Ups and Downs

This has been a week full of ups and downs. It turns out that driving comes back pretty easily. After last weekend's trial run at the cemetery, Jeff had enough confidence in my driving that he thought I should try taking a quick spin around the neighborhood. I did, and that went well, so now he is making me drive everywhere. I have gotten a fair bit of practice in the last week, and am now quite confident that I will pass my driving test. I scheduled the test for February 21, so I have lots of time to practice before then. I am also getting better and better at getting my walker up and down the stairs and in and out of the car. So that's one big up.

Another up is that I am now able to walk short distances with two canes. This is a step harder than walking with the forearm crutches, and is one step closer to walking on my own. I first tried this out at my physical therapy session last Tuesday. During the session it felt like it was going very well. I thought that maybe this would be my new way of getting around. The forearm crutches are being and heavy, and fall over whenever I try to lean them on something. The canes are small and light, and have a little tripod thing at the bottom, so that they stand where they are set down. However, when I tried to use them for more than a few minutes or for something like going up and down a small set of stairs without a railing, or up and down a curb, it turned out to be extremely difficult. So this was one of my downs.

The first down of the week was finding out that my physical therapist is leaving for a different job. This week will be my last week working with her. I am sad about this both because I like her, and because she's a very good therapist, and I'm not sure that another therapist will be able to help me progress as quickly. My second down of the week came when I asked my physical therapist whether she thinks I will still be using the walker four months from now. She said that unfortunately her crystal ball was broken, and she couldn't predict, but she  implied that she thought I probably would be. That same day, my occupational therapist explained that there is not much that can be done therapy-wise to help with recovery of sensation. She said that there is really no way of knowing whether I will get sensation back on my right side.

So my big down is related to wondering how much I will recover. I have been told that brain recovery mostly happens in the first year after injury or surgery. I am now a little over seven months post surgery, and it is hard to imagine that my balance, coordination, and sensation will return to normal in the next five months. I really don't know-- no one knows-- whether this is possible. Part of the issue is that it is unclear whether I am waiting for tissue that has been damaged to heal (as was the case with my double vision, which was caused by a sort of stretching of the sixth cranial nerve), or whether I am dealing with tissue damage that is beyond healing and am working at creating new pathways to compensate for this loss. If it is the former, then sudden and dramatic change is possible (as was the case with my vision). However, if it is the latter, then progress is likely to be very slow, decreasing over time, and eventually stopping. I am still making steady progress, so I know that when my recovery stops moving forward I will be further along than I am now. But it is impossible to say how much further along. For now, I keep trudging forward, one step at a time.

On the Road Again

It's kind of hard to believe, but I may be driving again soon. Ever since moving here I have been in back-and-forth correspondence with the provincial licensing and insurance agency. Here in Saskatchewan, there is an agency equivalent to the DMV called SGI, that does everything the DMV does and also administers auto insurance. When I went to get my drivers license, I was required to report that I had a medical condition which might affect my driving. There was a series of letters that I had to respond to, and finally in December I was required to have my doctor fill out a form.

Somewhat to my surprise, he said that I had nothing wrong that would impair my ability to drive at that point, and recommended that I take a road test. I thought, fine, I'll take it in the spring after the snow melts, because I was in no hurry to get back on the road and was a bit nervous about driving in the ice and snow. Then, a couple of weeks ago I received a letter from SGI stating that I had to take my road test before March 3, or  my license would be suspended for noncompliance. I called and asked if I could delay the test, and they said no. My only options were to either take the test by March 3, voluntarily surrender my license, or have my license suspended.

I explained the situation to my physical therapist and occupational therapist, and they said maybe I should just get back to driving. My occupational therapist did some tests with me, including speed of moving my foot back and forth to simulate quickly stepping on the gas and brake, and a reaction time test that involved using both hands to press buttons that would light up in various places across my entire visual field including peripheral vision. These tests are normed on elderly populations, and I am average or above-average for a person over 72 years old. This means that I passed the tests, suggesting that I have the physical capacity to drive. At my last physical therapy session we worked on having me get my walker in and out of the car by myself. We also worked on getting the walker up and down a short flight of stairs, which I would have to do to get in and out of the house on my own. At my next occupational therapy session I will be trying out a driving simulator.

