Possibly the last photo I'll have of myself with a completely straight left arm.
January 23, 2011. Or to use the Kiwi convention, 23 January 2011. I wonder how long it will take me to forget the date on which I broke my left elbow. Just a few minutes after this photo was taken, while riding my (rented) bike on the Central Otago Rail Trail, I slipped in some deep gravel at one side of the trail and went down with my bike. Or off my bike. Or something. I honestly don't remember the hitting the ground with my arm part, but I do remember that horrible feeling of "oh no, I am about to go down here." Next thing I knew I was curled up on my side, having hit my head (I think), left shoulder, arm, hip and left knee on the ground. I must have put out my left arm to stop my fall, because my injury was consistent with that. You put your arm out straight, wrist braces you, triceps tendon becomes quite taut and is strong enough to rip off the point of your elbow, which it does in a nice clean break. Once on the ground I immediately began yelling "I'm OK, I'm OK" despite not really feeling OK, because I didn't want Ari and Evan to worry. Ari was riding in a recumbent tagalong behind Evan's bike, which had been working really well, and the last thing I wanted was for them to crash because they were twisting their heads to look at me. Fortunately, they stopped without incident. I sat up and felt a lot of pain in my left arm, but it wasn't obviously out of shape or anything, so I didn't know what might have happened. Evan came over to feel it and said "I think you may have dislocated it. See, feel here -- a piece feels like it's missing." I reached over to touch the back side of my elbow, the part I couldn't see, and felt a bit sick. Something was definitely wrong. Nothing for it but to get to an Emergency Room. Pretty soon I insisted that they ride up to the next town to get help, and I sat by my bike trying to get over feeling nauseated and dizzy. It was a hot day with no shade on the trail, and I didn't relish the thought of sitting in the sun with no protection while in this much pain, so after about 5 minutes or so I managed to get myself onto my bike and ride the remaining 5k to the next town on the trail. The same feature of the bike that, in my opinion, led in part to the accident (extremely low entry frame - see photo),
allowed me to hoist myself up onto the seat using only one hand on the bars and holding my left arm awkwardly against my side, ride S-L-O-W-L-Y off the trail using only my front brake. I was lucky that the trail sloped just slightly downhill at that point, so I barely had to pedal and barely had to brake (as you might guess, I was really nervous about braking with the front brake only and sending myself flying off the bike again). Anyway -- I managed it, somehow, and arrived just in time to find Evan and Ari setting off with our host/coordinator and another friend to pick me up. On to the doctor I went -- apparently it wasn't obvious enough to take me right to the ER for an X-Ray, so I saw the GP on call in the small town of Alexandria, who sent me to the hospital at Clyde, the next town over, to find out what was going on with my elbow.
It was a hot weekend afternoon, so the place was completely empty except for me and the girl I'd shared the GP's waiting room with -- she'd been stepped on by a horse. The ED (here they call it "Emergency Department") staff were really friendly and of course let me see the X-ray as soon as it was done. Ooooooh!! Something looked wrong there for sure. The whole "point" of my elbow was up behind my humerus, as if it had been flipped back like a lid on a shampoo bottle. Kind of like this →
They told me I'd need to go to the ED in Dunedin to see about having surgery, but as it was Sunday evening and the scrapes on my arm would doubtless need more cleaning, etc, I might as well just wait until the next morning to go there. That seemed fine to me, as it was now after 6 pm and we were hungry and tired and exhausted, and I didn't want to hassle with finding a place to stay in Dunedin. So the ED folks put my arm in a backslab cast and gave me a sling, and our hosts took us back to the small house we'd rented from them. It was lovely and comfortable and boasted 4 bedrooms and 2 bathrooms and was more luxury than we needed, and somehow, I made some dinner while Ari went outside and jumped on the trampoline with Evan. I was taking only ibuprofen and paracetamol but I guess it was fairly stable once it was immobilized and I was able to tolerate the pain with the help of a glass of wine. It was quite nice having my own bedroom all to myself, and I managed to do OK sleeping.
