Saturday, January 21, 2012

Ta dah! Almost 4 Months Later . . . I'm Boot Free! (Catalan Tee Outfit)

Well, so much has happened over the last few weeks. I've been swamped at work dealing with report cards and setting up my room from the move, along with doing physical therapy a couple times a week after work, so I've gotten behind on my updates. The good news is though, I am making a lot of progress and have gotten rid of my crutches and my stabilizer boot. I'm walking!! A bit awkwardly, but I'm walking.

So, let's go back a few weeks, shall we? I've been doing well in physical therapy and have now progressed from practicing walking to riding an exercise bike and doing one legged balancing exercises, leg presses and squats. Last Wednesday, I went to work without my stabilizer boot, with the aid of a crutch. I made it most of the day before I had to put my boot back on due to swelling, stabbing nerve pains and the lovely purple coloring in my foot. However, this was the day after physical therapy, so I was already sore from that. I tried to keep this in mind so I wouldn't get discouraged. On Thursday, I felt so much better! I made it all day without crutches or the boot. I was swollen in my ankles but not golf ball sized swelling like the day before, and I had no stabbing nerve pain. Woo Hoo! (More CCRP/RSD updates below the outfit post.)

So, I put real shoes on both of my feet Sunday morning and went to church stabilizer boot free for the first time in almost 4 months. I can't tell you how giddy I was. ha, ha. I wore the Catalan Tee for the first time with my Steamer Trunk skirt.

Catalan Tee, Steamer Trunk Skirt, Mia Pali Boots

Scavenger Hunt bracelets

Here's another way I've worn the Steamer Trunk skirt in the past. This was a popback purchase from last year. This poor skirt got horrible reviews because it isn't lined and has a tendency to show lumps and bumps. Luckily, it works fine for me and I love the shape of this skirt.

Steamer Trunk Skirt with Pansy Scoopneck Tee
I've got a couple of backlog outfits while still in my boot that I will try to post in the next few days. Now all I need is a tan. ha, ha. The upside of walking is that  . . . I'm walking. The downside is that I have to wear tennis shoes at work, so this limits what I can wear. My outfits will be boring until I'm ready to wear normal shoes again. I'm really hoping to break out the flats and boots in a couple of weeks. I can wear them for "dates" and short outings, but am not ready to do so at work. :(

CCRP/RSD Update:

I went to see the Pain Management Specialist this past Monday to discuss steps for helping to get the RSD into remission. He told me the same thing as my foot specialist: He thinks that of all the patients he has seen with this disorder, he feels I have the best chance of fighting it due to my attitude and the fact we caught it early. Yay! I now have a special cream prepared by a compounding pharmacy containing Ketamine, Clonidine, Gabapentin, Imipramine, and Mefenamic Acid-lidocaine that I rub on my foot three times a day. I now take two Lyrica pills and am continuing to take Tramadol for the pain. 

Lumbar Sympathetic Nerve Block: 
Rebooting my Sympathetic Nervous System

While at my visit, the doctor suggested that we go ahead and do a nerve block that day as I had the day off and it is important to get aggressive in order to fight RSD. So, I did it! I really get nervous when I have to have procedures done, so couple that with the SUPRISE factor, and you can have an idea of why my blood pressure was 142 over 80 something. ha, ha. I was given some kind of IV sedation and some Versed to help with the nervousness. :) 

I rolled over onto the table and lay flat on my stomach with my head resting through an opening like on a massage table. They prepped the skin on my back and he then injected steroids and a numbing agent in my spinal cord. From what I understand, the procedure is similar to an epidural, but targets only the sympathetic nerves in my foot. (Yes, this is probably the lamest description of this procedure on the planet. ha, ha. Did I mention that it was a suprise and I was REALLY nervous? :) Perhaps, I'll have a better explanation after the next block.) It wasn't pleasant, but only lasted about ten minutes. I felt pressure and a little pain for just a bit and it was over. Whew! My blood pressure went down to a respectable 124 and I was set to go home. :D

The good news is that it WORKED! They put a temperature strip on both my feet after the procedure and almost immediately I felt a sudden warmth in my affected foot which they confirmed with the temp strip. This confirmed the diagnosis and meant that it will be possible to trick my nervous system into shutting off those pain sensations. I will get another one on Jan. 30, and then hopefully my last one will be on February 13. The hope is that each nerve block will turn off pain signals until I am pain free and the CRPS/RSD is in remission. I may need more than three blocks to achieve this goal, but hopefully not. I am so much more optimistic now.

