Rehabilitation after ADR surgery Archives - Page 4 of 6

10 ½ Months Update: Victory and Devastation

irisappenrodtFebruary 12, 2019February 12, 2019Leave a comment

This is going to be a short update, but I wanted to share a victory that I consider huge, but I am also experiencing a very devastating loss right now. First of all, my back is still fine, I didn’t get as many workouts in as I wanted over the last couple of weeks, mostly due to a nasty sinus infection. Right now, it’s not my back that is broken but my heart.

Victory
I have fought hard and long to get my ADR surgery approved and covered by my insurance carrier, Blue Cross Blue Shield (BCBS). At the beginning of my journey, I tried to get pre-authorization in the United States, first in Miami with Dr. Garcia, then Dr. Zigler at the Texas Back Institute. Both of these initial attempts, as well as the peer-to-peer reviews were unsuccessful (the procedure was deemed not medically necessary). I was denied appeal rights in Florida (which I still believe was not legal), and the written appeal through Dr. Zigler was again denied. That is when I paid out-of-pocket and went to Germany to have surgery with Dr. Desai, which has turned out to be the best decision of my life.

Upon my return to the US, I filed an international claim with BCBS for reimbursement. At that point I knew of so many others who got reimbursed for the exact same surgery and disc. But of course, I was denied coverage yet again still on the grounds of the procedure not being “medically necessary”. I filed a written appeal, complete with letter of medical necessity and my medical history, but I was denied again, but this time for the ESP disc not being FDA-approved. I had one last shot: filing an external appeal. I made one last effort, making my case and providing all the evidence I had, and submitted that last year in September. In early October, I received a letter from OPM (Office of Personnel Management), confirming that my appeal has been assigned a case number. Then I didn’t hear back until now .

A few days ago, I received the letter from OPM, stating that the reviewing physician ruled that my lumbar Artificial Disc surgery WAS INDEED medically necessary and an appropriate treatment option for me. I got the Explanation of Benefits from BCBC today, and also received a direct-deposit into my account this morning, covering the majority of my medical bill (but of course not all associated costs). So, later today, I will go to my credit union to pay off the loan I had to take out to finance my surgery in Germany.

I consider this not just a victory for myself, but for all others who seek coverage for ADR surgery. Health insurance is not cheap, and the least they should do is pay for our medical needs when we need it!

Devastation
I have posted about my sweet baby Ponce in the past. Due to a congenital heart defect, he developed severe congestive heart failure that became very evident during the summer of last year. We managed his condition with a sophisticated medication schedule as best we could, and he was such a happy puppy! As his condition progressed, we bought a “Ponce-mobile”, a pet stroller to be able to take him places. We would take him to Menchies’ frozen yogurt to have the sample cup of vanilla ice cream. We sometimes would go to that Italian restaurant close to our home, getting a table outside with Ponce sitting in his stroller, waiting for snacks. Even with that bad hand that nature has dealt him, he was so happy and the best puppy anybody could ever ask for.

Since November last year, we started to carry him up the stairs in our townhome, so his big heart didn’t have to work so hard (he had the tendency to race up the stairs, which wasn’t good for his condition). So, in hindsight, I got to hold him in my arms so many times, and I would give him kisses on the head while walking up the stairs. I would give anything to hold him just one more time.

On Saturday, February 9, 2019, I came home late from my midshift at work. As I was about to walk in, Ralf came out with Ponce on the leash because the puppy was restless. Around that time, Ponce went into significant respiratory distress, panting, coughing, not being able to settle down. At 2 am, we took him to an emergency vet to get a shot of Lasix, a diuretic (“waterpill”) to get the fluids out of his lungs. After all, that was what helped Ponce the last time this happened. But not this time. We didn’t want to leave him at the vet all alone, so we took him home. But he was still struggling to breathe. So, we turned around and took him right back, where he was placed on oxygen. The vet informed us that there is no realistic hope that he would recover again from this, so we had to make that horrible but kind decision. We made our baby a promise that we won’t let him suffer.

Our precious, innocent, sweet Poncebear passed away in peace, in the early morning hours on Sunday, nestled between both of our arms while we talked to him, kissing his little head, petting his fur that was supposed to be groomed the very next day on Monday. Then we had to walk out of that room, having to leave behind our baby laying on his angel blanket on that exam room table, then sitting in the car in front of the vet’s office, having to drive away without my baby in the backseat.

Words cannot describe what I feel right now. I am chocking on tears, re-living this moment, feeling guilty, even though I know it was the right thing to do. I hate coming home, where there is no Poncebear greeting me at the stairs. He left such a huge void, and I hate the thought that he is “out there” until we get his ashes back, hopefully on Thursday or Friday. Then our baby will come home forever. We love you so very much, Poncebear!

