A mix of outdoor and Zwift rides to start the month. Temperatures have generally been lower than normal plus there’s been a fair bit of rain. Harder to stay motivated with nearly half the rides being indoors. Summer is coming and outdoor rides will become the norm.

Several eye appointments in the first week as the corneal eye saga continues. Had a follow-up appointment with the ophthalmologist who performed the detached retina corrective procedure. All is well from his perspective – retina is firmly attached to the back of the eye. Briefly discussed the on ongoing irritation created by the conjunctiva granuloma. Didn’t seem to be a fan of removing it and cautioned about the thinness of the cornea. Nothing good would happen if that gets perforated. Suggested a contact lens and laser procedure (YAG) to clear up the cloudiness that developed after cataract surgery. Return visit scheduled for 6 months later.

Had the second treatment of IPL (intense pulsed light) treatment for the Meibomian Gland Dysfunction. The upper and lower eye lid glands get clogged, preventing the golden olive oil from being released – contributing to dry eye syndrome. After performing the treatment, the doc commented that if anyone was a candidate for IPL, it’s me. On the plus side, over 20 functioning glands on each upper and lower but several were clogged. Continue to use heated rice bags daily for 10 minutes on each eye to help prevent the pores from clogging.

Returned to Walter Reed for the twice rescheduled appointment with my primary ophthalmologist treating the corneal irritation. Pushed the plan for removing the granuloma as I’m completely convinced it’s the underlying cause for most of the foreign body sensation (FBS) that has plagued the eye for the last 2 years and YAG. Not discounting the dry eye syndrome but the contact lens stops most of the irritation after insertion. Symptoms return when removed. Pulling the lower eye lid downward slightly also stops the irritation. As has been the case for many of the treatments since the detachment, eye was feeling better at times, even without the contact lens which still creates its own level of discomfort. Rx is outdated as vision changed after superficial keratectomy and wearing a hard lens just gets fatiguing. A new condition gets added to the mix: pinguecula. Mine seem to be raised from the conjunctiva more than usual (go figure!) and is likely the cause of the worsening irritation. Another round of steroid drops with the added fun of contact removal and re-insertion. The doc agreed but said he was being deployed the following week for 4 months. Choice was to wait for his return or have someone else from his staff perform the procedure. Waited long enough, full speed ahead as it would likely be closer to 6 months before the procedure could be scheduled. A question was posed, “Is there ever a time you’re able to forget about the eye?” There are moments, measured in minutes, that it recedes into the background but not very much. Too many daily tasks revolve around the symptoms: Rx drops, moisturizing ointments, contact stuff, blurred vision, irritation without the contact, etc. Hopeful that excision of the granuloma alleviates most of the symptoms.

Finally, had a virtual appointment with my PCM at the VA to discuss my ever-changing lipid profile. Total CHOL increased by 71 points in 8 months with the only known change being daily supplements of Rx Omega 3. A few months after stopping the fish oil capsules, total CHOL value dropped 56 points. Lipoprotein A and Calcium scores are still elevated, and the discussion was focused on treatment: statin Rx. After reading “Outlive” by Peter Attia, no longer opposed to taking a statin to drive down negative lipid profiles as much as possible. Began taking half of a 40 mg Rosuvastatin tablet daily. Will redo blood work after several months to check changes.

Now the real last bit of medical news before returning to the regularly scheduled content of cycling and food. Mom (81 years old) has full-blown Alzheimer’s, no short-term memory but thankfully still remembers family members and Dad (83 years old) recently diagnosed with Parkinson’s and experiencing cognitive decline and short term memory loss. Attia’s book mentions genetic testing for APOE and its 3 variants: e2, e3, and e4. In summary, e2 seems to protect against dementia, e3 is the most common, and e4 increases risk of developing Alzheimer’s by a factor of between 2 and 12 (depending if one or two alleles). Last time taking parents to their quarterly neurology appointment, asked the doc his view. Surprisingly, he wasn’t against testing. He cautioned that results weren’t predictive but does indicate relative risk factor of developing brain rot. Paid $125 to Alzheimers.Org and received 3 cotton swabs. Rubbed inside of the mouth with each one and placed them in the included return letter. Several weeks later, received the results: lucky me! Inherited an e4 allele from Mom and Dad. Yes, risk factor for developing Alzheimer’s increased exponentially. Again, results are not predictive, just more likely. According the Attia, the number one activity that can delay or mayhaps even prevent development is EXERCISE. Got that part down pretty well. Specifically, aerobic endurance (Zone 2) and weight training are key. Other contributing actions include healthy biochemistry (working on that), nutrition (maybe more Mediterranean-style meals), and sleep (yea, that’s a problem with sleep apnea – addressed with mandibular device as CPAP isn’t tolerated); Restless Leg Syndrome (RLS), and Periodic Limb Movement Disorder (PLMD). Return to the sleep docs at the VA in July to determine treatment options. Tried numerous Rx previously and none had any effect on RLS or PLMD. We’ll see.

