Thursday, September 18, 2008

Doc Update

Wooh. What a morning...I'm currently teetering on the edge of total exhaustion. My first car ride in three weeks, then sitting and standing and walking...more than I've done in a long time. Before I collapse and (hopefully) wipe out for a while, I thought I'd write all this down while it's fresh in my noggin.

First, none of the ongoing recovery symptoms I'm having surprised Doc. The numbness, the pains, the electric current running from my posterior to my toes...all of it totally "normal." So at least that's something, right?

He confirmed it: I am a circus freak of the highest order. The fragment that broke off after the disc herniation was indeed the largest he's ever seen. The length of your fingers - it literally blew out this time, and the force somehow drove the L4 disc material down into the L5-S1 nerve area in the canal. Once it found a home there, I immediately experienced the intense pain and then the almost instant numbness and weakness. Managed to wedge between (and sort of around, it's hard to write what he showed us) two nerve roots that control all sorts of stuff. It was almost as if I'd had a car accident and the trauma did it - but I didn't. I remember that morning I woke with the usual pains (the herniation, no doubt) in my back - then, as I sat for 8 hours working and not really focusing on anything else (this is a gift, I think, and a blessing for me, to be able to hyperfocus on work to shut out the discomfort), the fragment began to move. I remember the instant the pain blinded me (that must have been when it hit the nerves), then Jeff calling the doc's answering service and him saying go to the ER now and the MRI and all the rest of it...but I am so thankful I didn't know at the time how bad it really was...even now I'm a bit scared after the fact.

Doc admitted he was shocked by the size and the position of the fragment - he had others come in to see it during the surgery. They videotaped, too. So my suspicions that I'll soon be anonymously famous are spot on.

He said this is the type of injury that does often result in permanent disability. In my case, though, he believes this numbness and most of the weakness will resolve as the nerves heal. There is little I can do to speed up the process (I asked). He says it is entirely possible I will be left with a little weakness and some numbness - but nothing like it is now, and nothing like it was before the surgery. I am going to have to accept certain facts that I don't want to accept. I'll get there. I know I am lucky and I am so thankful we acted quickly - but it is frightening when I can't control something. This is definitely out of my control for the time being.

My regimen: walking, daily, a LOT (as much as I can tolerate, the pain does tend to guide you in these matters) and swimming daily. No physical therapy yet. I am a hugely high risk case - as he put it I am "genetically prone to herniate." Every single female on my mother's side has had back surgery, I have recently learned (I'm adopted, for those who don't know, and it's complicated - but I do have contact w/several members of her family). So, no PT for a month - the PT is on ME. That's fine. I need to make this my top priority now. The pain is definitely a strong motivational factor here. I can and I will work my tail off (so to speak) to get the muscles stronger. That is the one thing I can control in all of this...

Once this initial surgery trauma wanes, we'll deal with the vertebrae collapsing on top of each other. This happened w/L3-4 - I remember the bone on bone pain and while it's bad, I was able to control w/Ultram, Motrin 800 and a TON OF EXERCISE. He knows I can do this - I'm not the patient who runs screaming every time I have some pain (I have a ridiculously high pain tolerance now). Once the collapse is final, then the two vertebrae can begin to fuse - my L3-4 is completely fused. No surgery needed. Took about 18 months. So I can do this again. Once that L3-4 fused I remember two years with virtually no pain. I can DO THIS.

Let's see....oh yes. Meds. Motrin I can deal with, anything beyond I get uppity. Lyrica is on standby for nerve pain that gets too intense, but I gained 13 pounds in two weeks on the big dose (haven't lost it, either, and that's always bad for lower back), and I swelled up all over. My eyes looked all was strange. We will use it if it becomes absolutely necessary. Oh yes, it also makes me "trippy" - I see pretty colors and shapes. Some would pay for that kind of high, I think, but I hate it (despite my years as a Deadhead I never really went the "trippy" route). Ultram if needed when the bone scraping starts - and a patch or something even stronger, whatever I need in my arsenal. We'll deal with that when it happens, and I feel confident Doc will make sure I have whatever I need to be as "comfortable" as possible throughout.

Bottom line: I am lucky to be walking at all. I didn't know until today how serious this was - I knew it was bad, but I didn't know it was something that could compromise me forever. I'm in battle mode now. Time to get this done. I may be a circus freak, but I am the most motivated circus freak you will ever meet.

As for the future, we just don't know. I know I'll be okay, it might be a little tougher than I'd planned...but I know I'll hike my Colorado mountains and walk in NYC at a New Yorker's pace (!) and play in the Quarter and see Bruce from the front row again. And I might even have a baby...though not now. Ohhhhhh no.

And I am amazed at my foresight to secure a wonderful job that doesn't require driving 120 miles each day. I'm getting faster on the laptop, learning Apple a little more and thinking a little more clearly each day. I'll be back to speed before you know it. I have an incredibly solid support system in place, I've got a fabulous surgeon who understands my need to understand what is happening and why and I've found work that stimulates my curious mind and feeds that news-y beast that lives within and probably always will. Life is good. I will probably have bad days (tomorrow comes to mind, after all the activity of today), but I'm writing this down so I can go back on those days and remember who I am and what I can do.

One other thing: he said the MRI (with contrast, YUK that kinda hurt) showed VERY little scar tissue formation from my previous discectomy/laminectomy in Feb 2007. That is HUGE. I did what he told me, worked w/swimming, stretching and walking, and kept the scar tissue to a bare minimum. I also took B vitamins and E, which are supposed to help w/nerves. The reason this is important: scar tissue is a big complication w/back surgeries like mine...the tissue can wrap around nerves and cause the same pains and problems that the fragments cause. Once it forms, there is no way to fix it. Going back in to remove only creates more excess scar tissue. Never ending cycle. Failed Back Syndrome (shudder). I did it once, recently, I can do it again. Bare minimum. Walk so the spider web doesn't get you.

I see Doc again in one month, to check progress. And there will be progress. I am sure of it.

Off to crash now, hopefully for a while.

No comments: