Jump!

jump |jəmp|verb1 [ intrans. ] to push oneself off a surface and into the air by using the muscles in one’s legs and feet : the cat jumped off his lap |he jumped twenty-five feet to the ground.

This is an RFJ (right-footed jump).

I’ve become a pro at what I like to call “left-footed jumping” (LFJ for all you acronym lovers) but which most people refer to as “hopping.”  Need to reach a lemon high up in a tree?  LFJ.  Super excited about something to the point where I don’t care that I look like a child, Mario doing a fist pump, or a character from One Flew Over the Cuckoo’s Nest?  LFJ.  Imitating anybody with two functional feet?  L Freakin’ J.

From glancing at my CT scans, one can quickly discern that I have not landed — in the most forceful sense of the word — on my right foot in five years (I have osteoporotic bone despite how much cheese and yogurt I consume.  Friendly recommendation:  listen to your doctors and engage in weight-bearing exercise if you are able).  If the corollary of “what goes up must come down” holds true, then I have not jumped in five years.

Activities I miss:

-jumping to grab things

-jumping in sports/any athletic endeavor

-jumping on a trampoline

-jumping to express excitement

-jumping in front of someone to scare them (this “someone” is usually my beloved brother)

-jumping for the sake of jumping

-jumping while dancing; more specifically, jumping while dancing to this song:

The fact that I haven’t jumped in five years is, to quote my buddies Kriss Kross, “wiggity, wiggity, wiggity whack.”

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Half a Decade

Ok, I think you’ve all heard enough about pain.  I’m going to give that four-letter word a little vacation…if not in real life then at least in the blogosphere.

My accident occurred five years ago.  Not on the dot.  Not even in the month of September.  But it happened half a decade ago.  Of course, I know the exact date.  And you probably do too if you’ve been following this blog since Day 1 (major props if you have and you aren’t my mom).

Most anniversaries, be they of upbeat occasions or mournful ones, are observed on a specific day.  You got married on July 5th.  Your grandfather passed away on January 23rd.  Today is your birthday.

Of course, there is often an extension of the celebration or grieving:  you just got married and now you’re jetting off to Jakarta for your honeymoon.  You lost a loved one and you’re formally mourning for a year; informally mourning forever.  But specific dates trigger extra excitement or forlornness.  Do you forget your birthday?  Your wedding anniversary?  The day of a tragedy?  (September 11th, for one, will never let us forget that horrific day).

I didn’t realize that five years had passed since my accident until about five days after the exact date.  On August 27th, I glanced at the calendar, looked at what I had done five days prior, and was impressed that I had carried on as usual.  With some pride, I evaluated how far I’d come in the coping realm and got back to whatever I had been doing.

Beat the light.

But here and there I feel a hole, a sadness.  I watch someone sprint down a crosswalk to make a light and realize I haven’t made that seemingly pedestrian move in over five years.

For the next week, I will observe the anniversary of my accident by writing about all of the things I haven’t done in five years.  Please join me on this journey.

 

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Pain Can be Like a Children’s Play…

Someone is having fun. Someone is not.

…but it is not child’s play.

An eccentric friend bought you tickets to a show for your birthday.  You never know what he will choose.  He’s dragged you to corny portrayals of Aesop’s Fables and compelling adaptations of Shakespeare’s work.  You wince at the thought of watching adult actors parade around the stage donning animal costumes.  You long to hear Shakespearean English.  (Full disclosure:  I personally would much rather watch the former than the latter — who doesn’t love a talking turtle?! — but this is you, not me).

Yet you also remember a time when you eagerly awaited a performance of Macbeth and then proceeded to look at but not “take in” the first act, doze through the second, and full-on snore through the third.  The play was there but you weren’t tuned into it.  Your ears were open, but your auditory cortex was no longer processing sound waves.  Maybe you were tired.  Maybe you were spacey.  Maybe you had an amazing song stuck in your head.

The opposite has happened:  on occasion, you’ve attended the cheesy children’s plays that you typically find to be beneath you and had a blast.  Or you’ve gone to a movie with a 24% critic/35% viewer approval rating on Rotten Tomatoes and laughed nonstop.  And then you watched the movie a second time and were appalled that you initially enjoyed it.

So what gives?  Are you nuts?

Absolutely not!

Same movie.  Different reactions.

Each time you attend a performance — whether it be a movie, a play, a dance show, a choral concert — you bring to the venue a unique composition of perceptive aptitude.  When you saw that trashy movie the first time, you went to a late-night showing with a close friend and had low expectations.  You focused on the movie enough to catch the jokes but not so intently that your intellectual side stepped in and made you feel guilty that you weren’t watching a documentary or indie art film.  The second time, you were alone, fully alert, and ready to analyze each scene.

