Showing posts with label hip joint pain. Show all posts
Showing posts with label hip joint pain. Show all posts
1.19.2012
Physical Therapy & Finding the Balance with Ankylosing Spondylitis
Several months ago I wrote a blog post outlining my current condition with my hips and walking. My post ended with a declaration that I would keep fighting to find the balance. I've been meaning to write a follow up to that post, to tell you what's happened since then and what I know now that I didn't know then.
In that post, I had a lot of questions. I wanted to walk outdoors for exercise and to help my joints. I discovered very quickly that didn't help, but caused a spike in pain, fever and limping. I had a lot of questions about the condition of my hip joints and at that time was dreaming frequently about limping, hip replacement surgery, and treatment options for Ankylosing Spondylitis, the form of inflammatory, autoimmune arthritis I have that attacks my spine and joints.
I wanted to know if my hip joints were damaged.
I wanted to know if I pushed through the flare ups caused by walking, if I was damaging my joints or helping them.
I wanted to know what might be in my future, as far as mobility. Would I need a cane or wheelchair, would I need hip replacement surgery?
Since that post, I have had a CT scan of my pelvis and hips, a physical therapy evaluation, and 3.5 months of weekly (sometimes twice weekly) physical therapy. I have some answers and insights now, and the dreams about hip replacements have stopped.
I learned from my scan results that my hip joints are still in good condition and that my SI (or sacroiliac) joints (the joints that connect your hip joints to your lumbar spine) are showing damage.
I learned from my physical therapy evaluation that my SI joints were extremely unstable. I was walking very sloppily, my joints too loose in their sockets.
I learned that my hypermobility (fancy word for joints that are way too flexible) on its own would eventually cause problems, but paired with Ankylosing Spondylitis will increase and speed up the damage to my joints.
I learned that with the level of inflammation in my body, any extra walking (especially if I am already in a flare, having hip pain or limping) is not advised and will damage my joints.
This was and continues to be, very helpful information for me. I began to work hard in PT to strengthen the muscles that surround and support my joints. I worked to improve my posture so that if my spine fuses into a locked position, I will be less likely to fuse stooped over. I did exercises at home. I faithfully went to my PT appointments in all kinds of weather, limping or not, with a fever or not, exhausted or well, to tell the truth, I'm almost always exhausted.
I strengthened my muscles. I improved the stability of my joints. I improved my posture (but I'm still working on that and likely will be for the rest of my life). I had evaluations of my shoulders, spine, chest bones.
I 'graduated' from physical therapy about a week ago. I adored my therapist and will miss her.
So how am I now? I still limp sometimes, but when I walk more than usual (say at a mall or Costco), I am less likely to be limping or limping as dramatically afterward. I still have hip pain, but I have less sleep disturbance due to hip pain. My hips, which had referred pain from my SI joints, and pain from inflammation in the actual hip joint, are causing me less worry. You can no longer find me Googling "Hip Replacement Surgery."
I still have pain in pretty much every joint in my body -- from my jaw to my toes. I still limp sometimes. I have spine pain every day. If I use too much energy, walk too much, or am on my feet for too long, I pay for it. I still run low-grade fevers fairly often, especially when I am in a flare, or have been pushing too hard.
I cannot walk for exercise, as much as I crave my old routine.
The ideal forms of exercise for me are low, to no, impact. That means mild exercise in the water, home physical therapy program designed specifically for me, etc. I cannot and/or should not walk much, run, jump, skip, hop, play most sports.
I can deal with most of that, but I gotta tell ya -- I MISS WALKING.
If you can walk, will you do me favor? Will you go for a walk sometime in the next week or two for me and take a picture of yourself? Will you post it in a blog post and link up in the comments of this post, or post it to the Live Art.fully Facebook page? Will you breathe deeply and look for things like birds, sunsets or sunrises, black tree silhouettes against sky, clouds, or natural bodies of water? Will you take a picture of any beauty you find? Will you enjoy your walk for me? I would love to hear about your walk through beauty.
So where do I go from here? I keep doing my home exercises, I keep working on my posture {STAND TALL!}, I breathe deeply to expand my chest and rib cage regularly to hopefully prevent that from fusing. I try and listen to my therapist and work on energy conservation and resting and asking for help and accepting help.
