Dog Show Weekend!

This weekend was regional specialities and supported entries at the Ocala dog show grounds for the Belgian Shepherds. Thanks to my wonderful friends Stacy, Shanna and John; I was able to attend both days this week-end. My first dog show week-end out since the accident. Hurrah!

The person setting in the walker with the pro-camera? Well, that's me. I've been putting together the puzzle pieces to get back into showing and photographing dogs with my changed circumstances. This week-end, I did a dry run test of the photography portion.

Here is a close up of my working rig. The walker is an Etac Avant. the bag hanging from the front of the walker is a Skip Hop Duo Double Diaper Bag. In the cane holder of the walker is a camera monopod.

There is nothing particularly innovative about my rig. Rather, I knew what I wanted to be able to do and knew that the walker I was sent home with wouldn't work. I proceeded to set about finding solutions that would work for me; to give me the flexibility and freedom to achieve my goals. Search Engines and the Internet were my advisers and friends!

I can barely walk with a walker, so I need a walker that provides me good, stable support; the walker needs to frame me. Further, my walker and I; along with one of my dogs, need to be able to travel about outdoors, and over rough terrain. Eventually, my walker, my dog, and my camera equipment will find a way to make it back to the dog show/trial circuit.

As I started looking for a walker; my initial set of requirements were: rugged, stable, big wheels, no cable brakes and the ability to turn on a dime for competition dog obedience. My search led me to the Etac Avant, and I couldn't be happier. By the way, I purchased my Etac walker from Amazon.com, and can highly recommend the service and pricing.

Next, I needed a way to carry around my dog gear and my professional camera equipment. Currently, backpacks are not an option due to my shoulder and collar bone injuries; I'm leery of waist belts or fanny packs due to my inherent instability and I don't yet have the strength and endurance to pull something behind me. That sort of left a walker bag, but all of the walker bags I had seen in medical supply catalogs were just too small.

Back to my friends the Internet and Search Engines. I discovered that baby stroller and bicycle accessories make fine and dandy walker and wheelchair accessories and usually cost less than medical supplies. I hunted around on the net for awhile, then telephoned Skip Hop and spoke with a representative. I ordered my Skip Hop Duo Double in a color scheme to match my walker, and can honestly say that it is working out wonderful. Even for day to day use, the bag is more useful than the wire basket which came standard with the walker.

Yes, things are looking up. Over the next week I'll go through the photos I took of the dogs in the ring, and work on my prep work and training for showing in AKC Obedience and Rally in Spring.

..
Somehow you'll escape
all that waiting and staying.
You'll find the bright places
where Boom Bands are playing.
..
Dr. Seuss; Oh the Places You'll Go!

Accident Scene Photos

Opened the mail today, and I had received a DVD full of accident scene photos taken by the highway patrol.


This is one of the photos. This is the passenger side; my side of the car; after I was cut out. As I flipped through the photos, I just kept thinking; oh my; we are all so lucky to be alive. And, seeing the conditions of the two dog crates, we are incredibly lucky the dogs are fine.

Oh, and this my friends, is a very good illustration why I have always believed that dogs should travel in cars inside of crates. Those crates saved their lives. It also helped that our team mates were at the accident scene helping with our dogs, since neither of us were in any shape to care for our dogs.

Bionic Leg

I've received my disk of x-rays from the surgeon. So, I'm putting up some pictures to give you all an idea of the bionic leg. This would be my right leg. Who knows what happened; whether I was madly pushing my passenger side brake pad, or exploded in the air bag, and/or most definitely trapped by the entire contents of the engine block settling in the passenger side leg space.

Eventually, I'll get the x-ray images from the second hospital, the before images if you will, with the hip to ankle external fixator. Or, you can peek at the picture of my knee on the trauma table a few hours post injury.

As a side note, one of these days, I really want to take a trip to a trauma center and see one of these super duper imaging tables. I have absolutely no recollection of the whole experience. After surgery, while I was doing something about having a PICC line installed, I recall somebody telling me about this wonderful machine that scanned and imaged my whole body. Fortunately, excluding all the damage to my extremities; this rest of my body is in pretty good shape.

