To Hell With Them All

I will never again follow professional cycling. I more or less swore off of it after the Floyd Landis debacle last year, and have reaffirmed my commitment to stop caring as the doping scandals have multiplied this season.

They all cheat, they're all dirty.

Now, if cycling lifted the ban on all illegal substances and doping practices tomorrow, I'd be fine with that. On the flip side, if they increased the doping penalty to a lifetime ban, I'd support that, too. One way or the other. What's going on now is not working, and nobody benefits from it.

I suspect this will be the first of very many years that I don't follow the Tour de France or any other European pro race at all. Screw 'em.

Hitting Close To Home

I'm still on the recovery path from my knee as it slowly heals. I'm not riding outside yet, but my trainer efforts in the gym are now fairly long and intense.

But as I improve, others in the local cycling community have also fallen prey to serious injury. A teammate of mine crashed during a training ride and broke her pelvis. Another teammate crashed hard in a race and had to seek medical attention for serious back pain. Worst of all, a long-time riding buddy of mine (from another local team) was struck by a car and seriously injured. He's stable and fully functional, but has sustained numerous broken bones and deep lacerations that will take surgery to repair.

My dislocated knee and subsequent surgery don't seem so serious anymore. To everyone I've ridden with who is now laid low by injuries worse than mine, I wish you all speedy recoveries and a quick return to the bike.

Stick A Fork In Me

I'm officially done following pro cycling. Forever. Every single rider of any consequence is slowly but surely admitting to or being accused of past doping offenses. Many are suspected of currently doping, even as the scandals multiply.

The simple truth is this: pro cyclists cannot be competitive without EPO and human growth hormone---they cannot rely on their own physical conditioning and mental preparation to deliver them victories in races. It is a constant race to the bottom, as new riders find themselves forced to dope just to compete with the veterans and maintain their contracts.

Jan Ullrich, Ivan Basso, Floyd Landis, Lance Armstrong and all the other stars have been or will be implicated in doping scandals. The accusations, denials and counter-accusations will only multiply from here.

Why follow a sport that cannibalizes itself by forcing its stars to cheat and then destroying their names and banning them from competition when they are caught? Even professional baseball isn't this despicable.

It's a shame, but this will be the first year since 2001 that I haven't watched the Tour de France. Why bother? Will any great riders be left to compete? Are they even truly great riders?

I'm done.

Progress Report

Slowly but surely, my left leg is recovering from the trauma it has endured over the past month and a half. I am now walking without a limp and can even muster a couple of jog-like strides when crossing a street with oncoming traffic. I still wear my knee brace everywhere but in bed, but I'm not in any significant pain and only the most strenuous activities cause discomfort in my knee.

Yesterday I was able to pedal for ten pain-free minutes on one of the stationary trainers in the gym. A couple of days before I could only handle five. Every once in a while a pedal stroke will cause sharp pain in my kneecap, but for the most part I can spin at a reasonable pace (80-90 rpm) without wanting to stop immediately.

While the pain and discomfort (and the swelling) have subsided, the sorry state of my left leg has become more apparent. The injury, surgery and subsequent physical inactivity have significantly atrophied my once-impressive quads. What remains is a skinny, asymmetrical waste that barely passes as an adult limb. Compared to my other leg, the difference is striking:



Please disregard the fact that I naturally have chicken legs and focus instead on the difference that is obvious in the photo. My right quad is much larger than the left, and my left knee is still somewhat lumpy where the knee scopes and cartilage removal incision have left small scars.

So it's now been about seven weeks since my initial injury and almost four weeks since surgery. As is obvious, rebuilding my muscular strength is going to take time. Rebuilding my aerobic strength won't be as difficult, but it will take time as well. I highly doubt I'll reach competitive form before the racing season ends. I'll give it my best shot, though.

Tomorrow it's back on the trainer and hopefully next week I'll be in good enough shape to actually ride my bike outside for the first time since April 3rd. That would be awesome.

Moving About

My knee has steadily improved since surgery a week and a half ago.

The days immediately following the procedure were rough, with a lot of pain, a lot of pain medication, and a lot of lying around. And still I was on crutches.

Two days after the month anniversary of the original injury that reduced me to a crippled waste, the orthopedist evaluated my post-operative progress. All is good, he said, and promptly removed my stitches. Of the five, only one hurt.

