The Road

I'm training for the Philly half-marathon and had to do my eight mile run today. It's beautiful out, but it still took effort to drag myself out the door and off to the Schuylkill River. I've never run eight miles before, and it can be difficult to get motivated if you're running alone. I got on the trail and the road seemed endless out in front of me. As my feet hit the pavement, images flashed through my head of the past four years. Recovering from each new surgery, re-learning how to walk three separate times. Each time I would drag myself out the door and hit the trail on crutches, a cane, and finally my own two feet. During those times, the road seemed endless too. I felt as hard as I tried, as strong as I was, I could never reach the end of that road. All I could do was keep my head down and power through each step.

Today the sun was out and the leaves were turning, and I kept my head up to absorb everything around me. The river ran along next to me as I traveled further and further. And would you believe somewhere around mile 4 a monarch butterfly flew along with me for a few seconds? If you recall this post from almost exactly a year ago, you'll understand my life continuing to come full circle.

The road used to be so frightening to me because it was boundless and I never knew when or if I could get off it. Now I'm realizing that's the beauty of it. The road stretched out in front of me and I released my feet and just ran. For the first time, I enjoyed how limitless it was. Because this time I could keep running.

Transitions

My life is currently in a series of transitions. I'm transitioning from suburban life to city life, from a familiar home to a new apartment. I'm transitioning from an employee to a student. Most importantly, I'm transitioning from a patient to a practitioner. Granted this transition will take me three long years, but the process is beginning. The problem with transitions is you cannot simply forget the past.

I'm having some difficulties moving from the patient mindset. This is because I still have pain and frustrations about what exactly is occurring with my body. Sitting through classes is quite difficult at times. It seems like my piriformis muscle refuses to relax, no matter how much I stretch it, stim it, or ice it when I get home from school. I'm looking into pelvic floor therapists in Philadelphia and will hopefully find some time to make improvements.

Don't get me wrong, my pain levels have tremendously decreased from a year ago. The combination of hip and pelvic surgeries, as well as the proceeding physical therapy and the intense prolotherapy injections into trigger points have made the pain much more liveable.

I think today was an especially emotional one because we covered the pelvis and pelvic floor muscles in Anatomy class. On the one hand, I was ecstatic because it's structures and muscles I'm so familiar with, which will give me time to catch up on previous lectures. On the other hand, it was difficult to sit through- mentally and literally. When we talked about the ischial tuberosities, I was more aware of the pressure and pain emanating from my own sit bones. When we talked about the pubic symphysis, I was more aware of the scars covering that area on my body, and the erosion of the bone I'm dealing with. We talked about the obturator internus, which I know too well how that feels to be internally palpated and worked on by a therapist. Finally we spent a great deal in the powerpoint talking about the piriformis and how it is the reference point of the pelvic region. Slide after slide, I stared it down, almost challenging it. This is my great enemy, who I will do everything in my power to finally defeat. I'm determined to learn everything I can so that I am no longer at its mercy. And so that I can effectively treat my own patients one day.

Just a side-note: now that I'm in school, I have less time to answer the personal emails I receive. Please know that I read each and every one, as well as all the comments you leave. You are not alone. And if you ever find yourself in Philadelphia, drop me an email and we can get coffee.

Power
 
Living     in the earth-deposits     of our history

Today a backhoe divulged    out of a crumbling flank of earth
one bottle     amber   perfect   a hundred-year-old
cure for fever     or melancholy     a tonic
for living on this earth    in the winters of this climate

Today I was reading about Marie Curie:
she must have known she suffered     from radiation sickness
her body bombarded for years     by the element
she had purified
It seems she denied to the end
the source of the cataracts on her eyes
the cracked and suppurating skin     of her finger-ends
till she could no longer hold     a test-tube or a pencil

She died    a famous woman    denying
her wounds
denying
her wounds    came    from the same source as her power

                    -Adrienne Rich


I came across this poem today because I am reading Wild by Cheryl Strayed, a grief-stricken and lost woman who decides to hike the Pacific Crest Trail to find catharsis. She is completely unprepared and ends up carrying a ridiculously heavy pack. Later on in her journey she is given some help on what items she can get rid of to lighten her load. She relented on most things except her copy of The Dream of a Common Language by Adrienne Rich. She brought other books as well, but was able to burn chapters as she read them. But there was something in this book that she safeguarded and there was some reason she carried it thousands of miles. I wanted to know why. I felt connected to Cheryl a few pages in because she was a female backpacker, choosing a poetry book as her lone companion. It had to be pretty special.

