Broken leg experience

CAUTION: do not read if you have a weak stomach. I talk about the injury and various hospital procedures in detail.

I was finishing up a mountain bike ride with my riding buddies, Kurt, Chris, Doug and Brad. We were riding the trails near Lake Sawyer/Black Diamond and we had just popped back out on Hwy 169 about a mile from the cars. Since it was such a nice and warm day, I decided to ride the 4 miles back home instead of hitching a ride with Kurt like I sometimes do when the weather sucks. We briefly chatted about plans for the next ride, then everyone else headed for the cars and I took a different trail towards home.

The trailhead I was on had a ditch dug across it to keep cars out, and I figured it would be easy to ride through, since it was maybe 5 feet deep. As I rode in, I realized it had been dug out more than the last time I rode through, and the bottom was not so smooth. As I went up the far side, I got jostled around and felt the front end of the bike start to come up too much. I must have instinctively unclipped from the left pedal to catch myself. My best guess is I put out my left foot while coming down but still moving forward, catching toes between some rocks. My foot felt odd as I went down. I caught a glimpse of the it, pointing about 90 degrees to the left while the shin was still pointing forward. I got to my hands knees and instantly realized it was bad. I could tell the ankle was dislocated, and the tibia was poking out more than it should have been.

I immediately started screaming as loud as I could. "Kurt! Chris! Brad! Doug!" over and over. I was only about 50 feet from Maple Valley Highway, but there was the 5 foot deep ditch to cross to get there. I was dreading having to crawl through that to flag someone down on the road. I continued to yell, and hoped dearly that they would hear me. It was probably only a couple of minutes, but time slows down in these kinds of situations. Chris and Brad came into view and I was so relieved. I was still on my hands and knees as the guys came over. Chris took one look and me and told Kurt to call 911. Chris took the lead on first aid, getting me on my back and getting my leg supported. Everyone acted fast to help me get as comfortable as possible. I was pretty tense, just clenching my teeth and holding my chest with my arms crossed. I don't remember when the shaking started, but it was fairly constant once it got going. I tried to look down at my foot at one point, but Chris advised against it, covering my eyes.

I think it was less than 10 minutes before Fire and Rescue came. Sirens never sounded so sweet. They got to work assessing me, calling in an "obvious dislocation and fracture" on the radio. The asked me a bunch of questions; name, address, etc. BP was 170 over something, pulse around 100. They worked on getting my shoe off so they could put a splint on. The shoe came off without hurting too much. They asked if I could feel my toes, and if I could still move them. I hadn't tried up until that point, and it felt very strange. My toes just weren't where they were supposed to be. But I could move them ever so slightly, and I could feel them, so that was good sign. Fire and Rescue guys appologized over the fact that they had no pain medication. I'd have to wait until the hospital for that.

Then we waited for an ambulance to arrive. I don't remember how long that took. Kurt had also got a hold of Kathy who was in route as well. Kathy got there and was able to help out with various questions. I was heading to Valley Medical. They put me on a back board to carry me across the ditch and out to the gurney. Kathy was going to run to house to organize the kids, and then head to the hospital. I was loaded in and we were on our way. No lights and sirens, since the injury wasn't life threating.

As we went through the intersection at 4 Corners, the ambulance drifted toward the center curb divider, and we bumped the curb. It was nothing really, just a light brush. The fire guy sitting with me though got a smile on his face and said he was going to have to give the driver a hard time about that. I jokingly asked "He's a rookie, huh?" and the fire guys said "No, he drives the fire engine!". We had an uneventful ride the rest of the way to the hospital. We got to the ER and as the driver came around to open the doors, I asked jokingly, "What was up with the curb?" He apologized and said something about getting something in his eye.

They wheeled me into the ER and started checking my leg out. I was shaking pretty good at that point, though I wasn't cold. I had lots of admirers in the ER. One guy said since Harbor View is so close, they don't get to see trauma like this very often. I'm glad I could be a learning experience :). Kathy actually got to take a picture of my leg before they realigned it. I won't post them here, since they are a little disturbing. If you really want to see it anyways, here is a link, but you've been warned.

They wheeled in an x-ray machine to take some pictures before trying to realign the leg. The ER doctor explained his assessment, and what they were going to do. Dislocated ankle, broken fibula, multiple fractures around the end of the tibia. He explained they were going to give me some strong pain medications, and a disassociative drug, then pull on the leg to set the ankle back. A group of about 5 guys in lab coats gathered around me as he explained this. The next thing I knew the leg, foot and ankle were all pointing the right way again. Kathy said she watched them work and basically once I was out, during the space of one breath, they pulled on the leg and lined it back up. I don't know how long I was out, but it couldn't have been more than a few minutes. Then it was off to another set of x-rays, and then wait for a hospital room to open up. The ER doctor wasn't sure when the surgery would be, but possibly not for a couple days.

