One month later…

Still working on healing. Monday is the end of three weeks of physical therapy to rebuild strength and increase flexibility, and though there’s still transient pain, life feels almost back to normal.

Violin lessons start again Monday afternoon. I haven’t yet been able to play, but I have a feeling it’s fear more than anything else. Tomorrow I’ll have to pick it up and play, at least for a few minutes.

Haven’t been able to do much with the sax yet, either. The effort of playing leads to achiness where all the work was done, so I’m left with nothing more than very occasional, short term practice.

Some days are pretty discouraging.

But things really are much better than they once were.

Back to work

Recovery has been much faster than I (or anyone) thought it would be. Went back to work on Wednesday, and finished the week feeling fairly good. Thursday afternoon involved a walk across campus from office to class, but it was uneventful. My voice comes and goes, and I’m usually asleep by 9pm, but things seem almost back to normal. The incision’s still pretty scary — I’m hoping turtleneck weather holds out another week or so — but it’s visibly healing.

Still some residual aches, especially in my right arm and between my shoulders, but this is probably from a combination of nerve inflammation and the bone graft. Arm muscles are pretty tender, too, because they’re now getting the use they didn’t get for a couple of weeks. Getting out of bed in the morning is still rough, with shoulder pains from hard sleep.

But looking at the top shelf at the grocery store doesn’t set off headaches anymore, and the mystery pains from two weeks ago are gone. The obsession about nerve damage has disappeared, replaced by uncertainty about the fusion and plating — uncertainties that will fade in time.

And it’s still difficult to write about this. I’ve kept some emotional distance from this whole episode, and it’s come through my writing about it. The workings have been intellectually interesting, but I know it’s also had an emotional impact — though I can’t deal with exploring it yet. The first time I was able to wash my hair I felt my skull through my scalp, and was struck by how a small column of bone and some tissue are all that hold my life together.

About a year ago I watched my mother pass peacefully after twelve years with Alzheimer’s. As we dressed her in fresh clothing, her body still warm, I felt bone through skin, and wondered how we live such connected lives trapped in these fragile, limited cages.

Long couple of days

Though surgery was scheduled for 10:30a, I didn’t actually go into the OR until almost 6:00p. Spent much of the time doing relaxation exercises, trying not to think of the reality of what was about to happen. Also spent time trying not to think about how hungry I was getting, since I hadn’t eaten after 10:30 the night before.

But at last they came with sedatives, and about thirty seconds later I was waking up in the recovery room. I had been told that it would only take a few hours to recover before going home, but because I seem to be sensitive to anesthesia, I wasn’t able to leave the hospital until 9:00 the next morning. One of the requirements was to walk from my room to each end of the hallway, but between muzzy-headedness and a lack of coordination, that didn’t happen until about ten hours later.

The time since then has been a little rough. I’ve avoided pain meds and muscle relaxants, but my mood is very low. Used the word “demoralized” this morning. It’s difficult not to be able to eat much — my esophagus is sore and behaving strangely — and I don’t feel very sharp mentally. Add to that the assorted aches and pains which are probably from my body readjusting to the new arrangement of neckbones, and an odd patch of numbness under my chin. And the incision looks just like what it is, which is disconcerting to see on my neck. I had a towel hanging over the mirror until this afternoon, because it would have been too much, on top of all the other stuff I’ve been dealing with, to see the incision and the Dermabond holding it together.

Enforced laziness isn’t fun for very long.

Some talk about when I’ll be able to play the violin again, but today it seems like it won’t happen for a long, long time. I realize, though, that this is only my mood talking.

More later.

Surgery Tomorrow

Tomorrow is the “anterior cervical minidiskectomy with fusion and plating C5-C6.” Though I try to keep the images of my neck being cut open and bones reamed out with power tools out of my head, I’m ready for this. Since last Friday I’ve had to wear a soft collar whenever in transit (car, plane) to keep from further injury because even a small accident could lead to permanent nerve damage. Though the pain is what brought me to the doctor, I’m even more ready to get rid of the constant worry.

Picked up some shirts that button down the front, since my wardrobe consists almost entirely of turtlenecks, pullover sweaters, long-sleeved t-shirts, and fleece. It might be a few days before I’ll be able to pull clothes over my head.

Later it’s to the grocery store for soft food. The esophagus has to be moved out of the way. I try not to think of that too much, either.

