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Trip Report #: 103

A (Year-Long) Trip Report

for the

Most Challenging Mountain I've Ever Climbed




In September 2010, I suffered a severe compound tib/fib fracture, so severe in fact that I nearly lost my foot. The injury was caused when a rock broke lose while I was climbing Vesper Peak in the North Cascades of Washington. The "recovery trip report" on the following page is my day-to-day recovery notes for the year following the climbing accident. All except the first few days (when I was in the hospital and too drugged to think) was written as it occurred. Fraught with frustrating setbacks and dangerous complications, my injury and the resulting recovery posed the biggest challenges that I have experienced in life so far. It was also a whirlwind education on the US medical system, insurance and financial negotiations, and living life with a disability. For awhile I struggled to maintain my PhD work at the University of Washington, but I eventually decided to forgo my studies to focus on healing and dealing. But through it all, I was spurred onwards by the endless support of family and friends (thanks!), as well as my uninjured love for the mountains and outdoor adventure. Amazingly, over the course of a couple of years, I achieved a nearly complete recovery. Although I'd never say I am glad for the climbing accident and injury, I am grateful for the experience and the stronger and wiser person it allowed me to become.

Warning #1: When I started this "recovery trip report" I had no idea it would go on so long. So this page might take awhile to fully load, and might also occupy a few hours of your time if you read it all.

Warning #2: Some of the photos on this page might be considered graphic. But I wanted to share the reality of a serious climbing injury.

Warning #3: I apologize if some of my daily entries are somewhat negative, overly candid, long-winded, kind of whiny, or just plain wacky. Throughout the recovery, I underwent a lot of psychological turmoil as I struggled to accept the situation and setbacks. As an exercise and adventure junkie, the forced inactivity and separation from the outdoors was at times overwhelmingly oppressive and definitely the most difficult aspect of the recovery. And as a brutally independent person, the crutched life and dependence on others was also very difficult to accept. Sharing my thoughts and experiences became a way of coping with the injury.




Table of Contents for my Recovery Trip Report





o o o o o



The Accident
DAY 0 • SEPT 14, 2010


I wonder if I can make it down alone, I asked myself. Probably not. I watched the blood already dripping through the jacket that was literally holding my foot on my leg. I pondered the rugged rock walls surrounding me. This could be worse, I thought—I was fortunate that I didn't hit my head or break my back; and that the rope caught my fall. But it also could be better.

To distract myself from the pain and anxiety about my sister's safety, I rustled in my pack. I found some alphabet cookies. C-R-A-P, I spelled out.



DAY
0
SEPT 14
2010

While climbing with my sister on the North Face of Vesper Peak (North Cascades, WA), a rock of indeterminate size broke loose and I fell, caught by the rope but suffering a serious compound tib/fib fracture and severed arteries. With my sister Jenny's help, we staunched the blood flow with a jacket, used a sling as a makeshift tourniquet, and splinted the leg with an ice axe. Then Jenny left me anchored to a bush while she made a harrowing descent to go get help. In a stroke of luck that probably saved my foot (and maybe even my life), she was able to find a cell signal on the ridge and get through to 911. Only three hours after the fall, I was plucked off the mountain and airlifted to Providence Regional Medical Center in Everett.

Click here to read my complete first hand accident and rescue report, which is on a separate page. (I wrote the accident report about a week after the accident, while I was still in the hospital.)

Makeshift splint with a fleece jacket, crampon straps, and ice axe. My leg was bleeding quite a lot, so we put a tourniquet around my thigh; I later learned I had severed two arteries.

Crap....(distracting myself with alphabet cookies at my bush anchor shortly after we stabilized my foot and my sister left to go get help).

Helicopter coming in to pluck me off the mountain.



Recovery Part I
15 days in the Hospital
DAYS 1 to 15 • SEPT 15 to SEPT 29, 2010


"The bandages are too tight."

"Morphine should help with that. Then you won't feel a thing," replied the nurse, reaching for my button that allowed me to self-administer painkillers through my IV.

I snatched the button and shoved it under my blankets. "I don’t want any drugs. I just want my bandages on my leg loosened." The painkillers made me feel nauseous and itchy, and although it was only a few days since I had broken my leg, I avoided medications whenever possible. Besides, it seemed a better solution to address the actual cause of the pain.

"I'll get you some Vicodin, then, if you don't want the Morphine."

"What about just loosening the bandages? They're too tight." I felt helpless, and like a broken record. I hated being a patient. The nurses probably grumbled about me in the hallways.

The nurse left the room. In a few minutes she returned with the Vicodin. And Valium.



DAY
1
SEPT 15
2010

That night I nearly lost my foot. The first surgery—which took about 1.5 hours—was a standard and uneventful open reduction surgery to install a plate on the shattered lower tibia. No plate was put on the broken fibula, which being a skinnier and non-weight-bearing bone usually heals on its own. The surgery was conducted by orthopedic surgeon Dr. Peter Kinahan. Dr. Kinahan's attention to detail would turn out to save my foot—as I was being awakened after the surgery, he noticed that my foot was completely colorless and he called in vascular surgeon Dr. Mark Papenhausen to take a look at it. Dr. Papenhausen reported that the two main arteries to the foot were damaged (one artery had actually been severed by the broken bones, but fortunately it was crushed and clotted enough that I had not bled out). I would need immediate reconstructive surgery.

In a painstaking and rather impressive five-hour surgery, Papenhausen replaced the sections of damaged artery with portions of a vein he removed from my calf. The blood began to flow back into the foot. However, I was not out of the woods yet. With the renewed blood flow, the muscle on the outside of my leg began to swell with blood, in a condition called compartment syndrome. The pressure inside my leg became so great that Kinahan's stitches began to pull open and the tissues within the compartment began to die. This necessitated a fasciotomy, in which the fascia of the compartment was slit open to relieve the pressure. The slit opened to a 7" x 5" wound as the muscle swelled freely. (Over the next week the wound would be drained via a wound vac and would shrink a little, but it would still require a significant skin graft to close.) At 5 am, Papenhausen reported that the surgery was a success.

I woke up on the morning of Sept 15 in a hospital room and my parents' voices. Drugged on morphine, it took me a few minutes to register that the accident had not just been a bad dream after all. I was given 2-3 units of blood, as I had lost quite a bit of blood both on the mountain and during surgery.

Interesting note: a short article was published in the Bellingham Herald about my accident; according to them, the rope—which saved my life—"may have minimized the fall."

X-rays from my tib/fib fracture. (These are just two slightly different views of my left leg. Fortunately, I didn't break both legs as it might appear from a cursory glance at the image.)

The plate along my tibia looks like a nut tool!
DAY
2
SEPT 16
2010

I discovered that morphine isn't the wonder drug movies always make it out to be. I told the nurse I would rather endure the pain than the haze of nausea and grogginess, but apparently patients in intensive care don't get much say in their pain medications. The painkiller-induced haze continued. (In the days that followed, the fight over pain medications became a constant reminder of my helplessness as a patient; with each shift-change, I would have to convince the nurse that, no, I did not want drugs. When they put me on an IV drip that allowed me to self-administer my painkillers by pressing a button, my daily battle became hiding my button from the nurses so they couldn't press it.)

My roommate had a rather unique set of personality traits: near-deaf, extroverted, and incontinent. I was annoyed rather than amused, and I requested being moved to a more peaceful location.

An insurance agent dropped by. It became clear that my University of Washington student insurance plan did not offer very good coverage outside of the "network" hospitals in Seattle. Under my plan, I would be expected to pay 40% of my medical bills at Providence, which had already hit the hundred-thousand mark. Even more disheartening was the fact that had I been at a either UW Medical Center or Harborview in Seattle, my out-of-pocket maximum would have been a mere $1,125. But I had had no choice but to go where the helicopter took me. (Update: After some conversations with my insurance company, I ended up negotiating 90% coverage under "emergency" status. Even so, my 10% portion of the bill from my two weeks at Providence—plus my 40% portion of any non-emergency Providence-related follow-up—greatly exceeded the $1,125 out-of-pocket maximum I would have paid at a network hospital.)

DAY
3
SEPT 17
2010

I spent the day groggy, nauseous, in pain, and now severely itchy (the itchiness I later learned was from the IV antibiotics). I was given another unit of blood due to continued bleeding of the wound through the wound vac. My parents stayed with me most of the day.

DAY
4
SEPT 18
2010

I convinced the nurse to allow me to take oral painkillers; I chose House's favorite: Vicodin. Also, I snuck a pair of shorts and t-shirt under my hospital gown. With clothes, I immediately felt like less of an invalid, and I requested a pair of crutches so I could move around. I made it as far as the door before the blood rush to my leg caused me to make a hasty retreat back to bed and nearly succumb to the nurse's attempts to put me back on morphine. To avoid blood clots from the trauma and immobility in my leg, I was put on anti clotting medication called Coumadin. It was enlightening to discover that Coumadin is essentially the same ingredient that makes up rat poison. I would take Coumadin for 6 months, so the nurses wheeled in an old VHS player and my parents and I were subjected to thirty minutes of the 1980s production titled "Living with Coumadin."

DAY
5
SEPT 19
2010

I was beginning to discover another side effect of the pain medications: constipation. I guzzled a bottle of milk of magnesia and ate some prunes, but it did nothing for me.

DAY
6
SEPT 20
2010

This was they day I was scheduled to have surgery to place a skin graft over the bulging shin muscle that had been exposed by the fasciotomy on the night of the accident. The skin graft would be taken from my upper thigh. However, when they unwrapped my bandages, the surgeon discovered an exposed tendon running down the center of the open wound; tendons cannot be grafted over, so they had to pull some of the muscle over the tendon. It would take a few days for the muscle to reestablish itself, so they rebandaged my leg and rescheduled the vascular surgery for Sept 22 (the surgery was later rescheduled to Sept 24).

A wound vac was placed over my open muscle to allow it to drain and make a nice vascular bed for a skin graft.
DAY
7
SEPT 21
2010

To avoid the continued high medical costs of being at a non-network hospital, I requested to be moved to UW Medical Center or Harborview in Seattle. But I was a lone voice, as both my parents and the medical team discouraged the move at this stage in my recovery.

Feeling helpless and outnumbered, I transferred my unhappiness into my leg. By mid-morning, the pain in my leg had escalated and was not responding to pain medication. I was pretty sure that the pain was a result of the fresh wrapping being too tight, but my nurse (who had actually introduced herself as a "pain queen") was convinced that her concoction of staggered Vicodin, Dilaudid, Oxycodone, and morphine drip would do the trick. It took several hours of frustrated pleading to get her to see if loosening the wrapping would help. Immediately this alleviated the pain. But the damage was done, and I spent the rest of the day drugged and nauseous. It was a rough day.

DAY
8
SEPT 22
2010

Upon examination of the gruesome open muscle on my lower leg, the surgeon decided to hold off on my skin graft for two more days. My hospital stay was beginning to seem never-ending.

Later that afternoon, a few positive recovery milestones were reached: the catheter was removed, my bowels finally released some 10-day old food, and I wheel-chaired around the floor for an hour. The blood rush to my leg was still bad whenever it was not elevated, but it had at least become tolerable enough to sit in a wheelchair.

A nutritionist came by and we discussed a target calorie intake (~2000-2400 kcal) and protein intake (80-105 g) to fuel my body's healing. Tasteless hospital food would make this quite a challenge, so I enlisted my poor parents to make daily trips to the Safeway and Subway.

I realized that the Autumn quarter at UW would be starting in less than a week. I probably wouldn't be making it to the class I was scheduled to take. I tried to compose an email to my advisor to let him know of my injury, but I was unable to concentrate long enough to write the email (how does House perform surgeries while on Vicodin?), so I finally had to get my dad to do it.

(It is also interesting to note that I had been running a mild fever (99-100°F) up to this day, but from this day onward my fever disappeared and I maintained a constant 98.1°F until I left the hospital. I wonder if the mild fever had anything to do with a shift in metabolic rate during the body's most intensive healing stage (this comes from an interesting article I had found discussing a theory of post-injury metabolic "ebb" and "flow")).

Healing stitches; this vein was used to reconstruct the arteries in my foot.
DAY
9
SEPT 23
2010

After getting more sleep over the last week than I usually get in a month, I had begun to wake up long before sunrise. I used this time to start trying to catch up on emails. A few notable events occurred throughout the day: 8:30-10am, my mom and sister visited; 10:30-11am, I went on a wheel chair ride; 11-12pm, I made a sculpey mallard duck; 12-12:30pm, my orthopedic surgeon Dr. Kinahan stopped by to say hello; 12:30-1:30pm, I learned how to operate the wound vac on my leg, in the case that the vascular surgery scheduled for the next day would be postponed and I would have to go home for a week and get home wound care; 2-3:30pm, my landlady visited and gave me some fruit, flowers, and a pink sweatshirt; 6:30pm, my parents went out and picked up Subway for dinner; 7:30pm, I went on another self-propelled wheel-chair ride. A good day, considering. I realized I had accidentally skipped one of my doses of medication.

DAY
10
SEPT 24
2010

I was scheduled for surgery to place a skin graft over the open muscle on my lower leg, but given the delays over the preceding week, I went into the surgery certain that the surgeon would again proclaim the muscle not ready for the skin graft. So I was surprised when I woke up to news that the skin graft had been successful. Skin for the graft had been taken from my upper thigh, which began to sting like a really bad road rash.

I distracted myself from the road rash by working on my accident trip report, making a sculpey frog, and doing arm exercises by lifting cans of baked beans. Even though I was beginning to feel much better and quite antsy in the hospital, I was required to stay for five more days since the skin graft needed to be closely watched and kept in a controlled environment underneath a wound vac.

A gruesome reality under the cast: My skin graft, staples, and stitches.

My skin graft donor site felt like a really bad road rash.
DAY
11
SEPT 25
2010

My IV was removed. Then came the heart monitor leads, when the nurses got tired of rushing into my room only to discover me doing situps in bed. Now my only remaining leash was the wound vac for the skin graft. Up until this point, it had been a real challenge to keep all my leashes in tow whenever I needed to hobble over to the bathroom.

My vascular PA visited and told me it would probably be a year before I was recovered, and even then he thought I would probably have swelling in the muscle and a foot drop for a long time. By now I realized I was in for a long haul recovery.

After a game of Scrabble, my parents left to drive back to their home up in Canada. This would be the first time since that accident that both of them would go home; at least one of them had been nearby every day since the accident.

Throughout the day I had my camera set up taking a photo every 30 seconds, creating an interesting timelapse video where nurses, doctors, and parents darted around at superhuman speeds, and meals and Scrabble games and bathroom breaks were conducted in a blink of an eye. A strange contrast to how the days at the hospital seemed to be endless and painfully slow. (To see more of my timelapse videos or read about how I make them, see my timelapse photography page.)

Timelapse: A way to make time move faster when stuck in a hospital bed
Length of video: 33.3 sec
Real time: 4 h 15 min
Number of frames: 999
Interval between photos: 15 sec
Frame speed of video: 30 frames/sec
Timelapse speed: 450x real time

DAY
12
SEPT 26
2010

This was a day of visitors. Lots of friends came by to chat, wish me well, and give me books and magazines. When I was finally alone, I shot a 1.5 hour timelapse of the clouds moving outside my window and made a drawing of the glaciers on Mt. Rainier. I was really hungry all day, even though I was just sitting in bed. I guess healing takes energy! I tried to push the protein, but I often succumbed to my sweet tooth.

DAY
13
SEPT 27
2010

I spent the morning posting my Vesper accident report on my website, and then I spent the rest of the day responding to comments and revising the text. I also busied myself by taking a 5 hour timelapse of the clouds moving outside my window, wheel-chairing around the hallways, and making a sculpey hedgehog and giraffe (I was developing quite a sculpey farm by this point). The guy across the hallway—who never stopped talking about the achievements of his daughters, complaining about poor room service, and hacking phlegm—was finally sent home.

Life in a hospital bed.
DAY
14
SEPT 28
2010

This was my last full day at the hospital. I spent the morning revising my accident report and adding to my growing sculpey farm a seagull, flamingo, and cat. I got permission to wheel-chair around the cafeteria floor, where I raided the vending machines for late night snacks.

DAY
15
SEPT 29
2010

My last day at the hospital! Fresh dressings were put on my skin graft and donor site; these dressings would remain in place until my follow-up appointment in a week. Removing the old dressing from my donor site was probably the most painful episode of my entire hospital experience.

I was given a removable boot cast to give support to the broken bones. To fit my leg in the boot, I needed to get my foot to 90°, rather than the more relaxed angle it had been at since I entered the hospital. It turned out to be excruciatingly painful to rotate the foot upwards, and I managed to get it about halfway before refusing to go further. I noticed my foot cocked out at a weird angle too—although no one else seemed concerned over this, it freaked me out. I think I was making a scene, since the nurse filled out a prescription for Valium. The nurse suggested to my parents that over the next couple of days they drug me out and torque my foot upwards.

I was finally discharged at about 1pm; rather than excited about my long-anticipated release, I was consumed with terror about the future foot-torquing I was to endure. I stretched out in the back of my Subaru as my dad drove up to my parents' house in Canada, where I would be staying for awhile. My parents had the house all prepared for me, with a wheelchair, 2 walkers, a commode, and a bathtub seat.




Recovery Part II
6 weeks living with my parents
DAYS 16 to 56 • SEPT 30 to NOV 9, 2010


I sat on the floor of my old bedroom, staring blankly at my toes. Swollen sausages, I thought. I tried to move them. No response. I tried to move my foot up. No response. I began to sob.


I heard the car slow down behind me. Uh, oh, I thought. Not again.

"Do you want a ride somewhere?" A nice lady with a Canadian accent.

"No thank you. I'm just out for a walk."

She studied my soaked sweatshirt, my crutches, and the plastic garbage bag ballooned over my leg. I must have looked quite the sight. "You sure?" She gave me an incredulous look.

I nodded, hitched my pack on my shoulders, and began to plod on through the rain. By fighting my immobility, I won small but valuable daily victories over my broken leg.



DAY
16
SEPT 30
2010

When I was finally discharged after 15 days in the hospital, I was still unable to live on my own. I couldn't sit or stand upright for more than a few minutes before blood rush to my leg forced me back into a prostrate position. My parents welcomed me home for as long as I needed, so to Abbotsford (BC) I went.

