BruceBlog

Some people have said to me, 'But you have been out riding since then, how were you riding if this is your first two-wheel ride?' This is true, I have been out riding in the last five years, but not on a two wheel bicycle. I actually have a three-wheel bicycle. Let me explain.

My Three-Wheel Bicycle

For some people with a spinal cord injury (SCI), depending on the severity of the damage, it can completely compromise one's sense of balance. Sometimes this is a permanent change and sometimes it is temporary. You just don't know until you wait long enough for the shock to calm down in your body (this takes about six months typically) and the healing has begun. But, as I have learned, spinal cord injury healing can go on for many years and some things can take longer than others to repair themselves and return movement and sensation. Anyway, because we were not sure if my sense of balance was going to be compromised or not and, because Janene was well aware of my passion for cycling, she wanted to get me back on a bicycle as soon as possible back then.

So, sometime within the first year after my injuries, Janene got me the most amazing three-wheel bicycle I have ever seen. It is a Mission Cycles Tribrid shown in the image to the right. This bicycle has disc brakes and gears similar to a two-wheel bicycle and although it's heavier than a two-wheel bicycle, it's actually pretty light compared to other three-wheel bicycles I've seen in the past. (In a previous life, I probably would have conspired to jump this three-wheel bicycle off a ramp or something!) However, the first big challenge that I had to overcome with even the three-wheel bicycle was finding a seat that I could sit on for any duration of time.

My Bicycle Seat Saga

Because my SCI occurred mainly in the lower lumbar spine, it also affected the sacral spine and therefore the nerves in that area. The sacral spine controls much of the movement and sensation below your waist. One of the issues I encountered was the nerves that control all my gluteal muscles and, to some degree, my perineum were all compromised. This meant that the muscles controlled by these nerves stopped working which caused tremendous muscle atrophy resulting in the muscles shrinking to almost nothing. So, the muscles in my butt and my crotch were compromised which made sitting on just about any surface very painful and difficult. Fortunately, these muscles just barely began working within five months of my injuries and have now recovered to some degree today. However, to this day, I still have special cushions to sit on and even with them I cannot sit still for very long. This made sitting in general very difficult for me, let alone on a bicycle seat. In fact, I need to wear two pairs of cycling shorts now for my stationary bike and my mountain bike. Even then, I can only make it for about an hour. But, at least I am able to ride now!

Prepping For the Ride

The Actual Ride

Earlier this year in April, I reached five years since my spinal cord injury. Although this anniversary passed nearly unnoticed by many people around me, the value of what I have experienced in these five years still weighs heavy on me most days.

Back in April, I thought about writing this post, but I passed over it for some reason I can no longer recall. Most of the time I live my life in the new ways to which I have become accustomed and I'm able to deal rationally with most things that come up. But a couple weeks ago, I was driving to a hiking spot in Boulder County and I came across a cycling event. As I saw more and more riders it really threw me for a loop emotionally and I was so overcome I had to pull over. I see individual riders all over Boulder County all the time and I'm fine with that. I have accepted the fact that I cannot cycle the way I used to do so often. But I guess seeing all the people riding together for an event was a strong reminder of something I used to love and I still really miss. Anyway, this experience got me thinking and I figured I should write up something about the fifth year anniversary of my injuries because it's still very much always in the background (and sometimes the foreground) of my life.

Experiencing such traumatic injuries and going through the recovery was a profound experience for me physically, mentally and emotionally. As I just described above, there are still some life changes that get to me. There are big physical things like cycling events and even little physical things like the difficulty (or impossibility) of getting down on the floor to play with our puppies. Such physical limitations are something that I've learned to deal with the most. It's the mental and emotional stuff that still creeps up and surprises me from time-to-time.

Gratitude

As I have stated in a previous post, I still experience a tremendous amount of gratitude for the people in my life and for the experience that I've been through. Without going through something like this, it's difficult to understand what I mean. But recently I was reminded of it again by my fellow paraplegic friend John.

John and I meet up periodically since his own injury in 2017, but this time was a bit different. It was right before July 4th when he and I last hung out. John is doing amazingly well adjusting to life in a wheel chair. At one point, John paused to look me in the eye in a way that he never has. He then thanked me for something that I offered him early in his experience that he said he still holds to this day and it gets him through many daily difficulties. What I offered him was a statement that I learned from my wife Janene and that is, 'fake it 'til you make it.' He said that he didn't understand the value of this statement at the time, but since then he has grabbed ahold of it as a sort of mantra to move forward in his recovery and his life. I was quite touched that it has worked as well for him as it has for me.

