[Ken Kifer's Bike Pages]
ARTICLE: My Fall -- The Story of a Bicycling Injury and Recovery
During the winter of 2002, I fell while riding my bike and fractured my hip. This account tells about the accident and about my recovery over the next four months.

When did my bicycle accident occur? Have I had many cycling accidents during my life? What events led to this injury? Why is a fracture of the upper femur called a broken hip? What was the cause of my fall from the bike? Why did I have such a serious injury? Should my injury discourage people from riding bicycles? Was I depressed by my injury? How did I fare in the hospital? How did the muscles in my thigh react to the injury? How did the process of relearning how to walk begin? How did my ability to move my leg and to walk gradually improve? What did I do to hasten this improvement? How could I chart my progress? Why was a second trip to the hospital necessary? Why was the third month difficult? What major change occurred at the end of the month? What kind of bike did I need to begin riding again? Why was bicycling helpful? Why do I now say that I am completely better?


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My Fall -- The Story of a Bicycling Injury and Recovery

I would like to express my gratitude to my sister, my brother and his wife, my close friend, and the doctors and nurses who helped me through this crisis.

On March 15, 2002, while riding my bike in the early afternoon, I suffered the worst fall of my life. I thought it would be honest and straight-forward for me to tell about my fall and how I recovered from it.

Since I began communicating on the internet in 1997, I have encountered a lot of skepticism because I claimed few falls in over 100,000 miles of riding a bike. I had three falls during the years 1965 to 1968, and I had another three falls during the years 1987 and 1988. With two of the falls, I skinned up the palms of my hands, with one I strained a rib (lifting was painful, but nothing else bothered me), and with the other three, I suffered almost no injury.

I also have fallen a few times when the bicycle wasn't moving, which I have never counted in with the others. Damage was slight, except to my pride. I don't remember any falls on my bike as a child, although I had two head injuries before I got my bike which probably helped make me a cautious child. Throughout childhood, I was injured just twice more that I remember: a broken arm in 1960, when nearly 15, and a scraped wrist a year later.

I have never felt that it would be impossible for me to have another accident on my bike, but I did feel that I wouldn't repeat any of my former mistakes and that a fall would be unlikely. I considered my greatest risk to be losing control in the event of an emergency, such as a car running me off of the road.

The place and conditions under which I had my most serious fall were not at all what I would or could have predicted. Much the opposite; if anyone had described my fall ahead of time, I would say that it could not happen, and the only proof that it did happen are my memory and the events and consequences that followed.

The bicycle was a mountain bike which I had purchased for $50. It was an odd mountain bike, having a short wheelbase and dropped handlebars, and it was not as stable as the touring bikes I am used to riding. Someone had mounted the brakes too far forward, on the curve of the drops. The left (front) aero-style brake did not work very well, likely due to forcing the cables under the handlebar tape. The bike also had extremely wide tires (2.2 inches) with aggressive treads. I had purchased the bike because it seemed to be a very good bargain and because I was curious about riding a different kind of bike. I had not intended to use the bike to ride to town, but the road up my mountain had just had its pavement removed to prepare it for resurfacing, and I had just broken the axle on my touring bike. Before the day of the accident, I had ridden the mountain bike about 150 miles, including three trips to town. On the way to town on this fourth trip, while stopped at the local store, the bike fell over, and the handlebars twisted sideways. I straighten them, but I did not immediately retighten them, not considering them excessively loose.

When my accident occurred, I was riding the bike north towards a right turn to my bank on a three-lane road. Along the edge of the road was the standard curb and gutter, with the gutter slightly deeper than normal due to a drain which I had just passed. I looked back to see if anyone was behind me in preparation for a right turn (no one was there). When I looked straight ahead, I was already in the gutter. This shocked me because I must have drifted two feet or more to the right while looking back without noticing the fact. I then had an immediate choice to either stop in the gutter or to ride out of it, climbing over a pavement edge at an extreme angle that seemed to be less than an inch. Stopping in the gutter did not seem too desirable to me, both because I would be in the wrong position on the road and because I would have to reach quite far forward to reach the brakes, one of which barely worked. Although I knew that crossing a pavement edge at such an angle would tend to throw me, the danger seemed to be minor because it was such a slight lip and because I had such big tires.

