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.

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.

Accident History: Part 8

Although I was projected to be serving at least a three to five month tenure, I cleared inpatient rehab in only a single month. During that time I was engaged in a varied assortment of physical, occupational, and speech therapies. I had to relearn an impressively basic array of both physical and cognitive skills, and things were tough going, especially at first.

Having been fed and hydrated through tubes and an IV throughout the entire ordeal, I had to be taught how to swallow whole food and liquids again. As my trache was slowly downsized and eventually removed, I also spent a substantial amount of time learning how to speak again. Through the use of some very basic visual puzzles, my speech therapist and I also played games designed to stress memory and simple associations, all in the service of spurring on my cognitive recovery.

Admittedly, I had an incredibly difficult time staying awake during the first week or two of speech therapy. In addition to the cognitive focus of the "brain games," this was where I did a variety of odd exercises to strengthen my swallowing reflex and worked on enunciating various words while coping with a bandaged hole in my throat post-trach removal.

I had to relearn basic locomotion in physical therapy, covering the spectrum of learning to sit up under my own power all the way to standing and walking around with a cane. Manual dexterity and other functional movements were the province of my occupational therapies, which tended to center on things like cooking safety or exercises designed to return my right arm to its fully-functioning and dominant role.

Suffice it to say that I managed to push through my rehabilitative tasks in extremely good time, but I would be remiss in claiming a purely personal triumph. I had an amazing support system of family and friends: my nuclear family was a near-constant presence, and my Mom actually took work off to stay with me during the day and wheel me around to my various therapies and other on-site appointments. Some extended family members and several very good personal friends also visited me, which certainly had a very uplifting effect.

An incredibly skilled and compassionate team of doctors, therapists, nurses, and orderlies tended to my ensemble of needs, and they can (along with my family and friends) lay claim to most of my inpatient success. Without them all of my personal efforts would have meant little; their caring and capable professionalism provided me with all the tools necessary to facilitate my immediate recovery and enter the next phase: outpatient rehab.

Accident History: Part 7

And speaking of relapses, I neglected to mention another set of respiratory hurdles during my hospitalization. Due to the lung punctures and bronchial tearing, I was afflicted with an extreme bout of pneumonia and the initial doubt over whether or not my right lung could even be saved. My thoracic surgeon (who would require two attempts at reattaching my torn right bronchus and succeed on the second try primarily through the creative use of surrounding fibrous tissue to wrap the bronchus in place) cautioned my parents that the prospects of saving the lung were grim, and although he may be forced to remove it if the procedure went badly, he would do his damnedest to save it.

As I indicated earlier, the reattachment was successful, and despite the concern over my right lung's survival, shortly thereafter it began circulating blood once again and began to heal itself. (My chronology might be a bit off on this one: as I understand it now, the right lung began showing tangible signs of regeneration within a fairly short time after the bronchial reattachment, but its ultimate fate remained in doubt for some time.)

Accident History: Part 6

Before I could begin my surprisingly short stint in inpatient rehab, I had to actually get there. For the first time in nearly two months, I was actually outdoors, but only long enough to move me into the loading area and onto an ambulance. (I had at least one window in my hospital room, but the flat of my back was an inopportune position for seeing anything but passing clouds.)

After the artificially lit and largely sterile hospital interior, being outside for even a brief time was almost surreal. Being mostly disconnected from my menagerie of tubes, sensors, and other apparatuses was a very liberating experience, but actually being outside, if only for a few minutes, was definitely a hallmark achievement. (Because I was largely--if not entirely--cognizant at the time, I remember the nurses being very emotional at my departure; it wouldn't dawn on me until much later, but their understandable skepticism at me even surviving, much less recovering, made my leaving the hospital seem to be a nearly unprecedented accomplishment and triumph. It was a victory that they had facilitated, but I believe the gravity of the outcome of their hard work and diligence was only truly realized when I was actually cleared to leave and on my way out.)

My trip was fairly unremarkable; my dad rode with me in the ambulance, along with the requisite paramedic, and after staring at an entirely new ceiling for an hour or so, we arrived. I was then slowly taken out of the ambulance and carted into the facility. Now, much like any hospital or rehabilitative center, my new surroundings were not particularly remarkable, but the fact that they were at all different from the hospital was a rather stark change for me.