10 Months Update: Stepping Up my Game in 2019!

irisappenrodtJanuary 23, 2019January 23, 2019Leave a comment

In this Update:

Adding Structured Training - For Real!
First Mountain Bike Outing in a While!

Adding Structured Training
After spending a wonderful time with my family over Christmas and New Year’s, I was hitting the ground running, starting the first week of January. One big benefit of writing this blog is that it makes me reflect on my progress (or lack thereof). I have to say that I haven’t felt all that great: I have been really sore between my shoulder blades and upper back (you could single out individual knots), my lower back has been fine but also tight, and my endurance level is pitiful. I do treasure the absence of the crippling pain every day though!!!

Here is a significant pattern that I am very much aware of: between my stressful job (and long hours), the demands of graduate school, and day-to-day errands, I just don’t find the time to do true workouts! Last summer, I was trying to commit to a structured workout routine every week, no matter what. I have to admit that this didn’t work out at all – I failed miserably! I realized that without guidance and structure, I won’t be able to do what I need to do in terms of exercise. So, I adjusted my strategy: my dear friend Angela Clough is the owner of the Crossfit Lake Nona gym, and she agreed to help me achieve my workout goals in a safe and effective way. Angela has recovered from a serious back injury herself, so she knows my fears (especially of lifting weights) and where I am coming from. She is creating tailored workouts for me, so that I can get strong and fit again without jeopardizing my new back.

Meet Angela, my photo-bombing trainer:

Over the last couple weeks, Angela assessed my abilities, strengths, and weaknesses in order to come up with a progressive workout plan. There were four “assessment days” during which my posterior chain, hamstrings, glutes, shoulders, and core were put to the test… But don’t let the word “assessment” fool you, I was soooore (in a good way, if you know what I mean) like I haven’t been in a long time!

First of all, I want to thank my physical therapist and trainer Bill for doing a fantastic job rehabbing me after surgery. Apparently, my back muscles are a lot stronger than expected, which was evident during the Sorenson test (see picture). I was able to hold the required position for 3 minutes and 10 seconds, which I was told was an excellent result! But now, I am ready to enter the next phase of fitness and wellness.

DAY 1
Starting out with some very basic movements and exercises to gauge my overall strengths and symmetry .

DAY 2

DAY 2
After Day 1, I couldn’t lift my arms over my head for a couple of days, even if my life depended on it during a bank robbery. I haven’t done pull-ups and push-ups like that in ages, and even though the pull-ups were banded, they kicked my butt, lol!

DAY 3
Day 3 was scary and exciting all at once. I know I need to re-introduce weight training into my routine to keep my bones and muscles strong. But I am not going to lie: I have been a tad leery about lifting weights but having such a competent coach has helped me gain the confidence I needed. To be perfectly clear, though, I have absolutely not ambition to become an Olympic Weightlifter or Powerlifter. But I need to be able to train with weights to protect my back and bones!

Here is the answer to the question that most likely crossed your mind at this point: how did/do I feel? AMAZING! Doing a deadlift correctly will tax your hamstrings and glutes but should never strain your back. At no time did I feel any pain or undesired discomfort during or after the move! After all: that’s why I chose the LP-ESP and its buffering properties. Before surgery, I couldn't even pick up my 13-pound senior-puppy!

P.S.: I also realized that I needed flat, non-cushioned shoes to secure a non-wobbly stance while lifting, so I got a pair of Nike Metcons (my first non-Hoka pair in a long time).

Before surgery, I couldn't even pick up my 13-pound senior-puppy!

DAY 4
At this point, I can already feel the effects of a structured workout program. I have more energy, my muscles between my shoulder blades and lower back are significantly less tight, and I feel overall a greater sense of wellness, if that makes any sense. However, Day 4 had a heavy focus on the hamstrings and glutes, so for the next couple days, I dreaded stairs and walked like a duck! But I am all recovered now and ready to begin my actual workouts this week!!!

Biking in Hal Scott Preserve
I haven’t had the chance to ride my new mountain bike much at all, lately. I am also still in the process of finding the right saddle for my butt, but maybe if my glutes get stronger, my tolerance will, too. So, last Saturday we went on a leisurely ride (my legs were still tired from the Day 4 workout) at Hal Scott Preserve. There is an interesting network of trails, going from grassy-overgrown, to hard-packed dirt, to large-gravel trails, to peanut butter mud holes. It was a beautiful Florida day, just before the next cold-front was rolling in. I think I should get properly fitted at JC’s bike shop to get the saddle-issue resolved. After that, I will be unstoppable!!!