In the last couple years, I have a newfound enjoyment in hiking. Although I cannot hike trails the way I used to (I used to run them!), I still get a lot of enjoyment out of the challenge of a trail and from being outside. I also find the solitude of hiking very comforting and I even seek out trails that are less busy for this reason. I used to say that cycling and running were both a form of meditation for me and now I've found that hiking can be the same for me.

But, overall, I think most about the positivity and support I continue to receive from family and friends. Without this, I would not be where I am today. I feel very fortunate to have so many people supporting me.

Improvements and Acceptance

So much of what drives me forward are the small gains that my body has made over the last five years. My nerve pain has improved dramatically over time, but it is by no means gone. The strength in my lower body has also improved dramatically over time, but by no means is my body at 100%. Such improvements and the positivity of the people around me are the hope that keeps me moving forward. But I have also had to face the fact that my body will never be the same.

Acknowledgement and acceptance are two related but very different concepts. Acknowledgement of my limitations is important, especially when it comes to gauging improvements on a day-to-day, week-to-week, month-to-month and even year-to-year basis. But acceptance of my limitations is a whole different level. While I have certainly accepted my injuries, what is not so easy to accept is some level of permanence of these injuries. This is a complex issue that has taken me quite a while to tease apart.

While I acknowledge the injuries to my body and I accept the fact that they happened, it is still difficult to accept the severity of these injuries as permanent. Consider a bone fracture. Relatively speaking, under optimal conditions, bone fractures do heal over time. However, healing a bone fracture oftentimes means immobilizing the joints around the bone fracture. The result of such immobilization is that the soft tissues around the fracture (e.g., ligaments, muscles, nerves, tendons, etc.) wind up experiencing damage due to the immobilization that lasts much longer beyond the healing of the original bone fracture. This soft tissue damage is a side effect to the actual injury, but it is the side effects that require prolonged physical therapy and hard work to overcome. It is these side effects that I am still dealing with today. Having spent two weeks lying in a bed in the ICU and then nine months in a wheel chair really took its toll on my body.

When movement begins to appear with a muscle for me, it doesn't mean that I can suddenly shed my leg braces and run down the street. It means that you can just barely see a flicker of movement in a muscle and it takes all the effort that I can possibly muster toward that muscle. Once this very minor movement begins to appear, the real battle is against the muscle atrophy and this is very, very difficult to overcome. It feels like no progress is being made and really requires a lot of mental focus not to be outdone by my own pessimism. Because such recovery requires a tremendous amount of consistent and diligent work over a long period of time, many people give up pretty quickly. I know I certainly have times where I feel like giving up. But I also know that the reward of regaining movement will not be affected by what I do on any given day, but is mainly affected by my long-term, consistent habits over time. In other words, it's about the long-term trend of the improvement. So, I keep telling myself that this is a marathon, not a sprint. I do my best to keep faith in the choices I make regarding my physical therapy, knowing that it's only going to make a difference over time. Much easier said than done.

Change is Constant

Recently I paid a visit to my physical therapist. I only see every 2-3 months to check in and guide me on the physical therapy work that I do on my own. She always checks out my progress to see how my body is doing and this time she found something new -- the tibialis muscles in both my legs are moving now!

The anterior tibialis muscles are what allow you to flex your feet upwards (this is called dorsal flexion). So far, I have only been able to press my feet down (this is called plantar flexion) because this is controlled by the calf muscles. But now that the anterior tibialis muscles are moving ever so slightly, I can begin to rebuild these as well. Just like my calves are taking time, these muscles will also take time to rebuild as well.

I am still working to rebuild my calf muscles and this is slow. My physical therapist reminded me that I'm not just strengthening my calves. I literally had no calf muscles left. So I am rebuilding my calves from nothing which is much more difficult. She also said that at this point, we have no idea if the calves are fully firing or not. In situations where there is nerve damage, you never know if you are getting a full squeeze from the muscle or if the whole muscle is firing yet. This makes the work much, much more difficult. She also told me that this is why most people give up.

My calves are increasing in size and strength, but they are very far from 100% functionality or strength. I still have a long way to go. But I still feel lucky to be where I'm at today with my body still healing.

