Commitment

I've made a commitment to a few things...

1. To continue losing weight via exercise (mountain biking primarily, but also at the gym), and food control. BTW, I am now down 45 pounds from my all-time high weight of 280. By the first race, I want to be a lot closer to 200 than I am now (235). Hopefully less than 200.
2. To actually COMPETE in 3 mountain bike races this spring. This should keep me on track with #1.
3. To make damn sure my asthma stays under control as much as possible, so I can get #1 and #2 accomplished.
4. To get my living room and my laundry under control tonight and tomorrow. Its driving me nuts.
5. To get my paramedic back.

So, there. I've put it out for the world to see. I plan on posting regular updates on #1-3, including that lovely weight tracker up at the top of this page.

Now, for those of you asking, "Why in the WORLD do you want to race in mountain bike races? After all, you treat these guys and gals all the time. You KNOW they get hurt." True... but I trail ride already. And its fun. Its a little different when you compete. I can be a very competitive person, and having a goal of racing (i.e. finishing) is a good goal to start with. These are simple races. I am not going down a 2000' foot decent or anything here, folk. This is decent singletrack located near my home, and I am familiar with it. Both from a perspective of riding it, and from getting people out of there. I came back to trail riding partly to understand a little more of the injuries I was seeing at the races, but being out there... well, I got bit by the bug again. And since my knee surgery, I've made a decision that I WANT TO DO THIS. Yeah, I might get hurt. I've slid out just riding the trail before. But hey, I know my EMS company will be out there providing EMS at the events... I know I'll be in good hands if I do get hurt. They are "the best"!

On the last commitment, I've decided to take the pre-paramedic class at Sierra College this winter/spring. I've already registered, and am waiting to schedule the class. Its the first step for me. I've been away so long, I need to start over. This is my chance. Then, I am HOPING that the fall part-time paramedic program will be up again at ARC. If not, I will find another program. I'd do it full-time if I could find someone to support me for the year it will take... any takers?

Finally! Back on the bike!

Its been since July 19. That was the last day I rode my bike, until today. July 21rst marked the day I had surgery to repair the damage I caused when I fell on May 5th. Until I woke up from the anesthetic, I was working off the idea that I would take about 3-4 weeks off my bike. It was the next day that I realized the surgery was much more involved than I (and even the surgeon) thought it would be. Rehab started two days after surgery, when I began to do quad sets and isometrics.

Reality still didn't really hit until I had to have the surgical drain placed. That was 2.5 weeks after the surgery. Then the infection that set my recovery back a few steps. And finally getting the drain removed. Once the drain came out, it was finally safe to get to the gym and ride the recumbent stationary bike. Then the upright. And I've been walking. And walking... and finally a little jogging (very little). But my knee felt good. A little tight, but that's going to be the case for a while.

Today, I got on my bike and actually RODE some of the rolling hills around Antelope. And my knee didn't hurt!

It was only 5 miles.

But I did it.

 Tomorrow will be the ride from my home to light rail. And back later in the day. :-)

Surgery

Yep. (Warning, what follows is a bit graphic)

Last week, I sent an email to my orthopedist, 'fessing up that I had aspirated fluid that was accumulating outside my knee. Did it by what is called needle aspiration (syringe and needle), following good aseptic technique each time. Not once, or twice, but three times. But, doing this is essentially playing russian roulette, risking infection each time. And the problem wasn't going away. In fact, when I was on my bike, it got worse (presumably due to pedaling). So, we chatted back and forth by email, and he let me know that the only way to fix this permanently at this point is surgery. Not on the inside of my knee, folk. On the outside.

What has happened is that a pocket developed, probably due to a shearing force when I hit the ground that tore away the tissue layer that holds the skin to the underlying tissues. There is an area below my knee that feels "rope-like". This is more than likely the tissue that sheared away. A "pseudomembrane" has formed in its place that is holding the fluid in that area, since the body likes to fill in voids with fluid. The surgeon will go in and open up this pocket, clean up the mess I made (like that rope-like stuff), check on the side of my knee for damage (its been getting progressively more sore since I started bicycling again), repair anything that needs it, and essentially attempt to "tack down" the underside of the skin to the tissue below with absorbable sutures, to keep the pocket from re-forming. If that last item can't be done, then I will be stuck with a drain in my leg for a few weeks (not a fun prospect). Needless to say, I am voting for the suturing.

This surgery will keep me out of commission EMS-wise, for a few weeks. Two weeks of VERY LIGHT duty (Think nothing to supervisory only), followed by a few weeks of ramping up to normal activity. I need to give the tissues a chance to really adhere to each other. Day job-wise, it means I am probably going to be working at home for a week or two, after a few days off for healing and pain control.

