Saturday's Acupuncture Appointment

I had my acupuncture appointment on Saturday. They didn't do the trigger point releases, and I was really disappointed. What they did do was check out my arms, specifically my left one where I'd had the "tennis elbow" surgery, and put needles in there. I don't know if it was anything they did, but the pain in my thoracic region was worse and I had pain running down my arm all weekend.
The pain in the arm went away, and I'm wondering if it was just something that they released that was working itself out or what. I don't have appointments for the next two weeks as the students are graduating, then I go back in early May and I really hope that they bring back the Pain Clinic then or that I have no need for by then!

Snap, Crackle, Pop!

Last Tuesday at the Pain Clinic was interesting. I had a different team of "practitioners" who had needles in some different places than the previous team. I'm not sure which set of needles did it (they had some in my ears, and in my calves, in addition to the ones in my ankles and hands that I get every week), but something unleashed some kind of chi because I wasn't able to sleep very well that night and ever since I've been kind of "energized" to say the least. I'm feeling kinda snappy and getting lots of stuff done, but not sleeping too well. I also had the most pain relief that lasted the longest since I've been getting acupuncture. Go figure.

I'm now noticing that when I move in certain ways that engage the newfound flexibility of my lumbar region, there is a distinct popping, crackling or crunching sensation. I wonder what this is? Is it the actual ProDisc or is it just that the new range of motion I have down there is causing the muscles to crunch around?

I'm kind of liking it, I have to say, the snap, crackle and pop of my newly flexible L5-S1 and my mad flowing chi.

More Prodisc drama

More on the Prodisc lawsuits, and Dr. B is quoted. For some reason, this doesn't bother me; I figure if they've got some financial investment in seeing that a surgery is successful, then the chances are better that it will be. There's probably all kinds of things wrong with thinking like that, but there you have it.

Did you buy the stock?

Synthes keeps going up!

Yo! Buy this stock!

Synthes is doing great, and so am I!

High Heels for the first time!

Went to a wedding this weekend and I wore heels for the first time in at least a year and a half! Here's me in the church bathroom in 'em.

Here's another shot outside the church.

You can't really see it here, but there was an older woman standing by the curb who had a cane. Last year that would have been me. Hell, just over six months ago, that would have been me! Even though I'm paying for it now, I'm so happy to be the one in heels and not the one with the cane.

Here I linked to an article in the times that discussed Medicare’s decision not to cover ADR surgery in patients over 60. As it turns out, this is not good news for ANYONE needing ADR, and possibly even fusion. Here’s why.

During my last check up, Theresa mentioned that the pace of their surgery schedule has really slowed as many/most insurance companies are now not paying for the type of surgery I got, that is, ADR combined with a fusion. They’ve narrowed the range of what is covered by adding the stipulation that there can be no other existing conditions, so if a patient needs ONE disc replaced and that’s it, ok. People like me who needed a fusion and a new disc would be shit out of luck. Thank goodness that I got my surgery when I did, as I can’t even think what the outcome might have been if I’d had to wait for even a few more months.

On top of that, I’ve been reading with interest the health care proposals of the three leading democratic presidential candidates (Clinton, Obama, and Edwards). They all seem to include/favor the formation of some kind of “institute” that would research the most effective treatments for the most common (read:expensive) health care issues.

From the NYTimes:

"Along these lines, the three leading Democratic candidates have quietly come up with nearly identical ideas. Deep inside their health care plans, Mrs. Clinton, Mr. Edwards and Mr. Obama have each called for the creation of a national institute to figure out which kinds of medical care actually work. This institute would sort through the scientific research on, say, spinal fusion and help people understand when it may make sense and when it’s likely to be just another big medical expense that doesn’t solve anything."

