From the Blue Ridge to Oak Ridge . . . then home again

[originally posted elsewhere on 4/11/23]

As I begin writing this in mid-March, it has been six months since I broke my leg, and I've been reminiscing about the events of that day and since then. It happened just after we finished the Blue Ridge Relay (BRR), so first a little background on that. The BRR is a 208-mile relay race (for runners) held each September since 2005 in the vicinity of the Blue Ridge Mountains, including several miles along the Blue Ridge Parkway itself. Max team size is 12, but elite teams can have fewer members. With a full team of 12 the race becomes a series of 36 slices of the total course, with each of the 12 runners tackling an assigned slice before handing off to the next runner. Repeat twice for a total of three segments per runner. (More details are available at https://blueridgerelay.com/). My team 1) finished and 2) did not finish last. A rousing success!

The race had ended (we ran from 7 AM on Friday until about 7 PM on Saturday). A couple hours for the awards ceremony and dinner, a couple more hours for the drive back to one of our rented "cabins"--not the one I was staying in--and we arrived at the house a little past 11 PM. I got out of the van I was riding in, stretched my legs, and then started toward the house to get my things and take one final ride to yet another rented house, about a mile down the hill. The driver of the team van (one of two such vans) had reached her final destination, so those of us who were assigned to the house down the road were planning to transfer from the van to a Suburban (unlike the vans, this was not a rental, but instead was the personal vehicle of one of the runners on my team). Before reaching the front door I remembered that, all those hours ago, I had not left anything in this house. All my things were in the duffel bag that I was carrying at the time, or maybe in the truck or back at the house. The thought struck me that my roommates might be waiting for me, wondering where I was and anxious to get back to our beds. I turned and looked across the front yard of this big, beautiful house at my friend's Suburban off in the distance, near the street. There was a porch light behind me and the automobile lights ahead, but otherwise it was dark, and a bit cold and rainy. As I trotted across the yard I noticed a lovely pathway of stone pavers cutting across it. When I stepped across that path to the grass on the other side . . . there was no grass, nor ground. I briefly felt weightless, and then I slammed into concrete roughly six feet below.

Immediately I heard a voice yell, "Call 911! Greg fell, call 911!" All I could think at first was, "Man that was really quick! How did they know about my mishap?" I didn't know it at the time, but a teammate was right behind me. As I lay there I wondered if an ambulance was overkill--if I was just badly bruised and might be able to get up--but when I thought about getting up and gingerly made an effort to do so, I realized that just walking it off wasn't in the cards. Pain exploded before I was able to even get started moving my left leg, and so I kept still. I was lying on my back in a corner that consisted of the intersection of a driveway and a retaining wall, in a light mist, surrounded by more and more of my friends. I had tucked my chin down during the fall--I had no memories of doing that, but I clearly had done so, as it was still tucked. My head and shoulders were off the ground, abs refusing to relax. My left leg was frozen in place, knee bent and near my chest, as if I were about to hit the water of a swimming pool doing a can opener . . . or as if I were at the gym, high stepping. It seemed like that, but with increasing pain as the shock started to wear off. By this time someone had brought a blanket to cover me, and another to put under my head. I lay there in the light rain, clutching my duffel bag and my leg, feeling thankful for friends and blankets, and wondering how I had managed to fall off of a six-foot retaining wall. I also wondered why the hell it wasn't lit up, so people could see the damn thing.

