Some Christmas Creations

As a toast to the recently released members of Pussy Riot (and because it's a fantastic name for a drink) I innvented a pretty tasty coctail over the holidays.

To a chilled glass add 2-3 cubes worth of ice, crushed or not.
Then pour:

• 1 shot vodka
• 1 tbsp pine-flavored simple syrup
• 1 tbsb porto
• 1 tbsp Cointreau

Stir briefly, Garnish with a twist of orange and add soda water if desired.

To make pine-flavored syrup, add 2 cups of sugar to 1 cup of water in a sauce pan and heat to the boiling point.  While the pan is heating, walk over to the christmas tree and pluck off 2 loosely packed cups of pine needles.  Place the needles in the heating syrup mix and bring to a boil.  Cool and place the entire mix into a jar.  If you want to kick it up a notch, you can whack the cooled mix into the blender and then blend until all is green and fragrant.  Let the particulates settle and then strain through a sieve.

Or, if you want to be a sissy about it, you could use a good piney gin like Tanqueray.

Leg Pain

My legs hurt today and it's awesome. This past weekend I went out for two 60+ mile rides with 'the fast guys'. See spot ride. Spot rode far. Spot rode fast. Spot is tired. Spot has trouble getting up the stairs. Spot has 40 stairs to climb from the basement to the 3rd floor in his new house. Woof. After two years of dragging through the aches pains and eventual surgeries that resulted from my screwed up leg, I'm finally seeing some real progress and remembering what it's like to go hard on a bicycle again. My legs feel fantastically pummeled after the weekend, tired in a way that I haven't felt ages. It is awesome. I had the idea a couple of weeks ago that I wanted to do Battenkill again. 3 other speedy dudes from the club are thinking of tackling it, and I've got some unfinished business with that race. It will be a great goal to shoot for, and after this weekend's riding, it seems that it is actually doable. I'm looking forward to the challenge.

Yeah,I hauled that

Turns out that my trailer can haul 320 pounds of crap. Not sure if I want to do it again though, my legs did not much care for it. Also, things were groaning and creaking pretty badly behind me during the ride. Better not to push my luck until they make some lighter weight cement.

Hot stuff

In advance of the coming frost I picked about 10 ghost peppers from one of the neighboring plots at our community garden. At first it must seem like am awesome idea, growing a weaponized chili plant. But then you taste the things.    Most sensible people realize upon eating the smallest sliver of one, these are not peppers to be trifled with.

Fortunately, no one has made the mistake of calling me sensible.Tonight I made death sauce.

I wore rubber gloves and long sleeves as a precaution, but I probably should have added a gas mask to the list.  Blending up peppers aerosolizes little tiny spice particles that make for an unexpected dose of capsaicin to the air. After a quick hit with the blender the air became rather spicy. Jennifer was coughing all the way in the living room and I had to flee upstairs to escape the fumes .

Now that it's bottled, the plan is to let it ferment a bit naturally and "mellow" before blending it up once again and straining the chunks.  Anyone stupid with an asbestos palate interested in trading the mix in a few weeks?

So, more house equals more house repair.

Even though the new place needs MUCH less work per square foot of real estate than the Mole Hole, 3 times the house is 3 times the house, and we want to put our stamp on the whole shebang.

I've been spending evenings in the basement with my cement; mixing up some slurry to spluck onto the walls of the basement to shore up any crumbling mortar.  I was getting my rhythm down pretty good and then I ran out of mix, so I shifted from putting up mortar, to knocking it down.  I spent Friday night knocking a hole in the kitchen wall to open up a window from years past.  While dirty, that part is really rewarding because it satisfies my long-standing need to take things apart.  It's even more satisfying than peeling off the label on a bottle of beer.

New House

So, after about 2 years of looking we finally bought a new house.  On Friday the 11th Jennifer and I closed on a house on 15th street, about 2 minutes walk from our current house.  It's got everything we were looking for, plus about 1000 extra square feet and $70,000 extra dollars, but hey we can't complain.  The whole deal seemed set to fall apart the whole time, so I didn't want to really blab to the world about it, but we've got the keys now, and the deed so it must be for real.

