Tuesday, September 29, 2009

Progress!

I am finally getting sustained relief from my symptoms. I can attribute it to many factors:

1. I don't have as many physical demands w/ Samantha in school all day.
2. I have a combination of medications that seem to be working w/ few side effects.
3. I am sleeping a lot. I go to bed around 9:30 and take a good nap each day.
4. I am working out on the circuit equipment 3x a week and walking 3x a week. The circuit exercises are designed to strengthen my core muscles in my pelvis so my SI joint doesn't go out of position.
5. I have adjusted the seat in my car and this has made a huge difference. I kept trying different lumbar cushions which helped some but not enough. Finally I decided to raise the seat higher and this put my back, hips, and leg in the optimum position for comfort.

I want to thank the Lord for helping me re-establish a little more "normalcy" and giving me grace to endure the lack of it. I also want to thank my family for all their support and love.

Wednesday, September 9, 2009

The Vicious Cycle of Physical and Emotional Pain

In the magazine "Neurology Now" there was a recent article about CRPS - Complex Regional Pain Syndrome, a condition in which nerves go crazy following an injury. You may have heard of it, esp. in relation to the ketamine coma, an extreme treatment administered in other countries. Some patients revert to this when there is no relief for nonstop extreme pain - they've tried everything from acupuncture to high doses of medications. In many cases,they decide to go through with this risky procedure as an alternative to suicide.

The main thing that caught my attention from the article was its wholistic approach to pain management. It pointed out that basically three factors are involved when someone experiences ongoing pain - the underlying causes of the pain, the pain itself, and the emotional affect it has on the patient. All three need to be treated.

I know this to be very true from my own comparatively minor daily struggle w/ discomfort. I call it that because it doesn't really hurt, it just nags at me, sort of like a sore stiff muscle or back ache. Right now as I'm writing this, I'm feeling pain in my backside, to put it delicately. I'm going to try adjusting my position which I do umpteen times a day to try to make it go away. (Editing note, after I finished this entry my discomfort was gone.)

There is a cycle that accompanies all this - the pain or discomfort creates emotional anxiety which then tenses the muscles which then leads to further pain. Of course the main thing to target is the underlying source of the pain, but that gets tricky for some of us folks. My physical therapist tells me repeatedly that I've got some of the most unusual symptoms she's ever seen. How does that make me feel? Good on the one hand, that I'm not going crazy, and terrible on the other, because it's harder to overcome. I have a hip rotation, SI joint displacement, one leg shorter than the other, and mild arthritis in my back (L1 and L2). Not an easy problem to fix.

Getting back to the article, the three things that need to be treated are the underlying source of the pain, the pain itself, and the emotional suffering. The author recommended targeting the initial injury area w/ physical therapy or some type of orthopedic related treatment, being under the care of a doctor who can help you choose appropriate medications to block pain and minimize anxiety or depression, and in some cases seeking psychological help.

If I'm understanding my body correctly, my vicious cycle goes something like this - first the discomfort/pain, then the anxiety and muscle tension accompanied by emotional distress, and finally twitching. I'm still under the care of a neurologist and am slowly weaning off of visits w/ the physical therapist while following her plan for restrictions/exercise. If needed I can go back to my orthopedic specialist and get more injections to the problem site. I take four prescribed medications, all of which are targeting the nervous and muscular systems. Fortunately, some of these also help w/ anxiety. I also take vitamins/supplements, some "prescribed" by my neurologist and others of my own choosing. I'm popping lots of pills!

When or if my SI joint stablizes (which is very unpredictable according to my physical therapist), I would like to try pain free living techniques that I've heard about. Right now those things could worsen my condition.

One last note, a secular medical article is often on target spiritually without knowing it, because it addresses the idea of wholistic health, pointing to the fact that we are God's creation. I like to remind myself that I'm here to glorify my maker, and my body is His temple, no matter how healthy. I should continually be striving for the best health possible, while at the same time accepting each difficult situation, knowing either way I'm an instrument to bring glory to His name.

Tuesday, September 1, 2009

The Big Picture with Samantha

As I was out walking this morning I had time to reflect on the bigger picture of the last week w/ Samantha struggling to adapt to first grade. The adjustment has been harder than we thought since she did fine with two years of preschool/preK and one year of kindergarten. This school day is much longer and harder and she's feeling it big time. As a home schooler, I struggle w/ whether it's healthier for her to be home w/ me; in the past I was convinced her being away at school was the best thing for her her well-being overall. With her sensory processing dysfunction, she found it extremely difficult to "just be a kid" at home and was demanding, out of sorts, and more needy in general. At school she was well-adjusted, happy to be with her peers, and enjoyed the routine. It gave her a place to not feel threatened by authority and feeling the need to compete with older siblings. We always felt that a neighborhood friend would have made a tremendous difference with our issues at home, but God didn't provide that for us so we've had to manage the best we could.

So the big picture - the positives of this experience of separation anxiety and "forced labor" in the classroom.

First, God is affirming that Samantha has truly attached to me as an adoptive child should. I have not really questioned this before since I felt her behavior issues were from her sensory problems, not lack of attachment. But as a parent it's always nice to have concrete evidence that when your child is in crisis they want you. Even my 17 yr old son demonstrated this when he first had leukemia. He was more open to touch, holding his hand, etc. than a boy naturally would be with his mother at that age. Samantha has expressed a lot of missing me, wanting me, and coming to me for comfort in the midst of all this. She's been waking up early and wanting me. She demands I put her to bed instead of Dave. All signs of "regressing" in a sense but normal for a child in pain.

Second, I have become more convinced that my age is a great comfort to Samantha. As I think about it, all the authority figures in her life have been mid-age women, including her foster mom in China. Her pre-school teachers are either my age or older. Her kindergarten teacher is probably in her fifties. Guess what, her 1st grade teacher is in what I'm guessing to be her late twenties. Samantha says she seems like a "sister" to her, meaning she's uncomfortable with how young she is. This has been strangely helpful to me and my role with Samantha because I've sometimes felt like I'm too old for her. I'm going to be in my sixties when she graduates high school. I've wondered if she views me as a grandma, not a mom. Her birth mom is probably much younger than me. Now I know she feels safe with an old hag like me (chuckle, chuckle). That's a good and positive thing.

Third, I'm seeing more evidence that Samantha's overall needs for growth and development require outside help. We can't do it ourselves. She and I have too volatile of a relationship, and our family situation and my health have put so much pressure on us that I don't want school work to become another source of contention. She literally demands to do things her own way when I attempt to work with her, writing things in reverse order, picking and choosing which part of the lesson she's willing to work on, reading only certain books that appeal to her (which is very confusing why she rejects so many), etc. But in one week's time, I've been amazed with the productivity I'm seeing coming home in her backpack. And since the example's been set at school, she then willingly does her homework, following the instructions! Sometimes I misunderstand the instructions and she makes sure to clarify what she's supposed to be doing!

Samantha has always struggled with hard work, be it small motor, large motor, potty training, picking up toys, etc. We've given her seven years to learn how to be a normal kid and tried to accommodate her as much as possible. But she needs to grow up. We'll still "baby" her at home as much as she needs, but she needs the balance of moving on in life. We know she's got it in her! She just doesn't know it, but she'll get it in time.