Stroke has Struck Me

Could be a winner boy, ya move quite well …

So maybe you’ve been wondering where I’ve been; it’s been a year and seven months, after all. Just what, exactly, have I been up to?

Did I get caught up with my camera? Did I get lost in the sites and smells of Southeast Asia? Did I get involved in political intrigue there in Bangkok (and there has been a lot of it, lately). Did I finally write that book? Did I chuck it all for the simple life of a Buddhist monk?

Unfortunately, it was none of those things.

My brain on a hematoma ...
“There is a 4.5×2.3×3.1cm mild heterogeneous hyperdense hematoma in left basal ganglion with
moderate surrounding brain edema involving left periventricular white matter, temporal and insular
region; subacute stage of hematoma is possible. There is mass effect, resulting in mild rightward
shifting of midline structure about 2.7mm and obliteration perimesencephalic cistern with mass effect
to left-side midbrain.”

On December 23, just a few days shy of my 45 birthday, I had a stroke — a hemorrhagic stroke, to be precise. You see there are two different kinds of stroke we are worried about, ischemic and hemorrhagic. The vast majority are ischemic, some 80 to 85 percent. The rest are hemorrhagic — essentially the bulk are blood clots in the brain; I had to be part of the “lucky” few who actually had blood in the brain.

So let’s have a look at our hemorrhagic stroke victims. Most of those who don’t get to a hospital right away end up dead; of those that do get to a hospital quickly, half still succumb after the first day or two. The trouble is, I didn’t know this — I didn’t know any of it until well after fact (and lucky that I could learn it at all).

Incidentally, that picture of my brain, taken Dec. 29, is taken from the bottom, looking up, so everything is reversed.

According to the doctors, there was no underlying factor, as far as they could determine. I was overweight then, but I didn’t have high blood pressure or anything like that. It’s “just one of those things.”

All I knew was that at sometime that afternoon, I had, well … something bad. I was sitting in my chair and when I stood up — I fell down. Repeatedly. It was all I could do to make it into bed; my right leg and arm were useless. That’s pretty much all I remember for the next few days, a confusing blur of falling down repeatedly on the way to and from my bed to the bathroom. I don’t remember it but I a took out the bathroom sink during one fall.

After a few days friends started dropping by on Christmas Day; they were concerned they hadn’t seen me in a while. I vaguely remember asking them to come back later; I wasn’t in any condition to answer the door.

It was late on the third day — this would be December 26 — when I finally let someone in the door. By then I was feeling well enough to actually answer it. The next day, my birthday, I decided to visit that hospital. I thought I was just humoring friends, I thought, but the hospital folk took one look at me and ushered me in. You can guess the rest.

Well sort of.

The last I remember is the emergency room on the 27th of December; I woke up on January 4 in ICU. What happened? I don’t really know for sure, but It seems I had a relapse; the bleeding had stopped before but began again. I remember none of  that, from the time checked in until I came to in ICU. Seven days — a week — just gone.

Apparently whatever gains I made in the early days — my leg, my arm — were gone, too. My right hand and arm were just so much meat attached to my torso; my leg wasn’t much better. To say I was a lousy patient — at first — was an understatement.

Eleven days after waking up, I was discharged to an “extended care facility”— nursing home for short — for a month. My leg was good enough for short periods without much help but I still had an ambulance ride out to country where the home was. The staff of the home was great, although it took a few days to get used to showering with help — fully clothed of coarse (them, not me). But I had learned after my first few days in ICU that nurses generally knew what was up.

And what do you know? A few weeks later at the nursing home I could bend my index finger. By the time I checked out a few weeks later I could bend all of my fingers and could walk — within reason — with only the slightest of limps and no help.

Since then it’s been therapy. Lots and lots of therapy. Six days a week, and between that and what I pursue on my own, between gym and at-home workouts, it’s been a full-time job, getting better.

I came home last August, finally, after the doctor signed off and let me fly. So … it’s been over a year now.

Have I gotten better?

Well that depends. What is better? At five months a friend I hadn’t seen in a long time talked with me for 20 minutes before he learned I had had a stroke, and that was because I mentioned it in passing. According to him I’m “better,” or at least nearly so.

I can’t deny it; I’m a very fortunate man who rarely lets a day go by without giving thanks. And yet when I look at my hand and think about my handwriting or my typing — I typed this, for the most part, with my left hand because my right still isn’t up to the task — or when I look at the muscles of my right side in a mirror, I can’t help but think I’ve got months still to go.

Still.

You’re so together boy

Oh, you handsome devil
I swear my nose isn’t that crooked. And how ’bout those horns? Flashed with me my right hand, no less.

And in some ways I think I won’t get better, at least like I was before. My hand writing will never be the same regardless of which hand I use in the future. And even if my right hand continues still to improve — I typed this sentence with both hands, albeit slowly; a month ago I couldn’t — there are things I’ll do left-handed now (I’m right handed, in case anyone needed me to clarify that — well I was. Kind of sloppily ambidextrous now, I guess).

Then there is the brain itself. Fortunately my aneurysm was a relatively small one, about 4.5cm at its widest point, at the base of my brain, namely my left basal ganglia (hence no operation for me). While the motor pathways for my right side are gone, my brain found — is finding — alternate pathways to use.

Huzzah?

