Tuesday, November 09, 2010

Spinal Confession

There are only two ways of telling the complete truth -- anonymously and posthumously. -Thomas Sowell

One of my very closest friends once commented that he had learned more about me from this blog than he had from nearly twenty years of face-to-face conversations. I plead guilty to being circumspect about my personal life. Another friend observed that I never actually avoided any conversation but after an evening of discussion I may have spoken in depth on how early Aegean cultures felt about a certain issue but he still didn't know my personal feelings on the subject.

Today I make a leap of self disclosure. I am doing this is response to a confluence to two factors. First, I have had conversations with both friends and family in the last two weeks in which I have hidden my current physical condition from them. Second, several of my dear friends have pointed out that such behavior may be less than optimal for everyone and with the deepest respect they told me to knock it off. After much reflection I have come to believe them to be much wiser than I on this issue, therefore I am going to change my behavior. So here goes:

In the fall of my sophomore year in high school it appeared that I had suffered a back injury while playing football, I was 14 at the time and the problem was misdiagnosed. The x-rays were read without my age being attached and the assumption was made that I was an adult male instead of just barely a teenager. For several years I took many aspirin a day for severe rheumatoid arthritis; a disease seldom found in young adults. Later in college I was reexamined by an orthopedic surgeon and father of a close friend and received my true diagnosis.

I have a congenital malformation in the small of my back. A teenage growth spurt and not football had been the aggravating factor. The facet joints at L4 & L5 (lumbar) on my right side are not well formed and do not perform their structural function of providing full range of lateral motion. I have been aware of this problem every day for the past 48+ years. Mostly I have kept this information to myself but the problem has become more acute in recent years. 

Last week the pain became so severe that I had to make my third trip to an emergency room for narcotic induced relief, the previous ER visits were in 1974 and 1986. Other than these three occasions I have managed the discomfort with exercise, pain meds and bed rest. I have missed scores of social events, dates, even intimate encounters over the years and used a variety of excuses other than the truth about my back to cover my absences. With the helpful yet still annoying prodding from several friends I have decided to stop deflecting sincere concern from those in my life, that process begins with this disclosure.

I won't bother with a complete history of my back pain, instead I will focus on my current situation. The most recent ER visit was two weeks prior to the date of this posting. I had been unable to stand upright for about 36 hours, getting out of bed was a full ten minute ordeal, any activity below knee level was simply out of the question. I had spent the better part of one entire day on the floor. Many thanks to M for getting this bound up old man to and from the hospital. As an aside, I apologize to anyone I spoke with on the phone that first week; I probably do not remember what we spoke about and I just wasn't ready to talk about all of this just yet. 

Once the ER physician heard the clinical details of my history and recognized my depth of understanding of the problem, we concurred in our diagnosis. The short term solution was to break the cycle of pain and spasm with major drugs. I was given injectable Dilaudid and Valium. Twenty minutes later the doctor returned to find me standing, back against the wall, a position that offers some short term relief, with obvious surprise he said: "I have never seen a patient standing after that much Dilaudid." I mention that part of the story because in the realm of silver linings, it appears I can now tolerate high dosages of pain medication without the buzz usually associated with them. And while that doesn't sound like much fun . . . I am now able to use Oxycodone on a regular basis to minimize the pain without being mentally altered.

One week later (a week ago today) I met my new primary care physician and fortunately found another doctor who recognized that I really am an educated adult able to understand and articulate my somatic issues and we rather quickly agreed on a course of treatment. I now have pain pills, pain patches and muscle spasm prescriptions with refills and liberal dosage limits as needed. Also I have a referral for physical therapy and once I am past this critical period we will go for a complete physical and perhaps even an MRI peek at my lower back before reassessing my condition.

For now, thank you for listening. I shall attempt to be more forthcoming about my condition, including public updates here on the blog, perhaps once a month in the near term. I would make one point from my decades of experience with a persistent medical condition -- anyone who has a chronic condition literally lives with it every day; talking about it is often simply tedious and annoying for us. I will try to be more open in conversations with my family and friends, if you will try to remember not to see me as merely a degenerate spine or a weak back. Illness, chronic injuries, syndromes are only one aspect of a person's being, but quite often the sickness becomes an all-encompassing label and the person begins to fade away.

My sincere appreciation for your concern, prayers and invocations; yes I will be availing myself of the myriad of interventions not found behind a medical school diploma. I am as open to a shaman's smoke as I am to a doctor's prescription pad.

7 comments:

Anonymous said...

Hmm... the cat prescription used to deal with this... perhaps it should have been a Maine Coon cat dosage all along.

mattg

SirFWALGMan said...

hope you get well soon.

mira amiras said...

I'm hoping the new openness extends to non-ailments as well! Methodologists are shit for self-disclosure.

indigenize said...

Thank you, Tim, both for the full story here and more, for your new intention to allow us who love you to not have to fight you to learn what's up.

And have no fear: I don't think there's any way we could ever see you as only a "degenerate spine." (Degenerate, maybe, but not only in spine. ) In return for your ongoing disclosure, I promise to never forget your fullness of being. Not a difficult thing to promise.

Smoke shop open upon request.
--Tina

Anonymous said...

Who's Tina?

Patricia said...

Ah, that explains so much. Chronic pain can so often warp all other response. So, how does perception shift with and without pain?

Jac57 said...

With severe degenerative disc disease, I absolutely 'feel your pain'. After a year on my back, I found an incredible pain management clinic that does radio frequency nerve ablation. It's a simple day surgery procedure. First time they zapped the nerves, I got 3-4 months relief. The second time I was relatively pain-free for 16 months! Had 10 facet levels blasted in Sept/Aug & I'm still feelin' good. This procedure gave me back my life!