My vacation from blogging

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Our first snow of the season is falling outside, an inch-deep Alberta Clipper. I am long past the cozy enchantment of anticipating snow drifts and the like. I’d rather watch it through the safe distance of film or video than experience it firsthand.

I’ve refrained from writing posts for the past couple weeks because I thought that doing so would be akin to pouring salt on a wound. Now that the worst of the nerve pain that plagued me through late summer to mid-November seems to be behind me, I have been quite angry over what happened. I am mad that I waited so long for relief (which, by the way, came randomly with the pulling of a heavy drawer while bent over at an awkward angle).

I am not exaggerating when I say that this interlude of nerve pain was the worst thing that has ever happened to me. Maybe there is something in the nature of pain that inclines a person to believe that the latest acute episode is the worst one, sort of a photo negative of one’s love life, how often we hear that a person’s current lover is the best one ever. With that aside, I will tell that I really did feel worse than I ever had.

I am no stranger to pain. I had a radical mastoidectomy, wherein a damaged part of the skull that borders the ear is removed. I was in labor for 44 hours when I had my daughter, and I had no pain medication for 24 out of those 44 hours (and this was back labor). I would add this year’s spinal fusion surgery to this list, but the pain of that procedure and its recovery were nowhere near as bad the preceding two events in this paragraph.

I know that there are millions, if not billions, of people in this world who’ve lived through pain far worse than I have. I can only attest to my own pain, and I am mad when I think of all the effort I devoted to finding a resolution to my recent pain. I don’t think I was taken seriously because I could still walk on my own and keep a straight face while doing so.

It must be hard for orthopedic doctors to understand that the pain of a patient who can work and communicate as normal can be important. In any given day or week, they see patients who’ve been broken through traumatic accidents, people who arrive for their appointments in a wheelchair or on a stretcher. So when someone like me comes knocking, a patient who seems to walk with apparent ease and can report their symptoms in a near-clinical¬†tone, they must be tempted to assume that such a patient is just worried but well. I was not.

After three months of asking for an explanation for why I suddenly felt so bad six months past my surgery, I learned a few things through an MRI and physical examinations. I am healing well from my L4/L5 fusion surgery. This does not surprise me because the pattern of my nerve pain was markedly different than what I experienced in the months leading up my surgery. Back then, I had numbness in my left knee and part of my foot, with flares of sciatic pain that struck at random. This time around, I had awful nerve pain in a band from my outer left hip to the inside of my left knee, only when I stood in place for more than a few minutes or walked more than a hundred yards or so.

It turns out that my L2/L3 and L3/L4 discs have degenerated more in the past year, but neither are in bad enough shape to qualify for more than conservative treatment measures. I also have bursitis in my hip and strain in a tendon that leads from my hip to my knee (ITBS, or iliotibial band syndrome). I’ve been doing physical therapy exercises for the bursitis and ITBS, but the aches and pains of those issues aren’t completely gone.

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I do not yet have clarity on what I can do to prevent further flare-ups of nerve pain. No one has offered me a prognosis or definitive reason for why my orthopedic problems continue. Last year, I heard that my lumbar degeneration is hereditary. This makes sense given that I have several close relatives with similar problems. However, there isn’t enough similarity between our symptoms and course of disease to model a course of action based on what has worked for the others.

I wish I knew if I there was something I am unwittingly doing that could be making things worse, that some qualified person could take me in hand and tell me that I should change my life in such-and-such ways because of my spinal stenosis. It seems I must draw that map myself.

I don’t think I have accurately conveyed how active I must be to lead the life that I do. Both my job and my life at home require all sorts of walking. Below is a chart of all the walking I’ve done since my surgery in March (from my Fitbit account, btw):

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I’ve discovered through long experience that the only sure thing that keeps my depression at bay is walking. I thank God that the chief prescription for my surgical recovery was walking. What would I do if my spinal stenosis progressed to the point when I couldn’t walk much at all? I’d practically need to remake myself.

I’ve watched far too many episodes of Agatha Christie’s Poirot lately. There was something Poirot said in the episode called “Appointment with Death” that is one of the most inspirational things I’ve ever heard:

“There is nothing in the world so damaged that it cannot be repaired by the hand of almighty God.”

A Rainy Saturday Morning

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Around 11 last night, it started raining hard enough to turn all the pipes on the roof into little dissonant steel drums. My sense of what keeps a house from surrendering to noxious fluids and vapors is vague at best. It’s only during a hard rain that I know for certain where the all the exhaust vents emerge atop the house.

