6 week surgical follow-up

6 week follow up went great! As you can see, the disc is sitting in there just perfectly and when I flex or extend my neck it behaves exactly as an organic disc would. And just look how perfect the other discs are! It's a beautiful sight to me. This is the last section of my spine that's not fused.

The knots, or adhesions, in my shoulder area remain, leftover from when the nerves were causing muscle spasms constantly. I bought some tennis balls and am rolling around on them trying to work the knots out, also doing lots of stretching in that area. Dr. Spivak was impressed with the range of motion that I've already been able to acheive, movement that was impossible or impossible without pain before. No more pain going down my arms, yay!

I've got an appointment with their pain management specialist for a shot or two next month, as I'm more concerned with the pain in my legs coming from my lower back than I am about the neck.

Physical Therapy yet again

I'm back for yet another round of Physical Therapy. Those of you who know me know that I am not crazy for PT for a variety of reasons.

So I had my first appointment last Tuesday. The therapist was nice enough, but not nearly as aggressive as I'd like her to be with the massage. I hadn't been to acupuncture for a few weeks and I was needing those knots to be worked out; her gentle massage just didn't cut it for me. Then, and this is really weird, she gave me the heat pack at the end of the session (don't they usually do that at the beginning, to warm the muscles up to work them?)and to top it all off, she put this huge heat pack under my shoulder so I was laying on top of it and all uneven. It really threw me out of whack and I hate myself for not opening my mouth sooner but she was with another patient and I didn't want to be a noodge. I had sciatica all the way home, I think from being all out of whack and not laying flat. I'm telling her not to do that again when I have my next appointment tomorrow.

Had another follow up with Dr. Bartoli. She (and her med student) did a nerve function test on me and, thank goodness, all is fine with my nerves. She thinks the numbness and "funny bone" feeling in my fingers is from the muscles in my shoulder and thoracic region not pulling their share of the weight so to speak and putting pressure on the nerves that affect those parts. I also got a few blessed trigger point injections, which never fail to please.

Saturday's Acupuncture Appointment

I had my acupuncture appointment on Saturday. They didn't do the trigger point releases, and I was really disappointed. What they did do was check out my arms, specifically my left one where I'd had the "tennis elbow" surgery, and put needles in there. I don't know if it was anything they did, but the pain in my thoracic region was worse and I had pain running down my arm all weekend.
The pain in the arm went away, and I'm wondering if it was just something that they released that was working itself out or what. I don't have appointments for the next two weeks as the students are graduating, then I go back in early May and I really hope that they bring back the Pain Clinic then or that I have no need for by then!

Alexander the Great

I had my first Alexander lesson on Friday afternoon with Nanette Walsh. I was really impressed with her; she was intelligent and really knowledgeable on physiology and anatomy and able to explain why she was asking me to do what she was. Plus she had the sweetest old dog named Harley who lay in the room with us, and came up to observe when we were standing up, like some kind of canine consultant, sniffing at my pant legs.

So the first thing we did as soon as we got into the room was “chair work.” She immediately had me stand in front of a straight backed, hard chair and she positioned me to correct way to prepare to sit. For me, it’s all about not having your chin jut out and tightening up the next muscles when I engage my back muscles to prepare to sit down, or stand up.

Then we went to the table and I lay down on my back with my knees up. She also place three small phone books (like the ones we get in NYC for just one neighborhood) about three inches thick total under the knob at the back of my head. My neck was just sort of suspended but supported. She explained that the books are to help keep the top of the head pointed forward, up and out. Adjustments were made to my shoulders and lower back to allow my body to spread outward. Nanette explained that that is the whole idea, for the body to spread out.

We also spent a lot of time on my breath. I’ve done my fair share of yoga and meditation and I was always taught that it’s best to blow your belly out when you take in breath, sending it to the small of your back and abdomen instead of just the chest. Nanette explained that for someone like me who has trouble with tense muscles in my neck and shoulders, it’s important to fill all the way up, and of course, out.

So now I’m practicing my “chair work,” and today I lay on my yoga mat for 10 minutes trying to “direct” my body to spread out. Nanette made sense to me, and I think after about a month or so of living with this new information, I’ll go back for more.

Here’s some information and a bit of history on the Alexander Technique. If you have back problems, it could be worth a try.

Pins and Needles, Needles and Pins ...

I had my first acupuncture appointment last Saturday and I go back again this Saturday and several Saturdays after that. My unsurance, Oxford, only partially covers alternative treatment so my co-pays at an "approved provider" would have been either 70 or 90 dollars a pop. Instead, I opted to go to the Tri-State College of Acupuncture, located near me at 14th and 8th Avenue.