After reading Attia’s book and the genetic testing results, the Missus put her internet sleuthing skills to work and found a local medical practice, Everest Health, that aligns closely with his Medicine 3.0 philosophy of individualized, science-based, pro-active approach and follows the Methuselah Protocol (holistic approach, evidence-based, personalized, advanced diagnostics, and continuous monitoring).  Firm believer in living a healthy, active life for as long as possible. Had the initial consult and signed up for the Base Camp membership with the first testing session scheduled for the middle of next month. It’s not food or cycling related but important to me so will be providing updates in the blog going forward.

Cycling for the first 9 days of May was split nearly 50/50 between Zwift (lots of rain) and outdoor rides. Did manage an outdoor metric ride, although Strava didn’t acknowledge the accomplishment. Realized training plan was woefully short on SST, threshold, and VO2max workouts. Will readjust in July after concluding international and national travel – all for vacation, personal enjoyment – in preparation for solo New England rando adventure and Mississippi River tour in mid-summer and early fall.

The Missus and I went on our first European river cruise, Viking’s Romantic Danube. An eight-day eastward trip from Regensburg, GE to Budapest, HU with stops in Passau, Krems, Telln, and Vienna. We expected to be the youngest passengers onboard the longship and accompanied by an octogenarian walker brigade and a slew of blue-haired ladies. We were pleasantly surprised. We were not the youngest and there were many other guests within a decade of us. Arrived early to spend a day in Munich before catching the train to Regensburg.  Didn’t see much of Passau and Krems as we took advantage of shore excursions to Salzburg and Gottweig Abbey, respectively. The accommodations, veranda suite with private balcony, were pretty nice. The staff was excellent. We didn’t sign up for the Silver Spirits package but our in-room fridge was stocked (and restocked daily) with beer, wine, champagne, soda, and water). No need to pay extra. Meals were varied to include regional specialties, but the taste was bland and portion sizes on the smaller side. To be expected with a primarily older crowd but extra portions were also served if requested. No bad meals but the one evening of regional mini desserts was not very good at all. Ate lunch off the boat a couple of times to have authentic, local cuisine. Bad for me but morning pastries were readily available until replace by cookies for the rest of the day. Shore excursions were available for nearly every day of the trip; both included and additional charges. The included were generally short walking tours with volunteer guides the provided local history and landmarks. All of the guides were excellent but the range was rather limited – the longest being just over a mile. A wide range of extra excursions but were rather expensive. We scheduled a Viator tour of Schonbrunn Palace and Gardens at a savings of several hundred dollars. Granted, the tour didn’t include a motor coach ride to the palace but the previous day’s included excursion taught the basics of navigating the local metro station and we had no problems arriving on time for the tour. The scenery was amazing, especially the day cruise through the Wachau Valley in Austria and our arrival in Budapest. Interestingly, the Danube divides the hilly Buda district from the flat Pest (pronounced Pesht) district. Vienna was a bit disappointing. The Old Town district didn’t have the same feel as other, centuries old cities. Has more of a modern metropolitan feel. Enjoyed unpacking once and seeing multiple countries and cities without living out of a suitcase. Are there cheaper ways to vacation and visiting multiple places? Naturally, but then it’s more of living out of a suitcase with multiple day trips via train or motorcoach. Loved the pace on the ship. The Missus loved being able to run along the Danube at each of our destinations. Would prefer to have more flexibility to exercise in the morning, without rising at the crack of dawn, eat breakfast, then partake in an onshore excursion. Maybe if we had or own river boat or barge, captain, cook, crew, etc. we could establish our own schedule and agenda. The biggest surprise of the trip was meeting and establishing friendship with two other couples from the US (CA and NY). We spent most meals together and had great conversations. Have even stayed in contact since the cruise and shared photos. Providing pictures of some of the scenery and all of the food without labels or descriptions.

