Day 364 - One Year Later: Deja Vu

As Yogi Berra is reported to have once said, "This is like deja vu all over again."

Later today we are going to my aunt's, the same one we were returning from when the accident happened last year. It has now been one year since the accident and over a year since the ER visit for her PSVT episode, give or take a day. There will NOT be a repeat of the events of last year, despite the recurring theme that has already started.

Part of the recurring theme is Jan was admitted to the hospital for the second PSVT episode that would not go away. Since she now has a cardiologist, she called the office. We went there to get an EKG of the PSVT rhythm. Her regular doctor wasn't in and the other doctor in the office admitted her to the hospital for observation.

From there, people didn't have a clue. We thought they would just get her heart rate down and send her home like the last time. Instead, they kept her overnight when we were told the doctor would make rounds in the morning. Wrong again. The nurse came in and gave her a non-related medication that Jan told her she didn't need. She didn't want to take it but the nurse said it was ordered. As she took the pill, the nurse told her she could refuse it. Ah, a little too late!

And trust me, this pill is as related to a heart problem as eye drops are to a hangnail.

The next morning the cardiac nurse practitioner order her an antibiotic and said the doctor would be in at 3-4PM. Great, I went to work but we texted a few times throughout the day.

I returned at a little after 3PM, by 4PM there was still no doctor. Almost a full day in the hospital without a doctor. I started to get a bad attitude because too many people in the medical field answer questions they should not, their answers are so optimistic as to be fairy tales.

The second problem with medical treatment is patients, in general, are too timid or in such compromised situations that they will not speak up for themselves. I think doctors and nurses have gotten away with being subtle bullies for far too long. As I age, I need to keep this in mind.

I had Jan page her nurse and I wanted REAL answers. I told her in no uncertain terms that she was not staying another night. She couldn't rest, which is what she needs most, and they had to stick her four times for an IV! They brought her a dinner meal just as the doctor was arriving, which she did not eat. I'm obviously going to fight that one.

The doctor finally showed up around 5:15PM and stayed about 30 minutes. He said he would not have kept her overnight and would have sent her to the ER to get the heart rate down. GREAT! Another lesson learned the hard way. At least I can be the jerk and let Jan remain mostly unscathed by my dip into vitriolic behavior.

As soon as the doctor left, Jan was discharged. I think the nurse wanted me out of there because I was not satisfied with having to wait 4 hours for an ice pack or 2 hours to be told she can take her nightly meds when the doctor had already told her that several hours before. They wanted to dispense all of her meds, which I had retrieved so they could have the dosages, from pharmacy. It isn't about money, except to the hospital. Why would she pay $40 for a pill from the hospital when the whole prescription for 30 days was $10 and she already has it and takes it normally? Communication is the problem with medicine today. They talk and seldom listen.

Life has, more or less, returned to normal. She's very tired, bruised where the IVs were botched, blew a vein and she still has some neck pain if she sleeps funny, but don't we all? I'm not pushing the plastic surgery for scar revision. It is her decision on the incision for revision.

On a funnier note, we went out to eat at a Japanese place last weekend. It was one of those sit-down-at-the-grill places and it was very good and I ate too much. Several people commented out of the blue that I looked like that guy that does Are You Smarter Than A Fifth Grader. That is usually a signal that I need a haircut.

Day 350 - 50 Weeks, Second Surgeon

We visited the second plastic surgeon about scar revision last Monday. She liked him better but still is unsure if she wants the revision. I can't say I blame her but I would want the daily reminder of seeing the scars removed. I don't have to be cut and heal though. I can't do it for her either so there's not much else I can do but offer encouragement.

We are still trying to find out where our escrow money went from our refinancing last month. They did send us a check for something but we can't figure out the difference between the pay-off (lower) and the amount being refinanced (higher). It is about one house payment so it is definitely worth looking for. As a matter of fact, it is halo scar revision money if you want to look at it that way!

If she decides to have the surgery, I will take before and after pictures.

Day 343 - Scalpel!

Last Monday we went to a plastic surgeon to see about scar revision on her forehead. He was nice enough and he indicated it was a simple procedure to be done in his office, but Jan is a little leery of being cut intentionally. As part of our new rules of medicine, as prescribed by me, we have a second opinion with another surgeon this coming Monday. I do not expect much of a different treatment plan, possibly only the price, which was actually cheaper than any of the follows up at Bilkmore.

Day 329 - Kicked Out!

Jan has been kicked out of PT. The PT guy says he can't really do anything more for her. We thank him for his help and support!

Day 315 - Jan's 30 Year Reunion

It has been 315 days since the accident and Jan had her 30-year reunion in Owensboro last night. It was actually a gathering of several years, encompassing the 70's and 80's Ohio County High School grads. There were about 100 people there so it was a good turn out.

Day 308 - Legally Speaking

We have passed 10 months since the accident. Things are mostly back to normal as much as anything is ever normal. We are refinancing the house to get a better rate. We are going from 27 years remaining at 6.675% to 15 years at 4.375. So we are dropping 2.3 points, shaving 12 years off the time and keeping about the same payment!

Jan has started going to church again. I, not being an overly religious person, do not participate in organized religion. I used to think I was agnostic but now I think that while God exists, he doesn't interfere with the affairs of man any more than we interfere with the single-celled life forms. That's just me, though.

The lawyer sent a letter telling Jan that they have sent the request for her insurance claim off and that should be resolved within 45 days. Additionally, the medical claim is being studied. We will see if there is anything to be done there. Frankly, I just want them to not be able to do what they did to Jan to anyone else. No further word from the Tennessee Medical Board on the outcome of their investigations into the doctor and the nurse practitioner.

Day 294 - 42 Weeks And Life Moves On

It has been over 200 days since the halo came off and Jan is still in physical therapy. She says her neck pops and cracks when she turns her head to the right. The scars look about the same, white dimples in her forehead the size of pencil erasers.

We just had the driveway sealed and still can't drive on it. They called early Saturday morning and said they could do it later that day if we wanted. So they did.

We also went to Nolin Dam for a cookout with my Dad. He was attending a Cattleman's association cookout and invited us. To get there we had to drive on the road where the accident happened. Jan realized shortly after we turned on to it. She said it made her a little sick at her stomach. I have the same feeling about Bilkmore.

Day 280 - 40 Weeks Still in Physical Therapy

Here we are at just over nine months later and Jan is still going to PT. Her PT guy was out part of last week so she only went last Friday. She developed an issue with her lower back and was in quite a bit of pain. That was unfortunate as there was a family get-together at the old family farm.

She took some pain killers and managed to get through it pretty well with some heat thrown in for good measure. She was doing much better this morning.

Not really much else to report, still trying to get Bilkmore billing sorted. That is a pain. If I were really worried about it I'd just pay it off. As it is, I hope I'm causing them more trouble and costing them more money than it is worth to them.

They send a statement and I call because it isn't right. Someday they will get it right but I won't live that long.

Day 259 - 37 Weeks and Jan's Birthday

Yesterday was Jan's birthday. We didn't do a lot. She's not really thrilled with counting numbers. To me they are just numbers, one more doesn't mean that much as long as people don't treat me differently because they think I'm old!

For her birthday we did go to her church ice cream social with our daughter, her boyfriend, his two sisters and one of his cousins. The burgers were good and the ice cream was homemade. Lots of people and plenty of entertainment for the little ones.

In the last month, I've made three visits to funeral homes. My friend's father that was in an accident and put into a halo (the proper way) finally succumbed to his injuries. Next, my uncle of 91 went downhill quick and left us. Finally, Jan's second mother had become frail and passed away just before her birthday.

She is still going to physical therapy although I'm sure the insurance is about to kick her off. The physical therapist is a great guy and has never sent us a bill for any co-pay or anything. The lawyers want to wait until maximum medical improvement before they present the claim.

