Day 111 Update - A Very Halo Christmas

And so we come, almost, to the end of December, the end of 2020.

Whew. What a year, right?

Christmas was great -  naturally I had the idea to get a string of battery powered Christmas lights and we figured how to drape them artfully around my Halo. After not doing anything too wild for Halloween it was a smash hit with the family and I was quite proud of taking advantage of a Christmastime Halo experience to get decorated up beside the tree. 

The last X-ray appointment with Dr. Lynn was back on December 7th - it’s as routine as can be at this point, in and out with ease and alacrity. Everything on the x-rays looks normal, the pinsites look just fine, so it took all of about 5 minutes to get the “all-clear, see you next month”. The next step will be a CT Scan - scheduled for December 31st (claim it on 2020’s insurance, thankyouverymuch) - and then we’ll see Dr. Lynn the following Monday, January 4th for the interpretation of said scan. That will be right at the four month mark, and there’s a chance - if the CT Scan looks good - that we might get the Halo off that first week of January. That would be a TERRIFIC way to ring in the New Year in my opinion. Or if he looks at it and says nah you need to keep cooking for another few weeks, well, that could happen as well. But I’m thinking positively and optimistically as best I can. 

The prospect of waiting another month is not awful, when I do consider it. While my laundry list of “Things To Do Once I’m Out Of the Halo” is being thoughtfully added to on a regular basis, if I’ve gotten good at anything these past 100+ days, it’s being patient. I can be patient a little longer if it means better neck health in the long run. 

100 Days, though - that milestone came on December 18th. What a wild thing to have lived with this brace on for 100 Days. What’s really remarkable at this point is just how normal it feels. I’ve virtually no neck pain or discomfort (unless I sleep oddly and wake up with a crick in my neck or shoulders), so I go about my daily routine and often don’t even think about this odd contraption strapped to my upper body. I take Graham out for walks, I do chores around the house, we go to the grocery store, I do some light loadbearing exercises to attempt to prevent ALL of my muscle mass from withering away - working around the Halo has become part of my routine, part of the normal. The  body - and the mind - can adapt to anything. It will be incredibly strange now when the Halo comes off. I mused on this to some family members over the holidays - right now, I know how the Halo feels, how it works, it’s “comfortable”, it’s “normal” - there are no surprises after this long in it. It’ll be oddly unnerving when it comes off as then I’ll be the proverbial baby deer finding its legs for the first time - having to re-learn back to a non-Halo center of gravity, getting used to new sensations and soreness as my neck protests against having to be used again. I’m looking forward to it, but the strange irony of The Halo becoming The Default is not lost on me. 

Things I’m looking forward to most once I’m out of the Halo - 

1) A Shower - So Many Showers - Lindsay got me a shower cap for Christmas since those pinsites may be pretty tender for a few days once the screws come out, but boy I can’t wait to take a shower

2) Riding My Bike (Indoors) - I picked my bike back up from the bike shop last week. They checked it out thoroughly and - it was fine. Barely a scratch. The chain fell off and had to be put back on, but otherwise, I took pretty much the full force of the crash. I’ve already put the bike back on my indoor trainer (we’ll talk about taking the bike outdoors again...someday way down the line) - but I do the majority of my riding indoors anyway - I should be able to get back to that pretty soon once I’m out of the Halo and boy I can’t wait to get some real cardiovascular activity going again

3) Pushups - I really want to do some pushups. And pullups. 

4) To Lay My Head On My Dog - I haven’t been able to use Graham as a pillow in almost FOUR MONTHS, people. This is a tragedy. 

There are others, but those are a few that spring to mind right away. 

I’ve got a few “Halo How-To” posts/videos/guides I want to make in the coming weeks as well - some resources for future Halo-wearers that might find this blog. Some of those nuts-and-bolts (hah) tips and tricks that I found helpful on other people’s blogs in the early days of my journey deserve to have their space here. 

This time next week I’ll know about the results of the CT Scan as well so - more news incoming. 

BIG UPDATE - HALO REMOVAL POST

Day 82 Update - No(vember) News Is Good News

 I almost put this update off til tomorrow but then realized that would mean I wouldn’t have posted anything during the entire month of November and well, that just won’t do. In truth, I’ve been sitting on this update for several weeks now, since my last x-ray appointment back on, uh, November 3rd. 

Not a lot of terribly interesting things have happened in the month of November.

And yet, that’s good news at this stage. We’re now solidly into the “no news is good news” part of the process, patiently waiting on time to pass and the bones to knit themselves back together. 

Update on the new back pins installed at the end of last month -  things are looking pretty well. The new pinsites are not nearly as “open-woundish” as the original ones were. There have been some small amounts of discharge at times, but not nearly the giant-globules-of-dried-pus levels we were seeing consistently over those first weeks. Daily pin site cleanings continue, at times we are using both hydrogen peroxide AND neosporin to really deliver the ol’ one-two punch to keep them in line. The front pinsites continue to be virtually no issue whatsoever. 

The first week or so after the new pins were put in was pretty wretched, to be honest. Having, at that point, gotten very used to how everything felt and to a basically “pain-free” level of living, to suddenly go back to having constant spikes of pain through my skull everytime I moved was more than a little discouraging. Thankfully - as we hoped - after several days of chewing ibuprofen and gritting my teeth (but not too tightly, lest it cause even more skull pain) - the aching started to subside and eventually evened out to merely the background level of “discomfort” that has become the quite-liveable norm these days. 

This also provided an opportunity to see how the wound sites where the old pins were taken out will heal. As I’ll be dealing with four of those at such time as the Halo comes off, it was a nice preview. No stitches or anything required - once the pins came out, the skin in the area just kind of slapped itself back together, and Dr. Lynn’s only instruction was to “pack those suckers full of Neosporin for a week”. So we did, and Lindsay reports they are healing nicely. It seemed like all the pain was from the new sites - not so much the old - which gives hope for not too much localized pain when the screws come out when the Halo comes off. 

The last x-ray appointment back on Nov 3rd was all smooth sailing. Virtually nothing has changed on the x-rays - everything is still aligned properly. Dr. Lynn was able to point out how you can see, faintly, where the bones are stitching themselves back together, pinpointing some progress. The plan from here out is thus: in early December, we’ll do another set of x-rays (at the three month mark) - expecting here to see virtually the same as these previous ones. Then, in January - at the four month mark - we’ll do a CT scan. Dr. Lynn explained that while x-rays let us see that everything is aligned and hint at the bone growth happening, only CT scans can adequately show just how strong the bones are/have grown back together. So the CT scan will really provide the gold standard for when it’s time to take the Halo off. We COULD do CT scans at three months - sometimes bones grow back fast, and it’s theoretically possible we could be in a good-enough spot to remove the Halo then. But - CT scans hit the body with about 1500x the radiation that x-rays do, and Dr. Lynn said he doesn’t like “over-ordering” them - he’d rather wait another month and do the CT scan in January. If the bones don’t look quite ready at that point, we can wait another few weeks or a month and then check again. But he said - and I agree - I’m fine with wearing the Halo for a few extra weeks if it promotes better bone growth in the long run. While I’m eager to get out of this cage, in the grand scheme of things, a few more weeks or a month won’t make that much difference. Patience is a virtue, and all that. 

