Category — medical world

Monday, July 14th – Today I had an appointment with my terrific Primary Care Physician at Scripps Clinic, Dr. Sanjeev Shah. And, just as with Dr. William Bugbee in June and Dr. H. Arthur Silverman in April, I was looking forward to seeing Dr. Shah with a certain amount of trepidation. I never know how MDs are going to react to hearing that I have been receiving chiropractic adjustments three or four times a week for more than four months now. Twice now I’ve been more than pleasantly surprised — I would say instead, I’ve been astonished — by the positive and encouraging attitude my doctors have shown. Since I previously had only my late OB/GYN father’s long-standing and negative opinion of chiropractic to go by, it has been nothing short of a revelation to see how open these MDs are to chiropractic, and to “alternative medicine” in general. Scripps Clinic actually has a Department of Alternative Medicine. And, as I mentioned in an earlier post, the University of California San Diego Medical School is now sending its Fellows seeking Board certification in Pain Management to Seaside Chiropractic, for a certain number of hours learning from Dr. David Klein how chiropractic can be efficacious in managing pain.

Dr.Sanjeev Shah commented on how good my blood pressure looked, and how great I  looked, having lost a fair bit of weight since I last saw him in February. He also mentioned that I seemed to be walking better than I had been. So then I told him the story of my Skeptic’s Journey with Chiropractic. I showed him how I can now move the right foot, that had been “like a block of wood attached to the leg,” to quote Dr. Klein; I showed him how I can wiggle the toes, which a few months ago just sat there, immobile, no matter what I did. (Still can’t quite pick up marbles with them, but that will happen soon.) I showed him how I can now reach both arms behind my back — also new in the last couple of months.   I told him how much better I feel, overall. I reported Dr. Bugbee’s remark about “keeping me out of the hands of the surgeons,” and awaited his comments.

Dr. Sanjeev Shah did not disappoint me. He said: “That’s quite a statement, coming from a surgeon! I would say, it’s obviously working for you — keep at it. And I’ll see you in six months!”

I told him I hoped to be walking without the cane at that appointment in January!

So three out of my three regular MDs have unequivocally given me the thumbs-up I guess I was hoping for!  Cheers to Dr. Sanjeev Shah and his two colleagues, who are to be congratulated for their open-mindedness to chiropractic in the face of the evidence:  ME!

Thanks for reading — Betsy

Saturday, April 16th — I had a visit with my rheumatologist, Dr. H. Arthur Silverman, at Scripps Clinic, on Thursday, having not seen him since December, before my journey with chiropractic began. I needed a new prescription from him for Norco (yes, I am still taking opioid painkillers, although not nearly so many as I did a couple of months ago), so I made sure I got the prescription before I told him I was going to a chiropractor. I suppose I thought he might fling open the door of the examining room and tell me never to darken it again, or something like that. I was actually surprised at how receptive he was.  He sat down and said, “Tell me about it,” and I did. When I finished, Dr. H. Arthur Silverman said, “Well, you’re looking terrific; whatever is happening, it’s all good if you’re feeling so much better. Just keep it up, and I’ll see you in six months!”

It was sort of anticlimactic, actually.  Yesterday, I had said to David Klein, “Wonder what I can say to my rheumatologist tomorrow.” And David said, “How about bye-bye?” No, not just yet; but I’m keeping an open mind.  Maybe someday.  I figure, if I can be comfortable at some point without taking any pain medication, I will be ready to say bye-bye to my  rheumatologist, who has been really helpful to me up to now. Dr. H. Arthur Silverman couldn’t have been kinder or more supportive to me over the past few difficult years, and I appreciate all he’s done for me.

Not just yet, as I said.  Here it is almost midnight on a Saturday night, and I’m in the middle of one of my Midnight Perambulations. That’s what I call it when the peripheral neuropathies in my feet (caused, I suppose, by nerve damage during the last two hip revisions) start giving me electric shocks and long, deep aches. I can’t lie down quietly, and now I can’t really even sit comfortably because there are those toes, twingling away. “Dem toes, dem toes, dem daaam toes…”  Now, I take Lyrica for the neuropathies (thank you, Dr. Silverman!); and it helps, in that I only have to Perambulate about twice a week now instead of every night, as I did last fall. And I don’t have to cry about the pain any more. But I am hoping that the chiropractic adjustments will eventually free some poor little nerves that have been SUBLUXATED — love that word! — trapped between the vertebrae, and maybe the toes won’t twingle any more.  Here I was, all happy because I have gotten back some of the sensation in the sole of my right foot.  I should have kept quiet about that, maybe I jinxed myself.

So, right at this point in time, I guess I have a foot in both camps, as they say.  I’m not giving up the drugs, but I’m getting as much chiropractic treatment as I can. Let’s see what happens.  It’ll be a surprise.

Tuesday, March 25th –  Well, I apparently got it a bit wrong. The musical sound actually emanated from the robot, but was triggered by the resonating frequency of the bone.

I believe I would still rather think of it as “singing bones.”  I love the thought of that.

