Osteoporosis Won't Break Me

  Osteoporosis. That is an interesting word to hear at 37 years old. That's what I got. I had to do a bone density scan last week. Not just because my broken foot is taking its sweet time to heal, but I am also very thin, malnourished, and I have ovarian failure. Yup. You read that right too. Ovarian failure. These are two things someone in their thirties rarely has to think about. This is now what I face. Although a little frightening, I see this challenge as a learning opportunity. It isn't a great deal of fun for a man to read about ovaries so I will keep that short and simple.

  For years I have had irregular periods. For a few years I was treated for ovarian cysts and that worked out great. When we moved from a metropolitan area in Texas to a rural area of New Mexico I kind of brushed it off not wanting to find an OB-GYN because, let's face it, who does? After 2 years and a serious lack of periods I finally broke down. I would love not to have one, but I am smart enough to know it is not good to not have them. There is not a chance of pregnancy. I had my tubes tied back in 2011 due to my fragile health. I found an OB-GYN. After a detailed exam and discussion she knew things might be more complicated. She ran some blood work and called back a few weeks later to notify me that I have ovarian failure. What's that?

  Well, I had been warned since my early thirties that many auto-immune diseases cause early menopause. My assumption was that may be what is causing me to be irregular. I have never heard of ovarian failure.  The Mayo Clinic refers to it as ovarian insufficiency. That word again, "insufficiency". Seems to be one of my running themes. Basically, my ovaries are not producing enough estrogen and/or eggs. This is not normal for women under 40. It is different from menopause in that women with ovarian failure or insufficiency can have periods on and off and possibly even get pregnant during this time (not me). Women who have premature menopause  stop having periods completely. Glad we got that sorted out. So the next question is what do we do about that?

  The doctor talked about hormone therapy and a few other things. All of which I listened to but barely understood. This is not in my wheel house and I have never even researched them. I am such an information junkie, I am usually ahead of the curve. She then explained she wanted to consult with an endocrinologist (specializes in hormone and hormone glands) as well as my primary care physician to go over options for any possible treatment. Her concern, of course, was starting something that may be dangerous considering my complex medical history. She heard I broke some bones in my foot so she decided to have a bone density scan done.

  I had to go to the local hospital. All diagnostic imaging is done there in our small town. That is a scary experience during COVID and I have been there several times since I broke my foot for different scans. A side note to this is the woman who checked me in was not wearing a mask. It is state mandated and it is a hospital. That made me uncomfortable. The scan took hardly any time. She did have to take my official height. I am proud to say I am officially 5'3". I am the tall one in my family haha Due to the pandemic, results get to the doctors faster. Radiologists are not having to do as much since healthcare is focused on necessity right now. The very next day the OB-GYN called to let me know I have osteoporosis.

  Now that was not what I was expecting. I am pretty good at being prepared for a new diagnosis. My gut instincts are good at knowing even before I consciously know myself.  Not this time. Because it is not something that was on my radar and no one in my family has really talked about it, I honestly had no concrete idea on what the different bone diseases/disorders meant. She explained and I listened, but I can't relay what she said. I don't think it registered at the time. Again, she wanted to consult with my endo and primary care doctor before starting any treatment, but some treatment is needed. I do take a calcium supplement and vitamin D because I do not absorb them naturally. She believes some hormone treatment may be necessary at this point.

  Osteoporosis literally means porous bone. Bones do have a blood supply. They also have two very important cells called osteoblasts and osteoclasts. The osteoblasts break bones down. Osteoclasts rebuild. Diabetics already produce more osteoblasts than osteoclasts which is why it takes longer for our bones to heal along with poor circulation. In osteoporosis there are also more osteoblasts than osteoclasts causing the body to lose more bone than it can reproduce. This makes the bones porous and brittle. Sometimes something as little as a sneeze or minor bump can cause a bone to break. The main concerns are the spine, hips, and wrists. I have read that even just sitting there a vertebrae may crumble. How do you protect yourself when you are a 37 year old mother?

  Strength training, impact exercises, and nutrition. So, we know I can only do so much nutrition wise. I eat as healthy as I can within my limitations. My body does not absorb all nutrients. I take supplements to help, but it is not a fix all. I am limited in protein intake due to my gastroparesis. Most of us know, protein is crucial for repair and development of the body. That one gets me. I have always exercised. In the past ten years it has really only consisted of long walks and yoga. Since my broken foot I have had to become more creative. I do a lot of floor or chair work which really strengthens your arms, abs, butt, hips, and back. Little did I know, that strength training is exactly what is necessary for osteoporosis. Score one for Lauren. The impact exercises will come in due time. They are things like walking, running, and jumping. But at least I know. Now, I can be sure to do a variety of exercises even beyond my foot injury. 

  I have mentioned this before, but I found some great content on YouTube for "hurt foot" workouts. Donovan Green (Dr. Oz's trainer) and Caroline Jordan are my two favorites. They make chair cardio videos. Caroline also makes floor barre and total body non-weight bearing workouts. I have come to really enjoy them. I used to be a long distance runner and basketball player. These workouts get me to that level of intensity. Who would've thought? Walking and yoga are peaceful, but nothing beats a runners' high. I am strengthening muscles I didn't know I had yet are so crucial to preventing injury. They have even gotten my shoulder feeling great. I had a labral tear last August and have struggled through physical therapy and more to rehab. These exercises really strengthen your posture muscles in turn strengthening your shoulders. I highly suggest you try it before you knock it, especially during this pandemic. It will reduce anxiety, help you strengthen, possibly lose weight (if needed), and as my son puts it, "It's somethin' to do". I recruited him for my evening routines. It has changed my life for the better.

  That is what is so cool. We all say, "there is always a rainbow at the end of a storm" or "the sun will come out tomorrow" yet it is difficult to really internalize. We also know there is power in positive thinking. Well, the shoulder injury and then the foot injury seemed horrible, but have now proven to actually be a blessing. They have made me really slow down. I tend to push myself beyond my limits then pay for it. These injuries have reset my mind reminding me to not push so hard. They also brought me to new exercises. I learned I really enjoy things I normally passed up. That has made me rethink trying other new things in other aspects of my life, These two trainers are incredible at educating while not judging. They are motivational. I have learned to be compassionate with myself. I am constantly reminded to be grateful for how incredible the human body is. It is one of the rare things that can heal and get stronger. I am better at pushing away negativity. I am better at focusing on my health. That helps all else fall in to place. 

  As I sit here with my foot propped up and no end in sight, I do feel thankful. I am excited for the day I can walk again because that just means I can add more to my arsenal. I will never get bored with the variety of exercises I can do. I may not be competing anymore, but I think I am stronger than when I was. I talk about exercise so much because I love it. Movement is medicine. Having a bad day> Exercise and get endorphines. Feeling tired? Exercise and get endorphines. Bored? Don't eat. Get up and move. The endorphine rush is real. The best natural remedy on earth. As long as you are doing it right and for the right reasons, there are only good side effects. Even as sick as I am, I think I was born with far too much energy and I have to get it out some way. 

So, welcome osteoporosis and ovarian failure. I am here to fight and win. 

Appreciate The Victories

  I wanted to write last week, but was honestly just too exhausted emotionally to get anything out there. I know I am not alone. Again, I am a positive person. I just do not think anyone is getting through this year unscathed. In an effort to avoid further conversation about the barrage of information that is being pushed down our throats currently, let's go back to talking about the main point of this blog; my absurd health and the events that unfold.

  My focus today is my biggest frustration of the moment. I have mentioned it before, but this darn broken foot of mine. I am typically confined to my home due to my health. I have to nearly pack up the house just to leave for a few hours; meds, emergency gear, protective measures, etc. The current pandemic has forced me to stay in even more, which has actually proven good for my Lupus. If only all others would fall in line. Lupus is really affected by sun rays so the less time outside is reducing inflammation inside my body. I am getting cabin fever though. With my foot broken it is limiting my activities even more and that is driving me crazy.

  I went to the podiatrist two weeks ago for a follow-up hoping I would be able to begin using only the walking boot with no crutches. No dice! Everything is still in place and aligned which is normally a big concern with diabetics. That one was a relief. However, my foot is not ready yet. I was moved into a smaller boot. The first one went up to my knee. This one is mid calf. But I still needed 2 weeks continuing non-weight bearing. Then, the plan is to move on walking with the crutches as support the third week. The fourth week I will be allowed to walk in the boot without a scooter or crutches for one to two hours a day. I will see him after that week.

  I am on the third week. Although I am feeling improvement I am not ready to put my foot down too much so I am using the crutches and scooter just as I had. I have put a little more weight on it, but not much. Next week I will try walking in the boot with the crutches. I am just too afraid to push too quickly and end up spending more time recovering. Let's get'er done by taking it slow.

