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Week 19-21

19 weeks post op

I have been talking up a storm with my PT about a zillion things every time I see him… frankly I think I could ask him questions all day for about 3-4 months straight before I ran out! Recently we have been talking about different ways to reduce inflammation in muscles so that they work better and don’t hurt so much. I have mentioned it online before, but I was telling him I was having trouble finding web info on strain/counterstrain. This was used 18 years ago on me to stop muscle spams and I found even in HORRIBLE pain it was a good fix. BUT I had not been able to locate information that was easy to access… I have found a muscle there and a muscle there, but nothing comprehensive that wasn’t a book. Well bless his heart he started looking into it for me and found enough info that he has been trying some our last few sessions to chill out my shoulder/neck issues! Between that, ultrasound and taping it’s been great to help chase away the pain so that we can eventually get on to strengthening!

I am still paying for my “hike” on Sunday ( It’s now Thursday). The pain is back to a dullish roar reminding me to take it easy and not just live life all willy nilly! I get it… I hate it, but I get it and have resigned myself to rest and cut myself some slack and just be amazed that I DID walk 2 miles and I am not in screamin pain at the hospital ,just sitting on ice several times a day and not able to do as much around the house like I had been, translation more laying and sitting than I had been doing.

The other ongoing conversation we have is about the many many many ways I still continue to compensate for weak muscles while doing exercises at PT. I am still having weakness on the left side ( my old good side) in the hip abductors. Mainly Glute minimums and Medius… they hurt and I want them to stop… the are partnered with tight IT band and some other little muscles in there in the very front of the hip. They are stronger than they were 3 weeks ago, but lets just say the gain is not noticeable by much, well to me anyway. Sometimes I feel that my PT is watching me so closely that he’s going to burn a hole through me. BUT I knew that he is watching for compensation and muscle fatigue… he ALWAYS sees it before I feel it. He stops me, adjust the exercise and then we move on. It happens all the time, so often that I really don’t think to mention it, but his ability to see my body not working right and then STOPPING the exercise and changing it so that I can get stronger faster with less pain… that’s gold. It’s also the sign of a therapist that really knows what they are doing. It also means that he is not always following the protocol to the letter… it means he is following it’s spirit and following the structure of what muscles build on what….

He had me do another exercise today that brought me back to that – HEY I have no motor control experience again… and here I thought we were done with that 🙂 For those that are curious he had me lay on the table raise my leg at a 90 degree angle to my body ( or as far up as it would go… and then just make circle in the air with my leg/foot… guess what muscles that needs….. if you guessed glute medius and minimus plus others you would be dead on… looks like that and the single legged bridges are going to be homework for awhile.

Many people have asked me how you find a good PT and frankly I think there are a bunch of ways to answer that question.

I think there are 2 things that are of equal importance to me…

1. Does this person think that the SI joint can sublex/partially dislocate/cause pain by being in malalignment…. if yes continue on… if no…. I think your going to just keep butting heads… they don’t seem to believe that the problem you have as someone with SIJD is the cause of your pain… so move on…

2. Do you feel comfortable with this person? Your going to get close , they are going to be touching you and dealing with you while your in pain, weak, and vulnerable… do you trust them? Cause the bottom line… once your home from your surgery… this is the person you are going to need to turn to and is gong to help you in the upcoming months. If you are constantly second guessing them…. it’s no good. If you don’t think you can ask questions or honestly tell them how you are feeling and what you are experiencing…. treatment is simply going to be harder for both of you.

3. I realize in most clinics the idea of a PT being one on one with a patient is not common… but is your PT watching you do your exercises? Are the noticing things and adjusting for you? I have found over and over again I am insecure about how I am doing things… I did bridges for years and they were horribly painful to do… and I never did them “right” now – a regular bridge with 2 feet on t eh ground… they are SIMPLE! Now that every thing is where it should be, but I OFTEN find myself asking… am I doing this right? Single legged standing – often heard from my mouth… I’m leaning aren’t I… I’m not doing that right am I? Sometimes I am right but the feeling is so foreign that I think it’s wrong… other times I am pretty sure I am doing something wrong, but I don’t have now to fix it!

