Revision ACL Surgery and Rehab

For most city commute I prefer to ride my bicycle. This early March I was in a dilemma to ride my bike to a work meeting at EGL. It was a 4PM meeting, clear day, I rolled in a formal shirt into my laptop bag. At Trinity circle, as if like a premonition, the bungee cord from my pannier snapped and got stuck in my rear wheel. Fortunately, there was no damage done, I thanked my stars and carried on. But just after command hospital, as the road narrows down a bit, I could hear a car blare its horn to an empty stretch of road. In the next minute, the car behind this one brushed past my cycle. For a brief second I crashed into the rear door of the blue car, half cursing, half balancing, half bracing for the impending fall. The next thing - a big thud as the back of head met the tarmac. The familiar ligament pain the left knee was back.

Lying face up on the road, my cycle, bag, phone scattered around, all at the mercy of oncoming traffic, I let out a loud scream (Kantara style ;), - this would change many things in my diurnal life.

A lot changed - Ooty Ultra and Hennur Ultras were the first to go. I was adamant with recovery, hoping (almost sure) that the knee will be good in a few days. The few days turned to a few weeks. I began to use an elbow crutch to walk, but the exertion caused calf strain right up to the back of the knee. It took me 3 days to release a brick-like calf muscle and then a spasmed popliteus muscle.

After about a week, when the mobility did not improve, I started physio sessions with a focus to improve knee extension. These sessions caused excruciating pain, but it had to be done. Eventually after a month of grief, I went in for an MRI, only to confirm the Anterior Cruciate Ligament (ACL) had torn, with some damages to the cartilage.

My first issue with ACL was way back in 2001, a freak football injury. Then my first Arthroscopic surgery in 2006 (read here) and then another bicycle accident in 2015 (photoblog here).

I have mixed opinion of Ortho / radiology experts. The MRI reports are seldom clear and one has to interpret them with a lot of contextual background. One physio suspected bone chipping, MRI second opinion indicated that my previous screws were not in place. Amidst this confusion, I suspended my physio sessions. The knee mobility got back and I started strengthening my knee at the gym.

I eventually visited my Ortho of last resort - Dr. Hemanth Kalyan. He had had conducted my surgery way back in 2006. We discussed the option of a second surgery, but decided to give it 3 months of strengthening to see if we could avoid surgery.

The surgery option that was prescribed was using a Hamstring tendon graft and an arthroscopic procedure using an Endobutton & a bio screw. Dr. H was confident of finding another tunnel without disturbing the previous tunnel or screws.

In the coming weeks, I was able to shuffle jog about 1-2kms with lot of discomfort. I was able to lift weights, deadlift (up to 80kgs), lunges, leg extensions & curls. I used the time off running, to do what I could in the gym. Not too bad, eh.

I also added a few sessions of swim. Running was out of question, even a busy day with lots of walking would give me pain by evening.

I decided to get it sorted out - once and for all! My ACL "reconstruction" had to wait till our dream home "construction" could be complete. Within 3 days of Grihapravesh of Tadvanam our new home, on Vijayadashami, I did my hospital-pravesh - same knee, same injury, same hospital, same doctor, separated by thousands of miles of running and 16years!

Revision ACL Surgery

Technically speaking, the surgical / therapeutic procedures performed was:

Revision arthroscopic ACL Reconstruction left knee using 6 stranded ipsilateral semitenidinous and gracilis with microfracture chondral lesion and medial meniscus balancing left knee done by Dr. Hemant Kalyan (HK)

I was wheeled into OT room2, after an overnight fast in hospital overalls (incl. a disposable underwear) at 7:30am. Mine was the first surgery for HK, I spent sometime in the waiting room. By 8, I was wheeled into a super large OT with some massive overhead lights and lots of sophisticated equipment. The anaesthetist and 2 orderlies got working on me. I was seated on the OT bed and felt a few pricks in my lower back - spinal anaesthesia done. Soon the legs felt heavy and then felt nothing. HK came in and started going over my case with another doctor, spoke to my awake "upper half" briefly.

I had seen this video explaining the Endobutton ACL reconstruction technique earlier. I had a sense of what is coming. (It's quite a procedure, check out the video)

Right through the 1.5 - 2hr surgery I didn't sleep. I had a cloth wall at my waistline to prevent me seeing the procedure. I could "feel" the drilling and the hammering of my joint, but no pain, like it was being done to the bed or something.

While I was being sewed up after the surgery, HK walked across to my conscious half and gave a summary. "We got a nice 10mm graft from the hamstring tendon (usually 8mm is sufficient). The earlier screws did not come in the way, so we left it as is. There was some cartilage damage, which we fixed via a procedure called the microfracture which allows for tissue from the bone marrow to form the cartilage naturally. All's well!"

I now have a bioscrew, an endobutton and 2 titanium screws in my left knee!!

