Fight it

"Fight it," my friend exclaimed. I had just told her how I was feeling. Nobody, especially my close friends, wants to see me slide into the abyss once again. It's too dark. The road back is too steep and so distant. Certainly I'm not at all interested in visiting that space again, but I fear it's on the way. "Fight it," I scream to myself! Fight it! Simple. But is that all there is to it?

Those of us who know, know. It's certainly not as simple as that. In the best of times, it's not as simple as that. That's the myth. Fight and depression will relent. Peace, serenity and happiness will reign. That's the cruel, believable myth. And that's in the best of times. But that's not depression.

In depression's advantageous times, times like this, of injury or illness, when everything I typically use to cope, everything which brings me joy, and meaning, and purpose; battling depression is definitely not as simple as, "Fight it!" When removed from my joyful, meaningful, and purposeful activities, fighting is an uphill battle on a peg leg with one arm tied behind my back. It doesn't work. I flail, and fall flat, and suffocate in the mud.

Yesterday was rough. In my analysis, I realized this injury has disconnected me from everything I hold dear. My coping mechanisms, my life, are so distant they feel lost. I'm spending many, many hours alone. I've been disconnected from the very things which not only allow me to battle depression, but also allow me to be me. Working. Running. Biking. Hiking. Playing. Traveling. And taking care of my responsibilities. I'm on my own, which normally would be fine, but there's only so much (or in this case so little) I can do on my own right now. It's no wonder I've been sinking.

My friend's words keep ringing in my ears. "Fight it!" No, it's not that simple, but maybe I can do more than I've been doing. Maybe I've been too willing to wallow in what I can't do rather than what I can. I'm not a fan of self-pity. If depression is going to take me down, and I'm not saying it will, I at least need to battle. No matter my infirmities. I've got to fight.

4 Weeks Post-op

It's been 4 weeks since my surgery to remove the extruded portion of my L4 disc, 8 weeks since the original injury, and I'm trying my best to deal with a very slow recovery. Yesterday was a really tough day. After attempting to increase my level of activity just a bit, I again ended up in fairly significant pain. I saw my surgeon's physician assistant, and she assured me I'm doing as expected. She kept saying, "It takes time." Patience is not one of my virtues, I guess. I really expected to be further along the road to recovery by now, and I certainly didn't expect to continue having so much pain.

Pain is discouraging and frustrating, but I did get some good news yesterday. The physician assistant cleared me to begin walking for exercise, as my pain allows. She also cleared me to begin gentle physical therapy strengthening exercises. I still can't work, as I continue to have significant lifting restrictions, but I'm happy to be cleared for increased activity. I just hope my pain will decrease and allow me to do what she's now granted permission to do.

On another front, my date went well. It was fun. Beautiful evening, great stadium, and our team won with a walk-off home run in the bottom of the ninth inning. We'll see where things go from here. We may just continue to be friends, I think, but one can never have too many friends. I'm proud of myself for pushing through my fears and going out at all. Fear gets me nowhere. Courage, on the other hand, can lead to great things. And I think we all deserve great things.

Confidence

It's a big day. I have a date. A what, you ask? Yes, I have a date. Believe me, I'm just as surprised as anyone. An acquaintance I've known for years called me out of the blue a few days ago. He asked me out. We're going to dinner and a baseball game tonight. I'm excited, and flattered, and scared to death!

My crisis of confidence began as soon as I hung up the phone with Mister (obviously, not his real name). His call pushed so many fraidy-cat buttons for me. To name a few: I'm not a girly, girl. I have short hair. I don't wear make-up. I don't polish my nails. I don't even own a dress. I had a hard time even finding something sort of appealing to wear. If I'm not in my work clothes, I'm in running gear or sweats. Which begs the question, what does he see in me? Don't men like all of those things?

I know some men don't necessarily care about girly-ness, but the bigger fear dating brings out in me is one in which you all may identify. Depression. I've been thinking about it a lot over these last three days. I feel defective. Depression makes me feel defective. On some level I know I'm not, but that isn't necessarily going to be the opinion of everyone. Deep down, I guess I still struggle with feeling defective because of my mental illness.