But the best thing is, the sound is perceptible to someone OUTSIDE my body. Dr. Klein could hear it perfectly well.  That is so neat!

When I got home after my adjustment today, I was feeling pretty stretchy and limber… not a usual feeling for me. And I suddenly thought:  “I have to fill out a form each time I go to see Dr. Klein, with a drawing of a human figure. I shade in the places where I feel pain, and assign each place a number on the pain scale from 1 to 10. When I started seeing him just under a month ago, I was giving each area a 4 or a5; and the past week, I’ve been giving every area a 3.  But hey, I can hardly believe it — if I had to fill out that form right now, I’d put a 2 on every single pain area!”

This may not seem very significant to you, but to me, it’s almost miraculous. I haven’t been down to 2 for at least three years. I mentioned at the beginning of this blog that in the past two and a half years I’ve had three revisions of earlier bilateral total hip replacements. The second one turned out to require rebuilding of the whole left side of the pelvic bone with a special porous metal, into which new bone would grow and fuse. This was due to the fact that the polymer coating on the original implant had eaten away a big hole in the bone, which had to be cleared of necrotic tissue and then covered with metal plates so there would be something that could hold the screws of the new implant.  (No wonder I was having a lot, A LOT, of pain!)

That revision dislocated within ten days, but I didn’t realize it (and neither did anyone at the rehab facility) because I was on such a high level of opiates for pain management. The surgery had to be redone two months later. My surgeon said the pelvic bone couldn’t be rebuilt a third time. If this went wrong for any reason, I would be in a wheelchair the rest of my life. I spent a total of four months in a skilled nursing facility, with two months of placing no weight on the operated side. The only time I could get out of bed was to lurch to the bathroom on my walker: hop with all my weight on the right foot, then a tippy-toe touchdown on the left, just for a second. The rest of the time I spent with physical therapy and learning to walk again. When I came home from rehab in March 2007, I then had the task of coming off a strong dependency on Fentanyl — not at all fun, in fact, pretty awful. I was on the walker through August 2007, in fact, and have been walking with a cane ever since. On good days my pain level was 3; on many days it was 5.  I thought it would be that way permanently, and so I learned to live with it and got on with my life.

I don’t suppose it is realistic to expect that 2 will be repeated every day from now on. But I do, now, have a reasonable hope that my regular adjustments will really get rid of my pain eventually. I cannot thank David Klein enough! It’s so exciting to see how quickly I’m making progress under his care. In addition, his wonderful staff — Roseanna and Emily and Cheng Cheng — are so supportive and cheerful, so happy to witness my improvement:  I love coming to this office. (Oh, and it doesn’t hurt to mention that there is always a basket of chocolate-covered peppermint patties on the front desk, and a daily plateful of some kind of sinful cookie or little pastry.  No wonder my diet has ground to a halt…)

Chiropractic is a journey I never thought I’d be making, and I am inexpressibly grateful to all the folks at Seaside Chiropractic.

Wednesday, March 19th — Today, after Dr. Klein used the robot on my feet, I noticed little indentations in the skin and underlying flesh. I commented on the edema, wondering if it would go away eventually. He gave me a brief mini-lecture on how fluids like blood travel through the body, via the circulatory system — a closed system with the heart as the central pump. In other words, blood is pumped to all parts of the body by means of the arteries, and returns to the heart through the veins. Lymph is a clear fluid that is squeezed from blood plasma — basically, it’s blood that has no red cells.  The lymphatic system is a one-way system rather than a circulatory system. Lymph collects in many little sacs throughout the body, often near the joints, and drains out through little one-way valves.  That’s what is causing the edema in my feet — an over-collection of lymph, made worse by gravity. (This is massively oversimplified, by the way. If you’re interested in more about lymph and the lymphatic system, go to Google.  It’ll give you several websites of varying complexity that will tell you more than you ever wanted to know about lymph.)

Dr. Klein suggested that my physical therapist might perform a lymphatic massage to help drain the excess lymph out of my feet.  It’s a simple massage using a “milking” movement of the hands, from the feet back toward the legs.  If my artificial hips permitted me to reach my feet, which they do not, I could easily do it myself.  Maybe I could do it by doing my regular PT leg-lifts, then bending the knees back.  I’ll try that and report back to Dr. Klein.

He has worked on my shoulders with the robot three times now, and that feels very good too. I notice that I’m able to tolerate higher levels of pressure from the robot than I was at the beginning. At first, it was 10 pounds of pressure at the neck, and 15 pounds at shoulder level. Farther down the back, where the vertebrae are larger, he used 20 pounds.  Now Dr. Klein starts at 15 pounds on the neck, moves to 20 around the shoulders, and 25 lower down the back. Nothing has ever been painful! The worst it’s been during an adjustment, I would say, is the feeling that my teeth are chattering when he starts on the neck. I guess this must be how the pavement feels when the workmen start jackhammering! And even that isn’t really very bad at all. I do feel pretty stiff and sore the next morning, briefly; but then, it’s hard to tell how much of that pain is caused by the adjustments and how much is just the regular garden-variety stiffness and soreness I’ve been living with for years.