12 Days Post-Op: Doctor follow up and my first jog

12 days after surgery it's time for my first follow up at the doctor. The splint finally came off and boy did it feel great to get some fresh air on my arm! It also felt great to frantically itch the skin for the first 5 minutes. Turns out that the sutures are all internal and dissolve-able, so there weren't any stitches to remove.

I was able to do a bit of motion, albeit very stiff and sore and essentially assisted by my right hand. But at least it's a start. The motions of concern are of course flexion and extension; also twisting the wrist from palm-up to palm-down, and grip strength. It's extremely bizarre to struggle to do such simple things. I didn't get to see my actual surgeon, rather a orthopedic Physician Assistant (PA) whose instructions seemed rather conservative in my opinion. He suggested doing assisted motions for 5 minutes, 3 to 5 times per day. (In contrast, April's doctors had her begin rigorous physical therapy a.s.a.p.) So, I expect to push myself more than he recommended if I don't encounter any problems. He says I can't undo anything they've fixed (unless I crash my bike again, or fall on it in general) although it's possible to aggravate it if I overdo therapy.

Here's the range of motion I have as of Monday night:

Once I'd been released from the doctor, I got on the bike and worked a half day in the afternoon. I spent an hour in the garden and then jogged 4.5miles for the first time since the accident. It felt wonderful to get my heart rate up again. I'd gone from rigorous workouts 5-6 days per week to no noteable exercise for the last 3+ weeks, aside from easy spins on the bike for commuting and work. So it's a very positive step to get some decent cardio again and although I couldn't swing my arms like a normal runner, I didn't have any other problems and hope to keep running 2-4 days a week until I can start swimming and/or road biking.

Garden Work Day

Time to gather all our community gardeners for a work day effort. Invasive weeds in the gravel pathways are getting out of control and there's a few other chores to tend to. It's also a good way to keep everyone social and build a better sense of community amongst the gardeners, since we often don't see each other much at the garden. The garden as a whole is coming along great this year- we have so much more space for growing after the new layout was built over the winter. Our returning gardeners are gaining experience and expertise and the new folks are bringing fresh energy and expertise of their own. We've even been informed that Denver Urban Gardens chose ours to highlight when the local news station expressed interest in doing a story on community gardens!

In elbow news, it's still feeling alright and the hand swelling is improving. Only a couple more days until I go back to the doctor on Monday to get my splint removed and I can't wait! It's getting itchy and trying to shower without getting it wet is quite a pain (and showers are therefore unfortunately rare.) Hand function and grip strength is improving as well. I have an admittedly ridiculous fantasy that they'll remove the splint and it'll be instantly back to normal. Good luck on the one!

I've kept commuting via mountain bike ever since Bike To Work Day earlier this week. I belong on a bike, it's basically that simple. I feel so much better even getting a couple short rides between the home and the bus and work and back, even if it's one-handed and extra cautious. I'm planning to be back working light duty on the bike starting next week. My co-workers who I was subbing for last week are back now, and there's not work for me to do in the office unless someone is taking time off. But mostly I can't wait to be out moving around in the city, getting a bit of exercise, seeing fresh scenery and being outside.

1 Week Post-Op: Bike To Work Day

I'm covering dispatch duties in the Boulder office at work this week. It works out well to keep me restful and safe. Things are going pretty well... pain is at bay and I quit taking painkillers after just 48 hours; no alarming issues besides swelling in my hand. Aside from my garden ride last week, I hadn't been back on the bike until today. Each year a day in June is designated Colorado Bike To Work Day, where local businesses all over the Front Range (especially in Boulder) set up free breakfast stations for cyclists commuting to work. Designed to encourage car-free transit, it's a fun day to take advantage of free food and coffee all over town for those of us who ride every day regardless. This is my 8th annual Bike To Work Day here, and I wasn't about to let elbow surgery leave me on the sidelines. So I hopped on the mountain bike and caught the bus up to Boulder and kept my streak alive. While there are a ton of dedicated cyclists and commuters in Boulder, this day really brings 'em out of the woodwork. And I found that making my rounds to breakfast stations with an arm in a splint and sling earns mad props (and extra generous food offerings!)

