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    Balancing exercise and pain - advice?

    This past week I bought a pair of hiking sticks. I find that using one in each hand helps me to stand a little straighter. My arms get more of a workout which hopefully does a little bit of good and building upper body strength. with better weather yesterday I walked outside down the block with the sticks - almost to the end probably 75 yards turned around and walked home in about three hours later feeling decent walked all the way to the end about 100 yards in turned around and came home. by last night I was feeling sore in sleeping last night was very unpleasant. today I didn't much less and feel exceptionally weak. if I really have a solid L4 S1 fusion in the surgeons claim that the x-rays from 11 months after surgery show that to be the case and EMG studies show no ongoing denervation, then feeling that I'm getting weaker in that area is probably my imagination. if anything had happened with the hardware I imagine I would be experiencing sudden and excruciating pain which thank the Lord I'm not. The neuromuscular chief at Penn said work on your core including abdominal muscles. I have tried that gently and the result has invariably been at least two days of rather extreme pain. it's frustrating I have no idea why and where it's coming from except in the area of the pelvic girdle time using the term correctly it sure as hell is coming from there.

    the individual training sessions I'm paying for at the local gym for the first month of three sessions have focused on upper body which I'd pretty much ignored. I'm absolutely certain I need much more core strength. The gym agree but says i need upper body first. I live just outside of Trenton New Jersey and could go for treatment anywhere in the Princeton Mercer County area. but I have no idea where. I've certainly had physical therapy and neuromuscular i.e. EMG. I would like to know if there is any specific identifiable nerve constriction that is accounting for my difficulty in although the post surgery MRI showed extreme stenosis still existing at multiple levels I have been told that this has nothing to do with my current weakness. and of course one question I wish I understood was whether or not current continued dogged exercise could overcome the problems. so far it's not working.

    but I'm told I probably over intellectualize my problems?

    has anyone here had any experience with trying to balance the right amount of exercise against resulting pain?

    #2
    Gordon, your weakness may be due to muscle loss depending on how much you were off your feet after surgery. I know I was shocked at how weak I felt because I was a big weight lifting guy before my surgeries. I didn't understand how much the surgeries took out of me and how long it would take to get some of the strength back. We have a tend to feel good and do more than we should and then we pay the price for it. It is important to have a schedule for your walks and how far to go so you start out walking that doesn't take too much out of you. Your schedule should set how much to increase each week so you don't go too far. My wife and I were driving back to our house and she talked about how we use to walk so far in our town and it hit me how much little walking I can do any more each day.

    As far as exercise and pain balance you need to understand the difference between our chronic pain and the muscle pain from working out. I don't think you should do much if it increases your chronic pain but if you are talking about muscle pain then you should only be in pain for two days or else you are pushing it too much. It takes time to figure out what the balance is for you. I wish you good wish for exercising and pain because we do need to still get some exercise no matter how much pain we have just to stay in some shape.
    1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
    2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

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      #3
      Hi mark

      thank you for the kind words. Just back from a 30 min individual session. trainer recommends 10 to 12 curls with 8 pound weight in each hand, presses from houlder to above head, pushes from side to arms extended in front of chest, and hold both together and twist at waist level from side to side all the time holding core tight.

      I find it difficult to adhere to a schedule but i think what i am hearing is that i better try to adopt a fixed schedule of some sort and figure out some kind of bench mark. of what to do in a daY.

      my chronic pain is at night. last night to sleep at 1 am then wake up at 4 am can hardly move, struggle down the HALL AND BACK, one hyrdocodone allow sleep to seven thirty and a second allow sleep to 930 or 945. That is a decent night. A BAD night is sleep at 1 am and awake every 60 to 90 minutes .... the rest of night. Forced movement helps as well as hamstring stretches. When i have had a bad night i do much less the next day and with 24 to 48 hours the nights get less bad.

      surgery was 11/27 2013. It was february 2014 before i was doing any kind of exercise and march before i went back to gym. I tried to walk on my own without crutch or stick for next 6 months... did poorly, bent over terrible. did PT BUT, AT $50 co pay a pop, not more than 3 or 4 a month and didn't get leg brace until this january.

