As endurance athletes (yes, I am finally comfortable calling myself an athlete) we are constantly measuring ourselves by numbers: how many hours we have trained this week; what kilometre pace we have done; what average speed we achieved; what our splits are; how fast our transition was; how much we weigh; etc; etc. However, our performance relies on the power of words.
A lot has been written on the power of words and I am fully aware of the value associated with being a good wordsmith – after all I earn a living from words. But, it has only really been the last couple of months that I have realised the true power of words.
Words impact on an athlete’s performance in so many ways. At the Challenge Wanaka training camp in October, for example, Sam Warriner reiterated several times the mantras that she uses to power her through a race: ‘Long and Strong’ for her swim; ‘In the Box’ (and others) on her ride, and; ‘Quick Feet’ on her run. She repeats these simple expressions over and over to sharpen her focus. Geoff has also given me words to focus on while training and in the race and several of the websites that I have used (especially those relating to swimming – like Swim Smooth) have discussed the value of simple expressions that help improve and maintain good technique.
Recently I have also read that researchers in the UK found that athletes who used the swear words of their choice during training performed better than those who were forbidden from using any bad language. I tried this on my long ride the other day and I have to say, even if I didn’t perform any better, it made me feel better to swear at the top of my lungs as I battled my way into the gale force winds. I yelled the word five or six times and then just got on with it.
Conversely, words can be extremely distracting. I frequently have conversations with myself in my head when I am training, especially on long easy sessions. My mind will flip from one topic to the next in an instant. This became very clear to me on a run through Hagley Park when I was at a conference in Christchurch in November. Often the different strands of the conversation would overlap or one part would abruptly interrupt another. A typical 30 second section of the run went something like this:
Quick feet, quick feet. Shit it’s hot. Man I feel like crap today. Quick feet. Quick fe. She looks hot. I’m quicker than him. This surface is difficult to run on. Quick fee. Ahh, that shade is good. I wonder what the earth quake really felt like. Get out of the road you bloody idiot. I really have to concentrate better. There is a great blog post in all of this. Quick feet. Quick feet. I could start it like. I am gonna call it the power of words. Quick f. Shit my foot hurts.
This went on for the entire 30 minutes of the run and it was one of my worst of the year. The conversation just would not stop and I could not focus. I guess that is one of the things that sets top athletes apart from the rest. They can concentrate on a very narrow set of objectives and use simple mantras to become totally and utterly focussed on the task at hand. My problem is that I can only do this for very short periods of time (a few minutes, maximum) before my mind starts to wander. On my better training sessions and races, I am able to bring my mind back to focus relatively quickly by using those few key words, but I can never maintain it for an entire session or race.
I have also begun to reflect on when words become truly powerful. For me, words without action are vacuous and hollow. They lack meaning and passion. Perhaps that is why Challenge Wanaka is so meaningful for me. It allows me to put my words into action. Words that are simple, potent and powerful. This contrasts with the words that I use in my academic life, which are often complicated, convoluted and impotent. When I use words in training and racing their effect is immediately evident and gratifying, but when I lecture or publish even though I hope that my words have an impact, I may never see the impact that they have.
When and how words are delivered also has a huge impact on their potency. Even though Coach Geoff can tend to give me too much information at times (sorry Geoff, sometimes it’s overload for a rank amateur like me), the timing and use of words is brilliant at motivating me. Everything from a simple photocopied certificate posted to my home address that read ‘Congratulations on completing the first 20 weeks of training’. To a text that I received last night from Geoff, after I had informed him of the details of my latest training session, that read:
Jeez ur getting really fit. U are humming along nicely which is exactly what I worked out for ur training schedule. Get excited for the 15th because Richard Mitchell is fit and fast and ready to race.
Those words make all the pain and effort worth it and I will remember them on race day. When the going gets tough they will mean so much to me.
29 December 2010
28 December 2010
Mother Nature
It’s amazing how Mother Nature can change our perceptions of a place.
I’ve been in Hawea (near Wanaka) since the Monday before Christmas. I have set up an office in the lounge of my in-law’s holiday house so that I can work and I have been utilising the Wanaka community pool for swim training, hitting the Challenge course for riding and circulating around a 7km block in Hawea for my runs.
It’s been a big week with four rides totalling 376km, the biggest being 191.7km in just over 7 hours over the Challenge course (plus a little bit more). I did more than 21 hours of training between Tuesday and Sunday last week (including one rest day). Even in normal conditions this would have been a tough week, but there have been persistent strong northerly winds for most of the week (certainly every ride), making it the most unpleasant of training weeks yet.