As back pain is one of the major health care costs, lumbar fusion and I suppose ADR, though the article didn’t specifically mention it, would be researched for their efficacy. Apparently there are some studies that show that fusion is, in some cases, no more successful in treating back pain than other methods. While this is true, and I'm not advocating that anyone and everyone who requests a spinal fusion should be able to get one, I am afraid that the insurance companies will seize on any study that supports a conclusion that means they don’t have to pay for a procedure. The Times article goes on to state that Medicare and the insurance companies would then use the research to “determine when a procedure or a drug would be covered” (read: they’d use the research to deny coverage).

Of course, this is all just my opinion, and wouldn't it be nice if I were proven wrong, but if there's anything I've learned in the past year or so, it's that insurance companies are pretty predictable when it comes to cutting what they cover and putting more of the insurance premiums we pay into their own pockets.

Medicare Denies ProDisc Coverage

From today's Times: This is not good news.

"How'm I doin'?"

Shame on me for not updating, but I've got a good reason; I've been busy doing other things rather than obsessing about my back!

So I'm seeing a physical therapist for the stabbing, tearing pain in the middle of my upper back. It was most likely brought on by me trying to overdo everything cause I just felt so good and ready to try to stretch and work out like I normally do, well, like I normally did almost a year and a half ago. Swimming, which is supposed to be so good, probably should have been done with a bit more restraint than I went for it, but say la vee.

The PT mostly just massages the region around where the pain originates. It's all 'crunchy' cause there are so many knots in the muscles. This isn't a relaxing massage, either, folks. She puts some real elbow grease into it and I'm usually sore just from the rubbing, but I know it's good sore cause it means that blood and oxygen are getting to the muscles that need it. Then I do some light, very light, exercises for that region, and what do you know? It's getting better. When I go back for my post-op visit in June it will be six months and that's when Theresa says they usually start the PT for the lower back, the area that was actually most affected by the surgery, even though what I'm experiencing with my upper back is a result of my whole skeletal structure being shifted around. This Friday will be five months to the day since the surgery, we'll see how I'm doing then.

I was over my back ...

This looks and feels the same to me as it has for the past couple months now. Still sore, still feels like it's going to pull apart when I stretch (which I found out yesterday I wasn't supposed to be doing. Oops.)

Talked to Theresa yesterday about the weird burning pain in my upper back that gives me the chills and the willies and the persistent nag of the threat of full blown sciatica shooting down my legs. She repeated her mantra that I'm overdoing it and I should listen to my body. How do I start to listen to my body now? Much of my life has been spent ignoring those tiny tweaks and twinges in order to just get through the day. How else could I have spent years fencing, rock climbing, running long distances? I'm not sure what listening to my body even means.

So today at the gym I only did legs, and I haven't been swimming for a week, afraid I'll get the burning pulling pain in the water and necessitate a rescue by the lifeguard. It's that bad, and I sometimes can't feel when it's coming. I Also can't believe I did it to myself trying to stretch. When will I learn that I'm not competing with anyone and it doesn't matter all that much if I exercise six times a week or three? I'm still getting plenty of exercise walking Tony every single day (but in fact the walking is what brings out the sciatica, what to do?). Today at the gym I was feeling good after a half hour on the elliptical cardio machine and full leg weight circuit; I had no twinges in my legs until I started stretching my quads (which I was told I could and should do), at which point I felt that little shock go down my legs. I'm thinking it has something to do with arching my back, which I did slightly while performing the stretch.

It's clear I must cut back my activites, which I already have been forced to. I miss swimming, I miss the smell of the chlorine and the beauty of our pool; I miss gliding through the water, channeling Michael Phelps, rocking from side to side gulping in air.

Just when I thought it was safe to be so over this whole ordeal, it's, if you'll excuse the pun, back.

