fractured radius

2017/05/16

Alaska: State & State of Mind

The genesis of this piece involved a response to a dear friend’s lamentations concerning his move from Alaska after nineteen years and his burning desire to return to ‘The Last Frontier’ even after spending a year in the lower 48.  After he read it he saw the potential for the response to become the foundation for a blog posting.  After some brief consideration I, too, saw this potential; for his creative eye and his suggestion I cannot thank him enough!  While I’ve written on a number of different topics in the three and a half years I’ve been blogging the basis for this blog was ‘to document the learnings and experiences of one man who lived his entire previous fifty nine and a half years in the suburban lower 48 before picking up his home, saying goodbye to friends and moving to semi-rural south central Alaska.’  Given this foundation a reflection on this amazing lifestyle and why some folks ‘just do it’ seemed very apropos.

Only those whose souls have been scored by the raw majesty and awesome power of Alaska can truly understand the potent pull exerted by the amazing geography and abundance of wild animals. There are a lot of negatives to living in ‘The Great Land’ but once smitten we tend to look at them as ‘inconveniences’; kinda like the price we pay to live in such spectacular and amazing settings so alive with wildlife and so blessed with such an abundance of stunning scenery. Sadly, medical insurance is one such major ‘inconvenience’ and one which has cost me dearly since late March of 2015. I’ve even had times when I tried to imagine living someplace outside Alyeska. It was those times that reaffirmed my need to remain here in ‘The Last Frontier’ mainly because I couldn’t envision living any other place. I should’ve known this would be the case as I have no real wont to be anyplace other than Alaska and I make this statement as I go into the summer which is one of my least favorite seasons – I think I dislike break-up more – thanks to the continual light, the hordes of mosquitoes and similar hordes of tourists.

Alaska is definitely not for everyone and probably not for even a sizeable amount of people for as I’ve told so many people; “Things are just different up here”.  In a nutshell and unless one lives in Anchorage and rarely travels beyond its confines – and what a sin that would be – one must be able to handle many more potentially serious issues than a ‘typical’ person in the lower 48.  The fact that hypothermia is the number one killer in Alaska (not bears, wolves and/or moose as most tourists believe…) speaks to this concept.  A simple hike on a backwoods trail can turn deadly when the weather suddenly shifts from sunshine to cold rain and one has to make the return trek cold and wet on slippery rocks and suddenly voluminous creeks.

During my time in the lower 48 I visited almost all 48 states; rarely did I find places where it is so easy to venture just a few dozen miles outside a large population center and suddenly be ‘in the middle of nowhere’.  In my experience this is true in Maine, northern Michigan, Montana and a number of the states in the southwest.  But even in the aforementioned one can usually get a cell signal.  This is far from true in Alaska thanks to a minimal population which doesn’t support cell tower densities so common in the lower 48 and so many tall mountain chains.  This can be an annoyance to a problem in the summer; it can be deadly in the winter.  Therefore, it takes a different mind-set when traveling outside larger towns.  One must be prepared for all kinds of potential weather related issues (road closures, rapid flooding, high winds, brutal cold and immense snowfalls) as well as those involving a lack of ‘typical’ services like gas stations, towing services, mechanical expertise and similar.

By nature, Alaskans tend to be fiercely independent and more self-sufficient than most of the population in the lower 48.  The latter is almost a requirement as the low population density means goods and services are fewer and much further between.  While western style medicine is fairly good in and around Anchorage or Fairbanks it is much less so in semi-rural to rural areas.  Such locations are lucky if they have a small clinic and such clinics often have only physician’s assistants on staff.  There is a distinct lack of medications beyond the very basics.  As an example when I fell and severely fractured my left radius and ulna at the elbow the local clinic had nothing to give me for the pain, not even Tylenol III!  In addition, they had no splint large enough for my use so they improvised a splint and I drove myself to Mat-Su Regional in south Wasilla (against their wishes).  I was lucky our clinic had a small x-ray machine with which they confirmed my fractures.

I’ve offered up but a few of the differences between life in the lower 48 and that in semi-rural Alaska; there are a myriad more especially if one is living partially or completely off the grid.  Anyone doing so will confirm that such a lifestyle requires a load of energy in tandem with a broad knowledge of many areas – carpentry, plumbing, electrical, outdoor survival, food handling to mention just a few – just to survive, let alone thrive.  To someone with no interest in living in such a ‘basic’ manner those who do so seem ‘extreme’.  While I would not be comfortable in such circumstances – I really want my broadband connection, indoor plumbing and hot water – I can appreciate the lifestyle and would even be willing to try it for a time.  But then I am someone who gave up all the conveniences and ease of suburban living in the lower 48 for a somewhat more austere existence in semi-rural south central Alaska.

