Can You Spare a Dime?

I've taken to sleeping on my spare change. Actually, I think I mentioned here (or maybe on Facebook) that I've been carrying around a quarter and a dime which I use to visualize a healthy back. If you lay them next to each other, it would look like a cross section view of a healthy disc (the quarter) and spinal column (the dime).

I've decided that my back just wasn't getting the message so now I've taken to sleeping on them. Yes, they're there, right under my back pillow.

I'm thinking there may be some interference in the signal due to the back pillow so I'm giving some thought to taping them directly to my back as close to the injured disc as I can estimate.

Don't knock it. I once heard of a lady who taped a silver dollar to her baby son's bellybutton because it was an "outy" and she thought it would pop. I believe this was the same lady who taught me the phrase "sew buttons on your underwear."

Suddenly, a lot things make much more sense, don't they?

Avoid Alcohol

Some of my medications indicate one should Avoid Alcohol. I looked up "avoid" and got this:

–verb (used with object)
1. to keep away from; keep clear of; shun: to avoid a person; to avoid taxes; to avoid danger.
2. to prevent from happening: to avoid falling.
3. Law. to make void or of no effect; invalidate.
4. Obsolete. to empty; eject or expel.

Good thing I looked it up, too, because I was using "avoid" as
-verb
1. don't go out of your way for.
2. not a problem if you weren't planning on operating heavy machinery anyway.
3. besides, wine is it's own food group.

Being the last day of the year, it's good I figured that out. Not that I was planning on going anywhere. Pizza and a movie. (And, maybe a litte wine through a straw.)

Side Effects and Their Side Effects

All these drugs have side effects, right? Such as addiction, although I think it's more polite to say chemical dependence when it's a prescribed drug. There are some side effects which I pledge I will never talk about here. Not ever. (Did I say pledge? Did I say not ever? Hmmm. I've never really thought about moving to DC before....)

Some of these side effects have an upside. Such as, I have been introduced to the nutritional value and tastiness of prunes. And, I no longer notice that the powder never fully dissolves in my juice. And, I'm reminded that MOM doesn't just refer to my mother.

Some of these side effects contribute to my daily pill consumption as I must take more pills to counter the effects of other pills. And, guess what? Some of these side-effect-battling drugs have side effects of their own. Oh, yes.

So it breaks down like this: I was taking one pill a day before October, and one multivitamin. Now, in addition, I take 6 pills for pain, two more to counter their side effects, 12 for inflammation, and six more as an anti-depressant. (What they tell me is the antidepressants are for pain. I think they're really for patient management.)

Yesterday, I felt slightly nauseous. Part of the problem, I think, is we exchanged two yellow ones for the 12 brown ones. Just a bad exchange rate. But to counter this increase in anti-inflammation pills, she doubled the dosage in the anti-depressants so I only have to take half as many. It also means the green ones are now white. Not white like the white ones. Those are tablets. These are capsules. Follow?

Since we'll be going at least another month with the drugs, I recently reviewed all my meds with my doctor. She asked me if we had already tried acetaminophen or ibuprofen as the anti-inflammation ingredient in our little recipe. We had tried the acetaminophen (some time ago) but not the ibuprofen. The brown ones are just Advil (ibuprofen) but it takes four Advil, three times per day to reach the desired dosage, which definitely exceeds label recommendations. (She just told me to ignore those.)

Actually, when this whole thing started, all I was taking was Advil until I started exceeding the limits on the label. That's when I called my doctor. And so here we are, almost right back to where I started. Wouldn't that just be a doozey - if Advil turns out to be the answer? (It was always there right in front of me. There's no place like home, there's no place....)

In fact, I've been telling anyone who would listen since day numero uno that ibuprofen works better for me than acetaminophen. This is just the first time anyone took into account the patient's input.

As it turns out, I do feel a little better today. I don't know if it's the Advil or not but I'm more careful to eat something with my dosings to avoid the nausea. I did have a slight headache today which I didn't even think was possible! (But that could have something to do with my interpretation of Avoid Alcohol.)

X-Rays

The neurosurgery department called today and asked if I wouldn't mind getting a couple more x-rays done before our appointment on Tuesday. Yea, I thought. They've already looked at my file. They have a plan. They called me.

Well, of course, I wouldn't mind. I went straight to the doctor's office. Of course, I was careful not to repeat the Buttons Incident. I wondered, did the Radiology Tech see the Note In My File? Was in part of my Permanent Record? Would I be searched for buttons?

I gave her no buttons to find, and as it turned out, she never asked and I was quite relieved.

The poses she put me in were different from the last time which was good because I couldn't figure out why Neurology wanted new x-rays when x-rays won't show a herniated disk. At least these pictures are of slightly different things which means they have something in mind. I mean, perhaps they were thinking and not just following a standard protocol. (Best Practices, I'm told they're called.)

After that was done, I swung by the pharmacy to pick up a whole bag of drugs. (I'm thinking of purchasing a reusable tote bag. Maybe I can create a bag that doubles as a tote and a pill box with separate chambers or pockets for the various medications and they're varying dosing schedules. (Coming to a pharmacy near you....)

When I got home, I called the Neurology Department and reported the x-ray task was completed. (The whole thing is digital now so they could already see the images on their computer.) I asked, While I'm at it would you like me to get an MRI to have ready for our appointment on Tuesday? I could do it Monday or even later today.

That's when semi-euphoric dreamland became practical, cost containment, reality. No, they told me. They didn't want an MRI until after we met.

Not sure why that makes sense. Seems we would have more to talk about if we had more information. I'll bet you two bits they order an MRI on Tuesday. I'll have to arrange another ride and another appointment to review the MRI we could've reviewed during our initial meeting.

I guess that's just the way these things work.

I'd be interested in comparing the two MRI images. Well, guess that'll be next time. I'll keep you posted.

Got Spoons?*

It's here. My copy of Shades of Grey by Jasper Fforde has arrived. It's a good thing it arrived just before a long weekend because I already have enough Distractions From Work.

This is my first book for 2010 and the last book of 2009 all at the same time. My alpha and omega. If I start writing with a slight English accent, you'll know why.

The protagonist is Red which is cool because that's my favorite color. Oh, the joy! The insanity! The sheer pleasure! It's so awesome.


