Sunday, September 29, 2013

7 Quick Takes

7 quick takes sm1 7 Quick Takes Friday (vol. 193)

I'm using the name, and I'll link to Jen's post even though weekend is over and I'm definitely not QT official.

1) Somehow I have only posted once in the last 20 days, and I'm not sure if that one post technically counts as a post since it's a giveaway.  But, it's a giveaway for an awesome book and because I am SO not on the ball this month, I think we'll just say that it's going to go on for another week or so before I pick a winner.  So go sign up, if you're interested in that sort of thing.

2) I was trying to figure out why it's been so long since I've posted much, but now I remember.  Shortly after my last (real) post was when the whole area around Rocky Mountain National Park flooded.  I don't live there, but that's always been a favorite destination of mine and so all the coverage on that was extremely distracting for a while.  And shortly after that, I got some sort of stomach bug that cost me a week of work and 8 pounds.  Now, while my ever fluctuating weight has hit the high end of where I like it to be, that is NOT how I want to lose that pound or two, and I worked hard to replace all those fluids and bring it back up.  Now I have to work on some probiotics of some sort because my poor gut has been hit hard recently. (I feel like some of the canyons in Colorado and my gut got some similar treatment...)

3) Wow, TMI.  Between the lack of posting and then posting that, thank you to anyone still reading this post and who hasn't deleted this blog from their reader!

4) I haven't seen this on EVERY facebook feed yet, so I'll take a chance and share it here. It's a little long, 15 minutes, but it is a beautiful story of a father's confession to his small daughter about how he felt when she was diagnosed with Down's syndrome and even how he wanted to choose abortion, but how much he loves her now.  He shares this with the hope that if others hear it, they will be spared the mistake he almost made.

5) So, spiders and I.  It's no good.  There was a spider in the hallway at work the other day.  I should have taken care of it, but I didn't.  I should have at least asked someone else to take care of it (especially since there was a bit of a possibility that it may have been a nasty variety), but instead I texted a friend about the fact that there's a spider on the wall.  You KNOW she's a good friend when she didn't suggest any ridiculous and unworkable solutions, like killing it myself, but rather a good solution that I should hang a sign pointing to it that something like "Kill me."  I don't deal well with spiders.  And if you're one of those types that believes in setting them free outside, you are welcome to come over and free all the spiders in my vicinity.

6) At least it wasn't a scorpion.  My sister just had one of those in her house- and she lives in an area that we did not know had scorpions!!!- and that's just not okay.  I've had a bear in my yard this summer and that was SO much better. No joke.  First of all, in the yard, not in my living room.  Second of all, if a bear did somehow get in my house, it can't hide in my shoe or in my bed sheets.  There's no hiding it! Third, if there's a bear in your house, it's worthy of a call to someone else to take care of it.  If there's scorpions, you can get an exterminator, sure, but you still have to take care of the scorpion that's right in front of you.  911 is not interested in arachnids in your house until it's too late, like you get a sting and have an allergic reaction.

I may not visit my sister ever again....

Also, I've never been to Texas, and I may never go.

7) Last week, I was hiking in late summer weather and I was sweating in my T-shirt and light pants.  This week, I was hiking in the snow.  Gotta love the mountains, they are constantly changing! Don't get me wrong, I love it and I was all kinds of giddy about hiking in snow and fall colors and cool temperatures, but I was also shocked by the quick switch.

Seriously, Merry Christmas

Sunday, September 22, 2013

A Giveaway!

So, I was going to do a giveaway with my Quick Takes on the 13th.  That didn't happen.  I figured, no matter, I'd do them with this week's Quick Takes.  But I'm not getting to the Quick Takes.  Or any other blogging apparently, but that's not what we're here to talk about today.  I'm too excited to wait and see if I get to QT's next week, so I'll just do the giveaway now.