And maybe, when spring comes, I will swallow my pride and get a wheelchair and let my family take me on their walks. Someday my disease process may run its course and allow me to walk as much as I want again. I am hopeful for that. But for now, in order to take care of my body the way it is currently, I will try not to damage it further by causing it extra wear and tear.
I will live with hope. I will watch my daughters learn the graceful art of ballet. I will stand tall. I will breathe deeply and keep smiling, because life is beautiful and every moment is a gift. And yes, as always, I will keep fighting to find the balance.
6.19.2011
Finding the Balance with Chronic Disease
It can get discouraging -- the spectrum of pain and ability (or dis-ability) my health can span in a single day. Yesterday, despite raging back pain, I was able to dress nicely and go to church, chat with friends and draw encouragement from church members who took the time to thank me for my writing and even a family friend / deacon who always notices when I make it to church, and as he is aware of the challenges of my disease, will say to me affirmingly, "Nice to see you vertical!"
It is truly amazing sometimes, the amount of pain I can be in and still appear "normal." Ankylosing Spondylitis, especially if the patient does not use a walker, cane, or wheelchair to get around, and is not yet fused into a curved, stooped position, is truly an invisible illness. I look normal, but inside inflammation rages through my spine and joints and I experience the pain others can't see.
One normal day for others is like a marathon for me. I am so tired and being out and about tires me with systematic efficiency -- draining me of energy and pumping up my pain levels. Something as routine and simple for most people as grocery shopping, can leave me too exhausted to speak, feverish, and in severe pain.
It's really frustrating that people can't understand. It's awful to think that people around me may think I am making this up, faking it, or that my pain is really just some mild aching.
Pre-diagnosis, I enjoyed an outdoor walking routine. Never one to enjoy exercise or athletics, I discovered walking offered many positive benefits: increased energy, decreased stress and anxiety, improved posture. I loved my "artful walks" -- enjoying the skyline, backdrop of pastel sunsets to black tree silhouettes, music in my ears thanks to my MP3 player, fresh air, and the scent of laundry detergent from neighbors doing their laundry. Sometimes I paused to capture one of these images with a camera, or to jot down a snippet of a sentence in a notebook. Inspiration was all around.
I became unable to continue my walks about a year ago -- three months before I was diagnosed. The walks caused a spike in the pain and limping, and elevated my low-grade fevers.
This week I determined to try again. According to Arthritis Today magazine, walking is an excellent form of exercise for arthritis. Walking lubricates the joints, releases pain-fighting chemicals... It sounded great to me.
The first day I walked 1.5 miles, divided into two walks.
It was wonderful! I was back to my old routine. The beautiful afternoon or pre-sunset skies, the fresh air, the drifting laundry scent hovering in my neighborhood right along with a very real sense of hope. I was strong, I would prevail, and I would show Ankylosing Spondylitis who was in control!
The next day I went out again for another 0.75 miles. Not that far. The walk increased my spinal pain, and by the end I had knee and hip soreness. Oh well, I mused, I was strong and I would walk through it and soon I would be better.
By the end of the next day I could barely gimp through my tiny house, my hip on fire with inflammation, the ligaments and muscles that support the joint feeling pulled and bruised.
My spirits and hope sank.
What if I wouldn't be able to reclaim my walks? What if walking for exercise aggravated my hip joints to the point that it claimed the ability to walk even the small bits I need to maintain my life? I just don't know what the future holds for me with this disease. I don't know if I may be one who needs to have hip replacement surgery, or ends up in a wheelchair.
I'm 32 years old. I'm not prepared to choose a cane or use a wheelchair for trips to the zoo or the mall.
It's a very isolating sense of worry; a very isolating pain. I thank everyone in my life who takes me at my word when I say I am exhausted or in severe pain, even when I "look normal" and am smiling.
So while I take a day or two off from my walking and turn to research to try to find the answers to my questions, I cast out the proverbial net and pull in my thrashing, fighting hope, and know that tomorrow may be better than today.
I will keep fighting to find the balance.
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