Category Archives: Health

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The Perfect Day

Have you ever taken time to imagine your perfect day?

I mean THE PERFECT DAY from the time your eyes open until the time your eyes close at the end of the day.

Not necessarily in the context of your current situation, if it could go ANY WAY YOU WANT.

If, for example, you hate your job, a perfect day wouldn’t be a great day at work but maybe no work at all or killing it at the perfect work environment.

It seems like an unproductive exercise but taking the time to write down or think about a perfect day from beginning to end might unlock something simple that you could add to your day to make it better.

The Life Changing Magic of Appreciation

Protect Your Brain From Alzheimer’s and Other Dysfunction

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I discovered "The Model Health Show" hosted by Shawn Stevenson after I heard him interviewed about his own health journey on another podcast.

Stevenson is knowledgeable and dives deep into the science of common health issues to inform people and encourage them to make health (and sleep) a priority.

Dementia is an issue that's personal to so many of us. My aunt was never formally diagnosed but I experienced the fallout and devastation of her brain dysfunction first-hand. I have no doubt that certain areas of her brain were damaged by plaque, stroke, chemo or something.

I had never heard about a possible connection between Alzheimer's and insulin resistance. Could Type II diabetes have contributed or caused my aunt's problem?

Dr. Steven Masley makes a convincing case for it in this episode and offers suggestions to minimize, reverse or prevent the condition.

The interview alone is eye-opening and convincing but I'm anxious to read his book, The Better Brain Solution, available today (Jan 2, 2018).

I'll let you know what I think of the book.

I have a few go-to podcasts that I love. I gravitate toward the topics of business, creativity, productivity, human behavior, brain stuff, personal development, technology, self-care and writing. If you have any suggestions for episodes or shows that fit those categories or something else interesting , I'd love to hear about them.

Shawn Stevenson on the Art of Charm

Bilateral Patellar Tendon Recovery~ Pt. 3

Recovering from bilateral patellar tendon rupture

Welcome to part 3 of this series. You can read parts 1 and 2 to get you up to speed.

This is where things (meaning Mark) got going (finally). Things seemed to progress so quickly during this time period (from complete dependence for just about everything to almost complete independence) that it’s hard to remember what happened when but I’ll do my best.

Mark was scheduled to meet with the surgeon for the third time 4 weeks after his staples were removed. The transportation company cancelled at the last minute and we had to reschedule for the following week. Since his appointment was on a Thursday, it took almost another full week to schedule the initial consultation with a physical therapist who was highly recommended for this injury. My point is, your circumstances might put you a little ahead of Mark’s progress when you account for weekends and our delay.

We continued with the bending therapy in the meantime. The surgeon added heel slides. This engaged Mark’s quads. They sound easy but weren’t. Same set-up with locked leg resting on the ottoman. Mark sat on the edge of the chair with his other heel (unbraced leg) resting on a sliding board (sock or other cloth to reduce friction) and used his quad to pull the heel back, bending at the knee. This was another exercise that showed slow but definite progress. He got stronger and more steady by the day. This exercise also showed how much his quads had atrophied and couldn’t possibly support his body in a standing position. Crazy!

It’s important to note that we relied on a transportation company with a wheelchair van for all follow-up and therapy appointments until a couple of weeks into formal physical therapy. Luckily, worker’s comp covered this with no issue.

Weeks 6-12

Mark went to therapy at least 3 times before they had him stand (with crutches still locked in extension).

During these sessions, they moved his knee cap around, stretched him, measured his range of motion, loosened the quad muscles using a thing that resembled a butter knife and did e stim and ice.

Mark was also able to get into the pool with help of a lift. We chose this facility specifically for access to the pool. I have no doubt that this accellerated Mark’s progress. His ability to move freely in the water without braces improved his range of motion and leg strength without the risk of falling or unnecessary stress on his knees. It also helped with Mark’s stability. If you can rehab at a place with a pool, definitely choose that option.

On October 3, which was 2 months to the day after his surgery, Mark was on his feet for the first time. The blood rush to his feet was so uncomfortable and distracting that it was hard for him to focus on his balance.