I awoke to the sounds of the same hard rain this morning. I’ve already done the dishes, started the laundry, and done some basic grocery shopping this morning. I really should fold the clothes. When the dryer starts dinging, it’s like a siren call of domestic duty–fold me now, lest you need to dust off the dreaded iron.

I will resist that call in favor of writing a bit. I don’t think there’s anything in that dryer that can’t be unwrinkled with a few minutes of fluffing.

I suppose it’s a cardinal sign of self-absorption to the start several paragraphs in a row with the word I. Indeed this post focuses on me and my recent struggles.

In sharing these problems, I hope that I am not merely alienating my readers. It is not impossible that some of you have endured the same or similar trials. If that is the case for you, I hope you find some solace in seeing a kindred spirit emerge from similar adversity.

I am just arising from flare-ups of chronic pain and depression that spanned three months. It began with hip pain and ended with the worst variant of sciatica that I’ve ever had the misfortune of feeling.

I did have a few random days I felt no pain at all. All the while, I had no pain unless I was moving. To feel no pain at rest is a blessing ordinarily taken for granted. I recently joined a Facebook support group for people who’ve had spinal fusion surgery. My first impression was how fortunate I am among that cohort of patients. Compared to that group of patients, my burden is light. I don’t struggle to sleep because of pain. I can work.

Here is the thing I gleaned from reading those stories: The only pain you know is your own, and it should not be discounted just because someone else has suffered more. There were moments of my most recent sciatica episode that afforded me the worst pain I’ve ever felt. It’s a pain that does not season you pleasantly with wisdom or humility. Instead, it just makes you bitter that it happened, a rude surprise that you still had a little innocence left to steal.

It all ended with a moment akin to the last bolt of lightning that flashes at the end of a storm. I was putting away laundry and leaned over to open one of my clothes drawers, a drawer that is heavy with clothes that need pruning. I felt rushed (for no good reason) to finish the laundry, so I stayed bent over at the same awkward angle as I closed the drawer. As I pushed it closed, I felt a bizarre stretching in my lower back, and the ends of my spinal fusion felt like they were sparking with a bit of heat.

I straightened myself out, dreading that I might have complicated hereditary lumbar degeneration with a careless accident. As I walked down the hallway from my bedroom, I realized that something quite different had happened. My sciatica was gone. My awkward maneuver made a supremely lucky adjustment, one that I couldn’t repeat in a hundred tries.

I am still contending with the ordinary legacy of ongoing recovery from my spinal fusion surgery, which presents a random array of numbness and nerve pains. It is a calm I’ve not known for long since the height of summer.

I’m devoting this time before the holiday rush to some deeper rest. I’ve been digging into some Agatha Christie stories, both in print and on television. Actually, Agatha Christie is an author I willfully ignored until now, dismissing her body of work as trite without having read a line of her work. I’ve been pleasantly surprised at how witty and sometimes bawdy her prose can be. The stories I’ve read and seen on screen are reminders that the moral compass of humanity isn’t degenerating more with each succeeding generation. The good and bad have always existed, only the fashions and technology have changed.

I’ve been pleasantly surprised at how witty and sometimes bawdy her prose can be. The stories I’ve read and seen on screen are reminders that the moral compass of humanity isn’t degenerating more with each succeeding generation. The good and bad have always existed; only the fashions and technology have changed.

With that written, I will now attend to folding the laundry, avoiding any foolish haste with the pushing and pulling of drawers.

Chronic

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I decided to use a benign floral image for this post rather than recycle one of my x-rays. That photo reminds me that there is truth, beauty, and comfort to be found in places outside myself. Right now I find little solace on the inside.

I am still contending with orthopedic pain that is trending toward chronic pain. More of my problems have been revealed through recent doctor visits. All of these issues are just different facets of the same stone, but the substance of this stone resists identification.

My lumbar spine issues were partially resolved through the L4/L5 fusion surgery I had back in March. When I look at my orthopedic visit summaries, I don’t like that diagnoses like “lumbar spinal stenosis” and “radiculopathy” are marked as resolved, as if my surgery totally alleviated those issues. In truth, the surgery repaired my worst disc space, but I have three more problematic discs. My MRI from December of last year revealed that I had four bulging or ruptured discs in my lumbar spine. The degree of deterioration between L4/L5 was far advanced compared to the other discs, so it was chosen for surgical intervention.

