Progress

Oooooo, don't you just love the sound of that? Progress! It's a fantastic word, isn't it?

Well, I'm happy to report further progress with my back/hip issues. Ok, well, happy may be a severe understatement. If you've been following this issue for a while now, you'll know the depths of despair dealing with this injury has dragged me to. So 'progress' is pretty much like saying "multiple orgasms" to me right now.

Today was my last physical therapy session. I've basically moved beyond "treatment", doing so well with all the exercises they have given me and being all-but pain free now for quite some time. Sure, there has been the odd mini flare-up, where I haven't paid attention or have overdone it on something I wasn't supposed to be doing (like housework, conveniently enough) but they are short-lived and I am bouncing back much faster.

This was not my last time going to the physical therapist, however. The facility also does sports specific and personal training and we agreed that it would make sense for me to continue on a program of personal training for a while. You see, my previous issues all flared back up again as soon as I was discharged from physical therapy and tried to return to a more full-body fitness routine. It was like, by trying to take one more step forward towards being strong and fit once more, I would wind up 10 steps back.

Since I don't want that to happen again, I really want to take the next few steps under supervision of an expert. Dustin, my PT, is an athletic trainer and the types of exercises and instruction I have received from him and Kyle, the owner of the facility, include a lot of routines and approaches that are different from anything I have ever done before. So, despite my prior status as a personal trainer, their experience is far greater than mine and their approach rooted in athletic training, which means a focus on preventing injury as well as increasing balance, strength, and endurance.

So, from hereon out, the focus is all on progress. We're going to build upon the foundation we have created, without flaring up my symptoms and with the goal of making me strong and more injury resilient than I have been for quite some time. Which is everything I have been hoping for and everything I have wanted from a treatment program.

I am sooooo incredibly happy that I did not give up and that I kept switching and changing professionals and strategies until I found one that worked for me. I could never quite accept that I was out for the count at age 35 and I'm pleased to say that, although there may be some things that I may never do again, and others that I have to do much less than I did before, I have every hope that I will return to little miss buff Rantypants in the near future.

Now, for my part, all I need to do is start eating more healthfully again. That has definitely been a lagging factor. Although I haven't been eating POORLY (its not like I'm a drive-thru-junkie or anything) I definitely have not been making proper nutrition the top of my list of priorities. That needs to change now, especially if I am going to be upping the ante on the workout side. I'll need a quality diet to fuel my routines.

All in all, this sounds suspiciously like the old me is returning. It's been a long time coming, let me tell you, but I'm glad to meet the old Ms. Rantypants again. I liked her much better and have missed her a lot.

Needles

23 of them to be precise, inserted into my lower back and buttocks yesterday afternoon and that stayed there for 30 minutes, vibrating with electrical waves.

No, I was not abducted by aliens. I finally went to an acupuncture appointment.

One of the things that I've realized since being in chronic pain, is that certain things that used to bother me, are now no big deal. When you deal with varying levels of pain every day and have to get up and get on with your day, your life, despite it, it gives you a whole new outlook on life and a whole new ability to shut out pain. With a greater appreciation for the good days also comes a more balanced perspective on short-term pain itself, especially when that pain or discomfort is directed at healing you. So, from this place I was able to get through 23 needles being inserted into my flesh with no more than a rush of adrenaline and some sweaty palms.

It started with the acupuncturist listening to my twenty minute story of pain, injury, failed treatments and symptoms. It's quite a discussion and when I sit down and actually go through it chronologically for people, they're actually quite taken aback. I mean, I walk into the room like any other person, I'm not in a wheelchair and I'm fairly well turned-out and so some people, I wouldn't mind betting, actually think my problems are exaggerated or that I'm some kind of hypochondriac. As I go down the list of 'stuff', you can see their eyebrows raise, then furrow, their mouth twitch and twist.

This time was no different and the acupuncturist scribbled notes furiously as I talked. Then she stopped, put down her pencil, and told me that acupuncture could only really deal with the pain and neurological symptoms (something which I already knew) and that she felt it would be best to start in my SI joint area, since this was the most chronic of the conditions (even though the most acute is my back right now.) And so we did.

How did it feel? Exactly as you would think it would feel. Pricking and stinging, on a similar pain level as when you pluck your eyebrows, except, of course, in your butt. I am still yet to have the magical experience that some nutty people report when they say they "don't feel" needles (whether through acupuncture, blood drawing, or vaccinations). I think these people are lacking some nerve endings because it's a frickin' needle and it's going into your skin - it's your body's natural reaction to feel it. So, it was a bit painful but nothing unbearable. Bearability is the yardstick these days.

Then, once the electrical stimulus thingumy was attached to the needles and started pulsing away, it was kind of like having a tens unit on your back, which I've had used a number of times. After which I got to lay on the table in the dark, face-down for thirty minutes, as the needles went to work.

All very ho-hum at the end of the day except that, when I got up, I'd had my head resting on the massage table for so long that my right eye was blurry. I could barely see through it for the first ten minutes and had to sit in the car and wait for some vision to return before I could pull away. The blurriness lasted for about an hour before I was back to normal and so I was kinda freaked out about that for a while. Not digging the loss of vision at all.

And how do I feel this morning? Well, no different, quite honestly. I wasn't in much pain, if any, yesterday to begin with, so there wasn't anything to immediately relieve. This morning I went back to the gym after a week off, where I did my PT exercises, 10 minutes on the arm-bike, 10 minute on the reclining bike, and 10 minutes of walking and now my SI joint is acting up again. So nothing too strenuous, you would think. Yet I've got that tingling and burning in my sacrum and going down my legs. The minute I even TRY to do any kind of physical activity it gets mad and I can not stress enough how careful and cautious I am in every movement. Sucks.

The acupuncturist would like to see me every week but, at $75 a time, I'm going to stretch that out a bit more. I don't know what I should have been expecting after my first treatment but I'm not feeling any immediate benefit. She did say I should be feeling great this morning but I woke up feeling the same as normal (when I'm not injured or in the middle of a flare-up, normal) so on that measurement it didn't do squat. Maybe a couple more sessions will tell me more, maybe not. I'm impassive about the whole thing, honestly. If there is a placebo effect I think I'll be immune to it. I'm neither convinced acupuncture can help me nor certain that it won't. It's one of those "leave no stone unturned" type efforts for me.

One thing the acupuncturist did say when examining me is that I have some compressed lower vertebrae - something nobody has told me before. Neither has there ever been an x-ray or MRI on my back. All the focus up until this point has been on my hips. So, I'm going to mention this to my doctor today when I see him and see if we can get me in for an x-ray. I'm still convinced that there is some underlying, root cause of all this pain and discomfort, that there is some other problem that is causing all these others, and I wouldn't be surprised to hear that it has something to do with my back.

Where is Travelvixen?

I'm here but just ridiculously busy lately, especially now the sun is out and I'm out of the house with the family, more than I'm home and inside. Plus, what 13 month old actually lets her mother sit at a computer and blog while she's around? Well, not mine!

In truth (although there is validity to all of that) I had been waiting to post a epiphanic entry about how I had managed to self-fix my hip and back issues after changing strategies for the 1,000th time about six weeks ago. Unfortunately, the epiphany wound up being nothing more than a pipe dream and, having bored myself to tears with all my whiney posts about S.I. this and nerve-pain that in the last year, I just couldn't bring myself to share the solemn news: said new strategy is an all-out failure. Pain is back with a vengeance along with muscle relaxers, anti-inflammatories, the PT exercises, and ice in the bucketload.

Blech. I'll post the details another time since I don't have the time or inclination to devote to the sorry story right now. Needless to say, strategy 1001 is now in full effect, which is basically strategy 999 revisted. Confused? Yeah, well you're probably about as confused as I am frustrated. Sigh.

Let's also not even mention the 6lbs of weight I've gained since I stopped posting my dieting progress on this site. That's just depressing... and shameful. It's not like I was even at my goal 6lbs ago!

Don't feel sorry for me, I'm soldiering on.

Other stuff preventing me from blogging is work. Work is busy. That's a good thing, by the way, especially when you're a commissioned sales person, so I'm not complaining. But it does mean that, instead of taking a 15 minute break mid-morning to post something fun or insightful here or on Lazy Crazy Daisy, I've been plonking away on the keyboard for profit. Then, at the end of the day, I'm so sick-to-death of staring at a computer screen, that I just can't bring myself to open the laptop back up to blog.

