Six Month Update--Back to Basics

moreicinc in moreSix months ago today I had my back operation (a microdiscectomy and laminectomy of L5, if you don't remember). While the initial recovery had its ups and downs, overall I am reasonably pleased with my progress.  I saw my surgeon a few weeks ago and he told me that I should feel free to resume all of my normal activities, so that is in itself a pretty good sign. If I had to rate my satisfaction with the process of getting the surgery, I would say that I was 90% satisfied.

In the main, I am feeling a lot better.  I had been dealing with a herniated disc and related nerve pain for six years.  The pain would flare up and give me a really bad 3-4 months and then it would go away.  During these six years I have made lots of changes in my life, from sitting on a balance ball as much as possible (both at home watching TV and and my desk at work), to walking much more (3-4 miles per day 4-5 days per week).  I also spend a considerable amount of time off the ball doing "core" strengthening exercises.

In late October of 2011 I hurt my back again, and the pain was so bad, and required so much medication to get through my day, that I opted for the surgery.  I was also totally numb from hip to toe on my right leg.  Well, since the operation, the pain is almost totally gone, and the numbness has improved a lot.  For reasons unknown to me I had a terrible episode from mid-August to mid-September, where the nerve pain returned and combined with terrible spasming of my piriformis muscle.  I had to resume the full complement of medication just to get through the day (which was depressing) but thanks to exercising and patience it went away eventually.

At this point, though, I am doing fine.  Some days the numbness returns to pre-operative levels, but it is getting better all the time (though the doctor told me that it could take another year until my nerves are fully regenerated).  One thing I have noticed is that most days I have an incredible amount of stiffness and pain in bed and upon waking.  Stretching helps, but most days I take two Naproxen in the morning and two Tylenol later in the day to get relief, and some days I still need to take a Percocet (though this is increasingly rare, thank God).Fortunately the stiffness usually disappears within an hour or two of getting up, but I am thinking of visiting my chiropractor again to see if he has some suggested stretches to help with this issue.

So right now, the challenge is to decide just how far I want to take my doctor's permission to "resume normal activities".  For instance, I went to see a movie a couple of weeks ago (Lincoln--I highly recommend it) and after two and half hours in a reclining movie theatre seat I had two days of really bad back spasms.  So the next time I went to a movie I stood--no pain, but not a recipe for date night with the wife!  I have avoided lengthy car rides, though I've begun increasing my time on the road.  I am somewhat dreading the first heavy snowfall of the winter, and am more than a bit nervous about how I will do swinging a bat during the upcoming softball season (I coach a high school team).  When I mentioned my concerns about swinging a bat to the doctor, he said that he would never recommend that activity, but I should try it, and if I get hurt again he'd be happy to operate again.  I guess that passes for humor in the medical profession...

Well, unless something unexpectedly bad happens this will probably be the last post in this series.  I hope that other sciatic pain sufferers have had the chance to read these jottings, and that they have been helpful.  Feel free to leave comments if you wish, and good luck!

Back in the High Life Again

48 hours after the surgery was completed I am still feeling pretty good!  The midpoint of my back feels very bruised, though  nothing is evident on the skin.  And I have absolutely no nerve pain.  My throat is still sore from intubation, but the more water I drink the better it gets.  I am incredibly optimistic, but I am also quite aware that this could be the result of the medications I have been given.

I was given pretty healthy amounts of some powerful drugs.  To control muscle spasms I was prescribed cyclobenzaprine, and to control pain, Percocet.  They have been doing a good job, but I am more than a little woozy on the medicines.  I find myself sleeping a lot, which is probably a good thing.  "Tired Nature's sweet restorer" is what Shakespeare called it, and I could use some restoration.  But it makes me feel like one of the cats--I am up for a few hours, sleep some, wake up for a few hours, sleep some more, etc.  When I woke up this morning at 10:00 I had no idea what day it was.

The medicine is definitely helping, and I am trying to get active, but I am not rushing anything.  Besides walking around the house a bit, Courtney and I took a stroll around the yard this morning.  It was only about  a tenth of a mile all told, but I was pretty shaky at the end of it.  I will try the walk a couple of more times today, and keep it going in the coming days.  I would like to be up to a mile by the 10 day marker, but if I can't make it that far I won't be too upset.

Anyway, the main takeaway here is that the surgery seems to have been very successful.  So long as I can dot the i's and cross the t's during the recovery, I should come out of this in great shape.  Thanks for reading!

Get Back

Jojo was a man who thought he was a loner, but fortunately, I am surrounded by people who care for me.  I have previously written about my back condition and about my worries about the surgery I had yesterday.  As the time for the operation approached, I was getting more and more nervous.  But some friends invited the Sassy Librarian and me to dinner the night before, which helped take my mind off things.  And the Sassy one did her best to keep me calm. I also had phone calls and messages from friends and family expressing their support, and willingness to help out.  What a wonderful feeling, to know that people care!

