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Catchall.

The Back Story

If you don’t like gory pictures, you probably shouldn’t look through the album above, since it includes a close up of the disc material removed from my back.

So, as I previously wrote, I had a lower back event on New Year’s Eve. That appears to have been my L4-L5 disc exploding, squishing like a tube of toothpaste, excess material constricting my spinal canal where the spinal cord splits into the nerve roots that feed the butt, hips, legs, and feet.

MRI on January 16th pretty clearly shows this (you can see the black/gray blob blocking off most of the spinal canal between the last two full-sized vertebrae). By stupid measurements, compared to MRI of the same area three years ago, I may have lost 1/4″ of height by squashing that disc.

I saw a neurosurgeon about whether I should have surgery; his opinion was basically “No-brainer, yes.” He said with or without the surgery, I’ll be in basically the same state after about a year, with basically the same risk levels for re-injury, and the same after 5 years. I asked him about risk of repeat rupture, with versus without surgery. He laughed and said, “Basically the same — but either way, there’s so little disc left that it probably can’t do much.” Way to look on the bright side, doctor! The main differentiator between yes and no seems to be faster relief with the surgery.

Before going through with the surgery, I went back to talk to my regular back doctor to make sure he didn’t think it was a mistake. He thought it was a reasonable decision to make, although he said something like, “If I was a surgeon, I’d want to operate on you, too — you’re young and you’re going to heal well and quickly, versus performing a ‘salvage’ surgery on a 75 year old.”

The surgery is a microdiscectomy, which apparently has some other names. Small incision, grind some vertebra bone out of the way, reach into the spinal column with cutting and grabbing tools (guided by some kind of camera/microscope) to remove the extrusion and any other bulge that the surgeon deems beneficial. Animated explanation behind this link.

The surgery was last Thursday, January 31st, 9:20 AM. Shouldn’t be any real surprises — no drinking alcohol for days beforehand, no eating or drinking anything starting at midnight before the surgery; IV, brief conversation with the surgeon who said it should take about 90 minutes and that he’d give us a picture of the removed material (and that it would look like crab meat). I remember hugs and kisses and see you laters with KrisDi, then waking up in the recovery room with a nurse who started feeding me crackers and soda — feeling groggy, confused, and sore.

Apparently, during this time, KrisDi talked to the surgeon, and he showed her this picture of Krang after removal from my back.

After a while, they moved me back to the same room I was in pre-op, where KrisDi was. Getting from the gurney into the chair was very unpleasant, with a giant shot of pain down the back of my right leg while trying to turn and get up. Continued getting snacks, various blood pressure or other minor medical tests, then they decided it was OK for me to go, around 12:30. KrisDi went to pick up prescriptions and get the truck, a volunteer (who arrived like 15 minutes late) took me in a wheelchair down to the truck.

Then we went out directly to have ramen for lunch. The lack of nerve pinch was already quite noticeable. Soreness and drug affects still had me moving pretty slow.

Before bed, I could already tell standing up straight was better, I could stand up and look up and look around without tweaking in my tailbone, I wasn’t getting shooting pain in my butt or down my legs (I have gotten one or two shooting pains in the process of getting in and out of bed).

Now…entering my fourth 24 hour period following the completion of my surgery. I stopped taking painkillers yesterday. My back gets tired if I sit or stand too long, and I actually feel pretty normal when I stand up after lying down and resting for a while. When I’m not tired, I can go up and down the stairs pretty comfortably.

Bending and twisting is clearly a no-no, aside from the fact that it’s currently forbidden. KrisDi has to do almost everything for me, which is frustrating.

Recovery plan…I’m not sure how long the no bending/twisting stricture lasts; I know I’m not allowed any exercise aside from walking for at least 2-3 weeks. No lifting more than 10 pounds for 3 months (so KrisDi gets to carry all our luggage for a family trip to visit Dad in Florida). In the short term, I’m supposed to limit stints of sitting or standing (which is pretty natural right now). I’ll have a follow up with the surgeon in about two weeks.

On a logistics note…I haven’t driven my car since December, since it’s low (therefore difficult for me to enter/exit) and a clutch. When we bought the truck, one of our lines of reasoning was “Well, snaotheus might get hurt and be unable to drive his clutch; we might have an accident and need a spare vehicle. This way we don’t need to rent a car. It’s unlikely those two things would happen at the same time.” Of course, KrisDi got rear-ended the week of my surgery. I need the truck, her car’s in the shop, and she can’t drive my car. So, Les is borrowing my car, and KrisDi is borrowing his.

Posted by snaotheus, 1 comment

Why does my back hurt even more?

Four Days After some MRIs

New Year’s Eve, we hosted a party. We had two families from relatively far away who stayed the night.

11 PM New Year’s Eve, I tried to change from pants into pajamas. I put my hand on something and leaned while I tried to lift one of my legs out of my pants. A moment later, I found myself on the floor gasping and crying with pain exploding in my lower back. KrisDi came up shortly after and found me on all fours trying to get control of myself again.

