Artificial Disc Replacement Archives

2 Years 3 Months Update: Long Overdue

irisappenrodtAugust 25, 2020August 25, 2020Leave a comment

In This Update

Good-Bye Emergency Department – Hello Education!
Having a Predictable Schedule

Ever since I started writing this blog, I never missed an update. Until now. In fact, I missed two updates. Thinking of the words of the son of my dear friend Libby, who just passed away from chemo complications a couple weeks ago: “Life is difficult, life is hard”. The last few months have been brutal, putting me in a constant state of anxiety and depression. But I am trying hard to overcome this, the effect of this unprecedented pandemic has had on my mental health, Ralf’s setbacks, finding my way in a new job, then having to travel to Germany for a family emergency… it is just getting a bit much.

Good-Bye Emergency Department – Hello Education!
But let me start by recapping the month of June – my last weeks as ED nurse during this COVID-19 pandemic. Ironically, I got the new job as Simulation Coordinator already back at the beginning of March. However, due to the dire circumstances, I was on hold until June 22^nd. I admit that after the first COVID wave somewhat subsided, things were less scary and dangerous during the first part of the month. It was about two weeks after Florida loosened the restrictions and opened the bars again, when almost overnight we experienced a consistent influx of sick Corona patients. I remember the day I was in triage, shortly before my transfer, where I was more exposed to COVID in this one 12-hours shift than during the past three weeks!!! It was scary! And those Covid patients weren’t old or compromised, they were in their mid-twenties! I remember that bartender who couldn’t finish a single sentence because he was so short of breath, with a fever of 103. I was locked in with that 27-year old guy for over an hour, doing blood cultures, EKG, and trying to keep him stable until I transferred him to the ICU. Same day, I cared for a 25-year old girl, who went to the bar with friends for a drink… and on and on it went. It was amazing to see the obvious pattern. So many people just got careless, acting as if the pandemic was over and there was no need for masks or social distancing. And I get it: I have been more than depressed with what life has become. I am mourning the freedom to go to the movies, or a restaurant, hug my friends, or go grocery shopping without fear of a deadly disease that has taken over the world. But I have seen the truth, the sick, the repercussion of letting your guard down. And it’s not just about me: what if I take that virus home to Ralf?

However, just as the second COVID-19 wave was taking off, I finally got to my new destination: The Education department as the new Simulation Coordinator – a job I was very much looking forward to! During most of my graduate education, I was fascinated by and focused on healthcare simulation. Now all the hard work finally paid off, and on June 19^th, I worked my last day in the Emergency Department. This was a bitter-sweet moment: I always wanted to be an Emergency Nurse, and I consider myself very lucky that I got to open up a brand-new Emergency Department at the VA Hospital in Lake Nona in 2015. But now it was time to say good-bye…

Ralf was so excited for my new job, he got me flowers on my last day!

Fast forward to June 22^nd, 2020: the day I was finally starting my new position as Simulation Coordinator at the VA Hospital in Lake Nona! Here’s to a new chapter in my nursing path! But I must say, the last day in the ED was quite emotional, and I will miss my patients and my peeps for sure…

I admit, I was pretty nervous on my first day, not knowing what to expect. The good think is that I have been around the Orlando VA for so long that I know my way around – as well as a lot of people. What was “unique” about this position was the fact that the previous Simulation Coordinator had been gone for almost a year, and even before that, the lab wasn’t quiet utilized as intended. And the madness of the pandemic, when stuff was just taken from the Simulation Lab, never to be seen again, made my job an even bigger challenge.

Having a Predictable Schedule
With my new job came also a predictable schedule: Monday through Friday, 0800-1630, weekends and holidays off! I also got a government laptop to work from home if need be, which added a new layer of flexibility (extremely important feature as I found out in July…). So, Ralf and I went on some outings on my days off – and it was so much less stressful all around. No more fear of exposure, no more 12-hours shifts, coming home late… I didn’t realize how much of a difference this would make.

We explored the north entrance of the Lake Lizzie Preserve on a rainy day, then the south entrance the following weekend. We also went for a bike ride at Triple N Ranch, were I haven’t been in so long. It reminded me what outdoor adventures in Florida during summer time always have in common: LOTS of water, and lots of turtle activity!

