Eighteen Months: Thoughts on Recovery So Far

It’s been 18 months. Eighteen months ago today I drove up the mountain to spend the morning skiing. They tell me that I ended up riding down from the mountain in a helicopter that headed straight to the hospital emergency room.

It didn’t take too long for the doctors to figure out that I’d broken a few vertebrae. It took a couple weeks for the doctors to start talking with any sort of certainty about the extent of my spinal cord injury. Even then they were reluctant to say much definitively or to make prognoses.

Within a couple weeks, I was told that the extent of my injury officially put me in the category “quadriplegic” … which confused me (and I’ll never use that term to describe myself) because even by then I’d recovered probably 80% of the movement in my one hand, and the other never did seem to be affected.

About the same time I received this information, I was also told what a general timeline for recovery might be. In short what I heard was that the first six months were critical – that I should work as diligently as possible in those first six months in order to realize the greatest gains.

What I heard next was that while gains might not be quite so obvious, that I might expect to continue seeing improvement for as long as 18 months.

I’m thankful that the past eighteen months have proven that prediction right. Early on, the gains were obvious to me and to everyone who watched me move around. Recently, though, the improvements are much more subtle – probably not noticeable by most people, but enough for me to know that I move a little better today than I did a month ago.

One thing I don’t remember anyone saying when they talked about a recovery timeline was that I should expect after eighteen months. Will my recovery and improvements stagnate? Now that it’s been eighteen months, should I not expect any more improvements?  

It’s been eighteen months. I feel lucky that I’ve regained as much mobility as I have. I’m grateful that I can move around mostly normally.

It’s been eighteen months, and I get frustrated that I can’t move around as smoothly as I used to could. Just this morning, I almost yelled and threw things when I stubbed my toe on the (smooth, even, predictable) floor, because that leg doesn’t work right any more.

It’s been eighteen months. I don’t know the future, so there’s no way for me to know today whether I’ll continue making mobility improvements tomorrow; or next month; or next year; or five years from now. But I’ll keep working at it, doing my best to be more capable every day than I was the day before.

$ 0.02

I wish: a brief lament

I realized a couple weeks ago that I’ve kind of gotten used to most of the lasting effects of my spinal cord injury. If I’m distracted by other things, I just move. But if I think about the ways I move differently now, I notice deficiencies.

Most of the time when I notice deficiencies, I either focus my conscious brain on engaging the muscles that aren’t working right; or I think to myself something like, “I need to exercise that muscle more intentionally.”

The view from as high as we got

The other day, though, I got frustrated. See, what happened is that we were out hiking. We had just started down when we were passed by this guy who had a child in his backpack. He was moving quickly, and with confidence. He didn’t look rushed. He moved really smoothly and fluidly as he flew by us.

I thought to myself (as I focused almost all my attention on foot placement and muscle engagement), “I used to move like that. I wish I could still move like that.”

When I think about how much more extensive my injury could have been, I recognize that I’m ridiculously lucky to be as mobile as I am. And still every so often I lament what I’ve lost.

I Place My Foot Carefully: A Reflection on Moving

“I place my foot carefully

            deliberately

            out of necessity

      so that my progress is

            smooth

      unhindered by a misstep

            a stumble

using my hands well

      is critical

      they’re instrumental

            in maintaining good balance

      and help facilitate

            forward progress

it takes concentration

      my body knows

            physically

      when my mind wanders

      then brings all of me back

            to focus

            on the next step

when it all works together

      I get where I’m going

            and revel in

      success achieved”

was written about climbing Class 3 ridges in Colorado’s high country; also applies to recent excursions along city sidewalks.

Continuing Recovery

I came away from my skiing accident broken. The knee that was injured (ACL and MCL) is part of the same leg that has been most significantly affected by the Spinal Cord Injury. It really didn’t work at all for at least a couple days. And when I started to be able to use it again, regaining muscular control was complicated by the fact that the ligaments weren’t doing what they were supposed to.

