As Dan Via lay face down in the surf in Corolla, unable to move his arms and legs, the thought flashed through his mind: "I'll probably never ride my bike again."
It was Labor Day weekend and the Williamsburg pediatrician, then 51, was relaxing at the North Carolina beach with his wife, Susan, and their younger son, Nathan. The family had had an emotionally grueling summer with the acute illness of his 90-year-old mother-in-law; and a week earlier, his older son, Forrest, had left for his freshman year at Radford University.
At midday, in slightly choppy chest-deep water, Via was lying on a boogie board, when a strong wave caught the board and propelled him forward face-first into the sand. He remembers the blow. His neck hyper-extended, the force of the water tore the ligaments and ruptured a disc in his upper neck. But he never lost consciousness — not as strangers dragged him to safety, not while the local emergency crew stabilized him, and not in the Nightingale helicopter as it transported him to a hospital in Norfolk. Later that same day, after extensive screening tests, he had a bone graft and a steel plate and screws inserted in his spine to fuse discs C3 and C4.
He was effectively a quadriplegic with an uncertain future. His doctors weren't optimistic that he'd walk again. They thought he might learn to feed himself.
Via has defied the odds. Last weekend, as part of the 100-mile Cap2Cap ride from Williamsburg to Richmond, familiar territory for the cycling enthusiast, he rode a full 25 miles in a recumbent bike. "It eliminates the balance issue," he says, somewhat ruefully of his low-to-the-ground three-wheeler.
Family and community support
In January, just four months after the accident, he returned part-time to his medical practice, Sentara Pediatric Physicians. "I think he has increased the demands on himself and is now probably seeing the same number of patients as before," says Jennifer Altman, one of six physicians in the practice.
Initially, she says, his colleagues were concerned about how the emotional and physical demands — dealing with a squirming 15-month-old, for example — would affect his healing process. The fears proved unfounded. "It sounds trite, but he has been inspiring to us in the office and to his patients as well. Children don't notice his disability, they see past it," she says. "I'm able to see his improvements day to day and week to week. He has become much more his old self. This is his second home."
Slowly, but surely, Via is defying his doctors' gloomy prognosis and regaining full function. "When I look at him now, it's just like he has arthritis," says his wife, Susan, who took a leave of absence from her job teaching violin at the College of William and Mary to look after him. "She was steadfastly positive," he says.
The couple met as musicians for the Virginia Symphony, where Via played the double bass for 7 years prior to returning to his undergraduate alma mater Duke for his medical degree. "He's a really, really talented natural musician," says Susan, noting that he went to Juilliard, a top-ranked music school.
The couple continued to perform in chamber concerts together up until the accident. For months afterward, Susan didn't practice the violin in the house out of sensitivity to Dan's feelings. While he's only picked up the bass a couple of times since and says he doesn't have the necessary fluidity of movement or the range of motion to play, he has resumed playing the piano.
It's his somewhat labored gait, using a single stick for additional support, that still frustrates Via. "I have to focus and concentrate every minute," he says. Any fall — and he's had one — is intrinsically dangerous to his hard-won recovery.
Working to regain function
Less than a week after his surgery, Via was transferred to MCV in Richmond for inpatient rehab. For six hours daily for six weeks he had physical, occupational and speech therapy. Within a week he started to get a little movement in his left hand; by the end of the second he was using a splint attached to the hand to help feed himself. For three weeks he did strengthening exercises to improve his swallowing.
He had Botox injections in his legs and, with three or four nurses holding him, moving his legs for him, he gradually relearned how to walk. In six weeks, he progressed from not being able to sit up — just listing to one side — to taking shuffling steps with a walker for up to 50 feet. He also regained the ability to shave and brush his teeth. He was most thankful that after two months he regained control of his bowel and bladder functions.
"I wanted to do absolutely everything I could in the first six months when progress is the most rapid with spinal cord injuries, and then build on that for the next 2 or 3 years," he says. He admits that he was at his lowest spirits at the very beginning, but his incremental improvement and the support of family and friends buoyed him.
Once released, he started going to Sheltering Arms, a Richmond facility that specializes in spinal cord injuries. Friends and family took turns making the daily drive for the 5 or 6 hours of daily therapy that resulted in more slow, steady progress. He started to regain some use of his right hand and arm and started walking with two canes. From there he headed to the Shepherd Center in Atlanta that specializes in spinal cord and brain injuries. There he mingled with dozens of patients from all over the world who had similar experiences. "It was very positive from a practical and emotional standpoint," says the 6-foot-1 physician. "There was a real mix of functionality. Some were permanent quadriplegics; others — like me — were improving but not certain where they'd end up." The practical advantages included resources such as water therapy and zero-gravity exercises using a parachute harness for walking.
Fears, frustrations and biking
In Atlanta, therapists put him on an upright bike, an experiment he's not yet ready to repeat, though he now has a road bike set up as a stationary trainer in his home. They had him drive around Atlanta for an hour as part of driver re-training. His foot got stuck behind the brake pedal. A larger brake pedal in his car and a shower rail and an extra set of banisters in his James City County home are the main modifications the family has made to accommodate his physical limitations.
Mostly Via misses the biking he'd become accustomed to over the past four years, when bad knees forced the switch from running. He would crank out 150 miles a week on the road, 5,000 to 6,000 miles a year, he was constantly updating his bike and finding just the model to meet his needs. "It was a big part of my day-to-day life," he says. He would ride to work, ride in groups, ride with friends, and he loved to ride solo. "If you're out by yourself on a Sunday morning it becomes a Zen-like, spiritual experience," he says.
A friend who had a similar injury lent him his recumbent bike. He has worked his way up to pedaling 20 miles at a stretch on a regular basis. "It's amazing to be outside, on the road," he says.
One of the hardest things has been reintegrating into society. "You feel like you fit in in these rehab places," he says, getting up to stretch his limbs. "In normal life, you feel self-conscious and conspicuous. I'm aware that people notice that I'm moving differently."
On the plus side, he has become more patient and a better listener.
"I can't be in a hurry," he says with a wry grin.Copyright © 2015, Los Angeles Times