Memories post Epic and back Injury 2018

Riding after Epic – written 2020

Andy and I did the 100 Miler from Clanwilliam.  Andy commented that we were fit from Epic and it was a fun ride. Stats 160 km, 9h40, 2915m. It was also very hot – swimming in river along the way. It was my first ride with new nutrition theory. We both realized we were still tired from the Epic. Otherwise, the race went well – was a long way though!

Andy and I had entered the Joburg2C which is in April, 2018. As normal, we entered Atta and Tankwa in preparation for this race.

Atta stats: 122 km, 7h59, 2416m

Tankwa stats: Day 1: 83km, 5h06, 1475m Day 2: 86.4km, 6h12, 2041m, Day 3: 84.8km, 4h39, 1089m

Accident and back injury in Tokai

My accident on Saturday 24 February 2018 in Tokai after doing the Silvermine loop around mid-day as it had rained in the morning.

I took a wrong turn (the place destroyed by the fires and I didn’t recognize the track) onto a downhill track. There are jumps with ditches which I didn’t know about. I was going too slowly and ended up flipping over when my front wheel clipped a ditch that I was unable to jump.

I flipped over, hit my head and landed on my back. I was in extreme pain but could move. I slowly worked my way back the dirt road about 50m back from where I called Pen to fetch me. I worked my way slowly down the mountain and got a lift from a crew maintaining the tracks. In retrospect I should have let myself be casevac off the mountain and been immediately stabilized. Taking myself to hospital and giving the impression of mobility contributed to the incorrect diagnosis.

I was X-Rayed at Constantiaberg casualty. They X-rayed my neck but couldn’t find any breakages so sent me home with painkillers and diagnosis of whiplash. I was in extreme pain and struggled to get from vertical to horizontal to sleep.

On the Monday I arranged for a physio appointment to help with the pain. She was thankfully very gentle. On the Thursday 1-3 March I still flew to Nelspruit to commission a machine only surviving on heavy painkillers. On the second physio visit on Monday 5th she advised that I get a second opinion as I should not be in so much pain. I was referred to Christian Barnard Sports Science Dr Kohler.

I had an appointment on Wednesday 7th where after a very short meeting (you mountain bikers are crazy) sent me for a CT scan. This took place on Thursday 6th. I was in the CT scan for one and a half hours. They could not give me the report but said I had to see the doctor straight away. I went straight to KOHLER but he said he would wait for the report and I should come back tomorrow (Friday). I duly came back on Friday where he looked at the scan. He said he needed advice from a colleague – who was not available. He said I needed further X-rays – which I duly had done. He said he would come back to me but I heard nothing for the whole weekend.

I then called and emailed my frustration on Monday. He called to say they “that they trying to decide if I needed a collar or not”. All of this time in extreme pain I called Hugh my GP and said I gently needed a second opinion.

I was immediately seen on Monday afternoon the 12th by Dr Polley, a spinal surgeon at Vincent Pallotti Hospital. He viewed the original CT scan and immediately identified 5 fractures – C2 split, T2 crushed 40% and pressing on spinal cord, T3,T4 &T5. He was not worried about C2 (neck) but stability of T2. He said that if he had seen me on the day of the accident, he would have operated immediately. But seeing that it was two weeks since the accident to go the slower but non-invasive route. I had a full thoracic brace with Philadelphia collar making neck, chest and back immobile for 3 months (only removed for showering). I had second X-rays after 2 weeks to ensure that still stable after which it was only a matter of time. The relief of seeing a doctor that knew what he was talking about and getting the right advice was immense. Overall of this time I was on the most powerful painkillers 4 hourly.

Dr.Kohler, when I called him to say that I was getting another opinion, he called me on the Tuesday. His last words to me is that I should wear a neck brace! Enough said.

And so, the recovery journey began. Slowly the pain eased and I was able to reduce pain killers. I walked a lot as the only form of exercise I could do. I was not allowed to drive so Uber was extremely useful. Managing the chaffing and itching was a struggle where I went through mountains of baby powder. Sleeping only on your back with a brace was interesting.

