I busted a wheel.
Let’s go through how that came to pass, much like we might assess a crash after the fact by looking at the highlight reel. Here's how I came to not be riding a motorcycle this spring. Fellow CT contrib and all-around Good Judgment Guy Dr. Kaplan will interject with some editorializing about how many big fat mistakes this big fat rider made.
Questionable decision #1: Sell a bike, regret it, buy a faster version
Last year, I sold my vintage flat-track machine. I loved it, but I had a lot going on in my life and it seemed like racing wasn’t the best use of my time and money. I couldn’t even make it a whole season before the junkie shakes hit and I had to replace it. I rustled up a modern 450 and resumed Saturday nights of sucking down cold beer, greasy cheeseburgers, and red dust.
Doc: Error #1: Lemmy’s cerebral shopping lobe clearly seized, driving him to impulsively buy the instrument of his own destruction.
My lap times dropped. My speed increased. There was no doubt my trusty little Honda was outshining my big ol’ twin. It was far more powerful and much lighter, which also meant I was coming off the bike with greater frequency. Hell, I was low-siding that bike with regularity, and that means a high-side isn’t far beyond that point. Those are usually pretty spectacular.
Error #2: Failing to learn from object lessons. Falling off is not conducive to remaining injury-free. Reams of injury literature substantiate this causal association. Lemmy was not required to recreate it on his own.
After one Saturday of racing and crashing, my foot hurt, towards the outside by my toes.
Questionable decision #2: Mismatched, crappy gear
Now, I should probably admit something here. I work for a place that moves a ton of protective gear. I wear a fair amount of it. I don’t wear full race leathers, as my home track is just a fifth of a mile, but I do wear dirt gear, body armor, and a motocross boot. That’s right: one MX boot. On my left side, with my steel shoe. On the right, though, I always wore a worn-out work boot. The sole was pretty thin, which meant I had great pedal feel. What I didn’t have, though, was anything resembling protection. I get this feeling Dr. K is going to chime in right about here.
Error #3: Violating the law of bilateral symmetry. What is on one side should be the same on the other. Boots are not sold individually. Willful disobedience can be the only explanation for choosing to wear an inferior and unprotective comfy boot during a hazardous activity.
Questionable decision #3: Assume everything is sort of alright because everything works sort of alright
I went to see my family doctor, and he didn’t seem to know what was wrong, but he wanted an X-ray.
Omission #1 and Error #4: Lemmy has glossed over the timeline, omitting the months between injury and seeking medical advice. The error was seeking injury advice from a family practice doctor. We have specialists for that. (Yes, like me.) I even would have made a house call. (I have been to Lemmy Mountain.)
While there, I asked my doctor to take a peek at my ankle, too, because that had started making a weird little click when I descended stairs. It didn’t really hurt. It just felt a little weird. I could still ride around and kick my bikes to start them, but sometimes my ankle would give out or lock up a little.
Error #5: Failing to recognize that sounds that should come from a dog training clicker should not come from one’s ankle.
An X-ray showed a lesion on my talus bone. (Another angle even showed a little piece of cartilage that had broken off.) The doc seemed to think that was causing my click, and sent me for an MRI. That was in October. I didn’t see any real point in undergoing surgery to repair an ankle that wasn’t misbehaving, and besides, it was my foot that was hurting.
Error #6: Failing to realize that everything is connected. Ankle injuries are serious stuff. An ankle injury may lead to a lot of foot pain but less pain at the site of ankle injury.
So I did what I do: I ignored it. Until one day in late February, when my ankle started hurting. And hurting. And finally it got so bad by the following morning that I crawled to my computer on my hands and knees, wrote a little note to RevZilla telling them I couldn’t make it into the office, and went back to the doctor, who asked me why in the hell I hadn’t gotten that MRI as I’d been instructed to do.
I got one that day. He took a peek at it, and told me I’d blown a hole in my bone that was 10 mm across (about a third of the width of the whole thing).
To repair me, in layman’s terms, they'd cut into both sides of my ankle and then cut off a big chunk of my tibia to gain access to the piece I banged up. After that, the doc was gonna use a small apple-corer-lookin’ thinger and pull that damaged cartilage and bone out. Then he was gonna take healthy bone and cartilage from a non-weight-bearing part of the outside of my ankle, and core that out, as well. To finish, he’d drop in the new plug, bolt the tibia back together, zip up both my new skin flaps.
Lemmy’s surgery used the Osteoarticular Transfer System (OATS), a method of moving bone and cartilage to repair what was damaged.