Mark was so wobbly that first time that it was hard to imagine him walking again. But the therapists explained that his brain just had to remember what this standing was all about. They brought a full length mirror over to help the brain make the connection.

Fear is another factor here. He was on crutches with a therapist on either side but you have no confidence that your legs/knees won’t collapse.

Two days later, they got Mark on his feet for a few isometric and balance exercises. He was a lot more steady and a lot less fearful. He was confident enough to do a round at home. So, by his fourth day of therapy (weekend and days in-between) he was on his feet for exercises only. He was still locked in extension, so picture Frankenstein. Also, we still relied on the wheelchair to get anywhere in the house. It was another week before he was pivot transferring to and from the wheelchair instead of sliding or scooting into the chair.

By the end of the second week of therapy, he was allowed to take his braces off at night for sleeping and when he was just sitting around at home. His legs still didn’t bend easily on their own so he mostly still used the ottoman but would sit with his legs bent and resting on the floor for increasingly longer periods of time.

By his second full week of therapy, his sessions were 3-4 hours long. He worked in the gym standing, stretching, doing isometrics and other manipulations with a therapist nearly constantly at his side. They unlocked his braces to 30 degress and started letting him walk at therapy with crutches. If he buckled or tripped (which he didn’t), his legs wouldn’t bend more than 30 degrees. The crutches were more for stability than weight-bearing. He also did pool work (mini squats, walking, bicycles while floating in an inner tube, step-ups and downs, side steps) for 60-90 minutes then back to the gym for ice and estim for 30 minutes.

I accompanied him to therapy (driving him after he could sit in a car) because he needed help changing after his pool work. Remember, at this point, he wasn’t supposed to stand without the braces which makes it hard to undress and dress-especially when you’re wet.

Mark was able to manage by himself even after the pool sessions (freeing up my days and weeks considerably) at about the 12 week mark. HALLELUJA! It was just about at this time that Mark was cleared to do stairs and was finally able to sleep in our bed upstairs.

Some Final Random Notes:

This time period definitely saw the most notable progress. Mark got more independent by the day. We’re a few days from the 4 month anniversary. He still notices sustained but slow progress.

Mark’s knees are sore after therapy because they work him constantly. Ice and rest helps. He’s been walking without braces and crutches for about 3 weeks. He’s been showering (with a bench in our tub) since right around the 12 week mark. He still walks pretty stiff-legged, gets fatigued easily with too much walking or standing and has experienced swelling in the ankles for the same reason.

We took Luke to a tournament in New Jersey the weekend of November 12 (3 months and 1 week post-op). Mark had been cleared to drive but could only do so for about an hour before he got too stiff and sore. Also, his ankles were swollen when we got back. Probably 6 hours in a car and watching two long matches before that. Other than that, Mark can run errands on his own and drives himself to therapy.

Mark’s left knee is still behind the right in terms of range of motion and pain. Nobody seems to be concerned about it. As my friend (a PT) explained, you would never expect two injuries to respond exactly the same way, even in the same knee or joint. That makes sense but it’s frustrating and a little scary for him.

It’s too early to tell when Mark can return to work. If he had a desk job, it would be sooner. As a tennis pro, he’s typically on his feet 6-10 hours a day. That’s not possible at this point. Plus he needs the extensive therapy to continue to progress.

I don’t intend to write another whole post but will likely add a footnote to this one when he’s finally back to normal just to give you an idea of how long the process was for him beginning to end.

If you have any specific questions about this injury, caregiving, progress you can find my contact information by clicking the “contact” tab at the top of the page.

Bilateral Patellar Tendon Rupture~Recovery Pt. 1

bilateral patellar tendon rupture and recovery

Warning: This is a LONG post. If you or someone you know has suffered this rare injury, I hope it helps. That’s pretty much the point of it. The post will bore everyone else. This is the first of 3 parts. Part 2 covers weeks 2-6. In part 3, I talk about Mark’s experience during weeks 6-12.

It’s important to note that your experience might be completely different depending on your ability to rehab at home after the surgery, your age, weight, whether you have someone at home with you 24/7 (our situation) and the type of repair that was done. Mark did not require cadaver tendons which might have affected the healing timeline on the front end.

