Thursday, April 2, 2009
I got my taxes filed today. Took advantage of the fee tax help the AARP offers to disabled persons. I feel so relieved! Thank you AARP and your volunteers for providing such a great service!!!
If you want to find out if there's an AARP tax aid office near you check this link
Thursday, March 19, 2009
Are you ready??
This examination of the most important months of tests and chest syndrome exit at all.
1. Processor sets the pulse in the wrist and keep his hand in the same place, and then asked the patient to wear head to the same point of a member which is conducting the examination.
2. After that request from the patient that is the head of the wizard behind his shoulder while taking in a roundabout lateral or brutal (Lateral Rotation).
3. Processor requests from the patient to take a long breath and keeps it.
Be testing positive: When the pulse disappears entirely, this clearly noted in this examination.
Overall, I can see the gist of what they are explaining. But I don't know what I'd do if my Doctor or Processor ever asked me to make the wizard head position :P
Once again I want to say that Adson's and Tinel's tests are unfakeable because, if done correctly and you really have an impingement , you will lose your pulse. I think a good examination will conduct these tests. However I am super surprised that the Disability Determination Exams I have gone to for Medi-Cal and also for Social Security Disability did not include these tests.
And any good examiner will do them. However they can still be botched if the examiner doesn't know how to find the pulse.
p.s. do check out the link for the Arabic site because the images of the specific tests are the best I've run across. Even Wikipedia doesn't have pictures for the tests!
Thursday, January 15, 2009
Here's what I've had delivered w/ their web addresses in order: best to worst of what I deem most useful to people with RSIs.
1.Support Plus Pretty awesome www.supportplus.com
2.Dynamic Living Also great www.dynamic-living.com
3.Office Ergonomics Computer help www.ergobilities.com
4.Functional Solutions Pretty much covers all physical limitations, as in: something for everyone www.beabletodo.com
5.Sammons Preston ENRICHMENTS much like Functional Solutions above www.sammonspreston.com
6.Easier Living Good for rollator walkers/ carts and some ergo-utensils www.easierliving.com
7.AbleWare Really for people with mobility challenges. But a couple of ergo-utensils
Tuesday, December 30, 2008
Did you know that if you don't have an attorney, they have a free service called the Information & Assistance Unit that has officers on hand to answer your questions pertaining to the legalities of the WC system? There are 24 offices in California and the link to those phone numbers are here.
I've posted about this before but I recently talked to another injured Californian that did not know about this FREE service. I have used it on several occasions by going to a Workshop, calling for help and even going down in person to have specific questions answered. I would advise you to have specific questions written down before talking with an officer an keep them limited to WC issues only. That's their area of expertise- not Social Security or Long Term Disability.
California Division of Workers' Compensation:
http://www.dir.ca.gov/ and Info & Assistance
Another thing to try is contacting a lawyer with your questions, you might get a response. It a total long shot but it could work even if this lawyer knows he or she won't take the case, they could take the time to answer a question or two..... Just don't hold your breath!!
Sunday, December 28, 2008
My MRI of the cervical spine reveals disc bulges at:
| C4-5 (1-2mm no significant central spinal stenosis), |
C5-6 (2-3mm left paracentral disk bulge & mild facet hypertrophy causing mild foraminal narrowing on the left, &
C6-7 (3-4mm right paracentral disk protrusion, which indented the thecal sac.)
There was mild uncovertebral & facet hypertrophy. Findings cause moderate lateral recess stenosis & narrowing bilaterally and a moderate to severe central spine stenosis.
Options for care- Cervical epidural steroid injections
Questions I have to find answers to:
- Can disc degeneration be reversed or just slowed down?
- What does an cervical epidural steroid shot do?
- How much does that hurt???!
- Can an MRI definately prove that this was a pre-existing condition rather than a secondary injury of Thoracic Outlet?
- And for extra credit: What the heck does the above diagnosis say in layman's terms
Monday, December 8, 2008
"The Shoulder Fallacy
Everybody has been ordered to "Put your shoulders back" by a mother, teacher, or drill Sergent. And how do we comply? We push our shoulders back with all our might. This position is sustainable for the moment it takes to march out of sight of the authority figure.Once we are alone again, we release our shoulders to their habitually rounded position and slink away. What a tragedy! No one wants bad posture, but the idea of maintaining that uncomfortable "shoulders back" position is unrealistic and fat from pleasant." ....