      Comment


        #4
        Scoliosis??

        I have developed scoliosis. The surgeon's first inclination 18 months ago was to fuse my entire lumbar spine. The neuro was against the idea and they told me they did not because the other disc were dried out and somewhat fused anyway. But the trainer at the gym asked me how tall are you? five foot two!?

        I said oh no at one point i was a hair under 5 foot eleven. Before surgery i was five 8 at least. Now i am beginning to wonder. I have a hard time reaching for something on top of my refrigerator and putting plates back on shelves above eye level is difficult. If i try to drink out of a bottle standing up, I can't UNLESS i flex my knees int a squatting position.

        I suppose one way to get info is schedule an appointment with my primary and ask him to measure me? Its been six months since i have seen him.

        Any one here with knowledge of or experience with scoliosis?

        Comment


          #5
          Typically scoliosis is your spine bending side way instead of being upright. With the loss of height you are talking about it seems like you have a bad scoliosis. I can't imagine going from 5'11" to now people thinking you are 5'2".

          You hit the problem with working out and I hope you can get a daily working out. For me I try to walk or do some landscaping around the house because I can't seem to not overdo weighting lifting as I was always over working when I was healthy and doing a lot of weight training. I try to limit how much I do but I seem to push it too much. If you can stay with the workout and not do too much maybe you will be able to workout every day you are suppose to do. Ask your trainer about what exercise to do for scoliosis as you should be able to improve some by building up your core muscles and the back muscles that keep your spine erect.
          1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
          2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

          Comment


            #6
            Thank you once again Mark,

            on Wednesday I saw my primary physician for the first time about 6 months he gave me the quickie for metaphysical reported blood pressure pulse, lungs etc. okay. said that he could discern no scoliosis. measured scar at my request and informed me that it must've been 19.5 cm and not inches. he said it looks like about 20.5 cm. I probably misremembered since the measurement was taken when the stitches were removed at home about 10 days after surgery and I was still pretty drugged. so I suppose that's good. Dr. thought hiking sticks were excellent idea and lengthened each about 3 inches suggesting I could use my arms with the greater length try to walk more upright. other than willingness to try to find me is pain management specialist primary had no other suggestions

            Wednesday Thursday Friday began practicing short walks three times a day increasing from probably 75 feet to 100 feet to 125 feet each day.

            I have a very small backyard got the lawnmower out on Friday struggled for 10 minutes maybe 12 .
            with another 10 or 12 minute session yesterday in a third today I finished cutting the grass in back, electric mower, but very irregular territory necessitating push pull up down. but I suppose good exercise sure hurt like hell. but I am sitting now without pain.... wow so that this must mean that exerting my body while on feet is not causing serious problem. I understand about core and am trying to include. I am wondering if I should extend the length of time that I stay on feet attempting to walk because quite honestly standing up for more than 10 to 15 minutes at a time and I don't mean just standing and me moving and walking around since the surgery has simply not happened. that's probably not good. I am able to get through the night semi decently and as long as this is the case I'm beginning to think I should focus more on the amount of time I spend on my legs powering through whatever pain results although I'm certainly not about to try to go from 10 or 12 minutes at a stretch to 20 minutes at a stretch. would be a good idea but I'm beginning to think that if I can accomplish that in six or eight weeks I might be doing well?

            wife is yelling please try to forgive proofing voice recognition errors

            Comment


              #7
              Gordon, I think you have found the right idea about being up more. As long as you can tell it is muscle pain then keep pushing but if you find yourself dealing with a lot of pain at night back off a bit as you don't need to start over just cut back a bit. Glad to hear you haven't lost so much height as that was a lot. Yes being able to do 20 minutes at a time after six or eight weeks is good. I know I started just trying to get to the front door the first week, then out to the porch, leading to going to the corner. I felt like I was doing good once I could walk around the block without an major issues. Once I got to that level it was just a matter of keeping to stretch out the time I was walking.

