Athlete Blogs
February 18th, 2010Good-by 2010 season - hello 2011 season (warning: long, medical explanation)
I hate that I have another serious medical issue affecting my daily life, my cycling life and my athletic goals. It makes me feel like even though I'm only 35 years old, my body is aging, betraying me. This post will be a description of a long term problem I have been dealing with and one that has become much more severe in the last few years. In the last year, it has curtailed my activities, training and mental state.For much of my life I have had a "tight back". Even going back 10+ years, when doing long rides I have always had tightness and pain in my lower back - quite mild many years ago but something that has always been there. In years back this pain has been mild. One of those things where if you ride 5 hrs, the back hurts, more than anything else. I always just assumed it was the weak link in my body on long rides, never enough of an issue to stop me from doing what I wanted.
Over the last 5 or 6 years this tightness morphed into pain. Pain enough to seek chiropractic treatment, massage, that sort of thing. Usually only an issue after a long day or long weekend of riding. Most days nothing and not a chronic pain issue.
Going back 2 years or so this "tightness" became chronic pain. A dull constant pain 24/7, a pain that makes longer rides more difficult to endure, painful to stand up, drive long distances, etc. It got to the point I was going to the chiropractor weekly for adjustments which seemed to help, didn't hurt, but didn't solve the problem.
Go back 1 year, and I knew I was in trouble. I knew my body was failing me and knew I had a progressively more serious injury festering. Rides over 2 hrs were painful, painful enough that I'd do pretty much anything to avoid them if I could. No more longer races or group rides. No mountains of misery. No six gap. Shorter races and workouts, like 60 or 75 minutes were ok. I was able to maintain a very high level of fitness and FTP on 7 hrs/week - even reaching an FTP of 375w at 148lbs going into nationals in 2009.
In the fall of 2009 I had an MRI done and it showed 2 herniated discs. 50% of people walking around have some amount of herniation but show no symptoms or pain. The next step of treatment was a series of 3 epidural steroid injections to reduce inflammation and hopefully eliminate the pain. These treatments were done as an outpatient procedure, 2 weeks apart. They give you IV sedatives and pain killers which is fun for anyone who got a txt or email from me that day, and sadly give you some false hope that they fixed the problem. No dice, after each treatment the next day it was back.
At this point (november or so) I was only able to ride 75 min max and most of that time the lower back was hurting, but with tough workouts I tried to make the legs hurt more than the back. A solid 30 or 40% of the time I'd finish the workout, some days I'd give in to the back pain others I'd finish.
I continued to receive 2x/weekly adjustments, I wore my orthodontics every day, slept in a certain way, took glucosamine and even bought a new car with better seats to attempt to alleviate the cause. The result was I have a bunch of fancy pillows and a nice Lexus sedan, but no changes in the back pain.
Those out reading who have lived with chronic pain will be able to relate, but it is hard to describe the physical and mental effects of being in constant pain - day and night. Trouble sleeping, snapping at the wife, dreading standing up knowing it would hurt like hell - all had become the norm in the fall of 2009.
Having been through alot medically in the past, I remained as optimistic as I could and I continued to hope that conservative treatment would solve the problem and I continued to train with as much focus and precision as I could muster. Training finally did come down to a daily fight between total despair over the situation (usually at 5AM in a cold garage) and feeling good on the bike. Some days I'd have a good workout, feeling strong and motivated and some days I'd climb off the bike after 5 or 8 minutes in total defeat.
The next step was a test that I did today, 2/18/2010 which would determine which herniated disc(s) were causing the pain and what the modality was. The ideal situation would be to identify a disc that was causing pressure on the nerve - because going in and doing a Microdiscectomy is a highly successful treatment.
Unfortunately the test indicated that it wasn't pressure on the nerve, but rather both a ruptured L3/L4 and L4/L5 discs. Not only were the discs ruptured and leaking fluid, they were also degenerated significantly compared to normal healthy discs.
I was excited and eager to get this test done to figure out what is going on. I knew it would hurt. I had no idea how much - since I had to provide feedback on the how and where of the pain, no sedatives or pain killers could be administered during the test. It hurt. It hurt worse than any VO2 interval I have every done. It hurt bad enough that even IV morphine immediately afterwards did little more than take the edge off the pain.
So what is next? Next week I have 2 surgical consults and I'm not entirely sure what all of my options are except disc replacement. Given the level of degeneration I can't see any long term solution other than a complete disc replacement and honestly I'm ready for any procedure that allows me to live without pain and hopefully ride my bike pain free too. I'd be happy with the former at this point. The bad thing is that disc replacement is not necessarily a slam dunk like a knee or hip replacement is. In fact the surgical options are not terribly promising but I don't want to get too wrapped up in that now.
So as far as racing in 2010 goes - who the hell knows. I tried a few weeks ago at "january nationals" in chapel hill. Fitness was fine, I'm riding at a FTP of 330w or so, 155lbs, so not terrible - but after 90 min on the bike the pain was severe and once I hit 2 hrs in, I could barely pedal, let alone generate any real power - so I pealed off with one lap to go.
At this point I consider any riding I get in to simply be for health reasons, to help keep my sanity but I have no plans to race at this point. I had already long since given up on defending at masters nationals - though I am relishing the fact that I have numerous athletes that have outstanding podium chances. Even if all I can do is get on the rollers and spin for 30 minutes, do some pushups and stretches (Kristy likes it that I don't look sickly at 145lbs now) I will - because it's good for my mood and I know I've been a complete wreck some days and Kristy deserves an enormous amount of credit living with me through all I have had to deal with.
That's it for now, it's getting late and I have a long day tomorrow in Richmond for some meetings. Hopefully I'll have more information next week. Until then I hope I can wake up tomorrow and have a nice ride before I hit the road.
This weekend should be exciting for those racing in Greenville, can't wait to see how that goes. I know a particular M35+ guy who is going to hurt some people. I won't be there - Kristy and I are having dinner with some really good friends saturday night, and otherwise are planning a nice relaxing weekend at home.
Cheers,
Pete
