Monday, March 1, 2021

Sticks and Wheels

The ever-cheerful and quietly but persistently diligent Takaoka-san deserves some sort of medal. The house-call physical therapist has to put up with my tendency to underestimate risk and overestimate my ability, trying to prevent me from causing a self-inflicted catastrophe--this would not be a good time to break a leg again, for example--while at the same time encouraging me to progress in my rehab. He would clearly prefer to take things steadily and in small, safe increments. I, on the other hand, have a definite "I want it all, and I want it now!" attitude much of the time, despite my efforts to leaven my enthusiasm with a little sensible caution. Moderation has never really been my strong suit, though.

This morning he brought along the pair of Lofstrand crutches that I've been using at the rehab center lately. He stopped by there on the way to my place to pick them up, with the aim of assessing and improving my skill at walking with them in the less-forgiving and more straitened home environment. The idea was to see how well I could navigate narrow spaces and movement impediments while performing everyday functions in the various rooms of the house, and to provide me with pointers on how to move more smoothly and safely. That worked very well. So well, in fact, that it seemed to me that the area of operation could be expanded a bit, and the functions increased.

After he'd gone to the trouble of picking up the crutches, it seemed to me that we might as well see how well I could use them to get around the yard's very uneven surfaces, moving along over loose gravel, tree roots, branches, and the like. That was apparently activity that Takaoka-san had tentatively scheduled for a near-future date, as was the experiment of entering the car with the crutches for the first time, and the subsequent eventually successful but briefly too exciting entry to my genkan.

Since we were so close to the condo next door, it then seemed like a good idea to me to determine whether I was up to climbing their difficult stairs using the Lofstrand sticks. I did manage it, but I'm afraid that it was pretty stressful for the long-suffering PT. He'd planned that practice for still further in the future (and rightly so, to be honest: I'm not up to doing that smoothly, yet, and it was a bit foolhardy of me to try it, despite being successful). He's very good about gently discouraging me from doing really unwise things, and very gamely supports my efforts to push things just a bit more every week.

I was glad to see that he was obviously genuinely pleased to learn that I had passed my senior driver's assessment yesterday. It was concrete evidence of the result of his hard work--and that of the other therapists and helpers in the rehab center--in helping me deal with a serious lifestyle hurdle.

He and his colleagues are sure to be pleased when they learn that this afternoon I was successful in getting my driver's license renewed; that's one of the major goals we'd been working toward, and that it went well is a tribute to their diligence and skill. 

There's a certain hint of the surreal in being able to drive somewhat more capably than I can walk, but getting along fairly smoothly both on the Lofstrand crutch sticks and on the car's wheels is improved mobility on two fronts, and a definite improvement over the wheelchair. I'm looking forward to the expression on the PTs' faces when I point out--innocently, in passing--that the new license still includes the motorcycle permission.

Sunday, February 28, 2021

Hurdle Cleared

Today I attended the mandatory senior drivers' training course, which includes a vision test, lecture on new traffic regulations, and a brief practical driving test.  The course is provided by local driving schools at the behest of the prefectural safety commission and the National Police Agency that oversees them. Mine was done at the Saitama Motor Driving School not far from the riverbank and the station. After considerable concern over whether I would be assessed as capable of driving, and thus qualifying for the upcoming renewal of my driver's license, I am very pleased that I passed the test handily, and can now go over to the local police headquarters and get my license renewed for a few more years. 

Since I've been driving several times each week with no problems, including going back and forth to the rehab center and various shopping trips, I wasn't worried about my driving not making the grade. In a culture where appearances are important, though, I was slightly anxious about the response that I would get from the driving test staff when they found that I need a walker to get to the driver's seat. In effect, they were having to pass on the safe driving ability, in an unmodified car, of a guy who cannot walk properly. 

To their credit, all of the staff were very gracious and professional, arranging for me to sit near the door and minimizing the distances I had to walk. The actual testers very matter-of-factly asked "Can you drive?", and when I assured them that I can, they went out of their way to accommodate me, folding up and storing the walker, hovering nearby if they thought I might need balance assistance, and the like.

