Moving Along

It has been a year marked by movement, often slower and sometimes more hesitant than I would prefer, but undeniably progressing movement.

From a wheelchair to a walker, thence to crutches, and driving, and moving along more or less steadily through shopping areas, pushing shopping carts through supermarkets, entering and exiting bars and restaurants, and accomplishing the surprisingly tricky task of taking out the trash, I've been doing more moving along than I usually realize at the time.

Switching from day care with rehabilitation to an entirely intensive rehabilitation mode in my daily routine had been a significant move, too, and appears to be showing good results. 

It hasn't been an easy year, but I didn't expect it to be. It has been a rather successful one, though, as far as progress in mobility is concerned. As the Year of the plodding, determined Ox ends, I'm looking forward to "my" year, the coming Year of the Tiger, with some expectation of at least some faster, more aggressive movement, but in any case, plodding or pouncing, continuing with moving along. 

Merry Christmas

May all of my relatives, friends, and other visitors to the blog have a very Merry Christmas, or very enjoyable other holidays they might celebrate in this season, or just a very good time overall as the year winds down.

May peace and good will prevail, generosity and kindness carry the day, and the greedy and selfish be confounded. Even a single candle serves to diminish the darkness, but the more light and warmth, the better.

May all of you receive your heart's desire, achieve your goals, and grasp every possible opportunity for happiness in the holiday season. 

Breathing Easier

 Back in early July when I got my second COVID-19 vaccination at a local clinic, I had them do a chest X-ray, too. That X-ray is part of the annual set of tests subsidized by the city, and the only one of the tests that I don't have done at my usual family doctor's clinic. Ironically, Dr. Nishida's love of the newest and best in medical equipment has rendered his X-ray results unacceptable to the city's system: he's gone digital while the city still requires analogue film. 

In any case, the clinic called me up the other day to let me know that the official results of the X-ray analysis were ready, and rather ominously said that I'd need to consult  with the doctor instead of just picking up the form or having them mail it to me. When I went and spoke to the clinic director, she told me that I'd need to have a CT scan done, to try to determine whether the cloudy spot on my lung is early stage lung cancer. They don't have the necessary equipment, so she gave me a referral to take to somewhere with a good CT scanner. Naturally, I arranged to have it done at the Nishida Clinic.

An incipient lung cancer diagnosis wouldn't be a great surprise, given that until a couple of years ago I'd been a very heavy smoker for several decades. On the other hand, except for one false alarm back in the '80s (it turned out to be the shadow of a rib), every year my chest X-rays have been so clear that numerous doctors have assumed that I was a non-smoker. Nevertheless, I awaited the CT scan results with some trepidation: I'm too busy to be dealing with lung cancer right now, but I'll do whatever I must.

I was pleased to get good news. It turns out that the small amount of haze in the lower right lobe of my lung isn't anything to worry about, and definitely does not appear to be cancer. Great, another bullet dodged. I got the distinct impression that Dr. Nishida was even happier about the diagnosis than I was.

So, it's back to the rehab routine, breathing a little easier now that I don't have to worry--at least for now-- about a new problem.

Alarums and Excursions

 It has been a month since I switched to full-on rehabilitation mode. A fairly intense and strenuous two and a half hours or so, each morning Tuesday through Friday, following the Monday morning home visit therapy session, and supplemented by several daily sessions at home of whatever exercises the therapists have recommended, seems to be about right. 

Occasional shopping trips, suitably masked and distanced, are practical opportunities to test the returning functions, and point up any real-life shortcomings that require more work. One quickly learns the limits of one's balancing skills, for instance, when carrying five or six kilogram shopping bags while using forearm crutches.

A shopping excursion last Sunday took me on a drive across town and gave me a chance along the way to check on the status of a restaurant and pub that I'm planning to visit again when the current pandemic countermeasure restrictions are lifted, or at least eased. For now, they've both decided to wait to reopen until they can do so under more viable conditions. The news today is that Saitama will be following Tokyo's lead closely, essentially allowing restaurants and bars to serve alcohol until eight in the evening and stay open until nine, starting  from October first. That's still very limiting, but even an eight o'clock last call is a considerable improvement. It appears that the forecast is for draft beer this coming weekend.

Autumn having arrived in the wake of the typhoon that pushed summer out, Sunday afternoon was cool, and cooled further once the sun set. I was happy about that, since Monday morning walking practice with the home visit physical therapist in the hottest days of summer had been a heat stroke risk. Later in the evening, however, I quickly went from pleasantly cool to shivering with chills, and donning a sweater and hooded sweatshirt didn't make much difference. A check showed that my temperature had rapidly risen to 38.5: not that high, but very sudden, and alarming in these pandemic times. Naturally,  COVID-19 came immediately to mind...not the most warming of thoughts.