Then I'm still trying to have a social life, even though it's like planning a military operation just trying to get together with anyone in the summer. I honestly believe that they should oust all those top military dudes in Afghanistan and just hire a bunch of wives/mothers to plot western victory! Although I don't know what I'd do without my Outlook calendar and my android phone's calendar synchronization...

So, with all that said, I leave the end of this post without really having posted anything at all but with the hope that I'll have the time (and inclination) to share again soon.

Until then...

A shot in the ass

Not the metaphorical kind but the literal kind.

Today, my doctor decided to finally listen to me.

After asking me every week if was "80% better? 90% better?" I finally stopped him and said, "You KEEP ASKING ME THAT! I know you WANT ME to be 90% better - I do too - but I'm not and I don't see any point in lying about it."

That stopped him in his tracks. He ditched his rush-rush attitude, sat on the table and looked at me. I breathed a sigh of relief. Dude, I've been trying to tell you I AM NOT SIGNIFICANTLY BETTER!

I explained the process of how my PT had stopped my previous relief strategies in their tracks when she diagnosed me with the SI joint problem and how that had increased my pain and created new pains because now I no longer had my short-fix, self-help treatments. I told him that yes, indeed, some of that had subsided but the fact remains that I have so many different pains that fluctuate on a day-by-day, week-by-week basis, as well as the original pains I visited him with initially, that's hard to say exactly what percent better I am. Depending on what measure you're using I could actually say I'm WORSE!

His feeling was that I was somehow stuck. I've done so much, had so many different kinds of treatments (CONTINUE to have many different kinds of treatments) and, while I may be progressing, it definitely seems as though something is getting in the way of me making that switch into real recovery.

I was all, like, WELL YES! THAT'S WHY I'M HERE!

In all fairness, I'm a new patient to him. He's been dealing with me since Feb 1, I've been dealing with me and this hip thing since October '05.

So, we skipped the osteo manipulation for today, since I don't think all that cracking was helping anyway. Doc asked me where the majority of the pain seemed to start from, where the worst of it was and I pointed to my right butt cheek - for the anatomically correct, my piriformis area. It pretty much never stops aching, being sore, and/or burning. He pushed in there too and agreed that it definitely felt hard and tight. (Again, I'm all like, YES, THAT'S WHAT I SAID!)

Then he suggested a cortisone shot. At which point my hands began to sweat, I began to hyperventilate and I said something pathetic like "I don't do needles. I don't do needles!" Despite his assertion that I "wouldn't feel it" (when do you never not feel a needle piercing your skin!?) I was still mentally figuring out how to get out of there without getting stabbed. Yet, he made a good point: I've tried everything else and if I want to get better I need to try everything. It could be that I have a chronically tight piriformis muscle and no amount of therapy is going to release it. The cortisone shot could be just the thing to chill things out and allow other affected parts to release, heal, and get better.

I had to admit that he was right and, with Jamaica looming on the horizon, the prospect of some relief for my vacation without hours and hours of working out or icing, sounded very attractive. So, I just made the decision there and then to do it. JUST DO IT! No pontificating or working myself up, get that damn needle in my ass, stat!

As it goes, it didn't hurt that bad. It did hurt though. But, I've had worse. (Obvy... I've had a hip surgery and a c-section.)

Doc said that my SI ligament is VERY tight (pregnancy?) and that this could actually have more to do with my pain than any skeletal misalignment. (I like the sound of that.) So, we're going to see how these cortisone injections work and he's going to do some specific manipulation when I come back, just for the SI ligament. In the meantime, no PT, light stretching and rest for my poor sore butt.

Am I noticing any difference? Sure, in the department of less stiffness/aching but right now my butt is sore from the jab itself, so it might be a day or so before I feel the real benefit.

I also had another Alexander Technique appointment today. Despite my mixed feelings from the last one, I actually felt like we made progress today, finding some key elements to my posture puzzle. Pelvic floor muscles and illiopsoas need to be engaged. This totally connected for me because I've had problems with tightness in these places also. Engaging these areas immediately lifted me off my lower back, made me feel taller, and reduced my heel-fall impact while I was walking. Amazing! Everything started feeling much more natural!

We also practiced standing up, sitting down, bending over, and picking up weights using the same techinques and I immediately felt the difference, as opposed to my back taking the weight. Next appointment, in two weeks, we'll get into picking up less stable weights of like, oh, well, 20lbs. I wonder why....?

An apology to my readers (should there be any remaining)

I have just noticed that my last six bazillion posts are either about my hip or my weight.

So, this is just a quick post to apologize to any of you left out there who may still be reading this blog and hoping (against all hope) that I will find something new to "rant" about.

At one point this blog was about travel and politics and opinions and interesting stuff like that. Now it's just a sad reflection of what my life has become - a merry-go-round of medical appointments and sulking.

Must do better. In life as well as on blog.

Stay tuned...

Recovery is time consuming

I've been too busy recently to blog about what's going on, specifically with my hips problems, so it's time for a recap.

Last week I had my first Alexander Technique appointment. For those of you who have absolutely no idea what this is and are perhaps wondering if I'm heading for a bionic hip or something, here is a brief synopsis of what the AT is and why I'm trying it.

Using the description from the official website: "an Alexander Technique teacher helps you to identify and lose the harmful habits you have built up over a lifetime of stress and learn to move more freely." So, basically, someone takes a look at your body mechanics, the way you move, the way you sit, your posture, and helps you to be in a more natural alignment, thus helping you to mitigate muskuloskeletal pain caused by your misalignment. This, of course, is a gross oversimplification of what this process is all about but, unless you're really into it, I think that description suffices for the purpose of this post. If you want to know more, you can visit the Alexander Technique website at http://www.alexandertechnique.com.

The Alexander Technique has been around since the 1800s, when it was created by it's namesake, Frederick Matthias Alexander but I learned about it from my friend, E, of The Gurly Life, who has been suffering from the same hip and SI Joint issues as I have. It's not new news to me that my posture leaves a lot to be desired and, after hearing consistently from my physical therapist that I have the body mechanics of a rag doll, I felt the time was right to add Alexander to my treatment strategy.

As I live in the Sacraghetto area, I am not blessed with an awful lot of options when it comes to these alternative treatment options. So, I had the grand choice of one AT teacher within 100 miles. For the purposes of this blog, we'll call him Jim, although that's not his real name.

Jim works out of a granny annex at the back of his home and it did occur to me briefly, as I walked down the residential driveway, that I could be heading into the lair of a sex offender or something. Fortunately, although Jim is indeed 'weird' (at least by my definition of the word), he appears to be safe. Jim's 'weirdness' comes from his posture, general demeanor and the way he speaks. The first thing that bothered me is that he holds himself like a caveman, with long arms that seem to hang limply from his shoulders and large hands that almost brush his knees when he walks. This wasn't very encouraging, since I was there to learn 'better' posture from this guy - developing the gait of a prehistoric cavewoman wasn't on my list of goals for the year. (I know, right?) Secondly, Jim has this presence about him that is very... superior and supercilious, let's call it, but in that quiet and self-contained way that makes you think that he spends all day meditating, eating willow bark, and avoiding any and all stress in life.

I may be over-reaching in my first impressions, but it seems like Jim lives his life in a bubble of calm, peace, and ease, and feels a level of disdain and pity for the rest of us who run around in our complicated lives, stressing ourselves out with roller-coaster emotions, and poor habits. He obviously sees his work as an AT teacher, as a way to preach a better way and I guess that's where I had a problem connecting with him. His teaching felt borderline creepy-religious-cult. I know I'm over-reacting here, because I don't think at all that this guy is dangerous, but I'm just trying to convey the reasons why he irritated me.

Now, I'd like to be clear in this - I don't aspire to live a life of calm, peace, and ease. Really. I mean it. The very thought makes me want to puke with panic. I like roller-coasters, both literally and figuratively. I never feel more alive than when I'm zooming through the air on some crazy theme-park contraption, the wind whipping at my face and adrenaline rushing through my body. I don't want to live my life on a flat-line - I'm ok with ups and downs because the downs make the ups so much sweeter, and the ups make the downs bearable. I recognize that's not for everyone - some people prefer to live life on a calmer sea - but that's me. And for some reason, people like Jim just freak me out. I have a phobia of those quiet, self-contained, calm people. I think part of me fears that they're really just bottling it all up and that, at some point, it's all going to come bubbling over in some major, psychotic breakdown. Emotions - both high and low - are natural and it seems unnatural (and dangerous) to me, that someone can regulate their emotional self to such an extent that they never really display or experience extreme joy or sadness. Ok, psychoanalyze this all you want, it is kind of an oddity I'll admit but not something I plan on stewing over. So let's move on...

