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 -- >

Clavicle Break: Week 10 (August 25, 2018 - August 31, 2018)

Pain Level: 1
Discomfort: 1
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.  Starting to use the left arm almost as much as the right.
Physical Therapy: 5lb range of motion exercises plus some additional strength related movements.

Pain and Discomfort

Pain and discomfort continued to decline this week. Saturday was a little rough, because that was the day we took Dawson to Kill Creek Park for his first Triathlon (which he completely rocked, by the way - holy COW that boy has a competitive streak!). There was lots of walking and moving around, and it took its toll. Still, it wasn't too bad, considering how bad it was just a few weeks previous.

There continues to be minor pain in other areas around my chest.  It's mainly on the left side (go figure).  Under my arm about midway down it's sometimes sore when I breathe deeply.  It also shows up under and around my left shoulder blade towards my spine.  That's diminished somewhat if I can stretch and pop my back with the right twists (which do not aggravate my clavicle anymore).  This could be simply post-event-trauma that's going to need time to work itself out, but if it persists until my X-ray appointment on 9/19, I'll ask about it.

I think it's worth noting is that, while the clavicle itself appears mostly fine, with only a hint of "stickiness" now and again, there is still some discomfort around the joint every now and again - on both ends of the bone, actually.  Again, if that persists, I'll mention it, and maybe go for an MRI to see if there's anything there.

Most promising is that there have been multiple times this week when I've gotten up to do something, and only after I've finished what I wanted to do (go to the break room for more coffee, go talk with someone, etc.) did it occur to me that my collar bone hadn't occurred to me.  There was no pain or weirdness to notice.  That's a great thing!

Physical Therapy

I started adding a couple of additional weighted exercises into my physical therapy.  I'm still sticking with 5lbs until the doc clears me, but I think it's safe to add some curls, and bent-over dumbell rows.  I also ramped up my leg exercises with lunges, squats, and deadlifts.  I started planning additional cycling specific strength training, in addition to the structured plan I'd already committed myself to.

I skipped Saturday and Sunday spins, but got back on the saddle Tuesday, Wednesday, and Thursday. Good rides, and productive.

Equipment

I got a new saddle to replace the one that snapped during The Event. I went from a Fizik Aliante R1 Versus Evo Large, to a Fizik Arione R3 Versus Evo Large. The Arione is designed for someone with a little more flexibility than the Aliante was, and the R3 means it has their k:ium rails, rather than carbon. I used their saddle fit wizard to find this one, where before I'd been winging it. I went with the R3 k:ium rails because I just didn't feel like messing with the carbon rails this time around.  It was an immediate comfortable fit.

<-- Week Nine | Series | Week Eleven -- >

Clavicle Break: Week 9 (August 18, 2018 - August 24, 2018)

Pain Level: 1, occasional ibuprofen.
Discomfort: 1-4
Attire: Normal.
Sleeping: Bed.
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.

I skipped my Saturday light intensity spin session - I just wasn't feeling it, and we had a late night with our 5 year old anyway.  I did get up Sunday and rocked a 60 minute session after a careful night's sleep.  As hoped, there was no pain Sunday morning after Saturday's soreness, though the collar bone still felt "sticky" as they say.  I think that's reasonable evidence that how I sleep makes a huge difference.

The rest of the week saw my normal Tuesday, Wednesday, Thursday sessions, each one going very well.

I have to admit, at the beginning of the week I was starting to worry about how well was healing. I would have expected the stickiness to dissipate more by this point.  I  started wondering if the regular daily movement I'm subjecting the shoulder to, including physical therapy, was getting in the way of hard fibrous material forming.  So I did some additional and closer reading of what I could find online, and decided to relax a little.  8 weeks is too soon to start getting impatient with healing.  I'd know more during my final follow-up X-Rays on 9/19... unless something happens to cause obvious re-injury, that is.

Towards the end of the week the pain and discomfort continued to slowly dwindle.  It's hard to say it's getting better day to day, but the 2-3 week rolling average shows improvement.  Maybe there's nothing to worry about, and things are going the way they should be.

More than my actual shoulder, it's the ribs and back I'm worried about.  I can't tell if it's tight muscles, or something else.  Either way, by the end of the day, laying down for the night is a notable relief.  It's like there's something there that, if I were only to stretch it out just the right way, everything would snap back into place.  I'll keep monitoring it and ask the PT about it if it continues.

Aside from that, as I'm looking forward I think I'm going to try to plan some strength training back into things as well.  I'm not interested in taking my cycling to a level that would require me being emaciated except for the legs.  Rather, I'm interested in being generally fit all around, but with an emphasis on cycling performance.  Upper body mass, frowned upon by the more elite cyclists, not only won't phase me, but is actually (especially now) that much more attractive.  I don't want to sacrifice my cycling fitness... I just want to add more body strength.  That balancing act will be the tricky part.

