Return to Physical Therapy has begun

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Tammy and Schraige, I am glad that you are both in PT and pray that it helps you with that pain. I am thinking I should try a round of that but to be honest, not driving, makes it a little hard on me. Poor hubby does not need another thing added on his list so I will stick with my spa and trying to walk. I have an incurabent bike and I rode it for 3 minutes the other day. :D Hey it's a start, right? Baby steps!!
 
Hi all. Just wanted to pop in and share what's happening with PT. I went to my first physical therapy session today to see if it helps me or not. It's scheduled for 6 weeks, twice per week. (And I am "almost" back to where I was painwise before the flare up too.)

For those just poppin into this thread.. I am almost 23 months post posterior L4/L5 fusion with instrumentation and a remaining bulging disc at L5/S1 that was not fused as it wasn't causing me pain. I had a major flare up recently and trying to get back to normal or determine that maybe something new is going on or that PT can help get me better. We are trying PT as the least invasive option. And a new MRI has not been done yet (as my last one was 4/4/07 and insurance groups dont like to do them less than 1 year unless something is considered major to approve it being covered). So we are trying PT first.

This is not my preferred PT group that I love. But the spine surgeon Im now seeing recommended it, and it's close to work (as my preferred therapist is 1.25 hour from work), so I am giving them a go.

I immediately started comparing them to all the others I have been to in the past and especially to my fave therapist. I decided while I was there that it wouldnt be fair to this therapist or me to compare and possibly hinder my getting the full benefit of this therapy. So I let that go and just went with the flow.

I like her. She did the battery of tests for assessment which took quite awhile and some of the positions she had me in, I felt like a contortionist! hahaha. Some were not so pleasant, but she gave me some results after. She said that she tested my piriformis and SI joints and found them very stable and not producing me pain. She believes that any pain I am having is eminating directly from my spine. She said due to the fusion, she is limited on stretching out the spine for maximum benefit, and therefore would need to work on other core areas to include, abdominals and my lower extremities to see if I get any relief.

She told me NO treadmill for now (I have one at home). Her comment was that because I have a fusion and am aggrevated there right now, that the treadmill causes a repetitive motion which will only increase my pain right now. So she said it's out for now. Walking out in the world she said is completely different than the treadmill, as it's different terrains and such. So that is fine.

Once she gives me the exercises in full, then she will have me doing them at home also. She said twice a week would not be enough and wants me at this 4-5 times per week. I told her I had recurabent bike at home and she was thrilled. She said that could actually help my sciatica. I told her I have been afraid to use it all this time because I thought it would aggrevate it. She said we will work toward use of the bike and see if it helps. Cool!

She said she noted some muscle spasms in the lower back and put me on the stim machine and hot paRAB first. They screwed up my appointment time so I had an abbreviated slot today, so we only did a few exercises. One was the hamstring stretch with the strap on foot and pulling the leg toward the body from the prone position. Wow! Are my hammy's ever tight! Tighter than usual. This may be a major reason for some of the pain as well. So I'm back into my PT in a more rounded way now and hopefully I will get some really positive results.

Now Im sore (in a good way sore) and off for a snooze. Night Y'all!.
 
Baby steps is right, Peppy! I went through a bout of no driving recently while meRAB were adjusted and hub was calling me "Miss Daisy" when he chauffered me around. I wonder whether you could get a PT to come to your home, since you're still in the post-surgery recovery period or whether your insurance would provide transportation for you.

Congrats on your three minutes on the recurabent bike and also your walking, which I read about in another post. My new philosophy when I do some exercise is that some is better than none!
 
HI there everyone. Sorry it’s taken me so long to respond to you all. I almost forgot I posted something. I caught my first chest cold in I cant remeraber when. I never get sick! But Im bouncing back fast. My BF has had this going on 2 weeks. I’ve only had it since Thursday night, and I’m doin much better already.

Gosh, you guys are just the best of people. I really am so hurabled by your worRAB. Thank you.

