Need to stop saying things will get better. Apparently, the bottom hasn’t been reached but can certainly hope it’s in sight. Another ride with a fair bit of elevation a few days after the Wolf Gap ride left the legs a little drained. Informed the others on the ride the legs and back had experienced enough fun as would be taking the alternate route around the final two climbs and would meet up at their intersection. Pace dropped and the small group rode ahead. Heard radar detected a vehicle approaching and it seemed to accelerate quickly as it passed by. Still not the most comfortable in that situation since the crash, veered to the right in response. Shifted a little too far and thought I could make the next right turn to recover. Made the turn but unable to stay on the road and crossed over the road an into a gravel area on the other side. Grabbed the breaks, rear tire slid and went down. On the left side, again. Knew impact had taken a different toll even though the gravel should’ve provided a softer landing. Attempting to climb out from under the bike (Synful has had a rough time of it), unable to do much with the left arm. Fell hard on the shoulder and movement was painful and minimal. Successfully re-mounted, linked up with the others and got a lift from one of the others who had parked about 10 miles from where the rest of us began the ride. Informed the Missus while waiting for my ride to add a few more miles that we were likely going to miss our dinner reservations for the evening as a trip to the ER was necessary. Way to ruin our 34th wedding anniversary.
Able to change and place the bike in the back of the vehicle (with an assist from the others) and let them know my plans. Spoke with the Missus again to provide more details on the incident and decided to stop at the house and head to the ER together. Had a diagnosis after 3 plus hours, X-rays and CT scan: nondisplaced fracture of the acromion process. Need to the CT scan to confirm as the X-rays were inconclusive. If that’s the only injury, standard protocol is a sling for 4-6 weeks until the bone heals enough then begin physical therapy. Received a referral for an orthopedic consult for some time later in the week. Wasn’t necessary to mention but no cycling until seen by ortho. Apparently, acromion fractures aren’t that common (yea me, again). Really need to stop crashing on a bicycle and breaking bones – 5 fractures in the past 4 years.
Not convinced acromion was the only casualty. Lots of shoulder noises with various movements and ROM in any direction (flexion, abduction, and extension) was painful and minimal. Post of the chronic discomfort was limited to the posterior side of shoulder. The bony protrusion on the top of the shoulder (acromion) is no longer visible and now asymmetric compared to the right shoulder. Elbow and wrist flexion aren’t problematic and induce no pain during movement. Putting a shirt on is a bit of a challenge and far more uncomfortable than removing it.
Finally had the ortho appointment after another wonderful experience with the DoD healthcare for retirees. Use the sling and return in 4 weeks. Not even enough shoulder movement to evaluate potential soft tissue damage. If ROM isn’t improved by the next visit, will consider additional diagnostic tests. Wonderful – going to waste the next 4 weeks not treating any other potential injuries and hope the fracture is the only injury. ROM improved marginally over next 3 weeks and evaluated at PT office at 40 degrees shoulder flexion and 60 degrees for abduction (flexed elbow) and extension. Frozen shoulder primary concern for long-term shoulder immobilization which can take 3-12 months to regain full ROM. Key is starting passive ROM exercise as soon as possible as long as nondisplaced acromion fracture is only injury. Still not convinced there isn’t associated soft tissue damage. Sleeping isn’t overly relaxing and doing most tasks one-handed is getting old, quickly. Performed some passive ROM exercises later that day, sans shirt, and noticed a divit in the pec during flexion. Returned the following day for actual PT: ultrasound, message, electrical stimulation, a little kinesio tape, and a little passive ROM (flexion and abduction) and active (flexed elbow abduction – chicken wings) exercised. Mildly shocked with the range of motion as able to extend hand above the head for both extension and abduction. Movement was uncomfortable but not pain limiting. Showed the therapist the pec divit and he speculated a tear in the pectoralis minor – it lays over the top outside corner of the larger pectoralis major and attaches at the acromion. Only an MRI can determine the severity of the tear and if there’s any other soft tissue damage. Seems like ample ammunition to request an MRI at the follow-up ortho appointment the first week in August. ROM was severely limited the day after the PT session. Very sore and stiff but consistently improved over time. Actually able to actively extend shoulder and raise hand above the head.
Chronic eye irritation noticeably decreased early in the second week. No where near irritation free but actually have moments that aren’t a constant reminder. Still looking for answers as the Cyclosporine emulsion drops doesn’t seem to be the long term solution, corneal specialist suggested autologous serum eye drops (ASEDs). They’re often recommended for treating a number of corneal conditions to include dry eye and neurotrophic keratopathy. The drops are not approved by the FDA as the treatment is considered a medical procedure and experimental/investigational. Vital Tears is the leading manufacturer of ASEDs and the producer of mine. After donating 7 vials of blood, they’re shipped to the facility for processing (clotting, centrifuging, diluting with sterile saline and adding proteins, growth factors, vitamins, antioxidants, and electrolytes. The drops are intended to mirror natural tears but with increased concentrations of each component in order to heal the corneal cells. The individual vials are stored in the freezer while the one being used is stored in the fridge. The standard protocol is 4 drops a day and each vial lasts one week. The opening of the vial is larger than all of the other drops used so far, thus placing a larger volume of liquid on the eye per drop. The current supply will last 3 months but after only a few days, it has significantly reduced the eye irritability. Almost feel like a normal person again – minus the blurry vision due to the cataract.