<-- Week Eight | Series | Week Ten -- >

Mommy, what's a "tour"?

Dawson: Mommy, what's a tour?
Jami: It's like a trip. Like a tour of a country, or a tour of a factory...
Dawson: Like the Tour de France?
Jami: Yes.

... beat.

Dawson. Those boys oughta be done by now, don't you think?


Dawson is 5.

Clavicle Break: Week 8 (August 11, 2018 - August 17, 2018)

Pain Level: 1 to 2, occasional ibuprofen.
Discomfort: 4 to 10
Attire: Normal.
Sleeping: Bed.
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.

Work continued as normal.  It's basically a desk job, so there isn't much physical strain to be had.  The most physical stress I put on myself this week was moving a monitor from one room to another.  I don't think that was overdoing it.

I continued riding the indoor trainer this week.  I'm sticking to the low intensity recovery sessions - and plan to until I get fully released by the doctor.  The previous week, all my sessions were 30 minutes.  This week, I stuck (mostly) to the plan I mapped out, calling for me to substitute 45 minute sessions in for the sessions that would have been high intensity.

That said, my motivation wasn't great.  I skipped Wednesday (30 minutes), but did ride Thursday evening for 45 minutes.

I did have a bit more general pain this week than previously.  The pain in my chest, most noticeable when breathing full deep breaths was back and worse than last week, and my collar bone seemed to be a little more upset at me as well.  Based on the timing and the fact that I haven't done anything physically strenuous this week tells me that I'm probably sleeping on it wrong - or the indoor training is to blame.

I'm going with sleeping habits for now.

If it doesn't settle down soon, I'm going to reach out to the doctor and ask them what they think.  I hope that it's just general aches and pains from the fairly intense trauma from the crash, but it may be a good idea to get a more professional opinion if it keeps up.

I did re-watch the video of the crash.  Call it morbid, but I wanted to watch the actual event frame by frame to see how things went down.  I was also interested in the conversations.  I've considered transcribing it... maybe it's just my way of continually processing it.  Fun stuff...

This week was also interesting from a mental standpoint: it was the first time a sense of unreality set in - that feeling that "this didn't really happen to me, and I'll wake up completely back to normal."  It wasn't a deep feeling by any means, but it was there.  I'm not sure why it took so long to happen, but there you have it.

<-- Week Seven | Series | Week Nine -->

Clavicle Break: Week 7 (August 4, 2018 - August 10, 2018)

Pain Level: 1, no pain medication.
Discomfort: 1 to 10
Attire: Normal.
Sleeping: Bed.
Nutrition: Transitioning back to weight loss caloric intake, with supplements geared towards bone regrowth.
Mobility: Getting around normally, but still being careful.
Physical Therapy: 3lb range of motion exercises.

This marks my return to relatively normal life as I return to work.  My first day back was Tuesday, August 7th.

Tuesday, August 7th was also my first day back on the trainer.  On Monday, the 6th, I moved the bike down to the basement and was able, without too much trouble, to get it reconnected to the Tacx Neo Smart trainer.  On Tuesday, I attempted my first short and easy 30 minute ride to test the waters and see how things felt.

They.  Felt.  Awesome.  I was grinning from ear to ear nearly the whole time.  I cannot describe how great it felt to be back on the saddle.  There was a very slight level of discomfort in the shoulder that came and went, and wasn't affected by my position.  All in all, this first session green lit future sessions without question.

I rode indoors again Wednesday, Thursday, Saturday, and Sunday.  I posted to /r/TrainerRoad about my plan, and got some good feedback.  The plan was basically to follow the same workout schedule I was previously on, but replace every workout with a very low intensity workout.  I wanted to avoid anything that could cause me to pull to hard on the handlebars.  Furthermore, I'd start with 30 minute sessions only, and increase the time for what would have been intense sessions to 45 minutes and 60 minutes over a few weeks.  Everything would still be low intensity, but where the previous plan called for high intensity, I'd just increase the duration to 45 minutes, then 60 minutes as my body allowed.

Perhaps (hopefully) coincidentally, the latter part of this week saw an increase in pain in other, previously unnoticed areas, specifically between my shoulder blades, and at various areas around my rib cage.  Hearkening back to The Event, where I felt some distinct pains at various points in my back and sides, I became more and more convinced that I had done some ribs as well.  There wasn't any constant ache, but I felt some distinct soreness when breathing deeply as well as a curious NEED to breathe deeply.  I decided to weather it for another week or so.  If it stuck around through the 17th of August, I'd call the doctor about it.  The pain was minor, and wasn't preventing me from doing anything - call it a weakness, but not a limiter.

