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Category Archives: physical therapy

Physical therapy update

News on the PT front. For the last several weeks, E has been working on trigger points that affect my back. She’s been able to progressively go deeper on the trigger points, which is a good thing. It means the tp’s are getting worked out…it also means OW OW OW OW OW. Jeezus, that woman has tough hands.

But something has been working, because the bad knee that never wants to straighten has gotten one degree away from being straight. The other knee is almost back to being hyper-extended (which they both used to be waaaaay back before I first started abruptly having problems with them). We both kind of surmise that after all the work strengthening my muscles and then loosening up all my trigger points (varied and vast), I finally made progress. So after my appointment, E pronounced that she would see me in TWO WEEKS. It has only been about a month or six weeks since I’ve started seeing her only once a week instead of two…now I’m being moved to every two weeks. I suspicion I’ll be having withdrawal symptoms this week, since I won’t see E at all.  I can’t tell you how long I’ve been seeing her…I can’t remember anymore. It’s been probably close to 18 months altogether, considering how many different body parts I had to work on.

Starting tomorrow, it will be a week since I’ve had PT. That’s not entirely new, but we’ll see what happens in the days following. I haven’t gone without PT for more than about 7 or 8 days in all that time. Already my back and knee are tired today, but maybe by tomorrow they’ll be feeling better (I had to stand around for over an hour during training with Butthead, so….)

Anyway, the good news is, if I can keep things in good form, I can stop going to PT. While I will miss E a lot because I like her very much, I won’t miss having to go to PT once or twice a week every single week for …ever. However, I am thinking I will start going to get trigger point massage from a massage therapist (who used to share space with my PT office), maybe once a month to keep up with maintenance. Trigger points definitely come back, especially in someone like me who is not only prone to them, but has myofascial pain syndrome…kind of pre-disposing me to issues like this. On the down side, massage therapy isn’t covered by my insurance…but I’ve been paying co-pays for PT, so it will actually be less expensive for me to go to massage therapy once a month than what is cost in co-pays four times a month. And waaay less than it was costing me to go eight times a month!

So, one tentative step forward, and we shall see where it leads.

 

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Travel me this…

We went and done did the vacation. And now we’re back, to which my entire body says woohoo.

The drive to the lake was completely uneventful, save for the climb in elevation that made our ears pop over and over again. We made a quick stop at a farm on the way to the lake so we could take a tour that they offered. After that, it was onward to the lake area. I was nervous about the hotel we were going to be staying in, despite the fact that I did lots and lots of research. I knew it was going to look old on the outside, but that the rooms had been renovated recently on the inside. And that is exactly what we ended up seeing.

Unfortunately, the first room we were assigned to had some problems, so they moved us to an adjacent, identical room. Not a big deal considering it was off-season and we were one of three rooms rented in the whole place. And although the rooms were very clean and very nicely decorated, they also turned out to be pretty small. I thought I had remembered that there was a small couch in the room, but that was not to be. The room had a bed, a place to set your keys under the wall-mounted flat screen tv, and a very shallow/small desk with a straight chair. There was no closet to hang our winter coats, no place to put our suitcases except directly on the floor, and no mirror in the room. No place to put our clothes in drawers if we had wanted to. The bathroom was very very small, with no counter top space for our toiletries. Again, the bathroom was spotless and clearly updated, but almost claustrophic-small. There was a teeny tiny refrigerator and a microscopic microwave, both crammed into an alcove that probably could have been laid out better. If they had put the fridge on the floor (in the space that seemed provided for it) and the microwave above, they could have used the higher space for a small closet or just open hanging space.

We had a very small private deck off the back that led down to an open grassy area, that then led directly to a finger of the lake. It was lovely, though slightly marred by all the docks that were pulled up onto the grass, and the not-so-attractive facility across the lake. The people who were running the hotel were very nice. I have no qualms about any of what we had, with the exception of overall space (which is my fault for not paying better attention, I guess, when I was researching the rooms).

