Wednesday, June 23, 2010

Velodrome Crash: the Long Story

I had been interested in racing the track for a while, but didn't have the confidence to try it out.  After a clinic last December, another 2-day clinic about a month ago, and then a great workout session the night before, I felt comfortable racing at the Hellyer Velodrome's “Get Ready for Summer” races on Saturday, May 29, 2010.  We would have our own women's category 4 field, rather than race with the guys.  The first race was a tempo race, with points given each lap for the 12 laps.  I think I came in first or maybe second for a couple laps, and I ended up placing third overall.  Our next race was a 12-lap scratch race, which is like a criterium in that the winner is determined by who finishes the whole thing first.

I'm #519 in red. photo by Steve Woo

Throughout the race, I felt like people were squeezing the group somewhat down track (i.e., towards the inside); for me to move around I would go up and around and advance.  I realized partway through that I did not feel comfortable advancing my position, and settled somewhere towards the back, looking for a good opportunity.  With three laps to go, I was in the sprinter's lane (the innermost lane on the track) behind a line of riders.  We were approaching turn three.  I have a few seconds of memory lapse here but the next thing I recall is riding on the apron pavement towards the warmup circle (in the infield area) and seeing someone down immediately in front of me.  I had nowhere to go.  It was a déjà vu moment from last year as I flew over my handlebars and hit the ground.  Stars flashed and I came to a stop, sitting up.  I assessed the situation and immediately felt relief--no great pain.  Maybe I wasn't that hurt.  But moving a little, I was certain my right collarbone was broken.  I felt angry, mostly, and was pretty quiet.  I noticed some blood trickling down my face and people were coming over.  It was very sunny, bright and hot sitting there on the black asphalt.

People began helping me while we waited for the ambulance.  The initial numbing shock started to wear off and I could feel the pain increasing, mostly in my shoulder.  Since I couldn't lie down, and I had hit my head, a friend stabilized my neck while I sat.  It was quite a while, so thank you, Evan. I felt bleeding in my pelvic area and thought for sure there must be blood gushing.  Once the paramedics arrived, I heard the words "dislocated" and "deformed" with regard to my shoulder, and was not amused.  The thought of someone pulling my arm to put it back in place was horrifying.  They were good about not forcing a certain position and got me on the spine board (yeah, here we go again) and into the ambulance.  I asked for morphine since last year I didn't get pain medication quickly enough.  The paramedic continued asking me questions and I felt sleepy but he didn't want me sleeping, I guess.  I felt like I was still bleeding in my pelvic area and mentioned it again.  But the bleeding was internal; the paramedic put an ice pack there and also one on my shoulder, which brought some relief.  I was most impressed that he was able to start an IV while the ambulance was moving without jabbing me all over.

I arrived at the Regional Medical Center San Jose, the closest trauma center, and things got busy.  I was very happy to see two good friends, Rita and Amy, waiting there for me.  The ER staff did some Xrays and other exams and cut off my favorite bib shorts and team jersey.  It wasn't until we were there for some time that they noticed a puncture wound on my shoulder, and soon discovered that the clavicle fracture was open, meaning that it had broken through the skin.  This has been my nightmare and the ultimate in bad injuries! Ahhh!  The surgeon came in and numbed it, thinking he could perhaps set it in the ER.  I felt and heard him tapping on the bone (ugh!) but at least it didn't hurt.  It became clear that surgery would be required.  Later I learned that the clavicle had fractured, completely shredding the ligaments attached to the scapula below, and piercing through the trapezius muscle and out through the skin.  Somehow it had also retracted back in a bit; so there wasn’t a huge piece of bone sticking out, at least.

 Waiting for the results to come in, I was still 
unaware of the compound fracture.

