Why I Understand

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Why I Understand
This guy’s walking down the street when he falls in a hole. A doctor passes by, and the guy shouts, “Hey, you, can you help me out?” The doctor writes a prescription, throws it down in the hole, and moves on. Then a priest comes along, and the guy shouts, “Father, I’m down in this hole. Can you help me out?” The priest writes a prayer, throws it down in the hole, and moves on. Then a friend walks by. “Hey, Joe, it’s me. Can you help me out?” And the friend jumps into the hole.

The guy says, “Are you nuts? Now we’re both down here.” The friend says, “Yeah, but I’ve been down here before, and I know the way out.”
Inspired by The West Wing

Heidi ArmstrongInjury came knocking for the first time in 1999 following a spectacular crash at a National Championship Series mountain bike race. Denial compelled me to ignore my unwelcomed guest.

My first doctor claimed I’d never race my mountain bike again. I built up a fierce resentment of my injury and my doctor. I also developed a severe complication, Reflex Sympathetic Dystrophy, which caused unrelenting swelling and mental exhaustion.

How did I go from elite athlete to a cripple? The one thing I could always depend on, my well-trained athletic body, let me down. Injury left me angry, frustrated, hopeless and trapped. It yanked me out of my sport and my social network. It held me at gunpoint and fled with my identity and self-worth.

Fueled by rage, anger, denial and resentment, I forced my way through surgery and year one post-op. I grew increasingly bitter and moody, highly unlike my normal temperament. Without my sport I felt like I had no purpose. My life previously revolved around mountain bike racing; injury left me feeling empty and impatient.

Late into my first year of gimphood and before my second surgery, I realized I had better find another way of coping or my best friend and roommate, Christine, was going to toss me over the 3rd story balcony. I wished for another severely injured athlete to connect with, but I couldn’t find one. Everyone else’s injury came and left in revolving door fashion. Mine busted in like a couch-surfing relative and refused to leave.

Following a day of compulsive cassette tape Windexing and Christine’s fortuitous intervention, I recognized the importance of adopting some new tools to assist on the road to recovery. They say if all you have is a hammer, then everything looks like a nail. For me, the hammer wasn’t working. I needed pliers. I needed a box wrench. I didn’t always need force. I needed softness. I needed to forego my denial and surrender to what was. I needed balance, resilience, guidance, and optimism. I needed to find strength and the voice lost inside me. The voice that told me to change my attitude but to never give up—the voice that told me I would walk again and that somehow, by some miracle, my swelling would dissipate. The voice that told me one day I would sit on my mountain bike and race again.

I realized the only way out of hammer-land required assembling a small army of gifted practitioners. I found a Licensed Professional Counselor to penetrate my anger and frustration and help me productively unravel my real issues, which snuck up with the subtlety of a bomb when I could no longer train for hours a day. I wanted to run from my real issues, but I knew I’d suffer a hard landing from the 3rd story balcony if I didn’t face the challenge of painful personal growth. I found a new orthopedic surgeon with experience relevant to my pathology. I found a chiropractor specializing in Active Release Therapy to address years of compensatory issues that accompany injury. Recovery necessitates help from a diverse care team. Over the months and years, I inefficiently but inexorably cobbled together a group of practitioners to help me rebuild a positive attitude.

Frisbee dog

I found that rebuilding required using my cobweb-covered right brain. Kelsey, my dear friend and physical therapist, suggested photography to begin journey to tap my creativity and inner strength (the photo of Bella catching her frisbee mid-air is an all-time favorite). Photography created a bridge between my right and left brain. It allowed me to see the beauty in my environment, color, life, vibrance…and it made me grateful. Grateful to focus, literally and metaphorically, on the beauty in front of me. Kelsey also insisted I start a gratitude journal. On days when I was in so much pain I couldn’t focus, when my voice shook because I was too devastated to admit my fear of never racing again, when I felt the whole world left, I looked back at my gratitude journal to grasp the one thought or moment or person who made my soul smile on my darkest days.

I also started receiving phone calls from practitioners. “Heidi, I have a patient who is an injured athlete. He doesn’t need psychotherapy; he needs to talk to someone else who has been in the hole and knows the way out.” “Send ‘em my way,” I’d reply. Since the first phone call, I’ve worked with many injured athletes, helping them crawl out of the injury hole.

My next stop on the journey following surgery number two…activity jail. This was my term for six months of nothing. And I mean *nothing*! No cooking, no cleaning, no grocery shopping, no walking the dog, no social life, no walking to the mailbox. N. O. T. H. I. N. G. I had to depend on Christine for absolutely everything. From athlete to invalid, my brain fought magnificent internal arguments to accept such complete assistance from another. I thrashed about spectacularly until I finally relented and realized if she was in my condition I’d do the exact same thing for her.

