The past 15 months have not been very kind to me in that I've had surgery on my right femur and left clavicle as the result of bicycle crashes. When the doctor repaired my femur he mentioned my hip joint was bone on bone and I might need a rig ht hip replacement in the future. Well the future is now because over the past 12 months the pain and stiffness in that joint is reminiscent of what my left hip felt like 15 years ago. This time I am not going to wait like I did back then and have scheduled the surgery for December 17th. It will be more complicated because before my hip can be replaced the metal nails and intramedullary rod inserted last year have to be removed. The doctor in Rome GA who did the original femur repair recommended doing this in two separate procedures, but he also thought I should consider having this done in Atlanta since going back and forth to Rome would be a hassle. He even recommended a doctor I should consider.
I went to the recommended Atlanta ortho doctor who felt that the removal and replacement procedure could be done at the same time. In a pre op visit he outlined the procedure in detail. Interestingly removing last year's hardware will take as long as the replacement procedure. Nevertheless there is a good chance I will be able to go home the same day. That will be my immediate goal: get out of the hospital as fast as I can. I am very adept at figuring out how to pass post surgery protocol as home is always preferable to a hospital. As always my longer term recovery goals are measured in terms of cycling. I did a road bike ride 6 weeks after my left hip replacement and 4 weeks after each knee replacement. Each of those rides were about 20 miles. I will aim for a short road ride in 4 weeks. Hopefully that sets the stage for me to complete a 200 km RUSA event on January 30th. If I'm on target I may solicit someone to ride a tandem with me. While this may seem far fetched I did complete a 200 km event on a tandem in October, 2014, 4 weeks to the day following femur surgery.
I'm often asked why I do this stuff. The answer is always the same: given all my orthopedic issues cycling is one of the few aerobic activities I can still do. I gave up running, basketball, tennis, hiking and to a large extent even swimming and walking. About all I have left is cycling and canoeing/kayaking and it's much more convenient to cycle. Wish me luck with the surgery and more importantly the recovery.
See you on the road!!
Friday, December 11, 2015
Wednesday, July 01, 2015
Back to the Future--First Day at Chubb
Today my stepson Jeff sent me an email announcing the Chubb Group of Insurance Companies had agreed to be acquired by Ace Insurance. It reminded me that exactly 47 years ago today I started my post-college career at an insurance company then called Chubb & Son in downtown Manhattan. There were about 20 of us in a small training room dressed in our new business suits; most of them like me had just finished college and come to begin our business careers. We were from all over the country, and we all hoped some day that we would be the head of everything. I had been excited and nervous ever since I had received an offer from Chubb a few months before graduation. Several of us became very close friends that summer enjoying all the things New York city and the surrounding area offered. Since it was Monday we worked 3 days and then had a 4 day July 4th holiday. One of the guys, Charles Collette had a pool party at his parent's house in NJ and invited us all.
We were all in a general insurance training course for about 6 weeks, and then we we chose--or rather were assigned--to various departments. Most of us wound up in an underwriting department although a few went into Claims or Operations (1968 version of IT). I had been hired specifically for personal lines because having worked as a clerk in the Virginia Department of Motor Vehicles I had some basic knowledge--so they thought--about personal auto insurance. At the time personal lines underwriting compared to commercial lines underwriting was viewed by most folks coming into insurance as a dead end for many reasons I won't bother mentioning. But it was a large part of Chubb's overall revenue and I figured if it didn't turn around I wouldn't be blamed, but if it did, maybe I would get some credit. Over the next 10 years that's exactly what happened and my career progressed. In the late 60's and early 70's Chubb was a medium sized company with about 30 branch offices and 5,000 employees. One way to get ahead was to be willing to go where ever they needed someone. I started in New York, went to Atlanta for about 4 months on a short term assignment, then back to New York. Then back to Atlanta for 3 years, followed by a home office assignment in New Jersey. In 1976 it was off to Los Angeles and then 2 years later a nice promotion took me to New Haven. In 1982 another big promotion took me back to Atlanta.
