Sciatica Pain and Sleep Positions

bike
New bike!

I’m going through a weird stage with back pain. It’s not new, but it seems especially magnified in recent months. I’m stronger than I have been in a long time, despite being almost completely unable to run. But almost magically (and not in a good way!) when I lie down in bed, the pain starts with a vengeance. I don’t know exactly what’s happening, but even my usual trick of elevating my legs isn’t helping as much as it used to. Something is definitely shifting when I get in bed, and it’s happening no matter what mattress I try— new, old, foam, springs, etc.

I get sciatica-type symptoms that start with a burning/tingling pain in my right butt cheek and trace down my leg to the hamstring, lateral thigh, and sometimes all the way to the heel. Next comes intense pain in the right front hip, and once it starts, it’s very hard to stop it.

I got a new bike— a cruiser with a very stable seat to keep my SI joints from getting angry— and can ride it without aggravating my back, which is awesome. It’s easy on my neck, too, since I sit upright in the seat rather than leaning over to reach the handlebars. I walk 5 or more miles every day, lift light weights, do a core workout like it’s my religion, and row a mile on our awesome Concept2 machine. For these reasons, I’m pretty strong, although I really want to return to more freedom and running. The lack of comfortable sleep position is maddening, and the pain can be crazy-making. Sometimes I change positions for three hours before I can go to sleep, but other times I get lucky and only move around for about an hour before conking out. It’s very frustrating to go to bed exhausted but unable to sleep because of pain. Lately, I sometimes have no pain at all until I lie down, which is quite bizarre.

No matter how long this shit goes on with chronic pain, I’m never able to get to used to it. There’s still some huge part of me that thinks it’s temporary, or maybe fake, despite making some serious strides toward peace with reality. But when I watch soccer on TV, I still feel the field under my cleans, the ball against my feet, and the rush of adrenaline from scoring a goal. I’m not sure that longing to play sports, to compete, to be free, will ever go away.

Regenerative Medicine

I’m highly skeptical of our modern medical industry— not because of practitioners so much as insurance companies’ influence on patient care. I’ve heard of boutique medicine, which as I understand it is essentially cash-pay for individualized treatment outside the bounds of insurers, but I’d never had experience with that type of doctor. I already pay more than my mortgage every month for our health insurance, then still owe co-pays and deductibles if I actually use the insurance, so the idea of paying fully out of pocket isn’t appealing at all. But desperation breeds willingness to try new things, so I went to an open house for a regenerative medicine doctor who practices outside the confines of insurance interference.

The facility was nice and clean, but not overly ornate. It had less of a clinical feeling and more of a personal vibe, and the doctor and physician’s assistant were welcoming and engaging as they greeted visitors. Instead of a waiting room full of literature about prescription drugs, I saw holistic supplements and bone broth for sale. The doc and PA looked extremely fit and healthy, and while of course looks can be deceiving, as an athlete, I was impressed that they appeared to work hard for their physiques. Cautiously, I began to feel hopeful and wonder if I’d finally found some real medical help. I registered for my first appointment, then went home to fill out a dozen pages of online paperwork.

The questions asked by the clinic’s online health history program were shockingly personal, in a good way. Even for the gender identifier, their were options beyond just male/female. I’m not transgender, but if I were, there was a space to identify as myself. What a breath of fresh air! I listed the various diagnoses I’d received over the years (fibromyalgia, cervical dystonia, guttate psoriasis, etc.), but also answered questions about my diet, exercise, and sleep habits. The forms were more thorough and probing than anything I’d seen at an insurance-accepted place.

A few days later, I sat in my truck outside the office and tried to calm myself with a few deep breaths. I wasn’t nervous about what would happen at the appointment, but I was very nervous that even the cash-pay, uninhibited-by-insurance doctor couldn’t help me. I’d put so much hope in the hands of medical professionals in the past and usually been slapped with disappointment, so I’d mostly quit seeking medical interventions. But May was a really, really hard month for me, and I needed help ASAP.

