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!

Here again

Yes, I'm still here. Awake and wondering about the new day. What will it hold for me? Pain, of course, although I just took the morning trio of the right drugs and I'm waiting for the curtain to drop and give me some relief. My surgeon told me that I would remember him for the rest of my life; every morning when I got out of bed, I would mention his name and he's right, I do and I damn him.

Okay, that's a little strong for me, I really do appreciate his skills and his honesty. He said it would hurt me every morning for a very long time and it has already started. I've only 3 or more months into it; the real test comes with time. And see, as I type, the pain recedes a little bit. No, it's not due to my typing skills but to the passage of time and the speed and efficiency of the drugs as they move throughout my system.

Later…I have posted a lot of nonsense to my Projections blog and that was my 'smarts' for the day. I'm at a point where I'm slightly brain dead and dysfunctional. Could it be drugs? Of course it! Everything in my life is about drugs, as it should be. Pain=drugs. Simple. Seriously now…I'm half in and half out of my previous minute or two of euphoria induced by the 'Big Three' and I'm coming out the wrong end; into pain again. But relief is just a few steps away. What a life, it's all pain and then the side effects of the drugs used to fight the war against pain. Hmmm? Why, if we have a war against drugs, why don't we have a war against pain? Why, when we are in pain, are we told to suck it up? Who gave those people the moral authority to say such a thing? Tell them to get lost! Better yet, wish the same pain upon them. Cruel? You bet, but those who say 'suck it up' are far more cruel. And stupid.

Looking at my journal

I was just thinking, once again, that this year's Journal has devolved into one sad story. This year and the last have been filled with pain and more pain along with an ample dose of frustration. I'm certainly tired of it and I'm sure that any reader would be as well. I think I will open up last year's journal and see what was happening on this day a year ago.

Okay, the 25^th was a Saturday in 2008 and apparently I was doing the very same thing I'm doing today, browsing my Journal.

It's close to 6 now and I'm feeling awake but not all that thrilled with the day. Of course it's the pain. And the fact that I may have made a mistake by reading through my journal for this year. I read where I first became aware that the pain was more than just a temporary setback to my marathon training. I called it Piriformis Syndrome because that was what I wanted it to be. It wasn't and that was back in March. And I read about the times that I had to wait to see a doctor. 3 months of simply waiting in 6 week segments. 6 weeks where nothing happened to improve my condition. An unknown condition? And more waiting, in 2 or 3 week segments this time.

Wow! March of 2008 was when I decided that I had Piriformis Syndrome and that was only after I had suffered from pain since when? Here's a clip from the first day of 2008.

Since it's the first day of the year, I suppose I should include a physical assessment. I know that last night, as I was putting on my pajamas, Laurae commented that I was certainly making a lot of noise with my groans of discomfort. Oops! It's true, stretching causes some pains in my joints, but I reassured her that although my body might be failing, my mind was still medium sharp.

And then in the middle of January…

I don't know why I'm feeling so sore today. I didn't do that much out of the ordinary, but I'm moving slow and painfully. Is this what old age is all about?

And just a few months before that, November 27^th of 2007…

I ended up with a 24.5 minute time for the second half. That's 12.25 minute/miles and it felt pretty good. 4.68 miles total

In November of 2007 I was good, very good. I guess I could say that January of 2008 was the 'official' start of my pain and the beginning of my slide downhill to my present condition. I was looking for the account of my early morning race where I felt that I had actually done something bad to my body. I thought it was in December of 2007 but who knows. I do remember the event because I had been training and feeling as if I couldn't go very fast at all and had been disappointed by my time and the persistent pain I felt in my hip. It was a gray morning and I was walking back to my car when I saw a racewalker go by, on his way into the park. He was moving fairly fast and since racewalkers were and are rare sightings, I decided to chase after him. My goal was to catch up with him by the one mile marker. He had a good 50 yard head start so I had to pour it on to catch up. And I did. Right at the mile marker I caught up to him and then stopped to walk back. A long and painful walk back. I was very proud of myself and quite sore. That pain never went away.

It seems as if I'm closing in on the two year anniversary of my 'Pain' and it's painful results. What a trip this has been. A trip I certainly didn't want to take and one that I wish I could end on a happy note. I'm still looking for a repeat of the 12.25 minute/mile and I'm not giving up.