              I have an electric mower too and I love mine, of course it only takes me 10 minutes to mow our lawn. I landscape our lawn and broke up the lawn with planting areas. The good part was it cut back on how much mowing I have to do. People talk about our landscaping and the color of our flowers and bushes while I don't have to do as much anymore other than early in the Spring getting the annuals planted and the edges cut in. One thing about landscaping I could do it in steps each day I could get out. Much of it I can do sitting or kneeling if I need to do that. I have changed all my landscaping tools IE mower, trimmer, edger to electric battery and I told my son and SIL I would never get another gas engine tool. My son mows for me about every other time and he loves the electric mower too.

              Keep going on and increase a little each week and before you know it you will be as good as you can be. That was a shock to me to realize after surgery that this is as good as it was going to be for me. Surgeries took a lot out of me but I guess as much as was done it is no wonder it took so much out of me. My wife commented the other day that we used to walk many blocks and now I can only do a couple of blocks now. I hope as the weather gets better I can walk more and get back to being able to walk the 5 blocks down to my daughter, SI, and granddaughters. It was a good workout walking down there and then my wife and I would walk back after sitting down for a while as we visited with them. Do you have a place to walk to eventually that would be a goal for you? It sounds as if you are doing fine after surgery and you just need to be patient with recovery.
              1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
              2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

              Comment


                #8
                Hello Gordon. It is good to see you are working hard to improve your health. Some things are here to stay, but exercise as you can. If it were me I would join a hospital fitness club. The hospital I use has a" hospital in the hospital". I have Scoliosis and have had it for quiet a few years. At one point I was 5'3'', but last check I was 4' 11". I have many other problems with my back, no surgery is even talked about. My Neuro Surgeon told me over 10 years ago he couldn't reverse all the damage I had and he sent me to a Pain Management Dr.

                I am so bent I can hardly walk.. I have been using a 4 wheel walker/with seat, but the DR. is ordering me a power Chair. In order to have any life I guess this is how I will live the rest of my life. I know I am much older than you so l hope there is much out there to help you. I'm glad you are getting info from others, especially Mark. Mark has been a great help to me.

                I would be very careful about what kind of gym you go to. I know there are good ones, but some aren't so good.

                It's good to have you on board here at BrainTalk. there is much to learn, just ask questions.

                you take care, Julia s
                Did you ever know that you're my hero and every thing I would like to be I can fly higher than an eagle
                'cause you are the wind beneath my wings

                for my brother Ben

                Comment


                  #9
                  Mark and Julia,

                  thank you ever so much again for the posts and encouragement. I think it was last Friday that I was able to take four walks of probably more than 100 yards each - I was actually beginning to think of tryting to walk all the way to my daughtes place... maybe 250 yards but then I started hurting again at night. so I backed off but I have been using the hiking sticks every day and staying on my feet for probably 45 minutes or more not at one time but total during the day.

                  julia I hear what you say about the gym but unless I go to my primary and try to get him to declare me permanently disabled I'm locked into a year-long contract. my trainer is nice but I have trouble getting 29 minutes let alone 30. I was going to the gym for almost a year even before the surgery.
                  Now i have been to Robert Wood Johnson which likely qualifies as the major local hospital run outpatient physical therapy. I last saw them January 5 and the guy there essentially said that he thought I knew how to do properly all the exercises I should be doing and that he didn't thin i should be coming back to see him until I had some new medical diagnosis or plan. and now it turns out i have no such thing. :-(

                  well I thought I was supposed to be seen by neuromuscular at Penn on March 5. turns out I was mistaken. the guy there said he has no clue and his perscription is to keep on going to the gym and call him another six months. he claims the tests I had and of December show ongoing denervation.

                  so yes I feel a bit abandoned. interesting that you mentioned pain management. when I went to see my primary about two weeks ago he said that he would look up someone in pain management to refer me to if I wanted. I understood him to be thinking about a change of painkiller. my wife with whom I am not getting on well things the pain management is going to be something like yoga about which I am skeptical although I have watched some YouTube videos about German experiments with fascia which is in the general universe of yoga and which the neuromuscular guy i saw at PENN and rather contemptuously dismissed.

                  would you or anyone say a little more about pain manaGEMENT?

