Tag health and fitness

Broken Thumb

Angel Ackerman 3 Comments

In 2023, I had two falls close together (two bouts tumbling down the stairs in two weeks) and in general, I tend to fall more in winter (and not even outoor falls due to weather and ice). These two factors and my hospitalization with AFib after my falls in 2023 led me to go to the emergency room yesterday because of my fall at lunch time on Wednesday.

(For more info on my hospitalization in 2023, click here.)

I just wanted to make sure that this fall didn’t lead to a sequence of falls.

In similar cautiousness, today I visited my old ortho practice from when I broke my ankle in 2016. That’s the infamous “I broke my ankle and went to the Chinese buffet before heading to urgent care for an x-ray” incident. Read more about that here.

I felt silly, because my injury is pretty minor compared to other orthopedic cases. The ER told me that if it didn’t feel better in two weeks to follow up with ortho.

But I know from past breaks that the first two weeks is when the healing really solidifies and if it heals wrong, I would have more problems. And I wanted better direction on how to splint it, a better splint, and confirmation it was broken.

It is. In two places in the knuckle.

This is my right hand. At this point only one finger of my right hand has not been screwed up in some capacity.

And the doctor seemed to agree with my fastidiousness. He gave me a better splint and some first aid tape and told me to come back in four weeks for a follow up and new x-rays. His assistant gave me some Coban tape and some buddy strips for the splint.

I have a high-deductible insurance plan and I do not have an HSA, so I know I will pay more than I want to for this, but it’s my dominant hand and I need it to work.

Playing my favorite game: ER or urgent care?

Angel Ackerman 1 Comment

Yesterday, in a strange turn of events, I had a fall. More of a trip.

But let’s back up. Remember that tire incident from my last post? The day after that post (which was not the same day as the incident) I came down with an ailment that still has me congested and softly coughing.

I have to wonder if I had COVID.

It’s only been the last few days that I’ve felt myself. And that might contribute to the perfect storm that put me in this position.

I forgot to take my baclofen yesterday and all I had before I went to pick up Nan for our errands was coffee and a couple Munchkins. (With Eva on vacation, those of us left behind had to take the dog to the Dunkin Drive Thru window.) I even forgot to take my blood pressure.

When I got home, it was probably 11:40. I had coffee from Panera and groceries in the car, as well as some plastic bins from the dollar store to organize the deep freezer.

I brought the coffee in first and got the dog out of the crate. The backyard had a lot of dog poo, and I wasn’t sure she peed.

So I put on her collar and her prong, leashed her up and checked for dogs and people. We went across the yard.., and the mailman popped off a porch four houses down.

I had not put on my hands-free, waist, back-up leash. So I dropped to my knees to better control the dog lunging at the mail carrier. I got her settled (the dog, not the mail lady) and put her back in the house.

I went to the store to get the items from the dollar store. The mail lady approached me to give me the mail. I accepted it, placing it in the large-ish plastic basin containing all the items from the dollar store.

I turned, got my foot caught on the dog’s outdoor place stay, and fell. I fell with a bit of a twist, landing both on my stuff and on my right thumb.

Assymmetry percentage

I landed on the sidewalk and along the steps.

I smashed the basin. It never even made it into the house.

The fall probably happened around 12:20. My watch didn’t register it as a hard fall, probably because the basin broke my fall and prevented more serious injury.

The thumb hurt but it moved well, so I took my Baclofen, had some lunch and sat down for a while. My phone suggested my gait had been awful that day.

Thumb directly after accident

At 5 p.m., I did a shift as the front counter bagger at Chick-Fil-A. 4 hours.

Had dinner. Came home. Went to bed.

Woke suddenly in the middle of the night. My thumb hurt and it was bending less than it was earlier. I went back to sleep, planning to go to urgent care in the morning. The recycling truck came around at a bit after 4 a.m., woke me, and I couldn’t get back to sleep. I decided that even though I got less than five hours sleep I would just get up.

When I looked at my phone, I noticed a series of notifications. Apparently, my heart rate had been high while I was sleeping. Since I had that afib incident after my falls in 2023, I did an ecg on my phone. It was fine.

