Play it again Sam...

On again, off again, recovery is a continuous swing between good days, experiencing tremendous highs and bad days, dragging through the trough.  You expect it, you try to plan for it, but sometimes you aren't prepared, it's just life.

Roughly one more week to go.  The wound "side walls" are healing quickly, however the depth is not receding at the same pace and there is some concern.  It could be nothing, it could be something, we just don't know.  So, I'm effectively on bed rest for 3 days with minimal activity reserved for required movement, for example traveling to the bathroom.  The hope is to isolate anything that could be impacting the healing process.  The wound is directly over the top of the femur bone so there is friction caused by just about anything...other than sitting still.  The trouble is that movement is good for blood flow, which is also good for healing, so I have to balance and moderate.  


If by next Wednesday there isn't tremendous improvement, the nurse will do a culture and run some tests.  Yeah, that sucks.  It's a waiting game.  One more week.  Who knows.  Let's just focus on the fact that Wednesday could be a very good day.

Again, I'm reminded of how small and insignificant my predicament is, today Chile was hit with an earthquake 800 times as powerful as the one that hit Haiti.  Okay, enough said.

California, Find Yourself Here

Maybe there is something more to the slogan, "Find Yourself Here" than meets the eye.   

Monday the woundVAC came off, we did it for two reasons: 1) the tissue around the wound was inflamed and irritated 2) the wound looked far enough along that it could make it the rest of the way without external assistance.  Fast forward, it's yesterday, the tissue around the wound has healed, #1 - check but on #2 - double fault. We reinstalled the infamous woundVAC.  After four days of glorious freedom, it was determined that the wound wasn't healing fast enough without the woundVAC's miracle works of accelerating the healing process. 

For whatever reason, I've had more pain this past week and felt worse without it.  I am happy for the return of my machine, although it makes me more tired. The pain is reduced for some reason, for now.

So I'm finding myself.  There are ups and downs; you have to manage your own expectations and do what you can with what you've got.  Two more weeks of antibiotics and hopefully that will be the end of the woundVAC as well.


I'm searching for depth in the slogan of the state we currently reside, that's what I am focused on.

Just when you need it...

First there was a glorious Sunday.  Annie and I headed out for a road trip (for me that consists of anything further than the doctor's office or grocery store) to spend the beautiful afternoon roaming south down the coast from Solana Beach.   It was great to spend time with Annie, it's funny how you forget how good it feels to do things like sitting on a park bench watching surfers and the waves in the warm sun.


Yesterday (Monday) was another visit to the doctor.  In the last week we've not had as much progress in the healing department as before, which is to be expected.  Needless to say it's been a little rough with the lull.  HOWEVER...Sandy removed the woundVAC and dressing and felt like it might be time to REMOVE the damn thing.  The doctor concurred and I could hardly contain my excitement.  In addition, the doctor told me to get off the crutches completely unless fatigued or pained.  I left the appointment on "cloud nine".

To top it off Pat Herbst, a good friend and fellow runner from Portland, Oregon was in town for a business meeting.  I can't say enough good things about Pat and his family.  Jean, his wife, hosts us with Pat, once a year for Hood to Coast both in Portland for the start and Seaside for the finish.  This isn't a few runners sleeping in their house, it's 12 guys and in some cases more.  In short, she ROCKS!  She's the sister we all wished for and it's great to have her as part of a very special weekend. Not to mention their children are exceptional.  Mallory, Patrick and Ronan have benefited from good parental genes, but Pat and Jean are phenomenal parents and create an incredible environment for the children to flourish.  Each of the kids made homemade "get well" cards for me, two times over. One set mailed to the house in Boulder and when they found out Pat was going to see me, they made another set.  Hallmark could take some lessons from these three.


Thank you Mallory, Patrick and Ronan !  You guys are amazing!

