C[omp]ute

From: andrew cooke <andrew@...>

Date: Mon, 11 Mar 2019 09:39:13 -0300

One year ago today, Sunday 11 March 2018, just after breakfast, I was
looking for my favorite cycling shirt, getting ready to ride a route I
hoped to share later in the week with a friend.

That is all I remember.

https://www.strava.com/activities/1458282810/overview

Then, in a warm haze, I am thinking "this could be serious;" "maybe I
should pay attention;" "focus."  Sometime around Tuesday or Wednesday,
in Intermediate Care at Clinica Alemana, with nurses and beeping
machines, and Paulina explaining to me (patiently, every hour or so
for the last few days - I had been "conscious but absent" since Monday
morning) that a car had hit me; that I had been injured and operated
on; that I had received blood transfusions; that I had a steel rod in
my leg; that I was now OK.

 - Head trauma
 - Fractured right clavicle (collarbone)
 - Exposed, fractured left femur (thigh)
 - Fractured metatarsal (hand)
 - Fractured right ribs (3rd, 4th, and 5th)

I was in hospital for 7 days.  The last few in normal care.  Final day
I asked to have a shower.  When I saw blood running with the water I
fainted.

The ambulance that took me home had the same crew that had taken me
in.  I asked how I had been - the EMT said "in some pain."

Final cost $17.894.596 (CLP - around $30k USD).

Home, Paulina had the bed raised, an extra seat on the toilet, a seat
in the shower, a wheelchair.  I remember my first shower - it was a
huge effort to lift my foot over the (4 inch) shower wall, and I
collapsed, twitching, on the seat.

I was high as a kite - even back home - on opioids for a couple of
weeks.

My recovery was slow but steady.  A physiotherapist came to visit and
taught me some exercises.  After a month or two I was walking with
crutches.

Paulina was exhausted from caring for me while still trying to work.
For a while we had someone visit, a few times a week, to clean and
prepare some food.


On Sundays many roads here are closed to cars, given over to cyclists,
runners, inline skaters.  A week after my accident a friend returned
to the intersection.  He found a witness, someone who flagged when
traffic could or could not pass through the ciclovia, who said I was
hit by a pickup that had run a red light.

I later learned that the driver stopped (to his credit).  Someone
called the police and an ambulance.  I was on the ground, dazed,
trying to stand but unable.  The police asked me where I lived -
apparently I replied "Europa," which is the name of our street, but
also, literally, "Europe."  So they assumed I was a tourist - a
wealthy gringo with travel insurance - and sent me to the best
hospital in town.

An investigation was opened by the police.  My medical records include
a blood test showing no alcohol.  We informed the investigating
magistrate of the witness but later, when called to the police station
to give evidence, they had not received the information.  We gave it
again.  By the time it was investigated video records from street
cameras had expired.


After the accident my bike was in a police compound; Paulina collected
it and I started repairs.  The front wheel was tacoed, so I bought a
new rim (which Paulina collected - I am so grateful for all the
legwork she has done over the last year) and spokes, and laced it to
the old hub.

Mounting the new wheel on the bike, I realized that the thru-axle was
bent, so I ordered a new axle.  When I received the axle I realized
the hub itself was bent, so I ordered a new hub.  Given how Shimano
thru-axle hubs work, I only needed to replace the inner sleeve (so I
didn't need to rebuild the entire wheel).

Mounting the new wheel again, I realized that the fork was bent, so I
ordered a new fork.  This was delivered to the UK, because mid August
I felt good enough to travel home and see my parents.

I also replaced the handlebars, although the (slight) damage there was
caused by me over-tightening the brakes, not the accident.  In
addition I had to replace the rear light (stolen while in police
custody) and my helmet.


The weekend of September 8/9 I was feeling good enough to travel with
Paulina to La Serena.  We wanted to check on my old flat, where a
friend had been living rent-free, to make sure it was OK for Paulina's
father to move there.

The flat was a mess.  So bad we did not sleep there, but instead
walked into town and stayed at a hotel.  The next day we returned, to
continue cleaning.  By the end of the weekend the place wasn't too
bad, but my leg was painful.

