When we hear unpleasant news, we grit our teeth and the muscles in our necks tighten up.  That  spreads to the rest of the spine and it reverberates throughout the body.  Many of us will experience tension headaches from the stress as well as stomach upsets.  It is all connected to the bad news.  Some of us feel stress in our shoulders as soon as bad news is encountered.  Many of us feel it in our low backs.  Everyone has that area of the body that tightens up initially when a stressor is encountered. We have had many of those lately. 

Under normal circumstances, the sympathetic nervous system is in balance with the parasympathetic nervous system.  When a person is threatened in some way, the autonomic nervous system becomes unbalanced and the body goes into high alert with blood pumping and the heart racing.  All of the muscles in the body tighten up in order to defend against the stressor.  This  can cause increased pain in all of  the muscles of the body.

In addition, when we don't sleep due to stress, the body cannot recover from the stressors of the day and sleep deprived individuals are even more stressed and therefore feel more pain. 

What can be do about the economic stress and its effect on our body?  We can get our normal 7-8 hours of sleep.  Regular exercise including a good stretching program is key to keeping our body systems going.  A good diet including supplements like B complex and vitamin C will help guard against illness especially when we are vulnerable.  Keeping hydrated is essential for everyone at all times.  Staying away from stressors like caffeine and nicotine can help us to keep our pain under control.  Meditation and biofeedback can be helpful as well. 

My personal favorite anti-stressors include all of the above as well as Primal Reflex Release exercises and the CES system by Alpha Stim.  Both help to rebalance the autonomic nervous system. 

When we become stressed, we often give up on the everyday healthy habits that we find so important during our normal activities when things are going well.  We need to maintain those habits in order to be able to manage during the stressful times.  This will help to guard against any increased pain that may be caused by a stressor, even the bad economy.

My knee is hurting from the chair at work. The elevator is out in my apt. I'm on the highest floor. Anywho..

Physical Therapist Asst looks at my ankle and says you have a lot of swelling. I need to give you a massage on your ankle. So, I'm going thru the ropes of exercises. Now, I'm getting scolded by the Paraguarian and Bulgarian PTA about my ankle.  Thick accents say to me, you need to come to therapy b/c your ankle needs much work. Bulgarian PTA is working my ankle like I kick her. She kneads my ankle for 10 minutes. My thick scar receives kneading  for five minutes alone. I'm like dayum !

Her comes the Paraguayan PTA to measure my ankle. The measurements are for improvement in my ankle. She pulls and pushes my ankle to feats that I have not confidentially gain on my on! She goes over my measurements and says you have not improve here. Also, she tells me. My scars tissue is restricting my range of motion.  We will work on this.. I told her that I'll ice down at home. She says no.. You need your electrical stimulation on your ankle. I said ok! Now, i'm iced and have current going at 16. When I first had physical therapy after surgery. I was up to 20.  I lay back on the table with my arms over my eyes. I start crying the pain was not cool for me. The Paraguayan PTA comes over to say something me. Tears are flowing hard. She apologies for the measurements. I told her i'm ok.

I'll be in PT for months..  *sigh*.

I'm calling my ortho nurse and asking for ultrasound too.  Maybe it will loosen my scar tissue. I'll ask about my own personal TENS unit or Celebrex script.

My Internist told me that my scar is keloid.  She says they inject cortizone in the scar to lighten it. I need to call her and ask does it breaks down the scar tissue too. I would hate to have surgery to reduce the scar tissue.  Mebbe I need to go back to acupuncture for help with scarring.

Those of you with back pain, this guy or folks on his blog says it great for it.

My day  was supposed to be restful or free flowing.. damn!

In Minnesota, a program called Stand Up and Be Strong was developed in response to the growing evidence that falling is a major cause of hospitalization and declining health in adults over the age of 65 years.   

Research has shown that physical activity is effective in improving balance and strength, two primary elements of strong stance.  Additional evidence has shown strengthening to be a primary and effective tactic to decrease incidences of falling.  It is only one part of a multifaceted, comprehensive approach, but it is a key ingredient to achieve and maintain safe and independent function. 

I have often thought that probably 100% of the clients we care for through  Seniors' Choice at Home could benefit from a regular strengthening program through a physical and/or occupational therapist.  Unfortunately, Medicare and private insurances pay for these services only when they meet certain criteria.  However, the cost is an investment that brings valuable benefits.

Yesterday, I spent some time with an occupational therapist from a new company in Minnesota called Above and Beyond Senior Services.  She and her partner, a physical therapist, both have extensive experience working with seniors.  One of the reasons they started their company was because they believed that seniors could benefit from their services beyond the time that Medicare allows.  Besides physical and occuaptional therapy services, they offer a wealth of help including cognitive assessment.   Their assessment and interpretation of a battery of evaluation tools help seniors and their caregivers learn how cognitive impairment affects one's living situation, medication and money management, driving and activities of daily living.  Even more importantly, they help clients and care givers learn how they can improve their living situation.  You can check out Above and Beyond at thir website:  www.aboveservices.com.  In general, Minnesota has some good resources regarding fall prevention at: www.mnfallsprevention.org

There are many good physical/occupational therapy organizations all over the US.  Even though the service may seem expensive, preventing a fall, preventing a hospitalization, preventing a nursing home stay are all invaluable.  The US has not come very far in helping patients recover from a hip fracture.  The mortality rate has not improved very much in the past 50 years, so any measures to prevent a fall are so worth the expense.