Pat is one of those friends that is always there, just when you need him.  He's the guy in the van before an important leg of the race getting you psyched up or after a tough leg offering congratulations or solace.  But Pat goes way beyond the short weekend we spend together, running.  He flew into San Diego and made his way up the coast to Encinitas.  Even though he's a keynote speaker on multiple days of the meeting this week, he still made time to come see me.  He's just that kind of guy.  Thanks Pat!

With that I need to give a quick shout out to the entire Hood to Coast crowd, who have, as they always do rallied behind a fallen runner.  Tim Hammill hooked me up with a consult to make sure I was on the right track with the locals; multiple phone calls, posts and emails of support from all the guys have helped sustain my positivity, just when I needed it the most.

To cap the evening off, Emily, a good friend from Boulder who now lives in Santa Monica, was in the area and stopped by for a visit.  It's full circle. Emily was actually with Annie and me, six years ago when I broke my leg.  Her dad saved the day.  We're lucky, she'll be back with Scott for the weekend.

Thanks to my family and friends for all the support through this, we are past the halfway point and I feel great!  While it might be a while before I'm running again, I am comforted at the thought of just being able to live a "tube, pump, catheter free" lifestyle. 

I see the doctor again on March 8, two days before the antibiotic cycle finishes and the PICC line is pulled.  We most likely will stay in the San Diego area through mid-March to make sure everything wraps up, but who knows maybe it'll be longer.

SAW LXXXVIII - the movie

I've never liked the SAW series of movies, just a bit too gory and too much insight into a sick and twisted mind.  However, I do have some photos that probably qualify for some future installment of their movies.

Sandy, my wound nurse, changes the woundVAC dressing three days a week.  She's AWESOME!  Sandy is fun loving, easy going and makes this awful process totally bearable.  Greg and Annie have documented the healing process since she began changing the dressings on Wednesday, the day after I was released from the hospital.  By all accounts the healing process is ahead of schedule.  My live-in nutritionist and lovely wife, Annie, has ensured I am eating foods that promote healing along with a lot of rest, other than some PT exercises and the occasional outing.  

This past Monday, I had my first follow-up with the orthopedic doctor who performed the surgery to eradicate the infection in the wound.  He gave me the thumbs up on the healing process and instructions to continue to bear weight as pain allowed on my leg.  I don't see him again for another two weeks.  I think the highlight for everyone, including me, was the response I had to the increased pain medications I took prior to the woundVAC change in the doctor's office.  I've never been so loopy my whole life.  Sandy would ask,"Does that hurt?" and I would just laugh.  Needless to say, we've cut back on pain medications....but, that doesn't mean we can't have a little fun with this whole mess.  Sandy and Annie thought it appropriate to "dress" my wound up a bit this past Friday for some fun.
 

Even though we are only ending our second week, the end is in sight and I am getting accustom to the tubes that hang off me and the portable pumps I have to carry around with me, wherever I go.  I do get some strange stares occasionally while out and about, I simply say I am an experiment, I normally live underwater and the pumps keep me alive on land. Hell we're in California, anything is possible, right?  Although, I did scare a small child.  

I keep an upbeat attitude most days, but I'd be false if I said there aren't tough days too, I've had a couple this past week.  Trapped, irritated, angry...I can be my own worst enemy.  Annie keeps me focused and loves me through even the toughest of moments, I don't know what I would do without her compassion.

For those with a strong stomach and who would like to see more interesting and revealing pictures, check out this link: Staph Recovery

I started back to work on Monday.  I've got a reclining camping chair (nothing like the Big Bubba chair I had when I first broke my leg, but it will do just fine) and a lap desk for the computer.  I'm obviously limited to computer work and phone calls, client and office visits are still not feasible. I'm happy to be back, it is certainly a nice distraction, along with the view.  I'd be going nuts if we were still in Boulder for the winter.

"I know but one freedom and that is the freedom of the mind." -  Antoine de Saint-Exupery

Yes, I will run again...

