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The Off-season screw up

 

I knew my due for this blog was the week after the inaugural Women’s Paris Roubaix, so after I’ve written my spring blog about “Roubaix or not Roubaix” I was planning a blog on my Post-Roubaix-Feels: How it was, how it felt, how I experienced this very special day within the peloton. Little did I know that the week after Roubaix would be quite a game-changer for my season, priorities, timeline and general health and therefore also a change of the main topic of this blog. 

That said I still want to start with a short recap of “my Roubaix” before jumping into the drama that followed and my current state. 

29th of September. Final Course Recon. There we were. Finally. Only a few days away from the first ever edition of Paris Roubaix for women! After 3 postponements, it all looked like it is really going to finally happen and as if it’s going to be wet!

I was nervous! I felt so comfortable riding on the infamous cobbles from the first recon in summer 2020 till the last one today. I looked at the profile: Loved it! We visited the infamous showers: Got goosebumps! Now standing in the velodrome: Even more goosebumps! I just really wanted to race this race and I wanted to race well. I was ready and our wait finally came to an end!

It was a hectic start to the race, as expected and the fight for positions the closer we came towards the first pavé section was tough with quite a lot of crashes due to that. Unfortunately I came down too. Just 3 k ahead of the first sector Megan Jastrab’s bike suddenly diagonally right in front of me. No chance to avoid it. I crashed quite hard but was able to continue after a short check on Megan, Kasia and myself. 

Since we all went down together. I was heartbroken because of the timing of the crash the speed of the bunch was so high, that I wasn’t able to chase back on.  Making it feel like I was never part of the race. The biggest fight I had during the race was the fight with the team cars blocking the pavés. As soon as there was a crash ahead, there was almost no way through. Especially in wet conditions, where there is not a lot of good lines to ride. I still managed to jumped from group to group and finally ended up in a good one. We lost quite some time in the car barrages, that’s why I was even more heartbroken to look into the results and see the OTL-out of time limit- behind all our names. The official result finally showed that we came in on position 62-70, just 18 seconds behind the last rider in the time limit BUT we finished, we made our lap in the velodrome, washed the dirt off in the showers and made history! And I loved it! I loved every sector and my first thought was: When can I do this again?!

After a quick clean up in the camper, we made our way to the Eurotunnel because the Women’s Tour started just two days later. I was pretty banged up: bruised hip, shoulder and  ribs. Especially the last one mentioned gave me quite a hard time breathing and riding, but I was able to do both and therefore good to go. Jokingly at the start of Stage 1 I said to my teammate Veronica: “If I am going to crash on my left side again today. I think I am just going to pass out” 

Well, that joke was on me: Around 70k into the race on a straight road, we were probably riding around 45 km/h, a rider on my left side crashed into me, causing me to get off the road into the grass and unfortunately right down into a ditch. I went over my handlebar and slammed right onto my head. Sparing my left side but compressing my spine quite bad. A classic “jump into shallow water” injury. 

I immediately felt that something was not right with my thoracic spine and therefore asked the paramedics not to move me. I checked if I could feel my legs and move them, which I could, but I was bothered by a weird tingly feeling on my outer thigh. It became clear the reason for this was that I had landed in nettles! However, I was still had big concerns and surprisingly, even though I expressed them a few times, I was walked to the ambulance.  On the way I realised that my collarbone was broken and quite dislocated, with one bone fragment pushing up my skin. I told the race doc that I did not even feel any pain in my collarbone with the pain in my back being very predominant. 

Once again to my surprise, ignoring my mentioning, I was put into the ambulance without any spinal precautions and was told I would be dropped off at the next team car. I received 1 g of Paracetamol, still being in severe back pain. We followed the race for around one hour till we crossed the finish line in Banbury. I was dropped off at team parking and walked to the camper. We were told and pointed out in the race book to proceed to the closest A&E, where our Swanny Jodie drove me. Because of Covid nobody is allowed to accompany patients, but with my phone with me and Jodie pointing out that I crashed onto my head, we showed my very visible collarbone fracture and I once again mentioned my severe back pain. Side note: As my stroke of luck continued, this day was the day that WhatsApp and Instagram went down 😀

