I have written this book about SAM, an avid bicyclist and racer, whose cycling career was abruptly terminated by Pudendal Neuralgia and his life uprooted. New cycling related problems soon developed, including interstitial cystitis and severe low back pain. I discuss in the book many details relating to SAM's diagnosis, treatment and recovery from extremely serious injury over a SIX-YEAR timeframe. SAM's recovery turned out better than I ever thought possible. Read SAM's story to check out the details including a very effective diet and exercise program and another which has completely eliminated low back pain.

The True Story of Sam: Some Things All Bicyclists Should Know

By Samuel E. Shull

AuthorHouse

Copyright © 2012 Samuel E. Shull
All right reserved.
ISBN: 978-1-4772-1640-8

Contents

Dedication................................................................................................iiiAcknowledgment............................................................................................vForward...................................................................................................viiPreface...................................................................................................ixContents..................................................................................................xi1 About Sam...............................................................................................12 Why Active Bicyclists and Many Others Should Have Pudendal Nerve Awareness..............................33 Termination of Bicycling Career at Age 70...............................................................94 Doctor's Diagnosis and Treatment - A Six-year Time Frame................................................135 Interstitial Cystitis — The First New Problem — Diagnosis and Treatment.....................256 Severe Low Back Pain — The Second New Problem — Diagnosis and Recovery......................297 A Simple Golf Swing Which is Easy on the Back...........................................................338 Why I Went to a Salmon Rich Diet........................................................................359 Lessons Learned About the Use of Hyaluronic Acid........................................................3710 Some Thoughts for Cyclists Wishing to Protect Butts and Body...........................................4111 Some Concluding Thoughts and Lessons Learned...........................................................43Bibliography..............................................................................................49

Chapter One

About Sam

I was born in Lancaster, PA. In my youth I spent many, many hours biking the roads in rural Lancaster County. In the late 1960s I moved with my wife and family to the Williamsport, PA area where I discovered the thrill of bicycle racing. I developed a deep passion for the sport. I was introduced to the sport of racing by my son Richard, who ultimately raced with the cycling team at Cornell University in Ithaca, NY. My first real experience training with Richard in the mountains surrounding Williamsport was not a good one. I quickly "pooped out" and needed a rope tow by Richard back to our transport vehicle. I quickly learned, as a result of this event, that excellent conditioning is a prerequisite to successful bicycle racing.

For about thirty years I competed in many racing events. Such included local area races, state and national United States Cycling Federation events, state and national Senior Olympics (now called National Senior Games) and team triathlons. I always finished near the top of the competition field and never lost my passion for training or racing.

I believe my greatest cycling accomplishment was winning a 20-kilometer time trial during the 1993 National Senior Games in Baton Rouge, LA. Competition was with 65 competitors in the 55 to 60 age group from the United States, Mexico and Canada. I continued to actively pursue racing until 2005, when at the age of 70 I experienced severe pain, first in the buttocks and then later in the lower back. I describe the approach to dealing with these ailments in subsequent sections as well as my continuing motivation to set new goals for self-improvement.

Chapter Two

Why Active Bicyclists and Many Others Should Have Pudendal Nerve Awareness

I am certain that 99 plus percent of you have never heard of the pudendal nerve. Neither have a very high percentage of those in the medical profession and those who have know little about it.

The pudendal nerve originates in the pelvic region. There are three branches associated with the nerve: a rectal branch, perineal branch, and clitoral/penile branch (female/male). The nerve is responsible for orgasm, urination and defecation. Its pathway may be tortuous among ligaments, muscles and other body structures, which if altered may damage the nerve. The pain associated with such damage can be horrendous. Individuals, particularly those who have no understanding of the problem and have no idea who to contact for help or how to treat it, have become suicidal. Recognizing the symptoms of potential nerve problems and taking prompt action is very important. Once the damage reaches a certain point, it may become irreversible. If nerve entrapment occurs and invasive surgery is required, chances for a "good recovery" may be remote.

It is important, but true, that the mainstream medical profession has little knowledge about pudendal neuralgia (PN). Such is defined by Taber's Cyclopedic Medical Dictionary1 as pain occurring along the course of the nerve. It may be caused by pressure on nerve trunks, nutritional deficiencies, toxins or inflammation. A major symptom is pain when sitting. Frequently there are urinary, rectal or sexual problems. Individuals prone to pudendal neuralgia in addition to cyclists may be those who had chronic constipation, prior pelvic surgery, frequent infections, a hard fall, difficult childbirth or actual entrapment, each of which could remodel the nerve.

The cyclist can be particularly vulnerable to pudendal neuralgia (PN). Prolonged sitting, often with poorly padded cycling shorts on hard, narrow poorly designed and positioned saddles, coupled with repetitive movement and hard thrusting of the legs may seriously compromise the health of the nerve. In some circles, pudendal neuralgia is referred to as cyclists' syndrome. Men and women have common symptoms for pudendal neuralgia. It does not seem to significantly impact one sex more than the other. It is not age related.

The prevalence of pudendal neuralgia in this country appears to be unknown. Very frequently pudendal nerve problems are misdiagnosed as chronic non-bacterial prostatitis (five times for me by different doctors) or some other problem such as interstitial cystitis, which causes pain in the pelvic area. One problem is that much understanding of pudendal nerve issues is so recent that in many cases they have gone misdiagnosed or undiagnosed for years.

I have developed pudendal neuralgia as described above and in several instances experienced the horrendous pain mentioned. In Chapters 3 and 4 I recount some of the events that terminated my bicycling career along with the doctor's assessment of my condition and prescribed treatment. However, before concluding this chapter, I want to share with you, as an addendum to this chapter, some comments from my friend Kris in Belgium. He has given me permission to include his story in the book. Kris's condition and experience is similar but not identical to mine. In his case nerve damage has progressed to the point of actual entrapment (PNE). His story helps illustrate what damage to the nerve can do to one's life.

ADDENDUM: Kris' Story

I am a 47-year-old male, I work in IT involving sitting all day long, and in my free time I was a avid cyclist and runner. I often ran more than 50 km a week and cycled 250 km in one week. Everybody should say ..you are very healthy . right ?? I remember the first time I felt 'it' was almost 7 years ago in the beginning of October 2004. I still remember the date as the feeling has never left me since then. I first felt it when...