Wednesday, October 24, 2007

The Joy of Movement - Oct 25

My father taught me a lesson in creative movement that I will never forget. When I was about 12 years old, my father's knees troubled him, preventing running from being his primary vehicle for exercise. Undaunted, he created a kind of squatting duck-walk that was every bit as aerobic and worked the quads much more than the patellar tendon. I was mortified. I was entering middle school and my father was so uncool - in public!

In recent years, my knees have troubled me also. Unable to run (or do much else) in the dreary Boston winter, I worked out a cemetery routine. Forest Hills Cemetery, directly behind our street, became the forum for hurdles over bushes, invisible chair squats against the walls and dips using adjacent headstones.

Last weekend, I was feeling pretty down. On Friday, my leg throbbed quite a bit, and I spent most of the day in bed. I woke up Saturday dreading a repeat. Finally, it occurred to me that I could be creative with movement. I turned on some jam music - live Poi Dog Pondering - then tossed about on my bed for two hours. I kicked my feet over the bed, created a rowing maching out of an elastic band and did lying down squats on the wall. The joy of movement. Without being active, I felt like Samson having his hair cut off - lost and powerless.

After this spark, Melissa contributed another one. She brought the bike trainer out and hooked up my road bike. Okay, so I wasn't spinning very fast, and my ankle hurt a bit. But I was moving and alive.

The tendon that held on - Oct 24

It is too easy to get pulled into the mechanical paradigm of bones, tight tendons and swollen tissue. There is another dimension to this healing that is less tangible.

Melissa has been working with me using a healing modality called Somatic Experiencing. It is a body-centered or nervous system-centered approach to dealing with trauma that will complement her training in Social Work (plus it will add more letters after her name). The basic theory is that the body has an incredibly strong drive towards healing, and that the nervous system - or the reptilian brain - knows what to do. In a session, she will direct me to notice what is happening in my body and have me repeat motions very slowly. In one session, I felt like I could sense my left arm trying to push the boulder away, my gaze starting to turn to the left. My reptilian brain, such as it is, had initiated a response to the slipping boulder. That response never had a chance to complete. By getting into the experience, then "renegotiating" the trauma and recognizing that I am safe in the present, it gives my nervous system a chance to leave the event behind. A quasi-spiritual exorcism of the trauma.

A couple of nights ago, I awoke with my leg throbbing. I had tried to wean myself off my evening dose of Oxycontin. I flopped and thrashed until Melissa woke up. A line of tightness began at the outside of the bony part of my heel. It extended upwards through the outer muscle in my calf to a painful point on the outer tendon behind my knee. From there, it continued up the outer edge of my hamstring to envelope my right sit bone in a deep ache. Melissa rubbed it for a long while, then laid down to sleep. I still flopped and thrashed. It was painful, but my angst was more than physical. I rubbed and stretched to no avail. Finally, Melissa asked me to lay flat on my back while she held my heels.

Some floodgate opened, and I started to relive the experience. Melissa holding my heels must have provided enough safety to go there. I can't quite explain what occurred. I didn't exactly remember the sights or motions of my accident. I didn't reexperience the sensations of injury. Instead, I had the *sense* of what had been happening beneath a conscious level during the moments of falling and impact. As soon as Melissa put her hands on my heels, I started wailing and hyperventilating. My hands first went to my left leg, as though taking inventory of remaining resources. Then I felt the pulling in my right leg. The line from my heel to sit bone felt like tight piano strings pulled to the limit of their tensile strength. Without the bone maintaining structure, my tendons held on as though Armageddon were approaching.

I cried and rocked and rubbed my leg. Eventually words came. I found myself telling those tendons, "you did a good job." Then, "what would happen if you let go now?" At the same time, I felt sensation at the point of my fracture. I could almost imagine my tibia waking up, telling the tendons that they could relax, returning to the work of maintaining structure. It was cathartic. After two hours, the sun came up, and my tendons stopped aching.

Was it real? My achilles was a notch softer in the days following, and I am walking with a bit more ease. I don't know whether my tibia actually woke up. Unfortunately, the Orthopedist's x-ray machine was not working this morning, so I don't know whether the fracture is fusing. Revisiting the accident a few nights ago was real enough to expand the dimensions of healing a little bit more. Enough to rock the healing, I suppose. And at the risk of undue personification, I am glad that my tendons had the courage to hold on.