There were a bunch of us sitting in the waiting area, and of course I'm wondering how many of these people are ahead of me for a nine thirty appointment. Turns out, the class lets out at that time and we all get teamed up with a pair of pin-pushers and go to the back. I had an Asian guy who looked like he was ready for his close up, nattily dressed and all officious in his white coat, and a Russian or other Eastern European woman who seemed disappointed that I had so many scars.

They talked to me for a long time, asking all kinds of questions about how I was sleeping and if I had any digestive problems, etc. It was kind of depressing to have to rattle off my list of stuff that's wrong. The clicking in my hip, the pain in my neck, the occasional sciatica, the leg pain, the acid reflux, the two surgeries on my arms, the sinus surgery; it was such a litany that I decided not to even report the biopsy that I'd had on my right breast two weeks ago and that was still seeping blood.

They called in their supervisor, a Chinese lady with an accent so thick I could barely understand her questions. Mostly what she was saying was "better?" when they stuck me with a needle or pressed somewhere.

I had needles everywhere. My arms, ankles, knees, and that was just the front side. They had me flip over and did the same thing to my back.

I can't say that I felt all that much better afterward, but they said it's an ongoing thing, so I might not feel anything for the first few treatments. They also have a pain clinic on Tuesdays that they recommended to me in addition to the Saturday appointments.

It seems like this is going to be a life-long thing with my back.

I have to say, I was looking forward to being pain-free for at least a little while, but a few months into my recovery from the low back surgery, the upper back and neck starting getting painful. When I discussed the upper back pain with Teresa at Dr. Balderston's office, she told me that the cervical disc replacement surgery was a lot easier than the lumbar. Okay.

I have high hopes for the acupuncture.

High Heels for the first time!

Went to a wedding this weekend and I wore heels for the first time in at least a year and a half! Here's me in the church bathroom in 'em.

Here's another shot outside the church.

You can't really see it here, but there was an older woman standing by the curb who had a cane. Last year that would have been me. Hell, just over six months ago, that would have been me! Even though I'm paying for it now, I'm so happy to be the one in heels and not the one with the cane.

Here I linked to an article in the times that discussed Medicare’s decision not to cover ADR surgery in patients over 60. As it turns out, this is not good news for ANYONE needing ADR, and possibly even fusion. Here’s why.

During my last check up, Theresa mentioned that the pace of their surgery schedule has really slowed as many/most insurance companies are now not paying for the type of surgery I got, that is, ADR combined with a fusion. They’ve narrowed the range of what is covered by adding the stipulation that there can be no other existing conditions, so if a patient needs ONE disc replaced and that’s it, ok. People like me who needed a fusion and a new disc would be shit out of luck. Thank goodness that I got my surgery when I did, as I can’t even think what the outcome might have been if I’d had to wait for even a few more months.

On top of that, I’ve been reading with interest the health care proposals of the three leading democratic presidential candidates (Clinton, Obama, and Edwards). They all seem to include/favor the formation of some kind of “institute” that would research the most effective treatments for the most common (read:expensive) health care issues.

From the NYTimes:

"Along these lines, the three leading Democratic candidates have quietly come up with nearly identical ideas. Deep inside their health care plans, Mrs. Clinton, Mr. Edwards and Mr. Obama have each called for the creation of a national institute to figure out which kinds of medical care actually work. This institute would sort through the scientific research on, say, spinal fusion and help people understand when it may make sense and when it’s likely to be just another big medical expense that doesn’t solve anything."

As back pain is one of the major health care costs, lumbar fusion and I suppose ADR, though the article didn’t specifically mention it, would be researched for their efficacy. Apparently there are some studies that show that fusion is, in some cases, no more successful in treating back pain than other methods. While this is true, and I'm not advocating that anyone and everyone who requests a spinal fusion should be able to get one, I am afraid that the insurance companies will seize on any study that supports a conclusion that means they don’t have to pay for a procedure. The Times article goes on to state that Medicare and the insurance companies would then use the research to “determine when a procedure or a drug would be covered” (read: they’d use the research to deny coverage).

Of course, this is all just my opinion, and wouldn't it be nice if I were proven wrong, but if there's anything I've learned in the past year or so, it's that insurance companies are pretty predictable when it comes to cutting what they cover and putting more of the insurance premiums we pay into their own pockets.

"How'm I doin'?"

Shame on me for not updating, but I've got a good reason; I've been busy doing other things rather than obsessing about my back!