4. Are they teachable… can they follow someone else directions ( your post -op protocol) and are they willing to learn a little from the patient….while we don’t know everything most of us have a decent working , albeit incomplete, knowledge of the SI area… even if it is simply by pointing to what hurts, or knowing what has caused pain before…. So while we know us, we HAVE To respect that they have been to school and they know things we don’t’. Lets learn from them and give them the respect they deserve. Ask them to teach you and hopefully that will open up a conversation where you can share what you have learned as well!

5. Soft tissue work…. it would seem not every PT thinks this is real important… I disagree with them. The muscles that are too tight must be stretched out and start to relax as well as strengthen what’s weak. So Your PT doesn’t like ultrasound… When it comes to the post op massage and ultrasound I do think you need to speak up or be prepared to add a massage therapist. But before you bolt for the door and start googling PT’s in your area… Think about talking to them. Tell them how much you have been let down by traditional medicine, in the cliff notes version, and how fearful you are of failure… and the PT that designed the protocol says this is important and your scared!! Cause really, that’s what is driving must of us when we say BUT MY PT WON”T LISTEN!!!!! We are scared they are going to do it wrong and mess us up…. and even I felt that way a tiny bit deep down inside about my super fantastic PT… what if he doesn’t understand it the way she meant it… what if he wont’ do massage…. and at first, I did have to talk about bilateral ultrasound…. I was a little worried he wasn’t going to do it… all I had to do was ask and it was done… but I was worried it would be a thing… it wasn’t.

6. OVER COMMUNICATE! I know it’s not in everyone’s DNA to talk it all out, but it’s really going to serve you both in the long run.

I hope this gives you some help in finding a PT that can work with you and help you get your life back.. with or WITHOUT surgery!!!!!!!

week 20

It was lesson time with my PT again. Earlier this week he has me do standing pelvic tilts against a wall… put my feet in front of me about 2 ft and then try to lean forward off the wall without moving my feet. This means I have to engage the lower abs, the glutes, and quatratus Lumborum or however you spell that AND a WHOLE bunch of other stuff. Lesson – AMY IS NOT AS STRONG AS SHE THINKS SHE IS AND STILL NEEDS TO SLOW DOWN!

oui vey! I wasn’t wrecked or anything, but man I didn’t think I could still get that sore! It was a timely reminder for me as my kids get out of school and I want to play the role of a fully healed momma that does 4 trillion things with her kids. I will have to settle on a trillion and ice 🙂

Am I stronger, you bet! Single legged standing is getting easier but it’s “nice” to know that my PT can still find ways to challenge me, because I am sure that life will do that too. Summer’s coming and life doesn’t slow down with 2 grade school aged kids, that’s for sure! I fear less… I may be sore and tight on days, but it can be fixed and doesn’t last forever. My neck/shoulder issues are slightly less and we will start concentrating on those a little more in PT starting next week.

I think the big lesson these last few weeks for me have been about dreaming big again. I mean really big… like life in front of me big. It’s scary… it’s new..and yet it’s really exciting. I have wandered around for the last few days with this big knot in my stomach. It has been suggested to me that I seriously take a look at going back to school to become a PT or a PTA. SOOOOOOOOOOOOOOOOOO far from my life as a school teacher and Area Director in Youth Ministry…. math? Science? I avoided those things like the plague last time I was in school. But I’ve been talking, and chewing, and dreaming and thinking… why not… I mean really I am eating up all the papers I can find on SI issues and muscle imbalances and modalities that might help… I am a sponge at PT asking why what , where – and thankfully have a willing teacher. I mean today as I was doing exercises I also got quizzed on what muscles were working and what they do! It’s great! I am absorbing information as fast as I can…. but school… again… is that crazy? Is that dreaming too big? Is it too big a dream to think that I could not only learn the information, but that I would have a body that will allow me to HELP OTHERS GET BETTER? Is that really possible? Or is that insanity….

