Monday, September 30, 2013

Stavanger Aftenbladet follows Day 4 of SBS

Norway still has real journalists, and newspapers too! What a concept... To cover Super Brevet Scandinavia a journalist and a photographer from the Stavanger paper met us in Skien. On the last day they followed the ride from Skien to Kristiansand.

Those who speak Danish or Norwegian can read the original article here! For the rest of us, click here to see the Norwegian version (with photos) with captions in English. A text translation (by Elizabeth Astrue) is below.

“And they choose to do this, when there are perfectly good buses to take!” Gunvor Vikan peers into the darkness. She's the night receptionist at the Sportellet (Sport hotel) at the recreational park in Skien, Norway. As bow-legged men stagger through the door there is a click-clacking sound, not of cowboy boots, but of bike shoes with metal cleats. A majority of those present agree that the Super Brevet Scandinavia seems more like a nightmare than a voluntary bicycle event.

At 9:30 p.m., a 50-year-old man from Ålgård lands in the lobby, hungry and in pain. (It feels as if someone has been hitting his thighs with a sledge hammer, he explains.) In the lobby, refreshments – a Coke and a pastry – are offered. They disappear, causing a blood-sugar spike for the exhausted cyclist. Now it's time to bend over to take off his bike shoes. The whole process is punctuated with groans and sighs. “Oh, my balls!” he exclaims in his native Danish. (Norwegians hear something even more comical—‘Oh, my stolen balls!”). From the sound of it, there is reason to believe that the cyclist forgot to lubricate his hind parts!

A few evenings ago, Johnny Stausholm boarded the new ferry at Risavika for Denmark, together with the carbon steed he would ride for four days and over 1200 kilometers. Previously he rode Trondheim – Oslo (550 kilometers), and a tour from Norway to Kosovo, a distance of 3400 kilometers in 22 days.

But the Super Brevet Scandinavia has proven even more challenging than these rides. It has brought many varieties of pain, not just for beaten-up, sore muscles, but also for hips, back and neck. Ever since a car collision from behind in April 2001, Stausholm has suffered from chronic and debilitating whiplash pain.

During the first years after the car accident, Stausholm spent much of his time at home, taking powerful pain killers. One day in 2008, he got on a bicycle. The pain throbbed throughout his body, relentless. Nevertheless, managed to start working again, half-time at Aibel as an engineer.

He could not avoid or escape the physical pain, but the mental framework of having a goal, building fitness, and pushing his own limits was an effective way of dealing with it. On Super Brevet Scandinavia, he wanted to see if he could take that framework to the next level. “Physically this is not going to be so difficult. The hardest part will be getting enough mental distance from the pain”, Johnny said before crossing the Skagerrak.

The sun goes down. Soon it will be shining somewhere else other than Siljan, outside of Skien. The moon is rising over Norway. If there were a man in the moon, he would be gazing down on a road of gray asphalt cutting through a field of half-ripened oats. Soon he would notice two miniscule, ant-like humans, each straddling a tiny metal frame with wheels at both ends.

They've been leaning forward in that same position since an early breakfast in Uddevalla, Sweden. At this point their bicycles have mowed through nearly 330 of the 350 kilometers for the day. The two men riding through the approaching dusk and cool are Peter Meisel (Germany) and Johnny Stausholm.

Finally, both of them dismount. Johnny opens his mouth, not to curse whoever invented the bicycle but with his own tribute to cycling poetry: “This was pissing hard!” (Not hard enough to make him abandon at Skien, as it turned out.)

At the gas station at Arendal, people roll up to fill up their tanks with fuel. The cyclists fill up with juice, water, chicken and lasagne. This is the fourth and final day of the ride around Scandinavia. Many of these cyclists do not look capable of riding 300 kilometers through the day and into the night. Some have soft, round bellies, which even the most spacious bike jersey cannot contain. But they all have mental endurance, an iron will and determination.

Jens Glad Balchen is the Stavanger man who bicycled 4800 kilometers in 11 days, as he crossed the American continent in 2011. He accompanied Johnny Stausholm on some of the qualifying rides for Super Brevet Scandinavia. “On a brevet, riders can hit the wall physically, and still press on. During one event like this, a friend of mine rode for three days without any sleep”, says Balchen. After the qualifying rides, he gave Johnny a gift: a tube of butt cream. On this ride, liberal doses were applied to both chamois and skin every day. None of that seemed to work in the end.

