Hospital Experience III

I would like to thank you for reading my blog.  Your comments, publicly and privately, have kept me motivated during this down time.  Let’s press on.

In case you missed the accident post

part I 

part II 

When I last left you  I was having trouble urinating.  Nurse Shannon impressed upon me the importance of urinating.  If she didn’t have 350 ml of urine during her shift then I wouldn’t be allowed to go home.  The clock was now ticking… against me.

Over the years as my dedication to cycling and my mileage increased many of the things I used to do on my free time were put on the back burner.  My free time waned as I moved through the stages of recreational bike rider (read occasional rider), avid cyclist, enthusiast cyclist and eventually to an Ultra Cyclist.  Cycling is a very time intensive sport. You can easily loose 4-6 hours of productivity in your day but gain the intangibles of mental clarity, stress relief and physical fitness.  Many of the hobbies I had before cycling have become a thing of the past.  I have joked with my friends and said, “I used to _________ but that was BC” BC- before cycling.

You might recall from my last post that I was unable to eat my breakfast.  It had been more than 24 hours since my last meal — a protein shake.  I drank my juice and had a scant amount of oatmeal which I promptly threw up during my two PT visits.  As the hours passed my stomach came back online. I ordered lunch and consumed it zestfully.  The cart arrived.  The main course – macaroni and cheese, the cheese was delightfully browned from the center giving way to the caramel colored brunt edges – just the way I like it, bread rolls in individual baggies with frozen butter, oh why oh why can’t I have soft butter… and mixed vegetables that, surprisingly, were not overcooked.  Am I really in a hospital?  Compliments to the chef, serveur! I had been drinking juices and water moderately up until that point.

I starting to feel my bladder expanding. A nice accompaniment to my pleasantly full stomach…finally.  I thought I must be ready to urinate. I reached for the bed pan set myself up and I waited…and waited…and nothing.  I was having performance anxiety of a different type. The nurse checked in on me and again I handed her an empty bottle with the shame of someone turning in a final exam to a proctor being ill prepared and subsequently the document is devoid of correct answers.

She informed me that the surgeon was concerned.  His concern would lead to my torture at the hands of the pleasant nurse Shannon.  The next thing she said made me shudder, “….Catheter”.  Few words can put the fear of God in you like that one word.  Can you say shrinkage?

I use to take lots of pictures of landscapes and I enjoyed it.  Notice I didn’t dare call myself a photographer.  This was during the age of the SLR and print film. Do you remember those days?  Buying film in 24 or 36 exposure.  Counting each shot you took.  Ensuring that each picture was perfectly in focus and composed just right.  Now in the digital age we shoot pictures indiscriminately without regard to quantity or quality.  Today a picture can be taken with your “Smartphone”,  a word that didn’t even exist in the dictionary back in 1987!  I enjoyed the process of scouting locations or interesting people and I would frame the results.  I still have a few photos from those days – framed and on my walls.  This is one of my favorites. “I used to take pictures … but that was BC.”
Taken when I was in Egypt on a plateau that overlooked the Great Pyramids.

The Greeks are famous for saying everything in moderation but I don’t think they had to fear a catheter.  Drinking in moderation wasn’t working.  The fear of a catheter was now my new source of motivation to HYDRATE!  I thought about all the times I did long training rides and didn’t hydrate by the “one bottle and hour” rule.  I often go on 6-8 hours rides and not pee once.  I feel fine and finish my rides quite strong with surges and sprints towards the end.  I feared that living in this chronically dehydrated state had now impacted my ability to pee on command.

With renewed interest and now stress added on top,  I began a more aggressive plan on hydrating.  I had a new goal a new challenge! However, I still had reservations.  What happens if I fill my bladder up and then still can’t urinate?  Wouldn’t that be it’s own torment?  Wouldn’t that be a more serious medical issue?

I used to ride a motorcycle   I’ve had 3 very fast motorcycles (Ninjas and Suzuki’s) from 600-1100 cc.  Yes I was the guy in full black Hein Gericke leathers, Alpine Stars racing boots and blacked-out face shield.  Yes I was also the guy ripping up and down Palomar Mountain that you detest.  I have done some ridiculous things on motorcycles.  Often I would find a stretch of road and open it up!  Full throttle! top Gear! Redline!  or as motorcyclist call it WFO (wide fucking open) referring to the throttle — 150-160 mph on the freeway or if I was lucky enough to find a deserted road I would “PEG IT”. I would take the motorcycle to it’s limits scraping pegs, knees and mufflers on curvy canyon or mountain roads.  The adrenaline coursing through my veins as I laid the bike over just inches from the ground made my body tingle.  I am lucky to have escaped certain death in many situations. Motorcycling taught me to be a great bike handler and a fearless and skilled descender on my human powered bike.  Now when I descend a mountain on a pedal bike things seem to be happening in slow motion.  If I take a line and then need to alter the line I can and often do.  On a motorcycle you get one shot … you bank into a corner and it better be right.  I loved my Sunday mornings on my motorcycle.  Yeah “I used to be a motorcyclist … But that was BC.”

Garden variety catheters


A few more of my attempts to pee in the bottle had come to naught.  I had stalled nurse Shannon long enough.  She left the room and returned with a packet.  She explained that this must be done because for some reason my body was not working properly.  I was awake on the 7th floor but my urinary system was still downstairs in the Operating Room.  Nurse Shannon and I were about to take our relationship to the next level.

