Back in physical therapy

My foot, my dumbbell

Photo description: brown carpet in the background, a pale short and wide foot with green nailpolish stepping on a grey dumbbell marked with "15" for its weight.

Because my new pain management doctor doesn't believe me that I'm taking three or more dance classes a week (and therefore meeting the current recommendations for physical activity according to the US government), I consented to going back to physical therapy, with the caveat that it had to be aquatic PT (I miss lap swimming, and my last pool adventure over the summer was a minor disaster pain-wise as the water pressure alone hurt).  Despite knowing he's being a fatphobic jerk, he's the first doctor that has taken me seriously about my desire to be on something other than opioids but realizing that opioids are the meds that are getting me through life right now.

A couple weeks ago, I had my PT evaluation with the new clinic (my old one doesn't have pool access).  I decided to wear my department t-shirt with the university logo and "KINESIOLOGY" in large letters, along with comfy drawstring shorts and my trusty sneakers.  PT evaluations almost always involve being touched in various ways to see how joints move (or don't move), to see what hurts with what kind of pressure, to test strengths, weaknesses, or imbalances, and sometimes end with heat, ice, or some other soothing modality (because if you're in need of PT, these evaluations almost always cause pain or other problems).

Since I've been through physical therapy quite a few times in my life (three times just for my spine fracture & vertebra slip), I have certain requirements that need to be met to deal with a PT.  First of all, my weight (if mentioned at all) needs to be addressed in a weight-neutral manner.  I have a history of disordered eating.  Yes, fatness is correlated with various biomechanical issues, but so is being tall, so is bone structure, so is age.  For the vast majority of people, weight is not modifiable.  The only thing dieting has ever done to me is make me unhealthy and bigger than had I just left my body alone.  Besides, people of all sizes get injured and disabled....so just treat me like a person with an injury or disability!

My second requirement is an acknowledgement of my desire to be active.  This is why I tend to go to appointments in my department's tshirt, a shirt from a triathlon or 5k, or a dance related shirt (like one of my Bellydance Superstars show shirts).  I want to be clear....physical activity isn't something that magically makes me a good fattie or some sort of supercrip.  I just have found that if I don't show proof of my prior activity status, I don't get treated seriously (I had a PT not believe that I was active at one point, despite my involvement in a dance troupe and dancing from 15-20 hours a week on top of my full time job).

Lastly, compassion.  The combination of my love of being in motion and being a people-pleasing introvert means I will push to far at least once...and I will struggle to the point of tears and panic to tell the PT or PTA that I've gone too far.  There are a lot of things that my body can do that I shouldn't do (like impinging my sciatic nerve), but I still do them in the attempt at getting praise and being treated as a "treatment compliant patient."  This is awful, both for me and the PT.  I'm slowly getting better at saying stop, but if I don't have therapist-client rapport yet....well, it's going to take a lot to actually be able to say it.  This is something that comes from trust (and works best when I have only a one or two person "team"....I only roleplay an extrovert!).

The therapy pool at the PT clinic

Photo description: shown at an angle, a small indoor pool, approximately ten feet by 10 feet with stairs and handrail leading in to the approximately four foot deep green-tinged water.  There is a mirror on the upper right side of the picture and wooden doors on the upper left side.  The tile around the pool is grey, the pool itself has beige, blue, and coral tiles in a geometric pattern.  A wooden bench is barely shown in the lower right side of the photo.

I agreed to biweekly aquatic physical therapy at the new clinic.  I gave it a good solid couple of weeks.  I really tried....but just being in the water hurt.  Walking hurt worse as the 98 degree Fahrenheit water loosened up my already hypermobile ligaments and tendons and ended up pinching nerves.  I wasn't even getting any benefit from the water exercise because I was either too strong, too flexible, or in too much pain.

Thankfully, this physical therapist is being awesome (not only does she meet my PT requirements that I put at the beginning of this post, but she's friendly and funny).  We're doing "land-based" PT including E-stim (like industrial TENS) and dry needling (like a cousin to acupuncture, but different in that it tries to derail nerve issues in trigger points).  We'll see what happens.  I really don't have the money to be doing the human guinea pig thing ($20 biweekly copays add up, especially with my other medical bills), but I would really like to be more functional in my life.  I'm still dubious as the increased pain is draining my energy, making school and work extremely difficult.  I guess what matters is that I'm trying, right?

