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.