My appointment was over an hour long— 60+ minutes with just the doctor and me! No interruptions, no hurried feelings, no bullshit. It was more like a conversation than a medical appointment, even though he examined my back and talked about symptoms and tests and nutrition. I pulled out my usual stack of photographic evidence— pictures of my ghost-white fingers (Raynaud’s), rash-covered torso, and a few other oldies-but-goodies. He listened, talked, and drew diagrams on a dry-erase board. Unlike every other doctor’s appointment I’ve ever been to, I never once felt like I was keeping him from something more important than our time together.

I left with orders for comprehensive blood work and a kit for finger-prick testing and urinalysis. The doctor would start investigating from the most basic upward, and would look at everything from my cholesterol levels to potential food sensitivities. Only one lab in town could perform the tests, which told me how out-of-the-ordinary this doctor’s protocols were compared to most MDs. The first test was SpectraCell’s CardioMetabolic Panel (plus a few other things, like hormone levels), and next week I’ll find out the name of the next test.

I also bought several supplements that he recommended, including a highly concentrated and purified version of fish oil capsules. His goal is to attack the systemic inflammation in my body, and while he looks for the cause through blood work, he wants to knock it down as much as possible in the meantime. And no NSAIDs! That was one of the most shocking things he said. I’ve been on and off (mostly on) the NSAID train for so many years, but he’s adamant that NSAIDs actually inhibit healing. I’m sure there are skeptics, but after years of NSAIDs and chronic pain, I’m very willing to try new theories.

I’ve had one blood draw already and will go for the next one next week. Once the results come back, maybe I’ll finally have a path to wellness. Of all the things I’ve tried over the years, this line of medical treatment seems to make the most sense, and for the first time in a long time, I’m hopeful again.

Running, Renewal, and a Pretty Good Month

cheaha sunset
Gorgeous sunset at Cheaha.

I’ve had as good an October so far as I had a bad September, health-wise. It’s been a almost six weeks since I’ve needed a chiropractic adjustment (although I have to twist, roll, and traction myself daily), and I’m back up to running multiple times per week and lifting weights. Until a few days ago, I was sleeping pretty well, too. Chronic health problems are often cyclical, and I was reminded of that a few days ago when my hips and low back felt locked and painful and self-care wasn’t cutting it. I didn’t do anything out of the ordinary to cause the issue, and I’m hoping a quick trip to my beloved chiropractor will fix my woes.

I bit off more than I can chew with work, and some of that stress is probably contributing to my tight muscles and sore back. The teaching semester will be over in about five weeks— not that I’m counting— and getting down to one job plus writing will be relieving. I don’t know if it’s age, health issues, or what, but I just can’t work as many jobs as I used to without feeling overwhelmed.

I had a business meeting at an office about twenty miles from the state forest, and I knew a good run in the clean air would help clear my mind. I saw an awesome rattlesnake and enjoyed the solitude. I had to stop a few times to try to work the kinks out of my back, but otherwise it was a great run. I hope I can get out there again soon. And speaking of awesome runs– I had a great one at Cheaha State Park in Alabama. The mountain views, the morning mist…it was one of those days when it’s great to be alive and aware.

Feeling Better, Looking Ahead

bayou sunrise
Sunrise over the bayou while I ran at an hour when I’m usually still in bed.

I had a rough September, starting with a flareup of cervical dystonia. I’d been working out pretty hard for a couple months, and I suspect some of the exercises I did were too much for my neck. As I began to recover, I got a cold, and the next day got the stomach flu. It was almost comical except that I felt awful and got super dehydrated.