I was allowed to walk down the stairs, go to work (at my desk), go to physical therapy and come home. Not one thing more. For six months. If I wanted to go out more than once I called my firefighter friend Erick to carry me down the stairs. He’s 6’4” and I’m 5’11”. We were a planet of arms and legs traveling down the stairs, me thrown over his shoulder in a fireman’s carry.

Fireman's carry

My good friend, Erick, and me reliving the months when I could barely go up and down stairs

One day, after almost two years on crutches, my leg began to work again. I could do a leg lift! Kelsey provided one finger’s resistance to my lifting, then two fingers, then a hand, then an arm. And then I needed real weights. Then I lost a crutch. And then I ditched the last crutch, but I gained a cane. I walked proudly with my cane. When the world wondered why I needed one in the first place, I smiled with the knowledge I was getting closer. Closer to walking again. Closer to kicking some ass again.

I spent four and one-half years in physical therapy, three days a week. Every day, without fail, I woke and told myself, “Two feet on the ground. Here we go.”

My injury became a gift. I had an opportunity to deal with the real issues. I didn’t want to, but I was more or less forced to. After I decided to wrestle with my real issues I had peace. I began to appreciate the time injury gave me to grow and evolve. I realized I was OK just being. I learned how to feel all kinds of different emotions instead of perpetual anger and frustration. I lived with grace instead of force. I wasn’t solely defined by my last race finish or stellar training ride. I grew from the inside, defining myself as a creative, intuitive, resilient woman.

Ultimately, I did ride my bike again. In fact, I even raced again and I had a great time.

And then came another test. But this time I was better prepared. I had more than a hammer.

15 weeks before my accident I was one of 66 women (out of 1000+ co-ed starters) to finish the Leadville Trail 100 (world’s most difficult 1-day mountain bike race: 100+ miles; 10,000+ ft in elevation; 14,000+ ft of climbing).

Leadville Traill 100 finish lineThen, in November 2010, I crashed while cross country skiing. You may be thinking, “Cross country skiing? That’s supposed to be safe!” Lots of folks have said those exact words to me. The fact is, it is safe. Unfortunately, that day there was a spot on the far end of the orthopedic injury bell curve that had my name all over it.

I suffered an extremely obscure knee fracture and a completely torn MCL, which nobody seemed to care about because they were so alarmed by the fracture. My lower leg looked like it was being held together by only skin when left unbraced.

I came back to Austin from West Yellowstone (where it all went down) and had to temporarily move in with Christine (yup…same best friend!). She had a sofa that needed holding down and I was the perfect one for the job. I was completely incapacitated. I could barely make it to the bathroom and back to the sofa alone. I needed help with everything.

One afternoon I was laying in position A on the sofa and she sat down next to me. “Heidi, I’m worried about you. I know what you went through last time. I just want you to know you are so much more than an athlete. I don’t want you to be lost again.” I appreciated her earnest concern. She didn’t want to deal with Heidi v1.0 again—that girl she wanted to toss off the third floor balcony.

I told her (in the most confident sounding voice I could muster): “This time will be different. Last time, at least for the first year, I felt like I was emotionally wrestling with greased pigs. I got dirty and the pigs liked it. I know I am fulfilled and whole without my mountain bike. I’m not saying this is going to be easy. It will be different now because I have tools to deal with this.”

I called the best orthopedic surgeons in Austin and got responses like, “Oh, I saw one of those fractures in residency.” I ultimately settled on an Austin-based orthopedic trauma surgeon and scheduled what was supposed to be a complex ACL reconstruction for December 2010. I woke up to a nurse telling me I hadn’t needed ACL reconstruction after all. It was the first of an infinite amount of Chinese stars I’ve had to dodge for the past (at the time of this writing) 27 months.

In March of 2011 I had a second surgery in Austin to remove extensive scar tissue and relieve a terrible pressure and pulling sensation under my patellar tendon. The surgery was declared bloody by virtue of the fact that the surgeon had to tourniquet my leg…never a good sign.

I was told to slowly return to my activities. I had about three quasi-functional months, then the pulling, pain, and pressure returned. Walking was possible only through creative usage of a patellar tendonitis strap. Instead of placing it over my tendon, I placed it above my knee. I lived with unrelenting burning pain, so I went back to my Austin-based doctor, insisting on another MRI. It revealed my scar, only bigger and stronger. He wanted to remove it once again. I decided it was time to see the best.