Then there was — and is — my attention span. Back in the hospital I could concentrate for about five minutes on a problem before me brain was done; when I got out of the nursing home a month later I was good for 15 minutes. Six months ago I could go for an hour or two before I need a brake, preferably a lengthy one.

Today, I’m more or less back to normal, with regard to my attention span. But what of the rest? My speech and speaking voice are shadows of what they once were, for example, in terms of being heard and understood. One day, it’s okay, the next … not so much.

Time will tell.

But that’s okay.

Maybe it’s just because I had a hemorrhagic stroke and lived to tell about it. Maybe it’s because that after a year of therapy and working out, I’m better than most survivors — I walk into the gym, after all.

Besides, there is a bright side. I weigh the same as I did in high school, for the first time since high school.

Time will tell.

Rest Your Weary Bones

A Martini for What Ails Ye

Okay, a rainy day spent indoors catching up on some oft-delayed work meant nothing interesting caught my photographic eye. So I’m dipping way back into the archives for the Photo a Day today. Here’s something from an assignment for a photography class — don’t remember what the assignment was for or what the class was — strobe class or what?

I’ll let it speak for itself.

Rest your weary bones with a martini ...

Incidentally, the film grain is for real; this is a scanned image of a negative. The toning is of course, Photoshop.  Here’s another image from the same set.

Kick back and rest your weary bones ...

Ruptured Quadriceps Tendon? What Ruptured Quadriceps Tendon?

Fuck Yeah! I can walk! And welcome all you meme googlers.Rap My Knuckes and Jump for Joy, I Got a Clean Bill of Health from Dr. McCoy

Actually it was from Dr. Phat, my orthopedic doctor and surgeon here in Ho Chi Minh City, née Sai Gon. And I should qualify clean bill of health. He is more than satisfied with my recovery from surgery thus far, terming it – and I quote – amazing. I guess it’s not common for folks who suffer a complete tear of their quadriceps tendon to be back at work full time three weeks after surgery, and walking around unaided even before that.

Yay me. And here’s some blatant SEO: fuck yeah.

He said there was no reason for me to come back to see him, unless I developed problems of some sort in the future, but he doesn’t foresee any. Or, of course, if I bust something else on my body involving bones or muscles. Being the klutz that I am, this is not entirely beyond the realm of probability.

But does that mean my leg is healed? That “it’s all better?” as I’m asked frequently? No, not at all. I still walk with a slight limp; most people wouldn’t even notice it, although it becomes more pronounced throughout the day if I’m walking and or standing a lot. While I can walk both up stairs and down now, I still need a railing to hold onto to walk down. This isn’t out of fear of my leg buckling – which still occasionally happens – but simply because my muscles still aren’t strong enough.

Walking up stairs I can do without a railing for one flight of stairs; if there is two, there had better be a railing or a wall to brace against. At the end of a Saturday or Sunday in which I normally teach six hours a day and often times eight, my leg, could it verbally express itself, would say: “Yo, dude, screw them stairs and screw you if you expect me to do down them. Unless the building is on fire, we’re taking the elevator, champ.”

And my leg does express itself frequently through its individual component parts; it is almost constantly sore, to one degree or another. Use my leg too much on any given day, and my Frankenstein quadriceps tendon lets me know, using even more colorful language than that evidenced above. Plus the rest of my muscles in my leg suffer degrees of fatigue and soreness. My calf is pretty much always sore, all day, all the time. The IT band in my right leg often weighs in at the end of the day to let me know that it is indeed done for the day, and could use a good stretching. Needless to say my hamstring and quadriceps muscles also frequently have things to say, although not as much as the rest of the lot.

Bilateral symmetry: you're doing it wrong. Three months and few weeks after surgery for a torn quadriceps tendonMy right leg and I have frequent conversations these days.

I’m still looking at months of physical rehabilitation before “it’s all better.” It will be a least a year or so, in total, before I can walk normally without thinking about it, before my level of muscle (re)development matches that of my left leg – hooray for bilateral symmetry. As Dr. Phat said, the only thing left now is physical therapy, i.e., exercise, and lots of it.

And as you can see, bilateral symmetry – I don’t have it. The muscles in my injured leg are still noticeably underdeveloped compared to my good leg — although I am standing a bit of an angle compared to the mirror; my Franken patella isn’t that much higher than the one in my good leg. But it is higher, because my quadricep and tendon have shortened, as discussed below.

Furthermore, in the interests of posterity and future sufferers of ruptured quadriceps tendons, I’ve done the unthinkable and posted a picture of my pasty white self  in my underwear on the Internet. At least I’ve spared you from having to look at my junk in the process. And frankly that smiley icon is considerably bigger than it needs to be. Add this to my list of things I never thought I’d do or experience – like tearing my quadriceps tendon.

So When Does the Surgical Incision Stop Itching?

The short answer? Years, but then I expected that. Even now, more than three months after the surgery, sometimes the surgical incision site itches. The lengthwise incision minimizes damage to the nerves beneath the skin, avoiding any major ones, but still there is some unavoidable damage – a small price to pay in the long run for the ability to walk again, trust me.

