Bicycling First Aid

  • If in doubt, go to Urgent Care
  • If anything is possibly life-threatening, call 9-1-1
  • If somewhere between those two, have someone take you to the nearest Emergency Department
  • Nothing in here is to be construed as a substitute for obtaining professional assistance
  • If your helmet strikes the pavement with your head in it, it is time for a new helmet. A bike helmet is a single-use item in that regard. Before you throw it away, crush it. (It’s not that hard, and can be satisfying in a way. Thank it for its service as you destroy it.) Destroying it ensures that some innocent person won’t come upon it in your trash and say, “Sweet! A free helmet!” and place their self at risk.
  • Road rash is your most likely ailment. That’s what your water bottle is for. Squirt the road rash liberally with clean water right away. It will hurt less then than it will later. Try to get dirt and gravel out as soon as possible. As soon as you can, wash thoroughly with soap and water. Again, the sooner you do it, the less it hurts. Bandaging road rash is tricky – you don’t want a dressing to stick to it and re-injure the area when you pull it off later – and road rash usually appears on bony prominences (joints) so it is hard to get dressings to stay in place. For road rash you want:
    Non-stick gauze
    Roller gauze
    Tape
    Maybe 2×2 or 4×4 gauze pads depending on wound size and drainage
    Band-net
    See photos below. You may also needs gauze pads (not pictured) if particularly leaky. Hot tip: Cut tape first, stick one end where it’s handy, then you have tape ready without having to free up hands to cut it while trying to hold a dressing in place. The non-stick gauze is impregnated with petroleum jelly (Vaseline), which will make it stay in place so your hands are free. It will also make it not stick to the wound when you remove it later. And it keeps the wound bed moist to promote healing. (Sorry Ivy, who hates the word “moist” almost as much as “mouth feel”.) The roller gauze soaks up some fluids and keeps the Vaseline from attracting dust and grit in the air. The band net holds it all in place. It works well over elbows and knees, where it is hard to get dressings to stay. Cut it longer than you think you need.
  • Broken collar bones are the bane of cyclists. See a doctor for that. The treatment advice I have would make this too long and I’d rather do it face-to-face.
  • Broken ribs are likely if you are older or crash hard. Treatment is mostly pain control. In the old detective movies, the hero got kicked in the ribs, stumbled back to his office, and had his secretary wrap yards of adhesive tape around his chest. He’d head right back out to the streets and bring down the bad guy.
    Broken ribs hurt way too much for that. Plus, the old adhesive tape technique increases the risk of pneumonia. You have to breathe and the chest wall has to stay mobile. Ibuprofen is not recommended, as it slows the growth of new bone, so retards healing. Lidocaine patches can help with pain. The bad news is that they only work for 12 hours, then you need 12 hours off before they are effective again. Kinesio-tape can help with the pain and swelling from rib fractures. It can stay in place for several days.
    Apply the tape as shown. Round all corners so it is less likely to peel. Apply the tape as shown in the picture below. The two pieces should cross over the area of greatest pain. There should be no tension on the tape. Rub it to activate the adhesive (which requires mild heat). The photo below is taping over a bruise. Same concept for ribs; the central point of the lattice should be the area of greatest pain.
  • I should probably add that, if you have to provide CPR, Good Samaritan laws prevent you from being sued if you make your best effort. Get trained on CPR and use of AED. Both can be done without training – it beats watching someone die. What is written here is not training. I’m not going to fit a ½ day course into a paragraph; and I’m not qualified to train you. You can do compressions only without breathing. Check for a pulse first. Don’t do CPR on someone whose heart is beating. They won’t like it and it won’t help. CPR requires effort – deep and fast. About 2-2 ½ inches deep and 100-120 times/minute. My trainers taught me to sing “Stayin’ Alive” or “Another One Bites the Dust” to keep the tempo. For most people, the former is probably a better choice; though if I woke up to my rescuer singing the latter to me, I’d be happy. It is not comfortable for the patient. Ribs may be broken. As my friend said after he came back to life, “My chest really hurts. I think she broke my ribs. But don’t tell her anything. She saved my life and I’m not complaining.”
the legs running diagonally up and to the right are a little short…

COVID-19

copyright Jay Ward Productions

On another note, our Fearless Leader told us about the “beautiful” test for COVID-19. I don’t know about his definition of beauty, but that’s a mighty long swab that goes into your nostril. If your nasal passages didn’t curve, it would come out the back of your head. Luckily, it’s a very flexible swab. It tickles but it doesn’t hurt. If you need the test, get tested. If not, save the test for those who do need it, as the supply is limited despite what Fearless Leader says.

