Please, please, wear your helmet!

I really believe that if I hadn't been wearing a helmet when I crashed that I would not have survived. I had a broken skull, broken facial bones, and severe bleeding in my brain - and that was with the impact lessened by hitting my helmet rather than hitting my bare head directly. And every doctor I've seen who has looked at the results of my head cat scan has said something like "that is a significant brain injury".

I've worn a biking helmet for what seems like forever - actually since the days of the original Bell Biker - and I plan to continue that habit. Today's helmets are light-weight, have plenty of air vents, and are comfortable to wear. Funny though, when I went to see my primary care doc to make sure that she was up-to-speed on my not so great condition in case I needed her help with anything, she thought I should get a motorcycle helmet. Somehow I don't think that would be too comfortable, and it would certainly be hot. Me? I'm sticking with a bicycle helmet, and in case anyone has any doubts, I'll be buying a new helmet before I get on my bike again!

To all of my fellow cyclists - if you're currently riding and not wearing a helmet - please, please, please join the helmet-wearing crowd. It may just save your life someday as it just saved mine.



OK, so there's a bit of blood on my helmet... if you look to the right of the Giro logo and just above the strap, you can actually see a dent on the outside helmet material.


Apparently this is the side of my helmet and head that hit the ground. It amazes me that the helmet is still pretty much in one piece - but it does have some pretty severe cracks in the underlying material.


Another view of the through and through cracks - this time looking up at the helmet from the bottom.

Surviving the food

...or can you even call it food?

Hospital food is definitely a problem...

I don't remember anything about the food at Mass General. I do know that my mom kept me supplied with shakes from the ice cream shop in the hospital - so apparently I didn't find the food acceptable. Not too much of a surprise, right?

The problem continued at Spaulding Rehab Hospital, and if anything the problem was even more severe. At Mass General there was a place to buy decent food. At Spaulding, the only public cafeteria was run by the same folks who ran the in-house food service. First I guess I'd better tell you that my normal diet tends to vegetarian and fish - so yes, I guess you could say I'm a bit fussy. I was supposed to be on a normal diet with no special foods. It was obvious from the first meal at Spaulding - a dinner - that the food was absolutely inedible. Mom went to try to get me something from the cafeteria to help tide me over until the next morning, and then she made some emergency phone calls to friends of mine who went shopping for food I could keep in the room and in the refrigerator in the kitchen on the floor. My friends brought food early the next day, including cereal, peanut butter, bread, veggies, cheese, and prepared foods from a whole foods market. Many thanks to Barb and Steve and Pam for bringing food to help me to survive that week without losing a ton of weight (not something that is advisable for me!). And Steve also told us about a takeout service in Boston with a central number and access to many restaurants, which helped with allowing us to select different (and interesting) dinners. The food problem was solved, and my mom & I could now eat together so she didn't need to get food once she got back to the hotel at night.

If you're in Boston and looking for food, the takeout service that we used was DiningIn.com. The service delivers food from lots of good restaurants for a very reasonable delivery fee. It certainly was a good solution to the food problem I had while at Spaulding Rehab - but it would also be a good service for those of you who are visiting Boston and don't feel like cooking!

Hospital & rehab

...not a normal followup from a bike ride

I don't recommend that you follow in my footsteps...

I spent a week in Mass General Hospital (MGH) followed by a week at Spaulding Rehabilitation Hospital. I suspect that if I didn't have someone to stay with me on my release that my stay in the rehab hospital may have been longer.

I've been told I was in three different places at MGH, starting with neurological ICU, moving to a neurology bed, and ending in a trauma bed. You could fool me... Intensive care? That's not in my memory, although I'm told that I was talking and interacting with people throughout. Hmmm... Actually, I have very little memory of my time in the hospital, although I do remember my visitors. I may not have been speaking with them normally - and I initially had a short-term memory problem so it's more than likely that I repeated the same comments and questions - but I remember the folks who took time out of their busy lives to visit me, and I greatly appreciated the visits.