The rest of life continues to be pretty normal. Work keeps me busy, I walk several miles daily on my treadmill, and Graham demands nigh-constant attention when he’s not napping on the sofa. I’ve started venturing out of the house more often than just for the doctor’s visits now - after two months I decided I really wanted to get back to going about one of my favorite errands - grocery shopping - so we’ve resumed our weekly trips to Walmart. I figured it would be a shame to not go out in public when possible with the Halo on to see what kind of public reaction it gets. So far - not a ton, at least that I’ve noticed. I’ve had a couple Walmart cashiers engage me in friendly dialogue about it, and one kindly old lady shook her head as she passed and remarked “my goodness, and I thought having to wear a mask was bad!” The Walmart cashier tonight did seem hesitant at first, then finally broached the topic with an “Alright, so - I’m sorry - I just - I have to ask, and you don’t have to answer if you don’t want, but….” - which gave Lindsay and I the idea that we need to create a sign I can wear on my back that says something to the effect of “Feel Free To Ask, I Don’t Mind”. It’s not that I’m trying to set myself up as the Halo Ambassador, but I certainly have not gotten tired of talking about it, so hey, why not invite conversation?

Next appointment is on December 7th, only a week away. More updates to come (with hopefully less of a delay before the next post!)

Next Update - A Very Halo Christmas

Graham, the ever-faithful guard dog

This is a highly normal x-ray

Day 51 Update - The (New) Holes In My Head

 Today, we will talk about the holes in my head.

I was going to tell you about pinsites anyway, but thanks to a last minute doctor’s appointment yesterday, the story just got exponentially better.

So as a quick reminder, the Halo brace is screwed into my head at four points. The bolts, or “pins”, that are used are screwed directly into my skull to a depth of just a few millimeters and tightened to 8 lbs of torque. After the first couple weeks of a somewhat-annoying constant tension headache, they honestly have not been terribly uncomfortable. As with anything, the body adapts and you just get used to the sensation of wearing a slightly-too-small hat 24/7. It always feels more like a band of pressure around the head as opposed to four distinct insertion points, and once I got used to it, it really has been hardly noticeable the last few weeks. I mean, as “hardly noticeable” as a Halo brace can be. 

With four pins screwing directly into your skull though, the Number One home maintenance practice required while in a Halo is what L and I affectionately refer to as “PinCare” - every night before bed we use q-tips and a syringe to clean around the pinsites with hydrogen peroxide or an antibacterial cleaner. Risk of infection at those pinsites is one of the only major “complications” of the brace, so we’ve been religious about cleaning and care on our daily schedule. 

Of course, the best laid plans of mice and men, etc, etc. 

A couple weeks into this whole debacle, Lindsay noted that she was still seeing a lot of active discharge from around the back pinsites. The front ones (in my forehead) - no problem at all, clean as a whistle with no issues. But the back ones were still, well, just oozing pus from what appeared to be still some active wound trauma right around/below where the pin inserted. (Did I mention this post might not be for the faint of heart of you out there? Read on at your own risk). At no point did the back pinsites ever HURT - which is still my primary metric for “is there an infection / is something seriously wrong” - for all their weeping and oozing they never got red or inflamed or started being painful. We dithered for a while on if this was normal vs severe enough to call the doctors about - we finally did make a few calls and I was given an antibiotic prescription. At my first xray follow up a few weeks ago the PA checked out the sites and said to keep taking the antibiotic and let them know if it got any worse. 

It never got much worse, but it really didn’t get much better, either. We continued to clean and pull a multitude of crumb-sized chunks of dried discharge out of my hair every night. Lindsay could show me pictures of the sites but of course I couldn’t see them - and still there was no discomfort or pain. I was scheduled to go in on Nov 3rd for my next x-ray shots, so we figured we were just holding on til then for the next in-person look. However, to my surprise, a couple days ago I got a call saying “Dr. Lynn has decided he’d like to see those pinsites in person so why don’t you come in this Thursday”. So into the car I was loaded (getting much better at that every time, for sure) and off we went. 

I was delighted to see Todd the Orthotist again in the doctor's office. He checked out the sites and hemmed and hawed, then Dr. Lynn came in and took a look as well. He said it was a good sign that I was not having any pain or tenderness - that would be the sign of a more serious infection - but he did say that based on how “open-wound” the back sites were looking, it would be a good idea to go ahead and put in new pins in an adjacent spot and remove those current back two.

Oh, well, okay, today just got more interesting. 

Dr. Lynn said it would be possible to schedule the procedure at the hospital and put me under general anesthesia, but in a moment of bravado (real or imagined, who can say), I suggested we go ahead and just do it right there in the office. No sense waiting, let’s just make it happen. So off they went to get the supplies they needed and I sat in a chair in the room wondering exactly what I had just agreed to. 

In a way, it wasn’t unlike a dental procedure (if you’ve ever had that done). Dr. Lynn came in and injected local anesthetic into the sides of my head (very much when they inject the like into your gums - that sharp needle and then that flooding/burning sensation as the agent spreads through the area). After about 10 minutes it had gotten nice and numb and so Todd brought forth his Special Magical Halo Brace Pin Screwdrivers and the new pins. The whole thing took only between five and ten minutes - it was like having my own personal pit crew working on me. There are numerous holes in the halo part of the brace, so Dr. Lynn started on the right side and screwed in a new pin in the slot adjacent to the current one. There was a mild stinging pain that the anesthesia didn’t quite cover, but the primary sensation was just pressure - a ton of pressure. As the bolt enters your skull, the best way to describe the feeling is as if your head was in a vise being slowly squeezed tighter and tighter...and tighter...and tighter. For about ten seconds I did in fact begin to wonder if my skull was just going shatter- the pressure started at the site and then just slowly radiated across my entire skull in slow moving waves. Once the pin was “set” though, it seemed to stabilize and lessen slightly. The pin on the left side actually went in a little easier - it seemed to sort of “balance out” the pressure waves from the right side - and once they were torqued to the proper amount, they simply unscrewed the first set of pins. I didn’t even feel them coming out at all (probably thanks to the fun new sensations going on with the new ones). 

And that was pretty much that. New pins in the back, two holes in my head where the old pins had come out. The skin there has enough elasticity to work to close itself over the old pin sites it seems, as no stitches or anything of that sort were required - Dr. Lynn said to just slap on the neosporin a couple times a day for a week and keep an eye on it. We’ll return back today (Friday) to have Todd check the back pins to make sure they are still at the proper torque (standard procedure after 24 hours with new pins). And then I go back for x-rays next Tuesday so that will be another chance to make sure all is well with the (new) holes in my head. 

I wasn’t feeling too bad for the first few hours after the new pin installation, but into the later afternoon the local anesthetic wore off and I started having flashbacks to those hospital-pain-levels from The Early Days. Back to chewing ibuprofen on schedule for a few days at least, it seems. Thankfully I slept just fine last night. Seems like moving around actually starts triggering more pain, but Lindsay says everything looks as good as it can for now. 

Oh and of course I have to share the two highest compliments received of the day. Both Todd and Dr. Lynn were MASSIVELY impressed with the shirt that Lindsay has custom cut for me to fit around the Halo that I wear when out in public. They both said in all their years of seeing people in similar circumstances, they've never seen something that cleverly constructed. All credit to Lindsay on that one - I'll show some more details in a future post on what exactly she's done to my shirts to make them wearable, but have to give her a shout out for that compliment. 

