Friday, November 11, 2011

My First Performance Review


If we were considering my Physical Rehabilitation this year as a job, one could say that I had my first Performance Review yesterday. If we were to stick with the “student” theory, then one could say that I had my first exam… AND I PASSED!

My first Team Meeting was held on August 30, 2011. If you recall, the members of that Team were: Dr. Julie (Facility President), Dr. Mark (Vice President and Biofeedback Specialist), Nancy (PT) and my husband. To note, since that meeting, my Team has grown even larger: Lori is my Exercise PT (aka “The Exercise Guru”), Molly is the Office Manager (aka my Insurance Advocate) and occasionally, we bother Leslie (aka the Women’s Health Specialist). I could NOT be blessed with such a responsive and proactive Team!

At the August Meeting, the Team presented me with a list of Six Goals. When they handed me this list, I was mortified. I did not think that I could meet even half of the goals. I was wrong! The following is the list of goals, along with my current progress on those goals (time to celebrate):

1. Stephanie will be consistent with keeping a daily pain log to monitor pain and activities.
Not only was I consistent with the daily pain log, but I kept the pain log that required me to record my activities and pain levels EVERY TWO HOURS for six weeks in a row (not missing one period, let alone day). Through these pain logs, the Team was able to determine which exercises and activities triggered pain in my body and which decreased pain. The pain logs also helped encourage me to continue my Acupuncture Treatment. With the Treatment Plan at the PT Facility and my Treatment Plan at the Acupuncture Facility, my pain levels went from an averaged Level 6 (Distress)/8 (Horrible) to an average Level 4 (Uncomfortable). What does this mean? The pain logs encouraged me by showing me that, with the help of the Plans, my pain has been CUT IN HALF in the past 3 months!




2. Stephanie will be independent in her home exercise program, completing her exercises three times a day.
At first, the word “independent” was the trigger-word for the Team. I was my typical determined, stubborn self. I wanted to do everything that I was doing at the Facility at home; however, The Team wanted to make sure that I exercised under strict supervision. It took about 6 weeks, but after steady Strength-Training Exercises twice each week with Lori, the Team finally agreed to let me exercise at home. Yes, this added a great deal to my at-home schedule. Daily, I walk up to 2 miles (which takes about 40 minutes), and each set of exercises take about 10 minutes (another 20-30 minutes per day). Additionally, 2-3 times each week, I complete a 30 minute (modified) Circuit Training Exercise and on days when I rest from the Circuit Training, I use my neighbor’s Elliptical Machine.

The best thing about expanding the Plan to my home is that I am very motivated to exercise there! These activities make me feel better! They reduce my pain (despite what one would think that they would increase my pain levels) and they stretch out muscles that tighten or spasm from “sitting around” too often. Plus, I have proven myself to The Team that not only WILL I do my exercises at home, but I will go above and beyond to strengthen my very weak body!




3. Stephanie will have a good understanding and show good judgment with pacing activities and have a good activity to rest balance.
I am working on this… I have a much greater understanding as to which activities hurt my body and what I can now do that I once could not. In my last blog, I listed ALL of the activities that I can now do that once were restricted or limited. It has been so wonderful to feel “normal” again – or at least closer to it!

My greatest struggle is that when I feel “good” I push myself. My adrenaline kicks in and I am the Energizer Bunny – I keep going and going and going! I don’t want to stop! The downside is that once I stop, by body starts screaming. However, in the past 3 months, the number of times I “over-do-it” has greatly decreased. The entire Team works on helping me stay on-track when it comes to maintaining an appropriate pace and encouraging me to rest – especially my husband. I still have stern restrictions regarding which activities I can tolerate, how often I can “play” and when I should rest, but when I adhere to such restrictions, my body is rewarded.




4. Stephanie will be independent in her nutrition and have a caloric intake of 2000-2400 calories/day for adequate weight gain of 5lbs.
On August 30, 2011, I weighed a ghastly 94.5 lbs. Since I had first hurt my back, I had lost a total of 30 pounds! At 94.5 pounds, I was dangerously underweight and my Team helped explain to me that if I did not gain weight, (since I have such little body-fat) my body will “eat” the muscle that I have been working so hard to build.

Currently, I am ½ pound from away from my (first) goal weight, weighing in at 99 lbs. According to my nurse, the lowest Ideal Weight for someone of my height and body-frame would be 101 lbs. According to my Physiatrist, the ideal weight for me to get pregnant would be 105lbs-110lbs. While I still have a ways to go, my metabolism is (slowly but surely) finally catching up with my increase in activity and is allowing my body to gain the weight it desperately needs!




5. Stephanie will understand the importance of adequate sleep for a good rehab potential and get at least 8 hours (8-10) of sleep per night.
I have ALWAYS understood the importance of sleep (to the extreme, in fact - ha); however, I was not always able to make it through a night without extreme discomfort. My body was not able to stay in one position for too long without spasms taking over. With the help of my amazing Acupuncturist, Maureen, my body has been able to maintain sustained positions (sitting, standing and lying down) for much longer than ever before!