However, when I began crossing the pavement lip, the bike threw me violently off at a 90° angle into the traffic lane. My body landed on the pavement horizontal to the ground, with all of my weight landing on the side of my left hip. On hitting the ground, I immediately felt great pain, and I found myself almost paralyzed on the left side. With great difficulty, I managed to crawl out of the road, and at that point, a paramedic arrived, began supporting my legs, and called for an ambulance on his phone. Within minutes, I was placed in the ambulance and taken to the hospital, receiving a intravenous needle along the way. My doctor arrived almost immediately, I was X-rayed, revealing a fractured hip, and he planned to operate the same day, but then had to change to the next morning due to another operation. I told him to give me no more than the necessary details, as I am easily upset by such things, and he told me that my bone was broken in three places, and that he would use a pin and a plate to bind them together. The pin and plate would be made of stainless steel, so there never would be a necessity to remove them.

Later, I very gradually came to recognize that the injury was to my upper femur, just below where it mounts into the hip socket, and not to the pelvis itself. My doctor says this is called a hip fracture by tradition. While the break in some aspects is no more of a problem than a broken leg, the location makes a splint impossible, and an operation necessary. As I saw on the X-ray taken over a month later, a rather large rod follows the bone into the hip socket while a plate runs down my leg, which is held in place by four screws into the bone. I'm glad that he did not tell me all that at the time, as it would have been upsetting to me.

As I lay there, I wondered what had caused my accident. Many times when I had injured myself in the past, everything seemed to act in slow motion, but in this case, everything happened so quickly that I had hardly been able to record it all, let alone analyze. My first theory was that the handlebar must had been too loose, causing me to veer into the gutter and causing me to be thrown when I tried to climb out. However, I found myself discarding this notion within a day or two. There's no way that the handlebars could have turned that much without my immediately recognizing the fact. Indeed, months later when I rode the bike again, I did not tighten the handlebars or have trouble with them as a result. No, the only explanation was the bike itself. The short wheelbase caused it to react differently when I looked behind. When I look behind, sometimes the bike I'm riding does move to the left or the right, and the short wheelbase of this bike must have caused it to move farther than what I expected. What about climbing over the slight lip? I had made a very quick decision based on zero experience that climbing that lip at an angle on such big tires would be less dangerous than on my usual, much smaller tires. However, the opposite had proven true, and the big tires had just seemed to provide much more energy to flip me.

Another important question is why did I have such a serious injury? There are three answers to this question. First, I am 56. While my doctor confirmed that my bones were strong; nonetheless, as one gets older the chances of a fracture get greater. However, one cyclist wrote and told me that he had fractured his hip at 22. Second, the way I landed on the ground threw all of the weight of my body into my hip socket. Indeed, I did not have a bruise, scratch, or other sign of injury elsewhere on my body. If my body had been rotated to the left or right or if I had landed on my feet or arms first, the hip injury would not have occurred. Hip injuries while cycling are fairly rare; since my accident, I have learned of five other cyclists with the same injury. Third, in spite of the requirement for surgery and a hospital stay, my hip fracture was a simple broken bone; only the location made this more severe than a normal broken leg or arm.

One of the nurses present when I was first taken to my room said, "I'll never ride a bike again." Well, that is certainly the last reaction I would want people to have. I have never denied that there is an element of risk to cycling. While I have never been worried about a simple fall, I have had to make emergency maneuvers to escape being hit by automobiles on a number of occasions, so I have been aware that the threat of injury or death is there. To me the blessings conferred upon my life while bicycling -- the grand experience, the better health, and the economic independence -- all outweigh the risks involved. Certainly, my present accident, while creating a need for some months of recuperation and involving heavy expenses, was by no means serious enough to make me wish I had remained car-dependent. There was some indirect acknowledgement of the advantages of cycling by the hospital staff and my doctor while I was there, as they could not help noticing that my body was lean, strong, and healthy.

