I have few recollections of what occurred at the time of the crash, and recall little of the days immediately following it. What follows then is the best I can do describing my crash of April 14th, 2024, and lengthy (ongoing) recovery. I plan to return to this post from time to time to provide monthly recovery updates, as that piece is still a work-in-progress.
Navigate the Post
- The Accident & Injuries
- The Impacts
- August Update
- September Update
- October Update
- November Update
- Thoughts on ICBC’s Enhanced Care Model
Note: I would have preferred to write this some time ago, but I could only type well enough as of August 6th (when I published the first part of this), barely, to do so. If nothing else, the typing and the thinking have both been excellent therapy.
The Accident
I went out for a bit of a joyride on the afternoon of Sunday, April 14th. I usually head out for an hour or two and do 30-60km on these types of rides. Beyond that it was a pretty unremarkable day – clear and cool for spring in Vancouver.
Just past Boundary Road, I was heading east on Rumble Street in southwest Burnaby, crossing Joffre, when a car turned left across my path, slamming into me at what seemed like it must have been 40-50 km/hr. In my reading of the surgery notes from hospital, they estimated the car was going about 50km/hr from the force of the impact. Regardless, it was fast enough to throw me into the windshield of the car, and up over the roof of the vehicle according to the police report. I landed on the pavement about 10-15 feet behind it. I remember the other vehicle coming to a stop diagonally, sort of pointing away from me.
The only thing I can recall from the impact is the driver exclaiming repeatedly that he never saw me – on an absolutely clear day with excellent visibility. And before anyone assumes anything, I was wearing a white helmet, dressed in a very visible bright red cycling jersey. Apparently I never fully lost consciousness, but absolutely everything from that moment until days later in Royal Columbian Hospital is a blur. I know I was awake at times, but I wouldn’t really say I was “conscious” until several days after the crash.
Somehow, I managed to provide my wife’s cell number to a bystander, who called, and followed that up with a text message when she couldn’t reach my wife. In a strange turn of events, the bystander also provided contact info for the driver. Thinking he was a witness, my wife sent him a text asking what he saw, to which he responded that he was actually the driver who hit me. Given BC’s no-fault driver insurance, this hardly matters, as he’ll likely suffer not so much as a reprimand for his careless driving.
I spent three weeks in Royal Columbian Hospital, before being transferred for another five, to GF Strong, a rehab hospital that specializes in Spinal Cord and Traumatic Brain Injuries (more on that shortly). In total I spent eight weeks in hospital.
My wife visited me at both hospitals every day and the kids as much as their schedules would allow. What I’m about to describe in The Injuries section below gave them all a good scare, and in some ways, particularly the first days were probably as hard, if not worse, for them than they were for me. I wasn’t exactly cognizant of much going on.
The Injuries
Note: This section has obviously had significant contributions from my wife, since I have zero recollection of anything from surgery, ICU or the first week in hospital.
You’ll have to bear with me through this section. My injury list was serious and extensive. I’m also going to try to describe things below in roughly the order they happened.
Stop the Bleeding
When I arrived at Royal Columbian Emergency I had a lot of internal and external bleeding. The most obvious injuries were a massive gash just below my left elbow and additional gashes at my outer left knee and on my outer left thigh. I have scars from all of them, but the real souvenir is about five inches long, extending down my left forearm from my elbow. However, it was all the internal damage that would come to dominate everything that followed.
Non-responsive
Once they finished stitching up my wounds, apparently I had become non-responsive. This was when they suspected I’d had one or more strokes. Neurology became involved at this point and, while not even my wife knew at the time, they must have done some imaging, as these pictures were referred to during an ophthalmology follow-up I had on August 2.
Catheter Embolism
Once they stitched up my external damage, they needed to do something called a catheter embolism. In spite of its scary sounding name, Google says it’s a “minimally invasive” procedure to stop bleeding.
Carotid Artery Stent
After the embolism, the neurologist’s recommendation was to put a stent in my right Carotid artery (which was apparently in much worse shape than my left). The reasoning was two-fold. Not only would it ensure enough blood and oxygen would get to my brain, but the chances of blood clots would be reduced. They were openly wondering whether my brain would get enough oxygen to prevent me suffering permanent damage. I guess it did, though my wife has probably always suspected my brain is a little oxygen-deficient. At one point in those first days they were planning to stent the other Carotid, but at the time, felt I wasn’t stable enough.
Bowels, Spleen and Diaphragm
Which came first, the bowels or the spleen? Actually, I’m only half kidding. I returned to general surgery with my bowels and in my chest cavity and my spleen an unsalvageable mess. Yes, you read that right – in my chest cavity. The force of the accident had jammed my bowels up into a place they weren’t supposed to be, and my spleen was too badly damaged to be saved. The surgeon originally thought they may have to take out sections of my bowels, but apparently found them to be in one piece, more or less, and repairable.
