Breaking the Silence

It's been about two weeks since the car accident.  I have kept pretty quiet during this time, evaluating my situation and seeking out legal advice.  There have been too many effects from this accident, and too significant, for me to ignore.  I had hoped that by now the effects would have diminished, or cleared up completely, but they haven't.  So I have retained legal counsel to represent my best interests in settling my personal injury claims against the insurance of and the driver who hit me.  

How do you distinguish the way I was before the accident from the way I am now, you might wonder?  It's easy to dismiss the impact if all you see is the general picture.  I was in a wheelchair when it happened, I still require a wheelchair now.  I could walk with a walker, I still can now.  I've continued to make important progress in physical therapy.  So everything's fine, right?

Wrong.  You see, that's just not enough detail to understand what's really been happening.  The number one impact of the accident has been pain.  So much pain.  But I was in pain before, you might argue.  That would be true.  But fortunately the medical profession has decided it's useful to measure pain on a scale, and so we have a handy tool for identifying changes in pain levels.  Before the accident my daily, average pain was at a level of 2-3.  At that level I choose to abstain from narcotic pain medicines and could function optimally in physical therapy.  After the accident, my daily average pain level has not gone below 4 and is most often between 5 and 6.  That's twice as bad.  At that level I need narcotic pain medicine on a daily basis and my ability to achieve goals in physical therapy is dramatically impacted.  In addition, my power chair is still in the repair shop, and without it I'm stuck in a manual wheelchair that doesn't recline at all, and the backrest doesn't come all the way up my back, so it causes me pain the whole time I'm sitting in it and restricts my ability to get out of the house or spend time out of my bed.  In a power chair I can get in and out of the house all by myself; in a manual chair I have to have someone to help leverage the front caster wheels over my front door threshold, requiring a second person to stand behind me and pop a wheelie as I go through the door.

The impact on my therapy performance is a significant problem when you consider that medical insurance will only provide a specific number of physical therapy visits per calendar year.  I had objectives that we were hoping to accomplish before my visits ran out and now, with my performance diminished by pain and the resulting decrease in stamina, some objectives will be out of reach unless I can somehow extend my access to physical therapy.  These aren't just generalizations, either, I'm not just speculating that I'm 'probably' not doing as well as I would have been without the extra pain.  There are measurable differences in my performance at therapy.  Before the accident I could walk with my walker for 168ft without having to stop and sit down to rest, and I was adding anywhere from 20-50ft per week to my previous records to reach that point.  A couple of days after the accident when I returned to therapy the furthest I could push had dropped to 105ft.  Two weeks after the accident, through tremendous effort and a lot of pain, I've still only regained up to 125ft at one time, way behind where I was before the accident even all this time later, and only gaining about ten feet per week.

Of course, there are still highlights.  I never sit back and take it easy, it's not in my nature, and being hurt in a car accident does not lessen my burning desire to get back to a more normal, active life.  So of course I've continued to make progress in therapy, including pushing beyond a handful of practice stairs until I can now climb a full 12-step flight of stairs, rest at the top, and then come back down.  It's a tremendous step forward, but it comes at a great price; accomplishing those stairs raises my pain level to 6 every time, and it takes at least a day afterward to recover from the muscle fatigue in my legs and get my pain back down to a 4 and 5.  I continue to extend the total distance I can walk within a therapy session, which is good, but because of my diminished ability, this is done in shorter segments with longer rests in between; instead of walking 440ft in one or two really long walks, I have just now accomplished walking 440ft in four shorter walks.  

I have an altered sense of numbness in my right foot.  Due to the nature of my spinal cord injury it is very difficult for me to assess if this is a worsening of sensation in that foot or an improvement in sensation in the left foot; I can only tell that they no longer feel the same and one doesn't work as well as the other.  That and other nerve-related symptoms will be discussed with my neurosurgeon when I see him on Monday, and I think it's very possible that he will recommend MRI to evaluate whether the accident has caused any changes in swelling or affected the tumors at all.

Lastly, there is an emotional component to this accident, for which I was not prepared.  I knew I would likely be in pain from it, although I thought the pain would go back to 'normal' by now.  I knew there could possibly be swelling or other nerve damage that might cause problems, and mentally prepared myself for those issues.  But I didn't realize that I would be terrified every time I get in the car from now on, flinching from every minor swerve, gripping my wheelchair arms until my hands turn white and feel numb while frantically watching the vehicles on all sides of me and hoping none of them makes any stupid mistakes.  I didn't know this fear would compel me to stay home more, to pass up on outings I might otherwise have considered, because 'out there' I'm so much more vulnerable than 'in here' at home.  I didn't know I would have nightmares in which I relive the accident, and wake up sweating and afraid.

So yes, I've been down, and I've been kicked while I'm down, but I'm still kicking back, and I'm not going to sit here and let someone ruin everything I've worked for.  I've discussed this blog with my attorney, and with the understanding that nothing I say here is any different from what my medical records will show, have been advised that I can keep writing.  No more silence.