I headed for the bathroom. And as soon as I opened my bedroom door, I had to fight not to urinate on myself. With no warning. As I got closer to the bathroom, it was harder not to lose control– and in the end I didn’t really make it.

Thumb in the ER

Now my thumb would not bend at all.

I began to wonder: Do I have too many complexities for Urgent Care? With my disability and my heart history…

At 5:30 a.m., I decided to bite the bullet and walk to the ER.

A ten-lead echocardiogram was normal. Thumb shows a possible chip fracture.

I came home and called my neurologist, who is also a physiatrist, leaving a message in case she wanted to see me since I had a weird combination of symptoms. The person who assisted me asked me all sorts of questions.

While on hold with their office, I looked up the number for the Institute for Hand and Upper Extremity Rehabilitaton. I have worked with their therapists for two of my previous finger injuries on my right hand. They are now closed.

The person on the line with me from the neurologist’s office suggested I call the orthopedic specialist, especially since it’s the same doctor whom I consulted with when I broke my ankle ten years ago. The ER advised I call them if it got worse or did not improve.

But I would like to confirm whether or not it is broken and get a better treatment plan than this huge, cheap splint the ER gave me.

The person on the phone at the ortho’s office assured me that it was smart to be seen, right away, versus waiting for time to pass. She even had a cancellation for tomorrow morning.

So I guess we’ll have more updates tomorrow.

The finger and the feast

Angel Ackerman 1 Comment

Maybe the title is a misnomer.

There is no feast, but I like alliteration.

I went to the hospital yesterday for a specialty diagnostic ultrasound of the middle finger of my right hand. I’ve been having issues with it for six months. There were about four instances, about once a month where when I reached for something, it felt like the finger exploded and I screamed out. The pain only lasted 20-30 seconds, but the whole experience reminded me of when I had a mallet finger on the neighboring ring finger. And I keep expecting to see that finger drooping.

[If you would like to learn more about mallet finger: here is the blog entry about my um… accident… where I sustained an injury removing my socks. This is the entry about meeting with the orthopedic specialist.]

And every time I move the top of my finger independently of my other fingers, it clicks. Not painfully, but it’s noticeable. It’s just weird.

Today I had to go to St Lukes Bethlehem, which is the main urban campus of the hospital network because if the specialty nature of the ultrasound. I did not know that the parking deck was under construction. And for the first time in my life, I had to use valet parking. I technically had enough time to look for parking in the neighborhoods near the hospital but… I thought that stress would be higher than just using the valet service.

I checked in at the kiosk, and thinking about it now I never had the chance to check if my Able Pay was on my file because I will be paying for this test out of pocket. I have a high deductible medical plan and I have about $1,200 left of my $3,500 annual individual deductible. Able Pay gets me a discount on procedures and offers me interest-free payment plans.

Of course they asked if I might have had a fall and I had to tell them, “Of course I might have had a fall, but not one I can connect to this problem.”

The test itself involved the doctor and the radiologist– and the doctor could feel my clicking finger. BUT because of the nature of the click, remember it only happens if the finger is acting independently, he couldn’t get an image of it. The way he held my finger to get the image prevented the click. OR he couldn’t get the ultrasound into the proper place at the right time.

He found fluid around the joint, but he couldn’t say whether or not it caused or was related to the click. And he couldn’t see anything wrong.

He said he could “grill me” longer and keep trying weird things to take the image, but we both decided it wasn’t necessary. If he didn’t see anything structurally worrying AND I no longer have the pain– then I’m satisfied.

My neurologist asked if I wanted to see a hand specialist as a next step to examine the inflammation. I said no, unless the pain returns.

In the meantime, influenced by my experience at the Hindu temple and my recent overeating/ weight gain, I have done an impressive (in my opinion) job removing animal products and artificial sweeteners from my diet. I am working to reduce caffeine consumption but that has not been as successful.

So far this week, I have had no meat, milk only in my coffee, two servings of cheese, and I may have consumed eggs in baked goods that I did not make. But the main baked good in question is packaged gingerbread cookies that came from Grocery Outlet. They are GMO-free and I have eaten four small cookies (which comes out to one per day).

The scale is three pounds down, which might be because I moved the scale and this is an old house. I am also surprised that my protein levels have still been hitting 60-80 grams a day.

