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.

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.

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.

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?

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.