Thursday, July 7, 2016

The 3 year view

On July 1, I became a member of Kaiser Permanente again, after being gone for three years.  For those who are not in the Colorado area (or another area where Kaiser is), Kaiser is a different system...  Basically there is regular insurance where you have a set of providers, pharmacies, radiology, hospitals, etc. you use.  Then if you have Kaiser it is a completely different set, but it is all linked together really well, so your medical record is all under one roof that can be seen by your primary care physician, any specialists, any pharmacists (because the pharmacies are Kaiser pharmacies).  And you can order all medications from one spot, the same spot where you can email any of your providers...  it is an integrated delivery system and after spending three years away from it, I am grateful to be back.  Note: it takes a lot of technology to link all this together.

I will miss my neurologist who is outside of Kaiser - he was one of only two neurologists I have ever liked.

So that is the background!

Today I went to see my rehab physician who I had seen for many years before I took my "explore the world" break from Kaiser (I don't know that I would encourage others to explore the world after I did so - it was confusing!).

Three years - he could look up where I had been in terms of my health from three years ago (another cool part of Kaiser!).  And then he could do the usual tests and compare.  He could put my prescriptions into the system and I can set them all up through mail order, through the same interface where I can email my physician, etc.  Cool stuff.

The tests: One test is to, while sitting, simply left up onto your heels.  I had lost this ability.  But my feet popped up!  And he pushed on my toes (to see if I could hold them up) and they didn't just go down.  It took a bit of pushing.  My grip strength is normal - I knew this because I can write with a pencil now which for those of you who have never had grip strength affected - it takes more grip strength to use a pencil.  And when seated, I could lift my legs up, which means muscles called hip flexors are working a bit.  I couldn't do this until pretty recently.  And....  and...  and... (the excitement of my new tricks!), I was sitting on an exam table and could hold my arms up and out for him to test their strength.  The exam table is a key term because I could lean back on something.  It takes core muscles to "let go" and hold your arms up.

I pointed out to him the things I couldn't do previously and though he said he thought I was correct, there wasn't the excitement generated as when I am writing this blog and smiling.

I also got to ask him which muscles, specifically, aren't working correctly and make me walk, well, in a goofy way.  And since he is a rehab doc, that is his specialty and he explained it so I understood!  I have the weak hip flexors which are basically on the top of your legs (above your quads).  But then there are muscles on the side of your legs, also by the hip flexors.  To stop my leg from swinging a bit around, those have to be stronger.  They also have to be stronger to walk straight.  And then my leaning which was one of the first things that was wrong before I was diagnosed...  those are my lower back muscles.  And that give me more understanding and direction.

Then he asked, "so why do you do all of this?"  If a random person asked me that I would tell them it is none of their business!  And I hadn't thought of it.  _Why_ do I do all of this.  And my answer just came out: "because I love it!"  I do - I really do love this stuff.  Part of it is I never thought I would improve - I thought I would continue to gradually decline.  But a larger part of it is the mindset I have been given - a stubborn runner mindset.  Once an athlete, always an athlete.  Once a runner, always a runner.

And you just never know what your body can learn to do again - like a baby learning to walk.  Never say never seems to be my theme.