Laura said:
Two more days of babying and checking in again. It is getting better day by day if I don't do anything damaging!
The doctor said no point in doing X-rays because that area seldom shows anything. His suggestions were basically what I am doing.
The worst part is all the other areas that are getting kinked up from my efforts to stay in positions that aren't painful on the backside and right hip.
I've got a tray table that raises and lowers and I'm doing reading and writing by hand there while standing. I did think I could put a laptop on it but I'm not sure I want to be stressed that way right now. I am getting a lot of reading/thinking done!
I think I'll be back in the saddle - with care - in a couple more weeks at most. We'll see.
Thanks again to all for well-wishes and all positive energies manifested in helping the network.
Laura, thank you for this, and the thought of you standing for possibly extended periods of time, when not in the pool, brought to mind some health related information learned while attending massage therapy school back in 2002.
As may be already known, while walking, even for short periods of time (e.g., 20 minutes is very beneficial in general for many reasons), one of the benefits of walking includes the inducement of natural and helpful pressures on the bones (particularly beneficial to those with calcium-mining issues as occurs with osteoporosis) and the facilitative blood pumping effect arising from the contraction and relaxation of leg muscles to reduce the tendency of venous pooling in the legs while standing.
Both compression socks/hose (aka, "support hose") and ergonomic standing mats offer preventative/ameliorative aids for those standing for long periods of time. Additionally, while standing, fidgeting, shifting the weight frequently back and forth, and similar leg movements may also get the blood pumping upwards, but, of course, in your case, extra care must be taken in abrupt movements creating stressful and/or pain-inducing postures.
The following are given to provide further information along these lines:
_http://www.keywen.com/en/POOLING#BLOOD_POOLING
Blood Pooling
1) The reduced blood flows to the heart are believed to originate in blood pooling in the lower body upon standing.
2) Well-designed diabetic support socks help prevent blood pooling in the feet and lower legs, which alleviates many of these problems. Move Up
3) Surgery may be necessary for the evacuation of a hematoma (blood pooling from a hemorrhage).
Blood
1) The patients may have a reduced blood volume throughout their body, or the hypovolemia may occur due to blood pooling in the abdomen and legs.
2) General anesthetics used during surgery can dilate your veins, which can increase the risk of blood pooling and then clotting.
3) Long periods standing can result in blood pooling in the legs, with blood pressure too high to return blood to the heart.
Pooling
1) Elastic compression stockings may be used to reduce your swelling and prevent blood from pooling in your veins in your legs.
2) Other treatments include filters to catch blood clots and compression stockings that prevent blood from pooling and clotting. Move Up
3) Venous insufficiency is a very common condition resulting from decreased blood flow from the leg veins up to the heart, with pooling of blood in the veins.
_http://www.usc.edu/dept/biomed/bme403/Section_3/venous_pooling.html
Venous Pooling
Venous pooling is the accumulation of blood in the veins (of legs) due to gravitational pull when a person changes position from lying down to standing up.
Because the veins are so much more pliable then the arteries, due to a decrease in smooth muscle lining, they are capable of expanding without recoil to a greater extent. This property enables them to take an excess of 300-800ml of blood when a person stands up. Like all other systemic disturbances, it also affects a series of sensors of which the baro-receptors are the most important in this case. The decrease in blood flow/CO, stimulates the baro-receptors to compensate by increasing heart rate and vasoconstriction. This is meant to equalize pressure and flow deficiencies created by the lack of blood. Unfortunately, this system is very sensitive to external factors, such as temperature and pressure changes, which can cause significant changes in the response. For example, motion provides a quick alternative to restabilization of blood pressure and flow, since the muscles involved act as secondary pumping mechanisms for the venous surplus, moving it along. This also prevents edema in the legs, as the fluid pressure gradient is now equalized.
_http://www.slanket.es/circulation_booster/circulation_booster_clinical_study.pdf
Venous Pooling
In tall or upright animals such as man, large hydrostatic forces exist within the venous and arterial vasculature. Pooling is induced by an increase in hydrostatic pressure (the gravitational force exerted by the column of blood between the heart and the foot) reduces blood volume within the central circulation
and thereby increases the work of the heart (increased heart rate) in an attempt to maintain cardiac output.
