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home again (#projectfemur)

I returned home from GW Hospital on Saturday afternoon. It’s great to be home.

I’m a little weaker than I was going in, as my lungs took a beating from the embolisms. Yawns and sneezes are still works-in-progress: they are not as full-bodied as they should be. I’m on an anti-coagulant (Xarelto) and two powerful antibiotics (thankfully, not for too long, as they are beating up my GI tract, killing both the beneficial flora as well as the nasty stuff).

My PT is a little behind schedule now, which is to be expected – plenty of time to make up for the lost days. My right foot and ankle are still prone to swelling, though that’s improving little-by-little every day (I think some T.E.D. Hose are in order to try and keep the swelling at bay). The flexibility in my right leg is improving as the swelling subsides.

So all-in-all, I’m getting better. 🙂

a speed bump (#projectfemur)

I was released from National Rehabilitation Hospital on Tuesday, Feb 4. All good.

Then early Tuesday morning, I had a bilateral pulmonary embolism. What I initially thought was muscle cramping rapidly developed into crushing pain on my right side and the inability to take a deep breath. By 4:30am, I could barely breathe.

sprite rushed me to the GW Hospital ER, where my guess at diagnosis was confirmed, and I was admitted. I ended up being in the ER for 14.5 hours (no beds), had a litany of tests (CT scan, X-ray, ultrasounds of legs, lungs and heart), was put on big doses of Lovenox (a blood anti-coagulant), and tried to keep the pain in check (morphine was gooood). My pulmonologist told me I had PEs in both lungs, and that I was lucky I caught ’em when I did.

I eventually got a room, and after eating my dinner (a sandwich provided by my friend, Greg), the pain presented with a bang on my left side. I couldn’t breathe, and I was in extreme pain, even with oxycodone in my system.

Overnight, I was put on Dilaudid (worked great) and later Tramadol (useless), and I got some sleep (sitting up – reclining hurts). Today, my pulmonologist has me on a PCA Dilaudid drip (i.e. the “happy button,” where I have some control over the dosing), as well as antibiotics as I seem to be battling pneumonia. It was a better day.

And today, I’ve made the transition from the IV Dilaudid to a Dilaudid pill – all good. I also got to take a sponge bath – ahhhh….

I’ll be here for a few more days. Once out, I’ll be on an oral anti-coagulant for a while.

Lessons learned:

1. My apartment is bad for ambulation, which likely caused the PE (not enough walking/standing activity). Once I get home, I’ll need to stand and boogie a lot, and get outside when I can. The recent snow in DC doesn’t help, but it’ll get warm soon enough..

2. My physical therapy has given me great strength in my legs, arms, and core (about 3 weeks ahead of an average person with the same injury, per my PT evaluation here at GW).

3. My endurance and overall conditioning likely saved my life. Even with the PE, I still had a pulse-ox of 96, normal blood pressure, and full heart function. Even when I had my issues late last night, I only dropped to 93 (still within the “normal” range).

So that’s where I am. NRH got me working on strength and crutching skills, and I did really well. My hemoglobin levels are good again. But the mistake was my not being active enough at home: the PT alone didn’t cut it.

So… there ‘ya go! Just a speed bump – albeit one that could’ve been lethal. I’m glad I knew of the risk and was familiar with the symptoms.

ten on tuesday: i am… (#projectfemur)

Per Carole’s prompt this week, I figured her topic fit in well with an update on my injury recovery. So…

I am…

  1. …able to function well with crutches.
  2. …happy that my hematocrit is essentially back to normal.
  3. …almost ready to transition back to OTC pain medication.
  4. …still smiling every single morning.
  5. …still seeing this as an adventure – a positive, fun adventure!
  6. …appreciative of all the doctors, nurses, techs, physical therapists, occupational therapists, dietitians, custodians, and fellow travelers on this rehab journey.
  7. …glad that my right leg is getting more flexible and mobile each day (and without my being able to bear my body weight on it).
  8. …pleased beyond words at the support I’ve received from family and friends – y’all are awesome!
  9. …grateful to National Rehabilitation hospital for getting me from weak and anemic to strong and (mostly) independent over an 18 day span.
  10. …happy to be home.

