Tag: accident

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The One with the Subarachnoid Hematoma

Summary

On Thursday, October 8, I fell while mowing the lawn. I hit the back of my head on the sidewalk. I was unconscious for a short time. Tina drove me to urgent care and then to the Emergency Room at Portland Adventist Hospital. A CT scan showed a small subarachnoid hematoma had occurred in my occipital lobe. I was transferred via ambulance to the trauma and intensive care unit at OHSU where I stayed under observation for 24 hours. A second CT scan showed no additional bleeding and I was eventually released after one full day in the hospital. It’s now a few days later and I feel better. I still feel the effects of the injury but I can tell it’s getting better.

Details

October 8, 15:56, home

  • I was mowing the area in the red box where the lawn meets the sidewalk.
  • Bricks are laid sideways by the sidewalk.

I was mowing the section of lawn shown above in the red box. Where the lawn meets the sidewalk there are bricks laid sideways to form a border. The bricks are approximately 2-3 inches higher than the sidewalk. I was mowing diagonally from northwest to southeast with the distance continually getting shorter. As I finished up the section, I did not pay attention to where I was stepping. I must have stepped backwards and placed my foot partially on a brick. I Iost my balance or twisted my ankle or both. I fell backwards and the back of my head hit the concrete.

Everything went black but I was still aware. I could hear some boys down the block shouting to my next door neighbor, Bobby. I knew I had injured myself. My hands were tingling and it felt like they were raised in the air. I tried to lay them down but I couldn’t move. I also couldn’t make my eyes open.

After Bobby and the boys arrived, I managed to force my eyes open but I still couldn’t move. I might have told them that I was OK but I wasn’t. I sat up and felt the back of my head where it hurt – there was no blood which I felt was a good sign. Bobby sent one of the boys to the house to get Tina. He told her I had been “knocked out cold” when she came to the door.

16:00

By the time Tina came out, I felt the back of my head again and noticed my fingers were wet with blood. There was a brief discussion about what to do before I lurched to my feet and walked towards the house. I immediately noticed an unsteadiness in my gait. I also noticed a pain on the inside surface of my right ankle that extended 4-6 inches up my leg.

Once inside, I sat in my chair to recover. I noticed that when I moved my head and then stopped, the world seemed to keep moving as if my head was still moving. I decided I would need professional care.

16:19, Legacy-GoHealth Urgent Care

We departed for urgent care and arrived 10 minutes later. After a short wait, they informed us that they did not take head injury cases. We departed urgent care 8 minutes after we arrived.

16:49, Adventist Health Portland, Emergency Room

Twenty minutes later Tina dropped me off at the Emergency Room. Only patients and caregivers are allowed in the waiting area so I went in on my own. I described the incident to the receptionist and she told me to take a seat in the waiting room. There were a limited number of chairs and they had been arranged per social distancing guidelines. I settled into one where I waited for the next 90 minutes. Since she wasn’t allowed inside, Tina drove to 7-Eleven to get a snack for me.

17:58

Tina returned from 7-Eleven with white chocolate M&Ms, a favorite. I decided to save them for later especially since eating with the mask promised to be awkward. As I waited I noted that I could feel blood drops falling on my shoulder occasionally. I also grew a little chilled. I was dressed in a t-shirt and shorts. There was a fireplace a short distance from where I was sitting, but all the seats near it were occupied. As time wore on, I grew increasingly uncomfortable sitting in the chair but I did not feel confident in walking. I noted that my shoulders and the back of my neck were sore.

18:36

A triage nurse called my name. I went to the triage area and described the incident. Soon they whisked me away for a CT scan for my head and X-rays for my ankle. Ten minutes later, I was back in the waiting room but now the fireplace chair was available so I took it. I also took the opportunity to eat some of the M&M’s, raising my mask each time I ate a few. I inadvertently spilled some during one of these maneuvers but knew that I couldn’t risk picking them up.

19:03, Consult Room 8

I didn’t have enough time to finish the M&M’s before I was called back again, this time to a “consult” room where Tina was finally allowed to join me. They had me remove my shirt and put on a hospital gown. They also put in an intravenous line in each arm and treated my head wound, all at the same time. The vein they chose in my right arm was “blown” so they had to redo the IV in that arm. Because of the soreness in my neck, they put me in a cervical collar as a precaution. All of this was being done because the CT scan had shown that I had a small subarachnoid hemorrhage which could require surgery if it got worse. They were preparing me for a transfer to Oregon Health Sciences University Hospital where the Level One trauma center provides exceptional care for traumatic brain injuries.

