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Collision course – my story of pain today

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  • CT Collision course – my story of pain today

    I was riding my bike on my normal route to work today. Then it happened, like a blink. A car that was not supposed to be there was there, coming at me. No time to change course or apply breaks, just brace for impact.

    I was headed west bound on a 2 lane road. Entering a light controlled intersection on a green light. A jeep grand Cherokee, which was in the opposing left-hand, turn lane, crossed traffic and met me.

    We hit in an instant. I think I recall my instinct being tuck, get on the hood, and drop head (to roll over). Truthfully I don’t know if those cognitions came during or after the fact. I do remember a sense of hardness, a hardness that meets you and tests your entire will to stay in one piece. In all my years playing football, I have never felt something so strong that it threatened to tear limb from limb. Next came the weightlessness and the spinning. I remember thinking, well this is good. Between the twisting on multiple axes, I was senseless to right myself. This was pleasant. Then came the fall, as I hit the ground all the worldly sensations came rushing back into me. Pain entered hard through the legs, L side of my spine, I instantly felt my entire left side recoiling. Knowing I was somewhere in the middle of the street, where more traffic could meet me I rolled left, saw the car whom hit me turn around, rolled right and attempted some primitive crawling motion, unsuccessful. Then I succumbed to the sensations, put my head on the pavement and breathed. I told myself the damage was done, and in time my body and mind would heal – I just had to breathe through this. The sign of the first responder, I started groaning and screaming, nothing intelligible, he looked scared. I told him to give me his hand, he was reluctant. I said just hold my hand.

    Moments later the paramedics were there, an ortho physician assistant was clearing my spine, it appeared that none of my extremities were grossly out of alignment. I have a vague sense of coming down in a crumple, with my left knee coming down underneath me pinned into internal rotation, valgus and flexion—that does not look right. Ambulance, more groaning, all I want to do is groan and move. Not stand up per se, but just escape the onslaught of sensations that were bombarding me.

    Before being loaded into the ambulance, I checked the door. Denver Paramedics, I was still going to make it to work today, albeit not in the correct department (I work at the community/trauma hospital, Denver Health which is where Denver Paramedics operates). The ED was an interesting place, my first ambulance ride, my first trip to an ED since probably forever.

    It took an abnormal amount of time to get me off the stretcher and out of the neck collar. I knew my neck and lumbar spine were fine, even though my pelvis and l-spine were locked in spasms crawling up my back; I laid there for 30 min or so. They tried to keep my legs straight. Which once the spine is cleared makes absolutely no sense. The only thing my body wanted to do was curl up into a ball, a ball so tight that I could appease my slowly building tension in my abdominals, psoas, and hip muscles. The interns performed there standard procedures, they asked me to rate my pain, I said 1/10. Which is strange, clearly the magnitude of collision would deem a higher level. I just hit a car head on going probably 20mph while the opposing vehicle went at least 15 mph. I flew maybe 10 to 15 feet. My bike was crumpled. The cross bar of my bike which was between my L knee and the car was bent at least 10 degrees. Was I trying to just “be a man”. I don’t know but I knew that what I was feeling at this point was alright. Most of my extremities were fine. I was mildly concerned about a tib plateau fracture and or fibula fracture. But most of my discomforts were telling me to move, and keep moving so to register this as pain did not seem correct.

    I was taken to X-rays, everything I was concerned about was x-rayed. I was able to walk—barely but I knew that would rule out an ankle fx—Ottwa ankle rules.

    I returned to the ED, waited and waited some more. I turned down taking any pain meds, I wanted to do an n=1 experiment. That experiment being, firstly I wanted to really feel, clearly, moment to moment what my body was going through, secondly I also wanted to take this idea of ideomotion and try it out, thirdly I wanted to experience what it was like to have counseling and how that affected my pain symptoms.