.If you have never had a catheter installed while you are awake you can’t relate.  If you have then I apologize for having you relive with me the discomfort and pain of what I am about to describe.  It was the strangest sensation.  I felt like I was urinating but I wasn’t and it felt all wrong it was all in reverse.  I could see the seemingly harmless, flexible and pliable red tube disappearing into my penis and I could feel it entering my body now.  When it hit bottom, my bladder, she moved the tube in and out. I felt like I was finally urinating.  I squawked,  “oh good we have something now!” She simply shook her head in a disapproving fashion the way a pitcher signals to his catcher when he doesn’t like the catcher’s recommendation … he shakes off the pitch selected and throws the heat instead. Shannon then pulled out the catheter and seemed as frustrated as I was.

I used to be a runner.  I loved running.  I ran road.  I ran dirt.  I have done many 5K’s, a few 10K’s and two Half Marathons.  When I was in the Marine Corps I would run the first half of the 5k, required as part of our Physical Fitness Test (PFT),  stop and smoke a cigarette with another Marine named Chris.  We would watch the other Marines suffer as they ran past us at the turnaround point.  Then we would flick the cigarette and finish the second half chasing everyone down striving for a negative split.  We could do 19-20 minute 5K that way or run straight through and max out the points in the test by running sub 18 minutes. I miss Chris he was a good running partner.  I have never run a full marathon …not officially anyway.  But I once ran over the requisite 26.2 miles (about 28 miles) in training just so I could say to myself, and to no one else, that I could do it.  I was out on a training run and felt great at 21 miles, “the wall”, people talk about so I kept running.  I never felt the wall.  I don’t know what people mean by that.  I was living in Santee, CA at the time and it was a cool 80 ish F in the morning and well over 100F for my last 5 miles.  It was a 4 hour run through road and dirt and stopping for stop lights.  It was a good run. It was a good day. Yeah “I used to be a runner … but that was BC”.

Nurse Shannon returns she has consulted with the surgeon.  She has to try again.  The surgeon hypothesizes that the nurse has put too much lube and that some of it must have plugged the very small opening of the catheter tube.  Wait, that was too much lube?  Are you kidding? I tremble imagining what no lube would feel like.  And then I’m horrified to hear that she will be putting that damn tube in me again.  I tried to urinate on my own but I only have a dribble to show for my intense focus – 350 ml seemed to this cyclist brain to be an interminable climb!

Here we go again with the catheter sliding into me.  In and out once she hits bottom and still no flow.  She pulls the tube out and scraps everything.  I’m really concerned now.  She rushes off to call the surgeon.  She returns arms akimbo and says if I don’t start flowing soon we will have to resort to more extreme measures. She smiles but I sense the urgency in her voice.  I’m not sure what qualifies as extreme measures put that damn catheter up my !@#$ was pretty damn extreme lady! My refractory urinary system is putting me through hell!

I hated writing when I was in school.  I enjoyed just one writing class in college, just one.  All my other classes were a chore.  They were work and requirements for my degrees.  Yeah degrees — I have a few of them Associates because when in the Marine Corps you never know when you are going to get transferred so you better get it while you can.  Bachelor of Science from Embry-Riddle Aeronautical University — later my alma mater would become infamous during the 9/11 investigation when it was discovered one of the terrorist had attended my school.  Oh yeah and a Masters of Business Administration MBA finance because I thought I was going to be a VP in some corporate empire.  I digress, when I started blogging back in 2004 or 2005, can’t remember, I discovered that writing was actually enjoyable.  If I could choose the subject matter I wanted to write about then it was fun.  Devoid of the encumbrance of a time schedule or the requisite subject of which I must expound upon my writing became pleasurable — can you tell I don’t like structure or being told what to do?  Hence why I became a business owner… to do it my way. My blog posts allowed me to express my interests.  I felt obliged to divulge the secrets of my successful races.  But more importantly I felt duty-bound to communicate, in significant detail, my failures.  Yeah “I hated writing… but that was BC.”

I am now determined to make this happen.  Time and time again I attempt to urinate.  Beads of sweat actually form on my brow as I concentrate and push with all my might. And then… a dribble.  Then a trickle.  And finally a stream.  It had been 30+ hours since I had last urinated. Each time I had something I would call the nurse into the room.  I was like the properly prepared student standing at the teacher’s desk waiting to have their Ace quality paper graded.  I eventually had more than 350 ml for nurse Shannon- always an overachiever.  But there I was each time a little more flow and each a little more proud of my urine in a bottle.  Isn’t that just ridiculous?  But this meant no more catheter from the evil woman! Nurse Shannon wasn’t evil but that damn catheter… This straw colored liquid in the graduated vessel meant my freedom!

Staples on my right hip

Thank you for reading my blog.  With my urinary system working discharge was imminent.  Stay tuned for a more pleasurable post about the family and friends  that made my stay enjoyable.

Hospital Experience II

Where… where….am… I?  What…what…is.. this? Oh my God I can’t feel my legs! I can’t wiggle my toes! What the fuck?!

Click here for Hospital Experience I

Hospital Experience III here

Nurses come to my side and apprise me of the current situation.  I am in a recovery room and that I have just come out of surgery.  How many times have they come to the aid of a bewildered patient?  How many times have they had to provide comfort and calm to a startled and rattled patient?

