The One with the Subarachnoid Hematoma

Summary

On Thursday, October 8, I fell while mowing the lawn. I hit the back of my head on the sidewalk. I was unconscious for a short time. Tina drove me to urgent care and then to the Emergency Room at Portland Adventist Hospital. A CT scan showed a small subarachnoid hematoma had occurred in my occipital lobe. I was transferred via ambulance to the trauma and intensive care unit at OHSU where I stayed under observation for 24 hours. A second CT scan showed no additional bleeding and I was eventually released after one full day in the hospital. It’s now a few days later and I feel better. I still feel the effects of the injury but I can tell it’s getting better.

Details

October 8, 15:56, home

I was mowing the section of lawn shown above in the red box. Where the lawn meets the sidewalk there are bricks laid sideways to form a border. The bricks are approximately 2-3 inches higher than the sidewalk. I was mowing diagonally from northwest to southeast with the distance continually getting shorter. As I finished up the section, I did not pay attention to where I was stepping. I must have stepped backwards and placed my foot partially on a brick. I Iost my balance or twisted my ankle or both. I fell backwards and the back of my head hit the concrete.

Everything went black but I was still aware. I could hear some boys down the block shouting to my next door neighbor, Bobby. I knew I had injured myself. My hands were tingling and it felt like they were raised in the air. I tried to lay them down but I couldn’t move. I also couldn’t make my eyes open.

After Bobby and the boys arrived, I managed to force my eyes open but I still couldn’t move. I might have told them that I was OK but I wasn’t. I sat up and felt the back of my head where it hurt – there was no blood which I felt was a good sign. Bobby sent one of the boys to the house to get Tina. He told her I had been “knocked out cold” when she came to the door.

16:00

By the time Tina came out, I felt the back of my head again and noticed my fingers were wet with blood. There was a brief discussion about what to do before I lurched to my feet and walked towards the house. I immediately noticed an unsteadiness in my gait. I also noticed a pain on the inside surface of my right ankle that extended 4-6 inches up my leg.

Once inside, I sat in my chair to recover. I noticed that when I moved my head and then stopped, the world seemed to keep moving as if my head was still moving. I decided I would need professional care.

16:19, Legacy-GoHealth Urgent Care

We departed for urgent care and arrived 10 minutes later. After a short wait, they informed us that they did not take head injury cases. We departed urgent care 8 minutes after we arrived.

16:49, Adventist Health Portland, Emergency Room

Twenty minutes later Tina dropped me off at the Emergency Room. Only patients and caregivers are allowed in the waiting area so I went in on my own. I described the incident to the receptionist and she told me to take a seat in the waiting room. There were a limited number of chairs and they had been arranged per social distancing guidelines. I settled into one where I waited for the next 90 minutes. Since she wasn’t allowed inside, Tina drove to 7-Eleven to get a snack for me.

17:58

Tina returned from 7-Eleven with white chocolate M&Ms, a favorite. I decided to save them for later especially since eating with the mask promised to be awkward. As I waited I noted that I could feel blood drops falling on my shoulder occasionally. I also grew a little chilled. I was dressed in a t-shirt and shorts. There was a fireplace a short distance from where I was sitting, but all the seats near it were occupied. As time wore on, I grew increasingly uncomfortable sitting in the chair but I did not feel confident in walking. I noted that my shoulders and the back of my neck were sore.

18:36

A triage nurse called my name. I went to the triage area and described the incident. Soon they whisked me away for a CT scan for my head and X-rays for my ankle. Ten minutes later, I was back in the waiting room but now the fireplace chair was available so I took it. I also took the opportunity to eat some of the M&M’s, raising my mask each time I ate a few. I inadvertently spilled some during one of these maneuvers but knew that I couldn’t risk picking them up.

