Saturday, July 25, 2020

Ninety Days Later

NOTE: this blog is posted in reverse chronological order. The first entry is from Dec 2019.


The surgery was a success. The back doctor with the history-book name sounding like an ancient conqueror, did exactly what he said he would. 

The stubborn pulmonary doc who almost scotched the whole deal weeks prior, might now enjoy some sour milk and Special K while he eats his words about my having surgery-denying apnea. 

In the post-op room, I nearly screwed things up when, jelly-legged from the anesthesia, I fell off the gurney trying to retrieve something. They had already dressed me and set me up for release, but then hesitated, surprised to see me on the floor.  I impressed them by getting up on my own. Not that I could feel my legs. It was arm strength that got me up. Soon I was getting a wheelchair ride out to the curb, and man was I happy to get in the car and get out of there. 

In normal times maybe they would have kept me over for falling on my can. But during COVID days in South FL bed space is a very big deal.

It took about six or seven weeks for the vicious sciatica to let up completely. I admit, there were times as late as week 5 when I wondered if the surgery had been a failure.  Back pain is diabolical.  The nerves were angry from an intruding surgeon. It took weeks for them to settle down.  Thank you, my friend and fellow back surgery veteran, Louie J, for sharing your experience so I could have the patience to understand this fact.

I had a deep purple bruise from the gurney fall the diameter of a tortilla. It eventually faded away.

The cane and the walker are deep in a closet. The geriatric shower chair (acquired from a dead neighbor, thus the name we gave it, "Ralph's Ghost's Chair) is a donation now to the Viet Vets.

Mercy came from somewhere. 
Rock N roll.

Wednesday, April 29, 2020

Vertical Farming

(a pre-imagined scenario)

So the mad surgeon's plan tomorrow is to muster his troop of tools and tunnel thru a bit of backbone fascia and then find the pinched nerves and clear the area.  There are ascending and descending levels of disks, and he relies on navigation coordinates. At the hot zone, he'll trim and scrape and vacuum out chunks of semi-hardened ooze from the ruptured disk.

It's a harvest of pain.

Meanwhile, I daydream of being able to reach up high and pick a few plump tomatoes from a vertical farm's top shelf. The stem fragrance goes on forever.

I put them in a basket (not too heavy a load though) and walk to the front of the greenhouse to pay the man for his nice hydroponic products.  (The optimistic verbs here are "reach" and "walk.")

The owner is Russo-Finnish. His crayon-written store signs have strange Cyrillic letters and spelling and are phrased like Spenserian Stanzas.

Or prayer.

The mad surgeon has a name like a Mongolian warrior and is rotund and sincere and appears bodily strong, as an invading emperor should be.

I dream, floating on Propofol, of a tomato salad. With feta, olives, cauliflower bits, Oil & V.






Friday, April 24, 2020

Tipping Point

Several days of back and forth about pulmonary clearance, and this particular patient is tired of being in the middle and pulled in multiple directions.  Constantly explaining and re-explaining an old issue, trying to propel my way through the gauntlet.

Things will resolve as they will. After a lot of back and forth, I took their PFT test and hopefully that should suffice. Will know Monday, surgery supposed to be on Thursday.




Monday, April 20, 2020

Have Another Tylenol, Cowboy


Politely Contentious

Monday. The journey through the maze of gatekeepers and box-checkers continues.

FaceTime visits with a cardiologist and then a pulmonary guy were major hurdles in the battle to get clearance for surgery. The doctors want to be liberal about allowing it, and at the same time one of them wants to stubbornly hold to a moment in history's records, just as stubbornly as I want to deny it.

Somewhere there is a middle ground, and I'm tired of being jerked around by both sides. Eventually the decisions will have to come from my neurosurgeon who put all this fast-track path in motion to begin with.

As my wife recommended, I have to try and put these skirmishes into individual boxes (the lids rattle with the zeal of authority trying to prevail). And when they are in those boxes, I return my focus to the main goal, which is to have the back operation.  I never expected it to be such an entangled and often politely contentious path to travel.

Saturday, April 18, 2020

Health Workers and a Yellow Mask

I'm about halfway through the surgery clearance hoops.