It takes only a few seconds for my station to become clear to me.   I now know where I am.  I know why I am here.  But there is still something very disconcerting…I can’t feel my legs.  The worst scenario creeps into my head…they fucked up!  I won’t be able to ride again, walk again, run… Fear, then anger builds inside of me, then it becomes fear again

I exclaim, “Nurse I can’t feel my legs I can’t wiggle my toes!”

Once again the calming voice comes to me and says,  “You had an epidural for your surgery.  You are awake from the general anesthesia but the epidural hasn’t worn off yet.”

I think to myself I will fight this and move my legs— but nothing.  I become frustrated.  I pass out.  Later I awake and try again.  I am frantic.

The nurse comes again and mollifies me, “relax, be patient it will wear off soon”.

I fought the nurse telling her I could beat the anesthesia.  They laughed at me of course.  But I came out fighting!

I remember her soothing demeanor.  I began to assess what I knew for sure.  I had had a bike accident, I fractured my femur, 24 hours later I checked into the hospital, I was then scheduled for emergency surgery, I was now in the recovery room.  Prior to the surgery I had this one preoccupying thought— I was starving….hmm…I’m not hungry now.  I have no idea what time it is but it must be late in the night or the wee hours of the next day.  I’m good now I have my bearings and my locus of control.

The nurse checks on me again.  I remember joking with her and calling her by the wrong name.  She took it in stride.  We took a picture…I can’t remember the picture being taken.

Recovery room nurse I can’t remember her name

When I got home I searched on YouTube for videos about my surgery. Isn’t YouTube amazing?  You can find virtually anything on there.  What is even more amazing is the body’s resilience and how it recovers from major trauma and the subsequent stress of surgery.


The first 40 seconds or so pertain to my injury

and here is the finished product

Hours pass and I am transported to my room on the 7th floor.  Honestly I don’t remember being conveyed through the labyrinth again.  I don’t remember anything that happened that night.  I assume my vitals were taken at some point throughout the night.  

The following morning I met Shannon.  She would be my nurse until I was discharged.  First order of business was breakfast.  The hospital wanted me to eat, bring my strength up, make me mobile, and begin my transition from recovery patient to discharged patient.  

I let the nurse place my breakfast order for me.  The menu options were the usual American style breakfast.  Being a creature of habit, I love my coffee in the morning but it wasn’t appetizing at all anything after that would be inconsequential.   Along with my coffee I like to eat a very light breakfast – whether it’s a 50 or 500 mile ride.  As soon as I start pedaling I begin taking in calories.  If I have breakfast it’s usually toast and peanut butter, or a small bowl of oatmeal, or a cup of Greek yogurt with honey and/or fresh berries or a Probar.   I prefer to eat light or not at all so I can get on the bike within an hour of waking up.  

Breakfast arrived and I couldn’t bear the smell of it.  The night before while waiting for surgery I was ravenous.  I fantasized of a big hearty meal …gluttony even.  But now I couldn’t lift the dome off of the main dish.  I pushed it aside.  I was nauseous.  My friends know me to always be hungry.

Two physical therapist came to visit.  My task, their task, was to make me mobile and get me to the bathroom.  I was presented with a walker.  A shocking reality came to me at that moment– I must be pretty jacked up!  If I needed a walker that meant I wasn’t going to be very mobile was I?  The PT’s were kind and helpful as they assisted me to move my recently operated leg off the bed.  They helped me up and instructed me how to take my first few steps.  All was good…for a few seconds and then…vertigo.  I was nauseous and spat up.  I motioned to the PT that I was sick she reached for a bucket and I began to vomit.  First dry heaves and then the retching became productive as I expelled a thick gooey substance.  How pitiful I must have looked to that PT.  Stabilized by only a walker, the rear of my hospital gown open, regurgitating into a bucket.  I was quite the example of a sickly and weak man. I was embarrassed, humiliated and apologized profusely that they had to see me this way.  Eventually, I reached the bathroom.  I stood over the toilet and tried to urinate but nothing came out.  I tried and tried was I experiencing a serious case of stage fright?  Little did I know that my biggest struggle for discharge had just begun.

Hours later I had my second PT visit.  The PT suggested we try a walk out into the hall.  Things went well as we past the threshold of my room.  The big expansive hallway was bright and inviting.  I made progress, albeit slowly and carefully, with no apparent direction.  My bike rides are the same.  I leave my home with a goal of a certain number of hours but no dedicated route.  Those first few miles I assess how I am feeling and then choose the routes to complement how I’m feeling.  If I feel flat and lacking power I take the coast, if my legs feel fresh and strong I take to the hills.

Here I was standing in the middle of the hallway to my right a long hallway, to my left a shorter walk with a massive and enticing window as a reward.  I told the PT we were going to the window to take a look outside.  Just about halfway, I became sick again.  I held it together long enough for the PT to run back to my and fetch a catch bucket.  Great… more humiliation but now in public view!  I emptied out the exiguous breakfast I had had earlier and gave the PT my bucket. Was this in her job description I wondered.  Again, I apologized as I tidied and steadied myself.

She said, “Let’s head back to the room that’s enough progress for today”

I countered, “No. We are going to the window.  That’s was the goal and the goal hasn’t changed.  You’re my wing-woman come on.”

Shortly after vomiting…again.  Are those helmet tan lines on my forehead?

