Tag Archives: Injuries

I’m a terrible blogger

23 Aug

I haven’t updated in way too long, but that’s largely because not much has changed. Here’s what has changed since my last update:

  • The feeling on the left side of my face is a little bit more normal. The occasional sharp pains have become less frequent. I don’t know whether I should expect this to get any better than it already is.
  • The tenderness around the site of the fracture has gone away.
  • Since the accident, I have experienced (but apparently have forgotten to write about) some pain in my left ear. I’ve generally assumed it was a result of swelling around the fracture. This hasn’t gone away completely, but it is a lot better than it was for a while.

As for billing, not much is going on. I paid my $25 bill from Alta Bates. I also received another copy of the bill from Berkeley Emergency Medical Group, and responded by sending them the information for the insurance that they had neglected to bill.

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.

The return of somewhat normal conversation

21 Apr

My speech has improved to the point where I can sometimes carry on a one-on-one conversation without feeling a need to explain my injury to the other person. If I need to speak loudly for whatever reason, it’s still pretty obvious that something isn’t quite right, but I can now speak at a more-or-less normal volume without feeling overly self conscious. This allowed me to finally pick up the pay check that’s been waiting for me since the beginning of the month and drop the course I’ve been planning to drop since the injury.

Introduction

18 Apr

Just under two weeks ago, I fell off of my bicycle and sustained a number of injuries, the most serious of which was a mandibular fracture. I plan to use this blog to share various musings related to these injuries, as well as things I’ve learned that might be helpful to other people in similar situations.

At various times, it may be helpful for a reader to know that I am a vegan and a graduate student in mathematics. I suspect that anybody who knows me and finds this blog would recognize that I am the author, but I don’t plan on identifying myself at this time.

Obviously, I’m getting something of a late start on this blog, with the accident nearly two weeks behind me already. I’ve been meaning to start this blog for some time now, but life has been busy. I have quite a number of entries that I’d like to write, and I plan on back-dating some posts according to when I first thought to write them.

An insurance form

6 Apr

This afternoon, I completed an insurance form for the cycling club. I don’t really understand what it’s for. I don’t see why there would be an insurance policy that would pay anybody other than me (the club didn’t incur any costs from the accident), but I’ve already signed a waiver freeing the club from any liability.

The form wasn’t particularly remarkable except for two things. First, it had checkboxes for 21 body parts, and I was to indicate which had been injured. I ended up checking just under half of them (10). However, most of the injuries were very minor, such as light scratches on the front of my neck and my right ear. The second thing was that I was asked to indicate whether my injuries were minor or serious, and I wasn’t sure what the answer was. While a broken jaw certainly isn’t fun, plenty of people recover from it, and relatively quickly. I assumed that there was some serious legal definition of “serious injury,” and I looked around and found that I was right, at least in the State of New York.  A Google search turned up a page on the New York serious injury threshold:

“Serious injury” means a personal injury which results in death; dismemberment; significant disfigurement; a fracture; loss of a fetus; permanent loss of use of a body organ, member, function or system; permanent consequential limitation of use of a body organ or member; significant limitation of use of a body function or system, or a medically determined injury or impairment of a non permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less that ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment.

I’m nowhere near New York, and neither is the insurer, but this was good enough for me. While most of that wouldn’t describe any of my injuries, I definitely have a fracture.

Monday doctor visits

6 Apr

I called the oral surgeon’s office as soon as they opened at 8AM. They were able to make an 11AM appointment for me, but they told me that  I should get a referral from University Health Services (UHS) so that my student health insurance plan would cover treatment. I called UHS, and they told me that I should come to urgent care to get my authorization.

