On Friday, June 13th I went for a late evening shakeout run. I popped out the front door of my now-former residence and took it easy - 20 minutes out and 20 minutes back. It was the space in between those 20-minute stints of running that later made an impression on me. After doing the "out" portion of the run, I stopped at the top of the trail and looked east over the town of Boulder. In a moment that was as cliche as it was inspiring, I realized how much I was enjoying my life in Colorado. I should recap the moment, in which the sun was setting behind me, shrouding the rest of this fantastic place in reds, pinks, purples, and shadows. The end of the month would mark my one-year anniversary in Boulder.
I was running one of many fantastic trails in town.
I was excited about the impending move into a new house.
I was two weeks into my new job and enjoying it very much.
I was also feeling very fit...
With several races on the schedule in July and September, I planned to take on the Boulder Skyline Traverse the following morning - a run starting at the Mesa Trail head and spanning nearly 17 miles. Those attempting this traverse tag the five most prominent summits in the Boulder Front Range (South Boulder Peak, Bear Peak, Green Mountain, Flagstaff, and Mount Sanitas), accumulating more than 6,500 ft of vertical gain in the process. As I stood on the trail, half way through my nighttime jaunt I had a 'life is good' moment. I went to bed excitedly awaiting my opportunity to take a crack at the front range five.
The following morning arrived and I took the run as it came. Jay and Scott, my partners in crime, set out from the Mesa trail-head a short while before me. I ran a few miles from the house to the trail-head in hopes of warming up the legs before ascending Shadow Canyon - the first and biggest climb of the day. I was definitely lacking in energy once I started climbing, and this would be a recurring theme throughout the day. Nevertheless, I was able to grind into a low gear and keep moving when things felt rough. I did a decent job managing my nutrition throughout the day, though I did feel pretty dehydrated from sun exposure by the time I tagged the top of Green. I eventually crossed paths with Scott while he was filling his water on the Green Mountain descent. We ran together for the rest of the day, notching the Flagstaff summit before the long-ish decent to Eben G Fine Park. We met Jay there, who had somehow passed Scott undetected while he was filling up where I spotted him on Green. From Eben G Fine Park we crossed the creek and made our way over Red Rocks before descending to the Mount Sanitas trail-head for the final push of the day. Jay made his way up the Sanitas trail while Scott and I waited a couple minutes for Eric, our refueling specialist at Eben G and cohort for the ascent of Sanitas. We started out relatively strong, but Scott and I had no match for Eric's fresh legs this late in the run. As Eric disappeared out of sight I continued to push on ahead of Scott and saw Jay about 50 yards up the trail. With crowds on the trail and tired legs, I let my eyes wander ahead rather than staying focused on my footing. With less than a mile to the Sanitas summit, my luck swung in a very undesirable direction.
Catching a toe on a root, I stumbled awkwardly and landed knee first into a jagged rock sticking out of the trail. While it is not generally desired, "eating it" comes with the territory when trail running is your activity of choice. As much as you try to avoid it, you may not come away from every run unscathed. As such, I thought very little of the impact. In my mind I expected to see some bruising, scrapes, and maybe a little blood. It certainly wouldn't end my day - I hopped of the trail to inspect the damage. As one may experience after accidentally cutting themselves with a knife, there is a brief time period in which the skin does not immediately bleed from penetration. Sitting on a rock with legs bent I could see into a large, quarter-sized puncture in the center of my knee. It was white with some blue-green lines, but things were happening fast and I was not computing. I then straightened my leg and watched my knee cap slide lengthwise on its track, noticing the visible tendons and blood vessels that were also exposed. "Fuck!" The only word I could muster, knowing that this was not good. The blood started filling the kneecap like some kind of Halloween-themed swimming pool, suitably sized for a Lego-man and two of his closest friends. At this point Scott had caught up to where I was seated and a few other folks stepped off the trail to offer help. I was the only one immediately aware of the 'depth' of my problem, and was trying to wrap my head around a solution. A middle aged woman stepped over to me and looked at the bloody knee. She said, "Oh honey, that's a pretty bad scrape - you may need a bandage for that." Without saying anything I sprayed my water-bottle into the joint, clearing the blood away while I flexed my knee. She got a good look at the high school anatomy lesson that was my inner knee. She then gasped and exclaimed, "Oh. Oh my! That is terrible!"
