The Gurly Life

Bare assed like a monkey

Sigh.

Yes, I'm talking about me. You may recall my shameful and detailed experience at the doctor's office over a decade ago for a sigmoidoscopy. It appears that karma has chosen for me to be bare-assed when I have something medical going on, and there are interns or students to be educated. I assume in a past life I was an ass to interns and students, or called students and interns asses, or I was just a harasser and would smack them on the ass, I don't know. Your guess is as good as mine.

Today I had PT for my hip. It's still going on, but the hip is improving, slowly, but improving, so this is a good thing. One of the issues that I'm having is that all the muscles starting from my lumbar spine through my SI joint, ass, hip and thigh tend to bunch up and get really tight. This slows down the healing. No, this prevents the healing.

The last couple of sessions have involved some very serious deep PT to unclench all the clenchiness. Did I mention that the muscles that bunch up and tighten include the ass muscles? I think you know where this is going, but I'm going to say it anyway. Part of today's PT involved unclenching my ass muscles. This required at least one of my butt cheeks to be fully exposed, oiled up, and dug into with enthusiasm. I dare not imagine the visual.

However, Johnny, the really cute intern who was observing our session, did not need to imagine the visual, as he was privy to the whole spectacle from his seat in the very front row. Well, at least he didn't get a seat and had to remain standing, which was sufficiently respectful to my ass. Come to think of it, all those med students at the sigmoidoscopy remained standing as well.

All rise, the Honorable Assy McButtersons presiding.

The proof is in the pudding

Did you know that the original version of that phrase was, the proof of the pudding is in the eating? The phrase appears to date to the 1600's, but may have been used as early as the 14th century. (From here.) But I digress.

What pudding, you may ask?

Recently, I went to a new physical therapist, who thought that perhaps my hip problem was not due to what the doctors think it might be, i.e., a labral tear, but rather something else. In addition to what she noticed during my evaluation, she thinks that my femurs are basically popping out of their sockets, so much so you can actually feel the head of the femur if I put my palm on my the front of my hip joint. What I did, too, was take notes between the first and second appointment, describing what kind of pain and discomfort I was experiencing doing what, which was helpful. I'm such a good little patient!

I got a few more exercises to do since then, which I have been doing since I'm a good little patient, and they seem to be helping. Today I went to the farmers' market, which is usually torture because walking slowly is very painful very fast, and I had very little pain.

The PT will be happy to hear it.

A major challenge to the ego

Really, this should be a post about the wonders of modern technology. To wit:

Today I had my second PT appointment. It was hard work but excellent. My hips are coming out of their sockets and I'm knock-kneed. No wonder running caused me some problems. What I have to teach my body to do now is to suck my femurs into their sockets and points my kneecaps forward instead of towards each other. Easy peasy. We worked on some yoga poses, but more like modifications, and ways to do the above.

Here's where the awesome technology comes into it. The PT used my trusty iPhone to video me doing the exercises while she explained what I'm supposed to do. This way I can run the video while I do the exercises and not miss anything. The great thing about this is that she can give me a lot of info in a short time and I can see what I did and replicate it.

The less great thing is watching myself on video. It's a combination of "Ew! My feet are fat - how does anyone have fat feet??" "Oh look, kankles," "Oh no, not kankles because my calves are so fat that they unkankle my ankles - thank goodness for small mercies," "Well, ok, my ass looks good," "Really, overall I look pretty good maybe that weight training is working a bit," "Oh god does my knee really look pudgy like that when I bend my leg?" "Well I guess that's not so bad," "When am I going to lose the baby fat?" And by baby fat I don't mean baby weight, I mean baby fat. "My feet look like barges," and "I look great!"

In retrospect, I'm not sure that getting my eyesight fixed with lasers was the best idea ever. On the plus side, I watched part of one of them after the session was over and I think I ran every red light between PT and the gym -- I couldn't get there fast enough. If you're having trouble getting motivated to go work out, just video yourself doing daily tasks, it's likely to work. Well, maybe if you're a woman it will work, not sure if you're a guy.

If you have an interest in PT and hip issues, feel free to watch. If not, I don't recommend them -- ultimately, they're really boring. Also, don't watch them just to watch me, it's creepy.

I didn't break!