I was scheduled for surgery as soon as possible, the next morning.  They admitted me from the ER and put me on morphine to help with the pain.  I was nervous about the surgery but was comforted by the company of good friends.  They wheeled me to the OR where the surgeon explained his plan to repair the torn ligaments and to stabilize the fracture using a surgical device called a "tight rope."  Also, the anesthesiologist and I discussed diabetes management; he was interested in my Dexcom CGM, which he kept with him during the surgery. The next thing I remember was waking up with severe pain in my shoulder.  I was in a daze the rest of the day and would briefly see my friend Rita every now and then when I woke up.  Thanks for staying with me all day.  After some physical therapy to get me moving a little the next day, Monday, I was ready to go home.  I wanted to get back to San Francisco; if I needed further medical care, I preferred to go to my regular doctor.  Also, it was so hot in that hospital that I was constantly sweating and uncomfortable.  My friend June from my bike team stopped by after the Memorial Day Crit and graciously offered to wait for me to be discharged and to drive me home.  I was still a bit dizzy and unstable walking around but the medical staff seemed to feel it was okay to leave.  I noticed some pain in my right calf that I hadn't felt before.

 Before surgery

 After surgery: the two metal "buttons" connect the clavicle and 
corocoid process via "rope" and constitute the "tight rope."

I was glad to be home and was comforted by my having my roommate Radhika there.  Sleeping was still difficult and I woke up that night around 1:30 AM, a bit uncomfortable, but fell asleep again.  I had some weird dreams including one where I was outside in a storm at my parents' home in Utah, watching lightning strike uncomfortably close.  I thought that I might get struck and then a thick bolt, covered with burning embers, struck my parents' house, causing it to burst into flames.  Then the lightning came my way, striking me and throwing me down into a dark pit, where I was burned up.  Lovely!  I'm so lucky! I woke up at that point to severe pain in my right side.  It was around 4:30 AM and I was disappointed I hadn't slept more.  I thought I must have jammed my arm into my side or something--that the pain was just from sleeping in a bad position.  After standing up and walking around a bit, the pain started to subside.  Still, when I would try to lie down again, the pain would return.  Last year, the rib and L2 fracture diagnoses took about a week to come in, so I assumed I had just broken a rib that was somehow missed on Xray.  Or maybe somehow my side was slightly injured and my sleeping position further injured it.  I did sleep again for a bit and after that, I couldn't find any comfortable position.  I noticed that the pain in my side was completely eclipsing my collarbone pain.

A good cycling friend (and nurse!), Cheryl, came that morning to help me and stayed for quite some time; I was so grateful for her company and help.  I was feeling anxious about being home alone with this pain and was still somewhat lightheaded and unstable at times.  I was so happy to finally be able to shower and was put at ease to have her there. Throughout the day, the pain would get worse and then subside again.  My doctor felt like the trauma center most likely did not miss a rib fracture and helped me to get a new prescription for pain medication.  In the afternoon, a case worker from my health plan called; she was in the process of transferring my medical records from the trauma center, including my radiology images.  She asked how I was doing and I told her about the pain, that it was a "10 out of 10" when I tried to breathe deeply.  Basically, I could not breathe normally at all. It felt just like a broken rib. She recommended that if it did not improve with the vicodin, that I head to the ER.  I took another vicodin and the pain did improve somewhat.  But by about 4 PM when my friend Colleen arrived to visit, I felt like it was time to go in.  I was mostly worried that my shallow breathing would cause my blood oxygen levels to drop and that that might put any brain injury (if I had one) at greater risk.  I was still pretty sure I had a rib fracture--the pain felt very sharp and was consistent with where I fell.