We had a chuckle and I continued to shuffle – me and my walker and my IV machine.  As I reached the window I felt this huge sense of control again.  I had held off vomiting and had transported myself a good distance less than 12 hours post surgery.  While looking out to the surrounding hills the PT and I discussed my accident, my injury, my surgery, my expected recovery and so on.  I came to the realization that here in the hospital it didn’t matter whether you were a great athlete or a couch potato.  The staff was there to help you get well, recover and send you home to your loved ones.  But I couldn’t help remember a line from a movie.

“Here you are all equally worthless”

While I was up and around I decided to make another trip to the bathroom.  I still couldn’t pee. Nurse Shannon added a little more stress to my predicament if I couldn’t urinate I couldn’t go home.  I focused intently but nothing would come out. I was so frustrated.  How can a normal body function such as urinating take so much effort.

In the next segment the drama of not being able to void continues you won’t want to miss it…

Hospital Experience III here

My Hospital Experience Part I

Headline:  George “Red Eyed Vireo” Vargas undergoes emergency surgery for broken leg

Click here for previous post regarding my crash

Hospital Experience Part II here

On Jan 3, 2014 approximately 24 hours after my crash I drove myself to the ER.  I winced, limped, and hobbled my way from the car park to the Emergency Room  registration desk.  I had brought with me several cycling magazines expecting to be sitting in the waiting area all day.  Much to my surprise, no sooner had I answered the basic questions I was escorted to the examination room directly from the registration desk.  Within 10 minutes I was under the X-Ray machine and within another 10 minutes I got the news. The process was annoyingly efficient. The report I dreaded hearing came far too soon.

“Mr. Vargas you have a femoral neck fracture” or words to that effect.  I stared blankly, incredulously, into the ER doctor’s eyes.  It was almost a scene from a movie from that statement forward.  Time slowed… almost stopped… as the ER doctor continued to speak her voice became inaudible.  The once wide examining room suddenly transformed to a tunnel closing in on her lips.  I stared at her lips mouthing words and yet no sound. For the life of me, I can’t tell you anything else the ER doctor said after she said “…fracture”.  It might have been seconds or minutes but then I paused, breathed deeply, regrouped and regained my focus.  This is important, life altering, news I must heed.  I then listened with the rapt attention of someone being handed a life sentence, quizzically, since I was innocent!

The ER doctor exited the room and returned within a few minutes.  She had contacted the Orthopedic surgeon on duty and he confirmed the fracture and requested that I be transferred to his hospital immediately.  An emergency surgery procedure was necessary.  I thought there was a void in the information flow.  “Wait what are my options?”  I asked. “Surgery?  That’s it?  Can we talk about options?”

“The specialist will go over your options once you are under his care at the main hospital.” ER doctor explained. “We are arranging transportation now.  Should only be a few minutes before we move you.” she continued.

Then as if on cue, like roadies backstage, scads of people came into the room.  One person doing an EKG on the right side of me.  A 2-person team on the left side of the bed drawing blood and setting up an IV. Then another young man who was an intern introduced himself.  Simultaneously, my nurse was being relieved and a new nurse was coming on to his shift.  Lots of people and activity in a small room and lots of poking, prodding and charting.  At one point I counted 5 people not including me in the room.  It was approximately 9:30 am and I was told that I could not eat or drink until my surgery.  “SURGERY?!?” That word still had not sunk in.

Wait what the heck is going on?  Everything was happening so fast.  I had walked yes walked into the ER fewer than 30 minutes before and I was already, admitted, IV’d, EKG’d, blood tested and being prepped for transport which was tantamount to being prepped for surgery.  But wait I hadn’t even read a complete article in one of the cycling magazines I brought with me.

And why this reticence towards surgery?  Call me old fashioned, superstitious or just plain apprehensive but I don’t like the thought of being put to sleep and going under the knife.  Have I watched too many movies?  Have I watched too many real life investigations? Maybe but accidents do happen and simple surgeries have turned into dramatic medical complications.  But there’s yet another ratiocination.  I reasoned that I had  fallen or crashed on my bike many times before, in quite spectacular fashion mind you, without breaking anything save my skin. And now a speed bump is going to claim me as its prize?  I imagined the speed bump reveling in its victory.  “I felled the mighty George Vargas!”  (I’m not mighty but to a speed bump I must look like a giant) Damn speed bump! How pitiful I was giving life to the speed bump but in my mind it was as evil as the those squirrels in the Gieco commercial.

While waiting for my transport things started to slow down.  The oncoming nurse  took a little more time explaining what is typical in these cases.  He also showed me my x-ray and deciphered the medical terminology.  He took the time to write down for me what was wrong with me. This small act of kindness paid off in spades.  Now when my friends asked me what my injury was I could speak intelligently about it.  I was also armed with information to do my own Google searches 🙂  But not now I had to conserve battery power on my phone.  I had to call my son’s mom to make arrangements to pick up our son from camp. Oh dear, what will my son think of me all jacked up? Wait did I have clean underwear on today?

The note the nurse handed to me.  It was the most salient bit of information I was given on day one of my ordeal.

Of course the entire staff was wondering “how the heck did you walk in here with a broken femur?” And then I became something of a sideshow.  Here come see the lady with two heads born on an island never before charted.  Yeah … like that! I was the guy who rode is bike and finished his bike ride climbing hill and dale then to top it off he walked into the ER.  People kept coming in to the examination room asking tons of questions.  I felt like saying, “And now for my next trick!”