9 1/2 Month Update: Holiday Edition!

irisappenrodtJanuary 2, 2019January 2, 2019Leave a comment

In this Update:

Busy Times Before the Holidays
Airboat Ride
Ponce Care

Busy Times Before the Holidays
The good news: after 3 years of working the holidays, I finally got both weeks off this year. The bad news: I still had to work four 12-hour shifts in a row at the maddening-busy ER in order to string together my days-off to accommodate my mom’s arrival from Germany. I worked Friday, Saturday, Sunday, and Monday, “off” on Tuesday, then jury duty on Wednesday from 9AM to almost 5PM, followed by racing home, just to turn around and go to the airport, where their flight landed at 5:55PM. If I knew that my mom and step-dad were going to be stuck in immigration for another three hours, I wouldn’t have had to rush so much.

I certainly put my back and ESP disc up to a challenge, especially after working four brutal days in a row, which is always demanding on the body and mind. On that one day off on Tuesday, I started the day early to run errands across town, then I cleaned my 2-story town home top to bottom, which included deep cleaning two full and one half-bathrooms, vacuuming/mopping the floors, and converting Ralf’s office into a guest room. Just before my work-marathon, Ralf and I put together another cabinet, complete with six drawers. That was a couple notches up from the shoe cabinet that I recently assembled and involved lots of crawling on the floor, putting in screws at awkward angles, and putting the finished product in place.

Ooooh, and then there was the issue with that massive, electric recliner that cluttered up my living room. In the months leading up to my surgery, I basically lived in that thing due to the back pain. But now, I no longer needed it, and it really didn’t fit with the new couch anymore! Ralf and I had to wrestle that thing into the garage by sliding it down the stairs, step by step. Ralf did the heavy lifting, of course, but I am proud to say that I hung on to that sucker to prevent it from crushing my love on the way down. Rest in peace, recliner. You will be returned to the Wallaby Ranch, where I got it as a loaner from a good friend who was trying to help me be more comfortable.

Before Surgery
After Surgery

Airboat Ride
Anyways, I did have a wonderful holiday season, which I got to spend with my family. However, those two weeks have been quite busy: I took my family on various outings, such as Disney Springs, Celebration, and Portofino Bay at Universal. In fact, I surprised my mom with a mother/daughter spa day at the Mandara Spa at Portofino, since she never had a massage at a spa – ever! Because she doesn’t speak English, I booked a “couples massage”, to be able to tell her what’s happening. This was also a nice massage for me, but boy, am I tight between my shoulder blades!

So, the day before New Year’s, we went on an airboat ride, which can be quite bumpy but are a “must” to get glimpse at the amazing nature and wildlife Florida has to offer. The outfitter was located in Christmas, Florida (yes, that’s the actual name of the town) and lasted for about an hour. Again, those airboats can be a tad bumpy, and there isn’t really anything to hang on to. However, the tour was amazing and my ESP buffered those little shocks like a champ. No pain during or after, which made me very happy! I suppose people who suffer from severe degenerative disc disease (DDD) can understand what big of a deal a simple outing like that can be, when your natural disc is toast and any harsh motion will send waves of pain down your spine. We had a blast, my family enjoyed this experience as much as I have, and I must say that things like this make me feel normal again.

Ponce Care
As I mentioned in a previous update, my fur-baby’s diagnosis, which was finally confirmed with an echocardiogram, revealed severe heart failure with respiratory complications. So, his medications were significantly increased, and a second diuretic was added to keep the fluid in his lungs at bay. However, that also meant that we now have to carry him up and down the stairs, and that quite frequently, due to his need to pee more often. Especially at 1 AM in the morning, carrying him down/up two flights of steep stairs was a bit of a challenge, so Ralf and I took turns.

The reason why I am sharing this is the fact that I was unable to pick Ponce up prior to surgery at all! I actually dropped him once half-way up because my back gave out. Now, his 13 pounds doesn’t bother me anymore, and I can carry him without any issues or pain.

Even with his occasional wheezy cough, Ponce is still very happy and is enjoying a life full of snacks, treats, and belly-rubs. So, from my family to yours, we hope you also had an amazing holiday season with friends and family. Merry Christmas and Happy New Year!!! 2018 has been an intense but good year for me. Let's see what 2019 has to offer...

9 Months Update: Ikea Challenge

irisappenrodtDecember 13, 2018December 29, 2018Leave a comment

In This Update:

The Ultimate Test: Putting Together an Ikea Shoe Cabinet
Finding New Ways of Torture
Ponce Update

Ikea Challenge

Last weekend, my fiancé participated in this intimidating bike-packing event, the CFITT 2018. I dropped him off at New Smyrna beach (east coast of Florida) on Saturday, where he (along with a large group of other brave souls) started the race to the other side: Chrystal River/Inglis on the west coast of Florida – via mountain bike, mostly off-road,about 280 miles! He made it in 2 ½ days, which is an amazing accomplishment.Did I ever mention that Ralf has two metal hips? Yes, we are the bionic couple!