So early Monday morning the PT visit was cancelled, as was the rehab session for the following morning,  and a reservation made for a COVID-19 test at the Nishida Clinic, where I've been a regular for a couple of decades. Their protocol for the test is to have the testees arrive shortly before noon and wait in their cars in the parking lot, to minimize contact with the other clinic patients and staff. I showed up early, called to let them know I'd arrived, and waited until a trio of nurses in PPE gear wheeled out some equipment and took up station behind the car. Dr. Nishida rushed out in a full protective suit, very different from his usual tie and casually worn lab coat image. The test was done quickly, and I then waited a little longer for the nearby pharmacy's gowned and masked staffer  to deliver some medicine to my car, with the remainder to be delivered to my home mailbox. Nobody was taking a chance of infection by having me inside their facility, and very justifiably so.

Then I returned home, to quarantine myself until Dr. Nishida reported the test results Tuesday evening. By this time my fever had already dropped somewhat, and I still didn't have any other remarkable symptoms aside from a mild runny nose. Having been vaccinated already, though, and being aware that some infected people are even entirely asymptomatic, I still couldn't dismiss the possibility that I had the virus. I really didn't look forward to the tracking and testing and general disruption that this would cause among the people with whom I've been in contact: mostly rehab-connected people and center staff and users. 

The announcement that the test results were negative came late Tuesday afternoon: a great relief, indeed, for me and--as I found out when I showed up at rehab Wednesday morning--for my Care Manager, and the therapists, nurses, and other medical staff who deal with me regularly. My attempts to apologize for causing concern with what turned out to be a false alarm were met with a clear and very gratifying consensus response that it's much better to be safe than sorry, and to err on the side of caution.

I would just as soon have October be a little less exciting, at least from a pandemic point of view.

Miss You

 I haven't been keeping up with the news sufficiently of late. There has been more work lately, and more physical activity, and more demands on my time to accomplish various tasks. The extra work and activity are beneficial and I am grateful, but there has been a cost, as there is for most things.

I've gotten even further behind with email correspondence, only occasionally able to rise above work-related stuff and communicate with friends. I've also become increasingly unable to keep well informed about current events: I miss a lot of news stories and sometimes only learn about them through others' discussions of the topics.

That's how I missed, and how I learned of, the sad news that Charlie Watts won't be drumming any more, at least not in any venues where I can attend. I just found out a few hours ago that he passed away, and it's hard not to find significance of a superstitious sort in my completely coincidental switch of my stereo playlists the other day from the likes of Dire Straits and Aerosmith to the Rolling Stones. I must have played "Satisfaction" and "Midnight Rambler" a dozen times each in the last week, after a hiatus on Stones music of maybe six months.

If memory serves, "Paint it Black" was the first 45 rpm record I ever bought myself, when I was 16 or 17, and it was either that or the Yardbirds'  "Shapes of Things" being played at excessive volume that damaged the speakers on my Dad's brand-new Magnavox stereo. 

The Rolling Stones provided a lot of the background music for my teen years, and a lot of my memories of those days--and many later years, too--strut and stretch and skip and swagger to the sound of Charlie's drumbeats and cymbal crashes. 

I'm going to miss you, Charlie Watts. 

Changes

 In another week it will have been two years since I was released from a long hospital stay, returned, as it were, to the wild. Neither "set free" nor "let loose" would have been accurate at the time: when I wasn't confined to a wheelchair, I was constrained by a bed. Standing up unassisted was the focus of my determination: just before leaving the rehabilitation hospital I had finally managed to stand up--briefly--with the assistance of a physical therapist.

But there have been changes.

As recently as a year ago I was finally learning how to walk with a walker, although most significant movement was still in the wheelchair.  Rehab proceeded apace, and the staff of the day care/rehab center assured me that my progress was unusually swift. It did not seem so to me; it seemed, if not continental drift slow, at least glacial slow. Reviewing and reflecting on various documents, photos, and video records lately has somewhat persuaded me, however. So has consideration of my current and near-future situation.

I'm driving a loaner sub-compact Suzuki Swift while my Escudo is being inspected and repaired, and the navigation system updated to reflect, especially, all of the new or greatly changed streets and buildings in town. The fact that I'm driving when I could barely stand up not too long ago is certainly a significant change, and there's a considerable difference between commuting to rehab in a wheelchair strapped into a van and driving back and forth myself. Not that long ago, I would probably have been unable to fit into the loaner's driver's seat. Nearly 50 kilos lighter than I was when I started at the day care center, I'm not exactly svelte at 90 kilos or so, but it's not particularly difficult to get in and out and drive the Swift.

