Thursday, October 28, 2010

How I Broke my Jaw And Some Advice

A week an half ago I was on my way to work taking a train to Grand Central Station. The train I take is an express and is always packed, so as usual I stood near the door leaning against the wall. While riding, I was reading the news on my phone, again just like normal. Once the train went underground however, the train seemed to heat up quite rapidly. It may have just been in my head, but I started to get dizzy. Concerned I undid the top button on my shirt and loosened my tie. At the same time I sat strait down on the floor. The logic is pretty simple, if you pass out while sitting you can not fall (you are already on the ground). I started feeling better and the train was seriously slowing down / about to stop and open the doors. I was sitting on the side where the door opened to the plat form. Since I was feeling better, and not wanting to be trampled, I stood up. To do this in the cramped space I had to flip over, one knee down, then a foot, then the other foot; I say this just to note that I did not jump to my feet, it was slow.

I have no recollection after standing up; just a whiting out. It is hard to describe, but a white haze flashed in an instant from left to right. I know the train was still moving, all be it very slowly, and the doors were closed. I remember there was a man in front of me, a man behind me, and three men (including a rather tall man) to my right. That may have been the second best time to pass out as I could not have helped but fall into someone who would have been able to at least slow my decent (the best would have been while still sitting down). The next thing I remember was coming to on the platform face down with a man telling me "don't get up ... stay down". Confused about what I was doing on the ground, I did not really pay attention to him pushing myself up to a seated position.

Story side note. In a random coincidence my parents ended up having dinner with someone not only on my train, but a few people away from me who saw me fall. I will save you the details on how they made the connection, but before the chance dinner meeting through a mutual friend our families were complete strangers. He said that I took once step off the train, then went down hitting a garbage can on the way. He ran to get help, and by the time he got back I was being taken care of.

Things are a little murky after that, but I remember someone from officialdom (maybe a conductor or ticket taker) coming over. There was also a female passenger who identified herself as a doctor who assisted. The left side of my face really hurt, and I knew right away something was broken. Grand Central has their own EMS who were called. One of them asked me what my name was. I knew it was a cognitive function type test. I also knew that there was no way that they could know if I gave them the right answer. That thought process was actually comforting in my self assessment knowing that a neurological injury likely had been avoided. I answered regardless, and even mutter something about how did they know I was giving them the right answer. Once I spoke, I could tell the break was in or somehow effected my jaw bone. There were follow up general questions such as who the president is and what day of the week it was, all of which I answered. The good samaritan doctor looked at my chin which was bleeding, and tried to bandage it with what she had. She left after Grand Central's EMS showed up.

It seems a bit ridiculous now, but the thing that bothered me the most besides my jaw was that fact that I had bleed all over my suit and one of my favorite ties. That was connected to the question of how I was supposed to show up at work either with a bloody suit or without my jacket, tie, and more unconventionally without any pants. I had just started at a new law firm. That Monday was the start of my second week, and just my fourth day. My boss has been very understanding, but I think it is generally bad form to have missed more days than you have worked, which has been the case since the injury.

Grand Central's EMS called for an ambulance and the 'real' EMS (I use the word 'real' not in any way to say that GC's EMS were any less qualified, just because I do not know how else to distinguish them). They came and did an assessment. They had to change the band aid on my chin which I had bled through, and took me to the ambulance. I called my father, a doctor, from the ambulance. He met me in the hospital emergency room. A Cat-Scan revealed that it was not just one fracture but two. The second one was my chin. When I was younger I had braces. When the braces came off they put a small permanent wire across the back of my teeth. That wire likely saved my teeth (though I have at least one small chip), and was holding the two pieces together in place. Without the wire the pieces would have moved independently resulting in excruciating pain and the possibility of one of the pieces puncturing through my skin. Since it was not considered an emergency, I had to wait until the next day for the surgery. The gash on my chin needed to be stitched closed, and could not wait.

They took me in to a room connected to the ER. Once the doctor started, I started feeling dizzy again. I said something to the doctor and my father who were in the room. I did not pass out, but it was severe. They put the chair way back and then lifted my left up on their shoulders. While inverted, I heard what sounded like a women screaming in agony. I was told by my mother who had gotten to the ER by this time, that it was actually a women screaming something about Jesus. The dizzy spell passed and the doctor finished the stitches. A female doctor who had seen me earlier poked her head in and said; "he still looks pale" to which I replied; "nope, I'm fine, this is my normal color".

Up until that day while I had broken a few bones I had never needed stitches. I passed through stitches to surgery. I now have a plate permanently screwed into my chin which looks horrific in the x-ray, but beyond that is unnoticeable. More painful and problematic is the surgical braces used to rubber band my mouth shut. It is not as bad as having my jaw wired such, but it is pretty bad.

I think a serious jaw fracture is among the worst non-permanent injuries you can get. It hurts to talk, and can only be attempted through clenched teeth. My diet consists of only what I can sip through a straw. Despite the specialty meal replacement drinks and mixes, it is still not easy to get the right nutrition. I could (as still can) stand to loose some weight, but this is the wrong way to do it. Sleeping is exceedingly difficult. Did I mention the constant irritation and pain. Of course the initial descriptor is important, this is a non-permanent injury. In a little over a month from now the surgical braces come off and this all becomes an unpleasant memory.

The question of why this happened still looms. The doctors found nothing in my blood work, nor any of the other battery of tests they ran. I was wired up for a 24+ hour monitor. Depending on the results of that the doctors may suggest a month long monitor to see if it is a heart issue. The best guess they have right now is that it was just a drop in blood pressure from standing up in cramped quarters for to long; one of those random things that just happens sometimes.

That is less then comforting. Nothing like this has ever happened to me before and there appears no reason for it to ever happen again. Then again, there does not appear to be a concrete reason for it having happened as it did. The incident has left me with two unfortunate afterthoughts; either I had some warning of what was about to happen and was to stupid to just sit back down, or the right combination of heat, exhaustion, and dehydration can just knock me out with no warning. The options are not necessarily mutually exclusive.

In case you are curious, it was my father who was posting condition updates for me while I was in the hospital.

The whole thing is just so stupid. I have taken risks before to help people. I have been careful and/or lucky enough to have avoided injury in those situations while still being able to render effective assistance. This is nothing like that. I was not saving some kid from drowning in a pool or catching someone before they cracked their head open (I suppose similarly to what happened to me). I just passed out; no greater good attempted, no evil averted, not even an unfortunate freak accident in which I could at least be consoled that I took the proverbial bullet instead of someone else who it might have killed, I just fell face first.

What can be learned and what good can come from this? How about some keep it simple stupid advice; 'Sit Down and Stay Down'. When your rights are involved you should listen to the song and stand up for them. When you feel dizzy listen to me and sit down. As long as you are not in danger where you are seated, stay down until you can get someone else to help you. The extra few minutes on the ground could save you weeks of misery, if not more.

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