Pondering the Hipocritical Oath

As I was in the water doing an aquafit class this evening and trying desperately to pretend it wasn’t happening I was thinking about what the dr has prescribed to me for fitness, activity, and weight loss.

I wonder, do they do anything close to what they prescribe?

• 2-3 x 45 minute aquafitness classes split between cardio and strength or substituted with swimming laps (currently Monday, Thursday, Sunday)
• 2 x 30 minutes strength training
• walking as much as possible, about 5km per day or 25-35km/week
• a diet of approximately 1500-1600 calories per day (nutritionally balanced of course) required to do a 60lb weight loss (while maintaining muscle, see above)

All while holding down a 40-45h/week job with ~2h of commuting each day.

I know some do. But I also know a LOT don’t.

It can be a full time job to be fulfilling their recommendations, doing the meal plans and all the scratch cooking, and managing meds. Add in pain that flares about once a month and the constant fear of hurting yourself if you do anything remotely fun or different, and there isn’t much room for anything else really.

At the end of the day I will do what they say because Dr knows best. Just be sure that you do as they say not as they do.

A little polish helps

It is amazing the difference a little toenail polish can make!

*Not my real feet

I’ve had naked toes for weeks because leaning over to paint them is both difficult and painful.

And as I explained to my coworker: Naked toes look like boy toes, and boy toes are ugly!

So I caved and paid someone to paint them for me. What a difference! I feel pretty again!

Surgeon Consult #2 update

The Surgeon said to me “the thing about our wait list is that often people heal themselves while waiting to see us”.

The verdict is this: There’s nothing they can do.

If I was still in pain they would cut away the disc and hope it wouldn’t happen again. But since the pain is (mostly) gone they have the wait and see approach. Which isn’t a bad option considering we’re talking about a very important structure!

That said “wait and see” isn’t exactly waiting and seeing. Here’s what they recommend:

-get to a healthy weight. According to BMI the top of that is 140 for me. There’s NO way that will be happening so I’m aiming for 160. A 50lb total loss for me with a goal of 18 months to pull it off

-exercise daily, adding in more strength and core work. I already walk about 5-8km per day and see a trainer 2×30 min per week but I have to step it up. I’ll now be adding physio/core exercises for 30 min 3x a week and additional cardio like biking 2x per week.

-continue to see physio. TV and I agreed we can go down to 30 min once every 3 weeks now that I have no more coverage. It is a balance of how I feel and what we can afford

-start getting regular massage on my back. Planning about every 2-3 weeks right now. Again, depends on what we can afford.

I’ve got a referral to a dietician for weight loss strategies and a walking epidural appt in my back pocket for September if needed.

This is not going to be easy and it is going to be for life. I can’t imagine fitting one more moment of any of the above into my routine but it has to be done so we will make it work. Husband is going to take over some extra cooking and cleaning duties and together we will somehow get this new routine working without anything dramatic like me having to quit my job.

I’ll keep you posted, especially on how I manage this weight loss issue. Not looking forward to it one bit but I have to learn to live with the hand I’ve been dealt – a bad back that makes me want to eat and a slow metabolism that makes that not allowed!

2 steps forward, 1 step back, then running full force!

Hey everyone! I’m back from what I’d lovingly describe as the plauge. It was awful. 12 days of the sickest I’ve ever been, 2 Dr visits, countless meds, and 1 lingering cough that just won’t quit. Good news is aside from the cough I’m mostly back.

Speaking of which, thanks to TV my physio and the McKenzie Protocol I’m feeling SO much better!

The exercises brought me to be able to move and function without pain for the first time in weeks. It is a scientific evaluation of movement and what will make the pain move upwards towards the back from the legs. Basically we found the bending backwards feels good so I’m (trying to) do the above exercise 5-6 times a day to keep the pain at bay.

Right when I was feeling better from my back I got sick with the plague cold so I haven’t had a lot of time to enjoy my newfound comfort. That said, I have exercises with Burke that I can now do and I’ll be able to step up my workouts now that I’m not limited by pain!

