Follow up

It's now been over three months. I'd like to say I'm completely back to normal. Actually, I think I've forgotten what normal feels like.

My wrist and collar bone are completely healed. Hurrah!! But my shoulder was still in pain and my range of motion extremely limited when I went back to the bone doctor. (Interestingly enough, on my chart, they were only checking on my wrist until I reminded them that my broken collar bone from the wreck was my main concern, that the wrist was the crack we didn't figure out until our second visit) The physician's assistant (a check on a broken wrist not warranting a bone doctor) thought I might have injured my rotator cuff and ordered an MRI and gave me some mumbojumbo about the collarbone having to heal before it would show up. (Had I gone to the Greenville Trauma Unit..... but water under that bridge) He scared me properly with thoughts of surgery and a year's worth of rehabilitation and physical therapy.

In the first few days following our return from S. Africa, Maura managed to work in a trip to the ER on Father's Day night with a gall bladder attack. As we were waiting to hear about her surgery date, I put the MRI date to the next week, and they pushed my follow up with the doctor about a week and a half later... just to give me time to stress about it since I didn't have anything else to do. What they didn't know was that I had an ace up my sleeve when my son's best friend/brother's mother called and pulled strings to get me an earlier appointment. Turns out I just had some separation issues and only needed physical therapy. I have become model patient of the physical therapy place. While they are fussing at everyone else to use their injured part more, they are bragging on me for improving at every visit. I'm one of the few, I think, that actually do those exercises every single day. I WANT to get better. I am MOTIVATED.

But the brain will just not heal by sheer will power. It's like trying to use hustle in golf. It just doesn't work that way. I really thought I was getting better in S. Africa. It was low stress. I was enjoying my time with Maura. I was getting 10-11 hours sleep per night. I was able to go most of the day and help her or read in the library, ride the bus or do light walking. Most of my dizzy spells had passed.

And then, we came home. I was feeling good so I tried to do a little cleaning out.. two closets over three or four days.. that's all. And it totally wiped me out... Dizzy, Exhausted... just crazy worn out.... and then... the ER, etc. Maura had her surgery on Friday, June 20, Kerry's birthday. I was too wiped out to stay with her so Nicholas took me home and Kerry stayed. I didn't have any trouble sleeping. I probably slept my normal 10 + hours. Nicholas brought me back to relieve Kerry and I stayed and we watched the World Cup (BTW the World Cup was a lifesaver that weekend because we only had Doris and Dale to visit poor Maura and TV is BORING!!!!!). I was still just unbelievable tired and had what I believe was a series of small seizures while sitting in the chair during the game. It felt the same as when I was doing the EEG where I just keep falling asleep except the last time I had a trembling all over. It's kind of hard to explain and I definitely do not want it to have been seizure activity, but I think it was. 

I have asked for a referral for a new neurologist and am waiting for a call for an appointment (2-3 weeks now). I am on a waitlist. I continue to have greatly reduced energy and am dizzy when getting up in the mornings and when going to bed at night (or anytime). My head generally does not do well with up and down. I feel good for small periods of time and do normal things and then feel abnormally tired.

So... not finished yet, I guess.

Lessons Before Dying

I always thought that if I had a wreck on my scooter that I would die. I figured it would be quick, and having watched my parents and Kerry’s die in various slow ways, I didn’t necessarily think it would be a bad thing. That was selfish, of course.

I did sometimes wonder if I should NOT wear my helmet to assure that I wouldn’t survive with my brain somehow intact with the rest of my body useless. It’s really amazing somehow that I can be as ignorant as I am.  Even with my helmet on, my brain was incredibly shook up; and at the assumedly really slow speed I was going, my body took a pretty severe beating. There are very few places on the road that I traveled back and forth to school every day where I would have survived. I am damn lucky… or something beyond luck… to be alive.

When God is ready for me, I will go. I’ve believed that for a long time. My children think I’m really morbid because I think, and talk, about death. But I think it’s really weird to be human and to know your life is finite and not think about that. I spent a great deal of my youth and early adulthood with undiagnosed depression and often looked at death as an escape to the pain of living. The suicide of a close friend cured me of ever seeking that escape for myself as I witnessed the aftermath on the people who loved her, including myself… a  scar that  remains for any who have experienced it.

