Bullet With Butterfly Wings – The Smashing Pumpkins 1995
My scapulas have been something I have been working on in physical therapy, and my PT examined them a bit today at my session, and I could tell they were not working “properly” I didn’t realize how much they winged out until I snapped a few pictures of them!
This is happening for a number of reasons; physical trauma, nerve damage, thoracic outlet syndrome, torn arteries, subclavian steal syndrome, what I suspect to be damage from surgery in 2017, and a connective tissue disorder that I was born with… the list keeps growing.
There is a reason I drive/commute over an hour each way to physical therapy at the Ability Lab in downtown Chicago, and that is because they are THE BEST. I don’t just mean my experience, they are the #1 physical medicine and rehabilitation hospital in the country. My PT checks how I am moving with every exercise and modifies what needs to be changed to suit me. My neck exercises are still pretty hard, so we moved those down a notch, and are stepping up the lower scapula ones a little more. When you have an overall dysfunctional body it’s hard to figure out what to focus on yourself, that’s why I have the professionals helping me.
I am trying to really push myself, and can already see some improvement in my functional abilities. Less weakness in my arm and hand, more strength in my shoulder, and less popping of joints. I am sore all the time, and triggered a migraine last week, but I know it will be worth it in the long run.
Since I had the botox on my esophagus last month, I have noticed a huge difference in my ability to eat as well. I still don’t have much of an appetite and have to remind myself that I HAVE to eat, but it is getting better. My esophagus was spontaneously spasming before, and it could get scary. Often times when this would happen I would feel like I was choking, and couldn’t quite catch my breath afterward. It has only happened once since the botox, and honestly it was because I was eating WAY too fast. I haven’t gained any weight back, but I have stopped losing weight, and I am at a healthy weight for my body, so the doctors and I are not worried about it anymore; as long as I am getting enough food/nutrition. In April I will follow-up with the GI at Northwestern about that procedure, I’ll also follow up with my vascular neurologist and get repeat scans of my blood vessels/stents to make sure all is good in my vascular health.
All in all, making good progress and seeing some good results. I don’t know that I’ll ever get to 100% again, but I’m having more good days than bad ones, so I am a pretty satisfied patient for once!
Swim – Jack’s Mannequin – 2008 … this song gets me through the tough days, the lyrics are at the end of this post. Just keep swimming.
I received an e-mail from Northwestern University today reminding me to fill out my six month survey for their cervical artery dissection registry. I am happy to report my symptoms have continued to get better, and the pain has remained a more steady, manageable level. That is not to say I am pain free, far from it, but I am up and moving at least a few hours a day, my migraines have calmed way down, and that is huge progress.
There are still some questions as to why/how this dissection happened, and at this point it is hard to say. These things can happen spontaneously, or they can happen from trauma. My neurologist at Northwestern has referred me to a genetic counselor to discuss testing for a connective tissue disorder. This could be what caused the dissection. Knowing if I have a genetic condition won’t mean they can fix it. It will just give us a better picture of why these things keep happening in my body, and the best treatment.
I have a lot of referrals I am catching up with. So far on the agenda this fall are genetic counseling, GI, an esophogram, a different kind of cardiologist than the last one I saw, and a follow-up at the Ability Lab.
Here is some background on Cervical Artery Dissections (mine was the left vertebral):
There are four main arteries that supply blood flow to the brain. Two carotid arteries and two vertebral arteries. The carotid arteries can be felt on each side of the lower neck, immediately below the angle of the jaw. The vertebral arteries are located in the back of the neck near the spine and cannot be felt on physical exam.
The artery walls are made up of three layers of different types of tissue, each with a specific function. Dissection occurs when a tear in the artery wall allows blood to leak between the layers and separate them. The effect has been described as what happens to a piece of plywood that gets wet.
Cervical artery dissection is a dissection of any of the arteries in the neck. It can involve a carotid or vertebral artery and sometimes multiple arteries can be involved.
Certain medical conditions such as Marfan or vascular Ehlers-Danlos syndromes – types of genetic connective tissue diseases – fibromuscular dysplasia or atherosclerosis (the accumulation of fatty plaque in the artery walls) put individuals at risk for developing cervical artery dissection. Cervical artery dissection in these patients is called “spontaneous,” meaning that it occurs without trauma to the head or neck.
Cervical artery dissection also can occur in the general population as a result of blunt trauma injury to the neck, such as a high-speed car accident or a fall, with chiropractic manipulation, or from hyperextension of the neck in sports or exercise. Cervical artery dissection has also been reported after heavy weight lifting.
High blood pressure and smoking increase the risk of cervical artery dissection. Some cases of cervical artery dissection also have been reported after invasive diagnostic procedures.
Cervical artery dissection begins as a tear in one layer of the artery wall. Blood leaks through this tear and spreads between the layers of the wall. As the blood collects in the area of the dissection, it forms a clot that limits blood flow through the artery. If the clot is large enough to completely block blood flow, this can result in a stroke. Equally dangerous, pieces of the clot can break off and travel up through the bloodstream, limit the blood flow to the brain and cause a stroke.
Depending on where the dissection occurs in the artery, it may cause the artery to bulge in the area where the blood is pooling. This bulging, blood-filled area is called a pseudoaneurysm. If within the brain, these can be fragile and carry a risk of breaking and causing bleeding around the brain (called a subarachnoid hemorrhage); however if in the neck, these rarely break, though they may produce symptoms by pressing on surrounding structures. Sometimes pseudoaneurysms can form after the initial artery dissection.
Sometimes a stroke is the first sign of cervical artery dissection and emergency treatment is required. More commonly, symptoms develop over a period of hours or days, even in patients who have traumatic injuries. Symptoms are general rather than specific and include headache, neck and face pain (especially pain around the eyes), vision disturbances such as double vision or a droopy eyelid, a pulsatile “whooshing” sound in one of the ears, known as pulsatile tinnitus, or a sudden decrease in sense of taste and/or weakness on one side of the body.
Stroke can develop hours, days or even a week after these symptoms begin. This is the most serious risk of cervical artery dissection.