Thursday, December 5, 2013

Bionic Woman

continued from part 2, HERE.

I did my due diligence, believe me.  Spinal surgery isn't something you jump into just because one or two specialists tell you to.  The first neurosurgeon I met with impressed me.  Kind, patient, thorough and smart he instilled confidence as he explained my options.  Despite having done my homework on the two surgical approaches, I learned quite a bit from him.  He did a series of neuro tests and we discovered that my walking had been altered, a fact I hadn't noticed.  It's strange how we compensate without realizing it.  He asked me to do the field sobriety test that police use, walking heel to toe in a straight line.  I flunked as I could not take one step without falling over.  I admit, it jarred me.

The pain in my neck, shoulders, and left arm had continued to increase daily and my right arm and hand is now symptomatic.  Although I hated to do it, I had finally accepted that I could no longer work and went on medical leave.  Though I had tried a long list of medications, I had declined pain killers any stronger than Ibuprofen, wine, and muscle relaxers.  Something about failing the walking test and the potential permanence of my condition led me to accept the neurosurgeon's suggestion that I try a nerve pain killer as well as a narcotic pain medication.  The good doctor ordered additional tests including a C-spine CT and X-rays.  In the meantime I continued to seek additional opinions.

Research kept pointing me towards Jefferson University.  Still, I met with another neurosurgeon that my neurologist had recommended.  He was very pleasant but was ruled out almost immediately as his medical group was not authorized to perform the type of surgery I was hoping for.  In most cases like mine, the bulging disc is removed and replaced with a bone graft either taken from the patient's own body, typically the hip, or from a cadaver donor.  The vertebrae above and below are fused with a plate and screws. This limits mobility of the neck.  Also, just as with my congenital partial fusion of C5/C6, the added stress on the bones above and below the fusion will begin to degenerate.  Additional surgeries are likely.  The other option and the one I prefer is an artificial disc replacement.  Just as with the fusion surgery, the bulging disc is removed.  Then a metal plate is secured to the bones above and below with a plastic ball in the middle creating a ball bearing.  Mobility is much greater and the stress on the bones above and below is not a concern.

This doctor agreed that artificial disc replacement was a good alternative and he began to think out loud of colleagues he could refer me to.  The first place he mentioned was Jeff (Jefferson).  I told him I was aware of Dr. Heller at Jefferson and his response sealed the deal.  "I couldn't be in better hands," he said.  He couldn't be happier that I would be with Josh, his good friend.  Dr. Joshua Heller was the first opinion I had sought.  Happy with the ringing endorsement, I was relieved to have made my decision.  Next was the CT and X-rays.

I've taken my meds as instructed, though they don't really make a dent in the pain.  The zapping electric shock in my hands has been unrelenting.  I constantly drop things due to weakness.  Simple tasks like washing my hands or buttoning buttons are difficult and increase the sensation. The meds have, however delivered their promise of weight gain as a side effect.  I feel like a hose has been plugged into my belly button as I've blown up at an alarming rate.  My face is as round as a cherry tomato.  My eating hasn't changed and I actually crave salad, but I am not able to move around much.  I've also developed twitches that occur while awake or asleep.  I get woken often by them and also by my jaw opening and slamming shut, sometimes catching my tongue to the point of biting into it.  This is likely caused by the spinal cord damage, almost like I'm getting erroneous signals from a fried wire.  So, I've done what anyone would do in my position.  I've watched all of the episodes of The Good Wife (prior to this season) and I'm on the last season of Breaking Bad on Netflix.

Mark is my Prince Charming.  He's everything to everyone in our little family, mostly without complaint though he has episodes of what he calls "Rage Cleaning."  I am grateful that he is on sabbatical this semester and able to take over for our family.  He not only shops, cooks, cleans, and chauffeurs the family, but he also spent most of Thanksgiving decorating for Christmas.  The outside of the house can be seen for miles and it is fabulous.

At my second appointment with my neurosurgeon, he ordered more X-rays as he needed additional views with my neck in different positions to gauge stability, so I headed back to radiology.  While waiting for him to decide if I would qualify for disc replacement versus fusion, I watched a few videos of the surgery on youtube.  Mark can't stand the site of a needle, so he thinks I've completely lost it.  I used to be squeamish, but having three kids and being a fan of horror films and zombie shows has desensitized me.  At one point I caught myself thinking of tandoori BBQ chicken while watching a disc being removed and it was my own thought that grossed me out.

My mentor, friend, and boss Diane picked me up at 7:15 am and took me to my pre-op appointment on Tuesday so that Mark could get the kids off to school.  At noon my friend Lauren brought me lunch and stayed with me through the many questions, poking, and proding.  These are the kind of Wonder Women that I draw to me.  I spent all day getting my blood pressure checked (3 times), giving my health history, list of allergies and medications, an EKG, a blood draw, and conversation with an anesthesiologist.  I even had a chest X-ray and I swear in the dark I emit a soft glow.

Mark's mom will be here for two weeks, thank the lord, though getting here has been it's own challenge due to fog.  Yesterday she had flight delays and cancellations, arriving in Chicago last night only to have her last leg cancelled.  She's in the air as I type.  She too is Wonder Woman.

