Winter Running - The Aftermath

The Orthopedic Surgeon gave me a call yesterday (Saturday) around noon, after reviewing my MRI.  Monty, what's behind curtain number 2?

A torn deltoid ligament, a cracked / broken syndesmotic joint, and most likely damage to another ligament (I have which one written down somewhere, but I just can't remember everything he rattled off to me at the moment.)  Bottom line he said that it's very unstable, and he'd be very reluctant to start any physical therapy on that ankle for at least 6 weeks.  His words as I remember them: "I wouldn't want anyone cranking on that joint for a while".  So, his suggestion was to stabilize the ankle with a plate and some screws to stabilize the joint and speed healing. 

The good news with this is that after a week of a hard cast, he'll remove that and I go back to a boot.  Then, a week or so after that, we start talking physical therapy.  If all goes well, 3 weeks after surgery I could start swimming (as soon as the wounds from surgery heal) so long as there's no discomfort in doing so.  Cycling on the bike trainer could happen shortly after that.  Running?  Not sure I remember exactly what he said, but it's certainly sooner than without going under the knife.

Will I be ready for my Half Iron triathlon in September?  Most likely not.  That could be pushing it.  But there's a lot of individual variance in recovery here.  I'm not setting my hopes on anything, but am hoping to be at least swimming and easy spinning on my bike trainer in a reasonable amount of time.  Hell, if I can walk comfortably (somewhat) in 6 weeks I'll be stoked.

Monday at noon I'm scheduled for the fun and games.  Should be home by dinner - which I'll sleep through I'm sure.  Tuesday, if all goes well, I'll be on conference calls for work from the comfort of my living room.  I'm sure that if I'm not liking this walking boot thing, that I'll most likely despise the hard cast.  But it's only a week of the hard cast, so that's not bad.

The Dangers of Winter Running - Part Deux

So, as I was saying, the Orthopedic surgeon was great.  He gave us a lot of detail yesterday.  And most importantly, he didn't pull any punches and was very to the point and up front.  He explained that my recovery time, without surgery, would yield 6 weeks before I could put any significant pressure on my leg and even think about swimming or cycling.  However, with the surgery, that time would be cut to 3 weeks before I could swim (individual results may vary), maybe cycle, and physical therapy would start after 2 weeks.  My knee-jerk reaction was, of course, then why aren't we just doing the surgery!?  But, my wife, the ever-logical one, jumped in stating that going into my ankle if the damage doesn't warrant it could very well be risking unnecessary complications.  * heavy sigh*   Anyway, as I wrote yesterday, an MRI was in order so the doc could make a fully informed decision.

So, I had the MRI last night (Friday).  I have the DVD of the images, but I of course have no idea what the hell I'm looking at.  The tech that did my MRI said he looked at them - I of course asked if it was truly a car wreck down in my ankle or what?  His response: "...I'm on a low-res display, and there so much fluid in there that it's all fuzzy".  Great.

Oh, and after he asked me what I did to myself, and how it happened, his retort was: "You should take up rowing".

I'm currently awaiting the Orthopedist to ring me up.  He said he'd call on Friday night or Saturday after he reviewed the MRI, and we'd talk about options.  In the meantime, the swelling in my ankle is out of control and there's really not any position now that is comfortable.  My wife has dubbed it the ankle that ate New York

   


Ironically, my wife - JL goes Vegan - had a guest post from Matt Frazier, of No Meat Athlete who wrote about  winter running tips on Friday morning.  I think JL received his post via email shortly after I arrived in the ER.

Again, more to come.......

The Dangers of Winter Running - Part I

Thursday morning was an interesting one.  It started out normal enough - up at 445a to get myself together for a usual morning run.  Depending on the day, the number of us running could be as many as 8 or 9, but yesterday it was just my good friend Tom and I.  We met at 530a at our usual spot and headed off on one of our regular running loops - about 6 miles total for me round trip.

Cut to: about 3 miles into the run, we came to a section that had a lot of piled snow.  It's in a section of a small subdivision that is bisected by creek - the snow is piled up around and on the bridge that lets us cross.  Again, this is one of our regular loops, so we knew it was coming, and started to navigate our way over it.  We got to the other side of the bridge (only 15 feet or so) and as we half jogged, half walked, over the snow section I hopped over the last small mound of snow to get back to clear roads. 

As soon as my left foot went down, I knew I was in trouble.  It only took a second but it felt like forever.