I just can't seem to put this behind me. I have blinding rage every single time I have to deal with anything related to Bilkmore. The reason is the bills, they keep coming in. Bilkmore does an even lousier job of managing their bills than they do with medical care. It turns out each visit is a new account number so the automatic payments I've been making are going to the wrong account. Not to mention the fact that we get four bills for each visit; one for the hospital/clinic, one for the doctor, one for the x-ray and one for the x-ray reader. Each of them gets a co-pay so we wind up paying nearly $100 each visit for the privilege of being frustrated to the point of screaming.

There can be only one solution: brainwashing to get it out of my head. While Jan was drugged and merely had to survive it, I was awake, sober and traumatized psychologically by the whole thing. I'm not squeamish in the least. I can dig into my own flesh to retrieve an impaled object but watching them treat her like that for 80 days is impossible to take without a lot of anger.

I called to find out why the account hasn't shown a posted payment in two months and I was informed the account had a hold on it while they attempted to move the funds to the proper account. Incredibly, the lady could not make the numbers she had match the ones displayed online. What were the odds? Based on previous experience, I was not surprised. She said she could send me a detailed statement but she would have to remove the hold and stop the money transfer. As a former computer programmer, that just goes all over me as being the dumbest thing I've ever heard.

We do not need socialized healthcare in this country or any form of single-payer. What we need in this country is a good system of billing and standardizing forms. Different accounts for each visit is BS. Paying a copay for four different things under the same roof is BS. Billing two different amounts, depending on the way it is paid is, you guessed it, BS. Maybe this should be an episode of Penn and Teller's BS show on Showtime.

Day 224 - 32 Weeks and a Cookout With Friends and Family

Jan continues therapy. We went to a cookout at a friend's house. This is the friend who's father was in a head-on crash and is also in a halo. He is making progress but at 82 years old, it will be difficult for him. Our prayers and thoughts remain with him.

Day 217 - 31 Weeks And Home Again

We are finally back home after a very long three flights. I have just about caught up with all the yard work and such. Things are pretty much back to normal. Jan resumed physical therapy.

One more picture from Hawaii, Tessa surfing.

Day 210 - 30 Weeks and Submerging

We are still in Hawaii for a few more days. I had a few scooter dives today and became certified for their use. We got Justin, Tessa's boyfriend, to take the introductory scuba lesson. He did well enough that he went on a shore dive with us and the instructor.

We have seen Waimea canyon and been to a Luau. Kauai is much more laid back than Oahu or Maui.

Day 203 - 29 Weeks and Aloha!

We traveled to Kauai, Hawaii yesterday and boy was it a long day, literally. We left Nashville at 10:00 AM and arrived in Kauai at 7:40 PM but you have to add five hours due to time zones. We did get to see a few fireworks in Hawaii but we were tired and finally arrived at the resort around 9:00 PM. To our bodies, it felt like 2:00 AM SUNDAY!

Now we have nine more days of Kauai before we have to do it all again in reverse. Jan is doing some of her exercises in the shower every day but not her full therapy.

This is a picture from our room, facing the ocean.

Day 199 - The Final Journey!

Here we are at nearly 200 days and it was the last visit to Bilkmore. Jan's questions were mostly answered. The only restriction she has it to not have any ligament adjustments by a chiropractor for another six months. Other than that, he said he did not need to see her again.

The rest of it is they FINALLY got the imaging appointment down correctly. We arrived exactly 30 minutes early as I was bound and determined to hold them to their word. The appointment went very smoothly and she had her images done in 15 minutes. We were upstairs and in the waiting room by 1:20PM and then taken to an exam room by 1:45PM.

He wrote her another prescription for six weeks of physical therapy and basically said she may still improve some. He dismissed the pin scars completely, saying they were fine. Obviously, he's never had a halo! For that matter, neither have I but I certainly know the scars are not what I'd call "barely noticeable" unless you are nearsighted and are viewing from more than 20 feet away!

The most annoying part is when we asked for copies of the images, which we already pay for the imaging, they want $15 for copies. In the end, the desk person basically told us to lie and say they were for a second opinion so they would be free. Is that not the most screwed up thing?

I pitched a fit via email with the doctor's office because they did not want to allow Jan to get her images at WKDI. They promised to have all of the previous images available for us when she came for this visit is the only reason we agreed to allow Bilkmore's imaging lab another chance.

THAT WAS THE LAST TIME WE WILL SET FOOT ON BILKMORE!

Day 196 - 28 Weeks And Nobody Can See Me!

Just three more days until the next doctor's visit! We believe Jan is nearing maximum medical improvement. That is a technical term meaning little if any new progress will be achieved. She is still doing physical therapy but anything now will be very slow to return. Most of her mobility is back, just that last little bit is all she lacks. She complains that backing up her car is still a problem. Obviously here pin scars are not going to get much better. They have gone from red to pink to white.

Her single biggest complaint is the inner ear and balance issues that she first developed about halfway through the halo confinement. It will go away for a time but it never fully resolves. We do not know if it is accident or halo related or if it is just a coincidence. I tend to not believe in coincidences since I'm a technically oriented person that solves problems for a living.

She has been on five different antibiotics this year alone and is now on a steroid to see if that will clear it up. Her blood sugar spiked considerably the first day on the steroid but has returned to more normal levels.

I have filed a complaint against the nurse practitioner since there is, literally, nothing more she can possibly do to keep Jan from getting what she deserved all along in medical care. The NP purposely deterred Jan from seeing the doctor when it was well within her rights to see a doctor from the very beginning. Only a fool believes others are looking out for there best interests. Everyone tries to maximize their own return. The goals are certainly different. Jan wants to recover and the NP wanted to make as much money as possible from the treatment. The fact she was ineffectively dispensing care was Jan's misfortune.

I was requested to take the blog down from public view by legal counsel so I assume nobody else is reading this but Jan and I for the time being. At this time, only authorized persons can view the blog. If all goes well, I will turn it back on for public view after things are settled. I doubt that will be before the end of the year though.

Day 189 - 10 Days Until Bilkmore Again

We are at 27 weeks post-accident and 10 days until the next visit to Bilkmore's Children's Hospital. She is not looking forward to it but we hope this is the last visit there.

We had a cookout party to celebrate Tessa's graduation yesterday. We bought a grill and patio furniture to make sure everything was as good as it could be. Jan had a good time and a good day. Lots of family and friends showed up and we had a good time.

My mother's birthday is today and we had a cookie dough ice cream cake for her as well. A friend said that was the perfect dessert on so many levels. It is cake, ice cream and cookies.

It was very hot so we wound up mostly inside. I cooked on the grill in the front yard because the shade is much better there than in the back at that time of day.

We should have taken pictures but I was so busy it never crossed my mind. Maybe next time!

The improvement in Jan's neck is about as good as it is going to get. The PT guy thinks she will be finished with PT by the time we leave for Hawaii.

Day 183 - Lightning Strikes Again!

I received a call late yesterday from a very good friend I've known since high school. He did not sound like his normal, chipper self. He recently went through a bought of cancer with his throat and tonsils. Even during that ordeal of surgery, chemo and radiation, he was always in good, positive spirits. I was initially afraid he was going to tell me it was back.

Some of the first words he said were, "My dad has been in a car accident." After finding out he was alive but in the hospital, the second statement that floored me was, "He is getting the same treatment as Jan." This elderly gentleman was in a head-on collision and has a broken neck. The difference is they took him to Louisville and they evaluated him for a day before deciding on a halo with the family. When they finally put the halo on, they had a team of neurosurgeons put it on him, not just a single, unsupervised resident without a clue!

Jan's experience prepared my friend and the rest of the family for what was to come. He asked all kinds of questions and the family entered into this journey with volumes more information that Jan and I did. He said he knew what to ask thanks to our (in)experience.

Needless to say, our prayers, and I hope yours, are with them during this difficult time.

