Wednesday, February 17, 2010

Inch by inch

Today my physical therapist told me that the swelling in my sacrum/low back area, had subsided a tad. It was a small change but the only positive one in the two weeks I've been with her, so we had a mini celebration. (Basically, a quiet and brief "woot")

Who knows what made the difference between Monday and Wednesday? Who knows if it was anything I changed that recently or just accumulative effects of everything I've been doing over the last two weeks.

All I can tell you is what changed:
  • On Monday, at my doctor's appointment, he did some osteopathic manipulation on me, cracking my lumbar and hip areas. Not as much as the previous time and I didn't feel any immediate relief, but who knows?
  • Doc also gave me a different anti-inflammatory. I was taking plain-ole Ibuprofen in prescription strength (600mg) before and I have been taking that, in one dose or another, for many years for headaches, aches, and pains. Instead I'm now taking an NSAID that is typically prescribed for arthritis patients, Meloxicam.
  • I started sitting less at my chair in my office and just less overall. What I discovered was that standing wasn't a whole lot better, either. My back got really tired really fast and I felt as though I was going out of alignment big-time; I would end up standing with all my weight on my good leg and then that hip would start to hurt. Walking around and sitting or laying down periodically seemed to help overall. Basically, not doing anything for too long seems to be the key.
  • I've also been cutting back on caffeine and sugar. I've gone down to only one sugar in my coffee and am trying to only have one cup of coffee in the morning. When I was pregnant I only drank one cup in the morning and, in the first 6-7 months of my pregnancy, my hip symptoms all-but went away. I have no idea if this has anything to do with anything, although I do know that sugar and caffeine can be inflammatory.

Any one of these things could be the difference... or not. It's so hard to tell, especially when I am personally not feeling any improvement from the pain and tightness side. In fact, I would say that, without the ability to stretch things out or get massage, I have felt tighter and more pain overall. Not that my pain is a 7 out of 10 or anything but the things I could previously alleviate with self treatment, I can no longer affect, so they persist.

I have been keeping a pain journal but it has only served to confuse me more about what may be making a difference and what may not because the same thing on two different days can produce different results. Plus, my pain is often diffuse, varies throughout the day, and can present differently - as burning, as tweaking, as stabbing/acute, as sticking/popping/clicking, or as aching - in different areas, at different times. There are some constants, of course, but I can't say I've felt any positive improvements in any of them; as I said, I'm actually feeling a bit worse.

I'll spare you the details but my PT has an educated explanation for everything that is happening to me (including the wild fluctuations in case/effect and pain) and so I still have confidence that I am getting the best possible care. So, the journey continues. I'm doing as I'm told: doing the exercises, doing the icing, doing the resting, doing the journaling, doing the change in body mechanics, doing the NSAIDs... I just have to keep in mind that I'm trying to undo possibly 4.5 years of misdiagnosis, wrong treatments, and bad behaviors.

As I said to a friend recently however, hope without proof or progress is hard. At least this little budge in my inflammation is a positive sign we may be on the right track.


e said...

The hardest thing right now is patience - you've been dealing with this for so long, I can relate to just being sick of it. One thing I noticed as I healed from the surgery and then from the SI problems, is that the progress is very slow, and takes a long time. If I had charted the pain on a graph, it would be a squiggly line with a downward tendency, but the horizontal axis would be in months, not days. It may be that before you actually feel less pain you have to reduce the inflammation even further. Hang in there!

But I do want to point something out: you mentioned that the PT doesn't believe that food will have much of an effect, but you also mention that coffee and sugar do. I can tell you for sure that coffee aggravates my sinuses, and sugar will make a mild uti flare up. My point is this, and I have made it 100 times, but will keep making it: food does affect inflammation. It might not heal you, but if you're able to reduce the inflammation, your body can make faster progress. I encourage you to keep playing with food, see what works for you and what does not.

One reason I'm such an advocate of using food to heal is that I don't want to be 40 and on several prescription meds that I might have to take for the rest of my life. Meds are fine in the short term, to fix problems, or for certain life-threatening diseases, but the less I can take, the better.

Anyway, I have full confidence that you will heal from this, and that you will strike a balance that works for you, and I am very excited that your PT told you there's less swelling. This is very good news. If this is indeed the right path, and I have high hopes that it is, I think there will be a tipping point soon and you will start getting relief in increasing increments.

TravelVixen said...

Thanks for the support, e. As someone who has been through this - LITERALLY all of it - it means a lot coming from you.

I hear you on the food but, as we've discussed before, it's going to be a last ditch resort.

If you spent a week with me you would know that my diet is very simple and pretty 'fresh' (as in unpackaged) as it is. I love food; it is one of the joys in life and yet I have spent the last 35 years denying myself something or other for health or weight. I continue to not eat what I really want on a regular basis because of that. To add further restrictions or limitations, at least to the extent you do, would impact my enjoyment of life. With the frustration of the pain and the injury itself, it's one more thing I don't want to add to the list of things I dread when waking up each day.

Maybe if I was single and traveling the world and in tip-top shape doing a lot of the other things that make me happy more often, it would be just one small thing I could do for myself. But, cumulatively, it's too much for me to be able to deal with at this time and place in my life.

I'm not sure if that makes sense or if that's difficult to understand because our lives are so different right now but that's the best way I can explain why I'm resistant to your continued pleas for me to explore the food thing futher. I love you for continually trying, however!

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