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:

Giving thanks

It is 15 degrees F (approx -10 C). The sun is bright. The sky is a brilliant blue. There are no clouds. There is no wind. We have fresh snow, so the sun glints off of countless facets. It is the sort of day that those who don’t live in snowy climes may not be able to appreciate, and those who do often forget to appreciate.

As I rode home from the library, I began to ruminate over things I am thankful for (most, in some way, related to this blog). I am thankful for:

  • construction workers who work outside all day all winter long.
  • constrgarbage trucks blocking the road so I can practice my cyclocross skills.
  • shanty
    ice fishing shanty, snowy day

    the lake near my house that becomes a massive and nearly private park in the winter. After skating on the street last Sunday, I skiied across the lake this Sunday.

  • Ally, Ed, and Steve – who turned a 105 mile slog through 40 degree (4 degrees C) rain inIMG_0363to something do-able. While they claim misery loves cold raincompany, company can also make it not misery, as evidenced by this smile at the end of that day. (Not to mention that we were even smiling for the picture.)
  • Steve (a different Steve) and Kevin, who stuck with me through thick and thin (and thinner) on a long and hard day in the heat and headwind.
  • Anders, who picked up a new helmet for me at the end of said long day, so I could Andersride again the next day.
  • the entire Cycle America staff, for handling the logistics so we could ride. A special shout out to Ed (a different Ed) for delightful surprises on the routes; and to Dan, who never met a hill he didn’t like.
  • the half-fast cycling club, including those I started riding with more than 40 years ago, and those I haven’t yet met.
  • the glaciers which all managed to miss the driftless area, making for great bike riding in the area of the Horribly Hilly Hundreds (and to HHH, as I just learned that I was selected in the lottery to ride this year).
  • icicles. Snow to sculpt.
  • the Parks Department, for plowing the bike paths.IMG_1494.jpg
  • public libraries.
  • getting old. I’ve seen a lot of folks the past couple of weeks with broken ribs from slipping and falling on the ice. Many tell me how horrible it is to get old.  I think it beats the alternative.

Life is what happens…

…to you when you’re busy making other plans. John Lennon said that in the song ¨Beautiful Boy¨.

He wasn’t the first to say it. Cartoonist Allen Saunders (Steve  Roper and Mike Nomad, Mary Worth, Kerry Drake)  said it in 1957. I don’t know any other writer who had three comic strips in syndication at the same time. Saunders’ strips were soap operas before TV came along, though they continued into the TV era.

Comic strips are the thinking person’s Twitter. Squeezing something pithy into one or four panels is a pretty good trick. A weeklong (or longer) story arc is like a tweet storm. When I say ¨the thinking person’s Twitter¨, I’m thinking less of Saunders and more of Watterston (Calvin and Hobbes), Mallet (Frazz), Wiley – last name Miller, but he signs “Wiley” –  (Non Sequitur), and Trudeau (Doonesbury).

Back to Lennon; I can’t help thinking of our president whenever I hear Lennon’s “Happiness is a Warm Gun” – “Lying with his eyes while his hands are busy working overtime.”

Today’s plan was for the annual Fall Colors Bike Ride – the famous Blue Spoon to Little Village festival of fine foods.  Tim, the instigator, announced that he’d be out of the area after we set a date. I found out only the night before that “area” meant “continent”. Tenny was the next to bail – a bad cold. When we were down to two, Rosebud begged off, saying he could do this week or next, but not both.

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Sugar Maple

I decided to do it as a solo ride. Since I’m used to following Tim, I thought it would be safer to scout the route ahead of time via map and make myself a cue sheet. That’s what I did but, when going to bed last night, the bathroom faucet wouldn’t turn off. When getting up this morning, the kitchen light wouldn’t turn on. I also realized that the point of this ride is mostly getting in one last ride with my friends and I would miss that doing it alone, even if we do it next week.

So it was off to the hardware store for parts to do some home repairs. On the walk back I ran into a couple standing at a bus stop and asking where to find the Capital City Trail – “the one that goes to Milwaukee”. I pointed out the trail, which they were standing next to (a bit confusing, as it is a sidewalk for the short stretch in their view).