This post contains affiliate links to products we used (and are using). If you purchase a product I receive a small commission at no additional cost to you. I took the time to include links for your convenience, too. You probably have a lot going on.

Here goes…

It’s been three months since Mark got hurt at work. It seems like we are just coming up for air. Though, he still has a long road of recovery ahead.

Mark wasn’t cleared by the surgeon to try to stand at therapy until 2 months after the surgery. He was completely NON-WEIGHT-BEARING and LEGS LOCKED IN EXTENSION for two full months.

Since blowing both tendons is so rare (even the health professionals kept forgetting the ramifications), there’s very little information on the internet about recovery.

Non-weight-bearing means a completely different thing when you have one good leg. Logistically and therapeutically.

Weeks 1 & 2: Care and Comfort

The first week was all about pain management, getting regular (KWIM), comfort and avoiding blood clots.

Since I was helping Mark with every single maneuver and task in the first few weeks, it was great that friends and family (who really couldn’t do much else for him) brought meals and gift cards for the local grocery store. It made feeding everyone easy on the fly. (It’s not even possible to express how humbled, grateful and relieved I was to receive this type of support so I won’t even try. If you know someone going through this, it’s an excellent way to help).

Mark was pretty much finished with the pain killers within 7-10 days.

The hardest thing for him was getting comfortable with both legs locked in extension in braces.

Mark also experienced an almost constant tingling, numbness and coldness in his feet, especially from the ball of his foot and toes. The kids or I would squeeze his feet with light pressure to relieve this as often as he asked. It gave him very temporary relief. Now that he’s on his feet more, he doesn’t notice it as much. At least it doesn’t bother him if it is there.

One dose of Senekot at night worked great to get the pipes moving that were jammed up from pain killers. ‘Nuf said.

Otherwise, good food, hot coffee in the morning, a captivating book and “The Sopranos” (loaned by a neighbor) kept things bearable in the beginning. We are so lucky to have the most thoughtful and generous friends and family. People were so supportive and thought of ways to ease the burden and this terrifying turn of events.

Blood Clots

Mark was on Lovanox shots (in the stomach-super fun) for 3 weeks post-op then 325 mg of aspirin 2X per day.

Ten days after he was finished with the Lovanox, he experienced a sudden onset of back pain (kidney/lower lung) in his left side. Accompanied by an occassional catching when he tried to take a deep breath.

No other classic symptoms associated with blood clots (swelling, other shortness of breath, chest pain). His symptoms improved with ibuprofen and lasted about 12 hours. We wrote it off as muscle pain or strain.

Two weeks later, the same pain returned in his back on the right side. This was more severe, lasted longer and again improved with ibuprofen. Since it was the second episode, we went to the ER. (No easy task when you can’t get into a car-grateful for a good friend who jumped in with his wheelchair van.)

Turns out that he had a clot in each femoral artery and pulmonary emboli in his right lung.

Long story not short, the hemotologist put him on 15 mg of Xarelto 2X per day for 3 weeks then 20 mg once a day until at least 3 months after he is completely mobile and unrestricted. He has had no problems on Xarelto.

My advice, don’t mess around with aspirin after the Lovanox. Insurance company will resist because it’s supposedly expensive but beg the surgeon to campaign for it or get a hemotologist to confer before you leave the hospital.

Hopefully you can afford the copay. If not, get to the ER as soon as you get whiff of a symptom, no matter how difficult it is.

Miscellaneous Comfort Tips

We realized a day or two after Mark got home that he got a lot of relief by laying flat and resting his legs on bed pillows long-ways. Sometimes two under each leg. It relieved pressure in his lower back and reduced swelling in his feet, ankles and legs. It also got his heels off the bed.

Mark iced his knees fairly regularly in the first two weeks. I left the hospital with the ice packs and covers plus refill ice packs. These 8 gel packs can also be heated and have come in handy for stretching once therapy started outside the house.

