The conclusion to Michael’s tale of a solo mountain biking adventure gone awry. If you haven’t already, start with Part I.
Suzanne has got to be the best patient advocate on the planet.
While in the emergency room with the doctors initiating their diagnosis, Suzanne is drilling them with questions regarding immediate aid, diagnosis alternatives, speed of care, insurance details, etc. These guys had met their match and were going to be accountable for their recommendations and performance.
They x-rayed my right hip area. After half an hour the emergency room doctor reported that he did not see any displacement or fracture. Given the pain I was experiencing, he decided on a CT scan of my right hip. The CT scan showed something irregular, but, they did not scan a wide enough area, so they performed another CT scan that included my right hip and thigh. There they see the problem. A fracture of the femur and hip. These are the words I did not want to hear. At this point, I had suffered over 24 hours in hopes that I could avoid an overnight hospital stay. I was proud of the fact that through my entire life, I had never spent a night in a hospital. Oh well. My personal doctor made a Sunday evening visit to the emergency room and consulted with orthopedic surgeons who felt that I should be transferred to Hoag Orthopedic Hospital in Irvine, where I could be scheduled for surgery in the morning. Did you say Surgery, WTF? Whatever happened to a cast?
At 11:00 pm I was put into a transport ambulance and taken to Hoag Orthopedic Hospital Irvine with Suzanne following in our car. The orthopedic surgeons at Hoag Irvine work on an on-call basis. I drew Dr. P (name shortened) as the Monday morning on-call surgeon.
Rolling into a hospital on your back is not a fun thing, but, this Hoag Orthopedic Hospital Irvine is something. It is less than two years old and there was no one there. Wood parquet floors, cherry wood doors, private individual rooms, high definition television, On Demand movies, a bed that does everything from a small remote control and two nurses for every patient. I wondered why there weren’t chocolate mints on my pillow. With surgery scheduled for 8:30 the next morning, I could not eat after midnight. As they told me this I looked at the clock and it was 11:50 pm. No way to get any food in 10 minutes. How about some water? Okay but you can’t drink any after midnight.
In the morning, about 7:30 am, a surgeon right out of central casting glides into the room and introduces himself as Dr. P. I’ve reviewed your x-rays and CT scans and feel you need surgery whereby we insert a rod into your femur to stabilize the fracture. This is a common procedure requiring a small incision at the hip. The rod will stabilize the femur quickly enabling a faster recovery. I was resigned. This is the third doctor that was recommending surgery. Dr. P was double-booked this morning and unable to perform my surgery until the following morning, so, rather than wait an additional day, I was going to be handed off to another orthopedic surgeon, Dr. G, for surgery at 3:30 pm that same afternoon. Whatever. BTW, you look familiar I said. It turns out that Dr. P and I occasionally ride together with the same road cycling group from Corona del Mar. On these group road rides, we meet early, sometimes before daylight and there can be 20 or more riders. Most riders peel off whenever and wherever their schedule demands. It is not unusual to ride with someone and not recognize them in street clothes. I had never met Dr P but I have ridden with him in this group.
Now, because my surgery has been rescheduled to that afternoon, I still could not eat or drink anything. They hook me up to an IV for hydration and I pass the time until I am to be transferred for surgery preparation. At 1:45 pm, fifteen minutes before I am to be taken to surgery preparation, Dr. G walks in the room. He too looks familiar and it happens that he cycles with our group too. What are the chances of that? Dr. G proceeds to tell me that in his opinion, I have a choice. In his opinion, considering that the fracture is not displaced, i.e., the bones are where they are supposed to be with no deformity, because after the break I cycled two miles, transferred boats, maneuvered to and from the forward cabin on my sail boat and sailed across the channel and all the while the femur did not displace, that if I were to care for this break by completely immobilizing it, I may not need surgery. Given the rare but significant complications we hear about surgery; infections, antibiotics, anesthesiology, etc, the last think I want to do is have surgery. But why the hell are you coming in here 15 minutes before I’m to roll into surgery and asking me to make such an important decision within this small window of time. Tell that candy striper to stand down. I’m not going to surgery until I understand my alternatives better. Get Dr. P in here and let’s discuss this. Well, Dr. P is in surgery and unavailable. You have no idea how right I want you to be doctor, but I need additional qualified opinions. Then Dr. G did an unusual but effective thing. He said look, the other doctors that have seen you support a surgical alternative. The easy thing for me to do is perform the surgery. This is an easy procedure and I get paid a lot of money to do it. I just want you to know before you go to surgery, that you have options. Dr. G excused himself and said I had 30 minutes before my surgery time slot evaporated.
I called my general physician. He too was frustrated that this “choice” surfaced so late. I called a rider in our group to see if he had a sense of which one of these doctors was more rational and conservative. They both got high marks. I soon came to realize how brave Dr. G was being. He had all the support, reason and motivation to go to surgery, but, he wanted to do the right thing and what he thought was best for me. Go figure. I had choices. Soon thereafter, Dr. G walks back in the room. He said he again was sorry for the late visit. He had taken my x-rays and CT scans to the surgeons lounge to get other qualified opinions. He told me he shared my x-rays and CT scans with three surgeons, the first one saying, “If that’s my hip, you’re not touching me” The other doctors concurred. I asked about Dr P. He was still unavailable. I said fine, check me out of here. While collecting my things, Dr. P calls. He says he spoke with Dr. G and the other surgeons and concurs that, with diligence, I could reach a full recovery without surgery. Two hours later, after a brief physical therapy session, I was rolling out the front door to the waiting Suzanne.
I am now at home the day after my hospital visit. I cannot put any weight on my right heal. I can put slight weight on my right toes. This is a helpful tip I would not have known if it were not for the brief physical therapy session offered by the hospital. I can get around on crutches, but, it is painful. I cannot drive. It is best to stay off it entirely for the first two or three weeks. The bone should heal within six weeks and it will be several weeks after that before I will regain strength in my right leg. All in all a much better approach to healing than surgery and having a rod inserted into my femur.
I wouldn’t have taken the time to scribe this if I did not see some lessons here that are worth sharing: the wisdom of riding alone in a remote area; willingness to accept medical assistance when we clearly need it; questioning hasty medical diagnosis, etc. I also wanted to acknowledge the heroes that surfaced when I was in need. The Catalina Island Company employee that helped me off my bike and brought the lifeguards to me, the lifeguards, my “brother from another mother” Kelly for dropping everything to get to the Island and sail me and my boat home, the BYC staff for showing me and other club members how much they care about their members, Suzanne for loving, comforting and caring for me and for Dr. G for doing the right thing and sticking his neck out when others would not.
See you around the club. All the best!
Michael Lee Toerge is the Chairman of the Newport Beach Planning Commission.