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| Ari & Evan hanging out with me in the Dunedin ED |
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| Doesn't look so bad here, but yes, swollen |
The next few days in Dunedin were spent with part of each day in the ED meeting that day's nurses and the orthopedic surgery registrars (residents) and having my wounds cleaned and re-dressed and a new plaster half-cast made every time. Luckily we had planned to be in Dunedin anyway. The registrars didn't want to do surgery for a few days in order to lessen any chance of infection from my skin abrasions mucking up the incision, so I decided I might as well wait and have the surgery back in Wellington when I arrived home a few days later. Little did I know how that would pan out . . . . I bought some cheap fleeces and vests at a huge used clothing place in Dunedin - end of Jan can still be fairly chilly on the coasts of the S Island so I wanted some things I could cut off part of the left sleeves from - and I was thankful to have the distractions of seeing yellow-eyed penguins at the reserve on the Otago Peninsula, and immense albatross flying overhead that same evening, and the Cadbury chocolate factory to distract me from my discomfort and from not being able to move my left arm. That immobility, more than pain, was what really bothered me during that time before surgery. When Ari had broken his arm a couple of months previously, Evan and I had both commented on how we had never broken bones other than fingers or toes and had no idea what it was like to wear a cast and not be able to move. Well, now I knew, and I hated it! 
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| Yellow Eyed Penguin wading out of the surf at the end of a long day of fishing |
On the way back to Wellington we stopped in again at the Buskers Festival in Christchurch and enjoyed another night of performances. Ari's favorite was a great physical circus/aerial act called Campground Chaos, which entertained us with amazing acrobatics and fun Kiwiana. And I have never seen muscles like those on one of the performers, who was quite adept at cracking a giant bullwhip. Apparently hanging out with a whip, and literally hanging out, gets one quite a six-pack.
Check out image #30 in this set, for example (the fire eater).
The best thing, if there can be said to have been one, about when I broke my elbow, was that my mom arrived in New Zealand while we were still on the South Island. The plan had been that she'd meet us in Picton and we were going to do a couple of days on the Queen Charlotte Track. Instead, we had her stay in Wellington to await our return home, which we did a day later. What a godsend! Ari's school was about to begin and I could not really use my left arm. Although thankfully I hadn't broken my right, I soon learned how many things require that second arm as a steadier, or a helper. No using a knife, since I couldn't hold still the thing being cut. No tying shoes. No putting my hair in a ponytail. No driving obviously.
We returned to
Wellington on a Friday and reported in to the orthopedic clinic at Wellington
Hospital. More X-rays. More waiting. We were told it would probably be a couple of days before I
could get in for surgery, as my injury was stable. Not to belabor this, but that was the understatement of the
year. I ended up waiting a week, so that the total wait between
breaking my elbow and having it “fixed” was 10 days. During this time I was in a half cast with my arm in a sling
and luckily in moderate, rather than severe pain. The worst day was when I showed up at the hospital and was
told early in the morning that I would be scheduled for surgery that day. I was made to put on a hospital gown,
and for the convenience of the registrar, or the nurse, I had an IV drip put in
my arm, even though no one knew when I might actually hit the operating
table. Of course, this was now the
2nd or 3rd time I had been told the night before to
forego all food and drink after midnight “just in case.” There was nowhere for me to wait at
that point, so I sat, in my hospital gown, on a guerney in the waiting room of
the ortho clinic. After an hour
and a half, we asked about possibly moving and I was placed in the post-op
room, where at least I had a bed.
However, having a bed here meant nothing, and I was basically ignored
all day. My requests about what
the likelihood and timing of surgery might be went unanswered. Eventually at 5:30 I demanded to see
the orthopedic registrar on duty. When
he showed up, the first thing he said was “you should get dressed and go
home.” At that point, Evan and I
both lost it. The registrar kept
saying “I understand” when we started complaining about the lack of
communication with the surgical
team, and Evan started yelling at him – “No you DON’T understand!” I have rarely seen Evan so pissed
off. We both told off the
registrar and got ourselves out of
there. That night, the consultant
surgeon called us to apologize and promised that I would have surgery the next
day. True enough, on February 1,
2011, it finally happened. Two
pins and a figure 8 wire were wrapped around my olecranon. It was Ari’s first day of school. Again, I was unbelievably lucky to have my mom
visiting. Our negative impression
of Wellington Hospital continued when I ended up staying in the hospital many
more hours than necessary (I was there overnight for 2 nights) because the
nurse forgot to start the IV antibiotic that I needed several doses of before I
could leave. Otherwise, it wasn’t
memorable. I went home with a half-cast
and sling again but was told that in about a week I’d have the cast off and
would need to start moving it.