Oh and they both also said that I smelled remarkably better then most people they see in Halo braces. So, uh...good to know that my current personal hygiene levels are above the mean. 

Never a dull moment in this life, it seems. Dr. Lynn mentioned he had taken a look at the x-rays from a few weeks ago and he was very pleased, so hopefully we’ll get more of that good news next week. I also had a good chance to talk to Todd about the actual procedure of when they put the Halo Brace on, so I might unpack that a little more in a future post. 

New update will come next week after the next x-ray report! 

Next Update - Day 82

BONUS - For the Real Strong of Heart - Here's video of them screwing in the new pins as well as a link for pictures of the before and after of the infected pin sites

And here is a link to some very mildly graphic photos

Day 37 Update - Let's Talk About Neck Bones

If you want a career with a nice predictable schedule that never changes, neurosurgery might not be for you.

My first post-op appointment with Dr. Lynn was originally scheduled for September 29th, but a couple days prior I received a call from his office that unfortunately the appointment would have to be moved a whole week and a half later to October 8th. This was, at first, disheartening - this first post-op appointment would include x-rays to ensure all the bones in my neck were still aligned properly and we were on the right track, and I was anxious to get that (hopefully) good news report. Then, the day before the October 8th appointment, I got ANOTHER call that Dr. Lynn had been called into an emergency surgery the morning of my appointment but that I should still come in and see his PA who I’d met at some point during my hospital stay. While unfortunate to not get to see Dr. Lynn himself, I realize this sort of thing must happen somewhat regularly. Whose regular appointment did I bump when I had to have my Halo procedure? Must be a constant scheduling nightmare, since it’s not like emergency spinal surgeries and procedures happen on a nice predictable schedule, after all.

The appointment with the PA was great. After a month of parsing the written (no visual) reports from several of my initial CT scans at the time of the accident, combined with a hefty amount of research on the cervical spine by way of Google and free-access medical journals, I finally came to a full understanding of exactly how the bones in my neck had broken. For those of you who are not, as of yet, experts on the cervical spine, please sit back and enjoy

BREAKNECK BEAN’S HIGHLY SCIENTIFIC LECTURE ON THE NECK BONE AREA

Okay, so, you have 7 vertebrae in your cervical spine, labeled C1-C7, that connect your skull to the top of your thoracic spine (your “back” spine, as opposed to the “neck” spine)

C1 and C2 - where the worst of my damage was located - are at the top, and they are a little different from all the rest - they have a unique mechanism that controls the rotation of your head from left to right. C1, at the very top, is “The Donut”. No kidding, that’s not my term, Dr. Lynn used that at one point describing things to me in the hospital, so that’s as scientifically accurate as it gets. C1 is a circular ring (hence, donut) that sits right beneath your skull - in fact your skull actually sits on two little “pad” areas right on the top. C2 sits right beneath it, and it is also semi-ring-like in shape, but with a really unique feature - a “Pin” that extends upwards from C2 into the ring of C1. The Donut rotates around this Pin as a pivot point, and that’s the entire reason we can indicate “No” to someone without having to use words. Left and right rotational movement - The Donut (carrying your skull) swiveling around this pivot point - got it? Yes, there will be a quiz at the end of this.

So when I crashed headfirst into the ground, a couple things happened.

First off, imagine taking a donut (in my head, for some reason, it’s always a sour cream donut - something about the shape of those makes me think of the bony ridges and processes of the cervical spine vertebrae) and dropping it on the kitchen floor from about chest height or so. Incredibly sad. Donut on the floor, probably split into multiple pieces. (Quick, 5 second rule, it’s still edible if you move fast!) That’s what happened to my Donut. It effectively cracked in three places - two sections along the back of the ring and one diagonal fracture towards the front and side. Unfortunately this did not qualify me for the very cool-sounding diagnosis of a “Jefferson Fracture” (named for Sir Geoffrey Jefferson of medical fame, not the 3rd POTUS, I don’t think HE was ever cool enough to break his neck) - this requires a “burst fracture” in four separate locations, and mine was only nice enough to break in three. So close!

Moving down the cervical spine, we find out what happens when force is rapidly applied to The Pin of C2 as The Donut around it gets thrown violently around. In this case, it decides to snap right off. This is naturally a serious - but also the most common - type of injury to C2, since that pin is sitting there like a turkey wishbone just waiting to be snapped. This is why I immediately couldn’t turn or move my head at all right after the injury - with that connection broken between C1 and C2, suddenly that whole pivot joint mechanism is very much non-functional. Some of my reading over the last month determined that one of the decisions between Halo brace natural healing vs surgery is based on how far this pin moves once it is snapped. There’s about a 5mm threshold, it seems - where if the pin bone moves out of place by more than that about there’s a much lower chance of being able to get it to reattach and grow back to where it should be on the base of C2. Mine moved approximately 4mm - any more and surgery might have been the only option.

C3-C7 are much simpler bones, they are sort of like building blocks that just go down the rest of your neck spine. My C7 had a bit of a compression fracture but nothing nearly as serious as what was going on up near the skull (had it been only the C7 fracture I suffered, Dr. Lynn said they would have put me in a hard neck brace for a few weeks and called it a day). As it was, in comparison to what was going on up in C1-C2, C7 was almost an afterthought by comparison.

I also learned - from one of the doctors in the emergency room - that your spinal cord controls more and more vital functions the further up it goes. So if you damage your spinal cord at C6-C7, you might suffer loss of function and control of your legs or lower body. Getting up towards C4-5 you’re talking much higher risks of becoming quadriplegic. The C1-C3 area is where autonomous breathing functions are located (this is the area that actor Christopher Reeve of “Superman” fame damaged in his horseback riding injury) - the doctor pointed out very kindly that had C1 or C2 been jolted enough to cause any spinal injury in that area, I very probably would have just suffocated to death in that ditch. Fun!

But with no spinal injuries, it was just a matter of determining how the bones could be put back together. Screws and pins would do it, a la the surgery option - but since C1-C2 control your neck rotation, that’s why you lose some of that functionality after such a procedure. Metal screws and bolts are great for holding things together, but not for allowing everything in your neck to work precisely the way it was designed. So, the Halo brace immobilizes everything while the bones grow back together, and here we are.

Anyway, yeah, thanks for coming to my TED Talk about neck bones.

So the report on the first post-op x-rays was very good. Fractures can still be seen in several areas, naturally, but everything is lined up where it should be and that’s exactly what we want after one month. Amanda, the PA, said we usually don’t start seeing actual “fusion” of the neck bones until 8-12 weeks, so hopefully we’ll get an even better report at my next check-up in early November (assuming Dr. Lynn doesn’t have to reschedule on me 4 more times). Mostly I’m really curious to get his opinion on my injury as a whole and ask him some specific questions (especially about the procedure when he “set” the neck bones and they put on the brace) so look for more reporting on that subject down the road.

Otherwise, life is good and I’m really feeling fine. It seemed to take about 4 weeks for my body to really “get used” to the Halo - it’s still awkward and cumbersome, but MUCH less so than it was those first couple of weeks. The human body is remarkably adaptable. As odd as it sounds, the screws in my skull aren’t even uncomfortable now, I just register their presence but there’s no pain at all, just a slight pressure. And most days, the neck itself feels pretty good. I’m still mostly sleeping sitting propped up in a chair - it just seems to be the most comfortable position overall - and I’ll wake up most mornings with a lot of stiffness or a sore spot in my neck, but it almost always works out pretty quickly after I get up and move around. Work keeps me busy, Graham keeps me entertained, and Lindsay keeps me from doing anything stupid that I shouldn’t, so all-in-all - the prognosis is good!