It was recommended that I go out in an empty parking lot and just see what driving feels like. There was a bridal show going on where we expected to have a big empty parking lot, so went out this afternoon to the cemetery instead. There was not another living soul there, so I was pretty sure I wouldn't hurt anyone. Also, everything was covered in several feet of snow, so if I hit anything it would be a snow bank. I drove around at a top speed of about 15 mph, on the winding roads of the cemetery, which were plowed but still quite snowy. Jeff was in the passenger seat, nervous at first, but once I got going he said it felt like I was driving just like normal. He even asked if I want to  drive over to the University where we were headed (I did not). I need to call SGI tomorrow to clarify what I am legally allowed to do right now-- I certainly need to practice more before taking the road test, but I'm not sure what my status is in terms of being allowed to drive.

But it looks like I really might be driving again soon. It's kind of hard to imagine having that much independence again. It's exciting and also a little bit scary – I haven't been anywhere by myself since June. I think I will go ahead and make the appointment for the road test, so sometime before March 3 I will probably be on the road again!

Trial and Error

After Christmas, we bought a bread machine. Sometime in the fall, our KitchenAid mixer started having trouble handling dough. We took it in for service, and it needed several gears replaced. I checked forums and reviews online, and the consensus was that older KitchenAid mixers did a better job handling dough but that for the past 10 years or so they have not been so good. Apparently once they break, they just keep breaking. I decided at that point that we needed something else for making bread and pizza dough. So with the after Christmas sales combined with an unpopular color (white as opposed to the more desirable stainless steel), I was able to get a good deal on a good bread machine. However it apparently takes some learning to get a good loaf of bread.

The first loaf I made turned out solid as a brick, likely because I didn't follow the recipe (I made up my own) and didn't measure the ingredients very carefully. I followed all the instructions on the second loaf, doing everything you're supposed to do to get it to rise better. Apparently I did too much, because it rose so well it ended up baking to the top of the lid of the bread machine. When we opened it up to try to get the loaf out, the top crust came with it.

 

 I have since successfully made dough for whole-wheat rolls baked in the oven, and tonight we had a yeast-dough cornbread baked fully in the bread machine that turned out great. It just took a little trial and error.

I feel like I am constantly engaging in trial and error these days. With my physical recovery, trying out new things here in Regina, and getting back into academia, I never quite feel like I know what I'm doing. And just when I think I figure it out, the target changes.

I'm typing this blog post using Dragon, the dictation software I gave up on back in August or September. I had an appointment with an occupational therapist in December, and she pointed out to me that although I am able to type, I am very slow compared with what I used to be able to do. Right now I only type of about 10 words per minute, and now that I am back into teaching and more engaged in my job, I need to be able to type more quickly. Dragon is working much better for me this time around, partly because I have some support from my occupational therapist, and partly because my voice is more consistent. There is still a lot to learn, but I think once I get used to it it will really help me go more quickly with my work.

Today I also tried walking with forearm crutches for the first time in about a month. Last time I tried it was very difficult and effortful, but today it was actually much easier. The forearm crutches are not very functional for daily use, because I can't carry anything when I'm using them and they are hard to stand up against things so they fall to the floor a lot. However, they are much better than using the walker for approximating normal walking, so it is good to practice with them and encouraging that I'm getting better at it. Jeff took a video of today's walk:

So much trial and error can be frustrating and exhausting, but it does feel good when things start to go right!

Cold Sunshine

Yesterday Jeff and I went for a walk on a path that is just across the street from our building at the university. It was a beautiful day, sunny and not quite as cold as it has been.

In front of Wascana Lake, all covered in snow, with Regina's only hill in the background.

I foolishly decided that "not as cold" meant "not so cold," and dressed for fashion (having brought the camera) instead of for warmth. It was -11C (12F), and it turns out that even if it has been colder than that most days, and even if the sun is shining, that is still really freaking cold. Our walk was cut short not by my mobility limitations, but by my lack of understanding of cold temperatures. I understand thermometer readings down to about 25F, as that is really the lower bound of normal northwest weather. Anything below that is just "really cold" in my mind. So I'm having to get used to the fact that there are many degrees of "really cold."

Jeff, on the other hand-- who had trouble adjusting to the subtleties of northwest weather (he never quite believed that in the mountains it could be 80F in the afternoon, then drop to near freezing when the sun went down, or that you need to bring a jacket to the coast no matter what the forecast says)-- dressed sensibly in long johns and his warmest coat and hat.

Along Wascana Lake, in the tracks of the path's snow plow

Jeff says this picture reminds him of pictures people would take of him when he was four years old. Just imagine that those snow plow tracks are regular tire tracks, and you can almost see it :)