Surgery

The one thing I heard from everyone was "do not have surgery." Back surgery for disc problems has a low success rate. A large part of that, I think, comes from Degenerative Disc Disease, which I have. Those herniated discs are weak and getting weaker. Surgery will take away the herniation, but it cannot fix the weak disc. Chances are high the walls will deteriorate more and another bulge will occur. Surgery is also expensive and healing is time-consuming. Lastly, and this is entirely my conclusion, surgery is deceptive: it is a quick fix and it is hard to remember that life is different after it.

What do I mean, when I say different? This is my own hypothesis, backed by no medical knowledge, and I want to emphasize that because there are enough uneducated quacks out there peddling cures with no backing. It is dangerous to listen to the internet. Even me. Still, when I spoke to people who knew of others with failed surgeries (and there are a lot--everyone knows someone with back pain), the thing I heard most often was "they went back to normal" and hurt their back again. While a lot of that may be DDD, I kind of wonder how much of "normal" is what hurt me in the first place. Normal for me meant sedentary. It meant poor lifting techniques. It meant being a little overweight. It meant not listening to my body. It meant high-impact sports and activities when I did actually leave my couch.

I will not be resuming my "normal" life, despite that being what the surgeon suggested. I am trying to be more active but I am also choosing to give up certain activities I used to do. I walk now and will never jog or run again. A personal choice, but I feel the constant impact caused by jogging or running create a risk I am not willing to make. I will never sky dive, bungee jump, do high impact martial arts, jump on a trampoline, or lift heavy weights again. Those are choices I've made because despite a high failure rate, I think there is a good chance I don't ever have to suffer that kind of back pain again. I will walk, do careful yoga with the guidance of someone aware of my injury, pilates and gentle aerobics/light weight lifting. My husband and I are cleaning up our diets and trying to shed some pounds. No longer am I concerned about being thin because I want to look good: I just want less weight pressing down on my spine. Normal for me now means not sitting all day. Not twisting to pop my back. Squatting instead of bending when I need something on the ground. I may not be able to avoid another injury, but I sure as hell don't want to find myself in pain and wonder if I could have done something different or better.

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The actual surgery was fast. We were at the hospital less than five hours. My surgeon was a bit fast in explaining things but very kind. When I woke up I felt no pain for the first time in months. Recovery has been a remarkably quick process. The most difficult thing was feeling better but knowing I needed to continue to act injured. That means it felt like I could pick things up and lift things heavier than 10 pounds and jump and skip and I absolutely COULD NOT do these things if I wanted to help heal. You know what? A lot of those stories of failed surgeries involved trying to do "normal" things too early. Listen to your surgeon. You trusted him to cut into your spine, you might as well trust that he knows a thing or two about healing.

People Just Want to Help

People just want to help when you are injured. Ok, that is not entirely true. Many people are uncomfortable with injuries and illness. They want to offer help but feel terrified you might actually accept. When you are the said injured or ill party, it is also difficult to ask for and accept help, or even to hear the offers.

With my back injury most people wanted to help by offering advice. Here are some of the many things suggested:

1. Chiropractor. Everyone had a favorite chiropractor they were sure would "fix me." Now, I have nothing against chiropractic work. I think there must certainly be times when it is effective or beneficial because people are so damned crazy about it. However, I know for myself, with weak discs and muscles so very tight, the thought of someone "manipulating" my spine was downright terrifying.

2. Spinal Inversion. This is when you hang from your feet and allow gravity to "gently" elongate your spine. In theory, I supposed, it would ease tension on my nerves and possibly stretch those tight muscles. This one seemed appealing in my mind but not at all a good idea to put into practice. If just walking was enough to reduce me to a sweaty, pale and cringing mass hanging was surely going to kill me. That is my theory at least.

3. Reiki. Again, I know people who feel strongly about Reiki and I don't want to diss something very important to them. For me, though, it was outrageous to spend lots of money for no physical touch. It is difficult for me to believe that kind of back pain is caused by bad energy or a block in my energy flow. I think it is caused by some seriously bad luck, practices and genetics.

4. Feldenkreis. This is actually something I am still considering, but it is really for after the healing process has begun. It is a series of conscious movement designed to teach us about our bodies and how to move in the most efficient and gentle way possible. Great for the elderly or the fragile. In this case, because I believe a lot of my injury had to do with treating my body poorly, this seems like something which may assist in being more aware of how I move and what my body says to me. I'm not sure, which is largely why I haven't pursued it yet.

