Dr. AGB Goes to Back Rehab

Not back to rehab

Day 5: A Pain Free Day

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My schedule today consists of relaxation group, music group, conditioning, pool (aerobics), PT group, individual relaxation, and Preview group (A dream is not a plan).  These sessions are all 55 minutes in length.

I woke up today pain free!

My usual routine is to open my eyes and “scan” my body for pain and tension.  I then initiate a routine of stretches in bed to warm the muscles, wake them up gently to reduce risk of injury and put most of my joints through range of motion movements to lubricate the joints—preparing them to move without injury.  Every day for the last 21 years, I have recognized pain in bed, sometimes only after I move.  Sometimes the pain wakes me up, but I have been fortunate because I generally do not have pain at rest.  The problem with that has been that I can’t run my life from bed at rest!  The upside is that at my worst I can feel better if I take the weight of my head off my spine and get still.  (There are downsides to stillness and limiting my range of motion as I am discovering.)

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Today, I move through my exercises and I am still pain free!  I get out of bed and move to my sun room where I do my sun salute to wake the brain.  I am still pain free!  I drink my morning 4 ounce smoothie getting in my carbs to break my fast; I am still pain free!   I groom; I am still pain free!  I enjoy my breakfast of a high fiber cereal that will contribute to my sense of satiety mid-afternoon; I am still pain free!  (Two Dreams clients will recognize the morning ritual that assists in the transition from the sleep to the awake state!)  I pack my lunch, drive to rehab, and I am still pain free!  Only after conditioning does my pain rear its ugly head but it is a low 3 with a tension of 2.  I address the tension in individual relaxation where I reduce the perception of tension in my upper back even though the surface EMG remains virtually unchanged (6.1 baseline to 6.3 at the end of the session).  Still, the joy of a pain free day just 5 days into the program gives me hope.

I am so happy but full of fear.  It is hard to unlearn fear of re-injury or flare.  Intellectually I get it—I have a lot of control over what happens this weekend.  But, I have had flare ups that I could not attribute to anything.  I am learning that without the proper body mechanics what looks like the insult to my body is just what I label as the insult.  The flare is really due to hundreds of little insults over time leading up to the flare.  And, the flare really did have a herald sign as my pain and tension increased without my notice.  I vow to be more self-aware.  What an order!  I have lived with this condition 21 years by compartmentalizing and denying the pain conscious awareness.  I am sometimes aware that it is happening but often I am looking at it from afar, not seeing it as happening to me.

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We get instruction on management over the weekend in our Preview Group.  I am prescribed a home exercise program which includes aerobic conditioning, strengthening, and stretching which I am to do once per day.  I am to practice relaxation for 10 minutes twice per day.  I am going to focus on deep breathing this weekend, the only technique I have been trained in.  I have reading in my text book, continuous posture practice, body mechanics, and a plan for the use of distraction if my pain increases.  To give me the best chance of making it through the weekend without having a flare I am to  breathe, use thermal techniques such as heat or ice on the affected muscle group, pace myself (I need to pace the homework!) and use medications.  I want to make it through the weekend without a flare but A DREAM IS NOT A PLAN.  So, I plan and I hope.

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