In my early 30’s, I thought I was going to die in the Joyce Kilmer Forest when I was repeatedly stung by bees. Even though we had benedryl and I took some immediately, my head felt like it was swelling to the size of a giant pumpkin and I was having a sort of out of body experience. We were a couple of miles up the mountain from our car and several more miles even then from any kind of civilization. I was with my husband Kerry and we had left our girls with their grandmother. I was sitting on a rock trying to get my husband to go on down the mountain without me because I didn’t think I could make it and I was trying to think of last words to say to him. It wasn’t that I was ready to go, but I was satisfied that I had already had a wonderful life and I could die knowing that I had been given so much that I could die being grateful for what I had had…. Only I didn’t quite know how to say that….. and he wasn’t leaving me anyway.

We made it down that mountain. We made it across the mountain in our car to the little medical clinic where the doctor was worried about my blood pressure being so low.. but  it was always low. But it took me over a year to get over those bee stings… it just messed with my head.  I didn’t die, but I didn’t forget either.

I’ve thought a lot about the darkness I experienced before I came back into consciousness. I can’t help but wonder if that’s what it is when we die. Is it like going to sleep, only without the dreaming? Do we just drift into darkness? It would be so easy. But the narcissist in me cries out, but where would I be? And the believer in me says where are the promises?

This is what I have learned/believed of the promises of Jesus. It is true that it is more blessed to give that to receive. It feels better. It brings more joy. It makes life better. When we forgive others, it is not for them, it is for us. We are the ones who are healed. We follow Jesus because of the life it gives us in the here and now. He gave his life to show us the way. It is in the giving of our lives that we receive our lives. Is there more? I believe there is. Do I have a clue as to what it will be like? I don’t think so. If it is a restful sleep in the darkness, will I be satisfied. I will. I have been given life in abundance. 

May 13, 2014

The Verdict

"The MRI of your brain showed nothing. Nothing abnormal that is." That was my neurologist trying to be cute. He is terribly lacking in social skills and I guess this is his attempt to connect. This was a pretty significant event in my life and it just felt like he was trivializing my experience, but I think he was just trying in a really bizarre way to make me feel comfortable. Anyway, it was good news that I didn't have a brain tumor, or a stroke, or bleeding in the brain, or my worst fear of all, signs of early Alzheimer's. There was no indication of the last... I just watched my mother slowly succumb... disappear... to that and feared that they might find it lurking in my brain as well.

He cleared me to go to South Africa with my daughter which was the main thing, and a mixed blessing. I really want this time and this experience with Maura; but the wreck left me poorly prepared to leave my students and my husband. I am a month behind on the plans I intended for both. My brain is still so addled... "Oh, that's all post-concussive," says my neurologist dismissively, "Would you like some drugs to help your cognition? Here's some you can look up on Web-MD to see if you'd like to try some."  

I stumble over my words and finally get out, "Are they useful with people who have had concussions?"

" Oh, they're good for anybody."  My brain absorbs this slowly as it does all things these days. As I've said before, I have a very challenging class at school (a class I wanted to teach when everyone thought I had lost my mind) and although they have been amazingly patient with me, I have not been sharp enough to do what I have been doing which is why I have decided to go ahead with my trip to South Africa. But adding another drug to my already large regimen of pills at this point seems a bad idea. I already set the alarm on my iphone twice a day and have an old lady pillbox. In spite of this temptation to try a magic pill, I decide to wait until the summer to give my concussion symptoms time to heal on their own first.

My lethargy and constant need for a nap may also be related to a recent discovery of a low functioning thyroid... as if I needed another medical diagnosis. My self image is not about being puny and inactive. No one who knows me sees me that way either. Giving up running because of my feet problems is one thing. Sitting around the house is another. I will work hard to find a solution and I will religiously take any medication that will help me back to an active lifestyle that does not make me so dependent on others. I am doing my best to be well behaved but this has probably been the biggest challenge of my life.  I really thought not being able to drive for six months would be the worst but it's such a toss up.

I have so many symptoms and there are so many factors that I really don't know what is causing what. Some things I'm fairly certain are my new medicine. The day I maxed out on my new medicine I almost cried in front of my students and I felt kinda drunk. Both feelings wore off by the end of the day.  The dizziness I feel every time I lean over or turn too fast is very consistent and is almost certainly concussion. Also concussion is the slurred speech which is mostly diminished. The inability to find words, substituting near miss words, and general sluggishness of thought is probably concussion but could also be related to my medicine. The jury is still out because it is listed as one of the many side effects of the drug I am taking. The tingling, stinging sensations in my legs, hands and feet are certainly the drug but so far are more disconcerting than painful. Well, they are sometimes painful, but for very short periods of time. I am dreaming more and very bizarrely... but who knows what that is.  I am somewhat more depressed but whether that is chemical or circumstantial cannot really be determined at this point.

