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.



Friday, December 11, 2020

Stepping Up

 It has been a little over 14 months since I was—finally--released from the hospital after a seven-month-long stay spread across three institutions in Tokyo. About a month after that, I started rehabilitation at a hospital-connected day care/rehab facility near my house.

At first, I was essentially unable to stand up unaided, and the apex of my physical accomplishment was an increased facility in transferring from wheelchair to bed and back. For a long time my legs hadn’t been able to obey my brain’s commands, and the lengthy hospital stay had led to significant muscle atrophy to go along with the spinal nerve issues. The very dedicated and professional physical and occupational therapists (PTs and OTs) had done their best, including arranging to borrow some specialized equipment to help start me walking again, but the conditions weren’t ideal and when I left the hospital I had a long way still to go.

The very able supervision and assistance of an extremely capable care manager--an ex-nurse who managed to be simultaneously compassionate, competent, friendly, and incisive—made all sorts of arrangements for renting equipment such as wheelchair, lift, etc., for selecting and scheduling home helper and nurses, and for securing transportation infinitely easier. Her help with navigating the complicated paperwork involved in welfare, insurance, and tax issues was absolutely invaluable. She has recently taken a leave of absence, and has been replaced by another lady who has so far also been quite helpful and kind.

Since leaving the hospital and returning home, I’ve been spending about three days a week at the day care/rehab place, working my way through various exercises with the help of a new set of hard-working, friendly therapists, nurses, and support staff, using a succession of equipment.

I’ve come up from barely capable of standing up from my wheelchair at the parallel bars, to striding along pretty smoothly with the aid of a “pickup walker” (i.e., one without wheels, that you pick up and set down ahead of yourself as you walk along).

For the last couple of months I’ve been fortunate to have another PT making weekly visits to my home, to help with tactics and tricks for specific functions such as cooking, showering, and the like in that more straitened environment.

While broadly aiming at increasing strength and restoring mobility overall, the current therapy focus is on climbing and descending steps and dealing with slopes and uneven surfaces. Walking smoothly on flat flooring is one thing, but my study is raised 15 cm from the next room, and climbing up that step was essential to being able to use Barghest, my desktop PC, and to accessing the books with which my study is lined floor to ceiling. Then there's the genkan, which as with most Japanese houses requires stepping up into the house from outside. My yard is far from even-surfaced. There’s my car, too, an SUV with a floorboard fairly high off the ground, but that’s a topic for another post.


So far, I’ve finally been successful in accessing my study—I now spend a major portion of my waking hours there--and have become progressively smoother getting into and out of the house through the genkan. Climbing steps is an important milestone along my mobility journey, and I’ve been stepping up to it with a will.

 


 

 

Sunday, April 12, 2020

Yakitori


On my first day in Japan, I arrived with only about five US dollars in my pocket. I made the silly mistake of getting it changed to yen as soon as I arrived at the airbase in Yokota...before I found out that you couldn't spend yen at the shops on the base. That turned out to be a mixed blessing: I couldn't buy anything until after I'd been left to my own devices in Yokosuka, so I still had most of my money left in the evening when I went to explore the area outside of the Navy base's gates.

At the time, the exchange rate was 360 yen to the US dollar, and the 1800 yen I got for my $5 had quite a lot more buying power than it has now. For example, a small bottle of beer cost 150 yen if memory serves, which is probably half of what it is now, maybe less. I say "probably" because it has been a very long time since I bought a small bottle of beer.

Naturally, I intended to investigate a local bar as one of my very first off-base actions, but before that I wanted something to eat. By the time we had arrived in Yokosuka after being driven down from Yokota, it was too late to do the administrative tasks such as checking into the command, getting billeting assignments, and the like, and it was too late to get a meal  in the mess hall. I'd gone most of the day without anything to eat, so after getting directions and a basic language lesson--more about that in another post, one of these days--from the guy standing watch at the barracks, I set out in search of food and a beer.

Within a minute or two of leaving the base, I was captured by an irresistible aroma, and led to a corner yattai food stall/cart selling charcoal-grilled skewered chicken: yakitori. You don't see many yakitori yattai these days, especially not the mobile, hand-drawn ones like that one was. They tend to be vans nowadays, and they set up shop outside of supermarkets more often than in entertainment districts. Considering it now, I suppose that the one I encountered on my first evening in Japan was probably getting most of its business from the bartenders and hostesses and shopkeepers in the area.

In any case, a few skewers of yakitori were my first "meal" in Japan, and they were delicious, fulfilling the savory, sweet, smokey promise that had caught me downwind. In commemoration of my first meal in Japan, a half-century ago, tonight's dinner centered on yakitori.