Frisco BBQ Fest

We'd been looking forward to making a return to the Frisco BBQ Fest since we made an impromptu trek last year. Luckily I was still feeling pretty alright after surgery, so we got into the car and headed west. Unlike the perfect mountain weather we encountered the first time, we drove through pouring rain all the way up to the tunnel. And unlike the forecast of 71' and mostly sunny, we arrived in Frisco to a blustery squall and cold rain that began within 5 minutes of parking the car. After sipping hot coffee inside a coffeeshop and April picking up a pair of warm pants at a consignment shop, the rain broke and we turned loose onto the tasty offerings. Despite the shivers, we still had a really fun evening of great BBQ and mouthwatering smells in the chilly air!

Post-op Day 1- biking to the garden

Feeling good today, moving around fine and pretty minor pain without overloading on the prescription painkillers. Not too shabby!

Last week I bemoaned the slow start at our garden this season, but yesterday we received notice that Denver Urban Gardens had a bunch of surplus tomato and pepper starter plants up for grabs. They'd been donated from a local plant nursery who hadn't sold their spring supply. April hurried over and grabbed a wonderful variety of hearty plants, including some fun peppers like "Hot Carrot," "Hot Tomato," "Hot Cherry" and "Hot Banana." This is great news-- and we basically are now fast-forwarding our plot by about 4-6 weeks!

No time to waste now that it's mid June, we carted them to the garden this afternoon to get them in the ground right away. Energized and motivated, I rigged up the trailer to haul the flat of plants the 12 blocks to our plot. I owed it to myself to defy orders and ride the day after surgery, right??

Surgery day.... finally!

Feeling good and a little faded after surgery today. Everything went smoothly from what I could tell; on time and no hassles, which was a relief. In the pre-op room, I finally got to meet with Dr. Gladu, my surgeon, for the first time. He's an avid skier and mountain biker so we had a lot to talk about and he understood my eagerness to get back on the bike. (To which he said, "If you fall again soon, you'll pull out all the hardware I'm about to put in." Well, I suppose I'll just have to use extra caution in the near future.) He expects the fracture to heal fully in 6-8 weeks and a while longer to recover my full range-of-motion and strength. That's a little sooner than I expected and very exciting to hear his confident prognosis.

in the pre-op bed

Exactly an hour after I walked into the operating room and laid down on the table, I was waking up in the post-op area dazed from the anesthesia but feeling alright. Amazing how quickly they can get this done! They turned me loose a couple hours later, but I learned that hospital policy will not allow you be discharged unless you climb into an automobile. We'd walked from home and our friend wouldn't be able to get there for another hour in his car. So we hailed a taxicab, got in and drove two blocks away from the hospital, then got and walked the rest of the way home!

I go back on Monday, June 27th (12 days) for my first follow up and to get the splint unwrapped. Til then, can't get it wet in the shower or bend my elbow at all.

Revised summer plans

Earlier this spring I was pondering what kind of solo bicycle adventure to undertake this year. For the most part I've satisfied my curiosities of southern Utah road touring in 2009 and 2010. I mulled some ideas... Denver to the West Coast? Vancouver to San Diego? Tour the northern Rockies? But I'm sick of riding on roads, around cars... I do that every day at work.

Then it hit me solidly: mountain bike the entire Colorado Trail, solo and self supported- 475miles from Denver to Durango, almost all off-pavement and a vast majority on singletrack in the remote Rockies. 63,000ft of elevation gain (more climbing than going from sealevel to Mt Everest's summit twice) with a highpoint at 13,334ft. A very tough ride, I arranged for 3 weeks off work in August and tailored my training to this goal. I'd already been lifting weights and swimming since last autumn, then expanded to also include running, strength circuit training, and long road and mountain bike rides. At the time of my elbow mishap I was training 6 days per week, in addition to riding for work. And still I was nervous I wouldn't be in good enough shape come August to complete the CT without major suffering.

