... and 5, 6, 7, 8

You know you're a dancer when... you are trying to time something entirely unrelated to dance and find yourself counting in sets of 8.
I've actually missed a lot of class, lately. I had oral surgery again last week, and I have discovered that stitches don't go well with raising my heart rate (THROB THROB THROB). Before that, though, I simply flaked out on pointe class for a few weeks because I was feeling leftover hormonal stuff (mainly fist-shaking rage). I think I am going to try technique class tonight (probably not pointe, simply because I can't eat well enough to get my energy levels up that high right now) if for no other reason than to unload the car load full of tutus that are clogging up every square inch of floor space in my sewing room. This latest batch was gone through while I was feeling particularly nasty, so I'm afraid I was pretty ruthless about throwing things away.
Honestly? I'd kind of like to blow off class, tonight. On the other hand... yesterday was stressful and upsetting so maybe the ballet "therapy" is exactly what I need. Besides, the inactivity of the past week has made my knees seize up something terrible.

Hummingbird Ballet

Our resident (and very vocal/cranky) Anna's hummingbird, Mr. Smalls, warms up at the barre:

I missed class last night because my knees swelled up in a rather disturbingly grapefuit-like manner. I am guessing that this was not the result the PT was aiming for.
So I spent a few moments on my own in the backyard after work today (it's cloudy, breezy, and cool, which is a miracle of no small measure in August in central CA) attempting to be graceful and balletic. Wearing street shoes is a bit of a hindrance, though.

FYI

Okay, just for the record? That knee cap stretching business this morning has equaled an unparalleled  amount of pain this evening. I think if I saw my PT right now I would kick him in the shins just to even the score.
 Or the sack, because this shit hurts.

Pretty Annoying Week

This past week or so has been really off the charts, pain-wise. I would like to blame it on the CLAM and the other stupid exercises I am supposed to be doing, but in all honesty I haven't been doing it as often as I am supposed to. Still, though, we are talking more knee pain in the past week than in the past several months. I went to class, anyway.  It adds another awful dimension to the deep hatred I have developed of assemblé.
Oh assemblé, I hate you so.

In other news I would like to share this bit of wisdom with you:
Never, after applying icy-hot/bengay/etc, no matter how much of a rush you are in to get to class, forget to wash your hands before using the bathroom.
Just... don't.
Trust me. 

DIY knee ice packs

Since I have been instructed to ice my knees five times a day I have to keep masses of ice packs in my freezer. I also needed some to take to work with me, and here is how I made them. They have little velcro straps to hold them on my knees (or ankles or whatever) and polar fleece covers, but you don't have to do all that fancy stuff if you don't want. Pardon my photos, they suck and they know it.

What you need:
-water (duh)
-rubbing alcohol
-gallon-size freezer bags with zippy tops (2) make sure they don't have those slider things on them, and are just plain zippy bags.
-food color (optional)

If you are using food coloring (I like it so that it's easy to tell what is in the bags) put two drops in one of the zippy bags. Then pour in your water and alcohol. The standard ratio is three parts water to 1 part alcohol, but I find that to be too squishy and liquidy for my taste. The more alcohol you use the squishier it will be. For this one I used 3/4 cup alcohol and 3 1/4 cups of water. Adjust to your own preference (you just want four cups total of liquid when you are done)

Squeeze out as much of the air as you can and zip the baggy closed. I like to write on the bag with a sharpie so I know exactly how much of each ingredient I put in the bag, for future reference.

Fold the bag in half. You can put some tape on the edges to hold it together if you want to be fancy about it.

Then stick the whole deal inside the second zippy bag and fold (and tape, if you want) that one as well.

Pop it in the freezer overnight and ba-da-bing-ba-da-boom, you are done. POW! Ice pack. You can use it just like this, if you want, just put a towel between the pack and your skin. 

Now, me, I have to haul these puppies to work with me. And use them during the day. I find it nearly impossible to be given free-reign to lay on the floor with ice packs on my knees for an hour a day. So I like to strap the ice packs on with ace bandages. It helps get them in closer contact with my knees, anyway. But ace bandages take up lots of room in my purse, and lots of time when I would rather be doing my job and/or eating my lunch. So I made these little pouches for them. Also, it means you don't need a towel. 

