Addressing the "what's up." This is a tad old, but I was encouraged to say SOMETHING. Having a good day, so finished up this post. Don't expect me to comment much into my symptoms of TBI. If you really really need to know, ask me directly. Some of this written stuff may be old, some of it may be new. My life has been confusing, so don't expect a complete understanding of "what's up."
I was inclined to giving up this blog. Principal reasons 1) not sure if I would endurance race again as I felt guilty about what racing did to my family and teammates 2) not sure if I would be able to race again 3) I feel like I missed 3 months of my life and barely figuring out what twitter is 4) getting alot of strange emails from this site. Apparently one of the "reviews" got linked to an online outfitters website driving up this site in the google search engine. A search engine guru had to explain to me how that happens and part of it is based on the subject heading of a blog post. Some searches will show up what I mean, as now this site appears high in the ranking. I've been told that is something that many websites spend years and money trying to achieve. My guess is it happened accidentally, but I have been persuaded to hold on to this. Apparently that outfitter has a powerful online presence. Strangely enough, now this site gets hundreds of hits on busy days, presumably back to those reviews, even if this site has been inactive for almost 3 months. I get strange emails that I really don't have energy for at the moment.
Fist of all, I want to thank the AR community and many others for the thoughts, emails, and calls. The kind words mean more than any therapy I have received. I want to address the rumors. No, I was not living on a ventilator like C Reeves. He had an unfortunate C-1 fracture severing part of his spinal cord above the respiratory center. Horse back riding does appear to be more dangerous than bicycling. It happens that gymnastics and horse back riding has the potential for C-1 injuries. Bicycling has mostly collar bone fractures and lots of abrasions, with a relatively low incidence of brain injuries, despite what some people think. I will preface by adding, after writing this I heard of an unfortunate and freak injury of Rob's Dad who became paralyzed after hitting a car on a bicycle--Rob is Michelle Lindsay's boyfriend for the few who know her or Rob. God be with him and his family. Life is ugly sometimes.
Sorry if I haven't responded to all email and phone calls. Life has been a wee bit challenging of lately. Many days I was just out, but sometimes I had a spark of energy to answer. Part of the benefit of email is that you can hide behind the cover of a typed word, as many times I don't really explain, as it's a drag. I mean, how do you really explain what it's like to have a brain injury. It also changes every day and sometimes hourly. Some of the days are exceedingly dark, and I am filled with anger. I will say, I have good moments and then I am productive again, and it feels great. The bottom line: I want people to know that I was involved in an extremely freak thing and please don't let it affect them. I will be ok. Actually, many people out there have been thru worse. After the accident, life has gone by somewhat quickly, and I have unfortunately missed out on alot. I just found out recently that a good friend from medical school accidentally died in Iraq while I was going thru all this. He was a trauma surgeon at Univ of Pennsylvania and on station in Iraq. He left his wife and kids behind. I attended medical school with her also. John was a great friend, very bright, hard working, but could drink us all under the table when needed. He and I traded off nudges at being top in our class, but in the end, he was first, and he deserved it more than any. His loss put things in perspective, but also makes me take pause when my neurologist reminds me how close my time came. I am kinda tired of people reminding me of that....
My life long desire is for people to be fit and get out and exercise, as we are too busy at work taking care of unhealthy people! Heart disease and obesity are killing more people a day than any endurance sport we have. In the US we have an estimated 2.5 million deaths/yr from heart disease despite advances in medical treatments. Compare that with the estimated 700 deaths from bicycling in 2008. Interestingly, 90% of those deaths occurred in riders not using helmets. Another bizarre statistic, walking is actually more dangerous than bicycling in terms of death according to a British medical journal study. Cycling is on par with riding in an SUV. In case your wonder, riding a bus is at the top, but motorcycling is off the charts bad for ya. I always knew that, as we used to get most of our organ donors from motorcycle accidents. Anyhow, the point is, exercise is good for ya, no matter. Life has a simple solution. If we ALL rode bicycles more, even possibly to work, we would help solve the health crisis, have a better answer for environmental concerns than any renewable energy scheme, and completely remove the swagger in the step of petroleum fed dictators. I keep hearing this over and over, that I survived and recovered quickly because of how fit I was at the time of accident. Fitness is one of the bodies best allies!
