Testing 1, 2, 3

As I said in my last post, I did a short ride today. Had a lot of misgivings about riding, fearing that I'd make it worse but also thought that so long as I didn't push it that it would be a good test and might actually aid healing.

So I went out to a local state park (LBJ State Park) near Stonewall with the Hampsten. I did a very easy 10 miles. In order to avoid putting any undue stress on the soleus I stayed seated the entire time (out of the saddle is harder on the calf muscle group and is harder to control) and used the gears pretty extensively to keep myself spinning easy.

I had a few minor twinges but then I always have a few minor twinges somewhere. Nothing serious nor remotely painful. As I write this I've got my leg elevated on an ice pack. I'm hoping that there won't be a worsening of pain or soreness as the day goes on. My plan now is to do a similarly easy but somewhat longer ride tomorrow.

Oh, and the weather was lovely so it was really nice to get out today.

An encouraging start. Now if I can just keep myself from doing too much, too soon (a recurring problem).

(Very) slowly improving

As I write this on 6 February,  since doing the 200K on January 28th and one short ride on the 31st I've not been on the bike. I've self-diagnosed the problem as a badly strained soleus. To save my non-medical friends from heading off to google, here's a definition from Encyclopedia Britannica:

Soleus muscle, a flat, broad muscle of the calf of the leg lying just beneath the gastrocnemius muscle. It arises from the upper portions of the tibia and fibula, the bones of the lower leg, and then joins with the gastrocnemius to attach via the Achilles tendon at the heel.

And here's a shot:

So it runs up the side of your leg between the heel and knee toward the outside. The protocol for a strained soleus is the standard RICE (rest, ice, compression, elevation) which is basically what I've been doing. A couple of days ago I added some short sessions with a foam roller and gentle stretching.

It feels better today. Not painful but I feel it, especially the first few steps after sitting.

My forced layoff from the bike has been made a little bit easier by the fact that it's been cold AF (overnight low in the upper 20's). Today is a bit warmer (high of 50) but I'm going to give it another day then perhaps try an easy ride on the Hampsten tomorrow.

In analyzing how this came about with an eye toward preventing a recurrence it seems fairly clear that my extended time of riding the 'bent exclusively did a pretty decent job of helping me maintain both fitness and leg strength but the position and specific muscle groups used were not exactly the same and that was the problem. It did a good enough job that I felt like I could make a hard effort when the truth was I needed some time to readjust to riding the DF.

In one part of the 200K, about 25 miles in there's a big climb on Gypsum Mine road. As I noted previously, I was really encouraged by how good my legs felt in my first rides on the Hampsten and I was feeling pretty good at that point. I hit that climb pretty hard with the goal of doing the whole climb seated (it peaks at 19%) and pushing hard the whole way. Post-injury analysis pretty strongly suggests that's when I strained the soleus. As noted previously, it started to feel sore further on in my ride and multiple stops to stretch didn't help.

I'm a bit worried about doing even a short ride but am hopeful that an easy spin will aid healing rather than cause a regression. We'll see.

In looking back through my last dozen or posts you'd get the impression that I'm a delicate lotus blossom that the slightest breath of cold will wither. In fact, for the most part the opposite is true and perhaps that's why I go on so much about any injuries I get. I've been an athlete all my life and have done a variety of sports over the years. For all that time I've been injury free the vast majority of the time. Modulo falling off the bike (which I've done twice) and nagging back ailments (mostly brought on by me doing something non-bike related and stupid) I've been remarkably injury free.

Hoping to get back to that soon.

Still hobbling about

After three days rest that included ice/heat, NSAID's, ace wrap, elevation, etc., and some gentle stretching on the third day I thought I'd try a short, easy ride.

Big mistake.

I went out first on the Hampsten. My Achilles and the muscles on my lower calf felt sore from the start but I thought they might loosen up a bit once I got going. Went two miles and that wasn't happening, in fact they started to feel worse so I turned around.

Decided since I was well acclimated to the 'bent that I'd head out on it. Rode at a super relaxed pace (12 MPH average speed), used easy gears, spun up what little climbing I did. Rode 15 miles total. The leg felt fine while riding, not a twinge.