Although adopting correct posture habits takes time...... The first ironclad rule may seem strange, but here it is: Forget about putting your shoulders back."
Here Tim gets into what shoulders should be doing instead of going back- however its my feeling that people with serious nerve and tendon issues that stem from their shoulder girdle should not be pulling shoulders down and opening up the collarbone. The tension that is carried there may not want to be fussed with so soon and a flare up could be inevitable. So, I'm skipping it. Sorry Tim!!
Imagine a model skeleton hanging in a very chic laboratory. The skeleton is held together by wires and a pole that travels form its base, through the cavity between the pelvic bones, along the spine, and up into the skull. Try standing in front of a mirror and imagining yourself suspended in the same manner. Yes, it seems a bit macabre, but a helpful exercise nonetheless. Does your pole travel gracefully up into your skull? Or does it pole out of your neck because head juts forward? Is the pole knocking into the back of your pelvis because you stand with your stomach thrust out? Is the pole too long because you allow your ribs to sag into your diaphragm, shortening your torso? The best way to make sure that your skeleton is giving its all is by remembering that just as in clothing, the line is what is important. Nothing on your model skeleton is crunched together or sticking out at the side. The skeleton looks relaxed, ready to samba or hit a tennis ball.
The body is engineered to function n the most efficient manner possible. That means that aches and pains can be avoided if the skeleton is given plenty of room to work. It also means a youthful , attractive silhouette really should have little to do with age. For some reason, many American women insist on foreshortening themselves by allowing their ribs to sink into their pelvis, and their heads to hang forward heavily. ... How does one go about getting things to line up? By starting with the pelvis.
One of the most helpful pieces of advice on the subject comes from a wonderful book called Your Carriage Madam by Janet Lane. Though published in 1934, it is not in the least bit dated, perhaps because the temptation to slump is eternal. Ms. Lane suggests that in order to bring the pelvis into proper alignment, one should imagine slipping between two tables at a crowded restaurant . Instinctively, one tucks one's bottom under and draws the navel to the sine. This is the proper position for one's pelvis. Since French bistros are usually packed and their tables are only inches apart, one can think of the proper pelvic alignment as the 'bistro position'. If one is familiar with pilates, it is also immediately recognized as the 'scooped' position that is the backbone of that fitness method. This ever-so-slight pelvic tilt keeps the bottom from jutting out and flattens the stomach. Not only does it make one look slimmer and taller, it provides support for the lower back. The change it makes to one's seated posture is tremendous. Next time you are seated at a desk, try slipping into bistro posture. It naturally bring the spine into contact with the chair and makes it far easier to pull those shoulders down. All this means less fatigue..."
Monday, November 10, 2008
GO 2.4 Optical Air Mouse and Compact Keyboard Suite The small keyboard is good for me because I was leaning to use the left side of the full keyboard AND it frees up the space where the number pad was so I can keep the mouse closer, making it more ergonomic. (UCLA has a great site devoted to ergonomics.) The mouse can be used on the table, in the air, or my favorite- on my leg. I haven't practiced enough with it in the air...
I also picked up some gloves at walgreen's post-halloween. They're painted to look like Mummy hands and have grip rubber on it so I'm wearing them backwards for better typing. They are working out great!! Warm hands that can still work thru gloves are A+ in my book.
here's what it all looks like:
Tuesday, October 28, 2008
In the days since my MRI I have talked to several TOS sufferers and they have all told me unless I was making a football goal with my arms in the imaging process, the compression would not show.
I just found out I wasn't being imaged to rule out TOS, they were looking for abnormalities other than compression in the thoracic outlet. And I would have had to been injected with dye and in a tube MRI machine for that kind of imaging.
My doctor said the film was poor to average image quality and that the place I went to was known for it. What was found in the film I had was disc bulges @ C4-5 (1-2mm) & C5-6, C6-7 levels (both 2-3mm). My doctor and I talked about neck traction as a solution as surgery does not seem to be needed.
Also- I have no idea what the WC Doc will interpret this as My treating doctor did say that because the MRI was done so late in the game it would be impossible to say if this was a precursor to the injury just as much as it would be a secondary injury. So quite possibly it won't help or hurt my case.
