Thinking about the future

Have been doing my physical therapy each morning like a good little patient.  Making sure I spend time walking throughout the day, do some gentle yoga a few times a week on my non PT days.  The more I move, the better I feel.  Standing around, sitting around only makes me stiff and uncomfortable.

My PT Danielle has still been out sick after her trip, so I have been bounced around to whomever is available in the meantime.  I’ve seen some assistants, some PTs, and then last week none of the openings would work with my schedule, so I did my exercises on my own, and scheduled a deep tissue massage.

Now this is no foo-foo spa type massage, although I enjoy those too – but a deep tissue massage to really get the muscles, and more importantly the nerves to release.  I was a mess, holding lots of tension deep in my muscles from months and months of pre-op sciatica spasms, and then the whole post-surgical lock down of all the muscles trying to protect my back.  Chronic pain will do that, you just tighten everything up without thinking….but at some point it needs to release.  Jerry spent a good hour and some change starting with my feet and working up to my shoulders and upper back.  I had knots deep in my calves, thighs, hips, butt, and beneath my shoulder blades.  He was able to get most of them worked out, but it left me with some pretty tender spots for a few days as they healed.  I’m feeling better now, but anxious to get back to m PT appointments with Danielle.  Hopefully no more last minute cancellations for her.

I’m anxious to work more on flexibility and strength building – I know I need the core strengthening and stability, but I’d like to work on rebuilding strength and flexibility, and find some things I can integrate into my preferred yoga and walking and spin bike work – rather than just the clinical do this many reps of this particular exercise.  I know I need both, but I’d sure like to feel like I’m adapting to real life again.

I’ve also been preparing to get back to soap making.  I need to order a few oils and supplies, which I will do this week, and then hopefully next week I can make a batch or two of soap.  I made the decision not to do any craft shows this fall, which feels a little strange honestly, but I knew I needed time to heal completely.  My intent was that I could then take the time this fall and winter to stock back up on soap, and be ready for spring without all the normal chaos of trying to squeeze it in.  I have a couple orders for Courageous MRKH soaps that I need to fill, an order of foot cream I need to make, and then just start working on restocking and getting caught up on production for spring.

I feel like I’m making good progress, able to think less about the specifics of recovery – and more about what my future looks like with a fused spine.  How to regain my strength and flexibility, and get back to “normal” life again.  I’m a week shy of 3 months post op, so about 12 weeks post op now.  You know you are far enough down the road to recovery when you think of how many months instead of weeks!  I’m feeling good.  Still have some tired and sore days, still have some days where the nerves are pissed off and I’m uncomfortable.  But they just serve to remind me to be kind to myself, use my ice, rest when I need to, stretch when I need to, and MOVE when I need to – and to rest.

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Back to work – More or less

Week 4 post op as of Monday, September 10.

Friday I went to a training at work – spent a few hours visiting and training and eating catered lunch.  After about 6 hours, my brain and body were tired and I headed home.

Monday I went to work knowing I had a whole lot that needed to be done in a short period of time.  I dread this particular week every semester for its work load and stress level – so coming back this week was bound to be a challenge.  I managed to get through most of the day – and getting most of what HAD to be done, done.

I can now clearly and easily tell when it’s time to get up and move.  Stairs are using different muscles – but in a good way – than what I’ve done for the last 4 weeks.  I’m still using ice packs to help control pain.  I’ve had to be a bit more casual in my work attire as well.  Usually I wear some version of khakis or casual slacks and a nice blouse, and then jeans and a nice blouse on Fridays.  Well – the waistline of jeans and khakis rubs right across my incision.  I can tolerate it for 2-3 hours – but then it’s pretty annoying.  So I asked and was given permission to wear leggings to work (better than pajama pants!), and I’ve had to be creative in finding shirts and sweaters that allow me some modesty and cover my butt.  I’m generally opposed to leggings except for working out – and today’s college students wear them all.the.time!  With no thought to modesty and covering their butt – no matter the size/shape!  But I digress – I do have modesty, and so I’ve been carefully considering how I can be work appropriate as I continue the recovery process.

Ok…so ice packs, moving when I feel like it, and soft elastic waist-lines to keep my incision happy.  And knowing my limits.  Monday I did about 7 hours, Tuesday was 6, and Wednesday about 6 1/2.  We’ll see how the rest of the week pans out – but I’m making an educated guess (tee hee…I work in education….get it???) that 6 hours is going to be my norm for a while.  If I didn’t have an hour each way, and a scheduled hour lunch break (making for an 11 hour round trip out of the house working gig) it might be different.  But for now – that’s what feels comfortable.  And thankfully, my work is very accommodating.

I’ve also begun doing more light stretches under doc’s orders.  Hamstrings, calves, quadriceps (wall sits), pelvic tilts, knee to chest, half crunches, etc.  Things to just start using those lower lumbar back muscles a tiny bit, and stretch my legs and hips out.  I’ve been doing some hip and hamstring stretches all along (the PT in the hospital said I could) plus some just ankle and knee rotations. Really just focusing on being comfortable and not getting locked up as stiff as a two-by-four!  Hence, I can still put my own socks on, tie my shoes,  and all that.  I’m still being very very careful not to bend or twist in the area of the fusion – only the pelvic tilt I’ve started this week per the doc.  I’m making slow but steady progress I think.  Getting stronger  – for example, I can more easily kneel down to pick up the dog food bowls and put them down full.  The stairs at work will help that too.  Stretching and using all the thigh and hip muscles more.

