Recovery update

12 Jul

It’s now been fourteen weeks since my accident and a month since I had the arch bars removed. For the most part, I’ve considered my recovery a success ever since I got the arch bars out and ceased to be under the care of the oral surgeon, but that wasn’t really the end of this adventure. Some things have continued to get better, but other things aren’t completely normal. Here’s my list of things that have improved and things that haven’t.

  • My mouth is opening a little bit wider than it was four weeks ago.
    Open wide
    By my measurement that’s about five centimeters between my upper and lower front teeth. That’s a full centimeter better than my last estimate. I also do better on the three finger test.
    Three fingers in mouth
    That’s a lousy picture because it’s actually pretty hard to take good pictures of one’s own mouth with a camera in one hand while sticking one’s other hand in one’s mouth. In spite of the bad picture, it’s significantly improved from last time, and in fact, I’m able to pass the test without my top teeth even making contact with my fingers.
  • Four weeks ago, I wrote about as “tingly numbness” on the left side of my face. This has perhaps improved somewhat, but it’s definitely still there. I’m hopeful that it will eventually go away altogether because it’s similar to the sensation I had on the left side of my face after having my wisdom teeth removed. That lasted a few months but did eventually go away.
  • Four weeks ago, I also mentioned a creaking sound from my jaw. That has gone away.
  • I continue to get occasional feelings of soreness on the right side of my jaw, but I think that these feelings have become less frequent.
  • I haven’t mentioned this before, but for several weeks, I’ve been getting occasional sharp pains on my left cheek.
  • There’s a region in my left jaw which is somewhat tender. I’m guessing this is the area around the fracture.
  • As you might notice in the first photo above, my face isn’t very symmetrical. I’ll write about this more extensively in the near future, but this isn’t something I expect to improve.

Accident reconstruction

8 Jul

Since my return to the site of the accident the other day, I’ve spent a good deal of time thinking about how the locations of my various injuries might reveal some information about how I hit the ground. Unfortunately, the only conclusion I’ve come to (so far) is that something very complicated must have happened because there was evidence of contact with the ground in so many places.

Here is what I think is the complete list of body parts which showed evidence of hitting the ground:

  • Right cheek (abrasions to the right of eye and mouth, black eye)
  • Right earlobe (minor abrasion)
  • Right side of upper lip (two chipped teeth and a cut which was sutured)
  • Right side of chin (laceration was sutured)
  • Neck (very minor scratches)
  • Top of right shoulder (abrasion)
  • Left elbow (small abrasion)
  • Right elbow (large abrasion, some soreness for a few weeks after accident)
  • Back of left hand (minor abrasions just below bottom knuckles)
  • Palm of left hand (skin stripped from an area near the wrist)
  • Back of right hand (small abrasions on lowest knuckle of index finger)
  • Legs (various scratches and scrapes, none bad enough to bandage)

There were probably a number of minor scratches on my torso, but none seemed particularly significant at the time. Note that there’s no reason to believe that the left side of my face (where the mandibular fracture was) made contact with the ground. The fracture was most likely caused by the force to the right side of my face.

The one thing that seems pretty clear from the injuries is that I fell on the right side of my body. This is something I had assumed since the day of the accident, and something that seems consistent with the accident having happened while turning right. Beyond that, it’s hard to say much. It hardly seems  geometrically possible that I could have fallen in such a way that all of these body parts could have come in contact with the ground. Here are a few of the more puzzling questions:

  • How did I manage to scrape both the front and back of my left hand? I’m just baffled. I really don’t have a clue.
  • How could I have scraped the top of my shoulder against the ground? Uneven pavement might have helped. Other than that, I don’t know.
  • How did I scrape both of my elbows when falling on the right side?
  • How did I scrape my elbows and my hands, but nothing on the arms in between?

While I typed these questions, I actually thought of an explanation for how I might have gone down. Here’s my best guess. After losing control of the bike, I fell to the right, with my right shoulder and face hitting the ground but my hands remaining on the handlebars. As my body slowed down but the bike continued skidding, my hands let go of the handlebars, and with the left side of my body moving faster than the right, I sort of rolled over so that both my left and right arms hit the ground. This course of events would seem to explain the second and third of my questions, but not the first or fourth.

It’s really all quite a mystery, and I’ll probably never know what really happened.

