Wednesday, September 14, 2011

Sons of Anarchy

also not having a good day.
not having a good day.

In the small corner of the world where mountain bikers roll around, "I fell off a bridge" is basically the same cry out for shelter from a domestically violent situation as "I fell down the stairs" is in the the rest of the world.  Come on, a bridge, Dad?  You know that we know that you know that we know that that's a big shiner on mom's strong right hook side.  But sure, say whatever gets her to put her mitts down for now.  

On the plus side, it doesn't look like it's really going to bruise that much. 
I could be wrong about that though. 
Sort of reminds me of the BRS race in 2010 and/or the time Ellen decided she'd had enough of Scotty's yapping for one day.   

Face, meet bridge.  Enchante.

It was a litle out of character for me, but all of the crashing on ones face that I've witnessed this year got me worked up a bit.  I mean, I've got kids coming.  What if something happened to me (for example, using my face for suspension) and I didn't have a perfect nose and model like teeth to smile at them with?  In a panic, I reached out to our resident dental hygenists assistant secretary (pretty much, he sits at the front desk and reads Dirt Rag all day) The Mighty Ken Tank to ease my troubled mind.  Turns out most people live through this sort of thing. 
A hypothetical trailside consultation with Face and Toof Doctor Ken Tank:

BFR:  OK, hypothetical worst case scenario, you and I are ripping along some rocky ridgeline, and I take a digger on my face.  Teeth are missing.  Half teeth poking out.  I"m a bloody, snaggletoothed, sobbing,  screaming monster, and we're, say, way out in West Virginia somewhere.  What do we do first?

Ken TankThe first thing to think about with any head injury is the neck.  If there is any question of neck stability it is NOT a good idea to ride out and risk severing the spinal cord.  I don't know of any makeshift C-spine collars that can be McGyvered up out on the trail.  Just stay put and wait the eternity for your friendly EMS to arrive.

BFR:   What's the biggest concern?  Where I once used to put meat in, there's meat coming out.  There's enough blood to make the whole scene look like something out of "The Shining."  Awful stuff.  Could I bleed to death?

Dr. Ken Tank:   Remember Jeremiah Bishop got a Lefort Fracture when racing La Ruta a few years back.  This is where the entire maxillary (upper jaw) complex is disarticulated from the cranial base.  Surprisingly, this doesn't hurt as bad as it looks or sounds because the accompanying nerve damage renders the face somewhat numb.  Fortunately, this is a rarity in the mountain biking world and the mechanism is usually high speed motor vehicle accident or bat to face.  Those of us not moving at World Cup speed hopefully have less to worry about.The good news is that you have to be pretty unfortunate to exsanguinate from facial lacerations - though scalp lacerations can be impressive.

BFR:  Who?  Yeah, that doesn't sound too bad.  And by exsanguinate, I presume you're talking about either Sangria or bleeding out in the lonely wilds of West By God Virginia like a hurt deer.  But anyway, let's get back to what's really important: Me.  Panic has set it.  Hysterical screaming the likes of which you've never witnessed.  I look like a redneck senior citizen that's been absent-mindedly gumming a buck knife for several hours.  What's the best way to stop bleeding from someones mouth?  Aaesthetically speaking, can duct tape be involved? 

Dr. Ken Tank:  Facial gashes - no different from a laceration elsewhere.  Pressure, Pressure, Pressure until you can get to a proper facility where things can be properly cleaned up under local anesthesia and evaluated for sutures.  There is less leeway for just letting things "granulate in" since we try to keep our faces pretty and free of deforming scars. 

BFR: Umm, yeah,  maybe you do.  So should I hook up my CO2 air inflator and blast my mouth with it?  No reason, really, just wondering if I can do that. 

Dr. Ken Tank: Intraoral gashes (tongue, lip, tooth socket) - again pressure -  any way you can think of.  Vasoconstrictors, if available, could prove useful.  But unless you are riding with your Cokehead buddy who happens to have his stash with him, you are left again with just pressure.  The tongue and lip are very vascular so this can be messy for a while, but outright exsanguination potential is low.

BFR: My Cokehead buddies and their gigantic snakes usually drop me on the climbs.  So no luck there.  But can I keep riding?  There's a wicked cool log ride coming up. 

Dr. Ken Tank: Other than neck injury, the other big concern is traumatic brain injury.  If there has been loss of consciousness or obvious disorientation, the rally is over for the day.  Get a CT scan to check for a head bleed.

