Category Archives: Therapy

Essay Writer

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I’m packing again. Seems I just got home and here my name is on another plane ticket.

At least my sciatica flare-up is calming down just in time for that five-hour butt-in-seat marathon. It mostly hurts when I do pelvic lifts, so maybe I won’t do them.

Unfortunately, my physical therapist has other ideas. She makes me do thirty of them and hold them for a count of five. To strengthen my lower back and hips, she says.

OK, then.

I tell her it feels as though someone is stabbing me with a knife right in the gluteus maximus every time my behind goes airborne. “Just go as high as you can then,” she says.

So understanding, she is.

Today she had me start on the stationary bike. During the last session, while lying on my side on the table doing leg lifts (she’s big on the lifting) my eyes lit upon the bike parked right next to me. And as I lifted my bent knee toward the ceiling, without letting my hips rotate with the movement and holding my tummy in, I started to drool.

bike

Oh, I wanted that.

As soon as I was done, and before she could say, “Let’s do the standing leg lifts,” I moved toward the bike. “You like that?” she asked.

“Yes,” I said as I slipped my left foot onto the pedal and swung my other leg over the seat. “Let me just see how it feels.”

“Oh, yes,” I breathed as soon as my tush hit the seat. Automatically, my feet began pedaling, telegraphing the message they weren’t going to stop any time soon.

“Do six minutes and then you’re done,” she said, caving.

It sure beat standing at the counter lifting my leg sideways and then backwards for three rounds of ten each.

Today I got out of doing them as well.

“Since you liked the bike so much last time, we’ll start on it,” she said the minute I came in. “Ten minutes.”

I climbed on happily. Oh, yes. I definitely like!

We’re shopping around for this bike since I hate the one I have and rarely use it. I miss my old one, which was similar to this one, but I broke the poor thing. This one is off the charts in price so I will have to do some more copyediting work, write/edit some more essays to help pay for it. And I will, soon as I can sit for long periods again.

Lift, one, two, three . . .

On This Earth

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A writer I much admire once wrote, “. . . waiting is the tense in which life is truly written.” Those words struck a chord with me when I read them three years ago. They’ve never left me. And sometimes when I am sitting in my rheumatologist’s waiting room, I think of how true those words are.

Reading Billies’ excellent post on waiting reminds me I meant to write about my time spent in that waiting room. While I was there in May, I came to the hard decision of looking for another doctor. Though things flow at a creeping pace at this office, I arrive on time at 3:30 p.m.

At 5:00 p.m. I see the front desk receptionist walk by me with her purse. She hasn’t yet taken my co-pay. I’d signed in and exchanged pleasantries with her and then taken my seat in the crowded waiting room. Deep into my reading, I only entertain a passing mental query as she goes by. After all, there is other staff.

At 5:30 p.m. the tech who does the preliminary workup, vitals and the dreaded weigh-in, sees me through the open sign-in window. “Did they pull your chart?” he asks.

I shrug my shoulders. How do I know?

He walks around and opens the door for me. “I’m sorry,” he says, as he escorts me toward the back. He chats with me as he works, asking how my writing is going. Fine, I say.

Before I’m shown to an exam room, I have to go up front and give my co-pay. “I can’t take a credit card. It’s after five,” says the young girl left at the front desk.

I shrug again. Not my problem. I’ve been there more than two hours by then. Somehow she gets it done.

I text my husband: “Two hours and haven’t been seen.”

“Unacceptable,” he fires back.

Sometime after 6:00 p.m. the PA comes in and makes himself comfortable. He takes an extensive history, dating from my last visit two months previously. He conscientiously taps onto his laptop my every utterance it seems. He asks me how to spell a word; I tell him. “I hate English,” he says with a sheepish grin. “It has its quirks,” I say.

He spends over 30 minutes with me, typing, chatting. I feel like I’m with family, the whole process is so familiar. With a shake of the hand he leaves me to my reading and waiting.

Around 7:00 p.m. my doctor walks in; smiling, he extends his hand towards me. He’s always smiling and he always shakes my hand. “How are you doing?” he asks. “Sorry about the wait.”

“It’s OK,” I murmur.

He meticulously reads what the PA wrote, then reviews certain comments/complaints. Satisfied with my responses, he asks me to step up onto the exam table.

He bends every one of my fingers by turn (ouch), then has me lie back and proceeds to bend my legs, my arms (no problem there), and listens to my heart, my lungs. He guides me to sit up and then checks my eyes and inside my mouth searching for RA’s sidekick, dryness of the mucous membranes. All checks out and he goes back to the desk. I step down and go sit across from him.

He checks his phone researching something for several long minutes, then comes to a decision regarding my current medications. He goes over the protocol with me. “You’re doing very well,” he says with that smile.

Returning his smile, I lock eyes with him for a moment. We are coming to the end of this slow-moving ballet we’ve engaged in for almost a decade.

And I remember why.