After about a year-and-a-half of wearing my old carbon fiber AFO braces (Ankle and Foot Orthoses), I recently got a new pair of Phat Braces which are also made of carbon fiber, but have a much better warranty and are widely used by people everywhere.  The big difference between my old braces and the new Phat Braces is that the Phat Braces are taller and stiffer (but they are beginning to soften a bit). They come up my leg to right below my knee which is further than my old braces . This makes them much more stable and it which allows me to balance and walk much easier. They also have some flexible plastic that wraps around the foot (as you can see in the image to the right) which also helps to provide more stability. The biggest benefit about them so far, however, is that it did not take my body six weeks to adjust to them. The previous braces actually took six weeks for my body to adjust and I was in pain the entire time. The company that provided them told me that's just how it goes. Through that adjustment period, I had to have at least a dozen manual adjustments to the carbon fiber (e.g., heat them up, bend out here and there, etc.), probably closer to 18 or so. With the new Phat Braces, I've only had two adjustments and my body has already adjusted to them -- literally less than a week. In fact, I have had the Phat Braces two weeks now and yesterday I did my first true Colorado hike since my injury in April 2014!

After nearly two years of no movement below my knees, I was pretty surprised to discover recently that there is movement in the achilles tendons on both my legs!

Back in late January, I went back to Craig Hospital for the annual re-evaluation of my spinal cord injury. During the four days of poking and probing my body, just like last year, they told me again, 'According to your internal organs, we can't tell that you have had a spinal cord injury.' This does not mean that I am unaffected, it means that I do not have the deterioration of internal organ function that they commonly see in the kidneys, liver, etc., etc. after such an injury. Many paraplegics are in a very bad way internally due to a whole host of issues that arise as side effects to the nerve damage. For example, I still have to deal with bladder and bowel issues from the nerve damage. These issues have improved significantly from the time of the injury nearly two years ago, but I am also lucky enough that my injuries were not as bad as they could have been. (I could go on an on about the degrees of damage here but I will spare you the details.)

There were two really positive discoveries during my re-evaluation, improvement in sensation and some new movement. The first discovery that I have much more sensation in my hamstrings, lower legs and feet than I realized. Nerves heal at such a slow rate that it's difficult to gauge the level of improvement on any given day. But if you have a baseline against which you can measure, then you can quantify the amount of improvement. I knew that the sensation had improved, but it was difficult to tell how much it had improved. Additionally, if you know anything about nerve sensation then you know that there are different flavors of it -- basically soft/light touch to heavy touch to sharp touch (and everything in between). Interestingly, damaged nerve sensation can go from numb at one end of the spectrum to hypersensitive at the other end. So they tested much of my body for nerve sensation and compared my current results to the results from one year ago as well as against the initial injury. The result was that the improvements were rather significant.

If you look at the two images above of the nerve dermatomes, pay attention to those from the waist down related to anything L3/L4 or below (the vertebrae in the lower spine including L3, L4, L5, S1, S2, S3, S4 and S5). Right now I'm dealing with sensation issues in my feet, lower legs, hamstrings, tailbone and crotch areas. The great thing is that my body is still healing and nobody knows how far it will go over time.

The second discovery was that the achilles tendons in both legs have some movement! There was just barely movement there, but it's movement nonetheless. It is very similar to the way that my butt/glutes returned. This new movement in my achilles tendons was such a minor amount of movement that I did not believe it at first. However, as my glutes have recovered and rebuilt, I have also learned that even minor movement can snowball over time into much more movement as the muscles are rebuilt. My glutes have largely returned, but they are still not 100% and won't be for some time, so I continue to work on rebuilding them. The same will be true for my calves. Right now my calves are basically gone due to the muscle atrophy. But, over time, I will enlist my calf muscles more and more and they will rebuild. In fact, in the 30 days or so since the movement in my achilles tendons was discovered, I can now feel that my calves are just beginning to engage. But only just beginning. It's going to take a lot more work over a long period of time before I can visibly produce dorsi- or plantar-flexion of my feet (which is driven by the calf muscles and the tibialis muscles).

As I have been telling everyone for the last year, in addition to waiting for my nerves to heal more, the big focus of my physical therapy has been fighting back against the severe amount of muscle atrophy that occurred as a result of my injuries and immobilization. It took me a while to realize that the muscle atrophy was something from which I could recover (as long as there was movement). At first, I was so weak from the immobilization after the emergency surgery and spending nine months in a wheelchair that I just assumed that the weakness was caused by and part of the paralysis. To a certain degree this was true, but what I have learned over time is that if I have movement I can rebuild the muscle. There is such a thing as having the movement return but perhaps not having 100% of the sensation return. Another positive thing is that I have experience dealing with muscle atrophy. Having dealt with it way back in high school with my first couple of knee injuries, I understand the dedication and hard work required to recover from muscle atrophy. It takes a lot of consistent, deliberate, difficult work to rebuild muscles that have shrank away. As many people have asked me, 'Are you still going to PT?' and my response is, 'PT is a way of life for me, it won't stop for years.'