Colleen braved the insanely steep ER driveway in her stick shift car and dropped me off.  I was becoming somewhat hysterical because I felt like something was really wrong but I hadn't been able to find an answer.  I had tried to get in touch with someone--anyone--to review my Xrays from the trauma center.  I knew I would not be able to sleep with this pain.  And I was becoming short of breath and very uncomfortable breathing.  I was seen very quickly (for an ER) and they started doing tests.  Let me tell you--if you have to be in an ER, Colleen is someone you want with you.  She had an uncanny way of making me laugh and relax and I was grateful for her company.  They did the chest Xrays and didn't find any broken ribs, and also started some blood work.  At the last moment, the attending doctor said he would run the D-dimer test to check for blood clots in my lungs.  He said that, due to my recent trauma and surgery, the test would likely come back as elevated, and that they would need to do a CT angiogram of my chest in that case.  He seemed to feel that it was unlikely that I would have clots, but that they would check it out anyway.

Well, the D-dimer test came back elevated. I asked, "How elevated is it?" and he responded that it is either elevated or not.  Oh.  I was hoping it would be like having a blood sugar of 150--a little high but not an emergency.  I was prepped for yet another CT exam and had the nasty, hot contrast injected as I held my breath.  The tech asked if I worked in radiology--I guess because I held still so well?  This is something I instruct people to do all the time so I guess I take it seriously when someone asks me to do it!  Back in the room, I waited with Colleen for the results.  I said, "I doubt it will show anything," and was not overly worried.  I didn't really know how serious blood clots were but they sounded bad.  After some time, a different doctor came to tell me the results.  She seemed serious when she said I had three small clots in my lungs.  I don't remember what else she told me but came to understand over the next hour that they would put me on heparin right away and that I would be admitted for treatment.  The nurse was having a difficult time getting the IV tubing set up and I was getting increasingly agitated as the doctor tried to explain again what was going on.  I asked if I would be okay and the only answer I got was, "It's good you came in."  Ugh.  They finally got the IV sorted out and injected a huge bolus of heparin.  My confidence was sort of shot with that particular nurse and I just hoped she was giving me the right amount.  Colleen was there and after the chaos calmed down, I started to relax a little.  Over the next hour or two, I could feel the pain lessening in my side with the heparin starting to work.  The IV heparin drip would continue for another day or so.

 I think the blood clot is that dark spot in the left wedge-like vessel. Get that?

I was moved to the telemonitoring floor where they would be watching my EKG constantly at the nursing station (in case I suddenly keeled over, I guess).  I was hooked up to the IV, the EKG leads/box, my insulin pump and had my Dexcom CGM handy.  Oh, and of course I had to keep my iPhone by my side.  It was impossible to move anywhere without dropping something.  I still can't find the clip for my pump so I have been carrying it everywhere.  I tried to see how low I could get my heart rate and was sort of disappointed it wouldn't go below 45.  I think I can get it to 42 when I am really rested.  I was hoping a 45 would set off some bradycardia alarm but alas, they were not concerned.  They frequently checked my blood pressure and temperature and regularly drew blood for lab tests.  Unfortunately, my veins were not happy and they had about a 30% success rate of finding one.  Most of the bruises have just disappeared.  They gave me pain medication when I asked, and I should have asked more frequently.   I was quickly breaking out in a rash all over due to some allergy and they decided it was probably from the morphine and/or vicodin.  I was not happy with the way vicodin was making my head feel, anyway, so we stopped the narcotics around noon on Wednesday.  Later, my doctor determined that the allergy was due to the IV cephalexin (antibiotic) I had post-op.

All throughout the day Wednesday, I had a stream of visitors who really kept my spirits up (and kept me distracted from worrying).  Those visits, flowers, calls and other help really meant so much to me.  Thank you, thank you.

I had an ultrasound exam to check for blood clots in my legs (negative) and a brain CT to check for possible brain injury, since a blood thinner could cause significant complications in that case.  I continued to feel sluggish in thinking and speaking, and since I work with people with brain disease and trauma, I know the signs all too well.  I was so worried.  At one point, the nurse said something that made me really scared and I called my mom and asked her to bump up her flight to that evening, instead of the next morning.  I think the comment, "I've had a patient die here from this," was not helpful.  I guess I wanted to know how serious it was; I think I would do better with statistics than a horror story, though.  After that, the doctor's suggestion that my prognosis was good didn't really stick well.

