Ramblings on healthcare, medical education, and life with a spinal cord injury
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Hi from Cleveland

Well, I never thought it would take this long to resume writing here, but apparently it has. I’ve mentioned in the past the intention to somewhat transition the blog to a discussion of not only my recovery, but also life as a medical student. So this is the first step in that direction. In addition to progress updates on my recovery, I’ll discuss topics I find interesting or relevant that are related to healthcare, as well as certain experiences I’ve had as a medical student. Updates will be shorter, but hopefully more frequent than they used to be (the past six months excluded, of course). There have been plenty of topics as of late that I’ve wanted to write about, from healthcare reform to cancer to H1N1.

But first, a much-needed progress update.

I’m going to let you in on a little secret – it turns out doctor school is a lot of work. Now, I know that may come as a surprise, but it really is. After making the move to Cleveland in June in preparation to start school, I got caught up tying up some loose ends on technical projects I was involved in as well as transitioning my physical therapy to local resources, getting moved in, and getting ready to start school. Once school started, I had to basically learn how to be a full-time student all over again Suffice it to say, it has taken a while to really get on track managing my time efficiently again.

For the first month after moving to Cleveland, I started doing my PT at MetroHealth. They’re one of fourteen (or eighteen – hard to tell from the various online resources) centers in the US designated by the National Institute on Disability and Rehabilitation Research as a “Model Center” for SCI research and rehab. Sinai in NY is also one of them. My docs in NY had recommended I get in touch with a particularly qualified physiatrist based at Metro, Dr. Greg Nemunaitis. So I did.

Rehab there went well, but since Metro is on the other side of Cleveland, it wasn’t a practical solution once classes started. So under Dr. Nemunaitis’ guidance, I transferred my care to the rehab department of University Hospitals, one of our teaching hospitals. Since it’s on campus, it’s ideal.

When classes started, the focus of block one, our first six weeks, was on epidemiology and public health. As part of it, we were all given pedometers and told to keep track of how many steps we all take within a given day. There was a recently discussed recommendation that everybody try to take 10,000 steps each day for better health. So the faculty wanted us all to take the 10,000 step challenge as well, and they made a competition out of it.

Although 10,000 steps was more than just a bit overly-optimistic for me, I spoke to the people running the challenge and suggested that I keep track of my steps but be allowed to use a multiplier. I wasn’t expecting to break any records, but at the very least it would give me some guidance as to my progress. And knowing me, having a concrete metric to measure my progress by would make me push myself that much harder.

So for the past three months I’ve been keeping track of how many steps I can walk within a given day. So rather than describe it, here’s a picture:

2009-11-18_Steps

The thicker line is actual steps at a given point of measurement, and the thin line is the five-day moving average.  The dip that occurs in September was due to some recurrent problems with my knee.  It seems I’m going to always have to be conscientious about it from this point on.   Regardless of that, I’ve moved from a max in the 500-600 range when I first started three months ago to a current best of 1200 steps in a given day within the past couple weeks.  So I’ve doubled my progress in that time.  Not bad, I don’t think.

Also, the moving-average has improved from around 600 in the beginning to around and above 900 recently.  Including the dip in September, I think that’s pretty good.  Both Cynthia (my PT back in NY) and my current PT didn’t feel there was any problem with me walking by myself at home, so I’ve been doing just that since July in addition to regular PT.  One of these days, I want to try walking to school in the morning, with a friend walking the chair.  PTs and doctor have all said that’s fine, and obviously I wouldn’t do anything crazy like try to walk across the street or through traffic, but it would be a good exercise.

Additionally, my steps have gotten more regular and more properly formed.  Although I’m far from walking normally at this point, I’m able to take a series of steps in succession without pausing between each one.  My current physical therapist has been putting a lot of emphasis on proper form, and I think this has a lot to do with it.  Both of my heels typically hit the ground first, as opposed to the balls of my feet (which has only started to happen consistently within the past few months).

I’ll continue to post updated versions of this graph from time to time, just to give an indication of my progress.  And maybe one of these days I’ll record a video.

So that’s where I’m at, recovery wise.  There probably won’t be any major milestones any time soon, since the process is slow.  But I figure as long as I can keep making that graph go in a generally upward direction, I’m in good shape.

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