I have one story from my stay at MGH, courtesy of my mother who was there with me every day. She told me about the nurses working at getting me walking in the hospital - because of course they want you to get up and moving. In my case there apparently was a bit of a delay - for my first four days there my chart specified bed rest. No walking, nothing. Then it was time to move. They gave me crutches, and I tried to use them but apparently said they were no good for me. The nurse agreed, and came back the next day with a walker. That didn't exactly do what the nurse thought it should since my reaction to the walker was to pick the thing up, walk for a number of steps carrying the walker, then put it down. And repeat. That must have been a sight! It certainly wasn't what the walker was meant for, so I quickly graduated to walking without an aid device.

And I even had a visit from a 4-legged friend! Well, I guess I should call him a 4-legged stranger. On the second to last day I was at MGH, a volunteer came by and asked if I'd like a visit from a dog. Of course I said yes - it was a nice change of pace and a pleasure to meet her big guy! I still couldn't ride my bike, but I could commune with a friendly dog who was happy to listen to me...

I do remember my time at Spaulding Rehab though - beginning with an ambulance ride for a short distance across Boston. The two hospitals are really within walking distance of one another - even though Spaulding is kind of set off by itself in the shadow of the Big Dig - but ambulance transportation was the order of the day for this gal. I was quickly settled into a room with the roommate from hell. That lasted for two full days and three nights until a nurse kindly told me I could request another room - which I did the morning after an exceptionally bad night. My new roommate was a very nice older woman (I think she said she was 87) who was recovering from knee surgery. What a huge improvement! Problem solved, and another lesson learned - it never hurts to request a new room! It's hard to share a room with a total stranger, and I think successful sharing involves a shared respect for one another. That didn't exist with in my first roommate, but my second was an absolute gem.

I had help from friends - again - as I got settled at Spaulding. Pam went to my house to pick up comfortable clothes for me since the recommended attire was normal clothing. A T-shirt, lightweight workout pants, and sneakers were a huge improvement over a hospital gown!

I've always appreciated my friends, and this experience really highlighted how very important good friends (including family!) really are.

It was partway through my stay at Spaulding when I discovered an interesting problem as I was moving from a standing (or sitting) position to laying down - and the same problem in reverse. It turned out that I have a condition called post traumatic benign vertigo, which is exactly what it sounds like - exteme dizziness (as in wow! the room is spinning) on switching between vertical and horizontal positions. I learned when I needed to get out of bed - as in, the bathroom is calling - that I needed to sit on the edge of the bed for a minute before I attempted to stand. Somehow I managed to not end up on the floor during any of my transitions!

The rebab hospital was an interesting experience to say the least. My expectations were that I would spend a lot of time working on improving from a physical standpoint - but looking back I don't think that was really the point. The fact is that I had significant injuries and probably needed to continue to be in a place with readily available medical care. But still, my focus was on trying to do everything I could to help myself get better faster.

Let's see, I was in Spaulding Rehab over a holiday weekend. I always thought that hospitals were one of the places that still pretty much had full services over the weekend. Well, I was wrong. I believe there was the normal contingent of nursing staff, but other services OT (occupational therapy), PT (physical therapy), etc. were running with minimal staff and services were definitely curtailed over the weekend. Well, I needed to be there anyway - I clearly wasn't ready to be home on my own yet - but you know me and exercise... I was very lucky that my mom stayed and was there every day (nothing like a 52-year old relying on her mother!!!) because I don't believe I would have been allowed off the floor on my own. In fact for the first couple of days I wasn't supposed to leave my room by myself. With her there, I was able to walk up and down the hall on my floor, visit with other patients who were also pacing the floors, and - luckily - walk outside by the river. The sidewalks were mostly under construction, so we were pretty limited as to where we could walk, but it was great to be able to get outside!

PT? Well, in the short physical therapy sessions I had, they had me do some exercises between parallel bars so I had something to grab if I was off balance. Then I walked up a flight of 3 stairs several times. After the first couple of days I graduated to the stairwells. The physical therapist wanted me to walk up the steps one foot at a time to the same step. That is, left foot to the first step, right foot to the first step, left foot to the second step - well, you get it! That lasted about 3 steps, and then I started walking up (and down) the stairs like a normal person. I must have been a very annoying (and demanding) patient!

