Here I am…again

All present and accounted for. OK, now that I have started the day, in which direction should I head with my writing? Should I ignore the obvious? Nah! I will have to write about what is happening and what's happening is more of the same old, same old…pain.

That's right; this blog is all about me and what's happening in my life. You can have your own blog if you want to read about you. And since this is my blog, I'm writing all about the pain…again. I was very depressed because of it yesterday and I think it was because I was watching a 75 year old guy painting my family room. Something I can no longer do for myself. It was very much a 'pity me' moment. Not that there is anything wrong with that, there isn't, as every once in awhile you have to be vulnerable and human. Besides, pity is sometimes therapeutic. It's a place to recover your perspective on life. I'm trying.

Now, on to today and the subject at hand. The pain is back with a vengeance. I don't know what I did to cause it, but there's no escaping it. The drugs aren't even touching it this morning and so I must wait and then wait some more. I know that patience is needed more than drugs and that the injured nerves will quiet themselves eventually, until the next time I stand or sit or walk or lean or bend...

Ah! There it goes…it's slowly fading as the nerves in my lower spine become used to this new and unique position; sitting. I really don't know if the drugs do much at all for the pain itself; perhaps they are simply making me a dull boy that forgets things like pain. Well, whatever works.

But what I really want is relief forever. I want to become 'normal' again. Any kind of normal will do. And that depends on the surgery and that's still a month or more away. I don't even have a date for it as the surgery schedules are all messed up because of the lack of specialized surgical suites; the room they do the surgery in. It has to be a sterile laminar airflow surgery unit and there is only one of those in the immediate area. There used to be two available, but one is being remodeled.

Remember when America was the leader in health care around the world? Well, I could have gone to Thailand this spring and had my surgery at Bumrungrad Hospital in Bangkok and I would be home now and recovering…and the cost would have been around $8,000, not including airfare.

Bumrungrad Hospital Link

Back to Reality

Here I am. Back again. Although I was actually fearful of going to sleep last night, because I didn't want to wake up with the same pain as yesterdays, I did sleep, and this morning's pain is down to a 3 on the pain scale. That deserves a Vicodin, but only one for now.

It's slightly cooler this morning; a good thing. I've opened the windows to remove the heat in the study. It was 78 in here about ten minutes ago and now it is 68 and falling. It's amazing how much heat the electronics in this room put out. It's always about 5 degrees warmer than the rest of the house in here.

OK, time for the second cup of tea and a slow walk down the hall. Slow is my world now. A little earlier, I had my first cup of tea in my hand and Boo the Cat demanded some attention, much as she is doing right now, so I put the tea down and then knelt to play with her. It took forever for me to get down on my hands and knees and then to get back up. And I felt very fragile while I was doing it; as if I could easily slip and hurt myself. Frail. Old man.

Ack! What's going on here? My perception of myself is changing and I'm not sure that I like it. 'Perception is reality' has been my mantra for years; taught to me by a lawyer whose job was to change people's perceptions. Create a new reality for them. (That is what lawyers do…) But…my old reality was just fine; In it, I was an elder who was fit and athletic. I looked younger. I thought like a younger person. I was optimistic and, sadly, I was also vain. But now? Who am I?

Well, this new reality is still shaking itself out and it may take awhile before the new me appears. I intend to remain optimistic, though some things cannot change by my altering of reality. My physical decline cannot be wished away. I do look older and I'm no longer fit. That is real. But that does not give me permission to lay down and let infirmity happen. And what does that mean, looking 'older'? I look like me, that's all. Did I really expect to be 40 or 50 years old forever? Of course not. But, in my heart of hearts, I wanted to be…

This aging process seems of no importance when you are in your 20's and all of the way up to your early 60's. Though it was very important to me when I was a child and wanted desperately to be older. And now I am. Much older. And once again, aging is important. If I let it be.

OK, I have been skipping all around the subject of aging for the past few paragraphs; what am I trying to say? One, my new reality is that I have some severe medical problems that will require major surgery to correct. Age did not cause the problems and I might have required the same surgery when I was 20…but here I am and I'm 68. That part of reality I cannot change. Two, aging does happen to us all. If we're lucky, we will all become gray and wrinkled. Eventually, if our luck holds out, we may even become feeble! Yahoo! And three, it's all good.

Now that I have preached, I must go out and practice. Until it's time for my next reality change…

Mistake

I definitely made a mistake last Saturday. I was feeling real good about the decision to have the surgery and so I decided that I could do a little gardening; just a little and so I completed the drip irrigation system, thinking that since I was only bending over half a dozen times and not doing any lifting or pushing, I would be safe. Wrong. 30 minutes of fun in the garden has given me 5 days of severe pain…so far.

So life goes on. And here I am; early in the morning and I have my cup of tea in one hand and my first of many doses of Vicodin in the other. Both items are needed each morning when I first become vertical. Yes, the pain is still with me and it's just as severe as it was yesterday and the day before that and the day before that, etc, etc. I guess I will have to grit my teeth and wait.

Waiting is what I do. I do have a promise of surgery in a 'couple of months' but no actual date. Nothing to pin my hopes on. No date to underline on my calendar. I've been told that someone from the surgeons office will be calling, soon. And so I wait. And then I wait some more.