I’d be non-weight-bearing for a month, later getting into a walking boot cast thing, shaping up with some physical therapy for a few more weeks, then boom, cured.
No sweat, right?
Questionable decision #4: Googling the medical procedure
Avoid images of what medical professionals are going to do you to your poor little body. Just take my word on this.
At this point, I emailed Dr. K, who gave me lots of good advice.
At last, some wise choices. Lemmy decided to get the damage fixed and sought advice! Some of my advice: Wound repair requires more protein that usual. Scar tissue is necessary for healing and requires Vitamin C to cross-link collagen, the building block of wound repair. Tylenol is great for pain. If you have a steady-state level of Tylenol before you have surgery (but not aspirin, as it inactivates the platelets you need for clotting), it helps keep you out of pain. It is easier to keep someone out of pain than it is to get them out of pain.
I went under the knife a week later, and came out with two new titanium screws. The drugs made me feel pretty crappy, and my ankle felt about how I imagine a fish feels as it’s being gutted. To my untrained eye, the results looked about the same. The docs gave me a truckload of Percocet and aspirin, but I got off that stuff quick, fast and in a hurry.
Another good decision to get off the Percocet. Opioid addiction is a big deal. Opioids also create constipation by decreasing colon squeeze.
I know! Without getting too graphic, my story notes describe my 45-minute struggle on Saturday (the first since Tuesday!) as “like crapping a sidewalk.”
Questionable decision #5: Assuming life without the use of one foot would be pretty similar to regular life
I learned a few things. First, I learned crutches should be issued with a backpack. You can’t carry anything at all on crutches. I also learned those very same crutches will give you one hell of an upper-body workout, and some very raw skin near your ribs.
I learned that your uninjured foot starts getting cranky, too, because it’s pretty much the only guy down there showing up for work, and I learned knee scooters are a wonderful way to give that uninjured foot a much-needed break.
I also found that I could only drive an automatic vehicle, so long as there was room to get my right leg over in the passenger footwell, because an ankle stuck at 90 degrees in a splint can’t really work an accelerator pedal.
Error #6: The traumatologist in me cringes at the thought of Lemmy sandwiched sideways in a truck cab driving with his left foot while his right leg is across the other side. Unsafe!
Questionable decision #6: Believing the doctor doesn’t know what he’s talking about
Icing my leg? I was healing up fine. Who needs to do that? Staying on my ass instead of upright? That’s for sick and elderly people, right? Painkillers and aspirin? Nah. (Doc: I am shocked.)
Or not. I learned quickly that trying to be a tough guy just slowed me down further, so I did something crazy: I listened. I started putting my feet up a little bit. I started using that ice pack. And before I knew it, it was time for my one-week followup.
I saw the surgical assistant who helped with my surgery, and he seemed unconcerned that I stopped taking the painkillers, but apparently the post-surgery aspirin was important — that was to prevent blood clots!
Questionable decision #7: Not asking the right questions
Read. A lot. Forums. Medical journals. Read what doctors have written, and patients. There’s a lot of information in the world. Take it with a grain of salt, but take it under consideration. (But again, my advice is to skip the photos.)
I didn’t realize how serious my injury was or how serious the surgery to repair it would be, nor was I really aware how limited my options were should the operation go kerflooey. I asked questions and got answers, but had I not been in a hurry to “get knitted up,” I would have asked more. (Though I probably wouldn’t have changed much at all, except maybe staying in bed right after surgery a bit longer.)
I can’t tell you what you need to ask. I can tell you to try to learn about what’s wrong and what options exist to fix it. I think it is probably also a good idea to get with a doctor who understands what you’re doing. Gardening and walking are fine, but not every doctor understands the forces at play when sliding around a flat track or kicking a stroker flathead to life. One of the surgical assistants who helped with my operation rode off-road bikes and he understood what I was trying to do, which made me a bit more confident.
I never asked about longevity, too. Remember, the body continues to deteriorate as you age, so not every medical procedure has an interminable shelf life. I also found out that the surgery I had, though promising looking, doesn’t have a lot of long-term study info because it hasn’t really been done for very long on this part of the body.
Another success! Lemmy gets it right. Ask a lot of questions. Don't stop until you understand why what is being proposed is thought to be the right thing for you. Ask about right now as well as later. Ask about alternatives and outcomes. Ask what else you should have asked and didn’t. If you are not satisfied, then ask for a second opinion. And bring someone else along so that they hear it, perhaps write it down, and remember it along with you.
I’m not done making mistakes and questionable decisions. I won’t be until I stop breathing, I guess.
Prolly ought to see a doctor if that happens.