That book!

I deleted my earlier post on the "Irrationality" interview because I thought it would bring me problems.  And I didn't want to sound anti-doctor.

Tonight I read the table of contents of Irrationality in Healthcare, and I'm angry all over again. 

 If you read it, then may  I suggest you also read:  When Doctors Don't Listen by Leana Wen, MD., and Joshua Kosowsky, MD, for the other side of the story.  Or at least read the Action Tips and Reviews.

I can't close without honoring my wonderful doctors in Burbank, CA.  And also the late Bernard Virshup, MD, for his early work in that area:  How  To Cope With Your Doctor. 

LUMBAR FUSION - The world, the flesh, the brace!

Like a cocktail weiner in a refrigerator croissant, I left the hospital with a comical new silhouette.  A brace of some kind was a given.  I had heard of them referred to as "the turtle," had seen one on a stranger that made me doubt how he got into or out of a car.  Other problems gave me no time to ask about it. 

Suddenly I had the hors d'oeurve model.  It was fat, tall, heavy.  Since my waist is smaller than my hips, it bounced around on my buns until it made a sore place.  Luckily, as I wrote earlier, the croissant part was taken off in the surgeon's office since it was never going to fit.  The bony inside part remained - a sort of corset more Queen Victoria than Victoria's Secret.

Yes, I've mentioned the thing before, but it seems some post-surgery patients are already working or at least appearing in public.  This involves clothing a bit more demanding than a choir robe.  Like many of you, I couldn't pass myself off as a visitor from an interesting, exotic place. 

Enter:  my dear daughter in her stylist mode with new clothes!  She was not enthusiastic about the world staring at the brace.  So, from her magic bag, she produced a sleeveless knit dress suitable for any event, with a very stretchable waist.  For cool days or job interviews, a matching pullover top - sort of an almost batwing pullover that would even cover up a bulletproof vest.

There was a cottony-looking knit tunic cover-up that I still wear for air conditioning.  Also a fashionable delicate, sleeveless tunic with lots of detail - even wore that when someone took a picture of pal Tom and me.

Luckily I had never taken my jeans to the tailor, so they could be worn with the brace and any top. 

But the things she brought were the magic.  I felt like a real person, healthy enough that we went out to eat and I even climbed several stairs to the restaurant.  There is no medicine better than looking in the mirror and feeling that you look perfectly good and ready to take on the world.

SPINE FUSION - how on earth to get comfortable

Tired of ranting for the moment, thought I'd talk comfort.  Ever since I was diagnosed, I've depended on my "posture chair."  It's called AGEN from Ikea. The fairly straight back is canted slightly back to give me a rest.

My new dentist has a great chair with no mystery lumps (some CA dentists bought chairs with a lump where someone thinks we need one.  I had to carry a fat pillow with me for survival.)

I'm getting to the point, here:  comfy things in strange places:
There was a catalog on the family table last week from a place called Magellan's.  I only opened it because I read everything that will hold still and some things that won't.  It's about travel supplies.

Until my diagnosis, I thought travel supplies were gas, car air, and/or much closer airports.  I learned after surgery that a wheelchair flight does not mean you sit in the wheelchair; you get the same dumb seat as everyone else.

In this mag was a section called customized comfort.  I was looking for a sticker shock, having recently priced a stand/sit desk. 

Instead I found Business Class foot rest that is so thick, even I might get thru a flight without my feet sticking out in front of me like the comedy sketch woman.  And inflatable seat cushion, and luxe inflatable lumbar cushion.  And each thing (you do have to blow them up a bit) was under $30 dollars.  On the next page was a seat cushion that you don't have to blow up.  Under $40 dollars.  Imagine. You can spend more on another page for a different lumbar cushion.   I think I'm supposed to say here that you ask your doctor about these. 

Anyway, any of these things looks more comfy than a certain wheelchair ...well, there I go into ranting again.   Just take care of yourself.  And look for comfort where you don't expect it.

SPINE FUSION - protecting my whole spine

This strange construct the surgeon put in was a surprise to the adjoining vertebrae.  When I fell after moving here, an X-ray suggested the "new" engineered spine is okay.  Am I considered completely healed by now?  Don't know.  It's been a bit over six months, and I don't have real pain for more than a second or two, usually no pain.

