Went out for my first ride today. It's been since July 22nd that I've been on the bike on the road. I needed just a bit more than five miles to get over 1,000 for the year. This ride was a gentle flat ride that was done at an easy spin. It was 5.7 miles and put me at 1,001 miles for the year. Not the 4,000+ I was planning on at the beginning of the year but considering how the crash interrupted riding this year it's just good to be back out on the road.
Just five miles but it did wear me out more than I would have anticipated. Starting the ride seemed easy enough. Balance was fine, steering was a bit shaky. Needed to focus on where I wanted to go or would go off course a bit, couldn't look left/right much more than briefly or that would steer the bike unintentionally. Steering was fine once I recognized that. In the early part of the ride I was thinking I might get at least 100 miles in December if the roads stay clear. By the time I was back I was thinking it will take time to build up to a 20 mile ride and I'll be doing well to get in 50 miles more before the end of the year.
In any case I'm riding again. All I have to do now is keep doing it.
Sunday, November 25, 2007
Friday, November 9, 2007
A new souvenier and progress
Went back to the crash site a while ago and found some debris from the crash. This is the right lens from my riding glasses. From the marks on the lens I'm guessing two impacts, at least, to the lens. The first would be the scratches going more top to bottom. The second would be those going more right to left. How do I know? I don't, still don't remember anything. However the left to right scratches seem to go over the top to bottom scratches so they must have come second.
Considering how gouged it is I have no idea how my face didn't get scratched up. Nose, brow, cheek, chin, not a mark on them. A little bit on the right of the head where the temple from the glasses would have been but nothing else.
I've been back to work for three weeks now. Very limited duty. Two hours a day the first week. Three a day the second and it was supposed to be four a day the third. Wasn't quite up to it so did the third week at three hours a day. Next week will be four a day. Feel much better at the end of this week than felt at the end of last week. I'm pretty sure I'll make it through next week okay. May be wanting Friday to come a little early. But that'll be okay. That happened sometimes before I crashed.
Have been spending some time on my new trainer. Feels okay. Have done two twenty minute spins on it now. I'm thinking I'll be able to get out for a short ride before the end of November.
I'm thinking with the spinning on the trainer and exercises from therapy the ride will be, relatively, easy. The part that will really need some testing is balance. Will need to ride in the yard a bit to see how that goes. Between now and the end of the year I only need five miles to be over 1,000 miles. About a quarter of what I was anticipating around the time of the crash but at least it's four digits.
Sunday, October 28, 2007
One week in the bag
Been back at work a week now. Just two hours a day. Start three hours a day next week. It was more effort than I anticipated. Physically, by the end of the week, I was a bit worn down. Mentally it was challenging to be alert the whole time. I'm hoping that the extra hour a day next week won't be more taxing.
It's hard to get anything done in two hours a day. To think two hours a day is tiring is hard to imagine. Good incentive to stick with the doctor's orders and not try and stretch my time. The goal is to get back to full time not to burn myself out and fail at resuming a normal work schedule.
PT has been good. I'm doing some exercises that seem to be restoring some of my flexibility and stabilizing my back and neck. My hamstrings and back had really tightened up during the sedentary recovery. Using the exercises to get some flexibility back is helping increase comfort with everything I do.
The back and neck stabilization exercises are really helpful. Before, a few times a day, I would make some move that caused a pain between my shoulder blades like something in my spine was snapping into or out of place. That happens much less frequently now and that's a good thing.
Keep on trying to expand the envelope of things I can do. I took my old road bike out and rode it on the yard, with my helmet on. Very short ride, just half the length of the yard and back to the starting point. Balance was okay if a bit tentative. Certainly not ready to ride at road speed much less on the road. Position on the bike felt uncomfortable. Could definitely feel tightness in my back bending over the bars and weakness in my shoulders keeping my my head and neck up and steering.
That experience led to ordering a stationary trainer to put the bike in. I have rollers but there's no way I'd be safe riding on them. With the stationary trainer I'll at least be able to get on, spin my legs, build some leg strength and aerobic capacity and monitor my back and shoulders for improved comfort in the riding position.
Now I've got two things to focus efforts on. Mental stamina to be able to build back up to a regular work schedule and physical stamina to be able to get out and ride again. I've succeeded, if somewhat underwhelmingly, at getting started back at both. Now I'll just have to keep building on these first efforts.
It's hard to get anything done in two hours a day. To think two hours a day is tiring is hard to imagine. Good incentive to stick with the doctor's orders and not try and stretch my time. The goal is to get back to full time not to burn myself out and fail at resuming a normal work schedule.
PT has been good. I'm doing some exercises that seem to be restoring some of my flexibility and stabilizing my back and neck. My hamstrings and back had really tightened up during the sedentary recovery. Using the exercises to get some flexibility back is helping increase comfort with everything I do.
The back and neck stabilization exercises are really helpful. Before, a few times a day, I would make some move that caused a pain between my shoulder blades like something in my spine was snapping into or out of place. That happens much less frequently now and that's a good thing.
Keep on trying to expand the envelope of things I can do. I took my old road bike out and rode it on the yard, with my helmet on. Very short ride, just half the length of the yard and back to the starting point. Balance was okay if a bit tentative. Certainly not ready to ride at road speed much less on the road. Position on the bike felt uncomfortable. Could definitely feel tightness in my back bending over the bars and weakness in my shoulders keeping my my head and neck up and steering.
That experience led to ordering a stationary trainer to put the bike in. I have rollers but there's no way I'd be safe riding on them. With the stationary trainer I'll at least be able to get on, spin my legs, build some leg strength and aerobic capacity and monitor my back and shoulders for improved comfort in the riding position.
Now I've got two things to focus efforts on. Mental stamina to be able to build back up to a regular work schedule and physical stamina to be able to get out and ride again. I've succeeded, if somewhat underwhelmingly, at getting started back at both. Now I'll just have to keep building on these first efforts.
Saturday, October 20, 2007
Back in the saddle
I spent two hours in the office Friday. First time there in three months! Felt strange. Didn't really get anything done in just two hours but did confirm I can do the commute and walk from the parking garage to the office and then the reverse when it's time to go.
The doctor is giving me very limited return to work. It was disappointing but after being there, and suffering a headache from the event, I'm thinking the doctor's approach is right. Imagine that!
Anyway I'm allowed two hours each day the first week, three hours per day the second week and so on until I'm back to a full time schedule. Also have been restricted from business travel until after I've been back seven weeks. As I said, a restricted schedule but seems to be the right thing.
I'm expecting the headache will stop happening on trips to the office shortly. That would mirror my other recovery experiences. Every new effort has been met by some headaches or other discomfort. As long as I persisted and kept at it the discomfort dissipated after just a few iterations of the new activity.
Received more opinions on the bumps on my temple. Spoke with an ENT and a neurologist. Both of them surmised they are aneurysms in a blood vessel that developed as a result of the crash. The neurologist scheduled follow up MRI and MRA to inspect and confirm. Then I go see a neurosurgeon with the result of those tests for confirmation of the diagnosis and determination what, if any, corrective action to take.
The doctor is giving me very limited return to work. It was disappointing but after being there, and suffering a headache from the event, I'm thinking the doctor's approach is right. Imagine that!
Anyway I'm allowed two hours each day the first week, three hours per day the second week and so on until I'm back to a full time schedule. Also have been restricted from business travel until after I've been back seven weeks. As I said, a restricted schedule but seems to be the right thing.
I'm expecting the headache will stop happening on trips to the office shortly. That would mirror my other recovery experiences. Every new effort has been met by some headaches or other discomfort. As long as I persisted and kept at it the discomfort dissipated after just a few iterations of the new activity.
Received more opinions on the bumps on my temple. Spoke with an ENT and a neurologist. Both of them surmised they are aneurysms in a blood vessel that developed as a result of the crash. The neurologist scheduled follow up MRI and MRA to inspect and confirm. Then I go see a neurosurgeon with the result of those tests for confirmation of the diagnosis and determination what, if any, corrective action to take.
Tuesday, October 16, 2007
Got a clean bill of health from Dr. McCoy!!
I received the following in email today from the doctor who administered the neuropsychological test.
"Your report was faxed to Dr. M this morning. Your exam performance was quite strong throughout. I will call you within a few days with the details, but the basic conclusion is that there is no significant cognitive impairment at this time, and to consider a gradual return to work."
Thursday I expect to get the doctor's note that approves return to work, finally. Yehah.
fyi the title of this entry is a reference to dialog from Star Trek
"Your report was faxed to Dr. M this morning. Your exam performance was quite strong throughout. I will call you within a few days with the details, but the basic conclusion is that there is no significant cognitive impairment at this time, and to consider a gradual return to work."
