The very long story is that back in 2011, I ended up with a cervical disk herniation that caused excruciating chronic pain in my right shoulder and arm for three solid months. I was eventually steered toward Healing Back Pain: The Mind-Body Connection, by John E. Sarno, and it worked.
Move forward to February, 2014, 15 months ago, and I developed lower back pain. Had back pain before, always went away. This time, it didn’t—at least until it took permanent residence in my left butt, hip, hamstring, calf, ankle and big toe without much back pain. This time, Sarno was only effective insofar as getting rid of the constant chronic aspect, and intensity, making it somewhat manageable—with good days, bad days, and the awful dreary days.
In short, while I could function, I was pretty much in pain most of the time. Sitting was the worst, driving was excruciatingly painful most of the time and after a long drive the intensity could last for 2 days afterward.
I don’t do pain pills much, very rarely. A couple Advil is about it for me. Alcohol is my pharmaceutical of choice.
In retrospect, today, the biggest toll on me I’d not taken account of is a general lack of interest in just about everything. I suppose that’s a reasonable description of depression setting in. It’s probably why I went so gung-ho on the move to Mexico. Only thing I could find that gave me a semblance of a sense of life.
The reason for the retrospective? Because since 2 p.m. yesterday I’ve been pain free for the first time in 15 months. I opted for the discectomy surgery and it appears to have been a 100% success. For the reasons why I made this choice and how it went down, read on. I really enjoyed doing this write up, the first I recall truly delighted in writing in a long time. Hope that comes through.
The decision process.
- As I said before, when I thought I was on track to permanent relief, everything works. And that’s the problem. Just like pain pills, it all works. And works and works and it has to keep working and you have to keep doing it to mitigate symptoms.
- But the root of the problem is a disc (L4-5 in my case) protruding out, pressing the nerve root against spine bone, causing the various pains in one side or the other. So the root solution is to create room. They do this by cutting away a channel in the bone, to make room.
- I’d been at this 15 months. I think that’s plenty long to try a lot of stuff and not rush to surgery. Surgeon told me that when it goes away on its own, it’s usually within about 3 months.
- My dad and two younger brothers had the exact same herniation, same symptoms, all got surgery within months of each other 5 years ago. All had 100% recoveries which have persisted to this day. Dr. William Sheridan, chief of neurosurgery at Kaiser, Redwood City, did the procedure on my dad and one of my brothers, and is who did mine yesterday.
- The decision to move 1,000 miles down the Baja peninsula kinda put me in decision-time mode. I figured that if I didn’t get it done now, then opting for it later would require either a significant stay in the States, or a number of trips. Plus, I want to be very active down there and about the only activities I can do is walking, light weight lifting, and gentle swimming.
There was one other part of the decision process, and that was an in-person consult with Drs. Mike and Mary Dan Eades. How it came to pass is unimportant, but what happened is that about a month ago, Mike and I found ourselves in an email exchange and it was discovered that we’d be in the same neck of the woods at the same time, so agreed to meet for lunch to chat about various common interests we share that don’t involve how many Inuit can dance on the head of a pin. And those common interests and commonalities are significant, ranging from business to political views, to travel and vacation homes in the Sierras.
So going forward, the dispute over Inuit and ketosis may continue, we may lose interest, but the snark aspect is definitely unnecessary in any case. Serendipitously, it was only a few days prior to this taking place that someone remarked in a comment that they cynically almost believed this whole thing was a set-up, to be followed by a big public makeup. I replied that I wished that were true, since all of our in-person engagements had always been terrific. But alas, no, it was not that. Still, we made no big public deal about setting it aside. I told only a handful of close confidants and Who’s Who, and the news was uniformly well received. You know, with views and ideas as radical and eclectic as I hold, it’s probably not a good idea to go about trashing those few friendships I manage to cultivate. They’re rare, and Mike sure contributed to showing me how valuable they can be. Treat them with care.