During my almost four years of living seven miles south of the village of Talkeetna and a half mile east of ‘The Spur’ I’ve changed in many ways; most of them for the better.  I’ve come to appreciate living on ‘Talkeetna time’, to not sweat the small stuff and to completely embrace the ‘great silence’ which surrounds me most of the year.  My lifestyle has slowed considerably and stress is something which has dropped away as well.  I love drinking a cup of coffee in my wooden rocking chair on my front porch as the sun slowly climbs above the boreal forest on a crisp October morning; watching Nature unfold about my place at any time of the day or night is a treat.  I love the fact that moose, bear and foxes are visitors to my property; I try to live in harmony with them.  I am so much more in touch with Nature because it surrounds me and drives so much of what I can, and cannot, do on any given day.  Deep within my soul I completely understand that Alaska is both a state and a state of mind…

Sure, there are ‘inconveniences’ to this life but then I don’t believe I’ve ever heard of a ‘perfect existence’.  As someone bitten by ‘the Alaska bug’ the country is part of my soul now and I so love her fierce independence and incredible majesty.  And I truly respect her for to fail to do so is to invite danger and even death.  Many would consider living over sixty miles from a full service grocery store, questionable electrical service, water from a well and a septic field to be far too ‘basic’; so be it.  I remember working for a large corporation, existing on the road almost ten months a year, living in crowded suburbs of large cities, being concerned about crime and spending days every year in traffic jams; compared to my current existence this seems like a form of corporate sponsored insanity.  No thank you; I love living in ‘The Great Land’ and cannot imagine life anywhere else!

Timbers Bald Eagle

A solitary Bald Eagle surveys the Halibut Cove area in Kachemak Bay State Park & Preserve. This majestic raptor truly symbolizes Alaskan independence and self-sufficiency!

2016/10/14

Accommodating Aging…

In a way I feel profoundly unqualified to write this piece for although I am 63 years of age I am continually discovering just how ill-prepared I am for my advancing years.  In hindsight I largely behaved as though I was ’18 and invincible’ until a foolish misstep on March 27, 2015 yielded a severely fractured left radius and ulna and forced me to recognize my own mortality.  Thirty eight thousand dollars and a session of major orthopedic surgery later I began to learn just how unprepared I was for life as a sexagenarian.

IMG_20150428_0002

Serious hardware required to repair my left elbow and left radius and ulna!

Looking back my preparations for aging were not helped by almost perfect health across my first five and a half decades; I suffered nothing worse than ‘pleurisy of the diaphragm’ – something that sent me to the hospital emergency room three times in my life – and the infrequent bout with the flu as well as a few cases of what could only have been potent staph food poisoning.  As I aged I watched so many of my peers start to struggle with back, neck and joint issues while I just continued to march forward.  I’d always struggled with my weight although I’d managed to remain perhaps eight to twelve pounds heavier than I should have been for most of my working life.  But, regardless, I cannot damn a life of great health especially as so many out there would probably kill to experience what I did in terms of a lack of health issues.

The aforementioned accident in March of 2015 really forced me to re-evaluate just how I was living in so many ways.  Because it left me with virtually an artificial left elbow along with a plate and six bone screws in my left forearm I was forced to give up any activities which involved impacts of any kind.  Sadly, the one exercise I truly enjoy is splitting firewood; that is now just a fond memory.  My left arm is probably 85% of what it was before the accident but for some unknown reason my left wrist – apparently uninjured in the fall – became very painful in June of 2015 and remains so to this day.  I proceeded to learn the truth of something a friend had shared with me; “You do not want to be of ‘interest’ to Western medicine!”.  I spent another $5,000 plus on tests including a bone scan but nothing revealed any cause for the pain.  At this point my left wrist is maybe 50% of what it was before the accident and hasn’t really improved much since it first began to ache.  This may well be as much recovery as I’m going to see.  My surgeon gave me two choices; learn to live with the situation or undergo another surgery to remove the plate and screws.  The latter is totally unknown; he cannot guarantee this will help and cannot even guarantee the operation wouldn’t make the arm/wrist worse.  I’ll wait until March of 2017 and then re-evaluate my healing.  Hopefully, by then, I’ll be able to make an informed choice.

But much more has changed since that March day in 2015; I still bear the mental scars of taking such a sudden, nasty fall and it has forced me to be very cautious when it comes to uncertain footing.  Given all the ice we’ve experienced across the past two winters this means I rarely get outside from November through April unless I put on traction ‘slip on’s’ and use my walking staves.  Even then I cannot escape a sense of dread whenever my feet slip.  I also believe something happened regarding my sense of balance which was never all that great; nowadays I’m much less steady on my feet and I’m flat out unwilling to put myself more than a few feet off the ground be it on a ladder or similar.

Everyone is aware as we age our faculties tend to become less sharp and are ‘off line’ more often.  Our physical prowess also tends to fade with the years as does our ability to fight off illness and especially to quickly recover.  For some of us this means we begin to lose faith in ourselves and our abilities; needless to say this is not good.  However, refusing to acknowledge aging can and does remove the ‘mind’s edge’ is also rather unhealthy as it leaves one vulnerable to making perceptual or memory related mistakes and then exacerbating them by refusing to consider one might be wrong.  This is a very fine balancing act and one I’m really struggling to find that point of parity.  I sense my accident and its fallout truly pushed me too far in the direction of self-doubt and uncertainty regarding my abilities.  Such a shift was probably good in terms of what I was willing to physically undertake and/or endure but not so good regarding my mental faculties.  With respect to the latter I feel I must come to embrace the idea that while my mental abilities may not be what they were ten or even five years back they are far from useless especially when factoring in experience.  And I should be pleased I’ve learned the surety of my youth hasn’t translated into me being unable to accept the lessening of my mental capabilities.  In the end a bit of healthy respect for memory ‘slippage’ and/or perceptual incongruities becoming more evident with my passing years is most likely a very good thing.

While I’ve been saying more and more often ‘this aging thing isn’t for the faint of heart’ I also recognize that regardless of its problems it does beat the alternative.  It is so very important to remember these concepts on those mornings when just getting out of bed after the previous day’s exertions can be a painful process.  For those of us lucky enough to live into our sixties, seventies and beyond inculcating a sense of celebrating our lives becomes more and more important.  As with so many other things in life if we allow ourselves to become mired in the minutiae we lose touch with ‘the big picture’ and this never produces a positive effect.  As stiff or sore as I might be some mornings I also know there’s a gel cap of Naproxen sodium in the bathroom medicine cabinet that will ease most of the pain.  Regarding my slowly declining mental facilities…well, I still function and the longer I live the more experience I have to call upon!  And, too, I continue to develop even more memories involving life in ‘The Great Land’…

 

2016/03/10

True 21st Century Heroes

After having lived what, in hindsight, was an insanely healthy life across my first 61 years I was ill-prepared when aging finally caught up with me.  Sadly, I had come to take good health for granted and, as such, was not at all ready to deal with what was headed my way.  Oh sure, I dealt with the usual things like very infrequent bouts of flu, occasional food poisoning, sore/stiff muscles from overdoing efforts and similar but really I was very healthy.  Nothing every knocked me down for long; in fact, the worst physical health issues I endured were my annual bouts with hay fever.  I really struggled with these as a child and not until my 35th birthday did the affliction suddenly disappear; surprisingly, this coincided with the remission of what I came to understand had been chronic depression.  I can only speculate I must have undergone some biochemical shift at that time, probably age related, and whatever allowed me to ‘outgrow’ the hay fever also caused the depression to slowly disappear.

But, as followers of this blog know, March of 2015 brought about a silly accident which had a huge impact on my physical and mental states of existence.  Stuffing my boot laces into my boots rather than tying them caused me to manage to catch one short length of exposed lace on the left boot around an eyelet on the right and brought me crashing down upon the black top in front of the Talkeetna PO.  This resulted in a severely fractured left radius and ulna ultimately requiring orthopedic surgery and the equivalent of an artificial elbow along with a plate and six bone screws.  But I’ve blogged about this earlier on and is not why I’m writing this today.

Rather, I’m writing about my recent experience with having all four wisdom teeth removed.  Again, I’ve had almost no previous dental issues having inherited Mom’s incredibly hard teeth.  I’ve only dealt with six cavities across my life one of which required a root canal (my fault).  So when I started feeling some pain well back in my mouth in late August I at first ignored said pain.  It mainly appeared only briefly and then disappeared for weeks so I wasn’t worried.  Yet, by mid-October, the pain was becoming more noticeable and beginning to impact my eating so I scheduled an appointment at the Sunshine Clinic is early November.  There I learned my wisdom teeth needed to be extracted with the first two scheduled for December 28th which was the earliest opening.  Said appointment went fine and I was fully recovered within four days.  The next appointment for the last two was January 18th but ‘Mr. Murphy’ had other plans as I came down with a bad case of food poisoning the evening of January 17th and cancelled my next day appointment.  The next opening was March 8th and that almost seven week period was an incredibly long time to wait.  Both teeth gave me regular pain but the lower wisdom tooth was very temperature sensitive and forced me to eat and drink nothing cooler than maybe 80°F unless I wanted to deal with sharp stabbing pain.  It produced almost continual low grade pain which was with me day and night.

