Sunday Stroke Survival: Holding Patterns

Right now, I'm in a holding pattern with my physical and occupational therapies. I quit showing positive gains and started losing ground as my Botox waned. I've stopped the appointment until a week after I get my next round of shots in two weeks. I found at my last sessions that I was getting more frustrated because of the back sliding progress. Better to save the billable hours with Medicare and my supplement on forward progress than waste them on frustration. In a perfect world I wouldn't have to pick and choose, but we all know this ain't a perfect world.

So, what am I doing with three extra hours a week not spoken for? I'll be pouring them into crafting projects. I've kind of pit them on hold while waiting for us to move. So much so that I even bought a plastic drawer storage container to hold it all. I had to buy another dual temp glue gun after the mini glue gun dropped a 2" piece of hot glue on my leg resulting in a 2nd degree burn just above my right knee.

While waiting for it and the longer, dual temp glue sticks to arrive My youngest granddaughter shopped at the nearest Dollar Tree for future items I'd need for my year-long crafting project plus Christmas for my huge family throng. I ended up buying a second set of storage drawers to keep it all tidy and organized. 

I'm currently looking for a folding card table to use for my battery powered sewing machine/ crafting table for the new house whenever we do move. My 600 sq ft apartment will be replaced with a master bedroom suite at about less than three-quarters the space, but that's okay because I have so little personal stuff. The craft/sewing table will fit between the wall and the side of the bed that I don't use. A queen-sized bed is way too big of a bed for me and one cat. Although it is comfortable.

So. I'm not wasting time twiddling my thumb. As for packing to move, that's not an issue. You see I've basically never unpacked since I've moved here a year ago. My clothes were packed in two large totes. One had warm weather clothes and the other was cold. I simply unpacked and repacked each tote as the seasons changed. The kitchen is another story. That will take about an hour separating my stuff from theirs. All the rest is still packed up from my move here. The rest of the house is the kids' domain. I don't what goes with us or stays. But I'll help them if they sort it.

For now, we are waiting on our seller and closing. Hopefully, it will be before the counterparts for this house.

Nothing is impossible. 

Sunday Stroke Survival: Waiting and Waiting Again

 

I'm aggravated. I often joke how God let my stroke happen to teach me patience, but no matter how true that statement is, it's still a work in progress for me almost 9 years later. I'm still waiting on Hanger to get back to me with news on my AFO. I'm hobbling around in my ill fitted brace and a broken foot. I can't stand longer than thirty minutes without the swelling of my foot to be unbearably painful. I can only walk short distances (50 ft) because the articulating ankle and the huge (2") girth distance my leg and the brace causes my foot and leg to rotate within the brace aggravating my pressure sore on the bottom of my foot again. 

Luckily it's winter and it's basically our "down time" for the homestead. So I don't have to tend a garden, critters, nor orchard. This will change in two months. I've called and left message to no call backs or been told "No news yet." 

Meanwhile, my Botox is wearing down so my therapist is getting less extension and having to work harder to get it. Even with dry needling, there's less carryover effects. But this doom and gloom report will be over with come the second week in March when I get the new series of Botox injections (plus a week before it kicks in). The good news is that they haven't had to go up on the dose yet. I've still got some range of motion in my shoulder so my pain levels are manageable. I truly wish my Baclofen pump hadn't been removed and COVID had never happened to delay my getting a new one (as do a lot of folks).

Do I sound whiny or have I just been on the pity pot too long this week? I'm just tired of waiting. I've tried being patient, but now the little stuff is starting to aggravate me. I have succeeded in not sweating the little stuff. Knowing it's ALL little stuff in the grand scheme of things. Except for this week. I see myself slipping back to my old ways of thinking (back when I was an alcoholic and junkie). It's a dangerous time for me and my sobriety I know this but have not been able to snap myself out of it. Maybe, this coupling with Valentine's day compounds my inability to cope. You see, thirty years ago my beloved asked me to share his life with with him on this day has something to do with it too. I'm just in a fragile state right now.

So pray for me for the next couple weeks if you can. I've never asked this of anyone before even though I know they do. And, thank you in advance.

Nothing is impossible.

Sunday Stroke Survival: 2020 Wrap Up and What's to Come

Oops I missed posting last week.

I hope everyone had a good Christmas holiday.  It's that time of year again for reviewing the past year and figuring out what's the plan for 2021.

In 2020 review...

I finished my cancer treatments with a clean bill of health!!!

Last year really flew by with only a couple events of any real, personal interesting points.  I got infected by COVID-19 way back in February and I didn't realize it until much later. The end of January, Mel got sick with a fairly high fever, horrendous cough, and moderate difficulty breathing. With no medical insurance, she fought me on going to the hospital, but I finally (after 3 days) won the argument. The doctor at first, thought it might  the flu, but ruled it out fairly quickly. They wanted to admit her, but she refused. They didn't know what her problem medically was. I brought her home and treated her the best I could homeopathically with herbs and immuno-boosters I grow here. I warned her that if her fever went above 103°F and if she did not respond to me she was going right back to the hospital. It didn't happen. Eventually, her fever broke and she got better except for a cough and loss of stamina which lasted for months.  As an after effect she now becomes short of breath and has a heart condition.

The first part of February, it was my turn. Even though I'd wash my hands and wore a mas while treating her, I got sick though not as bad. I felt like I was going to cough up pieces of lung tissue at any moment (I didn't), had a medium grade fever (100°- 101°), and was shorter of breathe. It lasted about two weeks. I had lost my sense of taste and smell  (I still moderately suffer with this). I did touch bases with my PCP, but didn't go in. His instructions were the standard- control the fever, push fluids, and rest. If it got any worse to go to the ER. So that's what I did. 

We didn't hear about COVID until March with the rest of the country. We figured that's what we had been fighting. An antibody test shoes I had it. We were luckier than others with this virus. It was no worse than a very bad cold or brush with the flu.

I had a T-car procedure done on my left cardioid artery. Uneventful, but now have to do the right one done Jan 5th 2021.

I started Botox again for my post stroke(s) spasticity. With Emory in and out of locked down mode for nonessential surgeries, it was looking like summer of 2021  before I could have another baclofen pump implanted. So far, my body's response to doing Botox again has been good.

After the first series of 400 units, I was almost able to straighten my arm to full extension and raise it above my head. Which is way better than the 6" I'm able to move it without the injections. I could shave my underarm with ease!  The gain gradually reduced over time and by Thanksgiving the pain of my entrapped shoulder and bicep returned but I was scheduled for more Botox the first week in December. So it was manageable and short lived. I'm in physical therapy again.