After the cruise, finally had time to make a couple of new bakery items: English muffins and kolaches (a traditional Czech pastry that’s popular in Texas of all places. The English muffins looked legit but definitely need improvement on rolling dough to an even thickness. Taste was decent, a little denser than preferred. They certainly don’t have the same shelf life as Thomas’ English muffins. The kolaches were quite tasty. Made them with two separate fillings: strawberry jam from Bordeaux and creamy sweet cheese. Tasted better fresh after baking but eating 10 of them at one sitting isn’t recommended. Recommend warming in the microwave for 25 seconds to restore most of the original flavor and texture.

Returned to cycling after 8 days of river cruising and walking 35+ miles. Not complaining but legs certainly did after accumulating over 550 miles (220 over 3-day Memorial Day Weekend) over the final 2 weeks of May.

 Next river cruise on our schedule is with Backroads on their Douro River Valley cruise with AmaWaterways in September 2026. Will see if the amount of cycling offered scratches my itch and how Ama compares to Viking.

April 2025

Covering the rest of March following an awesome time in the Arizona Sonora Desert courtesy of Bicycle Adventures and April in this update. Only home for a few days before spending time at the Southern Training Camp in FL. As we put the house on the market, far different than the real estate market in Northern Virginia, unsure of return trips. Weather couldn’t have been better – mild temperatures and minimal wind. Rode each of the 11 days there covering over 638 miles with 7,750’ of elevation in just under 33 hours. Time well spent. Will most certainly miss the location when the house sells but it’s time to exit the FL market.

Culinarily lazy while there and didn’t make anything new or exciting. Did sample Korean BBQ from one of the local food vendors that serve the neighborhood and visited our favorite establishment, Keel and Curley Winery, for gator bites and a burger. Also stopped at Parksdale Farm Market for a half flat of strawberries, strawberry cookies, bread, and milkshake. Yes, there will be strawberry baked goodness in the near future.

Returned to NoVA for a few days. Long enough to make strawberry banana and strawberry oatmeal muffins while the Missus made a pie. Unfortunately, began a long spell of indoor riding, with two exceptions, that lasted for most of April. Headed back to OH for two weeks to be with the parentals and continue getting their house ready to sell. Managed to complete my first randonneuring event 9 months, Triple Shot Permanent 100K which added DC to the American Explorer list. The indoor setup in OH was a recently purchased Zwift Ride (which includes a Wahoo Kickr Core and Zwift Controllers), fan, and mat. Zwiftie was easy to assemble, setup, and configure. Lots of adjustments are available in seat height and handlebar position and controllers are much more convenient than tapping keys on the computer or Companion App. Drawbacks include lack of dual sided power meter and only 170 mm crank arms. Although as of 16 April, an aftermarket adjustable crank is available that provides a range of 160 – 175 cm. It’s. also nice not worrying about the long-term effects of sweat dripping onto the frame, handlebars, hoods, cables, etc. Price isn’t bad either!

Continued being lazy in the kitchen although did prepare an Easter meal for the parents of pork tenderloin, roasted potatoes and brussel sprouts. They enjoyed it as the quality of institutional prepared meals tends to be less than ideal.

Separately, started reading “Outlive” by Peter Attia, MD which focuses on living longer but more importantly, living healthier for longer. Most of the ailments that develop later in life are the result of poor choices and behavior and are too a large extent, preventable! Couple of key takeaways – VO2max and muscular strength are highly correlated with living healthier, longer. Goal is a centenarian decathlete! Highly recommend it and take control of your health and life. Never too late to start. 

Long time no updates. Been a very hectic 9 months. Had many awesome experiences and adventures along with a host of unfortunate and discouraging events. Won’t attempt to cover everything but will give the Reader’s Digest or USA Today version. Spent an awesome nearly 3 weeks in France: 8 days with family in Bordeaux and Paris then 12 days with Trek Travel (Classic Climbs of the Tour) and a separate excursion to watch Stage 9 in Troyes. Great food, wine, and cycling. Returned stateside and then completed RAGBRAI (Register’s Annual Great Bicycle Ride Across Iowa). There was little cycling challenge to completing the event but it’s an 8-day party on a bike. Not my cup of tea but shared the experience with a half dozen other local cyclists and mostly had a great time. Recommend giving it a try but I won’t be repeating the fun. In the fall went south of the border to Mexico City and long weekend in Cabo San Lucas. Great food but no cycling opportunities.

On the not so good side, dealing with declining health if parental: one with Alzheimer’s and the other with Parkinsons. Had to transition both of them to an assisted living facility as their days of independent living quickly came to an end.