*You're just going to have to read the book, now, aren't you?

A Word From Our Sponsor

Here's an offer that's so limited, you can't have it.

Getting an x ray. No buttons on my underwear today!

Open Letter to Jasper Fforde

c/o Third Place Books
17171 Bothell Way NE
Lake Forest Park,
WA 98155

Dear Mr. Fforde:

I regret I will be unable to attend your book reading and signing on January 8th. I have been looking forward to your appearance in Seattle ever since I knew that your newest book, Shades of Grey, was due to be released.

The fact is I have a herniated disc that does not allow me to travel well. Or anything else, for that matter. I only have relief by lying down which is precisely what I am doing at this very moment.

I received a copy of your new book as a Christmas present which is due arrive any day. I thought I might mail it to Third Place Books for your signature but I can't even get out of bed to get to the post office. Besides, I thought it might be bad form for me to make a request of Third Place Books if I didn't actually buy the book from them. And then there was the risk the book wouldn't be returned which was a risk I am not prepared to take.

Maybe Third Place Books would be good enough to have you sign a new book and then mail it to me along with an invoice for all costs, including shipping and handling, and the wages paid for the low level employee who had to stand in line as my surrogate. Would you mind asking them for me since you'll be there anyway? Any chance you could include a photo of you with my surrogate? I would be much obliged.

Missing this appearance makes me double my regret at having missed your earlier appearance in the Seattle area on August 1st, 2007, during your promotion of First Among Sequels. It wasn't because I was unaware of your appearance or that I forgot to write it on my calendar. I didn't miss it because of health issues; I was perfectly healthy in 2007. I missed it, if I am to be perfectly candid, because it was sunny that day.

I would be surprised if anyone had shown up unless they were originally from out of town. However, any Seattle-ite that I know was outside enjoying the sunshine. I have no doubt that I was there with you in spirit as I most likely was reading, or had already read, First Among Sequels by that time.

Perhaps that is why you decided to return in January when the likelihood of sunshine here is at its lowest. A very wise decision. You should have a much better turnout than you did in August.

For having missed your Seattle appearances, I would like to help you out with a couple useful tips for visiting here:

There is only one place to get coffee. (What I mean is one chain of stores as you should run into one every few feet.) Plus, you will stand out as a foreign traveler if you don't order properly. I would suggest you order a
. 1/3rd decaf
· Triple shot
· Grande
· Sugar free vanilla
· Sugar free hazelnut
· Soy
· Light whip cream
· Extra hot
· 175 degrees
· White chocolate mocha

Also, there is a very high geek population here which you may have already been exposed to as they are not known to enjoy sunshine and may have been at your August book signing. I imagine your books go over well with the geek population already so I assume you need no further instruction on this matter.

I very much hope you enjoy your visit and the weather is not too dreary while you are here (although I imagine it must be much like Swindon). I'm sorry I didn't get to see you, for a second time. Much success to you on your U.S. tour. I hope to catch you the next time you're here.

Until then (unless I can persuade you to drop by the house on the way to the airport),
Lynn C.

P.S. The Seattle Times recently reported an incidence of time bandits in the area during the Christmas weekend. Please dispatch Thursday Next (and perhaps her father if you can reach him) as soon as possible. We are in need!

Melts In Your Mouth Not In Your Hands

Today's pill count will be 26! Actually 27, if you include the one I was taking before this all started, 28 if you include a multivitamin.

I spoke with my doctor yesterday and we tweaked the drug cocktail. We are in agreement that conservative measures are not working and surgery is the most likely outcome. (I already have an appointment to see someone in the Neurology department on Jan. 5.) In the meantime, we're trying a new combination of pills to see if we can't manage the pain better. The new recipe drops the two yellow ones for 12 (count 'em, 12) brown ones.

So now I take six white ones, two red ones, six green ones, and 12 brown ones. Every day. I wrote it all down someplace so I can keep track of which ones to take when.

I'm thinking it would be easier if I dumped them all into a bowl and just took a handful every couple of hours or so.

Where is Thursday Next When You Need Her?

Seattle's Museum of History and Industry was the victim of time bandits over the Christmas weekend. The good news is the damage can be repaired and Thursday should be here soon.

Heating Oil Angels

Not me. These guys: Heating Oil Angels.

Queries

If all good things must come to an end, do bad things necessarily last forever?

Is it bad when the hair on my legs gets so long I confuse it with my spider veins?

If I point my head towards the television, will you be convinced I'm really watching this game?

What's the difference between football Sunday, football Monday, football Thursday, and football Saturday?

Time!

Today is Day 10 after the epidural and I will have to report that it didn't work. I can move around a little more than I could before, I have been in a car, and can take my meals sitting at the table. So, that's progress.

But I couldn't type my last post sitting down. I tried to do it at my desktop but I had to take breaks to lie down before I could finish. Still, I shaved my legs and cut my toenails (but now I'm paying for it).

Better luck next time, I guess.

Ghosts

I had the most bizarre dream last night. I dreamt that I was visited by three ghosts, one after another. The first ghost was the ghost of Christmas Wild. This ghost led me on a journey that went over a river and through some woods. Upon arriving at our destination, I was presented with a domestic scene, the decibel level of which compared to that of a jackhammer. Everyone was smiling even though the only mode of communication seemed to be wild arm movements as nothing could overcome the din. Even amid all the noise and confusion, I found a peace that each family member possessed knowing they were together with people they love and care about. As this scene faded away, all that was left was paper strewn about everywhere, piles of dishes in the sink, leftover sugar-coated treats - and smiles on everyone's faces.

Before I could say, "Merry Christmas to all...," I was visited by a second ghost. This was the ghost of Christmas Child. This ghost was very short - about 24 inches. To make eye contact, I had to get down on the floor which was a good thing since I'm vertically challenged anyway. This ghost was enchanting - I couldn't take my eyes off him. Nobody could. Before long, everyone was on the floor grinning and cooing. The ghost was well aware that everyone was looking at him and he took full advantage and even posed for photographs (although no signatures). As the night wore on this little ghost got cranky and smelled bad. What was the meaning of this, I wondered. Was this ghost adorable or just manipulative? Cranky or just up past his bedtime? Smelly or just needed to change his pants?

