One Full Month Sans Therapist

For the first time in close to ten years, I am without a therapist. From January until the end of September, I was in CBT, and I believe made some progress. 

CBT deals with problems I have currently; however, I believe I would have been better served undergoing Schema therapy for all the old stuff that's been programmed and entrenched in me from childhood, as I am very triggered by familiar behaviors--and at the moment, I've come to the conclusion that I have more issues with women than men, and for the most part, women who are older than I am, either old enough to be an older sister, a young aunt, or old enough to be my mother. 

Thanks to my shitty childhood programming, I am sure I have a combination of schemas programmed into me, but I'd say my primary ones are fear of failure, abandonment, and rejection.  Additionally, I'm generally distrustful of those who I SHOULD trust (parents, family, and some close friends), and I believe my attachment style is anxious-avoidant.

I've been listening to all sorts of podcasts regarding rejection schemas, and CBT, and recovery from narcissistic abuse, as well as podcasts that might help inspire or motive me to leave this shitty job. 

Given the fact Maharajah's medical insurance will be changing come January, I don't know at this point whether it will cover counseling services/therapy. So I guess I'll have to cross that bridge when I come to it in two months. 

Meanwhile, I am still keeping up a brisk schedule of twice weekly acupuncture appointments, twice monthly chiropractic appointments, and trying to minimize what suffering I can. 

Next Monday I will be in NYC for appointments: routine six month follow up with kidney guy for my blood pressure; follow up w/internist where I'll get my 2nd shingles shot as well as a flu shot; and a 2 year follow up appt with a neuro ophthalmologist. 

Meanwhile, there's a thing going on with the ball of my foot, which has been brewing since the injury six months ago in Mexico, and the chiropractor palpated it and speculates something is going on at the insertion point for the tendon. There very clearly is a cyst forming under my callous (not a blister). So ONE MORE appointment either with the physiatrist or foot specialist.

December already has an EMG of the lower extremities and yet another consult with a rheumatologist to see what's going on. I'm ready for the fibromyalgia diagnosis, if that is what is lurking on the periphery for me. I just need to know that something IS going on, and it's not my imagination, and perhaps I'll stop this negative inner narrative I have with myself wherein I think I'm lazy or complacent or whatever, because I cannot seem to do what I need or want to do. 

All this is a lot to process, and is a full time job unto itself. I think I'm doing "good enough," but wish I were doing better. 

Three Months + 15 Days After The Mexico Debacle

The fact that I am even walking amazes me. I am by no means 100% back to how I was before Mexico, but all things considered I am appreciative of every day I am walking without a cane, crutch, or walker. When I get up in the morning, there's a twinge or two, but beyond this, I am moving. Going up and down stairs is still problematic, but I can do stairs if I am left without an alternative.

I followed up with my foot specialist on 8/19, and she released me from her care, and informed me that the ligaments are still in the process of healing up, but what further benefit to be gained once healing is complete will be marginal moving forward, and looks like the range of motion will not be restored completely. 

So yeah, disappointing! But I'm moving. Turns out I have a bunch of accessory or sesamoid bones in my feet, at the back of the heel and around each metatarsal head. When I hyperflexed my ankle during the injury, the spare bones injured the deep interior of my ankle mechanics. 

I'm continuing with my twice weekly acupuncture appointments, that is, until the end of the plan year--turns out the Maharajah's employer is changing the medical insurance YET AGAIN, this time to a plan where it covers 10 visits annually--FULL STOP. Acupuncture has been the only thing to help me. I'm just going to continue to ride it out as long as I can--and of course, hope that her office fees aren't too excessive, as I'd like to continue this as part of my care. 

Also on 8/19, I found my new internist, who is a DO, and of course, thanks to the Maharajah's employer changing medical plans--this DO is not in the network. I am hoping for the best, that we can "invite" him to the new plan, and hope he accepts. It took me two long years to find him. I am not starting over again with someone else, as this doc speaks my language and isn't intimidated by a patient who is actually engaged and involved in their own care plan.

Additionally, I found out last night that my therapist will be moving on to greener pastures towards the end of the month. Coincidentally, she's not in network for the new insurance either, so I would have had to part ways eventually. I'm not heart broken about it, but have a couple more weeks, and we have work to do, and I'm not even sure how to go about doing it--we're going to be focusing on effective communication, minimizing emotionally charged communication. At this point, I'd just assume ditch the next three weeks of sessions. My heart isn't in it, and this was designed to come to a conclusion at some point. 

Lots going on here, trying to continue to make sustainable changes, physically and psychologically, and of course, professionally. 

Life Continues to be a Cha-Cha

The day after I uttered, "Hey, I might be feeling better. I'm walking better. My hip bursitis feels like it's improving," I injured myself while out of the country, rendering me into a wheelchair for a full week, hobbling along to work with the Maharajah dropping me off every day, and me pretty much doing a whole lotta-nada.