Commuting while crippled

Minnesota MS 150 bike ride, June 2007

Photo description:  This photo was taken in 2007 at the MS 150 bike ride in Minnesota.  It was taken on a paved bike trail with grass and trees in the background.  I'm on a seafoam green road bike (skinny tires and curved handlebars).  I am visibly fat wearing spandex black cycling shorts and a jersey that says "Erik's Bike Shop" along with a white and teal helmet with a blonde ponytail visible.  I have dark sunglasses and a smile (although I didn't see the photographer...I was just having fun!).


The past few years as a graduate student, I've had a pretty constant gripe about the difficulties I've had with transportation to and from the campus.  I live within what would normally be considered "walking distance" from campus, which means that I live about 0.75 miles away from campus (which I could wheel if the hills wouldn't flip me backwards out of my chair).  As a kinesiologist (someone that studies human physical activity), I deal with ableism, both internalized and from a sociocultural standpoint.  It's compounded by being fat, with the standard response to being both fat and gimpy is "just get off your ass and you wouldn't be fat OR gimpy."  Yeah, right. *sarcasm*

Non-walking options are also prohibitive.  Handicap parking lot passes run about $325 for the school year (and does not guarantee a spot that is actually walking distance for me, or safe when I'm wheeling).  The city bus system doesn't have a spot nearby (as my home is considered close to campus).  The "special needs" bus requires a one hour window for a ride, which is not feasible with my schedule or my actual health care needs (and that's when it actually works....it is notorious for losing appointments).  I've asked my partner to drive me to campus, but it costs more gas (as he works from home usually) and it grates on my fierce need to be independent whenever possible.

I've been toying with options.  I've wanted a moped for about a decade now ever since I saw a Vespa scooter, but I would need a three-wheeled scooter because of my balance and my shortness.  I would also need money that I just don't have right now (the cheapest trike scooter I've seen is about $2,000 and the one I've been drooling at from Auto Moto with a roof is about $4,000).

Another option that I've wanted to pursue but can't afford is a recumbent trike.  They aren't that common, although recumbent exercise bikes in gyms and rehab facilities are.  This style of bike would allow me to bike without worrying about tipping over or dealing with legs that randomly give out on me.  Just like the moped, they are way out of my price range with most of them above $1,000 (and the good quality ones like the Catrike are at least $2,000).

My bronze crutch rigged to my red commuter

On Monday, I gave my old commuter bike a try.  It's a youth Giant brand mountain bike that I bought when I first moved to North Carolina (I nicknamed it the Red Dwarf Giant because of the small size).  I had a bike shop in 2008 swap the tires from trail tires (which are thick and nubby and make road riding more difficult) to commuter tires (that are thicker than road racing tires but smooth).  I tied my forearm crutch to the handlebars, which doesn't help with my balance and proprioception issues, but at least I have it to help me dismount and walk around campus.

Photo description:  Photo taken outdoors at a bike rack with a bush in the background.  It shows a bronze forearm crutch attached to the handlebars of a red commuter bike (hard to see because of the bright sunlight and bush in background).

How did it go?  Well, it was rough.  My partner helped me get the bike ready for me and we had to do some on-the-fly adjustments.  The seat had to be lowered significantly because I have to be able to reach the ground with my legs while on the seat....which means that I can't pedal in an efficient manner (and makes it much more difficult to pedal, especially up hills).  I'm also unable to stand up and pedal to tackle hills.  I was a sweaty mess for my meeting with my faculty adviser (thankfully my adviser is also a kinesiologist, so the "freshly exercised" look is pretty normal in our departmental offices).

Since the ride to and from campus wasn't too bad, I tried it again on Tuesday.  My rear end was sore because I wasn't wearing padded shorts and my seat is an original factory issued barely padded beast.  The seat position, while rectifies part of the problem with my balance, makes any incline hell on my body and my spine.  Being able to get to campus without using gas is great, but it hurts and burns energy that I still don't have.