Anyway, because the movement is starting to return, I was fitted for a new kind of braces (this is the third type of braces now). The type of braces I need are called ankle-foot orthotics or AFOs. The first type of AFOs I had were rigid hybrids comprised of aluminum struts with plastic foot and calf beds. The second type of AFOs I had were rigid plastic with some carbon fiber reinforcement around the ankles -- rigid meaning no flexion whatsoever. I am now on the third type of AFOs and these are known as dynamic response AFOs and they are made of carbon fiber.

See the image to the right and notice that there is only a thin strip of carbon fiber along the back of the achilles tendon area. This strip is flexible for two reasons:

1. To enlist the calf muscles in the stride
2. To rebound or spring back once it is loaded from the ankle flexion providing a more natural stride 

Just like the switch to the previous AFOs, these new AFOs changed my stride again. It's much more natural and I don't need to pick up my feet as much because my ankles are flexing naturally. The downside is that I am pretty damn wobbly right now due to my lack of calf or foot muscles, but this will improve over time. Also, my feet and lower legs are pretty sore from the new material (carbon fiber is not very forgiving -- I know this from owning several carbon fiber bikes). I have already had a couple of adjustments to them and I will need more. But it is also a matter of your body getting used them, kinda like a new pair of shoes but much worse. This will all improve over time.

Someday I will post all of the videos that Janene has made of me walking at the different stages throughout my recovery. It's pretty amazing to see the progress so far and I'm not even done yet. As I tell myself quite often, never give up.

Also, if you look closely you will see some little dots in between the L3 and L4 vertebrae. This is a plastic spacer and the dots are metal so it will show up in an x-ray. It's typical for the surgeon to insert a spacer in between the vertebrae in place of the disc that had to be removed (the disc was so badly damaged that they had to scrape it out). The spacer keeps the vertebrae the proper distance apart as the bone grows and fills in the space. According to the surgeon, the bone growth between the two vertebrae looks really good.

On April 24th, my family and I marked one year since my spinal cord injury and I was so totally shocked and very humbled by the surprise that Janene arranged for me. What an amazing wife!

We had made plans to go to a friend's birthday party at a place here in town. That afternoon my youngest daughter had a track meet and afterward I had to pick up my oldest daughter from her school in Boulder. These activities kept me busy until just after 6pm when I showed up at the location for our friend's birthday party.

As I crutched to the door and opened it, I saw my youngest daughter holding a big sign for and a huge crowd of our friends from the community screamed, 'Surprise!' It took me a second to realize that all of these people were here for me. I was so shocked by this thought that I almost lost it right there. Even now I get emotional thinking about it. I was so humbled that all of these friends showed up for me. I have been on the giving end of such support for others in the past, but I have never been on the receiving end.

It's hard for me to believe that it has been a whole year since this horrible accident took place. Early on, my good friend Greg, who has experienced two spinal cord injuries in his life, said to me:

'Just make it through the first year and everything will seem so much better.' 

He was right and this advice was poignant, though it took me a long time to really put it in perspective.

At the time, this seemed so far away that it was difficult to imagine. For a while, I even had this perception that I would actually return to what used to be normal for me. But, over the last year, I have come to realize that I need to get used to a new normal. The most difficult adjustment is my inability to run and cycle like I used to do so often.

Current Status

At this time, I am still paralyzed below the knees but I am hopeful that my body will continue to heal. I have so much more feeling in my feet after one year and I'm very hopeful that I will regain movement over time. Because of the paralysis, I wear leg braces to be able to stand and walk, and I also use arm crutches for balance. I am lucky enough that I can get around at home without using the crutches and at I have even started using only one crutch in places that are level and familiar to me.

Most people have no idea that a lower spinal cord injury like mine (L3-L4) often affects a patient's bowels and bladder function. Your digestion slows down due to the nerve damage and your ability to empty your bladder on your own can be affected. I still deal with some issues in both of these areas, but not to the extent that I did through the first eight months. I'm lucky that my body has healed the way it has and that there is medication to help things along otherwise.