My physical therapist works on improving the stiffness in the top of my foot in the ankle joint area, and so far there has been no improvement, but at my last session he looked surprised and said it had movement now and had softened up. I am also walking on my own and the pain in my toe pad area has improved. I still have good days and then VERY bad days with pain, color changes and swelling, but the good days are far out numbering the bad days now. I still can't make it without pain pills and often have to double up during the day, but hey, I'm walking!!!!

Lyrica and Tramadol update:

Both the Lyrica and Tramadol contribute to sleepiness throughout the day, but surprisingly, I'm getting used to it! I've never nodded off before, but I can go to sleep at the snap of a finger now, and then jerk awake suddenly. My husband bought me a Keurig coffee maker for my school room. I rely heavily on regular caffeine jolts to counteract the tiredness. :)

I'd also say that I'm a bit more forgetful and spacey than usual, so I'm relying on my wonderful teammate to keep me on track.

I weighed my usual weight until I started doubling up on the Lyrica. Now I've gained about two pounds and am in freak out mode. :) I am really watching what I eat, as I've read horror stories about major weight gain on Lyrica. My doctor said that it is mainly water retention, but apparently Lyrica also stimulates the old hunger response, so I'll just have to be careful, but ACK!, it is Girl Scout cookie season and I've ordered multiple boxes. What am I going to do? ha, ha. Other than that, and a cry session at school last week after a very bad day with pain and swelling, I'm not experiencing any more side effects -- knock on wood.

Hopefully yours,

Tuesday, January 3, 2012

Review: Made to Measure Tee by Weston Wear

Just a quick review and then a foot update for my RSD readers.

Made to Measure Tee
This will look better with a tan. I am so WHITE and pasty right now -- time to get out the self-tanner. :)

I bought this with my 25% off apology discount and with birthday money from my dad. I initially purchased the XS, my standard size in all shirts at Anthropologie and in Weston Wear dresses, but the ruching around the stomach area was very tight and unflattering on me, so I exchange it for a small. The small doesn't fit as snugly in the shoulder area, but fits much better in the tummy. It is still a bit clingy on me.

I do think the ruching on the sleeves, sides and stomach area adds interest to the shirt, and I love the pattern and the length of the sleeve. Wouldn't this pattern have made a great version of the Soft Structured Dress? I would have loved this in a dress, Weston Wear.

Unless you have a very small waist, you will want to size up in this shirt. I think in the six years I've shopped at Anthropologie, only a few XS tops have not worked out for me, so this top is truly clingy.

Helpfully yours,

Foot Update (RSD/CCRP)
I hope these updates will be helpful for someone else contending with RSD. I have looked for something similar, but unfortunately and sadly, have found mostly accounts of dealing with the pain of RSD from people that have been suffering for years. Many stories are discouraging and shocking and I just can't read them right now because they freak me out. So, it is my hope that  since I was diagnosed within three months that I am going to beat RSD, and thereby offer up a success story in the months to come. I'm going out fighting anyway. :D

So, here is the latest news:
I've been on Lyrica for a week now and am still not experiencing any side effects. I was warned by my doctor about water retention and weight gain, but (knock on wood) I still weigh exactly the same as I did last week -- 108.8. What are the odds of that?

The spasms in my foot continued today but were more intermittent, thank goodness. However, during my faculty meeting this morning, they got so bad, I had to hold my leg because it was jerking from side to side. I asked my physical therapist about it today and he thinks the physical therapy is probably contributing to them. The stress of moving back into my room and getting ready for the kids to come tomorrow, probably isn't helping. :D The spasms pretty much stopped by the afternoon and haven't been as intense or as frequent tonight. :)

I was told by my physical therapist that the therapy will start getting more intense as there is research that intense physical therapy can really help RSD. He shared a DVD in which children with this disorder had great success with five hour a day therapy sessions. Well, I'm not going to that extreme, but we did do much harder exercises and he made me work through the pain. He told me that before I finish with P.T., I will end up screaming at him, hating him or screaming and cussing aloud. He told me that is the norm for RSD P.T. patients and that some give up because they can't take the pain. I reassured him that I am highly motivated, I don't cuss and I will not scream at him or give up. He gave me that knowing look like, "We'll see." Well, I did do a couple of minor UGHS during one of the harder exercises, but I did fine. I did a few major UGHS once I got home from shooting pain flashes, but that is the norm with this stupid disorder and the P.T. is just making it worse for now.

