Showing posts with label bath county virginia. Show all posts
Showing posts with label bath county virginia. Show all posts

Wednesday, March 3, 2010

Motorcycling Memories: Oh Deer!, Eight; The Accident, IV

First published, Open Salon, MARCH 3, 2010 5:29PM


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[The University of Virginia Medical Center at Charlottesville. A teaching hospital with schools of Medicine and Nursing and Level One Trauma Center. Stock photo.]

This series is for Mishima666, who has waited longer than I promised he would.

The tease: June 24, 2005 Day Planner entry, after the fact: "Hit deer - totaled bike - ended at Trauma Unit, UVA Hosp, Charlottesville, 2 1/2 days - bad scene all around.

What you may have missed:

Part One: http://open.salon.com/blog/monte_canfield/2010/02/19/motorcycling_memories_oh_deer_part_one

Part Two: http://open.salon.com/blog/monte_canfield/2010/02/20/motorcycle_memories_oh_deer_part_two

Part Three: http://open.salon.com/blog/monte_canfield/2010/02/21/motorcycle_memories_oh_deer_part_three

Part Four: http://open.salon.com/blog/monte_canfield/2010/02/22/motorcycling_memories_oh_deer_part_four

Part Five: http://open.salon.com/blog/monte_canfield/2010/02/23/motorcycling_memories_oh_deer_part_five_the_accident

Part Six: http://open.salon.com/blog/monte_canfield/2010/02/25/motorcycling_memories_oh_deer_six_the_accident_ii

Part Seven: http://open.salon.com/blog/monte_canfield/2010/03/01/motorcycling_memories_oh_deer_seven_the_accident_iii

This is the final post in this series.

While I was not aware of it, the doctors must have been weaning the pain meds because I was beginning to feel a lot more pain once I was moved to the step down monitoring room, and I never again got to be watch the docs work on me while I was on the ceiling and they were on the floor. I kind of missed that.

I fell into a troubled sleep after they laid me on the bed, still on the board. I had the beginning of what would be with me for several weeks: weird, troubling dreams that caused me to wake in a sweat but which I could not remember other than they were dark and frightening.

A few hours later I woke and desperately had to pee. The nurse came in and said the catheter was working. But she took a look at the setup and said that the catheter was too small for the amount of fluids they were pumping through me. So I had a choice: pull this one and put in a larger one for some relief or live with the feeling of a constantly full bladder.

What a choice. Like most choices in the hospital it was no real choice at all. But she was pretty gentle when she pulled the smaller one and put in a much larger one. That hurt like hell for an instant but in minutes I felt relief.

I then insisted that they take me off of the spine board and the neck brace but the night doctor refused, saying that 'your spines are not cleared," meaning that radiology had not signed off.

I gave up arguing for then, had them elevate the head of the bed and fell back into a troubled sleep. Sue slept on the floor, exhausted. The next day we got them to bring in a roll away bed for her to sleep in.

In the morning, Saturday, I raised hell again about the board and brace and they went into the same song and dance. Finally, after they left I had Sue loosen the neck brace and the board straps without telling them and that helped some.

The Chief Resident of the step down unit came in around noon and I started my complaint all over again. The same answer came back: they were waiting for the Chief Radiologist to "clear my spines."

I blew up: "Don't tell me that in a 600 bed hospital with a Level One Trauma Center only one person in the entire staff has the authority to make that decision, and he isn't even in the building and may not be back until Monday! That is insane and can't be right! I want to speak to the Trauma Chief now!"

About an hour later, after I had told Sue to take off the neck brace, the Chief Resident came back in and said that 'your spines are cleared." If he noticed I was not wearing the neck brace he didn't say so. He and a nurse undid the straps, laid me on the side and removed the board. What a relief.

However, it was at that point that I realized that the outsides of both thighs, but mostly on the right side, were totally numb. I told Sue but did not tell the docs or I would have been right back on the board and sent back for more scans. I was and am convinced that it was laying immobilized on the board for 24 hours that caused the numbness. It took almost a year to get complete feeling in those areas, but they did recover.

By now the hematoma was really starting to hurt all the time and was beginning to harden on the edges. Within three days it would be hard as a rock. I was told that the rock hard feeling was "normal" and that it would soften in two or three weeks and be absorbed back into my body.

They gave me a dispenser button to push on my pain meds that afternoon and I quickly learned that it only dispensed what it wanted to dispense regardless of how many times you pushed it. So the pain in my shoulder, right big toe (which had a compression fracture of the joint and would forever be frozen immobile), and the hematoma just continued to mount.

