Monthly Summary - June 2011

Here's June 2011:

June 13:

June 21:

That pretty much sums it up.

Despite a promising start to the month, breaking my collarbone was a great way to derail training. Absolutely zero training from June 12-28. I finally did a little easy cardio last night on the elliptical and incline walking on the treadmill. It's definitely gonna take me a few more weeks to get back into any kind of rhythm, but I'll do my best to be patient...

Swim: 7,254 meters
Cycling (outdoors): 185.5 miles
Cycling (indoors): 0 (hours)
Run: 38.8 miles
Strength Training/Yoga: 3 sessions

Approximate monthly total training/racing time: 24.5 hours

Weight: 164

Double Doctor Day

This morning, when I realized that my car's GPS has two doctor's listed as "Favorite Locations", I got a little bummed out. I used to pride myself on not needing to go to the doctor very often. I guess this is what happens when you start getting old! :)

The nice thing though is that both appointments held good news.

The first stop was to Dr. Modabber for follow-up on the surgery to fix my busted clavicle. First was the x-ray, which looked like this:

Pretty rad, right? The doc wasn't joking when he said it was a long 10-hole plate and nine screws. He couldn't put a screw in the middle hole because (as you can see) there's no bone there to anchor it to! He again re-iterated how bad a break it was and told me that he had to do some funky stuff to tie a few fragments in place. The good news is that it looks good and he expects it to heal up just fine. It'll probably be 12 weeks before I'm back to "normal" but in the meantime, my only real restriction is to not force the clavicle to bear weight. Sounds good to me. He did warn me that the jarring from running and vibration from handlebars will not be particularly comfortable for a few weeks. So for starters, I'm gonna start with some hiking and short runs on soft surfaces and I'll get back to being very friendly with my trainer!

Appointment #2 was with the radiation oncologist for a six-month post-radiation follow-up. The MRI I had a couple weeks showed absolutely no re-growth of tumor tissue! That's awesome news! It doesn't mean that I'm definitely 100% out of the woods - last time around it took a few years before any re-growth was noticeable - but I'll take it!

Can I now be done with doctor's visits for at least a little while???

Franco Bikes

A couple weeks ago - just a few days before I broke my clavicle - I had the privilege of participating in a video and photo shoot for Franco Bicycles. I've actually been meaning and meaning to write a post about Franco and the great services and products they offer, but I kept putting it off. I'll get to that post at some point soon.

Back to the photo shoot: The owners, Franco and Julian, invited five of us, including the newly-out-of-retirement pro cyclist Ivan Dominguez (a/k/a The Cuban Missile) and plant-powered super ultra athlete Rich Roll to come up to Agoura Hills one morning and ride around Agoura Hills, the Malibu Canyons and the PCH for a few hours while a video and camera crew followed along. It was awesome fun hanging out with the other cyclists and feeling a bit like a rock star with an entourage. :)

Today Franco Bikes posted this kick-ass video from the day. Check it out on
Vimeo and on the Franco Bikes Facebook page. Or you can just watch it here:


Our Backyard from Franco Bicycles on Vimeo.

More about Franco to come soon!

Quick surgery/recovery update: After a couple rough days immediately after the surgery, I've been getting better and better by leaps and bounds every day. I'm now six days post-surgery and while the area of the break/plate and screws is pretty tender and my shoulder and neck are sore, I have great mobility in my shoulder and no real "pain". I haven't worn the stupid sling in a couple days (shh... don't tell the surgeon or my parents). I have a follow-up with the surgeon on Wednesday and should get the stitches out then. So far, I'm really pleased with the decision to have surgery. The real test will come the first time I jump on the trainer or try to go for a short run!

Post-Surgery #1

Surgery today went really well. It was a bit longer than expected and I have a fuzzy memory of a conversation with Dr. Modabber in the recovery room about there being more small fragments than he could see on the X-ray. Anyway, I have a long plate (the longest they make - always striving to be the best!) and nine screws. After surgery, I came home and took a long nap and have just been sitting around the house, relaxing and eating since. All things considered, I feel pretty good. I'm expecting tomorrow to be a tougher day, as the hospital pain meds wear off and the soreness sets in. But I'll take that as - and when - it comes.