Even though I require a low-dose of Ambien and a Muscle-Relaxer to make it through the night without waking, my body has finally developed a scheduled sleep pattern. With or without my alarm, I awake on my own after about 8-9 hours of sleep. I rarely wake in the middle of the night due to pain and the increase in my steady, scheduled sleep has helped me be more ready and able to endure the activities of the day!

6. Stephanie will be independent with an exercise program at The Facility that she initially performs before or after therapy, with time increasing as she tolerates and therapist determines.
The Team has teased me the most in regards to my Strength-Training Exercises because, when I finish, I have a very visible endorphin “high!” As stated above, twice each week, I work with Lori for at least 30 minutes prior to my pain-management PT sessions with Nancy. I can now easily complete a difficult Circuit Routine, I can maintain endurance on the Exercise Bike for at least 12 minutes, I am steadily increasing the weight used for exercises and we are now working on ways that I can learn the Equipment so that I can join a “regular” gym and increase the frequency of strength-training exercises that I complete (independently, outside of the facility) each week.

* * *



As I said, I met with Dr. Julie yesterday for the reevaluation. Dr. Julie had me complete four activities, four “bursts” (sets) of each. The activities tested my ability to: lift from below the knees, pull at shoulder-level, push forward (again, at shoulder-level) and push/lift above my head. After calculations, Dr. Julie determined that I was strongest when lifting and weakest when pushing. This type of reevaluation provided The Team with quantifiable data that allows them to not only determine areas of weakness (to target during Treatment), but it also gives The Team measurable data to compare when I complete reevaluations in the future.

As always, after the reevaluation, Dr. Julie and I had a consult. She told me that she was “thrilled” with the results and “very impressed” with the incredible progress that I have made on The Plan in less than three months!

After such a wonderful reevaluation, Dr. Julia and I talked about “what the future holds…” Last month, Lori and Nancy braced me with the hypothesis that I will likely not be able to return to work full-time in August; however they felt confident stating that I would be able to maintain a part-time job. After talking to Dr. Julie, and her review of the reevaluation results and progress that I’ve made since the last Team Meeting, Dr. Julie said that there is a strong possibility that I CAN tolerate and sustain a full-time job. However, Dr. Julie fears that my role as a Special Education Teacher may be too difficult for me to withstand given my physical limitations and the severe increase in expectations and requirements that a Special Education Teacher faces on a daily basis.

To explain, Special Education is not “what it used to be.” My role as a Resource Teacher in a Public School has changed greatly in the last five years (even more). A Resource Teacher was once known as a Case Manager/Teacher for students with minimal disabilities. Now, the school system is moving more towards inclusion and less towards dividing the students with disabilities based on needs and support. In terms of inclusion, this is amazing! In terms of creating learning environments that are beneficial for all students, my personal opinion is that, while there are great benefits to including students who have severe disabilities in a general education environment, I have found (in my own personal experience) that students who require a substantial amount of Special Education services would best have THEIR educational and emotional needs met in an environment designed specifically for those individual needs. That environment is not always in the Resource Room or the General Education setting. (Again – this is just my personal opinion based on my total 9 years of experience in the educational setting.)

How does this affect me? Dr. Julie feels that, due to the increase in demands in the world of Special Education, I would NOT be able to meet all of the needs and job requirements as a Resource Teacher. Granted, I still have NINE MONTHS of recovery so completely ruling-out returning to my job a Special Education Teacher is very pre-mature for now. Nancy, my case manager and confidant, assured me that it is WAY too soon to start thinking about what I will or will not be able to do as a career woman almost one year from now. She also is a believer, and encouraged me to continue to pray – pray over my body, pray over my recovery, pray over my role as a wife, pray over my future children (and ability to have them) and pray as to where God will lead me in terms of my career and future.




I may not know what the future holds, but I believe that it is bright. The entire Team is amazed at the tremendous amount of progress that I have made in less than THREE months. Can you imagine what NINE more months has in store for me? Please continue to pray that this is just the beginning of the miracle God is working in me! I know that he has not forgotten me! I know that God has not left my side; He is at every appointment, in every pill and speaks to me through every person in my life who supports and encourages my healing!

Friday, November 4, 2011

Your Prayers Worked!


Matthew 7:7 (NIV)
7 “Ask and it will be given to you; seek and you will find; knock and the door will be opened to you. 8 For everyone who asks receives; the one who seeks finds; and to the one who knocks, the door will be opened.

I do not know how to thank you for all of your prayers... God heard them! Within 48 hours of writing my blog and asking for your prayers, I got a call from the Insurance Department. I was told that I received authorization for an extension for Physical Therapy appointments. I get 20 ADDITIONAL appointments to cover the months of November through the end of December. Starting January, I also have 60 PT visits to use during the next fiscal year.

I have been told by my medical team that this truly IS a MIRACLE! Your prayers were not in vain, friends. I promise to continue to work hard on my recovery and to continue to be the example of God's healing on earth!

Thank you for believing with me!