Sunday, October 14, 2007

Two steps forward, One step back - Oct 14

Last Wednesday, I went to my second outpatient physical therapy appointment. I like my PT, whose name is Amy. She is exuberant and positive about my progress. She also spends time talking to me as a person, not just as an injured leg. Because the Orthopedist prescribed full weight bearing, she has worked with me on standing and walking.

One immediate priority was to find footwear. My Berkenstocks did a tolerable job of containing my foot. Unfortunately, the straps pressed into my pitting edema. (Pitting edema is the congealed swelling in my foot and ankle. It has turned waxy, and can be moved around under the skin. Herein lies my latest party trick; I can press my finger into my ankle leaving a deep depression much as one might do in soft wax). The sandals also made it hard to practice the normal movements of walking.

On the way up to Maine (to pick up the pooches at Melissa's parents house), we stopped in Freeport at the L.L. Bean mothership store. A very eager and sympathetic saleswoman helped me out. She empathized and told me about her three toe surgeries. She was a thin Southern woman with big, round eyeglass frames. After a myriad of unsuccessful attempts, we found a shoe that fit me and allowed me to practice walking. I am now the proud owner of some size 11, 4E New Balance sneakers. Essentially, I live in a double-wide.

The two steps forward part is this:
I found that I could bear more weight with the shoes. In Maine last weekend, I walked a quarter mile loop around Melissa's house, including a portion along a trail in a field. (A quarter mile isn't that long - think high school track). A few days ago, I walked in and out of MGH to go to my physical therapy appointment. I walked in and out of the mall to deliver my haywire MacBook to the Apple Store. I walked with Melissa and the dogs in Forest Hills Cemetery, an exquisite green space for walking and contemplation. The more I tried to put weight on my foot, the more I felt like I was handling it.

Then one step back:
That evening, my ankle throbbed and throbbed. Melissa tells me that I groaned a lot in my sleep. When I tried to walk on it the next day, I could hardly manage slight weight bearing. I have spent the last few days sitting in bed. Making the journey to the bathroom felt like the limit of my endurance.

The psychological journey was much longer than any of the walks that I took. When I was able to stand and walk on my foot, I felt so hopeful. My mind quickly skipped to the future and extrapolated a quick recovery. The world was bright and sunny.

Then, the pain in my ankle coincided with a few overcast, rainy days in Boston. The outlook of the world seemed grim. I was sure that I had done inexorable damage to my ankle. There was a discrepancy in professional opinion between the orthopedist in Colorado and the one in Massachusetts. The CO doc didn't want me weight bearing until 10 weeks (mid-October); he was concerned that my ankle had been compromised. Please tell me I'm not the only one who jumps to the worst conclusion. Has anyone else had a passing pain in their chest and assumed that a major artery was blocked? Has anyone experienced back pain and assumed slipped disc or worse? Not that those worst case fears overwhelm me; they're just the first messages to flash on the screen.

I am happy to say that my outlook has swung back to the middle. I spoke to both orthopedists (in CO and MA). It turns out that the discrepancy in opinion is not as large as I had interpreted. I have not done damage to my ankle; I simply pushed a little farther than I was ready for (which is what Mark's do best). Today, I have been able to put more weight on my foot again, and the gap between my current function and hiking a mountain is a little less vast.

Melissa's Birthday - Oct 12

Melissa entered this world late in the day on October 12, 1972. That day is a cause for celebration. If you read this, please reach out to Melissa and let her know that she is fantastic.

Melissa is a shining star in this world, but one that doesn't call attention to herself. Melissa cares deeply about people, about justice and about love. She has the endurance of an elk, the nurturing spirit of a mama bird and the sure-footedness of a mountain goat. She has worked so hard to care for people in need - at-risk youth or survivors of domestic violence. She has cultivated a deep caring for our dogs - even for Teacup's incessant barking! She has pursued reconciliation with her parents across the ideological divide. And now, she has been caring for me.

At first, I was so shortsighted about celebrating her birthday. I thought that I could do little to celebrate, since I was limited in walking, driving and even getting on the Internet (after my laptop fuzzed out). I thought perhaps that a little surprise was in order.