But if nothing else, it was a change of scene. I visited a local motel where I can sleep, and stayed for 6 nights. I managed to stay away from the nursing home for all but one day (which is no small miracle for me.)  I generally go every other day, if not every day.  However, I did get lots of calls from the staff regarding various concerns. Rob and Tony visited her during that time, as that is the only break I've gotten from the situation since mid June.

When I last wrote, my brother, my husband and I attended a family meeting at the nursing home about the future plans for my mom. For those just starting to read my blog, in June of this year, she fell and broke her right foot and her left leg. She did not require surgery for those injuries, but needed a great deal of therapy. Just when she concluded her therapy, and was about to go home, she fell and broke her hip.

The hip injury did require surgery, and the decline in my mom's health has been remarkable since that time. The anesthesia caused initial mental problems, but we were told even before the surgery that my mom "might never be the same." Apparently, for anyone over 50 (yes 50) anesthesia can pose numerous risks. It stays in the system, and does its dirty work for a long, long time. In fact, some of the effects can be permanent. I remember the first night my mom was brought back to the nursing home, after being released from the hospital, she kept seeing bugs on the wall, and was greatly agitated. The cognitive issues subsided a little, but then returned. There are many times when she is completely lucid, and others when she is anything but.

Two that stand out, are the time that she told her nursing assistants that she didn't need a shower, because she had spent the night at a nurse's home, and gotten her shower there (as well as her breakfast), and the time very recently, when she stopped her normal conversation with a nurse, and abruptly asked how those babies got up on her cabinet shelf, and how were they able to stay up there.

The timing of these type of events is enough to make your head spend, because everything will seem totally normal. Conversations will be typical, and then suddenly you enter the Twilight Zone. It is very startling, and extremely heartbreaking.

At any rate, we have reached the place where my mom's Medicare has pretty much run out. This leaves us with the expense of about $200 per day for her room in the nursing home.. Medicare B has taken up the cost of the therapy only. The 26th was the cutoff date. Here is our dilemma: She does not presently qualify for Assisted Living. There are certain criteria that have to be met. The nursing home does their assessment, and the assisted living facility will also do one. Presently, her rate of incontinence is a huge problem. The assisted living will accept some incontinence, but if the accidents are too frequent, and the clothes and bedding are undetected for too long, it becomes a problem they can't tolerate. She also needs to be able to follow and adhere to instructions for her safety, and that means using her walker and/or wheelchair properly, and at all times. (She is presently unable to recall that she needs to do these things, and often tries to stand up and walk without the use of either.)  She is so shaky on her feet at the moment, that this poses a tremendous risk. In fact, this past weekend, she got out of her wheelchair, and tripped and fell. She was sent to the ER for x-rays, as she fell on her broken hip side, but praise God, she was found to be okay this time--meaning nothing broken (except my heart.)

The falls are a constant risk, and you can only have a certain amount of falls once you get to assisted living, before you no longer qualify.  (Not to mention before she would have to go back to the nursing home.) There are levels of care that the assisted living provides, and with each add-on the cost increases to the point of becoming astronomical. Her costs would be close to $4,000 monthly with the needed additional care, such as the giving of medications and insulin shots, assistance in and out of the shower, help with transportation to and from doctor appointments, etc.

Several weeks ago, Rob and I researched the assisted living facilities in our local area. We decided that the Bluewater Bay and Sandestin locations were just too far to get to her quickly and conveniently. I would not want to make those long trips every time I needed to check on her or visit. So that pretty much left us with 2 choices. We decided on one that was near the hospital, and the clinic where her doctors are located. It was a little less expensive than the other one, and the rooms were actually larger. It was very nice. We looked at the one bedrooms.

So for the last two weeks, physical and occupational therapy have been working on getting my mom to a place where she could qualify for assisted living. However, they have warned us that she may not be able to achieve that goal right now, with unresolved physical and mental issues. We have not heard their assessment as of yet, but we do realize, while it would be the nicer option, in terms of some privacy and independence retained, it is also risky because she would only be checked on every 2 hours, instead of several times an hour, as she is now.