The transfer service arrived and I was taken to the main hospital.  It turns out that I should have gone to that hospital in the first place.  It was closer to home, bigger, newer and it was rated as a trauma center!  In the ambulance as I was making small talk with one of the paramedics we rolled over railroad tracks that were not as smooth as they should have been considering their proximity to the hospital.  The spring response rate on the back of the ambulance catapulted me off the gurney.  Yes, I got air and then I slammed back down to the gurney!  I saw stars!  I had no idea we were approaching something so rough nor did I anticipate how painful my hip was now 26 hours after my crash.  Long gone were the endorphins, adrenaline and shock that helped me continue my hill repeat training session in moderate to intense pain.  Now it was all real-time pain!

Once inside the new hospital I was taken to a very nice clean private room.  However It felt as though we had taken the most circuitous route in getting to my room. Is this hospital that big?  Or are these guys lost? Down one corridor, up another, turn left here, turn right here ok U-turn the Greek myth of the Labyrinth came to mind.

As I mentioned before my room was nice, private and with a view of the hills in the foreground over-layed by mountains in the background.  Oh the hills…oh the mountains how long would it be before I would climb up from your feet to your lovely curvy roads, ride along your spine and descend, or free fall as I call it, back to bottom?

My bed was equipped with a bed sore prevention air mattress.  The first time it made an adjustment it scared the poop out of me lol!  What the heck was that? At the foot of the bed was a pneumatic compression calf sleeve system to keep the blood from pooling in my lower extremities.  I appreciated all the bells and whistles included with my bed but I had no intention of making this a long term stay!! I was here for a surgery and that’s all.  Yes, I was finally coming to terms with undergoing surgery.  But that also meant getting it done and getting out of here! I would be recovering at home thankyouverymuch!

Before I could be sent home there was this little issue of a fractured femur.  It’s hard to see in the picture provided.  I was taking a picture of the computer screen with my iPhone.  If you look real hard there are two little yellow arrows that point to the fracture.  The fact that it is hard to see is a good thing.  Something else to notice is that my femur is not “significantly displaced” ,in other words, the bone is still pretty much together.  This would explain why I was able to complete my hill repeat climbing ride, carry on with the rest of my day and not report in to a hospital for another 24 hours later.  The pain was severe but it would have been debilitating had the femur become displaced.

Here is another picture to help you understand my fracture.

Soon after arriving at the hospital my son found his way to my room.  He’s always been good with puzzles and mazes.  He gave me the “I told you something was wrong daddy” look that only a 9 year old can give you and make you feel completely ashamed of your false bravado antics over the last 24 hours.  I apologized for not respecting his opinion and said I would pay more attention to him next time.

I was now in a holding pattern.  Vital signs were taken yet again, questionnaire after questionnaire was filled out via verbal Q&A.  Being a healthy guy, except for this broken leg, I repeatedly answered “No” to the exorbitant amount and often redundant questions about my medical history.

“Have you ever had….?” or

“Have you ever experienced ….?”  and

“How often do you….?”

My answer was “NO” “NO” and “Never” I could tell that each inquisitor grew weary of my negative responses and the lack of juicy material in which to dig in deeper with follow-up questions.

Hours passed and I continued to be monitored while waiting for my Orthopedic surgeon and the Operating Room to become available.  Friday night is a business night at a trauma center.  I got bumped out of my surgery spot a couple of times for more serious life-threatening cases.  By now the pain was really getting bad.  I was offered Morphine but it didn’t do anything for the real pain and what little efficacy there was wore off rather quickly.  I resolved to dealing with the pain because surgery was going to take care of everything. I was also very hungry!  It had been at least 12 hours since my last meal.  Which wasn’t even a meal it was a protein shake earlier that morning about 8am because believe it or not I had intended on riding that morning so I didn’t eat breakfast.

Eventually my number was called and I was conveyed to the Operating Ward to be prepped.  As we said in the Marine Corps…Hurry up and wait!  More and more incessant questioning…haven’t we done this already? Didn’t you and the other nurse compare notes? Don’t you have anything original to ask me?

I could see it was getting more and more real now.  I was close enough to see patients removed from the Operating Room.  I was given a shower cap to contain my abundant coffee color curly locks and then we waited again.

Surgeon marking an “X” on my upper right hip

The surgeon came in and we confirmed together that it was my right leg that needed surgery. We joked but we both knew the serious nature of his question.  I was happy to have that question asked more than once!  He made an “X” on my right upper thigh.  The anesthesiologist, aka Sandman, was a funny little man.  He was full of jokes.  Maybe he was just giddy from being at the hospital a full shift and more, it was past 11pm and he was still working.  He asked how much I wanted to be put under.  I said “all the way doc!”  He said he would do a general and an epidural.  The epidural thing would freak me out later.  I guess I didn’t really understand what that was going to do to me.  Everyone was great.  I felt as relaxed as one could feel before undergoing surgery.  As the surgeon came in one last time to check on me he reassured me that he was going to fix me.

A few anxious minutes passed and then I got the nod.  I was wheeled in to the Operating Room.  I tried to take in all that I could.  I’m a curious fellow.  I didn’t get a chance to see much –  the Sandman had other ideas.  I asked him to make sure to tell me when he was putting me to sleep.  I want to see how long I could fight his venom.  He said “Now” and I don’t remember another thing after that.  His venom was much stronger than my willpower.