I've been battling the defective thoughts and trying to convince myself I'm actually okay for 3 days now. I've been reminding myself Mister wouldn't have asked me out if he didn't want to spend time with me. And he's certainly seen me in running clothes and a baseball hat more than once over these last several years. But that deep feeling persists. It's discouraging. And somehow I feel like I, of all people, a blogger and speaker attempting to wipe out the stigma of depression, I shouldn't feel this way. And that thought does nothing to quell my fears, no matter how rational or irrational they may be.

So my worry thoughts continue, but I'm trudging through and going on a date tonight despite myself. It's my first date since D and I broke up over 2 years ago. I'm going to say a prayer before I leave, do my best to stay in the moment while I'm out, and above all enjoy myself. I'll let you know how it goes.

Healing?

I feel better. No, I don't. I'm healing. I'm not healing. My pain is improved. I'm in more pain. I'm moving better. No, moving hurts. And so it goes. Over the last 7 days I've yo-yo'd back and forth from feeling like I'm on the path to recovery to feeling like recovery from my back surgery is yet a long way off. It's been a bit frustrating to say the least.

One step forward, two steps back. That's how I began the week. On the heels of feeling better, I had a pretty big setback in my level of back pain. I began taking my pain pill again, and things slowly improved. As things improved I increased my level of activity. As I got more active my pain increased. By midweek I was really discouraged. Discouragement is not good for me.

Increased discouragement caused my mood to crumble. For a few days I had two things to battle, a painful back and a poor mood. I'm happy to report I got out of my house and socialized at least once each of the past three days, and that has helped my mood. I'm so grateful I have friends who sensed I needed to get out and offered me opportunities to do so. I do feel better.

I feel better mentally, and as I sit here right now my back pain is also improved. It's tolerable. It's not gone, but I'm again weaning off the pain pills without ill effect. That's encouraging. I'm trying to be a good patient. I'm trying to be patient. I've increased my activity but not a lot. I'm taking it more slowly than I did previously. It's still tough, mentally and physically, to have so little to do, but this too shall pass, right? This is temporary, I have to remember that.

Boredom

I confess. I'm not being a good patient. I'm so damn bored, I can't help it! It's just me, and Jet, and four walls for 90% of every day. It feels like my house is closing in on me. I try to find reasons to go out, but when you're not allowed to do anything and have no money to spend there aren't a lot of places to go. I'm really having a difficult time with all of this excess time. So I confess, I've been a bad girl.

I've been a bad girl, and unfortunately I think I'm paying for it. I began doing exercises for my weak left leg last week. Those went well, no ill effects, so I added some gentle peddling on my stationary recumbent bike. Just 10 minutes, gently, and that went well, too. I was walking half a block several times per day, as instructed, so I added a few sessions on the Alter-G, anti-gravity treadmill. I walked at only 40-45% of my body weight, not too strenuous, and that felt really good. I was actually able to walk, to stretch my legs, for 20 whole minutes! I think that was fine, but the back strengthening exercises I added a couple of days ago, I think those were ill advised. That's where I might have overdone it.

Don't tell my surgeon, but I think those back exercises have caused an increase in my left low back pain. I wasn't having any back pain, just left leg and foot pain, prior to the exercises. Now my back hurts again. I think I overdid it. I spoke with the surgeon's nurse today regarding another issue, and she reiterated my movement restrictions. She said something like, "The doctor doesn't want you to do anything more than short walks.Your back muscles, the area around your spine, and the nerve all need time to heal." Oops. Bad patient.

I guess the surgeon does know best. It seems I've set myself back a bit. So despite being bored out of my mind, I guess I'll sit on my duff for 95% of the next few days. Ugh! At least The Tour de France is on television, and I love to watch Le Tour, but that only covers me for a few hours. I should try to read a book, but I'm just not into it. It's strange, I know. I love to write, but I'm not a big book reader. Short attention span, I guess. Tomorrow I've got vacuuming and picking up dog doo to look forward to, and truthfully, I'm probably not allowed to do either of those activities either. But some things have to be done. I promise, doc, I won't do anything else! Really. I don't want to set myself back any further. Boredom, I guess, is here to stay.

Learning has occurred

It's not very often I find myself glad to be wrong, but this is one of those cases. The pain I wrote about in my last post has gotten better. I followed the instructions of the surgical nurse I spoke with on Friday. I took my pain pill as prescribed for three days, and what do you know? My pain progressively decreased. I'm relieved. I'm glad I was wrong, and better yet, I'm happy to report I even learned something from this experience.