This morning, I had to ask my partner to drive me to school.  Not only has biking blown through spoons that I sometimes don't have, it seems to have eaten the energy I need to get to work and to do my scholarly activities.  Just crawling out of bed, getting into the shower, getting dressed, and grabbing the easiest breakfast option left me feeling like I needed to go back to sleep because of extreme pain and fatigue.  I managed to get through my four hour shift, but I'm not sure if I can manage to get my reading done for class tomorrow, or if I'm going to be able to go to the intermediate tribaret bellydance class tonight.

The bike commuting experiment may continue, but we'll see what happens.  Money really has me stuck between a rock and a hard place.

Cyborg Dance Projekt Week 7: Trying moderation

Photo 2009 by Dave Stagner Photography

Photo on the left is from 2009 when I danced at CONvergence.  It was taken by Dave Stagner Photography.  It's black and white and shows me standing in a layback pose with one arm above my head with the other at my chest.  I'm wearing a black cropped dance top with long sleeves, black flared pants, and a hip scarf with a tiger on it.

Note:  I probably need more photos of me dancing some day for this blog!  If any photographer types want to get their name up here, hit me up....I've done a little amateur modeling for other local photogs, and I love it.

After last week's troubles, I'm making a more conscious effort to be gentle in this project.  People that know me know that I tend to have two modes of operation: on or off.  I first had it blatantly pointed out to me from my old kickboxing instructor, although I remember being praised for my "balls to the wall" type effort in most of my physical pursuits from triathlon training to Crossfit to dance (with doing 8-10 hour dance days in San Francisco in 2005).  I have a lot of trouble with moderation in physical activity, which probably isn't a surprise with blog posts about hating gentle physical activity or the 5k race I did untrained in my wheelchair.

I think some of this comes from dueling internalized ableism (from my birth defect-related experiences, like special ed gym classes in elementary school) and internalized sizeism (I've never been a thin person and have been bullied and harassed for being fat).  Some of it is just the sense of wonder that I get from learning a new task, pushing my body to its limits, or achieving various physical goals....I love the memories of the triathlons, the 150 miles of biking in a weekend, the polar plunge, the 40mph ride down a steep hill on my racing bike, the marathon dance classes....

Anyhow, I went to my friend Xavier's intermediate cabaret-style class on Sunday evening.  My bellydance background started with cab style, so I was pretty excited.  When I got there, he let me know that we were doing a Bozenka choreography that he learned at a master class.  When he said that, I knew that I would have to be careful to not overdo it...I knew that my brain would default to "learn the choreo at all costs!!"

My spine was being a little persnickety that night.  When we were warming up, I kept losing my balance (when you have spinal cord damage, sometimes standing is a balance pose).  I was a little concerned, but stood near the wall while bits of the intro were shown.  I decided to not do most of the fast spins in the choreography because it felt like a recipe for gimp-disaster (plus there's still useful muscle memory that can be gained by fudging movement!).

The one thing that I really learned is that it's hard to be careful when I'm being told to do something specific with my body (aka choreography).  My tendency is to force my body to do things it doesn't want to do (or shouldn't do biomechanically).  I have something to seriously work on if I intend to ever do choreographed dance performances.

For the other part of my attempt at moderation, I went back to classes on Tuesday but told myself (and my partner for accountability) that I would only go to two classes.  I would either do ATS 1 and 2, or do ATS 2 plus the intermediate tribaret class.  Since Melissa had a sub for her class, I stuck with ATS 1 & 2 (with the mental note that if my spine felt bad, I could stop...I was under no obligation to take 2 classes).

I did an OK job of being careful in the classes, and would crouch to watch movement explanations instead of following along (the value of mental rehearsal).  My spine was pissy that night, so I focused on trying to "fudge" movements in a way that was still readable to the other dancers as American Tribal Style is a group improv style that relies on visual cues to signal the next move.  I also tried to avoid leading as much as possible because of very similar issues I'm having with choreography....my brain is already focusing on not falling, keeping spine-safe dance posture, dancing, watching for cues, etc.

Finally, while not related to actual dancing but related to dance community, I'm using my Quickbooks knowledge in exchange for dance classes to help fund this project.  Not only will this help keep me in dance classes (at least 2 a week), but it means that I'll benefit from being at the studio more even when my body is being non-compliant.  These are people that I've known for most of my time in Greensboro, and these are people that have been awesome and caring when my spine got bad (including the wheelchair dance experiment).