My mom - talking to my case manager on my second day at Spaulding Rehab - mentioned that it would be a good thing if I could have access to a computer. And amazingly enough, there were computers with Internet access available to rent - at $7 a day. In the overall scheme of things that was money well spent since it allowed me to catch up on email, catch up with my biking buddies, and start to see what was going on in the world.

Is there a police report?

...and where is my bike?

Interesting.

My friend Steve - I think at the partial instigation of my sister and brother - attempted to find the official record of what happened. It turns out that because there was only a bicycle involved that there was no police report.

There was an ambulance report at the North Andover Fire Department - but it could not be released to anyone but me. After I returned home I drove over to the Fire Department and presented my identification. I was told I would get a phone call when the report was located (hmmm, doesn't it seem like they could have just pulled it out of a file drawer or printed it from a computer?), and then I could either go pick it up or they could put it in the mail. I got a phone call later that day to let me know that the report was ready but I opted to wait until the next morning to head back out to the Fire Department office and pick it up since I was still getting very tired with very little effort. The next morning, the ambulance report was in my hands. It still didn't shed any light on how my crash had occurred, but it did fill in some gaps in my memory.

My bike? My neighbor Paul knows folks in the North Andover police department. He went there to try to retrieve the bike for me, and found that it was actually held by the State Police - the folks who apparently handled the accident scene. He wrote them a letter, then went down in person. He managed to convince them that it was a good idea to release my bike to him - so I was able to see my somewhat injured bicycle when I returned home.

Where's Denise?

...searching and notification

I always carry identification with me - usually my driver's license - and I always carry my health insurance card. But there's something I need to fix - I've never carried "please notify in case of emergency" information on a regular basis. I've always carried it when I'm traveling with my bike, but I've never been in the habit of carrying this information when I'm wandering near my home. In this case that was a pretty big omission.

Luckily even though I remember nothing about the day of the crash, I was apparently still lucid enough to give the hospital the name and phone numbers of my family. And I believe my family still would have been notified because - as you'll see as you continue reading - it's likely that the folks at my office would have called them at some point before the end of that first day.

Work was another story. My coworkers started trying to find me in the late morning. Most people had assumed I had something going on and would be in in a bit, but I had a meeting scheduled at 11 - and I wasn't there. And everyone knew that if I wasn't going to be in or was going to be later than usual that I always let folks know. The phone calls started - first with calls to my home and my cell phone to see if I could be found. I wasn't there, and there was no answer at either phone, but they left messages for me just in case.

They tried the Andover police, and were referred to the State Police. Next on the "find Denise" agenda was phone calls to hospitals. Michael called Lawrence General Hospital. I wish I could have seen his face - and heard what I'm sure was a very vocal reaction - when they told him I was no longer there but would not tell him where I was. The HIPAA (Health Insurance Portability and Accountability Act) privacy regulation is extremely strict about the release of personal health information, but it seems to me that it wouldn't have hurt for them to tell Michael where I had been transferred. After all, if I had actually still been at Lawrence General they would have told him that I was there! And tell me, what does "no longer here" really mean? Released and OK? Transferred? Dead? Isn't the actual truth preferable to their answer?

The next call was placed by Ken, and the next hospital was Mass General. At that point at least they knew where I was. My sister called my office later in the day and spoke to Ken. She filled him in on what had happened, and he was able to pass on that update to everyone in the office. The next morning, Michael got an email with an update from Steve, who had just talked with my mom. When I went on my cross-country trip back in 2002, I made sure that my folks had the phone numbers of some of my friends here. That helped, because they were able to contact them for me.

The lesson: carry both identification and information on who to contact in an emergency. I believe the folks at work would have found me and notified my parents, but that's not a for sure situation. I happen to work for a very small company with unbelieveable people, and I suspect that the "find out what happened to Denise" exercise wouldn't have happened in just any company.

