Archive for August, 2015|Monthly archive page

Adventures with Broken Bones

It’s never nice hearing your own bone snap.

I was on the North Shore, Vancouver’s local playground. With three mountains only a few minutes out of the city, the north shore is our local winter ski fields, and our summer hiking and mountain biking trails. Since it was summer, I was mountain biking.

Unfortunately, having just spent six weeks on a road trip in Alaska, I was a little out of shape. And with a Whistler bike weekend coming up, I was also a little over-ambitious.

These two things are not a good combination.

I hit a trail too fast, messed up a tight corner, and the next thing I knew I was face down in the dirt with my bike in the bushes.

Huh. There was also something wrong with my arm. Looking at it, wrist seemed to have a strange dent, and my hand was a lot larger than it should be.

That was not good. I should probably go to a hospital.

Oddly, I was feeling little pain, although that might have just been because my brain had decided to stop taking calls from my wrist. I had a feeling that once the adrenalin wore off, I would find a number of increasingly grumpy voicemails from my arm, letting me know exactly what it thought of my decision to break my fall with my wrist.

I curled my wrist protectively against my chest, and began the very slow 7km journey back down the mountain.

It was normally a lot more fun without a broken wrist.

Summer in Vancouver is glorious. The sun doesn’t set until late, and the long, warm evenings are filled with people running, cycling, playing tennis, and blowing off the cobwebs after a day at work.

The flip side to this is that apparently 9pm on a Wednesday evening is peak hour at the local emergency room. There was one ER doctor, and about half a dozen other broken wrists and ankles. I was shown to a bed, covered with a warm blanket, and left to stare at the walls for an hour.

Eventually, a nurse came along. He whipped an IV needle into my left arm, slapped a name tag around my right, and bundled me off to x-ray.

“Put your wrist here. Not pregnant? Okay, hold still. Aaand you’re done. Thanks.” I had barely said hello to the radiologist before I was being escorted back to bed, and the familiar white wall to wait for the doctor.

I tried to hold on to the faint hope that I’d just strained my wrist, but I didn’t think so: arms aren’t supposed to bend in two places.

Broken wrist x-ray

This is not a good look for a wrist

Eventually the doctor turned up with the non-at-all surprising news that I’d broken my wrist. But not just broken it – I’d snapped the end of my radius off and sent it for a brief visit into my hand. It would need to be reset.

I was given a form to sign giving consent, while the nurse emptied a plunger of morphine and then procedural anaesthetic into my IV. A few seconds later, everything went a little fuzzy as the doctor jerked the end of my radius back into my arm. I awoke to find my arm swaddled in splints and a gap of about twenty minutes in my memory. Given that those twenty minutes probably included a great deal of pain, I decided not to go about looking for them any time soon.

I was discharged a few minutes later with printouts explaining everything that had happened, a prescription for painkillers, and instructions to come back for a check up next week.

That was it. It was remarkably efficient. Well, apart from the two hours staring at the white wall.

I had always considered breaking a bone to be a fairly major event. Not as bad as being shot, or losing a limb, obviously, but kinda serious. Not in Vancouver. Here’s it’s kinda considered par for the course; like parking tickets in LA, or rain in London; a minor, acceptable price to pay for the Vancouver lifestyle. In fact, since arriving here, I’ve always known at least one person with a broken bone; from hiking, from snowboarding, from hockey. You can even tell when the local ski mountains open in winter by the number of people on crutches you see the following week.

How hum-drum this was, was drilled into me a few days later when I texted my friend to let her know I couldn’t make the Whistler bike weekend. Rather than fuss or drench me in sympathy for my broken wrist, she simply rescheduled the trip for six weeks later.

This means that, if you’re going to break a bone, Vancouver is probably one of the best places in the world to do it. Aside from Canada’s comprehensive health care, the doctors here have plenty of experience putting people back together again after they’ve done something silly like break their wrist mountain biking.

British Columbia is Canada’s most active province, with roughly 86% of households engaging in fitness or sports of some kind. Within BC, Vancouver is the province’s largest city, and pretty much everyone here is an extreme sports junkie. There are very few fat people in Vancouver. A lot of people in yoga pants, but not many fat people.

Because of this, several hospitals specialise in sports related trauma, and there are hundreds of sports medicine specialists working in the city. Towns several hours away send people to Vancouver for surgery and treatment.

And it’s not just the patients who are sports mad; my orthopaedic resident greeted me with a broken wrist from mountain biking, and my physiotherapist had the exact same injury (and later surgery) from hiking. It was actually kinda nice that they really did know what I was going through.

No matter how bad or strange your injury, chances are the doctor’s seen the exact same thing earlier on that week.

But, while the hospitals and doctors may operate like machinery, it’s not exactly well-oiled machinery. More like rusted machinery, with parts missing, and other pieces bodged back together with gaff-tape and everybody hoping it’ll last another year before it blows up.

Because of how active people here are, the health system has a hard time keeping up. My orthopaedic surgeon was getting ten new broken wrists and ankles referred to him every day by the hospital – great for his job security, but not so great for one-on-one time with him. And because the doctors, hospitals and labs are all stretched beyond capacity, information often gets lost in the mix; critical exams aren’t requested, x-rays go missing, or lab results aren’t followed up on. This puts a lot of onus back on people to manage their health and make sure they’re asking the right questions.

For example, my wrist. Now, I’d (very definitely) broken my radius, but I discovered later that I also broke my ulna – and not one of my three different doctors mentioned it to me. The ER doctor didn’t tell me because she wasn’t sure; my first orthopedic specialist didn’t tell me because he thought the ER doctor had told me, while my second orthopedic surgeon (I was referred to a wrist specialist for surgery) didn’t tell me because – since he wasn’t operating on it – he didn’t really care. It wasn’t until six weeks later when my physiotherapist asked how it was healing that I found out about the break. Which explained why my ulna had been so bloody painful for the last six weeks.

