So I am sitting in the glider with an ice pack a heating pad and a hurting back. My son spilled some water in the kitchen which has a linoleum floor. I guess I missed some of it when I cleaned it up because as I stood up my heel went sliding through it and I was right down on the floor again. Nothing major like hitting hard on my ass but more or less one of those falls where you catch yourself on the way down. I put my arm out nd grabbed the counter and as I continued down that stretched my bck for me. Probably a little more then it could handle.
The pain was not bad at first but after a few minutes it started to burn and then I could feel the spot in my middle back where the muscle was tight. Grabbed to felexeril and headed upstairs to relax for a bit. Damn, I never even got to finish my bagel.
10/04/2004
Had a decent day. The back is rather sore and I have a new sensation on the bottom of my left foot. I have never had that burn like this before. It is not painful but not as bad as if say your foot "feel asleep" either. I noticed it while I was walking around Best Buy, where I grabbed "Boondock Saints" on DVD finally.
My wife has been bugging me to call the insurance company and have them send me back to the neurosurgeon but I am not sure what he will be able to do that my physician has not already done. There is no surgery for this and I am already on meds and PT. I also do not need a second opinion as I did that already.
I guess I will see how the next few weeks go with the weather changing. I know last winter was not that bad but this one is shaping up to be a very cold one based on current forecasts. Hopefully it is not to hard on me as I love the cold and look forward to snow every year.
My wife has been bugging me to call the insurance company and have them send me back to the neurosurgeon but I am not sure what he will be able to do that my physician has not already done. There is no surgery for this and I am already on meds and PT. I also do not need a second opinion as I did that already.
I guess I will see how the next few weeks go with the weather changing. I know last winter was not that bad but this one is shaping up to be a very cold one based on current forecasts. Hopefully it is not to hard on me as I love the cold and look forward to snow every year.
10/03/2004
To my fallen brothers
While the current war has mny peoples attention 11 years ago we had troops fighting in another battle. While the operation was called Gothic Serpent the battle that took place on Oct 3-4 is known as The battle of the Black Sea.
Of course I am talking about the US operation of Task Force Ranger and the brave men involved in the mission.
Sadly the fight they found themselves in was very heated and in the end resulted in the deaths of 19 brave men. They were there fighting for those who could not do it for themselves. They were there because they understood that sometimes you have to stand up for the little guy and sometimes die for them. Some of the men that were there that day are friends of mine but they all are my brothers in arms.
To those who served I say thank you and to those who did not make it home we will never forget you.
Rest In Peace brothers.
Task Force Ranger Memorial
Of course I am talking about the US operation of Task Force Ranger and the brave men involved in the mission.
Sadly the fight they found themselves in was very heated and in the end resulted in the deaths of 19 brave men. They were there fighting for those who could not do it for themselves. They were there because they understood that sometimes you have to stand up for the little guy and sometimes die for them. Some of the men that were there that day are friends of mine but they all are my brothers in arms.
To those who served I say thank you and to those who did not make it home we will never forget you.
Rest In Peace brothers.
Task Force Ranger Memorial
10/02/2004
Lazy days...
Spent most of the day relaxing. Had some pretty good spasms in the early evening and after dinner. I am certain that I have developed a tolerance to the flexeril and need to get it changed, even at the max dose it is not working.
I ended up in the recliner and watched the boob tube for a bit. That was interrupted by the sound of dueling chainsaws from the neighbors yard. They finally got their insurance to cover the removal of the tree from the storm last July. We had a micro burst that hit us and just destroyed about 4 square blocks. Lucky us, we live right in the middle of it. No houses came down but a lot of them had severe damage from trees coming down on them. I got lucky and only had my utility lines ripped out of the house when the neighbors tree came down across my back yard.
Anyway, looking forward to the coming weeks. My wifes schedule has changed so now we can get to the gym everyday. While it seems to aggravate the arachnoiditis for now I am willing to trade that for the cardio benefits as well it gets me out of the house for an hour or so each day. Sometimes just getting out is what you need.
I ended up in the recliner and watched the boob tube for a bit. That was interrupted by the sound of dueling chainsaws from the neighbors yard. They finally got their insurance to cover the removal of the tree from the storm last July. We had a micro burst that hit us and just destroyed about 4 square blocks. Lucky us, we live right in the middle of it. No houses came down but a lot of them had severe damage from trees coming down on them. I got lucky and only had my utility lines ripped out of the house when the neighbors tree came down across my back yard.
Anyway, looking forward to the coming weeks. My wifes schedule has changed so now we can get to the gym everyday. While it seems to aggravate the arachnoiditis for now I am willing to trade that for the cardio benefits as well it gets me out of the house for an hour or so each day. Sometimes just getting out is what you need.
It's getting cold out...
WOW! Woke up freezing cold this morning. Since it has not been cold enough I had not yet switched the heat on. I mean yesterday was 80 degrees outside during the day and while it cooled off some by nighttime I did not expect to wake up to 35F. I came down stairs and my house which usually stays around 72 had dropped to 67. Time to turn the heat on!!!
Spent yesterday doing some shopping with the wife. Felt good to get out of the house and walk around but much like I thought by the end of the day my back was not happy. It was not a burning pain but more like a dull throb and the occasional spasm.
We got the boys some winter coats and clothes for the winter. Old Navy had a killer sale on down coats left over from last season and we were able to find some in both the boys sizes. We also etook the to Toy's "R" Us and let them pick out a few things. They were running a buy 2 get the 3rd free sale on almost everything so we got some lego's for the youngest and the oldest picked out some cars and planes to ply with. I will have to head back during the week to do some Christmas shopping.
Since today is probbly the coldest day since I was diagnosed with the arachnoidits it will be interesting to see what the winter holds in store. I know they have studies saying the weather is not really a factor but I am guessing the guy who did the study did not have the condition himself!
Spent yesterday doing some shopping with the wife. Felt good to get out of the house and walk around but much like I thought by the end of the day my back was not happy. It was not a burning pain but more like a dull throb and the occasional spasm.
We got the boys some winter coats and clothes for the winter. Old Navy had a killer sale on down coats left over from last season and we were able to find some in both the boys sizes. We also etook the to Toy's "R" Us and let them pick out a few things. They were running a buy 2 get the 3rd free sale on almost everything so we got some lego's for the youngest and the oldest picked out some cars and planes to ply with. I will have to head back during the week to do some Christmas shopping.
Since today is probbly the coldest day since I was diagnosed with the arachnoidits it will be interesting to see what the winter holds in store. I know they have studies saying the weather is not really a factor but I am guessing the guy who did the study did not have the condition himself!
10/01/2004
It's a beautiful morning...
It is an awesome morning. I woke at 0445 wide awake and ready to go for some reason. No pain in the lower back and only a slight numbness in the left foot/leg. The plan today is to spend some time with my wife and do some much needed shopping.
Not sure how the back will hold up to all the walking around today so in anticipation I have taken my meds. I hate to do it when I obviously woke feeling good but I know that if I wait until the pain starts it will be tough for the meds to catch up with the pain.
First on the list is to swing by Home Depot and pay them to come measure the sliding doors. We are having them removed and replaced with steel double doors. The sliding doors are ok but who ever installed/purchased them bought the cheapest one on the market. The glass is not at all insulated nor is the frame. In the winter the cold air just comes in and the living room gets very cold. The new doors are double panes as well they have the mini blinds between the glass. This means we can get rid of that funky freaking "drape" that we have been using to keep the sun from beating into the room in the late afternoon (western exposure in that room.)
We are also plan to go look at some laptops and a digital cam corder. Two items we have been pricing for some time and have finally narrowed it down to what we really want. I have been wanting the camera for some time. My dad was always filming us when we were kids and having those to show my kids has been pretty cool. I would like to capture their youth and provide them with the same sentiments someday. The laptop is a business expense. Since I work from home and do not have one I am limited in my weekly travels and have had to miss out on a few mid week trips to the inlaws because of work concerns.
After that the day is up for grabs. We thought we might start some of the holiday shopping for the boys. Usually I wait until the week before but with the steady deterioration of my back I am not sure I want to deal with the madness at the mall 5 days before Christmas.
I will drop in after the shopping and give a sit-rep on the back.
Not sure how the back will hold up to all the walking around today so in anticipation I have taken my meds. I hate to do it when I obviously woke feeling good but I know that if I wait until the pain starts it will be tough for the meds to catch up with the pain.
First on the list is to swing by Home Depot and pay them to come measure the sliding doors. We are having them removed and replaced with steel double doors. The sliding doors are ok but who ever installed/purchased them bought the cheapest one on the market. The glass is not at all insulated nor is the frame. In the winter the cold air just comes in and the living room gets very cold. The new doors are double panes as well they have the mini blinds between the glass. This means we can get rid of that funky freaking "drape" that we have been using to keep the sun from beating into the room in the late afternoon (western exposure in that room.)
We are also plan to go look at some laptops and a digital cam corder. Two items we have been pricing for some time and have finally narrowed it down to what we really want. I have been wanting the camera for some time. My dad was always filming us when we were kids and having those to show my kids has been pretty cool. I would like to capture their youth and provide them with the same sentiments someday. The laptop is a business expense. Since I work from home and do not have one I am limited in my weekly travels and have had to miss out on a few mid week trips to the inlaws because of work concerns.
After that the day is up for grabs. We thought we might start some of the holiday shopping for the boys. Usually I wait until the week before but with the steady deterioration of my back I am not sure I want to deal with the madness at the mall 5 days before Christmas.
I will drop in after the shopping and give a sit-rep on the back.
9/30/2004
Up in the morning before the break of day...
I woke this morning to one of the headaches I described yesterday. Annoying and centered right at the back of the head just below the crown. Not throbbing but certainly enough to let you know it is there.
I read that some of these headaches can be helped by a mix of NSAID's and muscle relaxers so I took my Mobic, which is a Cox-2 inhibitor and the max dose of Flexeril as well as the Darvocet and it seems to be providing some relief. Of course with all those meds I am barley able to keep my head up right now. Maybe it is time to go watch MSNBC and see what is going on.
I read that some of these headaches can be helped by a mix of NSAID's and muscle relaxers so I took my Mobic, which is a Cox-2 inhibitor and the max dose of Flexeril as well as the Darvocet and it seems to be providing some relief. Of course with all those meds I am barley able to keep my head up right now. Maybe it is time to go watch MSNBC and see what is going on.
9/29/2004
CHRONIC HEADACHES IN ARACHNOIDITIS
CHRONIC HEADACHES IN ARACHNOIDITIS
I have been wondering for some time now about the headaches that I have been getting. They are not at all like a migraine or a cluster from what I have read. Sometimes I am fine for weeks at a time and then out of the blue I will wake with a headache that will last for days and sometimes a week. Narcotics offer little relief if any from them and when they do it is more in the form that I am able to get some sleep. While looking around I found this site and right off the top (#1) it describes what I experience. They are never so bad that I am unable to function rather they are in the "background" and annoying.
