Thursday, December 20, 2012

Busted Down On Cambell Street

After the obligatory week of post-Ironman indolence, I was looking forward to hopping on the ol' mountain bike and cruising back and forth to work.  Before leaving for work on 11/26 just after Thanksgiving, I pumped up the tubeless tires and got everything ready to go.  Tubeless tires had been a recent add-on, and they seemed to be doing OK, despite an irritating propensity to go flat over several days.

Cranking down the hill felt good.  The suspension was feeling loose and bouncy, even when I shifted it to/from fully locked mode.  Had I looked the bike over thoroughly, I would have noted that this was not the suspension, but the front tire, which was quickly flattening. 
A small thing, in hindsight.  But when I turned off Campbell Ave. to go into the hospital, the front wheel, and the whole bike, slipped quickly out from under me, and I went down hard on my right shoulder and hip.  It was a hard enough fall to knock the wind out of me, and I had a feeling something was wrong immediately.  I've had broken bones before, and I immediately recognized the electrical bone reverberation sensation that went with a fracture.  I did a quick head-to-toe, dragged myself and the bike to the curb, and tried to stand.

No go.  Immediate, breathtaking pain in my right hip.  When I examined it, my hip and pelvis were not acutely painful, but the area over the greater trochanter of my right femur (where the top of the leg bone pokes out) had some good "point tenderness," which is frequently associated with fractures.  My shoulder was also sore, but it seemed pretty minor in comparison to the hip pain.  I called work, then Karen, who called 911.  A couple of women pulled over and helped.  I had begun shivering, and one got me a blanket.

Silently, I decided to be done with Tubeless tires.  I know they're cutting edge, but this is one gimmick that just didn't bear fruit for me.  Back to plain old, predictable slime tubes.

Tucson Fire Department loaded me up and took me to the ER at work.  I was seen quickly, and my anesthesia colleagues popped in an IV.  Here's the initial X-ray:

Diagnosis: Right Femoral Neck Fracture, nondisplaced.  FWIW, Throckmorton's Sign was negative.  I also had a second degree acromioclavicular joint separation in my shoulder.

I got some pain meds, an epidural, and had it operated on by Dr. Jordan Smith.  The procedure was done under epidural only, which wasn't too bad, until the epidural wore off.  Transitioning from epidural to pain meds was quite unpleasant.  I stayed one night in the hospital and left the next day on crutches, or as our 4 year old called them, "crunches."  :-}

Post-surgical film on fluoroscopy
Initially, my prognosis was 8 weeks of "toe touch weight bearing," but the nondisplaced nature of the fracture, the rapid improvement, and the solidity of the repair got me upgraded to advancing from 0-100% weight bearing on postsurgical weeks 1-4.  I've been able to spin, swim (now with kicking), and do pilates.  Weight bearing is up to 75%, now three weeks post-fracture.

Unfortunately, I won't be running for 3-6 months, or biking the Kona Ironman course when we're there for a visit next month.  It's heartening to see improvement, and I'll be back to work when we get back from vacation.  But my whole next season just went from race planning to rehabilitation mode.  IM 70.3 St. George in May and the Tucson sprint series in March and July will likely be aquabikes.  I've qualified for Olympic Distance Nationals in August, but won't make the trip for a less than complete effort.  If all goes well and I dodge the 20% risk of avascular necrosis (which would lead to a hip replacement), I have a pretty good chance of being able to complete IM Arizona this November.  If not, I will aquabike it too.  Unless I'm getting a new hip.

So it goes.  Life is what happens when you're making other plans.  A bike accident sure could have been worse.  The long perspective is that this is more than likely just a bump in the road, and in the interim, life is still awesome in all measurable dimensions.

Oh, and I never would have watched the first four seasons of Sons of Anarchy.  Can't wait until Netflix gets season five.  :-} 

1 comment:

  1. Hip fracture in an triathlete 61 years old (anaesthesiologist) after a bike fall


    If I can help someone I commented my process of recovery after hip fracture by fall of bike 2 weeks ago t

    1. incredible the encouragement and the support of so many friends that some even knew. This is critical to the long and hard process that I face
    2. In the absence of scientific evidence that should be in a process such as this, given the limited scientific data available, I have prepared a rehabilitation plan with the Group of professionals and friends that are treat me, based on a very active/agressive and early rehabilitation in the belief that mobility is the basis of the recovery and the immobility it is the cause oh the failute
    3. This plan is far away of the conventional treatment of hip fracture and therefore nobody should follow it without an appropriate medical supervisión
    4. I tackle this period with the best of spirits and the highest positivity. Forgetting what happened.

    6. Very balanced and with a minimal restriction of food and proteins on which I do during training and supplemented with amino acids, vit D, calcium, Curcumin, omega-3, multivitamins and glucosamine
    7. from the 4th day of the operation walked with crutches with little support, I'm progressively, increasing today load 20 kg and walk with triple and double support alternative with crutches.
    8, Sessions of physiotherapy in the morning and evening including: 4 hours of magnetic therapy, muscle neuroestimuacion, gymnastics of uncommitted muscles, therapy proprioceptive Fendenkrais, bike static progressive periods, today 20 min, and tomorrow I start swimming and aquarunning.
    The medical tests all OK: Rx split stable, densitometry above normal, correct bone metabolism and scan with good supply blood to the femoral head and good at breaking osteoblastic activity. Absence of pain.

    10. The inconvenience of a sprain of the acromioclavicular joint which I am not doing him much attention and also hurt me crutches. I'm just treating it with taping and massage and it is slowly improving

    According to my observations, I go with 1 month in advance on the usual recovery, I wish I can go on like this and reduce delays, something that is not my main objective, which is a complete recovery of the hip in the period that is necessary

    On 1-4-14

    1 I started to walk without crutches (with 2-3 months in advance)
    2 continuous intensive rehabilitation: proprioception (Feldenkrais exercsises), swimming pool, bicycle static, elliptical and gym
    3 sessions of daily global gymnastics
    4 sessions of daily stretching
    5. daily magnetotherapy sessions
    6. Feelings very positive and waiting for the RX for control of day 10, looking forward already to start running

    densitometry, metabolism of calcium, control RX are perfect
    1. Very good sensations. Intense rehabilitation program and the moral high
    2. The weight remained as the previous fracture. The same diet: much protein, calcium, vitamins and vitamin D, more Curcumin, omega 3 and 4 amino acids.
    3. Magnetic therapy daily
    4. Intensive muscle gym, pool, bike and elliptical maintenance program.

    I copy the "trainig" of these 2 last day
    Tuesday: morning: 30 km in 1:30 h MTB + stretching. Evening MTB 6 km + massage and stretching + MTB 6 km
    Wednesday: 5 km MTB + 30 min elliptical 5.5 km 118 fc) + 5 min in reverse + weights and focused general gymnastics in leg 45 min session + swiming 30 min + aqua running 30 min + MTB 5 km

    So very happy, shortening deadlines head with prudence but with decision, and without fear. Consistent with my idea of rehabilitation through movement.