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.  :-} 

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