    A little background, I am part of a community of people, whom meet regularly to counsel each other. We are not professionals, but more like friends, we do not offer advice but more serve as partners for listening. How this works, is that when individuals meet, we have a timer, and we trade time. Trading time means that one person gets the undivided attention of the other while that person talks, laughs, cries and shares whatever they have going on with them. The goal is to give undivided and nonjudgmental attention to the other. So when I refer to counseling that is what I am referring to (within this post).

    So what did I notice, first off, the adrenaline that accompanied the accident was wearing off. I could feel moment by moment tension increasing in my right ankle and knee as they swelled. I also got the sense that my body wanted movement. I found myself doing the proverbial writhing. I shifted to and fro, side to side, at one point I was upside down on the bed with my feat elevated as high as they could get up the wall. I really could just not stay in any position for long.

    After a while of this I picked up the phone and called one of my ‘counselors’—so normally you trade time but in cases of pain and death it is allowed to have one way time. I talked with her, walked through the accident step by step in my head, talked through my worries and concerns, moaned, and kept telling her I just wanted to be a little ball (which is ironic, I guess because I am not a little man). It was weird but after I started to do this, and curl up into a ball these bouts of discomfort started to abate and I felt a bit calmer. The sense to move was abating and I could feel myself easing.

    During this time I did notice that my psoas bilaterally, but L greater than R, L hamstring seemed to be stuck in the “on position”. I could feel them ‘bubble’ sometimes as I would try to breathe, perform some Hannah Somatics side lying exercises but they were like in lock down protection mode. Also I had super nerve tension. To look down would send electrical signals down my e-spine. In fact afterwards, I had extreme trouble getting into the car because I could not flex my head due to this.

    I went through a phase of nausea, about the time I think my adrenaline was coming down, this was brief but not that intense. After I had relaxed for a bit and gone through about 30-40 min of counseling I started to feel very hungry. So I ate the lunch I packed (for work, not the accident). I also felt very cold in my feet so much so that I could not tell if my feet were cold or painful.

    Eventually, x-rays came back clear. I hobbled out of the ED. I could not stand up straight, left knee felt loose—I was apprehensive about putting weight on it and bending it. It also felt like there was corset around my waist that was cinched down super tight.

    This part of my experience has led to the following reflections.
    1. My discomfort was worse when I was alone. That having someone there (albeit on the phone mostly) greatly aided my discomfort.
    2. Expression of that pain through moaning and writhing did help.
    3. That in my case, after I knew I could move, the movement generally aided the discomfort. Overall I was quite surprised at some of the positions that I ultimately found comfort in. Also, I wonder how many acutely injured people are not implicitly given that authorization at these early stages that yes you can move.
    4. The general anxiety of the ED is very dreadful. There were people outside my door talking about the shooting in Connecticut. Also, listening to other people in discomfort also greatly increased my anxiety and perceived discomfort.
    5. I wish I had someone that knew some DNM. I would have loved to experience that during this “session”. Diane seriously, where were you?
    6. I think we could greatly, appease and decrease the use of opioid based pain meds if patients are given better attention during their time in the ED and providers do a damn good job of answering the question “Am I alright?”. I think much of my own education allowed me to answer this question myself, but I did find it surprising how much I had to pepper the MD’s with questions to determine what they were thinking


    I made it back home with the aide of my counselor friends. Eventually, I curled up into a ball and gradually eased into sleep. Throughout the day, I altered between supine, side lying, standing (hobbling). I found myself walking with a straight L leg because of perceived apprehension due to my questions of ligamentous stability (I am guessing a full MCL tear, perhaps an acute meniscus fold as well), and my R leg in max eversion because it hurts to DF through talocrual joint.

    At approx. 12 hours post-accident I decided to take 800 mg of ibuprofen, mostly because I wanted to see the effects (they were dramatic, maybe 50% more ease with movement.) Still I walk with a very guarded gait but right now I feel much more comfortable experimenting with different types of gait.

    Overall I am fine, I think I have a full thickness MCL tear (which is moderately disconcerting because one I have never had an ortho surgery and two the possible ramifications for the sports I like to do), but we’ll see come Monday. There was a lot of anxiety about financials but the other driver was at fault, he admitted, was cited and has insurance—so that eased one of the biggest anxieties of the day—how much this is going to cost me? I am pretty banged up, my helmet is cracked and with a sizable chunk taken out of it, my bike is done for.

