Shoulder pain

After the six month mark, I really have very little pain related to my hips, just a twinge now and then.  My back problems have gone away almost completely, despite the fact there are areas with severe osteoarthritis throughout most of my lumbar spine.  Exercise, good osteopath work have paid off.  I just need to avoid carrying any weight. That will set off problems.

What surprised me was that I was constantly noticing shoulder pain.  It has been problematic since breast cancer surgery, worse with repeated radiation, but nothing compared with the hips/back.  I was once again referred to the rheumatologist.   This is one of the specialists that work with osteoarthritis and joint problems.

X-rays showed I have reasonably bad problems in one shoulder, and less bad problems in the other.  My goal is to stop any progression of damage to these joints.

The doctor said that my problems with eating wheat are not causes of my joint problems.  Gluten auto-immune reactions can make joints hurt, but with current knowledge, this is not a cause.  She checked through all the blood work done by my family doctor, and said it does not look like I have any underlying problems that can contribute to joint deterioration, such as thyroid problems.

The next steps were a cortisone shot in one shoulder, and an MRI to assess more fully the damage.  I can get an MRI with the hip implants I have.  The metal can distort MRI images near my hips, but otherwise cause no danger.

I went for the cortisone shot last week.  The day of the injection was not particularly fun, but now after several days, there is no pain in the shoulder joint. Movement is still restricted, but the constant throbbing pain is gone.  It may last for several months to forever.

The changes in sensation take getting used to.  We can adjust to about any sort of pain, but when it changes, pain is designed to draw our undivided attention.

I gave myself a week to adjust and now it is time to start on exercises to see if I can do as well with my shoulders as I have for my back.

 

Six months after surgery

It is closing in on six months after surgery.  The good news is that I am beginning to forget that I’ve had surgery most of the time.   Most of the time, there is nothing to make me notice my hips or changes.

I can easily walk a kilometer with no problems. I need to expand this, but it is really cold outside in Montreal, so more distance may wait until spring.

I still need to exercise.  Even at six months, released from physical therapy, there is still progress to be made.  I found this out shopping one day when an old store had a particularly steep step that was difficult to traverse.  I’ve added a new exercise to work on this.  I put one foot on the second step from the bottom then straighten the leg to lift up.  It is hard, so I broke the move into two parts.  First to lift enough so that the non-working leg clears the first step. I tap/balance on the lower step first then continuing to lift it to join the other foot on the second step.

The surgery did not fix everything.  My back is still problematic and I need to learn how to move such that it won’t bother me often.

I’m having trouble with fatigue, I think it is left over from chemotherapy.  I went through a difficult three weeks trying different strategies with painkillers for my back. I’ve now been over one week with no pain medication.  I can survive it, but it is uncomfortable sometimes.  It does not seem to be affecting the fatigue, but I’ll give it another week or two to make sure.

I like the idea of being off all pain medications. After the pain I’ve felt, I can tolerate discomfort by remembering how bad things used to hurt.  The think I need to monitor is whether or not the pain prevents me from activities.

Without the painkillers, I do notice twinges of pain in my thighs/hips at the ends of the implants.  This is much  more pronounced in the left hip (surgery was nine months ago).   This is easily tolerable, but I do notice it regularly especially when I’m tired or my back is hurting.

The miracle is that I can do so much now, live normally and do regular things.  It took longer than I thought to be ready to start building strength, yet it is happening.

 

New Blog: Life after Crisis

I’ve started a new blog, http://helltowell.wordpress.com to cover the next phase of my life.

I will continue articles here from time to time, as cancer related thoughts will continue to be a part of my life. I wanted to have a place to write where the focus turns to rebuilding a life after a lengthy crisis situation. This new blog looks at how I reboot my life.

So much has changed since my first cancer diagnosis in 2001 which coincided with the beginnings of a decade of debilitating back/hip problems. I’ve struggled with major health issues for the past ten years, and now, finally, feel I can and must find ways to make use of all that I’ve learned in this past decade. In this time, I had the luxury of time to read, to explore and to meditate. During the periods of low energy, I have studied ancient history and philosophies, modern psychology, cognition and biology and in doing so, have found many answers I never thought possible. The next challenge is to take what I’ve learned, then re-emerge from my hermit cave into the world.

It won’t be easy. Life never is.

Three months after hip surgery

I apologize for the lack of entries.  I’ve been to Florida to recoop and barely touched the computer the entire month.  I was there during the weeks just before and after my three month landmark after my second hip surgery.

I had anticipated that at three months I’d be back to normal.  My family confirmed that I looked normal and walked without a hint of a limp.  My cane was the only thing that tipped off the recent surgery.  I still brought the cane most places with me, in part as a reminder not to over do, and also sometimes, I was glad to have the extra stability.   My reality is that I am still building strength and endurance. It is important that I am careful.  When I get tired, I can feel my balance is still not what it should be.