That night, I woke up at around 1 AM and went to the bathroom. Calf/Achilles felt pretty tight. Went back to bed. Woke up at 3 AM and it really hurt. Like "OMFG, I can't stand this" kind of hurt. I hadn't put the ace wrap on as I thought it'd be better to let it relax and breathe a bit. Got up at about 4 AM when I couldn't stand it anymore. Used the heating pad for a bit, rubbed on some CBD/Arnica (which doesn't really seem to help but can't hurt), wrapped it in the ace wrap then used the heating pad some more. Finally went back to sleep at around 5 AM.

So here we are two days later. Hurts to walk. Not bad but painful. No riding today (and it's supposed to get up to 78 today). I'm beginning to get vaguely concerned about the upcoming 1200K next month. The forecast is for pretty nice weather until Wednesday (it's Sunday as I write this) when it turns cold with a high of 46 and the "s" word in the forecast overnight when it gets down to 29. Sigh.

Oh, and I started dieting when I got here to Texas to take off the accumulated holiday pounds. Had lost 12 pounds and was pretty close to my goal. That's gone to hell.

Crap.

Crossover question partially answered

One of the things I've been wondering about for a while is the degree of "crossover" between riding a conventional (DF) bike and a recumbent. I've done a lot of web searching and have found a few reports of people that ride both but it seems like for most people once they start riding a 'bent they don't ride a DF anymore or at least don't do it very often or for longer distances.

Since we're limited in how much crap we can transport to our winter sojourn in Texas (or at least choose to limit it) I "only" brought two bikes in addition to Marcia's recumbent: the Cruzbike and the Hampsten less the front triangle. I'd wanted to get a third bottle cage installed on the S&S coupled Hampsten for quite some time and this seemed like a good opportunity so I sent the front triangle off to the day spa just prior to leaving Wisconsin to get it done and brought the rest of the bike here.

I got the bike back last week and immediately had an issue I had to deal with. I sent it off with everything removed but the headset since I didn't think they'd need to remove the headset in order to weld in new bottle cage mounts. Turns out they did remove them (whether they needed to or not) and then sent the completed bike back without the headset.

Sigh.

This resulted in frantic calls all over San Antonio looking for a headset. It's interesting how "old tech" a threadless 1 1/8" headset is these days but by a miracle I found a Chris King at a bike shop. They didn't even know they had it, the guy was poking round under their workbench after telling me they didn't have one, opened up a big box of bottom brackets and lo and behold: a headset. It was even the right color! What are the odds? So 175 mile drive and $178 and I had a new headset.

I did two shorter (44 and 32 mile) rides on the Hampsten and was really pleased with how I felt on it. I felt as though I had good power and really hadn't lost anything by riding the Cruzbike exclusively for a month. In fact, the only difference I noticed is one you might expect: extended out of the saddle efforts (say 50+ pedal strokes) resulted in my legs feeling tired. Given you don't do that at all on a 'bent it makes sense that there'd be some loss of strength there.

So on the basis of that I decided to do a longer ride: a nice 200K route out to Harper that I've done a number of times (it's a RUSA permanent route I own). It's got just over 6K feet of climbing but the climbing is "front loaded" with the bulk of it (about 4K feet) being in the first 70 miles.

I generally felt OK during the ride, but toward the last third my left calf/achilles started to feel really tight and sore. I stopped to stretch it several times but that didn't seem to help a whole lot. After finishing the ride my legs really hurt, especially below the knee.

Overnight and next day things got considerably worse. My left calf and achilles are incredibly painful, to the point that I can't walk even with a considerable limp. I'm doing the RICE protocol and as I write this 2 days later it's somewhat better but still pretty painful.

My theory is the position ("angle of attack") relative to the cranks is different enough on the 'bent that even though I got a decent cardio workout and maintained general leg strength through riding it, it did not fully translate to riding the DF. The difference, however minor, repeated for fifty thousand pedal strokes or so was too much.