Meanwhile I started the game of picking out the road rash gravel in my chest as it worked its way to the surface. This would go on for months.

Late Saturday afternoon they told me that I could go home the next afternoon if all continued to go well, and they saw no reason it would not. But how would we get home? We decided to ask my best friend back home, Jeff Stocker, to come and get us with my car and motorcycle trailer so we could get Sue's bike home and do it all in one long trip.

We called and as only a friend would do, he said "Glad to do it." Another angel, but this time not in disguise. We knew that about Jeff all along. I told him where to find the key to get into the house and garage, where to find the extra car key in the house, and how to hook up the trailer and its lights.

We expected him to arrive late Sunday afternoon, but he surprised us, left later that Saturday and stayed overnight in WVA, arriving just a bit after noon on Sunday.

Meanwhile, Saturday night I had to "go number two" and they gave me a bed pan. It was impossible and I gave up. I told them I wanted to be able to walk to the bathroom. They said "no" so when they left I had Sue lift my IV pole out of the socket on the bed and walk with me to the bathroom in the room. That worked. I was very unsteady on my feet, my broken toe hurt like hell, but it was worth it.

After Jeff arrived on Sunday and went with Sue to get Sue's bike loaded on the trailer I started putting pressure on the docs to release me immediately so we could get home that evening. Well, the same drill happened. The Chief Resident of the step down was off duty and they needed his approval to let me go. I went ballistic again. And the result was the same. Within an hour I was asked to sign the release.

I was getting the feeling that they were just as happy to see me go as I was to get out of there. I have always wondered how long someone would have to stay in a place like that if they were the quiet, mousy type.

When we started to get me dressed Sue noticed that I had blotchy rash areas pretty much all over and blushing areas that came and went. That would go on for weeks and we blamed it on the morphine getting out of my system.

But we learned when we got the bill from the hospital that when I arrived at the Trauma Center they had switched me from morphine to fentanyl, an opioid that is 75-100 times more powerful than morphine. And they gave me another opioid to take for the pain when I got home.

So for about a month I was still reacting to the opioids. Interestingly, I have taken opioids since and have had no adverse reactions to them. It must have been the strength of the dose that passed a threshold for me.

We got home Sunday night, Sue and Jeff taking turns driving, and nothing felt so good as sleeping in my own bed.

The next few weeks were painful. I continued to run a low grade fever for about a month; continued to have the blushing of my face, chest, buttocks, and legs; and, about ten days out started having my feet swell up and turn red in the evenings. Because they quit doing that after a couple of weeks I associated it with the opioids and perhaps it was. But it also could have been unrelated.

In any case we will never know but it could also have been the beginning of my erythromelalgia because I continued, off and on, to have the same phenomena happen after a few of the long, all day, rides we took when touring. The erythromelalgia began in earnest almost three years later in the Spring of 2008 resulting in my forced retirement for medical reasons. It continues today, with at least daily flares every night.

After about three weeks the hematoma was still the same size, still hard as a rock, and had turned to a fluorescent rainbow of colors. We decided to go to a local surgeon I like and have him take a look at it. He too had never seen a hematoma that large, agreed that it would soften at some point, and told me to come in when it started to do that.

At about the five week mark it started softening rapidly and I went in. He said it would take years to get that much blood absorbed so he drew off two huge 6" by 1 1/2" vials of the blood and told me to come back in a week. I told him we were going out of town for a week, so make it two.

When I went back in two weeks he drew off another vial of blood. At the next visit he said that the rest would eventually absorb, but that there would always be clusters of necrotized tissue in the area that would never soften. After almost five years you can still feel those lumps and there is still a tattoo of darker skin where the hematoma was.

Meanwhile, I was told that I should not ride a motorcycle for at least three months. After three weeks I saw an ad in the paper for a 1984 Honda Nighthawk 550 and insisted that we go look at is as a possible interim bike until I decided what kind of more permanent replacement bike to get.

Sue drove me to see it and it was a well kept bike at a good price, but my foot was still in a walking strap on cast and I could not shift. So I talked her into taking it for a test ride.

She could barely get her feet down because of the seat height, but, good trooper that she is, she rode it and said it was fine. We bought it, came back the next day with the trailer, and hauled it to a repair shop for new tires and brake pads, and a complete checkup, carb clean and synchronization, etc.