I got another AFO and new shoes. The AFO still needs work. I've formed new pressure sores above my ankle and at the first metatarsal (at the base of my big toe). Oi Vey! So far though, no reoccurrence of the pressure sore in the spot that has plagued me for eight years. I guess I should count my blessings. This is the first time my shoes didn't need alterations of build ups and rockers added.

That's been my year besides falls. When I entered PT again they estimated my falls by how many I had in the past couple weeks... 48 falls a year! That sounds like a lot, but thinking back, it's a little on the high side. I remember about 30... not counting falls that I averted by catching myself before I actually hit the floor or ground. Is that a lot? It seems fairly standard to me after back surgeries and strokes in the odd 30 years or so.

What's coming up on 2021...

• The right sided T-Car procedure of my carotid artery is slated on the 5th of January.
• We've got our new garden area ready for seed potatoes in February. The 5th tier of the garden is almost completely revamped for vegetables. The seeds have been ordered. So we should get a good harvest.
• We staked out where our tiny houses will be built and leveled it. We've set the foundation piers. Now we've just got to save for the rest of the lumber before building can commence.
• My 9-month post cancer ultrasound (the week before Christmas) of my thyroid area showed another mass. Just when everyone thought it was gone, surprise! So everything else is up in the air again! But for now, I'm still alive and fighting. So much for a normal year. Sigh!

Nothing is impossible.

Sunday Stroke Survival: I'm Back!

 Well, sort of. I'm still using the HP streaming "computer" with a 256 gig SD card to download all the updates and move files over to it so it's workable. Even with the black Friday sales, I couldn't buy a new or refurbished computer with the property tax due too. But, the SD card was less than $40 so I can start blogging again.

While I was down with computer woes, Kassity had her puppies November 1st. She had ten! Seven girls and three boys. Within an hour of being born we lost one boy and a girl leaving eight. All eight have gotten huge over the last five weeks. They now weigh about five pounds a piece. They have taken over the living, dining, kitchen. and breakfast nook. Both bedrooms have boards to prevent their access to them. They are constantly underfoot climbing our legs for attention. Kassity has weaned them early. She wanted her freedom from them. Now, they each have a small stuffed animal to play with. They look so cute carrying them around the open area. One minute they are cuddling with them and the next, the pups are shaking them trying to "kill" them.

Walking post stroke has been precarious. It's hard carrying the fabric tote with five splits (6"x 8"x 18" about 8-10lbs each) of firewood normally, but with four to eight puppies swarming the feet, it gets even more problematic. I use extra care when walking around them. I make sure I can hold onto something otherwise I'd trip and fall, or step on one of them.

The puppies are fascinated with my AFO. And no, I got my new one but it doesn't fit right either. My new shoes are on back order until the 15th. The Hanger folks refuse to adjust the AFO much without the new shoes. Frustrated, I lashed out at her. "All I want is to walk without pain! Is that too much to ask for? Can you do that or not?" In rare form I asked, "If the foot was amputated below the knee then could you build me a foot that worked right? I doubt it." I never had so much problems with Hanger in my old hometown as with this one. I've had a once a month, or every three months standing appointments with them over the last three years. We're driving 60 miles round trip with each appointment to boot. My frustration load has tipped and the end is not in sight. 

I hate this going around and around for months and only fixing the problem in small amounts. It's like going to get new glasses and you are looking at the eyechart with that machine flipping lenses, and they ask better or worse? Once I answered neither. The optician said I had to pick one. But I had answered truthfully the first time. That's about how I feel about Hanger now. I can't even go to the Hanger back home because the tech I had all the same problems with her not listening to me for two years is now head of that clinic! GRRRRRRRRR!

I talked with one of my neurology PAs last week when I had my Botox appointment and told her about my frustration with Hanger. She asked me whether I had tried Alliance Orthotics? I honestly never heard of them before. Have any of y'all? Do they listen to you? Can they really fix/build an AFO that works as advertised without causing pain and pressure sores??

Is walking without fear of falling with a spastic foot and ankle an impossibility for an AFO? If so, tell me. I'll make an appointment with another orthopedic surgeon tomorrow to schedule an amputation. I'm so tired of dealing with this! I mean I've been fitted for 6 AFOs (with the possibility of a 7th) in the past 8 years! All I want to do is WALK WITHOUT PAIN!! <stepping off the rant box>

The Botox worked fabulously! I was fantastic to be able to lift my arm above my head again., The return of the trapped shoulder pain and strong muscle spasms didn't really return until Thanksgiving. My appointment for the last set of the year was on Friday. There was an additional 100 units for use in trouble spots making this dose 400 units versus 300 units. It was fantastic to lift my arm above my head again. It's been since June of last year since I've been able to do that. I did manage to straighten my elbow to 170 degrees. the last 10 degrees of straightening the elbow to full extension was hampered by a new contracted spot in the bicep. The wrist recovered a 5 degree rotation and extension. That's movement than I've gotten in four years in therapy. The extension capabilities gradually wore off as Thanksgiving approached and the Botox wore off. I was locked in again by the next set of injections.  The neurologist did say he if he could get approval for 1,000 units (he can't) it would fix me up royally. I looked at him in shock, "Really?" "Just about," and he nodded.

The three years off from Botox did reset its results almost fully. While I was hoping for the four or five months lasting power, I knew that my spasticity has gotten so much worse that it was a pipe dream. For now, I'll take what I can get even though I'm giving the doctor permission to inject poison into me. Emory is still on partial lockdown again with the new resurgence of a new strain of mutated strain of COVID-19. While the option of having the new Baclofen pump placement in Athens is available. 

I just hate breaking in new doctors into the mix. My "ologistitis" is getting to the tilt point with the addition of an Otolaryngologist (for my silent acid reflux), a gastroenterologist (for my silent acid reflux), and a vascular specialist in 2020. Okay, a specialist is not technically an ologist but he has a specific field of study and treatment so to me it counts as one. They join my cardiologist, pulmonologist, immunologist, neurologist, oncologist, and my endocrinologist.

I think y'all are all caught up again. I'll be continuing physical therapy again next week when the Botox kicks in fully again. If only my body would allow movement without Botox...a girl can dream, can't she?

Nothing is impossible.

Sunday Stroke Survival: The Wait is On

Or, should I say continuing. It seems I'm constantly waiting on something these days.

