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!

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.

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.

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.

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.

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.

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!