This ain’t the Endo…

Tried “doing a trick” on my bicycle and “biffed it"

“Dude, what happened?”

Biffed it hard on the Marin.


me, looking kind of bummed, sitting in an urgent care waiting room with ice packs on my right shoulder, a sling around my right arm, and a big gash on my left palm.
Close up of my right elbow showing lots of road rash and blood
A bloody scrape on my right knee, seen through torn pants.
Road rash along my right forearm, from elbow to wrist.

“Anything break?”

Sure did…

x-ray of the elbow joint
x-ray of the elbow joint
x-ray of the elbow joint
x-ray of the shoulder
x-ray of the shoulder
x-ray of the shoulder
x-ray of the forearm
x-ray of the forearm
Patient presents to urgent care clinic with right elbow pain. He states that he was “doing a trick” on his bicycle and “biffed it" and fell onto his right elbow. He does have a history of prior shoulder injury but his shoulder is again hurting currently. He was helmeted and did not lose consciousness. No neck pain.Review of Systems
Constitutional: Negative.
HENT: Negative.
Respiratory: Negative.
Cardiovascular: Negative.
Gastrointestinal: Negative.
Genitourinary: Negative.
Musculoskeletal:
Right shoulder and elbow pain
Neurological: Negative.BP 127/81 (BP Location: LA-LEFT ARM, BP Patient Position: SITTING, Cuff Size: Standard Adult) | Pulse (!) 58 | Temp 98 °F (36.7 °C) (Oral) | Resp 16 | SpO2 99%
Physical Exam
Constitutional:
General: He is not in acute distress.
Appearance: Normal appearance. He is not ill-appearing, toxic-appearing or diaphoretic.
HENT:
Head: Atraumatic.
Mouth/Throat:
Mouth: Mucous membranes are moist.
Eyes:
Extraocular Movements: Extraocular movements intact.
Pulmonary:
Breath sounds: Normal breath sounds.
Musculoskeletal:
General: Swelling present.
Cervical back: Normal range of motion.
Comments: Right elbow and proximal forearm with superficial abrasions. Patient with significant pain with elbow extension and swelling noted about the elbow. He does have good range of motion of his right shoulder.
Skin:
General: Skin is warm.
Neurological:
General: No focal deficit present.
Mental Status: He is alert and oriented to person, place, and time.Medical Decision Making:
Patient presents to urgent care clinic with right elbow pain after a fall off of a bicycle. X-rays are obtained which show a radial neck fracture. He is placed in a sling after superficial abrasions were irrigated and dressed. Additionally, he had right shoulder x-rays which show AC separation. He states that he has a history of this. However, I have made referrals for both his elbow and his shoulder to Orthopedics. He is discharged home in good condition with return precautions.
Real doctor’s notes

“You broke your neck!?”

No. The ‘radial neck fracture’ refers to the “neck” of the radius, one of the two bones in the forearm. The radius is the bone that sits on the thumb side of the forearm. You can remember that fact by holding out both arms, curling both hands into fists, sticking both thumbs up into the air and yelling, “the radius is rad, brother!”

Turns out, I also fractured the other forearm bone, the ulna. You can recognize the ulna by its little “U” shaped head that wraps around the humerus bone in the upper arm, forming the elbow joint. Hitting the spot between the ulna and humerus just right can strike a nerve, causing a strange sensation, often referred to as “hitting the funny bone”.

Anyway…

“What was ‘the trick’?”

There’s a section of sidewalk right outside Houndogs Bar & Grill in Portland that’s just begging for some love. It’s like a 10ft gap between two driveways, with a gutter on the left, and a telephone pole on the right…

In theory, one could roll over the ‘up ramp’ with the front wheel, pop one’s weight forward when the rear tire hits the ‘up ramp’ lifting rear tire into air (“pop an Endo”), ride on just the front wheel between the gutter and telephone pole (“thread the needle”), clear the ‘down ramp’ with the front wheel, and bring the rear wheel down as close to the top of the ‘down ramp’ as possible (“stomp the landing”), and keep rollin’ on to beers, tacos, or whatever.

I was trying to pop an Endo, thread the needle, and stomp the landing, but forgot one important thing. Endo is short for ‘end-over-end’, which is an important/crappy/unavoidable part of the learning process.

“You good?”

Depends how I’m feeling:

  • Basic: You should see the other guy…
  • Nerdy: Good enough to .your-mother { position: sticky; }
  • Strong: It’ll take more than some concrete to stop me…
  • Shaky: Not good, but my therapist says I’m good enough…
  • Pedantic: Sure as Hell try to be…

“Was it worth it?”

Hell yeah! Ten reasons why:

  1. The bike seems fine.
  2. Every once in a while, I try doing things with my non-dominant arm, just to see how it feels. Turns out, it’s good practice.
  3. Electric toothbrushes and bidets exist for the rest.
  4. It could have been a lot worse. Wear your helmet, kids. I’m lucky to still be walking.
  5. “Pain is weakness leaving the body.” – Chesty Puller via Coach Gator
  6. “What does not kill me makes me stronger.” – Friedrich Nietzsche via Coach Roggerman
  7. “Pain heals. Chicks dig scars. Glory lasts forever.” – Shane Falco via Keanu Reeves
  8. I learned my lesson.
  9. “I never view mistakes as failures. They are simply opportunities to find out what doesn’t work.” – Thomas Edison
  10. I’ll stick that shit next time…



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