Final Weekly Update (8)

Yep, it’s finally happened. I’ve gotten tired of talking about myself, or at least about my accident and its sequelae. Besides, I’ve got other things I want to start writing about again, like reviewing a couple of new TV shows, and a book or two I’ve while I have been an invalid. (Cheryl said tonight she doesn’t want to be hanging around with someone who is in-valid. She’s right; I want some validity in my life.)

Sigh. So, one last time, I’ll run through my current status. I am by no means recovered or back to normal. But in almost every instance, I am seeing improvement and progress.

First up, my broken cervical spinous processes (broken neck). The PT I’m doing has loosened things up a bit, but I assume there is still a fair amount of swelling there, if the more obvious edema in my left wrist in any indication. It’s still tough to “look both ways” when crossing the street or turning right or left in my car. I can do it, but it feels sore, and things want to move slower. When I swim, I can’t always get my head as far around as I want, and I have to be careful about getting my mouth out to breathe. Breast-stroke is out of the question. But, the daily PT exercises show increasing range of motion and I am having less discomfort, and I think it’s just a matter of the swelling going down.

Inside my spine is another story. I’ve concluded my diagnosis is “central cord syndrome”, which is a segmental dysfunction of axodendritic transmission, primarily at the C7 level. If you don’t understand what that means, don’t worry, the neurologists don’t really get it either. No one really knows if there is cell death, or nerve fiber compromise, or what, but the basic result is that the messages from my brain to parts of my arms aren’t getting through in the same way they used to. I suspect you could think of it in crude terms as like a wire which has multiple strands. Some of those strands aren’t carrying the signal anymore, so the overall strength of the signal is weaker than it used to be.

All of the functions are there. I can sense heat and cold, and touch and location. I can tell the shape of an object, and have intact reflexes. I can move all of the muscles affected, but not as strongly, implying that some of the nerve-muscle interfaces may not be working. My symptoms of the central cord syndrome include (as I’ve said before): pins and needles sensations along the lower tract of the C7 nerve root, which is primarily the index and middle finger, and the outer portions of my forearms; pain in a couple of locations on the left, specifically at the base of my index finger, and at the outer tip of my elbow bone (the radius); weakness in what I call “straight finger gripping”, the action you make when you are trying to grab a book and pull it out from a shelf with just your hand, not moving your arm; and my ability to write is weakened as well (that is, using a pen is not as easy as it used to be.) Finally, my triceps muscles are weakened.

All of this is constant, and can be a major irritant if my mind is not otherwise occupied. Pain meds do not help; weight lifting and other finger exercises with putty, sponges, and rubber bands seem to be either keeping my strength up or actually improving it. But I really don’t know what the prognosis is for this. I’ve decided not to worry about whether it is permanent until March or April.

My jaw and lip laceration continue to mend. The superficial numbness around my lip/cheek laceration repair is rapidly going away, and the stiffness is easing up there as well. With a new lower plate of temporary teeth, I look a bit better, and can bite a few things. But I’m still aware I have a prosthesis in my mouth, which will require a bit more attention than just brushing and flossing, and which will take some getting used to, if only for a year or two while I go through the upcoming bone grafts and tooth implants. Cheryl says my jaw looks firmer than ever, so maybe it’s a good thing.

Inside my neck, my larynx, pharynx, esophagus, and broken hyoid bone all seem to be mending as well. I can not talk loudly (which may be a good thing?), and sound a bit hoarse, like someone getting over laryngitis. I still can’t swallow things as large as I would like. E.g., I can take a small round pill, about 7 mm, but not a larger oval one of about 13 mm. (Sorry for the precision, I can’t help it.) But I can take multiple swallows of liquids in a row, which is a big improvement when I’m thirsty or in a hurry. But foods which don’t dissolve so well in the mouth (like salmon) take more time. I’m still trying to get a new food every day; yesterday was chili with meat and beans; today was salmon burger and beans. But I failed with chibatta bread and olive oil.

My radial styloid fracture still has edema surrounding it, and is thus still sore with decreased range of movement.

My G-tube site is not yet healed, but hope is on the horizon, as I pulled these two little guys out of the area today. When I took the bandage off today (usually I put anew one one every 1-2 days), and had Cheryl take a look, we both said “Yikes! What’s that?!” At first, I was all frazzled and mad, and was afraid to touch them, assuming they were stuck to something deep inside, like my stomach. I took a chance, got a small hemostat, and gave a slight tug. They slid right out with no pain. Apparently, they have been working their way out over the past two weeks since the stitches holding them in place were cut. I guess they were what was anchoring the tube to my stomach; they are basically wires with little springs wound around, and have suture material attached. Hopefully, now that they’ve worked their way out, it should feel better and heal over faster!

The brightest spot in my recovery is that I continue to gain weight without getting fat. And I am gaining strength in the weight room after only two weeks of lifting. Legs are coming back faster than arms and shoulders, which is the norm. By next week, I hope to be over 140#; I think I may have been as low as 130 in the hospital, and will probably function best around 147-150.

As to my triathlon rehab, I’ve now tried all three sports. I have run twice, and went 2.75 miles (28 minutes) continuously today. On the bike trainer, I am up to about 20 minutes. And I swam 700 yards in about 18 minutes today. Of the three, I think the running will come around the easiest, and swimming the hardest. Running actually requires the least muscle mass, and swimming needs upper body strength, which will take longer to build.

Swimming is the most frustrating for other reasons. Since I’ve never thought of myself as a runner, I have a very detached attitude and approach towards the training – its just work, like my PT neck exercises. But swimming – I’ve done that all my life, and have ALWAYS (at least since I was 14) been able to just jump in the water after months away, and swim with a fair amount of grace and speed.

But not now. Whether it’s my neck stiffness, my triceps weakness, my overall depletion, or my puny chest and arm muscles, I am feeling slow. But certainly no slower swimming than I am running, and no weaker than I am biking or lifting. But it seems to bother me at an emotional level in a way that doesn’t in the other sports. I don’t know how I’ll react if I have the same ineptitude when I go skiing in February.

Anyway, this is the last time until the end of the year that I’ll indulge myself with a top to bottom review of my physical status. I’d like to return to a more balanced set of topics for this journal.