I mentioned that Milwaukee is a long walk. She replied, “Seven hours. It’s a nature walk, plus we’re trying to get home.” She told me how their plans had been derailed and this was their contingency plan. I pointed out that the trail is not continuous to Milwaukee and how to get to the actual trail to Milwaukee after the Cap City trail ends. If they make it in seven hours, I’ll be mightily impressed.

By early afternoon the temperature had climbed to >40 degrees. Time for a ride! Instead of the Blue Spoon and Little Village, I settled for Farm and Fleet and the library. But the cafes wouldn’t have had the replacement water filter cartridge I needed, nor the library book that was on hold. So much for plans. Now life, on the other hand…

Idaho

Here we are, in Idaho.

I can’t think of Idaho (or U. Utah Phillips) without thinking of Rosalie Sorrels. Rosalie was a folksinger from Boise. My favorite song of hers is actually a cover of a Shel Silverstein song.

03 You’re Always Welcome At Our House 1.m4a

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Rosalie Sorrels. Rick Ardinger/Courtesy of Red House Records (from the NPR link below)

Rosalie’s dark humor extends beyond Shel Silverstein’s songs. She also recorded a set of “Hostile Baby Rocking Songs”, the songs she sang to her children when she was at her wits end. She is not well-represented on YouTube, and the album “be careful, there’s a baby in the house” appears to be out of print. (I found it on Amazon for $182.27. It is available for loan from my local public library.)  For those who find these songs offensive, remember that singing hostile songs and abusing children are very different. I work with children who are victims of what the medical field refers to as “non-accidental trauma”. I do not consider that funny.

02 Baby Rocking Medley.m4a

As an aside, I want to put in a plug for public libraries. The library is one of the greatest public services government provides. I am happy to pay taxes to support libraries. I find it ironic that the “Little Free Library” movement has caught on so heavily in my hometown, as we have a phenomenal public library system. (Guess what? It’s free! And it’s not so little.) My kids got library cards when they were very young and we made weekly trips to the library – on Monday – early release day from school and my day off. We got to know the staff, some of whom are still there 20+ years later. I still go almost every Monday, even without the kids. When my daughter (now a college graduate and newly-minted Social Worker) visited from college, we always went to the library on Monday.

If money is burning a hole in your pocket and  you can’t think of who to donate to, think about your local public library foundation.

The good news about today’s ride is that the forecast, which was an 85% chance of thunderstorms last night, was amended to a 35% chance of showers by this morning. The bad news is that the rain beat those new odds.

As we left Spokane, it was getting darker. Figuring on safety in numbers I headed out with a group – the folks who usually finish near the same time I do, so I thought they’d ride a comfortable pace.

By the outskirts it was raining hard enough that I was getting chilly. I stopped to don raingear and lost the group. I started to work my way back toward them until the headwind convinced me of my folly. I slowed down and waited for some other folks to catch me to help with the wind.

My flat tire brought the end of my time with that group. As luck would have it, the sag wagon showed up within a minute, so I had company while I changed tubes, and someone to hold my bike so I didn’t have to lay it down. They convinced me to take another spare tube (I still had one left, plus a patch kit), as about 50 miles of today’s route would be inaccessible to the sag wagon.

I started out again and caught on with another small group. When I stopped for a bathroom break and to change out of my raingear, I lost them. I figured I’d be riding alone for the day, thinking no one was behind me anymore.

33219AE1-73F9-46EC-9E45-669FB70B40CF.jpegAt the Idaho state line I caught someone. at the lunch break I caught up with the folks I’d started with. By that time we were on the most  incredible bike path I’ve ever seen – a paved path which skirted the shore of lake Couer d’Alene, then followed along its backwaters and the river that feeds it. We had a tailwind for the last 20 flat miles.

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Bike bridge over Lake Couer d’ Alene. (It rises and falls in steps, not a smooth incline.)

Along the path we saw a moose and her calf, then about a half dozen Great Blue Herons. All were camera shy, so no photos.

It’s hard to call 94 miles a rest day but, compared to the two before and the one to follow, it was.

There were two crashes today. One rider came to dinner in a shoulder immobilizer after a crash on the path. A shout out to Steve from Rochester for staying with him until help came.

Tomorrow we cross Thompson Pass into Montana. 10% grade near the summit. Time for sleep.

Battening down the hatches – a thunderstorm is coming any minute now. (8:30 PM my time.)