There are a lot of cool original features; doors with glass paneling, crown molding, cast iron heater vents--the works.  As good as it is, we of course want to fix it up and make it our own.  The kitchen will be redone and we'll fix up one of the bedrooms (there are 7 listed) before we move in.  The nice thing is that since we still have our current place, we won't have to sleep and wake up in a construction zone.  Plus, there are enough rooms that we can simply shift our bedroom to one of the spares if we decide to re-do something.

Perhaps the biggest downside thus far is that I feel like a total douche when we've showed the place off to friends.  The house is so big and nice that it seems like pure ostentation rather than something reasonable to own or live in.  That should probably go away once we put in enough sweat equity, but for the moment we're THOSE people.

The awesome light fixture in the entry way.

 Jennifer's at the back, and I'm at the front and it is a loooong way away!

 Toasting our success and bragging to family in the second floor bathroom.

 Jennifer's favorite 'room'.  This one is either the punishment box or the 8th bedroom, depending on how you look at it.

Here we are surveying the back of our property.  Huzzah! The fence is YARDS away from us rather than feet.

Look ma, I'm in the news!

http://www.newsworks.org/index.php/homepage-feature/item/59504-bike-share-program-to-bring-more-cyclists-less-helmets-to-philly?linktype=hp_impact

Now I'm almost as famous for bike share as I was for the Brompton race!

What they actually did to my hip

I went in for my post-operation 4 week check today.  Turns out, they did a lot more work on me than I had thought.  Not only did they stitch my labrum back down to the pelvis, they also had to 'microfracture' the socket of the joint where some cartilage had pulled away from the hip.  Here's the full text.  My favorite is that I now know that there is such a thing as "bone wax".

OPERATIVE REPORT
PREOPERATIVE DIAGNOSES
1. Femoral acetabular impingement, right hip.
2. Suspected labral tear, right hip.
3. Suspected chondral lesion, right hip.
POSTOPERATIVE DIAGNOSES
1. Femoral acetabular impingement, right hip.
2. Chondral labral lesion, right hip.
3. Large chondral delamination acetabulum, right hip.
NAME OF PROCEDURE
1. Femoral acetabular arthroplasty, right hip.
2. Repair of torn labrum, right hip.
3. Removal of chondral lesion, right hip.
4. Microfracture, right acetabulum.
ANESTHESIA: Spinal.
DETAILS OF THE PROCEDURE: Following meeting the patient in the preoperative holding area and identification of the extremity to be operated on, the patient was brought to the operating room. Anesthesia was induced. The patient was positioned supine on the operating table. All bony prominences were padded. The right lower extremity was prepped and draped in the usual sterile fashion.

Utilizing a small anterior incision and modified Smith-Petersen approach, the hip capsule was exposed. An I-shaped capsulotomy was performed. The labrum was examined. There was evidence of tear from 10-12 o'clock position. labrum appeared to have ossification also. The slight ossification was removed. The labrum was reflected free of the acetabular rim. The acetabulum was exposed. There was a large chondral lesion at the 11 o'clock position, which was unfortunately full-thickness. The chondral lesion was removed. Microfracture of this region was performed. The hip was irrigated extensively. This was followed by repair of the labrum to the acetabular rim. 

At this point, attention was turned to the femoral neck. There was a large bump at the femoral head and neck junction, which was removed. Once adequate osteoplasty had been performed, the hip could be flexed 110 degrees and internally rotated 30 degrees. Bone wax was applied over the area of osteoplasty, followed by irrigation of the hip-and closure of the capsule and overlying tissues. A sterile dressing was placed over the incision.

The patient was then transferred to the postanesthesia recovery unit. The patient tolerated the procedure well and there were no intraoperative complications. Dr. Parvizi performed the entire procedure. Three Arthrex Biotech anchor sutures were utilized for repair.

