Physical Therapy – the next step in healing

I had my first physical therapy appointment this week.  I got a phone call the day before my appointment that Danielle would not be available due to an illness – but they could move me to the afternoon to meet with Brenda.  I asked if my follow ups would stay as scheduled with Danielle, and was assured that they would.  Knowing this, I accepted the change and planned to meet with her the next day.

She assessed my movement and range of motion, checked my reflexes and strength, and asked about what I have been doing so far and how I am feeling at this point.  While I have been doing quite a bit of stretching, she wants me to focus more on some micro movements.  Building stability and supporting the fusion as it heals.  I was given a sheet of stretches and exercises that take about 20 minutes to do each day.

I start laying on the edge of my bed and letting the outer leg dangle down – stretching the front quadriceps and hip flexor.  Hold for 30 seconds, bring it up and rest, then repeat.  Then switch sides.  Next, on my back knees bent, feet flat – lift and tighten my pelvic floor, belly button to spine, keeping my knees together, slowly rock knees side to side – holding stability and gently stretching hips – but not rotating the spine and it’s a steady motion – for a count of 20.  Next comes a hamstring stretch with a strap – knee bent slightly, foot flexed, pushing up through the heal, and keeping the pelvic floor and belly button engaged – 30 seconds, switch sides, twice each side.  Next is knees bent, feet flat, pillow between the knees.  Inhale and on the exhale, squeeze the pillow, lift the pelvic floor, and belly button to spine.  10 repetitions keeping steady with my breath.  Keeping with this same them, of lifting pelvic floor, belly button to spine, I then do slow and deliberate marching – micro movements of lifting my heel no more than 2 inches – focus on engaging those muscles in my pelvis and lower transverse abdominals.  Count of 20, and then we continue on the marching theme with lifting foot, straighten leg, lower and lift (small micro movements of less than 6 inches total) and back to knee bent, foot on the floor, then the other side. Up, straight, lower, lift, bend, down…count of 20 total.  When I’m done with all those, I roll to my side, feet stacked, knees stacked, hips stacked…and it’s clamshells – 20 working up to 30 each side.

When I’m done with the series of exercises, then I stand up between the bed and the wall and bend at the hips…hands on the wall to stretch the long muscles in my back – it’s kind of a modified downward facing dog – to stretch the long muscles in my mid and upper back.  I hold it for 30 seconds, and then switch to bring my hips forward and a slight backbend, allowing my hip flexors to stretch for about 20 seconds, then another set of stretch for 30, and flex back for 20.

So far this is feeling good, without too much difficulty.  I had to set my mind to just doing it first thing in the morning.  So I get up, let the dog out, start the coffee, and then into the spare room to lay on the bed in there and do the stretching and exercises.  Then let the dogs in, feed them, and off to the shower to start my day.  My intention is to then be able to continue to walk throughout the day and especially at lunch, and at least 3 days a week, spend 20-30 minutes doing a gentle yoga routine.

For the next 6 weeks I’ll be seeing Danielle for more physical therapy appointments on Tuesdays and Thursdays – so we’ll see how the routine changes, but it is my hope that getting up and doing the physical therapy first thing will be a routine I can keep long term – and that hopefully Danielle will help me to incorporate more yoga into the therapy routine.  I also wouldn’t mind using the morning to do a little ride on the exercise bike too – before I’m really awake and full of excuses as to why it won’t fit in today’s schedule.  I’m working to establish healthy habits and I know it will take a bit of time to establish the habit – but that’s where a little help from God will be useful!

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Counting Recovery

It is not quite 2 months since my surgery.  If you count days of the month, then tomorrow is 2 months.  If you count weeks, today is the end of the 9th week of spinal fusion recovery.  If you count weeks another way, Monday marks the start of the week 9-10 of recovery.  It’s kind of like vertebrae and disks – if the day is the vertebrae – and the disks are weeks – there is a week before and a week after.  I think at this point, I’m ready to just start counting MONTHS.

So I’m at 2 Months post op.  As I sit here today recounting my recovery, and reflecting on my progress – I feel “pretty good”.  I’ve made tons of progress of course, like I talked last week – no more walker, cane, back brace.  My discomfort is manageable.  I recognize that I have physical limits on what I can do, and my body does a good job of telling me when I’m pushing those limits.  But if I don’t do a bit of pushing, I won’t make progress, and I understand that too.

What am I doing?  Well, since you asked…I’m using a fitness tracker app to track my steps and other activities throughout the day.  It varies by day, but I generally get some combination that adds up to 6500 or so steps.  I don’t know the algorithm or logarithm that tells it that 15 minutes of stretching equals 1321 steps, but I look at it from an “overall activity level” .  For the record…that’s up from 250 steps a day the first week after surgery! Ha!!!  Anyway, I got on my exercise bike yesterday for 10 minutes, I did a 20ish minute yoga video and about 5 minutes of additional back stretches, and ended the day with a grand total of 6618 calculated steps for the day.  I try and use my lunch hour at work to go for a quick 10-15 walk, and then a gentle yoga video and some stretches.  The rest of what I do is just my moving around at work and home.  I’m trying to get into a routine of getting on my exercise bike more – since that is easier on my feet than tons of walking.  But mornings…ugh.  Trying to find the discipline to get up a little bit earlier every couple of days and pedal while the coffee brews…that’s my goal.  I enjoy my yoga during lunch time as well.

