Monthly Archives: September 2008

working out the workout

A key part of recovery for me is to soup up the workouts back to where they were before the accident.  I’ve got a long way to go.  I have to build strength and stamina significantly, and my flexibility is currently very poor as well.  Typically I’ll feel the tougher workouts later now, but I take some muscle soreness as a good sign – this is the mark of a good workout!

I’ve tried several new things over the past week.  My previous physical therapist, Debbie had gotten me on my mountain bike perched onto our trainer downstairs.  Most mornings over the past week I’ve gotten on and done about 15 minutes.  Then I’d follow up with maybe 3 ‘Sun Salutes’ (yoga), some stretching, and more recently some crunches (2 minutes of ’em).  It feels good after the fact, and I’m seeing some definite progress in my flexibility.

What I started today was a triathlon swim workout, with a coach.  This is a class that Kris talked me into taking.  Her rationale is that this is a low-key time in the class, as it’s mostly off-season (except for people like her targeting Ironman events in November!).  I was a bit nervous about it, but things went pretty well.  I’m still slow, but was able to make it through the class in pretty good shape.  I think we actually swam 1800 yards today, a new high point for me, including some form and minor speed drills.  Felt good!

As I was climbing out of the pool, I thought I had a strange interaction with the guy one lane over.  I thought I heard him say "… showing the world’s slowest swim workout?".  Didn’t sound very nice, so I said "Sorry, what?".  Then he said "maybe it’s just physical therapy".  Then I took off my swim cap (to make the scar on my head visible), and said calmly  "My experience is that physical therapy works".  Then I climbed out, somewhat perturbed, and went and showered up.  In the shower it occurred to me that he was probably talking about himself (he had adapted a very friendly tone).  This is probably a case of me not hearing correctly (plausible as I’m still healing from the punctured eardrum I got in the accident), and  carrying my feelings too close to the surface.  Good thing I didn’t say anything stupid.

Kris wanted to do a weight workout afterwards, so I took the bus towards home.  I hopped out on the way, near a Starbucks so I could pick up the New York Times and some espresso.  Then I walked home through the north end of Bridle Trails State Park. 

This was a nice way to cap off a good water workout.  I also realize that I’ve simulated a triathlon workout – swim, bike, walk.

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paying off a bet

Yesterday, my father and I went to see the Mariners play their next-to-last game of the season.  I’d not been to a game since the day before my bicycle accident.

Oddly, yesterday’s game was an occasion to pay off an unusual bet.  Seven years ago, I placed a wager with my longest-time friend Doron, who resides in New Jersey and has been a Yankee fan as long as I’ve known him (when we were 3!).  I don’t like the Yankees, having been a Mets fan for about as long.

You’ll recall in 2001 that the Mariners won 116 games, and they played the Yankees in the ALCS.  I traveled to New York on business just before the series, and bet Doron that whoever’s team lost would have to wear the headgear of the winner’s team for a full day.

Now my plan was to purchase an attractive foam letter ‘M’ for Doron when I won the bet.  As you may remember, the Mariners lost, so I lost the bet.

When I was in the hospital back in July, Doron was in Seattle and came to visit me – which was great!  However I was obnoxious (and foolish) enough to remind him of the bet, and invited him to provide said headgear, fearing what he might choose to do.

It turns out Doron is a much nicer person than I am.  He had a nice Yankee cap shipped a few days later.  I’ve worn it going out a number of times.  When we spoke on the phone a couple of weeks ago, he told me that he wanted me to wear to it the ballpark.  That is, the SEATTLE ballpark.

While it would have been fair to wear it to a Yankee/Mariner game, I didn’t get to go see the Yankees when they were here several weeks back.  So I wore it for the mop-up A’s/Mariners game yesterday.

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I agree that it would have been sweeter payoff for Doron if I had worn it for a Yankee game, and I would have loved to have gone.  In any case, none of the 37 other fans attending yesterday’s game said a word about it.  Oh well.


grief and pursuit of contentedness

Forgive me … time for some introspection.

For the past couple of weeks I’ve been experiencing some grief over the changes from the accident.  It’s been strange, given how optimistic I’d felt.  It’s also a normal part of the process of coming to terms with how things are.

If I look at where I am relative to July 1st, I feel very fortunate to be alive, and to have recovered so nicely.  I also feel very fortunate to have had the positive experiences with family and friends during recovery.  This is the thing that carries my spirit the highest, because it felt so extraordinary.

