CNN article and video on lack of investigation and accountability when motorists hit bicycle riders and pedestrians.

Bicycle injuries: Is the right-of-way fight getting ugly? - CNN.com

My Aching Back: Or Any Injury That Is Ineligible For Surgery

For my knees, reconstructive surgery was the only answer.  But when it came to the injuries to my spine resulting from getting hit by a car, there wasn't any torn tissue therefore there was nothing to surgically repair or replace.  I had spine injections--which are surgery but not corrective--and they worked for a couple of months of relief from the worst pain, but ultimately I had to either find a solution or live a lifetime of pain.

I was hit from the side with the car striking both my left knee and the front end of the bicycle directly, which then struck my other knee and ankle.  So my lower half went right and my upper half went left onto the car and then the roadway.  The bike was shot out from under me like a billiard ball, but not before torquing so hard that the Mavic racing wheels both--front and rear--twisted and snapped.  Being that my wheels are made of tougher stuff than I am, you can imagine the force on my spine.  You could jump on those wheels several times and the most damage you would be able to do is bend them a bit--they wouldn't taco and snap like they did when I was hit--so you can imagine what this did to the bone, muscle, and ligaments of my body.

Crashing doesn't compare in the least with getting hit by a car weighing more than a ton.

Anyway, immediately after the accident and for the next couple months I hurt all over.  I was actually afraid to have MRIs done of my hips because I thought I might have to have surgery on at least the left one.  But when it came to my spine I didn't hesitate to have it thoroughly checked out.

The MRIs revealed that I have several herniated discs in both my lumbar and thoracic spine as the result of getting hit, and later x-rays revealed that my spine is twisted in two places.

I was sent to a spine surgeon who said the damage wasn't severe enough to require surgery.  Basically what this means is, after surgery I might not be as functional as I would be if I didn't have it.  So the spine surgeon sent me to a pain specialist who performed a series of epidurals (spine injections) on my lumbar.  While this relieved the very worst of the pain for some time, it was temporary and actually didn't do anything about the cause of the pain.  I was told that eventually, over several years, the herniated discs should get better, but that they wouldn't be as they were before I was hit by the car.  He also told me that he could not perform this same procedure on my thoracic--so no surgery and no pain relief there.

A few months after the injections I felt the pain was almost as bad as it had been before receiving the injections, so I started to get desperate.  I turned to a nearby acupuncturist.  While the acupuncture helped in the couple of months that I tried it, particularly with all the muscle, tendon, and ligament injuries, I didn't feel it was helping my spine.

I then considered laser surgery, but before I tried something invasive I thought I would give a chiropractor a shot, and many of my friends highly recommended I try this option.

Looking on the internet, I found a chiropractor whose narrative was one of his own injury and pain, and how traditional chiropractic methods did not provide him long term relief, but when he was treated with a new technique where they actually move the bones into the correct position rather than simply relieving pain he experienced much better personal results.  In particular, he mentioned cycling, and as I am a cyclist this is what really sold me on trying out his practice.

Until going to the chiropractor ( Dr. Dominick M. Fazzari ) my pain was unending and intense.  On a scale of 10, at times the pain in my spine was a 9 (near tears) and most of the time it was a 7.  There was no position, sitting, standing, or laying down which was pain free.  Most particularly in my thoracic, the change was very impressive.

I have to say there still is no position which is pain free, but the pain has become more generalized, therefore less intense.  There have also been very positive changes particular in my posture and the alignment of my hips--so I limp less severely as a result of the chiropractor's treatment.  I remember thinking after the first couple of treatments that I limped in, but I walked out.

The main point of this whole story is, it's important to not only get a second opinion when you hit a wall on treatment, but to try various treatments to find a solution that will work for you.  The surgeons and pain specialists would never recommend a chiropractor for example, but they would recommend the acupuncturist.  And while the acupuncturist was very effective, ultimately much like the pain specialist, it was not the ultimate solution.

Ultimately, it's going to take years and a combination of treatments to get my spine and knees to full function again, but I am confident that so long as I continue the effort I will eventually recover full, pain free functionality.

Survival Mentality: Keep Your Spirits Up, Have Goals

I was watching an interview of Bear Gryllis by Anderson Cooper on CNN and was struck that he said the same things I say to people about surviving all sorts of extreme situations, such as physical rehabilitation, unemployment, or an even more serious personal tragedy.  He even has the same favorite quote by Winston Churchill who said, "If you are going through hell, keep going."

Most people don't realize that Bear at one time broke his back in three places.  His spine!  He went through a year of rehabilitation, and then climbed Mt. Everest with his father, who initially taught him how to climb as a child.

And of course everyone knows Lance Armstrong's story.

Thoughts of doom and gloom can be self-fulfilling.  If you don't have the will to persevere, to survive, then you wont--whether it's coming back from a terrible injury, an illness, being literally trapped and waiting for rescue, loss of a loved one, the end of a dear relationship, or unemployment.  People who are great survivors aren't usually survival experts, they typically have something else that sustains them and makes them more than the sum of their experience.  It could be faith, family, or a sense of mission for example. 