Then there is the option of going home. However, going home will never be the way it was. The social worker has informed us that if my brother moved in with her, and took her home, he would still need to provide 24 hour care (when he is not there) by a competent adult, who could do the things she needs done, and prevent her from doing the things she shouldn't. The most basic care would be $10 to $15 dollars an hour, and it would probably be more, considering the amount of care and assistance she would need. Rob and I are concerned about the amount of distance to be covered in her home, and feel that minimizing the area she covers would contribute to her safety. We also feel that she would be very unhappy being eyeballed all day long. She is a very private person, as I am, and I understand the need for some privacy, if at all possible. Of course, with my brother and his son moving in, there would be much more housework, washing, cooking, etc., and she is not really able to do that. They have lived there before, and while everyone got along fine, it is still very difficult when you are used to living alone.

The final choice is to stay in the nursing home, and try to get a private room. This would be about $700 or so more a month, as a supplemental payment to Medicaid, but what a difference it would make. It has nearly driven her crazy (as it would me) to be in the room with different people, and to share a bathroom. Even though she claims to hate the nursing home, with the exception of one unsolved incident on the nighttime shift, everyone has treated her royally. We like all the nurses and feel we can talk to them, and some have become real advocates for her. They genuinely care about her (though she has grown increasingly difficult to get along with, because of her anger, frustration, and the dementia.) The nursing assistants are nice (though often very slow in answering the call button, but that is the case almost anywhere these days.) I have been pleasantly surprised at the general compassion and caring that the staff exhibits. There was one incident where a CNA  was rough with her in the night, and I was called and informed that she had 2 superficial abrasions on her wrist. Unfortunately, because Betty couldn't remember the details, the investigation was dropped. But I requested that the overnight CNAs be accompanied by a nurse, though I don't know if that is still continuing. (The patients are checked often in the night to see if they are wet.) But that is the only negative incident in regard to her personal care that has occurred. I know most everyone else very well, but I am not familiar with the overnight CNA staff.  As nursing facilities go, the staff is excellent. Yes, there are frustrations for all of us sometimes, but there would be anywhere.

This post is getting too long, so I will tell you the outcome of the meeting, and where we stand now in the process, in my next entry. To avoid a nervous breakdown and a physical one, I am having to trust God every step of the way. Sometimes I succeed at that, and sometimes I don't. It is very, very difficult-the most difficult time of my life so far. I pray that the God who calmed the sea, would reach down and calm the storm in me...

Please see other articles that I have written here:

http://www.associatedcontent.com/user/109497/lonnette_harrell.html

Fortunately it's a very little shoe.  A Shoshanna-sized shoe, even.

We have been keeping an eye on Shoshanna's gross motor development for a while, and noting that her left side still lags significantly behind her right, and that there is noticeably less muscle mass in her left calf than in her right.  Longtime readers may recall that for quite a long time she would only use her left hand if we forced her to.  After months and months of that, she's definitely still right-hand dominant but she does use her left hand more or less appropriately for a right-handed person.

The same thing goes for her legs.  She can hop well on her right foot without support; she can't even conceptualize standing on just her left foot without help.  With encouragement and support, she can hop on the left foot, but we have really force her to start on that foot and she needs to be holding on to someone or something.

So at her 4-year checkup (other details below), I asked the pediatrician about it.  He tested her strength and noted that there is definitely a difference between the two legs (it was so, SO obvious) and opined that getting her back into PT was the best course of action.  Fortunately, Shoshanna thinks that this is the best idea EVER because as far as she's concerned, PT means getting to play on the trampoline, bike, scooters, and roller skates at school.  We'll have to see if she qualifies for services through the school district (and I am NOT looking forward to the headache of navigating that part of the school district along with the kindergarten paperwork maze); if not, our health insurance will cover it up to a certain point but then the services won't be part of her school day.

As for the rest of her checkup, it went brilliantly.  Once she got comfortable, she talked Dr. S's ear off, telling him all about school and her friends and informing him that she knows how to do math (which she does).  He told me that he didn't think we needed to test her lead levels despite our house almost certainly having lead paint somewhere... I said, "Is there any way this child has lead poisoning, really?"  He said, "Well, maybe she does, and without it she'd be a super-genius!"  I figure that if this is our kid on lead, we're better off that way, because if she was any cleverer, we'd be in some pretty deep trouble.  She also had her hearing and vision checked, both of which were perfectly normal, and she showed that she has a FREAKILY good memory - she remembered the "race car game" from when she had a tympanogram two years ago.  That's just SCARY.

Oh, and her size.  You know that you all want to know how big she is.  She weighed in at 36.6 pounds and was 39.5" tall.  For those playing along at home, that's 50th percentile for height and 65th for weight.  She really is a big girl.

I have evolved in the acute care setting. There's still a long ways to go, as everyday I see patients hooked up to equipments I've never seen before. But there's definite progress. Note writing, albeit not the most efficient, is becoming easier and taking a shorter period of time. I'm getting a little more patient interaction, as well as becoming more familiar with the nursing staff on the floor to coordinate activities. I know where to look for those little sockies, the assistive devices, the foley, the hema-vac, and at least know who to go for directions. I'm excited to see the amount of growth that can occur in the next 9 weeks! 