For the near term, it means that I can continue letting pain be my ever-vigilant guide.  I've been cleared to do anything that doesn't involve high impact, like running or tackle football.  Fortunately, I've got a bike that needs some riding.   The pain should generally subside over the coming weeks and months, and I should see an increase in range of motion and strength after 6 weeks when the bone is fully healed.  The doctor said that 6 months is when the labrum should have reattached fully and any replacement tissue from the microfracture should be in place.  This means  I should be essentially back to 100% by February and in time to actually race bikes next year.  Cool.
Long term, this also means that I'm at a higher likelihood of needing a hip replacement down the road, but probably not untill well later in life.  Dr. Parvisi thought that some time between the age of 65 and 80, I'd likely need a new joint.  Not so cool.  Also, I'll need to keep an eye on my other hip for similar pain so that we can catch it early on.  If we had gotten this one figured out earlier, it wouldn't have required removal of that chunk of cartilage, which would be better long term.  Now that I know what I'm looking for in terms of pain, I can hopefully catch that one in the early stages and save a lot of pain and annoyance.

For now though, I think I'll focus on a nice easy bike ride this weekend.

Let Pain Be Your Guide

I am pleased to report that I'm limber enough these days to ride back and forth to work.  My leg still isn't really working all that well, but certainly well enough to make the 1.5 mile trek in to the Municipal Services Building from home.  The doctor said, "Let pain be your guide as to what you can do."

Turns out my pain management strategy involves bikes, surprise surprise.

Since I'm not supposed to be bending my right leg past 90 degrees while riding, some modifications were in order-- I added a stem extender which moved the handlebars up about 4 inches, and then added a 80mm stem which I turned around backwards.  

Position so upright that it would make a Pashley Roadster blush.

BE HEALED

So, surgery went well I think. It's 7 days later and I am hobbling around pretty well without a crutch, though I still take one while walking to the subway and for longer trips.  I took last Tuesday through Friday off of work, expending some of my 42 remaining sick days.  An easy decision to make.  I had initially intended to go in to work on Friday, and probably could have managed it except for one critical oversight: poop.

I learned a valuable lesson in medicine this past week.  Opiates jam your shit up, very literally.  Since getting a drink of water was a pain, and going to the bathroom a bigger one, I didn't drink enough liquids on Wednesday or Thursday.  Also, I was enjoying the prescription of Vicodin that I was on, and the liberal instructions allowed me as many as 8 of those babies within 24 hours.  Well, as it turns out, that was dumb.  Friday morning I found that I had to take a poop but couldn't.  Not just a little constipated, but seriously impacted.  I've always had a pretty speedy digestive system, and this worked to my disadvantage this past week.  I spent the better part of the day on the toilet heaving and screaming and the like.  Look up "impacted stool remedy" and you'll get an idea of how things went.  I tried everything that they suggest on the websites and eventually succeeded to a degree, but gave myself a painful hernia in the process. Nice. The whole time I was sitting on the toilet I was paranoid that I was going to a) explode and b) wreck my surgery.  The one strict doctor's order was not to raise my leg to 90 degrees or greater if I could possibly help it.  I defy anyone to squeeze out a frozen cliff bar of poo with your legs at an obtuse angle.  Can't be done.

As for the surgery, I was in at 5 in the morning for pre-operation prep, was drugged up around 7 and was out of the operating room around 7:50 when I woke up to some paralyzed legs and a cozy hospital gown with heater built in.

It took about 6 more hours for the spinal anesthetic to wear off and for me to be able to move my toes again. Once that happened I was encouraged to see if I could move, pee and be on my way.  I still can't believe that i was able to walk out of the hospital some 9 hours after surgery.  Granted, I had crutches, and wan't particularly comfy at that point, but given that I'd just had hip surgery, doing pretty good.

What appeared in the MRI last month to be a torn labrum, actually ended up being a knob of cartilage on the ball of my hip and a matching cyst on the labrum.  Whenever I would bring my leg up to a seated angle, the knob of cartilage would bump into the labrum and throw my hip out of alignment.  This is certainly consistent with what I felt; it seemed as if I had a small gummy bear jammed in my hip joint whenever it moved.  Dr. Parvisi excised the nubbin and the cyst and put me back together.  I am supposed to let 'pain be my guide' and can start riding my bike as soon as tomorrow, if all goes well.  I'm going to make a test ride later this evening and we'll see how it goes.  Whee!

Under the knife

Well, a week can make all the difference.  I went to Dr. Wenneker again on Monday expecting some sort of head scratching and song and dance about what might be wrong with my leg.  To my surprise, he took one look at the report from the radiology lab and said, "Oh here it say's you've got a torn labrum."

Umm, isn't that what I was calling about all last week?