In my case, I've been though hard times in my life, particularly in the last several years, and I've won every time.  So getting hit by a car, going through surgeries, and rehabilitation is comparatively easy.  I am determined that this isn't going to end my lifelong love of cycling or active lifestyle, and with that in mind I have already bought my replacement bike: a 2011 Trek Madone 5.2 .

Sweet, right?

Today's Independent Medical Examiner is a Chiropractor

I have to go to the Independent Medical Examiner today. This one is a chiropractor. Basically, this is where no matter how injured you may be, the doctor is paid to say you are fine so the insurer can deny your claim. You could lose a leg and the IME would say you walked normally and required no further treatment.

I notice that they always have these examinations here in New York City in the most difficult to get to areas, and when you get there the waiting area is designed for discomfort, especially for the disabled.

The last IME appointment I went to, I had to wait about three hours and my spine was killing me. While there, I met someone who had been sent to an IME four times in a row and each time, after waiting for hours, they told him that they were done for the day and would have to reschedule him. I told him that legally they couldn't do that--as it was clearly unreasonable. The strategy was obviously that this person is very seriously injured, that there's no denying it, but if you keep requiring him to go to these appointments eventually he will miss one and then they can not only cut off his claim but refuse to pay any outstanding charges for treatment he has already received.

Lovely business, insurance.

When You Can't Go Cycling Due to Disability: Exploring Your Other Interests

In my case, cycling is my main thing, but you may have an activity which is just as dear to you which you can't do after an accident.

One time, when my wife and I had begun dating seriously, she actually said to me while standing in my apartment in Narashino, Chiba, Japan--which was more like a bicycle garage with a bed and a TV in it than a place to live--"You love cycling more than me, so you have to choose--me or cycling."  I smiled and replied, "It was nice knowing you."  I wasn't calling her bluff; I thought I shouldn't have to give up riding my bicycles for the sake of a relationship.  If I couldn't be a cyclist, then I couldn't be me, and therefore could not be happy.

She huffed, but didn't leave after presenting this ultimatum, and these days she actually looks forward to and supports my avid cycling habit--because it gets me out of the house and she gets to spend quality time with the television without distractions.

So fast forward to post-October 2010 when I became unable to go cycling.  I'm home for all but doctor appointments and physical therapy and particularly at first both of us were genuinely miserable with this new reality we suddenly found ourselves in, where I would not be riding at all.

I dealt with this exploring my other interests more deeply.  I started writing and reading more again--as I used to before moving to New York City--had just managed to save up for a planned purchase of a telescope and all its related equipment a few months later, and I have been strengthening both my practice of Nichiren Buddhism as well as the various wonderful relationships I have in my life with friends, peers, and family.  Despite being genuinely sad about not riding, I was able pour myself into other things which I could do.  I now absolutely love Astronomy, have rediscovered my love of reading several books at a time, writing, and something I used to not enjoy at all which is driving.  In fact, I think this time I've had to reflect on my hobbies and other talents will positively change my career and academic path.  I've even made some new friends amongst whom are professional Astronomers, and even an engineer from the Apollo missions.

While I consider it fortunate that I was hit in October, at the end of the season, so that I effectively will have only missed one full season of bicycle tours if I fulfill my goal and start riding again this Spring, I have also discovered that I am not some miserable bloke with only one joy in life--oh, yeah, and I have a wife too so I guess we have to count her in and call it two joys in life.

I don't feel it will be very hard to get back into cycling at least as strongly as I did before, especially as my many cycling friends have been simultaneously teasing and encouraging me to ride with them.  I don't think they even know what I look like in regular clothes!  At the same time, I don't want to toss aside this wealth of rediscovered interests and the new friends I have gained along the way.

In fact, as soon as I'm settled in a job and riding again, I'm strongly considering taking courses in film school.

No Fault And Doctor's Appointments: Some Basics You Should Know

If you were hit by a car in a No Fault state the first thing you need to know is that you can, and should go to any provider of care that accepts No Fault.  In New York this includes orthopedists, chiropractors, and acupuncturists.  You do not need prior approval, a referral, or have to choose from a list of pre-approved doctors as you would with an HMO or Workers Comp.  You do not need to contact the insurance company--in fact you should never speak to them directly unless your lawyer says you have to.

This is important not only so that you can get the proper care as soon as possible, but because it also supports your case against the driver's insurer and possibly the driver if you cannot receive an acceptable settlement from the insurer.  Remember, the auto insurer has claims people whose job is to reduce the amount of money they need to pay for your injuries.  The insurer would really love it if you didn't go to the doctor, they had their Independent Medical Examiner look at you, and then they could cut you off from receiving any medical care AND reduce the amount of liability money you would have received otherwise.

