Woods?

Look at that long county road, the way it stretches out ahead, calling to us! What's that around the corner? The winning lotto ticket, or certain DOOM? My good friend's well meaning comment (well meaning - the Northern version of "oh, bless her heart.") that I may not be out of the woods yet just triggers all kinds of remarks, some of which were inappropriate and I passed those on right away.

But seriously, the prospect of denial, of saying "no, this time I'm really fine," when I'm really NOT, raises the possibility that the process of feeling good may, itself, be a symptom. It's not that you're feeling good, it's that you're in denial about the loss of capacity you've experienced as the result of your trauma. Yikes! Or maybe it's about when, and how we count our losses.

Sometimes you're the windshield, sometimes you're the bug. We can always count on life to diminish us somehow, to turn our experiences into symptoms, to take from us our sense of "power" over the inevitable. Sometimes it just rains shit. Nothing to do about it.

Those of us who have experienced a good deal of chaos (and we know who we are), are likely to hedge, to plan, to arrange, to coordinate, as a way to feel like the mojo is back in pocket. Truth is, that mojo is coming back when it damned well feels like it.

I'm okay with some crap happening somewhere else for a while, but even that isn't a dodge. Nothing like sitting in an ER in triage to remind us how the lives of strangers effect our own. Around that bend ahead is "somewhere else" and I might be there soon.

By the way, the New Glarus EMS service, who arrived in time to drive me uphill for the helicopter, managed to get the first bill to us. If they drove as fast as they billed it would have been more impressive.

perspective

It's all about triage. Who's got it worse right now? Well, not me, I can tell you. I'm sitting in my favorite morning chair, drinking coffee, enjoying my meager dose of Loritab (5 ml less than allowed) and feeling pretty self-congratulatory about my "walk" to the corner and back).

When I came off the life flight copter and was admitted to UW Madison Trauma I was a pretty important guy. I got lots of quality attention and evaluation. It looked like surgery was imminent. Then a bunch of Wisconsinites got into auto accidents. Soon I was "competing" for attention with (literally) two SUVs full of wounded boy scouts returning from an outing. Okay, I have three broken vertebrae and a collapsed face, but these fellas are earnestly working on their "trying to die" merit badges and I'm "stable." Meaning I'm working on my "trying to breathe through a collapsed face" merit badge, and my "hold still and we'll get to you" badge. If that were my boy scout lying there, I would certainly agree with this reasoning. I agreed then, but bitchily.

Yesterday, I went to see a neurosurgeon, not mine, because he's in Madison, on referral from our GP, who was concerned about infection in my wound. The neurosurgeon was uneasy about even beginning to treat me when he wasn't sure what had been done. The more he thought about it, the more he wanted the folks in Madison to take responsibility. He had his folks, whom I had met for a total of 10 minutes, arrange an appointment in Madison and we got a call that made it sound like UW really wanted us there. This was all from his office, mind you, not UW.

When we got to Madison, I realized that this was exactly what I had been trying to avoid: an "admission" via the Emergency Room. Got there at about 3 p.m. The place was swamped (apparently more errant Wisconsinites trying to die). I had to admit that I was in almost no pain and that this was a wound check. This is the triage version of a "hangnail." The on call neurosurgeon from my actual department at UW was not PAGED until after 7 p.m. (Faithful readers know that this turned out to be a non-event, no admission, a change in antibiotics and then a release.) This means I occupied very expensive treatment space after travleing 3 hours by car, for a glorified clinic appointment. While I waiting a long time, someone else, inevitably, waited on me. And I should not have been there. I am not trying to die here. Not today.

Robyn, who is the only person I'm close to who did NOT have any interest in being a nurse, nurse's aide, etc., got to drive me home and put me to bed. There is a very funny story here about her frustration with me, the whole situation and a very rapid deterioration in personal care (the absolute first, I might add). "I'm sorry honey, but the urinal won' t fit there." I'll tell it later. Robyn has been more patient than I would probably have been, so we'll let the dust settle while I chuckle.

While I'm no longer a triage poster boy, every time I tell a new health person about my accident, my wounds, and my relative in-tact-ness, they all shake their heads and say "you could've died." For about an hour and a half, I had every wounded boy scout in Wisconsin trumped. I have managed to avoid any loss of neurological function. I'm looking at a full recovery, although I may not stand quite as straight as before. I am a certifiable NON-EVENT at emergency rooms across the mid-west. This, I believe is not so much an accomplishment as a lucky and safe place to be.

I took a walk this morning down to the corner and back. It felt pretty good. I used all my toes. They're homely but they work. Kind of like the rest of me.

Next up: Wired jaw weight loss plan. How does Sam cope with relative mute-ness? Beer through a straw? What will Robyn do for a project once Jeff finishes the deck?

Area 51

The MRI came back for my back, so I thought I'd share. I like the patriotic motif.

Feeling okay here right now thank you very much. I'm not sure what sort of utility a "birthday" designation for this day can really have. Will it grant me the ability to travel forward in time until I can get my wires out? Bad Jim Carey plot warning!

I'm really glad that everything I have hurt will heal. In a lot of rather particular ways I am specifically lucky. "If he'd hit here rather than there. . ." Trauma people love a little tension in the story.

For my 51st birthday find that I'm being totally taken care of by my old friend Robyn. However independent one may think one is, physical trauma applies the scientifically necessary perspective. "Mr. Independent, meet Mr. Pretty-Much-A-Sausage!" How you want them eggs done?
This is a pretty good shot of where they put my back together with the screws and bolts and silly putty.

Just hanging out here in Area 51, enjoying my easy chair and contemplating a smoothie.

A little decision here, litte one there. . . .

Here's a picture from my last day of BRMA. If you take a close look, you can see me straggling up this hill in Granny Gear. I could count on the guys to wait in the first available shade past the summit and on Chris to get yet another picture of me pulling up a hill. I had a lower gear added to what was a 12-speed. It gave me one low gear to work with. Man, my legs were getting tough! Everyone else on the trip was sporting a 28 speed road bike. I was working on convincing Chris that his biker superiority was due to better gear, rather than better conditioning.

Here's one of our conditioning stops right now. See how svelte? Here we watch Carroll change his tire again. Take care of that valve. Get down on your knees and face me. There, isn't that better? Sure was for the rest of us. I was thinking "boy am I glad my tires aren't bothering me!" That would suck. Now I'm looking at the photo and thinking "where's your fucking brace?"








Today it's about finding the space between "pain management" and "total zonedness" and tiptoe-ing in between them. I am learning that if the Vicodin knocks me right out it means I need more naps and it also means I can use less Vicodin. Ibuprophen is a good pal takes the edge off everything without those Michael Jackson-esque chilly naro-wierd vibes. Robyn's gone off to get a cortisone shot in her back so that she can continue to take excellent care of me, oh, and of herself and, um, . . . the kids. I am trying to read a little, write something, and in general to inject some more life into this routine.

I believe that this may be the fated "last curve" right here. Ride those breaks, boys. I was probably already in the grass by the time this picture was taken.













Where's that back brace? Life flight? UW Madison nurses? Perhaps more of a pike position would have helped.

Being 21 instead of 51 probably would have helped.

Will I do it next year? Quite possibly, but without the drama.

Thriller

Michael Jackson and I were born on the same day. When we'd play "I Want You Back," I used to joke that MJ and I have both changed remarkably during our lives, and that my metamorphosis was considerably cheaper, all in all. I just had to get fatter and lose my hair. I skipped all that time canoodling with plastic surgeons (until recently), plotting to make my skin lighter, my lips puffier. It was strange to find myself in recovery from this double-surgery listening to endless CNN updates on Michael's last few days, plans for his funeral, endless comments by fans.

I have been mostly working on moving from pain management back into "life insertion." (How the hell am I going to insert my life back into this?). The Vicodin they gave me is very effective for periods of time but is decidedly NOT benign. It makes the serious pain go away, but what is left is a strange buzz with "insects crawling around the edges." Seriously, I was relaxing in bed the other day and the little dust motes that float around in the sun turned into little flies and skirmished with each other at the periphery of my vision. Not butterflies, either. Flies. Is this Iowa? No, it's Mordor.