I was still contemplating these mysterious visions when a third ghost appeared. This was the ghost of Christmas Flamingos. Even though the ghost brought food and spirits, this ghost was very scary and stayed a very long time. I was presented with a scene that was slightly out of focus and I could hear people talking but something was wrong with their words. Everything they said became onebigstrungoutslipperyword. I kept wondering, how long will this last? How long must I be tortured by karaoke? Could it be that this is a vision of things to come? Must this continue until morning? Neighbors had lined up on the sidewalk to view the spectacle. They all wore expressions of confusion and had their hands over their ears. Was it cold outside? Was it about to snow? Could they hear no evil?

The ghost would not answer my questions. I was afraid of what the morning would bring. I begged the ghost of Christmas Flamingos as I tugged at her robes. We began to tussle and all of a sudden I found myself in bed wrestling with my bedsheets. I threw off the covers (drank my juice, ate my breakfast bar, swallowed some pain meds, waited for their effect) and ran (okay, limped) to the window.

No, it didn't snow. And no, there were no flamingos.

Relieved that I was alone, I pondered how the chips and dip and all my glassware had appeared on every available surface. It must have been a dream but what was its meaning?

I shook my head. I did't know. But, I was sure as hell that I woud be taking it easy on New Year's Eve!

Recipe For Disaster

Ingredients

1 herniated disk
1 PMS
1 handful Holidays
20+ relatives

Mix carefully as ingredients are volatile.

Am I Really ...

...pa⋅tient?

–adjective
4. bearing provocation, annoyance, misfortune, delay, hardship, pain, etc., with fortitude and calm and without complaint, anger, or the like.


Synonyms:
1. invalid. 4. uncomplaining, long-suffering, forbearing, resigned, passive, calm. 5. quiet, serene, unruffled, unexcited, self-possessed, composed. 6. sedulous, assiduous, untiring.

Antonyms:
4. hostile. 5. impatient, agitated.

Maybe the previous post (appearing next) should have be entitled something else....

Patient Patient

I told myself I wouldn't goof off today - and yet here I am. Maybe I can compromise by not staying long....

I'm getting my house cleaned and I'm telling you it will be worth every single penny. The house looks great. I'm telling you right now that if you need a house cleaner I can recommend this woman very highly. (I wonder if she cooks.....)

Saturday and Sunday were pretty good. (We're talking about me now.) I was able to get up and more around a little and also got to leave the house. However, Monday was pretty much back to my horizontal world. Today, I'm calling my roster of doctors to find out what's next ... when what to my wondering eyes should appear, this which I found on a website, here:

"It can take six to 10 days before you begin to respond to the steroid."

Okay. This could be the best of all possible situations. There is a possibility that this thing can still work. In the meantime, I can milk the cookie fairy for all s/he's worth!

(very quiet sinister laugh so as not to land me on the Naughty List)

Attitude Check

I didn't want to leave anyone with the impression that I'm depressed. I'm really okay; my attitude remains positive. If things don't work out today, they'll work out some other day. I have no doubt about that.

I had a visitor yesterday. We have friends visiting today. My netbook is portable so even though I'm horizontal, I'm not in bed (at the moment). I'm on the floor watching football. (Okay, technically, I'm not really watching. But it's on the TV and I'm feigning interest.)

The only problem I have (okay, I have many problems) is the kink in my right shoulder from typing on my side. (Try it. It's a skill.) Maybe I could prop up my arm with a roll of paper towels or something.

I got a lot of response from Sew Buttons On Your Underwear. Glad you liked it.

So, speaking of getting on with my life, I should probably take a shower and brush my teeth. (I'd floss but I ran out. It's on the list.)

The Jury's Out

...but it doesn't look good for the good guys.

I don't know if this is working. Yesterday was a pretty good day and I was hopeful that the drugs were taking effect. I wore a lumbar decompression belt (a girdle-like contraption) and there was some pain but it subsided after a bit. In fact, I left the house (first time in a while that didn't involve a doctor). I rode in the car which is something I haven't done in months without some level of pain. And, best of all, I was able to eat dinner at the dinner table. (Sadly, I've been taking all my meals either in bed or lying on the floor because I couldn't sit long enough to eat an entire meal.)

I have my quarter and my dime in my pocket and I take them out often and put them where I can see them, one next to the other. I look at them at try to visualize a healthy disc and a healthy spinal cord. I'm thinking about taping them to my back with the idea of transmitting this ideal directly to my spine. (I'll try anything.)

On Friday and Saturday, I didn't notice much of a change. While I waited for something to happen, I vowed I would resume a normal life (as much as possible) no matter how this turned out. I want to visit with friends and go back to work. I will just need to make adjustments. I thought I would miss Christmas but now I'm planning on going to the annual family fete and I don't think anyone will mind if I just claim some carpet and just hang out on the floor. (It's sort of odd, but so is my family.)

I also gave some thought to modifying my work environment. My computer monitors don't need to be changed. I can just change the orientation of the image on the screen. I can build a little platform or rent a gurney to lay on while I work. I can mount the keyboard vertically and I can buy a roller ball mouse that can similarly be mounted.

Alternatively, we might be able to hire some hands. I would be like some evil villain who occupies a host body - me supplying the brain power and the host body doing the physical work. (The difference being, I would be working for good instead of evil. You know, if you can consider tax returns as good.)

Yesterday, I allowed myself to be hopeful. I thought I wouldn't need to do all that. Today, I'm not so sure. (I would cry but the antidepressants won't let me.) I got up this morning with a hopeful attitude but I was in pain before I finished making my coffee. I took some percocet and went back to my horizontal life.

It could still work but I'm not going to hold my breath and I'm going to get on with my life as best I can. Besides, I have some really great angels and sooner or later this will all work out. It just might be later.

Seriously

(This is kind of a long post. Please don't miss the next post, Sew Buttons On Your Underwear.)

Everything went fine. Pretty much. Loose clothing. Check. No buttons on the underwear. Check. Prearranged cot for lying down upon arrival to Anesthesiology. (record player scratching) It seems the message was not conveyed to the appropriate person or persons - something about a new computer system and, you know - these guys just aren't used to checking for Notes in the Notes Field.

Not to worry. I found a half-comfortable bench and made myself half-comfortable. They did have a gurney for me to lie on when I got to the Operating Room.

