Tales from the peloton, April 4, 2004
Or: Take one bowl of Wheaties, two cups of coffee, 52 staples and call your orthopedic surgeon in three weeks
Morgan Andriulli describes himself as "a pack-fill Masters Racer from Huntsville, Alabama." On March 8, he broke his femur and shoulder during a lunchtime ride. This is his tale of the subsequent ER and hospital experiences. Morgan warns that his story "is kind of gross, contains nudity, toilet humor, drug humor and drug-induced toilet humor. By those factors alone, it should make for completely appropriate reading for cyclingnews.com fans." We agree.
Crunch. Monday, March 8, 2004
12:30 PM. I knew it was going to be a bad Monday the moment I hit the pavement. Not only had I been busted for playing hooky from work, from the angle of my right leg and shoulder, I clearly busted a lot more than that. What had been a quickie lunchtime bike ride on one of the first real springtime days of the year was now a literal crash course on the quality of our local emergency medical services.
For some reason my front tire slid out a lane paint stripe. The bike disappeared from beneath me and my body continued on a straight line on to the pavement with a sickening thud. I land on my right side like I'm scoring the winning run in co-ed softball. My fuzzy tights and long-sleeve jersey stick to the road like Velcro, sparing my carcass from road rash. This is not good since sliding or tumbling would have absorbed the crash energy much better than my femur and shoulder.
As a cyclist, I am relieved to see that my over-priced ride is unscathed. As a person with no intention of becoming human speed bump, the inability to move my right leg and arm is a bit disconcerting.
The entire student body of Alabama A&M University got to witness this sad bike handling demonstration in the middle of class change, so I recall many heads connected to cell phones hovering above.
"No, I cannot move. Please do not move me. Yes, call an ambulance." I hear the sirens within minutes. I am flattered by all the fuss.
The suspect paint stripe separating the westbound turn lane from the eastbound lane of Chase Road runs beneath my rib cage. I am perfectly positioned and totally happy to block traffic all day.
The police arrive and are immediately disappointed.
"No, a car did not hit me…. Really, I did this to myself. How about investigating this paint stripe for assault and battery?"
The nice lady attorney who recently renovated the office at the corner collects my bike for safekeeping.
Since there are no parts of me that can be lifted without risk of detaching, the Huntsville Emergency Medical Services Incorporated (HEMSI) guys bring out a special two-part stretcher to scoop me up like a large, 150-pound doggie doo.
There are no splints or drugs in the HEMSI van, so we resort to piling every item within reach beneath my leg to support it. My arm is clearly out of socket and the HEMSI guys keep commenting on the odd angle of my right leg. Because of this, I can neither recline fully, nor sit up. I am indefinitely propped on my right ass cheek using the working left leg and arm for stabilization.
Here begins the miracle of the beers. As an incentive to keep from snapping me in two, I offer the HEMSI guys case after case of beer to take it easy over the bumps
We hit the Huntsville Hospital ER, and the largess continues. So far the HEMSI technicians, ER staff, attending physicians, radiology staff, hospital volunteers and candy stripers are all still awaiting their free brew.
I scrawl signatures on a bunch of stuff, recite a half dozen phone numbers from memory and get rewarded with an armload of morphine. Ahhhhh….
Now the fun starts. Personal modesty stayed in the ambulance as soon as they cut off my tights and clothes, but I don't care. My naughty bits have been seen and groped by strangers more times than a tequila-fueled, carnival weekend in Rio, but I don't care.
The nice ER attending physician takes multiple attempts to re-locate my arm without success. Again, I don't care. X-Rays confirm the persistent shoulder "instability". Bummer.
I can't remember how many trips I took to radiology, but it seems like they ran me under the machine for more poses than a Sports Illustrated swimsuit model, only that a swimsuit model is better dressed.
"Sorry man, we got to move you again. We need another angle."
Hint: When the nurse or technician says, "take a deep breath," take a breath like it will be your last. Whatever is about to transpire will penetrate any morphine haze like lightning. The gods are speaking to me in no uncertain terms. "You have disappointed us for shirking work. For your slothful nature, you must now suffer. Shazam!"
Poof! Meanwhile, back in radiology, they are struggling with my oversized cyclist's lungs.
"Man, he's all lung. Can we move the camera back? Look, they go below his rib cage also. OK, drag him higher…. Sorry, man," as they again apologize for having to reposition the un-set femur and dislocated shoulder one more time.
The X-rays confirm that: 1) I am a windbag and there is now medical documentation, and 2) I am busted up good.
"Well you have an Old Man's break in your femur. We usually see this when some old guy falls off his walker. When you break something, you break it good. Congratulations, you just won a twelve-week leave of absence from using your leg and a free wallet-sized picture of the metal in your femur for the nice TSA guys at the airport. Oh yeah, your shoulder is still out of socket and busted also. We'll put it back in when we put you under for your leg."
"Thanks. That's good to know. How about some more of that morphine?"