I’m really looking forward to sun, bike rides, and our new patio! Bring on summer with good health along with it!

MRI results and a plan going forwards

Here’s the coles notes version of what happened with the MRI results and the appointment with the sports medicine Dr TT. Special thanks to SB for coming to the appointment with me – I needed that hug afterwards!

Compared to the previous MRI nothing is significantly different but the slight changes are able to explain the difference in pain that I have been experiencing fairly consistently since November and constantly for the last month.

I still have bulging of 3 discs in my spine which is compressing the sac that holds the spinal cord. Pain comes from that and from it touching other nerves that come off the sides like tree branches (called nerve roots). One of those controls the sensation down the leg, which is why my right leg always hurts.

Imagine a squishy disc on top of that light beige vertebra pushing onto the spine area and the nerves on each side. Like a donut that you gently push on and it flattens and gets bigger

There is nothing OMG needs to be dealt with now and nothing that screams surgery. I was hoping that surgery would be the holy grail for getting rid of my pain and unfortunately it doesn’t seem like that will be the case.

The pain is something that needs to be under better control because this isn’t going to go away any time soon. I may have better days and worse days but it isn’t something that “gets better” and fully goes away. I have been in significant daily pain for the last month which is the longest flare up that I have had.

My file is sent to a surgeon so I can meet with him (who knows how long that will take) and to an anesthesiologist because we are going to try a “walking epidural” which is cortisone in the spine to help with the pain for hopefully long periods of time. Also have a cocktail of meds for the symptoms: naproxen, tylenol, pain meds, muscle relaxant, stomach protector etc.

Fun fact: the pharmacist now knows me by name since I’m in there about every week or 2 since nothing is on the same schedule for repeats!

 

This is about 1/3 of what I take in a day, between the pain meds, anti-inflammatories, muscle relaxants, and assorted other meds and vitamins. Good thing that I learned to swallow pills in my teens.

I called the surgeon and because I’m a previous patient I was able to book a follow up appointment in mid April. Now I just have to be sure that they collate the records under my new name with the ones under my old name!

A quick call to the pain clinic/anesthesiologist revealed that files are triaged for priority but the wait is up to 6-8 months. MONTHS. It is hard to believe that they expect people who are in significant pain to wait half a year to get a potential long term pain management program. From the questions I was asked by the receptionist I would also be triaged low because I am able to walk right now.

I did some research and found that there are private pain clinics in Ottawa that also have super long wait lists, however there is a sister clinic in Toronto with a wait list of 3-4 weeks for an initial consultation. I’ve spent this morning preparing the referral form and a history/meds list to bring to the sports med doc so I can ask for a referral to the Toronto clinic.

Husband and I are VERY lucky that when I mentioned going to Toronto we both said “do it.” There was no discussion of cost or time commitment. We are thankfully able to do what needs to be done thanks to very supportive employers and a healthy emergency fund for unexpected expenses. I couldn’t imagine if my only choice was to wait here in Ottawa (though I’m not guaranteed that the Dr will send me to Toronto).

For now I’m continuing with physio, personal training, and medications. We’ve added to the list a muscle relaxant which seems to be helping but makes me completely exhausted. It will be another challenge to manage getting 3 doses of that into the schedule without becoming a total zombie.

Hopefully this helps to explain what’s been going on lately. It has definitely thrown a wrench into life lately but we’re working on getting back to something normal. Feel free to ask questions if you’ve got any. I’m happy to explain – it is what I’m good at!

It’s all fun and games till somebody gets hurt

Sorry to be  a downer guys, but I’m frustrated. I was so excited for games night at A&N’s place and to see people and have fun. By the time I arrived though I was asking for some ice and taking meds. For the record true friends don’t question you asking for a jar of turkey broth from the freezer for your back.

Today’s been and up and down day with a ski hill sized decline this evening. I ended up flat on my back, almost crying, after taking more meds than I usually would to try to dull the pain. Even after 30 minutes for them to kick in it was still barely tolerable so I was going to get a ride home with Uber.