In my pre-injury life, I had taken a grand total of a few aspirins and ibuprofens. Now, I had been prescribed a cocktail of medications. For my first month out of the hospital, my daily pill intake included:

  • Oxycodone: 10mg every 3 hours (painkiller)
  • Coumadin: 7.5mg MWF, 5mg TuThSaSu (blood thinner)
  • Valium: 10mg as needed (I only took this once and hated how it made me feel) (muscle relaxant)
  • Iron Ferrous Sulfate: 300mg (because I had lost a lot of blood)
  • Multivitamin: 1 tablet
  • Calcium+VitD: 2 600mg tablets

After a few days, however, I cut the Oxycodone cold turkey and from then on I just took Tylenol as needed to dull the pain. Finally, I was not constipated any more! (I made an interesting observation about my pain. During the first couple of weeks in the hospital, the pain in my leg was often excruciating, and the morphine and heavy narcotics seemed to do little to relieve it. In fact, I found that if I could withstand the pain long enough without taking painkillers, my pain would actually become more tolerable (and I became more clearheaded and less nauseous too). Shortly after I left the hospital I was not even taking Tylenol, despite the severeness of the injuries. I think my leg had fulfilled its lifetime pain quota during the first few weeks.)

When I had left the hospital, I had been unable to get my foot to 90° in the cast. The nurse had suggested to my parents that they load me up on painkillers and Valium and torque my foot upwards. I vehemently resisted this barbaric tact, and instead tried a more gradual technique, where I would remove my cast and slowly move my foot back and forth, holding the extreme positions for 10 seconds each time. After a few days of this, my ankle joint was not as swollen, and getting the foot to 90° seemed like no big deal. However, my foot was still cocked sideways a bit, and I made a note to ask Dr. Kinahan about this on my 1-week orthopedic follow-up appointment.

For the first week out of the hospital, the weather was pleasant, and I mostly rested on my parents' back porch reading books and napping and staring off into space. I kept my foot elevated as much as possible. The pain was not bad, but it was mostly just frustrating to be so confined by my own body. I hoped I wouldn't go insane over the next few months. I began a daily regimen of sit-ups, leg lifts, and arm lifts. I moved around the house using a mix of butt scooting, crutches, walkers, and wheelchairs. Even though the house has no bathrooms on the main floor, I resisted debasing myself to using the commode, and instead I labored up and down stairs several times a day. As the days progressed I used the crutches more and more, and I even began a daily crutch walk up and down the street. I also consumed several pounds of shrimp and yogurt my first week at home, in an effort to eat a lot of protein and calcium to heal my tissues and bones. My parents were quick to get me anything I needed or lend me a helping hand, which I greatly appreciated.

By the end of the first week, I had started to do some research work for my advisor at UW. Although it was often difficult to concentrate, it was nice to have something meaningful to do and I had to maintain some semblance of work to qualify as a full-time student (I needed my health care more than ever now!). My advisor was sympathetic to my condition, but I felt bad that I was unable to produce much. Recovery was turning out to be a full-time job.

DAY
17
OCT 1
2010

DAY
18
OCT 2
2010

DAY
19
OCT 3
2010

Ian Derrington, Jason Schilling, Stephanie Savage, and Erin Reading made an attempt to retrieve some of the climbing gear that I had left on Vesper the day of the accident. But dicey moats and heavy fog turned them around on the Vesper Glacier.

My friends' gear retrieval adventure.
DAY
20
OCT 4
2010


DAY
21
OCT 5
2010

With a better forecast than two days previous, Wayne Wallace, Josh Kaplan, and David Kratsh headed up to Vesper. This time, the gear retrieval adventure was a success. With some shenanigans, they managed to recover over half of my gear and even continue on to the summit; they admitted to having a pretty fun day doing it too. The gear retrieval efforts from my friends was a real morale boost as well as saved me a few hundred dollars. Thanks Ian, Jason, Stephanie, Erin, Wayne, Josh, and David!

DAY
22
OCT 6
2010

I had two follow-up appointments in Everett. The first appointment was to get my dressing changed on my skin graft, which they reported was healing nicely. The second appointment was with my orthopedic surgeon Dr. Kinahan. Dr. Kinahan said that everything looked good; he didn't think I would need a bone graph or a bone growth stimulator, but it was a bit too early to know (it turned out I ended up needing both). Although overall the results at this stage were positive, it was a bit disheartening when I was told that the muscles and tendon on the front of my leg might not function normally again, and that it would be at least 6 more weeks until I could do any weight-bearing (it turned out to be MUCH longer than this, so in retrospect 6 weeks would have been great). Given my continued lack of mobility, it looked like I would be staying with my parents for at least a few more weeks. So, on the drive home we stopped at REI to buy a pair of pants, as I only had one pair with me at my parents' place.

This is what a skin graft looks like. It's 3 weeks after the accident, and my leg still looks like it got in a tangle with a meat grinder.
DAY
23
OCT 7
2010

Soon, I began to worry about "foot drop," which occurs when one is unable to lift the foot, due to damage to the nerves controlling the muscles and tendon on the front of the leg. Try as I might, I could not get my foot to move upwards. I called my vascular surgeon Dr. Papenhausen. He told me that foot drop is a potential result of high pressures and tissue damage caused by compartment syndrome (which had caused my muscle to swell on the operating table). But he also enforced that it is impossible to know the extent of the foot drop at this stage in the recovery. While there was a chance I would never walk normally again, there was also a chance that under several months of physio I would regain normal function. I would have to wait until I could start bearing weight to know how much of a problem this would be.

I had started to notice that in addition to the "foot drop", my foot seemed to be cocked outwards. My orthopedic surgeon didn't seem concerned, but it still bugged me.

DAY
24
OCT 8
2010

DAY
25
OCT 9
2010

DAY
26
OCT 10
2010

DAY
27
OCT 11
2010

I had yet another follow-up appointment at Providence Regional Medical Center to check the progress of the skin graft and to change the wound dressing. It was Canadian Thanksgiving, so both of my parents drove down and we made a day of it. Healing was progressing, stitches and staples were painfully removed, and another dressing-change appointment was scheduled.

DAY
28
OCT 12
2010

I celebrated the four-week anniversary of my accident by cutting all pain medications (including Tylenol) cold turkey. I no longer needed to be worried about a hernia.

DAY
29
OCT 13
2010

I'd developed a routine at my parents' house: wake up at 8am, do 30 min of core exercises, go on a 30 min crutch walk, and then work on schoolwork or read a book while my parents were at work. Then an afternoon crutch walk (I don't know how many times cars pulled over asking me if I wanted a ride somewhere, and the incredulous looks I would get when I said I was out exercising—yes, even though it's pouring rain). Evening was dinner, reading or working on more schoolwork, answering emails, and sometimes playing a game of UpWords or Scrabble with my mom. I usually got to bed by midnight. I felt terribly lazy and inactive, considering that my pre-injury life had involved daily 8-mile runs and frequent multi-mile-with-60-lb pack climbs and hikes.

MONTH
1
OCT 14
2010

DAY
31
OCT 15
2010

DAY
32
OCT 16
2010

My mom drove me to Artist Point up at Mt. Baker Ski Area to enjoy the October sun in the mountains.

Shuksan in fall colors taken during my day"hike" to Artist Point.
DAY
33
OCT 17
2010


DAY
34
OCT 18
2010

I had another appointment at Providence Regional Medical Center to check the progress of my skin graft. After this appointment, I was able to do my own wound cleaning by running warm water over the wound area and then covering it with a bandage. It still looked pretty gross.

DAY
35
OCT 19
2010


DAY
36
OCT 20
2010


DAY
37
OCT 21
2010

I drove my Subaru for the first time since the accident, to go to the local used bookstore. Although my injured left leg started to throb and swell when it was unelevated for even this short a time, it was nice to be able to be more independent with my errands.

DAY
38
OCT 22
2010

I had an appointment with my vascular surgeon Dr. Papenhausen in Everett. This was the first time I had met with him, although I had talked with him on the phone once and my parents had met him on the day of the accident. He did an ultrasound of the reconstructed arteries; the blood flow appeared to be completely normal, although there would always be a bit of scar tissue where the arteries were stitched together. Papenhausen was encouraged by the fact I could twitch my foot (but not my toes) just a tad upwards, but still said that only time would tell if the foot drop would be a permanent condition.

He recommended I start wearing a compression sock to reduce swelling, although it would cause the stitches to break open a bit right now. When I asked how long I would need to wear them, he said perhaps the rest of my life—I bemoaned the fact that for the from now on out my sock colors would be restricted to tan, brown, and beige. Maybe black or off-white too if I was lucky.

Papenhausen also gave me the okay to go to Italy in a month (I had been concerned that perhaps the pressurized plane flight would be a problem), where I was scheduled to be a TA for my advisor at a five-week course at the ROSE School of Engineering in Pavia.

DAY
39
OCT 23
2010

Another nice weekend where I would give anything to be adventuring in the mountains.

Get well card from my long lost friends at the UW climbing gym.
DAY
40
OCT 24
2010

DAY
41
OCT 25
2010

I had a physio appointment in Abbotsford. Although it cost $55 for 45 min, it was very helpful. Commenting at the drastic lack of mobility in my foot (I could barely twitch it upward), the physiotherapist (named Brent) showed me several non-weight-bearing mobility and strength exercises—such as using exercise bands and doing foot circles—that I could do for at least 1 hour a day. He noted it would take several months and a lot of work to get my normal range of motion back, if ever.

DAY
42
OCT 26
2010

I began to take the cast off every evening to do minor physio exercises (resistance, foot circles, stretching). I also began to massage the skin graft and ankle in order to try to break up the adhesion between the tendons and the scar tissue. The mobility was slowly increasing.

DAY
43
OCT 27
2010

DAY
44
OCT 28
2010

DAY
45
OCT 29
2010

DAY
46
OCT 30
2010

My skin graft donor site, which should have been healed by this time, spontaneously started to blister and ooze. I began to bandage it again and put antibiotic ointment on it. I didn't really know why this was happening.

DAY
47
OCT 31
2010

DAY
48
NOV 1
2010

I noticed for the first time a very slight upwards twitch of my toes, but only when I was sitting with my foot out on the floor.

DAY
49
NOV 2
2010


DAY
50
NOV 3
2010

I had two more follow-up appointments. My parents and I were getting very used to the scenery along I-5 between Abbotsford and Everett. One appointment was to get fitted for a foot brace to keep my foot at 90° while I slept (this would help keep my Achilles tendon from shortening). The second appointment was with my orthopedic surgeon Dr. Kinahan. The x-rays were disappointing, since it seemed to me as if no healing of the bones had occurred—what was I doing wrong? I'm young and fit, and supposed to heal fast, I thought to myself. Kinahan said the lack of bone healing was likely because of my severe vascular injuries, which had reduced blood flow to the area. On a positive note, Kinahan was happy that the alignment had not shifted, and like Papenhausen he also gave me the go-ahead to go to Italy the following week, where I had plans to be a TA for my advisor.

One of my frequent follow-up appointments.
DAY
51
NOV 4
2010


DAY
52
NOV 5
2010


DAY
53
NOV 6
2010

The blisters on my skin graft donor site were not getting better, so I decided to go to a drop-in clinic in Abbotsford to get it looked at. I had noticed that as soon as some one blister would heal on one spot, another would pop up on another spot. The doctor told me to use non-stick pads and he prescribed me some oral and topical antibiotics. Even though the blisters disappeared two days later, the donor site continued to be easily aggravated, so I kept covering it with a bandage.

DAY
54
NOV 7
2010


DAY
55
NOV 8
2010

I had a second physiotherapy session. The physiotherapist noted the improvement in the mobility of my ankle since the last time he had seen me. He suggested I continue the isometric exercises and massages. Hmmm….$55 for him to tell me to continue what I was doing already.....

DAY
56
NOV 9
2010

While paring down some of my childhood toys and books at my parents' house, I discovered that rats had gotten into my old stuffed animals and had eaten most of the faces off. My favorite stuffed cat from my childhood, named Coco, was salvaged and given a skin graft.

When cleaning out my childhood toys, I discovered rats had gotten into my stuffed animals. So of course I took photos.

My stuffed cat Coco got a skin graft too. At 8 weeks, my skin graft is healing nicely. At 1 day, Coco's has already reached full healing.



Recovery Part III
Taking my crutches to Italy!
DAYS 57 to 94 • NOV 10 to DEC 17, 2010


“There’s no lift, you know,” the man in the ticket booth told me. He had a thick Italian accent.

“How long do I have?”

“20 minutes. Two hundred and ninety-six steps up and two hundred and ninety-six down." He looked doubtfully at my leg and crutches. I handed him fifteen euros.

The steps were slanted and uneven. Smoothed marble bowls, slightly offset from the center of each step, marked a millennium of footfalls. Around and round the spiral of triangles I went, constantly adjusting to the southeasterly tilt of the tower. Clomp, clomp, clomp; echoing with each step, I felt loud and clumsy. Near the top, where the stairs became narrower and steeper, I was forced to crawl. I hugged the wall to allow a man to move past me—even after two months on crutches, I hadn't gotten used to being passed.

It took me eight minutes to get to the top. I snapped a few photos. “Most accidents occur on the descent,” I thought, and started down.



DAY
57
NOV 10
2010

I returned to my apartment in Seattle. This was the first time I had been there since before the accident. My mom and I ended up unpacking and cleaning and repacking all night! I would be in Seattle for only three days.

DAYS
58-60
NOV 11-13
2010



MONTH
2
NOV 14
2010

I flew to Italy, where I would be a TA for my advisor Dr. Kramer at an intensive 5-week course in Earthquake Engineering he teaches at the ROSE School near Pavia. It would be quite an adventure on crutches, but I didn't want to give up the experience just because I was injured. I would return to Seattle on Dec 17.

DAYS
62-92
NOV 15 -
DEC 15
2010



MONTH
3
DEC 14
2010

Italy was like a daily obstacle course of crowded buses and trains, narrow streets, fast Fiats, wet cobblestones, uneven stairways, and 4-ft entryways! But I was determined not to let my broken leg stop me from enjoying this unique and beautiful country, and I managed to do several unique day trips to nearby areas:

  • Cinque Terre
  • Lake Como
  • Certosa di Pavia
  • Pisa
  • Lucca
  • Milan
  • Trento-Bolzano-Renon
  • Venice

Of course I took lots and lots of photos. I posted a trip report called "Italy on Crutches" that details my adventures and gives some of my favorite photos.

Regarding the injury, there seemed to be little improvement (or un-improvement) in my leg. At least my arms were getting strong with all the crutching around; however, but my fingers were starting to tingle and go numb, probably due to compression of the median nerve in the wrist.

Crutching around Cinque Terre 9 weeks after my injury.

Propping up the Leaning Tower of Pisa with my crutch.

To get around in Italy, you need all-wheel drive crutches.
DAY
93
DEC 16
2010

I woke up with pain in my leg, which was unusual since I had not felt much pain since the first few weeks after the accident. My leg looked a tad bit swollen but not too bad, so I didn't think much of it. I had fever and chills that night.

DAY
94
DEC 17
2010

I flew back to Seattle after nearly five weeks in Italy. I've never been so uncomfortable as I was during those 26 hours of travel, with the area over the plate on my tibia getting more swollen and red and the pain escalating by the minute. Pain was highly unusual for me, so I knew something was wrong. I suspected it was either an infection or that I had somehow caused the plate along the tibia to shift. For some reason, I was not at all surprised that my return to my normal life in Seattle was accompanied by a return to hospitals and medical assessments. Italy felt like it had just been a brief vacation from my new pattern in life back in the States.

(As will be detailed in the next section of this "recovery trip report," this was the onset of a major infection. Perhaps in retrospect I should not have gone to Italy, as the stresses of traveling might have depressed my immune system just enough to allow a full-blown infection to develop. However, the doctors told me that the infection had likely been brewing in my leg for awhile, probably introduced into the gaping compound fracture on the day of the accident or during my initial stay in the hospital. Bacteria are able to live in the surgically-installed metal hardware and, since the antibodies in the body cannot reach into the non-vascularized metal, the hardware becomes a ticking time bomb just waiting for a temporary dip in the immune system. Had I not gone to Italy, the infection might not have happened as soon as it did, but it probably would have happened at some point down the road. I will never know. I was just fortunate the ticking time bomb did not go off until the end of my Italian adventure.)




Recovery Part IV
A Major Setback: MRSA Infection
DAYS 95 to 110 • DEC 18, 2010 to JAN 2, 2011


I marked the edge of the swelling and redness on my leg with a ballpoint pen. At my emergency room visit a couple of days earlier, I had been diagnosed with a skin infection and sent home with oral antibiotics. Now, I watched as red streaks moved past the ink. My leg began to swell hideously with fluid. Mountainous nodules formed, then erupted with yellow puss as they broke through the skin. This did not look like a skin infection to me.



DAY
95
DEC 18
2010

Twenty-six hours after leaving Italy, I was finally home in Seattle. It was midnight when the plane touched down, so I decided to wait until morning to assess the status of my leg. Perhaps it would improve now that I was off the plane. I doubted that would be the case, but thinking that way would allow me at least a few hours of sleep. I unpacked as quickly as is possible on crutches, gobbled some painkillers, and collapsed into bed. The next morning, my leg seeming to be even worse, I headed to the emergency room at UW Medical center. Just sitting there, the redness patch grew and started to migrate up my leg. Great.

The ER doctors did an ultrasound to rule out a blood clot, took x-rays to rule out movement of the plate, and took blood tests to check for infection. I had an elevated white blood cell count, which is an indication of infection. They gave me some antibiotics (Vancomycin) by IV, and then sent me home with a prescription for two different strong antibiotics to take together over the next ten days (Sulfamethoxazoe/Trimethoprim 800/160 mg twice daily and Cephalexin 500mg four times daily). I was glad not to have to spend the night in the hospital, but was a bit skeptical that this was the end of it. With my recent open fracture and plate installation, I wondered why the ER doctors were not more concerned about it being a possible bone infection.

Although the antibiotics made me feel kind of airy and made my stomach upset, they did cause the skin to decrease in redness, but the area was still swollen and painful. I started to notice a significant buildup of fluid underneath the skin in the area over the plate. Hmmm, that didn't seem like something a skin infection would do.

DAY
96
DEC 19
2010


DAY
97
DEC 20
2010

I had an appointment with Dr. Kinahan at Everett Bone and Joint. My x-rays showed only slight bone healing. Not what I wanted to hear. Kinahan said he would write up the paperwork for me to get a bone stimulator to stimulate bone growth (these stimulators are based on research that has shown that subjecting the bone to electromagnetic pulses or ultrasonic waves associated with bone growth does actually appear to "kick start" healing). It looked like it would still be awhile before I could bear weight. With my middle fingers already numb from the crutching, I wondered if carpel tunnel would be a problem before this was over. Fun stuff.

Kinahan was quite concerned that the infection was in the bone around the plate rather than just the skin and underlying tissue. Infected bone cannot heal, so my lack of significant bone growth suggested that might be the case. He put me in touch with an infectious disease specialist, Dr. George Diaz, and I scheduled an appointment for the following day.