I got back downstairs somehow. I don’t clearly remember how, but I think KrisDi helped. I sat on the couch with our friends. G False Alarm, drunk as an ox and not particularly sensitive even when sober, kept bugging me by nudging or something similar, and neither my spine nor my attitude really appreciated it, which may have been evident when I followed through on a mild threat and nearly broke his finger.

I endured until we finished our New Year’s toast, then went back upstairs (again, don’t know how I got there). More crying and gasping, learning that crawling was no less painful than standing or walking, and I had gotten myself into bed, where I spent several minutes trying to find a position where I could relax that wasn’t painful. Eventually, I was in a position lying kind of on my back but rotated maybe 30-45 degrees to my left, with a huge pillow between my knees, using both my arms to pull my left knee toward my chest. This was painful, but bearable. I held it for maybe an hour before KrisDi came up for bed.

We decided I should go to the hospital. Logistically challenging, since all the adults in the house had drunk rather generously (and I was in too much pain to drive anyway). KrisDi asked Les to drive up from Bonney Lake to drive me to the ER, which he very kindly did. KrisDi helped me get down the stairs; I (comically) used Chilkat’s cut-down cane to try to help keep some of the weight off my back.

After getting to the hospital, I let Les go home as quick as I could so he wouldn’t have to wait while all I was doing was waiting. I squirmed uncomfortably in the wheelchair for what felt like forever but was probably 30 minutes before they took me in the back, did some simple tests and questions and looked at my four-day-old MRI results before declaring I should basically proceed with my existing plans to follow up with my back doctor. They gave me three prednisone pills and two oxycodone (on an empty stomach, after a sleepless night full of drinking — party time!) and prescriptions for more.

KrisDi got me home somewhere around 6 AM. Everyone was still asleep; we got me to the recliner upstairs and propped me up with pillows, where I entered drug-induced sleep for about two hours, before waking up and joining everyone for breakfast with my ER bracelet still on my wrist.

The initial pain, up to the point where I got to the hospital, was the most extreme pain I’ve ever experienced — by a large margin. However, it also marked a change in the pain I’d been experiencing since October. It wasn’t really going down my left leg at all any more, I wasn’t getting the numbness or shooting pains down the left leg; it was dominated by local pain directly in the lower back, but with some pain in the hamstrings and buttocks. After several days of prednisone, the bulk of the pain is now right hamstring / buttock centered, and not really shooting pains — feels like I badly strained or overworked the muscles.

Between “too much pain to drive without percocet” and “shouldn’t drive while on percocet”, I skipped work on Wednesday and Thursday, I set up a silly lying down workstation and spent some time on my back on a computer (worked surprisingly well). I got a little work done and got some silly old home computing things done as well. I finally went in today (now with a grown-up sized cane!) — holding off on the percocet until I was already at work (and only having one in the morning so I was OK to drive home in the afternoon). It was a fairly productive day that wasn’t terribly challenging for my back.

Follow up appointment with my back doctor Monday morning.

Happy New Year, everyone! Hope your new year celebration was less painful than mine.

Radiology report from thoracic MRI on 27 December

FINDINGS: Flattening of thoracic kyphosis is present. Multilevel Schmorl’s nodes and disc dehydration changes are seen lower thoracic spine suggesting Scheuermann’s syndrome.

AP dimension of the spinal canal is unremarkable.

Spinal cord is well-visualized without evidence for syrinx.

Upper thoracic levels show unremarkable posterior disc margins at T1-2 through T6-7. Nerve root canals are widely patent upper thoracic levels.

Lower thoracic spine shows T7-8, nerve root canals and facets show mild right facet degeneration.

T8-9: Broad-based minor bulging is seen on the right without nerve root flattening or cord contact. Nerve root canals are widely patent.

T9-10: Mild bulging is seen bilaterally. Right facet shows mild degeneration.

T10-11: Posterior disc margin is unremarkable. Facets show small amounts of joint fluid bilaterally.

T11-12: Posterior disc margin is unremarkable. Facets are unremarkable.

CONCLUSION:

  1. Multilevel Schmorl’s nodes and disc dehydration suggesting Scheuermann’s syndrome.
  2. Mild right-sided annular bulging T8-9.
  3. Bilobed annular bulging T9-10.

Thank you for this interesting referral.

Radiology report from lumbar MRI on 27 December

FINDINGS: The alignment of the lumbar spine shows mild scoliosis. Multilevel moderate disc space narrowing and dehydration changes are seen with multilevel Schmorl’s nodes suggesting Scheuermann’s syndrome.

The AP dimension of the spinal canal is narrow on a congenital basis. Pseudoarthroses are developing between spinous process L3-4, L4-5.

Conus is unremarkable in configuration and position.

L5-S1: The posterior disc margin shows mild bulging. Facets show minor degenerative changes. Nerve root canals are widely patent.

L4-5: Broad-based left-sided 10 mm disc protrusion markedly narrows left subarticular recess and creates marked flattening traversing left L5 nerve. Right subarticular recess is moderately narrowed and there is moderate to marked central stenosis. Right nerve root canal is moderate to moderately severely narrowed. Left nerve root canal is moderately narrowed.