Since we still have to prepare for my mom to arrive next week from Germany, and me being off a day and a half by myself, I decided to take on the Ikea challenge. We purchased a sectional couch, which we put together, but we also got a tall shoe cabinet waiting to be assembled. So,I repurposed the batteries from my electric toothbrush to get the powered screwdriver going, sorted, grouped, and spread-out all the parts, and went to work. If you ever put together anything from Ikea, you know that this can be a pretty agonizing experience.

I crawled on the floor, assembling this sucker one screw, hinge, and wooden connector at a time, and put it up against the wall, where it had to be mounted. I couldn’t even tie my own shoes prior to surgery, so this was a proud and liberating moment. I am still amazed what I can do again, and I won’t ever take this for granted.

Before...
After!

Finding New Ways of Torture

I guess, since I didn’t have to deal with back pain anymore, I decided to get creative to re-introduce pain into my life: I let a little Chinese lady rip my face off! I really dislike all that peach fuzz on my face and was thinking about ways to get rid of that. One by-product of being disabled was the discovery of pedicures. So, when I had my toes done last Sunday, the lady offered to wax my face. Adventurous me, I decided to give it a try. What’s the worst think that could happen, right? Weeeeelll, let me just say, having your little hairs brutally ripped off your face is anything but pleasant, as evidenced by involuntary tears streaming down my face! My face also looked (and felt) kind of sunburned for three days, but now it is smooth as a baby’s bottom, lol. Would I do it again? I am not so sure…

Ponce Update

Our Ponce-bear is doing better, but the echocardiogram revealed that his heart disease is now severe, which has been causing the recent events of respiratory distress and fainting episodes. He is now on an enhanced medication regiment, which seems to be helping a lot. In fact, he is so happy still, it melts my heart. He is so oblivious of his grim condition, and I hope it will stay that way for as long as possible.

Still my happy puppy!

8 1/2 Months Update: End-of-the-Semester-Stress – and then some…

irisappenrodtNovember 28, 2018December 29, 2018Leave a comment

In this Update:

Ponce drama
Managing full-time work with school stress
Cleaning is a workout, too!

Ponce drama

So, we have a furry son: Ponce. He is our most important member of the family, and even though he has been going through some health-issues for a while now, we have managed his health well with medication and certain lifestyle adjustments. However, while I was still at work, Ralf called me last night because Ponce was in respiratory distress, coughing, wheezing, and unable to lay down. He has been diagnosed with an enlarged heart that has been pressing on his little trachea at times, but overall, he is a happy (13-year-old) puppy! When I got home, Ponce’s breathing was shallow and he kept gagging and couldn’t lay down for most of the night. Our poor baby! Nobody got much sleep during the night, and to be honest, we were bracing ourselves for the worst. First thing in the morning, we scooped up our baby and rushed to our vet, where he was diagnosed with acute pleural effusion (water in his lungs). Maybe it was the cold-front that came through that triggered the event, but who knows? He got an injection of Lasix (diuretic) to get the fluid out, and so far, he appears to be better. Ponce has finally slept a few hours but has to go outside frequently to pee. He’s not out of the woods yet but we are hopeful! Ralf and I are a mess right now… at least I am off today!

Finally able to lay down, hope it will last...

Here is my boy during happier times…

Managing full-time work with school stress

Work-School-Sleep-Repeat: that has been my life over the last couple of weeks. I wish I could report more activities, such as biking and working out, but life has not let me get much of a break lately. In a way, this was a test of endurance and the ability to sit and focus on graduate schoolwork for long periods of time. I truly wish I could have worked out as planned but I just haven’t had any time to do so lately. In addition, I am experimenting with a new saddle for my bicycle that will agree with my seat bones better but so far, I haven’t found the right one yet. Work has been very stressful, especially with all the snowbirds coming down to Florida. I had some pretty intense days at work, which included having to restrain somebody while avoiding getting kicked in the head. Between tomorrow and Friday, I will hopefully be done with the last giant paper, and this will finally conclude this semester.

I feel the lack of structured rehab in terms of being “tight” allover. The muscles between the shoulder blades are in knots, and my lower back feels sore. HOWEVER, this soreness is also muscular and I have not had any pain creep up on me, for which I am grateful for! I mentioned in a previous post that I can still clearly remember the pain, how it felt like, and what kind of (even micro-) movements provoked it. I never had any of that pain come back. In a way, this was the test of my tolerance for sitting for extended times, coupled with tons of mental and physical stress. I’ll be honest: it sucks, but I got through it without major issues.

Cleaning is a workout, too!