After no luck in a used bookstore, I decided to cross the street and search in Barnes and Noble. Lo and behold, there was one copy left. Too curious to find a table, I plopped myself down on the carpet. Tall bookshelves rose above me as I turned to the first poem. It was the same poem Cheryl turned to her first night on the trail. It was perfect.

digging through notebooks

I found this entry in one of my notebooks, dated 2/25/12 and wanted to share it.

I have been gone a long time. Updating is getting difficult for me because I find I'm distancing myself from past horrors. And even though there are still health obstacles to overcome, I find it easier not to write about it. I want to enjoy life and relish in this happiness. For months now, I wake up in the morning feeling happy. Truly happy. For a period of time, the joyous emotions were so overwhelming that I would cry. Not just a few tears either. I opened my eyes each morning, and felt such a dramatic reduction in pain that I bawled. It was a right I thought I'd never get back.

The crying did not stop there. Life became dramatic- the sunlight caressing a tree a certain way would move me to tears. One day I was walking down the streets of Philadelphia with my sister and started crying without any sort of trigger. Luckily my sister was used to these reactions and told me to pull it together because we were about to walk into a pizza parlor to meet all her teammates. And it's best not to meet twenty girls on your sister's crew team when you're bawling your eyes out. Because then they'll want to know what's wrong and you'll have to tell them that nothing is wrong. In fact, things are wonderful. And they won't believe you and then you'll become that weird older dramatic sister that they try to avoid.

Luckily I pulled it together and no one was the wiser.

The frequency of these episodes has greatly been reduced over the past months. But they'll still happen if the trigger is good enough.

Many people have been writing to me asking me if my pain is gone. I'm still undergoing intense prolotherapy treatments, but I feel they are helping. I am being patient and putting faith in my doctor and my body to heal itself. But I don't want to talk about that today.

I remember years ago being so frustrated by all the depressing stories of women I found online. I realize now that writing is very therapeutic when you are struggling. People tend to stop when they are doing well. I think we just want to forget this ever happened to us and are anxious to go back to the way things used to be. This is of course impossible because we have been forever changed.

I wanted to write this post to give strength to anyone fighting a difficult battle right now. I remember how hard it used to be. I remember hitting my arms, bruising them repeatedly to try and distract myself from the pain. I remember driving in the car and thinking how easy it would be to turn the wheel slightly and escape from the pain.

I remember specific nights, crying on the floor, wondering how I was going to get through another day. If I only knew the happiness, the elation that I would feel just a year later. I couldn't whisper in my ear back then, so I'm whispering in your ear now.

Whoever you are, wherever you are, whatever your battle, however long it's been happening, keep going. Keep going. You can't give up when you don't know what tomorrow will bring.

To strive, to seek, to find, and not to yield.

I dreamed about writing a post like this for many years. Years, can you believe it? Whenever I have a moment to myself, old scenes flash before my eyes. They no longer haunt me, but I am still amazed they were lived through.

I'm trying to explain how I feel right now, but words are failing me. Imagine being weighed down by a huge pack while climbing a mountain. (Did you expect anything else?) The pack is so heavy, you cannot even lift your head up. Bending forward, teeth clenched, you spend all your energy taking one step at a time, being careful not to trip over anything in your path. Sometimes you stop and think about how far you have to go and life seems hopeless. You wonder if it's even worth it anymore to continue to take it, to continue stepping forward. If you could just take your pack off, if you could just lighten the load, if you could just feel a release for a little while...

Think about that burn in your legs, the ache in your back, the shortness of breath, and then imagine what it would be like to have your pack removed. Immediately, your back straightens and you realize how far from normal it was. With the weight now gone, you slowly regain your breath. Walking tall, you now lift your head and your eyes are just flooded with vistas of light. It is like you are seeing for the first time. You see everything around you and it all looks different. It does look like you are seeing it for the first time.

