Overcast and gloomy, but got my walk in (to Steve Perry)

After yesterday's PT walk, I was kind of sore around the surgery area, which is to be expected as those tight muscles and scar tissue are getting a workout. Later in the evening I had some random shooting pains down my left leg. Not debilitating, but noting this to tell the doc next week. I am still running a fever most of the time; it stayed at 99.8 most of the day.

I didn't feel so good today (joints hurting); the weather was overcast, so my guess is that a storm is coming. But I hauled my butt out to get PT in.

Today's walk...(to songs from Steve Perry's For the Love of Strange Medicine (1994) album):

Created by Google My Tracks on Android.
Name: 02/28/2013 Left Trail
Total distance: 1.47 km (0.9 mi)
Moving time: 32:04
Average speed: 3.38 km/h (2.1 mi/h)
Average moving speed: 2.74 km/h (1.7 mi/h)
Max speed: 3.60 km/h (2.2 mi/h)
Average pace: 17.75 min/km (28.6 min/mi)
Average moving pace: 21.89 min/km (35.2 min/mi)
Fastest pace: 16.67 min/km (26.8 min/mi)
Max elevation: 87 m (286 ft)
Min elevation: 60 m (197 ft)
Elevation gain: 62 m (203 ft)
Max grade: 3 %
Min grade: -6 %
Recorded: 02/28/2013 12:56pm


Also, working on more FMLA/ADA paperwork. Nothing more demoralizing than chronicling this hot health mess over and over, but it's a moving target at this point.

Milestone: tanking up...and a good day for PT walking (finally)

Today's post-spine surgery milestone: took my car to gas station for fill up on my own. Took dogs for moral support, lol. Lifting and maneuvering the pump w/hose felt heavier than I remember pre-surgery. It hurt some then, of course, but body is more aware of 5 lb lift limit now as back heals from being sliced. Not pleasant, but got it done. Then went home, needed a short nap. Pathetic.

 PT walking was particularly nice today, since the weather was cooperating. Here are a couple of pix from the walk (here in my neighborhood, on the walking trail).

First, a sign of spring, a mallard duck family swimming alongside the trail:



And they were on the way to the lake, which was about a 1/4 mile away:



I walked a little less than a mile (see stats below). This wasn't my first outing, of course, but I just loaded an app on my Android phone, My Tracks, that is pretty neat. Anything that can help me see that I am getting stronger in my recovery is motivating.

My Tracks records your path, speed, distance, and elevation while you walk, run, bike, or do anything else outdoors. While recording, you can view your data live, annotate your path, and hear periodic voice announcements of your progress. With My Tracks, you can share your GPS tracks and stats online:- Via Google+, Facebook, or Twitter- Using Google Maps, Google Fusion Tables, or Google Docs

- As a GPX, KML, CSV, or TCX file
My Tracks uses the GPS sensor in your device to record geographic and velocity statistics, but the app also syncs with third-party biometric sensors, including:
- Zephyr HxM Bluetooth heart rate monitor
- Polar WearLink Bluetooth heart rate monitor
- ANT+ heart rate and speed distance monitors (these require an ANT+ compatible phone)
My Tracks is an open source project. If you like to contribute, please visit:
http://mytracks.googlecode.com

So below are my stats from today's walk, for shiz and giggles. The numbers aren't impressive given how slow I have to go and it's somewhat hilly terrain, but hey, just a month ago I had a guy chiseling a herniated disc out of my spine, right?

Created by Google My Tracks on Android.
Name: 2/27/2013
Activity type: PT walking
Description: By Lake
Total distance: 1.38 km (0.9 mi)
Total time: 27:06
Moving time: 24:39
Average speed: 3.05 km/h (1.9 mi/h)
Average moving speed: 3.35 km/h (2.1 mi/h)
Max speed: 3.60 km/h (2.2 mi/h)
Average pace: 19.66 min/km (31.6 min/mi)
Average moving pace: 17.89 min/km (28.8 min/mi)
Fastest pace: 16.67 min/km (26.8 min/mi)
Max elevation: 116 m (380 ft)
Min elevation: 59 m (192 ft)
Elevation gain: 39 m (129 ft)
Max grade: 0 %
Min grade: 0 %
Recorded: 02/27/2013 1:57pm


Considering that a couple of years ago I used to be able to do a couple of laps around the lake barely breaking a sweat, my current condition is @ss post-RA diagnosis and back surgery. But it's the "new normal" now.