Come March 8th I was so ready for the procedure; once again, both teeth were removed with no issues and now – two days later – I am feeling no pain nor suffering any related issues to the removals.  But I have noticed something which still amazes me no end; I can hardly measure the joy I feel now that the wisdom teeth are history!  I awoke the morning of March 9th feeling better than I could ever remember feeling; at first I wondered why but very soon understood it was because I hadn’t slept – and awakened – with that same low grade dental pain I’d endured across the previous seven weeks!  This has carried over into today as I still feel so very good.  And, these realizations started me thinking regarding the human body and pain.

It still boggles my mind just how amazingly well the human body can manage pain!!  Granted, my dental based pain was hardly extreme – on the well-known pain scale of 0 to 10 I’d say it averaged maybe a 3 with infrequent jumps to maybe a 6 – but it was almost continuous.  In hindsight I believe I stopped being ‘aware’ of its continual nature a few weeks into that stage although when I accidentally bit down wrong the resultant pain would make me see stars.  Yet I continued to function about ‘normal’ for me with the exception of eating/drinking only ‘warm’ substances.  But now, with those nasty teeth gone for two days, I can start to appreciate just how wearing that continual pain must have been upon me.  I feel twenty years younger now and have a whole new, incredibly positive outlook on life!  That’s saying quite a lot given I’m still dealing with fallout from the aforementioned left elbow ‘incident’.

But it also made me ponder all those poor souls out there for whom daily pain that would make my dental issues seem like a walk in the park is their ‘norm’.  How do such brave beings find the strength, and more importantly, the perspective to get on with life?  Do their bodies manage to conceal or otherwise mitigate a large portion of their pain?  We’ve all known people who suffer from chronic pain; after enduring the tiny bit I did I cannot imagine how such noble souls can face each new day!  My brief experience highlighted just how wearing and grinding daily pain can be; it saps one’s energy, destroys one’s optimism and is always there with its slow, steady drumbeat of torment.  And I dealt with my meager pain for less than two months; what must it be like to endure such constant torture for years let alone a lifetime?  Even if their bodies are capable of greatly mitigating such misery how do they find the energy and the perspective to endure; let alone do so with dignity and grace?

These are questions I cannot answer and I recognize this is good because it means I’ve never experienced such circumstances.  But I also now understand such individuals are indeed heroes…heroes who walk among us daily.  Noble beings whom endure and, indeed, even aspire to greater heights despite being drained and crushed by daily torment.  In a time seemingly bereft of role models I believe such beings more than qualify for that title; they shine forth as amazing examples of the human will!  So the next time you cut your finger or wrench your back or struggle with a hacking cough and feel like you cannot handle it any longer remember those who live with intense misery day in and day out.  You know you will eventually heal but those amazing souls who live with daily pain have no such luxury yet they persevere and even rise above…  Truer heroes I cannot imagine!

2015/05/04

The Things We Take For Granted…

It has been over a month since I last posted to this blog; this time corresponds to the time I had my left arm either in a temporary cast, under the knife or in the post-op hard cast. Indeed, my trial began with a hard fall outside the Talkeetna PO on Thursday, March 26th due to my own laziness. In hindsight it is amazing to think that during my morning rush to handle a few chores before an appointment a simple misstep allowing my right boot lace to catch an open hook on my left boot could so change my near term future. One moment I was exiting the PO frustrated because the expected package hadn’t arrived and the next I was sprawled on my right side wondering what in blazes had just transpired. And then the pain began to register; initially involving my right knee and ankle but quickly shifting to my left arm.