Furthermore, as anyone who has ever dealt with deep scar tissue knows, it takes a long time to … settle down, for lack of a better term. There is some residual healing that takes months; nerve regeneration considerably longer. Plus the resulting scar tissue from a huge incision like this is … sticky, for lack of a better term. Especially where a joint is involved, it doesn’t want to slide and move smoothly with the tissue around it, and it takes a long time to sort itself out.

This is one of several reasons why physical therapy is critical; if the leg is immobile too long, that scar tissue can actually hinder range of motion. I swear, early on in physical therapy, I could feel the scar tissue underneath the skin tugging at the tissue beneath it. My imagination, you say … perhaps.

So yeah, the long and the short of it is I have roughly a circle of skin about an inch or so in diameter on my knee that is numb, and yet sometimes the flesh around it itches. I scratch, rub my knee and life goes on.

When I asked Dr. Phat about this and when I could expect it to subside, he said “years.” Then he looked up at me with a slightly alarmed look on his face, like it just occurred to him that this wasn’t exactly a bedside-mannerly thing to say.

The Venture Brothers' Baron Von Unterbheit: not my high school senior portrait.I smiled and said I expected as much. I had maxillofacial surgery when I was 18 to correct my mandibular prognathism – a fancy way of saying I had my underbite fixed. It wasn’t pronounced at all – I didn’t look like Baron Von Ünderbheit or anything – just a matter of a few millimeters, but I probably would have lost most of my teeth by now if I hadn’t had it corrected. Follow those links if you want to learn more.

The surgery involves cutting out hunks of jawbone, but at the same time avoiding severing a major facial nerve that runs through the jaw bone. Some numbness is unavoidable, as the surgeon has to handle and move the nerve as he cuts through the bone. To this day, some two decades later, I still don’t have complete feeling in a small patch beneath my lower lip. And to this day there is still some phantom itching in this area as the nerves continue their long regenerative process.

Dr. Phat was actually pretty interested in my surgery and recovery from that, asking specific questions about how my jaw was now, the feeling in my lip, etc. But then I suppose that’s kinda his thing. One of his raisons d’etre, as it were.

“Actually Your Quadriceps Tendon is Shorter”

There’s one more thing about this long recovery from a torn quadriceps tendon and the subsequent surgery. As I began to walk again without the aid of a crutch and brace about a month or so ago, I came to have the feeling that my leg was just ever so slightly shorter than the other one — a matter of a millimeter or two, maybe. Also, I noticed that my right foot seems to point a few degrees more laterally to the right, or to the outside, when I walk.

I assumed that these things were probably a combination of my imagination and the fact that my muscles had atrophied so much during six weeks of immobility outside of therapeutic exercises. But I asked Dr. Phat about it, and he said that actually the quadriceps muscle and tendon shortens during recovery when it’s immobile (just take a luck at those ugly legs in the picture above). After all, that’s why it takes so long to recover one’s range of motion.

So perhaps, at least temporarily, my leg could be a millimeter or two shorter than the other one.

As for my foot being in a slightly different position during my walking stride, that is also possible. It may just be a matter of weakened muscles, but as Dr. Phat explained, when surgeons put people’s bits back together, they do their best to put them back the way they were before, but it’s never quite the same.

This I know, too. Nothing is ever the same after a severe orthopedic injury. My junior year in high school I tore the syndesmosis tissue where the tibia and fibia meet at the base of my right leg. A few years before that, I had torn up that same ankle – torn ligaments, bone chips and whatnot. It was literally years before my right ankle ever felt normal, and to this day, it can’t take abuse like my left ankle. A slight sprain or twist that I could walk off in a few minutes on my left ankle means a few days of soreness for my right ankle.

Then there is the dislocated AC joint in my shoulder (again, on my right side; that side of my body is all sorts of messed up) that I’ve been living with for the past decade or so (knobby mountain bike tires and slick rock is a potentially bad combination).

So there you go. If you’re reading this because you’ve ruptured your quadriceps tendon and want to know what you’re in for, you’ve got a long road ahead, my friend. A long, difficult, frustrating road. But I’m here to tell you to hang in there, listen to your doctor, listen to your physical therapist, don’t skip out on your exercises – not if you want to walk again anytime soon – and you will be walking, riding a bike and even running again. But it will be a matter of months.

Did I mention that I jogged the other day? It was only across the physical therapy room at the hospital, and with little baby steps — but those were metaphorical giant leaps. Fuck yeah! Take that, random uncaring universe. Or karma. Once again, sorry Larry.

Karma Chameleon, Karma Quadriceps

In Which I Catch A6 and Ruminate on Recovery

No, no, no. Not *that* Karma Chamelon. I don't think Boy George and Culture Club had orthopedic problems and existential angst in mind. So a few days ago I passed the three-month mark: three months since I tore – completely severed, rather – the quadriceps tendon in my right leg, and had surgery to correct it the next day, Christmas Eve.

Has it really been a month since I last posted and laughed in the face of Fate and the Universe? I guess it has. I haven’t had a lot of bandwidth the past few weeks for much else beyond teaching and reading; I’ve had a cold that has persisted for two weeks – persisted in kicking my ass. I’ve compared notes with fellow expats, and it seems they have drawn the same conclusion I have – we don’t have the natural or resistance we would otherwise have back home, where our bodies are familiar with the bugs that get passed around.

Back in the States I typically would get a cold or the flu once or twice a year, and it would last a week or so. In between those times I might get a scratchy throat or a runny nose for a few days here and there, but nothing more than a minor annoyance.

