May 12, 2017
If you’re looking for the backstory, you aren’t going to find the whole thing here. This here’s a story of being knocked down, hard. Punched in the mouth, kicked in the ribs and stomped on when down. It’s a story of beating the odds and finding the beauty in the ugly. Being told “you may never” only to rise to one knee, then eventually to two feet, and achieving flight once again. This is a story of birth and being reborn. This here’s a story of a racer’s weekend turned into an 9 month ordeal consisting of 4 operations, loads of occupational therapy, babies, wives, and the people who helped make flight a reality once again.
It all happened coming in a bit too hot into this rock garden right here. This rock garden sees many a wheel fall into a hole. I did what Troy Brosnan did in 2014. Sorta. Troy was on his line, I wasn’t. Came in a bit hotter than I was practicing and got sucked to rider’s right in the chop. My front wheel found a hole and it was all over. Looked just like Brosnan’s crash, only he was lucky to find some dirt. I got my left arm out and it must have landed on a jagged rock. Thought I broke it. Soon learned it was much, much worse.
Smacked my head good. Wrist was going numb and my left ring finger really hurt. And I couldn’t see. Did my best to find a rock to sit on. Felt nauseous. Everyone kept practicing, save for Jeremy who was on the side of the garden and noticed me down. My eyes were kaleidoscoping. All I could see were colors blending into each other. It was scary. I knew my wrist was smoked. Could feel pins and needles. Jeremy hurried over and asked if I was OK. Told him “No” and he peeled out to get help. Everyone else still kept practicing. Only one rider stopped and asked if I wanted company. “Hell yes, please stay.” His name was Kris Roy. I kept telling him I couldn’t see or focus my vision. I thanked him for being there. He told me we were all family and he waited with me until the first responders showed. Must have been 5 long minutes seeing those colors. I was terrified it would mean I had a brain bleed or something. On what felt like the 6th minute, my vision started coming back into focus. “Thank God,” I thought. Took a look at my helmet, no cracks or even any real marks. Took a look at my goggles; there was a giant scratch the size of a tiger paw through the lens. Rock must have hit my goggles when I face planted. Face took the brunt of it, not the helmet. That would explain the visuals.
Next on the scene was Ernie Reale. Came rushing over calling me by name. It was good to see a familiar face. He was going to try to cut off my jersey but he forgot to pack his snips. He called for a gator. Asked if I wanted pain management. Didn’t have much pain….yet. They loaded me up and took me down. Hand looked bad. It was way out of place. Finger starting to pound. Head’s fine now. Adrenaline pumping like mad. I ask Ernie where the nearest good hospital is. Albany. 1 hour away. I shifted my mind to getting there and could focus on nothing else. I knew what a 1 hour ambo ride might cost, so I was focused on getting myself to the right place, on my own.
When I got to the bottom, Amy was immediately by my side. Jeremy never left either. I was kind of freaking out. She got me to go to first aid to get a form-fitted compression wrap. I was real jittery. Just wanted to take off for the hospital. I was a horrible patient. Agitated, nervous, hyper-focused on leaving. Amy was the only thing keeping the medic working on my arm. I remember seeing Jeremy walk in to see how it was all going. I know this was hard for J. Injury isn’t what he likes to think about…on any level. He was fighting through that for me, I know. It was great to have these guys. Without Amy, the guy wraping and forming my soft cast would have quit, I’m sure. The medic turns to Amy sand says “He’s concussed, look, he isn’t acting right.” Amy responds, “He’s totally normal, this is him.” I gotta say, that was a funny interaction. The girl knows me. It was comforting for sure. She was in there taking care of me and it felt amazing. I remember wanting to hug her. I could see her urgency and concern for me. It was real and it was genuine. Will never forget it. #TrueFriend #4Life.
Got done and was ready to take off to the nearest level-one trauma; Albany Medical Center. Couldn’t bare to see Amy loose her practice or race day. I knew I was going to be at the hospital for a while. Had a bad feeling about it. I jumped in my truck not wanting to spoil anyone’s weekend, especially Amy. I knew she was on fire for this one and really wanted to see her finish. As I drove away, Amy was in the rearview mirror coming towards my car. I drove away on her fading smaller and smaller in the rearview. All I could think was “Love you, girl. Thanks for caring about me.” You made the situation easier Aim. Thank you for the love.
One hour drive to get to the hospital. They take me right in. Swelling by the minute. I know now that my finger is broken, figuring my wrist is too, for sure. I mean, look at it. Right?
Wrong. They come in and tell me there are no broken bones. “What do you mean?” I said. “Look at where my hand is!” “We know,” the doctors said. “You dislocated it. And in the process, you snapped every ligament. “How can you tell without an MRI?” I asked. “Because we see no broken bones on the Xray and your hand cannot possibly be in that position without tearing every ligament” they responded. That’s when I learned what a radiocarpal dislocation is. It’s a super rare injury. A lightning strike they called it. Exceptionally rare. Requires a force and velocity typicaly only seen in auto or moto wrecks. Told ya I was cooking into that rock garden, didn’t I?