After taking a few minutes to attain a sitting position and assessing my condition as well as talking to a couple of folks who witnessed my ‘crash and burn’ these kind folks helped me to my feet. In so doing I recognized my left arm was seriously injured; by the time I’d taken the four uncertain steps to my vehicle I could no longer hold my left forearm horizontal to the ground and the pain flooding into my awareness from my left elbow told me the shock of the accident was wearing off. I couldn’t move my left fingers and the pain was so powerful it was making me nauseous. I did manage to tuck my now throbbing left hand into the left side pocket on my vest, slowly back myself into my vehicle and make a very painful drive home. As I’m really pig-headed regarding pain I decided to wait a few hours to see if the pain would subside; my lack of medical coverage also encouraged me to do so. In this case it was a very stupid move because when I finally yielded and called the Sunshine Clinic I could not get in until Friday morning. This cost me a very painful and sleepless night punctuated by groans, yelps and more than a few ‘colorful expletives’.

It was very apparent within the first few minutes the doctor’s assistant spent looking my arm over that I had broken bones; even though the clinic did their best they were not equipped to image such an injury because I could not straighten it. The clinic tried to locate pain killers but they had nothing for the severity of my injury. I was told to get to the Mat Su Regional Medical Clinic in Wasilla ASAP; they wanted to have an ambulance take me but I talked them into letting me find a local friend to take me. In the end I recognized I could drive and I was not going to pass out from the pain as the clinic folks worried so I packed a simple bag, made the arrangements to have the dogs cared for – possibly for days – and drove the 70 miles south to Wasilla. Thanks to the wonderful Emergency Department care I was immediately given a non-drowsy IM pain killer, had multiple x-rays taken and was given a custom fitted protective cast. Because of the swelling I was sent home with an order to contact an orthopedic surgeon first thing Monday to set up a visit. The surgeon (Dr. William Todd Pace) was able to see me that afternoon and after a brief review of the x-rays told me I had a severe injury in the form of a fractured ulna and a fractured radius with bone pieces visible in the image. He immediately called his assistant and had them clear his afternoon schedule for the next day; this spoke volumes to me regarding the injury’s severity. I drove home and made arrangements for a good friend to drive me to Wasilla the next morning for a noon surgery.

To shorten this sad tale I was taken into surgery by 13:00, given a general and spent 220 minutes under the knife during which time Dr. Pace resurfaced the elbow, cleaned and resurfaced my left radius, set and pinned the two bones and placed a large plate in place using another six pins. Here’s an image of his handiwork:

Serious hardware required to repair my left elbow!

Serious hardware required to repair my left elbow!

And thus I started to really learn just how much I’d taken my health for granted; I began to have an inkling right after the accident but I was still rather ‘shocky’ across those first 30 hours due to the pain and hence didn’t really understand what I was going to endure.  I was given a prescription for Percocet but thanks to the amazing skill of Dr. Pace I only needed them the first few days after the surgery. The hard cast was applied after the surgery on Tuesday, March 31st; it was finally removed Monday, April 27th.  During this four week period I daily learned just how great I’d had it the previous 60 years with respect to my health. Outside of cracked ribs from studying Tae Kwon Do and the ubiquitous broken toes from kicking furniture while barefoot my only skeletal injury was a greenstick fracture of my right ulna when I was in grade school.  Because of this I was ill-prepared to experience life in a cast!

Not a day passed I wasn’t frustrated, angered and/or amazed by how much I used my left arm/hand even though I am predominately right handed. And every time I was reminded just how much I took my generally excellent health for granted. Probably the worst thing was my inability to really bathe; the best I could do for that month was ‘wash cloth baths’ which were pretty much useless. One of the first things I did when I returned from having the cast removed was take a long, hot shower; I suspect this is what a religious experience must feel like! I learned that it is virtually impossible to wash just one hand and also endured the frustration of trying to pull one’s pants up with just one hand. I quickly learned to leave all bottles and screw type containers only partially tightened because otherwise I couldn’t open them. Entering my Ford Escape required a complex operation of backing into the open driver’s side door, then slowly rotating while pulling my legs in and finally reaching over my body with my right hand to close the door. Getting in and out of bed required always moving to a sitting position from the right side, then planting the right hand and pushing off so as to minimize strain on the left arm.  Typing with one hand is an arduous experience; slow and filled with errors. I could go on and on but you no doubt get the idea…

Based on my experience I would request that anyone reading this blog take a few minutes to reflect upon your health; if it is good revel in this fact but even if it is not so good remember it can always be worse. In the grand scheme this ‘very severe’ injury – Dr. Pace finally admitted this was such an injury after the cast came off – provided me with a true wake up call. And while it was a severe insult it pales in comparison to the kind of health issues so many people face on a daily basis. All of us blessed with good health need to be reminded that it takes but an instant to reverse what we take for granted; as such we should celebrate our wonderful luck every day. And we should foster a real sense of empathy for those who do not share in our luck!