My physical therapy appointment yesterday shed new light on the condition of my lower back. The more common term for severe degenerative disk disease is arthritis. Somehow it doesn’t seem as scary or bad described that way.
The initial treatment, regardless of what it is called, is to strengthen the muscles in the lowest part of the abdomen, and to stretch the hamstrings in the legs. There will be more exercises added later, but for now I’m doing four different strengthening exercises and two stretching ones twice a day. Each week I have a PT session with a therapist to monitor how I’m doing and to add new stretches or exercises to the routine.
Having endured months of off and on pain, sometimes extremely debilitating pain, I am very motivated to work two exercise periods into my daily routine; one when I first get up and the second when I arrive home from work.
I’ve also been working for months now to get a better chair at work, one that doesn’t aggravate my back just by sitting. The initial choice of chairs included only ones that were fairly beat up. Eventually I found on that only had a slight tilt to the right. Working with the “chair accommodation” person in the HR department I completed some paperwork, and had my doctor submit a questionnaire about my back condition. This resulted in several different chairs for me to try. Each was a “demo” chair and consequently somewhat beat up themselves. After a long series of events I now have a decent desk chair that is level; both side to side and front to back. However it does not have a tilt lock so I am unable to prevent the chair from leaning back when I do, and there are days when that backward lean is very uncomfortable. The company has ordered parts for my chair that will convert the seat pan tilt feature to a working back lock. I have no idea how long that will take - hopefully not very.
In keeping with my doctor’s orders to exercise at least 30 minutes five times a week, I took another walk this evening.
Nearly eleven months after I set out to lose weight I have not only lost 50 pounds but managed to keep it off. As a result many of my work clothes no longer fit. I can still wear them, but I am swimming inside of them now. At my peak weight I was wearing pants with a 44 inch waist line and using suspenders to hold them up. Over the weekend, with some birthday money in hand, we went shopping for new work clothes.
I am happy to say that the first pair of size 40 pants I tried on were too big. I was forced to go to a size 38. And the 38 inch waist line isn’t any too tight. This was a huge boost to my self image.
For the past several months my weight has been hovering around 200 pounds; some days a bit lower and some days a bit higher. Persistent back pain has prevented me from exercising very much at all and I think the inactivity has contributed to the slowing and stopping of my weight loss. Half of eating less and doing more is to do more. While I wish I was still losing a little weight I am pleased that my normal diet isn’t putting any weight on me, regardless of my slothfulness.
Later this week I am expecting the results of an x-ray series of my lower back. Hopefully we are eliminating structural problems like cracked vertebra or bulging or ruptured disks. Even if we identify a structural problem at least then I’ll know why my back isn’t healing like I think it should. Once I know what is (or isn’t) wrong with my back then I can start a measured program of walking and mild exercise to strengthen it once again.
At my physical last week, in addition to blood work, the doctor ordered an x-ray series on my lower back. I’ve had persistent, chronic lower back pain for eight or nine months now and she wanted to rule out structural problems first.
The x-ray shows severe degenerative disk disease. Calling it a disease is a bit of a misnomer; everyone as they ages has disk degeneration. It is a part of the aging process. In my case it appears to be accelerated or at least more advanced than one would expect in a 46-year old. I haven’t had a second opinion yet, or seen the x-rays for myself, but as I read over the literature on this condition it all rings true.
The next step, in addition to a second opinion, is to start physical therapy. As odd as it sounds, increase physical activity may actually improve the situation as it will strengthen the surrounding musculature and aid the ailing disks in their primary role of supporting the spine.
The good news is that my blood work came back normal across the board. My cholesterol is 148, and all the functions (thyroid, liver, et cetera) are within the normal parameters. The HDL component of cholesterol (the good stuff) is a bit low and I’ll be adding a daily supplement of fish oil to counteract that. In three months we’ll test it again to see where I’m at. The triage nurse assures me that the fish oil doesn’t taste like fish oil, and even it it does it can be frozen and taken as a lozenge.
So I’m a healthy 46-year old with degenerative disk disease.