You could see the care being shown as soon as you opened the car door. Hospital workers in scrubs , their faces hidden in thick masks, asked why you were there and then were happy to direct you. Watching only their eyes, we hear them explain in a nice way about who can go in and who can't.  My wife wanted to accompany me but couldn't. We expected that.

Next to us was a small mountain of donated takeout food in stacked trays, cheerfully picked up by  hospital workers as they arrived to work.

I spent a hectic hour inside the building being shuttled back and forth in a wheel chair between tests. At the last appointment, a guy gave me a yellow disposable face mask to replace the blue bandana I had not-so-artfully safety-pinned and wrapped around my head. I looked at the mask like it was a million-dollar item, rare and precisely rippled.  (We since have bought some cloth ones.)

Leaving, I kept my new yellow mask on and sat on a bench outside, enjoying the Florida breeze. I idly wondered if the color of my mask signaled "done for the day." I relaxed and waited for my wife to drive back and pick me up.

The hospital had been eerily quiet, compared to normal days. The wait areas were sparsely populated. Even the blood lab, which is normally overflowing with people, was empty. I was one of two people giving samples. I don't know what to assume from this, other than people are locked down at home and not going anywhere, not even to doctor appointments.

The business of medicine goes on, knowing no time nor place, caring for people as they need it. Health workers are getting accolades these days for all the heroics that they do. Just seeing some of that firsthand two days ago (and I'll see many more before the month ends)  makes me further appreciate why.

Monday, April 13, 2020

Plans are Underway (nervous fanfare)

The thirty minutes with the neurosurgeon via FaceTime today went smoother than I expected. He seems a caring and highly respectable guy. After discussing what the surgery does and doesn't do, I asked to sign up. To my surprise, he  is actively taking up my cause.

The neurosurgeon has already put his staff into motion coordinating the pre-op tests, hoping to justify surgery and squeeze it all in during these chaotic days of COVID19. My case is judged as potentially getting worse and further threatening my ability to do normal activities. Or something like that. So I'm hopefully in...as long as I pass the tests.

I have at least six appointments showing up on my schedule, all off the pre-op variety. Some are office and lab exams/tests/imaging (3 Wednesday), some FaceTime, one is for the COVID testing drive-thru.

Due to the virus restrictions, no accompanying adults are allowed inside the building. Doing this solo is a chilly prospect.

My neurosurgeon is pencilled in at the end of the month. This is an in-person meeting, and then the following morning at five-thirty, if all goes without a hitch, there will be a 90-minute surgery. Who knows?  By June, I might be back to normal. A guy can hope.






Wednesday, April 8, 2020

Decision Day (maybe) Approaches

The Options:  The outcomes hinge on whether or not my surgery is allowed, in this COVID19 Virus time of essential vs. non-essential care. The consultation call in four days with a neurosurgeon will decide that one way or the other. In some sense, I feel like I am going into an interview. That if I am pitifully lame enough and ingratiating, I will have surgery. If I am not of the proper demeanor or criteria, I will go to the back of the line. Simplistic exaggeration? No, it's how I write it.

1.  Have the surgery.  Unless it involves fusion, in which case I will decline.

2.  Wait until Mother Nature absorbs the damaged disk, and the pinched nerve pain dissipates. This could take weeks, a year, or never happen.

3.  Get yet another neurosurgeon's opinion. This is likely if surgery is delayed by COVID19 situation.

4.  Make no decision at all.

Saturday, April 4, 2020

Hours and God

Time takes on an odd quality this weekend. At home, it flies and sometimes it stalls, and when I go out and view my City, time seems to have stopped.

The churches are empty and the synagogues too.  The bars are closed, even Octopus' Garden.

Ok, enough ambience talk.

Last night, when sleeping in my normal right-side position, the sciatica or whatever the hell it is set my hips on fire. I was cramping and cursing and woke everyone up. It was the most pain I'd ever felt.

God cares for us and is merciful, yes indeed.

Wednesday, March 25, 2020

In the Horse Latitudes

Where there is no rain and not much wind. Not much moves. The game is about waiting.

The calendar informs me that my upcoming appointment with the neurosurgeon is on April 8, Passover.  I am not sure of his religious persuasion.  It's possible the appointment could be moved up or moved way back.

