Training Log Archive: SwampfoxIn the 7 days ending Apr 17, 2016: |
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Sunday Apr 17, 2016 #
Note
I've only been to the emergency room 3 times ever. Once, for volvulus back in 2010, when I crashed and burned on my bike a week and a half ago, and now, just after midnight on Sunday. The procedure each time has been the same. Check in at the desk where some basic information is taken about who you are and you insurance, then you are led to a little patient semi-room (no door, just a curtain that may or may not be drawn) where you are seen and where you wait in between things being done, then a nurse comes to take your vital signs, and then the on call ER physician shows up. My experience has been the ER docs work very quickly and efficiently, looking you over, doing some kind of quick assessment, and they decide what next steps to order
As I was led in, there was some activity but not much. Nothing hurried or anything that spoke of urgency--more quiet voices here and there, and signs of maybe several other rooms in service. Out in one hall a guy wandered out wanting if it was okay for him to pee. The staff told him to go back to his room and wait--I think they were going to do an urinalysis test for drugs or something, and that he was a very familiar character for them on weekend evenings.
When the ER doctor showed up, he asked what was wrong, did the very quick check-over, and ordered tests. A simple blood CBC, a chest x-ray, a CT scan with contrast, and an ultrasound of my shoulder and arm. It sounded weird they would want to do an ultrasound of my arm, but what had caught my ear was the CT scan, because I knew the contrast dye would require a line into my arm--ugh.
It turned out to be more than ugh. The nurse came in, explained they needed to put a line in my arm, and that it had to be in a large vein, as a larger than normal needle was required for the contrast (I supposed the dye had to go in quickly because of quick fade?) What she didn't explain was that this was a trickier insertion, or at least it proved so with me.
But, you do what you have to do, so I looked away (my goal is never, ever see the needle), closed my eyes, and tried to think happy thoughts. The nurse got started and I could feel the needle going in, then moving around a little while the nurse tried to get it where she wanted, then she just stopped. I didn't know what had happened. She had run into a vein valve (if I understood her right) and that was a problem (why I don't know, it's better to keep on concentrating on the happy thoughts.) Then she said "I'm so sorry." She had "blown" my vein, with the needle finally splitting the walls of the vein while she was trying to get it in the right spot.
This was the first time I had ever had someone "miss" with me, and I had always imagined a miss would lead to me feinting straight away, but here I was, still conscious for attempt #2. Fewer happy thoughts and more reliance on teeth gritting. Same exact result: "I'm so sorry." Well, now I was felling pretty sorry, too.
The nurse called for reinforcements, and a new nurse showed up for attempt #3, now in my other arm. No more happy thoughts. Reliance was wholly on the gritting of teeth. The nurse started the needle in, then said "well that just made a mess" but pushed a little further and the needle was in and taped into place. I had started sweating while this was going on, but it never felt like I was going to go out. Later in the night, I looked down at the edge of the bed, and saw a large blotch of fresh blood on the sheet.
I was told to expect some unusual things with the contrast dye, but to not worry (and actually with the needle in the rest of the procedure sounded like no big deal.) The unusual things would include: metallic taste in the back of the throat, a feeling of warmth all over, and an urge to urinate--though I would not need to urinate--and that all of this would only last a short amount of time. It was all exactly as described.
I had already had the chest x-ray by then, and the CBC was done, so it was back to the patient room for the ultrasound, which took a surprisingly long time--maybe almost as much as everything else taken together. A lot of attention was devoted to my left arm, for reasons still I was unable to guess, and for some reason it never crossed my mind to ask the technician.
More time passed and the ER physician stepped back in and sat down. "I don't have good news for you." He explained that the tests had revealed a partially deflated left lung, a pneumothorax (air pocket) in the left lung, a hemothorax in my left lung, and, as a topper, a shower of pulmonary embolisms that had broken off from several pencil length blood clots from large veins deep in my left arm. It didn't fully hit me as he was saying it, but I do remember thinking I hadn't been expecting *any* of that. I did realize life had just taken a considerable lurch in an unplanned direction.
I'm not sure of the sequence of events from there, but I think by then the ER doc had already called the on call surgeon (heal with steel) and the on duty hospitalist (medicine baby) for them to decide on how to proceed. It developed they didn't agree at all. The surgeon (if I understood right) wanted to stick a chest tube in me, drain the hematoma, reinflate the lung, and--incredibly to me--send me home! (I do wonder if I caught it all right.) The hospitalist wanted to run some more tests and admit me.
I asked the ER doc what he recommended. He said it would have to be my decision but if it were him, he would go with the hospitalist. Which just reinforced what I was going to do anyway.
The tests required more blood--surprise!--and a nurse stepped in with a tray with two largish flask like things and an indeterminate number of collection tubes. I didn't try to look because, once again, my tactic is to never look.
It proved to be easy, since the nurse said she could collect from the line already in me. She did her thing and more time passed.