  My shoulder injury that occurred last fall was supposed to be a simple eight weeks of physical therapy. That turned into sixteen weeks, then twenty four weeks.....and then COVID-19 caused the facility to close so I had a home program to follow. I continued that until I had reached my final goal/milestone. All in all it ended up going from October until May. Except, the facility opened up again in June so they called me in. As terrified as I was to leave the house I thought they would see the progress I made and release me. HA. Nope. They started me back up to finish out six more weeks. At this point, however, my foot was already broken so they had to modify a lot of my exercises. Although I enjoyed the challenge, I had to let them know that until I could bear more weight on my foot I just wasn't strong enough to be so active. That length of time has challenged my patience and emotions greatly.

  With my foot slowly moving along, I am becoming more fearful of the actual length of time for healing. Not only do I need to take baby steps to start bearing weight, it will then take six to eight weeks before I can possibly get out of a boot. Once out of the boot I will need special shoes and/or inserts to support my foot. I will also have a lengthy physical therapy/rehab time. I have come to accept that. I believe in about a year I may be where most healthy people are after four to five months. A very healthy person I know had a four year recovery from a sesamoid fracture of the foot. That bone is right near the big toe embedded in tendons. My fractures are of the calcaneus and cuboid, which is the heal bone and the bone that attaches it to the last three toes. Seems to me, I am no expert, but it seems to me they are similarly difficult to heal because of their positioning. That being said, I am just a little overwhelmed with the thought of it all.

  I am an active person. Sick or not, I exercise everyday, multiple times a day. Not just because I have always been an athlete, but when I eat I must get up and move otherwise the food sits like bricks in my belly. Trust me, I would be fine with a morning workout and be done for the day. I prefer to walk around or clean or something similar for the movement after food, but right now I have to find a creative way to move after lunch and dinner to get some movement in. We recently moved into a home that sits on front of a mountain. My husband and son have spent a lot of time hiking and discovering new "Goonie adventure's" as my son calls them. I am so envious. I try to push that down because it is just the reality of the moment holding me back from joining them, but I miss it. FOMO.

  We also live in an incredibly beautiful rural area of NM. There are so many hidden gems and well sought out tourist attractions. All outside and wide open spaces so during this moment in history it is perfect. I have yet to visit my favorite lake that I hear is pretty full right now. I haven't been able to get to that area to hike around either. My parents live in the wilderness, but it has been ages since I have been to their property even though it is a mere twenty five minutes from us. There is a lot of "I wish I could"s going on here. That only makes me feel sad because that is a lot of negative and fearful thinking.

  As this blog typically is, it is helping me iron out my thoughts in a cathartic way allowing me to see what I should be appreciating. I can definitely say I am learning a lot more about my body. Because I have had to get creative with movement and exercise I am probably stronger now than before. Most of what I do is upper body work so my arms and abs are steel right now. There is a lot of total body workouts I can do on a yoga mat without putting pressure on my foot so my legs are still be activated. The movements I am learning from the online program I came across have trained muscles I rarely used before. It is also helping my shoulder because the abs, hips, and butt are the center of your body. Making them strong creates balance helping strengthen your posture muscles. That comes along with shoulder strength so....bonus ;-) My only hope is that once I can incorporate weight bearing exercises I don't lose sight of what I have created now. That is a goal I plan on focusing on as I recover.

  It being the year of shelter in place seems like the best time to be laid up with an injury. My hope is that maintaining my active lifestyle while hurt will help during the rehab phase. Since I will be going to the same facility for physical therapy as I did for my shoulder, maybe they can get knocked out together and I can worry about something else. Isn't that human nature? When all goes well, we still find something we long for. The good thing is, I know that to be true. with that in mind it helps focus your mind and heart on what you do have that is positive.

  Everyday I wake up and work to find something I am proud of and hold it close. When life is so overwhelming, focusing on small victories is the best medicine. Today has not been my favorite day, BUT I have my small victories. I got up before my alarm meaning I had good sleep last night. I woke up in a good mood. I completed my workout, enjoying it the whole time. Man it was tough though. This Caroline Jordan health coach is awesome. It is raining so this high desert is getting some good moisture. I had no control of that, but it is nice. And I was able to get out and deal with an errand or two. Let me just say, rain and crutches are not easy. Believe it or not, writing this blog today is a victory.

  It seems I have so much to chronicle, share, and inform that I often second guess every word. I truly want to help someone out there who may be struggling with similar issues. I want to keep my friends and family up-to-date. When all this first began in my early twenties, I had no where to turn for a road map on how to navigate such a complex web of diseases. I had no one to look to as a role model for keeping your head above water and managing these disease that seem to fight one another.