I left Chubb in 1988 after a 20 year career. I've written about that in an earlier post so won't go into it again. But looking back on what would have been my 47th anniversary (and most likely my 4th year of retirement) I can remember with great fondness the friends I made during my career there. Most of them are either retired or went somewhere, but there are a few that I talk to occasionally. In any event today is a nostalgic day for me and most likely the second most important July 01 in Chubb's history.
We were all in a general insurance training course for about 6 weeks, and then we we chose--or rather were assigned--to various departments. Most of us wound up in an underwriting department although a few went into Claims or Operations (1968 version of IT). I had been hired specifically for personal lines because having worked as a clerk in the Virginia Department of Motor Vehicles I had some basic knowledge--so they thought--about personal auto insurance. At the time personal lines underwriting compared to commercial lines underwriting was viewed by most folks coming into insurance as a dead end for many reasons I won't bother mentioning. But it was a large part of Chubb's overall revenue and I figured if it didn't turn around I wouldn't be blamed, but if it did, maybe I would get some credit. Over the next 10 years that's exactly what happened and my career progressed. In the late 60's and early 70's Chubb was a medium sized company with about 30 branch offices and 5,000 employees. One way to get ahead was to be willing to go where ever they needed someone. I started in New York, went to Atlanta for about 4 months on a short term assignment, then back to New York. Then back to Atlanta for 3 years, followed by a home office assignment in New Jersey. In 1976 it was off to Los Angeles and then 2 years later a nice promotion took me to New Haven. In 1982 another big promotion took me back to Atlanta.
I left Chubb in 1988 after a 20 year career. I've written about that in an earlier post so won't go into it again. But looking back on what would have been my 47th anniversary (and most likely my 4th year of retirement) I can remember with great fondness the friends I made during my career there. Most of them are either retired or went somewhere, but there are a few that I talk to occasionally. In any event today is a nostalgic day for me and most likely the second most important July 01 in Chubb's history.
Thursday, April 23, 2015
Happy Birthday, Mother
Today, April 23, 2015, would have been my mother’s 100th birthday. Unfortunately, she has not been around to celebrate the last 36. Katherine Marcella Pie (pronounced pee-a) was the third of 9 children of Charles William and Nora Scollins Pie. It’s pretty amazing that my grandmother had her first child in 1909 and her last in 1928. She loved the fact she was born on the same date (not year) as William Shakespeare, even though his actual birthdate has been questioned. She grew up in Johnstown, Pennsylvania and was acknowledged by her entire family as the brightest of them all.
After high school she attended nursing school and wound up in Washington, DC at Saint Elizabeth’s Hospital. She spent time in their suicide ward which must have been stressful. I remember her telling me about a patient who attempted suicide by swallowing 47 razor blades (they must been used because he survived). She kept a journal from 1938 for about 10 years and the early portion is filled with various adventures she and her cohorts had as single females. During that time she met my father as he was heading oversees for World War II. I’ve written about their relationship in other posts so I won’t recount it here.
I remember her as someone who was adept at many things. She could sew and knit, was very quick witted and managed the house. She also wrote two novels but they were never published. The first was titled Right Out of My Mind and was similar to the book Please Don’t Eat the Daisies The second was a novel called The Invisible Scar and drew on her knowledge as a nurse. She and my father seldom argued, I can only recall 2 instances where things escalated between them and I remember because it was so unusual.
I inherited several characteristics from my mother: her love of books and the written word, her quick wittedness. After my father died she became very depressed and that seemed to stay with her for the rest of her life. She died from emphysema and smoked right up to the end. It was very sad to watch helplessly as a very talented woman never really recovered from becoming a widow. My brother and I who had been raised too survive on our own just did not know how to help. It was awfully sad and I regret not being able to figure out how I could have helped her.
In retrospect both my parents left this earth far too early because of the choice they made to smoke. It’s too bad I didn’t have more time with them as an adult, I think they both could have helped me grow and mature better than me doing it on my own.
Happy birthday, Mother. I miss you.
After high school she attended nursing school and wound up in Washington, DC at Saint Elizabeth’s Hospital. She spent time in their suicide ward which must have been stressful. I remember her telling me about a patient who attempted suicide by swallowing 47 razor blades (they must been used because he survived). She kept a journal from 1938 for about 10 years and the early portion is filled with various adventures she and her cohorts had as single females. During that time she met my father as he was heading oversees for World War II. I’ve written about their relationship in other posts so I won’t recount it here.
