First of all, I have lurked here for years. Since I didn’t feel I had anything to add, I never joined. However, primarily because of this forum, I ended up doing better at the scene of my accident than I had any right to expect. Here is what happened and what I learned from the experience.

FACTS:

Solo bike accident. I was in San Jose on a family outing. I was following my wife and adult step son. We went through a little “s” turn from one asphalt multi-use path to another asphalt multi-use path. Because I was the most experienced cyclist (and overconfident) I didn’t look ahead before entering the turn. As I entered the turn, I observed an orange warning cone in the middle of the path. I swerved to avoid the cone and dropped off the edge of the path onto the surrounding dirt. The bike slid out from underneath me and my right upper femur landed on the edge of the path. I did not hit my head and never lost consciousness.

I knew immediately it was a bad injury and directed my step son to call 911. When the first responders and paramedics arrived I advised them of the serious nature of the injury (I thought I had popped my hip capsule), directed them to take down notes on the various medications I had taken (all allergy based), advised them as to my allergic medical history, reminded myself repeatedly they needed to repeat the same questions many times to make sure they got the information correct and not to get angry with them. I made sure my wife had the contents of my jersey pockets (missed an allen wrench). I directed the first responders and my wife as to how best to physically support me.

After 10 mg of morphine the paramedics moved me to the ambulance. Once there, I quizzed the paramedic as to the various ER options and ruled out the first two immediately. (One was Kaiser and the other a small hospital). I ruled out Kaiser for 2 reasons-I wasn’t a Kaiser member and there was a possibility they would simply stabilize me and send me elsewhere. Since the hospital was small, I ruled it out. The remaining two options was the San Jose Trauma Center and 45 minutes further away was Stanford. I asked which one he and his fellow paramedics would go to and picked the Trauma Center. Once the choice was made, he called and obtained permission to administer another 5 mg of morphine.

Once at the ER they gave me another 5 mg of morphine. I directed them to cut off my shorts, explained my environmental allergy issue, asked for and obtained a prescription medication for allergies.

X-rays revealed a comminuted, displaced (2”) fracture of the femur in the trochanter area. This is immediately adjacent to the hip. I was transferred to a room while waiting for a surgical suite. Since surgery wasn’t immediately scheduled, I had my wife and step son research the assigned surgeon and do additional research on the hospital. Both got good grades and the surgeon had what I considered to be a good educational background. My step son found some negative comments about Stanford and I elected to stay where I was. Due to higher priority surgeries, I had to wait 27 hours before surgery.

Lessons learned:

Because I had visualized similar situations many times in the past and figured out what to do and the sequence of events, I never panicked, even though the pain was considerable and it seemed like forever before the first responders arrived. My calmness and take charge attitude helped those around me from escalating into panic or near panic mode. Because I hadn’t hit my head I was able to think fairly clearly and make the necessary decisions as to where to go and why. Since no one in my party had a GPS and we were unfamiliar with the area, there was a delay in the first responder’s arrival. In retrospect, a GPS would have speeded up things by 5-10 minutes. None of the traditional emergency/disaster items was of use in this matter, with the exception of cell phones.

Once I got to the hospital, I made numerous mistakes because I’d never thought through what was important. I didn’t ask for waterless shampoo or a shave. This would have been a good morale booster. I didn’t ask for a sponge bath. This would have prevented pressure sores from starting. I should have had some discussions with my wife as to what to do in case of something like this occurring, well before the accident. I didn’t do it because I “knew” I would never be the one to have a bad accident.

Since San Jose is about 300 miles from home, my wife was the one to drive us home. The trip lasted about 7 hours and the pain pills stopped being effective after about 5. I should have filled the pain medication in San Jose so I could have taken a second set of pills before getting home. When we did arrive in my home town, there was a delay in filling the prescription due to a clerical error causing additional delay. By then the pain was starting to get my attention.

Neighbors and friends were called for assistance once we got near home. I had 6 people help me get into the house, assisting my wife in setting up the spare bedroom for my use, unpacking the car and putting away the bicycles. Friends and neighbors have continued to be invaluable. They have installed entry ramps, replaced showerheads, installed grab bars in the shower, provided a commode adaptor to allow the use of grab rails in using the facilities and provided meals. In short, they have been fabulous.


I hope this report of my experience will be helpful to the community.

Welcome.

No offense intended, but it sounds like you told a lot of people what to do. Sometimes that can be good (like with unknowledgeable bystanders where you know more than they do), but often times it doesn't work out very well trying to be in charge and telling everybody how to do their jobs. Your injury was not unique or uncommon, although surely painful for you. The paramedics and ER staff would know how to treat it without outside guidance.

Welcome to the fire, new-goat! Sounds like it took a lot to get you here.

Nice review, especially what you did wrong. There are lessons to be learned there (GPS, preparing wife, pain meds). Thanks for sharing.

