This past week I have managed to stand twice a day for 30 minutes each time. This is a really great development, suggesting my knee has finally mended itself.

On Monday I will, once again, re-start the walking program.  Thankfully, my big brother Colin arrived in Kunming a few days ago, coming all the way from Atlanta, and he will be here for another week.  Colin is a very strong and tall guy, coming in at around 6’4”.  He will provide extra insurance in case anything goes sideways when I start walking next week.  The idea is that he will step in and help get me sitting quickly if he thinks I’m about to get injured again.

My neck is also on the mend and only starts to ache after many hours sitting upright without my neck brace in the afternoon. With that said, I was able to use my manual chair yesterday for the first time since the surgery and get out of the house to go hang out in downtown Kunming.  It was nice to see the “outside world” again as I’ve spent the last eight weeks either at the hospital or in my apartment.

I must admit, though, it has not been all that bad being cooped up in the apartment recently, because my mother and a now a dear new family friend, Fried, have transformed our backyard into the most unbelievable little garden, filled with fruit trees and plants … strawberries, blackberries, blueberries + oranges and figs and even a beautiful peach tree.  Yunnan Province must be pretty close to the Garden of Eden.  Everything seems to grow here in great variety as well as abundance.

Fried is a German fellow who has been living in Kunming for almost a decade after bicycling over here on his own all the way from Germany!

Today Fried has a Chinese wife and infant daughter and owns the premier late-night live music bar called the “Moon Dog” where foreigners and locals alike hang out for the amazing whisky selection as well as live music.

In Germany Fried also practiced professional landscape design and thus had the experience (and local knowledge) to help Mom turn a backyard full of weeds into a little slice of paradise in the space of just two weeks!   And now we even have a beautiful patio area where we can smoke Padron cigars in peace.

🙂

Panoramic view of the garden

Electric gateway to our secret garden!

View towards my bedroom window.

Blueberries … strawberrries … eat ’em as you pick ’em!

Fruit and herb section of  new garden

Still to go is a vine-covered trellis for shade.

Over the last few days it has been pouring cats and dogs in Kunming, and we were worried that our garden would be washed away.  To our surprise and delight, not even one flower was destroyed.  However, downtown Kunming experienced flooding that reminded me of Miami after a hurricane.

Downtown was so flooded that thousands of cars were washed away … people in makeshift boats were paddling around many streets in stiff currents …  and many hundreds, if not thousands of businesses were underwater … this in a city with more than 7 million population.

http://shanghaiist.com/2013/07/19/photos_heavy_flooding_in_kunming.php

Luckily, I live in the South West of Kunming where the floods were relatively minor.

My father left this afternoon for Hong Kong on the first leg of what we not-so-jokingly refer to as his first  “Global Pain Tour” … scheduled for the next month.   As my regular readers will recall, my neuropathic pain has unfortunately not decreased since the surgery and continues to seriously impact my rehabilitation on a daily basis.  And allodynia makes even touching my hands and arms feel some days as if glass from a broken bottle were being ground in!  I will go into more detail in future blogs as our pain management strategies develop.

The initial Global Pain Tour involves meeting both research neuroscientists as well as clinicians offering strategic insights as well as potentially useful therapies, all of which I’m game to try.  Meanwhile, we have just launched a parallel effort here in Kunming, which is a major centre for Traditional Chinese Medicine.  Specifically, we are investigating qigong breathing, acupuncture and well-proven, herb-derived nerve pain medicines.  East meets West … again!

I will also be adding pain management as an additional focus to this blog, because a recent U.S. government sponsored grant revealed that approximately 75% of spinal cord injured patients suffer from some form of neuropathic pain.  Many of my SCI friends rely on long-term use of drugs to reduce pain.

My dad and I intend to lay out many different pain management options for the SCI community, because relying on drugs, which admittedly I do at the moment as well, is not a long-term sustainable solution.

Sorry to have been off-line for more than a week, as I have been working flat-out to recondition my injured right knee.

Believe-it-or-not … turns out I’d broken my leg!

Yep, major fracture right above where the femur joins the knee.

Broke my leg after I broke my neck!

This plainly did not happen recently, as it had healed pretty well and without mis-alignment.

But it seems likely that the ligaments that hold my right knee together had been compromised by whatever caused such a major fracture.

I’d been able to stand okay here in Kunming, but once I started to “walk” the right knee gave way … and, as they say in boxing, I was down for the count.

The break was discovered after I stopped resisting the medical advice from the team here and agreed to an MRI.  Because getting into an MRI machine is always such a hassle for me, I can be really stubborn about all but essential MRIs.

So in recent weeks I’ve been working with a heat lamp and exercises to strengthen the knee, and yesterday I was able to stand again for 30 minutes, bearing 100% of my weight and without evident stress.

Next I’ll try two 30-minute standing sessions daily for a few days, and after that I’ll give walking another go.

