Of ribs and lungs

LONG STORY (but more for me than you, so read if you want!)

Saturday before last, just to get a day of biking in, Brad and I took off for Moab. We were meeting some friends down there for a shuttle ride, and left super early with the intention of returning that night. No camping gear or overnight bags, we forgot Brad’s phone and Jean Luc’s leash, and only had dog food for the day, but it was only a day trip so no worries, eh? It was finals week for me, so I took some Dramamine and wrote a paper on the drive down, and planned on coming home to spend Sunday finishing papers and projects and studying for a test.

Got to the shuttle, geared and loaded up, drove the hour to the top, and hopped on our bikes. About a half dozen friends that we haven’t seen in a while are there, as well as some that we see a lot, and it was a great group. It was a lovely day, sunny and just chilly enough to keep the sweat down. The first bit was super muddy and we did a lot of hike-a-bike, but then we hit paydirt and dry singletrack.

On LPS, I was feeling good, and riding well, even cleaning a technical left handed drop that a lot of people walked (yes, I make funny faces when riding technical stuff):

Then, about 20 minutes later, I’m swooping along and having a great time, keeping up with Brad even! We get to a spot where I think the trail goes left, then realize the trail goes right (learned later it went both ways around a tree), and try to correct my path to go right instead. My front wheel washes out and I tip over to the right, my right arm over my head, landing on my side. Unfortunately, my handlebars have turned to the right so the grip extends under my side, so instead of landing flat on the rock, I land on the handlebar. Ow!

Immediately, I hop up, gasping for breath, the wind knocked completely out of me. I pace around for a few minutes, then get on my bike to coast down to the rest of the group. I keep waiting for the “wind” to come back, but 10 minutes later I still feel like the fall was only moments ago. I bend over, and feel my ribs pop-pop in my back – *$&#, I’ve at least dislocated a couple. I’m in denial though, and keep thinking I’ll be able to breathe soon; really, it must just be the rib pain making me gasp.

Finally, it’s clear I won’t be able to bike, and need to go to the hospital. Problem: we’re on a trail 25 miles from town. Still thinking it’s just me being a baby about some dislocated ribs, we push our bikes back up the trail, since there’s a dirt road close by just a little ways back. (Well, I should admit that Brad ended up pushing both bikes back up since I was too out of breath.)

I sounded like a donkey – every breath was so tight that my voice would sound with each exhale. “Hee – haw!”

After 20-30 minutes, we made it to Sand Flats Road, and hopped back on the bikes to coast down. Brad let me ride his big bike since more suspension = less jarring = easier breathing. (He looked a little funny on my little bike, his 6’3” frame all bent and tucked.)

At the Porcupine trailhead, I caught a ride for about 15 miles. Brad continued to ride down since there was no room in the truck, and I waited for him at the bottom, since I’d calmed and relaxed enough to breathe more gently (through the nose did the trick). We get directions, and bike another 15 minutes to the hospital. By the time we arrive, it’s been over 3 hours since I fell.

At the hospital, they check me over and determine I’m not a high priority. My BP is perfect, my oxygen levels are 98%, I’m walking and coherent, just slightly gasping.

Next, 2 hours of sitting in the waiting room. I find one, and only one, position that is comfortable, and even fall asleep for a few minutes. Then, I shift and lose the position, and the pain and breathlessness come back, a nurse sees me, and I’m whisked to the examination room. Doctor exam where the doctor is cranky with me for not relaxing and clearly thinks I’m not really hurt, chest/shoulder x-rays, a shot of the “super ibuprofen” (Toradol) into my arse, and an hour later I’m feeling a lot better.

3.5 hours into my hospital visit, and 7.5 hours after falling, the doctor looks at my x-rays, declares some bruising only, and decides I can go home. I really was being a big baby!

Just then, the radiologist calls him, and when he walks in, the doctor has a different demeanor. “We’ve got some bad news. You’ve broken your 6^th rib, and punctured your right lung. We need to send you to Grand Junction for a chest tube – I only put in about 1 a year, so you’d be better off with a real surgeon.”

Excuse me? We’ve gone from bruising to a punctured lung in about 1 minute? Really? And the radiologist found it, not the doctor?

Finally, I don’t get ambulanced to Grand Junction (saving me about $5,000), but do get my first overnight hospital stay for observation, since my lung has only collapsed 20%, and that kind of air bubble outside the lung can heal itself, as long as the hole in the lung seals up.

Poor Brad, having no phone and no gear, sleeps in the car to keep the dog company (though the hospital staff offered him a place to sleep). He also takes good care of me, buying trashy magazines and renting movies for my laptop since I’m bored stupid, and carefully eating out of my sight since I’m only allowed clear liquids. Can you believe how delicious chicken broth becomes when it’s all you’re allowed??? Brad listens patiently as I describe how I’m going to eat bacon, and a burger, “hey a bacon-burger!” when I get out.

Sunday. The x-ray tech is swamped with emergencies, so I don’t get a follow-up scan until about 11am, and when I do, the (different and better) doctor sees that the bubble hasn’t decreased, and wants to keep me another day. *&#$! I’ve got a final on Monday and 2 projects due! Brad has nothing with him for an extended stay! What do we do with the dog?!!

We negotiate. Her concern is that our house is at +7,000 ft elevation, and that could worsen my condition, so I volunteer to stay at a friend’s house in Salt Lake, where the elevation is only 4500, same as Moab. I promise to get another x-ray on Monday to make sure the hole isn’t still leaking air.

Done!

At 2pm, we leave the hospital, and drive back to SLC (stopping in Green River to eat at Ray’s, where I eat the most delicious bacon-burger – they are rated best in Utah you know). I stay with the SLC friends, go to the doctor on Monday and am cleared to go home and just to keep an eye on my breathing and how I feel, and not to do anything that will cause heavy breathing for a week or two (the lung-hole-scab is fragile apparently).

Anyway, that’s a long story, but I wanted to write it all for my memory’s sake. And for the lessons learned:

• Always pack an overnight bag
• Don’t assume that just because a trail is popular and crowded that it’s safe…it took over 3 hours to get to the hospital and if my puncture were worse, I may not have made it.
• Don’t be too tough! If I’d admitted that this didn’t feel like any other broken rib I’d had before, we’d have realized something worse was going on and could have called for the rescue helicopter (for $ sake I’m glad we didn’t, but if I were worse off…)
• Bring first aid stuff with, and be prepared! We were trying to tie my ribs with a jacket to make breathing easier!

Now for the silver linings:

• Legitimate excuse to call in sick Monday and study: “sorry boss, the office is at too high an elevation,” so I got my projects finished.
• Only legitimate reason to not go to Alaska: “not allowed on a plane right now.” (Long story, but I was going to AK for the weekend for my sister’s graduation, which was a short visit for long flights and at a bad time of year, so while I wanted to go, it was better not to.)
• I'm clearly finally healthy: with one lung partially collapsed, my oxygen levels never dropped below 96%, which is better than a lot of the population normally! All the training and working out has paid off - I've come a LONG way since the days of chronic bronchitis and smoker's cough and whatnot (not me a smoker, a family member smoked in the house growing up and I was sick for years after I moved out), so I'm pretty happy!
  
• Friends are now renewing their Wilderness Rescue and EMT certifications, just in case. It was a good wakeup call for all of us; we get too relaxed and forget we’re so far from help.