Post crash recovery

It's been almost three weeks since my crash on Pinehurst road. There I suffered a some road rash, a bruised hip, a grade I/II AC (acromio-clavicular) separation and a cracked rib. Now things are finally getting better and I am able to exercise at moderate intensity without too much pain.

AC separation. In Grade 3 the AC ligament that supports your arm is torn.

Although I had trouble walking the night of the crash, my hip problems went away in less than one week. The shoulder still hurts but I regained nearly all movement -albeit with some pain- about a week later. I can move but I cannot sleep on it although now it is quite manageable. Much, much better than the grade III separation I suffered on the right shoulder in 2008.

The ribs are another matter. They hurt very little now, except when I cough or sneeze, but then the pain is pretty bad and it takes time to go away.

At first all I could do in terms of exercise was pedal easily on my rollers. Now I can run or ride relatively well as long as I don't push it too hard or for too long. But even then there will be a dull pain in my chest afterwards and that pain will last for several hours. Although the rib injury is much less painful than a grade III AC separation, what it lacks in intensity, it makes up for in being always there. With a shoulder injury one can find a spot where the pain is hardly noticeable. Not so with ribs. They always move and they are always painful.

More good news: the podium in Bredene today looked like a who's who in cross: Stybar, Nys and Albert. It also appears the snow is gone.

Also, the abbey at Rochefort got damaged by fire, but the beer and the beer brewers (the monks) are OK! That is excellent news for those who love a good Trappist Ale.

Running with a cracked rib

This weekend I found out that running with a cracked rib is a non-starter. It has been almost two weeks since my accident and my ribs felt a lot better so I was eager to go on a short run. Although I can still feel pain when I inhale deeply or when I cough, all in all the pain was moderate (before the run). Not so after my aborted run attempt.

Starting off was painful but I remember from my previous AC separation days that once the adrenalin kicks in things get better and then stay that way for about an hour. So I tried to ignore the pain and kept running hoping the pain would go away. But it did not go away it got worse; nor could I find a position -hard to do with ribs- where the pain was tolerable. It hurt no matter what. I had to abandon my endeavor.

All taped up and ready to roll...

Before the run I had taped up my shoulder because I found that that helps a little bit. But my shoulder was not the problem this time around. The AC separation is only a grade I or II, not the grade III that I suffered on the other side a few years ago. In any case, the rib pain quickly overshadowed everything and put an end to my attempt. After the "run" I taped my ribs and found that that helps a little too. Maybe it is just drawing my attention away from the injury--one does sense the tape on the skin- but it does appear to help a bit.

I guess I will have to take it easy for a while longer.

Meanwhile I had some more experiences with the famed US healthcare system -this time under the guise of a large HMO. Try to get a simple prescription refill. My package of dangerous vicodin says no refills but my doctor had assured me that this was just standard for this type of medication and that I could just call in and have it filled if I needed it.

It is not as easy as that. So far I have called three times and made no headway. It seems nothing can be achieved here without spending hours on the phone, listening to muzak and stupid messages, and being put on hold time after time. It really should not be that hard to get basic healthcare. In Europe I would have just walked into a pharmacy and bought the extra pills.

A very rough night

I had a very rough night last night. The rib pain is now my major problem. The shoulder hurts too but I can easily find positions where it hurts very little. As long as I avoid certain movements (especially raising my arm or putting my elbow forward) there is no issue. I can type just fine for example, with very little pain. My hip is no longer very painful either. Just a bit where the skin got an imprint from the roadway. But the rib pain is not getting any easier.

A road rash tattoo on my hip

Although you can take shallow breaths, which I am definitely doing, you can't totally avoid movement in your chest ever. Since every movement hurts that is not good. The background pain from my chest is always there and it is pretty bad, even with the pain killers. But that is not all. You can't very well go without coughing or sneezing and that REALLY hurts. It is totally surprising to me how often I cough (I was warned by the orthopedist that humans cough more often than they think) even though I have no colds or other respiratory issues such as allergies. I also suspect the shallow breathing makes it necessary for me to clear out airways more frequently.

I was shown how to cough with a pillow on the ribs to minimize the pain, but that only goes so far. And sneezing is far less predictable.

Despite the vicodin and a healthy dose of ibuprofen, I did not sleep well. I woke up at 4 AM and was quite sweaty. I had a hard time getting up and doing so only increased the pain further. I also got cold and felt even more miserable then. With my arm out of commission I cannot move my covers as easily and that surely had a lot to do with me getting too hot and sweaty.

I found out that one holds one's breath when getting up from the couch or bed. At least that is what I think is happening. You probably stabilize your chest so the long back muscles -the ones that get up you upright have a firm contact point. Or maybe I can just feel them contracting against a damaged rib cage? The latter sounds less convincing since they do not insert that far laterally on the rib. I have the distinct feeling I hold my breath to get up. It is something I never noticed before. One thing about getting hurt is that you suddenly realize all the unconscious movements you make to achieve something simple.

No more training for now. Deep breathing is no longer an option. Plus the shoulder makes riding dangerous and running next to impossible.

Another picture of my damaged helmet. You can see the missing chunk and a big scratch higher up.

Crash

Yesterday I crashed on my bike. The weather was nice even though it had been raining the past week, and I decided to go a 30 mile ride before the next storm hit. I had ridden the day before and avoided Pinehurst road, which is always shady, wet and full of debris this time of year. But yesterday I thought I might give it a try. Although it looked wet at the top it had been two days since the last rain and I felt it should be no problem going down the steep descent.

As I was coasting along, taking it easy and daydreaming, I suddenly lost control in a turn and went down. I clearly remember the whole sequence and I remember thinking, "wow this will be a lot of road rash." But I did not slide very far and quickly came to rest near the side of the road. I banged my shoulder and hip and had some difficulty getting up, but eventually I managed to get off the roadway. I also remember my face being very close to the roadway and what a strange perspective that was.

When I got up I walked a few steps and was able to get on my bike and ride some more. My bike was undamaged. Although the crash was similar to the one Alistair had that broke his frame, mine was unscathed. I was able to continue riding for eight more miles with very little problems but then decided to get home as my shoulder felt awkward and I could not put any weight on it or use the front brake effectively.

Very little damage to the jersey. It isn't even torn

I was able to undress and take a shower although I got very cold in the process. My clothes were black but Ok and I did not suffer much road rash (just the elbow), although I did get an imprint (tatoo-like) of the rough asphalt on my hip. After dressing my wounds I went to bed and lay there for a while. The pain in my shoulder, hip and chest became more intense and so I took some painkillers.

At night the pain got worse and I decided to call the doctor who sent me to the emergency room. I got X-rayed, got a brace and was sent home with a prescription for vicodin. They asked me about a head injury repeatedly but I could not remember hitting my head, nor did I feel any pain or show any other symptoms of a concussion. I was able to read and concentrate well in the afternoon and so I was not worried.

When we came home, my wife wanted to see my helmet and when she touched it she yelled out because  two large pieces came off that were loose. The helmet is an older helmet I have had for years, and one I wear in winter because it does not have large vents and is warmer than the newer versions. As far as I know it was without issues before the ride.

Some rather serious damage

My old Bell helmet with missing pieces

I had a rough night, despite the pain killers.

This morning when I woke up I felt better. My hip was a lot better and I was able to walk well. But my rib cage felt a lot worse. I had an appointment and went to see the orthopedist at Kaiser. There I was told I had a cracked rib and a grade I/II AC joint separation in my shoulder. Nothing much can be done about either of these and I was sent home with pain medication, instructions on how to cough with a pillow bracing (and keep coughing to clear my lungs) and an appointment for early January.