Monday, March 21, 2016

My bike accident

On Valentine's Day I was biking near Glen Ellen in Sonoma County with my friend Shweth. It was a beautiful day – about 75° and sunny – and both of us were pumped up the riding. Outside of the Glen Ellen market we spoke with the guy who had polio as a child and was paralyzed from the waist down. Yet, he could still pedal with his hands on a modified bike, and was planning to bike all over Italy later this year. Little did I know that an hour later I'd have my own physical disabilities.

About 45 minutes into our ride we took right turn to go downhill on a small two-lane country road. I checked my phone briefly to confirm we were going in the right direction. Either as a result of my checking my phone or generally being enraptured by the beautiful day, failed to process that a sharp right turn was coming up. I took the turn way too fast and went straight across the median. The road did not have much of a shoulder and there was a large ditch beyond the side of the road. There is also a barb wire fence, which I did not see at time; the paramedic told me about it later.

It's true what they say - "it all happens so quickly." As I tried to regain my balance I saw a big RV coming in the opposite direction. I thought for a split second, "maybe I can slip between the RV in the ditch." I almost called my balance in the gravel on the side of the road, but was not able to sustain it. I looked up, recognized that I was about to run into a big oak tree, and slammed into it going about 20 mph. Shweth had not yet come around the bend he heard a big thud. The RV stopped and protected me from any traffic. The passenger in the RV was a nurse (lucky me!). Shweth didn't see me as he biked past because RV was covering me by the nurse waved him down. If there's anything that chokes me up retelling of the story it's that Shweth ran back to me. I think he was much more concerned about my health than I was.

As I laid on the gravel, I was certain that I had mangled my left arm. I didn't want to look at it for fear of seeing a gruesome sight. When I was 15 I broke both my radius and my ulna at a soccer tournament in Atlanta. I looked down to see my left hand about an inch above the plane of my arm, and proceeded to shout many profanities that I'm sure shocked all the parents in the crowd. Until that point they probably thought that I was a mild-mannered, well spoken young man

With the nurse and Shweth hovering over me, I told Shweth to take a couple pictures. He thought I was joking at first. Somebody called 911 and luckily an ambulance was nearby – I think I waited about 20 minutes with them to arrive. In the meantime, the European doctor showed up – he was pretty useless. Then a Park Ranger showed up and put gauze on my left arm. Out of an abundance of caution the paramedics and firemen put me in one of those neck braces for people that have spinal cord injuries. They put me on a hard stretcher, strapped me in, and loaded me into the ambulance. The firemen took my bike to the fire station, where Shweth met them to claim the bike. Amazingly, my bike was not damaged at all. What I think happened is that put out my left arm slightly to brace myself, slammed into the tree (which popped my left elbow out of place), hit the tree with my left chest (causing some road rash), then fell to the side of the road. I didn't hit my head, or if I did my helmet protected me. As the paramedic told me, I'm a lucky guy. I have all my teeth, my neck is not broken, and I didn't get hit by the RV nor did I run into the barb wire fence.

All and all I was very calm after the accident. I was in pain but adrenaline was keeping that pain manageable I was coherent and talking to everyone. I enjoyed my conversation with the paramedic on the way to the hospital.

At the Santa Rosa Memorial Hospital, it was determined through x-rays and CT scan that I had dislocated my left elbow and broken my left radius (up toward my wrist). The doctor told me "were going to put your elbow back in place but you're not in the know it happened. In about 10 minutes you're going to say to us 'when are we going to put my all that back in place' and we will say to you 'we already did it.'" That's exactly what happened. Thank goodness for sophisticated anesthesia.

They also took an x-ray of my right wrist but determined that there was no broken bone there.

They put me in a pretty heavy duty splint that covered my entire left arm. I spent about six hours in the hospital, and then Shweth and I drove back to San Francisco. Well, Shweth drove. On the way we went to about three or four drugstores to see if they had pain medication but no one was open. I was in pain but it was not unbearable. Meagan came to pick me up at Shweth's place, and helped me get my medication and took the rental car back.

The following day was a holiday so I laid low. I was instructed to see an orthopedic surgeon as soon as possible, which I did on Tuesday. The surgeon, at UCSF, said that I would likely need surgery, but she wanted to pass me off to one of her colleagues who is an expert in elbow reconstruction. The doctor was also concerned about large bone fragment near my radial head, which she said might need to see her since it is in the middle of an important ligament. I was a bit concerned that I had done some really big damage to my elbow.

Throughout that week I continued to work from home. Both of my cases were in very busy times and to be honest I did need to work. My bosses were extremely understanding yet I powered through. I don't regret doing this, but it was a struggle… Especially one day where I was on the phone for at least eight hours. Toward the end of the week my right wrist started hurting more. I remember on Sunday evening I was watching Downton Abbey, picked up a cup of hot chocolate, and had to put it down immediately because my hand hurt so much. The following Monday (one week after the accident) I saw the elbow specialist. She conducted a fluoroscan (kind of like a live x-ray) and quickly saw that I had a broken right scaphoid, which is a bone in your hand. The doctor told me to stop working, which I promptly did.

My mom flew out here before my Monday appointment, and it was apparent from the moment she got here that I needed help doing just about everything.

On Wednesday afternoon we had a bit of a scare because of stupid bureaucracy. Long story short, I didn't talk to the anesthesiologist in time and they said my surgery would have to be postponed by at least two weeks because of that. It was a total bureaucratic f-up on their part. I made a number of phone calls and pleaded with a few people and was able to go forward with the surgery. I just about flipped out at the prospect of having to wait another two weeks for surgery

I had surgery on Thursday at UCSF. Part of the surgery was exploratory because they needed to see how strong my elbow was. Based on this assessment they would either reattach my ligament, take out the bone fragment, use a cadaver ligament, or do nothing. They determined that my elbow was pretty weak, but the ligament was strong enough to reattach (instead of using a cadaver ligament). They took my torn ligament, sutured it into a screw, and screwed it into my left elbow (I'm not sure which bone). They also put a screw in my right scaphoid. I left the hospital that afternoon with another full arm splint on my left and a forearm splint on my right.

On Saturday evening mom and I had to go to the ER to get pressure relief on my left arm. Swelling from surgery pinched a nerve, causing my left thumb to go pretty numb. This isn't a cause for long-term worry as I will very likely get full feeling back within 12 months.

Ever since then I have been recovering. A week after surgery they took off the splints, gave me a cast on my left forearm, gave me a hinged brace on my left arm, and gave me a removable brace on my right forearm. I've been going to occupational therapy twice a week and am making progress. It's going to be a long recovery: I can't play sports for another 9 to 12 months, I can't lift anything more than 1 to 2 pounds for another month, and I will be out of work until at least early May. I'm taking short-term disability, which gives me 60% of my paycheck. I'll take it. In another blog post I'll try to write about what I've been learning around this whole ordeal, such as listening to your body, the absolute necessity of people to take care of you and relying on their love and kindness, the difficulty of going slow (very different from how I normally operate!), the wonderful feeling of passing off my work to other people, and it takes forever to do anything and I actually don't have much free time, and appreciation for competent professionals. In the meantime, here are some photos.