Injury & Recovery
I didn't really know anything was wrong until I was safely on the ground. "I think that was a bad idea, you should go down a different way," I yelled up to Kat, who I had met just hours earlier at Redpoint just outside of Smith Rock. We were planning to head up to the Marsupials but her asthma had acted up so we decided to hang out at the Student Wall to warm up for the day. I had just set up a top rope anchors and rappelled spectacularly unsuccessfully down to the ground.
There wasn't any rockfall to blame or other weird circumstances I could pin this on. I had just started rappelling, my master point had shifted, and as I rounded a bend my left leg caught on the rock while my right came off. That's all it took for my kneecap to pop-pop out and back in place. I always rap with an autoblock so my "fall" as I was startled by this unexpected pain was a total of maybe a foot. Had I not taken that precaution, I likely would've landed butt-first on the ground.
As Kat made her way down, I sat rather dumbfounded. I didn't feel pain per se, but I felt decidedly bad. Bad as in the animal, something-is-very-wrong, hairs standing up sense of the word. Bad in the sense that moving my left knee and retching seemed to go hand in hand. I did, however, feel pain when I tried to stand up. Lots and lots of it. So I continued to sit and wait.
Lucky for me, this stranger who I met on Mountain Project was WFR certified. Having no stick clip (we were trad climbing after all!), we fashioned a splint out of a guidebook and some jackets. She took one look at my eyes and gave me the news that I was, in fact, in shock and that I was probably going to try to make some dumb decisions so I should let her make the calls. I tried valiantly to make those dumb decisions by brushing off all attempts to help me but relented when it was obvious that my pace of 10 feet per minute was not sustainable. As chance would have it, Smith Rock local Alan Collins was guiding right next to where we had set up. He had seen everything go down and kindly offered to call the park service and get someone with an ATV out to schlep me back to the parking lot. Of course I declined out of my base emotional state of stubborn midwestern politeness. Kat had the wherewithal to speak over me and tell Alan that an ATV would certainly be helpful.
The ATV could only go to the base of the scramble approach and I was in no condition to travel over third-class terrain so Kat and some other nearby climbers ran to get a litter that was stashed nearby. Riding in that litter with the aid of eight other climbers was one of the most terrifying experiences of my life. I held on for dear life as they passed me over rocks, set me down, readjusted, got tired, tripped, dropped me, but eventually made it to the parked ATV on the main trail. From there the park ranger zipped me up to the parking lot.
I am so immensely grateful for everyone who helped me that day. Kat selflessly came to my aid having known me for only a few hours, Alan was incredibly helpful in getting me connected to the park rangers and his clients were understanding as well. I'm indebted to the people who stopped climbing to help carry me in the litter across difficult terrain at not-insubstantial personal risk. I never wanted to put anyone in the position of having to rescue me, but receiving the kindness of strangers was such a humbling and heartwarming experience .
After the ATV reached the parking lot I felt good enough to get myself to the hospital. My driving foot, after all, was uninjured and I knew how expensive an ambulance was. I drove out only 20 or so minutes to the ER in Redmond and checked myself in. Obviously climbing accidents are their bread and butter so the ER docs were more informed than the usual "You rock climb?! On real cliffs?" response I get from most doctors. They sent me off to get X-rayed and I made every nervous dad joke I could to anyone who would listen. After the X-rays came back inconclusive, I got my first experience of a CT scan. It was fairly exciting, all considered.
The attending physician gave me the news bluntly - fractured tibia, fractured patella, torn ACL, possible meniscus damage. Fuck.
At this point in my life, I had been living "the dream." I was as fun-employed as it can get - indefinite time off of work with a job guaranteed when I got back. I had just driven up from California where I spent time climbing in Yosemite and Bishop and seeing friends in the Bay Area. I was planning on passing through Smith to visit friends before heading up to Index and Squamish where I was finally starting to feel like a local. I was hoping I could continue this for another month before the rainy season started. Apparently not.
I hadn't shed a single tear until I called my mom. "Before I say anything else, I just want to let you know that I'm OK." Is a phrase I'm sure all parents love to hear. I eked out a few more cogent words before starting to bawl uncontrollably. The gravity of what had happened hit like a ton of bricks and I was terrified. I was alone, hours from home, across the country from my family, and I couldn't walk. My insurance was running out at the end of the month and I knew that the ER bill was only the beginning.