Part I

Part II

Part III

Part IV

You can learn more about anesthesia here.

In the next blog post I will talk about my surgery, my recovery and my first few days at home.

Hospital Experience Part II here

Red Eyed Vireo – broken wing

Headline: George “Red Eyed Vireo” Vargas suffers a fractured femur from a low-speed fall!

STORY CONTINUES HERE with Hospital Experience I

HERE for Hospital Experience II

HERE for Hospital Experience III

On Thursday Jan 2, 2014 I went out for a hill repeat ride.  There are plenty of hills close to my home in San Marcos, California.  Here is the ride link on Strava.  The plan was simple – do as many repeats as I needed to get 5,000 feet of gain.

Why was 5k of climbing the goal? New year– new challenge.  The previous day on 01/01/14 I created the 10K-1M club on Strava.    10K-1M is 10,000 miles and 1,000,000 feet of climbing for the calendar year.  1,000,000 feet of climbing may sound impossible but I did a little math and came to the conclusion that it more than doable.

If you break up the 1,000,000 feet of gain into weekly chunks it means 20K of gain per week.

I then thought 4 rides per week with each averaging 5,000 feet would get me to my goal.

Obviously some days you climb more and some days you climb less. Additionally, there are times I do training blocks of 5-7 consecutive days which facilitates hefty total gain numbers.  Like everything else the more you ride the less elevation gain you need per ride.  For example, if you ride 5 days a week then you only need 4,000 feet per ride.

If you are like most of my friends who ride 6 days a week you are looking at slightly over 3,000 feet of gain per ride.  Riding more days is crucial because now you can do a 50 mile ride that only has 3,000 feet of gain which is a much easier ride than a 50 mile ride with 5,000 feet of gain.

Or you can do the math for the whole year and not just on a weekly basis.

250 rides with 4,000 feet of gain that still leaves you 115 rest days or days to make up for the days you missed your elevation goal

or 200 rides with 5,000 feet of gain that still leaves you with 165 rest days or make up days for the days you missed your elevation goal

I believe 10K miles and 1,000,000 feet is achievable if you stay focused on the climbing aspect of the goal.  The 10K miles will come.

As a baseline I used my 2013 numbers which were 11,000 miles and 700,000 feet of gain.  I knew there were a lot of recovery rides on flatter terrain.  I also knew I hadn’t done my typical work-up in preparation for big climbing events.  These climbing sessions are often on Palomar Mountain with 11.7 mile 4,200 feet of gain repeats.

Ok back to the ride….

I left the house and headed towards San Elijo Rd.  It is a popular area where the locals go to do hill repeats.  I made a right turn onto Questhaven and headed towards a secluded climb that is quite challenging and offers fantastic views from its summit, the dead end climb of Valborg.  In the first 7.4 miles I had climbed 1200 feet. I was off to a good start with perfect weather mid- 70’s in January! Temperarture was rising quickly and I was starting to regret having worn my long sleeve jersey.

I was feeling good and warming up for the much harder hills still to come.  I began my descent from Valborg summit at a relatively slow speed.  People who ride with me know that I am a skilled descender …sometimes even fearless.  However, this day I was taking it easy.  As the grade leveled off my speed dropped and I thought it was a good time to reach in my back jersey pocket and grab some fuel.  I must have lost focus for an instant because the next thing I know I am hitting a speed bump with only one hand on the handlebars.  The front wheel jack-knifed and I went down with a solid thud no sliding just BAM! Where I hit the ground is where I stayed.

As you can see from the graph below my speed, blue line, was in the low teens.  My best guess from the data is that I was only going 12.6 mph.  Yep it was a low-speed fall.  When I tell people I broke my hip many assume I was hit by a car or was bombing down a mountain but it wasn’t that dramatic, glamorous or even remotely spectacular. I didn’t rip my long sleeve jersey nor my shorts! From the outside I looked whole… intact.

The next thing I want you to notice from the graph above is the long flat elevation line in orange.  Since this graph has time on the X-axis there is no elevation gain or loss while I was stopped in one place for that length of time.  When I fell I was on the ground for at least 2 minutes trying to regain my composure.  A motorist, rare on this climb, came by and asked if I needed assistance.  I thought I might as well try to get up so as not to worry him.  The pain was immense but bearable.  I stood up but realized I couldn’t stand straight up nor put all my weight on my right leg.  I leaned on my bike with my head hung low.  I knew something was wrong but I couldn’t discern where the pain was coming from.

A few more minutes elapsed during which time I kept assuring the motorist that I was ok and that I could get home once I got back on the bike.  I would like for you to look again at the graph.  You will notice the red line, Heart Rate, is pretty stable save for 3 distinctive spikes.  Each one of those spikes in Heart Rate represent an attempt to mount the bike by raising my right leg over the saddle.  Each spike also represents the intense pain I felt lifting my leg.  It was very painful but all I could think of was I need to at least mount the bike so I can ride home.

