Friday, August 15, 2014

When last we met...

Notes, notes, notes. Please forgive the lack of focused composition as I jot...

I can taste the Autumn as it draws us closer. I look forward to the chance of a slight nip in the air early tomorrow morning. A loop of the BBU course, plus about 5 more, will be run if all goes as planned. It's the very course on which I will someday soon run three loops.

It's still difficult to imagine. I realized I was concerned about the 12 hour cutoff so I talked to Ian about it. As he did when I first emailed him asking for info on the Bradbury Dirt series, he answered my questions with his signature logic and put my mind at ease: The cutoff has some flexibility. I actually think 12 is reasonable if I am able to train consistently -- no broken parts. 

I seem to have been doing a roughly 15 mile long run every week for much of the summer, along with many wonderful hikes and shorter runs. I think I am ready to reach a bit. I anticipate that dealing with the antics of my spine and its belligerent cousins will be my biggest challenge, and the nearby presence of my friends and teammates will be my greatest boon. I am curious to compare these predictions to what actually occurs. I guess I really am treating this whole thing as yet another experiment.

I guided in the Bigelows for the first time earlier this week. My kids made this awesome slide show type thing after the event detailing what they'd learned. I chuckled to see versions of my own pearls ("bring LOTS of chocolate" and "it takes a 1.5 hours to make pasta on a constantly tended campfire") in writing & illustration.  But best of all was the picture of the albaquad. An albaquad is a four legged albatross that we all dreamed up together.  

There was a really great moment toward then end of the hike that I don't want to forget. We'd been out for almost 9 hours and people were trying hard to keep up morale, but one kid was feeling lousy and needed constant rest breaks. Somehow S and I started talking about music and to my surprise she mentioned having listened to some modern concert music like Steve Reich and John Cage at school, but she wasn't sure what she thought about it.  This is of course a hot topic for me, and I was eager to converse about it with a real live teen. 

Then it got even better.  "I just don't see," she mused, "how people can just improvise a melody on the spot."  The proverbial door to my proverbial home had flown open and I led her in for tea: I answered by singing a few bars of an improvised melody. She looked at me in surprise and wonder, calculating, hungry, neurons a-fire. Then, as if, taking her first steps in a fabulous new pair of shoes, maybe on a tighrope, she sang a few notes...and her first own little melody came into being. Sheer magic. Gone as soon as it happened, but happened it had. If it sounds beautiful to you, it will indeed sound beautiful to others...  

Southpaw's injury was 7 weeks ago today. I had trouble finding information at first, and kept googling the injury ("volar plate avulsion fractures") instead of how to overcome said injury ("stiff PIP joint", "PIP extension lag", "static extension splint", "pros and cons of serial casting"). 

When I finally figured out what to look for, a great deal of useful information turned up. And when I discovered CHT (certified hand therapist) Judy Colditz, I quickly became a disciple. After reading a few of her papers, I simply looked to her writings every time I had a question about my situation. In my experience, thus far, she has been 100% spot on with her recommendations and explanations. 

As Tim recommended several weeks ago, wrapping the fingers in Coban has been essential to reduce the stubborn edema. Colditz explained further that the presence of any circumferential pressure is more important in stimulating the movement of lymph fluid than any specific amount of pressure. 

My CHT, the wonderfully macguyverish Nicole, constructed a splint to encouraged PIP extension and sent me home with that, a compression glove that looks like something pilfered from a nursing home, and an instruction page of exercises. I soon learned that splinting doesn't actually suck too much IF you can get the thing to fit right. I added a bunch of padding over the fast-developing dorsal pressure points and jacked up the angle of the PIP joint, as instructed, as the ligaments slowly began to stretch. I tried to keep the device on for the recommended duration (at least 3 hours a day, the more the better, and all night) but sometimes it would just hurt terribly and no amount of adjusting could fix it. 

I was quite frustrated by the time I finally realized that the splint was not at fault. I'd stopped wrapping and wasn't using the old lady glove much because (bad reason alert) it just seemed like overkill. Plus it's easier to use a hand that isn't all covered in material/gadgets! So I started using compression simultaneously with the splint and lo and behold, the edema and pain were kept at bay, and the extra layers of padding helped too. Problem solved. A couple days later I was reading a Colditz paper on splinting and she mentioned that "splinting should also include some means of gentle compression".  Hm...noted...!

It worked so well that I again slacked off on the wrapping, especially on digit #4. It didn't seem too swollen or sore so I'd just wrap #3 and call it good. At therapy yesterday, Nicole remeasured the fingers to compare to the previous visit's measurements. Digit #3 was half better, half worse. Digit #4 was worse through and through. Everyone, buy stock in Coban and maybe also Vetrap... Motion is showing improvement across the board though, thankfully.

Nicole also devised a new splint to encourages many more degrees of PIP extension. It fits better and has more adjustment points. It will be a sizable step toward progress once the hand gets used to it over the next week or so. I never thought I'd get quite this perspective on hand-specific healing processes... 


  1. Are you doing the BBU 50 this year? Did I miss that? Cool!!!

  2. Yep, planning on 50 miles. I registered for the 50k but eventually I will get around to changing it. :D


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