Today I had my first physical in perhaps a dozen years. There are several dynamics at work here, not the least of which is a desire to keep my health for as long as possible. You see, when I was sixteen and the United States celebrated its Bicentennial I decided that I wanted to be alive to see the Tricentennial. I’ll be 116 then, and I’d like my body to be as fit and as healthy as possible.
Finding a new doctor is an interesting experience. This is a person you will be sharing intimate details of your person with, and if you happen to select a doctor with whom you can’t openly discuss bodily functions (or the lack thereof) you need to start over again. My insurance provider has a cumbersome to use but ultimately useful physician locator on their website. With a list of internists in hand I tried to figure out which to see. Finally I just settled for the first one alphabetically.
Dr. B was very approachable and easy to talk with; she didn’t talk down to us and I feel she listened to my concerns and addressed them. While the exam was perhaps a bit perfunctory (I didn’t actually turn my head and cough) I feel good about the visit. I should get the results of a back x-ray and blood work back early next week. I’ve also got a recommendation for a dermatologist as there is a history of skin melanoma in my family and I have some candidate moles.
In keeping with my new found desire to become active in my health once again I have a dentist appointment next week. Expect the posting following that visit to be one long “Gaaaaaah!” sound.
Eagle-eyed reader JJ, sent me this today:
net.zanshin.PlacesLivedException: placesLivedCount may not be decremented at net.zanshin.blogs.001243.html (I’ve lived in six states:iii) at net.zanshin.blogs.000572.html (I have lived in 7 states: xv) at net.zanshin (index.html:1) at user.jj (see what mark is doing:1) at user.jj (preflight checklist:114) 08 May 2007 12:13:04,553 ERROR JJUsingWebDaemon : [10.170.77.54-63b5c0.1126c1a3314.-7ff2] runtime exception…
It seems that in an earlier posting, 44 Things About Me I claimed to have lived in 7 states, and in this week’s posting, 46 Things About Me I only claimed 6 states. Hence the PlacesLivedException.
The correct answer hinges on what constitutes “lived in.” Two years ago I was using the looser “any place I’ve stayed that wasn’t a vacation” rule. This year I employed the “any place where I’ve had mail addressed” rule.
In my life I have lived in New York, Pennsylvania, Illinois, Indiana, Washington, South Carolina, and Kansas. Seven states. However, my stay in Pennsylvania was very brief, only about 4 or 5 weeks as my parents were in the process of moving from New York to Illinois. My mother and I stayed with my paternal grandparents while my father went ahead to start his new job and to find a rental house.
This brings up a slight exception to the “any place where I’ve had mail addressed” rule. You see, I was born in Brooklyn and lived there for 10 months before we moved to Illinois. I doubt that I got any mail in that time period. New York stays on the list since it is my place of birth. Pennsylvania is out as it was transitory.
And besides, as the the chief source of requirements for this site, I am allowed to change the rules without prior notice. Still, kudos to JJ for having caught the discrepancy. Heck, I’m tickled that someone out there is actually reading this stuff.
In honor of the date, here are 46 Things About Me…
It has been a year since my original laser eye surgery, actually more like 13 months. A requirement of the lifetime enhancement package that I got is to have annual eye exams. Yesterday afternoon I had the first of these and the results are not entirely good.
The eyes themselves are healthy and in good shape. There is no evidence of any disease not any lasting complications from the mechanical portion of the surgery. However, my vision is not what I’d hoped for. I have blurred vision frequently in the morning when I first get up that prevents me from reading, and my vision is blurry when I am tired. Both of these conditions are new to me - never in my life have I had blurred vision.
After a whole series of tests and measurements performed on my eyes by a technician I finally got to see the doctor. His first question to me confirmed my fear that my eyes weren’t where the surgery was supposed to leave them, “How is your reading?” In order to read I have to have the material at a full arms’ length otherwise I can’t focus clearly on the words or images. Having a bright lights is necessary too. I am unable to read anything held closer without straining or using a magnifying glass.