Eventually a different nurse stepped in with a tray that looked pretty much exactly like the tray the last nurse had had, right on down to the same two odd looking flasks. She explained that the hospitalist had ordered more tests, but that for some reason these tests had to be drawn from a different site at least 2" away from the line in my arm. It made no sense to me at the time, but what do I know, and at any rate they said they needed it, so.... (After the fact, I've thought it over some, and I am fairly suspicious is that what really happened was the first round had been spoiled or faulty in some way, and that maybe the nurse shouldn't have taken the blood from the existing line, and that the test had to be repeated with new blood, but it's only my guess.)
Finally, after all this, I was taken upstairs to be admitted to the hospital and given a room. A nurse scribbled my arrival time on a white board in the room: 0637. I had been up all night, and, strangely, didn't feel sleepy at all.
Almost as soon as I was in my room, the hospitalist who had "won" the argument came in to see me and go over the plan. He looked to about 70 and Wyoming through and through, looking more like a rancher than a doctor, and talked that way, too. He spoke in very direct terms.
I would be put on oxygen, they would work to stabilize my breathing, I would be put on a blood thinner, and they would try to have me ready to go home by Tuesday, which again sounded almost incredible to me. All that stuff wrong and I might go home on Tuesday? It was cognitive dissonance.
There was more to know about the blood thinner. There was a very powerful drug they would preferentially use, which would attack the clots directly. But because of the lung puncture and the concussion with possible brain bleeds, it was too risky for me. Plus, there was the major complication that I still needed shoulder surgery, which would be a no-go while on a blood thinner.
The next step down was a drug called Lovenox. It would prevent new clots from forming, giving my body time to gradually eat away at and absorb the clots in my arm and lungs, The big advantage Lovenox offered was that it could be stopped and would rapidly clear out of my body, within 12 hours, making surgery possible, whereupon I could re-start up the blood thinner. The disadvantage? I would need 1 injection a day for 4-6 weeks, and, once discharged, I would have to give the injection to myself. From my point of view, that was a major problem, considering I don't even look at needles shown in news coverage on the TV for flu season, etc.
I thanked the hospitalist, who was now going off duty, and he left.
Next I made a quick round of calls to let some key people what was up: my neighbors John Nutter and Suzanne Lewis, who would worry about me when they realized I wasn't home--which they would immediately because of the new snow and lack of Yowsa!; my mom, whom I knew would be unnerved by all this, but I had to tell her first hand; and finally Kris,
Kris said she would drive up and get there as soon as she could. I said that was ridiculous, that the highways were closed, and it was still snowing (outside my winter it looked like mid-winter with deep snow and slush on the roads) and that she should wait until it was safe. She said she was coming up as soon as she could anyway. I didn't get very far through any of this before I started crying.
Kris walked into my room sometime in the afternoon, and said the roads had been fine nearly the whole way, and never bad. Her presence immeasurably brightened me. She didn't say so then, but I know after the fact (because she told me) that she had been completely shocked by how I looked when she walked in. What can I say? Those gowns could make almost anyone look bad.
As I was led in, there was some activity but not much. Nothing hurried or anything that spoke of urgency--more quiet voices here and there, and signs of maybe several other rooms in service. Out in one hall a guy wandered out wanting if it was okay for him to pee. The staff told him to go back to his room and wait--I think they were going to do an urinalysis test for drugs or something, and that he was a very familiar character for them on weekend evenings.
When the ER doctor showed up, he asked what was wrong, did the very quick check-over, and ordered tests. A simple blood CBC, a chest x-ray, a CT scan with contrast, and an ultrasound of my shoulder and arm. It sounded weird they would want to do an ultrasound of my arm, but what had caught my ear was the CT scan, because I knew the contrast dye would require a line into my arm--ugh.
It turned out to be more than ugh. The nurse came in, explained they needed to put a line in my arm, and that it had to be in a large vein, as a larger than normal needle was required for the contrast (I supposed the dye had to go in quickly because of quick fade?) What she didn't explain was that this was a trickier insertion, or at least it proved so with me.
But, you do what you have to do, so I looked away (my goal is never, ever see the needle), closed my eyes, and tried to think happy thoughts. The nurse got started and I could feel the needle going in, then moving around a little while the nurse tried to get it where she wanted, then she just stopped. I didn't know what had happened. She had run into a vein valve (if I understood her right) and that was a problem (why I don't know, it's better to keep on concentrating on the happy thoughts.) Then she said "I'm so sorry." She had "blown" my vein, with the needle finally splitting the walls of the vein while she was trying to get it in the right spot.
This was the first time I had ever had someone "miss" with me, and I had always imagined a miss would lead to me feinting straight away, but here I was, still conscious for attempt #2. Fewer happy thoughts and more reliance on teeth gritting. Same exact result: "I'm so sorry." Well, now I was felling pretty sorry, too.
