Friday, August 30, 2013

For 2013, Three Bike Tours and a Surgery...

By Angela Connolly, Certified Medical Assistant -

There is nothing more frustrating for anyone to endure than chronic pain. When you lead an active lifestyle, and are a transportation/recreational cyclist, it seems even more unbearable to endure. Sometimes it takes a brave decision and a leap of faith to become fully functional again, and that is what Frank Warnock, this Blog's Admin, was inspired to do, by his desire to become as proficient a cyclist as he had been before his chronic low back and leg pain began to slowly take away the high level of cycling that he had enjoyed all of his life.

Disc rupture at the L4/L5 and
L5/S1 levels. Blackening of the
discs indicates dehydration.



Frank had suffered from chronic low back pain due to problems at the L4/L5/S1 levels. This is a common site for disc herniation, and in Frank's case, both levels had ruptured, with L5/S1 off alignment and in a "bone on bone" state. Although there are several possibilities, including cumulative trauma, his Doctors were unable to determine the exact origin of the problem. Two prior Discectomies and multiple steroid injections did not bring permanent relief, so a decision had to be made. Had he taken a conservative approach to the pain and done nothing, he would have risked becoming incapacitated someday. The vertebrae could have eventually fused over time, but in an inappropriate position, causing deformity and debilitation, and increased pain. An avid cyclist who looks forward to a lifetime of cycling, well into his advanced years, Frank found this possibility unacceptable, and he began to realize that a permanent solution had to be found.

Because Frank wasn't in constant pain, however, it was tempting to put off the decision. He would be reminded of the problem only when he hurt his back (which was so easy to do), most recently while on an almost thousand mile round trip tour to Lake Erie, PA. On this occasion, the simple action of lifting the front wheel of his bike over a curb set off the terrible pain. With each new injury, he would have to cope with moderate to severe pain for several days. It didn't take much to cause pain, only a simple movement, like lifting something, which, when he was unprepared for, would set off yet another attack of pain.

Frank, en-route to Lake Erie - via the Allegheny
Mountains - in mid June.
Before making the decision to undergo surgery, Frank had set three goals for himself to achieve for the year. Knowing that he faced a lengthy recovery, he wanted to enjoy touring with his friends from the White Clay Bicycle Club. The Hershey Weekend Tour and the Hawk Mountain Weekend were the tours that provided the preparation for the 12 day long Tour of Erie in June, combining for a total of 1,440 miles. Filled with hills and challenges, completing these Tours successfully gave Frank the encouragement to seek a surgical solution to his pain, so that he could continue to have many years of touring in his future.

Dr. Louis Quartararo
The journey to surgery began with the decision to seek out the best, state-of-the-art procedure that modern medicine has to offer. Traditional Spinal Fusions are routinely done through invasive, "open" procedures, which are very difficult for patients to recover from. Through an online search, we learned about the NJ Spine Institute, and Dr. Louis Quartararo, who specializes in minimally invasive spinal surgery. "Dr. Q", as everyone calls him, is confident, reassuring, and very kind, and his office staff is exceptionally professional and helpful. Also caring for Frank was Jenny Reyes, Dr.Q's Physician Assistant. With this award winning and experienced team in place, Frank felt confident and certain that he had made the right decision to go undergo a PLIF procedure, which means Posterior Lumbar Interbody Fusion. Done Endoscopically, this highly sophisticated procedure is only performed by a few Surgeons around the country, as it takes additional training and expertise for a surgeon to master. Unfortunately, this advanced level of care is not available in Delaware, but it was well worth the 2 1/2 hour drive to Paramus NJ, one town over from Fair Lawn and the lovely planned community of Radburn, where he grew up.

Above: Xray from the front, post-
op. Note the Spinal Fusion Stimulator
wired in the upper left of the image.




