Craig Pennell’s Cycling Crash Blog

Professor Craig Pennell, obstetrician and sport cyclist, was involved in a serious crash when a car failed to give way, turning across his path. His rib cage was torn from his spine and punctured a lung, amongst other injuries.

Originally Craig’s post-crash blog was hosted via his team/trainer Brad Hall Cycle Training website, now branding changed to Exercise Institute (Ex.In.) Hall Cycling (Hall cyc.) at http://www.exerciseinstitute.com.au/news-blog/ but Craig’s blog original links from Hall Cycling are dead, and the defunct Cycle Safe WA have dropped off.

Craig’s crash prompted his safety campaign called Cycle Safe WA, the blog links were best found via Internet Archive’s Wayback Machine, linked, saved, and attached below.

Last page is the start page, so you can begin from the bottom link, and work chronologically forward from the crash, by stepping backwards through the links (oldest last, last post first, blog style).
https://web.archive.org/web/20150309224158/http://www.cyclesafewa.com.au/craigs-blog/page/7/

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Background and the crash

Background and the crash

Cyclist Awareness

Having returned from Trento on a UWCT high, Brad and I mapped out a number of target events during October, November and December. These events were the State Four Man Team Time Trial Championships, the Gents (Two-Up Time Trial) and the Tour of Margaret River (TOMR). This would allow me to race with the Unicorn-Specialized Team on three occasions before a planned ‘light month’ over Christmas, which was going to begin on 13 November. I was taking my son Henry on the ultimate Leavers’ trip; 10 days in Corsica riding three legs of the Tour de France, doing other mountain climbs and enjoying this French island as a Father and Son pair. The ultimate boys trip for two keen cyclists.
The State Team Time Trial Championships went incredibly well, with the men’s team winning the Master’s category by several minutes.

THE CRASH
Saturday, 26 October 2013

Today was the day prior to ‘the Gents’ and after having a recovery week, I was keen for my planned 60-80 km ride at VTO1 (250 watts) on my Specialized SHIV.

To extend the normal Shelley Loop, to get enough distance to get in an 80km ride, I decided to ride around Wembley Golf Course and along the beachfront to Port Beach before doing the normal loop. I needed to make the decision when going along West Coast Highway to go along Curtin Avenue or Marine Parade – I made the wrong choice.

Marine Parade was not particularly busy, with the traffic moving along comfortably between 30-40km/h most of the time. I was enjoying my ride on my SHIV, and riding between 35-40km, fortunately on the bull-horns. Suddenly, a silver car that was driving toward me did a right-hand turn into Overton St. I don’t think she indicated, but I can’t be sure. She later claimed that she did not see me.
I remember screaming not again (this was the third time I’ve been hit by a car in 12 months), followed by ‘you stupid woman’. What happened next was like the Matrix movie flight scenes; I turned to the right and hit the car side on, and became airborne, going over the car. I was conscious at all stages of the accident and what happened afterwards. I hit the ground on my left-hand side and did not move. I could not move.

The pain in my left chest was excruciating and all I could do was pant. Just like the end of your tenth Mount Street repeat. The first things that came to mind was that another car was going to drive over me and that a well meaning bystander who’d watched too many movies about aeroplane crashes would try and stick their biro into my chest to relieve my pneumothorax. Fortunately, neither of these things occurred.

I realised that my head was OK, my brain was OK, and my hands were OK – three things critically important in my job as a high-risk Obstetrician and Researcher. I knew immediately that I had a punctured lung because I just couldn’t catch my breath. I was quickly surrounded by a group of passers-by who came to my aid and Colin, a cyclist who was riding behind me, was aiming to direct traffic around me.

I was fortunate that one of the people who came to my aid was a FiFo Occupational Health and Safety Officer who had good first aid training. She provided excellent care for me at the scene and kept my head and neck immobilised at all times.

The forty minutes that it took for the ambulance to arrive passed quickly, with people protecting my skin from the hot road. Colin and a number of others directed traffic at the scene. During this time, the traffic was crawling through Cottesloe. A number of wankers got out of their cars and shouted at those providing first aid that they should move me off the road to allow the important traffic to flow through Cottesloe. I could say nothing, but fortunately those around me replied with a tirade of abuse back at these idiots. After an extremely painful transfer, I was moved from my left side on the road to my left side on a gurney. All of this was aided by the Green Whistle and my trip in the ambulance was aided by a Ketamine infusion.

Over the next 6 hours, I was reviewed by emergency physicians, general surgeons, orthopaedic surgeons, upper-limb specialists, lower-limb specialists, cardiothoracic surgeons, plastic surgeons, vascular surgeons and numerous radiologists. I had more tests than I can count, abdominal and chest ultrasounds looking for intra-abdominal bleeding, heart and lung contusions and four CAT scans.

At the end of all of this, a kind cardiothoracic surgeon came up to me and held my hand. Having done this before many times myself in other medical situations, I knew the news that was coming was not good. He said that he was pleased to inform me that I did not have any fractures in my neck, nor did I have any abdominal injuries. He told me that I had 18 rib fractures on the left, with ribs 1-9 fractured both anteriorly and posteriorly. This meant that there was a large section of my chest wall that wasn’t attached to anything – a flail chest. He also told me that I had a lung contusion, a punctured left lung with air between the lung and the chest wall. To finish things off, I had five fractures in my scapula (shoulder blade) but there was far too much swelling to interpret this at this time. There was also a large haematoma in my left thigh that would be further evaluated the following day. My medical brain went into overdrive, and all I could remember was my trauma lectures as a medical student where I was taught that a flail chest and a punctured lung had a 25% mortality rate. My cardiothoracic surgeon must have seen the fear in my eyes, because he quite confidently told me that I would live through this experience. He organised for me to be admitted to the cardiothoracic surgical High Dependency Unit and I hoped that there would be no further bad news.

From day 1 until day 11 have been written in retrospect due to my injuries and drug induced haze.

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3 Comments


  1. mike pardon November 26, 2013Hiya Craig, i was really sad to hear of your accident mate. I am also gobsmacked to hear the ambulance took 40mins? Was it sent on a P1 ( which it should have been) ? I did call into SCGH to see you a couple of days after the incident but you where surrounded by docs. I heard that all your vitals where intact so i was then content you would be back stronger than ever.
    Hope to see you out on the road soon with your “never say never” riding attitude. get well soon mate

    reply


    • See Limes November 28, 2013Ambulance delayed because “doctor on scene” ?

