The inquiries as to my rehabilitation have become more frequent lately so it is time for another update. First I want to apologize to all of you who have written personal notes to me during the past month and a half and not received a reply. I'm not blowing you off, I swear. All of those messages are sitting in my inbox and will get a reply, hopefully in the not too distant future. I took a bit of a hiatus from personal email because I was just feeling a tad burned out with the whole thing. You all know I love to chat til your ears fall off, but eventually I just ran out of words for a spell. Too much talking about the accident and all my feelings. I needed a whole lot of just-for-me time.
I'm writing this from my room at the Euro-Spa in Bedford, Quebec, about a half hour from Montreal. Yes, a real spa, as in mineral baths, massages, and mud wraps. You can just imagine how hard it was for me not to burst out laughing when I was getting that last one done, lying naked on a giant piece of saran wrap as a little French woman slathered me with stinky mud. Diane and I came here to take a break from The World, and it has been wonderful so far; it will be hard to go home. It has been a little tough walking up and down the stairs, but I am managing ... and, I'm getting a little ahead of my story. I'll rewind back to the last report of late August so you can see how I got from "wheelchair and walker" to "walking up and down the stairs."
After sending my last update, I had this vision that the next message I sent to everyone would consist only of, "I wiggled my toe! I wiggled my toe!" That one, succinct line would capture and share the immeasurable joy I would feel about being nearly back to normal. It would also spare you all another 300 line message, as this one is already shaping up to me. (Guess I am back to being my old chatty self; better staple your ears on for good.) I imagined it coming right about now, early October, so it would be wonderful timing for everyone who was getting curious about how I progressed. My heart warmed as I envisioned the happy messages of, "Congratulations!" and "I knew you could do it!" coming back to me. The emotional high would last for days.
The "I wiggled my toe!" message will probably not be coming for a very long time. Figure December 2000. Hell of a Christmas present, though, if Santa brings it. But again, I am just a tad ahead of myself.
I was scheduled to go home on September 7th, the day after Labor Day. On September 3rd they started teaching me one of the very last skills I would need for wheelchair-independence in the Big Bad World – wheelchair wheelies! Can you say, "like a fish to water?" Allow me to brag for just a moment that I picked this up lickety-split, faster than most. It was the most fun I'd had since the accident; you couldn't keep me from doing a wheelie at practically every opportunity. Why is the skill important, you wonder? So a wheelchair can get over obstacles that would normally block the small front wheels, such as an uncut curb. Did I ever need to know how to do a full wheelie for that? Heck no! But who cares?
The only wheelie mishap occurred right in front of the nurses' station on my floor, the day after I learned the trick. I was sitting in the wheelie position talking to my physical therapist when I just lost my concentration and fell over backwards. I was totally fine, with no pain whatsoever – but it severely distressed the senile old Quebecker who sits right there by nurses' station all day long. I went to my room, and when I came back out over a half hour later Lydia was still upset about the whole thing. I could see the redness in her eyes as though she'd been crying. I tried to comfort her as best I could, assuring her that I was totally okay, when she said, "They didn't mean to do that to you, they were just trying to help." Oops, she thought the nurses had knocked me over. Time to apologize to all of the nurses for any grief she gave them about it. My wheelie escapades were the talk of the ward for the next several days.
The morning of my discharge I had the appointment for my neurology tests. We all had this expectation that I'd go there, they'd stick me with a few electrodes, a muscle would twitch here, a muscle would twitch there, and then I'd be told, "You should be back to normal in [October/November/December]!"
Now because I did a horrible job of subtle foreshadowing, you already know that's not what the neurologist said.
Basically, he couldn't get the muscle to twitch, neither here nor there nor anywhere. He started using words like "cut" and "complete damage" and "guarded" and "maybe never". Figure 18 months, he said, before it comes back, if it is going to come back.
So that was a bit of a tough appointment. I went back to the nursing home where I had to pack up my belongings for the trip home. Between the neurology tests and some apprehension about what home life was going to be like, the event was less happy than it should have been, and I was almost surly. I had imagined fond farewells with the many fine staff members who had taken care of me, but instead I just wanted to get everything packed up and get the hell out of there. So that's what happened; a few cursory good-byes with whoever happened to be around just as I was leaving, and a pensive ride home.
Don't despair, things get brighter for me in a couple of paragraphs. Just not yet.
The actual arrival home was fairly uneventful. I was delighted to see my cats, but things were slightly tense with Diane and getting around the house was a major effort, particularly having to bump myself up and down the stairs, easing my butt from step to step without putting any weight on my right leg, which was still not weight-bearing. Using the standard toilets was also way more effort than going to the bathroom should be.
So about three or four days after I got home, I had a day where I was totally depressed. It was the first and only time that I just felt sorry for myself. I just wanted to sit on the couch and lament my condition. I was miserable.