Frank's surgery was performed on July 25th at the International Center for Minimally Invasive Surgery in Wyckoff, NJ. After the nearly four hour long procedure, he stayed overnight at the facility, and was discharged the next day, to recover at home. Dr. Q said that the surgery went very well, and now, at five weeks post op, the recovery period is well underway. In many ways, the surgery itself is only the first step. It will take several months of healing, physical therapy, and a good diet rich in protein and calcium, to insure a fully successful fusion. And there have been some bumps in the road, like severe nerve pain requiring a visit back to NJ, to the Pain Management Dr. Gregory Lawler, who works with Dr. Q to help control patients' post op pain. Dr. Lawler immediately understood the origin of Frank's post op pain and prescribed appropriate medication to help. With the pain under control, we are seeing real progress in his recovery. And although Frank can't wait to get back on his bike, he realizes that by resuming cycling, and other physical activities slowly, he is making an investment in his future health, and that once he is fully healed, he will be back on the bike stronger than ever. He is looking forward in the coming weeks to working with his Physical Therapist, Matt Hanling, to reach that goal. Matt has outlined his treatment plan and goals for Frank, and we are confident that with Matt's expert help and encouragement, the therapy will progress smoothly.

Frank would like to encourage anyone who suffers from chronic pain, and exhausted all conservative options, to investigate all of the surgical possibilities available for treatment. Also consider going outside Delaware if that’s what it takes to find the latest and greatest techniques available. Modern medicine and science have so much to offer, and the success rates are extremely encouraging! You can visit the NJ Spine Institute and learn about all of these treatment options.

Right: View from the side, post-op. Note the re-alignment and gains in vertebral spacing. Nearly 1" in lost height was gained back as a result.


Angela Connolly is a Certified Medical Assistant, most recently in practice with St. Francis Healthcare in Wilmington, DE. With prior experience in Gynecology/Urology, her experience caring for Frank has given her new insight and appreciation into the issues surrounding patients undergoing treatments for Orthopedic/Spinal conditions. As Frank's primary caregiver and companion in the surgical/recovery experience, she is happy to report that her patient has been positive, cheerful, and a pleasure to care for!

Thursday, August 22, 2013

Public Workshop: U.S. 40 /SR 72 Intersection Improvements


From DelDOT's Website:

The Delaware Department of Transportation (DelDOT) is holding a Public Workshop to obtain comments from surrounding businesses and the general public for the capital project on SR 72. The project limits run along SR 72 approximately 600 feet south of Del Laws Road to the Belltown Run crossing of SR 72. The workshop will be held on Tuesday, September, 10, 2013 at Keene Elementary School, 200 LaGrange Avenue, Newark. The public is invited to attend any time between 5:00 pm and 8:00 pm.

The project involves reconstructing the intersection of U.S. 40 and SR 72 to provide an additional through lane on each approach to U.S. 40. In addition to improving pedestrian and bicycle access, the project also includes providing double left-turn lanes along both U.S. 40 approaches to SR 72. The project includes installing a new traffic signal and realigning the intersection at Del Laws Road, and revising the intersection geometry at Broadleaf Drive to allow eastbound left-turns with an acceleration lane to access northbound SR 72. These modifications are proposed to address congestion issues through the intersection as well as to address safety concerns.

The proposed improvements have been refined since the original public workshop on July 19, 2005, when a preferred alternative was selected based on public feedback through the public involvement process.

The same intersection, from the middle of U.S. 40 looking south on SR 72, during reconstruction 5 years ago. This project left bicyclists in a much worse situation, as newly added pedestrian refuge islands left little to no shoulder space through the intersection. Fortunately, a policy has since been adopted to ensure this doesn't happen again.

Interested persons are invited to express their views in writing, giving reasons for support of or in opposition to, the proposed project. Comments will be received during the workshop or can be mailed to DelDOT Public Relations, P.O. Box 778, Dover, DE 19903. When applicable, we offer the opportunity to fill out a questionnaire online which will automatically get emailed to Public Relations.

Poster's note:  It appears as though AASHTO compliant bike lanes are to be included in the project. Still, bicyclists are strongly encouraged to attend this meeting, as with all meetings and workshops that have (or should have) a bicycling component. This particular intersection does see a lot of bicycle (and pedestrian) traffic, and it is critical that we not only reverse the damage done 5 years ago, but actually turn it around into something safer.