I remember her as someone who was adept at many things. She could sew and knit, was very quick witted and managed the house. She also wrote two novels but they were never published. The first was titled Right Out of My Mind and was similar to the book Please Don’t Eat the Daisies The second was a novel called The Invisible Scar and drew on her knowledge as a nurse. She and my father seldom argued, I can only recall 2 instances where things escalated between them and I remember because it was so unusual.
I inherited several characteristics from my mother: her love of books and the written word, her quick wittedness. After my father died she became very depressed and that seemed to stay with her for the rest of her life. She died from emphysema and smoked right up to the end. It was very sad to watch helplessly as a very talented woman never really recovered from becoming a widow. My brother and I who had been raised too survive on our own just did not know how to help. It was awfully sad and I regret not being able to figure out how I could have helped her.
In retrospect both my parents left this earth far too early because of the choice they made to smoke. It’s too bad I didn’t have more time with them as an adult, I think they both could have helped me grow and mature better than me doing it on my own.
Happy birthday, Mother. I miss you.
Saturday, February 14, 2015
Hospirals & Health Care--Inside View
During the past 6 months I've been in 2 emergency rooms, 2 hospitals, undergone 2 surgeries, and am now facing time in a rehabilitation center which I think is a politically correct term for a nursing home. You learn a lot from inside this prism; here are some observations which are purely my opinions.
I have Medicare A&B, and AARP Plan F supplement through United Health Care along with a prescription drug card. The total cost is $340/month. My out of pocket expenses with this coverage have been minimal; except for co-pays on some drugs they have been zero. While I may not have access to every health care provider in my world there are plenty readily available. Having affordable health insurance, minimal co-pays and facility access eliminate lots of concern. My premiums do increase each year but they have been reasonable. Someday this system will totally implode, but probably not in my lifetime.
Health care providers have to follow many procedures, aka government regulations. It sometimes means waiting time, cant do that until we do this, etc. I also think since providers know they won't get the dollars they bill, they look for ways to increase volume with approved Medicare procedures. I've said it before, no individual really ever knows the true cost of their health care. Ever since doctors lost control no one really has control anymore. However, if the US ever completely turns it over to government control, costs will soar and quality will no doubt suffer. Ever wonder why the 3 branches of federal government completely remove themselves from traditional medical health care systems? I don't.
When you're in ER and/or move to the hospital more than one doctor may be managing your situation. That can quickly complicate matters. It is important to remain calm, ask plenty of questions as politely as possible. Usually you'll notice when they come talk to you there are 2 of them present so stuff doesn't fall through the cracks; it still can happen. Do your best to comprehend, and even when you think they are full of shit, your best response is "I'm not sure I understand the part about xxx, could you go over that again, please." I'm not the most patient person, but I am one the most stubborn so this lesson has been difficult for me. Learning to blend those characteristics into "determination" is one of my life goals.
Ever since I accidently overdosed on Vicodin to complete a century ride with broken ribs in 2007 I pay a lot of attention to pain medication management. Having overcome an alcohol problem a few years ago I don't want to develop another addiction. During the last few months I've learned that when you are in acute pain, medication is good. When needed make sure the providers know your complete health history and all medications you have been taking. Most problems arise when multiple meds, alcohol and other stuff get taken in unsupervised combinations. If possible use one pharmacy for medications and remember a good pharmacist is a valuable consultative resource, in spite of the internet. Of course being the son of a third generation druggist has somewhat prejudiced me.
Go to an ER when you wind up laying in the road after an accident or other similar potential life threatening situation. On the way, hope you will not be their top priority. Once you arrive and it's confirmed you are not, your goal is to get out of there ASAP. If you wind up in a hospital, your goal is to get treatment and get out of there ASAP. I'm sure it will be the same in the rehabilitation facility. The important goal is to move forward even if progress sometimes seems negligible.
I am anxious to get back to normal and on my bike again. It's been said this kind of stuff happens in threes; I hope my Paris-Brest-Paris incident and these 2 accidents mean I'm done with these encounters for a while.