Amazingly, by bringing other people into the fold, the surprise grew in wonderful dimensions. The surprise soon turned into a double-header, two nights in a row. Friends added their special touches - scrumptious stuffed squash, a growler full of stout, scented candles, flowers and best wishes. It turned out to be one of my best efforts at celebrating Melissa's birthday, yet I can claim very little of the credit. Bringing community into the picture gave birth to a wonderful celebration of Melissa.

So what I want to say is this.
I really wanted Melissa to feel loved, celebrated, supported, noticed. Some days, I can hardly believe the efforts that she has taken to care for me. Some mornings, she has spent her precious time dealing with all the logistics that it takes to get me out for a walk in the Arboretum. (I am not low maintenance. I need breakfast in bed before I can take my pain medication. My wheelchair needs to be lugged down two flights of stairs, and if the car is parked facing uphill, I need the door held open). She has spent time massaging, holding and paying attention to my injury and my soul.

Sometimes I ache to try and do enough for her. I feel so limited; all of the physical tasks fall to her. I can't walk the dogs or shop or run an errand. I can't even cook much beyond the simplest options. I am deeply affected by her caring and attention.

Lately, we have become fond of a new Patty Griffin song. Here is the chorus:

When you break down, I'll drive out and find you
If you forget my love, I'll try to remind you
And stay by you
When it don't come easy.

Well, it hasn't come easy for over two months, but Melissa stayed by me.

Wednesday, October 3, 2007

Homecoming! - Oct 3


Have a look at the leg! Beauty, eh?

Today, Mark came home. It was a momentous occasion. No, there were no arthritic dogs to woof gleefully and fan their tails like windmills. The pooches are on an extended visit with their grandparents. No, our neighbors weren't here to greet us. One upstairs neighbor expressed sympathy as she grimaced at Mark's exposed leg and hurried by. No, there were no onlookers. Instead, the occasion was momentous in our hearts. It has been hard on Melissa, who has lived with one foot at home and one foot at MGH, at the North End, then at our friend Deborah's house. Perhaps it hasn't been quite as hard on Mark, who has only one foot to stand on. Moreover, he's an inveterate couch surfer.

So we came home. Melissa made 9 trips from the car while Mark cheered from the porch. We celebrated with some crackers and brie cheese and red wine. The homecoming was not without humor. Melissa valiantly attempted to organize the armloads of books, clothes and medical supplies that we had collected en route. At one point, she wanted to recycle a small plastic bin. Mark hemmed and hawed, so Melissa asked, "Are you going to brush your teeth in bed, or are you a man who brushes his teeth at the sink?" The most humorous aspect of this exchange is that Melissa really hadn't intended to question my masculinity. However, this didn't stop me from howling foul play. Sure, emasculate the guy when he's already down!

Something about homecoming has lifted a bit of the fog of placeless existence. We started to think about plans and routine. We discussed which days we might use the athletic facilities at Simmons College where Melissa is pursuing an MSW. Mark praised the merits of iCalendar (it's a Mac thing). Melissa blurted out that she wanted to know when we were going to have a kid... (Whoa! I'm still working on walking).

YES, today has been MOMENTOUS. I visited the Orthopedic Surgeon today. He wants me to work towards full weight-bearing right away! So, while Melissa sat in a lounge at Simmons, fervently trying to catch up on reading, I walked down the sidewalk.

I should explain what I mean by walking. It means using crutches for support and moving slightly slower than your average banana slug. My internal dialogue goes something like this: Engage glutes, now ease weight onto foot - ow, ow, ow - now roll to ball of foot and stretch the toes back, oops, big toe won't bend backwards. Release and push (yeah, right) with toes. People either ask me if I'm okay or hurry past without making eye contact. One old lady asked me if I wanted instructions. I thought she was joking. She kindly demonstrated how to place my foot and move with the crutches. She suggested that I might do better with a walker. Still, I'm walking.

Homecoming. I'm saddened by a well-publicized accident in the Boston papers. A man was driving when a storm grate was flipped up by a semi and smashed through his windshield. Amazingly, he lived. However, since coming home, he has not been able to hold a normal conversation or make eye contact. He and his wife are immigrants from Poland. By profession, she is a teacher, and he an engineer. The American Dream, until... His wife mourned that it almost wasn't the same person coming home.

How fortunate our homecoming is. I am intact. Melissa and I have grown stronger and deeper through this ordeal. If the price of a deeper, more loving relationship between us is one gracilis, a lengthy recovery and a few scars, then I got a great bargain...