Next I learned what it means to “reduce” an injury. Pain. Lots of it. The reduction process moves everything back into alignment. For 45 minutes, I sat with my thumb in a metal Chinese handcuff complete with 20 lb sandbags hanging from my arm. My thumb literally felt like it was going to fall off. No pain meds. They knew I drove myself and my plan was to leave as soon as I could. So no pain meds allowed. Doc said the reduction was going to be more painful than the injury and that it would feel like my thumb was tearing off. He was not exaggerating. Not one bit.
After I was done with the reduction, the docs in residency came over. They wheeled in a portable X-ray machine. The looks on these guys faces; white as ghosts. It was extremely real for them. Deep intensity. Heavy focus. It was hard to look at their faces. Their expressions were all I needed to see to know how bad this was.
They hung my arm back up and began to force all 8 wrist bones back into place. They shot an X-ray in real time, then manipulated my bones again by hand and with force. Again and again and again and again. Must’ve been 25 X-rays and 25 minutes of this. Turns out, these guys did an aces job. When I got back to Baltimore, the bones were so well aligned that the docs could not tell anything was wrong with me. My surgeon even complimented the team in Albany doing the reduction. See kids? Knowing what hospitals and what docs to go to could mean the difference between getting things back, or not.
Some hospital staff are better than others. Adam was great. He was supportive and helpful and even kept me company checking in on me and working with me on a plan that would get me out of there as soon as it made sense. I knew all along that I wanted to go back to Baltimore to get this fixed. Albany was trying to talk me into a surgery the next day. Do you know how hard it is to make a call on this kind of stuff when you are all alone? Knowing that the medicine in Baltimore is world-class for hand and arm, I knew I had to wait. Adam helped me get my medical records and got me out and on my way. Thanks a million, Adam.
Jeanie and Joe show up. Jeanine, a working nurse practitioner, takes care of me in the parking lot at 11pm by saying all the right things and rubbing my back. Felt so good to have that kind of compassion. This chick is great at what she does. Anyone that ends up on her floor hits the jackpot. And Joe. What can I say. Thank’s for the meds, and hang out time buddy. I love you guys and I love your family. You both made this so much easier.
Spent the night with the team in Windham and packed up in the morning. Big shout out to Joe, Dylan, Jeremy and Amy for helping me with the pit and all my packing. Special shout out to Joe for physically holding the tent down with his bare arms in the fiercest storm Windham may have ever seen. Lightning like the Gods themselves were in battle and power outages for days as a result. Without Joe, our pit would have looked like everyone else’s.
Called Amanda from the road on my way back to Bmore. She already had the top docs in Baltimore picked out and ready to go. It would be the Curtis National Hand Clinic working out of Union Memorial in Baltimore City. Drove straight to their ER with my records and the disc images Adam gave me. Got my appointment next day with the doc I wanted. Surgery was scheduled for 5 days after that. Did someone say our healthcare system is broken? Hmmm….
Picked this man right here. Dr. Christopher Forthman. I chose…..wisely. While the doc wasn’t all gung-ho and positive about getting me back on my bike, he was supportive. But also cautious. Great bedside manner; calm, collected and willing to talk and explain things. His approach was to keep me aware of what the worse case scenario could be. If I could change anything about this process, it would be that. The worst case scenarios got into my head and made the coping process more difficult. The wrist is a very complicated joint. When you tear as many ligaments as I tore, the carpal bones more than likely fall out of place. There are 8 of them and if they don’t sit just right, pain and arthritis will set in. The only solution after that, is a fusion. A wrist fusion means that you would have bone grafted into your wrist joint from your hip, rendering your wrist solid over a 3-5 month period. No more pain, but also no bending the joint.
I was terrified. There I was, facing the nightmare of my riding being taken away. Doc told me this was gonna be a 9 month recovery. Fine. I can do my time. Went outside his office after his consultation and the gravity of it all set in. I sat there with Amanda and let it process. Turned to her and said….”I got a 9-monther for a reason. I just need to find the reason.” She looked at me and said…..”Mike, I think I am pregnant.” The pain and frustration melted away. I hugged her. We were not trying. This was not part of the plan. But 9 months for me and 9 for her? This was our calling. “I can do this time standing on my head,” I thought. Promised myself right there….that by the time the baby gets here, I will be ready to hold her with two working hands.
