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  1. #1
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    Wood in my knee wound

    Well, after a great season of progressing my riding and learning my new home's trails (Reno/Tahoe), I had a buddy out from Vermont for 2 weeks of riding. I'm sure you can see where this is going.

    On day three, we were hitting a jumpy trail. I had myself convinced that the upcoming line demanded muscle-truck speed, when in reality it wanted ballerina finesse.

    I overshot the landing by about 3 ft. Since the jump was built on a downgrade, this put me at 8-10 ft to flat. I was unable to absorb all of this on my trail bike, so I looked to cut as much speed as possible before laying it down. I got down to about 10 mph, and started rolling into what looked like a clear, open spot. Rolled over twice, and popped up thinking I'd be fine.

    I looked down and noticed a puncture wound spewing blood about 1" above my knee pad. I then tried to walk a bit, but I had what we'll call mixed results.

    My buddy showed up with a first aid kit, threw a quick clot on, and tried to get me moving while it was loose and i was sipping on delicious adrenaline. I was a mess. Couldn't bend it, couldn't coast cause the trail was tech, could barely hop along next to my bike.

    Luckily we were close to a fire road. 50-100 yards of embarrassing and painful travel made it clear I wasn't making it to the bottom of this sterling decent, so we formulated a plan. Jeremy and i would wait right there, and Curt and Landon would go grab the shuttle car and come pick us up at the GPS chords.

    Well, it took about 2 hrs, but they finally got there with my trusty xterra. Another 45 mins of driving back into town were required for medical attention, and I was like mama going through menopause. Hot, cold, hot, shut up Jimmy!, hot, cold.

    I, a broke grad student, had convinced myself that this was a job for no one other than the student health center. I'm getting my fees' worth, damn it. So that's where we went. Curt went in and asked for crutches, but instead they gave him the frail old secretary and a wheel chair. After some finangling, I ended up in the chair and in the health center. Student ID in hand, they couldn't refuse me service. So back i went into the tiny exam rooms.

    The nurse looked scared. She didn't know whether to ask me questions or scream for help. She slowly took the dressing off after I suggested cutting it with scissors, and started working on removing the quick clot gauze. The doctor eventually came in and asked me concussion test questions. She then felt on the wound for a second, suspected something was in there, and suggested an ambulance ride to the hospital.

    At this point I was shaking violently in a menopausal fit, attempting to refuse the ambulance. I mean Curt can drive, and he's a hell of a lot cheaper.

    This was about as controversial as a new bike lane at a city hall meeting. All of the staff started talking at once insisting that I let the pros handle it (don't tell Curt they said that), so I gave in and accepted the ride.

    2 campus cops, 3 firemen, and 2 paramedics eventually showed up to load me onto my stretcher. There are now about 10 adults and 2 beds in a 10 by 10 exam room. They managed to load me up, and off we went.

    I got to the ER, and they took me back right away. Temp of about 104, obvious deep wound, and a suspected thing-a-ma-bobber lodged in there. They gave me a bit of pain meds and sent me off for an x-ray.

    Much to their dismay, wood doesn't show up on x-rays. It's not that dense. But good news, no fractures.

    Somewhere along the way, they decide they're gonna go old school on this noise. They hit me with some morphine like a scene in band of brothers (we can only spare one, doc!), throw down a touch of lidocaine for the lawyers, grab the forceps, and start yanking. Hard. For 3 minutes. About a third of the way in i made the mistake of looking, and dude that was gross. This skinny little doc joyously yanking on my inflamed knee playing forceps tug of war with mama nature. Eventually doc won, and this was revealed:



    They gave it a good saline flush, wrote a script for antibiotics and 15 vicodin, and pretty much sent me out the door. "Son, you've had a puncture wound and a sprained knee. If the swelling persists, follow up with an orthopedic surgeon."

    This all took place on Thursday. Then our favorite day, Friday, came around, and the riding crew is all hopeful Uncle Andy (me) will be riding again in a week.

    Well, sorry boys. I had a fever. And a knee that wouldn't move. Bummer for sure, but let's monitor the fever and hope it gets better.

    Saturday comes. More fever. More pain. Less good. The knee won't budge, and when we take the dressing off, it's apparent that some microbes have found a new home in my leg.