My right leg is the worst injury; in the beginning we didn't know if I would keep the leg, or if I would ever walk. I'm hobbling around now with a walker, and I'm gradually improving in strength in PT; however, it's unknown how much function I'll regain.

The picture above left is a full body standing x-ray. This was taken on my first surgeon visit following cast/brace removal. I was a few steps ambulatory, and could step up on a 3" step, but not a full height step. It took me several weeks to be able to "stand", hanging on for dear life to the walker, without putting too much weight on my hands (which had just themselves been removed from casts). Finally, it dawned on me that I wasn't balanced; and if I wore a sandal with a heel on my right foot I could balance. The standing body x-ray is used to measure the amount of leg length discrepancy. The x-ray technician puts blocks under my right (short) leg until my hips are even; then snaps the x-ray. The surgeon uses this x-ray to determine the prescription for the shoe lift. I have a 3 cm discrepancy.

At any rate, the standing x-ray also has the benefit of illustrating my bionic leg! I have a IM nail in the femur, as well as a plate from the knee upwards about 1/2 of the femur, and another IM nail in the tibia. A screw in my ankle, a screw in my hip, and a whole bunch of screws in my knee.

Above, is the x-ray of the knee, and below is the x-ray of the tib/fib.

These x-rays were taken 6 weeks after the second surgery. The third surgery removed the femur plate and many of the screws.

PS - click the pictures to view a larger image!

ELEMENTary my dear

One of the very few times that Terry and I are both glad we have short legs.

Writing this journal has helped me to become more interested and curious as to what happened, and what is going on with me. Terry sent over some photos of her Element after it got towed to the storage yard.

The police took 91 photos at the scene, those are on their way, and I'll see about getting a few up here.

About this Blog

This blog is my place to come and talk about my recovery from the auto accident on May 20, 2006. It's intended to be my place to look over my milestones (when I need motivation and encouragement); as well as to rant, rave, educate or whatever else suits my fancy at the time I'm writing.

I started a paper journal while I was still in the hospital. Since both hands were in casts, this consisted solely of noting key milestone dates. Now, I'm going back to those dates and writing more about what was happening, and how I felt.

I can back date entries on this blog, so as I get around to electronically journalizing those first several months, I'll date them for the actual entry. In the mean time, I'm not going to wait around until I'm all caught up before I start journaling.

Just the act of starting this journal, and writing the first few entries has been mentally therapeutic. One, I feel a bit better mentally about some of the things that have been weighing on me; but more interesting, I'm starting to remember a few bits and pieces here and there. I really don't like having this huge blank spot in my memory; so if writing in detail about that time helps my memory, then I'm all for it!

If you happen to be someone who stops by and reads this journal, all of the skipping around is likely to be confusing. Sorry, but that's how it is right now. After the first several months are caught up, I'm sure it will be much better.

Third Surgery

Just about 4 1/2 months since the reconstruction ORIF surgery (to start putting my leg back together), Dr Cole decided it was time to take out some of my hardware. The good news is this means the bone is healing well; the bad news means; well, more surgery.

Dr Cole took out the plate that ran from my knee up the side of my femur, a bunch of screws in my knee, the screw in my ankle, and worked on breaking up the scar tissue in my knee. My knee is a real mess, and Dr Cole has done and continues to do amazing things putting it back together. This surgery was all arthroscopic, so the recovery will be much faster.

The day following surgery, I was able to bend my knee 105 degrees by myself. This is wonderful. Now, the next several weeks are going to be; ah, should we say horribly excruiciating while I work on bending my knee.

The PT got me up and moving in my walker the next morning, then later that afternoon came in with some crutches. We made our way down to a stair case, and I practiced going up and down stairs. Once I was confident on the stairs, I was ready to head home.

I've got the CPM (constant passive motion) machine at home. It's set up in the guest bed, that's where I sleep now. I try to spend at least 6 - 7 hours nightly in the CPM, then get out of it for a few hours of real sleep. The machine bends my knee up and down all night. Nasty thing to try and sleep with!

