Finally Back on the Bike

Thursday morning Carol and I drove down to Fiesta Island to go for a short ride.





On Monday I'd gotten down to B&L Bikes to get re-fitted to my bike and bring it home. They'd taken all my components off my old frame and moved them on to the new one, put some new handlebars on, rebuilt my damaged shifter, put some tape on the new bars, and trued my wheels. I was really surprised when it came time to pay. I was expecting to fork out at least $500. At the end of the day I walked away paying $48.

It was really special to see all the work that the guys at B&L were willing to do for me just to get me back on the road. From the time that I crutched my way into the shop two and a half months ago and they learned how badly I really was hurt, until I walked out with my bike they've been rooting for me the entire time. Randy Clark, an ex-pro rider, who does my bike fittings and is an all around great guy even invited me out to his bike team's Sunday ride. You can check out info on Randy's Big City Velo team here.

Getting back to the ride, we did a couple loops around Fiesta Island. Thirty minutes of riding or so. Being back on my bike felt great. It took me a few minutes to get to the point that I felt well balanced and was riding straight without having to concentrate on it. Back in my heyday I used to be able to average close to 26 mph out on Fiesta Island, this day 14 or 15 mph was about as fast as I got it going. All in all, the ride went about as well as could be expected. My left leg is still pretty weak, to the point that if I stand up on the pedals my leg isn't strong enough to bring the cranks through the dead spot at the top of the stroke (i.e. I can't pedal while standing up). Not being able to dorsiflex my left foot yet probably isn't helping much here either.

As far as my recovery goes, I'm starting to walk better and better. I can now walk/limp pretty well without my cane. I'm still using my cane to walk most of the time because Dr. Smith wants me to walk as smoothly as possible, but maybe in a couple more weeks I'll be able to walk well without anything other than my foot brace. I'm also starting to get a fair bit of tingling on the top of my foot again. Once I got off the pain medicine a couple months ago, the tingling in my foot (nerves coming back to life) was unbearable, to the point that I was taking medicine to dull the feeling a bit. A few weeks ago the tingling pretty much went away. Now I'm starting to get some tingling in areas that have to date been a little numb, which is pretty encouraging. It's not anywhere near as bad as before and hopefully it won't get to that point again.

Nearly back on the road

It turns out that my bike has been fixed and ready for pick-up for two weeks now. I guess I somehow missed the voicemail that the bike shop left for me. I've got an appointment set up for next Monday (Nov. 19) to get re-fitted to it. Hopefully my flexibility won't be so bad that I need a lot of new components (a new stem to raise up the handlebars for example) in order to get back on it. We'll see.

On the subject of bike fitting, if you do have any plans to begin making regular use of a bicycle, a bike fitting is money well spent. With the amount of repetitive motion that occurs on a bicycle, it's really easy to begin doing serious damage to your knees, back, ankles, hips, etc if you aren't properly fitted to your bike. This is even more critical if you're using any sort of clipless pedal system where your feet and ankles have a lot less freedom to move around when you ride.

Like I said in a previous post, getting back on my bike is going to be a giant milestone for me in my recovery. If I can get back on my bike and start riding again I'll be doing something that seemed like such an unlikelihood only a few months ago.

Recovery - Week 17

I finally got the chance to get away from work and make a trip up to Canada. I've been up visiting my parents since last Thursday. It's been really nice to be away from home for a while, especially since the weather is something other than San Diego's perpetual summer-like conditions. I've gotten to spend a lot of time with family and friends, which for me is what life's all about.

I've been making some progress with regard to walking. Two Saturdays ago I started walking with a cane. It was pretty tough at first. So much so that the day after I was too worn down to use anything other than my crutches to move around. At this point I'm starting to get around quite a bit better. I can walk without the cane, but not too smoothly. Dr. Smith wants to see me walking smoothly, even if that means going all the way back to my crutches, so I'm sticking with the cane for now.

In another important development, for the past couple days I've been able to put my left sock on without any assistance. Ever since I hurt myself I've been unable to pull my leg up/reach down far enough such that I could get my fingers to the end of my left toes. The past couple days I've found that if I sit in a chair, put my foot on the ground and lean over as much as I can, I can get my sock over my toes. I'm sure all my co-workers will be happy to know that I'll no longer be showing up at work looking for one of them to help me get my left sock on.