Day 182 - Six Month Rememberance

Today is exactly six months since the accident that left Jan with a type III C2 fracture. Things are nearly back to normal but only about 90%. We are still 17 days away from the next visit to the neurosurgeon.

On a sadder note, Tessa's hamster, Drizella, fell ill on Thursday night. Wednesday she was fine and seemed normal. They took her to the vet on Friday and the news wasn't good. She was 19 months old. She had a tumor behind an eye that caused it to bulge and put pressure on her jaw so that she could not eat. In just one day she lost a lot of weight and became debilitated. The vet helped her go peacefully.

This is a picture of Dru when she first came to our home in November 2007.

Day 175 - Lesson Recap

It is 25 weeks since the accident. Jan is driving and nearly back to normal but the last little bits of normal are the hardest to get back. She still has pains in her neck and shoulders and takes a fair bit more pain relievers than pre-accident. There are still several activities she has not rejoined, such as Jazzercise.

This whole ordeal has taught me several things that may be of value to others. I will try to relate them to you so that other people may learn from my mistakes. If just one person is spared the misery and suffering at the hands of the medical profession, it will have accomplished my goal.

1. If it is not a matter of life and death, get a second opinion
2. If it is an auto accident and there is PIP (personal injury protection) involved, let any other insurance pay first
3. You have a choice, don't be bullied
4. If you are given a nurse practitioner and don't feel comfortable, you can get the doctor scheduled instead
5. Do not let a resident perform complex procedures without an attending

Simple rules and I'll explain each of them in more detail and my thoughts for each. You will, hopefully, understand my reasoning for each and how it may affect you or a loved one in a medical emergency.

Beginning with the second opinion, this is what I think. In the case of Jan's injury, after the fact, we got a second opinion and that doctor said it might have been treated with just a brace. In the UK and other places, halos are rare. Had we had a discussion with a real doctor and not the resident just throwing the thing on her body and skull, things most certainly would have been different. If we had been part of the decision, I would have no room to complain.

Next, PIP insurance is to ensure that immediate medical care can be provided without worry of payment. It generally covers the first $10,000 per person. Jan burned through that in little under three hours. After that, the health insurance started paying and they slashed the originally billed amounts to slivers of the billed amount. If we had left the PIP out and let health insurance first reduce the bill, the PIP $10,000 would have more than covered all of the accident-related medical costs. It is also permissible to reimburse yourself for out of pocket costs first from the PIP money, which can be a lifesaver should there be extraordinary out of pocket expenses, such as travel, medications and other related expenses.

Choice is the cornerstone of a free society. After the halo was installed, Jan's choices dried up to none. Even though she was stuck with Bilkmore, she still had choices but they were not presented to us until it was nearly too late. She did not have to endure the repeated inefficiencies of the Bilkmore radiology department. She could have requested and if not honored then demanded that her radiology studies be done at a place more convenient for her. Convenience to the doctor or nurse is immaterial when the patient is being beaten down by the system. Patient comfort and ease is the primary concern of anyone that cares.

Nurse practitioners are usually very good and often spend more time with patients than doctors. However, if you feel you are not getting the attention and concern you deserve, as in Jan's two visits in 11 weeks, then you have the right to request a visit with the doctor instead. I only wish we had known this from the onset. We would have had no visits with that particular nurse. When she took 13 days to return our first call, I knew we were off to a bad start but did not know our rights.

Residents are not licensed doctors and as such are supposed to be supervised. They need to learn sometime and you learn by doing but there are certain things you do not want to be the guinea pig for when the inexperienced doctor is learning, especially when he is doing it alone without the necessary supervision. Jan's intern was not prepared, not experienced and certainly did not administer the halo properly. It is a team installation and he did it alone. When you are looking at 12 weeks in a halo, you want the person putting it on to be professional and to fit it as comfortably as possible.

There are other lessons learned from this but they are more personal. For one, I should have become more insistent that Jan's wishes be the highest priority from the beginning. Second, how and what I feel is not important if Jan isn't at least comfortable. Additionally, I can't do it all, no matter how hard I try. Finally, the medical establishment is about making money first and helping people if it is profitable.

Day 168 - Graduation!

Yesterday, Tessa graduated from high school. All those long years finally recognized. The class of 2009, we salute you.

Later today, we will attend Tessa's tennis team picnic. We picked up all the meat, buns and charcoal yesterday. I just hope it is not too hot. There is a shelter reserved even though the chance of rain is almost none. At least it should be shade.

Jan is driving on her own now. That's a big improvement at 24 weeks since the accident! She, and sometimes me, thought this day would never come. It has been the hardest five and a half months of our lives. It isn't over but it is closer than ever.

We've decided that she will get her, hopefully, last accident-related x-ray in Bowling Green before her July 1 visit rather than deal with Bilkmore's radiology department. We have never gotten her in and out of the imaging there in less than an hour. Either there were issues with the orders or the shuttle was late or the lab was busy. They are three for three on screw-ups and delays.

I refuse to make her put up with their nonsense any longer. It is her choice to be as comfortable as possible with all of it and she has had so much better experiences locally than at Bilkmore.

Here's another picture of all of us after the ceremony. Jan's hair is growing back out and her bangs cover the pin scars. It looks like my hair is getting a little longer as I look at this picture.

Tessa had a little gathering of friends at the house where they played Guitar Hero until nearly midnight.

The vacation situation is finally arranged. It looks like we are going to Kauai, Hawaii later this year! Two bedroom, ocean view in paradise!

Day 161 - Long Time, No Halo

It is officially 23 weeks since the accident and this is a long weekend. Memorial Day came early this year. Tomorrow we honor those that have given of themselves so that our way of life may be preserved.

The halo has been off 1 day longer than it was on, 80 days on, 81 days off. With that, she is just about ready to start driving herself. She's been making short trips with me to the grocery, to PT and the like. Backing up is hard still but getting better. She turns her head better than a month ago but not quite to pre-accident levels.

Tessa's last day of school is Thursday and she thinks she will be driving herself by next Friday. She knows I'll take her if she needs it. She doesn't want to be a burden but I don't mind.

Day 158 - You Do Look Like Him

I picked up Jan, to take her to physical therapy, on Wednesday afternoon. I was in her car and she attempted to drive to the PT office from her work. It is any easy drive without much traffic. She did OK but driving stretches her neck more than she would otherwise. She stresses over backing up and tries to find a spot where she can pull through.

When we arrived, she went on in but I had to make a conference call. I sat in the car for about 45 minutes to conduct business. Afterward, I went into the office to check on her progress. She was still getting the electro treatment on her shoulders and neck.

When she was done with that and the young lady was putting ice on her shoulder, she looked at me and said, "You really do look like Jeff Foxworthy."

Her father is the physical therapy business and he told her a few weeks ago that I was Jeff Foxworthy. She did a double-take but didn't believe it, thankfully.

I don't know if they put her up to it or not but it is just another episode in the comedy that is my life.

Day 154 - 22 Weeks Later

Today is 22 weeks since the accident. Things are still not back to normal. For one, Jan's neck is still not as mobile as before. As a result, she still is not driving. She does her physical therapy and it is improving slowly but surely. She also works out on the Wii Fit and it helps with other aspects of balance and strengthening.

We are still trying to nail down a vacation. Cancun was scratched for swine flu even though I think it is overblown and all. Statistically, some 30,000 people die in the US from the annual flu. There have been less than 70 deaths worldwide with most of those in Mexico. It must have been a slow news week!

We are either looking at Florida or Kauai (the northernmost Hawaiian island) for destinations. We have simple requirements:

• Timeshare availability
• Beach
• Reasonable airfare (or driving distance)
• Scuba diving available

So far, we can usually get two or three but all four have been a challenge with the time tables we are working with. Between school schedules, other people's vacations and high airfares for certain times, it has been a real puzzle to fit it all together.

Day 151 - Restless

Jan has been doing PT for a few weeks now and it is starting to show results. Her mobility is improving and her posture looks a little better. She still is not driving yet.

