My First Two-Wheel Ride Since My Spinal Cord Injury Five Years Ago

Yesterday, Janene took me for my first ride on a two-wheel bicycle since my injuries in 2014. I wasn't sure if I would ever be able to ride a two-wheel bicycle that I had enjoyed so much before the accident. It has been over five years since I've been on my mountain bike and the ride was glorious!

Some people have said to me, 'But you have been out riding since then, how were you riding if this is your first two-wheel ride?' This is true, I have been out riding in the last five years, but not on a two wheel bicycle. I actually have a three-wheel bicycle. Let me explain.

My Three-Wheel Bicycle

For some people with a spinal cord injury (SCI), depending on the severity of the damage, it can completely compromise your sense of balance. Sometimes this is a permanent change and sometimes it is temporary. You just don't know until you wait long enough for the shock to calm down in your body (for me, this took about six months) and the healing has begun. Anyway, because we were not sure if my sense of balance was going to be compromised or not and, because Janene was well aware of my passion for cycling, she wanted to get me back on a bicycle as soon as possible back then.

So, sometime within the first year after my injuries, Janene got me the most amazing three-wheel bicycle I have ever seen. It is a Mission Cycles Tribrid shown in the image to the right. This bicycle has disc brakes and gears similar to a two-wheel bicycle and although it's heavier than a two-wheel bicycle, it's actually pretty light compared to other three-wheel bicycles I've seen in the past. (In a previous life, I probably would have conspired to jump this three-wheel bicycle off a ramp or something!) However, the first big challenge that I had to overcome with even the three-wheel bicycle was finding a seat that I could sit on for any duration of time.

My Bicycle Seat Saga

Because my SCI occurred mainly in the lower lumbar spine, it also affected the sacral spine and therefore the nerves in that area. The sacral spine controls much of the movement and sensation below your waist. One of the issues I encountered was the nerves that control all my gluteal muscles and, to some degree, my perineum were all compromised. This meant that the muscles controlled by these nerves stopped working which caused tremendous muscle atrophy resulting in the muscles shrinking to almost nothing. So, the muscles in my butt and my crotch were compromised which made sitting on just about any surface very painful and difficult. Fortunately, these muscles just barely began working within five months of my injuries and have now recovered to some degree now. However, to this day, I still use special cushions to sit on and even with them I cannot sit still for very long. This made sitting in general very difficult for me, let alone on a bicycle seat. In fact, I need to wear two pairs of cycling shorts now for my stationary bike and my mountain bike. Even then, I can only make it for about an hour due to the pain. But, at least I can ride again!

Prepping For the Ride

Internally, I have been excited but nervous about getting back on my mountain bike. Long before my injuries back in 2010 or 2011, I had purchased this Yeti mountain bike (see the photo to the right). I have had several other mountain bikes, but this one has full suspension so it makes riding off-road trails sooooo much nicer. It's a superior uphill climbing machine. Anyway, I have been thinking about riding this bicycle for a long time. I even hopped on it once before but the seat caused me such pain that I had to get off quickly. So, I knew what I was up against with the limitations of my body and I had already been thinking about how I would overcome these long enough to get in a real ride duration. But getting my mountain bike ready for the ride was quite comical. It was as if all the forces in the universe were conspiring against me.

This bike still had the original seat and clipless pedals, so I knew that I had to change out those. But before I could start, I had to fix the flat tire on the rear which I discovered a couple weeks prior. So, I got a tube last week and swapped that out pretty quickly yesterday. Then I started working on the seat.

We had found a seat for the three-wheel bicycle that worked well enough for me to ride for about 30 minutes. So, I decided to grab the seat off the three-wheel bicycle and move it to my mountain bike. What I remembered as I was trying to mount the seat on the Yeti seat post was that the seat rails were a non-standard width and didn't exactly fit on the seatpost. Hmm, well I now remembered that I had to do the same thing on the three-wheel bicycle, so I just did the same thing on my mountain bike. With Janene's help, I got the seat mounted. Next, I moved on to the pedals.