L3-4: Mild bulging is seen. Subarticular recesses are mildly narrowed. Facets show mild degeneration. Nerve root canals are widely patent bilaterally.

L2-3: Mild bulging is present. Facets show right greater than left mild degeneration. Nerve root canals are widely patent.

L1-2: Minor bulging is visible on sagittal images only. STIR images show high STIR signal between spinous processes at L3-4 and L4-5 suggesting Baastrup’s syndrome and inflammation in these locations.

Prior imaging is available for comparison dated 5/18/2018. That study also showed multilevel Schmorl’s nodes, disc dehydration and narrow AP dimension of the spinal canal. Minor annular deformities L1-2, L2-3 and L5-S1 are unchanged. L4-5 left disc protrusion is markedly larger than prior study. High STIR signal between spinous processes was seen at L4-5 and L3-4.

CONCLUSION:

  1. L4-5 left disc protrusion creating central stenosis and marked left subarticular recess narrowing.
  2. L5-S1 mild bulging with mild facet degeneration.
  3. AP dimension of the spinal canal is narrow on a congenital basis.
  4. Mild annular bulging L2-3 and L1-2.
  5. Multilevel Schmorl’s nodes and disc dehydration changes are seen suggesting Scheuermann’s syndrome.
  6. Pseudoarthroses are developing between spinous processes with high STIR signal at L4-5 and L3-4 suggesting Baastrup’s syndrome.

Thank you for this interesting referral.

Posted by snaotheus, 2 comments

Why does my back hurt?

My back has been terrible for the last two months, including pain shooting down the legs, tingling in the legs, and leg weakness.

I got an MRI last night. For whatever reason, they sent me home with the images without an physician diagnosing them. My self diagnosis is a ruptured disk. Keep in mind, no professional has looked at it and told me anything yet, but images the images resulting from Google Image search of “ruptured lumbar disk mri” look awfully similar. Since I don’t know anything, there’s a high probability that I’m wrong.

Anyway, I have my followup appointment with the back doctor on the 9th, unless they can get me in earlier.

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April Part I

So, per my brief and vague allusion in my previous post, Chilkoot got Hand, Foot, and Mouth Disease. He started a fever the Friday before Easter, missed out on Daddy Son day on Saturday, missed out on Easter on Sunday (we didn’t want to infect the cousins with whatever he had — we didn’t find out until the next day that it was HFM). He started showing sores on Sunday, I think. Doctor on Monday. Last day of fever Tuesday. He only got a few sores on the outside of his mouth, one on his hand, and none on his feet — but the inside of his mouth was so ripped up he wouldn’t eat solid food for four days. One day, I think, Chilkoot consumed a total of two spoonfuls of yogurt, a pinch of bread, and half an Otter Pop. It was hard to get him to drink water. Poor kid. Anyway, I missed 2.5 days of work, KrisDi missed 2.5 days of work. Luckily, no one else got it from him. He was so good-natured about it. “Chilkoot, wash your hands!” “OK. I have hand foot mouth.” It was at least another week before he could handle a toothbrush in his mouth, and another week before flossing was OK.

Aside from that, I think KrisDi and Chilkat had a good Easter. I wasn’t there. I was with a sick kid. I think that was the day he threw up on the couch.

During Chilkoot’s recovery, we had a family long weekend in Portland. This was sort of a “We gave you kids a week at god damn theme parks, let us have some fucking good beer and good food” sort of thing. We dragged the kids to lots of breweries (Culmination, Coalition, Cascade, Hair of the Dog, Base Camp, Modern Times) and lots of restaurants (Stammtische [mediocre German regional dishes], Jam on Hawthorne [excellent breakfast], Screen Door [excellent breakfast], Blue Dot Donuts [excellent], Voodoo Donuts [novelties; taste ok], Marukin [OK ramen], Fire on the Mountain wings [good wings],  Salt & Straw [excellent ice cream], Chicagoland [good deep dish pizza]). We made a deal with the kids — we’ll buy you a new toy…if you get rid of ten others when we get home! Woo!

Chilkat started using her Magic School Bus science kit that she got for her birthday. I got her a silly joke book since she can read well enough to enjoy it. For a while, she gave us stand-up routines read directly out of the book, which was pretty funny.

Northwood came up here on a work quest to find a vendor to replace esoteric fan blades. His timing was perfect for helping with Chilkat’s Girl Scouts pinewood derby car — so our poor little girl had a metrologist, an aerospace engineer, and an engineering manager at her disposal. We did an OK job of letting her contribute. It’s green, like she wanted — it has the shape that she wanted — it has the samoa sticker she wanted. It has the profile / cross-section that we nudged her toward. It has the weighting we dictated. She helped with all the steps. It was fun to see Northwood. No one got seriously hurt.

Posted by snaotheus, 1 comment

Photo Count Update

Yup, still a nerd.

Chilkat’s still winning. Do we love her more? Do we have less time for pictures than we did before? Do we take fewer pictures of Chilkoot because he willfully makes weird faces or hides whenever we point a camera at him?

Posted by snaotheus, 2 comments