You were in a good mood in both instances, but the positive feeling disappeared by minute 20 the second time around because you were viewing the film through a different lens.  Your cognitive concentration was not distributed between thoughts about your friend, the yummy ice cream you had before the show, and the movie.  It was 100% on the movie.

The movie is like pain.  Once you enter the theater (the body, if you will), the show will go on regardless of your wishes, focus, and overall state of mind.  Likewise, if you have an inflammatory process occurring in your body, the inflammation will continue unless you turn to medication.

Have you ever walked into a movie theatre and thought, “hey, I’m really going to enjoy this movie.  Even if it’s awful, I’m going to love it.  I can make myself like this movie”?  Maybe you have.  But even if you jumped on the positive psychology bandwagon as you scarfed down your popcorn and chased it down with pop, did you actually end up liking the movie?  Or did you just deny the fact that you wasted ten bucks and two hours?

Have you ever attended a play that you thought you would love, everyone else in your party loves, but you just weren’t feeling it?

Pain, and lack of pain, occur in “heaven” and “hell” alike.

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P(l)ain and Simple

In the last post, which was ages ago (I may or may not have forgotten my WordPress password and reset it.  I’ll try to work on balancing the post-grad life with virtual posting…), I suggested that pain is a performance, albeit an unpalatable one that hurts the senses.  This esoteric analogy might itself be painful to readers who are not steeped in performance theory.  Please forgive me.

My goal in the next two posts is to concretize the eloquent theory (or god-awful gobbledygook, depending on your opinion) I posited over a month ago.  Today’s post is a primer for the pain performance itself.

Several people, including a few who suffer from chronic pain and many who do not, are stuck on the idea that pain is psychological.  “Your foot must be hurting because you’re stressed/upset/angry.”  “If you focused more on the positive aspects of your life, you wouldn’t experience so much foot pain.”  And then there are the corollaries:  “You’re going on vacation next week, right?  I bet your foot will feel better!”  “Congrats on the new job!  I bet your foot likes the good news.”

I like the good news, and my spirits usually follow accordingly.  But to be honest, my foot could care less…unless the new job is going to physical therapy full-time (“yay”) or hiking Mount Everest (nay).

By no means do I intend to debunk all claims that pain has a psychological component to it.  Biology and psychology perpetually intersect.  But there is a difference between the manifestation of psychological (i.e. hysterical or fictional) pain and the perception of physical pain that is exacerbated or minimized by one’s current emotional state.

From my experience, it is not emotion per se that affects pain levels; rather, it is the narrowing or widening of focus on the pain that can intensify or tame the amplitude of pain.  Cognitive concentration.  P(l)ain and simple.

This is where we get to pain as performance.

Tomorrow I will take you into a concert hall of your choice to help you gain a better understanding of pain.  Bring your opera glasses (or reading glasses if you’re part of the presbyopia crew).

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Pain as Performance

Thus far in the blogosphere, I’ve been wary of directly discussing pain.  Here are some reasons why:

  • We’ve all experienced, are experiencing, or will experience physical pain of some sort during our lifetimes.  What’s the use in reading one individual’s diatribe against Mr. Pain?
  • Discussing pain is depressing.
  • Analyzing pain does not lead to a reduction in felt pain.
  • I don’t want readers to cast me as “that annoying blogger who complains a lot.”

But my current physical state (I bet you can guess what it is!) is compelling me to “verbalize pain.”  I put this phrase in quotes because I’m using a linguistic construction from sociology/gender and women’s studies (GWS):  scholars imbue gender with a performative component — “doing gender” — to demonstrate that gender is not objective, biological, or set in stone but rather subjective, culturally constructed, and subject to change.  Gender is a performance.

A dangerous path to follow.

I want to attempt to discuss and analyze pain by thinking of the dreadful phenomenon as a performance (perhaps more comparable to a John Cage piece than a Handel…)

Pain, like sex (versus gender…I know you got excited there but this is not turning into 50 shades…yet), is biological.  Shit breaks, shit hurts, and we feel crappy.

Pain, like gender, has a socio-cultural component.  You’re in pain for a reason.  You’re in pain in a specific place in your body.  Your body is in a distinct location.  Your society treats pain a specific way.

If I had to sum up our society’s attitude towards pain, it would be with the old adage “no pain no gain.”

So how are we as individuals to respond to pain without gain?  Or worse yet, to pain with loss?