Still experiencing corneal irritation and now regularly seeing three different ophthalmologists. Underwent a bright light exposure, gave blood to create PRP drops, and incorporated an off label application of a blood pressure prescription converted to eye drop form. Slight improvement after nearly 3 months but not enough and will soon pursue more direct (i.e., invasive) procedures to treat the underlying causes (e.g., corneal scarring, conjunctival granuloma, and band keratopathy).

Have placed randonneuring on hold for a bit as time to train for 300-400K events aren’t in the calendar and the Missus isn’t such a fan. Alternatively, registered for Bicycle Adventures Arizona Sonora Bike Tour in March and Cycle of Life’s Mississippi River ride in the fall.

Will effort to be more consistent with updates. It’s a good thing this blog is a cathartic endeavor as there’s certainly been no clamoring from the vast reading audience for the latest cycling and culinary adventures.

Getting acquainted with the progressive lenses but small fonts are still a struggle. The magnification isn’t the same as the readers but now I can wear them all the time. Still not satisfied with the contact lens solution to reduce the eye irritation. It works but it’s a substitution for a different kind of bother. Not the end-state desired but trying to maintain a positive perspective – I do have vision in both eyes. Will say it dampens the enjoyment of cycling (along with vehicular trepidation). Vision isn’t as crisp in the left eye, often a watery sensation, and distorts the visual field. Temporarily closing the left eye improves the view but creates other deficiencies (e.g., depth perception, peripheral vision, and loss of visual field). A struggle to adapt to the new normal of eye issues for all waking hours.

Cycling strength and endurance are gradually returning. Most rides were outdoors but a few Zwift days due to rain or schedule constraints. Actually exceeded 1230 miles in Oct with a few metric century (Culpeper and Great Pumpkin Ride) distances (JD’s Tour de Loudoun), a big Skyline climbing day to Pinnacles (73 miles and 7300’ of elevation), and some tempo and threshold interval sessions. Returned to OH for four days of cold riding (temps in the 30s for every start). Reinforced the decision to abort outdoor rides when temps are below 40º except for pre-registered, organized events. Haven’t managed a full century which by default rules out any typical randonneuring distance (200K – 400K). RUSA released the 2024 ride calendar so starting to review and pencil in events and southern training camp windows leading up to the Classic Climbs of the Tour with Trek Travel in June. Thoughts, images, concerns, etc. of negative vehicle encounters permeate every ride. Much more nervous approaching intersections with vehicles present and often still cringe when being overtaken. Somewhat of a fun-sucker but have managed to greatly reduce the degree of physical drifting or swerving in response to “too close for comfort” drive-by.

A good mix of reruns and new baking/cooking items from the kitchen. Made gluten-free chocolate with chocolate chunks and chocolate and peanut butter chips muffins for a dear friend who lost her father after a lengthy illness. Made regular versions of the same along with pumpkin with cream cheese and pecan streusel. Had an Octoberfest meal with our daughter and son-in-law that included roasted half chicken, German potato dumplings, sauerkraut and brats, pretzel, and apple strudel (from scratch and phyllo dough). The chicken and pretzel were awesome. Wouldn’t make any changes to the former; only more dough and water with the latter. Recipe left the dough too dry to roll properly and then not enough to roll the dough to a long enough ‘noodle’ to create a properly sized pretzel. The sauerkraut was rather bland but added a variety of spices (ginger, dill, lemon peel, caraway seed, celery seed, fennel, and garlic) and other ingredients (carrots, onions, and apple) in a reprisal with the parentals that had an excellent flavor. The brats should’ve been grilled and the dumplings were meh. They never really firmed up. Maybe put them in an air fryer – defeats intent of a dumpling but they need something. Both strudels were good – the filling needed more brown sugar. All in all – a successful new, special dinner! Other meals included tuna and noodle casserole (no cream of mushroom soup) and pizza night. Fresh made pizza dough and ingredients are always better than store bough pizza. Primary disadvantage is lack of convenience. Even incorporated cheese sticks for the crust and breadsticks! Concluded the baking with a batch of biscuits for the wife while I returned to the parentals abode for a quick trip. Used the wrong recipe and the biscuits were too wet and didn’t rise or brown properly. Definitely owe the Missus a biscuit do-over.