I have felt pretty strong, albeit fatigued, all week but the wind is totally demoralising. Tail winds are fantastic! Yesterday, on the long ride, I was easily (and I do mean easily) maintaining 40-50km/hour downwind between Luggate and Cromwell. BUT, when I crossed the bridge over Lake Dunstan and turned into the wind, it was like someone had attached a huge parachute to my seat post and my speed more than halved.
I guess it is partly because it is so easy down wind, but is also definitely just the sheer veracity of the wind. My aero position simply becomes like massive scoop sucking in air that pushes against my body acting as an air brake. My cadence steadily slows and I have to chop down gear after gear and within five minutes I am pedalling furiously in a very low gear, going nowhere fast.
However, whether riding or running, it’s not just the physical impact on my effort. It saps my mental energy. The constant, deafening roar bombarding my eardrums makes it nigh on impossible to concentrate. The howling in the power lines emanates a sense of foreboding like a scene from a disaster movie. The browned-off grass in the dry summer landscape forms constant waves on the roadside that look like the powerful current of a fast flowing river and I feel like I have to battle against it. The normally placid lakes become angry with white-caps that smash the unsuspecting shores. This beautiful landscape somehow becomes hostile and inhospitable.
Despite all of this, I know that I run strong in the wind (my half marathon PB in October was run in one of these nasty winds) and my legs remained relatively fresh throughout my 190+ km ride the other day. I am feeling confident that, if/when the wind arrives I am ready to defeat it. I have trained in every type of weather this year: torrential rain, 32 degree heat, snow, frost and, more often than not, strong winds. I am ready for whatever Mother Nature chooses to throw at us on race day.
I’ve been in Hawea (near Wanaka) since the Monday before Christmas. I have set up an office in the lounge of my in-law’s holiday house so that I can work and I have been utilising the Wanaka community pool for swim training, hitting the Challenge course for riding and circulating around a 7km block in Hawea for my runs.
It’s been a big week with four rides totalling 376km, the biggest being 191.7km in just over 7 hours over the Challenge course (plus a little bit more). I did more than 21 hours of training between Tuesday and Sunday last week (including one rest day). Even in normal conditions this would have been a tough week, but there have been persistent strong northerly winds for most of the week (certainly every ride), making it the most unpleasant of training weeks yet.
I have felt pretty strong, albeit fatigued, all week but the wind is totally demoralising. Tail winds are fantastic! Yesterday, on the long ride, I was easily (and I do mean easily) maintaining 40-50km/hour downwind between Luggate and Cromwell. BUT, when I crossed the bridge over Lake Dunstan and turned into the wind, it was like someone had attached a huge parachute to my seat post and my speed more than halved.
I guess it is partly because it is so easy down wind, but is also definitely just the sheer veracity of the wind. My aero position simply becomes like massive scoop sucking in air that pushes against my body acting as an air brake. My cadence steadily slows and I have to chop down gear after gear and within five minutes I am pedalling furiously in a very low gear, going nowhere fast.
However, whether riding or running, it’s not just the physical impact on my effort. It saps my mental energy. The constant, deafening roar bombarding my eardrums makes it nigh on impossible to concentrate. The howling in the power lines emanates a sense of foreboding like a scene from a disaster movie. The browned-off grass in the dry summer landscape forms constant waves on the roadside that look like the powerful current of a fast flowing river and I feel like I have to battle against it. The normally placid lakes become angry with white-caps that smash the unsuspecting shores. This beautiful landscape somehow becomes hostile and inhospitable.
Despite all of this, I know that I run strong in the wind (my half marathon PB in October was run in one of these nasty winds) and my legs remained relatively fresh throughout my 190+ km ride the other day. I am feeling confident that, if/when the wind arrives I am ready to defeat it. I have trained in every type of weather this year: torrential rain, 32 degree heat, snow, frost and, more often than not, strong winds. I am ready for whatever Mother Nature chooses to throw at us on race day.
24 December 2010
A wierd place
Over the last few weeks, training has become a bit strange. It’s not that I am unmotivated; I have no problem getting out there and doing the work that Coach Geoff has set down in my program. But, sometimes, when I get out there I seem to be in a strange state of mind.
It’s really hard to describe. Sometimes, I feel a little lonely – as if I am going through this journey all alone, yet I know that many people have been along for the ride. Sometimes, I wonder what the hell I am doing – how dare I think that I am capable of this feat, yet I know I have put in the hard yards. Other times, I just want to get on with it – surely these last few weeks of training can’t really make that much difference?
While I know I am not just going through the motions when I train, sometimes I feel like I am, because I am so conditioned to do what is set out for me that I just get out there and do it. As a result I kind of feel that I am not putting in enough of an effort, even though the times I am doing and the way that my body feels I know that I am.
Does that make sense?