The few good samaritans finally went on with their hikes, leaving myself, Scott, and a hiker-doctor to sort the situation out. The doctor said it looked bad, but could be stitched up. He said it would be an infection risk, and that I should take care of it quickly to avoid complications. I asked how long he thought I would be unable to run, resulting in a mixture of amusement and annoyance on his part. Scott then helped me apply some folded up toilet paper and lent me his sweat-soaked bandana to cover the hole so I could hike down. (Sorry man, I should probably buy you a new one.). As I hobbled down, Scott made his way to the summit where Eric was waiting. Being the only one with a car, Eric had to descend in order to drive me to urgent care. Within 10 minutes of my own arrival at the trailhead, Jay and Eric appeared to transport me to the nearest medical assistance
Without going overboard, I have to say that the doctor who treated me at the urgent care clinic provided the best care I have ever received. No exceptions. He was quick, thorough, and informative - most importantly, he was completely aware of the fact that my goal was to continue running as soon as physically possible. He conveyed a very clear understanding of the fact that 'resuming everyday activity' meant trail running. Likewise, he undoubtedly stated that getting me back to running was our goal. The doctor immediately took X-rays to look for fractures and debris. After inspecting the images, he said there were no fractures to the kneecap, though there was a lot of gravel, dirt, and debris in the hole. They numbed me up and went to work, flushing the knee and pulling rocks out of it with a tweezers. To my relief, the urgent care specialist said that I had one clear layer of subcutaneous tissue remaining, which was protecting the kneecap and tendons from direct exposure. After discussing some options, the doctor carefully stitched up the wound and applied a dressing. He also emphasized that the size/depth of the wound, the amount of debris inside, and the length of exposure to bacteria would mean a relatively high infection risk. Given that the joint space was exposed on trail and covered with a dirty bandage, no amount of cleaning and sutures would provide an absolute guarantee against infection.
Unfortunately, infection became a reality within the next 24 hours. I visited urgent care 3 times in 4 days, and each time the doctors who checked my knee grew more concerned with the swelling, redness, and potential for infection based on the MOI. On day-4 the doctor I was working with insisted that I visit an infectious disease specialist. I had been keeping my mental state in check until that point, but the infection meant lengthier recovery and potential complications. After visiting the infectious disease clinic that week, I had a PICC line placed in my arm. This is a catheter that is inserted into the forearm, winding its way through the armpit, along the collarbone, and over the heart. I would then use this device to administer antibiotics via drip-bag and syringe on a daily basis. Likewise, I could not do any strenuous activity as long as I was hosting said PICC line. This included lifting more than ten pounds or raising my arm above my head. In other words, I was to be completely sedentary for several weeks, while simultaneously playing nurse to myself in the confines of my own bedroom. At this point, I experienced a mental low-point. I had some difficulty comprehending the fact that I went from trail running to hobbling onto the bus in the span of a few hours. Simply put, I lost my shit for a few days and I was incredibly grateful to have the support of my family, friends, and roommates.
After a couple of weeks, the PICC-line came out and my daily IV routine was finished. I was still on several high-potency oral antibiotics for another two weeks, but at least I could begin doing some kind of activity. I started riding my bike, going to the gym, and I eventually went for my first run. The first week of running was not pain-free. I was experiencing muscle imbalances, joint stiffness, and muscle atrophy, not to mention the extreme tightness of the knee itself from suturing the gap where significant tissue was lost. Nevertheless, I worked my way back into it, with Eric helping me tick off the miles from week to week. While I'm still on the uphill road to regaining fitness and consistency, today proved a huge milestone in the mental comeback from this injury. I set out this morning to do the first half of the Skyline Traverse, with the intent of tagging South Boulder, Bear, and Green before descending back to the house. I hit the trail in a mix of sun and clouds, with 20 oz of water and 2 gels. As it turns out, Ice Cube knew what he was talking about - today was a good day.
As I made my way up Shadow Canyon to South Boulder Peak I felt a very clear sense of control, and my pace was not putting me in debt early. I tagged South Boulder and made my way over to Bear Peak, offering directions to an Aussie fellow at the summit. Still feeling very energized, the idea of the full traverse became the top item on Sunday's to-do list. I made my way toward Green Mountain via the Bear Peak West Ridge trail with my focus on effortless turnover and energy conservation. As I topped Green I polished off my first gel and continued on over Flagstaff for my reunion with Mt. Sanitas. I was definitely feeling some fatigue pounding out the descent down Flagstaff. While I felt fluid and confident, I knew that my nutrition was the missing link as I only had 200 calories for the whole run (and had already consumed one of the two gels). Likewise, I was highly anticipating my arrival at Eben G Fine in order to refill my water bottle, having only had about 12 ounces in the first couple of hours.
I reached Eben G Fine feeling tired, but ready for the last push. I stomached gel number two and doused my head in water before filling up my bottle. I then took off to grind my way over Red Rocks, keeping my legs in check for the StairMaster that is the Sanitas Trail. As I reached the trail-head, I knew my legs were tired. Compared to the initial attempt eight weeks earlier, I was not currently riding a solid base of weekly mileage. On the other hand, I had a sense of purpose going up the mountain. After all, she stole the finish line (and a sizable chunk of kneecap) from me just two months prior. Redemption was waiting for me at the top.
After 3 hours and 24 minutes of work, I stood atop the Sanitas summit - the Skyline traverse finally complete after attempt number two. I'm not sure what I expected to feel, or if it should feel out of the ordinary at all. There was no vengeance or frustration, no anger or self pity. I just felt satisfied to come back and do the run that I was unable to complete a few months before. I felt like I often have on past Sanitas summits - sweaty, grimy, and pleased with the effort. I felt like my old self - running solid, enjoying the mountains, smiling and feeling happy. That's the point, right?
Just home from getting stitched up... |
Infection setting in - a.k.a. fatty-knee |
Sweet sweet medicine...what fun! |
The drugs are finally working... |
Breakfast and prep. |
Taken today - how lovely... |
Recovery juice. |