Grandpuppies

Of the several things I'm sad over missing out, the biggie disappointment is the trip to Texas to see Cannon and Annie's puppies. The good news though, is that one of his puppies is right here in Central Florida!

Amber lives with her buddy Kara, and parents Arlene and Bob. Arlene asked our friend Shanna to bring herself and Amber for a visit shortly after I was home from the hospital. Here prances in Ms Amber, about 11 weeks old I think; me in a hospital bed, casts on both arms, hospital type sicky smells and strange equipment around. Ms Amber just pranced around and took it all in stride. Including the home made wheelchair ramps!

About a month after I starting ambulating, Shanna came and got me one day for an outing to visit Arlene and Amber.

I'd been going stir crazy, 4 months laid up staring at the walls of this house or the hospital. This was the greatest outing, and I'm so glad that Shanna and Arelene put it together.

Shanna picked me up and we went up to Arlene's to visit and play with Amber. Kara, Amber's 4 year old Terv buddy and Amber were so much fun. Kara didn't like my walker at all, and Amber thought perhaps she should protect everyone also. However, puppy curiousity and yummy treats won out. It wasn't a blink before Amber decided I was just a person, all be it maybe a bit funny looking.

You can really tell that Kara and Amber are good buddies, here they are taking a rest break after showing me their version of the run around the something game.

After we played and visited; Shanna and Arlene took me to this German deli in the neighborhood. We had a wonderful lunch, and and even better desert. Yumm!

Here is Ms Amber giving out some puppy kisses to her mom Arlene.

I kind of like being a grandparent!

Why?

Why a blogger blog? Afterall, we've got the baby blog news thing on the homepage of our personal website.

To tell the truth, I'm not totally sure; yet I've created two different blogs this week. One public easily identified to us, and another undercover. I'm toying around with ideas of ways to use my new found challenges to do what I'm not sure. Part of me keeps thinking about what purpose I should have for surviving this, and another and bigger part thinks about ways to help and educate folks who may experience things like this themselves.

And, more truth to be told; I really, really need something to do, something with meaning. Something that will help drive me to tolerate the pain of physical and occupational therapy, drive me to find ways to do the things I want.

This journey that we've embarked upon; the unasked, unwanted, why me journey. This mid life change; well it's got more downs than ups, and likely to contain lots of griping and ranting along the path of discovery. Not the kind of feeling I want for our personal website.

You have brains in your head.
You have feet in your shoes
You can steer yourself
any direction you choose.
You're on your own.
And you know what you know.
And YOU are the guy who'll decide where to go.
- Dr. Suess Oh, the places you'll go!

Surgery Again

May 28, 2006

After a few days of preparation; including 3 hours on the x-ray table and various other types of testings and imaging, I rolled off to the surgery ward. Fortunately, my bestest mom-in-law was able to come up and stay with my husband, and visit with me.

I don't remember the first surgery at all, don't even remember waiting in prep, starting anesthesia; don't remember a thing. This surgery I remember. I was a 'fit in on the schedule', and since it was expected to be a long surgery, it was questionable what time my surgery would be. As such things would be, about the time I rolled into the prep area, my pain medication was wearing off. My biggest worry was getting my pain meds.

Here I lay on my bed, looking up into the faces ringed around me. Thinking to myself, this is the crew who will help me walk again some day. Huge conversation about where to put the surgical IV line. I had a PICC in my left arm, but this one person wanted an additional large bore line to get fluids in me in a hurry. I had already had one blood transfusion, and knew that I would also be getting blood for this surgery. So this discussion didn't bother me, what I found endearing was that the team worried about putting the line in my neck and leaving yet another scar; but there was literally no other place on my body available for the IV line.

About this time, I piped up and said something to the effect "take a look at me, what the heck do I care about whether I have one more scar? What I care about is keeping my leg and walking again; go right ahead and stick the IV in my neck; it will help you take good care of me!"

That's about the last thing I remember before waking up in recovery. When I woke up in recovery, both my husband and my mom-in-law were with me. I wanted to know two things, what time was it (which nurses shift) and what happened in surgery.