In addition to that leg hardly working at all, I’d lost most of my cardiovascular fitness while I was laying in the ICU for ten days – so much so that when I started PT, five minutes of balancing on my knees wore me out enough that I needed a breather. And while I made huge gains during PT, I spent most of the next five weeks in a wheelchair.

So when the inpatient portion of post-accident rehab was done, I had virtually no stamina. When I was discharged and able to be home again, every couple hours I’d have to stop what I was doing so I could lay down for a while. And when I wasn’t resting, I really wasn’t doing very much of anything except being more upright than horizontal.

It felt like a blow to my identity to need rest after a couple hours of simply existing in the world. I’ve never been the fittest guy around, but for years I’ve been able to spend a whole day going nonstop without really taking a break. Further, there are numerous times when I’ve strung together seven days like that in a row.

The physical recovery I longed for was that the mostly-broken leg would work again, and that I could regain most of the stamina that I’d lost.

Finally, over the past week or so, I’ve felt a beautiful confluence of healing. Our trip to California forced me to not stop for almost the whole day for a few days in a row ... which served to increase my stamina. And just this past week, one of the muscles that hasn’t worked for months finally started engaging again ... which allows my whole body to work more like it’s supposed to.

Add to that the fact that I’ve recently been able to start going on longer bike rides – bike rides on an actual bike, instead of that silly spin bike in the gym. It’s a good thing, because I’m registered for a 50k bike ride in a couple months.

The bike ride is a fundraiser for Craig Hospital. Craig is a specialty hospital which treats spinal cord injury and brain injury patients. I was inpatient there for five weeks, and continue to do Physical Therapy there as an outpatient. The staff there does phenomenal work. I’d encourage you to support Craig by making a contribution through my Pedal 4 Possible fundraising page

I’m not quite ready to take on the course I’ve registered for. Lucky for me I have time to build enough stamina between now and then.

On A Bike Again

I got on a bike again.

It was awkward, and slow, and tough to start & stop, and scary. I can only manage about 60% of the speed I once was able to maintain, and have stamina for maybe 20% of the distance.

But I can ride a bike again.

A year ago, I started figuring out how to spend more time riding than I had before. Racing a road bicycle, riding more challenging mountain bike trails, plotting bikepacking trips through remote and beautiful places, learning how to ride and race on a velodrome, and seeing how quickly (and how slowly) I could make my two-wheeled commute.

A day ago, I struggled at the end of an easy six mile ride that we had taken a 20 minute break in the middle of.

But I was on a bike again.

One day, in a flurry of broken bones up and down my back, all the planning and preparation and fitnessing drifted away like a dandelion puff ball on the current of a kid’s breath, and the bikes gathered dust for a while. Since then, I’ve figured out that I can lash a crutch to my bike so I’m able to walk when I get where I’m going. And it’s joyous to be able to move in a way that I’ve loved since before the age of 10, when I was skidding coaster brakes on gravel roads.

I’m getting back on bikes again.

Ski Accident Recovery: Out of the Torso and Neck Braces

Good news today. The neurosurgeon (who didn’t do surgery on me) told me today that the fractures in my spine are healed enough to not need the braces any more.

Halleluia!

I’ve been counting down the days for a couple weeks and counting down the hours for four days, waiting for the moment when I’d be free of those constraints. And I’ve been dreaming and worrying that I’d be sitting in the exam room and the doctor would tell me that I wasn’t healed enough to get rid of them.

Fortunately for me, we got good news today.

And then I experienced myself getting really slow and tentative, because this is all so new.

See, I’ve been in that turtle shell for so long that I’ve become somewhat dependent on it. All the muscles underneath the brace, which I haven't really used for months, have weakened to the point that I expect I’ll be exhausted by simply sitting up in a chair. And even though it was a pain to put on, take off, and exist in, I feel really vulnerable without the protection it provided, like I'm in danger of breaking.

But it’s time, and I’m thankful for being able to take the next step in this recovery that I’ve been working on for a few months. Right now, though, after being free of the braces for less than three hours, I think I’m gonna go take a nap.

