Beyond the Spine

So my spine has been stabilized and seems to be in good working order. Of course it is still stiff, painful, and needs a brace when I am out of bed, but all in all, is in decent working order. Just to fill in the blanks though, there are some other ailments from the accident that I'll talk about to let you know what I am working with in rehab.

As the doctors told me right after the operation, I was lucky and should be thankful that my body did what it was suppose to do. Namely, my bones took the brunt of the impact. There were many fractures but my skeleton absorbed the shock and protected my vital organs from major damage. Other than a quick flare up of the pancreas everything was left in tact, and for the force of the accident the doctors were very impressed with the lack of trauma to the organs.

Of course, that now means I am rehabbing with a host of minor and major ailments. First and foremost I have 5 or 6 fractures in my ribs. These are all expected to heal just fine but as many of you probably know, they heal slow, are easily aggravated, and can be very painful.

The frustrating thing is that each limb has its own problem. Some minor, some a little more worrisome. As for the left arm I have a fracture in the clavicle. It is not bad, although makes a funny bump on my shoulder, but the break is close to some ligaments. If I was to aggravate it in rehab it could damage the ligaments and mean another surgery, so for now, I keep it in a sling during workouts and it will be reexamined in a week or so.

I also have a fracture in my pelvis, it is thin and and doctors are not too concerned but the fracture does extend down into my hip bone. I just got the thumbs up to do weight bearing on it, but I would lying if I said it wasn't painful. It is frustrating because each small movement can set it off leaving me with shots of discomfort shooting through my body. Even with the pain, weight bearing means I am able to practice walking, so I will gladly work through some discomfort if it means I am able to walk.

The right leg is a bit worrisome. The right foot has nerve damage. Other than the instep of the foot I can't feel anything. I am able to move my toes downward and just a bit upward but not much else. This is a direct result of the location of the spinal injury. Based on the movement the doctors believe that feeling will return to my foot, but they say it may take some time, many months, possibly over a year to return, none the less the outlook is positive. It does make it hard to walk though when you can't feel your foot, and may mean I wear a brace for some months after I leave rehab.

And lastly my right arm. This is another area of nerve damage. It is not directly related to the spinal injury but probably more related to the flailing limbs in the crash. The doctors believe that I pulled, stretched, and damaged some nerves in my arm, and the results are a host of ailments throughout the limb. The thumb and pointer finger are painful, kind of an interior pain that hurts and tingles. The rest of the arm has a bit of a pins and needles feeling and an overall weakness to it. The wrist is extremely weak, picking up a one pound weight causes the wrist to crack at the joint and droop down. I can't fully extend the arm due to tightness. And lastly certain muscle movements are comically weak. All of this I am rehabbing, small workouts of all the individual ailments, and improvement has been pretty impressive already.

Each day the parts get just a little stronger, with a little more force, with a bit more range. Its encouraging but slow, very slow. It is nice to see improvement. And now that I can put weight on the left leg I am back to practicing walking. Two days ago I walked without assistance from the physical therapists, and with the aid of only one crutch. Fred Astaire I am not, but damn it it felt good to do it on my own. To feel a sense of independence, mixed of course with a sense of fear. The funny thing about rehab, each new movement is frightening, will my body do this or that? But after the first time, the second time is easier, and easier still after that, until you place that little bit of movement or action into the 'Can' folder instead of the 'Can't' folder.

Field of Dreams

I always get choked up when I watch the end of 'Field of Dreams'. The climax of the movie is a son playing a game of catch with his father in the backyard. While my brother had more talent on the diamond than I, the games of catch I played with my father were no less meaningful to me, now or then.

It has probably been 20 years since my dad and I played a game of catch but I still think back to them with a fondness that tears me up each time. How strange that on one of his last days in New York he accompanies me to physical therapy where the therapists wants to work on strengthening my nerve damaged right arm and wrist. She hands us a small medicine ball and, for the first time in two decades, dad and I played catch. Me unable to walk, with a spinal brace sitting in a wheelchair, him standing maybe three feet away. I don't think I could have felt closer to him at that moment or that the game of catch could have meant more to me.

My father has been a rock over the past few weeks and I couldn't love him more. Thanks dad.

The Skinny on My Spine

Here are the details as I understand them.

The spinal column is split into regions. There is the top which is the Cervical Region and supplies functions to the neck and arms. The middle is the Thoraic Region that helps with the chest and abdomen and helps with breathing and coughing. And the lower area is the Lumbar Region (think lower back) that helps out the legs and such. At the very bottom is the Sacral which helps with the bowels, bladder, and sexual functions.

For me, I shattered L4. Pulverized the poor thing into shards, the problem with the shards is that they get stuck in things, namely they got stuck in my spinal cord. Now, the spinal cord is fragile, tear anything and you have lost feeling in whatever that nerve is connected to. So what did I do, I sent a group of sharp bone shards directly into my spinal cord, buried them there with razor edges and then asked the doctors to play the most sensitive game of 'Operation' you could ever imagine. The stakes were a bit higher than I would have liked.