For those of you that don’t know, Uber sometimes has surge pricing where the cost goes up in response to increased demand. Well, I wasn’t planning to pay 2.7x more for my ride so I stuck it out a little while longer. That meant I could play a bit of Boggle (though med fog made it quite difficult) and a got bit of pride back that I could stay a bit longer.

Moral of the story is bring 4x the drugs you think you need, not 2x. And thank your friends for being truly awesome people and sharing their frozen goods with you.

22 days and counting

Nothing makes you feel better than a visit with friends! Lisa and Geoff came over last night and we talked, laughed, ate, and planned our new patio for this summer! We can’t wait to host bbq parties all weekend in the new back yard once all the snow is gone!

Aside from last night it’s been a long 3 weeks. But the good news is that it seems that each day I’m getting a little bit better. Still on the drugs (ALL the drugs) though slightly less often.

Physio has been toned down as has personal training. I even missed a few training sessions because I just couldn’t make it there. This week we discussed traction and hanging. It feels good to pull my upper half from my lower half. Husband does this thing where he puts his arms out zombie style and I put my arms over his and “hang” by letting him take some of my body weight. It works and feels good but it is quite the workout for him!

The homework from BC this week is to find a way to hang in the house to get the pressure off. He suggested grabbing onto a door frame; I reminded him I’m 5’3″ and I can’t reach the door frame! I think we have settled on using a stiff fabric like a dog leash and the door jammer to make “handles” that I can hang from on a basement door.

That’s me, the svelte stick figure just hangin’ out

Husband is away tonight and tomorrow, back tomorrow night. We’ve got a plan that everything I need is at counter height just in case things don’t go so well tomorrow morning.

Here’s to continued improvement this week and getting back to life as I knew it going forward. Meeting with the Sports Med Dr TT is on Thursday. Can’t wait to hear what the plan is going forward, though I am very certain it will simply be hurry up and wait for the surgeon referral. Either way I’ll get the MRI results that will help TV and BC with physio and training plans. Till then I wait.

Feel the love

Last night I was exhausted. I’ve struggled through 2 weeks of pain meds and anti-inflammatories and the accompanying exhaustion on top of physio appointments, work, and walking 5km a day in order to get it all done. On top of that Silly Sally was back and apparently had taken 5 glasses of coffee and a liking to the show Stomp.

On the other hand Husband, although tired, was really excited for last night. He’d found a new puzzle solving game that he knew we both would love and was excited to play it together for a Friday night date night since I’d be away for several nights visiting family and working away from home.

I’m actually very excited to play when we get the chance! Perhaps a Skype date while I’m away will be in order.

In the end though, love won over excitement. Husband tucked me in on the couch for a nap while he made dinner and, while watching me almost fall asleep in my lasagna like a toddler, made a plan to get my straight to bed and feeling better. He even planned out when he’d come up and make sure I didn’t need any more meds or water or anything.

Clearly our evening didn’t go as planned and I was sad that I couldn’t participate in the fun game that he was so excited for us to explore together. However I was filled with a loving feeling knowing that love was all that was important. Taking care of me was the number one goal for Husband.

The good news is I’m feeling better after an epic 14 hours of painless sleep, and Husband was able to play online with his BFF so not all was lost. However I gained a new appreciation for how difficult it to for Husband to care for me and a great respect for all he does. I’ll miss him these next few days for sure!

Medication tracking app

I recently realized that I’m taking meds when needed and not keeping track of how much or how often I’m taking them. This can be an issue not only for overdose (which I’m nowhere near!) but also for when the Dr asks what I’m doing for pain management.

I’m a (ex-)scientist and I need the data so I decided that the paper half-used system wasn’t working. Enter the mobile app Med Helper!

It is simple to generate a list of meds that you’re taking either on a schedule or as needed. Adding a dose is quick and easy and it will even remind you of regularly scheduled doses!

