Wednesday, June 22, 2011

Recovery - Week 6

I entered this week expecting it to be a lot like Week 5--mostly uneventful but still supported by amazing friends. Also, I was going to have dinner with my Dad in the midweek and an adventure in DC on Thursday. By midweek, I already knew from my orthopedic surgeon that I could be on crutches. Yes. You read correctly: CRUTCHES. Standing up felt extremely alien, as if I had to tell something outside of myself to move and support my weight.

My right foot (yes, the one with the compound fracture), had more bone damage than ligament damage (the left ankle took most of the "soft tissue" beating). As my surgeon has told me quite a few times, bone heals more predictably than ligaments. Thus, after today's X-ray, he grabbed a pair of crutches and told me to stand. Physical therapy will also change from stretching while lying down to practicing tricks (er...I mean, mundane and quotidian activities) on the crutches!

So, when my Dad came into town to take me out to dinner, I still wasn't exactly up for crutching around any areas larger than my apartment. As a matter of fact, standing was about all I could do for the first few days. So, going out to eat still happened in the wheelchair. But, it was the principle of the thing: I was standing weeks before I had initially expected to.

That Thursday, I decided to foray into the city to prove my own independence. In my attempts to cram my schedule that day, I did not in fact arrive where I needed to be on time. I mostly blame Capitol Hill. Rather than "waste time" switching metro lines, I thought that I could very easily get from Union Station up and over Capitol Hill in the blink of an eye. Well, my eye-blinks are longer than most, because it took about 45 minutes longer than expected. I also think many people naturally pity you when you're huffing and puffing up a hill in a wheelchair, seemingly bereft of any friends who could help you. But, I kept on chugging, and got a great workout. Since I was ridiculously late for the ceremony I had attempted to attend, I hung out in the botanical gardens to cool off and watch the flowers grow (Ok, so the families were more intriguing than the flowers to watch, especially since it's tourist season).

Meeting up with my friends, we wheeled about Capitol Hill. Ok, they walked and I wheeled. We all came back to my apartment and played games as if it were a Friday night. It was a Thursday night, however, and no one was ready for work the next day. Thankfully, when recovering from broken ankles and being a teacher, I could sleep in the next day.

That weekend, I got to enjoy a museum with friends (museums are MUCH more fun in wheelchairs), and saw Cars 2, which I thought was good. Onward and upward as I stand more every day and even begin hobbling about.

Recovery - Week 5

This week, on the whole, was the most uneventful. My roommates (who are also my colleagues), Adam and John, took Jason and I out for our birthdays. My birthday was the day of the accident, May 15th, and Jason's was even earlier, April 17th. But, in the craziness that is the end of a school-year for teachers, we never quite got around to the traditional dinner that our group of colleagues does. So, we went to a great pizza place in DC (Two Amy's), and then got delicious Argentine gelato (I didn't know that existed either) and walked around Georgetown, watching the sun set over river.

This week also saw the beginning of my physical therapy. Though I haven't told you yet, I've been blessed with good doctor's out here. My physical therapist is no exception. We're almost the exact same age, and so it's easy for us to converse while she stretches and tests the limits of my ankles' range of motion.

The weekend saw a group of friends come over to make dinner and watch a movie. It is always such a blessing to have an apartment full of friends. This group included everyone that was on the hike, so we reminisced about the event one month and some change removed from the incident. The memory of it still seems surreal, though the physical reminders are hard to ignore. It is a good reflection on Christ's saying, though, "This too shall pass." It passed so quickly. The pain, however intense it may have been at the time, was fleeting in the grand scheme of things. I do hope that this has taught me a bit about offering up pain before I complain about it, realizing that it shall pass and I want to find myself made better by it. That was this week, fairly uneventful, but fun nonetheless.

Recovery - Week 4


And so, on Sunday night, I rolled into Annapolis with my friend Matthew where several friends were waiting to greet me. We had dinner at a friends house. Their house only had steps up to the front door, so two of my rather strong male friends lifted me up and over the stairs (and the threshold) and brought my chair in behind me. After a lovely dinner, we went to stay at St. John's college in one of their newest dorms. I am happy to report that, while I never would have noticed such a thing before, the dorm was wonderfully handicapped accessible. I had an easy time opening doors for myself, accessing the bathroom, and taking care of the basic needs by myself. Sitting in a wheelchair now for almost a month, I realized how important it is to allow someone in a wheelchair who CAN do things for himself to DO those things. One already feels lame (literally) enough as it is, so it has been helpful to test my strength and see that there are things that I can still do on my own.

At the same time, sitting in a chair also has its limits and trains me to ask for help when I need it, something I was never very good at. So, our Annapolis adventure began with a good dinner but got even better from there. The next morning, we shared breakfast and then went out on the town. For those of you that have never been to Annapolis, MD, it is one of the best sailing towns on the Chesapeake (it's also the capital of Maryland). The weather was perfect and we got on a boat that my friend Hannah used to be a crew member on. That's what the picture is of. Again, my very strong friends carried me on and off the boat. We sailed for an hour or so on the Chesapeake, singing sea chanties and having the entire 70' boat mostly to ourselves. Afterwards, we ate ice cream and read poetry aloud under the gigantic trees on the campus of St. John's. Then, we got drinks and dinner on the water and discussed the nature of manliness, love, and other topics at great length (and, because I was there, at great volume).

The next morning, we awoke and took in the beautiful sunshine. Then, we drove to the best crab shack (in our humble opinion) in the area -- Cantler's, right on Mill Creek, just a bit above Annapolis. After enjoying a crab feast, which is always a long and laborious process though it provides plenty of time for good conversation, we had to part ways. My friend Monica drove me back to my place, and then dropped the car safely off with friends.

Later this week, my Summer Book Club of rising ninth graders began to meet, giving me a bit more direction and focus in my work this summer. It also woke me up to the fact that I would be teaching two new classes in the Fall (Latin and Greek) and so I began to work through those texts as well. And finally, one of the boys I tutored during the school year in Virginia arranged to see me a couple times a week, putting even more structure into my rather nebulous schedule of "rest and get better." I'm a doer, so I much prefer to have plans and activities (especially involving people) in as many of my days every week as possible.

Recovery - Week 3

This week started with a silver lining-- the last urology appointment ever (for a long time, at least, God willing). This gave me more energy and confidence to be out and about in front of people and I began to spend more time in the chair all day. I began to practice maneuverability and speed in the chair, but I have much to learn still. But, this was also the last week of school, so I really wanted to see all my boys before they left for the summer. As it was, they had been very good about sending me notes, letters, cookies, candy, fireworks, and sword-canes, so I felt that the least I could do was make an appearance on the last day of school, if only to collect their last assignments and begin the long weekend of grading.

So, by Wednesday, I felt strong enough to go in and teach almost all of my classes. On Thursday, I saw all of my classes. It was fun to wheel in and strange to have all of my seventh graders loom over me as if they were actually tall (ok, so a few of them ARE, but still, it was strange). In a wheelchair, my proportions feel very different. I am no longer 5'10" tall, 2' wide, and 1' thick. Now, I am four feet tall, three feet wide, and four feet thick (because my legs protrude out in front of me like a battering ram when I am in the chair). These strange proportions make me feel like an chunky dwarf, or a sphere with a diameter of 4 feet, rolling through the hallways, a jolly and talkative obstruction.

Being middle schoolers, they were quick to notice the new proportions, and wrote on the very top of the whiteboard "This will be very difficult to erase." Thankfully, I had my sword-cane just presented to me. One of the very first actions with the sword-cane was not beheading a recalcitrant student, no; it consisted of skewering an eraser and using the sword as an extension to erase the topmost section of the board, containing a phrase which now rang as a hollow lie. Ingenuity. I teach by example.

After collecting their last assignments, and gathering up my many gifts, I began to arrange my weekend around the grading that I had to do. Thanks to the help of a good friend, Stephen, I was able to finish all of it that weekend and turn my grades in on time. Though I didn't have the energy to attend graduation, I nevertheless managed to sing at the Baccalaureate Mass! We managed to find a handicapped accessible section of the choir loft, lower the microphone, and "sing from the waist up" as my choir director used to say when we were sitting down. The Baccalaureate Mass is always a beautiful and fitting way to end the school year, and send the Seniors onto their collegiate adventures. I was trying to convince my friends that I felt well enough to do an adventure of my own-- to ANNAPOLIS with some dear, old friends from college. But, that is a story for next week.