My diaphragm was also in the wrong place and needed repair. The surgeon was hoping it could be “coaxed” back down to where it belonged, but ultimately it required manual intervention.
Multiple Fractured Ribs
I have no idea how many exactly, but I broke several ribs and, honestly, they ended up the least of my concerns. During my recuperation, I really didn’t sneeze or cough much and aside from some slight stiffness I barely noticed them. If only everything could have been that easy.
The Impacts
Strokes
By far the strokes (yes, I had more than one) have had the largest impact on my life. They have affected my cognitive skills, memory, reading, writing, typing, vision, and my right hand. Somewhat miraculously, I suffered no lower body injuries, save for the gashes, but the strokes made my right hand uncoordinated and slow. This necessitated a couple months of extensive hand therapy. It could best be described as a near-useless appendage upon my release from hospital, but has thankfully shown remarkable improvement, to the point where I’ve regained probably 95% (as of December 1st) of pre-crash functioning, perhaps a little less where drumming is concerned.
Memory and cognition is, and shall remain for some time, a work-in-progress. When first released from hospital, I constantly forgot where I put things and misremembered details of almost everything. I couldn’t really read or even just parse the hands on a clock face very well, and I became confused easily. I’m happy to say this has improved significantly as well. I am, however, a long way from being fully recovered cognitively. The complex planning I used to do without so much as a thought isn’t ready for a return to work. In fact, while UX design and user testing used to form the bulk of my job, as a Scrum Master with UX responsibilities, planning now constitutes the majority of my work. If I had to put a percentage on my return to pre-crash cognitive skills, I’d say I’m at perhaps 60-70%.
Back in the early days of Royal Columbian, my wife says I was limited to one-word responses and most often stared off into space, so there’s clearly been lots of improvement on that front, too. I also had problems with things like labelling, categorization and word finding, often stumbling for terms that came easily to me before the crash. I had a speech therapy assessment in two sessions, on July 12th and 19th, and began 13 sessions on September 3rd.
So, while the cognitive domain is a bit of a mixed bag, in truth to look at me physically, you wouldn’t know I’ve had “polytrauma.” My speech therapist has been working with me to improve executive functioning and things like complex and abstract planning; exactly what I need now. As of December 1st, I’m near the end of the first block of sessions (with a reassessment and new block of sessions coming, and very impressed with her approach. I expect to have another three months of cognitive therapy approved and we’ll be switching gears in the new year to more real-world return-to-work prep exercises. This should take me to the end of February, when I expect to begin actual graduated return-to-work planning, and be done with all therapies.
As a result of losing my spleen, the other major impact on me is becoming immunocompromised. I’ve had five new vaccines as a result, with two of them requiring two doses at least two months apart, then either being finished completely or requiring boosters every five years. And, while we have always taken our COVID and flu vaccines enthusiastically, missing them now isn’t remotely an option. Thankfully, beyond that, and ensuring I do my best to avoid infections, I can proceed with my life fairly normally. I find myself constantly wondering what my risk of developing an infection in any given situation, but sadly this isn’t a situation where rigid percentages can be applied. Thankfully most of the immune system functions provided by the spleen are handled by other organs, notably the liver and kidneys.
Reticent Right Hand
I can’t really separate the right hand functioning from the stroke, as they go hand-in-hand (pun intended). This has largely been a slow, steady climb to regaining as much function as I can. It’s gone very well, but seemingly like everything, progress has been measured in weeks and months, and not days. As of December 1st, I’m 7.5 months past the crash and only now are the drumming, printing and typing all close to normal again, but given their dependency on fine motor skills, still not 100%. Daily tasks and general right hand use, though, is largely indistinguishable from before the crash. When it comes to returning to work, obviously I can’t separate the cognitive skills from the motor skills, and the former has a ways to go before I’d be comfortable doing so.
Visual fatigue, Light Sensitivity and Brain Fog
I lump all these together because they are inseparable in my mind. The biggest issue by far is the fog, which can most accurately be described as a very mild hangover, minus the headache. I’m also sensitive to bright sunlight and the white glare of overcast days. Finally, I have generalized visual fatigue, where I easily tire mentally and visually. It’s steadily improving, as I couldn’t tolerate more than 30-60 minutes of screen time at a stretch when I came home from GF Strong, and now I’m up to about three hours. The real test, I expect, will be to combine more cognitively taxing exercises with extended screen time and seeing how it goes. All I can say is, stay tuned.