Oh, we also finally got out new juicer....

.... And new "pets"!

One-Year Update: Special Edition! 1

irisappenrodtApril 4, 2019April 4, 20191 Comment

In this Update:

Reflection
Follow-up X-rays
Starting from Scratch
Emergency Management

Reflection
I am 12 months post-op, wow!!! Last year, same time, I was admitted to the SANA Dreifaltigkeits-Hospital in Cologne in hopes to reclaim my life. The feeling of finally boarding the airplane to fly overseas to have a German surgeon I have never met operate on my spine was simply indescribable: I would say it was a mix between anticipation, fear, and hope. Ralf and I arrived on a Saturday, the day before Easter and our 8-year anniversary, and I was admitted the following Tuesday. I met Dr. Desai that Tuesday for the first time, and I do remember that most of my worries melted away, and deep down, I knew I would be alright. And so it came to pass!

I decided to capture my reflection on video, and I hope that maybe it will help someone else, who faces a similar situation, to get through such a life-changing experience. I have also compiled some pictures from that time last year.

Ralf and I spent our 8-year anniversary (which also happened to be Easter Sunday) eating dinner at a Spanish restaurant in Cologne. He has suffered just as much through the last couple of years, so we both were ready to get this surgery done and over with!

This was my spine before: it still blows my mind how one degenerated disc (in my case L5/S1) can cause so much crippling pain and disability!

I remember everything! Dr. Desai actually stayed with me for 15 minutes in pre-op, talking to me until I was "put under" ...

Here I go, walker and all, for a stroll down to radiology to get my 1-day X-rays taken by Dr. Desai! At that time, ALL of the "old, crippling" pain had just vanished!

This was the first time I got to see my new spine, including my beautiful LP-ESP. Even though, the portion the covers the underside of L5 is a tad too long (2mm), the ESP covers my the entire endplate of S1. Fantastic outcome all around!

Here is an "up and personal" look of what's inside of me now (of course I got a new one, not the model, lol): the LP-ESP feels very stiff but that is great for protecting the facet joints while still providing motion in all six degrees, including shock absorption!

Here is my incision at two weeks right after Dr. Desai pulled my stitches versus today. Best scar ever!

And of course I had to wear my custom-made back brace. If it wasn't so stiff, it could have actually passed as a fashion accessory! So, after the six weeks were over, I had to find a purpose for that thing... Nailed it!

And here I am, at my last follow-up visit with Dr. Biren Desai, the person who gave me my life back! I might be biased but to me, he is not just an incredible surgeon but also a kind and humble human being. Thank you for everything, Dr. Desai!

Follow-up X-rays
And here they are: my 1-year follow up X-rays (lateral, flexion, extension, anterior). Dr. Desai said they look perfect, no issues whatsoever!

1-Year Lateral view:

Here is a side-by-side lateral view comparison of my 1-DAY old X-ray (Left) and my 1-YEAR old X-ray (Right):

Flexion (Left) and Extension (Right):

Aaaand anterior:

Starting from scratch
I know I said it a few times in the past, and believe me, it wasn’t for lack of motivation that I didn’t get to stick to regular workouts as planned, but things are starting to fall into place. Since I missed six weeks of workouts due to my overloaded, crazy schedule, Angela had me start from scratch, and this time, I WILL make it happen!!!

Food for thought: During the time that I was still on FMLA (when I was off during the first three months after surgery), I was very active, but as soon as work and school resumed, all bets were off! That is something that others in my line of work/type of schedule may face themselves, but even if you can’t make it three times per week to the gym, recovery from ADR can still go well…

Ralf and I also made to Seminole State Forest for a 2-hour bike ride through those beautiful (and often bumpy or sandy) wooded trails… (yes, it's the end of March here, those are the perks living in Florida)

This picture has actually a very personal meaning to me. Before my pain prevented me from doing anything physical anymore, Ralf and I did a lot of outdoors activities together - always together. That was taken away from us when I couldn't come anymore due to being disabled. But now, we can - together!