So I'm seeing a physical therapist for the stabbing, tearing pain in the middle of my upper back. It was most likely brought on by me trying to overdo everything cause I just felt so good and ready to try to stretch and work out like I normally do, well, like I normally did almost a year and a half ago. Swimming, which is supposed to be so good, probably should have been done with a bit more restraint than I went for it, but say la vee.

The PT mostly just massages the region around where the pain originates. It's all 'crunchy' cause there are so many knots in the muscles. This isn't a relaxing massage, either, folks. She puts some real elbow grease into it and I'm usually sore just from the rubbing, but I know it's good sore cause it means that blood and oxygen are getting to the muscles that need it. Then I do some light, very light, exercises for that region, and what do you know? It's getting better. When I go back for my post-op visit in June it will be six months and that's when Theresa says they usually start the PT for the lower back, the area that was actually most affected by the surgery, even though what I'm experiencing with my upper back is a result of my whole skeletal structure being shifted around. This Friday will be five months to the day since the surgery, we'll see how I'm doing then.

I was over my back ...

This looks and feels the same to me as it has for the past couple months now. Still sore, still feels like it's going to pull apart when I stretch (which I found out yesterday I wasn't supposed to be doing. Oops.)

Talked to Theresa yesterday about the weird burning pain in my upper back that gives me the chills and the willies and the persistent nag of the threat of full blown sciatica shooting down my legs. She repeated her mantra that I'm overdoing it and I should listen to my body. How do I start to listen to my body now? Much of my life has been spent ignoring those tiny tweaks and twinges in order to just get through the day. How else could I have spent years fencing, rock climbing, running long distances? I'm not sure what listening to my body even means.

So today at the gym I only did legs, and I haven't been swimming for a week, afraid I'll get the burning pulling pain in the water and necessitate a rescue by the lifeguard. It's that bad, and I sometimes can't feel when it's coming. I Also can't believe I did it to myself trying to stretch. When will I learn that I'm not competing with anyone and it doesn't matter all that much if I exercise six times a week or three? I'm still getting plenty of exercise walking Tony every single day (but in fact the walking is what brings out the sciatica, what to do?). Today at the gym I was feeling good after a half hour on the elliptical cardio machine and full leg weight circuit; I had no twinges in my legs until I started stretching my quads (which I was told I could and should do), at which point I felt that little shock go down my legs. I'm thinking it has something to do with arching my back, which I did slightly while performing the stretch.

It's clear I must cut back my activites, which I already have been forced to. I miss swimming, I miss the smell of the chlorine and the beauty of our pool; I miss gliding through the water, channeling Michael Phelps, rocking from side to side gulping in air.

Just when I thought it was safe to be so over this whole ordeal, it's, if you'll excuse the pun, back.

Comic relief

At first glance, this xray doesn't look too much different fromt this one, but if you look closely, you can see that the fused area is filling in a bit more with bone.

That's good.

Right after I was shown into an exam room, one of the interns came in to see me. Last visit Dr. B. brought this kid in to see my progress and introduced him, saying that he had "scrubbed in" on my surgery. (Thanks to Grey's Anatomy, I now know what that means.) So this kid (I kid you not, he was like 12 years old) comes in and asks me a bunch of questions about pain, activities, etc. He examined the scars and said they looked "good," whatever that means, and took some notes. I asked him about the slight sciatica feeling pain I was getting when I lean forward sometimes and his answer was basically, don't lean forward like that. *rim shot* Who is this guy, Jackie Vernon?

Dr. Balderston came in a few minutes later and said it looked "absolutely beautiful," and was healing exactly as it should, which of course is great to hear. I joked with him that usually when someone says I look beautiful, they are looking at my face, but I'd take the compliment however it came. He joked back (unusual for him, he's usually all business)that for him, face, back, whatever, it was all the same. It felt so good to joke around with him, after all the seriousness in the past year or so. What a relief! I'm now allowed to start swimming again, and can use any of the elliptical machines in the gym, as well as the stationary bike. This will give some much needed variety to my workouts, and help to redevelop my leg muscles. I still can't believe how much walking still hurts my legs (and feet!).

My next follow up appointment isn't until June (three months from now!) and I joked to Dr. Balderston that if at the three month follow up had the intern coming in first, I wondered who would be coming at the six month visit, the janitor? *rim shot*

But seriously folks, everything is going just like it should, and that's no joke!

All the barking dogs were not in the ring ...