      Seriously – 40 mins? Someone needs to complain….

      reply


  2. Melanie Gates November 29, 2013Hi Craig – My thoughts are with you and your family. You are an amazing man and it is thanks to you that I recently celebrated my twins first birthday. I cried when I just read about your accident. Stay strong and keep healing xxxxxx

    reply

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Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

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Day 6 Post Crash

Day 6
Friday, 1 November 2013

My orthopaedic review occurred early on Friday morning. My previously, grossly, swollen shoulder was now thin, bruised and had a very abnormal appearance. A surgical repair was clearly required however, exactly which one could not be determined without an MRI. I was pleased that my shoulder was going to be fixed in terms of long-term function, but disappointed that I had not known this 24 hours earlier as I would have left my chest tube in-situ for my impending surgery.

Given that my left shoulder now felt like a bag of marbles every time I lay back on to the pillows, I knew that the MRI was going to be uncomfortable. The pain specialist did not think that topping up the paraspinal would offer me any additional benefits, as currently my ribs were quite comfortable.

The MRI was planned for 4pm. I had the maximum dose of the two different medications I could use for breakthrough pain as I left the ward to go to the MRI unit. I had only previously had one of these agents at a time.

Getting my left shoulder positioned into the small cradle that had been attached to the MRI bed to optimise shoulder imaging was extremely uncomfortable with my unstable comminuted fractures in my scapula (multiple little pieces pushed into each other). The massive amounts of pre-emptive analgesia must have provided some additional analgesia, but it didn’t feel like it at the time.

Going into the MRI tube was relaxing, because at last nobody was fiddling with my position. As the MRI machine started, it became quite noisy, but nowhere as noisy as I had anticipated based on the experience of others. Red laser beams were spinning around me to allow optimising of the images and for the next 20-30 minutes, I remained in the tube. Throughout this time, I had almost continuous hallucinations, which I am sure were due to my dramatic increase in analgesia. These hallucinations were like the medical/anatomical images that are seen on TV shows like House and CSI Miami. I remember feeling like I was spinning around the optic nerve to bright light at the end; the focus of the vessel pattern was becoming clearer as I got closer. I also remember a hallucination where I was inside a chest cavity as it received a blow from the left with the chest wall deforming under the impact of the blow and the ribs snapping all the way down the front and the back, generating a flail segment. I could then see the lung collapsing as the air escaped from the hole in the lung, caused by the sharp end of one of the many rib fractures.

Discussions with my orthopaedic surgeon that evening confirmed that my AC ligament was intact and my clavicle was intact. Unfortunately, my scapula was so damaged that the Acromion wasn’t connected to any bones, hence I had an unstable shoulder, similar to a complete AC joint disruption. He described some surgery he would perform at 8am the next day to insert some plates and hooks to try and hold this all back together.

I became concerned about the anaesthetic issues for tomorrow’s surgery. Earlier this morning, my paravertebral block had been removed as it had been there for the maximum possible (5 days). I also knew that anaesthetists were extremely uncomfortable performing anaesthesia on patients with a flail chest without a chest tube. I also wanted to know if I could have another paravertebral block inserted to cover the next weeks pain.

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Day 4 & 5 Post Crash

Day 4
Wednesday, 30 October 2013

The next two days are a blur. I can remember my eldest son visiting and that I had eight lines/leads/catheters attached to me. I can remember my wife asking for no visitors and spending most of this day and the next day sleeping interspersed with my breathing exercises, all with my leg elevated above my head. Fortunately, my haematoma was getting smaller each day.

Day 5
Thursday, 31 October 2013

Day five in the HDU was mostly spent resting, doing my breathing exercises and using my various means of analgesia to get comfortable. An X-ray late in the afternoon showed that whilst my left lower lobe still remained collapsed, all of the fluid had been removed from my left pleural cavity and my left upper lobe had expanded. Based on this, the decision was made to remove my chest tube later that day.

I was now well enough to be transferred out of the HDU to the cardiothoracic unit where I had my own private room rather. As the gross swelling around my shoulder had been reducing, it revealed how deformed my left shoulder was due to the multiple scapula fractures. My AC joint appeared distracted above 3cm, even though the ligament was apparently intact. My professional work and my cycling required that my shoulder was returned to the best possible condition as soon as possible.

Despite having my paraspinal catheter topped-up and additional pre-emptive analgesia; having the chest tube removed felt like having a hot poker being slowly pulled between my ribs, followed by the urgency of holding the suture tight to stop air re-entering my pleural cavity through the drain site. At least once this was removed, I had one less tube. I was now down to seven.

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Day 3 Post Crash

First Chest drain
Day 3
Tuesday, 29 October 2013

I spent most of day 3 in HDU resting quietly, doing my physio breathing drills and trying to keep on top of my pain relief for my chest wall fractures. I was surprised to get a text from a family member of the driver who hit me on Saturday. It’s hard to know how to respond to a text like this. I decided to keep it factual and told her about all of my fractures and lung injury and that I was in the HDU of the cardiothoracic unit.

After yet more X-rays of my chest, I was informed that my pneumothorax (air around my lung) had not improved in 72 hours and that there was increasing fluid in my pleural cavity (space between ribs and lung). This was not unexpected, given that I had a flail chest, something of which I was reminded of every time I coughed when the flail segment moved in the opposite direction to my chest wall. The surgeon recommended the insertion of a chest tube to drain the air and fluid in my chest cavity. Hopefully, this could be removed in 48-72 hours.

The chest tube was inserted in the evening. Having inserted chest tubes in other people when I was an intern and resident, I unfortunately knew exactly what was in-store. It was extremely difficult to get me in the appropriate position to insert the tube due to my five scapula fractures, my cardiac monitoring and all of my other tubes inserted into relevant body cavities. I was fortunately given significant analgesia via my drip for both the positioning and the insertion of the tube. There are two things that I can remember about the tube insertion; the first is that the tube was inserted in the middle of my flail segment. Whilst the dissection to insert the tube was not particularly uncomfortable, the pressure in the flail segment while the 8mm rod was forced between my two ribs whilst pushing the flail inwards is something I will not forget. It was moments like this that I hoped people who cause injury to others should get to experience some of their discomfort during the healing process.

