I opted to have the screw removed from scaphoid as I was noticing acute pain in that specific area. I had the operation on the 27th March 2015, and unwisely, elected to have it out with local anesthetic, not general anesthetic. Being awake for this ideal was not optimal, but we were unfortunately pressed for time for a appointment and having general anesthetic would have made this impossible. It’s hard to unsee something like this and I cringe occasionally at flashbacks. As readers if this blog will know, my wrist’s flexion is poor. Yet to get access to the scaphoid my wrist needed serious flexion to obtain access. So, pumped up with a (surprisingly painful) load of local anesthetic, the doc made his first cut…. A serious amount of cutting followed and wrist manipulations that caused a lot of bone cracking, nerve twinges and me wandering what the hell I was doing awake for this. Locating the exact position of the screw required in-situ x-rays. Took some time, but it was found. An electric screwdriver was used to extract it and I felt the torque it had on the bone as it pressed against the others. Charming experience. Another 10 minutes and I was stitched up and released into the world outside the hospital. Was told it wouldn’t hurt too much afterwards. Well, that was a one-way joke. Loaded up on Endone only to feel nauseous and pathetic pain-targeting. I switched to Panadeine Forte (current) and am hoping pain subsides soon. Anticipate a follow up to this in 10 days time or so when the stitches are removed.
This update represent a 12 month follow-up from my previous appointment back in Jan 2014.
The good news is that my scaphoid is no worse than before, and possibly marginally improved if anything. A bit of lesser bad news was that the capitate bone had displaced itself and possibly was becoming arthritic at the point of contact with the scaphoid/lunate. But in the scheme of things, this is minor.
The more significant bad news is that the the distance between the carpal bones that I damaged and the radius has halved. In the CT Scan image you can see how close the scaphoid is to the radius. Actually, the screw is making contact with the radius. There are two interpretations of this:
- The cartilage at the wrist joint would have undergone trauma and some time would have been required for it to settle down. Now if it had settled down prior to the image captured 12 months ago then the halving of this distance should be taken as a negative. This means that the area is progressing towards arthritis; but how soon is anyone’s guess.
- However if the cartilage had not settled down prior to the image captured 12 months ago then the normal distance was not measured at the time. If so, this is more positive news. That is the measured distance today may be closer to normal and it is not accelerating to arthritis.
Only time will tell which is the case.
My hands extension/flexion is currently something like 30%/50%. If these measures decrease significantly to say 10% each, OR, pain increases dramatically at the joint then I will need a full wrist fusion.
So all up, a bit of mixed news.
I can manage up to a 3hr mtb ride and then it’s time for a rest for the rest of the day. My hand also feels way better in Summer than Winter. Might have to retire in Vietnam….
My solution is to enjoy each day and ride as often (and safely) as I can as if it’s my last chance.
Having spent a lot of time trying to tune the stock FOX 34 Talas 140-160, it seems it’s always a case of pro’s n con’s. Significantly reduce the preload and it’s reasonably plush at the top of the travel, but with that comes dangerous wallow on low-speed events. Ramp it higher than recommended and mid to high support is there at the cost of a jarring ride. The 2014 fork is a big jump from 2013, but it still is lacking as there is always a compromise. I recently switched the fork over to a Rockshox Pike solo-air 150mm. This necessitated a new headset to bypass the OD2 setup and now brings it back to standard with a 1 1/8 steerer/headset…but well worth it! Forks are normally nasty out of the box and take time to bed-in. However, even with basic settings it was night and day better than the Fox. The Rockshox rapid recovery system coupled with the robust the charger damper keeps the oil separate from the air and as in the case of high quality car shock absorbers like Bilstein, this makes for very consistent and fast damping.
A lot of Pike owners on various mtb forums are using dramatically less preload with the dual aims of maximizing (i) high frequency plushness and (ii) usable travel. The Rockshox-recommended sag settings suggested 65 psi was approximate for my riders weight. As this is a trail geometry bike, I measured sag in the seated position and took the average of a few measurements. I was after 25% sag and my Topeak shock pump took 53 psi to obtain that.
Well under the Rockshox recommendation, but it’s possible that it may have been closer with sag measured in the attack position. Rockshox have the intelligent approach of allowing you to alter the low-speed compression in the OPEN mode, something that Fox’s CTD does not allow. Interestingly, and quite surprising to me was that low speed compression actually made the fork smoother generally. I suspect it keeps it higher in the travel and the rebound displacements are less than might otherwise be the case. I am still tinkering with rebound, it’s a bit tricky given the changeable terrain.
Current suspension settings:
– Riders weight= 72kg (154 lbs) – PIKE 150mm solo air with no bottomless tokens installed. The following fork settings I believe are pretty optimal in terms of overall comfort and performance.
A note on bottomless tokens: I have now tried with none and, with a single token as a comparison. I could not discern a significant difference (benefit) in using a token. I put this down to my weight and the size of the travel. My research leads to me to believe they are probably necessary for a riders weight greater 80kg and/or forks of less travel. I have heard in recent times “Rockshox forks and Fox shocks” and from my experience its definitely the case. The fork and shock are now well balanced and the bike makes for a surprisingly efficient and plush ride. I feel I can ride a lot longer due to this. This is the way the bike should have left factory. The Pike upgrade (?) is highly recommended to make a great bike even better.