Because of him, I remain here, on this earth.

We shake hands and I make my way to the front desk. I schedule my next appointment, then exit the office. It is now 8:00 p.m.

Written for: Weekly Writing Challenge: Fit to Write

Maskerade

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RA is such a handy little villain. So easy to blame for whatever feels wrong. If I’m tired, I blame RA. If I’m fatigued, I definitely blame RA. If my joints ache for any reason, it’s RA’s fault. If my hands are stiff, sore and swollen, well, we know why, don’t we?

So, this past week my hip hurt. Bad. Immediately, I thought bursitis. It’s back. Suck it up. It’s RA at work again. I downed some of my friend/nemesis, good ole Prednisone. 20 mg. Take that, RA.

But the next day, there was no improvement, rather it felt infinitesimally worse. How could that be? I downed another 20 mg. And what struck me as strange was that it did not hurt to walk. That did not jibe with bursitis, but I pushed that to the back of my mind and concentrated on the exquisite pain I felt just touching the skin around the right side of my pelvis.

I added the heating pad to my regimen, sleeping on it, exactly like you’re not supposed to do. I depended on its automatic shut-off. And anyhow, who was sleeping? 10 mg of Flexeril afforded me three hours tops. The pain was King!

Soon there were bags under my eyes from sleep deprivation and a funny little trail of pink dots over my hip. “I don’t like the looks of that,” said my husband. “Stop using that heating pad.”

But of course, I didn’t. It was palliative; it was a placebo for my pain. The dots got bigger and redder. But still I could walk without the slightest limp. How could it be bursitis?

Yesterday I caved. Went to the Urgent Care. My heart rate was 108, my BP was 160 over what I don’t remember. My systolic BP usually runs between 110 and 120, my heart rate 80 something.  Yep, I was in pain. In so much pain, I couldn’t even multiply 2.5 times 6 to tell the nurse what my weekly Methotrexate dose is. Me, who could calculate IV drips in my head couldn’t multiply simple numbers.

Later in the exam room, my husband verified that 2.5 x 6 was 15; I was on 15 mg of MTX. The doctor came in, did the normal drive-by history, then took one look at my hip and said, “Aha, you have shingles.”

Shingles!! (Insert four- letter word here!)

Well, blow me down. I’d never even seen a case of shingles in all my years of nursing, though I have read about it. Read about how painful it can be. And ironically, I just finished a course on pain management for my license renewal. How providential.

I was given a shot of Toradol along with some sympathy. The Toradol is for pain and inflammation, the sympathy was a bonus from the nurse. And then, I was sent home with a long list of prescriptions. The Percocet makes me sleepy and dizzy, so I’ve been catching up on my sleep.

But the Lidocaine patches, mercy me, what a blessing. They suck away the peripheral pain from all over my right side. I can touch now without causing that electrifying agony, and paradoxically, my sensation is returning. My skin had felt numb, yet on fire. Neuralgia is a funny thing.  So funny, it almost made me cry.

Now, I have to concede that RA is only indirectly involved in this little incident. The meds I take for it leave me immunosuppressed. But this taught me something. To not let RA mask what might be truly going on. I suffered for four days needlessly. I should have sought treatment sooner. I shouldn’t have waited and self-treated. This lesson was driven home quite piercingly.

Meanwhile, the nurse said I am contagious so I had to tell everybody to stay away for a week. I won’t have my little ray of sunshine this weekend.

smile

My best medicine. A loving smile from my cutie.

Knock on Wood

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prednisone

 

I have escaped the clutches of this little entity once again. The first time we met was after I ended up in the hospital with a pleural effusion and a pericardial effusion eight years ago. That’s how I was formally introduced to Rheumatoid Arthritis. It did not come calling lightly.

Instead of the chest tube I visualized upon hearing my diagnosis from the ER physician, I was put on a steroid regimen. A drug I’d administered countless times to my patients now became my lifeline. For a while. After several months, I successfully weaned off and stayed off, until this past year.

It started back in February of 2012. My right hand became so painful; I could barely run a brush through my hair. The pain soon had a stranglehold on my hand and on my day.

Forget cooking, forget housework, forget laundry. And worst of all, forget my bike. I couldn’t hold on to the handlebars with just one hand and remain steady as I pedaled. The endorphins my exercise produced were canceled out by the electric fire of pain. Anything that touched my hand sent an exquisite shooting pain up my arm. The joint at the end of my index finger was swollen into a ball and I had to use a brace to keep the finger immobilized.

Eating became a trial. I could barely hang on to a fork, and wielding a knife became an impossibility. It was the same with a pen. I think that hurt me the most, not just physically, but in my soul. Even so, I stubbornly wrote volumes of notes for a friend while I sat in the library. My ace-wrapped hand a blinding nest of pain, I held that pen and I wrote and I wrote. RA was not going to deprive me of even that.