Monday, we got in the car to go to my vascular surgeon's appointment and it wouldn't start. It wouldn't have been so bad if the doctor didn't have an 24-hour in advance cancellation policy./ A missed appointment  cost me $50 and it wasn't my fault. The appointment was for a six-month scan of my right carotid artery.

It wouldn't have been so bad but we got slammed with storms from Bertha and Cristobal, and then Laura. The access road, really another driveway, washed out. Even with 4-wheel, drive it's near impossible to make it up the hill from our place to the main road. It has rained almost daily here and with each storm the drive gets worse. The owner of the land the access cuts through is hard pressed to repair it without a storm washing away his repair work.

Where I have trouble getting up the hill is the trouble spot I'm talking about. It actually looks pretty good in the video compared to now. There's no clay left on the broken pavement and the potholes I talk about have been repeatedly been filled in with broken cinder blocks and large rocks. Those bits and pieces are exposed and new bigger potholes have emerged as the water finds new ways to get down the road.

The tow truck drivers that have come to our assistance in the past have just refused to even try and that was when the drive wasn't that bad. Now, they look at us as if we're insane. "You want me to go where with my tow truck?! Uh, NO." So just how were we supposed to get our vehicle to the shop to get it fixed? We are both transplants here and didn't know anybody to call.

Mel and GEICO were working furiously to find someone. It took two days. but an angel of the last towing service in a three county area, said he'd try. He got halfway down and had to stop. He manage to get his flat bed tow truck back to level ground before he called with the bad news.

Mel's frustration turned to desperation and tears as she talked with him. Then, he said, "Wait a minute. Let me call you right back."

The dogs went nuts and tore up the driveway. Not only our two but the "community dogs" too in hot pursuit. Around the bend in our driveway came a big, burly, bear of a man. He hollered over the commotion of the six large dogs, Big and burly, but soft spoken and polite. "You were right. Passed that downhill bit it was smooth."

I called to the dogs to let him pass. Mel met him at our huge car park/turn around area by the barn.  Of course the Blazer wasn't there, it was back behind the house where Mel had dropped off 100 lbs of chicken feed. "I checked with my boss if I could come down and see if I could help," he explained. "So what's it doing?" They walked around back. If it wasn't for the virus scare, Mel would have hugged his neck and kissed his cheek. He'd walked almost 1/4 mile to get to us carrying a hefty toolbox.

After a couple of attempts to start the vehicle there was a definite gas smell, and then the the engine kicked over in a roaring start. Mel looked flabbergasted. She thought he was thinking, "Dumb females. panicking for nothing. But, he wasn't. He recounted a story of how a friend of his had a similar problem with his car. The result was a tiny pinhole leak in his fuel line. His friend almost tore his engine apart looking for it. He advised Mel with trying to start the car. It would start eventually. When she had the money, take it to the only garage in town. They had a liquid which would show where the leak was, but it wouldn't be cheap.

Mel once again suppressed the urge to hug him, but thanked him profusely. Now, we're waiting on enough days in a row for the owner of that portion of the driveway fixed. But we have remains of another slow moving hurricane passing over us with no break in sight for another week at least. So we are waiting for that.

We were able to get groceries and make it to my Botox appointment. Now, I'm just waiting for the Botox to kick in.

Nothing is impossible.

Sunday Stroke Survival: Action/Reaction

With the virus still active in places and being in the high risk category, I've put off the idea of having the baclofen replaced. It's still simmering on a back burner. It would have been off the stove entirely if it hadn't worked so well.  I've got to do something about the pain the spasticity is causing.

Sitting around and waiting has never been an option for me when there's another action I can take. I've decided to take another round of Botox. It's scheduled for September 11th. It's been three years since I've voluntarily injected the poison into my body. While I'm looking forward to it/not looking forward to it, it is some relief to the immobility and pain. At this point 45 days out of 90 is better than nothing because three muscle relaxers aren't touching it.

In talking to the nurse yesterday, I'll be back to the 300 units for injections into my muscles. Since there has been a break in the cycle of injections, we discussed whether my body would reset back to square one was possible. It is entirely possible that the lower unit dose will hold for the entire 90 days between injection cycles for pain control and improved mobility with PT like it did 7 years ago. Here's hoping.

Others have told me that they don't understand my pain with my spasticity. They have spastic muscles also, but it does not cause them pain while mine seems off the charts. While the contracted muscles causes a tightening sensation, it's not what technically causes my pain levels to shoot me into space. So, I have been evaluating where exactly the pain is and what causes the pain to increase so much. I have discovered there are several sources.

Although I consciously try to minimize the actions that intensifies the pain that only accounts for less than 50%.

1. Movement of the affected arm or leg while episodes of increased tightness is present. While the tightness or high tone is always present, sometimes are worse than others.
2. Cramping of already tight muscles. Not just rhythmic waves of cramping (tolerable) but the sharp, "Charlie horse" cramping that accompanies a movement the spastic muscle does not like (weight bearing, leg in full extension, or moving it an inch this way or that) . Once started, the Charlie horse cramp takes on a life of its own. It demands the arm or leg be held in a certain spot or the cramp increases in intensity. This cycle can last two hours, takes a break, and then starts up again.
3. Incident muscles and joints trapped between two spastic muscle groups. My trapezius, shoulder, and neck instantly come to mind. I recovered my shoulder muscles range of motion early after my first stroke. In spite of injuries, I still have that range of motion.  But its range of motion is limited by spastic bicep and pectoral muscles. So it wants and needs to move but can't. 
4. Psuedo involuntary movements of spastic muscles like with coughs and sneezes cause additional contractions of these muscles and cause pain. Even the simple acts of of blowing your nose or clearing your throat takes the contraction affecting these muscles.

Then there's my list of 'try not to do. that cause pain. Things like hitting a chair with my affected arm's funny bone, which is decidedly unfunny, causes a rippling effect into spastic muscles. The dead weight of carrying a spastic limb also causes its own level of pain. I try, when seated at the table, to keep my elbow supported on the table. The brunt of the weight of my arm is no longer carried by my shoulder. But with movement, like taking a drink, my arm will slip from it's perch causing a jarring pain in my shoulder and bicep. While walking when the spasticity isn't too bad, I can hook my thumb into the waistband of my pants to relax or help support the weight of my arm. All bets are off when the spasticity is very bad and my arm is drawn up into my chest. All six or seven lbs of dead weight rely on my shoulder to carry it. Don't think that's not too bad? Try carrying a half a gallon of milk around all the time and you'll see what I mean.

