Inspiration

You guys know that I haven't been knitting in months, thanks to my brain being out of order due to pain and pain meds (Gabapentin has been both a blessing and a curse for me).  I've tried knitting on the socks I'd started before the herniated disc, but it's still not clicking for me.  I did start a very basic beanie on large needles, just to get my hands in back to that knitting movement, but I don't have a pattern and I'm at the point of needing to decrease at the top to finish it, so it's languishing at the moment.

But inspiration has arrived:  Karen and Jimmymeow returned from a trip to Vermont with a sweet surprise for me - yarn from a farm that that they visited:

It's undyed and has more of a sheepy texture than the usual superwash merino yarn that I buy.  I really like it.

See the little bits of dried grass/hay/sheep debris that came off when I wound it?  You can tell it's been minimally processed which adds to the lovely natural color and feel.

Sounds like a fun place to visit!

I started thinking about knitting a classic cabled winter hat, which brought me down the rabbit hole of patterns on Ravelry.  You can search by yarn weight but if you don't have a general idea of what you're looking for, it'll take hours to narrow things down.  Since I wanted cables, but not a charted pattern because I've never learned how to read a chart and now is definitely not the time to start, LOL, it was fairly easy to find a hat that looked cute with a written pattern.

I wound the yarn yesterday, pulled out my needles, and cast on.  I fully expect to make mistakes, be dissatisfied at my fabric (too tight or too loose), undo a lot of it, and possibly restart the entire hat, but that's my normal knitting process and I am thrilled to be in the thick of it, finally.  And all it took was a tapering off of the Gabapentin (still have a couple weeks to go, but the dosage is much less) and some really cool yarn from some really good friends.  Creative, too:

This was attached to the gift bag of yarn - Karen is so clever!

Herniated Disc Update #7 - Post Surgery

According to my surgeon, the recovery time for a laminectomy and discectomy is six weeks.  Considering I'd been dealing with a herniated disc for six months, six weeks didn't sound all that bad.  Besides, both the PA and my doctor said that after the first two weeks, I could go back to my normal life (whatever that is) with just a few caveats until the six weeks were up.  You'll want to stay tuned for this...

But let's back up to surgery day.  After I got home I parked myself on the couch, had a light dinner, visited with Diane who'd brought me some flowers, and finally felt enough pain in my back to warrant some Tramadol.  Of course I was really wary of taking anything thanks to how barfy I got from most everything I tried in the months leading up to this, but along with the pain meds I was also sent home with a prescription for an anti-nausea medication; I took both and fell asleep. 

On Tuesday I woke up feeling crummy but not barfy, so I continued with the pain meds.  Really it wasn't that bad but considering I'd spent enough time at 10 on the pain scale in the early months of the herniation, I decided to not go there if I could help it.  The pain was mostly located in my back but I still had a little bit in my leg from the nerve.  The other oddball thing was that I'd be perfectly still, standing or lying down, and I'd get the biggest ZAP of pain - it'd take my breath away for a moment.  This was the nerve reacting to surgery, yay.  When that happened for the first time I was glad I hadn't started tapering off Gabapentin just yet.  I needed as much help as I could get for that nerve.  It wasn't something that warranted taking Tramadol because it was too unpredictable - the zaps would just happen whenever they felt like happening.

Wednesday was my worst day with pain from the surgery - the incision area hurt plus my back ached pretty bad.  That was the day I could also remove the dressing covering the incision, and even though it was covered with steri strips, I could see some deep red bruises forming.  But hey, I got to take a shower, so that was great.  Although it was also a challenge since the post-op instructions said to not let the shower spray hit the incision.  I was paranoid that I'd accidentally turn with my back to the spray out of habit...let's face it, at 56 I've been showering for a lot of years without any thought going into which way I should be facing.  I made it through that OK, feeling both better as well as beat afterward.  I took the pain meds and for the first time since surgery on Monday, took the muscle relaxer that I'd gone home with - and side note, let's hear it for an in-hospital pharmacy who filled everything and sent it up to recovery; one less errand for Jeff to do afterward.

On Thursday I felt so much better that I only ended up taking half the dose of the muscle relaxer before I went to bed; no pain meds.  I thought that was really great - I've had so many pain meds in my system this year that not needing anything was better than good.  The zaps continued.