Now that I’ve been close to 90% normal (my normal), I’m increasing my exercise again. I got up at 5 this morning and went for a run, happy to avoid the 90-degree temps that will come later today. The sunset over the bayou was enough to encourage me to stop and enjoy it even though I knew I had limited time to run before the heat rose to a miserable level.
As I regain running strength, I’m alternating ten minutes of endurance training– slow, steady pace– with five minutes of speedwork– fast (for me) pace but not sprint. I’m comfortably up to 35 minutes of running each session, and I’m sure I could do more, but I don’t want to relapse into another battle with neck spasms.
I bought a new peanut, which is essentially two lacrosse balls joined to form a torture device. I hate using it, but it’s highly effective at breaking some of my cervical and thoracic spasms. I was super stiff and headed toward immobility last night, but the peanut came through for me and I feel much better this morning.
I’ve also gotten more dedicated to rolling, which I intended to mean I’m rolling twice every day, but what actually means I’m rolling about five days a week. I use a solid foam roller and it’s helping a lot to reduce the tension in my legs and back. Rolling the outside of my thighs makes my eyes water, but, like the peanut, the results are totally worth the temporary discomfort.
One of the weirdest, lingering effects of my September health issues is a major shift in my appetite. I lost four pounds when I had the stomach flu, and I’m pretty sure most of it was fluid loss. However, since then, I’m alternately ravenous for random food (like beans, rice, and salsa for breakfast!) and unable to finish my meals. I’ve been a mega-portion eater for many years, so this shift is very odd. I’m giving myself some leeway and allowing, within reason, whatever meals I want. I draw the line at pure crap, like the serious cravings I’ve been having for milkshakes, but I admit to eating corn chips and Mexican food for breakfast this morning.
I’m not one to wish time away, but I’m really looking forward to October. I hope the ridiculous high temperatures will finally drop. I can’t wait to actually feel cold when I walk outside. This October marks three years since my back started giving me major trouble, but I’m not dwelling on that anniversary. I’m ready to do some serious hiking and backpacking when the weather cools off, and I’m certain October will bring the cool breezes and nights that I crave.

Three Weeks, Three Ailments

I’ve had a tough three weeks. Technically, a tough three weeks and three days. I woke up three Mondays ago completely unable to turn my head. It was nothing new, just an aggravation of persistent cervical dystonia, but I’d really thought my body was doing better than ever. I’d been feeling strong lately and had upped my workout intensity. I’d been lifting heavier weights than usual and doing more core work, especially planks, than I’d ever done in my life. I felt pretty great, all things considered. Then I woke up and couldn’t move my head.

My awesome chiropractor, who I’m truly not sure I can live without, helped set my vertebrae back where they belong. He found most of the issues in the thoracic spine, and it took a few days and multiple adjustments, but I started feeling normal (normal for me!) again. My talented PT friends worked on me, too, and after a couple sessions of Dolphin Neurostim, I was looking left and right without turning my entire body. I took a week off from exercise, which I hated, but I thought some rest might help me move on from neck trouble faster than usual. It seemed to work, and by day 8, I was walking comfortably for an hour and lifting a few light weights.

As the middle of the second week approached, my head was turning pretty well without chiropractor help, and I set my sights on returning to running and other challenging workouts. I actually missed planking and couldn’t wait to return to it. Then my throat got sore, a headache came on, and I was super tired. Symptoms of a common cold were alarming enough, but then I felt sick. Really, really sick. I spent the night throwing up and generally feeling like death. Every joint in my body ached. The next day, I was dizzy and exhausted and a nurse at a walk-in clinic said my blood pressure was 80/50 (hence the dizziness) and my pulse was 118. Dehydration is a scary beast.

I hate going to the doctor. Dealing with chronic pain and medical conditions has already required too much time in doctors’ offices, so the idea of going even for severe dehydration is off limits. Stubborn, stupid, whatever. We all make our choices. My wife bought me some crackers and Gatorade and we went home rather than to the hospital as the nurse suggested. One of the only bonuses about being that sick was it gave me the ability to sleep. I slept more the last several nights than I have in years.

After a miserable weekend, the stomach stuff and dehydration were under control, but the cold was back with a vengeance. My neck was super tight and painful again and I felt defeated. After three weeks of fighting one ailment after another, I’d lost three pounds and watched the visible muscles in my abdomen begin to disappear. I could tell my legs and arms were getting weaker, too. Everything I’d worked so hard for was literally wasting away. I allowed a five-minute pity party, then got out the Wii. There’s nothing like a hearty game of Wii Fit Plus hula hoop to make me feel alive again. I was stiff and sore, but it was great to get moving again.

My chiropractor loosened up my t-spine again, and I’m eating normally without any stomach trouble. Mostly all that’s still hanging on are the cold symptoms, plus the usual stiff neck. I’m so ready to be back to a full life. I charged up my old Garmin watch and am ready to go as soon as I can breathe through my nose again.

In the midst of all this, the weather has gotten cooler—finally. We still hit daytime temps of 90+, but the evenings are less humid and more tolerable. I’m really hoping that by this weekend I’ll be able to get out and enjoy the taste of fall in the air. One of the hardest things about being hurt and sick is being forced to take a break from life. I’m ready to get out and explore my corner of the world.

Dirt Road Running and River Tubing

red dirt road
The T described by the shuttle driver was an intersection of wide dirt roads. Perfect for running.

I planned to run eight miles on forest roads yesterday morning and meet friends for a day on the river afterward. Despite careful planning, I realized my chosen route wouldn’t work when I found out from the kayak shuttle driver that my friends’ drop-off point was going to be more southerly than I thought. If I ran the route I chose, I’d come to the river north of them, and I was pretty sure I couldn’t catch their kayaks with my 99-cent tube. The shuttle driver saved the day by giving me fantastic directions for a pig-trail route to catch up with them further south. The new plan made me a little uneasy but sparked my curiosity. As my friends boarded the shuttle, I repacked my bag, ditching my iPod in favor of a compass and adding extra Gin Gins in case I got lost and hungry.

The shuttle driver’s directions were spot-on, even though he failed to mention a few turnoffs that made me more than a little nervous. Every time I passed another trail, I wondered if he’d forgotten to mention a turn. I decided to run out for an hour, and if I didn’t find the river by then, I’d turn around and follow my footsteps (and compass) back to my truck. I love adventures, but I hate going off road without a map. None of the forest maps I own—not even the official Forest Service map—shows the route I was on yesterday.

jurek endure bottle
Rationing my water from one of two 10oz bottles on my Jurek Endure waistpack.

At the eighteen-minute mark, I found the T the driver told me about. “You’ll come to a place where you’ll either have to go left or right,” he said. “Turn left.” I’d written his words down on a tiny piece of paper and stuffed it in my waistpack so I wouldn’t risk my memory playing tricks. I turned left like he said, and within ten minutes I was at the river.

Unfortunately, my friends were way upstream, so I had time to kill. I turned around and ran a bit more, than came back to the river and talked with a family who’d arrived via shuttle for tubing. What I witnessed—and the conversations I had with that family—is too powerful and emotional for me to talk about yet, but suffice it to say I felt the convergence of tragedy, unfairness, hope, and resilience. Rather than wait for my friends, I decided to hike further upriver and process my encounter with the family of strangers.

I found another unmarked trail, this one narrow and crisscrossed by spider webs, but it was a decent hike. I followed the route upstream for a mile until I hit an impasse. A huge patch of wetlands suddenly appeared, and I don’t think I could’ve even made it through with snake waders and boots, let alone in running shorts and sneakers. I dipped down off the trail onto a sandy beach and sat under a cypress tree in the river. My back and neck were really bothering me and I hadn’t slept more than three hours the night before, but the cold water felt great. I wished I could figure out a way to float on my back and completely relax without being carried by the current.

blackwater river
My riverfront view as I waited for my kayaking friends to paddle downstream.

My friends arrived eventually, better late than never, and their kayaks were loaded with food and supplies. It was great to see them paddling their kayaks toward me, and I sat with them on the beach and pigged out for a while before we headed downstream. I’d run with a deflated tube bungeed to my waistpack, and once I got it blown up, we took off down the river. Note for future adventures: tubing on a 99-cent piece of crap is a lot slower than going down the river on a kayak. I ended up getting towed a good portion of the way by three generous friends who switched off paddling duties as I clung to the tails of their kayaks. I told them I’d be fine and would catch up eventually, but they stayed with me anyway. Five slow miles later, we floated under the last bridge before the river becomes non-navigable, and I walked up the bank to my truck. Changing into dry, cotton clothes felt great after being wet literally all day.

