5 Months post Lumbar Fusion

6 screws. 3 rods. 2 inter-vertebral cages. That’s what’s been holding my spine together for the past 5 months. I’m well on my way to a good solid fusion, my bone growth is good. My muscles have reattached, and I’ve worked to strengthen muscles I’ve ignored for years – probably decades. I’m feeling pretty good overall, and I’m working on the areas that sneak up and bother me. I’ve been in physical therapy for 12 weeks now, and am looking at another 6. Rehab and Recovery is WORK – but it’s also working.

My physical therapist Danielle has left now – to be a momma to a 2 year old boy they are adopting from another country. I’m thrilled for her, and we talked a few times about bringing him home and how excited (and nervous) she is about it. I never did ask her why she went the adoption route, but I know she doesn’t have any other children. Whatever her reason, I’m just thrilled that this dream is becoming a reality for her!

So Danielle left to be a mom, and I got referred to another PT in the clinic, Brenda. I worked with her one of my first visits, but I felt it was a good opportunity for fresh eyes and to talk about my current symptoms and see what adjustments we might need to make. She reviewed my chart notes and did some assessment and moved me around and watched me move. She is comfortable with how my spine is healing and how I’m moving around the fusion. My deep core work is keeping the fusion and my spine in general supported and aligned. My pelvis and the pesky SI joint was a little out of alignment, so she worked to line me up better, and doing so, she found that my Iliotibial Band (IT Band) is inflamed. It runs from the hip to the tibia along the outside of the leg, and helps to support the knee. What I had been attributing to sciatic inflammation on the right side (and had me quite concerned actually) is actually a muscle pain memory – and caused by the inflamed IT band – not the nerve.

So, our focus is now to change the muscle and pain memory. We are working to heal the inflammation in my IT band and then work on my body mechanics to prevent it from flaring again. Remember me talking about bossy muscles before? Well, that’s what’s going on again. My hamstring is trying to compensate for what my hip and glutes should be doing. My pelvis is out of whack making the SI joint inflamed, and so then I move wrong and cause new problems – like an inflamed IT band. IT band injuries are often attributed to running injuries – overuse when there is a bio-mechanical misalignment. I’ve done that in spades…so time to work on releasing the IT band and hope that allows me to work on continued strengthening in my hips and glutes.

So…how to release the IT band – well trigger point massage is the best way, but let me tell you…it’s NOT fun. Brenda used a torture device and really massaged where the IT band connects to the tibia (outside top of the calf), and along the edge above my knee where the hamstring connects. I don’t remember what she called it – but that’s probably because I was gritting my teeth and trying not to hyperventilate. She also did some work on my hip, with the trigger points as well. We talked about home care and how to continue working on the IT band. I have a tennis ball and a wall – and I lean into the hot-spots in my hip and glute and through direct pressure and tiny micro movements, I am working to get the tension (aka nearly cramping they are so tight) out of my muscles in my hip and glute. I also have a “massage stick” that I use to roll massage along the outside of my thigh and search for and find all the tender hot spots along the IT band and hamstring. When I find a hot spot, I stop and put direct HARD pressure on it, and slowly roll off of it. It’s not fun…I suck a lot of air through clenched teeth…but hopefully it’s doing the trick. Kind of like a begging toddler – you just irritate it, nag it, and keep after it constantly until the muscle gives up and relaxes. It’s still very, very sore – but the memory pain of the sciatic nerve that I thought was going on, is diminishing. So that suggests that what I’m doing is helping.

I’ve also been doing massage on my left foot – the one with the nerve pain, trying the same theory – lets see if I can irritate it into healing through persistent massage. I’m also working on ankle stretches, because as Brenda put it, “On the spectrum of flexibility – you are quite stiff. Your joints don’t move enough to be able to stretch the muscles that are tight.” Um…thanks, I think. So ankle stretches a couple times a day has been added to my PT rehab plan.