Oh and just wait, the next post is gonna be about “pin care” on the screw sites in my skull and that’s gonna be REAL fun. Stay tuned!

Edit - The Next Post - Pinsite Fun

First post-op Xray after a month - 
Pin bone aligned and beginning
to reattach

CT Scan day of the injury -
"The Pin" of the C2 circled

Day 22 Update - A Visit to Todd and Other Miscellaneous

For as bad as everyone complains about the road conditions and potholes here in South Carolina, I’ve honestly never really been bothered by them that much. Well, that is, until I rode in the backseat of a car in a Halo brace where every slight bump and jolt seems to resonate into the bars of my cage. But, on Day 14, it was time to venture back into the outside world for the first follow up appointment with Todd the Orthotist.

I had met Todd in the hospital a couple times - he came by before the Halo installation to take some basic measurements for the procedure, and then afterwards for a post-op screw tightening. This would be just a basic check up to make sure everything with the brace was still behaving exactly as it should. My first follow up with Dr. Lynne the neurosurgeon wouldn’t be for another couple weeks still, at which time we’d actually see how the neck healing was progressing.

Oh, here’s a good spot to talk about a quick CLOTHING update - the vest part of the Halo sits right on your skin and never comes off, but as usual, Lindsay had gotten clever. We took a couple of my sleeveless t shirts and cut the shoulder sections apart, which allowed me to step into a shirt and then slide the front and back now-separated halves up through and underneath the vest and secured under the shoulder sections. There’s just enough wiggle room to get a shirt threaded underneath, which not only allowed a layer of fabric to protect my skin from any irritation, but also allowed me to not feel like I was half naked all the time. This was fine for getting around the house, but further creativity was needed for going outside the house. We made some creative cuts into the back of a large zip up fleece jacket for it to fit around the bars of the Halo in the back. Not perfect, but pretty good for a first attempt. We’ll have plenty of time to keep experimenting with a couple of other extra large hoodies and shirts I picked up as well. One may be in a Halo, but that doesn’t mean one can’t attempt to be as fly as possible at all times.

Snug in my jury-rigged jacket and folded into the car again (much easier than when coming home from the hospital, great strides in mobility over the last week and a half!), we trundled on down to Todd’s office. It was a pretty simple visit all things considered. Todd checked everything out to make sure it all looked good and showed us that the foam pads lining the inside of the vest are actually removable without having to take off the vest itself! With creative use of trash-bag liners to separate the foam from the velcro lining of the vest, it can be removed and swapped out for alternate foam pads should we desire to wash or air out the pads from time to time. It was - while not exactly painful - a rather jostling experience, so I doubt we’ll be doing it every day or two, but it’s good to have the option ready for whenever we need it.

Todd answered a few of our questions and said - barring any unforeseen circumstances - the next time we would see him would be to remove the Halo in however many months down the road Dr. Lynne decided it was time. Optimistically, nothing with the Halo will need adjustment throughout the process - he said to give him a call if any head pain worsened, as that could be a sign that one of the skull screws was loosening and needed to be tightened. He was able to provide the trivia tidbit I had been wondering about - that the entire Halo contraption weighs about 12 lbs total - and also provided us with the wrench set that I must carry with me at all times in case of some catastrophic event in which the vest would need to be removed. Literally, I can’t take this thing off without three separate wrenches for the various bolts and screws that hold it together. That done we returned home and back to our normal routine.

We’ve stabilized into a pretty normal routine at this point. I’m still sleeping in my recliner each night and have graduated to reclining slightly (still more comfortable to sleep mostly sitting up vs lying down - I think this has to do with how the weight of my head is distributed between the four skull pins), and this allows me to keep my feet propped up to avoid any swollen ankles. I’m able to get around the house more and more normally, if still at half-speed or so. Turning or rotating is the most deliberate action - I’m getting better at a smoooooth turn where my entire body rotates at once (I mean my head has to move with the torso, it’s locked into place) - but the smoother the action is the less strain I feel on the neck as I turn. Weekdays I make the climb up the stairs to my office where I’ve found that one thing the Halo is good for is curbing my low-grade physical ADD - whereas before I would often get up from my chair every 20 minutes while working to go do something I had just thought of or been distracted by, now it’s easier to sit and work for at least a couple hours at a time without moving, as it’s when I’m stillest for long periods of time that I am most prone to (almost) forget about my portable, wearable metal cage.

“Pincare” is a new part of our nightly routine as well. One of primary things you have to take care of while in a Halo is maintenance of the four sites where the pins screw into my skull. The four sites have to be cleaned daily to ensure no infection sets in. Using Q-tips and and an antimicrobial/bacterial cleanser (off-brand Hibiclens), Lindsay swabs around the sites to ensure they’re staying as clean and germ-free as possible. Currently, the back two pin sites are causing a bit of consternation. They didn’t shave or trim my hair at all when they put the screws in back there, so for one they are a little hard to see and get to, but for two those two sites are showing some signs of a yellowish discharge (sorry people, no filter here when it comes to the gory details). This is not necessarily abnormal or a huge warning sign as redness, irritation/inflammation, or pain at the sites would be (really the sites don’t hurt at all), but we’ve upgraded (on Todd’s instructions) to using hydrogen peroxide on those sites for a few days for some added cleansing benefit. I’m really not concerned as long as there is no pain or redness - Lindsay is a bit more cautious - but between the two of us I’m confident we would catch any true problems in the early stages and head them off then.

Still plenty of things to do, so thankfully I have never been bored. It is a little astounding how much extra time I feel as though I have some days. In my “previous” life between cycling, running, and working out I was often being physically active for 15-20 hours per week, so to have that much extra time now to sit and get extra sleep, extra reading/gaming/watching done, etc is really a shift in “how I spend my time”. It’s all pretty productive though, so I’m happy.

The higher amount of neck pain I was experiencing last week seems to have subsided a bit. I’m usually only taking a few ibuprofen at night when the fatigue of the day allows more soreness and tenderness to creep in, and to help alleviate any pain that might keep me from sleeping. I’m sleeping pretty well actually, usually in chunks of at least 3-4 hours at a time and sleeping soundly while I’m out. Rest is when the body heals the most, so I’m trying to keep doing as much of that as possible.

I’m constantly reminded - and humbled - by how many good people surround me in my life. Daily reports of people thinking, wishing-well, and praying, as well as dozens of friends stepping up to help provide meals, help around the house, and offers of assistance for anything that we might need over the next few months while I’m facing some of these physical limitations provide daily encouragement and a level of support for which I can never express enough gratitude in return. This recovery may be a tough journey, but I’m very fortunate to not have to walk it alone.