If I look at where I am relative to June 30th, I feel sad.  I don’t see as well.  I look different.  I’m unable to run, bike, or drive currently.  I feel numb in much of my face, and about one-third of my head.  And I didn’t do anything wrong.  I was on my way to work, and was unfortunate enough to be in the path of someone who probably felt agitated about being late for his job interview, so he took too hard a right turn onto a side street.  And he took me with him.

I’ve never seen or spoken to this driver, and I probably never will.  All in all that’s best because I have no clear idea of what my feelings towards him are, or what I’d say to him.  All I know is that I’m forever changed by his actions.  And so is my family.

Someday, when I’ve come to terms with all of this, I’ll feel content with things again.  The interesting thing is that currently my discontent helps to fuel my zeal for recovery.  I’m determined to get back to doing what I enjoy (running and working), and determined not to let some bad luck get in my way.

Interesting set of circumstances.  My discontent fuels pursuit of my content.  And at a certain point, adaptation to these new circumstances will kick in.  At least I hope that’s the case.

Thanks for listening.


rolling through therapy

For the past three weeks, I’ve been working with a neurological rehab company called Rehab Without Walls.  They provide physical, speech, and occupational therapies.  It’s a pretty good setup – they send the therapists to your home, and you work there.  Possibly the most convenient arrangement you can find.

The overall aim of the program is to get you beyond the inpatient type of rehab, to assess your condition, and get you ready for an outpatient therapy program.  Basically, the idea is to set you up for the longer term by determining and developing some focus areas.

As an example, my physical therapist asked me about long-term goals and interests, and then tailored the program towards those areas.  I’m particularly lucky there, because my physical progress has been superb.  I’m able to do more than was expected – I’m up and around, my balance is not bad, I can walk along uneven trail for quite a while, and swimming has gone pretty well. 

The physical therapy areas I’ll focus on longer term are stretching (I’m very tight, even more than usual), developing stamina and core strength, and loosening and strengthening my left shoulder (which is tight because of the broken clavicle and scapula).

Curious thing about speech and occupational therapy is that the names are somewhat misleading. 

Speech therapy governs much of the cognitive area beyond speech.  In the hospital, my speech therapist also focused on how capable I was of swallowing back when my feeding tube was removed.  It’s an incredibly broad area.  This wave of speech therapy has mostly involved planning ways to organize my life, and set up a re-entry plan back into the workforce.  Doing these things tend to touch on many of the traditional areas in which Traumatic Brain Injury Patients struggle.  The therapy is valuable across the board, because these things address real world issues for both home and work.  The unfortunate part is that for me, it was a bit difficult to develop tests and tasks that truly resemble the work that I do.  So, I’ll need to focus efforts going forward towards determining potential problem areas I’ll want to work on.

Occupational therapy in the rehab phase seems geared towards getting you moving along in your everyday tasks.  In the hospital, my therapist had me scramble an egg and do basic shopping and dining out math (how much will the items you select cost, and how much change will you get?).  My therapist at home took me to the store to shop for groceries, threw some more complex math scenarios at me (figure out how much a car will cost given the following discount, rebate, and tax ratios).  He also had me do basic stretches with my shoulder.  The most seemingly random thing we did was geared towards helping me determine how poor my monocular depth perception is by playing catch with a volleyball – which went surprisingly well.

This week, I’ve had to set up the next phase of therapy by finding places to go, getting my doctor to refer me, and getting "discharged" from Rehab Without Walls.

I especially enjoyed the physical therapy.  We spent a lot of time walking the trails in Bridle Trails State Park.  The therapist was good company, and provided very experienced guidance towards getting to work out, and getting fuller range of motion from my shoulder.  I expressed concerns about getting to "full recovery" to her as I did to the other therapists.  The answer to these concerns was consistently "you’ve made amazing progress, but you have to expect you’ll need to change and adapt to the new you".  This is a nice way of saying that full recovery is distant, despite my great progress.

This last point is particularly difficult for me.  In many ways, my baseline for myself is still pre-accident.  I am more patient with my physical progress because it’s easier for me to quantify and to plan for.  It’s hard to do this for cognitive stuff.  This, my friends is why I diligently try to do the New York Times crossword puzzles, why I play Scrabble, and why I have put together a work re-entry plan with my boss.  More ways that I’ve supplemented therapy include playing a full-time parenting role at home with the kids and with Kris – and hey – that’ll challenge those logic centers!  I am also trying to organize some of the work we’re planning on the house.