I spent the rest of the week and weekend feeling sore from the actual back surgery but overall not too bad all things considered.  I was trying very hard to rest and not do the things that were on the forbidden list for the first two weeks.  These consisted of:

• No bending forward beyond a 45 degree angle
• No twisting side to side
• No lifting anything over 15 lbs and if I had to carry something, to hold it close to my abdomen
• No driving
• No exercise or physical therapy
• And the big kicker, no sitting for longer than 20 minutes at a time

I tried to behave myself, I really did.  But similar to subconsciously putting my back to shower spray, it was really hard to not to bend forward beyond 45 degrees - I'd catch myself bending forward to reach a drink from the coffee table as I was lounging on the couch.  Or I reached into our bottom drawer freezer for an ice pack - argh!!  I was very frustrated with myself every time this happened.  I was pretty much perfect with the sitting, lifting, and driving, but bending and twisting really vexed me.

Which leads me to week two.  On Monday I woke up and felt like myself again.  I walked with my normal stride and while my back hurt a little, it mostly only bothered me getting on or off of something, like the couch or bed.  And yes, I was still getting zaps of pain, yay.

But then came Tuesday.  I woke up feeling good again, carefully swung my feet off the bed to start my day, took a step, and pain shot through my leg like fire.  After catching my breath, I realized that this wasn't a zap of pain but rather, it was the same nerve pain in the same area - groin, front of thigh, and top of knee - that I'd been dealing with since this entire thing began back in March. 

As you might imagine, I started going there:  the surgery didn't work, I'd accidentally bent too often, I'd twisted and messed it up...it was not a good place to be.  Not only did this continue, but it started hurting worse than before the surgery.  At the same time, I realized that the zaps were easing up and by Thursday I had my last one.  Which meant that the irritation on the nerve from the surgery had stopped, and the nerve pain in my leg was an indication of a failed discectomy.  It was hard not to think otherwise. 

The pain continued to increase in intensity and duration.  My despair was ramping up because if this didn't work, was I stuck living with nerve pain for the rest of my life?  Jeff was trying to stay positive but even he got a little down as the leg pain happened again and again and again.  There's a bit of a stigma with having back surgery as it's one of the more notorious in terms of failing, or being worse off than before, so you can probably understand why things looked bleaker and bleaker to us as I continued to hurt.

I had my two-week follow up appointment with the PA on Tuesday afternoon.  I was blunt in telling him that not only was I hurting, but that I was hurting worse than before.  He reassured me that I didn't screw it up with random accidental bending or twisting but rather, my nerve was extra irritated thanks to the disc fragment pressing on it, and then with the act of removing the disc fragment.  He said it's not common to have an increase in intensity of nerve pain after a discectomy, but it's also not unheard of, either.  I'm in the 10 - 20% of people who experience this.  Of course I am. 

My PA told me to continue with the bending and twisting limitations, and that I still should not start physical therapy or exercising, beyond walking as tolerated, for another two weeks.  He also offered to prescribe a round of steroids to help speed this process along, which I jumped at.  Anything to stop this pain.  He thinks the steroids will get enough inflammation reduced that I should begin to feel better over the weekend.  Please let that be the case!

So that's where I'm at as of about two and a half weeks post surgery.  It hasn't been the miracle cure where I woke up with the nerve pain gone, and all I needed to do was recover from having back surgery; nope not at all.  But my hopes are up once again and this time, I hope they stay up. 

Herniated Disc Update #5

Well it's after 4:00 pm on a Tuesday and I just remembered that I hadn't written, or even started, a post for the WWU.  That's unusual for me but I've been even more scattered than usual because, drumroll please...I'm scheduled to have surgery on Monday.

I guess from that announcement you deduced that my visit with the neurosurgeon last week went well.  It did.  Jeff went with me; we first met with the PA, who was super friendly and informative.  Before he came in the room he went over the paperwork that I'd brought, checked my MRI, and said that all I needed was to have the disc fragment that is pressing on the nerve removed and I'd be back to my old self once I'd recovered from the surgery...with no nerve pain.

No. Nerve. Pain.

Of course Jeff and I had a lot of questions, starting with how successful is this surgery?  The PA said very successful.  We asked what would happen and learned about the procedure and how they would only work on the left side, with the actual operation taking about 30 minutes.  It would be done on an outpatient level, at one of the local hospitals.

