esiwkcolcretnuoc

Hey, punks. !emit ni sdrawkcab og s'teL

I missed Wednesday's sessions because Monday night I decided getting sick would be a great idea. Boo to that. I'm better now (I think), so hopefully it's game on again tomorrow. Doing nothing and wasting time are indeed my areas of expertise, but such activities are quite poor rehabilitation.

Pre-sick, Monday = grand! Well, okay, some parts were, at least. The evening saw a visit from the Grand Master K (no, not Käpt'n K), a pal from school, who made the inconveniently-not-as-the-crow-flies trek around the lake from the Cleveland area to hang out for a few hours... I believe "rocktastic" would be an appropriate word to describe such a character. He even schooled the streets of downtown Detroit at 11p. eeks.

Continuing anti-chronologically, Monday aft's OT was typical pick up/move around/reach/stack with various objects and locations. It's hard to describe this stuff in a sufficiently exciting manner... They seem like humdrum everyday activities, but that's the idea; further, we're working tenodesis, range of motion, gross and fine motor skills, strength against gravity/with weights, posture, and patience(!), all at once. Anyway, look at it however you wish - I heart.

Before OT, I had a kidney ultrasound. No need to hide your extreme jealousy.

Then Monday morn's PT was also mostly standard procedure. I wheeled around in yet another manual, this time a major low rider. Gratuitous photo:



This one wasn't too bad though, minus the kindergarten-chair-knees effect. As you can see, we wrapped stretchy Thera-Band tubing around the rims to help out with grip - not necessarily the best solution, but effective enough that I squeezed in two laps in the allotted time, twice as far (but still equally as pathetic) as in the two chairs I've tried with completely unmodified rims.

Moving backwards again, Friday was a slight change of pace, as I was paired up with a different therapist for the afternoon. Yes, still Giger and arm e-stim bike, as has become the new usual, but in between was a mix of sitting balance and boxing-style arm exercises. Time to start punching people out. Be afraid! I could smudge your mascara or something.

Other randomness:

--Monday: first time I've ever operated an iPod
--Coincidentally, I saw the real Käpt'n K and friends in Cleveland
--Finally got some stickers (and openSUSE 11.0 64-bit) on the lapster
--A linked list is surprisingly efficient when recursively reversing characters in a string of unpredictable length (thoughts?)
--Blueberries.

No mas para ahora! BTW, I'm sorry I am having trouble keeping up with replying to everyone's comments, but I really appreciate your support, hellos, stories, questions, contributions, and even the occasional mockery... Readers are what elevate this from a diary to a blog, after all, and without any responses, it's really just a lecture. So, hardcore thanks for the interaction, because I'm listening.

TTFN, Tigger might say. Joyeux vendredi à tout le monde.

fat half recap

Hey all! It's been a while, no? Here they come.

First of all, massive congratulations to Jonathan Roche on completing last Sunday's Ironman triathlon! Wow. That's a lot of miles of self-propulsion.

Next, thanks to everyone for contributing to Mr. Roche's efforts, and therefore mine, in whatever way possible - I'm secretly a real softie, and reading so many notes saying that you've been thinking of me (and Jonathan, too!) the past few days is and has been extremely touching. BTW, it's still ok to send a donation to Jonathan until mid-August; check out his site or one of my last few posts for the address/method. You're not too late ;-) Again, both your contributions and thoughts are so incredibly appreciated. Try as I might, I don't think I can say that enough...

On to the therapy updates.

OT has been grand. Lots of picking up and moving, of course. My Fri session was moved to Thurs. We played Scrabble for almost 2h. It was beautiful. Then Monday saw some stacking of washers and such, as well as folding towels to work on two-handed coordination. As it turns out, I still can't do laundry. Today (rather than Friday) I went for about 2h again, picking up blocks, putting together a disaster of a pipe-and-joint sculpture, playing some speed Scrabble, and wrapping up with some back/shoulder e-stim.

