Friday, May 19, 2006

Wrist recovery and rehab

(continued from “The fracture and surgery”)

Feb 2006

A couple days after surgery (x-ray 1, 2) when they cast me, my surgeon, Dr P., gives me the option of a half-cast that will only go from my hand to my elbow. He cautions that I will have to be very careful, though, not to twist my arm, lest I re-injure the wrist.

With an audible sigh, I indicate the bluish lump on my forehead. "See this? I can't even go to the bathroom without running into a towel rack. I'm a walking disaster. No. Gimmie the full-body cast. It will be much better," I say with disgust.

He laughs and comments that at least I'm honest.

I get a cast from my thumb to my armpit. I make sure to bring the grip again, so they can mold the cast around it. It will make an interesting conversation point at least.

For the entire month of February I'm in the cast.
From the beginning, I am never really clear on the concept of "you will be off the bike until the end of May." At the time of surgery I hear "four weeks" and think I'll be riding again in March. No, that would be four weeks in a cast...

For the first week after surgery, I awaken every two hours in pain, even though I'm eating Percocet like it's candy. I'm ready to chew the cast off like a wolverine, convinced that it's too tight and that's why I can't feel my fingers... Truth is, I can't feel my fingers because of the anesthetic block they used. Sensation will take more than a week to return to minimal, and more than a month to return completely.

Within 10 days of inactivity, depression begins to set in, and I start losing interest in many of the things that usually make me happy. I have to force myself to eat and to bathe, because I would rather not. It's too much trouble. After two weeks, I decide I've had enough and I go for a jog, telling myself that people in Arizona have casts and they manage to put up with the itchy and sweaty, so by golley, so can I. I have a glorious 30 minute jog in the damp February morning.

As it happens, itchy and sweaty don't bother me. My cast gets damp from sweat and now I cannot get the arm warm. It's cold all day until I crawl under the covers that night. The next day, no matter what coat I wear, my arm stays cold again. At 2pm, I break down and call Dr P.

His nurse Susan reads me the Riot Act when she hears that I've gone jogging, and reminds me that I am 2 weeks out of major bone surgery. She proceeds to describe how sub-Saharan Africa is now potentially growing inside my cast and infecting my open incision, and says I should come down immediately for a new cast.

Awww, man! I have some really cool signatures on this cast! Duncan Riffle, Eric Carter, Mike Miranda... oh, well.

I speed to Balboa Medical Center, certain that seconds count in my race against bacteria. Thoughts of chewing the cast off like a wolverine again enter my brain, but I push them aside. I arrive at Balboa, they remove the cast, and find mild skin irritation, but nothing more. So much for sub-Saharan Africa... I'm recast and released on my own recognisance.

Before I leave, I ask the attending physician what to do about the depression. He has no answers, but suggests I set up an appointment with psychiatric. Tears fill my eyes. This is why I began riding in the first place... so I wouldn't have to go to psych. Extreme physical exertion is my panacea. It keeps me sane. Inactivity is my enemy... and slowly I am being overcome.

Thankfully the next day my co-worker points out that I'm more than half-way there, and that in only two weeks I'll be getting the cast off. Thanks Juan. I needed that. I resolve to grit through the last two weeks as if they are another endurance event.

March 3, 2006

Finally on March 3, my cast is removed and I animatedly talk about "riding soon." Dr P. looks at me and cocks his head. "You know you won't be riding until the end of May," he says.

"What??!" I exclaim. "But, I have a race," I say emphatically (he finds this amusing and tries to surpress a grin). "No, really. I have a race. A big one. I have to be ready."

"When is it?" he asks.

"May 27th weekend," I tell him.

"Hmmm... you can probably race it, but you'll be doing indoor training only until then."

"No way..." I protest.

"Way." He points to the day planner I am holding in my hands. "Can I see that?" he asks.

"Umm... sure," and I hand it to him. He takes out his pen and writes "Indoor training only!!" drawing arrows through the 20th of May, smiles, and hands it back to me.

I laugh and shake my head, reading, "Indoor training only!!"

Then he says, "Look, you have only one right wrist. People get debilitating arthritis for much less than you have done. I know it seems like a long time off the bike, but it is a small slice out of your life, and you are barely half-way through it. It's your choice."

I sit for a moment, remembering a conversation I had the week after I got the cast. I showed up to the 3rd Winter Series Downhill Race at Fontana, CA, and ran into pro racer Eric Carter, who noticed that the cast was molded around a handlebar grip. I laughed and said, "Yeah, it's kinda funny. But I told my doctor I wouldn't ride."

He looked at me with that easy smile he has, then in all seriousness he said, "Then don't be a liar."

The words stung as if he'd slapped me. "No! No, I'm not riding," I protested.

"Good. Let it heal. There's no need to push too soon," he said. This from EC, who was injured for over half the season last year.

This brief conversation
I will carry with me and remember for a long time. I didn't really need to be told to listen to my doctor, but I'm glad Eric reminded me how vital it is.

Back in Orthopedics,
as I talk to Dr P., reality sets in and I accept that I will be off the bike unitl the end of May.

Slowly, he and I develop trust in our doctor-patient relationship. By the end of March, it seems he knows I will not lie to him about my activity, nor will I go against his recommendations. In return, he will be totally straight with me on my progress, putting me ahead of schedule when he believes I am strong enough.

I begin occupational therapy (rehab) the first week of March.

No comments: