Accident at unnamed Oregon mixed crag

Making a thread to detail my accident this weekend. Hopefully nobody pilfers the 6-7 draws we left on route. If you find them before I come back - thats why they are hanging there. The Crag will remain unnamed for sensitivity to it's FAs who wish it to remain off of mountainproject. I will remain anonymous since I am deeply embarrassed and ashamed that I allowed this accident to happen. If you figure out who I am, I ask that you please respect my wish for anonymity.

So here it goes - I made my way to this crag on Saturday to get some mixed mileage out of the way, and to have some fun drytooling. Some quick background - I am a climber who aims to be all around strong. I've had a great season and have achieved many of my goals, such as being comfortable onsighting 5.11 on gear - knocking out classic alpine rock routes - and generally climbing most days. I have been climbing for 8 years. So this was just another day out and about. I jumped into my partner's car and started our commute. Thirty minutes into the drive I remember that I forgot my helmet (I'm sure you know where this is going) but then waive it off and decide to climb without. We arrive at the crag, hike in, and warm up on two routes to get the blood warm - M3 and M4. I am feeling good after these two warmups and choose to lead one more warmup before we start punting off of the hard stuff. This one is perhaps M5. 

I start off the lead and cruise the technical climbing quickly. I'm feeling great. After dispatching the last of the technical stuff, I head up the remainder of the route - which is significantly more low angle. I clip a draw (green kong), pull a bulge, and establish myself on a chossy/mossy/muddy slab. I feel comfortable despite the relative instability of everything around me and have a great right tool hook. I dig around the mud and moss looking for something good and fail to find anything worthwhile. I then see a better hook on a flake higher up and move to secure it. It seats well, and I feel good about it. Right as I move up on the tool, however, it pops (the flake either broke or shifted) and my right tool pops in succession as I am choked up on it. I feel myself losing my balance and as my front points start to pop - the realization is clear. I am going to fall. My right crampon catches the rope, I start to invert, and this is the last thing that I remember. 

I come to - I am hanging upside down and staring at a ledge below me. The ledge is splattered with blood and I dumbly stare. It dawns on me that this blood must be mine. I feel as if I am in a dream. I feebly try to move my body or open my mouth and say something, but I fail to do anything. I feel my partner lower me to the ground and I am deeply confused. I can't remember where I am, why I have crampons on, but I know that I am not in a good spot. After a few minutes of repetitive statements and questions, it all starts slowly coming back to me. I focus on the details of the day and the route to make certain that my condition isn't dire. My body hurts, my leg is injured, my head is bleeding, but I am ambulatory and we decide to get down before my condition deteriorates. We hike back to the car and I have since been laying in the back of my truck back in town - dealing with concussion symptoms and playing the accident on repeat in my head. I chose not to go to the hospital since I don't have health insurance and my head injury is not deteriorating. Miraculously, none of my limbs are broken or punctured. My brain seems to still work in despite of the symptoms/damage.

The facts:

- I fell roughly 20 feet down sharp, low angle terrain, and bounced off of at least one ledge

- I hit my head at some point in the fall and lost consciousness

My observations:

- I was too relaxed on easy, low angle terrain and rushed a placement that I should have hammered and then tested with a tug

- I didn't have my right tool in a place that would arrest a popped tool effectively while moving up onto the new placement.

- This route was likely put up in Winter and I should have waited until the crag was frozen up before heading out there. That way, I would have had easy and straightforward frozen moss/mud to swing into. I made a mistake by showing up when it wasn't frozen over.

What I learned:

- If you forgot your helmet for a day of drytooling, turn around and go get it - no exception.

- It doesn't matter how strong you are if you lose your balance

- I should get health insurance

Overall, I feel deeply grateful that I (somehow) didn't end up with more serious trauma. It makes me anxious to think of how that fall could have went differently. I am thankful that I was able to spend one of my nine lives and walk away. This is a dent to my ego, and is overall a strong lesson learned. I feel shame that I let this happen. Please don't snag my draws - I'll be back soon to collect them. 

Ehh still might want to get checked out by a doc. If you feel your condition start to deteriorate, worsening/sudden headache, mood changes such as irritability, loss of balance, fuck the risk of bankruptcy and get your head imaged.