My recovery was progressing better than expected until August when the pain I used to feel while standing in place came roaring back worse than I’d ever felt in the past. This is admittedly a strange problem: when I am resting or walking quickly, the pain I feel is minimal or nonexistent. Moving slowly or standing in place becomes very painful within a couple minutes. We’ve all known the mental agony of waiting. It’s like this pain is that torment made physically manifest.

This disappointing development is odd considering that the serial x-rays after my fusion show that the area is healing and fusing well. My spinal surgeon referred me to another doctor in the orthopedic practice, one who focuses on hip and knee problems. The hip/knee doctor diagnosed me with (and this is a mouthful, admittedly) iliotibial band syndrome with sartorial strain. He prescribed physical therapy for this problem.

The exercises I learned in my PT sessions have helped resolve much of the tension I was feeling in my left leg, but my pain I feel while standing in place or walking slowly has not diminished.

I had a follow-up appointment with the hip/knee doctor today. He considered my complaints and carefully reviewed my pelvic x-rays. He told me that I have arthritis in my left sacroiliac joint, where my spine joins my pelvis. I’ve started a prednisone dose pack to reduce the inflammation in the joint. If these pills do not substantially reduce my pain, it is likely that I will get getting a cortisone shot directly in that joint (guided by x-ray for proper placement).

It so happens that the hip/knee doctor has also had spinal fusion surgery, and he told me that he also has arthritis in that joint and has had such injections twice. When he revealed this information to me, I silently wondered why he didn’t mention this history during my visit last month. It would have stopped me from dreadfully speculating that my pain while standing was due to another ruptured disc. Really, I spent too much time considering that lumbar degeneration could follow a trajectory similar to that archaic domino theory of communism.

Apparently, there is something of a domino issue going on with my arthritis. I have extensive arthritis in my lumbar spine. That my spinal arthritis has been developing silently and painlessly for years seems proof of divine mercy in my life. Now that this arthritis has spread to an adjacent joint, the pain at that spot definitely has volume.

All of this static has occupied much of my mental space lately. I suppose there is a bizarre happy medium of suffering. A life free of adversity would be tasteless, its beauty as shallow as a polyester pantsuit, pleasing and wrinkle-free only from a distance. There must be a point of saturation for pain. Once this point is crossed, there is no eloquence, poetry, or melody. Life condenses to necessity, and the challenge is to keep from turning inward, for that is where pain reigns as long as it rages.

Fall Photo Walk, September 30

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This post has a dual purpose. As indicated through its title, I will share some photos I took on a walk this morning. I will also devote part of this post to explaining why I haven’t been posting as often.

Our heatwave is over, and the weather has been ideal for the past couple days. I am so grateful that the sweltering temperatures have dissipated. It feels strange to write that we reached temperatures in the low 90’s during the first week of fall. When the heat becomes oppressive, I linger on memories of cold temperatures.

One memory in particular that helped sustain me through this recent heat hails from seven years ago. I was working nights in a freezer (a tidbit I also mentioned in my post from earlier today). To be more specific, I worked part of my shift in a freezer. Even though I had ample gear from my employer to protect me from the cold, I’d often struggle with feeling that my feet were cold when I tried to fall asleep at home later in the day.

Necessity required me to keep a strange schedule during that era. I failed to launch several times in my earlier adulthood. After each of several ill-planned goals had fallen apart, I’d move back into my parent’s house, dwell on my faults at length, and grasp another straw. By the time I reached 35 and had a child of my own, I figured I needed to stick with something, anything. The place that felt like home was a massive grocery warehouse, where I still work and have grown to love as much as anyone can become attached to a workplace.

I spent my first three years there on the night shift, and I’d devote half of my nights to the perishable section. I’d go home after work and rest for a couple hours until it was time to get my daughter ready for school. I’d feel too worn out during this first “shift” of sleep to fuss over feeling cold. Once I dropped my daughter off at school, I’d go home and back to bed. In the winter months, I’d often be plagued with “cold feet” when I’d fall asleep that second time.

I remember getting out of bed and soaking my feet in hot water, but most of the time it seemed that my water heater was too lazy to offer me water hot enough to warm up my feet. No other remedy seemed equal to this challenge without making me wake up in a sweat by noon.

During the recent heat, I dwelled on that memory several times, as if I could resurrect that chill in my feet just by thinking about it. I learned that cold is not a state of mind.

Now for why I haven’t been posting as much lately . . . About a week and a half ago, I found out why my hip and thigh have been aching lately. It was not related to my back surgery. Instead, the issue is muscular, and I have started physical therapy to remedy this problem.