Clearly I won't be attempting the CT this summer. Instead of pushing myself to new personal levels of physical endurance and strength, my world is now going to focus on pushing myself back to what I once took for granted. The CT will be there for me next summer and I intend to tackle it then, in better fitness than I could have achieved this summer and with my bike and equipment situations better thought out. Maybe it's an ok delay. It's a different approach to my summer for sure, but an interesting one all the same.

This week I came up with a rather arbitrary, somewhat haphazard timeline of goals for my elbow rehab. Weekly goals of what I hope to accomplish, more or less. Some are probably overly ambitious, others maybe sandbagging a bit. I basically listed all the things I like to do, ordered with some respect to how difficult they might be given my injury recovery. (goals are cumulative)

Surgery is Wednesday, June 15th. I hope I'll be getting the sutures removed and starting physical therapy about a week later.

6/15     Wk #0     surgery
6/22     Wk #1     "Colorado Bike to Work Day" and sutures removed
6/25                     hit the gym- strength work on legs, abs, lower back, core muscles
6/27                     return to light bike duty at work
7/2       Wk #2     hiking in the mountains and running 3+ miles in the city
7/9       Wk #3     switch from riding mountain bike at work to my Bianchi cyclocross bike (faster, more efficient)
7/16      Wk #4    swimming at the gym, freestyle if possible
7/23      Wk #5    road bike ride on flat terrain, 20+ miles
7/30      Wk #6    ride my track bike for work
8/2        Wk #7    lift weights for chest and shoulders
8/9        Wk #8    start practicing my upright bass
8/16      Wk #9    road bike ride with climbs - ride Lookout Mountain
8/23      Wk #10  do pull-ups
8/30      Wk #11  do push-ups, triceps lifts
9/3        Wk #12  re-join my chamber orchestra for fall session on upright bass
9/10      Wk #13  easy mountain bike ride
9/17      Wk #14  strength circuit training
9/24      Wk #15  moderate mountain bike ride
10/1      Wk #16  road ride up to the Peak-to-Peak Highway
10/8      Wk #17  vigorous mountain bike ride
10/15    Wk #18  ride the Kokopelli Trail (142mi) and/or White Rim Trail (100mi) on my mountain bike
10/22    Wk #19  full free-weight lifting regimen
10/29    Wk #20  back to 'normal' !?

8/4/2012              ride the Colorado Trail !

I'll keep this list updated with my accomplishments and setbacks!

Evening in the garden

Our garden got off to a wobbly start this year, but it's coming along. We got inspired and ambitious back in early April when we were having an unseasonably warm stretch of spring. So we took our chances and sewed a bunch of seeds a few weeks earlier than we normally do. Soon after, of course, it dropped to near freezing for several nights, followed by a bunch of cold cold rain & hail while we were in Utah, and kind of stunted things. The Utah trip put us a couple weeks behind an ideal schedule for transplanting starter plants. Plus the free starters that we graciously get from Denver Urban Gardens were smaller than we'd expected.

It shouldn't sound like I'm complaining, cuz I'm not. I'm just eager to see growth spurts and be teased with the first blooms of our tomatoes, peppers, beans, squash, etc. It'll happen eventually but this growing season is going to take a bit of patience. Summer has finally arrived with consistent temps in the 80's so things should be taking off now.

Plenty of lettuce, arugula, radishes, sugarsnap peas and cilantro already so we are enjoying hearty fresh salads every day. What a healthy, tasty pleasure of the early summer!

Friday elbow update

I actually went back to work on Wednesday and Thursday for 'light duty' deliveries and some time consuming court filing jobs. I really have little to no pain, still not taking any painkillers. It's just hard to deal with one arm and a poorly functioning left hand. I'm trying to get in as many hours as I can before being laid up after surgery, but more so, I'd rather be outside moving around whenever possible. As much as I typically wish I could take time off work to get stuff done, I can't really get much done with one arm... and it gets boring fast.

At the Fracture Clinic, they say the cuts are healing just fine and scheduled me to go under the knife on Wednesday morning. I'm excited to get this over with and start healing! My surgeon will be Dr. Gladu, the head of the Kaiser orthopedic department and an elbow specialist. Hopefully I'll be in good hands.