I very much resented being required to get this authorization. It seemed ridiculous that they couldn’t just trust the emergency room doctor’s word that I needed to see an oral surgeon. I spent the better part of an hour waiting at UHS before seeing a nurse and then a doctor. The nurse took my temperature and my blood pressure (both were normal) and asked me a few questions about my accident and the injuries. She showed me a piece of paper with faces showing various levels of discomfort and had me rate my pain according to the numbers labeling the faces. However, there were two sets of labels, one from 1-10, and one from 0-5. I didn’t ask which one she wanted me to use, but I said my pain was about a 2. For the most part, my injuries have been a bit uncomfortable, but not particularly painful.  The doctor looked at my various injuries and had another nurse bandage my scrapes. This actually made me rather glad to have come in because I had so many scrapes and not enough energy to bandage all of them. The nurse also gave me material for dressing my wounds for the next five days before I go back to get my stitches removed. I left with a bill of $15.60 not covered by insurance. Most of that was for the bandages the nurse had given me, which were $55 before insurance  (and $11 after).

About an hour after getting out of UHS, I had my appointment with the oral surgeon. He seemed nice and friendly without being intrusive (and, as a somewhat shy individual, I’ve found a lot of medical professionals to be intrusive). He showed me my x-rays, and explained my fracture, a condyle mandibular fracture. I was mildly disgusted when he told me that the model skull on which he was pointing out the condyle, a thin part of the mandible near the joint, was a real human skull, and I became altogether horrified when he removed the jaw from the skull and asked me to hold it.  He told me that the condyle fracture was a common type of fracture, which usually was treated without open surgery. The usual treatment was to anesthetize the patient, prod the bone back into place, and wire the jaw shut for a few weeks. In a small proportion of cases, however, this doesn’t work, so an open surgery is necessary. He added that there was a small number of cases in which it isn’t necessary to wire the jaw shut; sometimes the bone will stay in place well enough that  it is sufficient to keep the patient on a liquid diet. He didn’t specify any time frame for the liquid diet, so I asked if this liquid diet would be for the rest of the patient’s life. “No, just a few weeks.” he answered, laughing.

In my case, the surgeon said, it will be necessary to wait a few days until my face is less swollen to do anything. He wasn’t sure whether it will be necessary to wire my jaw, and he won’t know until he has me asleep in the office. He told me he would have his receptionist call me in the afternoon to set up an appointment.

The oral surgeon also expressed concern about my two chipped front teeth. I told him that I was planning on having them fixed, but I thought that the broken jaw was a more pressing concern. He agreed, but said that I should have a dentist put a temporary seal on it. He said that since I had only  lived in the area for seven months, he couldn’t imagine that I would have had any reason to find a dentist by now. I was more than a little bit amused by this, having long been told that I should have a dentist clean my teeth every six months. I said, that I had, in fact, found a dentist, and I told him who it was. The oral surgeon told me that my dentist was a great dentist, and then made an appointment with the dentist for me that afternoon.

I also asked the oral surgeon if he had any suggestions for keeping my mouth clean if my mouth were wired shut. He suggested getting a children’s toothbrush and Sensodyne toothpaste. I wasn’t crazy about the Sensodyne suggestion, but I decided to get a children’s toothbrush to use with my usual Tom’s of Maine toothpaste.

I had plenty of time to get to the dentist’s office, but somehow I still ended up running to catch the bus to get there. This certainly wasn’t a good thing for me to be doing with broken jaw, but I didn’t fall, and I did catch the bus. When I got to the dentist’s office, he put a seal on one of the teeth, which he said almost had a nerve exposed. He said that both of the teeth were only chipped in the outermost layers, and he expects that they will be fixable. However, we’ll have to watch them carefully, and they may end up needing root canal work.

I repeated the question about keeping my teeth clean to the dentist, and he suggested a Water Pik, so I added that to my shopping list, too.

About twenty minutes after I got out of the dentist’s office, I got a call from the receptionist at the oral surgeon’s office. She told me that the next two appointments available were Wednesday of this week and Tuesday of next week. She added that she’d have to check with the surgeon to see if Wednesday would be too soon and call me back later. She also told me I’d need a friend to drive me home from the procedure, so I headed into the office to find somebody who could do that for me.