I’ve had pain on a chronic basis for over a year now. In my experience, depression and pain profit from each other. I visited my family doctor and inquired if I should start taking an antidepressant again. She suggested that I try Cymbalta since it has shown promise in tempering chronic pain.

I took Cymbalta for ten days and could tolerate no more. Everyone reacts a bit differently to these types of drugs. While I am sure it has worked wonders for some people, it did not do so for me. It nearly silenced my orthopedic pain. Unfortunately, I had some side effects which were intolerable.

The main problem definitely resides in the Too Much Information file. It’s one of those facts of life that merits little reflection if things are working as they should. If this process is disrupted, it can loom large enough in the mind (and part of the body, too, I suppose) to crowd out other concerns.

There is no delicate way of relating the problem. I developed the worse case of constipation I’ve ever experienced. The whole interlude haunts me like a quote I read in an oddball book I read years ago called Holy Wisdom by Augustine Baker. Baker wrote a series of resignations or things he’d be willing to endure if God’s will demanded it of him. In one of them, he claimed that he would “not yield to the motion of nature, which perhaps out of wearisomeness would fain have life at an end.”

Over the past year, I’ve been prescribed a couple medicines that helped me with my orthopedic pain. On gabapentin, I couldn’t remember shit. On Cymbalta, I couldn’t give a shit, both literally and figuratively. I’d rather feel the pain. At least that pain is diminishing again.

Back to my walk this morning . . . Fall color has been a bit stunted due to low rainfall over the past couple months. If this drought deepens, I doubt we’ll have many picture perfect leaves when the color peaks. No matter how much rain we get, I’ll be grateful for an end to the heat by the time October is over. The temperatures may climb into the 80’s again next weekend.

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Friday

About 40% of my physical misery has lifted since my last post. I was able to devote a chunk of my evening to the garden, and my hip/thigh pain was just a background ache. Next week I am scheduled for an appointment to see if this new pain is related to my surgery or if it is a distinct problem unto itself. I don’t care for either possibility. I don’t like the notion of my physical recovery sliding backwards, and I certainly don’t want to discover that I have some different orthopaedic issue.

When I was young, my dad offered the same diagnosis for all that ailed me. He’d tell me that all the trouble was due to a “crosswise” fart. Maybe he learned of such troublesome flatus during his stint as a military medic. I really wish my new pain was due to the mythical crosswise fart taking up residence in my hip joint. At least it would leave eventually. Despite the lowering of its volume today, I know it’s something that will no longer be ignored, like a neglected tooth gone bad.

Tomorrow I am going to attend another car show with my husband. Ever thoughtful, he is going to carry a small folding chair for me in case my leg starts aching from the slow walking and standing around. It’s one of those oddities of my healing that I can withstand faster walking but the slowing down and stopping is hard for me.

While it hard to get clean shots of the cars at such events, sometimes the people are just as interesting as the vehicles. The shot below is fairly typical of my photos from car shows. The uncropped images are full of strangers (or parts of them):

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The Slow Down

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The above picture offers the sunnier side of my state of mind over the past fortnight. Although I am anticipating fall and all of its cozy and colorful diversions, I have encountered a difficulty, or curve in the road, if you will.

Until a couple weeks ago, my recovery from back surgery had been progressing well. At that point, I developed pains that are equally novel and aggravating to me. I have radiating pain in my left hip and thigh that is not constant but almost unbearably loud at times (if pain can be considered to have a volume of sorts). It’s a good thing that I am not fond of shopping, for it seems worst when I do the slow walking that is typical of that activity.

By the time I am standing at the register, I feel a pain that is par with active labor, but I can keep a stone-like expression on my face. I haven’t exhausted myself so thoroughly with insincerity since my teenage years when I pretended (unconvincingly) that I hadn’t been drinking.

I’ve called my spine doctor’s office twice since this started. The first time their response was to put me back on gabapentin. I was game for this strategy because I figure that the slight forgetfulness it induces could be helpful. Why would I want to remember this misery in vivid detail?

I called again today asking for something other than a prescription. I fear that if I don’t change the direction of my conversations with this office that I will embark on a path that meanders through various drug remedies that end in a heavy daily dose of haldol or thorazine to shut me up.

My doctor’s assistant told me that the doctor may schedule an MRI to investigate this new pain. I will hear tomorrow if this is going to happen.

In the meantime, I’ve somehow been keeping up with work and home. I’ve tried to stuff my time with as many distractions as my energy will allow.

I’ve made a couple slideshow videos that contain some of my photos of past leaf seasons.

