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."

L'essentiel est invisible pour les x-rays - Nov 15

On ne voit bien qu'avec le coeur. L'essentiel est invisible pour les yeux. (Only with the heart does one see clearly. The essential is invisible to the eyes) - Antoine de Saint-Exupery, Le Petit Prince

On Halloween, I had some long awaited x-rays. Then, last week, I had the chance to go over the x-rays with my physical therapist. She showed me those x-rays side by side with others from August 10, the day that the rod and screws were placed in my tibia. No difference. The same gaping fracture showed up in the middle of my tibia on each slide.

Needless to say, the rest of my week was pretty hard. I couldn't shake the discouragement. Twelve weeks and no sign of the bone healing. My vision of bearing weight on a slowly growing bone crumbled into an image of walking around on a flimsy piece of metal with bone fragments and screws rattling loose. It's the most disheartened that I've been through this ordeal.

Well, there is nothing to do but continue. Melissa gave me a pep talk. Let this be a motivator rather than a de-motivator; this makes it even more important to have the right attitude and do the things that promote healing. Our friend Margot, who is a healer (and a Physician's Assistant by training) said that x-rays are crap. They disempower by dictating success or failure. Instead, we need to be empowered to promote our own healing. Deborah, with whom I stayed after the hospital, said to just deny the outcome of the x-rays and keep on being optimistic.

I think I'm through the slump. Everyone is right; there is nothing to do but stay optimistic. I'm also trying to take care of all bases. I've increased my calcium supplement; I'm heating the fracture area to bring blood flow; I'm bearing weight and promoting circulation on the bike trainer - and swimming, for the first time last week! We'll also try some massage and acupuncture. I'm ready to keep going.

Black and white x-ray images convey such a sense of authority. They seem to be the last word on how my healing is going. Long after viewing them, my mind's eye still traces the fracture lines. Given the apparent objectivity of x-rays, I found it exceedingly difficult to have faith in my body's own timetable for healing. It has been helpful to be reminded that the most important things - hope, determination, love and support from friends - are invisible to the x-ray.

On receiving help - Nov 1

There are times that I think, "what did I do to deserve this?" when faced with the startling kindness of friends.

We have received so many amazing meals in the last few weeks. Our friends Dawnellen and Kurt cooked a magical chickpea curry and frosted Halloween cupcakes right before our eyes. Hondo and Alycia prepared us a medley of salad, quiche and lasagna. Then, Alycia's sister Greta - whom I have never met - treated us to mushroom and pepper quesadillas and chocolate chip pumpkin bread (which actually evaporates at room temperature). Tracey, my colleague at Girls' LEAP, besides loaning me the first two seasons of "The Office," brought over stuffed peppers - with vegetarian "lamb." Margot loaned her crockpot with some starter veggies for convenient stewing. The list goes on for a long time.

I have been transported to appointments. Many friends have lent their healing touch - through massage and energy work. Even the calls and emails buoy my spirits. When first released, I was taken in by Deborah and Phil for two weeks; now, I spend Monday nights at their house to ease the commute to Girls' LEAP. (Okay, I can't fib - it's really for the sci-fi tv shows on Monday night...who am I?) The help has been so valuable; besides spending a lot more time doing mundane tasks and physical therapy homework, we need to know that the community is there for us.

Our friends Rob and Aviva have helped as much as anyone. It has been hard for me to grasp at times. I assume that we are imposing, being a burden by needing this help. Rob and Aviva came bringing arugula, squash and fruit crisp while I stayed with Deborah and Phil. Rob has taken me to a few medical appointments. Lately, Rob has been escorting me on the 3/4 mile walk from Girls' LEAP to his house on Tuesday afternoons. Aya, their 14 month old daughter, rides in the backpack, then coaches me on walking when we arrive at their apartment.

At several points along the way, Rob and Aviva have thanked me for inviting them into my healing journey. Thanked me! I'm starting to let it soak in, though it's not intuitive for me. Rob and Aviva have plenty to do in raising their daughter in a kind and intentional way. I hardly understand how they are thanking me for adding more responsibilities. Other friends have said that it is great that we have communicated what we needed.

A quote on a recognition wall at Simmons College reminds that the point is not to pay back kindness, but to pass it on.

I am overwhelmed with kindness. It makes me look at the times that I have been self-absorbed or ill-attuned to another's needs. Feeling this kindness from friends makes me want to be there when the next person needs help. It makes me want to pass it on.

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.