It was a very successful trip in terms of nothing going wrong, but I was so ready for something crazy to happen that when it didn’t I was almost a little let down. I’m excited about the future, though—after seeing all those pig trails, I’m ready to go back and explore more uncharted territory. I’m going to take my GPS and make my own map of the trails. Who knows? Maybe I can sell copies of the map (to that one other person besides me in the whole world who would want to hike there?). Better keep my day jobs.

Stabilizing SI Joints for Air Squats

squat si joint
No, I’m not about to go to the bathroom in my yard. I’m descending into a squat while holding my SI joints!

My re-acquired (or earned!) ability to squat is absolutely awesome. Many years—yes, years—of persistence, hard work, and dedication finally paid off the day I realized I could finally squat again after so much time of squat=excruciating low back pain.

Since the breakthrough day, I’ve slowly added squatting back into my workout routine. The benefits, both psychological and physical, are obvious already. I have more energy because I feel like I’ve accomplished something major. My workouts are more challenging, in a good way, because I can squat. I’m better able to strengthen my body, which helps keep my joints safe and stable. And I’m so, so excited!

My squats come with a caveat. I’m up to sixty air squats in one workout, but I have to do every single one while using my hands to hold my SI joints in place. If that sounds weird, I promise it looks weird, too, but it works for me. I dig my fingers into the divots near the joints that attach my pelvis to my spine, apply pressure, and squat without pain. I can’t go beyond parallel without sacral nerve irritation, but I can squat! I can squat!

Did I mention I can squat again? J My newfound squatting ability has injected life into my strength-training workouts. I’ve recommitted myself to doing as many resistance exercises as my body will allow, and I feel great. My posture is already improved, and I can hold my puppy with more confidence when she pulls on her leash. I’ve been doing a good core workout plus basic arm weights for quite some time, but squatting has really reminded me of how much a strong body can protect itself—even when it needs to protect itself from itself (thanks, autoimmune issues).

I can’t add weight to my squats since my hands are busy holding my SI joints in alignment, but I have faith that one day I’ll progress. Just the fact that I can do the basic movement again is a huge victory. Every time I squat, I smile. It’s a great feeling to be able to squat, and I’ve worked hard and long to earn it.

Earlier Mornings and Organization

I’m making a major effort to organize and restructure my life. The reasons are varied, but the bottom line is I need to be more productive if I’m going to have a shot at accomplishing my major life goals. Lately I’ve dedicated a lot of thought to what I want my life to look like, and I realized (no shock) that my lack of Type-A tendencies hold me back from getting the most from my days. My brain is scattered, my workspace is scattered, and there’s no way I’m maxing out my potential in the midst of chaos. I could make excuses, some of which are legitimate (like how exhausting it is to fight chronic health issues), but the crux of the problem remains the same—I have goals, and I can’t accomplish them if I don’t get organized.

inspirational quotes
I put together some inspiration to hang over my newly organized desk. These are just simple notecards I wrote on and laid out before tacking them onto a cork board.

I printed a simple Excel spreadsheet to itemize my days and times, and started yesterday by filling in what I did with each time block. My ultimate plan is to write myself a schedule and adhere to it come hell or high water, but for now I’m just feeling out what a truly organized life will be like. I spent three hours going through stacks of paper, drawers of random stuff, and bins with pens that don’t write anymore. I chose to work meticulously rather than just tidying my space, and the task definitely started to drag. However, when I was done, I had a usable, organized desk. A large paper grocery bag full of recyclables proved just how much crap I’d kept for years.