Every 12 minutes, CNN gives an update on how Michael Jackson needed an anaesthesiologist to administer drugs that make my Vicodin look like party favors just so the poor sucker could sleep! He wanted to be knocked out. Out. With flies. From Mordor.

I'm an old buzz hound. I like that vodka martini and maybe a little something buzz in the afternoon after work. I like that feel good all over warm me up and give the world a hippie hug sort of buzz. I cannot relate to this narcotic buzz that somehow makes you colder, more distant, isolated from your pain but also from most else.

I'm happy to feeling well enough to walk, to talk a little, to type badly and to connect again across less distance. I'm pleased that when my friends think I'm messing up they just tell me, rather than suggest a different anaesthesiologist or something.

Thanks to Jeff and Kevin and Yvonne for helping get our beds set up so Robyn can sleep too. We've really been enjoying going to bed early. Robyn's been enjoying just going to bed at all.

Making things happen

This was going to be a very busy month. My personal goal was managing to ride BRMA, my friends' four day bicycling extravaganza through central Wisconsin. For me, this is a particularly big deal because it meant starting the summer in much better condition than I have in a long time. We were riding 50 miles per day and were about 30 miles into day three when I took a curve too hot and went into the ditch. In one sense, mission accomplished. I was definitely keeping up, although we all know I took more stops on those monster hills than anyone else.

Upon return from BRMA, I was headed to Minneapolis to learn more about a peer norming model for dealing with young adult alcohol abuse, then a big family trip to Ithaca New York to see Greg and John (senior brother in law and spouse) and then visit New York City.

Things happen in slow motion and they happen very quickly. I remember feeling the rear end of the bike coming around and realizing that I was not going to make the curve and saying, out loud "ooooh, nooooooooo!." Then I remember being on my face in the tall grass, feeling a lot of blook gushing from my nasal area, and realizing that my back hurt badly. I also remember wiggling toes and fingers and feeling pretty good that they wiggled back.

Two of of the boys were behind me and went right by me, since I flew quite a way over my handlebars and was not visible from the road. I crawled to the road and used the phone in my fanny pack to tell my pals they were going to have to ride back over two hills to come find me. Didn't take them long either. Keith took a good look, called 911 and said "we're going to get you a ride." We all decided I should lie down again.

The folks from the local ambulance service came out and quickly summmoned a helicopter. The sherriff said I did not smell like beer. This is because it was bloody hot out there and I was one big metabolizing boy. I mentioned "good insurance" and they were all over that helicopter. No one wanted to be the first to move me.

Life flight to Madison was claustrophobic and someone said somehting about a torn lung which didn't help. I was just panicking at the time, trying to get air, and people had all kinds of stuff in my face. I knew my lungs were okay, or was pretty sure, but couldn't talk to anyone about it. All I could see was an air vent overhead. They did give me some very good drugs on the 'copter.

At Madison, they did about 300 CT scans and an MRI, mostly without pain meds. All you guys who snoozed through Lamaze class and didn't learn to breathe through pain, you have only yourselves to blame. Best class I ever took. The verdict:

C 1 - the section of your spine that connects to your head - fractured and intact.
T2, T3 - spine behind your heart, between your shoulder blades - smooshed. These bad boys will be fused.
Fosset fracture of the facial region - means that my face was broken all sorts of ways and kind of mashed in.

My friend Geof describes this all in terms of "crumple zones" to protect the brain. My face took it, and my spine took it, so my brain can still function.

While all this diagnostic work was going on, everyone in the Central Wisconsin area was busy getting into worse trauma than me. I mean really, how does a middle aged bike accident compete with an SUV full of boy scouts? Poor little fellas with their futures ahead of them, lying strewn all over the Emergency suite trying not to die. I on the other hand, was perfectly stable (miserable, and stable), a redundant baby boomer recreationalist taking up space. Bottom line, after 10 hours of surgery my spinal dude made me wait a day. A 97 hour, flat on the back, thank God U Madison nurses are beautiful day.