The point is that it was hard to settle into the advice I was getting from Jim because of how I felt about him. However, I did get some good nuggets that make sense and that I have been trying to deploy into my regular day.

Our spine (neck to tailbone) is connected, not just in a literal sense, but in a behavioral sense also. Meaning, what you do at the top of your spine affects everything below it, and visa versa. This may sound simple and obvious but it's more than that. For instance, if you let your chin jut and/or down out when you're stressed or thinking, it not only affects your neck and upper back (which is a no-brainer) but it throws off your entire balance because now your whole spine has to readjust to balance your head (which, let's face it, is a big-ole thing on your shoulders) resulting in unnatural load bearing in different areas of your back and the connecting muscles. It's these types of readjustments that result in chronic pain. Your body, over time, unlearns the way to be in balance, the way our skeleton was designed. Our muscles start taking over from our skeleton, to do the job of holding us upright, and - hey presto! - all sorts of odd (painful) things happen.

Personally, my poor habits include hyperextending and locking out my legs when I stand, over-arching my back, curving my shoulders, and (at the same time) driving my heel into the ground ahead of me when I walk. This last one is important because, what this means in relation to all my other body mechanics, is that I am literally driving the head of my femur into my hip socket with force, every time I take a step. OUCH! All the other stuff amounts to me placing too much load on my lower back. What feels like a "natural" or "upright" posture for me, is actually leaning back. When readjusted for 'neutral', I feel like I am leaning forward. It's the craziest thing! So, I have to re-learn standing, sitting, and walking (amongst other things.)

Jim actually told me to watch Daisy walk because, obviously, her body mechanics have not been contaminated by modern life... yet. She walks with her head leading and her body following, almost as if she is about to fall forward at any time. Although this may be an extreme example of what I need to do, the basis for my new posture is right there: lead with my head, not my feet. There's a lot more involved in it than that, of course, stuff about pausing, giving my body directions, "letting my neck be freeeeee!", looking down from my ears (!), and pulling back my ribs to name a few, but essentially that's the primary guiding factor. (And yes, I did feel and look a bit like a prehistoric cavewoman in the "ideal" posture. I think I'm going to have to modify it a bit to suit me, for vanity purposes!)

After all the walking and sitting instruction, I got to lay down with my head balancing on a paperback book, knees up. Again, my instruction was to let my neck be "freeeee" and to lengthen my spine through relaxation. My homework was to do this for 15 minutes a day every day. Something which I just haven't found the time to do. I guess I could be doing it now instead of blogging, so maybe I don't really have an excuse. Drats!

Add this to my physical therapy exercises and appointment, doctor appointments, and other miscellaneous advice about how to move, bend-down, stand, roll-over, sit-up etc... and it's all a little overwhelming.

I've calculated that, if I did everything the physical therapist and Jim tells me to do, I'd spend approximately 4 hours each day just working on my recovery. Who has that kind of time when you have a full time job and are the mother of an 11 month old??? It's like having a second, part-time job!

That four hours breaks down into:

• 20 minutes of physical therapy exercises 3x per day
• 20 minutes of laying down, icing my back, 3x day
• 15 minutes of AT head-on-book balancing 1x per day
• PLUS, at least one hour per day, most days, at appointments for either my doctor (who I see for osteopathic manipulation once per week), my physical therapist (who I see 3x per week), and now Jim (one time per week + 30 minutes drive-time each way.)

All that time comes out of somewhere and none of these folks take appointments outside of business hours, so, I have to take early or late lunches, resulting in things like me eating pre-packed salads in the bathroom while trying to shower.

As I said, this is not to mention the almost-impossibility of trying to remember all the other advice about my general, everyday movements. Trying to go through a 3-step, back-friendly process just to bend down and pick something up off the floor, kind of just flies out the window when it's your daughter reaching for a choking hazard. It's ok when you have the time to remember it but, for the most part, I'm too busy to spend time thinking for ten minutes every time I move a body part. I try but it's an imperfect science right now. I guess I would say that I'm learning to be more aware of what I'm doing, when I'm doing it, which is a start.

Adding to this, I am trying to re-incorporate some yoga back into my routine every day. I know my physical therapist said no yoga but she isn't a yoga practitioner and I think (from what she has said to me) she has a shallow understanding of the discipline, reducing it to all those power-hot-yoga classes, taught by a svelte 20-something, who understands little-to-nothing about proper body mechanics. Good yogis spend years and years refining their technique and understanding of the human body and there are certain sectors of yoga that place strict emphasis on proper posture and alignment, most specifically Iyengar yoga, which is what my friend, E, practices. So, I found a book on yoga and back pain using Iyengar principles and which has a section on SI Joint Dysfunction. On Monday I started (slowly and gently and cautiously) adding some of the positions into my evening workout routine. My other goal is to find a weekend or evening class locally that I can attend, where I can get some one-on-one instruction (which has really helped E) but finding that in the Sacraghetto area is proving to be hard and, anyway, when on earth would I fit it in????

Then there's the cost.

Each doctor's visit is $25, each physical therapy visit is $45 and each Alexander Technique appointment is $70. Add that up and I'm already spending a wopping $230 a week on these treatments! I could literally go broke just trying to get healthy.

It would all be easier to bear if I were feeling any significant difference in my pain but I'm not. The only improvement that I have noticed is a reduction in the shooting, nerve-related pain that was occasionally going down my thigh and into my ankle. I'm still left with a sore low back, a sore right butt cheek, a very, very sore outer thigh (from a tight IT band) and soreness and twinges in my inner thigh/groin, as well as around my hip flexors/psoas.

I keep telling myself that I have been experiencing this chronic pain for years and so it's going to take more than weeks to undo all the damage and compensation and bad habits but, as much as that makes sense rationally, emotionally (and financially!) you need to see results to keep plugging forward on the same path. I've been with this new diagnosis and treatment plan for 5 weeks now and I would have thought I would be feeling more of an improvement than I have.

My doctor seems to bear this out because, every Monday when I see him, he asks me how much better I am doing (as a percentage). Each week he sayes something like: "So, are you 70% better? 80%?" and each week I reply with "No, more like 30%." I get the feeling he thinks that I am being obstinate or difficult but really what's the point in lying? 30% may even be overstating it, quite frankly.

I veer from despondent to hopeful on any day in any given week. My hope comes from my friend, E, who has battled this and come out the other side. My despondency comes from my lack of time to really do everything I need to do, the cost, the slow (if at all existent) progress, and the repeated pattern of pain. It's not an excrutiating pain but, at any time of day, whether sitting, standing, laying down, or walking, I'm experiencing low grade pain (3-4 out of 10) somewhere in my body. After a while it wears you down.

So, after all of this, I'm not sure where it leaves me. Except, it seems, with a broken "J" key on my keyboard. It literally just flipped off, up into the air, and landed on my lap. Not that I use the J key much but every time I tap a key near it, which is I, H, K, M, and N, it flies away again. So, off to order a new keyboard from the IT department...

Quick Update

1. HIP

My swelling continued to go down, my PT said today. I think it's the new anti-inflam because we're not doing anything else significantly different, or at least anything that would affect my inflammation that quickly.

She also tested my flexibility because I was complaining that my leg felt tight, particularly in the quad. Yeah, well... NOT. I'm still hyperflexible. The pain I'm feeling IS nerve pain. It's sinking in slowly. VERY slowly. Each piece of information sits, absorbs, and is added to a previous piece of information.

It's hardly a wonder I'm not religious - if I need 3 weeks of continuous examples, education, and proof that my pain is not muscle/tightness related, think how much proof you'd have to show me to convince me that God actually exists! (This is not a comment on anyone who IS religious, by the way. It's just the way I am. I don't take things at face value. Sorry!)

Talking of which... my PT is a believer and has taken my studious silence during a recent chat with her intern about where she worships, as agreement with the same. Now my PT includes instruction on how to pray for better health and to put my fate in God's hands.

Sorry folks... I don't see God poking my nerve endings. I'm going to stick with trying to fix this one myself.

And lest you think that I am a horrible heathen (which you may very well do anyway), I am at least not planning on telling her that I am a non-believer. She is a nice person who is just trying to help me and, quite honestly, I don't want to have "that" conversation with her (and she is the type that would have "that" conversation.) I respect her right to worship whomever she wants and neither want to be converted nor engaged in a religious debate. So, I'm staying "mum", as wel say in Blighty.