After insisting he didn’t need the test, he announced on a Friday night that he’d just been tested. I haven’t been able to determine how long it actually takes to perform the test. The CDC website is vague on this. On the day I was tested I was told it would take 4-5 days to get results. Maybe it’s faster if you’re the President. (And mine came back in 72 hours, per the original estimate.)

If that sounds like a confession, it is.

This reminds me of the HIV/AIDS crisis in San Francisco in the 1980s. Anonymous testing centers were set up throughout the city. Test results only went in your medical record if you volunteered them. Everyone wanted to be tested but no one wanted their results known. To have AIDS as a pre-existing condition meant the end of health insurance for you; not to mention the end of your love life. People didn’t want to come near you. No one would touch you. Treatment was still experimental. Life span was considered limited. When I had a mysterious illness in 1993, my doctor’s first actions were to test for HIV and TB. (I had neither – and I had been monogamous since my first negative test, when my partner insisted we be tested before having sex.)

Now (at least temporarily) insurance is not an issue. At the time I am writing this, I am in “self-quarantine”. Before you read it, my negative result will be back and I will no longer be a pariah. I came down with a cold after visiting an ill family member in Minnesota. Many of my co-workers also had colds and missed some work. That is pretty normal for this time of year. What is not normal is for me to be sick enough to miss work. That hasn’t happened in years. I’m sure my resistance was lowered by my surgery this winter. I lost my voice but didn’t really feel all that sick. I started riding the bus to work instead of riding my bike, in order to save energy, and because my dormant asthma was beginning to raise its ugly head. I was able only to whisper most of the day, which was what convinced me to stop working until I could talk again. I had to sleep sitting up. I was inhaling Albuterol in order to sleep without coughing. On Thursday I was diagnosed with an acute asthma exacerbation secondary to an acute upper respiratory infection (a cold). I was placed on a five day dose of oral prednisone and told to return to work on Saturday. I did not meet criteria for COVID-19 testing.

On Friday evening, Employee Health placed me on paid administrative leave. I was ordered to undergo COVID-19 testing and not return to work until a negative result was posted and they notified my supervisor in writing that I was cleared to return to work. I was to self-quarantine. Note that this was now two weeks after I had gotten sick and the night before I was planning to return to work. I was clearly improving, and was told I would improve greatly after the second day of steroids. They could not yet tell me when a test would be available. Note that this was days after our president claimed that the beautiful test was available to anyone who wanted it. I, as a front-line health care worker, did not yet have access to the test.

On Saturday, I was called and instructed to report for testing. I was greeted by a doctor, RN, and CNA, all dressed in disposable gowns, gloves, and masks. They all placed face shields when we entered the testing room. Swabs were inserted though my nostrils to my nasopharynx (back of the throat, farther down than you’ve ever reached, or maybe thought possible). They were held there for 10 seconds to soak up some goop. That was it. Now go home and wait.

https://www.dailykos.com/stories/2020/3/14/1927440/-Coronavirus-A-Letter-from-Italy?detail=emaildkre (People in Italy singing together, from their balconies, while on lockdown.)

I decided life was not surreal enough so I decided to watch The Twilight Zone. Season one, episode one was called, “Where is Everybody?” A man walks into a town with signs of recent (as in moments ago) life, but there seems to be no one around. The streets here look something like that now. It was the perfect choice. https://ytcropper.com/cropped/FC5e7007b47e54c

My neighborhood library branch was to have a grand re-opening in a new location last weekend. The grand opening was canceled, but the library was to open anyway. Monday it was closed due to staffing shortages. At least I got to see the outside, complete with covered bike parking. And I got to ride my bike for the first time in 2 ½ weeks. It felt great! (And later that day they announced that all libraries were closing effective Tuesday, 3/17.)

Now I know I don’t have COVID-19. I still can’t work because I can’t talk without coughing. The prednisone has not worked its magic. I can’t tell that it did anything of benefit. I can’t very well wear a sign that says “I’m negative!” so as not to scare people when I cough. Sort of the anti-Hester Prynne. While I don’t have it, that does not put me at any less risk of getting it now. While I’m no longer quarantined, that doesn’t make life much different.

The airlines are asking for a federal bailout. The banks and investors are buoyed up by slashed interest rates. Meanwhile, all of my neighborhood restaurants are closed. Some of them allow curbside pick up, but you can’t go inside. Most of those employers don’t provide paid sick leave. Some are doing it voluntarily right now. Who is going to prop them up? They don’t have billions in reserves.

Giro d’Italia

The Giro d’Italia, previously scheduled for May, has been postponed indefinitely.

I could have sworn I had used this clip already, but the WordPress search feature didn’t find it, nor did my manual search. Adrian Monk suddenly looks positively normal.https://ytcropper.com/cropped/FP5e70248033472. As usual, if you only read this in email, you see only my words and miss the good stuff.