Abdominal Incision 12 weeks

OK, still not looking too much better, but they say it needs three months to work fully. Wouldn't it look better in three months anyway? It seems that this is similar to Groundhog Day (the day, not the movie), in that if the ground hog sees his shadow it's six more weeks of winter, and if not it will be an early spring. Well, how much earlier can spring come than the second week of March, which is six weeks from Groundhog Day? It's the same thing in my book. Anyway, I digress, but only because I'm just not too excited about the results from the Neosporin Scar Solution so far. I'm hoping that there will be a big improvement all of a sudden in the next few weeks because as you can see in the picture, I bought a two piece bathing suit! It's a TYR fitness suit and it's going to be great for swimming laps. It fits great and I was having a real problem with the one pieces; my torso is longer by at least a quarter to a half an inch, so all the suits that fit my hips were digging into my shoulders because they were too short for me. So I'll be flaunting my scars at the London Terrace pool, I hope no one is squeamish!

Comic relief

At first glance, this xray doesn't look too much different fromt this one, but if you look closely, you can see that the fused area is filling in a bit more with bone.

That's good.

Right after I was shown into an exam room, one of the interns came in to see me. Last visit Dr. B. brought this kid in to see my progress and introduced him, saying that he had "scrubbed in" on my surgery. (Thanks to Grey's Anatomy, I now know what that means.) So this kid (I kid you not, he was like 12 years old) comes in and asks me a bunch of questions about pain, activities, etc. He examined the scars and said they looked "good," whatever that means, and took some notes. I asked him about the slight sciatica feeling pain I was getting when I lean forward sometimes and his answer was basically, don't lean forward like that. *rim shot* Who is this guy, Jackie Vernon?

Dr. Balderston came in a few minutes later and said it looked "absolutely beautiful," and was healing exactly as it should, which of course is great to hear. I joked with him that usually when someone says I look beautiful, they are looking at my face, but I'd take the compliment however it came. He joked back (unusual for him, he's usually all business)that for him, face, back, whatever, it was all the same. It felt so good to joke around with him, after all the seriousness in the past year or so. What a relief! I'm now allowed to start swimming again, and can use any of the elliptical machines in the gym, as well as the stationary bike. This will give some much needed variety to my workouts, and help to redevelop my leg muscles. I still can't believe how much walking still hurts my legs (and feet!).

My next follow up appointment isn't until June (three months from now!) and I joked to Dr. Balderston that if at the three month follow up had the intern coming in first, I wondered who would be coming at the six month visit, the janitor? *rim shot*

But seriously folks, everything is going just like it should, and that's no joke!

Abdominal Incision 10 weeks

On with the Neosporin Scar Solution Challenge ...
It doesn't look too much different from last week's photo, but I didn't really expect results in one week.

I've still got the sciatica-type pain in my left leg and hip, and I'm now thinking that walking Tony, when he's in an excited state and pulling a bit on the leash, isn't the best thing for me. True, he's only 17 pounds, but I just had major surgery 10 weeks ago.

I'm feeling very frustrated right now. I mentioned before that I had stopped going to the gym in favor of walking Tony, but with the weather being absolutely frigid, neither one of us wanted to spend much time outside. Then I started to feel the pain and panicked and started to try to take it easy. But after about a week or so of that, I started to go stir crazy. I need exercise, mentally almost more than physically at this point. Plus with Tony being all in an anxious state about something, I needed to stop and rearrange things.

So I went to the gym today and rode the recumbent bike for twenty-five minutes and then came home. We'll increase the dog-walker's time in the afternoon from a half hour to an hour so Tony gets his exercise too and see how we all do. From just that short session at the gym, I'm already feeling better.

Uptown Girl!

Yesterday I went the farthest yet on my own, up to 96th and CPW to my dentist's office. I took the 10th Avenue bus up there and walked the block and a half from the stop to his office. The uptown bus was definitely a smoother ride than the crosstown double length job, with all its weird rattley segments, so even though I was on the bus for much longer (try 40 minutes!), I was ok. On the way home, I was very close to the C train, so I ventured down the stairs and, surprize! It was ok. I was worried again about bumping and jostling, but it wasn't crowded at all and it was really fun to be on the subway again, without the cane and without Tyler and without worrying.