Venous pooling within the lower limbs is all too common in individuals with impaired mobility although even those without defined pathology may experience pooling during prolonged upright standing or sitting. Furthermore, pooling within the periphery if protracted can lead to swelling (oedema) due to extremities leads to increased transcapillary filtration into the interstitial space. In fact, during prolonged standing, about 600ml of blood collects within the legs. Concomitantly, the reabsorption of interstitial fluid is reduced resulting in increase extravascular fluid volume (Stick, Grau & Witzleb,1989).
These processes can in turn induce severe discomfort or pain that may impair mobility further. In addition, protracted immobility can lead to the development of deep vein thrombosis (DVT), particularly in the lower limb. Intravascular thrombus formation in addition to stasis has been related to primary lesions of endothelial cells, and changes of blood coagulability with risk factors including physical inactivity, occupation, work posture, and long-distance flight (economy class syndrome)(Breddin, 1989). DVT is also
associated with swelling, reddening and pain that may be precipitated or exacerbated by standing or walking and may result in endothelial lesions. The most serious (and rare) complication of DVT is pulmonary embolism.
Reduction or retardation of limb pooling may occur via the induction of venous outflow from the periphery and into the central circulation. This has been demonstrated via lower limb muscular contraction and in particular the Soleus and Gastrocnemius complex of the calf that forces blood from the vasculature
tethered to the muscle fibres. Such a mechanism is termed the ‘muscle pump’ and may be mediated via normal locomotion or a voluntary contraction. Furthermore, it has been proposed that ‘fidgeting’ is in fact an
involuntary behaviour whose function may include activation of the muscle pump.
_http://www.cobaeurope.com/knowledge/health-safety/standing-on-anti-fatigue-matting/281
The Impact of Standing
Regular prolonged standing on hard floor surfaces can create pain and discomfort, and if ignored, can have long-term health implications. It can damage joints, cause swelling of the legs and lead to problems in the feet including bunions, corns, Achilles tendonitis and other orthopaedic conditions.
Standing affects our circulatory system which is responsible for moving blood throughout the body. It makes the heart work harder and puts increased pressure on the walls of the veins. Varicose veins and other similar venous disorders can have more dangerous consequences increasing the potential for heart attack and stroke.
[...]
That is why when we stand, we subject the walls of our veins to increased pressure which can cause long-term damage. When standing still, gravity makes fluid settle in the feet and legs which can create pooling and swelling. The heart has to increase its beat rate to compensate for this.
Research into venous pressure on a sample of workers found that the pressure when seated was 56mm, while the pressure for standing was 87mm. The pressure dropped to 21mm after taking around 10 steps concluding that walking for two to four minutes a day after every 15 minute period of standing was more comfortable than standing without walking (Konz S, Johnson S, Work Design 1-629, 2000).
How does Anti-Fatigue Matting help?
Anti-fatigue matting is more than just a comfortable standing surface. The cushioning helps to promote regular foot movement as the feet naturally adapt to the ‘flexible’ surface of the mat. The movement of muscles contracting and expanding is very subtle indeed, but is enough to help circulate blood towards the heart without expending so much energy as that experienced on a concrete floor.
Prolonged standing ultimately leads to pressure on the bony plantar (sole) of the feet which causes shifting of the weight. An anti-fatigue mat helps to reduce the concussion and distributes the pressure over a greater surface area. This reduces muscle activity and in turn fatigue.
Thermal comfort is another aspect of anti-fatigue matting as blood circulation is affected by extremes of temperature. Anti-fatigue mats protect operatives from cold concrete floors.
Attached is a picture from the above article showing how the relaxation/contraction pumping effect of the calf muscles in movement relates to upward movement of blood flow back towards the heart.
Just in case of interest/need, as potential leads in a search, below are two amazon.com links for anti-fatigue standing mats and compression hosiery:
_http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=anti-fatigue%20mats%20for%20standing
_http://www.amazon.com/s/ref=nb_sb_noss_1?url=search-alias%3Daps&field-keywords=support%20hose&sprefix=suppo%2Caps