19:36

Text message to my family: “I’m ok. Everything is precaution.”

19:52, Ambulance Bay

My ambulance attendant, Levi, explained that it would take about 15 minutes to transport me to the OHSU emergency room. When I arrived, he said I should be prepared for a massive number of people swarming around me because OHSU is a teaching hospital. He also explained the different procedures I should expect. After he was done, I joked that there was no way we were getting there in 15 minutes. His reply: “We will use the lights.”

20:04, OHSU, Emergency Room

19 minutes later they unloaded me from the ambulance and rolled me into the ER where everything happened as he had explained. There were least 20 people in the room with me. At one point somebody asked if I had taken aspirin that day to which I replied, “Every day!” That really changed the mood in the room because aspirin is a blood thinner and made me a “big three” which I assumed is a risk level assessment. After a bit of debate, they decided to “roll” me to examine my spine because of the neck and shoulder pain.

21:16, ER room 26

After the initial kerfuffle, they moved me to my own room temporarily until I could get a bed in the ICU. My nurse assured me that it would be soon but the conversation he had in the hall before he came in said otherwise. Tina was allowed to visit during this time and she brought a bag of essentials including my CPAP machine which allowed me to doze a little. Once an hour they would wake me for a neurological exam that included answering questions, performing simple actions with my feet and hands, and a pupil examination. I became increasingly uncomfortable because I had to lay on my back and did not have any pain meds until just before they transferred me to the ICU.

23:37

First pain meds, dilaudid, delivered

October 9, 01:30 (approximate), Richard J. Mullins Trauma and Surgical Intensive Care Unit, Room 17

A bed finally became available but visiting hours were over and Tina had to go home. After I was transferred to the ICU, a team of nurses put me in a different bed and made me much more comfortable for the duration of my remaining stay. I also got a second CT scan at this time. I dozed some but would wake for the occasional neuro exam. Each time I requested that they plug in my CPAP but that needed to be approved from someone from respiratory. The blood pressure cuff on my left arm would inflate every hour to the point of nearly unbearable pain. I had less painful cuffs on my lower legs that would alternately inflate and then deflate. As I dozed if felt like one of our cats was snuggling up to my leg.

05:41

The second CT scan showed that the hematoma had not grown which means I would be released around 18:00. I had slept some but without the CPAP I do not sleep well. A nurse asked me if I was sore and I told her my throat was quite sore from snoring and can I please use my CPAP? She hooked it up and said “it was like this when I came on shift.”

10:21

“Sitting up and eating an omelet” I reported to my family via text message. It is my first food since the M&M’s more than 12 hours ago. Sitting up made me very dizzy and so nauseous that my mouth started watering as if I was going to throw up but it passed.

Omelet tasted delicious

12:30

My doctor concluded that there is no neck fracture and they remove the cervical collar. I also noticed that the giant “goose egg” on the back of my head has receded completely. The wound itself is an abrasion and did not require stitches. It does hurt and they give me occasional pain killers for it.

13:18

14:13

I moved from my bed to an adjacent reclining chair. I enjoyed a very bland meal of macaroni and cheese, spaghetti squash, a dinner roll and orange slices. I tried to order cheese cake but they said that it exceeded my carb allowance. I remained in the chair for the rest of my stay except to take a walk in the hall with a physical therapist who cleared me for release. My ankle hurt during the test but x-rays are negative for a fracture.

14:35

I passed the cognitive ability test with flying colors and will be released that evening. Estimates for release vary from 18:00 to 20:00.

19:14

Home with prescriptions for Tylenol and oxycodone. I took the week off from work. The healing begins.

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The Fall

It’s 5:36 on the morning of January 31, 2018. I had set an early alarm and am walking out the front door of our house looking at the sky. The security footage shows me linger on the sidewalk in front of the house for several minutes before turning south to climb the hill to the end of our street for a better view of the cloudy sky.

10 minutes later the camera shows my return – carefully walking across the front yard holding my left forearm stiffly in front of me with my right hand. At the front door I try the doorbell three times before finding a way to open the door with my feet.

The inside camera doesn’t catch my entry through the front door but it is activated when I walk through the kitchen and come to rest at the dining room table, forearm on the table. A few minutes later Tina appears and I shuffle out the front door for our trip to the emergency room.

As I watched it for the first time, I was surprised at how little of the pain was visible in those silent images. There is just one moment as I wait for Tina to respond to the doorbell that I throw my head back wailing but the moment passes quickly.

