Herniated Disc Update #9 - One Year Later

It's been just over a year since my L3-L4 disc decided to blow up so it's time for a final update on my saga. 

After trying pain management with medication and epidural steroid injections as well as physical therapy for over five months, nothing improved enough to make it through the day without extreme pain.  I was finally ready to consult with a neurosurgeon about this.  My neurosurgeon came highly recommended by a number of people I trusted, so when he said he could fix this and make me feel better, I decided to try a surgical intervention.

Seven months ago I had a laminectomy and discectomy to relieve pressure on my nerve.  While the surgery went well, it took much longer than my neurosurgeon predicted for me to feel 100% again, which made me question my decision to have surgery in the first place.  You hear so many tales of back surgery gone wrong, and the longer it took for me to feel better, the more nervous I became.  Had my surgeon said something along the lines of "your nerve has been compressed for so long that it will take quite a while for it to settle down" I would have accepted the continued leg pain as part of the recovery instead of worrying that the surgery didn't solve anything.

That said, surgery was the key to healing my herniated disc.  I can say that now.  I can't even remember when my leg pain finally went away thanks to my other medical event, which was a grand mal seizure two months after surgery.  As I was dealing with a new set of issues, the leg pain went on the back burner.  I suspect it was somewhere around January that it finally resolved.

As for my back, my physical therapist told me that after having surgery - any surgery on any part of the body - it's changed forever.  So I need to be aware of that and not do anything that might bring on another disc problem.  I will not do any kind of jumping/high impact exercise ever again.  And that's OK - better to lose the jump rope than to go through that painful hell. 

I've been gently easing back into exercise.  I walked for about four weeks before adding in a little bit of running.  I like running and want to do it.  My hopes are to build up to running three miles.  However, if I start to have pain, I will stop.  It's not worth getting hurt again.  I don't see myself ever running long distances - I think my days of doing a half marathon, or probably even a 10K are done.  But if I can run a few miles and feel good, I'll be content with that.

There is a happy ending to my herniated disc.  It took a lot of trying different things to get to this point.  It was the most painful thing I've ever gone through; pain that was 24/7, pain that hurt so badly that I was ready to hurl myself out of the car at one point.  It's not something I would wish on anyone.  But if you've discovered my blog while searching for someone who has gone through this and come out OK on the other side, I want to give you some hope that it can get better.  Hang in there.

Herniated Disc Update #8 PLUS Seizure Update

Herniated disc update:  It's been 3.5 months since I had surgery - a laminectomy and discectomy of the L3 - for my herniated disc.  I had a third follow up appointment with my neurosurgeon last week; we discussed getting another MRI to check things out since my leg is still not 100% better - it's hugely improved, but I still have incidents where if I move wrong or get in the car awkwardly, I'll get that old familiar shooting leg pain.  But, since the recommended course of action would be to continue to wait for more healing to happen, we decided to hold off on the MRI.  I'll hold off until August, if need be - our insurance runs on a fiscal year so I've hit my deductible already and any big tests won't cost me much at this point; why not get one if there's any doubt?

With all of the craziness of the seizure and then traveling, I have completely gotten off of my physical therapy routine, which is too bad because I can tell that I'm not as flexible as I was; in fact, every time I get up from sitting, I have to steady myself and I walk stiffly for a minute or so until things get moving again.  My doctor is very pro physical therapy so I'll begin another round with Amanda this week and hopefully with that plus more time to heal, I can put this herniated disc saga behind me soon.  I'm ready to be done with it, believe me.

Seizure update:  A lot has been happening with this while nothing much has changed.  Right before Christmas I had a second opinion via telephone from a seizure disorder neurologist located in New Haven, Connecticut.  This was via 2nd.MD, which is a service provided as part of our health insurance, and while I went into it thinking it could be a whole lot of nothing, it ended up being incredibly helpful.  Prior to the telephone call I'd given permission for my ER records, with the CT scan, MRI, EEG, etc, to be sent to the specialist, so when we spoke she'd gone over everything and gave me her take on what might be going on, along with what she recommended. 

She agreed with my original neurologist that with the EEG showing abnormal activity, I do need to be on anti-seizure medicine, although she recommended switching to one that should be easier on me than the Keppra has been, side effect-wise.  She also recommended getting another EEG, even while taking the medicine; she said that if it came back showing less abnormal activity, that would be an indicator that the medicine is working, which would give me some peace of mind (more on that in a bit).  Another thing she recommended was that I see an epileptologist in Houston for a workup, which I'm on board with doing.