After more questions (what would the restrictions be, what is the recovery like, etc), I asked one last question:  did I need to have the injections and pain management and physical therapy, then, if this surgery is so successful?  Because I was wondering, what the hell, did I just waste five months with that when I could have had surgery right away and avoid being in pain all this time?

No.  He said that even if I had presented to them back in April, with the MRI and extreme pain, they still would have had me go through pain management because sometimes the epidural steroid injections can give enough pain relief while the swelling is going down for the disc to shrink and/or move away from the nerve...and it might not be an issue after that.  They don't do surgery unless other options to fix this have been exhausted.

Hearing that was confirmation that I hadn't been foolish in trying to get the herniated disc healed without jumping into surgery.  It made me feel good, plus made me feel like I'd gone to the right neurosurgeon.  He was recommended by pretty much everyone when I was asking who to see, from healthcare professionals to friends who had used him, but still, you don't know until you actually meet with the person.

When the surgeon came in, we liked him right away.  And then peppered him with questions, LOL.  Jeff the statistics person asked what percentage success rate did this particular operation have:  92 - 95% was the surgeon's response.  Well, we were both leaning toward the surgical option, but hearing that was the final kicker toward doing it.

The thought of getting my life back is very appealing.  Obviously I don't want to do anything impulsive just to have that, but after more than six months of hurting, I'm at the point of being willing to try something different.

Oh, speaking of being scattered, the other great news is that the surgeon said I can stop taking Gabapentin!  Really happy about that - I might get my brain back to normal.  Or at least normal for me.

Worst. Ride. Ever.

Welcome to my roller coaster, where one thing gets helped but then another thing stands out more, pain-wise.  Tickets are free but you're gonna pay if you get on this ride, believe me.

After my two injections last Thursday, I waited both in anticipation of feeling like a new woman, and in dread of potential side effects that might make me feel horrible for days.  Well, neither really happened.

I don't feel like a new woman.  Yes, I do think the injections helped relieve some pain in my glute and down the outside of my thigh.  But - and I'm conjecturing here - I think that by easing that pain made the nerve pain from the herniated disc stand out more.  Or else it was a coincidence, but man, my standard pain areas (groin, front of thigh, knee) have been hurting bad.  Funnnn times.  So, since I was experiencing a pain flare, I increased my Gabapentin (the nerve medication) by an extra pill, taking two in the morning instead of one, with my standard two in the evening.  It's not like I decided to do this of my own volition; my pain management group told me I could take an extra Gabapentin if I was hurting a lot more.  More on that in a minute.

I was very apprehensive about side effects from the steroid injections thanks to my experiences in the past.  This go-round it was changed up and they used a different type of steroid for the injection in hopes of avoiding them.  I got the standard steroid flush on day two:

It looks like I used the wrong shade of blush for my skin tone...and swiped it over my nose and chin as well as my cheeks and then hit my neck and my chest for fun.

Once the flush appeared I braced myself for the rest of the side effects, but none came, can you believe it?  Something went well for me for a change.

And yes, I realize that more than one thing has gone well for me since this began, but living like this for so long is an emotional and physical roller coaster.  It's hard to make plans because I never know how I'll be doing - for example, we were invited to Logan's birthday party on Saturday afternoon and I didn't know if I'd actually get to go...it all depended on what the steroid did to me.  Thankfully I was able to attend (fun pictures to come in Friday's post), but it's so hard to get excited for something when you know your body might let you down.

Back to the Gabapentin:  I ended up having a pretty rough time with it; my hands were shaking much more than usual, distractions were at an all-time high, and my memory was shot.  So I dropped back down to my usual dosage yesterday.  Also yesterday, my PT gave me some exercises to try when that pain is really bad and after my visit I did feel better so maybe things are turning up.

See?  Roller coaster. 

Herniated Disc Update #4

I had an appointment with the PA, Kristen, at my pain doctor's office last week.  Jeff met me there and I am really glad he did because I'd forgotten a lot of the oddities that had happened in the seven weeks since my last visit.

He brought up my blue fingers and the auditory hallucinations, as he called them - I just said there was a party happening in my head.  Off and on, I could hear the murmur of a group of people talking but couldn't really make out any words - it was like they were at a party in the distance.  Yes I know that is weird but it only lasted for a few days and I think it probably was related to going off the Butrans pain patch.

