Tag Archives: Neurosurgery

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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.

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18 Weeks Post Spinal Fusion

I haven’t really counted the weeks lately, been counting months mostly – but it was a question floating around in my head, so I grabbed my phone and counted the weeks.

You know, we go through life every day – just doing life, but not really paying attention to anything outside of the moment. Most folks this time of year are focusing on Christmas obviously – so thinking ahead to make sure they have gifts for everyone, all the right things in the fridge for special meals, and planning those last few days to make sure everything on the list gets done in time. But how many folks look back? Some do for sure – especially those who are missing a special someone who isn’t with them for the holiday. But as a rule, we don’t necessarily think back with any specificity about what the last few weeks, months, or even years have looked like in our lives. We just do life – one day at a time. Each morning brings new opportunities.

Many of you know I work at a university – so my work life centers around academic calendars – the start and end of semesters, the work associated with beginnings and endings. Juggling new students, and students about to graduate. Its a perpetual cycle, but one that is also very predictable. I work from a calendar that reminds me of specific tasks needing to be done each week in order for the semester to continue to run smoothly. So when I threw the wrench of spinal surgery into my work life – it was kind of crazy. I was out of work for 4 weeks, and I spent most of the remaining 12 weeks of the semester trying to catch back up! I expect the spring semester to be back to a more normal feel – not constantly playing catch up.

As my last post explained, in my recovery from surgery, I was having some trouble with my SI joint, and so my therapist scaled back what I was doing to really focus on deep core strength, and supporting my spine with some very targeted work. I’m happy to say that the rest and focused work on stabilization worked like a charm. Of course, the KT tape probably helped too! My SI joint and therefore my pelvis has stayed nice and straight and stable. This is the foundation of our weight bearing structure, so when it is out of alignment, it messes with everything else. After nearly two weeks of really focusing on the deep core muscles, I can really pin point them and ensure they are engaged and working to support my spine. I am beginning to add back in more of the other work and exercises again – but slowly, and only after warming up with the core work first.

I’ve been keeping up with the nerve work too – neural flossing – to continue to keep those pathways clear. I don’t have the constant nerve pain like I did, but I need to stretch it regularly as I continue to heal. What we don’t want at this point is to have any scar tissue forming that the nerves can get hung up on. It might be time to schedule another couple of massages – one to focus on the surface adhesions and keeping the scar itself moving around, and another one to focus on the deep tissue tension as I gain strength, that I keep the neural paths open and moving. While it has been 4 months, there is still active healing and scar tissue forming (or hopefully not forming) – and so the timing is right for another couple of massages.

As the year wraps up, I can’t help but be grateful for all the prayers that have been offered on my behalf this year. For healing, for strength and for joy and prosperity. I’ve leaned heavy on my faith this year, and have been greatly blessed. My prayer for each of you this year is that you too are richly blessed and that you know the love of God in your heart. Merry Christmas, friends!

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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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