It hasn't been that long since nurses were offering to help feed me lunch. I declined despite understanding their concern: my fine motor control wasn't real great after being bed-ridden for months and having muscles atrophy. These days I'm cooking over half of the meals at home, and walking around with heavy pots, sharp knives, and the like has become routine, while stretching up or down to get things, or twisting and maneuvering around tables or chairs while carrying plates of food  is no longer astonishing.

My schedule and activities are soon going to change, too. After just short of two years, I'll be shifting from a six-hour, three times weekly day care schedule with rehab built into it, to a two-and-a-half-hour, four times weekly morning intensive rehab arrangement. The place and the physical/occupational therapists are the same, but the equipment is somewhat different and I'm dispensing with the help that I've been getting with bathing, as well as skipping the center-provided lunch. The actual time devoted to exercise and practice is going to more than double.

There have been, and will continue to be, lots of changes.

Got a Second

 I got my second COVID-19 vaccination this afternoon, in a process as smoothly run as the previous time. Because it was the second in the series, the nurses were even more solicitous than before: they checked carefully for any sign of anaphylaxis, unusual inflammation, or other adverse reaction, especially wary since they knew that I was driving home. I appreciate their efforts and concern, but so far even after eight hours I have experienced no discomfort whatsoever.

It seems that any side effects are likely to appear tomorrow if at all. As I did last time, I've proactively cancelled my appointment at day care/rehab tomorrow. Again as last time, if I don't show any symptoms--particularly fever--tomorrow morning, I'll cancel the cancellation and go on about the rehab routine as usual.

Apparently I'll be able to consider myself fully vaccinated in another two weeks. I would in any case have continued to follow the masking and social distance behavior and intend to do so even after the two weeks have passed. It's not particularly burdensome, it relieves others of anxiety, and may serve to reduce the spread of infection regardless of vaccination status.

I am looking forward to hearing confirmations from all my relatives and friends that they too have been successfully vaccinated. 

We'll see what tomorrow brings, but for now, so far, so good.

Having a Shot

 The result so far of my first COVID-19 vaccination shot last Monday afternoon has been utterly unexciting. Having heard from a few people who developed minor pain in their arms or mild fever, I had proactively canceled my day care/rehab appointment for the day following the inoculation. If your temperature rises above 37 °C they turn you away from the care center in any case, and I wanted to avoid causing a same-day cancellation. The folks at the center were appreciative of my concern, but told me that should I change my mind I could call in the morning and "cancel the cancellation".

A couple of weeks ago I spent 10 hours nearly continuously attempting to complete an internet appointment for the vaccination. Telephoning the appointment site was notoriously difficult, but doing it on the 'net wasn't that much easier, as far as I could see. I did finally manage to complete the log-in and appointment process, at one of my two preferred choices of venue. Once I got there Monday afternoon with paperwork in hand, the process was very smooth, indeed.

The only physical reaction that I experienced from the shot was minor itching at the injection site, maybe half as itchy as a mosquito bite, that subsided to nothing after an hour or so. No pain, no lassitude, no fever: anti-climactic, really.

I did as had been suggested and went to rehab the next day after all, having checked and found my temperature as normal as ever.

I'm aware that there is an increased chance of experiencing unpleasant side effects after the second dose, and a couple of the PTs and care specialists I've spoken with reported pain or other effects with various degrees of severity  after their second shot; a couple of them had to take the day off from work, and at least one lady says that she wasn't entirely back to normal for about three days, although she seems to be rather unusual in that respect.

I'm scheduled to get the second dose on July 5th, and I plan to repeat my proactive cancellation of rehab for the next day. With luck I'll be able to rescind the cancellation, with less luck I may experience some discomfort next time. Either way, I'll be happy when my vaccination is complete. 

I'll be happier still when my younger relatives and friends--who should be getting theirs in the next stage of the process--are done with it, too. I'll be even happier when enough of the population is vaccinated that the pandemic becomes manageable enough to responsibly allow businesses to resume normal operation. I have friends in the hospitality and entertainment business for whom this has been a serious disaster, and I hope to see them recovering as soon as possible.

I'm looking forward to the day when having a shot is a reference to Herradura, or Ardbeg, or Jameson, or Meyers's.

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.

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.

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.

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.