But over here on the other side of the planet, there are bugs floating around that my white blood cells haven’t encountered before, and when you come down with a cold, it’s a bitch kitty, as my old man would have said. Coughing up technicolor snot – or blowing it out of your nose – every twenty minutes or so. Coughing until you sound like a trumpeting, randy elk. Not fun.

Somehow, thanks to my usual pig-headedness and over-the-counter drugs, I managed to keep up my teaching load, which is now back to full time. But as I say, the past few weeks, I haven’t had much bandwidth for aught else.

A technical diagram illustrating where the quadriceps tendon rupture occurred.That has included my therapy exercises, but now that I’m walking unaided, it doesn’t seem to have slowed down my recovery. Of course I make it a point to walk up and down stairs at every opportunity.

I still need a bannister to lean on, but when one is present, I take the stairs. I’ve been able to walk up stairs normally – provided they aren’t too high and there is the aforementioned bannister present – for the past three weeks or so; for the last two weeks or so, I’ve been able to walk down stairs normally.

This tends to make my leg a bit sore at the point of the injury/surgical repair if I do it too much, but then, no pain no gain, at this point. My therapist, Mistress Lien, continues to be pleased with my progress. Although when I showed up last week – having canceled my weekly appointment the previous week because I was barfing up chunks of lung – and I looked like death and was braying like a donkey when I coughed, she politely inquired wtf I was doing there.

I wasn’t going to miss another week of therapy, I said, cold or no. Besides, a little physical activity might help – get the lymph moving around, and whatnot. And I’ve noticed that when my sinuses are swollen, physical activity is one of the few things that relieves them – the blood flows elsewhere, for a bit.

To top it all off I accepted a bit of freelance web development work from an old acquaintance that I know through work, and that’s kept me busy too, lo these past weeks. But I’ve enjoyed getting my hands dirty with CSS, PHP and whatnot again. Nerd is as nerd does. But as I say, no time for anything else.

Karma for Funky Walk: I’m Sorry Larry

I howl with rage and despair, just like this dog. Despair_by_FluffleNeCharkaAs I’ve noted before, I’ve been more than a little obsessed with the existential meaning behind my torn quadriceps tendon. I can’t help but think to some degree that perhaps that it is karma. Maybe not for one thing, but maybe for several little things. Maybe my karmic bank vault was a little too full and some sort of cosmic pressure valve opened – and I suffered a serious injury stepping off a bus.

The other day I was walking through the park – my gate is almost normal, at this point – when my leg buckled and I stumbled and nearly fell before I recovered. In order to walk with a near normal gate I still have to consciously think about it; my leg is still too weak otherwise and I limp noticeably. The buckling happens less and less as my leg gets stronger, but it still happens once in a while.

I found myself drawing stares from other people in the park, stares like I haven’t drawn since I left the crutch at home. It’s funny how quickly I’ve gone from an object of amazement – a foreigner walking with a crutch! In public! Out in the street! – to just another expat walking around Sai Gon. Once again the only people that give me a second glance these days are people that want to sell me something.

But as I regained my balance after my leg buckled that day in the park, I crossed a vast gulf of time, back to grade school and junior high, and in my minds eye I pictured a kid named Larry. Larry – or as a friend and I had dubbed him, as teenagers are wont to be cruel – Funky Walk.

Larry was suffered from what I presume now was some sort of congenital defect; one of his legs was malformed and didn’t quite point in the right direction, and he walked with a noticeable limp. I went to large suburban elementary school and junior high school, and he was one of those kids you see around, in the halls, in the lunch room, but never get to know. Of course, Larry stood out because of his rolling, rocking gate.

In junior high I had a friend; let’s call him “Ralph.” For a year or two we were pretty tight buds, and then in high school we grew apart. It was one of those growing-up kind of things where at some point you stop and think “why was I friends with that guy? He’s an asshole.” Granted, Ralph might very well have thought the same thing about me.

Keep on Truckin' Larry, wherever you are -- sorry we were teenage dicks. Anyway, whenever we saw Larry around school, we always remarked “there goes Funky Walk.” He looked like that iconic “Keep on Trucking” guy drawn by R. Crumb — himself iconic — when he walked. Teenagers can be real dicks, and I was no different, unfortunately.

I haven’t thought about Larry in decades; not since high school, of course. But the other day, I could picture him in my mind’s eye as if it were 1982 and I had just passed him in the halls of Anderson Junior High. His long dishwater blonde hair, black t-shirt and faded boot cut jeans (Larry actually looked pretty hip for a kid in the suburbs of Cincinnati, Ohio, in 1982, come to think of it).

Must have been tough growing up with that abnormal gate. He probably went to a lot of doctors and physical therapists, and in the end he was stuck with it – unlike me, who has a light at the end of his gimpy tunnel. I remember at some point in high school, I was hanging out with a girl, and Larry walked by, and I said something like “There goes Funky Walk.”

I guess I wasn’t quite into my more-thoughtful, post-teenage-dick phase yet. She informed me, and rightfully so, that I was an asshole, and that Larry was actually a pretty cool guy.

Larry, wherever you are are now, I owe you an apology. For what it’s worth, I’m sorry I was and adolescent dickhead. Having had a small taste of what it’s like, to be stared at because you aren’t as able bodied as everyone else, to say you have my respect would be an understatement.

