Down and Back: Adapting to Change

The leaves are starting to pile up in the yard.

Down and back. Shoulders down and back.

That has been almost a mantra for me over the past few weeks. Ever since I started physical therapy on Oct. 3, therapists have reminded me many times to make sure my shoulders are down—not up around my ears—and back—not slumped forward.

Because I do tend to slump. My posture is horrible. Years of hunching over first paper and pen, then typewriters, then a word processor, then computers have instilled in me a slumped over posture.

Even now, as I write this, I have to remind myself over and over to sit up straight.

One of my therapists, Kyle, explained that when I lift up my right shoulder, whether it’s to pick up something, reach for something, or indulging in bad posture, I’m “grinding” those nerves that are irritated.

“When you feel pain, check to see what position your shoulder is in,” he told me once.

He recommended finding a cue to remind myself to keep the shoulders down and back. So far, I realize pretty quickly when I’m slumping forward or holding my shoulders up around my ears. But I would like to think of an actual cue.

Physical therapy has been a positive experience for me. I still have pain, but I am feeling stronger. And Kyle, plus Darius and Katie, are teaching me ways to adapt so I’m not putting pressure on nerves.

For example, during last Thursday’s session, I was having a lot of pain when I lifted up both arms to do an exercise with a stretch band. That pain had gotten better, but it seemed to have flared up again.

I can easily tell now what muscle soreness from exercise is and what the original nerve pain is.

Katie and Kyle were ready to find another way for me to strengthen the muscles without pain. It involved lying face down on a table and lifting my arm from that position. Gravity wasn’t pulling on my shoulder, so no pain.

I’ve been working on making adjustments in other areas of my life, too. When the pain was at its worst, it was very hard to use the computer—to move the mouse around, to hold my arms up to type.

Not using a computer was not an option for me. I write and edit for a living. I write and edit because I love doing those things.

The written word is like my breath.

So I am adapting. At home, I placed a firm pillow in my desk chair to lift myself up so I didn’t have to do any lifting of the shoulder to work.

I’m still working on my desk environment at the newspaper office. I originally had the mouse and its pad almost an arm’s length away from me so I could use the space right in front of me to place notebooks, reports, etc. Reaching for the mouse and moving it hurt. I found that moving the mouse pad closer to me helped a great deal.

In my daily life, I’ve learned that it’s OK to place my drinking glass on the left side of my plate so I can lift it with my left hand. I’ve learned that I can throw things pretty well with my left hand when I’m playing with Chase Bird. (He likes to smack rolled up pieces of paper or little play mice. It’s like playing volleyball with him.)

Chase Bird enjoying the sunshine on the enclosed porch.

A doctor told me years ago that I would have to adapt my life to having depression. I learned what helps me with the depression, and with OCD, and what doesn’t.

I’m learning that it works with my physical health, too. I can find ways to do the things I want to do. I just have to adapt.

And keep my shoulders down and back.

Have you ever had to adapt the way you did an activity? What would be a good cue to remind me to place my shoulders in a better position? I appreciate your input!

Adapting in the world of OCD and depression

Several years ago, during a bad time with my depression, my family doctor told me I would probably always have low times and have to have my medications tweaked. But he said I could learn to adapt to having to do this, adapt to the way I was.

I’ve been thinking about adapting a lot lately. I’ve had to make a lot of adaptations in my daily life because of a change, namely a broken bone in my foot.

A broken foot is not a tragic circumstance. There are so many people who are suffering so much worse than me.

But any change in the life of someone with OCD and depression can cause anxiety. 

Three weeks ago, I wrote about having anxiety over my broken foot. I had worries about how I would handle the OCD and other anxiety associated with a change in my daily life.

But I would adapt, I wrote.

And I have adapted. I have made adjustments in my schedule, in how I do things, in order to accommodate the orthopedic boot I must wear and the crutches I’m supposed to use.

Here are a few of the changes I’ve had to make to adapt to having a broken foot:

I had to learn to navigate the world using crutches.

 It hurt at first. My upper arms got incredibly sore from using the crutches. But I kept telling myself that I had to keep using them to let my body get used to them. And it did.

The purse I was carrying was just too heavy for me to try to tote along with crutches.

