3/7/14. The post where I learn a different way to overachieve.

3/7/14: woke up a little after 4am this morning.  Not because of my foot, but because I realized I had made an error in yesterday's post.  I fixed it, but the email had already gone out to those who subscribe by email, so I have to 'fess up.  RSD stands for Reflex Sympathetic Dystrophy, not Disorder. Yep, that's the error that woke me up at 4am.  Doesn't seem quite as important in the light of day.

I was a light sleeper long before RSD and my foot is rarely the thing that wakes me up.  It is usually something like, "Did I make a mistake in my post?" Or "Do I have enough safety pins in my purse?"  But these days, once I am awake, my foot chimes in.  "These covers hurt. No wait, don't take them off. Now I'm cold.  Put on some socks. Ouch, these socks hurt."  Hard to go back to sleep with all that noise in the background.  Fortunately, this morning it was feeling better than last night. 

I had a PT appointment first thing this morning and I left the house with a pain level at about a 6.  I had a successful appointment.  Since I was feeling pretty good, they let me ride the exercise bike (carefully) for eight minutes.  I also walked on the treadmill at the very slowest setting (still in the harness to keep my weight off my foot) for 20 minutes, a new record.  While I walked, my PT stood with me and gave me another pep talk.

The gist of the pep talk was that I am improving, even if I don't realize it.  He told me about the changes he had seen since I started and said I had improved much more quickly than he expected, and more quickly than other RSD patients he has treated.  Then he reminded me about not overdoing it.  He told me the reason he was letting me walk for twenty minutes on the treadmill was to help me see what my walking pace should be. Which, as he pointed out, is not the pace at which he sees me walking when I come into the office.  Slow down. 

His parting words were, "I know you are an overachiever.  Maybe you can try overachieving at being patient."  Yes. I can do that.  I can be patient.  I can be the most patient person ever.  Now get me out of this harness so I can get out there and start being patient.  

Happy tonight because my brother and sister-by-love are coming in tonight to visit for the weekend.  (Don't worry - it is not the ones who just had a baby.)  Looking forward to a quiet, fun weekend. I promise to take it slow.  And I promise I will wake up in the middle of the night to remind myself to take it slow.

3/6/14. The post where I learn about the somatic nervous system.

3/6/14: had a doctor appointment first thing this morning.  Pain level was at a 7 and my foot had some pretty interesting color, so it wasn't difficult to explain to my doctor that the nerve blocks hadn't worked.  Fortunately, he was not stumped by the news.  

In most cases of RSD, the culprit is a malfunction of the sympathetic nervous system, which is responsible for the body's "fight or flight" reaction. For that reason, my first two nerve blocks targeted the sympathetic nerves.  However, in some cases (according to my doctor, approximately 25-30% of the cases he sees), the culprit is the somatic nervous system, which is responsible for voluntary movement in the body.  Since the first two nerve blocks were not effective, he believes I have the more rare somatic version.

So, not only do I have a fairly rare nerve disorder, I may have the more rare version of the disorder.  Because that's how I roll.  The next step, as you would probably expect, is two nerve blocks of the somatic nerve system.  My doctor feels certain that I will get some relief from these nerve blocks, because there are only a few options where RSD is concerned.  He called it a "no-brainer."  I hope he's right.  He also said it is extremely rare for a person not to respond to either type of nerve block.  I really hope he's right.  (There is a plan "c" in the event the next two nerve blocks don't work, but I'm an optimist, so I'm not going to go into that right now.)

I did a little research after my appointment and learned more about the somatic nervous system and its relationship to RSD.  One of the articles I read said that the name change of the disorder from RSD (Reflex Sympathetic Dystrophy) to CRPS (Complex Regional Pain Syndrome) was at least partially based on the realization that the sympathetic nerve system is not always the cause of the disorder.  After talking to my doctor and doing my independent research, I'm willing to try two more nerve blocks.  The first one is two weeks from today. Fortunately, it is a busy two weeks and will pass quickly.

Tonight was lovely.  I have been part of a "Lenten small group" through my church for five years.  Our group has become very close and always looks forward to getting together. Our group is a little different than what you might expect.  We kick off the group each Lent season with a happy hour get-together to determine the format for our weekly meetings, meet once a week for discussion and fellowship, and finish the season with a movie night to watch a movie that inevitably presents itself during our weekly discussions.  Because that's how we roll.  Tonight was our happy hour kick-off and it was really nice to reconnect. 

When I got home, my foot looked more interesting than it has in some time and I was up to an 8.  But it still felt like a pretty good day.  Because that's how I roll.

