Now the rest of the story….

January 17, 2007

Uncategorized

I normally pride myself on having a high pain threshold. But over the past two weeks my pride has been dampened significantly and I now feel like I have no thresholds at all.

So that my last post (email to work) makes any sense, here’s the context! (the really really long version)

Thurs the 4th I was walking downhill to my car in the morning in the rain and slipped on wet concrete. Because of the hill, almost all of the sidewalk concrete is deliberately textured, which usually prevents any slippage, even in the rain. However, there is one square of sidewalk that is completely smooth. I don’t know why, it’s a total hazard. We’ve all slipped on it before (small slips with no injuries), even without rain on the pavement. That particular morning it was hard to avoid as there were trashcans and such on the good part of the sidewalk. It was a true slapstick moment – I stepped forward on my left foot, got no traction whatsoever, and both feet flew out in front of me and I landed hard on my sits bones (or ischeal tuberosities for those of you who care for the real names of things).

I got up, was in immediate pain, but didn’t think much of it and decided to “walk it off” and went to my car. Getting in was intensely painful, but I still didn’t really think all that much about it. Got to work and getting out of the car was even worse than getting in had been… and I began to worry. After sitting at my desk for about 30 mins or so with the pain increasing steadily, I made an appt w/ my primary doc.

She sent me home with anti-inflammatories and vicodin, and told me not to move for about 4 days. Also, I had contracted a urinary tract infection on top of everything else, and so got some antibiotics to put that to rest. I followed the doc’s advice, but the pain was still really bad, even through the vicodin. At a follow-up appt, the doc put me on oral steroids, thinking that this would be more effective than NSAIDs, so I took Medrol for 6 days, along with a Percocet upgrade from the vicodin, and another prescribed week away from work.

That Thursday night, for reasons unknown, my esophagus decided to stop working. It was bedtime and I took my pills, and they got stuck. Not in my throat, but in my esophagus, about the same level as my heart. I couldn’t do anything to make it go down, peristalsis just wasn’t happening. Liquids would go ok, but nothing else would go. The pain got intense, and of course I panicked as breathing was becoming difficult. I woke SDG (Safe-Dancing-Guy) up to take me to the ER. Just as we were finishing throwing our clothes on and discussing where the nearest ER was, I started to feel the need to throw up, which was actually a relief on some level. Made it to the bathroom, but then nothing would come up and the pain was something like I’d never felt before. Finally, and unexpectedly as I was about to give up and have SDG take me then and there, I projectile vomited my shoes. Well, not my shoes of course, but whatever was stuck in my esophagus as well as everything else I’d eaten that day. One of SDG’s roommates (present in another room at the time) remarked that he had never heard anyone puke so violently (and this is a guy who would know, it’s a long story). Anyway, with the puking done, the pain was still in evidence, even though I was pretty sure that nothing was still stuck, so we went to the ER anyway. The ER staff was all very kind, and over time while I was waiting to be examined the pain started to lessen. They ended up giving me lidocaine to swallow, along with maalox (sp?) to calm everything down. They weren’t very interested in the cause of the initial blockage, but told me to go the liquid diet route for a couple of days so as not to tempt fate.

Saw the doc again this Monday, and was in such pain (ass and legs, not esophagus) that I was crying on the table. She immediately ordered the CT and got me a referral to a Phys Med specialist. Everyone at PAMF was really on the ball. They got me into my CT that afternoon, even though they had no more appts (they just squeezed me in quickly when they could). My CT tech, Judy, was really nice, and we bonded a bit since I work on the software she uses to do her job.

With the CT over, SDG picked me up and drove me home like the sweetheart he is. Actually, an aside here for a moment as I brag and publicly (as much as this is public) thank SDG for being so fantastically wonderful through all of this. He’s practically waited on me hand and foot, kept me calm during the pain when I was really at my wits’ end, and massaged and coddled me. While I hate being so incredibly dependent, I’m so happy and feel tremendously lucky and thankful that I have SDG here for me.

The specialist was able to see me yesterday — also amazingly quick given the schedules of these doctors. he bent me around — “Does this hurt? How about this? Hrm… does this hurt?” He was business-like, but still gentle, and didn’t seem overly in a hurry, even though I know he had other people waitng on him. He got my lying comfortably on the bed and went off to go over his findings and come up with a plan. He came back in not much after that and proposed to give me Oxycontin for the pain (less because it’s stronger than percocet — which it isn’t depending on the dose – but because it’s extended-release so that I could take less pills but still be assured of coverage. He gave me leave to augment with my percocet if I still needed to). He also decided to give me a stronger anti-inflammatory now that I was off the steroids that hadn’t seemed to help. In addition, he suggested that he give me a caudal epidural. That’s when they find this special place near the base of your back, stick a needle in until it makes contact with a special part of your spinal cord, and then they pump in a little anesthesia, and a lot of cortisone. On top of all that, he gave me pills that are used to relieve pain from nerve damage – he said they might help since the majority of my pain is nerve (sciatic mostly) pain. He gave me a large sample pack since he said my insurance may not cover that particular drug. Awesome. I must’ve looked so pitiful or something, ’cause he was so nice and I couldn’t believe all the treatment he was piling on.

He was able to to the epidural right then and there. It was really weird. The got me in a room with an x-ray machine that they used to make sure that they had inserted the needle in the right place. I’ve had cortisone shots before, in my foot, and so I had a general understanding of what it might feel like, and the doc was nice and told me what to expect as well. But let me tell you, it was something unlike I’ve ever experienced. I can’t say it was painful exactly – it was more like it was extremely uncomfortable, and I have trouble finding words other than that to describe it. Imagine — you’ve got your spinal fluid, and it exists at a particular pressure. Then someone sticks a needle into you, and without removing anything, injects more fluid (at a temperature that is colder than your internal temperature by far). It is absolutely the weirdest sense of pressure at the base of your spine. Crazy.

Then the doc ordered two MRIs. One stat – to check out my l4-5 vertbral dics to see what’s going on there to cause the sciatic symptoms. The other is to check out an object that they found incidentally on the CT while looking for fractures. They’re not sure if it’s a sacral foraminal mass, or a tarlov’s cyst. Neither of these is really a great thing, so I’m pretty damn curious to see what they find out.

In any case, the great people in Radiology (who know me by name now since the same tech that did my original CT helped the doc do the epidural) managed to squeeze in my stat lumbar MRI that night at 7:30. They we really going out of their way to take care of me. And wonder of wonders, they were able to schedule the second MRI for next Wednesday. I’m still in shock at how quickly all this is happening.

In any case, I did the MRI last night, but am still waiting on the results from that. Meanwhile, I’m attempting to work from home during my drug-induced haze. Last week I was on the narcotics (downers) and the steroids (uppers) which sort of cancelled each other out in some senses, so I was weird, but not excessively sleepy. This week it’s all narcotics and NSAIDs… nothing to speed me up so I’m always having to force myself to focus and not fall asleep. It doesn’t help that the least painful position to be in is lying in bed — that makes me want to fall asleep when I’m not on meds.

So there it is. The current situation. If any of you have dealt with this kind of thing before and want to impart wisdom, I am all ears.

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