Sunday, June 16, 2013

Continuing the process...

So here we are again. It's about two months since my surgery. Woo. At this point, I am moving around at nearly a "normal" level in most situations. Driving gives me no significant issues, contrasted against when I first started driving after the procedure. At that point, I was still very stiff and could only drive after much effort of getting into a vehicle. Anyway, as I said, I'm now able to get through most situations in a normal fashion. I can go grocery shopping, pick up the baby, and have sex. (Though we'd made sure that still worked a while ago. Indeed.)

 So now, two months out, my focus has shifted from the recovery mode of making sure there were no major complications from the procedure and regaining the minimal level of movement to now looking to start back on a path to better overall general health and fitness.

Before the surgery, I had been doing a regular resistance training routine from which I had started to see some good results. I am going to be getting back into that starting this week at the office. Now, some would be skeptical of "starting this week" when said regarding a fitness routine, but in this particular case it becomes easier since there is a nice exercise facility at my office.

I've also started reading a book called "Foundation: Redefine Your Core, Conquer Back Pain, and Move with Confidence". This book emphasizes a particular methodology of movement and strengthening of the back, legs, and hips in a way that is supposedly more in tune with how our bodies were intended to move. The authors contrast this against how we Westerners typically move, emphasizing and over-straining the low-back via movement habits and lifestyle (long sitting, poor posture, etc.) I have to admit, from their ground-work laid out in the early chapters, they make a compelling argument. I've started some of the basic exercises they indicate, and I can tell it's utilizing my structural muscles in a different way already, even starting only today.  Based on the reviews on Amazon from actual readers and the glittery bits provided by celebrity endorsers in the text itself, I've got some high hopes for this material. Those high hopes also stem from the fact that the introductory material describing how they arrived at their conclusions on structural physiology really resonated with my own experiences during my struggles with back pain. I've always noticed how, even with having my share of physical therapy and medications, my back only got to a certain level of liveability. There were always certain movements that made me nervous because of how they felt; certain elements of my core strength never seemed to stabilize and improve regardless of activity level or attention. These are ideas that the authors address specifically, and indicate marked improvement for all of the users who follow the exercises properly. If all goes well, I hope to provide yet another glowing review. I wish this because if it's true, that means my back is stronger, my movement is freer, and my body is less of a problem for me than it once was.


Friday, May 31, 2013

"....uuuuppddaaaaattessssss....", said the zombie blogger.

Received the bill for my spinal surgery yesterday afternoon.

Cost of procedure: $53,213.18
Responsible amount: $150.00

Thank God, sense of relief, +1 for insurance, and all that.

Now that we've that detail out of the way, on to better news. (Well, better in a certain sense, but to be sure, it was really good news to not be on the hook for 50 grand.)

But what might to me somehow be better than that? I had a follow up visit with my surgeon last week. During the visit, he indicated things are looking good, right on schedule, healing nicely, etc. They took an x-ray to check the installation's condition, which he said looks good. So he then told me I could start riding my bike again. Granted, it's in a limited fashion at this point, because we're still waiting for a more complete fusion of the two vertebrae and for the muscles to fully heal from the procedure. But anything is better than nothing, especially after not having ridden much at all over the last two years.

In my excitement, I forgot to even ask him if I was OK for lifting things of any greater weight than I'd been allowed up to that point. You know, like kids and stuff. I called the office back to get that detail sorted out whilst driving to the bike shop. (Parenthetical Insertion: I did roll my eyes at myself. Priorities, right? You should have seen the look my wife gave me. But I'm really quite grateful at how understanding she actually is regarding, well, lots of things, but my need for cycling specifically in this case.)

Anyway after the good news, I did immediately speed to the bike shop and buy full tune-up materials.
  • new brake pads (kool stops all the way)
  • new cables and housings- brakes and shifting
  • cable lube
  • degreaser
  • drive train lube
  • new bar tape
 I then proceeded to drive back to the house, forgo my usual daytime sleep hours, and work on completely stripping my bike, cleaning every bit of it thoroughly, and putting it all back together. If as a cyclist you've never jumped headfirst into a full tune-up like this, I would highly recommend learning how and going for it. There's a very real, visceral connection that this somehow imparts. Though it's a pile of inanimate objects that have no intrinsic value, there's just... something... about connecting to the bike in this way. And one can easily find examples of this sort of idea all over the web, in bike magazines, etc. It's one of those things that's difficult to explain to "non-believers".