With that being said, even today and tomorrow, I will add more challenging activities to my agenda: cleaning and moving stuff around. I also mentioned in a previous update that I was not able to clean my home anymore due to the pain and disability. Well, we decided to buy a new couch, shoe cabinets, and dressers from Ikea, which are going to be delivered tomorrow. That means moving things around, vacuuming, etc., in order to be ready for the delivery. Oh, we also decided to assemble everything ourselves, which should be interesting.

8 Months Update: Back to Volunteering!

irisappenrodtNovember 15, 2018December 29, 2018Leave a comment

In this Update:

Disney’s Food & Wine Half-Marathon
Active Shooter Drill
Hal Scott Preserve Outing

Disney’s Food & Wine Half-Marathon

Sunday before last was another milestone for me: returning to be a medical volunteer for the Walt Disney World running races! To put this into perspective, the last time I volunteered didn’t go so well... My back was so far gone then that I shouldn’t have volunteered in the first place, but I remember the depression and fear of losing yet another activity I really enjoye, to my evolving disability. I had to stand a lot that day, which caused my back to “seize-up” and lock into place. I also couldn’t get down to the stretcher anymore, which added to my pain and frustration. To top it all off, when I got to my car after the event, I stood for about five minutes next to the open driver’s door, trying to prepare myself to sit down. I looked around, and when there was nobody else around, I let out a scream and forced myself into the seat. The pain was so overwhelming that I got nauseated, started to sweat, and cry. It took me another several minutes before I could drive off the parking lot.

Fast forward to Sunday before last: this was the first Disney race since my surgery, and even though I had to get up at 3 am, I was so excited that I was able to go! I watched over 10,000 participants come through the finish line, and even though I was on my feet for hours, my back was doing ok! Sure, I felt a tad sore, but that was also due to the inability to do my proper rehab over the last few weeks (still working on a solution for that issue). But I was really ok and didn’t have a set-back at all!

In fact, after leaving from Disney, I satisfied my civic duty and voted early...

Active-Shooter Drill

Later that same week I participated in yet another event: an active shooter drill at work, complete with fake victims, covered in fake blood. I have been with the Orlando VA Emergency Response Team since 2014, and I am so grateful that I was able to return in full capacity! I was part of the Medical Emergency Tactical Team (METT) and ran with two team mates and a Stryker stretcher to the 4^th floor to stabilize and retrieve “victims” of the “shooting”. The hardest part was to get that stupid stretcher to comply, but after cutting off shirts and applying some pressure dressings, we got everybody to the Emergency Department for “treatment”. Before April 4^th, 2018, I wouldn’t have been able to do any of this! So, ADR surgery saved not just my life, but also my “victims”, lol!

Hals Scott Preserve Outing

Even though I still haven’t figured out yet where and how to do consistent rehab, I went for a nice mountain bike outing in Hal Scott Preserve. My new ride is amazing but I need to find a better saddle that fits better with my “female anatomy” and seat bones. This wasn’t single track but had a variety of different trails, which where challenging at times but gave me a good workout. Besides deer and a black racer snake, we encountered a tortoise having lunch…

I started doing light deadlifts with the kettlebells that we still have in the garage to strengthen my back, and I have not just tolerated the exercises well, it actually felt good while doing them. Zero discomfort! I do listen to my back and go with how movements/activities feel, so this was very encouraging. It still blows my mind that I live in this oh-so cutting-edge “wellness community”, which has not a single calisthenics park to offer… Maybe the new construction close to work will have something suitable for doing some bodyweight workouts? We will find out eventually.

7 1/2 Months Update: A New Commitment 1

irisappenrodtOctober 31, 2018December 29, 20181 Comment

In this Update:

Need for new commitment
Santos Single-Track Adventure
OPM Appeal

Need for New Commitment

This realization is actually nothing new as I have struggled with this issue before. Over the last two weeks I have been so stressed and busy with work, school, and other obligations that I didn’t have the time or energy to do much in terms of structured rehabilitation.

I love my job as ED nurse but the demands and needs of the department do not leave much time or energy for anything else. First of all, we have to work every two weeks an additional 8-hour shift to make up 80 hours per pay period, and for some reason, this additional shift always screws up my schedule. Secondly, I now have jury duty pretty much every other week for the next year. This is especially fun when I work until midnight the day before, just to be at the downtown courthouse at 08:45 am. I had my first day today and I am EXHAUSTED! Thirdly, I am still in graduate school until the end of 2019, which demands a significant amount of time as well. In addition, I just had to re-commit to teach the PMDB (Prevention and Management of Disruptive Behavior) class at our hospital on a regular basis. This is a mandatory class that has to be taken by all staff members working at my facility, and classes are eight hours long and scheduled at least twice a month. This is in addition to full-time work which is a mid-shift (11 am to 11:30 pm), mind me not. So, when should I commit to rehab?