By the way, I have heard from quite a few readers who've had lumbar or cervical surgery about sharing my info here. While every case is unique, it's been good to read that much of the recovery is slow but steady and requires patience and care not to re-injure. The alternative is additional surgeries, so at least gives people an idea of whether they want to take the plunge and go under the knife.

I've had my fair share of problems so far (like the flu and coughing myself into shooting back pain again), but I don't regret having the surgery. The additional chronic misery was making me almost despondent. At least I could do something about this -- dealing with the pre-existing auto-immune stuff is a long-term war.

Related:
* RA rears up and says "don't forget about me."
* Can put on jeans again!
* Not so fast, young lady...your back is still f'd up
* Post-surgery update: tail end of flu; may need another MRI
* Week 3 post-spine surgery, week 2 of the flu
* Week 2 post-L5-S1 slice and dice: good news, not so good news
* News on life after the L5-S1 slice and dice

RA rears up and says "don't forget about me."

A big "duh" moment today. Realized that the perpetual fever/chills I've been having for months is likely from my untreated RA; it's a common symptom. I've not been on any rheumatoid arthritis meds for at least 4 months because I might need surgery. Since it's not clear whether I'm done with the knife, I still have not gone back on Enbrel.

My RA flares when storm fronts roll through and I can feel one's heading this way now without looking at that forecast.   I'm sure the inflammation from surgery trauma is making things worse, but the uncontrolled RA can cause joint swelling, low-grade fever, and fatigue when it flares up. And,  as I've said in the past, weather fronts coming in can really kick my ass when the RA is not in check.

Of course on top of that when I got the flu in Feb, the underlying fever just got worse. Now that I've licked the flu bug, it's no surprise that the low-grade fever is still hanging around.

I've become so used to my RA chronic pain that I just tried to put that out of my mind to focus on my back and healing for the last month. I guess it just likes to remind me that it's there when the clouds roll in.

Yesterday was a beautiful day and my pain level was way down and I was able to walk a good distance without really getting wiped. Today my joints and feet are crying uncle -- that's definitely the RA as the weather changes.

Nothing llike juggling the "normal" chronic autoimmune pain along with the post-surgery fun, they don't play well with one another.

The victory of being able to wear jeans for the first time since surgery is a sign of healing of my spine, so I celebrated that. I can't heal away RA; at least the fibromyalgia is pretty well controlled with the med I am on (Lyrica). I finally get back to see the rheumatologist in March; hopefully I will know by that time about whether my back gets the green light or not from the back surgeon, if so, I can try RA drugs again.

What's kind of frustrating is that while I need to get back on Enbrel, I know that won't be a picnic going back on that weekly shot and its side effects; it generally makes me sick for a couple of days (bad muscle aches, fever), but then for the next 5 days it's like my RA is almost gone. Not a perfect solution, but I have to tackle these things as they come. I was working on finding the right RA med with my rheumatologist over the last year, but when my back herniated in August, that had to go out the window. Getting back on track with the best RA regimen is the next challenge. Spine -- hurry up and repair!

Spine surgery update: can put on jeans again!

Small victory this AM.  Was able to put on regular jeans today without them hurting my low back area (L5-S1) where my bilateral discectomy was. I know it's a pitiful "victory" by almost any other standard, but it's another sign that healing is under way.