Riding with Johnny on the final day is Reidar Svendsen, 49, a nurse from Kristiansand. Reidar fishes a cell phone out of a pocket. “It is sore, and needs some care,” he says into the phone. (Is he talking to his better half about his lower half?) Having completed Trondhjem-Oslo three times, Reidar was looking for a bigger challenge. He seems to have found it, but admits that he could not have managed to reach Arendal without Johnny out in front, pulling him. “That man is a machine. I almost had to ‘throw an anchor at him’, to get him to slow down”, Reidar explains.

Looking at Reidar the nurse, all red and sweaty and on the verge of masochistic bliss, I have to ask: “Is it really healthy to push the body so hard?” “Next question!”, he replies before adding: “Mentally this is definitely healthy, as you're released from thinking about anything specific. If you ask doctors if certain body parts are harmed by endurance cycling, you will get varying answers”, he explains.

I decide to ask Svein Ørn, doctor and trainer for the professional cyclist Alexander Kristoff. He says, “Going on a drinking binge for several days is more damaging to the organs than riding a brevet.” “Trained cyclists turn the pedals about 80 times a minute”, photographer and cyclist Anders Minge tells me. That means something like 268,000 pedal rotations in 56 hours for the Super Brevet Scandinavia participants. The number doesn’t concern Dr. Ørn: “The knees can take it fine. Remember that professional cyclists can ride 30,000 kilometers in a year. Otherwise, the body can tolerate the stress of a long-distance cycling event easier than a shorter, strenuous event like running a marathon. Bicycling is not as hard on the joints as running. And it's easier for cyclists to eat, drink and rest. But in the end, it is all about listening to the body and not pressing it too hard”, Svein Ørn concludes.

At the gas station in Arendal, Johnny Stausholm declares that he's completely empty. Then he eats a piece of lasagne, takes a couple of mild pain relievers, throws his leg over the top tube and pedals on, with Reidar close behind. As they approach Kristiansand, Johnny mistakenly thinks they still have 40 kilometers to go; when he learns there are only 25 kilometers left, he turns to Reidar and says, “Let’s go!”

Together they push into Kristiansand, where the support crew is waiting. Johnny receives a medal around his neck, a cold beer in his hand, and broad smiles all around.

Jens Glad Balchen’s butt cream has passed the test. So has Johnny: “During the ride there were terribly painful moments, but I've reached a new mental goal. This is definitely a victory. This is my pain killer, my drug of choice.”

17 stories from 1200K

The Waterford, still not unpacked...

…nor the duffel...
I've been unpacking the ride:

1. Sailing lessons
2. The real ride begins…
3. Somewhere in Sweden
4. No man's land
5. Two kinds of fika
6. Darkness on the edge of town
7. Zombie breakfast in Uddevalla
8. The disease and the cure
9. Crossing over
10. The last ferry
11. What normal people do
12. Saving Norway
13. A deeper well
14. Norwegian Wood
15. Going through the car wash
16. And then god created the deli…
17. Still on the bridge


From other riders of SBS 2013:

Friday, September 27, 2013

A magnetic moment

Today I went to Valley Medical. Lay on my back on a tray. Let the technician slide me backwards into a metal tube.

I hate feeling trapped. So I closed my eyes and clenched my right hand around the panic button. Whenever I felt like escaping the metal tube I thought please let them find something, please let them find it, the root cause.

It has been eight-and-a-half-months since the neurosurgeon ordered an MRI of my cervical spine.

All I can say is, if Blue Shield looks affordable to you, think again.

Thursday, September 19, 2013

Come be human, like the rest of us

Time to put on the thinking cap!
You think a journey to recover from brain injury is mostly personal, right?

As in, who does she think she is, putting her personal struggles out there on the Internet? ;-)

Well it's true the process is 100% individual. Unique to each survivor. But that doesn't mean personal.

In fact, one of the most surprising things is that large stakeholders in my recovery have been completely and strangely impersonal. Their actions have nothing to do with me or my injury or what I need to recover. I've come to realize they're not invested in my success. There's no human connection.

Just to be clear, I'm talking about these social entities:

  • medicine
  • neuropsychology (the expert witness branch)
  • insurance
  • employers

To recover from a brain injury you'll need at least their cooperation. Hey I don't like it either but that doesn't change anything. You need them.

What happened when I needed them? It would take a whole series of posts. Maybe there will be a series of posts...

Or we'll just use a cycling event as metaphor. What it has not been like: the Tour de France or Paris-Brest-Paris. Supporters lining the route, cheering. Official sponsors and candy thrown from cars. Girls on podiums. Ordinary folks getting inspired. Headline coverage.

Nope, it has been more like a handful of supporters, immediate family or loyal friends or employees of Services for Brain Injury in San Jose. Spread over 1200 kilometers of unmarked roads. Rain and wind not in the forecast. Mini-marts turning out the lights as I walk up to the door. Locals throwing objects and running me off the road with their cars. No headlines. That's the reality.

