Injured again

Southern California and far-away places. Hiking, wildlife, cycling etc.

Injured again

Postby Ellen » Sun Jan 17, 2016 5:00 pm

Howdy All :)

Day 1 (Wednesday)

On Wednesday December 30, Sally and I hiked up Falling Rock Canyon to Ontario and Bighorn Peaks. We brought and used microspikes. On the way down Icehouse Canyon, I tripped over a rock in the dirt trail (dislodged it) and flew right shoulder first into a warped root. When I made contact, I knew something was terribly wrong -- I actually felt the top of my humerus move back, then forward. Sally was at my side instantly and I took a moment to collect myself before standing up. She made a sling with bandanas and we continued to walk the 1.5 miles to our cars.

I felt shaky and off balance, resulting in two more falls to my knees. When we hit the icy part of the trail, a kind stranger tried to help me get through without falling and nearly slid off the trail himself. Walking out was made more difficult by an enormous tree blocking the trail near the TH. Sally and I activating SAR (especially after falling two more times) but I didn't want the stigma of being rescued again. When we reached our cars, I laid down to avoid passing out. We were blessed with the arrival of my friend Diver Dan, who recommended that we go to the emergency room at San Antonio Community Hospital. He drove me and Sally followed in my car.

It's best to avoid ERs in the evening, especially coming up on a holiday weekend. The place was a zoo -- Sally and I were worried about contracting the plague the longer we waited :? Finally got into X-Ray. The tech was very nice and upbeat -- said it probably wasn't as bad as I thought. Post X-Ray, she became serious and said she was moving up my priority to get me a bed more quickly. Back to the germ-ridden waiting room. Sally snagged us Coca Cola and chips from a vending machine. Despite the fuel, I became very light headed. Sally jumped into action and I was rolled inside and placed on a stretcher in the corridor. My systolic blood pressure was 80 palp. A RN started an IV and gave me morphine. The ER doctor told me I had a bad fracture -- the humeral head (ball) had broken off the humerus, there were cracks in the humeral head and the humerus was displaced anteriorly and medially.

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The ER physician said I would need surgery but that they would be sending me home :shock: The ER RNs were just as surprised as Sally and me. Saint Sally drove me home where Larry met us and drove her back to her car at Icehouse TH. It was a very painful night but at least I was in my own bed and had my fur babies.

Day 2 (Thursday)

I called my primary care physician in Riverside Thursday morning (New Year Eve's day) -- he recommended that I go to the Riverside Community Hospital ER for an ortho consult. I brought the disk with X-Rays and San Antonio's discharge notes. I was seen by a PA and some RNs who asked me why I bothered coming to the ER. No one looked at my X-Rays or my shoulder. I was told that my primary care doctor should have referred me to an ortho and that he should not have sent me to the ER. It's important to note that I have good insurance and can go to a specialist without a referral from my primary care doctor. I called my primary care doctor (the ER had thrown him under the bus) and he did his utmost to have me seen by an ortho. Due to New Years, no ortho was on call

Day 3 (Friday -- New Years Day)

Sister Sally, Miracle Marilyn and Larry came to my house on New Years Day -- bringing food, beer and fellowship. Marilyn took me to the grocery store to stock up (I couldn't drive). Several physician hiking friends reached out to me via Facebook. It became quickly apparent that no ortho in Riverside could manage the complexity of my fracture -- I would need to got to Los Angeles or to the desert to have a great surgeon. These physician friends understood that I was an athlete and should pursue the best possible outcome.

Day 4 and 5 (Saturday and Sunday)

In limbo, hoping that I would be able to see someone on Monday. I was in a lot of pain. In addition to the shoulder swelling, my right forearm was swollen. It was apparent that I was bleeding into my chest. As much as I wanted to be admitted for pain control, it was clear from talking with my physician friends that I needed the "A Team" to operate on my shoulder.

Day 6 (Monday)

My Los Angeles hiking physician friend and his contacts got me into Christopher Lee, MD (Stetson-Powell) on Monday afternoon for a consult. Miracle Marilyn drove to me to Burbank. Dr. Lee discussed my options -- reverse shoulder replacement or open reduction internal fixation (ORIF) with plate and screws. I wanted to try to salvage my shoulder -- also didn't want the movement limitations imposed by reverse shoulder replacement. Due to the severity of the fracture, Dr. Lee noted that I may require a shoulder replacement in the future. Now I needed a surgery date.

Day 7 (Tuesday)

My Los Angeles physician friend recommended that my primary care physician conduct pre-op exam, EKG and blood work to expedite surgery. My primary care physician was fabulous (as usual) and expedited the pre-op tests. The pain and swelling in my shoulder, forearm and chest continued to worsen.