By now it is about 6 pm and I have to pee like the Johnstown flood. The nice nurse comes in with the one liter jug, which I promptly fill and request backup. Finishing with that record attempt, I find out my wife has been located waiting for me at the local bike club meeting. This is good, because ever since I took morphine, I am no longer legal to sign consent for surgery, 10 CDs for 99 cents or anything else.
A surgery slot is scheduled for 8 PM, which again is good because I have been propped on my right butt cheek since about noon and the pose is starting to lose its appeal. The only advantage is that the dope keeps me from caring too much about the pain, the nonsense I spew or the fact that my privates are now on display for family, friends and strangers alike.
8:30 PM. Finally get rolled into surgery for femur. The apparatus in the operating room is some kind of multi-axis device designed to straighten broken parts and provide a number of degrees of freedom so the surgeons can operate without bending up the patient any more.
"As long as I don't wake up a Republican, do what you want." I try to enunciate this or think it aloud.
This is the last thing I recall on March 8.
Damage Report: My right leg has been enhanced with a 7 inch plate with 10 self-tapping screws and is swollen to Zeppelin-sized proportions. Make that a lead Zeppelin. I cannot move it under its own power. The muscles are swollen and locked in mortal combat. I ain't walking any time soon. The physical therapist comes by and advises me that it is okay to flex the quad and hamstrings for 10 seconds. I wonder how I am supposed to do that since the muscles have been clenched hard for 36 hours and could not be made harder even if I poured concrete over them. Thanks to all the hardware, I am thankfully spared a cast. The only evidence of the trauma is the discreet, 27cm, 51-staple incision running the length of my right thigh. At worst, for the next ten weeks I'll be hopping the stairway to Heaven.
The shoulder is scheduled to collect a permanent screw to secure some loose bone and an anchor to reattach soft tissue on Friday. All this busted stuff will keep me out of a walker and off crutches for five weeks. As long as whatever I need is within one rotation of my backside, I'm good to go.
Oh, and I am still not a Republican. They did not have time to install any extra Angry White Male while in surgery.
The day after. Tuesday, March 9
I recall long conversations throughout the night trying to answer stupid questions from unknown people. The words come out slow and reedy and I wish I would shut up. I am boring and un-funny on drugs. I am much more witty and charming under the influence of un-filtered pain.
Cubic yards of swelling and inflammation in post-op recovery. Right leg is about three times its original size. I have a button that chases pain with Demerol. Every time the button is applied, a large cartoon mallet whacks me in the head. I make cuckoo sounds, my eyes get little X's over them and I pass out for 45 minutes.
This is not sleeping and not pain free. It is just pain delay. While awake, my eyes spiral around cartoon-like and it is impossible to watch TV, read, or hold a coherent conversation. Passing out is some sort of sleepless dream state, featuring highlights from Disney's Fantasia, especially the part where Mickey gets overwhelmed with the marching buckets. People ask lots of stupid questions all the time. I won't shut up and they don't stop asking. I never think to tell them to shut up and no one tells me to shut up.
My left leg is numb. It was not numb before surgery. The doctors are unconcerned with this, but my level of anxiety is amplified by the drugs and I keep asking.
Wednesday, March 10
Physical therapist came by. I get to flex right quad, hip flexors and hamstring for ten seconds. Why bother? Everything feels like it has been flexed for the last 24 hours. I could not possibly make the muscle any harder if I set it in concrete. Did I do that gag already?
The PT says I'll get a walker or a wheelchair. No prognosis yet for the right shoulder.
I ask the nurse to reduce the Demerol dosage so I can stay awake. She does, so I now stay awake but I am all goofy. I quit Demerol late on Tuesday. The nurse brings Lortabb. By 10 AM I am much happier and stable.
Noon. I get to brush teeth for the first time since Monday morning.
Hop-scooted the walker over to the bathroom for an attempt at increasingly urgent personal business. All systems NOT go. At least I can move around a bit. There are three bags running hanging on to me, one in and two out.
5:35 PM. Dinner: ham and taters. They must want me constipated or dead.
Friends bring videos. Jamie brings videos. I am too loopy to watch anything. Even worse, the VCR in the room has no remote control other than the nearest loved one. Dad and sister call. I make no sense, but sound upbeat nonetheless.
Jugging: I am becoming quite skilled at using "the jug". I must have some kind of world-class bladder because I can nearly top off a one-liter container without having to go so bad. Jugging should be a competitive sport. I would top the neatness and volume competitions. I'm looking for sponsors. Perhaps Depends Adult Undergarments is interested.
Considering the "big lungs" comment, I must be built for long-distance cycling. I can breathe a lot and I never have to pee.
Thursday, March 11
Still can't take a shower or bath, therefore I stink. I have not taken care of other Very Important Personal Business since Monday. Something has got to give. The right leg appears more swollen than yesterday. More stuff is sore as well: Abdomen, jaws, arm, butt. All that stuff has been clenched or used in non-traditional ways.
