They Tried to Make Me Go to Rehab — I Said Yes, Yes, Yes!

Guest poster Don Blount sets an example for us all by the way he’s coming back from hip replacement surgery.

BlountOnBiking
April 20 marked 39 days since I underwent surgery to replace my left hip.

Since then my focus has been on recovery, rehab and rest.

This is my second hip replacement; my right hip was replaced with an artificial joint in 2004. But this time around a less-invasive surgery has enabled me to recover more quickly.

I checked into the hospital at 12:30 p.m. March 12, underwent surgery later that day, and was on my way home by 2:30 p.m. March 13, a stay of 26 hours.

Because I was fit, my surgeon’s directions was to monitor any swelling I had in my leg. A physical therapist instructed me to not overdo it.

I was on a bike trainer by Sunday. I was not pedaling fast, hard or with any resistance but I was pedaling.

Trainer_Rehab

I spent my days doing rehab exercises and reading while elevating and icing my leg. I read nine books in 30 days and watched live at least part of every game of the NCAA men’s basketball tournament.

My rehab includes:

  • Bike. First on the trainer and now on the road.

Bike_Selfie copy

  • Pool. I have a series of exercises to do in the pool to strengthen my hip and legs. This workout takes about 50 minutes.
  • Gym. Leg extensions, leg curls, leg presses, calf raises, resistance bands, treadmill and elliptical trainer. This workout takes about 90 minutes. Here’s a look.
  • Exercises for core, hamstrings, quadriceps and glutes and stretches for quadriceps. Click here to view workout video:

I am still working on walking without a limp and building my stamina. I find that rest includes a lot of naps after rehab work.

Without question, cycling has helped me through this process. Physically, I am in better shape and that has its obvious benefits. But mentally having ridden hills, centuries and double centuries helped me too. As I have told others, recovering from hip replacement surgery is nothing compared to going up a long difficult climb.

Overall, I am pleased with my progress. I returned to work on April 15 and although I am doing well, I do not receive full clearance until June 12, which is three months after surgery. Hmm, that would put the Bass Lake Powerhouse Double Century just under four months away….

Sideways

Our frequent guest poster, Don Blount, is dealing with a setback.

BlountOnBikingMy cycling year has gone sideways.

I had planned on building on what I did last year, riding a total 6,500 miles and completing a bunch of challenging rides, including the Tour of the California Alps Death Ride and my first double century.

This year my goal was to complete three double centuries, which would give me a California Triple Crown and to complete the Death Ride again.

But man makes plans and God laughs.

Instead of preparing for my next ride, I am readying for major surgery in March and rehab with hopes of being able to complete a double century by the fall.

Don's left hip.

Don’s left hip.

The problem is osteoarthritis in my left hip. It is something that I have been tracking for nearly two years. X-rays taken about last May showed no cartilage in the joint, which meant there was bone on bone grinding.

My doctor described it succinctly: “You have a crappy hip.”

Cycling is a non-weight bearing activity – except for standing when climbing or making a hard effort – so the only option was to live with it until it became problematic.

So I rode and for the most part without any significant problems.

In October I had a quick consult with an orthopedic surgeon who looked at the x-ray, and told me to come see him when I was ready. Ready meant ready for hip replacement surgery.

Don's right (replaced) hip.

Don’s right (replaced) hip.

The hip was balky but it provided no real indication that it would fail.

But over the Christmas holidays it took a turn, becoming increasingly difficult to use until one morning after New Year’s I got up and could not walk at all.

My hip had not just deteriorated; it felt as if it had imploded. I can ride, I can work out. But the pain became constant and I needed a cane to walk.

It was time for hip replacement surgery.

I spoke with my doctor who referred me to the surgeon and a surgery date was scheduled.

I may view this major surgery a bit differently than other people since I had my right hip replaced in 2004. People do not know I have a replacement hip unless I tell them. The surgeon says I can be on bike trainer a few days after surgery.