Did I say Operating Room? Well, turns out that's where we were. I was expecting to be in any typical exam room. After all, I was only getting an injection. But we were in an operating room (my first) and it didn't look nearly as glamorous as it does on TV. It was both awesome (the equipment was pretty cool) and slightly nerve racking.

I was lying down when I met the doctor and we were able to conduct most of the interview that way. This is somewhat problematic and it occurs every time I see any doctor. I'm usually not in pain during this interview - either because I've made myself comfortable by lying on an exam table or because my meds are working. I pass all the tests with flying colors and when he asks, "How's your pain right now?" I have to reply that it's nearly zero but I always add "but it'll be a 10 in ten minutes." I get the feeling that I'm not taken seriously.

Anyway, this doctor, Dr. Needles, he showed me my MRI - which was the first time I had seen it. It was pretty spectacular. Imagine a circle about the size of a silver dollar and next to it, almost touching, is another circle the size of a dime. The silver dollar would be the disk and the dime would be the spinal cord.

Next, imagine there's a circle that encompasses the other two such that this boundary circle comes close to but doesn't touch the other two circles. I don't know what the boundary circle is called but imagine this boundary cannot be penetrated. (Actually, I believe it can be but just work with me here.)

Now, imagine the silver dollar becoming ovoid like an egg with the "pointy" end pointing towards the dime. My pointy silver dollar is crushing my dime! It was quite the visual and in my entirely unprofessional opinion I'm lucky to be walking at all!

With the preliminaries out of the way, including the signed consent stating that I am fully aware* that nearly anything could happen from this point forward, I got on the table and dropped my drawers.

After administering a local anesthetic, the doctor inserted a needle into a sacral foramina (the top one on the right). He would pause for an x-ray photo op, adjust the needle, take another x-ray, and so on, alternating slight movement of the needle with a current x-ray image showing him exactly what was going on.

At some point, while the needle was in me he casually mentions that he might nick a nerve. He asked if I wouldn't mind not jumping off the table if that should happen. (Breathe, breathe.) I could hear my heart monitor and I'm quite sure it was approaching 100. No problem, doc, I'll let you know.

As it turns out, he didn't nick anything so that was good. When everything was in position, he injected a dye. On the x-ray he could see where the dye spread and that told him where the medicine would spread. That done, he injected the medicine. At this point, I started feeling some pain. The dye and the medicine were now filling the remaining space between my ovoid silver dollar and my flattened dime. Space being limited, this caused extra pressure on the dime.

We finished up, I got off the table, and I received my "post-op" care. While I was standing there, the dye and medicine continued to crush my poor little dime. Let me just say here that the pain I was now feeling made the last two and a half months look like sissy stuff. The Do Re Mi scale didn't apply any longer. Before I left the room, I couldn't put any pressure on my right leg at all. I had to request a wheelchair ride out of the hospital. (I didn't get a sticker or a lollipop or nothin'.)

Getting in and out of the car was pretty tricky but by the time we got home, some of that pain wore off so I was able to hobble to my trusted bed under my own power. And now the pain as at the level it was this morning which is 0 when I'm lying down and pain and numbness when I stand up, escalating in intensity over a span of ten minutes to the point I need to lie down again.

It could be a couple days before I know if this worked or not. If not, they can try again from a different approach.


*If you don't count the four percocet I took earlier.

Sew Buttons On Your Underwear

For my appointment today, I was advised to wear loose clothing. And, so I did. But having exposed my derriere as many times as I have in the last few months*, I took careful consideration with my underwear. I knew that my pants would necessarily be lowered so I wanted to be sure the waistband was pretty, that the elastic was not unraveled or stretched out, and - heaven forbid - there were no holes.

I also knew the procedure involved x-ray.

The last time I got an x-ray was October 12 which was the first time I consulted my primary care physician regarding this pain I was having. I went to Radiology where I exchanged my clothes for a gown - cloth, not paper, but ill-fitting all the same. No metal was the rule - no jewelry and, if my bra had metal hooks, no bra. Under my ill-fitting gown, I was only in my drawers. And just so you know, these didn't have holes in them either. They were striped boy-short style from Victoria Secret.

I was posed in various positions - standing up and facing forward, standing sideways, lying down on my back, and lying on my side. Some of these positions were painful to get in and out of. But after some time we got it all done and I was allowed to return to my street clothes. It was then - I remember the exact moment - as I was zipping up my jeans I looked down and realized I had buttons on my underwear!

They're not functional, mind you, nor are they metal. But they were there. I came out of the dressing room, half dressed and with all humility (actually, humiliation was more like it) I had to confess that I had buttons on my underwear.

The technician looked at me with absolute disbelief. She was so incredulous that I had to lift the gown and show her. She quickly checked the images and determined that, for the present purpose, the buttons wouldn't interfere. However, she indicated she would "note the file" so that whoever saw the images wouldn't misinterpret the dark spots on my x-rays.

Needless to say, I made sure I wasn't wearing buttons on my underwear today!

*For purposes of this post, I am omitting exposure due to alcohol.

Angels and Demons

I am a little worried that the responses from the Universe, or what have you, have been coming from demons rather than angels.  Before I saw Dr. Other Guy, I asked the angels for three things:  1) Relief from worry; 2) a solution; 3) make the solution obvious.  It turns out (from reviewing earlier posts) that I also asked for traction to work in six treatments.  It didn't but it's interesting to note that I quit after seven. 

So here I am thinking that all the answers that have been provided have been coming from angels.  But what if they haven't been?  What if the answers haven't been yet revealed?  (That, grasshopper, is always the Question.)

There have been times during my period of bed rest that I had the thought that the next time I leave this house, it will be on a stretcher.  Unfortunately, it has come very close to that.  For today's appointment, Hubby will drive and I will be lying down on the back seat.  I've prearranged for the doctor's office to have something for me to lie on while in the waiting area and during the doctor consult/interview.  Of course, I will be lying down for the procedure but I needed to make arrangements for me to lie down between the car and the actual procedure.

My dark thought has been that the obvious, unambiguous question will come in the form of emergency surgery because something has ruptured or my condition has been deteriorating, unchecked, while I wait for this appointment, or that doctor, or those test results, or whatever.  While the doctors (administrators, insurance company) are doing what they're doing, I'm just lying here getting worse.