Fuck Yeah! I can walk! And welcome all you meme googlers.P.S. SEO Funnies

It seems a lot of people are out there are wandering the Vast Series of Tubes in search of things related to the “Fuck Yeah” meme. My previous post has generated a lot of traffic in the month that it’s been up, most of which came from Google searches for “fuck yeah;” it’s become the second most popular landing page on this blog. Notably, it doesn’t contain the words “fuck yeah” anywhere in the post, but it does sport an example of the Fuck Yeah meme in the form of an image, and “fuck yeah” is included in the image tags (’cause I’m a good little search engine optimizer).

Of course I used that image because it adequately conveyed how I felt, being able to walk unaided and ride a bike, albeit a stationary one, for the first time since I ruptured my quad tendon. So for all you folks who landed here, read my meandering prose and all the while wondered “what the hell,” I bid you welcome.

And fuck yeah. I can walk. I may look like an R. Crumb cartoon when I do it, but I can walk.

Ha Ha! Screw You, Universe!

Fuck Yeah! I can walk again. And ride a bike. Up yours, Random Twist of Fate!Today was a glorious day. Less than 10 weeks from the day I suffered a quadriceps tendon rupture  — 67 days, to be precise — almost to the very hour, I bent my leg 115 degrees.

And I got on that stationary bike in the physical therapy room of the hospital. The one that has teased and taunted me lo these many weeks. And I was spinning. Three hundred and sixty degrees, I followed the pedals around.

And it was glorious.

And then I walked around my neighborhood here in Ho Chi Minh City, Viet Nam. Without a crutch. Granted, they were short, slow steps, and my gate was wonky, and at times my right leg was a little wobbly, but I. fucking. walked.

And it was glorious.

As you may recall previously here on the Gecko’s Bark, I had been disillusioned, as I had been literally stuck at 100 degrees, in terms of my ability to bend my injured leg. But after a week of somewhat aggressive stretching — frequent and just to the point of pain and a wee bit beyond at times —  today I could bend my leg 115 degrees.

And today I got on the stationary bike, and instead of rotating forward, and stopping when I couldn’t bend my leg any farther, and then rotating in the opposite direction until I reached the same point again — I’ve been stuck doing that for three weeks now — today, I sent those pedals through 360 degrees of rotation. I could feel the tightness in my knee, but it didn’t hurt.

BOOHYAH!

It was bliss. Mistress Lien, my therapist, had to um, firmly insist that I step down after 15 minutes — and she kept insisting, firmly, that I wasn’t to spin faster than 25 kilometers an hour on the lowest setting of resistance.

And she also decided after doing a bunch of new exercises — oh, she was cruel mistress today, my physiotherapist —  that my atrophied gam had recovered enough strength that I should begin walking around without the crutch. More than just around my apartment.

Outside. In the world. Walk. Around. Without a crutch.

It was scary. Like the first time you have sex is scary.

And I did.

Walk, that is. And my entire leg is tired and sore, my hip flexor, which has to pick up the majority of the slack by my weak-ass quadriceps and hamstring muscles, not to mention my abused calf muscle — well, let’s just say it’s a good thing my hip flexor can’t express itself in words. Because it would be cussing a blue streak that would make a drunk sailor blush.

As for the point of injury, it’s very sore and puffy … kinda like after the first time I had sex! *insert rim shot here*

But I walked. And I spun.

Glorious.

Stick it up your ass, Universe. Blow me, Fate. I can walk again.

Damn My Quadriceps, I’m Walking (Sort Of) Home. Through the Park, Even

A technical diagram illustrating where the quadriceps tendon rupture occurred. Well it’s been a few days since I whined about my torn quadriceps tendon, so I figured I’d remedy that. Saturday, Feb. 25 – heh, just realized it’s a leap year – will be nine weeks to the day I had my surgery on Christmas Eve. I had a therapy appointment today – the physical kind, not the head-shrinking kind – and I had hoped in the back of my mind that today might be the day that I could actually spin on the stationary bike.

I don’t know whether or not it’s because I am a once and future avid cyclist, or what, but that is some sort of milestone for me, psychologically. I can walk now, sort of. I don’t use my crutch around the apartment except when I get in and out of the shower, and then it’s just a matter of being safe. I really can’t walk with a normal gate yet – my quadriceps muscle and the related muscles, aductors, abductors and so forth, along with my calf continue to get stronger, but they ain’t there yet — but I can walk unaided for short distances. Out in the real world though, I generally use the crutch, but as little as possible in terms of weight bearing.

But for the past two weeks, in spite of doing my therapeutic exercises with a near religious monomania, for the second week in a row, I couldn’t bend my leg beyond 100 degrees. You need to be able to bend it about 110- to about 120-degrees to spin on a bike. Based on others’ experiences with recovering from a quadriceps tendon rupture, most people don’t get beyond 100 degrees until they are into their third month of recovery – I’ve just begun mine, so I guess I shouldn’t be pissing and moaning.

But still.

I have dreams about running and riding my bike. And it’s like well … it’s like dreaming about sex. It’s so intense and so real and so amazing and then, well, then I wake up. And I look at my leg and think, unlike a sex dream, I can’t do anything about this except be patient.

