Monday, December 23, 2013

Sometimes it is about the bike…

I used to enjoy cycling a lot. In the 90s, I enjoyed riding in long rides and was proud of the century rides (rides of 100+ miles in one day) that I completed. While I never had visions of racing, I just enjoyed the freedom and the view. This came to an end when my health got a bit weird and I had to readjust.

As some know, that readjustment led to inactivity and weight gain. As my health was straightened out and I lost 50 pounds, I made a move to Arizona where I bought a new bike and started commuting to and from work by bike. I explored the area by riding on the many bike lanes and canal paths that are here; again the view from the bike was pretty nice. In the process I lost another 50 pounds and started running.

One of the things I enjoyed about commuting was that it was my moment of Zen. It was a chance to prepare for or unwind from the day (depending on which way I was going) and let my mind clear out all of the clutter so I could stay focused on what needed to be done. There was no better way for me to relax. Nothing stopped my commute. Not the monsoons, dust storms, extreme heat, occasional below freezing temperatures in mornings, steady rain, or darkness. The people I met while riding always had interesting stories, some of them were ASU faculty, others worked in other places, and some were homeless. Commuting by bike helped me feel good about others and myself.

Eventually, I picked up a new road bike at the first bike shop that I felt “at home” with. For the first time, I was motivated not to ride solo all of the time, but with a group. I became a faster and stronger cyclist by riding in this group and started to participate in the community races like the Tour de Scottsdale, where I performed better than I expected. I was proud to wear my Bike Barn jersey when riding.

There is an end to everything, to good things as well.
– Chaucer

On December 23rd, 2011, the Friday before Christmas, I realized that about 3pm I was one of three people still in the office. I had a couple of things I wanted to finish up so that I could return to work for the short week ready to get things done. However, I was already tired of riding in the dark (sunset was at 5:25pm) and decided I would head out at about 4pm. I was also concerned about the traffic around Tempe Marketplace where the backup the past couple of evenings had been pretty bad due to all of the holiday shoppers. Plus, the weather had been nice as it was clear skies with the temperature still in the 60s. So at about 4pm, I put on my cycling clothes and put on my backpack so I can carry my iPad, work clothes, and empty food containers with me home.

The traffic was pretty bad that evening. The traffic entering Tempe Marketplace was backed up at least a mile and was stopped in major intersections. I was careful to keep my speed slower than normal so that I could be able to react to any inattentive and/or impatient drivers. After getting past the mall I relaxed, but did not pick up my speed. There was a homeless guy pedaling along the same bike lane and we chatted for a few minutes about bicycles and the freedom they give us. Then I went past Westwood High School, and headed south as I normally do. While I often go at about 25 MPH down this road, I am just feeling too good and relaxed to push it this time. I am ready to go home and try out a new ice cream recipe, but I just wanted to enjoy the nice warm day and sunlight.

One of the things that can make riding down Extension Road difficult at times is that the wide bike lanes often have debris in them. Another issue I have to watch out for is the drivers that make a right turn by driving in the bike lane before they get to the corner to make the turn. After Main Street, Extension becomes a four-lane road for a couple of miles so I often have some room to work with once I get past this point.

I look up at the stoplight as I approach Main Street and it is green and then I notice that the crosswalk countdown had not begun yet, so I have plenty of time to cross the road. I “take the lane” by riding in the middle of it despite the fact that no one is behind me. I do this so I can be more visible on the road and have plenty of room to react to any debris I might need to go around on the road. As I enter the intersection, I notice a car coming from the other direction with their left turn signal on. Then the car continues into the intersection without stopping and starts to turn left. I realize I am in trouble. My quick reaction tells me to lean to the left and hope the car goes through quickly and I miss the back end of the car; however, the car begins to straighten out, so now I quickly decide the better course of action is to turn to the right and hope that I can get past before the car makes the turn. I push the right pedal all the way down and hold it there so my left pedal and foot will be as high as possible.

The car turns.

What I remember is yelling very loudly “Oh… Shit.” I remember the car making impact. I remember the sky vanishing twice. Then I am laying on my right side on the ground remembering all of my first aid training.

