Continuing saga - April 25

Some explanations are long overdue.

I am hard at work - I'll be transitioning to full-time Director of Development at Girls' LEAP. Grant season has kept me quite busy (not to mention my side project consulting for Melissa's brother-in-law's business). So, I have not managed to blog much.

Melissa is networking up a storm - trying to find her way into a good Social Work job after she finishes her degree this year. A congenial work environment, good clinical experience and a reasonable salary - not too much to ask.

Teacup (the brown dog) is exploring medical conditions - two UTI's and an abscess behind her eye (makes her look really grotesque). Fortunately, we have very good (though pricey) local veterinary care. Teacup came to us for free, but we've been paying for her ever since. On the other hand, Glory (the yellow dog) cost us $20 as a pup and has been largely issue-free. (She does eat poop, though)

Now for the x-ray.

The pictures here are from October. I was trying to get the recent ones, but the doc didn't send them in a file I could open. So, I'll try to explain, and you'll have to imagine. In October, you can see all the hardware. The big screws came out in my surgery in Dec. However, you can also see the clean-looking fracture. It looked about the same in December (clean = no bone growing). That was the big concern in December.

What we understood was that if the bone wasn't growing, I was going to need additional surgery. However, what we didn't understand was that the bone could be growing (which it is), but NOT fusing. (Here is where your imagination comes in) Imagine the bone at the fracture growing outward like a big old Ponderosa Pine. On my x-ray on Apr 9, the bone showed A LOT of growth. Most of the growth was outward, and the fracture only showed fusing on one side (lateral). It is not clear whether it will fuse without surgery, and my next x-ray is not until OCTOBER! Interestingly, my fibula (which has a much better blood supply) is completely healed.

So, here's what could happen:
1) the bone could fuse together on its own (I like this option)
2) the bone could fail to fuse, and I could get a bone graft (shave a piece of bone off my hip, grind it into a paste, insert it into the gap in my tibia, compress the fracture with a plate to concentrate the bone growth...) - not my favorite option
3) the rod could weaken (even crack) from use. I would probably notice increased pain. At this point, I would either need surgery right away, or the bone might be taking enough weight (and would be stimulated to grow more since the stability provided by the rod would be diminished) that I would not need surgery (I kind of like how dramatic this sounds)
4) I could heal through some other mind-body method like acupuncture, Tantric meditations or Dianetics.

Well, I AM trying acupuncture (which sounds better than option 2). My acupuncturist is doing something that seems a lot like the bone stimulator used by physical therapists. She wraps chains (and tin foil) around my injury and uses a sparker to produce some current. I don't know - it feels like it's doing something. I'm also getting regular massage - actually "structural integration." A lot like rolfing (very deep tissue work to break up scar tissue). This feels much more effective than the PT that I was getting, yet insurance doesn't pay for it. Still, it's worth it to me to try to get more range of motion back.

And today ... Melissa and I hiked for 3.5 hours. It's true. My leg hurt the whole time, but it didn't get worse over the course of the hike. I used trekking poles (but so did many of the other hikers out there). So - there's hope. Oh yes, I also bouldered on the retaining wall up the street (being careful not to fall off in an uncontrolled way).

This is a long haul. I get down sometimes. I think I understand why people give up, and I don't judge that. It's just plain hard. However, I also get stubborn. There's not much else to do except to keep on keepin' on. Giving up would only mean that I'd have to climb back out of that hole in order to move on - which seems like far more effort than doggedly staying on track. And so, the saga continues.

Seven Months ... and Climbing! March 9

Three weeks ago, Melissa and I went up to Vermont to visit some friends from Eckerd Youth Alternatives - where I worked with juvenile offenders a decade ago. The first picture is our 3 mile walk - a beautiful sunny day on the road where our friends live. Naw, I don't miss open spaces and mountains at all...

