Back Augmentation

After a recent visit with the back doctors, I am struck by the marked contrast between how great I feel on the outside and how thrashed I look on the inside!

After nearly three months of convalescence, last week was the first follow-on visit with the back doctors since surgery.  We compared "after the fall" x-ray film with film they took on the day of this recent visit.  The before surgery film showed a lower-down vertebra completely exploded and a higher-up vertebra pretty-well cracked.  The doctors explained that had the upper vertebra experienced damage similar to the lower one it would have been game over for my spinal cord.   Toward the base of the spinal column our spinal cords divide into several smaller nerve bundles that continue down to the lower extremities, and the exploded vertebra they replaced was below this critical junction.  Yet again, a very lucky dude.

The x-rays from the recent visit showed significant scaffolding they had installed on either side of my backbone like a ladder but with screws attached and extending into either side of each of four vertebra.  I'll save you the doctors' blow-by-blow of the surgery, but given that this blog is all about being a "cautionary tale" (please skip the rest of this paragraph if you're sensitive to graphic surgery descriptions) I will leave your imagination with the doctors being far from gentle with me while peeling back muscle and scouring bone prior to drilling screw placements to prevent infection.  

Because it hasn't felt like there's much of anything new back there, I was expecting to see not much more than a series of screws holding the vertebral together. Surprise! I wasn't aware they had installed that much hardware and that it will remain in place for the duration.

The doctors were pleased with what they saw and indicated I should gradually test the boundaries of BLT (bending, lifting, and twisting) restrictions established at the outset of the first three months after surgery.  Initially while still bed-ridden I was cautioned countless times to treat my legs & torso like a solid log and roll en-masse from one side of the bed to the other for position shifts to avoid pressure sores, linen changes, sponge baths, and other vital functions.  After gaining the freedom of my power wheel chair I was allowed to sit up throughout the day and carefully reach out with the slightest bit of back twist & bend.

Eventually, and within the limits of the range of motion resulting from the hardware, I should be able to do just about everything I was doing before the fall.  It's not that I might yank something loose by trying to do too much, but rather it will probably be a little bit more difficult to reach down and tie my shoes. The doctors suggested looking into shoes with Velcro straps, . . . but you still have to get down there to strap them, and I haven't seen Mountaineering boots with Velcro straps in any case.

Other good news is that I shouldn't be overly concerned about the numbness I feel in my lower left side where they went in to replace that one lower vertebra.  They explained that in moving a lot of stuff around during surgery the nerves in the area tend to shut down but that eventually they would likely settle down and start reporting feeling again.  OK, so I'll suspend disbelief on this aspect of recovery until the next visit with them three months hence.

Potential bad news is that because I'll be bending/twisting with only a subset of vertebra those that remain in action will get much more wear and tear then they would have otherwise, and there's a chance---even a likelihood---that within a decade or so they will be done and will need to be fused as well.  The doctors said that everyone is different and there's really no single protocol for long-term recovery from this type of surgery, so I'll just move forward with the assumption that my body will adapt and build muscle to support the weakened areas and everything will be just fine. 

Harborview redux - shower time!

Beginning to settle into a quasi routine. Returning each evening to an apartment at the Ballard Landmark with spectacular views of both the Olympics and the Cascades has been very welcoming, but with only a bed for furniture I was motivated to visit Ikea to select a table and chairs, bedside tables and lamps. Taking the two hour Metro trip down to Ikea was quite an adventure I can tell you, and I probably shouldn't have had that second cup of coffee before heading out.

This week a group of friends came over for pizza and beer and afterwards assembled the furniture. It was a very fun evening filled with laughter and gentle ribbing about furniture assembly skills. Now the apartment looks a little more civilized and I have more flat spaces to lay things out on at the end of the day. Thanks guys!

Also this week Marijane and I went back to Harborview for another round of X-rays and evaluations. It felt marvelous having the casts removed from my arms and leg, but kind of gnarly looking.  We've come to make very good acquaintance with the cast team and they give us a hard time.  Coincidentally a patient and spouse who had seen Marijane and me on a previous appointment were there again, and they indicated I was looking very much better, . . . less like a train wreck anyway.  