Once I get back home on Wednesday I'm going to get on top of getting my bike rebuilt. The parts are all down at the shop, they just need to be assembled. Because I'd put a few dents into my road frame frame over the season, I bought an identical, used Specialized E5 frameset off eBay a couple months ago. I'm going to get the Campagnolo Record components moved from my wrecked bike onto the new frame. The handlebars that were on my old bike are toast, so I'll also be buying a new set of those. I may also need to buy a new shifter, or at least pay to have my old one rebuilt as it got pretty trashed during the accident.

My hope is that I can think about going on a casual ride within a couple weeks. I've been riding the stationary bike a bit as part of my recovery, so I know I can ride, just not very strongly. Hopefully when my bike is fixed I'll be able to go down to the shop, get fitted to it and take it for a spin. Back when I was in the hospital I can two visions in my head that kept me going towards recovery:

1. Getting back on my repaired bike and riding it away from the bike shop
2. Being able to get strong enough on my bike so that I could do my 65 mile Saturday ride like I used to

Based upon how I'm feeling right now, I'm pretty close to being able to accomplish the first of these two visions. The second one is still a long, long way away from happening, but I'm still confident that I'll get there as long as I continue to work towards it.

Recovery - Week 15

Well, I haven't quite gotten to the point of walking yet. I'm starting to get more and more weight onto my left leg, things just aren't progressing as quickly as I might have liked.

I had a visit with my hip surgeon on Monday this week and he thought things were healing well. He wanted me to work on getting my foot brace modified such that I had one that would fit in my shoes. I haven't been wearing a brace to hold up my foot while I've been walking, mainly because the small one that I have still doesn't fit in a shoe. It's just a hard piece of plastic, so it isn't really possible to walk on it very well either. However, because I haven't been using a brace for my foot, my hip and knee have had to compensate for my inability to lift my left foot. So my gait hasn't been the smoothest.

As a result, I've now gone back to the larger foot brace I got when I was in the hospital, the infamous bunny boot. It's rather shaggy looking, but it works pretty well. It's got a nice tread on the bottom and is flexible in the ankle, so one can walk in it pretty well. I've been wearing it for the past two days and it seems to have helped me get more weight on to my left leg. At this point I'm hoping that I'm only a couple days away from being comfortable with all my weight on my left leg. From there it'll simply be a matter of trying to walk with one crutch or a cane.

I'll keep you posted.

Recovery - Week 12

It's now 12 weeks since my accident and 11 weeks since my hip surgery. Week 12 is a bit of magic mark as I'm now allowed to begin to place my foot on the ground when I walk in my crutches. The notion is as follows:

Week 12 - begin to place my foot on the ground as a I walk
Week 13 - start out applying 10 pounds of pressure as I walk. Each day increase 10 pounds up to a max of 50 pounds
Week 14 - keep increasing by 10 pounds per day, up to 100 pounds
Week 15 - give 'er!

Back when I had my hip surgery and Dr. Smith told me that I needed to wait 12 weeks before I'd be allowed to walk, I had a picture in my mind of week 12 coming to an end, me being stood up by a physiotherapist (without my crutches) and being pushed like a bird out of a nest. So I was more than a little disappointed the last time I visited Dr. Smith and he outlined his 4 week plan for me.

So, I continue to count down the weeks. When I got back to work four weeks ago I was telling myself it was "only" four weeks until I'd be able to walk. Now it's yet another 3 or so. I'll get there one day, it feels like forever though.

At this point I can understand why they want you to take 4 weeks to build up to walking. When I first started putting my foot on the ground, it felt incredibly good. All of a sudden nerves and muscles that had been doing nothing for the past 3 months were glad to have something to do. However, my gait is ridiculously bad. As my left leg tries to move through a stride, my hip ends up doing a ton of the work. The more I walk the better it gets though. Hopefully next week as I begin to put weight onto my left leg things will begin to get a little better.

Putting my foot down, even if it's with very little pressure does really make my hip feel better. My physiotherapist mentioned that beginning to apply weight would stimulate my hip bones to recover even more and it definitely seems to be helping. My hip is beginning to feel really solid these days. Now that the muscles in my lower back no longer have to hold up my dangling left leg, they're starting to feel a lot better as well.

One of the things that also complicates my ability to walk is the fact that I still can't really dorsiflex my left ankle. I'm able to lift my toes and half my foot pretty well; however, I still can't raise my entire foot. So when I walk I've gotta take it pretty slow to ensure that I don't trip over my foot. I am starting to feel more of the muscles in my left shin, so things seem to be moving in the right direction. I just need to continue to be patient and wait for my nerve damage to recover.