That was the high point of my recovery.

Post operation, my thighs were asymmetric - on the left hand side was
a "bulge" which, clearly visible in the X-rays, enclosed the end of
the rod that held my femur together.  The rod was "too long."  It
appeared to be "rubbing" on the inside of the leg, placing a limit on
how far I could walk.  As it became more inflamed, I could walk less
distance.  The upper limit was around 3,000 steps a day (a few km).

The day after returning from La Serena (Sept 10) I asked the doctor
what could be done.  The answer was: nothing, until the bone had
healed, which takes a year.


On September 11 I attended court.  The police claimed that the driver
had illegally run a red light.  Chilean law is different to UK law -
for a "light" infraction like this (running a red light and not
killing me) the emphasis is on compensating the victim.  In general
terms, either we agree some kind of compensation, or the driver is
prosecuted.  The driver has to balance the amount of compensation
against the inconvenience of being prosecuted, the likelihood of being
convicted, and the possibility of any sanction.

To start negotiations over compensation we needed to know the amount
outstanding after (the driver's) accident and (my) medical insurance,
but we still had not been billed by the hospital.

So the case was postponed and we returned home to chase up the
paperwork.  Once we had the bill Paulina took it to the driver's
insurers, who agreed to pay $5.854.407.  Then she went to my medical
insurance, who eventually (December 21) agreed to pay $8.327.938,
leaving a balance of $3.712.251.

And this is where we stand.  The case appears to be stalled pending
further police investigation.


Since it was difficult to walk I tried cycling again.  This was
clearly better for my health, and I could manage around 20 minutes
without hurting my leg too much.

But, perhaps related to this exercise, a new problem surfaced.  The
rod appeared to get "caught" on something (tendon? muscle?).  This
hurt, I froze and slowly wiggled my leg to "undo" the blockage.
Afraid to walk, I hobbled slowly round the house.

Despite my reduced movements this repeated, more severely.
Frustrated, and now nearly a year after my operation (February 18,
2019), I returned to the doctor.  He was, I think, surprised.  The
next day I received a call from the hospital - someone had canceled an
operation, there was a free slot Fri February 22.  I agreed
immediately.


The operation to remove the rod went smoothly.  I entered theater late
in the day and was kept for observation overnight.  The leg had two
dressings - one near the knee (incisions to remove screws) and another
on the upper thigh (more screws and the rod itself).  These were the
usual clear plastic sheets, with external padding for protection, to
be left in place as the wound heals.

Thursday, February 28, I was feeling good enough to be sat at the
computer, working, when I felt a drop of liquid hit my leg.  Removing
the padding, visible through the dressing, were blisters.  One had
burst.

Back at the hospital, the dressings were removed, the skin wiped
clean.  I was sent back home with basic antibiotics and
anti-histamines.

Life with exposed wounds and stitches is boring and uncomfortable
(although the anti-histamines meant I slept much of the time).  The
stitches catch clothing and the wound has to be kept clean and open to
the air, so you're either lying in bed or wandering cold and naked
through the house.  It was uncomfortable to be seated for any length
of time, making work difficult (credit to my employers for their
support).

Monday March 4 I returned to hospital.  Although I felt things were
improving (no blood / pus stains on the bedsheets on the last night,
for example) it still didn't look good (quite frankly, it looked
terrifying - red, yellow and blistered - but it was not painful and
did not smell).  A nurse (a nice nurse - senior and smart and
friendly) thought it looked more like an infection than an allergy,
and the doctor agreed, changing the antibiotic to something more
specific.

The next few days, although still boring and uncomfortable, showed
real improvement.  On Wednesday March 6 my stitches were removed.

Since then, the skin has continued to heal.  Importantly, the pain
from the rod - at least the worst, when it got "hooked" around tendons
- has gone.  There is still some pain when walking, but it is
difficult to know if it the old soreness, or associated with the
bruising from the operation.


A year after the accident, I still do not know if I will be able to
walk, or cycle, as before.

Andrew