There were concerns about a possible head injury, but I did not share them. I wondered how bad my injuries were and speculated that maybe I had broken my hip. When the ambulance arrived, two paramedics approached, a man (clearly in charge) and a woman (new to the job and a little freaked out, I later learned). The woman hung back and didn't say much, while the man began talking to me, assessing my mental and physical condition. I think I was able to convince him that I did not have any spinal or head injuries, but he said he was required to put me on a back board, anyway. Ok, no problem. Well, one slight problem--I was in that corner, on the driveway and with my right side against the wall. He explained his dilemma and gave me a chance to weigh in. Do we lift your left side up and put the board under you, or roll you slightly onto your left side and get the board under you from the right? Well, both of those options sucked. I think I requested putting the board under me from the right side, so we tried that first. With the wall in the way, though, it was proving to be impractical, so the left side was it. All this movement hurt like hell, so I asked him to give me something for the pain. I don't remember what drugs were involved, but I do remember him saying that he could give me something immediately, or something better on the ambulance (which he always referred to as his "truck"). "Both, please." I'm no push-over when it come to pain, but that particular pain was like nothing I had ever experienced. I think I did get something while lying on the driveway, but it still hurt quite a bit being put onto the back board and then hoisted onto a stretcher and into the truck. I think I got my "both" once we were onboard. Before leaving, the senior paramedic gave me a choice of destinations. I forget the name of the near facility, but it was a compromise between close proximity and lesser capability on the one hand, or a longer drive to a better, more capable hospital. The farther place he called Wautauga, or Wautauga Regional Medical Center. I had no idea about either facility, so it was hard to choose--until he told me that if we go to the closer place and find out that there is a broken bone, we would have to go to Wautauga. I told him to just go straight to Wautauga, since I knew something was broken. It turned out to be a femur instead of a hip, but it was indeed broken.

A few of my teammates rode in the ambulance with me. I hope they were able to get some sleep, because sleep would have made the whole crappy night just a tiny bit less crappy for them. The head paramedic spoke with me a bit on the drive. Going over bumps in the road caused minor spikes in the pain, but I don't recall it being bad. When we got to the hospital, I think I was in and out of consciousness, or at least I have holes in my memory of that late Saturday night/early Sunday morning. I recall being asked if I would mind if they cut my clothing away. Not at all, I thought, even without being told that the alternative to cutting it off would be to lift me up and remove it the regular way. Cut away, my good man, cut away. Not the shoes, though. Not my brand new Hoka running shoes, a gift from Hoka corporate to each member of my team. I still wear those shoes to this day. The paramedics and nurses did a good job of immobilizing my leg while gently removing the shoe; I felt zero pain. While my things were being collected, bagged, and stored away, I helped someone get into my phone, whether by facial recognition or numeric code or both. I helped them identify and call emergency contacts, primarily my wife, my parents, and my brother. I spent a fair amount of time explaining my plans for that Sunday (9/11/22) to a nurse, and helping her undo those plans. Rather than fly straight home to Las Vegas, I had a visit planned in Camden, TN. My flight was from Charlotte to Nashville, where I had a rental car reserved, a Tesla. It would have been my first time driving a Tesla--mostly because that's all that was left when I made the reservation. Anyway, she was happy to call the airline and explain the situation; they were kind enough to cancel the reservation and also waive the late-cancellation fee, once she explained that I was at the emergency room and about to be wheeled into the OR. She seemed to be about to rush off somewhere when that call ended, and I had to quickly speak up and tell her that I had one more reservation to cancel. A similar conversation at the rental car place did the trick, and my reservations were cancelled with no fees incurred. Yes!

Time for surgery prep. The first item of note was taking x-rays so the surgeon could formulate a plan to fix me. That required straightening my leg, which I had tried several times and knew would be most unpleasant. I stalled and stalled as much as possible, asking for more pain medicine. At other hospitals in the past few years I've been handed literature by the staff talking about pain and pain management. The gist of it was that they don't want you to suffer, and it's your decision how much pain you want to feel. The consensus seemed to be that if you need more pain medicine, you should not hesitate to ask. So I asked. I still felt pain, and I let them know that. I asked for more, several times. I think I remember being told that they could not give me a particular pain medicine because of what was already in my system, and I think I remember being given morphine. Four times. Finally they decided that I had had enough (and I suppose they had had enough, too). It was time to straighten my leg.

I don't remember that. My friends tell me that I screamed bloody murder, so I was definitely conscious. Blacking out that memory is a handy defense mechanism, one for which I am grateful.