DAY
98
DEC 21
2010

I returned to Everett to see Dr. George Diaz, the infectious disease specialist. With the significant fluid buildup over the plate, he suspected infection of the plate and area around it. He was particularly interested when I mentioned that when I started wearing compression socks back in late October one of my healed stitch scars had opened up and had oozed some puss for awhile, and had finally closed up about a week previous. He told me I would need an ultrasound to determine the extent of the fluid buildup, and then likely a surgery to remove the infected fluid. Given that it looked like I was in for long haul of hospital treatment, I expressed my concern having to come up to Everett all the time (not only was it more effort, but my Graduate Appointee Health Insurance did not cover me as well outside of the UW network hospitals). He arranged for my care to be transferred to the UW Medical Center and Harborview.

That night, I noticed that the infected area had become so tight and full of fluid that an old stitch scar was starting to ooze puss.

DAY
99
DEC 22
2010

My ever-helpful landlady (thanks Cherie!) drove me to the UW Medical Center to get an ultrasound to assess the fluid/puss buildup in my leg. The ultrasound indicated there was about a cup of puss in the area above the plate. Ug.

By this time, I knew I needed immediate attention. The skin on my lower leg was beginning to form frightening black bulges that were causing my scars to reopen and leak orange puss. I kept remembering the scene from the movie Alien where an alien suddenly burst out of the guy's body. Feeling a bit like I had been forgotten by all the doctors (it didn't help that I was in the middle of transferring my care to Seattle and it was Christmastime), I checked myself into the ER.

After the usual blood tests and hospital gown, eventually I was seen by someone from the ortho department. They took one look at my leg and said I would need to get surgery as soon as possible to remove the infected fluid, clean out the infected area, and likely remove the recently-installed hardware from the bone. Since the metal hardware is not vascularized and the antibodies in the body cannot reach into it, once the bacteria establish a home in the metal it must be removed in order to eradicate the infection. Once symptoms begin to show, is important to get the infected hardware out as soon as possible before the bone infection becomes too extensive to treat via antibiotics. The bone cannot really heal until the infection is eradicated.

The ortho doctors hit me with some pretty frightening news. Since my bone was far from healed, there was a good chance I would need an external fixator on my leg (since they were reticent to put in a new plate and risk another infection). I had watched my mom endure external fixation for a broken tibia earlier the same year (the results of hitting a telephone pole at 70mph), and I did not want to deal with having an external cage around my foot for an extended period of time. The doctors also told me I was at greater risk for developing compartment syndrome again during surgery, and needing another faciotomy and skin graft. This really was starting to feel like a nightmare that would never end. I felt like the previous three months of healing—during which I had already nearly gone crazy from the immobility—was negated and I would be starting all over again.

After a day in the ER, I was transferred to Harborview Medical Center, also in Seattle (if I had known the 20 minute ambulance ride would end up costing $1500, I would have taken a taxi, called a friend, or even hobbled there). I would stay at Harborview overnight—blowing through about $5,000 more—getting my INR down to clottable levels and have surgery the next day. My parents arrived that night. It was becoming apparent that Christmas would be at Harborview—or at least in Seattle—this year.

The gruesome results of infected hardware. I later learned that these mountains of puss are called "pustules," which seems like a pretty good term for them.
DAY
100
DEC 23
2010

I began the day with a CT scan to assess the degree of infection and new bone growth (as both look about the same on a typical x-ray). The orthopedic surgeon on my case, Dr. James Krieg, felt there was just enough new bone growth (particularly of the nearby fibula which could act as a thin strut) so that the plate could be taken out without need of an external fixator. This was the first positive news I'd heard in a long time.

In a surgery that took a couple of hours, Krieg opened up my leg, drained the infected fluid, removed the plate from the bone, and washed the area out to remove as much bacteria as possible. He inserted a tube into the wound to monitor drainage, and then stitched me back up. I was fortunate that Harborview is probably the best hospital in the country for this type of complicated surgery, and everything went as well as possible. The next day, I was given the plate and screws they had removed from my leg—a unique souvenir from my injury.

When I had come back to my room after the operation, my parents had been told that I had been woken up and had to be put back under anesthetic. Even the nurse wrongly assumed it was because of pain from the surgery. However, the last thing I could remember was throwing a fit when they tried to insert a catheter into me. Guess standard practice is to knock out unruly patients.

The infected hardware that they took out of my leg. I'm a biohazard now.
DAY
101
DEC 24
2010

Having gotten through a relatively painless night on a single Tylenol, I hoped I would be discharged. Hospital beds are not the most enjoyable place to spend the holidays, especially for someone as active as myself. My leg looked and felt much better without the massive swollen nodules of puss (I later learned the medical terminology for these is "pustules"). Plus, even though I was impressed with the state-of-the art facilities at Harborview, the food was terrible and I decided I'd just eat Cliff bars out of the vending machine in the lobby until I could leave.

So it was pretty disappointing when the doctors told me I'd have to stay in the hospital for a few more days. They needed to culture the puss to determine the best course of antibiotics, and they also wanted to monitor the drainage from a tube in my leg to make sure the infection was not spreading. At least they allowed me to roam the hospital hallways as long as I kept a cell phone with me. I discovered that many of the waiting rooms had puzzles, so I made it my goal to leave every waiting room with a completed puzzle. This was a bit challenging, as often the puzzles were missing about 30 pieces or were combined with pieces from other puzzles.

Since I would need to take strong IV antibiotics for several weeks in order to eradicate any bone infection that had started, I was outfitted with a PICC line. A PICC line—the acronym stands for peripherally inserted central catheter—is a thin flexible tube that is inserted into a peripheral vein in the upper arm and advanced until the catheter tip terminates in the chest just above the right atrium of the heart; in this way, the antibiotics enter the bloodstream in larger and faster moving veins, rather than in the veins in the arm which would quickly be trashed by the strong antibiotics. Getting outfitted with the PICC line was a relatively painless process, but I was pretty weirded out when the tube went into my jugular vein and I could hear it squeaking along (since the jugular runs close to the eardrum); the tube had to be backed out a few times before it went into the desired vein leading to the chest wall.

DAY
102
DEC 25
2010

It did not look as if I would be out of the hospital for Christmas. However, after some pleading, I was allowed to leave the hospital with my parents for about 10 hours in-between my morning and evening doses of IV antibiotics. I enjoyed walking around Green Lake, working a puzzle, giving my family presents I had bought in Italy, and sharing a Christmas dinner with my parents, sister, aunt, and uncle. It was a strange feeling to return to the hospital that night.

My friend Mark sent me a great Christmas present. He had fashioned a set of chains for my crutch tips, so I could have more traction on snow and non-pavement terrain. It was predicted to be a cold winter in Seattle, so his gift would likely be very useful.

Another Christmas present was that finally, after 3 months, I stopped bandaging my skin graft donor site. It did not break out into spontaneous blisters anymore. (Hmm....wonder if this constant blistering had been related to the underlying infection in my leg.)

My first (and hopefully only) Christmas in a hospital room.

A Christmas present from a friend: chains for my crutches. Now I could still go on my daily crutch walk even if it snowed!
DAY
103
DEC 26
2010

In the morning, the drainage tube was removed. The feeling of the tube sliding along my bone made me gag. One less leash keeping me in the hospital!

Then, the culture results came in. They were rather terrifying: Methicillin Resistant Staphyloccus Aureus (MRSA). MRSA is an aggressive and resistant strain of staph that has been creating problematic infection outbreaks (mostly associated with hospitals) in the recent years. The MRSA had likely been brewing in my leg for awhile, probably introduced into the gaping compound fracture on the day of the accident or during my initial stay in the hospital. A sign of a persistent infection was the overall lack of new bone growth and healing on the fractured tibia; even after three months since the injury, my bones were still very broken. The MRSA was just waiting for a temporary dip in my immune system. It was slightly frightening to hear how people in the same situation as me had been known to lose their leg to MRSA. One of the nurses handed me a "Living with MRSA" booklet.

The treatment plan would be a 3-8-week course of the very strong IV antibiotic Vancomycin; after this, I would transfer to an oral antibiotic for several more weeks. While on Vancomycin, I would need to self-administer the antibiotics via the IV PICC line twice daily, and have a home care nurse drop off supplies and draw blood in order to monitor the amount of white blood cells and antibiotics in my system.

Since it was a holiday weekend, I would have to wait until the next day (Monday, Dec 27) until I could set up home care and be discharged from the hospital. So, I spent yet another day crutching around the hospital hallways, doing puzzles, and playing Scrabble. In situations like this, I regret the fact that I don't like TV or video games. It was now 5 days after I left my apartment planning to just be gone for a couple of hours for an ultrasound test on my swollen leg. For the second time (the first time being the day of the accident), I had narrowly missed losing my leg. This was my 20th day in a hospital since the accident.

DAY
104
DEC 27
2010

On the morning of my discharge from the hospital, after spending the last week hobbling freely around the hospital—at least one of those days with an oozing infection on my leg—I was quarantined. Quarantine involved being moved into a private room, and anyone entering had to wear green smocks, and anyone leaving had to wash their hands. It seemed about 6 days too late to be putting me in quarantine. Somehow I don't think that MRSA only becomes contagious once they've identified it as MRSA.

It took all morning to arrange my discharge and get all my prescriptions and follow-up appointments sorted out. But by afternoon I was free! Freedom lasted just long enough to pick up some lunch and groceries, and then I had an appointment to establish a primary care doctor and after that the home care nurse arrived to chain me to my IV antibiotics for a couple of hours. He taught me how to administer my own antibiotics into my PICC line using a battery powered pump that slowly pushed the antibiotics through a syringe and into the tube in my arm. Like a TV commercial that makes you wonder why anyone would even take the advertised drug, the nurse chattered off a list of possible side effects of the antibiotics (nausea, explosive diarrhea, death), secondary infections (of the intestines or the IV site), and problems of the PICC line (breaking, leaving the end cap in the heart, walking up into the jugular). When the home nurse finally left, I was calculating the likelihood that I would experience an IV-related death that night.

DAY
105
DEC 28
2010

I spent the better part of the day on the phone with my insurance provider, home care, and the UW hospital trying to find an affordable way to receive my antibiotic treatments. I had discovered the home care I was set up with was going to cost me thousands of dollars. After several hours on the phone with my insurance provider and home care outfit, I had still not found a cheaper solution short of checking myself into the hospital for 6 weeks. My medical bills were quickly eating up all the money I had saved for my next four years of graduate studies.

After the near miss with serious bone infection, the next couple of months would be chock full of follow-up appointments. I had to follow up with three different departments: Harborview Orthopedic for tracking the bone infection and the healing and alignment of the bone, Harborview Infectious Disease for tracking the appearance of the wound and the effectiveness and my body's response to the strong antibiotics, and Harborview Vascular for tracking the skin graft and repaired arteries and my blood INR levels. Plus, I had the twice daily IV antibiotics and the weekly blood draws and wound and IV dressing changes administered by a home care nurse. And then there was physio to get my leg back in working condition. Recovery really was turning out to be a full time job. It was a good thing I had transferred all my care to Seattle (where I live) rather than Everett (where I had initially been airlifted).

In my life previous to the injury, I had ingested a grand total of only a few ibuprofens. Now I was making up for the paucity of pills in my pre-injury life. For the next several weeks, I would be taking a very strong IV antibiotic called Vancomycin for the infection, Coumadin to keep my blood thin and prevent blood clots in the leg, Tylenol about once ever ten days for discomfort, and Multivitamins and Calcium/Vit-D supplements for general health boost. It is difficult to feel like a normal healthy person when your counter is lined with pill bottles, but other than the frequent nausea and upset stomach caused by the Vancomycin (I hoped the bacteria in my leg were feeling just as nasty as me, and would die of starvation sooner than I would), I felt fine and had practically no pain in the leg (besides the episode with the infection, I had felt very little pain since Week 3, which always seemed to surprise the doctors given the surgeries and brokenness of my bones).

I had to administer the strong antibiotic called Vancomycin via an IV line. I hoped the Vancomycin would kill the infection before it killed me.
DAY
106
DEC 29
2010

I had a follow-up appointment with the Harborview orthopedic team to check how my leg was doing after the plate removal the previous week. I discovered that there is a free shuttle running from the U-District to Harborview—at least something is free in the American Health Care system.

It turned out that the orthopedic physician who saw me was a friend from the indoor climbing gym at the University of Washington. I took this as a good sign, as he knew I was an athlete and, being a fellow climbing enthusiast, he would understand that I would settle for nothing less than full strength and function of my leg.

Also, I started using a bone growth stimulator. I had actually acquired this bone stimulator on Dec 21, but had been unable to use it yet due to the emergency operation because of the infection. The stimulator involved putting my leg inside a cradle, where it was subjected to electromagnetic pulses associated with bone growth (research has shown that these electromagnetic pulses do actually appear to "kick start" healing). My stimulator—a product by CMF Bone Growth Stimulation—was programmed for 30 minutes of usage a day for up to 9 months. Most people use them between 2-5 months. Bone stimulators are very expensive, and are only covered by insurance 3 months after an injury.

The bone growth stimulator which produces electromagnetic pulses that research has shown to be associated with bone growth. Mine came in a convenient cradle form.
DAY
107
DEC 30
2010


DAY
108
DEC 31
2010

New Years eve at my parents' house, hooked up to an IV working a puzzle and doing foot circles in my bone stimulator. We decided we'd switch to Central time for the night so we could welcome in the new year and get to bed. Let's hope 2011 is a better year!

DAY
109
JAN 1
2011

Of course it had to be the most brilliant and calm New Years day, perfect for skiing or snowshoeing. I entertained the possibilities of one-legged skiing but concluded that one-legged falling would be hazardous to my broken leg. Sometimes I just felt so overwhelmingly trapped by the injury.

My parents got me arm-style (instead of armpit style) crutches as a late Christmas present. I hoped these would help the numbness in my hands and protect the PICC line running up my arm from being crushed. Due to the numbness, PICC line, and Vancomycin-induced nausea I tried to restrain myself from my long crutch walks; even so, it was good to get the blood flowing in order to keep myself mentally sane....

2011 is my year to train for old age.
DAY
110
JAN 2
2011

Back in October, my mom had driven me up to Mt. Baker Ski Area to photograph Mt. Shuksan in it's autumn splendor. Now we returned to the now-snowy terrain for some more photos of this gorgeous Cascade summit.

Refreshed and rejuvenated by the crisp mountain air, I felt better already. New Years had definitely been a psychological low point and my one-day-late New Years resolution was that my recovery would move forward from here on out!

Winter evening light on Mt. Shuksan.

My night photography page.



Recovery Part V
Just Living
DAYS 111 to 141 • JAN 3 to FEB 2, 2011


It had snowed overnight, so it was time to put the chains on. I had saved the battered old crutch tips I had used in Italy, and now I outfitted these with the chains and twist ties my friend Mark has made for me for Christmas. Out the door I went.

With the slightly fatalistic attitude I had begun to develop regarding my injury, I weaved around my neighborhood on a mission: to crutch the slushiest sidewalk, the iciest stairs, the steepest slope, the deepest drift. Typical of Seattle snow, slush was everywhere and I had to settle for a rather pitiful drift.

The only weakness I could find was that they tended to skid on smoother inside floors. Perhaps Mark can fashion some crutch tip suction cups, I thought.



DAY
111
JAN 3
2011

With the infection under control, I was now just waiting for the strong antibiotics to kill off any lingering MRSA in my bone and body. Then, the plan was to get the metal plate reinstalled on my leg. Since the bones in my leg could not heal while infected or without the pressure of the plate holding them together, my recovery felt stagnated—if not backtracked—for several weeks.

It was the beginning of the Winter Quarter at the University of Washington. Fortunately, I was not taking any courses. With my research obligations, doctors appointments, treatments, surgeries, physiotherapy, and just daily life and getting from one place to the next, most days I felt like I was on a steep and windy road driving a truck whose brakes had failed (perhaps my original misspelling of "failing breaks" works just as well). There were still several miles of road ahead. But, remembering my New Years resolution, I was determined to attack my recovery with a more positive outlook.

DAY
112
JAN 4
2011


DAY
113
JAN 5
2011

I had a follow-up appointment with the Harborview orthopedic team to take x-rays and remove the stitches in my leg. I also had the opportunity for a long chat with my surgeon Dr. James Krieg (this was the first time I really got to talk with him about my leg, as I had been pretty medicated all the other times I saw him). He was optimistic about my long-term recovery, although he would not commit to a complete recovery ("we'll get you back to climbing and hiking again, for sure; but running is an unknown at this point"). My heart sank when I heard I might never run again, as running is something I love just as much as climbing. Then, I decided that a life without running would not be an option. I will run again.

Dr. Krieg said that once the infection was eradicated in about 4 more weeks, I would undergo surgery to get a plate put back on my tibia. Due to all the trauma and the scarring from the initial plate which had been along the inside of my leg, he would put the new plate on the side of the tibia that faces the outside of my leg, inserted between the fibula and tibia. Also, he would do a bone graft in order to create more sites for bone growth (this would involve inserting bone fragments taken from the top of my tibia into the vicinity of the break at the base of my tibia). Krieg also mentioned a frightening possibility that the bones would require rebreaking to get a better alignment. This injury was getting complicated.

We also discussed the options for being able to lift my foot again. Early on in my recovery I had noticed an inability to lift my foot past 90°. I had assumed this was nerve or tendon damage along the front of my leg, but as the soft tissue had begun to heal over the last couple of months, it was almost as if it was hitting a physical block, rather than lack of nerve signal or weakness, every time I tried to lift it past 90°. Krieg suggested this could be a shortening on the tendon in the back of my leg or a buildup of scar tissue or bone between the base of the tibia and an ankle bone; once diagnosed, he felt this could be fixed, perhaps at the same time as the surgery to install the new plate.

I ended the appointment with my standard question: "How long until I can start bearing weight?" Krieg's reply: "Three more months. Probably." With the numbness in my hands beginning to spread past just my middle fingers, I hoped there was a good carpel tunnel surgeon at Harborview.

DAY
114
JAN 6
2011

The previous day at Harborview, I had requested copies of all my x-rays. Going through them, I noticed they had included an x-ray that had been taken of my right leg in May 2010, when I had a small stress fracture (a stress fracture seems so insignificant now!). I compared these to the x-rays of my injured left leg to see if I could distinguish any differences in the alignment of the bones. It appeared to me as if the tibia on my injured left leg was shifted a bit closer to the top ankle bone (or perhaps it was scar tissue closing the gap). I wondered if this could be the main reason I could not lift my foot up normally.