But that's not what I believe.  I don't know if this injection will work or not.  But I do believe that everything will work out the way it's supposed to.  (Just as I finished writing that sentence, an angel appeared and he gave me a cookie!  Is that a good sign, or what?)

I think the demons are just in my head.  (But wish me luck anyway!)

Time Keeps on Drippin' Drippin' Drippin'

(Or, Who is Steve Miller and Why is he in the rain?, Alex....)

I am so busy today that I had to interrupt whatever I was doing in order to do this.  I was actually going to name this post Sick Day but time was getting away from me and this is what you get instead:

Sorry, boss. I can't come in to work today, not even via a remote connection from my bed.  I have several very excellent reasons which mostly fall under the category of Avoiding Work.  (Please remember, I have studied under the Great Master of Avoidance so don't even challenge me on this one.)

I am so busy that I will have to prioritize.  Yes, it's come to that.  Maybe even make a list.  It's that serious.

First, my sleeping habits severely limit the time available to be productive.  Twelve hours of sleep, while an excellent source of creativity, is generally not as productive as being awake.

Second, I have several posts that have to be written.  This one, one that will soon follow with the clever title of Angels and Demons, and one that will deal with the issue of Cost Containment in Health Care.  These things don't just happen.  All the stuff you find on the internet has to come from somewhere.

Along those lines, I need to contact my doctor today.  The reasons for that will be covered under the forthcoming Angels and Demons post.  I also need to further my research on the cost containment issue before I publish my thoughtful remarks on the subject.

Third, I have decided that today is the day to get my internet shopping done.  I have my wallet right here beside me, and I know how to use it.

Fourth, ... I'm pretty sure there were several other reasons that I can't bring to mind at the moment. Be assured, however, they were very important and very time consuming. (I probably should have made that list.)

I will make every effort to Avoid as quickly as possible so that I may resume my normal duties. I hope this will not affect my massive Corporate Bonus.

P.S.  This post took several hours in itself and I haven't even adressed the other aforementioned Very Important Avoidances.  While working on this post, I found it absolutely necessary that I change all my formatting settings, check in on Facebook, and take a call from Glenn.  So, as you can see, I might be out all week.  You may feel free to mail my paycheck to my home adress.  Thank you.

Backyard Angels

I've been meaning to mention the angels in my backyard. You see, once upon a time in a land about 2,000-3,000 miles away (depending on where you start), a little girl (that would be me) was allowed to name the family cat. Little Girl must have had strong feelings for the babysitter because she named the cat after her, Mrs. Setzler.

Little Girl's mother was afraid that Mrs. Setzler would be offended if she knew that her name had been given to a cat (or, in fact, she was) so Little Girl agreed to change the name which became Mrs. Setzler-Angel.

Little Girl grew up and moved the aforementioned far, far away, got married to her Prince Charming, moved into a castle and lived happily every after - until, that is, some Evil Wizard cast his wicked spell causing debilitating back pain for Little Girl who was now all grown up.

In search for a cure, Now Grown Little Girl was advised to seek the antidote (I considered using anecdote) from angels. So, she set about looking for angels everywhere she went.

One day, a friendly black and white cat came to visit Now Grown Rapidly Aging Little Girl. NGRALG liked the cat very much so decided to name it Formerly From California Charlie (although she briefly considered Thunder Snow and later shortened the name to Charlie). She later discovered that Charlie was a girl cat, so NGRALG renamed the cat Charlie-Angel and considered the matter settled.

Not so, because several days later Charlie-Angel showed up in the backyard with a friend - another black and white cat. "I must name this new cat," thought Now Grown Rapidly Aging Broken Little Girl. Presuming the new cat to be male, NGRABLG wondered if Charlie-Angel's friend should be called Sylvia. Deciding against it, she named him Mr. Angel. But since all fairytale damsels (or she-cats, as the case may be) need a prince, he was renamed Prince Angel.

And, that's how I came to have two angels in my backyard.

There's no moral to this tale (or tail), except don't step on a crack. What they say is true!

Demotivation

I won the 2010 demotivational calendar from Despair, Inc. at last night's company Christmas party. Oh, yes! I am so uninspired!

I had four percocet before I even left the house and two more just before the party started and I did fine. I know this drug can make people pretty high, but it doesn't seem to have that effect on me. (Of course, anyone who is high probably thinks he isn't!) Anyway, the pain level was very tolerable.

We had a great time. Two women organized it and did a fabulous job. Dinner and presents, games and good cheer. Only Rudolph was missing. (We were told he was down the street at Starbucks getting a latte.)

We had several attendees who were not employees but relatives or friends of employees. One (a Follower's sister) attends every year and even looks forward to the event. Asked what she was doing this weekend, she told people she was going to someone else's company Christmas party. Who does that?

January brings in a new calendar, a new book and a visit from its author (see Motivation, previous post, appearing next), and hopefully a change in this blog's name to Chocolate Chip Mint (see second post, second to last).

Ironically, my resolutions for 2009 were to be cured of back pain (which means I was suffering some form of back pain a year ago, the specifics of which I can't recall except my medical records show that I sought physical therapy in February of 2009), and to read a particular book. I didn't keep the second and I don't have to tell you how I did on the first.

I think I'll just focus on the upcoming week before I worry about the upcoming New Year.

Motivation

Jasper Fforde will be in the Seattle area on January 8th promoting his new book, Shades of Grey. Woo hoo!

Better to Read Anyway

I got two new Netflix movies in the mail yesterday but had to get Hubby to dig through the recycle bin because that's where I put them directly after I got them from the mailbox.

I also had to report one movie never arrived. My Netflix account shows that it was mailed November 24. Now I wonder if that one got recycled too!

Besides making me ditzy (really, I wasn't before), the meds make me sleepy. I've been sleeping until 10. So today, instead of taking my meds at bedtime, I'll try taking them with dinner to see if I can't get up at some more reasonable time.

I'm also going to call a housekeeper. Today.

I just started reading Disquiet, Please! The dust jacket says "If laughter is the best medicine, Disquiet, Please is truly a wonder drug."

I couldn't agree more.

New Low

I'm watching daytime TV. Must. Get. Out. Of. Bed.