It's always good when learning occurs at my advanced age. (Insert smiley face emoji here.) Like me, my mother was dubious as to the nurse's simple instructions. She couldn't believe that's "all they were going to do." As I tried to calm my mother's concern, I said something aloud which I had never thought about previously. It went something like this, "Well mom, even though this pain is unique to me, it's probably not unique to them. They've probably heard this hundreds, if not thousands of times, and they know from experience my pain will get better if I just do what they recommend." As I said it, I felt a knocking upside my head. Wow, I thought, that was really profound.

The knocking upside my head occurred because I realized I've been in the surgical nurse's shoes hundreds, if not thousands, of times with my own patients. The complaints of my patients, which maybe I dismiss without enough compassion, are unique to them. For example, even though I've seen thousands of total knee replacements, and I know exactly the various pains my patients may experience, my patients don't have that knowledge. I know which of their pains is normal, and I know that pain will improve if they do as I recommend. I see their entire course of recovery, and I know how the story ends. They don't. I need to remember that when I return to work.

I need to remember what I just taught myself. I think I do a pretty good job of empathetically communicating with my patients, but there's always room for improvement. When I return to work I need to be kind, reassure my patients, and be careful not to come off as dismissive. I don't want my patients to feel like I did on Friday. I don't want them to feel dismissed when they express concern over a symptom, unique to them, which I've heard many times before. Reassurance is important. From now on I will do my best to provide more than just instructions. I will work to reassure my patients, too. Whether suffering from pain, illness or depression, isn't that what we all crave?

Pain

It's been a rough couple of days here. My back appears to be healing, at least in the area of L4 where the surgery was performed, however I now have increased pain a few vertebrae below L4. It is significant pain, too. It hurts just to the left of approximately S1, the uppermost vertebra of the sacrum. It's been difficult to find a comfortable position, and the pain is waking me several times a night. I called my surgeon's office yesterday. The nurse I spoke with assured me it was likely pain related to my surgery and encouraged me to be more consistent with taking my pain medication. I hope she's correct, but I fear she isn't.

I'm pretty sure this pain is not related to my surgery. I think it's part of the original injury but at a different vertebral level. I complained about this pain a few days prior to my surgery, which is when it first presented itself, and was told it was likely referred pain from my L4 injury. I was hopeful they were correct then, too, but I don't think they are. This pain feels different and acts differently.

Despite my concerns, I did as told yesterday. I took my pain pill every four hours as prescribed. It didn't seem to make a difference. Now it's the weekend, and I hurt. I'm doing what I can to relieve the pain and remain as active as possible, within the limits of my post-operative restrictions, of course. I'm taking my pain med regularly, icing my back, walking half a block, and strengthening my left leg as best I can. I really hope this pain subsides, as my surgical team assures me it will, but I remain dubious. I'm already anticipating I'll be on the phone with them first thing Monday morning. I just hope they listen.

Recovering

I'm home and recovering from my back surgery. My surgery on Monday went very well. The surgeon was able to remove a larger than expected L4 disc fragment, which had already calcified, without having to cut through the vertebra. So I still have all of my vertebral bone intact. Usually the surgeon needs to cut a small window in the vertebra in order to reach the disc fragment, but my disc fragment had extruded so far laterally, he was able to get at it without having to cut through the bone. I think that's a good thing.

I woke up in the recovery room relieved. I was able to wiggle all my toes. Paralysis, though only a 1% risk, was possible. I was in pain, but the pain was almost all in my back rather than in my left leg, so that was a good thing, too. As I sit here right now, my left leg is pain free and the numbness and tingling I had prior to surgery is almost gone. I'm thrilled.

My strength, too, is returning. My left quads and hip seem to be back to nearly full function. They are less weak than they were prior to surgery. I continue to have foot drop, but I knew the foot drop would likely take several weeks to resolve. I'm hopeful that's the case, and anxious to regain that strength. Foot drop is now the only thing between me and eventually running again.

