Health

Thursday 10 July 2014

Concussion: A cautionary tale about 'fixie bikes'

Nora Costigan vows never to bike again without body armour

It was a balmy Sunday in July, smack bang in the middle of our heatwave. I was making a journey of a few hundred yards to get stuff in the shops, while the rest of my friends found a spot in a hotel garden for a post sea-swim beverage.

I was riding my friend Claire's stylish bike 'Goldie', which has only one gear, straps around the pedals and a confusing backpedalling brake function; I believe the hipsters call them 'fixie bikes'. Despite having a hipster haircut that would suggest otherwise, I had never ridden one of these.

So, I set off and less than a hundred yards from the departure spot, I slowed down and tried to put my foot on the ground for balance, however I wasn't able to kick my flip-flopped foot free of the pedal straps quickly enough and as I toppled diagonally past the point of no return, thinking "Uh-oh, this is going to hurt", I knew I was about to get up close and personal with the Dun Laoghaire street.

I don't really remember the point of impact. My memory comes back in clichéd style, with everything spinning. Four girls had seen me fall and were crouched over me asking if I was ok. I'm a robust enough individual, and would always be the sort to pop up, dust myself off, and say "I'm grand", before scuttling off embarrassed at having had a spill in the first place. But despite the mortifying nature of having fallen off a bike at about one mile an hour, as soon as I pulled myself into a seated position, I knew I was in need of a doctor.

The left side of my head had taken the majority of the impact, from my temple along the side of my scalp, and felt sickeningly tender and pulsating with blinding pain. The girls who'd seen the fall got me to the side of the road and told me I'd been knocked unconscious for nearly a minute. To add, well, injury to injury, the remainder of the impact had been taken by the top of my left shoulder -- my aromioclavicular joint, as the doctors later told me -- and I couldn't move my arm.

The girls called an ambulance and fished my phone out of my pocket to summon my friends. I'd like to tell you I was a brave soldier throughout this, but as my consciousness returned fully and the initial adrenaline wore off, I became very scared, bewildered and sore.

The ambulance crew came along and strapped me onto a board with foam bricks beside my head to restrict my movement in case I'd had a spinal injury. They got me into the ambulance and went through the motions of asking my name and the date, and whilst I answered in a reasonable time, I found myself struggling with the date because of the fog of pain in my head.

I was taken to St Vincent's Hospital in Donnybrook, with my dutiful friend and housemate Peter accompanying me in the ambulance. The weather was as warm as we'd ever had, but in the ambulance I began trembling uncontrollably, which I was informed was my body going into shock.

My vital signs were sufficiently normal not to warrant a scan on my brain, so after some X-rays -- which came up normal -- and a few hours' observation, I asked to go home.

In hindsight, a night in hospital probably would have been wiser. I was unsteady on my feet and had massive pain in my head, not to mention the immovable arm. I was still in shock, but was hankering after the comfort of my own home.

The doctor said I could go, but warned me that I'd had a concussion and that the pain would get worse before it would get better.

The next morning, the doctor's warning proved to be a comical understatement as I woke up in tears with the pain in my head.

However, aside from the physical pain in my head, my brain just felt 'wrong'. It felt like something had changed, like it wasn't the same brain I'd had before I fell and this brought about a feeling of fear.

A concussion is a type of brain injury, the most minor kind in fact, although it felt far from minor from where I was sitting.

Technically, a concussion is a short loss of normal brain function in response to a head trauma, but the term is used to describe any minor injury to the head or brain.

The unfamiliarity of the feeling in my head genuinely frightened me; I started thinking I would perhaps end up with a permanently altered brain, or some chronic pain that never went away. I was made acutely aware of the fragility of the human body and vowed never to set my bum on a bike saddle again, without full body armour.

The impact of the fall had affected the whole side of my head, so I was also unable to chew without pain in my skull. The aforementioned Peter was forced to take a day off work to make soup and generally assist me.

On the second day, the pain intensified and moved to behind my eye. I was panicking a little at this stage, as I felt strange and like I wasn't myself.

Also, the whole left side of my face puffed up with delayed swelling and bruising just from the severity of the bang. I couldn't look at TV or read anything, the only respite was closing my eyes, lying still, and eventually, ibuprofen.

On the third day, the pain stabilised and I made a foolish attempt to return to work, but the effort of the four-stop journey on the Luas alone meant that when I walked in the office door, my colleagues took one look at my face, dosed me with sweet tea to stop me fainting, and put me in a taxi straight home.

Only on the fifth day after the fall did I feel like my old brain was returning, the pain behind my eyes was subsiding and the fear that I'd been changed forever, was gone.

I was overwhelmed with gratitude for my health, and sent some embarrassing texts proclaiming my appreciation of life to my friends.

I got too cocky too soon though, as the pain behind my eye returned on the Sunday, after a weekend's activity. I spent the rest of the following week tip-toeing around myself, taking care not to do anything strenuous.

I recovered fully, but I'm aware that it could have been a lot worse. I now no longer take my brain and its function for granted, and regard my skull as a flimsy protector of its precious cargo. I won't get on a bike without a helmet ever again.

So, for anyone in any doubt, here are the facts; the head is delicate and needs protection; always wear a bike helmet.

Oh, and having a hipster haircut does not actually enable you to ride a hipster bike.

Irish Independent

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