The entire operation went very smoothly, and I now intend to head over to the main police station to get my license renewed, maybe as soon as tomorrow, the first day of the renewal period, which is a month on either side of my upcoming birthday.

I'm very happy to have overcome that small but important senior driving assessment hurdle.

Thursday, January 21, 2021

Two Years Along the Road

Two years ago today I broke my leg, which turned out to be a mixed blessing initiating a chain of events long and challenging, sometimes strange but often educational, and even occasionally surprisingly pleasant.  I've gone from essentially bed-ridden and largely incapable, to significantly more mobile and surprisingly functional.
A year ago today I was, as I am today, writing a blog post in the day care center where I do my rehabilitation work. I described myself then as “sanguine about my chances for eventually being able once more to walk, and drive, and cook, and even return to my desk at the office”. It turns out that I was right to be (cautiously) optimistic.
The doctor who officially assessed my handicap level just prior to my release from the hospital told me to prepare mentally and emotionally, and resign myself to the likelihood of being wheelchair-bound for the rest of my life.  He appears to have been somewhat too pessimistic: I have returned the rental wheelchair upon which I relied for over a year. 
I am now, using a walker, walking smoothly and with relatively little effort. Completely hands-free walking is still limited to only a few steps, and I still have some balance and fine motor control issues, but walking with one hand on a railing or nearby stable surface for support is getting easier and easier for more and more steps each day. Stair climbing practice proceeds apace, and it seems that I can realistically expect to be walking with a cane in the relatively near future. Beyond that it’s a tougher call, but I’m relatively pleased with my progress on the walking front.
With my driver’s license renewal coming up, and the new requirement for a senior driver ability assessment in the offing, I was somewhat concerned. Thanks to Takaoka-san, my house-call physical therapist, and to the endlessly patient, cheerful, inventive, and professional crew of therapists and other staff at the day care/rehab center, I’m now able to get into and out of my car, and drive and park it pretty much anywhere that I want to. I’m quite confident about passing any driving tests that may be imposed, as long as the authorities don’t have a problem with me getting up to the driver’s seat using a walker.
Cooking and related tasks have become feasible, and I’ll be doing more as the time increases during which I can stay standing up and balanced while using both hands for the fetching, chopping, stirring, or whatever. Cooking has moved from the “can I?” to a “how smoothly can I?” area.
As for my paying jobs, I continue to work from home on one or another computer, having gotten a head start on the COVID-19-driven teleworking campaign with my hospitalization around a year before the novel coronavirus became an issue. Using either a portable WiFi router when at rehab or my home internet provider when in the house, I have relatively little trouble with the job, and probably became acclimated to large-scale teleworking much sooner than my colleagues, who have been forced into at least partial teleworking more recently. By the time that COVID-19 is no longer serious enough to demand teleworking and other anti-infection measures, I may actually be physically recovered enough to return to a physical presence in the office. We’ll see whether or when that takes place.
The world has changed considerably in the last two years, particularly in the last year, and so have I. Restrictions on activities imposed by the pandemic have affected me personally less than they have most of my friends and relatives, because my movement and activity had already been severely constrained by the vagaries of my nervous system and musculature. It now seems much more realistic to look forward to actually visiting restaurants and bars and other places that I had erstwhile been wont to frequent. 
I have reasonable hope that restrictions on operation—whether those of shops or of my own body--will be lifted before too very much longer. I’m not letting up on my rehab efforts, and a full—or at least sufficient—recovery will, I know, take as long as it will take. I’m hoping that’s less than another two years, or even another year, but I intend to keep up the pace, and maybe even increase it a bit.
I can get down the road by driving now, but that doesn’t mean that I won’t be walking, too.

Friday, January 1, 2021

Diligent, Dogged, Determined

I wish all of you a very happy, healthy, exciting, and prosperous Year of the Ox!