My health insurance approved the surgery with a modest co-pay and the good doctor approved the artificial replacement.  There is a chance that once he gets a closer look, he may decide fusion is necessary, but he is prepared for it.  I have been carrying the CDs of the MRI, CT, X-rays and reports in my purse along with my health care declaration and living will for weeks, just in case.  My bag is packed with a change of clothes and toiletries.  I haven't eaten since midnight when I wolfed down a salad and a Little Debbie Christmas tree cake (don't judge) and I stopped drinking at 8:30 this morning.  I'm ready to go.

Recently we have been given hope that I will, in time regain what I have lost.  There is no guarantee but the dismal prognosis I had been originally given isn't a guarantee either.  It makes sense I suppose to prepare patients for the possibility of permanent damage but I don't accept that.  My surgery is at 12:30pm Eastern time today, Thursday, December 5th.  It is expected to take 3-4 hours and I will stay for one or 2 nights.  Mark will be joined at Jeff by one of our pastors and his mom and will provide updates through my ReJenerationS twitter account and on fb.  In addition to prayers and good thoughts, I have another request.  I'd like to keep Mark busy and laughing all day.  Either on this post in comments or on fb, please post jokes, funny stories, and videos.  I want him bombarded and distracted while I'm getting fixed up.

I'm not particularly scared.  I just want this over.  I've got friends and family all over the globe lifting me up.  I'm in great hands at Jeff.  I've got the good Lord on my side and plenty of work left to do on this earth.  So, me and my brand new Wonder Woman uniform (pajama pants, t-shirt and robe) are headed out the door.  After all nothing else would do.

Wednesday, December 4, 2013

Emulating Wonder Woman

continued from part 1, HERE

As a tot my heroine was Wonder Woman. Beautiful, strong, justice fighter and feminist icon, I didn't just look up to her. I wanted to BE her. According to family lore, my parents took me to Penney's to buy my very own Wonder Woman costume. This was in the late 1970s and I was about 3. They had other costumes in stock but not Wonder Woman. No other costume would do so I stood my ground and we left empty handed. My Aunt Sandy was living in Florida at the time and she went on a search and found it. Back then we had to wait for Saturday morning to watch cartoons. The way my mom tells it, I woke up early in anticipation of the show and put on my costume believing that it would give me the same powers as the Amazonian Princess. When my powers failed to materialize I had a complete meltdown, barging in on my still sleeping parents. In my first identity crisis I screamed in disbelief that it wasn't working and where was my invisible jet?!

I consider myself to be young, even at 37, with more of my life ahead of me than behind. My purpose here on this planet is to be a justice fighter and I accept that role with joy. When I take a step back and look at my life I am amazed at what I've survived and what I have accomplished either in spite of or as a result of some pretty heavy experiences. Whether it be my work in high school and college in child abuse prevention, my years of community service through AmeriCorps*VISTA, my 20s in domestic violence intervention, or my 30s as an advocate for the disability community, I am honored to serve the underserved and blessed to have found work that shares my focus.

My pain, numbness, and increasing weakness were no longer just annoyances. It was stopping me in my tracks, preventing me from my work. Weeks of conservative care didn't help so I saw a neurologist who ordered an MRI of my C-spine. Our assumption was that I had a bulging disk in my neck that was pinching a nerve. I was given a CD of the MRI images and it was clear that my disc between C4/C5 was herniated. The radiologist posted the written report on-line which I accessed through my health care website on a Sunday morning. I spent the better part of the day combing through the one page report. Going only to well respected medical sites I meticulously deciphered each finding and reported them one by one to Mark. He was dubious about my layman interpretations and reminded me that we would be meeting with the neurologist in a few days. "Leave it alone," he insisted.

By late Sunday afternoon I felt confident in my understanding of mild endplate irregularity, discogenic marrow signal change, mild to moderate loss of height and signal, marked hyperplasia, uncinate hypertrophy causing moderate to severe neuroforaminal stenosis and paracentral disc protrusion that focally deforms the ventral theca. As a Momologist I do not need to have a degree in neurology to read and grasp medical terminology. We Momologists hone skills out of necessity to help our children with special needs.

The third impression in the report is the one that made my blood run cold. Posterior disc bulge at C4/C5 that compresses the spinal cord, eccentric to the left. The central cord shows associated focal T2 hyper intensity at this level consistent with myelomalacia from chronic impression. The report lists 5 impressions. Why the radiologist stuck this one smack dab in the middle baffles me. Irrational, I raged at the injustice of the order of findings that in my mind should have been ranked in some kind of order that made sense, such as; least important to most pressing or the reverse.

Myelomalacia. I searched and searched for more information, desperate enough to peek at Wiki. Mark categorically dismissed my discoveries, even taking away my computer and insisting that we wait to hear from the neurologist, but I knew what I read. I spent the rest of the Sunday and Monday in a very dark place. Then, in the middle of the night I woke up for no reason feeling a peace I did not understand and I knew everything would be alright.

We saw my neurologist who confirmed in the first 30 seconds with him what I had already come to accept. I have a bulging disc that has been protruding into my spinal cord for some time causing damage that is likely permanent. Without surgery it would progress but it would not improve my condition. Mark went pale and got very quiet. I knew he was entering the dark place that I had been just a few days prior. My doctor did a EMG and found that my nerves are fine, giving further support to laying blame for my symptoms firmly at the feet of the spinal cord damage. We left with an appointment to see a neurosurgeon.

In some ways I had come to believe I was a mild version of Wonder Woman or that I at least emulated her in some ways, but my body had failed me and my super powers weren't working.

continued in part 3, HERE