I was transferred to the recovery room, where I waited for over 2hours to get some sensation back to my legs. My knee was all strapped up in crepe bandage and the immobilizer brace. Weird sensations, stiffness, dull pain came by during the post op evening, with it discomfort while lying down in the bed all day and disturbed sleep during the night.

On his evening visit, HK mentioned that I it was ok to put all my weight on my operated leg already and should begin my physiotherapy session on Day1 itself.

The IV line was a pain, with constant pain killers, antibiotics, etc. and other injections. The food was good, I was able to get to regular food from the next day. The support of my wife during the hospital stay alleviated the discomfort to a great extent.

I was discharged after 2 days at the hospital. I am now in my 4th week post surgery, the vastus medialis oblique (vmo) muscle needs more tlc but in general I'm recovering well. If I feel inspired enough, I will create another post on the rehab.

Thank you for reading and your good wishes for my recovery! 

“Life is not a journey to the grave with the intention of arriving safely in a well preserved body, but rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming, “Wow what a ride!” ― Hunter S. Thompson

Cheers and have a good day!

Ps: fellow biker and dear friend, Shilpi added a pretty accurate illustration

Dealing with failure

Recovery

I was expectedly stiff and sore in a lot of places the night of finishing the 24h. Sleep is usually very difficult, with each turning and change in position needing multiple adjustments. My pelvic was still sore and wouldn’t support my legs. I improvised by tying two towels around my knee and pulled them with my hands to change position. But I slept surprising well, given the conditions.

The next day, I used one of the ubiquitous plastic chairs for support, as I leaned forward, supporting each step with my hands to move a bit. By evening, I was walking straight without the chair. The next day, I was riding a bike and managed a few beers with some friends, and a dinner with others.

I put my feet up for 4 days while I slept, but I simply could not shake off the feeling that I had failed. The mind rationalizes – “you gave it your best”, “your body was not there for that last one hour”, “you can’t plan for such injuries”. But each day, I cursed myself a hundred times, “I had missed a golden chance”. Kanan’s words while we were on track, kept coming back to haunt me “Accha mauka hai, bhaiyya”.

Feedback and way forward

I got a plenty of feedback (mostly solicited, some unsolicited) – try more food (close to 400cal / hr), was it too much caffeine (21 caffeinated gels), you need to put on more weight, more solid food, went out too fast (w.r.t the 10th hour for about 20 laps), was overwhelmed by the target – should have been more relaxed about it, etc. etc. I certainly chocked. I feel I could have done better in the enjoyment department, mentally. Physically, long strides during walking may have been a wrong idea, need to put some more time in the gym for some strengthening.

Comparison chart showing the hare and tortoise story – me in red and KJ in blue. (lap & distance credit: KJ)

These things were playing round and round, nothing really helped get rid of the feeling of dejection. I contemplated stop running these events, running altogether. A lot of what-ifs played about, I pulled myself out of bed one night, to see my splits.
But, I got here not expecting anything from running, not allowing myself to be bogged down by results and not making running another stressful rat race.

But again, I draw inspiration from the sexagenarian runners on the national Aussie team at Soochow. For now, I will take the advice of two wise men, who said - drink more beer and do some fun running! Cheers!

My Panchakarma Virechana Experience

I lay down face up on the bare bed, stark naked except for a cloth barely covering my privates. My hands are stretched far out to one corner, warm oil drips onto my starved and somewhat weakened body, from legs to the torso to the arms. Then, in pressurized machine like manner, he massages up and down and in circular fashion swishing the oil and squezzing my organs. As my skin stretches and my skeleton offers meek resistance, I close my eyes into submission...

For a couple of years now we have been trying Ayurveda – during Sh’s pregnancy, to battle my daughter’s asthma and incessant coughs and colds; with good success. Our confidence in Ayurveda’s holistic healing approach and our friendly neighborhood Ayurveda doctor (Dr. Nayana) has only grown since.

I tried to apply Ayurveda to cure a skin eczema that I have been having for the last 12years or so. The steroid based allopathy medicines don’t get to the root cause.

After a few months of some mild medicines and kashayam, my doctor suggested I “treat” myself to a full Panchakarma Virechana detox program to get rid of any Pitha dosha that may be causing this. It was the most I have spent on myself in a while, but I decided to give it a shot.

The best part of the whole exercise was the suspense factor. The doctor modifies the phases as per the reaction to the current & previous phases. It pans out one step a day. In my case, I was in constant consultation with my doctor on Whatsap. So it was more one “ping” at a time. I had no idea how the massage phase would be, no clue on the purging process, etc, only knew that it would go on for 12 days.

Preparation phase – 3 days

This was perhaps the easiest. I had to take digestive medicine Chitrakadi Vati for 3 days and have easy-to-digest home cooked food. Curd and fruits were proscribed.

