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.
Saturday, August 18, 2007
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.
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