October 21, 2021 - A Year+ Later

For months now I’ve been meaning to get around to posting another update, and as we passed the one year mark of the accident last month, I decided it was finally time. So naturally it took me another 5+ weeks.

No news has been good news, for the last 8 months. When the Halo came off in January, I recall thinking, “boy wouldn’t it be nice to have a nice, quiet, boring year” - and I’m pleased to report that - for the most part - that’s exactly what I’ve had. Maybe 2022 is just storing up its energy. We’ll cross that bridge when we come to it. 

The extended last phase of my recovery has gone magnificently well, if slowly - but that’s exactly what was expected. The first three months of the year were all just about getting functional neck strength and movement back. After four months of complete non-usage, my neck muscles were so weak that I could really only turn my head by a few degrees in any direction. Amazingly, I wasn’t prescribed any official physical therapy - Dr. Lynne told me that I could see a PT if I felt like I needed one, but otherwise I should just keep living normally and let those neck muscles slowly strengthen themselves up over time. By the end of February, I was rarely wearing the removable neck brace at all. I don’t remember an exact day that was the “last time” I wore it, as it was a very slow gradual reduction of use until it eventually found its way up to my top closet shelf where it lives to this day. Through much of the spring my neck motion still felt pretty limited - every week or two I could tell that I was getting a little bit more range of motion back, but it was an extremely gradual process. Patience was the word of the year, no doubt. Thankfully, even with a limited range of motion, daily life felt a whole lot more normal. I was able to drive again (carefully, with very strategic mirror placement), get back to riding my bike (indoors only - more on that later), and overall I felt incredibly pleased and grateful for the ability to get back to doing all the things I loved. 

And the rest of the year continued much the same. It’s tough to put a measurement at any given time on how much neck mobility I had regained - I wasn’t using measuring devices to see what angle of flexibility I had in any given direction, it was all very intuitive - and there were better days and worse days when the muscles of my neck would be overused or tired or more fresh or more sore. But I was back to doing 95% of my normal life activities, and so I had no complaints. Here we are now in October, and if I had to put a number on it, I feel as though I probably have about 80% of my pre-accident neck mobility back. That last 20% will come with time, the speed of which will be solely determined by how much dedicated and focused stretching into those last degrees of flexion I do. But everything I need for normal, functional life is there. Now that tight feeling in my neck is just like when most of us inflexible people try to touch our toes without bending our knees and feel our twanging hamstrings groan in protest. No pain, only tightness. And that seems like a very reasonable outcome to deal with, all things considered. 

One question I do hear routinely - “So, are you still riding your bike?” The answer of course is yes - but about 99.9% of that is indoors on my bike trainer. I have a terrific indoor setup including a KICKR bike trainer that utilizes my actual road bike, along with cycling programs like Zwift and Fulgaz that give me a super immersive riding simulation with far less risk of swerving cars and edges of mountain roads. I’m at about 8500 miles for the year so far, exactly 40 of which took place outside (on a beach cruiser along flat bike paths down in Florida). Will I ever ride outside again? I’m almost certain I will at some point down the line. For most of this year, my neck just hasn’t felt strong enough to be able to feel safely confident about being able to turn my head quickly to check traffic, and until that day, I’d rather not take any more risks than necessary. For now, if I can get 90% of the enjoyment and fitness returns by using my indoor trainer (with about 2% of the risk of outdoor riding) - well, that’s a cost/benefit/risk analysis I’ll continue to make for the rest of my life. 

Look, at the end of the day, I’m incredibly lucky that I can still ride my bike at all. I’m lucky that I’m sitting here typing these words. It’s not lost on me how close I came to shuffling off this mortal coil a year ago, and the fact that I have seemingly little to no long term negative effects from my broken neck and Halo brace experience is a miracle for which I work to be thankful every day. Even stranger, at times, is how many good memories I have of last fall. As difficult and painful and complex as the process was, Lindsay and I look back almost fondly on the extra time we were able to spend together and the wonderfully strange and entertaining stories and memories with which we came away from this journey. And I can say without a doubt that my appreciation for my community has grown a thousandfold over the last year. Sometimes you don’t get to understand just how much the people close to you “have your back” until they are actually there, supporting you every moment and day through a trying time. I’ll never repay the debt I owe to all those in my life who lent me their strength when I needed it the most - so now all I can do is try to pay it forward in kind. 

I don’t know what the future holds for BreakneckBean. I plan to keep it active, not just for posterity but also in the off-chance that someone else who suddenly one day finds themselves in a Halo can find this story and take away a glimmer of hope or ideas of how to navigate the process. Finding other people’s blogs was of a great help to me those first few days in the hospital, so if I can “pay it forward” in that respect as well - that’s a win in my book. 

If you have stumbled on this “end of story” post first - here’s a couple helpful links if you want to take in more of my story from the beginning

Part One - The Accident

Video - Halo Removal

"Halo" - Song Parody

February 6th Update - Moving In The Right Direction

 After kicking off the New Year by getting the Halo removed on Jan 6th, most of the month was still ruled by being patient and waiting for time to pass, trusting the healing process to continue as long as I didn’t get in the way too much.

