My pain level is inconsistent. When the PT who I didn't get along well with told me to keep stressing the glut med tendon in order to be able to say he got me off crutches, the pain went way up....8/10, with me crying hysterically half the night, on narcotics every 4 hours so that I could get out of bed (because without them, I couldn't), etc. My main issue is that instead of listening to me and assessing the problem, he just dismissed my concerns outright. Then, when it got really bad, that's when he got angry and yelled at me how great he is and dropped me from his caseload.
So, after that, I used my own training, and used the crutches, rested it, iced it, and the pain went way down, back to what it has been since the surgery, especially after the orthopod gave the cortisone shot.
I have both tendon damage and labral tear, so it will take awhile for everything to heal....on the order of several months. As it is, it's been since Feb since I started to use crutches, and still can't completely get off of them. It's been since Jan when the pain first started....so about 6 months now.
I was trained with early mobilization protocols...long story, but in orthopedics you have the early movers and the immobilizers. So, under early mobilization philosophy, you do push it some, but you monitor closely the pain level and other signs of damage/overuse and immediately back off if you get an inflammation response. You let it rest a few days, then start back, but less aggressively. Your seeking to exercise the tissue as much as you can without causing further damage. Basically, you're choosing to have less risk of adhesions, loss of tensile strength in the tendon, loss of ROM, loss of strength, scars, etc in exchange for a greater risk of disrupting the repair, but you're keeping a close eye on things to lessen the chance of disrupting the repair as much as you can. So, I tend to do this with my own injury. The PT who I've returned to seeing said it was fine to have mild or moderate pain and that it would be expected especially with the myofascial release techniques she's using, but severe pain is wrong and to back off if I get that....which I interpret as a 7/10 or worse. Still, because of the philosophy I was trained with, I tend to push it to the edge because getting surgical scars and adhesions deep in tissue can lead to long term disability and once they are present, at least in the hand, it's very difficult to remove them. If the surgeon goes in to release the adhesions, then the very cutting involved from that surgery will create more adhesions. However, my knowledge of labral repairs is limited in this regard, but I assume it's the same deal, especially since the orthopod said, "oh, that's good, that means you're disrupting adhesion formation, which can be a problem."
The way I'm resting it is by using one crutch, by limiting the amount I go out and have to walk on the leg each day, keeping my distance of walking to household distances, I don't lift any more than 1 pound weights, and I pay attention to the pain level while stretching. Still, yesterday while stretching I was distracted, so may not have noticed some pain until it was too late, and the area is still hurting today. I wish I didn't get distracted, but I'll take it easy over the next few days to give it an opportunity to heal and hope I didn't compromise the surgical repair.
The main issue with the PT I didn't get along well with is he didn't listen. I kept trying to tell him what was happening, but he just dismissed it. I take severe pain levels seriously, but he didn't until I was crying hysterically from the pain and doped out on narcotics.
Anyway, all the professionals involved tell me it will eventually heal, but these injuries just take forever....several months to a year or so after surgery.View Thread
You're welcome. If the asthma medications don't work well for you, you may want to ask your doctor to do more tests to be sure it actually is asthma. These tests can include spirometry before and after rescue medicines, challenge tests (you do spirometry, then breath in something that should cause an attack if you have asthma, then you redo the spirometry), allergy tests (allergies and asthma tend to go together, though not always), more thorough history of symptoms and what triggers them (are they typical asthma triggers, for instance), they could also look for sinus issues or skin problems which would support an asthma diagnosis (also called the atopic march), etc.
However, you don't describe anything that definitively rules out asthma. Glad my post helped you.View Thread
The orthopod appointment went well. I was bit nervous about it before hand, since the PT who removed me from his caseload and told me to get lost works at the same physician owned business as the orthopod works. The orthopod understood what I was saying about the tendon damage and overstressing a damaged tendon and seemed pleased that this is what it was as opposed to whatever he heard from the PT who got angry at me. The orthopod gave me another injection of cortisone around the tendon, said he was fine with me increasing crutch support if the damaged tendon was screaming at me, and then wrote out the new order for PT for me to take to the PT who I saw before the surgery. The orthopod said he was fine with keeping me as a patient, told me to return in 2 months, and said I should do well, but it will just take time for everything to heal. I like the orthopod. I'm now back seeing the PT who I saw before the surgery, and we get along well.
Most PTs are not like the one who threw me out. He just kept yelling at me that I didn't realize how great he was and that was the reason for him discharging me. The essence of what I was questioning was that I have a tendon with known damage by MRI, the PT was pushing for me to be off crutches even though the area where that tendon inserts (the same area the MRI documented problems at) was yelling with pain. He said to keep stressing it. I questioned this, he insisted, so I continued to stress it because I didn't want to argue with him, and it got worse. When I told him the outcome of his instructions, he got defensive. I simply wasn't trained to deal with damaged tendons like that....you can exercise the tendon if the pain is mild or sometimes even if it's moderate, but in the face of severe pain, I was trained to get the stress off the tendon if it responds with severe pain. I asked some of my coworkers, PTs who have experience in outpatient, and they agreed with me on tendons and said this particular PT likely had issues with insecurity and didn't like treating patients who have some knowledge. I've been to outpatient PT before, and every other experience I've had has been positive. I've never encountered a PT like that. As it is, in the state I was trained his actions would be considered detrimental practice...very bad in the eyes of the licensing board, so I was surprised. Anyway, I'm back with PT I saw before surgery and she's very nice and it's going well with her.