There is not much I can do in the meantime. No steroid injection cushion to ride, no new supply of pain pills. I am in the waiting game like everyone else. I do my at-home exercises and keep trying to drop a few pounds.

I ventured into the World of Cooties to visit my dermatologist. Had to be done. Like everyone, next is a trip for groceries. I'm keeping the delivery trucks busy, too. I can get wine faster than face masks.

The Orange Idiot Man wants to artificially start things up again, with his hot air being the wind to take us out of the Dead Sea, I suppose. But most agree it's a reckless notion and one that the state governors will deny.

Saturday, March 21, 2020

Aleve and X-rated Sleep

I've never been a fan of the drug Naproxen (i.e., Aleve). Among men, Aleve has the reputation of being a chick pill for menstrual cramps.

But one of my doctors along the way (I think it was the dimwit at the Urgent Care Center), prescribed a stronger version of Naproxen, which I have been trying out (since nothing else on my long list of pain pills seems to be doing well). The full results are not in.

 The early report is, I had a vivid sex dream last night. So I'll take another tab tonight.

Friday, March 20, 2020

Hip Study

Further x-rays this morning at CCFL revealed nothing wrong with the hips other than some osteoarthritis.

The environment and the people are vibrating uneasily with the COVID19 fear. Still, there is a general politeness and a sense of unity about it all. Of course, there are the rowdy idiots who think it's a hoax or at best a huge exaggeration. These are spotted usually in traffic, driving like belligerent maniacs, similar to the freshly unchained rustics in their big pickups and Ford Expeditions, owning the road after the 2016 election.

Wednesday, March 18, 2020

Seismic Shift

I'm going to have surgery.

I don't know when, but it will happen. Much depends on how drastically the Covid19 crisis impacts the hospital priorities, supplies, and staff.

I'm hoping I can get in before the shit hits the fan.

I have been down the road of nonsurgical treatment and it didnt work. The ruptured disc won't heal by itself.  Almost five months of pain. I can't continue this way.

In a second opinion, Dr. M at CCFL convincingly recommended that I cut the cycle of pain and have a microdiscectomy.  She referred me to Dr. D who I will meet with April 8.

PT is off my calendar for now.  One day I'll go back ... as a recovering back surgery patient.



Thursday, March 12, 2020

PT in the Days of CoronaVirus

I tense up in the waiting room, which is a shared room with regular patients and the PT people.  The regular patients are of varying decrepit appearances, and in my imagination any of them could be a carrier.

Once I get inside the PT gym, I feel less exposed, but that can be a false perception. So far, no one has mentioned the virus to me.  The therapists tend to wear gloves more often and use a lot of spray disinfectant on the workout machines and bed areas. Some patients wear masks. I'm not certain (at any location) if this means they have it or don't want to have it.

I will likely suspend my PT trips next week, or Cleveland Clinic might suspend them first. It's getting crazy out there, and everyone is moving toward increased home isolation.  Nothing is certain. Everything for everyone is day by day.  It's mid-March year 2020. Major concerts and sporting events (the Final Four & The Masters to name two) are canceled, as are any large gatherings of people. Cities are going into shelter and stay put mode.

Will the ban include precincts where voting is held? Let's hope not. FL seems determined to vote.


Saturday, March 7, 2020

Dueling Ailments

The past two days, the sciatica (opponent number 1) has been intense in my left hip and leg. Nothing relieves it other than sitting and laying down. Both of which I did a lot of yesterday.

Maybe too much. The back (opponent number 2) locked up twice last night and then again in an even bigger way this morning. The pain and cramping goes across the pelvis coast to coast, and the legs freeze in place. The only way out of it is to wait, then sit somewhere with a firm base (NOT the soft edge of the bed or on a soft sofa). The legs will have the spaz-yips momentarily, then stop.

The leg pain is way too much like it was in November.


Friday, March 6, 2020

Renewed Hopes

The PT therapist discontinued massages for piriformis muscle syndrome and shifted to a new experiment in which she manually stretches the left-side abductors vertically.  The way I understand it, this is an attempt to "slide" the pinched nerve out of the way.