That’s my new starting point on which to build and hopefully I can complete a California Triple Crown in 2016.

Deer Flies and Fire Ants

If you ride for any length of time, you’re bound to have an encounter with bees. But sometimes, inhabitants of the insect world can be other types — and cause even more discomfort than a bee sting.

While pedaling beside a stormwater runoff basin during the week, I felt a sharp stinging sensation in my right arm — as though a red-hot needle had just pricked the surface of my skin. I couldn’t react right away, because the path took a turn into some woods and I needed to concentrate on my line. But shortly after, I looked down at my arm and saw a deer fly just sitting there. It hadn’t moved, but also didn’t seem to have done any more damage than the initial prick. Good thing about deer flies: They’re not very quick. I stopped the bike and smacked it. It squashed like a rotten tomato.

The bite did no harm. I had no swelling, no inflammation. Maybe I got lucky. The luck didn’t last long.

Saturday evening, I was installing a new garden hose on the side of the house. A few spots on my lawn are starting to brown out, and it was time to wet them down before the once-a-week sprinkling I give the entire lawn (We have an in-ground sprinkler system, but we’re allowed to water by hand whenever we want). I was in my usual Texas summer attire: shorts and old boat shoes with holes in the soles. Nothing unusual.

Until something did feel unusual. Not quite the same sensation as the deer fly bite, but I felt tiny things crawling over my feet and ankles. In the gathering dusk, I had trouble seeing exactly what they were, but I knew. Fire ants. I must have stepped on a hidden ant hill and set them to swarming.

I dropped the hose and dashed into the house. My wife ordered me into the shower to wash down my feet, while she found some hydrocortisone cream. I smeared that all over my feet when I got out of the shower, and found some Benadryl — the strongest antihistamine we have in the house. For the last hour before going to bed, I applied cold compresses to my feet.

Not a pretty sight. Doesn't feel great, either.

Not a pretty sight. Doesn’t feel great, either.

I was doubtful whether I would make the Sunday club ride. That would be disappointing, because we already had some B riders lined up, and it would be nice to ride with other people instead of on my own.

The Benadryl did its job — I slept like the dead until my dogs woke me up around 5 a.m. The first thing I did was assess the damage. It looked pretty much as the picture shows. Some of the bites had already started to rise into small blisters. Those are the ones that dare you to scratch them. But if you do, all manner of bad stuff can happen. I set about getting ready for the ride.

When feet are enclosed in snug cycling shoes, the fire ant bites aren’t noticeable. We did a nice 45-mil ride to Kyle and back, and I was hardly bothered by the bites at all — except for one on the inside of my middle finger. That must have happened when I tried to flick off one of the ants. It just grabbed my finger instead. And it was right at the spot where my finger curls around the handlebar. I constantly had to adjust my grip on the ride, so as not to rub on the bite.

So, two good things out of this adventure: the deer fly bite had no consequences, and you can ride though a dozen or more fire ant bites without them bothering you.

I’ll be sure to let you know if I’m proved wrong on that score the next time I don’t take precautions when working in the yard.

 

Biking — But Not Better

After riding last Sunday and feeling much better, I hoped exercise would help my current gout flare up. So, on Tuesday, I got home a little earlier than usual and took the bike out for another quick ride. I felt better after an hour’s pedal, but my foot was still sore. However, two hours later, when I went to take the dogs for a walk, I was walking almost normally.

I felt good going to bed Tuesday night, but when the dogs got me up Wednesday morning, I could barely make it to back door. The gout pain had come back with a vengeance. To get to the class I teach in the afternoon, I have a quarter-mile walk across campus. It felt like an expedition. I couldn’t wait to sit when I got to the classroom.

So, I bit the bullet and called the doctor. He didn’t have any slots open, but he’s part of a physician’s group with offices across the metro area, and one of his colleagues could see me this evening.