Carrots

7 Jul

This evening (by which I mean Monday, July 6), I acquired three large carrots, weighing a full pound among them and ate them. My jaw handled them just fine, but I was concerned about my repaired front teeth, so tried to bite with my side teeth. This was somewhat challenging because it was hard to open my mouth wide enough to fit the thicker parts of the carrots into the side of my mouth. However, I did eventually succeed in eating all three carrots, allowing me to answer in the affirmative the question of whether it is possible for me to eat so many carrots as to make me feel sick. Fortunately, I’m feeling better already, though.

One of the three carrots I ate, in my hand (which I did not eat).

One of the three carrots I ate, in my hand (which I did not eat).

Thirteen week billing update

5 Jul

I’ve seen a little bit of action on the billing front this week.

  • When I posted my last update, I had just emailed my second insurance information to Berkeley Emergency Medical Group and Bay Imaging Consultants. The next morning, I received an email from Bay Imaging Consultants informing me that they had billed the second insurance. I have still heard nothing from Berkeley Emergency Medical Group.
  • I received a bill from Alta Bates Summit Medical Center for my treatment. The total amount was $1,944.10, but insurance adjustments decreased that by $505.45 and insurance payments knocked off an additional $1,413.65, leaving me to pay only $25. I plan on paying  this amount by credit card in a few weeks so that it will go on my August statement rather than July. I have the money in my account, but I might as well earn interest on it for another month.I also requested an itemized bill from Alta Bates by phone, and this arrived on Friday. I haven’t found it very helpful, though. It does have a charge of $16.72 for “ORAL/IBUPROFEN 600MG T”, which I’m not sure I received. It’s possible that it’s something they had me take some in the hospital (but sixteen dollars worth?), but I definitely didn’t take a bottle home with me. The doctor actually gave me a prescription for ibuprofen, but the pharmacist told me to just buy it over the counter. I don’t plan on looking into this because I don’t think it would affect the amount I pay after insurance.

    Incidentally, neither the original bill nor the itemized bill tells me which insurance paid, but I think it’s my father’s insurance because I did tell Alta Bates that his insurance was primary.

The accident revisited

4 Jul

I have to begin with a confession. When I wrote about my accident, I wasn’t entirely sure that everything I was saying was true. I didn’t say anything that I knew to be false, but I didn’t remember all of the details of how I had fallen. When I had no information about something, I didn’t say anything, but there were a couple of statements I made that were guesses based on what I did remember and what seemed to be the best information at the time.

For example, I wrote that I had been taking the downhill stretches faster than I was accustomed, and claimed that this was the cause of my accident. It’s true that I had taken some downhill stretches faster than I would have when riding alone, but I never had any specific recollection of going fast down the particular hill where the accident took place. When I stated that I had been going faster at the time of the accident, I was extrapolating based on what I did remember in a way that seemed to explain why I had fallen. Similarly, when I said that my bike crossed over the center line in the road, I didn’t have any specific recollection of that having happened at that particular turn. I had some recollection of it having happened somewhere, and it seemed reasonable to conclude that it was the place where I had crashed.

Anyway, I needed to make that confession because I revisited the scene of the accident this morning, and what I saw there led me to question both of the claims discussed in the preceding paragraph.

As I approached the turn where the accident took place, I could see that there were plenty of signs warning of a difficult turn. First was  something painted on the street by a well-meaning amateur.

SLOW!

Then there were the road signs as I approached the turns.

Right Turn, 15MPH
I’ve always been a careful cyclist, so this signage came as a surprise to me. I just couldn’t believe that I’d ignored it. The fact that I didn’t remember it being there  might suggest that I wasn’t paying close enough attention, but I also could easily have forgotten in my post-accident shock. (It also occurred to me that when the EMT asked how fast I had been going and eventually got me to agree that I had been going 20 to 30 miles per hour, I had admitted to breaking the speed limit.)

When I got to the actual turn, there were even more warnings.

Yellow Light, Right Arrow

I stopped at the corner to reflect on things and examine the scene for a while. Obviously, with the accident having happened 90 days earlier, there were no visible traces of my accident. However, one patch of pavement did catch my attention.

Cracked pavement

With the shade and an unfavorable angle, the photo doesn’t adequately display the magnitude of the hazard that this presents to bicyclists. In particular, it’s hard to see in the picture how deep some of the ridges were. Here’s another shot, which still doesn’t really do it justice, but it provides a little bit more information.

Another view of the cracked pavement

Also, the hill that preceded this turn actually did seem pretty steep, contrary to what I had thought when I looked at it on Google Street View.

Somewhat steep hill

In the hours since my return to the site, I’ve become increasingly convinced that the condition of the pavement played some role in my accident. The evidence is far from conclusive, but my biggest objection to that theory was easily resolved. This objection was that the cracked pavement was only found on the side where I was supposed to be riding, and I remembered crossing over the center line. As I mentioned previously, though, that memory of crossing the line may not be from this particular spot. Moreover, even if it is from that spot, it’s possible that I lost control on the broken pavement and then crossed over the line and fell.

I’ve spent a good amount of time examining my injuries and the scratches that the bike acquired in the accident, trying to figure out exactly how I fell and whether that might convey any information about the quality of the pavement I was on. The main way that such information might arise is if the bike were scratched in places that wouldn’t touch smooth pavement when I fell on it, but might have been able to touch pavement that was sufficiently uneven. Indeed, there are some scratches in places that seem like they shouldn’t have made contact with the road, but it’s not clear to me that the scratches could have come from falling on the ridged pavement either. The only other possibility seems to be that these scratches predated the accident (but I didn’t notice them until afterwards) or that they were acquired while the bike was at the fire station.

Since the morning, I’ve also had flashbacks of falling from my bike towards badly cracked pavement. I suspect that this isn’t an actual memory but something that my mind has fabricated to support my new theory of the cause of the accident.

Of course, all of this speculation on what happened that day has only minimal practical value. Determining the cause of the accident isn’t going to change the fact that it happened. Nor would it change the fact that the worst effects of the accident have, by all indications, passed. The only possible benefit from knowing why I fell would seem to be liability purposes, and not only does it seem unlikely that I’d be able to build a strong enough case, but I have no interest in pursuing litigation against a city that is broke when my insurance companies seem to have picked up most of the tab for my bills. I’d much rather see money go to fixing road hazards, which is why I reported this spot on the East Bay Bicycle Coalition’s hazard reporting site. Much to their credit, Oakland’s Public Works Agency apparently does a good job of fixing hazards quickly after they are reported, according to an article in the East Bay Express.

Apples

4 Jul

When the oral surgeon took my arch bars out, he told me that I’d be able to resume eating the hardest foods “some time around the fourth of July.” Obviously that was an approximate date, but it seemed as good a day as any, so yesterday I acquired a bag of eight Royal Gala apples. Originally, I was planning on saving them for breakfast, but I got hungry around midnight, so I ate one at about 12:05AM and another a few minutes later. I had another one for breakfast, and just finished another one a few minutes ago. So far, I haven’t had serious problems with my jaw, although with the first couple there was some pain on the right side (opposite the fracture). My repaired teeth also seem to have handled it fine.

In other news, I took a ride back to the scene of my accident this morning. I’ll write about my visit as soon as I can, but there’s actually quite a bit to say about it, so the post might not make it up for a day or two.

Twelve week billing update

30 Jun

It was a quiet week on the billing front with only one piece of mail coming in. I certainly can’t complain. Anyway, I took care of some of my outstanding obligations, too. Here’s what’s new:

  • I received a bill from Berkeley Emergency Medical Group for services performed in the emergency room, in particular the following:
    • “ER INTERMEDIATE EXAM” – My best guess is that this is just the doctor looking at my injuries. The full charge was $349, there was an adjustment of -$229.76 (presumably this is the difference between the network rate and the full charge), and insurance (the UC Berkeley plan) paid $95.39, leaving me with $23.85.
    • “INTER REP UP TO 2.5CM” – I think this refers to the suturing of my chin. I don’t know what “REP” stands for, though. In any case, the full charge was $527, but the insurance adjustment took off $329.60 and insurance paid $157.92, leaving me with $39.48.
    • “SIMPLE REP UP TO 2.5” – I think this refers to the suturing of my lip. The charge was $303, the insurance adjustment took off $238.16, and insurance paid $51.87, leaving me with $12.97.
  • The bill read a balance of $76.30, which doesn’t seem too bad, but I just sent them an email with my other insurance information to see if they can get that plan to pay some of this balance.

  • I filled out the form from Meridian Resource Company about accident liability online. I also emailed Bay Imaging Consultants with my second insurance information. When I say that I did these things, I mean that I did them within the last half hour. The good thing about me doing these weekly updates on billing is that it gives me an artificial deadline to meet my responsibilities. I feel like I should make some progress from week to week so that I won’t seem irresponsible to any hypothetical readers.