Thursday morning, I received the news that my brain CT was clear. I was feeling a little more clear-headed and was greatly relieved by these results.  The nurses had started me on a twice daily regimen of Lovenox shots on Wednesday, as well as coumadin.  The coumadin (i.e., warfarin) is a drug that interferes with blood clotting, and is the drug I will be taking for six months while the clots dissolve.  It takes a while to build up, so in the meantime, they wanted me on Lovenox as a backup.  Lovenox is a form of heparin that also works to block clotting.  The needles are huge and leave bruises that don't want to go away.  Since I was comfortable giving myself injections, I was sent home Thursday.  Thank you to Alissa for helping my mom with the flowers and for taking me home.

 Flowers from the hospital stays.

My INR, a measure of clotting time, was 1.5 when I left the hospital; they want me to be at 2-3 for the duration of my treatment.  I continued taking the Lovenox shots until the next Monday.  Since then, my INR levels have been 2.7, 2.3, 1.7, 1.4 and then 2.6.  I will continue going in for blood work a couple times a week until things stabilize better.  I have learned that the INR is affected by foods, exercise, sickness, stress, etc., which sure sounds like another fun drug that I get to take all the time (i.e., insulin).  But fortunately, there is a clinic with pharmacists who read my results and call me, telling me how much to take for the next few days.  I am looking forward to going in for blood work less often, since I'm getting weary of being poked in my arms.

As of now, the pain is gone except for my back and shoulder and occasional headaches.  The clavicle is healing well and I can already drive.  The road rash has mostly healed.  If it weren't for the blood clots, I could imagine being out on the road again in another week.  I am still easily fatigued, though, and don't want to ride until I am 100% confident of my upper body stability.  Although racing is completely out of the question, I have been told it is okay to ride my bike while taking coumadin, as long as I am extra careful.  But since I am always careful, I'm not sure what this will mean for me.  I was glad to connect with a few other athletes who have had blood clots and continued training to some degree while on coumadin.  Compared to last year, I am physically less injured.  But the clots present a different challenge that from here on out, seems more mental.  It has been hard.

I am so grateful to the many friends and family who stepped in to help me out, and for your continued support.  It would have been impossibly difficult without you.  Thank you.

Relaxing outside at Crissy Field.

Here are some additional pictures.  My mom tells me I should warn you that they could make some people queasy.  But I don't think they are so horrible.

Sunday, June 13, 2010

Race Report: 2010 Kern County Stage Race

I had meant to post this earlier.  Here it is, although it seems long ago now.  I originally wrote this up for my team back in May and have left it pretty much the same.

Race: Kern County Stage Race (Bakersfield area, CA)
Date: May 14-16, 2010
Category raced: 4
Weather: sunny, some wind, warm to hot
Number of starters: 22
Early Birds present: racing: Deanna, Michal, Anne; supporting: team director Laurel Green
Other teams present: Dolce Vita, Tibco II, Los Ranchos, Metromint, Velo Allegro, Los Gatos, MetalMtn, Lenovo, DudeGirl
Your goal for the race: Do my best to place high in the GC (general classification or overall finishing placement).

Short story:
We raced 4 races in 3 days and took 2 ice baths.  The races went: good, good, bad, great!

Long story:
Stage 1: Bena Individual Time Trial (ITT), May 14, 2010, 9 AM, warm to hot