Emergency Management
My plan is still in motion: I decided to use my MSN Nurse Educator degree to try to transition to the incredible National SimLEARN center in Orlando (still VA) to reduce my stress level and have a more structured schedule. But even if I leave the bedside to continue my nursing path in a different role, I still have my Disaster Response and Emergency Management teams to provide some "hands-on" emergency nursing. April 2^nd was our pre-preparation meeting to go over detailed plans and check our gear for the upcoming annual Mass Casualty Incident (MCI) drill, an interdisciplinary mock mass casualty event that all emergency services within the city of Orlando will respond to!

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!

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!

5 1/2 Months Update: Follow-Up X-Rays! 2

irisappenrodtSeptember 5, 2018December 29, 20182 Comments

In This Issue:

5 1/2 Months Follow-Up and X-rays
Physical therapy
(Attempted) bike outing to Charles Bronson Wildlife Area
Insurance battle update

5 1/2 Months Update:

I made it! I am almost six-month post-op from my L5/S1 artificial disc replacement (LP-ESP)! I just had my x-rays taken and mailed the CD off to Dr. Desai to make sure he has them in time, but I think the images look good! In fact, the disc looks just like it did on the x-ray that I had the day after surgery. I was laughing a little when looking at the report from the radiology center because the radiologist called my ADR an “intervertebral disc spacer”. But he also noted that there is no bone loss, that I have good bone density, no erosion or hardware complications. Also, the report states “no facet osteoarthropathy”, nor did he find any other issues with my spine. I don’t know about you, but I think I have a pretty spine (including my shiny “disc spacer”, lol).

LATERAL

ANTERIOR

OBLIQUE LEFT

OBLIQUE RIGHT

Even though I have been feeling great overall, I am relieved to see/read the confirmation that everything is alright in black and white (literally). I do have minor aches and pains here and there, but I realized that this is most often the case after long periods of inactivity. I really need to keep that in mind while going through graduate school because I have the tendency to work on assignments for hours on end without realizing it.

At this point in my recovery, I am thrilled to wake up in the morning without that pain. I still remember the pain pretty well… Sometimes, I think about a movement that would have hurt me tremendously prior to surgery, and then I just do it (like bending) pain free – leaving me in awe every time!

Physical Therapy:

With that being said, I finally made it to PT with Bill, and I was SORE the day after! Not in my back but my abs and thighs! He had me do side-planks, monster-walks with squats, weighted lunges, and crunches over a medicine ball. That’s what I get for not working out in the gym enough, but I was asking Bill to put together a workout routine that I can do on my own and hopefully stick to it.

(Attempted) Mountain Bike Outing to Charles Bronson Wildlife Management Area:

This was, hands down, the hardest and shortest mountain bike outing I have been on to date. We picked this wildlife preserve, which neither one of us has ever been to before. It started out very innocently, with old roadways that were overgrown but ridable. Then the trails got somewhat muddy, which makes it harder to pedal because the tires are more “glued” to the ground. It’s a little like riding on chewing gum, actually. Then there came the first puddles, and then they turned into longer stretches of flooded, overgrown, messy trails that took everything out of me.

It felt like forever when I finally waived the white flag and surrendered! I made it an unbelievable distance of 1.6 miles before I had to admit that I won’t be able to complete this loop of 20 miles like this… Ralf captured my confession on his GoPro camera….

Of course, I now had to back-track those agonizing 1.6 miles back to the parking lot! There were actually vultures circling above, just waiting for me to collapse and become dinner. Ha, eat my titanium spine, suckers!

Once back in the parking lot, I recovered enough to go with Plan B: a hike down the Florida trail. Meh, that was not the same, but I did get to spend some more time in nature. Speaking of which, I almost walked right into a spider web with a giant (to me anyways) spider just waving at me! In case you didn’t know, I don’t do spiders! That’s when you let your 6 foot better-half walk in front of you, hehehe…

Insurance-Battle Update:

There is also news regarding my battle with BCBS: so, after my claim for reimbursement got denied (on grounds of not being ‘medically necessary’), I put together an appeals package that included a letter of medical necessity from Dr. Desai, a personal statement, and several research articles. I also pointed out that BCBS reimbursed other patients in the past (including one from Florida) who had the same surgery overseas.

