"National standard of care"

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Hey---guess what I have a 2 cm full-thickness tear in my left one of!

Answer: the only functional supraspinatus I have left in my body!

I may have mentioned a biking accident I had several months ago. At that time I requested my attending physician to order an MRI considering my previous bad luck with rotator cuffs and impromptu dismounting of a bicycle. The doc wrote the order, but muttered that the insurance company might not approve payment. That led me to postpone the order to avoid being hosed by my insurer. To abbreviate the story, I then went to a physical medicine guy who was very helpful but told me to call him if the pain didn't go away after a few courses of prednisone. It didn't, so I did. And the scan he reordered showed exactly what I felt: torn supra with some other mild collateral damage. Not like my disaster 4 years ago, but a surgery-grade impairment.

Naturally I expressed great irritation for having to wait for the MRI until retraction of the tissues began (fortunately no muscle retraction, unlike previously). The doctor, a nice gentleman who nevertheless felt defensive about my ire (which was actually aimed at my primary, not him), told me that a 3-month wait-and-see approach to this type of injury was the "national standard of care" before an expensive test was ordered. I asked him where this "national standard of care" was codified, and he told me "nowhere." He said it's something that doctors learn as part of their practice.

Yeah, I bet. But I wonder who teaches them.

When a 57-year-old man walks in and tells a doctor that he's flown over his handlebars and deflected the fall with one arm and fast thinking, I'd think the "national standard of care" would be to exercise some fucking professional discretion and carry out a complete diagnosis.

I think what we have now in this country is a "national standard of don't-care."

Two roads diverged near a wood, and I...

*...I fucking "augered in," as the top gun pilots say, about 90 minutes later. Augered in how, and to what? one may wonder. On my road bike is how, and into a goddam curb that was supposed to be a curb cut, according to my beautiful mind, is what. Happily, I made the most of the time dilation phenomenon, which is well known to all who have witnessed themselves heading toward an inevitable high-speed calamity. With the grace of an Ed Sullivan acrobat opening for Freddie and the Dreamers, I relinquished the handlebars and handsprung onto the concrete sidewalk, pulling off a maneuver, with my arms, something like what parachutists do when their feet meet the ground too fast for comfort. Strangely, I suffered no hand abrasions from the concrete sidewalk, or any other scrapes except one about a quarter-inch in diameter at the crotchward side of the left knee.

However, I spent the next several days in fairly intensive pain, greatly fearing I'd ripped up my only unsullied rotator cuff. Now, after a negative x-ray and some healing time, it looks like I get off the hook with a moderate-but-manageable shoulder sprain. And that, loyal reader, is why I've been offline for almost a week. It also partially accounts for the muddled portions of my previous post.

Anyway, I took the photo at the early cusp of the photographers' "golden hour" with a highly limited iPhone 3G camera. I do believe that I may get on the bike again on Sunday and try again... but not 76 miles this time.

Friday evening editor's note

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Hello. RubberCrutch has been away from his blogging equipment for a few weeks owing to various mundane causes including a busy, exciting lifestyle; a case of poison ivy; and a bout of fever that may have been caused by a German medical bulb thermometer that registers exactly 4 degrees Fahrenheit higher than ones' actual temperature. He will return to his post at his earliest possible convenience.

Incidentally, it makes lots of sense to learn how to recognize poisonous flora in your yard. Although RubberCrutch was nearly driven insane by a case of poison ivy (or oak or sumac) contracted in California almost 35 years ago to this very day, he still forgets what the stuff looks like. Don't be like RubberCrutch --- be sure to use your noodle every day. Thank you for your attention to this matter.

Son of Wise Sayings

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If you think you're 10 pounds overweight, then there's a high probability that you are actually 30 pounds overweight.

Wise sayings

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If you have only one handkerchief with you while doing a 3-mile run, be sure to wipe the sweat out of your eyes before you blow your nose.

Eternal truths

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John McCain offered to let his wife flash 500,000 bikers at Sturgis because he thinks she is a "cunt."

Eternal truths

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Orthopedic radiologists cannot find my acromioclavicular joint because I have a "muscular chest."