What you need:

-polarfleece fabric, about half a yard (I used this because the thickness is right, it won't unravel in the wash, and it is stretchy)

-18 inches of sew-on velcro (hook side and loop side)

-thread

Okay. Cut  a piece of polarfleece about 13 1/2" square, and another about 4" X  25")

Cut your velcro in to 6"strips and pin all of the scratchy (hook) side on one end of the long strap piece. Pin all of the soft (loop) pieces on the opposite end of the strap. Before you sew it down wrap it around your leg to make sure it's all in the right spot.

                                    

Then sew the velcro down.

If you want to serge the edges go ahead and do it now. Polarfleece won't unravel too badly, so you can skip this step. I serged mine just for the heck of it. Serge all the way around the strap and down one side of the square.

Then arrange your strap on top of your square, about two inches down from the top edge (parallel to BOTH unserged edges). I put the scratchy side of the velcro facing UP so that it wouldn't be likely to scratch me when I use it later.

Then stitch through both layers in the center of the strap. I went in a sort of zig-zaggy pattern on this one, but you can just sew a square or a few lines, it doesn't matter.

 Okay, you are almost done! Fold the square in half.

Fold up the end of the straps to get them out of the way.

Now stitch together the unserged edges, 1/2 inch from the edge. Leave one end open so you can put the ice pack in later. I just stuck it through my serger so it trimmed off all the extra.

There! It's done! Now you can slip the ice pack in through the open end and pop this baby in the freezer. Did and DONE.

first physical therapy appointment for my knees

So the PT came in, poked at me, and made me lay in various positions while bending, lifting, and otherwise manipulating my legs. Then he left the room and came back with a life-size plastic model of the structure of a healthy knee and pointed to a join between the unnaturally blue tendony thing and the plastic bone. "This is the problem" he said "you see this thing? It's right in the middle of the leg bone? Well, on you it's not there, it's all the way over here" and he poked the little bump under my knee. " So, when you bend your knee the tendon isn't moving through this groove above the kneecap, but is grinding against the edge of the bone. So, it's already real susceptible to inflammation. And right now you have a LOT of inflammation going on in here."
And there is that word again.
So, the verdict is that I am put together all wrong (tell me something I don't know!) so when you add in a ton of inflammation you get a ton of pain. He gave me these day-glo rubber tube things and instructed me to do an exercise called "the clam" (No. Really. They thought that was a good name for it). And to ice my knees "aggressively" which means five times a day, both sides. And then we'll see how things are in another month. The thing in my knee that forms a little lump that clunks around when I squish it is the muscle supporting the inner edge of my knee cap going in to "emergency spasms" (or some damn thing) in an effort to deal with the effects of my shitty skeletal structure combined with my shitty auto-immune thing. Well, that explains that, anyway.
While I would dearly love to address the root cause of all this pain, the inflammation, there is very little that Kaiser can do for me besides give me anti-inflammatory drugs. But, hey, at least I *can* take them and haven't had any serious troubles from them yet. I bleed like a stuck pig when I poke myself in the finger at work (constantly) but otherwise I am not experiencing trouble. And it keeps me, at least for now, from having to try disease modifying drugs like TNF inhibitors (which my sister uses because YAY this is genetic and she can't take the anti-inflammatory drugs, but you have to give yourself injections and I am pretty sure that would make me throw up)

The good news is that the PT was very impressed with how strong and flexible my legs are, which is all thanks to ballet. When I was first starting in September my legs positively shuddered during pliés. After my first class my teacher spent quite a while with me, sitting on the floor showing me exercises I could use to strengthen my janky thigh muscles to protect my tricky knees. Aside from enjoying dancing I feel better when I think I am doing something positive for myself, being proactive and taking command of my own body. Also, considering I wouldn't have quit anyway even if he'd told me I was just doing myself more damage... I am glad to hear that that is NOT the case.

Big Week

Last week felt like a big week for me.
Thursday I had my long-awaited and much-anticipated appointment with my doctor. I explained what the situation was with my knees and while the whole thing is basically tied in to the rheumatism (everything is tied in to the rheumatism, including the stupid little skin rash I have developed) he thinks it looks like something called Patello-Femoral Syndrome (PFS). It basically means that I have to keep taking anti-inflammatory drugs (which I couldn't get through a day without, anyway) and start going back to a physical therapist to try to get my leg muscles even stronger to stabilize the connective tissues in my knees. I always forget why I like my doctor, so a visit every year is important just so I don't go on a rampage and kill everyone at Kaiser. My doctor has a very good bedside manner (and if you know Kaiser then you know how rare that can be) and is always willing to take longer than the allotted ten minutes to talk to me. He might not always hit the nail on the head, but at this point I think he's the best I am going to do while using this HMO. We looked at my x-rays (from way back in November) together so I could actually see what was going on in there structurally. The bones look good, still smooth and round in the places they need to be smooth and round. Connective tissues do not show up on x-rays so the rest of it is kind of conjecture. Looking at the symptoms, though, the diagnoses is at least closer to the mark than anything else we've tried in the past ten months.
Anyway, the good news is that (as of November) there didn't seem to be a leap toward degeneration in the joint. Only time will tell, but there it is. I can deal with pain. What I can't deal with is fusing in to a solid lump that cannot move at all anymore. They will undoubtedly tell me not to do a lot of jumps in ballet class. But I will cross that bridge when I get to it.