Comparison of my right and left leg.
DAY
115
JAN 7
2011


DAY
116
JAN 8
2011

I started thinking about talking with a lawyer. With my medical bills possibly reaching $400,000 by the end of the year and a $100,000 maximum benefit on my graduate student insurance plan, it seemed I would be losing all of my hard-earned savings that were meant for the next four years of grad school. I was still a bit peeved about the fact that they had not honored my Sept 16 request to be transferred from Providence to Harborview, as this subjected me to much higher non-network rates and spread out my bill among two hospitals which had the result of decreasing any charity coverage. Already, more than one person had mentioned bankruptcy. This predicament didn't seem fair - What is the point of paying for medical insurance if the insured end up loosing all of their money anyway? I needed to talk to someone who knew more about it than I did.

DAY
117
JAN 9
2011


DAY
118
JAN 10
2011

I had a follow-up appointment with Dr. John Lynch at the infectious disease clinic at Harborview. He was encouraged that there was no visible swelling or redness of my leg. I asked when I could transition from the astringent IV Vancomycin (which was wrecking havoc on my intestinal system) and be put on slightly milder oral antibiotics. Expecting him to tell me a few more weeks, I was pleasantly surprised when he decided to remove my PICC line and put me on a heavy dosage of oral Bactrim (which I would have to take for 9 more weeks). I was to keep a close eye on my leg to make sure there were no signs of the infection returning if the Bactrim proved to not be strong enough to fight the lingering MRSA. It was nice not to have to bother with the twice daily IV anymore, and especially nice to have the return of about 23 hours of time each week.

DAY
119
JAN 11
2011


DAY
120
JAN 12
2011

It snowed overnight, so it was time to put the chains on. I had saved the battered old crutch tips I had used in Italy, and now I outfitted these with the chains and twist ties my friend Mark has made for me at Christmastime. I swapped the chained tips onto the end of my crutches, and out the door I went. With the slightly fatalistic attitude I've began develop regarding my injury, I weaved around my neighborhood on a mission: to crutch the slushiest sidewalk, the iciest stairs, the deepest drift, the steepest slope (typical of Seattle snow, slush was everywhere and I had to settle for a rather pitiful drift). I also beelined for any new surface—doormats, rubber, grass, smooth pavement, coarse pavement, metal stairs, inside floors, etc. The verdict: Mark needs to patent the crutch chains; on all outdoor surfaces and snow types, they performed superbly. Their only weakness was on smoother inside floors, where they tended to slide.

In an email I received later that day, my friend gave a great description of this typical Seattle snowstorm: "...and this snow is killing me; last night it was pristine powdery snow and then you wake up and it is all just dirty slush, doesn't make for very good snow balls."

That evening, I nearly broke my leg anew when a crutch (sans chains now) skidded out from under me on the smooth floor of a grocery store. By now I've learned not to buy eggs. Perhaps Mark can fashion some suction cups for my crutch tips....

DAY
121
JAN 13
2011


MONTH
4
JAN 14
2011


DAY
123
JAN 15
2011


DAY
124
JAN 16
2011

I discovered that the cushy leather seats and elevated footrests at my neighborhood Starbucks were a perfect place to work on my numerical analyses, computer programming, and poster distractions. The staff soon knew me by name, brought me my coffee, and started to joke that they should get me a bell so I could ring for service.

A poster of State High Points I created while doing foot circles.
A poster of the 100 Highest Summits in WA. More foot circles.

My projects page.
DAY
125
JAN 17
2011


DAY
126
JAN 18
2011

My Subaru started to have problems steering. I took it to my mechanic. "Front left leg is broke, looks like you'll need a new transfer case"; his ironic wording made me wish my leg repair could be as simple as a new transmission.

DAY
127
JAN 19
2011

The next day, my microwave bit the dust. I've become a firm believer in the statement "when it rains it pours."

DAY
128
JAN 20
2011

The results from my weekly blood test showed that my blood was much too thin, due to the interaction of the new oral antibiotic with my blood thinners (which I had been taking ever since the accident to prevent blood clots in the leg from the trauma and inactivity). Hmm….that seems like something the pharmacist should check when they hand out a prescription to someone who has noted other medications on the sign-in form. Good thing the interaction of Bactrim and Coumadin is not spontaneous combustion.

DAY
129
JAN 21
2011


DAY
130
JAN 22
2011

I was really starting to miss my weekend escapes into the mountains, which would always refresh my body and soul. Weekends had merged with weekdays. Life just kind of moved along. I had noticed that my view of the world around me had become progressively less vibrant, less detailed, less alive. I had begun to feel I was just waiting for my real life to resume.

So, in an effort to distract and reinvigorate myself, I bought a Fisheye lens for the weekend. With its 160° field of view and focal point that nearly touches the lens, the fisheye allows the photographer to capture eye-popping angles, creative focus points, and unique perspectives. When I found myself crawling along the ground trying to get just the right perspective on a string of water droplets on a leaf, I realized I had temporarily forgotten about my leg. I was actually enjoying myself.

(After debating back and forth, I ended up returning the fisheye lens after the weekend; my reason was that without a full-frame sensor, I would never be able to maximize the fisheye effect of the lens. I hoped Canon would come out with an EF-S version of a fisheye lens, or that someday I could afford a new camera setup.)

Water droplets balanced on a leaf.
Self-portrait in a crosswalk button.

My fisheye photography page.
DAY
131
JAN 23
2011

Inspired by the previous day's photo adventures, I decided to the Kerry Park overlook on Queen Anne Hill and take some photos of Seattle at twilight. While the low clouds obscured Mt. Rainier, they turned a pretty pink as they reflected the city lights.

Seattle night skyline from Queen Anne Hill.

My night photography page.
DAY
132
JAN 24
2011

I was greeted by yet another pile of medical bills when I got home in the evening. My response to these doorstep piles has evolved over the last few months. Sometimes I throw my crutches across the yard and do a wild hop dance; other times I flip the crutches around and madly bash the pile of bills. The best result is achieved when I have enough presence of mind to throw only one crutch, which allows me to bash the bills to smithereens, have a baton for my hop dance, and safely retrieve the thrown crutch once I'm done. It always makes for a good work-out.

Okay, maybe I went a bit crazy with this entry, but it always helps to add a little humor to a tough situation....

DAY
133
JAN 25
2011


DAY
134
JAN 26
2011

People have started to ask about my "skiing injury." Perhaps if I start thinking of it as a skiing injury, then I'm doing pretty good in my recovery timeline…..

DAY
135
JAN 27
2011


DAY
136
JAN 28
2011

I was asked to write a feature article for this year's Northwest Mountaineering Journal. The topic would be my recovery, however I wanted to present it. Scrolling through these day-to-day notes, I am surprised at how long the "trip report" had become. It's also interesting to me to see how I switch back and forth between past tense and present tense, which often (though not always) reflects my state of mind at the time—whether I am accepting the situation that day or trying to remove myself from it. When I started taking recovery notes that first week in the hospital back in September 2010, I definitely did not foresee the challenges and length of the recovery ahead. I now have a new challenge in life: boiling my recovery down into a few pages for submission.

DAY
137
JAN 29
2011


DAY
138
JAN 30
2011


DAY
139
JAN 31
2011


DAY
140
FEB 1
2011

It was a beautiful day. With the clear skies making Mt. Rainier visible, I went back to Queen Anne Hill to photograph the Seattle night skyline at night.

Seattle night skyline from Queen Anne Hill, Mt. Rainier visible in background.

My night photography page.
DAY
141
FEB 2
2011

When I had last talked with my orthopedic surgeon Dr. Krieg about a month ago, the plan was to wait until the infection was under control, and then do a series of surgeries, which would involve: re-breaking the bone to achieve a better alignment, taking a bone graft from my upper tibia and hip, screwing plates along the tibia and fibula, and cutting a section of my Achilles tendon to slightly lengthen it in order to reduce future stiffness problems. Needless to say, I wasn't looking forward to this. As my dad aptly put it, "Go back to Go. Do not collect $200".

So I was pleasantly shocked when, at my pre-surgery appointment with Krieg, he proposed a new Plan A: Do nothing. X-rays had shown that my bones were finally starting to heal, in large part due to the MRSA being killed off. Why not let the body try to heal itself? There were some major advantages to this new plan: it would avoid a painful surgery and healing setback, it would avoid some more large medical bills, and it would avoid the increased risk of infection introduced by metal hardware. The major risk to the "do nothing" plan was if my bones started to shift as I began to put a little weight on them. In the case of shifting, I would undergo the surgeries that were now Plan B. It seemed a clear choice. Plan A.

One hundred and forty-one days, and finally some good news!




Recovery Part VI
Pedaling Forward
DAYS 142 to 197 • FEB 3 to MAR 30, 2011


"Looks like a skiing injury," I heard from behind me.

"Rock climbing." Rock falling, I thought to myself.

The man looked almost relieved—he was probably a skier himself. "Dangerous sport. Will you climb again?"

"Soon as I can."



DAY
142
FEB 3
2011

Back in October 2010, forty-one days after the accident, I had gone to a physiotherapist to get some exercises to help regain mobility in my foot. My leg and skin graft were still pretty chewed up at the time, and I probably shocked the poor guy. He told me to do foot circles, which I had done ever since. They had actually been pretty effective at keeping the soft tissue from stiffening or weakening too much.

Now it was time for some more advanced physio. The physiotherapist (named Jon) did all the standard evaluations of mobility and strength and flexibility, using my uninjured right foot/ankle/leg for comparison. My left ankle had consistently 5-15° less range of motion than my right, and still would not pull up to 90°, but Jon was nevertheless encouraged (surprised even) at the amount of function and strength I still despite the long-term immobility and severity of the injuries in that area. I did not feel any pain. Jon gave me the usual rubber exercise bands and daily regimen of stretches and resistance exercises.

A major step forward: Jon told me I could start putting 25% weight on my left leg. Without a metal plate generating pressures necessary for bone healing, my orthopedic surgeon determined slight weight-bearing was a necessary risk, even though the bones were still quite broken. Using a scale to determine what 25% felt like, it didn't seem like much. Even when I pushed it up to 40% when the physiotherapist wasn't looking, there was no pain—but knowing myself, I doubt I'd feel any pain until the bone actually snapped. It would still be awhile before I would be fully weight bearing—I didn't need to worry about jeopardizing my upcoming elite status of spending half a year on crutches.

Ironically, as I start physio, my main area of pain has become the 6-inch scar running down my calf. This scar was created the night of the accident when the surgeon removed my vein to use it for the artery reconstruction in my foot. The scar tissue is adhered to the underlying muscle, resulting in burning pain whenever I flex my calf. A physiotherapist friend recommended getting a snakebite kit and using the pump extractor to break up the adhesion. It looks a bit gruesome to see your skin sucked into a tube, but it is actually working pretty well!

Seems like each time I went to the hospital, they sold me a new boot....the most recent one fits my snowshoes perfectly.

Using a pump extractor from a snakebite kit ($14 REI) to break up the scar tissue adhesion.
DAY
143
FEB 4
2011

"Is it more painful than usual?", "Is that some new redness and swelling?" "Does the angle look 'weird' (as my ortho doc said it would if the bones shifted)?" Probably not, but I find myself hypersensitive to my leg these days. Earlier in the week, I narrowly avoided a major surgery (rebreaking, grafting, plating, tendon clipping), but this surgery is still pending, depending on whether or not the broken bones in my tibia maintain their alignment as I begin doing some minor physio. There is some evidence for misalignment already with my foot cocking outwards, but until I begin walking it's difficult to know at this point if this will be a major or minor problem (if major, it would require a re-break). It's nerve-wracking, to say the least! I hope my bones know what kind of punishment they are in for if they shift.

DAY
144
FEB 5
2011

At first, I had thought 25% weight-bearing was a pretty pitiful amount of weight. It certainly felt like hardly any pressure every time I stepped down at 25%. But then I started to think of it in terms of gallons of milk. Each gallon of milk weighs about 8.3lbs. Twenty-five percent of an 180 lb person (not me!) is 5.4 gallons of milk. For a 120 lb person it's 3.6 gallons. Thinking about strapping this number of milk jugs over my knee makes 25% weight-bearing seem like a significant amount of weight.

DAY
145
FEB 6
2011

I was going to spend the afternoon reading a book for once, but I got distracted by finishing a poster of climbing routes on Mt. Rainier….it's the closest I get to climbing these days.

A poster of climbing routes on Mt. Rainier.

My projects page.
DAY
146
FEB 7
2011


DAY
147
FEB 8
2011

At my physio appointment, Jon told me that I can start using a recumbent exercise bike to start strengthening my leg muscles. Good news! Looks like I'll need to take my leg-comparison photos to capture my leg at its most atrophied state.

At 11:45am on Feb 8 this post read: "I'm hoping I can find a fellow post-broken-leg-climber that might have an extra recumbent exercise bike lying around that I could borrow for a few months."

By the end of the day, a fellow climber had offered to buy a bike off craigslist and deliver it right to my door, another had offered to give me his "exercise bike clothes hanger", and several others had pointed me towards good deals or offered to help me pick up a bike once I found one. Wow, thanks! Climbers to the rescue!

Hence begins the pedal-pedal-pedal era of my recovery....

Atrophy after nearly 5 months of non-weight bearing. And the leg is still broken. Ug.
Battlescars: Skin graft donor site (left) and skin graft (right) still healing (the donor site blistered until I got on the IV antibiotics, and the left leg has undergone 5 surgeries now).
DAY
148
FEB 9
2011

Pedal pedal pedalpedalpedal pedalpedal pedal pedalpedalpedal pedal pedal pedal pedalpedal pedal pedal pedalpedalpedal pedalpedal pedal pedalpedalpedal pedal pedal pedal pedalpedal pedal pedal pedalpedalpedal pedalpedal pedal pedalpedalpedal pedal pedal pedal pedalpedal pedal pedal pedalpedalpedal pedalpedal pedal pedalpedalpedal pedal pedal pedal pedalpedal pedal pedal pedalpedalpedal pedalpedal pedal pedalpedalpedal pedal pedal pedal pedalpedal pedal pedal pedalpedalpedal pedalpedal pedal pedalpedalpedal pedal pedal pedal pedalpedal pedal pedal pedalpedalpedal pedalpedal pedal pedalpedalpedal pedal pedal pedal pedalpedal pedal pedal pedalpedalpedal pedalpedal pedal pedalpedalpedal pedal pedal pedal pedalpedal…..

DAY
149
FEB 10
2011

…pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal pedal…..

DAY
150
FEB 11
2011

…pedalpedal pedalpedal pedalpedal pedalpedal pedalpedal pedalpedal pedalpedal pedalpedal pedalpedal pedalpedal pedalpedal pedalpedal …..

Aside from the pedaling, I did a mathematical analysis of my muscle loss after five months of non-weight bearing. Considering both muscle atrophy and a layer of muscle-to-fat conversion, my calculations showed I had lost about 4.8 lbs of muscle (uncertainty range of 2.7-7.1 lbs). I would have expected more from looking at my leg, but can't argue with math! (Click the link to jump to the analysis table and discussion of my calculations.)

....pedalpedal 4.8lbs pedalpedal 4.8lbs pedalpedal 4.8lbs pedalpedal 4.8lbs 4.8lbs 4.8lbs 4.8lbs 4.8 4.8 4.8 4.8 4.8 4.8 4.8 could be as much as 7.1 pedalpedal 7.1 7.1 7.1 7.1 7.1 7.1 7.1 7.1 7.1 7.1 pedal....

Jump to analysis tables of muscle loss.
DAY
151
FEB 12
2011

I woke up wondering how many people climb Mt. Rainier each year. I got kind of carried away, and by the end of the weekend and several colorful pie charts and graphs later, I decided I had answered my question sufficiently. My statistical study—which can be accessed by the link to the right—looks at statistics such as Total Annual Climbers over the last Century, Summit Success Rates and Number of Climbers by Month and Route, Temperatures and Wind Speeds at Camp Muir, Search-and-Rescue Data and Costs, Accident Causes, Total Fatalities and Annual Fatality Rates, etc.

Go to my new page on Mt. Rainier Statistics.
DAY
152
FEB 13
2011

MONTH
5
FEB 14
2011


DAY
154
FEB 15
2011


DAY
155
FEB 16
2011

I worked on a new Picket Range page for my website. I can think of no better way to encourage myself to make a full recovery. I will settle for nothing less with my leg than being able to hike and climb in the Pickets again.

Pedal, pedal, pedal.

Click here to go to my new Picket Range page.
DAY
156
FEB 17
2011

Due to the complications of my recovery, I had scheduled, canceled, rescheduled, and finally successfully rescheduled a presentation I was giving to the Seattle Mountaineers. It was really encouraging to see the turnout, put faces to names, and be uplifted by encouraging words regarding my recovery. Thanks everyone! Now, if I can only find that There that several people told me to hang in; then I'd be set.

Flyer for my Mountaineers slideshow.
DAY
157
FEB 18
2011


DAY
158
FEB 19
2011

I had the amazing the opportunity to join John Scurlock on a flight over the North Cascades to do some aerial photography. It was a clear (and windy!) day, and we flew in the afternoon to catch the evening light and alpenglow. Since by now I had almost forgotten what mountains looked like, I refreshed my memory by taking over 1500 photos. The flight was a spectacular morale boost for my mountain-hungry soul. Thanks John.

Link to my aerial photo page.
DAY
159
FEB 20
2011


DAY
160
FEB 21
2011

Nearing half a year on crutches, and by this time I am experiencing severe homesickness for mountain adventure. In a strange way of coping, I loaded thumbnails onto my website to give a photo for each trip report—below are thumbnails for my trip reports in order from my first climb in 1994 (Overhanging Tower with my dad when I was 11 years old) to the present....
…1994… …2003… …2004… …2005… …2006… …2007… …2008… …2009… …2010… …2011…
Link to linked chronology of my trip reports.

DAY
161
FEB 22
2011

DAY
162
FEB 23
2011

DAY
163
FEB 24
2011

DAY
164
FEB 25
2011

DAY
165
FEB 26
2011

DAY
166
FEB 27
2011

DAY
167
FEB 28
2011

DAY
168
MAR 1
2011


DAY
169
MAR 2
2011

"50% weight-bearing," the orthopedic physician told me. I pondered this for a moment, then replied, "7.2 gallons of milk." It seemed like more of a weight-bearing achievement to think of the number of milk jugs I would have to strap over my knee to get this much weight. (Each gallon of milk weighs about 8.3 lbs, so for a 180lb person 50% weight-bearing would be a whopping 10.8 gallons of milk).