Due to complications, I have not seen by case study pt for the past 2 days and honestly, I missed her! She wasn't clear for PT treatment today but we still paid her a visit- and she said she's glad we didn't forget about her...such a cute little lady. Her case has gotten more interesting with the complications, though I wish it were less because it'd be better for her.

I've just finished the stir fry noodles - prepped on Monday - and will head to the gym now to blow out exhaust and generate good energy!

The office is empty. I'm always the last one to leave. I used to be the last out of the classroom in kindergarten. That's me, haven't changed a bit through all these years!

Yes, I am now doing one land and one pool visit at re-hab for six weeks. I already see some changes..I am constantly sore now. I know, no pain, no gain. In talking to the pool therapist (Brandy) today about anagrams she said she would need to see one. It is a little difficult to explain. I did this one today after therapy, and will give it to her next week when I visit. She gave me another good work out, though before all this vertigo, etc. ever happened, what I did today would be child's play. That's ok, I am making an improvement, little by little. And yes, she did notice my more northern accent. It becomes the clarifier in the anagram.

Here's the comics collage for today.

I partially feel like suggesting I go jogging was a clever way to trick me into realizing that even though we're making progress in my knee rehabilitation, I'm not ready to jump back in. Luckily when I told Jacquie about the pain, rather than advising I take another few weeks off, she took to my suggestion that I could ride to our appointments as a warm-up. It's only 1.5 miles, totally flat, I'll take it easy I promise. I tried not to push too hard or seem too excited by the thought, that somehow the suggestion is so fragile that it would smash if I try to force it.

I can't help but feel a bit silly about my injury. I realize it isn't anything TOO serious, but still. Thousands of people ride their bikes each day, many of them riding more miles with less experience and conditioning...so what did I do wrong? I expect it was all those days I got lazy and didn't stretch before riding home from work, or having never gotten a bike fitting. But I am not alone! Yesterday I found Chris' page. Finally, someone who is a more experienced rider having the same troubles as I am. I hate to say it, but misery loves company, but at least I'm in good company.

Call me to tour this wonderful three bedroom, two bath, one car grage home with pergo floors in all common areas and a fabulous tiered back yard with lush mature landscaping and hardwood trees! Hitting this market this week at 149,900 with updated pain colors, window covering and more. This may not be a NEW home but it has a mordern floor plan and a great fenced-in yard. Located near Half-Moon off the Summersill light, turn right on Autumn and left on Winter, home is on your right near end of the cul-de-sac. Very close to Summersill Elem.

This lovely home is owned by none other than Jesse James Smith, who runs Carolina Fitness Boot Camp. Group sessions available, great rates and unmatched enthusiasm!

Visit Carolina Fitness Boot Camp at http://www.CarolinaFitnessBootCamp.com

         Whether you are preparing to have a new knee or hip surgery, or you just had surgery, one of your key allies in a successful recover is ice.  The use of ice, in a pack or bag, is a natural way to drastically improve healing, reduce edema, inflammation, and pain. 

Since ice is a natural substance, the only side-effects you have to worry about are:

1. You need to make sure your ice pack is wrapped in a pillowcase or towel. Do not place an ice pack directly on your skin.  It can burn, or blister you.

2. Discomfort. Icing in general is not a pleasurable experience.

3. Condensation or wetness. In which having a small towel under your limb to catch the water will aid with that.

To achieve amazing results, one must understand some key principles.

Successful Icing is based on three key factors:

1)    Size of area covered with the cold pack.

2)    Significance of the cold obtained be the ice pack.  Rather the difference between the temperature of the ice pack and your tissue.  The colder the better. (CAUTION) please use a towel or pillow case between the ice pack and your skin.

3)    Time or duration you have applied the ice pack.

First: Large enough ice-pack to do the job.

The size of the ice pack is critical.  The larger the surface area covered by the cold, the better the physiological response/adaptation to the cold effects. 

Suggested Ice Packs:

        Rehabilitation grade ice packs called ColPac.  Lots of Physical Therapy Centers use them.

asc by Chattanooga are the best.  Try here. http://www.painreliever.com/Colpac%20Products.html?gclid=COuz0vbdlZYCFQQCagodl0GdEQ

        Longs Drugs also carries a really affordable

 ice pack. look for the 15”  x 10” size.

      You can also make your own.  I have listed the recipe for home-made ice packs under the                 category.

Second:  Ice pack is cold enough to achieve effect.

         It is important to use one of the above, or similar ice pack systems to achieve great results.  Using frozen vegetables, and ice cubes is not cold enough. 

         What do I mean “ not cold enough”.  The ice pack must stay consistently cold for at least 20 minutes.  Ice, and or frozen vegetables absorb your body heat and warm up to room temperature too fast.  

Third:   Time required to achieve optimal results.

         For icing to be effective, the first 10-15  minutes are required to initiate the bio-chemical/physiological response that will benefit your healing. Then icing requires a second 10 minutes minimum to reach full effectiveness.  That is why it is important to have adequate cold and keep the ice pack applied for 25-30 minutes. 