  I am a professional student. I love to learn and research. I rarely found anything. One thing I found solace in was learning that President John F. Kennedy likely suffered from the same rare disorder I have, APS Type II. A little snippet, they actually had him isolated for a while to give him steroid treatments so when he began to run for president he looked healthy and vital. All the while, even during his presidency, he suffered in pain daily. His back and adrenal glands really took him out. That is a small pinhole picture for you. There is not a whole lot written about it. Anyway, I needed a JFK to look to during those first few difficult years. I want to make it easier for a layman who may be ill or have a family member who is ill to find some real account information. Not just medical jargon, but real world accounts. I hope that this blog reaches someone who truly needs it. I pray that it leads them to better scientific research to gain knowledge. Science talks the talk, I walk the walk. Together we can conquer.

The Battle We Fight Together

   This week has been a bit tough. I tend to stay on the positive side, but I am a multi-layered person. The confusion, unknown, and emotional roller coaster of COVID-19 is overwhelming me more and more as people continue to divide and shame one another. More people are rebelling against recommendations for safety, sometimes using politics as a guise. The truth is, we are all grieving.

   We are grieving the things we were used to having daily. We are grieving the freedom we had. When I say freedom I am not talking politically or liberties; I am talking about freedom from this pandemic. It is the pandemic that has taken away our freedom to run to the store for something trivial. It has taken away jobs and our freedom to quickly find financial resources/assistance. It has taken away the luxury of having fully stocked shelves with an abundance of non-essential items. We miss the salons. We miss the parks. We miss the gatherings. We miss knowing what tomorrow will bring. And everyone grieves differently.

   You hear about the five stages of grief. When we think of grief, we typically think of death. That is not the only source of grief in our lives. Some grief we can overcome, but some is cyclical. The death of a parent never gets easier, it just becomes more distant when the tears run out. The loss of a close friend by moving far away is something we tend to learn to deal with and get past. That often comes by creative ways of staying in touch or finding another outlet. The grief of losing the championship in your favorite sport will fade. Losing so much to illness causes great grief. This grief tends to be cyclical. I can only speak for myself, but after becoming so sick it became a disability I deal with grief daily.

   I had dealt with Hashimoto's disease since I was in 8th grade. I dealt with IC for several years. And I had learned to deal with Type I diabetes fairly well. They all frustrated me and caused grief, but I could cope with it. I was still able to be in school. I was still able to work. I was still able to eat regular food. I was still able to run and swim and play basketball. I was still able to be an over-achiever and proud of it. I thought I was just tired. I thought I was just stretching myself too thin. I brushed it all off thinking it was going to pass. I was wrong.

   When I turned 25 I was living the life I had planned out. I was achieving the goals I had set for myself and finding new ones along the way. I am not good at sitting still. Then the wall came tumbling down the day I went to the doctor to express my exhaustion. Maybe my medication dosage needed to be changed. It had to be something simple. As I was talking to the doctor she stopped me and said, "I thought you were coming in to get disability paperwork filled out. I would normally tell people no on first request, especially without knowing the patient. You, my dear, need to go on disability." I am sure my face twisted.

   I pushed back a little. I have always seen doctors as people of authority. I am not the type to resist authority. So I meekly asked her a million questions trying to understand why. It didn't matter. It had shocked and scared me enough. She said to quit school immediately. I was only a few weeks from my bachelor's so I said surely I could finish out the next few weeks. She said no. She worked in the same clinic building I did. She said I needed to take short term disability from work starting immediately. I know the whole time my face must have expressed shock and confusion. Then she began ordering tests and explaining in more detail her concerns.

   I left her office holding myself together. I think shock was keeping me numb. I reported to my boss. That was my last day of work. I went home and emailed my professors. It was too late to withdrawal so I simply had to ride out the next few weeks with the grades I had already gotten through previous assignments. There were three classes I was not able to complete to obtain my degree. I was devastated. I still believed I would return to work in a few months and maybe finish out school. I just assumed I needed to get stabilized. I had no idea it was going to grow to the spider web it has become.

   Months went on, test continued, and things got illuminated. I was sent to one specialist after another. I was rushed off to the Mayo Clinic. I was forced to go on permanent disability. More diagnoses rolled in, one after another. Then there was the trial and error phases of stabiliaing each condition. Within a few short months I had gone from a full-time working mother in college full-time to staying at home or living in doctors' offices. My diet was changed completely. My nightstand started to get filled with more prescription bottles. My freedom was slowly drifting away. Long gone were the days of spontaneity. Long gone were the days of competitive running. Long gone were the days of eating at a restaurant liberally. Long gone was everything I knew. The rug was ripped out from underneath me with no warning.