                  The 30 minute gym sessions have been mainly upper body oriented with 5 or 8 pounds weights. one in each hand, but also with the idea of keeping core muscles as tense as possible core strength definitely not there but every time i try it i seem to get really sore.

                  being in the24th year of my internet newsletter and mailing list and tending to be a bit of a loner anyway has made me way too isolated. Two good friends of 10 and 20 years each are struggling to survive, and have withdrawn into themselves. Crazy times we live in.

                  Comment


                    #10
                    Gordon, sorry to hear about the trouble with your wife right now. PM is a wide range of strategies depending on the doctor. I would avoid the ones that want to do injections as some are not much more than shot docs as it gives them the highest pay. Good PM doctors will adjust the strategy based on your condition which certainly needs to be appropriate with recovering from surgery. Good luck with the pain doctor and I hope you get one that will do what fits your situation the best. Keep up the good work on the walking as you are progressing just fine. I remember how discouraging it was following my surgeries to only be able to walk a short distance but doing that each day lead to walks that were a bit longer the following weeks. You should hit a point that you start to progress much faster once your body recovers from the surgery.
                    1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
                    2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

                    Comment


                      #11
                      Hi Mark,

                      at the time you wrote this I was actually in ca healthcare a newish hospital on the north edge of Trenton Ewing and falling into apparently a case pretty severe sepsis. other than horrible pain most stark symptom was. I understand the survival rate for what I had is about 5% and I'm told that PNCL's will be needed for each kidney.

                      there is a muscle and I've been told the name and cannot remember it that lies between the kidneys in the spine and that it had access from what I don't know and become infected. how long it had been that way I am not certain I'm not sure if anyone is certain but apparently a long time probably at least 6 to 8 months from the time my recovery from the other surgery having reached the plateau.

                      I spec now that the hydrocodone I was taking may have masked the onset of these other problems, and to make matters even worse apparently my kidneys with kidney stones. that came as a real shock so to serious ongoing problems and being treated once and since May 31 I have been treated merwick rehabilitation in West Windsor Plainsboro New Jersey.

                      I have been getting a daily intravenous drip of something called tchervotonin...... (sp)? a class3 sporin

                      since about May 10. there PT OT is very good.... my strength is returning I cannot yet walk on my own with a walker but I can't get in and out of bed for my wheelchair and my son got bless them brought in my computer which is the reason I'm online.

                      my PT mahavesh about 10 days ago allocated the area from which the severe pain is coming and found what she said it was a nodule. she gave what she called a deep friction massage of the area and when she hit the module it really hurt but afterwards felt much better. two more sessions on the nodule revealed changing shape. the next was something the size of a grain of unpopped popcorn and last night there was a third one that felt like a "blob."

                      we got an x-ray about 9 PM last night and am awaiting the radiologists report. the radiologists came back and took a second picture because apparently the first picture did not show enough of the affected area. of course my pessimistic mindset is worried about lots of other icky problems that could be indicated.

                      I think my last post in this thread was April 29, the very day that things went south. I share all I only really this in the hope of learning more.

                      Comment


                        #12
                        what happened to me april 29 to jun 25

                        Hi Mark,

                        at the time you wrote this I was actually in capitol healthcare, a newish hospital on the north edge of Trenton Ewing and falling into apparently a case pretty severe sepsis. other than horrible pain most stark symptom was DELERIUM. I understand the survival rate for what I had is about 5% and I'm told that PNCL's will be needed for each kidney.

                        there is a muscle and I've been told the name and cannot remember it that lies between the kidneys in the spine and that it had access from what I don't know and become infected. how long it had been that way I am not certain I'm not sure if anyone is certain but apparently a long time probably at least 6 to 8 months from the time my recovery from the other surgery having reached the plateau.

