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May 2004 
 May 8th 

Logs & Stories -  May 2004

May 8, 2004 - Mazatlan

(Email from Karryn via Internet Cafe)

Hi, everyone. This is an update on Bill's progress, although for some of you it is the first time you're hearing that he broke his back in March.

Here's the condensed version of the injury: Bill had a major seizure at about 5:30 in the morning on March 18th, most likely due to a bad reaction to anesthetic that he'd had the day before during a minor hospital procedure. When he crashed onto the cabin floor, an already-damaged vertebra broke (we were unaware of the issue with it, although now we recognize that he had symptoms starting a year ago). His thrashing about from the seizure and the pain as he regained consciousness probably made the break worse. It took quite a while before he was lucid again his first memory is of the ambulance doctor kneeling over him on his bunk. In the period after the seizure ended and before the ambulance arrived he was trying to walk around, something that still makes me shiver.

The solution to the vertebrae damage was a six-hour operation with two surgeons to put titanium screws and pins in his back. After spending a weekend leaking spinal fluid, he needed an additional operation to seal a hole in the lining of his spinal cord. Before the surgeries he had a slight numbness in his left foot, but during both operations the left nerve root in the crushed vertebra (L5, the bone right above the sacral bones in the pelvis) had to be moved aside, thus creating more general numbness in his left foot and slight paralysis in his lower left leg. Because no nerves were severed, we've been told he is likely to eventually make a full recovery, although the time period involved isn't clear.

Because of Bill's post-surgery pain and lack of mobility, moving back to the boat was out of the question, so we've ended up with a two-month stay in a one-bedroom apartment in an inexpensive hotel in Mazatlan. The hotel and nearby businesses comprise an extensive community of Mexican nationals and many American and Canadian expatriates; these people have been a welcome cheering section for Bill as they watch him improve day by day.

Bill's pain during the first two weeks after getting released from the hospital was almost unmanageable, particularly at night, and even up until two weeks ago he still had enough discomfort that his orthopedic surgeon was concerned that his body might be rejecting the titanium hardware. At that point, the doctor changed pain medications and asked us to come back for more x-rays this week. Yesterday we went back and the doctor was pleased by both what he saw in the x-ray, Bill's mobility and control, and the fact that his pain is now mostly gone (what little remains is mostly from exercising muscles that have atrophied).

After a week of being bedridden, Bill had gotten out of bed for the first time only three days prior to our transit from the hospital to the hotel, and I was seriously concerned when the neurosurgeon wanted us to leave, as I couldn't imagine being able to take care of him without help and without the resources of the medical institution (although they had reduced his pain medication enough that the hospital's cable TV shows were no longer interesting!). Since we didn't think he was capable of getting into and out of a car we paid for an ambulance ride. During the first four weeks, he used a walker to get around, but during the first three days he couldn't even move the walker by himself. Showering was a two-person affair, not nearly as much fun as you might think.

Now we've been out of the hospital nearly six weeks and he's been making good progress. Two weeks ago a friend of a neighbor lent him crutches, which for a week were just what he needed, and then they became too cumbersome. At the beginning of this week we acquired two canes, enabling him to walk more comfortably. Without the canes he can walk (ok, more like stumble) short distances in the apartment. He can go moderate distances with just one cane, but for any treks outside the hotel he generally uses both. The furthest he's walked is the mile jaunt to the local park and back. This week we finally managed to graduate from having to take taxis everywhere to riding buses.

So far he can't flex his left foot very well, having less than half the range and about 10% of the strength of his right foot. Sensation and control continue to increase; just a week ago he began to be able to lift his left big toe very slightly, although he still can't lift his other toes. Physical therapy is very important, although we've had a problem with lack of attention at the rehabilitation clinic we've been going to (the other patients are far worse off than Bill; we discussed the issue with the orthopedic surgeon yesterday and are hoping for a better experience next week). We also started attending a water exercise class a week ago, and found that this works very well and that Bill can actually exercise his cardiovascular system by swimming laps afterwards. We anticipate spending a lot of time in pools over the summer months.

Our plan at this point is to leave the boat here in Mazatlan for the summer and fly back to the Northwest to continue with Bill's medical care, get out of the heat and humidity and visit friends and relatives. After getting hit by lightning last year, we ended up staying on the Mexican mainland in San Carlos, with temperatures similar to Baja (100 degrees F), but humidity levels at 80-100%, much higher than Baja. We found the experience particularly uncomfortable, and since Mazatlan's summer climate is similar to San Carlos', we felt that leaving might be a good idea. Our plan is to depart in early June and return in early October, spending much of the intervening period with Bill's mother in Bellingham.

In addition to expediting Bill's recovery, we'd like to do further investigation into the cause of the seizure. While we believe that the seizure was likely to be related to the anesthetic he had been given at the hospital, Bill's neurosurgeon has not confirmed this; he did strongly say, though, that not further testing for causality was necessary, odd since several of our friends in medical professions have said the opposite. At this point we have no evidence that Bill has any continuing problem like epilepsy or a tumor.

Obviously, we can't make any serious plans for next winter without knowing how fit Bill will be at that time.

Despite the fact that this is a major life event, Bill has been optimistic, and actually grateful that the vertebra broke here; the fall from the seizure was short and low-impact enough that no bruises or marks were left on his body, suggesting that the vertebra was particularly fragile and likely to fail in the future. If it had happened in a remote place, say, in Bahia de Los Angeles or on a passage to the South Pacific, the circumstances would have been much, much more complicated and his outcome most likely worse. As it was, we spent several days in the hospital wondering if he would survive the operations, let alone not be a paraplegic, so we feel pretty good that he can feel his toes and walk. We don't know what life has in store for us next or how this will affect our sailing plans, but we remain grateful for the time we've been able to spend with our kids and the wonderful friends and family we have, and are looking forward to Bill's continued recovery.

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