And the next day it passed. I was back on track with my usual attitude about the whole thing, which I personally think is a great one. Basically it all boils down to this for me: even if my left foot never comes back, I will still have the happy, active lifestyle that I love. Paraplegics ski. A paraplegic just climbed El Capitan using gear that he invented. A fellow with multiple sclerosis hiked the entire length of the Appalachian Trail on crutches. Wheelchair-bound people play basketball and race marathons. One stupid little paralyzed foot is not going to keep me from pursuing my adventures. I might not be able to do them exactly as I first envisioned, but you won't be able to hold me back from being Out There.
That's not to say I don't ever still feel just a little sad about where I am now. There are lots of triggers to bring on very brief moments of wistfulness, from seeing my Gatorade mix in the pantry to looking at the giant posters of athletic people at the doctor's and PT's offices to watching all of the bicyclists in the area to hearing all the radio ads for ski areas as the winter sports season approaches. This is never a feeling of, "Woe is me, my life totally sucks," though, but rather, "I am looking forward to doing that again; I wish I could do it now." Then I tackle whatever task is at hand.
I also feel compelled to say to all the people who have felt bad for me, because they knew how active I liked to be, that this has not been all misery for me. Sure, I never would have chosen to total my motorcycle and be hit by a Jeep, but some really good things have happened pretty much only because of the wreck. Now I know how I would react in a situation like this, whereas before I could only surmise what I thought I would do, and I am very happy with that reaction. I've been able to get in touch with a lot of friends, some of whom I'd not spoken with in years. I've felt really cared about by a large number of people who'd been "mere acquaintances". I've met many wonderful people – the caregivers who are rehabilitating me, some of whom likely will end up long-term friends. I've already lined up a mountain biking trip with a physical therapist from the Visiting Nurses Association, to go when I am able. I've had more time to write, even if it is not the creative fiction that I particularly enjoy but instead these self-indulgent autobiographical vignettes. 10 pounds have come off and stayed off. When I have been feeling like I just needed to vegetate, I've started up a computer game I've had for months but never played and didn't feel one damn bit guilty about it!
Most importantly, though, has been that Diane and I have grown closer than we've ever been. Sure, we had some pretty tough times because of the accident, and as I mentioned in my first report we've been through a pretty tough couple of years. There's still some unresolved issues, like the matter of me riding again. Yes, a relationship is never conflict-free. But I can't really overstate how happy I am about how our relationship is going now, how our marriage has really blossomed. Something like this accident is a real eye-opener to what's really important to you, bouncing your Cart of Life out of the rut it has been plodding along in. What is it that really gives you pleasure? What do you want out of your relationships with other people, and what do you want to give back to them? You want the answers ... go get hit by a Jeep.
Ok, back to the chronology. Here I am at line 169 with still a month to go. I'll try to pick up the pace.
On September 14th, I had my first appointment with the orthopaedist who will be managing the rest of my care, an older doctor who had been recommended to me by a couple of different sources. He was very happy with my x-rays, remarking that my bone growth was noticably ahead of where he would expect after seven weeks.
He had unfortunately not yet seen the neurological report, so he could not speak directly as to what was wrong with my leg, just what he expected based on his years of experience. Where the neurologist had used the word "cut", he was inclined to use "bruised", and for "guarded" he preferred "98%". It wasn't, "18+ months, maybe never," to him, but rather, "in a year." It was still not as bright as our earliest expectations of two to three months, but it was a much more rosy picture nonetheless, don't you think?
The best piece of news from that appointment was that I could start weight bearing on my right leg, the one that had the non-displaced fracture of the tibial plateau. I'd still use the walker for a while, but this made a huge difference in the effort needed for the stairs, the toilet, and a variety of other tasks. (When I later told my physical therapist I was using the walker to go up and down the stairs, her only reaction was to say, "I really don't think I want to know how you are doing that." But as that therapist from the Visiting Nurses said, I'm the kind of guy who needs a therapist that will put up with me striving for my limits, and "I don't want to know" was a better answer to me than, "Stop doing that!" :-) )
The doctor scheduled me for outpatient physical therapy three times per week starting on the 17th, right upstairs from his office. So now I am regularly making the 40 minute trip down to the city from out in the woods where I live for sessions that typically last about an hour and a half to two hours. Because of this I'm still not quite up to forty hour work weeks, but I'm getting closer, managing 30+ hours in the typical week.
My recollection is a little hazy, but I believe that the last time I used the wheelchair to get around was the day the doctor said I could use my right leg. I still have it around if I need it, and have sat in it a few times to maintain my wheelie-popping skills (use it or lose it, baby!) but it will probably be going back to the medical store in the next month or so.
The other milestones I've reached since the 14th might not seem lofty, but they were really significant to me.
On September 21st I stopped using the walker and started using crutches, a much more rapid method of getting about. I've not touched the walker since then, though I still have it, Just In Case.