Sorry, off the soapbox now. About two weeks after the accident I slipped into symptoms of TBI. That's where I have been on and off. Initially it was mostly speech trouble, profound fatigue, and a few other fun symptoms. I seemingly slept enough those weeks to last a lifetime. Missed alot of work. It's sometimes described as an "awake" coma which is a good way of describing the feeling. TBI stands for traumatic brain injury compex. Don't bother googling it, you won't get far. This is different from L Neeson's wife injury. That was seemingly from bleeding that just didn't stop until it impinged on her respiratory and cardiovascular center in the brain. Her bleeding reported originated from the area surrounding the brain. We tend to call that subdural or epidural bleeding, and it happens to be very correctable, but she delayed going to a hospital. As they say with head injury, the person having it usually doesn't know something is going on. My bleeding stopped and rebled a few weeks later, but was different. I sustained intraparenchymal (within the brain) bleeding, versus the more common epidural type. Generally takes more of an impact to have intraparenchymal bleeding and it is sometimes harder to pick up easily on CT scan, as MRI's are better. As my doctors say, I was very lucky to survive this incident, especially since I got mediavacued to a horrible hospital. I suppose, Im more than lucky. The freezing cold day and hypothermia prevented more brain damage, I had teammates attending to me, and a race doctor, paramedic, and ambulance within an ear shot. Unfortunately, even minor incidents can cause the epidural type of bleeding, like L Neeson's wife. Bicycle helmets prevent most of those. The important thing to remember is if someone has head trauma, call a doctor or go to the hospital, and most importantly, see a neurosurgeon and/or neurologist. Maybe, don't endurance race solo?
In some respects, my next ambition is to set up a TBI head injury website as it's very difficult to get help. Maybe turn this into a TBI website? Part of the problem is that people with TBI forget. Often they forget they even had TBI or what it was like. I honestly can't remember many of the days, but my wife can surely remind me. Also I would like to address medical evacuation insurance. Surprisingly, the care I received was off the charts awful at the 2nd hospital I was med evacuated to. Med evac insurance would of prevented that as some policies allow you to name your destination hospital. Maybe just a freak thing, but I was literally forgotten about for 10+ hrs in the emergency room, as the ambulance driver apparently signed me out to someone who went off shift. Luckily I woke up after 8-10 hrs of being unconscious. Never received IV fluids until 10 hours after the accident until I became conscious again. The point is, med evac insurance will allow you to go straight to a 2nd hospital your comfortable with. The small cost alone would of prevented the very expensive flight my wife had to make.
Many people rely on the internet these days, even for medical advice, and TBI has very little on the net except for lawyer ad's. I hope to change that. TBI happens to be a cash cow as finger pointing is common after an accident. My accident was simply my fault. I just happen to be looking at a map and mentally counting the minutes we were behind the 1st place team. Some people I know thought it was funny that I was counting minutes, but in reality, it was barely 5 degrees outside and we were being careful, if even afraid of the weather. Still, I was worried we might get out of touch.
To dispel a few myths: people's brains don't have retrograde amnesia like on the TV show "Samantha Who?" Anterograde amnesia is possible after a head trauma. If your hit hard enough there is either a neutrotransmitter malfunction or damage to the nerve axon. Short term memory can be poor for awhile, but in most cases, it improves in time. In some respects, it may be a partly beneficial response, as people in bad accidents with head trauma don't have recollection for the event or the pain following the episode. As I recall, my fractures didn't bother me much for several weeks. I still don't recall the pain, even if my ribs still bother me when trying to swim. Another plug for medivac insurance, the hospital in SW virginia missed many of my fractures. One point: you don't ask someone who was unconscious in a head trauma to name "which parts hurt" and exclusively rely on that for xrays.
For those out there with TBI or getting a diagnosis of the similar postconcussion syndrome: See a neurologist! They happen to be the most experienced in TBI. They can help monitor your recovery and dictate things that can help. Most of the research on TBI is controversial as it is very hard to study. However, we know from crossover studies and stroke injury data that mild exercise for 30 minutes a day can help improve recovery by elevating cerebral blood flow. Although this is still debated, I did find that gentle exercise was helpful for many of the symptoms and very likely improved my brain function. Yes, exercise can help prevent mental deterioration in the elderly. The military has many ongoing current studies, and possibly we will have more answers soon.