The nurse called for reinforcements, and a new nurse showed up for attempt #3, now in my other arm. No more happy thoughts. Reliance was wholly on the gritting of teeth. The nurse started the needle in, then said "well that just made a mess" but pushed a little further and the needle was in and taped into place. I had started sweating while this was going on, but it never felt like I was going to go out. Later in the night, I looked down at the edge of the bed, and saw a large blotch of fresh blood on the sheet.
I was told to expect some unusual things with the contrast dye, but to not worry (and actually with the needle in the rest of the procedure sounded like no big deal.) The unusual things would include: metallic taste in the back of the throat, a feeling of warmth all over, and an urge to urinate--though I would not need to urinate--and that all of this would only last a short amount of time. It was all exactly as described.
I had already had the chest x-ray by then, and the CBC was done, so it was back to the patient room for the ultrasound, which took a surprisingly long time--maybe almost as much as everything else taken together. A lot of attention was devoted to my left arm, for reasons still I was unable to guess, and for some reason it never crossed my mind to ask the technician.
More time passed and the ER physician stepped back in and sat down. "I don't have good news for you." He explained that the tests had revealed a partially deflated left lung, a pneumothorax (air pocket) in the left lung, a hemothorax in my left lung, and, as a topper, a shower of pulmonary embolisms that had broken off from several pencil length blood clots from large veins deep in my left arm. It didn't fully hit me as he was saying it, but I do remember thinking I hadn't been expecting *any* of that. I did realize life had just taken a considerable lurch in an unplanned direction.
I'm not sure of the sequence of events from there, but I think by then the ER doc had already called the on call surgeon (heal with steel) and the on duty hospitalist (medicine baby) for them to decide on how to proceed. It developed they didn't agree at all. The surgeon (if I understood right) wanted to stick a chest tube in me, drain the hematoma, reinflate the lung, and--incredibly to me--send me home! (I do wonder if I caught it all right.) The hospitalist wanted to run some more tests and admit me.
I asked the ER doc what he recommended. He said it would have to be my decision but if it were him, he would go with the hospitalist. Which just reinforced what I was going to do anyway.
The tests required more blood--surprise!--and a nurse stepped in with a tray with two largish flask like things and an indeterminate number of collection tubes. I didn't try to look because, once again, my tactic is to never look.
It proved to be easy, since the nurse said she could collect from the line already in me. She did her thing and more time passed.
Eventually a different nurse stepped in with a tray that looked pretty much exactly like the tray the last nurse had had, right on down to the same two odd looking flasks. She explained that the hospitalist had ordered more tests, but that for some reason these tests had to be drawn from a different site at least 2" away from the line in my arm. It made no sense to me at the time, but what do I know, and at any rate they said they needed it, so.... (After the fact, I've thought it over some, and I am fairly suspicious is that what really happened was the first round had been spoiled or faulty in some way, and that maybe the nurse shouldn't have taken the blood from the existing line, and that the test had to be repeated with new blood, but it's only my guess.)
Finally, after all this, I was taken upstairs to be admitted to the hospital and given a room. A nurse scribbled my arrival time on a white board in the room: 0637. I had been up all night, and, strangely, didn't feel sleepy at all.
Almost as soon as I was in my room, the hospitalist who had "won" the argument came in to see me and go over the plan. He looked to about 70 and Wyoming through and through, looking more like a rancher than a doctor, and talked that way, too. He spoke in very direct terms.
I would be put on oxygen, they would work to stabilize my breathing, I would be put on a blood thinner, and they would try to have me ready to go home by Tuesday, which again sounded almost incredible to me. All that stuff wrong and I might go home on Tuesday? It was cognitive dissonance.
There was more to know about the blood thinner. There was a very powerful drug they would preferentially use, which would attack the clots directly. But because of the lung puncture and the concussion with possible brain bleeds, it was too risky for me. Plus, there was the major complication that I still needed shoulder surgery, which would be a no-go while on a blood thinner.
The next step down was a drug called Lovenox. It would prevent new clots from forming, giving my body time to gradually eat away at and absorb the clots in my arm and lungs, The big advantage Lovenox offered was that it could be stopped and would rapidly clear out of my body, within 12 hours, making surgery possible, whereupon I could re-start up the blood thinner. The disadvantage? I would need 1 injection a day for 4-6 weeks, and, once discharged, I would have to give the injection to myself. From my point of view, that was a major problem, considering I don't even look at needles shown in news coverage on the TV for flu season, etc.
I thanked the hospitalist, who was now going off duty, and he left.
Next I made a quick round of calls to let some key people what was up: my neighbors John Nutter and Suzanne Lewis, who would worry about me when they realized I wasn't home--which they would immediately because of the new snow and lack of Yowsa!; my mom, whom I knew would be unnerved by all this, but I had to tell her first hand; and finally Kris,
Kris said she would drive up and get there as soon as she could. I said that was ridiculous, that the highways were closed, and it was still snowing (outside my winter it looked like mid-winter with deep snow and slush on the roads) and that she should wait until it was safe. She said she was coming up as soon as she could anyway. I didn't get very far through any of this before I started crying.