I had the surgery on Jan 18. Doc has to re-evaluate progress in another couple of weeks. I had a big setback after 3 weeks of the flu and violent coughing (that can actually re-herniate the disc). Incision area has healed (on the outside, anyway), but gets a little tender from clothes rubbing after walking. Any positive milestone is welcome, no matter how seemingly insignificant! The proof:

The other good news is that I only have minor coughing from the remnants of the flu. This damn thing lasts forever, btw - still dealing with sinus crap, but it's at the non-contagious stage now, just annoying. I am able to go out for walking PT, but it does take a lot out of me (not aerobically, though). My back muscles were greatly bruised by the surgery and so while walking doesn't hurt, they get very sore afterwards.

The walks are less painful than sitting for any length at the computer or in a chair. After about 30 minutes my back and spine hurt. Sitting is actually one of the worst things for recovery from spine surgery. Walking is least painful, though in my case the neuropathy makes walking unpleasant at times. Conflicting problems are making this recovery slower than the norm (6 weeks). I am just keeping fingers crossed that the next MRI shows all is well. No bending, twisting or carrying more than 5 lbs will be the rule for some time.

Not so fast, young lady...your back is still f'd up

Saw the surgeon today (my second follow-up, the first from getting over the flu) to assess my progress after the bilateral discectomy I had on January 18 (L5-S1). Got some unexpected news. Based on the inflammation caused by the three weeks of coughing, the numbness and more recent shooting pains down my left leg indicate a setback, but it's too soon to do an MRI. He wants to wait another month, to let it heal more.

My stamina is really poor post-flu; I can walk most of the time without pain, the stabbing is random. I'm definitely not limping as I was prior to surgery.

The inflammation now explains the daily fevers I've been experiencing (between 99.5 and 101). The area around my incision is sore now that I am moving about. It is thankfully not swollen (externally anyway). As I expected, he said that I've essentially lost 3 weeks of recovery. Sitting, standing, walking or my few test drives really do me in.

Also a sign of slow, compromised recovery -- numbness in my left leg that was gone immediately after surgery has returned and is slow to recede (he expects it will over the next month). He said that the muscles he moved around during surgery were greatly impacted by the unexpected chiseling he had to do in there; they are taking a longer time to recover. Fortunately there has been no infection.

He also said he's not going to entertain another surgery at this time; too soon. He hopes that I'll show more healing and to call in two weeks. I have another appointment in a month.

He also put the nail in the coffin for a return to work on March 4. Looks like I will probably be out of work another month if all goes well.

Post-surgery update: tail end of flu; may need another MRI

The flu bug that has slayed me for three weeks is now on the way out of my system. It has left me with a few annoyances -- night fevers, incredible fatigue, vision problems (dry, blurry) -- that I hope will pass soon. The coughing has nearly ceased, but its effect has cost me in terms of my recovery from L5-S1 bilateral discectomy surgery on January 18.

I coughed so much the first week and a half that I had shooting pains down my leg again, suggesting I may have re-herniated somewhat and that's a big concern. I had to wait out this flu until I could make an appointment to see the surgeon. I go next Tuesday, he may suggest an MRI so we know what we're dealing with. Here's how it went:


Week of 1/28: flu hits full force; heavy, sometimes violent coughing from 1/30-2/9. Expected weakness, fever and sinus discharge (nasal/eyes). Pain and inflammation/swelling at incision.

* Coughing in some instances caused some shooting leg pain down left and right legs, worse on left.
* One spell caused increased numbness down left leg; bad tingling/burning
* Weakness in both legs consistent.
* Unable to do PT walking at all because of flu symptoms.
* Used Tylenol to reduce fever: two 500 mg, 3x/day.

Post-flu

There is soreness near the surgical incision (right), but overall the wound itself has healed really well over the last few weeks. All of the "krazy glue" used to seal me on the outside (he used dissolving stitches on the inside) has fallen off now, leaving a vertical scar about 2" long along my lower back.

Because he had to chisel out part of the herniation that had calcified, there was quite a bit or trauma to the surrounding tissue, and that caused a lot of bruising. That has gone away, but the area around it is pretty discolored and, well, unattractive, but this is my war wound. We'll see what clears up long term.

