Dobinson Rule #1 – don’t fall off your bike!

Well, I suppose it had to happen. I did have a little off on the Velodrome last year when an old, apparently perished but visually OK front tubular skidded down the track, but this was my first road fall. Last year it was just a few bruises, but this time it’s a couple of broken ribs and a clavicle.

According to onlookers, I didn’t see a blue cord linking some road cones, and was dragged down by it. They also say I was unconscious for a few minutes, but I have no memory from deciding to avoid a car by entering a road work area (all my fault), enountering the retaining cord at the end of the roadworks, until being helped to my feet by the excellent paramedic who attended in his green and yellow 4WD.

What follows is an account of the various – er – impacts of falling off a bike. As one of the founders of Glasgow Green Cycle Club, Andy Dobinson says – Rule #1 for coping with bike falls is “don’t fall off”! Hence the title of this blog item. Also see my general polemical blog on helmets.

Helmet

I was wearing a Kash helmet, very well fitting, no pressure points, with an adjuster strap at the back. As I was knocked out for a few minutes, the helmet has saved me from a lot worse. There is a scuff on its left side, but my only head symptoms are almost imperceptible. A VERY slight tender spot on the left temple, and a tender point below the lump on the back of my head – the occiput? – where the plastic strap adjuster is mounted.

Kash Dieci helmet

Kash Dieci helmet

I feel lucky but also vindicated in refusing to do the easy thing and cycle with no thought of the consequences of an accident as even a luminary like Chris Boardman feels is acceptable, refusing to wear a helmet on TV. Some say helmets are only of any benefit below 11mph because they are so lightly built. But much of our cycling is below that speed, even if you believe that limitation; abrasions would clearly be reduced at any speed; and in my view, any crumple zone that isn’t your head must be a good thing. I really can’t understand the mentality and motives of those who are against helmet and some higher visibility clothing (at night, at least for the latter) for cyclists.

Somehow the anti-helmet lobby seems to think that self protection and road design protection for cyclists is an either-or argument; that wearing helmets might reduce the pressure for better bike lanes, road furniture and all the rest. In my view, we could have both, and it’s up to an individual with common sense to do their best to protect themselves whatever else is done. Control what you can control.

We would not any longer argue against safety belts – and air bags – in cars, although once upon a time some did. There are those that argue that these car driver protection features make things worse for pedestrians, as drivers fear injuries to themselves less. But surely this isn’t a reason to withdraw them – any more than helmets deprecate the argument for better roads for cyclists – but it IS a reason to bite harder on careless, reckless and dangerous driving.

I wonder if some people are so caught up with increasing cycling take-up they feel that asking people to wear some protective gear is a turn-off for new entrants. My opinion is great, if they don’t want to use a bike because they will look silly, they are saving themselves and others a lot of potential problems! But then I don’t have commercial or PR reasons to drive up cycling numbers at any expense.

The NHS

As nearly everyone does, who has occasion to be served by the NHS, they end up being incredibly grateful for its being there! Of course not everyone is satisfied with it, and that includes its own professionals and other workers in some cases, but to be scraped up off the road, assessed, put in a bed and get 48 hours of continuous personal attention, all at no cost “at the point of delivery”, as they say, is inspiring. It makes you WANT to get better not to let all that support down!

And my case is a small one. There is so much more on offer for more serious cases. I’m not aggressively political about the NHS – there are lots of right and wrong ways to organise and fund such a huge organisation – and a lot of people know a lot more about it than me, but the principle that our population is looked after this way has to remain. Some people can afford to pay – as they can for education, housing, travel and all the rest – and if they want to go elsewhere, so be it. But like me, the vast majority need a safety net, and the NHS is it! Tax and NI that pays for the NHS is differential – higher earners pay more – and is is always under review, so the model for funding can be adjusted. There is, under successive governments of all colours, private provision and contracts in the NHS (6% of NHS activity is by private provision I heard this morning from Philip Hammond), and if this, appropriately performance monitored like all Government contracts, is the best quality/cost solution, so be it. But free provision at the point of delivery must remain.

Incidentally, the food was basic, but with choices, and right for me given that I was getting no exercise. I liked the soups, the (usual for me) cereal breakfasts, juices and three choices of main course for dinner!

Dinner time!

Dinner time!

The good, the bad and the ugly

Or – the expected, the unexpected and the reality!

Expected: x-Rays showed broken bones, but the painkillers dealt with pain from their initial movement, and I was OK with dealing with the time it would take for them to heal! I was surprised that on the road, just after the accident, I managed to get up and get into the para-medic’s car, and then out again and into Ann’s car (she came because my bike wouldn’t go into the paramedic car, and when she got there he fastest way was for her to take me to the Hosptial (the old Southern General, the new South Glasgow University Hospital (SGUH).