According to the police report, a 92 year-old woman struck me at or about 4:40pm; she would later be cited for failure to yield when making a left turn. Eyewitnesses reported that I enter the intersection safely and legally. They also reported that I shouted quite loudly prior to impact and that I flipped as I flew through the air for 15 to 20 feet.

As I am lying on the ground I have a chance to do a quick head-to-toe assessment while not moving. I am laying on my right side with my right hand between both my knees. My legs look fine, but they feel a bit weird. My left arm is resting on my left hip and the wrist is obviously broken since my hand is several inches higher and shoved up my arm a tiny bit. In addition, my head was really foggy and ringing.

The first person to come running up was a woman. I never got her name, but I think she was with the Mesa Sheriff’s Department. She asked if I was ok and was quite stunned that I responded. She did not expect a conscious victim. She told me not to move and I responded that I am a former first aid instructor and that moving was the last thing I was going to do. I immediately provided her with all of my vital information and pointed out that I was more worried about the concussion that I just received than the obvious fracture and dislocation of my wrist.

Then a guy comes up from behind and states he works for the local ambulance company. Then he tells me not to move. Trust me, I am not going to move. I then tell him all of my vital information and point out my concerns about concussion since that is not visibly obvious. He has the woman hold my neck and head in place so that I cannot move my head and potentially cause damage to my neck and back. I understand what he instructed and why, but I am not sure how helpful it really was since I was still laying on my side, with my backpack and helmet on.

Then the fire department arrives (it may have only been two minutes since impact at this point). Once again, I tell him all of my vital information and point out my concerns about a concussion. I remember one of the fire fighters telling me that he will gather up my bike. Then another one looks at my shoes and tells me that he is a cyclist and that he recognizes how expensive my cycling shoes are and offers to remove them for me so that the ER does not cut them off. He also informed me that the bike was totaled.

Then the police arrive and the officer was stunned to see that I was conscious and took my report. Once again, I tell him all of my vital information and point out my concerns about a concussion. It was at this time I found out that I was hit by a 92 year-old woman who claimed to not have seen me until she had collided with me. According to the report she was going at about 15 MPH and I reported that I was going close to 20 MPH. The officer was also surprised that I almost got the color of the car correct. I thought it might have been a dark green mid-size car and the officer told me that it was a blue Toyota Camry. Also, I think the officer was also a bit frustrated at the age of the driver.

Then the ambulance showed up and once again, I had to tell them all of my vital information and point out my concerns about a concussion. Finally, my backpack and helmet are removed and I am placed on a stretched and immobilized. While this was going on there was a debate as to which ER to send me. The one closer to the house was not a Level One Trauma Center but they thought a surgeon might be on duty who could repair my wrist; however the concussion issue was what tipped the balance for me to be sent to Scottsdale Healthcare Osborn Medical Center. The attendant in the back of the ambulance was a runner, so at least I had something to talk about with her. Before we left the scene, I was told that the officer was going to take the remains of my bike home and inform Dawn of what was going on.

When I arrived at the ER, I was rushed in to get evaluated and x-rayed. I did my best to stay upbeat and interacted with the nurses and doctors as much as I could. The lead ER doctor was Dr. Green, and both he and another person in the ER were mountain bikers. At this time, hunger and fatigue was beginning to settle in, but I had to wait for all of the x-rays and CT scan to come back and be read. The swelling in my wrist was beginning to get bad and they were not quite sure when they should operate on my wrist. In the meantime, they determine that both legs are only bruised, but they were surprised by the very little road rash I had. I only had minor road rash on my left leg and shoulder. While they were doing their evaluation and such, I found out I was one of two people to arrive at the ER at about the same time. The other guy was a motorcyclist who was not wearing a helmet. I was labeled as the guy with a helmet. It was also during this time that the hospital called Dawn to let her know where I was and that I was complaining about some arm pain.