Then, this weekend was momentous. Yesterday (Mar 8) was the seven month anniversary of my accident. It was also the first time that I've been on a climbing wall since. I was a bit apprehensive and doubtful; for the last half year, climbing has taken a back seat to more basic issues (like walking and pain management).

However, the trip went very well. Although I know this number won't mean much to some, I was able to climb several 5.10's - mostly without hanging on the rope. I even made it up an easy 5.11 with a couple of hangs. My foot and ankle didn't really do all the things that they're supposed to, but I'm happy that I was able to use it well enough to climb reasonably well.

It also reminds me that I'm not the only one with limitations. You don't really have to have a high profile, gruesome accident to have physical limitations (I just tend towards the dramatic). Plenty of climbers have tendon issues, knees that don't bend a certain way or shoulders that give trouble. The same goes for other sports. Somehow, it's a little easier to put things in that context - nobody escapes without limitations for long. And part of the task (or even the joy?) of getting older appears to be figuring out how to do a good job taking care of those limitations.

Okay - enough philosophy. On another note, I also carried Teacup for 10 minutes this weekend. Some of you know our arthritic pointer, Teacup. She walks for about 20 minutes, then we put her in the backpack and carry her for the rest of the walk. She's 50 pounds, so not too heavy but more than a day pack. Teacup has summited quite a few 4,000' peaks in New Hampshire that way. Well, today I carried her for about 10 minutes at the end of a walk. It was just like old times, and she and I both appreciated it.

One month from today - April 9 - I get my x-ray. I've started weekly acupuncture and rolfing, in addition to weight lifting with my legs and other cardio options. It's all I can do, so I hope it is stimulating bone growth. I'll know in a month.

Thanks to everyone for your care, friendship and support.

Six Months! Feb 8

Some people travel the world taking pictures with a stuffed animal or pink flamingo in each frame. For us, it seems to be Teacup - our quirky mascot. She embodies such a wonderful attitude. With a sudden onset of arthritis four years ago, she went from being a marathon dog to a hobbler. Yet, she stays happy and excited and motivated. So, Teacup surfaces in our pictures as a symbol of good spirits in the face of adversity - and besides, we love taking her with us.

Friday was the six month anniversary of my accident. It is also the "halfway" point, based on the medical opinion that it would be a full year recovery. I feel like I'm able to take the long view - able to see that this will turn out fabulously well in the long run. No matter what bumps in the road I encounter in the short term, this can be a long-term source of motivation and staying present. It doesn't go away, so I have to keep paying attention - keep listening to what I need to do to heal.

Taking stock at six months:

- I'm alive
- I have a leg
- Melissa and I care deeply about each other
- We're not bankrupt
- I'm happy

What else?

I hiked 2 1/2 miles last weekend! Up a rocky trail in the Great Blue Hills just south of Boston. I did pretty well and didn't have to use my poles until the very end. My strength is coming back, and I'm supposed to do squats and lunges. I started with 65 lbs squats (yeah, I'm pretty ripped...).

Melissa is taking her last classes for her Masters in Social Work. We're counting down the weeks. It has been a long road, and this fall felt particularly difficult - trying to juggle school, work and caring for me. Lately, Melissa has been working both days on the weekend. And then I end up working both days, too. However, it feels really good to have work that I care about.

I'm trying to dodge all of the colds and flu that are going around Boston. Our housemate came back coughing up her lungs after a few weeks away. My co-workers have been sick, and Melissa has just come down with a cold. I definitely don't need to get sick while I'm trying to heal my bones.

I am walking around without a cane, though I walk slowly and weave occasionally. This weekend, I walked for an hour in the Arboretum without a cane. The last 15 minutes were pretty painful, but I didn't feel wrecked the next day. I'm sure a lot of people didn't notice my injury. I'm realizing that most of the time, other people's hurts and pains (even physical ones) aren't very visible. Lots of people have to overcome some kind of adversity every day.