Unexpected: I must have been protected initially by adrenaline release, because by the time I was moving from A&E to the acute assessment ward, I was feeling faint just sitting up, let alone standing up!

Assessment at SGUH

Assessment at SGUH

I was given oral morphine for pain relief, alternated with Codeine based Cocodamol; I do use Ibuprofen, but the hospital were initially reluctant owing to my historical asthma, but later on deemed it part of the painkiller regime. By the time I had to be rolled out of bed into a gurney for a second X-ray, I could hardly bear to move (11.45pm on the first day!) Then it turned out I was to wait a further 15 hours for that X-ray for comparison purposes, so the move to and fro had been abortive, but it reminded me how hard it was do do just simple things. I think I might have managed a short pee during that process, a rare event during my hospital stay!

That first day, I was, unprompted, thanked profusely by my surgical consultant for wearing a helmet. He had clearly seen a lot worse. I didn’t ask him to elaborate!

The reality

After getting home, the reality of the problem of having taken morphine and Cocodamol for two days set in. Accident on Monday lunchtime, home on Wednesday afternoon, conducted a Maths tutoring lesson on Thursday, plus another meeting on that topic. I felt great. But then on Friday, my digestive system decided it needed to make room for breakfast, and that was painful. And no room to speak of was made. All morning, various drugs and plugs to help out were administered. Friday was a difficult day! That evening, matters (!) eased a bit, and Saturday has been an improvement. More drugs and plugs Sunday!

So part of the reality of my accident wasn’t just the bone breaks, but the unexpected “bonus” of the side effects of the pain killers. Even thinking about sitting on a saddle sends a shudder down my spine to the affected area!

The diagnosis

Looking at the injuries, and hearing eyewitness accounts, it seems I fell to the left, landed on the road near, or even on the kerb on my left side and back, plus caught the inside of my left armpit/shoulder on the handlebar stem, where the Garmin was mounted. That fell off, and the ONLY other bike damage was the usual scuff to the left edge of the saddle.

Tear to edge of saddle

Tear to edge of saddle

The bruising seems to indicate the left side fall too:

Underarm bruise from stem?

Underarm bruise from stem?

I had no tears to clothing, but then I always try to wear two layers, because then any friction is taken up between the two layers, not between one layer and my skin.

On this short trip I didn’t wear my Gore undershorts that I usually do, and as expected, the only slight “rash” was in that upper outer thigh area, on the left of course, where I only had one layer, but even then the cycling shorts didn’t tear. Elsewhere just bruising, no road rash.

Rash at shorts, bruise under double Jersey

Rash at shorts, bruise under double Jersey

A good deal of bruising appeared over my left clavicle, which might have broken at a 35 year old previous break, and it this I will need to have assessed in a couple of weeks.

Left clavicle bruising over break

Left clavicle bruising over break

No bruising to the head (slightly tender, but very slightly, in two places, but clearly the helmet has done its job. I picked it not by brand or price, but because of all those that Condor in London stocked, its inner shape matched my head the best.

Side view of helmet

Side view of helmet

There are NO pressure points, just an even fit all around. I think that’s very important. Just like shoes, and maybe especially ski boots, different manufacturers have a different default last, and it’s good to try out a lot to get the last that fits you!

Medium term rehabilitation

The received wisdom is that muscular strength from training starts to reduce after 3 days of no activity, but that cardio-vascular fitness is slower to decline – but of course DOES decline.

All my blood pressure tests, with pulse and oxygen saturation were fine, tested at least 6 times during my hospital stay. Mostly my pulse was at 55 resting, and BP near 120:80, and oxygen >96%.

BP, pulse and oxygen

BP, pulse and oxygen

I was on 2 litre per hour oxygen for a day or so, but didn’t need it after that:

On low oxygen...

On low oxygen…

In the case of rib fractures, with the reduced ability to breathe in fully, there is the issue that bronchial sounds at the base of the affected lung betray affected and reduced movement of air through the lungs. Painkillers are supposed to allow the victim to breathe more fully, and where possible to cough to help remove fluid from the affected lung, but this can be painful and difficult. I still have that six days later.

So return to my foregoing fitness, and reduced weight, is going to take time. At the moment I’m hoping we will be able to take bikes on holiday as planned and get miles in wherever we stop in the Motorhome.

The turbo will help before then, but at the moment, the relevant part of my anatomy doesn’t feel like sitting on a saddle!

Warm baths are fantastic, and this afternoon a jacuzzi is on the cards, so at present I’m just trying to keep comfortable in that way. A little swimming will help with some full body exercise in a supported environment. Walking the dog (Gandhi) has never been such a big part of my exercise regime!

I wasn’t planning any racing this year (!) but I would like to get back to what passes for full fitness for a 69 year old. I had been doing quite well!

Onwards and upwards!