A couple of months ago, Ecce Fiat started talking about this book she was reading, and she had some quotes that made me want to run out and buy the book.  So I did.  And I love it!  I'm only about halfway through, but I have to take my time with it and soak it up.  It's called Interior Freedom and it's by Jacques Philippe. I would give you a chunk of what I've highlighted, but they'd come after me for copyright violations, since I've highlighted so much of it.  Did I mention that I love this book?

He starts out by explaining that true freedom doesn't mean that we get to choose the options that suit us the best from a range of possibilities.  For the Christian, true freedom, instead, lies "in the possibility of believing, hoping, and loving in all circumstances, thanks to the the assistance of the Holy Spirit who 'helps us in our weakness.'"  He goes on to explain that we don't really choose our cross, but we can choose to consent to it.

One point that I especially loved was his discussion of how trustingly accepting the reality of whatever situation we are in can go through stages of rebellion, resignation, and consent.  I have been in all of those.  When I hit resignation, I thought it was the best I could possibly manage.  I love this quote:

Resignation may represent a certain degree of progress beyond rebellion, in the sense that it leads to a less aggressive and more realistic approach. But it is not enough.  It may be a virtue for philosophers, but it is not a Christian virtue, since it doesn't include hope. Resignation is a declaration of powerlessness that goes no further. It may be a necessary stage, but if one stops there it is also sterile.
I love that call to hope.  Whatever the circumstances, there is hope.  "Where grace is accepted, it is never in vain, but is always fruitful."

I feel like I'm doing a horrible job of explaining this book, but it's a nice, short easy read.  And you should read it.  I'm going to help you.  I will give away one copy of the book, either print or Kin.dle edition, to one commenter.  Just leave a comment and you are entered to win it. Simple enough.  I'm not sure how long this will go.  Maybe until Friday-ish?  I make no promises, though I think I can safely say that it will not end any sooner than that.

P.S. It's a perfect book to take to Adoration!

Sunday, September 8, 2013

A Pain in the Neck

I think I have a herniated disc in my neck.  Or two.  My guess is around C5-6 or 6-7. Or both.  I don't really know because I've never had the imaging done.  Why bother?  The symptoms have never gotten to the point where I was going to do anything besides conservative treatment for it anyway. I'm not sure where it started, but I know a couple of things that really got it rolling.

My neck was feeling a little stiff when I signed up for the second massage that I ever got in my life.  That was before I moved out here, so it was not given by one of the excellent massage therapists that I see out here.  And it was only my second one, so I wasn't as vocal as I am now.  Anyway, I told her my neck was sore, so she bent my neck forward and rotated at the same time to stretch it.  It wasn't real comfortable, and I should have said something, but I don't remember it actually being painful at the time.  What I do remember is that my shoulder (well, between my neck and shoulder) was achy the next day.  I thought it was just muscle soreness, but it lasted for several weeks.  I started to work on some different things for my shoulder, but it didn't seem to help all that much.  Then I started paying attention to my neck and realized that the pain was referring from my neck.

After a few weeks, it went away for the most part for a while.  Occasionally it might fire up a bit, but it never lasted long, and even in that few weeks, it didn't really affect how I was moving.  I just felt it.  When I moved out here, I started working with a personal trainer some.  When I was using my arms a lot, I really got it wound up a couple of times.  It was hard to turn my head all the way, and there were a couple of times that I needed one of the other therapists to do a quick treatment for me.  The trainer really knows his stuff, so he corrected what I was doing (he actually was able to tell me ahead of time, but I did the wrong thing without thinking... Not his fault.)

But where it really got bad is when I fell and hit my head on a rock. That happened almost 18 months ago, and it was a bad fall.  I probably fell at least 5 or 6 feet and had to get 4 staples in my head (and I was just hiking, how silly can you be?!)  I felt like a complete moron and I also had this crazy "what the frick am I going to do now" thing going on in my head right after the fall.  Because who would I call out here to come help me?  At first, I wasn't sure if I could drive (didn't want to take the chance if I had a concussion).  I mean, there are friends here that would totally be willing to help, but no one that I really wanted to call. By the time I got to the car, I was completely confident that I was okay to drive, and I was able to get to the doctor with no problem. By the time I got there, they asked about my pain, and I answered for the pain in my head (which was extremely minor), but I was just then starting to notice the pain in my neck.  And it was really getting bad quickly.