BFR: If my helmet is split in half, should I continue to try to wear it? 

Dr. Ken Tank: Get off your bike, Dave.   

BFR: OK, despite your advice, log ride successfully navigated, and we're down near the road now.  But I've got some neck pain/dizziness/bloody vomit/painful diarrhea/etc.  Should we pin it back to the car in a 20 MPH paceline? 

Dr. Ken Tank: You and I both know you can't go 20 mph in a paceline.

BFR:  Valid Point.  OK, what are the long term implications for someone with a facial injury like this?  Surgery?  Recovery time?  Will I be a wolf-faced, pygmy monster forever?  

Dr. Ken Tank:  Most of these injuries (exepting critical brain or spinal cord injury) will not keep you from doing your thing again in short order.  Albeit, a little slower.

Fractured tooth (root still in) - depending on the level of the fracture this is usually a salvageable situation.  It may only need a cosmetic composite restoration or it may need a a root canal, post & core build-up and crown.  Just depends.
Picked entire tooth off of ground - best to wash off with water (or Hank's Balanced Salt Solution if you happen to be so prepared) and place all the way back in the socket ideally oriented correctly.  The prognosis of an avulsed tooth can actually be good if the tooth is cleaned and quickly replaced.  It then needs to be properly stabilized to adjacent teeth by a health care professional for a few weeks.  You will need a root canal for this scenario as the blood vessels that enter the apex of the root have been severed rendering the tooth non-vital (dead).  You also may need a crown or veneer on this because these teeth tend to discolor with time.

If the fractured or avulsed tooth doesn't make it, one still has options.  Doing nothing - but missing one of your front six teeth doesn't tend to accelerate the rise up the corporate latter or getting lucky with the ladies in our society.  The quickest, easiest, and cheapest solution is to get a removable partial denture or "flipper".  Looks fine but usually not all that great in the function department and you have to take it out to soak in a cup each night.  Beyond that, the two more permanent fixes are either a dental bridge or dental implants with or without accompanying bone graft.

BFR:   Can I get calf augmentation and teeth implants at the same time? 

Dr. Ken Tank:   You can get a tetanus shot and recheck for a brain bleed. 

BFR:  Does dental insurance usually cover this?  Medical insurance? 

 Dr. Ken Tank: Most of this would typically be covered with medical insurance since it is the result of a traumatic injury, though dental may kick in for some of the more cosmetic intraoral stuff.

Yup.  There you have it.  Nearly 288 years of dental hygeine secretary assistance will make you a wise, wise man.  Thank you, Venerable Ken Tank, for your guidance in this matter.  Hopefully we never need it. 

Moving on, and decidely not on the subject of facial lacerations because he's way to smooove for that, Danny Flow is making a list of Colorado's finest young Oxygen-immune specimens that he's put behind him and kept there.  And it's growing.
It would seem they spelled Earallysville wrong.  But it's always good to see a VA in a sea of COs.  Represent. 

And how about the Harvest Moon.  A 6 pack of us, along with about 8 beers, made it to the top of the local hill to take in the moon, relax a bit, and fend off the local feral pet population. 
We also did some modeling. 

Scud may have lost a hand to the feral pets, but he's still perpetually psyched. 

Did you miss the Harvest moon?  Not necessarily.  She's still burning bright and open for business through most of this week, albeit running later and later. 

Other reportable worthiness?  Preddy Creek. 
No Hisers were injured in the creation of this trail.  Nor were they even there. 
Yeah, the expert loop keeps inching along, one rogue hoe at a time.  Today, Wednesday, 5:30 PM, we'll be after it again, with our without Hiser.  Likely without, as it would seem he's officially thrown in the proverbial towell (and also fallen off the proverbial wagon.) Apparently, all of that Bike Polo makes a man soft (and likely confused.) 
How do I feel about this new state of being the uncontested trailwork champion?  I'll be honest, it's lonely at the top.  Unless you're 5. 

Gav dropping his old man.  . 

The Preddy loop: more kids ripping around that thing than a merry-go-round. 

That's the happenins, Captains. 
Do something terrific.  Wear your helmet. 

1 comment:

  1. Wow, great writeup. I hadn't made the bridge connection between Rick's malfortune and my 2010 malfortune until you dredged up that repressed memory.

    One other useful crash tip: find a teammate (it was Danny in my case), and ask "How bad does this look?". Danny was helpful enough to say, "It's fine. Get back out and race."