To that the L3 and L5 vertebrae were also broken, but they were breaks that were cleaner and were able to be reset with hardware. Kind of like each was cracked in half, reset, and screwed back together.

As for the shards, the operation became a challenge of picking small pieces of my vertebrae out of my spinal cord, pull too hard, tug the wrong way, and there goes feeling somewhere. Almost hard to write this. But for 9+ hours they labored away, slowly cleaning up the damage I had done. Once the cleaning was done they redid the vertebrae, and I am a little foggy on all this but with a truckload of hardware, screws, rods, and more they stabilized my spine.

In the end they were exceedingly happy about the results. So much so that there was an expected second operation on the table and they now believe it to be unneeded. What was that operation you ask? Let me tell you. They start by opening my stomach, working between the major veins just after the aorta splits, move aside my major interior organs to get to the spinal cord and column where they repair what could be considered the interior rather than the exterior of the area. Dangerous, frighteningly dangerous. But we are hoping, crossing our fingers, and praying that this will be unnecessary down the road.

In the end, the diligence and extraordinary efforts of the surgeons not only succeeded in pulling off a miraculous operation, but did it so well that the even more dangerous operation is off the table for now. How can you express your gratitude in that type of a situation? It is hard to adequately express my thanks to the team of neurosurgeons at Long Island College Hospital that have put me in such a good place for recovery. They are amazing people.

Sponge Baths

I mentioned this in the email many of you received but I would like to talk about the nurses of the I.C.U. for a moment. This is my first time spending an extended amount of time in the hospital and of all the people who have helped me over the last few weeks the nurses have been the most incredible.

At my worst, in the days just after operation, I was incoherent, full of tubes, monitors, and drugs, barely understanding what was going on around me. Those were the days of just making it through, hoping there were no complications, and the nurses, bless them, just helped you get there. Their job was to help you along medically and make sure you were as comfortable as possible. In moments of coherence they would let you know how things were going, what was coming down the road, and would lend a sympathetic ear to my fears and concerns of the unknown.

And each morning they would strip you down, change your clothes and bedding, give you a sponge bath, and leave you clean and calm, showing you the tenderness usually reserved for a newborn. As I sat up sleepless each night I got excited as the sun began to rise because I knew, in an hour, a nurse, for 45 minutes, would do everything she could to wash and care for me and make me feel human at my most vulnerable.

As things got better, as I recovered and stabilized, the nurse changed into a confidante and friend. Talking for hours and giving me a sense that I was still the same person as the one before the operation. They would offer advice on legal issues, patient care, rehab, doctors. It was not a company line but rather considerate and measured advice. So just a simple thanks to the ICU nurses, to make the well-being of others your mission in life takes an amazing amount of humbleness and sacrifice, to them I will always be indebted.

I.C.U. Psychosis

ICU Psychosis is this fun little thing that is frighteningly common to trauma patients in the ICU. They commonly exhibit a cluster of serious psychiatric symptoms.

ICU psychosis is caused by a combination of things, like environmental problems such as: sleep deprivation, stress, continuous light, medical monitoring, loss of day cycle (think being in an enclosed room all the time) and more. Add to this medical causes like pain, drug side effects, medical trauma, and dehydration.

More or less with the constant monitoring, trauma, drugs, disorienting location and host of other symptoms ICU units are the perfect place for people to go nuts for a short amount of time.

This was mentioned to me one day by Saul, the doctor I mentioned earlier, and happened to me that very night. It was 3 days after the operation. At the time sleep came in 30 minute intervals, hopefully totaling an few hours a day. I still had a morphine system for the pain, oxygen tubes, and an arm full of various IVs, not to mention the monitoring system for my vitals.

After dozing for about a hour (a record at the time) I woke up in the middle of the night disoriented and in excruciating pain. My face and head felt fine but the rest of my body seemed distant. My back felt like 1,000 nails were piercing it, my limbs, other than one hand, weren't moving or reacting at all. With the room covered in drapes I could not recognize any details that had seemed so familiar. I had no idea how I got their,and although I knew I had the operation, I was completely lost on where I was and what was going on.

Looking around I saw all of the medical apparatus coming out of my body, the frame of the bed seemed to be connected to me, and the walls and windows of the room seemed no different than my own limbs. Everything in the room felt as though it were a part of me, as if when I was sleeping a construction crew had drilled, nailed, and cemented my body to the architecture of the room. For 20 minutes I thought that I had morphed and melted into the this undefined space. It was as if the pain I was feeling was the beams of the room going through my body. If I stayed there I thought the architecture would just slowly consume me until I was swallowed by the room.

And the funny thing is I tried to stay calm. To rationally think of what was going on, but each new clue led me to the same conclusion, I was being devoured by the building.