I was relieved to learn when the receptionist called me back a couple of hours later that the surgeon will be able to do the procedure on Wednesday. Although I’m not in pain most of the time, there are enough positions that are quite painful, that I’d really like to get it done as soon as possible. After scheduling the appointment, the surgeon transferred me to another member of the office staff, who told me that their office didn’t contract with either of my health insurers, and she told me the cost of the service, which was just under $3700. I knew that my insurance would cover some of the costs, even if it was out of network, but I wondered why I was referred to an out-of-network doctor in the first place. I know I’ll be able to afford whatever it costs, but of course I’d rather pay for as little as possible.

The hospital

5 Apr

Upon arriving at the hospital, I found myself waiting in the hallway for an room. A man–whose position was not made known to me–asked me a number of questions about the accident. He also asked about my medical history. He asked if I’d ever had surgery, and I said I’d only had wisdom teeth removed, which he translated as a “no”. Somebody cut my shirt off of me, an act which rather annoyed me because I felt very much capable of removing my shirt myself, and I resented the loss of the shirt.

Eventually, they did find a room with space for me, and they proceeded to move me into the room and ignore me for a while. I found myself periodically whimpering, half because of the discomfort in my jaw and half because I thought it might make somebody pay attention to me. Lying on the bed, I had some time to examine my wounds–at least those which I could see. Both of my hands were bleeding: my right hand on the back side, and my left hand on both the front and back. I had scraped my right shoulder and both of my elbows, and it seemed like there was some blood on my face, but I couldn’t see my face. I also noticed that my top and bottom teeth weren’t lining up normally.

A doctor came in and introduced myself. He looked at my wounds briefly, and seemed particularly interested in my bleeding hands. He suggested, “Maybe you should wear gloves next time.” I half expected him to look at my bleeding right shoulder and suggest that I also wear a shirt next time, too.

The first person to see me for any significant amount of time was an x-ray technician (or whatever the person who takes the x-rays is called). He complained repeatedly that the doctor should have just requested a CT scan of my head because he wanted so many different angles. He did, at least, assure me that I was a good patient, although I don’t have any idea why he thought this to be the case. There was also apparently some problem with the equipment, and so some of the shots had to be retaken several times. I heard the technician talking to somebody else in the room where he controlled the x-ray machine, and it sounded like he was saying that something was far out of place. I didn’t know what he was talking about, but I suspected it had to do with my x-rays. The technician came back into the room and told me he just needed one more x-ray. He told me to lean my head back for the shot, but I found it too painful to my jaw to lean that far back, so he found an alternative position.

When I returned to the bed and waited to be seen by the doctor, it occurred to me that I had been carrying my iPod Touch on my bike at the time of the accident. This was only significant in that it could be confused for a phone. I found the bag of my possessions near the foot of my bed, and–sure enough–the iPod was in my shoe, and my phone was nowhere to be found. I knew that I’d get my phone back whenever I got my bike back, but I didn’t know when that would be. I figured I could probably take a bus down to the fire station to pick up the bike, but I didn’t know how long it would be before I’d feel up for the trip.

Eventually, the doctor came back and asked me how I was doing. It seemed like a strange question, given that the answer should have been apparent from my very presence in the emergency room (not to mention my appearance). I tried to be optimistic, answering, “Pretty well given the circumstances.” He answered, almost as if he was trying to undercut my optimism, “Well…you broke your jaw.” He told me that I’d have to see an oral surgeon as soon as possible during the week so that the surgeon could “fix [me] up.” He then explained to me how hitting the right side of my head had caused a fracture on the left side. He also started to tell me about “the other way to break your jaw”, which apparently involved hitting the front of one’s chin. When he finished explaining, I told him, “I guess I’ll have to try that another time,” attempting to sarcastically allude to my lack of interest in another way to break my jaw. He didn’t seem to appreciate my morbid sense of humor, answering, “No, I think once is enough.” He didn’t tell me how the oral surgeon would be fixing me up, but he said that I’d need to be on a liquid diet at least until I saw the oral surgeon. I couldn’t imagine chewing with my jaw feeling the way it was, so I wasn’t at all bothered by this restriction.

The doctor and a nurse then proceeded to clean off my various wounds. In addition to the ones I had seen, there was a cut on my upper lip, a cut on my chin, and a few abrasions on the right side of my face. The chin, I was told, needed to be stitched. As the nurse and doctor cleaned and stitched me, my thoughts turned to my teaching job.  After a subpar fall semester, I’ve put a lot of work into teaching this semester, and I was concerned that I might not be able to finish the job with the broken jaw.

