April 30th, second ride (and still waiting for Spring)

Rode the S100 around Wabeek with Pauline , meaning some climbing but 4 miles only.

Left leg feels only slightly different, like numb but only on some spots. Standing up feels really good.

So i continued and went to Birmingham taking a longer route, for a total of 16 miles and 80 minutes.

The thing is, I don't know what intensity I can put. Since there is no pain or adverse feeling, I have to limit myself without any feedback.

So, I made some more research on the web, in French this time, and it confused me even more. Some guys stopped all activity for 45 days, some for only a couple of weeks.

Sunday April 24th, first ride !

So, this morning, we were off to Island Lake Recreation Area with the family. This is a very mellow single track, 13 miles long but with only a few hills.

I had prepared my bike by rising the handlebar by about 3 cm so I would be less bent over.

We warmed-up for 3 miles on the paved path before arriving at the trailhead were the singletrack starts. At this point I let them go and I was going to stay on the pavement and do my own very easy ride. But, since I know every turn and up and down of the trail and it crosses the road at several places, i managed to ride several sections of the trail while avoiding the major difficulties. Since I was alone I was really controlling my pace.

Turns out it was a blast. With my full suspension Superfly, i was barely making any effort. The few hills I did, I climbed them on the granny gear and i did not let my heart go up did not break any sweat (well temperature was in the mid 50s only).

It was good to turn the legs, even at low speed. I did 14 miles in one hour and a half of riding. Besides the shorts rubbing on the incision, still sensitive from that strips irritation i developed, it did not have any pain or strange feeling or anything. Of course, I did not try to push and I am sure I was below 120 bpm the whole time.

I felt rusted and not flowing but I think this is due to the fact I haven't done any singletrack since November or December, before the first snowfall.

I am not sure what to do next but I think I will do hour long rides on the Superfly with very gradual intensity increase. I will wear the HRM so I can keep HR in check.

My next appointment with Dr Oppat is in about 4 weeks and he asked me not to push until then. The only risk he mentioned was about the stitches, he wanted to make sure I was going to let them heal fully before putting stress on them.

That's OK with me, that will be perfect for going out with Pauline.

April 14th, first trainer ride

First day on the trainer since the eiae surgery. 30 mins at 13mph, low cadence 60 rpm.
Difficult to pedal and hold the handlebar. Did not want to push at all. Strange feeling of knowing you have a plastic tube bending in your belly.

The Surgery

The surgery was done April 7th, at the University of Virginia Hospital in Charlottesvile, by Dr Ken Cherry, which is Chief of Surgery there and is the reason why I traveled there from Detroit.

Dr Cherry has operated around 20 cyclists suffering from external iliac artery endofibrosis in the last 16 years. He was recommended by another cyclist that also had eiae, as probably the best expert of that condition in the US, knowing that this is a recently disease and the number of reported cases is very small.

Dr Oppat, the vascular surgeon that took care of my here in Detroit and confirmed the diagnostic of eiae, was kind enough to consult with Dr Cherry and send him my arteriogram and other exams.

In another post i need to explain how eiae was diagnosed and the symptoms the couple of years leading to the operation.

So, Dr Cherry got me on his schedule really quickly (like 3 weeks after my phone call) and the only protocol he needed to do was an Ankle Brachial Index the day before. Results of the ABI was exactly the same as the one I did in November with Dr Oppat : 0.23 after less than 4 minutes of a hard workout (on the stationary bike this time).

Valerie and I met with Dr Cherry the day before the surgery and he was really straightforward.

He explained that until he was there and looked at the artery, he did not know if he was going to do a patch or a graft. He also said he was going to do a second small incision and release the inguinal ligament on the left side.

He gave us the stats : 85% success.

The surgery went well. Turned out that the artery condition was much worse than the arteriogram indicated and they elected to do a interposition graft with a 8 mm knitted Gelsoft Dacron graft. 5/6 of the external iliac artery was removed.

Here's the sketch that Dr Cherry did when I saw him the next day.

Post operation was OK, I had some strong pain killer (oxycodon) prescribed and that helped for the incision pain.

They had me raise and walk in the hallway the next day, Friday morning (really I could have waited another day ... the incision was really painful and I could not use my core muscles for any motion).

I saw Dr Cherry Friday evening and he said I was going to be discharged Saturday morning.

That was quick.

My first feeling was that was too quick and I was worried I was going to hurt a lot but in hindsight that was an excellent decision.

Saturday late morning, I was able to walk slowly to the car and we went back to the hotel.

We even had a nice meal at the Mediterranean restaurant in the mall by our hotel and I spend the rest of the Saturday resting in my bed.

Sunday was the return drive home. Valerie and my father took turns at the wheel. We stopped every couple hours and I walked 10 minutes every time. Not a problem. We left Charlottesville at 8 and arrived home at 9 pm.

Later, Dr Oppat told me it was risky to have driven that much only two days after this surgery.

First symptoms

The first time I reported on my training diary pain or weakness on my left leg was in the summer of 2007, July 22nd exactly. So merely 3 years after starting cycling.

June and July of 2007 had been extremely intense for me. I did my first long endurance races. First the 8 hours of Cannonsburg, MI in mountain bike, then in France l'Ariegeoise cyclosportive (160 km and 3 or 4 passes) and finally the insane Etape du Tour Foix-Loudenvielle with 200 km and 5 passes, the most difficult stage of the Tour that year and my first Etape.

Tough program. And in between I would ride in Catalunya and in the Pyrenees.

Pain under intensity started shortly after l'Etape and I noted this several times on my diary in France and then back in Michigan.

I attributed this weakness to fatigue and overuse, maybe muscle damage after the exhausting Etape where I had to stop every km on the last pass (Peyresourde) that I crossed in total agony.