While a bit disappointing, this isn't really surprising. I was hoping that in an ideal world (or at least my ideal world) that once acclimated to riding the 'bent I could switch back and forth seamlessly between the two e.g., say I've got a 1200K in 6 weeks where I'd like to ride the 'bent. Start riding it exclusively 2-3 weeks beforehand and then go (or vice-versa with the DF). That might be possible but this experience suggests the differences are substantial enough that it also might not be.

More experience required.

Medical follow up

As I posted earlier, I had an initial visit with a physician here in Texas specializing in treatment of the hands. The initial consult was positive and on his recommendation I had two tests done: an Electromyography (EMG) test and a bone scan. The EMG test involves placing electrodes (pads, needles or both) at various points and testing nerve conduction pathways. The bone scan injects a dye and you go back four hours later for a low intensity, long duration scan. During that interval the dye accumulates in "problem" areas.

I had the follow up visit this week. It did not go well. In fact, it typified everything I loathe about the medical industry (note that I didn't say "profession").

The Eminent Physician (EP) arrived 35 minutes late. The upside is the Pile of Meat (PoM - me) got to read an article in a back issue of Smithsonian about the Apollo 11 flight and moon landing in its entirety while I waited.

After a perfunctory greeting (but no explanation or apology for the wait) the EP asked if I'd had any relief from the steroid injection in my thumb. I said no, and said "I forgot to ask last time, what is going on with my thumb?" The question clearly annoyed the EP who said I had arthritis. I commented that the onset was very sudden (like "instant") and I could feel something moving under the skin at the point of pain and my understanding was arthritis generally was progressive. This annoyed him further but he didn't respond and pulling up my x-ray would have been a waste of his valuable time: after all, he'd made his diagnosis and treatment and I likely wouldn't understand it anyway.

We moved on.

Without further comment to me, he began looking at the EMG results and making notes. Reading upside down, I saw that he circled several areas of the results and wrote things like "45ms" in his notes so I'm assuming at various points in the neural pathways in my arms/wrists there was a propagation delay of 45ms and that this isn't normal.

When he was done reading and making notes (as nearly as I could tell, he didn't look at the bone scan results) he said he wanted to give me a steroid injection in both wrists. When I asked why he looked offended and said I had abnormal findings in the EMG and this would help him determine whether it was my wrists or elbows. When I asked him what "abnormal" meant i.e., how bad it was he became annoyed and said it was irrelevant, that I had an abnormality and that he had proposed a treatment.

At that point, I tried to develop a "decision tree" i.e., if the injections help what does that tell you and what would the next steps be, if they don't help, what does that tell you and what would the next steps be. This clearly annoyed him further and finally he said "it doesn't matter to me whether you get the injections or not" (which was a real relief because after all, it's all about him).

It was glaringly apparent that my role as PoM was to be tested,report symptoms and accept treatment without question and, of course, pay the bill. Anything else was a waste of the EP's valuable time.

So what kind of ridiculous questions was I asking? Here's a sample:

• You asked if someone had driven me in because the injections would leave my hands numb. How long will this persist?
• So the EMG results are abnormal, can you give me an idea of how bad they are?
• Assuming the injections help, does this mean I'll be on a regular program of injections for the rest of my life?
• Assuming the injections help and nothing else changes i.e., I still do long distance cycling, how likely is this to reoccur?

On and on, blah, blah, blah. One inane question after another. No wonder he viewed it as a waste of his valuable time.

In the end, I decided to have the injections in the hope that they provide some relief to my hands but I won't be going back. I was strongly tempted to just get up and walk out but restrained myself since I'd already invested that much time with the EP.

I'd like to say this was an exception, that I caught an EP on a bad day (which really should be irrelevant to me as a patient but hey, we're all human), etc., but frankly this is exactly coincident with my 66 years of experience with the medical industry (there's that word again). In general, minds are made up - often before they even see you, whatever you have to say is for the most part irrelevant and their on the spot diagnosis is sacrosanct. Being by nature an optimist, I was hoping for a different outcome.

This whole episode is why it's entirely likely that if I ever develop a progressive disease e.g., cancer, I'll wait until it's essentially untreatable before consulting an EP despite the fact that unlike 33 million people in the country (and climbing) I have pretty good health insurance.