I did indeed have a myleogram as well as the ESI's and I am waiting for the hospital to get me a copy of the records from those. I am interested in seeing as well as verifying what they gave me during those procedures. I do not recall at anytime during them anyone mentioning this as a possible side effect long term. In fact I clearly recall the doctor telling me that I might have a headache in an hour or so after the procedures but it would subside. The cause of the headache being the introduction of fluid into the spinal column.
The only way I can explain it that might make sense is imagine a balloon filled with water and tied off. There is nowhere for the water to go as it is totally enclosed. Know, without bursting the balloon add more liquid to it. When you do this it will not only increase the volume of water it will increase the pressure that the balloon is exerting. Know imagine that balloon is the membrane that surrounds your spinal column and brain. When you add the fluid and it expands it has no where to go and it will exert its pressure on the brain. I know this may be an oversimplification of what happens after an ESI but I think it gets the picture across.
My beef with all of this is that I was not informed of the long term effects of the ESI and Myleogram by anyone during the process. The bitch of that is that none of the ESI's provided me with the relief they had hoped for and the myleogram did not show them the nerves that were being pinched. Of course we did not know any of this before the procedures so it really does not matter, it is just one of those things. Kind of like being kicked after you have gone to the mat.
I probably would have still gone through all the procedures had I known the long term effects but I would have at least been able to do more research on them before deciding. I fell into the typical doctor/patient trap of "he/she is the doc and the professional ,so I will just do it." This has certainly taught me that if it something pertaining to my body I want more then that as an excuse to have a procedure and I certainly want to know about all possible side effects. I think the docs appreciate this approach now as well. I have found that when I approach them about an issue and I also express what I have learned about it they are more apt to let me have a say in how we will proceed.
I have been wondering for some time now about the headaches that I have been getting. They are not at all like a migraine or a cluster from what I have read. Sometimes I am fine for weeks at a time and then out of the blue I will wake with a headache that will last for days and sometimes a week. Narcotics offer little relief if any from them and when they do it is more in the form that I am able to get some sleep. While looking around I found this site and right off the top (#1) it describes what I experience. They are never so bad that I am unable to function rather they are in the "background" and annoying.
I did indeed have a myleogram as well as the ESI's and I am waiting for the hospital to get me a copy of the records from those. I am interested in seeing as well as verifying what they gave me during those procedures. I do not recall at anytime during them anyone mentioning this as a possible side effect long term. In fact I clearly recall the doctor telling me that I might have a headache in an hour or so after the procedures but it would subside. The cause of the headache being the introduction of fluid into the spinal column.
The only way I can explain it that might make sense is imagine a balloon filled with water and tied off. There is nowhere for the water to go as it is totally enclosed. Know, without bursting the balloon add more liquid to it. When you do this it will not only increase the volume of water it will increase the pressure that the balloon is exerting. Know imagine that balloon is the membrane that surrounds your spinal column and brain. When you add the fluid and it expands it has no where to go and it will exert its pressure on the brain. I know this may be an oversimplification of what happens after an ESI but I think it gets the picture across.
My beef with all of this is that I was not informed of the long term effects of the ESI and Myleogram by anyone during the process. The bitch of that is that none of the ESI's provided me with the relief they had hoped for and the myleogram did not show them the nerves that were being pinched. Of course we did not know any of this before the procedures so it really does not matter, it is just one of those things. Kind of like being kicked after you have gone to the mat.
I probably would have still gone through all the procedures had I known the long term effects but I would have at least been able to do more research on them before deciding. I fell into the typical doctor/patient trap of "he/she is the doc and the professional ,so I will just do it." This has certainly taught me that if it something pertaining to my body I want more then that as an excuse to have a procedure and I certainly want to know about all possible side effects. I think the docs appreciate this approach now as well. I have found that when I approach them about an issue and I also express what I have learned about it they are more apt to let me have a say in how we will proceed.
9/27/2004
Damnit
Well I guess it has been a non-eventful day. We went over to Home Depot to see about getting the deck sliding glass doors replaced with steel French doors with the double pained windows and the vertical blinds between the windows. We have had this house for 3 years and have hated the deck doors from day one. We also looked at some privacy fence for the south side of the backyard. Finally block out the blight of a yard next door. How could someone let their house become that funky and dilapidated?
Found some cool stuff as well as all the summer stuff that is on sale now like the lawnmower we have looked at like 100 times. It was almost half off and is now just $499. It is one of those beasts that cuts, mulches and vacuums. Since we have a ton of trees we spend a lot of time in the fall raking and bagging. It would be nice to have the mower do it all for you. They also had some grills on sale. Our's is on it's last leg and should be put out to pasture.
I also stopped by the pharmacy to pick up my refill of meds. They kill me with the way they do business. It is the same prescription I have had before only this time the doc wrote it for double the amount. It still only cost the $5 co-pay. There are some meds that are cheaper for me to buy without the co-pay. I have a 3 tier plan that is divided into Generic/Preferred/Non-Preferred. The last one is the one that kills me. It is basically for drugs that have no generic equals like Flexiril 5mg. Now there is a flexiril 10mg that has a generic and is only $5 co-pay but if I get the 5mg pills then I have to pay the higher co-pay which is like $75. That is all fine except if I get the 5mg pills and do not use the insurance card they are only $55. There are a few other meds that it is like that as well. You leave the pharmacy scratching your head.
Anyway, know that I know that I can get more for the same price I will mention it to the doc and see if he will write them all like that. I know it may not seem like much but when you spend about $150 a month on meds every penny saved helps.