Next Entry - A Discussion of Neck Bones

Graham the Occasional Lapdog 
provides regular emotional support

Adjusting To The Halo - The First Two Weeks At Home (Days 3-18)

I’m writing this blog for two primary reasons - one, to capture the story and share it as it happens (while I take great delight in sharing my condition on any given day in great detail to whomever might ask, this might provide updates for those a little further outside my QuarantineSphere whom I’m not interacting with on a regular basis) - but also because the minute it was decided I was going to start a Halo Journey, frenetic Googling turned up a small handful of blogs by other people documenting their experiences in similar circumstances. Those blogs provided invaluable insight and advice to this terrifically strange and unique phase of life I’m now entering for the next few months.

Because it is my wont (and because I have more than a little extra free time on my hands these days) I may get rather granular at times with the details, or I may just provide semi-regular updates on how things are going - hard to say at this point. I don’t have a lot of planning going into this blog, I’m just here for the ride and to jot down a few thoughts and collect a few memories for the future. And if someone who I have never and may never meet finds this blog, years from now, and finds it in any way resourceful or helpful as they or someone they know gets outfitted with their very own Halo, well, then my time here will be very well spent indeed.

But for now, let’s have a recap of the first couple of weeks of Living With A Halo.

After consideration, I decided to peg the day the Halo was installed (not sure what other verb to use there, really), Wednesday September 9th, 2020 as Day 0. So Thursday 9/10/20 became Day 1, and so on from there. I came home from the hospital on Day 3. Dr. Lynne said that the “listed protocol time” for wearing a Halo brace is 6 months - however it seems that can vary somewhat based on the severity of the break, how quickly the bones heal, etc - many people report a Halo time of three to four months. So in my mind, I’m already “counting up” to Day 180 - and if I’m able to get released early for Good Behavior, well fantastic.

But that’s a long way off. For now, it’s just a matter of Getting Through Today.

As I recap the first two weeks, it might work best to break out some topics individually.

Mobility / Activity - For the first couple of days, every single movement was slow, difficult, and (often) painful. I was still weak and adjusting to my new center of gravity as provided by the Halo, and even simple movements like getting out of a chair or turning around while standing had to be done at about 10% speed. While nothing else on my body really hurt, everything in your upper body connects to your neck somehow - so using my arms to lift or brace myself and many minor upper body adjustments or movements if not done at the absolute easiest intensity and speed would cause bolts of pain to shoot through the neck. The Halo keeps your neck and spine immobilized, but I still had a lot of damaged nerves and muscles that would fire off warnings anytime they felt movement from elsewhere. On Day 5 I managed to get out of a chair by myself without any assistance, which felt like a huge win. Every day after that for the first two weeks seemed to bring a measurable increase in strength and ability. My lower body was more or less unscathed, so once I was standing I was able to do some knee raises and other light lower body activity and stretches just to try to keep the blood flowing and the body moving as much as possible.

The one lower body side effect I did experience was a good bit of swelling in my legs and feet - turns out sitting for 22 hours a day isn't the most conducive to good circulation. Propping my feet up seemed to help the most, so as much as possible especially while sleeping I continue to try to elevate my legs to keep the blood flowing. 

I waited until Week Two at home (Day 11) to climb the stairs at home up to the second floor, but by then my stability and balance had progressed to the point where - as long as I moved slowly and deliberately - I felt like I could move in just about any way I needed to (within the locked in confines of the Halo, or course). As long as my torso and head stay locked in the same plane, I can get around pretty well. Easy, slow movement is the key, especially while everything that's damaged and inflamed in the neck heals here in the early stages.

Pain - Overall I feel remarkably fortunate to have as little ongoing, acute pain as I do. I think I expected more, honestly, but - as long as I’m remaining still, or moving at a glacial pace - it’s more levels of discomfort, if anything. I was prescribed oxycontin as needed coming out of the hospital, but by Day 6 or so was mostly just taking ibuprofen as they actually seemed to give better relief for what negative effects I was feeling. Week One at home was mostly dominated by head pain from getting used to the screws of the Halo brace in my skull. I don’t feel the individual “pin” sites, as they’re called - rather, the four of them surrounding my head result in more a feeling of a tight band encircling my head at that level. This ongoing tension headache would come and go throughout the day, but slowly lessened into Week Two, I think mostly as my body became accustomed to the sensation. Week Two actually started bringing more neck pain - likely because as I was able to move around more and more, the Halo has to prevent me from moving in any way I shouldn’t - and every time it limits me, it stops me right as my neck starts to protest whatever action I was about to try to do. This builds up through the day and tends to get worse in the evening as my fatigue also increases. Overall, very manageable though, and for that I am very grateful.

Sleeping - The most consistently painful action I felt the first few days having the Halo were trying to move from lying on my back and getting onto my feet, and vice versa. I never really slept very well in the hospital, and the first night at home, trying to get comfortable in any position was almost impossible at first. Eventually I decided to just try sleeping while in the most discomfort-less position possible, sitting straight up in a recliner. It actually worked pretty well. I would stay up as late as possible into the night to get as tired as possible, and then would be able to fall asleep for at least a few hours at a time. It’s an odd sensation - when you fall asleep while sitting, usually your head starts to fall to one side or in front (sometimes jerking you back away, right?) - but in a Halo, my head is perfectly suspended and locked in place. Waking up was a trip sometimes, trying to figure out why it felt like my head was floating in space before my senses caught up and remembered the contraption into which I was now built. I established a pretty good routine of sleeping in at least 2-3 decent chunks throughout the night - often I would wake up for a while and it would take me a while to get back to sleep, but I would keep my phone and books close at hand and just tried to embrace a multi-phasic sleep schedule for the time being.

Activity - So what AM I doing? Getting really good at sitting in a chair, that’s for sure. Thankfully I had plenty of accumulated vacation time at work, and Lindsay was doing almost all her adjunct teaching from home, so we were able to really just spend a lot of time sitting in the living room together, reading, watching movies and TV shows, gaming, etc. We have a phrase we use for those days that happen a couple of times per year, often a Saturday with no obligations, where we just make it a lazy day, forget about the concept of time and the calendar and adult responsibilities and do nothing but sit on the couch for the entirety of a day and and eat snacks and just hang out together - we call them “The Days That Don’t Exist”. Well - that first week from home was “The Week That Didn’t Exist” - and it was honestly pretty great just to focus on rest and recovery. While it feels really strange to be at home and not be able to be as active as I normally am, I also have no shortage of books to read, video games to play, and movies to watch, so I’m certainly not going to get bored anytime soon! I’m very fortunate in that I am able to work entirely remotely, so on Day 12 I went “back to work” from my home office. It was actually really nice to achieve another step in the feeling of a normal routine, and gave me another (seated) activity to pour my time and returning energy into.

Overall - life is good. Yes, the Halo is requiring some significant adjustments to life right now and forcing me to be a lot more deliberate than I usually am with every single action - but when I consider how much worse my accident could have been, I feel extraordinarily fortunate. When I consider just how much harder all this would be a broken leg, or wrist, or cracked ribs, etc - it makes me realize that my injury and limitations are not nearly as bad as many people who might be in a similar situation. All any of us can ever do is to respond in the most positive, beneficial way to the circumstances we find ourselves in - I remind myself constantly that mindset is half the battle on a journey such as this one.