Kris walked into my room sometime in the afternoon, and said the roads had been fine nearly the whole way, and never bad. Her presence immeasurably brightened me. She didn't say so then, but I know after the fact (because she told me) that she had been completely shocked by how I looked when she walked in. What can I say? Those gowns could make almost anyone look bad.
Note
Sunday continued...
Sunday otherwise was a pretty typical day in the hospital. Nurses come and check on you every so often, people come and see what you would like for breakfast, lunch, etc. and in between you think maybe you can do lots of reading or check stuff on the internet, but really it's hard (at least it was for me) to get anything like that done at all. You just don't feel like it.
A respiratory nurse came by several times to see how I was doing with my breathing. Even with oxygen, even the tiniest thing--like just standing up--was enough to get me out of breath, even with oxygen. Quite a change in circumstance. She had me "smoke the peace pipe" several times, but suggested we stop when I told her it made no difference whatsoever that I could tell.
Besides being on oxygen, I was under no restriction. I could have whatever I wanted to eat, and I could mover around as much as liked, and do so on my own. In the evening I thought a shower would be good, so I got the nurse to wrap up the line in my arm, and I headed in to the bathroom to shower. It took forever. Everything I did got me out of breath. Taking off my shirt. Taking off my pants. Showering. Drying myself off, etc. etc. Again, all this with oxygen. I couldn't help but wondering: is this how it's going to be? How long? It was bare and stark how reduced I had become in less than 24 hours.
My main nurse was a tall, pretty well built guy, maybe 40ish, named Jeremy. You wouldn't take him for a nurse if you met him on the street. A nice guy, and I liked him. When we compared noted, it turned out he was a big mountain biker, did snow biking, too, and almost for sure we had crossed trails up top this season while I was running (I'm almost the only person that was running up there at all this winter) and he was snow biking.
Jeremy gave me my first 2 shots of Lovenox. They are injected in what he called "the fluff" (fat) that most people have in ample amounts around their waste. (And here an irony: a few days before my crash, I had been a little surprised and displeased to see how much weight had crept onto me since early January. But now, thank goodness I had some extra layering for the needle to go into--ha!) For the first injection, Jeremy went to a spot about 2" above my belly button. Not to over dramatize, but once the Lovenox went in, it stung pretty good--nowhere close to intolerable, but something like maybe a sweat bee sting, and one that lingered for several minutes. Quite different from any other shot I've ever had. As the prolonged stinging was going on and drawing unneeded attention to the fact I just had a shot (and for me, it's all mental, the more I think about it, the more likely I am to get woozy and pass out, the more quickly I can put it behind me, the less likely I am to keel over), I was thinking along fairly wimpy terms: "holy crap, 6 weeks of this, and they think I can give it to myself????"
In between shots (every 12 hours), I did have a thought, though. I remembered that ever since I had shingles 2 years back, a large area of my right waist side had remained numbed. Maybe if the shots went there, they at least wouldn't hurt as much.
When Jeremy came for the next shot (which I was curious about, because the hospitalist had clearly said 1 shot per day, and this was the second shot, but I guessed that maybe they were ramping up the medication quickly the first day; then surely it would go to 1 shot per day) and he started to ready another patch of skin around my belly button, I asked him if he could use my side area as well, explaing the numb area and my hopes, and he said "I usually work around the belly button in a circular rotation, but I suppose we can use the side." I've discovered many times that sometimes if you speak up and ask if something has to be a certain way or not in the hospital, it will turn out that maybe it doesn't have to be. You just have to be willing to ask and assert at least a little bit on your behalf. Otherwise, it's just the system rolling along.
The shot still stung, but it was wayyyyy milder.
Before Jeremy left to go off duty, he wished me well. And he said I could learn how to give the shots myself. Before he left--and I can't remember exactly how he phrased it--he stood and said something as a kind of general observation, of people in general, and while not *directed* at me, of course meant for my ears, to use or discard: "You know, in situations like this, eventually people either decide to just get on with it or not."
That was Sunday, and I slept all night with no problem.
Sunday otherwise was a pretty typical day in the hospital. Nurses come and check on you every so often, people come and see what you would like for breakfast, lunch, etc. and in between you think maybe you can do lots of reading or check stuff on the internet, but really it's hard (at least it was for me) to get anything like that done at all. You just don't feel like it.
A respiratory nurse came by several times to see how I was doing with my breathing. Even with oxygen, even the tiniest thing--like just standing up--was enough to get me out of breath, even with oxygen. Quite a change in circumstance. She had me "smoke the peace pipe" several times, but suggested we stop when I told her it made no difference whatsoever that I could tell.