The Buick Gran Sport Nationals, a large event for the Buick muscle car types, are in town this week and I, a Buick owner, have been at the track for a few days now. Due to this, Jan is going to PT in the morning for Wednesday and Friday.

Tessa takes her to work most mornings and will continue to do so until the end of the school year. After that, we are hopeful that she can again drive. At this point, the halo has been off for 71 days.

Day 146 - Flower Power

We went to Jan's floral class final on Wednesday, which is actually just a party where the classes made the floral arrangements. It was at a house downtown known as the Greer House. It was built in 1906. We took the grand tour. It is a very interesting home. The folks that live there are very interested in preserving the history of the house.

I finally got tired of waiting for Bilkmore to call me back and called earlier in the week. I spoke to the same patient advocate, which won't really amount to much, but it makes me feel better. Cheaper than therapy. Plus, as long as I'm disputing things, I'm not going to pay them, especially for such shoddy service and poor care.

It is still a few weeks before the plastic surgeon would want to look at Jan's forehead. I'm hoping something like laser resurfacing can be done as an outpatient procedure. I'm not sure that will fill in the divots or not, though.

The doctor had gloves on when he removed the halo with his assistant but the nurse never had gloves on any time she tightened the halo. No wonder Jan's pins became infected, which have made the scars I've posted in earlier posts. Most people only have scars the size of pencil tips but Jan's are deep and the size of pencil erasers.

Day 143 - Wii Work Out

I had some reward dollars from one of the big chain stores that were expiring. After last Friday's PT sessions, we went to the store and bought a Wii Fit. It is supposed to help with balance and strength, two things Jan needs to work on. I'm going to count it as a Mother's Day present!

So far, the whole family has played with it. My Wii age started at 51, then went to 55, 45, 38 and then 32. I'm not sure of the value of the Wii age but it is a yardstick to compare results by.

Jan is really good at the hula hoop, initially beating Tessa's high score. The game does require specific activities that raise your heart rate. Time will tell but preliminary results are encouraging.

Late last Sunday, but well before dark, Jan drove to the grocery store with me and back. She says it still pulls and causes some slight pain to look left and right but she is trying. The bad news is the PT guy says she should not drive. I respect his opinion but by the same token, she needs short trips to build her confidence back. Heck, she still has more neck mobility than half the old folks driving today! The doctor just told her not to drive with the collar.

Day 140 - The Road Less Traveled

Twenty weeks ago today, it all went wrong. My curiosity got the best of me and I rode over to the accident location on my motorcycle last weekend. I had to look around, to help me understand. The GPS coordinates are N37 17.239 W86 19.229 if you are the least bit curious.

Jan has expressed no interest and even stated she doesn't want to revisit the site. I can't blame her.

This is the view of the road right before the infamous curve. There is a long straight before the curve. It appears we made it part of the way through the curve before it got out of shape.

The mailboxes in the upper right, just to the left of the tree, is where the gravel in the road came from. Click on any of the pictures to see the enlarged version.

We were only four miles away from my Dad's house, even less as the crow flies.

This is the same place but from the other side of the road at the intersection of Highway 238 and W. Vincent Road.

The next picture is of the road and the driveway. The late hour, similar to the lighting on a late fall evening, casts shadows where the gravel is on the road. It hasn't rained for several days and there is still gravel in the road. From the dispersal pattern, it may be pushed onto the road when vehicles exit the driveway.

We had already started the skid before the "School Bus" sign but had not left the road. We never touched the sign but I can't even remember it. We never even got close to the outside guard rail. I doubt we even crossed the center line except when the skid started.

I learned early on in my driving career, before the advent of ABS brakes, that if you are skidding, you have to ease off the brakes to regain control. I doubt even ABS brakes work well once the vehicle has turned sideways.

Last, we have the final resting place of the little red Mazda Miata. There is now a limb from the ice storm in pretty much the exact spot the car came to rest. The grass has grown up, hiding the ditch but it nicely defines the drive that leads off into the woods.

Heading back to Bowling Green, I drove this road very carefully. Even so, I did not feel the least bit afraid of this particular strip of blacktop. I am not superstitious and don't believe in fate.

As Jan has noted more than once when she expresses her trepidations about returning behind the wheel, I crashed the Miata and then had to drive an hour to Nashville. Then, a mere 15 hours later and with no sleep to speak of, had to drive her home in the halo.

People keep telling her she was lucky. I would have to disagree. Lucky would have been to have never had the accident. A bit less lucky would have been to have damaged the car and walked away, as I did. Lucky would have been getting an all-clear diagnosis at the first hospital. Lucky would have been getting a good doctor at Bilkmore. Lucky would have been getting a sympathetic and effective nurse practitioner. Luck had nothing to do with it. Sure, it could have been worse but it could have gone so much better. I think this accident is the antithesis of luck.

Oh, Bilkmore still hasn't called back from the Day 126 report. Anyone surprised? They do send bills, though. No luck there!

However, the drier is fixed and so quiet we can hardly tell it is running if there are no buttons pinging around in the drum.

Day 136 - Dry As A Bone

Jan has had two more physical therapy sessions since last time. TENS with heat then exercises and ice. The PT guy says her posture looks better. The changes are subtle and I don't notice the changes. Kind of like you don't notice your hair growing.

We are looking for a profile picture to see how her posture is now compared to before the accident to get some measure of what we are working with. Here's a picture from 2006 that was taken for our 20-year vow renewals. Not sure it shows a lot but it is the only one I can find.

She hasn't driven any more since the one short trip to Sam's but I keep prodding her to see if she wants to try a short trip here or there.

After Jan's most recent trip to physical therapy, we arrived home. Clothes were in the dryer so I went to start it. It sounded funny, all to quiet. Upon closer examination, the belt broke and the drum doesn't turn.

As I type this, the dryer is in a state of severe disassembly, scattered all over the utility room, awaiting the procurement of a new belt. The bright side of this affair is the new level of cleanliness. After 15 years of lint build-up, it is now as clean as new.

I suspect it will work better with a new belt as the old one had been shedding material for quite some time. I had no idea what the black powder under it was when we moved almost three years ago until now. Once inside of it, I could tell the belt had frayed, leaving a fine black residue all over the inside of the dryer.

Day 133 - On The Road Again

It is 19 weeks since the accident and Jan drove for the first time since December 14th, 2008. It wasn't far or fast but she drove from my work to Sam's Club, which is maybe half a mile. She was nervous, even a little anxious, but did fine. I don't know that she will be driving to work any time soon but a little progress is still progress.

PT is going well and she gets through it mostly pain-free. He adds a new exercise each visit and she is supposed to do them a few times a day between PT visits. She does the TENS and ice at the end of her visit lately. Sometimes she does the TENS first but ice is always the last thing.

Her pain level fluctuates but she manages it with Tylenol and Advil. She complains about her sleep not being restful as well. I'm not sure what we can do about that.

We've been trying to find a summer vacation destination. Cancun, Mexico was our preferred destination since it has a beach and scuba diving. I'd found a nice place and cheap airfare but the $200 round trip airfare was short-lived. It has more than doubled. Florida is looking like the next viable option since we would drive there.

Day 130 - Rehab After One Week

Jan has been getting rehab every other day for a few days now. Things are going well but the progress is slow. The physical therapist's view is that it should not hurt. She can stretch but should not cause pain. She has added a breathing exercise and a pushing the chest out exercise. She has been doing these exercises daily along with getting two to three miles of walking in every day.

There are several people that have appointments at or around the same time as Jan. We've gotten to know them in a casual sense. Everyone is laughing and cutting up. One guy had a knee replacement, another has a prosthetic below the knee and several receive treatments for things that aren't as obvious.

Everyone seems to really like PT guy. Jan and I like him, too! A friend's daughter works for him. She's much more talkative at work than I've ever seen her at church or out anywhere else.