Eliminating animal products and artificial sweeteners is a great way to be mindful about eating. Sure, I want to promote preserving resources and eliminate animal suffering, but there is less food noise to contend with if you start with the vegan options and ask “will one of these work?” and the bonus is that I end up getting more fiber and meeting my fruit and vegetable goals because plant-based non-manufactured foods are often the most nutrient dense.

Today I visit the ENT to set up an old lady hearing test.

We now have a deep freezer

Angel Ackerman 1 Comment

We recently got an old, hand-me-down deep freezer.

And at the same time, the federal government shutdown and Pennsylvania state budget impasse have complicated SNAP benefits for families who have them.

I heard on the news that 1-in-8 Americans have SNAP (Supplemental Nutrition or “food stamps”). I heard one story this morning about an unemployed widow with a 15-year-old son whose soundbite suggested she sent him to school so he could eat breakfast and lunch.

I hope she’s sending him to school for an education, first and foremost.

I consider myself a fiscally-conservative Democrat who believes that education and healthcare should be attainable and fair. I would love to have a Ph.D., but I can’t afford to finish my masters and I refuse to go into debt for it. I also have a disability, and even when I am well-employed I often have to make choices about my medical care.

Right now, I have my own small business. I work a part-time job in the food service industry to provide some reliable income on a steady timeline. I am an adjunct instructor at my local community college, and if you break it down to an hourly rate, I probably make a similar wage at my fast food job (because of the fact that I did not have the money to finish my degrees). And I have freelance writing and editing jobs and a mini author’s assistant job.

And I’m always on the look out for more. Applied for another this morning.

I started my career in public relations, and ended up in print journalism, which led to a long career of lay-offs as newspapers died. I worked in non-profit communications and development, where I learned a massive amount of useful skills like grant writing but also experienced a ridiculous amount of toxic managerial behavior. Some people work in the non-profit sector because they want to make the world a better place, but at the same time, many of those people have either childhood trauma and/or personal insecurities that create some challenging environments in an already difficult field.

I mention all of this because I have experience with unemployment. I have experience with being the single mom with maybe enough resources to survive a month. I was a single mom raising a teenager who lost her job during the pandemic and did not find out if she qualified for unemployment until the weekend after she accepted a new job. I was unemployed for four months and had opened my home to one of my daughter’s friends who didn’t feel safe in her own home.

I applied for public assistance because I was volunteering at a non-profit that provides services for people exiting human trafficking situations and my “boss” suggested it. Because I had no income and I had an official dependent, I received more than $700/month in food stamps. And Medicaid. Which was a great help. Even though I only received food stamps for four months, I rationed them so they lasted almost a year.

I had accepted a job in the warehouse at Stitch Fix. I loved that job, and the company, but after three years they decided to close our warehouse. After three years at a wage where my take-home pay was the same as what I had made as the development manager for a small non-profit with a two-million-dollar annual budget (thanks to the fact that Stitch Fix offered their employees free medical benefits), I found myself laid off again.

And when my unemployment ran out, I once again applied for food stamps. I had gone on multiple interviews, built up my small business, but still struggled with the cost of my medical care– my estranged husband put me on his benefits but my medicine was $50-$100 a month and all my doctor’s appointments I had to pay out of pocket because of the high deductible. So I really hoped I would qualify for Medicaid again. And I did.

I also qualified for $525 in food stamps.

Around this same time, Trump got re-elected and the cheap refrigerator I bought started freezing the food in the refrigerator and not freezing the food in the freezer. But I couldn’t afford a new fridge– and I still can’t– so we started buying only what we could eat in a few days, or foods that could safely thaw and refreeze.

Lettuce is not one of them, if you were curious.

The point of all this is to ask: Regardless of how you feel about who uses food stamps or how the government distributes them or whether or not people try hard enough or work hard enough, why is no one asking why we have a system where 1-in-eight Americans qualifies for food stamps?

I have seen and heard so many things about the system, and I have known people who work in the branches of government that distribute these types of assistance and they are all people who want to help. I have met people afraid to work because they might lose assistance, and I have seen people who need the help lose it because they made too much money. (And, like me, it’s usually people who need medical care.)