I couldn't turn my head very far.  It hurt to use my right arm (which is a really big problem when I'm really right hand dominant and use my hands a lot in my work). I only saw a couple patients the next day before I realized that I couldn't do it.  I had the next week off for vacation, which was a good thing, but driving with it all wasn't very fun. It would also give me headaches.

That was all at it's worst, and it didn't stay that bad for very long, but I had pain with turning my head with driving for months.  I would get pain in my upper shoulders and into my neck all the time with work and would go home with headaches. I could always feel it reaching to shut off my alarm clock or reaching overhead. I had to be really careful when I was climbing and had to go for easier climbs and fewer climbs because otherwise I would flare it all up again.  I could get the pain fairly well managed, but never gone. Massages helped a lot to keep my functioning, but I got used to dealing with a low grade of pain constantly.

I rarely thought of myself as someone with chronic pain, but the definition of chronic pain is pain that lasts greater than 3 months. So... Yeah.  That'd be chronic pain. Even though I never got many of the symptoms that I mentioned in this post, I still had a few, such as the chronic tightness.

Wow, so how bored are you right now? ;)  Anyway, I have a specific reason for the things I told you here.  I'm going to be referring back to it when I try to explain some of what I've been learning. It's easier to give you my personal story than trying to generalize things. Just so you're not in suspense, though, I have been more pain free in the couple of weeks than I've been in the last 18 months.  It's a combination of things that's helped over time, but some of what I've been studying recently has helped me get over the place where I was stuck.

Friday, September 6, 2013

7 Quick Takes Friday

7 quick takes sm1 7 Quick Takes Friday (vol. 193)

1) I got my teeth cleaned on my day off this week. Because nothing screams "great day off" like sharp instruments in your mouth.  I was offered a numbing gel for my gums, but honestly the texture and taste of that stuff is worse for me than the cleaning. The good news is, my teeth are clean and this was a new office to me, but I'm a fan.  Loved the staff, and I'm impressed with the dentist... Which was a concern, because I know him from other stuff, and I always get a little nervous about going to acquaintances for things, because what if they stink?  Then it's awkward.  But there is no stinkage, and I'll be happy to go back (or as happy as you can be to go to the dentist, anyway.) During the visit, we finalized our climbing plans for this afternoon.  That's how I know him, from climbing (and he's very much taken, so it's only about climbing. Sheesh.)  The hygienist thinks we're all crazy (a number of our mutual climbing friends also see him).

On the way home, I decided that my teeth were so clean that I wasn't sure if I wanted to eat for the rest of the day.  Then I walked in the door to my house and started eating.

2) Next week, I have a different appointment scheduled.  This one's a massage.  It's been about 6 weeks, and I'm ready.  Looking forward to that appointment a lot more than the dental one!  Although I have to say that I'm not quite as desperate as I could be.  There've been times where I've really needed a massage because of pain/tightness/headaches. But it's not been as bad recently.  Some of the chronic pain stuff that I've been learning and using is really helping. Nonetheless, massages are still da bomb* and I can't wait.

3) Are you tired of hearing about my gluten free/dairy free stuff yet.  No worries, you're not alone.  Everyone around me is bored of it, too.  But here's what I noticed this week.  Allergies have been bad around here for a lot of people, but I've barely been bothered this time around.  It was a little bit, but you know when it was worst? When I broke my diet and had way too much cheese.  Itchy eyes and stuffy nose.  Good times. And the breathing was the worst when I had gluten.  Sometimes I wonder if I'm making this stuff up because it's not like I have anything drastic like celiac's, but the other day I was feeling some sympathy for a patient with red, watery eyes who was all stuffed up with allergies, while I marveled at how easily I was breathing, and I hadn't used the nose spray or inhaler for quite some time.