Snehakarma or Oleation Phase – 3 days

My previous experiments with intermittent fasting & bullet proof coffee came handy here. You start your day by consuming 15ml to 50ml (increasing quantities – Shodana Sneha) of medicated ghee on empty stomach, sip warm water periodically and fast till noon, to aid the absorption of ghee. Ghee is actually euphemism, don’t imagine anything as tasty. My burping was not much but brought out the pungent taste back to the mouth. Diet for the rest of the day was only watery rice gruel (Ganji). By the third day, the boredom of not eating as per your regular schedule and the food you want got to me.

Abhyanga (massage) and Swedana Phase – 3 days

 This was the first time I had massage of any kind. Despite all the running, I have so far stayed away from deep tissue massages that are very popular with runners. The oil massage (with special oil – Shatavari + Chinchadi thailam) was an experience in itself. Taking your clothes off with just a komana to cover your vitals is in itself a quantum leap from my comfort zone. 40mins of Abhyanga, breaks more mental barriers than physical, I guess. 
I felt frail as I got off the massage table. The body is but on rent, take care of it enough to lead a happy life, don't be too attached to it, it is on rent after all.
Swedana / sweating follows for 15mins in a steaming chamber. I liked the Paanamrutha after the massage. The relaxation of the massage comes at the cost of dietary & sleep restrictions. Rice is ok, No Urad / Toor daal, no fermented foods, no coffee / tea – rules out a lot of staple food. Pongal with tadaka & tomato rasam (without daal) were my treats. I figured if you take a deep breath of coffee decoction and drink green tea, it comes close to actually drinking coffee. And, don’t relax too much, so you fall asleep - Sleeping during the day is prohibited.

The core of it all – Virechana Phase – 1 day (thankfully!)

This is the actual purgation process. The idea of the previous phases is to loosen the Kapha rooted in the organs, gut and intestines. The idea of Virechana is then to purge this out of the system via the anal route.

I was told that on this day, after the massage, a kashayam is given and within one hour, the urges will start. One would have urges for about 15 times during the day. You are only allowed to sip warm water till evening when the purgatory process is over. Simple, right? But the actual day was quite miserable.

The massage, medicine (one bowl of chamanprash like porridge) and a glass of diluted kashayam were actually nice, quite contrary to what was to come.

Within about 30mins, the medicine started doing its thing. The urges came in 30mins intervals to start with, then more frequently. I joked that the timing chart looked like my 5K split timings, precise to start with. S said it was closest to an edema-like feeling I will ever get. Jokes apart, by noon, I was already into double digits. By 3pm or so, the very idea of going to the bathroom was nauseating. Surprisingly, the last thing on my mind was hunger – I had lost the wish to eat, anything! By 4pm, the doctor gave the go-ahead for a bath and eat some Ganji. Finally by 5pm or so, after some 16 purging sessions, I was done and hopefully, the Kaphas have left as well.

Samsarjana / Recovery phase – 2 days

For the next couple of days, my weakened digestive system should be given time to recover slowly. More dietary restrictions, starting with Ganji, then moving to Pongal, rice and rasam for the second day. One the third day, I am allowed to eat fruits and get back to regular diet.

I am yet to figure out if this cures my skin eczema issues. My initial reaction is relief that I am nearing the end of this. I certainly feel light, I have lost 4kgs in this period. You are what you eat, there is no doubt about it. Do I recommend it? Yes.

Do challenge your body to move out of your comfort zone, and if the purging process comes with the multitude of benefits that it claims, you have more reason to do it.

Je suis Cyclist

A short note on the title - In the days of limping to normalcy that followed this incident, I couldn't but help draw a parallel of this "traffic terrorism" to the Charlie Hebdo shooting. The below is my silent protest against how badly cyclists are treated in the city...

Quick update: The bad news - the only way to fix the tear of my torn graft is a second surgery. The good news, is, for now my surgeon has suggested to get back to running, the surgery can wait... for now!

Cloud Valley - A trip that took my trip

The title borrowed from Haren’s ride report, borrowed because, I deserve it more than anyone else.
Life is always about squeezing a little more. No, no I don’t mean to sound like your boss, but hey, my wife is not a HR Manager for nothing. Anyway, what I was getting at is that, there was a helluva lot of traveling happening in the last 10days Bangalore-Cochin-Alleppey-Chennai-Bangalore and then I was off to Coorg again!
But the annual RTMC pilgrimage to Cloud Valley in Coorg is a guaranteed un-winder, I needed a strong dose of that one!

It would also be Shreya’s first overnighter with the bullet club and we started the Saturday, 29th May with gusto. We are both sufficiently cramster-ed now – mutually gifted riding jackets, saddle bags and waist pouch to carry everything from nail polish, comb (new additions to the luggage, or was it eye liner) and the usual – running shoes, sunscreen and spares.
The getting there:
We joined about 25 bullets at Bangalore Univ campus at 6:30 or so. Just so there is no serious problem, I had given my bullet for service last week. First puncture in 20km from the start. In about 30mins with help from Horny, Tampon, Conrod and Dicso we replaced the punctured tube with a new one from Conrod.
The rear shocks creaked like an old iron cot that creaks when you ‘sleep’ on it as you went up and down even on a slight bump.

