Wednesday, July 2, 2014

Pelvic Fractures Cheat Evolution



It is very important a rider has the best position possible on the bike. On flat ground with normal riding speeds, air resistance, the drag, accounts for 70 to 90 % of the force the rider has to overcome. This force increases with the square of the speed, so the faster you go, the more important it is to have efficient aerodynamics. The human body has it limitations. Years ago I capitalized on an unfortunate accident to improve my position, likely bypassing 100,000 years or so of evolutionary gains, assuming of course, fast bike riders are the major procreators, which seems reasonable, if not predictable. (Consider how universally attractive they are, the high energy level, unparallelled endurance and ability to suffer. And that's just the female racers)

Several days before a long vacation trip to the South of France I had packed my number one bike and rode my number two bike to the local Tuesday night race. This was almost 20 years ago, and in those days we carried a frame pump which worked very well but added a bit of weight. During the race I noticed it was a little loose so I snatched it off the mount, went to the back of a fast moving pack and tossed it to the side. When it hit the ground the pump took a wicked hop. Knowing I needed it for my trip, I had to look back a second to see where it eventually stopped. I bumped a wheel in front of me, and went down hard in a millisecond. I landed on my left hip and noted an immediate pain in my pubic bone.

The next stop was the ER where learned I had a pelvic fracture, requiring no special treatment. I was given a set of crutches and told to have my activity limited only by pain. The Orthopod  predicted I would not be able to ride for at least a month, but it was OK to try. The French trip was a done deal. We had paid for the plane tickets, the rental car and the house. We had invited a number of others who, like myself, had made all the 'not going to work' arrangements. So it was off to France two days later and yes I did take the packed bike.

This was my first broken bone and first set of crutches. I was given a prescription for narcotic pain pills which were stolen off my desk at work before I even tried one. No way I was calling the ER and asking for another prescription. They had heard the " pain meds were stolen or lost" story a million times and I would have been forever labeled a doper (pain med doper - the lowest). So I went with the ibuprofen whenever I had to do some moving around. There was usually no pain at rest. The problem with this anti inflammatory medication was it did something funky with my temperature regulation and frequently gave me hot flashes.

Dragging the luggage and getting on the plane caused a considerable amount of discomfort. After boarding I took a few pills and when all the lights were out, I felt I was comfortable enough to sleep. Mid flight I was awaken by the worst hot flash I had experienced. I made all the air control adjustments possible with no relief. I was burning up. Everyone on the plane appeared to be asleep including my wife Charlotte, who was right next to me. I had to take off some clothes. I assumed the maneuver would be frowned upon by any passenger taking notice but I concluded, besides family, I did not know a soul on the plane, would never see any one of them again, and could care less about their low opinion of me. I removed my polo shirt and carefully draped it over the back of the seat to avoid any skin contact with the upholstery. I had hoped to get several hours of sleep and get re-dressed before anyone could see me. I felt much better immediately and dosed off within minutes.

A short time later I was awaken by a belligerent passenger taking great offense with my attire. Fortunately it was my wife who already had a pretty low opinion of my antics. After a brief argument  it was back to sleep without the shirt. Luckily no one else was awakened, especially my 16 year old daughter, a typical American teenager, embarrassed to be seen with her parents. The sight of her dad without a shirt in a very public place would have put her on the Psychiatrist couch for a decade. When getting off the plane I wore my sunglasses with ball cap, looking down all the way to the baggage claim. I only saw a couple of people pointing.

We had rented an old farm house outside of a small village close to Moustiere  famous for painted china. The house was 20 paces from a thin country paved rode, half way up an 8 mile, 5 to 7 % climb, with a famous gorge at the bottom and the small village at the top. I was resigned to the likelihood  I would not be riding. It was very uncomfortable even to walk on the.ubiquitous uneven ground.

On the second day we went to the gorge and rented paddle boats to cruise the waters. To my amazement I discovered I could paddle (essentially same action as turning the crank on a bike) very hard with no pain whatsoever. Upon returning to the house, I unpacked, and with some help, assembled the bike. I put on my riding attire (kit), shoes, and helmet and went to the road prepared to ride. But reality set in when I found there was no way to lift either leg without feeling I was being pulled apart by some type a medieval rack. I could not get on the bike.

