Tuesday, July 18, 2017

Severity of Carol's injuries went way beyond broken bones, raising issues of shock, blood loss, nerve damage, kidney damage, elevated pressures, and more

Comminuted fracture of Carol
Shuler's left arm
How severe were Carol's injuries from our September 2015 eviction, when Missouri deputies body slammed her butt-first to the ground and yanked so viciously on her limbs that her left arm was broken just above the elbow, requiring trauma surgery? What kind of issues can crop up from a comminuted fracture -- a bone broken into three or more fragments -- of the sort Carol had? Did this put Carol's overall health at risk? Did it even put her life in danger?

We recently received Carol's medical records from Cox Medical Center in Springfield, Missouri, where her fracture was diagnosed and treated, and she underwent 4-5 months of physical and occupational therapy. (Portions of the records are embedded at the end of this post.) Let's see what those records tell us:

A "shattered" bone

I've used the term "shattered" to describe Carol's injuries here, based on a layman's examination of X-rays. I had no idea if that term actually fit, from a medical sense. It turns out that it does. This is from Carol's Outpatient Rehabilitation Intake Form, dated 10/28/15, roughly seven weeks after the injury and six weeks after surgery:

Purpose of Therapy: Recovery from ortho trauma surgery on shattered left elbow/arm and dislocation on 9/16. Need better ROM (range of motion) and function of arm to normal.

Using the term "shattered" to describe Carol's injuries was not an exaggeration. Members of her medical team used the same term.

A need for oxygen

Carol has reported receiving oxygen twice during the evening on the day she was injured -- once at Cox North and once at Cox South. Notes on the rehab intake form show that she was given oxygen twice on 9/9/15.

Why was Carol given oxygen, twice? We don't know for sure, but the most likely reason is that medical personnel saw signs that she was in danger of going into shock -- and shock, often triggered by blood loss, can kill people if not treated in a timely fashion.

Carol was not bleeding in an external way, one that could be seen. But when I saw her in the hospital, the morning after her injury, her right arm was purple from bruising, from shoulder to finger tip. And that was the unbroken arm. I can only imagine how bad bruising was on the broken arm, which was in a fiberglass splint.

Bruising occurs when blood gets trapped beneath the surface of the skin. This probably is what triggered the need for oxygen in Carol's case -- and concerns about shock.

More about blood loss

As a layman, I had not thought much about blood loss in Carol's case -- either due to the injury or surgery. An Operative Report from her medical records shows she had 150 ml of blood loss. That might be a normal amount due to surgery, but blood loss can be an issue with fractures themselves.

From a Web site about a lawyer who specializes in personal-injury cases that often involve fractures:

Bone is living tissue with its own blood supply. The soft inside center of bone (bone marrow) is where the body makes its blood cells. Between 10-15 million red blood cells are made every second in the bone marrow.

A lot of blood is found inside our bones, especially the long bones in our arms and legs. There are many arteries inside our bones which deliver blood to our bones from the arterial circulation originating from the heart. . . .

Since our bones, especially the long bones in our arms and legs, have a rich blood supply, a broken bone injury can result in excessive bleeding. For example, a bone fracture of the thigh bone (femur) can result in 1-2 liters of blood loss. Substantial bleeding from a bone fracture often causes the victim of a bone fracture injury to go into shock. (Again, this points to the need for oxygen in Carol's case).

The high energy forces from car, truck and motorcycle accidents often cause broken bone injuries where the bone is shattered into many pieces. This type of bone fracture is called a “comminuted fracture.” Shattered bone fragments often have sharp and pointed edges which can tear nearby blood vessels. The most frequent areas where blood vessels are damaged from shattered bone fragments are in the arms and legs.

A comminuted fracture, the kind Carol had, often tears nearby blood vessels? No wonder her medical team was concerned about oxygen, shock, and issues related to blood loss.

A matter of nerve

Carol's Operative Report indicates surgeon Brian Buck performed an "in situ ulnar nerve release" as part of the repair. This indicates Carol's ulnar nerve was damaged, or compressed, near the elbow. From a medical-journal article on the subject:

Ulnar nerve entrapment at the elbow is the second most common compression neuropathy in the upper extremity following carpal tunnel syndrome . . .  with an estimated prevalence of 1% in the US population. . . .

Trauma and arthritis have both been implicated as causes for ulnar neuropathy. Nevertheless, the most frequent cause of cubital tunnel syndrome remains idiopathic. Multiple potential sites of compression exist along the path of the ulnar nerve.

Concerns about kidney damage

A Consultative Report by Dr. Brian Rekus indicates Carol had a number of elevated pressures -- blood pressure, thyroid, creatinine -- after surgery.  Rekus, an internist, was brought in to help manage those.

Elevated creatinine levels signify kidney disease or impaired kidney function. Carol's level was elevated at 1.53, and when checked a few days later, had decreased to 1.3.

The bottom line: Injuries that Missouri deputies inflicted upon Carol went way beyond the broken bones that look downright scary on an X-ray. It's really scary when you review her medical records and see that the severity of her injuries caused issues that, if not treated promptly and properly, could have put her overall health -- even her life -- at risk.

And yet, these same cops treat the matter so blithely that they created written narratives -- hinting that Carol broke her own arm by flailing about in the back seat of a patrol car -- that would have to improve to be absurd. This reflects the utter disregard and contempt too many cops have for the general public -- especially when everyday citizens become the victims of police brutality.