This was good news. X-rays at my orthopedic follow-up appointment showed that the bones had not shifted and they were continuing to heal. The only negative report was an evident decrease in bone density of the bones in my lower leg and foot (they appeared darker on the x-ray than normal), due to the long term lack of weight-bearing. If all goes well, I might be able to walk on my leg (in an air cast of course) by the end of the month! My goal is to take my first crutchless steps on the half-year anniversary of the accident. I have 12 days to get there.

This CT scan of both legs, taken Feb 2, shows how the bone density in my left leg (on the right in the image) has decreased relative to the right leg (on the left in the image) because of the lack of weight-bearing.
DAY
170
MAR 3
2011

After my physiotherapy appointment, I started a line plot to track my ankle mobility measurements by date. So far, there's a positive positive slope in all measurements! My main concerns are cocking up my foot and big toe so I don't trip when I walk. I'm not a ballerina, so being able to fully point my foot is not a huge priority.

Plotting my Range of Motion measurements. On this plot, I show the measurements on my injured left foot as a percentage of normal measurements from my right foot (using the absolute angle rather than a percentage would be deceptive, as some motions—like cocking the toes up, for instance—have a much larger range than other motions—like eversion of the foot, for instance). (I keep this chart updated for most recent physio appointment, so only one set of measurements corresponds to March 3.)
DAY
171
MAR 4
2011

I have always avoided exercise machines at all costs, but for the next while it would be the best way to regain fitness and muscle strength without subjecting my legs to high impact forces. My physiotherapist suggested an elliptical as the best way to get a "running style" workout without the high impact; he speculated I could start using one in about a month or so. I didn't want to have to schlep into a gym every day, so I looked into the possibility of getting my own elliptical. A quick search on craigslist indicates that ellipticals are expensive and humongous machines that most people buy with lofty intentions in mind, use five or six times, and then put in the garage, use as a clothes hanger, or both. Seeing as I would need to make up for at least 200 days worth of missed 8-mile runs, I wanted to make sure to get a sturdy elliptical, not one of the many K-mart specials I would surely run into the ground.

Thus began the elliptical adventure. As with alpine climbing, research of the objective is key, so I started to frequent craigslist and various elliptical reviews. Overwhelmed with the possibilities, exasperated at the inordinate amount of time I was spending glued to craigslist, and not wanting to spend the entire month of March armchair ellipticalling, I decided to find an elliptical that looked good and just get it. It would then be all ready to go when I could start using it. I could be of little help other than poking the elliptical with my crutches, so my friend Roger and his friend Jerry offered to help me get it set up. We would do it in style, with Jerry's U-haul-sized truck.

There were several cruxes on this adventure:

  • Crux #1: Finding a good elliptical for a grad student price.
  • Crux #2: Transporting the 200lb, 7-ft long, 5.5-ft high object to my home.
  • Crux #3: Getting the 200lb, 7-ft long, 5.5-ft high object safely down a set of stairs, around a tight corner, and through a narrow doorway, while in the pouring rain. (We came close to literally raising the lean-to roof over my entryway when the tipped machine proved to be a few inches to tall, but fortunately we were able to figure out how to unscrew the handles and thus avoid surely losing my damage deposit on my apartment.)
  • Crux #4: Finding a place to put it without the result of having to sleep on the floor or hop over it every time I needed to go to the bathroom.
  • Crux #5: Resisting the urge to use it until I was cleared for 100% weight-bearing in at least a month or so.

In the end, it was a very successful adventure. Avoiding potential catastrophe at every turn, I think we all had a lot of fun. Thanks Roger and Jerry!

Loading the 200lb, 7ft-long, 5.5ft-high elliptical into Jerry's truck.

The main crux: getting it under, down, around, and in.

Skin-grafted Coco and Elmo will guard it from me for the next month or so.
DAY
172
MAR 5
2011


DAY
173
MAR 6
2011


DAY
174
MAR 7
2011

I had a follow-up appointment with my infectious disease doctor at Harborview. On the bus ride there, I sat next to a guy who also had hobbled on with crutches. He enthusiastically told me he had just gotten outfitted with a prosthetic leg. Turns out surgeons had recently amputated his leg because of a MRSA infection. Yikes, I wonder how close I had come to losing mine? I also marveled at how this guy could be so happy—I definitely wasn't exuding happiness regarding my injury, and I still had my leg! I want whatever he's on.

Fortunately, my doctor had only positive things to say. It looked like I had won the battle with the obnoxious MRSA. Having been on strong antibiotics since the end of December, I am looking forward to the return of the good bacteria into my intestinal system—never again will I take those little buggers for granted.

DAY
175
MAR 8
2011


DAY
176
MAR 9
2011

I decided to entertain myself my making a timelapse from my usual cushy seat at Starbucks. This timelapse captures an hour at 150x speed. Things to watch for: my sister on her hands and knees, the pink Nalgene, me on crutches, my shoe, ball of tinfoil, seat occupation, flow of customers....

Just think—if every one of these customers spent $2-5, that's a lot of money spent on coffee in just one hour!

To see more of my timelapse videos or read about how I make them, see my timelapse photography page.

Timelapse: An Hour in the Life of a Chair Leg at Starbucks
Length of video: 23.6 sec
Real time: 1 hour
Number of frames: 354
Interval between photos: 10 sec
Frame speed of video: 15 frames/sec
Timelapse speed: 150x real time

DAY
177
MAR 10
2011

4,…

DAY
178
MAR 11
2011

...3,...

The daily doorstep pile reached a new record: 12 deep in bill statements, claim forms, insurance denials, and collections notices. I vote Yes for health care reform.

DAY
179
MAR 12
2011

...2,...

Another fun timelapse, this time of game night with some friends. I wish my recovery could be expedited by a factor of 150x!

Things to watch for: playing cards on the table (great idea Mike!), disappearing chips and strawberries, line-up, execution, and clean-up of the monopoly figures...

To see more of my timelapse videos or read about how I make them, see my timelapse photography page.

Timelapse: Game Night Fun
Length of video: 20.5 sec
Real time: 52 min
Number of frames: 308
Interval between photos: 10 sec
Frame speed of video: 15 frames/sec
Timelapse speed: 150x real time

DAY
180
MAR 13
2011

...1,...

This was the last day of my prescription for rat poison. Known under the benign medical name Warfrin (or Coumedin), the blood thinner I had been taking to prevent the occurrence of blood clots in my reconstructed arteries is actually one of the main substances used to kill rats (it's interesting the stuff we put in our bodies to make them better). Gone are the days of feeling I am going to bleed to death from a simple paper cut. I should celebrate by eating a plate of brussel sprouts (brussel sprouts contain a lot of Vitamin K, something you are not supposed to have while on blood thinners).

Tired of being a pill-popping junkie, I decided to stop taking my antibiotics too, although it was still three days before my nine week dose ran out. Now all I am taking is calcium supplements and probiotics. (I do admit, there are moments—a recent episode involving a crutch stuck in a car door with fingers loaded in shopping bags comes to mind—when I wish I were taking some slightly less legal substances too.)

MONTH
6
MAR 14
2011

...0! Happy 6th-month anniversary (of the accident)! Whoopee—I have achieved the elite status of half a year on crutches. Don't know whether to celebrate or cry. 6 months = 181 days = 4344 hours = 260,640 minutes. And still a long way off releasing the "hold button" on the adventurous life I love....

A couple of weeks ago, I had planned to take my first step on the 6th month anniversary of the accident. However, now that this day had actually arrived, I decided that from a risk-to-benefit standpoint, it was probably best I readjust my rather arbitrary first-step deadline until after I talked to my physiotherapist about it. So I tentatively set my first-step day for a couple of weeks from now. After all, at this point, what's another 336 hours?

DAY
182
MAR 15
2011

A History: The Battle of the Province of Left Leg and the Tragedy of Intestineville

For years—decades even—the friendly inhabitants of Intestineville had a peaceful existence. Then one day, an enemy swarm of MRSA invaded the Province of Left Leg, in the southern reaches of the empire. The MRSA were stealthy; they had amassed unnoticed around the borders of the province and over the course of a few months had waited patiently for the right moment to attack. The queen of the empire was caught completely unaware by their attack. She quickly mobilized her troops.

Since the queen's troops came from the northern end of the empire, they passed through Intestineville en route to Left Leg. Trained into a one-track mindset to kill, the troops wiped out the peaceful village. Reinforcement troops continued to pass through the area, and Intenstineville became a dry and ugly wasteland. The queen felt great remorse for the slain innocent inhabitants, especially as she began to realize the important role the Intestinevillians had played in the productivity and lushness of the middle of her empire.

But at that time the battle in Left Leg was of primary importance. Part of the queen's empire was at stake. The enemies were powerful, and for awhile it appeared that the queen would have to forfeit a large province of her southern empire to the enemy swarm. Massive amounts of ammunition were needed to kill each MRSA soldier. It was essential that a constant flow of ammunition reached the queen's troops. Fortunately, the queen had tremendous resources and persistence, and her troops were constantly resupplied and suicidal. The strong and merciless Vanco division of troops fought first, greatly depleting the MRSA ranks; then, to confuse the enemy with new tactics, the queen sent in her rugged veteran Bactrim division. After a long and epic battle lasting day and night for several weeks, the queen's warfare strategy of attrition finally paid off. The last MRSA soldier was killed. The queen had recaptured Left Leg.

Memories of the previously lush and fertile land of the middle empire were strong, and living creatures again began to populate Intestineville. But as these inhabitants began to reassemble, they began to plot. They wanted revenge for their unfairly massacred ancestors. Not the violent sort, they began to torture the queen with cruel jokes and convinced nearby villages to join them in their pranks. The queen—still feeling remorse over what had become known as the Tragedy of Intestineville and seeing that these new inhabitants were a friendly breed at heart—allowed them to exact their revenge without punishment. She knew that sooner or later, they would settle into their naturally peaceful selves and begin re-cultivating the land to become just as lush and productive as the Intestineville of the past.

Down south, what would become known as the Battle of the Province of Left Leg had done a great deal of damage. It would take awhile for the area to rebuild. The queen realized how important Left Leg was to the livelihood of her empire, so she paid special attention to the province, sending it extra resources and lowering its taxes. She was determined to have the province achieve its previous strength and power (then, like any politician, she could increase her demands and taxes upon the province and hence profit from her efforts). She knew it would take awhile, but with her care and attention, Left Leg would thrive again.

DAY
183
MAR 16
2011

When I left the hospital on Day 15 of my epic recovery saga, I was in a state of frenzy. Although some of my frenzy was due to the intense pain and bloodrush upon moving around, most of my reaction was to the appearance of my foot. It didn't look right at all. Not only did it not want to bend upward (totally normal I learned, due to the severe swelling at the time), but it also cocked outward (not so normal, but no one seemed too concerned for some reason). Now, nearly half a year later, the outward tendency of my foot has become especially noticeable as I try to do a normal walking step with my crutches—to get the foot to point forward I have to twist my knee inward quite a bit. This worries me, and confirms Dr. Krieg's comments that bone alignment might be an issue, which would necessitate a re-break to fix. Re-breaking the bone would be like starting over. After all this, could I get myself to do that? I do not know.

DAY
184
MAR 17
2011

I asked about my bone alignment issue at my physiotherapy session. My physiotherapist Jon said I wouldn't really know if alignment would be a problem until I began using the foot normally again, but he thought things looked in my favor and continued to give positive comments about my progress thus far. Jon told me to start 75% weight-bearing, which involves just one crutch under my opposite arm. And still in the walking boot of course. With my 40lb schoolpack on my back, this is actually like 100% weight bearing; but I live so much of my life with a heavy pack on that my legs probably think I weigh about 160lbs anyway.

Of course another physio session means another set of data points for my plot...positive slopes (literally and mathematically)....

Plotting my Range of Motion measurements. On this plot, I show the measurements on my injured left foot as a percentage of normal measurements from my right foot (using the absolute angle rather than a percentage would be deceptive, as some motions—like cocking the toes up, for instance—have a much larger range than other motions—like eversion of the foot, for instance). (I keep this chart updated for most recent physio appointment, so only one set of measurements corresponds to March 17.)
DAY
185
MAR 18
2011

Gotta fill my poster quota for the month.


TOP LEFT: This poster uses cartograms to illustrate the distribution of energy sources—such as coal, petroleum, hydroelectricity, etc.—across the United States. Click here to see more of my cartogram studies.

TOP RIGHT: This poster shows the 16 major volcanoes of the Cascade Volcanic Arc. These are the ones considered "potentially active" by the USGS, and other volcanic summits and formations are not shown. Click here to see more of my poster creations.

BOTTOM: This poster gives a list and map of Steck and Roper's Fifty Classic Climbs of North America. A "tick list" of great climbs! Click here to see more of my poster creations.

DAY
186
MAR 19
2011


DAY
187
MAR 20
2011

Spring Break week! (I hope the term "Spring Rebreak" never comes to fruition.) I had managed to keep my week free of appointments so I could help my parents install a wood floor in a house we have been building on Saturna Island. Hammering is always therapeutic.

While on Saturna, I also went on my first real bike ride! In lower gear then I would like to use, of course. At this stage, my leg still fragile and only 75% weight-bearing, it would not be a good idea to bike in Seattle (I'm slightly terrified of biking in Seattle even without a broken leg). But out on Saturna I can just leave my crutches lying at the end of the driveway, and bike for an hour without seeing any more traffic than sparrows and deer. Cold fingers, fresh air rushing by my face, and a bit of rain—ah, what freedom! It's nice to bike further than the living room.

"Does the cast count?" "Only if you wear it on your head," replied my dad. My first bike ride outside of my living room!
I commandeered the spot in front of the wood stove for my daily leg physio. Hopefully by the end of the week ths floor in the photo would be a nice new wood floor.
Timelapse: For the speed, we charge $36,000/hour.
Length of video: 23 sec
Real time: 4.6 hours
Number of frames: 547
Interval between photos: 30 sec
Frame speed of video: 24 frames/sec
Timelapse speed: 720x real time

Timelapse: Flooring the Spare Bedroom in 26.4 sec.
Length of video: 26.4 sec
Real time: 3.2 hours
Number of frames: 396
Interval between photos: 30 sec
Frame speed of video: 15 frames/sec
Timelapse speed: 450x real time

DAY
188
MAR 21
2011

DAY
189
MAR 22
2011

DAY
190
MAR 23
2011

DAY
191
MAR 24
2011

DAY
192
MAR 25
2011

DAY
193
MAR 26
2011

DAY
194
MAR 27
2011


DAY
195
MAR 28
2011

My physiotherapist had recommended not biking in Seattle yet, at least until I was 100% weight bearing. But after a week of hour long bike rides on the quiet roads Saturna Island, now back in Seattle I found myself sneaking glances at my bike languishing in the corner of my apartment. It looked lonely. I figured I'd just pump up the tires. Then I decided to move it closer to the door, just to have it ready for when my physiotherapist said I could use it, you know. I checked my calendar—my next physiotherapy appointment was four days away. A good patient, I hopped over to my recumbent bike in the corner of my living room and began to pedal away. I missed the fresh air rushing past my face. I glanced over at my bike by the door. I pedaled. I glanced. Next thing I knew I was no longer missing the fresh air was rushing past my face. I never was a very patient patient.

DAY
196
MAR 29
2011


DAY
197
MAR 30
2011

My small apartment is pretty hazardous for crutches, so I have gotten into the habit of hopping, crawling, and leaning on furniture. Recently, I've found myself wondering how I got from one end of the room to the other. Did I hop? Crawl? Or did I accidentally walk? Or—in a shiver of fright, I glance down at my leg to make sure it still looks straight—did I hop on the wrong foot!? I take these thoughts as a good sign—that my leg is telling me it is getting ready for walking again. That will be nice—it is annoying not to be able to walk.

I've put my (clean and unused) left shoe next to my (tattered and worn) right one by my door. Hmmmm....didn't I do a similar thing with my bike the day before?....




Recovery Part VII
100% Weight-bearing! (Doesn't Always Mean Walking)
DAYS 198 to 272 • MAR 31 to JUN 13, 2011


I scoped out the parking lot for the spot that offered the furthest walking distance from the store entrance.



DAY
198
MAR 31
2011

I took my first step. Then another. Then I walked around the physiotherapy room. No boot to boot. Rather than wobble around and fall flat on my face (as other broken-leg recoverees had warned would happen after over half a year of not walking), my leg actually felt pretty strong. Seems that my 3-4 hours a day of exercise bands, stretching, leg lifts, sit-ups, biking, and foot circles have paid off. A crazy thought flashed through my head: I wonder what would happen if I took off running down the hall? ..... But of course I didn't.

My physiotherapist recommended gradually incorporating a bit of unassisted walking and ellipticalling into my daily life. At first he told me to to continue wearing the boot, but then I confessed that I had actually been foregoing the boot for a few weeks now; in fact, the only times I wore it were when I came to my physio appointments. (Imagine walking with a rigid stump for a leg that is 2 inches longer than the other leg; this is not only annoying but also seems as if it would hinder any improvement in ankle strength.) So, bootless and crutchless I embarked on the world. For a few minutes a day at least.

(To be truthful, my overall emotion is not one of excitement to be taking my first steps since the injury, but rather "well, it's been nearly 7 months, it's about time." But, literally and figuratively, this is certainly a positive step forward!)

And of course, another set of data points for my plot. Other than lifting my foot, the range of motion is pretty much back to normal. It still cocks out when I try to walk, but I am trying to train myself to keep it in.

Plotting my Range of Motion measurements. On this plot, I show the measurements on my injured left foot as a percentage of normal measurements from my right foot (using the absolute angle rather than a percentage would be deceptive, as some motions—like cocking the toes up, for instance—have a much larger range than other motions—like eversion of the foot, for instance). (I keep this chart updated for most recent physio appointment, so only one set of measurements corresponds to March 31.)
DAY
199
APR 1
2011

Coco growled at me. I informed him that his elliptical-guarding career was over, and he resumed his stuffed cat-nap.

Each day I am allowed to use the elliptical for one more minute than the previous day, starting from 5 minutes (today). At this rate, my recumbent bike will be a clothes hanger within a couple of months.

DAY
200
APR 2
2011


DAY
201
APR 3
2011

It's starting to be the time of year for bird photography. Since I am still on crutches for all but short, unburdened ventures, all I can photograph is big, slow birds….

Tufted Puffin
Wood Duck

Click here to see more of my bird photography.
DAY
202
APR 4
2011


DAY
203
APR 5
2011

I dread my doorstep except on postal holidays and Sundays. Emergency Physician Statements, Anesthesia Services, Surgeries, Hospital Stays, Insurance Claim Forms, Maximum Benefit Reacheds, Total Charges Dues, Make Check Payable Toos, Overdue Notices, Collections Notices, …Canada is looking pretty good.