The air is chilly, the early morning rays of sun are peaking over the mountain tops, filling the clouds with color. People rustle about making last minute adjustments.  There is electricity in the air and it's not an impending thunderstorm.  Race starts are exhilarating, full of opportunity and energy and of "what could be today".   I am present in my mind, body and spirit, it has all of me.  Every racer here has their story and is here for a reason, to conquer themselves and discover the outer limits of possibility, push beyond and arrive at a new place within themselves.  I am on that journey.

It's August 21, 2010, thirty weeks ago I started battling an infection and now I am standing on the starting line of the Leadville 100.  I draw inspiration from those that have battled far darker and menacing threats to overcome them and live again, I am only spectator to their trials.  I will run with heart, open my soul to the experience and complete a 10 year dream.  Ah, I love visualization.


The reality is that I am okay with any healthy outcome.  While I have dreams and goals, simply to live a healthy life with my wife, Annie is achievement enough for me.  I accepted on Sunday, the possibility of never running again, I am at peace with that outcome.  I have so much more to be grateful for and celebrate, everyday.


It's times like these that I reflect on what I've brought to this world and the people around me, it's not all about the dream of racing Leadville. I could volunteer more, help more people, be more positive, more kind.  Today, I'll simply cherish the small things - wash my hair, get cleaned up, get outside and love my wife.

"No thought, no reflection, no analysis, no cultivation, no intention; let it settle itself." - Tilopa

Life, is just life...I have everything in the world to be grateful for and my predicament pails in comparison to those in Haiti, my heart goes out to that nation.  Unfortunately, Annie and Greg took me to the ER on Sunday morning for oozing that had begun from the top of my hip incision that morning.  Ironically, the oozing eased and relieved the tremendous pressure building in and around the incision and I was again able to bear weight on my left leg while walking with crutches.  After three hours waiting, I was admitted.  


They quickly ascertained I did not have a hematoma as thought on Friday and the collection of fluid was indeed "alien juice" (aka puss) from the infection.  In fact, what was thought to be a superficial infection on Friday, was a full-blown deep-tissue infection.  I was in surgery by 4pm for an irrigation, debris removal and fluid evacuation. While there, the surgeon noticed the infection had made it to the entry/exit point of the femoral nail. He took a tissue sample and left the wound completely open and put an elastic/rubber surgical dressing over the hole.

Of course Annie was by my side, always my light and supportive partner.  My Dad and Catherine were in the area for a conference, we had originally planned on spending time with them, but certainly not in the ER or hospital.  I was grateful for their presence, compassion and support.  Greg gave up his entire Sunday to be with us, he is truly a friend.  He brought a level head, sound advice, supportive and positive energy, I was grateful for his selflessness.

I was admitted to the hospital for observation and antibiotics.  I was put on what I like to call the "Vampire" drug, Vancomician.  It kills everything, including your hearing and kidneys if not monitored properly. 

Monday brought new and painful experiences.  The nurses removed the surgical dressing and installed a WoundVAC.  Essentially, they stuffed the wound with special packing foam and installed a suction cup of sorts to the top and a tube is attached to a pump that creates negative pressure and sucks out bad fluid and allows the wound to heal from the bottom up.  Monday concluded with the infectious disease doctor, who told me it was staph and we were waiting on cultures to determine the strain and susceptibility.  So I continued with a regular IV and the Vampire drug and one more night in the hospital.  I'll keep my perspective on hospital doctors to myself and simply comment on the quality of the nurses, which was superb.  

Tuesday brought new information and new "installations".  I found that I had the MSSA strain of staph, better news than having MRSA (which is a killer).   In order to go home and get a six week cycle of Nafcillian, equally effective on this strain, but less impact on my body, they needed to install a PICC line, essentially a central catheter inside a major vein that leads directly to my heart.  That process sucked and over all the damn thing is uncomfortable.  Once they'd installed the PICC they hooked that up to a battery powered pump that automatically administers a dose every for hours.  So, I have a woundVAC bag hanging off my left side and a PICC pump hanging off my right arm, needless to say mobility is pretty limited.  A few hours later I was happy to be discharged and go home.  Sleep had been elusive for nearly 5 nights and both Annie and I were ready to go home and get some sleep.