After my chin was stitched, the doctor raised the question of whether my lip needed to be sutured. I felt my lip with my tongue, and it felt as though something might have been stuck in the cut. I wondered if it might have been the fragments of my chipped teeth. The nurse and doctor proceeded to examine the cut, and sure enough, I heard the doctor comment that it looked like there was something in the cut before the nurse exclaimed, “It’s his tooth! His tooth shattered in his lip.” She seemed genuinely excited, as though she had never seen a case like this before. Within a few minutes, the fragments of the tooth were cleaned out, and the lip was sutured. The nurse mentioned that I was almost ready to go home, before leaving me to call my mother, who had called while the doctor was stitching my chin, on a hospital phone.

A short while later, a nurse told me I could leave as soon as I had clothing. Fortunately, my shorts weren’t damaged, but I’d need a shirt to replace the one that was cut off of my back. They found a black shirt for me, although I don’t know where it came from. A nurse gave me several sheets of paper with information about my injuries, a prescription for Vicodin, and a note that I should take three days off from school. I was more than a little bit surprised that they were releasing me without even bandaging any of my wounds, but I was glad to get out of the hospital and into the taxi that would take me home.

The scene of the accident

5 Apr

Unsurprisingly, the fall left me in a state of shock, and if not for the other cyclists surrounding me and telling me to sit down, I just might have gotten back on my bike again. Waiting at the side of the road, I realized that I was bleeding in at least a few places, at least one of my front teeth was chipped, and the left side of my jaw was sore. The bleeding didn’t seem like a big deal to me. I’ve always been the sort of person who is getting scrapes here and there, and they’ve always healed quickly enough. I was rather disturbed by the idea that my teeth had broken, having had a longstanding fear of breaking or losing teeth. I wanted to look in the road for the pieces that had chipped off, but I knew that others would restrain me if I didn’t restrain myself. Instead, I contented myself with a hope that a dentist would be able to replace the lost pieces with something artificial.

The ride leader made a call, apparently to an emergency number, and a few minutes later, a fire truck arrived from the fire station that I was told was just down the street. A firefighter looked at me, asked me some questions about the accident, and somehow determined that I had full recall of the event and no loss of consciousness. He asked whether I had somebody who could drive me to the hospital, and I answered in the negative. In truth, some of my friends would have been able to do it, but I always tend to be averse to asking people to do things for me, and I wasn’t going to overcome this weakness while in a state of shock. As the ambulance arrived, one of the other cyclists said to me, “We’ll see you back on the bike soon!” I reacted with some skepticism, not because I didn’t want to ride my bike again, but because I didn’t see any reason to hurry back to the club.

An EMT got out of the ambulance,  examined me and asked me a few questions. Most of the questions weren’t any trouble for me to answer, but when he asked how fast I had been moving before the collision, I couldn’t say, not having a speedometer. He asked if I had been going 50 miles per hour, and I couldn’t imagine that I had been moving that fast, so I said I hadn’t. He asked me which hospital I wanted to go to. I  explained that I was new to the area and wasn’t familiar with the hospitals. He again repeated the question about my speed, this time emphasizing that it was actually fairly important. He didn’t seem to understand that I didn’t have any way of knowing this information, and the fact of it being important wasn’t going to change this. He asked if I had been in the 20-30 miles per hour range, and I said that I probably had been. He decided that this was slow enough that I could be taken to Alta Bates Medical Center in Berkeley.

At this point, the EMTs had me lie down on a stretcher (which seemed wholly unnecessary to me given that I was able to walk), and the ride leader said that he had talked to my father (whom I had listed as my emergency contact for the ride). The EMT relayed this information to me, saying, “You hear that? Your Dad’s going to meet you at the hospital.” I told him I was doubtful of this claim and explained that my father lived in Massachusetts. Shortly thereafter, I was loaded onto the ambulance and on my way to the hospital.

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