I certainly was not depressed by my injury. I maintained a positive mood from the time the paramedic arrived until I returned to Scottsboro seven weeks later. While the accident was by no means desirable, I made up my mind to concentrate on getting better rather than on whatever ill consequences were involved. It is true that when I watched some stupid TV program which jerked the emotions that tears came quickly and easily. All of my emotions were stronger and closer to the surface.

Having lived in the Scottsboro area off and on since 1978, I was aware that many people in the community have had a poor opinion of their hospital. Having spent time with my parents while they were in more than half a dozen hospitals in three cities, I can report that the care at the Scottsboro hospital was as good as or better than the care elsewhere. It's true that nobody came on a couple of occasions when I buzzed for help (I buzzed only when necessary), and there were a couple of nurses who were obviously unsympathetic, but most of the nurses were eager to help and extremely cooperative, often going out of their way to be useful. I considered one of them to be my angel because she solved so many problems for me.

What do you do when you find yourself in bed almost unable to move? Well, I called friends and family on the phone to let them know what happened, and I used my laptop (I had carried it with me in the ambulance rather than leave it on the bike) during the night. I did not use my laptop to any great extent for writing as 1) lying down flat on one's back is not the best position in which to write and 2) I was not exactly in my most productive writing mood. It was four days after my accident before I answered any emails, and I didn't emailed my son and the newslists about what had happened to me after I left the hospital, mainly because I needed to muster my courage. Although I usually don't watch TV, I watched it a good bit in the hospital. I was in a good mood to passively watch entertainment. There was also a steady stream of nurses checking my pulse and blood pressure, taking blood samples, getting me to breathe, bringing food, removing the tray, getting water, emptying my urinal, and moving me around. Every couple of hours, I would perform whatever exercises I could while in the bed, using a guide the therapists had given me. As a result of all these activities, the days passed rather quickly.

My most noticeable physical problem, which was true both before and after the operation, was that the muscles in the injured left thigh were all in full cramp mode. The position of my leg could be adjusted very slowly without pain or problem but any attempt to move it at normal speed would cause me to scream. I was comfortable lying in bed flat on my back with my legs spread apart, but any change in position created pain. At first, I felt a good bit of pain all the time and took morpheme, but after a few days, my pain dropped to level one unless my leg was moved too quickly; then it was off of the scale. Since morpheme was not necessary for the first pain or helpful with the second, I asked them to discontinue it. Towards the end of the week, I quit perceiving the cramp in my leg as pain, and soon after than, my leg quit cramping. Also, ironically, much of the pain during these days was felt in my lower leg and foot, which had not been injured. My foot was more sensitive to touch or towards being moved than my thigh. As the cramp disappeared, so did the muscles. My strong thigh muscles melted away, and a roll of fat appeared under the leg. I found I had to grow new muscles, and I had to learn how to use them all over again, as if I had never walked before.

The first three days involved only minor changes. During the first day, I was able to relax my leg from a folded position to an extended position and to make myself comfortable. I was able to move my left foot just fine. My operation was in the morning of the second day, and I asked to be put to sleep during it, so my next memory is of my brother and his wife coming by to see me, but I was too sleepy to answer them. My doctor said that I talked to him after my operation and that I was in good spirits, but the memory evaporated without trace. I think I slept most of the third day too. During this first period, my leg was extremely sensitive, and the nurses had me screaming when they came in to move me to get me to sleep partway on my side.

I believe that it was on the fourth morning that the doctor requested for me to sit in a chair for most of the day. Fortunately, one of the nurses who came to help me sit up was most understanding, and I was able to to direct them so I got onto the chair with a minimum of pain. However, before an hour was up, I was so miserable that I tried to get onto the potty by myself, and there I was even more uncomfortable. Eventually, the nurses came and helped me get back into bed, where I was finally comfortable. That night I was relaxed enough to answer some email questions to the website for the first time.