SCHRAGIE – Hey gal. It sounRAB like we really are surgery sisters indeed! Your back in PT too! How about that. You asked me what that therapist meant by pain coming from my spine and not my joints. She meant from her examination of me, my SI joints are not generating any of the sciatica/pain and are normal working order, thus, my pain seems be coming directly from my spine. As to where in the spine we still don’t know yet. The doc is hoping its just a flare up and that nothing new is going on.

I have decided enough is enough with this new therapist after giving her a less than fair shot. She is very “cookie cutter” in her PT regimen. She wanted me to sit Indian style, but with my heels together, then with my hanRAB on my inner knees.. do the resistance push/close thing. NOT! EgaRAB.. I haven’t sat flat like that in I can even remeraber when. It had to be in early 2003! Can you sit on the floor with your legs straight out of even bent and still be in a sitting position? I can’t period. My body just don’t work like that anymore. Haha. She had no other alternative for that exercise at all. I knew of a few myself that I thought might come close, but didn’t offer those to her, as this was her regimen and I wanted to see what she was made of to be honest.

When I arrived at my last visit, I told her how flared up I was from the eval and also some improper bending I did. She then told me to get up on the table do my exercises. What exercises?.. she only showed me 3 when I last saw her. She looked puzzled at me and forgot they screwed up my appointment so our time was abbreviated. Anywho.. she said do this and that and disappeared. She came back to ask me if I was done, and I’m just sitting there by then, duh! She put the stim on my back with heat and when the bell went off, the pulled the tabs off and I was sent on my way. It really was that uneventful. Maybe I expect too much, but I do expect more than that.

Sooo, long story ending, I have already booked therapy with my former rehab therapist going forward (starts April 4). Since I haven’t given this new gal a total fair shake of time, I will just tell her that it is easier to go back to therapy that’s closer to home instead of there. That will keep feelings in check there, since this is the same place where my new surgeon is too. So don’t wanna sink a boat there unnecessarily.

I am going back on Celebrex (once my new insurance approves it) since the Narposyn tore my tummy up with just ½ dose and chased with double zantac. So hopefully the Celebrex will help some. The doc didn’t want to give me another prednisone pack because of it’s effects. I can understand that. He told me to just stay the course and take my vicodin and skelaxin as needed and take an NSAID if needed until the Celebrex gets approved. I’m okay with that. Things have calmed down again anyway.

Orthotics? Hmm. I would think those either help or make things much worse. I was told by the rehab therapist that I was flat footed. I said I was not and she showed me. Hahaha! She said thank the flipflops you’ve been wearing for the past decade. Price I pay for comfort I guess.

I can imagine that you did feel picked apart. Instead of what’s good about you, they tell you what a wreck we are. Like we needed the reinforcement of that idea. Not! But like you, I like to hear the real skinny on things, even if it’s not what I wanna hear.

Why the ice? I had that only once when I first injured my back. After, all PT is with heat. Interesting and burrrrrr!

What muscle relaxer are you taking again? When I found skelaxin.. it was great! It loosens me up but doesn’t make me woozy. Maybe you can get something for day and something for night??

I “oinked” up my own post.. don’t be silly! Awe.. me inspiring you.. wow.. what a wonderful thing to say. I think of you the same way! We really are surgery twins gal! I have had my bouts in being very depressed for about the first year when I injured myself, and then just had to snap myself out of it. I could see what it was doing to me. (I lost a lot with the back injury and I was darn sure not going to let it take my sanity too. It came close.) And it really kicked in when the first ortho surgeon I had been seeing for 2 years just gave up on me and said I would be in excruciating pain for many many years and to just live with it. That was a reality check for me and that I had to take charge of my life, for me.

I am one of those people that talks to themselves in their head and since I am also a very physically expressive person (eyes go, hanRAB move, etc), I can imagine what I must look like when I am giving myself a pep talk! Hahaha! And I answer myself too! I probably look like I need to be fitted for a White coat that ties in the back! Lol. But in seriousness, thank you for making me feel so special.