In working to remove the clipless pedals on the mountain bike, I realized right away that I had to find my allen wrenches. After a hunt around the house, I found a different set but it didn't have an allen key big enough to remove my pedals. So, I called one neighbor and there was no answer. I called another neighbor and he said come on over and let's figure it out. He loaned me the correct size allen wrench. Then I had to actually break the seal to the pedals to remove them. This was no easy task, but we eventually conquered it. Now I needed to find one of my helmets.

This is where things get tricky. Since my accident five years ago, we have moved our master bedroom twice (once to the main level and once back upstairs). Additionally, last year we had to pack up everything on the first floor of our house and move out due to the remodeling. So, finding my cycling tools, helmets, cycling clothes, etc. required me to dig through many boxes to locate all the gear. I could not locate the helmet that I was searching for, so I still need to find that one. But anyway, two hours of prep work and we finally got ready and out the door for the actual ride!

The Actual Ride

Once we got rolling, I realized that I can still ride! Getting on and off the bike is not so easy for me and I had to lower the seat because I cannot move my ankles at all with the braces on my lower legs. But once I got moving, everything went great and we had a really good ride despite the pain.

One thing that I used to love about cycling was climbing hills. I could climb for hours and I loved it. But yesterday I quickly realized that even small hills were quite the challenge for me. Actually they are a very good challenge and I really want to do more of it. But I'm far from being ready to take on my favorite ride in Boulder County -- Flagstaff Mountain.

I was so thrilled to be able to feel the movement of being on a bicycle again. Now I can't wait to go on my next ride.

Five Years Later...

Earlier this year in April, I reached five years since my spinal cord injury. Although this anniversary passed nearly unnoticed by many people around me, the value of what I have experienced in these five years still weighs heavy on me most days.

Back in April, I thought about writing this post, but I passed over it for some reason I can no longer recall. Most of the time I live my life in the new ways to which I have become accustomed and I'm able to deal rationally with most things that come up. But a couple weeks ago, I was driving to a hiking spot in Boulder County and I came across a cycling event. As I saw more and more riders it really threw me for a loop emotionally and I was so overcome I had to pull over. I see individual riders all over Boulder County all the time and I'm fine with that. I have accepted the fact that I cannot cycle the way I used to do so often. But I guess seeing all the people riding together for an event was a strong reminder of something I used to love and I still really miss. Anyway, this experience got me thinking and I figured I should write up something about the fifth year anniversary of my injuries because it's still very much always in the background (and sometimes the foreground) of my life.

Experiencing such traumatic injuries and going through the recovery was a profound experience for me physically, mentally and emotionally. As I just described above, there are still some life changes that get to me. There are big physical things like cycling events and even little physical things like the difficulty (or impossibility) of getting down on the floor to play with our puppies. Such physical limitations are something that I've learned to deal with the most. It's the mental and emotional stuff that still creeps up and surprises me from time-to-time.

Gratitude

As I have stated in a previous post, I still experience a tremendous amount of gratitude for the people in my life and for the experience that I've been through. Without going through something like this, it's difficult to understand what I mean. But recently I was reminded of it again by my fellow paraplegic friend John.

John and I meet up periodically since his own injury in 2017, but this time was a bit different. It was right before July 4th when he and I last hung out. John is doing amazingly well adjusting to life in a wheel chair. At one point, John paused to look me in the eye in a way that he never has. He then thanked me for something that I offered him early in his experience that he said he still holds to this day and it gets him through many daily difficulties. What I offered him was a statement that I learned from my wife Janene and that is, 'fake it 'til you make it.' He said that he didn't understand the value of this statement at the time, but since then he has grabbed ahold of it as a sort of mantra to move forward in his recovery and his life. I was quite touched that it has worked as well for him as it has for me.

In the last couple years, I have a newfound enjoyment in hiking. Although I cannot hike trails the way I used to (I used to run them!), I still get a lot of enjoyment out of the challenge of a trail and from being outside. I also find the solitude of hiking very comforting and I even seek out trails that are less busy for this reason. I used to say that cycling and running were both a form of meditation for me and now I've found that hiking can be the same for me.

But, overall, I think most about the positivity and support I continue to receive from family and friends. Without this, I would not be where I am today. I feel very fortunate to have so many people supporting me.

Improvements and Acceptance

So much of what drives me forward are the small gains that my body has made over the last five years. My nerve pain has improved dramatically over time, but it is by no means gone. The strength in my lower body has also improved dramatically over time, but by no means is my body at 100%. Such improvements and the positivity of the people around me are the hope that keeps me moving forward. But I have also had to face the fact that my body will never be the same.

Acknowledgement and acceptance are two related but very different concepts. Acknowledgement of my limitations is important, especially when it comes to gauging improvements on a day-to-day, week-to-week, month-to-month and even year-to-year basis. But acceptance of my limitations is a whole different level. While I have certainly accepted my injuries, what is not so easy to accept is some level of permanence of these injuries. This is a complex issue that has taken me quite a while to tease apart.

While I acknowledge the injuries to my body and I accept the fact that they happened, it is still difficult to accept the severity of these injuries as permanent. Consider a bone fracture. Relatively speaking, under optimal conditions, bone fractures do heal over time. However, healing a bone fracture oftentimes means immobilizing the joints around the bone fracture. The result of such immobilization is that the soft tissues around the fracture (e.g., ligaments, muscles, nerves, tendons, etc.) wind up experiencing damage due to the immobilization that lasts much longer beyond the healing of the original bone fracture. This soft tissue damage is a side effect to the actual injury, but it is the side effects that require prolonged physical therapy and hard work to overcome. It is these side effects that I am still dealing with today. Having spent two weeks lying in a bed in the ICU and then nine months in a wheel chair really took its toll on my body.

When movement begins to appear with a muscle for me, it doesn't mean that I can suddenly shed my leg braces and run down the street. It means that you can just barely see a flicker of movement in a muscle and it takes all the effort that I can possibly muster toward that muscle. Once this very minor movement begins to appear, the real battle is against the muscle atrophy and this is very, very difficult to overcome. It feels like no progress is being made and really requires a lot of mental focus not to be outdone by my own pessimism. Because such recovery requires a tremendous amount of consistent and diligent work over a long period of time, many people give up pretty quickly. I know I certainly have times where I feel like giving up. But I also know that the reward of regaining movement will not be affected by what I do on any given day, but is mainly affected by my long-term, consistent habits over time. In other words, it's about the long-term trend of the improvement. So, I keep telling myself that this is a marathon, not a sprint. I do my best to keep faith in the choices I make regarding my physical therapy, knowing that it's only going to make a difference over time. Much easier said than done.

Change is Constant

Looking back over the last five years, our family has undergone many changes. Five years ago, Bailey was 11 years old and Jade was 16 years old. Bailey was in elementary school and Jade was in high school and Janene was still working for the Colorado State Public Defender. Today, Bailey is in high school, has her drivers license and is beginning to consider university while Jade is about to enter her last semester of university to complete her student teaching and will then graduate. Janene has since retired from her position with the State and has opened her own private law practice. This a lot of change, albeit these are normal changes.

For me, life has changed quite a bit in the last five years. For the first nine months, I was in a wheel chair. This alone was quite jarring to me and everyone around me for a variety of reasons. One of the most difficult parts was not being at eye level with people and therefore always feeling vulnerable and somehow 'less than' what I once was. I still remember the first time that I walked in the hospital using a walker and with the help of two physical therapists. I couldn't believe how different the perspective was from my wheel chair vs. standing upright to shake someone's hand and look them in the eye. I remember thinking, 'I want this back!' This moment was a big motivator for me to learn to walk again using arm crutches, although it took an immense amount of hard work over those nine months. Since that time, I have spent the last four-and-a-half years focused on getting stronger and gaining better balance and more movement. It has meant doing some form of PT nearly every single day, so it has really become a way of life for me. I am very lucky to have gained much more strength throughout my lower body and even regained some movement. But the journey is far from over. I'm still hopeful that I will gain more movement in time so I just need to keep going.

It is also fascinating to look back at the videos that Janene took while I was learning to walk again. When I began trying to walk while I was still in the wheel chair, I was barely able to stand on my own with the arm crutches. As I tried to walk, I was literally throwing my legs forward to take steps. Over time, I progressed bit by bit toward actual walking with a more normal gait and somewhat normal strength. For me, it is shocking to see how weak my body was through this initial time period. It's always a reminder of how far I have come.