We went away again (I know how very lucky I am to be living this kind of life), and Monday was another one of my patented, "trifecta" days where I have up to 3 (or sometimes more) appointments scheduled. All are medical in nature, and all are follow up visits, hopefully helping me achieve my goals of lowering my bp, improving my pain or mobility, and improving my sleep quality--which, will hopefully improve my overall sense of well being.

First appointment was a set back. It was with my kidney guy, who I see 2x annually, who is monitoring and treating my hypertension. Despite my improved numbers ELSEWHERE (pain doc, rheumatologist, even Sam's Club pharmacy!), my numbers refuse to budge at the kidney guy. The time has come for me to take yet another medication, to try to battle yet another invisible dragon--my bp. I've been given a beta blocker to work along with my pre-existing ACE-i and aldactazide. It's a lot. 

I view this as a set back, as I've always measured my progress or success after my bypass by things OTHER than my weight: blood chemistry, how many medications I'm taking, as well as resolved medical issues I used to have. Before my bypass I was on 6-7 meds, which I managed to reduce to 2. Now it's 3. And I'm not happy. 

Additionally, the beta blocker works with the sympathetic nervous system--and if I'm right, that means the medication might help my anxiety--which I now translate to me doing the very thing I did NOT want, to go on an anti-anxiety medication--as I do not want to take medication just to manage going to a shitty job where I am neither fulfilled nor my efforts acknowledged. So I'm disappointed that all my tweaking with Taurine and N-acetylcysteine did not pan out the way I hoped at his office. I suspect I have white coat syndrome. That aside, we're going to try out the new medication for a month. 

This all is a huge hassle, as it involves me searching out interactions for every single supplement I currently take, and involves me jockeying around when I take my current Rxs. And then there's the issue of quality of life--leg swelling? Dry mouth? Am I going to be able to have a cocktail if I want?

Okay--yeah, I know. It'll help minimize risks for stroke. It'll also help me minimize my risks for left ventricle hypertrophy.

Doesn't mean I have to like it.

Second appointment was with my foot doc--and of course I injured myself in the interim between my last appointment and this one. So it was good to see her, get MORE xrays, get a proper air cast to stabilize the ankle further, and get yet another diagnosis: "ankle impingement." I've got spare bones in my feet, and apparently when I hyperflexed my foot during my injury, my spare bones bruised the soft tissue deep in the posterior of my ankle. FUN. 

Third appointment was with the ENT to follow up on my CPAP compliance. Seemed straight forward. And I am getting some benefit out of it, albeit my snoring has reduced when I use it--though I have yet to feel any improvement as far as feeling refreshed. 

All in all these are necessary appointments, which I view as tools to help me achieve all of my goals. 

Here it is, the middle of June, and I *DID* have hope (and the GOAL) of getting myself out of my shitty job, but I'm working on that, too. I know that my mood and stress will change for the better once I am out of here. I just have to be patient and also employ some effective goal setting. 

My CBT homework is to start some lists, of what I want, what type of job, what type of workplace, and of course start researching different job requirements, and computer certification courses. 

Last night was CBT. Tonight is acupuncture. Tomorrow is a dental appointment before work and chiropractic after work.

All this could be overwhelming, I guess. I have everything so organized, I'm pretty much operating on muscle memory and forward momentum. 

Surely something's gotta give, right? 

Life Is Like A Cha-Cha (2 Steps Forward, 1 Step Back)

Remind me the next time I want to verbally articulate that I might possibly be feeling better to just keep it to myself.

I am now ten days out from a pretty bad fall which I sustained in Mexico last week. The fall was 100% preventable and due to negligence, and unfortunately whatever legal recourse available to me would be so limited, it wouldn't be worth the time, sweat, tears, and money to pursue it.

There were several things for which I am thankful surrounding or involving the fall: 

1. That it happened in a controlled environment where I got immediate medical attention;
2. That the resort at a minimum (truly, the bare minimum they actually did for my physical welfare) was to provide me a wheel chair, of which I remained in the entire duration of my visit so at least I wasn't a prisoner in my hotel room;
3. That the injury wasn't more severe or catastrophic.

It happened before we even checked in at the resort, and it resulted in me neither going to the beach, pool, nor spa for my short stint. 

Fortunately for me, I have been in CBT since February and I am nearly done with an online psychology course, both of which have been instrumental in helping me not catastrophize what happened.

Unfortunately, I had a very long wait ahead of me before I'd know with any certainty the extent of my injuries. So there was that sense of dread that what little progress I was making would not just be dashed by this injury, but that it might have been more severe.

