Monday, May 23, 2016

Broken, not broken

Beat with our Iditarod-inspired tripod. He collected the markers from downed trees off the trail in March.
This week I've been less enthused about my runs, dragging around a sore leg and the knowledge that my hand is not going to get better on its own. Last Wednesday, a doctor performed a nerve conduction study and concluded I have "very severe" carpal tunnel syndrome. The numbers point to grade five, which is as advanced as this injury becomes before the nerve stops firing altogether, and the damage can be permanent. There's already muscle atrophy. My distal motor latency has actually deteriorated since I had a similar test done in March, even though I gave up the activity that prompted my symptoms (cycling), wore a wrist brace, performed PT exercises, and took anti-inflammatories. At this point, the cause is impossible to determine — my case is definitely not typical, and there's no way to say whether it's overuse from the race to Nome, acute injury from a crash, genetics, a combination, or something else entirely. All I know is it's bad, and getting worse. Both the doctor who conducted the test and the surgeon I originally consulted were adamant that I not mess around with this.

The results must have been concerning enough to fast-track through an overbooked schedule, because the surgeon offered an appointment next week. The next available dates weren't until July. I booked it, because the odds of full recovery after transverse carpal ligament release are high. Without surgery, the odds that I'd have to manage this for the rest of my life also are high. That's nerve injury. I learned a similar lesson in 2009 — "Frostbite is forever."

I did not expect busy Boulder doctors to expedite this process, so I'd already registered for what I hoped would be my first trail race in Colorado, the Golden Gate Dirty 30. The race is June 4, so clearly I won't be able to participate. Disappointment about this is among the many emotions the prospect of surgery has ignited.

Of course there's anticipation. (No more invisible spiders crawling all over my fingers, no more electric shock pain!)

And there's fear. (Unless you count wisdom teeth extraction when I was 15, I've never had surgery. I might die. That possibility is noted in the manual.)

There's disbelief. (Given my risky and high-impact sporting activities, I would have never guessed my first surgery would target a stereotypical typing injury.)

And hope. (I might be able to hand-write like an adult, draw, eat with a fork and knife, and ride bikes again by July!)

 I was bummed out after Wednesday's nerve conduction test. Beyond the bad numbers, the phrase "it's getting worse" is especially discouraging after you've spent two months avoiding something you loved because you believed abstinence would make your injury better. Adding to this helpless feeling was the full limp I was sporting after slipping in mud and bashing my leg on rocks during a run on Tuesday. A bruise the size and shape of a softball ballooned out from my shin, and hurt quite a bit. But it was "just a bruise," and I was feeling defiant about this pathetic array of limb injuries, so I took a couple of lunchtime hours to march up Fern Canyon.

Fern Canyon has become a personal nemesis, because it is perhaps the meanest of the mean (standard hiking) routes in the Flatirons. I maintain concerns that I will always be a flailing, stumbling, inadequate mountain runner/hiker. This is particularly sad if I continue as a non-cyclist, and my only running options are mountains. I love mountains. But they do not love me. At least, I believe they might be conspiring with gravity to knock me around a bit. I was thinking about this the other day as I crept down Gregory Canyon — no matter how much I practice this, I may not improve because the issue isn't limited skills or strength, it's balance perception. If I descend Gregory Canyon enough, eventually I'll have a stronger core and ankles, but I'll likely still feel the pull of vertigo with every step. How much training does it take to realign proprioception?

But yes, Fern Canyon. My leg hurt, but I tagged Bear Peak, and this weirdly made me feel a lot better.

 The rest of the week involved some running around with a painful bruised leg, because I was in training for the Dirty 30 and wanted to make sure my proprioception was dialed. Beat guided me on a tour of a couple of the semi-secret routes on Green Mountain, which were steep and fun but shattered any confidence I may have tenuously gained.