Not much of an update tonight. Still no callback from Bilkmore. Surprised?

Day 126 - 18 Week Journey

It has been 18 weeks since the accident, almost seven since the halo came off and things are slowly returning to normal. She rarely wears the collar but tends to carry it with her just in case.

Yesterday she had a haircut by her good friend that came and cut her hair while in the halo. The short hair that has grown in where she was scrubbed bald is now about two inches long. It sticks up a bit. You can also see blond hairs around the rear pin sites where I was treating it with hydrogen peroxide.

After the haircut, she had her night guard altered to keep her teeth set when she sleeps. It helps her TMJ. I noticed she does not move her neck when she turns to look left or right. She turns her whole body. She can move her neck, she just hasn't started to do it again. Hopefully, PT will improve that.

Another oddity was when she was reclined in the dental chair, her head doesn't lay back on the headrest. That is probably from her halo forcing her head so far forward. It didn't help her posture at all, either.

Since she has started PT and there is absolutely nothing that can be done to harm her by Bilkmore, I've been dealing with the patient advocate office again. The doctor admitted that the halo should have been put on by two people. That and the fact that the NP would not make any attempt to improve the situation and scared her more than she helped is fuel for my campaign against Bilkmore. Allowing a second year resident to perform a surgical procedure on Jan unassisted and unsupervised was terrible, allowing the NP to compound it was insulting!

I wish I had more to report on the Bilkmore issue but guess what? They haven't called me back in more than three days. The problem of returning calls by Bilkmore people is chronic. Completely unacceptable.

As a side note, I watched an episode of Fox's Fringe titled Inner Child that originally aired on April 7th. It is an X-Files like show and they used a halo with the vertical bars as part of a prop device. To someone familiar with them, it was obviously a halo ring and bars.

Day 123 - First Physical Therapy Visit

Wednesday, tax day, was Jan's first day for physical therapy. It was pretty easy. He showed her an exercise she can do now called the "I don't know and I don't care." She needs to lift her shoulders up, the don't know part, and to try to squeeze her shoulder blades together.

She only had heat and electrostimulation yesterday and it did make her feel better. She still tired out early. The visits are Monday, Wednesday and Friday for the time being.

Tuesday was her return visit to the heart doctor. She was really worried about it the whole day before her appointment. She took a half valium before the trip and it helped. There was a two hour wait because the doctor had an emergency pace maker procedure.

He explained her echocardiogram and said it was fine. Her valves are good and he mentioned, only because it was on the report, that there was slight leakage. Nothing to be concerned about because 70% of the people on the street have the same thing and will never know it. Other than that, he said she has such long times between the PSVT episodes he wouldn't put her on medication and the cath-electrode (ablation) procedure is only a last resort if medication doesn't work.

Day 120 - First Day of Work!

Easter was yesterday and today is Jan's first day of work.

To start with, the hour long trip to the middle of no where went without a hitch. There was still a lot of storm damage evident. The tops of almost every tree of any size was broken off. First we went to the church where Jan visited the graves of her parents while the children of the congregation hunted for Easter eggs. After that, we returned to Caneyville to Jan's sister's house for lunch. Everyone brought something and it was a pretty good meal.

The first day of work was a bit of a challenge. For the most part, everything went well. Tessa took her to work on her way to school. Jan made it to lunch but she tired out a little early. I picked her up at around 2:00PM. She rested pretty much the rest of the day, taking it easy.

She was hoping to get into physical therapy this week but she doesn't feel she's strong enough yet.

Keep your fingers crossed. She returns to the heart doctor tomorrow.

Day 117 - Good Friday!

Today is Good Friday and I get the day off. Jan is planning on what to wear to the church on Sunday. She's thinking of blue jeans for comfort. I can't disagree with her.

Jan went to work for a meeting on Wednesday and stayed a couple of hours. It wore her out but she did better than she expected. She will return to work on Monday if all goes well. We will see how long she makes it. She knows I will come get here when she feels like she has done enough and hopefully before she does too much.

Last night was the first night since the accident that she has slept without the halo or the collar. She used one of those neck pillows that wrap around. It is somewhat supportive without being as binding as the collar.

I called around to a couple of plastic surgeons about reconstructive options for the pin dimples in her forehead. One said to wait about six months and the other said 10 weeks. It looks like they both agree it should be later but not on how much later.

Day 114 - Another Doctor Visit

Today, 114 days (or 16 weeks and two days) since the accident, is our 23rd anniversary! And they said it would not last! To celebrate, I'm looking for something in Cancun for a vacation later!

Yesterday, Jan had a visit with the heart doctor for an ultrasound of her heart, also known as an echocardiogram. She would have had this done sooner but the accident and subsequent halo-vest really put a damper on all things torso related. She needs to reschedule her mammogram as well. We won't know the results of the echocardiogram until next week when she returns for her followup visit.

Her neck continues to grow stronger and make progress. She has been going longer and longer without the collar but she still sleeps in it. She doesn't think she is ready to sleep without a collar. She always wears one when riding in a car. We just have to get her to where she can get her PT started.

Day 111 - Pins Sites At One Month

It is now one month since the halo was removed. The pin sites are "healed" skin wise but the depressions in the flesh or bone are quite prominent. Here is the picture I took this morning. As you can see, the sites are clearly visible.

Jan has been taking her collar off for anywhere from several minutes to an hour at a time. She is not comfortable doing it but it does not hurt her any more than wearing the collar. She is showering without it as well.

She did not take much Tylenol yesterday but did use some heat packs. She also did not take a valium tablet at bedtime and she slept well.

If all goes according to plan, she will return to work on April 13th. She may only do a half-day or just a few days a week but she wants to try going back. Since she still can't drive we have rides to and from work set up for her. The fallback is me being the catch-all in case she tires quickly or misses her ride to work. Her fellow staffers where she works have already said they will run interference for her, keeping the curious away when she feels tired. I have no doubt they will take good care of her. Her boss did not expect her back this month but she is resilient.

We have plans for her to see some of her family over Easter at the old family church. Some of them have not seen her since Thanksgiving, four and a half months ago.

Day 108 - Physical Therapy? Soon!

Jan had her second visit with the doctor today and, as usual, a simple thing is over six hours. That's the worst of it. The good news is she can take the collar off any time she wants. The doctor said she needs to wean off of it, probably within two to four weeks. At that time, she can start physical therapy. Her next appointment is not until July 1 when he, hopefully, will declare her cured and free do as she pleases.

For those that wish more details, they follow. We left at 12:30PM, arrived at the hospital by 1:45PM for a 2:30PM appointment. At all of the old appointments with the neurosurgery clinic, she had to go to the imaging lab at the main hospital by shuttle and then always to the OTHER IMAGINING LAB because they were backed up and then back to the neurosurgery clinic. Minimum of one hour both times plus all the hassle of getting a halo patient into and out of a van twice.

This time, we stopped at the imaging lab at the children's hospital ground floor, since we are trained to do that by the old clinic. She registered at the imaging lab at 1:50PM. The orders were not in the system so the check-in person called up to the doctor's office and they faxed them down. We waited 20 minutes and they said they were faxing them down but they never arrived. The guy finally went up to the ninth floor and got them. It was now 2:15PM.

The guy returned with the orders for imaging in his hands and put Jan in the queue. That took another 20 minutes and she was now officially late for her appointment. When she got back to the x-ray room, it didn't say if the collar needed to be on or off. They called the office but didn't get the doctor. They paged him and it took another 10 minutes. He called back and said to take it off. Jan didn't feel comfortable standing unassisted without it so the tech put me in a lead apron and I held her hands. She had to hold her head normally then bend her head forward and backward for x-rays of each view. She got through it fine if a little shaky.

We arrived on the ninth floor a good 45 minutes late for the appointment but still sat another 30 minutes in the waiting area. Once in an exam room, we spoke with the physician's assistant, the one that actually told me that the nurse practitioner canceled the appointment and she had scheduled Jan back with the neurosurgeon. Boy, was she honest and enlightening!