The day after, the 22nd, I stopped wearing the full length leg brace I'd had to keep my knee stabilized because of the blown out ACL. My leg is strong enough to provide the necessary support, and rarely buckles except on uneven terrain. I may not ever need reconstructive ACL surgery (and its attendant rehab), which before I'd taken as a given. Even if I do need it, medical technology has advanced to the point where getting it done two years from now offers results as fine as having it done immediately after the injury. Though the leg brace is gone, I still wear a huge walking cast/boot to stabilize my ankle.
If you were in the shower with me on September 24th the second thing you would have noticed – right after making a mental note of how odd it was to be in the shower with me – would have been that I was standing up. I was so tired of the bench and hand-held water hose, I set my mind to try showering standing up. Using a great deal of concentration, I managed pretty well, and boy what a pleasure it was to have water spilling down over my head and body in a torrential drenching. Clearly one of life's simple pleasures.
The following Tuesday, September 28th, I took my leave of the crutches. Lurching around with the walking cast on my left foot and a hiking boot on my right, I feel a bit like Frankenstein's monster in search of a good brain. At least with Halloween nearly upon us maybe I won't look like such a freak, I just need to pick up some neck bolts and some pale green face paint at the costume shop to complete the look.
Four days later, on the first of October, I had my second appointment with the orthopaedist. His office had received the neurological report by then and he was supposed to spell out for me what it meant. Unfortunately, he found the report to be ambiguous and nearly useless to him; it gave him no insight into my condition. This was a little disappointing, but not so much for me as for Diane, since as previously noted I'd already come to terms with the fact that the foot might not ever get better, and in any event all I expected was maybe a slight revision in the estimate of when I could possibly see improvement. She was very frustrated and upset with not having any more answers about what my future was going to be like.
He recommended me to a physiatrist, which is sort of like a Dr. Physical Therapist, who he really trusts to do a thorough analysis and lay out in plain terms what the situation is. Unfortunately this guy is in such demand that the earliest appointment they could wrangle for me is December 9th. They tell me I'm on the cancellation waiting list with a double star by my name, though.
October 6th I was fitted for an AFO, a type of orthotic that fits inside regular footwear and up the calf to guard against permanent "foot drop", the condition where the ligaments and tendons of the foot and lower leg shrink up and the foot always hangs down. Once it happens it is apparently very difficult, if not impossible, to regain the flexibility that is lost. When the AFO arrives later this week, I should be able to ditch the cumbersome walking cast and do gait training with my physical therapists. That will put me one step closer, no pun intended, to being normal.
The following day I tried to ride my mountain bike. It didn't work. I tried to clip in to my left pedal, but with no rigidity to my foot I just could not manage it. The AFO might change that, but if not I am thinking of ordering some new pedals that will allow me to easily have my foot firmly affixed to pedal. Not that I'll be out doing any single track before winter sets in, but at least it would feel so tremendously liberating if I could just ride down my half-mile long driveway to the road.
So here I am now, the weekend of October 9th, Spa Weekend. My physical condition is that I have a bit of soreness throughout my left leg that can get pretty uncomfortable at times, and the parasthesia (that electrical tingling) is still omnipresent in my left foot. I have some trouble sleeping soundly through the night because of the discomfort, but overall the pain is more distracting than debilitating. Twice a day I take twenty minutes to manipulate my ankle, my toes and the bones in my foot to maintain flexibility and guard against permanent foot drop. Three times a week I go to physical therapy where they do additional flexibility stretches and I work on strength training and balance exercises, as well as ride the exercise bicycle and mooch a free workout of my upper body. My favorite part of PT is an exercise where I balance on my right foot and hurl a nine pound ball at an inclined mini-trampoline, catching it on the return while staying balanced on one foot. Repeat 50 times.
The next milestone? I'm getting my long hair cut off. I'm donating it to kids with cancer, so they can have wigs of real hair after they lose their own hair from chemotherapy treatments. I like the look of the long hair, but it is just such a hassle.
I don't think I will be sending another update for a good long while now, probably three or four months. Maybe just a short note to tell you that I've been out snowshoeing or even tried some downhill skiing. Maybe even "I wiggled my toe, I wiggled my toe!" but don't count on it.
Thank you all again for your interest and support during this time in my life. It has really, really meant a lot to me. I'm blessed with knowing so many thoughtful and open people. You've all made a tremendous difference in how I've been able to work through this injury.
PS to folks in the Washington DC area: I am coming down for the Internet Engineering Task Force meeting from November 6th to November 12th at the Omni in NW DC, near American University. It's a week of work for me, but I still have time to get together for lunch or dinner, as well as the time on the weekend. Please let me know if you are interested in getting together for a visit so we can work out a good time. If you don't contact me, I'll be contacting you. :-)