So it's back to Botox for me again. One step forward and two back. Sigh! It's like my mama used to say, "There will always be an again."

Nothing is impossible.

Sunday Stroke Survival: Still Dealing with Broken Bones

The mini saga on my broken foot continues. I've spent the last couple of weeks dealing with how to prevent this happening again. And maybe in the process, getting my foot to heal faster. Try as I might. I just can't be totally nonweight bearing on my poor foot. My lifestyle, home, and vehicle are not set up for it. I want to say at  this point, I'm so over this!

In the morning, I don my sock and AFO. At this point my foot looks normal. I hobble to the bathroom bearing weight on my heel build up. Little, sharp twinges of pain shoot through my foot as I rise from the commode telling me that my foot is still broken and it wasn't a bad dream. Because of not wearing a shoe with my AFO, my foot inverts with each step as much as the AFO will allow. So begins my day.

I hobble to my rollator sitting where I left it the night before...about ten steps from the bathroom door. I'll one legged roll it to my computer.I'll turn on my little electric heater. I'll read and answer my emails, scan the news, answer YouTube comments and play a couple of games on Pogo.com.  Pogo.com has two daily challenges in various games so I'm not constantly playing the same games which is nice.

I use the heater to take the morning chill off me. If I'm still chilly by the time I finish my computer work, I'll one legged scoot to the wood stove. Try as I might, I can't make a fire sitting down. There's paper to crumble, an intricate pattern of various sized kindling to lay, and wood to be lifted into the side of the wood stove. It's just barely 7 AM by this time. If I'm chilly, Mel will be freezing when she gets up. While the kindling and wood catches, I'll still be running my personal heater.

I'll sort through my morning and afternoon medications. My medications include Lasix, a potent diuretic.For the next three hours it's a race to see if I make it to the toilet in time. I was slow before living post stroke, but now it's ridiculous. It's a 50-50 shot whether I make it or not. I've gotten to where I keep an extra pair of panties, pants, and socks in the bathroom just in case. Yes, it's gotten that bad. The really bad part is none of the bathroom doors are wide enough for my rollator to fit through so I'm up walking again.

I'll fix Mel's pot of tea and breakfast while I'm up fixing mine. Thank God I make in advance breakfast and freeze it. I made a month's worth of pancakes, French toast, and waffles before I broke my foot. We also do a "big" breakfast for dinner about once a week: bacon, grits, eggs and toast. All I have to do each morning is heat it up and prepare the fruit. Like other people drink coffee in the morning, we've got to have our hot tea for the caffeine jolt. At night, it's a pot of decaffeinated Earl Grey.

After breakfast, I'm chomping at the bit to do something. I haven't seen the rabbits in a month! The rollator does not like the straw bedding in the rabbit barn. Same goes for the chickens in their coop. I've chatted with Little Red and Houdini (Hoo di hoo) as I come and go on one of my various trips out and about because these roosters are still free ranging to give the hens a break.

But I'm nonweight bearing so I spin plarn or wool, or knit for a while until I'm bored with it, and then, it's back to the computer again. And so goes my days.

That brings me to my latest quest...how to stop my foot from breaking again because of the spasticity and my AFO. I went to my brace maker. She cut the heel build up down by half. My contracted Achilles heel pulls a bit more but I can live with it. She also put a bar into the padding to keep the ball of my foot from striking so hard with each step and built up the side of my AFO so my inversion isn't so bad. She told me I need a new AFO. This one is only three years old and Medicare and my insurance only pays for a new one every five years. Caught between a rock and a hard place once again. She also suggested putting a rocker sole on the bottom of my shoe on my affected side. It would cost $40 and my insurance doesn't cover it. I'd have to leave my shoe with the cobbler for a week. It's a good thing that I bought a second pair of shoes. I've got one in the shop now. The second pair will go in when the first ones are done.

standard AFO

After my brace maker made the adjustments to my AFO, I was praying hard for a solution to my AFO problem. Although I could charge it to a credit card, I didn't want to. It's another bill added to a fixed income that I had to pay. Well, my prayer was answered. We'd fight the rule (again). But instead of my doctors starting a letters to get it qualified like last time, all I'd have to do is get my doctor to document the changes to my foot because of the spasticity. I could do that! I might mention here that my brace maker, the shoe place, and my PCP are all 30 miles away in a neighboring town. So I've been up and driving around too.

I've just have to hang on until May when I'm scheduled for my rhizotomy. If that alone doesn't markedly reduce my spasticity, I can do Botox again. It's now been nine months since my last injections. More  than enough time for the Botox to get totally out of my system. Maybe, it'll work better like when I first got them. At least that's what I'm praying for if I need Botox again. Maybe, I can again be making forward strides in stroke recovery again.

But this will be a busy year for me and doctors as if it hasn't been already.

At my cardiologist's office, I was greeted by the news that I now have three aortic aneurysms. One in my abdomen and two in the femoral arteries (in each leg). As if three bad valves and an electrical problem in my heart weren't bad enough. The arteries are bad enough that they have to be fixed or they'll rupture killing me. That's slated for sometime this early summer.

My yearly blood work showed some areas of concern mainly my kidneys. The tests showed moderate kidney damage/disease. So, I'm being watched for that. I know the culprits- A bad family history and the drugs I have to be on. I can't do anything about either, but pray. You know if it wasn't for my body working against me, I'd live on this Earth forever. But that's not going to keep me from trying. God willing.

Oh, and about my foot. When I go to bed at night, I pull off my AFO and sock. I'm greeted by my red, angry cartoon foot. You know the one where the swelling is so bad it looks like a balloon? Below the spandex support is rounded with swelling. My toes look like Vienna sausages wedged in those little tin cans. Well, I try to be nonweight bearing.

Nothing is impossible.

Sunday Stroke Survival: Spasticity and Botox Again

My next series of Botox injections is May 1st. So is it any wonder the effectiveness of my Botox is wearing out. I hope upon hope with each series of injections that the effectiveness will carry through until the next appointment, but I'm literally sorely disappointed. The spasticity returns full force weeks before the next series is due. Not that the spasticity disappears with the Botox, but it brings the pain down to a dull roar and the tightness into manageable levels where some movement is possible.

Keep in mind that mine is not the average spasticity that quite a few post stroke survivors suffer with. It isn't sporadic episodes, but a constant bane to my existence of living post stroke. It is classified as severe spasticity. There no cure or treatment that works 100% for anybody. Heck, they (the researchers) are still trying to define it. It's that different in everyone stricken with it. So there isn't even a sure definition for it.