Last note on this: pain is still pretty constant. Not much change there, although I take my friend, e's point, that my overall trend may be slowly downwards by small degrees; it may take a while to register that there's a difference.

2. WEIGHT

Today 147.8lbs and 36.3% fat. So, my tally is 13.2lbs lost and 2.8lbs to go to my target. 6.3% of my bodyfat still to lose. Blech!

On the plus side, with all this physical therapy focusing on strengthening my trunk, I'm going to end up with six-pack abs!

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.

This week's mission: no sitting

I have been keeping a pain journal over the last week or so at the suggestion of my new physical therapist. Our goal, of course, is to try and determine what actions aggravate my pain symptoms.

So far it has not been incredibly helpful. My pain levels have always seemed to spike and subside without any real 'event' to pinpoint. The journal is mostly confirming this, although it is beginning to help us hypothesize some scenarios regarding my level of activity.

In short, I generally report better pain levels on days after being active. That is not to say hiking and running around like I used to (oh that would be wonderful again some day, but clearly not yet) but just days where I'm not sat at my desk for most of the day, the way I am M-F when at work. When I'm really busy, like last week, I can get so engrossed in what I'm doing that I can easily sit down one minute and, four hours later, look up to find I haven't moved, eaten, or drunk anything. When I do go to stand up again, my brain begins to clue-into the pain I have been ignoring, presumably because I'm always in some sort of pain and have become accustomed to putting it to one side most of the time, at least mentally, and when my brain is otherwise engaged. I also feel a slight clunk in my sacrum area (probably actually my S.I. joint, but I'm still learning to pinpoint exactly where that is) as if everything is trying to realign as I stand.

The mornings after these kinds of sitting days, I notice that I have more nerve pain (I have begun to differentiate now between nerve and muscle pain) in odd places, like down my leg into my knee, sometimes in my calf and ankle, up into my groin and psoas and often on the opposite side to my primary injury. It's not pain all at once, everywhere, but it's like someone is randomly poking you with a needle from the inside out, at different spots at different times, whether sitting and resting or standing and moving around.

This is not to say that I am pain free on days when I am active, or the day after. I definitely experience some of that same stabbing pain, only less, and some soreness in my muscles of my leg and lower back - more like a soreness, as I said, though, or a dull-ache - not the stabbing neuromuscular pain of other days.

So, my PT is hypothesizing that my SI joint issue is aggravated by compression and sagnation, meaning that sitting compresses my SI joint, putting pressure on it, and that my inflammation is made worse by periods of inactivity, where fluid has time to settle and build.

This would be good news if this was the case because the alternative would be that my joint is made worse my compression, load-bearing, and motion - meaning, sitting and laying down more would be the prescription. As someone who likes to be active and who, mentally, feels like this kind of prescription is a death sentence (almost literally), I am hoping against all hope that the first one is true.

My PT told me the story of a woman who was told by her surgeon that she needed back surgery but that, after the surgery, she would not be able to sit for some time because she would be pulling ont he muscles he cut through and would be hindering her healing. She was, understandably, pretty freaked out by this because the idea of completely eliminating sitting from her life for a while, was pretty daunting. So, she did something really smart: instead of waiting until after the surgery to figure this out, she decided to practice for a month before the surgery, by only laying, walking or standing for three weeks. You've probably already guessed what happened to her - after 3 weeks, she was cured. She had no back pain whatsoever and didn't need the surgery! Wow!

So, for the next week, my mission is to all-but completely avoid sitting. I'm going to stand at my pub table to work on my computer (as I am now) and if I need to rest I'll lay down or I'll walk around a bit to avoid stiffening up.

Meanwhile I'll keep up my walking now the weather is better, as a control, and see how my pain journal looks this time next week.

Of course, if this doesn't work, I'm going to have to try a week of not walking. However, based upon the fact that my symptoms have not got any better on this decreased activity plan that my PT has me on (and, in regards to the nerve pain, sometimes worse!) I'm going to guess (hope?) that it's the sitting thing that is my nemesis.

I'm also going to tape-up my hips while I'm standing and walking, again as my PT suggested. She did this to me last week and I had an instant feeling of relief and decompression in my lower back and sacrum area. (Further proof this is an SI joint issue, she says.)

My inflammation is not down yet but I'm hoping that we can get beyond that this week with this new plan because I've been doing my exercises 2-3 times a day, icing 3 times a day, changing the way I bend down and pick things up, and generally being very cognizant of my back, and yet nothing feels remotely better yet. I need some progress in order to feel like I'm on the right track and even the PT said that I should have started to feel some kind of incremental improvement by now. So, something is still wrong and unaddressed. I hope this is it.

Wish me luck and, if you're on FB and want to send me a nudge every once in a while to be sure I haven't forgotten myself and started sitting down again, go ahead!

On a completely unrelated note....

This weekend I FINALLY met a goal I have had for the last 2 years - I did a one day photography workshop with Penny Silvia, the photographer who has been taking pics of me, Joss, and Daisy since I was pregnant.

Although it was a crash course for amateurs in how to utilize your camera's settings and I definitely cannot claim pro status yet, I already found the information I learned incredibly helpful yesterday when the family went to Tahoe. I think I got some really cute pics of Daisy in the snow, that I am really proud of. Here is one I LOVE here, and you can see more in my photo set on Flickr, if you'd like to provide some feedback! :o)

From counter-productive to counter-intuitive

As you know, I have a new physical therapist - Marcia. I've been seeing her for about a week now and it's been a difficult 7 days. Not because of the therapy or the pain (no change there yet) but because of the prescription. Essentially, she is undoing everything I was doing to self-treat for the last 4.5 years; every piece of advice and diagnosis I've received from countless doctors, surgeons, physical therapists, chiropractors, and osteopaths.

It's proving to be not only a physical adjustment but a mental one as well.

In the last few visits, I've had the opportunity to quiz Marcia more about my diagnosis and prescription for recovery; to try and understand it from different angles. I'm not sure I'm 100% in-tune with it yet but, oversimplified, this is what has begun to sink in.

The pain(s) in my hip, buttocks, and leg that everyone has been treating as muscular are, in fact, neuropathy - nerve pain. This is wild to me. Just WILD. Not a single medical practitioner until this point has even mentioned nerve pain. Not one. The continued diagnosis of tight this muscle and irritated that ligament has been such a constant in the last four years that I can't even begin to get my head around the fact that the pain I'm feeling in many instances (obviously not all) is not muscular.

I believe and understand what Marcia is saying intellectually but there is still some part of me that won't grasp it, refuses to grasp it. It's like saying that the last four years, or at the very least the most recent two (since my surgery) have been a lie, a mistake, a serial misdiagnosis. I want to believe and trust that she is right - because she sure sounds like she knows what she's talking about - but to do that I have to have faith in the fact that she, this one person, has looked at the same person, the same symptoms, and come up with a completely different diagnosis. That's hard to grasp.

Of course, once you accept that your problem is not muscular but neurological, then you have to accept that the solution, your treatment strategy, and everything you've been doing up until this point, has been 100% wrong. And, in some cases, even counter-productive. Again, this is tough to accept; it's a big paradigm shift.

The nerve pain is not only made worse by excessive stretching (my previous self-treatment MO) but, my increased or hyper flexibility from the stretching, is preventing my muscles from protecting the irritated nerves and, therefore, continued stretching only serves to make the muscles spasm more, in order to try and protect the nerves. Basically, everything is freaking out, one thing trying to protect the other and actually making things worse. My pattern of stretching, doing yoga, and massaging only served to make my joint more unstable (hello pops and clicks) and my muscles more freaked out (hello IT band syndrome, psoas pain.)

So, yoga, at least for now, is out. (There's another big adjustment.) Anything that involves twisting or stretching my lower back or side-bending, is bad. No touching the toes, no picking things up below waist-height without bending my knees, no sitting straight up out of bed, no turning around in my car seat to grab Daisy's binky. In fact, Marcia taped my back after today's appointment, to help me understand all of the movements I make in a day that can potentially inflame my back. I have 3 layers of thick tape - one vertically to prevent forward flexion, one diagonally, to prevent twisting, and one horizontally to prevent side flexion - and feel as though I have a mini corset on.

For a good hour, the lack of mobility made me feel like I was a zombie. I got used to it as the day progressed, however, and have identified my sitting on the floor, legs crossed, as being the primary culprit, pulling and tugging on the tape. Otherwise, I have found that I do a pretty good job of avoiding any of the offending movements, probably because I have subconsciously been modifying my movements for some time and, also, I admit, because I knew the tape was there. Of course, when you have an active ten month old, avoiding sitting on the floor isn't always the easiest goal to meet.

In addition to the taping, Marcia has got me doing some core strengthening exercises and icing at least three times a day. In fact, I think that ice and rest is going to be a frequent prescription for my aches and pains in the long term. Learning what makes my symptoms flare up and avoiding that whenever possible is the primary objective - but that's in a perfect world; for the real world, RICE is going to be my new best friend.

As I said at the beginning of this post, I have not felt a significant difference in pain or discomfort yet. My pain and irritation usually fluctuates (sometimes wildly) from day-to-day, week-to-week, and so it's hard to determine what, if any benefits, I am getting from the new course of treatment. One thing I am very cognizant of, however, is that my previous pattern has been in place for four years and so it's going to take more than a week to undo the habits and damage done.

Right now I just have to have a bit of blind faith that Marcia is significantly smarter than about 10 other people who were equally, if not more, medically qualified on paper. So far, I have to say that it's hard to stay the course and not jump back into old habits, especially when any benefits from the new plan will be small, incremental, and long term. There is nothing to tell me I'm on the right track yet and for this impatient, results-oriented A-type personality, that's the toughest adjustment of all.

Going backwards

... to go forwards.


That's the highly abbreviated version of the plan my new physical therapist prescribed for me today.


I'll start with the fact that I cried.


Yes. Me. Tears. WTH?


From the moment that Marcia, my new PT, started talking, I began to get a lump in my throat. I think that it was a combination of stored-up anticipation and last-ditch hope being released, as I began to realize that this chick was no ordinary PT. My new doc was right - she is the bombdiggedybomb of physical therapists and, given that she will be PT #5 for my hip, I should know the difference.


Then, when I started to talk (and she actually listened!), to explain my five years of pain and failed treatments, the way my life has been impacted both physically and emotionally, the sense of hopelessness that I will ever find relief, and the simple things that I wanted to achieve by being there, the tears began to flow.

Just from looking at the diagram of my body on the intake form, where I'd scratched angry Zs and diagonal lines to show pain, ache, and burning in various places, she was able to hypothesize 90% of what I was going through and why, before I'd even given her the verbal ins-an-and outs. I knew this because, in a stroke of luck, she was training an intern from Sac State that day and, through her explaining her thought process and strategy for quizzing me, I was able to learn not only what she knew, but also what that knowledge was telling her. Her experience was skipping her ahead, joining the dots almost quicker than I could place them.

She would be examining me and asking me questions and saying things to the intern like, "Typically in patients experiencing xyz, the abc nerve is also inflamed and patients will also describe discomfort doing 123 or 456,"meanwhile I would be nodding profusely, as she named seemingly disconnected symptoms that I hadn't yet described.

Then, she grabbed a life-size skeleton of the pelvis and lower back and began to explain to me, not in lamens terms, but in real medical language that assumed I was an intelligent and engaaged adult, how my SI (sacro-illiac) joint, pelvis, pubic bone, and lumbar spine worked together, where the nerves came in and out, what differnt kinds of nerves produced different kinds of pain and why, how they played off one another, how inflammation played a role and how my surgery had resulted in some problems and my pregnancy in others. It was a comprehensive explanation that I will spare you the specifics of because, although I got the general gist of it, I couldn't even begin to remember 90% of the terminology. However, the fact that it all made sense to her, that everything came together in an explainable story, made me want to jump up and kiss her. I was close, let me tell you.

I also liked the fact that she stopped me a couple of times as I went to bend down and pick something up, or get on the treatment table in a certain way, or try to turn over from front to back. She stopped me and showed me how my movements could be affecting my pain and inflammation right now.

The end-result of all of this is the following:

1. Nerves around my hip, specifically in my SI joint, were/are inflamed after my surgery and never really got the opportunity to calm-down. They're now causing irritation and inflammation in other nerves - in other words, the inflammation has been spreading. This is the cause of a lot of my referred pain and muscle pulls. So, strategy #1 is immediate and short-term: to reduce the inflammation through ice, anti-inflammatories and avoiding activities that irritate those nerves. This includes repetitive motion of my hip particularly with impact (walking), anything that involves bearing weight on that leg singularly (yoga, lunges), and stretching my leg across the plane of motion that replicates the pain (yoga and many of the stretches that previous PTs gave me). I am now icing my lower back three times a day with ice directly on the skin which, she believes, provides a deeper kind of numbing and cooling for those deep nerves that are pissed off in my lower back and hip.
2. My hip and groin on the right side is hyper flexible in one specific plane of motion and impinged in the opposing plane of motion. The hyper flexation is causing instability in the joint overall (popping and snapping and clunking). So, strategy #2 in the short term is to stabilize the muscles all around that joint properly, ensuring a more natural range-of-motion and pattern of movement that will, in turn, begin to alleviate some of the core nerve irritation/inflammation and prevent further injury. I already have some exercises to start me on that journey.
3. Long term, her goal for me after the short-term goals are achieved, is to get me to a place where my physical check-book is balanced. She explained to me that it wasn't that I would never be able to do many of the activities I did before I was injured and that now irritate the injury, but that I would just need to balance those negative activities with the positive ones. So, maybe I can ski again one day but maybe I can only ski one day at a time vs. two in a row and instead, on the second day, have a day of rest and self-treatment. I liked the way she explained this. It made sense to me. Just don't go into the "physical red". I can do that.

So, I'm off on the new plan... stepping back on some of my regular physical activities for a while with the goal of forging forward with renewed knowledge and awareness of my body and what makes it tick (or, specifically for me, click). I already did the icing at lunch time and about to do it again after I publish this post.

Wish me luck...

Back on the hip wagon

It's been a while since I posted anything about my hip. Hopefully a long enough hiatus to ensure that you're not all groaning in misery at the mere mention of it - but then, maybe not! ;o)

Anyway, if you've been following my titbits on Facebook, you'll know that I finally decided to make a doctor/PCP and medical group switch, and today was my first appointment with my new PCP.

Since my insurance is an HMO, my medical group is a big deal, in fact more of a big deal than my PCP, ultimately, becuase it dictates which specialists I can see. Long story short, I was originally with Hill Physicians when I first moved up to the Sacramento area several years ago and was very satisfied with all the referrals I received BUT hated my backwater doctor at the time. I switched to a younger doctor, with computer medical records (woot), who I loved (love) but she was a part of Mercy Medical Group - sort of like a mini Kaiser around here. Unfortunately, the "mini" meant mini service and mini options but with all of the same restrictions as KP. I had to fight to get my hip surgery done arthroscopically because Mercy didn't have a surgeon who had done it before (finally having to get a surgeon affiliated with Hill to scrub-in, so I wouldn't have to have open surgery). I then had to go out-of-network and out-of-pocket for physical therapy after my surgery because the Mercy therapists kicked me out the minute I was walking. Finally, to get the Osteopathic Manipulation my doc felt I needed to progress, I had to drive 45-60 minutes each way, to a town called Lincoln, on a 2-lane highway.

Although I loved my doc and honestly believe it is unlikely that I will ever find someone with a bedside manner that so completely suits me, the reality is that, aside from all but the basic cold, flu type illnesses (which I rarely have), she refers me out and so I spent more time with disparate "specialists" than I did with her. And, as I said, the specialists in Mercy are not all that special, in my humble (yet increasingly experienced) opinion.

It pains me to have to start this whole process again for the third time but I've plateaud with my hip in a place that is not acceptable for me at this time in my life. I honestly don't know if moving around like this is the solution but what I do know is that I've got to keep trying. I won't rest until I turn over every rock, trying to find the magical combination of treatment and care that will help me get to a better place.

Unfortunately, I've eliminated "recovery" or "pain free" from my vocabulary these days, as I'm not sure these are reasonable goals. Honestly, I'd just like to be able to get in and out of my car without worrying about twisting or turning the wrong way, pulling something, or clicking or popping something. Not to have to think about every little movement and make adjustments all the time would be victory for me. I want to be able to chase Daisy around the garden and perhaps even ski down a bunny hill with her for the first time - no black diamonds or anything, just a gentle little slope and some amateurish ploughing. Beyond that, I don't know what I'm going to achieve but I know I'm going to work hard to make it the best result I possibly can.

With all this in mind, I went to my doctor's appointment this morning.

