Part 4: INJURY, ILLNESS AND INSULT

The High Care Ward is one step down from ICU. The following are monitored constantly via ‘machines’ - heart rate, oxygen levels, intracranial pressure (pressure in the brain) and, every 30 minutes, blood pressure. If any of those numbers go outside of an acceptable range, the machine sounds an alarm and that brings nursing staff in to check on the patient.
My blood pressure was relatively high and my oxygen levels relatively low. I had oxygen blowing softly, but constantly into my nostrils via tiny tubes. Not surprising really since my lungs weren’t able to function optimally due to the pneumonia.
I slept as often as I could and found the oxygen pipes in my nose to be highly irritating.
“When can this come off me?” I asked a sister.
“When your oxygen levels are above 90,” she said.
They were hovering in the low/mid 80s. So I decided that would be my first goal. The twice daily physiotherapy sessions were focussed getting my lungs more active. I embraced these sessions and gave 100% every time in terms of commitment and effort. Gradually my oxygen levels began to rise. Between physio sessions I was encouraged by the physio to use a plastic inhale/exhale device every hour to exercise my lungs, which I did - every half hour. I decided that my goal was to reach 100 and get these pipes out of my nose as soon as possible.
I was admitted on Tuesday 18 September and by Thursday afternoon I had managed to reach 100 during my breathing exercises. My average started to climb and when it was at 95, they took the nose pipes out. First short-term goal achieved.
Late on Day 3 my back brace arrived and I began to wear it when I walked anywhere. It’s quite light, very adjustable and easy to put on and take off. It feels very supportive once on and is designed to prevent me from twisting or bending my spine. My two fractured vertebrae need time and stability to heal. And should do so in about 12 weeks.
I had begun to do some short walks in the hospital with my physio. I was very out of breath during these walks and I decided that my next goal was to walk up and down stairs, which I achieved on the morning of Day 4. It’s amazing how a short walk can feel like such a challenge. Having been an above average fitness all my adult life, it was both worrying and humbling.
Now that I was taking muscle relaxant tablets three times a day, the pain that had been so all-consuming across my back and into my diaphragm had subsided somewhat, but not completely.
I spoke to the physiotherapists that worked with me and did some online research too. I appear to have sustained something called Thoracic Strain, which can be caused by various things, including trauma to the Thoracic Spine. Thoracic Strain is the injury of muscles or tendons that attach to the upper part of your back, behind your chest. Severity can range from the pulling to the tearing of these muscles or ligaments.
‘There are five muscles that make up the thoracic cage; the intercostals (external, internal and innermost), subcostals, and transversus thoracis. These muscles act to change the volume of the thoracic cavity during respiration.’
This all makes sense as to why I was in such pain and had such difficulty with moving and breathing after my fall.
Once I have recovered properly I will contact the first neurosurgeon and explain to him what happened after he discharged me. I want him to know that in future, when treating a spinal injury, he should consider that there may be more to it than only vertebrae damage.
While the recovery of my lungs was in process, I had plenty of time to think about my fall.
What could possibly have happened that made a stock standard wheelie, that I have done hundreds of thousands of times since the age of 10, go wrong?
Of course telling friends, family and work colleagues what happened, is a two-part process:
“I flipped while doing a wheelie...”
“Really? You? But aren’t you really good at that? Aren’t you a mountain bike skills instructor?”
Yes. Yes. Yes. Yes. Naturally I have felt all levels of embarrassment and humiliation. But I have faced each one head on and grown in both humility and appreciation of the fact that even though - or maybe, just when - you think you are in complete control of something you are really good at, something can change that in an instant.
The most obvious reason I flipped is that my back brake didn’t bind at the moment I expected it to, keeping me on the good side of my balance point. It wasn’t my first wheelie that morning so the brake had been working as I needed it to.
Much as I wanted to blame the incident on the bike, it seems I couldn’t. I had to reluctantly concede that it was rider error. Is it an age thing? I’m 48 and there may just be a chance that my intuitive abilities could be losing their edge, although it’s something I find hard to accept, and will fiercely contest...
I was just very fortunate that my injury, while quite serious, isn’t life-path altering. But it has been attitude-altering.
I have usually felt that most people’s mountain bike crashes could have been prevented/avoided if they had invested some money and time in a skills improvement course of some kind with an experienced instructor.
Knowledge + Practice + More Practice + Even More Practice = Lower Fall Risk. That’s always been my attitude towards mountain biking ability.
Yet, here I lie, an experienced mountain bike skills instructor that started BMX racing in 1981 and mountain biking in 1991, receiving High Care Ward treatment for an illness that developed as a result of an injury sustained in a fall, while popping a fairly basic wheelie... Injury>>>Illness>>>Insult. The triple crown!
At least I have the opportunity to learn lessons during my ‘detour’ and can look forward to riding bikes again.

Part 5: MAYBE IT WAS THE BIKE AFTER ALL... (to come)