All of these things allow me to exercise my depleted word-finding capability as well as begin to exercise more of the Executive Function areas.

My point is that despite the fact that my progress has been amazing so far, I’ve got to keep my eyes on the longer term goal of recovery.  The best way to do that is to keep my brain and body humming along as much as possible.


at the scene

I visited the scene of the accident for the first time yesterday.  I’d been interested in doing this for a while, although I’m not entirely sure why.

As I’ve mentioned before, I don’t recall anything about the accident.  It’s possible that part of me wants to remember things about it, although that’s unlikely.  More probable is that I just want to understand more about what happened to me on July 1st, and visiting the scene is one way of doing that.

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The location of my bicycle and the pickup truck are still visible on the road.  How can I be sure?  Well – the location is just about where you’d think, and the outline is labeled seat, FT (front tire), RT (rear tire).  The pickup truck’s orientation is marked behind me in the picture above. 

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The size and shape are correct too.  That’s my bike alright.

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The picture above is Kris standing on the corner where the collision took place.  I was riding in the bike lane of the road behind her when the pickup truck cut me off while making the turn onto the side street.  That’s where and how it all happened.

I’m going to get a copy of the police report, which will help me form an accurate picture of what really happened.

We talked about this with our eldest daughter at the dinner table tonight.  She wondered why I wanted the police report, suggesting that .  I explained that it would help me to understand more of what happened.  So she asked whether it would help to discuss things with witnesses or not.  Kris told her that the witnesses might find discussing this with me disturbing.  I volunteered that I might also find it disturbing.  Her questions were very good ones, and talking about this did help me to understand why we’re doing this on the personal level.

There are other reasons as well.  We need to be armed with factual information for the insurance folks – given that the gentleman who nearly killed me didn’t have car insurance, it’s all on us to do this.

Understand that I don’t spend much time in an average day worrying about any of this.  That said, knowing what happened will make it easier to come to peace with all of this.


memories from dreamland in the hospital

I mentioned that soon after waking from my weeklong sedation, that my experiences did not always fully reflect reality.  Particularly during the night, my sense of location and time just might have taken a turn into dreamland.  Fortunately, this never took an adverse turn, so it’s pretty easy to laugh about this now.

After going over the caring bridge journal and guestbook entries again, I’ve worked out at least some correction to my dreamlike memories.  It’s impossible for me to capture all of them, but I have several here which I think are amusing.

Sleeping by the Castle

The first one occurred the first night after I woke up.  That night my friends Willie and Meg were staying with me, although they were not visible to me for some reason.  Instead what I remember were groups of workers building a set with Cinderella’s castle on it.  It was blue, and there was a lot of fake snow and clouds around.  Also, the activity around the bed made for me just outside the castle made sleeping difficult.

Obviously, no stage and no castle were in my room.

Dad takes me to SF

A couple of days after the "castle" experience, my father picked me up and drove me around San Francisco.  We were going to visit some friends and run some errands, I thought.  Then we ended up in someone’s kitchen, with him talking to some people in the next room, while I remained laid on a gurney, waiting while they spoke. 

In actuality, he’d come along while I was attempting to see a specialist for my eye in another part of the hospital.  I have no idea why I felt I was being driven around in a car.

Floating in the River with May

I had surgery on my face about ten days after the accident.  The night before I remember being restless, possibly apprehensive about the surgery.  My friend May greeted me upon my arrival into a basement room in which we were to sleep in individual boats.  When we woke up the boats were to be sent out to sea, so this was some sort of weird ‘christening’ for them.  I simply could not settle down though.  The idea of sleeping on a boat is relaxing, but I stirred May awake several times throughout the night.  Eventually, she had to get up and go to work.

I was certain that May had asked a nurse to take me over to a small, pastoral-looking office where I saw my friends Lynn and Randy.  I was very surprised to see them, and remember thinking wow, I didn’t know they worked here.  I recall asking a bunch when the doctor would be in to operate, and was very surprised to hear that it was three or four in the morning.  I’d been sure it was light when I’d been outside!

Obviously, I’d never left my room.  No boats, no water, no outside, no daylight.  The friends I’d been with were in my room, looking after me.

Gittin’ Into Surgery, then Hassling Amy and Bob

The next day, we waited forever for the surgery.  I was second behind someone else, whose operation seemingly went on forever.  When they finally wheeled me in, I felt I was placed on a conveyer belt.  I rolled from station to station while they tuned the machines necessary for the surgery, and I remember hearing someone call me over loud music playing in the background.  Then I went to sleep.