Besides being on oxygen, I was under no restriction. I could have whatever I wanted to eat, and I could mover around as much as liked, and do so on my own. In the evening I thought a shower would be good, so I got the nurse to wrap up the line in my arm, and I headed in to the bathroom to shower. It took forever. Everything I did got me out of breath. Taking off my shirt. Taking off my pants. Showering. Drying myself off, etc. etc. Again, all this with oxygen. I couldn't help but wondering: is this how it's going to be? How long? It was bare and stark how reduced I had become in less than 24 hours.
My main nurse was a tall, pretty well built guy, maybe 40ish, named Jeremy. You wouldn't take him for a nurse if you met him on the street. A nice guy, and I liked him. When we compared noted, it turned out he was a big mountain biker, did snow biking, too, and almost for sure we had crossed trails up top this season while I was running (I'm almost the only person that was running up there at all this winter) and he was snow biking.
Jeremy gave me my first 2 shots of Lovenox. They are injected in what he called "the fluff" (fat) that most people have in ample amounts around their waste. (And here an irony: a few days before my crash, I had been a little surprised and displeased to see how much weight had crept onto me since early January. But now, thank goodness I had some extra layering for the needle to go into--ha!) For the first injection, Jeremy went to a spot about 2" above my belly button. Not to over dramatize, but once the Lovenox went in, it stung pretty good--nowhere close to intolerable, but something like maybe a sweat bee sting, and one that lingered for several minutes. Quite different from any other shot I've ever had. As the prolonged stinging was going on and drawing unneeded attention to the fact I just had a shot (and for me, it's all mental, the more I think about it, the more likely I am to get woozy and pass out, the more quickly I can put it behind me, the less likely I am to keel over), I was thinking along fairly wimpy terms: "holy crap, 6 weeks of this, and they think I can give it to myself????"
In between shots (every 12 hours), I did have a thought, though. I remembered that ever since I had shingles 2 years back, a large area of my right waist side had remained numbed. Maybe if the shots went there, they at least wouldn't hurt as much.
When Jeremy came for the next shot (which I was curious about, because the hospitalist had clearly said 1 shot per day, and this was the second shot, but I guessed that maybe they were ramping up the medication quickly the first day; then surely it would go to 1 shot per day) and he started to ready another patch of skin around my belly button, I asked him if he could use my side area as well, explaing the numb area and my hopes, and he said "I usually work around the belly button in a circular rotation, but I suppose we can use the side." I've discovered many times that sometimes if you speak up and ask if something has to be a certain way or not in the hospital, it will turn out that maybe it doesn't have to be. You just have to be willing to ask and assert at least a little bit on your behalf. Otherwise, it's just the system rolling along.
The shot still stung, but it was wayyyyy milder.
Before Jeremy left to go off duty, he wished me well. And he said I could learn how to give the shots myself. Before he left--and I can't remember exactly how he phrased it--he stood and said something as a kind of general observation, of people in general, and while not *directed* at me, of course meant for my ears, to use or discard: "You know, in situations like this, eventually people either decide to just get on with it or not."
That was Sunday, and I slept all night with no problem.
Note
This is me smokin' the peace pipe on Sunday, as Kris found me. I know I look way too good to be true, but I swear there has been absolutely no photo retouching.
 |
| From publiken |
Saturday Apr 16, 2016 #
Note
It was overcast all day long with light snow falling off and on, but not sticking on paved surfaces for most of the day. I went over to my next door neighbors late in the afternoon and talked with them for a while, and left shortly before dusk. Instead of just walking, I walked all the way around the block (a whole block!) just to get at least a tiny bit of exercise. It was clear that compared with yesterday, my breath was shorter, and it's not like I was speed walking.
Kris called in the evening and we talked for a while. She had been in fairly regular contact with her older sister--an Registered Nurse (RN)--about my condition for a while, and Kris's sister had told her sometime earlier that day that she was really concerned and that if things got any worse for me, I should go to the hospital.
It was about 9 pm when we said goodbye, and I started thinking about that, and the fact that sometimes in the next few hours a major snow storm was due. I thought my breathing was not as good as it had been in the day, or was I just imagining it? What if I needed to go to the hospital, but couldn't get there? The hospital is really close, but if you can't even get out of the driveway...and around here, only the major streets get plowed.
So I decided to have some late supper, take a shower, and then assess. But first I packed a day pack with a few essentials, like contacts, toiletries, a couple of books--just in case.
Everything takes longer than you think when you're one armed, got cracked ribs, and aren't breathing well, and so by the time I had everything sorted out and done, it was about midnight. The roads were still okay, so far, and my breathing wasn't any better, so, by then the choice seemed to be narrowed down to one choice. The last thing I did before driving off to the hospital was to send a note to Kris to let her know if she hadn't heard from me by a certain time in the morning and she tried to call and couldn't reach me, it would be because I was in the hospital.
I got to the hospital at about 12:30 Sunday morning.
Kris called in the evening and we talked for a while. She had been in fairly regular contact with her older sister--an Registered Nurse (RN)--about my condition for a while, and Kris's sister had told her sometime earlier that day that she was really concerned and that if things got any worse for me, I should go to the hospital.