Onward to the next five years!

New Braces and Hiking in Colorado

After about a year-and-a-half of wearing my old carbon fiber AFO braces (Ankle and Foot Orthoses), I recently got a new pair of Phat Braces which are also made of carbon fiber, but have a much better warranty and are widely used by people everywhere.  The big difference between my old braces and the new Phat Braces is that the Phat Braces are taller and stiffer (but they are beginning to soften a bit). They come up my leg to right below my knee which is further than my old braces . This makes them much more stable and it which allows me to balance and walk much easier. They also have some flexible plastic that wraps around the foot (as you can see in the image to the right) which also helps to provide more stability. The biggest benefit about them so far, however, is that it did not take my body six weeks to adjust to them. The previous braces actually took six weeks for my body to adjust and I was in pain the entire time. The company that provided them told me that's just how it goes. Through that adjustment period, I had to have at least a dozen manual adjustments to the carbon fiber (e.g., heat them up, bend out here and there, etc.), probably closer to 18 or so. With the new Phat Braces, I've only had two adjustments and my body has already adjusted to them -- literally less than a week. In fact, I have had the Phat Braces two weeks now and yesterday I did my first true Colorado hike since my injury in April 2014!

Yesterday we decided to go hiking in Evergreen, CO because we were trying to get back to the spot where I proposed to Janene 20 years ago. We thought it would be cool to go back there because later this month Janene and I will be celebrating our 20th wedding anniversary. I was a bit intimidated when we started the hike because of the elevation gain on the trail and the number of large rocks that you hike over on the trail. I did take a single arm crutch with me but it almost made things more difficult because of the angle at which you hold the arm crutch vs. the angle of the rocks on such an uphill elevation. Also, my new braces make going uphill difficult because they are still stiff, but they will soften a bit more in time. But with Janene's help, I completed the hike. Janene did make a good suggestion that instead of using an arm crutch I should consider getting some hiking poles. Because you hold them at a different angle, it could make going uphill and downhill over rocks easier for me. So, I'm going to try some out soon at REI.

Although the distance was not that great (1.7 miles), this was the most uphill/downhill I have done since my spinal cord injury 3.5 years ago -- I actually impressed myself. As proof of the level of workout for my body, my lower back and my hips were really tired after the hike and sore this morning. But I really enjoyed getting out for a hike with Janene and Bailey. So, I'm really looking forward to doing more hiking. I guess I can really start enjoying the fact that we live in Colorado again!

Three Years After

Monday, April 24th marked the third anniversary of my spinal cord injury. It seems like the injury took place so long ago now and yet it has only been three years. So much has happened in my family's life in the last three years. I now have a 19-year-old who is about ready to complete her first year of college and a 14-year-old who is getting ready to enter high school in August. Through all of these experiences along this journey, I now feel like I am emerging from the other side. I believe that I have finally found peace with this whole ordeal. It has not been easy to get to this point and it's difficult to convey how hard-fought my successes continue to be. But those closest to me know, and that's what matters to me.

Gratitude

As I look back at all the photos and videos Janene has taken over this three year period, read through the Caring Bridge posts and my blog posts, the progress I have made is pretty amazing to me. Believe it or not, I actually have a lot of gratitude for the fact that this experience happened to me. Yes, I just said that I am thankful for the experience. I did not arrive at this place easily or lightly, so stop and consider that statement for a moment. After three years of pondering every aspect of this entire situation, I feel that I am a better person for it in many ways. This whole experience forced me to get myself in order and I'm now a better person for it.

From the beginning of this experience three years ago, I have been lucky enough to be surrounded by people who provided me a constant stream of positive support. From the folks I worked with at the hospitals to all of my family, friends and co-workers, the positive vibes are what have inspired me to keep going. There were also a couple of notable things that two people told me that I have hung on to that have kept me going to this day:

• My wife Janene has always taught our girls that no matter what you're doing in life, you need to 'fake it 'til you make it'. This catchphrase helps you to feel confident and optimistic about something as you build your ability until such a time where you gain the necessary experience to actually feel genuinely assured that you have reached a successful point. Although she has always intended this for the benefit of our daughters, I have been able to internalize it and use it to my own benefit in my recovery. Repeating this statement in my head has taken me quite far and I continue to use it to this day.
  