4) So my days off have been a little stressful lately.  I have so much crap to do that I start to freak out about all the stuff that must be done and there's no way to do it all and then I get overwhelmed and start playing tetris or solitaire (I'd play something cooler, like Candy Crush, but then I'd never cook or clean or any of the things that I do too infrequently already, so I limit myself to the oldies) instead of actually doing something useful.  Part of my brain knows that doing a little bit of something is better than doing all of nothing, but when I get overwhelmed, I usually pick doing nothing because I don't know what little bit to start with.  Ahem.  Anyway, what I had to do as my list mentally grew and my hours mentally shrunk was to take a deep breath, and tell myself to pick one thing.  So that's what I did.  I picked the one thing that most needed to be done, and I focused on that.  And I mostly ignored the other stuff, though I got a couple of bonus things taken care of.  But my freak out ceased, and I got something done, and I enjoyed some of the unstructured time that I need in order to function.

5) I am getting SO excited for next weekend.  I have a friend coming out and she's only been this way once in her life, so I can't wait to take her to some of my favorite places. I can't tell you how much I need some time with people that get it, and get me. I can't wait to spend some quality time with my friend, in the mountains, and hopefully we can find some aspens showing off all their fall glory.  And animals.  The place that I'm taking her has a lot of animals, so I hope they come out to play for us.  It's going to be fantastically awesome.

6) I'm seriously pumped that it's weekend again for this weekend, too.  I have hiking plans and plans to relax, and I just booked a flight next month to go visit some friends I have been missing a creepy amount. I also worked enough hours to get a little bonus on my paycheck, and I only have a little bit of catch up work to do.  Plus, I have bruised knees and slightly sore muscles from climbing the other day, and that makes me happy because I went out there and did some climbing instead of barely making an effort.  It's good when I can push myself. Ooh, and my internet's back.  I was going to finish this last take last night and post it this morning, but the internet was MIA.  Anyway, so to all of this I say, sweet.*

7) I was looking for an old post to link and as I was scrolling through some of my previous posts, I realized that this blog is lousy with mountain pictures and nothing else.  Eh, well.  Y'all are too polite to say if it's boring you, so mountain pics it is.  You're stuck with 'em.

Have a wonderful weekend, and head over to Jen's for more Quick Takes!

*Yes, I said it.  I'm really that cool.  Or that nerdy.  You decide.

Sunday, September 1, 2013

Chronic Pain Is a Pain in the Butt

This is a little more technical post that may not be of interest to everyone, but several people were interested in the chronic pain stuff and since I've been working on turning it over in my brain so much, it might help me to straighten it out better in my head if I write it.  And it sounds like it might be beneficial to some people that either have or know people with chronic pain. This will probably be a number of posts because it's such a complex thing and I've got a lot on my mind in regard to it.  

I'm a physical therapist, and chronic pain has been a pain in my butt since I started practicing.  I have met tons of wonderful people with this horrible problem, and it is SO frustrating to be so incompetent in the face of it. Things like fibromyalgia, chronic fatigue syndrome, chronic back and neck pain after things like a car accident or falls, ongoing extreme pain and sensitivity after an traumatic fracture, and many more things. All too often, there is lots of pain, but little known reason for it.  I treat lots of pain every day, but these are the kinds of things that I dread seeing walk through the door, because these are some of the people that most need help, and they seem to be the people that I can help the least.

When they come to see me, there is always a specific problem that I am supposed to be treating.  Back pain. Neck pain. Arm pain.  Muscle and joint pain. Trigger points.  The thing is, I'm usually pretty good at treating those things in a scenario when things are mostly caused by a mechanical reason.  For example, I remember one patient who came in with back pain and he'd had a surgery for it, but was still having pain.  I took one look and saw one shoulder sitting back farther than the other.  I took him in front of the mirror, showed him how he was rotated and stood him up straight.  His pain decreased immediately, and we identified some work areas where he was constantly twisting in that direction and fixed him.  Ahh, I like the easy ones like that.

