Chapter 1

I begin this journal a month after my 50^th birthday and 24 hours into my first round of corticosteroids for radicular pain through my right  shoulder and arm and an experience of soreness, heat, and tingling that radiated from my thoracic spine to both arms and legs. “On fire” is an apt metaphor for the 12 hours of unrelenting pain I experienced through the night and into the morning until the doctor on call on Saturday prescribed the steroids. Wild fires are sweeping Colorado and Arizona this summer, destroying countless acres of land and changing scores of lives as people lose their homes, businesses, and sense of rootedness to a familiar landscape. But people rebuild after natural disasters and the land regenerates itself after a fire. Over a decade ago I remember seeing pictures of the mountainsides of Mount Saint Helens just a few years after its devastating volcanic eruption. No stands of tall trees were in evidence, but fields of beautiful flowers stretched for miles, punctuated by low clusters of bushes and an army of slender saplings reaching toward the sky. The wonder of regeneration in nature. I am fearful that I won’t regenerate.

  The emergency room x-ray showed that I have a degenerated disk in my neck and bone spurs that may be pressing on a nerve. But the internist has referred to this condition as a chronic condition--degenerative spinal arthritis. Do I have an injury that is the result of some repetitive activity (like word processing) or is this the result of a sudden strain on my neck in yoga  class? As I reflect on the last twelve months, there have been indications that something fundamental was awry in my body that I was unable to “name”. I function best when I can  label, categorize, and understand experience. I teach graduate classes about social work practice with children and families at a  public university in the large Midwestern city where we live. I also have had a small counseling practice for 20 years. This push and pull to name and understand things keeps me comfortable and feeling “at home” in the land of psychotherapy and in the halls of academia. I am 6 months short of completing a PhD, started part-time 10 years ago.

  It is interesting that I would enter the program at age 40 on the heels of an intense bout with lower back problems and finish the program at age 50 with a diagnosis of injury in my upper back. Both conditions have resulted from a life script that I have obediently followed since childhood that commands me to push myself beyond limits, to mildly defy boundaries when I perceive them, to question authority, and to reach past the present moment. Now my age and the body I live in are obstinately challenging a primary set of  principles that have shaped and directed me to strive, to win, and to succeed in all arenas of my life.

I see those messages also firmly etched on the  faces of my husband and our oldest son and reflected in their own accomplishments in sports, education, and career aspirations. Our youngest son, however, about to leave for college in Colorado in the fall, has  frequently refused to live by our  Type A commandments that prescribe how to lead a successful life. He has challenged us throughout his life to “lighten up”. While he has been forced on many occasion to carry the heavy stone script  tablets around with him by his parents, his grandparents, and his teachers, he dislikes the experience intensely and would prefer to play his guitar. I imagine that the chiseled monuments will sit in his dorm room, reminding him to complete assignments, to choose to use his time wisely, to get some exercise, and to study. He’ll probably turn them to the wall so that the words don’t haunt him. But, once away from the  pressures and directives that we have imposed upon him about how to get to the Promised Land in America , he will get to his own promised destination by himself, in his own way, through his music and  in the company of other people with whom he loves to spend time. Why is it that it has taken a potentially disabling condition to finally challenge my beast of burden mentality? It is time to smite the tablets. If not, they will serve as a rather sad gravestone, a testament to my life of  trying to stay ahead,  to reach the finish line, and to remain on top. Of what?

  Feel like I have overdone it after a fairly inactive day. Sitting in this chair feels better. I feel just on the verge of light-headed so just took half an Ativan. After sitting on the lounger on the deck and reading for a half hour, began to experience some tingling in arms and aching in upper  back. Tried lying on couch for awhile but then had tingling in legs and arms. Tried laying prone on stomach on floor pillows and light-headedness and tingling increased. Right now I can feel the tops of my legs-mild burning. Feel less light-headed in this upright position. My body feels depressed-I am teary for the first time reading the New York Times obituaries for the 911 victims.

  Last summer I had a panoply of symptoms that, as I look back, were perhaps early signs of cervical spine disc degeneration and neurological complications. Chiropractors assert that everything from sinus problems to impotence can be attributed to spinal abnormalities. Perhaps they are right.