Found some cool stuff as well as all the summer stuff that is on sale now like the lawnmower we have looked at like 100 times. It was almost half off and is now just $499. It is one of those beasts that cuts, mulches and vacuums. Since we have a ton of trees we spend a lot of time in the fall raking and bagging. It would be nice to have the mower do it all for you. They also had some grills on sale. Our's is on it's last leg and should be put out to pasture.
I also stopped by the pharmacy to pick up my refill of meds. They kill me with the way they do business. It is the same prescription I have had before only this time the doc wrote it for double the amount. It still only cost the $5 co-pay. There are some meds that are cheaper for me to buy without the co-pay. I have a 3 tier plan that is divided into Generic/Preferred/Non-Preferred. The last one is the one that kills me. It is basically for drugs that have no generic equals like Flexiril 5mg. Now there is a flexiril 10mg that has a generic and is only $5 co-pay but if I get the 5mg pills then I have to pay the higher co-pay which is like $75. That is all fine except if I get the 5mg pills and do not use the insurance card they are only $55. There are a few other meds that it is like that as well. You leave the pharmacy scratching your head.
Anyway, know that I know that I can get more for the same price I will mention it to the doc and see if he will write them all like that. I know it may not seem like much but when you spend about $150 a month on meds every penny saved helps.
Soooo?
I guess one of the questions that I have been asked to most is "how did you break your back?"
It really is not a simple answer and I honestly do not know when it broke only when we were able to diagnose it. A myriad of causes exists and many of them would fit my injury very well. Generally though it is something that happens over time and then one day, "BAM!" it is there. I remember that day very well as it was the most pain I had ever had until that day.
I had been having lower back pains prior to the "big day" and had seen my primary care doc. He sent me off for some X-Rays thinking that the pain and leg numbness might be Sciatica but the X-Ray showed Grade I spondylolisthesis. Since I still had mobility and only limited pain I was given ibuprofen and a PT regimen to help increase muscle tone in the area.
The Coup de Grace for me believe it or not was a freaking paint can lid. I had been painting the baby's room for most of the morning and when I was done like anyone else would have I bent over to close the bucket of paint. When I stood up that was all she wrote. A muscle spasm like none other dropped me to the floor. What really sucked was I was upstairs and home alone. I just laid there for a few minutes and then pretty much crawled my way to the stairs. As this was a Sunday I had to call my doc's answering service and he called me back. When I explained what happened he told me that is known as a flair up. I went and saw him the next day and was referred out to a Neurosurgeon.
The neurosurgeon is really where the journey begins as it was through him that I went through most of the pain management as well as the surgery.
I would say the biggest issue I deal with is that I do not present as a disabled person. I can walk unassisted for the most part, but when I am in stores that have carts I use one even if I am only getting a few items. If I am at the mall I can walk around for most of the day provided I stop and sit every 20-30 minutes.
I think my family was the biggest hurdle. I come from a military and very athletic family. I took them quite some time to come around to the fact that this is something that makes life a bit more interesting. I think their "come to Jesus" was when they saw me in the hospital after surgery. I think that was also the point that I realized that this is something that I will deal with forever.
I remember being all gung ho about returning to work as soon as possible. I thought 90 days post-op would see me back in the brewery doing what I really loved to do. The day I went to see the doc post-op to have the staples removed was a big smack in the face. He told me that I would not even start PT until 30-60 days post-op and that 6 months was probably the soonest he would consider allowing me to go back to work and that would be only part time and would require a position that allowed me to sit/stand as needed and not lift more then 20lbs. The brewery was definitely out of the question.
I will have to finish this later as my youngest just came downstairs and is looking for some breakfast.
It really is not a simple answer and I honestly do not know when it broke only when we were able to diagnose it. A myriad of causes exists and many of them would fit my injury very well. Generally though it is something that happens over time and then one day, "BAM!" it is there. I remember that day very well as it was the most pain I had ever had until that day.
I had been having lower back pains prior to the "big day" and had seen my primary care doc. He sent me off for some X-Rays thinking that the pain and leg numbness might be Sciatica but the X-Ray showed Grade I spondylolisthesis. Since I still had mobility and only limited pain I was given ibuprofen and a PT regimen to help increase muscle tone in the area.
The Coup de Grace for me believe it or not was a freaking paint can lid. I had been painting the baby's room for most of the morning and when I was done like anyone else would have I bent over to close the bucket of paint. When I stood up that was all she wrote. A muscle spasm like none other dropped me to the floor. What really sucked was I was upstairs and home alone. I just laid there for a few minutes and then pretty much crawled my way to the stairs. As this was a Sunday I had to call my doc's answering service and he called me back. When I explained what happened he told me that is known as a flair up. I went and saw him the next day and was referred out to a Neurosurgeon.
The neurosurgeon is really where the journey begins as it was through him that I went through most of the pain management as well as the surgery.
I would say the biggest issue I deal with is that I do not present as a disabled person. I can walk unassisted for the most part, but when I am in stores that have carts I use one even if I am only getting a few items. If I am at the mall I can walk around for most of the day provided I stop and sit every 20-30 minutes.
I think my family was the biggest hurdle. I come from a military and very athletic family. I took them quite some time to come around to the fact that this is something that makes life a bit more interesting. I think their "come to Jesus" was when they saw me in the hospital after surgery. I think that was also the point that I realized that this is something that I will deal with forever.
