July 31, 2014 PT O.P. #2

 Today was my second out-patient PT session.  My knee flexed to 94-97 degrees.  I think it should be greater, but Kathleen, the therapist, says it's good.  She will be on vacation next week, and I'll see Sandi, the therapist I had last year.  I'll ask her where I should be.  Today, besides the equipment (or toy) room, I went into the machine room to work out on some step glider piece of equipment, only for 5 minutes.  I burned 17 calories. Yesterday when I got home, I tried my exercise bike and found my  knee  can make the rotation. Yay!

Pain in the Butt

You might think you have sciatic pain, but you might be wrong.  You might have iliotibial band syndrome, IBS,  which causes your piraformis muscle to be impinged on.   Thought I knew all the body parts likely to cause a problem, but I was wrong.  Good news is successful treatment is available.

Hind Sight

     "Then the law is a ass," wrote Charles Dickens.  I might add, "Medicine is a ass."  I went for a follow-up visit to the specialist who had advised that my status as glaucoma suspect had in his opinion progressed to glaucoma, though of the low or normal tension variety.  I wasn't convinced but agreed, finally, to the SLT, after doing research which indicated it was pretty much risk-free if not always helpful.  So I asked the esteemed doctor a few questions, which seemed reasonable to me, but the answers were either  non-existent or off-base enough as to be meaningless.  He asked, as does his office mate, "What's new?"   Well, what do you want to know? In regard to what? would be my question.  But I mention a few symptoms and he says I should tell them to Dr. S.  I do know the difference between the cornea and the retina, but can't always sort out which symptom goes with what part.  He hunches over the computer and says that the eye pressure is lower than before, but not as low as he would like. My eyes, as usual, fall to his feet; I notice he is wearing a black  leather ankle brace, and wonder if he is in much pain.  The tech had previously told me my eye pressure was 12 and his "target" pressure was 11. I know that eye pressure means nothing in itself.  High can be OK and low can be not OK.  Eye pressure measurements just happen to be a "best test" in assessing the health of the optic nerve.  I ask if all today's testing and pictures show if the optic nerve shows any more damage, but he doesn't respond.   Since I'd had  laser for retinal tear (in other eye) since I'd last seen him, I asked about the effect of physical therapy as possibly being detrimental, since the eye has had 2 tears already.  He said to avoid any exercise that could possibly raise pressure and contribute to another tear, like lifting something heavy for 3 hours or more.  He added to likewise avoid the type of yoga where the head is lowered for several hours.  The ass.  How helpful is that.  Maybe his research paper on oral sex among orangutans was well received by his peers, but he could have spent his time studying human eyes. 
    I mention that my vision is blurry in the mornings.  He believes it to be from the so-called "secondary cataract" and says that is a simple fix with a laser.  I say I think it may be from Fuchs' Dystrophy, but he says that blurriness is not a usual symptom.  All of the renowned ophthalmologists and about 5,000 members of the Corneal Dystrophy Foundation would strongly disagree, and I know he is wrong.  I say nothing, but start to lose trust in  his decisions. He obviously doesn't keep up with latest ophthalmic developments because I'd just read an article on Fuchs' in his waiting room.  If it's true that when all you have is a hammer, everything looks like a nail, then it must be true that when all you have is a laser, everything looks like it needs lasering.

July 28, 2014 Out-Patient P.T.

Physical Therapy, for the uninitiated, is surprisingly hands-off.  The therapist observes and instructs, the patient does the work, pretty much at their own pace.  At my first session today, the therapy was the first human contact I'd had where the person trying to help didn't have a blade in their hand. 

July 23, 2014

  Last night was miserable, not because of any pain in the knee, but because of the nagging discomfort from hip down outside of leg to foot.  I took my quota of aspirin and Tylenol, used ice pack, but somewhere in the early morning hours contemplated taking some Percocet.  I think it may  help me sleep, but the next day my stomach is upset which has happened 2 out of the last 3 times, so I lay there weighing the positive against the negative, and eventually fell asleep without having to make any decision.
   This morning the sciatic pain or the iliatibial band discomfort was still there, and I'm getting tired of it.  It strikes me that what totally occupies my  every waking moment is of zero interest to anyone else in the world.  But wait.  The therapist from The Eddy is to come this morning.  She has to care.  That's her job.  So I tell her that when the tension is affecting the side of my leg that I don't think I should do any of the routine exercises, even though I have already reached a satisfactory level.  I tell her what Michael the P.A. at Ortho NY said yesterday about the ilial band or whatever.  She knew immediately what he meant, and isolated the exact spot where the pain originated.  She left me with some exercises for that condition.  When I asked what could be a possible cause, if that is indeed the correct diagnosis, she said it's usually from a strain or overuse.  So I'm hopeful that this was only a minor bump on the road to recovery.  As a matter of fact, when she isolated the "trigger spot" and worked on it a little, it felt better.  And that feeling I had that something needed to "crack" or move out of the way seems to have dissipated.  Maybe chiropractors are effective after all.
      At discharge from the hospital, you are instructed to contact the surgeon's office for follow up care.   Two weeks later, when you visit the doctor's office (P.A.) you are given a script, and the back sheet has a list of providers for Rehab, at least 20 different offices, and it's up to you where you choose to go,  there or elsewhere.    Some come highly recommended, but I'm leaning toward the familiar.  Sometimes I wish I were as important as the POTUS: it would be a relief to delegate.

Postage Please

   I had FU for knee today.  I was supposed to see Rich Dalaba, but he wasn't there, so had to see another P.A.  As per my home therapist, I asked about the missing Celebrex at the desk and then of the P.A. There was no record of any type that indicated someone from the office was going to mail some out, in lieu of waiting for the physicians review.  The P.A. gave me some anyway, a whole box actually, but he said he would advise against taking them as long as I was on aspirin, though my prescription list clearly stated to take both.
     When we got home, I went out to the mailbox and there was an envelope from Ortho Ny, with the samples of Celebrex inside.  Inside an inner envelope which bore the usps stamp RETURN TO SENDER; MUST HAVE POSTAGE AFFIXED.  If anyone needs Celebrex, let me kniow.

Default Complaint

   This morning the Patient Relations Representative called me to ask about the hospital experience which I had "issues" with.  I did indeed have several issues, but I'd only blogged about them, nothing public.  I had searched the St. Peter's website for responsible people and contact information, but found nothing other than an obscure blurb  that  confirmed the existence of a patient rep without revealing that person's name.  I called a number and was given a name, reluctantly it seemed.  So I did what I often do:  put my thoughts in letter form, and then stash it in a folder.
     So after I relayed to "Rosa" what my issues were, I asked her how she knew to contact me, as I hadn't made any contact  with them.  Yes, I had, she told me, through an email to the chief officer or administrator, and he had contacted her, as the patient representative.  This threw me somewhat, because I knew I'd been unable to recover  either an email or the name of any higher-up.  I started to think that maybe I had been in one of those drug-induced amnesia states, the kind I don't believe in, but what could the explanation be.  I didn't regret their receiving my complaint; I believe people should do their jobs, and those who hold a position of  responsibility  should carry out their function.  But I was sure I hadn't sent an email.   My brain got wracked again, and then I recalled telling the intake coordinator from The Eddy about my health concerns due to the lack of sanitary measures there.  She'd told me I should write a letter, to the head of the hospital and also to the surgeon.  I said maybe, but that I didn't think they'd be interested. She was quite concerned about the risk of infection, and now that I think about it, her position is probably that of a "mandated reporter" (as mine was when an advocate for migrant affairs), and she probably felt required to do so.  But she must have used my name rather than hers?