I have about $2,300 left on my deductible this year, and I have spent almost an equal amount if you read my EOBs from the insurance company. I’m losing my hearing in one ear and I need a hearing test and a visit with the audiologist. The muscles in my one leg have been spasming 24-hours-a-day for almost a year now and I just blamed it on my cerebral palsy but my neurologist has concerns that previously noted damage to my spine (from all these years of walking crooked) may have caused nerve damage in my lower back. And my one finger has been doing crazy things for about a year.

That’s probably at least $6,000 worth of tests. Do I just try to schedule it all before the end of the year and finance the $2,000+ remaining of the deductible on a credit card? Or Able Pay? or do I wait until I am better off financially?

Back to the deep freezer. A friend of the family was hoping to get a decade-plus year old freezer out of his house. We took it. We took all the stuff from our cheap refrigerator that needed better freezer conditions and piled it in. And I thought– when Trump was elected an I was worried about the future of food stamps, I didn’t have a freezer to fill. I did however invest in every non-perishable food item I could tolerate.

Dried Beans. Plain-old Rice. Canned Fruit. Canned Vegs. Nutritional Yeast. Some condiments. Canned Tuna. Spam. Canned Chicken.

My childhood traumas leave me to ruminate frequently about food scarcity, financial security and general stability. I will probably always behave as if every trip to the grocery store is the last one I can afford. And I have done my grocery shopping at the Dollar Tree and the Grocery Outlet because I only had $20 left to feed us for the week.

The Office of Vocational Rehab considers me the most severely tier of worker, whereas the federal government says I do not qualify for disability because I work so much and at so many jobs. But the federal government doesn’t take into consideration that I have to work that hard to make ends meet. And I don’t always succeed and I often hurt myself doing it. And I just work past it.

But how do you determine an equitable way to decide who deserves help? And I ask a third time: Why does 1-in-eight Americans receive food stamps? What is wrong with our society if 1-in-eight people cannot afford to feed themselves according to the criteria the government sets forth?

Food for thought.

End of Summer Update

Angel Ackerman 1 Comment

More than a month has passed again. Since I last blogged, I have taught three classes at Northampton Community College in their creative writing program. Well, it’s one class and I’ve taught for three weeks. I am the instructor for their publishing class, “Paths to Publication for the Aspiring Author.”

My falls have been minor. A little too frequent, but they typically classify as trips and I have managed not to significantly hurt myself when I go down. Though I hate that they are happening about every other week.

I had two of my four annual doctor visits– gynecologist yesterday and primary care provider today. I even got my pneumonia vaccine, since the recommendations have changed from age 65 to age 50. Shingles will be next.

I have officially lost ten pounds during the last year. It’s not as much progress as I would like to see, but it was enough to please my doctor. He says my efforts in weight, nutrition, rest and exercise will have a huge impact on my life in ten or twenty years.

Though I am still a big fall risk.

I did finally get some medication issues straightened out between CVS and my insurance company. The insurance company kept refusing to pay for my pills until my neurologist changed the dosage of the individual pills from 5 to 10 mg. If I need five, I need to cut them in half– but at least they are paid for!

Well… That’s a first

Angel Ackerman 1 Comment

Every week, usually during the weekend, I walk down to my local CVS. It’s about a half mile away, and between my daughter and I, we usually have a prescription to retrieve. And if you buy items at CVS regularly, it triggers a variety of digital coupons that can have a domino effect and yield good deals.

Today I had about $5 in ExtraBucks, plus a $2 off a $12 purchase, plus some digital manufacturer coupons in the CVS app, and some product-specific CVS coupons that I planned to add to a 30% your full-price purchase coupon.

I bought a 90 count of Total Home kitchen trash bags (which were similar in price to a 100 bag box at Target), plus eight-gallon trash bags that were expensive for the number of bags in the box. BUT– I had a $5 off $15 coupon for Total Home trash liners AND the 30% total full-price purchase coupon, and the $20 box of 13-gallon bags would guarantee I hit the minimum after the 30% reduction.

Eva needed large bandages and some first aid cream, which was also full price. My bill came to about $43 and after coupons and discounts was $20.31.

