Wednesday, April 06, 2016

Injuries are never fair

Ah, the post-adventure blues. I always experience them to some degree, but this particular bout has been both tempered by excitement about the upcoming move to Colorado (April 21!) and exacerbated by frustration about my hand. Carpal tunnel syndrome gets no respect because it's a "typing" (read: desk jockey/couch potato) injury, but it's more debilitating than I anticipated.

Unlike the other sports injuries I've had, CTS has managed to irritate all aspects of my life. With limited dexterity and almost no strength in my right hand, I have to sloppily use my left hand for eating, writing, cleaning, shopping. Driving is more difficult, typing is a mess, and don't get me started on my page design job at which I'm now at least 20 percent slower. Sleep has been fitful because I often roll onto my arm in some way that causes me to wake up with shooting pain in my three affected fingers. Although the throbbing and tingling comes and goes, there's nearly always a low level of pain, despite taking four Aleve per day (my "prescription" from a physician I consulted in Nome.)

It is getting better, slowly, which is encouraging. The Nome doctors urged me to wait a few weeks before taking more drastic measures, since my case seems likely to be an acute injury. Since we're moving to Boulder at the end of the month and I'd need to switch doctors/physical therapists/hand specialists anyway, patience seemed like the sensible choice.

More on the acute theory: One week before the start of the ITI, I went over the handlebars during a fast descent and landed hard on my right side. Most of the initial pain radiated from my shoulder, but there were cuts on my palm indicating that I also landed on my hand, which would have impacted my wrist. With plenty of other pains and pre-race anxiety to distract me, I may not have noticed any initial compression. It's possible I started the race with a minor acute injury, and handlebar throttling and stress exacerbated it. Further crashes on ice (I had a bad one in the Dalzell Gorge that left my whole lower arm swollen) also could have added to the inflammation. It's one theory. Overuse doesn't really explain why I had problems from the first day, or why I suddenly have such an advanced case when I've never experienced nerve damage from any other long bike ride I've done.

The bad news from Dr. Google is that a majority of people with CTS, acute and repetitive, don't recover from it without surgical intervention. Especially with more advanced cases where mobility is severely impacted. Dr. Google always manages to bring me down. First he got into my head with all the lung studies, and now this. I should stay away.

One aspect of this injury that I haven't mentioned yet, perhaps because it hurts the most, is not being able to ride a bike. Beat thinks I am being smart about recovery, but really my hand hurts when I touch anything, so the temptation to ride is not there. Beyond the CTS, I can't say I feel too many after-effects from the ride to Nome. My sleep is poor, but that's because of CTS, and I'm still more hungry (All. The. Time.) than is warranted. But my energy levels are normal and my legs feel great, which is why I'm glad to have running in my life. Running keeps me from sliding too deep into post-adventure blues.

Of course I don't want to end up with other injuries on top of my limpy hand, so I'm trying to be prudent about returning to an activity after a month "off." An hour or so a day, five to six days a week seems prudent. I cherish these hours, as that's always one difficult aspect of the post-adventure transition — going from a predominantly physical existence to a sedentary one. The fatigue is quick to wear off, leaving all that conditioning that makes it feel more natural to move than to sit still.

I took Tuesday off because both of my shins were sore after Monday's run (see, restraint.) Still, I was chomping at the bit to get out today, even though there was a heat wave and it was 93 degrees, and just one week ago I was overheating at 65. I went to San Francisco to meet an editor, and took advantage of the commute home to revisit one of my favorite spots in the Bay Area, Sweeney Ridge. In my long absence I'd forgotten about the 30-percent grades climbing out of Pacifica, and nearly fainted at mile six (Not exaggerating. I experienced dizziness and briefly blacked-out vision, and chose to sit down on the trail before it wasn't a choice.)

But it was a beautiful day, even in the hot hot heat. I intend to use these final weeks to revisit some of the places that I'll miss the most. California has been my home for more than five years — it's difficult to fathom, as it feels as though I just moved here, especially with Alaska vistas so fresh in my memory. This realization of "leaving home" was enough to cause me to tear up as I descended toward a sweeping view of San Francisco, the Bay, the Santa Cruz Mountains, Crystal Springs Reservoir, and Mount Diablo. I was listening to a song by Darlingside that I'd played on repeat during my second day on the Yukon, when I was surrounded by the white expanse of the mile-wide river:

I stood above the Rocky Mountains
where Colorado touches New Mexico
And I could see a hundred miles
but I was many thousand miles from home.

13 comments:

  1. Here in the UK the surgery is about 30 minutes a hand under local anaesthetic. Best having one done and then the other, I found.
    For me, it has been a permanent cure. HTH.

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  2. Right arm? Could all the computer time exacerbate the problem? I had a burgeoning case of CTS, but I switched from a mouse to a track ball, it relaxed my hand/wrist a little, and the CTS went away, never to return.

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    1. Computer time has been minimal since late February. Normally I use a laptop with an inset mouse, switching often through different sitting/laying down positions (I don't have a desk.) At this point I have my right hand in a brace and barely use it at all. Left hand has no issues. Although it would be nice to blame a computer, the culprit is the bike.

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  3. Mine was the bike but it was ok on a recumbent. I couldn't use a saw or screwdriver so I had the operations.

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  4. Yeah Sweeney ridge is awesome.

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  5. Give it more time. Its taken me a few times almost 3-4 months before it completely recovers.

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  6. CTS is incredibly frustrating. I'm glad you can run to keep the blues away!!! Just one word from experience - when I finally accepted that I needed to see a doc about my CTS, the specialists were booked really far out. Then I had another couple of months before I could get in (and mine did not get better by itself). You might get yourself on the books with someone near Boulder, and then cancel it if you recover on your own. I hope that you do start to feel better soon!!!

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  7. Anonymous9:16 AM

    https://nutritiousmovement.com/anatomy-misconceptions/ Check out #3 and then about a minute in on this video for more info on CTS and some stretches that may help you. https://www.youtube.com/watch?v=dif5mKa9muU

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  8. Yes, stay away from Dr. Google. And stay away from people who say things like, "I googled your diagnosis, and it really depressed me."

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  9. Hi Jill,

    I had CTS back in the mid 70's to a point where in the morning I could not pick up a toothbrush. Surgery today I'm sure is far different than the mid 70's where they made a flap from my mid wrist and up my palm to address the ailment. The good news is that for the past 40 years: No problems at all.

    The Bike: You can ride with CTS but it's one of those funny bikes: A recumbent. You can even get an AZUB for off road. I've been riding a recumbent since the early 90's and can not ride a road or FAT Bike more than an hour or two before my wrists, shoulder and neck hurt!!

    So do your two or more opinions and surgery may be the best option. It was for me.

    As always, enjoy your adventurelogs!!

    Be well

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  10. Hi Jill,
    Off topic from this post, but my brother an I both just finished your book "Be Brave, Be Strong". We really enjoyed it. In June he and I are doing a small section of the Divide Trail from Banff to Whitefish and then I'm taking the Norther Tier out to the coast while he heads out to watch the Olympic trials. I'm excited for the trip and I enjoyed reading your experience racing the trail!
    -Bryan

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    1. Thanks Bryan! I appreciate the note. Good luck on your adventures.

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  11. I look forward to reading about all of the new routes you'll be learning in CO. When I moved away from Mountain View, Bohlman On-Orbit was my goodbye ride. Hit it 3x the week before I moved. I wish I'd heard about Everesting back then. Thanks as always for sharing.

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