Injury--panic--asthma

[run it, ride it]

Backstory:

I did a real number on my clavicle last May. It was my fifth or sixth time on a mountain bike. The surgeon screwed me back together, I recovered easily from the ordeal and started riding again with the usual bravado. Then I had the hardware removed in November, and the bone re-fractured the day after surgery without provocation. Turns out I'm not invincible.

Pain never bothered me. I went through the first fracture without complaint. It was the circumstance of the second break that gave me pause--I'd just moved my elbow out slightly and CRRR-SNAP, seven months of healing bone collapsed. After the first fracture my surgeon had been after me to take it EASY, but the second fracture was another story. I just couldn't believe, after how careful I'd been the first time around, that my body was really so fragile. I refused to raise my arm above my head until my surgeon lifted it there himself in February, saying,

"Hey, if it's gonna break again, this is the place for it to happen!"

It looks healed, it FEELS healed, but it looked and felt healed when I had the plate taken out, too. My surgeon had never seen anything like what happened with me. We're still on uncertain ground for healing time. Technically, my only concern now is screw holes filling in. I am allowed back on a bike. When I was allowed back on the bike after the first fracture I leaped on quicker than a Thoroughbred out of the start gate. Second time around, I'm wary.

The positioning after break #2 was okay, so I didn't have another plate put in. But that also meant there was nothing to stabilize the bone. I consciously held back my shoulder for every second of the day and barricaded myself safely in pillows at night for months.

I still pathologically hold my shoulder in place even though the bone is once again intact. My shoulder feels like it's full of golf balls. I am still scared to do overhead physio exercises (the bone clicks and cracks and scares the hell out of me) and am on my way to a rotator cuff injury if I don't get on track. Logically I know this. I know the imbalance can be corrected with good training, rehab and massage therapy. I know reconditioning will be a long hard road, but I will get back to where I was. I know.

Here is the problem: the weather is above freezing and I've been back on the road bike, but I have a lot of work to do to catch up with the riders I usually go out with. I have exercise-induced asthma. It gets better with training and is characterized by a gradual constricting of my windpipe. I know when I've reached my limit and I let off. The more relaxed I am, the less it affects me. I am sure it's more than 50% mental. Running in the past week has not provoked it.

But on my last ride I had an asthma attack like never, ever before. I'd gone out with another guy who also needed some major re-conditioning. The pace was slow, but we got lost and ended up riding much further than planned. We were exhausted but good-humoured about it. Still, I felt anxious at how slow my hills were, concerned I was slowing him down... Up one of the last hills, my throat just closed. No warning, no gradual tightening. I panicked, undid my helmet strap and pulled away my balaclava. This wasn't exercise-induced. I was panicking. I thought maybe I was wanting or needing to sob, to cry. I gave into the impulse and my throat only closed tighter.

I didn't stop riding, as I felt I had to try to remain calm as possible, steady steady steady--as though stopping would be acknowledging the asthma and letting it consume me. It eased a little. The remainder of the ride was on-and-off asthma. I have never carried an emergency puffer--I knew my limits! But this was uncontrollable, unpredictable.

Has anyone else experienced this? I am sure the change in asthma is due to residual fear about my clavicle and frustration at my lost conditioning. Can this be fixed with good training and time? I wasn't afraid of falling off the bike, I was afraid and frustrated, I think, that I have lost too much conditioning to regain, or that I will always be injured, or that I will never heal. Now I am afraid about the asthma.

Will time heal all? You ladies are tough athletes, compassionate individuals, and have come through incredible amounts of physical, emotional and mental duress.

I trust you will have some words of wisdom!

Finally admitting fear,
RR

[kelownagirl]

Backstory:

I did a real number on my clavicle last May. It was my fifth or sixth time on a mountain bike. The surgeon screwed me back together, I recovered easily from the ordeal and started riding again with the usual bravado. Then I had the hardware removed in November, and the bone re-fractured the day after surgery without provocation. Turns out I'm not invincible.

