Fall from a Mountain Bike, Part 2

Last week, I told about falling off my mountain bike and making it to the hospital with obviously injured left shoulder and leg. I had just arrived at the emergency department at the end of my last posting.

I swooned as soon as they pushed me into the treatment room. That passed pretty fast once I was flat on the bed. An IV was quickly started in my hand and I was injected with morphine. I didn’t like the way it made me feel but I was very glad to have the pain controlled.

Getting my x-rays was the worst part of my ED adventure. Even after morphine, it was torture to get my arm in the correct position to diagnose my posterior shoulder dislocation. Most shoulders dislocate forward or anterior. Mine had dislocated backwards. I had read about posterior shoulder dislocations, but it is so unusual that none of my emergency medicine colleagues I talked with could actually remember having seen one before. It also explains why my efforts to reduce it on the mountain were unsuccessful.

It was nice being taken care of by my friends. The emergency physician and nurses took special care of me. The trauma surgeon heard I was there and poked his head in on me.

Once the diagnosis was made, they put me out and the orthopedist pulled on my arm. He thought it was back in and ordered more x-rays but, as I came to, I could tell very clearly it was not. I told him so and, even though I am a doctor, he still sent me for x-rays to check. That led to more of the same painful positioning for more x-rays.

When I got back to the room, the orthopedist came and told me it was still dislocated. I resisted saying, “I told you so.” He then said he was pretty sure he could put it back in without more medicine because I had already been given so much. As soon as he started to pull, my hollering convinced him he was not correct. The next time they put me under, they were more successful and I woke up with my correctly positioned shoulder held in place with a sling.

The x-rays of my knee didn’t show an obvious fracture so I was discharged with my leg in an immobilizer. My wife took me home and I got into the house and bed without too much trouble since I was able to limp on the bad leg as I walked with only one crutch.

Then next day, I had an MRI. It showed good news for the shoulder: no specific injury. But the news for the leg was bad: non-displaced tibial plateau fracture. The tibia is the shin bone and its plateau is the large part that forms the knee joint. So, I went to non-weight bearing for six weeks! That would be bad enough if I could have walked on crutches but, for the first couple of weeks, I had to use only one crutch. That meant that, to get around, I have to crawl (using just one arm and one leg,) use a wheel chair, or hop. Since we have a tri-level house, I was basically stuck in my bedroom where all I could do was hop from the bed to the toilet and back again.

It was interesting how being laid up worked on my head. All I could do was lie in bed and worry. I worried about being constipated from taking narcotics and lying in bed. I worried about getting addicted to the pain medicine. I worried about a blood clot forming in my swollen, immobile leg. I worried that my leg would never be the same again and I my active life as I knew it had come to an end. I pictured my self an addicted, constipated cripple on blood thinners. To make all of this worrying worse, I had trouble sleeping because of the pain and discomfort of the sling and immobilizer so I had plenty of long nights to contemplate my bleak future.

Fortunately, all worked out well for me. I missed nine weeks of work but, no constipation, no blood clots, no addiction. Back hiking and riding my bike. Just a setback that has helped me be more empathetic towards others in similar situations.