I was injured on 5/20, and we arrived back home on 5/23. The moment Uber dropped us off, we loaded our luggage in our car and we headed to urgent care to get an xray. Urgent care provided me a useless air cast and equally useless crutches, and a preliminary interpretation of the xrays of my ankle and my knee. No fractures in either, but some concern of a torn meniscus in the knee.

The next day I called P4.0 to see if she could fit me in, and sadly she works in NJ on Thursdays and Friday she was booked solid. She doesn't have office hours on the weekend, and Monday was Memorial Day. Tuesdays she's in NYC, so the earliest I could get in to see her was yesterday, 5/29, which was already prescheduled, as it was the date of my third and final series of shots in my knees.

She allayed any concerns regarding my achilles tendon and calf muscle, both of which I was concerned with a possible tear. 

I'm pretty fortunate that we travel so much. This wasn't a trip of a lifetime. Mexico is a manageable destination (as is Florida), so if I want to go, we'll go again. It was neither the first nor last time I'll visit either. 

Everyone that knew the Maharajah at the work conference remarked at how composed I was, despite the obvious physical pain and limitation of a wheel chair. And I recounted how lucky I was, regarding the circumstances. Also, what wasn't conveyed was, if your baseline of pain normally is a 4-5, to go from that to say a 7-8 (or even possibly a ten on day 1), makes the additional pain bearable. If I went from 0-1 daily to 7-8, I think psychologically I'd be worse off. So, as my therapist would say to me, my pain is actually serving me (and possibly making me more resilient). 

So my job is to stay the course, continue taking care of myself, and try to rally as much as possible, as the trip to Mexico was not a full vacation, but the intent was for me to rest up and physically prepare myself for another trip coming up. 

On a related note, I feel quite strongly that my new acupuncturist has helped me more in such a relatively short amount of time compared to the years of physical therapy and years of regular chiropractic care.

Onward and Upward

My blood pressure continues to maintain good numbers. Yesterday was 110/70. SWEET. Let's see if it will hold thereabouts when I see my kidney guy next month.

I am now up to my second round of injections in my knee, with the third to happen in 15 days.

I'm continuing to keep a tight schedule, all in the hopes of improving my mobility and pain issues--which reminds me, I need to call the orthotist to find out a status on my orthodics which were being revised.

Appointments in the mornings before work for injections or MRI or xrays, and appointments in the evenings after work for acupuncture (2 days a week, Monday and Friday), cognitive behavioral therapy, as well as physical therapy on Wednesdays and Saturdays with chiropractic on alternating Saturdays immediately following physical therapy. Dental stuff. Eye glasses. 

Then there's the issue of household stuff like groceries and pharmacy runs and laundry drop off/pick ups, and somehow getting all that done. But things are so precariously tight, that if I miss groceries or laundry, it can be problematic trying to find the time to do so. I've tried to get the household into a schedule of running the garbage to the dumpster before work on Mondays and Fridays, and laundry drop off/pick ups after work on Mondays and Fridays. I consider it a win if we manage to do this on a Sunday, which lessens our demands for time on Mondays at least.

While we were away three weeks ago, I saw an acupuncturist twice, and decided to get back into the swing of things with more regular acupuncture appointments. I managed to find a very capable and caring acupuncturist close to home and have been seeing her for the last 3 weeks or so, and have noticed a change in my hip bursitis as well as some improvement with my walking. Perhaps I can delay getting nerve ablation in my back. Only time will tell. But she's very helpful, and I see each session building on the work and benefits of the previous session. I even feel some sense of psychological benefit to the sessions too--even validation in some regards. 

She's such a good acupuncturist, even the Maharajah has decided to seek out treatment from her. And I've recommended her to at least one co-worker. 

Physical therapy is making me stronger but not improving my pain issues. And perhaps once I discontinue PT, whenever that might be, I'll consider joining the YWCA and start going there on Mon-Wed-Fri. Perhaps. 

I've also been taking an online psychology course which has been helpful. It's a 10 week course, and I am up to week 7, and from now until the end of the course, I have to try to entrench new neural pathways by establishing a new habit for me, in this case, improving my sleep.

So I'm chipping away at things, making some improvements, and trying to forgive myself by not achieving my goal faster, but to focus on making incremental progress. Last night I got six hours of sleep, so I just have to start tweaking what time I actually get to bed until I finally arrive at 7 hours of sleep a night.

I have to remind myself, I AM WORTH IT. 

Another Day, Another Trifecta: One Detail I Neglected to Mention

During the first appointment, which was with P4.0, they were taking my vitals, and I had them do my BP manually (as I feel it's more accurate than the robots), and my number was:

110/64 

This pleases me immensely. I have many goals, some crazy to some, but trying to get my BP lowered further (when quinipril and aldactazide wasn't cutting it, sufficiently, for my goals), has been like trying to slay an invisible dragon.