    So I headed to the other emergency room in town to get their opinion. As soon as they see it, swabs and cultures are started. Blood is drawn. X-rays are ordered. An orthopedic surgeon is contacted. No news from the x-ray, so on to an MRI. The surgeon comes in and tells me I'm the lucky owner of a 1 in 10000 MRI. The stick lodged all the way to the knee joint, connecting the wound and my knee. He thinks there are still some wood fragments in there, puss and dead tissue all throughout, infection in the joint, and he wants to go all 2013 on this thing and operate. I was rolled. Into the OR at about 6 am Sunday morning.

    So I've been in the hospital since Saturday night. It's Monday now. The surgery went well, and doc has me all cleaned out. I'm going into my third night here and can't wait to get out. I'm on IV antibiotics around the clock, and my bowel movements are cause for celebration. I'm hopeful that the infection will clear up, and I'll be cutting up the rug at my brothers wedding in 4 weeks.



    Hospital highlight:an unnamed doctor from hospital number 2 helped build the line that I ate it on. Bless you, sir.

    I have some graphic pictures of the wound. Let me know if you want me to share them. Thanks for reading


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    Last edited by vitale232; 09-17-2013 at 08:01 AM.

  2. #2
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    Wood in my knee wound

    That sounds thoroughly unpleasant. Infections are no fun at all, do you know what the infection is? Sometimes they can be really hard to shift. Is the wound clean with no pus coming out now?

    Are you able to bend the knee, or is it still stuck straight?

    Strong IV antibiotics trash all your veins so it's worth taking as good care of the cannula in your arm as possible. Make sure that it's flushed through with saline after every use and try not to move that arm too much. If you're on crutches try and keep the weight off that arm when walking too. It's when they're having to replace the cannula with a new one in a new location each day that it really gets annoying, especially when the doctor can't find any good veins to use and takes several goes to get the fresh one in.

    I saw a picture a few years ago of someone who'd been doing jumps near where there had been forestry operations. They went off course, crashed and ended up with their calf impaled by a sawn off branch which went right through the entire leg! They ended up being taken to hospital with the branch still through the calf as the branch had to be removed surgically.

  3. #3
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    Re: Wood in my knee wound

    Quote Originally Posted by WR304 View Post
    do you know what the infection is? Is the wound clean with no pus coming out now?

    Are you able to bend the knee, or is it still stuck straight?

    They ended up being taken to hospital with the branch still through the calf as the branch had to be removed surgically.
    Thanks for the reply. Sounds like you have some experience or work in medical?

    Unfortunately, the surgical cultures aren't showing much at this point. The doc seems a bit bummed about it, since there was clearly infection when he went IN there.

    The surgical dressing just came off, and it looks like he made a big, thorough cut. He went from about mid knee to above where the redness was, and claims to have cleaned it out well. There's no fever or signs of returning infection at this point. The drain he installed never showed any puss, nor does the surgical dressing/wound.

    I'm getting a bit more mobility back in the knee, but it seems limited by my trepedous quad. The muscle shakes like Miley Cyrus on stage.

    Dude, puncture /impalement wounds are no joke. I vote we as mountain bikers push to have management age cues pad about 10 ft out from singletrack. It obviously require a sweeping twice a day to keep em good and clean :beer:

    But seriously, it felt like a somewhat freak accident. 999 times out of 1000, no wedge shaped stick impalement and i keep on having fun. Or 1" lower it hits the knee pad. Alternatively, it could've been a gut shot, so I guess it wasn't THAT bad.

    We're fragile creatures going fast through the forest. So as Forest says, SH:T HAPPENS

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    Wood in my knee wound

    Are you allowed to go home as soon as this course of antibiotics is finished?

    I've had plenty of experience of infections and IV antibiotics with my left leg in the past. It had MRSA in the bone (hospital acquired), leading to so many months in hospital and failed courses of antibiotics it's not even funny.

    If your leg seems good now that's a really encouraging sign, hopefully the operation cleared out the infection so your body can heal up normally. After an operation I like to have extra protein (1.5 to 2g per kg of bodyweight) to give myself the best chance of healing quickly.

    If you minimise the painkillers you may feel better too. I try and take as few as possible post operation before stopping them completely within a day or so, and only the basic ones like aspirin and paracetamol at that. The stronger painkillers have various adverse side effects (codeine leading to constipation, morphine making me sick etc) which can actually make you feel worse than just dealing with a bit of pain. If in doubt lookup the side effects of whatever you're offered before taking them.