The major issue? The bed was horrible. Horrible in the manner of we both slept fitfully the two nights we were there, waking up in the morning sore and exhausted. There was not a stitch of padding on the bed…all you felt was hard surface and the springs below. I actually tried to put the comforter underneath me as padding and slept with just a sheet the first night, but the comforter did absolutely no good. We were both so body-sore in the mornings that it was a pretty big black mark on the weekend.

We found several restaurants that offered gluten-free options, so I was able to eat pretty comfortably all weekend. We did a little shopping, then did our sight-seeing thing. It was nice to spend time with Hub away from the dogs and away from everyday responsibilities. The drive home was fine, too. We both slept so poorly the night before that we were both awake by 7am and we were on the road home by 9am. Checkout was 11am, but we were tired and sore and only wanted to be done at that point. It was very unfortunate.

My parents seemed to do okay with our dogs. I’m told everything went fine, but I did hear a couple of times (from my mom) that Butthead barked a lot at night. I tried to warn them, but I guess they didn’t realize… But they survived the weekend with the dogs, and the dogs survived a weekend with my parents (and brother), so all is well.

I’m glad I go back to see E for physical therapy tomorrow. I’ve got a stinger going up my hip and to my back that is really hurting me. I’m guessing it was the crappy bed that did it. If we ever travel again, we’re going to have to bring our own bed.

(that’s a joke, because we’re never going to travel again) (hee hee)

Ooooh, I almost forgot to mention, one of the places we went sight-seeing included a hike in the woods. We weren’t particularly prepared for the length of the hike, but I did it! It was 30 degrees out and snowing, and there was a lot of ice on the path and the stairs along the path, but we did it. I didn’t panic when I got tired, and I didn’t panic when I thought about how deep into the woods we were and what might happen if one of us got hurt or one of us had a heart issue. On the way in we were enjoy the nature around us, and on the way back I was more thinking about how tired and cold I was, and wondering if I was going to make it out of the hike without just sagging to the ground. But hey, I did it, and I survived it without an attack. WOO!

Here are a couple of quick nature photos. Enjoy!

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You put one foot in, you take one foot out

I doubt highly I’ll be doing much shaking about. *sigh*

I had my follow-up with my orthopedic doctor today, post MRI of both of my knees. I’m not fond of the MRI process, but luckily this was an open MRI and the technician was very nice. I was uncomfortable–mostly because of my back–but I made it through without any real anxiety attacks or panic attacks. There were a couple of points where I was not thrilled, but I centered myself and kept myself in the moment…and I completed both knees and got myself out of there in tact.

Back to today’s follow-up. My regular ortho was apparently running late, so his colleague came in to get started talking to me. She brought up my MRI pictures and started pointing out good things…and bad things. Part way through the conversation, my ortho joined us.

Good news…no meniscus damage in either knee, and although both show normal meniscus wear, they are also considered to be in good shape. Yay. Bad news…I’ve got arthritis in both knees that are slightly more advanced than someone my age. Boo.

Good news…no surgery required to repair my right knee. Yay. Bad news…even PT is not going to resolve my pain or the glorious popping in my right knee. Boo.

Good news…nothing physical blocking my left leg from straightening all the way. Yay. Bad news…it may never straighten out, even with continued PT. Boo.

Good news…the doctor doesn’t want to see me back unless something changes that requires attention. Yay. Bad news…I have to continue to live with the pain and limitations that I have right now (and they might get worse). Boo.

So the appointment was mixed. And on top of that, he suggested that I could continue with PT to straighten my left leg, but only if I felt I could accomplish it without pain. He said he would be satisfied with the extension that I have now, but that it is my choice. The issue I have with staying as-is, is that I walk with a limp because the knee is bent slightly, which throws my entire body off-balance. I believe it is affecting my back and my neck, and really my whole system. I think it is responsible for some of the trigger points I have in the area, too. If I stay as-is, I continue to make my body cock-eyed. If I attempt to continue with PT, I could put myself in more pain for possibly no reward.