More

I'm somewhat wordy this morning. I suppose that's good and I should be happy that my mind is still sharp enough to string a few words together. But what am I thinking? What am I going to do with the day? And that's going to be the question for the next three months. With surgery not even on the calendar yet, I'm facing a long wait with my days and nights filled with drugs to keep me pain free or as close to pain free as the chemicals will allow. But…narcotics don't stop nerve pain. They just muddle your head enough to make you less aware of the pain. This works. Sometimes. Believe me, an offended nerve will cut right through a narcotic haze to deliver its message! I will be taking two other drugs that are prescribed just for nerve pain. One doesn't do anything at all; it's the one I've been using for the past three months and the other one may or may not work but the significant side effect is that I will become lethargic and my mind will slip into low gear. Which won't bother me because I will be beyond worrying. Just cruising.

But wait, I didn't even mention why I'm waiting for surgery again. Since my post-op pain was not decreasing but instead was increasing, the surgeon wanted another MRI, one with contrast and one without. And since my laminectomy had removed the overlaying bone, this latest MRI revealed the fact that the nerve root on the right side of L-5 was caught in the foramen, the hole in the bone, and scarring and bone growth was holding it firmly. In the previous surgery, he had probed that nerve channel for 5 cm and found it free, that was standard, but his probe couldn't reach behind the pedicle where the nerve was caught. So, a Foraminotomy is going to be scheduled sometime in the first part of the new year. It's a major surgery with a few days of hospital stay but I don't anticipate having to donate my own blood for it as I did last time. And why are we waiting so long? Because the bone grafts from the previous surgery have to be strong enough to support me after he cuts away some of bone that is causing so much pain for me.

No Marathon This Year

Tomorrow morning is the start of the Portland Marathon, my favorite, and I can use my imagination and see the crowds in the early morning darkness. I can feel the jostling as the participants move about in the street, trying to keep warm and stay focused on the event ahead. But I won't be there and I'm only tormenting myself with these thoughts…I suppose I should recap all that has brought me to this point in time; now. I'm two and a half months post op and I still live with pain 24/7. Yes, it's better than it was immediately after surgery but now it has become static, nothing is happening to change the situation. I do my walking, my exercise and I take my pills and still the pain is there. Disabling me mentally as well as physically. My mind is no longer my own since pain and its attendant medications have taken up residence there. I take an average of five Norco a day for pain and it has been that way for close to two months now. I even take Dilaudid on those occasions when Norco won't do the job; it's rare, but it happens. Those really scramble your thoughts.

I've been to see my surgeon and as soon as he walked into the exam room he saw that there was something wrong; 'What's going on?' he asked and then I proceeded to tell him. He was quite serious as he did a quick neurological exam and then told me that he had expected to see me in much better shape that I was in. He said the nerve that passes through the foramen on the right side of L-5, the last lumbar vertebra was the culprit and he was at a loss as to why. He ordered a 'with and without' MRI for me as soon as possible. (That's one with contrast media injected and one without) Then he will meet with us as soon as possible after that. He was nice enough to go over his surgical notes with me and showed me where he had explored the channel for the L-5 nerve for a distance of 'x' centimeters and had concluded that it was free of anything that might injure the nerve. He said that it might very well be that the previous nerve injury, the crushing of the nerve that had brought me to him to begin with, had injured the nerve beyond repair. Nerves normally repair themselves without a problem. You can cut a nerve and the two halves will eventually find their way past the scar that obstructs them and rejoin. Anyway, it's all conjecture at this point and he needs the MRI before he can come up with some sort of plan.

I asked him about the drugs and the amount I was taking and he said that they were not a problem. Pain control was first and he said that we would confront the addiction problem afterwards. In the meantime, I was to take them whenever needed. And as he said, they really do very little for nerve pain. The pain remains when you take them but your mind is muddled enough so that the pain doesn't seem quite as important as it was.

Once again I'm without a plan. This is where I was a year or so ago. Waiting for relief. And another marathon.

Recap

It's been a month since my surgery and so it's time for a recap. First, the surgery is not for the faint of heart. It took 6 hours of cutting and grinding on my spine before the surgeon called it good and sent me to the recovery room. Now, to be honest, this surgeon did his best to make sure I understood what was going to happen. His words to me, a year and a half ago, were, 'I'm going to put a world of hurt on you.' And then just before the surgery, You've never felt pain like this. You ready?' And he was right. I had a thoracotomy about 30 years ago and I thought that was the most painful thing I had ever endured. So now I have a new benchmark for pain, a four vertebrae laminectomy.

The pain was managed quite well in the hospital because the meds are almost always given by IV and the effects are felt right away. At home I have to use the oral route and means a good thirty minutes might pass before I see any relief. Plus the fact that nerve pain is very difficult to manage. Only opiates can touch it and then not well. Bone pain is also one of the worst to try and manage. It's the same story; opiates are the only thing that control bone pain. The pain from incision site and the muscles beneath is a distant memory, if there ever was any pain at all? Truth, I don't remember it.