Since the last update, there have been all sorts of the usual Giger, e-stim bike, weights, and sitting balance in PT. Some changes have been coming around, though. This week I have started spending the "lunch hour", 12p-1p, at rehab on normal therapy days (Mon/Wed/Fri), extending sessions unofficially to four hours at a time. During this extra hour, which comes after my "official" time on Mondays and before such on Wednesdays and Fridays, I can go in and use the e-stim bike semi-unattended if one is free. This is a fairly popular thing to do, as it means patients can do other therapeutic stuff during official session time without missing the benefits of the zap bike.

So what am I doing instead?

Ironically, I do the e-stim bike. Starting last Friday, to be accurate, I've been working on an upper extremity FES cycle, exercising my arms, shoulders, and back muscles. The idea is the same as the leg e-stim bike - synchronized muscular stimulation to pedal a cycle - but this time with arms instead of legs. Many muscles may be stimulated, from forearm/wrist to upper arm to shoulder to back areas; so far, I've been doing biceps (elbow benders), triceps (elbow straighteners), and traps (trapezius: muscles that go from the neck through the shoulders to the back, moving a lot of stuff). While the leg bike runs a full warm up/exercise/cool down in a little over 1h, the upper extremity cycle goes through a complete workout sequence in around 30min (which, trust me, is plenty).

For me, it's definitely a hardcore neck/shoulder task. On one end, the traps are mostly in charge of holding my head up, which is a fair load of work on its own, as they are weak and I have an enormous melon. But then they are also being zapped into submission and expected to help out in the cycling process! eek.

However similar the two may be, though, the uppers cycle is much different from the leg bike. To be honest, the leg bike is a fairly passive exercise; fire it up and then play Wii or something, not exactly putting in a lot of effort because I can't move those muscles on my own. But not so with the arm cycle. Instead, here I'm expected to pedal like crazy to maintain a pretty fast pace, and the electrical stimulation kicks in to keep me from slowing down too much. That is, the leg bike does all the work, but I actively do the work on the arm bike. It's doable, but by the end of the sequence (if I haven't lapsed into "passive" yet) I'm getting shocked at full blast and still not quite keeping up to speed.

Overall, it's pretty much awesome. Sure, it tears my shoulders/back to painmed-justifying shreds. It works my biceps super solid, though - I do basically no stimulation power to them because I have good sensation there, so shocking hurts - and I think the stimulation to the triceps is very important to regaining their strength and control. So in summary, simultaneous ouches and yays I suppose.

Ugh! There are still a few more points to cover, but I'm spent for now. Feel free to go back to doing something useful, and I'll distract you again soon.

man of iron

Hey! Follow Jonathan Roche as he swims, bikes, and runs around Lake Placid:

http://ironman.com

You may need to click around a bit to find exactly what you're looking for, but it's worth it.

Nighty nighty.

posty

Hey hey, friendlitons! Just a quick one.

Friday and Monday, physical therapy = mostly the usual. I got to humiliate myself with another manual chair for part of the Fri session. It was essentially an average, everyday chair - a bit larger front to back to accommodate my 3.2-mile-long femurs, but no mods to help with grip - so, umm, not so easy to use. I wheeled a little less than 150 meters in the hour I spent in it, down from 200m in the flat-rim chair. Afterwards I was also quite more sore than after the other chair... Sob sob.

Occupational therapy was lots more grip practice with both hands, all the while sporting some wrist weights. We may have shown in PT that my right arm is at least a little bit stronger than the left, but entirely not so with dexterity (if you can call it that); ole righty just isn't so nimble yet. But, avoiding it will definitely not effect improvement. Monday I also worked on upward reach, moving things around - OT Christmas ornaments? ;-) - between high and low horizontal bars.

That's about the size of it. Again, this weekend is the Ironman Triathlon over at Lake Placid, and Jonathan Roche is participating, graciously raising funds to help support my family and my continuation of such effective rehabilitation. Please please consider helping out if you can; just send a check made out to "John Link Benefit Fund" to:

Breakthrough Health & Fitness, Inc.
370 Interlocken Blvd., Suite 400
Broomfield, CO 80021

(Make sure to include your full name and address!)

I appreciate your support so incredibly much. Keep an eye out on the 20th for Mr. Roche! Just amazing. :-)

a real boy!