Brew

If only the coffee maker were here in the bedroom, right on the night stand. Wouldn't that be perfect? Just within arm's reach....

Dr. Needles

I'm really tired. I'm still in bed with no desire to get out. I'm assuming it's the meds that's making me feel this way.

I dropped out of traction yesterday. Dr. Stretch sent me an e-mail imploring me to come back. He even offered free treatments unless or until it works. He said he would call me as well which hasn't happened yet. While his offer is generous, I don't think I'll change my mind. First of all, I'm committed to getting this shot and the two treatments are incompatible. Secondly, while there's time to get in five more treatments before the epidural, I just can't find the energy to get out of bed.

This second reason is a stupid one for not to seeking treatment. But as I mentioned before, I'm not sure it was working, and I'm not sure it ever will. Dr. Stretch is a firm believer in this treatment and it's hard not to get caught up in his enthusiasm (especially when he's offering free treatments). Plus, he's a really good and caring person. Plus, PLUS, treatment would give me a reason to get out of bed at least every other day!

Getting out of bed is the best reason I can think of for continuing treatment. That's a lousy reason for seeking treatment for a spinal disorder, but might be a good reason for a mental disorder. I might have to think about that one!

In the meantime, as I lie in bed and avoid phone calls from jilted health care providers, I have scheduled my epidural appointment. Actually, I scheduled two with two different doctors. I can only keep one.

There are two different delivery systems for the epidural. The first (which would be this Friday) is delivery via a catheter which is inserted at the affected area. The insertion is based on the MRI and x-ray images, as I understand it. A local anesthetic is administered and the whole procedure is performed by an anesthesiologist.

The second is similar except the insertion of the delivery system (needle?) is guided by x-ray. My understanding is I will be on an x-ray table during the procedure so the doctor will be able to more accurately deliver the medicine. I think I will be opting for this method but it means I will have to wait until December 17. Between now and then, I can take my meds, stay in bed, and even continue traction.

The medicine is mostly an anti-inflammatory which is supposed to reduce the pressure on my spinal cord caused by the herniated disc. I asked Dr. Other Guy about surgery yesterday and he still thinks this may go away on its own. Even if it does not, how I respond to the shot will help him (and eventually a surgeon) understand what surgery is necessary. Dr. Other Guy has not discouraged me from continuing traction. He said it was great for people with disposable incomes and that it probably wasn't hurting me. (But he also said there was nothing proven to reduce the time it takes for this to heal.)

December 17 seems like a long way away.

Meds and Bedrest

The first is a picture of me on bedrest taken by my netbook. I'm actually lying down but the netbook is propped up on its side so the orientation is correct from the camera's point of view - if that makes any sense at all.

The second is is a picture of All My Meds. (Good title for TV drama?) Taken in my kitchen with my phone.

I'm getting way too comfortable in bed.... It's not a bad life - you know, if you don't really need one. Breakfast and coffee in bed. Endless surfing. No chores.

One of my friends brought me a latte and visited with me in bed. (She wasn't in bed with me. Just clarifying....) If I didn't have to think about work or non-virtual relationships, I think I would just stay here.

I wonder if I put myself on bedrest a month ago if this would all be over by now.

Surgery

I've never had any so what do I know. I don't even have the injection scheduled and I'm already thinking about the surgery. The question isn't whether I should have the injection versus traction. I think the question is really traction versus surgery. All the injection does is give me some pain relief while my body tries to heal itself. But everyone seems to say that really all injections are a precursor to surgery. No one gets the injection and then just gets better. Surgery always follows injection.

Again, what do I know? But from where I lay, surgery sounds like relief.

Taking It Easy

I'm blogging from bed. I have my netbook on it's side.... Typing is a little awkward.

I'm starting yet a new drug today. The muscle relaxant doesn't seem to be doing anything for me so now I've been prescribed an antidepressant. Theoretically, I should be pain free, relaxed, and happy!

I've been getting traction three times a week which so far hasn't improved my condition but makes me feel proactive while I'm waiting around for my doctors to figure this out. So in addition to relaxed and happy, I should be a couple inches taller.

I was told during today's traction, I should just go home afterward and lay down. So here I am, in bed with my netbook, listening to Pandora, watching Hulu, and keeping in touch with my faithful readers.

I'm waiting to hear from an anesthesiologist to schedule my epidural. Meanwhile, I have a decision to make: I can't do both the epidural and continue the traction treatments. If I could stay in bed for another four weeks while I continue the traction, I might consider it. But it's expensive, might ultimately not work, and I really need to get back to work.

The epidural option is attractive because it could provide me with some pain relief, is less expensive, will allow me to get back to work, and get off narcotics. It has the potential to give me my life back. Gee, when I put it that way the choice seems clear.

On the other hand, if the epidural doesn't work, the only options left are finding an oral pain regimen that works, starting all over with the traction treatments (they're progressive in nature and I'm almost to the halfway point now), or surgery.

If the doctor is right that this will most likely go away on its own, the traction is irrelevant and the only issue left is pain management. From that point of view, the epidural seems to be the right choice. I'm leaning that way anyway.

Traction (DRX 9000, actually) is promoted as an alternative to surgery. (Turns out there's no literature to support this.) The underlying premise, or one of them anyway, is that surgery is bad and should be avoided at all costs. (Let me remind you, traction is costly.) On the other hand, if the doctor had told me that the MRI indicated surgery was necessary, I would have jumped on the opportunity just for the pain relief.

Oh well. Until I hear from the anesthesiologist, I'll just take it easy.

Prick*

From my doctor:

I had asked someone to phone you about this so here is the text of that. Please let her know that the MRI does demonstrate a disc herniation which I think accounts for her pain it is something that I think will still resolve over time. If she wishes better pain control for now she might consider an epidural steroid injection. If she has questions about this let me know. The epidural steroid injection might help decrease inflammation and swelling and lessen pain while we wait for this to get better.What it means is that the disc has protruded out beyond its normal confines and is more in the middle of the canal but is to the side some and may be coming in contact with the nerve that could cause the buttock pain. Typically this type of pain would go all the way down the leg but right now it doesn't appear to be that way for you. So in general these get better on their own most of the time without surgery. The issue is pain control. There haven't been any therapies proven to shorten the course of time it takes to recover. So the purpose of the epidural steroid injection is to improve pain control until it is clear that this is improving on its own.