  There were days of sadness. There were days of anger. There were days of confusion. There were days that were kind of OK. And there were days with these all combined. I became creative with my food so I wouldn't feel so deprived or separated from the norm. I bought yoga videos and starting taking long walks to replace the sports I was no longer able to enjoy. I surrounded myself with good friends and family that didn't see the sick, they saw Lauren. I prayed. I kept myself going, and still do, knowing that this pain will not be in vain. I will see the beauty of this mess eventually, I thought. No one around me really understood what I was going through and I had no idea how to express it. I also did not know what to do to reclaim myself. How do I find Lauren in this new normal? Will I ever be happy with it? 12 years later I can tell you it gets easier, but it is definitely cyclical.

   It wasn't until I saw a therapist that I realized all these emotions were part of grief. I didn't think grief came from becoming ill. When she explained to me that I was mourning the life I was had, it all made sense. The Lauren that I once knew was gone. I needed to discover a new Lauren to help mourn what was now gone. Then I started analyzing everything. I was a double major in psychology and nursing so it made sense. As it became more clear I became more comfortable with the idea of grief. The thing is, I thought I would overcome it.

   The reality is, everyday there is something new. When you lose a loved one or a tangible item it is final. When you lose freedoms it can be endless. As my diseases progress things get tougher. More limitations are brought on by simply progressing. My two most recent injuries are perfect examples. I know that I have accepted my diseases. They do not define me, they are just simply there. Ok. Got it. What I didn't realize is that I am not accepting the less common complications and progression. Somewhere in my mind I think I assumed because I am so diligent and disciplined none of that would come up. I thought I was above all that. I now see how delusional that was/is. I am now facing some real problems I thought only happened to other people.

  This is much like the current crisis we are in globally and nationally. This illness that we do not understand has snuck in and taken over every aspect of our lives. It is affecting us as a whole yet individually at the same time in different ways. We have lost the freedom to simply run to the corner store for only milk or a soda. We have lost the security of knowing what we need will be at the store. We have lost jobs and opportunities. We have lost in-person contact, hugs, handshakes, etc. We cannot just go to the movies or a sit down restaurant. We have lost faith in our leaders. Yet we have nothing tangible we can fight, but one another. We need something to yell at, point a finger towards, blame. It is just this faceless, invisible, misunderstood virus with no emotions or thoughts or prejudices. Nothing we do will change its nature. We feel hopeless.

   The truth is, there is something to fight. It is not the person wearing the mask. It is not the politician who speaks as if they know this illness like they know the enemies we fight in war. It is not the doctor or scientist explaining their findings to us. And it is not the people who are trying to keep us safe by setting guidelines. What we need to fight is the virus. COVID-19. It has a name. Its face is that of those it has infected. There is power in numbers. No single man has ever fought a war and won on his own. He has a team, a military, a weapon. Our weapon, for the current moment, is simple hygiene and wearing protective gear like masks. Soon our weapon will hopefully be a vaccine and better treatment options. We have to go through this methodically and not rush anything. If there is anything we all know, it is that rushing leads to mistakes/oversights and set backs. 

   I believe. I have hope. I have faith. We will get to the other side of this. I know for sure we will be facing a "new normal". We have to find creative ways to fill the voids we feel in our lives. We have to do it together though. It is a must. We cannot battle one another. We must focus our battle solely on the virus. We are all multi-layered people living in a nuanced world so we are going to be dealing with other issues beside and combined with COVID-19. But we must remember, the fight is with COVID-19, not with one another. I send out love, hugs, and prayers to all. I send out faith. 

A year full of surprises

   In August 2019 my son and I were taking a nice afternoon walk. I was keeping an eye on my son as he rode his bike in front of me. All of a sudden I fell. Flat on my face. There was no crack in the pavement, no rocks to trip me up, and I did not take a misstep. I just fell. Arms out and everything. I had a few scrapes and bruises, but nothing too bad. I was in a lot of pain, but nothing I could pinpoint other than the scrapes. Cut to September and it became a different story.

   

   After a long night in a hotel room preparing for an eye doctor appointment I woke up with some terrible pain in my right shoulder. Being the product of a football coach and a lifelong athlete, I figured the pain would pass. It didn't. It got to the point that you could not even touch it. I could barely open a car door. It ended up being a labral tear with some bicep tendinitis. I was referred to a physical therapist. After three months I was still in a great deal of pain. At that point I was sent to an orthopedic specialist where I was given a steroid shot. Goodness, that hurt. It did help me get through eight more weeks of therapy. I still needed another eight weeks but this insanity, now known as COVID-19, halted all treatment. 