At least my writing projects are going well this week. I am really enjoying working on my Iditarod book, although a few hours of submersing myself in it often leaves me more exhausted than a long run. I'm also negotiating a contract to have "Be Brave, Be Strong" produced as an audio book. No, I won't be the narrator — therefore, it might actually be okay. The adventure genre is a challenging market for books, because a fair percentage of the audience are not regular readers. Audio books are great for busy folks who perhaps want a diversion while they're commuting or out for a long run. I've resisted offers to work on audio books in the past, because — full disclosure — I don't enjoy and don't listen to audio books (for me, something is lost when I'm being talked at, rather than reading. Perhaps I'm too attached to having full control of my reading experience. Or have too short an attention span.) But this is a good opportunity. I'm excited!

After my consultation with the surgeon on Monday, I was again bummed out, because there was admittedly a sliver of hope that she would look at my results and say "hey, I think a cortisone shot could fix this." (A cortisone shot probably wouldn't even mitigate the pain of grade 5 CTS.) It was again lunchtime, so I again went to the Cragmoor trailhead for another go at Fern Canyon. My leg was finally feeling less sore after I took a day off Sunday and the swelling had gone down, so I marched happily up to Bear Peak through intermittent rainstorms. My goal was to do the descent a bit better, so I furrowed my brow in concentration and employed my trekking pole for a little more stability as I hopped down rock steps. Near the bottom of Fern Canyon, when the 1,900 feet-in-0.8-mile-descent veers onto a nicely runnable doubletrack, I stepped up on a boulder and clumsily bashed my sore shin on the rock.

!!!! There were loud swear words.

I may have lost my temper and stabbed my trekking pole violently into the rock, multiple times, with enough force to make deep gouges in the surface. It's amazing the pole didn't snap. +1 Black Diamond carbon Z-Pole.

The bruise is swollen again, and larger than before.

Well. Clearly it's my turn to feel broken right now. I'll find another way around it.

10 comments:

  1. I said in a comment a few weeks ago that I'd had the carpal tunnels done in both my wrists. It is a simple, local anaesthetic operation lasting less than an hour.
    I've never had a problem with mine since they were done. You won't regret it.

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  2. My dad ignored his carpel tunnel issues for too long and now has no feeling at all in most of his right hand and some of his left. Don't be angry at the short term(hopefully) imposition Jill, look forward to a long term solution. Good luck with the surgery.
    Oh, and the views up there are amazing!
    Dave

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  3. Anonymous7:05 AM

    what ever doesn't kill yah just make yah stronger...

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  4. You will do great with surgery. Short term pain and inconvenience for long term gain. You will be back biking before you know it. It's a pain to take time for recovery from surgery but the time will be over before you know it. Look at me! So glad you are having surgery sooner as opposed to later. Good luck! And even if you are a little bit of a klutz in the mountains, you are still out there bagging peaks and doing lots of miles! Keep going.

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  5. You will do great with surgery. Short term pain and inconvenience for long term gain. You will be back biking before you know it. It's a pain to take time for recovery from surgery but the time will be over before you know it. Look at me! So glad you are having surgery sooner as opposed to later. Good luck! And even if you are a little bit of a klutz in the mountains, you are still out there bagging peaks and doing lots of miles! Keep going.

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  6. Tonya S.9:06 AM

    Soon enough you will back at it, and glad you got the surgery done quickly. At least you are in a beautiful and exciting new place to explore, clumsy or not. I think an audio book for the adventure set is a great idea. Like you, I prefer to hold a book, but I can see how readers interested in the topic would like to listen to your book on the go.

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  7. Hope you can overcome the CTS. As Tom Wolfe put it so well in "The Right Stuff", it can burst at any seam.

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  8. Ditto on all the surgery comments. Glad you got fast-tracked. Also glad you're going the audiobooks route. I've listened to them for years and I love them! If it wasn't for audiobooks, I'd read (consume?) probably 2 books a year. I generally go through 2 or 3 audiobooks a month. I listen to them while driving (and whatever's on public radio doesn't interest me) or when I'm on trails that I know so well that I'm a bit bored.

    P.S. Sounds like the Flatirons are anything by flat!

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  9. Love the pics of the Flatirons and the Fountain formation, spent a lot of time on those crags...

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