I was nervous to tell Kristen about my decision to not get another epidural steroid injection since the last one didn't help at all - I stayed the same, pain-wise.  Well, I didn't need to be worried; she listened to me and agreed that another injection wasn't in order, whew!  I know everyone is really kind and caring at my pain management clinic, but I rarely challenge a doctor so this was hard for me to do.

Kristen was very thorough with going back through her notes, confirming pain levels over the last several months, and not only where I was hurting, but things like the pins and needles at my knee - did it wrap around the leg or was it only in the front?  Although it happens constantly, I didn't know - isn't that funny?  I got the answer a few minutes later when the pins and needles started again:  it's only on the front.  It happened off and on during the appointment and I was glad that Kristen could see the frequency and also how I wasn't doing anything when they began.  We went over my prescriptions; I was only on Gabapentin at that point.  Oh and four Aleve a day.  Even with that, I still hurt.

That was the talking part of the appointment; next I sat on the exam table while she tested my leg strength.  Then the fun began, with her pressing on my back to see where I hurt.  My back was barely an ouch, but when she got down to my hip area, or the sacrum as I have learned, there were a lot of ouches, especially on the left side.  Then there was more talking:  she suspected that the reason why the last injection didn't help was because the previous one had done the trick and the herniated disc and fragment had moved off of the nerve root.  So the injection did nothing because there was nothing to be done...in that area.

Jeff and I got an anatomy lesson at that point, where Kristen showed on a skeleton model the area that was hurting on me.  She explained that everything sort-of overlaps in the back and one issue can lead to another, and I was experiencing sacroiliac joint pain, or SI pain as it's commonly known.  The areas where I was still hurting (glute, groin, leg) can be caused by the SI, and she was pretty confident that was where my lasting pain was coming from.  Of course Jeff and I both said "wait, was there a herniated disc??" and she said yes, very much so, as shown on the MRI.  So while the herniated disc is under control (fingers crossed, PLEASE BE SO), now we can see that the SI joint is inflamed.

The treatment for this?  Taking Meloxicam, an anti-inflammatory drug, plus getting an injection in that joint.  Yes.  Another injection.  Yippee.  Obviously I am not thrilled about that because of how sick I got from my last steroid injection, but if this works I will be mostly pain free and that will be worth it.  The good thing about this is that if the injection doesn't work, there are alternatives, such as a plasma-rich injection - but that isn't covered by insurance so we might as well start with the one that is.  Hopefully the steroid injection will happen later this week; my doctor's schedule is pretty full plus he's on call at the hospital, so we'll see.

If it sounds like I'm throwing everything at this and hoping something sticks, I kind of am...with the advice of competent medical professionals, of course.  But I'm tired of hurting, I'm tired of not getting to do much because of the pain, and I'm tired of this dominating my life.

I'm still going to go to the neurosurgeon consultation appointment in September.  At this point I still want to hear what his take is on my injury and what he might recommend.  I don't think I need surgery but I'm not a doctor and I could be wrong - shocking, I know.

Geez Louise, Not Again

I wasn't sure what I would be writing about today but I didn't think it would be this, again.  But dang it, just when I think I'm doing better with my herniated disc, and that the pain I have on a daily basis is tolerable (albeit with Gabapentin), I have a day like Saturday that reminds me that I am not done with this yet, not by a long shot.

I did some things on Saturday that WERE NORMAL, sheesh, but by late afternoon I was hurting much more than I have been, and it kept getting worse.  And because I did some different things, I don't know what was the culprit, or if it was simply a case of overdoing it, which, come ON.

Possible culprits:

I sat on a metal chair at Blue Baker for a couple of hours.  But I've been doing this for a month now without extra pain, so I don't think this was it.

Then I vacuumed the tile floors for the first time in months (Jeff has been taking care of this since my injury).  Vacuuming is on the "don't do this" list, but we have a Dyson cordless stick vac, which is super lightweight.  I didn't even push it back and forth like I normally would; instead I held it close to my body and walk forward in straight lines.  OK a couple of times I bent forward to get it under some furniture, but I worked at doing it with the least possible movement.  I didn't even empty the dirt cylinder - I had Jeff do that because it does take effort to pop it open.

After lazing around for a few hours, Jeff and I went to the mall to see a pop-up art show put on by our local art league.  It's a small mall and we didn't have far to walk to get to the show, which was in an empty storefront.  The show wasn't huge and we made the circle a couple of times but didn't see anything that needed to come home with us.

