I may have had problems finding a humorous quote about amnesia on the internet, but here is no dearth of inspirational quotes about adversity. All of us encounter various types of adversity in our lives. Hopefully, we become more strengthened by them than weakened. 

I have been trying to approach recovery from my bike crash five days ago with positive thoughts and healthy practices in order to heal as quickly as possible. I'm more of a fighter than a victim. I don't know how much a positive mental attitude has to do with physical healing -- how can you quantify something like that? -- but there's plenty of anecdotal (even empirical) evidence to show how important the mind-body connection is. I believe it's helping, so it probably is. I'm more certain that my level of physical conditioning before the accident has helped me recover faster.

I'm not totally healed yet by a long shot but I'm pleased with the results so far, especially for someone of my age.

I haven't had any major symptoms from the concussion. I do still have the same amount of amnesia from the wreck and I've come to peace with not knowing the cause of it. I'm grateful for no bad memories of pain from the hard landing and the half hour after it. My ribs and some of the abrasions are taking a little longer to heal but I see major improvements, which is encouraging. I've got more bruises showing up every day but they don't hurt.

I'll get through this. Hopefully, I'll be all that much stronger for it. No additional bravado, however. I think I'll be very careful not to konk my noggin on anything again.

PAIN IS INEVITABLE; SUFFERING IS OPTIONAL.

This is a quote I've heard about as long as I've been running (30 years), especially ultra running (more than half that). I always thought it was from a Nike ad or something, but on one website it's attributed to M. Kathleen Casey, so if it's hers originally, I'll give her credit.

Fortunately, I have had less pain after the bike crash than I expected. I sure don't have any endorphins dulling the pain now (since I haven't done any aerobic exercise in five days), so I have to give credit to the Ibuprofen I'm taking, the rate of healing that has occurred so far, and perhaps my ultra runner's stoicism. I'm used to pain. I don't like it any more than anyone else, but I have a pretty high tolerance for it.

My aches and pains have shifted somewhat over the course of the week.

I can assure you that the most painful thing I've done is to accidentally bump the major abrasions on my left arm or leg on something like a door or edge of a counter. Balance issues are sometimes a problem after a concussion but my clumsiness is nothing new. I've always been a bit of a "bull in a china shop," as much because of trying to move from one place to another too hurriedly as an issue with balance. It just hurts more now if I hit one of the deeper wounds, even the ones that have scabbed over. Youch.

I already miss views like this one from the Ice Lake Trail near Silverton  7-24-09)

On the third or fourth day I started getting a dull headache, possibly from the concussion but just as likely from using the computer so much this week with my old glasses. The main reason I got the new glasses, which were destroyed in the crash, was because of trouble with reading, close-up work, and using the computer. The old glasses are only good for distance vision. I'm not used to having headaches so when I get even a minor one I'm real aware of it.

One day I also had that 15-minute sensation of zigzagging lights that affects my vision but I had that a couple of other times this summer, not just since the crash. Some say it's a precursor to migraines. It usually affects me when I'm under some sort of unusual stress (I got the light pattern frequently the last few years I worked, but no headaches). Various vision disturbances may occur after a concussion.

I haven't had any other of the other possible post-concussion symptoms I listed in an earlier entry, thank goodness. The side of my head above my left ear that hurt when I touched it? It still hurts about the same, but only if I touch it. (So don't touch it, silly!)

Sometimes my rib cage hurts from the fracture(s) on my left side. Deep breaths to prevent pneumonia don't hurt any more, but my first -- and only! -- sneeze was epic. Oh, my. I'll stifle any more of those! Coughing and laughing aren't painful. Lying on my back in bed IS painful. It feels like someone's sitting on my chest. Sitting up from the prone position and getting out of bed at night once or twice to go to the bathroom is almost unbearable, so I've been sleeping half sitting up on the couch since the second night post-wreck. I can get into more comfortable positions there than I can in bed, and it's not difficult to stand up from a sitting position on the couch. I'll sleep there until there's no more elephant on my chest.

Mostly because of the rib fractures, I haven't done any exercise outdoors yet. I don't think the impact of even walking would be good for it or my sore head. I've been staying inside the camper most of the time to rest, stay out of dusty conditions, avoid infection from other people, and avoid strange looks at my face. My hair and glasses hide most of the remaining facial abrasions, though, and long sleeves and pants cover the abrasions and bruises when I go out.

WOUND CARE

I am so relieved that my face is not only healing better than I ever expected (sans bad scars, I think), but it's also healing faster than most of my other wounds. I'm so happy about that!!

Here is one of the Pathetic Sue photos that Jim took when I first got to the ER (if you think that's bad, the close-up frontal views of my face are more disturbing and I haven't shown them in the journal) . . .

Two or three hours after the crash

. . . and one from five days later, just to show you the astonishing progress:

Five days later  -- stitches are out and my face looks a lot better

I'll try to show a true "after" shot of this side of my face when it's fully healed. There was no damage on the other side.