On top of that, cops generally have access to lawyers, who are more than happy to dump on abuse victims, trying to sell bogus law-enforcement stories that have little, or no, resemblance to the truth.

This post, along with the supporting documents below, shows just how badly Carol was injured -- and how easily her condition could have taken a turn in a dark direction. That cops would create written statements that they know are false shows how little they care about those they supposedly "serve and protect."


Anonymous said...

A classic example of police brutality putting your overall health at risk. Excellent reporting, LS.

Anonymous said...

This makes the cops lies about Carol breaking her own arm even more sickening.

Anonymous said...

Must admit I had not thought about the potential "side effects" of police brutality. This was an assault on Carol's entire being.

Anonymous said...

I've been following your blog for 5-6 years, and this is one of the most important posts you've ever written. It's filled with important health information and illustrates the impact a traumatic event can have on overall health. Hope this gets widespread attention. Lots of information the public needs to know.

Anonymous said...

Make the bastards pay!

Anonymous said...

I'm sure the guy I call "Anonymous Sassy Shithead" (ASS) will be writing in to tell us what actually happened and what all of this really means. BTW, "ASS" and "LAWYER" are synonyms

legalschnauzer said...

@8:54 --

ASS. I like it, and it fits.

Anonymous said...

I had never heard of creatinine. Thought readers might be interested in this article. Must be pretty important stuff for kidney function:


Anonymous said...

Can't help but think about the woman who was shot and killed by a cop in Minnesota over the weekend. She called cops over concern about thugs possibly having a fight/assault in the alley behind her home. Then, the cops arrive and shoot HER! Still can't believe it.

She would have been safer dealing with street thugs than with the cop thugs.

legalschnauzer said...

@9:03 --

I've never had an encounter with a street thug. But Carol and I both have been beaten up by cop thugs, both times in and around our own homes.

I would take my chances with a street thug any day over a cop thug.

Anonymous said...

Reading this makes my blood boil. Some of these "thops" (a thug and a cop) deserve to go to prison.

legalschnauzer said...

Crimes were committed here, no doubt, both state and federal. So you aren't exaggerating when you say people should go to prison. You are right on target.

Anonymous said...

You must be a man of restraint, Schnauzer. If cops had done that to my wife, a couple of them would be 12 feet under right now.

legalschnauzer said...

@9:49 --

I understand your feelings, for sure. Shooting cops, of course, comes with certain unpleasant repercussions, so I don't recommend it.

Bev said...

I love you two for your bravery and truth-telling. I am so sorry for such trauma you endured.

Another real risk of shattered bone is that numerous blood clots internally created can travel through blood vessels resulting in deadly or severe attacks on the lungs, heart and brain, risking heart attacks and stroke or mini-strokes. So, it could have been life threatening as you suggest.

I think it was Rodney King's beating and trial that caused to be opened all the psychological/counseling material in L.A.'s police files for the court and jury to consider. About 40% of police then were beating up their own families, so citizens/strangers had a 60% vs. 40% chance of things being reasonable. With the political parties indifference to justice, I wonder what that percentage is now.

Thank you for all you do for truth and justice.

legalschnauzer said...

Bev --

Thanks for your kind and insightful words. The notion of thug cops beating up on their own families is certainly interesting. I'm convinced there is something wrong with the cop who broke Carol's arm. I think most semi-healthy people recognize when they are in a position to hurt someone, and they try not to do it. In Carol's case, a normal person should have seen she was sitting on her fanny, directly on the ground, after a cop slammed her there. A normal person would have known, "that woman is in an awkward/vulnerable position, so we need to be careful." On top of that, a normal cop would have known Carol had committed no crime, and she was not a threat to anyone, so there was no reason to handcuff her.

A semi-thoughtful cop/person, if he felt the need to place Carol in handcuffs, could have bent down or even sat on the ground beside her to put the cuffs in place. Instead, this clown stood over her and bent down to grab her just above the elbow and yank on her arms. That is what broke her left arm and caused severe bruising up and down her right arm.

Not only was he brutal, vicious, and hateful, he also was lazy. It was too much effort to get into proper position to place the cuffs, so he yanked on Carol's arms and broke one of them. Still makes me sick to think of it. This was a very difficult post to write, to go through the medical records and see how my wife was put at risk of major damage.

Also, it makes me sick to think that the SOB landlord and his lawyer (not to mention my own brother, David Shuler) caused these thugs to be on the property when they had no lawful grounds to be there. We were lawfully occupying that apartment, and the law is very clear on that.

legalschnauzer said...

Hey Bev... This is Carol, Roger's wife. Thank you so much for your kind & insightful comment. It is interesting that you mention the risk of blood clots with such a fracture. I can verify that the doctors & nurses who cared for me at Cox Medical Center, both initially & for my trauma surgery stay, were very concerned about potential blood clots. They were very attentive to that in regards to my care. I did not question them as to why they had such concerns, but your comment explains why they were monitoring & treating me for possible blood clots. Thank you.

Bev said...

Hi Carol. Hi Roger. So good to hear from you.

I should have added to my comment about that 60% chance of having a reasonable outcome with a police officer, which would be based on a random person's chances in L.A. those years ago.

Once prejudice or political targeting is afoot, it becomes kafkaesque. I did not want to understate what you have had to endure which is nightmarish. You all are my heroes.