Group rides do provide a fair amount of insurance against break downs, accidents and other variables on the highways. The entire band of bulleters waited at McD for us to catch up, a quick breakfast later, we were highway bound again towards Srirangapatana.
I totally enjoyed the good roads to Madikeri, cruising at 80-90kmph. We reached Cloud Valley at 1pm and welcomed by Uday and his family. The inevitable pandi curry meal happened over ride stories and some poor jokes.
Those of us who weren’t high yet, made our way to the Cauvery river bed at 5, bathed and rode back. Some more ride stories and papad mama jokes kept us entertained around the camp fire right through the night.
The place:
Cloud Valley itself is awesome. You should see my earlier report on this here. It is a nice report, go read!
Apparently, the best time to visit is when the flowering season when the coffee seeds come into bloom and look like snow! The Jasmine-like aroma also fills up the entire region.

The run:
So, I made quick enquiries in the evening with Uday ‘where can I go for a jog in the morning?’. I have become some kind of a fan of these runs - where you have no clue what’s in store, no idea of how long you are going to take to get back, where (if ever) you will find some water, civilization, etc. But I headed out on the path that had taken us to the river the previous evening. It was 6:30 and it was perfect for a long run. The trail took me on some serious uphills along winding coffee estates. There was not a single soul to ask for directions, you knew you were trespassing when the dogs barked louder. After about 4.5km, the path brought me back close to where I had started. Nice! I ran into the trail again, so I could finish a perfect 10!

The story of a Tired Tire:
One-a-puncture, two-a-puncture, three-a-puncture, four!
I am the rear tire of KA04-EM 1983, you have seen how I was born, right. It is here if you want a flashback. I have nearly done 15000kms on road now and my predecessor had taken care of the rear for about 40000kms. My owner is a nice guy (yes!) and he takes care to ‘fill me up’ with 30psi always. He likes to take me on good roads, bumpy roads and very very bumpy roads, but I like adventure too.

I have been very loyal and have not disappointed him on any of his long rides… so far.
So yesterday, just as I was warming up, something happened and suddenly there was air all inside me and in another moment the wheel was hurting me. That local tube inside me had a puncture. My owner should have known better not to buy a local tube from the “Aslam Bhai” mechs on the road side.
Anyways, my owner, a big fan of DIY, fitted a new tube (Original!!) inside me, and I was happy again.

My owner’s missus is a light lady and I have usually no problems with carrying both of them. But they stopped at this place where the milestone said ‘Hunsur 10’. There were people selling jackfruits. They are those big, heavy, thorny (I hate thorns) things that people like to eat.
My owner should have put this in the front and the that lazy front tire should have taken some load. I must add that front tire is a senior one (55k kms), but had not worn out at all, because he does not do any work. He only takes the load of my owner’s arms and has good suspension to pass on the shocks from bad roads. If you ask me, the jackfruit should have been showed right through his valve.
But, we hard workers are always made to ‘squeeze a little more’. That is life – as my owner says it.
So the jackfruit came into one side of the saddle bag and the rest of the stuff was rearranged.

Now when the owner started to ride, the mud guard started to flirt with me. It started to come so close and rub me in the wrong places. I started getting hot.
Even the original rubber was able to withstand this and our safety was compromised near Bidadi. I tried to hold on as much longer as I could (I am very conscientious tire, you see), so it a while for my owner to realize the puncture. Luckily, I went fully flat near a ‘pancher’ shop. But the pancher guy was drunk and sleepy and despite taking all care, he patched the not-original rubber tube (remember the old one that punctured yesterday) very carelessly.
I anyway didn’t like this duplicate rubber tube.

So far it was still ok. It was still about 4pm in the evening. But we had just started the motions again, some 20k and then bam, one more flat. By this time, the wheel had started to bang me from the other side and it was slightly bent I think. I was feeling wobbly also. This time was terrible. My owner left his wife on the side of the road (very unsafe place) and put all his weight on the tank, standing on the foot peg and leaning in front and road me without air for 2km to get a puncture shop.
This guy was ok, he put the puncture and in about 30mins, owner went back and picked up his wife. There were dark clouds and I am sure he wanted to get home before it rain. But, I like rain!
So we started off again, the jack fruit load was still on me and I think I was dizzy because of the bent wheel. Anyways, it was now dark and we went another 20k and came to the NICE road. It is a very nice road and I was happy because there are no thorns, potholes or nails on this road.