 

Another Day, Another Trifecta

Yesterday was a day off from the office, but I kept up a pretty brisk pace and scheduled things pretty tight. Luckily, all three appointments run like a Swiss timepiece, and I was able to deftly move from one to the next, and so on.

First appointment was the follow-up with P4.0. Things went well, and there is some improvement, so the last six weeks haven't been a complete act of futility. She wrote me an Rx for more muscle relaxants so I have them on hand if I need them, and an MRI is scheduled for Friday, and the stage is being set for the hyaluronate injections for both knees (a total of six appointments total--to be repeated again six months from now), and the MRI is in preparations for the nerve ablation in my back to be done 2-3 injections each side (if I remember correctly). 

Second appointment was physical therapy, and while wrapping up my assigned exercises, I asked my physical therapist about the possibility of putting me on the leg press, as surely there is benefit in building up strength in my quadriceps. I didn't go into detail how I know my knee caps aren't "tracking right," and the machine would further enhance my physical therapy. As I said, "I don't want to just go through the motions of staying in a holding pattern--I actually want to improve." He put me on the leg press and I managed to knock out a couple more repetitions than he suggested. This appointment was to replace Saturday's appointment which was rescheduled due to some in house training for their staff, and I am looking forward to my normally scheduled appointment tomorrow, so I can continue to build on whatever progress I started on Monday's appointment.

Third appointment was my annual ultrasound of my thyroid. Looks like one of the nodules has gotten bigger--won't know for sure until I get the radiology report. I am set to see my endocrinologist in June--so depending on how much bigger it's gotten, I'll no doubt get a call from her or a message on the patient portal, instructing me on what is to come next (if anything at all). 

The day was mostly self-care, so that's a win in my opinion. 

Tonight is my weekly CBT appointment. Tomorrow is physical therapy. Friday is the MRI.

Additionally, I am feeling the effects (I think!) from the 5HTP, which I was taking before I started the muscle relaxants (and resumed once I was off them). Given that it has been so long since I've woken up feeling actually refreshed when I wake up, it is hard for me to articulate how I feel; however, I don't feel that sense of foreboding and dread, and I'm not groggy--so I'll take that as a minor improvement, and I hope to build on that.

Adding Reinjury to Insult... Thereabouts

It's a bit of a TL; DR. Cliffnotes: I hurt myself, and might be in an existential crisis.

On Sunday I re-injured my shoulder. The same shoulder I injured 5+ years ago, which sent me down the rabbit hole of trying to find a physiatrist, after physiatrist, and physical therapy after physical therapy. Recently, I finally got to the point of realizing no amount of therapy was going to help things, and the issues died down a bit, though I still have had persistent golfers and tennis elbow in both elbows for 5+ years, and the shoulder tendinopathy has persisted, but manageable. And Sunday I fucked that all up by trying to do too much and not rest or acknowledge to myself that I have limits.

If I don't rest, my body will find a way to just shut down, and it did, in spectacularly painful fashion. While, yes, it was me and my neediness and my damned ego and pride to blame. But beyond this, YES, I'll blame this on my mom. I've connected the dots quite effectively, and did so in Tuesday's session, and Tuesday's session was all talk because I couldn't write and participate in this week's exercise.

The topic involved my shoulder injury, actually. I told my therapist two distinct stories involving my mom:

1. On my wedding day she showed up at the wedding location and announced to everyone present (including M’s family members and college buddies) how M was marrying me "for the green card." I told my therapist the subtext from this is: I am not valuable enough to marry a man younger than me, handsome, educated, and upwardly mobile WITHOUT him having ulterior motives.

2. (At a time well before I put up boundaries of what I'd tell my mom) When I was applying for a job at a Court Clerk's Office, she informed me, "Whatever you do, don't tell them how much you love giving head!" (she then commenced laughing like a lunatic). The subtext from this is: I am not valuable enough to land a job of that status and standing on my own merits and capabilities WITHOUT debasing myself.

Only recently have I become aware that I have a hole in my being or my psyche, a hole that should have been filled with self-esteem, the seeds of which SHOULD have been planted by my mother, and here I am, age 50, trying to figure out how to fill that hole myself--and realizing I lack the tools to do so.

Messages I have been sent my entire life involve how I only have value as long as I am doing something for someone else--all external sources--nothing from within. And as much as I do not consider myself a “people pleaser,” yet it was that very thing which led me to injuring my shoulder.

So how does my injury play into this faulty logic or dynamic?

I foolishly thought that I got fulfillment (or something thereabouts) by taking care of M by way of providing him nourishment. Yet, I’m realizing now, 18 years into this marriage he's not filling that hole in my psyche by nourishing ME with feedback. What little feedback he gives (if at all), falls into this deep hole, an abyss, and just evaporates--his feedback will never be enough to fill that hole, and I realize how unreasonable it is for me to expect it.

