Showing posts with label snowboarding accident. Show all posts
Showing posts with label snowboarding accident. Show all posts

Tuesday, March 9, 2010

The Moments of the Accident

Before you read any further, if you are my Mom or my wife, you are to immediately report to this website. I'm sorry, but you're not ready to see how awesome this injury was.

Up until now, I haven't fully explained how I hit that tree on my snowboard last month. Honestly, there aren't many ways you can hit a tree. Here's how I did it. This will be somewhat long, but hopefully interesting. I mean, I hit a tree.

I vividly remember the whole incident, except for the parts where I don't remember anything. I can still see my floppy foot dangling from my leg. And that murderous stare that tree gave me will burn in my mind forever.

Actually, I don't remember if there was a snow face involved. I do know that it wasn't an evergreen tree. It was about two feet wide. And it was grown with one purpose in mind: total snowboarder annihilation.

It was my fourth and final day to dominate Breckendridge's slopes. Everyone else from The Team had retired after three days. So I dedicated my last day to practicing my switch stance.

What's that mean? When I go down the slopes, I lead with my natural foot, my right. When you ride with your switchfoot, you're essentially riding backwards with the unnatural foot in front. In my case, my left.

It's good to practice riding down on your switch stance. It improves your fundamentals and presents a challenge since it's harder to do. I believe riding switch stance prevented me from injuring myself any further than I did. I'll explain in a bit.

At about five minutes before 10:00 AM, I'm coming down on my second run of the morning. I'm guessing, but I might have been in the neighborhood of 40 to 45 MPH. I don't make very many cuts when I come down the trails. I tend to go straight down.

I had just completed the same run earlier for my first one of the day. I was familiar with the terrain, and perhaps a bit overconfident. Me, overconfident? No way!

About a hundred yards in front of me, from left to right, I spot the murder tree, a little girl skier, and a small forest of evergreen trees.

My planned line was to race between the murder tree and the little skier. The skier would have been about ten feet to my right, so I had plenty of space. As I'm approaching what would turn out to be the landing site, the little skier continues to take small turns next to the forest on the right. Perfect. Everything is going according to plan.

Now one of our responsibilities on the slopes is to try to predict where the people in front of us will be in the future. Sounds impossible. But she appeared to want to do her tiny left and right turns next to the forest the whole way down.

My predictions of the future, as we know, were false.

As I get about ten yards away, she has a sudden change of heart and immediately cuts way left, right in front of me and very close to the murder tree. If you've never been skiing before, this is actually okay for her to do. Everyone in front of you has the right of way.

Time to plan out an alternate route. Fast. I probably have three seconds.

At first, I thought I still had enough room to squeeze in between the skier and the death tree. But there were risks. I could trip the skier. I could hit the evil tree. If I didn't hit the skier, I could frighten her and cause her to fall down and hurt herself.

Five yards away. This option is stupid. A decision is overdue. I have maybe 1 or 2 seconds left to figure something out.

My 220lbs of momentum was already taking me left near the murder tree. I decided to cut further to the left in front of the tree and pass it on the right.

Hey, I thought, I'm an expert snowboarder! I can do this. Piece of cake!

Since I'm riding switchfoot, and leading with my left foot, I'm looking deeply into the death tree's snow face. He's angry. I'm cutting left. Hard. I appear to be making no progress in my desperate attempt to go left of the murder tree. It just keeps growing, and growing, and growing in my field of vision.

My brain immediately sends out an emergency bulletin: brace for impact!

The "expert snowboarder" makes contact with the murder tree.

The bottom of my snowboard hit the face of the tree where my right boot sits. Just before impact, something had put me down on my butt. I probably fell because I freaked out. But my speed was dramatically reduced as a result. This probably saved my ankle from sustaining any more hilarious damage.

Since I was riding switchfoot, I had an opportunity to see everything in front of me. Had I been riding with my regular foot, my back would have been facing the tree. I might not have seen the impact coming. I probably would have hit the three standing up. That would have been very bad.

As the snowboard hit the tree, my right foot was overextended and rotated upward, toes toward shin, suddenly and quickly. This force instantly apple sauced my tibia and snapped my fibula in half. It also severely stretched a nerve running along my heel, numbing most of the important parts of my foot. Finally, it made my leg about two inches shorter.

Of course, I learned about all of this later. At the time, I was in an insane amount of pain.