 

I’ve even added a few other things like Ice and Physio Exercises so I can track everything I’m doing. It isn’t a drug but it is important that I keep track of them.

There’s also a reports feature so you can see several different views of the data for what you’ve taken and when and your daily compliance for regularly scheduled meds.

Downsides: This version doesn’t show you what the pills look like so if you need that it may not be the app for you. Additionally I had a hard time deleting something I didn’t need anymore.

Upsides: Very easy to use. Includes reminders to take medications at certain times – this would be helpful for unusual things like antibiotics or new meds while you form a habit. You can have multiple profiles to keep track of family members as well. Room to store phone numbers for Dr and Pharmacy as well.

Let’s not forget an obvious upside being that if something happens to me, I have my health info right in the app. (This is also in the Health App for iPhone as well, FYI)

This is a great idea for anyone who is looking to keep track of meds on a temporary or ongoing basis. I’ll keep you posted with my experiences!

 

MRI round 2

Tuesday was a heck of a day. It was snowy and only going to get worse – forecast for 30cm (12in) of snow over the course of the day. Little did we know it would end up being 51.2cm (20in) and lead to a harrowing drive to the hospital!

I started the day with a trip to my trainer, BC. We did my workout despite me being sore and I told him a lot of the psychology behind what is happening with me right now. I miss being able to get up a good sweat, to participate in group exercise classes, and to say “Yes, let’s do it!” instead of “I don’t think I can”. He agreed that we can start to move a bit faster between exercises to get my heart rate up and to make me sweat in our sessions. I just had to promise that I’d listen to my body and tell him when/if it hurt.

The good news about still being in the flare from last week was that I had the MRI that night. The bad news is that we had to find our car under a 1/2 meter of snow to get there! Between Husband and I we managed to unearth the car. The snow was very light and I insisted on shovelling a bit before it got too bad (it was still snowing at that time, going into hour 15 of constant snow). Husband made me promise to stop the moment it even hinted at hurting my back and off I went.

Dude, where’s my car?

I shovelled and cleared and dug to get the car free and at the time it felt pretty ok. I think being surrounded by a giant ice pack called Canada helped! When I came in though I realized I’d over stretched myself a bit and ended up laying on my back on the flat wood floor, my new favourite place when I’m sore.

The MRI dept called me early and said I was welcome to come in early if I liked, they’d had a lot of cancellations and I was happy to be able to get in before the original 10pm exam time. Husband drove and I’m glad he did because he’s a much calmer driver than I am in the snow! We got stuck on a big hill but otherwise it was a relatively uneventful trip. Not so for the 10 buses we saw stranded on the way there (and 6 on the way home!).

As expected the MRI was nothing special. Stay still in a small tube (EYES CLOSED!!) for 15 minutes while it loudly whirs and clacks around you. Aside from my butt muscle spasming and my brain bouncing around it was actually pretty enjoyable.

The results will be ready in 7-10 days and sent to both the sports med physician (TT) and my family dr (LM). The results mean a lot in terms of the treatment plan for me for the next few months and the recurrence possibility for the next few years. I’m very nervous and anxious about what the results will be because it will likely be 1 of 2 options:

1. Conservative treatment with physio and trainer to keep the flares down as much as possible. Will cost a lot of $ and is a treatment not a solution as the degeneration will continue over time.
2. Surgery to replace discs or fuse vertebrae. It is a surgery that could work or could not work in terms of relieving the pain. It is also surgery, so that has inherent risks. But it may be the only way that I have a chance at a pain free future, especially since we plan to have kids at some point in the next few years.

I have an appointment with the sports med Dr T on March 10th, 20 days from now. She did say however that if I’m going to get referred to the surgeon again she would do that right when the results are in and not wait until we could get an appointment. I really want to know the results as soon as possible. I can’t interpret them or know what will happen until I speak with Dr T but I also really want to have some amount of information to put my mind at ease.

Not sure what to do but wait, so wait I will. 20 more sleeps till we get some answers (I hope).