Ha ha! Sorry about completely vanishing, especially at such a key time. The Google Bots declared this a spam blog and barred me from posting until the Google Humans reviewed it. I guess I write like a v1@gra e-mail author... oops. So again, I apologize. Thanks for coming by, whether I'm here or not.

clips

Hey hey, hep cats. It's back to the city of motors, with tales for all to enjoy/be bored of/skip! Let's dig in.

As you may have picked up by now, I was down in Carlinville for the past week or so, having a raucous time meeting with case managers, getting a haircut, and going to the dentist. We did have some fun - happy 60th anniversary to the Grandparents Link! - but I missed out on Fourth-o-July festivities because I am an infection machine. I did have the opportunity to squeeze in a round of writing splint guitar before the week was over.

Yesterday's physical therapy was Giger-->FES bike-->weights downstairs, working on triceps and the variety of muscles used in rowing during the lifting portion. My triceps, though not functionally useful, appear to be a bit stronger every time :-) We also finished watching Miracle, and I talked to Jonathan Roche and the FlyLady while on the Giger.

Occupational therapy today = picking up various items and moving them to various places within my range of motion. I was a little late and more than a little sore from all the time in the car, so I felt even less productive than usual. There is some major envy of some people, such as a portion of the OT crew, who got to go to Rothbury... *due for my next Primus fix*

As I mentioned, I'm hurting a bit from the drive back and forth. It's anywhere between 9-12h to travel from Point A to Point B. To prevent major repetitive friction issues, I ride this long haul with a small ROHO cushion behind my lower back. However, such eliminates any lateral support from the chair's back rest; thus, I must brace myself with my elbows on the arm rests to keep from falling sideways. Doing so wears pretty hard on my neck, shoulders, and upper back - "coat-hanger" pain, for the shape of the affected regions. It was ouch enough that I had to take some pain meds before therapy, which I feel bad doing (although I really don't have a good reason why). If it counts for anything, though, it was only the children's Tylenol of prescription painkillers... Oh well! Whine whine.

Not much else worthwhile to say. Again soon it shall be. Peace yourselves out.

wow

Whatup, friends old and new! Beware: this post is sort of serious.

Allow me to explode with appreciation for - okay, pretty much everyone. Specifically, though, I would like to highlight two people I talked to today, whom you very likely already know.

Jonathan Roche is a personal trainer, double-digit marathon and triathlon competitor, and motivator extraordinaire. He spearheads many projects, such as the Momentum Fitness system and the No Excuses! workout (and more), focusing on helping normal people exercise and improve health without having to rewrite their entire lives. Inspiration level: astronomical. Check out Momentum Fitness/No Excuses, his radio show, and his Yahoo! group.

Next, one quite famously known as "The FlyLady" is another incredible motivator, with emphasis on simple accomplishments and easy daily routines that help people reclaim their lives starting on the home front, again without requiring commitment to unrealistic lifestyle changes. She’s a lifesaver and cheerleader offering free online help, centering on perfectionism, procrastination, and the accompanying guilt. Inspiration level: from 1 to 10, a 37.2. Check out her online resources.

Today my mom and I (mostly mom, as I was on the Giger) had the privilege of talking to this awesome pair on Mr. Roche's radio show on BlogTalkRadio (listen here). We discussed quite a bit of stuff, from my injury to surgery to college to rehab to what may lie in my future. Mr. Roche is swimming+biking+running in the grueling Ironman Triathlon on 20 July 2008, at the end of next week. He is generously donating funds raised from this event to my family to cover medical expenses and my continued rehabilitation. Wow.

You can help contribute, too, by pledging support to Jonathan - simply send a check made out
to "John Link Benefit Fund" to:

Breakthrough Health & Fitness, Inc.
370 Interlocken Blvd., Suite 400
Broomfield, CO 80021

Please include your full name and address. Understatement: your support is very much appreciated.

Let me point out that such people, including you, oh reader, amaze me. To barely know me, yet support so enthusiastically, is unbelievable... I don't want to lapse into too much Brie and Camembert here, but when it so often gets difficult just to keep plugging along, people like this (and you) reveal themselves.

Cheese aside, thanks. l8r.

repostfest

eek!

