Monday, May 31, 2010

Today's Secret Word is "Hematoma"

More writeup later on Memorial Day weekend, which was fun but had some unexpected turns.

In the meantime, if you're wondering what it looks like to have a giant mass of bruise and blood on the side of your hip, you may click the tiny pics below.

WARNING: Pics may not be safe to open while eating...and possibly not safe for work, especially if you work at an eatery.

UPDATES (Friday, 4-June, One week later):
If I don't update this now, I'll forget. After this happened, of course, I scoured the internet for healing advice. Maybe this will be useful to somebody someday -- mostly, I would say it applies specifically to a hematoma above your wasteband. If it's lower, you gotta worry about femoral artery stuff; if it's higher, you gotta worry about splenic artery stuff. So be careful!

Some observations:
* If you are concerned, get it checked immediately! If you fractured your pelvis or ruptured your spleen (supposedly, both of these hurt a ton, though), you can loose a lot of blood in the pelvis area without necessarily noticing it. By the time you do (blood pressure drops, fainting), it will be too late.
* If you want to feel if you broke a bone, you need to gently move the lump out of the way, and push down on bone. It might take a couple days before you can do this comfortably. If you can stand and walk, though, that's a Good Thign.
* Another test for a "hip pointer" is a to cross your legs while sitting, move your legs away from the hematoma, turn upper body towards it (this stretches tendons/muscles out over the hip), and have someone push on your upper hip.
* A test for femoral breakage is to put your feet straight out, then let them fall together in the middle so your big toes touch and your feet make a "V." Supposedly, some sort of assymetry will be obvious if you have a broken femur.
* Push in around your abdomen area, making sure there's no unusual firmness or pain away from the site of injury -- this would be some sort of organ damage you don't want to mess with.
* If you don't have cuts/abrasions in that area, you might have hit your handlebars or had some other blunt trauma. If you slid on the ground and got some cuts, be even more careful about avoiding infection.

Healing and Treatment

* Mine has decreased in size by about half in a week, thankfully, but is still quite prominent.
* Several medical personnel and friends said this was the largest one they've ever seen (for what that's worth)
* On the other hand, less body fat = less cushioning AND less tissue to hide the swelling, so proportion-wise, it probably looks worse
* Compression has been the biggest help. If you can't or don't see a doctor, you can still go to the pharmacy and get a simple ace bandage and gauze. Wrap that thing as tight as you can stand. Then you can walk or bike without it jiggling around.
* I iced at first for pain (a day or two), now that it's lumpy and clotted, switched to heat (hot bad and baths) to help things move around, drain, and heal.
* ER doctor cut a hole in the side to drain, but it didn't get as much as we'd like. However, I found that I can sit in a bathtub and squeeze some of it out occasionally still. That is, being underwater helps.
* Took hot epsom salt baths. Felt better, but not sure how much it really helped.
* Didn't take much NSAIDs at first, as I didn't want to interfere with healing. Now that it's in a slow recovery phase, been taking mega-ibuprofen, as suggested by Dr.
* Got up to date on the tetanus shot -- not a bad idea, as I get scraped up more than an average Grown Man I guess.

* I guess this can take weeks or months to go away, or might even be lumpy after a year (ugh). I'll update this as I can
* After a day or so to make sure the bleeding has stopped (stops increasing in size, no lightheaded/dizzy feeling from blood loss), active recovery that doesn't cause undue pain seems to be a good thing. I had a hard time walking the next day, but compression helped. 2 days later, I was able to mt. bike. It took 6 days before I could run.

Recovery - 2 Weeks later
* After 2 weeks, this thing is much smaller but still present. It is a tough, moveable lump about the size of half a hard-boiled egg. Very light pain if I push it, but mostly painless.
* Compression, along with some drainage early (due to the doctor's incision), really helped it get smaller
* I really believe that active recovery made a huge difference. With compression, I was able to run after 6 days -- then I was able to run completely uninhibited. It really seemed to shrink after a week of running.
* I also swam a bit with a waterproof bandage after a week, in addition to riding a bike
* I went up to decent elevation (13,800 feet) without any noticeable effects

* I nicknamed mine "Happy"


  1. Mike - hope you're alright man. That looks pretty nasty. I'm taking it you came off your bike.

  2. @Nick:
    Thanks...Blame the rider, not the bike! Err, something like that.

    A doctor in Fruita tried, around 3AM Sat morning. It varied from a slow flow to occasional "gushes", but didn't fully drain.
    Apparently, surgical draining can do more damage (besides putting me in a hospital, again, something I try to avoid like the plague).
    On the plus side, not draining it all means I can recapture some of the iron and other usable bits of dead red blood cells. At least that's what I'm telling myself.

  3. Mike...we just learned about hematomas in my EMT class and my EMT instructor is always looking for photos to add to his slide show. How do you feel about sharing "Happy" with EMT students for years to come?