Thursday I expect to get the doctor's note that approves return to work, finally. Yehah.
fyi the title of this entry is a reference to dialog from Star Trek
Most productive day yet
Over the past few months of recovery a few things have accumulated around the house. There's been the regular stuff that comes in the mail box which may or may not be related to the accident and then the stuff that's been picked up on the doctor visits. I've let it pile up at different spots in the house. A bit more than a week ago I decide to try and get it all in order. I put it all on my desk to file, toss, etc. as needed.
The mess sat on my desk until this past weekend. Late Sunday I spent about three hours going through everything and cleaning up my desk. I followed that up with about another hour of organizing Monday morning. The interesting part to me is the week it sat on my desk. During that week I somehow wasn't able to do the work to clear it off the desk. I don't know why I wasn't able to. I certainly looked at it often enough and thought about doing it. I just wasn't able to start doing the clean up. Then Sunday I was able to sit down and go to work on the mess.
As I've written here before it's only with hindsight that I'm able to recognize some of the deficits which I'm attributing to TBI. It's a really strange thing because at the time my perception is that things are normal. A week or two passes and I'm doing something I wasn't before and at that point I'm able to recognize that there was a deficit.
In essence I guess it could be described as changing reality day by day and week by week. One day I can't do something and it seems normal, the next week I can and that is the new normal. The good part of this is I haven't been able to tell when things aren't right. The problems might have really frustrated me otherwise. And the fact that there's been steady improvement probably helped keep me from recognizing I was stuck at something so I didn't have the time to recognize the difference and get discouraged. Of course the bad part is I'm a bit suspicious at this point when I'm not able to get right into doing something. Is it me or is it a result of TBI?
Anyway this week I'm feeling clearer than I have since becoming aware of the world again in the hospital. The really weird thing is every other day between then and now I thought I was clear. Its only with each new day that I can look back at prior days and recognize that I wasn't as clear as I thought. At some point these improvements will stop. But when, and how close am I to that point now? Recovering from cracking my head open has definitely been a very strange experience.
The mess sat on my desk until this past weekend. Late Sunday I spent about three hours going through everything and cleaning up my desk. I followed that up with about another hour of organizing Monday morning. The interesting part to me is the week it sat on my desk. During that week I somehow wasn't able to do the work to clear it off the desk. I don't know why I wasn't able to. I certainly looked at it often enough and thought about doing it. I just wasn't able to start doing the clean up. Then Sunday I was able to sit down and go to work on the mess.
As I've written here before it's only with hindsight that I'm able to recognize some of the deficits which I'm attributing to TBI. It's a really strange thing because at the time my perception is that things are normal. A week or two passes and I'm doing something I wasn't before and at that point I'm able to recognize that there was a deficit.
In essence I guess it could be described as changing reality day by day and week by week. One day I can't do something and it seems normal, the next week I can and that is the new normal. The good part of this is I haven't been able to tell when things aren't right. The problems might have really frustrated me otherwise. And the fact that there's been steady improvement probably helped keep me from recognizing I was stuck at something so I didn't have the time to recognize the difference and get discouraged. Of course the bad part is I'm a bit suspicious at this point when I'm not able to get right into doing something. Is it me or is it a result of TBI?
Anyway this week I'm feeling clearer than I have since becoming aware of the world again in the hospital. The really weird thing is every other day between then and now I thought I was clear. Its only with each new day that I can look back at prior days and recognize that I wasn't as clear as I thought. At some point these improvements will stop. But when, and how close am I to that point now? Recovering from cracking my head open has definitely been a very strange experience.
Thursday, October 11, 2007
Stymied by health care customer 'service' again
I'm ready to get back to work. Really I am. Had an appointment last week where I took a full day neuropsychological evaluation. Have an appointment next week were a doctor is supposed to review the results of the evaluation and presumably approve my return to work.
During the test last week I spoke with the doctor about wanting to get back to work and the upcoming appointment to be cleared to do so. He acknowledged the appointment and promised to get the report to the next fellow in a few days.
The office of the doctor who's (hopefully) going to send me back to work called today. They haven't received the neruopsychological report. They said there's no use in keeping the appointment if they haven't gotten the report. If the appointment needs to be rescheduled that would probably mean at least a six week delay before I could see him! argh, argh, argh!!!
The doctor who was supposed to prepare it is away and can't be reached! Argh. I have his email and have sent an urgent request for him to prepare the report. Of course there's no way of knowing if he'll read his email while he's away. The one spot of hope I have in this is that the email address he gave me appears to be a personal address, not a business address. It's doctorsname@optonline.net. That seems like a personal email account, right?
During the test last week I spoke with the doctor about wanting to get back to work and the upcoming appointment to be cleared to do so. He acknowledged the appointment and promised to get the report to the next fellow in a few days.
The office of the doctor who's (hopefully) going to send me back to work called today. They haven't received the neruopsychological report. They said there's no use in keeping the appointment if they haven't gotten the report. If the appointment needs to be rescheduled that would probably mean at least a six week delay before I could see him! argh, argh, argh!!!
The doctor who was supposed to prepare it is away and can't be reached! Argh. I have his email and have sent an urgent request for him to prepare the report. Of course there's no way of knowing if he'll read his email while he's away. The one spot of hope I have in this is that the email address he gave me appears to be a personal address, not a business address. It's doctorsname@optonline.net. That seems like a personal email account, right?
Wednesday, October 10, 2007
Gone Walkabout
I've had it with being cooped up and driven around. Today I decided to go for a walk to get some errands done. Seemed like a good idea after all I haven't really exercised now for three months. (I hesitated to say exercise because for me cycling is catharsis not exercise.)
Like every other American community mine is built for the car not foot traffic or bicycles. The shops where I needed to do my errands were quite a distance, about 2½ miles, away. I didn't drive because I still haven't been cleared to drive.
On the outbound journey there were a number of points where I stopped and seriously considered calling home to get picked up. A number of sensations occurred that made me think about stopping. The walking made my head hurt. Not continuously but there were intermittent episodes and the pain occurred mostly in the area where my helmet contacted the pavement when I crashed. I also found that if I looked at things along the side of the road I tended not to be able to maintain my direction. If I looked ahead I went where I was looking. If I looked off to the side I would slowly drift off course one way or another. Not a good thing when there's no sidewalk and drifting the wrong way would take me into traffic.
The other thing is that I was slow. I didn't recognize that at first. A woman walking a dog made that clear to me though. After my first mile she and the dog appeared and passed by me. She greeted me on the way by and kept moving. By my reconning she wasn't walking very quickly. However within 20 or 30 yards I realized she had already gone twice the distance beyond the point we met as I had! Compared to my pace she was sprinting.
Still I'm pretty pleased with myself for having completed the walk. Just a week or two ago I probably couldn't have done it. And even though I seriously considered giving up several times along the way I stuck to it and made the whole trip. I've been mostly sitting on my butt "recovering" for the last twelve weeks. Being able to do something like this really seems like recovery to me.
Like every other American community mine is built for the car not foot traffic or bicycles. The shops where I needed to do my errands were quite a distance, about 2½ miles, away. I didn't drive because I still haven't been cleared to drive.
On the outbound journey there were a number of points where I stopped and seriously considered calling home to get picked up. A number of sensations occurred that made me think about stopping. The walking made my head hurt. Not continuously but there were intermittent episodes and the pain occurred mostly in the area where my helmet contacted the pavement when I crashed. I also found that if I looked at things along the side of the road I tended not to be able to maintain my direction. If I looked ahead I went where I was looking. If I looked off to the side I would slowly drift off course one way or another. Not a good thing when there's no sidewalk and drifting the wrong way would take me into traffic.
The other thing is that I was slow. I didn't recognize that at first. A woman walking a dog made that clear to me though. After my first mile she and the dog appeared and passed by me. She greeted me on the way by and kept moving. By my reconning she wasn't walking very quickly. However within 20 or 30 yards I realized she had already gone twice the distance beyond the point we met as I had! Compared to my pace she was sprinting.
Still I'm pretty pleased with myself for having completed the walk. Just a week or two ago I probably couldn't have done it. And even though I seriously considered giving up several times along the way I stuck to it and made the whole trip. I've been mostly sitting on my butt "recovering" for the last twelve weeks. Being able to do something like this really seems like recovery to me.
How much longer?
I'm feeling much better. Feel sure I could be back at work now but need doctor's approval before I can do that or drive. Have a doctor's appointment next week where I expect to be cleared to go back to work. Problem is the doctor's office won't schedule me for the drivers test until the doctor sees me. So even though I expect to get approval next week for return to work I think it'll be at least a few days (or more) before they get me scheduled for the driver test.