The other thing that the fog and fatigue also triggers are vestibular symptoms. Steady improvement on that front is offset by the fact that returning to running is a slow proposition. I’ve managed 10k at a 5:10 pace so far, and have been as fast as a 4:54 pace on shorter efforts of up to 8k. I tire more easily now on efforts that barely broke me a sweat before the crash, but am seeing light at the end of the tunnel, with less fatigue all the time. The cycling is improving a bit faster than the running, which, like the right hand and cognitive functioning, are both also measured in weeks and months as opposed to days. I’m doing both e.bike and trainer rides right now and managing substantial trainer sessions at continually increasing power outputs. I hesitate to say I’m fully recovered physically, but I’m very close, and doing most physical things almost as well as I did before the crash. The most noticeable difference is that I need to do everything with far more intention and attention now. Whether it’s where I place my foot plant and watching for tripping / ankle-turning hazards when running, or slowing down and double / triple checking at corners when I’m riding, I take far more care with everything. And, frankly, being more intentional isn’t remotely a bad thing.
Tubes and (more) Scars
It’s probably worth mentioning at this point that I was also intubated for breathing, had a PICC line so the multiple needles I got were easier to handle, had chest and stomach tubes to drain blood, had a feeding tube to get calories into me (I dropped about 30lbs at my skinniest point), and even had a catheter for, well, you know …
In addition to the scars I’ve already mentioned, I’ve got about a foot long beauty running the length of my abdomen, another that meets that one, perpendicular to it and a little 2″ one on my ribs, under my arm. Apparently diaphragm, bowel and splenectomy surgery is hard to do neatly. The thing about big cuts and organ removal is that they can cause some mild loss of sensation. There’s a good chance it will return, but a very small area in my left pectoral and under my arm has experienced this.
I think I actually count five scars on my torso …
I guess the photo above isn’t as bad as it could be, anyway.
August Update
No More Hand Therapy
This change had been coming for a while, as I was plateauing with the therapy while the hand continued to progress slowly. Really, if you’re doing all the assigned exercises and still seeing improvement, there isn’t a lot more the therapist can do. Beyond working a little on the continuing stiffness/osteoarthritis I’m developing, using the hand continually for nearly everything (as I do) is really the best therapy. I thank my lucky stars I’m a drummer because I’m convinced that nothing is better hand therapy. I continue to see improved function, fine and gross motor skills, with typing and printing also continuing to see slow, steady improvement. As always, my goal remains to get as close to where I was before the crash as possible.
Running and Cycling Good for Recovery
There’s a litany of data supporting the benefits of cardiovascular exercise on recovering from an acquired/traumatic brain injury. People recover faster and show more improvement in their cognitive functioning overall. It’s very slow, but my vestibular symptoms also seem to be lessening just a little bit. I still experience the brain “fog” but the dizziness and balance issues I experience are a tiny bit less intense than when I came home from GF Strong.
I’ve also decided to do my best to do either a run, e-bike or trainer ride most days. I’m obviously not training for anything now, but I figure the only way I can reduce my vestibular symptoms as fast as possible is to continually desensitize myself by triggering them. It’s what all vestibular physio is based on, and running is a particularly big trigger. I usually have to stop occasionally while running, so working toward longer periods of continuous running is also a goal. As I said I can do a few km without stopping much, at roughly a 5:30/km pace. This weekend (October 13th) I hope to finally crack the 10k mark, now that my pace is getting a bit better.
As I said, my trainer rides are currently clocking in around 60-75 minutes, max. I’m not worried about power output or distance at all, just moderate intervals. It always slips my mind just how far I’ve come in the nearly six months since the crash, and that I need to be patient. When I first came home from GF Strong I had to pause and rest just going up the stairs and now I’m doing decent rides and runs. So, with both, I’m focusing on increasing duration very incrementally for some time, and only then very gradually increasing the intensity.
Long-term Disability Approved
By far the best news in September was that my LTD claim was approved when we had our Manulife phone interview. In general, the entire Manulife LTD application process was pretty painless. I’m not sure at this point whether there’s a return to work in my future or not, but the focus is always to get back to a place where I could return to my job. That’s also been my approach with therapy since day 1. Regardless of what ends up happening, I want to get as close to my old self as possible. Right now, I’m still dealing with significant cognitive deficits in things like complex planning, reading retention and recall, and memory, and while a little less directly related to work, some of my remaining vestibular triggers, light sensitivity and visual fatigue would absolutely kill my ability to work more than about 90 minutes at a stretch. It’s not as bad as when I was first released from hospital, but I still get very frustrated trying to do some things that came easily to me before the crash, and my attention to detail and recall is, frankly, still shitty. My typing speed is also a fraction of what it was in the “before times” and far more mistake-prone. One thing I have already decided is that, given my immunocompromised status, any return to work will be 100% remote or it’s not happening. My employer has accommodated other immunocompromised people so I don’t think this should be a showstopper.