You cannot help but reach out in front of you, just to make sure this is all really happening. As you continue to walk upward, you pause several times, checking to see if you are still carrying the weight, but you realize you just feel the ache of carrying it for so long. It's at that moment you understand how much weight you had been carrying this whole time, and what a toll it took on you. Life is now a second chance. It's a gift.

My prolotherapy treatments are working. They really are. The release I feel is unbelievable. We still have a lot of work left, but every time I go my pain decreases less and less. I'm beginning to go every two weeks now in order to treat the front of my hips as well.

I've been an emotional wreck recently because I am just so happy. I cannot contain it, I cannot hide it. It spills out of me in long waves. After my treatment last week, I cried for almost an hour in the recovery room with my dad and sister. I just could not stop and kept apologizing to them and the nurses who came in. It was like every bad thing that has happened to me needed to be released from my body. There's a lot that needs to leave. If you see me, don't be surprised if I start to tear up. In fact it's already happened in this coffee shop. Never did I understand what tears of happiness were until now. Every moment feels a bit dramatic. I just did not think I would ever feel this way again. It's as if life has said to me, "Welcome back."

Butterflies

Recently we are having brilliant weather. The leaves are turning, and the sun is shining through them to create autumn kaleidoscopes. There are rolling clouds accompanied by a faint wind that is just breezy enough to fly a kite successfully (which is really all that matters). Comfy clothing is back, along with the savory scents of bread, pumpkin, and campfires.

This weather just demands long winding drives, with open vistas of oranges, yellows, and reds amidst the green landscape. One day last week I was out cruising to wonderful music, making waves with my hand out the window, and all of a sudden a monarch butterfly flew directly in front of my car. For almost a minute we flew together, and I watched it gracefully dance as if by magic.

The next day I went for a lumbar MRI, and on my way to the facility a monarch appeared again in front of my car. Even though I was miles from the previous location, I like to think it was the same butterfly. I will never forget the way their wings glowed, flooded by sunlight.

I found out a few days later that my MRI came back clean. No obstruction in my lower back, vertebrae are in place, etc. I think this is the first clean MRI I have gotten back in four years. I was shocked. And then shocked that I was shocked. I have become so accustomed to the odds not being in my favor that I have adopted the wrong mindset.

The even better news is I have been feeling less pain on most days. I do believe I feel my body healing itself. This is when I'm supposed to be noticing some relief from the prolotherapy, so I really think it is helping. Which makes it all worth it. I am still anxious about what's to come, but I'm holding steadfast to hope. My next treatment isn't until November 17th, so there's more time to notice improvement. When I stop to really think about it, I get choked up. There's been a few tears this week, only because I don't even know what I will do if this is the final stretch. That's a lie. I will go out dancing. I will run a marathon. I will climb everything. I will be carefree. I will be happy.

I've been spending a lot of time reminiscing how far I've come. The constant in my life has always been my family and friends, who have stood by me no matter what. I have always been slow to trust and let people in, but these wonderful beings took the time to break down all my walls. I have been so much happier lately and have not needed to rely on them like I used to. It is so comforting to know I have people in my life who accept and love all parts of me. And who will be there for whatever lies ahead. I owe them everything. I stumbled upon this song a few days ago, and it's been playing nonstop. It's called Rely by Alex Cornish and it's here as a tribute to everyone who got me through this far.



Right now I'm taking each day as it comes. I am anxiously awaiting decisions from physical therapy programs. I'm icing, stretching, and doing yoga on a regular basis. I'm working, taking classes, and enjoying every minute of fall. And of course, I'm always on the lookout for more butterflies.

Three's a charm

Thursday marked my third prolotherapy treatment and it went much better than anticipated. I'd like to say I walked in with a larger batch of courage, but I think it had a lot to do with the two Demerol injections I received at the office.

But sure, let's say I was much better prepared this go around. Really, I was. I did yoga the day before to balance my chi. I had a fun, relaxing night. I woke up feeling confident and ready for the challenge ahead. I brought earphones and made a rockin' Beethoven playlist in the car. I did not take the Xanax and felt like myself. I walked in the office, on time, with a clear and steady mind. I was immediately brought back by the nurse where I signed the necessary paperwork, and then got a Demerol injection into my hip by my specialist. Both he and my super tall nurse remarked how bony my hips were and I smiled. Then, I took off my pants and put on the open-backed hospital gown, and positioned myself on the table. Then the whole crew came in- my dad, doctor, and the nurse and I was asked if I felt the Demerol. I did not feel much of a difference, so I received a second injection into my hip, and then we began.