Getting the driver's test scheduled is a frustration. I called the practice to see if they would go ahead and schedule it now for shortly after the appointment when, presumably, the doctor will request the test. Worse that could happen is the doctor decides I'm not ready and the test has to be canceled or rescheduled. They said no. They won't schedule the test until the doctor writes the order. I asked to speak with the doctor. I was told no, practice policy is you talk to the doctor when scheduled to see him! I asked to leave a message for the doctor. I was told no, practice policy is they don't take messages for the doctors!! I couldn't believe it!!!
That's one thing I found from this accident. Medical services ARE NOT set up to provide good customer service. Injury treatment may be good but customer service just doesn't exist.
As I said, I am feeling much better but still not 100%. There are still a few issues. My hands hurt at the end of the day. They're sore. Asked one of my doctors, an orthopedist, about that and he said I should wait until at least six months post accident to see if soreness abates. Also there are two small soft lumps on my right temple that haven't gone away. Am trying to find someone to diagnose what they are and if they're a problem. So far I've been given three opinions. They're air that hasn't been absorbed (it was an open head fracture and I did get air on the brain), they're fat that was displaced there by the accident or they're blood or lymph fluid that accumulated there from the accident. Regardless they're a little sore. My head is mostly okay but sometimes it hurts. (Who never got a headache?) When it hurts the pain isn't significant but it is distracting. When it happens it's transient and doesn't occur often so I'm not very concerned about it. Sometimes the top hurts with a sharp pain, sometimes the right front hurts with a dull pain and sometimes it feels like there's a band around my head squeezing. When the band around the head feeling happens the bumps feel as if they're throbbing. Because of that I would like to get a more definitive diagnosis for the bumps then maybe air or maybe fat or maybe blood or maybe lymph fluid. The last complaint I'll catalog is my right cheek and eyelid feel tight. If I close my eye or try to move that part of my face it feels stiff and resistant to being moved.
Regardless of how all that may sound it really isn't a problem. It's just different than things used to be. And it is much better than even three weeks ago. So I'm pretty happy with the way things are. Plus there's been continual improvement since the accident so I'm expecting these problems will continue to abate. All the doctors have been in agreement that they're surprised I'm in such good shape given the initial MRI findings.
One other thing I've written about here is the palsy on the right side of my face. It's mostly gone. I'm at the point now where I can easily drink from a glass or bottle without dribbling and without trying hard to prevent the dribble. It was just a couple weeks ago that I couldn't drink without dribbling unless the cup or glass had a large enough diameter.
All in all things are good. I feel like the doctors are keeping me from work now.
Getting the driver's test scheduled is a frustration. I called the practice to see if they would go ahead and schedule it now for shortly after the appointment when, presumably, the doctor will request the test. Worse that could happen is the doctor decides I'm not ready and the test has to be canceled or rescheduled. They said no. They won't schedule the test until the doctor writes the order. I asked to speak with the doctor. I was told no, practice policy is you talk to the doctor when scheduled to see him! I asked to leave a message for the doctor. I was told no, practice policy is they don't take messages for the doctors!! I couldn't believe it!!!
That's one thing I found from this accident. Medical services ARE NOT set up to provide good customer service. Injury treatment may be good but customer service just doesn't exist.
As I said, I am feeling much better but still not 100%. There are still a few issues. My hands hurt at the end of the day. They're sore. Asked one of my doctors, an orthopedist, about that and he said I should wait until at least six months post accident to see if soreness abates. Also there are two small soft lumps on my right temple that haven't gone away. Am trying to find someone to diagnose what they are and if they're a problem. So far I've been given three opinions. They're air that hasn't been absorbed (it was an open head fracture and I did get air on the brain), they're fat that was displaced there by the accident or they're blood or lymph fluid that accumulated there from the accident. Regardless they're a little sore. My head is mostly okay but sometimes it hurts. (Who never got a headache?) When it hurts the pain isn't significant but it is distracting. When it happens it's transient and doesn't occur often so I'm not very concerned about it. Sometimes the top hurts with a sharp pain, sometimes the right front hurts with a dull pain and sometimes it feels like there's a band around my head squeezing. When the band around the head feeling happens the bumps feel as if they're throbbing. Because of that I would like to get a more definitive diagnosis for the bumps then maybe air or maybe fat or maybe blood or maybe lymph fluid. The last complaint I'll catalog is my right cheek and eyelid feel tight. If I close my eye or try to move that part of my face it feels stiff and resistant to being moved.
Regardless of how all that may sound it really isn't a problem. It's just different than things used to be. And it is much better than even three weeks ago. So I'm pretty happy with the way things are. Plus there's been continual improvement since the accident so I'm expecting these problems will continue to abate. All the doctors have been in agreement that they're surprised I'm in such good shape given the initial MRI findings.
One other thing I've written about here is the palsy on the right side of my face. It's mostly gone. I'm at the point now where I can easily drink from a glass or bottle without dribbling and without trying hard to prevent the dribble. It was just a couple weeks ago that I couldn't drink without dribbling unless the cup or glass had a large enough diameter.
All in all things are good. I feel like the doctors are keeping me from work now.
Monday, October 1, 2007
A New Week
This last week has been pretty good even though it includes some experiences that illustrate more recovery is needed to get back to "normal." I feel well enough that I expect to be back to work very soon. Don't have to be 100% to get back (at least that's what I think & believe the doctors have the same outlook).
I have an appointment Wednesday for a neuropsychological evaluation. It's supposed take 6 - 12 hours. The results of that test, and a full day EEG that I had, will be used at my doctor's visit later in the month to decide how much work I can handle and how soon. Going back will be tough no doubt but still good to get started up on the old routine again.
Monday or Tuesday last week I got a cold. It lasted for the whole week. Some congestion is still clearing up. Coughing and sneezing were torture. Each cough produced a band of pain along two adjacent ribs on my right side. They hurt all the way from the front around to the back and seemed to tug at the attached vertebra, ow! Of course this seemed to emanate from the ribs attached to the fractured vertebra. I did my best to suppress every cough and sneeze to avoid the pain. Still I did sneeze and cough so it was a painful week.
Over the weekend the youngest kid, 10 years old, wanted to "build something with wood." He asks to do this every once in a while. When the request is indulged it usually becomes frustrating for us both. The kid imagines building a house or something nearly as ambitious. The adult, guess who, supervises and guides without a clear plan what to build or materials enough to build it as big as the child imagines. And the kid always finds hammering and sawing to be more work than imagined. This time the project is a tree house.
Fortunately we have an old club house that I built that I've wanted to remove from the yard for a while. I struck a deal with the 10 year old that he readily agreed to. Take apart the club house and we'll use that wood to build the tree house. I didn't expect it to go far because it would take at least a few weekends for the boy to disassemble the club house and I told him that. He agreed anyway because he was so intent on building the tree house.
Surprise, surprise. The 10 year old spent seven hours working non-stop by himself on Saturday and another three Sunday, with a friend, taking it apart. There's still more to do but he, and on Sunday he and his friend, did an incredible amount of work.
What was I able to do to help? I picked out the needed tools, instructed in their use, identified what to take off in what order and provided safety supervision. Safety was mostly making sure he knocked out nails so none were sticking up to perforate a foot. And, a few times, I hefted the sledge hammer to help him get some pieces loosened.
Turns out that level of effort is my physical exertion maximum at this point. Nearly the entire time the ten year old worked I stood and watched. But I did stand most of the time. The up side is I "worked" for seven hours on Saturday. The down side is "normal" physical activities still aren't normal for me. As has been the case for every problem so far capability has improved with time.
The remaining question is the brain. Recovery the last few weeks helped me recognize that I wouldn't have been successful returning to work sooner. Now I feel like I've recovered enough that I am evaluating my cognition more accurately. I'm pretty sure I'll get started back at work after the doctor's review of the MRI and neuropsychological exam. Here's hoping the doctor sees things this way too!
Friday, September 21, 2007
Where in the world was the crash?
It occurred to me some people might be interested in a better understanding of what the crash scene was like. At least I wanted to get a better perspective of what it looked like from the online vantage points I knew of.
The maps.google link is the only way I can share the spot right now. I've got a Google Earth Placemark that I've got to figure out how to make available. In any case the crash site is marked in this link. It's a road map overlaid on a satellite view. Zoom in by double clicking. The spot is marked with a red pushpin. Click the Satellite button to remove the map overlay. Click the Hybird button to get the overlay back.
It should work in any modern web browser on any modern operating system (Windows, Linux, Mac OS X). I've tried it on all but the last.
Navigate along the roads a bit and you'll see that there are fantastic bike rides around here. Going to the north, Lake Waramug and Bantam Lake are two good rides. Even better if taken as a single longer outing.
The maps.google link is the only way I can share the spot right now. I've got a Google Earth Placemark that I've got to figure out how to make available. In any case the crash site is marked in this link. It's a road map overlaid on a satellite view. Zoom in by double clicking. The spot is marked with a red pushpin. Click the Satellite button to remove the map overlay. Click the Hybird button to get the overlay back.