PS: I’m psyched you’re somewhat okay!

Kip Kasperwrote:

Ehh still might want to get checked out by a doc. If you feel your condition start to deteriorate, worsening/sudden headache, mood changes such as irritability, loss of balance, fuck the risk of bankruptcy and get your head imaged.

PS: I’m psyched you’re somewhat okay!

This.  You don’t want to mess around with a possible tbi. You might feel more or less fine now, but can still have a tbi. I know two people who had very similar head injuries to yours (in one case the injury was less severe) who’s lives were significantly impacted by not realizing how severe their brain injuries were in the days and weeks after the accident.  You should go to the hospital and tread super carefully for the next few months.  (Ie don’t do anything that can jostle your head: bouldering, whippers, skiing, mountain biking, etc) 

You are lying in your truck after this happened? To save money? Go to the hospital. People who know him, get his ass to the hospital. 

Go to the hospital. Period. 

Brain injuries are no joke. A few thousand dollars vs Your Life. 

Tradibanned wrote:

Slow your roll people. The hospital is going to cost him a fortune. Dritbaggy, do you have any tbi symptoms? 

Loss of consciousness, altered levels of consciousness, disorientation/confusion and headache are all symptoms of a traumatic brain injury. So yes, Dirtbaggy experienced serious TBI symptoms and should absolutely seek medical care. Brain injury is a serious medical condition and can evolve after the initial injury. It is not a joke and is not something to be taken lightly.

Tradibanned wrote:

Slow your roll people. The hospital is going to cost him a fortune. Dritbaggy, do you have any tbi symptoms? 

Did you even read the post?  He knocked himself out and was confused about where he was.  Those are textbook TBI symptoms.  Here's the result of a quick google search, which I'm sure even you are capable of:

https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

Your constant trolling is frustrating enough when you're not trolling a thread where somebody could be in need of serious medical attention; this is beyond ridiculous.  Go find something better to do.

Adrienne Voughtwrote:

Loss of consciousness, altered levels of consciousness, disorientation/confusion and headache are all symptoms of a traumatic brain injury. So yes, Dirtbaggy experienced serious TBI symptoms and should absolutely seek medical care. Brain injury is a serious medical condition and can evolve after the initial injury. It is not a joke and is not something to be taken lightly.

Kyle Tarry wrote:

Did you even read the post?  He knocked himself out and was confused about where he was.  Those are textbook TBI symptoms.  Here's the result of a quick google search, which I'm sure even you are capable of:

https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

Your constant trolling is frustrating enough when you're not trolling a thread where somebody could be in need of serious medical attention; this is beyond ridiculous.  Good find something better to do.

Let the man speak for himself. He does not yet seem to have any symptoms that would require a hospital visit. I'm just trying to save him thousands of dollars in bills if he doesn't need them.

Just out of curiosity, exactly what do you guys think an ER is going to do that has more than a microscopic chance of helping the OP?

OTOH, it sounds to me like he needs a friend who can put him up for a bit, (some place other than the back of a truck,) keep an eye on him, and make sure he does get treatment if he develops a post-concussive syndrome. Or get him to the hospital in the unlikely event he decompensates acutely.

Finally, hitting his head again anytime soon could be a really bad idea.

Mark E Dixonwrote:

Just out of curiosity, exactly what do you guys think an ER is going to do that has more than a microscopic chance of helping the OP?

OTOH, it sounds to me like he needs a friend who can put him up for a bit, (some place other than the back of a truck,) keep an eye on him, and make sure he does get treatment if he develops a post-concussive syndrome. Or get him to the hospital in the unlikely event he decompensates acutely.

Finally, hitting his head again anytime soon could be a really bad idea.

To assume that the OP’s head injury is “simply a concussion” is a very dangerous assumption. Without a CT Scan the extent of their head injuries are unknown.

Based on the description of their accident, symptoms and the fact they state they continue to deal with “concussive symptoms” it’s possible they have bleeding in their brain, it’s possible they have a skull fracture. A brain bleed is a serious condition that can evolve after the initial injury with serious complications and consequences.