I have Medicare A&B, and AARP Plan F supplement through United Health Care along with a prescription drug card. The total cost is $340/month. My out of pocket expenses with this coverage have been minimal; except for co-pays on some drugs they have been zero. While I may not have access to every health care provider in my world there are plenty readily available. Having affordable health insurance, minimal co-pays and facility access eliminate lots of concern. My premiums do increase each year but they have been reasonable. Someday this system will totally implode, but probably not in my lifetime.
Health care providers have to follow many procedures, aka government regulations. It sometimes means waiting time, cant do that until we do this, etc. I also think since providers know they won't get the dollars they bill, they look for ways to increase volume with approved Medicare procedures. I've said it before, no individual really ever knows the true cost of their health care. Ever since doctors lost control no one really has control anymore. However, if the US ever completely turns it over to government control, costs will soar and quality will no doubt suffer. Ever wonder why the 3 branches of federal government completely remove themselves from traditional medical health care systems? I don't.
When you're in ER and/or move to the hospital more than one doctor may be managing your situation. That can quickly complicate matters. It is important to remain calm, ask plenty of questions as politely as possible. Usually you'll notice when they come talk to you there are 2 of them present so stuff doesn't fall through the cracks; it still can happen. Do your best to comprehend, and even when you think they are full of shit, your best response is "I'm not sure I understand the part about xxx, could you go over that again, please." I'm not the most patient person, but I am one the most stubborn so this lesson has been difficult for me. Learning to blend those characteristics into "determination" is one of my life goals.
Ever since I accidently overdosed on Vicodin to complete a century ride with broken ribs in 2007 I pay a lot of attention to pain medication management. Having overcome an alcohol problem a few years ago I don't want to develop another addiction. During the last few months I've learned that when you are in acute pain, medication is good. When needed make sure the providers know your complete health history and all medications you have been taking. Most problems arise when multiple meds, alcohol and other stuff get taken in unsupervised combinations. If possible use one pharmacy for medications and remember a good pharmacist is a valuable consultative resource, in spite of the internet. Of course being the son of a third generation druggist has somewhat prejudiced me.
Go to an ER when you wind up laying in the road after an accident or other similar potential life threatening situation. On the way, hope you will not be their top priority. Once you arrive and it's confirmed you are not, your goal is to get out of there ASAP. If you wind up in a hospital, your goal is to get treatment and get out of there ASAP. I'm sure it will be the same in the rehabilitation facility. The important goal is to move forward even if progress sometimes seems negligible.
I am anxious to get back to normal and on my bike again. It's been said this kind of stuff happens in threes; I hope my Paris-Brest-Paris incident and these 2 accidents mean I'm done with these encounters for a while.
Wednesday, February 04, 2015
Bike Accidents--Update
On September 9, 2013 I wrote about the bike accidents I had in over 50 years of cycling. Unfortunately that now needs updating. I've had 2 crashes that landed me in an ER; both involved fractures. One occurred on September 28th on a Randoneur ride which started in Rome. Despite a fractured femur I did a 200 km ride 4 weeks later. Details of that are in a post dated October 26.
On Saturday while doing a 115 km Rando event I crossed railroad tracks and managed to drop my front wheel into a wide gap. The tracks were at an angle and I lined up on the right side of the road to cross them perpendicular as I've done thousands of times. A car passed me going in the same direction and I was paying more attention to that than the tracks. A wide gap grabbed my front wheel and I went down on my left side. That earned me an ambulance ride to Atlanta Medical Center where after 5 hours of x-rays and CAT scan I was diagnosed with a displaced left clavicle fracture, concussion and a hip pointer.
They elected not to do surgery on my clavicle then, but a follow up discussion with the ortho doctor who has done work on me before led me to conclude surgery is the best option for me. Trying to wear a clavicle brace that I could not take off or put on myself turned out to be too uncomfortable; and this opinion from someone who knows how to manage pain. I hope to be back riding on the road soon, but will have to figure out that timetable after surgery which is scheduled for February 12.