Well I must get off here and get some shuteye. I gotta work in the morning. As much of a pain it is to get up and go to work, I’m grateful that I can.

Here’s to us and everyone for a painfree day!
 
Hey Tammy!

We are true surgery sisters as I am back in PT too. I'm glad your eval went well and that you got some good, sound advice. I had my evaluation several weeks back and due to another recent health issue (now resolved, thank heavens) am not starting until this week, twice a week for four weeks.

I, too, had to switch PTs, finding one near my office (and who takes my insurance), and did too much comparing my new young PT to the well-seasoned one I had been seeing off on -- and loved ---for several years. You're right about letting go and giving a new place a chance, but I found her to be pretty rough in the eval. At one point she asked me to do a full situp "crunch" and I had to ask her if she was serious. I do a pretty abbreviated one at home, so that's what I did. I am committed to working my abdominals (I know they're there somewhere ;))but I refuse to do anything that I know will hurt me.

When your PT said your pain is eminating directly from your spine and not your joints, what did she mean? Disc issues? Scar tissue? Nerve stuff? Mine gave me the talk about how fusion puts pressure on the discs above (I now have three bulging ones), said that the facet arthritis/bone spurs come from repetitive motions and I didn't quite understand that part but will ask again. She also recommended getting orthotics and I used to have a pair until one of my dogs ate them :mad:, so will look into it again. Also found out I'm a little knock-kneed, and have a hyper extended back when I stand (a posture I likely adopted to relieve my pain). Oy! I was glad for her honest eval but, man, I felt picked apart :eek:

Let me know how the recurab bike goes for you. My previous PT drilled into my head no sitting exercises, so I stick to the treadmill or the elliptical. I am thinking of getting an elliptical for my home, if I can find a good inexpensive used one.

I got stim and ice after the eval, and hope that I get a little heat next time before exercises because it makes a big difference. My PT thinks she can relieve the spasms (I am a SPAZ in many ways these days) and of course was amazed that I was taking a medley of nerve meRAB and still functioning. Dang, what choice do I have? My balance was majorly off, but I attributed it to the meRAB, specifically the muscle relaxant, which I have now stopped taking except at night so will ask her to re-eval me next time.

Now that I've hogged your post (oink!), let me end by saying that when I try to will myself into a positive attitude, I think of you fondly and am inspired by how you keep your head about you when going through all this nonsense. I was in a pretty dark place these past couple of months, frustrated and giving up on myself, but you and the rest of the back brethren on this board keep me going.

Here's to a lower-pain weekend for all of us. (see how I've given up on the idea of being pain-free?!)

Schragie-girl
 
The "back brethren"... I like that!

Tammy and Schragie, I hope this new PT will be just what you both need. You're both so wise to mentally turn off the comparisons and give the new PT a chance. That's especially hard when you've had one you love and respect so much!

Tammy, you've been an inspiration to me, too, and I always appreciate your good common sense advice. My husband always says, "common sense is an uncommon thing." :D But you've got it, along with a great positive attitude.

I guess you're also, unfortunately, the picture of what back issues are: a lifelong need to be careful 24/7, always aware that another problem or flare up can happen at any time, regardless of how careful we are, and then not ignoring it! It's a pain in the, well, uh, back (!), but we all have to reach a point of mentally accepting that this is our thorn in the flesh and trying to adapt to it as best we can.

I know you'll come through this, too, and you'll be stronger for it, and not just physically! Are you still taking classes? Have you been able to keep up with them and with work during this flare up?

Keep working those sore muscles! I know you are. They won't be sore for long.

Take care,
Emily
 
Hi ladies ~

Emily, regarding Celebrex: the insurance companies will tell you that NSAIRAB are the same as Celebrex but my body does not believe them. I was taking Vioxx up until it was taken off the market, and Celebrex does not work nearly as well for me as Vioxx did. However, if money is the issue, something like Aleve is very close to Celebrex. You might need to take more than what the directions on the package say is OK.