Fitness – August 2024
If nothing else, I’m not going to regress in my recovery because I didn’t put in the effort. The list below also doesn’t include my therapies or homework, which probably averages about an an hour a day now. When I first began my hand and vestibular physiotherapy, it was common for me to spend three to five hours a day.
- Run: 33km
- Walk: 50km
- Cycling (trainer & e-bike): 178km
- Weights: 4.5 hrs
- Yoga: 4.5 hrs
- Drums: 9 hrs
September Update
This month’s update is pretty short. Just two or three things and my fitness stats. I expect October will bring a fair bit more news, as I wait on resolution to a couple things.
Victoria
For the first time since my crash, we got back to Victoria from September 17-20. It wasn’t quite the same without craft beer or whisky, but it was still very enjoyable. Sadly, Connie was nursing a calf/outer knee strain, so we couldn’t do the walking we typically love to do while there. I did have my fastest short run, at the time, since the crash while there (4.5k @ 5:15/km) so that’s something I guess. I’ve since done 8k @ 5:06/km.
Weights
Early in the month I decided I didn’t really like going to the weight room to do my strength workouts with me missing my spleen and all, and given my need to keep building strength, I asked my OT if it would be possible to get some weights for home. Much to my surprise, it was approved by ICBC and I feel much more comfortable not exposing myself to the viral stew at the gym. This will be particularly beneficial with flu season coming soon and COVID already seeing significant community spread.
New Bike Choices
I finally got my bike money from ICBC in August and I’ve just begun shopping for a replacement steed since mid-September. I’m taking my time, not only because I hope to snag an end-of-season bargain on a 2024 model, but also because I want to be sure I won’t switch to more transport and city biking. If I don’t feel I need a road machine any longer it’ll reduce my cost by half or more. I think I’ll ultimately still want to do group road rides, but it’s best to be sure and not regret my purchase immediately after making it.
Fitness – September 2024
This month, I tried to get a little more regimented with my fitness and saw pretty significant increases in time/distance across the board. While I’m not beating myself up for missing workouts, I also need to do my best to stick to a schedule and it paid off in September. I set modest time or distance goals for all major activity types a week ago to see how well I could do in the coming weeks and months.
Running continues to be the most challenging to return to, and still a significant vestibular symptom trigger. I continue to see improvement in my strength, coordination and general right hand functioning. Typing and writing are still slow, but improving. Drumming is surprisingly improving the most, buit closer to nearing a plateau, I think. I walked a lot in Victoria, so that’s more a blip than actual progress, but walking a lot is thankfully not an issue. Cycling on the trainer is seeing glimpses of power returning, but progress is also very slow.
- Running: 55 km
- Walking: 92 km
- Cycling (trainer & e-bike): 233 km
- Weights: 6.75 hrs
- Yoga: 6.2 hrs
- Drums: 7.5hrs
Notes
- I haven’t mentioned it so far, but one thing I have struggled with since the crash is keeping up my weight. I used to hold steady at about 165, which was probably ten pounds heavier than I’d have liked. Now I usually weigh 148-150. In a perfect world I’d weigh around 155. I’ve taken to smaller, more frequent meals because my appetite has been smaller since my hospital stay, with all the abdominal and chest related surgeries, and eating denser, more high calorie foods often comes with additional salt, sugar, cholesterol or a combination of them. Hopefully I’ll gain that final 5-7 pounds at some point.
- I also have slightly elevated BP now, but really have been dealing with it for a few years, but the medication I’m taking for it (Amlodipine) seems to cause constipation. I tried a few things without much success and finally gave in to Metamucil in the past week, and that seems to have done the trick. I’m very regular now and much happier. We already eat a pretty high fibre diet, so I figured I didn’t need it, but I’m glad I tried it. Unlike polyethylene glycol, I can use it daily, with the added benefits of potentially helping to regulate blood sugar, blood pressure and LDL cholesterol. Man, does all this stuff make me sound old now.
- In addition to the new vaccines resulting from my immunocompromised status, I have to take infections more seriously in a general sense. So, in addition to masking when in confined spaces, things like live hockey games, concerts and places where people pack tightly like sardines are no longer a good option for me. I guess being a bit of an introvert is finally paying off, whether I like it or not.