Ski Accident Recovery: Reflections on getting off the toilet

I used to tell people that I did my best to stay fit because I want to be able to get off of the toilet when I’m 90 years old. Thing is, today, at age 48, I have trouble standing up from the toilet without assistance.

Yep. I spent years riding bikes and running and swimming and hiking and climbing and playing volleyball & basketball – and I spent most of my 40s lifting and gymnasticsing and HIITing so I could be in good shape. Today, however, I walk slowly and with a limp. And I haven’t been this weak since … maybe, ever.

It feels unfair, that after the work I did to gain fitness, it’s gone in a moment. One day I had the physical capacity to do almost anything I wanted to do. The next day I didn’t get out of the ICU bed. And when I did get up days later, I couldn’t stand up even with help from four people.

I don’t expect this to be my permanent reality. I’m stronger today than I was at the end of March. I’m stronger today than I was in early May when I was released from the hospital. I’m probably stronger today than I was last week. In the ‘clouds and silver lining’ category, that makes me happy.

So, I suppose my current project is similar to my project before the accident – get stronger, get fitter, so that I have an easier time getting off the toilet at 90 than I do at 48.

One Month Ago, One Week From Now

So, I'm ready. One month ago today (Monday), I was released from being an inpatient at Craig Hospital. And one week from today, hopefully my reality will change substantially. I'm ready.

See, here's what I'm dealing with. In mid March I experienced an accident while skiing, which caused damage to my knee and shoulder (sprains), to my spinal column (broken vertebrae), to my spinal cord (damage to nerves inside the vertebrae), and to my brain (concussion). Since then, I've been working through what feels like a really slow process of healing from those injuries.

But Monday is a big day. We'll be going to see the surgeon (who didn't do surgery on me) - the surgeon who first saw me because of the broken vertebrae - the surgeon who directed me to wear a torso brace whenever I'm not in bed, and a neck brace 100% of the time. Our hope is that the x-rays we get later this week will show that there's enough healing of the fractures that these braces will no longer be necessary.

Of course, the paranoia and worry that almost overwhelm me every night say that there'll be some problem that will require immediate surgery (on Monday afternoon), which will lead to seven more months of bracing. My rational mind does its best to squash those ideas, but they keep popping up especially when I'm laying in bed not quite drifting off to sleep.

Hopefully, soon I'll finally be allowed to go without those braces. Which will feel ridiculously great, and probably exhausting at the same time, since I'll hafta start using those torso muscles that've been on break for months. But I'll take exhausted, since it'll mean that I can move around more freely.

Here's hoping for good news on Monday - because I'm ready to start moving a little more than I've been able to.

It's Gonna Be a While - Reflections on Wishing Recovery was More Complete Already

I’m tired of not feeling right. I’m tired of not feeling like I feel like I should. It doesn’t get to me every day, but the list of ways I obviously don’t feel quite right gets to me once in a while.

The most frustrating part is that my muscles don’t work the way they’re supposed to – don’t work the way they used to. Which means that:
* I get up really slowly from chairs
* It’s a long and involved processes for me to get out of bed
* My gait is really slow, awkward, I walk with a significant limp
and I either have to use crutches or I weave all over the place

Add that to the neck and torso braces (which together prevent me from bending above the waist) that I’ll be wearing for at least a couple more weeks, and I’m feeling pretty physically incompetent.

Beyond that, my brain (which was never the sharpest or quickest), isn’t quite keeping up the way it should. Plus, unrelated to the injury from a couple months ago, I’m having my glasses prescription updated ... which means that I get to get used to wearing glasses.

I'm not feeling right, not feeling like I want to. I'm not moving around like I'd like to, and I’ve started resigning myself to the truth that I may not ever again be able to some of the things I used to love doing.

Yes, I'm still working at recovery - doing the stretching and strength training and muscular electro-stimulation that I'm supposed to - but running and jumping, cycling and skiing, climbing and backpacking, all are impossible right now, and it seems like a stretch that I'll ever get back to those things.

There are times that I believe fully and completely that after recovery I'll be back to being able to do 100% of what I used to do.