I am realizing my illusion/delusion involving my relationship with food and fulfillment. I am realizing now that if I am not experiencing fulfillment in regards to taking care of M, then I have zero fulfillment in my life. And somehow I can intellectualize this without emotion, without tears. I have too much to do and lack the luxury of time for tears.

TIMELINE OF EVENTS LEADING TO MY INJURY:

Saturday was a flurry of errands: drop off car at Honda, then take an Uber to physical therapy, then an Uber to my chiropractor, then an Uber to get a massage, then walk to Honda to pick up car. At this point, I *SHOULD* have gone home to rest up, yet still managed to continue running every errand still remaining on my list for that day: Vitamin Shoppe (this counts as self-care, IMHO, because it was for tryptophan to help my unyielding sleep problems), then Korean market for groceries, then Trader Joes for some things I can only get there--only to realize one of the vital things were not in stock, then lastly, to Sam's Club to pick up M's Rx.

Sunday, I got up at 9 a.m., and was on my feet in the kitchen cutting vegetables and getting things started for Sunday’s lunch and dinner, as well as lining up the week's worth of meals. I finally sat down for a moment (after 4 hours) to ice down my feet, as my feet were BEYOND hurting, and then I recommenced vegetable cutting and planning and plating things up and getting organized for the week.

2:30 a.m. MONDAY, I woke out of a sound sleep in utter agony. The shoulder tendinopathy pain which has plagued me for about 5-6 years at this point, amped up to an unbearable level. I started to sob in agony; however, I realized couldn't even sob in response, as I realized sobbing only intensified the pain.

By 5 a.m., I forced myself out of bed,  in search of ibuprofen and in search of my TENS unit, which M decided to squirrel away. So in pain, I had to go on a scavenger hunt. I sat in my chair using the TENS, and feeling like a zombie.

Monday, I forced myself to go to work, and as the day went on, I could lift my arm less and less. At one point, I got very worried, and thought for a hot second that I might have had a stroke.

Tuesday was more of the same. Tuesday morning, I emailed P4.0, asking if she could phone in an Rx for muscle relaxants, Tuesday afternoon, I took a late lunch and went to my chiropractor (again), who spent over an hour doing everything he could to alleviate my suffering. I'd be lost without him, by the way. I went back to the office to wrap some things up, and then went to my session with my therapist. I picked up M, and went home and realized I couldn't take my clothing off, as it required to be pulled up over my head. I sat there trembling in agony, and I couldn’t control myself further and sobbed until I snotted myself.

Wednesday I called out sick from work. I managed to drop M off at the train, and then I took myself to get breakfast--driving my car one handed. I then went to the Korean market for a few items I absolutely needed. Then went home to realize M scrubbed the tub (before going to work), so I could take a hot bath and soak. I ran a bath and called my physical therapist to see if I could come in earlier than my 6:40 appointment--they fit me in for 2:40 instead.

After the bath, I sat in the chair for several hours, resting, and alternating TENS and EMS on my neck and shoulders. I managed to get myself dressed, and went to Sam's Club as my blood pressure Rx was ready, and I was down to 2 more doses in my existing bottle and needed to pick it up, otherwise I'd have to make a lunchtime run there on Friday when I would be completely OUT of pills, and would have caused a logistical headache to pick up the Rx during lunch.

I managed to go to physical therapy, and then I picked up my new reading glasses, and talked myself out of the impulse to go back to Sam's Club for a rotisserie chicken (mind you, it's 2/10th of a mile from my house, my street literally ends where Sam's is). I did what I needed to do, and just went home to rest for another hour or two before I had to retrieve M from the train station. 

So, even on a day that should have been complete rest, I still managed to do four errands/tasks, not including taking that hot soak.

What people might possibly see on my exterior is someone who is strong or resilient; however, in my interior, I am resentful and angry and exhausted and feel weak with this unending series of painful challenges.

Thursday I felt the tiniest bit better, and went to the office, and the director acknowledged my existence (or specifically, my absence the day before), and asked how I was doing.

My chiropractor texted me to see how I was doing—as he is the only one who really knows to what level I was in crisis. Given his schedule for the next week is going to be demanding, he was able to fit me in for another treatment Thursday night.

Here it is Friday, and I’m able to lift my arm a wee bit more than I could all week—and even manage to pull my pants up with my left arm. I’m not 100% back to where I was before, but there has been some improvement.

And it was a good thing I picked up my Rx on Wednesday—remember what I said about logistical headache? Well, today (Friday), I will be picking up my orthotics during lunch. Had I opted out of doing so on Wednesday, that would have meant going 2.5 more days without the orthotics until Monday’s flurry of appointments and running around.

Six Days Later...

