Posted in Concussion, Concussion Recovery, Injury, Life lessons, Mental Health

Denial – Why is it so hard to overcome?

From almost the moment I suffered my MTBI until to day, why have I had such a difficult time in admitting that my braining is not functioning properly? Although I am consistently getting better, why is it so hard for me to accept that I am still struggling in some areas and to come to grips with that reality? Denial doesn’t help me heal. All it does is hide my reality from those who are around me. And as one can imagine, that isn’t the best course of action.

At this point, my only goal for 2022, is to accept the fact that my recovery is taking longer than expected and go give myself the time and space to fully recover. No matter how long that takes.

Posted in Concussion, Concussion Recovery, Injury, Life lessons, Mental Health

Its “Only” a concussion

Looking back to the day of my injury, I can recall these words going through my my mind:

“Thank goodness its only a “mild” concussion and I don’t have any broken bones.”

At the time it seemed like a reasonable thought. But now, almost 3 months after being struck by the car, I would probably look at things a bit differently. At the time, I was not very familiar with concussions, concussion symptoms and the recovery journey. My limited experience was based on a concussion my 20-year old son experienced when he was 11, a concussion my 31-year old daughter experienced at 21 and a concussion I experienced nearly 30-years ago. My son and I recovered rapidly and were back to our “usual” selves in a week or so. But with my daughter’s concussion, the affects lingered for months and had a profound impact on her senior year of college. But as I am won’t to do, I figured if the Doctor told me my concussion is “mild” my reaction is to think, “how bad can this be?” and to believe that I will be fully recovered in a week to ten days. My biggest concern at the time was how long it was going to take for the swelling in my leg to subside.

Before I go on, I am going to step back a bit and look at some things that define a concussion. These definitions are taken from the CDC website, https://www.cdc.gov/headsup/basics/concussion_whatis.html

“A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.”

Also,

“Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.”

Think about that for a moment, a concussion is a traumatic brain injury and is only defined as a mild because the symptoms are not life threatening. Concussions may not be life threatening, but they can be life altering so from that perspective should they be considered as mild? The final sentence of the paragraph sums it up, “the effects of a concussion can be serious.” Based on what I now know and what I am experiencing, all concussions are serious and need to be treated as such.

I know my perspective on concussions have changed over the course of the last 3-months. But, this has all been for the better as I have educated myself and embarked on my healing journey.

Posted in Concussion, Concussion Recovery, Injury, Life lessons, Rehabilitation

Sept 7, 2021

The day things changed

September 7th 2021 started out like just like any other warm September day. The sun was out, the temperature was not too warm and there was a gentle breeze to really keep things comfortable.

As I was finishing up my workday, I looked out the window and asked myself:

“What do you want to do today, ride or run?”

Since I had not been running much recently, I decided that today was a good day for a run. Looking back with 20-20 hindsight, it was NOT A GOOD Day for a run.

I went upstairs got changed into my running gear, came downstairs, pulled on my running shoes and headed out the door. The first 2-1/2 miles of the run were uneventful. I passed some people on my local trail and was thoroughly enjoying the run. In a matter of moments, things would go completely off the rails.

The last thing I remember from the run was passing a lady who was out walking her dog and thinking “That is a cute little dog!” which is completely out of character for me.

The next thing I know, I am flat on my back in the middle of the road, with blood dripping out of my head and have EMT’s and the police asking me what seemed like a million questions. Since I had no idea what happened, they shared with me that as I was crossing through an intersection a car came around the corner in the wrong lane and hit me. Fortunately for me, there was a witness who gave a description of how the crash occurred to the police while they were on scene. To this day I still don’t know if my head wound was from hitting the windshield of the car or from hitting the ground, but in the long run it really doesn’t matter.

Yes, getting the staples put in hurt.

As I got some awareness of what was going on, I tried my best to figure out how badly I was hurt. I quickly determined that I could move all of my extremities, so I wasn’t paralyzed. That was a relief. I also concluded that since I could think and speak, my brain was reasonably intact as well. That turned out to be not quite so correct, but there will be more on that later. I could see the cuts, scrapes and a big bruise forming on my leg, but since there were no bones sticking out, I guessed it wasn’t too badly hurt. However, I found out later, the injury was a bit more significant than I originally believed.

Can you say – Morel-Lavallée lesion – a closed degloving soft tissue injury, as a result of abrupt separation of skin and subcutaneous tissue from the underlying fascia. 

The Riverdale Park, MD EMTs did a great job in caring for me. They responded to the call in a matter of minutes, and then had me prepped for transport and delivered to the Washington Hospital Center Trauma Unit in less than 25 minutes. One of the EMTs was even kind enough to turn off my Garmin when I asked her. Great customer service.

The first thing that happened at the hospital was the ceremonial “Cutting Off of the Clothes”. Before they started, I asked: “Do you really have to cut my clothes? Can’t you just slide them off?” I knew they couldn’t do that, but I figured it didn’t hurt to ask. Anyway, replacing my running gear wasn’t a big concern at the time.

Then they proceeded to do a concussion screening and the normal battery of tests, x-rays and CT scans. All of these came back clean with no broken bones or bleeding in my brain which was a great relief. While I was waiting for the all this to start one of the Doctor’s asked: “Is there anyone you want me to call?”