I was extremely lucky and as mentioned by other spinal specialists who have seen the X-rays, it was not my time. Being fit not only reduced my injury but definitely helped with my recovery. The muscles in my back gave immediate support to fractured back and neck.

After 3 months in the brace I was allowed to remove the brace. But no cycling or any impact as the bones take 6 months to knit properly.

I was referred to the most amazing physio team whose main expertise is helping patients recover from spinal injuries. They helped with the pain, advising on exercises and slowly getting mobility back. More than anything was the proper advice and also understanding what was happening and the process.

I was more determined than ever to recover. In the 3-6 month period I also went spinning at the gym very slowly increasing the intensity, really relying on my body to tell me how much. I was very careful as I was still dealing with pain. It was amazing to be able to exercise and break into a sweat without the brace.

My final check with Dr Polley was at 6 months where he gave me the all clear “but try not to fall again”.

My physio left Cape Town so moved on to Pilates by the same team. This is truly amazing for my stretching and spinal mobility and try to never miss a session. Such sessions are like taking a pain killer but better.

The moment I got on my bike for my first ride was something I had been looking forward to as I saw it as a major step to “being normal”. There was huge apprehension on my MTB because one can’t ride on single track without being positive and confident. For a long time, I completely avoided rough stuff until my confidence grew.

The other major impact was support from family and friends. There was not a moment that went by where I wasn’t contacted about my recovery. When I couldn’t ride, I regularly stayed in touch with my cycling buddies meeting them at coffee stops. I could not have stayed motivated without this support.

The support and guidance from Dr Polley and physios was critical in my recovery. After getting the correct diagnosis I really felt I was in good hands.

Having a solid base from physio, walking and spinning, by the time I was able to ride, I built up my strength quite quickly.

My first road race was the 100 miler about 8 months since the accident. It was very emotional.

Then DC At end November.

My first MTB race in 2019 was Attakwas 121km, 8:30, 2676m.

Then Tankwa 284km, 19h46, 4849mover 4 days.

Confidence on technical stuff is a real challenge after such an accident. But it is not possible to ride a MTB without a confident approach. In the end I invested in a dropper which definitely helps with a lower center of gravity on technical downhills.

Do I still have pain (2022)? It varies but I find I only have to resort to medication approx once per month. I am also realized that I have a high pain threshold and actually have to take this into consideration when trying to decide how sore I really am.

Dr. Polley did follow up with Constantiaberg Emergency and did put policies in place where patients with these types of accidents had to be referred and could not just be sent home with pain killers.

I checked my helmet properly and it had completely cracked on the impact. It definitely saved me.

Ongoing riding experience – written 2020

When we do our rides there is always a lot of discussion around medical matters, aches and pains. It was common knowledge that I was often on antibiotics for my chest, especially around season changes. The advice given was to see a pulmonologist.

After the Epic in 2017 my GP recommended Dr Sean Rogers.

I went for the assessment, and he found that I had an underlying infection in my chest that was never being properly cured. It could be related to asthma. I only had 80% lung effectiveness – something which I also had during the Epic. The treatment was a 20 day antibiotic and cortisone to hammer the infection and then a maintenance of a very low dose antibiotic and daily asthma pump.

This has worked extremely well from 2017 until September 2019 where I got a massive infection again where I had to withdraw from Cape Pioneer. So this topic is work in progress.

From the accident my mental goal was to be normal and healthy again. This creates enormous pressure, trying to do this while still having pain or effects of the accident. During the recovery phase where there was still a lot of pain which in a way was a controlling factor as it limited what I could do.

I did a lot of walking which was the chance to exercise while still in pain. It was an opportunity to go into the outdoors and also to think and reflect. Get my mind right. As soon as the brace was off after 3 months, I used the opportunity to start spinning. Here I started off on a low base and progressively built up.

With all of this there was a strong determination to able to carry on with my cycling as if the accident hadn’t happened. It was not just about the physical exercise. It is a stress reliever. Wanting my body to feel fit and strong again. It is the camaraderie with friends at the same time.

There is then the test to see if you are normal. My first road ride, the One Tonnner, was a huge goal and achievement. This was followed by DC, Attakwas and Tankwa.