My replacement bike shopping landed on the Canyon Ultimate CF SLX Movistar 9.0, with Campagnolo Record groupset.  Unfortunately (or perhaps fortunately) it won't be available in the U.S. until early 2019.  I took the time to see how it might compare to my Torelli, may she rest in peace...

Physical therapy continued this week, and I increased the weight from 2lbs to 3 lbs.  As before, the only movement that continued to cause some difficulty was the palm up front raise.

<-- Week Six | Series | Week Eight -->

Clavicle Break: Week 6 (July 28, 2018 - August 3, 2018)

Pain Level: 1 to 2, no pain medication.
Discomfort: 4 to 10
Attire: Pretty much normal.
Sleeping: Bed.
Nutrition: Higher than normal calories to maximize healing, with supplements geared towards bone regrowth.
Mobility: Getting around fairly normally, but still being careful.
Physical Therapy: 2lb range of motion exercises.

I continued living Diet-Life this week, but started preparing for the trip to Colorado.  A friend and I drove out on the 31st.  It wasn't the most comfortable ride, but it wasn't horrific, either.

Physical therapy continued throughout the trip, and I was able to keep my nutrition levels up at maximal healing levels.  The palm up front raise continued to give me a little trouble this week as well.  Somehow, I figured this would be the case, and would be something to bring up to the physical therapist.  I'm using 2lbs weights at this point.

Since this is about the healing process, I won't go too much into the trip itself, other than to say I'd accepted the fact that I couldn't ride, so I enjoyed the time with friends.  I continued to focus on the Seven 622 SLX as my replacement bike, but the cost was starting to look practically out of reach.  I started looking around again, and was told about the Canyon Ultimate CF SLX by a friend.

Discomfort and pain levels had pretty much leveled off to about a 4 on the discomfort scale, ramping up to 9 or 10, then moving into real pain if I exerted myself too much.

The last day of the trip was, for some reason, the worst as far as pain goes.  I think the cumulative effect of the trip caught up with me.  This was the first time I'd taken pain medication since ditching the narcotics.  OTC Alleve for the win.

<-- Week Five | Series | Week Seven -->

Clavicle Break: Week 5 (July 21, 2018 - July 28, 2018)

Pain Level: 1 to 3 no pain medication.
Discomfort: 5 to 10
Attire: Getting back to normal, so long as it goes on without much strain.
Sleeping: Bed.
Nutrition: Higher than normal calories to maximize healing, with supplements geared towards bone regrowth.
Mobility: Getting around fairly normally, but still being very careful.
Physical Therapy: Body weight range of motion exercises.

I had my first follow up Orthopedic visit on the 26th of this week.  Until then, it was business as usual.  I had full range of motion nearly immediately in my shoulder, though there was stiffness and some pain that didn't seem to come from the clavicle itself.  I credit my small attempts at movement a few times a day in the days prior.  The X-Rays showed no sign of calcification, but that's completely normal.  The doctor was able to (gently) push and pull on the clavicle with no obvious movement, indicating that the bones were definitely knitting together, even if it didn't show on the X-Rays.  He gave me the go ahead to ditch the sling and start physical therapy.

He also released me back to work, just in time for my trip to Colorado (where I would have ridden the Copper Triangle with friends).  I felt better about taking PTO for that time, rather than doing it while still on medical leave.

Physical therapy consisted of body weight arm movements, including side raises, front raises (palm up and palm down), "coke can" raises, low resistance theraband cross body pulls, and finally shoulder blade compressions followed by toe-touches meant to stretch the back (that last one felt absolutely phenomenal).  I was prescribed these 3 times a day for 30 seconds, building 15 seconds a day until I reached two minutes.  After that, I could start adding light weights, starting with 2lbs, then 3lbs, and finally 5lbs, incremented weekly.  I could postpone the additional weight if the pain dictated it, but I was advised not to advance the weights.  This is recovery - not strength training.  The idea is to explore and identify problems, not exacerbate them.

The only exercise that gave me any trouble is the palm up front raise.  Something is stretched, torn, ripped, or otherwise damaged that catches at the top end of that movement.

I was very diligent with physical therapy this week.

A lot of time was spent in the recliner, though not as much as previously.  I continued with the YouTube videos, the cycling documentaries (having exhausted what I could easily find on Lance Armstrong), and followed the Tour de France through Thomas' win in Paris.