The plan is to continue with the intermediate cabaret class on Sunday evenings along with two classes on Tuesdays.  I would love to add another day of classes, but between my academic classes (on Monday and Thursday evenings), my bookkeeping duties, and desire to spend time with my fiance and friends....we'll see what happens.

Fitness, fashion, fatness, frustration

Bad photo with tight top

So I use a neat survey site called CrowdTap that asks various questions about various companies and products, one of them being Old Navy (I generally love Old Navy as my fashion preferences are usually pretty plain but functional and semi-sporty).  I got the opportunity to sample their Active line using a coupon that gave me a pair of compression pants and a top.  I was pretty excited, but a little nervous since the coupon was for in-store use only and their plus sizes are offered only online.  I generally fit in their XL or XXL straight sizes, but their sizing is consistently inconsistent.

The photo to the right shows me, a pale short & fat woman, wearing fitted black capris with teal trim on the calf, black socks, fitted teal top, with my right hand on my hip, left hand holding on to a table for balance.

So I went to one of the local shops with my partner to see what we could find.  I was really excited by some of the colors, but really dismayed that it was hard to find anything I wanted in anything bigger than a medium.  I lucked out and found some compression pants (which seem to help with some of the leg spasms that I get when I try to work out using my legs) that were in my size with teal mesh insets (ON calls the color "Pirate Cove").  The coordinating tops though stopped at a women's XL.  Since I own some of ON's tops in XL, I poked through the rack to see if I could find the biggest XL I could find (I think my other half was confused by this until I showed him the several inches difference between the biggest XL and another XL of the same color).  I decided to risk the smaller size as the only options in store for the XXL were an eye-piercing pink and a see-through white.  I'm not comfortable with how the XL hugs my tummy rolls and the sleeves are too tight for a good TRX workout (or anything with a lot of arm movement).

The photo was taken for the CrowdTap challenge that gave me the free clothes.  The top would be awesome in the right size for working out at the gym as the fabric is a nice technical (quick-drying) fabric.  The pants would be awesome if they were a bit shorter (but I'm 4'11" so I think everything should be shorter!) and if they had a drawstring in the waist to keep them up.

I just wish I could find the XXL top locally in the teal "Pirate Cove" color!  I also wish that the plus size clothes, especially the activewear, were available in stores because of the odd sizing issues that I always have with them.

Fat wheeling

I came across this gem of a meme recently on a Facebook group for disabled folks and was instantly livid.  The image shows an elderly white gentleman with round spectacles perched on his nose, a black hat, grey scarf, black coat, and white dress shirt with white text that reads "Back in my day wheelchairs were for disabled people, not fat people."

My first reaction was "wait, WHAT?"  I was led to this spiraling stream of thoughts, from "some people are disabled then become fat" to "why does it matter as long as the person is doing what they can do to help themselves have a life worth living?" 

There are several things going on with this meme, and the first hits on some very real issues with the current "obesity epidemic" panic.  The thought that fatness causes disability, or that fatness is disabling.  They are two separate things.  Some fat people have mobility problems, but so do some tall people.  Some people with mobility impairments become fat for a number of reasons, but many mobility impaired people's weights don't change.  Correlation does not equal causation.

The second is what gets me as a kinesiologist.  If a wheelchair helps a person get through their activities of daily living and maybe even gives them a chance to find joyful (and, dare I say, pain-free or pain-reduced) movement, then USE THE CHAIR!  If a cane allows a person to walk for longer distance, then USE THE CANE!  If your built environment is inaccessible to you with a manual wheelchair, the USE THE SCOOTER (or power chair or whatever else).  Being able to be part of a community, to be as independent as possible, and to be happy are all components of being a healthy person

There are so many people in the disability community that are so caught up in the obesi-panic or are trying to make an artificial delineation between who counts as abled and who counts as disabled....this needs to stop.  Now.  There are so many people in the supposed scientific community that are spouting fat stigma messages that are just contributing to the mental unwellness of fat people (and honestly, creating a panic within disability communities to try to keep disabled kids from getting The Fat).