I put on my headphones and transported myself into a different place of symphonies and high vaulted concert halls and standing ovations. My dad and I also worked on my breathing, which I was able to control this time. In all honesty, the whole process went very smoothly. Yes I still felt pain, but it was nothing compared to the previous two times. In fact, I was in high spirits and attempting a few jokes. We tried to take pictures of all the long needles sticking out of my butt and hips so I could feel like a badass. Or a pin cushion. Now you see why I was only attempting jokes. Don't worry, pictures will never go up here.

We went a bit longer than the previous two treatments, around an hour and fifteen minutes. I think we tackled more spots in different locations, especially my lower back- lumbar area specifically. I'm hopeful that this all might be working because examination felt better in certain area we hit aggressively last time. Soon I will also be getting an MRI of my lower back to see if there are any nerve structure issues. The doctor wants this new information to better treat me in the future. I also received my first treatments on the anterior portion of my body. Using very small needles, Dr. Magaziner injected all of my hip scars, as well as my two long pelvis scars.

I feel the need to reiterate how well the treatment went. I was on quite the high because I felt I was ahead for once. It was the same feeling I get after reaching a summit. Nothing can touch you.

The Demerol did not make me hazy and I still felt I had control over myself. Unfortunately the side effects of Demerol include nausea, so I went to lie down in the room next door after we were finished. I did not get sick, and the doctor quickly injected my hip with some anti-nausea medication.

Back at home, I got in bed and put some ice on all the areas that were injected. I was very sore, especially feeling pain in my lower back and hips. Bending over was definitely not an option. I rested in bed all day, and spent most of the time sleeping off the Demerol. When I woke up in the morning, I still felt a lot of pain in my hips and lower back, making it difficult to move around. So the recovery was a bit more difficult than previous times. But I woke up today (two days later) feeling almost as good as new. The important things were to lay down, rest, and ice.

It's been a pretty crazy week. Monday I was in the emergency room for a terrible terrible ear injection. I missed my second anatomy lecture because of it. I'm frustrated how much my body continues to fight against me, but I try to remain levelheaded. Some days I just want to burst. I'm tired of being stuck- I want to wake up and go for a run. I want to go out and dance. I want to play tennis. I want to climb. I want to push my body and embrace it. But I know I must stay patient and wait and heal and work through it.

I can do this. I can do this. We can do this. Some days we walk ablaze with hope, and some days we just continue.

If you are in need of some hope, I've got a great dose of it right here: A young deaf woman hears for the first time. Imagine what it will be like to feel healthy again and let's keep on together.

From the book: Poems to Live by in Uncertain Times

September

by Jennifer Michael Hecht

Tonight there must be people who are getting what they want.
I let my oars fall into the water.
Good for them. Good for them, getting what they want.

The night is so still that I forget to breathe.
The dark air is getting colder. Birds are leaving.

Tonight there are people getting just what they need.

The air is so still that it seems to stop my heart.
I remember you in a black and white photograph
taken this time of some year. You were leaning against
a half-shed tree, standing in the leaves the tree had lost.

When I finally exhale it takes forever to be over.

Tonight, there are people who are so happy,
that they have forgotten to worry about tomorrow.

Somewhere, people have entirely forgotten about tomorrow.
My hand trails in the water.
I should not have dropped those oars. Such a soft wind.

A Rumi night

To dance is not to jump to your feet at once
and rise painlessly in the air like dust.
To rise above both worlds
is to dance in the blood of your pain
and give up your life.

To Joy

"Joyful, as a hero going to conquest
As truth's fiery reflection
It smiles at the scientist
To virtue's steep hill
It leads the sufferer on
Atop faith's lofty summit."