*I was referring to the injection, not the doctor, btw.

MRI Results

Don't know what this means yet:

Narrative
[HST]: Buttock pain on the right and right ankle pain
[SAS]: As aboveTechnique: Nonenhanced MRI of the lumbar spine. Comparison: None available.
Correlation: October 15, 2009.
Findings: The lumbar spine shows a smooth lordotic curvature within normal promontory angle. The vertebral bodies are normal in number, shape and interrelationships.There is minimal to mild degenerative T2 signal loss and intervertebral discs with moderate loss of normal disc height at L5/S1. There are mild, multilevel degenerative facet and ligamentum flavum hypertrophic changes.Conus medullaris terminates the level of L1.

Limited, visualized soft tissue structures are grossly unremarkable.

L3/4: No focal disc herniation, central canal or neural foraminal narrowing.
L4/5: No focal disc herniation, central canal or neural foraminal narrowing.
L5/S1: Large, central disc protrusion contributing to moderate to severe central canal and proximal bilateral moderate neural foraminal narrowing, left greater than right.

Impression: Central disc protrusion contributing into central canal and neural foraminal narrowing. L5/S1.

POSITIVE ALERT COMMENT: Radiology significant finding alert system has been activated.

Computer problems so short post today. Had the MRI today and started taking a muscle relaxant. Not sure it's working yet.

Pain Scale Revised

A Follower of this (b)log has suggested the following changes to the Pain Scale:

11 = Homicidal
12 = Suicidal

Dr. Other Guy

Got in to see the doctor today and he ordered an MRI. Didn't get much more than that done. It felt like a waste of time because I could have told him I needed an MRI a month ago. And I could have done that by phone.

He also made some recommendations for additional pain medications which he can't actually prescribe. No, he can only add his notes to the file. I have to talk to my regular doctor for that. So, I called her office and we have an appointment for a telephone consultation tomorrow afternoon. I don't know what combination of drugs he recommended but it'll be some cocktail!

So, no. No answers. He said the symptoms don't really point to any easy diagnosis. Many of the symptoms point to a pinched nerve, however if that's what it really is the symptoms would be more like this. The symptoms could be indicative of a muscle problem, but then the symptoms would look a little more like that.

The MRI isn't a very good diagnostic tool for fishing expeditions. It can be helpful if it clearly points to something or clearly eliminates something else. But two identical MRI's can produce completely different (or no) symptoms in different patients. So any results from the MRI has to be somewhat obvious to be of any use. If not, the next step would be additional testing of some kind.

The MRI is scheduled for Wednesday. At least I didn't have to wait another month for that! They told me on the phone I'll be able to go in feet first so it shouldn't be too bad. They also told me I should wear something comfortable - and nothing with metal - so I'm planning on wearing my pajamas and my slippers that look like little rubber duckies. :-)

Tired

I'm just tired today. Pain level has reached 8.5-9 today. I'm just tired of it hurting. Hopefully, I'll get some answers tomorrow.

I don't think my meds are working.

Bo Derek's a 10?

I am often asked how my pain is on a scale of 1 to 10. If I say "12," it seems I am written off as some sort of crazy person. But this would be the answer I'd give when I tried to explain how painful it is to get out of bed.

It's obvious I'm exaggerating because 10 is supposed to be the worst pain ever on the scale. But who's ever had the worst pain ever? What's mine is not yours. What I'm trying to do, though, is communicate that I'm in pain to someone who I imagine doesn't hear me.

The very worst pain I've ever had is a migraine headache. It only lasts a few short hours compared to the two months I've had my current pain. I've had some very bad headaches in my 46 years but only two where I prayed for Death to take me. Death would have been better than enduring the pain. (I'm not kidding either. No exaggeration here.)

If I had that pain now - for eight weeks - I'd be dead. I would either have committed suicide, gone insane, or possible made it to an Emergency Room where I would be relieved of consciousness by morphine drip.

So, no, my pain level isn't 12. It isn't even 10. That being said, the worst it could be now is 9 which on the Do Re Mi Pain Scale is "I Cry Out In Pain." (I hit 10 twice when I started taking Percocet but I think that was a reaction to the drug, not the pain. I didn't actually pass out; I got down on the floor before I lost consciousness.)

8 or 9 was generally where I started my day. I would take one or two Vicodin and walk around the kitchen - sometimes moaning - until the drugs started taking effect about an hour later.

I just switched to Percocet a week ago and that first pill of the day would make me nearly pass out. So now I don't get out of bed - it's safer that way. I eat a breakfast bar in bed, take my meds in bed, and then wait 30-40 minutes before I even get up. I haven't felt faint since. I actually take two so you would think I'd be pretty high by the time I get out of bed. (My Facebook entries from earlier today seem to support this!) But even after two Percocet my pain level is 6-8 and it stays in that range until I can take two more about five hours later. Then it levels off to 4-6.

I go walking every day and if I do this in the afternoon, my pain drops to maybe 1-3.

About 5pm the pain starts to increase a little. By then my midday drugs start to wear off, I've been on my feet (avoiding sitting), and I'm starting to get tired. I'll make dinner, watch a little TV, and the sitting will agitate me. The pain level gets to about 3-5 by the time I go to bed.

Getting back in bed is not as difficult as it used to be. (It used be almost as difficult to get in as get out.) Within 30-60 minutes the pain level drops to 0-1 where I can sleep.

Whether Bo Derek is a 10 or not is anyone's opinion. I just know I'm not - at least not right now.

Do Re Mi Fa So La Ti Do

I was faxed some forms to fill out in anticipation of my doctor's appointment on Monday and it contained a scale that I am already finding useful. It's a pain scale which allows me to describe my level of pain at any given time. I made a copy for me to carry around in my pocket because I am often asked to describe my pain on a scale of 1 to 10 but my scale is likely different from the person who is asking so this will allow me to be more consistent with my answers.

It will also allow me to keep track of my pain. I've been tracking my drug intake since they were first prescribed on 10/17/09 but not my pain levels. (As of this moment, I've taken 214 pills of one variety or another.) I've only kept sporadic notes about the treatment I've received so far and the activities I've undertaken or avoided.