I went into auto pilot. I did not control the sounds or words coming out of my mouth. I believe I screamed two things at the top of my lungs over and over again: "SOMEONE PLEASE HELP ME," and, "AHHHHH!"

Thankfully I yelled things that were useful. I mean, think about it. Given the circumstances, I stood a great chance of saying some things that might not have been helpful at all.

If you've never met me before, I should tell you that I'm louder than you. There have been many over the years that have come close, perhaps even equaled my unnatural volume. Naturally, this particular characteristic constantly annoys my friends, co-workers, and fans of the visiting team at ball games.

While annoying the majority of the time, my domination in the volume area helped get me out of a tight jam.

Within seconds, a male skier stopped next to me and said, "I saw and heard the whole thing." I'm guessing he heard the fibula and tibia break. Awesome! That's one part I don't remember.

He told me he was a doctor. How amazing is that? He and I started to evaluate my situation.

Surprisingly, I wasn't crying. I think I even said, "I can't believe I'm not crying. This hurts really bad." He told me someone was getting a hold of Ski Patrol. This was at about 10:00 AM.

He asked me where it hurt. I told him I think I had a fracture just above my right ankle. My toes felt wet, so I was worried that the break was through the skin and that I was bleeding badly in my boot. By that time another female skier had stopped by. We asked if she had a scarf I could use as a tourniquet. She didn't have anything, so the doctor and I just used our hands right below my knee to apply as much pressure as possible.

At some point the doctor decided to get me out of my snowboard. He started to get my boots off. I showed him how to loosen the left boot. Then work began on my right boot. As we're doing this, he's asking my name, where I'm from, all the boring questions you ask to make sure your patient stays awake and doesn't flip out. Man, I am so thankful for that!

We finally get the last strap of my right boot loose. Now, without any support, my right foot dangles from my leg like it's soap on a rope. The bones had been broken all the way through, giving me an unnecessary, gross, and painful new joint. I instinctively grab for the heel of the boot to brace it.

That's when I tell the doctor, "my wife is going to kill me." He asks why. I manage to say, "she told me to be careful this morning before I left." In my messed up head, I seriously thought Brooke was going to go into a yell-storm the instance she saw me at the clinic. I was afraid.

The doctor asks if there's anyone else out here on the mountain with me. I told him no. He asks me if I'd like to call my wife. He takes out his phone and we give her a call. No answer.

I manage to get my phone out and try a few times. No answer.

I called everyone that was in the cabin that day. No answer!

While we're waiting for Ski Patrol to show up, I'm constantly thanking this guy. He did a fantastic job keeping me calm and relaxed. I know he told me his name, but I don't remember it. Fortunately, in the next few days, our phone bill from the last billing cycle will be available. We plan on getting his number from the bill and calling him to thank him.

Finally, at around 10:20 AM, a lone Ski Patrol lady comes down and sits next to me. She tells me her name, which of course I've forgotten, and asks what happened. I tell her how it went down. The doctor confirms the story and tells her what type of injury he thinks it is.

She asks me where it hurts, so I show her my new joint. She tells the doctor he can leave if he wishes. Before he goes, I shake his hand and thank him one more time. This guy was a rock star. If the roles were reversed, I would have fainted at some point -- probably when he first hit the tree.

The Ski Patrol lady asks me what my pain level is on a scale of 0 through 10, 0 being...

I interrupt her with, "Ten! Ten! Ten!"

She asks, "Ok, Tony, do we have your consent to help you with your injury today?"

I'm genuinely confused by this question. My ankle really hurts. Why did you come down here? Why wouldn't I want your help? I tell her of course she has my consent!

As we're sitting there, her asking me questions, me enjoying my new found flexibility, I have two pressing questions of my own:
  1. Does the clinic have high-powered pain medication?
  2. Does the clinic have heavy-duty scissors?
The first request is obvious. She tells me yes. I get happy about that. It's been over 30 minutes, my shock and adrenaline have started to wear off. The pain level is rising.

The second question was related to the boot. The boot that is snugly attached to my jelly ankle. Seriously, that boot was not coming off of my foot the normal way. I'd punch the first person that tried it. I'd rather wear the boot for the rest of my life.

She tells me not to worry about it and that we'll figure things out once we get to the clinic. It's the classic delay tactic. Well played, Ski Patrol. She knew the whole time. That boot was coming off the normal way.

