PT magic

So far, so good. Doug, my new physical therapist, wrote that I am “progressing nicely” in my patient file yesterday -- my sixth appointment with him, post-spasm.

I’d been on medication for two weeks by the time Doug and I had our initial consultation and evaluation. Although I was pain-free -- for the first time since I can’t remember -- Doug said the offending muscle was still tight, something he set to correct with massage.

“I don’t believe in ultrasound. I’d much rather get my hands on you and work the muscles,” he said. And work them he did, very effectively. After my second visit, I successfully stopped taking Mobic, the anti-inflammatory drug.

During the past month, Doug has reviewed my home exercises, and gradually added others. If a new exercise targeted the same area as an old one, I adopted the newer version.

Massages focused in and around my right hip at each appointment until the muscles loosened to Doug’s satisfaction. By my fourth visit, I felt great. But, I didn’t know how much to credit Doug’s massages and the new exercises, since I was still on Amrix. And although I hated taking the muscle relaxant, I was afraid not to.

“Let’s stop the Amrix the night before your next appointment,” Doug suggested. “Then, if you’re in pain that morning, we can take care of it.”

Now, I’m coming up on one week, drug-free. No spasms. In fact, I feel pretty good! I still have some stiffness in the morning, but it’s nothing compared to the low-back pain I had accepted as my “new normal” within the past year.

My posture and gait have improved, too, if only my muscles would remember that. It’s strange how the body adjusts to chronic pain and discomfort. For awhile, I’ve been aware that my stride resembled a modified waddle -- like I was negotiating tires in an obstacle course – to accommodate my arthritic hip. With Doug’s help, I now feel more flexible and able to walk normally, something I need to consciously remind my muscles, lest I start quacking!

The next challenge is…[drum roll]…yard work. I have avoided doing anything remotely strenuous to prevent a recurring spasm, but Doug wants me to take the plunge. “I’d rather you go about your normal business so we can address any problems, rather than your calling me in pain after I’ve discharged you,” he said.

So, sometime between now and late next week, I’ll be donning my gloves to break up the weed "kegger" that has been taking over my garden. Wish me luck!

Out of control

“I feel good…na-na-na-na-na-na-na…didn’t know if I would…”

One week ago today, a roundtrip walk from my bed to the bathroom triggered a muscle spasm in my right hip that stole my breath, stopped me in my tracks and scared the crap out of Mark – and me.

Except for the morning pain I had before my spondylolisthesis surgery, this was the worst! I’m not sure how I got back to bed, but (after waving my poor husband off) I did make it there on my own. It was 2AM. I gratefully swallowed the naproxen Mark brought to me and went back to sleep.

I tend to gauge the severity of my back pain each day by my range of motion and the ability to perform routine tasks. So, when I got up at 5:15AM, I was ready to determine this spasm’s place on the pain continuum.

The naproxen had taken the edge off, and I was able to get dressed and go upstairs. Although I managed to get through most of my daily isometric exercises, for the first time ever, I opted to stay off the treadmill.

That’s when reality sunk in: the spasm was in control, not me. Being unable to control your body is an awful feeling; one I work to avoid every day. But on this day, as I dejectedly shuffled to my office and lowered myself into the computer chair, I felt like I had failed.

Years ago, a physical therapist explained that back pain is often at its worst first thing in the morning. This may seem counterintuitive, since you would (theoretically) be rested after a night’s sleep. However, while the body is horizontal, fluid in the spine’s vertebrae collects in tiny pools, and it is that accumulated fluid that can cause morning back pain in many people. Once you get up and start moving, the fluid drains and the pain usually dissipates.

That has always been the case for me, even with this – the mother of all muscle spasms. And, after about 30 minutes of sitting upright, I was able to go downstairs (albeit gingerly) and get on with my day.

Given the debilitating nature of the spasm that morning, I was surprised to be mobile and self-sufficient throughout the day, but I did not let that lull me into a false sense of recovery. No, the spasm was still there...lurking...waiting to strike again.