5. Cranio-sacral massage. This is interesting. It sounds hippie-dippie, I know. But there is actual science to back it up so save that skepticism. I unfortunate approach many of these suggestions with too much skeptic and it may have caused me to miss out on opportunities earlier on in my injury for help and a chance to avoid surgery. This massage aids in moving blood and spinal fluid. If you didn't know, the spine doesn't get much blood flow and the fluid can be fairly stagnant. By getting blood and movement in the area injured, healing oxygen and nutrients can accelerate the healing process.
-this is a further addition but deserved its own little column. I do think any massage can be beneficial for a variety of back injuries, but be careful if choosing this. A very informed therapist and speak up if there are any bad pains or feelings. One of the things I desired the most (and received the least) when I was injured was touch. There were so many days where I think if I could have just had some soothing hands on my hair or skin my mental state alone would have improved exponentially. Cranio-sacral therapy is a great way to get two birds with one stone: actual bodily relief combined with the emotional healing of connecting with another person.

6. The advice I heard most often was this: Do not have surgery. The internet reiterated this. Tons of websites and all of them warned against surgery. Low success rates, infections, high cost with low reward, etc. All of this may be true. I can tell you what is also true: when you are in any kind of chronic pain which truly ruins who you are and how you experience life, you become willing to try almost anything. So if you have been in pain and tried other avenues and your life has become a black hole and then someone says you should consider surgery then please for all that is good consider it. I was desperate and the surgery seemed like a glowing beacon of relief. And you know what? It fucking was. It was a miracle, if you believe in such things. It was hope and relief and release all in one heavily medicated package. I was lucky and woke up feeling no pain other than at the incision site. It makes me weep a bit even now to remember that moment when, despite feeling hazy from anesthesia, I realized my hip and leg didn't burn and hurt. It was perhaps the most wonderful moment in my life, which is saying something because I have had some awesome moments.

I am not saying run and get surgery. My surgeon would only consider my candidacy because I had attempted so many other avenues of healing and they had failed. Still, I am so glad I considered it because it changed my life. All the time now I hear about failed surgeries and I start to panic a bit but I'd like to talk about that separately sometime.

When people offer all of their advice it is well intentioned. It is difficult to see someone debilitated and hurting. It is hard to know what to do or say. And as the injured party it is difficult to know what you want. For me, I found that company, sympathy and some heavy duty painkillers made life bearable enough to wade through treatments until I found relief.

Sitting is killing us

No, really. Sitting so much is killing us. Our bodies weren't made for it. Both times I've thrown out my back came after months of prolonged sitting. The first time I was playing a lot of World of Warcraft and watching tv. It was no big deal at the time for me to sit for 4-9 hours at a time. Nine hours! This past time, I had begun my Masters and the classes were online. This meant I was again sitting from when I woke up to when I went to sleep. That, and then beginning to jog, are some of the catalysts for my injury.

Still don't believe me? Take a moment to look at this:

http://i.imgur.com/Kf7nW.png

Now I still need to sit often. I am drawing, writing and still in classes. The difference is I have a timer. It may seem silly, but setting my phone to beep every hour is a great reminder to get up. I'll walk around a bit or stretch. Do some dishes or play with my cat. Anything that isn't sitting. My physical activity has also increased. Now I dance and walk daily, because I know that my body needs it. Beyond vanity, beyond even what we know about heart disease and obesity, exercise is important for our bones. Those bones, ligaments and tendons we take for granted, which carry us every where and give us shape and strength need movement.

Quick Link

http://blogs.discovermagazine.com/notrocketscience/2011/05/11/a-memory-for-pain-stored-in-the-spine/

Turns out our memories of pain are stored in the spine. The "too long, didn't read" for the article is this: when we are hurt, a chemical in our brain and spine remember the pain and even after the initial injury is over, the area will often remain sensitive long after the fact.

