Post Triple Bypass 2019 Analysis

So, my first go at the Triple Bypass since 2012 has come and gone.

I didn't finish.

Again.

Completed in 2008 in 8:11:57.

Completed in 2009 in 9:18:53.

DNF'd in 2012 at mile 56 and 5:21:33.

DNF'd in 2019 at mile 76 and 6:25:01.

So, as you can see, there's a downward trend in terms of performance and completion. Not my preference, even if I went a lot farther in not a lot more time from 2012 to 2019.  In fact, in 2019 my average moving speed was about a mile-and-a-half faster than in 2012.  So, there's that.

In 2012, I took the whole thing for granted. I was overweight, under-trained, and had a minor sinus infection that drained me further. I didn't sleep the night before, knowing that it was going to be a hard day.

This year, in 2019, I did not take the whole thing for granted. I was still a bit overweight, I was not under-trained, but I did have a bit of a head cold that was at its worst the Friday before the Saturday ride. Moreover, I had a pretty stressful week from lots of travel (and eating - family vacation the weekend before) and little rest leading up to the ride, and I only gave myself two days at altitude to acclimate - that's definitely not enough, and I felt it. Excuses... excuses.

I don't know if I'll try the TBP again. I do know that in two and a half weeks, I'm riding the Copper Triangle and it's going to very closely mirror what I did complete of the Triple this year. About the same mileage. About the same elevation gain. Here's what's going to be different:

Altitude - It is what it is. Travel plans and resort bookings are already set. Can't fix this.

Travel - Other than getting to Colorado, I don't have any, so that's ideal.

Weight - Losing weight while building power and performance is a very tough balance to maintain. So, I figure I have the most bang-for-the-buck to be had by maintaining my current power (260 watt FTP) and dropping weight. I was about 190lbs (86kg) for the TPB. I'm taking a three-prong approach to try and cut weight without losing too much power.

1. Drop from the middle of a TrainerRoad mid volume cycling plan to the beginning of a low volume plan. This will both reduce the volume and the intensity, without eliminating training altogether.  Basically, I'm entering maintenance mode.
2. Start tracking what I eat again (MyFitnessPal) and keep at or slightly below my target daily calories. The lower volume workout plan should allow this to happen without sacrificing the workout quality.  Basically, what I should have been doing all along.
3. Add (very) short runs in the morning to add aerobic conditioning, increased caloric burn, and generally broaden my fitness base.  I'm not sure of the wisdom here, but my son likes to run, so I want to get better at it, too.

I'd love to get to 175lbs (79kg) by Copper, but if I'm sub-180, I'll be happy. That'll put my w/kg ration from about 3.15 to 3.3.  If I pace properly, that should be completely possible.  The last thing I want to do is push anything too hard and ruin my chances of completing the ride by starving myself or going out guns ablazin'. I'll watch this closely, and if the shorter, less intense workouts are becoming too difficult, I'll adjust accordingly.

Head Cold - I'm hitting this with everything I have. It's still very much present, but hopefully in two and a half weeks, it'll be gone.

Other things I'm going to manage carefully are stress at work and home and sleep. Less of the former, and more of the latter.

Surgery Delayed - And Maybe Again

I've been fighting a head cold, and as a result of that, the surgery that was scheduled for the 27th of November was delayed.

It's been rescheduled for the 4th of December.

I'm still fighting sinus congestion, so it may be delayed again.

I'm already critically behind on my scheduled training in order to be fully ready for the rides starting in April.  I'll be able to do them, I've no doubt, but I'm starting to doubt how WELL I'll be able to do them.  The one in April, in particular, is an "A" race for me - that's right, a "race", not a "ride".

We'll see.

It's difficult to describe the level of frustration I'm feeling about this right now, so I won't bother.

130 Days after The Event

I went to get X-Rays of my collar bone after spending 6 weeks on the Exogen machine, and as I expected, there was no discernible bridge bone growth between the two halves.

the X-Ray at day 130 looked pretty much exactly the same as the X-Ray at Day 1.

So, the doctor and I discussed options.

1. I could ride it out and hope that eventually the bones would fuse together.
2. I could schedule surgery and knock it out.

Option 1 - Ride it Out

Pros

• No surgical risk.
• No additional PTO required.
• No post surgery recovery time.
• No additional time off bike.

Cons

• In terms of healing, past performance indicates future results.  It hasn't healed yet, so chances are it won't, at least not anytime soon.
• I may never be able to lift more than 5 or 10 lbs with my left arm.
• I may never be able to ride with the same strength as I have in the past.

Option 2 - Knock it Out

Pros

• Much better chance of full recovery.  Not guaranteed, but far better.
• Full recovery means the ability to work out and get closer to my full potential physically.

