Armour Suit IV: Walk like a toddler

At each massage, one every two weeks, I have locked my hips back up in the Armour suit. This is really annoying.

My massage person says he wants to be able to lie face down like a baby: head, arms and legs all lifted and playing. That is core strength. Babies can do that… why can’t we? He says that when he does play therapy with kids, by a certain age they lose that. He picks them up and flies them around lying on his arms: by age 4 or 5, they fold up. They have lost touch with that core.

I think about that.

During a massage a few months ago he pokes my lower belly. “Tilt your hips using your abdominal muscles.” Feels weird, but I do. “You aren’t engaging your core.” I find it really annoying to have to relearn how to walk.

Engaging my core. Little children who have just learned to walk do lead with their bellies. And they can still lie on the floor on their bellies, all limbs up.

I am trying to picture an adult who walks with their belly. Who? The Buddha’s belly comes to mind. But I can’t see him walking. Who? Toshiro Mifune: the old samurai movies. He and the others walk like small children: from their core, from their bellies.

I try it for two weeks. I flatten the arch of my lower back by using my abdominal muscles, not my gluteus maximus. I walk with my feet apart a bit, my belly leading. I am trying not to walk with my toes gripping the ground. I walk with toes up. He says I have walked with my toes gripping the ground for years, and that is the only place that I have early arthritis.

It feels a bit silly to walk like a samurai. When I do it right, I can feel that engaged core and my legs and hips feel looser. It is not elegant, not a catwalk uptight shake your ass walk. It is more of a loose free walk, like a toddler, like a buddha. I don’t care. I have to concentrate to keep my abdominal muscles flattening the arch of my back, and so I walk slower.

After two weeks I am back: it’s worked. Partially. My hips are LESS locked. The metatarsal phalangeal joints, the big toes, are less sore then they’ve been for years. And I can feel that abdominal core.

Skiing I try to do the same thing. Engage the abdomen and keep it engaged, and ski with my toes up. I ski slowly and with great swooping turns, letting the skis do the work. Rentals. They give me 158s the first day, I talk them into 165s the second day and then I am on 172s. Finally feels stable. I am getting used to that core feeling. I quit when I get too tired, going in before my kids.

Walk like a toddler, walk like a samurai, walk with core engaged.

First published on everything2.com January 7, 2016. I needed the right picture: this is my sister and me about a month before she died of breast cancer. I miss her so.

Armour Suit III

My trial run for this vacation is swimming 400 yards. The swim is slow but fine. However, at 4:30 am I start having vertigo and throwing up. Have to cancel clinic. Lasts about 4 hours. Not reassuring for our Christmas plans.

My daughter has her wisdom teeth out on Monday before Christmas, so is instructed to not exercise heavily for five days. I got dry sockets and was sick as snot in college, but mine were much more impacted. She does fine, stops the hydrocodone in 24 hours, and drops to a 200mg ibuprofen three times a day by Christmas. On with the ski plans!

We head for a family resort on the east side. Up to to slopes on a hotel ski bus the first day, renting skis. For the first time ever, my goal is to ski gently. I have been skiing since age 9, but have not skied in five years and had two major bouts with strep A that affect my muscles. The second time my fast twitch muscles didn’t work for ten months. The first goal was to survive and the second is will I get my muscles back?

I rent downhill skis. Last time I skied telemark, but they don’t have any to rent, and anyhow, tele is harder. In college I had 190cm dead straight Heads for downhill, so now they rent me 163cm skis. We ride the lift up. 20 degrees at the top, an inch of new snow on groomed slopes and gorgeous. And… I can ski.

I am trying NOT to engage the armour suit. My massage person thinks that’s what made me sick swimming, reengaging it and just trashing my muscles. He’s right, I think. I just swam the way I always have, but slowly. My goal down the hill is NOT to fall into old patterns. I ski gently, let the skis do much of the work, carving swoopy turns. Every so often I get quickly and feel the suit kicking in and I back off. I drag my right pole for balance when I am tired.

My daughter asks for pointers on our third or fourth run. She has not skied for five years either. She is doing the work and I show her how to finish a turn using the curve of the ski. Finishing the turn lets her slow down, so she gets the swoopy feel in the turn but doesn’t lose control. On the lift we watch people. Nearly everyone drops their hands. Try turning your lower body with your arms dropped behind. Doesn’t work. Hands and shoulders down the hill and let the lower body do the turning….