I used to work in the A&E myself, so I know what it´s like and I know it takes time, so I was getting ready for an at least 4 hour wait. After 3 hours my fingers got numb and white, so I asked for a sling to get the muscle tension out of the shoulder and arm, to release nerves and blood vessels. It’s more painful at first, when the tension drops, but it’s a relief and less painful after some time.  An x-ray and the expected 4 hours later, I was called in to see the doctor. He confirmed the collarbone fracture and called it a “proper job”, I took my chance and told him, that the collarbone is no big deal, but I am really worried about my spine. I told him in what way, from around which height and with what kind of speed I crashed on my head and finally I could see someone else showing and expressing the same concern I had. So I was once again surprised, that despite those concerns and the idea of a full body CT scan because of the high speed trauma I was asked to sit down in the waiting room again before receiving a spinal x-ray. The only good thing: I received some more painkillers there. The paracetamol from around 1 pm wasn’t really doing anything anymore. It was now around 8 pm. 

One more x-ray in and with a bit less pain, I was told that my back pain has a reason as two of my thoracic vertebrae bodies T5 and T6 were fractured. To what extend should be examined in a CT scan as well as checking my thorax for signs of another thoracic injury or if the collarbone fracture is causing a pneumothorax or haemothorax, so air or blood in your lung in places where they should not be. Probably needless to mention: I am still waiting in seated position in the waiting room and walking to the CT. Back to the waiting room afterwards. 

Around 10:30 pm I receive the results of the scan: The known collarbone fracture, a fracture of the 5th left rib, a stable fracture of T5 and an unstable 3 column fracture of T6.  The last fracture now finally “promoted” me into a hospital bed and I am told that I am going to be transferred to the spine specialists in Oxfords John Radcliffe Hospital. It is now around midnight. Our lovely swanny Jodie still makes her way to the hospital again to drop off my suitcase. 12:30 am I get picked up by an ambulance to transfer me to Oxford and once again, kind of becoming a running joke, I am transferred in seated position. Not only to my surprise but especially to the surprise of the nurses on the trauma unit in Oxford that were expecting an unstable spinal fracture under full spinal precautions, but instead it is me in race clothes sitting in a chair seat. To my relief they are the first ones telling them, that this is not the way to treat a spinal trauma and I know that from now on, I am in good hands. 

It is now 1:30am, but I am not even tired because now I just lie there and start to worry. I am told ideally not to move anymore. I am only allowed to lie flat on my back up to max. 30° upright position. I have to use a bedpan and need full care, only being able to grab whats within the reach of my right arm. To my confusion there are no rooms on the ward, only curtains separate patients to the corridor and the rest of the ward. It is quite noisy and bright even though it’s the middle of the night. I guess my late turn up didn’t help to make friends. Nonetheless I am just happy to feel in good care and to receive a good amount of pain meds. I use my face mask as a sleeping mask (thanks compulsory masking!!!) and the moment the codeine hits, I can sleep a little.

In the morning the spinal surgeons make an early round and visit me. They inform me that the fractured vertebrae bodies are going to need surgical fixation. 

My spirits, the few that were still left, are now broken. From telling myself “there won’t be any fracture” during the A&E wait, changing my hopes to “it’s gonna be a stable one” after the X-ray. Then accepting that it’s an unstable fracture but still keeping the hope of a conservative treatment. Hearing the medical recommendation of a surgery now, it’s just one step too far and I feel overwhelmed. I try to hold it together and tell them I would like to consult the spine specialist of the orthopaedic clinic in Germany, that I work at from time to time and that I would, in general, like to be transported to Germany. 

Knowing I am a doctor myself working in orthopaedics, they were already expecting that reaction and tell me they need to do an MRI scan before they can decide if I am transportable at all and how urgent my surgical treatment is.

I am told to stay fasted in case they need to perform surgery immediately. A few hours later I get my MRI scan, around 4 pm I am told I won’t have surgery today, since the spinal surgeons are stuck in the theatre with a polytraumatic patient. I will have to wait for the next day the either get the “green light” for the transport or the go for surgery. I found my spirits back and my hopes now shifted to “I’ll be transported back as fast as possible”. So together with my boyfriend, Dirk Tenner (my boss at the clinic) and the help of SVL we try to arrange everything in case the green light is given. 