    We as therapist rarely get to experience the lives of our patients. I am writing this post from my perspective of both the therapist and the patient to further my insight into the human experience.
    Last edited by Milehigh; 16-12-2012, 06:51 PM.
    --------------------------------------------------------------
    Body is imbued with mind, and mind is embodied.

  • #2
    Holy schmutz Eric, I'm so sorry I wasn't there to help you! You should have called - I had no patients booked today all day! (Well, I might not have been able to teleport myself to Denver in a timely manner anyway...)

    Anyway, thank you so much for the excellent case study of your own experience. Write to this thread every day please.
    Diane
    www.dermoneuromodulation.com
    SensibleSolutionsPhysiotherapy
    HumanAntiGravitySuit blog
    Neurotonics PT Teamblog
    Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
    Canadian Physiotherapy Association Pain Science Division Facebook page
    @PainPhysiosCan
    WCPT PhysiotherapyPainNetwork on Facebook
    @WCPTPTPN
    Neuroscience and Pain Science for Manual PTs Facebook page

    @dfjpt
    SomaSimple on Facebook
    @somasimple

    "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

    “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

    “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

    "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

    "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

    Comment


    • #3
      So sorry to hear this Eric but thank you so much for sharing. You should forward this to Lorimer. This was so eloquently written and I believe it could reach a wide audience through re-posting to BodyInMind. This "n=1 narrative" needs to be shared...If they aren't interested, I would love to re-post this to my site...
      Joseph Brence, DPT, FAAOMPT, COMT, DAC
      "Great spirits have always encountered violent opposition from mediocre minds" - Albert Einstein
      Blog: www.forwardthinkingpt.com

      Comment


      • #4
        Wow, Eric, glad you came out of it relatively ok. MCLs heal good, right?

        Your vivid account takes me back to a similar accident I had on a motorcycle back in 2005. Some idiot pulled right out in front of me and BAM! Fortunately, I went hurtling over the hood of the car, and, exactly as you described, it was an eerily pleasurable feeling swirling through the air- perhaps because the alternative of going SPLAT against the side of the car or another oncoming vehicle was at least momentarily avoided.

        I ended up hitting the relatively soft boughs of a large Carolina long-needle pine and fell to the ground inopportunely into a patch of poison ivy. That turned out to be the worst of my "injuries", fortunately.

        The motorcycle was junked and I doubled my life insurance policy.

        I look forward to hearing more about your journey to recovery.
        John Ware, PT
        Fellow of the American Academy of Orthopedic Manual Physical Therapists
        "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
        “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
        be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

        Comment


        • #5
          Thank you for writing this account, Eric. It was fortunate you could remember so clearly (ie no concussion) and Lorimer would likely be very interested in a detailed account of a prang involvong a physio.

          Hope you do OK but watch out for the second or third day post-event; your emotions could go erratic...

          Nari

          Comment


          • #6
            Thank you Eric, so much.

            Good to read you are safe.
            Carol Lynn Chevrier LMT
            " The truth is, people may see things differently. But they don't really want to. '' Don Draper.

            Comment


            • #7
              I've tweeted BIM - we'll see what happens. They go offline on weekends usually.
              Diane
              www.dermoneuromodulation.com
              SensibleSolutionsPhysiotherapy
              HumanAntiGravitySuit blog
              Neurotonics PT Teamblog
              Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
              Canadian Physiotherapy Association Pain Science Division Facebook page
              @PainPhysiosCan
              WCPT PhysiotherapyPainNetwork on Facebook
              @WCPTPTPN
              Neuroscience and Pain Science for Manual PTs Facebook page

              @dfjpt
              SomaSimple on Facebook
              @somasimple

              "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

              “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

              “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

              "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

              "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

              Comment


              • #8
                Glad to hear you have "seen the other side" and are able to give such a vivid account and first-person perspective.

