Near Death – The Impacts of my Injuries

Note: If you find the context and tense jumping around a bit below, I’ve done some fall and winter edits since I first wrote this in August.

Strokes

By far the strokes (yes, I had more than one) have had the largest impact on my life. They have affected my cognitive skills, memory, reading, writing, typing, vision, and my right hand. Somewhat miraculously, I suffered no lower body injuries, save for the gashes, but the strokes made my right hand uncoordinated and slow. This necessitated a couple months of extensive hand therapy. It could best be described as a near-useless appendage upon my release from hospital, but has thankfully shown remarkable improvement, to the point where I’ve regained most of my pre-crash functioning, even including typing, printing and drumming, just not as quickly as I used to do any of them.

Memory and cognition has also been a stroke-related work-in-progress. When first released from hospital, I constantly forgot where I put things and misremembered details of almost everything. I couldn’t really read or even just parse the hands on a clock face very well, and I became confused easily. This has improved significantly as well. I am, however, not yet fully recovered cognitively, and may never be. The complex planning I used to do without much thought isn’t ready for a return to work. In fact, while UX design and user testing used to form the bulk of my job, as a Scrum Master with UX responsibilities, planning now constitutes the majority of my work. If I had to put a percentage on my return to pre-crash cognitive skills, I’d say I’m at perhaps 90% – very close but not 100%.

Back in the early days of Royal Columbian, my wife says I was limited to one-word responses and most often stared off into space, so there’s clearly been lots of improvement on that front, too. I also had problems with things like labelling, categorization and word finding, often stumbling for terms that came easily to me before the crash. I had a speech therapy assessment in two sessions, on July 12th and 19th, and began 13 sessions on September 3rd, 2024.

So, while the cognitive domain is a bit of a mixed bag, in truth to look at me physically, you wouldn’t know I’ve had “polytrauma.” My cognitive SLP therapist has been working with me to improve executive functioning and things like complex and abstract planning. As of December 31st, I finished the first block of sessions, was reassessed in January, and began a new block of sessions thereafter. I have been very impressed with her approach throughout my therapy. I expect to have another three months of cognitive SLP therapy approved and we’ll be switching gears in the new year to more real-world return-to-work prep exercises. This should take me to mid-April, when I expect to begin actual graduated return-to-work planning (if that comes to pass), and be done with all therapies. When all is said and done I’ll probably have had about six months of cognitive / speech therapy.

As a result of losing my spleen, the other major impact on me is that of becoming immunocompromised. I’ve had five new vaccines as a result, with two of them requiring two doses at least two months apart, then either being finished completely or requiring boosters in five years. And, while we have always taken our COVID and flu vaccines enthusiastically, missing them now isn’t remotely an option. Thankfully, beyond that, and ensuring I do my best to avoid bacterial infections, I can proceed with my life fairly normally. I often find myself wondering what my risk of developing an infection in any given situation is, but this really isn’t a context where rigid percentages can be applied. At least most of the immune system functions previously provided by the spleen are then handled by other organs, notably the liver and kidneys, and the vaccines should protect me from most of the rest of the potentially fatal things.

Reticent Right Hand

I can’t really separate the right hand functioning from the strokes, as they go “hand-in-hand.” This has largely been a slow, steady climb to regaining as much function as I can. It’s gone very well, but like everything, progress has been measured in weeks and months, and not days. As of late 2024, the drumming, printing and typing were all becoming “passable,” but given their dependency on fine motor skills, still not near 100%. Daily tasks and general right hand use, though, were largely indistinguishable from before the crash.

My wife says that in the very early days of my hospitalization, I had a lot of right and lower limb swelling, so I’m exceedingly thankful for how much things have improved on that front. When it comes to returning to work, obviously I can’t separate the cognitive skills from the motor skills, and the former has further to go before I’d be comfortable doing so.

Visual fatigue, Light Sensitivity and Brain Fog

I lump all these together because the boundaries of any of them blend seamlessly into each other. The biggest issue by far is the fog, which can most accurately be described as a very mild hangover, minus the headache. I’m also sensitive to bright sunlight and the white glare of overcast days. Finally, I have generalized visual fatigue, causing me to easily tire mentally. It’s all improved a lot since I left GF Strong, as I couldn’t tolerate more than 30-60 minutes of screen time at a stretch and now I’m up to half a day or more. The real test, I expect, will be to combine more cognitively taxing exercises with extended screen time and seeing how it goes. All I can say is, stay tuned. In closing, physically I could return to work tomorrow. Cognitively, it’ll be a little while yet.

The other thing that the fog and visual fatigue also triggers is vestibular symptoms. Steady improvement on that front is offset by the fact that returning to running has been a slow proposition. As of the end of October, I’ve managed 12-13k at a 5:30-ish pace so far, and have been as fast as a 4:40 pace on shorter efforts of up to 5k. I am seeing light at the end of the tunnel, with less fatigue and fewer vestibular symptoms all the time. The cycling is improving a bit faster than the running, and both of which, like the right hand and cognitive functioning, are also measured in weeks and months as opposed to days. I’m doing both e-bike and trainer rides right now and managing substantial trainer sessions at continually increasing power outputs. With lingering minor symptoms I hesitate to say I’m fully recovered physically, but I’m very close, and doing most physical things almost as well as I did before the crash, just with a little less stamina.

The most noticeable difference is that I need to do everything with far more intention and attention now. Whether it’s where I place my foot plant and watching for tripping / ankle-turning hazards when running, or slowing down and double / triple checking at corners when I’m riding, I take far more care with everything. And, frankly, being more intentional isn’t remotely a bad thing. I guess it’s simply a matter of living more presently than I did before the crash.

Tubes and (more) Scars

It’s probably worth mentioning at this point that I was also intubated for breathing, had a PICC line so the multiple needles I got were easier to handle, had chest and stomach tubes to drain blood, had a feeding tube to get calories into me (I dropped about 30 lbs at my skinniest point), and even had a catheter for, well, you know …

In addition to the scars I’ve already mentioned, I’ve got about a foot long beauty running the length of my abdomen, another that meets that one, perpendicular to it and a little 2″ one on my ribs, under my arm. Apparently diaphragm, bowel and splenectomy surgery is hard to do neatly. The thing about big cuts and organ removal is that they can cause some mild loss of sensation. There’s a good chance it will return, but a very small area in my left pectoral and under my arm has experienced this.