Saturday, January 20, 2007

Accident History: Part 10

With my rehabilitative days seemingly over, I began my long and setback-ridden road to greater whole body recovery (a presently incomplete objective, mind you). In the spirit of returning to my former physical ambitions, I made a less than graceful return to my martial arts club. Things progressed at a relatively safe clip at first, with my instructor clamping down on any particularly extreme exertions, which were themselves woefully underwhelming due to my heavily deconditioned and gimpy state. But that didn't quite last.

It wasn't long before (in hindsight of course) it became apparent that I was playing well above my physical paygrade, and having returned to intermittent class attendance around Christmas time, it couldn't have been more than a couple months before I threw out both groins (crescent kicks be damned) and then repeatedly attempted to do the undoable: work through them. This refusal to immediately withdraw locked me into an short-lived cycle of reinjury, which eventually forced me to bow out of class for the indefinite future (no pun intended).

So began a trend, one that I think I always recognized to a certain degree, but have only now fully wrapped my brain around. Other injuries followed, some more or less serious, some my fault and others not. Although exact chronologies are a little lost on me, I coughed myself into two inguinal hernias, but there was (for once) nothing I could do about it. My musculature was obviously still quite atrophied and unbalanced, and as I was constantly hacking up a technicolor assortment of mucus and other icky business as my lungs diligently tried to cleanse themselves, it was really only a matter of time before I herniated myself. My abdominal wall, which really had held up remarkably well over all those months of deep-throated coughing, finally gave, resulting in two consecutive hernia operations. The first was around Christmas time that year, and the other fell just days before my birthday in February of '06 (as you'll come to see, timing is my specialty).

Hernias suck. There's really not much more to say about it. Once again, my parents came through in fine style and helped me out by taking some time off work. Eventually I would get used to the synthetic mesh that now inhabits my lower abdomen, but I don't want to get ahead of myself here.

I had another orthopedic surgery planned for late in '05, but that surgery was delayed by the unexpected first herniation and requisite procedure (although I herniated both sides, the right side was not nearly as bad and was not recognized until later, hence the second surgery two months after the first). So my orthopedic surgery--a procedure to shorten my healthy right-leg by an inch due to the length discrepancies between my left and right femurs at the time--finally got underway in January of '06.

Now, I've prided myself on having a particularly high pain tolerance and for that reason have opted out of my various pain medications at different times (and because the pain was preferable to constipation, believe it or not), but this was not one of those times. This hurt. A lot. I also had to hold down for at least one overnight in the hospital (it may have been two, but I'm no longer sure), and here was where I came to appreciate the solitude of my earlier inpatient days, as my neighbor constantly rivaled the surrounding electronics and other machines with his snoring and other horrible and mysterious noises. But I digress...

It was under this context--almost miraculously returned to a near-perfect symmetry of femur length on both sides--that I returned to rehab, albeit much closer to home this time (which would still delay my full-fledged return to college until the Summer of '06). Once again, I benefited from apparent paragons in the therapeutic profession. This rehabilitative episode was interrupted twice, once for the second hernia surgery, and then once again to pull two screws out of my recently-embattled right leg. Both sidelined me for at least a couple weeks, but that fact was particularly damning after the screw removal, as the atrophy that occurred in my right quad during that time coupled with the loss of load-bearing capacity in that femur's titanium rod caused me to develop a particularly nasty case of patellar tendonitis (although tendinosis was a more likely diagnosis, especially considering the injury's present longevity) when I returned to loading exercises. Sigh.

Another irritating physical hurdle, but one that I have mostly (read: mostly, not entirely) cleared as of now. I've been out of my most recent bout of rehab for some months, but we're still not quite up to speed yet. I also developed a rather interesting flare-up of tennis elbow on my left arm (more tendonitis/osis) due to my months on any combination of crutches, a single crutch, or a cane. That also falls under the mostly resolved but still lingering category as of now. The list goes on, though...

We finally get to the injuries that I'm clearly completely at fault for. To start out with my most ridiculously bone-headed maneuver (but not most painful) misadventure thus far, I thought it would be prudent to start back-bridging as a component of my recreational workout regimen. Unfortunately, making excellent progress and getting the bridge position all the way onto my forehead without great difficulty (hand-supported, of course) after several weeks of work wasn't quite enough for me; instead, I decided to push for that nose contact. Bad move. I pulled both external obliques (just like my groin pulls, my left was far worse than my right side, but still...). Ouch. Abdominal strains--like hernias--also suck, as there is little to nothing that can be done physically that doesn't somehow engage the core. Another "smart" move on my part. (And let's just not talk about my subsequent reinjury a few weeks later, when I thought that a "little" bit of bridge work was again in my best interests as I was starting to feel a little better.) Those strains, like the aforementioned tendon issues, are not fully resolved, but they have made significant progress and no longer plague my every movement.