Thursday, October 23, 2008
I can't say I felt confident at any point of my experience in the office where I had my MRI. They were disorganized, couldn't get my name right (I was always Last name first, First name last), and the office felt weird to me. All things combined didn't put me at ease and I believe that is half of what makes a medical appointment a good one. (The other half= doing the job right i.e. diagnosis and treatment)
I know its vague to say the office didn't feel right to me but they had pergo flooring down and it was really warpy. Like it had been laid down on top of a carpet that hadn't been cleared of children's toys or something. And there was an optical peacockesque light in the lobby. You know the ones that you begged your parents to but you when you went to Spencer's at the mall? Bizarre.
Question: How was the MRI experience and how did it come out?
Answer: Just fine :)
The woman who conducted the MRI was very sweet and prepared me (as it was my first time). I wasn't scared to begin with but her pep talk seemed genuine and she boosted my comfort level. I was given a panic button to squeeze If I had a freak out moment during the process. *Sidenote- I thought MRIs were in tubes but this wasn't. I was getting a cervical spine image and was on a table underneath a huge Star Trek Enterprise shaped magnet (?) from my waist up. It was probably 4" from my face and I believe I wasn't closed in on the sides. The sounds they make are enough to make me believe in sound torture as real method of making people lose their mind though :P * I was hearing sounds that weren't there. My mind was being rattled for sure.
After the MRI, I got the images while I acclimated to the world. I was surprised the were ready so fast and that I was the one to handle them. (A doctor referred me there so I thought they'd be sent to him, especially since I have no appointments w/ him on the horizon.) Again, this was my first MRI so I don't know much- but I thought the images looked good.
In the days since my MRI I have talked to several TOS sufferers and they have all told me unless I was making a football goal with my arms in the imaging process, the compression would not show. I just confirmed this sentiment on emedicine.com
The need to study the patient in different positions (eg, in abduction or in adduction) is important for the physician performing the MR imaging study because a simple image obtained in the anatomic position may obscure unprovoked vascular compression.
*I believe in sound torture now...
I also felt like this guy I saw in the BBC series "Spaced" who begins to hear a song within the sounds of everyday life. Coincidentally, I saw this episode the night before I had the MRI and I was stifling laughter for most of my procedure.. I wanted to embed the clip here but it's no longer allowed by YouTube. But if you want a laugh please check it out here !
Wednesday, October 22, 2008
My professor is concerned for me to be sure though and that is nice!! She is constantly on the move in the gym space we do our Feldenkrais work in and she stops and makes adjustments on what I am doing or just asks if I'm ok. I think I am beginning to become more aware of my body and understanding that there is more than one way to move my body to get something accomplished.
However, this week was a discouraging one. I had to take a tramadol during class But the professor came over and did some Functional Integration work with me. She worked on my upper back, scalenes, collarbone and ribs.
| from WikipediaFunctional integration |
In a Functional Integration lesson, the practitioner uses his hands to guide the movement of the student, in sitting, lying or standing. All of the movements are expanded from the habitual patterns of the student. This allows the student to feel safe, and gives the student the opportunity to observe the movement in detail. Through precision of touch and movement, the student learns how to eliminate excess effort and thus move more freely and easily. Lessons may be very specific in addressing particular issues brought by the student, or can be more global in scope.
After this session of one on one my cloud was lifted and I tried to participate in class again. I would not say I physically felt "better" but it was certainly nice for my problem areas to move without me causing added stress (if that makes sense). One on one Functional Integration is something I would like to do more of. Unfortunately for me, its not the focus of this class and like all bodywork, its costly.. .
Sunday, October 5, 2008
So far I can tell you that it is guided sensory awareness with slow movement. To an outsider, it probably looks like a bizarre adult nap time since its a gymnasium full of us on mats (and many with blankets too!). I saw it as a challenge the first day and pushed myself to the limit. (I gotta learn to accept my limitations... its just so hard) I actually started having a neck spasm while on the mat. But the professor, who is trained in Feldenkrais and has been instructing since 1994, came over to me and gave me a modification and I was able to continue
Here are the Guidelines for success and comfort in Feldenkrais Awareness Through Movement given to me in class:
"Take it easy do each movement w/ as little effort as possible.