My second memory was the warm body fluid running out of the tube and down my side once the introducer had been removed. The tube was quickly attached to a drainage bottle (later to be known as Mr Bubbles) and 1L of blood drained into the bottle along with the air that had been surrounding my partially inflated lung. Over the next 48 hours, 1.5L of blood drained from this chest tube into the bottle. It explained to me now another reason why I was feeling so seedy; I had dropped my haemoglobin from approximately 153g/L to 103g/L. Thirty per cent of my blood volume was in either my thigh or my chest. Fortunately, the blood in my thigh was going to be reabsorbed and recycled. I had an iron infusion to try and aid my body’s ability to replace the blood lost into my chest cavity and subsequently, the bottle.

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Day 2 Post Crash

Day 2
Monday, 28 October 2013

During my second day in HDU, my thigh pain progressively improved and my oxygen requirements reduced to 3L minute via nasal prongs. Around lunchtime, I was taken down to the operating theatre recovery area for the head of the pain team at SCGH to insert a paravertebral block. This block involved a catheter being inserted next to my vertebral arches to enable to release of local anaesthetic right next to the nerves that supply my middle ribs from approximately the 3rd to 8th rib. It was to remain inserted for the next 5 days to provide local pain relief and decrease my need for opioid analgesia. Given the magnitude of the pain in my ribs and shoulder, inserting the block was relatively painless. The block was very effective at providing constant low-level pain relief for the next five days.

I spent much of the rest of the day in a drug induced high, thinking I was invincible.

An interesting thing often happens when you’re involved in a near-death motor vehicle accident; unexpected people come and visit you. One such unexpected visit was from a clinical colleague with whom there had been 18 months of preceding acrimony. He held my hand and said that he sincerely apologised for his behaviour over the past 18 months and told me that he had a great deal of respect for my clinical skills and acumen. This visit and discussion came as an extreme surprise to me and it is not something I will forget.

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Day 1 Post Crash

Day 1
Sunday, 27 October 2013

I remember waking up in the High Dependency Unit, the pain was intense. I could barely move or breathe and there were tubes everywhere. My first medical review was by a Cardiothoracic Surgeon who brightened my day up immediately, because he was wearing a blue t-shirt that said ‘Christ is the reason for Christmas’. We discussed my injuries, my breathing and my ongoing oxygen requirements. He informed me that the current plan was to allow my chest to try and heal spontaneously, without intervention.

I was troubled by increasing amounts of pain in my left thigh. We had a look, only to see that my thigh was grossly enlarged with some superficial bruising and it appeared to contain an enlarging haematoma. Over the next two hours, I was reviewed by lower-limb orthopaedic consultants, a vascular consultant and plastic surgeons; there was the concern that my haematoma was causing me to develop compartment syndrome, where the increase pressure in a fixed space can cut off all blood supply to tissue and cause nerve damage. Compartment syndrome is relatively common in the calf after injury, but is quite uncommon after thigh injuries. The two treatment options were a conservative ‘watch and wait’ approach, or surgical release of the compartment (draining the haematoma) with delayed surgical closure. The surgeons informed me that there was an up to 30% risk of muscle weakness in the thigh after this procedure; this was clearly not something I was keen on as an individual or a cyclist. The conservative approach, if successful, resulted in a proportion of people with deep residual haematomas that eventually calcified, and caused pain with muscle contraction. Clearly none of these options were ideal. The decision was made to try the conservative approach for the next 6 hours. The surgical team organised a CT angiogram to see if they could identify the bleeding vessel injuring my thigh muscles which would enable them to block it via endovascular techniques to avoid surgery on my thigh.

The Radiology Consultant decided that I had had too much exposure in the last 24 hours so he suggested that an ultrasound of my thigh would be a good way of demarcating the location and size of the haematoma. This could be repeated in a few hours to look at progress over time. The Sonographer started scanning my thigh, taking some routine measurements and commenting on my absence of fat. She then became a very quiet Sonographer, which immediately made me worry. I’ve heard my patients say this to me when I’m scanning them and their babies with problems; they always say that the silence is meaningful. I asked to have a look at the pictures, which clearly showed a 12x10x8cm haematoma. She said she had never seen one this large before. The Radiologist reviewed the images and he stated that he thought the clot was stable and not increasing in size. I returned to the ward where I spent the next 72 hours with my leg elevated above my chest using an unusually shaped pillow. Fortunately, the 1L haematoma began to slowly absorb spontaneously without the need for surgery.

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Background and the crash

Background and the crash

Cyclist Awareness

Having returned from Trento on a UWCT high, Brad and I mapped out a number of target events during October, November and December. These events were the State Four Man Team Time Trial Championships, the Gents (Two-Up Time Trial) and the Tour of Margaret River (TOMR). This would allow me to race with the Unicorn-Specialized Team on three occasions before a planned ‘light month’ over Christmas, which was going to begin on 13 November. I was taking my son Henry on the ultimate Leavers’ trip; 10 days in Corsica riding three legs of the Tour de France, doing other mountain climbs and enjoying this French island as a Father and Son pair. The ultimate boys trip for two keen cyclists.
The State Team Time Trial Championships went incredibly well, with the men’s team winning the Master’s category by several minutes.

THE CRASH
Saturday, 26 October 2013

Today was the day prior to ‘the Gents’ and after having a recovery week, I was keen for my planned 60-80 km ride at VTO1 (250 watts) on my Specialized SHIV.

To extend the normal Shelley Loop, to get enough distance to get in an 80km ride, I decided to ride around Wembley Golf Course and along the beachfront to Port Beach before doing the normal loop. I needed to make the decision when going along West Coast Highway to go along Curtin Avenue or Marine Parade – I made the wrong choice.

Marine Parade was not particularly busy, with the traffic moving along comfortably between 30-40km/h most of the time. I was enjoying my ride on my SHIV, and riding between 35-40km, fortunately on the bull-horns. Suddenly, a silver car that was driving toward me did a right-hand turn into Overton St. I don’t think she indicated, but I can’t be sure. She later claimed that she did not see me.
I remember screaming not again (this was the third time I’ve been hit by a car in 12 months), followed by ‘you stupid woman’. What happened next was like the Matrix movie flight scenes; I turned to the right and hit the car side on, and became airborne, going over the car. I was conscious at all stages of the accident and what happened afterwards. I hit the ground on my left-hand side and did not move. I could not move.

The pain in my left chest was excruciating and all I could do was pant. Just like the end of your tenth Mount Street repeat. The first things that came to mind was that another car was going to drive over me and that a well meaning bystander who’d watched too many movies about aeroplane crashes would try and stick their biro into my chest to relieve my pneumothorax. Fortunately, neither of these things occurred.

