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.

Still Chipping Away At Possible Solutions

What's being actively done?

1. I have gone through three sessions with my new therapist--so far the first three sessions have been to unpack and inventory all my issues; hopefully next week's session will be some active work/therapy; in the meantime--
2. The therapist recommended I download Headspace, an app for my phone, that seems like it could be a useful tool towards reducing stress with guided meditation, and possibly help me establish better sleep hygiene and exercise routine. Maharajah says he'll help me with downloading and navigating it;
3. Yesterday, I ordered a pair of shoes from Orthofeet, and look forward to the day they arrive, as regardless of which pair of shoes (and which orthodics) I wear, my feet are in moderate pain; 
4. Today I rescheduled my eye exam for next month as I am not eligible for new eyeglasses until then;
    
5. Monday is a consultation with yet another physiatrist (she will be the FOURTH one since 2013). Hopefully she can put some fresh eyes on my collection of issues, and hopefully help figure out whatever might be going on in my feet--as I think that's the missing link, which is exacerbating my knee, hip, and low back pain;
6. Next on my to do list will be to schedule both, a pedicure and a deep tissue massage on Sunday--pedicure is a preparation for the physiatrist, as I literally want to put my best foot forward, considering that's what's going to be examined on Monday.

Depending on whatever POPS UP on the Xrays on Monday, hopefully, I can cancel my neurologist appointment in NYC--as that seems to be the last modality or discipline that hasn't been explored to get to the root of my problems. Perhaps the new physiatrist can refer me to a neuro and or an ortho right there, and alleviating the need for me to go to NYC for every little thing.

I have my bag packed for Monday's appointment loaded with my folio including all the hard copies of my reports and MRI/Xray CDs; a thumb drive with all the reports, my supplement schedule, and of course all the filled out new patient forms (in case they didn't receive them on their portal), as well as scanned copies of my most recent lab reports. Waze is pre-programmed with the address and appointment time. So I'm about as prepared as possible for this, and hope it won't make me too late on Monday morning. 

I guess this is where I shine, when I'm not actively engaging in Eyeore-like behavior: I have a problem and rather than wallow, I handle things best when I come up with a plan, and well, for the last few months I haven't had one, and I've been just STUCK.

Hopefully between the new therapist (and therapy--CBT), and a new physiatrist, there is a possibility I'll turn this around. At a minimum, it's all a distraction that takes my intense focus off what I call the futility loop and focuses more on solutions.

Reading Is Fundamental

This morning, I was in my car with a half hour to spare before my workday started, and I decided to try to thumb through my copy of "Face Your Fear," by Rabbi Shmuley Boteach. I don't know if I cannot focus on the words on the page because I have an issue or avoidance of the words, or if I need a new Rx in my glasses or something else is at play.

Admittedly, I am forever distracted.

So, I went to YouTube, in search of lectures and speeches by the rabbi, and I found this one in regards to honoring bad parents: https://youtu.be/HBTPPNYXCdQ, which I also shared with my sister.

Spoiler alert: even without watching this, I'm already doing pretty much what he suggests.

Tomorrow is another session with the new therapist, and I hope we are able to finish unpacking my issues with enough time to spare to actually start to "get to work" on things.

Still no movement on improving my sleep hygiene or getting back on the bike. Insurance approved the new CPAP, so there IS some microscopic movement going on. Progress. And still no movement on reading the "Feeling Good" book. 

Perhaps I should schedule an appointment today for an eye exam.

Other than all this, things are status quo. 

New Layout & More Updates Ahead

So I've been doing a bit of Kon-Marie to my blog, tidying things up, and letting go (mostly of emotional shit) that doesn't foster joy.

Sometime in the next week, I'll be updating my side panel with books I have found useful, and some useful links/resources. 

Light Reading: Advanced Glycation End Products

(Some notes from stuff I've read regarding advanced glycation end products.)

I've come to realize that pretty much all the food we eat is designed to not just sustain us, but also contribute to our ultimate demise via AGEs (things like homocysteine, or protein in our urine, for instance).  Cooked foods where the Maillard reaction takes place, even more so. It's overwhelming if you fall into the same rabbit hole I have.  

See also: The post I did on methylation, homocysteine etc. It's pretty useful, I think. And overwhelming, but more useful than overwhelming. YMMV.

Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704564/

Special note: Because a low or acidic pH arrests AGE development, new AGE formation in cooked meat was tested following exposure to acidic solutions (marinades) of lemon juice and vinegar.


Advanced glycation end-products: modifiable environmental factors profoundly mediate insulin resistance
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512899/

Trying to Make Some Sense of This

Let's face it, I journal on this blog pretty much for my own record keeping, and perhaps to share my experiences with friends who might have some of the same or similar issues etc. 

So, pretty much, if you're here, you're considered a friend; and if you're here, it's because I pointed you in the direction of this blog. I invited you here.

So this blog is pretty personal--even if I am using a nom de plume. 

I want to make the analogy of it being a virtual cocktail party where I've invited you; however, in reality, I have unlocked my diary, and allowed you to read my inner-most thoughts.

I feel oddly in a position to explain the title of the blog, which comes full circle back to me explaining myself. Which, is--in a word, off-putting. 

I'm not going to change the name of my blog to suit a particular audience, by the way. Why? Because it would negate my experiences. My experiences of being judged or seen as invisible because I am fat or now in my 50s, or because I have valid complaints and known issues (of which I'm seeking out solutions). Additionally, as a child of a mother with borderline personality disorder, I've gone my entire life simply not being heard. Me, my thoughts, my needs, etc, have never been deemed as having value.

I could expand on this, but why should I when someone (who obviously), without reading the content of my blog posts, decides to critique the name and tone of my blog title?

Little did this person realize that they are participating in the very thing which I have fought my entire life against. It is about as ridiculous as me screaming "Fire!" in a crowded movie theater, and having someone critique the T-shirt I'm wearing that says "I'm with stupid." 

This is where I remind myself that not everyone who is "friendly" is an actual friend. Sure--some are friendly acquaintances--if that--but most are passers-by. And if you've read far enough into my blog and its archives, I have a flow chart of sorts in my head--and beneath each person's name are two potential options: 1. Twinkie? 2. Dairy product? 

All I know is a friend wouldn't (or shouldn't) start with criticisms, when someone has trusted you enough to share their inner-most personal thoughts and struggles.

I doubt the critic will revisit my blog, knowing what a negative vibe they got just from the title--and that's okay; however, if they do revisit, and they decide to read this post, they are cordially invited to think critically for a hot second and realize that not every opinion needs to be elucidated. This, I think, is a by-product of social media, that sense of narcissism of "Omg! I need to express all of my opinions, all the time, even on the FB walls, Twitter feeds, or blog posts of everyone I know!" 

Yes yes, your grandmother was right: "If you have nothing nice to say, say nothing at all." I'll expand on that further with a chestnut I crafted myself, "If you have nothing loving or supportive to say--I'll gladly accept your silence."

This is my blog, my prerogative; just like I have censored myself countless times elsewhere on the internet because, quite frankly, I know my thoughts and opinions aren't welcome 100% of the time with 100% of audiences. But see? Right there? It's called awareness.

Here endeth the sermon.