The third attempt did the trick.  I was now rolling down the rest of the descent.  It took a lot of effort to clip into my right pedal.  I ride Shimano Dura-Ace pedals.  They are competition level and have a very strong retention spring.  I ride the pedals with the retention spring tightened to their maximum setting.  I take for granted how easily I can get in and out of clip-less pedals 🙂

Once I was rolling, a few things became apparent straightaway.  Pedaling while standing was painful, more painful while seated, and very painful if seated and pulling up on the right pedal.  I made the junction of Questhaven and San Elijo, a left turn would take me home a right turn would bring on more hills.  I thought to myself that I just need to keep riding and “loosen up” whatever was hurting.  I made a right turn.  In hindsight, I should have made the left turn and gone straight home.  Instead I kept riding, kept training…what was I thinking?

I climbed San Elijo Rd to the firehouse 1 mile, 8:21 at 194 Normalized Power.  A far cry from the power I had intended on putting out today.  My threshold is 260 watts.  On these short efforts, fewer than 10 minutes, my training goal for the day was to climb them at 280-320 watts (4-4,5 w/kg).  It was difficult and painful but I all I kept thinking was I have to keep riding and this will feel better.  I had changed my goals for the day from VO2 Max work to just getting through the workout.  I hit the summit and descended down Twin Oaks Valley Rd towards Cal State San Marcos hitting a maximum free fall speed of almost 48 mph yay! It felt great not to pedal for a couple of minutes after the last 8 minutes of agony I had just endured.

For a split second, as I rolled over the summit of the climb, I doubted whether I should descend Twin Oaks Valley Rd into San Marcos.  I knew the climb back to where I was now would be much steeper.  I was gliding over the top at 10 mph.  I also knew this was the point of no return going down Twin Oaks meant I was going further away from home and adding another steep climb to make it back to my home.  Now coasting at 15 mph.  Once gravity took over,  and I started to feel mother nature pull me down the hill,  the speed increased almost exponentially on the 9% grade 20, 25, 30, 35 mph, more refreshing wind in my face, 40, 45 mph I just couldn’t resist the exhilarating feeling of the descent. Weeee!

I made a U-turn at Craven, the bottom of the hill.  I climbed the 1.6 miles, 15:42 193 Normalized Power.  The numbers were very disappointing but I had now given up on being able to produce power. There are 9% sections on this hill and they were very difficult, which is to say painful.  I thought maybe I was feeling better and I should keep going. Was I in shock?  Was the pain being overcome by my endorphins?

I was now back at the firehouse.  I descended a short hill and turned right onto the -steepest hill of the day, Double Peak. I could have easily gone straight and by-passed Double Peak. It is 1 mile gains 500 feet with pitches that are 15% or more.  The second half of the hill averages 11.4% and gains 300 feet.  My Normalized Power was 219 watts.  It wasn’t my intention to put out 219 I was quite happy in the low 190’s but that’s just what you need to get up the damn steep thing! This climb was very difficult and very painful.  I was being stubborn and trying to use good form so I insisted on pulling up on the pedals on the 15% grade and that shot the pain factor through the roof.  After a few pedal strokes of that nonsense, I just stood up and climbed the remainder of the hill standing. Surely, if I could ride and climb 15% grades standing I can’t be hurt that bad right? This was my inner dialog,  justifying my need to finish the training ride.

I descended off of Double Peak made a right turn onto San Elijo Rd.  I had a short descent and made a right turn onto Wild Canyon Rd. Another hill I could have by-passed and headed home.   I climbed the short hill until it made the junction to Double Peak but decided I was now in too much pain to climb that steep sucka again.

I was running out of steam, as in motivation to train, or loosing focus on blocking out the pain.  The pain of my right leg was not diminishing.  In fact, it was becoming more and more pronounced.  My pedal mechanics, which I pride myself in working towards having a fluid supple style, was now reduced to a herky-jerky square, not a smooth circular pedal stroke no it had become an unsightly mess.  I was no longer sitting squarely on my saddle.  Instead I was favoring my right hip.  I knew I had just enough pain tolerance left in me to get me home. Earlier, just after the crash, the pain continuum spanned from discomfort to extreme pain.  Now that I made the decision to turn for home discomfort was no longer on the scale.  Now that scale had been reduced to only the top tier, extreme pain to holy shit I better get home or I will flop right here on the side of the road pain.  There wasn’t anything I could do to avoid pain.  Just sitting on the saddle and hitting cracks and road imperfections were shooting sharp pain signals to my brain.

As I approached my driveway I realized I had not disengaged my right leg for the last 1.5 hours since the fall.  I now became very aware that I had a major hurdle to overcome –  unclipping from my right pedal.  I hadn’t considered how much pain making the twisting motion required to get out of my pedal was going to cause.  I tried and tried but the pain was too much.  Finally, I made a major effort and let out a loud grunt and was able to disengage from my right pedal. Wouldn’t it have been easier to just loosen up the straps of the shoe, remove my foot and leave the shoe attached to the pedal?  Yes of course! But remember in my mind I didn’t think I was really injured.

Graph of ride AFTER the crash– Little did I know I had just ridden 16 miles, 2200 feet of gain and 1.5 hours on a fractured femur.

You know what the funny thing was?  I was denial.  I got home grabbed some ice and Ibuprofen.  Someone had just recently told me that taking Ibuprofen helps with swelling and therefore helps the healing process.  I thought if I started icing straightaway I would be ready to lead the Saturday morning REV Cycling team ride.