Apparently Jefferson Hospital is just as dysfunctional as the rest of the medical profession; Wenneker was never notified that the MRI that he'd requested for me was complete.  What the fuck.  At this point though, I'm honestly happy that they found something, anything that could be at the root of all of the problems that have kept me from my beloved bike riding for the past 18 months.  Let's get me into surgery and get me recovering and make this happen.

I called the surgical specialists at the Rothman Institute, the orthopedic specialty clinic at Jefferson, and was expecting a long wait.  Every other time I've tried to schedule an appointment with a specialist it's been a 4-6 week wait and I expected something similar here.  Nope, called on Monday, in on Wednesday.  I got in to see a guy who specializes in hip surgery at one of the top ranked clinics in the country in 2 days.  Once I got to my appointment, I registered on a touch screen and they called me up to the desk within 1 minute.  Then I completed my patient questionnaire on an Ipad and was ushered into the doctor's suite within 5 minutes.  Totally night and day difference in customer experience.  I did have to wait a fairly long time once I was in the room, but at least I was there, getting seen.  Maybe my standards have been lowered too far, but whatever, at this point it doesn't take much to make me happy.

Once he came in, Dr. Parivisi went over the MRI, X-rays and my patient report, flexed my leg around a little, listened to my symptoms and gave me 2 options.  Option one is to wait for it to see if it heals on its own, with maybe some anti-inflammatories.  Option two is to open me up, clean out the chunks of gristle that are all torn up in there and smooth out the cartilage on my hip.  I figure that if 18 months of pain is probably enough to convince me that time is not going to help.  We're going to go for broke and open me up.  This seems like the only reasonable option at this point, particularly since the last month has seen my hip pain get worse and worse.  I'm now taking 4-6 of my pain pills a day, rather than 2 every couple of days.  Sitting hurts, standing hurts, riding a bike hurts, sleeping hurts.  Time to get this show on the road.  I go in to surgery on July 30th and should go home the same day.  Dr. Parivisi said that I should be fairly mobile with crutches for the first week, and then weight bearing after that.  He expected I'll probably be able to get back on a bike within 3 weeks  and start aggressive physical therapy after that.  Full recovery is rather long though, 3+ months before I get full range of motion and strength close to normal.  Whatever.  I can deal with 3 months of improvement after 18 months of decline.

Fucking leg

Just a place holder here for what will probably be a diatribe.  My leg continues to hurt unabated.  I had an MRI a few weeks ago to determine if there was some tearing of the labrum around my hip joint.  After 5 calls, finally got word from the doctor that there was nothing to be found.

Motherfucker.

I was serioiusly pleased at the idea of something that someone could go in and fix.  Now I'm back in no-man's-land with damaged goods and no way forward.

I repeat; Motherfucker.

My RAAM experience was so much better than I anticipated.  I'll post a full synopsis when Meurig finishes, probably some time tomorrow.  In my time back home, I've basically been glued to the live tracker.  You can share the same experience of watching little dots move on a great looking map here:

http://www.tractalis.com/raam2013/ 

Seriously Colorado?

Found this stand in the Denver airport. Did not make a purchase.

RAAm Approacheth

I head out for California tomorrow to start the final prep for Meurig's RAAM attempt.  I'll be working the 12 hour night shift with Meurig's wife Kristie and a bike club friend Kevin the ex-seminarian psychologist.  Should be good times between 7 and 7.  There are 10 of us on the crew all told.  3 person night crew, 3 person day crew and 4 people running logistical support with an RV where we'll do cooking, some sleeping and some washing.  Conveniently, Kristie's cousin is a massage therapist and will be on hand to pummel the cramps out of Meruig, and maybe the rest of us.

I'm kind of on the fence about how enjoyable I think the experience is going to be.  I've seen Bicycle Dreams, and it looks like the majority of the trip will be pretty dull, interspersed with moments of panic or frustration.  That said, I have absolute faith in Meurig's ability to get the job done.  The guy is looking fantastic and has the constitution and mental strength to get across the country. As he put it "I'm just an engine, mate."  You can check out the crazies that do this thing in the trailer here.