  Although she has always intended this for the benefit of our daughters, I have been able to internalize it and use it to my own benefit in my recovery. Repeating this statement in my head has taken me quite far and I continue to use it to this day. Thank you so much, Janene. I love you!

• My friend Greg, who has had two spinal cord injuries in his life (can you believe that?!), told me something very early on in my journey, that I held in my head to help me get through the first year and beyond. He said something like, 'I know you you are not in a place where you can understand what this means yet, but you will get there in time. Just do everything you can to make it through the first year and everything will seem 1000% better. You won't be totally healed in one year, but you will feel much, much better.' Ironically, I saw Greg the week of my first year anniversary and I told him about this and he didn't even remember telling me this. I think he was quite surprised that I held on to it for so long, but it was truly a lifeline. Thank you, Greg.

Lesson Learned

I have learned a lot in three years as this experience has taught me a lot, especially the way that you handle an experience. Most importantly, I've learned that when you are faced with a horribly painful experience (emotionally, mentally, physically) that changes your life, you can choose to one of two paths:

1. Either, you can be angry, resistant, resentful and stuck on the fact that something was taken from you. I have met plenty of people on my journey who were here and until they change their outlook, they won't be able to move on.
2. Or, you can acknowledge that it sucks but still feel gratitude for the positive aspects and for being able to be alive to experience it all. I haven't met any people who can say that they feel thankful for their experience with a spinal cord injury, but I have read about some. It was not easy for me to get to this point.

And this certainly doesn't mean that I'm done. My recovery will continue for years.

On that note, singer-songwriter Ryan Adams who I have listened to for years summarizes my whole point best in the following interview:
He says it best by summarizing it this way: Pain helps us learn who we really are.

Reminders Along the Journey

Just recently, one of my colleagues from our Munich, Germany headquarters visited my office in Boulder. I have not seen this guy in person since before the accident so he was really shocked to see me walking and to see how well I am doing now. He said he was so surprised because the last he heard from me I was still in the wheelchair (the look on his face was priceless!). It's moments like this one that remind me of how far I've come and continue to drive me forward.

Thank you to everyone who has helped me in any way along this journey.

Annual Spinal Cord Injury Re-evaluation

Recently I went back to Craig Hospital for an annual spinal cord injury re-evaluation and the results were very positive. It was really nice to see some familiar faces of the people for whom I have such deep admiration like my doctors, physical therapists and administrative staff. My doctor and therapists were quite surprised to see how well I am doing, especially given that I'm still seeing improvements three years later. Mainly because so many spinal cord injury patients have serious issues even years later. I am so lucky to no longer be taking any medications and to be walking again.

It has also been nearly one year since I have been back to Craig Hospital and it seems like such a different place to me now. Being back there again feels odd for a couple of reasons. First, due to the extensive construction/remodel, the amount of change to the hospital makes it seem like a different place entirely. It used to be much smaller which encouraged more close interaction between patients and staff. Now the place is so big (i.e., big hallways, larger individual rooms, etc.) that patients can have more privacy if they want or even avoid some forms of interaction. Second, although I am comfortable being around so many folks who have been so severely injured (not everyone is), I have noticed that some folks are confused by me. I can tell the way they look at me that they are wondering what I am doing there because, outwardly, I do not appear as someone who has experienced a spinal cord injury. I have been lucky enough to make it out of the wheelchair and to walk on my own. Though my feet are still paralyzed, I wear flexible, carbon fiber AFO braces on my legs and walk with one arm crutch, the braces are covered by my pants so it's puzzling to many people.