Dawn calls a friend to take her to the ER. She was concerned how to get my bike home and if I had an injury that would have made it difficult for me to get in and out of a car. Our friend picks up Dawn and Lexi. Lindsey stayed home to receive the bike parts. They didn’t want the elderly next-door neighbor to get upset when he saw a police car pull up with bike pieces. She gets to the hospital between 6:30pm and 7:00pm and the police officer is there in the lobby and meets her. He then hands her my bike, or rather he handed her a chard of my front fork. He had meant it as a way to lighten the mood; however, he did not know that no one had told Dawn anything whatsoever yet (beyond the "arm pain").

Dawn is sent back to see me and she sees the deformed and swelling wrist. She gets briefed on everything. While the doctors are off trying to decide on their plan of action, I look down between my feet and see a guy walking by that I recognize. I am not sure if it is whom I think it is, so I wearily called his name and he is stunned as he recognizes me. He is one of the guys from the Bike Barn that I ride with on the Sunday morning rides and he works at the hospital. Because I was out of it a lot of the time, I did not see him too much. However, I do know that he was around quite a bit and check in on Dawn a bit to see if she needed anything.

At this point there is a plan of action. One of the concerns was the swelling going on in my wrist; the swelling was bad enough to make it impossible to do surgery on the wrist. So they dope me up big time and relocate my wrist to reduce the swelling. This involved grabbing my hand and pulling it back down to where it belonged on the end of my arm.

Late on the morning of Christmas Eve, I had the surgery to reassemble my wrist and hand. The surgery lasted three hours and involved a stainless steel plate, twelve screws, and a pin. The scaphoid bone in my left hand (it is the big bone below my thumb) was broken in half and need a screw to hold it together. And then I had a plate attached to the bone in my arm and six wrist fragments were reassembled. What made things so difficult was that the fragments were “180 degrees apart from each other” and he was only able to get five of them on to the plate with screws, hence the need for a pin that was used for the sixth fragment. I also later found out that my surgeon was voted Arizona Hand Surgeon of the Year a year later, so you know I was in great hands.

Dawn had already begun a search for a lawyer because we knew this was bad. I had suggested that she call the Bike Barn to see if they knew of someone. I knew there was a lawyer in Tucson that specialized in situations involving cyclists, so I was hoping there was one in Phoenix. When the surgeon came out of surgery and spoke to Dawn, he handed her a card and told her she did not need to call this guy, but she needed to call a lawyer to make sure I had what I needed for what was to come.

There is not too much more to talk about in regards to the hospital. I got a lot of drugs and very little sleep. The one thing that freaked me out was when they were testing my reflexes after surgery. My left arm was suspended in the air and they would touch my fingers asking if I felt that. I responded I did, except that it felt as if my hand was resting on my stomach, not up in the air. The only way to explain the disconnected feeling is the phrase “phantom limb syndrome,” except I still had the limb.

I had some great nurses while in the hospital. Two of them were cyclists and one of them occasionally commuted to work by bike. I did my best to do what they told me, but there was on time I tried to push it and should have asked for their help. They were constantly asking me if I wanted to go to the bathroom. I remembered from a TED Talk that they worried about things like this from trauma victims. This is due to the body shutting down and once you have a bowel movement, which is an indicator that everything is trying to work again, the medical staff start to feel good about your chances of survival. One time I tried to go to the bathroom without any help, this was when I discovered how weak my legs were from the crash and the drugs.

Late on the afternoon of Christmas Day there was a debate on whether to discharge me or not. The deciding factor was that they were able to find a pharmacy to fill my prescriptions. Therefore, I was able to go home and have the planned Christmas dinner at our friend’s house (the same one that took Dawn to the hospital) and then figure out how to sleep at home. For several weeks, I slept on the coach with my arm suspended in the air from my homemade light stand that I built to use for photography.