The snowmobile and toboggan dudes show up a few minutes later. Both guys introduce themselves to me and then throw a splint on my right leg. Before I knew it, the four of us were on our way to the clinic at the base of Peak 9. I was able to chat with one of the toboggan Ski Patrol dudes en route to the clinic. We talked about the weather, the bumpy ride, and how my ankle felt amazing on all of the bumps.

We reached the clinic around 10:40AM. That's when I saw my snowboard for the first time since the accident. There were absolutely no signs of damage. Not even a scratch! To this day that aggravates me.

Once I finally got Brooke on the phone, I gave her a quick, detail free explanation of the morning's events. I give her the location and tell her to come on by.

In the clinic, they're checking me out, head to toe, and asking me a million questions. One series of questions went something like, "Would you consider yourself a beginner, intermediate, or expert snowboarder?" I thought they were trying to play a funny joke on me. I used to think I was an expert. I don't know now. This is pretty embarrassing.

I answered expert.

After Brooke showed up around 11:00AM, they put me under conscious sedation to remove my floppy foot from my extremely tight snowboarding boot. My nurse assured me that I wouldn't remember I thing. I called her a liar, in a joking, friendly fashion of course. But still, I kind of meant it.

What do I know? Nothing. But her explanation to me about the whole procedure was I won't be unconscious, I just won't remember a thing. That means I will consciously experience that boot coming off of my ankle!

Just before I stopped remembering things, they asked Brooke if she'd like to leave during the procedure. She said no, so I mumbled, "she has a morbid obsession." It's true, she likes looking at gross things. She's a nurse.

I found out later that the words that actually left my mouth were, "she's morbidly obese."

When I started remembering again, I asked if I screamed when they pulled off the boot. Everyone nodded yes. Then I asked if I screamed like a girl. This woman who was with another injured patient in the bed next to us pulled the curtain back and said, "no, you cried like a man the whole time."

I didn't remember anything about the boot. So I apologized to my nurse.

I found out from the clinic doctor that I severely messed up my ankle. She said I might even have possible tendon and ligament damage. They had arranged for an ambulance to take me to the hospital for surgery later that day.

That's about when it hit me. I'm not an expert snowboarder. I was an idiot that day for going so fast near that tree and that skier. I might not get the chance to snowboard again.

Actually, it's worse than that. It's going to take a lot of hard, painful work just to learn to walk again.

As I was leaving, moving from my bed to the ambulance stretcher, we noticed a ton of debris from the tree. There was tree bark everywhere. One nurse mentioned it was the most she'd ever seen. It could only be from one source.

I decided to keep this piece of bark as a reminder to never hit trees going 45 MPH. It hurts.

If there's anyone out there that can identify this type of tree just from this image of its bark, please let me know. I want to know everything there is to know about this tree, especially its life expectancy.

I also want to wipe that stupid snow face grin right off of its face.

Monday, February 22, 2010

Re-enactment

The mail just arrived. We received several items from friends and family, including a DVD collection of two American classics from a friend in Egypt: Navy Seals and Red Dawn. Thanks, Jim!

I also received two drawings from my nephews Jacob and Joshua. One of the drawings is a very accurate re-enactment of the accident.

There's me, in the tree, with my snowboard on the ground. I think that's the skier I tried to avoid and a Ski Patrol person to the left. It's like I'm back at the scene of the accident all over again.

Independent Research

Because Brooke is studying at George Washington University to become a nurse practitioner, she has access to hundreds of medical journals. Since my next appointment is tomorrow, and the majority of my time is spent ironically watching the Winter Olympics, I thought I'd do some research today and prepare for tomorrow's meeting with The Closer.

The first article I checked out was co-authored by my first surgeon. Entitled, "The Snowboarder's Foot and Ankle," I figured it would still contain some relevant information even though it was written 12 years ago.

As Figure 1 from his paper demonstrates, I am not the only idiot that's hit a tree. I've considered contacting the other 8% to form an exclusive club. We'd have monthly newsletters about how dumb we are.

I also read in another paper that high energy or crush injuries to the ankle and lower leg are at risk for tibial compartment syndrome. During my stay at the hospital, I was advised of this risk and informed I did not want to get it. When your surgeon tells you that no amount of morphine can alleviate the pain from this syndrome, it's surprising how quickly one can overcome any constipation issues.