After reassembling all the bits, I had yet to tape the bars. This is one part that's as much a meditative ceremony as it is a maintenance procedure. Back into the house to scrub the grime, grease, and years of weariness off my hands and face. As the last wraps of tape were coiled on and taped into place, the fuller picture was revealed.

My noble steed was resplendent in its fresh cleanliness, just begging to go see places.

That first ride was rather a tenuous thing. At that point, my back muscles were still very tight from the surgery, still very sore, and I could only go down the street and back. I barely managed to get back over the lip at the bottom of the driveway. A pretty sad ride in most respects.

If felt like I'd learned how to fly.

Friday, May 10, 2013

So I guess part of "ethos" of blogging is to maintain some sort of regularity. To that end, here we are.

Today is May 10th, being roughly three weeks since surgery. My overall level of discomfort is much better, and I have been able to engage in some normal activities such as driving. That said, I'm still quite sensitive to various movements and can't bend, crouch, or stay in the same position for long periods of time.

Luckily at work, I have a convertible desk which affords me the luxury of either standing or sitting at my desk. My employer was gracious enough to provide this, much to my relief.

So... at this point I'm in a bit of waiting game. Just moseyin' along, waiting for fuller recovery to set in. Once I'm able to start moving a bit more, I am anxious to get back into my exercise routine and start feeling more vigorous again.

Starting back to work my regular night schedule at work on Monday evening. Did a week of day time this week to 'ramp up', so to speak. So at least starting work again is some kind of progress, and has gotten me feeling a little more human again.

But... nothing more at this point worth writing. More to come, I'm sure. I hope. Ok, maybe.

Friday, April 26, 2013

A brief update. This being Friday night, it is now roughly eight and half days or so since my surgery. 

All things considered (you know, like they cut my back open and all), I think I'm coming along well. I had a short ride in the car today to see how I would do, and it wasn't the worst thing I've ever experienced. Getting into the car, and for the duration of the ride, I was actually ok. Getting back out of the car, and for a couple hours after the ride, I was noticeably stiffer and more sore than beforehand. But, that's the nature of recovery- seeing how far you've come, finding how far you've yet to go.

On a good note, however, I've definitely noticed that, apart from the pain of the surgical site (which is not insignificant, to be sure) I have felt virtually none of the previous "injury" pain- meaning the stabbing, shocking pains that would trigger on certain angles of sitting or bending with my back. Of course, I've been limiting the bending, as in not, to be inline with my recovery guidelines. Nevertheless, I am very eager to start feeling more of what this is going to be like after the surgery pain has passed and the installation sets up more permanently.

From the first glimpses I've had, it looks to be quite refreshing.

Monday, April 22, 2013

Greetings and Salutations. 

So here we are, almost three and a half years since my last post to this blog. That last post was also only the second post on this blog. That would definitely qualify as "forgotten".

I have decided to try to pick up again for a couple of reasons. I am still dealing with all of the issues I had outlined in the first post in which I detailed my goals for this space. Over the last few years, I have made regrettably irregular progress on all those fronts. Here is that original list, with my current status inserted under each:

  • persistent back problems
    • this is the most significant issue; explanation following.
  • carpal tunnel syndrome
    • actually better on this bit; I have a standing desk at work, and have taken measures to ensure it's not gotten worse, and is usually  better / manageable. 
  • excessive weight
    • not doing so great here, due in large part to the back problems. Currently sitting at 210 lbs on the button. At least some portion of this weight increase is due to having started weight training again. I've been making somewhat regular use of our exercise facilities at the office, and have noticed decent progress in my overall strength and tone. However, I do indeed carry far too much excess weight around the middle. I've also been somewhat limited in how much training I could really do, because of the back problems.
  • strength
    • see above. Still needs work in several ares, most notably overall back strength and tone.
  • creativity
    • still fighting the everlasting fight. It comes in fits and starts. I've made some decent progress on some of my writing projects, but in a sporadic pattern. I still need to work out some actual regularity and start finishing those projects.
  • stress / depression
    • making some actual, real progress on this front. Several months ago, I had started regular meetings with an old mentor / friend to try to start addressing some of the long standing issues I've carried.
    • In the last few weeks, I have also started seeing an actual therapist on the advice of our family doctor. I had asked for some kind of diagnosis or at least thoughts on "my depression", and based on our conversation he referred me, insisting that he wasn't comfortable making a determination himself. Awesome.