I woke up in front of a computer, at a desk looking out over a nice lawn, with the sun setting.  I did some work for a while.  Suddenly, I couldn’t see anything.  I heard my friends Amy and Bob talking, and asked them if I could work on a laptop.  No, sorry.  Then I tried to get up.  Nope.  I remember talking with them a lot, and getting lots of very polite ‘no’ answers to my requests.  They were so nice about it, but man it was a bummer.

I don’t know what to make of the surgery stuff, but it turns out I’d woken up late at night with Amy and Bob in my room.  My eyes were stitched shut following surgery (which they didn’t know!).  And I wasn’t remembering that I was in the hospital when asking to get up, work, etc. 

Running into John and Nathaniel

One morning, I thought I’d woken up very early and wandered off to do some work.  It felt good getting this done, so then I took a walk over to a huge room with bunches of chairs set up to look out at a meadow, splashed in sunlight.  After meditating on the grass for a while, I looked over and noticed my friends John and Nathaniel sitting next to me.

"Hey guys – what are you doing here?" I asked.  They explained that they were here visiting me.  We chatted for a while longer, and I remember saying something about the sunshine.  "Um – Paul, it’s 3 am" was the reply.  I couldn’t believe it.  How could they explain the light outdoors?

No need to explain this one.  John and Nathaniel overlapped their shifts looking after me at 3 am … in my room.

What Does It All Mean?

Honestly, I think this reflected the medication, and perhaps the nature of my injury.  The weird thing here is that often, my friends were inserted into a dream’s image.  I’ve got no real idea what they heard, as I’ve seldom spoken about these dreams with them.  Now, I find most of these stories amusing.  The possible exception is the one in which my eyes are stitched shut – that one sounds sad to me. 

There are more too.  For example, I imagined sleeping two nights in the rear corner of a restaurant where parties were going on, tended by my nurse Dana (herself a former marathoner).  Or being steered back to my bed in an old attic by my friend Max.  And so on.


visiting at work

Today started out on an upbeat note with a good physical therapy session involving a brisk walk in Bridle Trails State Park.  I followed this with a discussion with my counselor, about goals and accomplishments.  Then, the afternoon loomed free. and I thought about one of the aforementioned goals, which was reconnecting with people at work. 

So it was quickly off to the bus to get to the office.  I looked up the schedule online again, and this time entered the correct AM/PM setting, and then walked very quickly down to the stop, catching the bus with about 5 minutes to spare.

An interesting side note of traveling to work by bus.  I passed the accident site for the first time.  There appears to be an orange-painted outline of something tall about where I would have landed.  It’s possible but not certain that this is an outline of me where I landed.  I tried snapping a picture with my cell phone on the way back, but clicked too soon.  I’ll need to head back and get outside and walk around a little.  I don’t know why this is interesting or important, but it’s an impulse I’ll definitely indulge sometime.

I arrived at work after a fifteen or twenty minute trip.  Understand that I wasn’t even sure that my badge would work.  I vaguely recalled my manager saying something while i was in the hospital about being concerned that I’d lost it, and that he might have flagged the card as lost.  So I was happy when I was able to open the side door nearest the bus stop without any issue.  I walked to the receptionist and got a new bus pass (which I need now).

Now the fun part.  I wandered up to my office and saw that a very kind person next door has been watering my plants.  There were some new things waiting for me on my desk, but I didn’t want to take much time to examine them today – I needed to get back on the bus after about 90 minutes.

I wandered the halls for a little while and really enjoyed talked with a number of folks, including several from my team.  It was heartening to hear people’s surprise at how well I’ve recovered, and I shared with them my feeling of how fortunate I am.  I tried to convey how much I appreciate the positive support I’d gotten from the folks at work, including thanking some of those who had come to sit with me in the hospital.

I felt amazed at how warmly received I was.  My intent was simply to go in to reconnect a bit, and that was very easy to initiate with everyone I saw.  With a couple of folks I actually talked a bit of work, which was also fun.  I can’t tell you how much I miss my "everyday" feeling of life, so touching a bit of that is great!

Predictably, I ran out of time all too quickly.  I’ll definitely have to make a trip back in sometime soon to see more folks.  But I coasted through the rest of the afternoon and evening on the positive vibe I drew from visiting the fine folks at work.