Friday's class was terribly small. There were only four of us for barre, and then just three for center work! It felt very strange. The Friday class is usually packed beyond capacity so I am not sure what was going on there. Summer vacations? Because we were so low on students the class was extremely intense and exhausting. We did grands jetés, which was fun and new, and I think I may be getting very slightly better at chaînés turns, though they are still sort of hit and miss. I asked about class schedules and my teacher thinks I should try out the level 3-5 class (because I can't make it to the regular level 3 class until September) and see what I think. I may give it a shot, but probably not until late in July. Until then I am totally happy where I am and still feel challenged enough not to be bored.

Doctor's Appointment: Preparation

Well, I have an appointment with my primary care doctor this week. There are a couple of things I want to discuss with him, and the biggest is (probably quite obviously) my knees. I have learned from a lifetime of Kaiser's brand of medical care, and so I am spending a little time tonight brushing up on my anatomy and such. Seriously guys, patients should not have to do this. I am capable of it, you are probably capable of it, but some people aren't. And those people will just slip through the cracks in the system. It's rather frustrating.
Anyhow, I have discovered (this was a huge surprise to me, though it really shouldn't have been) that tendonitis can be caused by rheumatism. I don't know why it didn't occur to me before. Rheumatism equals inflammation, and tendonitis is definitely based on that same mechanism.
Anyway, the good news is that I have some ammunition to take to my appointment, as well as a ten month record of trying and failing the regular first-line treatment. So, maybe I will get some suggestions?
I have very little faith in the medical establishment right now.

Ow. TMI alert, but I am hurting a lot right now, in my feminine regions. The timing is all wonky and totally wrong which means I am probably just having a bout of mittelschmerz, which I have experienced off and on since I was a teenager. It's been more off than on since my mid twenties but it used to be clockwork-regular. It occurs to me, at this late hour, that mittelschmerz is an inflammatory condition of unknown origin. Just like every other damn thing that is wrong with me. Why don't doctors look at the big picture and tally up all these things once in a while?

Sigh...

Anyway. No feeling sorry for myself! I have a new ballet classmate with artificial hips! Talk about moxie!

HMO: Huge Mutha-effin' Ordeal

I think there is something going on with my knees. No, okay, I mean there is something going on with my knees that is not rheumatism related. I don't know. It's just that my father, bless his heart, was just diagnosed with a ligament injury after being treated FOR TEN YEARS for arthritis in the joint. Though Kaiser had done CT scans in the past that showed the problem, their right hand has never been any good at figuring out what their left hand is doing. So it sat there, mis-diagnosed, for ten years. And now, after additional injury and a damn-near malpractice case he is going to be needing surgery.
What I am saying is that my TOTALLY CRAPPY HMO couldn't figure out that you had a paper cut if you stood in the office sawing at yourself with a business card. They would probably give you vicodin and an antidepressant and tell you it's all in your head.
So, I am not feeling terribly confidant in the sort-of-diagnoses they sort of didn't quite almost give me but not really. They just want to shut you up, so you go home and leave them alone.
ANYWAY. I have made an appointment (it's over a month away, because this is Kaiser we are talking about. Anyone who thinks socialized medicine would result in waiting lists and rationed care has obviously never been to Kaiser in their life). I am drawing schematics (sorry, no, diagrams) and preparing index cards with a speech. I seriously considered bringing my laptop and setting up a PowerPoint presentation: These are my symptoms! Here is a list of common injuries that can cause these symptoms! Here is the standard first-line treatment for these conditions! Here is a long-term prognoses! Take notes! There will be a quiz afterwards!"

I'm also kind of a hypochondriac. But I have been thinking that this might be ligament or tendon related for a few months, now. Ever since I discovered that there is a lump in my knee just to the upper inside edge of my knee cap. It goes THUNK when you touch it.