The new guy is literally a quarter of a mile up the street. I practically passed his surgery every day without even paying it a second notice! I found him through my health insurance's online doctor site, by looking for another D.O. (Doctor of Osteopathy.) I have a lot of respect for doctors who do the extra time (2-6 years more than a regular doctor) and become a D.O. and, so far, I like their approach to treatment, so it was important to me not to lose that, if possible, in the switch.

Doing a little research on him, I was intrigued. In these days of computerized medical records, where doctors half-listen to you while they busy themselves with typing on a keyboard or fighting with an "F" button of some sort, he is an old-fashioned type doctor with an old-fashioned family practice. He "specializes" in total health care, from infancy and childhood, through adulthood, everything from pediatric to women's health, dermatology, nutrition, chiropracty, osteopathic manipulation, in-office minor surgical procedures and physical therapy - all in his surgery. (I KNOW!) I met with him briefly before I made the switch and he bristled at the very mention of referrals. "We like to take care of as much as we can here," he said. "For us, it's about continuity of care." Although I know this could either be a blessing or a curse, it was different enough to make me curious. The PCP >>> referral route hasn't served me too well as yet, so a truely different approach is probably my best chance yet at a different result.

Not that old-fashioned equals "old" or out of date, at least where it matters. No, he doesn't have computerized medical records and has had his local practice for 20 years but he's a fit, energetic, attractive, 50-ish man, the chief physician for the local Hill Physicians region and is involved in academic testing on the California Osteopathic State Board. These things tell me that he stays up-to-date yet is experienced enough to know what's what, especially within his own medical group - and knowing how to negotiate the system is an under-valued quality in a doctor, I am finding.

In person he turns out to be the typical "A-type" personality. A short, brusque, multi-tasker, who knows what he's doing and likes to get to the point. He is constantly on the move with purposeful energy, walking around his surgery simultaneously signing-off on charts, texting on his mobile phone, making and answering calls between patients, and conversing in harried-tones to his staff. He takes notes by verbally recording his voice on his smart phone, presumably because he doesn't want to take the time between patients to sit down and write (or type) something. He moves from one task to the next fluidly and his staff orbit around him in the kind of practiced way that makes you realize that he demands a lot of them but is admired by them; they've also obviously been with him as a team for some time.

His bedside manner isn't touchy-feely and sitting in front of him to explain the reason for your visit is an exercise in summation and verbal bullet-pointing - state your needs up front and remove the unecessary words; get to the point! He's a jolt to the system if you've been used to someone chatty and sympathetic, as I have. And if you're looking for someone to talk about how you're "feeling" non-medically... this guy is not for you.

But, I think I'm going to like him. He's definitely an adjustment for me but one I can easily make with my "get on with it" personality. Although I like to think of myself as a fairly friendly individual, I have come to value expertise and capability over friendliness. I've had friendly and look where it's got me. I go to the doctor to get "fixed" not to socialize, so I can look past this if I get results.

Within five minutes, we'd moved beyond my long-winded hip history (which he rushed me through) and determined that there wasn't much point in looking at what had already been done: Surgery - check; Orthopedists - check; Physical Therapists - check; Osteopathic Manipulation - check; Results - notsomuch. What did I expect to gain from seeing him? he asked me. I couldn't provide a concrete answer because I don't know what it's realistc to expect. It's an open-ended objective, really. We settled on someone different doing something different for, hopefully, a different result.

He immediately whisked me away to his manipulation treatment room where he cracked (and I mean popopopopopopop) my back, my ribs, my hips and pelvis in 3 swift and yet painless movements that took less than 30 seconds to perform. He then told me that I hadn't had really good physical therapy until I had been to a local lady, just half a mile away. He said she was the (and I quote) "best in the west" and if something was "fixable" to any extent possible, she would be the one to fix it. He told me she wasn't within my medical network but that he knew her well enough over the years that he his patients had a special cash rate with her of just $45 per visit (only $20 more that I would have to pay with insurance anyway.) He scribbled illegibly on a pad to refer me to her as we walked out and back to the front desk, mentioned a follow-up appointment in two weeks and said goodbye as his receptionist took his cue and had three appointment times/dates ready for me to pick from.

Not ten minutes after I had first shook his hand, I walked out of there, having been assessed and dismissed in short order. It was like being at the Dennys of doctors: good, solid food you can rely on, dished-out quickly by a busy and well-practiced kitchen. (I like Dennys, by the way. If you don't have a favorable opinion of Dennys, just replace with your favorite fast-and-yummy diner-food joint.)

Of course, as we say in the UK, the proof is in the pudding. Meaning, the results will speak for themeselves. But right now, I'm just happy to be on a different course.

I called the Physical Therapist, by the way, and have an appointment for 8:15am tomorrow morning. So, more after that...

Friday Motivation - Week 11: Progress!

Above pic is me and Hubby in July of '07. (Man, I need a tan again!)

Well, this week has been interesting.

Let's get the diet stuff out of the way...

CURRENT WEIGHT: 153.2lbs
WEIGHT LOST THIS WEEK: 0.8lbs
TOTAL WEIGHT LOST TO DATE: 7.8lbs
NUMBER OF WEEKS TO GOAL: 3
LBS TO GOAL: 8.2lbs

I'm definitely noticing a difference in the way my clothes are fitting and am able to get into even more of my pre-pregnancy pants at this point - a huge relief for my pocket-book as well as my ego, lemme tell ya! If I can only get below 150 before my vacation to Jamaica (which is the date of my 3 week goal), I think I would feel a decent level of success, even if I don't make it all the way down to the golden 145.

Finally, after a long and brutal illness, my massage therapist returned to work yesterday and I had my first appointment with her in a long time. It turned out to be a breakthrough appointment.

We discovered that my pubic bone issues were being caused? exacerbated? by a lot of tightness where my adductor muscle connects at the joint. Once we got the adductor to release, the pubic bone pain all-but evaporated! She also managed to get my lower-back pain and tightness to go away - the first time in what seems like FOR-EVER! Of course, I now have upper-back pain (more on that later.) My body is like a toothpaste tube with no opening.

I left her office feeling like a completely new person. All the sense of instability that I had in my hip, pelvis, and pubic area seemed to be gone! Then, I decided to do a short yoga workout (all I had time for) and found that the difference in the quality of my movement was marked. Instead of feeling like my right leg was wading through mud in comparison to the fluidity of my left leg, it felt more like water. I was more balanced, felt stronger, and definitely found that my muscles relaxed and eased into poses faster.

To say that I was elated by this development was a complete and utter understatement. Even though I went to bed with tightness in my upper back, shoulders, and neck, just the fact that it was no longer in my hips and pelvis gave me a huge sense of relief - it was progress!

I woke up this morning feeling lighter and more positive than I have in a long time. This morning I had an osteopath appointment and I drove the 45 minutes there with a renewed sense of optimism that, eventually, if I keep doing what I'm doing, I will be healthy and fit and free of chronic pain once more; that I may be able to ski and hike and chase Daisy around the garden; that I will not be afraid to move in certain ways again; and that I will get to the end of the day without the sense of mental, emotional, and physical fatigue that I currently experience, quietly battling away with the pain and stiffness that currently plagues my life (and trying to pretend that it's really not there.)

I turned the music up in my car, bopped around, and actually started to think about the joys of Christmas for the first time. This sounds sort of cliched and all but I actually realized that the sense of hopelessness I have been feeling about the status of my hip has been impacting my energy level and enthusiasm for the season just about as much as the pain itself.

There's been an element of long-term doom hanging over my head for the last year and a half, a feeling that I was stuck with this pain and resulting limitations for life, and that by the time I'm in my 50s and 60s, I'll be so disabled by the whole thing (plus all the other pains of older age) that I won't be able to enjoy life any more. For me, it's not simply enough to exist in life - I have to live it. I have to go sky-diving and zip lining and ATV'ing and hiking and visit new countries and experience new things; without the feeling that I can go at life with full-on gusto, I'm lost. I realized this morning, in that moment of carefree driving, that I was losing hope that this is how my life would be.

Maybe you think I'm crazy for feeling this way, that I'm over-reacting, but I've been dealing with hip pain for 4 years now and have spent the last 18 months of my life recovering from one surgery or another plus I became a first time mommy - when you put it all together it takes it's toll mentally as well as physically. There are days when I miss who I was before all of this, physically and emotionally, so bad that I want to cry. I look at those pictures of me in 2007 (the ones that keep heading up these Friday blog entries) and I wonder how I was possibly that girl and how quickly (relatively speaking) I got from there to here.

So, yes, it was a big deal when I did that yoga workout yesterday and things felt different.