What I don't like are the ones that have been in for numerous back surgeries for a number of different things with a varying degree of success, but never manage to be pain free.  They've already been to a number of physical therapists and they've already done a lot of exercises, and with only limited progress.  Those are the ones that I know are going to go out the door with only a limited amount of progress.

Or people who have had a car accident and they are so fired up with muscle and soft tissue pain that all the things that I normally do that usually leave people feeling fantastic just leave these folks feeling worse.  And why does it last so freaking long (sometimes years) after a car accident?

Here's what's always gotten me about chronic pain.  I am only going to treat the body part, right? But when I'm taking a history, people with chronic pain often have a whole host of things going on:

-Depression (makes sense; seems like dealing with unexplained, ongoing pain that is often not well understood by healthcare providers would be awfully depressing.)
-Anxiety (again, makes sense)
-TMJ syndrome
-High blood pressure (a body under that much stress? Makes sense.)
-Chronic fatigue
-Insomnia (those two are often present and are completely unfair that they exist together.)
-Pain in multiple sites
-Pain that's often fairly generalized and hard to describe exactly where it is or what is causing it
-Sometimes complain about being cold all the time
-Poor hair growth or hair loss
-Don't feel like themselves and wonder who they are and how they got to be where they are
-Chronic knots/trigger points in the muscles
-Difficulty concentrating or thinking

I'm sure there's others, and not everyone has everything on the list, but usually it's a combination of several of those things.  These are the people that I have to be really careful with my treatment, because too much often brings about an exaggerated pain and/or fatigue response. These are the people that usually have lots of knots that are causing pain, and feel better when I release those knots, but come back and report that they felt good for a few days (if we're lucky) or maybe only a couple of hours.  And when I get my hands on the knots again, they're back to where they were when I started.

Then there are often those people that I treat that have some very mild forms of some of those symptoms, but it's not quite as bad and is not enough to be completely debilitating, even though it's affecting the quality of life. In so many people, they tell me about these different symptoms with a hint of helplessness in their tones and attitudes that breaks my heart.  They usually finish with some sort of a comment about how "maybe I'm just crazy."  I can see how they would feel that way, given that there's this huge variety of things going on that seem to be so unrelated on the surface, and because they've usually had a number of tests that don't show anything and doctors are baffled by what to do with them.  The good doctors tell them "we just don't know."  Other doctors say "there's nothing wrong with you" or they want to send them only to a psychiatrist.  It's even worse if there was some sort of an accident claim and someone is questioning whether they are really feeling all the things they say they feel. Patients end up feeling defeated, and I don't blame them. I can't tell you the number of times someone shrugs and tells me that they live with daily pain and they've just learned to ignore it.

I had no idea why some of these symptoms would show up so many times.  It was frustrating, because I'd be addressing this one small bit of a huge problem.  I knew they needed more, but I didn't know what, or where to send them to try to find more relief.  All pain clinics want to do is to find the right drug cocktail (or so it seems). Many of the patients had already had many of the most modern medical tests in our arsenal. I would straight up tell patients that I don't know why these things are happening, but they aren't making it up.  And I would wonder why these things were happening, wonder why we could get something to loosen up, but not stay that way, why chronic pain is so freaking resistant to treatment.  But I had no idea where to start with it all, so I usually just left it at that. I wondered why, and tried to treat the muscles and nerves (mostly peripheral nerves) and joints as best I could and figured a tiny bit of progress is better than no progress at all.

That is some of my professional experience of chronic pain. Next time, I'll tell you about a bit of personal experience (though I never had a lot of the symptoms listed above, and didn't even really recognize it in those terms for a while... Well, how about I wait and explain it then, hmm?)