I saw tangible improvements during my 2.5 week stay.  By the end of the trip, I could do things in the morning, then go for a one mile walk outside without needing a big rest afterwards.  When I first arrived, the mile walk was doable, yet required a recovery period afterwards.

In Montreal, I don’t have a car, so I walk most places or take public transit.  In Florida, a car is required for almost everything.  You’d think this would save my energy for the activities, yet Fort Myers has huge shopping complexes, with immense, full parking lots.  I can walk as far in a parking lot as I do to get from my apartment to the stores a long block away in Montreal.

I was amazed that I can actually tolerate going shopping again.  It has been several years where pain levels forced me to limit any trips out to a single goal and return home immediately and even then, I might pay in pain for up to six days afterwards.  Now I can go to one of the huge Florida outlet centers, walk and browse for a couple hours, then return home and still do things.

My energy levels varied, sometimes I felt like I was totally normal for a few days, then I’d be hit by one or two days of fatigue.  Again, I think this is more related to cancer recovery than hip surgery.

At my  mother’s church, I was able to compare notes with some other hip surgery patients.  It was interesting to see even a woman in her 90’s, who had surgery the same time I did, walking well with her walker.  She was intent on her physical therapy and very happy at her progress.  We each heal at our own rate, but even with all the difficulties, being able to walk again is like a miracle.

At three months, I can pick up things I drop on the floor again in the normal way, squatting down rather than bending at the waist.   All the exercises are paying off.

When I returned home, I was able to handle the 35 steps up to my apartment, yet I was aware that I still need to continue with my exercises and continue strengthening all the muscles that I’ve been working on the last months.

I really thought at three months I’d be feeling normal since this is where most information about hip recovery ends.  I know if I stop exercising and working on details of improved range of motion and balance, my progress will stop and I will be forever frozen at that level of mobility.    I need to  work  diligently on strength and balance.  The literature alludes to it taking more like 12 months to make a complete recovery.  I can now believe this.  The difference is between looking normal to others versus actually rebuilding everything so that I FEEL normal with unrestricted movement.

I’m glad the worst is behind me.  Six months have passed since my first surgery.  This is a long time to be required to focus on a single goal.  For the next nine months, I can begin to reconnect to the world and begin doing more and more normal things.  That said, my recovery and exercise program must be an important priority, but no longer at the exclusion of other things.

The worst is behind me. Yeah!

Done with Physiotherapy

My physiotherapist just left after his last visit.  He’s been coming to my home to work with me for almost six months, three months for each surgery.

He was impressed with my progress in the past two weeks and encouraged me to keep working at the exercises to improve my strength.  After this, he thinks working out at the gym will be my best choice to get back into the best shape.  He said I can use most of the gym equipment, but should avoid high impact exercises such as running, jumping or things they do in many aerobic classes.  I could go cross country skiing, but not downhill unless I’ve very, very careful, same for snowboarding.

Swimming, bicycle and elliptical machines are good. With the gym equipment, I need to progress slowly.  He recommends not using much weight  on the machine where one pushes against weight to starting with legs bent and you push to straighten the legs.  Other machines I can use normally.  I’ll look into this when I get back from Florida.

He brought some exercises for my back to further work on balance and strength. He brought about a dozen exercises and suggested I work on them about three at a time, then progressing every week or two.

He suggested if I want more physical therapy to go Institut de physiatrie du Québec which is not far from where I live.

I’m feeling much steadier than I was last week while I still cannot do the stair exercises with holding onto something.  I’ve upped the number of repetitions from two sets of ten to two sets of 20. Maybe when I’m good at that I’ll be able to do it without holding on.

I was able to stand on each foot for a full minute, without shoes.  I was surprised I was able to improve so much – two weeks ago I had done only 12 seconds on one leg, 20 on the other.

This is a big landmark.  I”m ten weeks after hip replacement surgery now.  Only in the last few days have I begun to feel like I am walking normally.  When they say it will take 3 months to get back near normal, they actually mean it.  They also say it takes a full year to fully recover. Lots more work ahead, but the good kind – building strength rather than just remedial work.

Still working

I’m keeping up with the exercises every day.  They are easier, yet I still cannot do any of the stair exercises without holding on with one hand. That at least is an improvement from holding on with two hands!

Distances I can walk are improving. I can walk a kilometer (half mile) interspersed with shopping without nasty repercussions.  Up until now, I’ve been walking to places close to my house on errands or food runs. Now, I’ll have to begin adding distance for the sake of endurance.

In one week, I go to Florida for the rest of December.  The idea of walking out in nicer weather is appealing. Hopefully, it will be warm enough to swim in a heated pool, but one can never predict Florida weather this time of year.

I’ve finished sewing my velvet jacket, with only adding hardware for closures.  I’m going to stop at the fancy button store to get some clasps after my trip to the oncologist today.  The store has thousands of unusual buttons and embellishments for clothes.  When I first walked by the store, this seemed an odd boutique, yet I tend to go there for each and every sewing project.  Buttons are cool.