I remember being all gung ho about returning to work as soon as possible. I thought 90 days post-op would see me back in the brewery doing what I really loved to do. The day I went to see the doc post-op to have the staples removed was a big smack in the face. He told me that I would not even start PT until 30-60 days post-op and that 6 months was probably the soonest he would consider allowing me to go back to work and that would be only part time and would require a position that allowed me to sit/stand as needed and not lift more then 20lbs. The brewery was definitely out of the question.
I will have to finish this later as my youngest just came downstairs and is looking for some breakfast.
9/26/2004
Sunday is just another day
Woke up to shooting pains in my leg and foot at about 0500 this morning. Took some meds and tried to get back to sleep but it was no use. Maybe a soak in a hot tub would help. Time to start dropping hints about buying one and gauge the reaction.
Came down and made the usual pot of coffee and sat down to cruise the web. Nothing new it seems is happening that early in the morning as most of the sites still had yesterdays crap on them. About the only thing I discovered this morning is that I really need to buy a new chair for the computer desk.
Humdrum kind of start today. Maybe this would be a good day to just veg out and watch some old war flicks. Drag out "A Bridge Too Far" and "The Longest Day", that should kill about 6 hours.
Came down and made the usual pot of coffee and sat down to cruise the web. Nothing new it seems is happening that early in the morning as most of the sites still had yesterdays crap on them. About the only thing I discovered this morning is that I really need to buy a new chair for the computer desk.
Humdrum kind of start today. Maybe this would be a good day to just veg out and watch some old war flicks. Drag out "A Bridge Too Far" and "The Longest Day", that should kill about 6 hours.
9/25/2004
Just another day
Well pretty much a normal day. I spent it with my sons just hanging around and goofing off. I took them out to lunch and then for some frozen custard since their mom had to work this afternoon.
Pain level was moderate today but I laid off the meds so that I could drive the boys around town. We went and bought some stuff to make cookies and brownies tomorrow. Good ones, not those open the log and cut them up crappy cookies. Fresh from scratch cookies like mom used to make. Nothing better then something you have made yourself.
I paid in spades though for skipping the meds this morning. By the late afternoon my back was on fire and it seemed like the pain meds were not going to catch up at all. I ended up dozing off with the youngest when he went down for his nap and when I woke up I was good to go.
Tomorrow I will spend the day in the kitchen with them and show them how to bake. I figure we can make a few dozen cookies, a tray of brownies and then maybe a cheesecake (New York Style!) I have some great low fat recipes for all of them and they come out damn good IMHO.
Pain level was moderate today but I laid off the meds so that I could drive the boys around town. We went and bought some stuff to make cookies and brownies tomorrow. Good ones, not those open the log and cut them up crappy cookies. Fresh from scratch cookies like mom used to make. Nothing better then something you have made yourself.
I paid in spades though for skipping the meds this morning. By the late afternoon my back was on fire and it seemed like the pain meds were not going to catch up at all. I ended up dozing off with the youngest when he went down for his nap and when I woke up I was good to go.
Tomorrow I will spend the day in the kitchen with them and show them how to bake. I figure we can make a few dozen cookies, a tray of brownies and then maybe a cheesecake (New York Style!) I have some great low fat recipes for all of them and they come out damn good IMHO.
9/24/2004
Thank God It's Friday!!!
Not really though. Since I work from home I can pretty much make any day Friday if I feel like it.
Got to bed fairly early last night. The baby refused to take a nap during the day. He just sat there staring back at me whenever I tried to put him down to sleep. I figured it would be hell trying at bed time as when he is over tired he is super cranky. I was shocked, about 18:45 he just dozed off in my lap. Since the wife was at work and the oldest does not have school today I took the baby upstairs and let the oldest watch Cartoon Network until 21:00.
I slept pretty well but woke up with a headache and a sore back. The burning sensation is still lingering but I found that if I recline on the couch (the ends recline like a LA-Z-BOY) and put a pillow under my knees I can get rather comfortable and reduce the pain level some. Works well if I have a few hours to just relax and not have to worry about playing taxi.
I did get some work done as well, but sitting in the chair can become rather tiresome and I need to take a break every few hours or so. I need to find a better chair then this one someday. I was thinking of switching all my work over to laptop and buying a recliner for the office. I would be able to get tons more done if I did not have to get up every 2-3 hours. Time to start dropping hints for Christmas!!!
Got to bed fairly early last night. The baby refused to take a nap during the day. He just sat there staring back at me whenever I tried to put him down to sleep. I figured it would be hell trying at bed time as when he is over tired he is super cranky. I was shocked, about 18:45 he just dozed off in my lap. Since the wife was at work and the oldest does not have school today I took the baby upstairs and let the oldest watch Cartoon Network until 21:00.
I slept pretty well but woke up with a headache and a sore back. The burning sensation is still lingering but I found that if I recline on the couch (the ends recline like a LA-Z-BOY) and put a pillow under my knees I can get rather comfortable and reduce the pain level some. Works well if I have a few hours to just relax and not have to worry about playing taxi.
I did get some work done as well, but sitting in the chair can become rather tiresome and I need to take a break every few hours or so. I need to find a better chair then this one someday. I was thinking of switching all my work over to laptop and buying a recliner for the office. I would be able to get tons more done if I did not have to get up every 2-3 hours. Time to start dropping hints for Christmas!!!
9/23/2004
An image of BAK being inserted
.
This is what the BAK cage is and how it is inserted into the spine.
Surgical procedures
I found some interesting things this morning on exactly what happens during the surgery. The first is the laminectomy that the surgeon performs to free the nerves being affected.