We lived up to our Early Bird name by arriving before Velo Promo had even set up the tent, and were perhaps the second group there.  The parking area was next to the train tracks and also the road to the local dump, so there was a pretty steady flow of trains and trucks.  I had pre-ridden the 10-mile (10.2 mi according to my computer) course the day before a few times, and noted some pretty strong headwinds on the return leg.  The course starts out flat, then has a pretty steep and short descent, followed by a barely perceptible rise for a few miles.  Towards the turnaround, there is a mild climb for a couple minutes, which levels out as the road turns right.  I had borrowed a Zipp tubular front wheel and worked out my paranoia about getting a flat the day before.  I used my time trial bike and aero helmet.  I warmed up for about 40 minutes on the trainer and then rode some on the road to get a feel for the wind, which seemed similar to, although not as strong as the day before.  We started every 30 seconds in alphabetical order (the same order as our bib numbers).  I went off at 9:21:00 behind another category 4 woman; there were 2 gaps ahead of her from no-shows.  I would use the riders ahead of me as targets.  My goal was to pass but not be passed by anyone.  I worked pretty hard on the way out and tried to go harder on the way back.  I was able to pass the rider ahead of me after about 2.5 miles and got close but did not pass a group of two further ahead.  I could hear someone behind me on the hill but was able to pull away on the flat before the finish.  I finished in a time of 29:01 and came in 6th.  I felt that I could have been more consistent in my effort and that I wasted some time by veering around the road a bit, trying to find a smoother path.

Time trial staging area.  A train full of cars passed by right before this one.

After the TT, we found the local Trader Joe's (HOORAY for that) and then relaxed for the rest of the day, aside from our stage race ritual: the ice bath.  I apologize to the other hotel visitors who tried to get ice after we were done...

Stage 2: Walker Basin Road Race (~30 mi), May 15, 2010, 9 AM, warm, some winds

Again we scored prime parking spots (next to the graveyard of course) by our early arrival after winding through some narrow canyon roads.  It was fairly cool when we arrived and I contemplated putting on knee and arm warmers and maybe a jacket; but after warming up and by the race start, it was a jersey-only kind of race.  The finish was on a climb similar to Snelling Road Race (as I recall) and we pre-rode that a few times.  We would do 3 laps with time points possible for each lap for the first three across the line, and one final, 4th lap with more points awarded for the top 3 finishers.  The course started on a mild downhill over some rough roads (but not "Madera rough"), and then turned right onto some rollers, straight into a pretty decent headwind.  It then turned right and looped back through some mild turns to the start/finish at the top of a hill.  Centerline rule was in effect (which means all racers must stay to the right of the yellow line).  Before the right turn up the finishing hill, there is a straight-away, then a left turn and brief descent.  Laurel had pointed out a road sign on the left that might be a good place to start the sprint.  The hill was longer than one might guess.

Walker Basin area. No, the race was not on the dirt road. Photo courtesy of Jill Eyres. 

We started off and made our way through the first loop.  The pack was staying together although there were surges now and then.  On the outbound long stretch, the pack really slowed and often, no one would pull through to the front.  There was a strong headwind here.  I went out as did Deanna and also riders from Tibco II, Metromint and Dolce Vita (and probably others that I missed).  But once someone started pulling, there were not many willing to take the reigns it seemed.  After taking a turn pulling, my approach was to just keep slowing until it was semi-ridiculous and someone would eventually pull through.  I felt comfortable in the pack, moving around.  I wanted to be near the front for the first lap while we got used to the course, and also wanted to stay close to the front in order to try for some points and test a finish strategy.  We made our way around and were starting on the short descent and I decided to just go for it to get ahead at that point.  Well, I was ahead at the beginning of the climb but you know how this story ends... I was passed by two then more people right before the finish line. Dang! There was a gal from Metalmtn who stayed back and then just powered up that hill like she did hill sprints in her sleep.  Anyway, I decided that the effort was probably not worth the few seconds I would gain, and decided to try and conserve a bit more, working for a better finish for this race and saving energy for the afternoon.

The pack stayed together and I tried to work up toward the front on the last straightaway stretch.  People were jockeying for good spots and I was probably in the front third but not as far up as I would have liked.  We got to the hill and I was jamming it, feeling pretty good, but needed to shift to my small chain ring.  I tried and tried but it was stuck and the hill was getting steeper then BAM! it dropped and it felt like my chain had come off.  But it hadn't.  Some people passed me and I was mad but I got it going and worked to keep ahead of the gal beside me.  She had contested the first hill points and I had passed her then.  Everyone finishing with the pack was given the same time, which was A-OK with me.