Doc expected it to be a 2.5 hour operation. It ended up being 4.5 hours. He found a bigger mess than he expected. And he took his time. Thank you Doc. When I woke, he told me that the lunate and scaphoid bones did not want to sit properly. Had to pin them internally. He again warned me of the worst case scenarios. What I know now is that he nailed the procedure. Slam-dunked it. This guy took his time and dialed my wrist back in. Over 25 anchors. An anchor is a staple in a bone that you pass thread through. The thread then sutchers the ligaments back together where they broke in two. He couldn’t even tell me how many ligaments he repaired. There were that many to fix and it was that complicated.
If you’re following Ken Roczen, then you know what an external fixator is. They come with risk of infection and they are cumbersome to care for. Doc opted for a internal fixator for me. It was a metal bar roughly 9″ long bolted to my arm and hand that prevented my wrist from bending. Wore this for 3 months walking around with a non-bendable wrist. Surgery #3 removed it.
When I woke from surgery, the doc was standing at the foot of my bed underscoring the potential for fusion. I could barely think let alone here that grim shit again. My arm was nerve blocked. It felt like a giant club attached to my shoulder. The block wore off in 12 hours and the pain set in. It was incredible pain. I cannot do it justice in words. I have never felt this kind of pain and I have had my knee rebuilt before so I was not a first-timer. I asked for ice. They told me they could not bring me ice, only frozen bags of blue goo. The goo was frozen so hard it could not conform to my round arm. It was useless. Pain would not subside. All they were doing was pumping me full of opiates. I was begging for ice. No, they said again. I could not believe what was happening. To make things worse, the nurses really did not give a fuck. I just do not know how else to put it. They were awful. I was in debilitating pain and all they kept doing was getting me high with IV and oral opiates. I needed an anti-inflammatory protocol and there was none in place. My only choice was to bounce. Had to go home and help myself.
Left the hospital by yanking my own IV and jumping in the car with Amanda. She helped me get the fuck out. The hospital called my cell. I didn’t pick up. Amanda filled a cooler with ice water, wrapped my arm in plastic and I dunked it deep. This did it. Felt so good I can still feel the relief when I re-live it in my head.
It’s hard to imagine this happening, but it did. The police knocked on my front door. The hospital sent them. Crazy, right? Lady cop said she needed to make sure I didn’t have any needles sticking out of my arm. I showed her my arm and she asked what hospital I was at. I told her Union Memorial. She immediately moved off our door step and started walking towards her car. As she was walking away, she said “That place is the worst for aftercare. Whenever we have one of our own admitted, we get them out as soon as we possibly can.” Fascinating. Filed a formal complaint with the hospital but they really didn’t give a shit. Hired the right doc. That was a good move. The facility, not so much. Never want to go back to that hospital again.
The next 2 days would be some of the hardest time I have ever done. I thought I knew what pain felt like. I had no idea. What I felt reset the 10 on my pain scale. I remember grabbing Amanda and just holding on for dear life. I slept in 45 minute windows, then re-dunked my arm in the cooler for 20 mins again. This lasted for two days and then finally, the pain subsided. At one point, I really didn’t know if it would ever end. It was just that bad.
This is the first time I saw my hand post-op. The cut in the center is where the ligaments were repaired. The other two are where the internal fixator was bolted. The yellow balls are the pins inserted into my broken ring finger holding it together to heal. It was emotional seeing my hand and arm like this. For the first time, I felt like I disrespected my body, big time.
This is where the ligaments were repaired on the flip side.
With my stitches out, I got fitted for this plastic removable hard cast. I started some light OT work.
Healing begins. I buy a road bike and ride it 60 days post op. Every bump hurts. I ride one handed a lot. The internal fixator keeps me safe. Two weeks later, I try and ride trail on my 6″ bike. Surprised that I can. So I go on rides, with a wrist that won’t bend and a finger that can’t really close. I actually started to adapt and never had any pain at all. But going downhill, fast, wasn’t really possible.
40 days post op, external pins removed. Doc used a vice grips : /
New incision made at base of thumb. Internal pins holding lunate and scaphoid in place were removed.
Doc re-cut my healed scars to remove the internal fixator. This really sucked. And my arm got shaved again. I left this surgery with a burning at the base of my thumb that I have no words for. Fire is a close comparison. That fire lasted for weeks. I got used to it thinking that was the new normal. Doc was unsure what it was. Maybe a nerve. It subsided after about 30-40 days.
I start OT full time. It aint easy. Trying, trying, trying. I fashioned a custom jig our of one-by-eight to help straighten my broken finger, which was healing bent and weird. Cut slits in the board and looped velcro through the slits to pull the bend out of my fingers.