I admit that I am struggling with this. I am trying to stick to my rehab stretches but I haven’t done much in terms of working out. I am overall feeling a tad “creaky”, including my lower back. Not pain, which I am grateful for, but I can feel the effects of not exercising. I do run around at work a lot, but that doesn’t substitute for a structured workout. So, starting this week, I will go to a gym (preferably three times a week) and follow a workout regimen that is initially body-weight based. Once I feel ready, I will add weightlifting to the mix to finally get strong again. My fiancé is very knowledgeable and fit himself, so I will have him come up with my initial workout plan, which I can follow safely. This will be hard due to the above-mentioned challenges but I didn’t go through this nightmare to start neglecting my new back. I am also considering a career change to a more consistent schedule and less stress, even though I would certainly miss the adrenaline and crazy situations in the emergency department. We’ll see…

Santos Single-Track Adventure

Remember my new mountain bike? I didn’t really have the chance to take my new ride out into the woods until last Saturday: Ralf and I met up with some dear friends at Santos, where a network of 100 miles of single-track mountain bike trails spans like spaghetti throughout the Ocala woods! I must say that at least to me, those trails where rather technical but also so much fun!

I rode many trails in the various Florida woods in the past, but this is only my second time to explore true single-track trails. I have to work on my timing though, as I was thinking to myself “oh, a rock, let’s ride around it… CATUNK…oh, well, next time…”. In the later portion, there were also some scary drops involved, and a I decided to walk my bike through a couple of them, rather than ride it out, lol! We clocked out at 28 miles, of which 8 were on the paved trail back to the parking lot. After that, I was toast…

The day after I was quite sore (especially the thighs and shoulders) but I can’t wait to do it again!!!

Unfortunately, the GoPro didn't capture any of the more technical trails but this is a small clip from the beginning...

OPM Appeal

So, here goes nothing! I submitted my appeal request to OPM and hope that I was able to make my case. The discrimination and unethical practices of health insurance companies, such as Blue Cross Blue Shield, are infuriating! It is beyond comprehension how they get away with all this, covering one person while denying another – for the exact same procedure/disc! But I am not giving up!

7 Months Update: Reflection

irisappenrodtOctober 17, 2018December 29, 2018Leave a comment

In this Update:

Deployment wrap-up
Reflection
Paisley trail ride with new bike
Insurance update

Deployment wrap-up

So, this is it: the last four days of my first out-of-state deployment are coming to an end. The lessons learned so far include that everything can change in a heartbeat, that you cannot count on maintaining a healthy diet on missions like this, that deployment and graduate school are not friends, and that you may meet some amazing people during times like this. I also couldn’t keep up with rehab and stretches (that carpet was yucky and the bed too soft for it). So, would I do it again? Absolutely! In fact, after my return Saturday evening, I barely had time to adjust, wash my clothes and get ready for my 12-hour mid-shift on Monday, when Hurricane Michael made its appearance in the Gulf of Mexico. Needless to say, by Thursday I was back on alert for possible deployment to Mexico Beach, Florida but so far, the facilities in Georgia are providing enough manpower…

Last (I hope it was) oatmeal breakfast at Ft Bragg...

I do hope to see some of my new-found friends again – even though that usually entails that disaster strikes beforehand. I guess we all share the passion of helping others when they need it most, even if that means leaving our own lives and families behind at times.

Reflection

I wanted to take this time to reflect on the last few weeks and how it affected my (still less than 8-month post-op) back. Looking at the overall outcome people described on ADR support groups, I came to realize that (especially) lumbar ADR surgery may take a year or so to show full effect. I was just reading Layne Hermansons’ one-year update and the struggles he has had during his recovery. Even though it took his body longer to heal, he now leads a pain-free and active lifestyle again. I truly believe that the majority of people who undergo ADR surgery will end up leading a normal, pain-free life again, even if it takes longer for some to fully recover. I am one of those lucky ones, who had this amazing result very early on, but just because your timeline of recovery may be different doesn’t mean you won’t get there.

With that being said, many fellow degenerative disc disease sufferers have asked about sitting for prolonged periods of time. During my deployment, I had the opportunity to test my sitting-abilities pretty thoroughly, since my commute was 2 ½ hours (each way!) by bus to get to those North Carolina coastal communities. I also “pretzeled” up over two seats to snooze at 06:30 am, which went surprisingly well. Neither the sitting nor “pretzeling” caused any harm or pain, which amazed me especially since I wasn’t able to do my maintenance stretches like I would at home. I was able to handle my luggage and a fairly heavy backpack during this trip without issues. There were also days where I had to stand in place for long periods of time – an (in)activity I wouldn’t have dared before surgery! I did shift my weight this way or that, but I was able to move without the feeling of this severe stiffness in my lower back later.