19:03, Consult Room 8

I didn’t have enough time to finish the M&M’s before I was called back again, this time to a “consult” room where Tina was finally allowed to join me. They had me remove my shirt and put on a hospital gown. They also put in an intravenous line in each arm and treated my head wound, all at the same time. The vein they chose in my right arm was “blown” so they had to redo the IV in that arm. Because of the soreness in my neck, they put me in a cervical collar as a precaution. All of this was being done because the CT scan had shown that I had a small subarachnoid hemorrhage which could require surgery if it got worse. They were preparing me for a transfer to Oregon Health Sciences University Hospital where the Level One trauma center provides exceptional care for traumatic brain injuries.

19:36

Text message to my family: “I’m ok. Everything is precaution.”

19:52, Ambulance Bay

My ambulance attendant, Levi, explained that it would take about 15 minutes to transport me to the OHSU emergency room. When I arrived, he said I should be prepared for a massive number of people swarming around me because OHSU is a teaching hospital. He also explained the different procedures I should expect. After he was done, I joked that there was no way we were getting there in 15 minutes. His reply: “We will use the lights.”

20:04, OHSU, Emergency Room

19 minutes later they unloaded me from the ambulance and rolled me into the ER where everything happened as he had explained. There were least 20 people in the room with me. At one point somebody asked if I had taken aspirin that day to which I replied, “Every day!” That really changed the mood in the room because aspirin is a blood thinner and made me a “big three” which I assumed is a risk level assessment. After a bit of debate, they decided to “roll” me to examine my spine because of the neck and shoulder pain.

21:16, ER room 26

After the initial kerfuffle, they moved me to my own room temporarily until I could get a bed in the ICU. My nurse assured me that it would be soon but the conversation he had in the hall before he came in said otherwise. Tina was allowed to visit during this time and she brought a bag of essentials including my CPAP machine which allowed me to doze a little. Once an hour they would wake me for a neurological exam that included answering questions, performing simple actions with my feet and hands, and a pupil examination. I became increasingly uncomfortable because I had to lay on my back and did not have any pain meds until just before they transferred me to the ICU.

23:37

First pain meds, dilaudid, delivered

October 9, 01:30 (approximate), Richard J. Mullins Trauma and Surgical Intensive Care Unit, Room 17

A bed finally became available but visiting hours were over and Tina had to go home. After I was transferred to the ICU, a team of nurses put me in a different bed and made me much more comfortable for the duration of my remaining stay. I also got a second CT scan at this time. I dozed some but would wake for the occasional neuro exam. Each time I requested that they plug in my CPAP but that needed to be approved from someone from respiratory. The blood pressure cuff on my left arm would inflate every hour to the point of nearly unbearable pain. I had less painful cuffs on my lower legs that would alternately inflate and then deflate. As I dozed if felt like one of our cats was snuggling up to my leg.

05:41

The second CT scan showed that the hematoma had not grown which means I would be released around 18:00. I had slept some but without the CPAP I do not sleep well. A nurse asked me if I was sore and I told her my throat was quite sore from snoring and can I please use my CPAP? She hooked it up and said “it was like this when I came on shift.”

10:21

“Sitting up and eating an omelet” I reported to my family via text message. It is my first food since the M&M’s more than 12 hours ago. Sitting up made me very dizzy and so nauseous that my mouth started watering as if I was going to throw up but it passed.

Omelet tasted delicious

12:30

My doctor concluded that there is no neck fracture and they remove the cervical collar. I also noticed that the giant “goose egg” on the back of my head has receded completely. The wound itself is an abrasion and did not require stitches. It does hurt and they give me occasional pain killers for it.

13:18

14:13

I moved from my bed to an adjacent reclining chair. I enjoyed a very bland meal of macaroni and cheese, spaghetti squash, a dinner roll and orange slices. I tried to order cheese cake but they said that it exceeded my carb allowance. I remained in the chair for the rest of my stay except to take a walk in the hall with a physical therapist who cleared me for release. My ankle hurt during the test but x-rays are negative for a fracture.

14:35

I passed the cognitive ability test with flying colors and will be released that evening. Estimates for release vary from 18:00 to 20:00.