Next Entry: Day Twenty Two

Graham is a willing and attentive HHCP 
(Home Health Care Pupper)
and mostly just demands payment in food

Part Two - The Hospital

Once I was surrounded by Trained Medical Experts, the situation escalated quickly - both in their response and my understanding of the severity of my predicament. Turns out Medical Experts take neck injuries VERY seriously (who would have guessed?) A hard neck brace secured, I was wheeled back to an ER table and descended upon by a small horde of medical professionals. I repeated the short version of my story to what seemed like a dozen different people, blood draws were taken, an IV was inserted, and before too long I was being wheeled back for a CT scan. There was a palpably equal sense of relief and astonishment from each doctor I spoke to - relief that in spite of a clearly serious neck injury I was experiencing no loss of motor control or sensation anywhere in my body - and astonishment that after suffering said neck injury I had proceeded to climb unassisted out of a ditch and then spend 3 or so hours meandering down to the hospital 50 miles away from where the accident had taken place.

What I quickly realized as nothing short of miraculous was that - other than the obvious pending neck diagnosis - I seemed to be in remarkably good shape. In terms of acute injuries, other than my neck, I had a decent sized cut on one knee, a small abrasion on my right shoulder, and a small spattering of other cuts and bruises. Every other major limb and part of my body seemed to have escaped unscathed. I can’t say for sure that I must have landed almost entirely on my head during whichever part of the plunge my body impacted the ground the most, but from the lack of other injuries, it sure seemed that way. Regardless, the doctors ordered immediate CT scans and x-rays of my entire body from the waist up just to ensure there were no other internal injuries.

One definite plus of this whole experience was a recalculation of my own personal pain thresholds. Y’know, the whole “on a scale of 1-10, where is your pain right now? It hadn’t been properly calibrated in a while and I was soon provided a great opportunity. As they tried to transfer me onto the table for the CT scan, it became apparent that after spending several hours in a seated or propped up position, everything in my neck and upper back had locked up to the point where getting me to a fully lying flat position felt almost impossible. While sitting or lying still I was more or less okay, but the instant I tried to move or tilt my upper body in any direction, pain radiated out from my neck like a series of cascading explosions. If a “10” on my Personal Pain Threshold is screaming at full volume, forcing my body to stretch out into a supine position took me to about a 9.6. Thankfully, doctors don’t seem to mind you screaming in their face as long as you apologize very sincerely once you can breathe again, so I don’t think there are any hard feelings on his part.

The CT scan showed fractures in the C1, C2, and C7 vertebrae of my neck. From my lying position I never did get to see the images (note to self - request those at next follow up visit to the doctor). The decision was quickly made to transfer me to the larger and better-equipped Greenville Memorial hospital downtown, so a nice dose of fentanyl later I finally checked off the bucket list item of getting to ride in an ambulance (no siren though, how sad). At Greenville we repeated much of the ER experience from Greer. I fully codified my story in repeating it to several doctors, basic neurological tests, more CT scans. A few hours passed here and finally I was moved to a regular room.

That evening I met Dr. Lynn, the neurosurgeon who would handle my case. We immediately got along well and he was able to make clear the situation and spell out the options. Your C1 and C2 vertebrae are at the top of the stack of the spinal column in your neck and function as the pivot joint that allows you to have side-to-side rotational movement of your head. Based on the level of fractures, we had two options. Option 1 was fusion surgery, where they would go in and fix all the broken parts of my neck with rods and screws - this would be, all things considered, a pretty standard procedure and would no doubt fix everything, with the unfortunate side effect of causing a 50% permanent loss of that rotational movement for the rest of my life. Option 2 was a Halo Brace, which by locking my head/neck/torso in place would cause the next 4-6 months of life to be very interestingly awkward - but, if all went well - would allow my neck bones to heal naturally, restoring full mobility and strength to the area just like any other broken bone in the body.

It was a pretty easy decision. Dr. Lynn said that were he in my shoes, based on lifestyle and age factors - he would opt for the Halo. The challenge of living with the difficulty of the brace for six months seemed to me to be a pretty solid trade off in order to be able to regain full use of my neck. And worse case scenario - if something with the Halo went wrong - we could always perform surgery at that point. Once you go the surgical route, there’s no undoing it though - so it seemed wise to keep that as a last resort. Late that night they took me for some MRIs, and the next morning we decided officially to opt for the Halo.

Hospitals are never the most entertaining places - and when you’re locked in place, on your back, in a neck brace, basically unable to move except for your arms - they get really boring, really fast. Time slowed to a crawl that first night - my pain wasn’t overwhelming, thanks to the regular doses of oxycontin they plied me with every four hours, but the discomfort was at a serious level. Sleep was fitful when I was able to doze off, and the twinges of pain, post-nasal-drip, and deep body fatigue that had finally set in kept me in a constant twilight of malaise. Thankfully, while she couldn’t spend the night due to Covid-related restrictions on visiting hours, Lindsay had managed to procure and send me up a phone charger cable so I had a lifeline to the outside world.

Tuesday was a long day of waiting and watching the hours tick by unendingly slowly. The Halo procedure was scheduled for Wednesday morning, so there was nothing to do Tuesday but lie and wait. I’ve never been very claustrophobic, but I soon discovered that being locked in place on your back in a neck brace can get real old, real fast. Time passed slowly, Lindsay was able to visit in the afternoon, the meds came on schedule, I sipped half an Ensure as the only food I could really get down, and soon night came again. A Harry Potter marathon on TV got me through the night, as I dozed on-again, off-again to the sounds of Order of the Phoenix and The Half Blood Prince.

Finally Wednesday dawned - Halo Day. At 9am I was wheeled down to pre-op, and by 10:30 they wheeled me back. The one other time of my life I had been put under anesthesia was for sinus surgery 15+ years ago, and let me tell you what, those professional anesthesiologists know what they are doing. Just like that procedure, I remember being wheeled into the operating room, being lifted onto the table, and then BOOM, out went the lights. In what felt like mere moments, the lights were back on and I was slowly swimming out of the post-op daze. By about 2pm I was taken to my new hospital room and the rest of the day passed in a daze of dozing and attempting to get used to this new sensation of being encased in this new contraption.

Easily one of the best things about being fitted with the Halo was that I was soon after allowed to have control of my own hospital bed - so I was able on Thursday to start adjusting my bed slightly up and down to give some variance of position. My pain and discomfort floated pretty regularly between a 3-7 on my 10 point scale depending on how far away I was from the next pain med allocation. I finally was able to get some food down - institutionalized eggs and grits never tasted so good as they did that Thursday morning. One side effect was an excess of jaw stiffness and tension, so eating was still pretty difficult - and I could still really only recline my hospital bed up so far - but it was progress in the right direction, and progress was what I was most eager for.

The timeframe for when I would get to go home was in flux and largely related to how soon I showed progress in getting up and moving around - the doctor wanted me mobile before he released me from the hospital. Thursday late in the morning the physical therapists came by for the first time. It occurred to me that I had not even done so much as sit up for 3+ days by this point, so I was more than a little anxious to see how much I could move. The short answer was - “not a lot”. Turns out that three days lying on your back, then adding a twelve pound weight to your upper body really messes with all levels of your equilibrium. We were able to get me to a sitting position (achieved in the Halo by rolling onto your side and then levering up into a sitting position, since the brace effectively removes your ability to twist, bend, or rotate your torso), which I found to be absolutely exhausting. We sat for a minute, then slowly got me up and into a standing position. Never in my life has standing up been so difficult and felt like such an achievement. The twelve pound Halo felt like a two hundred pound weight sitting on my head, and I was able to stand for roughly 60 seconds, sweat dripping down my face with the effort, until I started to feel lightheaded and my vision started to swim, at which point we eased me back down onto the bed and the therapists hailed a job well done for a first day. Personally I was more than a little disheartened - it felt pretty defeating to have to take such baby steps to build physical strength back - but I resolved to take it one day at a time and just look for incremental progress.