All the healing in my hand and arm ended up trapping my broken ring finger tendon in scar tissue. So I lost the ability to close the finger all the way. This REALLY sucked. No ring finger flextion pretty much means no grip. No grip means no riding. Terrified all over again. Doc said he could fix it and made it sound easy. It would be my hardest challenge yet. Had no idea what I was in for. This time, doc made it sound like a breeze and a sure-thing. That, I liked a lot cause I didn’t really worry about this operation as I did the last few : )
Went in for the fourth surgery. At my suggestion, the doc agreed to wake me up 3/4 of the way through surgery to see how much range I got back. It’s the only real way to tell. The only other choice is to chance it and just try to move it when I wake up to see what I got back. But you only really get one shot at fixing something like this. I saw people awake on the Internet for this surgery, so I suggested it and the doc agreed to do it. With my finger and hand cut wide open, in mid-operation, I was awake moving it so that we could be sure the doc freed as much of that tendon as possible. What you see below is the following: my hand pre-op, the tendon being pried off scar tissue, the complete incision, me closing my fist, awake during the op.
The surgery to free a trapped finger tendon is called tenolysis. The bitch about a tenolysis is that you have to go to OT the very next day. And you have move that finger and keep on moving that finger all day long for at least 60 days to keep whatever range you got back and avoid the tendon scarring up again. So there I was, finger in stitches, moving it. Blood everywhere. Took a month for this incision to close. Every time it started to heal, I had to bend the finger and the healed scar would rip open again. Awful. The only real healing time is at night.
To make matters worse, I thought I had an infection at one point. My finger was purple and red and yellow and orange. And it was swelling massive. Wouldn’t you fucking know it…..I found myself back in the hell hole – Union Memorial Hospital…..on IV antibiotics. Talk about a nightmare. I locked it up and did my best. I was out in 24 hours.
What you never really see here is what happens to the fingers and your dexterity from only 30 days of inactivity. After I had my finger pins out, I had to re-learn how to move every finger in my hand; they were all frozen solid. It was impossible at first to even touch my thumb to any finger at all. That’s where Janice came in. I owe a ton of my recovery to this angel right here. We spent time together. She helped me get range back in individual fingers, my wrist, and helped me get my ring finger to close. I was with Janice for 3-5 days during the week at times. Thank God for this woman and the medicine in and around Baltimore. Janice is a veteran occupational therapist who has seen it all. She was positive, forward thinking and collaborative in my treatment. Always listening to what I had to say even if I was just rambling on and on due to nerves and being unsure how this would all play out. Did I mention the awesome conversation this woman holds down? : ) Thanks for everything, Janice. I really appreciate your kind hearted and good nature of care. I have 95-98% of my range in my left ring finger because of the treatment Janice worked with me on.
With Janice’s routines to do at home, I was moving my hand, fingers and wrist 6 times a day according to a very regimented routine. I never let up on that routine. It got me back.
The second I found out what I had and how bad it could be, I started reaching out to see who else might have dealt with this before and who might be riding on a fused wrist. The following people were there for me in ways that helped tremendously. Thank you, everyone.
Matt’s a former teammate and good buddy. He went down around the same time as me and broke his wrist. We both had complex cases and we spoke often. Tell ya what, Matt. You’re one inspirational and supportive guy when the shit hits the fan. Thanks.
Bobby the Berminator
Bobby is a good friend and teammate. He was there to listen to me whine, bitch and moan whenever I needed to. And he always knew it would get better and that none of what I worried about would happen. Thanks Bermy.
Nelson got hurt shortly after I did. We spoke a lot by text over the course of a month or two and it helped out a lot. He is all healed up now and I am glad for him. Thanks Nelson. You are one of the greatest ambassadors of our sport that I know.
Found Jason by running Google searches on wrist fusions and biking. Saw a post from him asking about fusions from back in 2009 on MTBR. Wasn’t sure if the email was still good, or if he was even alive, or if he even had a wrist fusion. Lobbed a Hail-Mary and emailed him. He responded immediately with his X-rays, case history and even videos of him riding. He did have a fused wrist. And he never let it slow him down. Turns out he is expert BMX and the guy to beat. Dallas knew his name well. Jason sent me videos on him riding with his fused wrist. Simply amazing what I saw him doing. Jason helped me realize that the worst case scenario would not be bad at all. Thanks Jason.
Did more Googling and realized that Brandon Turman from VitalMTB was posting several years ago on a wrist brace I knew I would eventually need. So I emailed him. And just like Carnes, Brandon sent me everything – his entire case history complete with x-rays. He also dislocated his wrist, badly. Requiring the same kinds of repairs I needed. We talked through email and he shared lots of content and photos. He’s been back to ripping for years now. Through Brandon, I learned that it was not only possible to come back, but highly likely. He stoked me out big time. Thanks B.
This one gets the biggest and most special shout out. Never once did she discourage me from going back to what I love to do. She always believed I would push through, even through the darkest suffering and pain. Every surgery, at my bedside. Every recovery, doing the things needed to comfort and heal me. I am honored to have this powerful, intelligent woman by my side. Thank you Amanda. For everything.
Welcome to the world, baby girl. Holding her with two strong, working hands. All is well. And I’m back. Hell yeah buddy, I’m back \m/