race day.  That's not a surprise, as practice does make perfect (or approaches it at least).  What I find more interesting is that it's also become more of an exercise in minimalism.  Over time you do begin to understand what you need for a race, and pack only the necessities.   The main thing that changes is the amount of nutrition that you bring based on the distance that is being raced.

The best advice I received for packing for, and practicing, transitions was simple and obvious.  When you're doing your brick workouts (bike to run, most commonly) lay out your gear in your garage or basement and simulate T2.  You'll realize if you forgot something (hat, gel, whatever) and after doing this enough times, packing your transition bag will become quite easy. 

This isn't to say that you won't forget something on race day.  My first 70.3 event a couple years ago felt intimidating.  I can pack for an Olympic distance triathlon in minutes.  But this felt different.  In the end, the biggest difference was nutrition - more to the point the amount that I had to pack was different.  But, I was thrown off none-the-less and had a few moments of pulling everything out of my transition bag and triple checking everything.

By the way, I didn't pack enough nutrition for that Half Iron race. I bonked badly on the run.  Oops.