I won't spill all the details but suffice to say the NP rejected Jan's appointment and the PA promptly took ownership of the case and things have been so much better. She listened to the horror stories about the halo installation, the poor fit and the lack of support from the neurosurgery clinic. She said she took over Jan's case now and it would certainly be a better experience. So far, she has been dead on. The PA also told us she would brief the doctor on the issues before meeting with Jan and me and that we should tell him as well since he is an assistant professor at the hospital.

When the doctor arrived, we were fairly sure he was briefed but he played it very professionally, saying he would follow up on our issues and that she was past that portion. He said it would only get better from now on. She can't drive yet until the collar comes off and she can look to her sides and her weight limit is just 10 pounds but she is basically free of the collar when she has the confidence to take it off.

The tingling in her leg is a pinched nerve, caused by the vest. The doctor said it was much like a bruise. With luck, it will resolve within a few weeks or months. The pin holes are healed but still noticeably deep. He does not believe they will change much other than the pinkness of the skin turning whiter. I think she should at least consult someone about reconstruction to at least lessen them. After all, her forehead was fine after the accident and they are the ones that scarred her, physically and mentally.

After reviewing her x-rays with us, he said it looked very good. He said she would not need surgery, would not be paralyzed and there was no danger of her damaging the bones in her neck. According to him, it is healed well enough. The bones will remodel for some time but the strength is good enough to have no reservations.

He said she could take the collar off any time she wanted and encouraged me to help her wean off of it. Jan has the prescription for physical therapy now and can start in as little as two weeks but should be completely out of the collar in four weeks. PT could last as much as six weeks, depending on progress.

We left the office right about 6:00 PM and arrived back home just after 7:00 PM. A long day but overall, it was a good visit. Jan broke down a bit while detailing the trials she, and I by proxy had been subjected to through the previous months. If only she could have seen him from the beginning, things would have been so much better, possibly even tolerable.

Posts from here on will probably be fewer unless there is a funny redneck story to tell. I will continue to update on significant items as they occur but I think the worst is definitely behind us.

Day 105 - Audio Sound Bite

At 15 weeks since the accident, 24 days since the halo came off and just three days until the return visit to the doctor, I finally figured it out. I recorded the visit where the doctor removed the halo. I've converted the audio on the cell phone to something I can upload.

Here is a slide show along with a snippet of the doctor's comments before halo removal, answering the question we didn't ask. Jan believes after I filed the complaint and caused a big stink, the doctor felt he needed to add an unsolicited verdict on the halo setup. This was the thing he said that annoyed me but I kept quiet because the halo was still on her at this point.

Day 104 - Jan Went Up The Hill

The scholarship interviews on campus were a test of Jan's stamina. She spent all day without a nap. It did get to her a bit and after lunch she had me put a heating pad on her neck. We finally arrived back home around 6:30PM and she was pretty tired.

We won't find out anything about the results until Tessa gets a letter next week. We have our fingers crossed! Even if she doesn't get the Presidential Scholarship, she has the Award of Excellence Scholarship and is in the Honors College. Between the scholarship and the KEES money, she should be pretty much set.

After all the running around yesterday, we only walked two miles but it was a day without a rest break that she is used to. She slept pretty well last night and now we only have to see the doctor on Wednesday to see what happens next! Hopefully, physical therapy will be prescribed.

Fingers crossed and hoping for the best!

Day 102 - Retribution!

Some times I think too much and other times not enough. Things bounce around in the back of my mind until they make sense. Or maybe they make me crazy. Either way, I wind up acting upon them.

On this occasion, I called Bilkmore and confronted them about the December 16th bill, the one where Jan wound up back at the ER because of them providing no halo instructions. If they had given her or me any useful information and expectations, she would not have wound up back at the ER in less than 24 hours! The short version is they wiped out the entire bill for that day! Minor victory for our team! Money isn't the issue. It is about what was not right.

Tomorrow is an all-day event on Campus for Tessa. Jan is a little anxious about spending the whole day without the comfort of a chair to recline in if she gets exhausted. It will certainly be a test of her endurance. I can take her home at any time and Tessa can handle it all by herself if need be but it is a family event and Jan wants to attend.

I'm going to make sure she gets a good night's rest and keep my fingers crossed.

Day 100 - How To Wash Your Hair In A Cervical Collar

Triple-digit days since the accident. Only seven days, as I type this, until she returns to the doctor. Jan is looking forward to it, but with some apprehension. Any change is stressful when you don't know what happens next. She has been walking three miles each day the last few days so that is building up. Physical therapy will be hard but it will get her back to normal.

The lady at Hello Halo blog was having trouble washing her hair. Since Jan washes her's in the shower every day, she and I came up with this arrangement where we remove the back of the collar and put a wide velcro strap across the back to hold her head in the collar. That way her hair isn't covered by the collar back that goes from above her ears to below her shoulders. In this picture, she has her hair pinned up to show the back of the collar as it wraps around and the black strap that gives her some support.

Today was the first time in more than 100 days that she took ibuprofen for pain. NSAID drugs (aspirin, ibuprofen, naproxen) are not good for broken bones in the early stages of healing. They are anti-inflammatory and the healing process requires the inflammation response to cause the bones to properly grow back together. She is not in a lot of pain but it is that annoying ache and pinch that just won't go away yet.

I was speaking with someone about our accident. After showing him the pictures of the Miata, he remarked that a taller vehicle, such as Jan's Honda Pilot, probably would have rolled sooner and more than once. Even so, a Miata normally has no roof protection but our Miata had a hardtop and the roll bar. The odds are, the Miata survived the rollover better than the Honda Pilot would have. A Pilot, while full-bodied, does not have a roll bar reinforced top. Just sheet metal.

I used to operate a tow truck for my father. I recovered a few rolled cars in my time. If you google some rollover pictures, you will see that cars and trucks without roll bars are not any safer than a Miata with a roll bar.

In the end, accidents happen and nobody can predict how it will end. Some times, surviving is all you can hope for.

Day 98 - Is This The New Normal?

At 14 weeks after the accident, it almost feels like this is the new normal. This is a normal Jan does not want, nor do I. She feels like her progress is so slow and she just wants to be back like she was before the accident. I know she can do this but she needs more encouragement. She thinks her progress is slow but it took seconds to break her neck, 80 days to get atrophied muscles and it can't all be undone overnight.

With only nine days until her next appointment, I am trying to keep her motivated. Some of the time, I wish she'd do a blog on her own. She is still working on her on-line class and contemplating how she can get to work with minimal effort. She wants to return to work but just doesn't have the stamina for a full day.

Today, she walked about two miles, part of it at the grocery where we got more yogurt! Even if she isn't a fan, it is helpful with healing the bones.

Day 96 - Lame Update

It has been 96 days since Jan and I had the accident but only 16 days since the halo was removed. I've been back to work for two weeks and she has 12 days until the next appointment.

Not much has changed since the last update. She continues to walk as much as possible but without the ability to go anywhere on her own, she feels a bit isolated and trapped at home. We IM during the day and I go home every day for lunch. She doesn't get out as much as she did with the halo. I try to get her out but she just doesn't feel like it some of the time.

However, yesterday, we all got out. Jan, Tessa and I went shopping. I did not take the handicap placard either so she walked a little more. Afterward, we picked up some dinner.

Two other halo wearers have come to my attention. One is like Jan, already out of the halo while the other is only a few weeks into her time. Jan has been emailing the new user with any helpful tips she has. Our thoughts and prayers go out to her.

Day 94 - Nothing Much To Report

Two weeks in the collar, two weeks to go before the next doctor visit. She's walking as much as she can. We did a mile the other night when she walked to her very pregnant friend's house. Triplets!

Her neck is a little stiff in the morning but nowhere near as bad as the halo! Other than that, she didn't take any valium or Tylenol today but she hasn't been sleeping as well. Tonight she wants to take a whole valium to see if that helps her sleep better. I say it can't hurt.