I'm actually starting to feel not only like a normal human again, but a New Yorker! Yay!

I feel good!

I'm feeling like kicking up my heels!

I'm feeling really good lately. I've still got some really persistent itching in the incision area (I guess I can call it a scar now) and a twinge in my left lower back that feels like the start of sciatica, but isn't (a signal from my body that I'm over doing it a bit).

Spoke to Theresa on Friday about the quasi-sciatica pain and got the go-ahead to start riding the recumbent stationary bike at the gym. The reason that they don't tell everyone to do it is because some people have a lot of pain and discomfort when they sit. This can continue up to 6 months after the surgery. Lucky for me, I managed the bike for 20 minutes no problem. I'm really glad to have something else besides walking to do; it was getting boring, and now that I'm walking Tony more than just for "business," I needed another activity for the gym.

Thursday Tony and I walked up to 44th and 9th back (three miles total) to 24th and 10th. It's not a very picturesque walk, lots of trucks and buses up that way. Going south on 10th Avenue is definitely a better option, except it's really cold ; the wind whips off the Hudson like a mother. Most picturesque would be the walkway in Hudson River Park, but that would be colder still, plus Tony hates rollerbladers and skateboarders (don't we all?). Yesterday we went two miles and today too, a mile in the morning and a mile in the afternoon. Plus, I went over to the gym at 8th Ave. (another mile round trip) and rode the recumbent bike for 20 minutes for an additional three and a half miles. I'm also doing a bit of upper body work, biceps and triceps and shoulders, light weights, lotsa reps.

Both scars are very itchy. I still can't bend properly, so I keep my slippers, sneakers and boots (the only footwear I've been in for a year) on a shelf so I won't have to bend to get them. Also, washing my face at the sink and brushing my teeth are still hard. Well, brushing the teeth isn't so bad, it's the spitting, ever try spitting NOT on yourself without bending at the waist? I could bend at the hips, but I'd have to stand in the tub to reach the sink; I'd look like one of those dipping birds Anyway, we moved a small stool into the bathroom. Did I mention the itching? Otherwise I could positively jump for joy! But don't tell my doctor.

Ain't Technology Grand?

I'm looking good!
Or so Dr. Balderston says. He pulled the remainder of the surgical tape off the abdominal incision and it doesn't look as bad as I thought it would. He says it's still somewhat swollen, and I can attest to the fact that it is still very sore to the touch. Those red marks on the sides are bruises from when the surgical tape was on and I had the distention problem, causing blisters to form under the tape. Ugh.
He was really impressed with my walking regimen, but didn't give me permission to do anything more than that at least until I see him again in another six weeks. I am allowed to begin doing some upper body work, mostly arms and shoulders (no lat pulldowns, chest or pec work for now), with five pound weights (he started at three pounds, but I got him up to five, ha!). I'm also allowed to start moving my body into different positions, like mild twisting, and I'm permitted to lift and carry up to fifteen pounds. But no bending yet.

I asked him about my still throbbing legs, he said it will go away as I become more used to walking upright (ha, soon I'll be using tools just like a human!). Apparently all my feverish stationary bicycle riding and swimming don't use the same muscles as good old-fashioned walking.





As you can see from the xrays, (click on the images to see them larger)he didn't take out the old rods; there was so much bone grown over them that he said it would have been a much more painful recovery for me. What they did do was cut the rods and reposition them so that my shoulders and thoracic region are now above my pelvis, and not pitching forward (compare to this). The first little red arrow in the xray on the right is where they cut the rod, the second points out the L3-4 fusion with small metal cage and screw, the third arrow points to the ProDisc at L5-S1.

Ain't technology grand?