I was able to get out into the garage this week and really cleaned the bike up.  It was easier with both arms available, but I still approached it very carefully.  I didn't repair anything, but I did get all the dirt off of it and realigned the handlebars.  I found a couple of new things, though.  A barely noticeable, yet still worrisome deformity in the rear wheel, and a snapped rail in my saddle.  The rear wheel is concerning, but the saddle is toast.  The dent in the top tube is still a concern, but I was confident that neither it nor the weird deformity in the rear wheel would hinder any indoor training efforts.  Since that's all I planned to do for the foreseeable future, I wasn't that concerned.  However, I didn't have confidence in the frame (as awesome as it's been) for outdoor riding, so I started gathering info for my next bike.  I focused on aero road bikes this week, gathering a list of about 20 potentials.  The point of this is that through my injury, my love and passion for the sport hadn't diminished.  I was mentally, if not physically prepared to go all in, full gas, 100%.

My bike research settled on the Seven 622 SLX custom bike.  I started to think about how I could afford it.

All in all, this was the first week that things started feeling relatively normal.  I still did everything slowly, deliberately, and carefully, but I was able to do pretty much everything within reason.  It was living Diet-Life.  Life-Light.

Just in time for the trip to Colorado, where I wouldn't be riding the Copper Triangle with my friends.

<-- Week Four | Series | Week Six -->

Clavicle Break: Week 4 (July 14, 2018 - July 20, 2018)

Pain Level: 1 to 4, no pain medication.
Discomfort Level: 6-10
Attire:  Shorts and a sling.  Occasional button up shirts.
Sleeping: Recliner, then bed.
Nutrition: Higher than normal calories to maximize healing, with supplements geared towards bone regrowth.
Mobility: Slow, but able to move around much easier.
Physical Therapy: None

Week four saw more improvements in pain level, mobility, and nutritional intake.  I also moved back to bed, and out of the recliner.  It was with no small amount of satisfaction that I removed the sheets from the recliner, and largely put the living room back to normal.

That said, I still spent the vast majority of my time in the recliner.  I continued watching YouTube videos on cycling, documentaries about Lance Armstrong, and following the Tour de France.  Richie Porte - Ugh.  Makes my problems look small...

I was able to get up and spend more time at the computer, but only in short stretches due to the position required of my left arm.  I had about 15 to 20 minutes at a time before I had to take a break.  I'm not sure if the pain was from the break, or the tightness in soft tissue - I suspect the latter.  Most of my time on the computer was spent narrowing down the list of bike replacement candidates.

I was able to spend more time with my son playing Legos and Hotwheels.  He'd been very very good through the previous weeks, and seemed to understand that I just couldn't do some of the things I'd previously done.

I did attempt some time without the sling.  I didn't try moving my shoulder much, but I did let it hang free.  That lasted about a day and a half.  I called the doctor's office to find out what they recommended for physical therapy.  They answered that they recommended I stay in the sling 100% and save physical therapy for later.  I resisted for a day or so - convinced I knew my body better than they did, then went with their advice and went back to the sling as the discomfort mounted into pain.  I accepted, eventually, that maybe they had a little more experience with this than I.  My elbow was pretty well seized up though, so I worked that until I could at least open and close it fully, even if it did hurt some.  I continued with this even after putting the sling back on... I just saved it for when I was sitting down, or changing the sling out for shower time.

I did notice this week that I could rest some weight on the arm.  Sitting down, I could lean forward and relax with my elbows resting on my knees.  This was very encouraging, as it resembles the position I'd be in on the bike.  Also, simply relaxing in a different position felt great.

<-- Week Three | Series | Week Five -->

Clavicle Break: Week 3 (July 7, 2018 - July 13, 2018)

Pain Level: 4 to 7, weaning off Norco 5/325.
Discomfort Level: 10
Attire: Shorts and a sling.  Occasional button down shirts.
Sleeping: Recliner.
Nutrition: Higher than normal calories to maximize healing, with supplements geared towards bone regrowth.
Mobility: Slow, but getting more comfortable moving around.
Physical Therapy: None

Week three is more of the same as week two in terms of mobility and eating.  I did, however, stop taking pain medication.  True to what I'd been told and most of what I'd read, the constant pain dissipated during week three to the point that I was comfortable ditching the narcotics.  I still had to be careful though, b/c pain could easily ramp right back up to 10 if I moved wrong.  The constant ache was gone, but the bone and surrounding tissues were still very much broken.

I tried a night in our bed this week, but found it to be too uncomfortable, so I went back to the recliner.

To pass the time, I watched YouTube videos on cycling, Lance Armstrong documentaries, and followed the Tour de France.

