Wednesday, 9 March 2016

My recent accident

On Tuesday, February 22, I slipped and fell while walking from my office at Queen's University to the bus stop. In the process I seriously damaged my elbow, and will be in a cast for at least the next 10 weeks. Here is the story in more detail – not quite "gory detail" but close. By the way, I am dictating this via Dragon Naturally Speaking; typing with a few fingers of one hand is no fun at all.

 I do not recall exactly whether I tripped or slipped, but I was told later that there was ice in that area. What I do recall is trying to catch myself with my left arm, and the feeling of surprise when, despite that, my head hit the pavement anyway. I do not think I lost consciousness, but am not entirely sure. I remember people talking nearby, apparently clueless about what to do. Then someone who knew first-aid started asking me questions and applying napkins, probably from a nearby hotdog truck, to stop the bleeding on my forehead. Someone called 911, possibly at his request.

The ambulance arrived quickly, since the Frontenac County ambulance station is only about 2 km away. The paramedics were very reassuring and helpful; I felt confident I was in good hands. They got my backpack off, but quickly determined that any attempt to move my left arm resulted in serious pain. They loaded me onto a gurney and drove me to the Kingston General Hospital Emergency Department. Fortunately that was only a few blocks away, but I doubt I could have walked it cradling a damaged arm.

My wife was teaching a class across campus at the time. Unbeknownst to me, someone at the paramedic station overheard the dispatch location, and called a friend wondering if she were the one who was injured. That happened to be an administrative assistant in my School, who looked out the window and saw the paramedics assisting me. She talked to our business manager, who came down, verified that it was me, found out where my wife was teaching, and went to tell her what had happened just after her class finished. She came right over to the ER; the hospital is on the edge of campus, and is affiliated with our medical school.

Some combination of me, the paramedics, and the staff at the ER got my heavy winter coat and shirt off without cutting. I didn't have to wait very long for help. The first priority was to stop the bleeding on my forehead, which wasn't hard with direct pressure (though it did keep reopening later, until the doctor had time to stitch it). My left elbow looked distorted, and they realized it could be broken. So they sent me for X-rays (which is part of the reason it took so long to get to the stitching process).

It was difficult to get the right angles since every attempt to rotate my forearm resulted in severe pain. The results were good enough to show that the elbow was partly dislocated, with significant damage to the bone. Thus they sent for an orthopedic consult; he wanted more accurate pictures, so sent me for a CT scan. There was damage to the radial cap, the joint was indeed partly dislocated, and the ulna was "shredded". That may sound overly dramatic, but they made me look at the x-ray and there is no other way to describe what that showed. It would clearly require surgery to correct.

The first priority was to immobilize the arm to avoid pain and further damage. They put me under "conscious anaesthetic", but I still remember the pain when they un-dislocated the joint. They admitted me overnight, hoping to do the surgery the next day, but since I was fifth on the board, it was likely that it would take until Thursday. At some point they hooked me up to an IV, to make sure I would stay hydrated, and to apply the serious pain medication I needed. All told, my wife says that we spent about eight hours in the ER.

I spent all of Wednesday morning not eating, since for a while they hoped they would be able to get to me that day. Unfortunately, in the early afternoon it became clear that I would end the day second on the board, with at least one orthopedic surgery worse than mine. On Thursday they did the surgery in the late morning, stretching into the early afternoon; it took about three hours total. They plated the shredded bone. They had to replace the radial cap, since apparently it had been eroded by arthritis I never knew I had. So I guess I am now partly bionic :-)

The surgeons had told me that the pain might be severe enough to require one of two fairly dangerous remediations. One of them was a temporary nerve block, which has the possibility of nerve damage. I do not recall the other one. Fortunately I didn't need either; some serious pain medication was sufficient. They kept me overnight, and released me late the next morning.

I plan to talk about life with the gigantic cast in later posts.