Friday, June 17, 2011

Recovery - Week 2

And so, Week 2 began at the Heights. It was nice to be so close to people and to begin to feel the upsurge of support from my friends and the Heights community. Immediately letters and cards from my students and parents began pouring in. They did much to keep me entertained. The moms provided great meals, and the boys provided hilarious gag gifts. Of the many gifts I received, the most notable include bacon-flavored dental floss, enough fireworks to last me for two fourth of Julys, and a sword-cane. Yes. That's right. A sword-cane.

Many wanted to see me, but I still just needed lots of sleep and lots of food. This particular week would have to be a blur of appointments and insurance phone calls as I figured out exactly what the protocol was for finding an orthopedic surgeon that would be willing to help me close by. I also had to see a urologist until my Urinary Tract Infection was cleared up. I had a few visitors in the apartment, but I wasn't ready for the general public yet.

That weekend, Memorial Day weekend, my friend Jason was good enough to take me to Mass both days and wheel me around DC. It was nice to be out and about, even though I grew tired very easily and the jaunts out were never too much longer than four hours. The week ended and I was spending most of the days out of bed, though I was still on what felt like I was on more medication than my grandma. As it turns out, I wasn't. So, perspective is a good thing!

Recovery - Week 1

And so, I woke up in the hospital. I was in no state to call the appropriate people, though I did manage to call my dad that day. Almost all the other phone calls were fielded by Jackie and a good friend, Tommy Marshall, who came down to Winchester, VA for company and extra help. The hospital stay consisted of the usual--pushing the button for morphine when necessary, having nurses come in at odd times to take vitals, give medications, or serve meals, and trying to stay coherent long enough to do much of anything (read, speak, pick up the phone). Thankfully, we got the word out pretty fast that I couldn't handle phone calls unless they were very important. I remember on Tuesday throwing the phone off the hook and keeping it that way most of the day because it would always ring at the worst times.

The four days in the hospital provided a clearer picture of what my recovery would look like, and helped prepare me for that recovery. The surgeon who operated on my ankles said I would be in a wheelchair for three months, and crutches after that for an unknown period of time. Meanwhile, I got to practice getting in and out of my wheelchair using just my arms. I had strict orders to put no weight on my ankles for three months. Transferring myself in and out of cars, showers, and beds was an interesting learning experience. I must say that now, almost five weeks removed from the accident, I am quite good. It was slow at first.

So, the morphine had caused some issues with my bladder, but they released me anyway. My buddy Will, the med-student from the hike, picked me up and took me home. The ride home was painful for my ankles, and Will very heroically put up with my groans in the back seat. We got lost a couple times, and forgot to pick up a much-needed pain prescription, so that Thursday evening was a nightmare as my friends Stephen and Will tried to figure things out. When finally the pain was under control, late Friday morning, I was taken back to the emergency room because of my bladder. Morphine and Oxycodone fall into the category of narcotics. Narcotics freeze one's bladder. I also had a Urinary Tract Infection that they gave me yet another prescription for.

I filled the prescription and looked forward to the first weekend of relative freedom from the hospital. My parents visited that weekend and helped with a lot of errands that would get me settled in my new place. I guess I should say a bit about that transition. For the last year and a half, I had lived with a wonderful family in Gaithersburg, in their basement. This basement apartment was no longer an option for me in my wheelchair. I had already been planning on moving into the school at the apartment on June 1st. My school has a third floor apartment for a few of the teachers and the entire school is very handicapped accessible. My good friend Jason graciously chose to move out fifteen days earlier than arranged to accommodate my injured self. He even acted as nurse for the first few weeks ensuring that I was clean, comfortable, and well-fed.

So, when my mom and dad visited me, it was in my new apartment. They helped make my bathroom handicapped accessible, and brought me most of the necessities from my apartment. Additionally, it was just nice to see them and have them see the reality that I was OK. Thus, week one ended as I said goodbye to my parents (they had to return to school and work), and attempted to set up a schedule for myself in this new place and new situation.

Tuesday, June 14, 2011

The Story - Tom's Perspective




Memory serves us best in remembering images, music, and multi-sensory experiences. I remember a lot of this experience primarily because of the images and multi-sensory experience (alas, there wasn't much in the way of music). Thank God I was not hiking alone. Even more luckily, I was hiking with a first year med student (Will), an E.R. Nurse (Jackie), and an editor (Leslie). We were hiking in the Shenandoah National Park in honor of my twenty-fourth birthday. We had planned a simple day-hike down into a creek and back out, including a bit of a picnic complete with frosted cake. It was about four miles in one way, and four miles back over the same trail.