There are times when I dream that everything goes to hell and that everything I've gained back over the past couple months was a fluke - that I'll lose all the progress from the past couple months and will end up needing to use a breath-powered wheelchair to get around.

And there are times when what feels more true than the rest is that I've permanently lost some of the physical capabilities I once had.

I feel like everything's going to hell very rarely; I feel like everything'll be completely back to what was normal a little more often; most of the time, though, I just wish that I felt right again.

I'm tired of not feeling right, and I long for the day when what today doesn't feel right will all of a sudden be normal. I think it's gonna be a while.

I Don't Feel At Home In My Own Body

I don’t feel at home in my own body.

If you’ve been following along, you know that I experienced an accident while skiing. You know that I spent almost seven weeks in the hospital recovering from my injuries and rehabilitating my body.

I’m getting around better now that I was six weeks ago ... better, even, than I was when I was discharged. But I’m still nowhere close to moving the way I did before the injury. Perhaps I’ll never make it back to that standard. Perhaps I’ll never get close to the standard, and my foot will always drag along the ground. I hope it doesn’t – I hope I get close to moving the way I did before. But even though I’ve figured out how to navigate current reality (slowly, carefully, and with a great deal of thought and attention paid to every single step), I long to be able to move the way I did before.

I don’t feel at home in my own body.

In addition to the loss and alteration of movement, part of this injury is that I’ve experienced a loss and alteration of sensation. Walking outside on a cool and snowy May day in Colorado, I notice that while one leg is cold, the other feels warm. Walking barefoot on the bathroom floor, one foot feels like the floor is heated while the other notices that the tile is cool to the touch. Stretching my hamstrings (which I know have been tight since like 1974), one feels the stretch while the other gets to a point where it just doesn’t move any more. It’s disorienting, and a little confusing.

I don’t feel at home in my own body.

It feels a little like I’m staying for the holidays at a relative’s house. The surroundings are sort of familiar, but not really home. And it feels like as soon as whatever’s happening is finished, I’ll be back in my own home.

Except I won’t. This is my residence from now on. This is how I exist from now on. Disorientated in my own body. It’s obviously not my first choice. But if I’m optimistic, I’ve got a few decades to get used to it. But the truth is still obvious almost every time I move around.

I don’t feel at home in my own body.

Home Today

Today’s the day. Today’s the day they told me to go. I had lived in the same room for just over five weeks; today’s the day I walked from that to my car, and my love drove us to our home.

In the hospital, I found myself moving quickly up and down the halls. The wheelchair rolled quickly down the smooth hallway. And when I walked, I made better time than most people who were living in the rooms near mine.

Today, though, I move back out into the not-hospital world - where I notice that as comparatively quickly as I locomoted in the hospital, I’m slow compared to most people. I’m slow, and my gait is stilted and shuffling.

Now I sit in the comfort of our home, recognizing that the hospital is safer and easier to navigate than an apartment complex or a grocery store or the sidewalk next to a parking lot. I sit here, recognizing that I’ll be slow and clumsy for a while.

And today - the day I’m released from the hospital, the day I come home - today, I realize again that it will be challenging to make my way through this world. And embedded within that realization, I begin to understand the truth that I'm just the same as every single other person. 

One Week

One week

One week from today
I’ll be done here

One week from today
I’ll sleep in my own bed
in a place I can call home

but today
today, while I’m still in a place
where help is just a push of a button away
where someone is paid
to tend to my needs
and assist with my deficiencies
today, while I’m still in this place
I feel safe

Weeks ago,
my physical situation was dire
today I’ve improved
and seem to be improving every day
over the next months
I’ll continue to work for the same

but in this moment,
releasing me one week from today
from the safety of hospital confines
to a home, beautiful though it may be
feels abrupt

today, I yearn to be at home
because I long to embrace regular life
out of a hospital
alongside the beautiful people
who are creating a family with me
yet still it frightens me to think of leaving
the security of this place

but today, and for the next week
fear and excitement exist alongside one another