My walking stick from the ren faire

So, glam up your wheels, glitz up your cane, bedazzle your walker, grab your carved walking stick (mine is in the photo to the right that I purchased four years ago at the Carolina Renaissance Festival....it's a medium brown wood with green leather wrapping, brass studs, and runes carved in it vertically with the runes for "strength," "balance," and "journey"...might not be in that exact order), and move your body as joyfully as possible.  If you don't believe me, see this post by Ragen of Dances With Fat about fat people in scooters.  Or her post entitled "Bad Fatties on Escalators--A Rant."

Stroll and roll happily :-)

Mourning the loss of my 1 rep maximum

A lonely 15lb dumbbell & my foot

For those of you non-weightlifter types, the title might not make a lot of sense.  For those of you that are, this post is probably not going to be what you're expecting.  I like bending words like this...it's probably one of the reasons why I'm working on my PhD!

Yesterday morning I had my first real physical therapy appointment post-surgery.  I don't know if it was fatigue, PMS, percoset, or just plain absentmindedness, but I asked my therapist if I would ever weightlift again.  She gave me a sad look and said "yeah, sure....high reps, low weights though" and said something about toning versus bulking.

I started crying.  So much of my identity as a person has been wrapped up in my strength.  I loved lifting heavy things and putting them back down in all sorts of ways.  It didn't matter if it was a dumbbell, a piece of furniture, someone's heavy box of books that they were moving, a tractor tire, or a big dog.  I absolutely love the feeling of my muscles getting tight and moving that heavy thing through space.

Being strong was also something that got me through a lot of hard times in my life.  I have had a lot of internalized fat phobia and ableism, but finding that my body type (both the fatness and the dwarfness) was particularly well-suited to lifting really heavy things made me feel incredible.  It showed me that athletic bodies come in a diverse array of shapes and sizes.  It gave me the emotional strength to deal with all the crap that fat folks deal with at the gym.  The gym was a place where I felt like I had control over what happened both to my body and to my life.

Now, I'm mourning the loss of ever finding my 1 rep maximum.  I used to be able to back squat at least 165 pounds (that was the highest I hit in Crossfit before I screwed up my knee....and I would have been able to go higher once I cleaned up my form).  I could deadlift around that much as well (I was being really careful with my DL form because of my already diagnosed spine issues....I was in chronic pain management at the time, including opioids, but was trying to be stubborn and "athlete-like").  I won't even be able to do a 5x5 program like Stronglifts (warning: not a HAES page) because my lifetime lifting maximum will likely be the weight of a standard barbell (45lbs).

The xray of my hardware, day of surgery

This new reality hurts.  I'm not sure if it would have been easier to deal with it had it not been part of a long drawn out process (more like an acute and severe injury that requires immediate surgery).  All of this "will I or won't I be able to do xyz" is exhausting.  It also sets up this expectation that I need to try and see if I can still do something, whether or not it hurts me....particularly because of my embodiment as both fat and disabled and how society thinks that if I can just "fix" being fat, I'll no longer be disabled.

There is a possibility that I may still be able to do heavy bench press work, as long as someone racks my weight (this also means I have to learn to ask for help and accept help more readily, something I struggle with).  I'm not sure if this is a ray of hope, or another weird place where I wonder if I'm disabled enough for para-athletics (I would hope that broken spine + fusion + nerve damage/SCI = eligible for IPC powerlifting, but IPC standards have very specific categories of impairment).  Many powerlifting organizations have bench-only competitions as part of their competitions, if I wanted to pursue them.  I don't know if that would make me happy or if I would just mourn squatting and deadlifting.

So for today, I mourn the loss of my 1 rep max that I will never actually experience...and it hurts.  And tomorrow?  Well, I go back to physical therapy and just keep trying to get stronger, no matter what kind of sport or physical activity outcome comes of it. 

Bodies are always changing, no matter what.  Age, injury, illness, hormones, environment, oppression, emotions....every body, everybody's bodies never stay the same.

Psoas I see my body

For those of you who don't get the anatomy pun, the psoas is a muscle that connects the lumbar area of the spine to the pelvis.  It's pronounced "so-as."