This doesn't surprise me. I've read in my research that our bodies remember pain. Currently I have no pain or injury, but my right hip is still so tight I can't sit indian-style or cross my right leg over my left knee. It remembers how weak my back was and it overcompensated by becoming tight to protect my joints and hold my weight. So even though its support is no longer necessary, it remembers and won't release just yet. While I haven't tried it (unfortunately the practice is expensive and not covered by insurance) ROLFing is a practice which takes this idea and tries to erase that memory. Think very deep tissue massage and chiropractic work combined, and that is my understanding of what ROLFing is. I love the idea of being able to erase that memory of injury, of fully healing the body and starting fresh.

Another quick note is this:

I love to dance. I am not particularly good at it, but I do love it. Right before my injury got bad I bought a game for the wii called "Just Dance 2." Contemporary songs and dance moves and I can dance my ass off in the privacy of my own home. It may sound silly, but I was pretty devastated when I couldn't play my game so soon after purchasing it because my back simply hurt too much. I am sure the twisting, arching, jumping and shaking motions of the game didn't help.

Yesterday, for the first time since January, I was able to play my game. I danced for two hours. TWO HOURS. I was sweaty and sore. I had rug burn on the soles of my feet. It was the best time and one of the many times when I stop and think about how grateful I am for health.

Despair

I am not someone prone to depression or despair. While I do get angry, hurt or sad, it does not take me long to shed those emotions and become re-balanced. Recently my mother used my back injury as a metaphor for when we become spiritually unbalanced and the harm that comes of it. The metaphor was apt, but it also pertains to how physical ills can quickly make us feel emotionally ill as well.

For two weeks I woke up every hour or two in devastating pain. Normally a back sleeper, my muscles were so locked up I had to sleep on my sides. However, every hour or so the side I was sleeping on would lock up and spasm, the electric heat forcing me to wake up and get out of bed. Hunched over I would shuffle to my husband's office across the hall so I wouldn't wake him (fruitless, really...he always woke when I did). Once there I would carefully get onto my hands and knees and sob. Eventually I could get onto the floor completely and stretch those aching joints and muscles enough to get back up and go to bed. Switching sides I would fall asleep only to rinse and repeat...all night.

There is something very bleak and dismal about being on the cold floor at 4 in the morning, body and muscles haywire, mind exhausted. It is so quiet at 4AM. And dark. The loneliness, the exhaustion and the pain are overwhelming. For the first time since some melodramatic teen years I began to yearn for death. This was terrifying. I want to clarify that I don't think I felt suicidal--I wasn't interested in ending my own life. It was just that the relief of death seemed so beautiful and desirable that all I could think of was how much better death would be than living in pain.

My back was so unbalanced I walked like Quasimodo, hunched and side-ways, feet shuffling. Emotionally I felt the same: unable to become centered, I veered headfirst into depression. Painkillers muffled my physical pain but amplified my despair. I was tired and I was sick in my heart.

I wish I had some great advice about how I pulled myself up and out of that cold and dark place. After a few epidurals (steroids) and some heavier painkillers I was, eventually, able to sleep for 2-4 hours at a time. It is weird when that little sleep still feels like a blessing. Sleeping helped a little. Friends would come and visit me and that helped a little. However, it really wasn't until my surgery that I felt the true beginnings of release from the despair I had been carrying for months. I can't explain what it was like to wake up with no pain. Overwhelming. Miraculous, maybe? I'm not sure. I know that there was a moment before surgery when I thought "if this doesn't work, I might have to consider suicide, because I simply can't live like this anymore."

There are people who live everyday with pain. Probably a good many of them with more pain than I was experiencing. They have talent, maybe, or some acceptance that allows them to remain balanced in their hearts even as their bodies are breaking down. I didn't have that strength and I am not ashamed of my weakness. The link between the physical body and the metaphorical heart is strong, though. So when things are physically tough the mental anguish can be overwhelming.

To anyone who has experienced something similar...I'm so sorry. For anyone currently experiencing it, I hope it gets better, from the bottom of my now-balanced heart.

Diagnosing.

When I blew my back out in 2006 it was a complete surprise. I was young and active with little family history of major back injuries. When I reached my apartment in Raleigh my husband (then boyfriend) Zack took me to urgent care. I distinctly remember how terrible that trip was. The car ride, the chairs in the waiting room that were too hard, the spasming muscles and what felt like patronizing staff made the whole ordeal terrible. I received my first-ever shot in the ass, a muscle relaxer that burned like hellfire. They felt so badly for me they let me sleep on a table for an hour before moving me to be x-rayed.