Therapy

Healing. That’s it. One week post op, Mark had an appointment with the surgeon to remove the surgical bandage. The next week he went back to get the staples removed.

Transportation

Mark was unable to get into or ride in a normal car or van. Even if he could have gotten in without levitating, he wasn’t allowed to bend his legs. We were lucky that the worker’s comp covered all transportation costs until he was able to get into a car. They sent a wheelchair van for all doctor visits and therapy.

Equipment

Here is a list of “MUST-HAVES“: Mark was injured at work and the Worker’s Comp carrier has been great about getting him everything he needs to help with his comfort and recovery. We are lucky NOT to have co-pays.

If you have high deductibles and are blessed with family and friends who really want to help, maybe they would be willing to help you afford these things for a few months.

Urinal (get one before you leave hospital)
Wash basin (again, hospital)
Extra wide bedside commode (not the drop-arm model which would be a death trap)
Ramp if you have stairs to the first floor of your home
Sliding board
Reclining Wheelchair (if possible)
Case of wipes
Fully automatic hospital bed (this is an affiliate link but you won’t likely be able to afford this. Insurance probably will. Campaign for the fully automatic. But get whatever you can.)

Since I cared for my aunt in our home for two years prior to Mark’s accident, we were equipped with a ramp into the house, a bedroom on the first floor with a fully automatic hospital bed and an extra wide bedside commode.

Let’s Talk About The Commode

Mark’s not a big guy so he likely wouldn’t have been approved for the extra wide commode (insurance approval is based on weight)-but we had one. Knowing what I know now, I would have paid the difference or bought one outright. It makes sponge-bathing himself so much easier and more comfortable. Since we don’t have a shower on the first floor or even a walk-in, this is important. Even if we had an accessible shower on the first floor, getting in there would have been virtually impossible with his restrictions in the first 8 weeks.

Also, Mark avoided a bed pan by learning how to maneuver onto the commode. Sorry for the graphic detail but this would be important to a person facing this injury.

How to Transfer When You Can’t Bend or Stand On Either Leg

Being locked in extension (legs straight out in braces) and non-weight-bearing, made transfers (even to a wheelchair or commode) tricky.

Luckily the hospital PT showed him how to slide onto the commode and wheelchair while his legs were still supported on the bed. He scooted sideways on the bed then backed into either chair. See photo below to see what I mean: (sorry for the blurry pic but gives you an idea).

how to transfer to wheelchair with bilateral patellar tendon injury

In the wheelchair, he would slowly back out while I supported his braced legs until the wheelchair leg supports could be swung into place (either by him or one of the kids-yes, a 3 man operation at first). Another trick was bridging the leg supports with 2 sliding boards so his legs wouldn’t fall through or have to be strapped to the supports. See photo below:

Reclining wheelchair and bridge for legs

We have a chair in the living room with a weirdly large ottoman. Both are low and were easy for Mark to slide onto from the wheelchair. (Photo below) If not for this furniture, Mark would have been stuck in bed or the wheelchair for 8 weeks.

bilateral patellar tendon rupture recovery and support

Let’s talk about the wheelchair for a minute.

The equipment company sent a lightweight wheelchair sized according to Mark’s height and weight. As much as I appreciated the size for maneuverability through the house, the narrow seat was uncomfortable for Mark since his legs were locked straight out in front of him. Imagine sitting upright in any chair with your legs straight out.

After a couple of tries, they found him a reclining chair which was much more comfortable for long periods of time (trips to surgeon, ER and in a wheelchair van).

The seat base is wide and deep and the ability to recline the back even a little makes a big difference. If you can get your hands on one of these bad-boys, even if you have to buy it yourself and resell it on Amazon when you’re finished, you won’t be sorry.

Hospital Bed

As I mentioned above, we already have a hospital bed because I cared for my aunt before Mark was injured. I’m guessing most insurance companies will authorize a hospital bed because they were asking if we would need one when Mark was still in the hospital. Get one if you can. If you can get a fully automatic one, get it. The bed made sleeping on his back bearable.

Mark didn’t need the trapeze so we sent it back. A bigger person might need one.

