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Scheherazade in Blue Jeans
freelance alchemist
Orthopedist! 
24th-Feb-2014 01:05 pm
Hearth
Wow, today has a Lot of Things in it.

So today I went to the orthopedist, as ordered by Dr. Awesome. I'm not thrilled with the orthopedist's office in general, for entirely predictable reasons (lack of attention paid to the reasons I'm there, assumptions that the patient knows jack shit), but the quality of medical care is fine, and if I only get one Dr. Awesome, better it should be genetics & new primary care, right? Right.

So.

"I don't mean to be melodramatic," says the orthopod, "but you are very weak." I am to have what he calls the Deluxe Package of PT, twice weekly, for an estimated six months to start with. I need to learn how to stand without locking my knees, for starters. I need to strengthen my legs and ankle so my ankle won't give out quite so often, and so I don't end up as incapacitated when it does. And I need to reduce the wear and tear I've been putting on my joints and ligaments.

Also my left sacroiliac joint is totally out of alignment, which is probably a moderate to large cause of my daily pain right now. PT will sort that out. That one thing might help me be a lot more functional.

And now I have orthotics. By which I mean that now I am very aware, with every step, how incorrectly I have been walking. I mean, I have a characteristic bouncy walk because one of my legs is slightly shorter than the other so it's that or limp (and, when tired, no choice: just limp). But also: I knew that I pronated. I've been wearing little heel cups for that, which apparently weren't helping as much as I thought they were. But the guy who molded my orthotics showed me what my arch was doing. I have very high arches... that almost completely collapse upon contact with the ground. So my entire foot rolls inward. And my calves apparently roll inward. Because with the orthotics in, I feel weirdly like my heels and calves are *pushed out*. But this is apparently proper alignment.

The PT will focus on my feet, legs, and SI joint to start with, as those are the most critical, and we'll see what can be done about my hands. The orthopod was very *shrug* about those - he was really only able? willing? to test gross motor skills and my problems are with fine motor skills. But this is a lot to do already, and I'm fine taking it step by step.

This is definitely the year of taking care of everything I'd been letting slide for, um, decades. (Listen, anything that can kill me got handled first, and often I had insufficient spoons to deal with the things that were just putting me in pain or discomfort.)

EDIT: Oh yeah, insurance doesn't cover orthotics. Which are $250. So this is a reminder that you can sponsor me via a PayPal subscription or Patreon if you like.
Comments 
(Deleted comment)
24th-Feb-2014 06:19 pm (UTC)
But the kind that costs me money, rather than the other way around! >.
(Deleted comment)
24th-Feb-2014 06:23 pm (UTC)
Yes! It'll be lots of work, but worth it.
24th-Feb-2014 06:35 pm (UTC)
When you're ready to address the hands, if the PT isn't able to help without more direction, look into seeing an ortho who specializes in hands -- that's really its own subfield.
25th-Feb-2014 09:54 pm (UTC)
Seconded.
24th-Feb-2014 07:47 pm (UTC)
very weak . . . Deluxe Package of PT

*nod* I've got an incredibly weak core due to the Great Eviscerating of 1998, so I've compensated a lot with my back and other parts of my body. I started working with a trainer last January, and now it's rare that my lower back aches the way it did.

FWIW, if you keep having problems with your SI joint slipping out of place--ie, if the ligaments are stretched--you may want to look into prolotherapy. It's deliberate inflammation stimulated via injection therapy, but it can create scar tissue to help hold joints into place when the ligaments get overstretched. I'll be looking into it for myself come Monday.

And yep, I understand the "letting things slide for decades." I've had a pap smear, um, twice in the last decade or so? And it's been 10+ years since I've even had a physical. Yay new health insurance!! (Can you tell I'm excited? *grin*)
24th-Feb-2014 08:00 pm (UTC)
I'll keep prolotherapy in mind - thanks!

Active poly has meant always keeping my annual exams and paps current. Which speaks to a whole thing of taking care of other people (by not being a vector) before I take care of myself, now that I think about it...

Yay insurance!
24th-Feb-2014 08:43 pm (UTC)
Yeah, my relationship is pretty mono, so pap smears and the like get filed under "that which is unlikely to immediately kill me."

In the decade I've been without insurance, my first pap was to check for HPV, as I'd had a low-risk potential exposure a year or two prior. My second was in conjunction with getting my (two-years-overdue) IUD swapped out.

Other than that? Broken arm, a couple of rounds of cellulitis, and pinkeye. That's it. Hell, I went for 5 years without getting my teeth cleaned because I couldn't afford it.

Yay health insurance indeed! :D
24th-Feb-2014 07:58 pm (UTC)
I love my orthotics. I've been off my cane for four years now.
25th-Feb-2014 12:06 am (UTC)
East Tennessee has a pain pill epidemic, partially (or largely) caused by the over-prescription of opiod pain killers for chronic pain. I am loathe to say jail is good for people, but I have several clients who went in using a walker or wheelchair who now ambulate just fine on their own. The difference? The prison provides the (very cheap to them) physical therapy that these folks could never afford on their own. Or thought they could not afford.

Granted, I've also had clients lose the jail health care lottery and end up with exploding body parts.

But.

Physical therapy is good. And I suspect you have the right brain for doing all that you're supposed to at home. Unlike some of us here. Who suck. (I don't suck. I really don't. I just have no discipline and am ace at making excuses. Gym tomorrow, I promise. :) )
25th-Feb-2014 02:18 am (UTC)
If you know the kind of orthotics you need, check out the options at your local drug store. Less than $20, similar enough to the real thing.

When I got my PF diagnosis, I was measured for orthotics but I knew it was my own ridiculously high arches that need insane amounts of support so I tried Dr Schols since my insurance also didn't cover the real thing. They worked just fine. Of course, you've got different issues, so ymmv, but it's worth checking out.
25th-Feb-2014 01:29 pm (UTC)
... Not really, actually. Custom orthotics are so many times better than the cheap drugstore crap Dr Scholl's sells. I, too, have high arches and pronate, and let me tell you how little drug store shoe inserts did to help.
25th-Feb-2014 11:53 pm (UTC)
As I said, YOUR MILEAGE MAY VARY. The fact that things I picked up the drug store worked for me, does not in any way guarantee that it will work for anyone else. What's crap for you was heaven for my feet.

Since its literally hundreds of dollars cheaper, it's not a sin to look into it.
26th-Feb-2014 08:10 pm (UTC)
I was assuming that the heel cups 'Song mentioned in her post (as not having been nearly as helpful as she thought) were OTC.

The only non-custom orthotics that have been any use to me were the little stick-in half-moon arch inserts my physical therapist at Duke Sports Medicine gave me.
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