Then we walked a little way past the art show and found a Van's store, which I had to go into because it reminded me of California.  After perusing everything and finding a cool t-shirt with the California bear on it but they only had mediums in women's sizes which are too small for me so sadly I left it there, I knew I'd had enough because I was starting to limp.  So we walked back to our car.

Since we were really close, we drove to Bahama Buck's to get sno-cones.  After several 100+ degree days with more to come, we thought that sounded good.  So did about one hundred other people but luckily we got in before most of the mob and Jeff was able to snag a table while I ordered.  Jeff took this picture of me because he said my teeth were turning green from my blue coconut sno-cone:

No green teeth here...my tongue was blue, though.  But you can see the line of people snaking around the place.  Also I put a filter on this shot because mannnnn, was I looking rough.  Freckles and wrinkles and no makeup, oh my!

We planned out meals for the coming week and then we went home because I was really hurting with sharper pains than I've had in a while.  This was disappointing as we figured the walking ended up being too much for me even though we'd only walked a short distance.

I pretty much spent the rest of the evening on my zero gravity chair, watching Veronica Mars - but hey, I finally made it to the newest season!

Yes we have a lawn chair in the living room - it adds to the decor, don't you agree?  Actually it's folded up against the wall next to the patterned chair when I'm not using it, but the color is right for the room, at least.

I went to bed in a lot of pain, thinking that the walking had caused this.  When I woke up on Sunday I remembered that I'd vacuumed before the walk.  So...was it the vacuuming?  Or the walking?  Or both?  It would be nice to know, but I'm not ready to try either anytime soon while I get past this flare of pain.  Oh and speaking of pain, I forgot that I could have taken an additional Gabapentin when the pain kicked in, instead of waiting to take my normal dose later in the evening.  Thank you side effects of Gabapentin for that...I forgot that I'm an active participant in my pain management.

Last thing:  At the urging of a lot of people, I've made an appointment with a neurosurgeon for a consultation about my herniated disc.  I do not want to have surgery.  But, as my PT pointed out, it might be good to know what is recommended, and if I didn't have surgery now (if the doctor does think it's necessary), what would I be looking at in a few years?  The appointment isn't for another month; I'll let you know how it goes afterward.

My Brain is Borked

I think I've mentioned that my brain has been foggy from the medicine I've been taking for my herniated disc, but it recently took a turn for the worse in the form of:

• Writing a check with the recipient's address in the dollar amount line.

• Forgot to click my usual payment method for a meal service that we've been using pretty regularly for about six months, so when Jeff was picking it up, they said I clicked cash and boy was that a lovely mix up.  Luckily they were really nice about it and let Jeff take the food without paying.  He did tell them "my wife doesn't make mistakes like this but she's on some medicine that's working against her brain" and they were all "oh we know she always pays, we'll just run the card" - which is what I always click as payment when I order online.

• Wrote a check to our yard guy and put his name in the dollar amount line.

• Finally picked up my knitting needles after several months off.  Continued with a sock that I'd started, going round and round for about an inch, which was fiddly on tiny needles but I did it.  Then it was time for the heel.  Had to look up how to do the heel I've done many times.  Fine.  Started that and about four rows in I'd both dropped a stitch and messed up a decrease.  At least I was able to rip it back to the beginning without too much trouble.

• Since socks seemed to be too challenging, I pulled out a prewound skein of larger yarn, got out bigger needles, and decided to cast on for an easy hat.  I had the yarn in my fingers correctly to begin the cast on, but had to stare at it for a minute before it came back to me as to how to do it.  Got the correct number cast on and joined in the round to begin the K2, P2 ribbing.  About 10 stitches in I realized I didn't actually join in the round and was just knitting a straight piece of fabric.  Undid those stitches and correctly joined it in the round.  Once again I began the K2, P2 ribbing.  Got to the very end of the round and it was evident I would end on a K2, which is wrong.  Looked back at my work to see if I went wrong toward the end, in which case I could tink back a few stitches, but no.  I did it at the beginning.  And then toward the middle.  Two mistakes on the first round?  Time to unravel and put it aside.

• I've been listening to a podcast while I do my PT exercises and I was telling Jeff about it - well, it's about a huge art theft from a museum decades ago and there's this psychiatrist who tricked a patient into giving him his house in the Hamptons and access to his fortune...and oh my god I've been listening to two different podcasts.  No wonder I'm confused.  The Shrink Next Door and Last Seen, in case you were interested/wondering.