The center was divided into several "wings," with each one corresponding to different types of injuries: stroke, spinal, etc. I was wheeled into the brain injury area, which was actually sealed off from the rest of the facility via a coded door to prevent any of the patients from wandering outside the section and hurting themselves or others. (Although I was bed-bound, many of the other patients were not afflicted with such comprehensive, whole-body injuries, so they were able to come and go from their rooms, at least to a certain degree, when they were not eating or in therapy.)

Because I was still afflicted with a MRSA infection, I was the sole occupant of a two-person room; this certainly allowed me a degree of spaciousness and freedom that I would not truly appreciate until a later procedure, but that fact was largely lost on me at the time because I was boarded in a single at the hospital as well.

I may only have advanced a day thus far, but there's quite a bit more to come. As I said before, I'll try to gain positive ground this week. I'm sure I'll reflect back on times in both the hospital and inpatient rehab even after the narrative has moved beyond those times, but you'll just have to bear with my periodic chronological relapses.

Accident History: Part 5

That largely sums up my major surgical moments, at least initially. Although I had a variety of other minor procedures during my 55-day tenure in the neural ICU, I was unaware of or am simply unable to remember them. (That's not to say that I "remember" any of my tangible procedures from my time spent in the ICU. I have a vague remembrance of several minor, non-surgical procedures, but the vast majority of my hospital time is forever lost to me. I do remember several nurses, especially those who spent time with me towards the end, but much of my time-served is only remembered in the hallucinatory shades of ICU psychosis.)

I've also lost vision in my left eye as a direct byproduct of my traumatic head injury, and because my optic nerve itself was damaged and beyond self-regeneration, my only plausible hope of restoring binocular vision is through embryonic stem cell therapy, which is, to say the least, in an embattled state here in the U.S. (I don't think I need to rant about my position on embryonic stem cell research and the ethics of its implementation here. Suffice it to say that I am a major proponent and scorn the effort's of this current administration and its associates to undermine its advancement here in the United States.)

The long and short of my hospitalization is this: after spending nearly two months in a hospital bed and embodying the fallible nature of probability, I was discharged to an inpatient rehabilitation facility to begin my next step on the "road to recovery."

Accident History: Part 4

In addition to my flailed chest, my nose, jaw, and right clavicle (collarbone) were broken. Because moving or thrashing about would have exacerbated these (and other) injuries, I was placed in a drug-induced coma for several weeks to allow for the aforementioned to heal "naturally."

Both of my eye orbits and right humerus were also fractured, but my left-side orbit was allowed to set and heal during the coma stage. However, my right-eye orbit and right humerus both required surgery: reconstructive plastic surgery for the former, titanium plating for the latter. My left femur met with a similar fate. It was compound fractured and needed to be rodded to restore the bone's structural integrity. (Both the arm and leg required titanium pins and screws, respectively, in order to hold their hardware in place. Titanium screws will have another role in another leg, but not for over a year.)

Accident History: Part 3

My other injuries were many, but several screamed for precedence. Cue triage.

In conjunction with my bronchial tear, both of my lungs had been punctured. This necessitated the surgical implantation of an array of chest tubes for both re-inflation and stabilization and a tracheostomy to facilitate the continuous usage of a respirator. (According to my family, the respirator was a major irritant, and, when conscious, I would constantly pull it off of my trach in frustration.) The crash had literally flailed my chest, resulting in a ribcage riddled with breaks and fractures and forming a clear basis for my extensive respiratory damage.

The closed-head trauma I sustained during the crash became another issue of immediate importance. I had major swelling of the brain, but because I hadn't actually split my head open, it was swelling into a dangerously finite amount of space. This injury was my greatest initial hurdle beyond surviving the crash itself. Until the swelling could be checked, the risk of permanent brain damage rose alarmingly, and an advanced brain monitoring utility called a LICOX machine was "installed" into the top of my head to monitor my intracranial pressure (ICP) and act as a "brain catheter" to help siphon off excess fluids and relieve pressure.