As Walter Cronkite used to say:

Beware the ides of March

Spring will return someday. I just read our Fearless Leader’s reaction when asked about the slow response to COVID-19: “I don’t take responsibility at all.” This seems to sum up his presidency and his life. I picture it as his epitaph.

In celebration of the ides, we saw a production of “Julius Caesar” set in a women’s prison with an all-woman cast.

The Ides of March reminded me of this one-hit wonder of 1970. The recording is from 2014 – even those with brief fame can have a revival. The lyrics were creepy in 1970. Time and age do not make them better. This was a great song for high school band kids who wanted to be rock-n-rollers. Great horn parts for bands that also covered “Got to get you into my life”.

What I really wanted to do was take a break from the news of the day and think about the coming of spring with a bunch of old flower photos, some of which have appeared here in the past, others not; mostly from my yard.

This is to make up for my minimal time out of the house while sick the last couple of weeks; not to mention 6 weeks earlier this winter after surgery. I’m becoming a hermit. I will end up with as much time off this winter as I took to ride coast-to-coast. This is way less fun. I guess I could call it a dress rehearsal for retirement; but I certainly hope for a more active retirement than this.

Paying your way

I often see the argument that bicyclists use the streets for free, while motorists pay for them. The Department of Transportation of Madison, WI just published a report with a few pertinent facts.

Perception that “bicyclists don’t pay their way”

  • Most bicycling takes place on local streets and roads that are primarily paid for through property taxes and other general local taxes. [ed note: i.e. not gasoline taxes]
  • Bicycling inflicts virtually no damage on roads and streets compared with automobiles and trucks.
  • A 200-pound bicyclist with a 50-pound bike will impose approximately 1/65,000th the roadway damage of a 4,000 pound car.
    * Information from “Who Pays for Roads?” Published by U.S. PIRG Education Fund (2015)
  • Motor vehicle use imposes costs on the environment and public health in the form of air pollution, noise, injuries and damage from crashes, and a host of other rarely quantified costs. These costs are borne by all of society. [Ed note: One of those non-quantified costs could be the public health cost of chronic conditions exacerbated by a lack of exercise.]
  • A 2009 analysis by the Victoria Transport Policy Institute estimated that the external cost of a mile of bicycling was less than a penny, while the cost imposed by a mile of walking was 0.2 cents—compared with external costs of driving of more than 29 cents per mile.
    * Entire bulleted list from https://madison.legistar.com/View.ashx?M=F&ID=8153596&GUID=D5225649-E313-4285-B94F-85E1D72066D3

I’ve also seen the justification that, since many bicyclists also drive cars, we are already paying our way by paying gas taxes when we drive. I guess one could argue that every mile we ride is “stealing” because we aren’t paying gas tax for those miles. One could argue that, but one would be wrong. See the list above.

What I haven’t seen in print before is an examination of toll roads. The state to the south of here has many highways on which vehicle tolls are collected. Here there has been fierce opposition to the notion of toll roads. I have not seen fierce opposition to the bike trails that require a toll, either in the form of a day use fee or an annual permit. Around here, some of those are trails used heavily for commuting, not just recreation. Are those not toll roads? Are toll roads okay for bikes but not for cars and trucks?

Speaking of paying your way…

Where does your money go? Do you pay annual dues to AAA? Do you think of it as a form of insurance for emergency road service? It may be that, but it also pays for advocacy on behalf of cars and drivers. If you ride a bike, you may want to match that/offset that with a membership to the League of American Bicyclists. If you have a state organization, like the Bicycle Federation of Wisconsin, toss a little more their way. Do you ride with a local club but don’t bother to pay dues because you don’t think you ride with them enough? Pay your dues. You may have a local or regional advocacy organization, or one that advocates for the kind of riding you do. If you want to advocate for bicycling, spend at least as much money there as you spend for cars.

You can also help pay your way via Adopt-a-Highway programs, in which you clean up roadside trash tossed there by other vehicle users. When spring arrives, we’ll be announcing our next cleanup near Brigham Park. Other bike groups also have programs (including the folks behind the Horribly Hilly Hundreds and the Death Ride). You can probably find (or start) one near you.

McCoy Tyner 1938-2020

I can’t end this post without a shoutout to one of the greats – pianist MyCoy Tyner, who played in the seminal early 1960s quartet of John Coltrane (during the time he recorded “A Love Supreme” and “My Favorite Things”), fronted his own bands, and worked with many of the other greats of the last 60 years. When looking for one of his solo works from the early 70s, I came across this instead:

Tyner died on March 6, 2020.

This I Believe, or Why I Box

What I believe don’t mean shit. That is to say there is “what I believe” and “what is so”. They aren’t the same, and don’t even have to have a relationship.

