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.

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.

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

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.

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?

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.

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.

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!