It’s kind of a wierd place to be and I wonder if I am the only one that goes through this in the lead up to an ironman or if this is what I am supposed to be feeling? I certainly haven’t experienced this before any other race that I have done.
It’s really hard to describe. Sometimes, I feel a little lonely – as if I am going through this journey all alone, yet I know that many people have been along for the ride. Sometimes, I wonder what the hell I am doing – how dare I think that I am capable of this feat, yet I know I have put in the hard yards. Other times, I just want to get on with it – surely these last few weeks of training can’t really make that much difference?
While I know I am not just going through the motions when I train, sometimes I feel like I am, because I am so conditioned to do what is set out for me that I just get out there and do it. As a result I kind of feel that I am not putting in enough of an effort, even though the times I am doing and the way that my body feels I know that I am.
Does that make sense?
It’s kind of a wierd place to be and I wonder if I am the only one that goes through this in the lead up to an ironman or if this is what I am supposed to be feeling? I certainly haven’t experienced this before any other race that I have done.
19 December 2010
Awesome day's training
I had a great race effort training session today. I did 3x 10 minute race effort swims in the harbour and got straight on the bike. For some reason my legs felt great after having been flat all week and I headed out at around 34-35km/h for a 90km ride. In the end I managed 33.1km/h and completed the 90km 10 minutes faster than the South Island Half Ironman (2:44:45 for 90.8km) and got off felling pretty fresh.
Then it was off on a 60 minute run at Ironman effort. My legs were feeling pretty fresh and I was able to easily maintain a steady 5:12-5:18 minutes per km (about 3:40 marathon pace). I know that I won't be able to mainatin that on race day, but it was a strong, relaxed effort. If I had done this at Ashburton, I would have been well under 5:40 for the race.
Yes, of course, this was all faster than race day pace, but I felt that the effort was about right to simulate race day. I hope I got it right!
Once again, Coach Geoff's training schedule seems to be coming through for me and I am starting to hit my straps (hopefully) just at the right time.
Then it was off on a 60 minute run at Ironman effort. My legs were feeling pretty fresh and I was able to easily maintain a steady 5:12-5:18 minutes per km (about 3:40 marathon pace). I know that I won't be able to mainatin that on race day, but it was a strong, relaxed effort. If I had done this at Ashburton, I would have been well under 5:40 for the race.
Yes, of course, this was all faster than race day pace, but I felt that the effort was about right to simulate race day. I hope I got it right!
Once again, Coach Geoff's training schedule seems to be coming through for me and I am starting to hit my straps (hopefully) just at the right time.
15 December 2010
Jacqueline in the news
Just in case you aren't sure who Jacqueline Wyatt is and how brace she is, have a look at this article from Campbell Live:
http://www.3news.co.nz/More-Christmas-magic-for-another-family/tabid/367/articleID/191038/Default.aspx
http://www.3news.co.nz/More-Christmas-magic-for-another-family/tabid/367/articleID/191038/Default.aspx
Radio Sport Interview December Update
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Thanks to Gracie Prodcutions for permission to post this interview that aired on Sport Lately (Radio Sport) 14 December 2010.
13 December 2010
Time to show we care
As I have already noted in this blog (see Giving Back), on 18 November 2010, 12 year old Blenheim girl, Jaqueline Wyatt, had her pelvis crushed by a large truck while she was riding her bike to school. She was fighting for her life for several days and now she is on the long, slow, painful road to recovery.
I have a huge amount of empathy for Jacqueline and her family so I have set up a page for you to sponsor me on race day. All of the money will go directly to the Jacqueline Wyatt Recovery Appeal Trust (which is headed by Jacqueline's School principal).
You can choose to donate an amount regardless of my result or I have a couple of options where you can incentivise me to go as far as possible in the race (a per kilometre sponsorship) or finish fast (sponsorship per minute faster than my (secret) target of 14 hours).
If you want to help, please go to the page that I have set up and complete the short sponsorship form or email me directly and I will tell you how you can desposit money into the Trust's account: richard.mitchell@xtra.co.nz.
I have a huge amount of empathy for Jacqueline and her family so I have set up a page for you to sponsor me on race day. All of the money will go directly to the Jacqueline Wyatt Recovery Appeal Trust (which is headed by Jacqueline's School principal).
You can choose to donate an amount regardless of my result or I have a couple of options where you can incentivise me to go as far as possible in the race (a per kilometre sponsorship) or finish fast (sponsorship per minute faster than my (secret) target of 14 hours).
If you want to help, please go to the page that I have set up and complete the short sponsorship form or email me directly and I will tell you how you can desposit money into the Trust's account: richard.mitchell@xtra.co.nz.