So there… I am!

another update on the ‘ol femur

Many things have happened since my last update, so I’ll give a quick summary:

I can now walk (tripod-style) with both a walker and crutches. The latter will be my go-to for most things, but the walker will be more useful in the house and for some other endeavors.

My hemoglobin level is back to normal, which means I have a lot more energy when doing things, with more endurance. As a result, I’ve been doing really, really well in physical and occupational therapy, exceeding my therapists’ (and my own) expectations. I do well on stairs, can get into and out of a car without assistance, can navigate a kitchen, work my way around a bathroom, and make my way into and out of bed.

My upper body and core strength, in particular, has made great progress from all of the PT and OT. My left leg is also getting stronger, especially in terms of lateral stability. And my ability to balance on my left leg has improved a lot as my right leg improves.

My right leg is getting stronger and more flexible every day. It still isn’t lifting as a whole, but that’s coming along well, and should happen sometime fairly soon. As muscles re-awaken, the leg gets more stable and mobile – all good.

I still can’t bear weight on the repaired leg, which is typical for my kind of repair (a rod running the length of the femur, with screws and pins at both ends holding things together). The break is starting to calcify, which is a big plus. My orthopedist is happy with my progress, and he removed the staples from my incisions yesterday (lemme tell ‘ya – it felt great to have the staples out).

I’m being released from the rehab facility next Tuesday, heading home from there. I can’t wait to get home to my sprite, my cats, and my kitchen. Yes, The Burrow will be a new challenge, but I’m up to it. I ordered some equipment to help me function during my recovery, which is a tangible sign of going home – significant, for sure.

Thanks to everybody for the emails, tweets, cards, visits, and other messages of support. They make a real difference, and I’m grateful.

Days since surgery: 18

a quick update on the femur

Heya!

I’ve been at a rehab facility since last Thursday night. The ambulance transfer from GW Hospital was bumpy and most uncomfortable (even when hopped up on potent painkillers), but the new facility is perfect for getting me back on my feet, with excellent medical and therapy staff, a nice building, decent food, and good wi-fi. 😉

Since arriving here, I’ve undergone physical and occupational therapy evaluations – a three-day process that was slowed by the holiday weekend – which have brought forth aggressive, three-hours-per-day PT and OT sessions. It’s taxing on me, but that’s a good thing.

One thing I’ve been overcoming is a low hemoglobin count, due to both the transfusion-free nature of my surgery and the internal blood loss from the crash. It bottomed out just after my arrival at the rehab facility, but has been on the rise since. It makes a huge difference! Standing initially made me winded and woozy. Now I can stand (with a walker, as I can’t bear weight on the repaired leg just yet), and I’m not on the verge of passing out.

So I’m still here, getting better every day, still smiling. I even got to go outside yesterday (before the snow and cold moved back in), and the sun felt nice on my skin – natural vitamin D production, can’t beat it!

project femur (or how my ski season ended with a bang)

There’s no way to keep this brief, so here goes:

Last Saturday, I was skiing at Liberty Mountain, Pennsylvania, coaching their alpine race team. The weather had been foggy and rainy all day, a once hard-as-rock snow surface turned into a slushy, peeling mess.

On our penultimate run of the day, the kids, my fellow coach, Tyler, and I were taking a run on Lower Ultra, making giant slalom turns. The snow, by this point (12:40pm), was really soupy. About 3/4 way down the run, I caught the edge of my right ski in the snow. I was going approximately 40 miles per hour, and was now hurtling, with little control, toward a stand of trees and rocks.