I've had my right kneecap completely covered in tattoo ink, and I know how bad that region of the leg can hurt when subjected to repeated injections by vibrating needles. It's not fun. But the removal of one stitch at the very top edge of my left kneecap put the tattooing to shame. I thought for a second I was going to die, seriously.

I take pain pretty well, and try to avoid pain medicine whenever possible. I fancy myself a tough guy when it comes to hurting. This was more than I've ever felt in my life, no joke. Luckily it only lasted a few seconds and the final stitch was out of my leg for good.

The doctor then brought me the best knee brace ever invented, because after getting the thing on (which felt GREAT after the stitches were removed), I strolled out of the office like it was nothing. For the first time in over a month, I didn't need crutches to walk.

The feeling of liberation is hard to describe.

I've been walking again for four days now, and though my leg is still extremely weak and sore, and there is still some odd swelling, I feel much better. I cannot yet fully bend my knee, nor can I twist it or put an exceptional amount of weight on it, but the progress I've made is noticeable.

Because I can move around without crutches, I'll be making my triumphant return to the gym tomorrow. Upper body only, of course, but it's a start. I'm dying to be back lifting weights again after losing a full month to this injury. I will be resigned to machines only, though, since I can't carry any kind of weight and therefore won't be able to load the barbells to work out with free weights for a while.

When I'll be able to start riding again, I have no idea. I can't yet complete a full pedaling motion with my leg, and putting that much pressure on the limb hurts too bad anyway. Hopefully soon I'll be back out on the road. We'll see.

The Cutting Room

This past Wednesday I finally had surgery on my utterly-destroyed left kneecap in the form of knee arthroscopy. I can't say it was incredibly fun, but it was interesting to say the least.

The pre-op processing went extremely quickly, as I was in the pre-op room being interviewed by a nurse and an anesthesiologist just ten minutes after my scheduled arrival time. They seemed surprised by my low heart rate (it hovered around 45-50 bpm on the various vital signs monitors I was hooked to throughout the day) and by my request to remain conscious during the surgery. Apparently, most people are all-too willing to be knocked out, and they weren't used to someone saying "I wanna watch!".

It took a while to finally get in the OR, but once I did, things moved very quickly. Another anesthesiologist, a deadpan Asian doc with a great sense of humor, gave me the spinal injection that reduced my legs to lifeless stumps and my surgeon went straight to work. The insertion of the scopes into my knee was a little disconcerting, because I felt the pressure if not any pain. A few times he moved my kneecap around and brushed my femur with the scope and I got a little queasy. Other than that, it was smooth sailing.

I was able to watch the whole procedure on a TV screen next to me, and got to see all of my ligaments, tendons and leg bones in high definition. My surgeon explained everything he was doing and specifically pointed out what we were looking at on the screen. It was all very fascinating.

He pulled out a huge chunk of cartilage from my kneecap that had broken loose when I initially dislocated my joint, and granted my apparently strange request to take it home with me. I now have a chunk of cartilage in a little cup. I'm so proud!

I spent the rest of the afternoon in various recovery rooms trying to regain the feeling in my legs and trying not to piss myself, since I was dead below the waist and helplessly subject to nature's various whims. Eventually, five hours after the operation, I was cleared to go home.



Now, several days later, my knee is still a bit swollen and my stitches (three entry points, three small cuts) are a little gross-looking. I'm regaining mobility each day and I'm off the Percocet. I couldn't wait to get off of it. It didn't make me feel euphoric or happy or at ease---it just made me feel dizzy and disoriented, and totally uninterested in getting out of bed.

I guess I'll never be a drug addict.

My surgeon will remove the stitches a couple of days from now during my follow-up appointment and we'll begin outlining a rehab program. I've already lost a month to this injury and I'm ready to start walking, riding and working out, just like the old days. If I never see these crutches again, it will be too soon.

Countdown

So the date of my knee surgery draws nearer. I'm not nervous about the actual procedure or the subsequent pain I'm sure to endure, but I can't shake this nagging feeling that my knee will never be the same as it was.

I'm not an anxious person, and I'm not a worrier. In fact, if anything, I tend to blow things off too often, even when they're important. I roll with the punches, go with the flow, float like the wind, etc. But thinking about my knee I just can't relax.