It's a hopeful new phase. I am struggling along in month five of the acute sciatic pain and lack of mobility.  Still looking for an answer.

Meanwhile, the past couple of PT sessions have been light because of the setback from the leg stretcher machine a couple of weeks ago.

I wonder about the CoronaVirus in the waiting room. Then again, it is more dangerous driving across town.  Getting to Cleveland Clinic FL is about a 45-minute trip each way.

In general, the mood everywhere seems better, now that the Dem primary race seems to be heading in a less insane direction.  Hopefully this trend continues because Biden can heal things, if he's nominated and if we give him an overwhelming turnout (one that has legit accounting) in November.

Thursday, February 27, 2020

Back Again

The back pain has risen its ugly head again. It drove me to bed early, and with a little help from my friends I slept twelve hours. This morning I'm creaky but managed a shower.  I'm using my cane just in case of a lockup spasm. I took a muscle relaxer, the first in three weeks. I heard someone we know with back pain got an Ozone treatment. I wonder if I will have to go that far afield in search of relief.

The flare-up is a result of that damn leg stretcher or whatever-they-call-it machine at PT.

So the number of active problems is back to two again.

Anyway, I built the Timeline (three pages in a Word chart format) and have it at my disposal now. It covers higher level events than a mere flare-up. That's what this blog helps me grouse and vent about.

Tuesday, February 25, 2020

Meanwhile at Rehab...and History Chart Notions

Yesterday's brief adventure on the medievil leg stretcher machine left me sore. Here on the next day I'm hobbling more than usual.  I said with bravado I'd try it again, but next time I'll tell the therapist no. The position on that machine aggravated my back.

Overall, the sessions have strengthened my body and spirit, and I have an improved center of balance. I can do without a cane 90% now. My weakest moments are extended periods standing. Even walking is better than standing still. The duration of either activity is not where it should be, by a long shot.
I don't know what a 72-year could should be capable of. Sometimes I think my therapist forgets that I'm un viejo, and I have to remind her.

There have been days I would rather not go, and I suppose that's a normal feeing. But once there, I immediately get the energy and hopeful vibes from the therapist and others at work, and the hour goes quickly. I am scheduled through March and then will have an evaluation as to what's next.

Last night in my 3 am sleeplessness period, I envisioned. timeline for all of this so I won't have to explain so much to the next doctor I see.  The chart would cover major events from September to the Present, a History at a Glance sort of thing. When I have the time and uninterrupted quiet.

There will be another doctor, I tell myself.  I plan to switch Pain Mgmt docs and go to either CCFL or Memorial and ask for help on this Piriformis or whatever it is pain.  I'll ask for an injection. And images, x-ray or CT, of the pelvic area. Something I've asked for in the past and never had.


Monday, February 17, 2020

Mystery Origins

My Doc's PA said the excruciating pain remaining in my left hip/butt and leg may be due to the sacroiliac joint or SI joint, which is the junction of the sacrum and ilium. An SI problem can mock the same symptoms as a protruding disk.  The only way to know for sure is to have a diagnostic injection into the joint.

This hip & leg stuff has been an excruciating ailment for months, caused by sciatica they say. The source of the pain is the herniated disc, they said, whose ruptured content impinges on nerves in the spinal canal.

Now I 'm not sure they were right or wrong or half and half. It's like a game of Clue.

My current theory on my second and now worst ailment? As the ER doc said, and as my PT therapist believes, the hip/butt area pain is more likely muscular. A deep strain of the piraformis, painful in itself and raising hell by pinching the sciatic nerve as well.




Saturday, February 15, 2020

Tall Stick mean Change, Kemo Sabe

I recall an NC writer friend recovering from knee surgeries who returned gradually to his hiking spot, Crowders Mountain, and used a tall staff or hiking stick as a walking aide, rather than a cane. I think initially he may have had two sticks, like a skiing-type person.

At the PT place, I saw a viejo surfer dude using something vertical and similar as he left the lobby. His support was like a flat totem pole or tall Hawaiian tiki stick.

I have put the cane down mostly (sometimes out of stubbornness rather than good sense), and am considering a tall stick to replace the cane, upon which I invariably lean forward with a grimace, appearing bent and pitiful. It's in no way a posture-assisting device, but I think a tall stick or staff might be.

