UCL Surgery Update

Above: Thumbs up before surgery

Ok first of all, please excuse the typos and all of the mistakes I’m sure will follow. My left hand is my new ‘dominant’ hand for the next 10 days or so. Typing will be slow and arduous for sure so don’t expect my usually long updates!

Also, a warning on a couple of the pictures. They are fairly graphic pictures of the inside of my thumb. Not any blood or anything like that, just the hole in my hand where they did the repair, a ligament and some sutures. Still, if pictures of surgery freak you out, you should just close the page now.

That being said, the surgery on Tuesday went well. 70 minutes in total from start to finish. Even thought I had a local block for my arm and was sedated, I remember some of the procedure which is pretty cool.

Above: My UCL ligament being pulled back into place

According to Dr. Rust the UCL rupture was very clean. A very tiny fragment of bone came off with the ligament which made it really easy for her to know where to place then anchor for reattachment. Once she had that figured out, everything was set in place and I was sutured up and in recovery in no time. Between pre-op, actual surgery, and post-op recovery, I was only at the facility for 4.5 hours total. Not too bad.

Above: Suturing the incision site from the inside out

Currently I have on a huge splint to immobilize my thumb. I can’t tell you how bad this sucks. Try to NOT use the thumb on your dominant hand for a while and you’ll understand. Fortunately the splint comes off on April 2^nd when I go into a spica cast. Still, it’s amazing what I can do with just my left hand. I’ve even switched the mouse on the computer over to my left hand for the next 10 days which is working out quite nicely. Anyway, I’ll post more soon as things progress.

Ruptured UCL / Torn RCL - Ouch!

You may recall from my last post that I took a spill off of my mountain bike at my last Adventure Race in Perdenales Falls State Park. Yes I bent my thumb back and it hurt like hell but I didn't think anything of it other than it being a bad sprain. Sure there was some pain and swelling but my range of motion was still 95% and it was getting a little better everyday.

Enter my old friend Hoss who happens to be a physical therapist. Hoss saw my update and called me up. In some fairly colorful language told me I needed to go have it looked at. I quote: "An opposable thumb is what separates us from lower life forms....you don't want to f*** around with your thumb." Got it. So a couple of days later when it didn't feel like my thumb was really improving I made the call to have it looked at.

A few X-rays later Dr. Saenz said it was questionable enough to get an MRI done on it. Ok...better safe than sorry. I had an MRI done last year on my elbow and it was no big deal but the machine they used to do my thumb was super powerful compared to the one from my elbow. I could literally feel the magnetism of the machine pulsing through my body. Pretty weird. Anyway, I left with the films in hand to go see the hand specialist. I'm fairly good with pictures so I pulled them out to see what I could make out on them but with 100 or so images I could only narrow down the scans to the page that had the ligaments on it. From there is wasn't sure if the orientation of my hand would show a ligament in one image and not the other.

Oh well. Better to let the experts do this I suppose. Fortunately I was lucky enough to get a referral to Dr. Rust at the Hand Center here in San Antonio. The Hand Center is the facility that treats all of the NBA players and other professional athletes in the area. If you mess your hand up, this is where you want to be sent.

After the initial exam, Dr. Rust order up a couple of more X-rays of the thumb and pulled out the MRI films I had given her. With the new X-rays and the MRI film in hand she put them up on the light board and explained what we were looking at.

Here's how it went. If you hold up your right thumb in the "Thumbs Up" position and go to the big knuckle at the bottom of the V between your thumb and index finger, there are ligaments on each side of that knuckle that extend just over the joint of the bone in the pad of your thumb to the next bone in your thumb (towards the tip of your thumb). Looking at your own thumb, the ligament on the right is the Ulnar Collateral Ligament and the one on the left (toward the pad/palm of your thumb) is the Radial Collateral Ligament. These ligaments give your thumb lateral stability which prevents that joint from moving excessively from side to side. My RCL is torn on the lower end and should heal on it's own. However, my UCL is ruptured (torn completely away from the bone) and has to be surgically repaired. She actually pointed at the MRI and said, "See this ligament over here....there should be one on the other side just like it. Yours is now down here just flopping around. We've got to go in and fix that."



