Still in pain

I was up at 4 to take my first Norco and then, as I was making my tea, I had this thought…what if I never get any better? What if I have to endure this pain forever? I didn't like the thought at all. Okay, I need my antidepressants and soon.

Really. I was (and still am) depressed about the continuing pain. I think I'll go back to a full dosage of Neurontin next week and see if that helps. Is it a terrible pain? No, I can stand it for the most part as long as I have Norco to fall back on when it's at its worst. But I was hoping that at some point I could say goodbye to pain…forever. But now it looks as if pain will always be my companion. And I will always be taking Norco…3 or 4 a day. Forever.

What's my pain level? It's always at level 3 or 4 until the Norco begins to work.

3 Tolerable		Very noticeable pain, like an accidental cut, a blow to the nose causing a bloody nose, or a doctor giving you an injection. The pain is not so strong that you cannot get used to it. Eventually, most of the time you don't notice the pain. You have adapted to it.
4 Distressing		Strong, deep pain, like an average toothache, the initial pain from a bee sting, or minor trauma to part of the body, such as stubbing your toe real hard. So strong you notice the pain all the time and cannot completely adapt. This pain level can be simulated by pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails, and squeezing real hard. Note how the simulated pain is initially piercing but becomes dull after that.

That's the difference…adapting. And it's the Norco that helps me to adapt. I noted the other day that it was always about an hour after taking a Norco that I would suddenly feel pain free and I was so happy when it happened. Euphoric! No pain! That feeling would last about three hours and then gradually fade until I needed another Norco. Or I would try to wait as long as I could. If it's getting close to bedtime, say within a few hours, then I do without most times, knowing that sleep will 'cure' me until I wake, in pain, in the early morning and start the cycle all over again..

We're going to be walking again this morning and I know it will be painful at times, so I will take another Norco at some point during the walk or just before. Hopefully, that will last me until late in the day. I had a four Norco day not too long ago and I would rather not have them. The side effects of opioids are no fun!

Better!

Now, what has happened to me? I'm getting better! It's all very odd as I was still in pain and walking slowly when I went into the Lowe's store yesterday morning and by the time I came out, I was literally running! Without pain! Yes, the pain has come back briefly and lightly and I'm willing to deal with it because I'm getting better! I am in a time of awe and wonderment as I try to envision a life without that constant pain and the drugs to combat the pain.

I had a moment or two of weird thoughts as I came up with the idea of the 'Miracle of Lowe's. Why not? There is 'The Miracle at Lourdes' in France where the faithful come to be healed and buy water from the spring there. And just like Lourdes, I can see a pile of crutches, canes and wheelchairs by the front door at Lowe's, left there by those who were healed. Lowe's doesn't have a grotto and spring as Lourdes does, but they could just leave the water running at the drinking fountain in the back, near the restrooms.

Yikes!

Update

(Yesterday) Here I am again, three days later and I'm much changed. Very much. First, the pain has been reduced greatly. I really want to cry about this and I will, but I'm still at a stage where I don't quite believe it has happened. Two full years of pain. Pain that would never quite go away, even with all the narcotics I was taking. Pain that was masked but never absent. And now it's negligible. Sure, I have some pain right now but I can tell that most of it is from the surgery itself and it will go away in time. As a graduate student of pain I know the difference.

The surgery itself took a little over four hours, about twice as long as my surgeon had hoped for. He described the process for me; cutting away at the scar tissue from the previous surgery bit by bit while looking for the offending nerve and being extremely careful. Of course. Unfortunately, nerves and scar tissue look very much alike. When he found the nerve he followed it down the tiny tunnel that led away from the spine until he found the 'sharp pointy thing' that was pressing into it. Carefully moving the nerve out of the way, he excised the 'pointy thing' and all of the material nearby. He also opened up a much larger tunnel for the nerve to reside in and that is where it is right now; bruised and somewhat angry, as only nerves can get. But…the main source of irritation is gone.

(Today) I feel odd and words are not coming easily these days. I'm sure it's because I am not entirely certain of the success of the surgery and all my attention is focused on how I feel and then trying to sort out the pains. Is that pain, ouch! from the surgery or is it from the condition that existed before surgery? A new pain? Ouch! What's the cause for it? I'm afraid that all of this detective work uses up most of my mental capacity for reasoning.