After standing next to the bike for a few minutes, pondering my options, I devised a plan. I walked the bike to a small tree in the front yard where there was a horizontal limb just over my head. I had Charlotte hold the bike and I pulled myself to a chin up type position. She then slid the bike underneath me as I lowered myself onto the seat. I was pointing downhill and toward the road. I could see there was no traffic. I clicked into the pedals, went through the yard and onto the road without a hitch. I was riding. Nothing beats the feeling of the first few minutes riding a bike in another country, especially with the scene so different from home. This was a mountain dotted with stone farm houses. Most of the farmers were growing fields of lavender, which we never see in the deep south USA. Their scent was glorious. Though July, it was cool and not at all humid. The road was winding and canopied with old oaks in single file, as is so common in Europe.

I started uphill knowing I could govern my speed so much more easily. It was four miles to the top and after a few switchbacks I was in a nice rhythm with no pain. No one was driving either direction. As I made my next turn, thirty yards ahead, stood a humongous wild boar in the middle of the road immediately displaying a hostile attitude toward my presence. I had never seen a wild boar and thought they only existed in story books. I would have been no less shocked to see a dinosaur. Going up hill, it is easy to do a near track stand i.e. moving way less than 1 mph. I crept along hoping he would move while slowly approaching his fixed position. The classic Mexican standoff.  I didn't think I could safely turn around on such a narrow road and I sensed my fleeing would provoke a chase I might not win. I prayed for a car either way which did not come of course. I knew I could not get off the bike. Five seconds seemed like an hour. Ten yards away I let out a blood curdling scream:

              " Get the fuck out of my way!".

Amazingly, despite the prehistoric look and the unlikeliness he had even attended preschool, the beast was able to understand enough English to get the point. He immediately turned and ran.

I made it to the top and back down without incident. I rode to the tree and grabbed the limb, clicked out of the pedals, pulled up and let the bike drop to the ground. This mount and dismount was repeated daily and I was able to ride for hours every day accompanied by my long time friend, Dick. The riding and the towns were fabulous. The bumps in the rode were killers, but other than these, which I learned to miss, there were no problems.

Given the new "flexibility" of the pelvis I decided to work on my position. Every day I moved my seat back a mm or so, stretching me out ever so slightly over the handle bars with my back more parallel to the ground. This did not generate any discomfort. I also was able to purchase a longer stem which is the piece connecting the handle bars to the bike frame, adding another cm or so of stretch. I then lowered the handle bars for the final adjustment.

I had successfully cheated biology and "evolved" into a really nice position which, despite my age, I have been able to maintain. When I bought my next bike and was fitted  at the shop in Atlanta sponsoring my team, the bike had to be specially constructed to add 2 full cm to the top tube, the part of the frame going from the seat (post) to the handle bars.

As you have likely heard "one good break deserves another". Two years ago another came my way. This one was at 54 mph coming down the Grand Teton Pass, resulting in another pelvic fracture, and as opposed to the first, "unstable". There was no riding for months and therefore no further work on the drag. I was happy enough with the position, so no issue there. This fracture necessitated a horizontal titanium bar about 12 inches long, running midway across the sacrum. It is very visible even with riding clothes. After the fracture healed I had to make the decision about it's removal. The new Orthopod went over the negatives: Infection, anesthesia, breaking off screws, chronic pelvic pain versus the benefit: It does looks a little weird and bothers me when doing sit ups.

To help with my decision I decided to review my old aerospace engineering books. My torso is a somewhat like a wing. The shoulders are the leading edge and with a small butt and some thickness though the chest I am convinced I have some "lift" at high speeds (Google- Bernoulli principle). Ever since my radical position improvement in France, I have been somewhat concerned about an unsteady back end and the implications it might have for further crashes. This is a problem for race cars and likely you have seen the solution. When I went back for the preop appointment he asked if I was ready to schedule the procedure. I replied.

             " I don't need an operation, I'd rather have the spoiler"
   
               




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