A Fortnight and a Day

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Wake me when this mess of a winter is over. I really wish I could hibernate through this season. Having lived in Ohio for most of my life, I am accustomed to wide variances in weather. A 70 degree weekend in February is not impossible. I’ve also witnessed a two-inch snowfall in May. Still, recent weather has tested my endurance:

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These brief reprieves of warmer temperatures make it hard to acclimate oneself to the spells of ridiculous cold. Our average January high and low should be 33° and 19°, respectively, but it seems we hardly ever have a winter day that represents that average.

At least the crazy weather has afforded my daughter a few snow days to work on switching back her nights and days.

In other news, we have found a second guinea pig, aptly named Buddy:

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He is quite unlike our other guinea pig L’Orange in one way: he actually likes to snack on vegetables. I hope they do not develop a sibling rivalry with Buddy occupying the role of the child who better conforms parental exceptions whilst taunting his rival sibling in secret (btw, I was that sort of sibling when I was growing up).

It is too soon to tell how well the guinea pigs will get along. I’ve taken Buddy to the vet for assurance that he is not carrying infectious diseases, but I feel I should wait a bit longer to put them together in a large habitat. L’Orange just seems to be a mountain of a man compared to little Buddy. I did succumb to temptation and placed L’Orange in Buddy’s cage for a few minutes a couple days ago. What ensued was a comedy of errors wherein L’Orange literally dragged his ass around the cage while Buddy tried to make his elder a hobby horse. I suppose they can have another opportunity to sort out who’s the boss at a later date.

My vacation at home during the first week of the year was a misery of sciatic grade pain and frozen weather. I learned something important that week: spinal stenosis and sedentary living do not combine well. As much as I’d like to do so, it is a terrible idea for me to sit down and read for eight hours a day, no matter how engrossing the texts before me might be.

As for my back, it turns out that my L3/L4 disc is bulging to the point that it is impinging a root nerve that runs across my left hip, thigh, and knee. As a result, I have nerve pain along that pathway. I will be getting an epidural injection soon to help remedy this issue.

I had one of my periodic surgery follow-ups last week. It’s been ten months since my L4/L5 fusion, and my spine is fusing well:

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If only my lumbar degeneration had been confined to the disc that was removed. If so, I would be fairly trouble-free at this point with orthopedic pain.

p.s. Of all the Golden Age mysteries I’ve read recently, I highly recommend Agatha Christie’s The Pale Horse. I think that Christie’s body of work explores a lot of the anxiety of coping with a changing modern world. This theme is very apparent in this novel.

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.”

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.