And then there's the orthopedics...

I always thought breaking a collarbone wasn't that big a deal because you just walked around with a sling. Wrong.  It just means that it's in such an awkward place that no cast is possible. I'm one of the lucky ones that had a clean break. However, I'm old so that means it might not heal on its own. It's a wait and see proposition. The bone doctor told me I could take the sling off at my follow up appointment. I was elated!!!. My muscles were so cramped and relieved. I raised my hand over my head for the first time in over 3 weeks. It was heaven for my muscles.... but after one day off the sling my collar bone hurt so badly that I had to take Advil the next night. The doctor had told me that they might have to put a stint in it anyway if it didn't heal on its own. I had an ugly thought that he wanted to make sure he got his surgery by telling me I could move it as long as I didn't carry any weight on it. Not true, I'm sure... but I've been wearing my sling part of the day since that one day. (And I fully intend to board the plane with it and ask for assistance.) I am also a wiggler in my sleep, switching often from one side to another.  Not being able to sleep on my left side has been very hard on me (and my husband). The worst part of the broken collar bone is how hard it is to wear a bra. First of all, I almost always wear running type bras which are simply impossible to put on with a broken collarbone. (If this is TMI for some of you, just skip ahead.) And second, any bra starts to hurt my shoulder after an hour or so.  Fortunately, I've been in the habit of wearing a wool camisole over my bra for more than a year. My son was so right in that you can wear wool for weeks without it smelling bad. I didn't believe him but it is true. (And if my son's wool clothing doesn't stink, believe me, nobody's will!) Anyway, I've been wearing that instead of a bra to anywhere but school. I feel a little guilty because at my age and it being in the summer, it can be a traumatic experience for those around me.. but i really don't get out much and try to hide behind my sling as much as possible. About a third of my church congregation are homeless, so they're a pretty tolerant group and it's not much of an issue there.

The worst orthopedic pain has actually not been the breaks but the bruised and separated from the sternum ribs. How your ribs can separate from the sternum without breaking I don't know but the ER people said they stretched but didn't break. The first week or two I could barely breathe and would fight a sneeze and make this horrible sound to prevent one.

Even now, I cannot turn in bed without pain in my upper chest. And if I cough, I feel the need to rub it. I asked the orthopedist about it because the weekend before my appointment it hurt when I breathed after a period of being better and then got better when I slept but then got red. He looked at it and said it could be some busted blood vessels and that it was just going to take a long time to heal. I still have pain in my upper chest but the lower rib pain is pretty much gone. I was worried for a while that I might have bruised my heart. I still think I might have bruised my esophagus. I've had more acid issues than I've had in a while.

And then there's my wrist. They x-rayed it on my first visit when I told them it hurt, but the physician's assistant didn't see a break. On my follow-up, I saw the doctor and said it still hurt. When he touched it, I almost came off the table. Another x-ray and he identified a crack.  No cast but a brace to wear. It really helps, too. I would bump it in the night before and it would wake me up. But just one more thing that just takes time to heal. Evidently, I needed some work on my character with a particular emphasis on patience.

This seems like a long blog, but I've actually spent 10-12 hours writing it in 10 - 20 minute snippets. It does seem kinda whiny in places but that's not at all the way I feel. What I feel is really, really grateful. I have been given extra, and I assume for a reason. I plan to live it and rejoice in it.

May 11, 2014

The Wreck

This is what I have learned of my wreck. It didn't happen on the in-between road. It happened right after the left turn going toward the road that connects Greenville and Pickens. Even though this road has an elementary school on it, people drive too fast on it. It was after four so the school traffic was pretty much gone and no one actually saw the  accident. (Well, one of my students told me a girl from our school saw it and said I just fell over, but I have yet to talk to her.) My husband finally talked to the man who stopped. He thinks he came right after it happened. The other car was not speeding away. It was stopped and the man was looking down at me but drove away when he saw that my rescuer was going to stop. So not a man who caused me to wreck after all, and I could easily have been run over on that road so his stopping probably made me more visible.

He told Kerry that his biggest concern was that I was in presentation breathing. It was a term I remembered from my recently renewed CPR class. It's when the victim has slow, intermittent gasping breaths. We were instructed to start CPR when this is the case, which is why I assume he decided to turn me over from my face down position to my back and remove my helmet. (He just happened to be a volunteer fireman on his way to pick up his child from robotics club at the middle school.) When he did this I started to breathe normally. I probably owe this man my life. What do you do for a man who saves your life? A thank you note? A gift card? It all seems inappropriate.... as does nothing... I'm still trying to figure it out.