I went in and saw the orthopedic surgeon last Friday. Got all the pre-op stuff out of the way already. So, when is all this happening? Next Tuesday, July 21st.

Back on the bike

Today, I got back on my bike. This is the first time since the crash on May 5th that I have ridden. I missed it so much! I didn't get to just ride. I was actually working EMS at a race in Folsom tonight, the Running of the Bullipedes. So, I loaded up the panniers with the EMS gear (An AED, diagnostic tools, cervical collars, airway management items, wound care, splints, slings, water, and more... Yeah, it all fits!), hooked them on the rack (which I had to re-install last night), strapped the oxygen tank onto the top of the rack, put on my NEW helmet (Yes, I did retire my old one after the crash), and followed the racers on the mini-marathon (1 mile) through historic Folsom. I stayed behind the racers for most of it, talking with one of the Folsom PD motorcycle officers that was also following the racers. He was really nice to talk to.

The race was over almost as quickly as it started. First team to finish took 4 minutes 30 seconds. The last team took 20 minutes. It was 100 degrees out there. Rather toasty! I stayed at the finish for a few reasons. One was that the roads were closed, but the more important was that there was a medical emergency nearby, that required them to get an ambulance in there. No, it wasn't any of the racers. Folsom Fire treatd that patient. And then there was the parade and running of the bulls. The parade was nice to watch while I guzzled water. I sweated off a LOT of fluid while out there. The bulls were walked. All of them behaved.

Afterward, I headed up the hill. Sweated off even more fluid! Got back to the Jeep, unloaded the world, and headed home. It was still over 90 when I left.

Although short and warm, it was really good to get back on my bike. I was planning on riding to work tomorrow, but I just picked up a shift at the ballpark. Maybe next week. :-)

Crash Update

My knee bruised up, swelled up, and developed a good sized effusion (fluid under the surface of the skin in my case, but not in the joint thankfully). A good section of it is still numb (which may be really good right now, but worries me). I was hoping the numbness would have improved by now, which makes me think I may have actually damaged some of the nerves in the area that I landed on. Hope it comes back.The bruising is also tracking down my leg, a function of gravity, which unfortunately makes it look worse.

I've been able to work my EMS shifts. Worked a mountain bike event Wed, and a baseball game Thu. I inadvertantly knelt down on it Thursday night, which was a BIG mistake. I am surprised I didn't yell out loud when I did it, but since I was with a patient at the time, I am glad I didn't. Never scare the patient, right? ;-)

I am still icing it during the day. The ER doc prescribed a narcotic to help me sleep, but I haven't needed it since Wed night. Good thing, as I hate taking narcotics.

Crash

I crashed my bike today.

I was riding my bike from a light rail station to work (All of about a mile at the most), with the intention to ride my bike on the American River Bike Trail after work. I was riding down 12th Street, and got to 12th and G Streets, and the light was changing, so I was going to turn onto G street, which would get me closer to work. I started to brake, and another cyclist on G Street suddenly was in my path. I hit the brakes hard, and crashed. My right knee hit, then my face, and finally my left knee and shoulder.

My first thought was that I had crashed into the other cyclist. So I asked him if he was alright. I never even touched him! Good. Then he asked me if I was ok. I told him I wasn't sure yet, while my face was still on the ground. I turned over, and took a quick inventory. A little blood on my face, one of my teeth felt funny (but it was still there, and intact), and I felt my legs. Hurting, but intact. I looked at my right knee, which already had started bruising up. I sat for a minute, and politely waved off a lady who had gotten out of her car to help. I got up, and quickly checked my bike. It was ok.

I got on my bike, and crossed the street. I asked the other cyclist again if he was ok. He was. I pedaled to work and locked up my bike in the bike room. Wiped my face with my hand and realized it was mildly bloody. Got in the elevator and got some 4x4s, antibiotic ointment, and an ice pack from a first aid kit at work. A few minutes later, my face looked reasonably normal again after cleaning it and applying some of the antibiotic ointment. Just a small cut under my nose, and abrasions on my nose.

I then focused on my now very sore knee. I took a nice look at it. Bruising and red, with abrasions. NIIIICE. Ice pack went on it. My shoulder was beginning to ache as well. I had things to do at work, so I got to them to get my mind off my injuries. Attended a conference call, and emailed my boss telling her about the accident and that I may leave to work at home. Finished the call, packed up my work laptop, and headed home.