It was about 9 pm when we said goodbye, and I started thinking about that, and the fact that sometimes in the next few hours a major snow storm was due. I thought my breathing was not as good as it had been in the day, or was I just imagining it? What if I needed to go to the hospital, but couldn't get there? The hospital is really close, but if you can't even get out of the driveway...and around here, only the major streets get plowed.
So I decided to have some late supper, take a shower, and then assess. But first I packed a day pack with a few essentials, like contacts, toiletries, a couple of books--just in case.
Everything takes longer than you think when you're one armed, got cracked ribs, and aren't breathing well, and so by the time I had everything sorted out and done, it was about midnight. The roads were still okay, so far, and my breathing wasn't any better, so, by then the choice seemed to be narrowed down to one choice. The last thing I did before driving off to the hospital was to send a note to Kris to let her know if she hadn't heard from me by a certain time in the morning and she tried to call and couldn't reach me, it would be because I was in the hospital.
I got to the hospital at about 12:30 Sunday morning.
Friday Apr 15, 2016 #
Note
(I am going back in time to try to update in a coherent fashion what has happened over the past few days.)
Kris called this morning; I had to rush to the phone and was lying down and so when she commented I sounded out of breath, well, I was, and told her I had tried to rush to catch the phone while it was still ringing.
Late in the day, I took a much shorter walk than yesterday, and when it seemed like I might have been a little out of breath going up a hill or when I was walking a little faster, what Kris said came back to me for a moment. But it was a grey day, colder, and a spring storm was ready to move in, and I was mostly thinking of that.
Kris called this morning; I had to rush to the phone and was lying down and so when she commented I sounded out of breath, well, I was, and told her I had tried to rush to catch the phone while it was still ringing.
Late in the day, I took a much shorter walk than yesterday, and when it seemed like I might have been a little out of breath going up a hill or when I was walking a little faster, what Kris said came back to me for a moment. But it was a grey day, colder, and a spring storm was ready to move in, and I was mostly thinking of that.
Thursday Apr 14, 2016 #
Note
Not too long ago I had written a friend and mentioned how sometimes it works out the smallest marginal differences can lead to very large outcomes in individual lives in ways that would have been impossible to foresee.
A personal example showed up in short order. Thursday a week ago, I had finished up my usual work in the afternoon, and, as the day was nice, I headed out for a bike ride for some exercise. I didn't have any set place to go to or route to follow, and chose to ride west to the river to begin with. I rode over the river bridge, through the light right after, and, when traffic allowed, I did a u-turn right before reaching the interstate. (What if I hadn't u-turned? What if there had been traffic? What if I had been stopped at the light in either direction? What if I had stayed on the street and never hopped onto the path? What if I had done any a thousand different minor possible things instead?) I passed back through the light, and then left the rode to get on the paralleling bike path.
The next thing I knew, I was on the ground, kind of sprawled out in a sitting position with my legs spread, and my bike was at my feet. I tried to sort things out while starting to check myself over. I didn't have the slightest memory of how I had ended up on the ground (and still don't.) At some point while I was doing that, there was a voice from above me: "Are you okay?" It was some guy. I hadn't heard or seen him come up on me, so that was a surprise, too. He went on: "I saw you flip off your bike while I was driving by so I came back to see if you were okay."
I told him thanks, and that I seemed to be okay, so he left. I spent a little more time looking myself over, including checking my helmet, which was cracked. It seemed I had landed (at least in part) on my head, and had knocked myself out. I didn't seen any blood anywhere, and my bike was fine, so I got up and decided to see if I could ride home, which was only a few miles away.
It was a little painful getting on my bike, but I managed that. But then I realized I wasn't sure which way to go. I could look to the west, and see the Snowies, and I knew that was west and I didn't want to go that way. But for what seemed to be a few minutes, I couldn't convince myself to head east towards home, because while I could see discrete objects that were familiar, they just didn't make sense in some connected (map-like) sense at first. Gradually my head cleared up though, and I could figure out that, yes, I needed to head east, so I peddled off.
My way home took me right by my doctor's office, and even though it was getting late in the afternoon by then, I thought I would stop by, just in case I could get someone to take a real quick look at me and make sure I was okay. I walked in the building, and up the stairs to the second floor, and went in open office. The doctors were already gone, but some nurses were still there, and two of them took me back and just talked with me briefly. They assured me I was lucid by then, and also said it would be a good idea to go to the hospital and get my head checked just in case.
So I peddled on home, and then drove over to the hospital, and stepped into ER. There I had a CT scan of my head and a couple of x-rays. A friendly ER doctor and nurse (by that I mean they really were quite nice to me) checked me over. The CT scan scan was clean, so very good. My neck was okay, and there weren't any signs of massive internal bleeding, so also good. The x-rays showed a large break of my left clavicle, with the bone ends completely displaced with no overlap in either the vertical or horizontal axis. Plus I had three cracked ribs. They sent me home with a prescription for some pain meds and a sling for my arm and told me I should seek an orthopedic surgeon the next day. By the next day, my left leg wasn't working so well either for walking, with a really sore hip flexor, and while I could breath more or less normally, breathing deep hurt.