I finally got a look at the bike. The bike was destroyed (see pictures below). The front wheel was severely warped and was ripped away from the bike when the carbon fiber fork broke in multiple spots. The aluminum frame of the bike took damage with the most notable being that the back left side of the frame was bent by the impact of the car. Because I had my right leg all the way down in my pedals, that meant my left foot was as high as possible and that the car’s bumper hit on or below the pedal; thus preventing my left leg from being severely broken. I think the backpack I was wearing must have prevented shoulder and back injuries since the backpack had internal metal stays that provide support for long hikes and a wide waist belt. My helmet did its job by protecting my head, but it was cracked in multiple places. The part that did not make sense to me was the amount of damage to the left side of the helmet and the minor road rash I had also on my left side; however, I was laying in the street on my right side. I remember everything from impact to flying through the air to lying on the street. However, I do not remember landing.

I had Monday and Tuesday off from work since the holidays were over the weekend. I was able to sit up and I had my laptop with me, so on Wednesday, Thursday, and Friday I handled a couple of planned phone conferences and did some work to help get some classes ready for the Spring semester. I would have called my director, but almost everyone in leadership had taken the week off. So I work with several faculty members around the country and never let on that there was an issue with me.

The following week brought the New Year and I began it with a visit to the surgeon’s office. The swelling had gone down more than expected and I was ordered to begin physical therapy the next day. Also, I was told that I was going to be in a splint for at least six weeks and out of work for a while.

While we were out, I had the remains of bike with me so I took them by the Bike Barn. When we got there, I asked if they could repair it for me. That got a chuckle out of the staff. They were amazed at the damage and were surprised at how warped the front wheel was; they had never seen a rim bend that much without breaking. Then I went by the office and officially and filled out the paper work to go on medical leave.

Progress was slow. The stitches were removed on January 12th and there was a plan to have a second surgery on January 23rd to remove any scar tissue around my wrist and tendons that might have formed and to remove the pin. The pin decided to come out a couple of days early, so they cancelled the surgery. Despite this, progress was slow with physical therapy. I struggled to regain strength and mobility. I couldn’t turn my hand over to hold candy in it and couldn’t hold a fork or knife. Typing was incredibly slow as I couldn’t move my fingers and had to move the entire hand as one unit. But I was allowed to return to work on a part-time basis on February 2nd.

I was in physical therapy three times a week and it seemed to not be enough. In hindsight, I wish they had told me to do my exercises for eight hours a day as if it were my job. Instead, I was given the standard do this list of exercises four to five times a day. I was prescribed “aggressive” physical therapy, but now I had to manage doing this while returning to work. Unfortunately, my office was not flexible enough to let me work from home on days that I had physical therapy. Because I was not able to drive myself, Dawn ended up being removed from the naturopathic medical school because she needed to take care of me.

One of the things that were not addressed by the doctors related to my legs. I was fortunate that my chiropractor was able to get my hips realigned after bouncing on the pavement. This substantially reduced the leg pain I had been dealing with. Another issue was the post-concussion symptoms that I had to deal with after the crash. I dealt with a lot of headaches and occasional speech issues. They took a very long time to pass, but the eventually did.

It was very difficult for me to sit and watch things I should have been part of pass me by. I had been planning on running in my first marathon and triathlon. I had some very tough cycling goals that I was looking forward to. But I had to push all of these things aside. Just as I thought my life was returning to normal, I needed to have a second surgery. One of the screws that had been used to hold a fragment of my wrist bone was poking through and into the wrist joint. Therefore it was necessary for them to go in and remove the plate and eleven of the screws. The good news is that they were able to cut my arm open along the scar that they created when they operated the first time. They left the screw in my scaphoid because it was out of the way.

One of the side effects of having a screw in your body like I do is that you can no longer go to the dentist without a lot of pre-planning. Apparently you must take a regiment of antibiotics prior to having even a cleaning done. Also, with all of the flying I have done over the past two years, I have only had the airport x-ray machines detect the screw in my hand once.

Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever. That surrender, even the smallest act of giving up, stays with me. So when I feel like quitting, I ask myself, which would I rather live with?

Lance Armstrong

Getting back up to speed has been difficult. However, I have been able to take advantage of some opportunities.