The realization that I’m leaving in a week has kind of jostled me out of my multi-week stupor.   Planning and strategizing, even for a trip, are good for the mind.

 

Laying Low and a glitch

I’ve been laying low working on sewing projects and chain maille jewelry to keep me from over doing.   These are some projects I’ve been wanting to work on for a long time with enough of a challenge to make them interesting.

The audiobook I’ve been listening to is interesting, yet tends to put me into a bit of a stupor after keeping it running while I’m working.  Good for keeping me low key, but dulls my mind.  At least I’m attributing my dull mood to that this week, hence the lack of writing. No deep thoughts where thunk.

I finally pulled out some of my motivational type MP3s. Maybe that will get me going a bit.

Yesterday, I found I had stupidly lost a prescription from my doctor.  My doctor’s secretary called to tell me she could not reach the pharmacist at the number I gave her, so I said I’d just run over there to get his fax number for her.  I was happy she was being so attentive and helpful despite my inability to keep track of the prescription.  Thinking of where I was going, I grabbed my keys and descended the steps, for the short block to the pharmacy.

I noticed that I can walk faster than usual, then it dawned on me I’d left without my cane.  Oops!   The one street I have to cross is a bit busy, the light was green so I was able to continue over the curb at my speedy pace. Two steps into the road and I felt a very hard to describe sensation in my left hip. It felt like a bit of a clunking sound that reverberated through my bones, followed by a sharp pain.  I wanted to stop to assess what had happened, but I was in the middle of an intersection.  Suddenly, I regretted not having the cane there as a safety net.

By the time I arrived safely at the corner, the pain was gone already.  There was no additional pain, and I was walking normally.   I have no idea what happened, but it was an important reminder that I need to keep the cane with me when I go out for a while longer.

I”m guessing this was like the odd clicking I get on the stairs sometimes that the surgeon attributed to scar tissue.  I was walking faster than I have in the past, and probably taking longer steps.

As with anything, I’ll need to get used to the ins and outs of how these bionic parts work.

 

Mood and late recovery

Not surprising, my mood is linked to energy levels.  I am tending to be frustrated when I’m tired, and I get tired when I do too much.  The repercussions of doing too much on a single day carry over, putting a real damper on the days that follow.

I know this, yet cannot seem to avoid attempting to push my limits.

How many times have I written about this?

You’d think I’d learn.

Repercussions

My enthusiasm about my shopping trip on Friday remains, despite the fact that I’ve felt exhausted for three days.  A combination of cold and rain did not inspire me to overcome the fatigue to go out for a walk.

Pacing myself is so hard.  I’ve focused on doing the exercises.  They are difficult for me to do, so it is too easy to put them off.

I’ve taken to pulling out an audiobook to listen to while I do my 15 minutes on the stairs. It distracts me from both the painful parts and the boredom of the repetitions.  I’m not sure I could make myself do the exercises daily without this little trick.

The good part is that the latest variation of the  exercises are getting easier.  I’m doing them on both legs now, since these are exercises that are good for everyone.   The physio wanted me to lower  a foot to ground level very slowly, just brushing the floor with my foot without weight and lifting it from a variety of positions that Ive described in a previous post.  Eventually I am to do this without holding onto anything. Right now I have a cane in one hand and hold on with the other.  It is the only way to do the exercise with good form.  In time I’ll put less and less weight onto the railing until I can do it with just a finger touching, then I’ll be strong enough to begin the hands-free version.

The other exercise, balancing on one foot for a minute, is not so hard, but boring.  I have a stopwatch app on my phone which I use sometimes.  My electric toothbrush times out 2 minutes with warnings each 30 seconds, a perfect time to double task.  I probably look funny brushing my teeth in a flamingo pose, but at least, it is a way to get the activity into my regular schedule.

I am amazed the difference in stability with and without shoes.  I never knew this made such a difference.

Lots to do today, and I need to go out and walk, even in the rain.

First real shopping trip

Today, I ventured forth to attempt to locate some clothes from this century.  I’ve not been able to go out clothes shopping for far too long.  I exaggerate a bit in how long it has been, but the joy of a girly shopping trip was lost to me for the past six years.

I mentally mapped out a route to some of my favorite stores, keeping my goal limited to looking for a pair of black jeans.  For the first time in ages, I could walk through a store, browse a bit, then go to a second store, a third store and even a brief time in several other places.

I kept my collapsible cane with me and used it much of the time.  I learned that a cane seems to help do some of the work stabilizer muscles should be doing.

I was tired by the time I got home. My stamina is still not great.  Yet, I did not have to leave for fear of repercussions of walking and standing too much!

I actually found a pair of jeans – and the cheaper store branded jeans fit better than the fancier ones!

Needless to say,  I am thrilled.

PS: I also got the luxury of shopping on “black Friday” in Canada, where it was a normal workday, so the stores were not crowded.