I can ski! I ski with my toes lifted, not curled and gripping the ground. It changes my balance and I have to pay attention not to engage the suit. By 11 I want food and on the chair at 2 I am on my last run: I can feel the cold through my coat. We have a few more days, save energy. Also my right shin is informing me that I’ve bruised the crap out of it…

And the next day! Bruised shin, but more skiing, still gently. Now I have hope that I will get muscles back! Hooray for hope! Hooray for skiing toes up! Hooray for skiing without armour!

I will fight no more

I am tired of fighting
I am tired of fighting for justice
I am tired of fighting discrimination
I am tired of fighting for health care for all

I am tired of fighting insurance companies
I am tired of fighting medicare’s contractee
I am tired of fighting for prior authorization
I am tired

I will fight no more forever

I heal
I am a healer
I am trying to heal patients
I am trying to help patients heal

I am a healer
I help heal cancer
I help heal heart disease
I help heal PTSD
I help

heal cancer
heal heart disease
heal PTSD
heal addiction

I am a healer

heal the insurance company
heal the medicare contractor
heal the pharmaceutical company
heal

heal anxiety
heal depression
heal addiction

I will fight no more forever

I heal

The legs in the photograph don’t look delicate, do they? They are strong and beautiful and powerful. I took this at the National Junior Synchronized Swimming Competition in 2009. Those girls on the edge of being women are strong, they are a team, they work and play together. They have the skills and the strength to lift their bodies out of the water that far using their arms… think about the practice and strength needed to do that. We all want to heal and create fun and play and beauty. Let’s work as a team.

also on everything2.com

Headache without words

When I was in residency, a staff member brought a young man to see me.

The young man couldn’t talk. He could make some sounds. His head was a funny shape, asymmetric. His mother had rubella during her pregnancy: German measles.

“His head hurts.” said the group home staff member.

“How do you know?” I asked.

“He isn’t acting right. There is something wrong. He’s different.”

“How long?”

“About a week or ten days.”

“Did he fall?”

“We’ve talked about that but we don’t think so.”

I tell the young man what I am going to do before each part of the exam. I look in his ears carefully. His ear canals are odd too and I can’t see well. His exam is basically pretty normal for him. He is not running a fever. He doesn’t have a stiff neck. He doesn’t seem to have nasal congestion.

“If he hit his head, he could have a subdural, a bleed pressing on his brain.”

The staff member shakes their head.

“Ok. I can treat him for an ear infection, though I can’t see that well. If that doesn’t work, we will have to image his head. Would he stay still in a CT scanner?”

“No.” says the staff member.

“Then I would have to set it up with anesthesia. Which is difficult.”

So we treated him for an ear infection. No improvement. He returned. Exam unchanged. The staff was still sure his head hurt. I had never seen him before the initial visit, so I couldn’t tell.

I set up the CT scan with anesthesia. Twice, because they mucked it up the first time and it wasn’t coordinated right. I had to explain to multiple people on both anesthesia and radiology what and why I was doing it. “His head hurts and he can’t talk?” I argued until they gave in.

The ENT chief resident called me with the results. Not radiology. “What?” I said.

“It’s the biggest pseudocyst we’ve ever seen!” said the ENT chief. Surgeon. “He needs surgery!” His voice said “Cool!”

In residency I’d noticed a striking difference between family practice and other residency folks: internal medicine, surgery, neurology, all the subspecialties. They got excited when there was something rare or weird. I always thought, oh, shit, my poor patient.

“What is a pseudocyst?” I actually didn’t ask, because they knew I was just a lowly family practice resident and would probably not have heard of a pseudocyst. A cyst like structure can form of snot in the sinuses and can cause headaches. It can erode through the bone into the brain. His hadn’t, thank goodness, because that can be bad. Bad as in lethal.

Because of the measles, he had some of the largest sinuses ENT had seen ever, and the largest pseudocyst. ENT happily took him off to surgery. Great case.

I got to see him in follow up. He was his normal self. His group home staff member was delighted. “He’s back to normal! Thank you so much!”

But it’s the group home staff that noticed and cared and brought him in. “Thank you for bringing him in,” I said, “I would not have noticed. And some people wouldn’t have cared.”

Differentiating pseudocysts and other things: http://www.oapublishinglondon.com/article/1266

More on pseudocysts: http://www.ncbi.nlm.nih.gov/pubmed/6595617

Pseudocyst images: https://www.google.com/search?q=maxillary+sinus+pseudocyst&biw=1366&bih=634&source=lnms&tbm=isch&sa=X&ved=0CAcQ_AUoAWoVChMIoZzWwv_QyAIVUJuICh248gGC

Rubella in pregnancy: http://www.marchofdimes.org/complications/rubella-and-pregnancy.aspx

Rubella, aka German measles: http://www.mayoclinic.org/diseases-conditions/rubella/basics/definition/con-20020067