Well crap. She went on to explain that if I don't repair it now it'll just get worse and she'll have to use a cadaver ligament later on to reconstruct it. That would suck. I prefer to keep my own body parts and not add some stranger's to the mix. Or, I could also do nothing and have a floppy thumb for the rest of my life which some people opt to do. The problem there is that if you try to pick up anything heavy (imaging picking up a really heavy water bottle or something that requires your hand to be in that same position) the downward weight of the object will pull your thumb down (no lateral stability) as you try to grip it and over time you eventually won't be able to hold anything normally. That's not good no matter how you look at it. As you've probably guessed, I've opted to get this thing fixed by the hand specialist.

I told my AR Teammates that if there were any good news it's that I'll be forced to work on my running since I won't be able to ride my bike for a while! I've guess I've got to look at the positive side of this because I'll basically be giving everyone the "Thumbs Up" for weeks whether I'm in a great mood or not. Cut me off in traffic? Take this "thumbs up" buddy. Don't like the way I drive? "Thumbs up" to you too!

Anyhow, surgery's scheduled for Tuesday. I'm hoping to have pictures and post updates as I work through this little set back so stay tuned for that. And just to entertain myself while I'm healing, I'm thinking of mixing up the answers whenever someone asks me what I did to my thumb. You know...I was spear fishing on the Great Barrier Reef and was bitten by a shark.... fun stuff like that!

One Dislocated Thumb, Two River Crossings....

Above: Sebas, Bern and Ross re-enacting the great river crossing of 2010

Murphy’s Law states: “Anything that can go wrong will go wrong”. While that may be a generalized overstatement of our experience at the 12 Hour Eco-Lonestar race at Perdenales Falls State Park this past weekend, it was a tough day at the office by our high adventure racing standards.

Race day. Up at 5 a.m. and off to the race. At the race, unpacked and ready to roll we receive our instructions and boom, the race starts at 7 with a little 2 mile run down by the river and then a little climb back to TA. Sebas and Ross took off and Bernice and I did our best to keep up. Running down by the river I somehow managed to find the lone thorn vine which conveniently ripped my lower right leg to shreds. Awesome! First blood less than 5 minutes into the race. What else could go wrong?

Back at TA after the run we received our next set of instructions which consist of finding one checkpoint on a 13 mile bike loop. Less than 3 minutes into the ride and BAM…Ross breaks the chain on his bike. I’ve heard of this happening, but I’ve never seen it firsthand. Fortunately, Sebas had a chain tool in his pack and between the two of us we had the chain fixed in maybe a minute or two. Sweet. A total of two links were removed from Ross’ chain. This would unfortunately prove to be problematic for the next 11 hours.

Thinking the worst was behind us we set off on great ride around Perdenales Falls State Park. This place was a great mix of climbs, down hills, nice single track, Jeep roads, and some technical and not so technical spots. About mile 9 of the ride, I had taken over the lead on some technical areas and was cruising nicely through some flowy sections of the trail. I’m still not sure what exactly happened next other than my front tire slide out while I was moving along pretty quickly. Next thing I know, I’m on my way down and trying to brace my fall. My right hand hit the ground first but then collapsed when my right thumb decided to bend backwards towards my forearm. Sweet mother of pearl that hurt. My elbow, shoulder and head followed next. I’m not sure how I came unclipped from the bike but there I was after the tumble, flat on my back thinking that I had just broken my wrist or at a minimum had dislocated my thumb. Shortly thereafter, Sebas, Ross and Bernice showed up as I rolled around the dirt trying to get a handle on the pain. After a few choice expletives, and some jumping around it was clear that my wrist was not broken. My thumb was less fortunate however. Still fully functional but extremely sore we made it back to TA and my onboard pharmacy. I’d make it through the day with meds, but it was going to be painful.

