Turn the Page

Okay, I'm a kid of the 70's.  Bob Seger was a stud and did the guy ever know how to write a lyric...at least in my book.  Sure, he won't be remembered along with Elvis or Madonna, but I'll take his ballads any day. https://www.youtube.com/watch?v=GONmFCkCGCc  "Turn the Page"

Anyway, over the last several months this has been my theme for training, and now racing.  As most of you know, my last year was a bit less than typical and I won't bore you again with the specifics (read past posts if you want the details).  Suffice it to say that bodily brokenness, pain and limitation were the norm for many months.  That was then, this is now.

The annual Smith Mountain Lake Sprint Triathlon, the first Saturday in May is written in stone on the McGehee calendar.  It is the race that starts the new triathlon season!  Heavenly venue, my family around, great weather and many of my healthy/happy/successful athletes (several pictured above, a few missing) and friends racing here.

If you look closely at the picture of me on the bike at this race you will can notice two distinct things. 1) Can you tell I'm pretty happy to be racing?  The smile is a dead giveaway.
2) I am carrying a few extra pounds than typical this time of year:).
Believe me when I say that #1 out weighs #2 in my list of importance by...say...10 gazillion times!

Yes, I am back racing, Yes, I was able to swim, bike and run competitively after a blurry eyed watching of this same race last year...in a different state of being.  No, I did not race with pain.  No, I did not have any issues during the race.  Was I the same? No, not that either.  But am I whole...you darn well better believe that!  Earlier I told a friend that my racing "success" this year would be determined by my extensive race experience and my raw genetic gift.  This is in stark contrast to the high emphasis on fitness that I'd typically consider as the key to my racing.  To this point, I have and will continue to chart my course based on long term strategies, not my day to day emotions.

Words cannot begin to express my sincere appreciation for the support and encouragement I have received from family, friends and my athletes whom I love dearly!  I am humbled and ecstatic that I am back to being an endurance athlete.  I am happy for the new norm. Won't you join me in turning the page and continue writing new chapters?  

Some Hip News

Yesterday I drove down to NC to see a orthopedic specialist about my healed hip fracture.  It has now been 9 months since my original injury in the bike wreck (and 4 months since my last elbow surgery).  We had an informative discussion about my concerns and specific issues.  Dr. Stubbs at Wake Forest Medical is a nice man.  I now know much more than I did previously about my hip (a valgus impacted fracture of the neck of femur, surgically repaired with two titanium screws).  

Cutting to the chase Dr. Stubbs told me that I could continue to run, ride and swim as I've been doing over the past several months.  He suggested conservative progression and that I pay close attention to how my hip feels (and moves), but he does not want me to stop pursing my passion for exercise.  This is, of course, music to my tiny little ears!  As did my local orthopedist, he stated that I would probably end up with a full hip replacement at some point in my life, but "probably not in the next 5 years…but further down the road".  

On the more positive side he thought that my potential for avascular neucrosis (AVN) was less than I'd previously thought (due to how I've progressed to this point and the fact that the fracture was more a compression and less of a sheering force, possibly leaving slack in the vessels of my bone, not stretched/broken vessels).  At this point he suggested that I was more at risk of long term arthritis due to change in angle at the hip articulation.  It will take another two years, or so, to know if he is correct about the blood vessels, but at that time I could be considered clear from neucrosis potential.  Dr. Stubbs said that around 60% with this type of fracture has issues with avascular neucrosis, but most often these fractures occur in folks older than my relative youthJ.  

Anyway, I also learned that I should NOT be pushing hard on regaining full flexion at the hip since I have a spur of ossification (they took new x-rays) that would potentially cause more arthritis potential if I push into it.  Here's a few shots of my hip flexion to show my ability and my limitations with motion.  No, it is not the old "normal"...but it is not too bad considering the potential.  

He also suggested that I NOT become a gym rat doing things like lunges and squats.  He actually recommended not being in aero position too much of my riding (bummer, but livable) but suggesting that I spend most of my ride time sitting up on a road bike.  Again, he expressed the need for me to pay attention to how it feels/moves and go conservatively forward.  Several times he told me that I "should do what I love doing" and that sounds good to me.  Anyway, I certainly can not complain and I feel much better knowing what I know now.  

Below are some updated photos to show you how well my elbow is doing these days (please proceed cautiously at risk of your eye sight with the bottom picture as I show my updated "He-Man" look).  As you can see I continue to need to rebuild strength in the shoulder, chest, upper back and arm...but am progressing there.  I've been limiting my swimming a bit since I do continue to have some mild restrictions in my shoulder movement.  As seems to be the new norm, I continue to have some general stiffness in the elbow at the extremes of motion, but I am moving and swimming, so no complaints really!  