The folks who I wish I could see more are the nurses and techs. These are the folks who helped me the most when I was so vulnerable and confused and to whom I grew very attached. To understand just how attached I was, simply moving to a more independent room as I was getting better was upsetting to me because I was so emotionally attached to them. I learned that these people are cut from a unique cloth and possess very big hearts to do the work they do every day. Because they are so involved with the acute care of in-patients, they are very busy during the day and not available for much socializing as past patients come through. Luckily, there was one of my nurses who I ran into and was able to spend some time speaking with him. I really enjoyed catching up with him and hearing about new adventures in his career. He was one of the folks I was attached to at the time and he really made a difference in my experience. I will be eternally thankful for having met these wonderful people during such a traumatic time in my life.

Today I am walking nearly 100% of the time with the leg braces and have been for over two years. I am working to rebuild my calves and my glutes, but this is a very, very long and slow process due to severe muscle atrophy after not being able to move my glutes for five months and my calves for two years. Although my feet are not responding yet, we will see what the future holds. I still feel so very lucky to be alive and continuing to make progress.

Although I cannot run at all or cycle the way I did previously, I am very thankful to be able to work out as much as I can. I am now riding the stationary bike regularly, using my Total Gym (yes, I have a Chuck Norris Total Gym) to build my calves, using a Bosu to work on balance and strength in my lower body, doing ab roller workouts and walking as much as I can both indoors on a treadmill and outside. I'd like to make time for swimming laps again, but all of this can be time consuming (and tiring!). I am not nearly as fit as I was at the time of my injury, but I continue to work hard and to see noticeable improvements for which I am truly thankful.

Thank you to everyone who continues to stay in touch and check in on me from time-to-time. You may not think it's much to send a quick message, but these messages have meant a lot to me through this process. The support from family and friends has been what has truly kept me going. The patience displayed by Bailey, Jade and Janene is pretty amazing.

Next month will mark the three year anniversary of my injury. It seems so far away and yet it continues to affect my life every day. My life will never be the same, but I do believe I have found peace with this entire ordeal.

We Have Movement! :: Bruce Snyder's Status

After nearly two years of no movement below my knees, I was pretty surprised to discover recently that there is movement in the achilles tendons on both my legs!

Back in late January, I went back to Craig Hospital for the annual re-evaluation of my spinal cord injury. During the four days of poking and probing my body, just like last year, they told me again, 'According to your internal organs, we can't tell that you have had a spinal cord injury.' This does not mean that I am unaffected, it means that I do not have the deterioration of internal organ function that they commonly see in the kidneys, liver, etc., etc. after such an injury. Many paraplegics are in a very bad way internally due to a whole host of issues that arise as side effects to the nerve damage. For example, I still have to deal with bladder and bowel issues from the nerve damage. These issues have improved significantly from the time of the injury nearly two years ago, but I am also lucky enough that my injuries were not as bad as they could have been. (I could go on an on about the degrees of damage here but I will spare you the details.)

There were two really positive discoveries during my re-evaluation, improvement in sensation and some new movement. The first discovery that I have much more sensation in my hamstrings, lower legs and feet than I realized. Nerves heal at such a slow rate that it's difficult to gauge the level of improvement on any given day. But if you have a baseline against which you can measure, then you can quantify the amount of improvement. I knew that the sensation had improved, but it was difficult to tell how much it had improved. Additionally, if you know anything about nerve sensation then you know that there are different flavors of it -- basically soft/light touch to heavy touch to sharp touch (and everything in between). Interestingly, damaged nerve sensation can go from numb at one end of the spectrum to hypersensitive at the other end. So they tested much of my body for nerve sensation and compared my current results to the results from one year ago as well as against the initial injury. The result was that the improvements were rather significant.

If you look at the two images above of the nerve dermatomes, pay attention to those from the waist down related to anything L3/L4 or below (the vertebrae in the lower spine including L3, L4, L5, S1, S2, S3, S4 and S5). Right now I'm dealing with sensation issues in my feet, lower legs, hamstrings, tailbone and crotch areas. The great thing is that my body is still healing and nobody knows how far it will go over time.