In my 32 years, this is the first broken bone I've ever suffered, my first surgery, first anesthesia. I guess I'm overdue, statistically speaking. I've experienced a lot of this vicariously through April's ordeals from her humerous compound fracture and severely shattered elbow (suffered in an unlucky bike accident in San Francisco in October 2008.) Her injury is a far more complex and severe break than mine, and she's had 3 operations trying to regain her elbow function. She's still working at it today.

My fracture is a simpler fix, typically done with either a plate screwed over the broken pieces or, more commonly, a "tension band wire" repair. The complication of an olecranon fracture is that the triceps muscle tendons attach to the part of bone that's broken off. So that piece of bone has to be held in place to heal, and it also has to resist the forces of the triceps trying to pull it back apart. But it's also critical to regain the elbow's range of motion as quickly as possible while the bone heals. Therefore there is no cast, just the surgically installed hardware holding things together. As soon as the incision heals enough to remove the stitches, physical therapy begins asap to work on motion. Typically it takes 3-4 months to regain (almost) full motion, and 6-12 months to regain full strength.

So, Wednesday the pros cut me open and screw me back together. I can't wait to get on with the healing!

Elbow update

Had my initial evaluation with the Fracture Clinic this morning. Turns out there are some small cuts and scrapes on my elbow from landing on the concrete, and the doctor says that has to heal over before they can do the surgery. Apparently they won't make an incision through a wound because of a high risk of infection, specifically a bone infection in this case... and bone infection is a bad, bad thing.

So they cleaned up the wound, dressed it and put me in another splint. The doctor assures me that there is a 2 week window within which they can surgically repair the bone and not run into problems from the delay. Sounds a little suspect, but I'm not the doctor nor do I want an infection.

Got a prescription for some oral anti-biotics and a follow up appointment for Friday.

Bliss, followed by Disaster

Made my first trek of the season up to my beloved Nederland mountain bike trails on Saturday. 7am bus from Denver to Boulder, then the 8am bus up to Ned. I couldn't believe my eyes when I spied my old friend, former co-worker, bike racer extraordinaire, current Crested Butte resident and all around amazing girl Eszter also waiting for the Ned bus. She and (equally great) Chris were back on the Front Range for the weekend, and she was heading up to handily dominate the Single Speed USA event. She went off to race, I went off to ride, but we crossed paths a few times throughout the day and I eventually made my way to the race finish to say congrats and interlope with the lovely, wacky world of single-speed mt. bikers. Good times, great riding, wonderful folks. I was finally getting my mountain skills back, riding well both up and down and having a blast. 4hrs, 4000 vert ft climbing.

Then the disaster- back down in Boulder, riding back to catch the bus home via the bikepath. Distractedly looking over my shoulder, a momentary bit of carelessness, and  WHAM!!  I was picking myself up off the ground before I'd even realized that my handlebar had clipped a handrail and made my intimate acquaintance with the concrete path. What I quickly realized next was that my left elbow was not what it had been a few seconds earlier. Immediate swelling, a really funky feeling when bending it, and no strength to support myself with it. Not good.

Pedaled myself to the Boulder Emergency Room for evaluation and x-rays. My heart sunk when the nurse eventually walked back in with a right-to-the-point, "You need surgery." I'd broken the end of the olecranon, which is the "cup" part of the ball-and-socket joint.

broken and displaced 2cm:  fracture is visible directly above "20.0mm (P)"  (click photo to enlarge)

They put me in a splint and released me to follow up with my Kaiser Permanente insurance provider. I rode back to catch the bus to Denver, rode from the bus home. Pain was never bad, just felt like a bad bruise even without painkillers. Maybe that's a good sign?

Dad taught me to ride without training wheels when I was only 3 years old... I've spent the following 29 years riding year round, my primary hobby and my passion. For the past 11 years I've earned a meager but comfortable living as a bike messenger, making deliveries day in, day out, in any and every weather condition imaginable. 29 years, countless crashes- some pretty scary and severe, most mild and dumb. Today was only the third time I've ever needed medical attention from a bike wreck (the first, coincidentally, was for stitches on my right elbow when I was about 13.)

So now it's time to wait for an appointment at my Orthopedic Fracture Clinic in Denver.....