There is an IMMENSE amount that an ED, hospital or urgent care could do to help the OP. Definitive diagnosis of injuries, prevention of complications, care of the OPs initial trauma injuries and medical monitoring are just a few possibilities.

Yes it is also possible it is a concussion and they get a CT scan and are okay. But in my professional medical opinion that’s a gamble and assumption considering the description of the injury and symptoms.

There is a very small chance that a CT in the ER will show anything that warrants intervention, given the OPs description of his symptoms.

That chance isn't zero and it is up to him to decide whether it is a good use of his financial resources.

He may very well be better off saving the thousands of dollars and using it for neuropsychiatric therapy if it comes to that.

Unfortunately there isn't a good, low cost way for him to make an informed decision unless he is lucky enough to have a friend with the appropriate medical experience.

@Adrienne- a big ER bill isn't going to mean the same thing to you that it might to the OP. 

It's an unfortunate fact of our medical system that many us, including some of us with reasonable wealth, need to make this kind of cost/benefit calculation.

Edited to add (since I'll be locked out of this thread any second)-

if the OP can manage to see a PCP he might be able to get an order for a head CT or any other desired images. 

In which case he should have a friend call around to local hospitals and imaging centers and get the best price.

This can save hundreds, even thousands, of dollars.

Again, all of this assumes that the OP is as stable as he describes and is not, in fact, fighting for his life in the back of the truck.

Tradibanwrote:

Let the man speak for himself. He does not yet seem to have any symptoms that would require a hospital visit. I'm just trying to save him thousands of dollars in bills if he doesn't need them.

Unless you are a doctor, shut up. You also have no idea how the Oregon health care system for the uninsured works. You are spewing nonsense that might hurt someone. 

Mark E Dixonwrote:

There is a very small chance that a CT in the ER will show anything that warrants intervention, given the OPs description of his symptoms.

That chance isn't zero and it is up to him to decide whether it is a good use of his financial resources.

He may very well be better off saving the thousands of dollars and using it for neuropsychiatric therapy if it comes to that.

Unfortunately there isn't a good, low cost way for him to make an informed decision unless he is lucky enough to have a friend with the appropriate medical experience.

@Adrienne- a big ER bill isn't going to mean the same thing to you that it might to the OP. 

It's an unfortunate fact of our medical system that many us, including some of us with reasonable wealth, need to make this kind of cost/benefit calculation.

Edited to add (since I'll be locked out of this thread any second)-

if the OP can manage to see a PCP he might be able to get an order for a head CT or any other desired images. 

In which case he should have a friend call around to local hospitals and imaging centers and get the best price.

This can save hundreds, even thousands, of dollars.

Again, all of this assumes that the OP is as stable as he describes and is not, in fact, fighting for his life in the back of the truck.

Mark, what literature/science are you basing this statement on? That there is a “very small chance” they would warrant intervention?

(Respectfully, you have no idea what an ER bill would mean to me or what my finances are.)

And I agree with you, the prohibitive cost of our health care system today is obscene. The fact that the OP has to even consider money over health is wildly unfair. I see patient’s that suffer debilitating consequences because they delay seeking care due to finances. Please do not assume that I am not highly empathetic and understanding of that situation. It is awful.

I would also add that laying down suffering from “concussive symptoms” does not necessarily indicate a stable condition.

I am now at a friend's house and in a dark room - I plan to be here for the next few days. I am very grateful for that. I have slept ~30 of the last 48 hours. Staying away from light and sound is helpful. My symptoms are synonymous with a hangover when at their worst. If my symptoms get worse with time I will go to a medical facility. Thankfully, I am feeling better than I did during day one - I appreciate the concern from the community. I will be doing my best to stay away from screens, I apologize if I miss your reply.

bryanswrote:

Unless you are a doctor, shut up. You also have no idea how the Oregon health care system for the uninsured works. You are spewing nonsense that might hurt someone. 

I don't think the doctors know how the Oregon healthcare system for the uninsured works either, maybe you can enlighten us?

Is the OP a resident?