Another paper from 1996, "The Spectrum of Injuries from Snowboarding," said that over 80% of injured snowboarders were male. Shocking.

I learned that my tibia break is called a comminuted tibial plafond fracture. When doctors hear this, they understand that the surface, or plafond, of my tibia is severely fractured into multiple fragments of various size, shape, and density. They can infer the amount of reconstruction and rehabilitation necessary to return the joint back to something resembling a working ankle.

When I first heard my doctor at the Breckenridge Clinic say, "comminuted tibial plafond fracture," I figured, hey, that sounds a bit more complicated than, "broken ankle," but no problem. Let's throw a cast on it and call it a day.

Of course, I'd have to bring in an independent consultant to verify the color of my cast. Since I'm color blind, Brooke would jump at the chance to get my foot wrapped up in pink fiberglass for four hilarious months. She's known for her antics. She sneaks Miralax into one of my drinks every day.

But to be serious for a moment, when the doctor told me those words, I didn't need to understand what they meant. The look on her face said it all.

After some more research and countless attempts to add up the number of fragments in my tibia (that's a fun challenge for those of you bored at work), we're starting to doubt I'll end up in a cast.

From one of the papers on my type of injury, I'm guessing this is what's in store for my ankle. This looks like something MacGyver would piece together in a tight situation using only a rubber band, someone's sock, and a nun-chuck. Yet another external fixator. I can't wait!

So we're armed with information for The Closer tomorrow. I'm hoping the whole ordeal goes well and we can get an official idea of things to come. If all else fails, MacGyver should be able to rig something up for me.

Saturday, February 20, 2010

The Map of the Apple Sauce Wreck


I found the tree I hit on Google Maps! So I created an annotated map to show you where and how I turned my ankle into the consistency of apple sauce.

Pictures of The Strongest Ankle Known to Man

Warning: the following images may be too gruesome for some of you. For others, this is probably the only reason you're here.

These are pictures of my right leg while I was receiving a new dressing on February 15th, two days after my first surgery. The minute we saw what was hiding underneath, Brooke leaped for a camera and grabbed some amazing photos. I also threw in some post-op x-rays for kicks.

In this image you can start to see the two metal titanium bars holding my leg together. The marking on my foot is where the nurses were able to get a reliable pulse.

Check out that hematoma (blood blister)! Apparently, this is a common occurrence with ankle fractures. This dude was huge! You can also see one of the nurses in the background doing the redress. I think her body language is saying, "this patient is loud and annoying."

Here you can see the incision site where they placed a semi-tubular plate to fix my fractured fibula. Since this bone was cleanly broken all the way through, it was the easiest to fix. They used eight screws to secure the plate. On my way into surgery, I may or may not have asked my doctor that I get the plate engraved with the words, "Big Rig."

Here's a good view of the external fixators holding my leg together. I have three pins screwed into my leg. One long threaded pin through my calcaneous bone (the heel bone) and two on the upper part of my tibia. This leaves four external sites to clamp down two titanium bars on the lateral and medial sides of my leg. This gives me the length of my foot back and holds the remaining broken mash of bones in place.

A fun quote from my Operative Procedure Report reads, "the distal-most proximal pin could not be placed into the back cortex, either by hand or by drill, due to the density" of the bone. This means I have super-human bone strength. I could probably punch through cement walls if I wanted.

Another line from the report says, "pre-drilling at a slow speed," was used to "avoid burning the bone." Thanks, guys!

Here's a close up of my blood blister. This was taken on February 15th. It grew quite a bit when we looked at it again four days later. Unfortunately, my new doctor in DC decided to drain it. I was hoping we could let it grow to about the same size of my head.

While we're on this picture, I guess I should mention I have nerve damage. The trauma to two nerves in my foot prevents me from feeling most sensations in my big toe and the bottom of my foot. This was due in part to the injury and in part to the titanium bars stretching my leg so tightly. We're hopeful the nerves will heal on their own and return some feeling. No worries, though. I can still walk if the feeling doesn't come back.

Here's a post-operation x-ray of my fixed fibula. You can see the staples used on the incision site. That's going to be an awesome scar! You can also barely make out the eight screws. The one at the bottom is difficult to see.

Here's a different angle on the plate and screws on the fibula. You can also see the fun times happening in the distal tibia just above.