I said to him: “No, but if you can hand me my phone, I would like to call my wife, if that is OK. I would prefer to call her myself, it would be better?” With that he was relieved and handed me the phone saying: “Thanks. I really don’t like making those kind of calls.”

The phone call to my wife went something like this:

Hi honey are you home?

No, I’m not. Are you?

No, I am in the hospital. I was hit by a car while I was out on my run, but everything seems to be OK. I am about to go for X-rays and a CT scan.

What? Hit by a car? Are you OK?

Yes, I seem to be fine. I have a big laceration on the back of my head and a bunch of cuts and scrapes on my leg, but other than that I think I am OK.

What happened?

I have no idea. I am missing about 5 minutes of my life. From what they told me as I was crossing the street, a car hit me.

Wow! That doesn’t seem good. Is there anything I can do?

Not really. Because of COVID only patients are allowed in the hospital. So I can call you when I am done. I love you and will talk to you later.

About four hours later I called my wife to come pick me up with five shiny new staples in my head and diagnosis of a “mild” concussion. I was shocked that they didn’t even give me a wheelchair ride to the door, they had me walk myself out to the waiting room. Not good customer service.

The Strava title for the day sums it up nicely.

Stay tuned for more. . .

Posted in Injury, Rehabilitation, Training

Training Nov 19-25

This was not a good week for me to pick to start reporting since my plans needed to revolve around traveling for the Thanksgiving holiday. This meant driving to Virginia on Wednesday and spending time with family until it was time to travel home on Friday. But, nonetheless, it was better to spend the time with my family rather than worrying about missing workouts. There will be plenty of time to make up for the missed workouts, but, you can’t make up missed family time.

Even with two days out for the holiday, I was still able to get five workouts in for the week. This isn’t too hard when your long workout for the week is just over 1 hour. That makes it pretty easy to make time in the day for a workout.

What was good about the week was that I was able to stay fairly true to my goal of easy aerobic workouts. The big column in the chart below represents the time in Zone 2 – what I am defining as my easy, aerobic pace and was where I was 54% of my time. The next bar is slightly higher in intensity and encompassed about 18% of my time. And in reality most of the time in Zone 3 was probably close to the Zone 2/3 border.

Training Nov 19-25

So what did my training look like for the week?

On Sunday, I thought I would start off with a fitness test – 30 minutes on the Concept 2 erg, shooting for max distance. I ended up at 7338 meters. The workout also included about 10 minutes of warm up. Cool down consisted of lying on the ground, gasping for breath. This workout was what gave me time in the two highest intensity zones in the chart above. My average HR for the effort was 167 and my max HR was 178, not bad for someone who’s measured max HR is 187.

Monday was 50 minutes on the elliptical trainer. I did intervals of 1 minute above threshold and 7 easy minutes.

Tuesday was an easy run. I went for 3 miles which was above the 2 miles I had planned, but my foot felt good so I added in some extra distance. The run was slow 9:28 pace but my HR stayed in the desired zone. This was a big win.

Wednesday and Thursday were off days, which was a good thing. My foot was a bit achy from the run on Tuesday.

Friday was another easy paced run, 2.5 miles at a 9:33 pace and once again I kept my HR spot on in the aerobic zone.

Saturday was an indoor aerobic circuit day of the elliptical trainer, inclined treadmill and erg. I did 2 circuits through with 10/10/12 minutes on each. I kept my HR low until the final time on the erg and then I let in creep up into Zone 4. All in all it was a great workout.

So I had a successful week of training. During the upcoming week, I am going to add a little bit to the duration of my workouts while keeping the overall intensity low. For the week I had 210 minutes of training, including 5.5 miles of running, So for this week, I will bump this up to 230 minutes and about 6 or 6.5 miles of running. Slow and steady will win this race.

 

Posted in Injury, Rehabilitation, Training

Training Begins: Oct 30 – Nov 5

Week 1 is in the books and even though it wasn’t perfect it wasn’t a bad start either.

The chart below shows my training time for the week broken out into HR Zones.

 

Chart

My goal was to keep 75% of my efforts in my aerobic zone (TrainingPeaks Zone 2).  For me, this is between 132-143 bpm, based on a max HR of 185 and a resting HR 45. As I did these “workouts”, that range seemed VERY, VERY low and at times it was hard not to bump up into zone 3 or even higher. I kept asking myself:

“Are these really even workouts?”

It felt like I was out for a leisurely stroll on what ever piece of equipment I was using  This was especially true while I was out on my bike.

When I did the math for the week I came out to 180 total minutes broken down to:

  • Zone 1 – 27 minutes – 15%
  • Zone 2 – 93 minutes – 51%
  • Zone 3 – 37 minutes – 20%
  • Zone 4 – 20 minutes – 11%
  • Zone 5 – 5 minutes – 3%

Numbers which are not far off my goals. The main thing to do are bump up some of the Zone 1 to Zone 2 and scale most of the Zone 4 down to Zone 2. I will see how that goes in week 2.

But, my two takeaways from the week are:

  • My foot feels great: and
  • I am not sore even though it was my first training in six weeks.

I plan to continue with the non-impact exercises for the next couple of weeks and then begin to gradually reintroduce running to my program either the last week of November or the first week of December depending on how impatient I become to start running again. Then as I progress through December I hope to be back to a level where I can run an easy 5k by the middle of January. That seems like such a low goal, but at this point by goal is to aim low and succeed, rather than aim high and injure myself.

But in the end, it just feels nice to be active again.