Today, a month later, I can usually manage the pain with Norco and nothing else. I do have some Dilaudid if I need it, which is rare. Even with the Norco, the pain is always there, just muted. Early mornings are some of the worst times as the Norco has worn off and the first one of the day hasn't begun to work. Plus, I've been laying flat for six hours or more and muscles are stiff. I have to 'log roll' to get out of bed and sit on the edge. My walker is a few feet away from me and I have to stand and reach for it. Painful! And it continues as I shuffle into the kitchen to make some tea. It usually takes thirty minutes or more before I can say that the pain is now in the background and I can think of other things. Does it ever go away? Never.

That's probably the thing I hate the most; the pain never goes away. And the management of that pain is now my life. Early in the morning, it feels hopeless and I'm quite depressed about it. But, at seven, I take my antidepressants and that feeling goes away. 'Better living through chemistry!' I can handle the pain, most of the time, throughout the day. I even abandon my walker! Luckily, the day always includes a two hour nap, which gives me a break from reality. By evening I'm quite conscious of the pain again and try to do as little as possible. 'Let sleeping dogs lie.'

I will be seeing the surgeon next week and will learn more about my future. I know, because he told me, that I have six months to a year to recuperate from this surgery. And I know I have only put in a month so far. So I must hope that it gets easier. Not much else for me to do…

I’m Walkin’

OK, I'm 12 days post op and things are looking up. Pain is still a constant and it appears that the doctor expects that. He prescribed a bottle with 200 Norco in it and 2 refills. That scares me when he thinks I will need 600 Norco! Norco, of course, is my new best friend, followed by Dilaudid. Or maybe it's the other way round? Sad, but I have no refills available for the Dilaudid, though I will ask for one this week. Dilaudid makes the mornings bearable. And the evenings. Twice a day is all I need and I will have to tell him that. I'm also taking Tizanidine, a muscle relaxant to help with back spasms.

I'm getting around more with my walker and taking longer walks. I try walking without it and find it to be moderately scary and don't get too far away from the walker. Also, I have to be picky as to when I go walking. The pain meds allow a short window of opportunity between the times I take those meds. I have to start walking about 45 minutes after taking my Norco and I must end it about an hour before the next one. Even with those restrictions, I have about 2 hours in which to exercise. If I'm not napping.

I just had a brain flare! Maybe I will paint my walker. It's mine after all and I do have some incredible paints. Maybe Sharpies would be the way to go? Why should walkers be industrial gray in color?

Can’t be mine…

Walkers. I used to be one and now I have one. What a letdown.

It wasn't too long after surgery, maybe a day, when I noticed the walker laying up against wall across from the bed. It didn't take me long to figure out that there was a good chance that particular walker was mine. It wasn't there by accident. This was confirmed by the nurse when she told me, "We'll get you up and standing in your walker while we make the bed." My walker? Later in the day, I was given a quick lesson in its use and was told once again that it was all mine and that I would only get one like this, free, in my lifetime. If I lost it, I was out of luck!

OK, I'm home and the walker came with me. I'm even appreciative of its presence, despite the fact that it has left 'walker tracks' all around the house; thin lines in the carpet left by wheel and brake as I drag myself around. Hey, it's definitely better than crawling!

Post-Op Day 6

Life goes on. Painfully. I don't know where the pain came from last night as I was getting ready for bed, but it was shockingly intense. I had wakened from napping on the Lazy Boy, had navigated to the kitchen for two of my pills and then into the bathroom. Even now, I can't remember where the pain came from; I was moving between the toilet and the countertop when it struck. BANG! This was the kind of pain you would expect to leave scars on your psyche. It may have.

It's been 5 hours since that event and I don't think I'm recovering at all from the pain of last night. And I've been up every two hours since that time. Most of the time, it's because I need to urinate and that's a good thing. I'm hoping that the increased urination will draw fluids away from my ankles, which were looking particularly swollen; a bad sign. As of this hour, I have urinated 3 times since midnight for a grand total of 43 milliliters.

Funny, ever since my year of Medical Miseries began with surgery to repair my umbilical hernia back in October of 2008, I have become quite comfortable with all of the different medical terms for peeing and pooping and how often those things should occur. Plus, the doctors and nurse are quick to discuss just what portion of your anatomy they will be caring for. It's all so familiar that we think nothing of discussing these matters in mixed company and even with strangers; as long as a few of them have a white coat on. Yes, all modesty is abandoned once you go through those hospital doors. Modesty only gets in the way. When I needed my catheter reinstalled late one night, I never even though about the gender of the one to do the chore. OK, I did think about it, but only briefly.