Michal, Deanna and I warmed down and then jetted out of there pretty quickly to get to the Havilah Climb race site.  We had about 4 hours to recover before the next race.  We found some prime parking in the shade and started refueling and resting for stage 3.  I was sort of guessing on how to manage my blood sugar since I had never done two longer (longer than 1 hour) races back to back like this.  Before I got on the course, my blood sugar was a little on the low side; I was hoping I didn't have too much insulin buzzing around.  I ate a chocolate GU and headed to the start.

Pinning my number while resting up for stage 3. Photo courtesy of Jill Eyres.

Stage 3: Havilah Hill Climb (~11 mi), May 15, 2010, 3 PM, hot in the sun, cooler at the top

We staged the race on the dirt road at the entryway to the ranch where we had been resting.  No one seemed able to tell us exactly how many miles we had to go. 17? 13? 15? No one seemed to know, although we were pretty sure we would have 4 miles before we got to the base of the main climb.  We started on a gradual climb--someone had said it was a neutral roll out--with Deanna setting a manageable pace.  Because of this, the pack stayed together for about 3.5 miles on what was actually a pretty steady climb (as I noticed more on the return trip).  Some people eventually got impatient and the pace took off.  We turned the corner and started the real climb.  I stayed with the main pack for a couple turns but then decided to focus on holding my own pace.  I lacked some zing in my legs and so ate a bit.  I stayed with a couple riders for a couple miles and then felt myself fading.  I ate some more but just felt crappy.  I wondered if my blood sugar was low but thought it might also be high.  I should have checked it but I didn't want to stop.  I think I ate some more but with about 3 miles to go I felt really horrible.  Michal passed me, motoring up and looking strong.  I was happy to see her having a good race.  Our good friend Julie Nevitt (category 3, racing masters) passed me around 1 or 2 miles to go and asked how I was.  I knew from my response that my blood sugar was low, since I could just barely mumble out, "Okay."  I was so happy to see Laurel around the last corner and finally made it to the top.  I finally pulled out my Dexcom and saw "45" and that it had been like that for the past 30-40 minutes.  Ugh, no wonder.  I think one reason I didn't check coming up is that when I see that, it totally deflates any remaining motivation since I start to get scared.  On the other hand, my doctor would probably pull me out if he saw that.  I should have stopped to check.  Michal took care of me at the top and helped me fuel up on watermelon and I recovered okay.  I was glad to see Deanna finish and we took some time to relax at the top a bit.  The total distance was 11 miles or so, I believe, with about 7 miles of serious climbing.  I was disappointed that I hadn't been able to give it my all, and felt like perhaps the race was over for me, in terms of reaching my goal to place well in the GC.  At least there was some great practice descending for 7 miles on twisty, gravelly roads!  I pounded out my frustration on the final 4-mile, fast descent back to our cars.

Trying to put on a smiley face after a frustrating race.

We all more or less willingly took an ice bath that night, knowing we had one big race to go.  While I was reflecting that evening, I decided that I should just try and forget about whatever time I had lost.  Who knew what would happen?