October Update
Vaccines Done
Well, for another five years, anyway. Losing your spleen not only means trying to be more careful about infections and taking precautions like masking in crowded spaces, but also getting a whole whack of new vaccines, almost all of which are to prevent encapsulated bacterial infections:
- Bexsero x1 (meningococcal group B diseases)
- Hib x1 (blood/brain infections, like meningitis)
- Prevnar 20 x1 (pneumococcal bacterial diseases)
- COVID/Flu (annually)
- Nimenrix x2 (eight weeks apart) (4 variants of meningococcal disease)
- Shingrix x2 (2-6 months apart) (Shingles)
Vestibular Physio Done
In truth, this is a massive list item checked. I needed a couple months of hand therapy to get my right hand well on the road to recovery (and it’s probably 75-80% of the way there now. However, between my stay in GF Strong and community therapy, I’ll have had just over six months of vestibular physio when I’m done November 26th. My only goals have always been a return to running and cycling. For some time, I had no idea what that looked like or how far I would get. Turns out, pretty far, with no ceiling detected at this point.
I’m now running 10k at a stretch, and feel like doing a half marathon again (just slower) is probably within reach. As well, I’m regularly doing 90 or more minutes on the trainer and beginning to rebuild the top end of my power by grinding out harder workouts. While I will probably be fighting minor balance issues while running for a long time, and remaining more careful with foot placement / not running at night, I’m in a pretty good place with the run/bike these days. I honestly thought my running days might be done with how I felt 3-4 months ago. I’m still very cautious riding my e-bike and feeling comfortable on the road may always be a struggle, but the one thing I have decided is that I’ll never ride solo on the open road again. I’ll only ride solo on separated bike infrastructure or neighbourhood side streets, group rides on the road, or not at all.
Return to Work?
This idea is nowhere near firm yet. However, it’s certainly a consideration. To this point I’d been almost positive I would simply retire at some point in the next year or so, but I have a morbid curiosity about how well I could do my job again and am sort of thinking of it as the last big step in my recovery. I also have a selfish reason for considering it, and will discuss that in a future update. As well, drawing my fulltime salary for perhaps a year or two would make the transition to full retirement much easier and allow us to plan a little more for the reduction in income while being that much closer to augmenting our retirement savings with CPP and OAS, or perhaps even beginning to collect them a couple years early if the hit to the amounts isn’t too large. My wife and I are currently 61 and 60, respectively, and my wife has already begun collecting her pension and will begin converting some RSPs to RIFs next March.
There are several things to consider before actually taking the big step of returning to work, and it will all hinge on, not only, how my cognitive therapy continues to progress, but being allowed both a graduated return to work over several weeks and accommodated with 100% remote work will be key for me. I will never step foot in an office again, now that I’m missing my spleen.
Fitness – October 2024
In October, I still increased my time or mileage over September in most categories, but not as dramatically month over month as I did through September. I’m still setting goals to nudge my time and distance where possible, but my focus now is switching to increasing intensity or improving things like power output.
- Total (walk, bike, run) Mileage: 414.7 km
- Running: 53.0 km
- Walking: 53.6 km
- Cycling (trainer, e-bike): 308.1 km
- Weights: 7h 58m
- Yoga: 5 h 38m
- Drums: 7 h 2m
Notes
- After struggling to put on weight since my eight week hospital stay, I’ve held pretty steady at 151-152 lbs for the past three weeks or so, just shy of my 155 goal weight.
- Just a word about disability insurance … While the general administrative stuff can be a hassle, and weaving your way through the application processes can be frustrating, I’m now receiving 90% of my net salary, and very thankful for that. It provides significant security and peace of mind when recovering as fully as possible should be your only concern. I have more thoughts about ICBC’s enhanced care model, and disability / income replacement insurance below.
November Update
November’s update is both very significant and pretty short. The big news is that, five years after last living in Victoria, we moved back in mid-November. I’m sure I’ll have more to say on the subject eventually, but in short, we signed a lease on November 4th, effective for November 15th, and I. Could. Not. Be. Happier. We’ve been wanting to get back since we last lived here, but expected to have to wait until we fully retired. I guess if one positive came out of my crash, it was this, and deciding I will no longer put off until tomorrow what I want to do today. Nearly dying does give you some perspective.
A Letter for a Careless Driver
The other somewhat major development is that, after careful consideration, and vacillating repeatedly, I decided late in November to send the driver who hit me a letter outlining the impact his carelessness has had on me. Drafting it is has been very therapeutic. As I said, my wife inadvertently got his contact info, so we were able to determine that his home-based business was a couple blocks from where he hit me. I don’t want a response; only to hope that he reads it and pays more attention to his surroundings when driving. Sending it will, of course, have to wait until the Canada Post strike is over.