I'm doing better after several PT visits, with more to come, extending into March. As I attested in the title poem inside my tiny book "February Toast," this is not a month for me to fuck with. And this time it has 29 days.

The PT is the only positive constant so far.

Yesterday I had what was likely the last visit to Escobar, the mad scientist Pain Mgmt doctor. I chose to wait on any further (more radical) treatment options and take at least a month for healing time without someone prodding and injecting me. The insurance doesn't want anymore anyway.

What develops next is a direct result of how well I continue to convalesce.

I am a long way from my friend's mountain treks. Maybe he could abstract pain better than I can. Meanwhile, I remain unready for prime time, but nevertheless am making incremental gains in my limited urban world these days, making trips to the barbershop or to the gas station (finally I am driving).




Saturday, February 8, 2020

Physical Rehab Works (so far)

I went into Thursday's PT session #2 more optimistic than before, ready to welcome the drills and stretches and massage that would help strengthen and lead me out of Pain City.

I wasn't disappointed.  Sore, but stronger and ready for the next session on Monday. Most importantly, I have been walking more without the cane.

The therapist worked me hard, stepping me up from the gentler sort of exercises I had been doing the past ten days. I left limber and aware of muscles in my legs and midsection that I had forgotten after three months of doing basically nothing.

This coming week, there are two more PT's then a Friday followup with the Pain Management doc. I am imagining, hoping, half-expecting this to be my last visit there for a long while.  At least six months before anymore steroid shots are allowable.  What else does the mad scientist have in mind? We'll see.

And what do the therapists at CCFL PT have in store for me? We'l see about that too.

Wednesday, February 5, 2020

During a bad week in America

It's getting a bit old, the doubt. It's scary what causes it.

It's not like everything in the world is exactly cheery. The news, the plague, the politics, the tyranny... it's depressing.

Once again I've had two or three days where I felt things were turning around. Then late yesterday and all day today, the pain nagged me. The free-walking was not so nice. My language grew worse.

Tomorrow is PT. I am a believer that it will help. But I am also prepared to bring out the big pain pills if things don't turn around.  Time will tell what the hell I can do next.


Saturday, February 1, 2020

Triple and a Full Moon

It's one of baseball's most exciting plays. The triple. Sometimes it can bring a triumphant end to the game.

I was nervous before my triple, ESI procedure #3.  I tried not to be predictive, that is, not pointing to either end of the turnout gauge and worrying over good or bad.  I took a Trammadol in advance to stay as neutral and relaxed as I could.

A new assistant stood near, as I lay on my stomach and raised my head from the torturous open square slot to take a peek.  Cute.  She will give me assurances toward the end of the shots. She knows I hate being positioned belly-down on this damn platform.  They pull my shorts down all they way this time.  The shots today must be farther the spine down toward L5 and S1.  In return she and the other, regular assistant, get at a full moore moon until the Doc comes in and drops a towel down and places his toolkit items there, or so it feels.

24 hours later I feel some relief. I suspect this is largely the lidocaine dilutive at work, or it could be power of suggestion.  I've learned that the injections can tease you.

Once again I won't really know until time passes. The chems seem to race through my system faster than most. By end of next week, I may have my own evaluation. Doc says the third time is a charm, but then again he said that about the 2nd ones, too.

PT will continue next week, and I look forward to the strengthening it provides.

Sunday, January 26, 2020

Scientific Method - or Playing Hunches

It's been two weeks since that brief sighting of "the Corner" where one hopes to turn. This morning I have a hunch it might be approaching again. I feel some relief.

I took Flexeril last night and put the dreaded Tizaninine away in a drawer. The Flex did a gentler job of relaxing muscles and easing the vicious grip and locked sensation the pinched nerve has put on me. I added 12 hours of sleep.

With the scientific method, you try something, and if it doesn't work, you try something else. The doctors frown at any deviation from the Rx dosages and schedules, but their approach having failed, I try different variations myself.

There is plenty of pain, impatience, and gnawing desperation to blame it on.

Best hunch is the worst of the pain will settle down and I'll be getting around with less pain by mid-February. Not sure if that's a hunch or a prayer.

