Physical "Ouch" Therapy

I’ve begun physical therapy again. This is an intervention I’ve become all-too familiar with having gone through it multiple times for stroke recovery, shoulder injury, and of course my spinal disease. Well, I’m back in therapy for my spinal disease, Ankylosing Spondylitis, which has progressed substantially this year with new fusions in the sacroiliac and neck regions. This has caused unbearable pain and for the first time since 2000, I have been on narcotic pain medications to manage it. Well, now that things have settled down due to lots of prednisone, my pain specialist felt it was time to go into physical therapy again to help maximize my benefits while I’m still in pain management.

Now, this is no simple matter for me. I have something called Body Dysmorphic Disorder, which I don’t talk about often, nor have I written about. But briefly it’s a psychological disorder that causes one to become hyperfocused on their body coupled with severe negative self-perceptions. I’ve had the disorder since I was about 12. One of my greatest struggles is seeing myself in a mirror. I become obsessed with my own image and not in any Narcissus-kind of way where he was in love with himself and spoke lovingly about his visage. No, my inner dialogue is destructive; it’s cruel; and it’s difficult to control. Now you ask what in the world does this have to do with physical therapy…

When I went for physical therapy on my shoulder, the place I went to was wall-to-wall mirrors. It became such a torment to go that I had my significant-other calling me out sick for my appointments until I stopped all together. Knowing I had to go to therapy again, I changed where I was going. I assumed that if I went to a large medical-based facility there would be less emphasis on body that this more sports-based rehab center had and more on actually helping patients with diseases. The night before I had to go I took twice my prescribed dose of antianxiety medication I was so terrified about having to face mirrors AND people looking so closely at my body.

So when I got to physical therapy, my first act was to scan for mirrors and with relief there was only one mirror the size you might have on the back of a door. Phew! The next thing I did was look for people with my body type. I’ve become overweight over the years due to the combined effect of too much prednisone and too-little activity. Another phew, not only were their different body types at various zones in the giant therapy room, but even several of the therapists were overweight. This put me at moderate ease, but I still scanned the room the whole time I was there to make sure no one was looking at me. Not only do I hate mirrors because I can’t disengage from them due to focusing on barely visible problems, asymmetries, or color changes (with Lupus I get the typical Lupus skin changes on my face), but I am preoccupied with how others must be looking at me. Thankfully, everyone was focused on their own tasks and I disappeared into the blur of activity. This was the perfect place for me.

While I was filled with relief that I didn’t have to worry about my body like I often do when I am out of my comfort zone, I did have to deal with the sheer challenge that I was going to be undertaking in the therapeutic process itself. Can I have a collective OUCH. There was a reason my pain specialist prescribed therapy while I was still on pain medications. I have a great physical therapist. And he has decided to challenge me and body parts. Body parts that just don’t work because of so many strokes coupled with nerve and joint damage.

So this week I spent 5 hours in physical therapy having joints rotated this way and that. Having to sit on a giant yoga/pilates ball that I thought was going to go flying out from under me or worse yet pop! while I lifted weights. Oh and having to relearn how to walk again. Who would have thought walking would be such a challenge but apparently, getting my legs to walk was not enough. I must sash-shay about with my arms a-swinging. And when I was all done, stepping, lifting, twisting, crunching, bouncing, pushing, and sash-shaying I thought I was going to fall down, go boom. And yet, I will go back to torture myself some more next week.