It should work in any modern web browser on any modern operating system (Windows, Linux, Mac OS X). I've tried it on all but the last.
Navigate along the roads a bit and you'll see that there are fantastic bike rides around here. Going to the north, Lake Waramug and Bantam Lake are two good rides. Even better if taken as a single longer outing.
Thursday, September 20, 2007
Are doctors pessimists and therapists optimists?
The neurologist and orthopedist keep advising caution and patience. Their counsel is "full recovery" will take six to nine months or longer and doesn't necessarily mean a return to preaccident health.
On the insurance forms they completed they noted limitations like no twisting, bending or stooping, don't reach above shoulder level and no climbing (um climb what, stairs or trees). One writes don't lift anything the other writes nothing over 10 pounds. Both write "no stress or physical demands." Sounds like a pretty idyllic and idle life. Especially the no stress part. Of course I'll need some minions to live that way. Last time I looked out my front door there wasn't a line of them waiting for the job. Any volunteers out there?
The therapists (physical, occupational and speech) have each given me exercises to do. Each of them encourages me to do the assigned exercises and a bit more. If I follow their advise then I'm not following the doctors' advise. They're essentially coaching me to hit the limit and then do a little more. From the first day the speech therapist saw me she talked about wanting to stretch my cheek to promote muscle activity on the right side of my face. The only reason she didn't on the first few visits was because she wasn't sure whether the sinus and eye socket fractures had healed enough to withstand the stress. Once she thought that milestone had passed she was in there tugging away. And the other two therapists upped the intensity with each visit as well.
In general the doctors have counseled "...wait and see, who knows what the ultimate outcome will be..." and other similar outlooks. The therapists seem to have the perspective "try more, do more" and they always act happy to see me so they can make me do just that.
So I wonder, are doctors pessimists and therapists optimists?
Meanwhile I feel good but I have this brain injury cloud hanging over my head. The neurologist presented me with a booklet "The Unseen Injury, Questions and Answers About Mild Brain Injury." When he gave it to me he said to keep in mind that mine was much worse than a mild brain injury. Well thanks.
Anyway, among all the various symptoms that can result from such an injury was the happy prognosis that sometimes symptoms don't manifest until the patient returns to their normal environment, e.g. work. Great. I feel good now but I wonder if I'll have symptoms appear once I try and reenter my "normal" life.
Oh well, I've got a full day neuropsychological evaluation coming up at the start of October. Hopefully that will give a sense of what might happen going forward.
On the insurance forms they completed they noted limitations like no twisting, bending or stooping, don't reach above shoulder level and no climbing (um climb what, stairs or trees). One writes don't lift anything the other writes nothing over 10 pounds. Both write "no stress or physical demands." Sounds like a pretty idyllic and idle life. Especially the no stress part. Of course I'll need some minions to live that way. Last time I looked out my front door there wasn't a line of them waiting for the job. Any volunteers out there?
The therapists (physical, occupational and speech) have each given me exercises to do. Each of them encourages me to do the assigned exercises and a bit more. If I follow their advise then I'm not following the doctors' advise. They're essentially coaching me to hit the limit and then do a little more. From the first day the speech therapist saw me she talked about wanting to stretch my cheek to promote muscle activity on the right side of my face. The only reason she didn't on the first few visits was because she wasn't sure whether the sinus and eye socket fractures had healed enough to withstand the stress. Once she thought that milestone had passed she was in there tugging away. And the other two therapists upped the intensity with each visit as well.
In general the doctors have counseled "...wait and see, who knows what the ultimate outcome will be..." and other similar outlooks. The therapists seem to have the perspective "try more, do more" and they always act happy to see me so they can make me do just that.
So I wonder, are doctors pessimists and therapists optimists?
Meanwhile I feel good but I have this brain injury cloud hanging over my head. The neurologist presented me with a booklet "The Unseen Injury, Questions and Answers About Mild Brain Injury." When he gave it to me he said to keep in mind that mine was much worse than a mild brain injury. Well thanks.
Anyway, among all the various symptoms that can result from such an injury was the happy prognosis that sometimes symptoms don't manifest until the patient returns to their normal environment, e.g. work. Great. I feel good now but I wonder if I'll have symptoms appear once I try and reenter my "normal" life.
Oh well, I've got a full day neuropsychological evaluation coming up at the start of October. Hopefully that will give a sense of what might happen going forward.
Monday, September 17, 2007
Doing better than some people expected
I'm still trying to figure out what actually caused my accident. The police and emergency responders don't believe a car hit me and so they attribute the accident to loss of control of the bike due to unknown cause.
I've spoken with the EMT chief who was on the scene. I was trying to get more information about the crash, anything the EMTs and police might have seen, and what the road conditions were. He said what I expected to hear, no witnesses and the road was in good condition with no debris or other impediments to traffic. However they did determine that the crash scene had been changed before emergency services arrived. Someone had moved my bike to the side of the road opposite the lane I was laying in and leaned up it against the guard rail.
He also said they were surprised by the severity of my injuries. They had never encountered a bicycle accident with injuries as severe as mine.
So, somebody moved my bicycle after the crash but there were no witnesses and nobody on scene when the first emergency responders showed up. Who moved the bicycle and why? I'd really like to know.
The EMT chief also told me something that was a bit chilling. He said he called the town's first selectman from the accident scene and told him there was a likely fatality on the road!
When the EMTs got on scene I wasn't breathing, didn't have a pulse and had bleed a lot from the head. And then they had to provide CPR for such a long time to get a pulse they just didn't think I'd survive. He said he was surprised and pleased to get a call from me.
Some expectations are good to exceed.
I've spoken with the EMT chief who was on the scene. I was trying to get more information about the crash, anything the EMTs and police might have seen, and what the road conditions were. He said what I expected to hear, no witnesses and the road was in good condition with no debris or other impediments to traffic. However they did determine that the crash scene had been changed before emergency services arrived. Someone had moved my bike to the side of the road opposite the lane I was laying in and leaned up it against the guard rail.
He also said they were surprised by the severity of my injuries. They had never encountered a bicycle accident with injuries as severe as mine.
So, somebody moved my bicycle after the crash but there were no witnesses and nobody on scene when the first emergency responders showed up. Who moved the bicycle and why? I'd really like to know.
The EMT chief also told me something that was a bit chilling. He said he called the town's first selectman from the accident scene and told him there was a likely fatality on the road!
When the EMTs got on scene I wasn't breathing, didn't have a pulse and had bleed a lot from the head. And then they had to provide CPR for such a long time to get a pulse they just didn't think I'd survive. He said he was surprised and pleased to get a call from me.
Some expectations are good to exceed.
Tuesday, September 11, 2007
Walking in the rain
One of the things I like about cycling is being outside and seeing the world change as it floats around the sun. Part and parcel to that is experiencing changing weather.
I walked outside in the rain recently. It was a mild rain. Still there was a bit of a thrill to being outside in it. I ride year round and have ridden in rain and snow. Going outside in the rain, even just to walk down the driveway and collect the mail, felt sort of like taking a risk. It was also a pleasant reminder of the changes I get to experience when I'm out on my bike.
Physically I don't feel lots of problems any more. By the end of each day my hands hurt and are painful to open and close. The right hand is difficult to close completely and doesn't have normal strength yet. The right shoulder and knee still need bandages if I'm going to wear clothing that covers them. Basically there's still a few dings and scrapes, they're not too severe but combined with the spine and neck fractures they do slow me down.
The biggest problems are the invisible injuries, fractures and swelling inside my head. The doctor calls it TBI (traumatic brain injury). I can't feel it or gage very will how it affects my ability to do things. I have to try and do things and see how well I do. At this point everything takes longer than it should and I'm not aware of where or how it gets off track. Almost like "thinking through molasses" without being aware you're in it.
I walked outside in the rain recently. It was a mild rain. Still there was a bit of a thrill to being outside in it. I ride year round and have ridden in rain and snow. Going outside in the rain, even just to walk down the driveway and collect the mail, felt sort of like taking a risk. It was also a pleasant reminder of the changes I get to experience when I'm out on my bike.
Physically I don't feel lots of problems any more. By the end of each day my hands hurt and are painful to open and close. The right hand is difficult to close completely and doesn't have normal strength yet. The right shoulder and knee still need bandages if I'm going to wear clothing that covers them. Basically there's still a few dings and scrapes, they're not too severe but combined with the spine and neck fractures they do slow me down.
The biggest problems are the invisible injuries, fractures and swelling inside my head. The doctor calls it TBI (traumatic brain injury). I can't feel it or gage very will how it affects my ability to do things. I have to try and do things and see how well I do. At this point everything takes longer than it should and I'm not aware of where or how it gets off track. Almost like "thinking through molasses" without being aware you're in it.