So that's a high-level recap of where I'm at. Referring again to my back problems, which I indicated above are the most significant issue lately, there is progress and new hope in this area.

First, some background on the whole thing... It all started back in nought five whilst I was away at college. I had started a work out routine to "get back into shape", a not altogether shameful goal to be sure. Well, one evening during a workout, I had made the terribly stupid, rookie mistake of not wearing a support belt during some back exercises. During one rep, I felt a 'pop' in my low back. It didn't hurt in the classic sense, but felt "weird" more than anything. I took it easy for a couple of weeks and let it recover. I felt ok for a long time, but over the several years since that initial incident, it has steadily grown worse. 

It finally came to a head two years ago in the early spring. One morning as I was drying off from a shower I stretched out my arm to put my towel down on the sink. My back had been sore and rather tentative in respect to much movement and as I reached out to drop the towel, I felt a gritty, angry, and intense pop, much more intense than the original incident several years prior. It was audible this time too; sounded just as terrible as you would expect it to. As soon as this eruption registered to the rest of my body, I instantly, involuntarily fell to the floor in excruciating pain. I was unable to stand, and a white-hot, blistering pain spread from my low spine throughout my entire back, down my legs, and made it nearly impossible to think. I somehow managed to crawl into the bedroom and up onto the bed to try to stretch it out, but I could not find a position of any relief. Krista helped me work my way downstairs to try to get to the couch to lay with a heating pad while we decided what to do. However, when I got to the bottom of the steps, which according to Krista had taken almost an hour of backing down on my knees, I could not force myself to go any further. It just hurt too much. She ended up calling the neighbors, and eventually I got assistance (was carried) onto the couch. People have asked me what my "bad back days" feel like, and I always find it hard to describe or relate the type and intensity of the pain. I've heard certain types of pain be compared to child birth, for instance. I don't make that assertion myself, but I've heard it used before. Anyway, I don't think I could ever overstate or over-dramatize the intensity of the pain in that moment. I literally (yes, "literally") could not force myself to stand, could not take a full breath, had tears streaming down my face, and basically wished a train would run me over at any moment to ease the suffering. It was truly that bad. They say that memories of specific moments tend to be stronger when tied to intense feelings. I remember that day quite vividly. Hah.

I ended up in the hospital for several days, had consultations with pain management people and an orthopaedic surgeon. I went through six weeks of physical therapy to get back to a minimally functional state, roughly 80% of pre-incident function. All things considered, this wasn't too bad.

Fast forward two years. The condition of my back had steadily declined, despite my best efforts to assuage the degradation via exercises and stretching. I had another consultation with the same surgeon who'd seen me initially in hospital and a few times since then. He reviewed the latest MRI that he'd requested, and said that the disk was basically gone, almost bone-on-bone. For a spinal joint, that's bad, mmmkay? He also indicated that since it was only the one disk, others next to it appearing completely healthy, surgery would likely be a good solution. Had other disks in the area been showing signs of degradation, surgery would be much more risky, since there's far less guarantee of where the actual problem is. Being only one bad disk, it's much more likely that it of course is the problem.

So this past Thursday, I underwent what is known as an L4-L5 Lumbar Fusion. Short version: remove old, crusty disk material; insert spacer with added marrow to reclaim the gap between the vertebrae; implant screws and plates to immobilize the joint; sew it all back up; don't move much for several weeks. The goal here is to use the spacer/marrow combination to recreate the space between the vertebrae while at the same time initializing a growth process that will eventually fuse the two bones together, making a rigid joint around the spacer. The screws and plates are to keep everything stable while this process (which can take anywhere from six months to a year) completes.

I am now home on medical leave, spending my time laying down, or slowly walking around to try to maintain my limited range of motion. The first few weeks are the most tenuous and require the utmost attention to not over-doing it in terms of stressing the new installation. Roughly six weeks out, I can start introducing mild activities, and increase from there based on consultations with my doctor. He had indicated before surgery that he was confident I'd be restored to full function after the procedure, strictly based on a couple things: the nature of my injury (just one disk, presented symptoms, etc) and my overall general condition. With that prognosis, we (Krista and I) opted to go for it.

So here I lie, on the cusp of a new season. I am quite hopeful, if not a bit impatient, for what may be ahead.