But just after the toll was paid, I went flat again. Promise, this was not my fault. It was the duplicate tube. I was focusing on my job and not paying attention to the mud guard also.
This time there was more problem, it was raining, there were no puncture or pancher shops open (it was a Sunday) and my owner had to do his circus stunt again for 2km. But he was getting good at it, I didn’t feel too much load at all.
I over-heard him tell his missus afterwards that he had only 260 bucks and the tube cost him 270!

Four is too much, I say. But, there was one good thing, that jackfruit went off to the front in the end. That lazy front tire also took load. Then he rode me very very slowly, the last 30kms to his home. I felt very ashamed of myself. I will not do this again. I will not do this again. I will not do this again.

Ultra Tense

Two weeks before the Ultra, on the last long training run, at GKVK with Dharam and co., my half-size-too-tight shoes finally decided to bring the curtains down. I had to pop a pain killer to ease the numbing pain in my toe. My toe nails will stay colored for a long time to come. Eleventh hour change to running shoes?

That Friday, I woke up from sleep, trying to loosen a stiff calf, ramming the heel against the floor. I had a cramp. I looked at my mobile for time – it was 530. Damn, I must have been running in my sleep all night. I must not have had enough water – or was it the cold?

No. 9 on the To-Do list before an Ultra says “Be Positive”. Over the last week, things had been a mixed bag at work, and I have been returning to an empty home. I have now moved out of my parents’ home to sharing a 2bhk with Doc, closer to work.

Doc had not been keeping well. He had to pull out of his 24-hour run plan. Madhu, who brought the whole ultra running to Bangalore, was down with flu, Meghana had to pull out, Sabine was not running. No. 9 was not happening.

But, with one week to go, I would silently clench my fist, with more prayer than conviction, “I can, I will”.

Tell your heart that the fear of suffering is worse than the suffering itself. And that no heart has ever suffered when it goes in search of its dreams.
- Paulo Coelho

Wear that Rubber

(‘Wear’ as in) intransitive and transitive verb damage by using or rubbing: to damage or alter something by using or rubbing it, or be damaged or altered in this way
(NOT as in) transitive verb use to cover or adorn body: to have something on all or part of the body as clothing, protection(!), or for another purpose, for example, to aid sight or hearing, either temporarily or habitually

If you are biker, you are already thinking about that rear tire now. The lesser mortals may choose from the host of other libidinous interpretations.
What is common, of course, is that you realize you forgot the rubber only when you had that slip.

With the water levels rising faster than the vegetable prices in Bangalore, it was time for some reprioritization. In my case, it really took a slip (skid?) to wake me up to the seriousness of the issue, especially with the cultivated habit of leaning into the every turn testing that fine angle out.

At this point allow me to digress slightly to introduce my gory bruise. A perfunctory right turn, no tire thread to hold, the skid… the right knee opens out to brace the fall. It occupies the right knee, (the good knee!!) about three weeks old now and the pigments are growing to give it that “polka brown over flesh-pink background”. It’s fascinating to watch a part of you grow back in quite that spectacular fashion. (Save those expletives for the comments section please, thank you)

It turned out to be a strangely symbiotic when I cycled home with the MRF for the Bullet and later rode home with the cycle tire on the Bullet.
The buying decision was not difficult for both tires. MRF apparently is the only one that makes good grip 19x3.5 tires for the Bullet. There is a slightly wider gripping Meteor, which has lesser availability, costlier and not a perfect match. Ahuja Continental is the OEM for Hero Cycles and the non-local tire available for the Hero Hawk’s 27x1.25 tire.

For all the technicals that go into tires, click here.
The MRF NyloGrip (rs. 800), Continental tire (rs. 80), cycle tube (rs. 40), brake shoe rubbers (rs. 20) completed my very rubbery shopping list for the weekend.

And jokes apart, Go on Wear that Rubber ;)

Sunken Spirits at Cloud Valley

I am drifting about wildly in a swirl called the ‘quarter life crisis’, trying to find some direction to my life. The mood has definitely been depressing during the last few days; I am simply not able to get rid of the lump in my throat. The group ride to cloud valley at Coorg, set in this gloomy backdrop, was an attempt to clear up some of the obscuration.