So today I got a spiral notebook and I'm keeping track of everything. I left some blank pages so I can go back and fill in as much as I can of what's happened since this began, as well as some relevant history. (I've been having acute back issues for almost two years - which, I guess, now qualifies as chronic.)

I suppose my doctors never anticipated I would be having pain this long. I know I didn't. But I think this scale - or something like it - should be "standard" when a patient calls or comes in complaining of pain. It would provide for much clearer communication upon which all health care is based.

Keeping a log should also be standard advice. I'm not just seeing one doctor, I'm seeing several. In a perfect world, my log would be online, secure, and available for viewing by any doctor I see. Even on paper, it gives the patient the ability to monitor progress and setbacks somewhat more objectively and, again, allows for clearer communication between doctor and patient. This seems like a "Do!" concept.

Another item which should be standard for patients complaining of pain, is a list of questions regarding activities that are limited by the patient's pain. This seems obvious to me but I wasn't given such a questionnaire until November 20th (after almost seven weeks of suffering) by a chiropractor from whom I have been seeking treatment.

I have to mention, this chiropractor has given me the most thorough exam to date with regard to testing reflexes and range of motion, as well as this questionnaire regarding activities which may be limited by pain. I am most grateful for his careful attention. He gave me his cell phone number and he called me over the weekend after my first treatment to see how I was doing. I understand that compared to the hospital with which my health insurance is associated he is just a little guy. And my doctor, as part of this huge organization, doesn't have the time to contact her patients for follow up. But I really appreciated his attention.

Anyway, my point with the questionnaire is that such a tool would offer another means of clearer communication between patient and doctor.

It probably would have been a good idea for my doctor to do a more thorough exam, come to think of it. She interviewed me, moved my leg around some, and judged my hip pain to be related to my back, not my hip. (This will be subject of a different entry - the name back(b)log is something of a misnomer as I don't actually have back pain.)

Finally, here's the pain scale:

0 = No pain
1 = Some pain but OK
2 = Mild pain worse
3 = Annoying pain
4 = Distracting pain
5 = Pain can't be ignored for long
6 = Pain can't be ignored at all
7 = It's hard to think and sleep
8 = Pain limits activity; nausea
9 = I cry out in pain
10 = Passed out

I'll write some more later about where I've been hanging out on this scale. I'm just thankful for the day, the ability to get out of bed, and (relatively speaking) my health.

Gratitude

It seems appropriate to mention the practice of "practicing gratitude." It's not something I do on a regular basis. It's like the practice of prayer, I suppose. Also, something I don't do. (Used to. Gave it up. Wasn't struck by lightning. Interestingly, I also reduced expectations, and thus disappointment.)

That being said, I've been practicing gratitude on my last few walks and it feels pretty good. It probably has to do with the endorphins and the fact it hasn't been raining the last couple of days. But it probably has more to do with the fact that I'm higher than a kite when I go out. (Thank you, Percocet.)

I've been talking to angels and I'm pretty sure they've been talking back....

Actually, I have a friend that believes in angels and she said I should talk to them and ask them for what I want. I should be specific. Don't just ask for answers (relating to my pain issues) but ask for a specific answer such as the "traction treatment will work in six sessions and the pain is not related to tumors or cancer," for example.

So I tried it and I can't say that it worked exactly but I am having a really good week, relatively speaking, and it feels good.

I can't say I believe in angels (although when one talks to them, one must be grateful to them when they provide - so thank you if you're out there) but I do believe in feeling good. It sure does feel better than feeling bad. Pity parties are not fun. Besides, no one shows up to them except me so it gets kind of lonely.

I've lost touch with my spiritual side over the last many years. I don't think I'm undergoing some sort of metamorphosis, or rebirth, or anything like that. But it does feel good to think about something (or someone) other than myself.

A lot of people think attitude and spirituality have a lot to do with recovery. They're probably right. I can't do this all by myself. Besides, it's not all about me anyway. That's easy to forget when one is crying because the pain is so bad. Conversely, the concept is easy to remember when one is high.

Well, I'm high right now so I feel good. And for that, and many, many, many other reasons, I feel grateful.

How Quickly Things Change

I spoke to my doctor today and she said the doctor I'm waiting four weeks for is the wrong guy! I really need to be with this Other Guy. So, she sent a referral for the Other Guy and the whole process seemingly started all over again.

Dr. Other Guy's office called and said they could get me in on December 29th - and I'm thinking "Can I get credit for time served? I've already been waiting for a week and a half."

All of a sudden, while we were on the phone, one of Dr. Other Guy's patients cancelled. So I grabbed it and I now have an appointment for Monday - this Monday. As in, six days (not weeks) from now!

So now I'm thinking, my doctors got wind of all this bad publicity and got scared! They knew it could utterly destroy them. Well, finally!

But now, what's to write about? Maybe I have a hangnail or something.....

If this pain thing gets solved, I'm changing the name of this blog to Chocolate Chip Mint.

testing

Not sure what I intend to do here - except avoid work. Actually, that's not hard to do as I am disabled from a pinched nerve in my back. All I can do is stand (literally, as sitting is painful) and wait for the pain meds to kick in and for the doctors to figure something out.

My experience with this pain is by no means extraordinary. I'm sure there are others that are suffering right now from dibilitating pain and who are frustrated by their healthcare. I want a place where I can share my experiences (read, gripe) and hopefully find others who will share with me their experiences.

If pain (specifically back pain) is such a common experience, then why aren't there as many pain clinics as Starbucks outlets? When I call my doctor to complain of EXTREME pain, why did they say "How's next Wednesday?" After seven weeks of suffering, why must I wait ANOTHER four weeks to see a specialist?

I'm mad. Really mad about this. And yet, I consider myself one of the lucky ones: I probably won't loose my job, I can afford the medical costs, I have a loving husband and supportive friends who can help me through this. But, still, it's not right. The system is not right. Other people are loosing their jobs, are alone, and can't afford the care - even shitty care.

This trip has been long, painful, frustrating, depressing. (Thank you for all the shoulders I've cried on. You know who you are.) And, as of yet, there's no end in sight. No answers. I just want to tell my story and hear yours. I would like to think we could figure out something out together, but more likely we can just support each other. That, in itself, would be of great comfort.