09 December 2010
In the press
I was recently interviewed by the D-Scene newspaper and they have syndicated it to their other papers. Despite some inaccuracies (i.e. the name of the race and the fact that I haven't yet spoken directly with the family), this hopefully the start of my efforts to give something back.
http://www.stuff.co.nz/marlborough-express/news/4439748/Recovery-tale-offers-hope#share
http://www.stuff.co.nz/marlborough-express/news/4439748/Recovery-tale-offers-hope#share
Sure beats Disneyland
My recent blogs may have painted a-less-than-rosey picture of my training over the last few weeks, but my time in Central Otago training on the Challenge Wanaka course was nothing short of mind-blowing. I have visited Wanaka several times a year for most of the past 25 years, but never have I experienced it like I did the weekend before last.
For some reason, while training all of my senses were heightened and every experience, especially the visual, filled me with awe. Perhaps it is because my view of the world was sepia-toned, filtered, as it is, through sunglasses and goggles: intensifying some colours and dulling others, magnifying contrasts and creating a painted world that would not look out of place hanging on the walls of some of the best art galleries in the world. Perhaps I am just 'in the zone'. Who knows and who cares? I just love that it has opened my eyes to a magnifcent place that I had begun to take for granted.
Here are some of the highlights (in no particular order):
I lie floating, weightless, in the early morning glow; soaring above diminutive sand dunes that sweep off into the distance in an endless desert. Ripples of light dance like a serpent across the surface of this vast, breathtaking wasteland. A glance to the left reveals golden shafts of light beaming down from the heavens. I pause and soak in the energy and then, in an instant, as my arm penetrates the surface of the lake, the peace and tranquility is broken and I begin my morning swim: energised and contented.
******************
A shimmering bay reveals itself below me as I cross the Lake Hawea dam. An iridescent, paua-shell blue, green and silver shimmers in the bright, bright light of the morning. The perfectly flat water somehow seems to be leaping off the surface of the earth; an abstract three-dimensional hologram - deep, sharp and crisp.
******************
Late in the evening in the half hour before sundown, clouds are floating along the ridges of the southern alps. To the west, the divine 'light of God' pierces the clouds like daggers. A real world reflection of the fearful depiction of the wilderness of a romantic landscape painting: imposing, scary and awe-inspiring. To the east, the light has an altogether different effect. Pure, soft, cotton top clouds billow up from a menacing saw-toothed ridge, appearing to be illuminated by a brilliantly white light from the inside: inviting, comforting and cuddly.
******************
Not only have the romantic painters been at work in this landscape, but the impressionists have applied their palette to this beautiful springtime scene. Renoir could easily have painted on the canvas of Glendhu Bay. Tiny ripples on the water disturb the mirrored image projected on to the bay and it is instantly transformed into a brilliant impressionist painting. Tiny brush strokes fade into each other, brilliant technicolour becomes muted water-colour. What was real now becomes imaginary.
Masses of lupins punctuate the roadside as if put there by Monet himself: every shade and hue of purple, pale and delicate through deep and moody. A brilliant contrast of colour against the harsh, inhospitable, sunburnt countryside.
******************
In the last hazy light of the day, a truly idyllic world. An emerald sea of grass. A surging golden tide of rape seed. A silhouetted cardboard cut-out scene: tractor and plough. A spray of dust wafting from the wave of earth churned up by a plough. A delicate agricultural sea-mist hanging in the still, cool air of dusk.
This is a truly special part of the world. The tag of most scenic iron distance race in the world is fully justified and, as a holidaymaker yelled to me from an inner tube as she floated down the Clutha River on the blisteringly hot day that I attempted to do a 3 hour run, "This beats Disneyland any day!"
******************
06 December 2010
A bit of a haematoma
Unfortunately, I picked up a bit of an injury over the weekend that has interrupted training. I have strained a muscle in my right shin which is causing quite a bit of a haematoma (bruise) in my lower leg. It's quite painful when I run and, even though I managed an hour long run on it on Saturday, I had to miss yesterday's long run. This is the second time I have had this type of injury - the first being when I was training for the Southland marathon last year - but this time it seems to be less severe.
Thankfully today is a rest day and I don't have another run scheduled until Wednesday. I'm hoping it will be okay on the bike tomorrow evening and it should be fine in the harbour (at 7am tomorrow).
Plenty of rest, a compression stocking and regular icing seems to have accelerated the healing process and it is starting to loosen up already. When the gall bladder infection settled down in August 2001, though, the haematoma I had then was a little more serious and in need of a bit more attention than a bit of rest and some ice.