My instinct was to avoid hitting the tree, so I tried to self-arrest, stopping myself before going off the trail and into the woods. I tumbled and tried to stop. My left ski released. My right ski planted itself perpendicular to the fall line, sank into the snow, and stuck, while my body kept rotating counter-clockwise. The ski didn’t release.

Something snapped. I tumbled one more time, and my right leg whipped around and landed in an awkward way, rotated out of a normal position.

“Fuck,” I thought, “I’m really hurt – and nobody knows I’m here.”

I didn’t move, not wanting to injure myself further. Adrenaline masked the pain. Two lift attendants saw the crash and called the ski patrol. Patrol arrived within 5 minutes, as did some of my fellow coaches. I was put on a backboard, my right leg rotated 45 degrees outward from its normal position. Had I dislocated my hip? Had I broken my hip or leg?

This would not be known until I could get to a hospital. The ski patrol loaded me on the backboard onto a sled and took me to the resort base, where I was transferred to an ambulance (the EMT with the ambulance recognized me from the Civil War Century – the ambulance was based in Fairfield, PA). Having had no pain medication, this really hurt, but I pushed through the pain.

30-or-so minutes later, we arrived at Gettysburg Hospital, where I was whisked into an exam room. I was given an IV drip of pain meds, which helped blunt the searing pain. I was given X-rays, which showed a dislocated (i.e. spiral) fracture of my right femur, a couple inches below the femoral head, and other damage that may have been pelvis fractures.

No wonder I hurt!

Given I was skiing so fast at the time of the fall, the orthopedist at Gettysburg wanted me to be transferred to a level one trauma center for my next steps. So I was given another ambulance ride, this time to George Washington University Hospital. Ativan helped me sleep through the whole ride (save for the last two miles, where I helped the drivers find the hospital).

New X-rays determined that only my femur was broken (very good news), and a CT scan showed no internal injuries. Early Sunday morning, I had surgery to repair my femur: four pins and a rod are my latest additions. Four hours of surgery produced a repaired, but very sore and tired, me.

Since then, I’ve been working to heal. It’s not easy. I can’t currently bear weight on the repaired leg. My upper body strength isn’t great, so standing up and using a walker is very difficult.

But I’m carrying on. I’ll be transferred to an outpatient physical therapy facility in the next day or two, where I’ll likely spend two weeks. I hope to be back on my bike by late spring, and skiing again next winter.

how can i stop at ten?

There were more great moments in 2013, come to think of it, though most some of these don’t have photos to accompany the story. In no particular order:

  • The surprise party that sprite threw for me in honor of my 40th birthday was too cool for words (And too amazing for me to snap a single picture). She rounded up friends from all aspects of my life to celebrate, and it was awesome.
  • Riding the Alpine Loop Gran Fondo in September – and being able to ride with UCI Pro Tour cyclists like Joe Dombrowski and Ben King.
    Climbing Reddish Knob
    But really, it was all about enjoying the experience with my cycling friends.
    The gang's all here!

    We made it to the top!

  • Seeing these cyclists atop Empire Pass near Park City, Utah, on a rainy day was inspiring (and made me wish I had a bike that day).
    Cyclists atop a rainy Empire Pass
  • Climbing ever higher…
    Climbing Lantz Mountain
  • Cuddling with our cats. Corey, especially, has turned into a bit of a lap cat (though he can still terrorize the other cats and upend The Burrow).
  • Sharing campfires with sprite in New Hampshire.
    Campfire
  • Friday evenings picnicking at The Yards: a lovely place to spend an evening with good food, good drink, and good friends.
    Artistic Yards Park picnic
  • And the beach was, as ever, relaxing.
    Feet on sand

So I suppose 2013 wasn’t the worst year, after all. Yes, there was an over-arching theme of family unease that cast a pallor over things, but it had a good number of fine moments that made me smile.

ten on tuesday: top ten moments of twenty thirteen

While I’m not always enamored of Carole’s “Ten on Tuesday” prompts (let’s just say the ones that focus on knitting aren’t my cuppa), today’s prompt works for me: a top-ten list of favorite moments that happened in A.D. 2013.