Reminded of the importance of perspective. Lately, been rather absorbed and more than a little dejected about the constant eye irritation and notion that it is the new norm. Often it takes an external reminder to help see the forest for the trees. A. slight prelude before addressing the big picture view. The eye irritation calmed considerably when the calendar flipped to September. Coincidence? Likely. Enough time had elapsed for the flare-up to burn itself out and return to the more tolerable low-level scratchiness. Still far from comfortable and becoming more convinced the left eye will always feel different than the right. During the first full calendar week of the month, visited an eye professional on four consecutive days; the first and the last being the optometrist. Returned to the optometrist for the first time since the initial diagnosis of the detached retina. Optically the eye has recovered and is correctable to 20-40. Not quite the same level as the 20-20 in the right but a far cry from 95% loss of vision and 20-200 experience over the past 7 months. Going to try progressive lenses with 3 different zones for far, intermediate, and near vision. If helpful, will look into cycling sunglasses with similar prescription inserts to assist with reading all data fields and delineating colors, especially in low light or nighttime conditions, on the Garmin GPS. She also commented on the calcium deposit on the inner portion of the cornea. There might be a treatment for that but will discuss with the ophthalmologist later.

Next visit with the retinal specialist who performed the corrective procedure (vitrectomy, retinopexy, and scleral buckle). Always positive and upbeat, he seemed to bounce into the office with arm outstretched for a fist-bump (the standard greeting). He started the conversation with “hand waving” and followed up saying that’s written in your chart for the first time you visited the office. That’s true, could only discern movement at the top of the visual field. Couldn’t determine what was moving, only that something was. He mentioned vision was 20-30 – quite the recovery from the starting point. He mentioned most patients don’t experience that kind of visual improvement. Had a brief discussion on the calcium deposit. He’s not a fan of the procedure to scrape the mass off the cornea as it’s already thin in some places and why risk it? Offered an alternative of wearing a nonprescription contact lens to act as a protective layer and prevent the eyelid from rubbing across it during every blink. Had recent experience with that when using the embryonic membrane but this time the lens would be much thinner. Not a resolution to the underlying condition but a reasonable approach to minimizing the irritability. Better able to see the forest afterwards. Easy to get wrapped up in the constant problems and taking good health for granted until something is taken away. Wearing progressive lens glasses fulltime instead of just readers and wearing a nonprescription contact lens isn’t too terrible of a burden for having 20-40 or 20-30 vision out of an eye that was essentially blind 7 months ago. He did mention the beginning of a cataract in the right eye but said it would be years before surgery would be necessary. Given the all clear and next follow up is 6-months down the road.

Third visit was to the corneal specialist. Cornea is healthy and recovered from the cataract surgery. Not much of response when expressed disappointment regarding the deficit in the far vision and the need for more than just readers. Oh well. Silly me to expect an acknowledgement that a procedure didn’t produce the results discussed previously. She concurred with the retinal specialist regarding scraping the calcium deposit off the cornea. Although she would perform it if requested. She was supportive of the nonprescription contact lens for the irritation. The only other option is work on tolerating a chronically irritated eyeball from blinking. But hey, don’t want to get lost in the forest again and only see individual trees. Failed to inquire about the plan for the two different eye drops: extend prescription or stop once the supply is exhausted. A little nervous about that as the drops seem to have helped but perhaps with the contact, the eye will retain tears better and reduce the dry eye symptoms. Still have hypoesthesia but not as encompassing as before. Full recovery from neurotrophic keratoconjunctivitus is mixed but symptoms have improved and didn’t have to pursue the latest FDA-approved and very expensive eye drops. Unless conditions worsen, no future follow up appointments required.

Final eye professional visit was a return to the optometrist to pursue the contact lens. Took a bit for the staff to understand the intent but finally able to see the doc without all of the other preliminary stuff as the last visit was only 4 days ago. Optometrist agreed to the daily soft lens but interestingly, there isn’t a no prescription option. The 30-day variety does but she indicated the lowest prescription available on the daily variant probably wouldn’t be noticed. Tried the trial lens and the relief was immediate. Would still require accommodation for the lens as over two decades have passed since contacts were last used. Really the only drawback is having to remove the lens to apply the eye drops and waiting 10 minutes before re-inserting. A minor nuisance in the greater scheme as it appears to eliminate the irritation caused by constantly blinking over the calcium deposit. Departed with a couple boxes of trial lenses until mine arrive.