Today he began  by working on desynthesizing my foot by vigorously rubbing it and massaging it with a rough towel. Then I did the usual abc's, circles, stretches, toe scrunches and toe and heel lifts. The exercise that caused me to scream out and bite my lip involved leaning forward and holding onto the P.T. table, while shifting my weight from side to side. Then I had to do little marching type steps while holding the table. I also rotated my foot on this thing that was the shape of a garbage can lid with a ball underneath. (He would laugh at this totally stupid description.) I had to put my foot on it, and make the "lid" touch down on four sides. That was the hardest exercise that I did. It made my foot go into spasms.

Okay, gotta go -- it's a "school" night. :D

Monday, January 2, 2012

Stripes: Outfit from the Archives and Foot Update

This may very well be my favorite recent outfit. I wore this to work this fall and the construction workers seemed to like it very much. ha, ha. Everything was purchased on sale except for the Tom's wedges -- I don't think they make it to sale. I think I got my money's worth on this shirt!

Banana Republic outlet, fall 2010
Ann Taylor Outlet: skirt and shirt, fall 2010
Tom's wedges and looping lanes belt (tan)

Trying out belts. I decided I preferred the neutral looping lanes belt  over this chocolate brown one.

Here are various weekend looks.

AG Stevie jeans, Slate Saddlebag Purse

Till later,

Foot Update:

I've now been on Lyrica for 6 days. I don't really notice an improvement, but I'm also not noticing any side effects either, and I don't think I've gained weight. I'll weigh tomorrow morning as that will be officially the one week mark. From what I understand, it takes at least one week to notice anything from taking Lyrica. I only take 1 pill at night. At first it made me very sleepy, but now I am getting used to it and I'm also getting used to taking a whole Tramadol pill without getting excessively sleepy. I'm not sure this is good news. (doper) Ha, ha.

I have developed a new symptom. Well, I've been experiencing twitches and spasms in my foot since the beginning, but now they are much, much worse and are quite frankly, driving me insane. I'm hoping that it is simply the physical therapy waking up unused muscles and causing them to go haywire as it seems to be worse at night after I've done my exercises in the afternoon. All of my toes go side to side and I feel it all down my foot. Then sometimes the muscles spasms are in my ankle joint area and cause my whole foot to jerk  to the side. I've tried every position known to man to try to get them to stop but nothing seems to help. The only time it seems to calm down is when my husband gives me a gentle foot massage. So, you guessed correctly, my poor husband is giving me a lot of those these days while he watches T.V. and I play on my iPad or read a book. :) 

The cold sensations haven't been as bad, but I have been feeling more warmth in the bad foot. It even feels warmer to the touch. This syndrome is so weird and I don't want any part of it. I have been diligently doing my P.T. exercises and have been making sure I keep up with my pain medicine.  I've also been doing a lot of praying and shamelessly asking all my friends to add me to their prayer lists and prayer groups at church.

Here is a really interesting diagram that explains the insane process of RSD/CRPS. 
Source International Research Foundation for RSD/CRPS. The diagram and text in blue were copied from the site.

Activation of the sympathetic nervous system following an injury is part of a fright-flight response to an emergency situation. This response is very important for survival. For example, firing of sympathetic nerves causes blood vessels in the skin to contract, forcing blood deep into muscle and enabling the victim to use his muscle to get up after an acute injury and escape from further danger. Also the decreased supply of blood to the skin reduces blood loss through superficial injuries that may occur on the surface of the body. 

Here's what I find to be interesting:
Ordinarily, the sympathetic nervous system shuts down within minutes to hours after an injury. For reasons we do not understand, individuals who go on to develop RSD / CRPS, the sympathetic nervous system appears to assume an abnormal function. Theoretically, this sympathetic activity at the site of injury could cause an inflammatory response causing the blood vessels to spasm leading to more swelling and pain. (See B, C, and D in Figure 1) The events could lead to more pain which triggers another response, establishing a vicious cycle of pain. And this is why I'm taking my pain meds regularly now!!

I go back to work tomorrow, so that should be interesting. I went to my room after P.T. on Friday and was unable to keep my foot down on the ground without severe shooting pains -- the kind that make you yell out "AAGH." If I kept my foot propped up I was fine. My foot also got cold, prickly and turned deep reddish purple. 

Oh, have I mentioned that I had to move my room over break from a portable into the building? My husband is there now. He wouldn't let me come and help. He's trying to unpack as many boxes as possible and at least get the furniture in place. We will worry about aesthetics later. 

I don't know what I'm going to do with 24 children now that my foot has gotten worse. :'( I work with a very supportive staff and have a great group of kids. I also have a rolling chair in my room so I'll make great use of that! :D  If I can make it through the room set up, and get report cards finished, I'll be able to breathe for awhile. 

Trying to be tough,