Journey to the Surgery Center

OK – I admit it.  I’ve been feeling sorry for myself.  Those of you who follow this blog might recall that I discussed my ongoing issue with nerve pain in my legs a couple of months ago.  Since that time I’ve had every test imaginable and all the professionals involved have concluded that the problem is in my spine.  Lumbar spinal stenosis, they say, also arthritis and other contributors to compression in my spine leading to narrowing of space for the nerves.  From the very first viewings of my MRI, it was suggested that surgery would be the most likely recommended route.  Still I remained unconvinced and resistant.  Something else must be wrong.  Just look at all the years I’ve spent caring for my spine with yoga and Pilates.  Of course, that overlooks the other bunch of years I was pounding on my spine and otherwise abusing my body as an ultrarunner.  And, of course, as much as I’d like to I can’t discount my age.  Even though inside my head I don’t feel any older than 40, all I have to do is look in the mirror and remember that the mind can tell one story while the body tells another.

Over the last several months I’ve done my best to find other ways of alleviating the pain (including ignoring it which can only take one so far.) First I tried medication designed specifically for nerve pain.  I got all of the side effects and none of the benefits.  Then I had a cortisone shot. The lidocaine applied before the shot reduced the pain for about 2 days, but as that wore off the pain crept right back in.  Within a week I was right back to where I started from.  I went back to over-the-counter NSAIDS, but soon was taking enough of those to burn multiple holes in my stomach.  I already have GI issues so I knew I could not go on with that.  Besides, they also stopped working no matter how much I took. Time to turn to the heavy-duty stuff (yup – the ones that the politicians are screaming about.)  The federal noose is being wrapped around doctors’ necks over these so only a limited amount is available to humans in pain.  Despite all the hand-wringing these haven’t been much help either.  My mind is foggy, but the fog isn’t sufficiently dense to mask the pain.  Physical therapy, acupuncture, myofascial release, energy healing.  All have been fun and interesting to explore and I will probably continue to do so.  But, unfortunately, none have given me any sustainable pain relief.

Anyone who has suffered with pain from anything, no matter how temporary, will know how quickly it takes over your life.  There doesn’t seem to be enough room in your head for anything else when pain invades the senses.  You have to think twice about doing anything.  Going out or even just getting out of bed requires a strong will.  It is so easy to just give into it and withdraw from life.  At the end of each of my yoga classes I always express gratitude for being able to move and breathe.  (Thanks to yoga teacher Sean Corne for reminding me of that in a workshop some years ago.)  Yet even remembering that becomes a challenge as pain sucks all of your energy.  Muscles tense up under the strain and imbalances are created that serve only to exacerbate the sensations.

This week, though, I had an abrupt wake-up call.  As I sat in my doctor’s office waiting my turn for a routine follow-up appointment I had scheduled, a friend came in who has the same doctor.  We had both had similar treatment for cancer a couple of years ago.  Thankfully, I have been in remission since completing chemo in 2015.  This woman has not been so fortunate.  Her cancer has returned with a vengeance to the point where she is running out of treatment options.  My heart goes out to her and her family.  But I could not help but recognize how fortunate I am.  Sure I may be hurting right now, but my condition is not life-threatening.  Quality of life, maybe, but otherwise I’m still pretty healthy.  As I’ve heard many times in many places, there is much more right with me than there is wrong.  Despite our complaints and inherent tendency to focus on the negative, this is true for most of us. Take a few minutes to think about that.  Gratitude lists are often recommended as a way to climb out of the “poor-me’s”.  Try listing all the things that you can do at the top of today’s gratitude list.  Can you see? Hear?  Feel?  Breathe and move?  Do you have enough to eat?  A warm and dry place to sleep?  Do you have friends and/or family who care about you?  Some of these will surely apply and I’m certain each of you will think of more.  None of us is perfect and life is full of trials and tribulations, but it still usually remains true – there is more right with us than there is wrong.  Sometimes all it requires to see that is simply a change of attitude.

So I’ve now arrived at surgery’s door and at this point I’m willing, almost glad to finally turn the problem over to someone else more competent than me at finding a solution.  I’ve learned that there is a reasonably reliable fix for my condition that has great success rates. Granted, spine surgery is never something to take lightly and I am well aware that anything can happen.  But at this point I’m ready to accept the outcome whatever it is.  My surgeon is enthusiastic about my ability to handle it and recover well.  All those years of Pilates and yoga have, in fact, helped me alot!  Maintaining a healthy level of mobility, strength and flexibility will get me through the surgery and help me recover quickly.  And then I hope to be better than ever with years of renewed life for my spine and its miraculous support for all my activities.

