Chapter  2

But this is only a theory at this point. I prefer it to the possibility that I might have chronic, degenerative spinal arthritis with no hope of cure. Pinched nerve problems respond nicely to surgery in which the damaged disc is removed, replaced with bone, and the vertebrae above and below fused with a titanium plate, thereby giving the nerve more room to exit from the spine. We visit the neurosurgeon. He confirms mild to moderate degenerative arthritis, referring to the osteophytes on the film. A common incidence among people over 50, many of whom develop these bone spurs and experience no symptoms whatsoever. No surgery indicated right now. Not until we see how things go…over a few months? He asserts that 80% of patients get better in a few months time with rest. Manage the pain with anti-inflammatories, corticosteroids, and pain medication. However, if my pain does not improve, or if my functioning is too compromised, then we will look at the surgery option again. Some people have a flare up of inflammation once or twice  a year, some more often. Some get worse and never get better. For this unlucky few, surgery is an option…sometimes.

  Last night I was ready to go to sleep and did I put pressure on the joint? Level 4 pain in my shoulder. Took a Vicodan prescribed yesterday by the neurosurgeon and fell asleep immediately. I was encouraged this morning. Was up at 6am , ironed 5 things, gardened for 30 minutes and did a few errands…library, pharmacy, back store, and hardware. My back was tired by lunch time. Resolved to stay quiet for the afternoon on couch, reading and watching TV. Took a short warm bath. Used lots of heat, took a muscle relaxer and two Tylenol. Finish up the Prednisone in two days. But I could not get comfortable. No pain until 3pm , and then a dull ache. By 4pm , I am starting to feel more mid-back discomfort and some very mild pain down my arms. Sitting in this chair does help.

  So I am discouraged. I remember feeling like this after my lower back problems eleven years ago. The neurosurgeon said that these incidences usually resolve themselves in several weeks time. I am going to have faith that this acute incident will gradually get better. For the rest of today, and tomorrow, I have got to figure out limiting my activity even more. This will mean very little moving around. This chair seems to be the best. Right now, I will work on the computer for awhile and then go downstairs so that I can lay prone on the weight bench. Then perhaps read for awhile.

  Week 6

 It has been a week of pure hell. In an effort to relax my aching back muscles, I did nothing at all around the house and lay prone or propped in a comfortable chair, ensconced in pillows and various heating pads. The pain in my shoulders seemed to be increasing. I am not sleeping and have no appetite. My husband is at work, my son away on a trip with his buddies in Colorado . I am glad he is not home to see me in this state. My own father had a major heart attack on the day of my high school graduation, and I remember the summer before I left home as he recuperated and dealt with the fact that he would have to retire from his job as a deputy chief in the Fire Department. Family crisis timed with a child’s separation from home is not a good combination. I carried some depression and guilt through my college years as I  nestled into my student life away from home while my parents struggled to rebuild their lives with four children still at home.

 Took a Vicodan for the pain and soreness and lay down on the couch to watch “Can Can” on cable with Shirley McClaine and Frank Sinatra. All at once a fire of pain swept from the base of my spine through my shoulders and into my elbows. I nearly lost my breath, became dizzy and nauseous and knew I was about to vomit and pass out. I grabbed the portable phone and lay myself down on the carpet to call 911. During the call I did pass out and came back to groggy consciousness to the sound of sirens approaching. The MedAct folks were wonderful as they loaded me into the ambulance and helped me try to reach my husband’s cell phone. He met us at he ER, where the physician diagnosed a Vesel-Vegel (sp) response to pain, antagonized by taking a Vicodan on an empty stomach. I was there for 3 hours, tended by a nurse who had a personal history of 14 years of neck pain incurred after a car accident. She listened carefully to my distress and  helped me with tips about medication, physical therapy, and ice packs. “I can’t return home like this”, I told my husband. The ER physician, prompted by the nurse, agreed to hospitalize me so that my own physician could work with me to come up with another treatment plan. Simple Celebrex, rest, and an occasional pain pill were not working. I was beside myself with fatigue and pain and fright.