Here is the problem with back injuries: there are so many different kinds. Further, pain is subjective. So while two people may share a "pull" of the same muscle, one person may be able to keep working and living while another is crippled and in bed. This variance in pain tolerance also makes diagnosis difficult. After my x-ray showed I was "fine" I was diagnosed with a pulled muscle. This meant for months I took relaxers, got massages and took hot baths, hoping the muscle would heal and release. Instead these treatments only prolonged my injury by confusing my pain signals. It wasn't until several months later I went and had an MRI done. That was when I learned I had herniations in my L5 and S1 discs. Once diagnosed, my healing then seemed like a dream. Epidurals (steroids) and physical therapy and I felt good as new in just over a month.

My back began hurting again in November 2010. Whereas before I had a defining moment of injury (the sneeze) this time it was a slow process. Which really just means I had pain and ignored it. My understanding is that herniated discs never really heal on their own. Inflammation may disappear and back strength and flexibility help prevent and alleviate injury, but the risk of inflaming those discs is always there. I knew this and still did not pay attention when my back began to ache.

When I finally went for treatment I was often asked "what sparked this injury?" Originally I blamed an aggressive massage gone wrong. Later I blamed becoming active after a long period of being sedentary. I also blamed our bed, which was so old and concave that it really acted more as a hammock for Zack and I then any sort of supportive sleeping system. Really though what sparked my injury was carelessness. Even having a history of back injury I ignored those small twinges and aches. Those moments when you almost feel your back give out and then forget the weakness the next day. I thought I could diagnose myself and move on with my life.

When I finally admitted that maybe my body was hurting more than a simple strain it was really too late. However, I thought I knew how to fix it and went to the doctors who had helped me so much the first time. Like me, they thought that it would be an easy fix. After all, shots and physical therapy worked before, so it was safe to assume they would work the second time.

I want to take a moment to say that blame should not be placed on my doctors for any "failed" treatments. Like ignoring my body previously, I was also more than willing to just move through the treatments this time without asking questions. The doctors used my old diagnosis and old treatments. So when I actually felt physically worse after my first epidural it really threw me. Why would something that, in my memory was adequate, actually amplify and accelerate my pain and weakness? What we had ignored was the difference in pain this time. Before my lower back ached and spasmed. This time my right hip was excruciating and I had sciatic pain. In physical therapy I mentioned it and my therapist noticed they had only given me an injection in my L5. However, in 2006 I received shots in both L5 and S1. This is the price of not being a participant in healing. They are only allowed to do three injections...and I had just allowed one to be botched.

This was two times then where not paying attention had a heavy price. Diagnosis is difficult. Symptoms and pain are subjective. I try not to focus too hard on what-ifs. What if I had been more cautious in November, what if I had my back checked out when I initially had pain, what if I had asked what the treatments were going to be, what if... Hindsight allows indulging in scenarios where we are masters of our own fate and geniuses at life. In some of my darker moments that hindsight was a blanket, but really it may just be a lesson that I hope to god I've learned. It has certainly forced me into something I should have wanted in the first place, which is to be an active participant with my body. At the very least I understand much more the consequences of self-diagnosis and rushed treatments.

It started with a sneeze.

My adventures with my back began with a sneeze. In 2006 I was mowing my parent's yard when I felt a giant sneeze coming on. I bent over and let it blow...and blew out my back. I remember crippling pain that sent me to the ground. Back spasming, I had to crawl to the house. No one was home and after laying on the floor for an hour, I managed to write a note to my parents explaining a partially mowed yard before painfully (and probably dangerously) driving myself 45 minutes to my apartment. Several visits to the doctor, some misdiagnoses, three shots in my spine and some physical therapy later, I thought I was all better.

In November, 2010, I felt a dull pain in my lower back. Ignoring it, I managed to make it through Christmas before crippling pain became my life. During my time at home I used the internet in desperation. I was desperate with questions, seeking solutions and stories. Unfortunately, this was a lesson: the internet was not my friend. There is so much information, scams and ill advice out there. Mostly I had been looking for other people's stories. I wanted to connect and sympathize, I wanted to read about successes and I needed some hope.

A friend suggested I put my story out there. No advice, because everyone's stories are different. No preaching, because gods know that doesn't help when every hour seems the bleakest. Just my experiences as I remember them and how this experience has fundamentally changed my relationship with my body and how I hope to move forward.