But from my standpoint, it's clear as crystal that the muscles tighten involuntarily, and then cramp. These cramps can last from several seconds to hours. Of course me, being Ms. Abby Normal and Ms. Overachiever, the cramping has to go on for hours around the clock. The only thing that saves me from nonstop agony and crying is my dry needling sessions. Unfortunately, I would have to have dry needling three times a week to keep the spasticity from worsening when my Botox wears off. I'd be in debt up to my eyeballs at $45 a session during these periods. I think even Bill Gates would have a problem with this kind of bill looking at the expenditure for the rest of his life. I'm not a spring chicken or even a fall hen any more, but still I have quite a few years left in me. I'd kind of like to live out my life as relatively pain free as possible without being drugged out of my gourd, wouldn't you?

I'd love to not have needles poked into me up to a hundred times a dry needling session also, but it's one of those love/hate relationships. It's where you tell the physical therapist to "hurt you good" so you aren't in continual pain from the spasticity. It's almost like a sadist/masochist relationship where no sexual pleasure is derived just pain relief.

My inside elbow after dry needling

I'd love not to look like a junkie (drug addict) from all the bruising that can be the results of dry needling too.  Within hours my arm will look like pictured. After 24 hours, all the nice black bruising is evident. Yes, I ask for it. Heck, I'm even paying for them to do it to me. How desperate is that? Like a junkie I have to have my dry needling fix to keep moving.

If there were one drug I could take to stop this cycle, you know I'd be the first in line for it.

But there isn't one. So I accept this treatment as a last resort. It's the only way I've found that works and keeps me moving. If it wasn't for the spasticity being so bad, I'd almost have full movement again. I can voluntarily straighten my elbow, open my right hand and straighten my fingers, with strong concentration, with the full Botox and dry needling. From week 2 after Botox to week 4, I can do this. It's slow going but I have voluntary movement on command. But I gradually lose function after that. As you can imagine, I work the Dickens out of my arm, and fingers during that time in the hopes of strengthening my weak muscles to combat the spasticity. For the past two years, I've been on this cycle of excitement, and then frustration. But still I'm fighting. It is tiring. Frustration does get the better of me, but I keep at it.

My inverted right foot and foot drop still makes walking difficult. After two years of dry needling I haven't progressed farther than one step without my AFO, but I'm still working at this too. I've noticed that the calf muscles have decreased in size over the past year. A loss of muscle mass is always concerning, but it can be gained back with time. My right calf is about half the size of my left. It's not because I don't work both calf muscles, I do. It's because of the AFO. Only half the support of my body is actually done by those muscles. But then again, I've always had very muscular thighs and calves from weight lifting in the past too. I may on occasion lift 50 lb bags of feed now, but it is a rarity rather than the norm these days. I've got a Mel for that.

I'm just going to have to work my right side more to build the muscles back up.You've heard of the One Hit Wonders? I'm a One Step Wonder. The ankle is weak and wobbles. My foot will actually bend and be locked into a greater than 70 degree angle of supination without the Botox and dry needling. Oh, and my toes? My big toe will point straight up and the rest of my toes will curl under. Try bearing weight like that! If it wasn't for my knee and hip being artificial already, I'd be worried about the continual strain they'd be under. Even so, my muscles holding these joints are strained with every step I take. Does this stop me from moving under my own power? Nope! I'm enjoying every moment I can on my own two feet. Every day I try standing and taking steps without my AFO. One day, I might just be surprised and take off.

Until then, it's Botox and dry needling.

Nothing is impossible.

Sunday Stroke Survival: How Do You Spell Relief?

How do I spell relief? B-O-T-O-X. It's been two weeks since my series of injections and it's finally working. Now, for those of you that don't know, my post stroke spasticity is pretty severe. It doesn't come and go in episodes, it's a constant battle. When the Botox wears off between a couple of weeks to a month prior to the next scheduled injections, I'm in pain. Read 8 of 10 on a 10 scale. As an example, tense your upper arm muscle as tight as you can. Now imagine a Charlie horse cramp in those muscles while it's already tight. That's what I go through nonstop until the next set of injections kick in. The cramp will last about two hours, stop for about an hour, and start again.The last part of December to the middle of January was spent like this. A heck of a way to ring in the new year. Because of a billing error, I was also unable to get my dry needling also. It was a grin and bear it situation. I don't want a repeat of that situation ever.

The Botox has kicked in none to soon. It February already. Potatoes, green peas, cabbages, and carrots need to be planted. We've expanded our garden this year. I've also built an elevated raised bed from pallets for another crop of strawberries. It's only a 3x3x3 planting area, but I'll be able to tend it just fine. It's only 27- 30 plants. I should get a few pints of jam out of it. I do love strawberry jam. Other fruits and vegetables I can lean over and harvest but the strawberries would be crushed before I got them in the basket. Also, other fruits and vegetable ripen at the bottom first, then ripen up the plant, but strawberries will always be at ground level for the entire harvest. A 3x6x3 planter is in the works for my herbs. The 1x3x3 pallet planters just couldn't hold enough plants and water for my herbs last year, but it was a good attempt by Mel.

We've spent the winter months harvesting angora rabbit wool. Never got a chance to spin it into yarn though. I also haven't made my urinary pads either. We've lost two chicken to predators this winter. So one of the hens that survived the attack is sitting on some eggs for us. She has an injured foot. A bite went through her foot and abscessed before we found her. She's got a comfortable spot inside by the wood stove until she heals, and can rejoin the remaining hens and rooster. So we've given her a job of sitting on some eggs to hatch out replacement birds. She's sitting on four eggs. As of this week, her leg is still tucked firmly against her body and she uses her wing as a crutch when she's out of her milk crate.

The cookbook is coming along very slowly. It's not so much the recipes but the pictures that is taking so long. I have to make the dish first. Then there is the staging of the dish to make it look beautiful and delicious. I still haven't decided on the title. But I'm still at it.

Mel is finding out just how difficult self publishing can be. Writing a book is the easy part. At least for her. All the folks she thought would jump at her dog training book, haven't. I've tried explaining to her that $8.99 is too high for a 42 page book, but she isn't listening. She's working on her social media presence like twitter and instagram, but she's sort of lost. Meanwhile, I haven't been on twitter since my stroke almost five year ago, but every week I'm gaining twenty-five new followers. Go figure. My books have become a stumbled upon and buy item, because I haven't promoted them a lick. That's okay though, the royalty monies peter in. With no new books published, I've become a has been author. That's okay too. It's just living post stroke for me. It's just not worth the frustration to really put in the work it will take. Trying to regain other things back and adapting things I really need to do take the forefront, and these cause enough frustration. Writing has always been a need to do luxury item for me. Needs before wants. Maybe one day again.

