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Wednesday, September 14, 2016

TWD therapy, copy

This post is also on Pinky blog, but with lots of Walking Dead graphics and some Negan talk at the end, in case you're a Walking Dead fan.

So this month we're doing manual therapy (hands on) on the sympathetic nervous system (direct nerve input to interrupt the fight or flight feedback loop), and every bit as much a bitch as all the other work I've done over the last 4 years, but seems to be working. If you are at all interested in techy body mechanic stuff, this is the best article I've found so far.

Physical therapy action mechanisms and effects on pain management

And here is a book.

Integrative Manual Therapy for the Autonomic Nervous System and Related Disorder

This is stuff that's been around awhile and very hotly debated for years. Many doctors don't see the point in wasting time on it and generally send patients straight to injections and surgeries, which are also hotly debated and fail to alleviate as much as 50% of the patients who suffer more invasive procedures. I first brought it up 5 days ago and I have 2 sessions left to go.

My thoughts on this 'waste of time'-

  • I've lost 2 pounds, mostly because of the overwhelming residual pain, but it's staying off and I'll take it.
  • In spite of that, I've quite suddenly felt like stepping back into my old workout routine and am now doing my daily walking, stretches, and core strength again. This includes basic arm work that I had to stop doing over this last year.
  • At first I wasn't sleeping well because of the pain flaring up again (likely in response to the worst part of allergy season), but I'm now sleeping really well and my pain level is waaaay down again.
  • The maddening itching, numbness, and referred pain that I've been tolerating along my spine for over 2 decades has stopped completely a couple of times, and mostly hums along at a much lower level this month and I barely even notice it.
  • Headaches flared up during this round of therapy but I figured out it was from laying prone, switched back to sitting and the headaches stopped.

I think the mechanism in simple terms is like using very particular pressure points with deep tissue movement to gain the attention of nerve response and break through a stuck in a rut fight or flight default to reset and train the feedback loop back into parasympathetic acceptance. Basically, instead of taking a muscle relaxer to force my nerves to let muscles relax, this is a way of directly talking the nerves into letting them relax anyway. It's about cutting through unnecessary nerve chatter without actually cutting the nerves.

People talk about meditation and medical marijuana and acupuncture and more, but there's a lot to be said for hands on direct communication with a nervous system. To me it feels like when someone calms a spooky horse down, there are certain ways to move and act that cut through the fear and distrust. If my nervous system is always on edge because of a disorder, and I can bypass pills, needles, and surgery getting relief, YES.

For one time readers and noobs passing by, I was ejected from a violently flipping vehicle years ago and healed poorly at home without any assistance or pain meds, covered it up and passed for normal as much as possible for 2+ decades, developed a wicked severe case of persistent unrelenting fibromyalgia, and finally slid into the dark abyss of immobility and disability. After much consultation and documentation, I am that weird patient who reacts counter intuitively to meds, and now a medical team is watching me come back from hopelessness to functionality over 4 years of physical therapy, along with changing my diet, which was key because I have also turned out to be diabetic.

In short, physical therapy works, at least for me. Compliance (key word) with a really good physical therapy team, complete with specific documentation and goals, has been turning my life around, and while I'm not cured of fibro or diabetes, I'm no longer as dependent on a caretaker as I was for several years before the therapy started.

Physical therapy is very grueling, and there have been a few walls that we've had to back up and figure out how to go around or get over. It takes the kind of commitment that an athlete makes to training. Physical therapy isn't a one stop fix it shop, like car mechanics. It's an ongoing process that measures and directs regaining functionality, and I'm finding that if it is measured by pain levels going up and down, people tend to quit and say it doesn't 'work'. Well, there are ways to slow down and try different things and it can still work. Communication with the therapist is vital. I am one of the very few patients my team has that still comes in voluntarily to keep improving, despite pain flaring up so bad that I have to take breaks.

I know there are lurkers hanging on through the sucky long hard dark nights in terrible amounts of pain and sometimes fear and hopelessness, and I just want you guys to know I've totally been there for years, and it really is possible to find real help. Keep trying. I have to ask my doctor for referrals to physical therapy (I'm so thankful he's on board with that), and it helps that my neurologist is willing to try that first before desperate efforts like surgeries. Once you start the surgeries, there is no reset back to pre-surgery. Nervous system surgeries involve intentionally damaging very specific nerve bundles in order to muffle pain, and this is fine if there's nerve damage and there's no other way. Also, that's how they fixed my heart rhythm problem, fried an overactive nerve, so I'm not anti-surgery at all. I'm just saying if your doctor isn't offering it, ask for it. If your medicare or insurance allows it, they legally cannot tell you no, but you do need to negotiate with a good reason for it. I usually have specific goals- I want to be able to put dishes away in my cupboard and it's hard to reach up without spiking pain or dropping something, so I'd like help with getting stronger and someone showing me how to move properly. Once you get the hang of setting your own goals, you might be surprised how quickly the medical field falls into step with you. It's more a matter of saying the right words than expecting someone to fix you when you live with ongoing vague symptoms that no one knows quite what to do with unless specific corrective procedures are clearly indicated.

I'm not sure how much more therapy I'll be allowed to keep referring into, hopefully as long as I can keep showing it's worth it with improvements. Medicare allows several months of therapy every year, and many insurance plans have physical therapy allowances, although they can be pretty stingy about it. I once complained years ago that my insurance was willing to pay for a $10,000 surgery but not another $1000 to prevent it. There are definitely flaws in the American health system and, sadly, most of our health care runs on plans outlined by insurance companies. For me it boiled down to what I was willing to pay out of pocket, and yes, we did go bankrupt over it, but I'm not in a motor chair. I was this close to qualifying for a motor chair, guys. Not saying I won't wind up there, but I am saying not yet.

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