Recovery - Weeks 4 to 8

Once I got home, the next 4 weeks were painfully monotonous.

Monday, Wednesday, and Friday I have been going to physiotherapy sessions that go for 1.5 hours. The first half hour usually involves some massage, stretching and range of motion exercises, especially in my knee. The last hour involves light weights and lots of leg exercise. Over weeks 4 to 8 we were slowly able to get the range of motion in my knee up to around 110 degrees. There was a lot of painful pushing and bending required to get it done, but eventually it got there.

The first couple weeks home (recovery week 4 and 5), Carol was generous enough to take time off work to look after my needs. With no way to walk on my own, no way to drive and no real capability of carrying anything I was pretty much dependent on her to keep me alive.

The third week (recovery week 6) my Mom came down and took over the role of caregiver. Rich and Christy were also down during the week, so while I wasn't up for any sort of big outings, we did get to go out for dinner every now and then and play some cards in the evenings. With me out of commission, Christy and Rich were able to visit all the local attractions on their own.

Week 4 (recovery week 7), Christy extended her stay an additional week and took over the role as my personal assistant.

Once I got to the start of recovery week 8, I was allowed to increase my max hip angle from 60 to 90 degrees, i.e. I could finally attempt to sit up in a chair. From there on out I started driving myself to the physiotherapist. At that point the biggest goal shifted to increasing the flexibility in my hip. My left groin was incredibly tight, my left hamstring a little less so. So each time I went to the physiotherapist, the first 30 minutes was a ton of pain as I was pulled and stretched well past what was comfortable.

Recovery - Week 3

Week 3 was quite a bit different than my previous weeks in the hospital.

First, the rehab floor had a dining room. It was pretty common for folks to head down to the dining room for meals. Conveniently, the dining room was also right next door to my room, so I didn't have too far to go. I'm not the biggest morning person, so I didn't always make it down there for breakfast, but I was there for lunch and dinner most days. Getting up, into my wheelchair and out to eat meant that I spent a little more time sitting up and gave me the chance to be a little more active.

Second, as previously mentioned, the rehab floor has a dedicated staff of occupational and physio therapists.

In the beginning my sessions focussed mainly on trying to get some basic strength and motion back into my non-injured leg and upper body. Having been in bed for so long, I had a lot of stiff under-used muscles. As the days progressed, we began to focus a lot more on the range of motion in my knee. I had orders from my knee surgeon that would allow me to bend my knee up to 40 degrees.

When we first started working on range in my knee I was able to bend it about 10 degrees. Over the course of the week, we eventually got up to 40 degrees. If you haven't ever had a joint injury where you've had reduced range of motion, trying to get it back is pretty tough. In my knee, all my leg muscles were tight, tense and stopping my knee from bending. There was also a lot of scar tissue that had grabbed onto my knee cap, and that needed to be worked loose. One of the ways that I worked on getting motion back into my knee was via a CPM (continuous passive motion) machine. The machine I had in the rehab unit was mounted to my bed, so it was really easy to get on when I had time. I was supposed to put in 6 hours per day and go up by 5 degrees per day.

Basically you strap your leg in to the machine, set the speed and angle of motion, and it then slowly bends your knee up and down for you. If I did a good job of staying on task I could get 2 hours in before breakfast, 2 hours after lunch and 2 hours before bed. Pretty darn boring, but certainly no more boring that laying there like a lump as I'd done the first 2 weeks in the hospital.

Towards the middle of the week I began spending a lot more time taking walks on my crutches as opposed to my walker. At first it's a little intimidating going from the stability of the walker to crutches (especially when you're already a little tipsy from all the drugs you're on), but once I got going on the crutches I was able to quickly improve my balance.

By the end of the week I was able to make the entire loop of the 11th floor on my crutches (over 200 feet) and bend my knee up to 40 degrees. These were all conditions of me getting myself the hell out of the hospital, so things were looking up. The last thing I needed to work on with the physios was getting up stairs and into a car. Luckily for me, Carol has a pretty accessible Sante Fe. As long as I fixed my knee brace at 40 degrees, I was able to sit at the edge of the passenger seat, pull by hips inside, and swing my leg around into the interior. As for stairs, those were pretty easy to master. I learned that if I went up backwards with my crutches in my left hand and my right hand on a banister, I could make my way up and down stairs pretty safely.

Come Friday I was finally allowed to get the heck out of the hospital. I can't possibly express to you how good it felt to get out of the hospital, away from the crazy nurses, and into a nice comfortable home/bed.