Praise then darkness, and creation unfinished

I saw the physical therapist today, and she gave me one new exercise (a variant on what I've already been doing), had me do a few things that I can't do at home, and then said that we're basically done, go home and keep doing these. Ideally all of them once a day indefinitely, but I suspect (from knowing me, and experience with other PT) that I'll probably decrease that to every other day, or less, but not right away.

The therapist is discharging my file [sic], meaning that if I need to return in a few months, I'll have to get a new prescription from my doctor.

I'm glad the therapist thinks I'm doing well enough that we can stop here, and this gets me back a few hours a week, plus the co-pay and transit fares, but my balance, while definitely improved after these few months of PT, still isn't as good as it once was.

Physical therapy went OK today. The therapist taught me a new exercise that should strengthen my hips, with the hope of both reducing pain and improving my balance, and sent me home with a piece of resistance band to use for that exercise. We also did some of the exercises from last week, but not all of them.

At the end of the session I asked about making more appointments, after the one I already had (for next week), and was surprised when the therapist said I probably won't need any more, because "those are the exercises." I did make one more, for the following week, because I can cancel the appointment if I don't need it, and this way I know I have an appointment at a time that works for me.

I'm trying to think of this as meaning I'm almost at my goal, but I'd thought there was more room for improvement, even given the underlying neurological problem.

I had physical therapy this afternoon, which went well. The therapist said I have made enough progress that I can stop doing the exercises whose purpose is to improve my awareness of the position of my body and especially my limbs. That's six exercises, out of the nine I was doing a couple of days ago.

I'm also going to start doing all my exercises standing up instead of in a chair, with something nearby to hold onto if necessary (a counter or the back of a chair). The therapist told me to start setting a timer for those, so I don't have to think about when to stop.

The new thing this week is standing still with my eyes closed for 20-30 seconds. The therapist emphasized I should start with my eyes open, and close them only once I'm feeling basically steady. So, stand with my eyes closed, then open them and rest a moment, repeat 3-5 times, once or twice a day.

I had my first appointment with the physical therapist specifically for balance today.

Most of what she did was evaluation, starting with a page of questions the receptionist gave me to fill out before my appointment. It asked how confident I was that I wouldn't lose my balance while doing a variety of different things. The examples include walking in my home, walking down the street, getting something out of a cabinet at eye level, using stairs, and riding an escalator (two questions: holding the handrail, and not holding on because I was carrying packages), all on a scale from 0 to 100 percent.

After that, the therapist asked me a bunch of questions about my balance, falls in the last year, and things I can do myself versus those I need help with. I noted that some of the "needs help" were physical, and some mental: dropping things, or worrying about doing so, is different from having trouble making decisions.

This was an in-person appointment, and I think had to be: some of what she did involved physical contact, and other things involved her watching me closely and looking for small changes: for example, asking me to stand still with my feet close together. She had me repeat that, and a few other things, once with my eyes open and once with them closed.

At one point I was sitting on a chair and she asked me to stand up, so she could watch me do so. She seemed a little surprised that I didn't have trouble, and didn't use either hand to support me, so I explained that doing exactly that is one of my existing physical therapy exercises (for either hip or knee, I don't remember anymore).

Today's appointment was an hour, and I have four half-hour follow-up appointments scheduled between now and the end of December. The therapist also gave two exercises to do at home, twice a day, and seven days a week. I should probably go do some of that after I post this.

This was less organized than usual, which I suspect is because the doctor is just back from paternity leave, and will be leaving Mt. Auburn hospital at the end of next week. Given that timing, I will probably call the MRI department to reschedule at least part of my upcoming head, cervical spine, and thoracic spine MRI: Dr. AbdelRazek suggested doing head and cervical spine as one part and thoracic spine separately, because that will give two sessions of about the same length. (His last day in the clinic will be the 13th, meaning he wouldn't be reading a report on an MRI starting around 5 p.m. that day.)

I only realized while describing this to cattitude that neither the doctor nor I had remembered the low-tech neurology test that involves moving pegs into and out of holes. We did the other low-tech neurology test, a pattern-matching thing, because I told him about having been frustrated by difficulty with a jigsaw puzzle a couple of months ago.

I also have a referral to physical therapy for balance, because of the recent falls I described to the doctor. Not sure I will use that, but it can't hurt to have it in their system.

I will be following up with Dr. Alison Morgan, at Mt. Auburn: Dr. AbdelRazek said that Dr. Morgan has training working with MS patients, but that was around 2003, and she's been doing general neurology. But I would rather see someone at that physical office than go out to Wellesley to see Dr. Katz. (I thought Dr. Katz was OK but only OK, which is relevant here.) Dr. AbdelRazek mentioned in passing that Brigham and Women's Hospital, where Dr. Morgan trained, has the largest MS center in the area. Since I'm not living on this side of the river, that might be worth looking into if I don't like Dr. Morgan. The first available appointment isn't until December, but since I saw Dr. AbdelRazek today I don't think that should be a problem.