                        I speculate now that the hydrocodone I was taking may have masked the onset of these other problems, and to make matters even worse apparently my kidneys with kidney stones. that came as a real shock so to serious ongoing problems and being treated once and since May 31 I have been treated merwick rehabilitation in West Windsor Plainsboro New Jersey.

                        I have been getting a daily intravenous drip of something called tchervotonin...... (sp)? a class3 sporin

                        since about May 10. there PT OT is very good.... my strength is returning I cannot yet walk on my own with a walker but I can't get in and out of bed for my wheelchair and my son got bless them brought in my computer which is the reason I'm online.

                        my PT mahavesh about 10 days ago allocated the area from which the severe pain is coming and found what she said it was a nodule. she gave what she called a deep friction massage of the area and when she hit the module it really hurt but afterwards felt much better. two more sessions on the nodule revealed changing shape. the next was something the size of a grain of unpopped popcorn and last night there was a third one that felt like a "blob."

                        we got an x-ray about 9 PM last night and am awaiting the radiologists report. the radiologists came back and took a second picture because apparently the first picture did not show enough of the affected area. of course my pessimistic mindset is worried about lots of other icky problems that could be indicated.

                        I think my last post in this thread was April 29, the very day that things went south. I share all I only really this in the hope of learning more.

                        of course concerned about the blob seems to be a pain the center on my sacroilliac.
                        Last edited by Gordon Cook; 06-25-2015, 08:24 AM. Reason: faulty voice recognition

                        Comment


                          #13
                          I am trying to find the item I last posted in.

                          trying to figure out what happens when they do the pncl's on the kidneys and whether that leaves me with massive amounts of stones traveling to the urethra and how to handle that pain management.

                          Comment


                            #14
                            Gordon, sorry about just now responding as I went with my wife up North to visit with her family and to see a few friends from when we lived there. I have been down for a couple weeks recovering from the trip but should be able to visit here every couple days now.

                            You have been through the wringer and I am sure the pain meds masked some of the symptoms helping put you in the mess you were in. 5% is a scary place to be but it sounds as if you are working your way back from that dismal perspective. I hope what they are doing has you on the right track for recovery.
                            Our lives aren't easy and it isn't easy for others to see what we are really going through as pain isn't something easy to see unless you live with someone and can see in in their face and body. I was at CVS and saw an acquaintance from a few years ago and he jokingly said "it must be nice to be on easy street" meaning not working any more. I said yes it is if you mean being in severe pain 24 hours a day every day. We don't need other people's empathy but it just shows how hidden our pain and disability is. I wish you a continued recovery and pray you get back on your feet soon and in the best health you can be.
                            1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
                            2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

                            Comment


                              #15
                              Thank you Mark

                              indeed how you have been able to do what you have done is awesome.

                              meanwhile I am making definite progress. expect to be going home July 24. came down with C diff. hazard of the three months of antibiotics. the PNCL of the right kidney was canceled because of this. argH!!!!! :-(

                              I have found out something new that our mention because I have never seen it mentioned before. and I think it explains where my pain has been coming from. S-I joint disorder!!

                              there is a good article in Wikipedia on this.

                              hopefully it can be satisfactorily treated and eventually my kidneys cleared out but now the new enemy is the Cdiff

                              immediately there is one thing that makes me happy and that is has been 23 hours since my last "narco". and feeling of any pain is mild. although if I move my body out of the right position OUCH!

                              wow! I have been on pain meds far too long.

                              took the first steps with a quad cane only for support and then walking longer distances with rolellater.

                              Not sure I understood your remark about empathy, but Lord knows, it seems to me empathy is gosh darn important?

                              One other thing, for the past five or six years, I had been feeling pain at night where the physical therapists told me it was because I needed stretching exercises because an older people the muscles tense up during sleep.

                              probably true however this experience has enabled me to sleep on my back. I always slept on my right side the site where what I believe my SI joint disorder has been developing. I had never slept on my back and now being able to sleep on my back hopefully by not putting pressure on THE joint.

                              I wonder if it would make sense to copy the thoughts about SI joint to a new form?

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