On the fifth morning, when I had to get up, a student and her instructor helped me. The student had had a similar injury and was appropriately careful. The instructor accidentally stepped on my foot. That would have had me screaming a day or two earlier, but my sensitivity was decreasing. That day, two therapists came in the afternoon and gave me some exercises I could do in bed. They also gave me some instructions about getting in and out of bed, and I got out of bed with less pain than ever before.

The next morning, I was helped by an unsympathetic nurse, who felt that pain was good for me, and another who I would describe as unempathetic. I was trying to get to the potty again, and they were not helping much. At one point, they left my left leg unsupported while I screamed. Finally, I got the one nurse to support the foot, so it could relax and slowly lower itself to the ground. That afternoon, in spite of my being nearly exhausted by the morning's activities, the therapists came again. This time, with their suggestions, I established that I could lock my two legs together whenever they were to be moved. From then on, moving me was not a problem -- after I had locked my legs together and instructed the nurses to handle only the right leg. I also made my first step on this day. It wasn't much; I merely lifted my foot enough to swing my leg forward on the walker, but I was crying with joy to walk that little bit (I had been moving around before, but by sliding the foot rather than by lifting it).

On the seventh day, moving me was no longer traumatic, as I kept my legs locked together. I even learned to get myself out of the bed. With the therapists, I was able to make three real steps (I moved further than that, but the rest involved sliding my foot).

I barely remember the eighth day. In the morning, the doctor told me that I could probably leave the next day, so most of my attention was directed towards getting ready. I walked a little that afternoon, but I was unable to make it as far as the door.

My final day involved a trauma in the morning, as I had become quite constipated and was unable to use either the potty or the bed pan (by this time, I was able to get in and out of the bed by myself). My doctor (a surgeon) had to give permission for them to be able to give me something to soften the stool and allow me some final relief. A good friend had been making trips to my home to round up the things I wanted to take with me, and he finished this task in the morning, and my brother and his wife arrived in the afternoon to take me to their home. Getting me into the car was not as difficult as I thought, and the car trip was no bother. Getting out of the car at their house, I amazed myself by "walking" twenty feet to get inside, but I stayed downstairs the first night because I was afraid of the stairs.

In the morning, I walked around some, and then I was able to get up the stairs by sitting on them and lifting my bottom with my right foot while my brother slowly lifted my left foot at the same time. That night while in bed, I was able to lift my knee for the first time. As this was similar to all my other relearning processes, let me explain more carefully how it happened. Although I had kept trying to lift the knee (it was one of my exercises which I tried to do every few hours), the muscles had refused to work. But this time, after I lifted the leg by hand while trying the first time, it lifted without my help the second time, and from then on, I could lift my knee whenever I wanted to (lifting my leg, however, was weeks in the future). In every case, relearning seemed to consist in trying to move while using my hand to perform the motion. Once I could perform the function with the muscles in my leg alone, I never forgot the trick, although I did have to spend some time strengthening those muscles.

Originally, the plan had been for me to spend a week with my brother and his wife, but they ended up keeping me nearly two weeks before sending me on an airplane to see my sister, probably to give my leg more time to heal before the trip. I will not continue to try to plot my progress day by day as the basic outline of my day's activities stayed pretty much the same.

Basically, each day I would try to walk as much on the walker as possible. I could walk a long distance in the house from the bedroom to the other end and back. Of course, in the beginning, I was putting almost no weight on my left foot but was supporting myself with my hands and with the other foot. Feeling tired or feeling pains in my leg was a sign for me to do less; feeling strong and energetic were signs to attempt more. Sitting in a chair would cause pain after a while, so I spent most of my time in the bed. After I was there a few days, my brother's wife, a nurse, pulled out the staples in my leg. At first, I was not able to get into the shower because I could not get my leg over the sill, so I washed up in the sink, but after I finally managed to get into the shower, I would sometimes go in and soak my leg or foot when they were painful. I also learned how to put a sock on the left foot. While at my brother's, I could not raise or lower my left leg except by cradling it in the right leg (they had to swap mattresses in order for me to be able to get into the bed at all), and I still could not lift my left heel off of the bed, except with my hands. Shortly before I left, my brother was interested in seeing whether I could use a cane or a crutch instead of the walker, to make getting onto the plane easier, but it was too difficult. I thought of a crude way to measure the strength of my leg by pressing down on the scale with my left foot. On my first attempt, I could press 40 pounds for a few seconds and, before I left, 45 pounds. Two days before I left, I walked too much and was in great pain, so I did very little walking the day before my trip.