31 August 2001, Austin Hospital
My condition has stabilised now and I haven't had any gall bladder attacks or fevers for about 36 hours. The nurse was in about half an hour ago to tell me that they would be transporting me back to Bethesda Hospital later today, but that they first wanted to change my dressings.
Changing my dressing is still pretty painful (see A bit sore) but I have become used to dealing with it. The major problem at the moment is that the swelling around my abdomen has become so bad that the cross bars on my external fixators have begun to rub on the wounds where the fixators enter my body. As a result I have developed a couple of really nasty ulcers around the base of my fixators that are now also requiring some attention. When I am rolled on to my side these new wounds are enlarged ever so slightly as the weakened skin and flesh tears a little. So, by now the wound around the right fixator is about the size of my thumb and very ulcerated (just like a mouth ulcer).
The swelling is now also making it extremely difficult to roll me to redress my gravel rash wounds on my torso and it takes several people to undertake the whole operation: two or three to roll and hold me and one to dress the wounds.
The team have just come in and they roll me to the right to reveal the wounds on my left. They are dressing the wound as normal and finish without a hitch. I'm back on my back now and I'm pumping the morphine button (PCA) to make sure that I am ready for the wound on my right which is much bigger and sensitive than the one on my left.
"Okay, ready?" says the nurse. "As ready as I'm going to be," I reply. I'm being rolled slowly and carefully on to my side. "STOP!", I shout, "I can feel a tearing by my fixator!" They stop and check out my fixator wound and it turns out that there is a small tear in my wound. It's not really painful and it's not bleeding, but there is a small amount of clear fluid seeping from the wound. "I think we can carry on with the dressings now," says the nurse as she mops up the fluid.
The rest of the dressing process goes without a hitch and they turn their attention to the new/expanded wound around my fixator. It's 'oozing' (as they describe it) quite a lot of fluid so they pack it with gauze to soak it up.
An hour passes and they come back to check it. As they remove the bandages covering the gauze, the full extent of the oozing was revealed. It has soaked right through the gauze and is beginning to pool in the plastic undersheet lining the bed. A quick discussion and the charge nurse decides that the underblacket and plastic sheet will have to be replaced even though I am being relocated later today. So, here we go again, more rolling and more pain...
This is going to be quite complicated as they are going to actually lift me off the bed and the swelling hangs off my backside whenever that happens. It's bloody excruciating and, without the crane that Bethesda has, I am not sure how they are going to manage it.
Step one: they roll me one way and bunch up the blanket and plastic sheet as far as they can. Step two: they roll me the other way and bunch the rest up. Step three: lift and remove. Problem: It's impossible to lift me. "One last try," says the charge nurse, "it has to come out." "One, Two, Three, Lift!" They all lift and the charge nurse pulls as hard as he can. "Ahhhh! You ripped me!", I yell. All at once they replace the plastic sheet and return me to my back.
Now there is a real problem. The ooze is coming out really quickly. The gauze is becoming sodden as soon as they pack my wound. They keep repacking it and eventually it slows a little. Any time I move I can feel it running down the inside of my thigh, but there isn't much pain so I ignore it.
A couple of hours have passed and I am in the back of an ambulance being transferred back to Bethesda. The ooze is pretty disgusting by now and I am soaking wet. The ambulance arrives at Bethesda and I am wheeled back into the rehab ward. It feels great to be back. I've only spent a couple of days here, but it feels much more welcoming than the Austin, perhaps because I know it's going to be home for a while.
The ambulance drivers hand me over to the nursing staff and explain about the ooze. A nurse takes a look. "Oh, my God!", she says. I am sure that can't be a good thing. A few minutes later Mary-Lou, the registrar, appears and looks at the wound. There is an instant look of shock on her face as she realises what is happening. "Righ,t let's get this sorted", she exclaims. "I can't believe they sent you back like this. How long has this been like this?", she asks. I explain what had happened.
"You have a massive haematoma in your torso and now it has direct access to the outside. We are going to have to milk it. Are you okay with that?" Mary-Lou explains. Of course, I agree but I ask for a quick explanation of what they are going to do. In essence, she explained that it would be like squeezing a massive pimple.
The process begins and litre after litre or haemoserous fluid is milked from my body. It is caught in a funnel held against my hip and placed in a bucket. After about an hour of milking, 9.5 litres of fluid is collected in the bucket and the oozing has largely subsided. The swelling that has plagued me since my accident is now gone and bags of limp skin hangs from my side. What a relief.
Post script: This event turned out to be a turning point in my recovery. Now I was unburdened by the swelling that had caused so much pain. It was also the source of my infection as this massive abdominal haematoma caused by a closed internal de-gloving injury had been communicating through my wounds with the outside world.