I realised that my head was OK, my brain was OK, and my hands were OK – three things critically important in my job as a high-risk Obstetrician and Researcher. I knew immediately that I had a punctured lung because I just couldn’t catch my breath. I was quickly surrounded by a group of passers-by who came to my aid and Colin, a cyclist who was riding behind me, was aiming to direct traffic around me.

I was fortunate that one of the people who came to my aid was a FiFo Occupational Health and Safety Officer who had good first aid training. She provided excellent care for me at the scene and kept my head and neck immobilised at all times.

The forty minutes that it took for the ambulance to arrive passed quickly, with people protecting my skin from the hot road. Colin and a number of others directed traffic at the scene. During this time, the traffic was crawling through Cottesloe. A number of wankers got out of their cars and shouted at those providing first aid that they should move me off the road to allow the important traffic to flow through Cottesloe. I could say nothing, but fortunately those around me replied with a tirade of abuse back at these idiots. After an extremely painful transfer, I was moved from my left side on the road to my left side on a gurney. All of this was aided by the Green Whistle and my trip in the ambulance was aided by a Ketamine infusion.

Over the next 6 hours, I was reviewed by emergency physicians, general surgeons, orthopaedic surgeons, upper-limb specialists, lower-limb specialists, cardiothoracic surgeons, plastic surgeons, vascular surgeons and numerous radiologists. I had more tests than I can count, abdominal and chest ultrasounds looking for intra-abdominal bleeding, heart and lung contusions and four CAT scans.

At the end of all of this, a kind cardiothoracic surgeon came up to me and held my hand. Having done this before many times myself in other medical situations, I knew the news that was coming was not good. He said that he was pleased to inform me that I did not have any fractures in my neck, nor did I have any abdominal injuries. He told me that I had 18 rib fractures on the left, with ribs 1-9 fractured both anteriorly and posteriorly. This meant that there was a large section of my chest wall that wasn’t attached to anything – a flail chest. He also told me that I had a lung contusion, a punctured left lung with air between the lung and the chest wall. To finish things off, I had five fractures in my scapula (shoulder blade) but there was far too much swelling to interpret this at this time. There was also a large haematoma in my left thigh that would be further evaluated the following day. My medical brain went into overdrive, and all I could remember was my trauma lectures as a medical student where I was taught that a flail chest and a punctured lung had a 25% mortality rate. My cardiothoracic surgeon must have seen the fear in my eyes, because he quite confidently told me that I would live through this experience. He organised for me to be admitted to the cardiothoracic surgical High Dependency Unit and I hoped that there would be no further bad news.

From day 1 until day 11 have been written in retrospect due to my injuries and drug induced haze.

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Page 7 of 7 «34567

Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

Every cyclist of every ability should be able to ride safely in Western Australia

Sign our Petition

Contact Details

Contact PAGE LINK

Email – admin

Postal: Empire Clinic
189 Carr Place

LEEDERVILLE WA 6007

Blog Calendar

M T W T F S S
« Dec
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31

Blog Updates

Copyright © 2014 CycleSafe WA

Scroll to Top

Wayback Machine
Feb MAR FEB
Previous capture 11 Next capture
2014 2015 2016
2 captures 11 Mar 15 – 29 Feb 16 sparklines
Close Help

Every cyclist of every ability should be able to ride safely in Western Australia

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Craig’s Blog

HomeCraig’s Blog → Day 1 Post Crash

Day 1 Post Crash

Day 1
Sunday, 27 October 2013

I remember waking up in the High Dependency Unit, the pain was intense. I could barely move or breathe and there were tubes everywhere. My first medical review was by a Cardiothoracic Surgeon who brightened my day up immediately, because he was wearing a blue t-shirt that said ‘Christ is the reason for Christmas’. We discussed my injuries, my breathing and my ongoing oxygen requirements. He informed me that the current plan was to allow my chest to try and heal spontaneously, without intervention.

I was troubled by increasing amounts of pain in my left thigh. We had a look, only to see that my thigh was grossly enlarged with some superficial bruising and it appeared to contain an enlarging haematoma. Over the next two hours, I was reviewed by lower-limb orthopaedic consultants, a vascular consultant and plastic surgeons; there was the concern that my haematoma was causing me to develop compartment syndrome, where the increase pressure in a fixed space can cut off all blood supply to tissue and cause nerve damage. Compartment syndrome is relatively common in the calf after injury, but is quite uncommon after thigh injuries. The two treatment options were a conservative ‘watch and wait’ approach, or surgical release of the compartment (draining the haematoma) with delayed surgical closure. The surgeons informed me that there was an up to 30% risk of muscle weakness in the thigh after this procedure; this was clearly not something I was keen on as an individual or a cyclist. The conservative approach, if successful, resulted in a proportion of people with deep residual haematomas that eventually calcified, and caused pain with muscle contraction. Clearly none of these options were ideal. The decision was made to try the conservative approach for the next 6 hours. The surgical team organised a CT angiogram to see if they could identify the bleeding vessel injuring my thigh muscles which would enable them to block it via endovascular techniques to avoid surgery on my thigh.

The Radiology Consultant decided that I had had too much exposure in the last 24 hours so he suggested that an ultrasound of my thigh would be a good way of demarcating the location and size of the haematoma. This could be repeated in a few hours to look at progress over time. The Sonographer started scanning my thigh, taking some routine measurements and commenting on my absence of fat. She then became a very quiet Sonographer, which immediately made me worry. I’ve heard my patients say this to me when I’m scanning them and their babies with problems; they always say that the silence is meaningful. I asked to have a look at the pictures, which clearly showed a 12x10x8cm haematoma. She said she had never seen one this large before. The Radiologist reviewed the images and he stated that he thought the clot was stable and not increasing in size. I returned to the ward where I spent the next 72 hours with my leg elevated above my chest using an unusually shaped pillow. Fortunately, the 1L haematoma began to slowly absorb spontaneously without the need for surgery.

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Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

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HomeCraig’s Blog → Day 2 Post Crash

Day 2 Post Crash

Day 2
Monday, 28 October 2013

During my second day in HDU, my thigh pain progressively improved and my oxygen requirements reduced to 3L minute via nasal prongs. Around lunchtime, I was taken down to the operating theatre recovery area for the head of the pain team at SCGH to insert a paravertebral block. This block involved a catheter being inserted next to my vertebral arches to enable to release of local anaesthetic right next to the nerves that supply my middle ribs from approximately the 3rd to 8th rib. It was to remain inserted for the next 5 days to provide local pain relief and decrease my need for opioid analgesia. Given the magnitude of the pain in my ribs and shoulder, inserting the block was relatively painless. The block was very effective at providing constant low-level pain relief for the next five days.