“It is to your benefit to find a very high quality ice pack and get used to using it after your exercise routine.” 

“Be consistent with your icing.  It is as important as pain meds, and exercises.”

                                                                Mark A. Smith P.T.

P.S. Ice is your friend!!!

He looked at me and smiled.  As he handed me the wallet, I remarked that it was one of the largest I had ever seen.  It was full of cash and credit cards causing a huge lump in his right buttock.  Every time this man sat down, the bulge pushed his right hip forward.  Since he worked as a truck driver, this caused a repetitive injury to his hip.  I asked him to remove most of the materials in the wallet before our next session.  He agreed readily.   I then asked him to consider putting the wallet in his front pocket but he assured me that the request was just more than he could agree to do.  "Habits are hard to change.  How about if I try to first one and see how I do?"  We agreed to take one step at a time.

Why do men always feel the need to fill up their wallets and to put them in a rear pocket?  Whatever the history of this particular practice, this can cause real problems with respect to back and hip pain.  So lots of cash can cause back pain.  Unloading that wallet for the man is just as important as unloading a purse for a woman.

For those that are pressed for time or dont think they have enough time to get a workout in I have a solution.  It is called the super leg workout.  I got this from Carlos Santana (not the musician), one of the most well known and sought after strength/conditioning professional in the industry.  Check him out at www.ihpfit.com.

This workout should take less then 2 minutes at its entirety and only requires your body weight.  Who doesnt have that amount of time?  If you tell me you dont have 2 minutes my answer is  "then just do it faster!"

So here it is:  

1.)   20 squats

2.)  20 alternating lunges

3.)  20 scissor jumps (not full depth)

4.)   20 jump squats

Now for those just beginning, here is a modified version:

Do the above but just do 6 reps of each.  Add 2 reps each week until you have worked up to 20 reps.  After completeing a set (at whatever rep scheme) rest 1-2 minutes and do another set or two (if you have the time).

If you dont like the jumps just substitute the split jump for lateral lunges and the jump squats for squats (at the end).

This will definitely build your leg strength and get your heart pumping.  Try it and you'll see!

Get Strong! Stay Strong!

Chris

It is a fascinating procedure, one that offers a lower level of invasiveness, as spinal surgeries go.  A rather quick recovery, and if it works, the reduction of pain is rather substantial. 

     Below is a picture of the titanium device.                                                          

It is placed between two vertebrae, and is not screwed into the vertebral bodies or any bone structure. It is placed between two of your spinous process and away from your nerves and spinal cord.

the procedure is called IPD: Interspinous Process Decompression. 

In layman's terms it acts as a sophisticated wedge that keeps your vertebrae from compressing your nerves when you are standing upright. 

The rehabilitation and recovery after this procedure is pretty straight forward.  

Your goals immediately after surgery are to:  1) get your pain in control, 2) decrease post op inflammation.3) begin to strengthen your legs, trunk and back.  See my next post about exercises for after the X-Stop surgery, and/or consult a physical therapist. 

   Here is a great website for further or more detailed information.

 http://www.back-pain-online.com/treatments/xstop.htm

Symptoms for spinal stenosis are:  

• dull or aching back pain spreading to your legs
• numbness and “pins and needles” in your legs, calves or buttocks
• weakness, or a loss of balance, and
• a decreased endurance for physical activities 

 The symptoms can increase when walking or standing for a length of time.  

If you have the about symptoms, you can decrease or  improve your symptoms if you sit, lean forward stretching your low back, lie down, and/or put your feet up. 

   Make sure you have a qualified MD assess you before you think you have spinal stenosis. There are other spinal conditions that have similar conditions.

Yes, all was fine and dandy until today's lab.  Today we palpated and drew the anterior and posterior hip, and for those of you who know what that means, you feel my pain.  For those of you who don't, let's just say we all got nakey and were drawn on in places that normally don't ever see sunlight.  Oh, it was loads of fun...  I know my classmates better than I really ever wanted to, honestly.  Now why do I like surface anatomy again?

Somehow I was never warned about the lack of modesty reserved for you when you enter a healthcare profession.  Slowly but surely I'm becoming numbed to many things that would have shocked me two years ago; working in a hospital and enrolling in PT school will do that to you, apparently.  I think that should be a prerequisite course for allied health and medical professionals: "How Not To Be Shocked By Crazy, Embarrassing, or Otherwise Shocking Things."  I might suggest that to my alma mater.  Speaking of which -- this weekend is homecoming!  I can't wait to join the festivities.  Go Buffs!

There is a small amount of scar tissue touching the cord, but the Dr. says that shouldn't cause any issues.  There were signal changes in the cord after the June 23rd surgery.  These signal changes are the cause of the numbness in my legs. The Dr. does not foresee any improvement in the numbness, but hey...at least I can walk. 