It was a futile quest. Typical Oregon clouds blocked any view of the rare super blue moon eclipse. Even before setting the alarm I knew this was likely but I thought it was worth a try and it was only one hour earlier than I had been waking recently.

As I hiked up the hill I remembered the numerous times this climb had been difficult and now it was easy. When I got to the top, I walked to the next street over and scanned the sky. Nothing. “Where should I be looking?” I wondered as I turned around and began walking back. I pulled up the web browser on my phone as I formulated the Google search phrase in my mind. Before I could type it, I stepped off the sidewalk and into a world of pain.

It was the curb strip and it was landscaped with lava rocks. I was laying face down and my left arm hurt a lot. I lay there moaning and swearing for a bit before attempting to get up. However, when I pushed up with my left arm, I felt no resistance from the ground. Confused, I looked up at my forearm and was surprised to see it was laying at a different angle than it “felt.” Instead of facing the ground, ready to push off, it was laying at a 45° angle the other way and on the other side, a position that is normally not possible because the shoulder won’t rotate far enough. I knew then it was bad.

More swearing and lots of self-recrimination (“Stupid, stupid, stupid!”). My phone was within reach so I called Tina who was still sleeping at home. It was 5:39 when I made the first call and 5:40 when I gave up after the third. I briefly considered a FaceTime call but abandoned that idea when my phone told me I had disabled it for cell data.

I needed to stand and I needed to walk the four blocks back to the house. I needed to keep my arm from flopping while I walked. Once I got to the house, I knew Tina could take over and make the remaining decisions such as whether we should go to urgent care or the emergency room.

I gathered my wits, grasped my left wrist with my right hand and lifted my left arm off the ground. I lurched to my knees, carefully centered my gravity and then stood. “Yes. Good. Ok. Ok.” I muttered as I turned towards home, eyes fixed on the ground immediately in front of me for fear of another misstep.

I had only taken a couple of steps before realizing that my sweat pants had slid down and would be a problem for walking. Except neither hand was free to pull them up. A nearby hedge was just the right height to temporarily rest my bad arm and pull up my pants with the good one.

Half a block later the problem arose again and I looked for a new arm rest. The problem with pulling up pants one-handed is that it is very difficult to pull up the side opposite your hand properly. I managed to get the waistband completely over my left buttock this time and was soon back to walking slowly and muttering encouragement to myself. “Just a little further. Almost there. We got this.” (Yes, I refer to myself as “we” for conversations in my head.)

Halfway home and I realized I was not wearing my glasses. I did not consider turning back to retrieve them. The thought was preposterous.

When got home I knew that I had to be especially careful crossing the yard. If I fell again, it could be disastrous. I walked very slowly and very carefully across the grass, feeling each step fully before shifting my weight forward. I tried the doorbell but Tina was fast asleep so I opened the door with my foot and walked inside yelling Tina’s name.

I went to the bedroom and she still lay in bed undisturbed. I sat on the edge of the bed by her feet, reached over and shook her. I waited for her to rouse and remove her earplugs before saying, “I fell and may have broken my arm. You have to take me to the hospital.” It took her a few seconds to realize what was happening but then she got out of bed and started dressing.

I wandered out to the dining room where I sat at the nearest chair, rested my injured arm on the table and began sobbing uncontrollably. I knew that I had done what was necessary to get help and now I could trust others to take care of me. The entirety of my situation came crashing down and I collapsed underneath the weight. My whole body shook and all my recent failures flooded my consciousness.

I closed my eyes and tried to focus on my breath, a technique used in mindful meditation. Time crawled. Soon I began wailing “What is taking so long?” over and over. The pain was immense and I knew it was not ending any time soon. Aside from the pain, the visceral feeling of danger felt like an existential threat. I was completely in fight-flight-freeze mode and all rationality had been suspended.

Tina came out and began reassuring me. She helped me out the door and into the car. She drove to the scene of the accident to retrieve my glasses and then on to the emergency room. The fifteen minute drive to the hospital seemed to take an eternity but I was calmer by this time and tried intermittently to focus on my breath again. It seemed to work but when I opened my eyes, we were hardly any closer than when I closed them. The swearing and self-deprecation continued throughout. I also came to realize that eventually I might be faced with even more pain while my arm was being put back into place.