We got the bike back in a week. So, one month from the accident I was riding locally again, taking my foot out of the walking boot and gingerly putting on my boots. I stuck to the wide four lane roads.

Six weeks from the date of the accident I put a new wind screen on it, and added some old saddlebags. We packed up our seat bags and tank bags, filled the saddlebags with rain gear, tools and sweatshirts and took off for a 1500 mile tour of the western Lake Michigan towns in Michigan, above Holland.

We had a great time. Both bikes ran great. The little 550 cc Honda ran like a top, cruised easily at 70-75 on the interstates, and was an all around good bike. I was in considerable pain the whole trip but covered that as much as possible with Ibuprophen and decided that the joy of riding was far greater than the pain.

But I had nagging fears about deer for a long time. Going to Michigan was not bad because there were many fewer deer than around here. But our hilly, timbered, home county, Tuscarawas, is the deer capital of this part of the country. Every year more deer are harvested here than in any other county in Ohio.

Our deer are known to be some of the largest white tail deer in the country. Mountain deer like the one that ran into my bike are much smaller than our deer and crashes here, even with cars and pickups, can be deadly, and are.

So I was a bit paranoid that entire remaining season, even though I rode almost every day. The paranoia was particularly bad when I rode the narrow back roads in these hills that I love. But every time I rode I insisted that I challenge myself to ride those kinds of roads at least for part of the ride.

Little by little I got over my fears and started enjoying the freedom and sense of oneness that I have had all of my life with my bike, God's beautiful world, and the joy that is riding.

It took a season but by the next Spring I had arrived at a "new normal." Nothing would ever be the same, physically or emotionally. I had been through a lot and come out with far less damage than I could have.

I had endured a lot of pain that I thought would be the worst I would experience. I did not know then that the pain I felt would be small compared to the pain I feel every day now from my erythromelalgia and the related neuropathies and vasculitis associated with it.

My shoulder still aches now and then and gets easily strained when I am lifting something, the toe is still frozen and is larger than the other toe, and the hematoma has left its necrotic lumps, scars and discolorations. And I still am especially alert for deer when I ride.

But at age 71 I have learned a lot too. I have learned that as you age "new normals" are part of the way things work. I have learned that we have a choice: we can whine about it or we can get on with life and do the best we can with what we have to work with.

I have learned that there are angels in disguise everywhere in all situations of our lives and that if we don't see them it is because we are not looking. I have learned that there are competent people who care and who dedicate their lives to professions that allow that caring to be expressed.

I have learned that the reason God gave me my wife was so that I would learn that we are never whole until we can wholly give ourselves to another. And, I have learned that God sends guardian angels to take care of fools and Englishmen, just like the saying says. And I am glad that I qualify for that service.

Most of all, I have learned that life is precious, not to be taken as something owed to us or as a random act of chance, but as a sacred gift to be cherished and to be lived to the fullest.

Thank all of you for reading this series.

Monte

Friday, February 26, 2010

Motorcycling Memories: Oh Deer!, Six; The Accident, II

Published on Open Salon,FEBRUARY 25, 2010 5:28PM



[Monte after the accident waiting for an ambulance.]
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The tease: June 24, 2005 Day Planner entry, after the fact: "Hit deer - totaled bike - ended at Trauma Unit, UVA Hosp, Charlottsville, 2 1/2 days - bad scene all around."

What you may have missed:

Part One: http://open.salon.com/blog/monte_canfield/2010/02/19/motorcycling_memories_oh_deer_part_one

Part Two: http://open.salon.com/blog/monte_canfield/2010/02/20/motorcycle_memories_oh_deer_part_two

Part Three: http://open.salon.com/blog/monte_canfield/2010/02/21/motorcycle_memories_oh_deer_part_three

Part Four: http://open.salon.com/blog/monte_canfield/2010/02/22/motorcycling_memories_oh_deer_part_four

Part Five: http://open.salon.com/blog/monte_canfield/2010/02/23/motorcycling_memories_oh_deer_part_five_the_accident


When we are in a serious accident and realize we have mde it and are alive if we have strong personalities there is a tendency to think we are "over the hump" and everything is going to be fine. Our optimism gets well ahead of the reality. Our hope becomes certainty that is based on what we want. And we don't want facts to get in the way.

That, in turn, makes us impatient with professional medical personnel who are trained not to cater to what we want but to follow well established and proven procedures that both ensure no more damage is done ("First do no harm.") and that what appears to be true about the health of the patient is, in fact, true. ("Test. test, and then test again.")

