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.

The Tortoise and his two Hares

Since we moved into our new house in Michigan, I have been spending quite a bit of time inside. I have projects to finish, addresses to change, tests to study for, etc. And now that I don't even have to walk from the parking lot to my office, I haven't been getting much exercise or fresh air. Fortunately, we have gone downtown a couple of times this week to see the sights, so at least I get to walk around then.

Today I needed a walk and I asked Ayden and Claire if they wanted to come with me. They got on dresses, put on shoes, got their babies (dolls) and their strollers ready and we took off. It was hilarious to see them walk. They would run and race each other with strollers careening madly down the sidewalk until they found something interesting. Then they would stop and stare at it and talk about it until I caught up and passed them. Then they would take off again to catch up to me until they found a new distraction. I felt quite a bit like the tortoise and the hare, and you can guess which part I played. I wasn't about to run, or even power walk to keep up. And I'm not sure I could have kept up if I had wanted to.

Towards the end, Ayden got tired and asked me to carry her stroller (because she didn't like the sound the wheels made when she pushed it). Claire however saw that our house was just down at the end of the street and took off running. I told her to wait for us at the corner. She got down to the corner and turned around to see us only half way down the block and decided to come back. She walked with us the rest of the way to the house. Ayden was talking to me as I walked and I could hear Claire singing some song but I didn't pay much attention to it. During a lull in the conversation, I finally caught what Claire was singing:

"If you caaann't run,

as fast as meeeee,

I'll just have to teach you,

aaaalll the time."

She repeated it over and over again all the way down the street to our house. She even came up with her own tune and stuck with it. That child's imagination never ceases to amaze me. For your entertainment, I took a video to share.

There's a hole in my living room... and in my heart

There just won't be room for my reclining chair in our new house. Even so, I never thought the chair would sell so fast. And when they came to pick it up I wasn't prepared for the emotional response I would experience. The gaping hole in the living room is a fitting representation. This phase of my life has ended, and none too soon: next week makes a full year. I can't remember sitting at the desk to work, but I guess it is time to get back into the habit and leave the cripple chair behind. How did the girls feel? Claire just thought it was cool to see them disassemble the chair and Ayden was a little treasure hunter once the chair was out of the way.

I slept in my chair last night. Not as a final farewell. In fact, I didn't know it would be gone at the time. I did it because I got home after 4:00 am and I didn't want to go into the bedroom and wake Wendy. I was up late finishing slides for my thesis defense. While it is true that I have had months to finish them, what would life be without procrastination?

My thesis defense went well, although longer than I expected. One of my committee members asked a lot of questions. However, they were questions of curiosity about my work, so I didn't feel intimidated. My committee gave a very favorable report, so I was pleased. Also, I was informed on Tuesday that the main results for my thesis have been accepted for publication in the Society for Industrial and Applied Mathematics Journal on Matrix Analysis and Applications.

On a sadder note, our first choice for a house fell through. The inspector found very serious foundational issues, so we bailed. We are working on putting in an offer for our next choice: cross your fingers. This one was built in 1971, rather than 1925, so hopefully we can avoid foundations slowly sinking into the Michigan mud on this one.

Run Forrest Run!

Some of you have had the privilege of seeing me run. Others of you have not been so fortunate. Wendy took a video of me running while we were playing outside with the girls. I decided to post it so you can all see my progress. To put this in context, I constructed a timeline of my advancements so you can see how long it has taken to be able to do certain activities.

1 week - I start rehab.
2.5 weeks - I can roll myself over in bed.
1 month - I get out of rehab. By this point I can walk about 30 feet on a walker before collapsing.
1.5 months - I start climbing steps. I can also take a few steps on my own although I fall a couple of times attemping this. My distance on the walker is improving (I can make it several hundred feet at a time now).
2.5 months - I am mostly using the walker now. I only use the wheelchair for convenience (now that I finally have one that is).
3 months - I am starting to see some progress in my right quad. I can straighten it when lying on my side in bed. Also, I am starting to stray from the walker. I purchase a cane.
4 months - I exchange my plastic shell for a corset. I can just barely raise my right leg leg against gravity (while I am sitting in a chair). I start using a treadmill with a lot of upper body assistance, and fall in the process.
5 months - I am walking most places without a cane now (this is December). In fact, the first week of January I travel to D.C. and that is the last time I take my cane anywhere. I can also drive (with my left foot).
6 months - My corset comes off, so no more back braces. The only piece of mobility equipment I still use is the left-foot accelerator in the car. I also try my hand at bowling for the first time (not too pretty).
7 months - I am getting around well enough to do major projects around the house. For example, I put in a new bathroom sink.
8 months - I am walking well enough that most people don't notice anything different unless they see me go up or down stairs. In fact, I fool everybody I meet on my trip to Ann Arbor, MI.
9 months - I can completely straighten my right leg against gravity, so there is noticeable improvement in my quad. I can also start to lift a meaningful amount of weight with my right leg.
10 months - I sell all of my equipment except my novelty cane and my left foot accelerator (which I still need). I don't think anymore about distances; I can walk as far as I want to.

I guess I didn't mention that I sold all the other equipment: wheelchair, walker, shower bench, etc. I finally didn't need it anymore and we decided to get rid of it before we moved.

And now, just short of 11 months, I can jump (a little) and run (kind of). Here it is for your amazement. It looks pretty ridiculous, so feel free to laugh; I always do.