My trip to my sister's on March 7, was not very difficult, as the skycaps pushed me in a wheelchair to the plane and on an electric cart to my folks at the other end. There was one misunderstanding when I was expected to walk onto the airplane, a task that was impossible for me.

At first at my sister's house in New Jersey, I was not able to get up the stairs. Downstairs were a bedroom, den, and small bathroom, without a tub or shower, so I went back to sponge baths. As the distances were short downstairs, I planned to do most of my walking outside. On my first trip, I was able to make it as far as the nearest stop sign, two houses down, but I was exhausted and had to rest before starting back. Fortunately, a neighbor arrived just at the right time to keep my sister occupied. I was very pleased the next day when I managed to walk as far as the other other stop sign, at least four times as far away. After building up for a few days, I would walk up to three times a day, mostly by myself. My walks soon extended around the block, which would take 40 minutes, and I also made some long walks when visiting stores with my sister. One of those walks was a killer, as we traveled the entire length of the mall and back, but I was never that tired again, even when traveling farther. My speed on the walker increased along with the distance I could travel. Between walks, I would rest on the couch, and very often I fell asleep.

Each time I was able to master a new skill, I called myself "Superman" or "the Bionic Man" but finally I came up with my own special moniker: "Hobble-Along," pronounced "hob-a-long" or "hob-ble-long."

After ten days at my sister's, I was able to make it up the stairs by hanging onto the railing and to make it down by sitting down and bumping down one step at a time. Upstairs, I could take a shower, and I could also check to see my strength on the scale. It had reached 75 pounds by that time, and it kept increasing by five pounds and then by ten pounds a day. By the 20th, I could depress the scale 120 pounds for a second or two, and I was walking outside up to an hour and 45 minutes per day. About the same time, I started being able to lift my leg into the bed instead of having to pick it up. I still could not lift my leg up when lying on the floor. By this time, I was making several trips up and down the stairs every day, pushing my walker in front of me and walking more than bumping.

After I managed to briefly depress the scale by 140 pounds, I was unable to use use the scale to chart my progress. The problem was that I still had to balance myself, and that made putting my full weight on my leg impossible. After abandoning that method of measurement, I came up with a new one: instead of depressing the scale briefly, I would see how much pressure I could maintain indefinitely. This weight began at 90 pounds and quickly and irregularly rose to 135 pounds, after which I could no longer increase it due to my need to balance. By this time, I felt ready to abandon the walker. Indeed, I was now making three trips of 40 minutes or more every day, some days reaching three hours a day. As I was having swelling in my leg, I kept it propped up as much as possible. I had a dream in which the doctor asked me what I was doing about the swelling, and I told him that I was walking 13 hours a day!

I started using two canes on March 25. For a while, I had experimented with using one, but one cane was not adequate. Two canes worked well, the left providing a firm support, and the right helping me balance. Once I started using them, I used the walker only once or twice more. Walking up and down stairs became easy with the canes, but walking around the block was initially more difficult. I basically had to start all over again, making it as far as the nearest stop sign and so on. In the remaining week and a half, I never got back to some of the places I had reached on the walker, but I did build up to walks that included several blocks. Before leaving, I found that I could walk a short distance without using any cane, but I flapped my arms as if I was about to take off. I told my sister that I didn't know if the problem was strength, balance, or fear. I was hopeful that I would be able to walk on one cane when going back on the airplane, but that did not quite happen.

