Tuesday, June 28, 2011

Next stop Alaska

Sitting in an airport lounge awaiting my flight to Vancouver, I think back to that night 4 months ago when my dear friend asked me if I wanted to go to Alaska with her for her birthday.  I was at my parents house at the time, high on narcotics, in a wheelchair, all around miserable.  June seemed a million years and a lifetime away.  A vacation in Alaska with dear friends a reason to get out bed the next morning.  Yes, I said immediately.  I'd love to.  I've always wanted to go to Alaska, the only place I've ever wanted to go on a cruise.  It sounded perfect

Now months later, I can't believe that it is reality.  In a few hours I'll be in Canada, tomorrow we board that ship to cruise up to Anchorage.  I have no idea how it is that it is June already, but I can't wait.  I may post pictures of glaciers calving into the ocean, of the wildlife we see, or I may not.  Just know that I am so happy to be Alaska bound with dear friends.

Thursday, June 16, 2011

An S&M relationship for good!

I’m in a Sadistic/ Masochistic relationship, and I like it.  Now don’t get any crazy ideas, but really I let this guy strap electrodes to my leg, put me in a 40 pound flack jacket and then do exercises, and that is just the beginning.  Yep, I’m talking about my physical therapist.  Still I go back twice a week because he knows what he’s doing and I’m getting better.

Physical therapy is a funny thing. Recovering from a surgery, especially one as extensive as mine, PT is essential.  However, physical therapy can do so much more.   I have friends in PT now for dog bites, bad backs, sore knees etc.  Sometimes we take how we move and how we exercise for granted. We focus on the big muscle groups or how far or hard we ride/ run/swim as we train.  Rarely, does anyone take a break and think about the muscles in your foot, hand, spine etc that makes all that possible.  Yet, in part that is the job of a PT.  Here’s a few snippets of my journey…

I have a deinnervated foot, half an ankle, a quad that had a section of it removed, and then significant muscular atrophy from months of sitting around doing nothing.  The first thing that my PT started working on was regaining my flexibility.  Then we progressed to work on my foot and ankle. You can’t stand if you have no strength in your ankle.  Think about it. First exercise assigned:  Pick up marbles with your toes!  Yep, I spent 15 minutes trying to make my little toes that can’t feel and can barely control to pick up marbles and drop them in a pitcher.  Good fun, 3 months later, I rock this exercise!

Then we progressed on to other fun ankle strengthening things like, put your foot on a BAPS (solid surface on a ball) and rotate it around.  It sounds silly, but week by week my ankle got less wobbly as I slowly learned to walk again.  There were all kinds of crazy core exercises to strengthen my back and get my abs back.  My BoSu ball and I became best friends. 

Soon, I started to be able to upright and the sadist focused on strengthening my ankle and balancing.  Thus, I became friends with a lovely pair of shoes I coined “Birkenstocks on balls.” First I just tried to walk on them, then I had to do various odd walks on them with resistance bands ties around my leg.  Thus, the S&M relationship began, because really that is crazy. 

Then the crazy lunges and core exercises really began.  Slowly, my body started to look like what it used to, but still my quad didn’t seem to activate normally through the surgical scar. So, the sadist attached electrodes to my leg and sent electrical stimuli through my quad at as strong of a frequency as I could handle all the while doing leg lifts.  I felt like a prisoner at Guantanamo Bay, yet I didn’t reveal any secrets.

Week after week the exercises intensified as did what I was allowed to do outside of the PT gym.  Yes, you can swim. Yes, you can spin. Yes, you can ride a bike. Yes, you can get on the elliptical. Aqua-jogging? yes.  The yeses began to grow, my strength, confidence and optimism slowly started to return.

Still the sadist always pushed me with a smile on his face, if I started to get good at an exercise he made it harder, up the resistance, up the weight, do it standing on a foam pad.  He pushed, I laughed and set out to meet the new harder version.  Thus the masochist in me is fueled.