-Blast

p.s. By chance do you ride with a quiet Chinese-ish fellow who busted up his femur a few years ago when he hit a railroad track on his bicycle?

good post oldmtngoat. there is nothing wrong with taking charge of your care.having worked in a hospital i saw lot of guys--it was a Vets hospital--come in doing the same thing. i think it's part of the pain/trauma response...for the rest of us it's a good wake-up call on how fast and how bad it can be..think about the same thing hours/days away from help..not much in a pocket size kit would be much help unless its filled with pain meds and the PLB is beeping away..

Welcome aboard. Understand your rationale for hospital and doc selection, but it may have been self-defeating. Bigger hospitals get you bigger name docs, but more of your direct care will be managed by residents, interns, and breath-takingly over-burdened nurses: good place to be if you have an unusual diagnosis, not so good if you do not, since the facilities there are very busy, resulting in 27 hour waits for OR time. Fixing femurs is fairly straight-forward work, and you might have been served as well, and much more promptly, at the smaller facility. ER's generally will not stabilize and transfer a fractured femur-hard to effectively stabilize it. Should not have to ask for a bath, and really should not have pressure sores developing-both represent a failure to provide basic care. Consider raising the issue with the risk managers at the facility, in the interest of protecting future patients. Hope the rest of your recovery is uneventful.

Eureka! My new PSK: A PLB with 50 tablets of vicodin duct taped to it!

Welcome, old goat!

I have waterless shampoo, shaving kit, and body wipes in our 96 hour kits, which are in our cars. It's amazing what just that will for to your morale, as you know.There have been several hospital visits that have gone MUCH better than it would have because of what we carry in our vehicles.

Be sure to throw a thank-you party or something for your kind neighbors. I'm sure you'd be in the forefront helping them out in a similar situation.

Again, welcome!

Welcome to the forum. Nice post,like it has been sead on this and other forums of this type, your head is the best survival kit. Now that you have lots of time to spend on the forum I hope we hear more from you. No more lurking.

Welcome to the forum.

I hope you aren't so bossy and know it all here

Welcome. I second some of the stuff earlier - especially regarding sponge bath and bedsores. If you got some, you need to at least talk to the hospital about it. Unless you're 90 and demented, it should be fairly easy to avoid them. Then again... if you're bed bound at home and developing them, it's a different story.

Would a GPS have helped? I doubt the first responders or ambulance has a GPS that reads out the grid coordinates. They'd be lucky to have a street-level GPS.

Probably a good call on Kaiser, if only for insurance. yeah, they might or might not have transferred you, but if they didn't you might have more headaches from insurance.

It does kind of sound like you were a bit bossy, but not being there, it's not really my place to critisize. BTW, they would have cut your shorts anyway

Time to sit down with your family at an ARC First aid course?

its important to tell people your expectations in the hospital. You are your own best advocate.

I hope you mind some sharpshooting but I would recommend you invest $20 in a ankle bracelet at roadid.com. That one piece of kit would have solved all your problems giving info to the first responders HAD you hit your head or gone into shock.

As for the hospital care, you may wish to get a business card from every person who treats you and the name of the group that bills for them. I know there are medical personnel on this forum but from personal experience through my sons tremendous medical bills, (and quite a few of my own) I have seen probably about 8% of my bills as bogus. Such as the doctor who billed me $400 for treatment. Since I did not have his card, I challenged it and found out he merely looked at my chart at the nurses station and billed me for his consult.

But for the most part, you get individual bills from the hospital, the doctors, the nurses group, then the extras like the surgical staff (anesthesiologist, etc) and it gets confusing on who you saw/who saw you/ and how your getting the bill.

Welcome aboard.

What if you had no health insurance like 40 million Americans?

Fixed that for you, though it'd probably be better if you did it. You know, to avoid politics...

-Blast, watching

Then he would most likely have a minimum $12,000 bill... like me

Great post, really makes me think. Thanks for sharing an obviously painful experience.

He would have received the same care, but been billed afterward. If he is like most uninsured patients, he would/will never pay any of it. The doctors and hospital would eat the bill. Because of the business structure and accounting rules, the docs would not receive any sort of tax advantage for providing this free care. Depending on the state, the hospital would like receive some sort of extra federal or state money at the end of the year if they provide 'X' amount of indigent or non-insured care.

I was between insurance when my wife got real sick and had to go to the doctor. Other than the rude receptionist at the dr. office who just counldn't accept the fact that we had no insurance and would be paying out of pocket, it wasn't a big deal. We had to have a whole bunch of $ tests ran and found out she was diabetic. We then talked to the accounting department and worked out a payment plan and it took a couple years to pay it off.

Glad you came out OK, Goat. You did well, though directing a hospital ER staff to cut off your shorts is really getting bossy.



You're entitled to your own opinion, but you're not entitled to your own facts.

Exactly right duckear.