This tension is inevitable when the patient is alert and opinionated. There are drugs that can help reduce that tension, which is good to the extent that they tone down the fantasies of the patient that insist that he can "walk out of here right now." It can be bad, however, when the drugs are used simply to control of the patient. Medical personnel therefore walk a fine line between doing what is right for the patient and what is convenient for them.


After I finally agreed to lay down it was decided that I should not get up again until the emergency services people got there to check me out. I didn't decide that; but it was easier to go along than to argue. Plus, I was starting to feel lightheaded and drained of energy.

The first thing the six of us, Sue, me and the two BMW riding couples, learned was that none of our cell phones could get a signal. So the first order of business was for someone to go find a phone and call for an ambulance. One of the couples set out to do that.

The blow to my chest had caused a hematoma that was increasing in size. It was continuing to bleed into the muscle and surrounding tissue. While I did not realize it would continue to get larger, we decided to try to get some ice to pack on it because it was hurting more and more.

While they were gone I was talking to Sue asking her what she had seen and what had happened to her while the wreck was going on. I was interested in this because had this happened two years ago we would have both been on the same motorcycle and both of us would likely have been badly hurt.

One of the reasons I had encouraged Sue to take the safety course and get her own motorcycle endorsement was because I had always feared what would happen to her in an accident were she riding with me.

She said that the first thing she saw was me on the ground sliding and the bike sliding along behind me. She did not see the deer run into the bike. Fortunately, I had taught her to not ride too close to me on tight roads like this one so that she would have time to react to something exactly like what happened.

She said she hit the brakes too hard and locked the wheels. That is usually very bad news unless the bike is fully straight and vertical and stays that way. Once you are in a slide on pavement the key is to NOT let up on the brakes until you are almost stopped and simply ride it out, keeping the bike straight and vertical.

If you release the brakes too soon the bike will almost always crash. She followed what she had learned and rode it out perfectly. The picture of the crash site in the last post shows the black streak she laid down after she locked the brakes.

Also, while we were waiting the guy who was still supporting my head on his leg told me that he and his wife and the other couple owned a BMW dealership in New Jersey and were also on the last day of their trip. They were also taking valley rides but had intended to ride only the larger, wider highways.

However, when they settled in behind us they found that they liked our pace and were enjoying the slower riding so they just decided to stick with us, even when we turned down the smaller road. He did say that I "looked like I knew where I was going." I said I did not, but knew where I intended to end up, and that this wasn't it!

After a few minutes the other couple returned having called 911 and said that an ambulance was on its way. Shortly after that a Game Warden who was in the area and heard the alert on his service radio pulled up in his truck.

He was very helpful, moved the deer off of the road and started directing the small amount of traffic that came down the road. By him keeping them moving we avoided a large crowd of onlookers gathering and getting in the way.

Some Granny Clampett type lady walked over from her farm and started telling everyone what to do and why and what she would do and why we should not ride motorcycles, and on and on.

At some point she went to look at the deer, came back and asked Sue if we wanted the deer! Sue said "no" so she went to make arrangements with the Game Warden to take the deer home and butcher it. I didn't even want to think about that but I do know that most states allow that.

It took the ambulance another 45 minutes to arrive. Looking at a map much later I could see why since the hospital was directly east from where we were and there was no direct cross road over the mountains. This meant that the ambulance had to ride 20 miles up to route 39, go across two mountains, across two valleys, and then turn down some 20 miles to us.

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[Stock photo of ambulance interior. Notice the orange "spine board" on the left wall.]


When the ambulance got there I was kind of out of it. The EMTs insisted that I not move. I protested, rather loudly, that if they would just help me onto my feet and be careful of my shoulder I could walk to the ambulance. That elicited the first stern "No!" of many I would hear over the next three days.

First they carefully put a neck stabilization brace on me.Then they removed my boots which caused my right foot to light up with pain. They then rolled me on my side and back onto a spine board and began to strap me into it from my forehead to my ankles.

It was at this point that I pointed out that I had a dislocated shoulder and to try to be careful of that. They looked at my shoulder and told me it was not dislocated. I said I knew it was no longer, because I had popped it back in place. They were very skeptical but one of the BMW guys said I was telling the truth and that they should have heard it! They became believers.

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[Stock photo of a spine board like the one
I would be strapped to.]

They started to put the strap below my shoulder across my chest when I went white with pain and said that it really hurt so they took a look at my chest. The hematoma was twice as big as it had been a half hour before. They were shocked at the size and concerned. Sue told them we had been putting ice on it and they agreed that was the best thing continue to do for now.