Once more: Sucks, this.

Strutting: as much as one can with a quadriceps tendon rupture and a crutch

On the plus side, I can actually walk around when I run errands nearby, instead of having to take taxis three blocks. The xe-om drivers cry out “Motorbike you?! Motorbike you?!” But I shake my head and say “không cảm ơn” and strut on by – as much as a guy with a crutch and a mild limp can strut. Even in this manner it still feels good to walk. Sometimes I over do it and by the end of the day my leg is more swollen and sore than perhaps it should be, but to hell with it.

I’m walking, so take that, Universe. Put that in your metaphorical pipe and suck on it.

And further to the plus side, I was walking home early this evening through a nearby park here in Ho Chi Minh City, née Sai Gon, when someone approached me and struck up a conversation. I was a little leery and guarded at first, as I live on the edge of the backpacker ghetto, and for every time a nice Vietnamese person who just wants to be sociable and practice a bit of English, there is someone on the make looking to earn a quick buck one way or another.

For example, the first time I walked through the park after my surgery, about two weeks or so after, I was still in the big-blue straight-leg brace, using both crutches, and my knee was still watermelon-sized and discolored. Sure enough, a young lady came up and launched into the “Handsome man where you go?” routine. “You wan’ massa? Boom boom?”

I sighed, looked down at my leg, looked back at her and smiled sardonically. “Do I look like I’m in any condition for boom boom?”

To which she replied, without missing a beat, “It no problem. I get on top, ride like cow girl! I go wit you?”

Sigh. “Không cảm ơn.” That means “no thank you,” in case you hadn’t sussed that out by now.

Anyway, fortunately for me, tonight, this young man fell into the latter category – just curious, friendly and wanting to talk English. Once we got past the usual banter – “Where are you from? What happened/what did you do to your leg? Are you are on holiday?” questions, we had a nice talk as I walked home.

The conversation ranged from football (what the rest of the world calls football, and us Yanks call soccer, that is) – he was surprised a Yank knew anything about football, I think – to Thai culture vs. Vietnamese culture. He agreed that yes, if the American national team would play a more European/Central-South American style of football, we could probably win a World Cup. When I suggested we needed a British or European coach, he countered with a Brazilian or Mexican coach, to which I readily agreed that this would be as good if not better.

Before the football conversation started though, when he asked me how long I had lived in Viet Nam I had to explain that it was only four months this time, but that I had lived here before, both in HCMC and an hour north in sticks up in Bien Hoa (and I’m too lazy to conjure up the diacritical marks, so we’re doing to have to do without tonight)  with six months spent teaching in Thailand in between. I noted that I liked living in Thailand well enough, but that when it came to teaching English, I preferred Viet Nam for several reasons. He didn’t seem surprised by this and offered up the observation that Vietnamese were more friendly and open to foreign people than Thais, generally, with which I readily agreed.

But then he admitted the only place he had been to in Thailand was Pattaya. Then he said “Vietnam, we don’t have any place like Pattaya here.” I instantly thought “You’ve obviously never been to Vung Tau, young man,” but I kept my mouth shut. But then he added: “But Thai culture is much more open to that and accepting. Vietnam, it is too conservative for anything like that.” I agreed with that, as I think it is generally true – Vung Tau not withstanding.

But after we discussed Thai culture and football, we came to the point where we were headed separate ways; we exchanged names and I told him to keep an eye out for me in the park, as I often walk home that way – it’s a bit out of the way for me sometimes, depending on where I’m coming from, but if I’m coming from the backpacker ghetto, it’s the best way to avoid the touts, xe-om drivers and working girls on Pham Ngu Lao street.

This sort of thing happens all the time here in Sai Gon; it happened to a lesser extent up in Bien Hoa, where foreigners are still exceptionally rare and exotic.

Doogie Howser, making a thoughtful post on his electronic journal, long before the term blog would enter the popular lexicon.So yeah, that was a nice little counterbalance to lift my spirits after my therapy appointment this afternoon. Okay, I’m going to get all Doogie Howser here.

I guess in the larger scheme of things I don’t have much to complain about. I’m chasing dreams, living abroad in an exotic locale, and other than my Franken knee and teeth that are long over due for a trip to the dentist, I have my health. And my leg will eventually recover (I’m told) and I’ll get around to going to the dentist one of these days. So life is good.

And tomorrow when I feel like bitching about my leg maybe I’ll come back and read this post again.

It Sucks! It Sucks! It Sucks!

Beavis (of Beavis and Butthead) says a quadriceps tendon tear sucks. I do concur. So I was thinking that since the previous post didn’t mention the Q word, that maybe it was time to see if I could turn that one-time non-occurrence plural; a streak of non-occurrences, as it were. But it is not to be, I’m afraid I’m going to have to mention and consequently expound upon my SEO-friendly quadriceps tendon tear.

That would be my torn quadriceps tendon. My ruptured quadriceps tendon, in other words, or quadriceps tendon rupture, if you prefer. There, I think that about covers it. For the rest of the post, I’m just going to say “my leg,” assuming that you understand that I’m referring to my screwed up leg, and not the healthy one (the one that’s tired of picking up the other’s slack).

But I’d be kidding myself if I said my life doesn’t revolve – sometimes literally – around my leg. Previously I’ve mentioned how it seems like for every bit of progress I make – the two-steps forward cliché – I subsequently take one step backward. The past few days have been no different.