Monday, August 19, 2013

Drop "Share The Road" Plaque? YES


Mark Luszcz, Chief Traffic Engineer, DelDOT wrote:

"There have been some discussions about the bike warning sign (W11-1) and supplemental SHARE THE ROAD (STR) plaque (W16-1P). Some have requested that we simply use the bike warning sign and abandon the STR plaque altogether. Some believe the plaque puts more onus on the biker to share the road than the motorist. As far as I know, there is no actual research showing the effectiveness of either the bike warning sign alone or with the STR plaque."

"I would like to get the Delaware biking community’s opinion on the use of the STR plaque."

Greetings, Mark.

I support the obsolescence of the "Share The Road" plaque because:

a) Most travel lanes in Delaware are substandard width (11-12' in most cases) and are impossible to share when factoring the 3' passing law, and

b) misinterpretation, leading to the usual defense of the driver that the W16-1P message is intended solely for bicycles.

I believe we should use W11-1 alone, as much as possible, especially along the more popular roads without shoulders, i.e. Upper Pike Creek Road. We must not forget that usage of this sign has been (to my knowledge) limited to warning drivers that bicyclists may be ahead, i.e. in a trail crossing or other brief road use situation - not actually riding the road as suggested by W16-1P. Therefore, the sooner we get started with this transition, the better.

Thank you so much for this superb effort on bicyclists behalf.

Ride on,
Frank Warnock
Delawarebikes.org

Poster's note: Mark has asked the bicycling community to comment on this issue. In the interest of consolidation, please visit this topic on Bike Delaware's website and comment there. Link HERE.

Sunday, August 18, 2013

How effective is the NCC Unified Development Code for bicycles?

The New Castle County Unified Development Code, under Street Standards, provides that space for a bicycle lane "shall" be included in cases requiring a right turn-only lane. As follows, under section 40.21.130, the following is found:

"Where necessary, the developer shall provide acceleration/deceleration lanes along major roads, as determined by DelDOT, as well as right- and left-turn lanes and bypass lanes, depending on local conditions and the amount of traffic generated by the proposed development. Where such lanes are required, they shall be at the expense of the developer. Acceleration, deceleration, bypass, and right-turn lanes shall include space for bicycle lanes, as required by DelDOT."

Yet, it is not hard to find an example where this bicycle safety provision was lost or removed in newly drafted or updated redevelopment plans, even though the New Castle County Unified Development Code under Street Standards says it "shall" be included.

Below are 4 examples where I believe this requirement was disregarded because of a breakdown during the approval process, or, there were circumstances preventing its full or even partial implementation as required in the county code.

Above: Main entrance to the "Traditions at Chistiana" housing development off Chapman Road, Newark. According to an unnamed source at DelDOT, the need for a Right Turn-Only Lane (RTOL) became apparent after the first phase of the development was completed, and was later added by request of residents. Therefore, because the RTOL was not included in the original plans, the bike lane provision fell through the cracks.  
















Above: Entrance to the Armed Forces Reserve Center on Rt.273 in Newark, a road designated on Delaware's Bicycle Map as a "regional bicycle route". New sidewalks, curbs, crosswalks, channelizing island, and "wave" style bike racks were installed. However, for reasons unknown, the bike lane provision was omitted. 



Above: Rt.4 entrance to the Delaware School for the Deaf, completed in 2011. This road has a 8' wide multi-use pathway that is also designated as the East Coast Greenway. The design and engineering that was chosen, however, render this as little more than a wide sidewalk that can have negative implications for bicyclists. Below: The condition of the asphalt is dismal at best, yet the fact that this facility exists was enough to forgo the bike lane requirement as part of DSD's final approval. Despite ample lane width on Rt.4 - a road determined to be an ideal bike lane candidate when it was reconstructed using ARRA funding in 2009 - the idea (brought forth by DelDOT Planning) fell on deaf ears.

On a personal note, I had written a blog post for Bike Delaware a couple of years ago on this same topic titled "Should Side Paths Trump Mandatory Bike Lane Requirements?" that was mysteriously deleted at some point after leaving my position on their board.


