Tuesday, May 31, 2011

THE injury

This is going to be a long, boring post all about my back injury. Yep, the one from my accident in 2002.

Yes, there's a reason. But now, you just get the injury. Details as best I could do this many years later.

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My car got t-boned in April 2002. The lady that hit me was driving an estimated 50 mph, and accelerating, at the moment of impact. She admitted such.

I initially felt no pain. You know, adrenalin and all. So when I called 9-1-1 I told the dispatcher no ambulance was needed. First mistake.

As the police officer who responded was wrapping things up with the other driver, and I was waiting for him to dismiss me, I began to notice a slight burning sensation in my lower back.

Realizing this was not right, and considering there was a hospital about two blocks away, I decided I would drive myself to the emergency room after the officer told me I could go. And so I did. Second mistake.

In the emergency room, I was treated like a drug-seeker. By this time the pain was so bad I could not sit down. Still a burning sensation. I would later be told by my family doctor that this is the type of pain people describe when something is touching a nerve.

The doctor who saw me completely dismissed me. Did no Xrays or MRIs, even when I requested them. Did no range-of-motion test. Gave me a prescription for ibuprofen and told me I would be in more pain in the morning, but that was normal, so don't worry.

Unfortunately I was still in a bit of shock, and didn't realize till later that night how I was treated. Or else he would have heard it then. But alas, when you're in shock, it takes quite a bit longer to process things.

My mom drove me home (I lived with my parents at the time, and soon became glad that I did), I went to bed.

When I awoke the next morning, I couldn't stand up straight. I was all hunched over like I belonged at the top of Notre Dame or something.

Guess the doc was right, huh? I was definitely in more pain.

I called in to work, and then called my chiropractor, who fit me in.

Shocked when they saw me, they did Xrays there in the office. The Xrays didn't reveal too much, except that when my knee hit the dashboard it knocked my right hip seriously out of alignment, and my right hip was now about three inches higher than my left. The first clue that my injury was more serious than the joke of a doctor I saw in the ER.

I followed up with a visit to my family doctor. He convinced me to go on Tylenol 3. I didn't want to, scared to death I would be one of those people that got addicted. Besides, I could get around, right?

He looked me in the eye and said "You can't stand up straight. You're in serious pain. This is what pain meds are for. If you don't like the way it feels, stop taking them. Okay?"

I reluctantly agreed. But Tylenol 3 did little for the pain.

He prescribed physical therapy, sent me to an orthopedist, suggested I continue chiropractic care. At one point I was being seen by six different medical professionals on a regular basis. But which ones... escapes me.

I had PT at 6:30am, to try to get it in before work. I'd see another doctor during lunch. Then leave a few minutes early to go to the third. Just about every day, for months.

Two different doctors suggested that I seek disability, and offered to complete the forms.

I refused.

I could get around, I could work.

Was I in constant pain? Sure. But to me disability means that you can't, and I could. So I refused.

While seeing all those doctors, I kept hearing the same phrase:

"It sort of acts like a herniated disk, but not really."

And since my auto insurance decided to fight my claims, and my health insurance wouldn't pay because the injury was sustained in a car accident, I was paying everything out of pocket.

So my doctors, not seeing definitive symptoms of a herniated disk, decided not to do the scans that would diagnose such, because they are very costly.

Besides, physical therapy combined with chiropractic treatment did lessen my pain.

Although my chiropractor, whom I was seeing three times a week, was frustrated because my body would not "hold" the adjustments. Basically, although I felt better when I left, I'd be right back where we started just a day or so later. Apparently this is not normal.

And at the end of six weeks of physical therapy, when they did my evaluation and compared it to the one they did at my first visit, my pain had indeed lessened. But so had my mobility. I was in less pain, but I lost range-of-motion. Also, not normal.

So my doctor prescribed another six weeks of PT, and I continued chiropractic treatment, and somehere in there my pain meds were upped to Vicodin.

And then, one morning in November, seven months after my accident, I woke up and was unable to walk unsupported, due to the excruciating pain in my right calf.

Now, knowing I hadn't hurt my leg recently, and knowing how the nerves in the lower back network down your legs, I called in to work, and then called my family doctor.

It was then that he ordered the MRI, that would show that I did not indeed have a normal herniated disk. I had a herniated disk with extrusion.

But even that wasn't special enough to describe the joy that was my injury.

Let's explore the differences (in my basic, not very scientific or medical-ease way).

Herniated disk = disk is bulging out, often hitting a nerve, causing terrible pain at the affected area

Herniated disk w/ extrusion = the disk has actually ruptured, and the nucleus of the disk, a jelly-like substance, is oozing out. Symptoms are often the same, or very similar to a normal herniated disk, because the disk is often bulging at the sight of the rupture.

my injury (in my doctor's words) = "imagine someone stomping on a jelly donut. The donut is your disk. The jelly that should be inside the donut is the nucleus of the disk. Your disk exploded like someone stomped on it."