Yesterday we drove back down to the hospital in Durango for a follow-up visit with an ER nurse to remove the ten stitches in my forehead gash (the one in my eyelid will dissolve in its own good time). I didn't get her name, but the nurse was great about answering our questions, checking out my other wounds, and giving suggestions that seemed more sensible than the ones we heard in the ER.

Maybe we heard the ER folks incorrectly, but I was sure they said to continue to use triple antibiotic cream on my abrasions and keep them covered with bandages until I came back to get the stitches removed in five days. We didn't get any written wound care instructions.

I'm glad we went back in four days, because Jim was right: after a couple of days, the abrasions should have been left open as much as possible to dry out and heal sooner. The nurse yesterday verified Jim's instinct. The lacerations and abrasions on my face were never covered, even when sleeping, and they have healed the fastest. Some of the others are still bleeding and oozing, especially when I take the bandages off in the morning or after our trip to Durango yesterday. The main reason I bandage them is because they are still oozing, but bandaging them seems to be counterproductive.

The nurse we saw yesterday said that it's important to wash the wounds twice a day with soap and warm water, then either cover them with a thin breathable membrane like Tegaderm or leave them open. I did clean the wounds at least twice a day all week and I've had no trouble with infection. The first two days I bathed with a cloth in the bathroom sink and washed my hair under the tall faucet in the kitchen sink, then apprehensively stepped into the shower on the third day and . . . it didn't hurt! I made sure the stitches and open wounds were well-covered with the Vaseline-like antibiotic ointment first.

Left forearm abrasion with Tegaderm membrane (8-7-09)

I've tried using the pieces of Tegaderm that the nurse gave me but I don't like them. The concept is good; I read some great reports about how the clear membrane, which can be left on 4-7 days, keeps water and dirt out, helps speed healing, and reduces scarring. One of the most useful sets of directions for application of the material, and drainage of fluids, was on a bicycling website! What I found was that the blood and other fluids accumulated faster than I could drain them properly, and the tape was a mess even when I made little "tents" for continuous drainage. I ended up using all the pieces but wasn't pleased with the results. It's probably more operator failure than failure of the Tegaderm.

On the nurse's recommendation, we purchased Mederma ointment at WalMart before leaving town. We had already stocked up on more bandages, pads, and tape and I noticed various products that promised a reduction in scarring. When I asked her about the products, she said many people have been pleased with Mederma. I've been using it on the abrasions that are no longer open, including my face, and the healing skin around the outsides of the ones that still occasionally "weep." It's not for use on open wounds.

She also reminded me of the importance of using sunscreen on the new skin that forms because it will sunburn so easily. The trauma staff emphasized that on Monday, too. The rest of my face, arms, and legs are pretty deeply tanned, so I may look like a patchwork quilt for a while!

Although Dr. Mapes was on duty while we were at the ER yesterday, we felt confident enough in the answers we got from the nurse about concussions that we didn't ask to speak to the doctor. The nurse advised us what signs to look for that are beyond "normal" and reminded us of the exponential danger of repeated concussions.

We already knew about that danger from the internet. That fact alone will probably be more likely to  cause me modify my future athletic endeavors than even knee replacements will.

SEEKING MEDICAL CARE WHEN TRAVELING

The challenges of finding good medical care on the road are increased even more when folks like us don't return to our home base very often. People who RV full-time and have NO home base can have even more problems when they need either routine or emergency care.

Jim and I have been pretty lucky with the excellent care we've received in the five years we've been traipsing around the country for months at a time. It kind of began during the AT Adventure Run. Although I was able to schedule an appointment in Roanoke with my orthopedist one time while we were in the area, I received prompt treatment by doctors, chiropractors, and massage therapists in North Carolina, Pennsylvania, New York, and Vermont that summer.

The same thing on our trips since then -- e.g., I had x-rays done in Leadville, CO after straining one of my knees two years ago, then followed up with an MRI and orthopedic visit at home. I've found good massage therapists all over the country, and both my old and my new insurance companies have covered my out-of-network emergency services as in-network. (For non-emergency care, however,m I had to first find in-network providers for that reduced rate.)

The front of Mercy Regional Medical Center in Durango (8-7-09)

This time I received good quality care at the hospital in Durango but a challenge was the long distance (about 65 miles) we had to go for 1) the initial ER visit, 2) the follow-up, and 3) a drugstore. There are no medical facilities, doctor's offices, or pharmacies in Silverton. That's the risk we take any time we go off to a fairly remote location to camp.

Now with any kind of annual or semi-annual care that really needs to be more consistent (such as dental cleanings, eye exams, mammograms/GYN visits, chiropractic treatment, dermatology check-ups for skin cancer, and yearly visits to the general physician) we much prefer to see the same doctors each time. That means scheduling as many of those visits as we can during the weeks we return to Roanoke each year. Strangely enough, the dental cleanings are the toughest to schedule because of insurance rules and our own schizophrenic race and travel schedule.

ODDS 'N ENDS

In order to make the long drive to Durango more cost-effective yesterday, we ran lots of errands. The most important after getting my stitches out was getting Jim's run-over cell phone replaced at one of the Verizon stores. He'd already talked to them on my phone. He knew the cost, terms, and that this store had what he waned in stock.