My observations haven't changed from that earlier post, but I would add one. Emergency rooms are the place to go for true emergencies. However, your care is prioritized by the level of trauma, not only yours but in comparison to every other patient. That's not a complaint; that's how it should be. For me that translated into first class quick treatment in Rome on a relatively calm day in their ER, compared to a 5 hour wait at Atlanta Medical Center on an evening they were also dealing with 2 fatalities. I was grateful not to be a level 1 trauma.
On Saturday while doing a 115 km Rando event I crossed railroad tracks and managed to drop my front wheel into a wide gap. The tracks were at an angle and I lined up on the right side of the road to cross them perpendicular as I've done thousands of times. A car passed me going in the same direction and I was paying more attention to that than the tracks. A wide gap grabbed my front wheel and I went down on my left side. That earned me an ambulance ride to Atlanta Medical Center where after 5 hours of x-rays and CAT scan I was diagnosed with a displaced left clavicle fracture, concussion and a hip pointer.
They elected not to do surgery on my clavicle then, but a follow up discussion with the ortho doctor who has done work on me before led me to conclude surgery is the best option for me. Trying to wear a clavicle brace that I could not take off or put on myself turned out to be too uncomfortable; and this opinion from someone who knows how to manage pain. I hope to be back riding on the road soon, but will have to figure out that timetable after surgery which is scheduled for February 12.
My observations haven't changed from that earlier post, but I would add one. Emergency rooms are the place to go for true emergencies. However, your care is prioritized by the level of trauma, not only yours but in comparison to every other patient. That's not a complaint; that's how it should be. For me that translated into first class quick treatment in Rome on a relatively calm day in their ER, compared to a 5 hour wait at Atlanta Medical Center on an evening they were also dealing with 2 fatalities. I was grateful not to be a level 1 trauma.
Thursday, January 22, 2015
Back to the Future--Happy Anniversary
Today would have been my parent’s 70th wedding anniversary. They got married within days after my father returned from World War II having served in the Army Medical Core in Africa. They originally met in Washington DC several years before after my father went on active duty and my mother worked as a nurse at St Elizabeth’s Hospital. My mother kept a journal from 1938—until 1948, and many of the posts express her love for him and hoping he would return and marry her. I know very little about how he felt about her though. However, from my mother's journal it's obvious they both wrote lots of letters during that time. She also mentioned many times the frustration of not hearing anything for months, then getting 6 letters. Sometimes letters did not arrive in any particular order in that she would get one and later receive another written weeks earlier. She often referred to "snail mail" which given it was the 1940's may have made her the inventor of that phrase.
They spent their first year together at Fort Meade Maryland where exactly 367 days later I arrived. From there they went to Fort Pickett in Virginia and later on after my father's discharge from active duty they moved to Harrisburg, Pennsylvania where my brother was born. Since the Fleming family drugstore had been sold while he was in the army my father went to work for Peoples Drug Stores and we wound up in Bristol for a while. Then he was promoted and we moved to Danville, Virginia. The rest of my parent's married life was spent there. Unfortunately it only lasted 17 years until my father died from lung cancer. My mother never really recovered from that loss and our family life was never the same.
These days most of my friends who are around my age have also lost there parents. Except for our next door neighbors the Browns whose patriarch died 5 years before my father, I was one of the first of my friends to lose a parent at such an early age. One of my regrets is that I didn't get to spend time with my father as an adult. My mother died 17 years later when I was 33 but in some ways she disappeared many years before as I've mentioned in some previous posts. As I reflect on this anniversary though my biggest regret is that my parents did not have many more years together.
They spent their first year together at Fort Meade Maryland where exactly 367 days later I arrived. From there they went to Fort Pickett in Virginia and later on after my father's discharge from active duty they moved to Harrisburg, Pennsylvania where my brother was born. Since the Fleming family drugstore had been sold while he was in the army my father went to work for Peoples Drug Stores and we wound up in Bristol for a while. Then he was promoted and we moved to Danville, Virginia. The rest of my parent's married life was spent there. Unfortunately it only lasted 17 years until my father died from lung cancer. My mother never really recovered from that loss and our family life was never the same.
These days most of my friends who are around my age have also lost there parents. Except for our next door neighbors the Browns whose patriarch died 5 years before my father, I was one of the first of my friends to lose a parent at such an early age. One of my regrets is that I didn't get to spend time with my father as an adult. My mother died 17 years later when I was 33 but in some ways she disappeared many years before as I've mentioned in some previous posts. As I reflect on this anniversary though my biggest regret is that my parents did not have many more years together.