The ROM has increased, the pain is about the same overall (it decreased from the severe levels with rest, ice, and cortisone shot..it's the same as it's been overall since the surgery), I have some concerns, but I'll discuss with the PT I'm now seeing at our next appointment. The strength isn't increasing that I can tell, but I keep doing the exercises...all within the pain tolerance of that tendon. The PT I'm now seeing told me to not go without crutch support right now because I didn't have the necessary ROM and strength....but she'll reassess at the next appointment since ROM has increased a great deal over the last few weeks.
What you describe with the person with CP is what I saw with my friends in college. They were college students and yet when they would go out in public, they were treated as if they didn't have the brains God gave a gnat, which ended up limiting their employment opportunities even when they could do the job. I recall one of my friends was getting a PhD in biology, and folks would talk to him and ask him if he could read and then congratulate him on it.
Sorry you were having problems with the asthma while running, though I'm glad it's getting better. I've been really fortunate in that my asthma has been really well controlled for 8 months now.View Thread
Please don't worry about the length of your post. "...is it normal to take one of these tests when you aren't feeling any symptoms and still get a normal result even when you have asthma?" Yes, it is. Having a normal spirometry test does not definitively rule out asthma because asthma is a reversible airway obstruction and so lung function varies day to day.
In terms of your other questions... I don't know. I've had times when doctors have told me to use inhaled corticosteroids 4 times a day because that's all they could add to my controllers without putting me on prednisone and they were trying to avoid prednisone. In your individual case, I don't know if it makes to do it or not...if you haven't already, I would ask your doctor what their reasoning is.View Thread
If you notice what triggers your asthma and avoid those things, it should help reduce your reliance on the medicines.
All risk is relative. So, you have to consider what the risk of not taking Advair 100/50 is and determine if that risk is greater than taking it. Yes, there have been deaths from it, but there have also been deaths from under treated asthma...not to mention folks who didn't die, but got neurological damage from not getting oxygen to the brain fast enough. The best person to determine the risks is your doctor, so if it were me, I would go on Advair 100/50. I've taken Advair 500/50 (same medicine, but higher dose) for over a decade and have had no problems with it, and it helps keep me breathing and makes the life threatening attacks much less common.
Advair contains both an inhaled corticosteroid and a long acting beta agonist. There are medicines that contain only the inhaled corticosteroid part, like FloVent or Qvar among others, and so they should have less risk from adverse medicine effects. You may want to ask your doctor if they think you can be controlled with these drugs instead.
The asthma drug that has the greatest long term risk is prednisone, It is much safer to take the Advair as opposed to a higher prednisone dose over time.
My doctors do a rapid taper with me, unless I've been on it for months....but some do gradual tapers with shorter treatment times. They'll normally do 40-80 mg a day for a week, then off. They told me there is less concern at this time with adrenal insufficiency with short bursts than there once was. Other than that, I don't know how to answer your question about tapering.
I don't know what is happening with you, but sometimes I have pain in my lungs during a flare. Usually, it feels like they are sunburned from the inside out, and sometimes it's a sharp pain in specific areas when I take a deep breath. I've never had a pop, and the only time I can't stand up straight is when I'm in obvious respiratory distress...once I take the rescue medicines with the nebulizer, I can stand up straight again.View Thread
My allergist said that omega 3 and antioxidants should help since they have anti inflammatory effects. However, I normally get them through diet and not through supplements.
Sorry, I can't help you with your other questions since I don't know. Asthma is tough, and sometimes you do everything right, but it just doesn't always happen the way you would like....there's just not enough known about the disease.View Thread
I have faced the same problem. The only time I was able to lose weight is when I ate mostly fruits and veggies...and exercised a lot, but wasn't working then and didn't have an orthopedic injury then either. I just pay attention to my behavior, since that I control, and I try to not concern myself with the result, which I can't control because of the corticosteroids. At any rate, my blood work looks really good, and I figure the behavior is helping in that way. I try to remain focused on what I can control and try to ignore what I can't.View Thread
I become allergic to new things commonly. The allergist told me some people just have a tendency to develop new allergies, and couldn't offer an explanation other than to avoid what I'm allergic to. There are toothpastes in healthcare stores which avoid commonly irritating substances that the more traditional brands have. The allergist just tells me I'm atopic, tending to develop new allergies without any known cause...I joke at times that I'll be allergic to oxygen by the time I'm 60.View Thread
Each area of the country is different, but in my area you would go to an urgent care center. I'm not sure whether they would take the insurance you have or not....but if not, then you would pay for it out of your own pocket...usually runs a few hundred dollars in my area. If you're really in trouble and have reason to believe its life threatening, then every emergency room in the USA is required to assess you and get you stable regardless of ability to pay by the federal law. However, emergency rooms are rather expensive, and the law doesn't forbid them from trying to come back to you to get you to pay at a later date. Urgent care is less expensive, and in my area is usually staffed by doctors who are board certified in emergency medicine, so they know about asthma. However, in different geographical areas they may be staffed by others, but should still be able to provide basic asthma care. I don't know, as a tourist, if your insurance would be accepted in the urgent care centers or the emergency rooms or not.View Thread