About a month ago I made some late new year's resolutions, something about losing some weight (that's not happening, I mean, who are we kidding?) and doing some weight training to regain lost muscle (that's happening). I have been going to the gym once a week, so it's not exactly a huge commitment. I figured, I do so many things for my health and well-being, what's another hour? Generally, I go on Friday nights. Behold, last night I was there for about 90 minutes, and could have done more.

I have a lackadaisical attitude: I decide I'm going to focus on a group of muscles more or less, like, say, upper body, and then I do mostly upper body stuff. But I just flit from machine to machine, whatever's available, whatever I feel like doing. I read the instructions on the machine very carefully to make sure I'm using it properly, I use low weights and I do a lot of repetitions. I'm very careful. Yes, I do 20 minutes of cardio before to warm up.

When I started, the next day I was sore and during I thought I was going to tear and break. I didn't. Last night I felt a little of my old strength back. It was a great relief.

 

Good news on the hip front - maybe

Since 2007, I have had problems with my hips. First, it was the left hip. I was a runner - not a very good runner, by any account, but a runner. I loved running. Running is a bang-for-your-buck form of exercise. You run 30 minutes, 3 times a week, and your body changes. I was on my way to having a great body, for once in my life. I'm not bitter, but I do digress.

Anyway. Bang. Buck. Right. Running was a very economical way to stay in great shape physically and mentally. Ask any runner. Then, in April of 2007, my left hip started hurting. Within a month and a half, I couldn't sleep except on my back and stuffed to the gills with Advil. I have many, many posts that deal with this, so the short version is that I was diagnosed with a femeroacetabular impingement and labral tear (they often go together, like cherries, only less delicious). On top of it, I also had hip bursitis. Yes, it was HUGE fun.

Blah blah blah, surgery (involving removing bits of loose labrum and shaving of extra femur, and learning that (a) bones bleed, and (b) that I'm not a bleeder), long-ass recovery (including some sacroiliac joint funny business), and voila, left hip good as new. Steady, strong, no pain. Huzzah!

Finally, in the summer of 2010, I noticed that my left hip no longer hurt, my SI joint was doing fine, and I thought, Ooh, maybe I'll try a tiny bit of running. And literally that week, my right hip started huring. Oh joy. Why has it taken so much longer down this road than the other hip? In part because it hasn't hurt very much, and the pain was intermittent. But a few months ago, things got worse, so finally I had to do something. I tried some PT, which made it worse still, so I stopped. I went back to my ortho, who gave me a tentative diagnosis of a labral tear. Greeaaat!

Why do I go into all this detail of what has gone before, you say? You, dear reader, probably know everything there is to know about my hip(s). But, I never assume that you remember it all, nor should you. It's my hip, you should not be required to remember my medical history. Besides, why would you, I repeat it in EVERY DAMN POST like my life depends on it.

There has been, however, a major difference between the pain in the left hip and the pain in the right: any weight bearing exercise would cause excruciating pain in my left hip, even a few minutes of walking was unbearable. The right hip does generally better with exercise. BIG DIFFERENCE, PEOPLE. BIG!

However, the PT guy told me labral tear/impingement, the ortho told me probably same thing, so who am I to say? What I forget is that I'm with my body 24/7, the doctor only sees me for a very short time out of my whole life. Which makes me a lot more responsible for my health than I like to admit.

So, panic panic panic, and my mom is leafing through the December issue of Yoga Journal, where they list practitioners, therapists etc. She spots several that might be useful to me, and I narrow it down to one, a physical therapist with a lot of letters after her name, who specializes in yoga asanas. OHMYGOD HOW PERFECT IS THAT?

Today I had my evaluation. Not cheap, by the way, and not covered by my insurance. But, if you make it through this whole post you will see that it would be a bargain at 10 times the price. The short(ish) version (oh, now I decide to be brief(ish)!) is as follows:

• My right leg is longer than my left [not news], but it does not appear that it's the leg itself, it appears that my pelvis is inverted [news!]. Or something. It tilts forward, and sits higher than the left. This also hitches up the back of my pelvis/hip, which then pokes my hamstrings at the top of my thigh, irritating said hamstrings/sciatic nerve. [As an aside, over a decade ago I had PT on my right hip because I was experiencing pain in the front of the hip. They figured out that either my quad or psoas or sartoris (they weren't sure which) was too tight, while my skeletal alignment/proportions were perfect. So, maybe this is the chickens coming home to roost with the muscle tightness - keep reading, you'll see what I mean.]
• Grinding my femur into the socket causes no discomfort or pain, it actually feels quite nice.
• My psoas muscle is the tightest she's ever felt. I repeat: my psoas muscle is super duper tight. I WIN!
• So, one possible source of the hip inbalance is this muscle yanking my pelvis right out of alignment. Maybe the pelvis went out, and the muscle tightened as a result, but it can't go back now the the muscle is tight. Point is, muscle is super tight, not good.
• The bad hip alignment, if left untreated, could over time cause spinal damage, like scoliosis. Did anyone say spinal damage?? [That actually sounds waaay worse than root canal, the classic metaphor for very unpleasant things. Avoiding spinal damage makes this whole thing a bargain at 10 times the price. I think spinal damage would be really, truly unpleasant. I don't want that. Nah-uh.]
• My muscle muscles are very strong, but my stabilizing muscles (small little muscles) are not really firing, most likely, so the hip is not sitting neutrally in the socket. Hence, problem.
• And, last but not least, it may not be a labral tear. Apparently, none of the major symptoms are present. [This would mean no nasty surgery.]

So, that's that. We are going to try a mix of PT and yoga adjustments so that yoga doesn't make the problem worse instead of better, and see what happens. If it turns out that it is not a labral tear, and I do not need to worry about having surgery, then you can just call me Dr. House. The less arrogant version of that is that I'm aware of my body. I will keep you posted, whether you like it or not, it seems.

Keep your fingers crossed.

The gym

I recently decided to take up weight training. Don't get excited, I won't be going more than once a week. However, since I am obviously the weakest link in that weight room, I thought I might show you what it's like by a Pictorial Representation.

Finally, a new year's resolution I'm not likely to stick to!

Have you ever made a new year's resolution that you didn't stick to? Perhaps I should rephrase that: have you ever made a new year's resolution that you still remembered when the hangover passed? Yeah, me neither. And I don't even drink.

Unfulfilled new year's resolutions inevitably lead to either shame or cynicism. Shame because you can't stick to them and what kind of person are you that you can't even stay on a diet for longer than 48 hours. Or cynisim, because why bother with new year's resolutions when you're just not strong enough to stick to a diet for longer than 48 hours.

Let's face it: losing weight and getting in shape is really the only new year's resolution that we, doughy first-world mollycoddles ever make. For example: this year, I'm going to lose weight and get in shape. Or: this year, I'm going to meet the love of my life, because I will be in shape and thin by February. Or: this year I will get promoted and I will be a fit, thin boss. Or: this year I will travel around the world, and as a result I will be fit and thin. Or: this year I will lose a bunch of weight so I can go to Paris for a week and eat my own weight in food and still fit in an airplane seat. Or: this year I will travel to India to take care of the orphans and while there I will get dysentery, which will suck but on the plus side I will be super thin. Anyway, you get the gist.

If you're a big fat liar, like me, you'll say something like, oh I just want to be healthy and feel good, when what you really mean is I would like to lose a little weight and look hot, but if I fail, I don't want to be held accountable because I'm healthy, and that was my goal, that's why I said it that way.

Inevitably, we are broadsided by a chocolate cake, and that's that.

My solution: make resolutions that I am not likely to follow through on. I know, this might at first glance appear to be a cynical approach to resolutions, but bear with me. This is a win-win kind of deal. No, it's a win-win-win kind of deal. Here's my resolution:

I'm going to get in better shape than I already am so that I can look good in a bikini in April, when I go to Maui with Willow and Adam. This is also a good idea because I need to replace some of the muscle I have lost since I stopped running.

(You heard me: we're going to Hawaii. Jealous much? Don't get sidetracked.)

The likelihood of this happening is almost zero. I hate the gym, this is well known. Weight training tends to give me super chunky thighs, with no apparent decrease in cellulitic fat. So just as soon as I begin to notice an uptick in thigh meatiness, I will give up the weight training and decide to focus on cardio. Which I hate even more. I cannot make peace with being on a machine that simulates movement but that is indoors and where I can cover a distance of virtual miles without ever moving. It's nightmarish to me. So, that will fall by the wayside, also.

Where is the win-win-win, you ask? Well, here it is. If I fail, I win, because I made a resolution that I don't really intend to fulfill. If by some miracle (i.e., just to be contrary) I manage to stick with it, I win too because I will have built muscle, maybe lost some fat, and now look better in a bikini -- that's all kinds of win right there. And either way, I win because I feel zero pressure to actually stick with it, which actually makes it more likely that I will.