After playing in the creek down at the bottom, we began to head back up. It had been raining intermittently, so we were in various states of drying off as we hiked. Conversing with Leslie at about 2pm, I spotted a vine off the left side of the trail, about ten yards away. It snaked down from high up in the tree, wrapped around a branch, and came all the way down to the forest floor. The branch it hung from must have been about sixty feet up. It looked like God had tied a rope swing to a ridiculously high branch. I began to climb, with Leslie looking on. When I noticed that I was closer to the branch than to the ground, I grew uncomfortable and began to climb down. About this time, Leslie shouted something to the effect of "look how high he is." Will and Jackie were further up the trail and could see that I was climbing fairly high. As I began to climb down, the vine snapped and down I came--fast. Too fast to think. There is nothing that I thought between the snapping and the ground. I heard two things: the snap of the vine and the crunch of my feet.

Immediate pain that defies description overwhelmed me and I began to scream "Ow" rather a lot. I thought it the best word for communicating what had happened, so I stuck with it for a long time. A good fifteen minutes or so, in fact. Will, Leslie, and Jackie immediately sprung into action. Jackie, standing over my left side, asked the most questions, which were answered solely with shouts (between the shouts of "Ow"). Will had a calm and collected look as he stood at my feet. Leslie looked worried, but steadily analyzed my eyes (when they were open, which was rarely). After a few pointed questions, we were all sure that there was no neck or back injury to speak of, so I could be moved. As we moved me on to the trail, we decided on a plan of action. Jackie would stay with me in order to bandage my ankles, staunch the blood-flow from my right ankle, and keep me from going into shock. Since I remembered the trail the best -- after all, I had picked the hike we were going to do -- I gave instructions to Will and Leslie as to how to get back to the trailhead. Will and Leslie raced off within twenty minutes of my fall.

This left Jackie and I with the keys to the car (a forgetful and hasty mistake), a backpack full of food (mostly upper middle class picnic food: classy cheeses, organic bread, etc.), and Will's coat. My shirt had already been sacrificed to stabilize my legs and stop the blood; sections of my jeans were now being used for the same purpose. I wrapped myself in Will's coat while Jackie and I prayed and tried to keep warm in the rain. The pain had subsided significantly and now only came in waves, which was something I could handle much better than the constant pain I had felt immediately after the fall.

Two hours after Will and Leslie had left, we heard some people coming up the trail. The noises came from the downhill part of the trail, and we knew we had sent Will and Leslie up the hill, so it wasn't them returning with help. A man and a woman rounded the bend a few yards from us. Looking him straight in the eyes, the very first thing I said was, "I just broke both my ankles, can you help?" I figured names and other niceties could be dealt with later. As it turns out, other niceties were dealt with quite well shortly afterwards. The man responded incredulously, "Why haven't you passed out?" knelt down by my ankles, and introduced himself as Saul, a practicing E.R. doctor in Brooklyn. He and Ani, his girlfriend, just happened to be on the first day of their long-term backpacking trip through the Shenandoah National Park.

They immediately provided relief of several kinds. Saul offered clothes that were actually dry and would keep me warm. Ani did the same for Jackie. Saul examined my ankles and reassured me that reconstructive surgery would be needed. With the infinite confidence of a doctor, he postulated that it looked like a trimalleolar fracture in my right ankle. I was intrigued to know what that meant, but didn't have the energy to ask at that point. I should remind the reader here that I had seen my left ankle, but both Jackie and Will had made me promise that I wouldn't look at my right ankle. I knew that it was a compound fracture, but I didn't know, and never will know, what it looked like. Jackie was worried that I might lose circulation – and thus my feet. Then, Saul and Ani set up a tent to get us out of the rain. Before he could move me, though, he wanted to wash my wound. Taking a little bit more from my jeans, he wadded it up and told me to bite it for the pain. He used purified water to clean out the gaping hole in my ankle.

After I got into the tent, the waiting game became ten times easier. Our smiles had returned since we were warm and dry, and had met such amazing people on the trail. We continued to pray. Soon enough, about an hour after Saul and Ani had stumbled upon us, the first search and rescue person arrived with Will and Leslie: Stacey. She had the demeanor of an experienced medic and deftly executed her duties. With Saul's help, she had my ankles stabilized in a trice and chatted pleasantly about her background and other duties. Already, I was impressed at the quality of the people who were helping us.