Even with this pain, I am still excited to see the leaves shed their chlorophyll and show their natural colors:


Follow me on Facebook, where you’ll find bonus photos and videos.

 

The Long View

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As the summer season draws to close each year, I am reminded that taking the long view forward can have a toxic impact on my mind. There’s nothing like stacking everything that’s needs done in a year or more to provoke depressive feelings in me.

The half spent sawtooth sunflower shown above well represents where I stand at this time. If I focus on what is best in the present tense, I feel well, but if I mull over what is painful or yet-to-happen, I feel a bit crushed. It’s like dismissing the beauty of this plant just because it blooms for such a short time.

I’m already feeling a bit of nostalgia over my medical leave for back surgery this past spring. It’s not like this small era was packed with halcyon days. For two months, I had time to delve into the tangential things my ordinary schedule does not permit, yet I did not have the energy to accomplish much at all. Four months later, I regret that I tainted this time with any expectations beyond healing.

At the time, I wrote that my expectations were very low, but I now realize that such writing was my hope of deflating then-impossible goals. No, I was not going to craft a cookbook bursting at the seams with recipes both cheap and easy. I wasn’t going to document the daily unfurling of early spring with perfectly focused images. Worst of all, I would not have a house that was truly clean.

I did accomplish what needed to be done. My back is still fusing ahead of schedule. I was able to drive during my daughter’s spring break, so we were not stuck at home during the days of her vacation. After I came home from the hospital, I maintained my usual weekday wake up time (5:30 a.m., no less). This provided continuity for my family and ensured that I wouldn’t feel jet lagged once I returned to work.

Twice the time I had for leave has now passed since I returned to work. I can’t claim that the surgery was entirely successful. The symptom that made this procedure (an L4/L5 fusion) necessary was increasing numbness in my feet and in one of my knees. I had a long-term ruptured disc that exerted considerable pressure on my spinal cord. I had sciatica for a three month span prior to my surgery, but I didn’t have much pain obviously related to my back before that symptom began.

My MRI and surgery revealed that my disc ruptured 10 to 15 years ago. I had developed extensive arthritis and hypertrophy in my lumbar spine over that time. I’ve written previously of being stunned at my mental oblivion regarding this disease process. I literally had no suspicion of this degeneration, despite having several family members who’ve suffered from similar problems.

Looking back, the whole long interlude reminds me of that movie The Others starring Nicole Kidman, (spoiler alert) wherein she crafts an entire reality based on denial of her and her children’s passing. She has all sorts of elaborate excuses for why they can’t do the same things living people do, such as her warning to the children that they musn’t open the drapes because they are allergic to sunlight.

During Trick or Treat nine years ago, I barely endured walking my daughter around for a couple hours because my lower back was aching. Rather than go to a doctor about it, I decided that my problem was entirely due to obesity and lost 130 pounds over the next three years. I didn’t make any medical appointments whatsoever during that time (and for another year afterward) except for ear treatments I couldn’t avoid. Why? Because I assumed that almost every symptom I had was due to my weight, and my diet was the slow cure. How absurd that seems now!

Once I went back to my family doctor for myself for the first time in four years, she was so shocked at my change in weight that she sent me straight to a GI specialist. After running all sorts of tests on me (including colonoscopy, endoscopy, and biopsies), the GI doctor informed that I was the first 40 year old patient he’d seen who’d achieved a 50% weight loss without gastric bypass surgery or the misfortune of cancer. My advice to those who are planning a diet beyond a 10% weight loss: keep your doctors informed, or else they might assume the worst.

Now I wonder if my ongoing lumbar degeneration dampened my appetite. I didn’t struggle with eating less and walking more during those years. Now that I’ve had the surgery, my appetite and weight are much more of a challenge. I’m in the midst of trying to lose the 25 pounds I’ve gained over the past year, and the losing has been very slow this time around, 6 pounds in 8 weeks so far.

I started this post with the notion that looking too far foward can be depressing, but most of the foregoing is a backhanded homage to my recent past. The subject of my spinal woes is one in which I am better off lingering on the past than thinking too far into the future. Once I had my surgery, I started getting mild to moderate muscle spasms on the left side of my back and my left thigh. Physical therapy helped dampen this problem by strengthening these muscles. If I don’t do those exercises, the spasms are sure to be worse. Now here’s how I could depress myself with contemplating the future: I am not going to retire until I am 67. If I consider that I might be working with spasms for 22 more years, I feel steamrolled flat at the prospect of it.

If I take this problem day by day, it is just a pain that is fleeting, a sensation that reminds me that I need to keep building my strength.