Day 8 (Wednesday)

My desert hiking physician friend contacted me and noted his ortho agreed with the treatment/surgery plan. Glendale Adventist Medical Center and Dr Lee's office asked me to come in on Thursday to check in, sign consent form, etc.

Day 9 (Thursday)

My older sister called me Thursday morning. My 92 year old mom had fallen in her assisted living facility and broken her hip. She was in Riverside Community Hospital and needed surgery. Thank goodness I have amazing sisters -- they handled everything. I was deteriorating day by day.

Saint Sally took me to the Thursday appointments at Glendale Adventist and Dr. Lee in Burbank. We stayed Thursday night with Sally's brother and sister-in-law who were fabulous hosts.

Day 10 (Friday)

Sally took me to Glendale Adventist and stayed until I was wheeled into surgery around 2 PM.

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The surgery took about 4 hours. I remember waking up in recovery wiping my eyes and coughing to clear the mucous from the endotracheal tube. Miracle Marilyn was in my room and they let her spend the night in a pull out bed. I don't think she sleep a wink more than I did. A catheter was placed in my neck to deliver numbing medicine to my shoulder. Sadly, the catheter came out around 2 AM (probably due to me sitting up to cough) and I felt that someone had lit up my shoulder with a blow torch.

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Day
Last edited by Ellen on Sat May 21, 2016 4:39 pm, edited 1 time in total.
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Re: Injured again

Postby Ellen » Mon Jan 18, 2016 2:18 pm

Day 11 (Saturday)

Dr. Lee came in early Saturday morning -- he was very happy with the result of putting Humpty Dumpty back together again. I was hoping to be discharged but he explained that I was very anemic and wanted to give me a blood transfusion and keep me another night. Apparently I had been bleeding internally into my arm and chest steadily since the injury and lost two to three pints of blood. My normal hematocrit is 40 but during the surgery it dropped into the low 20's. This explained why my resting heart rate had risen from the mid-60's to over 100 and why I was short of breath walking up stairs :roll:

Saturday afternoon I convinced the staff to let me walk around unassisted and started doing laps around the floor. This made me feel better and distracted me from the shoulder pain.

Day 12 (Sunday) onward

Dr. Lee was happy with my response to the blood transfusion -- my hematocrit was now in the high 20's. Saint Marilyn drove back out to take me home. I made a bee-line for the bed as soon as I got home. My cats kept me company -- their warm bodies and purrs were soothing.

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The next days passed quickly. I starting on iron supplements to rebuild my red blood cells. The swelling and bruising in my arm and chest started to improve. Saint Sally took me to Dr. Lee for my first post-op visit on Thursday January 14. He gave me permission to walk, cycle and stairmaster while wearing a sling and warned that falling would be disastrous. Due to the severity of the fracture, I am at high risk for avascular necrosis (AVN) of the humeral head. Avascular necrosis refers to inadequate blood supply -- basically the bone dies and shrinks :( As a result, I would need a shoulder replacement. Full recovery from this injury is a year assuming everything heals.

On Friday, I started using the recumbent bike at my sister's Jazzercise studio. Between the lay off post-injury and blood loss, I am in pathetic shape, much as I was following my 2008 hiking misadventure. At least I have lots of practice getting back in shape :roll: :lol:

The timing was impeccable -- I've been yearning for snow to snowshoe and crampon climb and am grounded right as we get enough of the white stuff :? I'm enjoying the winter vicariously through friends' photos. Depending on my rate of healing and how long the snow lasts, I may be able to squeak out a tramshoe in the spring. After my next doctor's visit in early February, I'd like to come out and do desert hikes that I've heard about but never done.

I can't thank my friends enough for doing their utmost to ensure that 1) I had a top notch surgeon and 2) had transportation and moral support. I am not happy with the delay in treatment which resulted in agonizing pain and significant blood loss.

Compared to life-altering injuries suffered by several hiking friends (paralysis and multiple fractures), my injury is insignificant. I have the utmost respect and admiration for these people -- they have positive attitudes and train as hard as any elite athlete.

Miles of smiles,
Ellen
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Re: Injured again

Postby Wildhorse » Mon Jan 18, 2016 3:34 pm

What an ordeal.

If I have the right picture, you had completed a difficult off-trail ascent, and then tripped on a rock on a trail. As we know, hiking off trail is supposed to be so much more dangerous. My worst injury (a broken foot) happened on a single paved step in my back yard. It could have been worse.

On the trail and off, life is dangerous it seems. It is really nice to have such good friends as you do.

As Helen Keller once said: "Security is superstition."
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Re: Injured again

Postby Ed » Mon Jan 18, 2016 4:21 pm

My humerus fracture was a scratch by comparison.
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Re: Injured again

Postby Ed » Mon Jan 18, 2016 4:43 pm

Wildhorse wrote:My worst injury (a broken foot) happened on a single paved step in my back yard.