Tomorrow morning to the hospital at 10:30 to prepare for surgery at 12:30. If everything goes well I’ll be out by 7pm.

It’s hard to think about all of this. At the same time, though, I’m ready to let it go and let things happen as they will. There isn’t really a choice involved in having this done — though there are surgical risks, there are even greater risks in not taking care of it. As I sit here right now I have a low-grade headache and a dull pressure pain at the base of my neck. Though the pain itself isn’t debilitating, it’s become a constant presence, a reminder of imminent danger.

The end of tests

Finished up testing with an EMG on Wednesday afternoon. The needles were no more intimidating than those used for acupuncture, and the neurologist worked quickly. The nerve-zapping test was a little more difficult — it involved putting a low-grade taser on the nerves to see how quickly they conduct an impulse. The good news: no nerve damage, which is pretty incredible considering how much the spinal cord is compressed.

Pre-op tests today, surgery on Thursday. He’ll be pulling the disk, dropping in some cadaver bone to fuse the vertebrae, and putting in a titanium plate to hold everything in place. Here’s how far this kind of work has come in the past few years: it’ll be done as outpatient surgery. Cost-cutting is probably part of the reason, but my spine won’t be laid open to do this. They’ll go in through an incision on the front of my neck, go past the windpipe and esophagus, and take care of everything from there. Not as much chance for infection, much less damage to surrounding tissues (just some rooting around), and because of all the preliminary tests, no surprises for the surgeon. He’ll be digging around, cutting and attaching for forty-five minutes to an hour, and later in the day I’m heading home. What times we live in.

More tests

Today, the myelogram. This is the test I was feeling a lot of anxiety about. So I woke up early and planned to go to class so I would spend the morning obsessing about all of the ways in which it could go wrong (even going according to plan was scary).

An unexpected snowfall last night changed all that, so I spent the morning answering email, planning for my absence from classes, and chattering. A lot. Nervous energy was bouncing off the walls.

My catastrophizing paid off. Nothing could be as bad as I imagined it. The room was cold, the table hard against my bony frame. But the part I was most concerned about — the actual spinal tap — was very easy. The doctor had done hundreds of these, and other than a minor jolt along a leg nerve, I couldn’t tell when the needle had gone in. The dye was uncomfortable — pressure in my lower back and pelvis, and a vague sense of unease — but he took his time, so the pressure didn’t last long.

The Xrays were more difficult though. Because the trouble spot is in at the base of my neck, being on my stomach while keeping my chin on a rolled up towel was . . . well . . . difficult (<– midwestern understatement here). The pain between my shoulder blades absorbed all my thoughts. Apparently I’ve developed a way of carrying myself that keeps my spine from moving around too much. The Xray, though, required bending it in all directions, and all the while my head had to be up to keep the dye from running into my brain and causing a debilitating headache. The doctor and techs moved fast, though.

The only real problem came when all of that was over. I had to move to a gurney to be taken to get a CT scan. This involved the almost impossible maneuver of rolling from my stomach to my back, all the while keeping my head higher than the rest of my body (dye/brain again). I did okay with keeping my head up, but when the pressure of all that extra fluid hit the kink in the spinal cord, my shoulders felt a kind of pain I’ve never felt before. Pressure, profound achiness, enough pain to leave me shaking. When I got my breath back I asked the tech how long it would last, and he said, “Eventually it goes away. You probably didn’t want to hear ‘eventually.’” No. I didn’t. But “eventually” in this case meant a few minutes.

While waiting on the gurney in the hallway I kicked into some relaxation exercises and slipped into a light doze. It’s been twenty years since learning how to do that, and it still works even under the most trying situations.

The myelogram was followed by a CT scan. Easy. Closed my eyes and it was soon over.

Tomorrow: An EMG. Needles! Electrodes!

And the results of all these tests tomorrow afternoon. Surgery’s been scheduled for next week.

Spinal obsession

Now it’s time for anxiety.

Saw the neurosurgeon on Thursday. Working from write-up on the MRI, it looked as if three weeks of intensive physical therapy might take care of things. Increased flexibility could help with the herniated disk and stenosis (C5-6) for now, but surgery might be down the road a ways.

Friday. Phone call. The MRI was delivered to the neurosurgeon’s office — now it looks as if PT would be a very bad idea. Besides the disk problem and enlarged vertebrae, my spinal cord is swollen.