That proved fortunate, because it allowed me to get on a plane less than
2 weeks after surgery and hike the Milford Track. My two knights in shining armor, Evan and Edwin, carried
much of my gear so that I was able to do the trip with only a large (full)
daypack. The sling became a kind
of talisman for the trip, and I kept my arm in in most of the time.
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| Crossing Lake Te Anau to the start of the Milford Track - 2 weeks after surgery |
However, it was great to be able to
take my arm out of the sling for helping with my balance on steep downhill
parts of the track – basically the entire 3rd day. A blowup pillow under my arm helped me
to sleep, as did earplugs and just the right amount of fatigue. Evan kept reminding me I had just had
major surgery and not to be surprised that I was tired, or sore. Mostly I felt great.
Over the next few months, I made progress on getting my left arm to straighten out, going to physical therapy after a while and gradually becoming able to lift things, put weight on it, and have a useful degree of range of motion. By the time my mom left in mid-March, I was just starting to drive. Even so, the pain persisted, especially while sleeping, and I slept with a pillow under my arm almost always. It ended up being much more of a mental drain than
a physical one in some ways, because of the pain. My arm was keeping me from driving, from lifting
anything heavy, from running (too painful), from enjoying sex (paranoia
about my arm hurting and it was always getting in the way, not being
able to put any weight on it, etc), from sleeping on my left side, from
being able to put my hair in a ponytail (I cut it short again) and then
of course I couldn't do other things like kayak or bike or ride scooters
with Ari or whatever. I was definitely not in a space where I
wanted to pursue anything other than getting physically better, and the
timing was bad too -- I
had gotten hooked up with Forest and Bird, one of the big conservation
organizations here to do some more "high level" volunteering on projects
through a former MP that we know here, and then just as I was supposed
to start I had my arm in a cast for 3 weeks and couldn't type for longer
than that, so I had to forego working for them. Mentally I just wasn't
there and ready to commit to exploring some of the things I had planned, which was disappointing. In fact, the being mentally sidelined for several months really contributed to my wanting to stay here for another year. Who knows? Maybe that ended up being a blessing in disguise, although I'm guessing I would have agreed to stay, when Evan started suggesting it, even if I hadn't broken my elbow.
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| Waiting to go in to surgery |
On July 1st, 2011, I had a second surgery to remove the metalware in my elbow. Thankfully this was able to be a scheduled surgery, done in a private hospital, rather than having to wait to have it done at the public hospital. Basically, the surgery is so low on the totem pole of things that need to get done in an orthopedic surgery, that it would just never get done at the public hospital. The consultant who supervised the initial surgery did the second one (a registrar did the first one of course - teaching hospital) and it was all quite easy. In and out of my fabulous private hotel-style room in a day, with much less pain and swelling than the first surgery. I'm not sure I even took any prescription pain meds afterwards. (Did I mention that ALL of the medical care related to my elbow, multiple emergency room visits in those first days, two surgeries, follow ups, etc was free? Free. Under New Zealand's accident compensation scheme, you are entitled to free care for any injury that is the result of an accident. Whether or not you are a resident, a citizen or a tourist. Apparently even mosquito bites are considered to be accidents! A fall from a bike definitely is. So ultimately it is hard to complain too much about the wait I had for my surgery. If we had opted to use our private insurance, I would likely have had it done a few days earlier, but in the big scheme of things, the wait didn't affect the outcome.)
A year after the break, I had about 95% range of motion in my elbow and no real lingering problems. However, my arm will never go completely straight, and it still is sore from time to time, and weaker than the other one. I can do pushups though, and I've managed to get back on a bike without too much worry (although I still cannot really deal with the sound of bike tires on gravel and I have only road-biked). I'm still wary of steep downhills when hiking, because I fear slipping and landing hard on my left arm, but otherwise I don't think about it. This far out, it's hard to remember how painful it was for many months, and how it interfered with my life. I just hope to never do it again.
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