In the Oriental zodiac, the Ox is the second animal, after the Rat and preceding the Tiger in the race to visit the Jade Emperor. One version of the story goes that the Ox, not the most fleet of animals over the long run, but very diligent and ambitious, started out early to ensure a first-place arrival. That the cunning Rat tricked the Ox by hitching a ride and then jumping off and scampering across the finish line ahead of him does not detract from the prudent perseverance  with which the Ox approached the race.

People born in the Year of the Ox are supposed to have some of the characteristic traits of the Ox: they are said to be hard-working, prudent, methodical, steady, conservative, enduring, and responsible.

On the other hand, their admirable determination might on occasion become stubborn and inflexible, and they are not known for being expressive of their feelings.

I'm not a believer in astrology, whether Oriental or Occidental, but I find the tales amusing, and if the behavior of Ox-Year people matches the image, well, perhaps that's a self-fulfilling prophecy. And it doesn't hurt to contemplate the characteristics of the year's zodiac animal, whether to emulate or to avoid throughout the year.

After what seems to me to have been a long, slow slog, but which various therapists and medical personnel assure me is remarkably fast, I have progressed over the past year from "barely able to strand up, with assistance" to "no longer needing a wheelchair, pretty quick getting around with a walker, probably walking with a cane soon, and able to drive, carefully". Practical mobility has improved from a question of "whether" to one of "when". There is a lot of work still to be done before I enter any dance contests, however.

The Ox's diligence and dogged determination may be just what I should be striving to imitate this coming year, and in particular I should perhaps attempt to emulate its prudence and responsibility...two traits for which I have not necessarily been well known.

May the coming year be a very safe and happy one for you, and much, much better than this past year has been.

Friday, December 25, 2020

Merry Christmas & a Present for Me

Fervent wishes for a very Merry Christmas to my family and friends, and to the others who visit the blog.

If you celebrate other holidays instead of or in addition to Christmas,  I hope that you enjoy them very much.

May the season be very happy and healthy for you in any case, and may the coming new year be much better than any that preceded it.

May peace and good will prevail throughout the world, and the sooner the better!

Earlier today, a small foray intended to practice driving in the parking lot of a nearby supermarket worked out so well that I was able to just drive away and--smoothly and without incident, but not without a certain amount of trepidation--head over to the main post office and return home. 

Learning that the confidence I felt in driving, after nearly two years, and with half or so of that bed-ridden, was in fact not misplaced, was a very welcome Christmas present for me.

I hope that all of you get for Christmas whatever gift you most desire, and that you have a very happy holiday season.

Wednesday, December 23, 2020

It Takes Nerve

Looking over some older posts, and reviewing some email messages I’ve sent to friends and family members, I notice that I’ve been describing the condition that was (mostly) responsible for my long hospitalization as “myelitis”. That’s true enough and simple enough, but it’s also somewhat as if I had said I had a fever, sore throat, and breathing problems when in fact I had influenza.

Strictly speaking, the spinal cord condition that caused me so much trouble was a “spinal dural arteriovenous fistula”, which the medical folks seem to refer to as “SDAVF”. It seems to be a fairly rare condition, and from what I’ve read it appears that I was fortunate that it affected my spinal cord rather than my brain.

I was definitely fortunate that it was discovered and diagnosed fairly early, and that I had excellent medical care in top-notch facilities.

Since being released from the last of the three hospitals and concentrating on rehabilitation, I’ve been concerned about how soon—and how much—I’m likely to recover. I am of course hoping and striving for a full recovery that has me eventually in better-than-ever condition, but I’ve never been so optimistic that I could ignore reality. For a while it didn’t look as if my legs and feet were ever going to follow my brain’s orders properly. Lately, however, my recovery has been accelerating, with nerves and muscles cooperating rather well.

Dr. Nishida, the doctor whom I’ve been visiting for a couple of decades now for everything from colds to sprains, and who is now making monthly house calls to check on me, runs his own clinic as a GP these days, but was originally a specialist neurosurgeon/brain surgeon. He tells me that although the nerves connecting spinal cord to limbs readily regenerate it’s very unlikely that spinal cord nerve cells had died and are now regenerating. Instead, it’s rather as if some of them had been temporarily “asleep” and are now gradually awakening.

Whatever the nerve details may be, I’m very pleased to see returning function and almost daily expansion of my range of physical activity. Less than a year ago, I could barely stand up. A couple of days ago, I was practicing precise control of my foot and ankle as I maneuvered my car around my yard. It did take some courage to fire up the engine and hit the gas pedal for the first time in nearly two years, since it requires a light and careful touch to avoid sudden and very dramatic acceleration, and many people would be annoyed if I were to embed the car in my house, but in fact it went very smoothly.

Sometimes it takes nerve, sometimes it takes nerves, sometimes it takes both.

Wednesday, December 16, 2020

Drive

By this coming spring or summer, it’s quite possible that I may once again be driving…before I’ve entirely recovered my ability to walk properly. That’s not too odd, since driving has been an important part of my life for a very long time, whether cars, motorbikes, or trucks; I even drove a forklift for a while, back when I was 18 or so.

My driver’s license comes up for renewal within a month either side of my birthday at the end of March. Before I can get it renewed, I have to pass the recently-mandated senior drivers’ evaluation. This involves going to a nearby driving school, listening to a safety lecture, passing a vision test, and doing a 10-minute practical driving session with an instructor/evaluator.

The requirement for evaluating older drivers’ physical and mental condition was prompted by numerous high-profile traffic accidents involving seniors, including fairly numerous incidents—sometimes resulting in tragedy--of hitting the accelerator instead of the brake, and a few highly publicized cases of older drivers going the wrong way on expressways.

Driving the wrong way on an expressway is something of a feat, actually: virtually all exits have toll booths that should severely impede if not prevent entry, and entering the roadway from service/parking areas in the wrong direction is not something done out of merely slight confusion.

I haven’t reached that level of confusion yet, and my reflexes are still quite good. My judgement is as good as it ever was…I’ll wait until the laughter dies down on that last one.

I am, however, still recuperating and rehabilitating from being mostly bed-ridden for nearly a year. This time last year, I could barely stand up even with assistance. These days my mobility has improved greatly, but I’m still not able, while seated, to raise my right leg as high, or move it as quickly, as I would like. This worried me when I got the notice about appearing for the senior driving evaluation: I cannot pick up and move that right foot from the gas to the brake and back fast enough to make driving feasible. Not yet, anyway.

So, while my and the therapists’ and other rehab-related folks’ efforts are aimed at returning me to full mobility—or as close to it as possible—the immediate focus is on devising a strategy and tactics for making driving practical (and safe, of course). With the cooperation of my house-call therapist I’ve discovered that swiveling my foot at the heel is quite sufficient to deal with the gas and brake pedals on his kei-sized company car, and—since he very kindly drove his personal vehicle the other day so that I could try it—on a Toyota Voxy, as well. This swiveling motion, somewhat as in “heel & toe shifting”, is fine as long as the pedals aren’t too far apart, or too different in height from the floorboard. Using the walker when entering and exiting the car works pretty smoothly, too.

Next week, I’ll be trying out my own car, despite not being too sanguine about my chances. Shimada-san, my friend the mechanic, who has for many years been selling us used and new cars and bikes, and insurance, and along with his brother fixing our vehicles, too, has been taking care of my car since I entered the hospital. He went down to Tokyo to pick it up from the parking lot where I’d left it when I broke my leg and started my long hospital stay, and he’s been keeping it safe and starting it once in a while until I’m ready to drive it again. The car, a 2014 Suzuki Escudo, is an AWD compact SUV, and while its legroom is a plus, its height from the ground may prove a bit challenging for entry and egress. The gas and brake pedal configuration may cause some difficulty, too. We’ll see what happens next week.

Whether it’s in my own car or a rented or borrowed one, there is a fairly strong possibility that I may soon end up being able to drive quite competently and safely while still needing a walker (or maybe a cane, depending on near-future rehab progress). If so, it will be thanks to the efforts of the very dedicated PTs and my other valued supporters, and of course partly due to my own determination. Or my, well…drive.