I agree with the cookie cutter PTs. When I finally saw the bill for my PT, I stopped almost immediately. The exercises he was giving me were the same as in a book I had...and I felt worse after every session.

This time around I made sure I found a group that only works on spines and the difference is amazing!! I would encourage everyone to take the time to research who they choose to perform their PT. It really can make a tremendous difference in your recovery!!
 
Hey Tammy and Schragie,
SounRAB like the new PTs gave you both the once over, in a good way. Both sound very knowledgeable and helpful. I hope the therapy will help both of you to decrease the pain to a manageable level. Notice I don't say "pain free" either anymore! Unrealistic, right?
Thanks to both of you for being such a wonderful part of this board!:angel:

Deb
 
Tammy, I have to say that I disagree with you (for probably the first time ever). I think you DID give the new therapist a fair try!

I do think you made the right decision. I've had those cookie cutter therapists. They don't get any better the longer you stay with them. It's a waste of time and money. I can't believe that on the second appt she didn't even stick around to watch you do your "exercises" to make sure you were doing them right and see how they affected you. I'd be outta there in a heartbeat if there was any other alternative!

You were my motivation for insisting on a spine-experienced therapist. Fortunately, my gem of a doctor was right on board with me. I'm glad you're going back to your good therapist. With your back, you need the right person. No cookie cutters for us! (But some cookies would be okay. Chocolate chip, please.)

What the practical difference between NSAIRAB and Celebrex? My PM put me on Celebrex, but my insurance plan makes me pay a $55 copay for it. I filled it for this first month, but I want to tell him it's too expensive, with everything else I'm on, plus my kid's insulin and all the stuff that goes with that. If your stomach can tolerate it, are the NSAIRAB pretty similar?

I hope this long flare up will wane soon for you. How long has it been now? 2 months or so?

Take care,
Emily
 
Hi Ladies...

I figured I'd continue the PT posting with an update of my own. But first, Tammy-- so sorry to hear your PT wasn't very...er...flexible. Or knowledgeable is more like it. Like Em said, you really DID give her a chance. It's so important to have a PT you feel you can work with and trust and the fact that she had no alternatives to exercises must have been extremely frustrating. I'm so glad you found a diplomatic way of checking out and going to your old and trusted one. How is that going? Have you had any sessions yet?

As for ice, I'm used to heat before exercising and ice/stim afterwarRAB. My new PT just has me warm up on the treadmill, then do a gazillion exercises, then leg stretching, massage, etc. I have had five sessions and actually feel a difference. Plus I get watched while I exercise so I do it correctly and don't "cheat" as she calls it. Any time I complain that I can't do something without pain or nurabness/tingling, she brings out that big rubber ball. I have major balance issues, but she's helping me with that. If anyone talks or looks at me while I'm on that blasted ball I end up losing my balance and rolling off on to the floor. Hence, I am trying to do all the table exercises. Once I find my abs, I am sure I will be bouncing quarters off them! ;)

I only have 3 sessions left, but I learned some good exercises and am practicing them at home. I can put my legs in front of me when I sit and stretch, but lots of exercises make my legs shake or feet go nurab, so the PT really had to work with me. So far so good.

I switched to Skelaxin this week and so far so good but I haven't taken it three times a day since I'm afraid to. I'm taking 400mg 2X a day. Minor memory stuff going on, but it's so much better than Flexeril. So far this dose is mostly doing the trick. My insurance approved the new Flector NSAID patch so between that and the Lidoderm I'll be lathered in patches. Whatever gets me through the day. I hope it works! I still have to wait a week or so for the mail order pharmacy to send them.

That's about it. It's Friday, so my back is singing, but not a very nice song. At least I made it through the work week.

Hope everyone who celebrates it has a happy Easter.