Luckily our world of anything-at-your-fingertips was accidentally designed to be friendly to people with injuries and mobility issues. Within an hour, I had booked a house through AirBnB, ordered food delivered, and helped my partner arrange a rental car to come and pick me up. I wanted to stay in Redmond for a few days to get an MRI and see a local orthopedic surgeon as the ER docs had recommended surgery ASAP. My parents insisted on flying down which of course I initially rebuked but didn't put up much of a fight.
My partner arrived a day after I injured myself and I was already feeling much better emotionally. Just having someone who I loved to support me through this vulnerable time meant everything to me. We watched Queer Eye together, got take-out, and walked/crutched around Bend as I tried to forget about my uncertain future. My parents also arrived and set to work taking care of me in the way that parents do best. This strange circumstance was the first time my partner and my parents met. I'd like to think my injury made for a great icebreaker.
After the MRI and the appointment with the orthopedic surgeon, my prognosis didn't look quite so dire. While I had dislocated my patella and damaged my tibia and patella, it seemed like the damage was more contained and that all my ligaments and menisci were intact. The doctor did still recommend surgery but didn't feel it was as urgent as the ER doc had made it sound. After this good news, I decided to head back to Seattle and recuperate there.
It turns out that being injured while living out of one's car leaves a lot to be desired. While I was able to crash at my partner's place, I felt very self conscious about taking up space in their house and very unsettled by not having a place of my own. While they were nothing but gracious, the transition from complete independence of life on the road to being dependent on someone else for housing was very jarring. Looking for a new place to live rose up on my priority list so I shuttled around between open houses and doctor appointments for a few weeks.
The doctor I saw in Seattle had a yet better opinion on my knee. Based on the same MRI, he thought that only cartilage had been dislodged from my tibia and patella, no bone. He was 50-50 on recommending surgery until I developed a blood clot in my immobile leg at which point he strongly recommended against. I was to do physical therapy to get my mobility back and return later to reevaluate.
As anyone who has been injured knows, recovery isn't a straight line. It's up and down, back and forth, progress and regression until one day your injury slips your mind. You never fully heal, you just forget that you're broken.
I went back to top-roping in a locked knee brace a few weeks after my injury. This was probably a bad idea, but certainly not as bad an idea as bouldering in a knee brace which I also did. Old habits die hard. At that point, I was pretty desperate to hang on to the idea that I could stay active through recovery and that my life wouldn't be dramatically altered by this injury. I went to PT every other week and did the exercises religiously. I returned to work because I couldn't do much else and needed the insurance, and I found a place to live.
Recovery went forward, little by little. I started walking on my own power, I regained full motion of my knee, and I started returning to hiking and climbing in a low-key way. I would go and see my doctor every once in a while and would report that everything was going great but it still hurt when I put weight on my knee while it was bent. That part never got better.
I wanted it to be better so I ignored it. I could deal with it. I got really strong in my right leg, I got really strong in my glutes. I started biking everywhere. I climbed 14,000 vertical feet one weekend and 9,000 the next. I worked on V6 boulders and started hang-dogging 5.12s. I was fine. I was crushing it.
I was not fine. Every time I tried to go down stairs, I had to shuffle my feet one stair at a time. Down-climbing at the gym was cruxing me out. I started getting anxious about bending over to tie my shoes. My lower back got tweaked from my uneven muscle development. I could do a weighted right-legged squat in good form but got shaky doing them with both legs.
I made an appointment to see a new doctor. I was hoping a fresh set of eyes would lend some clarity. I brought the old MRI data with me and we looked at it together. "See this part of your patella?" he asked, pointing to the above photo. "You're missing over half the cartilage on it. I'm not concerned that you're still in pain, I'm amazed that you've been doing what you have been." This backhanded compliment blindsided me. I knew my situation wasn't ideal, but he made it out to seem like I was walking on borrowed time. The doctor discussed my options which he laid out in two categories - surgery or arthritis.
For the surgical option, he recommended an osteochondral allograft. Which is fancy language for scooping the cartilage off of a dead person and plopping it down onto my kneecap. Intense. The other option was to do nothing and monitor my patella's eventual decline into arthritis. The choice seems clear, no?
An osteochondral allograft has a recovery period like this:
Bed rest for a week
Knee brace for 6 weeks
Return to low activity after 6 months
Return to normal activity after 9-12 months
Yikes. This isn't an "out for a season" surgery. This is bona fide fuck-you-up-for-the-next-year surgery. This is recovery as a second job surgery. But looking at the long term, it seems like the choice is clear. What's half a year of not climbing, hiking, or biking in exchange for a lifetime of unrestricted mobility and pain-free knee movement?
As of now, I have another MRI scheduled for Monday. I'll post more updates when I have them!