I spent much of the rest of the day in a drug induced high, thinking I was invincible.

An interesting thing often happens when you’re involved in a near-death motor vehicle accident; unexpected people come and visit you. One such unexpected visit was from a clinical colleague with whom there had been 18 months of preceding acrimony. He held my hand and said that he sincerely apologised for his behaviour over the past 18 months and told me that he had a great deal of respect for my clinical skills and acumen. This visit and discussion came as an extreme surprise to me and it is not something I will forget.

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Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

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HomeCraig’s Blog → Day 3 Post Crash

Day 3 Post Crash

First Chest drain
Day 3
Tuesday, 29 October 2013

I spent most of day 3 in HDU resting quietly, doing my physio breathing drills and trying to keep on top of my pain relief for my chest wall fractures. I was surprised to get a text from a family member of the driver who hit me on Saturday. It’s hard to know how to respond to a text like this. I decided to keep it factual and told her about all of my fractures and lung injury and that I was in the HDU of the cardiothoracic unit.

After yet more X-rays of my chest, I was informed that my pneumothorax (air around my lung) had not improved in 72 hours and that there was increasing fluid in my pleural cavity (space between ribs and lung). This was not unexpected, given that I had a flail chest, something of which I was reminded of every time I coughed when the flail segment moved in the opposite direction to my chest wall. The surgeon recommended the insertion of a chest tube to drain the air and fluid in my chest cavity. Hopefully, this could be removed in 48-72 hours.

The chest tube was inserted in the evening. Having inserted chest tubes in other people when I was an intern and resident, I unfortunately knew exactly what was in-store. It was extremely difficult to get me in the appropriate position to insert the tube due to my five scapula fractures, my cardiac monitoring and all of my other tubes inserted into relevant body cavities. I was fortunately given significant analgesia via my drip for both the positioning and the insertion of the tube. There are two things that I can remember about the tube insertion; the first is that the tube was inserted in the middle of my flail segment. Whilst the dissection to insert the tube was not particularly uncomfortable, the pressure in the flail segment while the 8mm rod was forced between my two ribs whilst pushing the flail inwards is something I will not forget. It was moments like this that I hoped people who cause injury to others should get to experience some of their discomfort during the healing process.

My second memory was the warm body fluid running out of the tube and down my side once the introducer had been removed. The tube was quickly attached to a drainage bottle (later to be known as Mr Bubbles) and 1L of blood drained into the bottle along with the air that had been surrounding my partially inflated lung. Over the next 48 hours, 1.5L of blood drained from this chest tube into the bottle. It explained to me now another reason why I was feeling so seedy; I had dropped my haemoglobin from approximately 153g/L to 103g/L. Thirty per cent of my blood volume was in either my thigh or my chest. Fortunately, the blood in my thigh was going to be reabsorbed and recycled. I had an iron infusion to try and aid my body’s ability to replace the blood lost into my chest cavity and subsequently, the bottle.

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Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

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Postal: Empire Clinic
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LEEDERVILLE WA 6007

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HomeCraig’s Blog → Day 4 & 5 Post Crash

Day 4 & 5 Post Crash

Day 4
Wednesday, 30 October 2013

The next two days are a blur. I can remember my eldest son visiting and that I had eight lines/leads/catheters attached to me. I can remember my wife asking for no visitors and spending most of this day and the next day sleeping interspersed with my breathing exercises, all with my leg elevated above my head. Fortunately, my haematoma was getting smaller each day.

Day 5
Thursday, 31 October 2013

Day five in the HDU was mostly spent resting, doing my breathing exercises and using my various means of analgesia to get comfortable. An X-ray late in the afternoon showed that whilst my left lower lobe still remained collapsed, all of the fluid had been removed from my left pleural cavity and my left upper lobe had expanded. Based on this, the decision was made to remove my chest tube later that day.

I was now well enough to be transferred out of the HDU to the cardiothoracic unit where I had my own private room rather. As the gross swelling around my shoulder had been reducing, it revealed how deformed my left shoulder was due to the multiple scapula fractures. My AC joint appeared distracted above 3cm, even though the ligament was apparently intact. My professional work and my cycling required that my shoulder was returned to the best possible condition as soon as possible.

Despite having my paraspinal catheter topped-up and additional pre-emptive analgesia; having the chest tube removed felt like having a hot poker being slowly pulled between my ribs, followed by the urgency of holding the suture tight to stop air re-entering my pleural cavity through the drain site. At least once this was removed, I had one less tube. I was now down to seven.

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Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

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Postal: Empire Clinic
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LEEDERVILLE WA 6007

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HomeCraig’s Blog → Day 6 Post Crash

Day 6 Post Crash

Day 6
Friday, 1 November 2013

My orthopaedic review occurred early on Friday morning. My previously, grossly, swollen shoulder was now thin, bruised and had a very abnormal appearance. A surgical repair was clearly required however, exactly which one could not be determined without an MRI. I was pleased that my shoulder was going to be fixed in terms of long-term function, but disappointed that I had not known this 24 hours earlier as I would have left my chest tube in-situ for my impending surgery.

Given that my left shoulder now felt like a bag of marbles every time I lay back on to the pillows, I knew that the MRI was going to be uncomfortable. The pain specialist did not think that topping up the paraspinal would offer me any additional benefits, as currently my ribs were quite comfortable.

The MRI was planned for 4pm. I had the maximum dose of the two different medications I could use for breakthrough pain as I left the ward to go to the MRI unit. I had only previously had one of these agents at a time.

Getting my left shoulder positioned into the small cradle that had been attached to the MRI bed to optimise shoulder imaging was extremely uncomfortable with my unstable comminuted fractures in my scapula (multiple little pieces pushed into each other). The massive amounts of pre-emptive analgesia must have provided some additional analgesia, but it didn’t feel like it at the time.