The second discovery was that the achilles tendons in both legs have some movement! There was just barely movement there, but it's movement nonetheless. It is very similar to the way that my butt/glutes returned. This new movement in my achilles tendons was such a minor amount of movement that I did not believe it at first. However, as my glutes have recovered and rebuilt, I have also learned that even minor movement can snowball over time into much more movement as the muscles are rebuilt. My glutes have largely returned, but they are still not 100% and won't be for some time, so I continue to work on rebuilding them. The same will be true for my calves. Right now my calves are basically gone due to the muscle atrophy. But, over time, I will enlist my calf muscles more and more and they will rebuild. In fact, in the 30 days or so since the movement in my achilles tendons was discovered, I can now feel that my calves are just beginning to engage. But only just beginning. It's going to take a lot more work over a long period of time before I can visibly produce dorsi- or plantar-flexion of my feet (which is driven by the calf muscles and the tibialis muscles).

As I have been telling everyone for the last year, in addition to waiting for my nerves to heal more, the big focus of my physical therapy has been fighting back against the severe amount of muscle atrophy that occurred as a result of my injuries and immobilization. It took me a while to realize that the muscle atrophy was something from which I could recover (as long as there was movement). At first, I was so weak from the immobilization after the emergency surgery and spending nine months in a wheelchair that I just assumed that the weakness was caused by and part of the paralysis. To a certain degree this was true, but what I have learned over time is that if I have movement I can rebuild the muscle. There is such a thing as having the movement return but perhaps not having 100% of the sensation return. Another positive thing is that I have experience dealing with muscle atrophy. Having dealt with it way back in high school with my first couple of knee injuries, I understand the dedication and hard work required to recover from muscle atrophy. It takes a lot of consistent, deliberate, difficult work to rebuild muscles that have shrank away. As many people have asked me, 'Are you still going to PT?' and my response is, 'PT is a way of life for me, it won't stop for years.'


Anyway, because the movement is starting to return, I was fitted for a new kind of braces (this is the third type of braces now). The type of braces I need are called ankle-foot orthotics or AFOs. The first type of AFOs I had were rigid hybrids comprised of aluminum struts with plastic foot and calf beds. The second type of AFOs I had were rigid plastic with some carbon fiber reinforcement around the ankles -- rigid meaning no flexion whatsoever. I am now on the third type of AFOs and these are known as dynamic response AFOs and they are made of carbon fiber.

See the image to the right and notice that there is only a thin strip of carbon fiber along the back of the achilles tendon area. This strip is flexible for two reasons:

1. To enlist the calf muscles in the stride
2. To rebound or spring back once it is loaded from the ankle flexion providing a more natural stride 

Just like the switch to the previous AFOs, these new AFOs changed my stride again. It's much more natural and I don't need to pick up my feet as much because my ankles are flexing naturally. The downside is that I am pretty damn wobbly right now due to my lack of calf or foot muscles, but this will improve over time. Also, my feet and lower legs are pretty sore from the new material (carbon fiber is not very forgiving -- I know this from owning several carbon fiber bikes). I have already had a couple of adjustments to them and I will need more. But it is also a matter of your body getting used them, kinda like a new pair of shoes but much worse. This will all improve over time.

Someday I will post all of the videos that Janene has made of me walking at the different stages throughout my recovery. It's pretty amazing to see the progress so far and I'm not even done yet. As I tell myself quite often, never give up.

Check Out My Latest X-Rays :: Bruce Snyder's Status

On Friday, I paid a visit to my neurosurgeon and I have x-rays to show off! 

My neurosurgeon was happy to see me because it was the first time that he had seen me walking. He happily greeted me at the front desk which doctors almost never do, he just happened to be there when I walked in. It made me feel pretty good that my surgeon was so happy to see me. After all, this guy sees lots and lots of people who have had surgery. He said he was happy to see me walking because when I last saw him in November I was still in the wheelchair. 

Below you can see the two sets of x-rays -- one from the back and one from side. From both vantage points, you can easily see the hardware that was inserted. Even though I can feel the hardware in my back, it's still crazy for me to actually see it. Especially when I see how deep the screws go into each vertebrae. In the view from the back, you can also see the curve in my spine because the hardware is crooked. Oh well, I've been told that spinal surgery is more art than science -- sounds like writing code. 