Update on September 26, 2004: I just ordered (and received) a SHOE ID from Road ID so if something like this happens again the emergency personnel will have information on who to contact if I'm not able to supply that information myself. The company was very fast in filling my order - I placed the order on a Thursday, and it was shipped on Tuesday, and received on Saturday, definitely good service. I actually splurged and bought 2 IDs - one that attaches to my shoe, which is what I plan to use while cycling, and one that is worn around my neck for when I go hiking in my sandals. OK, two IDs may have been a splurge, but I think it will be worth it!

Although it isn't stated on the RoadID web site you can actually place information on both sides of the ID. My ID has my name, city/state/country, and emergency contact information (2 phone numbers for a good friend who lives (relatively) close to me, and 1 phone number for family members. On the back I have additional health-related information, like the name of my health insurance company, my primary care physician, my year of birth (apparently emergency personnel want a clue about how old you are), and some general health information. If you want information on both sides of the ID you will have to place your order over the phone since that capability isn't yet supported on the RoadID web site.

Update on April 27, 2008: RoadID now sells an interactive version of the ID, and I have switched to this new option. It's interactive in that there is a web site that is used to store important information, and that web site is made available via a code placed on the id. This allows me to keep my emergency contact and health information up-to-date without replacing the ID each time something changes. I spoke to the folks at RoadID about the reaction of emergency personnel, and they assured me that the interactive ID has been very well received.

The crash... a couple of missing days

May 20, 2004 is definitely not a day that I would choose to repeat!

I have no memories of the day, but I know that it started out with a bicycle commute to work. It was National Ride Your Bike to Work Week, and my bike and I had only made the commute one day that week. May 20th was a Thursday, and I was determined to ride in on both Thursday and Friday to make it a 3-days-by-bike commute week. Factors beyond my control apparently intervened though, and I crashed just about four miles from home.

My crash was in Andover, MA on route 125 not too far from the State Police office. It's a two-lane road with wide shoulders that carries quite a bit of traffic at the beginning and end of the day, all of the folks heading to the expressway on their way to work or back home. It's actually a good road for cycling, smooth shoulders, wooded on both sides of the road. And it's part of my regular commute to work, whether I'm in a car or on my bike as I was on May 20th.

What happened? I wish I could tell you, but I can't. I believe I flipped the bike based on the condition of the shift / brake levers (and the condition of my poor head), and someone at the scene told the medics that I hit a bump. A bump, a rut in the road that caught my tire, something else? This will continue to be a mystery... The North Andover Fire Department Ambulance responded and took me to Lawrence General Hospital. After an initial assessment, I was taken by helicopter to Massachusetts General Hospital (MGH). And hey - I'm bummed that I have no memory of that helicopter ride! After all you have to find good around the bad things that happen, right?

I was at Mass General for a week, but I remember absolutely nothing of the first 2 days, and have spotty memories of the next couple of days too. I've been told that when I arrived, a nurse who was waiting for me and the helicopter was told that they brought in an 18-year-old bicyclist - but she was looking for a 52-year-old. Yes, that was me, not an 18-year-old!

After my week at MGH, I spent a week at Spaulding Rehabilitation Hospital. After the initial call from Lawrence General Hospital, my folks came to Boston, and my mom continued her stay while I was in the hospital, and then spent my first two weeks home with me, just in case... It was great to have her here, but I'd be surprised if I wasn't making her a bit crazy toward the end. After all, I was making myself a little crazy because you know me - I need to be active! As it turns out, I'm moving much more slowly than I'd like, and I'm trying to behave, really!

Injuries? Well, there are a few broken bones - a pelvic bone (an inferior ramus fracture), a rib, a skull fracture, and fractures of some facial bones around one eye, some bleeding in my brain on the side opposite the fractures and some bruising in my brain on the other side, a lot of facial swelling. Stitches? Yes, those too - on my lip, across my right eyebrow, and on my right elbow. My right knee was pretty messed up with a cut too, but no stitches there. And wow - was my face red and bruised and swollen! And for the first few days in the hospital, my neck was as wide as my face, definitely not the norm for me. I suspect it was more shocking and scary for the friends and family who visited me in the first few days in the hospital than it was for me since at that point I don't remember seeing what I looked like. In fact, I don't remember much at all about my time at Mass General... That's a plan - protect the patient from her own image!