Praise then darkness, and creation unfinished

I'm still having trouble lying down, as well as standing and walking, but after doing almost none of my exercises/PT for a couple of weeks, I did half a dozen different exercises, sitting down. Adrian and Cattitude to help with this, by moving a chair and hooking the elastic band, before lunch, and by bringing me my hand weights after lunch and Scrabble.

That's almost all the available PT--most of what I do, I do either standing up, or lying on my back. I also did biceps curls for the first time in a few months, because that seemed like something I could do sitting on an ordinary chair. (I used to do them sitting on an en exercise ball at the gym, back when I was going to a gym.)

( numbers, for the hell of it )

I had a PT appointment today, moved slightly earlier at their request--that change turned out well, because traveling half an hour earlier meant I got home before dark, and when only a little of the sidewalk had frozen. I made it there and back without slipping and falling on the snow or ice, though there are some bits that are freezing dangerously between the trolley stop and our house. The PT is to improve my balance, and I don't know whether not falling this is more evidence that the PT is helping, or if what kept me from falling was the techniques I already knew/had worked out for walking in snow, ice, and slush.

Today I walked across the room while moving my head and keeping my focus on a target at the far end of the room, and did some balance things standing on a slightly squishy cushion: the same kind of moving my head while focusing on the wall (but closer), and also standing with my eyes closed.

I am going to try reducing the home exercises/practice to once a day, instead of twice. If it feels like I'm losing ground, go back to twice a day and tell the therapist.

I have one more appointment after this one, a week from Thursday.

The "acapella" "flutter valve" device that is supposed to help clear my lungs arrived today. The instructions were less than clear, even after I got out the magnifying glass so I could see them, but adrian_turtle found better instructions on the website of a COPD patient support group.

It felt like one thing too many, but she and cattitude provided useful support, and I have used the thing, as instructed by my doctor: take guaifenisin (expectorant), use my albuterol inhaler, then exhale through the device. I did in fact feel the flutter in my chest, which means I'm using it right. It has also produced a bit of a productive cough, but on the other hand my chest hurts in a tired-from-exertion way.

I also saw the physical therapist again. She tried teaching me a new exercise, but it made my shoulder hurt, so we're not doing that one. Instead, I'm supposed to do the exercises I already had for longer, and with my feet closer together, and added one where I stand with my eyes closed and one foot a bit forward.

Either the PT is already helping, or this is random variation, but I've felt steadier on my feet in the last couple of days. I also felt significantly, and reassuringly, steadier waiting for the trolley in the dark at Chestnut Hill Ave. today than a week ago. (Green line B, this is one of the stops that's not much more than a stripe of yellow paint between the tracks and the traffic lane.)

I had PT this afternoon, and this week the therapist had me doing some new exercises standing rather than sitting. I did some of them with my eyes closed, but am not sure it's prudent to do that here at home: I can use the edge of a counter to help me balance if necessary (instead of the barre in her office), but the office floor is flat, and a lot of the floor in this apartment isn't. I have a total of three new exercises, and will definitely be doing the other two sitting down.

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.

I'm winding down the occupational/physical therapy for my right hand and wrist, after seeing the therapist last week and discussing how to do this. On a whim, I just tried the same range-of-motion exercises with my left hand. It's stiffer than my right hand, and I can't separate my left thumb and index finger as far, or curve the thumb and fingers as smoothly.

It looks like it would be a good idea to do those stretches and exercises with my left hand. Try once or twice a day? I'm reducing the right hand exercises from three times daily while I was seeing the therapist, to daily over the last week, and then to three times a week, "fading to zero" over three months.

I had physical therapy for my knee this morning, and this may be the last session, depending on how I feel in the next weeks. ( details, not very exciting )

Yesterday, cattitude and I went to the Harvard Arboretum to look at and sniff lilacs. We were a bit late: a lot of the bushes had few flowers left, and some of the rest had almost no scent. Unfortunately, the lilacs that bloom latest are a variety whose scent I don't like. Also, Cattitude had some problems with the pollen even though he had taken an antihistamine, and I will probably have to make this trip without him next year. (adrian_turtle has expressed interest.)

On our way out, we passed a fine patch of lily of the valley, and enjoyed that scent (which neither of us are allergic to. This past weekend, Cattitude found an allegedly lily of the valley flavored macaron at the patisserie in Davis Square. I thought it just tasted sweet, he said there was a floral note that reminded him of soap, and we didn't eat the last bit. It's an artificial flavor, of course—all parts of the plant are considered poisonous—and I was partly just curious as to what the creator thought lily of the valley should taste like.

I have an appointment at Mount Auburn Hospital on Friday. There is a very fine patch of lily of the valley in a small parklike area between Mount Auburn Street and Memorial Drive, which I plan to visit before, after, or possibly both, depending how the timing goes.

( physical therapy stuff )

So, I had a cortisone shot in my left knee on April 12th, before going to Montreal on the 13th. The knee felt a lot better by the 14th, just occasional twinges, and I was feeling very optimistic. That lasted for about a week. On the 20th and 21st, the knee was stiff when I woke up; when I woke up this morning, it was both stiff and somewhat painful when I woke up.

I've been taking naproxen about once a day (mostly for hip stuff), and icing the knee some. I guess it's time to call the physical therapy place and see about knee PT. I'm still not sure if I need/want more hip PT; that's going to depend partly on whether/how much cortisone the shots I'm scheduled to get in both hips on Tuesday do.

ETA: The injection was 2ccs of depomedol (according to the visit notes I got in the mail 4/27); noting this here because the entry in their electronic medical records not only is less detailed, but says no medication was given. A copy of that should have been faxed to Dr. Bershel's office; they're in a different system so can't see each other's electronic records.

ETA again, 5/19: according to the bill I just got, it was 80 mg depomedrol.

Yesterday's PT session mostly went well, though I wound up arguing with the therapist about how ot makes sense to start increasing the amount of walking I do: she was pushing for "walk until you're tired or it starts to hurt," even though I've made clear that having to keep going when the hip hurts a little is the likeliest thing to make it hurt sharply. So that was annoying, in terms of not being listened to, and wondering how clear I'd been about the problem she's treating me for.

I do want to get back to walking more: that's part of the point of this PT. So, given the above, if I am out and about because I want to go somewhere specific, or get something done, I'm likely to take transit to whatever, do stuff, and then walk at least partway home. That way, if I run out of energy I get on the bus or train sooner; I don't either abandon my plans, or push through even though it hurts. (Moving slowly with frequently rests because my hip hurts isn't my idea of recreational walking.)

The good news is that the therapist thinks I may only need one more session of physical therapy for the hips, because they're significantly stronger than when I started. No new exercises, but I should try to increase the number of sets on some of them (either from two sets to three, or from one set to two), for the short term. Once PT is done, which might be in another fortnight, I can start doing the exercises two or three times a week, instead of almost every day.

At the beginning of the PT session, the therapist looked at my sneakers, and commented that they were good shoes (by which I think she meant, flat and designed for walking in) and then that they were wearing out. I asked if she could recommend someplace to replace them, and she gave me both a recommendation and a discount coupon for Marathon Sports. I went there after lunch yesterday, and was quite pleased: the salesman asked sensible questions about what I wanted and what size I was wearing, and then brought me things to try. I tried four or five pairs of sneakers, finding two that fit; lacking any other obvious differentiation, I bought the New Balance because they were slightly less expensive than the Adidas. (I'm not sure exactly how old the shoes I was wearing yesterday are, but I bought them while we were living in Bellevue, so at least two years ago.)