I’m the guy you hit with your car on April 14th. Since you said to my wife by text that you hoped I would recover fully, I thought I’d let you know what kind of damage even momentary inattentiveness can cause. My injuries were extensive and severe. Physically, I came into Royal Columbian Emergency with significant lacerations down my left arm and on my left thigh and knee, and multiple fractured ribs. The force of the crash with your car jammed my bowels up into my chest cavity and also resulted in me losing my spleen and rupturing my diaphragm. They had to put a stent in my right carotid artery for fear of enough oxygen getting to my brain, as I had become unresponsive shortly after arriving at RCH. As a result of the splenectomy alone, I am now permanently immunocompromised, which meant five new vaccines, in addition to annual COVID and flu shots. More significantly, I can no longer safely go to concerts, hockey games or anywhere people are crowded into smaller spaces, including even just a bite out at a busy restaurant. This poses significant challenges for attending my son’s wedding next year. In short I am at a substantially higher risk of contracting infections than I was before you hit me. I also have several disfiguring scars as a result. One the length of my abdomen, another about 4” long, perpendicular to that one (from the splenectomy), with a corresponding abdominal bulge, and more down my left forearm, on my knee and thigh, and several small scars from the feeding, drainage and intubation tubes. I spent three weeks in Royal Columbian and was transferred to GF Strong for another five weeks, which included starting very intense therapy and rehab. Less obvious but far more significant … I suffered several small strokes (I am not someone normally at high risk of stroke) resulting in a traumatic brain injury which, in turn, affected my right arm and hand motor skills and coordination. It is getting better but may never fully recover. I also had visual deficits when first released from hospital (which have thankfully mostly resolved aside from the visual fatigue). Similarly, I developed significant cognitive issues as a result of the brain injury. Memory, executive functioning, recall and many other issues have prevented me returning to work, which frankly, may never happen. I now also have severe light sensitivity, visual and mental fatigue and a persistent “brain fog” which may never lift.The brain injury has also caused significant vestibular symptoms, which have drastically affected my running and to a lesser degree, my cycling. I also am much more paranoid of traffic in general. I have just finished six months of vestibular physiotherapy, had two months of hand therapy after I left GF Strong and will be in cognitive therapy for several more months. I am not carrying around anger because it wouldn’t be productive, wouldn’t change anything and wouldn’t help my continuing recovery. I will just mention though, if it isn’t clear by implication, your lack of care has severely fucked up my life, and aside from your premiums paying for my recovery, I don’t imagine you’ve suffered so much as a reprimand for nearly ending my life. FYI, if we weren’t subject to no-fault insurance in BC I would have sued you for damages, and it would have cost you significantly more than higher insurance premiums. Frankly, IMO, you should have been charged with careless driving at a minimum. I remember you saying you didn’t see me (my ONLY recollection of anything for nearly a week). It was a very clear day and I was dressed very visibly, so I’ll just assume you weren’t paying nearly enough attention to be driving. In short, I have sustained life-altering injuries and you weren’t even charged with so much as a traffic violation. All of this doesn’t even touch on the stress and uncertainty your carelessness caused my wife and sons, who didn’t know if I would even survive, or, if so, if I would have permanent brain damage or possibly be blind (all things that were openly discussed in the first day or two). It also doesn’t touch on navigating the endless bureaucracy associated with income replacement insurance. Presently I have to deal with three different insurers (EI, ICBC and my LTD provider). It has been over seven and a half months since you hit me doing about 50km/hr (according to estimates from the hospital) when you should have been going much slower in that area. However I am not going to admonish you. It’s a pretty well established pattern that people pay less attention the closer they are to home, when driving. If I have one thing to say in closing it’s to please, PLEASE slow down, and pay attention. I nearly died because you weren’t doing so on April 14th. Given that you live very close to the crash location, I sincerely hope you'll think of this letter and my situation every time you pass it to go home.
Fitness – November 2024
Almost entirely due to the move, progress on my fitness took a major hit, and was down 58% from October. I expect December to see a nice rebound across the board.
- Total (walk, bike, run) Mileage: 173.2 km
- Running: 19.6 km
- Walking: 82.7 km
- Cycling (trainer, e-bike): 71.9 km
- Weights: 2h 38m
- Yoga: 4h 40m
- Drums: 1h 2m
Notes
- Our move ended up being quite the adventure with ferry delays, and heat / hot water issues, but that’s all been rectified (hopefully) and feels like another post for another day.
Thoughts on ICBC’s “Enhanced Care” Model
In May 2021, ICBC made a major change to how they deal with injuries resulting from vehicular accidents.
In truth, my ICBC experience hasn’t been as awful as many other peoples’ seem to have been (I suspect this is mostly due to getting a pretty decent Senior Injury and Recovery Specialist assigned to my claim). Still, between various delays, some utterly inexplicable things and purely random oddities, they do themselves no favours at times.