The Halo came off on a Wednesday, and it was Saturday before I was brave enough to actually remove the hard collar for a few minutes. Those first few days, the first week really, was ruled by a lot of soreness and “heaviness”, a lot of tenderness, and a lot of hesitation. It didn’t feel like a step backward - because the Halo came off, it was certainly forward - but much as it was back when I first had the Halo on, it was a matter of adjusting to a new normal, and reminding myself to be patient and let things run their course. My first shower came the following Tuesday - it was very tentative, but incredibly glorious. The feeling of warm water cascading down my head and shoulders and torso - amazing. I didn’t realize just how much I’d missed it until I was able to experience it again. Post shower, of course, I slapped that hard collar back on as fast as possible. 

The first couple weeks in the collar, it and I were absolute best friends. I would only take it off for a few minutes here or there, to shower or change shirts, for example. I slept in the recliner wearing the collar for the first week or so - it was just more comfortable, and I was perhaps a little worried about accidental “jerking” motions while sleeping that might cause any jolts of pain. It wasn’t really too uncomfortable to wear 24/7 - and it was a WHOLE lot less restrictive than the Halo, to be sure. 

The holes in my head are healing up SUPER well - my forehead wounds closed up after just a few days, and while they are still noticeable "divots" in my skin, they're looking much better. The holes on the side/back took a few extra days to scab over, but were quickly pain free and healing much the same. 

The back half of January felt like it brought more improvement, slowly but surely. At some point I started sleeping - still in the recliner - without the brace (waking up with a lot of stiffness/soreness) - and sometimes in the evening while sitting in the recliner I would take it off here and there to “let my neck breathe”. By the last week of January I was taking it off more, sometimes walking around the house without it on - and found that my confidence was growing at the same time as my neck was getting better at holding my head up. 

Monday, February 1st - a new month, and another visit to Dr. Lynn. Took the usual x-rays, which showed the C2 bone continuing to slowly heal - it will continue to do so over the next few months, it sounds like. But it’s moving in the right direction, still correctly aligned, and Dr. Lynn was very happy. He was even happier to hear how I was feeling - stronger every day, more confident; neck soreness but no pain. 

This moves us firmly into the part of recovery based on everything SURROUNDING the bone. The bone is in a good place - I had some pointed questions for my own peace of mind that Dr. Lynn answered by reassuring me that the bone is not at risk of re-breaking or being damaged at this point except through something catastrophic. And there’s really no other risk of “damaging” anything else either - all the soreness and pain I feel is just muscular at this point - the neck relearning how to work properly. But I’m now more-or-less cleared for most activities, all based on how I’m feeling. I can start doing stretches and working on regaining my neck range of motion - which definitely feels like a huge win and as though we’re getting into the “return-to-real-life” part of recovery. We’re going to keep doing monthly x-rays and check-ins with Dr. Lynn for at least the next couple months. So now I get to see how much progress I can make before I see him next.

It feels like I’m making progress in leaps and bounds. Thursday of this week was the first day that I went the entire day without wearing the brace at all (Friday I was pretty sore - still wearing the brace anytime the soreness gets too much or while doing certain actions, like riding in a car). I'm also back to sleeping without the brace, in bed - I just have to roll very slowly when turning from side to side! I’m working on incorporating a regular neck stretching and movement routine - although right now I only have a few degrees of movement in each direction, I know that will continue to improve, and I’m excited to see how I continue to make progress over time. 

Most recent x-ray from 2.1.21

Graham is very glad to be able to nap 
with Dad in bed again

January 10th, 2021 Update - THE HALO REMOVED

Dr. Lynn did me a solid and scheduled my CT scan for December 31st - specifically so I could claim it on my health insurance for 2020 (life pro tip: breaking your neck is a great way to hit your max deductible/out-of-pocket REAL fast). The CT scan was at the hospital in Greer and was a pretty simple in-and-out procedure, with a chance to meet a handful of new hospital employees and explain in enthusiastic detail the specifics of my predicament. 

It was then an INCREDIBLY long weekend, both to ring in the new year and attempt to wait patiently until my appointment the following Monday with Dr. Lynn to parse the results. 

The results - were good! The CT scan shows total healing of the C1 and C7 fractures (the two lesser of the three breaks). The C2 fracture is still in the process of healing. Where the “pin bone” (odontoid) is knitting itself back to the body of the C2 vertebrae, there is fusion across roughly half of the connector point. Naturally I forgot, in the moment, to snap a picture of the scan to post here, so please enjoy instead this rough sketch by Lindsay, my very capable artist-in-residence. 

The C2 pin (odontoid) bone, 
healed partially across

I get the sense that in a perfect world, at this point, we’d see complete fusion along this junction, but I didn’t feel any overt concern from Dr. Lynn. Sometimes there is slower healing on sections of bone like this, he indicated, and said that in time we should still see complete fusion. We’ll just need to keep looking at it, so we go back the first week of February for another set of x-rays to check on the progress. 

But with the amount of bone healing that we do see, said Dr. Lynn - “Yeah let’s get you out of this thing, huh?” Sweeter words I perhaps have never heard, and so we start out the New Year exactly as we hoped - with being freed from the Cage of the Halo Brace!

