If you ask a parent what they worry about when it comes to teenagers and biking, you’ll hear several themes: inattentive drivers, incautious cyclists, and what about that helmet? You’ve paid money and nagged. Will it stay on your kid’s head once they’re out of sight, or will it be relegated to the backpack to protect your teen’s requisite coolness?
Did you ever worry about handlebars?
Me neither, which is why I’m writing this post with Frank’s full permission.
Last week, the ToolMaster (my husband) and Frank (my son) went on a training ride to prepare for this summer’s holiday biking trip. They were in the home stretch, sticking to relatively deserted city roads, their minds on getting a soda at the local 7-11 to celebrate. Then Frank rounded a corner at the low speed of 10 miles per hour. As best we can tell, he took it too sharply. His front wheel jack-knifed on him and he was abruptly pitched forward.
I got the phone call ten minutes later. Could I come pick them up? Frank seemed fine, but a minor abdominal cut was leaking fat globules.
I took one look at the 1-inch non-bleeding wound, which looked like a tear, and we loaded the bikes and were off to emergency.
Hours later, stitches in place, we went home and to bed. Separately.
I wasn’t concerned. The wound had been probed. Though the forceps went deep enough to make me squeamish, and we hadn’t identified exactly how the injury occurred, nothing had penetrated into his abdomen. Frank’s blood pressure and pulse were stable. The ER doctor didn’t even think he needed antibiotics.
The next morning, Frank was under the weather, feeling all manner of stiffness and pains. He was tired. But this was to be expected, right? We’d gotten home at 1 AM, so he was short of sleep. It’s normal for muscle aches to be worse the day after an accident.
Only when he mentioned a specific type of pain did I realize we were dealing with bigger issues—confirmed on the way to our van when Frank briefly passed out.
So, peeps, in the sense of the Chinese curse, we had interesting times. We had firefighters visit while we waited for the ambulance to arrive. (Unfortunately, Molly was too preoccupied with Frank’s condition to take advantage of the dating opportunities.)
After the CT, things sped up. I’ve retained a montage of video-like clips: the surgeon saying things like “free fluid in the abdomen” and “possible ostomy”. The street clothes and watch and glasses removed. The cheerful-but-purposeful OR porter. The waiting room, bleak and chilled.
The ToolMaster’s eyes reflecting my fear…
In the end, Frank had the best possible outcome, given the circumstances. We think he landed on his handlebar, its brake lever causing the visible wound, its blunt end causing most of the damage. The contusion and shearing forces ripped some internal membranes and blood vessels, causing a slow leak of 700 mls of blood into his abdomen. He didn’t require a transfusion. They fixed the leak, closed him with tidy stitches and staples, and transferred him to the post-op ward, where his care was exceptional.
We’ve been home a few days now. Life is returning to normal.
However, I keep hearing from friends is that we were lucky — that while I’m upset with myself for failing to think like a doctor instead of a parent, my medical background helped. At least I knew what to look for. At least we got help before it was too late. So let’s fix some of the knowledge-gap right now, okay? Let’s arm you folks.
1. Know that while penetrating abdominal wounds provide drama, they aren’t necessarily what will cause disability or death. Blunt abdominal trauma, can be a silent, slow, but lethal danger. While this list is by no means comprehensive, watch for these warning signs:
- Increasing abdominal size (bloating)
- Increasing abdominal pain
- Diminished appetite, especially if it leads to vomiting
- Pallor, lightheadedness, passing out
- Shoulder-tip pain: When blood or infection irritate the nerve which supplies the diaphragm, an affected person feels pain in the tip of their shoulder. It doesn’t respond to massage, though you might mask it with painkillers.
2. We think Frank’s superficial wound was caused by a bike lever. While this kind of injury might not be on your radar, it’s not at all uncommon. Don’t believe me? Look at these links.
- Boy, 10, OK after being impaled on bike handle
- Schoolgirl impaled on bike’s handlebars thanks her nurses
- Teen impaled on bike lever
- Video about a hand being impaled on a bike lever (Look at minute 2:11 for close-up).
And so on.
Someone who is design-savvy needs to reconfigure these. The minor bend on the end isn’t enough to prevent impalement, as evidenced by the images.
So parents, when you are selecting your bikes, notice the lever placement. Brakes are obviously mandatory, but some levers are more exposed and sharper than others.
3. Bicycle helmets are a necessity at all ages, and they must be replaced after one impact.
In the hullaballoo about his belly, one thing stood out: we weren’t being directed to a neuro ICU for a brain injury, because though he struck his head at the scene of the accident, Frank’s helmet did its job. The belly heals much better than the brain.
No, you can’t make your kids wear their helmets out of your sight, but have you stressed their importance? And what about you? Are you wearing your own helmet? Are you expecting your kids or teens to sacrifice coolness when you won’t?
How are you on biking safety?
If you’ve found this post helpful, please feel free to pass it on.
I should be back later in the week with a non-medical post. To receive free e-mail updates from this blog, look to the green sign-up box in the right sidebar. Plus, connect with me on Twitter and Facebook.