The ride started the usual RTMC way, bullets pouring in at town hall till 630, and more guys joining in all along till Bidadi. The initial plan was to ride to Madikeri along Virajpet with the breakfast point at Bidadi. Anil’s 500 which was ridden by bladyphul packed up even before the ride had begun and then a few of us, including the new mod, Centhil, overshot the breakfast point at Bidadi. We finally stopped for poori, dosas and pongal at the coffee day outlet.
To reach Madikeri, take a right off Mysore road, a little after Srirangapatana. Another right turn after about 5-6kms will take you to Hunsur. From Hunsur you can either take the route via Kushalnagar to Madikeri. Or you can ride about 30kms longer route via Nagarhole forest, Titimati, Gonigoppal, Virajpet to Madikeri.
Going against our earlier plan, we took the Kushalnagar route on the (ill)advice of a local. There were bad stretches of potholed roads adding to the traffic on the ghat section; the ride was anything but footrest scrapping. When we regrouped at Madikeri, we had our first casualty. Arun aka naayi roast and prasy had a minor fall on the ghat section, no broken bones, just some dented fuel tank. He managed to dent it in the area where the two thighs meet each other, the tank and the seat ;-)
To reach cloud valley from Medikere, you need to ride along the lush green ghat route to Cherambane and take a left turn off Mithra wines. Cloud valley is an estate about 2kms from there.
At 230pm, the starving riders were treated to sumptuous meal. The non-veggies freaked out on pandi and koli curry, I settled for the pulav and daal and some very refreshing RC beer.
Meander to Misadventure
When the evening came, Prashee suggested we ride down to the river bed. 6 bullets took off, mindless of the dark clouds brewing up. The off-roading experience was awesome. We had to ride down a muddy lane leading right into the river bed, and ride across in silencer deep water. When all the bullets were over on the other side, the skies opened up. In coorg, when it rains it pours. Within minutes we were drenched completely. A lot of the slope we had used on our way down started to slide into the river and we decided to ride up whatever was left of it, before it became too slippery. Imagine this, a bullet is stuck half way up in slush, the rear wheel is high on rpm and spraying a thin sheet of slush around… and the rider needs help to push through. I got a first hand experience of what it feels like to have mud in your balls, rain in your eyes and ride like a maniac.
When we reached base, we were a sight to see!
Madikeri, like any other town, shuts down early. Pimpley and Prashee kept us transfixed with anecdotes of their rides even as the electricity flickered on and off. I had an early dinner and slipped into a slumber even as the story telling, the partying, singing and dancing continued well into the night.
I can’t curse myself enough for sleeping till late and missing a wonderful opportunity to ride at the crack of dawn with vijayraghavan and sam, in the mist to Talakaveri. I woke up at 8, not discerning if the thumping was in my head or in the frontyard.
Uday and Hem, our hosts at Cloud Valley, were at the top of hospitality ensuring that we were comfortable. Breakfast of Puttu and chutney, went in easily, round after round.
With naayi roast, having to fix a puncture, the start was delayed slightly, and we left the estate at 11.
A series of disaster events followed. First, the group was split, we got lost, and as we were back tracking, Tiger’s earthing wire burnt out, leading to one hour delay before we could get back on the right road. If that was not bad enough, naayi roast, who already had more than his share of bad luck, had another major fall. The rear tyre of his thunderbird, burst while he was doing good speed, sending him and prasy crashing on the highway. Although he riding gear protected him, prasy and the TB could not escape the impact, fractures, bruises on both of them.
The Highway is no more mine
I had left the larger group by this time and after a samosa break at Hunsur, had made it almost non-stop to Mandya. Mysore road had heavy traffic of cars and bikes all the way to Kengeri and to add to this were the sand laden trucks, spraying sand as you pass by. Maybe it’s a good idea to throw some paint pellets on their windscreens when you overtake them. Back home, my apartment’s interiors are being done and I had to get back early to be able to meet up with the carpenter. I rushed back without a break and was home by 530.
Although, there were some memorable moments on and off road on this ride, the mood as I hit the sack that evening, was no less depressing than what it was when I started.
Hot baths are good cures for depression. I should have just tried that in the first place. Sometimes it takes a tankful of fuel before you can think straight.

photos courtesy Centhil (aka Bakery)

Hospitalized

Time: 0745 hrs, 16th October 19, 2006
Location: Manipal Hospital, Operation Theatre B

The OT experience:
When I was wheeled into the OT…
I woke up at 6am on Monday – the staff nurse, clad in green, greeted me. He told me to take a bath and get into cotton whites by 730. I felt like the sacrificial lamb readied before halal. It was quite an awkward situation, the nurses were not used to seeing patients up and running before their surgery, “well, I am the patient”.
At 745, two nurses put me on a trolley, and wheeled me to the OT. That is the first time I was on a trolley. All along people look down into you, sad look on their faces – if it was empathy, it sure was misplaced.
The OT in Manipal hospital is in the second floor, I was wheeled in through two sets of doors into the pre-op area. It was shift change over time for the nurses and I was privy to their ‘you-take-my-shift’, ‘landlords-demanding-more-rent’ gossip.
I am skimpily dressed in cotton whites, in this makeshift chamber of white screens, waiting to be wheeled into the Operation Theatre-B. The pungent disinfectant fills the air and the nurses are chatting incessantly in the background. Lying down on the trolley in the pre-op chamber, while lazily rubbing my eyes, an eyelash comes loose. I placed it on the back of my closed fist, closed my eyes, prayed silently for a successful surgery and phoo…