  The internet is a blessing and a curse for symptom sufferers of any kind.   I was a fanatic surfer for those several symptomatic months. I had an intense episode of what I thought was allergic itching all over my body, particularly in my arms and legs. The symptoms cleared up a bit after the doctor gave me a prednisone shot….but not right away. For $500,  I had the house tested for mold. I became suspicious that the mulch that we spread each spring on the gardens was the culprit. Because my arms and face tingled when I sat down at the computer, I thought the plastic casing on the monitor was responsible.

  The internet, of course, had a few websites to support these suspicions. It seems like this “itching” went on for a couple of months off and on. A full battery of allergy tests did not find anything significant. The allergist prescribed Allegra and told me that it was probably dry skin and to use Eucarin lotion twice a day. My suspicion is that he wrote, “anxious, menopausal woman” in my chart. Neither of these things helped much. I think I just got used to the itching which began to fade after about 10 weeks, having labeled it a weird menopausal symptom. Plenty of websites and discussion board posts mentioned itching as a common experience among women entering The Pause.

  Then came the shortness of breath attacks. These were terrifying and I landed in the emergency room  three times because I couldn’t catch my breath. Once I stayed in the hospital overnight with a full battery of heart tests, CAT scan, the works. Of course everyone thought I was anxious. Angrily, I agreed. “I’m anxious because I can’t breathe and I don’t feel good!”. Clearly, I was under tremendous stress, some job-related combined with just plain physical malaise. I was not aware of being anxious about work. Just very stressed out and “handling it” although I physically felt terrible. At the third ER visit,  and after hearing about my episodic itching, the doctor mused, “Well, some people who get hives benefit from Tagamet, an antacid that is also a histamine blocker.”

  By now, I was also having pain around my stomach area near my rib cage, so off to the gastroenterologist for a scope to rule out an ulcer. Mild irritation of the duodenum. Prescription for Nexium. Once I began the antacid treatment, my breathing problems cleared up immediately. The internet offered up the information byte on a few asthma websites that some people who have acid reflux disease experience asthma-like symptoms. I immediately felt better having a name, a cause, and a remedy  for not being able to breathe. My doctor had missed looking down this alley with me, even after the third ER visit,  perhaps because I was overwhelming her with so many amorphous, unrelated symptoms that simply looked stress- and menopause-related. Her prescription of Ativan for anxiety, Ambien for sleeplessness, and a short course of Zoloft for a few months helped me make an extremely difficult decision to make a significant job change that lessened my stress tremendously. As I look back on these symptoms, perhaps I was having rib pain, referred from cervical disc problems which cleared up on their own.

I was in the ER while visiting our oldest son for Parents’ Weekend in October. During our first night in the hotel, I awoke at 1am with intense neurological signaling and a feeling of fire between my shoulder blades and  up and down both my arms. I also had a slight tremoring through the night, almost like a mini-seizure. I was terrified once again. Off to the hospital at 7 am . A true test of my husband’s love. The ER doctor checked my heart signs and suggested that long trips on airplanes can sometimes cause this symptom. When he took my history, I noticed his left eyebrow raise just slightly when I mentioned that I  was taking Zoloft and sometimes Ativan for anxiety. “Should I take one now?”, I asked. “No. We’ll give you one from the pharmacy here”. Again, I am sure he wrote something about “anxious, middle-aged woman” in the chart. Happily, the symptoms had begun to pass on the way to the hospital and were pretty much gone once I arrived. During subsequent internet surfing sessions begun in earnest once we arrived home, I was sure I was having some kind of reaction to Ativan, which I was only taking sporadically. A website about  withdrawal symptoms from tranquilizers confirmed this diagnosis in my mind.

To this point, I have had an X ray of my cervical spine, taken in the ER when I was there one Friday morning for pain in my shoulder and arm that I thought I was having a heart attack. The radiologist notes a degenerated disk between two vertebrae (C5 and C6) with some slight bone spurs, called osteophytes. At the time, I had no idea that back, arm, and shoulder pain could be generated from a problem in the neck. I had plenty of time to think about this as I lay prone in the MRI machine a few days later, my eyes tightly closed, concentrating on the final position in yoga class where we lay on the floor and gently release all conscious thought. The radiologist confirms once again with these films that I have degenerative disc disease, i.e. a flat and tired disc at the point in my cervical spine which we move 600-700 times a day. It is possible that the nerve that emanates from my spine at that spot and radiates into my right shoulder is being pinched and irritated. Nerves tend to manifest the feeling of irritation and pain not at their source but at the end of their paths, in this case in my scapula region, over the top of my shoulder, and down into my upper arm.

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