Tina parked near the emergency room entrance in a handicap spot and put her placard (which she keeps in her purse) on the dashboard. The waiting room was relatively empty when we arrived and I was admitted immediately. After standing in the admission office for a few minutes (I was afraid you sit because I didn’t know how hard or painful rising from the chair would be), we were walked to a room with a bed on which I sat to be evaluated.

It was quickly determined that x-rays would be needed. I was offered a wheelchair but I declined, still fearing the painful consequences of standing from a low seated position. We walked to the radiology room just outside of the ER where they thankfully had a downward facing projector which allowed me to rest my arm on the detector pad.

My actual x-ray

The x-rays showed that I had suffered a “simple dislocation” of the elbow which essentially means that there were no fractures. Obviously, that was good news but I knew that the possibility of more and greater pain lay ahead during the reduction maneuver that is used to restore the elbow to normal alignment. When the doctor told me that I would be “under” for the procedure, I immediately told him that I loved him. I was only half-joking.

When I awoke from the anesthesia (propofol), my arm was in a splint and a sling. When we checked out a short time later, the pain was considerably less and the events of the morning already felt like a fading memory.

It is now two weeks later during which time I have worn two splints and a brace but now my arm is free again. Physical therapy starts next week.

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Evening Bike Commute

Distance: 19.3 miles
Riding time: 109 minutes
Max speed: 32.6 mph
Average speed: 10.6 mph
Temperature: 75º
Soundtrack: Science Friday
Route:

  • Alder to 1st
  • 1st to Salmon
  • Salmon to Hawthorne Bridge
  • Hawthorne Bridge to Springwater Corridor
  • Springwater Corridor to Powell Butte
  • Various trails over Powell Butte to 162nd
  • 162nd to home

What a glorious sunny afternoon to ride my bike the long way home. It was a tremendous effort to climb Powell Butte – one that found me laying down, gasping for breath on the side of the trail at one point – but it was well worth it. On my way down the north side of the Butte, I wondered how hot my brake pads were getting. My rims were plenty hot when I got to the bottom and as I touched the front rim, I heard the distinct sound of air leaking from the front tire. At least it didn’t blow out when I was flying down the hill at 35 mph.

It took me about 15 minutes to pull the tube out and install my spare. I was actually pretty refreshed when I got back on and pedaled towards home. How surprised was I when I came upon this at 162nd and Division:

The picture is pretty blurry (you can click on it to get the full-size version), but it’s a car that had run up a telephone pole and came to rest in a vertical position. Somebody at the scene reckoned he must have been going 100 mph or better. I asked around and they said it had happened about 15 minutes before.

Now picture this: me in the bike lane at that moment had my bike tire not gone flat 15 minutes before. Freaky, huh? More pictures on my Flickr page.

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Once bitten, twice shy

Yesterday morning it was so nice outside that I decided to skip the Max and bike the entire way to work. I felt great and it was an awesome ride until I dismounted at the curb 30 feet from our front door. At some point after my right foot touched the pavement, I felt a little “pop” in my right calf and thought to myself, “Uh oh, that’s probably going to hurt.” Here’s the normal sequence of events for a dismount:

  1. Stand up on left pedal
  2. Swing right leg behind the seat
  3. Touch down right foot
  4. Touch down left foot

What’s weird is that I didn’t feel any pain until after I tested that initial thought. That means it probably happened as I was putting my left foot down. Once I put a little weight on my right foot, yow! I nearly fell over from the pain. Luckily, I had my bike there to brace me and hold me up. I hopped a few steps towards the door before trying it again, thinking it might just be a cramp that will fade away. No such luck. Still incredibly painful.

Eventually, I made it to my office where my friend, Erik, recommended icing it immediately. Luckily, we had a large ice pack in the freezer already and I wrapped it around my calf with an Ace bandage. It was very cold at first but after awhile I became absorbed with work and didn’t think about it. Over an hour later, the ice pack was mostly warm so I took it off so I could refreeze it for later re-icing of my calf. Strangely, the skin that had been beneath part of the ice pack was red, very hard to the touch and felt like it was a coupld of millimeters thick. It softened up in a couple of minutes, though, and I went on about the day.

My evening commute is nearly all downhill so I had no problem with my bike except stopping and dismounting, which I had to execute differently to avoid stretching the calf. After we got home from Thomas’ spring concert, I rested on the couch with my foot in the air. At that point there was still redness where the ice pack had been and there was pain similar to sunburn on the skin. I began to suspect that I had frostbite.

This morning Erik, who claims to have seen cases of frostbite, confirmed. This article says to never ice for more than 20 minutes at a time. The area is still red and feels lumpy in a few areas. I called the advice nurse at my doctor’s office and left a message. I suspect I’ll need to go see my doctor for the frostbite. The calf feels better already and I think I’ll be back on my bike on Monday.

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Walrus gumboot

Tina’s mom’s surgery to reattach her right index finger was successful. The accident also cut off the tip of her right middle finger, but they were unable to save it, but they contacted a injury lawyer from https://www.fieldinglaw.com/dallas/personal-injury-attorney/ to help with this. Tina really wanted to drive down to NM for Thanksgiving, but fate conspired to keep that from happening.

After Graham served his suspension Wednesday morning, he returned to school that afternoon. However, that night Tina woke to the sound of him vomiting in the bathroom. He stayed home sick Thursday, vomited that night and then stayed home from school Friday, too. Because it was very cold and windy, he also had to miss football practice and his last possible game yesterday. His team has another game next week, but we’ll be out of town at Tina’s Grandma Ruth’s funeral. He’s feeling much better today, but they don’t have school all of this week.

Tina got sick Friday night and has been resting and puking since then. She’s starting to recover and eat today, but she’s still weak. There’s no way we could manage a trip to NM now.

Thomas and I have not gotten sick yet. We both braved the wind and cold yesterday for his last football Saturday until next season. It was trying, but we both made it through. I was chilled all day after we got home, though. Winter in Oregon sucks!

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It pours

Today’s lone news was going to be about fixing the long-plugged toilet in the boys’ bathroom with my new closet auger last night, but that pales in comparison to the news from this morning and this afternoon.

Tina’s mom cut off one of her fingers in a table-saw accident. She’s scheduled for surgery on another finger tomorrow or the next day. We may drive down to NM next week to visit them and help out.

Graham was suspended from school today. He and a football teammate received a half-day suspension for fighting during recess. Details are still forthcoming, but the suspension will be served tomorrow morning.

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Hard drive blues

Thomas’ hard drive on his computer (my old Beige G3) went south quite awhile ago. I thought I had successfully copied everything from it last weekend onto another drive, but I couldn’t get his computer to boot with that drive. I thought there might be something wrong with that drive so this weekend I did some more drive swapping in order to get Thomas another drive. Here’s where things stood before I started:

  1. One 80 Gb drive in my computer is my startup drive
  2. One 80 Gb drive in my computer is a data-only (non-booting) drive
  3. One 30 Gb drive that was “laying around” that I had tried to make Thomas’ new drive but wouldn’t boot
  4. One 160 Gb new, unformatted drive

It’s really easy to swap drives in and out of my computer and it can hold up to four hard drives at a time. Because of that, I have been doing all the work there. One of the drive mounts is vertical and is held securely by a single screw. Almost every time I remove that screw, it falls between the hard drive and the mounting sled. Usually, I just turn the mounting sled upside down and the screw falls out. This time I forgot to do that and it evidently shorted out the hard drive circuit board next time I powered up. It took me a while to figure out what had happened since the only symptom was that my computer wouldn’t boot. When I realized what had happened, I switched focus back to installing Thomas’ new hard drive so that I could feel somewhat successful on the day. Alas, the same problem occurs there as the previous hard drive – the computer won’t recognize the drive as a boot drive. Failure there. After all my efforts, here’s what I had left:

  1. One 80 Gb unbootable and probably unreadable hard drive
  2. One 80 Gb drive with Thomas’ stuff on it that won’t boot in his computer
  3. One 30 Gb drive with Thomas’ stuff on it that won’t boot in his computer
  4. One 160 Gb drive presumably with my carbonite offer codes on it
  5. Two computers that won’t boot

I suppose there’s nothing wrong with the 30Gb drive so I’ll continue to work on getting that to work for Thomas. I’ve got a week-old backup that I can restore to the second 80Gb drive, but I really don’t have a drive I can boot with now. Perhaps I’ll boot with Thomas’ 30Gb in my computer until I can restore the 80.

Sometimes I really, really hate technology.

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Vital Statistics

Thomas got his hand slammed in a neighbor’s car door on Friday and had to go to the doctor. All is well but dealing with the neighbors has been difficult. Tina talks about it here.

Current reading: Paul McCartney: Many Years From Now by Barry Miles
Recent listening: Zoe’s Radio Show, DrugMusic, Blast Tyrant/Clutch
Recent viewing: Olympics: curling, ice dancing, men’s hockey
Recent playing: Halo (finished)
Imperative To Do: Pinewood Derby: Sand and repaint, rebates