Saturday, January 5, 2013

A Year with Too Many Injuries

2012 was dominated by a set of injuries. I hope the end of 2012 also signals the end of those problems and yesterday's surgery (January 4, 2013) was the last time I've been in a hospital for a while.

My worst of 2012: 
1) Clavicle fracture and shoulder separation Oct 14. Not even a good story to go with it, Sullivan Canyon/Fireroad, my default loop that I have surely ridden more than 1000 times, maybe close to 2000. Had my touring/flat pedals, slipped off and went over the handlebars. I thought I rolled out of the fall nicely and only got scrapes and was about to congratulate myself for good falling technique - until I touched my collar bone and felt it sticking up. Complicated enough with a few splinters, so I had surgery the next Friday (Anya's 12th birthday no less).

It was very hard to recover from the surgery, I was in awful shape for probably 4 days, much longer than I expected and much worse than I remember from other surgeries. Oddly enough, my bum right ankle started getting worse and worse after the injury and I've been limping or even wearing a walking boot since. No reason that there could be any connection, but it sure is a downer not having a functional arm and leg.

The UCLA hospital is a nightmare, feels like being in a Kafka novel, very different from the hospital in Durango where I ended up with what was arguably a much more serious injury 2 months earlier. To fix the shoulder separation, the surgeon tried a Bosworth screw, but that didn't work too well because the screw came out of the bone and became bent as we saw at the 2 month follow-up in December (the long screw in the pic below was supposed to be in the bony part to the left of it). Made me very nervous to see a pointy long thing just sticking into my chest, close to nerves and artery. So the whole thing had to come out soon, and the bent screw made hardware removal harder. Another day in the UCLA hospital, but as of last night I'm metal free again (so 2013 did start with more surgery).

2) Punctured Lung and Broken Ribs
I was looking forward to riding the complete Colorado Trail from Durango to Denver in 2012, about 500 miles. The trail goes through some of the more remote parts of the San Juan mountains that are otherwise very hard to reach. The Great Divide Mountain Bike Route, which I rode the year before, largely avoids the high parts of the San Juans and stays too close to roads (in fact, even has some long road stretches). But my trip on the Colorado Trail was cut short by an awkward fall. I crossed a little stream at night, stalled at something I didn't see, and fell over sideways. Harmless enough, but unfortunately there was a sharp stump around and I fell right onto that. Sharp enough that the impact broke one or two ribs and punctured my lung. It didn't seem to be too bad initially, although I was pretty sure about the broken rib as soon as I fell. I rode on for another hour or so and camped for the night, had a little swim in a creek. Not a great night, though, and adding insult to injury, I was bitten in the middle of night by a mouse. It crawled into my tent and bit me in the finger while I was sleeping. Hard to believe. By the next morning, I clearly could tell that something wasn't right beyond my ribs. I tried to ride on and had surprising difficulties on the climb - I was going at a rate of about 500 vertical feet an hour rather than 2000 and yet my heart rate was often near max and I had to stop.  It was obvious that I could not make it to Denver at this rate, in fact, going on might even require a rescue in the high mountains as this could only be worse at 12,000 feet. So it was just a question where to bail out and returning to Durango seemed the best choice with Silverton being the only other town within reach. It took me all morning to climb just a few thousand feet, but then I (almost) enjoyed the final downhill miles. I stopped at the first urgent care center and told them about my lung, although the doctor initially didn't believe it and thought that I just had some bruises. So it was "don't worry, we clean you up and you are on your way". They took x-rays anyway, maybe to amuse me, and then all of a sudden I became an emergency case. I was asked to lie down, hooked up to oxygen, and they called for an ambulance to the hospital. I thought that was an overreaction, but no, they were not going to let me ride my bike to the hospital. The room filled quickly with folks from the Durango Fire and Rescue Dept who thought I was an interesting case. They must have told their friends because more and more of those guys showed up until the room was really packed and they all wanted to examine me, too. Apparently the typical patient they see with a pneumothorax is in much worse shape. We couldn't use all of them, some guys took my bike to the fire station where they stored it and others took me to the hospital. I'm being unloaded at the Durango hospital here:

There I learned more about the treatment of a pneumothorax and realized that I won't leave Durango for a while. The lung is reinflated fairly quickly with a chest tube, i.e. a surgeon cuts a hole in the chest, sticks a tube into it (as high up as it goes), and connects it to a vacuum. That procedure takes about 20-30 mins, although the 15 mins or so while the lung expands are very painful even with a few shots of morphine. So they don't pump up the lung, but rather suck out air and other stuff around it. However, that isn't the end of the treatment because the procedure is followed by a few days with the hose connected to a pump until there is no blood or air coming out. It didn't feel too awful (but lots of painkillers), although being tethered to a hospital wall for days is rather restrictive. Kathy fedexed a kindle and a music player, which ameliorated the boredom. So 2 days on the trail, 4 in the hospital, and 2 more in Durango (and then I got a ride with Les Handy back to Denver - he had just finished the Colorado trail riding the opposite direction). When I got out of the hospital, one of the firefighters picked me up and took me to their station where I got back on my bike (all my equipment and clothes were there as well). I rode up the trail a little bit. Eventually, a total of 8 days which is what I had planned for the trip. Just not distributed like that. Durango is a nice town, though, and the medical care in Durango was the least aggravating this year.

A week later, Obin and I rode a section of the Colorado Trail closer to the Denver side as a day ride.

3) Stingrays Really Hurt!
Now for the most painful accident of the year: Getting stung by a stingray. 2 weeks after coming back from Colorado, Anya and I went paddling. It was a nice warm day, great for a paddle.
After getting back to the marina, Anya wanted to try my surfski, which is much more tippy than hers. So she went out again and quickly went overboard, which is what we expected. But then she yelled that she just stepped on something squishy and moving, so I told her to hang on to the boat and went in to pull her out. I had noticed stingrays earlier in the warm water of Mother's Beach, but now tried to get to Anya quickly and didn't shuffle slowly. I felt something squishy and a very sharp pain in my left foot just as I was getting Anya and boat out.  A few people at the boat house helped us wash off the boats and load them, one also brought a bottle of vinegar and I used that and water from the hose to wash out the cut. Vinegar also helps with jellyfish stings - but now it started to hurt more and more. It was a short ride home, 3 miles or so, but I started to cramp everywhere from pain. Even a few Vicodins (courtesy of my Colorado accident) didn't help one bit and Kathy drove me to the emergency room. By the time I arrived there, I was cramping up from pain so much that they couldn't take my blood pressure or pulse, it was that bad. Fortunately, there is am amazing low tech cure here and the doctor knew about it: Hot water. Very simple and extremely effective. The water has to be hot enough to denature the venom and uncomfortably warm will do. The pain almost immediately disappears (as long as you keep the foot in hot water). In order to warrant the emergency room charges, I also got x-rayed, but  soaking my foot in hot water for maybe 2 hours was really all the treatment needed. The cut was pretty deep, like a knife jab, but nothing broke off on the inside and no tendons were damaged. However, the delay between the injury and the hot water cure was long enough to cause some damage from the venom. No infection or other complication, though. It took a long time to heal and even 5 months later there is some numbness and scar tissue.

4) My Worst Poison Oak Attack Ever
A bizarre thing because I have no idea how or when it occurred. There is plenty of Poison Oak on my usual rides (Sullivan Canyon has lots), but I know how it looks and never have any problems with it. Yet in May, I got a rash everywhere, neck, arms, chest, hips, legs. Never figured out how that happened, although one theory is that somehow some leaves got into my shirt (maybe at Paramount Ranch during TBFC) and worked their way down. A very itchy week or 10 days. Fortunately, I don't react too extremely to poison oak because somebody with a severe reaction, like Kathy, would have ended up in a hospital.

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