Out on our bikes again for the next leg, we quickly ran down 2 checkpoints and then met up with a group from Houston as we went for a couple more checkpoints. Together we found another checkpoint and then set off downhill to find the last point across the river. Ross made the comment as we got to the river bank that in the previous 2 races he had done here that the river crossing had been dry and he thought it was funny that they called it a ‘river crossing’. Today however was another story. On this day, the Perdenales River was raging. Later in the day we saw signs warning of “Swift Water” and “Stay Out of the River”. It would have been nice to have seen those earlier in the day BEFORE we decided to cross the river.

Above: Me trying to smile through the pain and step aside so Bernice can take a picture of the rapids where we crossed the river.

So there we are at the river bank with the team from Houston. The checkpoint is on the other side of the river and there’s simply no other place to cross the river. Time to hike a bike. So one at a time we throw our bikes on our backs and start to make our way across the Perdenales. This is by far the fastest moving water I’ve even attempted to cross and by fast I mean when you picked your foot up to take a step, the water would literally sweep your foot and try to take you downstream. It was a fight just to stand there let alone walk. One by one we made it to the other side and the off we went to look for the checkpoint. We went to the left; the Houston team went to the right. We’ve got ‘em I thought. We’ll get the point and be done in no time while they’re lost. Right? Wrong. An hour or so later, we realized that BOTH teams were wrong. Both teams (us and the Houston team) plotted this same checkpoint wrong as the checkpoint was actually on the OTHER side of the river right next to TA where we just came from. We didn’t have to cross the river after all. Wow. Irony had dealt us a big blow as the Houston team was confirmation for us that we were headed in the right direction for that checkpoint and we in turn were confirmation for them that they were on the right track too.

Above: A couple that thought we were crazy to be anywhere near or in the water was kind enough to take our picture

Bummer. At this point we realize that our day is done. Done meaning that we won’t be competitive at all time wise. We were racing as an “Unofficial” 4 person team in a 3 person team race anyway but we really wanted to hang with the 3 person teams if we could. Oh well. I suppose lesser teammates would have packed it in and called it a day but we did the only thing that we know how to do. Deal with the mistake and just keep going. One small obstacle remained in our way…the river…again. Learning from the first crossing the second crossing went a little easier. Depending on where you crossed the river it was anywhere from just above your knees to waist deep. Again we somehow managed to make it across the river without anyone getting swept downstream.

And while I may write about it like it was a non-event, crossing this river was no joke. It is by far the most dangerous thing I’ve done in a race. Crossing that river was a little bit of a reality check. Had any of us been swept downstream, it would have been a potentially dire situation. I don’t think anyone would have drowned but we would have been beaten up pretty badly. Still, debris (logs, trees, brush, old fence lines etc.) was everywhere in the river. Get swept away and then get hung up, snagged or trapped under that stuff and you’re done. That being said, while it was the most dangerous thing we did all day it was also the most fun thing we did all day. I was proud of our team for working together to get across safely.

As the remainder of the day unfolded in front of us, Ross probably had the roughest day. Ross had the misfortune of the broken bike chain right off the bat which led to non-stop shifting problems for him ALL DAY LONG. His bike either shifted randomly or not at all. How he was able to stick with us for most of the race is a tribute to the great racer that he is. Add to that tummy trouble from a chick-fil-a sandwich the night before and Ross easily gets the “Badge of Honor” for continuing to race on in the face of adversity.

Sebas gets the award for falling in the river, completely submerging himself with his bike on his back, managing not to get swept away and then being able to stand back up again. How he was able to do it I don’t know. Water temp? 50ish degrees or so. Percentage of dry clothing on Sebas after the river crossing? Zero. Therefore, Sebas gets the “9 Lives” award with a note that he just used one of them.