That night I underwent surgery to clean the ulcerated wounds around my fixators, insert six suction drains that would continue to drain the haemoserous (the clear fluid that you get on wounds that helps the healing process) from my torso and to do a thorough cleaning of my gravel rash wounds.
The whole process gave me a new starting point. A new lease of life. A renewed determination to get through this. Tomorrow is a new beginning.
03 December 2010
Take away the pain
In a previous post on motivation (motivation part 3 - pain) I talked about how pain can be a good thing. How the pain of training actually feels good to me. Well this weekend, I had a power of good pain.
Sunday's 6 hour/175.8km ride redefined some of the pain that I have had in training. While my legs and groin were nothing beyond the normal long ride aches and pains (and a the odd bit of numbness), the pain that I experienced in my feet and neck were a distraction that I could not ignore.
Nearing half way on the ride my right foot began to smoulder. Just a whiff at first and nothing that a good scrunching of the toes couldn't fix, but by the time I reached the four and half hour mark both feet felt like flames were emanating from their soles. I had no choice but to dowse them with water and the momentary respite was pure bliss. However, the embers continued to glow and by the time I got 15 minutes down the road the flames had me in agony once again. I was able to stand it for another 15 minutes until I had to take both shoes off to stamp out the flame. I kid you not, the heat was so intense it felt like my feet were literally on fire! Thank goodness taking my shoes off helped otherwise I doubt that I could have gone much further nor could I have got off and run a marathon. (Apparently this is a relatively common problem related to the positioning of my cleats, the inner-soles and the type of shoe that I have. So hopefully I can sort this next week).
The other problem was an aching neck from being in aero position for such an extended period. It got so bad that from about 120km on, I begged for any hill at all so that I had an excuse to sit up and pedal. I never ever thought I would experience such a rush when I saw a 2 km climb coming up ahead. I literally screamed 'WOOHOO', when I saw it looming in front of me. Thank goodness that the Challenge course is so hilly; I don't think that I could handle a flat course for six hours.
Despite this, once again, this is good pain and I am glad that I endured it and I am a stronger person because of it. The pain that I went through on the night of 28 August 2001 (see help needed) and through 29 August 2001 was debilitating and disheartening, especially given I had thought that I was through the worst of it following my accident (see when the journey really began, the journey continues and a bit sore).
Early afternoon, 29 August 2001
I am staring at a tall, broad-shouldered surgeon at the end of the bed who is trying to figure out how he is going to use the endoscope to remove my gall bladder later today. You see, it turns out that last night's pain was acute acalculous cholecystitis (AAC) or a massively inflamed gall bladder and it has got to come out. "The problem is I usually rest the scope on your pelvis and you have all this bloody scaffolding in the road," says the surgeon in a very concerned voice. He bends down to get a better look at the angles and rotates his hands over my pelvis to mime the actions that he would have to perform. "Nah, there's no way we can get in through there." He pauses. "We'd normally go in through the belly button, where you've already got that scar, with the scope and make a couple of small cuts up here [pointing to just below my sternum]. But, there's just no way that is going to happen. The other option is to make a 30 centimetre incision from here to here [drawing a long arc on his torso that follows the bottom of his rib line]."
Oh my god! They are going to have to cut me open. Surely that is going to be dangerous in my state!?! Is this really necessary, surely no one died from a swollen gall bladder? Those I.V antibiotics must be pretty powerful, surely they'll work?
The surgeon interrupts my tarin of thought, clearly seeing that I am experiencing a considerable amount of agnst. "I think we are just going to have to wait and see what happens. It will have to come out, but there is just no way that we can do anything about it right now."
"What about the pain?", I ask. "That should subside, but if it doesn't we will have to do something about it", replies the gentle and caring giant of a surgeon. "Lets just wait and see. You have enough on your plate right now, without having to deal with more surgery. Once you are stronger and these fixitors are removed we can have another look."
I am not sure that I can really comprehend what this means. Is it life threatening? Is the pain going to return? Am I going to be able to eat (I haven't been able to eat since I vomitted up last night's dinner)? I don't think I can really deal with any more pain. My wounds are bad enough and that pain through the night and into this morning was absolutely out of this world. Please, make it go away...
Post script: It turns out that AAC is actually very dangerous! According to the Merck medical manual:
Acalculous cholecystitis typically causes sudden, excruciating pain in the upper abdomen in people with no previous symptoms or other evidence of a gallbladder disorder. The inflammation is often very severe and can lead to gangrene or rupture of the gallbladder. In people with other severe problems (including people in the intensive care unit for another reason), acalculous cholecystitis may be overlooked at first. The only symptoms may be a swollen (distended), tender abdomen or a fever with no known cause. If untreated, acalculous cholecystitis results in death for 65% of people.