Saturday, September 8, 2007
Cheek pull
The therapist stuck her fingers in my mouth today. She used them along with her thumb on my cheek to pull my cheek muscles. Weird to feel a muscle in your face tugged on.
My sinus fractures healed enough that they could stand the stress of this therapeutic massage. And the therapist has been threatening me with it since I first met her. Anyhow she had me do some face exercises after the cheek massage.
My therapy assignment is to use a mirror for the face exercises. The mirror is to see and help learn how to make facial expressions that are equal proportions on each side of the face. The right side of my mouth and chin have some palsy which may or may not go away. In the meantime I exercise by looking at my face in a mirror. Reps are tough.
To my eye there isn't much visible swelling in my face but everyone who sees me remarks how it's decreased since last they saw me. The doctors have been telling me swelling inside body spaces, like skull and sinuses, takes quite a long time to go down and is sometimes treated with steroid injections. The swelling continues to affect nerve and muscle function until it is gone and the tissue recovers from any damage.
My sinus fractures healed enough that they could stand the stress of this therapeutic massage. And the therapist has been threatening me with it since I first met her. Anyhow she had me do some face exercises after the cheek massage.
My therapy assignment is to use a mirror for the face exercises. The mirror is to see and help learn how to make facial expressions that are equal proportions on each side of the face. The right side of my mouth and chin have some palsy which may or may not go away. In the meantime I exercise by looking at my face in a mirror. Reps are tough.
To my eye there isn't much visible swelling in my face but everyone who sees me remarks how it's decreased since last they saw me. The doctors have been telling me swelling inside body spaces, like skull and sinuses, takes quite a long time to go down and is sometimes treated with steroid injections. The swelling continues to affect nerve and muscle function until it is gone and the tissue recovers from any damage.
Wednesday, September 5, 2007
1st posting break
I broke the posting pattern right after I got back home. So many things happening and so much more mobility required around the house that old routines like blogging became impossible chores.
A lot has gone on. Therapy has consumed pretty much all my energy. Doesn't seem like it should but I haven't got much else done since it began. The therapists keep giving me exercises to do! They're simple and I do them but afterwards I really don't get much else done. As with every other complaint things are improving.
On my most recent doctor visit they told me I wasn't even ready for part time work. Frustrating. Recognizing that I've only been able to focus on therapy during this recent stretch and not maintain other activities helped me understand it's probably a good idea. And it's a paid for opinion.
A few weeks ago a package arrived from work just as I was being ferried to an appointment. Didn't have time to open it before we left for therapy. My wife wondered whether I'd been sent a bundle of work. I surmised it would be a care package. For no good reason I started to have my doubts and they weren't calmed until the package was opened after therapy.
There's a lot of good stuff in the box. Thanks to everyone for sending it over. The pistachios were a big hit. When asked as a group the boys said they didn't like pistachios. After I got each kid to try one they all liked them. The pistachios were gone before the end of the day.
Two gifts seemed to cater to my likes and I've enjoyed them very much. One is chocolate and peanut butter truffles. I'm the only person in the house who appreciates them. That means the whole bag is mine to enjoy without even hoarding it.
The other item is, err was, black olives which are great in salads, on pizza, and for nibbling. I did most of the nibbling. The rest of the can was used to add garnish to salads.
There were many other things in the box. There's no doubt I needed a replacement bicycle helmet. The helmet in the box had tech company branding. From experience I know the products from some of those companies crash. I'm not sure I want something on my head that's known to crash. One crash was enough.
The helmet makes me think of riding. At the rate I'm going it'll be the end of the year before I'm even doing laps around the yard on the mountain bike. And speaking of riding, this year's been a disaster. Hurt my back at the end of February and that kept me off the road until the end of April. At the point this crash occurred had only 995 miles for the year. At the same point last year had 2,346 miles and would put on 1,382 more before the end of 2006. I'm not banking on any more miles in 2007. Even if I am able to ride more before the end of the year it won't be much. No matter what I'll end up with around 2,800 fewer miles this year than last! Argh!
Saturday, August 18, 2007
Breakfast Independence
Almost one month later and I'm able to make my first breakfast. Cooked that is. I've progressed from being served every meal, to being able to make coffee, to coffee & cold cereal. Today is my first "cooked for myself" meal. The pancake batter is a just add water mix that I favor. The thickness and lightness of the finished pancakes is controlled by the ratio of water to mix and amount of beating. The batter cooked up just the way I wanted. The water and beating were right on the first try.
To make breakfast I emptied the dishwasher, got the electric grill and a mixing bowl out, made the batter and set out a plate and silverware for myself. When I was done everything that should went in the dishwasher. Of course there's no free lunch (or breakfast). The whole process took me about 2½ or 3 hours, normally it would have been forty minutes or so. And when I finished I needed a three hour nap to recuperate. Definitely need to regain some stamina. Making breakfast shouldn't put me to sleep or take so long.
To make breakfast I emptied the dishwasher, got the electric grill and a mixing bowl out, made the batter and set out a plate and silverware for myself. When I was done everything that should went in the dishwasher. Of course there's no free lunch (or breakfast). The whole process took me about 2½ or 3 hours, normally it would have been forty minutes or so. And when I finished I needed a three hour nap to recuperate. Definitely need to regain some stamina. Making breakfast shouldn't put me to sleep or take so long.
Friday, August 17, 2007
Official airhead
Had some follow up visits today.
At the first one the doctor asked me the kind of anti-seizure medication I'm on! What?! Anti-seizure medication? Turns out I didn't just break bones in my head I broke my head open a little. That allowed air into my brain. The doctor saw it in the x-rays and radiologist report that came from the hospital. Apparently air on the brain can lead to seizures and anti-seizure medication may be prescribed as preventive therapy. I need to follow up and find out whether I should be getting anti-seizure medication. Now I'm a bit concerned.
Aside from that somewhat worrisome revelation the visit went well. Additional x-rays were taken to look at the condition of my neck, spine and hand. Finally got some clarity on my right hand. Turns out I have two fractures in it, the long bone in the index finger and the knuckle of the little finger. The one in the knuckle even has a common name, a boxer's fracture.
I was more confident in this doctor than any of the others so far. He was familiar with my chart, he brought up the the air issue which was news to me, and he listened while I described conditions and concerns in layman's terms. He then translated to medical terms and explained the terms. And he provided some guidelines for things like the neck brace and physical activity, e.g., squat only no bending at the waist, maximum weight I should lift 10#, eight weeks in the brace.
The other visit was for physical therapy. Went pretty well I thought. Was given a number of different sorts of tests. One written test was to compute in my head the total value of groups containing varying quantities and denominations of coins. Got a few totals wrong but, according to the therapist, all the most difficult were correct. She gave me finger exercises to do too. They're meant to work my right hand and improve range of motion. Strength work is next.
For therapy I had to write three goals. One, which will certainly be the last accomplished, is ride my bicycle.
Doing just those two appointments did make for a long day for me and wore me out. Got back to my chair at home and slept about three hours.
At the first one the doctor asked me the kind of anti-seizure medication I'm on! What?! Anti-seizure medication? Turns out I didn't just break bones in my head I broke my head open a little. That allowed air into my brain. The doctor saw it in the x-rays and radiologist report that came from the hospital. Apparently air on the brain can lead to seizures and anti-seizure medication may be prescribed as preventive therapy. I need to follow up and find out whether I should be getting anti-seizure medication. Now I'm a bit concerned.
Aside from that somewhat worrisome revelation the visit went well. Additional x-rays were taken to look at the condition of my neck, spine and hand. Finally got some clarity on my right hand. Turns out I have two fractures in it, the long bone in the index finger and the knuckle of the little finger. The one in the knuckle even has a common name, a boxer's fracture.
I was more confident in this doctor than any of the others so far. He was familiar with my chart, he brought up the the air issue which was news to me, and he listened while I described conditions and concerns in layman's terms. He then translated to medical terms and explained the terms. And he provided some guidelines for things like the neck brace and physical activity, e.g., squat only no bending at the waist, maximum weight I should lift 10#, eight weeks in the brace.
The other visit was for physical therapy. Went pretty well I thought. Was given a number of different sorts of tests. One written test was to compute in my head the total value of groups containing varying quantities and denominations of coins. Got a few totals wrong but, according to the therapist, all the most difficult were correct. She gave me finger exercises to do too. They're meant to work my right hand and improve range of motion. Strength work is next.
For therapy I had to write three goals. One, which will certainly be the last accomplished, is ride my bicycle.
Doing just those two appointments did make for a long day for me and wore me out. Got back to my chair at home and slept about three hours.