For some time now, I have been riding a stationary bike, doing lots of leg presses and walking much longer distances. I still see a physical therapist, but only for guidance and direction. All of the PT related activities I do are driven by me alone. I have experienced the need for PT previously from knee injuries so I already understood how it important it is to have the drive to push forward on my own. Luckily, all of these activities have helped me to recover from a fair amount of the muscle atrophy that took place from being stuck in a hospital bed and a wheelchair early on. But I still have a long way to go.

Riding a Bicycle 

In addition to riding the stationary bike, Janene recently purchased me a 3-wheel bicycle. While it's not the same as riding a road bike or a mountain bike like I used to do, it is very similar and it allows me the freedom of being on a bicycle. Strangely, we had a difficult time finding a shop that was willing to assemble the bike for us. I guess lots of shops aren't familiar with them and each one can be so different that they cannot predict the time it will actually take. Luckily, the Bikesmith in Boulder came through and was happy to do the job.

While riding, I do have a hard time keeping my feet in the proper place on the pedals, so I am thinking about putting some toe clips on there. Also, the seat is not very comfortable on my sit bones due of the muscle atrophy in my butt. I'm also hunting for some other seats to help me tolerate not only sitting for a longer period of time but also the bumps on the streets.

As I mentioned it's not the same as riding my road bike and climbing steep mountain roads like I used to love doing so much, but it's the best thing I can do at this time. I'm so grateful that my wife is encouraging me to do something that I love, even if it isn't exactly the same as it was before.

(I wrote this post in early December, but I forgot to post it, so here it is!)

Halloween and Thanksgiving are standard American holidays and they are definitely a good way to mark the progress of my recovery. They seemed to so far away for so long and yet they flew right by this year.

When you have kids, Halloween is a pretty fun time for them. From picking out pumpkins, to carving jack-o-lanterns, to jumping into big piles of leaves, to various Halloween parties leading up to the evening of trick-or-treating. When my girls were younger, they would get so excited for Halloween. They loved picking pumpkins right out of a pumpkin patch and couldn't wait to carve them. We would get out Halloween decorations for the house and carve our pumpkins together. They would really get into it with elaborate designs that they would trace on the pumpkins and require some time investment to carve whereas I would always carve simple, silly faces on my pumpkin that took no time at all to complete, but would make everyone laugh. Well this was the first year where my kids were not into Halloween very much.

This year I was on my own to hand out candy to the trick-or-treaters. Janene was away on a business trip and both my girls were with their friends elsewhere in town. Although I've been mostly walking with the crutches at this point, any time I need to carry something I still need to sit down in the wheelchair to do so. It was too difficult for me to hold the door open to greet the trick-or-treaters while holding the big bowl of candy, so I sat in my wheelchair. It was still fun though because I was down low enough to see all the kids at their eye level and they instinctively helped to hold the door open as I put candy in their bags. Many of the kids know me from coaching soccer, volunteering at the elementary school, etc., so they talked to me about how my recovery is progressing. It was nice to see them all.

Janene's folks came into town for several days to celebrate Thanksgiving and it was nice to have some family around for a while. They participated in our Thanksgiving traditions of fixing a big meal, going to see a movie and playing games afterwards. We also took the girls to see The Nutcracker ballet in Denver (as we have done for many years now) and afterwards we had dinner at a wonderful sushi restaurant. They also helped us put up Xmas holiday decorations around the house including all the outdoor lights. Janene and I have always done this with the girls but there's no way that I can climb a ladder and be on the roof in my current state so Janene's dad helped with that part.

I continue with my recovery from the spinal cord injury. I continue to walk on a treadmill just about every day during the week because we have a couple in the fitness room I'm building at my work office. I've worked up to about 40 minute sessions walking at about 2.5 miles per hour. Although this is not much by normal standards, it is really helping my body to recover quite a lot.

I also I got a stationary bike recently so that I can ride it on a regular basis. It is already help to rebuild the muscles in my hips and butt. I'd love to just put one of my bikes on my trainer an spin like I used to do, but there's no way that I can sit on a regular road bike seat at this point. The stationary bike has a wider more padded seat that allows me to ride for about 20 minutes at a time with a small amount of tension. Although it's a very different ride, it still feels good to be pedaling again.

I continue with physical therapy appointments in Boulder twice a week. These sessions are important because my physical therapist shows me many exercises to do and is continually checking my progress, but most of the recovery is my responsibility. I have to keep doing the work every day and stay motivated to beat the muscle atrophy that has transformed my body so much. Because I have been through muscle atrophy almost 30 years ago when I had one of my knees reconstructed, I know what the hard work is all about. I also know that physical therapy is what can save you from a major injury. And so, I fight on.