Of course, the purse would not have been so heavy if I didn’t stuff so much into it!

 I switched to this purse, which was a little easier to carry on my shoulder.

And if it falls from my shoulder while I’m using my crutches, it’s not too heavy on my arm.

I used to drive every day. I drove myself to work and to all my work-related appointments.

I haven’t driven for three weeks. Larry has driven me everywhere I needed to go.

He’s an excellent driver and has been incredibly helpful and patient. But it’s hard to give up the “control” of getting myself from one place to another.

More than once I’ve stood up at work and gotten my things together, forgetting for a short time that I couldn’t just walk out the door to my car and drive home. I had to wait for my ride.

My contamination OCD bothered me a little. I was anxious about keeping the boot clean. But I started thinking of my boot as just another shoe. Whatever my shoe on my left foot could touch, so could the boot on my right foot. That thinking helped.

So did good old exposures. I had to walk some places, like public bathrooms, where I didn’t really want to with my boot. I forced myself to do it, and soon enough the anxiety waned.

 I have an appointment with my orthopedic doctor this afternoon to check to see if the bone is healing.

I may need surgery. Hopefully, I won’t.

But no matter what the doctor determines today, I know that I can adapt to what comes next.

Adapting has taught me some things: gratitude, patience and confidence.

*I am grateful that the adaptations I’ve had to make are temporary. My foot will heal. I will reach the point where I won’t be on crutches and I won’t need to wear an orthopedic boot.

*I’ve learned to take some things slower. I have to go up and down steps very slowly, one step at a time. It takes me longer to get from point A to point B. That’s OK. Life doesn’t fall apart if I’m not rushing from one place to the next.

*I’ve learned to have confidence in my ability to handle changes. If I have to make more adaptations, I can do it. I’ve done it before. I can do it again.

What have you learned from having to adapt to changes in life?

Anxiety and a broken foot

I took a step forward in taking care of my physical health, and I ended up wearing a new boot.

In my last post, I wrote about the need I had to take care of my physical health. One of the problems I’d been experiencing was ongoing pain in my right foot.

I finally called my family doctor’s office Friday. They are in a temporary office location while a new facility is being built, so they are without on-site x-ray services. They suggested I go to a related practice that sees walk-in patients.

I went there Sunday and after they did x-rays, they told me that I had fractured the fifth metatarsal in my foot. They think it’s a stress fracture.

They outfitted me with a boot to keep the foot immobilized and will call me, probably today, with a referral to an orthopedic doctor.

As I sat in the exam room at the doctor’s office, waiting for them to finish all the paperwork, I could feel anxiety start building up. I admit that I let the anxiety take over for a while.

*It’s not safe to drive while wearing the boot. I drive fairly often for my job. I don’t want Larry to have to drive me everywhere I need to go for work. If I drive, I have to take the boot off. Will that hurt my foot more? How can I balance out the driving?

*How will I keep the boot clean? I thought immediately of the public bathroom at work. The floor doesn’t always look clean. How will I deal with that?

*What if I have to have a cast? How will I manage showering?

*The weather forecasters are calling for rain, sleet and snow on Wednesday. If I have my orthopedic doctor’s appointment on Wednesday, will I be able to get there?

*I did some Internet research on foot fractures. The need for surgery seems very unlikely. But what if I do need it? How will I work that out with my job?

Of course, these worries are based on fear of the unknown, fear of what might happen, on what ifs.

When I managed to push off the anxiety long enough to really think about my fears, I realized that I was worrying about things that might not happen.

If they did happen, I would adapt. I’ve adapted before. I can do it again.

*The orthopedic doctor can advise me on driving. I’ll work it out.

*Many years ago, I had bunion surgery and had to wear a light boot. I wore it everywhere I needed to, even in public places. I adapted.

*Several years ago, I had to wear a bandage on my hand for weeks to protect a bad cut. I had to cover it to take a shower. I adapted.

*I can reschedule a doctor’s appointment if that’s necessary. I’ve done it before.

*The orthopedic doctor will know what needs to be done to help the foot heal. I’ll adapt to the treatment he or she recommends.

I’m looking forward to healing and getting back to normal. If I have to adapt along the way, then that’s what I’ll do.

When have you had to adapt to changing circumstances? How did you manage to do it?