Again, I have to start by expressing my sincerest gratitude
for the incredible amount of support we’ve received. Friends from work continuously offer help in
whatever way they can, Kara’s friends from her Bible study group (
Side by Side)
have provided some fabulous meals, and my residency program has been
tremendously accommodating during the past two months. I only wish I could adequately express how
much the support, prayers, and words of encouragement have meant to us.
Now onto an update…
(Here's the
background in case you missed it the first time.)
Over the six weeks after my injury I had been looking
forward to the EMG, which is a much easier way to say electromyogram. An EMG measures the electrical conduction
through the nerves. They do this by
sending electrical shocks through the skin and measuring the velocity and also
by inserting needles into the muscles to measure the electrical activity
directly in the muscle. If you are
thinking this does not sound terribly comfortable, you have just confirmed your
understanding of this tortuous exam. In
saying that, you might wonder why I would be anticipating it for a month and a
half, but it is certainly difficult to sit around without any idea of the
prognosis and not being able to do anything to help the situation. There
are no therapies, no exercises, and no foods or pills that I can do to be
actively participating in my own welfare.
Just waiting and praying.
Well, that day finally came last week when I would be
brought down to the dungeon and tied up like Westley in the secret tree near
Prince Humperdinck’s castle. Leading up
to the EMG, I had hopes that even though I couldn’t will my arm to move with a
mere thought, perhaps the needle would pick up some electrical activity in the
muscle that was present, but too weak to contract the muscle and maybe just
needed more time to heal. Unfortunately,
I don’t have any great news after the EMG.
The simplest way to say it (and actually what the neurologist wrote in
my official medical record) is “there was no activation of the left triceps,
deltoid, and infraspinatus muscles.” On
a lighter note, however, I didn’t feel anything when the needle was inserted
into my deltoid.
After the EMG, I had an appointment with “The Brachial
Plexus Guys”. That’s what I call them. The brachial plexus clinic is made up of two
orthopedic hand surgeons and a neurosurgeon who are truly experts in this field
– traumatic brachial plexus injuries. In
fact, after the appointment, one of their several minions (a hand surgery
fellow) wrote down the title of
THE
hand surgery text (Green’s) and several chapters that they wrote on traumatic
brachial plexus injuries. I went online
to find it and discovered there are well over 1,000 publications between the
three of them! I cannot take for granted
the mere fact that I have access to the world experts!
OK, getting back to the appointment. I met with the neurosurgeon first and the
rest of the team followed. We had a
discussion about my career and how it is extremely frustrating to work so hard
and for so long toward a goal that is now more of an uncertainty. I still have one good arm and a brain, and
I’m optimistic that I will still practice emergency medicine despite the
potential need for adjustments in practice style, though I am also praying that
I won’t have to make any adjustments at all and that I’ll eventually heal. On that note, we also talked about how this
injury will probably
not heal
completely on its own based on the EMG results.
While my career absolutely is important to me, my active lifestyle is
even more so. Most of you reading this
know me and know that I was the guy on
every
intramural sports team, in addition to several city and church leagues,
simultaneously (sometimes to my wife’s chagrin); I was the guy willing to try anything,
especially if it pushed the limits of physical toughness (also to my wife’s
chagrin, which is why I purposely did not using the term “dangerous” here
J); I was the guy who would temporarily forget he
was a dad and often behaved as the trouble-making cousin with his kids,
constantly throwing, flipping, and wrestling with them. So as I pray for a complete recovery, I try to
keep the potentially realistic perspective that I won’t be able to do
everything that I could do prior to January 22, 2012. (I realize the previous sentence might
contradict
Mark 11:24,
but I can’t pretend to know the will of God and I find that I need to prepare
for all possible outcomes and that I cannot ignore the undesirable
possibilities.)
(Click on any of the pics for better viewing.)
(Click on any of the pics for better viewing.)
(Click on any of the pics for better viewing.)
(Click on any of the pics for better viewing.)
(Click on any of the pics for better viewing.)
As I was sitting in that office, there was a picture on the wall
of a cliff out over the sea and as we were having these discussions I pointed
at the picture and I said, “I want to be able to climb that.”
That’s what every little boy thinks when they
see a mountain or a cliff. The reply was
something like, “Unfortunately, there’s a very good chance you won’t be able to
hang from that cliff like you could before.”
I had just undergone the EMG a few hours earlier with somewhat
depressing results. So did I feel like
crying when that sort of long-term prognosis was mentioned? Yes.
Did I? No. But I did start thinking about what I might
and might not be able to do. Things like
riding carelessly on aggressive mountain bike trails, adventure races and high
ropes obstacle courses in the Army, play softball on the church softball team,
throw my kids in the pool, and the list goes on. After my internalized pity party was over, I
realized that there has to be a way to continue doing some of these things –
just look at
Jim Abbott.
 |
(Ignore the words -
this is the general concept) |
Despite trying to stay optimistic and trusting that God has
a plan in all of this, it sure is difficult to think about what the future
might hold when it has yet to be written.
A common phrase I kept hearing at the appointment was, “It’s still
early.” This was good to hear as a
reminder that there is still the possibility for some nerve regeneration –
nerves grow about 1 mm per day – but it was still mildly annoying since there
had been no improvement in function yet and it sure didn’t seem like it was
“early” to me! I have another
appointment on April 18
th and then another EMG about a month later
and this journey will very likely lead to nerve grafting surgery where they
will essentially transplant a nerve from somewhere else near my left shoulder or
my leg and bypass the injured section.
Then the journey starts again with rehab and the long road toward
getting ready for next ski season.
;-) Stay tuned. (
Season passes are cheaper if you get them before March 31st.)
I wrote everything above this paragraph about a week ago,
closer to the appointment, and you might have noticed that the theme so far in
this post has been disappointment and uncertainty, and maybe a little fear
secondary to that uncertainty. If I
broke my arm, it would heal and I’d go back to my normal life, but the
difference in this injury is that there is no crystal ball and even if I do
need surgery, would that lead to 80% of the strength and range of motion that I
had before? Only 20%? I don’t know. I think it is appropriate to be
disappointed with the EMG results, afraid of not knowing the extent of recovery
and not having any control over it, and even sad that this has happened to me,
but I also believe that I have a choice about how to respond to those
emotions. I try to stay positive as much
as I can and right now I am choosing just to take it one day at a time and take
it as it comes.
It’s not always easy to see the rainbow through the storm,
but I am surprised at how many things I have to be thankful about! For one, I could be dead - literally - or
much more severely injured if I was only a few more inches toward my head and
neck. I have pretty good function of my
wrist and hand. We still have our
minivan (“man van”) that we tried to sell last summer, which is good because my
car has a manual transmission. Kara will
tell you it’s a blessing that my chances of ever having a motorcycle in the
garage have dramatically decreased. I
have disability insurance, which is huge!
Another positive note is that I also had an MRI two weeks ago to
evaluate the rotator cuff, and while it seems the report showed many problem
areas and didn’t comment on anything being “normal,” there is nothing that
requires surgical repair.
I truly am in the best place to have an injury like this and
couldn’t ask for better friends and colleagues!
Please keep praying for a full recovery!
(If it loads slowly, make sure HD is off)
(Just watch the last minute, starting at 2:30)