I'm gravitating towards very energetic music - it seems to help drive me forward and keep up my motivation to heal. Green Day, Flogging Molly, Ozomatli - lively stuff. Lately, I've been wearing my iPod in the subway - it makes me feel like I'm in this self-contained bubble of happy motivation, and I can keep going through the pain and fatigue.

Learning to Fly - Jan 26

I flew to Omaha two weeks ago. Ah, the heartland in winter - just the place for some R&R. Okay, actually, I went to my cousin's wedding. This cousin is the sister of my cousin (Jason) who was with me during the accident. It felt important that I go for so many reasons - to support their marriage (a gay couple having a ceremony in Nebraska), to see Jason for the first time since my accident, to support their family after some hard times this fall and to see my mom and sister. When I returned home, my mom came along to spend a week with us and help out.

Well, I was afraid to take the trip! I have never been nervous about flying - the statistics about airline safety usually calm my fears. However, the weather was rough, and I had just read Deep Survival. The author (himself an aerobatics pilot) recounts his research on airline crashes. As a result he declined to go on a scheduled flight because the plane was a DC-10. That very flight crashed, killing all aboard. Yikes - not a confidence booster. I also questioned my aboard flight reading selection, K2: The Savage Mountain...

Well, I did fly. I actually sat in the airport for half an hour before checking in - debating whether or not to go. The flight out was one of those bumpy, scary flights where the captain talks to you in a calm voice. Then, I spent an extra day in Omaha because of the Boston snowstorm on the day that I was supposed to fly back. (Kind of like spending an extra day in Cancun, but not quite).

I feel quite sure that this is the aftermath of the trauma. I feel nervous about other cars on the highway, knowing that a flimsy seatbelt won't keep me safe from a crash at highway speeds. I shudder to think about climbing the North Chimney to get up to the Diamond on Long's Peak. Interestingly, I don't feel very concerned about Boston's iced up sidewalks. Perhaps it feels more manageable when it's a hazard right in front of me that affords me a little control.

This is the work, learning to fly again. The good part - the clues to my recovery - are in the details. I was able to carry my luggage and to walk through the Detroit terminal. I noticed that I handled stairs much more easily than even a week before. Then, last week, I ran up a flight of stairs. (It was more of a galumph, really). I walked a mile twice in the last 10 days, and I rode the subway at rush hour!

After the trip to Nebraska, it was great to have my mom here for a week. She cooked a few meals and helped out whenever possible. She also downloaded nearly all of our music onto her new Mac! We had some walks and talks. Altogether it was a pretty low-key visit - not an easy feat when we put her up in the living room on a wafer thin futon mattress.

This is my life for now. I'm not sure what I'll be able to do when this is all said and done. However, I have the support of Melissa, my family and wonderful friends. I have fulfilling work at a local non-profit. I'm able to swim, bike and lift weights regularly. I have Pink Floyd playing on iTunes - all the ingredients needed for learning to fly again.

Holiday Gifts - Jan 6

The picture on this blog entry has nothing to do with the holidays - its just a reminder of happy times and feeling whole and alive.

One thing about being injured - a lot of friends come to visit! It has been great to see many friends over the holidays. Friends came to cook, brought wine and treats, made us truffles and shared stories of what is happening in their lives.

There's something else about the holidays. So many people have been AMAZINGLY generous in helping us with medical expenses. Our financial picture looked pretty dim a few months ago. Since that time, it has been both humbling and uplifting to need so much help - and to receive it. Although we are not in the clear yet, the donations have been adding up. What looked like unimaginable debt (my bills total around $400,000) is descending to a level where we know we'll be okay.

Melissa and I have had many an emotional moment. Personal friends have reached out to help; we've also received support from parents and friends of friends. Several friends, including Mark's sister, have put together fundraising efforts. Mark's mom reached out to her circle, and they have been tremendously supportive. Friends who work in the outdoor field or attend graduate school (and we know how much they make) have helped out. A couple of friends who have the means have offered to make a meaningful gift to help close the gap. Even some strangers who heard the story and empathized have supported us. The list goes on. Finally, we should thank the state of Massachusetts that takes a humane stance towards people facing large, uncovered medical needs.