Take it slow- So you can pay attention to what you feel inside.
Do each movement completely- then take a short break before you begin again.
Relax- and let go of unnecessary tension in all parts of yourself.
It's ok to stop & rest- and do nothing whenever you wish.
If you feel any pain or discomfort- do less, move slower or smaller, go extra easy, or IMAGINE yourself doing the movement. Imagining the movement can be just as effective as physically doing it.
In Feldenkrais, Less = More."
To be continued......
Wednesday, September 24, 2008
The traction device is simply a longish hand towel, a theraband, tape and rope. First you get someone to help you loop the hand towel from the base of your neck to the top of your head- almost like a unicorn :P. Tie the towel into place up there then tape around the tie just to make sure its secure. Next, connect the theraband to the towel loop so you have a chain. Then, do the same with a rope, connecting it to the theraband.
How it all comes together:
The rope end goes on a door handle. Put your head in the towel end, with it around the base of your neck and the tied end close to your forehead/ hairline (think unicorn haha) then you sit down close to the door and slowly lay down. Scootching away from the door on your back until the chain gets taut and you begin to feel a pull through your neck. \
You can move away as much as you want. Also if your arms are too sensitive to fall to your sides, you can use a belt to loosely bind them in a folded arm, yet relaxed position across your belly. I listen to Jack Kornfield's Meditation for Beginners Disc 1 because it talks about pain a little bit.
The pull for me is such a relief. I feel my neck elongate and the feeling of compression goes away. My PT said its ok to do this for as long as you want too! I swear it is the best active thing I've done for discomfort throughout my TOS/ RSI experience and I recommend it wholeheartedly
how the loops of rope, theraband, and towel look all tied together
how you put your head in the towel loop (I know.. you're not a bunny..!)
Thursday, May 22, 2008
I suggest going thru the entire page, there are some valuable Suggestions and important Warnings. I've been putting a glass of water in the microwave with the rice sock when heating it to prevent fires and add a bit of moisture to the heating process. My screaming tendonitis pain is now more of a chattering pain with the help from my socks.
Even if you need help to make the sock, let your helper know that you don't need mad sewing skills or more than 5 minutes to make it.
Also, I suggest a sock that doesn't have a bend in the heel, that way the sock can lay flatter. .. I finally put that pair of toe-socks to work...
Tuesday, May 13, 2008
IF YOU ARE HURT ON THE JOB:
__Tell a supervisor immediately.
__Get the full names of everyone who witnessed the accident.
__Write up an accident report.
__Follow employer's request (go to employer's doctor, follow rx orders).
__If you feel that you are not being treated fairly, call the DWC.
MAKE A FOLDER TO HOLD ALL OF YOUR EMPLOYER'S INFORMATION, MEDICAL RECORDS, WORKERS' COMP CORRESPONDENCE AND ALL OTHER PERTINENT INFORMATION TO YOUR CLAIM !!!
__All medical screening and job classification tests
__Any awards, write-ups or employee warnings
__A calendar of vacation days, tardy and sick days
__A copy of all memos and correspondence that pertain to you and your job.
__DO NOT write on any of your documents; keep a notebook, or journal, with date, time, names, companies or doctors, nurses etc.
__Trust No One--get it in writing!
__Get a copy of anything that you have been asked to sign.
__Get a copy of any papers from doctor visits or doctor's report.
__If you do not understand what has been written, ask someone to explain the information to you.
__If the doctor's reports do not match what you have been told, you may need to secretly record each doctor visit.
California Division of Workers' Compensation:
__If you do not have an attorney, they have a free service called the Information & Assistance Unit that has officers on hand to answer your questions pertaining to the legalities of the WC system. (link to those phone numbers here)
__They cannot help you once you retain a lawyer.
__Unlike other courts, it can take three months to remove your attorney from your case if you are not satisfied with the service.
__Keep a record of everyone you speak with, the time, date, and the reason for the call.
__Fight for your rights to be heard.
Thursday, May 8, 2008
1. Bilateral upper extremity RSI.
2. Mild median ulnar neuritis.
3. Rule out TOS.
This seemed to have rubbed the examiner the wrong way. He said, "So what's you're disability?..What is RSI?" When I told him: Repetitive Strain Injuries, and then he met my bewildered look with one of his own.