Tried to find someone to meet me at Watt and I-80 and get me home. No go. But I expected that, for the time of day it was. I was hoping, though... So I got on a bus that got me closer to home. But, I had to either walk or ride from where the bus left me off. I realized on my way home that cycling was mildly less painful than walking. So, I biked almost all the way home. One hill was just a bit too much today, though. Walked that. Made it home, and my roommate was waiting for me. "So, how bad is it?", he asked me. I showed him. "Ouch", was his only response at the moment. The swelling on my knee was getting worse, regardless.And my shoulder was hurting more.

My business partner, friend and fellow EMT, got back to me, and I let him know what happened, along with a nice picture of my knee. His response, "Ouch!!!!, so when are you gonna get seen?" He was right, I need to get it checked out. I wasn't planning on it, since I had good mobility, but it was numb right at the top of the tibia (the larger bone in the lower leg). In me, that can be a sign of a fracture. So, I called up Kaiser advise, let them know what I did, and what was hurting. After conferring with their doc that is in the advise center, the decision was that I needed to go to the ER, and not a clinic appointment. Bleh...

So, I went to the ER to rule out a fracture. Since I had no major injuries, and I walked in, I was sent through the "fast track" portion of the ER. Sat on the gurney and chatted with the nurse for a few minutes. A few minutes after she left, I was seeing the doctor. She checked my knee, my face, and did a cursory check of my shoulder. She didn't think I fractured anything, but authorized a knee series to rule it out. Got x-rayed, and back to the bed. After a little bit, the doctor came in and let me know there was no fracture. That was my goal, anyway. She gave me a prescription for pain meds, and discharged me. Less than an hour total time! Wow! Truly fast-track!

So, whats it look like now? Its not pretty...

Oh, I am banned from riding my bike for a week. Ugh... but I need to let this get better.

Bike

Just a shot of my bike in the early morning light (er, dark) at the light rail station on my way to work:

 

 I kinda wish there was just a little more light at the time, but I like the shot.

Bike EMS

This last Sunday, I had the opportunity to be a "Bike EMT". Basically, two of us followed waves of half-marathon runners, to ensure that they stayed healthy on the course, and to treat any injuries or illnesses that might happen to them on the course. Being one of the few EMTs in our company that rides a bike on a regular basis, I volunteered to be one of them. We also had my business partner out there on an ATV, with gear attached that we may need to use to stabilize someone in the event of a more severe illness or injury.

My bike fitted EMS-style. That red bag is oxygen and airway supplies. Medical gear is in the panniers.

 

Steve on the ATV

I had ridden the course the Tuesday before, just to make sure I knew the expected problem spots (fast downhills, slip areas, etc). It was all along the American River Bike Trail, with the exception of an area at the beginning of the course, and along one of the bridges. But they would be protected by traffic controls (courtesy the local PD), and concrete and steel barricades on the bridge).

Thankfully, it was relatively uneventful out on the course. A few folk with cramps from dehydration or electrolyte imbalance, one that I kept an eye on that was doing her first half-marathon and was going to finish no matter what (She needed fluids and calories to continue), and some other issues treated at our tent at the finish line.

At one point, Steve needed to stop for gas to top off the ATV, just in case. They don't expect people to just drive up in an ATV. Probably turned a few heads!

 

Not sure who created this memorial, or why, but it is simple and beautiful.

 

Interesting sign over the Walker Bridge

Me, an athlete? Who would've thought?

Yep, I am cycling a lot nowadays. Riding from my home to the light rail station is a good 8 miles. I am working up to riding the entire way to work, about 14 miles. I ride that frequently now. And it is really getting easier. I was planning on doing the bike part of the Luna Bar Womens Triathlon (a friend asked me to do the ride portion, while she did the swim, and another person did the run). Unfortunately, it is the same weekend as a DMAT training down in southern CA I will be attending.

I like having the time to think to myself. The exercise gets my brain working, and I can problem solve a lot easier now... seriously!

Anyhow, here is a pic I took this morning of me in my biking attire. Yeah, it magnifies every flaw I have, but it is really comfortable! The shirt was given to me by one of my bosses, who is really revved that I am into cycling (She rides 22 miles each way to work daily! And enjoys the Death Ride, the Rubicon, the Tour de France (she rode the course last year for her vacation - not during the TdF, but after). Quite an inspiration for me!

Obviously, I am still losing weight. I had a period of time that I was gaining. It was frustrating, but then I started losing again. The thought is that I was building muscle, and the muscle is now burning more of the fat. Dunno. But I am glad to be losing again! Current weight: 249.0