Oh to dream… to dream and then ACT… to really put feet on this and DO something where I can help others… To be a PTA that you, you reading this could go to and I can say… hey… I get it… this sucks and we need to get you better… but lets NOT start with bridges ok 🙂

What do you think? Would you trust me as your PTA? ( I’d love to say your PT, but 7 years of school… I just can’t do it!)

20 weeks 2 days

I’m still dreaming and even acting… I started filling out my application for PTA school… My family is on board as are all my friends here in town and virtual. I figure applying can’t hurt right? I’ll follow this trail as far as it will let me. So that’s where that is for now. I’ll be sure to share when I know anything ok!

So today…. I am sore, I’m tired of being sore. I want to NOT be sore. I want to be strong. Yes, it’s seems to be my every 3 week temper tantrum – internally anyway. I still have to think about my body position all the time. I notice I still try to adjust my body so that the weaker muscles don’t’ get used as often… I have to really be intentional when I sit, stand, walk, climb stairs…. not because it hurts, but more because I can feel muscles pulling on my pelvis… like they want to go back to the way it was before surgery… I don’t know if that makes sense or not, but it’s like I am constantly noticing I need to readjust into pelvic neutral. I guess it’s like when someone tells you to stand up straight and you have to keep pulling your shoulders back… it doesn’t hurt at first, but eventually your shoulders get tired and you slump again… that is how this feels, but in the pelvis.

In single leg standing I feel firm and centered on the right ( previous bad side) the left is still sagging if you will… It’s not as painful, but I can tell it’s still weaker, and weaker means limitations in my mind. In PT I am ever thankful for all the stretching we do before we start strengthening. He continues to push and adjust, and test my limits and we both continue to learn. So I continue on that physical journey…. my pain is low, I think I would like to call it mild… it is constant, but it is muscle related. There is no pain in the SI area at all, there is very little buttock pain, I can feel the groin area tighten up at times and all those hip adductors get tight- and that’s usually when I feel some of the outer most abductors burn a little… I continue to take muscle relaxants 2 times a day and just asked my Dr. to switch me back to mobic for an anti- inflammatory… In the last few very hot days here I have been outside and on my feet a lot and I can feel all that tissue swelling, so I’ll continue to take the extra help keeping my pain down. By the grace of God my kidney tests came back fine! Some day I’ll get off all this, right?

But the reason I started to journal today was to tell you about a moment in my day when I thought of you all. They happen a lot, and I carry a journal in my purse so I don’t’ forget these moments to share with you – like the other day I was in my car and these Canadian Geese walked out in front of my car and I looked at the momma and her chicks and just started laughing… have you ever noticed they walk a lot like an SIJD patient!!!!!! Take a look, you might find yourself giggling! But that was not today’s moment, that was yesterdays 🙂
Today… I was at a big box store picking up Rubbermaid totes to hold some of the things from the basement… we had a flood, bad one, lots of water…. now we are throwing away and redoing, but anyway I was at the store and need those and some new shorts. I tried on like 10 pairs because none of my shorts fit now, it’s just like after pregnancy- my body is DIFFERENT.. the structure has changed… again… sigh… Oh to find a perfect fitting pair of jeans…. all you that have been pregnant understand this right! Anyway on my way out of the store my muscles were tired and reminding me that it was time for rest and ice. I walked past the rest room where this Mother and Daughter pair were in front of me. The Mom was in a wheelchair and looked to be in her 60’s. I stopped, and helped them open the door to the bathroom so the daughter could wheel her mom in. The younger woman looked at me and said,”People don’t usually notice how hard this is- thank you for stopping.” I smiled a melancholy smile and said, ” I do…. I know it’s not easy. Have a wonderful day and thanks.”I walked away thinking – this woman has no idea how close I was to being in a wheelchair just like her Mom, she has no idea that I know exactly what it means not to be noticed…” but today, to her, I was just a healthy young woman with an able body ready to help her. healthy, able, body……. isn’t that something.

20 weeks 5 days

Today I am a patient…. a SI fixation patient fighting her rear off to follow the rules, limit my activity based on my current strength, and care for myself. I STILL have left sided weakness that is presenting in “hip” pain… it creeps forward centimeter by centimeter and higher along the top of the back of the hip bone ( Iliac Crest). It’s limiting me again- grrrrr! bending is hard again and stairs at times are “hard” when I say hard I mean that my body doesn’t have the endurance to move properly all day long. The pain doesn’t stop me in my tracks any more, but it’s like something has been inserted into the muscles and they get wound up nice and tight during the day…. not my idea of progress. It still annoys me that it is my old good side that is acting up…. my right side… pretty darn normal… less pain on that side… the leg swings nice and free in the socket like it should – I can stand on the right leg and I stand tall and don’t lean into the hip at all, I’m pretty proud of that! The left leg… I don’t lean out as far as I did 2 weeks ago, but seriously…. annoying. I feel my pelvis get pulled forward by the tightness in the front… I have to make a concerted effort to hold pelvic neutral through the day…. it’s tiring… like holding your shoulders back all day when you aren’t use to it. I will throw my body a party when it learns to stay where I want it to! Cake and ice cream when stuff STAYS where it is suppose to!!! My hip flexors are pretty darn tight – we did a “check” at PT today… you hang the leg off the table while lying down and unsupported to about the mid thigh… opposite leg pulled up to chest and the extended leg should just hang down at a 90 degree angle…. needless to say mine does not – so we stretch and stretch and stretch… which at home looks like me hanging on my kitchen counter asking my kids to help hold mommy’s leg down…. thankfully they think this is REALLY fun…. I’m just happy to have an extra set of hands!!!!!!

Tomorrow though, tomorrow I am an observer. I am taking my first steps in applying to go back to school to be a PTA ( Physical Therapy Assistant). I will get to spend the whole day at a PT clinic and ask as many questions as I want and watch what other patients look like in treatment and what different therapists do through out the day. I’d be lying if I said I didn’t hope an SI patient walked through the door…. I mean the rest of the body is cool and all, but I kinda have a specialty in mind 🙂 If I think about it too much I start to have a bit of a panic attack… so just like recovery it’s one step at a time…. shadow a PT…. call for transcripts…. talk to advisory on Thursday…. send in application…. wait…..

 

21 weeks

Let’s start with school shall we…. I talked with the adviser today. I am registering for school- again – I am actually doing it, really taking steps to Be a PTA. I am still the only one that seems to feel this is crazy, and honestly I have dreams of how this works out, but no idea HOW it will turn out. Experience has taught me that the ride will be crazy, I will learn more about myself, my friends, my family, and what it means to love and depend on God. Growing pains…. waiting… putting one foot in front of the other…. going back to class, studying, papers…. all that sounds really hard. But I look at the course work and I see that in my last semester I have to do a research project – and I think PIECE OF CAKE – SI patients something with SI patients and I get all excited about doing that… it’s LITERALLY 3 years away, but the idea of it makes me excited. Like I said, I have no idea what happens after school, but I honestly believe that will all flesh out in the next few years, and I bet it will be better than anything I could have dreamed up.