Well that's it for now. Remember...

Nothing is impossible.

Sunday Stroke Survival: Sanity Restored

After y'all endured last week's melt down, I'm relieved to report that this to passed. Thank you for all the advice and support. I needed to blow off steam and it helped. Through a lot of prayer and meditation, this week I'm back to my old self. Relieved? I know I am. There are still difficult choices to be made, but I'm now back on stable ground mentally, if not physically.

First, I actually got six hours of uninterrupted sleep. It was just one night, but it helped immensely. Sleep deprivation is a powerful ailment, and plays havoc on both the body and the mind.

While the nocturnal Charlie horses continue, I start searching for other possible causes besides heart, neuro, and diet. I took a good look at my shoes. I missed my appointment to get my new, insurance covered shoes. Life just got too hectic and it slipped my mind. The specialty insole in my left shoe has a worn spot at the heel. This could be a major factor. Given the Botox has been wearing lean and my stance has changed, it could make all the difference in the world in over stressed muscles and tendons. I had taken a look at my activities and realized that every time I filled the kindling buckets with small branches, I could count on the Charlie horses occurring during the night. Picking up sticks and branches on level ground not so much, but there's only about a ten-foot surrounding the house that's fairly level everything else slopes either up or down. Even a slight slope causes me to shift my body weight more on my unaffected side to maintain my balance as I bend and lift. Poor body alignment. I'm sure any PT would agree. It only makes sense. I now carry a Grab-It with me for this activity.

I've made an appointment with my PCP for a new prescription for the shoes to be followed closely by Hanger, my orthodics company. Sadly and happily, I'll meet my deducible and max out of pocket yearly expense between neurology and cardiology by February again this year. So my shoes will be covered 100% once again. My Medicare doesn't kick in until July.

My heart affecting my stamina and breathing is another issue. I find I'm easily winded. The alternative of a triple valve replacement. It's looming closer and closer as much as I hate to admit it. I also dislike having to admit that I'm fearful of undergoing anesthesia again. After my heart stopping twice the last time, can you blame me? Of course, they'll purposely be stopping my heart to do this, but it's the whole restarting of the heart that is my issue. I have restarted hearts in ditches of mud and muck in the past, but it wasn't my heart. Does that sound stupid?

Having blown a gasket last week was cathartic for me last week. Where I was lost in a fog of hurt (both emotional and physical) everything was blurred, this week I can see clearer to decisions I made under distress were the right ones so my internal compass was still intact. It carried me through just as it always has. The issues of selling my house, and making my child and grandchildren homeless are still here. My Botox wearing off leaving me spastic and in chronic and severe pain is still occurring and will be until next month. My injection series is on the 27th and a week until it kicks in enough to make a difference. Hopefully, my insurance approves the increase to stop the Botox wearing off before the next series. I'm still living post stroke waiting on recovery.  Because of the stress of the situation that is my fault, my Fibromyalgia is still in flare mode. I'm going to HAVE to go back on my Cymbalta again at least until the flare lightens up. It sure won't hurt the depression either. I still can;t sleep lying flat or on my side, but the bruising has lessened and the scabs are disappearing. The area is still very tender. Even the shower spray hitting it will take my breath, but not as bad as last week. This week my coping skills are not barely hanging on by slipping fingernails. They are actually working and I'm able to function. Two songs ran through my soul this week and I realized THIS was for me...

 

 and  

 

 Big difference from last week, huh? I'm not saying that I won't fall into despair or succumb to the pity pot again. Of course, I will. I'm human, but...

Nothing is impossible.

Sunday Stroke Survival: What's Going On

Thanks to Obamacare <choke, choke>, my medical insurance changed as it did for most of us. As a result, instead of having 75 hours for PT, OT, and speech a year coverage I had 40 hrs of PT, 40 hrs of OT, and 40 hrs of speech therapies for a calendar year. This was good and bad. My premiums definitely went up. Big surprise there...not.

Old history, right? It's been enforce for a couple of years now. With these limitations in mind, here's how I work my therapy visits to last a whole year. Or, at least since I lost my old physical therapy group. I'll start the year with physical therapy (PT). Since I normally get Botox injections in January, it makes sense. I get both dry needling and PT stretching to gain the most I can. Since I've got a year of dry needling behind me, I can track when dry needling is for the optimum results. I use this accumulated data accordingly. I get Botox injections every 3 months so my therapies schedule sort of goes like this...

OT once a week for for 30-minute session the two weeks before and after Botox is scheduled. Just general heat, e-stim, and stretches to the best of the therapist ability. Believe me when I say, that even a 20 degree stretch on spastic muscles in my arm is a great relief. It hurts so good.


Two weeks after Botox is twice a week PT and dry needling. They are 30-45 minute sessions. This will continue for about 6 weeks.

I'll take a break from therapy for two weeks, and then start all over again. It comes pretty close to all of my PT and OT hours used by the end of the year. The beautiful part is the $30 copay disappears by February each year because not only have I met my deductible, but also my maximum out of pocket expense for the rest of the year. That equals to 80 hours of PT and OT a year. I actually gained 5 hours of contact time not including speech. What a novel concept.
 
Notice I only used my PT and OT hours. I still have 40 hrs I can use for speech therapy each year. I haven't yet used any speech therapy hours since the change. While in the Golden Isles, my stroke support group also had free, weekly communications meeting where we practiced speech and writing. Which was a blessing when my insurance only paid for 75 hours of all three. But since the change, the weekly meetings were enough, but I got plenty of practice with this blog and speaking for my husband.

Since moving to north Georgia, I don't see the need for structured appointments either. I write two blogs a week, videos on YouTube, and have a roommate who was in graduate school for speech therapy before moving here. No, Mel didn't graduate nor become an actual speech therapist, but she is an excellent prompter. Having someone around to interpret is a valuable resource for the aphasic. You get plenty of practice speaking.