Pain never bothered me. I went through the first fracture without complaint. It was the circumstance of the second break that gave me pause--I'd just moved my elbow out slightly and CRRR-SNAP, seven months of healing bone collapsed. After the first fracture my surgeon had been after me to take it EASY, but the second fracture was another story. I just couldn't believe, after how careful I'd been the first time around, that my body was really so fragile. I refused to raise my arm above my head until my surgeon lifted it there himself in February, saying,

"Hey, if it's gonna break again, this is the place for it to happen!"

It looks healed, it FEELS healed, but it looked and felt healed when I had the plate taken out, too. My surgeon had never seen anything like what happened with me. We're still on uncertain ground for healing time. Technically, my only concern now is screw holes filling in. I am allowed back on a bike. When I was allowed back on the bike after the first fracture I leaped on quicker than a Thoroughbred out of the start gate. Second time around, I'm wary.

The positioning after break #2 was okay, so I didn't have another plate put in. But that also meant there was nothing to stabilize the bone. I consciously held back my shoulder for every second of the day and barricaded myself safely in pillows at night for months.

I still pathologically hold my shoulder in place even though the bone is once again intact. My shoulder feels like it's full of golf balls. I am still scared to do overhead physio exercises (the bone clicks and cracks and scares the hell out of me) and am on my way to a rotator cuff injury if I don't get on track. Logically I know this. I know the imbalance can be corrected with good training, rehab and massage therapy. I know reconditioning will be a long hard road, but I will get back to where I was. I know.

Here is the problem: the weather is above freezing and I've been back on the road bike, but I have a lot of work to do to catch up with the riders I usually go out with. I have exercise-induced asthma. It gets better with training and is characterized by a gradual constricting of my windpipe. I know when I've reached my limit and I let off. The more relaxed I am, the less it affects me. I am sure it's more than 50% mental. Running in the past week has not provoked it.

But on my last ride I had an asthma attack like never, ever before. I'd gone out with another guy who also needed some major re-conditioning. The pace was slow, but we got lost and ended up riding much further than planned. We were exhausted but good-humoured about it. Still, I felt anxious at how slow my hills were, concerned I was slowing him down... Up one of the last hills, my throat just closed. No warning, no gradual tightening. I panicked, undid my helmet strap and pulled away my balaclava. This wasn't exercise-induced. I was panicking. I thought maybe I was wanting or needing to sob, to cry. I gave into the impulse and my throat only closed tighter.

I didn't stop riding, as I felt I had to try to remain calm as possible, steady steady steady--as though stopping would be acknowledging the asthma and letting it consume me. It eased a little. The remainder of the ride was on-and-off asthma. I have never carried an emergency puffer--I knew my limits! But this was uncontrollable, unpredictable.

Has anyone else experienced this? I am sure the change in asthma is due to residual fear about my clavicle and frustration at my lost conditioning. Can this be fixed with good training and time? I wasn't afraid of falling off the bike, I was afraid and frustrated, I think, that I have lost too much conditioning to regain, or that I will always be injured, or that I will never heal. Now I am afraid about the asthma.

Will time heal all? You ladies are tough athletes, compassionate individuals, and have come through incredible amounts of physical, emotional and mental duress.

I trust you will have some words of wisdom!

Finally admitting fear,
RR

First off, do you have an inhaler?

I was diagnosed with EI asthma after similar episodes in my first spring of biking. I got an inhaler and used it before, and sometimes again during strenuous rides. As my fitness level improved, I found I did not need it during warmer weather. Now I'm starting my 3rd season and I didn't use it all at this spring. So it leads me to the question - did I really have EI asthma, or was I just very unfit, or was it a panic attack combined with gasping for breath due to being unfit, or was it a combination?

I guess my point is - if my breathing difficulties were in part anxiety exacerbating the asthma (and I believe they were), then I still found using the puffer to help me, even it was actually a placebo effect. If I'm going on a really hard climbing ride, and temps are below 8 celcius, I carry my puffer. It puts me at ease. I think I'm less worried about, I'm more relaxed and it's less likely to happen.

[redrhodie]

{{{RR}}}

I think you need to take baby steps. You will heal. It takes time. Don't beat yourself up!

+1 to what kg said. You should carry an inhaler just in case.

[Tuckervill]

Because of the injury and the fear you are carrying around, I think you can't rule out a panic attack. I think more baby steps, other forms of exercise that you feel safer doing, and more time are in order.