I did find the motivation to head out to the garage and take a look at the bike.  I didn't clean it, I was only interested in a visual inspection.  I identified the following areas of damage - the handlebars were very much out of alignment, the handlebar tape on the right side was shredded, there was a dent of about 1.5" in the side of the top tube about halfway between the head tube and seat tube, and the rear tire was flat.  The dent wasn't deep and didn't appear structural, but it did cause me no small amount of concern.  I started gathering a list of potential replacement bikes.

That sharp pain in my right side seemed to resolve itself.  It was nowhere to be found this week.  Also, I didn't note any ribcage pain.  That was curious, and promising.

Showers continued to get easier and less painful, but I was still very very careful.

We went back into the doctor's office and they were able to remove those final two stitches.  They had to dig around a bit, but they got them.  They advised we keep it bandaged for another week or so, if only to avoid ripping it open by bumping it on something.  The skin was holding firm, but wasn't necessarily as strong as it would be when 100% healed.

All in all, healing appeared to be progressing fairly well.

<-- Week Two | Series | Week Four -->

Clavicle Break: Week 2 (June 30, 2018 - July 6, 2018)

Pain Level: 1-8, and tempered by Norco 5/325.
Discomfort Level: 10
Attire: Workout shorts and a sling.
Sleeping: Recliner.
Nutrition: Higher than normal calories to maximize healing, with supplements geared towards bone regrowth.
Mobility: Very low.
Physical Therapy: None

Week two is honestly a bit of a blur.

We did make it to my doctor to have the stitches removed.  This happened later in the week.  Getting there and back again was... unpleasant.  Not terribly painful, but certainly unpleasant.  Once there, they were able to pull all but two stitches, which were too deeply embedded.  They advised continued use of the bandage, wrapping, and antibiotics.  Another appointment was scheduled for the following week.

I lived in the recliner again this week.  Getting up only to shower and use the restroom.  It was very easy to aggravate the collar bone, shoulder, ribs, and arm.  So I just avoided moving as much as possible.

I binge watched The Office, Seasons 1 through 9, and then moved on to Supernatural.  I tried to go upstairs and build Legos with my son, but I couldn't take the position for long before I had to head back to the recliner.  I wasn't able to do this until late in week three.

Showers were easier because my wife found a waterproof sling that I could use.  That stabilized things enough that the pain was less than it had been, though I still dreaded them.  As such, these first two weeks saw me in the shower every other day, at most.

We continued to change the bandage on my arm daily.  Every day, the old bandage was a little less stained than the previous day, and there was no sign of infection.  It was looking like the doc did a decent job.  It's going to make for an ugly scar, but it didn't look like it would be infected.

I was also able to shift my thinking from weight loss to recovery this week.  I ate a lot more for every meal than I had since I started training, in hopes of sufficiently feeding the mechanisms involved in bone healing.  I'd read multiple places that bone growth requires at least an additional 600 calories.  I intended to provide.  I did some research on supplements and good foods to promote bone regrowth.  For foods, I basically landed on lots of whole foods, including fruits and vegetables (dark leafy greens).  For supplements, I landed on Glucosamine, Chondroitin, and MSM, plus multi-vitamins to round things off.

I also started practicing the concept of front loading the day with a relatively big breakfast, smaller lunch, and even smaller dinner.  While it didn't really apply to my current sedentary state, the idea is to provide more calories for the active day, and reduce calories right before bed.  So, I started aiming for a percentage of calories per meal at about 45/35/20.

The cramps in my left deltoid did not return this week, though the sharp pain in my right side remained - again, only when I moved my right arm in a specific way.

I started looking forward to the Tour de France, which started on July 7th.  I not only hadn't given up on cycling, but I started to feel all the more determined to get more involved and knowledgeable about it.

<-- Week One | Series | Week Three -->

2019 Canyon Utimate S / 2004 Torelli Scappa 55cm Geometry Comparison

Out of curiosity, I did some comparisons between my current bike, a 2004 55cm Torelli Scappa built out with various parts with what I'm eyeballing as the replacement, a stock Canyon Ultimate CF SLX 9.0 Movistar.

Torelli	Canyon Ultimate

I plugged my numbers into the Canyon sizing wizard (Their Perfect Position System), and they spit out a "Small" as the frame size for me. I thought that was curious - I'd always felt (note that I'd "felt", not "known") myself to be more of a Medium kind of guy. So I compared the Ultimate Small geometry and sizing to my Torelli...