That night, I went to orthopedic urgent care.

In my experience (which is, unfortunately, extensive), orthopedic surgeons are as elusive as rock stars, relegating the mundane chore of treating non-surgical patients to their PAs. I can count on one hand the number of knowledgeable, caring PAs I have encountered in my life. The guy I saw last week was not one of them.

“You have an ugly back!” he announced as he breezed into the exam room after viewing my X-ray films. Clearly, he had checked his bedside manner at the door.

“Really? I think my back is beautiful. What did the X-rays show?"

“Oh, just a lot of arthritis, bone spurs and stuff. Lots of wear and tear, but nothing to worry about.”

“Is there anything on the X-rays I should know about?”

“No, nothing to worry about. Just A LOT of wear and tear.”

Okaaay…

“What do you take for your arthritis?” he asked.

“An occasional ibuprofen, but usually nothing,” I said.

“Why?”

“Uh, because I don’t like taking pills.”

After diagnosing me with a muscle spasm (really?), the PA prescribed anti-inflammatory and muscle relaxant medication, and wrote a script for physical therapy.

Then, he gave me samples of two muscle relaxants to try. The first (Skelaxin) lasts six to eight hours; the second (Amrix ) works for 24 hours. I quickly determined that I needed a muscle relaxant working full-force when I get out of bed in the morning, so Amrix was the winner.

Now, one week later, I am essentially pain-free –- something I haven’t been in a long time -- but I hate the dry mouth and drowsiness caused by the drugs, not to mention the scary warnings against long-term use of both Amrix and Mobic.

So, my first question for the physical therapist next week will be,

“How can I continue to feel like this, without meds?”

I’ll let you know what he says.

Scam alert: International Blogging Recognition Council

Earlier this week, I opened my email to find this missive:

"During the month of July, the International Blogging Recognition Council (IBRC) had the pleasure of reviewing your blog Maria Talks Back. Your blog was referred to IBRC through our Refer-A-Blog program. 'The unemployment truth ~ can you handle it?' was the topic that the Council reviewed. Based on the review, the Council has recommended that your blog receive IBRC’s designation of 'Recognized Blog.' IBRC reserves this honor to those blogs that effectively connects with the audience and promotes the sharing of ideas and experiences.

"We invite you to visit our website to learn more about IBRC and our “Recognized Blog” award. Congratulation on your accomplishment.

Sarah L. Tolten
Review Committee Chair
International Blogging Recognition Council"

I must admit, I was flattered -- until I went to the website in search of a "badge" that would designate my blog as "recognized." It was available to me -- for a one-time fee of $45.

After conferring with fellow writers and bloggers, I've confirmed that this is a scam. As one colleague put it, "Awards you have to pay for aren't worth having. There's a big difference between paying for the award and paying an entry fee in a legitimate awards competition."

So, I am using the power of my pen to spread the word and, hopefully, hasten a swift demise to the IBRC.

The unemployment truth ~ can you handle it?

This recent YouTube video satirizes the games the federal government may be playing to cast a positive spin on current unemployment figures.

Since my husband, Mark, was laid off in January, we’ve become reluctant contestants in a whirlwind of other games, compliments of Corporate America:

- the “job-description-for-that-position-is-a-moving-target-because-we-don’t-know-what-we-want” shuffle,

- the “you’re-a-great-fit-but-we’re-putting-that-position-on-hold-for-now” waiting game,

and the ever-unpopular

- “we-want-to-find-one-person-with-the-skill-set-of-three-who-is-willing-to-work-for-peanuts” challenge

These games are the unreported reality behind the unemployment numbers. The economic climate has tilted the scales disproportionately in the employer’s favor, and corporations are taking full advantage -- at the expense of people’s lives and livelihoods.