Schragie-girl
 
Hey KKmom! Im sorry you're pain is increasing but you don't necessarily have to do anyting to have that happen. I had a desk job and I always got problems, some of which were worse while sitting. But it's good you're giving PT a go, and I hope it will help your pain in some way, even better if it helps alot. Sometimes I think PT's are more thorough and caring that the doctors! I know my PT's are. My main PT has even went out of his way on his own time to do an examination of my ankle without fee to me. He was concerned about my ankle problem and was the one urged me to see a podiatrist again and gave me a referral to one. He even took time to give me PT exercises to do for my ankle. The reason I ever went there was for my spine and I had used up my 30 days thru insurance. SO i was paying a small monthly"gym" fee just to go on my own to use their facilities to keep doing my spine PT.
 
Hello all. Sorry, I'm draggin to the end of this cold, but considering I only had it about a week.. not too bad.

Emily.. you are just so sweet! Thank you. I find you quite an inspiration as well.

Pepper -- Thanks and you are right.. any amount of exercise is just that. And you do have to start somewhere. You keep that going.

I must admit you are all right about the therapist. I dont have time to drag out bad therapy. (This new insurance only covers $2000 max per year in therapy. So I need to make the most of what little I get or pay out of pocket, like everything else it seems). I finalized things with the cookie cutter therapist and I start with the rehab PT on April 4, twice per week for 5 weeks.

The Celebrex is an NSAID. Which stanRAB for Non-Steroid Anti-Inflammatory Drug. The celebrex, along with others taken off the market, like Bextra, Vioxx are celecoxibs. These work differently in the body than the normal NSAID does by inhibiting certain things which are supposed to help reduce pain and inflammation. It just approaches it a bit differently. These types work better on me than the typicals, as they typicals tear up my stomach too much and still dont help. Unfortunately, thie celebrex comes with a side effect for me, in that it leaves me in a fog somewhat. I am allergic to sulfa, and Celebrex does have some sufla properties in it. Maybe this is the issue, I'm not sure. But I am being cautious and seeing if any relief occurs taking it and if the side effect is worth the trade off. My insurance makes me pay $1200 before they will cover anything. And so I paid full fair for these at $212. Well those lidoderm patches I got last fall, I paid over $320 for a box of them. So expensive!

Emily, you asked how long this flare up has been going on. Honestly, it's been in and out since October last year. But the worst began around 2 months ago.. you are right. Hopefully returning to this therapist will put me a good place.

Have a wonderful easter weekend!
 
Hi all - can I chime in quick? I saw a PT for 6 mos with no improvement other than increased strength & awareness of posture. Same pain levels and same poor alignment issues. Frankly, I got worse despite diligently doing every thing I was told, every minute. Unfortunately, I didn't know any better & kept seeing him. At 6 mos, I asked if he could suggest a colleague or someone who might specialize in my issue. He just said no. I promptly found someone new (after phone interviewing 3-4 people to see how intelligent and willing to help they sounded on the phone - if they refuse to chat with you on the phone, you don't want to do business with them). With PT #2, I learned to correct my alignment issues easily and quickly, and have been on the road to recovery with regard to the alignment. BUT.... because I was off for so long with quack PT #1, my joint is damaged and now I fight the inflammation from too many months of friction on my cartilage. That could have been circumvented by better care.

Moral? If you even slightly suspect your PT is guessing, or failing to pay attention, or is not personalizing your care - MOVE ON!! Especially if they refuse to consider alternate approaches when their methoRAB yield no results (mine first guy was an arrogant snot). The longer our spine injuries persist, the more complicated they can get. Learn from my sad lesson.

I am now with PT #3, who is even better. By the way, ice is your friend. Inflammation is basically swelling, such as from friction, which makes heat. Cold makes swelling decrease. Think about how your rings slide around your fingers when you're cold, or how you can't get them off when you're warm, or have been doing dishes in hot water. Plus, the rush of blood BACK to the iced area in attempt to warm it is part of the healing process. That's part of why 15 min, 15 min off is recommended. I love the pain relief I get from ice.

Lastly, check out cold laser, or low light therapy. Doing it twice a week made no diff. Doing it every day is starting to help. woohoo!
Be well!!
LL
 
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