I should be gathering my wetsuit, fuel, water bottles, running shoes, helmet (!) and slipping into a tri kit right now. It’s the morning of the Boulder 70.3 Ironman, which was a stepping stone for Boulder 140.6 in August. Instead, I’m sitting at my computer, sipping coffee from a tiger mug, nursing a headache and really not missing the race.
My, how things change.
Exactly four weeks ago, I experienced a bike crash at the HITS 70.3 race in Grand Junction, Colorado. This was supposed to be just a 56-mile training day for me as I was the cycle portion of a relay team, but instead turned into a 4 week (and likely longer) unplanned life interruption. Here’s exactly what happened:
Morning was cold and rainy – off and on drizzle, not torrential downpours, but conditions that would send me to the trainer in a heartbeat. I was much more bundled than I ever am for riding. Upon the swimmer coming in, I set out and actually – much to my surprise – wasn’t hating every second of it. By an hour in, I actually remember thinking to myself, “This is actually kind of nice.” Beautiful scenery, quiet roads and then…
I woke up in an ambulance. I wasn’t super with-it there, but I know I had on a neck collar, support for my trunk as well. Splotchy memories of arriving at the hospital, ct scans, stitches being put in and around my chin and forehead. I do hearing them say my cervical spine was fine and testing my ability to move in places. Frankly, panic never really passed through me during this initial treatment – I just hurt and was uncomfortable, okay – in solid pain.
I did hear the phrase bleeding on the brain and that I would be in ICU because if it didn’t stop it could be a serious problem. For some reason, this didn’t bother me either. The discomfort did – but not the possibility of serious complications. People came in an out to visit – I remember glimpses, but not a lot (an effect of miraculous medicine). I was asked repeatedly, “What happened.” The answer then is the same as the answer now – I don’t remember the accident at all. The best guess is that something got stuck in my spokes – jamming up the bike and sending me flying.
The next morning’s CT Scan showed the bleeding on the brain had stopped, so they moved me to a general floor out of ICU. My wrist was broken and I had quite a few scrapes – including a huge lump of a hematoma on my thigh that is still there today – but I was able to pass occupational therapy and mental tests so no horribly obvious effects of a brain injury. On day 4, they let me go on the long drive back to the Springs (my kids were there and they still had 2 weeks of school left, so I was eager to get out). This was Tuesday, May 19. My Mom came into town to help and meals started to pour in from friends. I had a few visitors and even got the stitches out of the front of my chin and eyebrow on Friday. I went on a few walks with my kids – short – in hopes of bringing movement back, but everything hurt and I was on a steady stream of oxycodone. Every morning I’d wake up just hoping that it would be the day that everything didn’t hurt…that morning never came.
The days were uneventful – I’d try to do a bit of online, freelance writing and nap and eat. Then, Memorial Day came and it was another day. Just another day. We settled in that evening with some good television and as I pushed back in the recliner I started to have immense pain in my right ribcage. Every breath I took was like a stab and I couldn’t get them in deeply or satisfyingly. I shifted positions – crumpled up, stretched out, pinched — and finally got up to go upstairs, thinking a yoga pose or two might alleviate. Once I got upstairs though, it stung worse and my kids had followed me – in distress. It’s a bit of a blur but now the whole family was there asking if I needed an ambulance or if I needed to go to the ER. My first reaction was “No, I’ll unkink it” but as the pain continued, I realized that I did need some kind of treatment. We arrived after what seemed like the longest, bumpiest ride (thank you Colorado Springs’ potholes) and I was taken almost immediately. From my symptoms, they took me in to do a CT scan only to report that I presented with dual pulmonary embolisms – blood clots on the lungs. Morphine didn’t touch the pain and by midnight, I’d been transported to a more southern hospital where neurology could better care for me. The complication was the brain bleed. Typical treatment for PEs is blood thinners – but they didn’t want to thin my blood and re-hemorrhage my brain.
I was on a heparin drip (blood thinner) with pretty strong pain meds for 4 days in the ICU. I discovered quickly I was among the most able-bodied in this unit – I talked and could walk. I was deemed a high-fall risk, however, and attached to constant monitors so every time I wanted to get out of bed – I had to buzz a nurse. This means every bathroom break, every tooth-brushing experience or just to sit in a chair instead of a hospital bed need an escort. Very quickly, the little things of life – going to the bathroom on your own – become precious. By day 3, the neurologists decided to put me on Coumadin – also called warfarin – which is a pill to thin my blood and help treat the clot which had come from my legs. I was informed I’d be on this thinner for 6 months and during this time any helmeted sports – including cycling – were out. I could not afford a brain bleed again.
Funny thing, I completely accept this. I had already resigned that the triathlon season was over. Suddenly this fun pastime that had sucked up so much of my time was just not a big deal. I just wanted to stand up without setting off alarms.
By Thursday, they moved me and my IV pole to the general recovery floor – out of ICU. There, I sat. Minor victories happened daily: I got to shower (attached to my IV pole) on day one on this floor; on day 2 I was detached from the constant monitoring so I could once again go the bathroom on my own; on day 3, my nurse got me special permissions to walk – outside – and I got to breathe real, fresh air; on day 4, I started doing laps around the floor and became known as the walker.
I expected, though, to be out by now. My mind was sharp and most of my pain was gone – I was off heavy-duty pain meds and awake all day. But, they were trying to get my blood to a specific level of thinness according to an assay called INR – so here I stayed, enduring vitals checks every four hours (including all night) and 4 am blood draws. Until the INR went up, they needed to keep me on the IV. Day one, the INR was 1 (normal); day 2 was still 1; day 3 was 1.1; day 4 – 1.3 — we were targeting a 2.5. The doctors and nurses felt for me and would even roll their eyes that I was still there – but my INR wouldn’t budge. I had staff come find me to tell me my INR level as soon as it was available to them – and it was never good news.
Finally, on Thursday – June 4th – a good 11 days of being in the hospital, the docs said they’d probably let me go home. We got words like “most likely” and they got ready to train me on transitional injections of blood thinners. Then neurology stepped in – at 3 pm — and said they wanted a hematology consult and another CT scan of the brain. It meant another night there. I understood why, but it didn’t make the frustration any easier.
When the scan came back clear on Friday and the hematologist said I would should be fine, I was finally given the OK to go home. I was excited, but mixed emotionally because being disconnected from the IV made me vulnerable to thicker blood and clots again. The clots likely occurred because of the trauma incurred via the bike accident.
I was home – 3 weeks afterwards – though. My INR was only 1.7 when they released me and I took Coumadin pills and Lovenox injections twice daily through Monday, where the next test showed me at a little over 3 for the INR. I still go in for blood tests every 2-3 days as they figure out the proper dosage, but I’m home and actually feel good. Just yesterday, the splint was removed from my arm and I can use it as tolerated.
The lingering symptoms remain: my head aches regularly, the right side of my forehead and my bottom lip are still numb, I still have scabs, stitches and scars from the wreck and the bulbous hematoma on my right thigh bulges and aches – but in general, I feel pretty good. I tire pretty easily, but nothing I can’t handle. I’ve come back to teaching yoga and hope to return to indoor cycling in the next couple weeks. I’m walking a lot with my son and even running for bits at a time – no scary terrain and not fast. I’ve done some very mild strength training and yin yoga on my own.
This will be a process and I don’t know where it will take me. I don’t have any goals right now – and, in a lot of ways, that feels really good.
This accident has prompted me to step back and take a look at life. I’ve tried to be intensely strong and not break down in complete tears during this month, and the support of family and friends has helped in that endeavor.
I’m slowing down instead of revving up and I kind of like it.