Now that I'm back at work we keep in touch by IM. She can do almost anything she wants except drive. Showering still causes her a little anxiety but I'm there if she needs me. I help her change the collar, dry her hair and clean the pin holes.

All of the holes are pretty much healed except the one. It looks like it is only held in by her hair but is hard as a rock. It will come out when it is ready.

Day 92 - Nurse's Choice For Halo Removal

Welcome to day 92, the official date the nurse practitioner would have picked for halo removal. Thank goodness I'm a stubborn so and so that argued with the powers that be for a revised schedule. We are almost half way into her collar phase. Next stop, physical therapy.

Jan has been walking over a mile most days. Several days have been 1.5 miles so that is an improvement. She continues to feel insecure without the collar but she tests her limits of mobility with it on. She doesn't have the full range of motion but she is a little leary of trying too much. I have not encouraged her to test too far.

The back of the collar is board-straight with no anatomical curve like a human neck. To help, we took a trick from the halo days by putting a rolled-up washcloth between her neck and the collar to give her some support while laying on the pillow.

We did get a quick response from the neurosurgeon's office. They have responded in less than 12 hours, less than that when you consider I emailed them at 10:00PM and I had a reply by 9:30AM the next day! Thankfully, the x-rays she needs will be in the same building so no shuttles and no delays getting back to the office. The doctor may still be running late but what can you do about that?

Our curiosity has gotten the best of us and we are speculating on why the doctor told us we'd be seeing the nurse and then the nurse canceled our appointment and pushed us back to the doctor. Jan thinks it is because we complained. I think it is because they are afraid she is going to press it further. Either way, I'm only disappointed it didn't happen from the very beginning.

Jan still hasn't gone back to work. She feels guilty about it but a full day would definitely be too much for her right now. She's thinking of trying a few partial days. Tessa could take her to work on her way to school. I could pick her up when she was tired, be it lunch or any time before or after. Now that the pin sites have mostly healed over, it isn't as critical to keep them from becoming infected with three times daily cleanings.

For those that care, the big red car is back on the ground and drivable. I just hope it quits marking territory after the repairs.

Day 90 - Survey Says...

Three months. 90 days. It seems like an eternity ago that everything turned upside down, literally. It has been a long journey back for Jan and she still isn't 100% yet but progress is slow when you speak in terms of bones.

Yesterday Jan walked something over a mile and a half. Pretty good. I took her to the mall to get a jacket and a few other things Tessa had put on hold at Old Navy. I took her in my truck, which did not have the handicapped tag in it. This meant we had to park in a normal spot and she had to walk a little farther. She did fine. Jan thinks that when it expires at the end of the month I should renew it. I'm hoping she does not need it renewed after March 30th!

After we arrived home, there was a call from an odd number we didn't recognize. It was a survey about Bilkmore. Too bad it was only about the neurosurgeon that took the halo off. I dearly wish it had been about any other single visit besides that one! Would she ever have let them have it! Does anyone else think they are cherry-picking the visits they survey?

The pin sites are healing nicely. All but one is now a pink depression. The fourth hole, behind her left ear, is still a bit scabby but is also healing. They are still a bit tender but not overly painful. I continue to massage them as they heal to prevent the skin from adhering to the bone.

Another halo patient contacted us through the blog. She was in an accident and started her own blog. She was looking for advice and a friendly chat about what to expect. Jan has corresponded with her a few times. I'm sure the poor woman is overwhelmed, just as Jan and I were.

We cleaned out the closet of all the slit t-shirts. They are now in the garage and will be recycled as shop rags. Of course, if you know a halo patient that needs them, I'll gladly forward them on.

Day 88 - Appointment Rescheduled

The doctor's office called on Wednesday and we now have an appointment for Jan on April 1, 2009, at the children's hospital again. I've emailed them to find out about getting x-rays since we took the CT scan on CD that we had done in Bowling Green.

The cold weather has put a damper on her walking outside so we went to Sam's last night to get some things and let her walk around indoors.

She continues to exercise her neck in small increments when we change the collar in the mornings.

Her church brought over two kinds of chili last night. It was very good. There was also a pumpkin creme pie, too!

Standing for any period of time still tires her out pretty quickly. Moving isn't as bad. Pain pills are less frequent and valium is about the same. Tylenol is her current pain pill of choice.

Day 86 - Appointment Cancellation? NO!

Yesterday was the first day I returned to work. Jan spent most of the morning working on homework while I went to the office. We IM'd and I picked up lunch at Zaxby's. She's walking just over a mile each day.

She is showering daily even though it is strange for her after three months without one. Her pin sites are cleaned three times a day and are healing well but the depressions are still quite deep and pink.

My work changed the FMLA date on my form to yesterday and informed me YESTERDAY! To get me through the expected recovery period, I faxed another form to the neurosurgery clinic to get it filled out since she still can't drive or turn her head.

I emailed the clinic to follow up on the fax since they have been horrible about getting anything completed. You can measure their response time with a calendar. Within an hour of the email, I received a call to cancel Jan's April 2nd appointment! No reason, only that the doctor's office would call to set up an appointment instead. I can't say I'm sorry we won't be seeing her again. After all, she'd still have had Jan in the halo for nearly another week.

Next, I faxed the form to be filled out to the doctor's office since the nurse canceled her. I faxed it in around lunch and I got it back by 3:30 PM! Amazing! Unfortunately, we did not get the replacement appointment call. I'll call at noon tomorrow if they haven't made a new appointment by then.

For show and tell we have the halo and vest assembled off the patient. It can be assembled symmetrically but it never was.

The back and front of the vest should have been positioned at the same level on the body. Instead, the back was at least a few inches above the front and it rubbed the area at the back base of Jan's rib cage nearly raw. I suspect she was only a few days away from a pressure sore.

Day 84 - 12 Weeks Since the Accident

How would you like to have this framing your view for three months? Never changing, never shifting, literally a portable prison with no escape. You can't see your body from the waist up except in a mirror or the ground in front of you as you walk. No looking over your shoulder at all! This is the view from a halo wearer's perspective.

Not much new to report. Pain is much lower and Jan's sleeping in the bed now. She's walking at least half a mile a day and building up to more. I suggested she use the treadmill since it is right next to my office but I think she's afraid of the stairs.

I came up with another idea to allow her to wash her hair easier. The back of the collar is quite large and comes up over halfway between the ears and the top of the scalp, making it nearly impossible to wash the back of her head and neck. I took a long velcro strip and fastened it to just the front on both sides so that her neck is exposed in the back and all of her hair can be washed. This keeps her neck and chin supported since she mostly leans forward while washing her hair and the time without the back is about the same as when we change it and dry her hair.

She thinks she still looks a little right when she is sitting in a neutral position, caused by having her head pointed right for 80 days. Time will tell. I'm sure Nurse Ratched (One Flew Over the Cuckoo's Nest reference) will have an excuse and equally useless explanation of why it doesn't matter and it had to be that way.

If we had let the NP decided when to get the CT scan instead of pushing for what Jan wanted, she'd still have another eight days in the halo instead of three days in the collar already!

After much thought and careful consideration, I've decided to contest the emergency room charges for the 16th of December. It is too bad the insurance company already paid their part because had the doctor, nurse, hospital or anyone that came in contact with us noticed Jan's higher respiration rate and lower blood oxygen levels due to the vest being too tight, it would have been completely avoided. To drive an hour, spend three hours in the hospital and be charged $2,300 to have the vest waist belt loosened by four notches when it was improperly fitted in the first place, is beyond my ability to swallow.

You can tell, I can't let it go. I get that but they won't learn unless someone makes them listen. Maybe it is me that makes them take notice. I seriously doubt it will have any effect but I'm too hard-headed to give up and they did not perform the required tasks nor give us the most rudimentary of halo-vest instructions.