Muh.

Meanwhile, he did tell me that my right knee, the one with the major pop (which comes from a defect behind the knee cap or on the bone that rubs against the knee cap…I can’t rememember which), will always give me limitations on some movements. Like getting up from low chairs (check) and walking on inclines (check). He said if it came to a point, I could get a brace to help me with any major activities. He wants me to leave that as a last resort because he says it could become a crutch…and instead he wants me to continue to strengthen the muscles around the knee to act as a “natural” brace. I’m already on that path with PT, so that gets a check-mark, too.

And thus, my appointment with the ortho ends and I go home. And wonder WTF to do now.

 
 

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Trigger point therapy

I have had trigger point therapy before. When I first got sick, I had a terrific massage therapist who used both East and West techniques for her clients. She was French, she did shiatsu, massage, physical therapy, accupuncture, accupressure, and probably more. I liked her a lot; she helped me very much over the course of eight months. But at the time, I was in so much pain overall and felt so crappy, I don’t recall how intense the trigger point release was. These last couple of weeks, E has been doing trigger point release for me, and it has hurt like hell.

I have two areas that E has been working on. E is incredibly adept at finding the trigger points, and every time she finds these particular ones, I end up clutching the table and attempting not to bawl (or scream). At least, not out loud. Today I had to wipe my eyes a couple of times because the pain was so intense. At one point, she was working hard on a trigger point that didn’t seem to want to give in (not a shocker for me, as my body is pretty stubborn), and she asked me how my weekend was. For once in our entire time working together, I was really only able to mutter that I couldn’t concentrate on our conversation because not only was the trigger point burning like a mo’fo, but the pain was referring up my back like smokey fingers burning pathways toward my neck. It was bad, ya’ll. E apologized, but didn’t let up, because the knot needed to be released. I just wish it didn’t hurt so damn much.

E went to a class over the weekend for a technique called “dry needling” for trigger points. She thought I might be a candidate for the technique, so she was excited to go to the training. However, when I saw her at my appointment today, she kind of nixed the idea. She told me that the technique was pretty painful…worse than the pain I was dealing with as we were talking (while she was releasing the trigger point in my thigh). She said she and her partner had to stop several times because it became so painful they couldn’t handle it. And they both have pretty good thresholds for pain. So I was just saying NO NO NO, keep those dry needles away from me! I couldn’t imagine the amount of pain they had gone through over a three day period of training. Yikes.

We aren’t even sure the knee pain I’m dealing with (on one side anyway) is from a trigger point or not. It actually came to me after she worked on the trigger point on my butt… I went to my big fancy book, The Trigger Point Therapy Workbook by Clair Davies, and went searching for the pages I had marked previously. One of them was for the exact spot where the pain had been bothering me. I think I had guessed in the past that maybe it was a trigger point and had tried to release the trigger point myself, but hadn’t been successful. But hey, why not bring it up to E! So I brought my book with me to one of my appointments and she started working on the specific trigger point I had marked in the book, and I’m partly hopeful that it’s working. The thing is, immediately after the release, the pain has subsided. But it doesn’t seem to last long…which is disappointing. I’m not sure if we can pin the pain on the trigger point or not… (there’s a birthday game for you! Pin the therapist’s hands on the trigger point?) Then again, the trigger point on my butt is taking some time to work, too. But the relief from that one lasts longer…

Who the hell knows, right? And yet we persist…

Tomorrow? MRI of both of my knees. Two hours in the MRI = so much fun. NOT.

 

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We interrupt this day

To schedule a muscle spasm. X 2.