I am counting my blessings every single day to be able to do what I do, because I can still (quite vividly) remember that ever-present, sickening, disabling, tear-provoking, quality-of-life-sucking, depression-inducing pain! The dread in the morning of moving out of bed, the screams of agony when putting on socks, the realization that I can’t do my job anymore… It’s all gone now, but the memory remains. Never, ever will I take my back for granted anymore.

Paisley trails

On a lighter note, I discovered some footage on the GoPro that captured, not just a nice section of the Paisley trails, but also the follow up phone call of my deployment orders – in the middle of the woods. Apparently, Ralf forgot to turn off the camera when the call came. This whole scenario had him pretty stressed…sorry, sweetie! But I really enjoyed riding these beautiful (mostly single-track) trails with my new bike: die Rote Zora (it’s a German thing, and yes, I do name my bike and my plants, too).

Insurance update

As some of you may know, I am still fighting an ongoing battle to appeal the denials of Blue Cross Blue Shield to reimburse me for the cost of my surgery. After submitting my surgeon’s letter of medical necessity and recent journal articles that show the superior efficacy of lumbar ADR surgery compared to fusion, I just got another set-back in the mail. Now BCBS denied my claim, not because the procedure wasn’t “medically necessary”, but because the disc (LP-ESP) is not FDA-approved! This is interesting, considering how many people got reimbursed by BCBS International for ADR surgery overseas, having either the M6 or ESP implanted. At this point, I have nothing to lose, so I will file an external appeal with OPM (I have BCBS Federal). I am planning to submit my appeal along with more evidence by this weekend. I’ll keep you guys updated.

6 1/2 Months Update: Disaster Response! 1

irisappenrodtOctober 3, 2018December 29, 20181 Comment

In This Update:

My new ride!
DEMPS activation and deployment (Disaster Essential Medical Personnel Services)

As I am writing this update, I am still at the Army Base Ft. Bragg in Fayetteville, NC with the DEMPS team, and I have been deployed now for 1 ½ weeks, so I am a tad tired.

What can I say: the last two weeks have been rather unusual. First, I bought a new mountain bike with plus tires, which should hopefully prevent me from getting stuck in the mud like the last time. Here I am, getting fitted for my beautiful Salsa Woodsmoke:

Of course, I really wanted to take my new ride out into the woods to try it out. So, Ralf and I drove from Deland to Paisley, where we hit some amazing single-track trails (they are part of the Ocala Forest) for about two hours. This new bike is great, and I can honestly say that I wouldn’t have been able to complete that loop in the woods with my old bike. I am now looking forward to many more adventures!

With that being said, while we were halfway to the bike shop (it’s an hour away), I got a phone call from my local Emergency Management coordinator to inform me that the Orlando VA is activating two DEMPS responders to go to North Carolina. My name came up and I was told that I was leaving on Sunday (the call came on Friday). After calling my nurse manager to let him know, and for him to take me off the schedule for the next two weeks, I continued on to the bike shop since we were already on the way and I also decided to ride the trails as planned. Later that weekend, I had to cancel a doctors’ appointment, inform my university professors, and write an email to the federal judge’s office to let them know that I won’t be there for my first day of jury duty.

The next couple of days were rather intense since nothing ever goes smoothly. Due to some internal hiccups, the travel coordinator couldn’t book my flight, accommodations, or rental car until Saturday afternoon. I struggled to get some last-minute items to take and also worked a little ahead on my school work. Yes, I was a tad stressed, but what else is new, right? I actually had my laptop and two school books in that backpack, which increased its weight significantly. But I can happily report that by LP-ESP handled the extra weight just fine and didn’t cause any pain. When I finally arrived at the airport to start my two-week deployment, I had no idea what to expect.

The travel to Fayetteville (with a two-hour layover in Charlotte, NC) when pretty smoothly, and I even got some homework done on the way. I was able to man-handle my luggage without any issues!

When I arrived at my final destination, the DEMPS coordinator was already waiting for me, as well as three other volunteers. I was instructed to get the car rental finalized, which wasn’t quite as easy as it sounds, considering that there were no more rentals available due to the hurricane repercussions. I did get one of the last vans, so I had to drive that monster (Dodge Caravan, 7 seater) to Ft. Bragg Army base, where we were staying. I arrived with three lovely ladies, Susan (mental health), Jesse (MD), and Marschall (LPN). I can say that we bonded instantly. Even though we were assigned to different teams (and at times locations), we still hung out during down-time. However, those down-times significantly shortened after we finally deployed to the coast though. I also learned about myself that I truly suck at bowling…

So, what have I been up to so far during this deployment? Well, the mission entailed to supplement the overwhelmed local healthcare staff, and to see all those patients, who have been unable to receive care due to a week-long (+) shutdown of their facilities. Hurricane Florence has created an enormous backlog by causing over 15,000 patient care appointments to be cancelled. Furthermore, the clinics at the coast in Wilmington and (less) in Jacksonville where severely hit and suffered great damage. Regardless of their individual backgrounds, all DEMPS responders got a crash course in documentation and issued a government laptop. We were then assigned into PAC teams and started to see patients. A LOT of patients. During the first five days, our teams stayed at the Fayetteville VAMC to help get through some of those cancelled appointments.