The fears you have about not being able to regain your fitness are totally without merit. You can get it back and your bones will heal and you'll have fun on the bike again. You seem to have really good insight into your thought processes and the fears. Trust yourself.

Karen

[tulip]

There's alot more to recovering from an injury than the bones healing up. After my big crash, it was a month before I could look at a bike, and then six more of very slow riding. Not to mention that I wasn't able to form complete sentences for months, too!

It's essential that you ask your doctor about an inhaler. Asthma is nothing to kid around with. My experience with asthma was quite bad. It was induced by molds (in my apartment at the time), exercise (particularly in cold weather), and stress (at work and at home--I had alot!) When I moved into a house with wood floors and no carpets to mold, it got alot better, but the stress was still there. Then I had all sorts of life changes and I haven't had asthma attacks for a few years but I still have my inhaler.

Ask your doctor about the emotional part of recovery. Perhaps a counselor who is experienced with post-injury work would be quite helpful. Fear is a huge factor and often manifests in physical pain and stress.

[run it, ride it]

Tulip, I think you're right. I need to ask MY doctor. Not my dad, who also happens to be a family physician My dad is convinced that a preventative inhaler is all I need and brings home samples whenever I decide to go back on the stuff. I've never really discussed it with my own physician (his colleague. Small town. Boy does it ever get awkward sometimes!).

Tuckerville, a panic attack is more than likely what occurred. I -am- very aware of my processes and feelings. I have to be. I have S.A.D. that causes severe anxiety, paranoia and depression in the winter. Usually exercise focuses and calms me, and it IS all uphill after Daylight Savings, but it's still a process. I still slip back into the chrysallis before emerging light and vibrant for the summer. The past few years have been especially rough, I realize now because I was working nights and living in a basement.

I'm a little sick of counsellors fishing for reasons I might not be feeling up to par, convinced it was all just stress from school (hah! School was about the only thing keeping me focused in one piece!) when after a few cycles I figured it out, and it turns out I just needed some sunlight! This year I put a lot of preparation into understanding and handling the S.A.D. without medication. Lightbox, social support network, journals, etc. It has not been easy.

Handling that with the injury on top of it, parents way south sailing for eight months, death in the family, problems with roommates, numerous career changes, the usual 'I have a BA--now what?!' crisis--the fact that I am now having such intense reactions about an injury seems silly after I calmly dealt with all the rest!

Time I know is key. After I ran varsity X-C and track, I couldn't mentally bring myself to run for a year straight. That's why I started biking. I'd get out there and start -training,- -comparing- myself to the times I was running as a high performance athlete. It was two years before I could handle running with a stopwatch or track how far I'd gone!

Strange enough, I've been riding my horses and coaching lessons without fear. Haven't come off, yet, and when I come close to being thrown, the last thing on my mind is my clavicle. I did have one panic attack with my horse in the summer when I had a badly sprained ankle on top of the broken clavicle. One of those he spooks, I get scared because I don't have a foot to bail on, he gets scared that I got scared because I never get scared, I get more scared because his scaredness has escalated--until we were both just one quivering mess of sweat and tears. But that was pretty isolated!

Ladies, thank you so far for the reassurance and stories of similar experience. I know I'll get fit, I do...

[sgtiger]

((((((RiRi))))))

Like others have mentioned it could have been a panic attack. I used to get those - not fun. But also keep in mind that stress & anxiety can make asthma symptoms worse or come on more frequently. If it does turn out to be the asthma, then it's probably a good idea to keep an inhaler with you. If you're caught out without the inhaler, caffeine can help unless contraindicated. The Double Espresso flavor of Clif Shots has 100*mg of caffeine, so maybe carry one of those with you or whatever other caffeine delivery vehicle of your choosing.(My son likes Coke, but he is very rarely allowed to have it any other time.) I'm also concerned that your clavicle re-fractured after having 7 mos. to heal. I recommend taking a calcium supplement that also contains vitamin D, magnesium, and zinc. Did your doc do a bone density test after your clavicle re-fractured? If not it may be a good idea to request one.

ETA: I'm not a physician nor have I ever played one on TV. The above are just recommendations based on my experiences. YMMV