Cons

• Inherent surgical risks.
• Surgical risks specific to clavicles.
• Good chance of more PTO required.
• Another 4-6 weeks in a sling.
• More time off bike short term.

I'm opting for surgery, and for the following reasons:

1. I have to think long term.  The pros and cons of having surgery line up so that most of the cons are short term and all the pros are long term.  The pros and cons of no surgery line up so that all of the pros are short term and most of the cons are long term.
2. I need to be able to lift more than 5lbs or so with my left arm at some point in life, hopefully sooner rather than later.
3. I really don't care to live much longer with the constant pain that ranges from barely noticeable to highly distracting.  It's never that bad these days, but it's more than I care to tolerate forever if I have the choice.
4. The doc made a seemingly side-note comment about having to go in eventually to fix it anyway, so better to do it sooner rather than later.  The longer we wait, the more complicated the surgery becomes because healing will continue, even if it never completes.

So, I'm waiting on a call back to get this scheduled and over with.

Dug DEEP Tonight

Tonight, I dug deep.  The evidence is clear...

Actually, what happened was this...

About midway through the second 10 minutes at highest power - about an hour or so in - I noticed some red droplets hitting my sweat-guard.  My son was in the room playing around, and I told him to go get a mirror.  I was starting to panic.  Red droplets?  I checked my nose... nothing.  I checked my forehead... nothing.

Then it dawned on me.

I was wearing a red bandanna, and though I've had the thing for years, I must have never washed it because it was "bleeding out" now that it was drenched with sweat.

*whew*

Funny thing is that my first thought wasn't to stop what I was doing, but to ask an easily distracted 5 year old to get me a mirror.

Clavicle Break Week 14 (Sep 23, 2018 - Sep 28, 2018)

Pain Level: 2
Discomfort: 2
Mobility: 9
Attire: Normal.
Sleeping: Bed.  Sleeping normally with no positional issues.
Nutrition: Supplements geared towards bone regrowth.  Back on the weight loss wagon.
Mobility: Getting around normally, but being careful again.
Physical Therapy: 5lb range of motion exercises plus some additional strength related movements.  Exogen device twice a day.

This will be the last of the weekly posts.  I'll update as needed from here.

I'm discouraged and frustrated by the apparent lack of healing.

Maybe it's that, or maybe something physical has happened, but it's hurt more this week than it has in over a month.

I'll keep going with the Exogen device, but I'm preparing myself for what feels like the inevitability of surgery.

Surgery I wanted the very day it happened, that if I'd gotten, I wouldn't be here writing this today.

<-- Week Thirteen | Series |

Music to my Bones

Picked this up today.  It's an ultrasonic bone growth stimulation device.

Here's to hoping it lives up to the hype...

Clavicle Break Week 13 (Sep 15, 2018 - Sep 22, 2018)

Pain Level: 1
Discomfort: 1
Mobility: 10
Attire: Normal.
Sleeping: Bed.  Sleeping normally with no positional issues.
Nutrition: Supplements geared towards bone regrowth.  Back on the weight loss wagon.
Mobility: Getting around normally.
Physical Therapy: 5lb range of motion exercises plus some additional strength related movements.

Doctor Update

I went to get my 12-13 week X-Rays done on Wednesday, the 19th.  It wasn't really what I was hoping.  Based on the x-rays alone, there's been no healing at all.  Those took on 9/19 look exactly like those taken 6 weeks ago.

The doc expected more as well, so the plan now is to use an ultrasonic bone growth stimulation device for the next 6 weeks and evaluate another set of X-Rays.  After that, if there's still no visible bridge bone formed, we'll talk other options.

Disappointed.

Pain and Discomfort

My injured shoulder feels like it's in good shape.  There's still some aching, but nothing even remotely debilitating.

Mobility

100% normal in typical day to day activities.  I'm not pushing it with strength training or heavy weights, but simply getting through the day feels unimpeded.

Physical Therapy

Same as before - I'm running through the activities with 5lb weights.  I've not been following the schedule as religiously as I should, but I'm not missing many days either.  I'm really looking forward to my X-Rays, after which I'm hoping I can start on some more gainful strength training.

Cycling Training

I took the week off training last week.  Work was relatively stressful, and I just felt like I needed a few days off.

However, On Sunday I actually got out on an outdoor ride for the first time since the accident.  It was a very low key ride around the neighborhood with my 5 year old son on my very comfortable MTB (Trek Stache 9.6), but it was enough to tell me that my shoulder felt great.

That ride was enough to inspire the confidence necessary to take a Ramp Test to see how much fitness I'd lost.  Not as much as I'd thought I would, pleasantly enough!