After the x-rays, prep continued. A nurse came by with a bottle for me to pee in. I did so, and she took it away, sadly a little too soon. Next the anesthesiologist came over and introduced himself, telling me he intended to give me an epidural. I did not know what to expect, exactly, from this surgery, but I knew I didn't want to be awake when it happened. I asked him to put me out, and to my surprise he readily agreed.

On a quick side note, I once had a procedure where I wasn't quite out when they started, and I remember the first minute or two. When I later had that same anesthesiologist for another procedure (in Las Vegas) and told him what happened the first time, he assured me he would not let it happen again, and he did not. Fast forward a couple years to Wautauga, and I told this to the doctor before anything was administered. I had a plan, and he agreed that it would be fine . . . although I wonder what he really thought about my idea, which was simply that I would raise my hand and try to keep it up as long as possible. When the arm relaxed onto the stretcher, he would know I was out. When he agreed to that, I asked to pee one more time. It seemed forever before a flow started, but a lot came out, and I was satisfied that I would not wet myself during the operation. I suppose it might have happened anyway and they just didn't mention it, but I did what I could.

I got the anesthesia, raised my hand as high as I could hold it for as long as possible, and passed out. I woke up, looked around, and realized that the surgery had not yet started. So, I stuck my hand up again. This happened two more times, making it four times in total that I stuck my arm up. I never did get a chance to ask him about this, but later I speculated that the doctor was testing me, gradually increasing the dose to see how it affected me. At the time I simply felt relieved each time I woke up and realized that they had not started yet.

I was groggy when I woke up, of course, but I soon felt awake and quite good. Maybe a little too good. I remember catching up on my "correspondence" as I called it at the time. I had phone, tablet, laptop, and chargers for each. I posted on Facebook, wrote emails, and asked a nurse to take my picture. I think I was a little loopy, though. If you read any of my correspondence, you can tell me what it was like reading it. Maybe tell me in private, lol.

I could not move my leg at all, and I could barely move the rest of me. I had no problem with that at first, but as the days crept by I started to get restless, feeling like I *had* to move. There is a Parkinson's thing where you get restless leg syndrome, but it affects the entire body (for me, anyway; we're all different). It is unpleasant in the best of times, when I am free to move around, but the combination of feeling compelled to move, the sure knowledge that it was impossible to do so, and the clock indicating several hours till sunrise made up a sour soup, with complimentary panic on the distant horizon, threatening to come for a visit. I practiced relaxation techniques for both body and mind, and I was mostly successful. I also used the sensation to motivate me to try to move that dead-weight boat anchor of a leg. Once I even asked the night nurse if I could stand for a while. He agreed, probably thinking that five minutes would be enough. No way. I stood for hours.

Day two in the hospital (Monday 9/12) brought some new faces--the physical and occupational therapists (PT and OT), plus a new shift of nurses. There were some familiar faces as well--my parents, up from Tennessee to spend what turned out to be the final four days of a five-day stay with me. I'm also told that my brother came to visit while I was in surgery on Sunday. He had to leave before I woke up, so I missed him. Seems like a long drive for nothing, but you never know in a situation like that, so of course you go if you can. In any case, day 2 was when the PT told me to get walking (very slowly with a walker for a very short distance, then back in bed) and the OT started teaching me about socks and how to put them on when you can't reach your feet, or even come anywhere close.

Days 3 and 4 were mostly more of the same. The walks grew a little longer, and I started first to wonder when I would be discharged, and then to plan for it. I eventually started thinking that day 5 would be the day, and when the head nurse agreed, we started packing up. We hit the road a little later than we had hoped, what with all the administrative requirements and paperwork that the hospital had to complete prior to discharging me, and we ended up driving through Knoxville during the afternoon rush hour.