Progress, maybe

Since I'm not allowed to do any exercise other than walk, I've been really trying to make the most of that. I've been going on increasingly longer walks everyday (Tony is upset that I don't take him along!), beginning with just walking around the hallways in my building and now including strolls around my Chelsea neighborhood. These latter outings are usually under the guise of running some errand, like picking up some fruit, dropping books off at the library, or buying a magazine or small treat for myself (croissants from Breadstix Cafe) while I'm out.

Yesterday I walked over the West Side Highway, up to 27th Street (when it started snowing!), back over to 10th Avenue, down to 23rd Street, up to 9th Avenue and then cut through my building for the last block cause I was freezing my ankles off in my capri sweats.

Today, since my long-frozen membership at NYSC has finally been unfrozen (I'd been working out at the London Terrace gym until just before I went into the hospital, it was much, much closer to home), and since I didn't feel like freezing my ankles again, I walked the two long blocks over to NYSC at 8th Ave. Once there, I walked a mile on the treadmill, then walked home with a small bag of fruit. My butt and legs have been sore since Tyler and I walked over to Bed Bath and Beyond on Sunday (four crosstown blocks from our apt., my farthest walk yet!) and took a cab back home (when I realized with a start of horror that I wasn't supposed to be in a car, but by then we were almost home, incident-free, thankfully).

Still, I've kept up with the walking every day this week. The soreness feels good; it's a different kind of achiness, a different kind of pain. This pain is from use, from increasing strength. It feels good. I'll let you know tomorrow if it still feels good, but whether it does or not, I'm still going to walk. Maybe just not as far.

Freedom!

It's 18 days out from surgery now and I don't think this incision looks much different than it did here. It sure does itch and burn and hurt. I've lost the weight I managed to put back on just before the surgery; I guess 8 days of not eating anything but ice chips will do that to you. I don't recommend it as a weight-loss tool. Also, I'm very, very pale. Not sure what's up with that.

Most of the pain I had when I came home (after the whole "natural gas" disaster, which was VERY painful and weird) was in my legs and stomach from the muscles being stretched. Not only was I not used to walking upright, but the ProDisc that went in a L5-S1 made me at least a quarter of an inch taller than I was before I started stooping. Having muscles stretched 24/7 was so much more painful than I would have imagined. Stretching usually feels good. This didn't.

The worst of this pain was centered right around Saturday (the 23rd) and Christmas Eve and Christmas Day, or at least it seemed so because I was no longer on the Demerol. I still have fluctuating pain in my legs and low back and stomach after I've been up and walking for a while, but they say that this will go away eventually. Dr. B. says it is not unusual for patients to have muscle pain from the stretching for months after the surgery. I was in such good shape (the word Dr. B. used to describe it was "remarkable") going in to the surgery (swam a quarter of a mile the day before), I just can't imagine what people go through with this type of surgery that are overweight and out of shape. If you are reading this and considering back surgery, start exercising yesterday!

Anyway, today I walked (gingerly!)from our apartment at 10th Ave to 8th Ave and bought some fruit. I was careful to only buy as much as I could comfortably carry, and that wasn't much; I'm officially not allowed to pick up anything that weighs 10 pounds or more and anything that weighs more than a mug of tea generally causes pain. It was weird being out without the cane, I felt a sense of freedom, but also like there was something missing, like I was exposed and vulnerable to injury. I avoided passersby assiduously, almost to the point of paranoia. Friendly neighborhood dogs are a problem now too, I can't risk getting sideswiped or jumped on by even a small dog, as the sudden jolt could torque the spine, wreaking havoc with all the healing muscles and the fusion. I've decided that the next time I go out on the street, I will take the cane, just because people tend to give you a bit more consideration and a wider berth when you walk with a cane. Even in New York. [That's right, Ben, I'm sacrificing freedom for security. Wanna fight about it?] Still, it was a heady experience, being out and about and upright.

Then I came home and took some Darvocet and went to bed, because this kind of freedom definitely has its price.

Four days till surgery!