Aren't I special?

But that explains why my symptoms didn't fit. Understand?

So, from there I got sent to another specialist, a neurosurgeon. Who told me that while I wasn't the youngest patient he's ever seen, and it wasn't the worst injury he'd ever seen, it was the worst injury he'd ever seen on someone so young.

Yay me.

He also advised me to immediately stop all physical manipulation. This meant no more chiropractic treatment, no more physical therapy, no more at-home exercises. Basically, the more I did to my back, the greater the chance that I actually worsened my condition. Great.

I wasn't to sit for too long. Or stand for too long. Never do anything faster than a walk. But don't walk too much. No heels on my shoes, flat comfy shoes only. Don't lift anything over 5 lbs on a regular basis, and never anything over 10 lbs. Don't ride roller coasters. Don't bend over too much. Don't, don't don't...

Here I was, in my early 20s, and I was being given more restrictions than my 80-year-old grandma.

And... there was nothing they could do for me, except for surgery.

Except... the surgery was exceptionally invasive, and should be put off as long as possible. So I was put on some stronger pain meds, and told to come back if the pain became "intolerable".

But at least... no more doctors, right? I'd see my family doctor for pain med refills, the occasional follow-up to the orthopeadist, and then see the surgeon again if the pain became intolerable or if I lost feeling or function in any of my lower extremities.

I was told to do whatever I needed to do to make myself as comfortable as possible, because (basically) that was all we could do.

I was in pain every moment of every day for nearly four years.

No, that is not an exaggeration. It is a literal, truthful statement.

Yes, that is even on the medication. The state-maximum allowed dosage of my prescribed combination of narcotics made my pain tolerable. But only if I made sure to take it at the prescribed intervals. As in, if I was late on just one dose, I would be bedridden with pain for the next 10-12 hours.

And since one of those medications had a half-life of 4-6 hours, this meant that I had to set my alarm to wake up in the middle of the night so I could take it, just so I could function the next day.

Which meant that for four years I did not get a good night's rest.

No, I'm not kidding.

Because of the nature of my injury, one of the most painful things to do, early on, was to drive. Sitting while extending my right leg in that way, was excruciating. My co-workers never knew this (I don't think), but for months I screamed my way to work in the morning, tears rolling down my cheeks, then I'd sit in the parking lot to compose myself before walking in.

I don't remember when that changed, but somewhere along the way, driving became okay again. Well, more tolerable at least.

And then, as the muscles in my lower back atrophied because they were no longer getting the signals from my brain, lying down (aka. sleeping) became my most painful activity.

Do you know what it's like for it to be painful to sleep?

I slept many nights in my dad's recliner, or in my bed with 4 pillows stacked under my knees to raise them in a mock-sitting position.

Did you know atrophy can be painful? I didn't. But it is. Or can be, at least. No one ever told me that.

The numbness & tingling in my legs became so frequent I rarely noticed it anymore. Although there was one troublesome symptom though, that I never got used to.

Every once in a while, I would have the odd sensation of a drop of water running down my right leg. Always my right leg. The first few times I would run to the bathroom, terrified that I had somehow peed myself, and was feeling it run down my leg. But nope, I was dry. Always. Every time (thank goodness!). Yet the sensation was there.

As the months passed, and it became apparent that I could tolerate the pain, my prognosis changed a little. Instead of telling me I would need surgery when the pain became intolerable, it changed to being that I would need surgery when I lost function of my right leg.

My right leg, because that's where the focus of my nerve damage was.

I was told that most likely I would either wake up in the morning unable to move it, or I would be walking, and suddenly would be dragging my leg behind me.

Scary. At first.

Then you get used to it. Plan on what to do. And pray that it doesn't happen while you're driving. But practice driving with your left foot, just in case.

And so I persisted.

I was also told during this time, that my injury was considered a "lifetime injury". Meaning that, surgery or not, I would be facing the consequences of this injury for the rest of my life. For the rest of my life, I would have to be careful, not lift too heavy of things, not jar myself too much, just general awareness & carefulness.

Four years in pain. It still seems unreal to me. I didn't really think about it at the time. I was just trying to live my life as best I could. I think I did a pretty good job.

I worked full time. Sometimes two jobs. I volunteered. I travelled. I did stuff.

I just did it all in pain. And a lot of it hunched over like a frail old lady.

I got glared at by people when I waited for my mom, or my (somewhat) older co-workers to pick up heavy things for me. Because unless I was hunched over at that precise moment, I didn't look injured. So I suppose I looked like a spoiled princess or something.

If I were walking around hunched over - and I got around just fine, mind you, I was just crooked & hunched over - I got stared at, offered wheelchairs, etc.

I certainly didn't date a whole lot.

And then, nearly four years after my accident, it happened.