Our financial picture is not settled. Some insurance questions linger (Mark's insurance may pay a small portion, despite the effective coverage date coming after the accident), and we have yet to negotiate with the Colorado hospital. Even scarier, it is possible that I will need more major surgeries (we'll see how my bone is doing at my next x-ray in April). However, Melissa and I both feel so supported and cared about. It has eased considerable anxiety on our parts.

Several friends requested that we use their support for "extras." This has been so helpful. These days, I am in pain most of the time. Sometimes it diminishes to just slight discomfort, but usually I have a deep ache from my hip to my ankle. Thanks to some really generous friends, I'm able to get regular massage - something that I couldn't afford otherwise. It also allowed us to join our neighborhood gym - something that I need in order to do some specialized physical therapy exercises.

And there is progress - I have been able to walk normally (although slowly) about a quarter of a mile recently. I can walk upstairs (on a good day) without a cane or holding the rail. Downstairs continues to elude me. I'm still missing a lot of range of motion in my ankle and toes, but I continue to stretch and work for it. My thigh is so weak (and skinny!) that my right leg shakes when I stand on it and bend my knee. Still, I can feel the strength coming back. I'm also able to swim - a life saver in the Boston winter.

And there is always the question of how to deal with the hard moments. I wish I could say that I'm always upbeat, always remembering to be grateful for keeping my life and leg, always focusing on the positive. Well, I'm mostly those things. I have some moments when I swear or cry or mope. I don't give in very often, because I'm finding that frustration and desperation actually don't help my leg to heal. Even with the pain and uncertainty about my future abilities, I know that the only thing to do is to keep going.

I also know that I'm not the only one. Something else about being injured - I hear lots of stories about other people's injuries and medical travails. Our species seems to have a wise impulse to share stories; it is a holiday gift not to be underestimated. It gives me perspective, helps quiet my selfish sense of unfairness and helps me empathize with many others before me who have dealt with pain and trauma.

Let's hope that 2008 brings healing - on so many levels.

Under Better Circumstances - Dec 19

We had a wonderful visit with Blase last weekend! Blase and his climbing partner were the first ones who arrived on the scene of my accident after my cousin Jason called for help. Blase also wrote a moving message and account of the rescue (in this blog - "Blase's Message - Sep 2"). It was great to connect with Blase under better circumstances!

Melissa and I had a chance to hear about Blase's work studying Montana's glaciers, his play on rock and snow in the West and stories about important people in his life. Blase and I circumambulated the great Peter's Hill - a towering monolith standing at least 200 feet high and providing a commanding view of downtown Boston. We ate scrumptious thin crust pizza at the local eatery and gabbed into the late evening.

Besides getting to make Blase's acquaintance for the second time, it was instructive and healing to reflect on the accident and rescue and to create a composite picture of what took place. Hearing his perspective helped me to understand how others reacted to the accident. I felt moved to hear that a whole crew of Park Service firefighters had scrambled up - ready to help but possessed of no technical rescue know-how. I stood in others' shoes when Blase depicted the team of 17 rescuers, drenched in sweat and out of water, straining to carry me safely and quickly.

It didn't hurt to hear Blase's perspective on my leg, either. As he noted, it sure looks a lot better than the last time he saw it. Though the rescuers worked diligently, the prospects for my foot had seemed somewhat dim with an eight-hour carry. He was pleased to see that I kept the foot, let alone that I am able to get around smoothly with crutches. The skin on my heal has been out of the woods for a couple of months, and my range of motion and strength returns slowly but surely.

