collarbone


14
Jul 12

Sleep at last, sleep at last

Since I hurt myself Monday I’ve struggled to be comfortable in any one position. This means poor-quality sleep: both sides of the bed, a pillow under my arm, no pillows, my recliner. Nothing has worked.

Last night I gave up and retreated to my arm chair, the only place I’ve been able to get comfortable, provided a certain formula of cushions and pillows is employed.

So I plumbed the seat cushion, the back cushion. I found a comforter. The Yankee dug my airplane pillow out of some closet. I wedged in a corner of the seat, put a throw pillow in place to support my arm, the airplane pillow around my neck and the comforter around everything else.

And I slept. I woke up at 8 a.m., after almost seven blissful hours uninterrupted without consciousness or pain. Of course I woke up feeling as if Jack Bauer was torturing my shoulder.

But I also woke up to this:

DrAllie

As far as I know she’d sleep on the arm of the chair most of the night, doing her part to nurse me back to health. She’s a good cat for the most part — despite biting my foot for no reason tonight. The arm I hurt is the the side she normally favors, but she’s stayed away from it all on her own.

Today I’ve resolved to sit perfectly still and do absolutely nothing. For the most part I’ve been successful. And my shoulder and collar bone have been grateful.

Then I compiled two pages of questions for my doctor. He might not like me as a patient when this is over.

So I’ve watched TV and read. I’ve nodded off. I’ve tried to stay awake. It isn’t most riveting Saturday, and unfortunately I don’t have a lot to share here. Let’s just try again tomorrow, shall we?


12
Jul 12

The kitteh will see you now

Allie

She’s helping.


11
Jul 12

The orthopedist says

Saw the local expert. He comes well recommended. We know people that he’s treated.

Everyone in his office was very nice and patient. (The nurse there was impressed by my road rash. I figure if you have to seek out medical help, give them something to admire. He gave me some debridement bandages, which is more attention than they received in the emergency room. He told me to leave them on until Thursday. “You’ll be amazed, bro.”)

The doctor himself did not rush us at all and waited for all of our questions. Told us the options and let us decide everything. He let me ask him the same question different ways, which is my habit when I’m trying to get more information.

The options are basically these: you can let a collar bone grow back together or you can surgically repair it. Letting nature take its course is a slower answer and there are risks of physical deformity and a concern about a loss of functionality. Surgically is faster and you are supposed to bounce back to your normal self.

I’m young, I’m active. I don’t want to be limited. My break, he said, was so far apart that naturally healing was something of a crapshoot. So we’re doing surgery.

This changes a lot of schedules, and will lay me up for a while, but it is better in the long run.

He told me which day his best people are working with him, so we know which day to have the procedure. It takes about 45 minutes, he said.

Until then, ice, rest and keep it still.

Being still isn’t hard. I’ve figured out, for the most part, how to get comfortable so that I can almost forget I’m hurt. Changing shirts is the worst. Getting in and out of bed is slow. Sleeping is a challenge. There are no real big problems, though. I’m just learning to do things slowly, one-handed and kicking myself for getting hurt.

Site note: I will not talk about this for days on end, I promise.


10
Jul 12

What I hurt in my bike wreck

My South Baldwin Regional Medical Center experience where, aside from the triage nurse, no one ever asked about a head injury and we never saw a doctor.

We wound up yesterday in the emergency room of a small regional hospital. When you can calmly walk yourself in, you think “This will do.”

A kind volunteer points me to the paperwork. The Yankee has to fill it out. In two or three minutes the triage nurse calls me back. Pulse, blood pressure, temperature. I tell him what happened, complain about my pain. He asks if my neck hurts. It does not. He asks me if I hit my head. Yes, I brought my helmet. He asks me if there are any cognition problems? I tell him no. He asks if I want to go to X-ray or wait for the doctor to order it. This decision is apparently up to me, so why wait? Let’s do the X-ray.

Someone from radiology quickly comes along, plops me in a wheelchair and rolls me back to X-ray for two quick shots. I prepare my best Yogi Berra joke. “They did a brain scan. It came back negative.”

I go back to the waiting room.

Soon a room opens up. My guess is that the above has all taken place in 30 minutes, give or take. The Yankee and I go back to the examination room, leaving our lovely friends Brian and Mrs. Brown to sit in the waiting room. We tried to get them to stay at the condo, but you know how concerned, caring people are.

And now the real waiting begins.

A nurse comes and leaves. The administration lady comes. No, I do not have a last rites preference. And I appreciate the protocol, but that’s not happening in here today, thanks.

Later another nurse comes in with a syringe of morphine. She wants to shoot it in my hip, but she can’t find my hip.

She can’t find my hip.

This … nurse … who somehow was trusted with a needle … can’t find my hip.

I was ready to give myself the shot.

A physician’s assistant comes in later to tell us about the X-ray. I have broken my collar bone. She’s waiting to hear from an orthopedic surgeon. Not too long after this I pop a sweat. I get the dizzy, dry-mouth sensation. A passing staffer kindly helps move me from sitting on the edge of the bed to reclining in the bed. I’m in too much pain to do it myself.

The simple act of lying in a bed when you have a broken collarbone is just about impossible, by the way.

The morphine, which the nurse said would provide some relief in 30 minutes, didn’t do anything. And has done a lot of nothing for an hour or so. I suspect that either my metabolism is super-charged or she pumped me full of saline.