Tuesday I was at my physical therapy appointment, and for the first time since I tore shit up in my thigh, I was able to bend my leg beyond 90 degrees – still not enough to complete a revolution on the stationary bike, even with the seat as high as possible, but getting close. I had been stuck at 90 degrees for a few weeks, so I was pretty excited about this. I can’t help but think that the speed of my recovery will increase significantly if I can just start spinning on the bike.

Then I was teaching a class on Wednesday evening – my one class, that meets three times a week. Things were going fine, orthopedic-wise; there was no more discomfort than usual. Then, near the end of class, the students were in small groups playing a board game – we were practicing with gerunds and infinitives, don’t you know – and I was wandering around monitoring, answering questions here and there. At one point I tripped over someone – just a small stumble, as someone decided that was an opportune time to stretch out her legs. I instinctively switched most of my weight to my good leg and my Tiny Tim crutch and jerked my leg up, bending it just a wee bit farther than it was ready to bend.

Looking back, the phrase “hurts like a motherfucker” comes to mind; I think that adequately conveys how it felt. Of course in the brief moments that I stood there stone still, sucking down the pain, I was thinking the blackest of thoughts terrible thoughts: I’ve torn out the sutures and subsequently re-torn my quadriceps tendon. Moments later I stood there bending my leg, flexing the quad muscle, etc., as the pain ebbed thereby proving this was not in fact the case and putting my addled, panicky brain at ease. At worse, some micro-tears and the attendant swelling and soreness the next day.

In retrospect, I was being silly, although I suppose given the circumstances I can forgive myself the momentary freak out. But I’ve been through this before, and probably will again, more than once, before I regain a full range of motion. And Dr. Phat himself noted that the rupture itself is healed, and short of some extreme accident – like stepping off a bus, sigh – that reinjury is extremely unlikely.

But these comforting thoughts were not enough to keep me from having a long night; the leg was achy and sore enough that an epic-length sleep became a series of short napping vignettes. This in turn made me crabby and somewhat depressed today; when my therapist looked at my leg and said “Whyyyyyy?” – well, that didn’t help.

On the plus side, I bent my leg to 105 degrees today. Fifteen more degrees and I’ll be spinning on the stationary bike. Another week? Two? As the immortal Butthead was wont to say. “It sucks. It Sucks. It SUCKS! IT SUCKS!”

It’s My Quadriceps Tendon Rupture and I’ll Cry If I Want To

On the plus side, if this situation can be said to have one – and really, it most emphatically DOES NOT – it’s given me an excuse to spend time doing one of the things I do best: goofing off in coffee shops and cafés while reading and writing. Of course I would generally be doing this anyway, but with my screwed up leg, I’ve been able to do it even longer and more often.

So there’s no silver lining to this experience that I can see, but I suppose we’ll call it – oh, I don’t know, maybe a bronze lining. No, not even than – a copper lining, or perhaps a cheap, impure grade of aluminum lining.

I think I will note here now that while I’ve kept this ruptured quadriceps tendon journal throughout the past two months, I’ve only just now published all the entries here on this blog, backdating them appropriately. I hadn’t planned to do so, originally, but at the time, back on Christmas Eve, I didn’t get a chance to post that original entry before it was time to prepare to go under Dr. Phat’s knife. Then, later on, I decided I wanted to keep the journal offline for awhile.

Writing “close to the moment,” as a creative writing instructor back in college termed it, can be labored and consequently problematic. So I decided to give myself the option of editing it after the fact, should it get a little to heavy handed. But to be quite honest, other than the inevitable copy editing and cutting out some of the more overly-repetitious ‘graphs here and there, I haven’t changed anything. And it is, therefore, a bit belabored and overbearing at times, but then life has been laborious and overbearing lo these past two months, so there you go.

Does that make it warranted? Perhaps it does; perhaps not. But then it’s my blog, and I’ll cry and bitch and moan if I want to.

You would cry too if it happened to you.

Enduring the Mood Swings of a Quadriceps Tendon Tear Recovery

6 weeks after surgery to repair my quadriceps tendon rupture -- look at me, I can bend my leg!So if you’ve read all the previous posts under this quadriceps tendon tear tag, then you know that it has been an emotional roller-coaster ride; it seems that from both a physical and psychological perspective my recovery involves a series of steps forward in conjunction with half as many steps back.

This past week has been no different.

A week ago, on January 31, I took the first unaided steps I’d taken since the early afternoon of December 23, more than five weeks previous. Granted they were small steps, and they were only a few, and they were taken while walking between parallel bars in the physical therapy room of my local hospital – my hands hovering warily just an inch or two above the bars — but they were steps taken with nothing but my own two feet and legs. No crutches, no assistance from the therapist – or from said parallel bars, for that matter – just me, myself and I.

I was euphoric, to say the least. I wanted to scream; I wanted to shout. I wanted – alas – to jump up and down.

On top of this wonderful landmark accomplishment — in addition to this astounding physical feat, these four small steps for a man, this giant leap for ruptured-quadriceps-tendon kind – my therapist decided that it was time for me to kiss the straight-leg brace goodbye, as well as one of my Tiny Tim crutches. This was an entire week ahead of schedule, mind you; my orthopedic surgeon, Dr. Phat, originally had told me that I would inhabit the brace for six weeks.