Going into the MRI tube was relaxing, because at last nobody was fiddling with my position. As the MRI machine started, it became quite noisy, but nowhere as noisy as I had anticipated based on the experience of others. Red laser beams were spinning around me to allow optimising of the images and for the next 20-30 minutes, I remained in the tube. Throughout this time, I had almost continuous hallucinations, which I am sure were due to my dramatic increase in analgesia. These hallucinations were like the medical/anatomical images that are seen on TV shows like House and CSI Miami. I remember feeling like I was spinning around the optic nerve to bright light at the end; the focus of the vessel pattern was becoming clearer as I got closer. I also remember a hallucination where I was inside a chest cavity as it received a blow from the left with the chest wall deforming under the impact of the blow and the ribs snapping all the way down the front and the back, generating a flail segment. I could then see the lung collapsing as the air escaped from the hole in the lung, caused by the sharp end of one of the many rib fractures.

Discussions with my orthopaedic surgeon that evening confirmed that my AC ligament was intact and my clavicle was intact. Unfortunately, my scapula was so damaged that the Acromion wasn’t connected to any bones, hence I had an unstable shoulder, similar to a complete AC joint disruption. He described some surgery he would perform at 8am the next day to insert some plates and hooks to try and hold this all back together.

I became concerned about the anaesthetic issues for tomorrow’s surgery. Earlier this morning, my paravertebral block had been removed as it had been there for the maximum possible (5 days). I also knew that anaesthetists were extremely uncomfortable performing anaesthesia on patients with a flail chest without a chest tube. I also wanted to know if I could have another paravertebral block inserted to cover the next weeks pain.

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Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

Every cyclist of every ability should be able to ride safely in Western Australia

Sign our Petition

Contact Details

Contact PAGE LINK

Email – admin

Postal: Empire Clinic
189 Carr Place

LEEDERVILLE WA 6007

Blog Calendar

M T W T F S S
« Dec
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31

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Feb MAR FEB
Previous capture 11 Next capture
2014 2015 2016
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HomeCraig’s Blog → Day 6 Post Crash

Day 6 Post Crash

Day 6
Friday, 1 November 2013

My orthopaedic review occurred early on Friday morning. My previously, grossly, swollen shoulder was now thin, bruised and had a very abnormal appearance. A surgical repair was clearly required however, exactly which one could not be determined without an MRI. I was pleased that my shoulder was going to be fixed in terms of long-term function, but disappointed that I had not known this 24 hours earlier as I would have left my chest tube in-situ for my impending surgery.

Given that my left shoulder now felt like a bag of marbles every time I lay back on to the pillows, I knew that the MRI was going to be uncomfortable. The pain specialist did not think that topping up the paraspinal would offer me any additional benefits, as currently my ribs were quite comfortable.

The MRI was planned for 4pm. I had the maximum dose of the two different medications I could use for breakthrough pain as I left the ward to go to the MRI unit. I had only previously had one of these agents at a time.

Getting my left shoulder positioned into the small cradle that had been attached to the MRI bed to optimise shoulder imaging was extremely uncomfortable with my unstable comminuted fractures in my scapula (multiple little pieces pushed into each other). The massive amounts of pre-emptive analgesia must have provided some additional analgesia, but it didn’t feel like it at the time.

Going into the MRI tube was relaxing, because at last nobody was fiddling with my position. As the MRI machine started, it became quite noisy, but nowhere as noisy as I had anticipated based on the experience of others. Red laser beams were spinning around me to allow optimising of the images and for the next 20-30 minutes, I remained in the tube. Throughout this time, I had almost continuous hallucinations, which I am sure were due to my dramatic increase in analgesia. These hallucinations were like the medical/anatomical images that are seen on TV shows like House and CSI Miami. I remember feeling like I was spinning around the optic nerve to bright light at the end; the focus of the vessel pattern was becoming clearer as I got closer. I also remember a hallucination where I was inside a chest cavity as it received a blow from the left with the chest wall deforming under the impact of the blow and the ribs snapping all the way down the front and the back, generating a flail segment. I could then see the lung collapsing as the air escaped from the hole in the lung, caused by the sharp end of one of the many rib fractures.

Discussions with my orthopaedic surgeon that evening confirmed that my AC ligament was intact and my clavicle was intact. Unfortunately, my scapula was so damaged that the Acromion wasn’t connected to any bones, hence I had an unstable shoulder, similar to a complete AC joint disruption. He described some surgery he would perform at 8am the next day to insert some plates and hooks to try and hold this all back together.

I became concerned about the anaesthetic issues for tomorrow’s surgery. Earlier this morning, my paravertebral block had been removed as it had been there for the maximum possible (5 days). I also knew that anaesthetists were extremely uncomfortable performing anaesthesia on patients with a flail chest without a chest tube. I also wanted to know if I could have another paravertebral block inserted to cover the next weeks pain.

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Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

Every cyclist of every ability should be able to ride safely in Western Australia

Sign our Petition

Contact Details

Contact PAGE LINK

Email – admin

Postal: Empire Clinic
189 Carr Place

LEEDERVILLE WA 6007

Blog Calendar

M T W T F S S
« Dec
1
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9 10 11 12 13 14 15
16 17 18 19 20 21 22
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Day 6 Post Crash « CycleSafe WA.pdf

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2014 2015 2016
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HomeCraig’s Blog → Day 7 Post Crash

Day 7 Post Crash

Day 7
Saturday, 2 November 2013

I began fasting at midnight for my planned surgery at 8am. In retrospect, I realised that I had eaten very little since Thursday morning, as I had absolutely no appetite. Therefore fasting was not much of a change. I was ready to go to theatre at 7.30am, but was told that my case had been delayed indefinitely due to two large cases that were blocking both theatres. As the day progressed, the messages indicated that my surgery had been delayed to 12 noon, and then 4pm, and 7pm. By 6pm, I was dehydrated, exhausted and now did remember that I had eaten very little since breakfast on Thursday.

At 6.30pm, the Anaesthetist informed me that he was going to try and do a self ventilating anaesthetic with a laryngeal mask to avoid the complications of positive pressure ventilation and the flail segment. He too wanted to avoid inserting another chest tube. One of the benefits of the delay was that there had been adequate time between the removal of the paravertebral block and the surgery that would enable another paravertebral block to be inserted for pain relief for the next five days.

I was taken into theatre, and the kind Anaesthetist put me to sleep in my ward bed without transferring me to the operating table, which would have been an extremely uncomfortable procedure. The next thing I remember was waking, lying on my right side with pillows down my front and back to keep me in that position, I was completely comfortable. This was the first time I had laid on my side for a week. One of the benefits of being an elite cyclist is having a fit cardiovascular system and a low heart rate. This benefit does not extend to operating recovery units where they remain concerned about individual’s heart rates when they are in the low 50s and upper 40s.