Moved up the return to outdoor riding schedule a few weeks as headed back to accompany the parentals to some medical appointments. No desire to pack up the Kickr and trainer bike so early on Synful is ok. Probably a better place for re-introduction to the great outdoors – minimal elevation changes and less vehicular traffic. Rode once in the neighborhood to ensure bike riding skills hadn’t completely atrophied. Great to return to real riding and exposure to the elements, real terrain changes and unfortunately other large moving vehicles and traffic signs/lights. Synful is now fully restored to pre-crash conditions with bar end shifters. Deficiency with Shimano shifters is they only change the rear cassette – no chainring movement. Still a significant improvement compared to no shifting while in aero position. Love it! Rode every day from parentals’ house, mostly mid-30 miles in distance with generally a different route every day. Had a minor incident with wet railroad tracks crossing the roadway at a sharp angle. Thought positioned properly to successfully navigate the tracks but nope.  Quick impact with the pavement. Bike was unscathed but picked up new road rash on the right side (thank goodness for that); elbow, hip, and knee along with two glove holes on the back of the hand and thinned jersey material at the back of the shoulder. Waited until back home before informing the Missus. Re-connected with the North Coast Inland Trail (NCIT) in Monroeville and headed east for several miles. Unlike the more western section, trail was unpaved, Even managed to squeeze in a metric century, Maumee Valley Association’s Irish Hills. Nice route: minimal vehicular traffic, decent roads, but did expect more rollers. Rode solo and kept it easy the entire ride. Folks riding the metric and full century were entitled to a lunch as part of the entry fee. Expectation was to have it at the conclusion of the ride. Wrong – it was at the turn-around stop. Made a deli sandwich of ham and cheese at 0915!

Stopped at a nearby seafood market to pick up some king salmon fillets. Had a discussion earlier in the week with parents about the difference between Atlantic and King which they had never had. Enjoyed some new flavors from the best ice cream shop, ever, Toft’s: banana peanut butter chunk and pumpkin cheesecake. Also made a peanut butter skillet cookie which turned out better than the first one. Actually ate breakfast at a previously unknown restaurant – Wake Up and Waffle. Pretty good stuff. Gathered some fresh fruit (Gala apples and Concord Pears) and nuts (Black Walnuts) from the parent’s property. Wouldn’t quite call it an orchard as two apple and one pear tree don’t quite satisfy the definition. Regardless, they never do anything with the fruit and gives me an excuse to bake!

Returned back home and continued to build endurance, outside! Never gets old, Vehicular traffic still causes anxiety and imagine it will for quite a while, if not forever. Retrieved the contacts and the new progressive lenses. Contact makes a difference as it significantly reduces the irritation. The new glasses on the other hand are another battle with frustration. Readers are much simpler, easier, and magnify print better than progressive lenses without the necessity of changing either head or position. Conversely, readers are a liability for anything other than near vision. Completely useless, actually worse and potentially dangerous for watching TV and driving. Like the eyeball and vision don’t have enough to deal with now progressive lens accommodation is added to the list!

Made a couple of new meals and put the fresh fruit to good use (muffins and a crisp). Half of the walnuts are drying – still have the other half to husk. Not an easy or clean task. Good thing the harvest article mentioned gloves, otherwise the entire hand would’ve been stained a dark brown. Even with gloves, the thumb still ended up discolored. First time making a dump cake (cherry) with layers of crescent rolls, cream cheese and sugar, brown sugar, cherry filling, yellow cake mix and topped with cinnamon. Made apple cinnamon (forgot to include the raisins), pear and walnut muffins, and apple-pear crisp with the fresh fruit brought back from OH. New dinners included a Greek classic, Moussaka and Patates Lemonates and a Louisiana version of shepherd’s pie, Shreveport Pie made with turkey and bayou-style spices. Any meal topped with mashed potatoes is a winner according to the Missus. The Moussaka was very good but kind of destroyed the kitchen and the Missus was none to pleased. The recipe used consisted of three layers: fried eggplant and yellow potatoes, meat sauce. (lamb), and topped with a bechamel sauce. Apparently there’s somewhat of a debate amongst Greek chefs regarding the inclusion of potatoes. Frying the eggplant and potatoes splattered hot oil everywhere. Still have flash burns on the back of my hand as a memento. Everything cleaned up just fine and the meal was quite good.

Both medical conditions continue to heal and recover at their own pace; one better than the other even though it’s newer. Range of motion at the shoulder is significantly improved to normal ROM for active flexion and abduction with extension making significant progress. Return visit to ortho retained enough concern to warrant an MRI. Results came back a mixed bag. No urgent need for surgery but more than a little concerned with the long term prognosis for regaining muscle tone and heaven forbid, gaining muscle mass and strength. Summary below:

Oblique mildly displaced fracture of acromion (previously reported as nondisplaced)

Comminuted, nondisplaced fracture of humeral head neck junction (new diagnosis); most significantly anterior

Moderate biceps tenosynovitis. No evidence of biceps tendon tear

Probable nondisplaced superior labral tear with associated inflammatory changes

Irregularity of posterior labrum

Shoulder joint effusion with evidence of synovitis

Evidence of muscular strain involving superior deltoid and infraspinatus muscles; no evidence of tears