Day 82 - Halo Minus 48 Hours

The halo has been off for two full days. As she prepares for bed, she has only had two halves of a pain pill and a valium and a half. That is a significant improvement in the pain.

I got her out for a little shopping at Krogers. She had already done two laps around the driveway. Between the two walks, she did just about a half-mile. As her strength and stamina returns, we'll push it farther as she can tolerate more.

Her second shower was less eventful. I've pretty much got the collar swap down. She can hold her head up by herself for the minute or two it takes to get the collar off, finish drying her neck and putting a dry one on. The pads easily dry overnight so there is always a fresh set of pads to go into the plastic when it dries.

She is still debating on trying the bed tonight or to stick with the chair. She's become comfortable with the chair but I suspect it is allowing her to be a bit lazy since it will lift her up. She's going to throw something at me for saying that. If I have a black eye, she did it!

After this post, updates will probably go back to every couple of days unless something significant happens. There is a new countdown for the next visit to get past the collar and into physical therapy. Just 26 days to go!

Day 81 - The First 24 Hours With A Collar

After one full day without the halo, the pain has eased. She is still hurting in her neck where the halo-vest had been pinching a nerve but we are hopeful it will recede quickly. So far she has only had one pain pill, broken in half and taken at two different times. After getting her up and cleaning her pin holes, I felt bad and was curled up in bed until almost 3PM with a stomach ache and killer headache.

The doctor did give her another collar. He was originally just going to give her another set of pads but just gave her the whole collar. So, now we have two collars so she can shower in one and change into a dry one afterward.

Speaking of the first shower, she was pretty apprehensive about her head while taking the collar off to wash her hair. In the end, it was pretty simple. The pin sites need to be cleaned three times a day and he told her to wash her hair every day and to just use plain shampoo. I'm also massaging the pin sites so they do not adhere to the bone.

Pain medication is way down again, thankfully. Less is doing more for her at the moment, which is a plus. We are breaking the pills in half, except for the time-release one, which is a bad thing to do.

A few more thoughts from the doctor visit yesterday that I didn't think to post. I wish she could have seen him from the very beginning instead of the rigid and utterly clueless nurse practitioner.

First, when I asked the doctor if I could take pictures, he said it was an odd request and nobody had ever asked that before but he didn't see a good reason not to allow it.

Second, he said she would need to see the same nurse practitioner next time at the same old place. I'm not thrilled but she can't do much wrong at this point since the halo is already off. If we'd have listened to her, the halo would still be on! She didn't want to see Jan until March 16th! If the nurse had ever had to wear one of these, she'd be more than willing to work with a patient to get it off as quickly as safely possible.

Third, the doctor said she would need the collar for only a month when the NP had said it would be six weeks in the collar. Physical therapy will be after she's regained some muscle strength.

The doctor cleared her for light-duty if she felt like it. Her weight limit has been increased from five pounds to 10. She's still pretty weak and tires easily but I'm hoping to get her out of the house on Friday. It is supposed to be 70 degrees tomorrow! The doctor said to walk as much as possible, it would be good exercise.

Finally, the doctor was surprised I wanted to keep the halo. I told them I was going to put it on eBay although it is generally instructed by a lawyer to retain all "evidence" until the claims are handled in case of legal proceedings. We haven't retained a lawyer and I hope it is not needed but that's no reason to be poorly prepared.

Day 80 - How To Remove A Halo!

Day 80 started with Jan still in her halo and vest. This is the last picture taken of her in it. We arrived at 3:45PM for the 4:15PM appointment. Registration was really quick and we had hoped to be back home quickly.

The doctor was running late due to a surgical emergency. Did I mention we spent two hours in the pediatric neurosurgery waiting room with children all over the place. She, literally, was the last patient he saw.

After the meet and greet, he started showing her the latest images. We pretty much knew what they showed and so did you reading this. The doctor then tried to show her the old images but could not pull them up. I offered to let him borrow my CD, which I conveniently had with me.

A nurse interrupted and Jan noticed she had a cervical collar with her. That made Jan smile as the doctor stepped out of the room to speak with her. When he returned, he then proceeded to explain the report and to compare the images. The statement we were looking for was announced, "The report doesn't seem very positive but it is healing nicely."

Jan was ecstatic! Then he said we just need to wait for the wrenches to which I said I've got them right here! Then he said she would be getting a collar and I produced the one we brought with us. He was starting to think I was reading his mind.

First, he removed the bolts that connected the halo ring around her head to the brackets that are supported by the bars. Now she was wearing a vest that was ready to come off. Her head was slowly tilting backward and the nurse braced her.

Then, they put the collar on her to help her keep her head up. She wasn't thrilled with it but she was just happy to not have the halo on anymore.

Finally, the doctor and his assistant removed the ring around her head by working at opposite corners and loosening the pins together. Funny, that's how I said it should have gone on! They held the ring in place until the last pin was removed and lifted it off of her head! The left front pin looks quite deep but the right one looks like it might actually heal without too much of a scar.

Yes, day 80 ended without a halo!

Day 79 - CT Results

She was pretty worried she wouldn't be able to lay still for the CT scan. Thankfully, that's over with and it wasn't the much longer MRI. The scan was done today at 2:15 PM. The interesting part of the report says:

1. Healing changes are evident within the comminuted C2 vertebral fracture with no change in position of alignment since 12/14/2008.

2. Nondisplaced fractures of the anterolateral aspects of the posterior arch of C1 remain unchanged.

Compared to the prior study of 12/14/2008 obtained from Bilkmore, there has been no change in position or alignment, and there is some evidence of healing at the fracture line at the base of the odontoid and within the anterior mass of the Cs vertebra.

The part that doesn't sound as good is this part:

There is no significant callus formation.

Other than that, I'll post the newest images. I see definite material where there was clearly open space. The part about no significant callus formation is not too troubling because as a healing indicator, that often trails real-world bone healing by a few weeks.

Here's the latest little movie.



The quality is low to save bandwidth but if you look at yesterday's movie, you can see noticeable changes that look encouraging.

Here are some more images. This first one is a side by side of the front of the C2 fracture. The first CT scan from the accident is on the left and the same images from today's CT scan on the right. The images are not as clear as I'd like but the obvious black (fracture) is much less visible in today's images.


This is the side view of the same C2 vertebrae with the fractures oriented the same, old on left, new on right. The gap has nearly closed and there is material filling the gap. I'm no doctor (or nurse for that matter as the medical profession likes to remind me) but this looks like substantial bone healing to my untrained eye.

For the final piece, here's the top-down slice that is pretty evident of the damage. You can see that it isn't completely healed but then again that really isn't expected. It just needs to be strong enough to allow the halo to come off and for her to transition to a collar.

Pray the doctor sees it my way! I don't think she can take much more. Her pain is off the chart. She has had as much pain medication now as when she first came home. She just sits in the chair and rocks back and forth in a zombie state. I've given her pain pills as close together as allowed, valium whenever she asks and the time-released pill at 7:30 PM on top of all that. She's got heat packs on her back, shoulder blades and right arm in hopes that will alleviate at least some of the tension and pain. Sunday and yesterday both were bad but not as bad as today.

Jan is in so much pain that she can't stand it. The narcotic pain pills fail to provide significant relief. It dulls it but it isn't knocking it back to a functional level for very long. She thinks it is more muscle spasms than anything but the valium isn't helping as much as it did before. She used to average two a day or less and now she is up to four and five a day without the same level of relief. The prescription says one every six hours but the NP verbally told her she could take two at a time. We haven't resorted to that yet because she resists it. Similar change for the pain pills, too. She used to be down to nothing besides Tylenol and now she's at five or more narcotics a day plus the time-released to sleep.

When she's awake she's been pacing the floor, trying to find a comfortable spot to rest with no relief. I've been helping her put heat on her shoulder blades and at the base of her neck/shoulders, which is nowhere near her injury.