I may have said a few choice words about the BC health system at that point.

But, even with the stretched health services, if you have to break something, you’re probably best off doing it in Vancouver. Which is a good thing, because living here, you’re probably going to break something.

Broken wrist with titanium plate

Post surgery. I am now part-titanium.


Alaskan Tales: #4: The Midnight Sun

I woke to birds singing. Sunlight was streaming through the window of my tent.

I should get up. I thought groggily, struggling out of my sleeping bag into the bitter cold of the morning. Wait. My one conscious brain cell interjected. I should check what time it is first. I held my watch up to the window. 3:40am. Right. Bugger that, I’m going back to sleep.

I collapsed back onto my bed roll, pulled my sleeping bag over my face, and went back to sleep. When I next woke up, birds were still singing, sunlight was still streaming in through the window of my tent, but it was 11am. I sighed.

I think it’s safe to say, I was having trouble adjusting to Alaska’s midnight sun.

I’d always been fascinated by the idea of the midnight sun. Was there really a time and place without night? Could you be so close to the poles that the day would last for weeks? The rising and setting of the sun seemed to be one of the few constant, immutable things in life, but, well, maybe, not really?

Arriving in Alaska in spring, we didn’t notice much difference at first; sure the days were longer, but nothing more extreme than in Vancouver around the solstice. Soon, however, the northern latitude began to make itself felt. Suddenly, we had no need of our torches and headlamps when camping, the sun began setting around 7pm, and stayed that way for hours. Once the sun had finally fallen below the horizon, a long-lasting twilight persisted until well after we’d gone to bed. By the time we woke up, the sun had already risen.*

Beyond the 60th parallel, the sunset grew later by seven minutes every day. In Fairbanks, we strolled along the Chenna river at 11pm, enjoying the languid sunset of the far north.

Oddly enough, Alaska has Daylight Saving Time. This seems a little unnecessary. If your sun doesn’t set until after midnight, you probably don’t need to be frugal with your daylight hours.

The chenna river late at night in Fairbanks

The chenna river, Fairbanks, at 11pm at night

I coped with it well for the first few weeks. The evenings were still so cold that I was my tent by midnight, snugging down into my sleeping bag, pulling it over my head to trap as much warmth as possible. I assumed it got dark at some point during the night, but I was never awake to see it.

Then, one night it all went horribly wrong. I was curious as to when it really did get dark, so I decided I would stay up until the night came.

This was a silly mistake.

At 2am, I gave up. The sun had started setting hours ago, but apparently saw something shiny along the way and got distracted, barely making it to the horizon. Now the world was slowly growing light again; the sky was  bright, and everything was a washed out grey. It reminded me of coming home after a long night in the pre-dawn netherworld between night and day.

Except that it was 2am and I was still waiting for it to actually be night before it got to be day again.

Giving up, I went to bed. I lay in my sleeping bag and watched the small window of my tent get lighter and lighter. Shortly afterwards, a bird next to my campground started singing.

At this point, my body clock just gave up and went on a holiday all of its own.

Over the next few nights, I found myself staying awake later and later, unable to asleep as my body stubbornly insisted that nope, daylight is not sleeping time. For a while I kept trying to get my body clock back on schedule, but it just stopped returning my calls.

Fortunately, I wasn’t the only one. A lot of other campers were having their own problems adjusting to the constant sunlight; some, like myself, were unable to fall asleep, while others woke up at 3am and couldn’t get back to sleep. It was Alaskan jet lag.

Even the locals weren’t immune. Homes in Alaska come with blackout curtains, and people try to stick to a regular schedule through the summer months to avoid this sort of thing, but I still heard stories of people getting up to make coffee at 4am, or accidentally going out fishing at midnight.

I got the impression that calling in late to work because you lost track of time is the Alaskan equivalent of “stuck in traffic”.

Midnight sunset

Midnight sunset along the Denali Highway

Eventually I decided to just roll with it. After all, I was on holiday, and the light was endless. So what if I didn’t start hiking until 3pm? It wasn’t as if I had a shortage of daylight to make it back in. The animals were also on a longer time frame, often snoozing away the warmer middle of the day before coming out in the evenings. Even the shops were open until late in the evening; summer is a busy time in a state that shuts down for half of the year.

I slept when I was tired, and ate when I was hungry. I didn’t bother about looking at my watch to see if I was having dinner at 6pm or 11pm – it made no difference. After a while, I couldn’t even find my watch.

But, as difficult as it was to adjust to, I was enjoying the strangeness of the midnight sun. It was every bit as otherworldly and magical as I had always imagined it to be. There was something utterly enchanting about sitting by a campfire at midnight, while birds sang, and squirrels chattered amongst the trees.

Eventually, my time in Alaska grew to an end. Rather than drive the same route back to Vancouver, I decided to take the ferry home. From south-east Alaska, the ferry heads due south for two days, before arriving in the BC port of Prince Rupert. You could either rent a cabin, or do as the locals do, and camp out on the back deck. I decided to camp.

That night, as we steamed south, the sun finally sank below the horizon. I unrolled my sleeping bag onto the deck and looked up at the dark sky, watching as the first stars in three weeks appeared, and night stole over the land. I was sad to leave the midnight sun, that endless day that is summer in Alaska, but I did have a new appreciation for night and regular sleeping patterns.

*Although that may be more because of our sleep patterns than Alaska’s daylight hours.

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