Since my last post I’ve been doing well with eating clean and with tracking my calories. I’ve reigned in most of my bad food habits. I’ve set up a routine of riding my exercise bike each day and have worked hard to move more in general. The scale has appreciated my efforts. I’ve also gotten much better about taking my supplements each day. I think all these things together are working to help me feel better not only physically, but emotionally. The whole adage of garbage in= garbage out is so true. When I fuel my body well, both nutritionally and with exercise and movement – the results are always better. So that’s my words of advice for all of you – treat your body like a temple. Be respectful and humble, know your limits – but push them a little too!

Hills and Valleys

Happy New Year! Welcome to 2019 and all the opportunities it presents!

This past month of healing and rehab has been challenging. I’ve been fighting with my SI joint, working on core strength, and trying to live my best life. But I must admit…it’s been a bigger challenge than I’ve maybe let on. And honestly, I’ve been feeling a bit sorry for myself. Post-surgical depression – it’s a very real thing – and a normal thing, and to be expected.

I had a major surgery – I intentionally broke my back and have had to heal. I’ve got screws and rods holding me together, and bone that is knitting itself back together. Muscles were cut, nerves were moved aside to do the work that needed to be done. I’ve got a six inch long incision to commemorate the event. I spent nearly 2 weeks hardly able to lift myself up out of a chair. Sure, I had pain before surgery – that’s what we were trying to fix – but I spent a good month in pretty intense pain as I healed. I lived on an ice pack and moved oh so carefully for weeks.

I’ve been walking since the day of my surgery – only a few steps at first – literally enough to get me from the bed to the toilet and back. And it wasn’t long before I was walking more to cut the muscle spasms and get the blood flowing to help ease the pain. Up and down the hallway, round and round I went. I gradually worked up to walking outside and down the driveway. Over the weeks, the walking increased as I healed. I traded the walker for a cane, and eventually gave up the cane too. I moved easier and easier, and increased my stamina to where I could easily and pretty comfortably walk a mile or more. With the increase in circulation, and healing in general I got off the pain meds and eventually the muscle relaxers too. I finally disabled all the medication alarms on my phone, so I wasn’t interrupted constantly. I felt like my life was returning to normal.

A new normal anyway – one that involved physical therapy and a rehabilitation process. I’ve gotten some of my flexibility back, definitely gained some strength, and we’ve been working on retraining different muscle groups. So much of the last 10+ years, I’ve relied on the strength of big muscle groups – and have lost muscle tone and strength in the smaller muscle groups that support everyday movements and specifically the spine. My quads and hamstrings were doing the work of moving my legs, and the hip muscles were letting them. My para-spinal muscles were holding me upright and taking the strain of lifting instead of having my deep core muscles hold me up and stabilized, and letting my legs and hips lift. I’m having to re-learn all the right body mechanics to support everyday life. I also now have a spinal column that doesn’t move the same as it was designed to.

I bend at the hips, not the waist. I don’t twist at the waist either. My pelvis must stay square and straight, and my spine above must maintain neutral spine position so as not to stress the lowest vertebrae nearest my pelvis. But I’m not a stiff board either (or I shouldn’t be)- I have to be able to flex and bend and twist throughout my mid and upper back. My shoulders need to move and flex and bend, my rib cage needs to move around – all while keeping my hips and pelvis straight. It’s working on those lower deep core muscles that keeps that straight and steady while allowing more movement above. So while I work on transverse abdominal strengthening, I also have to work on loosening up my upper spine and rib cage.

As the weather here in North Idaho has changed to welcome in winter snow, I’ve had to adapt my rehab routine. No more walking the driveway for exercise – it’s too slippery, even with Yak-Tracs on. I can’t walk casually and relaxed – I’m too tense. I don’t have a treadmill at home – although I think I would actually use one if I did. I thought that I was getting enough walking in just by “doing life indoors” but it’s become clear that it hasn’t been enough. I’ve been doing my PT exercises and stretches in the mornings each day, but as you know if you’ve been following my last few posts – I had to back off some of the yoga and other stuff I was doing to try and calm down my SI joint. It worked…mostly. My SI joint is more stable, and the core work I’ve been doing seems to be helping with that….but I took the “rest and recuperate” a bit too seriously, and got lazy. And my reward for my laziness is weight gain, inflammation, stiffness, and yes…pain.