I have a ton of movement and lifting restrictions for the next 12 weeks. That's going to be tough, but I'm going to do my best to be a good patient. I've already gained 3 pounds, and things that used to be muscular, like my tummy, have gotten soft. As a runner, that's really difficult to deal with. I guess I'll just have to quit looking in the mirror for a few months.

The only exercise I'm allowed right now is taking very short walks multiple times per day. Sounds easy, but so far, it hasn't been. I get really tired and really stiff after walking just half a block. Jet, too, is going a bit nuts. I feel really bad, as there's nothing I can do to relieve his boredom. I can't even take him on my short walks. If he pulled suddenly, I'd be screwed. I guess we're both going to be soft, heavy and stir crazy by the time I heal.

It's going to be a long road, but at least I'm on my way to healing now. I'm moving in the right direction, and there is an end in sight. That's way better than what was happening over the past 4 weeks. I'm grateful for that, and I'm looking forward to eventually getting back to my life. Despite everything, my life is good. And I'm hopeful it will only get better from here.

Surgery scheduled

The saga of my back will continue for another 12+ weeks. I am scheduled for back surgery on Wednesday, June 21st. Recovery and restrictions after surgery will last at least 12 weeks. The surgery will be a minimally invasive procedure to remove the extruded piece of disc currently displacing my L4 nerve root. There are lots of risks, of course, but they each occur 1% or less of the time, and the chance of never regaining my ankle flexion is high if I don't have the surgery. I can't run with foot drop. There is a chance I will not regain my ankle flexion even with the surgery, but surgery is the best option to make me a runner again. I can't imagine my life without running, so the decision was actually pretty simple.

I'm anxious, of course, about the surgery. I'm trying to keep the negative thoughts at bay. The thoughts of waking up in even more pain or paralyzed are the worst, but I push them aside, as I must, or I wouldn't be able to move. Even with no surgical complications, it will likely be a long time before I find out if I'll be able to run again. It's going to be a long road of re-strengthening what is now a very weak left leg. I've already lost so much.

Thinking about what I've lost, and what could have been saved if my MRI had been read correctly, and if I had been listened to by my inpatient treatment providers; it's of no use to me now. I sent a letter to the radiologist explaining the negative trickle down effect his erroneous reading has had on me and my care. I honestly answered all of the questions on the hospital satisfaction survey I received. I don't expect an apology. I don't need one. I did what I could. Now I have to work on letting go of my resentments. Now I have to face and deal with what I can control in today alone. So that's what I'm trying to do. Let go. Move forward. And pray for the best outcome possible.

UPDATE: Surgery moved up to Monday, June 19th. I'll let you know how it goes.

Spine Consult

It's hard to believe I've been dealing with this painful back injury for three solid weeks now. I'm beginning my fourth week without work tomorrow. I've been humbled by friends and coworkers who have mowed my lawn and arrived at my door with groceries and gift cards for gas. I'm so grateful for their generosity. I'll have to use my savings to pay the bills for as long as I can, but not having to worry about gas and groceries makes my life incredibly less stressful. At least I can go about my day to day activities without worrying about how much money is in my wallet.

I'm hoping for a quicker resolution to my back injury after seeing a spine specialist on Friday. During her exam there was no denying my pain, left leg weakness, loss of sensation, and loss of reflexes. She referred me to a surgeon. I see him this Wednesday.

Surgery is the likely option now, as my symptoms have continued to worsen. If the surgeon agrees, I'm going to push for surgery before the end of the week. Each passing day brings greater and greater apprehension for me. I can hardly control the worry thoughts. The longer this goes, and the weaker my leg gets, the less likely I am to have a full recovery after surgery.

A full recovery would mean the return of all of my leg strength. At this point it's possible that won't happen, even after they surgically relieve the pressure on my L4 nerve root. If I don't regain my leg strength, I would either not be able to run as I wish, or not be able to run at all. That thought scares me out of my mind. If I had the choice I would rather lose my home than lose the ability to run. A roof over my head can be replaced. The peace, serenity, joy, and drive I get from running can't.

That pretty much says it all. I'm scared, really scared, and anxious to get this thing fixed. I'm dealing with the pain. I'm doing my best to combat the inevitable progression of the weakness. And I'm continuing to attend to my responsibilities as well as I can. I'll let you know how it all goes. And if you're into prayers, I'm take them.