05 February 2015

A Re-Evaluation of My Spinal Cord Injury

Recently I had to go back at Craig Hospital for a re-evaluation of my spinal cord injury and the news turned out to be pretty good.

Last spring when the accident occurred, I really had no real idea what I was in for with regard to experiencing a spinal cord injury and the very long recovery to follow. And honestly nobody knows what will truly happen with regard to the recovery. The doctors have told me that I have all the good signs of healing and regaining movement, but only time will tell if my body can truly heal itself. 

The re-evaluation consisted of five days worth of inspection by many people looking at your body from every angle. I know it probably doesn't sound like much fun, but after you've already been through everything associated with a spinal cord injury, experiencing a little more inspection isn't a big deal. In fact, I was even eager to hear the results myself because the bottom line is I'm still a patient who relies on the professionals who have helped many others through this devastation many times before. 

The bottom line is that there is still no movement below my knees yet, but I have gotten some feeling back in my feet. My doctor tells me that this is a very good sign, especially in under a year since the accident. I still have a very long way to go but this is definitely good news. At this point in my life, after all I've been through since the accident, I'll take any bit of positive news I can. 

07 January 2015

Continuing Recovery, Ditching the Wheelchair and More :: Bruce Snyder's Status


In the last quarter of 2014, I made considerable progress with my recovery from the spinal cord injury. The physical therapy has made a big difference in the last three months to fight back against the muscle atrophy.

Physical Therapy

Recently I purchased a Total Gym which has helped the muscles in my hips and butt tremendously. It's really crazy how difficult walking can be when the muscles in your hips and butt (the gluteal muscles) have atrophied so badly. The thing that the Total Gym helps with is doing one legged leg presses without lifting the entire weight of my body every time. Because the Total Gym is at an incline, I can do many more leg presses with each individual leg and focus more on my form on each side. This has made a big difference in a short amount of time. And because the stationary bike and the Total Gym are both in the basement, I'm also doing stairs much more to get down there and back up which also helps.

Every day I'm doing a variety of physical therapy including walking on a treadmill, riding a stationary bike and now I'm also doing leg presses. Some of the main workouts I'm doing involve walking on the treadmill for 60 minutes at a time, riding the stationary bike for 30 minutes at a time and doing four sets of 25 leg presses on each leg. When I'm not doing this work I have many other exercises I do that include much smaller movements that are focused on a specific task. Slow, steady progress is the name of the game.

Ditching the Wheelchair

I have not been using the wheelchair much lately and just this week I stopped taking it to work at all. I'm only using the arm crutches and my leg braces. There are some difficulties with the crutches, however, like carrying things. Although I can carry small things when I'm just waddling around without the crutches, bigger and/or heavier items are still a problem when I'm using the crutches. I have been using a backpack when I'm using the crutches and, although it's kinda awkward, it works for many things.

I'm certainly not ready to run a marathon, but the recent progress has allowed me to walk around the house now even without using the crutches. I rely heavily on the braces that I wear on my lower legs because my feet are still paralyzed and that's fine for now. I definitely waddle like a penguin without the crutches, but that will change over time as I continue to rebuild muscle. I can now go up and down the stairs several times a day without the crutches.

Continued Positive Thinking

I've been keeping in touch with many friends since the accident who have all given me tremendous encouragement. My friend Simone advised me from his experience how important it is to do anything necessary to keep my morale high. He suggested remembering good times, watching movies you enjoy, spending time with friends and indulging in anything you can enjoy -- basically whatever it takes to stay positive. I have found this to be very true in my situation as well. In fact, I'm reading a book about this very topic right now.

You Are The Placebo is a book about what causes the placebo affect in the human body. It's essentially a publication about the author's research and experience using the power of deliberate meditation to willfully bring about change to the genes and therefore healing to the body. The author used this himself many years ago to heal his own spinal cord injury by tapping into the forces that create the placebo affect inside the human body. This the second book I've read on the topic of epigenetics and it is extremely fascinating because this area of research has demonstrated that human genes are not as static as we have been lead to believe. I'm still working through this book, but I'm learning a lot about the topic.