Here I am, I've got a few pills in me; Norco and Tizanidine. That makes me close to comfortable but offers no cures. And the Tizanidine is the one that gives me hallucinations that are more enjoyable than not. In another fifteen minutes, I can take a Dilaudid. An even better chance for fantasy! By the way, fantasy is 100% better than pain. Most of the hallucinations have been of a parallel universe. I live in this one but dream/live in that other one and sometimes they twist and loop and become one universe for a moment or two. Strange things can occur.

But, right now, the pain is affecting my memory and that makes writing very difficult for me. And, when I read over what I've written, a lot of it makes no sense. I may have to go and sit for awhile; in the dark.

 

 

It’s over…sort of

I'm 5 days post op and 2 days post hospital. Life goes on. And let me tell you about the pain! Yesterday afternoon, I was pretty well armed with my new drugs to stop pain. Norco, Neurontin, Tizanidine, Dilaudid and etc. I was sedated as much as I could be without falling over, but the only pain relief came when I was asleep. It's the same thing this morning; once I'm upright, the pain strikes me from every angle. Yikes! Did I do too much on Saturday morning? And how much is too much?

Well, I'm off to do a walk. From the study to the kitchen and back. Can I make it? (Minutes go by…tap your foot in frustration) OK, I'm back. I found that the trip down was very comfortable. I opened the door for the cat, heated up my creamer and made my cuppa tea, took my temperature (99.4) and then found that I hadn't included the Tizanidine in my 3:30 round of pills, so I took one. Up the hallway I rolled and then sat at here at the desk, still upright.

Anywho…what I discovered while making this trek was the fact that the pain decreases in a direct relationship with my speed. The slower I do anything, the less pain I have. So now I go slow, very, very slow, and it's enough to make my head explode. I'm the guy that hates to wait for anything and now I find myself waiting for…me.

Well, I'm certainly well medicated. There is still a lot of pain in my right hip and thigh and that comes right through the drugs, ripping through! I'm also quite 'spacey' this morning; I can't depend on 'me' for anything at all. I better explore and see what I really can do and what I think I can do..

I'm back and can report that I'm feeling better. My posture also dictates my pain levels, so I have to spend some time getting settled into just the right spot. Also, I have to move my fingers slowly on the keyboard or I am very frustrated by the many misspellings. And have I told you about the hallucinations? They would be scary if I weren't medicated to the brim. Plus, I talk to myself a lot; or I talk to the mysterious people that are here in the room with me. I only see them briefly and then they move to a place behind me.

 

Finally

Life goes on. And what is today? It's the day before, of course. The day before a whole new life for me. Tomorrow at this time I will be getting ready for the trip into Chico; to Enloe Hospital and my long awaited surgery. A laminectomy, foraminotomy and spinal fusion with instrumentation, to be a little more exact. And if the surgery has the expected outcome, I will be pain free for the first time in…oh, let's say 20 months.

OK, not completely pain free; not at first. I will still have to deal with the surgical pain. Dr. Mimbs, my neurosurgeon, has told me that immediately after the surgery, I will feel as if I've been run over by a truck. His truck. He apologizes for that, but it's to be expected. And he tells me that I will be in love with the 'clicker' for my PCA. (Patient Controlled Analgesia pump) That's the pump that delivers morphine as needed. I can certainly understand that kind of love! But, he also told me that I will not feel the pain in my hip and legs that has plagued me for so long.

Recovery will take from 6 months to 1 year. Which is a whole lot better than 'no recovery', which is what I had to look forward to if I didn't have the surgery.

That's the physical effect of this surgery. There is also a mental effect to deal with. I will have to become a person who is not in pain. That pain has controlled every aspect of my life for the past 20 months and it has changed me in ways that even I do not know of; yet. I have to imagine life with hope. I have to imagine life without Vicodin.

And it all starts tomorrow at 7:30, the expected time for surgery. After waking up in the recovery room, I can expect to enjoy a week in the hospital. I doubt that I will be allowed to use my netbook computer while I'm there. I'm taking a notebook and pen so that I can continue my daily journal in written form. That's what I'm hoping that I can do. I'm not sure how well or legibly I will be able to write while using the PCA, but I will give it a try.