One thing we *do* have in Laramie are orthopedic surgeons, with the largest (by far, I think) clinic in the state right here. So the next day I got seen, by an acquaintance I know from skiing and mountain biking, as it turned out, with the upshot being that surgery was scheduled for today to reduce the fracture and plate the two pieces together, subject to some pre-surgery items including blood work and a chest x-ray checking out. However, late in the day after getting the x-ray, I got a call from the clinic saying there was some question about the x-ray (which had revealed a small air pocket in my left lung), and that we wouldn't know for sure until the anesthesiologist could look it over. I did some reading over the evening, and decided what I would do depending on what the anesthesiologist said. When I heard back the next morning that the anesthesiologist had conferred with two other anesthesiologists (the problem of an air pocket being the result of a difficult to detect micropuncture of the lung, apparently), and that they collectively thought the surgery would be okay to go forward with but that they did have some concerns and might want to intubate my chest as a precaution, it made it a really easy call for me, and I chose to postpone the surgery.
Taking some more time to heal the other things up was the obvious thing. The most painful thing by far were the cracked ribs, especially while trying to get settled in for sleeping or getting back up. The leg was a real problem just in terms of mobility (and thankfully it's gotten much better in the past 2 days.) At times during the day my neck and upper back get very sore and stiff, and headaches come and go. Compounding all these things was that I was not allowed to take any ibuprofen, etc. pre-surgery. Hopefully with the passage of some time all those things will be markedly better, and in a week I will be better ready for surgery and able to fully care for myself afterwards.
It's been funny to me that of all the injuries and aches and pains, the thing that has been the *least* of a pain has been the broken clavicle itself! Cracked ribs are really no fun, as anyone who has had them knows. And cracked ribs going into surgery are something that have to be viewed quite seriously, for a variety of reasons.
My spirits are good, and will be better once the ribs and my breathing improve (I can get myself out of breath walking up even a small hill, or by walking fast for a few minutes across level ground, which is funny to compare with a few moments before the bike accident, when I could do a hell of a lot of strenuous things without getting out of breath!.) And there is much to be thankful for, #1 being that my head is okay. Thank goodness I had my helmet on!!! I *never* ride anywhere without wearing a helmet; if I hadn't been wearing my helmet, it's not clear I would have survived the fall.
Of course my plans for the next few weeks--and months--are upended entirely as regards to anything running or O-related, and it's not clear to me that I will be doing any O' racing for quite a while at least, if anything this year at all. And I don't really care (racing just doesn't have much appeal anymore unless the conditions are right for me and I'm feeling fit.) I'll just be looking forward to getting my shoulder fixed and getting to the point where I can start running and biking again, and from there start working on fitness again--which will surely take a hit during the recovery period ahead. Hopefully none of this will interfere with my piece of the Rocky Mountain O' Festival (course setter for the first 3 days, and assisting the other course setters for the other 3 days), and I don't see why it should as things stand now.
In the meantime, I figure I can at least work on my weight, and get that back to where it should be. About 2 weeks back I stepped on a scale for the first time since early January, and saw that my weight had drifted up over the winter, from a decent 139ish to noticeably flabbier 146+ lbs--at least on me, the difference is very obvious to the eye. I've already dropped 2 pounds from my pre-accident high, and I will get the rest!
A personal example showed up in short order. Thursday a week ago, I had finished up my usual work in the afternoon, and, as the day was nice, I headed out for a bike ride for some exercise. I didn't have any set place to go to or route to follow, and chose to ride west to the river to begin with. I rode over the river bridge, through the light right after, and, when traffic allowed, I did a u-turn right before reaching the interstate. (What if I hadn't u-turned? What if there had been traffic? What if I had been stopped at the light in either direction? What if I had stayed on the street and never hopped onto the path? What if I had done any a thousand different minor possible things instead?) I passed back through the light, and then left the rode to get on the paralleling bike path.
The next thing I knew, I was on the ground, kind of sprawled out in a sitting position with my legs spread, and my bike was at my feet. I tried to sort things out while starting to check myself over. I didn't have the slightest memory of how I had ended up on the ground (and still don't.) At some point while I was doing that, there was a voice from above me: "Are you okay?" It was some guy. I hadn't heard or seen him come up on me, so that was a surprise, too. He went on: "I saw you flip off your bike while I was driving by so I came back to see if you were okay."
I told him thanks, and that I seemed to be okay, so he left. I spent a little more time looking myself over, including checking my helmet, which was cracked. It seemed I had landed (at least in part) on my head, and had knocked myself out. I didn't seen any blood anywhere, and my bike was fine, so I got up and decided to see if I could ride home, which was only a few miles away.