There's been more, but you get the picture.  The reason behind this stems from me stopping the use of the Butrans pain patch, which is an opioid.  Basically I've been on one form or another of opioids for four months, and while I didn't have withdrawal symptoms (because the patch delivered a small amount of medicine every hour for 7 days, don't ask me how that works), I had the above-mentioned mistakes abound.  One sleepless night I googled opioid withdrawal and discovered something called post-acute withdrawal symptoms, or PAWS.

From Psychology Today:

Post-acute withdrawal varies in intensity and duration from one person to another; again, usually in correlation with the intensity and duration of one’s substance use. Its manifestations can fluctuate in severity, coming and going in wave-like recurrences, and include impairments in energy, concentration, attention span, memory, sleep, appetite, and mood—most commonly anxiety, irritability, anger, and depression.

Yep, that pretty much describes me, with the exception of depression because I'd started taking an antidepressant a month ago; I just couldn't stop crying, every day, for months.  My doctor said I had situational depression and once all of this is behind me, I most likely won't need what I'm taking.  Starting it before I stopped using the Butrans patch was an inadvertent stroke of good luck.

It figures that this has hit me - if I can experience side effects, it seems like I will.  Steroid injection?  Check.  Opioid withdrawal?  Check.  Chicken pox vaccine?  Check.  Oh yeah, let's not forget scopolamine (motion sickness patch) withdrawal - that was a fun one.  Can I just say that I'm getting tired of this?  Because I am.

If you see this person, treat her like a 3-year-old, please.

Oh - I wanted to stop using the pain patch to see if I was feeling better because I might be getting some relief from the steroid injection, or if I was just getting really good pain management.  It's a little of both - I do hurt a bit more, but so far I'm able to tolerate it without having to go back on the patch.  Now if I can just move beyond PAWS, that would be swell.

P.S.  One more thing to add to the list:  as I was typing this post, I noticed that my fingers were blue.  Turned them over and my palms were, too.  I kept thinking that I knew my jeans had been washed enough to not bleed dye onto my hands but that's what it looked like.  Finished the post and got up to wash the blue off my hands.  Hey guess what?  It didn't come off because my. hands. were. really. blue.  HOW did that not occur to me?  Sigh.  Borked brain.  Eventually they returned to normal, but geez.

Herniated Disc Update #3

Another month, another update.  Actually I was emailing my PT who had asked for my blog link and I was telling her how I started it in 2008 so I could have a place to go back and see how far I'd come and how much work I was putting into my diet and OH MY GOD I'm doing the same thing only for a herniated disc.  Isn't that a kick in the pants.

Well then.  It has only been three months since my saga of the disc began.  It feels like a lot longer than that, but I suspect that's what being in immense pain for more than two months will do to a person - it warps the timeline because of how long a day is when you hurt so bad.  I hope to NEVER hurt like that again.

My second epidural steroid injection gave me the pain relief I needed for about five weeks.  It wasn't 100% but it was a lot.  Then the nerve pain started to come back at the groin area and yes, you guessed it, I found that out when I sat down.  At least it didn't get horrible, but I was looking forward to my next injection very much.

I had my third visit with my pain doctor a week ago yesterday.  After listening to my list of issues he said he was encouraged at the news of the pins and needles that I have been feeling many many many times a day, from my just below my knee to the entire front of my shin.  He said that the nerve was waking back up which meant all of this was working.  I can put up with it; it's annoying as you might imagine, but it doesn't hurt, and if it means that I'm healing, then that's OK.

We went over my medications and I asked if I could stop using the Butrans patch, reason being that I'm feeling better - but am I feeling better because of the injection, or because of the pain meds, or both?  He was good with that and also good with my request for a prescription of the lowest dosage of Butrans just in case I end up feeling more pain than I'd like after I stop using the higher dosage patches.  I'd love to get by with just Aleve, and of course, the Gabapentin, which is the nerve medicine.

It looks like Gabapentin and I are going to be friends for quite a while.  I wasn't sure it was doing anything until I missed my evening meds one night; the following day my leg felt like it had creepy crawlies going up and down from the inside.  Which is different from the pins and needles, in case you were wondering.  Anyway, yes, it's working.  It's also giving me some lovely side effects in the form of brain fog, clumsiness, and shaking hands.  We discussed cutting down the dose but for now I'm going to try taking the entire dose in the evening to see if it helps with the side effects.

