Tag Archives: Healing

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Transitions

Today is officially the longest day of the year, the start of summer…and it’s 60 degrees, grey and scattered rain showers. Last Friday was nearly 80 and sunny and glorious – go figure.

At the beginning of next month, my new boss officially starts in the office. My boss of the last 15 years is retiring, but not officially until the beginning of August. So it’s a new season starting in our office as well.

It’s been 10 months since my back surgery, and I’m in the midst of my beginning of summer annual medical checkups. Made all the appointments, showed up for my mammogram last week. Next week is fasting blood work, and then my physical the following week. I feel good and have no great concerns to discuss with my primary care doctor, so hopefully this will be a smooth slide into the summer without more tests and appointments to think about.

How’s my back? Well, “good” or “better” are the easy answers. It’s different than before surgery obviously, since I have hardware holding me together, but it’s also been a long recovery process (well documented here on the blog). Today I don’t have chronic low back pain. I don’t have constant sciatic and muscle cramping in my back, hip, butt, or thigh. I don’t have the constant ache, and grabbing my low back when I twist or move funny. I don’t have to take over the counter or prescription medications to allow me to get through a day or night. I don’t have to have my heating pad waiting on the couch for me to come and sit for a few minutes and ease my muscles out of a cramp. But I’ve worked my butt off in physical therapy to both recover from the trauma of the surgery I had, but also to strengthen the muscles I haven’t used for years to support my spine. It’s an ongoing process of listening to my body while also pushing myself to improve.

I still have some lingering nerve issues, and recognize that I probably always will to some extent. Some of it is damage done before the surgery from my spine being unstable and pinching the nerves (sciatic)- some surface numbness on my right leg in several places that was present before the surgery….is still there. But the cramping that was an everyday thing before surgery is gone on the right side. Some of it is also from the surgery itself – I had a lot of sciatic cramping on the left side after surgery (I whined about it for weeks), and while the cramping has resolved – I still have some residual nerve pain in the top of my left foot. I whined about that quite a bit and worked on it during physical therapy – and while it’s vastly improved – it’s still there. But I’ll take a little bit of surface numbness and a touchy left foot over debilitating daily pain and muscle cramps any day!

I no longer have to get up 20 minutes early just to go through a series of stretches to wake up my muscles. I still do a series of range of motion stretches each morning just to get the blood flowing a little before my shower – and work off the sleep haze – but it’s not 3 sets of 10 repetitions of this one exercise, and then 3×10 of the next one, etc. During the week, I do yoga on my lunch break – specifically targeting my core strength, my hips, glutes, and hamstrings, and actually working on my upper body strength too. I have several dynamic flows that I work through to strengthen my body overall – not just focus on spine surgery rehab. Throughout the week I still end up doing all the same kinds of exercises that my PT taught me to do, and I’m seeing great progress in my strength.

I have tried and tried to like the exercise bike I bought (used) last year for cardio – but I just don’t. It caused me more body mechanic issues throughout my recovery because it’s basically just one movement in the same position over and over again – primarily focused on my hips and IT band. So I stopped using it at the suggestion of my PT when my IT band kept flaring. Instead I walk as much as I can. On the weekends I walk in the morning before a shower. During the week, I make it a point to get up and walk at work as often as I can…and then walk in the evening when I get home. Walking was the thing my surgeon had me doing immediately after surgery – like the same day….with a walker and a catheter in…I was walking the hallways every couple of hours. On day 2 they took the catheter out and I had to get up to use the bathroom….and walk the hallways every couple of hours. I have continued that pattern throughout my recovery. During my PT, I would start out on the treadmill for 10 minutes before seeing my PT for the rest of my appointment. As my rehab continued, I came to love my time on the treadmill, and as weather permitted I walked my driveway at home too. When I was allowed back on my exercise bike, and started having trouble with my IT band, I started thinking about selling the exercise bike and getting a treadmill. That’s still a discussion at our house – but I haven’t been on the bike for months now….and my IT band hasn’t flared in the least.

In January I made a concerted effort to start eating better, and tracking my food each day. I haven’t been perfect, but I’ve been much more aware. I’m down about 14 pounds, and the yoga has helped me trim off over 6 inches overall. I’ve been able to recognize what foods I can eat and continue to lose weight slowly – and I know what foods stall me out completely. My goal isn’t a number on a scale or a clothing tag – my goal is a healthy mind and body combined. My current routine is getting me closer and closer to that point.