Apologies for talking about bowel movements, but I did not have one for over five days--the entire stay in the hospital, plus some amount of time before I fell, whether hours or days. I knew it was coming soon, likely that day. I fervently hoped it would be at home in Crossville, but alas, that was not to be. Departing from Boone, NC, we drove toward Knoxville--as much as I would have loved to visit the campus of the mighty UT Vols, we were just passing through. As we left Knoxville heading south on I-75, I started looking for a place to pull over. I figured a restaurant would have good facilities and be a fine place to take care of business, but a truck stop would be better. I saw little other than office parks for a few minutes, and then a Pilot. Bingo!

At this point it was starting to feel rather urgent, but between the regular Parkinsonian constipation and the extra constipation brought on by dehydration and pain medicine, it was a slow process. That was probably a blessing because getting out of the van, hobbling into and through the store with my walker, and getting my special OT medical toilet frame set up--over and around the commode in the men's room--was not something we could do quickly. Or without drawing a great deal of attention. Once everything was in place, there was little to do other than sit and wait. I remember my poor Dad having to fend off curious looks from passersby wondering why he was sitting in the men's room. At one point I asked him to go to car for something, I don't remember what. It probably had something to do with reach, as mine was quite limited; maybe the grabber or a roll of toilet paper. Eventually the evolution was concluded, and we got back on the road.

It was only an hour or so to the house, and that hour passed uneventfully. However, getting to the house and parking in the driveway as close as possible to the front was the easy part. Getting out of the car, up three steps to the porch, and into the house was another matter entirely. I don't recall how long it took me to traverse such an otherwise short and easy distance, but it must have been at least 30 minutes. From there it was a short walk across the living room to my new best friend, a motorized recliner. I never thought I would need such a thing, but it sure did help. For the next few weeks I slept in it at night, napped in it during the day, sometimes took meals in it, read, watched TV, worked, did my PT exercises. What a blessing to have!

I had planned a 5-day trip for the race, flying from Las Vegas to Charlotte a day early to visit with friends and my big brother. That was Wednesday, Sep 7. On Thursday Sep 8 the team gathered in Charlotte and headed up to Virginia where the rented cabins stood waiting. When questioned later on about "Didn't you know about that retaining wall? Hadn't you seen that place before the night of the fall?", the memories did come back to me, and I had to admit that yes, I had been there briefly and I did see the front yard, including the two driveways and the retaining wall. In addition to Thursday night, I also saw them Friday morning before my first run. However, after being sleep-deprived from the 36-hour race and generally suffering from a state of mind similar to highway hypnosis, it just didn't register. In any case, we checked out the insides of our three rental houses and the beautiful views from their back decks, had dinner as a team, and eventually got to bed. So that was day 1 and day 2. Day 3 was the first half of the race, day 4 the second half, and day 5 was supposed to be a combination of flights into and out of Nashville with a road trip in between. Instead of 5 days away from home, I spent over 5 weeks away. I learned that flying would be a very bad idea due to the strong possibility of blood clots, which could be fatal. Driving was possible, but quite impractical. I could barely function in a house, let alone cramped up in a car. Besides, who would drive? Thus the decision was made to stay until I was medically deemed safe to fly. I wondered if that might take more than a week or two. No way. I left the hospital on Thursday, September 15. I flew home to Las Vegas on Saturday, October 15. Seasons changed while I was gone, the weather turning quite cool and making me raid my Dad's wardrobe for something warmer than my running clothes. The kids progressed in school. I lost weight, lol. My awesome wife held things together in my absence, but in mid-October all of us were glad that I was finally back at home.

I'm not complaining about the time away. Sure, it was hard on everyone involved, particularly on my wife, but every cloud has a silver lining. In this case, that silver lining was a rare opportunity to spend a great deal of quality time with my parents. My Mom has always been a good cook, and she holds nothing back when company is over. She cooked and baked all kinds of great food, and on top of that, friends of theirs brought food over. We were left wanting for nothing. I had a bunch of extra Parkinson's medication with me, but not enough for five weeks, so I spent some time on the phone with CVS, explaining the situation and arranging to refill several prescriptions in Crossville, TN instead of Las Vegas, NV. I found and visited a local orthopedics office to get my leg x-rayed and verify that it was continuing to heal, as well as to remove the staples that had been used to close after surgery. Everything was as it should be--a testament to the skill of the surgeon and the rest of the team in Boone, NC.