Tuesday, August 14, 2007
Argh, health care
Had a follow up Tuesday. Understood it was supposed to include some testing to start figuring out when I could be cleared for return to work. During the visit the doctors only asked questions. There were no empirical cognitive, memory or reaction tests done. What are they waiting for?
Saw psychologists and neuropsychologists during the visit. They all seemed surprised that I wanted some insight into when and how a return to work determination would be made. Had to press to get a commitment to come up with a projection! First step, they say, is an evaluation that will include empirical cognitive, memory and reaction tests. They told me it takes a long time to get the evaluation approved. How long? Oh, at least six weeks they said! Why wasn't this part of a care plan that was developed before I was released from the hospital?
The doctors will do a report calling for the testing then submit that to insurance. Once insurance approves and only then (that's a quote) the tests will be scheduled. Okay, how long till the report is ready? A day, two days? Oh, no, no, five to ten days maybe more. Argh, I feel like I'll be ready to be back to work before the testing happens!
Why does it seem like the system has no interest in defining a desired outcome, in this case return to work, and then planning the steps needed to accomplish that?
And why does it seem follow up is so poor? I've broken things before; wrist, knee cap, toe. Every time x-rays have been taken and follow up x-rays scheduled to check on the progress of the healing. Granted I've never broken bones in my head or fractured vertebra before but, based on prior experience, I'd expect a desire for follow up images to check on the progress of the healing. No doctors have even mentioned that. I think I have follow up to do to get additional images taken or at least explanations of why they aren't needed. The more "health care" I experience the more concerned I become about the case management part of it.
Saw psychologists and neuropsychologists during the visit. They all seemed surprised that I wanted some insight into when and how a return to work determination would be made. Had to press to get a commitment to come up with a projection! First step, they say, is an evaluation that will include empirical cognitive, memory and reaction tests. They told me it takes a long time to get the evaluation approved. How long? Oh, at least six weeks they said! Why wasn't this part of a care plan that was developed before I was released from the hospital?
The doctors will do a report calling for the testing then submit that to insurance. Once insurance approves and only then (that's a quote) the tests will be scheduled. Okay, how long till the report is ready? A day, two days? Oh, no, no, five to ten days maybe more. Argh, I feel like I'll be ready to be back to work before the testing happens!
Why does it seem like the system has no interest in defining a desired outcome, in this case return to work, and then planning the steps needed to accomplish that?
And why does it seem follow up is so poor? I've broken things before; wrist, knee cap, toe. Every time x-rays have been taken and follow up x-rays scheduled to check on the progress of the healing. Granted I've never broken bones in my head or fractured vertebra before but, based on prior experience, I'd expect a desire for follow up images to check on the progress of the healing. No doctors have even mentioned that. I think I have follow up to do to get additional images taken or at least explanations of why they aren't needed. The more "health care" I experience the more concerned I become about the case management part of it.
Monday, August 13, 2007
Better, slowly but surely
I'm pretty much done with the little white pills. Maybe one or two every day or so now. Still have some others that I take because the need for them isn't gone. "Pain free" most of the time. Yeah there's some persistent aches but they can be tolerated without chemical intervention.
Now it's things that aren't back to working right that are the focus. The right hand still is not closing all the way or able to make a tight grip. It closes most of the way, just a last tiny fraction to go and there's something that prevents closing the gap. It doesn't have much of a grip though. Sometimes I can twist the cap off a soda bottle, most of the time the left hand is needed.
The right side of my face is getting some motion back. My lips can be pursed enough now that if I'm careful and sip slowly nothing spills while drinking from a glass. And if I concentrate on it I can move some muscles a tiny bit on the right side of my face. At last week's doctor visit they told me that a nerve comes out of the skull in the right temporal lobe, the side of my head that smacked the road, that controls motion in the right side of the face. Just have to wait and see how much motion is recovered. Getting some independent motion back is a good indication that more might return.
My right eye still doesn't focus correctly most of the of the time. But the instances when it does focus are occurring more frequently.
Bed spins and chair spins are the biggest inconvenience now. Vertigo has been a problem since crashing and I've been unsteady on my feet at times. For the most part that's abated except in some specific circumstances. Sitting down in a low chair, getting up from a low chair, laying down in bed and rolling from my side to my back in bed can all cause the room to spin and usually do. The speed and duration of the spin have all been decreasing. I'm expecting the symptom to stop eventually just don't know when.
Have more doctor follow ups on the calendar. The next visit is supposed to involve some neurological testing. Supposedly they'll make a determination about physical or occupational therapy that might be needed before returning to work. There's even a possibility they might project a return to work date.
It's been great sitting around having nothing to do and no responsibility while recovering. But now I feel well enough that I'm definitely getting restless and bored. I don't know what the doctor's benchmark will be for return to work but I hope I'm there.
Now it's things that aren't back to working right that are the focus. The right hand still is not closing all the way or able to make a tight grip. It closes most of the way, just a last tiny fraction to go and there's something that prevents closing the gap. It doesn't have much of a grip though. Sometimes I can twist the cap off a soda bottle, most of the time the left hand is needed.
The right side of my face is getting some motion back. My lips can be pursed enough now that if I'm careful and sip slowly nothing spills while drinking from a glass. And if I concentrate on it I can move some muscles a tiny bit on the right side of my face. At last week's doctor visit they told me that a nerve comes out of the skull in the right temporal lobe, the side of my head that smacked the road, that controls motion in the right side of the face. Just have to wait and see how much motion is recovered. Getting some independent motion back is a good indication that more might return.
My right eye still doesn't focus correctly most of the of the time. But the instances when it does focus are occurring more frequently.
Bed spins and chair spins are the biggest inconvenience now. Vertigo has been a problem since crashing and I've been unsteady on my feet at times. For the most part that's abated except in some specific circumstances. Sitting down in a low chair, getting up from a low chair, laying down in bed and rolling from my side to my back in bed can all cause the room to spin and usually do. The speed and duration of the spin have all been decreasing. I'm expecting the symptom to stop eventually just don't know when.
Have more doctor follow ups on the calendar. The next visit is supposed to involve some neurological testing. Supposedly they'll make a determination about physical or occupational therapy that might be needed before returning to work. There's even a possibility they might project a return to work date.
It's been great sitting around having nothing to do and no responsibility while recovering. But now I feel well enough that I'm definitely getting restless and bored. I don't know what the doctor's benchmark will be for return to work but I hope I'm there.
Friday, August 10, 2007
Okay a picture, sort of
A few days ago I said I'd post a picture of me in the hospital. Decided not to do it because I thought it was a bit too nasty looking. On the other hand I'm fascinated by the result of the crash. So I came up with this alternative. It's an MRI cross section of my head taken the day of the crash. It doesn't show blood or bruises but does show where my head was swollen, left side of the image which is right side of my head. This cross section is right around eye level. Nose is at the top and the white circle is the skull. The MRI cross sections from just a little higher on the head show pretty much no swelling. If the helmet covered more of the head, the temple & cheek, I might not have visited the hospital so long. On the other hand if a helmet covered that much it might be so hot and uncomfortable even I might not wear one. In that case a hospital visit probably wouldn't have helped.
Thursday, August 9, 2007
Good day - Drink straw bad - Health Care Scary
Good day - Didn't have any narcotics until the day was over, that makes it good. It was a long day that wore me out and I finally needed relief at the end of the day. The day was long because had my first follow up doctor visits. Still have to wait until next week to get first prediction when I can get back to work.
Drink straw bad - One of today's follow up visits included a conversation that was approximately as follows. Doctor (D): "Good to see you again. You've been remembering not to use straws or blow your nose like you were told while in the hospital?" Me (M): "They gave me straws with every meal while in the hospital and helped me use them. I needed them to swallow fluids because I couldn't close my lips on a glass. Nobody said anything about blowing my nose. I blew my nose once while in the hospital, it hurt and produced a lot of blood so I didn't do it again." D: "Oh..., well with your sinuses fractured you should have been advised to avoid doing anything that could create pressure in them." M: "Sorry, nobody ever said anything." D: "Oh well it's been three weeks since the fracture. Fractures take about six weeks to heal. Try not to create any pressure on your sinues." M: "Okay." All the while I'm thinking how come this is the first time I'm hearing about it and why, if I wasn't supposed to get straws, were they served with every meal and if I'm not supposed to blow my nose why keep a fresh box of tissues on the stand by my bed?! Which leads me to...
Health care scary - At my follow ups I was being asked what were my diagnosis and what treatments I'd received in the hospital. It seemed the doctors didn't know. C'mon, I was unconscious the first 48 hours I was in the hospital. Diagnosis and treatment plan would/should have been decided then. And treatments should have been recorded on my chart. Why in the world is the patient being asked on a follow up visit? Wouldn't more appropriate questions be, "how does X feel now?," "did treatment Y which we asked you to do when you left have the desired effect?" Instead they're asking me detailed medical questions as if I should know the answers. Scary. And I've been given the only radiological report and images I know of. Head and neck only. At some point in the hospital someone told me I had a fractured spine and fractures in my hand. How'd they figure that out? Are there more pictures I haven't been given? And there was no follow up on the condition of my hand which is still a bit swollen and lacks strength and full range of motion. I think maybe it might be a good idea to move to Sweden until I'm healed up.