  5. #5
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    Re: Wood in my knee wound

    Wow, that is one hell of a tale. I salute you, and wish you a speedy recovery!

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  6. #6
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    Re: Wood in my knee wound

    I've got 2 knees again...



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    HOly hell you need to go see an orthopedic specialist like last week.

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    Re: Wood in my knee wound

    Quote Originally Posted by musikron View Post
    HOly hell you need to go see an orthopedic specialist like last week.
    Haha that's funny. I saw my ortho a week ago and see him a week from now. I also see my general practitioner every week. They're both very pleased with my progress. Here's what it used to look like. It was about the size of 5 knees.



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    Sorry somehow I missed the surgery part, I thought that was the remnants of the ER doc yanking that log out of your leg. Heal fast!

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    She was vicious. It would likely look worse.

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    The piece of wood you got in your knee looks almost identical to the one I posted yesterday! I knew I had a piece of branch in my leg, as it was clearly sticking out of my leg (I had to break the rest of branch off when it happened before I could ride home!). They x-rayed it (which was pointless) before the surgeon operated. Got the main piece out, but he missed around 4 other pieces in of varying sizes, the largest being 2cm long. Within a day I got a raging infection, which continued on and off until December. I have been through every antibiotic available.. The wound as of yesterday has finally healed, accident happened on the 3rd July last year.. Tom

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    What was the final outcome of your adventure...any lasting affects... riding again?

  13. #13
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    Quote Originally Posted by Tojaca View Post
    The piece of wood you got in your knee looks almost identical to the one I posted yesterday! I knew I had a piece of branch in my leg, as it was clearly sticking out of my leg (I had to break the rest of branch off when it happened before I could ride home!). They x-rayed it (which was pointless) before the surgeon operated. Got the main piece out, but he missed around 4 other pieces in of varying sizes, the largest being 2cm long. Within a day I got a raging infection, which continued on and off until December. I have been through every antibiotic available.. The wound as of yesterday has finally healed, accident happened on the 3rd July last year.. Tom
    That's nuts! I thought I was the only one that this could and would ever happen to. Glad to hear you finally healed up! Also makes me happy I got a good, thorough surgeon. It's crazy that you didn't even fall or anything. How long did they make you wait in the ER before they started treating you?

    And the X-Rays surely weren't pointless. The hospital made a ton of money off of mine.

    Glad you're finally feeling better, though.

    Quote Originally Posted by mces View Post
    What was the final outcome of your adventure...any lasting affects... riding again?
    I vote there still is no final outcome. Still healing for sure, but I'm doing really well. It's a little swollen all the time, and when I use it, it still goes up like a balloon. The swelling is generally back down by the next day, though. The worst thing for it as far as pain is concerned is sitting all day at work.

    But I really can't complain one little bit. I have been on a 5 day ski trip and done a fair bit of mountain biking within the last month (where is the snow?!). My surgeon told me to start pushing it a bit. He should have considered his words more wisely considering he was advising a guy that got a 3 inch piece of wood lodged completely into his leg... But yeah, it feels good and is slowly but surely getting towards 100%. I'm definitely a little more hesitant on the trail, and I'm really hopeful that will fade as the pain becomes a memory rather than a reality.

  14. #14
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    glad you are healing where are the good pics?
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    Pics would be good. What you 2 have been through is a nightmare. The chances of getting away without lifetime disability is not good from the moment of injury. Missing 2cm pieces of timber in or around a joint is very likely. I guess you have never tried to get fragmented wood out of soft tissue - it's near impossible. There is no way to expose every normal and potential soft tissue plane. Then you get fragments piercing through multiple planes etc. I can forgive a surgeon missing that. However, sending someone home with a high fever hours after a penetrating joint injury is really not forgivable. Death within a day was a possible outcome, if not within hours.

    Do not overdo your recoveries. Chronic joint infections are a real chance. Make sure YOU know the joint itself is healed before your rehabilitate the soft tissue around the joint and wider musculoskeletal system. That way your body will have time to tell you how it is going. Spontaneous "ejection" of foreign bodies through the skin can occur weeks and months after injury. That's the body's way of helping you - it's a payback for respecting there is something still not right.

    The only way to tell if the joint is OK and you are OK to push the recovery is something you have to learn as you go. No-one but you can feel it. With a background of MTB, there is a good chance you will not give up in fear.