Now to the upper/middle back, shoulder, and neck pain. Yup, seriously, I know, can I get a break!?

I keep putting out ribs. My osteopath snapped three more back into place today. My neck is also so tight she's amazed that I can move my head from side to side. How do I keep doing this to myself? You think I'd know, but I don't. I do, however, notice when my ribs pop out and it happens quite a lot and without any sort of fanfare. I can be sitting here at my desk, typing away, or I can be sitting with Daisy on the floor playing, and I'll feel a pop around my spine. I used to think it was my spine but it's not, it's ribs moving. But it's always when I'm sitting. The ribs are, of course, causing the shoulder and neck tension and, when unaddressed, result in the tension also going down my back. Clearly, the ribs need to be dealt with.

My osteopath suggested focusing on my lats, traps, and pecs more during my strength training workouts, to give my back and my ribs more muscular support and to help improve my posture. This is not the first time I have heard this in my lifetime and so I'm going take that advice and see what happens. I'm also making a very conscientious effort to sit in a more ergonomically correct position at my desk. I know I have a tendency to slouch and, when you work from home where nobody can see you, there is little motiviation to "sit pretty". Therefore, the only way to remember is to remind myself: I'm putting a little sticky on my computer that says "SIT UP STRAIGHT!"

Hopefully, if we can keep-up the progress with the hips and nip the back/shoulders/neck thing in the bud, I'll be able to sense true pain relief and the first inklings of long term recovery.

New Swooooon

Ohhhhhhhmagawwwwwwd. I finally saw New Moon last night and have to say that Team Jacob gave Team Edward a run for his money. Jeeeez... as my husband said, there is no aylor Lautner bulked-up that fast without artificial assistance. (Yes, Hubby came with me. I'm a lucky woman!)

I mean... HELLLO 6 pack abs! (And that little V that comes from the hips... fwoah... I need a fan!)
























But, at the end of the day, there's just no resisting the broody, come-to-bed eyes of a tortured-soul vampire. Team Edward will win every time, which (for those of us who have read and re-read the 4 books) we already know; poor Jacob is doomed to failure.

Although this post isn't intended to be a review of the movie, nor a Twihard gushing about the respective heart-throb's abs, here is my quick take on the movie.

I liked it better than Twilight... much better. I can see how some people are feeling it's a bit cheesy and I definitely felt that in the beginning but then I also felt the same way about Twilight. There are just such intense emotions in the books that develop over multiple scenes and conversations and this just can't be played-out in a movie (unless it was 5 hours long). So, by their very nature, movies of books always feel like they make jumps or leaps of logic or emotion, which can be awkward and, yes, a little cheesy at times. However, about a third of the way through, the intensity of the relationships in New Moon took over and I was into it.

I thought the special effects and the production values of New Moon were much better overall - although the scenes of the Quilettes changing into wolves had potential to look silly, they didn't; they did a good job with the transitions and with the movement of the wolves overall so that it was somewhat believeable (as believable as five men-come-wolves the size of grizzly bears moving at the speed of light can be!)

I also liked the changes they made from the book to the movie. In Twilight I felt that the added-in scenes were pointless and distracted you from the intensity of the love story (which really needed to be solidly established in the first movie for the rest to make sense.) Whereas, in New Moon, I thought the scenes they cut and added moved the story along without taking away too much from the central theme of Bella's pain and the developing relationship with Jacob. I especially liked the amped-up action scenes. I thought New Moon was the least interesting book overall and I thought that the movie improved on some of the pivotal moments that were somewhat lacklustre in the book.

What I didn't like as much was the soundtrack. I walked away from Twilight with each scene's music almost indelibly embedded in my head and, when I bought the CD, could picture which scene each song went with. I didn't get that same connection with New Moon. The soundtrack was forgettable and therefore the overall movie didn't seem to have that same "it" feel about it, if that makes sense.

Yet, the point of this post is more to wonder at the draw of these books and movies. WHAT IS IT about them? Yes, I have been somewhat vampire-crazy for many years and so I was pre-disposed to like these books regardless. But the impact they had on me when I read them and the level of giddy excitement I had waiting for the movie to start, is quite funny (haha and peculiar) to me.

I'll tell you that I shed a tear when I finished the last of the Twilight books. Those books got me through sleepless pregnant nights and plane journeys and, when I turned over the last page of Breaking Dawn, I literally mourned for the loss of Edward and Bella in my life, so much so that I picked book 1 back up again and started reading back through them. I have probably read each book at least three times by now and am again re-reading New Moon. Isn't that completely nuts???? I mean, I'm 34 years old! Aren't I supposed to be beyond the stage of getting obsessed with the latest teen craze?

Aparently not.

It's like Romeo and Juliet meets Dawson's Creek meets Buffy the Vampire Slayer meets... well, every major romantic plot line rolled into one. How many great movies or books can we name that meet these criteria!?

• Boy meets girl. Boy loses girl. Boy and girl re-unite.
• Good girl falls in love with 'bad' guy. Amazingly, he loves her back.
• Guy has scary secret he's afraid to reveal for fear of losing his girl but girl finds out and loves him anyway.
• Girl is put in danger and guy saves her.
• Guy or girl would rather die than be parted.
• Young love and lust denied and prohibited; the constant struggle with chastity.
• The love triangle. Girl is torn between two guys who fight for her attention.
• Best friend falls in love with best friend but he/she doesn't love him back the same way.
• Teenage rebellion.

... and more besides. The point is that Stephanie Meyer's genius is in the fact that she wraps all of these up into one saga and throws a little mystery and legend in for good measure. Regardless of the fact that she's no Shakespeare, her story is intoxicating and I am one big sucker for the whole shebang.

Roll on 2010 and the movie of my favorite book, Eclipse.

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Footnote: And, I might add, I left that movie theater without a single pain in either back or hip for the first time in WEEKS. Aparently Edward and Jacob's abs have restorative properties!

Connecting the dots

Yesterday I went to see my massage therapist. She has been on vacation for a few weeks and so I have not seen her in more than a month. During that time I have been stepping up my workout routine in an effort to get fit, get strong, and well, let's face it, lose that effin' baby weight. So, with all those things combined, I was a ball of muscles, tendons, ligaments, and fascia all fighting for a channel to spreadh their pain message. Tanya, my massage therapist, as usual, found them all one by one. It was brutal.

Today I went to see my osteopath. I had not seen her in 2 weeks. Her nose scrunched up in disappointment when I told her my current pain level (3-4) and list of ailments. (Nothing you haven't already heard, so I'll spare you the details.)

I told her I had been stepping up my exercise routine and thought that may have been the cause of the increased issues. She asked me exactly what that meant (ie: what I had been doing and how often) and by the time I had finished listing everything I do, she was pretty gobsmacked. It was only then I realized myself how much all these things I've been incrementally adding actually added up to:

• Power yoga 1-2 times per week
• Cardio @ the gym 3 mornings a week
• 30 minutes of strength training on the Total Gym 3 times a week
• 30 minute walks 3-4 times a week

Of course, I had the passing thought: Why the hell am I not losing weight? I didn't have time to linger because my treatment started.

At some point during an assault on my IT band, the doctor asked me if I was pooping fine. Strange question to ask, right, given that I was there for hip, groin, and thigh pain? It was, however, a thought-provoking question because that... um... particular element has been somewhat back-and-forth from different extremes lately. (Sorry if this is TMI - you know where the "x" is on your web browser!)

When I reported my... problem (let's call it) she said that osteopathic medicine believes that there is a connection between IT band tightness and my GI tract. Blockages or areas of tightness in my lateral thigh, therefore, could be caused by my erratic pooping or, of course, visa versa. I asked her which was which in my case and she said it was a bit like the chicken and the egg; you don't know which way around it is.

Logically, my brain went to the conclusion that nutrition and diet could be affecting all of this. (Of course --- and before you get to the comments section Elena --- this is not the first time I've heard this but it was the first time that I've opened my mind to the possibility.)

Further research when I got home basically led to articles on the autonomic nervous system (ANS) and the parasympathetic nervous system (PNS), which is a part of it. In lamens terms, the PNS regulates the body's visceral organs via the innervation of three kinds of tissues, one of which is muscle tissue. Through this process the PNS is connected to your GI tract, your bowels, your pelvis, and, particularly your pelvic diaphram. (It's all a lot more complicated and involved that that but that's the reader's digest version.)

Since all of these things are connected, it is possible that either:

(a) Many of my pain issues are causing pooping issues or

(b) My pooping issues are causing many of my pain issues, particularly in my pelvis and pubic bone area.