For the next four hours, while I lay half awake (half, as in top half), Dr. Hemanth Kalyan (HK) and his team of surgeons worked on my torn Anterior Cruciate Ligament (ACL). The OT was a large room with loads of instruments, big boxes with colourful buttons. There must have been about 5 surgeons, 3 anesthetists and 2 nurses. I could recognize Dr. Nishida’s smile even from within the mouthpiece.
As HK got his tools in place – the drill, the saw included, the anesthetist pierced my right hand for the IV and the drips came on. Then they pierced my lower back, the spine area for the anesthesia. In a few minutes, my legs started feeling heavy, and the feet felt as if there were a thousand ants swarming over them. I was told I could watch the surgery on a screen that was visible on my right side. The next thing I saw, a pale leg was being hoisted up by a couple of junior surgeons, it certainly didn’t feel like mine. A digital clock on my left read 8 something. There must have been some sedation injected intravenously coz I slept for about an hour.
When I woke up, a couple of junior surgeons tied up a green screen to prevent me from seeing my numb lower half, and the screen on which I could have seen the surgery live. (I got a CD of the Arthroscope recordings)
I can’t quite recollect the sequence, but I did hear a lot of noises – some scary, some good news, some shocking, some weird. I heard HK say a lot of pass-me-shaver, pass-the-saw, pass me this, pass me thats. I heard a lot of drilling, tapping noises. I could feel these vibrations in my bone. But since the pain was absent, it sent some confusing signals to my brain; it certainly didn’t feel like my leg that was being operated.
There were n no. of times when HK reprimanded a junior surgeon, “don’t you have common sense”, “did I ask you to use your brain”, “don’t you know you have to get a sharp one”, etc, etc. My doddappa, Dr. K G Das, a cardiologist of high repute, told me that a lot of interesting conversations happen during a surgery. That would be quite an interesting compilation to get hold of.
After a while, HK declared that the graft was ready. He even went on to explain the composition of the graft to his juniors. He asked for some marker ink, to color the graft, I presume. Then they started to set the Arthroscopy in place. It was a little later that I started to freak out. HK said, “there seems to be some problem here”. It turned out there was some problem with the source light of some kind. I had to resist my temptation to suggest some tricks myself, even as the surgeons were trying to fix the faulty source light. All kinds of options were being discussed – tilt it around, change of bulb, power cord, replacement of the light source itself. Yeah right, all this while my surgery was still on.
Around noon, they got it working again. By now, the effect of my anesthesia was wearing off and I was able to feel a bit. By putting my neck out, I managed to catch the attention of the anesthetist (who appeared to be smsing or playing a game on his cell or something). HK informed them that there was at least another hour of surgery left and I had to be put on general anesthesia. I was made to breathe out of an inhaler.
The next thing I remember, I was being wheeled out of the OT, with what felt like a real heavy bamboo sticks tied to my left leg and a dry and nauseating feeling in my throat.
I looked at the clock in the post-op, it read 2:30 – lot of time and lot of memories, not a lot of pain, not just yet….

Why Surgery?
For the last four years the ligament has been troubling me, with mild pain after a long workout, run or walk. The earlier frequent buckling of the knee had now disappeared. I decided to get over with it, so I may be good again.
When I started diagnosis with Dr. Kalyan, I was hoping it wouldn’t be a surgery, but then the MRI suggested no other option.

What is ACL reconstruction?
(Time for some education esp with likes of Mary Pierce and Yuvraj Singh’s ligaments due for reconstruction!!)
There is loads of education item on ACL here. (It’s a good site for most medical queries, go check maadi.) It sure is worth a read.
The latest is I am well on the path to recovery now, nearly 3 weeks after surgery. And should fit my running shoes in about 3 months from now.

Addendum 2014:
For the benefit of all those who are visiting the site and curious to know how things panned out, here's an update. I have had complete recovery as far as ACL surgery is concerned. Since then, I have completed about 17 marathons and 3 Ultra marathons and train pretty hard to be among the top 1% of most races in India.
I had a follow up MRI done in 2010 and consulted with Dr. Hemanth Kalyan again, he remarked that the MRI showed good placement of the screws and the ACL intact.
He also featured my progress back to normal life in a article that was published in The Week last year.
Remember, the rehabilitation is perhaps more important than the surgery itself. Take care.

Acc-Skid-Dent

Motorcycling is by its very nature potentially dangerous – perhaps that’s why we do it!

Odometer reading 13000 kms
Accident rate: 1/4333kms

Auto-gynec Accident
Place: Opposite to the Sagar Automobiles on Banerghatta Road.
Damages: Rs. 20 for removing the crash guard bend.
Physical Damages: Rs. 50 for Anti-Tetanus injection and dressing.
I was riding to work, just crossed Accenture, at a steady 40-50 kmph. One pretty gal was crossing the road, small momentary distraction and an auto in front decides to move into the right lane. I braked to avoid collision, my front disc brake locked, the sand near the divider side of the road made me lose balance. The crash guard met the divider on its way down. My right leg got a bad bruise after scraping against the divider.
By the way, the gal was gone before I regrouped myself and turned around.