Stage 4: Iron Hill Road Race (~46 mi), May 16, 2010, 8:45 AM

I had taken a look at a course map from and from what I could tell, we started on a longer descent.  Because of this, I really wanted to be in the front.  We started about 15 min late and people were huddling under the shade.  It was hot.  Soon enough we were off and I was on the front down the first hill.  Surprisingly, to me, though, it was more rolling the first several miles; I stayed in the front trying to set a good pace, expecting a longer descent at the top of each roller.  I felt like I was working pretty hard to keep the pace up as we climbed each roller.  Finally I moved back although I tried to stay close to the front.  We rode over the cattle guard (that could "kill you" if you rode over the middle according to the race official) and could see that the real descent was imminent.  Jill from Tibco II went to the front and set the pace down the hill.  I had not been quite at the front and was about 10 riders back, with a little separation and taking the inside line.  I came around a corner and saw a cloud of dirt off the side of the road, and then another rider down in the middle of the lane.  Oh no.  "Don't stop don't stop" was what went through my mind as my urge to stop and help kicked in.  (What I realized later is that in the moment, I was not thinking at all of anyone behind me, but only the rider who was down in front.  Thus it was crucial that I remembered and followed the "don't stop" rule that had been drilled into us by the mentors.  It made me feel totally inhuman at the moment but that was because there was not time to process the danger to those behind me as well.  Once I passed I remembered that there was a follow car behind us and that they would be given assistance.)  I slowed to avoid the rider and water bottles but was able to navigate around since I had taken the inside line.  I moved quickly to catch the group ahead and we finished the descent in silence.  Once it leveled off, everyone started talking about the crash.  One gal admitted to taking a line too wide and brushing the rider who came around her to the outside and who went down after the encounter.  The conversation continued, focused on the crash.  It was getting a bit negative and icky for me so after a few minutes of this I felt like it was time to move on and get things going.  Talking about the crash was not helping us to have a safer race at this point.  Jill from Tibco II, Christine from Dolce Vita and I set up a paceline; I wanted to take advantage of our break, which I felt had not been caused by the crash since I was behind it when it happened.  Still I sort of wondered if doing so at that time was a negative thing to do.  We had been riding comfortably for about 5 minutes, though, and still had a break and so it was time to get going. 

It took about 10 minutes to get things moving more smoothly in our rotating paceline.  One gal would pull off but not drift back and then the whole line would stall.  After this happened a few times, I rode up to her and just asked if she wanted to participate in a paceline. "Oh! Okay!" We increased the pace on this flatter section and our group of 8 continued until the next longer descent, where we dropped one rider.  I tried to hold up the group a little, but it didn't really work.  The momentum was moving fast and I didn't want to get dropped, too, so I picked it up again.  I had seen a really huge-looking hill on the profile and I kept expecting it at any moment.  It was when we started on the last big descent of the first loop that I realized we had already gone over the hills and that this course had a lot more flat and descending sections that I had thought.  Being in our paceline really helped make the climbs easier, since they weren't so steep that it became a truly individual effort.

Photo from the course by Jill Eyres.

Everyone chatted about the descent on the second loop and that we would all take it single file.  I wanted to be in the front, since I felt like I would naturally descend faster and wanted to keep it a comfortable but fast speed.  We all made it down safely and moved through the second lap.  I was a lot more conscientious about drinking water and eating every 40 min or so, since I knew it was hot out.  I was able to check my continuous glucose meter, and could see that I was in an okay zone.  What a huge relief.  We made it to the feed zone and I was so excited to see Laurel.  "Laurel, Laurel, I'm in the break! I'm in the break!" was what I was thinking but instead I yelled out "My bike computer is in the dirt!" since it had fallen off on the short dirt section right before.  Thank goodness Laurel picked it up! It would have been a super long and annoying trek out there otherwise, on top of a super long drive back to San Francisco.  The second time up the longer hill was tiring and felt never-ending; we could hear some music playing in the follow car behind us and someone asked them to turn it up.  So momentarily we were treated to some 90s rock music?  I can't recall the name but it I enjoyed the mini-party.  I had no computer and had no idea if we had 5 or 10 miles to go, so was so happy when he called out, "4 miles to go!" Hallelujah! Finally, we hit the descent, which had a lot of cornering but was not too technical, and rolled in close to Woody.  I knew the finish was a long climb and thought I would get dropped.  But then, in some effort at positive self-talk, I thought, "Hey Anne, you stayed with this group the whole time.  You belong!"  But I got dropped anyway (ugh!) and didn't have the energy to really push it harder.  I think there was one gal I could have beaten but knew from riding almost two laps with everyone that we had some super strong climbers in the group.  I also knew I wouldn't beat any of them for the GC, since the next time closest to me coming into this race was about 3 minutes faster.  (Thank goodness I had looked at the results beforehand.)  But I didn't want to slack too much because I had no idea how close people were coming from behind.  I just pushed through the interminable last 1 km and finally, finally reached the finish.  Lina from Metromint saved me by giving me a full bottle of chilled water after the finish.  My legs were ready to start a cramp fest.