After the laminectomy I also had fusion and instrumentation done to give stability to the area of the spine that was affected. The big difference in my case was that I did not receive a bone graft from my hip, I received a donor graft from a cadaver.
In addition I also received what is called a BAK cage to help keep the space between the vertebra open.
Total time I spent in surgery was about 9 hours start to finish. The only thing I remember was being wheeled from the prep area to the OR and asking them to take some pictures once they cracked me open. I mean how often do you really get to see your own spine through some media other then X-Ray?
In the prep room we did all the final prep for the surgery including signing a power of attorney should something go wrong and I would be unable to make my own decisions. They discussed the possibilities of complications from the surgery and the anesthesia (including death). Well it all may sound morbid they are issues that anyone having major surgery should consider.
When they finished throwing paperwork at me they started to put in the IV and EKG monitor leads. They also screwed little electric leads into my head and feet. I remember asking them what they were for and I think the answer was so they could see what nerves they were working on. After they finished I was wheeled into the OR.
The OR was the cleanest room I have ever been in. I remember seeing all the foam padding on the table and can only figure they used it to stabilize me into the position they would need. I also remember seeing the Makita drill boxes on the table and laughing to myself, after that I was out like a light.
I woke up in recovery shivering and shaking from coming out from under the anesthesia. They said that was a normal effect and then the warmest blanket I have ever had was put on me. They keep blankets in the warmer as the OR and Recovery rooms are kept very cold to hamper infectious organisms.
I remember my family coming in to see me but I was back out after that. I woke the next day in the ICU scratching the hell out of myself. Turns out that some people do not tolerate morphine well and the side effect is feeling itchy.
The rest of my stay in the hospital was about 5 day in the regular neuro ward doped up and watching the war on TV (my surgery was right after the war kicked off in Iraq). I do remember the nice nurse who helped me roll over and then packed a ton of ice on my back to keep the swelling down.
Anyway, just some memories from my surgery and hospital stay.
Laminectomy
The term laminectomy is derived from lumber (lower spine), lamina (part of the spinal canal's bony structure) and -ectomy (removal). The operation is performed to relieve pressure on one or more spinal nerve roots. This pressure, often called nerve root compression or a "pinched nerve", is what often causes back and leg pain.
Nerve root compression is caused by:
Ruptured disc - Also called a protruded, slipped or herniated disc.
Spondylosis - Deterioration or "wear and tear" of multiple discs with bony spur formation and degenerative disc.
Scar tissue
Combination of the above factors
After the laminectomy I also had fusion and instrumentation done to give stability to the area of the spine that was affected. The big difference in my case was that I did not receive a bone graft from my hip, I received a donor graft from a cadaver.
Another type of spine surgery is spinal fusion. The diseased disc and lamina are first removed. Pieces of bone are removed from your hip (donor) and are placed along the spine and between the vertebrae. This is called bone grafting. When the bone heals, this is called a bone fusion and the vertebrae no longer move separately. This fusion takes three months to heal.
Indications for Spinal Fusion
When a disc ruptures, the hydraulic effect of the disc is disrupted. The facet joints (the joints between two vertebrae), muscles, and surrounding ligaments are required to take over the job of the disc. If the disc does not heal, it is said to be degenerative. A degenerative disc is not able to support the weight of the body and the space between vertebra narrows. When the space between two vertebra narrows, so do the holes (or foramen) that the nerves pass through. This causes the nerve to be pinched and results in leg and/or back pain. Over time the facet joints become arthritic, get larger, and develop bone spurs.
This is called spondylolisis and narrows the formen even further. Finally, as the facet joints become arthritic and lose their cartilage, they begin to slide on one another. This allows one vertebrae to “slip” on the other, narrowing the hole even more. This kind of slipping and narrowing is a dynamic process and is worse when sitting or riding in a car and is called spondylolisthesis.
When a nerve is pinched by a ruptured disc, the disc material can be removed to relieve pressure on the nerve (laminectomy and discectomy). When the disc is degenerative and the nerve is pinched by bone (from narrowing of the disc space and foramen, spondylolisis, and slipping or spondlylolisthesis), spinal fusion is indicated to relieve pressure on the nerve and keep the vertebra from slipping.
With the development of fusion cages, it is now much easier to relieve pressure on a pinched nerve, keep the vertebra from slipping, and getting the fusion to heal. The fusion cages can be put in from the back or from the front. We prefer to put our cages in from the back because, the nerves can be seen better and protected better during surgery and the holes (foramen) can be made bigger allowing the nerve more room.
In addition I also received what is called a BAK cage to help keep the space between the vertebra open.
BAK Cage
Extracted from Agusta Orthopedic Surgery
This surgical procedure is used when there is severe enough disc degeneration and narrowing that more space is needed between the bones of the spine. A small cylinder is placed between the bones of the spine to hold them apart. The cage has holes in it and the bone grows in and around it, holding it in place. This relieves the pressure on the nerves of the spine and patients are usually able to return to a more active lifestyle and control their back pain.
The purpose of a spinal fusion is to eliminate painful motion that occurs at that spinal segment.
There are many techniques used to fuse spinal segments. The main advantage touted in favor of the BAK cage is that it can be done through a limited exposure.
The BAK cage is typically inserted from the anterior or frontal approach via a laproscopic procedure. Thus it requires no large incision and tissue trauma can be limited. Recovery time is thereby minimized.
The BAK cage allows the patient to be up and about without a hard plastic brace. However, the BAK fusion cage depends on the bone healing from one vertebra through the cage to the other vertebra. It is imperative that the patient not smoke. Smoking decreases blood supply (because of the nicotine). Spinal fusions require a good blood supply to heal and the process can take up to 4 months.