Drink straw bad - One of today's follow up visits included a conversation that was approximately as follows. Doctor (D): "Good to see you again. You've been remembering not to use straws or blow your nose like you were told while in the hospital?" Me (M): "They gave me straws with every meal while in the hospital and helped me use them. I needed them to swallow fluids because I couldn't close my lips on a glass. Nobody said anything about blowing my nose. I blew my nose once while in the hospital, it hurt and produced a lot of blood so I didn't do it again." D: "Oh..., well with your sinuses fractured you should have been advised to avoid doing anything that could create pressure in them." M: "Sorry, nobody ever said anything." D: "Oh well it's been three weeks since the fracture. Fractures take about six weeks to heal. Try not to create any pressure on your sinues." M: "Okay." All the while I'm thinking how come this is the first time I'm hearing about it and why, if I wasn't supposed to get straws, were they served with every meal and if I'm not supposed to blow my nose why keep a fresh box of tissues on the stand by my bed?! Which leads me to...
Health care scary - At my follow ups I was being asked what were my diagnosis and what treatments I'd received in the hospital. It seemed the doctors didn't know. C'mon, I was unconscious the first 48 hours I was in the hospital. Diagnosis and treatment plan would/should have been decided then. And treatments should have been recorded on my chart. Why in the world is the patient being asked on a follow up visit? Wouldn't more appropriate questions be, "how does X feel now?," "did treatment Y which we asked you to do when you left have the desired effect?" Instead they're asking me detailed medical questions as if I should know the answers. Scary. And I've been given the only radiological report and images I know of. Head and neck only. At some point in the hospital someone told me I had a fractured spine and fractures in my hand. How'd they figure that out? Are there more pictures I haven't been given? And there was no follow up on the condition of my hand which is still a bit swollen and lacks strength and full range of motion. I think maybe it might be a good idea to move to Sweden until I'm healed up.
Monday, August 6, 2007
Some Paralysis?
Haven't been on my follow up doctor visits yet. In the interim I've noted that there is no way I can make any voluntary motions on the right side of my face. Smiles and frowns happen only on the left side of the mouth. Can't arch the right eyebrow, pull back the right corner of the mouth, or blink just the right eye. And I still can't close the right hand all the way.
Given that the right side of my head whacked the road pretty hard, I've got the damaged helmet and head fractures to prove it, and I needed three minutes of CPR to start breathing on my own again I'm lucky those are the only problems. Still I'll be asking the doctor whether there are therapies to improve the situation. Among the things that might be done my first preference will always be physical therapy. Surgery, while it is certainly the only solution to some problems, is my least favorite option for anything.
I've still got a surgical pin in my left knee from 1983 when I broke my knee cap. Surgery to repair it included removing the smallest pieces of bone and installing a pin to fuse together the largest pieces. After recovery from surgery and follow up physical therapy indicated things were well on the mend the surgeon wanted to schedule a follow up surgery to remove the pin. I asked why it needed to be removed instead of being left alone. The surgeon couldn't describe any short or long term contraindications to leaving the pin in. His driving desire for removing the pin was because "that's the way they always did it." I elected not to have the surgery.
I'm hoping the same for my face. That there will be therapies to practice that don't involve surgery which can restore some if not all the mobility to my face.
Given that the right side of my head whacked the road pretty hard, I've got the damaged helmet and head fractures to prove it, and I needed three minutes of CPR to start breathing on my own again I'm lucky those are the only problems. Still I'll be asking the doctor whether there are therapies to improve the situation. Among the things that might be done my first preference will always be physical therapy. Surgery, while it is certainly the only solution to some problems, is my least favorite option for anything.
I've still got a surgical pin in my left knee from 1983 when I broke my knee cap. Surgery to repair it included removing the smallest pieces of bone and installing a pin to fuse together the largest pieces. After recovery from surgery and follow up physical therapy indicated things were well on the mend the surgeon wanted to schedule a follow up surgery to remove the pin. I asked why it needed to be removed instead of being left alone. The surgeon couldn't describe any short or long term contraindications to leaving the pin in. His driving desire for removing the pin was because "that's the way they always did it." I elected not to have the surgery.
I'm hoping the same for my face. That there will be therapies to practice that don't involve surgery which can restore some if not all the mobility to my face.
Sunday, August 5, 2007
Mornings are hardest
Mornings have officially become the hardest (read most painful) part of the day.
A conversation with my case manager a few days ago led to a new routine with the little white pills. Instead of beating down pain by taking a pill or two when I felt uncomfortable "as needed for pain" I'm taking a pill every few hours throughout the day. This keeps the narcotics at a consistent level in my blood and, the idea was, would promote a relatively consistent and acceptable level of comfort throughout the day. The idea worked wonderfully and resulted in two consecutive days during which I felt comparatively comfortable and pain free from wake up until bed time.
I credit the new routine with getting me my first two nights of real sleep. Nights that I slept for nearly six hours before waking for something then going right back to sleep.
Before the new routine my best night was 3½ hours of sleep. Typically after waking there'd be at least an hour of tossing and turning and consumption of meds before dozing for another hour of sleep. Then repeat the tossing/turning/sleep cycle until morning. They weren't very restful nights. An hour or three nap in the reclining chair usually followed sometime during the day.
The bad part of the new routine is the morning. I've been waking about 6:00. The med cycle starts at 9:00. There's no boost in the narcotics from the last dose in the evening until the first dose in the morning. So the morning is the day's lowest concentration of narcotics.
When I wake my jaw hurts, the teeth on the top right hand side of my mouth ache, and all the places where skin was scraped off which healed over during the night protest any movements in the morning. Most of the abraded skin is over joints and there's no way to avoid moving it. Skin over the right shoulder, right knee, and left knuckles all gets moved at least a little from almost any body movement. As a result each of the past two mornings have been adventures in pain. The very act of getting out of bed causes skin to move that has been still and healing for several hours. And even if I lay still and don't move my head aches. OUCH!
So far during recovery everything has felt different after a few days. I'm hoping this follows suit and mornings aren't so unpleasant anymore a few days from now.
A conversation with my case manager a few days ago led to a new routine with the little white pills. Instead of beating down pain by taking a pill or two when I felt uncomfortable "as needed for pain" I'm taking a pill every few hours throughout the day. This keeps the narcotics at a consistent level in my blood and, the idea was, would promote a relatively consistent and acceptable level of comfort throughout the day. The idea worked wonderfully and resulted in two consecutive days during which I felt comparatively comfortable and pain free from wake up until bed time.
I credit the new routine with getting me my first two nights of real sleep. Nights that I slept for nearly six hours before waking for something then going right back to sleep.
Before the new routine my best night was 3½ hours of sleep. Typically after waking there'd be at least an hour of tossing and turning and consumption of meds before dozing for another hour of sleep. Then repeat the tossing/turning/sleep cycle until morning. They weren't very restful nights. An hour or three nap in the reclining chair usually followed sometime during the day.
The bad part of the new routine is the morning. I've been waking about 6:00. The med cycle starts at 9:00. There's no boost in the narcotics from the last dose in the evening until the first dose in the morning. So the morning is the day's lowest concentration of narcotics.
When I wake my jaw hurts, the teeth on the top right hand side of my mouth ache, and all the places where skin was scraped off which healed over during the night protest any movements in the morning. Most of the abraded skin is over joints and there's no way to avoid moving it. Skin over the right shoulder, right knee, and left knuckles all gets moved at least a little from almost any body movement. As a result each of the past two mornings have been adventures in pain. The very act of getting out of bed causes skin to move that has been still and healing for several hours. And even if I lay still and don't move my head aches. OUCH!
So far during recovery everything has felt different after a few days. I'm hoping this follows suit and mornings aren't so unpleasant anymore a few days from now.
Thursday, August 2, 2007
Another day, new pains
Feel like I'm getting better each day. To the point that my family keeps reminding me that I have follow up doctor visits and physical therapy before anything is decided about when I can return to work. Still can't close the right hand all the way, talk without a lisp, close only the right eye (have to close both to get that one to close), or keep a drink in my mouth unless I pinch the right side of my mouth closed with my fingers. On the other hand I can now walk comfortably without shuffling and take real steps instead of half steps.
The "new pains" part is now that the big pains are going away I'm actually noticing how many other things ache to some degree or another. My knuckles, especially on the left hand, have some serious pieces of skin to grow back as do my right knee and shoulder. Normal healing will take care of it I'm sure but I'm ready for it to be finished already.
