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).
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