This post is getting loooong so I’ll tell you about the next 4 weeks post-op (weeks 2-6) in the next installment. I hope this has been helpful.

Crisis Mode

I WISH Mark’s room had a desk like that!

Mark blew out both knees last week. He’s a full-time tennis teaching pro. Yes, that’s his real job.

Truth be told, I can’t believe something like this hasn’t happened before this. He really wasn’t doing anything nutty or risky. He’s pretty conservative because his joints have always ached. He dislocated both shoulders before he graduated from college. Plus, teaching on a hard surface 8-10 hours a day for 30 years might lead to some wear-and-tear.

Here’s how I react to crisis:

My brain goes into hyper-efficiency lock-down. Do the bare minimum. Prune the unimportant, take care of only what’s necessary. The kids are at an age where they’re pretty self-sufficient and can help each other get where they need to go. I also have lots of family and good friends around who can help. (S/O to my brother John who took care of details at home when it happened).

The other thing my brain does which makes me hopeful and positive is to think about how much worse things could have been. In a weird, backwards way, it helps me be grateful even in what seems like a catastrophe.

Here’s what I’m talking about:

Mark had just returned from taking Luke to a tournament in Boston. He easily could have been walking fast or running for a flight and this could have happened. I can’t imagine how traumatized Luke would have been on top of managing this type of crisis long distance.
I’m glad it happened at work because…worker’s comp.
I’m grateful I don’t have the stress of managing a job outside the house on top of this.
I’m grateful I didn’t get the car crash call or the heart-attack-on-the-court call.
My mom can care for my aunt at her house while we get our bearings again. That means Mark has a hospital bed and a bathroom on the first floor because he won’t be able to bear weight on either leg for a while. My brain hasn’t quite caught up to that concept but we’ll deal with it.
Mark ran up to our cabin by himself the weekend before this happened to take care of some things. It’s remote and even if he remembers to take his phone with him, reception is sketchy. The nearest neighbor is not visible through the woods. Shudder.
Most surgeons haven’t seen a bilateral rupture of this type but it is repairable and they’re confident that he will be better than he ever was.

So, that’s how my brain works. You might think it’s pathetic denial but I’m sticking with it. It has given me a better outlook on what’s ahead.

My Theory About Why So Few People Truly Understand Caregiving

photo credit: Todd Diemer | Unsplash.com

When I took on the responsibility of caring for my elderly aunt, the only thing I knew was that I really had no idea what to expect.

Although my closest family and friends worried for my well-being, they have been so supportive and really make it possible.

I have thought a lot about why the impact of caregiving on families is so underestimated and misunderstood. A 2009 report estimated that family caregivers save the U.S. health care system more than 450 BILLION dollars per year.

It should be a priority to study and support family care situations. At the very least we could try to educate people about how best to prepare to care for a loved one.

Frankly, I don’t have the energy to advocate for policies and services to support caregivers even though family caregivers save taxpayers hundreds of billions of dollars of year. I think the reason it’s not a higher priority is that you can’t relate to it if you haven’t done it.

It’s impossible to paint an accurate picture of caregiving without compromising the dignity or privacy of the person being cared for. There are some private support channels online where people feel safe to open up and discuss the ugly details. I think these are important resources for caregivers but I learned very quickly that I didn’t want to spend what little free time I had swimming in the soup of other caregivers’ situations.

I have contributed to a different kind of caregiver support site that tries to keep the focus on promoting the happiness and health of the caregiver. If you’re a caregiver, check it out. Elizabeth is positive and offers excellent strategies and practical solutions for making your well-being a priority. [Sorry for the digression. Back to my point].

When anyone other than my closest friends or family members ask how my aunt is, I have little choice but to say “fine”. I have no desire to get into the challenges of our days to outsiders and unsupportive people because I feel like I’m betraying my aunt or complaining. To describe the graphic details of her personal care or her declining cognition would compromise her dignity and I’m just not willing to do that. It’s hard and she’s sweet so that’s that.

I wish I could prepare people for the monumental task of caring for an elderly loved one. I may write about some unexpected challenges that have little to do with her personal care so as not to compromise her privacy. Maybe some day, I’ll have the energy to advocate for policy initiatives to support the millions of people who are caring for their elderly family members but not today.