I also confirmed what I suspected—I’ve let my health problems dictate too much of my days. There are times when that can’t be helped, but overall, even attention to a health crisis can be scheduled in a spreadsheet. I’ve been nearly killing myself by running too late in the mornings. By the time I get around to running, it’s usually 92-95 degrees in the shade. I struggle with getting comfortable at night, which means I often don’t sleep well, which, in turn, means I don’t move very efficiently in the morning. When I do get up, I take a lot of time to traction and stretch my back, rub Cryoderm on my neck, and/or do whatever else my body demands. It’s sometimes 10 a.m. before I run, and that’s not the smartest routine in the summer in the Deep South. It’s also a productivity-killer.

Fix number one was definitely organizing my desk. I’m not entirely sure if it’s true that a cluttered space equals a cluttered mind, but I feel better when I look at my newly arranged workspace. It’s been a source of embarrassment for years, and the piles of junk on it have definitely hindered my productivity. Now it’s a place that signifies pride in myself and my work and dedication to my future. Seriously, it seems that important.

Fix number two is saying to hell with my health problems and insomnia and getting up early anyway. (I used to work the 5 a.m. – 5 p.m. shift, so it’s not like I’ve never had to get up early.) I set my alarm for 6:30 a.m., but when I still couldn’t get comfortable enough to sleep at 1 a.m., I grabbed my phone and changed the alarm to 7. It felt a little like defeat, but I respect my body enough not to punish myself too much for my pain. Guilt over health conditions is absolutely counter-productive. At 6:57, I woke up anyway and turned off the alarm before it could blare. That small action empowered me, and I headed to the kitchen to wake the dogs and put them out to do their business.

Side note—as far as “doing business,” like many runners, I much prefer to do mine before I run. I knew there was a possibility that last night’s dinner wouldn’t get moving at such an early hour, and I was right. Luckily, nothing catastrophic happened, although it was a little weird to head out the door to run before using the bathroom.

I drank ½ a cup of coffee and ate a Larabar, rubbed sunscreen on my face, and put on the running clothes I’d laid out the night before. I paced around the house as a preliminary warm-up, and played with our puppy for some dynamic movement. I sat on the porch stairs for a minute and self-tractioned my back, then knocked my SI joints into alignment against the tiled steps. So far, so good, and I was out the door before 8 a.m. to start my warm-up walk.

5.15 miles run
Electronic proof of a solid run. I used my refurbished iPod Nano and the Nike+ app to track my route, and the nice background pic belongs to the app.

The run wasn’t glorious or amazing or any of those other words I’d hoped would apply, but it was pretty damn good. The sun was still low enough that the mature trees in our neighborhood blocked it from directly cooking me, and the asphalt hadn’t heated up to the point of steam and odor yet. The bayou looked peaceful, almost like it was just waking up, too. I was covered in sweat by the end of my five-mile route, but not completely drenched like I am when I run later. The best part was, I wasn’t exhausted. I came home completely sold on running early in the morning and determined to back that alarm up to 6:30 and eventually to 6.

So far, my time log looks a lot better than yesterday’s. I couldn’t sleep two nights ago, partly because a nasty outbreak of psoriasis itched so bad that it kept me up. The skin calamity was the main reason I didn’t get up until almost 9 yesterday, but it had a strong effect on my productivity. What I’ve also realized is, staying in bed later doesn’t make me any less tired or any less itchy or really affect my pain and discomfort at all. In fact, I was less stiff this morning than usual after less time in bed.

Today’s To Do list is long, and it’s a good feeling to be partway through it at only 10:25 in the morning. I’m figuring out that I thrive off the sense of control I get from being extremely organized. Chronic pain demands so much attention, and it’s nice to fight back by telling my body that it’ll still get the help it needs, but that it’ll have to be helped efficiently and within my schedule. I truly feel empowered (also somewhat due to being able to squat again, which I’m sure makes me mentally and physically stronger!), and “empowerment” is something I haven’t really experienced in years. It’s a damn good feeling.

Daily Gratitude and Appreciation

I have three things to celebrate today. Nothing extraordinary, but focusing on the positive always makes me feel good.