A few days ago, I got a written reply from BCBS in the mail: they need more information???!!!??? They actually want my medical records from my pain specialist (Dr. Gayles), my current Primary Care Physician, and my Physical Therapist (Bill). Ok, no problem. BUT: BCBS also want my medical record from DR GARCIA, the very first surgeon I ever consulted with regarding ADR surgery. Yes, that is the same surgeon, who ruled me a perfect candidate for ADR but dropped me like a hot potato after BCBS DENIED my surgery with him. Hmmm, I really don’t see the point here, especially since he never even provided actual care to me. The other medical record BCBS wants to get is from a spinal fusion surgeon I consulted for about 5 minutes and who didn’t really answer any of my questions. Oh, well, I did send back yet another letter stating the same, so the ball is back in their court. To be continued…

5 Months Update: The Struggle is Real!

irisappenrodtAugust 22, 2018December 29, 2018Leave a comment

As I am sitting down to write this update, I came to realize that rehabilitation efforts can easily drift off to the sidelines. Even before surgery, my entire focus was on ADR and how to best rehab my back when it’s all said and done. Those of you who have been following my recovery, know how dedicated and consistent I have been with my rehab from day one. But looking back over the last two weeks made me aware that working a high-stress job with long hours along with all those responsibilities that come with adulthood can put a serious dent into my efforts! Life kind of sneaks up on you and before you know it, it’s been more than two weeks that I was able to do PT with Bill. I have also neglected my regular stretching exercises, meaning to do them in the morning before work but somehow not getting them done after all.

As a result, I had a few days where my lower (and upper) back was quite sore and tight, even along the “old route” to the right and into the right upper buttock (I guess the body will always remember). No, it was NOTHING like before and I am still waking up in the morning being able to roll out of bed without pain, but the soreness was pronounced enough to get my attention. I started doing my stretches a lot more often and even went on a couple bike rides (one local, one further away). I also went swimming at the local YMCA, which initially made the tightness worse, which then thankfully subsided.

I am happy to say that my back improved quickly again but this was a reminder that I am still in recovery and that I am still healing from this surgery. After all, I am only 5 ½ months post-op today! Writing this blog makes me reflect on what I am doing/not doing, which is great. Especially since I am adding another layer of stress and time commitment to my life: GRADUATE SCHOOL! This last Monday, I resumed classes at the University of Central Florida to finish the last year of my Master of Science in Nurse Education. Now it will be even more important to keep my rehab on track and to hold myself accountable for my own health.

As for the bike rides, the local outing took us to Moss Park, which is only 6 miles away and can be reached mostly by using bike lanes/sidewalks (our neighborhood is quite bike friendly). I felt pretty weak but that was also due to being tired from work and the intense heat. Moss Park abuts Lake Mary Jane, and I owned a house I wish it was on that beautiful lake 😉 The only downside of this route turned out to me the 2-mile stretch on the country road, where no designated bike lane exists. I don’t know what’s wrong with people sometimes, but this guy in his giant black truck really hated our guts and almost ran us off the road! I think we have him on video but I didn’t have time to look through all the GoPro footage yet. That’s why I don’t like road biking, especially in Florida! Anyways, we did make it back alive and in one piece, which I am very grateful for…

Melting away...

For the second bike ride, went to yet another new place (for me anyways): the Apopka Scenic Trails. Unfortunately, the portion that actually goes along the shore of Lake Apopka has been closed ever since Hurricane Mathew last year but the trails leading to it are still very nice. The added challenge to our bike outings is the extreme heat of the Florida summer, but so far, I have been holding up ok, even after sweating out liters of water (again) within a 3-hour ride. We made it to one of the observation towers, overlooking Lake Apopka.

Preview of next update: I filed my appeal to get reimbursed by BCBS, so stay tuned for that outcome! I am also going on a 4-day trip to New York City (first time!) with a couple old-time girlfriends of mine. We met 18 years ago during the Walt Disney World International program, where we were stuffed into “traditional” dirndl outfits that made me cringe, lol. I also got a letter to report for Jury Duty, which makes me feel like a real American now. My next update also marks my 6-month post-op date, so I need to get xrays ordered to sent to Dr. Desai!!! Stay tuned!