Saturday, January 03, 2015
Augusta 200 K Brevet
On New Years day I did what I've done for the past 5 New Years: rode the Augusta 200 K brevet. This year the official ride was moved to January 3rd, but several folks were pre-riding it on the first so I joined them. It was chilly but no rain which was predicted for today. Since I fractured my femur I've done just over 1000 Km in RUSA rides. Except for those efforts I've only ridden about 200 miles in the last 3 months. For 2015 I managed just over 5,000 miles of cycling which is slightly below average for me.
What I have noticed is that I've gotten slower over the last 2 years. Also when I complete a 100 or 200 km ride it takes longer to recover. I think those distance rides are pretty doable but I'm beginning to wonder how many longer rides I can manage in the future. I think the biggest issue is the arthritis that plagues my lower back and right hip. Yesterday I visited the doctor who surgically repaired my femur and x-rays show that while the fracture has completely healed my right hip joint is bone-on-bone. It certainly is no where near as painful as my left hip became before I had it replaced 14 years ago, but it has aggravated me from time to time. The doctor was amazed I could ride 200 Km, and there's no question that cycling is the best aerobic activity for me if I wanted to postpone replacement.
I always set goals each year usually around keeping fit. In 2015 I want to cycle at least 7,000 miles. Breaking that down means just under 20 miles a day, 135 miles a week, around 580 miles a month. It seems easy when you start with 125 on New Years but over time it's all about consistency. I have done just over 10,000 miles in a year, but that year I wasn't working and going to school. 7,000 seems like a worthy goal for 2015. I also want to reach at least 5,000 kilometers on RUSA events. I've reached over 4,000 the past 2 years so it's also attainable but I'll have to figure out a plan for that especially if I don't do many 300 and 400 Km events. My main RUSA goal is to continue my streak of 61 straight months of at least one 200 Km event and also do at least a 100 Km event each month as well. If I can achieve all these goals I can push any thought of hip replacement further into the future.
The only other goal I set is to do something every day to take care of my body. Yesterday it was as simple as getting a massage and doing some transverse Abdominal exercises. Today it will be a weight workout. Many days it could be simply 10-20 minutes of stretching or flexibility work. The hardest part of this goal is again consistency. It all looks good on paper the third day of 2015.
What I have noticed is that I've gotten slower over the last 2 years. Also when I complete a 100 or 200 km ride it takes longer to recover. I think those distance rides are pretty doable but I'm beginning to wonder how many longer rides I can manage in the future. I think the biggest issue is the arthritis that plagues my lower back and right hip. Yesterday I visited the doctor who surgically repaired my femur and x-rays show that while the fracture has completely healed my right hip joint is bone-on-bone. It certainly is no where near as painful as my left hip became before I had it replaced 14 years ago, but it has aggravated me from time to time. The doctor was amazed I could ride 200 Km, and there's no question that cycling is the best aerobic activity for me if I wanted to postpone replacement.
I always set goals each year usually around keeping fit. In 2015 I want to cycle at least 7,000 miles. Breaking that down means just under 20 miles a day, 135 miles a week, around 580 miles a month. It seems easy when you start with 125 on New Years but over time it's all about consistency. I have done just over 10,000 miles in a year, but that year I wasn't working and going to school. 7,000 seems like a worthy goal for 2015. I also want to reach at least 5,000 kilometers on RUSA events. I've reached over 4,000 the past 2 years so it's also attainable but I'll have to figure out a plan for that especially if I don't do many 300 and 400 Km events. My main RUSA goal is to continue my streak of 61 straight months of at least one 200 Km event and also do at least a 100 Km event each month as well. If I can achieve all these goals I can push any thought of hip replacement further into the future.
The only other goal I set is to do something every day to take care of my body. Yesterday it was as simple as getting a massage and doing some transverse Abdominal exercises. Today it will be a weight workout. Many days it could be simply 10-20 minutes of stretching or flexibility work. The hardest part of this goal is again consistency. It all looks good on paper the third day of 2015.
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