Little by little, the forest seemed to come alive. I had only a small window through which to view it, but it felt as if the trees themselves had begun to crowd more thickly around my tent. More than thirteen volunteers from the US Forest Service and National Parks were going to ensure that I made it to the ambulance in the nearest parking lot. They were not going to take me back up to the parking lot where my car was parked. Rather wisely, they decided to order an ambulance to go to the closest parking lot on the downhill side of the Shenandoah National Park where they would take me on a stretcher. Not only was the entire way downhill or level, but it was a shorter trek--about three miles.

So they cut off all my wet clothes, gave me some more dry ones, zipped me up into a warm emergency sleeping bag that felt like a cocoon, and strapped me down on a stretcher. For the next three hours, the pain escalated as my feet and ankles felt like overfilled balloon animals. The pressure building up in my legs began to push against the braces that were stabilizing my ankles and the pain was intense and unmitigated. Jackie and Stacey occasionally checked my vitals, and I asked for morphine not too long after the evacuation began. Six volunteers at a time guided the stretcher down the mountain, calling out large rocks, trees, and water sheds so as to prevent as many shocks to my legs as possible. They also very kindly tried to keep my ankles raised. Most entertainingly, we managed to converse for most of the three hour trip. Though most of my responses were shouted, they asked about my major, my home state of California, why I went to college in Michigan, my favorite authors and sayings in Greek and Latin. I also managed to get a few questions out myself and learned how many were from that area, the reasons they enjoyed working in the Shenandoah, and some basic information about the trees in the region (since my view for three hours was the forest canopy, I had a few questions pretty quickly).

The Forest Service volunteers relieved one another frequently, and all thirteen of them helped at the river crossings. Those were probably the most comforting part for me. I saw how they had set up webbing from tree to tree across the river, and each person was posted shoulder to shoulder in the river so that they could hand me across without any danger of dropping me. That was also where my memory recalls most vividly the looks on their faces, the encouraging words, and ultimately even the beauty of the forest with the sunset filtered through the golden-green leaves of the trees and conjuring up the smell of the soil and the water.

And finally, we reached the ambulance. I barely had it together mentally to say goodbye to everyone, and my goodbye was probably a strange one. I do remember saying goodbye to Saul and Ani, and perhaps to Stacey, but my mind actually began to fog up around this time -if it hadn't already been foggy. I was no longer helping to make the plans; I was now just along for the ride, in the hands of good people whom I could trust. Leslie and Will were going to be dropped off at my car and drive it to whatever hospital I ended up going to (they were initially told that I would end up in Richmond). Thank God Leslie could drive stick shift, since no one else in the party could. Jackie jumped into the front seat of the ambulance and began to negotiate where exactly I would end up. We had been refused a helicopter (three times) that would have brought us much closer to the DC area for my initial recovery. Apparently helicopters don't fly in thunderstorms. So, Jackie asked the right questions and discovered a hospital that had both an ER and an Operating Room with an orthopedic surgeon on call: Winchester Medical Center in Winchester, VA. In the ambulance, I was hooked up to an IV of morphine, but it didn't seem to help the pain much. I had a great conversation with the nurse on my left, Bridget, and it helped make the fifty-five minute drive much more enjoyable.

Finally, close to midnight, I arrived at the ER. They put an IV in my right arm as well and hooked me up to several cool machines that I found fascinating. As it turned out, the first IV they put into me had a powerful pain killer called Dilaudid, so my mood improved rapidly upon entering the ER. Most of the nurses were probably just annoyed that I was awake, much less asking a ton of questions and looking around all the time. They gently stabilized me and sent me off to the Radiology to see exactly what was wrong with me. After scanning what seemed like my entire body with a stunning array of machinery, I was wheeled into pre-op waiting room, signed some paperwork, and was on the Operating Table before I could realize what they were doing to me. The last thing I remember seeing right next to my table was the eerie blue and white glow of the x-rays of my ankle hovering over me. They had blown them up to a larger than normal size, and notated all over them. And then I sunk into deep and undreaming sleep.


And, we must include the only picture from the whole adventure on this, the inaugural post. The green is the tent, the hand is Stacey's, and the foggy heads floating in the background are mine and Jackie's. Thanks to Will for having the presence of mind to at least snap one picture. Jackie and Leslie had prudently left their phones in the car, and mine was temporarily out of commission due to the fall, and the rain, and I think out of compassion and empathy for my suffering. Brave little iPhone.