My writing as in holding a pen to paper hasn't improved much, but then most of the time I'm on my computer typing. It takes me three to four days to write out a blog post so sometimes this blog suffers from the effort I use up on my homesteading blog. The YouTube channel keeps both of us busy producing quality products. Yes, I may mess up my words, but as with the blog, I can edit it out or correct myself while filming. I'll often mention my aphasia especially when I mess up too bad. I've coined phrases like "arm pit tight" instead of fingertip tight while canning and "using the tools God gave me" when using my teeth to open or close zipper lock bags. They have been endearing phrases to my two able handed viewers. To my disabled viewers, it's shown them nifty tricks of doing things. If I make a mess, I'll always clean it up while cooking. For pouring things from one big pot into another, I have my lovely assistant to help. I make no excuses and tell no lies. What you see is what you get just like this blog.

Remember...

Nothing is impossible.

Sunday Stroke Survival: Spasticity Treatments and Results

Well, I had my latest round of Botox this week. This time with my new neurologist. He had mentioned in our initial meeting that he may try something different than my old neurologist. After a little discussion, he decided not to be adventurous because my maximum dosage was only 400 mg. Better to hit the spots that work.

I must admit I was a little bit disappointed, but he explained that even though he was basically hitting the same spots, he wasn't my previous neurologist. His technique and depths may be different. You can read what others have done (general areas) and still perform it differently. He did add that he was going to request/argue to get a higher dose of Botox out of my insurance carrier. He'll have a fight on his hands, but as my momma used to say, "never say never." After all, my insurance company also had a steadfast policy against another AFO within three years, and we know how that turned out from my previous blogs.

Although personally, the idea of putting even more of this toxic chemical in my body is not my first choice. But with the relaxation of the spasticity, I improve in function and ability. If another 50 or 100 mg. of Botox will reduce my spasticity enough to improve my elbow flexion, my index finger and thumbs mobility, or even straightens the inversion of my foot where I'm able to take even five steps without my AFO, it's worth it.

I've been doing dry needling for over a year now. In the beginning I was having treatments three times a week (upwards of 100 needle sticks between my arm and leg a session). The effects last 25 minutes to a couple of hours. Speed forward a year and a half, I have needling done once every two months on my leg (often only 3-5 needle sticks) and lasts for almost two months depending on where I'm at between Botox sessions. It's lasting that long and my foot is flat on the floor each step instead of the increased pressure and weighted step towards the outside edge of my foot. (This is what caused all my pressure sores the first two years after my stroke) 

A year and a half ago, my arm was clenched into my chest, the wrist was greater than 90 degrees, and the fingers didn't move. Again, fast forward to present time. Right before my Botox session, My arm rested at 45 to 60 degree angle. A far cry from at almost 180 degree angle it had before a Botox session. Even better, I was 5 degrees off from full extension at the elbow the day before the Botox. The wrist is still stubborn, but mostly because of the wrist contractures. The same goes for my ring and bird fingers, but my thumb, index and pinky fingers can be straightened into a sign language "I love you." I can even hold that position now for about 5 seconds after a good stretching session. I can move my thumb and index fingers together in a pincer form although it takes me a few minutes to do and a whole lot of concentration. I'm pretty well exhausted after doing it twice. The spots that get dry needling now, my steel traps (trapezius) once a month, my bicep twice a month, my pectoral and shoulder blade every four months, my triceps about every three months. My lower bicep, my elbow extenders, lower arm, wrist, and hand now only require WEEKLY visits. (Less than 25 sticks) How's that for progress?

My drugs have been a consistent juggle. Between 40-60 mg of Baclofen a day instead of the 80 mg I was up to. It depends on when my Botox wears off. Most days, it's 40 mg. I tried to drop the dose down to 20mg a day because I felt so good, but my body let me know the extra 20 mg per day. The Zannaflex is down to 8-12 mg per day instead of 16 mg. Again, it depends on how my Botox levels are. Most nights, it's 8 mg because it helps me sleep more comfortably. I eliminate the daytime dose. The Valium, I was on 5-10 mg. I can't even remember when the last time I took it. The really good thing, I was on Cymbalta and Lyrica for my fibromyalgia. Now, it's just Cymbalta. So less drugs and less pain is always a great thing. Better for my body and my pocketbook.

Yeah, it's been a while to reach this point. But like everything about recovering from stroke loss... it takes time. How much time? Who knows, but what else have I got to do? Anyhow...

Nothing is impossible.

Sunday Stroke Survival: The Effacy of Botox and the Autumnal Slump

Tis the season...for Botox semi failure. For two years in a row the autumn series of Botox only has limited effect. In talking to therapists and other stroke survivors who receive autumnal injections, they stated I'm not alone in this. Although there are no studies that document this effect, alas, it appears to be fairly common.

I'm left wondering why this is. Is it weather factors? It is chillier. For us down south it's a damp chilliness. The kind that seeps into your bones. Is the arthritis flares that make us perceive an ineffective results of the shots. It's a possibility. It could also be an age factor affecting the injections. But why only autumn? Why not other times of the year?

All I know is that this Botox series is a bust. The spasticity in my leg and arm have had little response to the Botox. So I can expect no improvement or recovery of the spastic muscles. It means no forward progress and I strongly dislike this. I always strive for progress, don't we all? While my arm no longer draws up into my chest like it did before the dry needling, the wrist is cocked at greater than  90 degrees. The best I've managed to straighten the wrist is 45 degrees. The hand is also in a light fist and the fingers will extend to 45 degrees, but it's a constant battle to fight the spasticity.

I should count my blessing though. While my muscles contort into these extreme positions it is only mildly uncomfortable now because of the dry needling once or twice a week. I do have to admit that skipping two weeks of therapy will cause the spasticity to get progressively worse. Three weeks between sessions my arm will slowly rise and lock into my chest. So dry needling has a hold over affect that is lengthening with treatments like I first read.

My dry needling buddy, who I've talked about before, has almost a two-month carry over effect between sessions now. He is now Botox free. I know I'll get there too. Considering how bad my spasticity is, I'm lucky to have any hold over effect at all. To have a two-week hold over is better than the 1-6 hour carry over that I had in the beginning. There are less and less active trigger points which causes problems which is excellent. For example, my bicep has almost no trigger points to hit so we are now working on the forearm, hand and deltoids. My traps are still a problem but getting better. They are no longer my steel traps, but more like lead (tough but malleable). Considering both of us have been in this study for post stroke spasticity for less than a year, we remain hopeful of ending this cycle permanently. I would honestly consider our response as positive results.

 By narrowing my view of what success is, I can maintain hope. Small strides or baby steps. When I look at the big picture, I could make myself seriously depressed. Small blessings focus has been my saving grace. Each blessing, no matter how small, is a stride forward. So in the autumnal slump of the Botox series the blessing of not being in the agonizing pain of full fledged spasticity is a greater blessing to focus on. Judging by last year, my winter series should have me on the track of positive, forward gains again. Three months to wait isn't long compared to the almost three years of no progress. I can take heart in that.