This is a sign of spinal cord trauma. It seems I’d remember injuring my back to the point that the spinal cord would swell, but I can’t recall anything that would account for it, other than some jarring around while jet-skiing on the ocean last August. (The memorable injury during that trip was a serious sunburn that left me on crutches. Lesson: Sunscreen is for feet, too.)

According to the MRI, I should be in bone-crunching pain right now. We’re all baffled by this. Today it’s just the usual neck pinches, along with occasional crampish sensations in the back of my legs.

So now we’re looking at surgery ASAP. This coming week will bring an EMG, which tests the conductivity of the nerves (needles and electrodes in my arms), and a myelogram, which is a spinal tap with unpleasantness added (enforced immobility, dye that can lead to a week-long headache — all spread over a two day period).

If the test results are as expected, it’ll be surgery the following week.

I was not expecting this at all. Since yesterday I’ve been careening wildly between anxious and cranky. I’m overwhelmed with thinking about how to manage my classes while I’m out (how long will that be?), along with flashes from an overactive, highly visual imagination. I’m also hypervigilant in looking for signs of impending bone-crunching pain, even though the MRI was taken over a week ago. For all I know the swelling could have subsided by now.

But I’m allowing myself a day or so of panic. Then it’ll be time to channel it into actually getting some things accomplished so I can head into this without worries about my responsibilities.

Pain in the neck

For the past couple of years, I’ve been having problems with headaches. Some lasted a few hours, the worst went on for a couple of months. Along with the headaches I’d get knots in my shoulders, pains darting into my back, throbbing from the base of my skull, and an odd sniffing reflex.

First I ignored them, thinking they were visible signs of invisible stress. They didn’t go away. Then I read about headaches and computer monitors, thought about the head tipping required with my usual bifocals, and invested in single-vision computer glasses. Work was more comfortable, but the headaches continued. Looking up on the top shelf of the grocery store would set one off; some mornings I’d wake up with one; on other days it wouldn’t set in until the evening.

Nearly every day I’d have some kind of pain — neck, eyes, sinuses, across the top of my head, along my temples, down my back, always somewhere. The last one continued for two months, and after finding myself sitting in a meeting, holding my head, and apologizing for not being able to concentrate on what everyone was saying because I’d had the same headache since August, I finally decided to go to the doctor. This is always a last resort, because I’m self-aware enough to recognize my own hypochondria. Though blessed with good health, I’m also hyperaware of every little blip that my body goes through — I have to filter out the useful from the normal, and have poor judgment in figuring out what needs to be attended to.

My doctor immediately referred me to a neurologist. She was “worried” about the throbbing at the base of my skull. The neurologist, however, diagnosed it as the common occipital headache, and put me on medication. The muscle relaxants were, as always, quite nice in the beginning, but eventually left me depressed and unfocused. The anti-inflammatories created stomach problems — a serious obstacle for someone who has a phobia about throwing up. After several unpleasant weeks of side effects and continuing headaches I asked to be taken off the medication so I could try acupuncture instead. Years before it had knocked out a persistent case of sciatica, so it seemed a far better choice than these meds.

One hour of acupuncture: No headache. Though they’d return, they never lasted long and were far less painful. After a couple of months of treatment, the pain was contained to specific areas in my neck, and no longer interfered significantly with my life.

But just in time for the six-month followup with the neurologist, the pain started in again. Sometimes it felt like hot needles laid across my spine, other times my shoulders felt hard pinches that wouldn’t ease for long minutes at a time, and one 3am I awoke feeling a spike going directly from the base of my skull to my sinus. The neurologist prescribed more medication. I asked for an Xray instead to make sure this wasn’t something structural or degenerative. Surprisingly, he scheduled me for an MRI.

The diagnosis: Two problems. One of my disks has slipped a bit to the side. The other problem is spinal stenosis. The passages for the spinal column and the branching nerves are closing up, causing compression and inflammation. This explains the numb hands, achy arms and shoulders, electrical jolts when running, and especially the headaches. I’ve now been referred to a neurosurgeon, and odds are it’ll mean surgery.

Though it will be good to feel normal again — it’s been a long time since that was true — I’m uneasy about being opened up, especially having work done that high up on my spine. More after talking with the neurosurgeon.