"Repetitive Strain Injury isn't a medical term. That's a cause. Your doctor's notes give me no medical diagnosis of your actual disability."
Let, me back up just a tad, when I got into his office, he had no idea who I was b/c he didn't have my files at first. Once he got them, it was obvious this was the first time he had looked at them. So he took all of 3 minutes to review/ skim and then launched into a hurried interview. I was still shaken about the lack of proof he had that I have a diagnosis and I feel I didn't answer his questions really well. The actual "examination" felt las routine as a ride operator's schpeel at a theme park. It was standard health stuff like heart rate, b.p., reflexes- but nothing really intensive with the arms. He did not do anything that would be irrefutable in support of a tendon realated injury. Adson's and Tinel's tests are unfakeable. He didn't do anything that I had done at my QME that involved precise, recorded measurement. When he did palpation, it seemed like it was too light and brief for anything to be determined. There were other things he had me do that seemed to be tests to rule out other additional disabilities. And at the end he wanted me to do windmills which I didn't do entirely.
All in all, it was a rotten exam. I feet like my doctor has let me down a bit and its going to affect me on this state disability determination ruling.
Monday, March 17, 2008
For the benefit of any others that may have an arm RSI and have to do a FCE here's a list of the things I did. Almost all of my tasks were administered and monitored by a high tech Occupational Therapy program. First, I verbally gave my work, injury, daily routine, and what-I-do-for-fun histories then this is what I did:
1. strapped a wireless pulse monitor on and took blood pressure
2. Treadmill- power walking! 10 minutes
3-5. Hand Dynamometer for hand strength:
- left then right hand (5 sec each time??), alternating hands 6x for each of all six grip positions
- left to right rapidly 6x for only one position
- left to right (5 sec each time??) 6x, same position
- key pinch position. alternating right then left hand for 5seconds each 6x
- index finger to thumb pinch position. same as before
- index finger & middle finger to thumb pinch position. same as before
10. Push with all my force one time for 5 seconds
11. Pull ...... one time, 5 seconds.
12. Weighted milk crate (not sure how much it weighed but I would guess 5 lbs) pick it up from a waist level platform and put it on another platform at shoulder height, then back again. 4 times. Repeat after 4x but with a weight added. (couldn't do it myself- if you can, they will keep adding weights til you can't)
13.Weighted milk crate- pick it up from the floor to the waist level platform, then back down. 4 times. Same deal after 4x, with weights. (More added if you can handle it.)
14. Weighted milk crate- pick up from the floor to shoulder level platform 4x. (Then weights added.)
+++++++++ no more exercises using the sensor equipment +++++++++++++
15. Pick weighted crate up from waist level platform and carry it 10 feet away, turn around, out it back down. Repeat 5x.
16. Stand, stoop & kneel + motor skills: moving 6 rows of 2 pegs at a time from a peg board wall starting at the floor- knee height to coordinating slots at knee height to chest height. Repeat 7x. This was timed.
17. 2 step stairs up and down. 24x. timed.
18. Crawl on hands and knees for a minute. (really)
19-22. Fine motor peg board:
- right hand: pick up pegs from dish and put as many in the peg board w/ right hand in 15 seconds (?)
- left hand: same
- both hands: same task at the same time for 15 seconds
- use both hands to assemble as many peg, washer, grommet & washer formations in 15 seconds
24. Took blood pressure.
Friday, February 8, 2008
Turns out, if you have enrolled in your employer's benefit package prior to your injury, the ins and outs of your work benefits can provide some interesting plot twists in your WC saga. I recommend going through your entire benefit brochure. Don't have one? Request one or go online (- it would be online if you have the option of managing your benefits online). The things that affected me in my time out of work due to injury in terms of my benefits I paid for are:
1. Losing Medical, Prescription Plan, Dental, Vision benefits due to reduction in PAID HOURS.
2. Short term disability and 3. Long term disability which are benefits that most often is paid for through some benefit plan at work.. Part of that automatic deduction from your check every week if you are enrolled in these particular benefits. It helps you out if you become disabled either randomly or from a work related injury.They provide income that you are not receiving normally- however they have limits, and in some cases, won't provide the same dollar amount income as one had before the disability. *IMPORTANT* To receive STD benefits, you — or someone acting on your behalf — must file a claim.