He started having me do lunges wearing a 40 pound weight vest.  Then other exercises in the flack jacket.  He wanted to load my Achilles so that I could prepare to run.  I now spend an hour at PT wearing this 40 pound vest.  Craziness I swear, yet I do it.  Sometimes, we jest about the combo exercises.  One day as a lark he said- stand on one leg on a foam pad, wearing a laser target, vibrate a body blade and throw a ball against the trampoline.  My prize for this stupidity, no BAPS board that day which is the true Guantanamo Bay exercise. 

I go, I go twice a week.  I spend 3 +/- hours there and I do whatever he says.  My reward, today he had me run on a treadmill.  5 months after my surgery and I’m starting to run again.  I’m well on the road back.  It feels great.  I’m good with this S&M thing we have going on!
I'm also incredibly thankful to my  PT Jonathan for travelling this long journey with me!

Wednesday, June 1, 2011

Are Physicians really Bad Patients??

Are doctors really worse patients than non-MD trained people?  I have given this question a lot of thought and have yet to reach a conclusion.  However, I’m going to start sharing some of my thoughts… 

I thought about this the other day as I headed to my dental cleaning, a dental cleaning I was 4 months late for mind you.  Also, this was my 3rd medical appointment of the day, plus an hour with my personal trainer.  Yep, it was a day of Lisa.  Funny thing is most days these days are “days of Lisa.”  MY medical appointments fill the functional hours of most days, and I hate it, and maybe that is my point.

Why do doctors have a rep as being bad patients?  Often, that rep stems from being non-compliant with their treating physician’s orders, their medications or their follow-up.  OK, maybe just being non-compliant in general.  I have tried really hard to be a good patient, but it is hard (oh so hard), and this is my full time job right now. 

So, as I drive from appointment to appointment, I question why is it hard for doctors to be compliant? At first I thought maybe it was the years and years of training where your schedule is not your own.  I personally spent 6 years in post medical school training, and I can’t even tell you how many appointments were missed because of unexpected emergencies, how many teeth cleanings were cancelled.  I won’t mention how long I went without certain standard screenings.  We were taught in medical school, and in our training, to put our duty, our patients, above our own health.  Even as our mentors would espouse that in order to be good physicians we have to take care of ourselves they would make it difficult for us to be released from duty to take care of our own needs.

Henceforth, for years we are taught to put off our needs. Whether they be simple needs like eating, using the facilities, or making our own appointments there was always a patient that had to be seen.  It is a part of the profession, but does it subliminally train physicians to put off their own care in order to focus on their patients?

As I examine my own life, I have realized that I have often rushed my recovery from injuries.  Four days after breakng my foot still non-weight-bearing on crutches, I was on service in the hospital responsible for 30-40 patients and new interns  trying to crutch around ahospital larger than 2-3 average city blocks. My attendings would laugh at me seated at the central nursing station with my foot up so I could be available, most days my colleagues would take the code beeper since I couldn’t get anywhere very fast. Yet, I was there bright and early every morning even though I had to pack to move across the country to start my fellowship through it all.  I never considered calling in sick, how would that have worked that then? Nothing bad happened, but I shudder to think of the possibilities if I couldn't have responded to an emergency on time.

After my first go-around with cancer surgery I returned to work a few weeks after being cleared to walk again post radiation. I was far from being ACTUALLY able to handle the rigors of my job and returned to work in a non-clinical status, but returned all the same.  I fell asleep on the floor playing with Sadie that first day back.  The first time I took call my foot was still so stiff upon waking that when I was called to a code in the middle of the night, I had to hop down the hall to respond.  I could hop pretty fast, but…

So, this time, I vowed to myself that I would take the time needed to heal myself before returning to work.  I have refused to feel guilty about that.  Every morning when it takes me 5 minutes of stretching to get out of bed, I know that I am far from being willing to be responsible for a baby’s life when I can’t respond quickly enough.  I am making great progress, but I am far from being ready to do my job, to accept responsibility for a child’s life.  I’m giving myself this time, and I can only hope that when I return to my profession I’ll be ready for it, because I do love my little charges!

I am learning to accept my limitations and take care of myself.  I know that when I return to caring for babies this will make me a better physician.