For the most part, Enhanced Care is ICBC’s euphemism for paying for therapy, income replacement insurance to 90% of salaries to $113k and in some cases (like mine), lump sum permanent impairment payments. They’ll also pay various expenses for things that help you recover. My experience with enhanced care has ranged from poor to decent. As I have finished all therapies save for my cognitive therapy, I have some thoughts I’d like to share. I suspect that experiences with it range pretty drastically, so take mine for what it is – one person’s individual experience.
Family Meeting Lies
At some point not long before your GF Strong discharge date, a family meeting occurs, and it includes all therapists you’ve seen while in rehab, any affected family members, the attending physician(s) and, nominally, third parties like ICBC. Attending on their behalf was a support and recovery specialist and his manager. The ICBC line is that they want to ensure your support in the transition back home, all the way through your eventual return to work. In this specialist’s case it seemed more like they wanted to ensure maximum mis/disinformation.
Of course, for all attendees’ benefit we were assured by him and his manager that ICBC’s financial support of necessary therapies would only begin when I was discharged (a point the attending physician made his manager repeat for all to hear). This is important because ICBC only pre-approves 12 weeks of therapy. Later, by email, he then insisted that he and his manager had misspoke, and the 12 weeks began from the date of the accident. This would have rendered their financial support nearly useless, as I ended up in hospital for eight weeks. Had I been limited to a mere four weeks of therapy, my progress would have been nearly nonexistent, as it would have ended on roughly August 14th.
As an aside, one thing I’ve found very odd in dealing with ICBC (and Manulife for that matter) is their over-reliance on family doctors. In fact, our original specialist wanted all assessments and treatment plans to come from our GP, as opposed to the therapists who actually do the assessments and provide the therapies. In many cases a GP won’t know anything about your therapies, and will have to reach out to the therapists for updates regardless. In short it just creates another barrier to things happening quickly. More important still, a GP has no acquired brain injury or vestibular rehabilitation expertise.
Turns out, the specialist was spouting complete BS. My claim was thankfully handed off to a senior support and recovery specialist, who has placed no such limitations on my therapies, and also seems to actually defer to the expertise of, well, the experts. The OT we hired (who’s excellent, BTW) thought he was inexperienced because ICBC usually approves therapy as needed for much longer than 12 weeks. While this has thankfully been the case, even just allowing someone to state incorrect information like this is very damaging and introduces completely unnecessary stress for people already frazzled and in a very vulnerable place. In my case, I’ve had hand, vestibular physio and speech/language (actually, cognitive) therapy approved for various lengths of time, well beyond the pre-approved 12 weeks.
ICBC Bike Damage Claim
After opening a claim within a couple days of my crash, my wife was simply ignored by the assigned adjuster (damage claims are handled by a completely different area). She periodically added information and occasionally asked for some sort of update as to progress. The adjuster couldn’t be bothered with so much as just an acknowledgment, let alone an update. We heard absolutely nothing for about 17 weeks, until roughly August 9th. I had escalated the lack of communication through social media first, then ICBC’s Fair Practices Office. After that I finally received an email from the adjuster’s manager. In it, she never apologized for his ignoring us for over four months, nor explained why, but did promise to get back to me the following week with an update on my claim.
It’s no big surprise that the ICBC manager never followed up, but as I did have her email address, expected to be bugging her regularly. I still maintain that five months is far too long to take to settle a claim for a written-off bike and a pair of wheels.
In a development that should come as a surprise to absolutely no one, there were still more delays from ICBC on the bike damage claim. Immediately after the adjuster’s manager said they’d get back to me the following week, they went on vacation for two. Not only that, but at virtually the same time as I got their out-of-office auto-reply when I followed up with them, the Fair Practices Office, with whom I had escalated my claim a week or so prior to August 9th, responded to me. In particular, as I had suggested there was no deterrent for people who drive carelessly, they assured me (with absolutely no supporting evidence) that “fault still matters” and more laughable still, that the system still has “the same incentives” to drive safely. Never mind that no-fault insurance literally removes those incentives by banning customers from suing for injuries and damage, no matter how bad they may be. Wrongful death? Careless driving causing death? Manslaughter? Lifelong, permanent and/or severe injuries? Never fear, as the system includes the same nonexistent incentives it’s always had. And sorry, but in many cases, ICBC footing the bill for some therapy sessions and providing a lump sum impairment payment (more on this below) isn’t going to be nearly enough.
Bike Claim Suddenly Settled
I was afraid I’d been a little too snarky in an email exchange I had with the Fair Practices Office, but lo and behold on August 22nd I received a call from the adjuster. Again, no explanation for ghosting us and no apology, but (drum roll please) a settlement offer. I was to receive nearly $7300, which is almost what I paid for the bike and wheels, minus the tax. I signed the the acceptance letter immediately and received a cheque in the mail September 10th, a mere four days from the five month anniversary of the crash, and an apology from the manager for taking so long (but still nothing from the adjuster).