I hit a patch of ice, and my left foot twisted and pronated in.  At the same time my leg twisted around the ankle - still underneath me - and all my weight came down on my left leg.  I had a flash in my mind of "oh, this is not good" and I went down hard.  I hadn't felt pain like that in a long, long, time.  I was on the ground, grabbing my lower left leg and trying to keep it from flexing and torquing in the middle of the shin / calf.  I calmed down enough to lay still, and could flex my foot - sort of - so I was beginning to think that it was just a bad sprain and in a few minutes the pain would start to go away.  My friend Tom had his hand on me, telling me to relax and take my time.  Eventually we tried to get me on my feet.  That was a short lived exercise.  As soon as I put weight on my left leg I went down again in just as much pain as before.  I remember Tom saying "oh my god" a few times and then we had to figure out what the heck we were going to do.

The pain was tremendous in my ankle, and strangely up high on my shin.  Hence, every time my leg would flex or torque, it would hurt everywhere. I had no idea what this meant at the time, but I was just happy to be able to flex my foot.

Tom did a nice 5K (roughly) sprint home to get his car.  I lay on the ground, in lovely 20F weather, and was just starting to get cold when he made it back.  I hopped into the front seat of his car and he got me to my house, and inside, and into a chair.  Tom told my wife JL,  what happened.  She hurriedly got her things together and we headed to the emergency room.  All this before JL had her 2nd cup of coffee!

It wasn't yet 700a when we got to the ER.  Check in was quick and everyone was great.  It took a bit of time to get me through the triage process and I sat in the hallway in a wheel chair waiting for radiology to come get me for some scans.

Waiting for the Radiologist

The radiology tech was great.  He was taking the scans, and being careful with my leg.  At one point, I was trying to convince myself that it was just a bad ankle and / or high ankle sprain.  You hear about some athletes getting these and it sounded good to me.  However, after one of scans, I realized he was on the phone talking to someone and I heard my name mentioned.  He came back to me and said he "saw something" higher up my leg, where half the pain was, and wants to rescan the ankle now to double-check something else.  The radiologist on-call came in, and they talked for a bit longer while I remained on the X-Ray table.

He then broke the news that he saw a fracture on my fibula and "something" in my ankle. 

The first words out of my mouth? "Oh, Fuc# me!"  I apologized for the outburst, to which he replied that he'd heard that one a few times before and not to worry.  I was wheeled back out to the hall in the ER where JL was holding station, and I sat and waited with an ice-pack on my ankle.  I told JL what he saw and said.  I was just beside myself.  The doc stopped by and said they were calling the Orthopedist on-call to review the scans.  She had office hours that morning, so shortly after 900a she called back - had looked at the scans - and asked that we should drive over to her office immediately.

So, with crutches and a lightweight ankle brace, we headed to the Orthopedist office.   Upon arrival it looked like a lot of the docs at this office are sports medicine docs.  That was comforting in some way.   Long story short here - more scans, and a bit of a more revealing diagnosis.

It looks like, most likely, the ankle twisting and pronating, combined with my leg twisting around it, snapped the tendon that holds the fibula and tibia together in the ankle.  This allowed the two bones to snap apart and causing a chain reaction up my leg that caused the fracture high up on my fibula just below my knee.  And tragically there was indeed a fracture in my ankle.

Lots of talk about "gaps" and "spaces" in my ankle.  Then the statement that I needed to come back tomorrow (well, today) to talk with one of the surgeons about the potential need to put a couple screws in there to get things back together.  Awesome.

Day 2: What, this isn't a normal ankle size?

So, we've been back to the Ortho to speak with the surgeon.  He didn't see enough "distance" in the gaps between some bones on my ankle X-Ray to be certain of next steps just yet.  And after torturing me on the table asking "does it hurt when I do this? (and then proceeding to twist my foot and ankle) he needed more information.  He ordered an MRI - stat - to determine if the ligaments and tendons (primarily the deltoid ligament) were damaged to the point of needing repair or if they're just stretched.

I'm booked for surgery on Monday, as he can get me in, and his opinion is that if it's needed, let's do it now.  He'll cancel it if need be based on the results of the MRI.  So, I'm scheduled for the MRI later today, and they've been instructed to call my Orthopedist as soon as it's done.  He said he'd call me later tonight or tomorrow and we'll make our final decisions.

More to come.......

Longing For The Good Pool

As I've been ranting and raving about recent swim workouts recently, I was thinking back to some of the better swims I've had over the past year.  I love open water swims with my triathlon club and once in a while get in a good pool workout at the local gym.  But last summer there were two great mornings that I recall fondly.