Yesterday I had a call from Dr. Balderston. He confirmed what I said here about the logistics of the surgery. Dr. Wernsing will open my abdomen and push my internal organs aside, then Dr. B will begin working on my spine. He said they will start from the bottom, L5-S1, and work up to L3-4, inserting as many as three ProDiscs total (IF he can fit them in). If he can't replace the discs in L4-5 and L3-4 he'll have to do a fusion on those and that will be done through the posterior incision. He also said they will tilt the vertebrae back from this anterior opening so that I can stand up straight again.

He assured me he'll be getting lots of rest this weekend, and that I'll see him just prior to going to sleep so I can do "what I need to do." He explained that some patients want to squeeze his hands to be sure that he doesn't have a tremor (sounds like I'm not the only one watching too much Grey's Anatomy!) I said the sight of him with clean glasses and in scrubs and not a golf shirt was good enough for me.

Surgery Countdown: Seven Days

The surgery is seven days away.

We spent Monday filling out forms, producing insurance (or as I like to call it, “UNsurance”) information and getting stuck with needles.

The lowlight of the day was when I had to see the cardiologist for a routine EKG. This is like a 40 second test. We were in the offices of Drs. Mandal (a father-daughter cardiology team) for 90 minutes, with only one other patient in the whole place. WTF? It was like a Three Stooges movie, with two admins and the doctor and her “Medical Assistant” running around and literally bumping into each other. And can I just add that they had the absolute worst magazine selection ever? There were three copies of the same issue of a golf magazine and some Prevention wannabe. The highlight of this lowlight was when the MA was taking my history and asked if I ever drank. I said yes. She said how much, I said a lot. She said how often, I said a lot. She asked if I went to AA. Well! I don’t, but hello? It’s ANONYMOUS!? Finally we were released so I could go donate my own blood to be used in the surgery.

The blood donation was definitely the highlight of the day. Darlene was the phlebotomist and once we started to joke around a little with her, she really loosened up, though she still wouldn’t let me take my camera out to take a photo of my blood, all neat and warm in its little pouch …

I found out that another surgeon will be making the incision in my stomach and pushing my organs to the side, exposing the spine anteriorly. They referred to this doctor as a “general surgeon.” Yeah, I know, doesn’t sound good does it? Sounds sort of like the interns are in the back flipping a coin to see who cuts my belly open (I’ve GOT to stop watching Grey’s Anatomy). That’s actually not the case, thank goodness, the General Surgeon that will be making that incision is Dr. David Wernsing and he’s been working with Dr. B for years. I’ll meet with him briefly the day before the surgery. Theresa told me that some patients don’t even ask to meet with him, laying eyes on him for the first time just prior to letting him cut them open. Ack!

She also told me that because of the anterior approach to the spine, I won’t be able to have anything by mouth for 3 days. This is what I’m dreading the most. I do like to eat and am worried about what my stomach will feel like. I get all gurgly after not eating for about 6 hours, I can’t picture three days! But I will definitely be on morphine and out of it from the surgery for at least two of those days so I’m hoping it won’t be too bad.

The operation itself lasts about 3 hours. Once Dr. Wernsing opens me up, Dr. B. will go in and insert the ProDisc(s) in L5-S1 and (if he can fit it) L4-5. Then they’ll close that incision, turn me over and cut again (this one Dr. B. can handle as there are no organs in the way to confuse him, ha) and fuse L3-4, then saw through the bone grafts in my thoracic region and take out the metal rods that have been in there for 20 years.

It’ll be at least two to three days till I can get up out of bed on my own, though they will help me to stand up and take a few steps, if I’m able, the day after surgery. I’ll have a catheter and a pee bag so I won’t have to worry about using a bed pan. Yay! Life is good when you have a pee bag.

Oh, and she also told me that since they’ll need access to the incisions on my front and back, wearing my own pajamas is out. Tune in tomorrow for pix of my own chic handmade hospital gowns!