Sunday, January 19, 2020

One's Own Medical Spreadsheet

From sometime in the wait zone between ESI procedures 2 and 3...

Escobar is a mad scientist and a seemingly decent and nice guy. His message has been consistent: to stay on the path and expect relief when (as part of the body's instinct to heal) the protruding part of the disk is re-absorbed.  Hopefully freeing the pinched nerve.  That would be The Moment hoped for.

How long that can take is fuzzy. Getting over a herniated disk can take weeks or up to a year and a half, the Doc says.  Does that mean all that time is filled with pain each and every day? No answer.

Target dates are not reliable. I lean toward Fate and Superstition.

I am getting old. Things fail. Entropy sets in. And old beliefs dig in deeper.

Note to self:  look up "pain fatigue."

Pills:  too many, as is, and the Holy AMA Book of Rules says take them all without deviating. Trimming dosages is an old pastime of mine, believing we are more often than not over-prescribed.  Just as doctors over-book their appointments. When three pills are called for, I'll listen to how I feel and take two, one, or none if I prefer.

It's my own heresy against the Church of Big Pharma.

Two of the back-pain pill Rx's are like zombie pills. I understand their importance but they will still have to work around my schedule. I mean, who wants to be a lobotomized pill-head 7x24? So I will allow gaps for reasonable Living Time, and push the deadhead pills toward low-activity times of day, or take them before sleep.

The new pills have to compete with my regular stable of pills. So it's like, for example, do I wheeze tonight by skipping the Singulair?  Adding that equals too much sleepiness. How about that muscle relaxer that deadens your soul?  Or the NSAIDs? And the heart meds? It's a regular stew.

And so on...one has to work it out using the self-informed formulas within their own medical spreadsheet.



Monday, January 13, 2020

Cautious, but maybe


Two nights ago an intimation of healing came. There was a general relaxation along the spine, a surprising ability to stretch and feel the spinal Lego parts that have caused all this.

I was cautiously optimistic the Corner was coming. The Corner they say is turnable...in time.

Feels like I'm late and looking.

A sense of impending healing gave me determination. A new opportunity. To get rid of the gimping and griping.

Today I've been walking some. Slow but unassisted. A quiet Indian.

With the healing and coping comes superstition. Or maybe it is not that but an enhanced awareness. Or maybe it's like going crazy.

27 years ago today Pete (my dad) died. In my dreams this week I asked for his help, and I imagine he responded.  I imagine he is around, watching. It wouldn't be the first time he offered courage.




Thursday, January 9, 2020

A Week Later: Juggling Possibilities

The second round of steroid injections seems to be doing better, at least in helping to ease the back pain itself.  No spasms or across-the-board meltdowns of lumbar pain. No major lockups.

This leaves the radiating sciatic pain into my hip and leg, which is still there, largely unchanged. It means the nerve is still pinched or trapped. I suppose anyway. Which equates to more hobbling around on the cane, or grin-and-bear-it attempts to walk without it.

I have the option of only one more round of injections, if I choose to take it.  This would take me out a few more uncertain weeks.

The Pain Doc reminds me that the steroid shots assist and accelerate healing. Key word is assist. The body does the rest.

A neurosurgeon has offered some clarity and a possible path of escape. My willingness to have surgery is on the uptrend. After all these weeks, exceeding the average time of such an ailment, I am impatient. I'm afraid of permanent damage. I have enough appetite for risk to consider a discectomy.   Two or three weeks recovery from surgery might beat an infinite number of weeks suffering without any progress. Then what if surgery is a flop?

Gotta think about it. And press ahead on the current road. Patience, they keep saying.

Thursday, January 2, 2020

Juiced, Procedure #2

After the three-week wait, I was in bad shape in the car going to Escobar Land.

Worse was climbing up on the table and laying face-down. Trying to be still and not spaz. The Doc and his assistant got quite a live demo of my pain. In return I was in a position to moon them.

The needles, as usual, are no big deal. Four containerized shots, each like drilling a little oil well.

I asked for hi-test, gimme all you got.  Doc said the 2nd time is sometimes a charm.

Again, it's all wait and see.