Bottom line: businesses (small and large) are reluctant to “pull the trigger” and make a hiring decision. And, while the unemployed needed jobs yesterday, employers are taking their sweet time. As our friend, MF, put it, “Instead of ‘settling’ for someone who meets eight out of 10 criteria, they keep looking for someone who meets all 10,” he said. “So they continue to search for the left-handed brain surgeon – because the previous guy was left-handed!”

If nothing else, this adventure has reaped a rich crop of surreal scenarios for Mark and other job-hunting friends:

- multiple interviews (the record, so far, is 10)

- being told “you’re the one” only to have the position pulled – or filled by someone else

- unwanted membership in the 50-50 Club (companies reluctant to hire anyone older than 50, and unwilling to pay more than $50,000)

- companies offering contract positions instead of regular jobs with benefits

- a growing list of industries that are going “off-shore” for less-qualified (but cheaper) talent

- zero follow-up or feedback from prospective employers

and, most disturbing,

- the sense that being unemployed is an automatic disqualifier.

There is a growing disconnect between the employed and the unemployed. Nationally, lifelines like the COBRA subsidy and emergency extensions for unemployment benefits have faded away. Now, as the November elections approach, speculation and political posturing have consigned the people behind the unemployment statistics to the role of political football.

Something’s gotta give.

Until then, Mark and I will push forward, and try to maintain that delicate balance between hopefulness and raising our hopes too high.

Dogs

My life has always included a dog.

Sarge was the collie mix my parents had when they were first married. Named for my dad’s rank in the Air Force, I didn’t know Sarge well since he was relegated to the basement after Anthony and I came along to ease Mom’s cleaning regimen. I hardly noticed when he passed away of old age.

Then, the summer I was eight, we got Ralphy. A bassett hound/beagle mix puppy, Ralphy was sweet, but capo dost (“hard head” or obstinate). He was fearless and did not hesitate to go toe-to-paw with my father over a stolen shoe or – one time – a stick of butter taken from the kitchen counter.

Ralphy was my dog. I woke up early to walk him, and trained him to sit, stay, “speak” and shake. During each of my extended hospital stays, my parents said Ralphy searched the house, looking for me. And as I recuperated at home, I was never alone with Ralphy at my bedside.

Bassetts and beagles are prone to tumors, and Ralphy had his fair share. All were benign until the one that took hold in his liver when he was 13. By the time we’d discovered it, the tumor was as big as a grapefruit, and so painful Ralphy would fall asleep sitting up.

We ended his suffering on Dec. 4, 1983 – one month and one day after my grandfather died. Later, Mark said I had cried equally for them both. I begged my mother to get another dog, but she’d had enough. “When you and Mark get married, you can get your own dog,” she said. One wrinkle: Mark had been allergic to dogs as a child, and he didn’t know if -- like his asthma -- he had outgrown that malady. We decided to chance it, but I told him, “If you are still allergic, you’re going on medication, because we are NOT returning the dog!”

We rescued Maggie from an animal shelter in South Orange, NJ. She was a black, spaniel mix, about 15-months-old, and shell-shocked from abuse. It took years before she trusted us to step over her while she slept, causing more than a few near-falls for Mark and me.

Not only was Mark not allergic to Maggie, he formed a strong bond with her. She was his first real pet and the perfect addition to our new home, just one month after our wedding. After J was born, eight years later, we learned that Maggie wasn’t crazy about kids. She wasn’t aggressive towards J; she just ignored her.

Later in life, Maggie developed lymphoma. We kept her comfortable on medication and let nature take its course. Then, in September 1999, as Hurricane Floyd was bearing down on Raleigh, Maggie lost control of her hindquarters and she couldn’t walk. “A system failure,” was what the emergency veterinarian told us, and the difficult decision was made to put her down. She was 15-years-old.

Mark took Maggie’s loss especially hard and vowed that we’d have an extended mourning period before considering another dog. Then, one sunny day in October, he suggested we go “look” at the animal shelter.