2013 wasn’t the best year for me by a long shot. Unlike Sarah, whose year was a self-admitted “meh,” my year had more than its share of unfortunate events (cue obligatory “Lemony Snicket” references). But this prompt has me looking to accentuate the positive from the year recently concluded, so here goes… something.

  1. I rode most of the length of the C&O Canal Towpath in on day back in June. It was 191 miles on a bike, all in one day, riding with my good friend and fellow Potomac Pedaler, Eric. It was a scenic challenge that tested my mental fortitude, and a bucket list ride fulfilled. And shots like this were common – and fun.
    Over-the-shoulder shot on the C&O
  2. While on the C&O, I saw an incredible sunset at the mouth of the Monacacy.
    Sunset over the C&O
  3. During my otherwise frustrating trip to Utah in March, I got to take in a beautiful moonrise over the Wasatch Mountains.
    Moonrise over the Wasatch
  4. I also enjoyed this view of the Wasatch as I left Utah at the end of March.
    Sun-dappled Wasatch Mountains
  5. Skiing with some of the EpicSki gang at Sugarbush, VT, at the beginning of March was a rare treat.
    Tumbler Trail, Mt. Ellen, Sugarbush
  6. Catching one of John’s last moments of bachelorhood on April 20th, minutes before he said “I do” to Nicole.
    John just before...
  7. Catching sunset the night before Mountains of Misery – what’s with sunset pix and me? I love ’em!
    Sunset over Blacksburg
  8. After a day at Bethany Beach, it was wonderful to see a movie at a classic, art deco movie house.
    The Clayton Theatre
  9. After hours of somewhat technical hiking, reaching the summit of Mt. Monadnock was particularly sweet.
    We made it!
  10. A schedule board at O’Hare airport shows a traveler hurrying to catch his connection.
    Making the flight?

What were some of your top moments of 2013? Talk about it in the comments!

decembery thoughts: trees and snow

Now that December is here, thoughts turn to the seasonal celebrations.

This weekend, sprite and I cut a tree for our little Burrow. It’s a Norway spruce, a real beauty. Friends came over on Sunday night to help decorate it, and it looks great.

And now The Burrow is starting to smell of coniferous forests, a soothing scent to this mountain boy.

Today was a snow day for much of DC. The storm packed a lot of punch, albeit decidedly not for the District. We received maybe half and inch of snow before a brief period of rain and then… nothing. The streets were passable, and even with tonight’s re-freeze, things aren’t that slick in town.

While I wish there had been snow, it was nice to have the day off to catch up on housework and sleep. The sinus gunk I last reported on has been tenacious, though it’s s-l-o-w-l-y starting to clear. The dry air in the area, in The Burrow, and in my office isn’t helping, but I’m drinking a lot of water to keep hydrated and help reclaim my nose. Luckily, it hasn’t “migrated south” into my lungs.

Still, I would have liked some accumulating snow. That’s one of the biggest gripes I have against DC: winters here are so anti-climactic. Sure, there were decent snow events in 2003, and the 2009-10 three-blizzard-wallop was something else. But the typical winter here is increasingly snow-free and, frankly, a bit depressing. My psyche needs snowy winters, and it may end up being a breaking point for me and my relationship with the District of Columbia.

Otherwise, there’s not a lot of excitement right now, but that’s bound to change, given Christmas is so close at hand. So… we’ll see.

Thank snow.

what’s with the sinuses?

It decided to sneak up on the Turkey Ridge house with sudden fury.

A sniffle. A sore throat. A feeling of being just… “off.”

And thus begins another bout with sinusitis. This one has some aches as well, likely due to my skiing yesterday (first day on slopes always reveals the weak spots in the physique). Oh well. This too shall pass…

Sniffle. Ugh.

Until then: how was everybody’s Thanksgiving? How was the weekend for my non-celebratory friends? Talk about it in the comments!

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