A good decision as its going to turn out, but I also made pretty bad ones along the way: Since I did not like the dizziness of the codeine, I thought I am fine with a bit of paracetamol and just skip the opioids in the evening, only to end up doubled over in pain during the night. I always tell my patients to exactly not do that and yet there I am doing it myself. Now I know for sure: Do not do it!!!

After an painful night, I got bad news: There was a medical flight blocked for me in two days, but due to the fuel shortage there was no patient transport available for the 45 min drive from Oxford to Heathrow. Spirits broken. Once again. But my mood quickly changed: First I got help to finally get out of my race clothes that I put on Monday morning before the start and was still stuck in on Wednesday, feeling like a new human being afterwards. Then I got a call by boyfriend saying: as soon as the green light is given, they going to send an ambulance from Germany to pick me up the next day: Thursday, 7th of October, my 32nd birthday. Because they could not get me to the airport, the plan was now to drive me back instead instead of flying me out. Now I just needed the okay, but my spirits were back, higher than ever and I was hoping for the best birthday present ever: Coming back home! And my hopes were not disappointed. They had a look at my MRI and even with the unstable fracture and some ruptured ligaments they gave their okay to a transport under full spinal precautions.

Thursday, 12.30 pm I was picked up. Well equipped with a bladder catheter and a lunch box we started our travel. After one ferry trip and passing three borders we arrived 1:30 am in my clinic and I think I never felt that happy to arrive at work 😀 I was welcomed by my colleague Steffi, who was working the nightshift that day and after a short examination and a lot of encouraging words, I fell asleep with the good, warm feeling of being back home. 

Also knowing that tomorrow I’ll be able to talk with my colleagues and bosses, in my native language about the possible treatment and their pros and cons. 

Quite early the next morning I had my first talk with one of our Chief Physician and Neurosurgeon, after quickly looking at the pictures the first impression looked as if I need to have a dorsal and ventral fixiation: A big, big surgery and a lot of metal in my back. I was and felt okay with the idea, even if it was a scary one, because I loved every idea that would eventually get me out of bed. He said he’s going to consult another colleague from the university clinic and come back to me again. A few hours later my great feeling from yesterday’s arrival was even excelled. After reviewing my pictures in detail and some exchange with his colleague, they decided to offer me a conservative treatment. Due to my age, my fitness, my knowledge about the injury, my bone and muscle “quality”and the risk of the surgery, we decided this would be the best option for me. With a brace, a lot of bedrest, regular x-ray controls and me, trying to be a well-behaved and educated patient. In the afternoon I received my brace, could get up for the first time in 4 days. A bit cold sweated, because my circulation was completely out of control, but walking never felt so good. Nor did using a proper toilet 😀

Next step was to schedule a surgery for the collarbone. My first ever surgery on the other side, but after the week I had, this seemed like no big of a deal. I stayed in the clinic for one week plus the four days in the Oxford. Worth a mention: Mieke Kröger, 1 hour after coming back from Track Europeans where she won gold and bronze, helped me to have my first shower and a proper braid of my collarbone beanie hair mess. Thanks again Mieke! All my colleagues, nurses, physios and docs were wonderful and supporting. So a massive thanks to you all too!

I am back home for a bit more than one week now. It’s a lot of adapting, a lot of figuring out how to do things. Figuring out what I can and what I can’t do. I have to slow down, I have to rest. But I am also getting better every day. The next x-ray is just around the corner and once again I am hoping for green light. This time to start training on a recumbent bike. 4 weeks of off-season is more than I ever did before, so I am ready to roll again. Even if still in horizontal position.

After last years crash and my knee injury in September, I screwed up my off-season AGAIN and I have screws in my collarbone but thankfully not in my spine. I am getting my off-season treats by watching other riders Instagram stories on their travels and watch the fun things they do and the places they go.

It might not be the greatest off-season of all time: I can’t travel, I can’t do any other sports, I can’t go somewhere, so far I can’t even have dinner or a coffee, but I am just so happy that I can walk, even if it is just from my bed to the couch and back for a few more weeks! 

And I am sure: I’ll be back! 

Tanja

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