In general, I'm holding my own. No new dramas or traumas. And after using my cane for a week, I'm feeling a feeling that is unfamiliar to me: a diminishment of my pain in my lower extremities. I'm still feeling like shit, but it's not an agonizing 7-8 on the pain scale, and perhaps even a smidge lower than my routine/baseline 5. Something (probably EVERYTHING combined) I'm doing is working.  

Orthotics haven't been received yet. 

I'm staying the course.

More PT tonight.

Lather, rinse, repeat.

10 Days Later...

Dinner party went swimmingly. Everyone left roughly 11 p.m., so no luck on getting on my bike, nor getting that hot bath as I had hoped.

I loaded the dishwasher, and tidied up as best as I could before hitting the hay.

The next day, I had an appointment to get molds of my feet taken for some custom orthotics. So I have one more week to go until they are ready.

I've been "keeping at it" with physical therapy 2x a week, and between the orthopedic shoes and PT 2x a week, I've felt a shift of sorts, until last Wednesday, when the therapists had me do exercises involving me standing full body weight, and balancing on one foot at a time--not something ideal for someone with a Morton's Neuroma. That unleashed more pain, gradually the next day, and that evening the pain was so bad, I could not attain any sleep whatsoever, and Friday I called out sick at work because I was exhausted and in pretty severe pain.

Saturday, I informed my physical therapist for the day of what transpired, and the cool thing about this PT group is, I am seen and treated by a team of therapists, so there's several different perspectives factored into my treatment and care, versus one person treating me throughout (as is/was the case at my previous physical therapy group).

Two nights ago, I had the distinct sensation that I didn't toss and turn as much, and at one point, I may have been aware that I was laying on my right hip longer than I have in a long while.

All this week I have been walking with my cane for assistance, until my orthotics come in, and also because the snow has made it challenging, and also? It's handy to have it on hand to give me a sense of security. ALSO? At work, it is a useful prop to remind some people that HEY! I HAVE LIMITATIONS!

I have continued with my CBT too, and it is really challenging me and my thought processes. I've said it a thousand times and will probably say it a thousand more, that I've spent a lifetime of repressing/suppressing unpleasant, negative, or traumatic things, so it's really a difficult challenge to try to tap into my feelings on a deeper level.

Coming up this weekend is my (now routine) Saturday physical therapy appointment, and an eye exam. 

Tonight, I will rush around to get some grocery shopping done. And tomorrow before work I hope to get my laundry dropped off/picked up, and maintenance check dropped off, so then once my eye exam is over on Saturday, I can run home and relax. 

That's the plan at least.  

Progress is still being made on a molecular level.

Projected date orthotics will be ready on/about 3/12.
Follow up with P4.0 is on 3/25.
Follow up with the foot specialist is 5/1.

Just Keep Swimming

Status update: Maintaining forward momentum.

Friday brought with it two appointments: Cardiologist and Foot Specialist. 

Good news from the cardiologist (copied & pasted from the patient portal): "Technically, left ventricular hypertrophy was not present, insofar as the wall thickness was at (but did not exceed) the upper limit of normal. It is also reassuring that it was the same as 5 years earlier. Since you BP is controlled with the current regimen, please continue and we will re-evaluate the ventricular walls again in the future for surveillance."

So there's THAT. "LVH was not present" is the string of words that actively grabbed my attention.  Between my age and hypertension still remaining on the high side of normal, and the occasional mention of "borderline LVH" on previous cardiac sonograms, I've been on high alert and vigilant to try to reverse whatever I can of this progressing, and from the looks of it, I'm succeeding at maintaining the same levels as five (almost six) years ago.

[I hoofed it from 96th/Lex to 102nd/Madison to get to the cardiologist; however, there was no way I was going to hoof it to 72nd/York to see the foot specialist. I cabbed it there. I wish I could say I didn't walk at all, but that'd be a lie. All in all I managed to walk 3.9 miles, entirely too much for my issues. And despite having plans for a nice dinner out with the husband, I waited around as long as I could, and then ran home to soak my feet and feel sorry for myself.]

Assessment from the foot specialist was:

• Tibialis dysfunction
• Peroneal tendonitis (of right lower extremity)
• Osteoarthritis of ankle or foot

This is on top of the diagnosis from P4.0 (Greater trochanteric pain syndrome, heel spurs, plantars fasciitis (both feet), and Morton's Neuroma in my right foot). 

I was given more stretches to perform daily, as well as a pair of gel heel cups to put in my orthopedic shoes, and I was given an Rx to get (yet another) pair of custom orthotics made to make the necessary corrections/adjustments. 

First order of business this morning was to contact the orthotics group and schedule an appointment (for tomorrow, during lunch) where they can make an impression of my feet. Here is hoping I will have the orthotics for a week or two before I follow up with P4.0.