Bone marrow edema at acromion and humeral head/neck junction

Moderate subacromial/subdeltoid bursitis

Bursal sided fraying of supraspinatus tendon with underlying tendinosis. No full thickness rotator cuff tear

Will resume physical therapy and share the MRI results to see if that changes the plan. On the positive side, can begin to slowly increase duration and intensity on the trainer with plan to return to outdoor riding in October. Still taking it easy to recover from near crippling effects of the last walk/slog session. Guess there were too many 2 ½ minutes slogs and body didn’t like it at all. High glute strain, almost like a muscle spasm. Just won’t release and not very comfortable. Surprisingly, the only time the symptoms mostly disappear is when spinning. Will have to accept running is not going to make a return to my activity log; no matter how badly desired. On the positive side, will proceed with planning to register for Trek Travel’s Classic Climbs of the Tour for summer 2024.

Return to PT was historically disappointing. Have regained full range of motion (yea, me!) but severely reduced muscle strength. Completed some flexion and abduction exercises with a weighted bar (very minimal – i.e., 5 lbs) along with extension and internal/external (rotator cuff) rotation exercises on a weighted pulley system. Now for the incredulous moment – don’t do push-ups or any pushing motion (bench or shoulder press, dips, etc.) with heavy weights, EVER! Therapist actually made a comment about not understanding military folks (and retirees) and the desire to do push-ups. Granted, not sure I could actually do a push-up yet and still reluctant to give knee push-ups a go. Wall push-ups aren’t a problem as long as hand, arm, and shoulder positions are aligned. So, graduated from PT. Unless condition deteriorates, no reason to return. Silly me thinking PT was intended to return to pre-injury condition. Nope, just don’t do certain tasks. Good grief!

Continued self-developed therapy at home. Able to do single-arm, full extension with 2-lb dumbbell but only 1-lb for abduction which is accompanied by all kinds of crackling and popping sounds. Not very pleasant to listen to and uncomfortable at times. Need to find the various colored bands to incorporate internal and external rotation movements. In a moment of bravery, or stupidity, did attempt knee push-ups. First two reps were fine but not the third – extreme burning, shooting pain originating in the should extending through medial deltoid. Wall push-ups present almost no discomfort. Attempted countertop push-ups a few days later. Those are a no-go too. Will message the ortho and relay the civilian, outsourced therapist’s comments reference foregoing all pushing movements. That’s not a return to pre-crash functionality.

Really thought the autologous drops were going to be the answer to the constant eye irritation. Most of the discomfort disappeared within days of starting the drops. Giving all credit to the serum drops, stopped administering the cyclosporine. Eye irritation returned in 3-4 days so naturally returned them to the daily routine. Started feeling better until visit with the corneal specialist. Described the disappointment of cataract surgery results; left eye acuity insufficient to read all print without reading glasses but far vision isn’t nearly as good a right eye. In effect, the cataract surgery will now require a corrective lens along with reading glasses. Doc seemed nonplussed with acuity results. As always, the Q-tip swab across the cornea caused increased irritation but instead of dissipating within 2-3 days, the irritation worsened. Progressed to an extent that warranted an interim appointment since the regular appointment was still a couple of weeks away. Irritation was reminiscent of dellen and concerned another developed or old one returned. No dellen – just extreme dry eye syndrome. Doc commented that she hadn’t seen it that dry and irritated in a long time. Inquired about drops and mentioned still using both along with erythromycin ointment at night. On the positive side, the lasik flap has resolved itself and the hypoesthesia continues to improve. In fact, the calcium deposit on the cornea might be a source of irritation now the corneal sensation has improved. Will follow-up and discuss having it scraped off in the near future. So incredibly tired of dealing with a broken eye for over half a year. Even after the cataract surgery, the left eye isn’t the same as before the detached retina. Not all doom and gloom as vision has been restored but the eye irritation is endless. Sleeping is about the only time there isn’t a constant reminder. Can barely sit at our new kitchen island during the day as the glare from the sunshine almost necessitates indoor shades. So don’t want this to be the new normal.

