I forget a whole lot about those first 6 months after the stroke, it’s insanely blurry but last week I was reminded of something that even at the time when it happened I remember thinking that it was hilarious and I also remember thinking “why in Sam Hell did that just happen?” What does that expression mean? Sam Hell. I was in physical therapy a few months after stroke day and she had me doing an exercise where I had to grab cones. It took me literally like 5 minutes to grab one cone and it was so frustrating that I wanted to scream but also couldn’t scream at the time and I just wanted to kill everyone. So I was doing this exercise and concentrating like hell on grabbing these stupid ass cones and I was so angry inside and I said “shut up.” That was not directed in any way at my therapist. I loved her. She hadn’t even said anything. I don’t even know why that came out of my mouth. I can’t believe I’ve never written about this before, I laughed about this for months. I said “shut up” out of nowhere and my PT said “did you just say shut up?” and looked bewildered. You’d think a PT that works in neuro rehab would be used to her brain-damaged patients saying all kinds of meaningless, weird stuff but who knows?
I’m telling you, I had ZERO control over what came out of my mouth, zero. Sometimes what I said didn’t even closely resemble what was in my head and sometimes things would come out of my mouth that – just came out. I wasn’t even planning to say anything but my mouth and vocal cords had a mind of their own. Now they match up, I think. I hope they do.
I told my mom to get a lumbar roll recently and told her to leave it in the car so it’s always there when she drives. I told her I’d make sure that it was positioned correctly and then she was talking about someone else who has back pain and is going somewhere soon and she said “well they probably have great chairs there.” Here’s the thing people, if you don’t learn about good posture and use your own muscles to practice good posture you can sit in the most ergonomic and best posture enhancing chair that exists on the planet and it will HELP things but quite frankly it won’t really make a difference. An ergonomic chair is all well and good but just like with everything else you have to do it for yourself. Here, learn.
If you want to use a lumbar roll – you know how your low back has a little bit of an inward curve right above the tailbone? You want to put it there. You want to maintain that curve.
I really can’t believe that I feel the need to say this stuff again but I do.
I am still getting backlash from a few people who I used to be friends with and am not anymore. I haven’t talked to these people in months and months but these people obviously can’t just move on with their lives and are apparently obsessed with what goes on on this blog of mine. A few days ago, I was threatened with lawsuits. Yes, you read that right. Lawsuits, plural. These people told me that if I don’t stop using their name they will file a lawsuit. Does this sound as ridiculous to you as it seemed to me? These are completely empty threats as I have NEVER, not once, used someone’s name that I had personal experience with in a negative way whatsoever. After a very mean comment was made on my blog by someone who used their FULL NAME, I got angry and retaliated by using that person’s name AFTER it was already on the blog, left by the person himself, and said some mean stuff – which has all since been deleted and you cannot find a trace of these peoples’ names anywhere on this blog. Barring this incident, never once has anyone that I had a personal experience with been named on here in a negative manner, NOT ONCE. Doing this to me and threatening me, a stroke victim, is evil.
I’ve only ever written about my experiences and my opinions. I’ve only ever told MY story which includes physical therapy stuff because…….well I am a physical therapist. I have a Doctorate in it. It’s my passion. If these people who threatened me find some legal loophole in which they tell me I have to stop, then I’ll have to stop. I certainly don’t have the money to fight some frivolous lawsuit, but they do. So….a few people might ruin it for a whole heck of a lot of other people. I’m sorry if this happens.
Some absolutely absurd things happened to me last night of which I won’t go into detail, but ermahgerd absurd! So this morning I need some laughs and thought you might too. I’ve learned that there’s a reason I love this kind of humor. Larry David was on The Tonight Show last week and all he does is bitch and complain about stuff and it was hilarious. He makes it so funny, I guess that’s why I love Grumpy Cat!
A friend that I haven’t talked to in a while contacted me yesterday and told me this…….This friend of mine is a speech therapist, keep that in mind as I tell you this story.