I didn't remember but it sounded familiar when people told me that they asked me for Kerry's number and I said it was in my phone in my pocket. I must have told them the code to get in, too, but I don't remember that. I vaguely remember answering other questions like my head hurting and that it hurt in the back of my head and that my left shoulder hurt; but I didn't remember any of that in the emergency room or when I got home. I only remembered when people told me and then I recalled it.

They removed the scooter from on top of my leg and a local towing company was called and kindly removed it five miles for a mere $230. They gave me a break because I was a local school teacher and didn't charge me another $200+ to store it for the 3-4 days it took me to go pick it up. Gee thanks. If I hadn't been unconscious, or at least not knowingly conscious, I could have had AAA tow it to my house for free.

We later went back and looked at the scene. There was very little in the way of skid marks or broken anything.. just some zig zags where I obviously tried to get control... and lost... but already on the right side of the road having made the turn. I really wish someone had seen what happened. They checked the cameras at the elementary school but the ones that might have picked it up had been eliminated a few years ago.

The bike itself had mostly cosmetic damage. The rear view mirror was  gone. (The right side was already gone when a rain soaked yard had caused it to fall before we got our paved drive.) The back tire was flat, a back light was cracked and some deep scratches on the left side, but other than that, it survived better than me.

May 10, 2014

A month ago what my family feared happened. I wrecked my Italian 500 Piaggio X9 scooter. Only I didn't die. I wasn't going the 90 something it was rated to go. (I never did.) I was probably going under 30 although there were no witnesses. I was wearing my helmet and my florescent yellow jacket, my boots and my long pants. The officer who came to the scene kindly presented me a ticket for driving too fast for conditions in the emergency room while I was still on the board and in a neck brace. I started to protest because I was a very cautious rider, but because I could remember nothing whatsoever about the wreck I couldn't really argue with him. I thanked him as he left the room. 

It had been a long day at school. It was the week before spring break and I was losing ground with my class of At-Risk middle-schoolers. We had just added two new students to bring me to a full load of 10, one from another school who came to us on contract from another at risk class after having thrown things at his last teacher and one who had a past of physical altercations and name calling with several of my present students. I also had felt a little off physically from a virus and a stressful couple of nights and days with a heart scare with my husband. The last little stick, or so I thought, was my missing sunglasses when I got to my bike. Why would anyone take my sunglasses? But it was a mild irritation and I had a beautiful ride home to look forward to. My school is located in the beautiful foothills of South Carolina and I ride a two-lane, hilly road through a rural area to my home. It was a sunny, not too hot day and I was looking forward to it. The last thing I remember was pulling out of the parking lot.

After that is a period of darkness, a sensation of zigzag and heaviness pulling on my arms and then being in an ambulance with a woman on my left asking me questions and people talking outside the ambulance. I specifically remember the sound of my principal Wanda and assistant principal Holley's voices. Holley said something kind as I was leaving but I don't remember what it was.  The woman asked me about my family and I told her my husband Kerry was home and Maura was in New Zealand. Later, I heard her tell someone on the phone that I had a daughter in Brazil and I said New Zealand, but she didn't hear me. Actually, Maura was home, but I had forgotten. There were two people and I remember them talking about why were they taking me to Easley and the woman said both me and my husband wanted me to go there, and I was thinking that I had never said anything about wanting to go anywhere. She also said that she couldn't see anything on me but a cut on my arm. I did tell her that my shoulder hurt. (I had a broken clavicle) I must have lost consciousness again because the next thing I remember was being wheeled into the room where Maura and Kerry were waiting. I don't remember arriving or entering the Emergency Room.

What I remember most there is being able to wiggle my feet and being so grateful. If I was going to survive a motorbike wreck, I wanted to be able to walk. (It didn't occur to be then that I might be too weak or tired to be able to walk on legs that could move.) The board was so uncomfortable and I was so stiff but I couldn't get off of it until they had done the x-rays and cat scan. They x-rayed my chest and shoulder and for some reason my right leg. It was probably one of the few parts that didn't hurt. My whole left side was beat to hell and I had contusions and bruises all over my left leg but they x-rayed my right... go figure.

I had my wreck around four in the afternoon and left the hospital in time to get to the pharmacy before nine. The ambulance people were right. I should have gone to Greenville. But since I survived, or at least, have so far, I guess it cost me less.