I should be a motivational speaker.

The definition of insanity

Doing the same thing over and over again, expecting a different result.

So simple. If only we could stop doing all the things we do over and over again so as to get a different result, instead of just doing the same things harder and louder and more emphatically.

To wit: are you the kind of person who pushes through when you are sick? Are you one of those people who refuses to kow tow to being sick or in pain or in poor health because you have more important things to do? At this point in human evolution, I think most of us are to some degree. We rarely have a choice. I mean, yes, we have a choice, but the options simply aren't very appetizing.

I am one of these people. Or rather, I used to be. Or rather, I've been trying to learn this lesson for years now. It all started with the infamous left hip. If you're new to this blog (what? I have a seventh reader?), the short version is lots of debilitating pain for several months, hip surgery, and more months of pain -- don't let anyone tell you hip surgery is easy to recover from -- and a major lifestyle shift. Major.

The lifstyle shift consisted in putting the integrity back into my health. Another simple concept, and so tough to do. Putting my health before all the other stuff and other people in my life was, and continues to be, a challenge. After all, if I don't do this thing now, when will I do it? I have a meeting here, a thing to finish there, a yoga class today, a hike tomorrow, a date next week, a friend coming in from out of town the following weekend. I miss all of that, and I'm behind, and that's not acceptable.

I partially learned my lesson with the hip problem - I ignored it for months, kept running and doing all the things I wanted to do, just refusing to acknowledge that something had to give. But the lesson is never fully learned. In May of last year, I caught a cold. The cold lowered into my lungs, and became bronchitis. I spent half my vacation on antibiotics and coughing half the night. One night I didn't sleep at all because I couldn't stop coughing. Not as restful as it sounds, by the way.

At the time, I did not have a lot of options, I could not simply stay home and rest. It was also a very stressful time. But I did learn another layer of the lesson. The first layer, don't set things up for myself so that I end up jammed and stressed. Easier said than done, by the way, it's hard to curb my enthusiasm. The next layer: REST WHEN I HAVE A COLD. That one is mostly for me because I have a tendency to get persistent, long-lasting coughs. I also tend not to dress warmly enough. I decide to wear cute pumps to the office and somehow forget that my office is cold most of the time and wearing no socks in there is just suicidal. Then I go to yoga. Or go for a walk in the evening when it's chilly and damp. You know, I didn't realize how stupid I've always been about this until just now, as I write this out and realize that asinine behavior unsurprisingly leads to poor results.

This time I didn't do any of that. I overdressed (sweated more than usual as a result, but I think that was ok), I stayed home even though all I had was a cold, I didn't go to yoga, I didn't go for evening walks, I went to bed early and avoided the alarm clock on days I could. I kept an eye of on the small number of things that had to get done during the week, and everything else, well, some of it got done, some did not. I slept a lot.

As an aside, I think that Nyquil might actually make things worse. I always take it because I think sleep is important in order to get over a cold, but every single time I've had a cold and took Nyquil, I got a cough. I took it the first night, and the next morning felt like I was going to die. I haven't taken it since, and I slept better and felt much more refreshed the next day. Koinkidink? Possibly.

Result: my cold raged for two days, then it started to die down. By Saturday morning I could go to yoga, and by Saturday night it was gone. I still cancelled most of my weekend plans and got plenty of sleep and rest, and avoided any kind of stress. I even cut short a mild hike because it was colder than anticipated.

It was extremely difficult not to do many of the things that I wanted (or felt I should) do. But the cold never got into my lungs. And since next weekend I will be in Cambria with my awesome friend Michelle, and I want to enjoy our time sick-free, it was worth it. I have to admit though that this whole week I felt wimpy and weak, how nobody likes a complainer, how a cold is not really being sick what about all the people with real illnesses and cancer?, and had to consciously push those thoughts aside to take care of myself.

I did something different, and got a different result. I can now say I had a moment of sanity.

I'm a sissy, not to mention completely inadequate

Sigh.

So last Monday, I went to the ortho for a diagnosis on for the pain in my right hip, which is bothersome but not debilitating. One thing you should know, which I didn't really know until I went, is that when you go to the ortho, it's because you want surgery. If you don't want surgery, you're basically wasting their time. His time. Yes, it could be her time, but I've yet to meet a woman ortho. I know they're out there, I just haven't met any yet.