Traveling to Celebrate the Holidays

I have not traveled on a plane since August which was quite difficult for me at the time. Sitting on the plane just for that two hour flight from Denver to Chicago was very difficult because my body was in a very different state back then. The muscles in my butt were so atrophied that sitting on anything but the cushion on my wheelchair was very difficult. In fact, sitting on that same cushion while in the plane was OK but it made me realize how much I moved around during the day even in the wheelchair. Sitting in the same seat with minimal movement for two hours was very difficult.

Contrast my experience four months ago with my experience traveling to Illinois and back last week to visit family for the holidays. Not only was sitting on the plane for the two hour flight not a problem, but I also was able to use a thinner cushion this time. This was definitely a test of the progress I have made in rebuilding my body from the ruinous side effects of the spinal cord injury. I'm happy to say that a two hour flight is not a problem at this point. However, I don't believe that I could do a 9-10 hour flight to Europe yet. (Prior to the accident, I traveled for business via a direct flight from Denver to Frankfurt, Germany and then on to Munich, Germany to my company's headquarters. Needless to say, I have not been able to make any trips to Europe since the accident. I am hopeful that by the one year mark in the second quarter I will be able to start this travel again.)

Although the two hour flight was much more manageable this time around, the four hours of delays in the airport due to weather were no fun. It meant that we didn't land in Illinois until almost 2am. Originally we were scheduled to land about 10:30pm. Enduring the delays was worth it to see family. I had not seen my brother or my parents since July when they left Colorado to return home. It was wonderful to see them all and they were very impressed by the progress I have made since they last saw me.

Janene and I are lucky that both our families live about 20 minutes apart. So when we travel to Illinois to visit we get to see them both. This is because we began dating way back in high school some 26 years ago. We have been in Colorado for 20 years this year and not once have we missed traveling to Illinois to visit our families for the holidays. But even with the short distance between our families, the schedule we adhere to when we are there doesn't leave much room for relaxation because just about every day we go back and forth between both houses. Still, we have a wonderful time visiting family and celebrating the holidays.

Thankfulness

The resiliency of the human body continues to amaze me. Comparing the state of my body today with the state of it back in the spring of 2013 just after the accident is quite remarkable. But I will say again that I am very lucky to not have sustained worse injuries. As I was told by many doctors, most people who get run over by a car don't live to tell about it. I know people who were at Craig Hospital for spinal cord injuries when I was there who are not as fortunate as me and who have had numerous other complications after leaving the hospital. My heart goes out to the them because my situation was bad enough the way it was, it's so difficult to think about everything being worse. I'm just very thankful for all the compassion and support I have received from friends, family and otherwise. 

02 December 2014

Halloween, Thanksgiving and SCI Recovery :: Bruce Snyder's Status

(I wrote this post in early December, but I forgot to post it, so here it is!)

Halloween and Thanksgiving are standard American holidays and they are definitely a good way to mark the progress of my recovery. They seemed to so far away for so long and yet they flew right by this year.

When you have kids, Halloween is a pretty fun time for them. From picking out pumpkins, to carving jack-o-lanterns, to jumping into big piles of leaves, to various Halloween parties leading up to the evening of trick-or-treating. When my girls were younger, they would get so excited for Halloween. They loved picking pumpkins right out of a pumpkin patch and couldn't wait to carve them. We would get out Halloween decorations for the house and carve our pumpkins together. They would really get into it with elaborate designs that they would trace on the pumpkins and require some time investment to carve whereas I would always carve simple, silly faces on my pumpkin that took no time at all to complete, but would make everyone laugh. Well this was the first year where my kids were not into Halloween very much.

This year I was on my own to hand out candy to the trick-or-treaters. Janene was away on a business trip and both my girls were with their friends elsewhere in town. Although I've been mostly walking with the crutches at this point, any time I need to carry something I still need to sit down in the wheelchair to do so. It was too difficult for me to hold the door open to greet the trick-or-treaters while holding the big bowl of candy, so I sat in my wheelchair. It was still fun though because I was down low enough to see all the kids at their eye level and they instinctively helped to hold the door open as I put candy in their bags. Many of the kids know me from coaching soccer, volunteering at the elementary school, etc., so they talked to me about how my recovery is progressing. It was nice to see them all.

Janene's folks came into town for several days to celebrate Thanksgiving and it was nice to have some family around for a while. They participated in our Thanksgiving traditions of fixing a big meal, going to see a movie and playing games afterwards. We also took the girls to see The Nutcracker ballet in Denver (as we have done for many years now) and afterwards we had dinner at a wonderful sushi restaurant. They also helped us put up Xmas holiday decorations around the house including all the outdoor lights. Janene and I have always done this with the girls but there's no way that I can climb a ladder and be on the roof in my current state so Janene's dad helped with that part.