A few photos of my day:

This looks familiar:

All smiles on the outside (before surgery):

Recovery room anesthesia and percoset-induced smile (and check out the "NO" on my right shoulder, there's a "YES" on the left one covered up by the ice pack and bandage):

Finally, not such a convincing smile:

I got tons of text message, email and twitter love today. Thanks to all!

And extra special thanks to Elizabeth and Mom and Dad for taking such good care of me yesterday! Mom's tomato soup is the best!

Here we go again!

Are you people starting to think that I actually enjoy surgery?

I promise that I don't.

Nonetheless, for the second time in less than a year, tomorrow morning I'm going under. This one doesn't seem like such a big deal and, compared to the last time, I guess it's not. But it's still surgery, it's still general anesthesia and, honestly, it's still pretty scary. The fact that I am choosing to have surgery is weighing heavily on my mind. I strongly believe it's the right choice, but the fact that it is a choice - and one I've been sitting on for over a week - has caused me to do a lot of second-guessing.

Surgery at 9:30 tomorrow morning. And assuming all goes as planned, an hour or so later I should be in recovery and by early afternoon, I should be on my way home. Then I could be back on my feet tomorrow evening. In a few days, I should be able to get out and start getting the heart working a little again.

And now, as promised, here's what actually happened:

That Saturday morning (June 11), I left home at 6:45 for my regular Saturday ride. Home to Ocean and San Vicente where I met up with the group. Then we rode the PCH out nearly to Pepperdine and on the way back I split from the group for a little climbing. Up Topanga and Old Topanga, back down and headed for home. Through Santa Monica, Brentwood, Westwood, Beverly Hills, West Hollywood. Now I'm half a mile from home. Feeling good and ready to get a busy day started (some stuff for the move, then meeting a friend for a run in Newport Beach, then family dinner in Long Beach). I stopped at the light at La Cienega and Melrose. For some reason, I stopped in between the second and third lane (instead of outside the third lane). I think I thought the guy on my right was going to turn right, but I don't know why I thought that. When the light turned green, I shot out and realized I was between lanes. I wanted to get over and the car on my right was a bit behind me, maybe to let me get over. I turned to signal him; to thank him and let him know I was going to get over. And then I fell. I couldn't have been going very fast; I'd only been pedaling for a second or two. I think I looked over my left shoulder to see the car on my right and raised my left hand to make the signal and just lost my balance. Maybe. Either way, I landed square on my shoulder. And I felt it right away. I was in the middle of the intersection and thankfully didn't get hit. I picked up my bike and the bar-end cap that fell out and moved to the sidewalk across the street. On my way, I knew I was f'ed. My shoulder hurt and I could feel a huge bump in the middle of my left collarbone. Maybe something is dislocated, I thought. But then I quickly realized there's no joint in the middle there. So I knew. I checked my bike and kit and realized there was really no damage to either. It was the least violent crash I've ever had. No road rash. A small bruise on my left hip. And a broken clavicle. I got back on the bike and rode home. I changed out of my kit (but not my base layer, which I couldn't pull over my head), apologized to the dogs waiting to go out and drove to the Cedar Sinai ER. The rest you should know.

p.s. Edwin, if you checked back in, click here for a picture of my break. In my research I've found that the surgery decision depends a lot on the location and severity of the break, but also on the attitude of the doctor you see and your own feelings about the surgery. Good luck!

Broken clavicle update and surgery decision

After breaking my clavicle on Saturday morning, I spent most of Sunday doing research on the injury. I read articles and blog posts online, spoke with friends and friends-of-friends who have either broken their clavicle or are orthopedic surgeons who treat the injury and tried to find surgeons in LA to see on Monday to discuss my options.