Above: The rebuilt entrance/exit to a newly renovated 4 Seasons Plaza in Glasgow, off of Rt.896, which will contain a Shop Rite Super Center. According to DelDOT, it is a pre-existing entrance, so the developer was not required to make any changes. However, it was requested that the pedestrian access facilities be brought up to standard, and the developer agreed to pay for it. While this is certainly welcome and likely spurred by concerns over the American Disabilities Act (ADA), it is with great shame that the "Street Standards" section under NCC code 40.21.130 is viewed as having little to no value, despite the fact that this area sees plenty of  bicyclists and pedestrians passing by or entering the shopping center. For those riding past the entrance, the risk of being "right hooked" is especially high.

Above: Kirkwood Highway at Harmony Road, the site of a new WaWa Super Store where NCC Code was met and bike lanes installed. However, as the cyclist in the distance is about to demonstrate, one is forced to move out into the high speed lane to avoid a traffic channelizing island (aka Pork Chop) before entering the properly designed bike lane. This came as quite a surprise, since DelDOT policy requires a 5' offset (4' in exceptional cases) between these islands and the white edge/shoulder line through intersections. DelDOT was notified via email on May 22, and agreed the island configuration is incorrect and will work on a mechanism to get it adjusted. However, no time frame was given.
Poster's Note: In summary, the above examples clearly illustrate that road advocacy must remain a top priority in our state. It is not my intention to blame DelDOT, New Castle Country, or anyone else involved in the development approval process that have led to these failures. But it is my opinion that road advocacy has taken a back seat to the interests surrounding Trails and Pathways, and the notion of reducing the amount of bicyclists on the roads. That said, I acknowledge that these agencies have performed some excellent work in other areas and projects. I appreciate their efforts, and I will continue to highlight these positive examples as well in the coming weeks and months.

Friday, August 16, 2013

Newark Bicycle Comittee Meeting on August 22

Attend a Newark Bicycle Committee meeting and become part of a community of cyclists who are working hard to improve safety and Newark's status as a bicycle-friendly city. Probably the most exciting project at this time is the creation of the city's Bicycle Plan, and beginning the implementation of bicycle-friendly infrastructure. Drop by and learn more!

AGENDA:

1.    Introductions

2.    Newark Bicycle Plan.

a.    Newark Bicycle Plan Update

3.    Community Day – 9/15/13

4.    Old Business

a.    Bicycle Improvements/ Sharrows – Part II

5.    New Business

6.    Adjourn


Volunteers are appreciated for all events and committee work. Meetings are held monthly at WILMAPCO on the 3rd Thursday, 4 p.m., click here for directions. Send us an email to be added to the committee email list.

Visit NBC's homepage for complete details.

Tuesday, August 6, 2013

Public Workshop: City of Wilmington Bike Facility Improvements

By Tamika Graham -- The City of Wilmington and its Bicycle Advisory Committee is aiming to capitalize on its past success of promoting bicycling with budget-friendly safety improvements. On November 2010, Wilmington successfully installed sharrow lane markings along Market Street in the downtown area - the first installation in the state of Delaware. Sharrow lane markings help convey to motorists and bicyclists that they must share the roads, and indicate a preferred path of travel and positioning for bicyclists relative to parked motor vehicles. This marking was formally introduced through the 2009 version of the Manual on Uniform Traffic Control Devices (MUTCD), which provides standards for traffic control devices, and has become very popular among states and cities aiming to encourage the safe coexistence of bicyclists and motorists. Wilmington bicyclists have noted the visible improvements in the downtown area and are often seen positioning themselves along the markings.

An application was submitted through the former Transportation Enhancements program (presently known as Transportation Alternative Program) for a variety of improvements citywide.  Using 80% of federal funds through this source will help the City leverage its limited resources.  Members of the public are invited to comment on a proposed north-south, east-west bicycle route that will consist of sharrow lane markings and bicycle directional signage through several neighborhoods across the City. This proposed project will implement recommendations from the adopted Wilmington Bicycle Plan to promote bicycle usage and safety. An open house public workshop will be held on Thursday, August 22nd, anytime between 4 p.m. and 7 p.m., in the main lobby of the Louis Redding City/County Building, 800 N French Street, Wilmington, 19801. Staff from the City of Wilmington, DelDOT consultants, and WILMAPCO will be present to answer questions. For more information, visit us on line HERE



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