Component	Canyon Ultimate  CF SLX 9 Small	<=>	Torelli (55cm)	Adjustable on Stock Canyon
Rider Height (cm)	172-178	N/A	177	No
Saddle Height (mm)	690-790	N/A	770	Yes
Seat tube length	494	<	590	No
Top tube length	543	<	550	No
Head tube length	130	<	151	No
Head tube angle	72.3°	?	Unmeasured	No
Seat tube angle	73.8°	?	Unmeasured	No
Chainstay length	415	>	397	No
Wheel base	993	>	988	No
Stack	546	<	570	No
Reach	385	>	375	No
Spacer	27.2	>	0	Yes
Stem length	90	<	110	No
Handlebar width	390	<	420	No
Crank length	170	<	172.5	No
Seat post diameter	27.2	==	27.2	No
Seat post length	350	N/A	Unmeasured	Yes
Wheel size	700c	==	700c	No

The Torelli is larger in a number of nonadjustable ways, most notably tube lengths, and stack.

However, the Small Canyon Ultimate frame has a longer chainstay length, a longer reach, a longer wheelbase, and will be closer overall to the ground. Based on my limited experience and understanding, those will have more impact in terms of fit and handling.

I didn't measure the angles, but the Torelli appears to be generally more "compressed" with its shorter wheelbase.  I'd bet that the angles are more open - closer to 90°.  Relative to the wheel base, this may make the center of gravity higher.

Other measurements where the Torelli is bigger, such as the handlebar width and crank length aren't intrinsic to the frame, and are ultimately adjustable if I want to move away from the stock Canyon Ultimate and spend the money.  I'm not really factoring those in.

I believe the Torelli will prove to be more twitchy and responsive than the Canyon, but less stable.  I anticipate cornering will require a little more effort with the Canyon, while maintaining my line will be slightly easier.  This may explain why going no-hands was always a little tough on the Torelli.  It was possible, but it never felt quite comfortable...

I'd like to take a photo of the Torelli and overlay it on top of the Canyon Ultimate to get a visual idea of how the measurements above look.  I'll give it a shot and see how that goes.  My photo manipulation skillz, never great, are nowhere near what they used to be.  I gave it a shot (no pun intended), and it didn't work out.  I'll just have to get the angles the old fashioned way.

At the end of the day I don't know what I'm talking about.  So I'm inclined, based on what I see and the understanding that the Canyon folk have a lot more experience, to go with their recommendation.  Not that I wouldn't have, mind you, I just wanted to see how the Ultimate compared to the Torelli.

Clavicle Break: Week 1 (June 23, 2018 - June 29, 2018)

Sidenote: Entirely for my own purposes, I imagined discomfort and pain as two separate, but conjoined scales.  First is discomfort, which ranges from 1 to 10.  After a level 10 discomfort, it graduates to level 1 pain, ramping up to the worst possible level 10 pain.  To those who wonder why I don't just collapse the scales in to the industry accepted chart, I answer "This one goes to eleven."

Pain Level: 6-8, but tempered by Norco 5/325.
Discomfort Level: 10
Attire: Workout shorts and a sling.
Sleeping: Recliner
Nutrition: Very little
Mobility: Very low
Physical Therapy: None


I don't remember Sunday.  I imagine that day was spent (by my wife) arranging the living room for an extended stay, including getting power out to the recliner for my phone, a TV tray set up nearby and within reach for my meals, books, remote control, and various flotsam.

It may have been on Sunday, or it may have been Saturday night, but my 5 year old decided to run his bike into the garage door and fall over.  He got up and proclaimed to my wife that he'd broken his collar bone, too.  He did not, he just wanted to be just like Daddy...

On Monday following The Event, we got in to see an Orthopedic surgeon.

First, however, we had to drive all the way back to the hospital ER I was originally admitted to.  It was about a 45 minute drive which isn't too bad in the grand scheme of things, but when your Ortho is 10 minutes from home, and you have to spend 2 hours or more in the car to get there and back including traffic and wait time, it's a problem.  So, the lesson is, get the X-Rays on CD before you leave the ER, just in case your Ortho and the ER can't electronically communicate like mine couldn't.

So, we made the drive.  He reviewed the X-Rays and determined that I wasn't a candidate for surgery.  There wasn't enough displacement between the two halves of the bone, and his opinion was that I had a 95% chance to heal naturally if I took care of it properly.  Surgery would have been unnecessary and would introduce risks that just weren't worth it.

It's difficult to express the level of disappointment I felt. I'd been training very hard for months in order to take part in my "A" event in Colorado - The Copper Triangle, and I had to come to terms with the fact that I wouldn't be riding that, or anything, anytime soon.  I left his office committed to getting a second opinion that led to surgery, but by the next morning, had come around to his way of thinking.  The risks just weren't worth it, and there'd be no guarantee that surgery would have gotten me back on the bike too much sooner anyway.  Well... it probably would have, but again with the risks.  Honestly, I think I was just too uncomfortable and exhausted physically to mentally deal with the effort of getting that second opinion.  I really did not want to leave the house again unless I absolutely had to.  I was full on Protect The Shoulder mode.