So now you’re wondering, what did Mike and Mary Dan advise concerning the possibility of surgery? Both were initially skeptical, knowing full well of the failure rates and in some cases, exacerbation of the condition. But then they bantered back & forth with each other, which was cool—with Mary Dan raising the possibility of Prolotherapy and Mike, a therapy that involved subcutaneous injections of anesthesia near the point of pain. The term for it escapes me just now. But then, MD also did point out that given the family history and 100% success, it just may be the way to go.
…So I went in for the consult with Sheridan and given my near-term move, he was able to get me on the schedule only 2 weeks out, with pre-op workups about 6 days prior. Everything for the pre-op stuff was perfectly fine, with one exception: sky-high blood pressure. We’re talking 170s / 110s sky high. Wow! And just three months prior, when I went in for the thyroid testing, I was 130s / 80-90s. That level would kick me out of performing the surgery. I had to go to work.
- Went and got a new top-of-line monitor, an Omron 10 Series Wireless with Bluetooth linkup to an iPhone app and an online data cruncher for nice graphs.
- Doc prescribed 25mg daily of Hydrochlorothiazide, a diuretic. Said call in a day or so if it didn’t do much, and it didn’t. So, they aded 5mg Amlodipene, a calcium channel blocker.
- After a couple of days, small improvement but not enough, so I reached out to Doc Eades. Essentially, short of doing an Mg IV drip on myself, pound chelated magnesium, making sure to get one that lists the actual Mg. You know you have enough when you get the shits, then back off. Also agreed that epsom salt baths might be helpful.
- So, I did it all, and doubled down on the meds, taking the dose morning and evening. Handled 800 mg of Mg with no probs: 4 tabs of Doctor’s Best High Absorption Magnesium (200 Mg Elemental).
So, I got the job done. Where I go from here, not sure. Hard to know how related it was to the chronic pain, combined with the trepidation of spinal surgery. Now that both are behind me and I’m moving to a less-stress environment, I guess I’ll wean off the meds, keep up the Mg, and keep monitoring to see how it goes. And who knows, my two daily ocean swims and lots of sun exposure might help too.
So, day of surgery, I kept reminding myself that while the team doing it “works for me,” I’m putting my life and well being in their hands. So, don’t be one of those pissy, demanding patients. You know what I mean. And I also thought the best way to distinguish myself would be banter, get everyone lafing. So, for instance:
- Religious preference or tradition? “Human Sacrifice.”
- What’s your name? “It’s Usually Suspected to be Keyser Söze.”
- What procedure are you here for? “Breast enlargement.”
- Wife’s phone number? “408-666-xxxx. She’s a real devil, and if we ever get a divorce, I’m asking for her number in the settlement” (as I show her my cartoonish devil tat on my shoulder). That one really got the head nurse chuckling. She kept repeating it, chuckling.
- When they strap the identity band around my wrist: “Now if things go south,” I ask, “do you just cut it off and tape it to my big toe?” ”No, there’s a separate toe tag for that,” she replies, smiling.
- Then she explains the color code to Beatrice for the status monitor out in the waiting room…pre-op, operating room, recovery, etc. “What’s the color for the morgue?” I ask.
- “Do you know I came out as a heterosexual when I was 7 years old?” Girls had cooties up until then.”
- And so on, polishing off with self deprecation. “You know what’s the funniest thing about me? That I think I’m funny.”
Anyway, it wasn’t without a complete absence of altercation, once I discovered that one of the IV bags was a wide-spectrum antibiotic, specifically touted as prophylactic. I tried to decline it and initially the nurses suggested I could do that. Just then, Dr. Sheridan stopped in to mark the spot, and I asked him. “You can decline it, but I won’t operate on you. It cuts the post-op infection rate by 50%,” he adds, which at first glance sounds reasonable. To his credit, he gave me the rest of the context. “With it, infection is 1%. Without, 2-3%.” So, to me, a 50% distinction without much of a difference. Beatrice added that I was worried it would trash my gut. “It might,” he said, “but you do not want to get an infection.” I wish I’d have added that I’d gone to great lengths to get it into shape and had reduced various auto-immune conditions such as sinus allergies and Hashimoto’s, and that a 3% risk would be acceptable to me in that context. OTOH, my bro got a blood clot in his leg following the surgery, the coumadin prescribed opened his incision, it got infected, and earned him a 10-day stay in the hospital—with lots more and stronger antibiotics. Not fun. Of course, I’m doubling down on the probiotics and prebiotics, now.