Once the pinch on the nerve is removed, the patients legs feel better and stronger almost immediately. The patient will experience moderate back discomfort, however. A lumbar corset can be worn for support. The intense back pain resolves quickly (2-3 days), but the residual nagging back ache lasts up until the fusion is healed.
The procedure must still be considered experimental. It is not widely available. It is also technically demanding and takes a lot of experience to master the technique. At this time there is promise for the procedure, but one must be very cautious about pursuing the surgery, reviewing the credentials and experience of the surgeons
Total time I spent in surgery was about 9 hours start to finish. The only thing I remember was being wheeled from the prep area to the OR and asking them to take some pictures once they cracked me open. I mean how often do you really get to see your own spine through some media other then X-Ray?
In the prep room we did all the final prep for the surgery including signing a power of attorney should something go wrong and I would be unable to make my own decisions. They discussed the possibilities of complications from the surgery and the anesthesia (including death). Well it all may sound morbid they are issues that anyone having major surgery should consider.
When they finished throwing paperwork at me they started to put in the IV and EKG monitor leads. They also screwed little electric leads into my head and feet. I remember asking them what they were for and I think the answer was so they could see what nerves they were working on. After they finished I was wheeled into the OR.
The OR was the cleanest room I have ever been in. I remember seeing all the foam padding on the table and can only figure they used it to stabilize me into the position they would need. I also remember seeing the Makita drill boxes on the table and laughing to myself, after that I was out like a light.
I woke up in recovery shivering and shaking from coming out from under the anesthesia. They said that was a normal effect and then the warmest blanket I have ever had was put on me. They keep blankets in the warmer as the OR and Recovery rooms are kept very cold to hamper infectious organisms.
I remember my family coming in to see me but I was back out after that. I woke the next day in the ICU scratching the hell out of myself. Turns out that some people do not tolerate morphine well and the side effect is feeling itchy.
The rest of my stay in the hospital was about 5 day in the regular neuro ward doped up and watching the war on TV (my surgery was right after the war kicked off in Iraq). I do remember the nice nurse who helped me roll over and then packed a ton of ice on my back to keep the swelling down.
Anyway, just some memories from my surgery and hospital stay.
What is Spondylolisthesis?
Spondylolisthesis is defined as the movement of adjacent vertebra relative to each other.
Although spondylolisthesis can be caused by many pathologic entities, degenerative spondylolisthesis is by far the most common. With aging, discs lose water content and ultimately height. As the vertebra on either side of the disc come closer to each other through the loss of disc height, the upper vertebra slides forward on the subadjacent vertebra producing spondylolisthesis. High stresses and motion produce degeneration of the disc and for this reason the most susceptible levels of the lumbar spine, L4-L5, followed by L3-L4 and L5-S1 are the vertebral segments most commonly involved.
Spondylolisthesis is also associated with deterioration of the facet joints connecting the two vertebra. As the facet joints become arthritic due to this deterioration, they enlarge in an attempt to confer stability. As the two rings of the vertebral segments which make up the spinal canal, slide past each other, the canal narrows in size . The combination of canal narrowing and enlargement of the facet joints, produces the characteristic nerve compression problems found in degenerative spondylolisthesis. The nerves are compressed in two major areas at the site of a degenerative spondylolisthesis. It is believed that a reduction in nerve blood flow accounts for the symptoms produced from spinal canal narrowing (Spinal stenosis).
That in a nutshell is what spondy is. Once again I feel good knowing that I am not average and have to be different. My spondy is at the L5/S1, which according to this passage is not the most prevalent spot! However my Spondy was brought about by Spondylolysis which is described below.
The most common X-ray identified cause of low back pain in adolescent athletes is a stress fracture in one of the bones (vertebrae) that make up the spinal column. Technically, this condition is called spondylolysis (spon-dee-low-lye-sis). It usually affects the fifth lumbar vertebra in the lower back, and much less commonly, the fourth lumbar vertebra.
If the stress fracture weakens the bone so much that it is unable to maintain its proper position, the vertebra can start to shift out of place. This condition is called spondylolisthesis (spon-dee-low-lis-thee-sis). If too much slippage occurs, the bones may begin to press on nerves and surgery may be necessary to correct the condition.
Basically it is a broken bone that allows the vertebra to move freely about. I was originally diagnosed in 2002 with this and spent several months doing physical therapy and pain management to control it. My job however required heavy lifting daily and usually in excess of 100lbs (about 45kilos) and upwards of 170lbs (about 77kilos) and no matter how much PT I was doing the stress put on my back ended up being to much. Sad thing is it was a kick ass job and I was the guy in charge of the whole operation.
So what happened? In the end the damage the lumbar spine was actually not so bad, I was only a grade II spondy but I was having a lot of trouble with the nerves that run from the L5. They were being compressed by the disk which in turn was causing shooting pain down the left leg as well as numbness. From time to time I would also have what is known as a "flair up" in which the muscles in the lower back became so over worked they would start to spasm. That would put you down for a couple of days with pain meds and muscle relaxers. I consulted with a neurosurgeon for several months who I must say was one of the most professional docs I have ever met. He helped me understand a lot of what was going on and mapped out a treatment plan for me that included all the possible outcomes and how we would treat X if Y happened. Due to the nerve compression though we decided to move forward and have the surgery done before the damage was permanent.
9/22/2004
Autumn is here...