And after all of that, I can begin dreaming of marathons again…

The Real Deal

The surgeon's office called yesterday and gave us some times and dates so now we feel like it's official and that the surgery really will happen. It is scheduled to start on the 14^th at 7:30 AM and we have to be at the hospital at 5:30. Back in the old days…you would have been there overnight, having checked in on the previous day. We have to be at Enloe Pre Admission this Thursday at 10 AM for some additional lab work. Then we have an appointment to see the doctor, my surgeon, on the 9^th for a final consultation. His office will also be sending us additional information via the post office. It's been a long time coming!

An odd thing I noticed; as the date for surgery draws closer, I find myself picking out old racing souvenir t-shirts to wear. Yesterday I was wearing the shirt from the Rock and Roll 1/2 Marathon in Phoenix that I completed in 2007? I think I'm being positive…I will be racewalking again!

Getting Closer

Life goes on. I've had my morning fun with Boo the Cat and made sure that I didn't bend too fast or anything foolish like that. Which I did yesterday and turned it into a very bad day! Apparently the best way to start the morning is to make no sudden moves. No bending. No stooping. Move slowly; like an old man. OK, it's not fun but it does save on the early morning pain. No wonder the old guys like it! But what is disturbing to me is the fact that no matter which way I move or how slowly, I can feel the pain just waiting for me to make a mistake. It's just a dull ache right now; a sort of tension in my right hip and leg. I know, absolutely, that if I make the wrong move, the pain will descend on me like an angry bear! So I sit…carefully.

And I wait. It's just 3 weeks till the day of my surgery. A surgery I'm so looking forward to! I'm even entertaining thoughts of racing again. OK, maybe not, but I can dream. I still subscribe to a couple of running magazines just because they are so uplifting to read. Although, I have never been a runner; I've always been a racewalker, but there aren't any good racewalking magazines so I make do with the next best thing. It's all about the race anyway. Not a race with others, but a race with yourself. That's what I've always loved about the marathons and half marathons; you're all alone in that crowd. It's all about your mind and your body. That's your competition…and the running magazines capture that feeling quite well.

Progress

How very nice! I'm having one of those 'It's a Miracle' mornings and the pain ranges from non-existent to minor. I have no idea as to why this happens every few weeks, but I do know that it's an illusion. I'm certainly not calling the doctor and cancelling the surgery. A year ago I might have considered it, but I've had these rare days come and go so often that I'm pretty much immune to the dreams of a real miracle. This is just a break in the action and I'm going to enjoy it for what it is.

On a secondary subject; my recent PVP surgery – after calling the doctor yesterday, I've been cut free of my second catheter now and all is well. My wounds are healing and I'm looking forward to my next surgery in less than a month. Yes, looking forward to it! It's been 18 months, more or less, of failed therapies and broken dreams to get to this point.

I will be donating my first of two units of blood next Monday and then again on the following Monday. That would be the 29th and just a little over two weeks from my surgery date…

The Good News

The good news is…the surgery is now scheduled for the 14^th of July. I have a real date that I can put on my calendar and count down the days.

Am I nervous? Yes, a little bit, but I do have the advantage of past medical training and I do know exactly what will be happening during this particular surgery. I even have prior experience with the same surgery, a laminectomy/foraminotomy/spinal fusion. As a Navy Hospital Corpsman on an orthopedic ward, I worked for a neurosurgeon and I took care of fusion patients. But that was close to 50 years ago and the procedure is much better today than it was back then. 50 years ago, some doctors would not even attempt a fusion like this. They only had wire to work with, plus some bone fragments from the patient's own hip. Now they have titanium rods and screws and polyaryletheretherketone cages to hold the biological bone growth material in place. High tech indeed!

Also, I have been educating myself as much as I can about the procedures. The current wisdom says that a well informed patient is less fearful and will have better results from the surgery. So I read and then I read some more. I have also looked at some of the videos that are available on-line. Those are hard to take at first viewing; after all, you are looking at a very large incision in the patients back and abdomen, with exposed bone, blood and lots of stainless steel hardware being used in some 'innovative' ways. The video I was watching was of a laminectomy being done in New Zealand and it was very graphic. But, I will view them again, just to be certain I know what will be happening.

As for the results, those will be up to me. Again, current wisdom says that the patient must take an active role in their own recovery and that means walking, walking and more walking. Starting the day after surgery, you have to be on your feet and moving. Pain must be secondary and must not interfere with your progress. Pain meds will be prescribed and only the stupid would refuse them for the lame reason that they don't want to appear to be weak in some way.

OK, it's easy to write this stuff today; what will I be saying the day before the surgery and the weeks after? Time will tell.