The final transition I’ll talk about today is menopause. Last year about this time, my doctor confirmed/agreed with me that I was likely peri-menopausal based on what I had been noticing in the preceding year. Menopause is a tricky thing to nail down in women like me with MRKH. Most women experience a change in their monthly menstrual cycle – and they notice the change because their pattern of bleeding (their period) changes. But I don’t have the benefit of being able to track differences in menstrual flow. Over the years I came to recognize subtle changes in my body during certain times of the month…and asking very pointed questions of my close girlfriends. I learned to notice not just pre-menstrual symptoms of emotional changes, bloating, tender breasts, and acne breakouts, but also the more subtle changes that came with ovulation. I actually had a pretty regular cycle that once I understood what I was experiencing, I could work to manage a little more effectively. But without the “period” to mark the date on the calendar, and obviously no worries of an unplanned pregnancy ever – it was just interesting to note what my body was doing. In the last 2 years I began being more aware of the fact that my “pms” symptoms were happening less frequently, and not near the end of the month as they used to be. Add in a whole lot of tossing off covers in the middle of the night, and some changes with vaginal moisture and elasticity – and my doctor marked my chart as peri-menopausal. We had a brief discussion last year about hormone replacement and options available – but I declined any formal treatment. I had a baseline bone density test last year which was totally normal, and I read a couple of hand-me-down books on menopause. Knowing this is a natural progression, and understanding that everyone’s experience varies greatly, I’ve opted to be preventative, but minimalist in my journey. I’ve added a women’s multi vitamin, vitamin E, and collagen for joint health, and made sure that I am eating a balanced diet that includes lots of variety in both vegetables and proteins, and a moderate amount of (mostly) whole grains. Thus far I have not been overly bothered by crazy mood swings, hot flashes, excess fatigue, thinning hair (it gets grayer each year, but it’s still thick and crazy curls), and I’m still able to effectively manage my weight. All in all…I think I’m doing just fine on this journey.

As I think about all the transitions going on with and around me lately, I try and remember to just put my trust in God. He has a plan, and my part in this plan requires me to act with compassion and humility, to trust Him completely, and to practice patience with His timing.

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Stability

As any healing journey progresses, you have highs and lows, hills and valleys, starts and stops – but the goal is stability.

Tomorrow marks 4 months of healing from Spinal Fusion surgery.  Overall I feel pretty good.  I’m off all the muscle relaxers and pain pills, and I rarely use ice packs now.  I do physical therapy exercises every morning, and add in gentle yoga routines most days.  I do as much walking as possible, but now that the weather has changed, it’s not safe to be walking outside – nor is it warm, for the record!  I need to establish a routine to get some time in on the spin bike a few times a week, but finding a consistent time is always a challenge.  

I saw my surgeon two weeks ago.  He says I’m doing great.  He will see me again in February, and then probably, I won’t need to see him again – it will just be my regular primary care doctor.  I did talk to him a little bit about the nerve pain in my foot – but nerves are slow to heal, and what I’m doing with physical therapy does seem to be having an impact.  I also talked to him about the movement and shifting in my pelvis and specifically the SI (sacroiliac joint).  He poked and prodded, and offered to do a cortisone injection into the joint.  We talked about extending my physical therapy, and about my recovery and rehabilitation in general.  I opted to not have the injection yet, and to see if more physical therapy will help stabilize it.  He agreed to the conservative approach, and approved another 6 weeks of physical therapy.  

In the past few weeks as I’ve increased my activity level, and done more and more muscle work for both flexibility and strength – essentially loosening up the crazy tension I was holding for so long…we’ve created a bit of a stability issue.  My body is learning how to move with and around the spinal fusion.  As I move and rotate my upper spine – my back pops a bit as things realign and adjust.  This isn’t causing any problems, but it is an indication that my muscles aren’t as tight (from chronic pain), and as they loosen, those joints can actually shift around and go back into alignment on their own.  I’m not concerned about the upper spine pops, nor is my physical therapist and surgeon.  But as I am moving, stretching, healing more an more – I am getting some popping and shifting happening along side my sacrum(that is now fused to the vertebrae L5 above it), through that SI joint which leads to a misalignment in my pelvis and hips.  Also the pops and shifts are the tissues themselves making noise – and creating a bit of inflammation. 

So…we are focusing almost all our attention during PT now on stabilizing the sacrum and pelvis through deep core stabilization.  We are backing off on some of the strengthening and flexibility in the big muscles (hips, glutes, thighs, etc) to focus on the inner most deep core stabilizing muscles – transverse abdominal and the multifidus.  Hopefully this step back to work on the less obvious muscles will give me the stability that we are after.  I also have to pay very close attention to body alignment.  No side bending; no twisting while reaching; feet, knees, and hips always squared up; no rotation unless hips are square and core is engaged. I need to really reign in my movements until we have the stability back on track.  

I’m finding myself in a valley, but with a clear path lined up to get me out of it. Three steps forward, and 2 steps back.  But no one said that recovery from spinal fusion would be easy!

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