I was feeling sorry for myself. Frustrated at slow healing with a couple of set backs. It was the holidays and so I ate my feelings into submission. Bread, cookies, candy, you name it. I drank more wine, I ate more mashed potatoes and gravy, rich holiday decadent meals – you name it. I’ve always been an emotional eater, and I’ve always had to pay attention to what I eat and the effects of stuffing my face to soothe my emotions. But I let it get the best of me. I wasn’t feeling great, and I wasn’t dealing with my emotions much at all. So I ate caramels, chocolate, toast with butter, and drank more wine. It’s my standard coping mechanism.

Truth be told, I knew exactly what I was doing. I’ve known for months – probably the last 2 years actually – that I needed to reign in the bad food habits. I’d been watching the scale slowly creep up little by little. But dang it – my life has been a stressful mess for a while. Add in back surgery and rehab – and this girl was in a full on pity party. A few months back I really started thinking about cleaning up my eating – thinking through which diet plans and nutritional information I could buy into. I thought back to what I’d tried in the past, and how successful each attempt had been. And I though about all the things that derailed me over the years. I was deep in research and reflection mode – but not yet ready to really jump in and take control.

Until now. New years day often results in resolutions – eat better, lose weight, exercise more – it’s all cliche really, why does one day on the calendar make it “the day” to start fresh. Marketing at it’s finest. Every business out there capitalizes on the new year in some way. A weekend of watching nutri-system, jenny craig, bow flex, and peloton commercials – and ads on the internet for different diets, exercise routines, supplements, shakes, and whatever are sure to make you think about your routine and wouldn’t it be smart to start fresh in the new year. Marketing genius I’m telling you! But that wasn’t what got my attention and spurred me into action. It was 2 things. Getting on the scale and seeing a number that was ugly but full of truth, and a visit to Physical Therapy with talks about inflammation and winter activity level and set backs – the hills and valleys of recovery and rehab after surgery.

Yep – I’d lazied myself into a mess. I need to move more in order to move comfortably. I need to reduce inflammation caused by sitting around and eating too much. I’m asking my compromised and healing body to carry around extra weight, and my choices about what I’m eating is causing inflammation of not just the fat cells. I was trying to get away with doing the bare minimum…instead of doing all I can to heal my body and my mind. It was the jolt I needed to get back on track. Hard core evidence of poor choices equals poor health.

So I took several steps in the positive direction. I downloaded my fitness pal again and put it on the home screen of my phone. I went home and set my alarm for 20 minutes earlier in the mornings. And I made a commitment to clean up my eating that resulted in a shopping trip to get good stuff back in the fridge and allows me to plan some healthier meals that don’t involve mashed potatoes and gravy. Yesterday I had my first clean eating day in MONTHS. When my alarm went off this morning, I crawled out of bed and headed for my exercise bike. I did 10 minutes on the bike, and then did 20 minutes of my stretching and core work. I’ve iced my back to reduce the inflammation around the nerves twice today. I packed a healthy clean lunch and snacks for today, and I’ve tracked my food so I have a clear idea of what I’m eating and how it’s affecting my nutrition.

My main goal is to get my body strong and healthy. This means I will move more and eat better. A pleasant side effect will be weight loss. But I also know that when I fuel my body well, and move my body well – I also FEEL better about myself and that ultimately will set me up for the best possible me this year and in the years to come.

Have you heard this song before? If not, take a good listen. It’s been on my mind a lot the last few weeks, and I hope it will encourage you and remind you that God is with you through all the Hills and Valleys.