Although my ICP was eventually brought within safe limits, the traumatic brain injury that I had sustained coupled with my narcotics regimen and an inability to verbally express myself due to the trach's aspiration-preventing, speech-impeding "balloon" would cause my true mental state to remain in doubt until much later.

Accident History: Part 2

I was told later that one of the first-responders at the scene spoke to me briefly, and that I attempted to respond but began choking on my own blood and quickly lost consciousness again. I remained pinned inside my mangled car for an hour before being freed from the wreckage. After being extricated, I was airlifted to a major medical center and immediately rushed into surgery. I was given six pints of blood during the initial surgery and defibrillated three times, and an exploratory abdominal surgery was conducted to determine why my chest cavity was filling up with air.

It was determined (via exploratory abdominal surgery) that my right main bronchus had been completely torn from its connection to the trachea due to the concussive force of the crash, and I was essentially leaking air into the rest of my body. My thoracic surgeon attempted to reconnect the torn bronchus, but the sutures quickly fell apart, forcing him to perform a second, far more inventive surgery. Reusing the incision, he affixed my bronchus to its original location and wrapped it in place using the surrounding fibrous tissues. This improvisational wrap, being far stronger than any type of suturing, successfully held everything together but would later cause right-side bronchial constriction due to the scar tissue that would be created during the healing process.

Accident History: Part 1

A fair amount of background is necessary to bring my audience up to speed. While the names of my family, my friends, and the institutions that I associate with are important, I am electing to keep certain specific information confidential for the sake of protecting their privacy.

I have been a student at one of the Midwest's state colleges since the Fall of 2003. Shortly after enrolling, I became a practicing member of a local martial arts club and Chinese historical society. Although the club is not directly associated with the college, it is allowed the limited use of the school's facilities. Since the club's practices were primarily held on campus, I was forced to commute from my hometown during the summer semester. The drive was roughly an hour each way, and because practices were held in the evenings, my return trip was almost invariably accomplished in total darkness.

On June 8th, 2004, after a delayed departure from practice, I set out for home. Towards the end of my drive, anywhere from ten to fifteen minutes away from my house, I met what would become a rather fateful deer. According to secondhand accounts (see: the driver of the truck I careened into), a number of deer had crossed the road in front of my car. As I'm sure you've deduced, I hit one of those deer, and that deer was not only pregnant, but also carrying a full-term fawn.

If you've read this far and believe me to be bluffing about the graphic nature of my accident, I advise you to stop reading now.

The deer was sliced in half on impact. The bottom half of the mother and her fawn were strewn across the road and an adjacent field, but the top half of the animal--the section with which I am most intimately acquainted--slid up the hood of my four-door sedan (which was admittedly incapable of gracefully deflecting a deer at 55+ mph) and came crashing through my windshield, slamming into me and literally pinning me to my seat.

Regrettably, the impact of the crash was not enough to stop the forward momentum of my car. I continued in a more-or-less forward direction but began drifting into oncoming traffic. The accelerator of my car remained depressed to a seemingly greater extent, judging by the damage done both to and by the Chevrolet 3500 which I eventually hit head-on. Not only was the "crew cab" truck itself quite a monster, but it was also pulling a sports car (I imagine it was some type of restored show car or even a race car) housed inside a thirty-something foot long trailer. Suffice it to say, I hit one of the biggest trucks commercially available to your average citizen, although doing so at least finally brought me to a complete stop.

Despite the vehicular mayhem, I was still extremely fortunate: the driver of the truck I hit saw me slowly veering into his lane and had come to a complete stop by the time of impact, so I ended up colliding with a stationary object rather than a moving one. Thankfully, the driver and his family were uninjured, and I was made to understand later that they received a brand new truck shortly thereafter. Without their unintentional intervention, there are any number of less desirable objects that I could have careened into, including but not limited to trees, houses, and farm equipment.

A Brief Introduction

I understand that a great degree of skepticism may follow what I have to say here, especially considering the graphic beginnings of my story. But to commemorate the second anniversary of my automobile accident, I will attempt to chronicle and explain the events that have, despite my constant efforts, defined my existence for nearly two years. I will do this to the best of my ability and memory, but precise accounts will sometimes be difficult (if not impossible) to recreate. This is ongoing history, not a static event, and I will present it as such.