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Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

Every cyclist of every ability should be able to ride safely in Western Australia

Sign our Petition

Contact Details

Contact PAGE LINK

Email – admin

Postal: Empire Clinic
189 Carr Place

LEEDERVILLE WA 6007

Blog Calendar

M T W T F S S
« Dec
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31

Blog Updates

Copyright © 2014 CycleSafe WA

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Day 7 Post Crash « CycleSafe WA.pdf

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2014 2015 2016
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HomeCraig’s Blog → Day 8 Post Crash

Day 8 Post Crash

Day 8
Sunday, 3 November 2013

The next thing I remember was waking up on my right side, surrounded by a bed full of pillows. During Sunday, I had absolutely no appetite and sipped on some fluids. My rehabilitation continued and I managed to walk the length of the corridor with a trolley carrying my IV fluids, paravertebral infusion pump and my oxygen cylinder. Within one week, I had progressed from planning a 200km ride to a 20m slow stroll completely wearing me out. It was hard at this point not to feel angry as well as disappointed. I continued doing my breathing and coughing exercises, but had not shown any real improvement over the past six days.

I underwent my daily chest X-ray in the early afternoon. By this stage, I knew all of the radiography staff by name. I was informed that my lung effusion had re-accumulated and that my left lower lobe was still collapsed. It was the surgeon’s recommendation that I have another chest tube inserted.

First time around, inserting the chest tube took approximately 15 minutes. On this occasion, it took more than an hour. Due to my rib fractures, the location of the previous chest tube and my shoulder surgery, an alternative awkward location needed to be chosen. It took three sets of equipment to eventually get a pigtail catheter inserted (rings on the outside and rings on the inside of my chest), multiple introducer tubes were broken and multiple pieces of equipment to advance the tube were also broken. My surgeon told me that it was because I had thick lats; whilst many times this would be a compliment, today, I wished I had no lats. Going through this hour-long procedure without my wife was extremely unwise. It was extremely painful and the two young nurses who were there to assist and support me will not forget this hour. Nor will their fingers that I was squeezing. The evening continued to deteriorate form this point.

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Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

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Day 8 Post Crash « CycleSafe WA.pdf

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Day 9 Post Crash

Day 9
Monday, 4 November 2013

Monday the 4th was my planned discharge date when the ortho surgery was planned for Saturday. This clearly was not going to happen. I had spent all night having agents orally and as suppositories to try and get my bowel working. None had been successful. By the time of the 8am ward round, I was in worse shape than the night before with even more severe bloating. It was clear that I had a bowel obstruction and this was probably due to all of the opiate analgesia I had required for my 23 fractures. I was told that I was going to fast (which I had essentially been doing since Thursday morning) and that I was going to be reviewed by the General Surgeons later that day to try and unblock by bowel and remove my additional 5kg of baggage. Fortunately by lunch time, I had passed wind, and so I was able to be on ‘clear fluids’. I remained on this for the next 2.5 days. After review by the General Surgeons, my three day bowel emptying regime began. The only way to describe this is unpleasant and I will give you no further details. By Monday evening, I feel the need for an emergency call to my friend to bring me 1L of vanilla bean ice-cream. Despite the lack of progress with my bowel, my appetite had returned after four days.

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Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

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Day 9 Post Crash « CycleSafe WA.pdf

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HomeCraig’s Blog → Day 10 Post Crash

Day 10 Post Crash

Day 10 Post Crash

Day 10
Tuesday, 5 November 2013

Bruising Day 10
The highlight of this morning was that there had been enough progress with my bowel that I could be up-graded to ‘nourishing fluids’. This now meant that I could have pureed soup that had been strained. If this is highlight of one’s day, it means that it was a pretty bad day.

Since the second chest tube was inserted, I had a further 1.7L of blood stained fluid drained from my chest. This loss had settled by mid Tuesday, and based on the clinical and findings, it was decided that this tube could also be removed. Despite 10 days of religiously performing my breathing and coughing exercises, and increasing my mobility to three laps of the hall pushing my appliances, my left lower lobe still had not expanded and I still required oxygen support

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Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

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Day 10 Post Crash « CycleSafe WA.pdf

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HomeCraig’s Blog → Day 11 Post Crash

Day 11 Post Crash

Day 11 Post Crash

Day 11
Wednesday, 6 November 2013

First Rehab roll to expand LLLDay 11 in the cardiothoracic surgical unit at SCGH. Discharge planned for day 13. Half way through my morning physiotherapy programme, they informed me that THEY’RE GETTING ME AN EXCERCISE BIKE TO TRY AND EXPAND MY LEFT LUNG.

I felt so excited, the first thing I did was urgently text Brad and the Unicorn Team to
make sure I could get a HCT shirt or Unicorn shirt. My physiotherapist informed me of my training plan for the next week. The plan was simple, one 10 minute cycling interval, three times per day (morning, afternoon and evening), with my heart rate less than 100 beats per minute, and my oxygen saturation greater than 92%. For my first day of training, I was to continue 2L of oxygen support via nasal prongs. This was not the interval set I was expecting; especially after the harsh interval sets I was performing before UWCT in Trento five weeks earlier. To aid me in performing this feeble 10-minute effort, my paraspinal catheter that was delivering local anaesthesia directly to the nerve roots that supply the areas, where I have 23 fractures, remained in place. At least I was on the road to recovery. I thought this first interval set was going to be a breeze and it was. I finished, sat in the chair with my ongoing oxygen support and asked the physio what this was designed to achieve. He said wait and see. About five minutes later, I began coughing and this lasted for nearly an hour.

The aim of these intervals was to improve airflow and encourage coughing to try to open up my collapsed lung. Physio sessions two and three were much easier as I knew what to expect and took pre-emptive analgesia before my 10 minutes of feeble pedalling such that the coughing wasn’t too painful. Despite the day of three episodes of challenging coughing, I was now in a good place. Cycling was now “an approved activity” as it is part of my recovery and tonight I could sleep in the same room as my bike. I do not think this will continue when I go home – my wife will have other ideas.