On the walk home, I stumbled walking up my least favorite hill. I could feel my feet dragging but just didn’t have the strength to fight them. Here’s the odd thing– I lost my balance because my toes were dragging upward along the sidewalk. My arms went out, and normally at this point I do a bit of a corkscrew roll to minimize the damage as I attempt to fling myself onto grass.

But today something very unusual happened.

I recovered my balance. My hands hit the ground, but my body bent more like a hinge instead of crashing into the concrete. I didn’t even scrape my palms. I bent; I stood up. I walked home.

Never in my life have I recovered my balance once I put out my hands and braced for the fall.

Never. Ever.

Now, when I got up this morning, I gave myself a stern talking to because I did not go to 8:30 a.m. Boot Camp with Greg at Apex, my favorite local private gym. My back hurt and I was groggy and a host of other excuses. So I made myself promise that I would walk to CVS.

I need to do some straight leg deadlifts and other exercises for my back and legs but I’m not that motivated yet. And I stumbled at home trying to walk around the vacuum cleaner at the bottom of the stairs (Eva got a new vacuum cleaner, well, her third of the same model) and tripped after the CVS trip over a huge cardboard box right in front of my eyes. But neither led to a fall. Let me repeat, neither led to a fall.

I’m having more leg, hip and knee pain than usual, perhaps due to the dampness, the rain and the drop in temperature. Who knows?

I checked my phone and before I left for CVS in the first place my walking asymmetry spiked to 36% and before and after the near-miss fall registered at 2%. Now, let me reiterate (as my favorite doctor would say) that these phone figures are far from precise or even scientific, but they do seem to accurately reflect trends in my gait. My fall risk/walking steadiness consistently gets classified as “okay.”

But when you look at the last six months, you can see a drop. And while both are still within the range for “okay,” I wonder about it.

And for the record, last night, at my four-hour shift for my very part-time job that has somehow become 23 hours a week (thanks to some staffing issues and I can understand that), I worked at least five different positions.

I did some standing still, then a lot of walking around across a nice stretch of distance, and then I stood still some more until 2.5 hours into my shift, I was asked to cover a break delivering food inside the restaurant. At the beginning of that change, twice over the first five minutes, the asymmetry registered as seven percent. Did I notice it? No. Did it happen beyond those two instances? No. And after that 30 minutes, I went back to a position where I primarily stood still but also did a lot of stocking which meant moving to various storage locations and lifting boxes of various weights.

And the pace of the restaurant means my heart rate is usually between 120-130 for my whole shift. I noticed last night it reached 172 bpm. That’s my maximum heart rate at my age! My heart is supposed to be physically incapable of doing more than 170 bpm.

As I promised my doctor, I have been taking my allergy medicine, watching my blood pressure and taking the appropriate prescriptions and taking my baclofen. I’ve been good about taking at least 10 mg before my shifts.

PS– the anecdotal evidence is mounting that the Twinings Sleep + vanilla and cinnamon tea with melatonin not only tastes like a baked good, but it also increases the amount of deep sleep I get. I will still keep Traditional Medicinals Valerian in my rotation, but Twinings is a definite win.

PPS– I ate almost a whole can of salt & vinegar Pringles last night and gained a pound overnight. And because of how Omada measures your success as an average of the whole week, they have my weight listed as 163.5. It was 161.5 yesterday and 162.5 today.

The Day the Garbage Trucks Swarmed

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My shift at the restaurant Thursday evening went much easier than Wednesday— though I couldn’t bend and reach the floor and I took a lot of Baclofen.

And my left hand strangely hurt last night in the fifth metatarsal, in the same spot where I broke my right hand what had to be a decade or more ago.

Today I slept until 8 a.m. when my Goffin’s cockatoo, Nala, screamed, probably concerned that I died in my sleep.

I stripped my bed, started laundry, drank some coffee and used household chores as my warmup for a home workout. (After clearing my business email and banking stuff.)

The scale showed another pound gone. Soon I might hit the ten-pound mark.

Nothing like 30 or 40 pound cat litter boxes to practice farmer’s carry. And five trips up and down the stairs gets the heart rate up.