In my short time in hospitals, I had learned that the night shift is h*ll on poor pitiful patients who can't do a single thing for themselves; as well as happen to be in severe pain that quickly escalates to the most awful maddening monster as the pain meds wear off. I most adamantly did not want to be left alone with that "evil night shift". Between the concussion mental confusion and the pain meds, at the time I truly considered night shift an evil time.

Dr. Cole and his PA's had warned me and my family several times, that they didn't know how much or what all they would get done on me. They had a limit to time they could keep me under, and I had just too much broken. So, my other recovery question was what did they do? Did they get it all done, or would I be going back to surgery again in a brief time?

The next morning the PA sunders in carrying some papers and asks if I want to see my x-rays! Well of course; leaving the most complicated for last, I see that my left hand has a temporary pin in my hand; my right hand has two temporary pins in my finger, my right collarbone can't be plated. The PA is showing my an 8 x 10 copy of my right leg x-ray, that first glimpse inspired the "bionic leg" euphemism.

Using some medical jargon, my right leg fractures were set by ORIF - Open Reduction Internal Fixation. This means I had surgery, and the "fixing" or holding of the broken bone is by means of something internal, or inside me. External fixation would be a cast, traction, or the Hoffman External Fixator I started with.

Here is a chart illustrating ORIF with an IM - Intramedullary - Nail. I have an IM nail in my femur, from my hip to my knee; with another IM nail in my tibia between my knee and ankle. Both the tibia and fibula are displaced fractures. Also called a tib/fib fracture. The tibia is the load bearing, big bone in the lower leg. As I understand it, the fibula bears little load, and will heal without requiring internal stuff.

Additionally, I have a plate that runs from my knee up the outside of my femur. The plate is screwed in many places. You can see an example plate chart here. The femur was shattered so badly, it needed both the IM nail and the plate.

I'm pleased to see that I don't have an external fixator on my knee, as I had been warned by Dr. Cole that the x-rays of my knee looked pretty bad and he expected that I might end up with one; but I'm wondering of course what's going on with my knee. Looking at the copy of the x-ray, my knee just looks like solid metal. I can see that I have a lot of incisions and staples around a very swollen knee.

About this time, Dr. Cole comes in looking very pleased with himself. Since we were discussing my knee, he enthusiastically starts telling us how happy he was to find more to work with in my knee than he expected. The patella was intact, and he was able to reattach various ligaments, tendons and things to live bone. The knee should eventually gain enough function while allowing the femur to heal; but will be riddled with bad arthritis in a few years requiring a knee replacement.

Dr. Cole goes on to tell me to keep a very close eye on one particular incision site, as they had found infection where one of the external fixator rods went through my leg; and had removed between one to two inches of dead and infected bone. He tells me that luckily the surgeons in Lakeland had put antibiotic beads in my leg, as well as I had been on IV antibiotics before surgery with Dr. Cole.

I don't understand the ramifications of many of the things Dr. Cole told me that first morning after surgery; in fact I had forgotten completely about the internal plate. I'm happy that Dr. Cole seems pleased and happy that I'm alive and likely to be walking again. Dr. Cole tells me I will need more surgery, but should be walking in a year or so. Ward and I are pleased.

Traumatologist

Traumatologist (trau·ma·tol·o·gist) (traw”m?-tol´?-jist)

n. miracle worker, orthopedic traumatology specialist
a. Dr. J Dean Cole; Florida Hospital Fracture Care Center


Never heard of a traumatologist before? Neither had we. Orthopedic traumatology is a new subspecialty of orthodpedic surgery. Stated very simply; its a specialty dealing with the multiple injuries of a trauma patient. Knowing when and what to do. Having the skill to do it, with the knowledge of how to be minimally invasive yet get the patient restored as quickly as possible.


As far as we are concerned Dr. Cole is a miracle worker. He not only saved my right leg, but has me up and around much quicker than we all anticipated.