Cycling activities remained confined to indoors on Zwift. Able to gradually lengthen rides to 75-80 minutes and mid Z2 effort levels. Managed 5-min tempo intervals and 1-min anaerobic interval sessions along with the predominantly steady state rides. Ortho gave the green light to outdoor riding when comfortable with the caution that another crash when not completely healed could have disastrous consequences. Frustrating to lose cycling for most of the year due to eye trauma and subsequent complications and crashes. This is the least amount of time spent outdoors, ever. And not just for cycling, although that’s been a major kick in the pants. Challenging to enjoy activities, whether inside or outside with a constant reminder the eye isn’t normal and physically limited by impaired shoulder movement and greatly diminished strength. Trying to maintain a positive outlook and doing whatever possible to continue the recovery train but sometimes the load gets pretty heavy. Looking forward to actually riding without the need for an avatar and curious about the response to vehicular traffic. Will find out soon enough. Initial plan was to return to the great outdoors in October and registering for the Great Pumpkin Ride at the end of the month. My octogenarian father has a couple of medical appointments the second week of September that require transportation. Will head back to play chauffeur, cook, helper, etc. and accelerate outdoor riding. Not taking trainer and associated bike. It’ll be a better environment for a return to outside as terrain is flat and significantly less vehicular traffic. Did register and paid down payment for Trek’s Classic Climbs of the Tour.

Updates on the road bikes: all parts are now in to restore Synful to pre-crash condition and install bar-end shifters on the clip-on aero bars. Cannondale finally came through with a replacement frame for the warranty claim. After an initial tease of offering a current year Hi-Mod frame (yellow and black), they found a 2022 dark teal SuperSix Evo Hi-Mod frame. Actually saw the frame the same day Synful was dropped off. Will see which bike is completed, hopefully both, in time for the good son trip.

New in the culinary ledger were stuffed peppers, rotisserie duck, BBQ chicken twice baked potatoes, one pot chicken shawarma, and a Fridge Queen Cake (forget to snap a photo). Boy child made a short, return visit and treated us to stuffed pork loin (spinach, onion, and Brie cheese), eggplant, zucchini, and tomato ratatouille, and turnips in remolaude sauce with chives, bourbon, and cream. The missus made a crème brulee cheesecake. Ironically, despised stuffed peppers as a child. No issues with consuming the stuffed portion but the peppers were gag worthy. Tastes definitely change with time and very much enjoy peppers, including stuffed peppers especially when the meat is ground lamb. Fair bit of searching required to obtain a whole duck. If planned ahead, nearly every local butcher could have ordered one but it made the menu Thursday night for the following Sunday night’s dinner. Good thing it was only 5 pounds as anything bigger wouldn’t have worked on the grill. Rotisserie adapter wasn’t the problem but even with removing the center grill grates, a larger bird wouldn’t have fit over the drip pan. Dry brined the duck 24 hours earlier, stuffed it with herbs, spices, scallions, and an orange and prepared an orange marmalade for basting. Cooking time wasn’t quite as long as anticipated, but it had a really good flavor. Wasn’t gamey at all. Accompanied the duck with twice baked sweet potatoes and roasted broccoli. The Missus wasn’t too keen on the shredded chicken and BBQ sauce but all of the flavors and textures blended well together. The chicken Shawarma was excellent. The chicken had a great flavor and using the same cast iron skillet to prepare the orzo infused it with additional flavoring. Initially the idea of placing the cold cucumber, tomato, and Feta salad on top seemed unnatural but again, the flavors blended well together. The Fridge Queen Cake (no photographic evidence) really wasn’t a cake. It consisted of heavy whipping cream (whipped by a mixer) with softened cream cheese, fresh blackberries, and blackberry jam in between layers of graham crackers topped with whipped cream and garnished with more fresh blackberries. Placed in the freezer overnight to set, taken out a few hours before serving then stored in the fridge afterwards. It was pretty good, especially when served with a scoop (or two) of southern blackberry cobbler ice cream. The boy child’s dish was extraordinary, as usual. Had to make a trip to the local butcher’s shop as the local grocery stores only had mini pork loins. Learned a couple of things about eggplant. Tasked to obtain Japanese eggplant, zucchini, and roma tomatoes all of similar diameter. Another search and find mission and eventually found Chinese eggplant which were an acceptable substitution. While on the hunt for duck, came across Japanese eggplant. The Chinese version are purple in color and much longer but consistent diameter than traditional eggplant while Japanese eggplant resemble a very dark purple or black zucchini. Who knew?! The Missus made two practice crème brulee cheesecakes on consecutive Sunday family dinners (no one complained) in preparation for real one with the boy child. The first one didn’t have the burned sugar topping as the kitchen torch didn’t arrive in time (to be honest, it wasn’t ordered in time). Nearly a year had passed since family dinner included both children. There wasn’t any difference between the second and third iteration – they were both excellent (as was the first one, too).

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 34^th 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.