3/5/14. The post where I get a new niece.

3/5/14: I was still feeling pretty bad last night, but I went straight to sleep when I got in bed.  A deep sleep - so deep I didn't hear the strange noises coming from our bedroom until my patient, long-suffering husband woke me up saying, "Can you hear that?"  Weird tapping and thumping all along the wall, like our cat was rolling around with a metallic toy.  Except we don't have a cat.  

Our next thought was that there was a mouse or some other kind of critter stuck inside the wall, although it sounded like it was coming from inside the room.  (I actually had a few other, much scarier thoughts, as I suspect he did, but we wisely kept them to ourselves.)  It was pitch black, but he bravely got out of bed to track down the source of the noise while I clutched my cell phone, with 9 and 1 already dialed, just in case.  

The source of the noise?  Some pigeons, trying to get out of the wind and cold, had decided to roost right up against the door leading from our bedroom to the patio. Periodically they would roust themselves and walk back and forth on the metal door plate, bumping against the door as they walked.  Our first thought was to shoo them away, but it was so cold we didn't have the heart to do it. They stayed all night, doing their periodic impressions of the Ghost of Christmas Past, and were still there when I got up this morning (pain level down to about 7, by the way).  By the time I left for work, they were gone, but they had left us quite a few reminders of their presence on the patio.  Time to buy a plastic owl.  And a pressure washer.

Shortly after I got up, I received a text telling me that my brother and his lovely wife (my sister-by-love) had gone to the hospital for the arrival of my new niece, about five days shy of her due date.  My family has a well-considered communication plan for such events (which I'm sure doesn't surprise any of you at this point) and we are always excited to put it into action.  An integral part of the communication plan is that no news is good news.  The next text would be the one informing me of her appearance, so I kept my phone close by all day.  

No word all morning.  This afternoon was my first PT appointment in nearly two weeks, so I reluctantly put away my phone.  Even though I had been doing my exercises, it was sort of a rough appointment because of my condition the last few days. Everything seemed to irritate my foot, so they were very careful.  I did more mirror therapy, and it was interesting to see that afterward my right foot turned red and complained loudly like I had worked it out, even though it had done nothing but rest on the floor for ten minutes while my left foot did all the work.  Interesting, and also annoying.  

I checked my phone immediately after PT for news of my niece.  Still nothing.  I went home to rest a little before our church's Ash Wednesday service.  While I was home, I got an interim text.  Things were progressing, but no niece yet.  This was approximately 11 hours after the first text.  I thought about how tired my sister-by-love must be already.  You go, girl - you can do this! 

Finally, just as we were walking into church to begin the service, the text came.  Raven Miranda came into the world at 7 lbs 7 oz and 20 1/4 inches long. So today was a great day.  As her uncle (AKA my patient, long-suffering husband) pointed out, a Raven born on Ash Wednesday is destined to be a handful.  Just like her aunt.

3/4/14. The post where my patient, long-suffering husband fixes (nearly) everything.

3/4/14: I was right about the delayed work start today.  Our office was closed until noon due to the Great Thundersleet Storm of 2014.  Which was fortunate for me, since not much sleep happened.  When I checked emails this morning, I had notes from two different friends with excellent suggestions for keeping my feet warm.  I have plenty of faults, but at least I have great taste in friends!

I dug out my warmest wool hiking socks, slid on my cowboy boots (which are not as comfortable when worn with my warmest wool hiking socks) and went to work for the reminder of the day.  I've been in the 8.5-9 range all day, but at least it never got any worse.  The good news is that this was likely the last really cold snap in my home city.  The bad news?  I have to go to DC for training next Tuesday through Thursday and I just checked the weather forecast.

Seriously???  Good thing I got a couple of really good suggestions for keeping warm this morning, because it looks like I will need them sooner rather than later.

But let's talk for a moment about my patient, long-suffering (and very handy) husband.  During the last week, in addition to a broken wife, he's been dealing with a broken garage door, a broken garbage disposal, and a broken elevator. (Yes, we have an elevator in our house.  We live in a brownstone-style three-story condo where all the living and sleeping areas are on the upper floors. Anyone who knows my history of accidents, injuries, and unexpected surgeries knows the elevator was a necessity, not a luxury.)

Thanks to his handiwork, all are fully functional today.  Except for the wife.  She's still broken, but she's working on it.  This one's going to take more than a hacksaw and wrench.  He knew my warranty had expired when he signed on, but I wouldn't blame him for secretly searching our state's lemon laws.  Luckily for me, he's always up for a challenge. 

