A Bike Accident August 8, 2010

Imagine, if you will, you are out for your morning run. It is a familiar course and a lovely Sunday morning. There is light traffic on the road if at all. You come around the corner and you meet some of that light traffic, a bicyclist. It being such a lovely morning the words “good morning’ form on your lips but before you can utter them the bicyclist performs a horrific upsy doodle and lands on his back, apparently knocked unconscious by the impact of hitting the ground. Having a cell phone with you and the presence of mind to use it, you call 911. You step out into the middle of the road to deter and flag down any traffic that might come down the road. The cyclist tries to rise up and you encourage him to not move, because you will take care of any traffic that might approach. The EMTs arrived in what seems to be too long of time but in reality is only a few minutes. They ask you a couple questions about him, ‘did he pass out’ and ‘for how long?’ They load him into the ambulance and whisk the cyclist off to the nearest hospital.

The preceding is how I imagine it might have been for the runner who witnessed my “upsy doodle” a week ago Sunday. My morning began a bit rushed since I slept in a little late. I had agreed to meet David on the bike trail riding his new “Red Baron” bicycle he had won during the last rendition of the Tour of California. I have not seen the “Red Baron” since he received it and was curious, not to mention going for a ride with David, something I had not done since he took up cycling a couple years ago.

The route I rode was a familiar one taking me by the almost governor’s residence. ‘De Casa Los Gobernados’ is what the sign on the stonewall proclaims, or used to, as this Sunday morning I noticed the sign had been vandalized and many letters had been removed. I rode by the residence just the Tuesday before, and now deep in thought, did not recall the sign being vandalized or maybe I just hadn’t noticed. Whatever, in any case the next thing and last before waking up on the tarmac was seeing a female runner.

I have no recollection of what I did next. I have only my bike as evidence of what might have happened. The front wheel is potatoe chipped, the left brake lever is at a right angle to the handle bars, the front wheel and fork are at a right angle to the frame. There are big scratches on both brake levers.

I ask myself did I hit the brakes hard propelling me over the handlebars or did I turn the wheel just enough to get the wheel sideways in the pavement ripples found near the center of the corner and then the wheel got caught up and over the top I went? I’ll never know as that time is lost to me. A black hole in my memory cells.

At the Emergency Room I was met with a team of professionals who, true to the television images I had witnessed many times before, cut my one and only Fall River Century jersey off of me. I cannot recall if I had been placed in a cervical collar by the EMTs or at the Emergency room. The cervical collar proved to be more painful than my other injuries while on. It rubbed against my larynx and I endured it for several hours until the CT scan report had been reviewed revealing I had no neck injuries. Later I was to realize the cervical collar had actually bruised my larynx. What the CT scan did reveal was I had two fractured ribs and a rib broken in two places on the left side. My whole left side was bruised. Whenever I attempted to raise my left leg it felt like it would cramp up. I had road rash on both knees and both elbows as well as my right wrist. Also I had endured a very small subdural hematoma as a result of hitting my head against the pavement. I needed to wait for the neurologist to release me, which was not to happen until Sunday evening, before getting word on discharge from the Trauma Intensive Care Unit.

They kept me overnight for observation and the next morning took me in for another CT scan. Later that afternoon I was informed they had deleted my results and would need to take another CT scan. I found these trips to the CT scanner a nice break in the monotony of sitting in bed. While being moved from the CT bed to my patient bed I experienced a 5 to 10 second bout of intense dizziness. I told my nurse and I expect she noted it in her patient notes. The next morning I woke up feeling a bit light headed but nowhere near the intensity of the day before. Once again I reported it to my day shift trauma nurse.

I subsequently learned when one experiences dizziness coupled with a resting heart rate of 57 medical people get excited. A carotid ultrasound, a heart ultrasound and an EKG were ordered to check out my heart. When the cardiologist came in during the early evening he asked some questions about family history and surmised an overreaction by all but he wanted to conduct some further tests to discern for sure whether I had passed out after hitting the pavement or in fact I had passed out first then had a wreck.