I appreciated it so much when my doctor and the woman in the treatment room - I know her name but not what her medical title is - both said independently of each other that they wanted me to be an active participant in my pain management and gave me the option to change up when I took the Gabapentin, and how if I had a particularly bad flare of pain, I could take an additional tablet earlier in the day, and also to call them if I felt like something wasn't working and they'd work with me to get me something that would help.  I don't have to wait six weeks between appointments to make a medicine change and that was good to hear.  I feel a little more empowered as I go through this herniated disc recovery.

I had my third epidural steroid injection that day, done the same way as the previous one, which was transforaminal (going in through the side of the vertebrae instead in the middle).  Everything went well, Jeff took me home to lay flat on the couch for the rest of the day, which I did like the model patient I am.  I felt really good the following day and even got myself dressed decently to go pick up a prescription and then go audition new purses:

Doesn't everybody empty out the paper stuffing from store purses and put the contents of their current purse inside to see if it's a good fit?  And then take some pictures so you can go home and ponder the finalists?  Also, ya think I like blue?  I didn't realize how much blue I had going on there, with my dress, phone case, and purse.  

Based on how things went for the last two injections, I knew that I'd feel crummy the second day after the injection and was prepared for a day of nausea and misery.  But it didn't happen, and I thought well hey, maybe my body is becoming accustomed to these steroid injections.

Uh, that would be a no.  Toward the evening I had the steroid flush - my cheeks got really red and I got hot.  My head got hot.  My hair got hot.  Oh yeah, and I was nauseated.  I went to bed with an ice pack on my head and a barf bag at my side, just in case.  The next day shaking was added to the aforementioned side effects.  And depression and despair because I was so freaking tired of feeling crappy.  The flush would happen, I'd run a little fever for an hour or so while my head was hot, and then it would ease up for a bit.  It was a rollercoaster of redness, hot hair, fever, shaking, depression, and despair (which are called 'mood swings' in the list of side effects...no, they are MOOD SWINGS) until Sunday morning.  I might get a few hours' relief and think OK, it's over and then bam, it would happen again.

I can't wait to get another injection in six weeks.  Said with some sarcasm.  OK a lot.  As long as I keep getting better and better I'll put up with the after effects, but I'm not looking forward to them...who would?

Herniated Disc Update #2

It's been a while since my last post about my herniated disc, so I thought I'd update you guys with what's been happening.  When I last left you, I had been given my first epidural steroid injection and was waiting for the steroid to kick in and relieve me of some of the nerve pain.  It never did, which was incredibly disheartening.  So except for the change in pain meds to a Butrans patch that I wore on my arm for a week at a time, nothing was different, including my pain levels.  We went to North Carolina as planned because I was tired of this injury stopping me from doing everything, and while I had some good distraction by being with Sam and my parents, I was hurting really bad and was taking Motrin all the time.

On the drive back, I was at a 9.5 on the pain scale, and feeling despair at ever getting better because the first epidural injection didn't work, the pain meds were barely helping, and I'd read a lot of stories online about other people living like this for years.  YEARS.  In tears (there's been a lot of tears since this happened), I called my pain management doctor's office and asked if I could get some prescription-strength ibuprofen.  Kristen, the PA, called me back said if I was needing to take that much Motrin, we needed to change the pain meds.  Luckily it was only changing the Butrans patch from 5mg to 10mg - nothing new since all of the previous pain meds I'd tried had made me incredibly nauseous, and increasing the dosage on Gabapentin, which is my nerve pain medicine.  Plus she told me to stop taking the Motrin altogether and take Aleve instead - two tablets every twelve hours.  I'm not sure what helped, or maybe it was everything, but I did get some relief and stopped wanting to throw myself out of the moving car.

While I was on the phone with Kristen I told her that I was worried about getting another epidural since the first one didn't work.  She went over my MRI again while talking to me, and said that there was more than one way to do the injection to get the steroid in the right spot, and she'd get with the doctor about me.  She was very reassuring and I had a glimmer of hope after talking with her, like maybe, just maybe, I might stop hurting so bad...most days my pain seesawed between a 7 - 8 on a scale of 10, with jabs of 9+ occasionally.