Their concern woke me up a bit and I think that was the first time I realized that maybe this thing was not quite over. So I quit arguing and they got me onto a gurney and into the ambulance. One thing, unrelated to the hematoma, that I did not know then is that I would spend the next 30 hours! strapped to the spine board.

Sue gathered up all of our loose items and put them in the ambulance. The BMW riders, whom we now considered angels in disguise, agreed to stay with the bikes until law enforcement showed up. After we left a State Trooper showed up and called a wrecker. He was told what hospital we were going to and told the wrecker driver to gather up both bikes and to follow him to the hospital where the wrecker could drop Sue's bike off.

Meanwhile, Sue rode in the front with the driver and two other EMTs rode in the back with me. I have little memory of the ride to the hospital. I don't know whether or not I was sleeping, or whether they put in an IV and had given me something to settle me down. I had been pretty uncooperative before they got me to agree to be strapped to the board.

In any case all I remember is the ride being bumpy and seeming to take forever. In fact it took probably 45 minutes or less. I was a bit more alert when they took me out of the ambulance and into the emergency room. Sue tells me that they would not let her stay with me saying they were going to do a lot of tests and meanwhile she should go fill out paperwork. I was told that we were at the Bath County Community Hospital in Hot Springs, VA.

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[The Emergency Room entrance at the Bath County Community Hospital, Hot Springs, VA]


[I later learned that the Bath Hospital was an acute and emergency care facility, tiny, with only 25 beds but equipped with trained emergency doctors and other personnel and had good laboratory and diagnostic equipment. All of the equipment and lab work was tied directly into the UVA Trauma Center at Charlottesville by telemetry so that the doctors at the Trauma Center could read the results directly although they were almost three hours away by car. So it was not the light weight facility I assumed it was.]

I really don't remember having the tests, but the bill says they did several CAT scans, head, shoulder, chest and spine and Xrays of my spine and my right foot. I do remember them bringing me to a small curtain enclosed area where Sue was and we talked a bit before she told me that based on the tests they were going to airlift me to the University of Virginia Medical Center's Trauma Center.

That did not sit well with me since I don't like to fly and surely did not want to fly in a helicopter over mountains! But Sue had already told the doctor that and he said that I should not worry they would give me some morphine before they loaded me on and I would be OK with the ride. I wasn't so sure but I was alert enough to know that if these preliminary tests indicated the need to airlift me to a huge trauma center I had better do it.

The final indignation was that, in order for me to be airlifted I had to have a catheter. Oh, joy! Some young nurse must have been doing it for the first time (she looked like she was about 13) and couldn't quite accomplish it. But she was very good at inflicting pain. I forgot all about my shoulder, my aching chest and my throbbing toe.

So some Brunhilde type that you would not want to meet in a dark alley came in to do it. By then I was wide awake and fearful. Well, Brunhilde slipped that puppy in there with so little pain I didn't realize she was done until she looked at me, smiled and said, "There you go." Another angel in disguise!

It was also the first time I realized that they had somehow gotten my clothes off of me and put me in a gown. How they did that then strapped me back to the spine board I have no idea. I remember none of that.

By then I could hear a chopper landing nearby and the doc came in with some nurses. At that point I also first realized that I had an IV line in. Whether that was done by the EMTs or by the folks at the hospital, I do not know. In any case the EMTs came back in with their gurney to take me by ambulance again to the chopper which had to land a few blocks from the hospital for some reason.

After they had me settled on the gurney the doc injected some morphine into the IV. I immediately noticed these blotchy red spots all over the arm the IV went into and these quickly spread. I also noticed that my tongue felt funny and I was getting kind of red all over. The doc was not watching so I told Sue who told him what was happening. He just said to her that "He really has to get to the Trauma Center."

He came over to me and said, "Look, you need to get to the Trauma Center. That hematoma is getting larger and we can't stop that here." Well, that was pretty powerful motivation for me and I just said, "OK. Thank you. We'll do whatever you say."

So he decided to give me some IV anti-allergic reaction medications and let me go. He told the EMTs to explain what had just happened and what meds he gave me. Then he turned to me and said, "Good luck. You should be fine. But you must do this to insure it." And they wheeled me out.

END OF PART SIX

Next: The Chopper Ride: "I didn't know that hallucinations were part of the morphine package." "Hurry up and wait." or "There is always someone worse off than you are." And, test, test and test again."