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!

Thankful for Healing

On this Thanksgiving Day, I’m thankful for the healing in my body this year.  The year isn’t over, nor is the healing, but it’s still something to be thankful for!

I’m at a touch over 3 months post spinal fusion.  My spine is held together by 6 screws and 3 rods, plus cages in the disk space between vertebrae L4-L5, and L5-S1.  Oh, and bone matter.  The goal is that everything will be held together by solid bone, and the titanium of course.  I will see my surgeon again next week, and expect a good report from him.

I’ve been in physical therapy for 6 weeks now.  Danielle is finally back, and she has been working me hard!  We have a couple areas of focus:  my hips and pelvis, and my upper back.  She wants increased movement and flexibility in my upper spine so I’m doing a lot of stretching and rotation work in my shoulders and upper rib cage, rotating from the bottom of my rib cage to look over my shoulders, and reach across my chest.   My hips and glutes are working as well to give me stability in my pelvis to support my sacrum and low back.  During my PT sessions, Danielle has me working on the Pilates reformer – doing a lot of squats in various positions to work specific muscles both in my hips and glutes, but also in my lower abs.  We are working on the flexibility of my low back (those muscles got VERY tight after surgery) while keeping my spine itself in a neutral position, but also stretching my hamstrings and hips.  Everything has been very tight because of years of chronic pain and moving in “defensive and protective” mode.  So I’m doing lots of stretches each day, as well as muscle building activities.  Danielle has also been working on helping the nerves to heal by loosening their paths as well as stretching them.  I have a series of “neural flossing” stretches and movements that are working like a charm.  Nerves heal so slowly, but I am noticing changes in my symptoms, so I know what I’m doing is helping!  Also, Danielle has been great about helping me modify and get comfortable in different yoga poses to help me get back into regular routines.  Best of all, she’s given me confidence to start really pushing my healing forward.

I’ve kind of turned the corner from being in a very protective healing mode and being extremely careful, almost fearful, about doing something to put my surgery in jeopardy – to pushing hard and moving much more.  My stamina is increasing, both muscular and cardio.  I can walk comfortably for a lot longer – it’s not just one slow gentle walk to the driveway, but 3 trips back and forth at a quick pace.  I’m noticing more muscle strength in the muscle groups we’ve been working on, but still need to focus on really engaging the RIGHT muscles to do the exercises, not what my body has been compensating with for years.  I laughed when Danielle said I have some really bossy muscles that need to take a back seat to the ones who are supposed to be working.  I won’t see her next week, but I will continue with my home exercises and yoga practices for hip and sacrum stability.  I have scheduled once a week check ins with her through the end of the year.  I’m doing much better – but I’m not “back to normal” yet, so therapy with guided exercises will help me get there.  Re-training muscles is hard work, in case you were wondering!

I’ve got a lot to be thankful for this year, but I really am thankful for the body God gave me and how resilient it is.  I pray you each have blessings abounding that you are also giving thanks for.

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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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