That said, work has continued to be pretty stressful, and so my motivation hasn't been that great this week either.  Not much by way of training.  I'm building up my mental fortitude to start again next week on Sweet Spot Base Mid Volume I plan in TrainerRoad.

Equipment

No changes.  Still waiting anxiously for next Spring...

<-- Week Twelve | Series | Week Fourteen -- >

Clavicle Break Week 12 (Sep 8, 2018 - Sep 14, 2018)

Pain Level: 1
Discomfort: 1
Mobility: 10
Attire: Normal.
Sleeping: Bed.  Sleeping normally with no positional issues.
Nutrition: Supplements geared towards bone regrowth.  Ate a lot this week.  Gained some pounds.
Mobility: Getting around normally.  Still being careful, but not feeling nervous about anything.
Physical Therapy: 5lb range of motion exercises plus some additional strength related movements.

Pain and Discomfort

At an all time low since my collision with the ground.  I'm still aware that there's an injury, but it's more of an itch, or a very minor ache, than actual pain.  The only thing that inches out of "Itch Territory" are the non-shoulder areas, i.e., my ribs and something somewhere around my left scapula.  Other than that, I'm feeling really good.

Mobility

100% normal in typical day to day activities.  I'm not pushing it with strength training or heavy weights, but simply getting through the day feels unimpeded.

Physical Therapy

Same as before - I'm running through the activities with 5lbs weights.  I've not been following the schedule as religiously as I should, but I'm not missing many days either.  I'm really looking forward to my X-Rays, after which I'm hoping I can start on some more gainful strength training.

Cycling Training

I took the week off training last week.  Work was relatively stressful, and I just felt like I needed a few days off.

However, On Sunday I actually got out on an outdoor ride for the first time since the accident.  It was a very low key ride around the neighborhood with my 5 year old son on my very comfortable MTB (Trek Stache 9.6), but it was enough to tell me that my shoulder felt great.

That ride was enough to inspire the confidence necessary to take a Ramp Test to see how much fitness I'd lost.  Not as much as I'd thought I would, pleasantly enough!

Equipment

No changes.  Still waiting anxiously for next Spring...

<-- Week Eleven | Series | Week Thirteen -- >

Ramp Test

I jumped the gun tonight and took a Ramp Test to see how far my FTP had dropped.  When I hit the deck on 6/23, I was officially at 232, but had probably climbed to about 240 with the training I'd done since that number was established.

With 12 weeks away from serious training efforts, I fully expected to drop below 200.  I've been spinning for a few weeks now, but it was all just spinning - no hard efforts.  Well, tonight I tested, and had only dropped to 224.  An official drop of only about 3.5%, and an unofficial drop of only 6.66%.

In spite of 13 weeks away from real training, I'm starting my next season higher than I started my last.  I can live with that.

How to take a Ramp Test.

Clavicle Break Week 11 (Sep 1, 2018 - Sep 7, 2018)

Pain Level: 1-6
Discomfort: 1
Mobility: 9
Attire: Normal.
Sleeping: Bed.  Sleeping on my left side becoming possible.
Nutrition: Weight loss caloric intake, with supplements geared towards bone regrowth.
Mobility: Getting around normally, but still being careful.
Physical Therapy: 5lb range of motion exercises plus some additional strength related movements.

Pain and Discomfort

Saturday was rough.  I'm not going to lie.  But it was rough only for a few minutes.  We took my 5 year old son to Field Station: Dinosaurs (Daddy liked it a lot more than he did - lots to see, but not much to do).  We started the visit with a run through their 18 hole mini-golf course, and ended it with a couple of hours walking through the park and looking at everything.  It was a lot of walking, and it was very hot.  By the time we got to the end, my shoulder was loudly complaining, almost to the point of screaming.  Then, I crossed my arms just right (I guess) and it settled right down.

After that, for the rest of the week, there was some occasional "stickiness" and what felt like bursitis pain (I already have that in my other shoulder from a similar, though much slower crash in college), but it was never anything I'd rate more than annoying.

Mobility

I am very nearly normal at this point.  There is still some light "stickiness" and discomfort if I've not moved my shoulder in the last hour or so, and the shoulder is not entirely "invisible" yet, but overall, mobility is very high and pain-free.

Physical Therapy

I continued with the 5lbs weights. I didn't hit every day, because of our weekend out of town, but I don't think it really affected me much.  When I got back into it, it was as if I'd never stopped.

Cycling Training

I kinda took this week off.  Work got especially crazy this week, and after the stress of the days, I just didn't have much left for anything but TV time with the wife and a glass of wine.

Equipment

Nothing new on the equipment front.  I have everything I need, and what I want won't be out until next year.  These bottle cages look pretty cool, though, and might make a good addition to the new bike when it arrives...

<-- Week Ten | Series | Week Twelve -- >