Saturday, May 29, 2010

It's Been a Long Time, I Shouldn't Have Left You Without a Dope Video

Bonus points for anyone who can identify the allusion in the title...

It's been nearly a year since my last post. I am still alive and progressing, but, the progress is less visible and much harder to quantify or describe in a blog post. I'm getting pretty close to the two year anniversary of my accident, Life Day as we call it now, on July 9. In case you have forgotten, Dr. Reichman told me that I could experience improvement for up to two years after the surgery but that significant progress beyond two years was unlikely. As it gets closer it makes me think about how much progress I have made and whether or not it is enough. It has also motivated me to make whatever progress I can before I reach the two-year mark.

I often tell myself that most of my problems are conditioning and muscle strength issues, rather than the result of neurologic malfunction. Somehow that makes me feel like I can extend the clock, which is hopeful, but not motivational. The fact is, I don't know how many of my current limitations would be resolved with a more ambitious exercise regimen and how many are here to stay.

This frame of mind has made me think about how to make progress for free. So, this week I started driving with only my right leg. As a point of reference, I stopped using the left foot accelerator shortly after we moved to Michigan and started driving with two feet, my left on the brake and my right on the gas. That only took a day or two to master. That method freed me of the portable accelerator (which I think we sold, although I can't be sure) and made it possible to drive any automatic transmission vehicle without extra equipment. If I can now master driving with just my right foot, I will be able to drive manual transmission vehicles again.

Driving with one foot brought something else to my attention. When I first started driving with two feet it was a real challenge to be able to lift my right toes up enough to keep them off the gas pedal (sounds really safe I know). Dorsiflexion (being able to lift up your toes) is still the greatest weakness in my right leg. However, this recent change to my driving has made me notice that I no longer have any difficulty keeping my foot off the gas pedal. In fact, I have just enough dorsiflexion to do it and no more. This can't possibly be coincidence. I am sure the repeated effort to lift my toes up enough to keep them off the gas pedal got me to where I am. So even though it is still a bit of a struggle to move my right leg between the two pedals when I drive one-footed, I am doing it in the hope that the repetition will yield further improvement.

Driving also got me thinking about what other therapy I could get for free. I have noticed that when I am standing I rest all my weight on my left leg and when I walk most of my propulsion comes from my left leg. Also, when I walk I still hyperextend my right leg so that most of the support comes from my knee locking rather than from my quad. When I bend down, I always lean to my left so that my weight is over my left leg. I have done it this way for so long that now I do it from custom, even though it is no longer necessary. In fact, I can stand on just my right leg. I can propel myself almost exclusively with my right leg, and I can squat with my weight evenly distributed. My quad has made quite a bit of progress, but I haven't limited the progress by favoring it so much. So this week I have been focusing on getting more from my normal activities by trying to do them more normally. For example, I started getting in and out of a car normally, rather than doing it like I am transferring from a walker or a wheelchair: another habit I developed. Interestingly enough, I forgot how normal people get in and out of cars. I knew I did it differently than I used to, but I couldn't remember how I used to do it. In fact, I asked Wendy and she couldn't describe how she does it either (strange how our actions become so mechanical that we cannot consciously describe them). I had to watch her do it and then really think about it to be able to do it myself.

In addition to trying to make better use of my right leg in the things I do daily, I am also trying to bring back activities I used to participate in before the accident. Wendy and I have been going down to the elementary school with the girls a few times a week. While they ride bikes and play on the playground we shoot hoops. We haven't played any one-on-one yet, but even just shooting, rebounding, dribbling, and picking up the ball are sufficiently different from my regular activities to leave me sore in different areas. Sometimes when I chase after a ball I try to "run". Running is still difficult and awkward and I feel ridiculous doing it, but I suppose using a walker and a cane looks a little ridiculous too, and if I hadn't done it I wouldn't be walking today. So I think there is more running in my future.

I am much better off than Dr. Hilmo suggested I might be (walking on braces and crutches around the house but living most of my life in a wheelchair). But I wouldn't call myself fully recovered either, as Dr. Reichman suggested was possible. I have been looking for ways to quantify my progress, both for my benefit and yours (assuming there is anyone still monitoring this blog). Recently we took the girls to a park and there was a twisty balance beam. I found that I was able to walk it, which required me to stand and balance with all my weight on my right leg (certainly not something I could do even 6 months ago). That seemed as good an indicator of my progress as anything else, so I decided to share.