“If we go to the animal shelter today, we’re getting a dog today,” I told him.

Can’t say I didn’t warn him – that afternoon we adopted Sandy.

A husky/shepherd mix, Sandy was three-months-old when we brought her home. J named her for the sandy color of her face, and she is the sweetest dog I’ve ever had. She’ll be 11 in July, but most people think she’s still a youngster. Sandy and J have grown up together, and, when R was an active toddler, Sandy had infinite patience. However, when she’s hurt or scared, I’m the one she comes to.

Despite the ache of arthritis in my lower back each morning, I feed Sandy and let her out, since I’m usually the first one up. As I shuffle to the kitchen while Sandy scampers ahead of me, I wonder if I will have the strength and will to start over with another dog, after her time with us ends. Probably. Because, in my mind, a home is not complete without a dog.

Living life

Crisis management is a vital parenting skill that I learned from a master – my mother.

When faced with my spondylolisthesis diagnosis and the reality that their 13-year-old daughter needed major spinal surgery to avoid paralysis, both my parents were matter-of-fact. Did I want the surgery? Was I comfortable with the surgeon? And, if either of my parents were freaking out on the inside, I never knew it.

During my surgery, Mom prayed and visualized Jesus carrying me. That brought her peace. Afterward, my surgeon, Hugo Keim, reported that all had gone well and I was fine. Dr. Keim and Mom never hit if off; he reserved his warm-and-fuzzy bedside manner for his patients, and didn’t have much charm leftover for their parents. Yet, after each of my surgeries, he updated her personally, instead of delegating the duty to a junior doctor on his surgical team. For that, Mom was grateful.

Post-op, I was in a body cast for six months. The kicker: for the first three months, I was bed-ridden so the spinal fusion could heal properly.

Caring for me at home was a challenge that Mom seemed to enjoy. She’s a natural at troubleshooting and, by the time the gurney rolled me through the front door, everything was in place.

One of my father’s brothers had located an old-fashioned hospital bed – crank-style – that he had cleaned and painted white. And, instead of sequestering me upstairs in my bedroom, Mom decided I would be in the dining room on the first floor “where all the action is,” she said. So, the dining room table and chairs were moved into the living room, creating a crowded by usable arrangement.

Since Mom had gone back to work by then, a phone was installed at my bedside. I was also given one of Dad’s police whistles to summon assistance, if needed, after everyone had gone upstairs to bed. With Dad working rotating shifts, Mom coming home midday for lunch and my brother checking in a few hours before Mom at day’s end, I was covered!

I didn’t realize it at the time, but Mom was teaching me how to deal with life’s curveballs. The takeaway: make a plan and execute, and keep living your life.

Happy Mother’s Day, Mom!

Size matters

“Don’t gain any weight.”

That was the parting advice from my rheumatologist during a recent visit.

Years ago, I was told that each one-pound gain in weight adds 10 pounds of pressure to your body’s joints. And this information from Johns Hopkins reports similar findings.

However, a weight gain of two or three pounds (okay, three!) is inevitable whenever I visit my parents. My mother’s amazing cooking and baking, combined with my father’s continual stockpiling of sweets (he brings pocketfuls of free cookies home from the bank every day), usually sabotages my best intentions within 24 hours.

Prior to my Easter visit, I had seen a number on the scale that had eluded me since before my son was born nine years ago. And, when my weight is down, I do notice a difference. There is less morning ache in my lower back and the stiffness in my hip decreases. I stand straighter and walk without a noticeable limp. Good motivators all, but no match from Mom’s homemade lasagna and meatballs.

So far, I’m down one pound. Considering there are still jelly beans and peanut butter eggs in the house, I count that as a major triumph.

Other news from the rheumatologist: 1) the arthritis in my hip is only in certain areas, but not the entire joint, and 2) the severity of my arthritis -– as evidenced by my X-rays -– means I qualify for a permanent handicapped placard. So, I’ve got that going for me, too.