After reviewing the x-rays the hand/wrist/forearm doctor decided I no longer need casts, so now I am in removable braces and can wash my hands and forearms properly. Likewise the foot/ankle/shin doctor decided I didn't need to be in a full-on cast so now I have matching removable boots.  In theory, I can take them off to thoroughly wash my legs, . . . if I could only reach the velcro bindings. (Note to self: it is OK to ask for this kind of help.)

So today was the really big day. It had been almost nine weeks since I had last taken a shower; by mid-morning I had taken the plunge and it was fantastic, like all the national holidays rolled up into one!   This first time needed to be on a weekend morning so that I had plenty of sleep and was fresh and able to think through all of the logistics associated with this first attempt. Also, Marijane nèeded to be on hand with plenty of time just in case something didn't work out and I needed an extra hand. 

Thankfully the logistics came together, catastrophe was avoided, and for the first time in nine weeks I feel wonderfully clean.  And without putting too fine a point on it, I just want to allude to how much doesn't naturally exfoliate when it's been trapped in casts for nine weeks or so. Pretty ripe.

Next visits to Harborview are at the end of the month for a first follow-up visit with the back doctors (one replaced vertebra and four fused as you may recall) and an additional follow-up with the hand doctors so that they can remove plates which will require surgery and more anesthesia. Oh joy!  With the plates out, however, I anticipate being able to start light physical therapy on my wrists and forearms by mid October. It will be interesting to learn what the back doctors have to say. From my point of view it feels pretty good and I just hope I haven't been doing too much and screwing it all up.

The heels, ankles, and shins will need quite a bit of additional convalescence time. We compared x-rays just after the surgeries to the most recent set and although we could see the wispy beginnings of new bone growth it was very apparent that there's quite a bit more that needs to regenerate before I can begin physical therapy.

All in all it was an excellent follow up visit to Harborview with lots of good news and the great joy of knowing that showers, many showers, are in my near future.

Slow motion

The first week on the job with the Mountaineers is complete and it has been an eye-opener. This may seem commonsensical but most everything takes longer to accomplish when you're sporting four casts and in a wheelchair. Not everything mind you; ironically, I motor along faster than most people walk so getting back and forth to bus stops happens in the blink of an eye.

Just about everything else requires strategy. From getting out of bed (and into the wheelchair) to getting out of the door, every step requires careful & methodical pre-planning. Sponging down (forget showering, and bathing is just a dream)? Brushing teeth and flossing? Shaving? Getting dressed? Preparing a lunch? We're talking two hours just to get to the breakfast table!

What you try to avoid above all else is dropping things. Picking things up after you drop them is a huge time sink. You use a long grabber device to pick things up and some things can be really slippery (like your cell phone) or very difficult to capture (like a credit card). The worst thing to drop of course is the grabber itself!  You're not totally SOL when this happens but retrieving it takes another big chunk of time, . . . You have to situate the wheelchair just so and then fully recline so you can barely reach down to retrieve the grabber. Oi!

At work you can no longer take for granted the simple things like preparing a cup of coffee or grabbing a snack out of the refrigerator. It's all about methodical process and careful planning to avoid catastrophes like dropping your coffee cup from a couple of feet off the ground or knocking over an open container of milk. Maneuvering around an office can be challenging as well. There are file cabinets and rolling chairs where you might not expect them so quite often you take detours to get to your planned destination.  It's all good, it just takes time.

Once home, just about every minute is spoken for in getting ready for the next day and preparing for bed.  All in all I have yet to arrive at work when I want to or get to bed on time.  I am getting better each day but man has this been a learning process.

The Mountaineers

They say never mix work with pleasure but I just couldn't resist.

Joining the Mountaineers staff as director of operations is a dream job for me. I love what the Mountaineers stands for and how it goes about moving forward towards achieving its mission and vision. In my mind the Mountaineers organization is one of a kind in the world, and I am consistently amazed by the volunteer ethos continually exhibited by the 500+ people who pay it forward year-in year-out without a second thought.

I have come to know their motivation. We share a love for exploring beautiful natural places and we gain great pleasure from enabling others to safely venture into these realms to establish their own connection. This is a rare and beautiful gift freely given to over ten thousand members which replicates endlessly throughout the outdoor community. There are countless instances where Mountaineers meet others in need and offer their assistance without regard to the impact on there own adventure.