This lasted for maybe 20 minutes, pure fright, and feeling like my brain was being stretched and might snap. I finally saw a push button lying on the bed, slowly it came to me that this was a 'call button' and if I pushed it someone, anyone would come. Luckily it was next to my good arm and after pushing it an ICU nurse showed up minutes later.

Calmly I explained to him how the building had begun digesting me and taking over my body, calmly he explained to me that I was a patient, had had a spinal operation and was in the ICU. His argument, mixed with a little morphine, worked, and while I still like my argument I finally was talked down from the ledge.

Welcome to the ICU.

The I.C.U.

The I.C.U. probably gives me the most mixed emotions of the whole recovery process. I arrived there after my surgery and stayed almost two weeks as my body stabilized itself.

The first few days were frightening, I was on a liquid diet, meaning it was either being pumped into me or I was sipping water, and lying flat on my back the whole time, that lasted for the first week.

During the first few days you are mixing trauma, pain, drugs, IVs, disorienting new location, a battery of doctors, constant checks of your vitals, trips to take X-Rays, Cat-Scans, MRIs, sponge baths, nurses, morphine drips and more into one of the most difficult cocktails you can imagine.

I was so weak at the time that the only thing I could do for myself was to grabbing little pieces of ice and rub it over my temple and forehead to cool down, or pop one in my mouth to suck on. Worried that I might have lost motion over major parts of my body I remember thinking how important it was that I grab the ice myself, that was me functioning on my own.

There was also sleep, or lack there of. Your body is trying to but between constant monitoring, the lights on, the dislocation, the sounds of other patients and the conversations of the nurses, the drugs, and the pain, god the pain, sleep was an afterthought. For me, I was happy if I slept for an hour or two a night, usually in 30 minute increments. I would usually be delirious from lack of sleep in the morning and many a night I would see images from a combination of delirium and drugs. I remember my mother rubbing my foot and falling asleep so that became our routine. When she came to the ICU she would rub my foot, the pain and tension would disappear and I would relax and sleep, even if briefly.

It was also in the I.C.U. that some of the most tender moments occured. The nurses there are now friends. When I could do nothing for myself they did it for me, washing, bathing, feeding, medicating, listening and empathizing. They did it all. My comfort and well being was their only goal and to give me a sense of dignity when I was so vulnerable meant the world. They are amazing people.

Coming next: I.C.U. Psychosis!

The Emergency Room

Immediately after my accident I arrived at the Long Island College Hospital Emergency Room. I knew something was wrong with my spine already but not the extent. While lying on the pavement I remember feeling a dead tingling sensation in my lower back and knowing the straighter I stayed and the less I moved the better. At the ER I tried to keep calm and while that day in particular was foggy in regards to what went on, when the x-rays and cat-scans happened, who I saw and what the order was, there was one moment for which I will be forever grateful.

Before I has been given a bed in the ER I was lying strapped to a gurney staring at the ceiling and trying to not lose it. My mind was racing, I was scared to death and the only thing I knew was that I was in the middle of a life altering moment. Just as I was feeling my most frightened and vulnerable I saw a young man approach, he laid his hand on my arm giving it a gentle squeeze, looked into my eyes with a calming demeanor, and while I forgot the exact words he said it was a simple,"It will be OK, you are in good hands and we will do all we can to take care of you." I will never forget the calm compassion of that look. It meant the world to me.

Some time later, when I had received a bed he returned. His name was Saul and he was a ER doctor. I don't remember the time-line of the day but we, amazingly, had a long ranging lucid conversation on a host of subjects. He was a doctor but also an artist. He had gone to Bard to receive his MFA and had work in a current exhibition at PS1. Our talk touched on personal physical injuries, how his work in the ER informed his own art practice, my own practice and upcoming work at Socrates Sculpture Park, the artist Mark di Suvero, gold-leafing, art school and a host of other subjects.

I will never forget the sensitivity he showed me that day, and with my girlfriend, the two of them allowed me to make it through what was the most frightening day of my life. It is not often you meet someone briefly and have the feeling you will know this person for years to come, and in his case I truly hope I do.

The Beginning....

If you have found this page you are probably a friend or family member and I thank you for checking in here. As you probably know the idea for this blog comes from an accident, namely my own accident. About two and a half weeks while on the way to work, I was struck by a car and suffered major spinal damage. The operation was a success and the outpouring of support has begun. The obvious question for me was how do I keep all of you, the people I am closest to, up to date on the highs and lows of the recovery process. This blog seemed like a good idea.

Over the next few days I am going to try and tell you as much about what has happened so far. This will include details about the accident, the operation, my time in the ICU and Neurology ward, and more. Simply, I will try to fill in the blanks for you and possibly do a little emotional purging for myself. Thanks for stopping in and please check back regularly.

Much love,

Scott Andresen