Permanent Impairment Payment
My Support and Recovery Specialist apparently discussed it with me, but my brain being what it is, I completely forgot. However, my injuries qualified me for a permanent impairment payment. While it really doesn’t come close to making up for an acquired brain injury, the lengthy recovery and rehab, or losing a spleen, to name just three, the money will at least help a bit, particularly when we buy another place. They have a very complex formula that factors everything into the calculation. There’s something for the broken ribs, the strokes, the brain injury, the right carotid artery dissection, the ruptured diaphragm, the splenectomy – everything. I don’t know how you accurately price being immunocompromised or a brain injury you may never fully recover from, but ICBC seems to have found a formula. They also do a final review once you’re recovered medically to the fullest extent possible, to see if any further compensation is warranted.
I have no idea how high these payments can go, but given what I was paid, I can’t imagine that it’s sufficient for more extreme injuries than mine, given that I suffered a life-altering brain injury and am permanently immunocompromised.
EI Nonsense
I’ll admit that this one is a bit of a head-scratcher, even by ICBC standards. As I said above, ICBC provides income replacement to 90% of your net income, to a maximum of a $113k salary.
While my ICBC recovery specialist has generally been good, she did an odd thing in early November. She asked if I would see if I qualify for federal EI sickness benefits. EI sickness benefits are usually the equivalent of short-term disability, only pay a maximum of $668 a week, and only last a maximum of 26 weeks.
Long story short, I submitted my EI application on October 3rd, and expected it to be denied, but I also had to wait for my final paycheque and vacation payout so that my ROE could be generated, so that my EI claim could be processed. Given that she reminded me that ICBC is secondary income replacement, I’d guess it was all about trying to reduce ICBC’s payout.
EI Sickness Benefits are also actually supposed to be applied for immediately after your accident, but I was collecting my full salary right up until I got LTD (our sick leave becomes STD. As well, you supposedly can’t collect ANY EI benefits and LTD at the same time, but I was led to believe I needed to do this so that ICBC would pay their top-up. However, somewhat inexplicably, they suddenly began making top-up payments last week. I suspect that she expected my claim to be denied, but it seemed odd and a HUGE waste of time to be forced to apply for insurance I likely wouldn’t collect. Nonetheless, I still needed the claim denial because I have to tell them if, by some miracle, I actually do qualify for EI. Not only that, but philosophically, I feel that ICBC should have to pay income top-up, given I nearly lost my life at the hands of someone driving a car. It’s worth noting here, that if I didn’t have any STD or LTD benefits, ICBC would be on the hook for the entirety of 90% of my net pay for as long as I was being “medically” cared for. No one has defined this term for me but I suspect that once my cognitive therapy is complete and my return to work is underway, that’s when both Manulife and ICBC will begin to claw back benefits, and my EI claim will be long finished.
Update: I did, in fact, qualify for EI. Before anyone gets excited, according to the agent I spoke to by calling the 1-800 EI number, after they deduct for my vacation payout and then also make their deductions to my payments for LTD, I’ll end up with approximately $60 a week. Not only that, but they somehow set my recovery date for sometime in December. To extend my claim to the maximum of 26 weeks, I’ll need my doctor to sign a medical certificate with an estimate of when I might be recovered, which will be a few months down the road, yet.
All this to reduce what ICBC has to pay by $60 a week for up to 26 weeks. Bonus points for having to now deal with three different insurers; Manulife, ICBC and the federal government. Bonus bonus points for now also having to do biweekly reports. For a whopping $60 a week. I could, of course, skip the EI entirely and just take the ICBC payments minus $120 biweekly, but at this point, I want every dollar due me, almost entirely on principle.
In Summary
ICBC basically lied during the family meeting at GF Strong, and my bike damage claim took about five months and near-endless frustration to get settled, but was a better offer than I expected. Recommended therapies have generally been approved quickly, without question. I also received a lump sum benefit, ICBC has actually begun my income replacement top-up but made me jump through EI hoops to get it, and if you recall from my September update, I had weights approved for home use and I’ve since had glasses with Transitions lenses approved to help with my light sensitivity ($1005). On the whole I’d say the good has more or less balanced out the bad. I’m ambivalent at best about the enhanced care model, particularly as it’s seemingly designed so that you’ll hopefully give up. I simply can’t give it a thumbs up when some aspects of it are mired in endless delays and administrivia, just to get benefits your premiums actually pay for, while clearly always having a focus on saving money. Recovery isn’t cheap, even if they’d prefer it be.