    I need to get over it and concentrate on the fact that I do
feel better. A whole lot better! And I have to realize that this process of pain reduction will take some time. And some effort on my part as I must be exercising and walking daily. I'm only four days post op and I still have surgical pain to deal with and that will take some time. Plus, I have to stretch the nerve pathways every day with a set of exercises that bring me pain. Okay, the word 'pain' is still going to be part of my everyday vocabulary but I will have room for other words now and that is what I wanted from my surgery.

Recap

The day of surgery is rapidly approaching (Jan 26^th) and I couldn't be happier. The surgery will be exploratory at vertebrae L5 and S1 and then, if everything is okay he will perform a Foraminotomy at L5. The intent of all this is to remove the pain. That was also the intent of the first surgery, six months ago. When the pain did not go away after that surgery, an MRI was done and it was determined that there was still an impingement on the nerve, something that couldn't be seen during that surgery. Then we had a five month wait until the bone grafts were strong enough for the second surgery. A CT Scan a few weeks ago confirmed that my grafts were strong enough to withstand the pressure of the operation. But…there's always a 'but' isn't there? The chances of failure have now gone up because it is the second surgery. Even so, I am eager; it's been two years of mind numbing pain and two years of having my mind numbed even further by the drugs that are supposed to ease that pain. Norco and Dilaudid have become more than mere acquaintances, they are now my best friends and that's a bummer! And the pain? It never went away. And after a month or so, the Norco and Dilaudid were losing their effectiveness. Another bummer! Or, as a friend once said; a stone bummer!

The plan, my recovery plan, starts with the third day after surgery and I should be home by then. The doctor says a one or two day stay after he has reamed out the foramen. Ouch! But…the nerve will be free after that and he said that as soon as I wake up I should feel the difference. Viva la difference! Back to the plan; it starts with walking at the park and doing a half mile. I want to increase that by a quarter mile every two days. I will do five or six days at the park and then a day of rest which allows the body time to rebuild. By the middle of spring I want to be doing 5k distances and at speed. I also want to make sure I can return to my race walking form; that's the only way I can get back to the 11 minute miles I do for a 5k race. Or, I used to do…

Marathons are out for this year and iffy for the next. I need to be in great shape before I go for my sixth medal and the all important t-shirt. At that point, I just want to be among the other athletes, enjoying the marathon vibes, I'm not going to be trying to set a personal record, I'm waiting till I'm seventy five for that.

Recap and the future

As it is the first day of the New Year, I should bring this blog back up to speed. My last entry was more rant than fact and was drug induced; pain drugs, and those do odd things to my mind while easing the body.

Enough of that, here is where I am in my plan to get back to racing, even if it's only 5 or 10K races.

Flash back to my surgery in mid July. The surgical pain was manageable and after the normal amount of R&R I was told to begin a recovery program of daily walks. This went well and I was soon up to four miles a day and getting faster all of the time. Then, something happened after one normal day of walking, I got out of the car to begin and I could tell something was wrong. I thought that perhaps I had strained something the day before but couldn't recall such a thing. Anyway, I was barely able to make it around the park, in fact I couldn't. Laurae had to go and get the car and come back for me. And so it went. All downhill. The pain increased and my mileage went down quickly. I was lucky to do a mile. And then, the pain afterwards was tremendous. Saw the surgeon and he knew there was something wrong as soon as he saw how I was standing. An MRI revealed that the L5 nerve on the right side was caught in the foramen and anything could make it hurt. Any movement at all. He told me that I would need additional surgery to free up the nerve as there was nothing that I could do via the exercise route to ease the pain. In fact, he said it would get only get worse during the time it took to get ready for surgery. Yes, I had to wait for about two months while my bone grafts from the initial surgery strengthened enough to support me after the next surgery. He gave me an appointment for a CT Scan in late December and then a consult immediately afterwards.

Okay, I've had the CT Scan and the consult and now I must wait for a surgery date. We assume it will be very soon as that was what the surgeon indicated that he wanted. We all do, because, as he predicted, the pain has only become worse. Much worse than it had been before the first surgery. Crippling pain. Yell out loud pain. Yes, he gave me enough drugs for the pain; at least I haven't been burdened by one of those sanctimonious surgeons that are afraid to give their patients any relief. But if I took all that was available, I would be semi conscious at best…tempting at times! But, I do see a resolution to this, surgery will be done and I will get better and I will be walking a 5K race in November, the Turkey Trot, and then another in March of 2011, the Almond Blossom – the one that I have won so many times. I want to do it again. Another marathon is possible in October of 2011, the Portland Marathon, my favorite!