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    Ask and you shall receive. Here are two pics now that it's pretty well healed up:





    As you can see, there's still a little bit of swelling. It's obviously nowhere near what it was in the first few pics, though, and I have 100% of my range of motion back. Just a little bit of pain if I push it too far.

    I know that the risk of a recurring infection is possible, but I feel like I'm pretty much out of the woods there. I had a PICC line inserted before discharge from the hospital, and injected myself with a heavy dose of antibiotics every morning for 6 weeks. It's highly unlikely anything survived. For those of you that don't know what a PICC line is, it's a small piece of tubing that's inserted into a vein through your upper arm and wraps all the way around to your heart. Pretty nuts.

    As piss-poor as my medical treatment was at the first hospital, it was that good at the second. I'm lucky to be approaching 100% again so quickly.
    Attached Thumbnails Attached Thumbnails Wood in my knee wound-camerazoom-20140201085739095.jpg  


  17. #17
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    congratulations and hoping you have a speedy recovery
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    The knee looks a lot better, you probably have a good chance of 100% recovery. Especially if you are not old.

    That 104F temperature indicated a raging infection. I'm sure the wound area felt hot to the touch, hurt like hell and was red.

    Good to see you are doing much better. Almost time to ride!!!!!!!!!

    Best wishes,
    Terry

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    Wow, crazy! And, glad to see you are recovering. I had a knee infection from my knee grinder about three weeks ago and it was crazy how fast and how much my my leg swelled up.

    How do you think this will change your riding in the future? I am thinking of always wearing knee and elbow pads from here on. Thinking knee+shin might be overboard, but I'd much rather be able to walk until my last days then be crippled if you know what I mean.

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    Quote Originally Posted by fastslowpronewb View Post
    Wow, crazy! And, glad to see you are recovering. I had a knee infection from my knee grinder about three weeks ago and it was crazy how fast and how much my my leg swelled up.

    How do you think this will change your riding in the future? I am thinking of always wearing knee and elbow pads from here on. Thinking knee+shin might be overboard, but I'd much rather be able to walk until my last days then be crippled if you know what I mean.
    Sorry to hear you're going through something similar! No bueno, I hope you heal quickly.

    It's interesting you should pose the "what's different" question. I've been wearing knee pads... even prior to the injury (661 Rage Knee). They're comfortable and I don't notice them after about 2 minutes. I even do long climbs in them. However, it's worth noting knee pads are not a silver bullet. I was wearing them when the piece-of-wood-deep-in-the-knee accident happened. Somehow the angle of the log managed to still get it wedged in there just below the pad.

    When I first got back on the bike, I definitely felt a lot more timid. I had this mentality that even the most mundane of mistakes could lead to big consequences. I think that's probably natural coming back from a life threatening injury. The feeling of possible impending doom seemed to fade the more I rode, and I'd say at this point (6 months of skiing and biking later), I'm doing nothing differently.

    On that note, I had an incredibly dumb fall the other day. At the bottom of a long, jump-filled, technical downhill, we we were taking the fire road back to the car. I had nothing but rotisserie burritos on my mind, and managed to wash out at ~25 mph on a turn. I planted the left knee (the one that was injured) to try and gain balance, failed, and came down with all 210 pounds on the side of my knee/knee cap. The knee pad did it's job in the fact that there was no laceration, but the knee ballooned up like crazy almost immediately (as I was eating the afore mentioned burrito). I had thoughts of months off the bike again and was starting to freak out. I went to the doctor, and they are chalking it up to a strain of the LCL/internal bruising of the soft tissue. Here I am a week later, and it's starting to look/feel a lot better. I'll probably be riding again within a week.

    I'm not sure what the point of my story is. I guess it's something like this: mountain biking is inherently risky. You can take some steps to minimize that risk, but in the end, ride the way that's fun to you. If you find it enjoyable to ride well below your ability to play it safe, go for it. That's not me, and I guess I'll keep having some consequences along the way. As Kurt Vonnegut would say, "So it goes."

    Heal up and get back on the bike!

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    Quote Originally Posted by vitale232 View Post
    Sorry to hear you're going through something similar! No bueno, I hope you heal quickly.

    I'm not sure what the point of my story is. I guess it's something like this: mountain biking is inherently risky. You can take some steps to minimize that risk, but in the end, ride the way that's fun to you. If you find it enjoyable to ride well below your ability to play it safe, go for it. That's not me, and I guess I'll keep having some consequences along the way. As Kurt Vonnegut would say, "So it goes."