While this neurologist does think I have some sort of seizure disorder, she was encouraging in getting me back to living a normal life.  Because I had no indication that a seizure was imminent, and because I had been dealing with a little stomach bug/not feeling great the weekend that it happened, she recommended that I pay attention to times when I am not feeling great, and during those times to not drive or swim or do anything that might result in getting seriously injured if I were to have another seizure.  Also I'm supposed to be sure and get plenty of good sleep, which hasn't been happening for me for years now so I'm not sure how I'm supposed to accomplish that, but I have been trying to go to bed earlier.  I still wake up in the middle of the night but I'm more rested when that happens, LOL. 

Last week I not only had an appointment with my neurosurgeon, but also with my neurologist - it was Neurology Week, woohoo!  I told my neurologist about the second opinion I'd gotten and she agreed to switch my anti-seizure medication to Lamictal; it's a very slow titration, 25 mg/week for two weeks before increasing another 25 mg, and we're heading to somewhere around 150 mg, so I'll be continuing to take the Keppra while this is happening.  I'm glad she was agreeable to the change.  She is putting in a referral for me for an epileptologist in Houston while my neurosurgeon is looking for one to refer me to as well - I am hopeful that between the two of them I'll end up with someone who can help me navigate through all of this and figure out what I really am dealing with.

What I want to end up with all of this is some peace of mind.  I'm having a hard time reconciling what happened.  One minute I was standing in my kitchen and then next thing I knew, I was on the ground, not knowing how I got there.  To go down like that with no warning, and to not be aware or have any memory of what was happening during the seizure has been really unsettling to me.  It doesn't make a lot of sense as to why it bothers me as much as it does, but when we were at a family gathering recently I happened to overhear someone say that he'd had a seizure, and when I asked him what had happened, he had a very similar story regarding how mysterious the entire event felt to him.  While I was sorry that he'd had a seizure, I was really glad that I got to compare and share our experiences.

I try not to worry, at least consciously, that this could happen again.  After all, I'm on anti-seizure medication, so that should be taking care of things, right?  But I will admit that the fear of another seizure is still deep inside of me because I'll notice that if I'm not feeling great I'll suddenly become irritable, and I think that's the worry - warranted or not - coming out.  I am still on my state-mandated three months of no driving which is fine with me.  It's annoying and inconvenient to not just hop in the car and go somewhere whenever I want to, but it's one less thing to worry about.

As for now, I'm doing what I'm supposed to be doing - taking my meds, resting my still-concussed brain, and trying to get back to my regularly-scheduled life, whatever that is at this point.

Herniated Disc Update #6, Surgery Edition

First things first:  I am allowed 20 minutes to sit.  Then I have to get up and "do activity" but really, I am discouraged from sitting very much at all.  Sitting is the scourge of back surgery.  So I've set a timer and I swear, I hear the theme from Mission Impossible - no, not the movies but the OGTVMI* - in my head every time I sit down.

Last Monday I had a laminectomy and discectomy for a herniated disc at L3-L4.  My MRI showed a disc fragment pressing on the nerve at L3, so the goal of the surgery was to remove that disc.  After six months of extreme pain, epidural steroid injections, opioid pain relievers, and physical therapy, I'd done all that I could to fix this; it was time for surgery.

My surgery experience went well.  I checked in and the clerk had an estimate of what our portion of the cost would be - she handed me the paperwork and both Jeff and I were kind of oh well, this is what it takes to get me better.  Then she asked me how much of that amount I would like to pay at the moment, which was great - I thought they would want payment in full.  I felt like I was on The Price is Right, naming a dollar amount and hoping it was correct, but she accepted so I guess I made it to the showcase showdown, or surgery showdown, in my case.

Pretty quickly after I checked in, they called me back to the pre op area.  My nurse was so nice; we discussed video games and the Nintendo Switch, which both his 8 year old son and I own, haha.  The best part was when he prepared to put in the IV port - he asked if I wanted lidocaine beforehand; Jeff and I looked at each other and said YES at the same time.  After the little sting of the lidocaine injection, I didn't feel a thing when he put in the IV catheter, so I highly recommend that option if you are ever offered it.

Taking selfies while waiting for surgery is so 21st century, no?

I was the third surgery scheduled for that morning and ended up going in later than expected because the second surgery ran long.  It was fine; we were watching HGTV and making sure to text people so they didn't worry that they weren't getting the "all is finished" text when it was expected.  One side note:  Jeff hasn't been with me for my previous surgeries, thanks to his old job, so the waiting surprised him.  Right before I was finally wheeled out to the OR, he commented that he thought we'd be done and home by now.  Hahahahahahaha.  He had no idea what was coming.

Bored.

I remember going into the operating room and speaking with the anesthesiologist for a minute before he put an oxygen mask over my mouth and nose and told me to take some deep breaths.  I did, and detected something other than oxygen in the mix, so I figured that would knock me out.  He kept telling me to take deep breaths because apparently I was harder to anesthetize than others, but finally, with an injection into my IV, I went off to dreamland.