Family Leaving 

Air Travel 

Driving 

Anyway, one thing that has really changed is the way I drive a car now. Being that I'm no longer driving my car and I still need to get a new one, in the meantime, we decided to have hand controls installed in Janene's car. When I was in the hospital I learned to drive with hand controls. After over 25 years of driving a car using the foot pedals for the accelerator and brakes, because I have no movement in my feet, I now have to use hand controls. It's a handle on the left side of the steering wheel and is easy to use, it just takes a bit to get your muscle memory to begin thinking in terms of the hand control vs. the foot pedals. Using the handle, you push to brake and pull down to accelerate -- it's really that simple. There's also a removable metal foot plate that keeps my feet from bumping the real accelerator and brake.

Since mid-July, I have been able to drive myself to work every day. The great thing about driving my wife's car is that it's Toyota Highlander, an SUV. This means that I can put my wheelchair in the back of the car without breaking it down (i.e., taking the wheels off of it, etc.). Because I'm lucky enough to be able to stand and I can now walk with the braces on my legs if I have something to lean on, I have taught myself to lift the wheelchair into the back of the car and then make my way along the driver's side by hanging onto the car and kinda shuffling along. It has been a liberating feeling to be capable of driving myself to work and running some errands around town.

The Fucking Health Insurance Industry

I know this is a bit off-topic, but it has been incredibly frustrating to navigate the insurance industry bullshit. In my life, I have been lucky enough to be a very healthy person and rarely ever needed to utilize my health insurance. Since this accident, I have been extremely grateful to have good health insurance. However, I have also discovered that there seems to be some super secret list of things that health insurance does not cover or that they are somehow required by some fucking insurance credo to give you a difficult time about. There's nothing quite like a hospital hounding you personally for a bill of nearly $400k because your health insurance keeps stalling. We had to chalk up the $2200 installation fees for the hand controls as an out-of-pocket expense -- and that's just one of the many costs that come out of own own pockets. I'm extremely fortunate to have a very good attorney to help me navigate the insurance industry. As he has explained to me, insurance companies get stuck between their own policies and the laws of different states. All I know is that without my attorney, I would be going mad right now.

Walking With Arm Crutches 

Discovering a New Normal 

This past Tuesday I was discharged from Craig Hospital and I was finally able to come home after eight weeks of healing in the hospital. It has been so great to be home again with my family, but it's certainly not without its challenges.

Because I am not able to move my feet, I am in a wheelchair. Such a change presents problems when you live in a multi-level home. So currently I am confined to the main level of our home. Janene and her mother Susan worked with the neighbors to move our bedroom from the second level into the room where my office used to be on the main level. She also installed ramps so that I can get in and out of the house, our family room and the front porch. I'm very grateful that we did not have to go through a giant home renovation to accommodate a wheelchair.

It feels comforting to be back in my home with my family, but it also feels strange to be at such a lower level. When I stand up I am six feet tall and this is the perspective from which I have always known my wife, my children, my parents and in-laws and my home. Being in a wheelchair changes that perspective instantly. I now have challenges trying to do just about anything in the kitchen. Doing laundry presents some issues, but I'm lucky that we have a front-loading washer and dryer. Because I'm still wearing the back brace, I'm prevented from bending over completely and reaching anything that falls on the floor. For this situation, I have a reacher-grabber. I will be very happy to get rid of this back brace, but I still have four weeks of it left (it needs to stay on for a total of 12 weeks).

Still, even given these challenges, the mental boost from just simply being home again is much needed. So much better than being alone in the hospital every night. I feel like I'm not in this alone anymore, like my family is here with me.

I had forgotten that Janene had some photos she took of a 3D digital rendering of the fractures in my spine and an x-ray while I was in the ICU in Boulder Community Hospital. The 3D rendering shows the dislocation and fractures in the L3 and L4 vertebrae. I hate to think about what the surgeon had to do to manipulate my spine to reset that dislocation. In the past, I have seen videos of spinal surgeries and it's not pretty. But I'm told that my surgeon is extremely talented and sought after for spinal and neuro surgeries.