Bernice? Well her race was flawless. She was tan, rested and ready to roll. In fact, this girl rode like the wind. She even cleaned a steep rock/gravel hill like it was nothing and schooled us on how to ride a mountain bike. When we were riding on the roads, she basically went into her ‘zone’ and pedal stroke for pedal stroke pulled away from us all slowly. She’s a machine on the bike and I know she was happy that we spent most of the race on our bikes. Bernice definitely get’s the “I’ll Show these Boys How to Race” award. Great job Bern.

As for me, today my right hand and thumb looks like a small bunch of bananas and my right leg looks like a cat used it for a scratching post. I’m 99.9% pretty sure that my thumb isn’t broken and according to my own self-diagnosis I believe that the ligaments and tendons in my right thumb are mostly intact however stretched and or slightly torn. I’ll live through the pain and keep doing what I need to do to get better and be a more helpful asset to my team. All in all it was a tough day but a great day just the same. We made a couple of errors that we’ll learn from and a couple of unforeseeable events (chain, thumb, shifting) that derailed us. Overall we did 50 plus miles on the bike, paddled about 5 miles and did probably 8 miles on foot. Thanks to Ross, Sebas and Bernice for having the right stuff to push on through the adversity that was the 12 Hours of the Eco-Lonestar. To me, that’s what it’s all about.

Beavers, Dinosaurs and Chicken Fried Steak

What a title for a blog entry. This past weekend I went to visit my parents in San Angelo, Texas where I grew up. Really, I don't think there is any other place on the planet quite like San Angelo. It's the only place that I know of where you can get an orange colored chicken fried steak with yellow cream gravy. Don't let the visual description fool you it's a GREAT tasting chicken fried steak.

Anyway, it had been about 6 months since I had made the trek up into West Texas. Having lived in San Antonio now for going on 15 years I am sometimes amazed by what I see and hear when I visit San Angelo. To start off with I have two gems for your consideration.

1. While enjoying my orange chicken fried steak at the original Henry's there was a large table perpendicular to ours where a large group was seated. Roughly 10 or so people. Some couples with their children and maybe the grandparents were there too. Seated at the end of the table directly across from me was a woman, probably in her mid 30's with her husband directly across from her. She had her purse hung on the back of her chair which didn't seem all that unusual until it was pointed out to me. There loud and proud on her purse was the Confederate Flag just as big as it could be. But wait it gets better. Across the flag written in rhinestones or some other exotic jewel was the word "Redneck". Wow! Maybe a Valentine's Day present from her husband? A little house warming gift from the last cross burning? I'm sure I lost IQ points just for being in the same room. Apparently the Klan is alive and well in West Texas.

2. While stopping to get gas I overheard the man in line in front of me utter this phrase to the cashier: "Thatn theres more gooder than da othern." (That one there is more gooder than the other one). I believe he was referring to one brand of chew or dip over another. Yes, he was serious. No, I'm not kidding. Clearly more IQ points were lost just for witnessing the event.

Yes indeed. What an interesting few days visiting the folks.

I did manage to get in a great ride while I was there with my buddy Kyle. I brought the single speed with me and we did about 25 miles at the State Park that surrounds what use to be O.C. Fisher Reservoir. In my 41 years I've never known this lake to ever really have any water in it. I think it's at around 10 percent of it's capacity right now so it's basically a puddle in the desert at this point. It's eerie as there are literally boat ramps that are MILES from the water.

Above: This would be a boat ramp...right down into the cactus patch.

While we were on our ride, Kyle pointed out a relatively new addition to the area. Beavers! Yes, beavers in the desert. While we didn't actually see the beavers first hand, there was plenty of beaver evidence to be seen. I had to snap a couple of pictures for proof. Pretty interesting stuff.

Above: Beaver evidence!

Lastly, on the ride back to the car we stopped off to check out the dinosaur tracks there in the park. It was kind of cool to think that we were riding our bikes in an area where dinosaurs used to roam.

Above: Dinosaur foot prints

I snapped a couple of quick pictures here too because...well...they were dinosaur tracks and that's just pretty freaking cool. That and beavers in the desert. I'm telling you, there's no other place on the planet quite like it.