The next day I underwent a cardiolyte stress test in the morning and a tilt table test in the afternoon. A cardiolight stress test consists of being placed in a machine that takes pictures of your heart at rest for 20 minutes. What was hard about this portion of the test was keeping both arms extended over my head especially my left arm as that tended to set off discomfort in the rib area plus the bruised portion of my left side. I found I could relax my left arm against the camera housing and endure the last few minutes. The next step was to chemically induce stress. They injected me with a drug dilating my arteries as if I were exercising. Along with the quickened breathing came nausea, sweating and bowel perturbations. I was reasurred these were all normal reactions and then shortly after their reassurance the effects abated. Less than 5 minutes total for this ordeal. I spent a little time in the bathroom since my bowels had not moved since Sunday morning. The last step was to put me back in the large picture taking machine for only 16 minutes this time and see what my heart looked like after being stressed. I was wheeled up to TICU to wait for the afternoon Tilt Table test. Did I mention I could not eat anything for either of these tests?

The Tilt Table test consisted of laying down on a table, getting strapped in, then tilted up to 70 degrees (consider 90 degrees as standing straight up). Once again they monitored my blood pressure and heart rate for 20 minutes. Then they lowered me and administered a nitroglycerin pill under my tounge. I was raised back up to 70 degrees while all in attendance waited for me to pass out. The cardiologist and his nurse assistants monitored my blood pressure and heart rate. I experienced the familiar feelings of nausea and sweating. A thought occurred to me advocating a beligerant stance, ‘by God I’m not going to faint!’ I struggled with this thought as passing out seemed like a good way to get over the feelings of nausea and the very intense sweating but around the time I might have wanted to pass out I began to feel slightly better. The cardiologist remarked my blood pressure was starting to come up indicating the nitroglycerin effect was wearing off. Instead of waiting the full 20 minutes he accepted the fact I was not going to pass out and 15 minutes would be enough time. They laid me down and recovery was almost instantaneous. I had to lay prone, though, for a few more minutes while my blood pressure climbed back to more acceptable levels. I was wheeled back to my room where my wife was waiting. The cardiologist gave us his report based on the results of the two tests. He had conducted two tests which proved nondiagnostic, but he wasn’t convinced there might not be another remote possibility. He wanted me to see a colleague who specialized in electronic heart monitoring. The cardiologist suggested we might monitor the heart over a year’s time with a small device embedded in my chest. He said I could go home and needed the on call trauma doc to discharge me.

When I got home I checked my email and found an email from the runner who had witnessed my oopsy doodle. I e-mailed the runner asking her to answer some questions about my accident. She answered them in full. Her perspective was she startled me and she answered a second e-mail describing exactly what she was wearing. My memory was only slightly accurate as she was wearing a baseball cap and shorts but the colors she described did not match my memory.

What this all means is I still do not know at this time whether I passed out first then had a wreck or passed out after colliding with the pavement. I have no history of heart problems. I have since examined the corner where the accident occurred and now know there is a six-inch wide depression, maybe an inch deep, running diagonally across the road. Not believing there is a heart problem then the only other conclusion I can draw is; either I slammed on the brakes for no good reason and catapulted myself over the bars. Or I made a slight correction at the time the front wheel was in the depression and the front end over corrected getting caught up in the depression and over the bars I sailed.

September 3, 2010

Since finishing the first chapter in this saga I have had a follow-up with my doctor’s Nurse Practioner who has referred me to the cardiologist specializing in electronic monitoring of the heart, an Ear, Nose and Throat specialist, and a PET scan to check out what the ER CT scan revealed in addition to my bike accident injuries.

I had the PET scan yesterday but will not receive any information until next Wednesday when I have another follow-up with the NP.

My injuries are almost healed as most of the road rash is now pink skin except my right elbow which was rubbed by the blood pressure cuff during hospitalization and my left knee. The left knee was pink with skin flakes I elected to peel off one evening and to my consternation the next evening discovered blood had pooled underneath making it look like a blood blister. I managed to control my desire to pop or peel this blister-like phenomenen and this morning it is a scab.

My left hip though still has a blood pool under the skin. I can poke it and watch it shake like jello. It is about an inch and a half in diameter. I can’t tell if it has decreased in diameter or not since first discovering it after my initial shower upon returning home from the hospital. I am assuming the body will eventually absorb the blood and it will be gone. I will have it checked out Wednesday when I visit with the NP again.

Last night I reread the hospital CT scan reports and now am experiencing some trepidation regarding the node found in the right lower lung, a lesion with ground glass internal density on the left seventh rib, a mass in the throat and something else needing an ENT specialist to inspect.

I have no personal history or family history of heart issues but do have family history with cancer. The throat, rib and lung issues could conceivably be indicative of cancer. The PET scan will indicate whether I need to see a pulmonary specialist or, heaven forbid, an oncologist.

It was hard to write the last word in the preceding sentence.

And time marches on.