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!

What is the least I can do?

A friend asked me a simple, but thought provoking question yesterday.

Friend (he just started jogging recently):  "Hey Jim, what is the least amount of exercise that I need to improve my fitness".
My other friend (a high performance runner) standing nearby: "giggle, giggle, giggle"
Me:  "Well that's a good question.  All you really need to do, is do more than you used to do."

So, did I answer him well?  Isn't that really all it takes to get more fit (or in the competitive folks minds...to get faster!).  Sure, we love our books, we love our blogs, we love our gadgets, we love our data, we love our schedules, we love our technology...but really all that is required is progressive sport specific overload.

So what can you do to become more fit (or faster, if that's your cup of tea)?
Options include:

1) more training volume
2) more training intensity
3) more training frequency
4) more technique work
5) improved body composition toward the ideal for your body, health and your sport
6) more of all of the above in various combinations

Finding the right combination for each individual is a process.  It is my goal to help my athletes stay healthy, to train consistently and to help them stay passionate about their sport over the long haul...as we work through each of these above factors.  Finding that unique individual combination is the real trick for those that seek their ultimate full potential.

What is the least I can do...nope that's not my style, but it does get me thinking,  I'm still seeking my full potential...how about you?

I'm pretty confident that the guy in the dark shirt once found his full potential!

Finding Answers

For those that read my "Starting the next Chapter" post you know that this past week Nancy and I went to Rochester, Minnesota for my consult with Dr. Shawn O'Driscoll at the Mayo Clinic.  Here's a recap for those that care.

The Mayo Clinic is an incredible place for sure!  It is seriously a mecca in the world of health care.  It is many things, including: huge, efficient, passionate, clean, on time, professional and best of all, extremely knowledgeable & caring.

  

My CT scan wasn't an easy thing for the technicians based on the extreme lack of range of motion in my left elbow (I can move it only 10-15 degrees total), yet this woman had me laughing and smiling the entire time while showing that her 42 years of experience at this job would find a way to get the job done. And that she did...you will see pictures (from my CT scan) below.  

So what is the problem with my elbow restriction?  It is called a "heterotropic ossification" or HO for short. This new growth of bone tissue occurs outside of the normal skeletal system and in my case is seriously restricting any possibility of moving my elbow. HO's can occur as the result of severe nerve trauma and is a self protective mechanism that the body sometimes uses after serious injury.  Just a few years ago doctors used radiation to try and eliminate these bony growths, but thankfully the answer does not involve that mechanism any longer.  The only way to get rid of an HO is through surgical removal. (by the way, I was told that the red "stuff" around my elbow joint in the scan below shows that I've had trauma to those areas of the bone...hopefully something I can overcome to avoid osteoarthritis type of issues later in life.)

So now we know the problem, and Dr. O'D says he can fix the problem.   Needless to say, I'm pretty ecstatic that I didn't go with the locally suggested "let's put you to sleep and manually manipulate your elbow" routine...who knows what might have happened with that.  Anyway, elbow surgery is tricky in that the joint spaces are restricted with nerve and blood supplies delicate and numerous in the region, yet I will tell you that I'm counting down the days until Sept. 16th when I will be under the scalpel.  Fixes are good, even if there is a bit of "valley" to walk through to get there.  

I will be in the hospital for 3 days and should be able to come home at hospital release.  Immediately after surgery my left arm will be placed in a CPM machine (Continuous Passive Motion) and this friend will be with me for the next month or so.  Morning, noon and night my elbow will be moving from the time surgery is over for the next many days. I will start with a 5 min. break each hour, then slowly progress my time out of the machine as my swelling, motion and pain dictate.  Needless to say, that could present some challenges from mid September till mid October as I work one handed yet again, but I need not fret on that at this point.  I have a plan, I believe in the fix and I see the light at the end of the tunnel.  I also EASILY recognize that my issue is small potatoes compared to so many in the world.  I am one of the fortunate ones that can search and seek the best help.  Not by my own doing...but by the will of a Greater Being I suppose?  I am not deserving...but I will take with faith that this is the answer that I've been seeking.  

Peace to you and thanks for your positive thoughts, prayers and expressions of concern.  

Natural Athlete?

Sure, I know there are genetic differences between individuals and yes, it's a fact that some folks have "the gift" (high VO2 max in particular, as well as optimal body composition).  But you know what, that doesn't mean it comes easy to them.  Winning races, podium finishing, setting personal bests (PR's), improving performance...it takes desire, thought, sweat, time, energy, focus, consistency, and plain hard work.  Doesn't matter if you have "the gift" or not, once the pond is big enough, even the big fish have to put in the time/effort in training and on race day.  Congrats to you if you are out there battling no matter the size of your gift...success is in the eye of the beholder honestly...not won or lost based on how the other fish performed that day.