I then texted my chiropractor to see if he could move my 9:30 to 11:30, as I have PT in the morning. And I guess the next thing for me to do will be to call my eye doctor and move my eye exam to next Saturday, either before or after physical therapy.

It doesn't feel like all that much is going on, on the surface; however, these are all preparations for the actual improvement to take place.

Due to snow on Thursday, my next physical therapy appointment was Saturday, and let's just say I was not in the right mindset to be there upon my arrival. 

I've done roughly 4 years of physical therapy and haven't had much in the way of improvement, if anything, I felt like I was in a holding pattern. As I see it more clearly NOW, at the time I was having physical therapy in the past, it was all with incomplete information. For the first time in about 5-6 years, I finally feel as if I have a proper diagnosis. 

Saturday, my physical therapist tractioned my groin, which was a "first" for me. I didn't know this was possible. And I don't want to get my hopes up too high, but I felt a difference afterwards. No. It didn't magically cure my issues. But I felt as if I moved differently after. I can only imagine how much more benefit I will experience as my therapy continues. 

I was planning on getting back on the bike this morning, as I was awake early due to the husband traveling on business today. At the last moment, he was having issues getting an Uber, so I suggested it'd be easier for me to drive him to the airport, and in doing so, it reprioritized me getting on the bike this morning.

Tonight I have a small dinner party with some friends from work, and I'm planting the idea in my head that I could very easily run a hot bath, and while it's running, I can hop on the bike, and knock out 30 minutes, then reward myself with a hot soak.

Let's see if I can make this happen tonight. Everyone should be gone by 9 or 10 the latest, so it IS feasible. Let me see if it becomes a reality. 

Today's Rabbit Hole: Ho'oponopono

Seems that the more I read, the more reading tangents I experience.

I started reading Debbie Mirza's book, "The Safest Place Possible," and I didn't get too far into the book before she made reference to the Hawaiian reconciliation practice of Ho'oponopono. This then led me to learn more about Dr. Hew Len's experience with the practice, and that was all the convincing I needed to hastily adopt this as part of my morning ritual.

Sure. My ritual is lighting a candle after my "morning evacuation," and merely thanking the universe for my husband, my house, my health, and I usually conclude that moment of mindfulness asking "please help me--help me help others." 

The mindfulness of Ho'oponopono's "I'm sorry. Forgive me. I love you. Thank you." seemed to fit right in with my morning sentiments.

Perhaps in doing so, there is some cosmic benefit, a Butterfly Effect of sorts. Perhaps.

Though I'm a skeptic about ALL THINGS, I don't see any harm in incorporating this as part of my morning routine.

I am having a difficult time getting any kind of traction with my CBT sessions. I have done the two assessment sessions and now have gone through two sessions after, which should have been where we start working with the CBT techniques. 

The problem of course is that I have repressed/suppressed/stifled my feelings all my life, and the things that I feel the most intense are merely the things on the surface. I cannot seem to dig far enough in to actually feel my feelings--which of course leads me to feel like I am failing myself, as I am pretty desperate to do what I can to change my mood and outlook and mindset. 

Tuesday's session wasn't all that useful to me personally, as we were filling out a mood log of an emotional event, and I couldn't get beyond four distinct feelings.

I've brought the mood log home and devoted more time to it, and even have solicited a friend who knows me pretty well to read my log and offer insights about my self which I cannot seem to tap into. He makes so much sense and has astutely shared his insights in the past about me or my experiences, in ways which I hadn't been able to process or articulate. 

I am continuing to work towards finding a solution to my pain issues, which will then lead me to being more active, which is also a part of the CBT regimen, taking care of myself. Meditation has been a part of that, however, I need to find something that holds my attention better than the Headspace app. I don't know if it's too simplistic or the voice of the narrator or what, but I cannot really sink my teeth into that as a meditation tool.

I am resistant to doing more physical therapy, but look at it as part of the process rather than the thing which will ultimately provide me pain relief. It's merely a step in the protocol that needs to be followed in order for me to get to the subsequent step or steps that will get me where I need to be.

Right this moment, I am pushing away feelings of futility and even depression or sadness or frustration, as they aren't productive or serving any good purpose for me. But it's hard to remain optimistic when, simply put, I don't feel well.

Screaming Into The Void

I'm acutely aware that the majority of my activity online, whether here, or on Twitter, or MeWe, pretty much is me screaming into the void. A part of me feels that kinship with that Nietzsche quote, "Sometimes when you stare into the abyss, the abyss stares back." Perhaps, eventually, someone will scream back from the void. Perhaps not.