To wind out this list, I'll move on to the present king of my self-injury moments. I managed these--unsurprisingly--near Christmas of '06. I was building on at least a couple months of sensible home workouts, and while I still pushed, I generally tended to push within the boundaries imposed by my present physical limitations. I found a way around my streak of good behavior, though it certainly wasn't intentional.

I had been working heavily eccentric bodyweight exercises to combat the patellar issue I was dealing with, and I had for some weeks decided to apply that methodology to my tennis elbow. Specifics are irrelevant and confounding, but suffice it to say that much of the eccentric loading I placed on my left arm (and right arm, too, as I was trying to remain relatively balanced) was being displaced into my shoulders because both arms were unsupported throughout their entire range of motion. Now, as I'm sure that anyone fond of injury forecasting might have guessed, we've now entered the notorious badlands of rotator cuff injury. But that's not all, and the wear and tear I was placing on those surprisingly delicate shoulder protectors was not yet apparent to me. Time for another self-imposed blunder...

At the conclusion of a rather intense workout, I brought everything to a close with a finisher. Now, typically this was enjoyably painful (every exercise enthusiast knows of what I speak: the glorious burn), but for some unfathomable reason, I opted for a truly ball-busting set of isometric chest presses against my basement wall. It didn't go well, but the real kicker is that I didn't even feel it until later. This departure from rationality coupled with the as-of-yet unknown rotator cuff issues created a dangerous synergy, resulting in two enormously painful pec strains (once again, with the left being significantly worse than the right).

My seemingly inevitable bouts of injury aggravation then proceeded on cue some weeks later during my Christmas break. My sister returned to my parent's house, which left me to tend the house for an easy week off--or so I thought. I had made some modest progress on the strains (as in there wasn't much passive pain), but having to keep a house running and--ironically enough--doing dishes is what tore me up again. I had tried being careful, but it just didn't quite work out. As the cliché goes, I am certainly my own worst enemy, but despite the almost laughable idiocy of my actions, I sincerely hope that someone (really, I'm serious, anyone) will peruse this narrative and realize that perhaps taking it just a little easier might be the smartest, most productive move of all.

So, now I sit here, typing away into my corner of the Blogosphere. Both groins feel relatively OK, my abdominal strains don't seem to trouble me much anymore, my tennis elbow seems mostly dormant, and my patellar tendonosis--while still needing some work--seems to fall in line most of the time. Pretty much all that remains is the nagging pain of my pec strains, and the atrophied state of my rotator cuff musculature, which will go unaddressed until my pectoral issues are resolved. While I believe that this unfortunate menagerie of injuries will eventually heal on its own (having talked to an athletic trainer friend of mine) with appropriate doses of time, ice, and rehabilitative exercise, I sincerely hope that no surgical intervention will be required. This was simply the final push, shoving my body past yet another threshold it was unprepared and unwilling to cross, and I will feel incredibly lucky to dodge the surgeon's scalpel for once.

It's not that it has taken me this many injuries and a legacy of pain to "get it." I think I've always understood, at least at some level, that discretion really is the better part of valor. But like anything else that is only understood in theoretical shades, these present injuries are the dastardly jolt that I apparently needed to thrust my understanding into the sphere of tangible reality. Now, with my workouts appropriately neutered and lacking in all upper-body movements, I sit here, winding my story down to the present day. I'm sure I'll step into the time machine from time to time, as I seem prone to periodically shake loose various anecdotes and introspections, be they deeply philosophical or utterly mundane, and pass them on to whoever will listen.

Monday, January 15, 2007

Accident History: Part 9

As my break draws to a close, let me ratchet up the pace to get things contemporary.

The most profound difference as I transitioned to outpatient therapies was simple: I was finally back home. I hadn’t yet returned to driving, but my family once again came through, making the 15-20 minute drive to a neighboring town as needed, and often times hanging out in the waiting area until I was done (usually 2-3 collective hours per session).

The therapies themselves don’t warrant much in the way of specifics: most were logical progressions of former exercises (both physical, occupational, and cognitive) from my inpatient experience. I continued to make very steady progress in the physical therapies, and despite a bit of a bumpy start in my speech therapy, I completed the entire regimen in relatively short order.

Once again, my claim to success is not entirely my own, as the credit is spread evenly amongst yet another team of highly qualified, skilled, and compassionate therapists and personnel; their outstanding and adaptive approaches helped to propel me out of outpatient treatments in a mere three or four months (I'm embarrassingly short on the exact duraction, but 3.5 months sounds about right).

I honestly wish that I could name names within this narrative, as I think that the contributions of just about everyone at every step of the way was nothing short of exceptional, but I’ll stick to my guns and hold the line of anonymity. But should anyone who has come to know me through any stage of my treatment and recovery ever chance down my lane of the Blogosphere, my heartfelt thanks goes out to you: I would not be where I am today without your unwavering diligence, skill, and--most importantly--your compassion.