Coming into this stage, I was about 11 minutes back; I noted that no one else seemed to pull in for about that time, or a little more.  Everyone in the break was ahead of me in the GC so my big hope was that we put enough time on the rest of the field for me to move up to 7th place.  And when it was all said and done, I finished with about a 1-min gap faster than 8th place and so was very happy to finish 7th in the GC.

I think stage races are my favorite road events, since the multi-day strategy adds a fun twist.  Also, with the various types of races, Kern balanced out peoples' strengths and weaknesses.  This particular event had a very friendly atmosphere and I got to know the other women pretty well by the end.  Of course it also provides a great opportunity to get to know each other on the team.  Also, Bob Leibold really makes the award ceremony special.  I would highly recommend this for everyone next year!  It takes 100 women for them to break even financially.  He currently puts this event on at a financial loss--it would be awesome to be able to support someone who is doing so much for women's racing in Nor Cal.

Early Birds Deanna, Michal, myself and team director Laurel (back) relaxing after a tough 3 days.

More photos from Jill can be seen here and the rest of my iPhone photos can be seen here.

Sunday, June 06, 2010

The Short Story

Memorial Day weekend, I was caught up in a crash that occurred directly in front of me while racing at the Hellyer Velodrome.  The most significant injury was an open fracture of my clavicle, which was surgically repaired the next day.  The following day, Monday, I was discharged and returned to San Francisco.  Early Tuesday morning, I felt severe pain in my right side, lower rib cage area.  I thought it was an undiagnosed rib fracture perhaps, but wasn't sure. The pain would subside and then return.  It made breathing difficult although I was not short of breath. I was worried I had experienced some head trauma and that I might not be getting enough O2 to my brain.  Late afternoon, I checked into the ER, where they determined I had 3 small blood clots in my lungs.  I was admitted to the hospital immediately and started on IV heparin to help dissolve the clots.  They would never really tell me I would make it through the whole thing so it was pretty traumatic.  I stayed in the hospital for 2 more days while they started adjusting my INR, which is the measure of how much the blood is clotting.  They want mine between 2 and 3.  I am taking a heparin injection (Lovenox) twice a day and warfarin (Coumadin aka rat poison) once a day to bring my levels up.  On Thursday when I was discharged, I was at 1.5.  While on warfarin, I am at risk for severe bleeding if I experience any trauma, so bike racing is obviously out.  I think cycling is out in general, since even a slow-moving fall could result in serious injury.  Also, "strenuous" exercise is out according to my doctor--such as exercise that might put a lot of strain on the muscles. (!!)  I am finding it really hard to get any medical advice on what that means, exactly, since I don't exactly fit the typical profile for people on blood thinners.  My doctor said most of his patients are elderly and that he doesn't have anyone in their 30s or 40s.  I don't think he can really understand my life.  I feel like I have been given a 6 month sentence and that I am now this fragile person--"Handle with care."  I think my body and mind were primed from the trauma last year, and it has been hard.  It is devastating to me because I had worked really hard to recover physically and mentally from last year, and was just at the point where everything was coming together.  Now, I find myself at the beginning again.  But this time, I don't know where I am heading.

I should add, on a more positive note, that I have gotten through this completely from the support of friends and family.  Thank you for your visits, calls, emails, flowers and other gifts.  I am very grateful.  Also, the clots seem to be dissolving so the long term prognosis is good.