Thanks again for your expressions of love, concern and support over the past 9 months!  My family is doing extremely well and I am excited about continuing to move forward and challenging myself.  As I have told many of you, 2015 will not define me as an athlete! I will take the year as my body allows and as I feel confident.  I will feel or respond to no pressure from the outside.  My strongest desire is to be moving consistently and happily over the many years to come, involved in triathlon, running and endurance sport as I have been over the previous nearly 30+ years.  Here's to an active and healthy 2015 for both you and I!

Creek Crossings

Trail running.  What in life is much better?  Sure I know: my family, my spirit, my friends, my athletes and my belief system...but otherwise not a lot is better than being out in the woods.  My preference is alone.  Listening to my breath, smelling the real world, and getting lost in a forest of meandering thoughts.

stock picture of our Poverty Creek 

As most of you know my running has been a bit limited lately.  Training intensity, duration/volume, frequency are all up in the air a bit right now.  That said, I was out in the woods around Pandapas Pond today for a number of comfortable, aerobic and glorious miles!  We locals know Poverty Creek trail like the back of our hands. The sections that stay muddy, the rocky patches, the occasional tree roots, the soft spots with perfect footing...and the creek crossings.  Have you seen our creek crossings lately?  Rocks, flat top rocks, large rocks, placed rocks at step width across the entire creek.  This isn't natural.

old picture, no phone when I go for a run

Are we getting soft?  The reasons for the rocks being placed there are no doubt valid to some, but I can't help ask myself, were they a positive change?  How do I respond when I'm running toward the creek now?  The only choice, back in the day, was do I run through fast or slow.  Now our choices are more numerous....and potentially telling about the runner each of us have become?

Okay, I must stop writing now...gotta get these wet socks off my feet.

Embrace Your Place!

There is a time for pushing, a time for grunting, a time for digging extra deep, a time for serious sweat, and a time for training/racing "pain"...there is also a time for thinking, rest and recovery!  Whether you are looking at your goal race this coming weekend (Richmond Marathon, Half Marathon, Ironman Cozumel, among others for some of my athletes), or backing off your training for a few weeks post season, do take the time to make a conscious effort to embrace your place.  Often times we spend months and month (years for many) working toward a specific goal, yet many times we do not take time to fully appreciate what it is we've achieved.  Getting started toward that next goal is not as important as taking the time to enjoy the goal you just reached!  This place may be our peak or it may be just a blip on the screen, we never know for sure, so embracing this spot only makes sense.

Sure we work hard and want more as endurance junkies, but where we've gotten to this point is most often impressive and has came at a cost (often to our families).  Embrace and breathe...here's to finding flow wherever it is that you may be!

There is Light!

This tunnel of mine started five and a half months ago on April 6th as a result of my first bike crash in 30 years of triathlon cycling. Please know that I am not complaining, my lot in life is relatively easy and I recognize that I am blessed beyond belief (some might say, this a first world problem), I get that.

I am now nine days post surgery #3 that occurred up at the Mayo Clinic in MN.  To say I am giddy about the result is a huge understatement!  I have been constantly moving my left elbow 24 hours a day for these past nine days.  That, after five+ months of it being stuck in one place at a 70 degree angle (okay, I did have a whopping 5 to 10 degrees of motion).  The medical term is ankylosis (a completely contractured joint), which resulted from the heterotropic ossification (or HO, an unwelcomed chunk of unattached bone) that grew directly in the joint of my left elbow.

Luckily my research took me to the right place as I found Dr. Shawn O'Driscoll at the Mayo Clinic. He is the stuck elbow guru that I needed.  He is aggressive, active, methodical with his surgery technique and experienced beyond belief.  My demeanor and athletic background made me the perfect candidate for his work.  I was confident...and rightfully so.  I was told that I had a 45% chance of this elbow ever being "normal" again, but an 85% chance of being functional.  With this doctor I had only a 1% chance of having permanent nerve damage in my hand vs. 11% according to the current literature.  I was happy to take those odds.

After 2+ hours of delicate elbow surgery and I ended up here (above picture) for the next three nights.  Motion and pain management was the name of the game.  My medical team was intelligent, friendly, large, professional and extremely involved & interested in my progression toward full recovery.  Not only was the HO removed (Dr. O stated that it was "significant" in size), but also removed was the screw that had been placed there to stabilize the fracture acutely.  There was also plenty of joint clean up and debridement around the ulnar nerve as well as a capsular release to help get my joint back into a world of movement again.  Here's a picture of the screw that was removed...happy to have that out of my ulna bone now (though I still have two even larger ones permanently in my left hip).

So for three days I mostly sat in the hospital bed with multiple tubes connecting me to modern medicine:).  I had the normal saline drip IV, a nerve block (another IV specific to the brachial plexus group of nerves to totally numb my arm/hand), a drainage tube and bottle that collected my surgical blood/edema, a pulsox unit for general HR/saturation data, cyclical leg compression sleeves, and of course, my trusty CPM machine. All of this, 24/7 for my time in the hospital.  

