My Long-Term Recovery Begins Anew

I used to write a blog about my love of randonneuring and the many joys it brings me as well as the challenges and obstacles I face as a parent and a professional maintaining a sense of balance and harmony in my busy life. Well, looking back at the past year, it seems like I've been losing the battle. Two posts in 2018 . . . ugh!

This has been a hard year for sure. Most dramatic and upsetting was the decline and then death of my dear father-in-law whose long fight with cancer was both an inspiration and a frequent distraction. With family in need far away in New England, my wife and I spent many weekends on the road this year and rarely with a bicycle. All things considered, I would not have spent my time differently, but trying to maintain a training and event schedule in the face of constantly changing needs left my head spinning more than usual and led to the cancelation of multiple riding plans with only short rides on Block Island on many a weekend.

While I rode more than I blogged in 2018, my riding declined rather dramatically as well, not only due to conflicting obligations but also as the result of gradual physical changes I've been facing in recent months that made riding more challenging and less enjoyable than in years past. As I have discussed before, I was diagnosed with avascular necrosis in 2015, a byproduct of the 2010 crash in which I originally broke my hip (and 24 other bones) while riding in the Endless Mountains 1000K.

This year I was not able even to muster a simple super randonneur (SR) result despite the best-laid plans . . . In fact, all I completed was the Atlanta 200K, the Bash Bish 300K, the Portland-Boston 400K, a few 100Ks, and a solo Catskill Climbfest 200K. I had sketched out such a lovely season, which was to be capped off by the epic Cascade 1200K I've been dreaming about for so long, but life, as they say, had other plans for me.

While my performance on the bike has declined in recent years, the issue that really got my attention was the increasing pain I felt in my left hip at first following and then during long rides. Randonneurs are remarkably adaptable and so it took some time for me to realize that I had been shortening, slowing and flattening my rides to avoid pain for some time. Finally, I determined that enough was enough and met with my surgeon to make plans. The only cure for avascular necrosis is to remove and replace the dead tissue so I consulted my calendar and scheduled a total hip replacement for a date this fall that would allow me enough time to recover and train for PBP 2019.

I'm pleased to report that the operation went very smoothly and ten days later I'm already well on the road to recovery. There are some significant differences this time around. I was shocked by how easy it was to stand on my new hip, for instance, the pain not nearly as dramatic as it was the last time I had to work through rehabilitation. I took a week off from work to focus on my recovery and can already see a light at the end of the (not too dark) tunnel.  

My surgeon tells me that I should be riding on a stationary bike within a few weeks and then back out on the roads within three months. This timeline seems perfect for a solid return to randonneuring in 2019 capped off with a strong finish at PBP, which is my concrete long-term goal. I've got spring rides reserved on the calendar and plans for plenty of winter base riding, strength training, and interval work.

It feels like a fresh start. More to come. Stay tuned!

Avascular Necrosis: Two Words I Really Did NOT Want to Hear at the Doctor's Office

Well, the dreaded day has finally arrived. I was just diagnosed with a case of avascular necrosis of the left femur. While I knew this was a possibility, I was hopeful that I would be able to hide among the 70% of hip fracture patients that do not wind up in this category.

Avascular necrosis is a fancy way of saying bone death due to blood loss. In my case, the condition is the result of a femoral neck fracture I sustained when hit from behind by a car on a 1000K brevet in Eastern Pennsylvania in 2010. The femoral neck is the narrow section of bone that connects the "ball" of the femur with the rest of the leg bone and when mine was shattered the surgeon immediately put it back together with the addition of several pins and screws. [See lovely illustration below]. I've not regained the full range of motion I once had in my left hip, but pain has not really been a factor . . . until recently. Over the past year, I've noticed a subtle weakening of and soreness in my left hip that's particularly evident when I get up from sitting in a soft chair or the driver's seat of my car after a long drive. I haven't yet developed a pronounced limp, but increasingly it takes me a few steps to sort things out.

In cases of avascular necrosis, the bone slowly dies as the result of inadequate blood circulation. There's nothing to be done to slow, stop or reverse the process and eventually, the joint will simply collapse into more of a "block and socket" than a "ball and socket." The great news here is that my cycling is not dramatically affected and does not contribute to making the condition any worse. The bad news is that it's only a matter of time before I will need a total hip replacement. So what's next? Well, my orthopedist suggests that I continue to live my life and enjoy my time on the bike with the addition of some strengthening and stretching exercises to keep things strong and limber. I'll be heading back for a follow-up visit in a year unless I notice any dramatic changes and it may be 3-5 years (or longer!) before I need a new hip.

My goal this year is to continue to strengthen my overall performance on the bike. I hope to build greater endurance, speed and climbing fitness with the overall goal of strength and comfort rather than a podium finish. Floyd Landis may have been able to win the Tour de France on a broken hip, but I'm shooting for something a bit less dramatic (and less drug-fueled). While I was hoping that 50 was going to be the new 30, at least it looks like won't be the new 70.