I saw Dr. Bernie, as everyone apparently calld him, at the SSIC in late August 2011. He checked me over and was fairly concerned after he had asked me to stand on my toes, and I couldn't. Neither could I lift my toes off the floor and stand on my heels only. While he had me lying down he held gently onto my toes and asked me to flex them up and down. I really couldn't. Right away he said he believed I had significant spinal stenosis, and would schedule an MRI.
We got the MRI done in less than three weeks at the Children's Hospital (CHEO) in Ottawa. It was fairly quick since the unit at CHEO was under-utilized and they were taking bookings early. Another visit to Dr. Bernie confirmed the diagnosis during which he referred me to Dr. Don Chow. Well, we sort of chose Dr. Chow since a) he had a great reputation, b) he is the Ottawa Senators' team doctor, and c) Heather had worked with him before when she was in the Diagnostic Radiology (fancy new term for X-Ray) department at the Ottawa Civic Hospital. He's the cream of the crop in Ottawa.
Br. Bernie also recommended some physiotherapy. Not that it would reverse the nerve deterioration in the lower legs, but that it might strengthen my back and core muscles which would help take some pressure off and protect things a bit better over the long haul.
The consultation with Dr. Chow was a few weeks later, and re-confirmed the diagnosis and he spent a lot of time showing me the damage to the spinal cord and vertebrae in the MRI views - like I would know the difference.
The last thing that was needed was to get into a pain management center to start getting cortisone shots in the spine. Unfortunately the waiting list is lengthy so it wasn't until January 2012 that I was able to get the first injection. The cortisone shots were administered by Dr. Stephane Legault at the Montfort Hospital.
I have to say that Dr. Legault is amazing - really I did not feel a thing - it was less painful than a regular blood test. Here's how the procedure goes: you sit on the edge of a bed bent over with your feet on a stool and a pillow across your knees , your shirt pulled up and your pants loose and down over your hips - just so you show your plumber's crack :-), the area is swabbed with a topical anesthetic, then a small needle with a local anesthetic freezes the tissue, then finally the big boy 4mm howitzer needle is driven into your spine with a ball peen hammer and a half litre of cortisone is squirted into your back blowing out a few disks in the process and forcing cerebro-spinal fluid shooting out your ears and causing temporary blindness, vomiting and a C4-level explosion of pain in the brain which makes you scream like a little schoolgirl!
Not really - just checking to see if you're paying attention. I'll bet you were wincing back there eh? Your sphincter tighten up just a bit? Come on, admit it!
Actually there is only a mild sensation of pressure in the area of the shot, which is administered with a fine needle and only a few CCs of cortisone.
They can only give the shots 3 times a year, so I had my second in July and the last in November. The effect on the shot was for me, immediate and lasted a good 4-6 weeks before some of the old pain started to return slowly. It was indicated that your level of activity or strain may dictate how much relief you get and for how long. I tried it both ways active and passive, but it was fairly even for me.
The pain is mostly managed by Naproxen for inflammation (spiked with the odd Ibuprofen) and T3's. Initially in 2011 I was prescribed Percoset, but stopped taking them after falling asleep everywhere - in the middle of a conversation, driving, on the john, in bed - whatever. I decided I was not comfortable with those side effects and opted for extra T3's. Right now it's been almost 8 weeks since the last shot and I average only 1-2 T3's a day.
For me, the pain is no longer the big concern. It's there and constant so you kind of get used to it. My concern is the slow and steady deterioration of the motor controls of my lower legs. I guess it's that part of the spinal cord & nerve roots that are compromised. My inner sense of balance is still very good, but my nerves are unable to properly utilize the little muscles in the lower legs and/or be aware of what they are doing so as to control them. As a result my thighs and buttocks are constantly tensing in an effort to maintain my centre of gravity, a job they are not designed to do and which explains why they are always aching and throbbing.
I was also getting numerous full-on muscle spasms (cramps) in my lower legs, usually at night lying in bed. It seems that once intentionally or accidentally causing a muscle to contract, e.g. by stretching or flexing, or just the weight of the sheet, the nerves do not know the muscle position and allow the muscle to continue contracting until it spasms. Man - those suckers can be painful, I tell you. Watching your foot arch into a curve so tight you look like an ape and think you could hang upside down on branch with it, or the muscle in the front along the shin bone bulge out like an egg - again squeeling like a schoolgirl. Well between the tears squeezing out and the cursing and hopping around like a maniac one can get a little frustrated. No?
Lately I've been so aware of every tiny little muscle twitch I've been able to wake up and move my leg or foot around back and forth quickly, which seems to confuse the nerves and eventually things seems to settle back down to quiet chaos. Having to be that aware does not help in getting a good nights sleep.
So really, surgery is not an option at all. At the rate at which I am losing muscular control, I could be in a wheelchair in a few years. So here we are, three days before surgery. I'll toss in one more post tomorrow summarizing my pre-op visit last week and the brace fitting.
Later.
No comments:
Post a Comment