3/3/14. The post where I have something in common with Ralph Macchio.

3/3/14: it continued to get colder in the night, but I was still feeling okay this morning.  Hung around the 6.5-7 range all night and while I was getting ready for work.  Hey, maybe the cold won't make it worse this time! Maybe between the nerve block and the PT, I'm starting to see some improvement!  Then I got in the car to drive to work.

23 degrees, with a wind chill of 15 degrees.  That may not be impressive to some of you, but I live in a city that regularly has three months in a row of 100+ temperatures so I don't have to deal with sub-freezing temperatures.  And certainly not in March.

By the time I made the ten minute drive to work, I had ramped up to an 8.  Even with socks and cowboy boots in a well-heated office, there was no way to keep my foot warm enough.  At the end of the work day, I was up to 8.5.  So much for my theory.

I went to handbell practice anyway. Trust me, I need all the practice I can get.  Things continued to go downhill and I spent most of the practice doing my best Karate Kid impression.

Playing handbells is hard enough (at least for me) without trying to balance on one foot.  On the plus side, if I ever get into a karate match with the town bully, I will be well-poised to deliver a take-down blow.  

I made it home ahead of the "thundersleet" storm headed our way.  I predict a delayed work start tomorrow.  At least for me.  I'm at a pretty solid 9 and my foot is swollen for the first time in awhile.  I think I'll stay home until it warms up a little. Maybe I'll work more on my Karate Kid crane move while I'm home.  You never know when it might come in handy.

3/2/14. The post where I extol the virtues of wine.

3/2/14: guess what works better than almond milk to help me sleep? A glass of wine.  I've been abstaining recently for diet purposes, but I had a glass last night after our winery visits and I slept really well.  When I woke up this morning, the cold front was blowing in and the pain level had crept up to a 7, so I was surprised it hadn't woken me up. I may have to rethink this diet... 

I tried the cowboy boot trick again at church this morning and it worked pretty well, considering the weather.  This afternoon, I went a different direction.  Yes, I own these.  Don't judge.

I'm a little torn.  They definitely irritate my foot (and everyone's eyes), but they are nice and warm on a cold, rainy afternoon.  I think I'll wear them for as long as I can tolerate it.  As I've mentioned, it's always a delicate dance, especially on bad weather days.

In other news, I made it through a week with no PT appointments and I did my exercises every day.  Go, me!  I have two appointments scheduled late in the coming week, so we'll see if my PT is as impressed with me as I am with myself.  I don't know if the core exercises are giving me any immediate pain relief, but they don't seem to be doing any harm and I am certainly getting toned up.  (I'm also finally starting to lose a little of the weight I gained when this ordeal started.  At least I was before I added wine back to the diet this weekend.  Priorities...I can't fix everything at once.)

I also have another doctor appointment later in the week, where we'll plan the next steps. I'll spend the next few days getting my thoughts together so I can give him a good assessment of the last two weeks.  So far, I've got: 

Likes - wine, new shoes, sleep, gummy vitamins

Dislikes - almond milk, cold, rain

Hmm...I'm going to have to do better than that.  That probably describes 95% of the population.  I'll work on it this week.  

3/1/14. The post where I make a couple of interesting discoveries.

3/1/14: I did sleep in shifts, but when you put together all the shifts, I got a decent amount of sleep and had a good day. (That's two good days in a row, for those of you keeping score at home.)  Hung out in the 5.5-6 range all day, which is a rare treat these days.

I spent most of the morning working on the computer and I made an interesting discovery.  If I adjust the chair high enough, my foot is completely suspended.  It always feels best when there is nothing touching it (and that is not always easy to accomplish).  Ultimately, I need to be using my foot as normally as possible, but every now and then it is nice to have some relief.  

In the late afternoon, we made a trip to some local wineries with friends and I made a second interesting discovery.  While dressing for the excursion, I decided to try on a pair of my cowboy boots just for kicks.  (Pardon the pun.)  While the toes of the boots are pointed, they are wide and turn upward, which means they don't touch my big toe or the top of my foot at all when I am sitting.  Even when I am standing, it feels pretty good, at least on a 5.5 kind of day.  Not sure why I didn't think of that before, but looks like I'll be a cowgirl more often in the near future.

It was a lovely afternoon and I think I am getting the hang of pacing myself.  I am hopeful the downward trend of the last two days continues. Tomorrow, another wet cold front comes through, so I'm trying to enjoy this while it lasts.  Giddyup, y'all.