Otherwise, I’ve been using the VitaGlide to strengthen my neck and shoulder muscles, and this has been going pretty well.  My neck is strong again.

On the pain front, not such great news yet.  I am still dealing with neuropathic pain, and recently my major challenge has been something called “allodynia” — http://en.wikipedia.org/wiki/Allodynia

Allodynia feels like having glass ground into my arms and hands and has kept me away from my keyboard much of the time.  The pain gets worse in the afternoon, and at night it keeps me from sleeping.  In order to get some sleep, for now I use drugs – alternating Amitriptyline and Lorazepam.

I really don’t like using drugs, so this summer my Dad and I are digging into a wide range of clinical research related to pain management.

We are also investigating Traditional Chinese Medicine, which naturally has a huge following in Yunnan Province.    Indeed, here in Kunming we have on offer world-class acupuncture as well as a range of herbal remedies that proprietary pharmaceutical drugs mimic to varying degrees.

I am also investigating hypnosis, and hope to learn a lot about self-hypnosis.

Finally, on the lighter note, here’s my favorite photo of the week … talk about a “Kunming Walking” protocol … 🙂

Photo by Dad on his own country walk …

It has now been about six weeks since my spinal cord surgery, and I am happy to say that my neck is mending very well.  It’s still a little sore, but I workout my upper body every day with weights and VitaGlide in order to strengthen the muscles surrounding my neck.

So here’s the story of the surgery, with some unusual illustrations courtesy of one of my physical therapists who routinely photographs and videos major surgical procedures in Kunming.

I remember being put in the hospital gown the morning of the surgery and rolling into an ultra modern operating theater that had been designed for Tongren Hospital by Australians.  My anesthesiologist, Professor Wu, who is the recently-retired chairman of the Department of Anesthesiology at Kunming Medical University, taught most of the anesthesiologists at the Peoples Liberation Army Hospital as well as in other major hospitals in Southern China.

Dr. Wu spoke flawless English, and I attempted to have a conversation with him, but I think his mind was focused on other things as he quickly put a mask over my face, and then I was out like a light.

The following photographs were taken by Niu Fang, the physical therapist I mentioned above.

The surgical team getting ready for surgery

This diagram illustrates the numerous layers surrounding the spinal cord.  Dr. Liu had to drill away the bone of three vertebral lamina (C-5 through C-7) to gain wide “barn door” access to my spinal cord.  Then in order to secure my spinal column at the end of the surgery, Dr. Liu used part of the vertebrae he had cut away, crushed up to make a sort of mortar, to reinforce positioning of the three titanium rods and six screws he used to stabilize my spinal column.

On a side note, my brother Mattias had the nerve to ask Dr. Liu if he could please save a small piece of my vertebrae as a keepsake!

Yes, that is how much I love my brother … how many many sisters would offer a piece of their spinal column as a gift?  🙂

Before the dura mater is opened … this is the scene

First a small puncture of the dura mater … and then a CSF gusher!

The dura mater is now wide open, exposing the pia mater in order to gain access to the arachnoid cyst on the anterior side of the pia mater, and also revealing 2 small syrinx cysts just inside of the pia mater that were successfully drained.

My surgical team deep in concentration

`

Sleeping peacefully on a lot of drugs right after the surgery 🙂

I have to admit that at first I was hesitant to look at these photos or watch the videos because I thought they might make me a little queasy.   However, I actually found these photo records very informative and wanted to share them with my regular readers.  I doubt many of you have ever before seen the inside of a spinal cord, so here you can have a peek at mine!   (If you’ve any questions about all this please feel free to e-mail me.)

Finally, there were two videos taken during my surgery. I have decided to post these on YouTube because they serve to illustrate a very important outcome of the surgery that could not be seen in a still photograph.

In the first video, note carefully that my spinal cord is not moving at all, being literally stuck in place by scar tissue and wedged in tightly by the big (3.5 cm) cyst.

Also worth observing is the absence of blood.  Dr. Liu is one of the very top neurosurgeons in the world, and his mantra is “no blood” when working on an open spinal cord.   On top of the pia mater you can actually see the tiny, delicate blood vessels that supply the spinal cord, and none of these have been nicked.  I lost virtually no blood during the entire surgery.

In the second video, after the team have surgically drained the big cyst and cleared out the scar tissue, you can actually see that my spinal cord has started beating again in rhythm with my heartbeat.  I learned that your spinal cord is supposed to pulse naturally with your heartbeat and breathing, but mine had unfortunately been frozen in place for over two years.  😦

It is incredible how Niu Fang captured all this on film … see for yourself!

Video 1:  No movement of the spinal cord: http://www.youtube.com/watch?v=w2soHLDNiWY&feature=youtu.be

Video 2:  Spinal cord is again pulsing with the beat of my heart: http://youtu.be/KW2s-eOMcD0