I had a good run this morning. A thunderstorm was building, so the air was cooler than usual and clouds covered the sun. Lots of birds sang in the trees, and I saw a redheaded woodpecker gather nesting material. It was a nice break from the sauna-like atmosphere of Florida in the summer. There wasn’t anything spectacular about today’s run, but I always appreciate every chance I get to explore the world on foot.

balega socks
I love these Balega socks and am proud to have gotten them dirty on their maiden voyage.

I tried out some new Balega socks. I got them on clearance, which is the only way I can afford them, and WOW, they’re nice! They held up well to a five-miler through several parks. They didn’t slip at all and my feet felt great—no blisters, no temperature issues, no constrictive fit. I’m glad I bought two pair.

 

 

 

 

puppy with ice
Roo is a sweet soul and loves to play with giant ice cubes.

My puppy is growing up and becoming a great dog. She has truly boundless energy, and she’s energized the whole household. There’s nothing like watching a puppy greet every day with excitement and curiosity. She’s sweet and soft and makes adorable groaning sounds when she stretches. The vet said I can start running with her when she’s eight months old, which means we’re on a short countdown. In about two months, I’ll have a new running buddy!

Squatting with Sacroiliac Joint Instability

air squat
Imperfect form, but I can squat! Victory!

I’m able to squat again! That probably sounds like a weird thing to celebrate, but I’m absolutely ecstatic. The recovery from my back pain/sacroiliac joint dysfunction has been long and complicated. I still believe that exercise with an emphasis on functional movement is the closest thing to a cure. I stick to my core workout like a religion. That said, it’s a tough road and sometimes I’m exhausted from the dedication it takes to heal myself. My three major holdouts in the battle against back pain have been sleeping, sitting, and squatting.

Sleeping is a night-by-night ordeal. Sometimes I can get comfortable and sleep 3 or 4 hours without even changing positions. Other times I spend almost all night turning, getting up to stretch, stacking and re-stacking pillows under my legs, and generally feeling like shit. Overall, my sleep situation is vastly improved, but if my SI joints are misaligned and put pressure on a nerve or two, I have a miserable night.

Sitting, too, is much improved, although I still can’t tolerate a soft surface like a couch or recliner. I do a lot of computer work while sitting on a wooden piano bench and am grateful I can sit half an hour on my butt. There was a time, not that long ago, when half a minute was torture.

Squatting is a bigger deal than I first realized. For starters, picking anything up with good body mechanics almost always requires squatting, especially if something heavy needs lifting. Petting small dogs requires squatting. Tying shoes requires squatting. You get the idea. I’ve made several adaptations, including training my puppy to get on a chair so I can pet her without squatting (no kidding!), but of course I want to be able to squat. My fitness has somewhat plateaued due to the lack of squatting, since lots of major weightlifting and core exercises require a squat.

A few days ago, after trying some new kneeling exercises to open my hips, I decided to advance to a wide-stance squat. I needed to lift a piece of landscaping concrete and didn’t want to ask for help. Living with chronic pain means frequently asking for help, and I hate asking people to do things for me. I took a deep breath and separated my feet well beyond the width of my hips, then squatted slowly. I waited for the usual searing pain to shoot through my right SI and into my right buttock, but all I felt was a slight twinge. I held the squat for a few seconds and got tears in my eyes. That may sound crazy, but anyone who’s had a physical limitation will understand. When that limitation is lifted—even if only partially—it feels like a personal miracle.

I’m very, very careful with my newfound squatting ability. As much as I’d like to do air squats until I drop (seriously, that’s my idea of fun), I’m only doing ten per day until I’m sure my back can handle more. I’m also resisting the urge to add weight to my squats. Just being able to squat is a huge accomplishment and I don’t want to take it for granted and end up hurt worse than ever.

I don’t keep a gratitude journal, although I probably should. If I did, one of the first things on my list this week would be “ability to squat.” Sometimes the simple things really are the best.