Whenever you fall, pick up something. I couldn’t pick her up though!!

From Bhat to Butt..er
Place: Yelagiri
Damages: A few thousand rupees
Physical Damages: Nil

My claim to fame at RTMC, the infamous tagging to ‘Butt..er’. If you draw a 2x2 BCG matrix (my MBA education is now taking over and I am now going to talk intelligently) with financial impact on vertical axis and physical impact on the other, this one accident would lie on the top left box. Top, meaning, really top and left, meaning, extreme left.
(MBA is abbreviation for Master in Business Administration and we are taught, among other things, to present data in boxes and pies).
In case it greyed your grey matter, all that was cryptic for “it cost me lots of money”.
RTMC rode to Yelagiri on the 19th March. You would have guessed from the ‘giri’ part of the name, that it is a hill station. There is a Ghat section climb on the way up (what else did u expect) - a narrow winding road with some hair-pins bends. There was no traffic on our way up.
I was doing good on the turns and I guess I got carried away a wee bit on the ride down. There were two bulls ahead of me and I was trying to catch up. On one of the left turns, I found myself in the middle lane, gunning straight at a Tata Sumo Victa. I braked hard and got most of the bike out of the way, but couldn’t avoid the brake lever and the mirror go whack against the mirror and beading, ripping the plastic off. Metal against plastic is not too much of a contest.The sumo full of doctors let me go after I promised to make good the damages (why?). We considered the option of using the comprehensive insurance I had, but it would take time for the formalities and then I heard the future premiums go up.
I got away with a bent brake lever but a badly hurt ego and image. I thought I did well to hold my nerves, stay on road and prevent what could have been worse.
I paid through my nose for the damages. I guess, I could have bought Yelagiri with that kinda dough.

House Full
Place: A few hundred meters from home - Boopsandra
Damages: Bent crash guard (I don’t remember it straight now)
Physical Damages: Rs. 50 for Anti-Tetanus injection and lots of Soframycin.

On 13th May, went on this Penukonda ride (check archives). After a heavy dinner, at around 10pm, I decided to pay a visit to BeeKay who was leaving to Singapore that night. My sister, Madhu, who had not seen him in a few years, decided to join me. Rishabh and Aryan her handsome sons wouldn’t miss any ride on the Thunderbird.
Any long ride gives a good high and there is always a hangover - there is a thump thump in the back of the head, the adrenaline levels are high and so is the confidence level.
I was turning right off the main road into a 100ft road. With a building in the corner and the rains leaving sand on the road, it was a bad idea to take it fast. I had slowed considerably, but nevertheless, had to steer the bike to turn. I remembered using the front brakes till the point of taking the turn, for some reason the bullet skidded. In a few seconds the four of us were on the road.
Aryan was crying, people from the chat stall nearby crowded around. Rishabh looked fine, there was no contact with the silencer, so there were no burns. Madhu’s pyjama was torn at the knee and there was some bleeding. Someone from the crowd brought a jug of water to clean up the wounds. Aryan had landed on my sister and was unhurt. It was when the water was poured on the wound, that the real pain surfaced. Rishabh, who had maintained his composure till this time, couldn’t hold it any longer.
BeeKay’s dad is a doctor and we decided to get the first-aid done at his place. When we reached there, 3 bleeding patients used up some 5liters of Dettol and some 1 kilo of cotton.
For the next one week nearly, everyone had their accident tales to share when they heard what happened. Thanks everyone for the wishes, I did get away this time…
Sister was back on the saddle the very next day, I feel trusted!

It took me two weeks to get back to using the hand fully. I survived all the oohs and aahs everyone who saw my bruise had to say. The pain of the wound per se was nothing, but the thought of putting my nephews and sister through this was.

This is one blog roll I don’t intend to add to!

I was wondering if accidents can be addictive, I must admit there is a sense of wild craziness to it. Searched the net for it, but drew a blank. Let me know if you have come across something on this before.

Some favorite quotes I picked up:

The chapter of accidents is the longest chapter in the book.
John Wilkes (1725–1797), British politician. The Doctor (Robert Southey).

There are no small accidents on this circuit.
Ayrton Senna (1960–1994), Brazilian motor racing driver. Remark made before the 1994 San Marino Grand Prix, during which he was killed. The Independent (London) (December 22, 1994).

Whenever you fall, pick up something.
Oswald Theodore Avery (1877–1955), Canadian bacteriologist.

The only way to be absolutely safe is never to try anything for the first time.

There are no accidents. God's just trying to remain anonymous.

Small Accidents are good for you, your reflexes improve with every fall.
Gurunandan, one passionate Bulleter.