A slight delay immediately arose, however - we’d have to see Todd the Orthotist for the Halo removal (as only he possessed the magical tools, wrenches, etc required) - and although we called over to his office - Todd had gone home for the day. So the soonest we could get in to see him was Wednesday morning, January 6th. Honestly, this was completely fine with me - After almost four months in the Halo, what was another couple of days? This also gave me the chance on Tuesday to capture some video footage I wanted for a few practical Halo videos I have contemplated making to post to Youtube at some point, as reference videos for other people who might find themselves in my shoes (or brace, in this case) someday. 

It also gave me a chance to mentally prepare myself for this next step. Don’t get me wrong - I was eager to get out of the Halo and move forward to the next stage of healing and progression - but at the same time, I can’t say I wasn’t a little nervous about what would come next. After four months in the Halo, it was (believe it not) comfortable. There was no pain, no discomfort - it was bulky, unwieldy, sure - but I had adapted it into my everyday life and I knew what everything felt like and how everything worked. And for an injury as unstable and mentally nerve-wracking as a neck fracture, well - stability and surety goes a long way, both physiologically and psychologically. 

Look, it’s not that I ACTUALLY thought that, once Halo-less, my head might fall off and roll away, but all I’m saying is that, were you in my shoes, you might also have weird dreams in which that very sort of thing happens. But, this is real life, and we must move forward with all the courage and mental fortitude we can muster to play the hand we are dealt. 

So, Wednesday morning, January 6th, 2021 dawned - Day 119 in the Halo - and to Todd’s office we went. (Per Todd’s advice from several months back, I had saved an oxycodone pill and tipped it back 15 minutes before arriving at his office) The procedure was smooth and simple - here’s a video for those who’d like to watch along. 

First Todd secured around my neck the hard Aspen collar that will become my new best friend for the next several weeks/months at least. Then, the rods connecting the “halo” part of the brace to the “vest” part of the brace were removed, one by one. These rods are really what effectively held my head in place - so as each one was removed, I could feel gravity taking control of my head again and could feel myself “sinking down” into the collar. What a terrifically odd feeling, to suddenly have that weight again - I immediately thought of a book I read recently by Canadian astronaut Chris Hadfield, describing what the “weight” of gravity feels like at first for astronauts returning from spending any length of time on the International Space Station. Thankfully the collar could do all the work for me while my neck muscles, long dormant, were suddenly forced to wake up and (attempt to) kick back into action. 

Once the rods were removed, it was to the halo itself. Todd and his assistant took out two screws at once on opposing sides of my head - the first two created a feeling of “pressure release” - not unlike the pressure I felt when they put the new screws in a couple months back to replace the infected pins in the back. Once those two were removed, they took out the remaining two - the moment when those two pins “released” was by far the most painful part of the process - specifically the screw at the front left side of my head had a distinct moment where it felt as though it were “ripping free” - thankfully a mere handful of moments and this pain began to subside. My head immediately did feel as though it weighed 30 pounds or more, but the Aspen collar provided all the support and stability I needed. We removed the vest portions, bandaged up the pin sites on my forehead, put the Halo remains in a large plastic bag to keep and save for posterity, and home we went. 

What a strange, wonderful, and absolutely bizarre sensation to not have the Halo on. It was jarring - not in a displeasing way - just in a discombobulating way. I felt overall as though I weighed 10 pounds lighter, but my head felt as though it weighed 20 pounds more. I felt both much freer - from the Halo - and yet more constrained - by the Aspen collar snug around my neck. But all in all - a net positive, and an absolute win, I decided. 

Because of how the C2 vertebrae was only partially healed, Dr. Lynn’s instructions are to wear the Aspen collar more or less full-time for the next month until I see him again. I am allowed to remove it for sleeping and showering, but I get the sense he doesn’t want me to work too hard on any “rehab protocol” until we check things with another x-ray in a month to see how that pin bone is doing. These first few days have been pretty slow and cautious. There is a lot of neck soreness and discomfort, but it seems to be getting marginally better each day. As Dr. Lynn put it “soreness is okay, pain is not” - it definitely feels like everything going on in the neck region is just soreness of a variety of different kinds. The collar keeps me secure and stable - it permits a very very tiny bit of neck movement but so far my goal is to keep things as still as possible. (For that matter, I really CAN'T move my neck very much anyway with how weak the muscles are) So far I have only removed the collar once for a few minutes just to let my neck breathe a little bit - it felt alright, but I’m SUPER tentative about accidentally making any kind of quick or sudden movement that would cause pain. I’m back to sleeping in the recliner for now but within a few more days I’m hoping to try lying flat and maybe even taking the collar off overnight. A lot of the soreness and pressure in the neck now reminds me a lot of the first few weeks in the Halo, so I’m optimistic that as my neck muscles get acclimated to even micro-usage, we’ll see definite improvement over the next few weeks. If I get a little stronger and feel a little better everyday, by the time we see Dr. Lynn on February 1st, I’ll be ready for whatever comes next!

Feels great to be Halo-Free!

The (terrifying) moment of truth, 
taking off the Aspen collar
for the first time