I did a pretty solid shoulder workout today, 22 minutes of just weights— including push press, dumbbell row, shoulder lateral raise.

Did some more wash, handled some more email and spoke with one of the Parisian Phoenix authors about a presentation we have been invited to give at Hellertown Library.

I did the dishes, started cooking some chicken livers for the dog, and made myself a big salad with lots of carrots.

I went to Panera for a while to work on my background material for the stories I am writing for Armchair Lehigh Valley regarding the May 20 primary.

And I got my schedule from the restaurant— 4 days in a row and 22 hours. I messaged my boss on Slack to warn her that that may be a struggle for me. She hired me so quickly I never had a chance to tell her about my cerebral palsy. She hired me to work 10-12 hours a week in the dining room, so I didn’t think I would have to.

But here I am, working 20+ hours all over the place.

I wasn’t sure how to bring it up, and I feel it’s better to do these things in person, but at least on Slack there’s a paper trail.

It turned out to be a great conversation. One we will continue in person. As I suspected, she’s short-staffed and I can really use the money so I didn’t want to complain.

Eva picked me up and we stopped at Grocery Outlet. And as soon as we got home, three garbage trucks swarmed us and our house.

I made a vegetable lovers DiGiorno thin crust pizza and split it with Eva and watched some more of The Pitt. Then I came up to make my bed, clean litter boxes, feed the bird, and get the cats water before my shower.

Now it is almost 8 p.m. and I plan to read until I am sleepy.

Yesterday was hard

Angel Ackerman 3 Comments

I don’t want to write this. I am tired and I want to go to bed and pray that I am not in too much pain to sleep. I won’t post it until tomorrow (Hence referring to today as yesterday in the title.)

Nothing bad happened. It was just a bad day physically, and it’s been a long time since a day hit me this hard.

I need to write about it though, because I am under strict instructions from my doctor to pay attention and note anything unusual because she’s heard some of my symptoms and said that if I were any other patient I’d be going for tests.

And if I don’t write this blog, I will forget today was a bad day physically.

It started nicely enough. Visted Nancy Scott and noticed then that climbing the stairs felt more stiff than usual.

Ate decently. Tried a sample meal replacement bar for breakfast and ate a HUGE brunch of potato, broccoli, multi color peppers, egg and feta. Had two pieces of licorice and a whole bunch of unsweetened and barely caffeinated tea.

I noticed while changing into my work uniform that my knuckles felt achy and weak and like I was about to injure my middle finger as I did with my mallet finger/sock incident of 2022. (If you want to read more about my mallet finger, click here.) This sensation returned again at the end of the night before I showered.

I took 10 mg of baclofen. In the morning, I took five.

Left for work at 1:30. So here’s the big reveal– in addition to my publishing company, I took what was supposed to be a very part-time job at Chick-Fil-A. My reasons for selecting that particular job were very specific. That might be a good topic for another post.

Once I arrive, I grab some Coke Zero. I usually stick to unsweetened iced tea or seltzer while I’m at the restaurant, but tonight I needed something a little extra. The back of my right thigh is spasming.

I started my shift running people their food inside the restaurant. It’s not my strongest position, but I like the movement. Then, I went to the drive-thru window for an hour, before I went back to running. My legs felt very heavy and clumsy the whole time.

Then, I went on break. And I ate a fruit cup. Everything still felt hard to move.(I walked a total of 15,000 steps today and two hours of my shift registered as exercise on my Apple Watch.) While outside I started stumbling, and twice I almost pelted some cars with bags of food.

And it was cold outside! Then, the icy rain started. Eventually, I got a poncho, and after about two hours I went inside and washed my hands for five straight minutes trying to get them warm again. At this point, my lower half hurts and I can’t bend and reach the floor.

And one of my supervisors accidentally clocks me in the cheekbone with his elbow. Hard.

I finally leave, and my phone alerts me that my heart rate is high. It hovered around 120-135 most of my shift. It usually does.

My toe hurts– not sure if I’m getting a blister or the toe I almost broke or the neuroma giving me trouble.

I came home, showered and made myself some food. And took 20 mg of baclofen. Making my grand total for the day 35 mg. I think. My blood pressure is also trending upward, at 112/78.