I was once talking to Kurt Diemberger, a world-famous Austrian climber. Famous, among other things, for climbing Broad Peak with Herman Buhl. Buhl disappeared on the way down, while they were descending a corniced ridge. I knew who Kurt Diemberger was, but I did not know I was talking to him, he was simply a stranger I was chatting with at a small party at a friend's house. When I joined him and another man, he was talking about a broken leg. Since everyone there was a mountaineer, I asked him what mountain he had the accident on. He smiled, and said he slipped and fell at the post office.

A world-famous Japanese woman climber recently fell to her death on a mountain in Japan. The description of the accident was discreet, but it was clear enough that while she and her friends were on the summit, she needed the privacy of the other side of a rock to take care of a call from nature, and fell to her death there.

I do not like descending that part of the Icehouse Canyon trail. I feel that I should be able to speed down it, but much of the footing is not good, and if I was ever sure-footed, I am not now.
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Re: Injured again

Postby neverwashasbeen » Tue Jan 19, 2016 11:26 am

Ellen, Godspeed on your recovery and please let me know when you want to do some desert hiking, I seem to have more free time these days.
Happy Trails!
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Re: Injured again

Postby Ed » Tue Jan 19, 2016 3:05 pm

Ellen,

Please keep us up to date on your recovery. Range of motion recovery, strength recovery, etc. Other people may not be interested in the details, but I am, and I am sure some other people are.

I also found it impossible to get a timely appointment with an orthopedist, despite having excellent health coverage, and being willing to go to either of two orthopedic clinics, one in Rancho Mirage and the one in La Jolla where I am a long-term customer. Had to wait a week or two, and ended up making a one-armed drive to San Diego.

The good thing about hiking is that you can start up again before making a 'full recovery' from an upper-body injury. As long as you don't fall.
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Re: Injured again

Postby Ellen » Wed Jan 20, 2016 3:36 pm

Howdy San Jacinto mountain family :)

Thanks so much for your kind words. I really appreciate knowing that others have been hurt doing relatively mundane activities. Looking forward to hiking again. I'll see if I can coax Miracle Marilyn and/or Sally into a desert hike soon 8)

Miles of smiles,
Ellen
Broken Blonde Hiking :lol:
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Re: Injured again

Postby cynthia23 » Sat Jan 23, 2016 8:21 pm

Ellen, I just now (the 23rd) read this post--I'm shocked by your ordeal and had no idea of the misery you've been suffering. I'm appalled--what a rotten injury (although as others have pointed out, at least since it's upper body, you can still carefully hike) and REALLY appalled by what you had to go through to get the shoulder repaired! In my naivete, I innocently thought that if you came into a hospital with a serious injury, they set you up right away for a surgery. I guess this comes from getting my ideas from TV doctor shows, which certainly do NOT feature patients with agonizing fractures being sent home to figure it all out on their own, do their own research, and find their own medical team. (and if not, to slowly bleed to death and/or be permanently crippled.) I'm just stunned at their lack of coordination, not to mention their lack of concern. What really is horrifying is that you are a bright, highly educated woman, with lots of medical knowledge and physician friends. Imagine if that injury had happened to someone who was, let's imagine, a day laborer who doesn't speak much English. Or even your average worker at Walmart, etc? How could they possibly have figured it all out, done the research, etc? That is assuming they had insurance, or insurance without a huge deductible? The answer is they couldn't, and that's one reason why there are so many sick and crippled people out there. Our medical system is deeply dysfunctional.

Okay, I'll get off my soapbox now and out of the realm of the political, and just say I'm so sorry you had to go through this. I wish you a speedy recovery--if anyone can 'get back on the horse' fast, it's certainly you, Ellen.

PS--and Kudos to your awesome friends, who are wonderful people.
Q: How many therapists does it take to screw in a light bulb? A: Only one, but the light bulb has to want to change ...
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Re: Injured again

Postby RichardK » Wed Jan 27, 2016 11:33 am

Hi Ellen

I am very sorry to learn of your injury. Although we have never met, I feel as if I know you through your numerous, excellent reports. Like you, I have also made a trip to the San Antonio Community Hospital ER after a fall in Icehouse Canyon. I did a face plant into a pile of rocks. It was my upper teeth that hit first and broke the fall. The bottom half of one incisor chipped off and the other one was pushed out of its socket. A nurse practitioner stitched a cut on my upper lip and told me to see a dentist about my teeth. Fortunately, my dentist was in his office on a Sunday morning doing paperwork. He was able to start the repairs immediately. Best wishes to you. Return to hiking soon.

Richard
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