19:14

Home with prescriptions for Tylenol and oxycodone. I took the week off from work. The healing begins.

Page 2: In Which I Explain My Life To The Class of 1985

I’ve been in Portland since 1990 after a short detour to San Diego after graduating from Wartburg. I met and married my wife, Tina, in 1992. We have two awesome boys who dictate how we spend most of our time. Both are very active in Boy Scout Troop 820 (troop820.org) and both play the double bass in the school orchestra after converting from the cello.

Graham is a nerd of the first order and thinks I’m the coolest nerd on the planet. He loves to play video games on our Xbox and Wii but is enthusiastic in almost everything he does — even when I enlist his help in yard chores. Since he was a baby we have known that he is strong-willed and joyous. He’s also very intelligent and somewhat arrogant about that fact, regarding it as a fact of life that he’s smarter than everyone else. I’m trying to work that out of him.

Thomas is more reserved than Graham and less likely to risk looking uncool. A year ago I helped him buy his first electric bass. Since then he has learned to play all of his favorite sons and a few “classics” that I asked him to learn. He can also has pick up Tina or my guitar and play them much better than either of us. In many ways he’s very much like I was at that age: long hair, quiet except with friends, stubborn and often inconsiderate. He’s also very smart but not always willing to work hard for great grades.

Continue reading “Page 2: In Which I Explain My Life To The Class of 1985”

The moon is in a phase and I guess that I am too

Last night Graham and Thomas had their final orchestra concert of the year. In anticipation of the event, several months ago I invited my mother to visit us at this time so that she could attend. Graham’s fourth grade orchestra was the first to play and they did a very nice job of showing how much they had improved during the year. After they took their bow, they all started off stage to make room for the fifth grade orchestra. As Graham stood near the edge of the stage waiting for the rest of the kids to move, he chatted and laughed with his nearby friends. I looked away for a second to talk to Tina and then we heard a crash in front of the stage followed by a gasp from the audience. Somebody fell. Tina asked, “Who fell?” Scanning the group near the commotion, I realized Graham was no longer on stage. “It’s Graham!” I told her as she stood and then rushed down the stairs to the stage.

Continue reading “The moon is in a phase and I guess that I am too”

Vital Statistics

Bike odometer: 2523
Van odometer: 154556
Aches & pains: miniature frost bite on my elbow (turned black), back in spasm for 3 days
Current reading: My Name Is Red by Orhan Pamuk, Cross-platform GUI Programming with wxWidgets
Recent listening: CovervilleLive from Austin, TX by Neko CaseThe 99 Most Essential Beethoven MasterpiecesWeird Al YankovicFinal Boss by MC Frontalot
Recent viewing: The Thing, The Tick, Numbers, Coraline, The Daily Show, Battlestar Galactica, This Week with George Stephanopolous, Meet the Press, Firefly, Welcome to Macintosh, Fringe, Confessions of a Superhero, Lost (Season 1)
Recent playing: Chain Factor, Galcon
Recently accomplished: Can recycling for Scouts, Coldplay tickets for Thomas, found outlet for Boy Scout can recycling, yard debris, Valentine’s Day plans, volunteered to be Troop 820 Treasurer, visited Evergreen Aerospace Museum
Imperative To Do: Freecycle, get rid of MacRenewal Macs, recover network functionality on old Tivo. Read their multimeter reviews for more information.

Transoceanic depth in this earth in this cenotaph

It’s been three weeks since Tina’s surgery and she is still recovering. Her mom, Jan, stayed with us for a couple of weeks and was a tremendous help, but we’re on our own again now. We’ve all gotten into a routine since she left, but we’ll be glad when Tina is back to full strength again. She’s frustrated with the speed of her recovery but glad that she already feels better now than she did before the surgery. She’s looking forward to an active spring and summer with our family.