The trauma surgeon at Lakeland, as well as several friends, recommended transferring me to Dr. Cole to work on my right leg. Seems this was a particularly busy time for trauma, and I stayed in Lakeland waiting for an available bed in Dr. Cole's surgical unit. The call came late one night, and off I buzzed in the back of an ambulance.


After a rocky admissions process (it would have been much better to have someone with me during the transfer), life in settled down on Dr. Cole's unit starting off with the most heavenly sponge bath! My first since the accident.

The World Turned Upside Down

May 20, 2006

It was to be Rosie's first run in a flyball tourney. We rode over early in the morning, to be home the night before on my birthday; as well as we both prefer to spend the night home with our hubbies when possible. Rosie and I traveled with Terry and Tchaika; as the Volvo had recently stranded us and Ward didn't trust it. We were almost to the exit off I-4 when I glanced around and spied the dastardly white sports car where it most definitely did not belong. And worse, most definitely headed for us.

Our introduction to median cross overs. High speed interstate motor vehicle collision [mvc]. Rollover. An auto accident of the worst imaginable. The stuff nightmares are made of. The collision closed the interstate, made the local news. The police reports are finally complete, including 91 photos. I'm not allowed to look at them, but have asked someone to pick out one for me to put on this blog.

When we stopped, we were upside down, don't know how many times we rolled. Terry and I are both short, we were hanging head down from our seat belts; both of us screaming we wanted OUT. Fortunately for us, as our team mates were behind us; and they were rapidly on the scene helping, though they would not let us out of our seatbelts. Taking care of our dogs; I was very worried about Ms Rosie. I'm told I hollered more about Rosie than me.

Concentrating on Rosie instead of me was probably just as well. I spent 40 days in the hospital; had two very long major surgeries before coming home to the family room converted to recovery room.

Rosie is fine; our friends Terry and Tchaika are well. I'm recovering and learning about life as mobility impaired. Cannon is learning to be my assistance dog. Rosie is helping to teach him.

I'm finally developing an interest in what's going on with me, and what happened. This is what the (now) bionic leg looked like before the first surgery: The broken right leg is the worse injury, the femur is busted into many crispy critters, the knee busted, and the tib/fib is fractured. Also broke right hand, right collarbone and left hand. Then for good measure throw in soft tissue ligament and tendon damage to the left knee, right ankle and left wrist. Mustn't forget the split open head and concussion.

We were transported to Lakeland Regional Hospital where the trauma unit took over with a long surgery. I woke up some time later to look down and see both legs and both arms bundled up. I had an external fixator on my right leg, from hip to ankle. Now I wish I had a picture of my external fixator, it looked much like an instrument of medieval torture encasing my leg. You can see an example here. Young nurses would come in, take one glance and turn green. The external fixator is a metal cage type device with metal pins going from the top of the cage, through your bone to the bottom of the cage. It fixes your bone is place, while leaving open the skin area for treatment to hopefully avoid infection.

My left leg was also bundled up; it was attached to some machine that constantly pressurised and released. I quickly named it the wave machine; it's purpose was to break up the blood clots that had the left knee swollen. I had finger tip to elbow casts on each hand, a PICC line for IVs in my left upper arm, and a broken right collarbone that was left to it's own devices to heal. I had 50 staples in the back of my head, and an unknown number of staples and stiches in my legs. Morphine and I did not get along. I'm told I was black and blue from tip to top. Fortunately, I have very few memories of this time.

I was in the trauma unit of a hospital two hours from home. Terry was in the same unit and hospital, yet they would not let us share a room. Some HIPAA excuse, though we both wanted to be together. Ward (husband), friends and family scrambling. One of our flyball team mates took both of our dogs to their vet. The dogs story will be in another post. There was much concern about the state of my right leg, many people started working on getting me transferred closer to home, and to someone who could try to save my leg.

Friends, acquaintances, and e-group members around the world sent cards and best wishes. Ward would bring the stack of cards to the hospital and open them up for me. It was so very wonderful hearing the best wishes, and seeing the cards. Best of all were the cards and photos from Robby and Norfolk; two foster Belgian Shepherds that had stayed with us for awhile.