After the surgery was complete, my doctor went out and spoke with Jeff, telling him it went great and he got everything out that was causing trouble.  I always think it's odd after day surgery that the patient rarely gets to speak with the surgeon but I guess they are already back in the OR with another patient by the time you wake up.  I have a follow up appointment next Tuesday so I hope to hear more details.

I woke up in Recovery 1, with just the nurse in the room.  It was so hard to keep my eyes open!  Eventually I was mostly awake and aware the my mouth was super dry, so she brought me a cup of ice water.  During this time the blood pressure machine kept starting;  apparently my BP was pretty high and my nurse needed to get it down before I could move on.  Now, I do have high blood pressure but it's managed well with medication - which I wasn't allowed to take before the surgery.  So I wasn't worried about that.  Honestly, I felt fine except for my dry mouth.

My lips were so dry, too - the nurse brought me some hospital lip balm but I was very happy to retrieve my ChapStick from Jeff when he finally came in.

I was drinking more water when the nurse, who I'd been chatting with, asked me if I drank coffee.  OK, subject change.  I said yes, and she offered to bring me a cup.  Coffee in the recovery room?  When did that become a thing?  Any case, I was very happy to accept it. 

She also brought me some saltines and graham crackers because she needed to give me medication that required some food in the stomach.  You guys.  I opened the saltines and took a small bite - less than a quarter of the cracker.  I started chewing and I swear to god, all of the pieces glued themselves inside my mouth - cheeks, teeth, tongue - I mean, I knew my mouth was dry but this was crazy.  The warm coffee helped with washing the cracker down, but from then on I could only take the most minuscule bite so I could swallow it.  It took at least 30 minutes to eat one saltine because my mouth stayed dry as the Sahara desert.  Finally I began dunking pieces of graham crackers in the coffee to soften them up and I got enough down to take the medicine.

Coffee, apple juice, ice water - service was pretty good at this restaurant.

Jeff was brought in at some point during this dry mouth/blood pressure time, and we waited for my blood pressure to drop.  I tried everything I could think of:  closing my eyes, taking slow calming breaths, not talking...nothing was working.  The nurse finally got permission to give me my normal blood pressure medicine, but it still didn't change.  My back also started hurting so she gave me some pain meds as well.  I couldn't tell if anything had changed with the pain in my leg - really, I couldn't feel my leg all that much.

Another room, more boredom.

Oh - during this time, the nurse said I looked familiar, and I told her I used to work in the gift shop and yep, that's where she knew me...and I haven't worked there in over a year!  Still, it was fun to talk about the purses and jewelry.  My blood pressure didn't drop any more, but I was alert enough to be moved to Recovery 2.  I was in Recovery 1 for longer than usual, which is normally about an hour and a half, and then you stay at least another hour and a half in Recovery 2...at this point Jeff started asking me what I wanted for dinner because that's when we'd be getting home.

The nurse in Recovery 2 said the same thing as the first nurse - I looked familiar.  Once again, I mentioned the gift shop and yep, that was it.  I actually remembered her so we talked about the goodies that she'd purchased.  After nearly an hour and a half my blood pressure finally dropped about 30 points, which was still in the high range, but my doctor said I could be released. 

I was ready to go but not so fast - first I had to take a walk with the nurse.  Have you ever seen people in physical therapy or at a hospital walking with a wide belt around their waist, with the nurse holding the back?  I have, and I always wondered how in the world that helped because it seemed like a pretty small system to hold a person upright.  Well, I am here to tell you that the belt/nurse combo works.  I was holding onto the railing in the hallway as I was wobbly walking, sure, but I stayed upright.

Up and ready to walk...but first let me get my hair out of my face.

I hesitated putting this picture in because it's just about the worst one ever - let's put a belt on and tighten it around your waist and then take a picture from behind...oh absolutely, that's definitely going to look lovely.  Also, not sure if I've mentioned this, but my secondary medication/coping mechanism for pain has been candy.  Lots of candy.  And no exercise.  I'd say I'm embarrassed about that, or mad at myself for having so much unhealthy food, but I'm not.  Enduring nerve pain for over six months took everything I had, and that included candy as well as pain meds.

I made it through my wobbly walk around the block - er, whatever it is inside a hospital.  Jeff filmed me from behind and when I saw it later, I looked like a drunk person trying to walk the line for a police officer.  Had that been the case, I would have been taken to jail, but it was good enough to be released from the hospital.  I was brought out in a wheelchair while Jeff brought the car to the hospital entrance, then gingerly got in the car, and went home to recover.  And as I mentioned above, Jeff had no idea how long this could take - my report time at the hospital was 8:30 am, and we left around 5:15 pm.  I think he's still a little surprised at how day surgery works, haha.

*OG TV Mission Impossible.  I just realize this didn't help as much as I thought it would, haha.