 

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“Jumping” for Joy

Accidents and illness do not discriminate:  they attack men and women; people of every race; the young and the old; the Christian, the Jew, and the atheist; the CEO of a Fortune 500 company and the janitor who cleans his/her office building.

Today is a day I will never forget.  The Supreme Court just gave millions of Americans a chance to heal from accidents, overcome acute illness, and manage chronic illness without falling into debt.  6/28/12:  WIN.

 

I can’t actually jump, but today I am “jumping” for joy.

 

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You’re Welcome to Come into Our Store if you can Make it Through the Door

I was sobered by a conversation I had a few weeks ago with a lady behind me in a line at a pastry shop in Cambridge, Mass.  Ok, ‘sobered’ isn’t quite the right word (sleep deprivation has been proven to negatively affect word choice) because I’ve never taken disability or inaccessibility lightly.  The talk was transformative.  At once I felt a bond with this complete stranger and an eery loneliness.

The bond was fueled by an acute awareness of the inaccessibility of the built environment (disability rights jargon for infrastructure and architectural layout) and a sense of futility within a society that has struggled to allow equal rights for all — wheelchair/cane/scooter/crutches or not.

I was visting friends at Harvard and they were pushing me in my transport chair as we explored Cambridge and Boston.  After a long day of hard work on the part of my friends (wheelchair and cobblestone are incompatible), we stopped at the aforementioned pastry shop to get a birthday cake.  

Yes, we stopped…right outside of the store…because there was no way to enter with the wheelchair.  In an awkward moment in which I felt both grateful that I could get up from the chair and enter the store and appalled that people with completely limited mobility could not do so, I “outted” myself as a person with an invisible disability (or a potential malingerer).  

Image

It would be nice if this picture correctly depicted the predominant view of disability in society. A more accurate picture would be a GIF showing the person using the wheelchair being intermittently slapped in the face.

In line and back in the chair (apparently it takes one of my friends 25 minutes to pick out a birthday cake, so sitting was necessary), a middle-aged woman said she was impressed that I was managing Beantown in a wheelchair.  I explained that I have a decent amount of mobility but can’t walk or stand for long periods of time; I could get by and walk when necessary.  Her response upset me:  “Yeah, we’re on vacation here from Florida and we had to leave our older daughter at home with a caretaker because we couldn’t imagine navigating this area with a power chair.”  

A deep sense of empathy, combined with an unhealthy dose of guilt about my “shade-of-grey” disability (you’re welcome, E. L. James) and an anger at the somewhat nebulous concept of society and the minds and bodies that comprise it, led to an instant connection.  

A connection forged by exclusion.  

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UFOs, AFOs, IPOs (oh wait, that’s Facebook’s problem)

BRACE OF THE DAY:  RICHIE BRACE (BRAND NAME)/ARTICULATED AFO (GENERIC)

In 1996, a sports podiatrist, Doug Richie, named a foot brace after himself.  We’ll forgive him for this narcissism because his product has helped many people with pained lower extremities.  The Richie Brace, also known as an ankle-foot orthosis (AFO, not to be confused with UFO, though sometimes resembling the latter more than the former), is a custom-fit brace comprised of a plastic footbed, lateral plastic stays, hinges that allow front-to-back and back-to-front motion, and Velcro straps that keep the brace in place.  Functionally, the brace (which I will refer to as an “AFO” since I went the generic route) limits motion of the subtalar joint (primarily side to side) while allowing full motion of the ankle joint (flex and point).

The original Richie Brace.

Pros:  Reduced pain in subtalar joint because it is not moving.  Unrestricted motion of ankle joint allows for a normal gait, which bodes well for other parts of the musculoskeletal system.  Fits into a regular athletic shoe, saving the owner money and the annoyance of buying bulky, sometimes unsightly ortho shoes.  Looks athletic.  Velcro straps allow for some adjustment.  People will frequently ask wearer if she was in a skiing accident.

Cons:  Can be difficult to fit.  Plastic sole and stays can rub and cause skin irritation or mild bone bruising.  Velcro sticks to, and can ruin, some types of pants (yes, I just went there).

My Experience:  After three failed attempts at customizing an AFO that would fit my foot, my orthotist and his manufacturers have created a product that fits well and allows me to walk further than with regular orthotics.  I’m still in the honeymoon phase of the brace, and thus hesitant to give the brace a resounding “yes,” but all signs point towards a step in the right direction!

Overall Impression:  Less limiting, and therefore more versatile, than the Arizona brace.  The articulated AFO does have some drawbacks, but they are minor compared to the problems with the Arizona brace.  