Last year while considering my fitness level, and my back pain level, I was researching yoga – but honestly, as a Christian, I was feeling a little bothered by the “Eastern Philosophy of Yoga” – the chanting and ooooohhhhhmmmmm – the stereotype I assigned in my head to what I thought about yoga.  And then I stumbled on a website that was Christian yoga practice.  Lots of information, some time in prayer, and a few websites later, I had reset my internal bias, and was ready to spend some focused time on a yoga mat WITH GOD.  And so for the last many months, I have been combining bible study, prayer, and yoga to my lunch time routine.  My favorite website and “teacher” is at www.carolinewilliamsyoga.com .  I’ve even exchanged emails with this beautiful woman, and she is by far my favorite Christian yoga video instructors.  A few of her guided meditations got me through a couple of rough nights early in my recovery, too.  Having that spiritual, faith-filled connection was vital when I needed to get through a pain flare.  Anyway, there is actually quite a community of Christian yogis out there.  If you too have been reluctant to think about yoga – I encourage you to do your own research, but I would hope that just watching one of Caroline’s many videos and listening to her bible study and prayer in EVERY PRACTICE, will convince you that just maybe, yoga might be a good fit for you too.

Alright, so next week I have my first appointment with my physical therapist.  She incidentally is also a yoga instructor, just FYI.  When I worked with her before for an issue with my upper back/shoulder she had me doing some yoga stretches then as well.  I hope that while working with her, I can get some tips about what modifications I can make to some poses, as I regain some strength, stability, and flexibility in recovering from this surgery.  I’m sure she’ll have me doing more than just yoga, but I’m hopeful we can work towards a sustainable long term plan to help me keep my back as strong and comfortable as possible.

Finally Friday – 6 weeks post op

As I expected, the end of last week (flight to Seattle) and this week (drive to Richland) exhausted me.  Sleep, ice, rest, and my back feels alright – but the fatigue is a very real thing.  I just don’t bounce back as quick as I did before the surgery.  As Chel and others keep reminding me – I’m putting a ton of energy into healing my back, growing bone, and so my extra energy reserves are bound to be low.  Sleep, eat well, take good care of my back as it heals – REST – is all part of recovery.

On Tuesday I had my 6 week check up with my surgeon.  X-rays first, that look very much like the ones they took 3 weeks earlier – except that I did flexion and extension instead of just standing up straight.  Doc says I’m pretty much where he expects me to be.  I talked through some of what I have been feeling nerve wise – and he takes credit for ticking off the nerves.  During surgery he had to move them out of the way to clean up the joints and do the fusion.  Nerves are slow to heal, but what I had pre-surgery was physical pinching of the nerves – now they are just irritated and need to adjust.  Continuing with ice through out the day and rest will keep the inflammation down and hopefully keep the nerves happier.  I have another appointment in about 8 weeks.  I have an appointment with the physical therapist in about 2 weeks and then appointments twice a week to see her for about 6 weeks.  I can start riding my exercise bike, and doing gentle yoga.  Gentle walking and stretching will also continue, and helps with the mad nerves stuff.  Still no NSAIDS – they affect fusion healing.  Still no heat – not good for the fusion either.  Careful and smart return to doing more and more – and working up to lifting up to about 35 pounds by the next time I see the doc.  As the nerves heal, and the muscles get stronger, the sense of soreness will dissipate as well.  Honestly, it’s not my back/surgical site that bothers me.  It’s my butt and down my legs to my feet – all nerve related.  When I’m not good about walking, resting, stretching, icing – that’s when the nerves start firing all crazy.  The muscle relaxers keep me from having major cramping and charlie horses – so that’s a good thing…but the muscles in my legs are sore.

Ok, but how do I really feel????  Well, pretty good most of the time.  The good outweighs the bad for sure.  I am moving better each day, feeling stronger.  I still am not wearing much besides leggings – as the waist band of my jeans and work pants rubs funny across my incision site and irritates it.  I can wear them for a couple hours, but then I am just annoyed – so leggings and a couple super soft elastic waisted skirts and such are my work wardrobe for now.  I’m able to do laundry without much trouble, and load and empty the dishwasher, even change the sheets on my bed.  I can bring in 2-3 smaller pieces of fire wood at a time so I don’t freeze.  I can take the trash out to the big can – as long as I don’t let it get too full – or put the used kitty litter in there – that makes it too heavy.

I’m thankful that I’m doing as well as I am, and that I can start to do even more, and get back to most of my routine. I know my back will tell me when to slow down, take a break, and sit on some ice for 30 minutes and take a break.

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