                Comment


                • #9
                  Thank you for sharing your experience with us.

                  I am glad that you are fine (overall).

                  Respectfully,
                  Keith
                  Blog: Keith's Korner
                  Twitter: @18mmPT

                  Comment


                  • #10
                    So glad to hear that you are okay following your accident. Thanks so much for sharing your experience.....and the depth of sharing, thank you.
                    "The danger is not that the soul should doubt whether there is any bread, but that, by a lie, it should persuade itself that it is not hungry" (Simone Weil)

                    Comment


                    • #11
                      Holy crap Eric!It is so good to hear you are ok.
                      Your writing style is so gripping I kind of wonder if you had been writing some of this mid-flight. I mean I know people on Soma can be dedicated.


                      I am sure BiM will pick this up. Keep writing, the insights as remarkable! Can I share this freely?
                      Byron Selorme -SomaSimpleton and Science Based Yoga Educator
                      Shavasana Yoga Center

                      "The first principle is that you must not fool yourself - and you are the easiest person to fool" Richard Feynman

                      Comment


                      • #12
                        Yes, please feel free and share this to whomever, however you would like. Thank you all for your kind words and support. On a comically ironic side, I was going through my messenger bag today. I found my copy of Anatomy Trains (author a Tom Myers) in the pocket. Normally, I would not bring such a large book to work on my ride (space and weight reasons), but I wanted to have it in case I wanted to reference it. My bag sits right over my l-spine and sacrum. I can't help but think it must not have hurt to have the extra layer of padding.

                        Eric
                        --------------------------------------------------------------
                        Body is imbued with mind, and mind is embodied.

                        Comment


                        • #13
                          Originally posted by Milehigh View Post
                          Yes, please feel free and share this to whomever, however you would like. Thank you all for your kind words and support. On a comically ironic side, I was going through my messenger bag today. I found my copy of Anatomy Trains (author a Tom Myers) in the pocket. Normally, I would not bring such a large book to work on my ride (space and weight reasons), but I wanted to have it in case I wanted to reference it. My bag sits right over my l-spine and sacrum. I can't help but think it must not have hurt to have the extra layer of padding.

                          Eric

                          :clap2::clap2::clap2:

                          That is hilarious.

                          I was musing earlier that it's likely a good thing that you've never had any "fascia released", because your unreleased (apparently..) fascia came in so handy to keep your physicality together through all this.
                          Diane
                          www.dermoneuromodulation.com
                          SensibleSolutionsPhysiotherapy
                          HumanAntiGravitySuit blog
                          Neurotonics PT Teamblog
                          Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                          Canadian Physiotherapy Association Pain Science Division Facebook page
                          @PainPhysiosCan
                          WCPT PhysiotherapyPainNetwork on Facebook
                          @WCPTPTPN
                          Neuroscience and Pain Science for Manual PTs Facebook page

                          @dfjpt
                          SomaSimple on Facebook
                          @somasimple

                          "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                          “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                          “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                          "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                          "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                          Comment


                          • #14
                            Eric,

                            Personally, I was "struck" in slow motion about a week ago and the trauma to me is something I think about a lot. Reading of what you've been through helps a great deal. Thank you.

                            What I assume was the influence of cultural norms is threaded through your narrative, and, for me, it is best described in the hesitance of the EMT to hold your hand. Later, you experienced the consequences of cosmetics when they tried to make your legs look better.

                            Small movements make all the difference, and I know you are aware of this. What we need is for those helping us to understand this. My caregivers didn't have a clue. Your friends do.
                            Barrett L. Dorko

                            Comment


                            • #15
                              Jeeze Eric! I am glad you are ok and very appreciative of your most excellent writing!

                              Also, like John W said, MCLs seem to heal a lot better than LCLs possibly due to there being more tissue to grow back onto. When the time comes, kinesiotaping with a fair amount of stretch starting with the middle of the tape from the medial knee and pulling proximal and distal in several different degrees of flexion can give a very comforting support.

                              Comment

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