It was a little painful getting on my bike, but I managed that. But then I realized I wasn't sure which way to go. I could look to the west, and see the Snowies, and I knew that was west and I didn't want to go that way. But for what seemed to be a few minutes, I couldn't convince myself to head east towards home, because while I could see discrete objects that were familiar, they just didn't make sense in some connected (map-like) sense at first. Gradually my head cleared up though, and I could figure out that, yes, I needed to head east, so I peddled off.
My way home took me right by my doctor's office, and even though it was getting late in the afternoon by then, I thought I would stop by, just in case I could get someone to take a real quick look at me and make sure I was okay. I walked in the building, and up the stairs to the second floor, and went in open office. The doctors were already gone, but some nurses were still there, and two of them took me back and just talked with me briefly. They assured me I was lucid by then, and also said it would be a good idea to go to the hospital and get my head checked just in case.
So I peddled on home, and then drove over to the hospital, and stepped into ER. There I had a CT scan of my head and a couple of x-rays. A friendly ER doctor and nurse (by that I mean they really were quite nice to me) checked me over. The CT scan scan was clean, so very good. My neck was okay, and there weren't any signs of massive internal bleeding, so also good. The x-rays showed a large break of my left clavicle, with the bone ends completely displaced with no overlap in either the vertical or horizontal axis. Plus I had three cracked ribs. They sent me home with a prescription for some pain meds and a sling for my arm and told me I should seek an orthopedic surgeon the next day. By the next day, my left leg wasn't working so well either for walking, with a really sore hip flexor, and while I could breath more or less normally, breathing deep hurt.
One thing we *do* have in Laramie are orthopedic surgeons, with the largest (by far, I think) clinic in the state right here. So the next day I got seen, by an acquaintance I know from skiing and mountain biking, as it turned out, with the upshot being that surgery was scheduled for today to reduce the fracture and plate the two pieces together, subject to some pre-surgery items including blood work and a chest x-ray checking out. However, late in the day after getting the x-ray, I got a call from the clinic saying there was some question about the x-ray (which had revealed a small air pocket in my left lung), and that we wouldn't know for sure until the anesthesiologist could look it over. I did some reading over the evening, and decided what I would do depending on what the anesthesiologist said. When I heard back the next morning that the anesthesiologist had conferred with two other anesthesiologists (the problem of an air pocket being the result of a difficult to detect micropuncture of the lung, apparently), and that they collectively thought the surgery would be okay to go forward with but that they did have some concerns and might want to intubate my chest as a precaution, it made it a really easy call for me, and I chose to postpone the surgery.
Taking some more time to heal the other things up was the obvious thing. The most painful thing by far were the cracked ribs, especially while trying to get settled in for sleeping or getting back up. The leg was a real problem just in terms of mobility (and thankfully it's gotten much better in the past 2 days.) At times during the day my neck and upper back get very sore and stiff, and headaches come and go. Compounding all these things was that I was not allowed to take any ibuprofen, etc. pre-surgery. Hopefully with the passage of some time all those things will be markedly better, and in a week I will be better ready for surgery and able to fully care for myself afterwards.
It's been funny to me that of all the injuries and aches and pains, the thing that has been the *least* of a pain has been the broken clavicle itself! Cracked ribs are really no fun, as anyone who has had them knows. And cracked ribs going into surgery are something that have to be viewed quite seriously, for a variety of reasons.
My spirits are good, and will be better once the ribs and my breathing improve (I can get myself out of breath walking up even a small hill, or by walking fast for a few minutes across level ground, which is funny to compare with a few moments before the bike accident, when I could do a hell of a lot of strenuous things without getting out of breath!.) And there is much to be thankful for, #1 being that my head is okay. Thank goodness I had my helmet on!!! I *never* ride anywhere without wearing a helmet; if I hadn't been wearing my helmet, it's not clear I would have survived the fall.
Of course my plans for the next few weeks--and months--are upended entirely as regards to anything running or O-related, and it's not clear to me that I will be doing any O' racing for quite a while at least, if anything this year at all. And I don't really care (racing just doesn't have much appeal anymore unless the conditions are right for me and I'm feeling fit.) I'll just be looking forward to getting my shoulder fixed and getting to the point where I can start running and biking again, and from there start working on fitness again--which will surely take a hit during the recovery period ahead. Hopefully none of this will interfere with my piece of the Rocky Mountain O' Festival (course setter for the first 3 days, and assisting the other course setters for the other 3 days), and I don't see why it should as things stand now.
In the meantime, I figure I can at least work on my weight, and get that back to where it should be. About 2 weeks back I stepped on a scale for the first time since early January, and saw that my weight had drifted up over the winter, from a decent 139ish to noticeably flabbier 146+ lbs--at least on me, the difference is very obvious to the eye. I've already dropped 2 pounds from my pre-accident high, and I will get the rest!
C • Ouch! 36