Then there is everything the Mountaineers does to support conservation of our beautiful natural places as well as outreach to youth who might not otherwise have access to these special places.  I feel so fortunate to be part if an organization with these lofty goals!

Getting ready to return to work

Yesterday Marijane, Marie and I hopped aboard Metro and did a dry run of my commute from the Landmark to my new workplace.  We took the 40 bus from Leary Way to downtown Fremont and then transferred to the 75 which took us to our final destination. The trip took about an hour (about 30 minutes in a car).  Marijane and Marie visited the final destination last weekend to evaluate possible wheelchair roadblocks and we ended up finding a safe way from the bus stop to the front door of my new workplace.

I have become adept at maneuvering my motorized wheelchair into the wheelchair accessible space at the front of the Metro buses such that I am able to raise my feet and lower my back and head to keep my feet as close to the level of my heart as possible which is what the doctors want. However to the other folks on the bus it looks like I'm totally chilling out.

Thankfully the dress code at this new workplace is pretty casual and that's good because for the next 6 months it's going to be pullover shirts and shorts for this young man!

New digs!

I've been making so much convalescence progress that our insurance provider decided it was time for me to migrate from a skilled nursing center to an assisted living community.  It makes perfect sense to me as I no longer have need of 24 hour nurse care, people doling out medications, or meals delivered to my bed.

Ideally I would head for home at this point, but because I'll be in this motorized wheelchair for the next 6 to 8 months, and because our home is so very wheelchair unfriendly it makes sense for me to remain in an ADA approved facility for the duration. It could be as simple as an apartment built for wheelchair-bound folk, however, because I am unable to load bear on hands or feet (just elbows and knees at this point) family members are concerned that if I deck then there would be nobody around to pick me up. Hence we've looked at several assisted living communities and have settled on the Ballard Landmark on Leary Way.

Miraculously, we were able to move from Anderson House to Ballard Landmark in a single day with the help of sister Laura and brother-in-law Bill. They packed up everything in my room, moved it out to their rental car,  transported it from Shoreline to Ballard, and then moved everything back into the Landmark.  I'll remain in a temporary guest suite for several days while the Landmark crew prepares my apartment; they want to replace carpet and paint the walls.  Simultaneously I'll coordinate delivery of a few pieces of IKEA furniture and a rented powered hospital bed, and then I'll be all set. 

The Landmark Community are very curious about me and I'll be making a bunch of new friends in the course of the next several months. By the way, it is a great place for visiting. The public spaces are very comfortable and well-appointed and it would be fun to entertain guests here.

First bus to Ballard

So, you've had a climbing gym accident, you've successfully made it through numerous surgeries, you've been bedridden for the last six weeks, but now you have just got a fancy new wheelchair and have demonstrated abilities to get around including on and off of buses.

You're free! Where would you go? What would you do?

I headed for home, and home for me is Ballard. More specifically my first and most pressing desire was too get to my barber, have a haircut and a thorough hair washing, and then have her shave the six-week beard off my face!  Heaven!!

Backing up just a bit. Laura and Bill arrived at Anderson House and sat with me for breakfast before we headed for the 348 bus stop. We took the 348 to Northgate Transit Center and caught the 40 to Ballard.  No muss no fuss. Disembarking at the main bus stop in Ballard was a very special moment: rolling along Market Street in perfect sunshine, seeing all the familiar places, feeling the energy of the neighborhood, knowing I was finally home.

In addition to the barber mission we also had an appointment to visit and tour Ballard Landmark on Leary Way. The Landmark is a senior assisted living community but in special cases they allow slightly less than senior individuals (like me!) to become residents. The tour left us very enthusiastic about my joining the community. You've got to see this place: many amenities and very well-appointed community spaces.  The one bedroom apartment we visited on the 5th floor has southwesterly views of both the ship canal and the Olympic range.  Ironically the Landmark is directly across the ship canal from Vertical World Climbing Gym.

Later in the afternoon we toured up and down Ballard Avenue stopping in various places. Sangrias at Matadors. Oysters at Acme bar.  Whiskeys at Macleod's.  Marijane and Marie joined us for dinner at Bastille. After a leisurely and entertaining meal I took Metro back to Anderson House and made it in time to watch the last 10 minutes of the Seahawks game.

What a fantastic first day of freedom!