I have a CT Scan in 1 month, at which time I will be relieved of my neck brace assuming everything looks good.  I have another MRI in six months to monitor the site.  The Dr. advised me to take it very easy.  I have not been cleared for Physical Therapy, he wants me to wait until after the brace is off.

All in all, it was great news!  Thank you for sending all the positive vibes my way...much appreciated!

Yes, I am back. No, I did not kill myself or accidentally get myself killed – yet. I have two partial entries written, but things kept happening so fast around me, I couldn't get anything finished before something else fell on top of my aluminum-wearing head (that is a joke). I know it is hard to believe that everything I write in here is real, yet it is, to the best of my ability to be honest, including about myself.

I am a real human being. These things have happened to me. Gets easier to understand the nearly daily wishing I could off myself, doesn't it?

I guess I am in sarcasm mode today. It isn't a pretty mode for me, and I am rarely in it. But it has been a very rough time lately. Pardon me if I accidentally repeat myself, as I am not reading my last entry first, so I have no idea what I wrote in that one at the time.

I think perhaps I wrote about my pathetic birthday party, where only seven people showed up and it rained the entire time until we took the tent down. Let's start from there. In no particular order, since I couldn't remember order if it bit me on the ass.

For one thing, I broke my left foot. Of course. How did I break my left foot? Just walking. Just walking. (I do love the movie, btw.) How is that for absurd? All I had to do was walk and my foot was broken. Do you wonder that I sit and shake my head and laugh or cry or feel like I am losing it when I can break my foot just walking?

It took three doctors and quite awhile to find out that this is what had happened. They finally sent me to a podiatrist in the boonies who called me “honey” and “dear” and made me want to punch him. He did x-rays, and came back in with the simple diagnosis “Hon, you're a mess.” It isn't just the fracture; there are about a half-dozen things wrong with my foot, which will probably send me back to physical therapy yet again.

There were days during all this waiting that I felt like large railroad spikes were being driven through various areas of my foot, especially my heel, which is where the fracture occurred. At least I heal well, and after three weeks in The Boot (I hate that thing; I feel like I should be a Dominatrix with a whip while wearing the thing, nothing against Dommes, mind you), my left foot was well on its way to healing, but my right foot was completely bruised from the metal insets on the The Boot. Luckily, no breaks on the right; just a tremendous amount of pain from the bruising.

Sirens outside again. This is about the third time I have heard them. I hope the city is still there, as it appears I certainly am.

I have another outbreak of Thrush. It's common, with the breathing meds I take for my COPD. It's easy enough to fix. But everything I eat, drink or take burns to eat,.drink, or take. To the point where I feel like screaming and have to jump up and down and shake my arm to make it STOP! Very painful.

I have been on the welfare merry-go-round yet again (also known as the “You-pathetic-loser-

What's-wrong-with-you-that-you-couldn't-make-it-on-your-own). My mother-in-law tried to get me signed up for everything. I did get signed up for Food Stamps, but there is one item missing they need (a note from a doctor saying I can't work, I believe), and I don't get them until then and I don't see my doctor until next week. The rabbi I used to work for paid my gas bill, reluctantly. And I am still facing the electric bill of over $600, wondering how in the world I am going to deal with that. Doing this poor person dance is difficult. It's like tap-dancing in a roomful of cats. Literally.

My life has been threatened by two different men in the past weeks. I may have mentioned one of these last time, but I don't recall. M-i-law S. has this agreement going with a group of guys that they get to borrow her car, as long as they fill it up with gas when they bring it back to her. That way, she has gas, they have transportation, and I, well, I think it's a weird deal at best.

At any rate, “the boys” as S. calls them were going to pick me up, pick up S., and all of us were going to run errands and go to appointments. Until I tried to point out that there would have been an easier way to do this (not really understanding what it was they were doing, mind you), and J. lost it. He screamed at me, called me every name in the book,, threatened to kill me, and damn near did by ramming the car within inches of a large truck on my side. I got out of the car when he stopped, because I will NEVER be in a car with that lunatic again. I was made to understand finally that he had been raped and very recently diagnosed with HIV with very low titers. I feel very badly for him for that, but that's all he had to say to me: “Look, this is what is happening, and I need some space, okay?” No problem. But he didn't say a thing until he nearly caused an accident.

Then there is my next-door-neighbor, M. And most of this breaks my heart because I do love his common-law-wife, K., I really do. She is sweet and kind and lovely, with a lot of laughter and love in her. We have been tip-toeing around things because M. can't stand me and vice versa. But it's all come to a head.

One day, I was talking to K., having a nice time, and we hugged (as we are prone to do) goodbye. M. saw us and snapped “Break it up!”. So we went our own ways to do whatever we were doing. Wouldn't you know it – I fell again (I fell 5 times in 6 days; I think that's a record). I asked her to come help a bit because I was in pain. She did, and then M. barges over like the shit-infested bull he is, and tells her (and I do quote exactly here): “Get your ass on home, bitch!” You don't talk to my friends in front of me that way, and you damn sure don't do it in my home. I was furious.