Last Saturday morning (roughly 9am), I was reaching down to brush Le Moo and ZZZIIIIIPPP the muscle along the top of my right shoulder that connects to my neck decided FUCK NO YOU WON’T! I spent the remainder of the day in ranging levels of discomfort, from OH SHIT to OW OW OW. I had trouble sleeping that night and couldn’t turn my head to the right hardly at all, and turning to the left brought enough unhappiness that I pretty much stopped doing that, too. I was barely hanging on to hope that I’d be able to see E on Monday and she’d work on the muscle and make the pain go away.

Then it snowed.

Started early Monday morning and continued through the day. By 10am I received an email stating that the PT office was closed and I was shit out of luck. I had already heard that this week was booked tight, so I was really thinking I wouldn’t be seeing E at all since I only had one appointment this week. So Tuesday morning–after another hours of spasms the night before that made my head twitch and another rough sleep–I called the PT office first thing in the morning. It was barely ten minutes after they opened and I was itching to get in contact. Luckily for me, they were able to fit me in before lunch that day, and I went in for my appointment.

E worked on the muscle and told me she could feel the spasm. When she was done, I had some relief, but by the time the afternoon rolled around, I was in pain all over again. Every movement I made felt like I was jarring my neck and shoulders against a brick wall. And last night I had a repeat of the twitchy-spasms for several hours. I wanted to cry because I felt like all the work E did had made no difference. Sleeping was uncomfortable and restless.

Then this morning I woke up and thought…ah, it’s okay! E really DID make it all better. Well, not ALL better, but waaaay better. I was able to move around without that jarring pain, even though I still felt tender. And as the day went on, I felt more and more relaxed and able to move my head more. Day went by, things are still good. Dinner, no problem. Came upstairs and did some stuff in the laundry room, all was fine. Then I picked up a step-stool that belonged in the pantry downstairs, so I carried it to the steps and asked Hub to reach up to grab it from me so it could go back to it’s storage place. However, his reach wasn’t as long as I expected and as I extended my arm (without thinking, of course) so he could take it….zzzzzzzzzziiiiiiipppppppp.

The same fucking muscle seized up and I literally yelped out loud. By this time he had the step-stool in hand and I yanked my arm back over the banister. I leaned over and put my forehead on the railing and I cried. Hub came rushing upstairs to see if he could help me, but I don’t think there is anything that can be done. I’ve got my shoulder down and am continuing to try to stretch the shoulder and neck muscle, but I feel it so tight, waiting to snap short again. I didn’t ride the bike last night because the pain was so bad, and now I can’t ride again tonight. And I go to the orthopedic doctor tomorrow to talk about my knees…I have no idea if I’m going to be able to drive (let alone sleep tonight). I’m not even sure I can go shower and wash my freaking hair…and shaving my legs? Not going to happen, sorry for the stubby/hairy legs, doctor.

ARG. Did I mention that things ALWAYS go bad when we try to take a vacation away from the house? @#$)(*%Y)#_$)@(#%

These spasms are driving me crazy. WTF WTF WTF

Also, OW OW OW.

 

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Really, I’m a 90-year-old woman

I’d like to introduce you to me–today–as the real 90-year-old-woman I am. Every single bone in my body is telling me that I am actually 90 years old. It all hurts…pretty much every single joint. It’s been getting worse over the last couple of weeks. I’m not sure what happened, but I’ve been heading downhill in terms of pain and ability to move without said pain. The newest place is my hips. Originally, it was only my left hip, but now both hurt…along with both knees, my back, my arms, and my finger joints.

It suuuuuuuucks. I’ve just spent the past half hour crying on and off. I’m frustrated and I’m tired. I haven’t been able to sleep because I can’t get comfortable, which of course makes everything worse when you are sleep-deprived. And I know I’ve written about this before, but today…right now, it’s worse than it has been in years. I am literally shuffling around to move. I considered borrowing a walker from my parents’ house, but I don’t want them to know how badly I am feeling.

I have PT today. I’m not sure how I’m going to make it through. I don’t want to burst into tears in the PT office. I’ve already done that twice here at home.