Troupe photo taken in 2008

I've stepped up my deep tissue massage routine because my partner moved in with me several months ago and I can more easily afford to give it the "old college try."  I've been seeing a specific massage therapist at Hand & Stone Massage biweekly for the past two or so months in hopes that I can be the most functional person I can be.  Sometimes that means that she works the kinks out of my shoulders from the combination of office job plus schoolwork plus wheeling plus cane usage.  Sometimes it means that means she wants to try a different technique to see if I can get any sort of relief from the messed up spine joint.  It started out with just getting near the fracture then progressed to glute and outer hip work.

On my second-to-last appointment, she suggested trying to loosen the psoas and asked if I'd ever had this done.  I replied yes and told her how I'd had it worked on when I was bellydancing as it's a persnickety muscle that can get wonky with various shimmies and other lower torso movements.  I told her that I was fine trying it again, even though I knew it involved uncovering my abdomen and having her dig near my pelvis.  This is definitely a sign that I trust my massage therapist.

So when I saw her on Thursday, she asked if I wanted to try the psoas work.  I let her know that as long as she wasn't neglecting some part of my upper body I was willing to try it.  I'd rather know that my shoulders are able to handle my mobility needs and my scholarly work, even though some of my work is going slowly due to the new fracture.

The majority of the massage goes as usual, although laying on my stomach hurts worse than usual because of the increase in spine instability.  She has me roll over, gets to the front of my shoulders and arms, and asks again about the psoas work.  She gets me properly draped to work on my abdomen. 

I quickly realize that I'm a bit nervous about having my belly touched.  When my belly is uncovered, I unconsciously sucked in a bit then had to keep telling myself to stay relaxed.  Every time she moves her hands off the psoas I relax, and every time she puts her hand back I try to pull myself in, then remind myself to stay loose.  It happens every time she moves, and it feels like this is the longest part of the massage (even though I know it's not).  I try to laugh it off with the therapist, apologizing for trying to suck in my stomach.  She laughs in that way that tells me "no worries" (one of the many reasons why she's the person I go to).

Ever since that appointment, I keep thinking about how my relationship to my body has changed as my level of disability has increased.  I've gained some weight recently, although I'm not sure how much of that is due to a decrease in my ability to exercise, if it's a side effect of the various medications I'm on to deal with the pain, or if it's moreso related to my birth defect.  I've never actually been a thin person, and only flirted with being what the BMI considers to be a "normal" weight when I flirted with eating disordered behaviors in high school.  When I was a triathlete, I was still fat enough to be considered a candidate for gastric bypass.  I've never been a small person, and never will be.  I don't have the genetics or the physiology for it, and I'm usually ok with it.

I admit, I'm struggling with my weight.  By that, I mean that I'm struggling with the meaning of my weight.  This is where it's murky and tied to issues of internalized ableism and internalized sizeism, and it's hard to admit as someone who studies both fat and dis/ability in physical activity & sport.  Gaining weight, for most adult people, is considered to be a moral failing.  I had a neurologist, while otherwise awesome (particularly awesome because he treated my education level as a perk not a hassle), start talking to me about calories in/calories out and how weight can contribute to spine pain (correlation =/= causation, as I'm pretty sure I'm in pain because MY SPINE IS BROKEN).  I'm struggling with how people look at my body in motion, how my legs rub when I limp, or how my wide hips fill up my wheelchair when I roll.  In an ideal world (or maybe just my ideal mental world), I would just be another body, getting around however my body-at-that-time gets around.

Ideally, that's how it would work.  That's how I became a fat athlete.  I was just another body in a sea of bodies.  I wasn't the culmination of several markers of Otherness.  I was just a person, doing person-things.  I hope to one day find that happy point where I'm just another body, an albeit fat crippled body, moving around as just another body. 

It's hard when everything is bound up with pain though.  Pain is raw.  Pain is all-encompassing.  Pain is distress.  Pain makes a person take notice to the exemption of whatever else is going on.  Pain makes my thoughts derail, and makes for some long & rambling blog posts.

P/so/as the massage didn't make a difference in my pain, I think it brought to light a discomfort I've been having in my body that was intangible.  There will be more experiences that I'll have that will show me my body in different ways (and you all will get a chance to see the results soon, with photographic evidence).