I continue with my recovery from the spinal cord injury. I continue to walk on a treadmill just about every day during the week because we have a couple in the fitness room I'm building at my work office. I've worked up to about 40 minute sessions walking at about 2.5 miles per hour. Although this is not much by normal standards, it is really helping my body to recover quite a lot.

I also I got a stationary bike recently so that I can ride it on a regular basis. It is already help to rebuild the muscles in my hips and butt. I'd love to just put one of my bikes on my trainer an spin like I used to do, but there's no way that I can sit on a regular road bike seat at this point. The stationary bike has a wider more padded seat that allows me to ride for about 20 minutes at a time with a small amount of tension. Although it's a very different ride, it still feels good to be pedaling again.

I continue with physical therapy appointments in Boulder twice a week. These sessions are important because my physical therapist shows me many exercises to do and is continually checking my progress, but most of the recovery is my responsibility. I have to keep doing the work every day and stay motivated to beat the muscle atrophy that has transformed my body so much. Because I have been through muscle atrophy almost 30 years ago when I had one of my knees reconstructed, I know what the hard work is all about. I also know that physical therapy is what can save you from a major injury. And so, I fight on.

05 October 2014

How to Test For the Shellshock Vulnerability and Upgrade Bash Using MacPorts on Mac OS X 10.9.4

Given all the hype recently over the bash Shellshock vulnerability, no matter what operating system being used, any affected version of bash should be patched and/or upgraded immediately.

You can quickly test your operating system to see if your bash version is vulnerable by following instructions on the Shellshocker website. TLDR, here is the command you need to run to test bash on your machine:

Note that the version of bash in my path (the newer one from MacPorts) is not affected by the vuln. Now I will test the version of bash installed as /bin/bash:


Notice that I piped the script directly to /bin/bash instead of relying upon the version of bash in my PATH. Because I have already installed Apple's update (noted below), /bin/bash is not affected either.

Apple Update 

Apple has already released an update containing a patched bash version, so it's very easy to update the standard bash version located in /bin/bash. But, if you are like me and you are using MacPorts to manage many binaries within Mac OS X, you may not be using the version of bash installed by Apple.

Use of MacPorts to Upgrade Bash

I have used MacPorts for years and I continue to get grief from people who love Homebrew. I must say that I do like both, but for some reason I have always kept coming back to MacPorts. Anyway, if you are using MacPorts then upgrading to the patched version of bash is especially easy. Below are the commands to upgrade bash:


Notice that, first, I told MacPorts to update it's cache of upgraded ports, second, I told MacPorts to tell me what ports had been upgraded and, third, I told MacPorts to upgrade only the bash port and not every port that has an upgrade (as arbitrarily upgrading random binaries can have side effects).

28 September 2014

Installing PostgreSQL 9.4 beta2 on Mac OS X 10.9.4 via MacPorts

After reading the blog post from EnterpriseDB about how Postgres Outperforms MongoDB, and because I have always preferred PostgreSQL to other databases, I had to check out the document handling capabilities that PostgreSQL has added recently.

Because I began using a newer computer this summer, I had not yet installed PostgreSQL. So I pulled up a previous post about installing PostgreSQL using MacPorts and did some searches to find the latest PostgreSQL. Below are the commands I ran.

First, I needed to figure out what the latest version of PostreSQL is in MacPorts:

This allowed me to see that PostgreSQL 9.4 beta2 is the latest version supported by MacPorts. So I embarked upon an installation of this version:
This install went off without a hitch, so I created a directory for the database and initialized the database:
From the ouptput of the installation, I copy/pasted the startup command and sent it to a file. I did the same for both the start and stop commands so that I have scripts to start and stop PG quickly:
After starting up PG for the first time, I opened another terminal in another tab to watch the log file to see if the database was started correctly:
Then I pulled up the docs via the local install of them (file:///opt/local/share/doc/postgresql94/html/index.html) and started digging into the document database support to play around.

