03 February 2012

I CAN FLY!

Tongass National Rainforest, Alaska, bridge
Bridge to Ziplining Course, Tongass National Rainforest, Alaska.
     OK, I can't really fly, but compared to where I was a few weeks ago, walking without a limp, without pain, and without distress feels like flying. I'm free, not weighted down by a foot made heavy by numbness or a leg cramped into a permanent charlie-horse.
     It all started with a sprained ankle in May 2011, keeping me from running the Bolder Boulder as planned. Next came lots of nights out with the puppy, lots of bending to play and pick things up, and no time to work out or swim. Just the daily grind.
     I don't know how my body could have gone from there to where I was the first week of December: Barely able to walk, using a walker (albeit a very nice cherry-red one) borrowed from a coworker, desperate for surgery. I may never know, but at least, through the magic of magnetic resonance imaging (MRI), I was able to see that the pain wasn't all in my head.
     Those of you who regularly read this blog will have seen the MRI picture I posted back in August clearly showing the cyst pressing against the nerves exiting my spinal cord at L4-L5 (lower lower back; actually the most common place for people to have trouble). I also had a bulging disk right below it (L5-S1) that was also compromising the spinal canal.
     I wish I knew how the cyst developed -- that is, could I have done something to prevent it? Even today I worry that it might come back, which I have been told is a possibility. Apparently, synovial fluid can leak out of the facet joints in the back and become calcified (here's a link to more back-related terminology: http://www.my-spine.com/terminology-for-ct-scans-and-mri-scans-lumbar-region.html).
     I'm going to physical therapy now and working to strengthen my hips and core so that there is less strain on my lower back. But I was in quite good condition before the puppy came and before the sprained ankle, and that didn't stop things from going downhill fast.
     Anyway... I tried various other treatments before deciding on surgery: physical therapy, two corticosteroid injections into the spinal canal (lumbar epidurals), rest, pain-killers, massage, meditation, and even standing at my desk instead of sitting. The first lumbar epidural seemed to work for a good couple of weeks, but then I was back to square one. The second shot had no effect. Pain killers -- well, they're not what they're cracked up to be. They hardly even took the edge off, and I was taking the max. dose per day. From July through the first week of December, I was on painkillers and still in so much pain I could barely function.
     So, in late October or early November, I asked my neurosurgeon (Dr. Alexander Mason) for help. He had walked me through the other alternatives, and it was clear to him that I'd done everything I could, that I was  absolutely "miserable" (his word), and that surgery was truly in order. Unfortunately, I had to wait until 14 December. But that gave me time to set things up for Gem at Dog Days Training Center, where he stayed from 10 December through 10 January, and finish up tasks at work before I passed things off to a very helpful, hardworking, and gracious coworker.
     On 14 December, my husband, Bear, and I went with much anticipation to the Minimally Invasive Spine Institute in Lafayette, Colorado, ready to have this ordeal over with. I was less scared of surgery than I was of having to live with the pain.
     Here's a pretty good animation of what happened during my surgery (not exactly, of course): http://www.spine-health.com/video/laminectomy-back-surgery-spinal-stenosis-video. The surgical staff removed the spinous process (the protective bone that protrudes from the spine), parts of the bone and joint, the cyst, and some synovial fluid that was leaking from the joint (the PA told me this fluid has a similar look and consistency as ear wax), and shaved off the bulging disk. All through an incision no longer than my ring finger.
     The funniest thing that happened that day was just after surgery, when I was in the recovery room: At one point, I thought I heard myself snoring, and I heard the nurses around me, but I knew I couldn't talk, so I started signing to them (!) -- spelling out in sign language: "Sorry for the snoring." One nurse was quite surprised, asking another person "Is she hearing impaired?" I have been talking to myself by spelling in sign language for years (I learned a bit of sign language when I worked at a school for mentally disabled children when I was 14), but it's funny that that would be the way I would try to communicate after surgery. I guess you just can't keep me from talking, even if you have a tube down my throat. (My mother would find this very funny because she says that as a toddler, once I began talking, it was almost impossible to get me to stop [or, as she put it, "she never ceases"].)
     Recovering from surgery was difficult. I was lucky enough to have good benefits and could stay home for six weeks in order to recover and gain strength. Here's one thing I learned: We truly take for granted being able to lie down. Once you take your back out of the equation, being able to lie down is a Herculean task. I had to get Bear to help me, and now every time I lie down I am grateful that I can do it easily and by myself.
     After a couple of weeks, I was feeling well enough to start weaning myself off of pain meds. I wanted to stop cold-turkey but knew that wasn't wise. Yet even slowing things down led to horrible withdrawal symptoms. I'd been on pain meds since July; that's over 5 months. The worst withdrawal symptom was restless leg syndrome. Not the kind that happens in your sleep and might bother your partner. We're talking full body restlessness with an incessant need to walk or kick your legs, pounding your feet into the floor. And that was accompanied by hot-flashes, anxiety, and insomnia.
     I can understand why some people with a physical dependence on opioid painkillers might become psychologically dependent as well, even addicted. I'll never look down my nose at anyone struggling with this problem. After the pain and inability to walk without a severe limp, this was the most difficult physical challenge I have ever been through. It took a good two to three weeks before the withdrawal symptoms subsided. Now my goal is to never take another pain pill again; I hope my back holds out. I also want to say thanks to Maia Szalavitz for setting my mind at ease about the difference between addiction and physical dependence. [And thanks also to Luis Carlos Montalván and his book Until Tuesday for inspiring me to feel grateful and write this post.]
     These days, I have almost no pain, just some twinges when I turn wrong or step down too hard. These days, walking is like flying -- a swift, smooth motion, head held high, shoulders broad. I am myself again, for the most part. Soon, I'll be able to start swimming, and then running. I'm hoping I'll be able to do a 5K sometime this summer. And maybe the doctor will clear me for zip-lining (again) and sky-diving so that I can do what I've always dreamed of doing -- really FLY. 

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