I carried on with the rest of my day running errands for the business (bank, post office etc) and spending time with my son.  I was in complete denial until my son noticed that I was in extreme pain just getting in and out of the car.  Why does it take a 9 year-old to tell you something is seriously wrong? “You should get that checked dad”

I fell asleep early that night about 8:30 pm which is very rare for me.  Did I pass out from the mental exhaustion of putting my pain aside?  The following morning I couldn’t get out of bed.  I had to lift my right leg with both hands because the pain moving my leg with it’s own muscles was unbearable.  I always gauge the progress of my recovery from a hard workout the previous day by those first few steps.  The pain and stiffness had intensified overnight.  This was NOT good.  I got my son ready and then drove him to camp.  When I returned home I was still thinking – “I need to ride to loosen this thing up” I knew that I could barely walk from the pain but I remembered from yesterday that being on the bike wasn’t nearly as painful as walking.

I stood in the garage looking at the bike I remembered how difficult it was for me to straddle and dismount the day before.  I remembered how painful it was to “unclip” as well.  I stood there for minutes thinking about how to avoid the initial pain of getting on and off the bike. “Once on the bike the ride will be fine”, I reasoned.  Fortunately, this inner dialog of justifying the need to ride with the reality of “there has to be something wrong” came to a sensible end.  The rational part of my brain finally said “uncle” and made a convincing argument to take my irrational self for a trip to the ER and have an x-ray taken. Would you believe I drove myself to the hospital just thinking I would get my leg checked out and be released with some pain meds?

The x-ray confirmed that I had a subtle subcapital fracture of the femoral neck. Amazingly it was not significantly displaced even though it had been 24 hours since the fracture and I had ridden and walked on it.

Thank you for reading my blog.  In the next blog post I will talk about my hospital experience.

First Century since Furnace Creek 508

I went out for a century. I hadn’t done a century since Furnace Creek 508 Oct 4. As many of you know my right thumb was fractured on Oct 30. I was off the bike for 3 weeks straight. Then I did 4 rides here and there with a total less than 150 miles in the last 3 weeks. It was not pretty but I got it done. My legs were shot around 70 miles and I had to limp home. It was 104 miles with only 5600 feet and I was pooped. Oh and I have also gained 6 lbs in the last 6 weeks.

Entire workout (137 watts):
Duration: 6:44:40 (7:03:41)
Work: 3202 kJ
TSS: 462 (intensity factor 0.843)
Norm Power: 186
VI: 1.36
Pw:HR: 15.56%
Pa:HR: -4.27%
Distance: 103.917 mi
Min Max Avg
Power: 0 697 137 watts
Heart Rate: 94 194 156 bpm
Cadence: 29 174 79 rpm
Speed: 0 40.9 16.0 mph
Pace 1:28 0:00 3:45 min/mi
Hub Torque: 0 411 68 lb-in
Crank Torque: 0 904 149 lb-in

Riding again…

Well not like before. But I have taken a few short rides. According to my surgeon I should not be riding for at least another three weeks. And even then I think he will not allow me to ride. I don’t blame him it is still very painful to use my right hand. When I ride I hold my left shoulder with my right hand (the busted one).

There is actually a lot of benefit to riding this way. Firstly, I am working on my riding skills. Secondly, I am able to focus on using my core to hold my body up and straight. I ride without a lot of pressure on my left hand. Thirdly, I focus on producing all power from good pedal mechanics. Pushing and pulling up on the pedals without the aide of my hands and arms pulling on the bars. Fourthly, I am doing my climbs seated and really working on my climbing technique. You know the old saying when given lemons make lemonade!!

Here’s what I have done lately:

Saturday November 22– 55 miles with 5000 feet of climbing (with a client)
Sunday November 23—60 miles with 2000 feet of climbing coastal ride
Thanksgiving Day..27—30 miles on my Fixed Gear 49 x 16 (81.5 GI) coastal with Brandy
Sunday ..November 30—30 miles on Fixed Gear 49 x 16 (El Chart below)

Where typically I would be doing 250-300 mile weeks this time of year I am barely getting 100 per week. My first event is the SAN DIEGO BREVET SERIES 200KM ON JANUARY 3, 2009.

A little more surgery stuff…

I went in on Thursday Nov. 6th. They put a T-plate and four screws to secure the bone fragments to help them mend properly.

The good news is the hardware will lessen the time off the bike. The doc has tentively revised the time to only 6 weeks off the bike with one week down already.

The bad news is he likes to take plates out. That means that in 6 months to a year I will have to undergo another surgery to take it out and a little more down time. In true Brandy fashion, as he was telling us all of this, she blurts out “Can we wait until next October, after Furnace Creek 508?” That’s my girl, always looking out for me. LOL.

Pre-op appt

Brandy and I walked out of our home today and saw the wonderful and serene sight of a rainbow. It really started my day off on a positive note.

Doc Altman. This gentleman set my thumb in the ER and did my pre op this morning.

I went to my pre-op appt today with the doc that treated me on Wednesday night. We went over my vital signs, a questioaire and the risks involved. I signed my consent and I was sent on my way. I guess I’m healthy base on the blood pressure. Of course they put the cuff on as soon as you sit down from walking in from the waiting room. My pulse seems high.

I don’t think it takes an experienced medical professional to see the difference between the first (bad) x-ray and the second (better).

My doc says I will be operated on by the best hand surgeon in the Southern Cal Kaiser network. I think they HAVE to say that. Imagine my discomfort after being told that I will be put under the knife of the worst hand surgeon in the network