I was a little scared, venturing forth on just one crutch with no brace to protect my misshapen leg, but nevertheless ecstatic. It felt so good to walk – not limp, but walk, bending my leg – even with the aid of a crutch. And it wasn’t – and still isn’t – a normal gait; while I do bend my knee when I take a step forward with my right leg, as I put weight on it and begin to step with my left leg I have to lock my right leg, consciously flexing my quadricep muscle. Furthermore, my quadriceps muscle is so weak, I can’t actually lock my leg – not completely, anyway.

But Mistress Lien, as I like to refer to my tiny little therapist, drills it into my head – lock your leg, lock your leg, lock your leg – ad nauseum, ad infinitum. It’s difficult to do, aside from my weak-ass quad. Being an erstwhile gym rat, it’s instinctive to not lock my knee; locking the knee = bad, in my mind – hyperextension, effed-up ligaments, etc.
But as my therapist has explained, locking the knee of my bad leg makes it more stable when I walk, keeping it from buckling, and consequently giving the quadriceps muscle much-needed use. Meanwhile, Dr. Phat has assured me that at this stage, the tendon has healed and the odds of re-injury are nil (provided I don’t run out and do something dumb – not that I can actually run). What’s important now is strengthening my leg muscles, namely the quad, and gradually getting that tendon back to a full-range of motion.

Lets Do Something Dumb to Celebrate

6 weeks after surgery to repair my quadriceps tendon rupture.So yeah, last week I was metaphorically jumping for joy, if not literally. I decided to celebrate by increasing my working hours. I went from teaching three classes a week to eight, and by the end of the week, I was paying for it several times over with pain and swelling. As the pain and swelling increased, my happy-happy-joy-joy decreased, to the point that by Sunday night after class I was depressed and angry.

Again.

When I showed up for my therapy appointment on Monday my therapist took one look at me knee and said something in Vietnamese that I’m sure would translate into English as “What the fuck!?” After talking things over with her and Dr. Phat, we all came to the obvious conclusion that eight classes was too much, and that I need to step back.

But then Dr. Phat noted that he was still amazed that I was able to teach three classes a week, just three weeks after surgery, without ill effects. I should probably clarify “without ill effects.” By the end of a class my knee would be swollen (above and beyond the usual) and sore, but I always recovered by the morning of the next day; things would be back to normal – the new gimpy, misshapen normal, that is. Not so after teaching two classes, however.

So now I’m back to teaching three classes this week, and next week I’ll bump it up to four. If that goes well, the week after that, I’ll try five, and so on.

6 weeks after surgery to repair my quadriceps tendon rupture -- nope, still no bilateral symmetry.According to the research I’ve done online, I shouldn’t be complaining; it seems many who suffer a quadriceps tendon tear take months before they return to work, even those with desk jobs. Still, I find it difficult to take solace in such facts. As I’ve noted here several times before, I constantly tell myself that I should be happy at this point that my disability isn’t permanent; almost everyday I see people on the streets of Sai Gon who can’t say the same.

But none of this changes the fact that I’m sick of this, sick of all of it. Sick of not being able bodied, sick of everything taking three times as long and being three times as difficult, sick of being treated by able-bodied people as … well, we’ll save that for another entry. I’ve already touched upon this topic, but recent events require their own entry, methinks.

Wallowing in Despair: Did I Tear My Quadriceps Tendon or My Mind?

I howl with rage and despair, just like this dog. Despair_by_FluffleNeCharkaI fear this post will be a variation on a familiar theme, if not outright repetitious; consider yourself warned.

Some days I think the mental toll of my injury is far worse than the physical. Little things that ordinarily wouldn’t trouble me, emotionally – you know, those days when things don’t seem to go your way – do trouble me when coupled with my infirmity.

Little things like the one ATM near my apartment being out of order. Little things like the fact that the hot plate I bought is actually an induction cooker, and will only work with special cookware, rendering useless the pot and pan I already own. Little things like sweeping the two main rooms of my apartment – because it takes a half hour instead of 5 minutes. Little things like the fact that ants got into my crackers, despite the fact that they were still in the original packaging. Little things like the fact that I’m supposed to be on a trip in Northern Thailand right now, since I have a week off from school for Tet. the Vietnamese celebration of the lunar new year – instead I’m stuck in a two-thirds empty Sai Gon with a busted leg.

Okay, that last one is perhaps not a small thing. But all these things by themselves would ordinarily be no big deal – at least not cause for a depressive episode. But combine them with the functional loss of your right leg for the near future, and a bad day becomes a black day. Add up several black days in a week and combine that with a diagnosed predilection for depression and you go to a pretty dark place sometimes. Well, I have, at any rate.

Fortunately or unfortunately, stubbornness prevents me from doing any of the things I find myself contemplating in dusty, little-used recesses of my mind in these dark moments. As I’ve noted in an earlier post, that would feel too much like capitulation – like letting a bastard Universe – God(s)? Karma? Fate? – asshole that is is, whatever it is – win. I’m much too angry these days for that. I refuse to yield.

Bless my Scottish ancestry.

As for physical recovery from my quadriceps tendon tear, I can bend my leg about 40 degrees now. And there was much rejoicing.