I asked about blood tests before the Ocrevus infusion, so Dr. AbdelRazek checked. I most recently had those tests in April, so don't need to worry about getting them before the infusion.

am basically OK, but last night I fell off the foam roller while doing a balance exercise, and cut my forehead on the corner of the dresser.

cattitude and adrian_turtle both heard me shout and hurried into the room, and I asked for an ice pack, which someone handed me. They got me a pillow so I could lie on my back on the floor, after I noticed blood trickling down my forehead. Adrian then went back to her Talmud study group (I told her I would be okay with just Cattitude there), and Cattitude brought me juice, and a gauze pad to press against the cut. After a few minutes I took his advice, went into the bathroom, and washed my forehead, and he taped a fresh pad over the cut and brought me a cup of tea.

Weirdly, before I fell I was doing better than usual at keeping my balance while standing on the foam roller. I always do this balance exercise facing the dresser or some other piece of furniture, so I can reach forward and use the top of the dresser to steady myself when I start to wobble. So, a more interesting evening than I'd expected or wanted, but not nearly as bad as it might have been.

I was up late (because of the caffeinated tea and probably adrenaline), but am feeling better after a night's sleep. I iced my left hand right after falling, and there's no noticeable bruise there, which is a relief.

I called our old favorite chocolate shop in New York today, to order chocolates for us and for roadnotes. Mark Varsano, the chocolatier, started by taking my name and address, but it wasn't until I gave him Roadnotes's name that he recognized me. Probably some combination of there being more Vickis than Velmas, her distinctive looks, and maybe that she'd been shopping there longer.

It was interesting selecting chocolate over the phone, since I couldn't see what was in the display case today (the website gives some examples of what he carries, and then adds "and much more")—and I just remembered that I'd meant to ask for a cashew or pecan turtle. But once he had Roadnotes for context, along with my name, Mark said "you want orange peel and ginger, right?" and we went from there. Is that kind of memory normal for people who work in retail, or is Mark Varsano's unusually good?

On the other hand, Varsano's is the shop that made me think "I live in a small town, population eight million," because Mark didn't just remember that I prefer dark chocolate, he would ask after baldanders's health. And today, along with whether I miss New York, he asked whether I had a job. That wasn't random; I'd mentioned being laid off, and job-hunting, to him back in 2012. However, rather than trusting his memory, Mark is going to look at his notes to put together a box for Roadnotes, since that's a better/more detailed description of what she's likely to want than I could come up with. (I talked to cattitude in the middle of writing this post, and he says those notes were pretty sparse last winter; I wonder if I will be getting a call back.)

We chose to be optimistic about the weather and the chocolate not melting in transit, rather than spending lots of money on FedEx overnight (Mark mentioned the FedEx pp, but in tones of "I wouldn't recommend this").

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I got out the trash-picked bosu (balance device) this morning, and tried standing on it and exercising a little. It was too easy, especially given that it's been over a year since I used one; when I was putting the bosu away I saw that, having been stood upon, it was visibly deflated. So, not worth keeping, but I am thinking of buying one.

Also in the self-care/maintenance department, I stopped at the supermarket pharmacy a couple of hours ago for a flu shot. I had a few minutes' wait after I asked for the vaccine, read and filled out the form, and gave the clerk my insurance card. The injection itself went smoothly. Like last year, it's costing me nothing (the insurer is paying $30), and they gave me a coupon for a discount on groceries. [ETA, for reference: I was given Fluvirin. Trivalent, which this season is A/H3N2, A/H1N1, and B.]

I saw Emilie again tonight, for the first time in a couple of weeks; she didn't have a class to teach afterwards, so was able to make up the time she'd missed in two previous sessions because she was running late and couldn't push that back. I got her to take a photo of me doing one of my balance things; this may become a new gym/exercise icon (the purple hair one is at least eight years old).

( in the meantime, numbers )

I sort of expected Emilie to be running a little late, so I took my time with cardio and stuff. And then we had a good session, and I impressed her a little. With exercise/balance stuff, I mean, though she was also delighted by my offhand use of the word "fortnight" to refer to how long she'd been gone. [She was out of town for less than that, but I only see her once a week, so missing one appointment means a fortnight's gap.]

( details, all from memory )

I was walking home from the subway this evening at twilight, and saw a firefly. I was startled and thought it might be a random reflection from the stone wall (which contains mica), so I watched until it blinked again. Then I called cattitude, who was walking through the park to meet me, and told him to keep an eye out. I saw another firefly on the other side of the wall, half a block north (less surprising, since there's grass on that side), and then nothing until we rendezvous'd. Cattitude said he had seen a firefly, after getting my call and crossing the street; we saw another, or the same one again, when we got back to that bit of the park.

It's May. The very end of May, but still May. I've gotten almost used to how many things are flowering early, but the fireflies are still a surprise. (I suspect that, as with most of the flowers that bloomed early, the firefly season will end earlier than usual this year.)

I was on my way home from the gym, so here's ( the usual gym stuff )