I have had this in draft form for many days now.  I have more pictures (Greg is chronicling the healing process) and certainly commentary to add for these past few days.  Annie and Greg have been incredible.  They've taken extremely good care of me.  I leave this post with a simple closing, "Infection, Infection you are my Rejection!", I will live to run again!

 

Good and Bad News. The Alien is back!

First the good news: I signed up for the Leadville 100 in August on Wednesday,7 months to get ready, and then Thursday came.

Well now for the bad news. I've had a huge setback this week, after accelerated strides the first 15 days. We made it to Solana Beach on Monday and it has rained for 5 straight days with some respites of sunshine. Thursday I decided to go to a physical therapist, I found one near the house. I had asked for a recommendation from the San Diego Track Club coach and contacted someone else earlier in the week, but had not heard back from him and went ahead and made the appointment with the local PT. Certainly my zest for accelerating my recovery was at the forefront of my mind and clouding judgment.

Needless to say there were warning signs from the minute a walked in the office, those I did not heed. She worked on my incision points and proceeded to do some soft tissue work around my hip incision where they removed the hardware.

I left feeling not quite right, went to the grocery store and by the time I got home could barely walk. I crawled into an Epsom Salt bath, got out and applied ice and within an hour required crutches to get around. Severe swelling had overcome the entire area and it was extremely painful, more painful than any other day of recovery.

Thursday night was no picnic, hot and cold flashes, hammering headache, the works. At 4:30am we moved upstairs to the couches (needless the say, the bed in our rental sucks and compounds the issue with my leg).

Friday morning I called my doctor in Boulder to get direction and explain the situation, I also talked to the PT that was recommended to me and he referred me to the CORE Orthopaedic Medical Center. I was miserable all day and in intense pain. The swelling was huge and throbbing and rock hard, no amount or duration of icing or Traumeel was having any effect. I made it to the appointment and they confirmed what my Boulder doctor had thought, I had a mild, superficial infection on the hip incision and a huge hematoma. I freaked. They explained, the hematoma is simply a collection of blood in the body caused by a broken blood vessel. So essentially on Thursday, the PT either aggravated or caused the blood vessel to rupture and create a hematoma. CORE gave me antibiotics for the infection and vicodin for the pain. I have a follow-up appointment Monday morning, if the hematoma doesn't grow larger over the weekend, in which case I was told to go to the ER.

We slept upstairs again last night (kind of a sleepover type thing - I woke at 2am and Annie watched a movie with me, sort of fun in that regard). All in all last night was good, however this morning the hematoma is looking larger, I'm in my favorite position these days, horizontal, hoping that it will subside a bit otherwise we'll be in the ER later today.

Greg arrives with his Mom this afternoon. I'm looking forward to that, a nice social distraction. A friend of mine, Andrew has a really good perspective on "being present". I am practicing patience in that presence at the moment. I'm pretty disappointed in myself and this whole situation. I knew better and didn't practice good judgment and neither did the PT, who should have known better professionally then to do work on me.

What am I focusing on? All the small things that make this better. Annie is the best, she takes such good care of me in every aspect, ever patient and loving. I am appreciating the value of drugs (I am normally against them). I took a shower today and changed clothes after two days, WOW that felt good. I have a great view of the endless ocean form the window, which reminds me of endless opportunities. Finally, of course I am visualizing a positive recovery and return to the trails.

Annie made a good point yesterday, perhaps this is a blessing in disguise. If I hadn't developed the hematoma, I might not have gone to see the doctor and discovered the infection, which in these circumstances could have been life threatening, if left untouched and untreated.

I'm in relatively good spirits, lessons learned:

1) Trust your initial instincts, don't compromise and expect the same results. I should have waited to see the PT that was recommended to me by the track coach.

2) Surgery is surgery, it takes awhile to recover no matter how good you feel, be patient and don't push it.

3) Don't buy ice packs that claim to last 8 hours, if you think it's too good to be true, well, it is.

4) Love is more powerful than fear.