Survived the cataract surgery. No real anesthesia but eye drops: numbing; antibiotics, and; dilating (x3). Procedure didn’t take very long, less than 30 minutes. First part is laser based then next phases is more like waterboarding for the eye ball. Unable to blink due to the eyelid opener. Not painful or uncomfortable; just weird. The back of my head was soaked by the time everything was finished. The eye patch was clear and held on by two thin strips of tape. Expected an opaque cover to block out light and keep eye strain to a minimum. Nope. Have to remove it to apply to two different drops: mixture of antibiotics and steroid along with the serum drops; each 4x a day. Vision still a little blurry on day of surgery but much closer to right eye clarity the following day. Have to wear the eye patch at night to prevent inadvertent scratching, rubbing, or poking during sleep for a week. The patch in conjunction with the broken shoulder make sleepy time such a joyous event. Post-op appointment was positive, left eye vision is 20/40. Quite the improvement from 20/200. Sad to say, jeweler’s vision has disappeared and difficult to read anything without glasses. Clarity continued to improve but still not to the same level as the right eye and objects seem smaller, or more distant, compared to the right eye. Vision is definitely better but now reading glasses are required to discern nearly any printed information. Bringing the document closer makes it worse. Eye still isn’t comfortable but guessing that’s due to the scleral buckle. Hoping that goes away with time. The hypoesthesia has also improved, not 100% resolved but feel every drop from the various meds hit the cornea and sense the eye pressure sensor when techs are taking a reading. Still taking the Pilocarpine drops at night as the pupil continues to dilate throughout the day. It doesn’t change as much as it did but it’s still bigger than the right eye by the end of the day. Shouldn’t really complain as vision, discomfort, and irritability are significantly improved. Just not pre-detachment level yet.
All saddle time has been relegated to the trainer and Zwift for the entire month. Most of the time has been Z2 but did complete AdZ in under an hour, used the new climbing portal for three different ascents, and had one SST workout of 4 x 5’ intervals. Progression during the month eventually enables placing the left hand gently on the top of the bars but nearly all of the weight supported by the good arm. Hard to maintain motivation with an unknown recovery timeline, again, with the potential for surgery – besides the cataract procedure. Took a few days off, surgery day and the following two days, then returned to easy spinning for a few more days. Good thing all rides are indoors as still waiting for the left Dura-Ace 12-speed shifter to ship from Shimano to return Synful to its proper pre-crash, pristine condition. No update on the Super Six Evo frame warranty from Cannondale either.
Returned to baking, primarily muffins, with a vengeance. Again, return of some favorites and new recipes. Rhubarb seemed available longer this year than in the past so made several batches of Strawberry Rhubarb and discovered a new recipe, Zucchini Rhubarb. The Missus thinks they’re the best ever. Three other new recipes included Bourbon Maple Pecan, Buttermilk Spice and Strawberry Crumble. The crumble was different from most other crumbles in that there really wasn’t any liquid. The butter wasn’t melted but cut cold and incorporated into the sugar with a pastry blender. My fruit tastes have changed with age and strawberries are no longer disgusting. Have also incorporated more fruit in the weekly diet as breakfast is plain or vanilla Greek yogurt with Strawberries, blueberries and either raspberries or blackberries has replaced the standard cereal and bananas for three days. Modified a standard raspberry muffin by topping it with white chocolate frosting (at the suggestion of sister-in-law). Each of the components are quite tasty but there isn’t an accumulative effect when combined. The combination works very well with a cake but not the same with muffins. Didn’t hurt to try. Banana nut with peanut butter and chocolate chips and peach streusel also returned to the lineup. Also made a peanut butter skillet cookie (with lots of extra goodness: peanut butter and chocolate chips, Reese’s Pieces, and mini M&Ms.) Pretty good but had to use the lower oven as the convection upper is making terrible noises and it was a little over-done. Will have to try again with a few minutes less baking time. Made peach cobbler cookies for the first time with the remaining fresh peaches. Had oven temperature challenges again and they didn’t set the way they should have – too soft. Still good, though! The only new dinner meal with Shrimp Mozambique. Really quick and easy and goes really well with Jasmine Rice! Boy child also provided pictorial evidence of far fancier cuisine than our hearty, homestyle fare: sweet potato gnocchi and seared mackeral.
Cycling and Culinary Flavors 