I kept trying to reach her on the phone, but of course, he was not allowing her to answer. He is a very controlling little schmuck, and if he doesn't want her to talk to anyone, he won't let her have the phone book, he won't put her on the phone, and he will talk to whoever is calling.

I tried maybe six times; I don't consider that harassment. I was truly concerned for her safety. He had closed all the doors and windows, wasn't letting her speak to anyone, and I was terrified for her.

So I called the police and told them this. And what happened? She backed M. up. She lied.

I whispered to her as she went into the house “I cannot believe you lied to the police!”. She ignored me. My heart was broken; here I was, going out on a limb for her, and she wouldn't even tell the truth to the police. I appeared to be some nutsy neighbor, and the police told me to stay on my side of the yard.

Now, I know that K. is bipolar. But she has been stable on mer meds for 20 some years. And I know that she has suffered mental/psychological/emotional abuse from M, probably for about the same timeframe. But I do not understand what she did. I just don't.

Maybe it's because I have never been a victim of abuse for long enough to get into the cycle. I have been in the situation, twice. Once with R., my current husband. I felt I owed it to him to try to work on the marriage, but he wasn't interested in that, and I probably should have kicked him out two years earlier than I did. The other time was brief, and not worth mentioning.

But I do not really understand the psychology here. I was so frustrated, and so sad watching all this go on.

The next day, I managed to get ahold of her for a few minutes to tell her she was still my friend no matter what, and ask her why she lied to the police. Unfortunately M. came stomping out, and decided to punish her for talking to me. He took her knitting she had been working on, and took the scissors and cut it off where she had been making something beautiful. Then he took several of her houseplants and threw them down on the ground, breaking some of the pots.

I had already called the police, because he had been over to my place and said “I hate you, and I hate your damn vines, too”, and pulled down some of my vines. He then said “Your life is going to be a lot shorter than you think it is.” Then he flat out said “I'm going to kill you.” So I called the police. They were in the middle of the fight when the police came, and this time, K. told them exactly what M. had done, and how he wouldn't let her ever have friends, etc.

This time, the police were more on hand to break them up and less to listen to me. They gave me a card with a case number on it if I wanted to go file charges at the Night Prosecutor's Office. Yeah, great, that'll do a whole hell of a lot. Worse, I lost the damned card, so now I can't find the number. I guess I can call, and see if I can get them to order M. into anger management and counseling. I don't know.

He certainly is no better; he is worse. He caught me at the door the other day and said “Where's K.?” I said “She isn't here.” He was right in my face. Apparently he believed me, and left. I don't know where she was. Probably talking a walk to get away from him.

Yesterday, S. and I ran around and went to the podiatrist, got some food and errands done. K. was on the porch, and I was just engaging in superficial conversation (Hi, how are you, lovely weather and all that) when M. comes out and barks “What are you doing here?." Um, I live her dude? He started going off on me, and K. was telling him to stop and she didn't need this and S. was trying to hustle me inside, telling me to ignore it, that all he wanted was a reaction from me.

I am still heartbroken. I find a friend whom I really like, and who lives right next door, and I cannot see her because her husband is an asshole. I hate this, I really do.

He's threatened me a third time over the phone. I am not afraid of him.

I am afraid of losing electricity. Losing electricity means losing my air conditioner, which equals losing breathing ability. Not to mention straining my already poor vision. I love good storms, but I always pray to Urantia to watch over the electricity and leave it on.

This time, I failed. We, landlocked lubbers, managed to suffer from the tail end of Hurricane Ike. I have never heard of a hurricane in the midwest, but it apparently is possible. We got the winds, and other states got the rain. The winds had knocked out the electricity about an hour after I got off the computer with a thing I do for pet-loss grief support. At least I got that done.

But when the electricity went off, I thought “Oh, my Gods, no!” I had no idea how long it would be off. I dug out an old phone and hooked it up. The buttons don't work right, so I can't always call out, but sometimes I can. I called friends in other areas, a few of whom didn't lose power and were giving me TV reports. I called the electric company; okay, I harassed the electric company about when the power would be back on. I knew I could not take it for long. And I heard a day; I heard three days: and with a sinking feeling, I heard a week.

It was six days. SIX DAYS. Six days without lights. Six days without washer or dryer. Six days without stove and hot water. Six days without TV and DVD player. Six days watching the food all go bad. Six days without computer. Six days without music. Six days all alone in the candle-lit dark, with no air conditioning.

Of course it had an effect. In the dark, I started hallucinating. I panicked. I ended up in the emergency room with one hell of a panic attack.

Or course it had an effect. After a week without A/C, I can't breathe right, and still can't. I called my pulmonologist's office and told them what had happened, and about the short course of Prednisone my old clinic used to give me, and they called in a prescription. Which isn't working. I have hit that Albuterol over and over again, and nothing seems to be working. It is a nightmare.