I lived in a recliner for the entire week, and basically had assistance with everything, aside from bathroom visits.  Fortunately, I was able to accomplish that on my own.  Showering was ridiculously painful and difficult because we didn't have an extra sling.  I self-supported the arm, and didn't to a great job of it.

Throughout the week, when I moved my right arm in a very specific way I experienced a stabbing pain in my right side, right at the bottom tip of the latissimus dorsi.  This was weird b/c it was my left side that took the hit.

Now and again, a small vertical strip in my left deltoid would seize and cramp painfully.  Unfortunately, I just had to wait it out because I couldn't move my arm to relieve it.

We changed the bandages above my elbow daily, and it was a bit of an ordeal because I had to raise my arm to get the bandage underneath.  That felt far less than stellar.  The old bandages were pretty stained every day, and we were on high alert for infection.  It was a filthy dirty wound.

My wife, by the way, was a superstar through all this.

I ate very little because I was still motivated to get down to my mountain climbing weight (~77kg), and because eating was uncomfortable and inconvenient.

A highlight of the week was receiving a package in the mail.  In the package was a set of training wheels that my Brother and Father ordered for me.  That gave me a very much needed laugh.

<-- The Event | Series | Week Two -->

Clavicle Break: The Event (June 23, 2018)

As a followup to my previous post... this time with more cowbell...

I broke my collar bone during a ride called The Tour de Lakes in Lees Summit, Missouri, at about 10:10 AM on 6/23.  I was going too fast in the aero bars down a hill that ended in a blind curve.  Unable to make the curve, I exited the pavement and hit the deck among the broken pavement, rocks, and trees.


Passing riders saw me within 2 minutes, assessed me, and called Ride Assistance (we had the number on all our wrist bands).  Within 14 minutes, the paramedics had arrived, and within 17, the ambulance had arrived.  While on site, my blood pressure dropped to 60/48, but other than that, I was awake, aware, and had no indication of head trauma.

Complete, but clean clavicle break

In terms of obvious injuries, my left arm above my elbow was on fire, my left shoulder was in serious distress, and there were several areas around my chest that hurt.  Something had happened to my arm - they were talking about blood pooling on the pavement.  I asked if it was arterial, and they told me I was fine.  My collar bone was definitely broken or dislocated, though apparently not obviously to even the trained eye, and it felt like I'd done some ribs as well.

While they were looking me over and prepping me for the trip to the ER, I recall making several comments about not leaving my bike behind.  I also remember looking it over as much as I was able, and confirming that at least the wheels weren't taco'd.

I was in the ER for about 5 hours while they gave me morphine, took X-Rays, cleaned and stitched my arm.  The clavicle was definitely broken, and the arm required 11 stitches, 7 external and 4 internal.  Something I hit in the tumbling tore an inch square hole in my arm down to the subcutaneous fat.  My Mother asked if she was looking at bone - fortunately, she was not.

Severe laceration/trench caused by unknown road debris

My wife and 5 year old son came to the hospital to see me and take me home.  I was really hoping my son wouldn't see me in this condition, but there wasn't much I could do about it.  He was witness to me in pretty severe pain, and got a close look at the bloody dirty hole in my arm.  He kept it together, though, with a lot of assurances from my wife, myself, and the staff that I would be perfectly OK - it would just take some time.

Most of the time was spent waiting, which shouldn't come as any surprise.  After they released me, it was straight home and to the recliner.  I got up only to use the restroom and take off my jersey.  Amazingly, we were able to get it off without cutting it off, and even more amazingly, it was completely intact!  All that damage to me, and somehow my jersey didn't get ripped up!

<-- Original Post | Series | Week One -->

So... This Happened...

At about 10:07 AM on June 23rd, I had the worst bicycle crash of my long and otherwise uneventful (and decidedly non-decorated) cycling career.

It was at about mile 45 of the 2018 Tour de Lakes.  The video linked to below shows the event, but essentially I was going too fast around an unfamiliar turn and was unable to negotiate it successfully.

Here is a video of the event:  https://youtu.be/-F4X9cidSmI

Here are a couple pictures that show the damage:

Complete, but clean clavicle break

The clavicle break was not a candidate for surgery, meaning I'm on a longer, but otherwise complication free recovery tract.

Severe laceration/trench caused by unknown road debris

The laceration/trench required 11 stitches in total, including 4 internal and 7 external. All but one was removed on Friday, June 6th. That one was too embedded and the tissue still too swollen to remove it safely. The final embedded stitch was safely removed on Friday, June 13th.