   Because I had been working so hard I was given an at-home program to follow. I completed eight more weeks at home. I finally reached a goal that was going to allow me to stop therapy. I was given some maintenance exercises to follow thereafter. I was elated. Something that was supposed to be a simple eight week program turned into a nine month attempt to rehab. I am a total Type A so of course I was ridiculously disciplined. I conquered my final goal for shoulder rehab on a Thursday. That Sunday was Mother's Day so we planned a cook-out with my parents. It was exciting. Not so fast. The world played an evil trick on me.

    For those of you who are unfamiliar with COVID, we have been in quarantine since early March. Since I am incredibly high risk I have been stuck at home since March 13. My parents run errands and get groceries when my husband cannot. We were pretty excited to hang out and do something "normal". The world has been in such upheaval. Health and science have been politicized. No one knows much about this novel virus, and new information is rolling in daily, sometimes contradicting the information we thought we already knew. Groceries are hard to come by. People have lost jobs and family members. Frightening stories roll out from all over the world. Churches are not holding in-person services. The school year was completed, by most, at home. The entire world is in survival mode against a predator we have no idea how to fight.

   That Sunday morning I woke up excited for the warm weather and eager to smell the beautiful aroma of a barbecue. My parents were going to show up in about an hour. My son and I were going to run out and get a soda before they came. My husband was in the shower. We just moved into a new home and things are a bit older. I closed the door to a steamy bathroom quickly because I hate steam. Weird, but true. A full length mirror behind the door fell and shattered. When I opened the door to see what the noise was I realized I needed to quickly clean up the glass so my husband could get out of the shower safely. Avoiding the glass, I made my way to the bathroom window. I am too short to open it so I stepped up on the toilet. You know where this is going...as I went to step off my supporting foot slipped. In an attempt to miss falling on glass, I stiffened up and landed awkwardly on my foot. I let out a scream, which is rare because I can take pain really well. Adrenaline was running so I don't remember feeling much. I thought I had just tweaked it. I cleaned up the glass and headed out for my soda.

  My foot hurt, but I have banged myself up pretty bad before so it was no big deal. My son kept asking if I was ok. I brushed it off saying "I'm fine. Just a stinger." When we got home I realized it was more than a stinger. It was hard to walk up the driveway to our front door. I did not want to take off my shoe because I did not want to see what was wrong. I also didn't want it to swell. I figured I'd deal with it after the cook-out. A little ice, some elevation, and I'd be good. WRONG. My dad had me take off my shoe so we could ice it. I quickly realized I could not even put weight on it. Being in the middle of the COVID-19 pandemic there was no way I was going to go to the ER.

   The next morning I got ahold of my doctor. He sent me for X-rays and referred me to a podiatrist. I was so frustrated because I had just finished up with my shoulder. Now I was going to have to heal another injury? Yup. Turns out I broke two bones. Calcaneus and cuboid. That is the heal bone and the stabilizing bone that connects it to the rest of your foot. Due to the fact that I have a gastric stimulator I am not able to have MRI's. In this type of injury it is important to get an MRI to evaluate soft tissue around the bones. The next best option is an ultrasound. Welcome to rural New Mexico. I was referred to a hospital a few hours away for said ultrasound as they are different than an ultrasound you would get during pregnancy. With a scheduled appointment confirmed a few times with specifics, we made the scary trek to another city that had a lot of COVID cases. Remember, I had been totally isolated for months. Now all of a sudden I was in and out of doctors' offices and hospitals, and a different city. I got to the hospital and checked in. In all of these settings only the patient is allowed. Due to the high number of cases of this highly contagious virus, no one is allowed to accompany you. After waiting a little while I was informed that they did not have the correct ultrasound machine. Apparently the frequency necessary is different than that of a typical ultrasound. The determination was that I needed to go to another state to get this ultrasound.

   I returned to my local doctor. We discussed options and decided to hold off on the ultrasound. I was just going to stay in a boot and not put any weight on it. I had already been doing this for about four weeks while trying to get all the imagining done. I was scheduled for a follow-up four weeks later in the hopes that I could move up to a walking boot.  Hopefully the walking boot would last about six- eight weeks then I could move on to physical therapy.

  In a strange twist, the physical therapy facility I had been going to for my shoulder called. They were now going to be allowed to bring patients back in. They wanted me to schedule an appointment. I explained I had done what was planned out for me, but they still wanted me to come in. I made the appointment letting them know I had injured my foot and could not put weight on it. Although it added some challenges, they determined I still need to work on my shoulder so they got creative with treatment and started me back up.  Oh goodness, I must stay positive! Surely I am near the end of total shoulder rehab. I took on the challenge.