The x-ray shows my spine after the surgery. Not only did they insert two rods and eight screws to fuse the L2-L5 vertebrae, but they also had to clean up all the bone fragments from various other fractures of the transverse process bones that occurred in the accident. When my pain meds fully wear off I can feel the hardware in my back and it's not fun. I'm still on pain meds for the next month, but it's a fraction of what I was once using. I'm worried that once the pain meds are done that I may deal with chronic pain, but I will have to cross that bridge when I come to it. For now, I'm still trying to get used to sitting up in my wheelchair for the full day without a rest.

I also have photos of some of the road rash from the accident. I will spare you the sight of these because they are gruesome. But I can tell you that I had horrible road rash along the left side of my torso, both up and across my back as well as down my leg. Additionally, I had a nasty laceration about six inches long on my left hip that had to be stitched together. There were other spots of road rash on my right side and other various places. My right ankle got pretty banged up in the accident. So much so that they x-rayed it to see if it was broken but they believe it only sustained soft tissue damage. Of course this is all in addition to the incision scar from the surgery that is about eight inches long. Even a week after the accident when I was finally coherent, the wounds looked pretty bad. When I was admitted to Craig Hospital, they took photos of all the wounds. Several weeks after I had been there, I saw the photos and almost dropped them when I first saw them. They were so bad that it was shocking to think that this was my own body. Thankfully, it's all healed up now and all that is left are lots of scars.

The muscles in my lower back are extremely tired by the time the evening rolls around. I'm told that they probably did not cut through them for the surgery, but instead they probably split them along natural lines. I won't know for sure until I have a follow-up appointment with the surgeon next month. At any rate, my lower back muscles are really tired and sore by the end of the day.

Every day I have to stretch out the muscles in my legs because they get so tight for not using them full-time. I also stand for various periods during the day to get my body used to having the full weight on it again. Even though I cannot stand for more than about 20 minutes at a time, I remember when I couldn't stand for even one minute. The healing continues to progress and I continue to be hopeful for a recovery that includes some movement in my feet. For now, I'm happy to be home and surrounded by the love of my family.

Today was my last day at Craig Hospital. It's hard to believe that it has been six weeks since I transferred there from Boulder Community Hospital after the accident. I have never been away from my Janene and my girls for this long. I can't wait to wake up in my own bed and see my family every morning.

But by no means is this journey over. The acute healing was just the first stage in this long road of recovery. I'm sure there will still be many ups and downs, but my hope is that being home with my family will bring me much needed comfort and mental relief.

Although I am excited to go home and be with my family, it is bittersweet to leave Craig Hospital. Because Craig is a non-profit hospital that specializes in Spinal Cord Injury (SCI) and Traumatic Brain Injury (TBI), everything is tailored to people in those two categories. Everything at Craig Hospital is wheelchair friendly, everything is reachable for folks in wheelchairs, all the people who work there are trained to deal with all the uniqueness of these two injuries, etc., etc. But most of all, the hardest part was leaving the friends I have made during my stay.

Even though I will be back at Craig to begin out-patient therapy next week, it was difficult to say to goodbye to my friends. These are the people with whom I laughed and cried, who I helped keep going when things were tough and who helped pick me up when I needed it. It truly brightened my day to see my friends make advancements in their healing and their therapy. In a strange way I will miss being with these people every day. Not only did this accident change me but these friends I made while at Craig changed me. I will miss them.

Over the last several days I have watched more TV than my entire stay in the hospital because of the World Cup. I spent the weekend watching the games in my room and a community room at Craig that has a big screen TV. I don't have a favorite team so I'm not rooting for any particular team. I just love to see a good match and boy have there been some excellent matches!

But the best thing about this day was actually coming home. My family really worked hard on transforming our house so that I can live on the main level. My in-laws cleared out my office and our neighbors helped move our bedroom furniture from the second level into it. My wife had ramps installed and a neighbor helped my father-in-law and Dad build a platform to help with one of the ramps. And this is just a few of the many things that they did. But pulling into the driveway really made me smile because they had put up banners and balloons across the front porch and even one huge one across the driveway! As I got out of the car, I realized that many of the bunches of balloons were tied to various jars of Justin's nut butters, a product for which I had developed a huge affinity right before my accident. I used to eat it with a spoon right out of the jar and finish off a jar every few days. But I have no idea how I'm going to eat THIS MUCH nut butter! It was truly a wonderful welcome. The best part of it all was hugging everyone in my family and knowing that I get to stay at my own house and sleep in my own bed for good instead of going back to the hospital at the end of the day.