***

So I went to PT and talked to E (my physical therapist) about the pain in my hips. I told her how much pain I was in, and that I was feeling like this must be some kind of systemic flare. But that at that moment, I was having so much pain in my hips, so could she check it out. She checked my back first and found I was out of alignment in several places, so she did some adjustments. Then she found my ribs on one side were not moving the same as the other side, so she tried to do an adjustment there. When she was done with that, she started checking out where the pain in my hip was coming from. Fortunately, or unfortunately, she found that the pain wasn’t coming from my hip, it was coming from my back and butt. And as soon as she started working on the trigger points, I remembered… We’d been through this before, last spring, when I was having back issues. She found some holy-hell trigger points on my glutes that made me cry it hurt so much. Rinse and repeat. I was nearly in tears, clutching the bed I was laying on as she worked on the trigger points again.

Good news is, since I’ve been home, I’ve been up and down out of my recliner and the hip area hasn’t hurt. So clearly she found the problem, but damn that hurt. I’m going back later in the week to have her work on it again, but she reminded me of the exercises I need to do to keep the areas stretched and loose.

This doesn’t address my arms or my knees, but if I’m having trigger point flares in my glutes, it stands to reason I’m probably having flares all over. Which blows chunks. I’m trying to eat more anti-inflammatory foods (made a pineapple-walnut smoothie with greek yogurt this afternoon which rocked the casbah), so maybe that will help, too.

I wish I could go to E every week forever. Insurance tells me otherwise, unfortunately. Last year our insurance had no max on the visits, but we changed plans this year and now I have a cap. Fucking sucks, that’s for sure.

 

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Guilty me

Does anyone else have this issue? Do you feel guilty about, say, everything?

Last week I had a PT appointment setup for Wednesday. This was right around a big snowstorm in our area, plus it was frigid cold. I went to a doctor’s appointment in the terrible storm with my mom…the roads were horrible, it took us twice as long to make the drive as it normally would. When we got home, I called my PT office and cancelled my appointment. In the year I’ve been going, I can count how many time I’ve had to cancel on one hand. Not even a whole hand. But I felt terribly guilty because I know E loses money from the appointment. Plus, it wasn’t the full 24 hours they request. But I was so tired from Mom’s appointment and I knew we were heading for multiple appointments on Thursday…and the Wednesday I was due for PT was supposed to be SOOOO COLD…and I’d need my father to drive me because of the roads. So I cancelled. And I felt shrouded in guilt.

Monday morning, which was supposed to be PT for me, the office called early to tell me that E had the flu. The prior week, the other physical therapist was out with the flu (Hub’s PT), but came back in time for his next appointment. Then hacked and coughed all over, although she wore a mask during the appointment. It scared the crap out of me because she could have given it to Hub (and subsequently me). So now the flu has been passed to E and her son… And I just got my appointment confirmation in email for tomorrow. And I don’t want to go. I don’t even know for sure that E will be back, but I do not want to risk getting the flu from E. I know she was at work on Friday, so if she got the flu over the weekend, I feel like she’d still be contagious if she came in today and/or tomorrow. And I do not want to get the flu. (I also heard from Hub that the other therapist in the office who also does acupuncture ALSO has the flu!) But I’m once again riddled with guilt over cancelling an appointment. I’ve spent so much time with E and the therapy aide, and I like talking to them. I feel like they are friends, so I don’t like taking away their work or disappointing them by not showing up.

I’ve talked to T about my guilt issues, and she tells me that she isn’t sure she can break through that with me. She thinks it is too deeply ingrained. Lucky me. But seriously, I have gotten better at saying NO and at thinking of myself when I need to make a decision that will fill me with guilt. Sometimes, though, it still gets the better of me.

But it’s the flu. And I don’t think I can screw around with that. Ugh.

 

 

 
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Posted by on January 28, 2014 in anxiety, guilt, physical therapy

 

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