Four main things in particular stand out in my memory of the time in Crossville. The first is that I provided tech support, which comes with the territory when you work in IT. Anything can sound confusing when you hear someone describe it, and that includes both trying to get something done on a computer, as well as trying to understand what is not working. Being present makes it so much easier, when I can see what is being done, and they can see what I'm trying to show. Lots of progress was made. The second is the fun stuff I got to do with my Mom. We watched the entire Lord of the Rings trilogy and the entire Hobbit trilogy--great stuff. We also listened to the audio book version of Educated, which Tara had read in school and recommended to me. Third was spending time with my Dad. We had plenty of time to talk about all kinds of things, but one of my favorite activities was just sitting with him and watching music videos on youtube. At one point while across the hall I heard a beautiful and haunting version of Goodbye Yellow Brick Road being sung by a woman whose voice I did not recognize. It turned out to be group called Foxes and Fossils, a cover band that did a fantastic job with a whole bunch of songs. Then there were all the old favorites by Merle Haggard, Johnny Cash, Ray Charles, Willie Nelson, the Eagles, and lots more. After sufficient time had passed and I was able to hobble down 9 stairs to the garage and use his weight machine, we also talked exercise. Speaking of exercise, the last two stand-out memories are of course physical therapy (PT) and occupational therapy (OT).

Before leaving the hospital I was strongly encouraged to schedule in-home PT and OT to continue what I had started learning in the hospital, and we did. After arriving at my parents' house well after dark on Thursday, the PT lead showed up the next day with paperwork, and I think she had some beginning exercises for me. We hit the ground running (no pun intended!) in both PT and OT, with a ratio of maybe 2:1 or 3:1 in favor of PT. When I first started walking, I had to put all of my weight on my walker when my right foot was off the ground, and use my arms to hold my body off the floor. I felt an absolute imperative to keep weight off my left foot, but of course the idea was to put weight on that foot to rehab the leg. How much weight? How soon? The answer was consistently, "As much as you can tolerate" and "Let pain be your guide". In addition to the ability to put weight on that leg, there was the issue of stiffness in my knee. I could barely bend that left leg, so one of my tasks was to work on that. Another was stairs. The practice steps at the hospital were easy due to two factors, neither of which applies to the real world. One, there was no wall attached to it above the rail, so I was able to lean far enough over that rail to put all my weight on it. Two, it was strong enough to support my entire body weight. Fast forward to the house, and suddenly there is a wall blocking me from leaning over the rail, and even if I could lean far enough to put all my weight on it, that would probably tear it right out of the wall. So I had to learn, strengthen, and rehab. "Let pain be your guide." The last big hurdle of these few weeks of PT was the bed. Getting into it proved impossible for at least a week or two. When I finally was able to work my way on top of the bed, the orientation of my body relative to the bed--obligated by the broken leg and the difficulty of going around to the other side of the bed--left me with my feet on the pillow and my head at the foot of the bed. A quick change of bedding and 15 minutes later Mom and Dad had things right as rain, and my head had a pillow. OT covered the basics of dressing, bathing, and going to the bathroom unassisted. Great fun. All are important topics, of course, and some special OT tools made these activities either far easier, or more likely made them possible.

With the difficulty of moving, the danger of falling, and my general state of mind (focused on other things), I did not take a shower right away. I probably needed one, since I had not been able to take a shower post-race or while in the hospital. On the other hand, I was not very active and not working up a sweat. In the early part of this period I had no desire to take a shower, let alone experience all the pain that would be right there with it, not to mention the awkwardness of getting dressed afterwards. As time went on, though, and my ability to function improved, I started to crave a shower. I had only two or three during that 5 week stay. Each felt good, and each was an improvement over the one before. OT tools helped, particularly the commode (which doubled as a shower chair) and the grabber.

