Yesterday I went to the doctor for the follow up on the blood work that they drew last week at my check-up. It turns out I'm not as bad off as I assumed I was. Yes, my blood sugar is a bit high, but it isn't completely out of control. The doctor and I both agree this is probably due to the extra weight I'm carrying around and that it needs to come off, but I am at a loss of how to do it. I have been watching what I eat and I don't know where I can cut back any further. I don't have the energy to go to the gym and any exercise I try hurts enough that I end up spending even more time out of commission. Then, she offered a suggestion that surprised me. Instead of yelling at me that I need to just diet and exercise MORE, or pushing weight loss pills on me (not a good thing for me,) she gave me an immediate referral to the new "Physical Medicine" office. She (the doctor) told me that the office handles diet and nutrition and also exercise and weight loss. They also happened to have an open appointment in the next 30 minutes, so I stuck around the waiting room for a few minutes and then went upstairs to see what this other "physical" doctor was like.
When I got to the office, I first met the receptionist who is very sweet (a happy receptionist is always a good sign.) Then I went over to see Dr "The Man." Wow! Dude's younger than me, built like an Iron Man Competitor, and, uh.... well... Yeah. He's pretty HAWT. Then I meet his assistant. HE is a shorter, more muscle-bound version of the Dr. Yum. Later I find out that Mr Assistant has not only been on Broadway FOUR times, but he also does cage fighting. Seriously?!?! The kid is too young to know who Erasure is, but he's been on Broadway, survived several cage matches, AND been through enough college that he can be a medical assistant?
Suddenly, my life feels pretty much wasted and full of uselessness.
When Dr The Man starts gathering information about the medical train wreck I have become, he is way more positive about improving my overall health than I am. We take a tour of the office - which is basically a scaled down work out gym - and he talks about the different types of treatments he provides. This is when I realize that this guy is one of those Chiropractor/Physical Therapy/Diet/Supplement guys. I'm actually ok with that. I've seen a few of his type before and I generally agree with this style of treatment, especially for my particular kind of ailment. Now, I've come a long way from being stuck in bed for six straight weeks with a migraine but I still have a very long way to go before I am back to my old self. Since I have improved about as much as I can with medication and lifestyle changes, the obvious next step is to work on the pain and stiffness directly with physical therapy. I just hope this guy actually LISTENS to what I have to say, because if he tells me to do 50 squats AFTER I tell him I have no cartilage in my knees, we are going to have words. The four-letter kind.
So, we sit down to talk and this guys asks a lot of questions. He listens to my answers and makes notes about anything that I didn't write down. It takes a little while to get through all the major points of my medical history. I'm sure I left something out, but I know got the major parts covered at least. He lets me know that I can send him an e-mail with anything else I think of later or if I have any questions for him. E-mail a doctor? Really? That sounds pretty cool.
He tells me that he's going to give me a Generalized Health Assessment so he can test my flexibility and strength and get an idea of what pain my levels are and where. As I look down at my jeans and ballet flats, I realize I am WAY overdressed for this. I decide give it my best shot, though, and I am surprised at how attentive this guy is. He doesn't just stare at me or ask if I hurt. He wants to know exactly where I hurt and what kind of pain it is. Stretching and bending isn't too bad, other than being uncomfortable in my jeans, but the endurance part is not fun. I break a sweat very easily and my knees are screaming at me. I just hope my eye makeup isn't running down my face. He also tests me for balance (which was embarrassing) and for coordination (which is even worse.) We find out that the entire right side of my body is much weaker than the left and the opposite sides aren't communicating with each other very well. At one point he has me close my eyes and march in place for an amount of time. I was really confused at the purpose of this until I opened my eyes. I had somehow managed to turn 90 degrees to the right without knowing it.
Once the Dr is satisfied that he has bent, twisted, marched, and lunged me as far as I can go, he lets me lay down on my stomach and hooks me up to an electro-therapy machine attached to my lower hips and just below my shoulder blades. I've been through this procedure before so I wasn't surprised by the tingling running up and down my back. He sets the machine at a comfortable level for me and applies ice packs to my back to help with the inflammation. After five minutes of that, he switches to a heating pad to encourage proper blood flow. Amazingly enough, after he turns off the machine and I sit up, I am not nearly as sore or tired as I thought I would be. I'm very pleasantly surprised.
We talked some more about the results of my exam. On a scale of 1-100, I've got a score of 57. The thing is, I'm actually having a good day and pain and fatigue-wise I'm actually feeling okay. Any other day that test might have a totally different outcome, probably worse. The test showed that I have excellent range of motion and strength levels in most of my joints. However, my hips are just not working right, and then there is the whole balance and coordination thing. He assures me that he has helped a lot of Fibro patients like myself and that this test is really to see where the worst part of my problems are, but that we will be able to work on a lot of other stuff, too. My official diagnosis is Bursitis of the hips and poor balance and muscle coordination, probably due to poor neurological transmission. Again, he assures me that he has seen this before and he knows how to fix it.
The Dr explains to me the plan he has created. We're looking at six months of pretty intense training to achieve my fitness and weight loss goals. Then we will discuss long-term tools for health and weight maintenance. For the next month, I will see him three times a week for physical exercise and weight checks. After that, he will start adding more exercises for me to do at home as we gradually reduce the frequency of the visits. Then, he asks me if I am interested dietary counseling in addition to the physical therapies. I tell him emphatically, Yes! I personally believe that many of my health problems derive from the extra weight I am carrying and I need to lose it quickly and permanently if I am going to avoid a diagnosis of Type II Diabetes before I turn 40. I understand that even if I lose the weight, I could still put my health in jeopardy if I don't get my sugar cravings under control. When I tell him about the three years of yoga and my experience teaching gymnastics at a children's gym compared to the last few years of migraine meds, weight gain, pain, and fatigue he starts to put together the whole puzzle.
Then, he gives me the "Mom" talk. I've heard this one before, many times. 'You are here because you are sick. You are sick because you have been taking care of everyone else in your life, but you don't take care of yourself. If you don't take care of yourself FIRST you won't be able to take care of anyone else. If you want to get better, you have to make a commitment to come to the appointments, but also you need to give yourself permission to spend time and energy on yourself so you can become healthy again.'
Alright. I get it. I agree to stick with this for the next six months. My other choices are far less appealing than spending a few hours a week working out. He is becoming confident that I am on board with making the changes he is suggesting and I feel pretty good about the choices he is offering. I think this will be very beneficial all around. Besides, the guy seems nice, genuinely concerned, and extremely knowledgeable. (Looking so good doesn't hurt either.)
By the time he gets to the part where he tells me what the new diet will consist of, it is clear we are already on the same page. I eat three smallish meals and two snacks a day and I need to limit my food intake to those times only. I use a specific bowl when I eat to ensure proper portion control. I pack up my leftover food after I am done serving so I can put it in the freezer for lunches later and so I don't go back for seconds. I stay away from pre-packaged junk food (like chips or cookies) and instead go for high protein/high fiber snacks (like apples, cheese, and peanut butter.) I don't fry any food at home. I use a limited amount of olive oil for cooking and I stick to the leanest cuts of meat. I should focus on getting as much fresh vegetables as I can, but limit the fruit because of the sugar content. Basically, I am already doing everything right but I still haven't lost any weight or gained back any energy. That's why I am here.
For the next few weeks I will keep a food journal and he will help me find places to fit in more fresh veggies and to cut out the extra sugar. He doesn't want me to cut out all carbs and sugar, but he does want to help me find a specific amount allowed each day and help me find ways to meet that goal and still feel satisfied. Then he tells me that, at least for right now, I can have my one cola per day but eventually, I will need to cut it back to one per week. He assures me that I don't have to quit it cold turkey. He wants me to make the changes gradually so I don't backslide. I think I like this guy.
Once I am done talking with the Dr, I go back to the receptionist to handle the scheduling and to figure out just how much all this is going to cost me. To my surprise, she already has all my information from the other office, has talked to my insurance company, and has all payment details ready for me to look over. Thankfully, I find out that this whole "plan" will cost significantly less than I originally thought. Since my regular doctor referred me over here, all the services offered are covered by the insurance and my portion of payment will be less than the amount of a co-pay per visit. I can handle that! I make my appointments for the rest of the week and I am free to go for the evening, a little sore and tired but very excited at the prospect of finally getting my physical health back on track.
As I head out to my car, I start thinking about how the next few months are going to look. The payment for the sessions will come out of our medical reimbursement account, so I have no financial excuses to miss or cancel. I have already decided that looking for work outside the house is not an option for the near future, so keeping up with the appointment schedule shouldn't be too difficult. Even if I end up landing a job in the next few months, these therapy appointments take less than 45 minutes. With a little work and a little more luck, I could make that fit into a lunch break. The office is a little more than a mile from the house which makes gas expenditure not an issue. It also means I don't have a long drive to discourage me from attending. Finally, I decide that I can put off the swim classes for a few weeks. I want to see how much the therapies hurt and, more importantly, how much energy I have to spare by the end of the day. Besides, I am aiming for two to three hours of exercise per week, and it appears that these sessions will meet that, easily.
Even though I am pretty tired, I still manage to plan a healthy dinner - grilled pork loin, green peas, and mashed potatoes. Thank goodness the girls are around to help me in the kitchen! TD handles nearly all the cooking so all I need to do is help her make a few adjustments and get dinner on the table. I'm proud to say, I went to bed at a decent hour because I did NOT grab a nap like I so desperately wanted to.
Today, I had to do the whole thing over again. I was extremely surprised at how good I felt waking up this morning and how well I managed to accomplish the exercises the Dr put me through today. Taking a preemptive dose of pain meds before I left for the office probably had a little bit to do with that. Either way, though, I did what I needed to do and I feel better for it.
Now, this streak of good days will probably come to an end before too much longer, and how I handle things then will really be sign of how well I am doing and if I have made any progress.