It is a rare form of gall bladder infection that can be caused by (amongst other things) other surgery, massive whole body infection (sepsis) - which I was now being treated for - or blunt trauma.
The pain has been described by many as the third most painful affliction known - behind child birth and passing a kidney stone.
Just over a week ago my Mum had her fifth or sixth gall bladder attack (from gall stones, which is less dangerous, but equally as painful) and the next time she has to go to the emergency room they will remove the stones. I don't know how she has put up with so many attacks. Once was enough for me, but in the end I had two further attacks. The second was while I was still in hospital and still with the fixitors in and the surgeon once again said that they would have to wait. The third was some months after my accident, once I had been released from hospital.
I was walking along the street with Carleen and we were about 10 minutes' away from home, when out of the blue the pain struck. It struck so hard that I partially collapsed and had to save my fall on a wall. I tried to walk, but the pain intensified and I could go no further. Thank goodness for the doctor that was passing on her way home from her shift at a local hospital. She spotted me and knew instantly that I was in trouble. She got out of her car and rushed over to us (probably thinking I was having a heart attack). I explained what it was and she helped us to her car and drove as fast as she could (which wasn't that fast because it was rush hour) to the nearest emergency room. Once there she handed me over to the ER staff and they administered morphine, but they couldn't remove it then and there as they wanted me to go back to the hospital that treated the orginal injury.
In the end I was referred to a private surgeon who said the best way forward was to claim on my medical insurance as this would be the quickest route to surgery. He was right and the next week, my gall bladder was removed and AAC confirmed.
I have no lasting effects, except I can't eat very fatty foods or drink a lot of beer (not a bad thing really).
Sunday's 6 hour/175.8km ride redefined some of the pain that I have had in training. While my legs and groin were nothing beyond the normal long ride aches and pains (and a the odd bit of numbness), the pain that I experienced in my feet and neck were a distraction that I could not ignore.
Nearing half way on the ride my right foot began to smoulder. Just a whiff at first and nothing that a good scrunching of the toes couldn't fix, but by the time I reached the four and half hour mark both feet felt like flames were emanating from their soles. I had no choice but to dowse them with water and the momentary respite was pure bliss. However, the embers continued to glow and by the time I got 15 minutes down the road the flames had me in agony once again. I was able to stand it for another 15 minutes until I had to take both shoes off to stamp out the flame. I kid you not, the heat was so intense it felt like my feet were literally on fire! Thank goodness taking my shoes off helped otherwise I doubt that I could have gone much further nor could I have got off and run a marathon. (Apparently this is a relatively common problem related to the positioning of my cleats, the inner-soles and the type of shoe that I have. So hopefully I can sort this next week).
The other problem was an aching neck from being in aero position for such an extended period. It got so bad that from about 120km on, I begged for any hill at all so that I had an excuse to sit up and pedal. I never ever thought I would experience such a rush when I saw a 2 km climb coming up ahead. I literally screamed 'WOOHOO', when I saw it looming in front of me. Thank goodness that the Challenge course is so hilly; I don't think that I could handle a flat course for six hours.
Despite this, once again, this is good pain and I am glad that I endured it and I am a stronger person because of it. The pain that I went through on the night of 28 August 2001 (see help needed) and through 29 August 2001 was debilitating and disheartening, especially given I had thought that I was through the worst of it following my accident (see when the journey really began, the journey continues and a bit sore).
Early afternoon, 29 August 2001
I am staring at a tall, broad-shouldered surgeon at the end of the bed who is trying to figure out how he is going to use the endoscope to remove my gall bladder later today. You see, it turns out that last night's pain was acute acalculous cholecystitis (AAC) or a massively inflamed gall bladder and it has got to come out. "The problem is I usually rest the scope on your pelvis and you have all this bloody scaffolding in the road," says the surgeon in a very concerned voice. He bends down to get a better look at the angles and rotates his hands over my pelvis to mime the actions that he would have to perform. "Nah, there's no way we can get in through there." He pauses. "We'd normally go in through the belly button, where you've already got that scar, with the scope and make a couple of small cuts up here [pointing to just below my sternum]. But, there's just no way that is going to happen. The other option is to make a 30 centimetre incision from here to here [drawing a long arc on his torso that follows the bottom of his rib line]."
Oh my god! They are going to have to cut me open. Surely that is going to be dangerous in my state!?! Is this really necessary, surely no one died from a swollen gall bladder? Those I.V antibiotics must be pretty powerful, surely they'll work?
The surgeon interrupts my tarin of thought, clearly seeing that I am experiencing a considerable amount of agnst. "I think we are just going to have to wait and see what happens. It will have to come out, but there is just no way that we can do anything about it right now."