In October 2011 I made my first trip to The Steadman Clinic in Vail. My patellar tendon was scarred down to my tibia and my patella was stuck like concrete. I was lacking 22 degrees of extension. Dr. Steadman diagnosed me with a severe case of arthrofibrosis. Of all knee pathologies, arthrofibrosis is arguably the most difficult to treat surgically. It requires the surgeon to have the hands of a jeweler, not a lumberjack.

Chris Watts, ATC, me, and Dr. Steadman

Chris Watts, ATC, me, and Dr. Steadman

My third surgery (and first at The Steadman Clinic) was December 7, 2011, which I now consider to be my knee’s birthday.  Without my effort to reach out to a new care team, I would have been crippled my entire life, but I wasn’t willing to accept being a gimp as my destiny.

During rehabilitation I connected with other athletes whose journeys have been as convoluted as mine.  They became my friends and Vail family.  We all shared one thing in common—that far end of the orthopedic injury bell curve.  Rehab became ground zero for swapping stories, empathy, compassion, support, and gimp jokes only we could understand.  Each of my friends has given up their lives to heal; some have been fired from their jobs, others have likely lost what they used to dream about. Our stories overlapped so much that we ended up completing one another’s sentences, and many conversations involved more head nods than words.  Best of all, nobody got impatient if one of us wasn’t healed yet.  Throughout my first recovery I longed to talk to another athlete who really got it.  Now I have connection to a whole group of friends who aren’t willing to accept being a gimp as their destiny either.

Leaving my care team and support system in Vail that first time was difficult.  Back home, I was reminded of all the normal trappings of life that I couldn’t participate in.  I learned the fickle nature of arthrofibrosis and acquiesced to forgoing my normal life once again.  It was like groundhog day, only this time I didn’t fight.

I accepted what was, so I suffered magnitudes less.  I used every tool I acquired from my first injury.  I accepted help.  I allowed my friends and husband to cook and clean for me.  I focused all of my energy on staying positive and hopeful.  My friends asked, “How in the world can you spend 8 hours a day on your back in a CPM?”  I went right back and picked up my creativity tool.  Creativity was my solace.  I learned to knit.  I did beadwork.  I wrote a ton.  I wrote real, hand-written thank you notes to everyone who helped me.  I spent 5 hours a day doing physical therapy.  I slept as much as my body needed.  I returned to the pool for aerobic exercise, something I swore I’d never do after way too many years of 5:30am workouts.  I learned how to strength train on my back or sitting in a chair.

Arthrofibrosis isn’t a one-and-done pathology.  I had a fourth and fifth surgery at The Steadman Clinic in March and May of 2012.  These two interventions were more minor, but carried all the restrictions of major surgery.

I had a tiny window of semi-normalcy during June 2012.    I began a walking progression and did a few 30-minute bike rides outside.  Ah, sunshine!!  Alas, it was another false dawn.  Around August I could tell the scar was growing back, restricting my movement.  I had a sixth surgery (also a more minor intervention) in September 2012 in an attempt to avoid another major surgery.

In November 2012, during a follow up visit, I traveled even further into that teeny tiny corner of the bell curve.  Nine months post-op, part of my scar had organized itself to look like an extra ligament in my knee, something Dr. Steadman told me he had never seen before.  Most of his patients are short a ligament or two.  I had an “extra” that sorely needed to go.  I had my seventh surgery on 7 November 2012.

West Texas mountain biking 1 week before surgery in 2014

West Texas mountain biking 1 week before surgery in 2014

2013 was a year of polar opposites–huge progress and setbacks. I accomplished three important goals: 1) walk down the aisle at our wedding; 2) stand up off the toilet unassisted–no pushing on the counter for assistance (I’m serious!); 3) conquer grocery shopping. I recovered slowly and smoothly from surgery number seven…until nine months post-op. Most arthrofibrosis patients risk scar regrowth within the first 12 weeks post-op. My knee has decided to push the danger zone out. Twice I’ve had random scar regrowth at nine months. In the fall of 2013, my care team and I decided to determine if lack of strength led to the symptoms. I got stronger and stronger, but my symptoms weren’t ameliorated. I made a proposal to my PT Luke based on the strength I’d built: within reason, I’m going to go “do life” for the next several months. I’m going to walk, go for easy hikes, and have a mountain bike adventure in west Texas. I’m even going to try an easy Nordic ski. sy Nordic ski. It had been nearly three years since I had experienced any semblance of a normal life.