And with all this I find myself wondering why isn't my collar bone broken? I'm presuming I went over the front of the bars or at least off the bike to the front. I've got abrasions in places that suggest that's what happened so how did I luck out and not break the collar bone? Not that I'm asking for it to be broken mind you. I'm just wondering since I had the bad luck to unload off the bike in the first place how'd I have the good luck not to break the collar bone like it seems every biker who crashes over the bars does?
The "new pains" part is now that the big pains are going away I'm actually noticing how many other things ache to some degree or another. My knuckles, especially on the left hand, have some serious pieces of skin to grow back as do my right knee and shoulder. Normal healing will take care of it I'm sure but I'm ready for it to be finished already.
And with all this I find myself wondering why isn't my collar bone broken? I'm presuming I went over the front of the bars or at least off the bike to the front. I've got abrasions in places that suggest that's what happened so how did I luck out and not break the collar bone? Not that I'm asking for it to be broken mind you. I'm just wondering since I had the bad luck to unload off the bike in the first place how'd I have the good luck not to break the collar bone like it seems every biker who crashes over the bars does?
Wednesday, August 1, 2007
A Report from the "1st Responder Broadcast Network" on my crash
Here's the link to the article...
Serious Bicycle Crash for Roxbury
After reading it I'm surprised I'm still around. Three minutes of CPR to get me started up again! I'm glad the EMTs kept trying.
Serious Bicycle Crash for Roxbury
After reading it I'm surprised I'm still around. Three minutes of CPR to get me started up again! I'm glad the EMTs kept trying.
Tuesday, July 31, 2007
Little White Pills & Neck Braces
My dad was a doctor, my mom a nurse. One of the things I learned growing up is that prescriptions for antibiotics should be taken completely regardless of how one feels to avoid developing treatment resistant infections and medicine resistant bugs. On the other hand prescriptions labeled x pills y times a day "as needed for pain" were to be eliminated as soon as possible to avoid developing dependencies and to get back to a medication free life as soon as possible.
I have three take "as needed" prescriptions. All for pain. I'm taking fewer than x pills and taking them less often than y times per day. But I still can't give up the little buggers and make it through a day. It's a frustration. I'll get to zero-zero I'm sure but sooner would be better than later in my book.
As for the neck brace, that's something I've been wearing since regaining consciousness in the hospital. They even had me shower with it on because of concern over additional damage that might be done to my fractured vertebra if I didn't. Regardless of my determination to follow doctors orders, and I will, I think the brace is a contributing factor to continued consumption of the little white pills. It seems to create some pressure at the back of the head that over the course of the day ends up leading to head and jaw pain and that gets me back to the pills.
My initial blog entry indicated three skull fractures. That was what I was told on the day I left the hospital. It seems that may have been a simplification because apparently skull refers to particular bones in the head. My understanding now is it would be more correct to refer to a single skull fracture, plus a fractured eye socket (right eye), and multiple fractures of the right cheek bone. Don't know if this is better or worse but believe it is more accurate. Doesn't change the amount of pain either.
I've been thinking of posting a picture of my face to go along with the helmet. Let you all see the effect of the impact on my head even after the major impact absorbed by the helmet. The head shot I have is three days after the accident so suspect it maximizes the apparent effect of the impact by giving time for swelling and bruising to become more evident.
Thanks for all the comments and emails received to date.
I have three take "as needed" prescriptions. All for pain. I'm taking fewer than x pills and taking them less often than y times per day. But I still can't give up the little buggers and make it through a day. It's a frustration. I'll get to zero-zero I'm sure but sooner would be better than later in my book.
As for the neck brace, that's something I've been wearing since regaining consciousness in the hospital. They even had me shower with it on because of concern over additional damage that might be done to my fractured vertebra if I didn't. Regardless of my determination to follow doctors orders, and I will, I think the brace is a contributing factor to continued consumption of the little white pills. It seems to create some pressure at the back of the head that over the course of the day ends up leading to head and jaw pain and that gets me back to the pills.
My initial blog entry indicated three skull fractures. That was what I was told on the day I left the hospital. It seems that may have been a simplification because apparently skull refers to particular bones in the head. My understanding now is it would be more correct to refer to a single skull fracture, plus a fractured eye socket (right eye), and multiple fractures of the right cheek bone. Don't know if this is better or worse but believe it is more accurate. Doesn't change the amount of pain either.
I've been thinking of posting a picture of my face to go along with the helmet. Let you all see the effect of the impact on my head even after the major impact absorbed by the helmet. The head shot I have is three days after the accident so suspect it maximizes the apparent effect of the impact by giving time for swelling and bruising to become more evident.
Thanks for all the comments and emails received to date.
Monday, July 30, 2007
Update - damaged helmet
As promised with yesterday's post here's the picture of the damaged helmet. Thought there was a picture that gave a better view of the depth of the damage but this will have to do for now. When I look at it I imagine the same level of damage to an actual head as being fatal. Bikers wear your helmets. I didn't "need" mine for 20 years of riding but it was on my head when it needed to be there.
Sunday, July 29, 2007
Nearly dead - the beginning
A few details,,, I was dead (maybe not technically, nobody got a flat EEG as far as I know) no breathing, pulse, pupil response when the EMTs got to me. They resuscitated me on the road. From that point I had tubes in my throat for the ride to New Milford Hospital, LifeStar to Hartford and through Tuesday when I was transferred from ICU to "step down" in Hartford and the tubes came out.
All of the above is second hand of course. I don't recall anything. My memory from late Saturday to the the hospital step down unit Tuesday afternoon is completely blank.
What I have noticed different and don't know yet if it will change...
- I have a lisp (most likely result of 3 skull fractures I'm told I suffered)
- Can't close mouth all the way, water leaks when I drink from a glass, fun at kids parties (again skull fractures probably)
- Teeth on top of mouth, right hand side, don't seem to fit in place any more (blame the skull fractures again)
- Something in my back cracks when I inhale and exhale (told I got two cracked vertebra too)
- Right eye doesn't close all the way
- Can't close my right hand all the way
...other things but thats a good starting list
Believe helmet was definitely a life saver. Will post a picture of the damaged article when I get the chance. If as much stuff came off my head as ground off the helmet there would be a quarter inch or more of grey matter spread on the road.
Wish I knew what happened. Want to go back to the spot and see if it stirs any memories. Have done lots of riding (tens of thousands of miles) without any incidents. I'd recently maintained the bike and ridden a few hundred miles on the maintenance with no issues noted.
Knew the EMT who resuscitated me. He didn't recognize me because of the blood and swelling. Haven't spoken to him in person yet but second hand reports from people who have say he said a 911 call came in from folks who wouldn't identify themselves and wouldn't stay around for help to arrive. Maybe nothing, maybe something. Regardless I'll probably never know unless memory magically comes back at some point.
Typings very tough. Won't be getting wads of content out. Probably not even after typing is easier since talking to the wind isn't my usual thing.
Anyway, all you bikers out there, ride careful, keep the rubber side down, wear your helmets. Friends and family - I will be back on the bike! !
All of the above is second hand of course. I don't recall anything. My memory from late Saturday to the the hospital step down unit Tuesday afternoon is completely blank.
What I have noticed different and don't know yet if it will change...
- I have a lisp (most likely result of 3 skull fractures I'm told I suffered)
- Can't close mouth all the way, water leaks when I drink from a glass, fun at kids parties (again skull fractures probably)
- Teeth on top of mouth, right hand side, don't seem to fit in place any more (blame the skull fractures again)
- Something in my back cracks when I inhale and exhale (told I got two cracked vertebra too)
- Right eye doesn't close all the way
- Can't close my right hand all the way
...other things but thats a good starting list
Believe helmet was definitely a life saver. Will post a picture of the damaged article when I get the chance. If as much stuff came off my head as ground off the helmet there would be a quarter inch or more of grey matter spread on the road.
Wish I knew what happened. Want to go back to the spot and see if it stirs any memories. Have done lots of riding (tens of thousands of miles) without any incidents. I'd recently maintained the bike and ridden a few hundred miles on the maintenance with no issues noted.
Knew the EMT who resuscitated me. He didn't recognize me because of the blood and swelling. Haven't spoken to him in person yet but second hand reports from people who have say he said a 911 call came in from folks who wouldn't identify themselves and wouldn't stay around for help to arrive. Maybe nothing, maybe something. Regardless I'll probably never know unless memory magically comes back at some point.
Typings very tough. Won't be getting wads of content out. Probably not even after typing is easier since talking to the wind isn't my usual thing.
Anyway, all you bikers out there, ride careful, keep the rubber side down, wear your helmets. Friends and family - I will be back on the bike! !
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