20 August 2014

Musings on life when things take an unexpected turn. This may be quite long, but it tells the full story of the crash and where my recovery has gotten too – read on if you have time and interest…..

So. Five weeks ago all was good. I was fit and healthy. Really enjoying riding my bike and the occasional race. Very happy to be playing in the garage building bikes and calling it ‘work’.

Things are a little different right now. I am very lucky to still be alive (which is what I try to tell myself when the pain in my hand has me sobbing uncontrollably), but my life is on hold and between the injuries and the drugs, I no longer feel like myself.

Twenty years ago, at age seventeen, I had a bad bike crash – bad enough that to this day I don’t recall what happened – despite apparently being conscious throughout, I have lost about three hours of memory. Fortunately, at that age you bounce back pretty quick, even if I needed a little plastic surgery to put me back together. Thank you National Health Service (there are some advantages to growing up in the UK). Since then, I have inevitably had the occasional tumble, minor broken bone and scrapes and bruises, but considering I ride around 10,000 miles each year, statistically I’ve been pretty safe. And yes I do like to ride fast. But those teenage years of crashing mountain bikes taught me good handling, so these days, riding mostly on the road, I have been a competent, confident bike rider. Generally one of the better (if faster is indeed better…) descenders among the local riders.

But unfortunately all it takes is one moment of slightly bad judgement. A little too much speed. Not quite enough confidence on a wet road. No prior experience with a new set of carbon rims in the wet. And suddenly, in a few seconds, everything changes.

I was in the lead group of six at the Tour of Auferheide, a 100 mile, out and back course on a beautiful scenic byway. These Fondo style events are great – kind of a race, but more a chance to ride fast with friends. Actually, this was the first time we’d had all four of the English Cycles race team members together, which was really fun. July in Oregon should be lovely and sunny – but this day we were greeted with thunderstorms and thus wet roads. And I’d never ridden this route before. All was good until the return descent on the out-and-back course. My teammate Lee had been gapped over the top, so I’d dropped back a little to ride him on – this meant I was accelerating as we came back up to the rest of the group, and having fun on the downhill I coasted past, coming up to the lead rider just as a right hand bend approached. This is where it went wrong. I think I tried to scrub a little speed (I was doing more than 40mph), but in the wet nothing much happened. So I drifted a little wide, but the corner tightened and I was out of road and out of options. When you’ve been riding and racing for almost 25 years your reactions are pretty good. So I can recall looking for an exit strategy, somewhere for the bike to run out, somewhere soft to land. But I came up with nothing except for the thought: ‘this is going to hurt’. I went into the grassy ditch by the side of the road, the front wheel dug in and I went over the bars to slam into a tree, upside down, with all of the momentum and energy of 40mph being dissipated in that impact. I took that force in my left scapula and rib cage, then fell straight down on to the top of my head, where my helmet nicely absorbed the drop. No concussion, no headache – although perhaps being knocked out might have been preferable. I was lying in the undergrowth where I had fallen, gasping and screaming. Lee was the first to me, having stopped as fast as he could and turned around, but more help was needed rapidly.

This is where things were fortunate – there is no cell service out there, the organizers had ham radio operators at various points, but getting major medical help was going to take time (the ambulance got to me after about an hour and three quarters). Another EC rider, Andrew, was in the group just a few minutes back, and immediately stopped to help – I didn’t actually know beforehand that he was previously an EMT. And soon after that, another rider stopped who is a current EMT. I owe both these guys a lot – they checked my neck and spine and were able to reassure me that I hadn’t broken my back. Which meant I could then be moved a little to get me off the various logs I was lying on. At this point I was just wearing wet lycra, and it wasn’t as if anyone else had much clothing to cover me with. But apparently the fire chief had been out cruising the course, and he had a shock kit with heated blankets and oxygen, which likely saved me from a bigger physical crisis before the ambulance finally arrived.

Which meant I had to be moved onto the stretcher. Hugely painful. I think I was moved three times between forest floor and hospital bed, and everytime I can recall yelling ‘no no no no no’. Not fun. In the ambulance they put an IV in and gave me some pain killers, and the long drive back to Eugene wasn’t too bad. Despite folk from the race being able to call Misha so she was waiting for me when I got to the hospital, somehow the ambulance hadn’t been able to radio in that they were on their way with me. So I was wheeled in, lifted over to the new stretcher, and someone started taking a look at me. Then things got a little crazy as suddenly nine medical staff descended upon me, and I was taken to the trauma unit. It seemed like several hours of x-rays, scans and other doctoring, before I was moved (‘no no no no no’) for the last time that day, into a bed in the step-down unit (one step down from ICU – I think ICU was full at the time).