My phone says my average walking asymmetry for the day was 2.5 percent, but I noticed there was a lot of asymmetry. Often when my numbers are bad, they are a lot higher but only happen once. This was happening frequently. It looks like it was happening a dozen times an hour.

So, I came home wet, cold, stumbling and hurting.

I record this now to improve my memory of what the bad days feel like.

Balance Assessment at Susquehanna Service Dogs

Angel Ackerman 1 Comment

About three years ago, Eva– my daughter, in the beginning of her career as a pet caregiver and dog trainer– said she wanted to train me a service dog. She wanted something to babysit me once she left home or when I was home alone.

She showed me some videos and I did some research and thought she had a point. When she leaves home, I will be a 50-something woman living alone with a history of falls and accidents. The presence of a dog in my life would keep me active and prevent spasticity issues, improve my gait as a dog’s gait never falters, and perform small tasks like bringing me my phone or picking items off the floor.

I have no doubt that with the right puppy and the time, Eva could train a service dog. But I suggested that for our first experience in the realm of service dogs, we should apply to an official service dog program.

Working with a program would teach us how the dogs are trained, give us support, guarantee good breeding and the physical fitness of the dog, and have some added legitimacy should people question my dog’s work.

Now there are no rules that prevent individuals from training their own service dogs. I think this is why one can encounter a variety of “fake” service dogs doing public access work. [I saw two service animals in the same restaurant this week. One looked like a well-trained Labradoodle with a handler who wasn’t cognizant of her surroundings. The Labradoodle was lying across the main floor area of the restaurant and not tucked under a table. The second was a small dog, perhaps some sort of schnauzer who barked and begged and whined and scratched at its owner’s leg for food the entire time. So, either that handler was having a medical emergency and the dog’s alerts were being ignored or the dog was not properly trained. A working dog should not make noise in public and it should not be distracted by food.]

I understand that training a dog with an agency or a professional trainer is expensive, but people who insist on using dogs for public access that are not properly trained make life harder for those people who have working dogs that don’t misbehave. Improperly trained dogs with public access are the dogs more prone to cause an incident with another dog.

And once I pay for my dog– which will take ALL of my savings– if that dog is attacked or threatened while working in public, that could impact its ability to do its job in the future. My dog might become afraid and unable to focus on its job. So I will have invested all of my money in a dog that won’t leave the house.

In the United States, there are no rules or governing agencies that regulate service dogs. There are, however, rules about what people can ask to a handler of a service dog– Does this dog do work that mitigates your disability? What tasks does the dog do? That’s it.

I have chronicled my service dog adventures on this blog. Here are most of the entries. (I am also working on a disability memoir.) There’s a lot to the process. My dog will be a light mobility dog.

They say the average placement takes four years start-to-finish. We filled out the application with Susquehanna Service Dogs in Summer 2022. I went to their facility and had an interview, fill out a survey of my life and health every six months, did an assessment while working with a dog where they recorded me, brought Eva with me to do public access work in a mall, passed a home visit, collaborated with a case worker to develop a plan of what my dog would actually need to do, and now yesterday, I went back to the facility with Eva for a balance assessment.

They had a mobility professional join us– I believe she was a physical therapist– and I worked with the dog and showed them how I get up off the floor and answered questions about my life and recent fall history. I love when Eva can come because she can tell them her insights. Apparently, she was annoyed because physically I was having a good day yesterday.

I worked with Captain. What we learned was that my dog will need to walk on my right. The dogs are trained to walk on the left, but when the dog is on my left I struggle to walk in a straight line. When the dog is on my right, my posture and ambulation is much more natural.

We also decided that my dog will be guided by a leash, versus a strap or a mobility harness. A mobility harness is rigid and has the most feedback between human and dog. In the photos, I am using a red strap on the far right. The strap was okay, and it’s an intermediary step between the harness and the leash, but it didn’t feel natural. (And the benefit of using leash only is that it gives the dog more freedom and space to get out of the way when I fall. Some dogs are trained to do things when a handler starts to fall, but I want my dog out of the way.)

