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.
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 4th 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 4th, 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.
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!
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.
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!
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 40th 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!
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!