She told me that her cousin, a 29 year-old woman who is married with a 2 year-old, had a rupture of a brain aneurysm and brain surgery a little over a month ago. She wasn’t diagnosed as having had a stroke during surgery but who knows? Very strange similarity here, my friend’s cousin is a physical therapist and is right now at the very same rehab hospital that I was at. She was in the ICU for 5 weeks. Jesus Christ. She was not able to swallow for a long time and my friend told me that her treating inpatient speech therapists had given her no oral motor exercises for swallowing. This angered my friend very much and she gave her cousin a bunch of exercises. She did them with her parents all day and was able to eat the next day. I was not allowed to have water for 2 weeks when I was in the hospital and was given zero oral motor exercises to help speed up the process of being able to eat solid food and drink water. My friend asked me “Is there anything I can tell her parents she should be doing that the doctors haven’t told her?” My answer: “ABSO-FREAKIN’-LUTELY YES!!!!!” I told my friend that her cousin needs to start some kind of meditation practice ASAP. While the most she can do is lay in bed right now, she can meditate and start working on the brain. When my friend comes to Pittsburgh again to see her I’m going to go visit, if the girl is accepting visitors. I sure as hell didn’t want visitors when I was like that so we’ll see. No one asked me anything about visitors though. As soon as I find a new meditation teacher that I like and trust and think would be appropriate for this I am going to ask if she will travel to the hospital and teach some stuff to my friend’s cousin.
I’ve had it. I’m so fed up. I’m just fed up. Her therapists didn’t do what the hell they were supposed to do. Nor did mine. Every other day I hear a f’d up story like this. I’ve just had it.
My mom had some low back pain recently, she did what I told her to do and she felt better. I learned this after PT school, I learned to treat this way in my McKenzie courses.
My mom said that it really is the natural tendency and automatic response to want to “stretch it out” and bend forward with low back pain. There is a reason that doing this makes it feel better momentarily, but doing that actually makes the problem worse in the long run. Ok disclaimer – this is for the majority of back pain. The majority, certainly not all. Not every person is the same and not every back problem is the same. Hey, all strokes are different so it makes sense that all back pain is different. But this really is true for backs. I have personal experience here as well. You absolutely cannot give someone generic exercises to help their back pain without first thoroughly evaluating how that person’s pain responds to different positions and movements. This is why this is soooooooooooo wrong….. Williams’ Flexion Exercises are a very old school thing given out to people with back pain. Sometimes, you would need exercises like these but if someone has you do these and just says “here are some exercises for back pain,” be afraid, be very afraid. There is a handout for these exercises in my PCP’s office with the heading “Exercises for Back Pain” and it makes me want to vomit. Sometimes, you’ll have pain or other weird symptoms far away from your back, your back may not hurt at all but the symptoms are caused by the spine. This is why it is SO vital to be evaluated. The right way.
I was always told that I was really good at explaining this so here goes nothin.’ Everyone has a back. I hope. Your back is made up of a column of bones called vertebrae that are stacked of top of one another. Here’s what it looks like. Clicking on the picture makes it bigger. In between each of those bones is an intervertebral disc. Here’s what that looks like. The bottom picture. I always told people to picture a jelly doughnut. An inner layer of gelatinous liquid surrounded by a more solid thing. That’s what the intervertebral disc is like, a bunch of jelly doughnuts in between each of your back bones. The outer part of the disc, the annulus fibrosus, has no nerve endings. The inner part of the disc, the nucleus pulposus, has some nerve endings, but still not a lot. When you have back pain – in most cases, not all – that jelly on the inside of the disc gets moved around and deforms the shape of the disc and then touches stuff that does have nerve endings or touches nerves themselves. This is what hurts. In really severe cases, the outer part of the disc will tear and then all the jelly on the inside comes outside of the disc and you have all this crap where it shouldn’t be and maybe the jelly maybe hits a nerve or something, and then your whole leg hurts (sciatica?) because every nerve is connected to every other nerve. IN MOST CASES, what happens is that because of everyone’s crappy posture and frequent bending over forward, that jelly gets compressed on the front side and pushed to the back of the disc. Like this…..