   Here I am, a week away from seeing the podiatrist for my follow-up and I am still in a great deal of pain. I am back to cringing every time I move. I know I take longer to heal with all I have going on. I also know I eat well and continue to find creative ways to exercise without bearing weight. Why then, is it still so painful? My research brain finally took over. I started looking things up only to get discouraged reading about healing in four- six weeks plus physical therapy. I decided to get my head out of the sand and look into diabetes and bone healing. Due to bad circulation that comes along with diabetes, the feet are a big concern. Nerves and tissue get damaged easily and it can quickly go bad. I had never paid attention to bone issues though.

   I pride myself on my knowledge. I call myself an information junky or professional student. I like to understand what is going on so I can play an active role; not just in my health, but in life. I often try to stay away from internet health research. It is like the bible in that anyone can find anything that suits their ideas/ fears/ opinions. I do not want to play doctor. I also did not want to call the doctor a week early, eventhough he said to call if anything came up. I just want to avoid more visits, especially since I am now back in organized physical therapy. My main fear is that he will want the ultrasound to look at the soft tissue if it is continuing to hurt so badly after seven weeks. Not only do I not want more appointments, but I do not want to travel. The pandemic of 2020 is no joke, especially for the high risk. Rather than call the doctor, I turned to the internet for validation. 

   Turns out it can take 87% longer for a broken bone to heal in a diabetic. On top of that, there is a 3.4 times higher risk of complications such as infection, dislocation, delayed union, nonunion, malunion, and more. What?! I looked high and low for something more positive, but this is what I kept coming across. Article after article, study after study. If there were no actual numbers, the information was the same. I am not sure how I feel about this. On one hand, I am glad to know it is normal for my body not to react like a generally healthy person (as if I thought I was Wolverine and could heal no matter what), but on the other hand the timeline seems so daunting. I have been and, a little moreso now, am worried about soft tissue damage and what treatment may look like beyond just healing the bone.

   What do I take away from this? Take a step back. Rest. Rest as much as possible. Be patient. I will have a bone density scan on Monday and will see the podiatrist Tuesday. He will give me the information I need. If it is necessary to travel for some additional imagining, so be it. Maybe it will be a nice change of scenery. Hopefully it will be fairly close. Remember that if there is ever a time to be laid up, it might as well be during a stay-at-home order due to the COVID-19 pandemic. Eat as well as possible. Drink water. Monitor my blood sugar closely to keep it as controlled as possible. Better control leads to better healing. And finally, take note. What have I learned in the past ten months being injured? Blessings. I have always had a positive attitude, but these things make you take inventory.

   This pandemic has left people lonely, sad, scared, out of work, financially strapped, and so much worse. My shoulder injury happened in August, but the pandemic truly began in January, then my foot in May. It is tough being chronically ill. I like to think I handle it well, but I do struggle just as anyone else would. This has made me want to be, what I refer to as, "Lauren sick" not "Lauren sick and injured". I actually miss just being sick. Maybe that wasn't so bad, eh? I am lucky to have my son and husband. We are lucky my husband has a job in an essential field like pharmacy. We have a home, clothes, food, and the most fantastic little nine month old rescue dog. We have luxuries like internet, TV, computers, cell phones, air conditioning, and running water. We live in NM with some of the most beautiful scenery. We have sunshine more days than not. Pandemic or not. Injured or not. I am so blessed to live this gift of life. I am so blessed to have a body, although sick and banged up, that allows me to move everyday. I have learned some pretty cool new exercises along the way that are actually really fun. Sometimes you have to embrace that kid in you and just let it all out. Chair jumping jacks are pretty darn fun. And chair boxing, come on now? So fun. Have you tried a "hurt foot workout party"? 

  Truth be told, I have been having a pity party these last three days. Researching, digesting, writing, and laughing have helped me get to this point. Life ain't all that bad. We go through some tough stuff sometimes. You cannot grow a beautiful garden in beautiful beach sand. Sometimes you have to cultivate the dirt, through some crap in, plant some seeds, and nurture it to see the true beauty that emerges. This pandemic, these diseases, these injuries have all made me who I am today. And today folks, I am one resilient, strong, smart, faithful, and proud fighter. Take that.

Snack For The Soul

When I referred to my surgery date in my last post as my new birthday, I had no idea how deep those feelings would really run. Every day I wake up feeling a little different. Every day there is some flash of novelty and comfort in my new world. Every day I become increasingly more aware of all the gifts that surround us. That all sounds so mushy and cliché, but it is so blatantly true.