 

Regarding Monday's Appointment With Physiatrist 4.0

[Some friends wonder how I manage to keep track of everything I need to do in order to get to the necessary appointments etc. Well. I blog herein as a matter of accountability and record keeping (especially for tracking progress!), I have reminders on my phone, virtual post-it notes on my desk top at work, and have a calendar that Maharajah and I both share and add appointments to, to keep track (and also involve each other, when necessary in appointments and plan-making).]

Monday's appointment with my current (now fourth) physiatrist (hereinafter dubbed P4.0) went much better than I anticipated. I actually managed to walk out of there with some hope and a preliminary plan of attack for the collection of issues I have.

Xrays were done at 8:00 and by 8:35, I was taken into the exam room for my vitals to be taken. By the time P4.0 was done with me, it was roughly 10:10 by the time I got out of the appointment.  Very pleased with the professionalism of everyone, and even more appreciative of the timing of everything, from how long I waited in the lobby until I was in the exam room, and thoroughly pleased with the level of detail the doctor went into during the examination.

Newest diagnosis: Greater trochanteric pain syndrome (plus a side dish of Morton's Neuroma). 

Also worth noting: Apparently my ass is weak. Like, at this moment in time, if I were to twerk, I'd probably hurt myself. Luckily, I live a life where twerking is outside of the realm of possibilities.

THE PRELIMINARY PLAN AS IT STANDS CURRENTLY:

Immediately:

1. RUMP/HIPS: An Rx for PT was given. I contacted the office of my preferred physical therapist, and I'm getting the same run around I got in AUGUST, where he's booked solid. Well, I don't want to wait to start working at something which will hopefully lead to me FEELING and BEING better. So I contacted my secondary place, and scheduled the consultation for 2/18, and also scheduled my next two appointments, to ensure I got the days and times conducive to MY schedule;

2. FEET: I scheduled an appointment with the P4.0's associate in NYC, who specializes in feet, so that doctor will tend to whatever is going on in my feet. Surprisingly, the Xray was not chock full of arthritis--this actually surprised me, because I have a lot of crepidation/granulation (or at least that's what it sounds like) when I walk or when I make circles with my feet. I have symptoms of a Morton's Neuroma, and on the Xray you can see bone spurs, and a weirdness where my bones are growing at an odd-ish angle. Also, my arches have fallen, and I no doubt have plantars fasciitis still. 

Not sure what to expect or anticipate from this appointment, but set it, as my theory is, my foot pain is causing instability in my gait, and as a consequence everything else (knees, hips, low back) is over-compensating as a result. 

Also worthwhile noting, I just got notification that the shoes I ordered from Orthofeet are out for delivery today, so I cannot wait to try them on and hope that my feet won't hurt so damned much when I walk in the interim;

3. KNEES: P4.0's office will contact insurance company regarding authorization for visco-supplementation injections (though, I am convinced it won't go through, because LAST year, they denied me, and even after going through a lengthy appeals process, they refused to cover it, despite the fact that we were assured when Maharajah's insurance changed, we were assured that the coverage was "identical," when clearly, IT IS NOT;

Rainy Day Projects/TBD at a Later Date:

4. LOW BACK: At some other point in time down the line, we are going to explore ablating the nerves in my low back, to manage the chronic, moderate/severe arthritis pain. P4.0 assures me that during her fellowship she learned a special way to do the ablation, which will slow down the rate of nerve regrowth. The mere idea of being able to go long lengths of time without pain, is almost unbelievable to me. Though I do have one friend who has had nerve ablation (granted, in her foot, I believe) and her results weren't so favorable;

5. ELBOW: This is a rainy day project at some point further out. I might actually bite the bullet and have PRP injection in my elbow. P4.0 mentioned how she could probably do it with just one injection (rather than multiple, pricier injections which my previous physiatrist was trying to convince me to commit to in 2017. 

So that's the plan so far!

The next three weeks (well, 2.5) of appointments line up thusly (which includes other self-care appts):

2/15: Weekly CBT
2/16: Chiro
2/18: Consultation with physical therapist
2/19: Weekly CBT
2/20: 1st appt w/physical therapist
2/22: Cardiologist & Foot specialist
2/23: 2nd appt w/physical therapist
2/26: Weekly CBT

As a direct consequence of the thoroughness of the examination and the capability of P4.0, I have cancelled my appointment with a neuro in NYC. There was a neuro portion of my examination, and I am sure that if I require to be referred out to a neuro, P4.0 has someone located conveniently within her office. So, brilliant! It actually helped me eliminate a redundant appointment!

Now if you'll excuse me, I've got a session on Headspace to listen to. 

PS: I'm especially mindful that as shitty as I think the medical coverage is, I am very very glad for the coverage we have at all, which is enabling me to get as much medical attention as necessary. I wish and hope for those Synvisc injections--but even if I cannot get them this year, if I can tackle some of my other issues, I'll be happy just to eliminate whatever aspects of my pain issues I can.