DAY
204
APR 6
2011


DAY
205
APR 7
2011

After over half a year of being on vacation from weight-bearing, my left leg is finding it difficult to resume its job of walking. My ankle tissues scream at me every time I try to take a step; and my Achilles tendon is incredibly tight. I keep my crutches nearby for any destination besides the bathroom. I feel like I've taken the fast track into old age.

On a positive note it doesn't look as if the bones are shifting (my constant paranoia) as I put weight on them. And it's been nice not to have to hop my coffee back to my seat at Starbucks anymore.

DAY
206
APR 8
2011


DAY
207
APR 9
2011

I spent the afternoon biking the paved Olympic Discovery Trail between Port Angeles and Sequim, an enjoyable 35 mile round trip. (I was in Port Angeles for a presentation I was giving to the Hurricane Ridge Winter Sports Club.) This bike ride was definitely the furthest I've gotten from my crutches since the accident. I figure this ride put my week's biking total at around 100 miles. Along with my daily exercise bands, stretches, core exercises, elliptical at one extra minute per day, bone stimulator, protein loading, and restlessly staring off into space longing for mountain adventure, at least I know I am doing everything I can to propel my recovery.

An enjoyable bike ride on the Olympic Discovery Trail.

The fragile boundary between Ocean and Continent.
DAY
208
APR 10
2011

On Sunday driving through Sequim on my way back to Seattle, I noticed a sign for the Olympic Game Farm. I decided to check it out. It turned out to be fun for photography, and it was also therapeutic to spend the afternoon with souls that could definitely empathize with entrapment (me with a broken leg, them with a chain link fence). The Farm was originally designed as a holding compound for animal actors for Walt Disney Studios, from the 1950s through the 1970s; most of the animals now at the farm are offspring of the previous animal actors.

Click here to see more of my animal photography.
DAY
209
APR 11
2011


DAY
210
APR 12
2011

I thought it would be nice to have an incline option on my elliptical, in order to stretch my Achilles tendon and to provide more of a workout in the future. But my elliptical does not have an incline feature. No worries, I could design my own! Since my low ceiling would not allow for a plywood ramp underneath the machine, my idea was to use foam ramps on the pedals. My mom offered to buy the supplies at her favorite foam shop, my dad glued the pieces together, and they boxed them up (along with a few other goodies) and sent them to Seattle. I cut them to shape and kept the scraps so I could have a series of inclines from 10-20°. One of the rare moments when I actually feel like an engineer....

How to avoid paying big bucks for the incline option on your elliptical.
DAY
211
APR 13
2011

One step forward, two steps back. Back on two crutches. How annoying. I knew walking was too good to be true.

Even though I had limited my "100% weight-bearing" to a measly daily 5-15 minutes sans crutches, over the last couple of weeks I had developed a worsening pain along the outside of my left foot. My physiotherapist suspects tendonitis—caused because the tendons in my foot had been pretty much unused for half a year—and suggested that I go totally back on the crutches until the pain goes away. It's frustrating. A Catch-22. How can I avoid aggravating the tendons every time I try to transition away from the crutches? Recovery can be annoyingly non-linear.

On a more positive note, I used some leg machines for the first time, and my physiotherapist was surprised when my left and right leg performed about the same. My right leg was demoralized, but my left leg gloated, and that's what counts at this point.

MONTH
7
APR 14
2011

7 months and still on 2 crutches….sigh….aarg….crap…..sigh…..still such a long way to go to full recovery….

DAY
213
APR 15
2011

Girl riding a bike with a pair of crutches sticking out of an oversized backpack and a cast on her leg, that's me, not something you see every day….

DAY
214
APR 16
2011

Inhaled some ibuprofen (I think these are the first pain meds I've taken in a few months) and the tendon pain disappeared. I feel like I could run.

I see a future powered by Vitamin I.
DAY
215
APR 17
2011

Spent the day crawling in the mud through the colorful tulip fields that blanket Skagit Valley every April.

Click here to see more of my flower photography.
DAY
216
APR 18
2011


DAY
217
APR 19
2011

Since inhaling the Ibuprofen three days ago, the tendon pain (that had been so evident in the days before that) has not returned. Walking, Take 2.

As I use the crutches less, I've noticed that the numbness and tingling in my fingers is lessening too.

DAY
218
APR 20
2011

Another physio session and a half-dozen more uninspiring exercises to add to my daily regimen.

I'm really starting to resent all the time I put into physio, with only slow (if any) progress. I've never been a fan of exercising on machines or while sitting down (and yes, this covers biking on both fronts). I find it quite lacking on both enjoyment and sweat scales. But, right now it's all I can do, so I will continue to spend a few hours a day enduring butt-bound exercising until I can run, climb, backpack, and hike again....

The doctors on:

  • Running: "Probably never again."
  • Climbing: "What, you still want to climb after it did this to you?"
  • Backpacking: "No heavy packs."
  • Hiking: "Of course. In a few months from now, at least."
  • All of the above: My goal.

First step: Walking.

DAY
219
APR 21
2011


DAY
220
APR 22
2011


DAY
221
APR 23
2011

Easter weekend….I fit right in with the Easter bunny with this weird hop-step gait I've adopted.

DAY
222
APR 24
2011

DAY
223
APR 25
2011

My car was impounded. After going grocery shopping on Easter (a mistake in the first place as it seemed everyone in Seattle had this idea), I returned home to find the only parking spot anywhere near my house was a rather primo spot underneath a Do Not Park Beyond This Point sign and appealing opposed to the idea of crutching my shopping bags several blocks. I planned to move it the next morning, but apparently Seattle traffic cops work on Easter too. Sigh....just another frustrating plus financial fallout of the broken leg.

I stomped into the car impound lot so frustrated I forgot my leg is still broken.

DAY
224
APR 26
2011


DAY
225
APR 27
2011

Physiotherapy Session 8.

It has always been easier for me to exercise if I am training for some particular race, climb, or adventure. So, in order to give a more tangible goal to my daily leg-strengthening bike rides, I have started to plan a 10-day bike trip down the Oregon coast for this summer. Pedal, pedal, pedal!

Oregon Coast Bike Route Poster. I guess this is how I plan a trip.
Click here to see more of my poster creations.
DAY
226
APR 28
2011


DAY
227
APR 29
2011


DAY
228
APR 30
2011

Night photography workshop. Hope everyone who attended had as much fun as I did!

Night photography at Gasworks Park, Seattle.
Click here to see my night photography.
DAY
229
MAY 1
2011

If there is one positive thing that's come out of my injury, it's the excuse to sit around and read. (Ironically, on the hike into Vesper the morning of the accident, I had commented to my sister that my one regret that summer was that I did not set aside enough days to just relax with a good book. I got my wish, I guess.) My existance over the last 8 months has been partially played out from one exciting fictional world to the next. Here's all the books I can remember reading (although I am sure there are more) over the last 8 months, listed in approximately the order I read them:

  1. Modern Surgical Care, Chapter 1: Metabloic Response to Starvation, Stress, and Sepsis by Thomas Miller
  2. Dome by Stephen King
  3. An Irish Country Doctor by Patrick Taylor
  4. Crutches User Manual by Some Medical Brand
  5. Living with Coumadin Booklet by Some Medical People
  6. Learning to Breathe by Alison Wright
  7. Time Traveler's Wife by Audrey Niffenegger
  8. Times Arrow by Martin Amis
  9. Seventh Son by Orson Scott Card
  10. Prentice Alvin by Orson Scott Card
  11. In the Heart of the Sea: The Tragedy of the Whaleship Essex by Nathaniel Philbrick
  12. The Universe in a Nutshell by Stephen Hawking
  13. Twilight by Stephanie Meyer
  14. Sarah: Women of Genesis by Orson Scott Card
  15. Rachel and Leah: Women of Genesis by Orson Scott Card
  16. Life and Death in Shanghai by Nien Cheng
  17. The Case for the Real Jesus by Lee Strobel
  18. Rebekah: Women of Genesis by Orson Scott Card
  19. Stone Tables by Orson Scott Card
  20. The Confession by John Grisham
  21. Fall of Giants by Ken Follet
  22. Geotechnical Earthquake Engineering by Steve Kramer
  23. Magic Street by Orson Scott Card
  24. The Sign of the Book by John Dunning
  25. Living with MRSA Booklet by Some Medical People
  26. Unbroken by Laura Hillenbrand
  27. Seabiscuit by Laura Hillenbrand
  28. Fifty Classic Ski Descents in North America by Chris Davenport, Art Burrows, and Penn Newhard
  29. Treasure Box by Orson Scott Card
  30. Pirate Latitudes by Michael Crichton
  31. A History of the World in 6 Glasses by Tom Standage
  32. 127 Hours by Aron Ralston
  33. Angels in the Wilderness by Amy Racina
  34. Back of Life Cereal Box by Quaker
  35. The Voice of the Night by Dean Koontz
  36. A Simple Plan by Scott Smith
  37. Relentless by Dean Koontz
  38. Breathless by Dean Koontz
  39. A Test of Will by Warren Macdonald
  40. Once and Future King by T.H. White
  41. The Crystal Cave by Mary Stewart
  42. Booked to Die by John Dunning
  43. Anthill by Edward Wilson
  44. True Grit by Charles Portis
  45. Water for Elephants by Sara Gruen
  46. Room by Emma Donoghue
  47. The Art of Racing in the Rain by Garth Stein
  48. An Irish Country Village by Patrick Taylor
  49. Flawed Dogs by Berkeley Breathed
  50. Roadside Geology of Washington by David Alt
  51. The Absolutely True Diary of a Part-Time Indian by Sherman Alexie
  52. Pastwatch: Redemption of Christopher Columbus by Orson Scott Card
  53. Bookwoman's Last Filing by John Dunning
  54. Little Bee by Chris Cleave
  55. The White Spider by Heinrich Harrer
  56. Thunderhead by Douglas Preston and Lincoln Child
  57. The Codex by Douglas Preston
  58. The Bookman's Promise by John Dunning
  59. Midnight in the Garden of Good and Evil by John Berendt
  60. Hammer of Eden by Ken Follet
  61. Bicycling the Pacific Coast Route Guide by Vicky Spring and Tom Kirkendall
  62. Edgar Sawtelle by David Wroblewski
  63. A Separate Peace by John Knowles
  64. Marley & Me by John Grogan
  65. Pontius Pilate by Paul Maier
  66. 430EX Speedlight Shoe-mount Flash User's Manual by Canon
  67. Ice Limit by Douglas Preston and Lincoln Child
  68. How to Ice Climb by Craig Luebben
  69. And these are just the ones I can remember, up to May 1. That's nearly a third of a book a day since I broke my leg. Mostly for my personal records, I decided to continue my reading list (past May 1) until the 1-year anniversary of my accident….

  70. Cold Comfort Farm by Stella Gibbons
  71. Whiteout by Ken Follet
  72. Jennie by Douglas Preston
  73. Animal Farm by George Orwell
  74. More than a Skeleton by Paul Maier
  75. The Clan of the Cave Bear by Jean Auel
  76. Impact by Douglas Preston
  77. Eye of the Needle by Ken Follet
  78. A Place Called Freedom by Ken Follet
  79. Equal Rites by Terry Pratchett
  80. Elephant Run by Roland Smith
  81. Riptide by Douglas Preston and Lincoln Child
  82. The Book Thief by Markus Zusak
  83. Field Guide to Birds of North America by Roger Peterson
  84. Hunger Games by Suzanne Collins
  85. Mort by Terry Pratchett
  86. The Valley of the Horses by Jean Auel
  87. The Help by Kathryn Stockett
  88. 365 Thank Yous by John Kralik
  89. The Giant's House by Elizabeth McCracken
  90. Pollyanna by Eleanor Porter
  91. Bedknobs and Broomsticks by Mary Norton
  92. The Borrowers by Mary Norton
  93. A Life on the Edge by Jim Whittaker
  94. Theodore Boone: Kid Lawyer by John Grisham
  95. Sarah's Key by Tatiana de Rosnay
  96. Divergent by Virginia Roth
  97. Think of a Number by John Verdon
  98. The Lovely Bones by Alice Sebold
  99. The Borrowers Afield by Mary Norton
  100. Lost Boys by Orson Scott Card
  101. Homebody by Orson Scott Card
  102. Shut Your Eyes Tight by John Verdon
  103. Folk of the Fringe by Orson Scott Card
  104. The Story of Beautiful Girl by Rachel Simon
  105. Yellowstone & Grand Teton Travel Guide by Moon Handbooks
  106. Gone Baby Gone by Dennis Lehane
  107. Plain Secrets: An Outsider among the Amish by Joe Mackall
  108. Sworn to Silence by Linda Castillo
  109. Glacier National Park Travel Guide by Moon Handbooks
  110. EMT-Basic Study Guide by McGraw Hill Publishers
  111. Death in Yellowstone: Accidents and Foolhardiness in the First National Park by Lee Whittlesey
  112. Mere Christianity by CS Lewis
DAY
230
MAY 2
2011

Evidently I am spending too much time (reading books) at Starbucks these days. A thought: If I had bought Starbucks stock in 1992, my medical bills wouldn't be an issue.

Number of Starbucks stores, 1971-2010.
DAY
231
MAY 3
2011


DAY
232
MAY 4
2011

Today I had my first x-ray in 2 months; during these 2 months I had gone from 0% to 100% weight-bearing. Last time I had talked with my orthopedic surgeon, he had warned about the possibility of needing a re-break (there was potential misalignment due to the emergency removal of the infected metal hardware in December). But good news—the tibia and fibula are healing nicely, with no obvious misalignment issues. However, I am still a long way off from regaining complete strength and function. Right now, hiking to the top of Mt. Si would be an expedition involving about 4 basecamps.

My x-rays from the day of the accident until now (updated later to show my one-year follow-ups).
DAY
233
MAY 5
2011

Physiotherapy Session 9. I decided that today I would give up my crutches for good (even though it's been over a month since I was told "100% weight-bearing," I've kept using a single crutch due to a lot of pain and weakness in rolling my foot forward). This must be the point in my recovery where the "no pain no gain" expression comes into play.

I'll put my crutches to use as my new gear storage rack.
DAY
234
MAY 6
2011


DAY
235
MAY 7
2011

I had become concerned about an outbreak of warts on my skin graft. However, I discovered today that they are not warts, but fragments of old sutures (mostly from the emergency artery reconstruction, I think) that are working their way out of my body. Given the number of fragments I see in the last xray, I imagine I'll be leaking sutures for several years….

DAY
236
MAY 8
2011

In preparation for my Oregon coast bike trip this summer, I experimented with attaching an old tripod head mount and point-and-shoot camera to my handlebars. Here's a video I took biking across the I-90 bridge on my way to Mercer Island. At 20x speed, I actually have a normal biking pace.

DAY
237
MAY 9
2011

A new walking distance record: car to waterfront at Gasworks Park.

More fun with night photography at Gasworks.

My night photography page.
DAY
238
MAY 10
2011


DAY
239
MAY 11
2011


DAY
240
MAY 12
2011

My skin graft on my lower leg is kind of interesting, since it has no sensation, grows no hair, and it shows every movement of the muscle and tendon that it is directly attached to. After a few hours in the sun today, I learned that it tans nicely.

DAY
241
MAY 13
2011


MONTH
8
MAY 14
2011

A few nice birthday surprises today: for the first time, I can walk on my toes without my left foot collapsing; also, I discovered that I can balance pretty well just standing on my left leg and if I take enough ibuprofen I can descend stairs without holding onto a railing. Happy Birthday to me!

DAY
243
MAY 15
2011

Wood flooring on Saturna Island, fun! Lots of birds on Saturna this time of year.

I also started to go on 30 minute walks, something I had not been able to do until this time. Next step: being able to walk for miles and miles with a heavy pack.


Click here to see more of my bird, bug, and flower photography.
DAY
244
MAY 16
2011

DAY
245
MAY 17
2011

DAY
246
MAY 18
2011

DAY
247
MAY 19
2011

DAY
248
MAY 20
2011

DAY
249
MAY 21
2011

DAY
250
MAY 22
2011


DAY
251
MAY 23
2011

Today marked the initial stages of my return to climbing. My friend Roger and I spent the evening climbing at Vertical World. I climbed all the 5.7 and 5.8 routes. Followed by ibuprofen and frozen peas.

My first time climbing since the pernicious Sept 14.
DAY
252
MAY 24
2011

If you can't hike and climb in them, how about fly above them. Thanks John for another amazing afternoon over the Cascades.

(Click the link to the right to see several aerial photos I took of peaks popping above clouds.)

Link to my aerial photo page.
DAY
253
MAY 25
2011


DAY
254
MAY 26
2011

Physiotherapy Session 10 (my insurance only covers 12 so that's why I keep track). My physiotherapist suspects that the rather significant pain I've continued to have in my foot might be nerve-related (something he called RSD) rather than tissue/bone-related. If so, I could push through the pain and maybe start to lose the limp. Maybe.

DAY
255
MAY 27
2011


DAY
256
MAY 28
2011


DAY
257
MAY 29
2011

I always have fun when I take my macro lens for a walk. Macro photography really gives an appreciation for the incredible detail and creativity of God's artwork. Here are some photos I took while peering into bushes and crawling along the side of the trail at Discovery Park in Seattle.


Click here to see more of my bug, flower, and other cool photos photography.
DAY
258
MAY 30
2011


DAY
259
MAY 31
2011


DAY
260
JUN 1
2011

Now that I could finally walk on my leg a mile or so, my dad and I took a trip down to Malheur National Wildlife Refuge in Oregon to do some birding. Birding for me involves trying to get a good (or at least identifiable) photo of every bird I see. Malheur has an incredible diversity of species, and in our 24 hours on the reserve, my dad and I spotted (and photographed) 76 different bird species!

Click here to see some of my favorite bird photos from the trip.
Pattycake, the most attentive birdwatcher at the hotel where we stayed on Malheur NWR.
DAY
261
JUN 2
2011

DAY
262
JUN 3
2011

DAY
263
JUN 4
2011

Decided to see if I could walk an hour without stopping. Have a slight limp, but it felt great. No ibuprofen needed.

DAY
264
JUN 5
2011

Went on two hour-long walks. Even the blister feels great.

DAY
265
JUN 6
2011

Decided to add a 20 lb load to my walk. And a hill. And some stairs. Pickets, here I come.

DAY
266
JUN 7
2011

I am now officially on Medical Leave from my graduate studies until the fall. My progress on my PhD this year has been pitiful, and my recent decision to take a medical leave is long overdue. Dealing with a serious injury really is a full time deal. My main focus of the next few months will be getting my leg back to full strength and function. Or at least as close to full as possible.