Nothing is impossible.

Sunday Stroke Survival: Botox Again and the Benefit of a Teamwork Approach

Had my usual round of Botox injections last week. Still at 400CCs of the poison for my spasticity. My hopes of doing away with them entirely with dry needling is still a distant hope. There's just too much high tone in the muscles to do without it totally yet.

In talking with most of the stroke survivors I know, they complain that their neurologists or therapists are useless. Offering little or no help at all. I'm happy to say that I cannot relate to this.

 Part is due to, I believe, is God's blessing and part in my attitude of looking at care/recovery providers as employees. If you have a medical provider that is not on the same page as you are in your recovery, why are you paying them. Yes, even if you are on Medicare or State Assistance, you are still paying them with your tax dollars. Now if you are in a small town, you may not have a choice, but where I am there are four or five of each specialty to choose from. Even if there only two, there is the lesser of two evils in a choice. Keep searching for a health care provider who thinks that it is possible to recover. That's what you really want, isn't it? I know I do.

I've often sung the praises of my neurology and therapy teams here on this blog. They believe like I do that nothing is impossible. They show they care about me and listen to what I have to say. This is important. It's called teamwork. Everyone is on the same page to get Jo to recover as much as possible. So what if my brain is telling the muscles to move in the wrong way. How do we fix it? How do we make it behave like it should? What can each one of us do to have a successful outcome? When I'm with my doctors or therapists (in this case) THIS is what we are talking about. When one of us hears something new, we bounce possibilities around. This is what I expect from my health care team and will accept nothing less, and why should I? Get on the same page or get out. Isn't this the way it should be?

This time around we had a change up. I asked both my therapist and my neurologist if the other could be present at my Botox session. Even though doctors get reports on their patients in therapy, it's not always the same as seeing it. My doctor was curious about dry needling because she hadn't heard of it before I started talking to her about it the beginning of this year. My therapist had never seen EMG driven needles for Botox before. So both were curious.

Shameless plug

My therapist is also supposed to make marketing calls on doctors to boost referrals for his company also. I understand the marketing aspects companies can demand and have often discussed this with my therapists not to mention achievable goals or progress for patients for insurance companies to keep patients on the roster. It pays to think outside the box when dealing with paperwork. It can cause them to pull most caregivers' hair out.

For me, being able to hold and carry things with my affected arm is a positive achieved goal, even though it is still not voluntarily mobile. For me, it's a huge achievement. To have limited control to do that is a giant leap forward and I can do it at will now almost all the time.

So my therapist marked the time of my appointment as a marketing call, but I benefited from it greatly. My therapist was able to discuss what he was doing with me and goals that he'd like to work on in the coming months. My doctor bounced ideas off him in order to hit the right spots with the Botox to make it possible.

While previously the main concentration of spasticity in my arm was in my upper bicep and pectoral muscles, the dynamics have changed with the dry needling. It is now the lower bicep and forearm that is the most spastic. The upper bicep and pectoral muscles have shut down in spastic movement. So guess where most of the injections took place. You got it.

Now, I know I'm extremely fortunate to get the meeting of the minds for my benefit. It all comes from the approach and being able to look at a problem from outside the normal. I make a point of surrounding myself with the outside-the-box thinking folks. Not so far out of left field to be truly strange, just a little avant garde. So who won? All of us. The neurologist learned first hand how to help her patients. The therapist was able to get a new referral source and learned more about patients having Botox. And lastly me, everyone is on the same page as far as goals and procedures for my benefit. It's a team effort.

If your doctor or other medical personnel are not working for you, find ways to work in your benefit. If you can't, replace them. Don't you deserve the best possible outcome? Can I get a "HELL Yeah!"? It may not happen overnight. For me, it took six months worth of schedule juggling to make it happen. But I think it was worth it. All you have to do is ask.

Nothing is impossible.

Thursday's Tumbles and Stumbles: The Lump

I'm happy and relieved to report no tumbles or stumbles in Murpheydom this week. At least nothing major, that is. So now a story...

"Honey, can you come check my back for me? I feel a painful lump back there and it's hard," my beloved asked me this weekend.

He's only has about 10% muscle mass and the rest is just skin over his skeleton. His wrist is less than six inches now. How do I know? The breadth of my left pinky to my thumb tip out stretched is six inches. Well, I can wrap my hand around his wrist and overlap my pinky finger with my thumb.

But I digress...
I walked over to his bed thinking now what? I was mentally running through the would of-could of-should of ignoring my own advice of don't borrow trouble. Don't I already have enough trouble in my life? 

Had he been bitten by some creepy crawly? Had it been after the aide and I changed his clothes the day before? We both do a through skin check on him. Could it have festered into an abscess so quick?

Either way it had to be drained and dressed. Depending on how big it was, I might even have to call the weekend duty nurse for a different antibiotic. Maybe whatever bit him was still in the bed with him? I'd have to catch it and kill it after seeing exactly what it was so I'd know how to treat my hubby.

I unbuttoned his shirt sleeves and his shirt. I'm inching it off him in case whatever bit him was still in his shirt. Nothing. No redness that I could see. "Reach your hand back and show me where it hurts?"
He did and I'm searching all around the area. I'm poking and prodding none to gently looking for a bite or abscess. Nothing! I asked him to point it out again and he did.

Then it dawned on me that the lump that he was feeling was his vertebrae! When I told him he just shook his head in disbelief. So I was borrowing trouble for nothing. I taped abdominal pads up his spine so it formed an upside down "T" from his hips up to try to prevent the bones from breaking through the skin. The added padding also makes him comfortable.

So no creepy crawlies, no abscess just care and comfort issues. I'm in a holding pattern waiting for the 17th when I have my next dry needling. My Botox should be kicking in about then too. So it should be interesting to see what happens.

My arm hasn't drawn up into the usual pinned against my chest position. In fact, it is still resting comfortably on my leg. Yippee! I've had one episode of spasticity this week and it lasted an hour. I've had no reaction to my reduced amount of Botox either. So I've been good. Still no more voluntary movement of my foot either. Shucks! Not that I haven't tried but the muscle tightness is preventing it. So I'm waiting on St Paddy's Day for more miracles. So with the luck of the Irish behind me and faith in the Father holding me up, I'm literally waiting on pins and needles.

How has your week been?