I joke with people that I applied to enter a Doctorate of Education program while high on drugs because I submitted my application about five weeks after the crash. I am now over halfway done with the program. I have changed jobs at ASU to take on more of a leadership role with a different area of campus. I have completed my first marathon with a time I will not discuss, but I did finish it. Just last week, I ran in the Fiesta Bowl Half Marathon with a time of 2 hours and 9 minutes.

I had a list of three things that I had to accomplish in order to be able to move on from the crash. The first one was to finish the ride home. The second one was to tell the story. The final one was to return to my cycling weight.

I bought a new bike in September of 2013. My friends at the Bike Barn helped me select the Specialized Roubaix, a bike with a lightweight carbon fiber frame. This model bike has been used to win several international races and is known for its comfort and handling abilities on rough roads. I also picked up an indoor trainer so I could get used to the bike before taking it on the streets. On October 26th, 2013, I completed the final 3.62 miles of the commute that was interrupted. That ride was nerve wracking and I was very glad when it was over. Since then, I have ridden twice more, both times were with the Bike Barn on their “no-drop” ride. I am looking forward to joining them on this twice a month ride until I am ready to join them on their faster rides. The next thing I need to do is go on solo rides again.

The thing that held me back on telling this story was my lawyer. I had a great lawyer that understood my needs and worked very hard to help me get what I needed. One of the things that happened is that I ran out of insurance coverage for physical therapy at the end of May. I was fortunate that after my second surgery to restart physical therapy with a different therapist that agreed to not bill me until after we had a settlement. I also discovered that your medical bills could change after you have been billed. Apparently it is routine practice for hospitals and doctors to charge you the price mandated by your insurance and then if there is a lawsuit involved, they can file a lien to recover the full cost of your medical care. Fortunately, my attorney was able to negotiate that down quite a bit. One of the things my surgeon was concerned about is how bad my arthritis will be in the future. There is already evidence that I have arthritis in my joints and it could be possible that down the road I may need to have my wrist fused due to the arthritis. Now that the litigation is completed, I can tell the story and show the pictures.

The third goal is one that I thought I would have achieved first. When I was hit, I was at my “winter weight” of 185 pounds. During the spring through fall when I am my most active, I usually weigh around 175 pounds. Currently, I am right at 200 pounds and this is after peaking at 215 pounds. On two different occasions, I managed to get near 190, but I need to get back to 180 pounds. Especially since I have clothes that I bought a week before the crash that I have never been able to wear. One of the obstacles that I have been dealing with in regards to meeting this goal is injuries. Ankle, leg, knee, and back pain has kept me from following a consistent running plan. Also, my left wrist still aches from time to time, and the limited flexibility can be frustrating.

There are fixed points through time where things must always stay the way they are. This is not one of them. This is an opportunity. A temporal tipping point. Whatever happens today will change future events—create its own timeline, its own reality. The future pivots around you. Here. Now. So do good.
– Doctor Who

Was 4:40 pm, December 23, 2011, a defining moment for me? While that moment has had a tremendous impact on me and those around me, I am not sure if I would call it a defining moment yet. I have fought to prevent that moment from being the moment that I stopped cycling. I am continually attempting to define myself as something other than a crash victim. As I look to the near future of 2014, the plan is to run in the Phoenix Marathon on March 1st and if I am feeling up to the challenge I will register for my first triathlon to be run on April 13th. Also in April I will defend my dissertation proposal. As I look beyond 2014, I am not sure how I will be defined. Whatever I decide to do, I will continue to ride on. And maybe one day the voice in the back of my head will go away, the one that tells me "I should not be here."

Tuesday, December 10, 2013

Dobson Dance Concert - Fall 2013

Lindsey had her fall dance concert a couple of weeks ago.

Trip to the Zoo

Playing catch up here...

Back in October, Dawn's mother (Cindy) came out for a visit. What made this interesting was at about the time her plane landed in Phoenix, Steven was flying out of Phoenix to head to a conference. Then on the evening he came home, Dawn had left earlier that morning to go to her high school reunion in Virginia.

The good news is that Cindy, Lindsey, Lexi, and myself was able to spend a day at the Phoenix Zoo.