27 September 2014

I Can Sqeeze My Butt! :: Bruce Snyder's Status

Two weeks ago I awoke to the discovery that I can squeeze my butt again! Those of you who read my last blog post know that I have paralysis across my butt and down the outsides of my hamstrings and that in that post I said: 
'Even if the movement of my feet does not return, I really wish that I could regain the feeling in my butt and the ability to squeeze the muscles so that I could build them back up again.'
Well believe it or not, I got my wish! I could hardly believe it myself! I was still lying in bed on Sunday morning when I made the discovery. I was in such disbelief that I laughed out loud and woke up Janene. As she heard me she bolted upright, bleary eyed and said, 'Are you OK?' Still laughing I told her I can squeeze my butt and we both could hardly believe it. Even though it was a very small squeeze, it's a sign that the healing is starting to take place. 

Technically the muscles in the butt are the gluteal muscle group as shown in the diagram comprised of the glueus maximus, gluteus medius and the gluteus minimus. The ability to squeeze these muscles is controlled by nerves that connect impulses sent from the brain, down the spinal column to the muscle to cause a contraction. The fact that the nerves have healed enough to allow me to squeeze them is a really good sign, it means that my body is healing itself. 

The squeeze was very small and quite weak but it was a start. Because these muscles have basically been dormant for five months means that they are terribly atrophied and therefore extremely weak. But even in the two weeks since this movement returned, I have been working the muscles to build them back up and the squeeze has only increased. At this point, it's not a huge increase, but as my Mom always told me growing up, 'Slow and steady wins the race.' 

Who thought I would be so happy for such a minor thing. But when I experienced such a devastating injury that forever changed my life, I learned very quickly to be happy for what I still have, as I have mentioned before. Now it's just a matter of working these muscles regularly via rehab to bring them back to life. Speaking of rehab, I also made a big change on this front last week. 

Changing My Rehab 

Since being released from Craig Hospital in June, I have been going back to Craig for rehab. After all, it is a world-renowned hospital for spinal cord and brain injuries. When I was first released from the hospital, my Dad was still in town and was driving me wherever I needed to go including to rehab at Craig Hospital. At first, I was going to rehab at Craig three times a week. It helped a lot to be in close contact with my physical therapist and to continue seeing my friends there. But it didn't take long for me to really get tired of making the 90 mile round trip and sitting in traffic for 2.5-3+ hours each time we made the trip. Remember, this was when I was still exhausted all the time and this drive only made things worse for me. I also got wise to the fact that insurance companies only pay for a certain number of visits. So I decided to keep doing my rehab at home and only check in with my PT at Craig once a week to more or less maximize my PT visits. For a while this worked, but because I am now back to work full-time, even making the trip to Craig once a week sunk a lot of time and I didn't get a lot of benefit from a one hour appointment once a week. So I began looking into other options including the Boulder Community Health's Mapleton Center for Outpatient Rehabilitation and also a company what specializes in spinal cord injury (SCI) rehab named Project Walk

Project Walk was especially compelling to me because it focuses on rebuilding the muscle mass that SCI patients lose from the injury and hospitalization. The professionals at Project Walk help patients to design a workout specifically for them and their situation to focus on their own goals. My ultimate goal is to walk again without the need for braces and crutches, and although this is dependent upon my body and its ability to heal, there's a lot that can be done in the meantime to get my body ready for more movement to return. I applied to Project Walk and received a call back within a day and began talking to them. Everything sounded great and was very much in tune with the way that I have always enjoyed pushing myself in my physical fitness, but there was one catch -- they wanted me to come to their San Diego office for three weeks. The problem with this is that I am just too busy at work right now with recruitment duties for open positions and I don't feel like I can put this on hold for three weeks. Because of this, I decided to look into a more local solution in Boulder for now. 

Boulder Community Health has an outpatient rehabilitation clinic called the Mapleton Center. A dear friend of mine who experienced a spinal injury a couple years ago went here for his rehab and told me that they really helped him. So I paid them a visit and got an evaluation by a PT who worked at the Spaulding Institute in Boston prior to coming to the Mapleton Center. Spaulding is a rehabilitation clinic out east that is well-known for its SCI program. So this week I began doing rehab at the Mapleton Center to see if this PT can help get me to get on the road to a more rigorous workout that will help me work toward my goals. This certainly doesn't mean that I have ruled out Project Walk, in fact, it is still very much on my mind. 