I was in Indianapolis last summer for work - just a few days, but enough to have to work training into the schedule.  Yep, the few days during the week was just enough for the old type-A / OCD to kick in and I began to worry about getting in my workouts.  The timing was pretty crappy, as I recall.  It was in early June, and I had two races coming up that month.  I can run almost anywhere, but where the heck was I going to get in a swim workout?  I went to Google Maps to locate my hotel, and saw that across the street was the NCAA Collegiate Athletic offices (cool), the NCAA Hall of Champions (still cool) and the National Institute for Fitness and Sport.  I didn't really know what the NIFS was, but it had to do with fitness and sport so I was thinking that this was getting cooler by the minute. Anyway, as I mapped what looked to be a good running route through the Indiana University campus, I stumbled across my savior for the upcoming week:

The IU Natatorium at IUPUI

Okay, the cool factor just went up a notch.  Time to pack the swimming gear.

I checked their hours for lap swimming, and the first morning I was in Indy, I walked the 10 minutes from my hotel to the pool.  Paid for a day pass, and headed to the lockers.  Interestingly, the locker rooms that were open to the public were fairly spartan - they reminded me of my high school swimming locker room.  I had to assume that the locker rooms for the IU team were a bit nicer! Anyway, not to worry I thought.  I'm here for the pool.  I hurriedly changed and got out to the deck.

I wasn't disappointed.

Oh, the joys of a long-course (50 meter) competition pool.   Deep all the way across (9-10 feet) and 8 lanes wide.  Waves were non-existant.  And while there were a fair number of people there, there was never more than 2 people a lane, and in a long-course pool you were never held up.

Cool water temps (they advertise that water being maintained at 72F at the time, but it felt cooler) meant you never felt overheated like I do at my local gym.  On top of that, they had an instructional pool (25 yards) in another area, and a full diving well with boards and platform tower. 

Man, this was great!

In the pool they have a wall covered with the names of all the swimmers who have set records in that pool: 101 American records and 15 World Records.  Walking back out side in the main hallway are photos of all the greats - too many to list, but needless to say I was a little late for work that morning (and the next!)

I write this having just come back from my local gym / pool.  Battling for lane space and grumbling about it to myself all morning.

The Transition Area

I read a post the other day from someone who, in one of their first longer distance triathlons, got to T1 and realized they had forgotten a few important items and had left them at home - HR monitor, nutrition.  I'm assuming it had to be pure oversight and a bag got left behind.  I suppose, similar to getting ready for ones first ever triathlon, that in your first long distance triathlon (a Half-Iron / 70.3 for instance), one might have their nerves a bit on edge.

My first triathlon ever had my nerves frazzled beyond belief.  The thought of just setting up my transition area was frightening.  As I recall, my wife and I went to a local triathlon a couple weeks before our race just to watch people come into T1 and T2.  It did help to see a transition area "live" and to realize that it's not rocket science.  But, I packed and re-packed my transition bag a dozen times before that first race.  And I'm pretty sure I brought waaaaay too much stuff for a sprint tri.

When I came out of the water and got to T1, I recall - not so fondly - a 'deer in the headlights' moment (or, four).  I stood there, frozen, staring at my transition area not knowing what to do first.  Looking back I'm surprised I actually found my way to my bike.  It's overwhelming the first couple of times you get into the transition area.  It's effectively a fenced in area of  controlled chaos.  People running in and out, bikes being un-racked and run to the "bike-out" area.  It can be intimidating for the first-timer - or even third-timer.  And heaven forbid you look up and see a veteran come in and out of T1. For the new triathlete, to see someone get in and out of the transition area as fast as some do can be shocking and humbling.

I've said many a time that I'm by no means an expert, but I've done this enough to know what works - for me at least - and I've found over the years that it has gotten easier to pack for my transition area on race day.  That's not a surprise, as practice does make perfect (or approaches it at least).  What I find more interesting is that it's also become more of an exercise in minimalism.  Over time you do begin to understand what you need for a race, and pack only the necessities.   The main thing that changes is the amount of nutrition that you bring based on the distance that is being raced.

The best advice I received for packing for, and practicing, transitions was simple and obvious.  When you're doing your brick workouts (bike to run, most commonly) lay out your gear in your garage or basement and simulate T2.  You'll realize if you forgot something (hat, gel, whatever) and after doing this enough times, packing your transition bag will become quite easy. 

This isn't to say that you won't forget something on race day.  My first 70.3 event a couple years ago felt intimidating.  I can pack for an Olympic distance triathlon in minutes.  But this felt different.  In the end, the biggest difference was nutrition - more to the point the amount that I had to pack was different.  But, I was thrown off none-the-less and had a few moments of pulling everything out of my transition bag and triple checking everything.

By the way, I didn't pack enough nutrition for that Half Iron race. I bonked badly on the run.  Oops.