I’m off pain meds during the day – so just muscle relaxers and regular tylenol – and ice – and walking – and stretching.  I can tell when hour 5 rolls around, as I start to tighten up and little twinges pop up.  So I know that’s the best time to do a gentle walk  – to the freezer – and get a fresh ice pack and sit for a while.  6 hours is the interval for both tylenol and the muscle relaxer.  It would be nice if I could take something a bit longer lasting – but not for a while.  Regular NSAIDS like ibuprofen and aleve affect bone growth and recovery in a fusion, so I’m not supposed to take them.  I’ve still been taking half a pain pill at bedtime, and another half at the magic 6 hours later – but I need to start taking a “read” on my body and see if I really need it or not.  I think more than anything I’m just “afraid” of the pain.  We’ll see how it goes this week I guess.

You know how I said I can clearly tell and feel when it’s time to move?  Yeah, that makes sleeping and the whole “overnight” thing interesting.  Meds last 5-6 hours, ice packs 2-3 hours, and my position needs to change somewhere in there too.  Pre-surgery I slept mostly on my right side.  Post-op has been mostly on my back with a pillow under my knees – but I get so stiff – and my hamstrings…yowsers.  So I’ve been trying to do a bit of side sleeping the last couple of nights too – left and right side.  Not sure either side is more comfortable – it’s just nice to have some options.  I tend to start on my back with ice, and then roll (log roll, log roll, log roll – hips and shoulders together!) to one side for a while…and then eventually get up, go get new ice, and start all over.  Only to be awakened a few hours later with warm ice packs, stiff legs, and need for 3am meds.  But the variety is nice

Oh…another interesting discovery this week – for the next YEAR…before I go to the dentist (even for just a cleaning) I have to take antibiotics.  And no major dental work without clearance from my back surgeon.  The bone growing business is SERIOUS apparently.  I also have to wait until after 6 weeks before I do anything.  I was due for a cleaning this week, but have rescheduled for mid October now.

Anyway, that’s how the week is going.  It’s nice to be back to a sort of normal routine, and I know the fatigue is to be expected.  I actually sort of scared myself a bit when I looked at my calendar and realized that the end of next week begins my seminar series that I teach…good mental challenge for me, but I have a sneaking suspicion it will be more physically tiring for me this time too.  I have a strategy session planned for tomorrow morning to get my head back in the game and make some solid plans.

I’ve been thinking about appropriate scriptures for this post for a couple of days – there are great verses in so many books of the bible – the New Testament for certain – any of the gospels, Philippians, Ephesians.  The Psalms of course – so beautiful and poetic.  But as always, when I start thinking about scripture to share, God leads me to the perfect one. I hope this verse from the prophet Jeremiah, from the book of Lamentations moves you as well.

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3 weeks post op

I’m starting to recognize that this recovery is a whole lot of ups and downs – 2 steps forward one step back.  Although, I also recognize that I am constantly  making small adjustments to what I’m doing.  While I do mostly have good days, it is the overnights that prove the biggest challenge.

First off…overnight I’m in one of two positions in bed – flat on my back with pillows under my knees  – or on my right side with knees bent, pillows between my knees and feet, and a pillow behind by back.  When I’m on my back, it’s pretty easy to keep the ice pack right where it needs to be, but after a couple hours the ice pack is no longer ice – it’s body temp.  When I’m on my side, the pillow behind my back is both for a bit of support – but also to hold the ice pack in place.  It’s the best I can do, but not the most effective for keeping the ice in place.  And of course, again it’s the melting factor.  So I’m also up several times a night.  I get stiff and uncomfortable no matter the position after a bit – and inevitably the cat wants to sleep on my feet or something which doesn’t help matters at all.  So I get up and pace the hallway to loosen up the muscles – stop at the bathroom since I’m up – pace some more – get a fresh ice pack, and back to bed.  I’m blaming it mostly on back surgery – but a 15 year old cheap mattress doesn’t help the situation I’m sure.

Inflammation is still an ongoing management issue as well.  During the day I walk quite a bit – which helps to keep the blood flowing and reduce the inflammation – or encourage it to dissipate anyway.  I do a lot of walking to the mail box and back – a couple walks in the morning, a couple in the afternoon, and one in the evening as it’s getting dark out.  If I’m in town at the winery, I take a longer walk around town every 2-3 hours.  My fitness app says I’m getting between 4500-8500 steps a day depending on what I do.  My surgeon wants at least 5000 right now.  I’m also supposed to ice my back frequently and for at least 20 minutes each time.  I try and be good about sitting down every hour or two to ice.  It’s actually a good pain management strategy too, as it decreases inflammation and increases blood flow.

My surgeon wanted me to wean off the back brace so that my muscles will gain strength.  I’m mostly off of it now – although I have been wearing it when I drive “just in case”.  It gives me just a bit of extra support as I gain confidence and get more comfortable with how to get in and out of vehicles without straining muscles or twisting my spine the wrong way.

My surgeon also has me weaning off the pain pills.  I’ve managed to reduce them to half doses every 6 hours (down from full doses every 4 hours) – which conveniently coincides with the 6 hours between muscle relaxers and the 6 hours between doses of OTC Tylenol.  I’m feeling pretty good at this level, and may start dropping the daytime doses and see how that goes.   I’m still only 3 weeks post op from major surgery – and the phrase my surgeon used was “First, you need to rest, Second you need to Ice, Third you need to walk, Fourth you need to do-but not overdo. Listen to your back.”  Seems like solid advice to me, and as I’ve said before, he has a great success rate with his surgeries.

Healing takes time and work….and rest.  But I do feel like I’m doing so much better, able to do most things around the house, and concentrate enough to do some telecommuting and help out with other projects for the winery and a few church deacon things too.  I’m trying to stay positive and be a good patient who follows directions!