However, we were most needed at those coastal communities, but the roads were still in such bad shape that it was impossible to get there yet. There was also no shelter for any of us to be found. It was a mess! Finally, on Friday the roads to Wilmington were passable, and Jacksonville by Friday, so it was decided to shuttle our teams by bus to their local clinics – 2 ½ hours each way, every day! Especially Wilmington was hit hard and suffered major damage. Therefore, we operated partially out of mobile response units (basically very large RVs) to start seeing patients.

On the (freezing) bus, again... From 6:30 am in the morning to when we return around 7 pm...

It is so unbelievable how someone’s home was completely destroyed while their neighbors house only had minor damage. I also found it very humbling to be thanked for my service by so many veterans, when I would normally thank for theirs.

I am a quite pressed for time, but I will return on Saturday this week and report back on my next update! I am still in awe what I am again able to do! ADR saved my life!

6 Months Update: I am So Stressed! 1

irisappenrodtSeptember 19, 2018December 29, 20181 Comment

In This Update:

First trip to New York City
Federal Disaster Response Team
Jury duty, work, and graduate school
Calisthenics workout

The last couple of weeks have been pretty intense and “non-stop”. Between full-time work, graduate school, getting ready for a possible deployment to a disaster zone, and jury duty, I haven’t been able to take a breath yet. I am trying to take care of myself but I admit that it is not easy if the day doesn’t’ have enough hours for me to get everything done.

The day after my last update, I flew out to New York City to meet up with long-time friends from when we all worked at the German Biergarten at Disney 18 years ago, and to celebrate a 40^th birthday. To make this happen, I had to work four days in a row to be able to string together my days off. I lost all my vacation time during my surgery and recovery, so I had to get creative. But I shouldn’t complain, since one of my friends (Beth) flew in the same day from Switzerland for only four days! But it was so worth it, especially since I haven’t seen my friend Dennise (who now lives in San Francisco) in over a decade!

So, after working the mid-shift for four days straight (in a rather busy ED), I tried to work ahead on my assignments for graduate school in between, so as to not to fall behind. I actually worked on a discussion post during my entire 2 ½ hour flight to NYC, which required me to drag my heavy books and laptop along for the journey. I am happy to report that I was able to maneuver and lift my carry-on suitcase without any problems, and sitting in the cramped seat was inconvenient but not painful.

After yet another hour of sitting in a taxi to get from JFK to the hotel in Manhattan, I was finally greeted with a glass of champagne by my friend Katharina, and that was the end of my efforts to get my homework done. For the next four days I did a LOT of walking, sightseeing, took the subway, and of course attended a couple rooftop bar parties.

I arrived on a Thursday in NYC and got back home Sunday evening - with a deficit on sleep for sure. On Monday, I had to work again, but Tuesday was a little different. Instead of going to work, I had to report to the downtown courthouse for my first experience of being summoned for jury duty. Well, let me just say that this was very different from what I had anticipated… I guess the universe thought that I wasn’t busy enough yet, so it decided to really make me do my civic duty. My jury duty turned out to be a long-term commitment that will fill my schedule with even more obligations for the next year (!!!) to come. Oh, well…

But wait, there is one more thing! In case you haven’t heard, but there was an enormous hurricane (Florence) aiming at the Carolinas/Virginia coast, which means that I am now on stand-by for deployment with the Federal Disaster Response Team. If I do go, I will stay for up to two weeks in a disaster zone to provide medical support to the community. Even if that isn’t going to happen now, the hurricane season is still young, I suppose, so I am trying to stay ahead on my school assignments while working full time. In any case, my suitcase is packed (again), my gear in order, and my back is compliant and pain-free!

Did I mention that I was a tad stressed lately? Needless to say, my rehabilitation efforts have been sabotaged more than once. As I mentioned in an earlier update, little “aches and pains” usually sneak up on me when I don’t work out. So, today (I am actually off, woohoo!), Ralf and I went to the calisthenics park at the Black Hammock trailhead for some rounds of pull-ups, push-ups, rows, and interval sprints. Even though I didn’t like doing them at the time, I feel really good right now, sitting showered in my comfy chair and writing this update. Looking back over those crazy couple of weeks, I feel so incredibly thankful: not for all the stress, but for the ability to do all those things without being crippled and in pain!