As I pursue recovery, I'll probably be spending a good deal of time helping my parents build a house out on Saturna Island, BC, which is where I headed this week. On Saturna, I relish being free from the constant nagging pressure I have in Seattle of dreadful exercise machines and oppressive weight rooms that I've been oft told are the "best" way to get my leg strong again. My long walks on Saturna—usually with a 20lb load now with no problems at all—are much more enjoyable, and seem to be doing a world of good for my leg.

I've realized that over the last few weeks, my classification of my leg has transitioned from "broken and useless" to "feeble but useful." I look forward to the day when I classify it as "mountain capable."

Click here to see more photos from the beautiful Saturna Island.
DAY
267
JUN 8
2011

DAY
268
JUN 9
2011

DAY
269
JUN 10
2011

DAY
270
JUN 11
2011

DAY
271
JUN 12
2011

DAY
272
JUN 13
2011




Recovery Part VIII
Another Setback: Stress Fracture
DAYS 273 to 328 • JUN 14 to AUG 8, 2011


SMACK! A bug hit the windowpane.

I wondered what the bug's last thoughts were. Blue skies, fresh air, freedom!

THWACK. I could relate.



MONTH
9
JUN 14
2011

Looks like I spoke too soon about "no problems at all" walking. I celebrated the nine-month anniversary of my accident by strapping on a walking boot cast again. (Actually, since I am on Saturna, I got my mom to bring me the walking boot she used after her tib/fib injury, a result of running into a telephone pole at 70mph just nine months before I suffered a nearly identical injury.)

Diagnosis: I suspect a stress fracture. Treatment: Rest. And a boot. 4-8 weeks. My, I am so tired of that form of treatment. Reason for injury: The months of immobility compounded by the bone infection had caused a significant decrease in bone density in my lower leg. Given this (depressingly) fragile state, I guess I overdid it in my exuberance to be walking again. During my daily walks over the last couple of weeks, I had monitored my leg and foot closely, and there had been no pain or swelling. (Anyway, considering the rigor my leg used to endure on a daily basis before the injury, it's hard to see walking slowly as anything short of an incredibly tame activity.) But then a few days ago, I started to feel a dull nagging pain in the area on the outside of my heel, and practically overnight I went from walking with no problem whatsoever to hardly being able to bear weight without keeping my foot padded and rigid.

No Pickets for me yet. Got to get this walking thing down first.

In this x-ray (taken in March), the darker areas of bone in my lower leg and heel indicate where the bone density had drastically decreased after months of immobility and a nasty bone infection. My bone density is still quite compromised, evidenced by the fact that I got a stress fracture from just walking. I just hope that the decreased bone density is reversible. (The holes in the tibia, by the way, are screw holes from the metal plate that was installed in September and then removed three months later when the MRSA decided to throw their Christmas fest.)
DAY
274
JUN 15
2011

I decided to stay awhile longer on Saturna Island. The deck extension needed finishing and the island's kayak rental outfit needed business. If I can't be in the mountains, I can't think of a better place to be than Saturna. Being on medical leave has its benefits. Plus, I have to have some distraction from this terminal broken leg of mine. Life not walking is hard to take. After over nine months of not truly waking, climbing season having arrived, and it looking less and less likely I will be able to even go hiking this summer, I've had about all I can take.

My stress fracture is much like the windowpane for these guys. Tantalizing blue skies. SMACK.
When you combine them with whale-watching, it's easy to be religious with exercise bands.

Sea kayaking: a good stress fracture recovery activity.
DAY
275
JUN 16
2011

DAY
276
JUN 17
2011

DAY
277
JUN 18
2011

DAY
278
JUN 19
2011

DAY
279
JUN 20
2011

DAY
280
JUN 21
2011

DAY
281
JUN 22
2011

DAY
282
JUN 23
2011

DAY
283
JUN 24
2011

DAY
284
JUN 25
2011

DAY
285
JUN 26
2011

DAY
286
JUN 27
2011

Back to the real world. (Seattle = bills and appointments.) I've noticed that I always have about 10x as many bills as appointments. Something there doesn't compute.

DAY
287
JUN 28
2011


DAY
288
JUN 29
2011


DAY
289
JUN 30
2011


DAY
290
JUL 1
2011

It's hard to spend a sunny day in July out of the mountains. Fortunately, John Scurlock had a solution: shooting some aerial video footage of Mt. Baker.

Awesome.

Thanks John.


Here's a 1 min clip of the aerial footage I shot with the Canon 5D live view video mode. This footage is unedited, so a bit jerky and the audio is just flight noise. Pretty cool to see a lenticular cloud from above! Link to my aerial photo page.

DAY
291
JUL 2
2011


DAY
292
JUL 3
2011

I didn't last long in the real world. Back to the island retreat to build some deck railing. This time with two sea kayaks strapped to my car (thanks Mike and Carrie!).

Stress fracture recovery mode.

My whale-watching physio sessions on the deck paid off. Who needs to go to Sea World?
DAY
293
JUL 4
2011

DAY
294
JUL 5
2011

DAY
295
JUL 6
2011

DAY
296
JUL 7
2011

DAY
297
JUL 8
2011

DAY
298
JUL 9
2011

DAY
299
JUL 10
2011

DAY
300
JUL 11
2011

DAY
301
JUL 12
2011

DAY
302
JUL 13
2011

MONTH
10
JUL 14
2011

1 month since the stress fracture and 10 months since the broken leg. Walking, Take 3.

DAY
304
JUL 15
2011


DAY
305
JUL 16
2011

Occasionally I get an email from someone who does not know of my injury or its seriousness, asking me what I am climbing these days or if I am interested in joining them on a climb. When I broke my leg back in September, I was sure I would be back climbing—or at the very least hiking—by this summer. After all, I have friends who have suffered broken legs from skiing accidents and a few months later have been tromping through the mountains. But I did not anticipate all the frustrating setbacks of the last year. It's hard to reassess my expectations. It's hard to sit out a season.

But one thing is for sure: Every day I spend out of the mountains just adds to the joy and appreciation I will have when I am able to climb and hike again! Already, the pleasure I get from the mundane task of walking across a room is not an insignificant supplement to daily life.

DAY
306
JUL 17
2011


DAY
307
JUL 18
2011


DAY
308
JUL 19
2011

Finally got scheduled for a bone density (DEXA) scan. I should get the results in about a week that will tell me how compromised my bones in my lower leg really are.

Also went indoor climbing (my friend Mark had flown from California to do some climbing in the Cascades, and by some miracle I connived him into a stuffy gym). To my climbing-starved soul, vertical plywood with a bad case of colorful plastic pimples is Yosemite in the making.

Climbing 5.12 in an earthquake. (Actually, I just climbed 5.8s and 5.9s, but even with the recent stress fracture that's better than last time!) This shot also shows the current state of my skin graft and scrawny leg muscle.
DAY
309
JUL 20
2011


DAY
310
JUL 21
2011


DAY
311
JUL 22
2011

Hungry for adventure, I decided to do an overnight kayak trip in the nearby and spectacular San Juan Islands. I invited my mom along for this "kayakpacking" adventure, and we had a wonderful/beautiful/memorable trip.Link to trip report.

DAY
312
JUL 23
2011

DAY
313
JUL 24
2011

DAY
314
JUL 25
2011

I got the results of my bone density scan, which showed a rather decreased bone density in my left leg (79% of normal="osteopenia"). This disheartening news explains why I got a stress fracture so easily. I hope I can recover most of my bone density via carefully resumed activity and lots of calcium in my diet—I've still got 62 years before I reach my osteoporotic 90's.

Now that it's been 6 weeks since the stress fracture made itself known (during which I have limited walking to only when necessary, used the boot on uneven terrain, and biked obsessively), I decided to try a 15 minute session on the elliptical. No pain, that's good. But with the compromised bone density, I need to take recovery even slower than slow. I foresee a lot of biking in my future. And a lot of yogurt.

DAY
315
JUL 26
2011

From paddling along scenic island coastline to flying above rugged glaciated mountains, it's times like these I realize how lucky I am to live in this part of the world. Thanks John for another amazing evening at 10,000ft.


Here's a 50 sec clip of some aerial footage (a flyby of Colfax Peak) I shot with the Canon 5D live view video mode. This footage is unedited, so a bit jerky. I've replaced the audio with an appropriately-titled song "Dreamscape." For more photos, see my aerial photo page.

DAY
316
JUL 27
2011


DAY
317
JUL 28
2011

A typical day: 1.5 liters of frozen yogurt and 1.5 hours of biking. It's not going to be calcium deficiency or immobility that keeps me from regaining my bone density.

DAY
318
JUL 29
2011

Seems my life revolves around one photoshoot to the next. So much to see, so much to photograph!

Night photography fun outside a Whole Foods in Seattle. Click here to go to my night photography page.
DAY
319
JUL 30
2011

Back to the island paradise.

I started following up my daily 1.5 hour bike rides with daily walks again, which I had not done since the stress fracture. Taking it slow at only 15 minutes a day for now, but it feels good to walk again. (Sigh...to think that a few months ago I was able to walk an hour a day. The potential is there, at least. One positive thing is that, despite the recent setback, the limp is lessening.)

My legs are starting to look more symmetrical. The goal is to make the function symmetrical. (The reflection is in the new deck extension that over the course of the summer I've designed, built (with help of course), railed, and am now staining. Breathing stain fumes for a few hours I've found to be quite therapeduic to the mind.)
DAY
320
JUL 31
2011

DAY
321
AUG 1
2011

DAY
322
AUG 2
2011

DAY
323
AUG 3
2011

DAY
324
AUG 4
2011

DAY
325
AUG 5
2011

DAY
326
AUG 6
2011

DAY
327
AUG 7
2011

DAY
328
AUG 8
2011

8 weeks since stress fracture. That's the upper end of the typical time frame for a foot stress fracture; being injured is getting tiresome so I hope that's the end of that. Now for some adventures….




Recovery Part IX
Adventuring
DAYS 329 to 364 • AUG 9 to SEPT 13, 2011


The geyser at the other end of the boardwalk began to erupt. I broke into a jog, hastily pulled out my camera, and started....

Wait, I broke into a jog?



DAY
329
AUG 9
2011

Spent the day packing and getting ready for one of my first real adventures of the summer: a 7-day bike trip down the Oregon Coast. I'd been waiting until I felt my leg was up to the challenge of pedaling a fully-loaded bike over 400 miles of rugged coastline, and I can only hope that nearly a year since the accident it is. Although plagued with a number of setbacks throughout my recovery, I've consistently been biking about 10 hours (probably equivalent to about 100-150 miles) a week for about half a year now, my miles motivated by visions of sea stacks, beaches, and breakers. Excited!

DAY
330
AUG 10
2011

Oregon Coast Bike Trip! A recovery milestone as my first leg-powered multi-day adventure since the accident. And no problems! Click here to read my trip report from this fabulous adventure.

DAY
331
AUG 11
2011

DAY
332
AUG 12
2011

DAY
333
AUG 13
2011

MONTH
11
AUG 14
2011

DAY
335
AUG 15
2011

DAY
336
AUG 16
2011

DAY
337
AUG 17
2011


DAY
338
AUG 18
2011


DAY
339
AUG 19
2011


DAY
340
AUG 20
2011

With all that biking I did last week, I've definitely noticed that my leg feels stronger and I am favoring it less and less. I've been taking measurements of my leg throughout my recovery, and I have noticed that my thigh muscles have totally come back (actually, thanks to all the biking, my thighs on both legs are slightly larger than before the accident!); however, my calf muscle on my left leg has sort of stagnated with a circumference of my left calf being a good inch less than my right calf (I don't think biking exercises the calf muscle much). Perhaps I need to focus more on walking and elliptical now.

DAY
341
AUG 21
2011


DAY
342
AUG 22
2011


DAY
343
AUG 23
2011

Since I've already reached my out-of-pocket maximum on this year's student insurance plan, I thought before my plan renewed in September I would get a (free) consult with a bone and joint specialist. I wanted to discuss my bone alignment and the potential need or benefit of an orthotic. The specialist (Dr. Ichikawa) did note some misalignment of my left ankle joint due to the injury, but he noted that it was minor and he was encouraged by the strength and range of motion of the joint. He didn't think I needed an orthotic at this point, and said that while there was a chance I would suffer early arthritis because of the alignment issue, there was also a chance I would have no problems at all. Only time would tell. I left the appointment feeling more confident about my leg's future—now that's an appointment worth going to!

DAY
344
AUG 24
2011

I got my almost-1-year follow-up xrays today. I think they forgot about me, since I ended up waiting 2 hours just to talk with a doctor about the results (needless to say, not my favorite way to spend a sunny summer afternoon). The bone continues to knit back together nicely. The body's healing ablities are really pretty amazing, if you consider what the xrays looked like the night of the accident.

My x-rays from the day of the accident until now.
DAY
345
AUG 25
2011

After such a fun biking adventure on the Oregon Coast last week, my all-too-familiar cravings for adventure have come roaring back. But my leg won't yet let me just go off hiking into my nearby Cascades. Hmmm....I wonder if there are any other beautiful bike tours I can do before the summer ends....

DAY
346
AUG 26
2011

Long story short, next thing I knew my trusty red Subaru and I were headed to Montana. I planned to do a bike trip along Glacier National Park's famed "Going-to-the-Sun" Road. Click here for the trip report for my amazing bike tour through Glacier National Park!

DAY
347
AUG 27
2011

DAY
348
AUG 28
2011

DAY
349
AUG 29
2011


DAY
350
AUG 30
2011

Not going back to Seattle yet, because I'm going to….

DAY
351
AUG 31
2011


DAY
352
SEPT 1
2011

….Yellowstone!

I spent a week in this amazingly unqiue national park, with no specific agenda other than to photograph anything and everything I saw. Also during this trip I hiked/biked to the summit of the park's 10,243-ft Mt. Washburn—this was my first mountain summit since nearly losing my leg, and within a year of the accident too! Click here for the trip report for my Yellowstone Road Trip.

DAY
353
SEPT 2
2011

DAY
354
SEPT 3
2011

DAY
355
SEPT 4
2011

DAY
356
SEPT 5
2011

DAY
357
SEPT 6
2011

DAY
358
SEPT 7
2011

DAY
359
SEPT 8
2011


DAY
360
SEPT 9
2011

On the long way back to Seattle….via Grand Teton NP….gotta make good use of that national parks pass…

DAY
361
SEPT 10
2011


DAY
362
SEPT 11
2011


DAY
363
SEPT 12
2011


DAY
364
SEPT 13
2011

Home and packing for my next adventure—airplane camping and aerial photography in the Canadian Rockies! (Click link to go to trip report.)

I never would have thought it possible, but despite my crippled leg and separation from mountain adventure, it was a great summer. A sequence amazing experiences: building a cabin on an island in British Columbia, kayaking in the San Juans, biking the Oregon Coast, road tripping to Glacier and Yellowstone and Grand Teton National Parks, and flying above the Canadian Rockies. I had a lot of fun.




One Year (and Beyond)
DAY 365 • SEPT 14, 2011


Suppose on Sept 14, 2010 I had been given a choice to walk away unscathed and unbroken, but as a payment I would have had to promise to never climb again. Would I have opted out of the injury for a life devoid of climbing and adventure? No way. I would have chosen the broken leg.

YEAR
1
SEPT 14
2011

I have decided to end this "recovery trip report" here, at the one-year anniversary of my climbing accident. I have valued being able to share a unique record of recovery, but now I need to move on—past the daily focus on my injury, and onto other things and longer term goals.

When I started documenting my day-to-day recovery on this page, I had no idea of the challenges and setbacks before me, and how long this report would become. I figured surely I'd be back to climbing and running by now. But I nearly lost my leg. Twice. Over the course of the year, I've had to constantly reassess my recovery expectations; it's my nature to push myself towards lofty goals, but I've been forced to realize—though have yet to really accept—that a serious injury has a mind of its own and recovery is not something that can be pushed or predetermined in ways that other goals might. There were glossy moments where the academic in me was able to chock it all up to "research on what a serious injury is like," but those moments were all too few and much too fleeting. All in all, this last year has certainly been the toughest episode of my life so far.

But good always comes out of crappy situations—friends and family have become even more important to me; I've gained respect for the amazing resilience of the human body; I have now an understanding and empathy for the thousands who deal daily with a disability or the American medical system; and—perhaps the best gift of all—I will for the rest of my life have a heightened appreciation of the generally underappreciated ability of just being able to walk. Climbing and running and mountain sunsets will be sweeter than ever when I can experience them again.

I might come back and add a few updates of monumental recovery milestones or—God forbid—any significant setbacks, but future trip reports (see my trip report chronology) will be the best way to report on my recovery. As of Sept 14, 2011 I am speed walking and biking hard, but not yet running or climbing. There's still a ways to go, but my leg is a lot better than it was a year ago, and it will continue to improve. My personal assessment is that reaching "nearly back to normal" takes about twice as long as the crutches stage, which for me was about 8 months—so I have 4 months left to go, which seems about right given my current state. Already the frightening nerve damage has ceased to be a problem, my range of motion is normal (amazingly, my initial nerve damage and foot droop gradually went away as I began walking), my limp is disappearing, and the strength is returning. Plus, I don't have any metal hardware in there to cause future problems (if anything good came out of the infection episode, it was that in necessitated removing the plate along my tibia). More and more, I find myself "forgetting" about my leg. I will run and climb again. I must.

And one last word. Suppose on Sept 14, 2010 I had been given a choice to walk away unscathed and unbroken, but as a payment I would have had to promise to never climb again. Would I have opted out of the injury for a life devoid of climbing and adventure? No way. I would have chosen the broken leg.

UPDATES
(after Sept 14, 2011)

Sept 16, 2011: The last battery for my bone stimulator ran out, giving me an excuse to stop using it. I'm not too good at sitting still for 30 minutes at a time, anyway.

Sept 29, 2011: My first outdoor rock climb since the accident. Granted, it was only 25-ft toproping outside the Mountaineer Clubhouse in Seattle, but indeed it was real rock (on basalt columns that—for roughly $65,000—were recently relocated from Vantage). My climbing partner was my sister Jenny, who had been with me the fateful day on Vesper.

Oct 8, 2011: My first significant dayhike since the accident, on the 7-mile Maple Pass loop (near Rainy Pass) with my mom. I noticed that my right boot was spattered in dried blood, bringing back memories of how I had rested my broken leg on top of it the day of the accident. But these memories were quickly obscured by a beautiful autumn day in the mountains, surrounded by snow-dusted views and a sea of yellow larch trees. (By the way, that's my mom in the photo, who also suffered a tib/fib fracture in 2010, it was an unlucky year for us!)

Oct 29, 2011: My first snowshoeing since the accident, a 7.5-mile hike to Park Butte Lookout and back (click link for trip report). This bodes well for the winter ahead!