The trip back was easier than the trip out. I got the skycaps to carry me through the airport, however, because walking would have taken forever. My brother picked me up, and the next morning gave me my mother's car to drive. I found I had no problem driving, and I drove back to Scottsboro, stopping to get some food and my mail before stopping at my doctor's office.

However, disaster lay ahead. My X-ray looked good, but after seeing the swelling in my leg and foot, the doctor wanted me to have an ultra-sound scan at the hospital. That scan discovered massive blood clots, so I was placed on a wheelchair, wheeled to a bed, and hooked up to a bottle of blood thinner. The danger was that a blood clot could travel to my lungs, causing intense pain and permanent damage. Blood clots are often fatal. Besides being depressed about being back in the hospital (I cried for the first time when I was told that I had blood clots), I became quite ill and nauseated, although blood tests never determined the cause. After four days, my blood was thin enough, and I was allowed to leave. I was so weak that I nearly fainted in the store, so I checked myself into a motel instead of going home.

The next day, I took most of the day getting home, as I could not cook at home, due to having to use two canes to move around. On the way, I stopped at a friend's farm, where walking was difficult. At home, I found my path to the cabin to be too difficult, and I had to find another route. Evidently, I placed too much strain on my right shoulder, and it hurt very badly that night. The next day, I had to leave the cabin, spend the day in town, and return that evening, as I could not yet prepare meals or get water from my spring. The second night, the pain was terrific, and I wondered if I had a blood clot in my lungs. I was reassured by the fact that there was no pain as long as I was lying flat on my back, the only painless position.

On Thursday, when I visited the doctor's, I was feeling a little better, and by Friday, April 12, I was beginning to feel normal again. Sometime during this period, I don't remember when, I found that I could get around with only one cane, using it on my right side, except when traveling in the woods. Balance was the only reason for using it, as I found I could balance perfectly on the right foot, and on the left foot and cane, but not on the left foot alone.

My routine for the rest of the April was to get up early and drive downtown (where I could get some inexpensive meals) and spend the day between the library and the park. I found I could walk only about half a mile without my wrist and hand hurting excessively, but I would make the trip up to five times a day. Each half mile trip would take about 20 minutes. I would also visit Walmart in the evening where I could walk using the grocery cart. I had discovered this method of walking back in New Jersey about the time I started using two canes. At first, it had been too difficult to do long, but now I could walk as far as I wanted with the slight support of the cart. For the most part, however, this was a discouraging month, as I could see no progress from day to day. Frequent rain and gloomy skies did not help my mood, although the rain was much needed for growing things.

In May, however, I could see a lot of change. I found that I could get around inside without using a cane, and that I needed only one cane in the woods. This made many tasks possible or easier, such as getting water from the spring, carrying groceries to the house, and cooking my meals, so I quit eating all my meals downtown and began taking care of myself again. At the store, I no longer headed for the grocery cart, but instead carried a basket. I also discovered that I could walk much farther than before, since I was no longer putting so much pressure on my right hand. On May 5th, I walked six miles ( 5½ separate trips), and two days later, I walked nearly as far, but slower this time. I was unable to walk much on Thursday or Friday, due to the weather, but on Friday, I got on the bike I had had the accident on and rode six miles!

Because this bike was hard to get onto (I had to lay it on the ground, straddle it, and pull it up under me -- all the time in danger of falling) and because I was a very shaky rider, I needed another kind of bike, at least temporarily, that was easier to get onto. Over the internet, I received recommendations to get a trike, an Easy Racer, a BikeE, and a Bike Friday. All of these bikes would be easier to get onto, but most were not readily available. I was able to test ride an Easy Racer EZ-1, and I quickly discovered that riding it was like learning to ride all over again, not an easy task in my condition. Therefore, I bought a woman's comfort bike the next week, on May 15th, three months after my fall. By keeping the seat low, I was able to ride this bike OK, although I was a little wobbly. I soon rode 12 miles in one day. When I talked to my doctor on the 17th, he thought I was walking too far, but he recommended riding as much as I wanted to. In the month that followed, I would ride this bike four or five days a week, in fairly flat terrain, usually making two or three six mile trips, stopping at the store for a drink in the middle of each ride. After riding to a store, I could hobble around without my cane. I called this penguin walking, as my whole body would swivel on my hip whenever my right foot was in the air, evidently to help my left leg balance.