Continue reading “Transoceanic depth in this earth in this cenotaph”

Vital Statistics

Bike odometer: 2523
Van odometer: 154411
Aches & pains: sciatica, tiny frostbite on elbow, lower back
Current reading: My Name Is Red by Orhan Pamuk, Cross-platform GUI Programming with wxWidgets
Recent listening: Bucketheadland by BucketheadThe Complete Goldberg Variations by Glenn GouldAcross A Crowded Room by Richard ThompsonWeird Al Yankovic
Recent viewing: The Illusionist, Hancock, Brainman, The Life Aquatic with Steve Zissou, Stay, How I Met Your Mother, The Office, Ravens at Steelers, Eagles at Cardinals, Fantastic Four, Battlestar Galactica, Monkey Shines, The Dark Knight, Mars Attacks
Recent playing: Chain Factor, Galcon
Recently accomplished: Cancelled Costco TV order, activated “new” Tivo, purchased new TV (again), Pinewood derby car for Graham, shopping, taking care of Tina
Imperative To Do: Freecycle, get rid of MacRenewal Macs, recover network functionality on old Tivo

I read the news today, oh boy

Monday, January 26, 2009

0600:
iPhone alarm wakes me with “Sonar”. I get out of bed, put on yesterday’s clothes and check Thomas’ room. His alarm clock is rumbling but he is not in his room. I wander around the house looking for him until I find him in bed with his Grandma. I wake him. I take my iPhone into the Big TV Room where I check mail, Twitter and Facebook.

Continue reading “I read the news today, oh boy”

You with your angel face

On this historical day our little family is going through a little bit of personal history. As I write this, Tina is in the operating room undergoing a hysterectomy. As many of you know, a couple of weeks ago Tina had what I described then as a “severe gynecological episode” which resulted in great loss of blood and a trip to the emergency room. After spending a night in the hospital and consulting with a new set of doctors, we concluded that her old doctor would no longer be treating her. For over a year she’s been having problems with irregular and lengthy menstrual cycles and her doctor insisted on treating her with hormones in the form of birth control pills. That treatment was ineffective and the ongoing condition resulted in frequent migraines, anemia, worsening a of her restless leg syndrome and a myriad of lesser symptoms. This all culminated in the middle of December when Tina’s period started and hasn’t stopped since. And so she is in the operating room now.

They are going to attempt to perform the procedure vaginally in order to reduce recovery time. However, if there are complications (details of which were explained to us but I cannot remember), they will make an incision for a laparotomy. They are equally prepared for either.

Tina’s mom arrived last night and will be helping out over the next week or so as Tina recovers. Since I’m working from home, I’ll also be able to help more than if I weren’t. We are lucky.

Update (13:00 PST): Tina is out of recovery and resting in her room. Pain medication is making her drowsy but she’ll probably be up for calls and visitors this evening. She’s in room 2406 at Adventist.

Update (14:00 PST): The doctor reported that the surgery went well. She called it an “assisted laparotomy”, I think. As I understand it, they made two small incisions to assist in the removal via vagina. Also, that last sentence is all kinds of wrong.

Morning Bike Ride

Distance: 10.0 miles
Riding time: 57 minutes
Max speed: 29.8 mph
Average speed: 10.4 mph
Temperature: 90º (according to questionable bike computer read)
Route:

  • Stanton to 162nd
  • 162nd to I-84 bike path
  • Bike path to Fairview Parkway
  • Fairview Parkway to Sandy
  • Sandy to 223rd
  • 223rd to Marine Drive
  • Marine Drive to 185th Ave
  • 185th to Airport Way
  • Airport Way to 158th
  • 158th to Fremont
  • Fremont to 156th
  • 156th to home
Tina recovered quickly from our soul-sapping ride last week and got back in the saddle on Saturday to ride with Thomas. I was more conservative about my recovery time and didn’t attempt to ride again until today. I felt pretty good the whole way and my legs felt fine going up hills. I had a conference call so I headed for home from Marine Drive but Tina decided to keep going.