The doctor on duty from my internist’s medical practice met us soon after I reached a hospital room upstairs  on a gurney. I was exhausted and frightened. He listened sympathetically and suggested that I could use a little psychotherapy. This angered me. Would he give the same recommendation to a little old lady or a twenty-three year old athlete with the same symptoms? “I need a plan!”, I beseeched him. “My nerves feel  so raw that, if the phone rings, I felt like someone had stuck my finger in a light socket.”  He changed my medication to include Neurontin and Elavil, often prescribed to patients with chronic pain and arranged for a physical therapist and a doctor from the Pain Management Clinic to visit me while I was in the hospital. After an injection of Ativan at 10:30 pm ,  I quickly melted into a  relaxed state and slept through the night for the first time in three weeks. I stayed two nights in the hospital with no pain and a feeling of safety. My own internist a woman with  a terse, non-relational bedside manner, visited for a short time to discharge me. “Go to the pain clinic and call my office to make an appointment with me for next week”. I feel reprimanded.

Two days after coming home, I am not out of the woods yet. Yesterday afternoon, I felt like a vice was gripping my shoulders and back muscles and I experienced 6 hours of unrelenting Level 7 pain. My husband was wonderful as he lay on the floor with me, stroked my arm, suggested headphones and Vivaldi, and held me. I took 4 baths, because I am pain-free in the warm water. Why? We finally called the doctor to ask if I could take two Vicodan, in addition to the Neurontin, Elavil, and Celebrex, and whether it would be OK to take some Ambien for sleep. “Yes”, he said. We made a pallet of foam, blankets, and pillows on the floor of the den because I still cannot sleep in a bed without pain tingling in my arms and down my legs. Why? I gratefully fell asleep, to greet the morning in a groggy, but pain-free state. My husband encourages me to stay off the internet today.

  Yesterday, I spent an hour reading about trigger-point injections and spinal stenosis, to ready myself for an appointment at the Pain Management Clinic this week. I have had a hazy, but pain-free day today. I am grateful, but feeling a little agoraphobic and a little anxious if my husband and son leave the house. I cannot let my mind drift towards the notion of this state being a permanent one in my life. Even as I type this idea, my stomach tightens and I want to cry. This cannot be a permanent disability. This must be an acute incident that will clear up in the next two months. I need to rest now. My hip joints are hot and I feel slightly sweaty.

Week 7

 A plan is in motion. I will visit Physical Therapy and Pain Management programs at the hospital next week. I have had two pain-free days. Nights, however, are another story. I still cannot lie in bed without some numbness in my right arm and down my side. The bed I have made in the den works better because it is a piece of egg crate foam on a carpet on the floor. Is it that my spine is completely straight?  Last night I had Level 3 pain and tingling in my arm and down both legs. This happened right before dinner, so I had little appetite. Made the mistake of visiting an arthritis website right before my husband came home. This terrifies me as I listen to people who cope with constant and debilitating pain. I cannot find a comfortable track of definition for my experience in the last month. Did I have an acute muscular event that will resolve over time? How much time? Do I have mild spinal arthritis that was aggravated by a particular set of circumstances that, if repeated, will have the same effect and, if addressed, will reduce the chance of recurrence? If I am looking at spinal surgery to address the narrowing of my spinal column, will the symptoms pretty much go away?

  To get to sleep, I took two baths, two Vicodans and an Ambien. Slept through the night. Awoke a bit groggy. Right now as I type, I have coldness in both upper arms and in hips and tops of my thighs. I am sitting in a low-slung, comfortable chair that supports my neck and back. Should I stop and re-adjust?  Let’s see how it goes with the keyboard on my lap. Arms are better, but now coldness on my rear. This is unnerving.

  I think my symptoms are better since I began wearing a posture bra. Size 36DD. I have an appointment with the plastic surgeon on Monday to explore breast reduction as a way to relieve the constant neck and back spasms I am having and to  improve my posture, permanently. I am not sure whether I am strong enough to go through with this right now. So I will simply explore the possibility. My internist is going to think I am nuts.

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