Antioxidants are very important in healing but also in preventing alzheimer's or similar after an accident. So, a complete multivitamin along with antioxidants is important, which can be supplemented with a diet high in colored vegetables. Omega 3's are very important for normal health, but crucial post brain trauma. Alot of research on that. There is some evidence that the Omega 6:9 ratio supplements may help. Exercise supplements like recover-ease and similar are very powerful antioxidants. The more antioxidants the better when it comes to brain cell injury. If you can get these supplements or vitamins in a daily diet, make sure to include bioflavenoids and phytonutrients in the diet or consider consuming the Green First drink mixes. The brain cells are similar to other cells but happen to be very sensitive to damage. In adults, they don't regenerate like some cells in the body, so treating the damage is crucial for long term results. Hyperbaric Oxygen Chamber therapy (HBOT) has been shown to be effective in TBI. I won't know how effective it is in my injury for several weeks. I hope to be getting my first treatments next week as access to this therapy is difficult. A word of caution, HBOT is highly controversial in TBI. Speak with a neurologist before embarking on this therapy as in some cases there can be a worsening in symptoms, seizures, or brain injury if remaining air pockets exist inside the cranium.
Exercise happens to have been studied in TBI therapy during a Univ of Buffalo study showing that 30 min of mild exercise a day improved symptoms and outcome. This study is controversial, but I found early on that exercise was very beneficial, often being the only modality keeping the symptoms at bay. However, sleep is probably the single most important item for brain recovery. Most people with TBI have difficulty sleeping, which can turn into a dirty cycle, as without sleep, the brain won't heal well. No behavior modification will work in TBI brain. Sleep drugs are unfortunately necessary and very important. I used to exist on very low weekly doses of sleep, but for the meantime, I sleep nearly 2-3 hrs a day more. Still, exercise is the daily daytime regimen. It's also very motivating knowing that exercise is like "taking a pill" and highly effective if done within reason. I certainly have pushed the boundaries of what is acceptable, and I have a hard drive of data that I hope will help others in the future.
Many folks who experience a TBI accident end up with conscious and unconscious repercussions. Psychiatrists, psychologists, and hypnotherapy can be very beneficial. I personally feel hypnotherapy was one of the more powerful therapies I had. I was having alot of unconscious fears driving a car around, let alone cycling, that gradually became conscious. Hypnotherapy did wonders. I know have less fear of riding a bicycle than I did preincident, but in a healthy way, as I am now more aware. In the beginning, my fear of driving was such that I resorted to a bicycle on somedays. Sounds strange, but it worked. Hypnotherapy cleared all that up.
Because of the exercise "pill" phenomenon, I have developed a good base of exercise training, mostly all at low intensity. Taking time off work and working shorter hours has allowed me to get a daily regimen of exercise. As we have discovered, going away and abstaining from exercise was not good. Unfortunately, hypnotherapy doesn't fix everything. I have mostly lost my desire of racing, especially adventure racing. They say my old self should come back, Time does Heal. I was previously very goal oriented and wanted to attend ARWC (AR World Series) and 3 international races (Ecomotion Brazil, XPD Australia, and Team Extreme Iceland), but that desire is now gone. In many respects, most of the season is now being scratched off. My principal goal race this year was the 1000 mile Ride Across the West as a precursor to RAAM. My mother was my "crew chief", and in many respects my wife and her pulled the plug on that. I recently did the Rocky Gap AR race to see if my desire of racing would come back, but unfortunately it just made me more confused and frustrated. It had nothing to do with the placing. I at least was happy to surprise my doctors, as how does somebody with TBI get 3rd place. Despite leading the first legs, I nearly pulled out a few times because of the headaches. I was experiencing way too much emotion to be enjoyable. Since I suffer from short term memory loss, I can't really recall every thing I felt. Physically I remember feeling fine despite the heat and longer than anticipated course. Afterwards, my interest wasn't there in doing it again. They tell me that is part of TBI, and my old self will come back. People keep reminding me, Time does Heal. This race taught me it's a long way away. So, answering, "will I race again, or can I race with them." I really don't know when. Trust me, I wish I did. I truly miss my old life.
I do have alot of help. Whether coincidence or not, I had met with a multisport coach Ken Mercke www.fitness-concepts.com to help organize my life and make me faster back in early January. The accident put on hold any training plans, but it happens that Ken was involved in a serious bike accident and had a form of TBI, so he has been alot of help in many other ways. Hearing his fears as helped very much. The link is a shameless plug, but he deserves it so very much. I first learned about TBI from Alexa at Even Keel Spa leading me to get further help. I owe her so very much for the help early on. I really was a wreck back then, physically and mentally. Her place was the first to get me back on my feet and help resolve some of the spasticity from the brain injury. My neurologist is pretty hip and educated, and I have certainly tried every regimen from Chinese Medicine to most of the studied regimens of Western Medicine. Most importantly, my wife is my ultimate caretaker. In many respects, we are now health and nutrition freaks. The accident has been healthy for our relationship, I suppose. It certainly hasn't been easy. In the past, I was mostly the caretaker, so the role reversal has been healthy. In many respects, I have felt like I have gotten the chance to push the BIG RESET button in life. My wife more than anyone knows what the neurologist said. She now thinks I am "a lucky man, blessed, and probably indescructible." Many have said "boy, she must be pissed." That's hardly the case. I know she is getting tired and exhausted of watching over me, as we all only have so much patience. She spends her whole day taking care of other people, so I worry how much longer she can endure this. We have both agreed that any races I do in the future she has the right to say no. I have to give her that. She at least wants to see me racing again, and she misses the old me, as do I. When the "foggy" coma feeling of TBI lifted, I was temporarily relieved. However, other things became apparent, stuff that I am just gonna have to life with like hearing loss, eye sight problems, etc. I had a pestering tumor as a kid and went thru 3 operations. I have had worse. I went from being quiet and mello at the start of TBI to angry and mad sometimes. Just recently, my doctors gave me the green light to do higher intensity stuff, and wow, anger can be a wonderful tool when channeled into training. I had my final Brain MRI this week, fingers crossed.
As a parting note, I feel I owe alot of my life to Odyssey racing and their staff, especially my teammates. Odyssey has been very helpful and sending kind words, if not saving my butt in the field. Also, despite people's grumping about the USARA from time to time, little did I know, the USARA insurance saved my butt. I always thought it was just liability insurance for the race director. It happens to be an effective secondary health insurance policy with only a $500 deductible. Trust me, they were far easier to deal with than Carefirst Blues. That's another whole frustrating story. The notice from the USARA insurance came in the mail at a time when I was wondering how we were gonna pay the bills without me working. Lastly, people should never try and compare adventure racing to other endurance sports. AR just happens to be a niche sport. That's ok. True dynamic growth will only ever happen from sprint AR racing, but there are only a very few people out there capable or willing to put on those type of races. In reality, true AR can only accept so much growth, and does it really need it? I also had enjoyed triathlon in the past, and hope to do one or two of those this year if I can handle the intensity training. I feel triathlon has probably done more for fitness and health than any sport, except possibly running. However, people compare triathlon and AR, and you just can't. I was involved in a bike accident during a triathlon many years ago, serious enough that I wrecked my bike, bent both wheels, and got taken care of by the paramedics. During that whole thing, people just kept racing right by me, nearly oblivious to my blood on the pavement. I went home that day, and of course never heard from anybody after the race. That is the difference. AR is a community, and we watch over each other. If Ididn't have teammates with me, I wouldn't be here typing today. In many respects, as tough as the last few months have been, I am not sure how I would of dealt if I was the one watching the incident and the roles were reversed. I have known Joe, my friend and teammate, since being college roomates. I don't remember alot of things, but I remember listening to him tell the story of removing my chin strap and wondering if I was dead, but then he had to call my wife to tell her what had happened. I suppose, we race side by side, getting each other thru life, just like a race. When I raced the recent Rocky Gap AR race, I seriously cried during the whole first paddle when my body allowed me to do that again. I cried at the start of the race when my wife said "good luck and be careful." I cried for all the memories and friends that I cherish. Someday I will be back!