Of course, if it's (b), a different diet could help.

And then, of course, there's the issue of my not losing weight despite all the exercising and dieting I have been doing.

And then I connected the dots.

And then came the acceptance.

Maybe - just maybe - if I changed my diet, I could affect my pain outcomes and lose weight.

Bottom line, I've been avoiding this conversation with myself for quite some time. I've seen friends change the way they eat and report benefits above-and-beyond weight-loss but I thought I knew better. (Or, realistically, hoped I did.) I've lost weight in the past on my own knowledge and under my own steam and thought I could just go down that the same path again.

Yet, it's not working. I've been at it for more than 4 months now and haven't really lost a pound. Ok, I haven't always been as "good" as I could have been and have only recently stepped-up the exercise but there should have been some incremental improvement; I haven't seen it.

Although I have been too stubborn to admit it, my body is not responding as it once did. This could be attributable to my age, my hip surgery, the fact I carried a baby, and/or my c-section. Who the hell knows? When I list it like that, it's quite frankly unsurprising that my body may be a different beast these days.

I'm not saying I'm definitely convinced there's some hollistic answer to all of my problems and I'm absolutely not saying I'm going to become some crazy person who will only eat certain foods and who delivers a 20 minute list of dos and don'ts to the waitress at a restaurant. I'm just saying that I'm open to modifying my diet right now. The whole nerve thing made sense on a practical level (rather than the hocusy-pocusy level that this stuff is often presented on) and so I'm willing to try.

So, I started googling nutrition and pain. I've already found some interesting information I think I can put to work right away and I'll report on that in a future post. For now I'll end here and await the "I told you so!" (and helpful advice) from my friend, Elena. :o)

No shame but no gain

The above picture was taken for Halloween 2007. Dang I was thin. Sigh.

Ok, so let's get straight to it. It was not the successful week I was hoping for.

CURRENT WEIGHT: 158.6 lbs
WEIGHT LOST THIS WEEK: +0.2lbs
CURRENT CLOTHING SIZE: 10-12
GOAL WEIGHT: 145lbs
GOAL CLOTHING SIZE: 6-8
NUMBER OF WEEKS TO GOAL: 10
LBS TO GOAL: 13.6 lbs

Clearly 0.2lbs can be the difference between pre-pee and post-pee, so I'm not going to beat myself up about that. But the reality is that I have not LOST any weight. Again. I'm stuck. I just don't get it.

This week I even instigated an early morning gym session. I got up Monday, Wednesday, and today at 5:30am, dashed off to the gym as quietly as I could, did 30 minutes of cardio, and dashed back before Daisy woke up. My goal was to get there and back in an hour, and I made it each day. On those same days, I still did a 30 minute Total Gym workout. I also did a Power Yoga workout on Thursday.

The only thing left to do, that has worked like gangbusters in the past, is to cut out my evening meal. Eating at night has never really worked for me. When I was at my thinnest, I was skipping that end-of-day meal and eating a snack in the late afternoon instead. This way, the food still has time to burn off.

Mostly, I eat in the evening to be social. Time with hubby, time with family etc... Secondarily, I eat because it makes sure Hubby eats - he needs to eat; we need to change the balance of weight in our relationship. Since Daisy has been born, however, we rarely get to eat together, we usually get take-out, and I eat it so fast that I barely get to taste it. So, it's got to go. That's the change for next week.

As for my hip. Rotten week. My right butt cheek feels like it's been hit with a baseball bat, over and over. I know what this is - a combination of a tight piriformis and tight IT band - but I'm going to have to get ahead of it today and take a muscle relaxant - I can barely sit on it.

Pain Drain

Tonight Hubby commented that I have a ton more energy at the end of the day when I haven't been in pain all day with my hip.

This may sounds obvious (DUH!) but it's not until you have a good day that you realize just how emotionally and physically draining daily pain can be.

So what did I do differently today? Well, I woke up with quite a bit of lower back and hip stiffness and, knowing I had a long day ahead of me that included a photo-shoot in William Land Park as well as an afternoon at the Pumpkin Patch (more on Lazy Crazy Daisy later) with some kiddos, I got ahead of my pain and took two pain-killers - the 1-2 punch of Ibuprofen and Codeine from the English wonder-pills, Nurofen Plus.

Normally, I don't like to rely on pain pills, especially since my pain is chronic and daily. First, it's just not good for you. Second, I'm shit-scared of being dependent. Third, how the hell do I know if I'm progressing with my other efforts if I'm constantly masking the pain? BUT, today's experience reminds me that, every now and again it's good to take a mental and physical health break from the daily beat-down of soreness and stiffness.

Incidentally, I think I need a new mattress. I just can't seem to get comfortable at night any more. Every part of my body - from my neck down to my feet - seems to twinge or ache while I'm in bed these days. It's been a week or two since I had a full night's rest; I continually wake up sometime between 1am and 3am feeling uncomfortable. I wonder how much difference a new mattress will make on my hip pain and stiffness? I'm going to have to save-up to find out!

Friday Motivation - Week 2 (On Monday)

Since I was on a business trip last week, I missed the opportunity to post my Friday Motivation picture and stats. However, since I'm not one to puss-out and use all that fattening conference food as an excuse, I weighed myself on Saturday morning and am posting Saturday's Friday Motivation on Monday. (Ahem)



This week's picture is from our honeymoon in Belize in June of 2007. Here I'm sitting on top of El Castillo, a Mayan pyramid at the ruins in Xunantunich. I chose this one because I'm not the smallest I've ever been here but I'm toned and comfortable with myself which, quite frankly, are two factors more important to me than any number on the scale.

That aside, I do need something to measure my goals by, so here we go with the dreaded stats. Not much to celebrate over except to say that I didn't put on weight last week, despite not working out, drinking like a fish, and eating conference food.

CURRENT WEIGHT: 158.6 lbs
WEIGHT LOST THIS WEEK: 0.4 lbs
CURRENT CLOTHING SIZE: 10-12
GOAL WEIGHT: 145lbs
GOAL CLOTHING SIZE: 6-8
NUMBER OF WEEKS TO GOAL: 12
LBS TO GOAL: 13.6 lbs

I guess I just need to do better this week.

As for my trip... man it was exhausting. 3 days of being in sales mode from 7am to 11pm - breakfast, lunch, dinner, cocktails (and boy, were there cocktails!) That said, it was the longest stint of time that I've spent just being "me" since Daisy was born. It was at once freeing and alien. I was so busy most of the time that, although I missed her, I was doing fine. That was until I saw a mommy and her baby bouncing around in the hotel pool on the last day, which brought tears to my eyes and sent me checking-out and speeding home.

During my conference, however, I had somewhat of a revelation.

When I couldn't get on one of the 3 working cardio machines at the hotel "fitness center" on Thursday morning, I decided instead to don a pair of jeans, some sneakers and two layers of sweater (because it was about 30 degrees!) and take a long walk to-and-from Starbucks. It was about one third of the way there, as I was striding in full-force down the strip, that I realized that my hip didn't hurt. Not one iota. Not my hip, not my thigh, not my knees. (My pinkie toe is another issue we won't address here.) For the first time, it actually occurred to me that I felt... well... normal! This was elating but surprising because I had been traipsing around all Wednesday in ridiculously high-heeled boots and had spent a good portion of my day on my feet in said high-heeled boots.

Was it the altitude? The crisp morning air? Of course, it definitely got me to wondering, especially when I woke up on Saturday morning after my first afternoon/night home, feeling as though I'd been hit by a truck.

The variables from my conference days in Tahoe as opposed to my regular days at home were:

1. More time on my feet/standing
2. Wearing high-heels
3. Less time on the computer
4. Drinking more alcohol
5. Different bed

So I concluded that I need to stand all day in high-heels with a cocktail in my hand? Sounds nice but but, of course, I'm joking.

What I can tell you is that this week I am going to:

1. Research a new matttress - especially after a horrible Saturday night where every part of me hurt, leading me to have a ridiculously tight illiopsoas that resulted in me needing a muscle-relaxant and a 600mg of ibuprofen before bed last night.
2. Sit straighter in my chair (can already attest that I am doing that as I write this post)
3. Get up more often from my desk and walk around/stretch (need to finish this post and then I will)
4. Buy new sneakers
5. Stop wearing flip-flops, even my orthopedic ones, when I go out (the cooler weather will help there)

I'd like to add drink apple-martinis in place of water there but I doubt that would do my weight or my liver any good.

So, we'll see if that makes any difference.