Sunday, March 06, 2011

I broke my elbow back in December. I've been telling people about it face to face, but for a while was reluctant to commit it to writing. Recently, a friend asked me in email for the story, and so here it is (slightly edited from my reply).

On Christmas Day at about 6pm, I took the dog out for his evening walk. Our usual route takes us to an intersection at Washington Blvd and Ocean Ave, where there is a traffic light. There is a pedestrian phase to the lights, and it was in our favour as we approached. Just as I was about the step into the road, a car came through the red light and stopped to make a right turn. (For non-Americans this is using the right-turn-on-red rule, which says you can make a right turn provide you treat the red light like a stop sign.) He didn't hit me, though with a fraction of a second different in the timing, it would have been a different story. I crossed behind his car, and as I did so, I slapped my hand on the back of the car and yelled. It might not have been the smartest idea, but it something I've done before and I know other people do, simply because there are so many motorists who are completely unaware of pedestrians. I got to the other side of the road, at which point he leapt out of his car, ran across to me and punched me in the face. It actually was not a very hard punch, but I think it might have caught me off balance, and I fell down and landed on my left elbow. He then ran back to his car, got in and drove off, though I was able to get up enough to see his number plate before he turned the corner. This all happened very fast. I don't think it was more than 3 or 4 seconds from when he got out of his car to when he got back in.

At this point, I had no idea that I had broken my elbow. It felt the way it does when you graze it. My initial inclination was to go on with the walk, but I soon decided that was not a great idea, and headed straight home, with Faithless Hound, who had made no effort to defend me, insisting on sniffing every single tree on the route. When we got back, I called to Ellen and took my glasses off to clean them, at which point I found out that the punch had driven them into the bridge of my nose and cut it. I could see that my jacket sleeve was still intact, so it didn't seem likely that this was just a graze. When I took it off and straightened my arm, it hurt a lot more than it had done before, and I could also see a swelling the size of a plum on my elbow. (Ellen says it was the size of an orange, but I think this is an exaggeration.)

I suspect I was in shock at this point, and I wasn't sure whether we should go to the ER, call the police or do nothing. In the end I called 911 to ask for advice, but then decided myself that we should just go to the ER, which is about 15-20 minutes drive from us. They did an X-ray and said that it would probably need surgery and we would have to call an orthopedist to arrange this. They put a splint on, gave me some painkillers (Percocet - Strong Stuff) and sent me home. I really recommend Christmas Day at around 7pm as the time for your emergencies: in and out in less than an hour. They had also called the police, who will often come out to the hospital to take statements, but this time said we should go to the police station. When I arrived, my blood pressure was 167/75, so high that Ellen thought they had misread it. It was down to 127/75 by the time we left. So it's likely I was in shock after the accident.

We then filed a police report at the local police station, and had photos taken of the injury on my face as well as my now-beslung arm. After checking very precisely where the accident happened - it's just on the line between an area policed by LAPD and one policed by LA County - they said we'd hear back from a detective in a few days.

As Christmas Day was a Saturday, it was Tuesday before we could see the orthopedist, who confirmed that I would need surgery to have a steel plate put in. He took one look at the X-ray and said, "that's not going to heal by itself". If the bone fragments can be positioned 50 microns apart they will regrow and join together. Mine were just under 2cm apart. The fractured bone is called the olecranon process of the ulna,
basically the cup-shaped bit at the joint. The triceps attach to the part of the bone that had broken and pull it apart when it break. The question was when, as the surgery should really be within two weeks of the injury. We wanted to travel to Mountain View for the New Year feast that our friends Vanda do. His initial inclination was to try to fit the surgery in that week, but in the end he gave the OK, and booked me in for January 5th.

During all this time I had surprisingly little pain. I hadn't taken any of the Percocet, and in fact took very little apart from some ibuprofen. Ellen and I gradually worked out ways of getting things done. I don't sleep well on my back, but if I slept on my side, then I had to twist my back to accommodate the immobilised arm, and so ended up with backache. We solved this by having Ellen shove a pillow in behind me for support once I was settled. Then I was waking up with my shoulder in spasm from being immobilised, so I started doing shrugs and putting a hot water bottle on it before I went to bed. Showering involved me putting my arm in a plastic bag, which Ellen then taped in place so no water got into the dressing. Remarkably, you can wash your right armpit with your right hand in a move I like to call the Funky Gibbon. My hand also swelled up to two or three times its normal size. The orthopedist had made a point of removing my wedding ring when I first saw him, as it would have meant cutting it off if he had left it any later. Or my finger getting gangrene and dropping off, which seemed undesirable.

After New Year, I went in for surgery. It's roughly a two and a half hour procedure which involves bringing the bone fragments back together, and attaching a metal plate. That's what you see on the later X-rays: there are screws going into perpendicular to the ulna, plus one long one under the plate which holds the tip of the bone in place. They can take the metal plate out after a few years, and I've yet to see if it sets off airport metal detectors. The anaesthetist had said he would do a nerve block so that I wouldn't have much pain for a few hours after the surgery. I think it didn't work, as I came round with the worst pain I can ever recall. This one did need Percocet, which unfortunately causes nausea unless you've eaten first. I had a couple of days of feeling generally sorry for myself, going back and forward between being in pain and feeling sick because I'd taken the Percocet to stop the pain. Eventually, Ellen got the doctor to prescribe some anti-nausea medication (as well as Vicodin, which I didn't take), and from then on things improved. The dressing was taken off six days later. The photos of the scar are from just after, when I was sitting in the doctor's office with my Nexus phone to hand. Then it was a matter of regaining my strength and motion through physical therapy, and gradually eliminating the need to use a sling.

I am largely healed now, apart from the last 20 degrees of movement in each direction, which is gradually improving with continued physical therapy. The orthopedist did say I might permanently lose a bit of straightening, perhaps 10 or 15 degrees. The pieces of bone aligned well and have knitted back together, and the scar is fading already. The police tracked found out that the car was a rental, and had been rented by a woman, not the man driving it. There is a little more detail about this, which for now I'll hold back.

1 comment:

Sarcasm (Un)Lmtd. said...

I looked at the picture... holy *bleep* *bleep*!!! I hope they find the guy. Hugs, and I hope the recovery is going well.