Yesterday I went to a PT clinic and observed all day. 12 hours… gone from the house for 12 hours… leaned on stuff A LOT all day, there is a LOT of standing in the world of PT. It was fascinating to watch different therapists and their patients. The clinic was laid back and easy going and the family like atmosphere was nice. It had a down home feel too it. I identified a few things that are going to be hard for me to adapt to… I will eventually, I think… but they will be a thorn in my side. 1. treating more than 1 patient at a time…. don’t like it. Don’t like it as a patient, and don’t like it watching as a prospective PTA. It was hard to watch all the compensation these patients were doing while the PT was unable to watch all the patients at one time or in some cases appeared to be mentally elsewhere…. but whatever the case, exercises done wrong and therefor patient not getting what is best or making the most of their time. Not sure that is a situation that can be changed. 2. Patient attachment, like youth ministry or teaching there is attachment, your working with these people in various states of pain and dysfunction… if I get to live the dream and figure out how to treat mostly SI patients…. you can bet that attachment will be an issue. 3. Attachment USUALLY leads to balance issues – not physical balance, but balance of life…. work can never be more important than my family. That is going to be as rough if not more so than number 1… being in trouble with the boss is one thing…. being in trouble with my family – that’s even worse…. so yeah those were the things that became VERY evident in a short time of observation. Hope that all pans out!

In physical news new stuff today at pt… new stuff means massive breakdown about an hour after I got home. Pain increased to moderate, and stairs where an issue, I had the grip of death on the banister again, and everything just plain hurt. I’ve been icing down and the pain has settled some, but not the feeling of weakness. We went out to eat and my hubby had to help me up out of the car and support me walking…. bummer. It will pass soon enough – but right now… all I have is bummer – well that and ice cream, cause that makes most things better 🙂 I am always slightly cautious when we do new stuff, but my Pt had me talking about stuff that really interests me so I was a little distracted… note to self… DON’T let PT distract me when he’s throwing new stuff at me :)! It makes me feel good in one way, but in another it just makes the deficits glaring. We reassessed goals today and agreed normal routine tasks around the house without increased pain and an active lifestyle with flip turns and ability to take classes at the local gym where reasonable goals. There was some mention of significant muscle deficits… I know it’s true, but still hate hearing it. I’ll go to PT as long as I’m continuing to improve and insurance will let me. But mostly tonight it’s just me telling myself this too shall pass, I’m getting better, it’s just harder to see at this very second.

 

21 weeks 3 days

So when exactly do these muscle imbalances stop?! No really… it’s an honest question that no one can seem to answer. It’s not that I’m not better…. that’s not it at all. It’s that it’s Sunday afternoon and I am STILL on ice and heating pad! ( Ice on the backside heat on the front! My groin is so tight I feel like it might snap! Why… say it with me now… glutes are still weak and the other muscles are compensating. It’s that while I can do basic tasks and make my house run and get out some I am NOT unlimited. I still feel the frustration of being “trapped” by my body. I had an awesome conversation today with one of my fellow SIJD’ers. Perspective is good – I am not where I was 5 months ago… neither is she… we are both better…. but somehow it’s not enough. Is that bad? Is it selfish that I want more? ‘Cause truth be told sometimes it feels that way… like I should be happy that I am this much better…. dare I say 85% better? What do I base that on…. the fact I can mostly navigate a full day in my house… it’s the more I start leaving the house and adding activities…. that’s when life gets tougher.

I think to myself… am I CRAZY…. thinking I will be healthy enough to go back to school in just a few months and care for my family….. is that just too much to ask for….. it can’t be right…. it can’t can it – that I am asking too much. I fiercely want to believe that it is NOT to much to ask. I feel like the fire to learn more and be able to treat others with SIJD has grown since I first started thinking about this as a possibility…. it chokes me up. and right past that it freaks the heck out of me. I guess the cold hard reality is my first year of college was spent laying on classroom floors due to SIJD….. I won’t be laying on the floor this time… but I might have ice packs in tow!

So yes, 5 months out from this surgery I am happy at how much more I can do… I am also still frustrated with the MANY limitations of my endurance, and still want more. At some point I will need to be happy with where I am, but stupidly tight hip flexors is not where I am choosing to stop…. WAY better than tight piriformis, but still not a lot of fun.


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