Despite the anticipated boredom, I'm actually a bit bummed that I won't be crewing the whole event.  My Cadillac benefits package from the government is pretty crummy when it comes to vacation time and I was only able to take 5 days of vacation for this.  I'll be bailing out in Wichita KS.  The flights hopefully won't be too expensive and I'll take a moment to scrawl an image of the divine Flying Spaghetti Monster on the road before heading home.  The cool thing is that we're going to try to give live updates as often as possible on our way across the country.  I'll be twittering the shit out of the ride at 3 in the morning, so make sure your phone is set to silent mode if you follow along.

New/old leaf

I just bought myself the first new pair of running shoes in 7 years. Asics 2000's seem like a worthy heir to the 10 or so pairs of 1030s, 1040s, 1050s and 1060s that I bought over the course of my college running days.

As an interesting aside, when writing this post from my phone, the word running always seems to come up as "ruining".  Maybe there's a message there.

If bike sharing looks even half as good in real-life as it does in this picture, we can declare success.

Mayor Nutter, testing out bike sharing around Rittenhouse Square last Tuesday.

I'm quasi-famous

So, it seems as though I've got a lot of life to commit to the blog as of late, since time keeps on passing.  Here's an article written about some of the work i'm doing in philly published in Urban Velo magazine this month.  Glad to have been mentioned.  Check out page 61 to read about Philadelphia, and page 65 to see a picture of me in action.

http://www.urbanvelo.org/issue36/p60-61.html

Back on the horse, a little.

This past weekend I did 2 good bike rides in a row.   That's a first in over a year.  Saturday I hung on for the entirety of the ever-crazy, ever-dumb, Saturday Morning World Championships called Vino-Velo .  The basic idea is that you and about 20 of the fastest people who aren't actually racing bikes, but who think they are, get together and ride a set course through the suburbs of Philadelphia.  There are sprints, traffic lights, stop signs, hills etc.  I have avoided it primarily because it's a great example of why drivers hate bike riders here, but it is awfully fun to go fast with other people on bikes.  My knee/hip/leg pain was manageable for the whole ride but I was pretty sore later in the day.  I imagine that's the expected effect of not riding hard for 14 months.

Sunday Jennifer and I went out for a  nice ride through the hills to the northwest of the city on Sunday.  Happily, I wasn't suffering too bad from the ride on Saturday and Jennifer took it easy on me.  She does love to attack up the short hills though.  I'm sure that if it weren't for the whole fear of crashing thing, she'd make a good bike racer.  Now, hopefully the trend keeps up since spring is here.

So, I guess we are a bit wussy in the cold now.

Jennifer decided that she needed her hat in the shower.

A video from when men were men and bicycles were made of STEEL!

Nice sunset

For some reason I really love winter sunsets. This was out near Haverford on a ride yesterday afternoon. For the first time in a long time it felt like my knee was working well. Not anywhere close to 100 percent, but moving in a good direction and that made the sunset all the nicer.

Beaten

Yesterday was my third treatment by a new doctor who has an "alternative" form of treatment for my knee pain problems that have plagued me for the past year.  He does a treatment called IASTM (Instrument Assisted Soft Tissue Mobilization) which is a classy acronym for pummeling the shit out of my legs and butt.  For decency sake, i'm not going to post the gruesome pictures of my ass bruise, but basically Dr. Wenneker takes something like one of these:

And then does some of this to my leg--

The process is a lot like squeegeing out all of the scar tissue from the muscles and tendons.  Let me tell you, it hurts.  It hurts a lot.  He is also big on something called 'dry needling' which basically sort of surprises your muscle into relaxing and becoming more flexible.  The process involves taking an accupuncture needle and inserting it into the skin over a knot in the muscle, then you stab it in and out at various angles to trick the muscle into relaxing.  That sounds a lot worse than it feels.  Really almost no pain on that one until I watched them doing it and it was basically like watching a sewing machine needle disapear into my flesh.  Weird.

At the end of the day, I really don't care how much the process hurts, as long as the results are there.  So far, so good.  I definitely feel improvement in my mobility, and the tightness and pain around my hip have diminished a lot (except where I got jabbed with the corisone shot yesterday) and I'm hopeful that with some extra strengthening and stretching, I'll actually be able to keep the gains and start riding more.  Fingers crossed.

Go big or go home

That's right folks, Jennifer just received 5 pounds of gummies. Should last  a week or two.