At the beginning of June, although I was already walking and cycling more than the average person, I was still not back to normal. I still needed the cane because my left leg, although lean and muscular, still lacked strength, muscle, flexibility, mobility, and fine motor skills. My head would bob from side to side when walking without it, and I would quickly tire. Simple actions such as bending over and picking up a piece of paper took effort, and stepping over the cable across my driveway without the cane was impossible. I also needed to lose some fat from my tummy. Even though my average daily amount of exercise had been about 1½ hours a day before the accident and had increased to 2 or 3 hours afterwards, I had gained about ten pounds, mostly during the third and fourth months, because the exercise had become less difficult.

I have not mentioned one important aspect: the cost. Medical costs in the US are a very strange creature. One person has complete medical coverage, another has partial coverage, a third has Medicare, a fourth has Medicaid, and a fifth has no insurance at all, because the cost of individual health care is prohibitive. As a result, their ability to pay varies significantly. In addition, insurance companies often negotiate their fees, and the government pays greatly reduced amounts for Medicare and Medicaid patients. Thus, the amount of money that an individual and/or that the insuring agency pays varies greatly, and the amount that the hospital receives varies as a result. Of course, when the hospital gives a discount or writes off a fee because the person has no money, those costs must be passed on to others. Medical costs are also higher due to malpractice suits and insurance, and also because the users have no choice in their treatment. A person in my condition, having money on hand and no insurance, must accept whatever discount is offered, which varied in my case from 50% to nothing. Nearly 90% of my expense was the hospital bill, which was discounted little, due to my lack of experience with such settlements. My total bill was over $20,000.

Someone could make the argument that bicycling is not worth it due to the high cost for this kind of injury. However, very few cyclists have hip fractures; since my accident I have heard of seven. There's a lot of people in my community who have had hip fractures without ever getting on a bike, and many are having hip and knee replacements due to lack of exercise. Anyway, the money I have saved by riding a bike over the years would cover these costs easily. The average person spends $3,700 a year on health care, which I haven't spent because of the good health furnished by cycling. My most expensive illness was due to an allergy problem in the mid-70's, which cost me considerably less than a thousand dollars over two years. One time I was visiting a doctor I hadn't seen in eight years, and she asked me who my regular doctor was. I told her, "You are." In addition, if I had never ridden a bike, I would have the risk of traveling in an automobile for an even greater number of miles plus the health risk from less exercise. Health problems created by lack of exercise can be much more expensive than a hip operation; a neighbor told me that his heart bypass cost $100,000.

Epilogue June 22, 2002

In recounting the amazing adventures of Hobble-Along, we have reached the point where he must drop his shtick and start acting human again.

What does it feel like to walk without a shtick? It is a weird and strange feeling like swimming without water wings or riding a bike without training wheels. I keep thinking that my leg is going to fall off. With the shtick, young women would drop their babies to hold the door for me, motorists would screech to a halt whenever I approached the curb and patiently wait 20 minutes while I doddered across, and everyone wanted a detailed account of my accident. Now that I am recovered, people slam doors in my face, drive over my toes, and look bored when I point out that I am bicycling to town again; isn't it great to be normal? However, I missed my last chance to get married; for a few months, I was helplessly dependent, but I blew it by becoming strong and self-sufficient again. For a while, I never got anything done because I was handicapped; now, I'm back to being lazy. At any rate, the cane very suddenly felt unnecessary. I can walk as fast and go anywhere without it, even down the trecherous climb into my cave. I can now step over the cable or do about anything else except put my shorts on while standing up.