*other points of interest are enrollment, average weekly earnings, paying for these benefits out of pocket while on disability (aka missed payroll deductions) , pre-existing and recurrent disabilities
1. yikes! I didn't know that
2. Short term disability (STD) covered me for the first 26 weeks of my injury. And at which time I had no idea it existed. I am just now understanding that STD and LTD are thing that I have already paid for and I'm figuring out now how they have or have not helped me. With STD, I'm still like HUH?. I'm not sure if I was supposed to receive $ from this plan. I didn't get any... thinking it was because I earned "too much" from WC. There are several sources of potential income while you are out, but they seems to cancel each other out, and the lowest amount is the winner as your main source of income :D
3. Long Term Disability (LTD) has just kicked in although my STD period ended 7 months ago... I guess this normal?? I will admit I was slow to provide them info they needed. My doctors and WC adjustor were slow too. Also. Now that I am PS and WC has ended LTD seems to be my only income now. There are steps I am taking to increase my benefit $ amount right now. It involves lots of forms and reading both fine print AND in between the lines Whereas Another service mine provides is Vocational Retraining $... This week I have a Functional Capacity Evaluation (FCE)- this is the LTD's in house doctor review- to see if I can work at for the same company in any position. I think. HUH? I want to stop here though, because I am still learning about this system.
I will fill in the holes on the questions I have as I get them answered
I decided to watch Eraserhead after my PT visit in which I got the bandaid put on just to surround myself with something more surreal than this fix. Now I am in in the mindset that ridiculous things are only a big a deal as we make them.
Actual solution? Could be.
The bandaid is there as a booby trap, if you will, for when I am studying or on the computer to NOT strain my neck. When I feel the tension on my skin from the bandaid, I know that I am not using my eyes to look down. ¡With symptoms of TOS, using your neck to do look down a lot agitates the ulnar nerve!
I will give it a try for a few days.
Friday, February 1, 2008
My current status is that I am receiving PT right now that treats Thoracic Outlet Syndrome (TOS) by way of something called the Peter Edgelow Protocol. Sounds funny don't it?? :P I promise to share all of my exercises that comprise the "protocol" later. All it means is a particular way of treating pain due to TOS... The equipment that is needed costs about $300 and the claims adjustor has been avoiding all requests to get it approved, combine that with the need for UR and I could be waiting about another 3 weeks before its ok-ed OR denied.
The problem is there are a chain of events pending>> I need to have this equipment in order for me to get the most out of the PT, otherwise, its just neat knowledge and arms the same as they ever was. I have only 2 visits left of PT for this injury. period. And the biggie= once I am done with this PT then my doctor is closing the case and I will become Permanent & Stationary (PS)/ Maximum Medical Improvement (MMI) [both mean the injured has plateaued and not expected to get any worse or better in the next year]. So you see, I need the PT equipment in order to close the case.
What I can do and what I probably will end up doing is paying for this stuff myself (with all my loads and loads of extra money I'm raking in from WC. HA!!....I can forgo food again this month it looks like). If UR deems this equipment necessary for my recovery they will reimburse me. That is the law- its not like, if they find out you are willing to pay for it, they deny the request and you have to foot the bill... although I don't think I am going to call up my adjustor and ask him if its ok for me to pay now & he can get me back later. I am going to stay mum about it and just cross my fingers that it gets approved and I get $300 back!! Also, it turns out I don't have to buy the whole thing and that might shave off some of the cost.
If you get a chance, go check out the link to Egdelow's site and look at the equipment... I challenge you to define thumbometer.
UPDATE:: I got a call ON the very day that I was going to plunk down my own money for the equipment... It was approved!! That was 4 days ago and now I have the kit! Yay!!
How this is gonna work:
I am not going to backtrack and go chronological with my experience. I would stay injured if I were to type that all out and besides, I am not into reliving all of it and, in turn, wallowing.
Instead I am going to cover things:
I wish I had known ahead of time= Mistakes
I have learned along the way= Hints
I still have questions about= Huh?
(more to come?)
I hope I am writing this blog as a resource. And I wish that people will comment, ask and answer questions here. I will be so happy if this happens. You know, I have a ridiculous amount of experience and knowledge about RSIs and the WC system in California now and it would be silly for me to not share it.