Did not sleep well last night for some reason. I am not sure if it was the burning sensation in the lower back or the fact that I was sweating even though the bedroom was not hot. The burning though I am sure is coming from the medrol wearing off and the nerves being restricted by the scar tissue. I was able to make it tolerable with some pain meds and at least get some sleep.
Pain is all mind over matter, right? If you do not mind it does not matter. I would like to take the guy who said that beat his ass senseless and then ask him his opinion on pain.
Today should be nice as well as The Autumnal Equinox. It is fairly nice out right now at 60F/16C. They are saying we will be in the high 70's to the mid 80's by late afternoon. Looks like some rain for tomorrow but that should help cool it down some more. I am looking forward to being able to keep the windows open for a few weeks before it gets to cold.
Pain is all mind over matter, right? If you do not mind it does not matter. I would like to take the guy who said that beat his ass senseless and then ask him his opinion on pain.
Today should be nice as well as The Autumnal Equinox. It is fairly nice out right now at 60F/16C. They are saying we will be in the high 70's to the mid 80's by late afternoon. Looks like some rain for tomorrow but that should help cool it down some more. I am looking forward to being able to keep the windows open for a few weeks before it gets to cold.
9/21/2004
I don't know what I been told
One thing I have not really talked about here is my service in the Army. It may have been a contributing factor to the spondylolisthesis so I guess this is a fitting forum for it.
I grew up the son of a US Army Field Artillery officer so naturally my life was spent seeing what goes on in the military. During the summer between my junior and senior years I decided I wanted to enlist so the very day I turned 17 I went and took the ASVAB and physical. Being a junior meant that I could not go on active duty yet as the Army requires a HS diploma or GED, so I looked at what was called split option. Basically I would enlist in the reserves and go to basic during the first summer and then after graduation I would go to AIT. There were no infantry units in my area and the only thing they were offering was 88T, railroad repairman. Not being someone who likes to fix things (I prefer to break them) I passed on the option and finished my senior year. In April of my senior year I hit MEPS again and got an AD 11X option. Of course back in my day there were more then 11B's and C's, you also had 11H and 11M's. I left Fort Benning in late 88 as a newly minted 11B ready to take on the world.
During my time in the Army I was stationed at Fort Irwin as part of the OPFOR. I was part of the 1/52INF(M) that played the role of the Soviet Army and trained other units how to fight the Soviet threat. Of course with the collapse of the Soviet Union or mission changed somewhat but we still trained all US Army units in armored warfare.
While I was at Irwin I was transitioned to 11M and given a Bradley to call my own. I thought hitting the ranges was fun as a leg but when they let me fire the 25mm cannon on the Bradley I knew I had found my true calling. Running a Bradley crew is a tough job though. You have both the vehicle and the dismounts to watch out for and it can be a handful at times.
I also went to the promotion board and then to PLDC while I was there. Upon graduation I made the cutoff score and was promoted from Corporal to Sergeant.
In the end I spent 6 years at Fort Irwin. While it was a great job and I loved the desert I did not want to homestead. This was all during the draw down of the mid 90's and new duty stations were tough to come by. It was either re-enlist for 5 years at the NTC or go to Korea for a year. I decided it was time for me to head home and go to college. In 1994 I left AD for the National Guard and went home to use my GI Bill to go to school.
I would love to go back to active duty but due to my current injuries I am no longer medically fit for service. When I had the surgery and they fused my vertebra together I was DQ'd for life from going back into the service. It appears that this is one of those injuries that they will not even consider a waiver to allow me to go back in a limited role.
I grew up the son of a US Army Field Artillery officer so naturally my life was spent seeing what goes on in the military. During the summer between my junior and senior years I decided I wanted to enlist so the very day I turned 17 I went and took the ASVAB and physical. Being a junior meant that I could not go on active duty yet as the Army requires a HS diploma or GED, so I looked at what was called split option. Basically I would enlist in the reserves and go to basic during the first summer and then after graduation I would go to AIT. There were no infantry units in my area and the only thing they were offering was 88T, railroad repairman. Not being someone who likes to fix things (I prefer to break them) I passed on the option and finished my senior year. In April of my senior year I hit MEPS again and got an AD 11X option. Of course back in my day there were more then 11B's and C's, you also had 11H and 11M's. I left Fort Benning in late 88 as a newly minted 11B ready to take on the world.
During my time in the Army I was stationed at Fort Irwin as part of the OPFOR. I was part of the 1/52INF(M) that played the role of the Soviet Army and trained other units how to fight the Soviet threat. Of course with the collapse of the Soviet Union or mission changed somewhat but we still trained all US Army units in armored warfare.
While I was at Irwin I was transitioned to 11M and given a Bradley to call my own. I thought hitting the ranges was fun as a leg but when they let me fire the 25mm cannon on the Bradley I knew I had found my true calling. Running a Bradley crew is a tough job though. You have both the vehicle and the dismounts to watch out for and it can be a handful at times.
I also went to the promotion board and then to PLDC while I was there. Upon graduation I made the cutoff score and was promoted from Corporal to Sergeant.
In the end I spent 6 years at Fort Irwin. While it was a great job and I loved the desert I did not want to homestead. This was all during the draw down of the mid 90's and new duty stations were tough to come by. It was either re-enlist for 5 years at the NTC or go to Korea for a year. I decided it was time for me to head home and go to college. In 1994 I left AD for the National Guard and went home to use my GI Bill to go to school.
I would love to go back to active duty but due to my current injuries I am no longer medically fit for service. When I had the surgery and they fused my vertebra together I was DQ'd for life from going back into the service. It appears that this is one of those injuries that they will not even consider a waiver to allow me to go back in a limited role.
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