"What about the pain?", I ask. "That should subside, but if it doesn't we will have to do something about it", replies the gentle and caring giant of a surgeon. "Lets just wait and see. You have enough on your plate right now, without having to deal with more surgery. Once you are stronger and these fixitors are removed we can have another look."
I am not sure that I can really comprehend what this means. Is it life threatening? Is the pain going to return? Am I going to be able to eat (I haven't been able to eat since I vomitted up last night's dinner)? I don't think I can really deal with any more pain. My wounds are bad enough and that pain through the night and into this morning was absolutely out of this world. Please, make it go away...
Post script: It turns out that AAC is actually very dangerous! According to the Merck medical manual:
Acalculous cholecystitis typically causes sudden, excruciating pain in the upper abdomen in people with no previous symptoms or other evidence of a gallbladder disorder. The inflammation is often very severe and can lead to gangrene or rupture of the gallbladder. In people with other severe problems (including people in the intensive care unit for another reason), acalculous cholecystitis may be overlooked at first. The only symptoms may be a swollen (distended), tender abdomen or a fever with no known cause. If untreated, acalculous cholecystitis results in death for 65% of people.
It is a rare form of gall bladder infection that can be caused by (amongst other things) other surgery, massive whole body infection (sepsis) - which I was now being treated for - or blunt trauma.
The pain has been described by many as the third most painful affliction known - behind child birth and passing a kidney stone.
Just over a week ago my Mum had her fifth or sixth gall bladder attack (from gall stones, which is less dangerous, but equally as painful) and the next time she has to go to the emergency room they will remove the stones. I don't know how she has put up with so many attacks. Once was enough for me, but in the end I had two further attacks. The second was while I was still in hospital and still with the fixitors in and the surgeon once again said that they would have to wait. The third was some months after my accident, once I had been released from hospital.
I was walking along the street with Carleen and we were about 10 minutes' away from home, when out of the blue the pain struck. It struck so hard that I partially collapsed and had to save my fall on a wall. I tried to walk, but the pain intensified and I could go no further. Thank goodness for the doctor that was passing on her way home from her shift at a local hospital. She spotted me and knew instantly that I was in trouble. She got out of her car and rushed over to us (probably thinking I was having a heart attack). I explained what it was and she helped us to her car and drove as fast as she could (which wasn't that fast because it was rush hour) to the nearest emergency room. Once there she handed me over to the ER staff and they administered morphine, but they couldn't remove it then and there as they wanted me to go back to the hospital that treated the orginal injury.
In the end I was referred to a private surgeon who said the best way forward was to claim on my medical insurance as this would be the quickest route to surgery. He was right and the next week, my gall bladder was removed and AAC confirmed.
I have no lasting effects, except I can't eat very fatty foods or drink a lot of beer (not a bad thing really).
02 December 2010
Giving back
Over the last few weeks several things have made me think back to the time of my accident. Not least of these has been the fact that there have been a spate of fatal and near fatal collisions between vehicles and cyclists. the result has been several 5 fatalities and several hospitalisations. How many more have to be killed or mamed before something is done to protect cyclists?!
Probably the accident that has been closest to the bone for me was the accident that almost claimed the life 12 year old Blenheim girl Jacqueline Wyatt (see Campbell live story at http://www.3news.co.nz/Teen-cyclist-recalls-collision-with-truck/tabid/367/articleID/188518/Default.aspx). Her accident bears an uncanny resemblence to mine and, like me, she is battling with a smashed pelvis and multiple other injuries. Her story moved me to tears and really cut Carleen up as she recalled the hard times that we went through during my long and painful recovery and neither of us could bear the thought poor Jackie and her family having to go through all that we had been through.
I want to help Jackie and the Wyatts through this ordeal in whatever way I can and I have started the wheels in motion to try and get in touch with them and some people raising money to help them out. I am not quite sure what I can do to help, but I have some ideas so watch this space.
Probably the accident that has been closest to the bone for me was the accident that almost claimed the life 12 year old Blenheim girl Jacqueline Wyatt (see Campbell live story at http://www.3news.co.nz/Teen-cyclist-recalls-collision-with-truck/tabid/367/articleID/188518/Default.aspx). Her accident bears an uncanny resemblence to mine and, like me, she is battling with a smashed pelvis and multiple other injuries. Her story moved me to tears and really cut Carleen up as she recalled the hard times that we went through during my long and painful recovery and neither of us could bear the thought poor Jackie and her family having to go through all that we had been through.
I want to help Jackie and the Wyatts through this ordeal in whatever way I can and I have started the wheels in motion to try and get in touch with them and some people raising money to help them out. I am not quite sure what I can do to help, but I have some ideas so watch this space.
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