Of course if there is a re-herniation, he's going to have to slice me again, and the prospect of that is frightening, but it happens 10%-15% of the time, and my odds were probably a bit worse because of the calcification and more traumatic surgery.

Surgery recovery

I do have to say once the horrible fog of the flu has lifted, it's easier to tell what is going on with my recovery from surgery since it's almost a month out. Being crapped out by that bug takes everything out of you. So, given this is about the first day I don't feel completely wiped by noon, I can report what is going on re: the spine surgery.

* Minimal exertion causes extreme fatigue, and increased fever at night is worse with exertion (~100)..

* Back pain and stiffness is constant; but I am not taking any additional prescription pain meds, toughing it out. Stopped those about a week and a half ago.
* Sitting for longer than 30 minutes in a chair is really uncomfortable.
* Standing is OK, walking at length is uncomfortable (but no more left-leg limping!)
* Returned to doing PT stretches.
* Re-started some walking on 2/13. Tiring; calf/foot numbness was noticeable, no shooting pain.
* Numbness and infrequent twitching down left leg.
* Numbness and tingling on undersides of both feet, and on top of left foot, down outside of left calf.

So that's what I'll discuss with the surgeon. I am far behind on my walking, and this has delayed my recovery, but I need a few round of walks to see what is/isn't working.

Driving (test)!

The big news is I drove for the first time last Friday. The surgeon said I was OK to try it as long as I could comfortably get behind the wheel. I wore a supportive wrap around my back (left over from my hysterectomy) for support. Kate came with me and I drove about a total of 2.5 miles.

How did it go? Well, let's just say I will not drive much for a while. That short jaunt was useful in letting me know just which muscles you use to drive, and how mine are very weak post-surgery. This is not unusual, but the end result is I experienced tailbone pain (not good), and some bad soreness that lasted a couple of days. I had to pop the Tylenol and immediately nodded off for a 4 hour nap.

I guess that's progress, eh? I'll report that to the surgeon as well.

And it's a Happy Valentine's Day -- much love to my wife Kate, who has been right there for me during all of this, reminding me not to bend, twist, and lift, and helping to sanitize our way through this flu. She's managed not to get it from my by some miracle! My major output of energy is to cook her a nice dinner tonight; the first I've really had enough energy to do, though I know it will mean early bedtime for me, lol. Well worth it.

Learned that I qualified for PTO donations!

Some good news, for the short run, since I am out for at least six weeks because of the L5-S1 spine surgery -- I've qualified for the Kiel Memorial Vacation/PTO Donation Program. 

"The Duke University Vacation and Duke University Health System Paid Time Off (PTO) Donation Program allows employees the opportunity to donate accrued vacation or PTO Short Term Bank (STB) hours to fellow employees who have experienced a catastrophic illness or injury and who have exhausted all accrued time, thus resulting in a prolonged,  unpaid leave of absence."

And that's definitely true in my case. The Kiel donations at this point, if enough colleagues choose to give, would cover about 2 weeks of my leave as it stands. 

It's still not clear whether I'll be out longer than six weeks (I need another MRI to see if the flu has caused me cough badly enough to have re-herniated), but I hope to be cleared to go back to work even part-time in March. The surgeon could only guesstimate for the leave form an average period of time that a patient having a bilateral discectomy is out, not knowing what he/she will find once they get in there or if there are any complications. So in my case the magic date is March 4 to return to work. I see him again this month to see what's up at this point. 

At least I have the good fortune to have this work benefit. So many do not. FMLA, the fed benefit for unpaid leave has been a help, but since it accrues on a rolling basis, I've nearly exhausted it because of my medical absences for my rheumatoid arthritis. That's an entirely different issue that can still place my job in jeopardy.

Navigating so much paperwork when you're ill, in pain or both is a challenge, and since I had to file all of it pre-surgery it was a reminder that our health and work benefit bureaucracy is a huge machine. I wish there was some way to simplify the these matters, but we all know that's not changing any time soon.