I got to the room, and was settling when they came and said they were doing surgery right away. The surgeon came in and explained the plan: the fibula was a clean fracture, they would put in a plate and 3 screws. The tibia had three pieces broken on the end, kind of crushed. Three screws to put it together, and then one screw to connect the fibula and tibia for support. The ankle actually looked fine, no bone or ligament damage. It was close to 6pm at that point, and we were told it would take about 3 hours before I would be out of recovery. We decided it would be best for Kathy to just head home and call my room about 10 to check on me. I got a shot of something in my I.V. that hit me pretty hard and had my head swimming, but the leg was feeling OK.

They wheeled me up to surgery and waited for the crew to arrive and then I waited on a gurney in the lobby. Additional fact: up to that point, I hadn't urinated. They let me try one more time, without any luck. But since they would run a catheter during surgery, it wasn't a problem. I don't remember anything after that, so I must have been unconcious by around 6:30.

I woke up in recovery very groggy. My throat was sore from the breathing tube. The recovery nurses were very helpful, giving me ice chips and talking me through everything. At some point someone showed me post-op pictures of the leg. I was still loopy so I barely remember, plus I didn't have contacts or glasses, so I just remember seeing some x-rays with screws.

Eventually they wheeled me back to my room. I remember asking what time it was and hearing 9:30, so their estimate was pretty accurate, right at 3 hours for the whole process. Kathy called at 10. I don't remember much of the call, but she got to hear that I was all right.

I had a fitful night, not really getting any sustained sleep. The RN would check on me, and try to get the pain medication correct. I don't know what they had me on out of the ER, something intravenous, but it was wearing off. The nurse suggested Percocet, since I would need something to take orally at home and I should try it out to make sure I could handle it. I took one tablet and after an hour my leg just continued to hurt more and more. Back to the intrevenous medication, which I now understand is called Dilaudid. A few hours later when that started wearing off, we tried 2 Percocet tablets. Again, it really didn't feel like it did anything, and the leg just continued to hurt more. In retrospect, I think the Percocet actually was working, but the intravenous stuff was so much stronger and pain level high enough that I wasn't noticing the Percocet.

I still hadn't urinated since the surgery so at about 2 or 3am they had a tech do a quick ultrasound on my bladder to see if it was full. Of course it was (I could have told them that :), so they ordered up a catheter. That procedure is definitely high up on the unpleasent-ness scale (for the guys, if you think the prostate check is unpleasent, the catheter is much worse). The ultrasound had shown about 800ml of urine, but after my bladder drained for while, the nurse came to empty the bag and was surprised that it had 1350ml in it. A few hours after that, they emptied another 2 full liters.

Kathy came by in the morning after sending the kids off to school. Also, both surgeons came by in the morning to check on me. They told me the surgery went well, with the bones lining up nice and cleanly. I got a review of the hardware they used, and the surgeon showed me where the incisions were. The rest of the morning was spent with occupational therapists, and physical therapists. They showed me how to use crutches and a walker, how to get out of bed, and on and off the toilet. I got to practice with crutches on the stairs too, since we have stairs at home. I also got some visits from some friends. It was nice to have the distractions.

The surgeon came by again in the late afternoon to check on my progress. The catheter came out (also a little painful) about 2pm and I was told I had 6 hours to urinate on my own. If I wasn't able to, they would put the catheter back in. Luckily, about 6:30pm I finally went on my own. Apparently that was the last thing holding up my release, so I would soon be going home. Fortunately, Kathy was on the way back down to the hospital with the kids. As we pulled into our neighborhood, I commented that it felt like I had been gone a week, but counting back, I had only been at the hospital for 31 hours.

In the end, not a very glamorous crash. Not a high speed wipeout, or nasty tumble, and no blood. All in all, it could have been much worse. I might be been miles from a road, where someone would have had to carry me out. The fracture could have been even nastier than it was too. And I'm very thankful my friends heard me and were able to help.

Through all this my wife Kathy has been a absolute angel, taking care everything I've needed.

Even if none of these people get to read this, I want to thank all of them: the first responders, fire and rescue, ambulance - minus the driver (I'm kidding! He did great!), ER staff, surgeons, recovery, RNs and PCAs. If you work in this type of job, please know that your work is appreciated!