Dr. Goodson, the shoulder surgeon comes by and gives me the news about my shoulder. He immediately confiscates the walker since it is bad for my shoulder. As long as everything I need is within one butt radius for the next four weeks, things will be easy.
IV came un-taped and pumps blood all over. Lortabbs keep me from caring too much.
Fellow victim of gravity, Dave Stone drops by. He brings me grippy socks for wheelchair motivation, special orthopedic shorts with Velcro up the side and anatomy books. I no longer need to moon all behind. I literally cannot fill his socks or shorts, but the stuff works well. I stop whining after a Dave visit.
My sister gives me a real live shampoo. Me being Sicilian and the direct descendant of a can of olive oil, it takes several passes to cut the oil spill on my head. I feel like $100. She gets to see more of her brother than a sister ever needs to see. I owe her about a decade's worth of baby sitting. She put in about that much on me the first week alone.
Friday, March 12
8AM. Nearly blew it for the shoulder surgery at 10 AM. The nurse brings me a small, clear juice and a cup of Jell-O around 5:30 AM. Bad move. Good Dr Goodson saw the scraps as evidence of my breaking the eight hour fast and called a meeting of all the floor nurses for some harsh words.
I said, "Look, I have to eat every two hours just to maintain weight. This midnight snack will be completely immolated by scalpel time. Don't let it stop you."
After two units of O-negative, I'm still a quart low for surgery. They order up another two units to get my depleted haematocrit level back up to the high twenties. (Legal limit for bike racing is 50 for guys, 46 for women. Civilian couch potatoes cruise around in the 30s.)
2 PM. The shoulder surgery happens. The arm feels okay, but my eye hurts like it has been poked with a stick. After they flag down an ophthalmologist, he confirms that the cornea has been poked with a stick. Or something. He gives me some ointment and a patch for it to heal.
My Russian friend Boris and loyal spouse Jamie are around for Friday night. Jamie hand feeds me Chicken fingers Roman-style because I am blind. Boris and I discuss Dr Zhivago and Russian politics in between fries and bites of chicken. Not a bad evening, especially after hitting the morphine button by accident a few times.
Saturday, March 13
The shoulder hurts more acutely than yesterday and I burn through a bag of morphine. I do this also in anticipation of a visit from Marcie the physical therapist.
Marcie shows up and we transfer over to the chair for some one-footed chair-scooting. After 45 minutes I am tanked. I crash, but take no more morphine.
10 PM. Okay, weirdness has invaded my head and a low level anxiety takes over. I feel as if I am adrift on an ice flow. It sucks. I can't sleep, don't want to sleep, don't want to snack, don't want to watch TV and cannot read. I just want to not do anything. Sensing something is not right, I buzz the nurse and she gives me a sleeping pill.
The pill knocks me out for precisely six hours. On awakening, I feel exactly the same. I call Jamie and give her the lowdown on my lowdown feeling. She says exactly this, "Have a snack, take a nap and you'll feel better. I've seen you do this after you bonk really bad."
I did, and felt better. Good call, that girl.
It's not that morphine makes you feel good when you are on it, it's that morphine makes you feel very bad when you quit. The reason people get hooked is that they never want to feel that bad.
Sunday, March 14
I'm back to normal in the cranium. Morphine sucks!
The doctor clears me for release, but I am reluctant to go. Mostly it is angst over being able to handle myself at the house. All I know is that it takes a team of goons to manhandle me out of the sack to the commode.
Not that that activity has produced any action in the last four days. Seven days of no-fiber food, complete inactivity and heavy narcotics has created a world-class intestinal gridlock that is a bigger problem than the injury itself. As sick and busted up as I am, I am not even the sickest nor the most busted up of the 15 patients on the Orthopedic Ward at Huntsville Hospital. The nurses do nothing but run from room to room dealing with real emergencies with really sick people. I am reluctant to push the call button with something as trivial as impending intestinal tectonic action.
They are simply too busy with the truly sick and busted patients to keep lifting my clogged-up carcass over to the throne every couple of hours whenever I feel "the urge." It is better for me to leave as soon as possible.
After a couple of servings of prune juice and the application of "more radical" procedures, NASA announces the discovery of a 10th planetoid beyond the orbit of Pluto. I am confident it shot from my colon around 6 PM Sunday evening. I am now free to travel without creating my own gravity field.
Boris, triathlete-pal Shahin and the good spouse Jamie pile me into the back of Shahin's station wagon like a cord of wood. The ride home is much smoother and less painful than the ride to the hospital. They pour me out at the house.
I am now "resting comfortably" at home, which is kind of like a vacation, except with pain, swelling and one-legged hopping. It is all up-hill from here, but I like a good hill-climb
Thanks to all who visited, called, brought food, books, videos, wrote cards and sent e-mails. It is more than I deserve, but is appreciated nonetheless. I tried to keep notes on everyone who visited and called, but those notes were made under the influence of strong narcotics. All I can say is a special thanks to all who took a lot of time to sit up with the half-dead and the drug-addled. Your case of beer is on the way.
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