Oh, and my hands hurt.

All in on the 'bent

We've been here in Texas for almost three weeks now and I've been riding the Cruzbike exclusively since our arrival. Although I've not minded it, it wasn't by choice. We try to limit the amount of stuff we bring down here, although truth be told it looks like we're moving, so I only brought one road bike plus the recumbent. The bike I brought was the Hampsten, or at least half of it.

I've been wanting to have a third bottle cage installed on the Hampsten for quite a while. There have been several rides I've done where there were long stretches without water and in the past I've either used a CamelBak or bought a bottle of water that I stuck in my saddlebag. Neither was a very good solution - the CamelBak makes my shoulders/neck hurt and buying single use plastic bottles is wasteful. So at any rate, I decided to get the additional cage installed on the downtube so I sent it off a week before Christmas. Since it's a S&S coupled bike, I only needed to send the front part of the bike and I brought the remainder with us.

So the only bike I've had here is the recumbent and that's what I've been riding. I've got about 600 miles on it now and am pretty comfortable riding it. I've been tweaking the fit and setup and still don't quite have it right. I rode it today and felt like I was reaching for the bars a bit too much causing tension in my shoulders so I moved them back a bit. Also, the headrest just isn't comfortable. I've tried a number of different pads inside it and have moved it up/down trying to find the right spot. I'm doing my Fredericksburg 100K loop route tomorrow and we'll see how it goes.

Other than that, I'm enjoying riding it. I've changed a bunch of stuff on it since I bought it including changing from the 1X drivetrain to a compact double which necessitated changing the handlebars and brake levers. The longest ride I've done to this point is 51 miles and the steepest climb I've done is 14% so I feel as though I can ride it just about everywhere here. Having said that, I'm not fully acclimated to it. My "bent legs" are getting stronger but it's still the case that after 30 miles or so they're feeling pretty tired which obviously isn't the case with the DF.

I'm doing a 1200K in March so I'll start riding the Hampsten mostly when it comes back, which should happen in a couple of days. I'm curious to see how my legs feel riding a DF after riding the recumbent exclusively for almost a month.

We'll see.

Deep in the heart of Texas

We're in Texas for our annual "escape from that godforsaken frozen wasteland".

In the time leading up to our departure we typically watch the weather fairly closely to see if there's something inbound that will affect us on the drive. We planned on leaving on 27 December and taking our usual 3 days to drive down but it looked like there was a good chance of freezing rain/snow on the 27th so we decided to leave half day earlier and make a 4 day trip of it.

Our first overnight was in Ankeny, about 4.5 hours driving. Our second stop was our usual first overnight in Emporia, KS, third stop was in Stephenville, TX then the rest of the way the next day. We have our "usuals" on the way down - Radius brewing in Emporia and the Hard Eight BBq in Stephenville.

It worked out that our 46th wedding anniversary was in Stephenville so our "romantic" anniversary dinner was at the Hard 8. After dinner we went to the only place in town where you can get a somewhat decent beer, The Purple Goat, and had one beer each. The Purple Goat is really odd and I'll be surprised if it lasts. You have to become a "member" in order to buy a beer and in order to become a member you have to give two pieces of ID (drivers license and credit card) which they enter into their system. We went there last year as well and I'd have thought they'd have the data from then but you apparently have to give it every time. I subsequently found out this is because the county (Erath) is a dry county.

I actually preferred taking a bit more time for the trip. This allowed us to take care of all the last minute things (packing those last few items, buttoning up the house, etc) at a leisurely pace on the day we left and made for some shorter driving days. The drive from Wisconsin to Emporia was a really long day and the drive to Stephenville from there is also a long one so it was nice to make one of those days shorter. I think we'll probably do the same thing in the future.

The drive down was uneventful and we got to Fredericksburg on the 30th early enough in the day to frantically unpack enough bike stuff to go for a short ride. The weather was really nice (relatively speaking) and high temperatures have range from the mid-50's to upper 70's. I know without even looking that it's warmer than in Wisconsin.

Now I'm trying to work off the weight I accumulated over the holidays and drive down. I sure wish I took weight off as easily as I put it on.