It also seems like I’m at the proper place in the timeline. The next step: When they have a group of dogs that are flexible enough to work on the right and the right size to work with me, I will get to meet them. It might take a few meetings to find the right dog. Once the right dog is selected and assigned, I believe they will do any specialized training while boarding on site and then I go to their facility for a three-week training session.

The dog itself has to be two-years-old and fully grown and cleared by a veterinarian before entering the work force. Moibility dogs have some of the hardest and most physical jobs out there for service dogs.

The Ups and Downs of February

Angel Ackerman Leave a comment

Lately, I’ve felt like nothing about my life is out-of-the-ordinary or interesting. Maybe that’s true, maybe it’s not.

But this week has been a humdinger. On Monday night, I came home from my supplementary part-time job (because as I’ve heard other people phrase it, “Winter is a hard time for small business” and I found what I think might be an awesome 10-hour-a-week job for me– if my body can handle it). I took a few Tylenol PM because my body was aching and I hadn’t used that particular medication in a long time. But, it’s spring kinda-sorta, and I haven’t been consistent with any antihistamines so I choked on the damn pills because of the allergy-related mucus.

Now, that’s not the end of the world, except I managed to recoil away from the bathroom sink and hit my face on the wooden shelf we use as a cabinet. I hit right along the cheekbone and it hurt like heck and managed to leave a narrow bruise almost parallel to my nose.

Now– some update/backstory as I move forward here– I am two months in to my three-month program at St. Luke’s medical fitness program Thrive. I have worked with several of the trainers (Alex, Claudia, Jim) and I can feel a difference since I returned to the gym. And this week I trained with Alex after several weeks primarily with Jim and Alex noticed I needed to up a bunch of my weights and he’s looking into changing my program.

Jim taught me some stretches for my IT band, because I’ve been having some new issues with spasms in that region, and my chiropractor had determined during our visit Wednesday that I had locked up my right knee. That’s totally new.

My blood pressure and heart rate has been weird. My heartrate has been high at random periods and at one point on Monday it dropped from 120 to 60 and went back up to 130 which could be a sign of afib. And then my blood pressure would come in at 120/65, which normally my blood pressure is 115/70 or 95/65 and now it’s blending the two.

I really have the feeling that to keep my weight and blood pressure under control I have to be very meticulous about what I eat. I am still struggling with that same five pounds. If I do my strength training and my workouts, walk at least 5,000 steps a day, and eat what a lot of people would call “clean” foods, I can lose weight and keep my blood pressure low (with an occasional salty snack when it dips too low). But even if I skip a workout, the weight comes back. It got so frustrating– that nothing ever changes– that I stopped tracking in my fancy fitness journal. And if I’m discouraged now, what happens in April when my program ends?

Thursday evening I had another great workout with Alex. I was mentioning that it had been almost two years to the day since I had my afib incident. I’m really starting to wonder if the change in the weather, and allergies, has something more to do with all this.

Thursday night I came home, showered, and went to bed, only to discover that one of the household cats was in my room and did not want to be. So I got up to let her out. And when I turned to get back into bed I don’t know if I tripped over something or if I misjudged where the space was to walk, but I fell.

Onto a stainless steel litter box.

Hard.

I took a photo of the bruise on the back of my knee today (it’s Sunday) and it’s blurry because it’s at a strange angle. I have another on my arm, that one’s less vivid but bigger.

On Friday, I did a lot of work for Parisian Phoenix Publishing and even agreed to pick up some extra hours Saturday night at the part-time job. Then, I had a really nice business meeting to brainstorm some strategy for 2025 and that included a beer and some wings (and some really yummy thin Triscuits. I had never had thin Triscuits before).

But then Saturday, I woke up with some sort of gastrointestinal issue. It didn’t seem severe enough to be a stomach bug, but I couldn’t come up with any food items that would have given me food poisoning. So I found someone to cover my shift and slept most of the day (and read Fourth Wing when I was awake).

Because I barely moved yesterday my body is painfully protesting walking. My lower body muscles don’t receive messages from my brain like they are supposed to, that’s due to the cerebral palsy. When I have a lazy day like I did yesterday, my legs literally forget what to do. There will be stretching today.

And it’s interesting that I think spring might have something to do with the stuff that keeps happening in March– because March is Cerebral Palsy Awareness Month.