[A few years ago, at High Holiday services, a member of our congregation read a piece from the prompt “This I Believe”. It was apparently based on an NPR program in which famous people read essays from that prompt. I decided to go home and write something, pretending that they might ask me to speak some day. This is the result…]

So let’s talk about something else.  What does have to have a relationship is you and anyone else. Two people have to be in relationship and we can talk about that.  We’ll get to that in a minute.

If we are looking at belief and reality, we might want to meditate. What does it mean to meditate (or “pray” in another vernacular)? Usually, when we meditate, we sit quietly and try to quiet the mind. Maybe we hold a question, or maybe we try to empty the mind. What really happens? We have some thoughts. Maybe we notice we’re having some thoughts and we try to suppress that because we’re supposed to be meditating.  Maybe we notice that isn’t working out so well. Maybe we notice that we’re having thoughts and think about that. Now we’re thinking about thinking. Where does that get us?  Maybe we think that’s not such a good idea and we try to stop it. Now we’re back to suppressing our thoughts, which didn’t work out so well the first time. 

So now we decide to really get down to business and we get quiet and something else happens. Then we notice that something else is happening and we think, “Yay! I’m meditating!” Then we notice that celebrating that we are meditating is not meditating and we start again.

This process may go on for a long time. Eventually we may get beyond it for a while. Or maybe we just fool ourselves for a while. Ever notice that the easiest person to fool is yourself?  Other people often have your number – the things that you think you’re hiding from others are not only visible, but so is the fact that you are trying to hide. Damn!

So that brings us to relationship. It is my experience that the only time I grow is when I am vulnerable, and I spend most of my time and energy trying to hide from that fact. I try to hide my vulnerability and I try to look competent in the world. Sometimes I do a pretty good job of it, if I do say so myself. But I’m still hiding.

There is one time that I can’t hide and that’s when I am boxing. Boxing is the ultimate feedback system. It’s a hard place to hide. I hear people talk about “the now”, as though that is a thing and not just what is.  We only have one place and time and that is here and now. 

Have you ever looked at fear? When you are afraid you are not here and now. Notice that fear requires a concept of the future.  You are never afraid of what is here and now, you are afraid of what might happen in the future – that future may be pretty soon, but it is not now. Fear also requires a sense of incompetence or incapacity – I’m afraid that something is going to happen and I won’t have the capacity to deal with it. If I am concerned with now, or I feel capable, I won’t feel fear. Try that.

Now, to get back to boxing. When I am boxing, I am trying to hit someone, but especially trying not to let that person hit me. The only way to not get hit is to be in relationship with that partner. I have to be with him or her.  If I am in relationship with that partner, I can see, feel, and know what s/he is doing. Then s/he won’t hit me. If I get hit, what do I do? First, I notice that I was not with my partner in that moment. I missed something. Then, maybe I beat myself up about that, which means I’m not with my partner and I get hit again. Maybe I then try to analyze what I did wrong to get hit, and I get hit again. It is only when I let that go and return to being present with my partner that s/he stops hitting me because I start getting out of the way.  

There is no way to fool myself in boxing. When I “meditate”, I can fool myself into thinking I’m meditating, when I’m really just thinking and getting caught up in my thoughts. When I’m boxing, if I’m caught up in my thoughts, someone hits me. Most of us learn faster that way. Or we go back to fear. 

At the same time that my partner is providing that service to me, I am providing that service to him/her. If s/he is somewhere else, I feel invited to hit him/her. I know that sounds stupid, but stay with me for a moment. If I hit that person, it serves them better than if I say, “Let’s stop and talk about this for a minute”.  That conversation takes us back into abstraction. 

Years ago, I was working with my trainer on a two person choreographed set of movements. There were 92 movements in this “dance”. First one person moved in an attacking way, then the other neutralized that attack and counter-attacked. We continued that way for several minutes. One day I forgot the reality of the attack and was just hanging out with the choreography – he does this, then I do this. The next thing I knew, I was sliding down a wall about 10 feet away and catching the vase of flowers I had dislodged from its niche, before it hit the floor.  While I ran to get a rag to mop up the water I spilled, I had a moment to reflect. My teacher had just taught me something that was much more real than if he had stopped and said, “Did you notice that you were a step ahead of me just there? That you were starting your counterattack without having neutralized my attack? That you were not in relationship with me, but instead only with the choreography?”

He didn’t say any of that. Sending me 10 feet across the room and into a wall said all of that and more, and much more eloquently. I remember that moment 30 years later. Would I have remembered the conversation? Would the intellectual analysis have served me the way the discomfort of hitting the wall did? I don’t think so. So I don’t care what you believe. Heck, I don’t even care what I believe. I do care about your experience and the truth to be found there. I care about my experience and how I can grow through that.  Belief and a few bucks will buy you a cup of coffee. The truth in your experience may do much more.