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