In speaking to Project Walk, I have learned that this place is a premier rehab clinic for SCI patients. Based on 10 years of medical research and partnering with hospitals and universities, Project Walk is like not other rehab clinic I have discovered. And although they originally wanted me to come out there for three weeks, in speaking with them they suggested that perhaps we could condense it to a week and just work a lot more hours while I'm there. Furthermore, I also learned that they are opening a clinic in the Boulder/Denver area in March 2015. So I'm kinda thinking that I need to see how things play out at the Mapleton Center before traveling to Project Walk in San Diego. If I can attend PT in Boulder for a while and then go to Project Walk in San Diego, perhaps I can be ready to take on even more when the Project Walk clinic opens here in the Boulder/Denver area. 

Dinner With Gareth and Mike 

This past week I had dinner with my coworker Mike O'Donnell and his buddy Gareth who helped me as I laid suffering in the street right after the accident. Not only was it was wonderful to see Gareth again, but this time with a clear head, it was also great to have dinner with my co-worker Mike who I really like. I learned a lot about both Gareth and Mike that night and I really enjoyed our time together. Spending some time with Gareth in a social setting really clued me in to who he is and I discovered that we have a lot in common in terms of the way we look at the world. Gareth also told me about a fascinating book that I'm just beginning to read now. 

Books

Anyone who knows me knows that I'm constantly reading something. I'm always on the look out for new books to read and, in fact, I even keep a list of books in a notebook in Evernote (which I use for everything now). The book Gareth told me about is titled, Biology of Belief. This book is about how new research shows that our DNA does not control our biology, instead our DNA is controlled by our positive and negative thoughts. Certainly this topic is of extreme interest to me right now because of my medical situation. I don't have much to say about this topic yet because I haven't read the book yet. But suffice it to say that I am reading and trying everything I can get my hands on at this point to help heal myself. 

When I told Janene about this book, she said it sounded similar to one recommended recently by a co-worker titled You Are the Placebo. This book is about how one's brain and body are shaped by their thoughts, their emotions and their intentions, not the other way around. Again, a captivating topic for me right now so I plan to read this book next. 

Perhaps these two books will help me move from the hope of more movement to the real belief that I am going to get movement back and I am going to walk one day. After all, I did tell Project Walk that my goal is to walk, but my dream is to one day cycle and run again. 

20 September 2014

More Yak Shaving to Install Git Via MacPorts But With MacOS X Mavericks

After performing a fresh install of MacOS X Mavericks on two computers recently. Because of the reinstall of the OS, I also had to reinstall a bunch of other tools including git. In doing so, I realized that the configurations that I had in my old .bash_profile would no longer work correctly and so I had to update the location of a couple files. 

I blogged about this previously so I had already done some research about installing MacPorts on a computer and I knew that I'd need to install the command-line tools for XCode first. So I installed XCode first using the App Store and then followed the instructions to install the XCode command-line tools. Once these were installed, then I was able to proceed with the installation of MacPorts. 

So I downloaded and installed MacPorts, ran sudo port selfupdate followed by sudo port install bash to get the latest version of bash. So that the OS can make use of this newer version of bash, I added it to the On MacOS X, I added the path to this newer version of bash to the /etc/shells file. To actually make use of this updated version of bash, I had to make my terminal aware of it. I always use iterm2 instead of the Apple terminal, it's just so much more powerful. So I changed my profile in iterm2 to launch this version of bash by adding the bash login command to be run when iterm2 opens a new terminal, /opt/local/bin/bash -l. Now when iterm2 starts up, it logs in to this newer version of bash automatically for me. Now I'm ready to install the git tools. 

To install git, I run the following command in the terminal that I've always run to install git via MacPorts: 
Unfortunately this was unexpected, but the answer is right there in the error -- instead of installing git-core, just install git. So I ran the command again with a different name for git:
This got further but threw another error about the readline utility, so I had to force activate the readline utility. Beyond that, everything installed correctly.

However, the git bash completion didn't seen to work. I was seeing the following error from my .bash_profile when the bash prompt was getting set up:
bash: __git_ps1: command not found
It turns out, because the name of git in MacPorts was changed from git-core to just git, the paths to some of the git bash completion had changed as well. All I really had to do was update my .bash_profile from this:
/opt/local/share/git-core/contrib/completion/git-completion.bash
to this:
/opt/local/share/git/contrib/completion/git-completion.bash
and everything worked correctly.