Dirtbaggy thanks for the write up... My climbing partners have been riding me to get a helmet and this is going to speed up my purchase for sure. Head injuries are hard, if you know who Tommy Rivs is you can see someone who treated a severe concussion on his own and months later was having mood swings and memory loss issues still. Be careful for the next month at least. If you have to go to the hospital start a GoFundMe. I am not made of money but I would help out. Our healthcare system sucks.

I am not a doctor, but I am one of the TBIs Max Tepfer mentioned (skull fracture, concussion, deafness, all that fun stuff) and I know quite a bit about our local healthcare system.

First advice - if you are an Oregon resident and are currently uninsured due to income, get on Oregon Health Plan immediately. Oregon has a generous and pretty well-run Medicaid system. No copays or coinsurance for ED visits, and a strong likelihood of retroactive coverage for any bills incurred during the enrollment process. If you are not a resident, check your state's Medicaid rules. The ACA expanded eligibility and coverage in most states.

Second advice - glad you're with a friend, because at the very, very least try not to be alone for a while. The near-term complications that can either kill you or make things much worse are edema, hemorrhage, and stroke. The symptoms for those things can come on fast, be rapidly debilitating (e.g. you may not be able to call yourself an ambulance, let alone drive yourself somewhere), and time is of the essence for treating them. While it's true that most TBIs (and, to be clear, you absolutely DO have a TBI, regardless of severity) won't be treated in the ED, if you happen to be one of of the unlucky few, having an early warning is critical if they are going to have to, say, cut out a piece of your skull to relieve pressure on your brain tissue. If you really don't want to go to the ED, call your PCP's office asap and have them refer you for imaging. Feel free to request they send you to a more affordable option (basically anywhere outside of the local hospital system). 

Once you're past the potentially fatal complications window (the next few days-ish, I believe), your medium- and long-term issues, if any, will probably be an unpredictable crapshoot. The joys of head injuries. You may well need treatment of some kind, but there shouldn't be as much urgency.

Third advice - to echo everyone above, do everything you can to avoid bumping or jostling your brainbox again for the next few months. Head injuries compound.

Feel free to reach out to me directly if you like, I'm happy to help if I can.

...my first-ever MP forum post and it's about brain injury. Womp womp.

@ Ashley- excellent advice. 

OP should look into Medicaid if he/she qualifies. 

He should take up your generous offer and DM you today.

@ Adrienne- 

I apologize if I overestimated your financial resources. 

I assumed, perhaps unfairly, that a medical professional would be more flush than "Dirtbaggy" lying injured in the back of his truck.

Here's one meta-analysis- unfortunately I don't have access to the paper so it may be total shite. 

But is in line with several others I googled just now. 

I'd consider 1% a pretty small chance. 

Obviously the percentage of scans warranting intervention will vary with patient population, so there's likely to be variation among studies.

Here's the Abstract-

Tradibanwrote:

I don't think the doctors know how the Oregon healthcare system for the uninsured works either, maybe you can enlighten us?

Is the OP a resident?

Quit trolling on a thread where a guy is asking for medical advice after knocking himself out. This isn't about your enlightenment or your entertainment and I don't see a hint that you care about this guy, you're just bored and running your mouth. But I repeat myself. And I don't even know you. 

ED doc here. I'm glad OP is alive and recovering. It's hard to start diagnosing without seeing someone (let alone not having a CT scan)...and not that I think with utmost confidence that this is what medically happened. But closed head injuries can cause concussions (no CT findings), TBI but also brain bleeds (epidural hematoma) where someone is first fine and then not. I don't want to fear monger or imply anything but just wanted to provide more medical context to the situation.

bryanswrote:

Quit trolling on a thread where a guy is asking for medical advice after knocking himself out. This isn't about your enlightenment or your entertainment and I don't see a hint that you care about this guy, you're just bored and running your mouth. But I repeat myself. And I don't even know you. 

I care. Do you? I have met many young people devastated by medical bills, if you are uninsured it is important to weigh your options. It's easy to say "go to the hospital" because you don't have to deal with the consequences but this young man does. All I'm saying is to slow down for a moment and assess the realities of the situation. Mark E Dixon has made some fine posts already in that regard. 

The sky isn't necessarily falling. 

Good luck amigo! (not you bryans, the OP)