Also on Thursday my Orthotist, Todd - responsible for the Halo brace device itself - came by to tighten the screws. Yes, it was vital that the day after the brace was placed, he do a quick tightening of the screws bolted into my skull at four points to ensure they were maintaining the proper torque and tension. Honestly, it sounds a lot worse than it was. The screws didn’t so much hurt (there’s not really a lot of nerves there in the thin skin around your skull), as much as they just created the sensation of “tightness” around your head. More on that later. Todd prided himself on being so skilled with the torque wrench required to tighten the screws that he could adjust them to the proper 7-8 pounds of pressure purely on feel alone. I was impressed and trusted him completely (although really, what else are you going to do with the man screwing bolts into your skull?)

The rest of Thursday passed without much note. Hospital food tastes great when it’s all you have to eat, I watched Mission Impossible 3, and the NFL season kicked off that night and all these elements brought cheer into my life and kept my spirits up. On Friday I had 2 PT sessions and made terrific progress, being able to stand with more ease and even trudge slowly halfway down the hallway and back aided by a walker. The doctors said with this progress I’d be able to go home on the following day, and finally I had a clear path to getting out of the hospital and on to the next stages of recovery. That night I was able to find one of my favorite comedy films of all time, Tommy Boy, on TV to bolster my spirits, and even though it was a largely sleepless night due to general discomfort, Saturday soon dawned.

By 10:30am I was on my way - very, very slowly - out of the hospital. Easily the most difficult part was folding me into the car for the ride home - my mobility was still extremely limited at this point due to neck pain radiating out into my entire upper body, and the Halo brace poles extended up above my head on four points, so it required some pretty creative contorting to get me into the car. Once secured tho, we trundled on home and unpacked me the same way into the house.

It was good to be home. Getting out of the hospital and back into familiar territory provided a huge psychological boost back into the realm of “normalcy”, and while I knew recovery and finding the new “Halo Brace Normal” was going to be quite a journey - I was ready to take it, one step at a time.

Part Three - Adjusting to the Halo - The First Two Weeks

 

In the Greer ER

Halo Brace, Freshly Applied

Finally sitting up unassisted

Part One - The Accident

You know, right up until the moment I flipped off the edge of the road, it was a TERRIFIC weekend.

Labor Day, 2020. Perfect weather and a couple of free mornings meant it was lining up to be a great weekend for cycling. Two days before, on Saturday, I had done a 125 mile ride on flatter roads (as flat as roads can get in the upstate of South Carolina) down towards Anderson. After a rest day on Sunday, it was time to do some climbing on Monday.

I love climbing hills on my bike. I’m nowhere close to setting any King of the Mountain records on Strava, but for whatever reason, I just love getting on a steep incline that stretches out for a few miles in front of me and just grinding it out. 9/7/20 was the day to finally go tackle the climb up to Sassafras Mountain, the highest point in South Carolina. The first section of road getting out there isn’t bad - a pretty gentle 7 mile uphill section on Hwy 178 - but then it turns into a much steeper uphill for 5 miles to reach the summit of Sassafras. Some sections on that climb were an absolutely brutal 15-20% gradient that forced me to squeeze every ounce of power out of my legs to keep the bike upright and moving forward. But slowly and surely, I knocked out each section and finally reached the top. Hands down it was the hardest piece of cycling I’ve ever done, and boy was it a fantastic feeling of achievement knowing that I had conquered that climb and now the rest of the ride was alllll downhill.

I’m not one to bomb the descents when I’m cycling. I’m actually not that much of a daredevil, and I tend to ride the brakes pretty hard. They don’t freak me out, but I have a healthy respect for the fact that no matter how good your tires or your handling/cornering skills are, there’s only ever a few square inches of rubber tire connecting you and the road at any moment, and there’s a lot that can happen to upset that precarious connection.

So, downhill we went. A short ways down the descent I turned onto a side road that would lead me up into NC and around a long circuitous route that would eventually meander back towards home. Gladys Fork Road. I actually only knew about and was riding this road because a friend of mine had done a similar route a few days before and I had noticed he used this connector road leading from Sassafras.

Less than two miles down Gladys Fork, a curve approached. I saw it coming clearly - the road leading up to it was downhill but straight. It was a pretty sharp curve, no other cars were coming, so I made sure I was on a good line at a reasonable speed and prepared to take the corner just like I had on a hundred other downhill descents.

And then I felt the skid.

I can think of few other heart-pounding, hair raising moments on a bike than when you feel your tires skid. I’ve never crashed before, but I’ve had a few times where on a (straight) downhill section I’ve squeezed the brakes a little too hard or hit some loose gravel and felt that wobbly, loss of control for a few microseconds before the tires found their grip again. The only thing I can reasonably compare it to is that feeling in the tiniest of intervals between when you know the car you’re in is about to hit / be hit by something, and the moment of actual impact. Adrenaline surges, time seems to dilate, and your vision and focus narrow on this singular moment of time in which nothing else but survival matters.

As best I can tell, a patch of loose gravel or sand was the culprit. My front tire went into a skid and I instantly lost the ability to steer with any traction. I remember everything, moment-by-moment, with perfect clarity (a positive? side effect of not blacking out or getting a concussion through the process) - not able to steer into the rest of the curve, my momentum carried me straight forward and off the edge of the road. There was no guardrail, and thick enough tree/foliage cover where I couldn’t see anything about where I was headed. But it happened so quickly that soon there wasn’t time to feel anything.

The primary memory I have of the moment of impact itself, oddly enough, is colors. Black and Green. My eyes must have closed involuntarily at some point. And the last thing I must have seen was the trees and brush I was hurtling towards - so I remember colors. Black and Green. And the sensation of flipping, of tumbling - not rolling or falling - but of sort of somersaulting forwards and down. I was shouting something incomprehensible (does adrenaline take over your vocal cords in such a moment as well?) I’m sure it happened in the flash of an eye, in my memory it stretches for a few seconds, before finally realizing I was motionless. But the key part - I realized I was motionless. I could still sense something. This must mean I was alive.

It was just like booting a computer up from a powered off state - or maybe just hitting the “restart” command. As best as I can tell I never lost consciousness, as there are no gaps in my memory, but there was a definite moment where, as I lay without moving, my brain started into a “boot-up and diagnostic mode”. First things first - I was alive. I was conscious, I was breathing, I was present. A quick prayer of thanks flashed through my mind. Then I opened my eyes to try to get my bearings.