I sit up, but soon take another turn to that sweaty, nauseated sensation. Back on the bed I go. I’m on my right side because lying flat is unbearable. Someone comes along and stuffs a pillow behind my back for support. This was, in point of fact, the best thing since sliced bread.

The physician’s assistant eventually returns and apologizes about the no-show ortho. He’s operating. Well, that’s understandable. She said, though, that they pulled him out of a surgery to glance at my film. He suggested we get an orthopedic consult at home this week. After a while we saw the X-ray ourselves.

X-ray

The nurse who doesn’t know where hips are later brings a shot of dilaudid for the other hip. This painkiller, she predicts, will make me loopy. (It did not, but it did leave me tired, and occasionally left me at a loss for words.)

That same nurse then disappears to fetch something called an immobilizer. Over the long period of her absence we decided that the basement of this hospital is as hard to find as my hip. We’d later come to learn that my discharge papers were equally difficult to find.

After a while the nurse returns and struggles with the immobilizer for a period of time beyond comical bemusement in front of us before finally asking for help on how to use it. The immobilizer is a large elastic band that wraps around the torso. There is a cuff to keep your bicep close to your side. Another cuff keeps your wrist secured to your ribs. The idea is to keep your shoulder in one place. (This is challenging medical technology. There are three strips of velcro on it.)

After five hours — Five hours! — we were given a small prescription and my discharge papers. To my recollection no one ever looked at my road rash. There’s a mildly impressive case on my shoulder and arm. There’s a little more on my hip, knee and leg. Good thing we’d cleaned it up before going to the hospital.

Aside from the cursory triage question no one ever, ever, asked about my head. Ever. The farther away from the hospital I get, the more appalling that becomes.

We never saw a doctor.

On the wall in the exam room there was a note about the hospital’s goal was that we’d recommend them for emergency care needs. That’s a tough sell.

This deserves mention: everyone was courteous.


9
Jul 12

In praise of bike helmets

Updated with higher quality images at the bottom. — Kenny.

Get up.

Get up, Kenny.

Get up now.

As my mind clears I find myself sprawled on the asphalt. Not lying. Not sitting. My bike was a few feet away. Getting up was hard.

There’s shade over there. Shade is a good idea. I can check everything out in the shade. I can’t put much weight on my left arm.

My ride is over. I know that before I reached the shade. I can feel my shoulder swelling.

A moment ago I’d been 29 miles into a 45-mile ride. I was riding along at an easy 18 miles per hour. There was a loud bang, a violent jolt and everything went white. I could hear my helmet disintegrating. The foam and plastic and rubber were ground up by the road.

The flimsy plastic top, the aesthetic cover of the helmet, popped off. It is upside down, coming to rest close to the chunk of wood that I hadn’t seen in the road. I bounced and slid maybe 20-25 feet.

I have to call someone. I can’t fish out my phone from the back pocket of my jersey because my arm doesn’t want to cooperate. When I finally reach it I’m relieved to see my phone still works. I get my wife’s voicemail.

“Call me back, please.” Details aren’t especially important in a voicemail. Over the next four minutes I slowly get my things organized for the walk out. My wife calls.

“I need you to come pick me up. I’m at the state park we were in, but I have to walk my bike out.”

I’m sore, but in no immediate danger. It is hot, but I have water. I looked at the odometer. There were 27 miles on it when I entered the park; there are 29 miles on it now. I have to walk two miles. Everything is fine.

I test my cognition and recall — years, presidents, names, tree species. I’m fine. I’m lucky.

She soon calls me from the park entrance and wants to know where I am. But I’m not worthy of a good conversation. I’m hurting and mad at myself.

I am walking” I say a little too forcefully, “my bike out.”

Soon it starts to rain, a cooling insult to a painful injury. A few minutes later I see The Yankee under an umbrella. I’m walking with my hand pinned to my waist.

I admitted I was hurt by saying “You’re going to have to put my bike on the rack. I can’t use my arm. I think we’re going to have to find a doctor.”

Back at the condo I can’t raise my hand above my head. I get cut out of my cycling jersey. I wipe off two hours of sweat. We clean up the road rash on my shoulder, arm, hip and knee.

I suggest we carry my helmet in case a doctor wants to see it. I can’t get that grinding sound out of my ears, but I had not looked at it.

In the hospital waiting room we took this picture of the back of my helmet:

helmet

Always wear a helmet, kids. Always.

Tomorrow: the medical tale.

UPDATE: Two weeks later, I decided to take some higher quality pictures.

This is the back of the helmet, as seen from above. So you’d be wearing this and facing the top of the frame. Note the chunk that the road just sheared off. Part of that is resting beside the helmet:

helmet

Again the back, this time from straight on. See how the upper left and center of the back was ground away? Note the small cracking at the base of the helmet’s back as well. See that crack on the left side? We’ll get to that next:

helmet

Here’s that left-side damage. Hardly a hairline crack:

helmet

This is a little farther up the side, but still on the left. As you’re wearing the helmet this crack would be directly over the left ear. The fracturing only stops at the air vent. Who knows how far it could have gone beyond that in a solid form, like a skull. From these pictures we can surmise that, without the helmet, the crown of my head over to my ear would have been heavily damaged:

helmet

Finally, looking up into the helmet. That’s one-piece, molded crash foam. Look how much it separated:

helmet