    Heal up and get back on the bike!
    Injury is definitely the X-Factor when it comes to high adrenaline sports. I went through the balls to the wall, take it to the limit, accept the consequences mode for years on bikes and motorcycles but have changed my perspective over the last 5 years or so. The older you get, the longer it takes to heal and the more you realize that a bad injury could cause you to give up the sport COMPLETELY. I've got friends that lost their lives, one lost his foot, another can barely walk and another lives on pain pills from sports injuries related to going mach 5 level adrenaline seeking.

    As long as you can accept the consequences, go for it. But there are real consequences to the most extreme levels of performance.
    Are you really sure about that?

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    Was happy to see you guys saw my train of thought. I thank God my knee injury wasn't worse, and know that eventually my leg will recover. But, in the mean time, I'm evaluating\analyzing what have I learned, what will I do different, etc.

    Vitale232, it's soo funny you mention the timidness and the "oh, there's an ant carrying a little pebble...AHHHH, get out of the way, I'm gonna crash!" mentality. Not being on the bike for a bit had me thinking "Wow, I can't believe we do what we do" for a few days...lol

    This is my second big spill, so I hope to overcome the initial challenges. I usually only wore knee pads when I was on a new trail, or new I was going to do something stupid. Now, I think I will always wear the pads If I know I will be flying down any hill with speed. The first week when the pain was the was the worse, I started thinking in extremes such as wearing a full face helm. for XC and climbs LOL.

    Really happy life moved on and you are able to skii and ride again, Vitale!

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    Quote Originally Posted by MSLKauai View Post
    Injury is definitely the X-Factor when it comes to high adrenaline sports. I went through the balls to the wall, take it to the limit, accept the consequences mode for years on bikes and motorcycles but have changed my perspective over the last 5 years or so. The older you get, the longer it takes to heal and the more you realize that a bad injury could cause you to give up the sport COMPLETELY. I've got friends that lost their lives, one lost his foot, another can barely walk and another lives on pain pills from sports injuries related to going mach 5 level adrenaline seeking.

    As long as you can accept the consequences, go for it. But there are real consequences to the most extreme levels of performance.
    MSL, I like what you said. For me, riding is deceptively dangerous. You have fun, speed, beautiful trails, it feels good, etc. Yet, it only takes a split second to be out for months.

    I was dreaming the other night that I was riding my bike...silly dream, right? lol But, in my dream, I started to think of all of my riding buddies. Every single one except two have had major injuries. Broken this, that,, surgery here, there, etc. And, I was thinking -- we've got to really be careful to balance the fun and life factor. I hope to ride into later age (31 now), but I also want to be able to walk, and play with my children for another 20, and my grand children. Shoot, I couldn't even put on my boxers by myself until a few days ago haha.

    So yeah, to add what you said. We should definitely consider and balance the fun with consequences factor. Thankfully, my work was semi-okay with me working half days for the first weeks, but if my injury was worse, my earning a livelihood could have been compromised.

    TLDR; Be safe, don't ruin your body, it's nice to wipe your own butt.

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    Quote Originally Posted by fastslowpronewb View Post
    MSL, I like what you said. For me, riding is deceptively dangerous. You have fun, speed, beautiful trails, it feels good, etc. Yet, it only takes a split second to be out for months.

    I was dreaming the other night that I was riding my bike...silly dream, right? lol But, in my dream, I started to think of all of my riding buddies. Every single one except two have had major injuries. Broken this, that,, surgery here, there, etc. And, I was thinking -- we've got to really be careful to balance the fun and life factor. I hope to ride into later age (31 now), but I also want to be able to walk, and play with my children for another 20, and my grand children. Shoot, I couldn't even put on my boxers by myself until a few days ago haha.

    So yeah, to add what you said. We should definitely consider and balance the fun with consequences factor. Thankfully, my work was semi-okay with me working half days for the first weeks, but if my injury was worse, my earning a livelihood could have been compromised.

    TLDR; Be safe, don't ruin your body, it's nice to wipe your own butt.
    This is very true. I think you can limit your risk by not riding way above your ability, but there's no way to eliminate it.

    There's a lot of merit to making the right decision when you're on the bike (e.g. not sending a 20 ft drop when you're uncomfortable on a 3 footer), but we still need to realize that you can get injured riding something that's easy to you. I mean I ate it on a fire road.

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