I still had about two and a half weeks to go until my second injection, so back to the couch for me for most of my day.  I still couldn't sit in a chair for more than a few minutes, if at all - there were many times when I'd sit down for dinner only to immediately stand up and I would have to eat my dinner while standing.  I also couldn't really drive because I couldn't sit upright in a car seat.  Oh and there was that whole brain fog from the pain meds thing, too - I couldn't concentrate enough to read a page from a book, or knit, or watch a movie.  I could make it through a short sitcom sometimes, but that was about it.  So mostly I was doing nothing.

This is a very isolating injury.  I went from going to BCS Fitness three times a week, and running three times a week - always with either a group at my workouts or with Jeff, Diane, and the Renegades - to nothing.  I was hurting too much to go out, and I couldn't drive, so I was home alone, miserable, and alternating between losing hope that I'd ever be without this excruciating pain to being optimistic that maybe my upcoming injection would work.  But mostly I was depressed.  I have gone through a lot of Kleenex since this happened.  Thankfully Diane came over just about every day after work and sat with me for a couple of hours, otherwise the only person I would see was Jeff.  I have a couple friends who check on me via text which is really nice.  But being cut off from about 98% of my social group contributed to my feeling of depression.

I'm not saying all of this to make you guys feel bad for me.  I'm documenting my experience with a herniated disc in case another sufferer comes across my blog; maybe they will feel a kinship with what I'm going through and maybe they won't feel so alone.  And maybe they'll get some hope from my treatment plan.

So.  That was the dark side of having a herniated disc.  I am now standing - no wait...SITTING - on the sunny side.  I had my second steroid epidural 11 days ago as of today and it has helped tremendously.  My team (PA and doctor) were hoping for 60% reduction in pain.  I would say I've gotten more like 80% and I am so relieved!  Not only for the pain mostly being gone, but because my doctor said that the MRI showed a fragment of the herniated disc had broken off and was pressing against the nerve right at L3, and if that injection didn't work, we would need to discuss getting with a neurosurgeon to remove the fragment and part of the disc.

The reason why this injection worked is because my doctor went in lower than the previous time.  This go-round he was right at the bottom of the L3 area, and kind of curved the needle around to right where the disc fragment was.  He touched the nerve a few times while making sure he was getting to the right spot and my leg zinged when that happened.  This took a little longer than the first injection but I didn't care as long as it worked.  And it did!  He does this under a live X-ray so he can see the needle and move it into position, injecting dye to check.  This is a picture of my spine with the needle in place, with the dye:

The injection sweet spot!

And now, I'm paranoid.  So many people have said that their injection only worked for a week, or two, or three, and then the pain came back.  Every time I sit down I wait for the familiar sharp pain to hit.  So far it's been good - none of that pain.  My thigh will still throb at times and my knee hurts, but nothing like before.  The only addition I've had is that when I stand up after I've been sitting, I get pins and needles from my knee down for a few minutes.  This happens every time I sit.  It's annoying but I'm used to it.

When an injection works, the next one will help even more - it's a cumulative effect.  I am scheduled for another injection in early July and am hoping to get one more before September 1, when our year begins again with insurance.  And then I don't think I will need any more injections for a while, which would be fine with me.

I have to be very careful with my spine, even though it never hurt and still doesn't.  But the point of these injections is to get some of the swelling down from the herniated disc to take the pressure off the nerve root.  I'm not to lift anything above my head, or bend forward too much, or lift much of anything at all.  It's hard to remember to be cautious sometimes because it's automatic with me to do normal things like bending down to unload the dishwasher and taking out several heavy Fiestaware plates to put in the cupboard.  So even though I'm feeling better, most of the housework is still on Jeff.

I had my first physical therapy appointment last week and my second one is later on this morning.  I'll write more about that on Wednesday.

So...after two and a half months of pure hell, I finally got some relief from the pain.  I credit having a doctor who is a working anesthesiologist and has the knowledge to do the injection a different way, and for the skill to move that needle around to just the right spot.  This is why I chose him when I was first diagnosed with a herniated disc - I checked out all of the pain management places in town and I liked the idea that he was still working at hospitals, helping patients with different needs, and not just running a pain clinic.

Thanks for sticking with me over the last few months - I am hoping SO MUCH that the second injection is signaling the beginning of the end of this nightmare.  Nerve pain is unbearable and I would not wish it on anyone.  Now, please keep your fingers crossed for me that the injection lasts for the entire six weeks.

Look at me, sitting and blogging like a normal person!