Now I am home and here's what my current world is looking like.  What a hoot...I'm still giddy about the potential!  

Check out my passive range of motion today after I've loosened things up!  Pretty awesome to have this back!  Yes, it's still a bit sore and I've got a long way to go in gaining strength and full active motion...but I am certainly a giddy dude right now!  

The key now is to continue getting this motion in a more natural manner and that requires near continuous motion of the joint.  Thankfully I've got the incredible support of my dear wife Nancy. I'll continue to "sleep" with the CMP machine until I can go 6 continuous hours without losing joint mobility.  So, about another month of this, weaning off the CPM machine and getting back to more normal life and activity.  I have plenty of work to do PT wise and this next 10 days is extremely important in keeping the range of motion I currently have.  I've got to keep moving, keep moving...hey, just like that Ironman I was supposed to be doing this weekend in Chattanooga...just keep moving!  

And I will!

Update on Jim's Health Status - Heading for Surgery #3 Soon!

For those that have followed my story, thanks for your patience.  The time has finally come for the next step in this chapter of my world.  I will soon be having surgery to "release" my left elbow. Surgery is scheduled for Tuesday, Sept. 16th, up in Rochester, Minnesota at the Mayo Clinic under the experienced hands of Shawn O'Driscoll one of the world's best elbow gurus.  I enter this step without reservation and while every surgery has it's risk, I feel no anxiety, only excitement about the potential for moving toward "normal" again.  I'm a long way from here:

but I do not quite stack up with the rest of my family when it comes to muscle don't you think?

My doctor will be removing the new (and un-welcomed) bone growth that naturally occurred as a result of significant trauma to my ulnar nerve.  This trauma occurred as a result of the serious bike wreck I had on April 6th of this year and was compounded by surgery/immobilization that may have triggered more significant trauma to the area.  In addition to having this heterotropic ossification removed, the surgeon will also remove the 3.5 inch screw (less titanium in my body...leaving only two screws in my left hip).  In addition he will clip, clean, debris, smooth and possibly transpose structures/nerves within my elbow as needed.  He will also come out with good insight into any arthritic changes my joint has suffered and thus we will have a better idea of how to move forward.  Below is a review for those interested in the anatomy of my injury.

I will wake up from surgery with a CPM (Continuous Passive Motion) machine attached to my arm in an attempt to limit swelling/edema and maintain range of motion.  This device will be moving my arm 24 hours a day for those first 3 days in the hospital at the Mayo.  Doc says I get a 5 min. break an hour to move around a bit and go to the bathroom, but otherwise, it's 100% elbow moving!  They will teach me to "milk" my elbow by working the extremes of the motion in particular and yes, I'll learn to sleep with this gadget somehow.  I will have a nerve block at my brachial plexus so that should do the trick on controlling pain.  Once I am discharged from the hospital I will be flying home (Nancy will be a great Sherpa of course) and bringing my trusty CPM machine with me for 4 to 6 weeks of more elbow moving fun!  Over time I will be weaning from it based on how the swelling and motion are improving along the way.  Here's a picture of one of these units:

As you can tell from my muscle picture above, once I've re-established good range of motion, I'll still have much work to do on regaining strength in my left upper body.  My biceps and triceps in particular, but also my shoulder complex/rotator cuff muscles which have all atrophied (and frozen) considerably over the past 5 months.  Anyway, I look excitedly toward all of the PT work ahead and will accept the challenges just like I was working toward that elusive Ironman race.

Thanks in advance for your thoughts, prayers and well wishes...and particularly for your patience with me, if you are one of my current athletes.  My wife and kids and entire family have been extremely patient through this and I am extremely grateful for their support.  Even with all the "hassle" I still believe you MUST go after your dreams!  Only a life chasing your true passion will be "enough" when the finish line is in sight.  Let us keep rolling and let us make the most of this and every day!

What Is Your Normal?

So...are you racing at USAT Nationals this weekend?  Are you recovering from last weekend's Half Ironman? Are you doing the local sprint tri?  Are you running your first Half Marathon?  Are you training long for that Fall goal race?

Obviously your norm isn't the normal.  Your goals, your races, your priorities, are different than the endurance junkie next to you.  Don't waste time comparing!  Spend your time productively moving forward, being positive, planning, strategizing, dreaming, and simply doing.

To those racing up in Wisconsin (Cortney, Patti, Kate, Jim and Edie in particular), I wish you a safe, smooth, and fulfilling experience! Each of you are WELL ready to attain the goals you seek.  To those racing locally (Tanya, Justin) may it be the same, but without the travel.  To those training long, may you find a weekend of smooth roads and happy trails!  To those recovering this weekend, peace to you and your family/friends relish in your time together.

As for me, I'm continuing to find out how it feels to be the slowest runner in my family...and I'm sooooo happy to be right where I am!  Go gettem gang!