Curing Heartburn Naturally

30-day-heartburn-solution-craig-fear

Kate has suffered from chronic, sometimes unbearable, heartburn for nearly 3 years. I’m guessing the sudden onset was hormonal and chemical. As my most adventurous eater, it’s been depressing for both of us.

I talked to her pediatrician about trying to alleviate symptoms with food. When I mentioned avoiding gluten as an experiment, she dismissed that with a speech about gluten-free being a popular fad and how gluten-free only helps people with Chron’s disease or IBS. And anyway, even a trace of gluten in the manufacturing process could trigger symptoms in the truly allergic. In short, the doc discouraged us from trying this. She rattled off the typical list of trigger foods (spicy, tomotoes, carbonated beverages-Kate doesn’t drink those, etc.) and suggested that Kate avoid those. Since Kate was down to eating eggs, potatoes and antacids and still was experiencing symptoms, the pediatrician agreed to order some tests.

Kate was scoped (no evidence of damage or distress), poked, prescribed Nexium, Zantac supplemented with Gaviscon and Tums and tried to manage as best she could for the next 2 years.

A friend told me that her teenage daughter noticed improvement in her heartburn symptoms after going gluten-free so it sparked my interest in that route again.

I turned to Amazon and found “The 30 Day Heartburn Solution” by Craig Fear. The reviews were encouraging. (I’ve never seen a book on Amazon with no 1 or 2 star reviews). Most reviews are from long-time heartburn and acid reflux sufferers who were pain-free after implementing the plan laid out in the book. Craig Fear wrote the book after curing his own chronic heartburn.

Fear designed an incremental plan to stop acid reflux through nutrition, basically avoiding the typical Western diet. It’s well-researched and explains why antacids (prescribed and OTC) contribute to the problem and are problematic long-term. The book is well-organized and thorough and lists all the foods you can eat under the plan. Approved foods include meats, dairy (if tolerated), eggs, nuts and seeds, vegetables and fruit and berries less frequently.

Kate noticed significant improvement just a couple of days into the plan. The first 2 weeks of the plan calls for eliminating all grains. Her willingness to try new foods in order to keep from feeling like a starved rabbit helped her get through the first couple of weeks.

After two weeks of grain-free, you can reintroduce non-gluten grains (corn, rice, oats, etc.). During this stage, you’re also encouraged to eat cultured and fermented foods to restore the natural acidity and health of the digestive system.

Cultured foods without added sugar are hard to find (sugar can be inflammatory and throw off the ph balance of the gut). Fermented foods in the grocery store (sauerkraut and pickled things) are packaged under high heat (which kills most of the beneficial bacteria). I found a simple recipe for sauerkraut that’s delicious and plan to try some other fermented vegetables. The cultured foods are a little trickier but we’ll track some down.

It’s hard to tell whether sticking to the plan 100% for a while would completely cure Kate (restore her digestive tract to allow her to enjoy any food any time~or even problematic foods occassionally without suffering). At her age, I feel like she’s old enough to decide whether to eat a certain food and suffer the consequences. Even when she eats a food that triggers symptoms, they are milder and short-lived.

One thing I learned is that we automatically blamed foods like spaghetti, pizza and tacos on the tomatoes or spice for Kate’s heartburn after eating them. There’s as good a chance that the culprit was the noodles or flour tortilla in those cases. Since some form of grain (usually gluten) is a part of nearly every meal, and in our mind, those foods are bland when served plain, I never considered that they were causing the problem.

One unexpected benefit that I noticed after Kate was on the plan for a couple of months was a decrease in the severity of PMS symptoms. When I pointed it out, she thought so too.

I highly recommend “The 30 Day Heartburn Solution” if you or someone you know suffers from chronic heartburn or acid reflux disease. It’s worth a try.

Notice: This post contains affiliate links. If you make a purchase through a link, I receive a small commission at no additional cost to you. Thanks for supporting the blog and I hope the book helps.

Being Home

Encouragement to help you make the most of being home