The last couple of weeks have been my best since the accident. Last week I began walking with the aid of braces on my lower legs and a walker. I am able to walk further and further every time. By no measure is it easy and I move very slowly because I have no feeling or control in my lower legs. At least the braces keep my feet stable so I can stand on them. This feels so amazing each time I do it that I am usually grinning from ear to ear. These experiences walking have made it pretty clear that I will be able to walk eventually, but it will be very different than how I walked before the accident.

There are so many things that I have learned about spinal cord injuries (SCI) since I have been at Craig Hospital in Denver. For example, the spinal cord can heal for up to two years or more! I met a guy who was a patient here at Craig 12 years ago and was a quadriplegic. Through the years, he has regained use of his entire upper body and even some of his lower body and legs. I was absolutely floored when this guy told me his story! This just goes to show how long it can take for spinal injuries to heal.

The spinal column consists of four regions as depicted in the image on the left-hand side. When injury occurs within a particular region, it can result in damaged nerves in that region and therefore impairment of certain body functions that are controlled by those nerves. If an injury is severe enough, the result can be paralysis of everything below the injury site.

Since I have been here at Craig, I have seen all sorts of different injuries in people. Some folks who have complete paralysis below the spinal injury and do not have that function return while other folks who have had a Cervical level injury who are able to walk again after sufficient healing. This is a good illustration of how unique each injury can be. There are so many variables that influence the situation that doctors cannot predict exactly what will happen to any single person. They have certainly seen many different injuries and can generalize about what functions they think might return after sufficient healing but there seem to be so many cases where people have had seemingly miraculous recoveries.

The spinal cord actually stops in the Thoracic region and a bundle of nerve roots known as the horse's tail (or cauda equina in Latin) continue through the Lumbar and Sacral regions of the spine. Because my injury involved fractures to the Lumbar region (L3 and L4 were fractured) it affects the horse's tail of nerve roots. This also means that there could be damage to the nerves below the injury site in the Sacral region. Among other functions, these nerve roots control the legs. This is why I lack control and sensitivity in portions of my lower legs and my feet. I have been told by my doctor and physical therapists that these nerve roots can take quite a while to heal so I will need to be very patient. This is basically a wait and see approach to my healing. In other words, it may take some time before we know if any of the functions that I have lost will return to any degree.

The fact that I am being released on Tuesday is very welcome. It has been just over seven weeks since my accident and just over five weeks that I have been at Craig Hospital. I am eager to get back to my home to be surrounded by my family and friends (and my dogs) on a regular basis. It's difficult to describe, but my friends here at Craig agree, although time seems to fly by, you also feel like you are standing still and that the accident was just a few days ago.

I have really made some wonderful friends while here at Craig Hospital. What we all have in common is the total experience of a spinal cord injury. But more importantly, all of the little experiences that go along with it, both good and not so good. Although we all started out as strangers and we are from places around the US both far and wide, we all quickly learned to comfort one another. It's a strange thing to make so many new friends when you are in the most vulnerable state of your life. This is how I learned the true meaning of compassion. For this, I will be forever grateful. It's the little encouragements every day from your friends that keep you going. These friends are both the people who are here to help you as well as the other patients to whom you have grown so close. Seeing their progress really boosts your mood and you never forget to tell them so. We have all had good days and bad, and it's these people who help pick you up and keep you moving forward. I never dreamed that a hospital could be such a positive place. But a hospital can also be a rather lonely place at times, too.

Although alone time can be a good thing for learning to heal your mind and to accept the injuries that changed your life, but being alone for too long can be difficult. As your loved ones continue to live their lives, you are alone in the hospital focusing on your injuries and your healing 24/7. Someone asked me the other day, 'So what is your other job?' and I laughed immediately because I knew what she was asking. Her implied notion was that you are doing rehab to focus on healing your injuries and that is your full-time job right now, but what is your real full-time work outside of here?

Healing in and of itself is exhausting, let alone when the PT starts up. And depending on your overall state of healing, adding the rigors of PT to the mix can nearly send you over the edge of what you can handle mentally. Thankfully I have had excellent doctors, nurses and techs while at Craig Hospital whose skills and experience have helped to speed my healing process. Add to that family and friends who have visited quite frequently and I have experienced an extremely speedy recovery and discharge. I have been told that rarely do they see someone heal so quickly and be released. All the medical professionals I have seen have commented about my health, physical fitness and positive attitude because these are the biggest factors in my healing. Who would have thought that what my oldest daughter calls fitness crazy is what healed me so fast?!