Someone said, “So sorry to hear you have to go through this.”  But I said, “Don’t be sorry.  I have a condition with a high probability of being fixed!  Many people have much worse problems for which there is no fix.”  I have good health insurance (Medicare – Yay!).  There is a competent surgeon and facility nearby that can do this for me.  I have help and support all around me.  I am very fortunate.  Having the problem is no fun, but if you have to have a problem, this one is better than many.


Finding Your Place in Space

Recently I heard a story about a meditation teacher addressing a class.  He asked his students to demonstrate how they feel space. Immediately every student raised their hands into the air.  The teacher laughed.  He said, “You don’t need to put your hands in the air.  You are already feeling space.”  Think about it.  Space is all around us.  And not just outside our bodies, but inside our bodies also.

Your body’s ability to sense its position in space is part of what we call “proprioception”.   The term also refers to recognizing the relative position of each limb in relationship to other parts of the body as well as the environment.  Proprioception is important in all movements of the body since it enables us to know where our limbs are in space without having to look.  When I teach chair exercise classes and ask participants to move their feet, everyone looks down.  This always makes me smile.  For most of us, our feet will move whether or not we are watching them.  But somehow we feel the need to help them along by looking.  I often ask my yoga students to close their eyes when standing in Mountain Pose and bring their feet to a parallel position.  Then I’ll ask them to open their eyes and see how they did. Surprisingly most do pretty well!  This demonstrates the ability to sense the position of one’s feet in space and each foot in relation to the other.

Of course, this is not true for everyone.  People with certain neurological conditions may have difficulty with proprioception.  It is also one of those senses that tends to diminish with age.  Several years ago I read a book called “My Stroke of Insight” by Jill Bolte-Taylor, a brain researcher who had a stroke.  While she was actually experiencing the stroke she was somehow able to marshal her knowledge of how the brain works and recognize what was happening to her.  The book describes her experience both during the stroke and in recovery.  As the stroke was happening, one of the indicators for her was that she became unable to distinguish where her body ended and other objects began. Every time I trip over something I think of this.  Even though I see the object and should be able to get around it, somehow I lose my ability to recognize where my body ends and the other object begins.  Thus we collide.  As my husband would say, “No – you’re just clumsy”. Point taken.  But I still prefer the other explanation.

Any of you who have ever had nerve damage to a limb will know that one of the goals of physical therapy is to restore functional mobility.  In an article discussing proprioception in physical therapy, author Brett Sears, P.T., describes how different nerve endings in your limbs relay information to your brain about the relative position of your limbs and the direction and speed of movement.  This process enables us to move in space without actually watching the movement.  Think of yourself walking.  Generally, you can move your arms and legs in space without looking at them and also usually manage to keep them from bumping into each other.  When this communication between brain and limb is disturbed, it needs to be retrained if possible.  Most of us understand the need for practicing balance, but proprioception is equally important.  The two senses work together to help us move efficiently.

So how can we work on improving proprioception?  One way is to create balance challenges.  Try standing on one foot.  You may notice that your standing foot starts to wobble.  If you pay attention you may recognize that the part of your foot that is wobbling changes minutely from moment to moment. This is your body adjusting to subtle shifts in your center of gravity.  For example, perhaps you are also moving your arms or maybe without even realizing it your body is tilting forward or back.  As these changes in positioning occur, your proprioception abilities are called upon to help you stabilize.  You will probably not be surprised to learn that both yoga and Pilates help to train your senses to respond to the constant changes occurring as you move through space in normal everyday activities.  These and other mind-body disciplines help practitioners to develop awareness of their bodies in space and the space in their bodies.

Moving through space requires more than just internal control.  We need to be aware of gravity and other forces that impact movement like momentum, uneven surfaces, and elevation changes as well as obstacles in our path.  Pilates in particular focuses on strengthening from your core or center.  Exercises help you to stabilize the center and move from there.  The concept of “oppositional lengthening” is emphasized so that movements from the center are balanced in all directions.  This does require attention and practice.  But as you learn your own body’s individual idiosyncrasies you begin to train your body to become better at making those subtle adjustments enabling you to move more easily through space.

Learning to move from our center can help in other ways as well.  We all know what it’s like to feel “off-center”.  This is usually a sign that we are stressed and losing balance in our lives in general.  Thoughts become scattered and unfocused.  Even routine activities can seem overwhelming.  Our mental muscles and nerves begin to lose their ability to adapt to changing experiences, internal and external.  This can easily translate into physical discomfort as well.  Fortunately, mind-body practices like yoga and Pilates can also help with these feelings. Breathing practices can help bring us back to our center, reminding us of what is really important in our lives.  Coming back to our centers and retraining our brains to adapt to shifting energies both internal and external can help us restore balance and ease as we move through space and through life.