I just had my 4-week follow up appointment with both of the surgeons who performed the procedure of implanting the Enterra Gastric Neurostimulator. I have to say that I had been really nervous about the appointments. I seemed to have hit a plateau shortly after the procedure and didn't seem to be improving in terms of nausea, fullness, and lack of appetite. For some reason in my mind, the natural processes in the world are in my control...... (Although it never seems to work out the way I want it). I was preparing myself to hear all the things I had done wrong since the surgery that would be halting my progress. I was so prepared for all the wrong things.

My first appointment was with Dr. Weiner, my gastroenterologist, and the Medtronic representative. Medtronic is the manufacturer of the Enterra and the rep helps the doctor become familiar with the treatment and technology.

At that appointment they asked about my symptoms. They were concerned with my level of nausea because that was one of my worst symptoms prior to surgery. I am happy to report that it has gone down at least 50%-75%. I complained of a lot of cramping. I describe it as chugging a glass of water and then sprinting...that kind of side cramp is what I feel. They explained to me that my stomach, the muscle, hasn't been used this way in a long time. As with any atrophied muscle, it will fatigue, cramp, and get sore. That's normal. I also complained of constipation. (TMI? Well this blog is to help inform, comfort, or inspire those in similar situations, so we have to talk truth) Dr. Weiner talked about my medications and my absorption rate. With my stomach processing more before things move into the small intestine, I am absorbing more of everything (Woot Woot!!) this leading to my system getting overloaded. He reduced one medication in half.

All in all, the symptoms, pain, soreness, and novelties are all normal and a positive sign. The rep said, statistically, I am in the top 5% of patients in terms of progress at this point. The doctor was really pleased as were my husband and I. Even the nurse and front office woman were in on the excitement as we have gone through this journey together.

"Weight gain at this point?" you may ask. Well, I am almost at my pre-op appointment weight again, but I am going in the right direction and that is more than we can say for the past several years. Appetite? I wake up hungry nearly every day. My portions are no bigger, just a better variety and more consistent. My diet restrictions are the same but I am able to enjoy more meats, vegetables, and fat because they no longer sit in my stomach for hours on end. I still get a distended belly every time I eat or drink. That will likely continue to happen just as an untreatable symptom of gastroparesis, but my stomach should grow a little so I can eat better portion sizes in time.

To check the device itself (remember it is sewn into a pocket of subcutaneous tissue in my abdomen) they held a large smart-phone looking thing (called The Enterragater, gggrrr) up to my belly where the device is, pressed it against my skin, and the screen started showing them information. Based on that information, which all looked positive, along with my symptoms they decided to bump the voltage up a notch. They told me to expect a fluttering sensation and possible nausea for the next 24 hours but it would subside. Essentially, that should increase my stomach activity a little more. They were right. Almost instantaneously, with a giggle, like feeling your baby kick for the first time, the fluttering began. I am lucky to say it never made me nauseous, just tired.

Unfortunately, with the start of the new school year I managed to catch a nasty cold. This has been a small setback, flaring up some unwanted symptoms, but what cold doesn't? We were told we should be able to see full effects of the device in 6 months to a year. I also have managed to unknowingly, in the fog of euphoria, ingest dairy, chicken, and strawberries - all of which I have allergies of some degree to. So a few more kinks, but thus is life.

The second surgeon merely needed to check the incisions. He works closely with Dr. Weiner and so he was already up to date on my progress and was pleased. Can I type that word enough? It is such a foreign feeling to me to walk out of doctor's offices with hope and positive reports.

I am (actively trying) not to allow the fear to hold me back. I am still trying to be conscious, careful, and conscientious, but I am human and sometimes forget to double or triple check ingredient lists or that I had strawberries yesterday so they aren't allowed for a few days if I would like to continue to feel well. And I don't beat myself up over a minor mistake because it will pass.

My diabetes is a bit of a roller coaster right now. I see my endocrinologist next week. With absorption rates changing and fluctuating so are my insulin needs and blood sugar levels. I have been struggling with a lot of lows which has only encouraged more calories. This crazy balancing act that is life can be fun sometimes. I am serious; I am enjoying this challenge.

I am slowly moving back in to normal daily activities. I am beginning to move better and with less pain. It will be a work in progress to learn to move with this inside of me, but as with anything, we adapt. I am smiling more. I am laughing more. I am enjoying more. It is amazing what a snack can do for your soul.