So that errand should have been handled quite quickly, right? Not. Have you ever been to a Verizon store? We are pleased with their coverage and most of their customer service, but going into the store has generally been a pain for us over the years because of the length of time it takes. Jim had to wait well over an hour to get his stored phone numbers transferred to his new phone because the guy in front of him had so many photos on his old camera that he wanted transferred to a new one. It took less than a minute to do Jim's numbers but he had to wait behind Photo Man.

Just get a camera, for Pete's sake!

The store has a display of several destroyed cell phones. Another woman came in with a run-over phone while Jim was waiting. I think that made him feel better about his. Hers was in two pieces, hanging together by a wire. She was able to talk to her husband on it (Jim was amused by that) but got a new one while she was there. Jim's was totally inoperable. He's very happy that his numbers could all be transferred. He had a copy of the numbers on the phone that he downloaded onto his computer but the file hadn't been updated in about a year.

It took all day yesterday to get everything done in Durango that we needed to do so Jim didn't get to run. Today he and Cody went back to my favorite trail in this area, the part of CT Seg. 25 that goes from Molas Pass to Rolling Pass. The weather was perfect, with no oncoming storms, but Jim decided to turn around after six miles (it's over eleven miles to Rolling Pass).

Photo of the two small lakes below the Colorado Trail in Seg. 25   (7-4-06)

There are two pretty lakes down below the trail that we always admire when we run that section. Today Jim decided to take Cody down there to swim. That turned into a bit of an adventure for the two of them! Not only was it farther to get back to the trail than Jim thought it would be (and all UP), the cross-country route he thought would be easier and shorter wasn't either easier or shorter. The landscape can fool you. Cody had more fun orienteering through the willows and sage and wildflowers than Jim did! He ended up lower than Molas Pass and still had to climb to get back to the truck. But he had a good last workout in the San Juan Mountains. I'm sorry I couldn't go with them.

And many congratulations to my brother Bill for walking his first official 5K race today!! Not only that, he was first of four men in the M60+ age group, in the top 25% overall, AND walked a speedy 14:16 per mile pace. I have to add some running to walk that fast! Good job, Bill!!!

I spent most of the day today working on web entries, catching up on correspondence, and writing thank you notes to some of the people who took care of me when I was literally "down" on Monday afternoon -- the Swansons, the ambulance crew, and the trauma team at the hospital..

I kept the wreck a secret from all of my family and most of our friends until I got the first four entries written. I wanted to do some healing first so I could assure them I'm OK, and the journal was the most efficient way to explain the crash and answer questions. After you've read this series of entries I'd be glad to answer any further questions. I appreciate the responses and concern I've gotten thus far. Thank you!

RACE & TRAVEL PLANS

My crash doesn't affect the rest of our plans for the summer.

Our next stop is Leadville, Colorado to work the 100-mile mountain bike race on August 15 and the 100-mile foot race on August 22. Jim is not running the race this time. Instead, we'll be working with the radio/communications team during both races and helping pre-race with packet-stuffing and rider/runner check-in. Lots of runners come out to altitude train for two weeks so it will be fun to see who's hanging out in town and running the course. I wonder what changes we'll see in town and in the races since we haven't been there in two years?

After that, we're heading farther west so Jim can run the Grand Teton 50-miler in Wyoming and the Bear 100 in Utah and Idaho (it spans the state line). It's been six years since we've been to the Bear. The course has changed to a point-to-point format and covers some new territory that Jim has never seen before, so it will probably seem like a new race to him.

Colorful leaves along The Bear course in 2003

Even before the bike crash I had no concrete plans for any other races this year. I'd do Sunmart and ATY in December if they were being held, but neither one is. There are some other fixed-time races I'm considering in the same time frame. I don't know how long it will take me to fully recover from this accident. I'm glad I don't have any races scheduled because I might start training too hard, too soon.

I won't be down for long, though. I was in great shape altitude- and hill-wise before the accident. That should facilitate recovery and maybe I won't lose too much conditioning. My main job is healing.

We're off to Leadville tomorrow. It's about a five-hour drive from Silverton, plus stops we'll make along the way in Montrose and Buena Vista to stock up on things that will be either unavailable or more expensive in Leadville. As much as we love the Silverton area, I think we've about OD'd on it after a total of 36 nights here (some before the Hardrock race, some after the Tahoe Rim Trail race in Nevada). This past week was a downer, too. A change of venue will do us both some good.

Since I'm back in the present time with the journal now, I think I'll continue updating it in real time and go back to fill in the gap between June 8 and August 3 as time allows. I'll include the upload date in red after those so you can tell which are new. We had a lot of fun in WY, CO, and NV during that time and I do want to include those stories and photos.

Next entry: news from Leadville and preparing to work the LT100 mountain bike race (a whopping 1,500 cyclists, including Lance Armstrong!)

Happy trails,

Sue AKA "Crash"
"Runtrails & Company" - Sue Norwood, Jim O'Neil, and Cody the Ultra Lab

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© 2009 Sue Norwood and Jim O'Neil