FOB leads to BB

 Well, an informative consult with an ortho doc this morning in re back pain.

I have probably broken my back! Hence: FOB (Fall Off Bike) has led to BB (Broken Back). More precisely, a compression fracture of T8.

X-rays point to T8 which is the 8th (thoracic) vertebra. The pix show some compression in the upper endplate of the vertebra which should be flat, not concave.  MRI will be scheduled next to get a better picture of things.

If the MRI results concur, then a procedure called kyphoplasty follows. Essentially, it is the insertion of a balloon into the fracture, its inflation to restore bone height, and then the insertion of bone cement into the vertebral body. Happily, it is an outpatient procedure called minimally invasive. AKA vertebroplasty, which is often used to prevent hunchback.

My guy recommends a spinal surgical center nearby. He says they are doing this procedure all the time.

Outcomes are positive in a majority of cases, with pain relief after 24 hours. If improvements occur with more conservative procedures (eg icing, heat etc) in 4 to 6 weeks, then the patient is probably not a candidate for the procedure. I am 3 weeks plus since my accident.

More to be revealed....

why oh why?

 It has been about 10 days since I proved myself a fool. The intervening time has not been uneventful.

A couple days after being in the ER I saw an ENT doc for the first time since high school. 

Back in the day, I developed a condition known as "swimmer's ear". This was a bacterial infection of the outer ear canal. At the time it was treated by a long cotton wick covered with aureomycin--an antibiotic--inserted in the ear canal right up to the ear drum. I recall that it affected my trumpet playing because of the imbalance of sound between the two ears. Aureomycin was a good drug, not unlike penicillin. Later they found that using aureomycin too frequently in the ears would lead to hearing impairment. Oops. Then it was back in the pool!. While we didn't have one in our family, almost all my friends' homes in Scottsale did, so we were always swimming somewhere. And, of course, there was much less AC in those days and the pool was a way to stay cool in summer. (Quick Google search: Aureomycin is now used in cattle feed. It protects the guts of cows. It was the first tetracycline; it was discovered in 1945. Generic name: chlortetracycline.)

But, I digress.The ENT guy pulled the plug from my left nostril and no bleeding ensued. I had been off my blood thinner several days at that point. I was still sore of nose and scabbed of knee. I was not to blow my nose, or otherwise strain for a few days. No lifting as case in point. He showed me some nasal gels (which have helped) and I was done.

I don't think I have written that the ER doc followed up on the phone with me after my accident, I was surprised because that had never happened to me as a result of other trips to the ER. He wanted to warn me that with a head strike that there was a possibility of a brain bleed several days post-accident. So, if I started to get headaches I was to return to the ER asap. Well, I didn't. Get headaches. (One of my neighbors suggested that these sort of delayed reactions are why insurance companies want to sette quickly after an accident.That way they are not responsible for them.)

Instead, what I got was back pain and it appears chronic. I have been relatively free of debilitating pain now for some 40 years. The fall appears to have rearranged my spine. It feels very much like I have herniated a disc in my thoracic region at about the lower level of my shoulder blades. On a scale of 10 this pain is about a 5, but with spasms--oh yes, spasms--it hits an 8 or 9. Tylenol is getting me to sleep at night and I am relatively better each morniing. But by noon I am really hurting. Tried icing and massage and heat. All provide some temporary relief and then--. So, an othopedic consult is scheduled for Aug 26. I will not go through another operation on my spine.

Meanwhile.....

I was scheduled for an angiogram at the Heart Failure Clinic at IMC Murray. This was not without its own drama. We were scheduled at 7 am so we broke our pandemic rule and stayed overnight in SLC with Lisa. When I was sitting watching my family unload the car--sorry, no lifting--a blood vessel bursts in my right nostril. It is brought under control fairly quickly because I am required not to be on any blood thinners prior to the angiogram. But there is familial concern about the procedure the next morning. 

I inform the docs on arrival and they decide to proceed cautiously. They do not find any evidence of what might have caused my weakened left ventricle. There is some narrowing of vessels and some increased pressure in the aortic artery but not, apparently, enough to stent anything. We are left to conclude that: either the chemo program is what caused the event or as a good friend says we can blame it on TMB = Too Many Birthdays.  