Beethoven has been my constant companion these past months. If you remember, it all started this summer when I blasted his 9th on the way to class every day. I stand by my statement that it is impossible to be in a bad mood when listening to Ode to Joy. Here try:

This performance occurred during the last night of the Proms, days after 9/11. You do not even have to watch, simply close your eyes and feel the tribute, the resilience, and above all, the exultation. Since the beginning of this summer I have listened to Beethoven's 9th at least once a day, usually more. And for 27 minutes, nothing else exists. It doesn't make me forget what I'm going through, but rather delivers the important message that life is worth living. Some days I like to think Beethoven himself is urging me to keep going. I'm halfway through his biography and read a few of his letters before I go to sleep. Let me tell you, Beethoven knows. He was a man who suffered much pain, who refused to take pain medicine because it would change him and hinder his musical prowess. Would his music be so mesmerizing if it did not spring from a dark place? His struggle is a testament to his commitment to life and reminds me that there are glorious moments worth fighting for. Somedays they might only last 27 minutes, but they are there.

I have been through two rounds of prolotherapy treatments, with the next one coming up in two weeks. I will be frank; they are absolutely awful. It's taken me so long to write about them because they are painful and by far the most difficult obstacle I've had to face. The first treatment in August went poorly because I walked in unprepared and overconfident. I thought I could tolerate any pain without difficulty. I was proven wrong very quickly. My mom and I went early on a Thursday morning, so I would be the first appointment of the day, and could rest the entire weekend before I had class again Monday night. We walked into my specialist office and were brought into the back room, where he conveniently has the equipment set up for prolotherapy treatments. My mom put on a heavy xray gown, while I undressed and put on a thin cotton hospital gown. I laid down on the table, belly down, and the tall attending nurse came over and asked me how I was doing. I smiled at her, and told her I was fine and have been through a lot worse. She did not say much more, but reminded me she had stress balls I could squeeze during the procedure. I thought she was being sweet, but was underestimating me.

My specialist came in and shook my hand and asked me if I was ready to begin. I might have smiled and gave him an enthusiastic, "let's do this!" He then began pressing my hips and legs and butt, looking for the painful areas and marking them with a blue marker. This unsettled me slightly because there were so many spots, and it was a reminder of how much pain I carry. After the markings, he said we were going to begin by numbing the area. Taking small needles, he goes to work right away, placing them in all the spots he's marked, moving quickly. I watch the xray machine in front of me, seeing the needles go in, and noting all the bones I have recently learned in anatomy class. This process shakes me up a bit, because the numbing medicine hurts going into the trigger points. The trigger points are bad enough by themselves, so they don't take well to invading needles. After the numbing, we begin the actual treatment, of injecting medicine into the same spots to cause heavy inflammation, hopefully triggering natural growth factors in my body. And this point is where I lost my nerve. The marking and numbing takes around 5 minutes, leaving around 45- 50 minutes of injecting needles repeatedly into my body. It hurts. I cannot even describe the pain. I feel the numbing needles have done nothing because I feel everything. In reality, I know I could be feeling worse pain, but this thought doesn't cross my mind. A few injections in, he accidentally hits my sciatic nerve and my whole leg shakes in anger. I cried out in pain, and lost whatever confidence I had after that. The nurse silently brought over the stress balls, and I took them in each hand and squeezed. My mom watched, shifting between holding my hand, patting my head, and holding my gaze. I could not have done it without her. And I know it must have been the most difficult thing for her, to watch me in such incredible pain. I felt guilty that she was being strong for me, and I couldn't be the same for her. The treatment carries on, and I still attempt to hold it together. Sometimes sounds escape from me, which I have no control. I whimper a bit, but I refuse to cry, to lose it completely in front of this doctor. Because even though he is a wonderful and talented man, he is my enemy for that hour. I have no choice but to direct my anger and frustration to him. And I refuse to let him win and see me upset. Partway through, he is concerned and asks me if I need a break, need to cry, need to stop for the day and do the second half of my body at a different time. I spit back that I am fine and let's keep moving. I take a one minute break around halfway through the treatment, and try to focus on my breathing. The rest of the treatment drags on, and after an hour it is finally over. I feel a bit light-headed and cannot get up right away. Since so much anesthetic is used, this is a normal reaction. Slowly, the compassionate nurse and my mom help me up. The nurse tells me how brave I was and how very few people have to go through something that long and intense over so much of their body. I slowly shuffle to the room next door and lie down for a second. The doctor wants me to stay there until I feel less light-headed, but all I want to do is get out of there. I am going to lose control any minute, so I quickly tell my mom to help me get dressed and we exit the building immediately. She opens the car door for me, and helps me lie down in the back, and then sits down in the front and turns back to look at me. She is concerned and I want to tell her it's okay, but instead I tell her I'm sorry and then the floodgates break. I ask her to plug my ipod in and soon classical music drifts through the car. I cry and cry and cry. I cry out in pain, I cry for having to go through something so awful, I cry because I do not know when it will end, I cry because I wanted to be braver, I cry because it feels right and because I need to.