Detailed Account of The Event -->

Legit Sore

Yesterday was the first time I can recall my quads being actually sore from cycling.  I've had that day-after burn from running and strength training (squats, deadlifts, etc), but never from cycling... until yesterday.  The workout was Spruce Knob, and consists of two thirty minute intervals separated by a 6 minute recovery interval.  All this at 85% FTP.  In other words, it's a tough one.  A lot of time is spent very near threshold power, and there's not a ton of relative recovery time between efforts.

I've done multiple centuries in the Kansas heat.  I've done the 120 mile Triple Bypass in Colorado three times (well, I actually finished it twice).  I've done all-out nothing-left-behind time trials and end-of-long-ride sprints.  None of those have me lingering muscle soreness.  The left me totally cooked, but not sore.

I'm going to read that as a sign that TrainerRoad is working.  Those workouts are the cause of this soreness, after all.  The weekend high intensity workouts prescribed in my Sustained Power Build plan are... well... intense.

On the TrainerRoad - What I've Learned So Far

Over the last year or so, after a several year hiatus, I've immersed myself in the world of cycling again.  This time, it's with a much higher focus on actual "training", rather than the bike riding I passed off as training in years past.

I've been riding bikes since I was about 4.  It wasn't really until this past April, 40*cough*-some-odd years later that I really started legit training.

I'm no stranger to hard rides.  Some of my "career highlights" include:

• Multiple unsupported centuries and near centuries in the Kansas summer heat and humidity.
• Multiple supported centuries and metric centuries in the Kansas summer heat and humidity.
• Three attempts at the Triple Bypass in Colorado, with two completions.
• The Tour of the Moon in Colorado.
• Thousands of miles on secondary Kansas highways and urban streets.

In April of 2017, I started riding a lot more in preparation for the Tour of the Moon in September.  That was a fantastic ride.  We had a great time.  6 months later, I raced the 2018 Corporate Challenge KC Time Trial.  It's a paltry 2 laps on the Kansas Speedway, totaling 3 miles.  I did it in 7m 22s, at an average power of about 250 watts, and I was completely cooked.  It took me 10 minutes to catch my breath, and another hour for the chest burn to subside.  I left everything out there on the track, and enjoyed every second of it.  As an added bonus, that performance earned me 5th in my age bracket overall, and 1st in my division!

That performance proved to be the tipping point for me.  Maybe I can actually do a little more with this cycling thing.  It inspired me to graduate from simply "riding my bike to get better" to actually "training."  I'd been listening to the TrainerRoad podcast for a few months already, so the concept of structured training was already in my mind.  After that race, I bought a smart trainer, the Tacx Neo Smart, some Favero Assioma power meter pedals, a few other odds and ends for my "pain cave", and a subscription to TrainerRoad.

I researched the training plans, asked some questions, and came up with a path designed to generate the most fitness given my limited time.  On August 4th, myself and a bunch of friends are tackling the Copper Triangle in Colorado (we do like our Colorado rides).  My training began 15 weeks prior to Go Time, on April 22nd.  That's not a lot of time, when you consider that the standard TR plan takes 28+ weeks.  I had to adjust the plans, and bank on having sufficient carry-over fitness to make it work.

So far, I think it's working.

Recall that I was completely spent lungs a-burnin' after pushing 250 watts for 7m 22s.

On Saturday June 8th, after training for 6 weeks, I did a workout composed of 5 6 minute intervals at 250 watts separated by 4 minutes of recovery.  That's nearly the equivalent of doing the Corporate Challenge Time Trial 5 times over with 4 minutes rest in between.  And I rocked it.  It was definitely challenging and there were moments when I didn't think I could do it.  But I did it.  And I wasn't completely spent afterwards.

In 6 weeks, I went from from being completely spent after a hard effort, to being able to repeat that hard effort 5 times with minimal rest.  That's improvement.

So, what have I learned so far:

• There is a distinct difference between riding my bike, and training.  Training definitely involves riding my bike, but riding my bike doesn't necessarily involve training.
• There is no substitute for honest effort structured training, designed by people who understand the sport and the physiology required to perform well.  Fully enjoying my outdoor rides is the point at the end of the day, but structured disciplined indoor training is vastly superior in terms of making the most progress in the least amount of time.
• Nutrition matters.  I knew this.  Now I know that I really don't know that much.  I've learned that it's not just what you eat, but also when you eat it.  Maybe when you eat it  is more important.  I'm still learning this.
• Cycling improvement is more like weight training than I'd previously considered.  The only way to get stronger is to push deep into uncomfortable territory.  Sounds so obvious, now that I write it down.
• That this is a journey.  Getting fit and becoming a faster more capable cyclist isn't a destination, it's a commitment that will take as much time as I'm willing to give it.