Next was a visit by the anesthesiologist and after the obligatory passing gas joke, he noted the Fitbit Charge HR on Bea’s wrist. “Does that one measure heart rate?” he asked. “Yep,” I replied. “And, I just got it last Saturday, loved it so much I ordered up the Fitbit Surge Fitness Superwatch and gave this one to her.” “It’s a hand-me-down,” Bea says. Anyway, he explained that a few days earlier, he had a chance to compare their own finger-clamp monitoring to the Apple watch, and it was within 2-3 bpm accurate. He was interested in checking this, so he hooked me back up to the monitor, I strapped on the Fitbit, and 86 to 86. Dead on. BTW, Bea’s heart rate averages 65 bpm and her blood pressure, 110 / 70.
Then Stephan from Uzbekistan wheels me to the OR and introduces me to the team. This is a brand new hospital and the room is tiled with huge flat-screen monitors, with even more suspended from the ceiling. My various MRI imaging is displaying all over the place. These folks are pure pro. I was so dammed impressed by every single one of them, especially given the hours, stresses, and disappointments that must come with the job. So friendly. I remarked: wow, wouldn’t it be nice to have Internet and one nurse, with a few clicks of the mouse, brings up YouTube, asks what I want. “Search for brain surgery vs. rocket science.”
So, I get a good laf out of the whole OR team. Perfect! Then, she asks what music I want to listen to as they make final preps. I say Rush, so she creates a Pandora station and we’re rocking to Spirit of Radio in the operating room, with her adding: “good choice!” How cool is that?
The anesthesiologist places an oxygen mask over my nose & mouth, I adjust it a bit. Then, a few minutes later, in his Asian accent says, “goodnight Richard,” as I feel a slight burning sensation at my IV point of entry. It was 12:20 pm, to the minute of scheduled time.
A couple of minutes later I let out some coughs. Seeing that I’m still on my back on the gurney, 30 degrees oblique to the operating table, I ask, “so when do we get started?” Everyone lafs. “We get that all the time! You’re done! I look up at the clock and it was 2 p.m. An hour and 40 minutes had passed, with the surgery itself lasting about an hour. Then I realize why the coughs. I have a sore throat from the intubation.
So, a bit groggy for another 30 minutes as they wheel me to the recovery room. I have to pee, which is a prerequisite to going home…that and walking. Nurse says she can bring a pan, and I can walk at 3, another 30 minutes or so. I decide to hold the pee and kill 2 birds. Then Beatrice and mom are led in, and I begin to realize I have no pain anywhere. Of course, I’m still doped, so we’ll see. Walk and pee goes off fine, Doc says that provided everything keeps going as planned, I can leave at 4:15. And that’s what happens, home by about 5.
I’d not ate or drank anything since about 10 p.m. the night before, save for a few oz of water to down the BP meds and Mg in the morning. On the drive back I begin to feel hungry, so ask mom if she could whip up some kid comfort food: Kraft Mac & Cheese (with butter and whole milk, of course), and her tuna salad (she uses sweet pickle relish in it) on white toast. I’d have had a glass of milk with it, but it would have clashed badly with my Seagram’s 7 & water. 🙂
Tonight is healthy fare: mom’s famous cabbage rolls, along with her mushroom rice. And tomorrow, it’s going to be stuffed bell peppers with mashed potatoes and caesar salad. I’ll picture those on the blog over the weekend.
Yes, I’m milking it for all it’s worth. And dad is here too, lending a hand. He did the shopping for that dinner while we were on the drive back.
So, zero pain, save for the incision and the throat, the latter now diminishing rapidly. I was so elated last night that I had to stay up until all vestiges of the drugs had worn off, just revel in having a new life. At 3:30 a.m., mom emerged from the guest room, scolded me, and so I finally went off to bed. I really had not taken account of how bad shit was and how I’d grown to just feel like I was used to it. Be careful what you allow yourself to accept like a pot of water coming up slowly to a boil.