The diagnosis of the ER to my surprise was that I had a seizure. This was something of a shock to all of us. I'm 58 years old and had never had a seizure in my life nor had anyone in my family. Our best guess was a blowout of my back tire which was flat when I was found, although there were no noticeable punctures. No one witnessed my demise, so any theory was surmise. The seizure diagnosis was made on the basis of my prolactin level which were almost triple normal levels. Apparently these only rise in nursing mothers and people who have had a seizure.  However, at this point, we knew so little that everyone was goggling and asking anyone they knew with medical expertise. My internist, who is my primary care physician, went out of town for spring break and I didn't get to see him until the following week. The neurologist, when I saw him the next week, diagnosed me with epilepsy based on a childhood memory of a strange episode that may or may not have been a seizure. I walked into the den where Nancy, our one day a week maid, was ironing and felt a shivering all over and moved up and down about twice and then stopped. If Nancy saw me, she never said a word. (What black woman would if she saw a white child acting strangely with no one else around to witness it) I certainly never told anyone about it. I also used to pass out for short periods of time, waking up as soon as I hit the floor, but no one believed me until my mama saw me one day and took me to the doctor. I don't know what he said about it... maybe low blood pressure because it usually happened after I got up from lying down and I eventually outgrew it or learned to get up more slowly.... But a diagnosis of epilepsy requires two seizures so he takes this unwitnessed "seizure" of probably 50 years ago with my recent unwitnessed seizure and declares me an epileptic... and also tells me I can't drive for six months, which turns out to be the most lenient time period I could have. South Carolina evidently believes in freedom to drive being most important. Other states ban you for up to two years.

At this point, I didn't even know where the accident took place. Since the elementary school was mentioned, I assumed it was on the 15 mph road between the two schools. It will be almost two weeks before I know the actual spot of my wreck. The night following my wreck I had a 4-5 second flashback in which the zigzag heaviness in the dark is accompanied by terror and the realization that I can't control my scooter before my brain mercifully shuts down and goes blank. This causes me to second guess the seizure diagnosis when it was paired with a witness to the wreck who later tells me that the person's wife who found me said they saw a car speeding away as they drove up. My neurologist had put me on epilepsy medicine after the EEG so I called on a Friday afternoon to tell them of this new information and to ask if they had the results of the EEG. They didn't call back.

By the weekend after spring break, I was feeling a little better physically and started doing more laundry, etc., but when I went to church on Easter Sunday I was suddenly just exhausted by the service. When we got to my brother's house, I went upstairs to lie down and as soon as I did, the world started spinning and didn't really stop. (I came down his stairs on my butt.)  I thought it must be the medicine I'm on and stopped taking it. I do call on Monday and reported my symptoms to the neurologist but neglected to tell them that I had stopped taking it. If they had called back, I would have; but they didn't.

I had planned to go to school the next day but realized that I couldn't. I attempted to go on Tuesday and was exhausted at the end of first period. I had to sit down second period for our skills activity and barely mad it through third. I called Kerry to come get me fourth. I finally saw Dr. Chang that afternoon and he informed me that I should go into a quiet, dark room for at least a week.. no reading, no TV, no stimulation. I had been finishing a book with a title I no longer remember (or anything about it) the week after my wreck. No one had told me not to. This is the longest now that I have ever been in my life without reading a book. I took his advice, more or less, and began my days of 3-4 naps a day. I needed them all. My speech was slurred. A shower wore me out and required an immediate nap. My family doesn't know who this person is. I am only now, a month later, able to write more than a paragraph so that I can began to document what has happened to me.

My neurologist finally got around to calling me while I was seeing Dr. Chang. Of course, they had closed by the time I called them back. Dr. Chang had gently reprimanded me for quitting my medicine and told me to start back on it. He read my EEG and told me that it definitely showed seizure activity in the left temporal lobe (incidentally the side of my body that hit the ground). He also took blood and called later telling me that my prolactin levels were back to normal, further confirming seizure activity. 

When my neurologist finally did make contact, I confessed and the nurse asked "What did Dr. Chang tell you to do?" and then said, "Yes, that's right. Do that." which didn't inspire me. She then said the dizziness was probably not from the medicine and that they would call something in to my pharmacy. They never did.  I go in on Monday to meet with him to go over my MRI, my EEG , my bloodwork, and I guess my treatment and diagnosis. I do so with trepidation and not much confidence. I intend to request that he share my information with Dr. Chang.