Back in the day, this blog was all about my racewalking 'career' and it was fun to share the various races with family and friends. Then, about 18 months ago, it became a pain blog as I tried to figure out what was happening to me. And now it's about to become a medical experience blog; for at least a year. Will it ever return to being a racewalking blog? I was talking to my son last night and he says 'kayaks' are where it's at. So, maybe in another years time, this will be my kayaking blog.

Decision made

We're back from seeing the doctor (yesterday) and I have lots of news. First; I'm going to have the back surgery, just as I anticipated. The surgery will take place in about 2 months time and it will be, in the surgeon's words…

"An L3-L5 Decompressive Laminectomy, Foraminotomy and Instrumented Fusion using PEEK Cages anteriorly in the disc spaces and pedicle screws posteriorly.

I have explained to the patient that this is a huge undertaking and would require about a 5 to 6 hour operation, hospitalization for about a week, maintenance in a brace for two to four months and restriction of vigorous activity for about 6 months."

Well…life goes on. And I'm quite happy this morning, but with an undercurrent of fear. Slight fear. That was a big decision that we made yesterday. My life will change, our lives will change. But hey, that can happen accidentally anytime, so changing it on purpose is just part of the rhythm of life. And life will go on as before. But better.

And I've done all, or most, of my homework on this. I've had plenty of time to do the research and since I still have my interest in all things medical; ever since my days as a Hospital Corpsman, (I used to work for a neurosurgeon and we had to take care of all of the spinal fusion cases on our surgical ward.) I have found this research to be both enlightening and fascinating. It's been close to 50 years since I last worked on those cases and surgery has changed a thousand times over since then; except for the basics. Anatomy and Physiology are still the same, so my A&P classes weren't wasted, and the goal of the surgeon hasn't changed. But the rest of it? Wow!

During the past year I've read all sorts of papers on the techniques used and watched many of the different videos on laminectomies and fusions. Yet Google tells me that there are even more papers to research and more videos to watch. When it comes time for the actual surgery, I will be a very well informed patient.

And now that we've made this decision, the daily pain is no longer an issue for me. I will do what I can; vacuuming, cooking, painting, etc, and when the pain arrives, as it will, I will stop, take a pill and not worry about it. Real relief is now in sight; just weeks away.

And a year from now? Will I be training for my 6^th marathon? That's still the plan. Even if I have to walk the 26.2 miles at a very slow pace, I want to do it again.

 

 

Losing

Did I mention that I've been losing weight? About eleven pounds in the last month. From April 9^th (225#) to May 2^nd (214#). And all from reducing portion size. And some caution when it comes to high calorie foods. Since I can't exercise right now, portion control is my only option to get the weight off. It's a slower way to lose weight, just a little over two pounds per week, but it works. An example was our dinner on Saturday; I cooked two skinless chicken breasts for us with a tasty baked coating of bread crumbs, parmesan cheese and mayo. We ate ½ a breast each and saved the remainder for Sunday night. I almost always ate a whole chicken breast before embarking on this.

My motivation for the weight loss is the fact that my increased weight has to be hastening the deterioration of my lumbar/sacral vertebrae and I know it will help my recovery after the planned surgery.

Looking back to when I first became aware of the Lumbar Stenosis pain; (end of December…2007) it was during that period when I first began to train and I was 20 pounds overweight from all of the holiday meals. I should have known better. Racewalking, or running, should only be attempted when you are within your target weight. Besides, exercise like that doesn't take off pounds as fast as dieting does. And you're risking your health when doing strenuous exercising while overweight.

I don't know if I could have avoided the Stenosis problem altogether if I had been in better shape when I first began to train; arthritic bone growth can't be denied, but I bet I could have gone a longer time without pain and that would have been nice!

6 more days

A week to go before I see the surgeon and possibly make plans for the laminectomy and fusion that I need. I can't get my hopes up yet. It seems like it has been forever since I walked in the park, let alone competed in a race! A distant and past life…so far.

I had a more painful day yesterday but I did without any Vicodin, despite the urge. I find that if I grit my teeth and wait for awhile, the pain subsides, unless I do something foolish, like moving. I know it doesn't make any sense to not use a painkiller when you're having pain, but I'm not happy with the effects of Vicodin and so I try to minimize its use.

The pain has become my life and if I look back in my journals, it's been my life ever since December of 2007; that is close to a year and a half. I'm at a point now where I worry when I don't have any pain and I welcome the pain back because that is 'normal'. I know it makes no sense when I write it down like that, but it's how I feel. Imagine having a headache for 18 months; sometimes a splitting headache and sometimes far less than that, but still a headache, wouldn't you be worried if it suddenly went away?

So this morning I can safely report that the pain is with me. Not very bad at all at this moment in time; maybe a 2. I still limp a little because of the pain in my left heel and that's part of the Stenosis pain in my right hip and leg. They're connected. And I know; I can sense, that all I have to do is to sit 'wrong' or bend over 'wrong' and the pain will quickly escalate to a level 5. So I don't dare to do very much and that contributes to a deterioration of my overall health.

But on the plus side, I have lost about ten pounds during the past two months and I did it without exercise. I did it with smaller portions and smarter choices.