Eleven week billing update

22 Jun

I decided to consolidate billing-related posts into a weekly digest from now on. I’d like to be able to say that it’s because I’m too busy to write a new post every time a bill comes, but that would be a lie. The only reason I can offer is that I was tired of thinking of titles for posts about billing.

With that said, here’s what’s happened in the last week.

  • I received a statement from my oral surgeon. It was dated June 10, which was the day I had the arch bars removed. It was addressed to my father, but at my address, apparently a result of confusion over the fact that one of my insurance policies is through my father. The statement said that I had a balance of $1,963.18 which was “Due Now.” This number is apparently the $1,888.18 for the surgery left unpaid by the UC Berkeley insurance plus a $75 fee for the office consultation the day after the accident. I had expected my second insurance plan to pay something, so I was a little bit surprised to see the whole amount due now. The statement also stated that interest of 18% per year would be charged after 60 days and that my entire balance was 61-90 days old. This latter measurement apparently began from the date of service rather than the date of billing.I called the office of the oral surgeon to see if they had billed the second insurance company. I was told that they had, that I would receive another statement after the insurance had paid, and that no interest would be charged until then. The statement I received was apparently “just an updated statement,” which apparently means I can ignore the part about the balance being due now.
  • I also received a letter from Meridian Resource Company, LLC, on behalf of Anthem Blue Cross seeking to determine whether somebody else may be liable for some of the charges from the oral surgeon’s office. The only way I can imagine that this would be the case is if the road condition were such that the City of Oakland were liable, but I doubt that this is the case.
  • I still have a bill from Bay Imaging Consultants for $53.79. They seem to have not billed my father’s insurance, so I should get them to do so. I’ve been lazy about it, though, because the bill doesn’t have a due date.

Bleeding gums

19 Jun

When I had the arch bars removed, I was promised that my gums would bleed easily for the next two or three weeks, particularly when I flossed. The gums have recovered faster than I expected, though. They bled in about three places the first night of flossing and two places for a couple of nights thereafter. There was one spot that bled for a couple more nights, but by now the bleeding has stopped altogether.

Loose ends, Part I

16 Jun

With my recovery nearly complete, my posts here will be less frequent than they once were. I’ll still be posting about billing and insurance when there’s news on that front. I’ll also post updates on any new developments with my injuries if and when things arise. Eventually, I’ll get around to posting about some of the things I’ve learned from my accident and its aftermath (including a guide for those who are recovering from similar injuries) and how my experiences have influenced my worldview.

In the mean time, there are a few things that I probably should have mentioned a while ago. I’ll post three here. I may include more in subsequent posts.

  • Some time after I returned from my oral surgery, I found an x-ray of my mouth among the things that I had carried home from the surgeon’s office. I have never had any recollection of the taking of the x-ray, but it was apparently done after I had my mouth wired, as the wires are visible. Here it is. Note that the left side of my mouth (with the fracture) appears on the right side of the image.
    x-ray
  • It seems that I’ve neglected to explain that the part of my jaw that I broke, the condyle (or maybe it was the neck of the condyloid process, just below the condyle) is located near the joint with the upper jaw, rather than near the teeth. I suspect that this made the recovery easier than it otherwise might have been because the pictures of jaws broken between the teeth look far more gruesome than anything I saw on my own face.
  • A few days after the oral surgeon wired my mouth shut, my mother mentioned to me that she had read that people who have their jaws wired shut often have to carry wire cutters for emergency use. I had no recollection of the oral surgeon saying anything to me about wire cutters, but I could not rule out the possibility that he had said something but I could not remember because I was still feeling the anesthesia. Furthermore, some research showed that my mother’s claim was correct. Moreover, I discovered a few days before my wireless upgrade that the instructions I received from the hospital said,

    If your jaw was wired shut, it is important that you be able to open the wires in any emergency that makes it difficult to breathe, such as vomiting, extreme coughing or choking. Therefore, you must carry a pair of small wire-cutters with you at all times. Be sure you know which wires to cut in case this is necessary. If not, ask your doctor.

    To be clear, this came from the hospital, and I had my jaw wired a few days later by an oral surgeon at a different practice. But I never carried a wire cutter. I’m still alive today. Go figure.

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