This past week found me grimacing every time I leaned forward in my seat or randomly when I put weight on my left leg, and then later, also my right. Ugh. Not much pain, but pain, nevertheless, coupled with a weird pulling sensation that I've felt before over the last 15 years or so. Ugh x 2. My normal reaction to it would be to stretch stretch stretch my back and my legs, but that is still verboten, so I was left with just the grimacing, which didn't help, and rest, which did.

Another call to Theresa pretty much confirmed what I had feared: I'm overdoing it. She said it's not unusual for patients to have pain associated with the surgery for months or even up to a year afterward. Of course, Type A competitor that I am, I was trying to be the "star" patient and really astound everyone with everything that I was doing. So much for that. I can't even imagine going through everything that I went through to still have pain.

So I decided to cut back on my activities. No more going to the gym every day on top of the dog walks, and walking for shorter distances with Tony until this goes away. It's already gotten better.

All this didn't take effect until today, of course, because I had to go to the dog show yesterday. I've been going to Westminster for a few years now, and really missed going last year (I was in bad shape last year this time, remember?). I was wondering what being on my feet for a good portion of the day was going to feel like, now I know: tired, achy, painful, but oh, I was in heaven!

I did come home to rest for an hour or so at mid-morning (right after I saw the Borders in the ring!), and it did seem to help. What also helped was the taking of a Darvocet around 12:30 and forcing myself to sit down and stay sitting for a half an hour. It was hard! I really had to not allow myself to get up and walk around, looking for pictures to take. I finally headed home, reluctantly, about 4:15. I SO could've stayed there all night and gone again today. Did I mention it was heavenly?

I have to say that of all the aches and pains I have today, and they are many (shoulders and neck, probably from camera; entire back, legs, hips and butt), I think my feet were the biggest casualty. I hadn't realized how tender they were from doing only the most minimal of walking for an entire year.

So my new rest regime starts today. I'm putting my feet up, waiting for the dog walker to come and take Tony out, and cueing up the DVR of the dog show that was on USA last night. At least my dogs are getting a rest today!

Uptown Girl!

Yesterday I went the farthest yet on my own, up to 96th and CPW to my dentist's office. I took the 10th Avenue bus up there and walked the block and a half from the stop to his office. The uptown bus was definitely a smoother ride than the crosstown double length job, with all its weird rattley segments, so even though I was on the bus for much longer (try 40 minutes!), I was ok. On the way home, I was very close to the C train, so I ventured down the stairs and, surprize! It was ok. I was worried again about bumping and jostling, but it wasn't crowded at all and it was really fun to be on the subway again, without the cane and without Tyler and without worrying.

I'm actually starting to feel not only like a normal human again, but a New Yorker! Yay!

Progress, maybe

Since I'm not allowed to do any exercise other than walk, I've been really trying to make the most of that. I've been going on increasingly longer walks everyday (Tony is upset that I don't take him along!), beginning with just walking around the hallways in my building and now including strolls around my Chelsea neighborhood. These latter outings are usually under the guise of running some errand, like picking up some fruit, dropping books off at the library, or buying a magazine or small treat for myself (croissants from Breadstix Cafe) while I'm out.

Yesterday I walked over the West Side Highway, up to 27th Street (when it started snowing!), back over to 10th Avenue, down to 23rd Street, up to 9th Avenue and then cut through my building for the last block cause I was freezing my ankles off in my capri sweats.

Today, since my long-frozen membership at NYSC has finally been unfrozen (I'd been working out at the London Terrace gym until just before I went into the hospital, it was much, much closer to home), and since I didn't feel like freezing my ankles again, I walked the two long blocks over to NYSC at 8th Ave. Once there, I walked a mile on the treadmill, then walked home with a small bag of fruit. My butt and legs have been sore since Tyler and I walked over to Bed Bath and Beyond on Sunday (four crosstown blocks from our apt., my farthest walk yet!) and took a cab back home (when I realized with a start of horror that I wasn't supposed to be in a car, but by then we were almost home, incident-free, thankfully).

Still, I've kept up with the walking every day this week. The soreness feels good; it's a different kind of achiness, a different kind of pain. This pain is from use, from increasing strength. It feels good. I'll let you know tomorrow if it still feels good, but whether it does or not, I'm still going to walk. Maybe just not as far.

Three days to go (from yesterday)

I knew I shouldn't have started this countdown thing, I have so much trouble keeping up ...

Anyway these are the three discs I'm having surgery on, illustrated on the front of one of my homemade hospital gowns, in case my doctor forgets what body part he's working on or something. Note the misspelling!