Well, not it. But I knew.

I was walking back to my desk at work, and my leg fell asleep - you know, that uncomfortable tingly, doesn't-want-to-move sensation? - while I was walking.

I got back to my desk and tried to rub it out, step it out, like you do when your leg falls asleep. But, of course, to no avail. So I called my family doctor.

He confirmed it, it was time for surgery.

Between consults & getting insurance approval (my case had by that time finally been settled, so my health insurance was left to cover the surgery & any subsequent treatment), it was two months before I actually got my surgery (have I mentioned that I'm convinced insurance companies are run by the devil?).

Unfortunately, I didn't read the fine print on my short-term disability insurance closely enough, and didn't get covered because I had my surgery two days too soon. (see devil comment above). Which means I went over 6 weeks without a paycheck of any sort. Nothing like adding the stress of financial woes to someone recovering from major surgery, right?

Anywho... my surgery was supposed to be 30-45 minutes, and I would be discharged that evening.

It ended up taking just over 90 minutes, and I was kept overnight.

Why, you ask? Well, because I was even more special than they originally thought!

When the surgeon opened me up, he discovered that the stuff that had exploded from my disc had, over the years, calcified on my nerves, cementing them to one another & to my spine. So, after repairing the disc, he had to "chisel" (his word) the calcifications from the nerves to free them.

And I was told that there was a significant chance (at this point I don't remember the percentage) that I would need an additional surgery in the future.

I was given several new narcotics, with the idea of these to be not only pain relief, but to keep me as immobile as possible. Meaning that one of them knocked me out about 20 minutes after I took it. Which is what it was supposed to do. Which means that I don't remember a whole lot of the following 6 weeks. Bits & pieces, but not much else.

I do know that the pain I'd been feeling for four years was gone, immediately. Oh sure, there was surgery pain, incision pain. But the pain of the injury was gone. Just... gone.

And I remember lying on my bed one day, just lying there, and I felt this twinge, and I started intentionally moving the muscles in my lower back. And I felt muscles that I hadn't felt in four years. The muscles that had atrophied were responding, and I could feel them again. It was such a surreal feeling.

I met FireMan 3 months after my surgery. I was still recovering. I had just gone off of all prescription medications, but still had a hard time getting around, walked a little funny, got sore easily, took a lot of ibuprofen & Tylenol.

We have a few funny stories from our first few weeks together, all as a result of my recovery. Funny to us, anyway.

So that's my story. Long as it was, it still barely touches on my experience. I feel like I left so much out.

I will say that hopefully now, when I post about stopping a workout because my back hurt, or not doing something around the house because my back hurt... well, that at least you, my readers, will understand a little bit better than the rest of the world.

Because it does get tiring sometimes, of mentioning something, and then getting comments about "pushing thru the pain" or how pushing on is the only way to strengthen those muscles, or just the looks you get. And quite frankly I don't usually feel like explaining the whole entire story.

I have to be very careful.

I know my body. I know the difference between what I can push thru, and what I can't.

My back will always be weak. Always. Not the muscles, but that particular disc will always be at risk for re-injury.

I could push thru more than I do. I have an incredible pain tolerance level, but it's not always about the pain. Sometimes it's about what the pain is a symptom of, what the pain is trying to tell you. And it's making a choice about what level of risk-taking is worth it.

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And just for fun, random interesting fact about me:

I'm approximately half an inch shorter post-accident than I was pre-accident. True story. Family doctor confirmed it with my records about a year after the accident.

Told ya I was special. Ha!

Thanks for checking in.

3 comments:

Melissa said...

Goodness, what an ordeal. Glad you were finally able to get some relief.

How did they fix it, if you don't mind my asking? I wonder mainly because I'm pretty sure I have a herniating or degenerating disc...I won't go to the doctor about it because I'm not ready to have anything done for it yet, but one day I guess I'll have to.

My son had a roll-over car wreck a couple years ago and got a compression injury to one of his vertibrae. They removed it and put some hip bone in and caged it with a titanium cage that he'll have forever (unless anything goes wrong with it). Did/could they not cage yours like that so it wouldn't be so fragile?

I am about 2 inches shorter than I was 20 years ago, lol. So is my husband. I guess we're going to have to start looking at Osteo-crap. Old age sucks. I don't feel that old.

Raleigh Crowl said...

I’m so sorry to hear about the awful way you were treated at the hospital. They really should have done scans and X-rays right then and there since you were in an accident. Did you consider pursuing legal action regarding your accident?

-- Raleigh Crowl

Javier Hoppes said...

You’re right. It’s not always about the physical pain. That goes away after a while. It’s the emotional scarring that takes time to heal. I do hope that this negative experience hasn’t been repeated, and that you will soon be okay. I think there may be grounds for legal action against the hospital though; perhaps negligence is one.

- Javier Hoppes -

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