Two days a week, I drive to a chiropractor to adjust my spine. Twice a month, I receive massage therapy from the technician at that same office to try and relieve the unrelenting pain in my lower back. 

After nearly a decade of sleeping on a metal bed frame with a 1-inch foam cushion inside prison, I now have lumbar scoliosis. I essentially have a C-shaped curve in my lumbar. This condition is most frequently seen in children, but the degenerative version occurs most commonly in adults over 65 years old, according to the American Association of Neurological Surgeons. I’m 49 years old.

Behind bars, I didn’t get outside a lot. I wasn’t exposed to much sun or wind, and my skin is clear with few age or sun spots. People who meet me tell me that I don’t look my age. Most of my friends who are still inside also don’t look their age. 

But physically, it’s a whole other story. People inside don’t get proper nutrition, exercise, rest or health care. According to Prison Policy Initiative, a research firm that focuses on mass incarceration, people in state prisons suffer from chronic health problems at a disproportionately high rate compared to the overall U.S. population. On top of that, correctional health care is difficult to access, low-quality and expensive. 

The ramifications extend years beyond prison, getting in the way of our ability to be fully productive and well, as I’m discovering. 

I still remember the first time I slept in a metal bunk bed in the Jefferson County Detention Center 10 years ago. It was frightening. I was on the top bunk with an open floor on both sides. I tend to toss and turn, because my hips hurt a lot, and I twist from side to side for relief. I didn’t sleep well nor through the night. I slept better once I got to a room where I had a wall to help anchor me. 

Once I was able to move to a bottom bunk, I no longer had to climb a ladder, but it was a mixed bag because I was too tall to sit upright on my bed. The constant hunching over couldn’t possibly have been good for my spine. 

Movies often portray men in prison as fitness buffs, but many women inside are just as passionate about taking care of themselves. At  La Vista Correctional Facility, my prison in Colorado, CrossFit was huge. We had access to a yard with a track, and in nice weather it was crowded with runners and walkers. The gym offered yoga, Zumba, pickleball and leagues for softball, volleyball and basketball. 

But the abysmal medical care works against those efforts. People tend not to talk a lot about physical infirmities in prison because it’s dangerous to be seen as vulnerable, emotionally or physically. That doesn’t mean people inside aren’t suffering. 

I had to wait more than a year for an electrocardiogram for a heart murmur, and only after submitting multiple requests. When I was finally approved, the nurse didn’t know how to use it, and I never got the results. One of my roommates had a fracture in her shin that went undiagnosed for more than a year. Unsurprisingly, it turned into a break, and even then it went untreated for close to two years. She received her much-needed surgery only after she was released from prison. 

I had another roommate with a 48-year sentence who was obese and had serious joint problems as well as a foot injury she developed in county jail before her conviction. When she entered the prison system, the authorities decided not to treat what they viewed as a preexisting condition. They also gave her a job that required her to be on her feet. 

It took her close to five years to get knee surgery. Afterward, she was given crutches and told to not put weight on it. There was no physical therapy. 

The lack of women’s health services was appalling too. Inside prison, you don’t even get an adequate supply of menstrual products. Everyone receives a set of 25 state-issued tampons or pads every month, and if you run out, you have to pay for more or make do. 

I haven’t had proper breast cancer screenings because my breasts were too small to fit into a mammogram machine. An ultrasound was not authorized by the insurance carrier. The last Pap smear I had was in 2015. 

Diabetes is also a serious problem inside, thanks to the terrible diet and lack of movement, which can contribute to obesity and heart disease. 

Every incarcerated person’s worst fear is to die inside prison alone. 

I get it. Medical staff in a correctional facility aren’t paid well, and I imagine it’s soul-sucking work, especially during a pandemic. Medical care is often contracted out, and staffing shortages have impacted correctional facilities throughout the country. 

Incarcerated people are also on some variant of Medicare and, just like outside, insurance companies don’t want to pay for anything. My roommate with the fracture was told multiple times that the insurance provider wouldn’t approve the referral to see a specialist because she was so close to being released. 

I got out of prison in December 2020. By most accounts, I’m considered to be a reentry success case. I have a full-time job at a university and a part-time job at Prison Journalism Project. Until recently, I’d been taking a full course load at a community college. I have a husband who adores me. 

But my health issues have followed me out. Many days, I struggle to get out of bed. Sometimes, I can’t walk upright due to the pain in my knees or down my sciatic nerve. Going up and down stairs is painful. When I sit for long drives for my work, my plantar fasciitis acts up. 

I’ve gained 60 pounds since I got out of prison, which does miserable things to a self-esteem that has already been beaten down. I am not happy with how I look, and I’m concerned about intimacy with my husband and how he sees me. I don’t like how clothes look on me. I feel ugly and slow. 

I know I would have more energy, sleep better and feel better about myself if I became more active. But I’m reluctant to go to the gym because I don’t want to be judged for not moving well.

These days, my head has started messing with me. Sometimes I wonder if this is part of the punishment I deserve. Who am I to feel OK? Who am I to try to move forward with my life? 

I might be physically free, but part of me still feels imprisoned.

Correction: Because of an editing error, an earlier version of the piece incorrectly claimed that the writer was released from prison in 2021. The correct year is 2020.