At some point I was told what damage I had done. Of the 13 ribs on the left, I had broken 12 of them, most in multiple places. My clavicle was broken. My scapula was broken in several places. My elbow was fractured. Very fortunately, my internal injuries were relatively light – bruised lungs with just a small puncture in the left one.

I recall very little from that first night. I assume I was on quite heavy sedation. And my recollection of the order of events may be a bit off, but I think the next day they decided to put an epidural in, to relieve the rib pain – I needed to be able to cough to clear out the blood from my lungs. With this I also got a catheter, so no need to worry about peeing. At some point two nurses gave me a sponge bath – badly needed having been a sweaty bike racer 36 hours previously. The orthopedic surgeon came to talk about my shoulder. They decided to pin my collarbone back together, and to do it soon because there wasn’t anything really giving that side of my torso any stability. This is where it all started to get rather scary. I went down to surgery, and was given a nerve block, and then anesthetic for the operation. The next thing I knew I woke up with an oxygen mask on, looking at oxygen saturation levels on the monitor that weren’t good – this needs to be above 90% and I was down in the 80s. The mask was a forced flow, which (I discovered later when I had one that actually worked as intended) is supposed to help you breathe by delivering pressurized oxygen to match your breathing rate. But this one was making ne breathe way too fast, and not allowing me to take a deep enough breath. I tried to tell the nurse, but between the mask and me not wanting to stop breathing, I couldn’t get the message across, and I was just sedated more instead.

Eventually I end up in ICU. For some reason they only have the monitor behind me, where I can’t see it. I ask them to get the fucking numbers on the screen in front of me, as I need the goal to work towards, but they can’t. Misha calls out the numbers and helps me slow my breathing. Still the numbers are low. The pulmonary doctor is pretty concerned – they don’t want to intubate me but may not have a choice. They stick a tube in my side to drain the fluid that has pooled between my ribs and lung – later we find out this has caused the left lung to collapse, with the right lung severely bruised. Which would explain the trouble breathing. Eventually I am able to stabilize without needing a tube down my throat, which I am so grateful for – that would not have been a good direction to be headed.

At some point I realize that my left arm no longer functions. It was okay before the operation, but no longer. We don’t know if the nerve damage is from the continued swelling after the crash, the operation, the nerve block or some combination. The arm doesn’t yet seem important anyway – breathing was the priority.

I really lucked out with my nurse in ICU. David was a good personality fit for me, and was keen to get me moving as soon as possible. At this point I had an oxygen feed, catheter, drain tube and various sensing wires, all of which had to be transferred to a wheelchair before we could think about walking. Then we had one guy pushing the chair, with David and another nurse either side of me whilst I took the slowest walk a few yards down the unit and back. A lot of effort, but moving helped open my lungs up, and I could cough up some more blood and gunk and get things cleared out.

Up to this point I hadn’t cried – there had been too much focus on working to survive to feel sorry for myself. But then that evening I saw an email about the donation fund, and read some of the messages, and it was tears of gratitude and thanks for all the care from the community.

A couple more days, and gradually the tubes and wires came out, and I was ready to move to a regular bed. And after a day there I decided I really wanted to go home, so went about making that happen.

So here I am. People have asked if I’ll race my bike again – I don’t have an answer for that, my ambition currently goes no further than a desire to ride my bike to the store. I have been riding the recumbent a little in the garage on the trainer – for the mental uplift from exercise and to get the blood moving rather than any intent of training. I have lost 12lbs, presumably mostly muscle – no big deal, just kinda funny seeing 132lbs on the scale….. Mostly I just want my arm back. The doctors seem optimistic that I should regain full function in 6-8 weeks. I really hope they are right. I have made progress with movement in my hand and wrist, but the arm is still dead weight until the elbow starts working again. Dealing with the mental side of my arm being inoperative is one side of things – the other is the constant pain in my hand. The thumb and index finger are completely numb, which hurts like the worst pins and needles, ramping up until it feels like my thumb is going to explode. But as my doctor said, if I’m feeling pain it is a good sign of the nerve connection…. So I’ll deal. Eventually this will be behind me, and I’ll look back on it as a period out of time and consider myself lucky to be alive.

Many thanks to all who have sent messages and donations – the support has been uplifting and humbling.