So if the jelly is squished backwards because of bad posture and bending forward and lifting things incorrectly, how should that be treated? Well you wanna push the jelly forward to get it back where it should be and the way to do this is by bending backwards. Then the disc needs to heal, and it will in a little while. What I’ve just explained is why I’m so crazy and obsessive about posture and body mechanics. If you always keep your spine straight, the jelly has a much smaller chance of getting moved around and you have a smaller chance of bad things happening.
The reason it feels better initially to bend forward and stretch the back is because when you do that, you’re momentarily relieving the pressure of the displaced and misshapen disc from the nerves of the spinal column that the disc is hitting and causing pain. But when you return to a normal position, you just displaced the jelly more and made the disc even more misshapen. So in the long run doing that actually makes it worse.
I really can’t believe I remember all of that. I just kind of impressed myself. DISCLAIMER, DISCLAIMER, DISCLAIMER!!!!!! This will not work for all back pain and if you’re having pain in your back(or neck) I highly suggest you go get evaluated by a McKenzie practitioner. Oh and buy this book This book explains everything I just said and gives exercises and progressions of exercises. Oh wait another disclaimer: I’m brain-damaged so don’t listen to a thing I say.
My brain has always worked a mile a minute and I was always someone who wanted instant gratification. Then my brain got extremely knocked around and there was nothing instant about any gratification. For the first 2 years, there was absolutely nothing, and I mean NOTHING, in terms of gratification so it wouldn’t have mattered if it was instant, it didn’t exist. When I had the stroke, on the inside my brain was still working a mile a minute but it sure as hell didn’t seem like it on the outside because I said some insanely weird things, when I could spit something out – and I was treated accordingly by pretty much everyone. So I was forced with the task of rebuilding my brain from the ground up. I couldn’t do anything anymore. Literally, anything. I couldn’t walk, I couldn’t talk, I couldn’t write, I couldn’t hold a book, could still read a book though, like I said cognitively I was fine inside. All those stupid cognitive tests they give you in the hospital like asking you the year and the president – I passed all those tests with flying colors. Except the word test, I couldn’t do that. See, I wasn’t dumb – I was injured. I couldn’t drink from a f’ing cup without a lid on it. I couldn’t feed myself. I couldn’t roll over, I couldn’t look up. LIFE.WAS.HELL. Life is not hell anymore. And I also don’t need instant gratification anymore. I’m quite used to things taking a while.
I’m really starting to like this new job of mine reviewing charts. It fits perfectly well with my introverted personality. It also will give me a lot of ideas for blog posts because I’ll be seeing words that I haven’t used in a while. So it’s perfect for me too right now to get used to this stuff again. I saw the term ‘accessory motion’ today and thought I’d write about it and explain what that means. There is a range of motion that every joint in your body is able to go through actively. To get more motion than you have, that’s where a physical therapist is useful. I mean, we’re useful for something. A PT would know how to take your joints through motions that you can’t do on your own. Think of the knee. Ok, straightening the leg is called extension of the knee. What happens physiologically speaking when you straighten the leg is that your shin bone(tibia) glides forward on the thigh bone(femur). You can’t just “glide your tibia anteriorly” by itself. You would have to straighten your leg in order to do this. But a PT can bend your knee, then push the tibia forward a little bit to help free up the motion that you can’t get to by yourself. I wrote about joint mobilizations before. That’s what a PT is doing when performing a mobilization on a joint, she’s using accessory motions. After a stroke, some motions will most likely be limited so you should have someone take your joints through the ranges you can’t get to by yourself so the joints and muscles don’t freeze up and get real tight.
Written by Amy Shissler PT,DPT, Cert. MDT <——That’s my full title. My knowledge, education, experience, and background were questioned and criticized recently which is a very, very, very, very big deal to me especially taking into account what I’ve been through. I just want anyone who lands on this blog looking for help to be confident in the fact that I know very, very,very well what the hell I’m talking about. 😛