There are people who are looking at how social entities function, why their actions are often inhumane, and how we can make them better.

Yesterday's New York Times has an opinion piece, Medicine's Search for Meaning. It's a hopeful one. It says that medical professionals are trained to distrust their emotions, that's why they can't express  empathy.

Some of the articles are less hopeful. More along the lines of Stanley Milgram's obedience experiment. They describe problems we don't have solutions for yet.

That's OK because it's not a bad thing to point out we have a problem. At least we're not pretending it doesn't exist and everything is working fine.

When we're thinking straight, we know the difference.

Wednesday, September 11, 2013

Go NeuroRacer, go!

Some practitioners seem to take a perverse glee in delivering dark, hopeless news about brain injury and the effects of aging on brain function. They actually seem to like it.

After all, patients can't possibly contradict them with evidence. They are the experts, which always feels good. And there's the hidden benefit of getting you out of their office. It's good for their schedules.

But some are actually pursuing solutions to the problem. Adam Gazzaley, M.D. PhD, for one. He looked at the grim dark news the medical establishment was handing out as recently as 5 years ago. Around the time of my accident. He thought 'I wonder if we can do something about that'.

The result is a video game called NeuroRacer, whose sole purpose is to improve brain function. It's designed to improve capabilities like multitasking, sustained attention, working memory. And it seems to work! You can read about it here.

If you can spare an hour, though, treat yourself to the excellent interview on KQED Radio.

NeuroRacer was built for a research experiment. It's not available commercially (there have been thousands of requests). It still needs to make the transition from lab to real world and that will take some time. It will be a journey...

At the very end of the radio show a caller asks given the (lack of) tools we have at the moment, what are the best things we can do for our brains, now.

Here's what Dr. Gazzaley says:
I'd say physical fitness has really yielded a remarkable amount of evidence that it has a powerful effect on keeping our brains healthy. So getting out and walking, interacting with other people, and pushing your brains, challenging yourself in your daily lives, I think are really a strong approach to keeping your brain healthy.
If I could change one thing about the world, everyone would have the capability for empathy. If I could change two things, every person recovering from a brain injury would hear this advice from the first doctor they see. The first visit. All in one go, with consistency, said just like that. In my case it felt like  a 1200K getting to this point...

When it comes to pass we'll retire this blog and go to CPH and hang out in cafes. Fika time! Pastries and conversation for everyone.

One pine

When both the lawyer and a soak at Watercourse Way happen on the same day, the order they happen in is key. Especially if the purpose of the soak is to head off getting sick. Repeat after me:

  1. Lawyer. 
  2. Hot tub.

Not the other way around.

Tuesday, September 10, 2013

The gift of the unexpected

A couple of cool articles to share. About the aftermath when something unexpected happens. The process of reinventing a life.
  • Two friends cycling across the US stopped in Aurora, Colorado. Where they went to a movie, a midnight showing of The Dark Knight Rises. The bike tour and their lives were interrupted. Last Friday in San Francisco they dipped wheels into the Pacific Ocean. 
  • After 20 years at the NIMH a psychiatrist is forced out of his position. He still has plenty to contribute but outside the context of his job, colleagues, workplace, how can that happen? He writes a book on how to make the most of adversity, how to adapt and learn from it. 
It sounds odd but life is so much richer since the accident. I'm NOT volunteering to go through this process again, mind you. Fighting is exhausting. Body, mind, spirit - depleted right now. Just saying there are benefits. They keep coming...

Right after takeoff from Copenhagen our plane had a mechanical issue. The flaps on the wing would not retract. We had to turn around. The pilot came on and said it would be a normal landing, but faster and heavier than usual. Because our brakes would heat up he had ordered the fire brigade at the airport, as a precaution.

We had 20 minutes to process what that might mean. Would the plane be intact after landing? Would everyone on board be intact? My seat was on top of the wing. They lowered the landing gear early to slow us down, and it made a horrible noise. The soundtrack of death. If the brakes caught fire, flames would spread toward the back of the plane. I would head in the other direction.

Everything went well. But judging from the applause on landing, I wasn't the only one having these thoughts.

Looking back on the experience here's a few more:
  1. There's no script - we can't know what comes next. Slow down and use all your senses. Take in what they're telling you. Savor each moment.
  2. My goodbye note was pretty ordinary. Not much original content. Note to self: dig a little deeper. Find something to say.
  3. Work used to consume my life. And I had trouble letting go of it. When the unexpected happens, you won't be firing yourself, you'll be picking up the pieces. Spend your energy on people who will help with that.
  4. Honestly there's no good reason to have an espresso before getting on an airplane!