Spinal surgery on Monday was a trip. Because no one was totally sure what the damage was to C1, which is pretty damned important connection, I got to be intibated while awake. Now this is something I don't recommend. It's all about not gagging when the nice man puts a tube down your airway. Counerintuitive to say the least. It took a while, and he was very patient.

My neurosurgeon, Dr. Sillay, is a very nice man and really seemed to know what he was doing. What impressed me is the degree to which he was truly "winging it." You don't know what things really look like until you're "in there." It's all about position. Once I was unconscious, they screwed into my skull and suspended me face down so that I was absolutely fixed in place. They monitored my brain and nerve function throughout the procedure, which took about 6.5 hours. Apparently the monitoring did not always indicate good news. At one point I was not responding well. When I awoke in recovery, Robyn told me my toes were wiggling! I remember none of that. I remember the next day, though, when they took the intibation out, looking at my wiggly toes over and over again. Wiggly fingers, too!

Thanks to Katie and the Crawley sisters for the visit, plant (Bromeliad!), and good wishes. Sorry I was such a zombie.

The day after surgery I was a star. I walked and talked and demonstrated my happiness that I could walk and talk! We decided to get back home and then arranged for the facial reconstructive surgery in Iowa City. My friends located the best plastic surgeon in the area and we set up a consult for Friday morning. I was discharged on a Thursday morning and Robyn drove me home. I don't recommend riding in a car as part of post-op rehab. We got me into bed and then bright and early Friday, off to UI we went to see the plastic surgeon, who I want to call Lambert. This turned out to be an all day thing, and I was just NOT on enough pain meds. Ow!

Next day Dr. Lambert re-wired my face. Yikes! The good news is that I'm solid and that this will heal. Bad news? No way can a fella eat like this. I'm constantly trying to get food in and it just doesn't on-load that fast. I'm losing weight like, well like a guy with his jaw wired shut! It's also hard to enounciate. This involves peeling my lips back from the wiring and then talking with parts of one's mouth that are "inside" the wire. A little like ventriloquism, maybe. I was a little worried that I'd just not be able to breathe inside here, but it's working pretty well. I'm learning to slam protein shakes and smoothies. I can also still drink coffee. Yay. Coffee.

I am having to learn to be glib. I need to choose a phrase and get it said during the small window of opportunity that may arise when someone can hear me. I suspect I won't be working much until I can get my jaw loose.

At any rate, that's what it's like in here and where I'm at physically. I think there's enough information here to catch most folks up and to serve as a springboard for further musings. It's not the physical stuff that is really messing with my head at this point. What a surprise!

Detroit metal

When I was a three year old boy I knew the name of every car that went by my house. I really liked the ones that were foreign cars. Those were the exotic ones. Bolksbagens and Mercedes Benzes.

Dad was pretty crazy when I was four. I guess he thought Mom was out with other men and he didn't like it when she went to tutor the kids down the road. Our house was on top of the hill and there were woods in back and small caves in the sides of the hills. Dad would stand out in the yard and watch the road until Mom drove home. One day he left in the brown Ford and came back with a little black car with fins and a back window that was slanted backward.

Ray Riggs was the landlord and he was a Mercury dealer and drove out every month to check the horses and collect the rent. He always drove a new demonstrator and must have sold Dad the Anglia. "It's an English Ford," Dad said, "a poor-man's sports car!" The Anglia was black had red bucket seats that came forward on hinges in front to allow passengers access to the back seat. The seats had no latches, so the seats also came forward during sudden stops. Mom got very good at reaching over and interrupting my progress toward the dashboard.

I always liked the American cars best. In the coming years we didn't own one. We drove the Anglia to the hospital to visit Dad and to enroll me in school and I always had to explain what it was, why my Mom worked, why my Dad stayed home and wrote. "What kind of job is that?" and I'd say "It's hard work." I always thought that regular families drove Chevrolets, Fords, and Mercuries. Buicks! They drove those Oldsmobiles with the chrome holes in those long hoods and all their rear windows slanted down the normal way, and on each rear deck, a baseball cap.

I drove a Buick for a while when I was a young man. It didn't help that much, really.