The diagnosis and treatment is straightforward. First, the aim is to control the pain. He prescribed the “fire extinguisher” — prednisone. (Luckily, I haven’t had the side effects of Prednisone others have had.) Then, there’s Colcrys. That will lower the uric acid levels in my blood. I’ll be on it for about four months. When I see my regular doc next month for my annual physical, we will be talking about long-term treatments to keep the uric acid level low. That will probably involve a drug like allopurinol or Uloric, but once that’s established, my gout should be under control.

I explained to the doctor about the beneficial effects of cycling on my gout. He was interested, but didn’t give it much credence. He was glad I’m still able to cycle, because it turns out he’s a cyclist, too. I had seen a cycling helmet under a chair in the examination room, and he pulled it out.

“This is what I use to explain to people why they should always wear helmets,” he said, handing it to me.

It had been in a big crash at some point, and had a large crack on its side.

“The helmet broke, but my head didn’t,” he said.

We chatted a bit more about cycling, and I got the impression that he travels at about the same average speed I do. But I had to get moving and pick up my prescriptions. My foot still hurts as I write this, but I’m hoping I’m finally on my way to controlling it. And maybe I’ll run into the doctor on the road sometime, too.

Cycling With Gout

I am proud to note that once again, I am suffering from the “Disease of Kings.” Yep, I have another gout flare up.

I have had them before, but this time, it’s different. This is my third attack in about four weeks. The first one lasted only 24 hours. The second one was with me a full week. This one got me on Friday, and we’ll see how long it lasts.

Gout is the crystallization of uric acid around a joint — often the big toe. That’s what I’ve been dealing with. It swells the joint, inflames it, hurts when it’s touched, and makes walking difficult. It’s accompanied by quite a lot of pain.

Walking the dogs around the block this evening was agony. I’m not looking forward to going in to work Monday — I’ll have to connive to stay parked at my desk, rather than walk around the building. Thank goodness I don’t have to move between buildings on Mondays.

A shot of my two feet shows right away which one is afflicted. The left foot is swollen around the joint, and the swelling has moved up the instep a bit, too. (I stood on the sides of my feet a little to show off the problem better.)

gout

But there’s one activity that isn’t adversely affected by gout: cycling. I did a short ride with my wife Saturday morning, and was looking forward to getting out again Sunday. I was even able to cut the grass, wearing fairly stiff-soled hiking shoes. But inactivity makes the pain worse, and when I got up Sunday morning, I could hardly move. I made an excuse to skip the club ride, but pledged that when I had medicated myself and had a decent breakfast, I would ride.

I decided to stay relatively close to home, in case things didn’t work out as I’d hoped. I needn’t have worried. The rigid soles of cycling shoes are great for gout sufferers, because they inhibit the toe joint from hinging. I did a couple of quick laps around the Veloway, attacked a hill going back into the neighborhood, and racked up a nice 26-mile ride before calling it quits.

After showering and getting dressed, I found that I could walk more easily than I could earlier. The increased circulation of blood from the cycling must have had a salubrious effect. It was only after several hours parked in front of the TV watching football that I reverted to the agony of Saturday night. I limped around the block with the pooches, and downed some Ibuprofen for the third time when I got home.

When you get a gout attack, odds are good that you’ll get more. Now, my job is to control the level of uric acid in my blood. Cherries are supposed to help. There are some foods I should minimize. One of the worst things for uric acid turns out to be beer. Cutting beer — even temporarily — will be my biggest adjustment (I really enjoy drinking craft beers!).

Various cycling forums are loaded with posts from gout-suffering cyclists, so I know I’m by no means alone. I’ve taken heed of some of their tips, and will be checking with my physician at my annual physical in a few weeks to see what else he might recommend — there are some effective pharmaceuticals for the treatment of gout.

In the meantime, I’ll stick to a more-or-less regular cycling schedule. Maybe that will speed up my recovery.