Pumping Iron

For the last several months I have been going to the gym twice a week (uhem, well, I've been trying at least). I have been frustrated trying to exercise my right quad because it is so week that I can't really do most of the exercises. If I do squats, all my weight is on my left leg. On the quad machine, if I use both legs, it's hard for my right leg to even maintain contact with the weight bar. On the other hand, if I just use my right leg, I can't make it budge at even the lowest setting. At the end of a workout, only my left leg felt fatigued. Of course, that has led to a rather large left leg, which only accentuates the difference between the two. It has been frustrating to say the least.

Lately I have had some success on the leg press. The leg press is a weight machine where you sit in a reclined position, put your feet up on a platform, and press down to lift the weight. The motion is similar to squatting or jumping. I can push quite a bit of weight with both legs. When I started I could barely push the first weight level (about 30 pounds) using just my right leg. Of course, if I want to jump I had better be able to do more than that.

Two weeks ago I had the idea to try negatives. I put the leg press on a setting that is a little higher than what I can push with just my right leg and use both legs to fully extend my knees. Then I take my left leg off and try to keep the leg press from falling back. When I started two weeks ago, I couldn't even keep the level 2 setting (60 pounds) from falling back. In fact, I couldn't even slow it down much. I had to catch it with my left leg to keep the weight from crashing down.

Today I was shocked to discover that I can now push through a full range of motion with just my right leg on a level 4 setting: 100 pounds. That is nearly one-tenth of my body weight (ha, ok, just a little exaggeration). I was pretty excited. I have been wondering if I am even making progress. Apparently the negatives are doing wonders and the consistency is starting to show. At this rate I will be running and jumping again in no time.

You're spine is so... twisted

I had my "last" doctor's appointment with neurosurgery today (there's a chance they want me to come in for another one). He told me I am doing pretty well considering I should probably be paralyzed. He also said that the alignment of the titanium cage looks good and my flexion is remarkable; usually fusions in this area restrict your flexibility quite a bit so I am lucky that I can bend as well as I do.

I noticed on the X-ray that my spine seemed crooked. I looked at previous images and found that this was not new. I asked the doctor about it and he said that it is usually impossible to get things perfectly straight after a burst fracture (good to know, I guess). I suppose that explains my miraculous twisting tummy: in case you were not aware, when I flex my six pack (ha), my belly button shifts over to the right side. In fact, flexing or not I think I am little lopsided. Apparently that isn't going away any time soon.

I also found out that I have about a 20% chance of needing another surgery within 5 years. My cushy deskjob actually makes me a little less likely and I can improve my odds even more by staying slim (time to start the diet again) and doing strength training for my core. Of course, Wendy is thrilled to have a solid medical/financial reason to insist on washboard abs. I guess it can't hurt... Apparently the extra strain on the remaining vertebrae can cause some wear and shifting and sometimes it gets bad enough that they have to go in and fix it. Fortunately, my good recovery, age, and the lack of a degenerative disease all play to my favor. In any case, I think I am done going to the doctor's office. I prefer to live in ignorance (and with my money, thank you).

The Bigger They Are...

As many of you know I have officially made my decision for graduate school. I accepted the offer to attend the University of Michigan and now Wendy and I have started looking for a house in the area. In spite of what Wendy says on her blog, it was a difficult decision. Both schools were outstanding and Bloomington was gorgeous. There were pros and cons to both options.

While I was visiting the University of Michigan a couple of the graduate students took us on a tour. During the tour my toe snagged and I fell. I caught myself and got right back up, but it was pretty embarrassing. My hotel roommate (Kyle) was really the only person that knew about my accident, so everyone just thought I was a klutz.

For some reason that fall started a chain of them. I almost fell while talking on the phone at my house. I just about tripped down the stairs at school, I just about lost it handing back tests in my class. It's weird because I haven't fallen in quite some time. I must have caught the falling bug in Michigan. Either that or I have just gotten lazy with my walking. I am sort of a cocky guy.

Tonight, Wendy and I were talking about my first few days in the hospital: throwing up, getting diapers changed, trying to roll over, sponge baths... what wonderful memories! It will be nine months on the 9th of this month. Nine months ago I was miserable and helpless, lying on a hospital bed. It reminds me of all the people that helped me along the way. Family members that helped take care of me in the ICU. Friends that visited and took care of the kids. Ward members that brought in meals. Doctors, surgeons, nurses, therapists, and other professionals that dealt with all my medical issues. Colleagues at school that covered my teaching assignment and donated money to help cover costs. Most importantly, Wendy. It wouldn't be fair to her to publicly admit everything she has done to take care of me. You have all been wonderful.

What a startling contrast with my current condition. On Monday night we took the girls to the park. I participated just as much as any other parent. I watched them go down slides and pushed them on the swings. I held Ayden so she could swing across the monkey bars. At the end of the night I "chased" the girls to the car. My brand of running is pretty comical, but it is starting to approximate the genuine article. I am just happy to have the balance to do something remotely close. I never have to worry about distances anymore; I can walk about as far as I want. I can completely take care of myself now and I can almost get up stairs without using hand rails. While I was in Michigan, one of the professors asked if I was going on the tour and I made a comment about keeping up. He joked that I was pretty tall: if I took big steps I should be fine. I told him about my accident and he was shocked. That always surprises me; I still feel it in every step. But most people don't notice now unless they see me go up stairs. Even then I have been told that I am starting to look pretty natural.

I can still remember my time in rehab, and yet, it seems surreal. When I was in the hospital, I could remember paragliding, but it seemed like a dream as well. Like it happened to somebody else. Now the same is happening with the accident. The memories are fading. And as my strength and ability returns, it gets harder and harder to remember the struggles of those first few months.

For those of you looking for a comical post (Karen), I started out that way, but I ended a little sappy. Hopefully you don't mind. Thanks again to all of you. I couldn't have done it without you. I am thrilled to be where I am and confident that I will keep getting better.