To start, you might notice that I reposted all the old stuff from CaringBridge to this site. Everything in May 2008 is a relic from those days. I recommend reading those entries if you have a minute, even if you rocked and kept up with them from the beginning... If you haven't gone through them yet, they contain quite a bit of useful info about me, surgery, and the start of rehab; if you had already glanced over them on the 'bridge, I changed/updated enough when re-posting that it's worth another perusal. Either way, I would greatly appreciate your comments on those entries so I can fill in missing info and start writing better overall.

Moving on, last week's therapy sessions weren't much to write home about - same PT capers as usual, plus stuff in OT that really doesn't seem to excite anyone but me... Lots of faux nerf equipment.

Speaking of home, that's where I've been for a few days and will be for a few more. It's nice to have a little break (and kitties and a subwoofer and constant secure internet), but rehabilitation is what I'm living for, so home is Detroit now. Oh well.

I thought I was going to write something interesting, but now I'm out of time :-( oops. Again soon it shall be. Continue to rock.

trabajando con manuel

Whatup! To start, I'm headed home for about a week as of tomorrow (Wed) - drop me a message/comment/call/whatever if you will also be in the area, and we can organize some rendezvous action.

Moving on, here come a few mildly interesting points, like needles in a mudaneity haystack.

First, I started occupational therapy last Wednesday! This stuff focuses more on hand/wrist stuff and other fine motor skills as applied real world style. Sessions are MWF afternoons. So far, it's just been evaluation and some experimentation to figure out what to work on. Meetings are only about 45min! After spending 3h at a time up in PT, these sessions barely show up on the temporal radar.

Coolest thing we've done so far: submerged e-stim. Get FES e-stim equipment and a bucket. Fill bucket with water. Stick one electrode in water. Attach other electrode to forearm. Place hand in water. Turn on electricity. Watch magic.


Upstairs at PT, Wednesday was typical Giger-->weights-->FES bike. Woohoo. Friday was out of order; first was Giger, then a cut ahead to the zapcycle for circa 1h15min. Then...



I got to try out a manual chair with special grips to compensate for my lack of, umm, grip. Let me describe poorly. A typical manual chair essentially just has a smaller wheel attached to each of the large back wheels; to move, the user grabs and pushes forward or backward as necessary. You already knew that.

This chair instead had wider, flat, semi-sticky rims in place of the "smaller wheels". Then the idea is that the user may place the palms on the flat rim part, thumbs forward, and use the friction to push around. This eliminates the need for significant dexterity - where a tight grasp is necessary (or at least a huge advantage) in an average Joe chair, fingers aren't used with these flat rims. Gloves with sticky palms further improve the effect. So, someone with shoulder/arm/back muscles but no hand control may implement such a chair to move manually.

I try to be one of those people. I made two laps around the track, extremely slowly and with quite a bit of assistance, for a total of around 200 meters. Pretty pathetic, huh. I'm a wimp. To give myself a tiny bit of credit, though, the grip gloves I was using did not even remotely fit (must acquit!); also, as is evident in the picture, I am enormous and ordinary manual chairs are designed for munchkins. Oh well. BTW, the chest/shoulder wrap is obviously a fashion statement.

This implementation of manual chair propulsion for those with minimal dexterity is relatively common - I had seen chairs with similar flat rims in my time at the RISL. A less common style, which I had assumed to exist but not seen until coming to Detroit, is to have pegs (projections!) coming out of the otherwise-unmodified "smaller wheel" type of grips. I always think of these as being like the wheel at the helm of a pirate ship... Imagine as you wish. With such rims, the user may push the palms or thumbs against these pegs for propulsion. These are what I was and still am hoping for, but no appropriately-equipped chairs are readily available here. According to basic physics, these make more sense than the flat+sticky kind: all of the user's energy is directed tangent to the wheel - the direction that actually causes rotation, and therefore motion - rather than expending some energy non-tangentially to create enough friction to rotate the wheels. Since I'm such a pathetic weakling, I don't really have enough strength to direct some away from movement and still expect to go anywhere. We'll see how it goes, matey.

Pack pack pack. Thanks for checking in. Palabra.