I'm still trying to be careful bending, but since it often doesn't hurt . . . face it, my nature is to get careless with common tasks.

This morning I walked for about an hour, away from traffic.  I take the cane, but use it very little.  Kept repeating my slogans:  " My stomach muscles are my bandage."  "Lean back and look under your glasses; don't lean over toward the pavement."  "Push shoulder blades together." 

Sometimes something still hurts a bit--then if I'm indoors, I tell myself to lean against the door jamb and check my posture.  I remember that many people my age hurt even with normal spines.

Yesterday I practiced going without cane from the far end of the parking lot to the coffee shop (talk about motivation) and faced how timid I can be walking in grass and off curbs.

I don't do stairs without the cane and a handrail that allows a firm grasp.

Now I have 3-pound dumbbells.  Strange for the woman who used to swing her heavy suitcase into the overhead on planes.  I'm in the "posture chair" with my back supported when I use them, so far.

Two years ago, I lived alone by choice, and thought nothing of it.  Now I don't go outside without a phone.
A year ago, I swore I would never use a cane.  Surprise.

SPINE FUSION - what I did wrong

One doctor said it would take me a year to recover--no wonder I hesitated about the surgery until I had no choice.  I'm please with the results but. . .

I let recuperating take over my life.  I became the convalesence.  If a PT wanted me to spend four hours waiting for her, I did.  If she told me not to go to the laundry room area, I didn't. 

When the visiting nurse insisted my daughter rush me back to the surgeon because my incision was red, we spent the whole afternoon finding out my incision was fine. 

I neglected my dental health, my eating habits, my eyesight, and my GI concerns and annual tests.  Yes, I needed to do my exercises and watch my back support. 

But the spine obsession was fear, lack of confidence, and not deciding when I needed to rest and recover versus when I needed to do what I could do.

Recently I saw a phrase that hit me right between the eyes, "No need to be less than you are now."

SPINAL FUSION - trying not to undo what the doctor has done

I wonder how this is going to look in print.

SPINE SURGERY -at home rehabbing myself secrets

 I have a few rehab secrets for use at home.   As usual, I insist you solemnly promise to check with your doctor.  Every type of spine surgery (mine was lumbar fusion) is different, and every patient is different.

Physical Therapists (PTs) were sent to me, as were visiting nurses, who were not all RNs.  The PTs had incredible schedules, called at all hours, and needed as much as a four-hour window when they might appear.  The last one, however, was as good as the best one from the rehab unit.

Some written instructions from the surgeon's office seem worth repeating:
"If your back is tired, rest.  If it feels stiff, stop.  If your back hurts, you have done too much."

I had been taught in the rehab unit to do a few simple exercises like: 
Lying in bed on my back, I would push the back of the knee into the bed.  This is good for one particular leg muscle that I had never  before thought about, and I still do this one in bed when I first wake up.  Another was pulling my heel toward my buns, then extending the leg again. Rest and do the other leg.  

At home, the PT had me start the bed exercises with the butt squeeze or bun clench.  That sometimes felt like it was pulling on a back muscle, but it wasn't really painful.  I also moved one leg at a time from side to side.  She assured me that yes, that would help my standing balance.

note: I have buns, unlike some of the PTs.  I always have one leg bent when I exercise the other leg in bed.  Regardless of what a rail-thin PT would like.


Lying on my back in bed without a pillow under my legs has always given me a backache, long before surgery.  Note:  Ever since first diagnosis a couple years ago, I've kept a big pillow in bed to rest my legs on.

  Ever since the surgery, just changing my position has helped almost any leg nerve pain.


In my posture chair, and only in my posture chair for back support, I also did sitting leg lifts with foot on the footstool; and sitting knee lifts from foot on the floor, resting between legs. 
 
After lifting a few ounces strapped to my cane, both arms at once, with the PT, I started using an 8 oz bottle of lotion in each hand.  And only in the posture chair.

The PTs had me walk on the patio with the walker for five minutes.  This included a step down to the landing and a step down to the patio.  

More later.