Slow Recovery

It’s been a disappointing week. I thought I had been making a good comeback from my fall two weeks ago. Last Sunday, I did an easy 32-mile ride with no bad consequences. But Monday, I developed some pains in my side.

I had been having these feelings pretty much since the fall, but they were minor. I mostly concentrated on that huge bruise I blogged about last week, and then a hip pointer made itself known. Football players (American football) and hockey players get these, from banging the point of their pelvis bones against something hard. Most of the time, it’s not there, but when I bend my left leg a certain way, the pain is enough to make me jump.

Then on Tuesday, I decided to do my after work ride. It’s a 19-20 mile jaunt through my neighborhood. This time, as soon as I got on the bike, I could feel that pain in my side again. It feels as though something under my ribs is bruised, and if I bend at the waist a certain way, it’s quite painful.

On the bike Tuesday, that ache was with me throughout the ride. Instead of 19 miles, I cut it short and did only 12.

“You should see the doc,” said my wife, when I told her what had happened.

Luckily, my doctor keeps evening hours on Wednesday, and booked me an appointment that evening. He’s always been supportive of my biking, because of the changes it’s made in such indicators as blood pressure and cholesterol levels. Of course, this is a negative effect.

He had me do some stretches, which didn’t hurt. He poked and prodded my sides, and found the quarter-sized spot on my left ribcage that triggered the pain. It’s where the rib meets cartilage, and he told me the cartilage is the damaged part.

“In my professional opinion,” he said, adopting a pedantic tone, “you’re banged up.”

There is nothing to be done. “Even if you had a broken rib, we wouldn’t do anything,” he said. “We’ve stopped wrapping ribs. It turns out that can cause pneumonia.”

He did recommend heat. And anti-inflammatories, which I’d already been taking. But it looks like it will be several weeks before the aches and pains go away.

I dug out the heating pad, and it does work. Saturday, I got on the bike and repeated the ride I had started Tuesday. This time, I did the whole 19 miles. My torso felt fine.

I rode again today. The only time it feels sore is when I stand to pedal up a hill, so I rode a mostly flat course. But I can ride without pain.

I’m looking forward to riding again Tuesday after work. My time in the saddle is really down this year. I’ve got some catching up to do.

 

Biking Through a Bruise

My fingers next to the bruise give an idea of its size.

My fingers next to the bruise give an idea of its size.

I’m still feeling the effects of that fall I had a week ago. I’ve got the biggest bruise on my hip that I’ve ever had, and it was quite painful to start with. However, one nice aspect of our sport is that it seems to help in recovery from these kinds of injuries.

The crash was odd in that I wasn’t moving all that fast. In fact, I was just slowing to make a turn when the rear wheel slid out from under me. But the full force of the impact fell on my left hip. I must have hit the pavement a lot harder than it first seemed, because two days after the crash, I had trouble rising from a chair. It felt like the whole left torso was bruised as well, although I could find no marks.

How did I treat the big bruise? It turns out that I did everything wrong. The recommended treatment for a bruise is to stretch and ice the affected area after the workout. In my case, I felt so good after riding this week that I did nothing except shower. For pain, acetaminophen is the recommended treatment — not ibuprofen. I gobbled ibuprofen two or three times a day.

Sitting for awhile, while watching TV, exacerbated the pain. Moving eased it. Except for Sunday, the day after the crash, I have been on the bike every day — sometimes pushing myself to climb a small hill a little bit faster, or do some intervals. Without fail, I felt better once I got home.

In one regard, I was lucky. I wasn’t bruised anywhere that came into contact with the bike. So when I ride, I feel like a normal person. It’s only after I’ve been stationary for an hour or more that pain becomes a problem.

Bruises heal themselves in seven to 10 days. My bruise is still impressive, in terms of the area it covers, but I can tell the coloring is already starting to fade. I expect to be back to normal in another couple of days. But in the meantime, I think I’ve healed a little faster by exercising those muscles under the bruise than I would have if I’d done nothing.