Hubris: Definition and Illustration

For those of you with long memories, ie 50 yrs back, you may recall that I was a bicycle rider. Between the ages of 30 and 40 I was pretty serious. Psych grad students and I would ride to 

Wood Camp Hollow in Logan Canyon and back 3 times a week.  Colleagues and I would do lazy 25-30 milers on Saturdays. A former Aggie head coach and I would shuck our hangovers from the parties at his place, after 4 hours of sleep, and meet at 6 am. I did one Century ride and was finished, before LoToJa really got started, by a spinal cord surgery (L5-S1 hemilaminectomy). After recovering from the surgery, I started swimming 3 times a week in the Unversity's pool. and did that for 10 years focusing exclusively on unweighted exercise. Not incidentally, I worked up to a one mile swim in about 3 months and maintained that for the 10 years. It put me in the best physical shape of my life

When we moved to Hyde Park we lived on a steep hillside with a 600 ft driveway. One could get a bike down the hill easily, but coming back up from Hyde Park City was a serious climb. My bike hung there unused for the 20+ years we were in Hyde Park. During that period a colleague and longtime fishing partner and friend died and his family gave me his bike. One of his two sons gave him the bike so that he could get around the little beach town in which they stayed during a couple months each winter in Baja. He didn't have it long before he died. Eventually I sold my racing bike and the remaining bike stayed until we moved out of Hyde Park. Our daughter claimed the bike. She, too, was a flash in the pan. She had it serviced and rode it for a number of months until she lost interest.

With the closing of the economy and the virus around us it has been difficult to get aerobic exercise. The clubs where we rode stationary bikes for aerobic workouts were closed. And my knees will not support daily walking. I need to take the weight off them for at least a day or two before going out again.  But why not try the bicycle again? Much slower of course. On the flat, etc. Surely, I am capable of that little bit. So, I put a few dollars into the bike again to tune it up and got it back yesterday.

Hubris: According to Siri it is overconfidence. 

The proprietor of the bicycle shop said that for people my age, he could show me how to get on and off. While I was cognizant that I might have that problem, I discounted it. Afterall, I had years of experience--accident free! He said not to be embarassed since he did it all the time. I ignored him.

When we arrived home with the bike I found that I could not mount it standing free, so I put it against the house and used the house to maintain my balance. In a few seconds I was speeding down the street in our development. There is maybe a 1-degree downslope the way I was headed and I seemed to gain a lot of speed very quickly, so after a 100 yards or so I neatly turned around and pedalled up-slope. My legs protested but it was only 100 yards. Approaching our garage--door open, one car in, and one car out--I realized that I didn't have a plan for getting off. 

The details at that point are a bit fuzzy but the outcome was not. I braked to a halt behind my car to put my left (dead) foot on the ground to be followed by my right (not so dead) foot and then Jan could steady the bike while I got off. Unfortunately, I failed to include her in the plan.  One or both of my legs failed to support me and I came off the bike over the bar and landed on both knees and abdomen, followed by my spine actually curving with the kinetic energy of the fall, and My nose hitting something in our storage shelves.  

Blood flowed. I took a minute to inventory and felt I had full function but not the initial strength to rise. The rest goes as you might expect. I worked the nosebleed with ice and towels and got it under control after 20 minutes. We cleaned and sprayed my scraped knees.  Tylenol helped the pain. We got dinner going and I took my evening pills, which included an Eliquis (blood thinner). I thought it is timed release and I have never had a sustained bleed using it. All went well until 9:30 or so when a vessel popped in my nose. I fought it for an hour and Jan drove me to the ER. We were there until 1 am. They did a CAT scan for the "headstrike" I had sustained and packed my left nostril.

So last night I couldn't use my CPAP machine and therefore had no O2. I slept sitting up in a chair, not well, because I kept being awakened by apneas. I hope today I can. I see an ENT doc on Friday after 2 days of no Eliquis and we'll see where we go from there.

Dumb, dumb, dumb.

But the bike still calls to me.....

Is it still hubristic?