Wearer tends to forget about all of the drawbacks (except for the bone bruising) when she realizes her mobility has increased at least 50% during brace use.  Gold star, articulated AFO.  And props to you, Dr. Richie.

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The Least Romantic Embrace

My right foot has been in a lot of things:  shoes with external coils, shoes with internal springs, shoes that aren’t cool enough for my grandma, walking boots, aircasts, various types of braces, deep sh*t…

The next few posts will discuss different types of ankle braces, the pros and cons to each, and my personal experience with them.  If you would like to read about shoes, please see the archives.

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BRACE OF THE DAY:  ARIZONA BRACE (CUSTOM FIT)

This brace hails from — you guessed it — Arizona.  It is a rigid brace with a leather exterior and a lace-up tying system that is eerily similar to a corset.  It prevents most foot motion by stabilizing the ankle, talocalcaneal, mid-tarsal, and subtalar joints while allowing the toes to wiggle.

Pros:  Reduced pain in affected joints because they are not moving.  Looks odd but tends to conjure up pleasant images of horseback riding and the Victorian era.  Durable.  Lace-up system is quick and effective.

Cons: Looks odd to people who are not familiar with the Victorian era (or who see no place for representations of it in the 21st century), which can lead to questioning or awkward stares.   The brace limits mobility to such an extent that after a short amount of time, the affected foot can start to ache.  Furthermore, the brace alters the user’s gait and subsequently can cause problems in other areas of the body, especially the opposite knee and the upper back.

My experience:  When I first received my Arizona Brace (AB), I was hopeful:  I could walk 8 or 10 blocks instead of the usual 4 or 5.  I had to purchase two new pairs of shoes (the brace is so bulky that it requires a larger shoe size…if anyone wants a 9 and a 9.5 of the same shoe, let me know), which was irksome.  The expense seemed worth it until I began to develop strain and pain in other parts of my body.  After a few weeks wearing the brace, my whole body was a wreck.  I realized that because I had to take out the shoe insole in order to accommodate the girth of the brace, my right foot was lower to the ground than the left one.  This mismatch explained the pervasive body aches.  A shoemaker used mega glue to adhere a Vibram sole to the right shoe.  While my feet are now at the same height, I still experience discomfort, though to a much lesser extent than before the shoe alteration.

Because the AB is so good at immobilization, the body must compensate for the lost motion.  But no matter how hard the knees and hips work to move the foot, the wearer ends up shuffling because it is impossible to bend enough for a natural step.  It is nearly impossible to go down a flight of stairs in this brace.  But it’s been done.  Many times.  Whether you land on your feet or ass at the end is debatable.

Overall impression:  A good brace to use intermittently for short periods of time.  Excellent to wear in a shoe when not weight bearing (for example, when typing up a paper or writing a blog post) because it prevents the user from the “micro movements” that result from mindless foot fidgeting.

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Can I at Least Get a McDreamy? Or a McSteamy?

After a hiatus of visiting various orthopedists (and a hiatus from blogging…life has been busier than usual) I will head to a new doctor next week and follow up that consultation with cocktails with my general orthopedist (one can only hope).

In a previous post, I discussed how I’ve seen foot and ankle specialists in several corners of the country.  I also acknowledged that the ability to do so, while financially draining and emotionally exhausting, constitutes access that many people do not have.  I expressed my gratitude for having the option to explore the medical terrain.  And I do remain grateful.

However, I have come to realize the issues that arise when one has a quasi-unlimited number of doctors to visit.  Where do you draw the line?  When do you decide that you have a permanent impairment that will likely not be fixed by a nascent surgery?  Is stopping the search “giving up” or is it a positive step towards accepting a physical — and consequently a social — reality?

I would gladly go to him for a visit.

I remain in a liminal place:  the daily pain I experience and the extent to which this hurt and limited mobility restrict my life lead me to continue a no-holds-barred search to find the doctor that will cure me.  Yet at the same time, a part of me is tired of this rat race and the perpetual process of getting hopes up, having them squashed, and blurting out obscenities about orthopedic surgeons during the car ride home.

In 4.5 years, I have come to control my wishes upon entering a doctor’s office.  I acknowledge that the doctor will likely disappoint me; he (and a few she’s) will not have an answer.

This coping mechanism of sorts has recently turned into jadedness.  I am jaded:  “tired, bored, or lacking enthusiasm, typically after having had too much of something” (Apple Dictionary).

I’ve had too many doctors.  And not one of them is named McDreamy.

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