I had my operation at Geisinger Wilkes-Barre, which is a very nice hospital. Having many family members who have had serious health problems, I have spent a good bit of time in doctor's offices and hospitals, and this place is one of the nicest I've seen.  And every single person, from the check-in attendants, to the nurses and doctors to the food service staff is cheerful, friendly and eager to help.  I am so glad that such a good hospital is so nearby.  I have heard of people making the 2.5 hour drive to NYC or Philadelphia for operations like this, but I don't think that is necessary at all.

What follows is a detailed recounting of my experiences yesterday.  They may not be applicable to everyone, but I hope that maybe someone else out there in the Internets might have their own worries calmed down by hearing about my operation.  Well, here goes!

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Due to discomfort and nerves I only slept for about 2 hours the night before the surgery, so I was in that "tired but wired" state when we got to the hospital at 6am.  At around 6:15am we were taken to the pre-surgery area.  Fortunately, Courtney was able to come back with me, which was a great help.  While I was there I changed into this really cool hi-tech surgical gown, which was designed to keep patients warm; it had pockets for warming pads to be inserted, and a hose plugged into the gown to blow warm air inside.  They also put surgical stockings on my legs to control swelling.  This sounds like a lot of extra precautions for a 20 minute operation, but it was as good idea, as things turned out, because my operation took an hour (as I will explain later).  Then they set me up with an IV in my right hand and I met the anesthesiologist and the nurse anesthetist.  Both were very friendly and helpful and made me feel more assured.  Or at least, that is what I thought.  Courtney was watching the pulse rate machine, which showed my heart rate jump from usual resting 60 BPM to 90 whenever one of the medicos came into talk to me!  But I've always had "white coat syndrome" so this shouldn't be a surprise. Shortly after my surgeon came by to go over last minute details (such as circling the proper location for the incision on my back with his pen) the nurse anesthetist came by to put some Versed in my IV so I could start to relax before the wheeled me back to begin.  I had never had this medicine (which among other things makes you sedated and takes away your memory of what happens next), but Courtney had been given it in the past, and couldn't stop talking about how helpful it was. Well, I remember saying something like "I don't think this stuff is all that great", and then next thing I know it was 4 hours later!

As I mentioned above, the operation took about three times as long as was expected.  When the surgeon drilled into the vertebra to get room to work, he found that things were highly calcified (indicating that I had been injured at least 5 years ago, which fits with my previous experience).  So he had to use miniature hammers, chisels and drills to remove the calcified area.  Once that was done, he carefully lifted the nerve away to remove the herniated disc material. Then he closed me up.  I have no stitches or staples and the incision area is still no more than 2 inches long.  

I woke up in the recovery room at around 11:30 and nurses and the surgeon all came by to update me and check on me. I was still loopy from the drugs but I was awake and not paralyzed, so I felt that things had gone very well.  I had a very sore throat because I had been intubated during the operation, but they gave me some water and ice chips which helped (plus I hadn't drank anything for over 12 hours by then).  There was one issue, however, that was not ideal...

During the operation they had to insert a Foley catheter to collect urine. This had been the ultimate fear in my life and the thing I was most nervous about leading up to the operation.  It was inserted and removed while I was sedated, but there was a terrible burning pain in my private part. Before I was taken to my room, the surgeon told me that I could avoid an overnight stay if before 4pm I could meet the following four goals:

1. the pain was under control
2. I could walk
3. I could eat
4. I could urinate

Over the next few hours I rested in a very pleasant hospital room with Courtney and her mother.  I drank about five big cups of water and noshed on a soft pretzel.  Swallowing was still hard, but the water helped.  The pain was greatly diminished--before the operation it was around a 4 on a scale of 10.  By 3pm it was a 1 (and that was coming from my front, not my back, if you catch my drift). Finally, at 3:15 I decided to try to urinate.  I stood up with the assistance of one of the nurses and went to the bathroom.  When I tried to "let it rip" I was greeted with the worst pain I have ever felt.  It was easily a 15 on a scale of 10!  But I was successful.  Since then it has gotten better each time, but let's just say that, unlike my phobia of deserts, this was a highly rational fear.

Anyway, the surgeon came by to check on me at 4:15 and cleared me to go home. It still took a couple of hours after that to get the IV out and go over the discharge paperwork, but we left the hospital at 7:10, and I walked out--no wheelchair necessary!  We drove to the local pharmacy to pick up the Percoset and muscle-relaxer prescriptions, and I hobbled around the store for 15 minutes, getting more steady every minute (though I felt totally exhausted).  It was great to get home at 8:00, whereupon I called my mother to give her an update, got ready for bed, and went to sleep.

As I write this it is about 24 hours after I woke up in the recovery room, and the pain is pretty much non-existent.  I am trying to be very deliberate in my movements, and I am super optimistic that this will do the trick!