The doctor confirmed that my right eye, the near eye that has now had two surgeries, wasn’t measuring where they had hoped. After the initial surgery in March 2006 it measured a 3. In English this meant I could read the smallest font size imaginable as long as I held the print no more than four inches from my face. Their explanation was that my eye had healed “stronger” than expected. After allowing it to heal for three months an enhancement procedure was performed to “flatten” the eye. Yesterday I learned that the target number for the enhancement was a 1 or a 1.25. My eye again over-reacted to the adjustment and has healed at a .5. This accounts for the full-arms length required to read a book or clearly see a computer screen.
The doctor is hesitant to “enhance” that eye again, for two reasons. First, it now has a history of over-reacting to adjustments, making it harder to gauge what adjustment to make. Second, each adjustment leaves behind some scaring and alters the surface of the eye at the edges of my vision. Repeated surgeries could start to have a detrimental effect.
He is willing to adjust my left eye, however, as it has had only the original procedure. I’m left-eye dominate and so that eye was designated for distance vision. What he is proposing is to take away some of the distance and make that eye slightly near-sighted. This would, if it succeeded, balance my eyes a bit more and hopefully more my near focal length into about 18 inches instead of 24 or more.
They have a long-wear contact lens that can be inserted that would back my left eye down to simulate the effects of the surgery, but I am reluctant to try that just yet. My fear, obviously, is that a new surgery on my left eye might result in the same situation as my right - an over-reaction that would leave me out of options and looking at corrective lens, either contacts or glasses. The remote possibility that after a year, two surgeries and $3000, that I might have to buy glasses again leaves me understandably upset.
Part of the process yesterday was dilation of my eyes, which left me unable to read or use a computer all last evening. Even though I knew this was a temporary condition, coming on the heels of the doctor’s news it left me feeling very out of control and like I’d made the biggest mistake possible with my eyes. I actually asked the doctor during our consultation if he “could put the astigmatisms back?”
The other upsetting aspect to all of this is a failure upon their part to do two things for me. One, my near vision wasn’t tested yesterday. Therefore we have no idea if it is 20/30 or 20/80 now. Once the drops causing the dilation have taken effect it is too late to perform that test.
The second failure upon their part was to notify me that the eye drops they had recommended have been pulled from the market. It seems that one bottle may have produced a mold in spite of the preservative in the liquid. I actually still have a bottle with a few drops left of that particular brand. They’ve been thrown away.
Over the coming weeks I will need to decide what to do about my vision. I am resigned to having blurry vision when I get tired, and to putting drops in my eyes every single morning to try and reduce the blurriness upon waking. But I am fearful of taking a chance on another surgery. It may make things right and good, but it could also make things far worse and it cannot be undone.
If you want to piss me off, if you want to do something that will cause me to hold a grudge, simply agree to meet me somewhere and then don’t show up. Nothing upsets me more or faster that being stood up.
For example. I scheduled a lunch with a bunch of the people I used to work with. I used Google Calendar. I actually am nerdy enough that I tested on myself to see what happens when a non-Google mail/calendar user gets a Google Calendar invite. The email comes with some nifty links so that you can respond: “yes”, “no”, or “maybe.” Easy. One-click and you’ve given common courtesy to the person scheduling the event.
Some of the people I invited I knew would not come. They never eat lunch out for their own reasons and I can respect that. I only invited them because they are friends and, well, friends invite friends to lunch. Of the ten or twelve invitations I sent out one person said maybe, and two others declined. Two more managed to indicate they were coming without successfully using the “yes” link in the email announcement.
So I went and stood around like a idiot for 30 minutes while no one showed up. The location was out of the way for me, 15 minutes each way; so an hour into this deal and I still don’t have lunch.
It would take, what, 30 seconds to pick up a cell phone, poke my entry in the address book and say, “Hey, I can’t come, I’m sorry.” No calls. No emails, no last-minute updates to the calendar. Nothing.
I don’t care if work keeps you busy. Personally I think using work as an excuse to not have a 60 minute lunch with a friend indicates an imbalance in your priorities, but then I’m strange. And even if you are going to use the “I’m suddenly too busy to come” excuse you have to actually broadcast that excuse somehow. Not caring enough for me and my feelings to make that 30 second phone call really frosts me.
So if you are reading this, and you previously said you were coming to lunch and you couldn’t be bothered to call or show up, then understand that I got your message. Same to you.