This last point brings me to the aftermath of getting unscrewed. Curiously, the screw removal has left me with an interesting bit of pain at the fracture site that occurs intermittently with weight bearing. With any luck, this pain means that the bones have a little more play which should stimulate bone growth. I also have more flexibility in my ankle - still very limited. This increase in flexibility means that I can try to work my muscles back to life. I am amazingly weak - my right thigh can hardly handle a single-leg squat of even 6 inches! However, through some weight lifting and the contortions concocted by my physical therapist, I hope that this will improve quickly. I am cleared to swim as well, since the stitches were removed today.

Here is the news on the bone front. The orthopedist didn't schedule another visit until April! He said that we wouldn't see much bone growth before that, but we ought to see signs four months out from taking the screws out. He also said that the more important sign is how I progress. If I am able to return to more normal activity and don't feel any pain with weight-bearing, twisting or higher impact movements, that would be a better sign of recovery than an inconclusive x-ray in April.

All this is to say that I am well within a "normal" timeframe and that full recovery is going to take a long time. I continue to be patient and to have a fantastic attitude (except when I don't). In order to stay on the bright side, my latest response to "how are you?" is that I'm doing great considering that my leg almost got hacked off last summer. For the moment, my mantra is "grateful for my life, grateful for this trial."

Unscrewed! Dec 8

Yesterday, I had surgery to remove several screws in my leg. The three locking screws (the blue ones in the picture) were connecting my tibia to the rod. In theory, by removing them, it will "dynamize" the rod - meaning that there will be a little more play in the bone ends. Hopefully, this will stimulate bone growth. The other two screws were holding my tibia and fibula together. They actually had broken, so only the short heads of the screws came out. (We had been told that this might happen). Those screws had been put in place to stabilize my ankle. With them out, we are hoping that I will get more range of motion.

The orthopedist performed the surgery using general anesthesia. Back in August and early September, when I had a surgery nearly every other day, it seemed like no big deal to "go under." I was totally dependent on the medical teams, and it wasn't that hard to surrender my consciousness at times. This time felt harder. I am glad to be "unscrewed," but I wasn't keen on having general anesthesia. I found it unnerving to breathe deeply into the mask and inhale the artificial-smelling gas. Earlier, while sitting in the waiting room, I also thought about the range of caregivers that I had experienced during my stay in the hospital.

Some were excellent - in tune with what I needed. Others brought strange power struggles into the room. One nurse in Colorado helped out when Melissa was at her wit's end trying to negotiate with the company that rented wound vacuums. The nurse spent an hour on the phone convincing the company to deliver a portable version. Frank, the ICU nurse and Rob, the anesthesia PA came to visit me several times after I had left their unit in the CO hospital.

On the other hand, after my flap surgery, one nurse was terribly passive aggressive. My catheter was draining improperly, and I was swelling noticeably. However, she gave a variety of excuses that delayed its removal. The next nurse came on shift and removed it immediately. Another nurse delayed giving me the oral pain medication that I was taking (percocet) for almost an hour after I asked for it. When I complained that I was in significant pain, she entered with a loaded syringe saying, "I'm going to give you a shot of morphine." After I protested, she chided me that the oral medication wouldn't take effect for 20 minutes - exactly why I had requested it earlier!

One nurse finally encapsulated it for me. She said that more important than wound or pain management, her top priority was good patient advocacy. Hospitals are complex places, and patients need to be and to have good advocates. Yesterday, I asked to forego "Versed," a medication that commonly is used to diminish anxiety before surgery. However, a medical practitioner had told me that it is actually a diluted amnesia-inducer. The advice helped me self-advocate to skip that medication.

So now, with this surgery finished, I will spend the weekend in bed (not as glamorous as it sounds). Then, we begin to "mobilize" my ankle - starting at my PT appointment on Monday morning. I hope mightily that getting these screws out will accelerate my return to some sense of normal function and activity. I also hope that this surgery will do the trick - stimulating my bones to grow. There is nothing to do but be patient and diligent with optimism and physical therapy. As Melissa said, "I'm looking forward to this being your last surgery."