By the time I was due to go home, I had been leaving my walker in favor of cane(s)--sometimes one, sometimes two--and after returning to Las Vegas, it did not take long before I stopped using the walker entirely. I had made an appointment with a local doctor to have my leg checked out, to ensure proper recovery--and get medical clearance to drive--but the doctor refused to see me. That irritated me enough that I thought "screw the doctor, and his blessing to drive . . .I'll do this myself and he can kiss my ass". Foolhardy, perhaps. Although I started driving right away, I did backtrack a little. I went to see my primary care physician, who said that I seemed fine and sent me to onsite PT. It was there that I learned a valuable addendum to "Let pain be your guide". That was never meant to be about level 3 to 4 pain; it meant that if the pain spiked to 8 or 9 (on a scale from 1 to 10), something was wrong. Short of that, everything would be fine. That 3-to-4 range is right where I needed to be. So whether at PT, at the gym, or at home, I no longer feared that I might be doing too much or that I might be undoing the surgical repair. That was most unlikely, even impossible, short of another catastrophic fall. So I chased the pain, working out hard enough to get to that 3-to-4 target zone. It was easy in the beginning, but before long I found that I had to push harder and do more to get there. Now there are only a few things left that hurt, things like a deep squat or lunge, carrying too much eight, or running too far or too fast.

As luck would have it, this year's Spartan races *do* include Las Vegas, and unlike past races where the Las Vegas Spartan weekend was actually held in Mesquite, this year they are actually right here in town. That's too good to pass up, so I'll give it a shot. I'm not 100%, but I am far better off than I was at the Arizona sprint in November. This time I have a super on Saturday (tomorrow!) and a sprint on Sunday. The beast will be later this year. I'm not ready to go all out on the obstacles, but I want to do more than just walk the course. I'll play it by ear and post the results.

Many times since the accident, I have wondered why this happened. Why did I fall? I don't fall, as a matter of . . . what? Record? Pride? I don't know, but such an accident has not happened to me in some time. So was it the sleep deprivation? The lack of lighting in such a hazardous spot? A carelessness brought about by Parkinson's and cognitive decline? I don't know, but I do know this. That first day at my parents' house--the day after being discharged and the first day of PT--my Mom fell and hurt herself. Because I fell and broke my leg, I was there. Because I was there and starting physical therapy, a skilled medical professional was there. This particular physical therapist also happened to be a nurse. Because the nurse was there, Mom had help immediately available. She needed it. Without that nurse there to assist, she would been alone, unable to get up, for who knows how long. It could have been a completely different kind of day, a fundamentally transformed day. So if me breaking a leg a week prior helped turn things around for her, then I'm content with all of it and satisfied with my role.

Addendum in early April

I pushed my final Spartan race of 2022 from October in Dallas to November in Phoenix. Running was still limited, slow, awkward, and painful, so I walked the course and skipped most of the obstacles. It was enough to complete my 2022 trifecta, but otherwise left me wanting more, wanting to perform better.

Next up were the 2023 Rock'n'Roll races in Las Vegas in February--a 5k on Saturday and a half marathon on Sunday. I played it safe in the 5k, starting at little more than a walk and gradually speeding up. To my surprise I was able to run without pain, even as I increased my pace significantly. It did hurt later that night and the next morning, but had stopped hurting by the half marathon start time on Sunday. The half went as well as could be expected--I ran the first 5 miles reasonably well and walked the rest. It hurt toward the end of the race and then into the next day, but quickly faded.

The Spartan races in March were similar. The Super (a 10k) on Saturday was difficult, but I was able to run it without holding much back. Same for the Sprint (a 5k) on Sunday. Now I'm back to running just to get better at running, rather than for rehab. I have gone from not being able to run at all, to having pain after 1 mile, to having pain after 5 miles. I hope to push that out to at least 13.1 this year. Stay tuned!