I get home and am carefully helped up to my room and lay in bed, icing the inflamed area. It hurts, but I am in not much more pain than I am used to on a daily basis. The worst is definitely over. My backside is covered up by gauze, and we check to make sure the sites are clean and not infected. It takes a few days before I feel better, and I carefully walk around and try not to sit. All the places where I was injected bruise, and my butt looks like a glorified black and blue pin cushion.

I don't know if it would have helped me to read an account of the treatment before I went, but I wanted to write this down in case anyone wanted to be better prepared. I wish I could say the second treatment two weeks ago was easier. This time I went with my dad, who is also a pillar of strength and support. I felt a bit more prepared this time, but I was still very anxious the night before and morning of. This time the doctor had me take Xanax for my nerves, but I did not like the affects. I don't like taking medicine to begin with because of my awful experiences with mood shifting in the past. I already don't have control over my body, I do not want to lose myself as well. I know how Beethoven must have felt. But I took it to try, but I think the affects were opposite what they should have been. I remember walking into the waiting area of the office and getting extremely anxious that the carpet wasn't vacuumed. I saw pieces of white fuzz everywhere, and back in the treatment room, I turned to my dad and told him I couldn't go through with it. I told him the carpet was filthy, and why couldn't they have cleaned it and maybe this place wasn't professional and maybe we were making a mistake, and why were we here in the first place?? He calmed me down and we worked on some breathing and then he tried to take me to a different place. "Picture going hiking with your friend," he said. "You're up in the mountains, the sun is shining, you're..." "Dad, stop," I barked back. "It's not working." I could not bring myself to leave that room. I don't need to talk about the treatment again, it went just like the last one, minus hitting the sciatic nerve. I know it affected my father deeply. I am so blessed to have such a strong family and group of friends who can support me. I don't know what I would have done without him in the room. I know it was hard for him. He had difficulty holding himself up during the treatment and had to leave the room for a few minutes to lie down. His blood pressure dropped from watching me in so much pain. I know he's embarrassed that he showed weakness, but it actually gave me even more strength. It validated the pain I was going through. Later, after the treatment was over, he turned to me in the car and told me in his short, but powerful way that he did not know many people who could go through what I did. We are going together to the next treatment in October, and I think we'll both do better. The doctor wants to try an injection before I begin for anxiety since the Xanax did not work. I told him I'd like to bring my speakers and play Beethoven during the hour. There are many things that can transcend the power of medicine.

One of the best things I have done since I last wrote is become more open about my feelings. Too often I turn in and tackle my dark moments alone, blocking everyone out. I have so many people who want to help, who want to be there. I find myself struggling in telling them how I really feel because I find it's a large burden. They constantly tell me it isn't, but I cannot help how I feel. Sometimes I feel so separated from everyone, and have almost an out-of-body experience. I'll be talking or hanging out with family or friends and what we're doing will seem so trivial and pointless. Or I'll get angry listening to someone talking about their "normal life." I know I've become bitter and I know that everyone has their own struggles in life. No one is normal and we all carry around baggage. I have found that when I reveal how I really feel to those around me, I feel much better. One time in particular last week, I broke down in front of a dear friend. I was originally going to lock myself in my room, lie in the dark listening to my music, and writing a post, but chose to be vulnerable instead. I was so relieved after sharing my fears, and felt stronger instantly. Another friend reminded me recently that I have so many people around me who want to help carry the weight. That it's okay to share it. I am learning so much about friendship.

I have pages and pages in my notebook of other things I want to say, but they will be for another time. I've included a link below of a translation of Freidrich Schiller's "To Joy" poem, written in 1785, that Beethoven so beautifully put to music in his 9th symphony. This is the poem in its entirety, only sections are sung in the chorale section.
http://raptusassociation.org/ode1785.html
There are so many good lines about overcoming the dark, and celebrating the light. Enjoy. And as always, keep fighting.

"Endure courageously, millions!
Endure for the better world."