I moved up my regular appointment a few weeks, but I still had to wait too many days before my rheumatologist could see me. I feared a cortisone injection was coming. I was afraid I’d wimp out at the sight of a needle going into my hand, though needles going into my arm every two months doesn’t seem to bother me.

But, he didn’t touch my hand and there was no mention of needle sticks. One glance sufficed. “It’s a wonder,” he said, “how RA can knock you down. Just one affected joint can immobilize you.”

Oh, yes.

Enter Prednisone. Ambrosia of the gods, it seemed. In short order, it gave me back my hand. Handed me back my life.  It became my crutch. I welcomed it and it moved in, lock, stock and barrel.

Oh, I tried to evict it after a while. Several times I started on my journey to displace it from my life. But then my hand would hurt and I’d run back to its protection, its shelter, its sanctuary. I was afraid of the pain, but I was terrified of my immobility.

Pain I could deal with. Loss of independence, I could not. So, I sought my fix. A literal fix, a repair. I turned and returned to the tiny white pill that had restored my life to me.

My attempts to sever that relationship continued, however. I did not like the dependence. I did not like how a bunch of little pills controlled me. The Methotrexate I accepted, the Prednisone galled me.

I began a hit and miss schedule. If I remembered, I took it. And many days I would conveniently remember to forget. Every morning, I’d flex my hand. There would be some tightness, some stiffness, some soreness, sometimes. Most days, my hand felt fine.

My labs have come back normal the last two visits. My CRP, sed rate, all the numbers fall where they should. The Prednisone stays in its bottle. And that stays in the medicine cabinet.  I give myself permission to hope that it also stays in the pharmacy.

Now, if you’ll excuse me, I’m going to go knock on wood.

 

My Lover, My Friend

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I’ve been trying to say goodbye to my friend called Prednisone. Or at least, so long. He’s a good buddy to have around at your beck and call, as long as he knows his place. His place in the medicine cabinet, that is. But, I think he loves me more than I love him, because he’s gotten a reprieve. Not only will our connection not be decreased, he will stay on board a bit longer.

I was all set to start our goodbye process, a process that can take weeks, even months. We’ve been intimately involved since March when my right hand suffered a blow, or rather a blow-up. It became so swollen and painful, it was basically rendered useless. My left hand jumped into the fray and compensated as best it could, but the only thing that tore at the devil called Pain was my bestest friend.

Candy, I used to call him, though he is a bitter pill to swallow, literally. Every morning he’s there, waiting patiently for me. I want him, but I don’t want him, even though he does make me feel good, spry, nimble, young again.  Like a lover, he gives me a good feeling all over, once that initial swallow of tea takes him down into my innermost.

We will have to continue our relationship through the rest of the year, I suppose. He has a new area to caress and concentrate on. My chest, right over my heart. How ironic is that?

Costochondritis, my doctor calls it. A fancy word for swelling of the cartilage that connects each rib to what is commonly called the breastbone. This pain is not as severe, but then I don’t use my chest like I do my hands. Though one thing it does have in common with the hand pain is that it’s there all the time. All the time.

So, when I leave for The Big Easy in a few days, my good buddy will be first and foremost on my list. I was going to take him along anyway, as insurance. Now, he will go with me as assurance.

The Long Hot Shower

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water stream from shower in close-up, showing ...

Image via Wikipedia

While taking a shower yesterday, a thought struck me. Could I claim a tax deduction for those long hot showers? After all, they are like medicine to me, practically a treatment procedure for my RA. I go in stiff and come out pliant.

I once read this man takes two hot showers a day for his RA. I only take one a day, though two would be nice. But, would that be a tax break on my water bill or my electricity bill, or both? Will just asking the question get me into hot water with the tax man?

And I don’t take those showers just for my RA. I do my best thinking in there. I go in cold and come out with all these story ideas, poetry outlines and passages. So could I lump them in with the home office deduction for my writing business?

Time, as they say, is money. And I spend a long time in those hot showers, a long time. The hot water feels so good, like liquid silk on my skin. I can practically see my joints loosening up, especially my hands. My hands are the most susceptible part of me to the RA related stiffness that sets in.

The saying that idle hands are the devil’s workshop cannot possibly apply to me. Anymore. For idle hands become painful hands for me. I like to keep them busy while I am awake. And what they mostly do, besides dreary housework and even drearier bill paying, is writing.

This brings me back to my original question, a tax deduction for my long hot showers. Why not? They are multi-purpose. They foster physical well-being and creativity. They are soothing and relaxing. I wonder if I can get the doctor to write me a prescription for hydrotherapy. It’s a thought.

The only thing that would make my long hot showers even more beneficial would be having someone to share them with. There’s a lot to be said for closeness and companionship to ease the pain of RA. Besides, it would also help out the environment, conserving water and all. Talk about compliant.

But, would he be my tax deduction or would I be his? Would that be one deduction, two deductions, three? Things that make you go hmmmm? Guess I’ll go take a long hot shower and think about that one.