And here I am. Food is spoiled, and I couldn't get it together to get to the Salvation Army to get a voucher. I can't breathe half the time, and cough like I am coughing up a lung. I can't tell you how many candles I used up over those six days. And a $300 co-pay I don't have.

Only one thing could “top” that one. And that is death, of course.

My M-i-l's sister-in-law died. I felt about HA as though she were my sister, even though without transportation and with her agoraphobia etc. I rarely saw her in the later years. But I still loved her.

She was at a picnic or something, and had to go to the bathroom, for which she needed help (she had put on a tremendous amount of weight, unfortunately). She started slipping, which set off her blood pressure, which set off her heart. Luckily, a paramedic was right there, and they got her to the hospital. She was in her room and stabilized when all hell broke lose, and S. started running towards her room. HZ had just had a heart attack a few months earlier. But she died of congestive heart failure, just after midnight that week. At least she got to get out and have a nice last day. But it still wounds, of course, and S. is hardly back to normal, and neither am I.

I'm sure there's more, but that is a black enough rock to go hide under for now.

]]> http://booktoots.wordpress.com/?p=314 Thu, 02 Oct 2008 20:21:38 +0000 booktoots http://booktoots.tl.wordpress.com/2008/10/03/its-the-small-steps-tkr/ Throughout a total knee replacement recuperation there are times when it seems that all the exercise and hard work just does not seem to be doing anything except cause pain and discomfort. You do not see results and it's so easy to get frustrated. Well, this blog post is intended to provide hope and cheer for every person going through recuperation from a tkr. Why?

I'm coming up on seven months after my total knee replacement surgery. My recuperation has involved exercise of some sort every day, sometimes more than others. And, just the other day as I was laying down at night my mind wondered to the time period involved since my surgery. Every tkr patient probably goes through the same steps, only at different times. Here is what I came up with:

It dawned on me that just within the last week, I can lay my leg flat against a surface (usually my mattress or couch) and there is DECREASED PAIN! Sometimes, there is no pain AT ALL!! This is after suffering from pain of different strengths affecting my hamstring for months and months. For the first few months, I could not even straighten my leg - as previously mentioned.

My leg can easily be moved off of the bed. Immediately after surgery, I could not lift my leg at all. Zilch. And, for the first few weeks after my tkr, my muscles needed to be strengthened enough to allow me to do something as simple as that. In fact, physical therapy dealt with many of these exercises. The exercises were exceptionally painful at first. Now, my leg can be moved as if it is second nature. Wow. That's huge.

My leg can be bent outwards while laying down. This means that I can bend my knee enough to stretch my inner thigh muscles. This couldn't be done before.

There was a time when it took all of my strength to simply lift my leg onto a step. (In fact, that is a physical therapy exercise). Now, the effort is much less. Of course, some days are better than others.

My knee can be straightened out. This was a concern with my surgeon since I had a definite bend in it immediately after surgery. I had worn an inch shoe lift for 30 years and it was now showing in my muscle structure. This is a HUGE improvement for me and I am thrilled by it. :)

My gait is “normal”. Now, I feel my ankle and knee “swing” like a regular walker. It's fun and entertaining, actually. :) Prior to my surgery, I couldn't do this. This took TONS of work to accomplish, however. And, it still needs worked on.

The back of my knee touches (lays flat against)  the surface I am laying on. Whooppeee!!! This is another HUGE improvement to me. :)

Even though I have a ways to go in fully recuperating from my total knee replacement surgery, it is progressing. It's a lot of small steps, a lot of pain and discomfort, and sometimes a lot of frustration – but it's worth it.

It's the small steps that add up to the big accomplishments. :)

The study had patients perform their physical therapy in front of a mirror compared to the control group that did their therapy in front of a clear plastic sheet.  Although the sample was very small, overwhelmingly those patients who did their therapy in front of a mirror had greater improvements from their therapy.

By placing the patient in front of a mirror it "provides patients with proper visual input because the reflection helps the patient think tht their affected arm is moving correctly, even though it may not be, hence stimulating the brain to help wth nerve control of limb movement".   This is truly a breakthrough in therapy for stroke patients or possibly any patient suffering nerve damage where limbs are impacted.

It doesn't take rocket science to help people recover.  In this case a mirror is the factor that made all the difference.  It takes ingenuity to come up with the questions.  It requires that we continue the "what if" question because that's how studies get designed...they start with a hypothesis.

Can you imagine how many patients can reduce the negative impact of stroke if they have access to this type of therapy?  You need to find someone who keeps on top of this information, like me, so you increase the options you have in your life.  I know it can be overwhelming, but being in the pipeline is how you will get access to the latest and greatest treatments.  I would hope that a stroke patient dealing with hemiparesis would go to their neurologist and physical therapist and ask about the Mirror Therapy.  It would have a big impact on your self-image and your quality of life.