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Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

Every cyclist of every ability should be able to ride safely in Western Australia

Sign our Petition

Contact Details

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Postal: Empire Clinic
189 Carr Place

LEEDERVILLE WA 6007

Blog Calendar

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Day 11 Post Crash « CycleSafe WA.pdf

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Feb MAR FEB
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2014 2015 2016
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HomeCraig’s Blog → Day 12 Post Crash

Day 12 Post Crash

Day 12 Post Crash

Day 12
Thursday, 7 November 2013

Bruising Day 12
Awaking today was like every cyclists dream: to the left of the bed was my bike. Unfortunately, the dream ended abruptly and I realised that it was more chest rehab to get the lower lobe of my left lung to expand. As per yesterday, the plan for today was three 10-minute sessions of rolling the pedals over keeping my heart rate less than 100 and my saturation above 92%. In keeping with my typical style, I made sure my heart rate was between 95 and 100bpm for the 10-minute interval, only to be a hypoxic mess at the end with my saturations of 80%. To make it clear, most people have an oxygen saturation of 98-100%.

When your oxygen saturation falls to 94% this actually equates to a 40% reduction in the amount of oxygen being carried by the blood. It became clear today that it was going to be a very slow process of recovery and that even getting my lungs expanded again was going to be a challenge. The doctors reviewed me today and my proposed date of discharge was delayed again by three days. This did however allow three extra days for the Unicorn-Specialized team to have the super-elite spin bike delivered to my house; now with my wife’s approval.

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Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

Every cyclist of every ability should be able to ride safely in Western Australia

Sign our Petition

Contact Details

Contact PAGE LINK

Email – admin

Postal: Empire Clinic
189 Carr Place

LEEDERVILLE WA 6007

Blog Calendar

M T W T F S S
« Dec
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9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
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Day 12 Post Crash « CycleSafe WA.pdf

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Feb MAR FEB
Previous capture 11 Next capture
2014 2015 2016
2 captures 11 Mar 15 – 29 Feb 16 sparklines
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HomeCraig’s Blog → Day 13 Post Crash

Day 13 Post Crash

Day 13
Friday, 8 November 2013

The morning started well when the mid-level medical team reviewed my progress – I had managed 24 hours on 1 litre per minute oxygen support and 2 litres oxygen support during cycling. They planned a repeat of my damaged chest wall and lung on Saturday and probable discharge Saturday, one day earlier than planned. I just needed to cope on no oxygen support today and extend my physio to walking the length of the corridor twice and walking up and down a flight of stairs unaided. I realised that the spin bike had not arrived at home yet and the Unicorn team were on their way to the Tour of Margaret River. In true Unicorn team spirit, Andrew arranged for one of his friends to deliver the spin bike to my house even though he was already in Margaret River. The day was back on track.

My first trip outdoors in nearly two weeks (with my wife), dressing changes and my physio session occupied the next few hours. I demonstrated that I could walk the corridor length twice, slowly, unaided and go up and down the stairs unaided with no oxygen support whilst maintaining my oxygen saturation above 92%. I also pedalled at “1 Watt” for ten minutes and kept my saturations above 94%. All hurdles had been completed, exactly as required, in keeping with my approach to HCT training – doing my program exactly as written in my program. Things then began to go down hill.

My cardiothoracic surgeon, who is clinically outstanding, spent 30 minutes reviewing me and the plan was changed – I needed a repeat chest X-ray on Saturday and Monday and could probably go home Monday or Tuesday. He believed that given my injury, the previous rapid re-accumulation of fluid around my lung and the appallingly slow progress in my chest, I should do my walking / cycling / respiratory exercise drills here in hospital for the next three days. It was just safer. I had to agree but it did indicate to me that my chest wall injury was worse than I had thought.

To finish off my afternoon, I at last made contact with the Police Officer involved with my case. He informed me that the driver involved in the accident (that had nearly killed me) had been charged with an offence – with failing to give way to the right, an offence that resulted in the loss of two demerit points. This is the same as the demerit point loss accrued when driving between 9-19km/hr over the speed limit. I was saddened, not angry, just saddened. I asked what would have happened if I had died in the crash and was informed that the driver would have been charged with the same offence as there was no evidence of dangerous driving. She just had not seen me.

Having only completed one of my three 10-minute rehab ‘spins’ today I decided to combine the rest. Actually, I rode for 45 minutes keeping my oxygen saturations above 90%. Ironically, I did this at exactly the same time as Team Unicorn raced the team time trial (my pet event) at the TOMR. I only found this out as I was surfing my iPhone whilst ‘spinning’ to avoid looking at the pathetic data. I pedalled for 40 minutes whilst Team Unicorn raced for 34:41 min coming 5th in race one of the TOMR.

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Blog Updates

Day 50 – 52 Post Crash

Day 50 Sunday, 15 December 2013 Watching the Criterium racing at tech park was an interesting experience. Watching others…

Day 47 – 49 Post Crash

Day 47 Thursday, 12 December 2013 The orthopaedic visit went well today. The plate and hooks has not moved and most of the …

Day 42 – 46 Post Crash

Day 42 – 46 Saturday 7 – Weds 11 December Four days away with my wife was amazing. To date, this has been the highlight…

Day 40 + 41 Post Crash

Day 40 Thursday, 5 December 2013 My clinical life is extremely busy. Coupled with my research, I often work 60-80 hours per …

Day 39 Post Crash

Day 39 Wednesday 4th December This week I had a lesson from ‘Mistress Rehab’. On the 25th November, I managed 8 minutes …

Day 38 Post Crash

Day 38 Tuesday 3rd December In many movies at college graduations, speeches talk about the best and worst years of your life…

Day 36 + 37 Post Crash

Day 36 – Sunday, 1 December 2013 Today was a good day. Despite still waking in pain from my chest wall injuries, I completed…

Day 35 Post Crash

Day 35 Saturday 30th November Today I learned a valuable lesson – recovery from major trauma (and/or surgery) takes time…

Day 34 Post Crash

Day 34 Friday, 29 November 2013 A picture paints a thousand words. Today was a milestone in my cycling recovery. I man…

Day 33 Post Crash

Day 33 Thursday, 28 November The theme from the last two days was good; why change a good thing! The good: My oxygen satura…

CycleSafe WA

Every cyclist of every ability should be able to ride safely in Western Australia

Sign our Petition

Contact Details

Contact PAGE LINK

Email – admin

Postal: Empire Clinic
189 Carr Place

LEEDERVILLE WA 6007

Blog Calendar

M T W T F S S
« Dec
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31

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Copyright © 2014 CycleSafe WA

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Day 13 Post Crash « CycleSafe WA.pdf

Day 14 Post Crash « CycleSafe WA.pdf

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