Also, if you look closely you will see some little dots in between the L3 and L4 vertebrae. This is a plastic spacer and the dots are metal so it will show up in an x-ray. It's typical for the surgeon to insert a spacer in between the vertebrae in place of the disc that had to be removed (the disc was so badly damaged that they had to scrape it out). The spacer keeps the vertebrae the proper distance apart as the bone grows and fills in the space. According to the surgeon, the bone growth between the two vertebrae looks really good.

Based on  my recovery and the state of healing in my spine, the surgeon told me that he doesn't want to see me for a year! He said that he feels that I'm ahead of the curve and that I should keep doing everything I'm doing. Yay! 

One Year Since My Spinal Cord Injury :: Bruce Snyder's Status

On April 24th, my family and I marked one year since my spinal cord injury and I was so totally shocked and very humbled by the surprise that Janene arranged for me. What an amazing wife!

We had made plans to go to a friend's birthday party at a place here in town. That afternoon my youngest daughter had a track meet and afterward I had to pick up my oldest daughter from her school in Boulder. These activities kept me busy until just after 6pm when I showed up at the location for our friend's birthday party.

As I crutched to the door and opened it, I saw my youngest daughter holding a big sign for and a huge crowd of our friends from the community screamed, 'Surprise!' It took me a second to realize that all of these people were here for me. I was so shocked by this thought that I almost lost it right there. Even now I get emotional thinking about it. I was so humbled that all of these friends showed up for me. I have been on the giving end of such support for others in the past, but I have never been on the receiving end.

It's hard for me to believe that it has been a whole year since this horrible accident took place. Early on, my good friend Greg, who has experienced two spinal cord injuries in his life, said to me:

'Just make it through the first year and everything will seem so much better.' 

He was right and this advice was poignant, though it took me a long time to really put it in perspective.

At the time, this seemed so far away that it was difficult to imagine. For a while, I even had this perception that I would actually return to what used to be normal for me. But, over the last year, I have come to realize that I need to get used to a new normal. The most difficult adjustment is my inability to run and cycle like I used to do so often.

Current Status

At this time, I am still paralyzed below the knees but I am hopeful that my body will continue to heal. I have so much more feeling in my feet after one year and I'm very hopeful that I will regain movement over time. Because of the paralysis, I wear leg braces to be able to stand and walk, and I also use arm crutches for balance. I am lucky enough that I can get around at home without using the crutches and at I have even started using only one crutch in places that are level and familiar to me.

Most people have no idea that a lower spinal cord injury like mine (L3-L4) often affects a patient's bowels and bladder function. Your digestion slows down due to the nerve damage and your ability to empty your bladder on your own can be affected. I still deal with some issues in both of these areas, but not to the extent that I did through the first eight months. I'm lucky that my body has healed the way it has and that there is medication to help things along otherwise.

For some time now, I have been riding a stationary bike, doing lots of leg presses and walking much longer distances. I still see a physical therapist, but only for guidance and direction. All of the PT related activities I do are driven by me alone. I have experienced the need for PT previously from knee injuries so I already understood how it important it is to have the drive to push forward on my own. Luckily, all of these activities have helped me to recover from a fair amount of the muscle atrophy that took place from being stuck in a hospital bed and a wheelchair early on. But I still have a long way to go.

Riding a Bicycle 

In addition to riding the stationary bike, Janene recently purchased me a 3-wheel bicycle. While it's not the same as riding a road bike or a mountain bike like I used to do, it is very similar and it allows me the freedom of being on a bicycle. Strangely, we had a difficult time finding a shop that was willing to assemble the bike for us. I guess lots of shops aren't familiar with them and each one can be so different that they cannot predict the time it will actually take. Luckily, the Bikesmith in Boulder came through and was happy to do the job.

While riding, I do have a hard time keeping my feet in the proper place on the pedals, so I am thinking about putting some toe clips on there. Also, the seat is not very comfortable on my sit bones due of the muscle atrophy in my butt. I'm also hunting for some other seats to help me tolerate not only sitting for a longer period of time but also the bumps on the streets.

As I mentioned it's not the same as riding my road bike and climbing steep mountain roads like I used to love doing so much, but it's the best thing I can do at this time. I'm so grateful that my wife is encouraging me to do something that I love, even if it isn't exactly the same as it was before.