The swelling has subsided considerably, and I've regained a significant range of motion. I can now almost fully bend my knee and there is no longer a dull ache to the joint. That dull ache has been replaced with very sharp pains any time I move my leg in the wrong direction or try to walk on it. The pains are very localized and very specific to the area around my kneecap.

That's what I'm most worried about---my kneecap. I've heard that once you dislocate your patella, the chance of it slipping out of place in the future is increased considerably. I can't imagine getting hurt again. Just thinking about the sound my knee made when it gave out and the pain that it caused makes my stomach turn, and the idea that it could happen again at any time scares the crap out of me.

I've never had an injury like this before. I've never broken a bone (other than a toe or two), never been seriously cut and even the crashes I've had on the bike were nothing more than bruises and road rash. My knee is different. It's serious. It requires surgery.

All I can do is recover from the operation and begin a rehab program, and be serious about it. And above all, be careful. I can't imagine my life without weight lifting and bike racing, and a damaged knee could compromise both of those pursuits. I'll do whatever it takes to come back fully fit and stronger than ever. I have to.

I'll drive myself crazy otherwise.

Finally, A Diagnosis

After two weeks of hobbling around on crutches, still unsure of the extent to which I damaged my left knee, I finally saw the orthopedist to follow-up on my MRI scan.

The diagnosis is much better than I had feared. No torn ligaments, no severe damage, no broken bones. To get a good idea of what I've got going on in my knee, I'll share with everyone my MRI report:

There is a large joint effusion with fluid observed in the medial gastrocnemius-semimembranosus bursa.

Translation: I have fluid in a pouch behind my knee joint as well as in the front. I could have told them that.

Full thickness cartilage defect measuring about 16mm in transverse dimension is observed at the patellar apex and medial facet on the axial series. The displaced cartilage fragment lies adjacent to the lateral side of the lateal femoral condyle. The displaced cartilage fragment measures about 14 mm in AP dimension and about 2 cm in craniocaudal dimension.

Translation: I knocked a chunk of cartilage loose when I dislocated my kneecap, and that sucker is still floating around in my knee. It's big.

There is marrow edema in the inferior pole of the patella medially. There is also marrow edema along the lateral aspect of the lateral femoral condyle with a little depression in the lateral distal femoral cortex.

Translation: Marrow edema is a common result of joint trauma, and indicates that I did indeed screw up my knee. There is marrow edema in multiple locations of my knee joint where trauma occurred.

The large joint effusion distends the joint and the patella is positioned slightly more lateral than usual. However, frank disruption of the medial retinacular complex is not appreciated.

Translation: The fluid causing my knee to swell is limiting my mobility. Duh. Also, my kneecap is just a tad out of place due to the pressure of the swelling, but overall the extent of the damage is not that severe.

But the most important observation, as far as I'm concerned:

The cruciate ligaments, collateral ligaments, quadriceps mechanism and muscles and tendons all appear normal. The medial and lateral meniscus both appear normal. Cartilage in the medial and lateral compartments is preserved.

Translation: I didn't tear my ACL, my MCL or any other ligaments and I don't have meniscus damage. I can't express in words how relieved I am to know that.

The bad news is that I'll still need surgery, though, to remove the chunk of cartilage that is still floating around in my knee causing pain and swelling. Luckily it will require no more than a small incision and arthroscopy, and won't result in a huge nasty scar like ACL surgery might.

I'm scheduled for surgery next Wednesday morning. After that I begin rehab and work toward getting back on the bike. With any luck I'll be able to make the Madison Cycling Regatta in Madison, Indiana in mid-July. I love that race, I'd hate to miss it.

More updates to come, of course.

O'Grady Finally Wins Something

photo courtesy Luc Claessen

I must admit that since Floyd Landis' major screw-up in last year's Tour de France, I haven't really been following pro cycling at all. It's almost impossible anyway, with half of every article written about the pro peloton being about drugs and scandals, rather than the actual racing.

But watching Stuart O'Grady finally win something, and win Paris-Roubaix of all races, and win it BIG in a solo break, was really impressive. I'm sure by next week he'll fail a doping test and be banned for four years, but in the meantime, congrats to him. He's always been a tough racer and never, ever gives up, and it's high time that his dedication to the sport received a prize like the cobblestone trophy from the Hell Of The North.

Good work, you Aussie bastard.