Anyway, so I went to see the ortho. Same doctor who fixed my left hip. He did a great job, by the way, this is a top-notch doctor who specializes in hips, so the right person for the job, if there's a hip job to be done. So this is all in the context of going to a great doctor. Even still, the whole experience was a bit surreal.

Naturally, since I decided to get the referral, my hip has more or less stopped hurting. That's always the way, isn't it? I also remind you that I do yoga. I'm not as limber as most of my yoga colleagues, but I am more limber than most normal humans. So when the doc put me on the little bed and started moving my leg around the hip socket to see where it would hurt, it didn't. At all. I had mild discomfort. I tried to tell him that when I do forward bends sometimes my sciatic nerve gets irritated, and that exercise tends to help rather than hurt. He was rather unimpressed.

He sent me down the hall to get more x-rays.

When I returned he told me my exam is boring and that if he did surgery he wouldn't need to shave my femur this time because it's at 53% and he doesn't do it unless it's at least 60% (of what?? who the hell knows, all I heard was NO SHAVING OF THE FEMUR, who gives a shit why!), but that maybe I don't need surgery, do I want surgery? It really depends on how much this bothers you, he said, it may actually be more painful for a while after surgery until it heals fully like the other one, even assuming you need surgery, which you might not. In all this, I was all, I really just want a diagnosis right now, it's a bit premature to even think about surgery, no?

When I asked what he meant by boring, he told me that usually people when they come to see him can hardly move and they've been in excruciating pain for months.

Eh hem. So, I'm a sissy and furthermore, inadequate. I had this crazy urge to blurt out, NO I WANT THE SURGERY DAMN IT JUST CUT ME OPEN! but the memory of the unpleasantness stopped me. I did lose my nerve a little and assured him that it WOULD get worse and I would come back for surgery then. I know, I know, whaddaya want, I caved under pressure -- the guys' tall and handsome and I had that crazy girl instinct to please him at all costs!

The sad thing is that I was certain that he would be at least mildly impressed by the fact that my hips are not tight like most people's. He was neither impressed nor amused. If anything, he just looked ... helpless.

The bottom line is that it's almost certainly the same thing I had on the other side, a femeroacetabular impingement. Booyah! Love. It. If you don't know what it is, Google it. I'm tired of looking it up.

I think in the end I stymied the doc's efforts. He said he felt bad because he couldn't really do anything for me. I guess orthos are compulsive problem fixers, like cops and firefighters, so my lame little pain and insistence that I did not want surgery did not allow him to really do what he does. So, in a last desperate move, he gave me a script for prescription strength ibuprofen. I told him that he did help, it's easier to manage it now that I know what it is. I don't think that made him feel any better. I am consoled (sort of) by the knowledge that the next person who sees him will be in severe pain and that he will be able to help them.

An ounce of prevention...

... had damn well better be worth a pound of cure. It sounds like fuzzy math to me, but I guess this is not really about math.

As you may or may not know, literally one month after my left hip finally healed from surgery, my right hip started giving me problems. This was August of 2010. Man, how time flies. I won't bore you with the details, so here are the details: it hurts. More or less, depending on how much time I spend sitting on a chair, and interestingly, how stressed or confronted I am. What is also interesting, and different from the left hip, is that generally speaking more exercise means less pain overall.

I did PT a few months ago, which made it worse. So I naturally stopped doing the exercises. I know my body enough to know when something is not working.

I am constantly modifying my behavior and what I wear (mostly what shoes I wear, but uncomfortable clothing will make it hurt, too - go figure!) based on whether I have pain, how much walking I will need to do and the concomitant pain I anticipate as a result of that walking. I compensate a lot.

As far as aches and pains go, it is not major. It is firmly in the "first world problems" category. However, my attitude has always been that if I just accept the aches and pains and chalk them up to "I'm getting old," then I can pretty much look forward to another 60 years or so of "getting old" and having pain, given my life expectancy. I am not exaggerating, my grandmother is 105. This business of being old for the next 60 years strikes me as complete and utter bullshit. You can be getting old if you like, leave me out of it. Thusly, I intend to solve my right hip problems. Without surgery, thank you very much.

Today I got myself a referral to the ortho center. I think at this point I want to know what is going on. A diagnosis would at least give me a sense of what it is that I need to do to address this.