I think I made a great deal on the 19" dropped frame bike I bought last month. I swapped it for a similar 22" diamond frame model for just $75 by keeping my "old" seat, wheels, and pedals (actually, I let them keep the pedals, and I put some rat traps on the bike). The bike I swapped in thus cost me about 30¢ a mile (250 miles), which I think is dirt cheap for physical therapy. One could also compute it at $3.00 an hour or $2.50 per day. Frankly, I considered it so valuable to my recovery that I wouldn't have hesitated getting it even if I had learned that I would be stuck with it. However, the new bike is more my size and will give me more power. I probably won't get back on my 25" touring bikes until this fall.

With the new bike, I made three separate trips to town within a week from the foot of the mountain, and today I have made the entire round trip (28 miles), including the climb to my cabin. I even took my usual evening walk of a mile just before dark. I still need to improve my balance a little, and I still have some aches and pains, but otherwise, I am back to normal after four months and one week.

I think I am a very fortunate person to have had so few injuries during my life. And I'm sure I will never tempt fate again by crossing a pavement lip at an extreme angle. But my injury has not been entirely negative. It has brought me closer to my family and community, it has given me an opportunity to see the power of the body to heal itself, and it has re-exposed me to some of the problems of beginning cyclists, a reminder which will help me create new web pages.

Is cycling worthwhile when the possibility exists of getting injured? You will have to decide that for yourself, but I have already decided for me. My strong and healthy bicycling body quickly recovered its ability even after losing almost all of the strength and control in my left (strongest) leg. It's true that I did not recover as quickly as a teenager would have, but I think I probably have done better than most people of 56. Certainly, most people my age could not ride a bike 28 miles in one day, even though it took me just over 4 months to regain that ability.

July 2, 2002

I can now put my shorts on while standing up, and I am riding up to 33 miles per day, including climbing my mountain twice, without difficulty. Still, some minor muscle weaknesses exist; I can't get on the bike cowboy style.

Thinking about my recovery, I recognize how similar it was in duration to recovering from a broken arm or leg. My broken arm, for instance, required six weeks in a cast, during the first half of which, I could not use my fingers at all. After the six weeks, I still had to be careful with my arm for some months. In this case, it was eight weeks before I could walk with one cane (for balance only), and slightly over two months more before I was comfortable without the cane. I believe this is very similar to the recovery time of a friend who broke his leg as a teenager. Thus, the loss of muscle strength which I experienced did not delay my recovery.

October 11, 2002

Recently, a friend said, "You sure were lucky to have recovered so quickly!" Although I was happy to see her, I had to forcefully disagree, "Luck had nothing to do with it; I worked to get better!" On the 15th, it will have been eight months since my injury, and I will have walked about 240 miles and ridden my bike nearly 2,250 miles since that time (the bicycling was done in five months' time). For a long time, my "new" leg was skinnier than the old one; now they are a matched set again. I am once again hopping onto my bike cowboy style, although I still lack fine control (previously, I could mount and dismount without the bike moving -- and do it in slow motion too). I consider myself 99% recovered, but that final percent may take years. In some ways, an injury is a benefit, as it causes us to count our blessings and to be grateful for what we still have.

March 2, 2003

I intended to post an update on the anniversary of my accident, but I was too busy creating other web pages at the time. It's really hard to tell now that I've had an accident. My left leg still bothers me some, but in other places from where I was injuried. My right arm bothers me a lot more. In January, another scan was made of my leg to see if I could go off of blood thinner, and the scan revealed that the main artery in my leg was no longer being used. It evidently was clogged with a clot back in February or March of last year, and the blood found new pathways through my leg. Kenneth Cooper describes a jogger surviving a heart attack the same way. We might say that due to lots of bicycling and walking, when the main highway was blocked, the blood found lots of bikeways to get through, and a disaster was avoided.

I also decided upon what caused the accident. Returning to the accident scene on several occasions, I found I could not reconcile where I fell with where I thought I was turning; therefore, I believe the bike turned more quickly than I intended, and thus I ended up turning where there was still too much of a lip. The problem, then, was not the tires on the bike but the bike's overquick (for me) response.

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