Nov 6, 2011: My first mountain summit since the accident (besides Mt. Washburn in Yellowstone, which didn't really count since I partly biked to the top), to the top of Sauk Mountain in the North Cascades, WA. With the fresh late-fall snowcover, it was a bit more effort than the simple hike it is in the summer. Warming up for more winter climbs ahead.

Nov 14, 2011: Exactly 14 months from the day of the accident, and I can lift my toes off the ground while sitting and keeping my heel on the ground. I've probably been able to do this for at least a few weeks now, but this was the first time I noticed it. I'll never forget those countless moments sitting on my parents' living room floor pleading with my foot to so much as twitch upwards.....yet nothing. Nothing but pure terror. Even a half year into my recovery, the doctors considered some degree of lifelong foot drop a likely possibility. Now that my foot finally has a nearly normal range of up-down motion, I figure it's earned the right to tap to the beat of any song it likes!

Nov 19, 2011: My second summit since the accident, to the top of Evergreen Mountain in the North Cascades, WA (click link for trip report). With steep slopes, deep snowshoeing, 4,200 ft of vertical gain, and two camera lenses in my pack, I am beginning to feel more like myself again.

Nov 23, 2011: There hasn't been a day since the accident that I haven't missed running. I used to run 8 miles every morning, religiously. A day just doesn't seem complete without a nice run. Early on in the recovery, I was told my leg might never again have the strength and function to run again. But with each recent hiking adventure, my leg has felt stronger and more functional. Joggable even. So I decided it was time to see what would happen if I tried to jog. Ten minutes and about half a mile at a slow and limping gait is a far cry from actually running, but it’s definitely progress! I have exactly a year to get ready for the Seattle Marathon 2012. And beat my previous time.

Dec 3, 2011: Fourteen and a half months after I nearly lost my leg on Vesper's North Face, I again set out for the summit of Vesper. This time, it was via the moderate East Ridge, as a snowy 13-mile late-fall climb with a group of friends (click here to go to trip report). It was a fun and rewarding day — finally I stood on the summit!

Dec 26, 2011: Ran my first mile without stopping. Took me 9 minutes. No pain. (For comparison, my pre-accident daily 8-mile runs were usually at a 7-minute-mile pace, but this wasn't a bad showing for my first mile-long run in over 15 months).

Jan 21, 2012: Ran the same mile as before. Took me 8 minutes. Tacked on a second mile at a slower pace. Then capped it off with my daily 5 miles on the elliptical and 10 miles on the exercise bike. Getting there....

Feb 25-Mar 2, 2012: This week I began amping up my jogging schedule, replacing my daily walk with a 20 minute jog 6 out of the 7 days. It's hard to hold myself back from doing too much (for instance, I'd love to go on an hour-long jog), but I've come too far to set myself back by doing too much too soon. My goal for the coming spring is to work myself up to jogging 5 miles daily. I feel the strength is there, but the big question mark is the bone density.

Mar 3-4, 2012: Nearly 18 painfully-rock-climbing-void months since I broke my leg, I did my first real rock climbing, on the basalt columns at Vantage in eastern WA. I experienced an initial pleasure and surprise when I romped up a couple of 5.10 cracks cleanly, but as the weekend wore on I became frustrated at my lack of stamina and how I struggled with moves and routes that had once seemed so easy. Priority-wacked-out that I am, I began seriously considering quitting my recently-acquired job just so I can move back to an area with a nearby climbing gym....

Apr 9-12, 2012: Climbing road trip to Red Rocks (click link for trip report). With each approach and climb, the leg felt stronger and more confident.

Summer in the mountains, here I come!

September 14, 2012: This will be my last post on this page. It is now two years after the accident, and I can truly say I am well on my way to my pre-injury self (the major physical roadblock being that I am still not able to run consistently without pain). In fact, in my enthusiasm to be back in the mountains, I did more climbing and multi-day backpacking adventures (10 big trips and 40 summits between June 21-Sept 21!) this last summer than any summer previous to the accident, which is rather amazing to consider. It feels so good to be (almost) back. Go to my trip report chronology to see all of my post-accident adventures.





Other Info


Hospitals and Doctors
First Round of Treatment (tib/fib fracture, artery reconstruction, faciotomy and skin graft):
Hospital: Providence Regional Medical Center, Everett, WA
Orthopedic: Dr. Peter Kinahan
Vascular: Dr. Mark Papenhausen, Dr. James Cook, and PA Tanner Vick
Wound Care: Heather


Second Round of Treatment (MRSA infection):
Hospitals: University of Washington and Harborview Medical Centers, Seattle, WA
Orthopedic: Dr. James Krieg
Infectious Disease: Dr. John Lynch

Other:
Physio: Jon Elvrom at Roosevelt Clinic, Seattle, WA
Bone & Joint / Podiatry: Douglas Ichikawa at Roosevelt Clinic, Seattle, WA


Surgeries

Battlescars
DAY
0
Sept 14, 2010 Open reduction surgery to put plate on my fractured tibia and sew up the place where the bones had broken through the skin. (1.5 hours, Dr. Peter Kinahan, Providence Regional Medical Center)
DAY
0
Sept 14 Artery reconstruction of the two main arteries in my foot using the vein from my upper calf. (painstaking 5 hour surgery, Dr. Mark Papenhausen, Providence Regional Medical Center)
DAY
0
Sept 14 Emergency fasciotomy when I developed compartment syndrome on the operating table. (a few minutes, Dr. Mark Papenhausen, Providence Regional Medical Center)
DAY
10
Sept 24 Skin graft over my open faciotomy, using donor skin from my upper thigh. (1.5 hours, Dr. James Cook, Providence Regional Medical Center)
DAY
100
Dec 23 Surgery to remove infected fluid and the infected hardware from my leg. (2 hours, Dr. James Krieg, Harborview Medical Center)
 
cancel-
led!
Surgery to re-break bone, do a bone graft, and put a plate back on the tibia (and fibula too).
 
cancel-
led!
Surgery to lengthen the Achilles tendon (usually after months of non-weight-bearing, people experience tendon-tightening that requires surgical intervention; for one reason or another, my tendons didn't tighten, so this surgery was cancelled).


Major Medical Treatments and Appointments



|_Hospital/ Emergency |_Follow-up Appointments |_Blood labs |_Physio related
DAYS
0-15
Sept 14-29, 2010
Hospital. 15 day stay in the intensive care unit at Providence Regional Medical Center (Everett, WA) to get medical care and surgeries (plate put on tibia, artery reconstruction, faciotomy, and skin graft).
DAY
22
Oct 6

Vascular Follow-up (dressing change at Providence Regional Medical Center)
DAY
22
Oct 6

Orthopedic Follow-up (with Dr. Kinahan at Everett Bone and Joint, x-rays to check bone alignment)
DAY
27
Oct 11

Vascular Follow-up (dressing change, stitches/staples removed at Providence Regional Medical Center)
DAY
34
Oct 18

Vascular Follow-up (dressing change at Providence Regional Medical Center)
DAY
34
Oct 18


Blood labs (at Providence Regional, associated with my INR levels)
DAY
38
Oct 22

Vascular Follow-up (with Dr. Papenhausen at Radia Imaging Center, ultrasound to check artery and overview of skin graft)
DAY
41
Oct 25



Physiotherapy (with Brent Hartman at Glenn Mountain Physio in Abbotsford)
DAY
50
Nov 3



Foot brace (to keep my foot at 90° at night, fitted at Cornerstone Prosthetics & Orthotics)
DAY
50
Nov 3

Orthopedic Follow-up (with Dr. Kinahan at Everett Bone and Joint, x-rays to check bone growth)
DAY
53
Nov 6
Drop-in Clinic because of blistering on skin graft donor site (in Abbotsford, given a prescription for antibiotics).
DAY
55
Nov 8



Physiotherapy (with Brent Hartman at Glenn Mountain Physio in Abbotsford)
DAY
95
Dec 18
Emergency Room visit to University of Washington Medical Center (Seattle, WA) for infection around my plate on my tibia.
DAY
97
Dec 20

Orthopedic Follow-up (with Dr. Kinahan at Everett Bone and Joint, x-rays to check bone growth and assess infection around plate)
DAY
98
Dec 21

Infectious Disease Consultation (with Dr. George Diaz near Providence Regional Medical Center, to assess treatment for infection around plate)
DAY
98
Dec 21



Bone Stimulator (met with a representative from CMF to get a bone growth stimulator)
DAY
99
Dec 22

Ultrasound (radiology department of UW Medical Center to look at fluid buildup around infected plate)
DAYS
99-104
Dec 22-27
Hospital. 6 day stay at Harborview Medical Center (Seattle, WA) to get the infected plate removed from my leg, wash out any infection, and receive an appropriate course of antibiotics.
DAY
104
Dec 27

General Follow-up (with Dr. Kristy Mitchell at Roosevelt Clinic, just to set up a primary care provider for my home care nurse to send my blood tests to)
DAY
104
Dec 27

Home Care (home care nurse came to set me up with my supplies for my self-administered antibiotics IV, which I would do twice daily for the next several weeks)
DAY
106
Dec 29

Orthopedic Follow-up (with Dr. Cory Lamblin at Harborview Orthopedic Green Team Clinic, check wound and change dressing, discuss next stages in recovery)
DAY
107
Dec 30


Blood labs and dressing change (at Roosevelt Clinic, associated with my IV antibiotics and INR levels)
DAY
113
Jan 5, 2011

Orthopedic Follow-up (with Dr. James Krieg at Harborview Orthopedic Green Team Clinic, x-rays, overview future treatment plan, remove stitches)
DAY
114
Jan 6


Blood labs and dressing change (at Roosevelt Clinic, associated with my IV antibiotics and INR levels)
DAY
118
Jan 10

Infectious Disease Follow-up (with Dr. John Lynch at Harborview Infectious Disease Clinic, check wound and monitor antibiotic efficiency and remove PICC line)
DAY
128
Jan 20


Blood labs (at Roosevelt Clinic, associated with my antibiotics and INR levels)
DAY
133
Jan 25


Blood labs (at Roosevelt Clinic, associated with my INR levels)
DAY
141
Feb 2

Orthopedic Follow-up (with Dr. James Krieg at Harborview Orthopedic Green Team Clinic, CT scan, check alignment, discuss various recovery plans)
DAY
141
Feb 2


Blood labs (at Harborview, associated with my INR levels)
DAY
142
Feb 3


Blood labs (at Roosevelt Clinic, associated with my antibiotics)
DAY
142
Feb 3



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 1)
DAY
147
Feb 8



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 2)
DAY
149
Feb 10


Blood labs (at Roosevelt Clinic, associated with my INR levels)
DAY
156
Feb 17


Blood labs (at Roosevelt Clinic, associated with my antibiotics and INR levels)
DAY
169
Mar 2

Orthopedic Follow-up (with Dr. James Krieg at Harborview Orthopedic Green Team Clinic, check alignment, bone growth)
DAY
170
Mar 3


Blood labs (at Roosevelt Clinic, associated with my INR levels)
DAY
170
Mar 3



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 3)
DAY
174
Mar 7

Infectious Disease Follow-up (with Dr. John Lynch at Harborview Infectious Disease Clinic, check wound and monitor antibiotic efficiency)
DAY
174
Mar 7


Blood labs (at Roosevelt Clinic, associated with my antibiotics)
DAY
184
Mar 17



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 4)
DAY
198
Mar 31



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 5)
DAY
211
Apr 13



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 6)
DAY
218
Apr 20



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 7)
DAY
225
Apr 27



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 8)
DAY
232
May 4

Orthopedic Follow-up (with Dr. James Krieg at Harborview Orthopedic Green Team Clinic, check alignment, bone growth)
DAY
233
May 5



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 9)
DAY
254
May 26



Physiotherapy (with Jon Elvrom at Roosevelt Clinic, Session 10)
DAY
286
Jun 27

General Appointment (at Roosevelt Clinic, to get foot checked out for suspected stress fracture)
DAY
287
Jun 28



Counseling (at Hall Health Center, this injury has just been too psychologically taxing)
DAY
288
Jun 29



Counseling (at Hall Health Center)
DAY
304
Jul 15

General Appointment (at Roosevelt Clinic, followup for stress fracture in foot and schedule bone density scan)
DAY
308
Jul 19

Bone Density (DEXA) Scan (at Roosevelt Clinic)
DAY
315
Jul 26

Phone Consult RE: Bone Density Scan (with doctor at Roosevelt Clinic)
DAY
328
Aug 8


Blood labs (at Roosevelt Clinic, get my Vitamin D level checked, turned out to be adequate as I would have expected just from looking at the tanned hue of my skin!)
DAY
343
Aug 23



Nutritionist Consult to find if there's anything I can do in my diet to achieve full recovery and get my bone density back (at Roosevelt Clinic)
DAY
343
Aug 23



Bone & Joint Consult about getting an orthotic (with Dr. Ichikawa at Roosevelt Clinic)
DAY
344
Aug 24

Orthopedic Follow-up (at Harborview Orthopedic Green Team Clinic, x-rays)



Medical Bills (Approx. totals)

Helicopter Rescue, Snohomish County Sheriff's Office Air Operations Helicopter Rescue Team *(ironic how life-saving things for which you would gratefully pay are often free) $ 0*
Providence Regional Medical Center, hospital stay and surgeries $ 199,243
Harborview Medical Center, hospital stay and surgeries $ 45,999
Follow-up Appointments (Vascular, Orthopedic, Infectious Disease, Bone Density) $ 7,507
Physiotherapy, Bone Stimulator, Casts, Foot braces, Walking boots, Exercise Bike and Elliptical, Councelling, Nutritionist $ 9,152
Prescriptions Drugs, Supplements, IV Antibiotics, and Blood Tests related to medications $ 11,765
Miscellaneous (crutches, several crutch tips, bandages, compression socks, parking fees, climbing gear lost, etc.) $ 1,570
TOTAL
   **Yikes, way above my maximum insurance benefit!
   ***But having a functioning leg is worth every penny! In a few years I won't miss the money, but I sure would have missed the leg.
$275,000+
**  ***



Mathematical Analysis of Muscle Loss

My most atrophied state, five months after the accident. After this I was able to start using a recumbent exercise bike to slowly start rebuilding muscle.
Plot of Muscle Loss and Regain.
Curves are approximate from one measurement to the next, and consider both muscle atrophy and muscle loss due to muscle-to-fat conversion. My left leg was at its most atrophied state at 5 months, after which I began gradually weight-bearing and started to regain muscle mass.

Five months of complete non-weight bearing led to quite a bit of muscle loss. Ever the engineer, I was curious to quantify the volume and weight of the muscle loss. I considered both muscle atrophy (calculations in Table 1 below) as well as muscle-to-fat conversion (calculations in Table 2 below).

The measurements for the following analysis were taken on Feb 9, 2011; this was Day 148, almost exactly 5 months after the tib/fib fracture. I had just started 25% weight-bearing, after being completely non-weight-bearing since the day of the injury. These measurements represent my left leg's most atrophied state, since on Feb 9 I started using a recumbent exercise bike and slowly rebuilding muscle mass. The plot at the beginning of this section contains measurements I took from Feb 9 onwards as I regained muscle mass.

TABLE 1: Muscle loss due to atrophy = 2.98 lbs:

I determined the muscle atrophy by comparing the circumference measurements of my atrophied left leg to my healthy right leg and using the density of muscle (1.06 g/cm^3). This gave about 1.3 L or 2.98 lbs of atrophy. (Note this assumes no muscle loss on my uninjured right leg, which might not be true if my one-legged hopping did not balance out my lack of running and hiking.)

I figure the leg measurements are roughly plus/minus 1 cm in accuracy. Within this range of uncertainty, my muscle atrophy could be as small as 0.7 L / 1.6 lbs or as large as 1.9 L / 4.5 lbs. Even with this range, it is less atrophy than I would have guessed looking at my leg. But you can't argue with math!

LEG PART CIRCUM-
FERENCE, LEFT LEG (injured)
CIRCUM-
FERENCE, RIGHT LEG
CROSS-SECTIONAL AREA DIFFERENCE LENGTH VOLUME LOSS WEIGHT LOSS DUE TO MUSCLE ATROPHY
Units cm cm cm^2 cm cm^3 g lbs
Upper Thigh 40 45 33.8 21 710 753 1.66
Lower Thigh 30 32 9.9 14 138 146 0.32
Calf 25 31 26.7 16 428 453 1.00
Ankle assumed the same (my left ankle is actually slightly bigger due to swelling and permanent enlargement around the skin graft, but this does not count as muscle gain or loss, so I will not consider it) 17 N/A N/A N/A
TOTALS         1,276 cm^3 = 1.3 L 1,353 g 2.98 lbs

TABLE 2: Muscle loss due to muscle-to-fat conversion = 1.85 lbs:

I also noticed that my left leg had become softer, which I assumed was conversion of the outer layer from muscle to fat. Fat has a density of 0.92 g/cm^3, 15% less than muscle—after all, fat people can float a lot better than muscular people. Assuming this layer of fat was 0.5 cm thick, this amounts to 0.79 L / 1.85 lbs of muscle converted to 1.60 lbs of fat. If instead I assumed a 0.7 cm (0.3 cm) thick converting zone, this amounts to conversion of 1.1 L / 2.5 lbs (0.5 L / 1.1 lbs) of muscle to 2.2 lbs (1.0 lbs) of fat.

LEG PART CIRCUM-
FERENCE, LEFT LEG (injured)
CROSS-SECTIONAL AREA OF 0.5 cm OF CONVERTED MUSCLE LENGTH VOLUME MUSCLE TO FAT WEIGHT OF MUSCLE WEIGHT OF FAT WEIGHT LOSS DUE TO MUSCLE-TO-FAT CONVERSION
Units cm cm^2 cm cm^3 g lbs g lbs g lbs
Upper Thigh 40 19.2 21 404 428 0.94 371 0.82 57 0.12
Lower Thigh 30 14.2 14 199 211 0.47 183 0.40 28 0.06
Calf 25 11.7 16 187 199 0.44 172 0.38 26 0.06
Ankle N/A N/A 17 0 0 0.00 0 0.00 0 0.00
TOTALS       790 cm^3 = 0.79 L 837 g 1.85 lbs 726 g 1.60 lbs 111 g 0.24 lbs

TOTAL muscle loss due to atrophy and muscle-to-fat conversion = 4.8 lbs:

So, considering both atrophy and muscle-to-fat conversion, over five months of complete non-weight bearing I lost about 4.8 lbs of muscle (uncertainty range of 2.7-7.1 lbs). See the graph at the beginning of this section to see how long it took to regain my lost muscle.....


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