The main thing I found out is that in most cases, it is not necessary to have surgery to fix a broken clavicle. With time, most fractured clavicles will heal on their own and come back as strong (or nearly as strong) as before. Unlike a broken arm or foot that can be re-set and secured with a cast, a broken clavicle cannot be re-set because, with no way to secure it with a cast, it wouldn't stay in place. But the body will grow fibrous tissue to reconnect the broken pieces of bone and eventually that fibrous tissue turns into bone. Even if it's not perfectly lined up, most people end up with a strong and stable clavicle that allows return to full function.

For severe breaks, where doctors are worried that the bone won't heal correctly and for professional athletes whose livelihood depends on a full recovery (like Lance Armstrong), surgery may be recommended. (But not always, for example, I don't think either Tony Romo or Tyler Hamilton had surgery when they had the injury. Insert your own Tyler Hamilton joke here!) Surgery can ensure that the bone is re-aligned and often results in a considerably quicker recovery.

My orthopedic surgeon-friends in New York and Montana who looked at my emailed x-ray image on Sunday said that I fell in a middle area - it's not an awful break or one that requires surgery, but it is somewhat displaced and there's a bit of risk it won't fully heal, or it could heal a little "shortened" because of how the broken ends will reconnect. Also, since I want to continue being semi-competitive in triathlons, I have less tolerance for the risk of a partial recovery. The consensus was that it should heal fine on it's own, but surgery was an option that could result in a better and quicker recovery.

My first call Monday morning was to Dr. Ramin Modabber, a local orthopedic surgeon who operated on Dan Empfield (of Quintana Roo and Slowtwitch fame) to fix his broken clavicle after Dan crashed during the Tour of California Time Trial last May. I got in to see Dr. Modabber that morning and he suggested that I have the surgery. He was very clear that, if I wanted I could just let it heal. And most likely it would heal just fine. Either way, once it was fully healed, I probably wouldn't know the difference. The thing I heard many times was that I was choosing between having a bump (from the bones resetting a little off) or a scar (from the surgery).

Dr. Modabber's concern was that given the relative location of the bone pieces, they might reconnect a little "off" and I could end up with a slightly shortened left shoulder. Also the fibrous tissue and re-grown bone that fills in the empty spaces between the broken bone pieces might not be as strong as the original bone. Would either of those things have any functional difference? Maybe. Maybe not. But it's hard to know.

The other advantage to having the surgery is that - assuming all goes as planned - it should accelerate my recovery time by up to four weeks. Without surgery, I'm looking at 6+ weeks before I can really start strengthening my shoulder. With the surgery, it could be as short as 10 days or two weeks.

Briefly, during surgery they re-set/re-allign the bones and put in a plate like this to hold it in place while it heals. Dr. Modabber told me that the plates come in a lot of different shapes and sizes.

This is what it looks like when it's in place:

There's a chance that they'll have to go back in later and remove the plate, but that depends more on whether I can feel the plate and if it's bothering me. That would be pretty beat, but I'll deal with that when/if it becomes an issue.

Surgery always has some risks - anesthesia, infection, nerve damage - but the risks are pretty low and I believe Dr. Modabber and his staff will do a great job.

So... surgery is scheduled for next Tuesday (June 21). No doubt I'll have more to say between now and then!

Thanks to everyone for your support and advice and suggestions!

Broken. For real.

This is what your clavicle is supposed to look like:

This is what mine looks like after a little bike crash yesterday morning:

I'll explain more about the accident/fall soon. Thankfully, other than the clavicle, I'm fine and my bike escaped totally unscathed.

Right now, I'm in a sling, doing research to find an orthopedic surgeon to evaluate whether I should have surgery or simply let it heal. In most cases with a broken clavicle, they just let it heal without surgery and it usually eventually comes back 100%. But there are some potential advantages to surgery. And some risks.

Either way, I'm out of commission for the near future. What a bummer. But broken bones heal and - at some point - I'll be back, good as new!