Triathlon race weekends, you've gotta love it!

Well it's another big race weekend for triathlon in my world.  Nope, I won't be donning the tri kit this weekend, but several of my One-on-One Endurance athletes will be racing and that always gets me fired up! On top of that, my 11 year old kiddo's will be racing the Kid's for Kid's Triathlon down in Winston Salem, NC tomorrow!

In my world there isn't a whole lot better in life than watching Grace and Spencer enjoy and challenge themselves in these kid only triathlons.  Their focus during the event is dead serious, but their joy and happiness before and after the race is beautifully child-like.  Oh if we could all go there a bit more with our own racing mentality!

Go be your best whether you are training or racing this weekend!

From this...

To this!  

Endurance Sport = Life

Without a doubt my training life is one of the more important aspects of my world. One of the things I love about my sporting world is that I only get out of it what I put into it. Work harder, work smarter, improve performance. The formula isn't always this easy, but in general I know that if I put more into my training, I typically have more joy and satisfaction in my world!

Just as in life, my goals and priorities are not your goals and priorities.  Please do not compare your training to mine, or to anyone elses. Just as in life we are different creatures with different needs. Training "correctly" is a delicate balance between art and science, this is the line I try to carefully walk as a coach (and endurance athlete).

I'm not interested in waiting any longer...time to get rolling again!

Training & Life: Starting the Next Chapter

Some might say that it wasn't supposed to be this way, but I can't live thinking that way.  Life changes, the script doesn't always go the way you thought it would.  April 6th, 2014 my world changed.  Sure I know it is selfish of me to think this way but it will always be a landmark day in my own little part of this grand world.  I was doing the norm, something I'd done multiple hundreds of times previously.  Nothing fancy, nothing crazy, just the norm. In the middle of a 60 mile ride that day. Prepping for the 140.6 mile journey I was planning to take in Chattanooga this September, in my own personal way.  In the blink of an eye, I'd crashed my bike, going from 25 mph to zero in a fraction of a second.  I slammed hard into the uphill asphalt of Bradshaw Road on the small rolling hill I was just starting to climb. My front wheel wobbling uncontrollably as I rocketed over the aerobars on my well used Cervelo.  Me on the ground repeating words that my mom wouldn't be proud of, yet telling my training buddy John repeatedly, "I'm okay, I'm okay" as he stood with a concerned look over me.

A few minutes pass and we're figuring out a way to get me back on my bike.  Sure I'm painfully battered, bloody and swollen, but we did need to get back home somehow.  For better or worse, I slowly covered five more miles of hilly terrain until John rode ahead and later picked me up in his truck.  At home I contemplated the injuries and chose to allow a few days of quiet, recovery time before sheepishly hobbling with one crutch into Dr. Amy's office on day number three.  After a series of xrays and being told to wait right there for a wheel chair, I recognized the page had turned, life had changed. I felt a thud in the gut when told that I'd fractured not only my heavily swollen elbow, but also my hip (at the neck of my femur). No one need tell me that this was not good for a multiple time marathoner and 25+ year triathlon junkie.

As I told my athletes at the time, it really is a small price to pay for the athletic life I have lived for my entire 51 years.  MANY have far worse problems and I try hard to not feel sorry for myself.  In reality I am a bit embarrassed that I lost control of my bike for some unknown reason.  I am also extremely sorry to have affected my family and my athletes during my extended injury and recovery period. 

Now at 3 months post-wreck I am becoming more and more confident that I will bounce back.  That said, I'm still not sure exactly what that means, but I am patient and totally at ease with seeing what the Good Lord has in mind for this new chapter in my life.  The long term health of my hip joint is my primary concern though my "stuck" (contractured) elbow is the most challenging current issue.  That said, I do live a happy and very blessed life here in Blacksburg and my support system (family and friends) is deep and strong. I will be forever grateful for that!

Again I say this with all sincerity, please do not worry about me. I am in good spirits and I have a strong body and I am wrapped in love here at home.  Also, do know that I would MUCH rather be dealing with this than to be dealing with some form of couch potato disease.  As you may/may not know, until this point, I have kept this story off of Facebook and such, as I've been learning and dealing with the change of life with my family, close friends and immediate community here in Blacksburg.  I am now ready to move forward a bit and share my experiences with others.  Thus my sharing of this blog.

So lets go train, go race, go win, go conquer, go work hard, go have fun, go kick butt and go tell the ones important to you that you love them!  I challenge you to continue to follow your passion and work to become the best you possible!  I will aim to do the same.

With love and passion for an active lifestyle!  

Jim

(below are a few pictures that you may find helpful in understanding this new chapter of mine)

New/permanent hardware for hip

Screw in elbow, NOT permanent

Left arm pre surgery

2 surgeries down...1? to go