Week 14 Update – Finding a Routine

irisappenrodtJuly 11, 2018July 11, 2018Leave a comment

I thought I share how my efforts of finding a routine have turned out this week: after that first intense week back to work, I finally was off for three days (Friday through Sunday). I already had a PT appointment scheduled with Bill for Friday afternoon and decided to commit to at least one PT session per week. I am already scheduled out for the next three weeks, so that way, I will go for sure. I also want to do at least one fun outdoor activity per week or at least every two weeks (as my schedule permits).

Bill worked on my sore spot over the bony prominence of L3. He thinks that either the ligament is still giving me grief or that I have a slight misalignment that is still present (he carefully mobilized that spot manually; I think it’s already making a difference, but time will tell). It really doesn’t bother me unless you press on the spot directly, so I don’t really notice it much anymore. It doesn’t give me any pain while I bike, jog, or work out, so that is good. Bill truly believes that this will resolve and will continue to work on this issue.

Speaking of PT: I have made huge progress over the last few weeks, and I am very pleased with the outcome so far. Bill adds more or substitutes different movements to my regiment while keeping me safe, which makes me feel at ease. I now do interval sprints on the treat mill, 50 pounds cable pull exercises (shoulder/arms), lunges with weights, and squats. He already informed me that next week, he will ramp-up my abdominal workout – I told him that I expect a six pack! We’ll see, lol.

Another milestone this week was the cleaning of my home! Mopped the floors AND vacuumed the carpet, whoohoo! I know, I know, it sounds silly but before the surgery I wasn’t able to do any of this. Mopping my floors always led to a vicious flare-up of crippling and disabling pain (same for vacuuming). But no more! I am happy to report that I conquered the mop and vacuum cleaner once and for all! *Add victory dance here*

Now to the fun stuff: as I mentioned during last week’s post, my next goal was to take those 15 miles I bicycled on pavement and take it to the woods! Saturday was the day: I ended up biking just shy of 20 miles (!) on trails in the Bull Creek Wildlife Management Area, and despite the fact that it was over 92 F (or more like 200 F in the sun), it was amazing! It’s been a long time since I explored the outdoors like this, and I was rewarded with the sighting of deer, wild boar, and a good-sized black racer (I almost run over). One very unique thing about Bull Creek is the fact that it has an old cemetery – in the middle of nowhere right in the woods. Many graves are from the 19^th century and still well cared for. Never seen anything like it!

Riding the trails was fun, and the only part of my body that got quite sore was my butt. However, the soreness wasn’t as bad as when I first started out biking years ago. Either my seat bones remember the saddle, or I got a big butt (more cushioning) from being dormant for so long… I may never know, lol!

I also crossed many bodies of waters since it has rained a LOT in Florida and some parts of the trails are flooded:

I crossed little puddles…..

… and big puddles, lol!

After this rather intense ride, my legs where heavy and I was quite tired – but no pain! I always wait and see how I feel the next day, and I am happy to report that I felt strong and refreshed. I am still amazed to no end how my condition has changed so dramatically from near-disability to doing things like this in only 14 weeks after major surgery! I am so incredibly thankful that I didn’t end up getting a fusion because I really don’t think it would have been the same outcome.

Week 6 Update

irisappenrodtMay 16, 2018June 14, 2018Leave a comment

Today, I am six weeks post-op, which means that I can take off my back brace! I am still a tad afraid to bend or twist but I guess that is normal. Recovery is also a mental game for sure!

I really need to start stretching though, since my hamstrings appear to be much shorter than they used to be! However, besides the lingering muscular issues I am still dealing with, there is no more crippling back pain that I used to suffer from! Now I can (carefully) take my rehab efforts to the next level.

In a couple of days I am going to see Ben to start getting regular medical massages, and I hope he can help me with the soreness. I still have that sore area in my lower-mid back that is tender to touch but I hope this is not because of the twisting-incident from last week but rather part of the recovery time.

I can now bend sideways and forward without pain (won’t do the back-bend though!), which I wasn’t able to do at all before the surgery. So, I take that as a victory and will now move forward by increasing my workouts (carefully). Maybe some light jogging (on soft ground) and definitely more stretching.