So in my case for instance, I was told at the Emergency Room the day I was hit that I should go to my regular doctor a week later for a follow-up.  Instead, I went straight to the orthopedist.  I went to the front desk and simply asked, "Do you take No Fault Insurance?"  They said yes, and I made an appointment.  If I had gone to my regular, general physician he probably would not have realized how badly injured I was, or referred me surgeons--and even if he did, for lack of a specialty his diagnosis would not have carried as much weight.

If that doesn't convince you, consider this.  When the insurer sent me to an Independent Medical Examiner, they sent me to an orthopedic surgeon; he was a quack who just denies claims all day, but he was a surgeon.  If the insurer feels they need a surgeon to deny your claim or cut you off from care, then certainly you need a surgeon on your side.  And it's paid for by No Fault, so you really have no reason not to see a surgeon.

The other main thing you need to know is that you can go to as many doctors as you like, but you can't go to two of them in the same day.  This includes Physical Therapy.  So in my case I can't go to a chiropractor or go to a follow-up with the surgeon and go to Physical Therapy on the same day.  So if you are receiving care from multiple sources, make sure to schedule them out.

Also don't let a lapse of time go between getting care and simply resting.  If you're not receiving treatment for a time, this indicates to the insurers--including Disability or Workers Comp--that you no longer need care.  As hard as it is to keep going, as much as you would love to take a month off from getting electrocuted, stabbed with needles, going to Physical Therapy, and getting your bones manipulated, you can't stop until you are 100% and ready to go back to your normal life.

Having a Strategy: Plan Ahead for the End of Your Disability Period

If you get a load of money, a major windfall either from the settlement with the driver's insurance or in court, there are generally two things you can do with it in my opinion.  If you have the discipline to save it or some significant portion of it, and you don't have any dire need to spend it, then by all means sock it away for retirement or a big purchase such as the down payment on a home.  If you have been constantly behind the eight ball though with high credit card balances and bills piling up, and particularly if you're prone to squandering money, then if you are going to blow it then blow it on debt relief.

Personally, I was somewhere in between.  I had student loans I could never seem to catch up on, and in the past year I had bought my first car, which was financed with fairly outrageous terms.  So day one I killed off two student loans completely--gone, a tremendous weight off my shoulders.  Day two, I paid off that car loan in cash.  Between the student loan and car payments I would no longer be making I reduced the amount that I would be paying out monthly by over $700.  That's over $700 more cash, in my pocket, every month--or well over $8,400 per year.  It's like giving myself a raise.  By paying off the auto financing only six months after I bought the car, I also saved myself over $8,000 over the next four years--so now we are up to well over $10,000 a year that I get to keep in my pocket over the next four years.  No more worrying about missing a payment or two on my car due to a period of belt tightening, or not having a car to get to better job opportunities and places to live (and enjoy cycling of course), the car is mine.  And no more student loan officers chasing after me.

Of course I had a decent amount of money left after that, and decided that it would be best to buy things which I was going to need to buy eventually anyway.  I had some broken down old furniture which I bought used and never intended to be permanent to my life which I replaced.  I finally bought my wife a decent bookcase, and I bought some electronics which were very reasonably priced.  I also was able to buy my wife a trip to visit her family and friends back home--in a foreign country--without it being a real belt tightener.

But then there are the unexpected expenses of Disability that you should set aside some money for, and when you think you have enough to tide you over, think again.

In my case, once I was approved for Social Security Disability I received a lump payment back to June--when my Long Term Disability insurer started paying on my claim.  That meant that there were thousands of dollars in overpayments to me as the Social Security Disability payments reduced the amount of my benefits from MetLife.  Since I didn't want this to drag out so that I just ended up under the gun with them for years to come, I told them to keep the money they would have otherwise paid me until the overpayment was settled.  That was two and a half hard months and at the end of it I didn't have much left other than what I invested--but it was worth it.

And it seems as soon as you have some money, people are coming at you from all sides to take it.  I can't go into the details, but you might literally need a bit of a war chest for the messy period between the end of your Disability period and being employed again.  You cannot count on your employer fulfilling their legal responsibilities to rehire you or even to not literally penalize you for being disabled; they may act illegally counting on the fact that you do not have the money to hire a lawyer and fight for your rights, or that you may be ignorant of what your rights are.  In any case, you should assume that at the end of your Disability period, you will most likely need to find another job.  Even global mega-corporations can get very petty, making it seem like you went AWOL even though they have been made well aware of the physical impossibility of you doing your job for some time.

Bottom Line, on the positive side: Look at the long view.  This is probably a once in a lifetime event for you, you will get past it, and ultimately you will have the benefit of having used that windfall you received in Liability money to your maximum long term benefit and having your injuries treated as best they could be.

My goal at the end of all this is that my knees and spine will be even better than they were before I was hit.  After all, I just had a major overhaul done, not only physically, but financially as well.  So long as you're smart about how you manage your Disability period, your physical treatment and recovery, and your financial stability, ultimately everything is going to be as good or better than it was before.