The edge of the road dropped off sharply into about a ten foot deep ravine, leading down from the road to a small creek at the bottom. I had apparently flipped end over end at least once, perhaps a couple times, and come to rest at the bottom of the ravine - sitting in an almost upright position - with my feet resting in the creek. “What an absurdly comfortable position to come to rest in”, I recall thinking briefly. As I opened my eyes, my first thought was to notice my right arm draped over my stomach - while simultaneously noting that I could feel nothing in that arm from my shoulder down. “Broken arm”, I thought instantly. “I can’t feel my right arm at all - I must have broken it when I landed. Maybe my shoulder?”. Apart from a few immediate bumps and scrapes, I wasn’t gushing blood from anywhere that I could see - okay, that’s good - I didn’t impale myself on a tree branch or anything. I sat there for a few - seconds, minutes? Time was hazy at this point - but soon I realized I was starting to regain feeling in my right arm. A few moments later, I realized I could move it and that it didn’t appear to be in any severe pain - “Okay, so perhaps not a broken arm - maybe I just landed on it oddly and did something to lose feeling in it”. Another minute or so and it was feeling just as good as my left - as good as could be after a plunge into a ravine off a bike at speed, I suppose.

My helmet was still on - slightly askew, but still fully buckled. I found the clasp and managed to unbuckle and remove it. I could tell it was cracked, but it wouldn’t be til much later when I would see just how solidly through the helmet had cracked, split - and undoubtedly saved my life.

It was somewhere around this point when I first made a full body move by sitting up and looking around - and instantly felt a bolt of pain in my neck. “Ahhhh hmmm okay there’s something definitely wrong there”, I thought. As I slowly gathered myself to stand up and widen the scope of my bearings, I felt that pain return a couple times - along with a couple moments of a clicking, grinding sensation in my neck. “Alright then, let’s just do everything we can to not move the neck,” was my thought, and so I began to stiffly move around to see what my next steps were.

My bike was halfway down the ravine a few feet above me. It looked intact, but I only momentarily considered trying to get it out of the brush it was lodged in - too much movement for that. The slope was steep enough where from my vantage point, I could actually hear a couple cars going by, but could only barely see the very tops of them passing by - no one would be able to see me or my bike where we currently were. Getting out, and back up to the road, was the only next logical step.

My phone - where was my phone? I carry my phone in one of the back pockets of my cycling jersey, but as I reached back around, I realized it was no longer there. This cued a stiffly frantic couple minutes or so of searching to try and find it - and what a relief to discover it had been thrown free of my pocket but was clearly visible sitting on a rock halfway up to the road.

I calculated my path back up. There were some large rocks/boulders in a sort of a giant step down pattern up from the bottom of the ravine where I was, so moving as cautiously and carefully as possible, I half climbed/half crawled from one rock to the next moving upwards - grabbing my phone as I passed by, and using small branches and brush to try to brace myself as I moved upward - all while trying to move my neck and head as little as possible.

I crested the edge and made it back onto the road. I realized I had left my helmet back down at the bottom, along with my bike - but sure enough, unless you really knew where to look, there was no way anyone was going to stumble on this accident site. I pulled out my phone - naturally, I had no service on this road in the Middle of The Edge of Nowhere, NC. “But remember,” I told myself, recalling hiking/camping trips with no cell service in the foothills of the Carolinas, “your phone GPS works even when you don’t have cell service”. I pulled up Google Maps, waited for GPS to lock onto my location, and dropped a pin where I was standing - that way I’d be able to find my way back here someday. That done - and with no cell service still - I started trudging down the road.

I knew I wasn’t that far from civilization - and I had heard at least 2 cars go by while I was in the ditch - so I wasn’t terribly concerned about being stranded out in the middle of nowhere. While my neck was certainly jacked up, and I could feel the general soreness of having taken such a tumble setting in, I was still fully mobile, so I was reasonably confident that if I had to walk a bit to find cell service or hitch a ride I could do so. Sure enough - it wasn’t more than a couple minutes but a car came down the road towards me.

At that moment, I needed a Good Samaritan. As it turns out, I got a Good Better Best Samaritan. Kaegan rolled up, the chillest dude I could have imagined, who seemed remarkably unphased at finding a bedraggled, bleeding, stiffly-moving, cycle-less cyclist in the middle of the road, forlornly waving an arm in an attempt to appear pathetic (and harmless) enough to earn a ride into town. He cleared off his passenger seat for me, chucking his bag into the backseat where his dog Gracie resided, and I folded myself gently into the car, explaining what happened. He said it was no problem to take me into the nearest town while I figured out the best course of action.

Look, in hindsight, yes, I probably should have called an ambulance. But that’s 20/20 in the rearview mirror - at the time I didn’t KNOW my neck was broken. All I knew is that something back there was a mess, I had full feeling and mobility in the rest of my body, and I had some nice cuts and scrapes. Who knows exactly where my threshold for calling for professional help was - if I’d had another broken bone or two? If I didn’t have feeling in one or more of my extremities? I felt at the time - and still do now - that I was thinking clearly - if I had survived ten minutes of climbing out of the ditch, surely I was fine to get a ride back to home turf and a local hospital. It made sense at the time. It still does. But yes, okay, next time I break my neck, I will call an ambulance on site. Promise.

Kaegan let me call my wife, Lindsay, from his cell phone, which had service, and we drove gently into the nearby town of Rosman. Very, very gently - I found pretty quick that going around curves or any rapid acceleration or braking overrode my ability to keep a totally still neck - any shift in movement was causing bolts of pain to fire up into my skull. We rolled into town and pulled up to a gas station where Kaegan ran inside to get me some water and ibuprofen. It took a little over an hour for Lindsay to make the drive up to Rosman to get me, and Kaegan volunteered to sit there in the car with me and wait for her. Like I said - the Best Samaritan. Sitting perfectly still in a motionless car felt pretty good actually, so we sat for an hour and swapped the Sparks Notes of our life stories with each other. He let slip that he was a minor star on TikTok - I promised to try to give him all the free advertising I could in return for his good deed - so if TikTok is still around when you’re reading this, make sure to go check out his profile @kaegandalton.

Having broken most land speed records between our house and Rosman, NC, Lindsay finally rolled into the parking lot where we were waiting. The stiffness and soreness had definitely begun to set in by this point, but we were able to very gingerly get me transferred from Kaegan’s car over to Lindsay’s. We thanked Kaegan again, profusely, and then started the drive back down the mountain. That was, to put it mildly, a long, long drive. We had to take it super slow so I could try to brace myself and not cause too much pain, but after an only mildly agonizing hour and a half or so, we had finally made it back to our hometown, and made a beeline for Greer Memorial Hospital.

This whole time we drove, although I was bracing against the pain, my natural optimism kicked in and my spirits were still pretty high. I detailed everything that had happened to Lindsay, we gave profuse thanks that I was still alive, and we pondered what the next steps would be. I knew we’d be in good hands at the hospital, and so can honestly say that there was little to no panic, fear, or worry in my head or heart as we got near. We pulled up to the front door at the Emergency Entrance of the hospital, and a nurse and a security guy came out to meet us. I had rolled down the window, and one of them asked me what was wrong.

“Well, I had a bit of a cycling accident and I seem to have jacked up my neck pretty good!”, I said, rather cheerily.

As the word “neck” left my mouth, the nurse’s demeanor instantly changed.

“DON’T. MOVE.” she shouted, as she sprinted back inside and came back moments later with a neck brace. “We need to get this on you before anything else happens”, she said with a piercing intensity that cut through my optimistic sheen.

It was at that moment I began to suspect that perhaps my injury was slightly more severe than I had previously thought.

Part Two: The Hospital

The ditch where I ended up. The road is offscreen
to the upper right. The creek where I came to rest 
along the let side 

My helmet undoubtedly saved 
the day and my life