Facing surgery means I savored every second of “doing life.” I still had limitations and constant pain, but it had been three years since I had experienced a remotely normal life. A gut feeling about Dr. Steadman’s imminent retirement led me to schedule surgery number 8 at the beginning of 2014. It was rescheduled, rescheduled again, then cancelled. I had to realize my worst fear–Dr. Steadman’s retirement. The man I had come to love and trust was retiring. Dr. Steadman is one-of-a-kind: wicked intuition; overflowing compassion; without ego; a warm, kind smile; bright blue eyes that looked straight into mine, “We’ll get through this together.”; a mind that could image a scar without even peering at a MRI. When I closed my eyes on the operating room table, I never, ever worried. I can walk today because of him, and my gratitude for his care is without end.

Dr. Steven Singleton studied with Dr. Steadman in the 90s, and took over his practice. Dr. Steadman’s nurse described Dr. Singleton “as close as we will ever get to Dr. Steadman.” I thought she was smoking crack, or blowing smoke–or something. She was absolutely accurate.

With Dr. Singleton a few hours after my surgery in February 2014

With Dr. Singleton a few hours after my surgery in February 2014

In February 2014 (after a 16 month break from the operating room), during surgery number eight, Dr. Singleton addressed the month-nine-scar that originated on one side of my patellar tendon, snuck underneath it, then attached to my medial meniscus. No wonder progress came to a halt. Nobody knows why a new scar appeared out of nowhere. That’s arthrofibrosis.

I’m once again on the road to recovery, starting over and rebuilding. I hope to report back nine months post-op with good news.

Crutch cramponsAlong the way, I became a CPM whisperer.  The beast is often restive at 1:00am, clunking, shrieking, grinding and squeaking so its captive cannot rest.  WD-40, straps, bungee cords, bicycle chain lube, dental floss, tape, towels and a flash light are the tools of my trade.  When one becomes insufferable, it gets replaced without remorse.  No black veils are necessary.  The CPM rep and I are on a first name basis.  I have also learned that ice machines can give you frostbite, crutches in Vail need crampons, and all of this paraphernalia sticks around too long and unexpectedly returns, just like bad relatives.

CPMLife for the past 26 months has been like driving around a traffic circle stuck in the inner lane.  Every once in a while I merge to the outside, put my blinker on to exit, and another car dives into the circle pushing me back into the inner lane.

My view hasn’t changed much, at least externally.  I’ve been on crutches for 2 years.  I’ve had extensive driving restrictions.  I spent spent 2012–almost 365 days in a row–in a CPM.  Physical therapy is my full time job and it doesn’t pay well.  I have had to say no to nearly every social invite.  I have had to endure friends and family judging me, blaming me and armchair quarterbacking my decisions and direction.  People make the darndest rude comments—You are still on crutches?  Another surgery?  My gosh, when are you going to be done with all of this?  Don’t you need to get a new doctor?  Why aren’t you better yet?  Having a debilitating and chronic injury that’s invisible to others leaves me open to scrutiny, questioning and judgment.  I look normal; why can’t I be normal?

Sometimes it seems like I’m walking at a standstill, as if on a treadmill, because the scenery in front of me doesn’t change.  But if I take time to look behind me, I realize just how far I have come—much further than most people would have thought possible and they are right, but only regarding people who have accepted their fate.

Martha Beck says, “A lot of people tell me, ’I need to find my passion.’  They rarely realize that the word ’passion‘ is from the Latin pati, ‘to suffer,’ or that passion originally meant ‘pain’ (as in The Passion of the Christ).  Knowing that, it becomes much easier to track your passions; even if you feel no interest in anything, odds are you have suffered.  Wayfinders of all cultures know that healing the self from any kind of torment is the groundwork for healing others, for creating a positive change in the world of Form and thereby establishing your career, your life’s work. Let’s track your true nature along this path of passion.”

My injury led me to my passion.  During the last thirteen years I have helped many athletes navigate the maze of injury–the impatience, frustration, loss of identity, and other common challenges.  Through my infinite list of restrictions and challenges, I found connection with other athletes by passing on the tools I have used to navigate the rocky road of injury.  I have helped fellow athletes realize recovery isn’t something you do; it’s something you become.

A few fun tidbits about me

I like pink polka dot PJs and fleece socks.

I like snow falling and dark rainy days.
My favorite Austin graffiti

I like the sound of my skate skis pushing snow and poles digging in.

Coffee is my favorite comfort food.

I love nerdy chemistry jokes.  I’m like Good Will Hunting when it comes to organic chemistry.

I grew up on the back of a horse.  Horses were my first teachers.

I have a wise red dog.

I love elephants and owls.

My favorite book is Flow.

I like the inspirational graffiti around Austin.  This little critter is my favorite.

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