Yoga For the Elderly, Decrepit, and Infirm

So, many moons ago (back in August, after my Summer job ended but before I started taking ballet) I was in the worst shape of my life and was seriously having trouble with the little things. Pain had become a constant in my life and I had just folded in on myself. Along with everything else, rheumatic conditions come along with a physical exhaustion that was not helped at all by the medications I had been prescribed, one of which is a sedative. And, my Summer job is HARD WORK, it's terribly brutal to my wrists and hands. I bring wrist braces to work and coat myself from the elbows down in Icy Hot two or three times a day. So, exercise? Not even happening. But, I decided that I was done looking sadly at the ballet studio's class schedules and that it was time to DO IT.
I knew I was out of shape and that it was going to be hard for me to get back in to the groove of regular exercise. So I decided I was going to do yoga every day in preparation for this whole ballet business. When I was in high school I came home every weekday afternoon and did yoga on the living room floor. My favorite things to do were shoulder stands (woo!) and sun salutation. I knew I couldn't put any weight on my hands and wrists anymore, so those were probably out. I looked around on Netflix and found "healing yoga for aches and pains" by these people. They aren't too annoying considering what else is out there (I have a preeeeeetty low opinion of most video exercise instructors).
I did it for a few days and I was feeling good! It was seriously difficult, though. I mean, really hard work. Now, this is what I affectionately call "old people yoga". Most of it is done sitting in a chair. Everything is modified for stability. But even so, MAN did I have a hard time with it. GEEZE. At one point in the video there is a modification of "eagle pose" (in which you cross your arms over each other at the elbow and link your hands to one another with your palms together) and it was so impossible that I quickly did a screen grab and this happened:

Anyway, so it was hard, but I was feeling progress. Unfortunately by the end of week one something was terribly wrong. My knees hurt. And so I stopped doing anything that could bother them. No weight bearing poses. Nothing. But then... they kept hurting.
They never stopped.
I started ballet class not long after that. The knees slowly became a part of my life. My doctor increased the dose on my pills. I learned to sleep with a heating pad and ice packs and spend as much time as possible in bed on any day when I knew I was going to be dancing. And yoga? I kind of forgot it.
So last week I decided to try out old "healing yoga for aches and pains" again. After all these months of ballet the entire thing is easier in a major way. It's not something you would notice if you were doing it consistently, but after a break for several months the difference is obvious. I still can't do anything that places my weight on my knees, though, so I have to skip the one posture they teach that involves that.
I was feeling pretty cocky about it after a few days and decided to try out another one of their videos, "yoga for common conditions". And boy howdey, that was a mistake. After the first three postures all involved either kneeling or folding the legs, I gave up. I can't even sit cross-legged on the floor anymore. So, my search for a new and gentle yoga program for ancient old codgers continues.
Updates as they become available!

On Cleaning One's Backside. An Essay.

So I have a couple of cats, and they are both very much Up In Our Bidness. But one of them (they are both about 8 or 9 years old) appears to be the most inflexible cat on the entire planet. Cats are supposed to be sleek and agile, right? But she is clumsy and kind of awkward. We occasionally complain at her because sometimes she just doesn't bother cleaning her posterior. And she sleeps on the bed, so SOMEONE has to clean it, right? Anywho. I have been watching her lately and I think the problem is just that she is not even vaguely flexible. To clean her rump she has to dig her claws in to a soft surface and then hike herself around to get in position. I wonder if maybe she had some traumatic injury as a kitten, or if she is just developing cat arthritis.
Because I know the feeling.
Not butt licking, of course ( I shouldn't have to add that "of course"). But, I have an awfully hard time getting up and around these days myself. Ballet is helping the flexibility, but my knees are shot all to heck. And I refuse to take showers because I think showers are gross. So I have to figure out how to get myself out of a bath tub on a regular basis. Right now I have a clawfoot tub with the original plumbing, which means exposed pipes that travel between the faucet and the shower head. So I can just grab on to the pipe right over the faucet, and sort of HAUL my ancient and creaky patoot out of the tub. I shudder to think about what will happen when we move. I am hoping, here is what I am hoping, I am hoping that the house will have been lived in by a very old woman. And so there will be one of those bars in the tub. For old folks.
They say you are only as old as you feel.
I think that makes me about NINETY.

edited to add: I forgot, this is the internet, so including a picture of said cat is practically required. The inflexible cat is madame on the left: