HERNIATED DISC, KNEE REPLACEMENT, NARCOTICS . . . OH MY!

Ladies and gentlemen, a doom-ish date draws nigh. Until now I have neglected to share with you that this holiday season does not hold for me visions of sugarplums dancing in my head (Mmm, sugarplums!). No, instead this holiday season will be spent recuperating from two separate surgeries. Allow me to share with you an MRI of my neck, taken last Monday 11/29/10. For your convenience I have labeled the sideslice view of my noggin for greater clarification:



 
If you can’t read the font, the vertical text reads “spinal cord,” the first horizontal text reads “bulging disc,” and the second horizontal text also reads “bulging disc.” As you can see, C5 has fully herniated and is pressing against my spinal cord. C4 is bulging slightly.

One thing about me: my health is infuriatingly testy. For some reason, I am prone to orthopedic injuries and weird, random ailments that perplex my doctors and myself. Subsequently, I have no idea how I turned up with a herniated disc. Seriously. There was no injury, no fall, no accident, no one thing that would have overtly led me to believe that I had herniated a cervical disc. Well, okay, let's back up.

In August, I noticed that the baby toe and the fourth toe on my right foot were completely numb. I chalked it up to a pinched nerve, from me sitting Indian-style on the couch when I'd be laptopping, because I kind of tuck my right foot up under my left thigh. But then I noticed the pinky finger and ring finger on my right hand was starting to feel numb, but it was really faint and very transitory numbness. However, I found it odd that it was the same digits on both the right foot and the right hand that were experiencing the numbness.

In September, I woke up one morning and couldn’t turn my head to the left without a lot of pain, and suddenly there was a severe burning sensation in my neck, going all the way down my left shoulder blade. There was no comfortable position I could find to sit in, and this lasted for about a week. By the time that week was over, my neck was kinked into this bizarre position that made me look like a turtle poking its head out of its shell. I kept thinking, you know, that it would get better, that I had just pulled my neck or whatever (don't ask me why I didn't realize how serious this was) and finally my mother was like Get thee to a doctor for thy neck is in the shape of a pretzel. So, yeah, the MRI revealed the herniated disc.

I'm having what's called an ACDF procedure on the 14th, where my surgeon will go in and remove the ruptured disc and place a small prosthetic device in between the cervical bones to hold the spine steady and to keep the cervical bones from grinding together.

I’m freaking out, one, because it’s spinal surgery and that squicks me out. Two, the surgeon goes in through the throat so the incision will be in the front of my neck and I’ll have a scar there where everyone will be able to see it. I won’t be able to hide the scar unless I wear a turtleneck, and I don’t wear turtlenecks (they’re so 1990!). I’ll be in the hospital overnight.  

Following the surgery I won’t be allowed to lift anything. I can move things that are less than five pounds, but I’m not going to be allowed to do very much, including bending and stooping, making rapid side to side motions, or moving my neck around excessively. I guess the upside is that this will include doing things like laundry or cooking (Hey, Mom’s got a few weeks off!). The downside is that on December 27^th . . .

. . . I am having a full left knee replacement done.

Yeah.

Why am I not postponing the knee surgery, you may be asking? Simple. We’ve met our $5000 medical deductible for the 2010 calendar year; if I wait to do the knee surgery until after the first of the year, then we will have a whole new $6000 deductible to pay (it went up for 2011) and I would like to avoid that. So I’m pushing this through and am plunging ahead with two major surgeries within two weeks time.

The knee replacement has been a long time in coming. I’ve had bad knees since I was a teen – I had my first knee surgery for plica syndrome when I was fifteen, and my second when I was sixteen. For some reason my knees have deteriorated much more quickly than one would expect for someone my age, and here I am at 41 needing two full knee replacements. Aside from my two earlier knee surgeries, I’ve done physical therapy, massage, exercises, stretching, icing, heat, lidocaine patches, and pain management. As I don’t want to live the rest of my life on pain management, I made the decision to go ahead and start the knee replacement process. I’ll do my left knee first, as it’s far more deteriorated, and then will do the right knee at a later date. The whole idea of having an entire joint replaced seriously grosses me out – I don’t even have words for how squicky I find the prospect to be. But, you know, it’s this or pain management.

I don’t like pain management; I don’t like pills or medications; I don’t like the side-effects of pain medication. Pain meds don’t make me feel dopey or anything, but they do affect my mood (WHEE! BooHiss). I’ve had people tell me I’m lucky that I have access to pain management because – unbelievable!  -- “those are the good drugs.” They are not the “good” drugs, especially if one is sensitive to opioids – who wants to spend their time nauseated and popping Zofran?

Fear of the surgery has kept me from having my knees replaced until now (I’ve been on pain management for three years), but now I feel like I’m on a hamster wheel of pain management and unless I do something, I will be stuck in this narcotic rut forever! I mean, pain management is highly regulated, as it should be. By saying “narcotic rut” I make it sound far more insidious than it really is. When you’re on pain management, basically you have a contract with your pain physician that you will only use him or her for your pain needs; this is to prevent people from doctor shopping, i.e. going from doctor to doctor to doctor seeking pain meds (this is an addictive behavior, though, not the behavior of a legitimate pain patient).

I’m required to bring in my medications once per month so the clinic can monitor them; I have to go in person to get a new prescription every month, and they do random urinalysis to ensure I am taking only the prescribed dose or less. I have no problem jumping through their hoops. A month hasn’t gone by that I haven’t had leftover medications – I never end up taking as much as I’m prescribed. Typically I will need a dose of pain meds at the end of the day or after I’ve been on my feet for a protracted length of time. I will sometimes need a second dose before bed because the pain can actually be severe enough to keep me from sleeping or to wake me up out of a dead sleep. Most days I just require one dose, though.

I went through a lot of trial and error to find the right combination of medications. Some medications worked really well, but only via IV or intramuscular (Demerol, which is not frequently used anymore anyway, because it apparently has a high risk for seizures). Some medications made me excessively itchy and really nauseated (Dilaudid). Some medications made me COMATOSE OMG *ZOMBIE* (Fentanyl). Some weren’t strong enough (Vicodin). So I’m currently prescribed Oxycodone* 15 mgs three times per day and 30 mgs Morphine three times per day.  I typically take one dose of Oxycodone and one dose of Morphine.

This reminds me of something I’ve ranted about to friends before. Any of you watch House? I grudgingly watch House, and while I’ll save the meta critique for TWOP as to why I find it to be an imperfect show with an unredeemingly unlikeable character (House) who is in fact not endearing, I will criticize House here for one major faux pas: You cannot tell me that an addiction to Vicodin is plausible. Here we have a man with a serious leg injury and ongoing chronic pain. As well, he is a physician. Not in a million years do I buy the premise that a physician with regular access to narcotic medications would stop at Vicodin, a low level narcotic pain reliever. It’s like trying to get me to believe that an Afghani poppy farmer has an addiction to extra-strength Tylenol. Whatevs, House. Whatevs! You know as well as I do that House, if plausibly written, would have been hitting the morphine, the dilaudid, the fentanyl, the oxycontin, the soma, etc, in the position he’s in with the access to drugs that he has. Vicodin? Oh, please. House may as well be gnawing on a candy necklace, as plausible as Vicodin is. Writers? FAIL.

And there’s the possum in the bathtub incident, but that’s a whole ‘nother post.

*Please note that Oxycodone is not Oxycontin, the latter being an extremely powerful and highly addictive narcotic.

**Wow, you may be thinking, you sure are long-winded. The answer to this is: Yes. That, and I type really fast.

AND THERE WAS . . . RAMAKI! THERE WAS RAMAKI! OH, 70s, WHERE HAVE YOU GONE?

It’s fitting that I ought to report in on Thanksgiving, seeing as it’s the biggest eating holiday of the year.

I have an interesting family. My parents divorced when I was eight. My father, Ken – who I shall refer to on this blog as . . . Ken  --  remarried to a woman named Barbie, no joke. After the divorce, my mother and I moved from San Diego to Albuquerque, where my mother had grown up. Going from San Diego to Albuquerque is like moving from the US to Cambodia or something. The two states could not be more disparate from another. Naturally I hated New Mexico upon arrival. I missed my father – who was, to be truthful, an unpleasant alcoholic who was never invited back to parties, but I was eight and didn’t understand these things – and I missed my friends, and the beautiful California weather and the ocean. When we arrived in Albuquerque, mom and I put up in a Howard Johnson’s next to a Denny’s until mom could find a suitable home. I still remember how the menus at Denny’s had masks on them when you turned them over. Each week there was a different animal.

We found a nice little condo in the northwest valley, off Rio Grande and Montano, and moved in. My mother had a lot of friends in New Mexico, so we were never hurting for company. One of mom’s good friends was Joe. Joe was the pastor at the youth fellowship at the University of New Mexico back in the late 50s/early 60s; he performed my mother and father’s wedding ceremony. When mom and I moved to Albuquerque, she and Joe became very close because Joe was also going through a divorce and they could commiserate, etc. They fell in love! Joe became my step-father about a year after my parents divorced – he used to joke about how he married my mother twice! Here, on this blog, I shall refer to Joe as my dad, because he was my dad. He earned the title and raised me like his own. Unlike Ken, but that’s a different story that, frankly, probably no one wants to read.

Anyhow, Joe had been married twice before. His first wife was Ruth and they had two daughters, Jodee and Marsha. Joe’s second wife was Christine, and she had a son and a daughter, Scott and Heidi. So, Jodee, Marsha, Scott, and Heidi became my step-sisters and step-brother. Joe was twenty-two years older than my mother, so all my siblings were older than I was. The youngest next to me was Scott, who is eight years older than I am. Anyhow, Marsha married Doug back in the early 70s and they had one son, Ethan. Unfortunately, Ethan was tragically murdered by a drunk/drugged driver in 1996. Marsha and Doug had split in the mid 70s and Marsha met Mark, whom she has been with since the 70s. After Ethan died, Marsha and Mark adopted Rima, my niece, from Russia. Rima came to the US when she was eleven, not speaking a word of English.

Jodee has one son, Gene – we don’t see Jodee or Gene anymore. When Joe married my mother, Jodee was very angry. She had never forgiven Joe for leaving Ruth, so for the duration of my parents’ marriage, Jodee referred to my mom as “my father’s current wife.” After my dad died in 2002, Jodee made it very clear that she wanted nothing to do with my mother or me, or our side of the family, and that’s the way it’s been since then. This, after my parents had been married for twenty-five years! Jodee is a strange egg. I always felt badly for her because she is just so angry all of the time, and when you’re angry all of the time, you can’t experience the joys in life. One year, during Thanksgiving dinner, she randomly announced that she had given up a baby girl for adoption – and this was after she had had my nephew Gene. Everybody froze; you could have heard a pin drop; forks stopped in midair. What do you say to that? “Oh, really? Well, hmm, wow! That’s a really big thing . . . ”

Scott married Karla, who is the loveliest woman in the entire universe; she is a school psychologist, but also an extremely accomplished musician. She plays flamenco guitar beautifully. My brother Scott is also a guitarist. Heidi married Joe (our other Joe!), who died far too young of Hepatitis C. Heidi is awesome – she used to work as a Volkswagon mechanic, and she hotwired her classic VW bus’s ignition to turn on and off using a light switch. That was a rad vehicle, totally. I was going to say It smelled like . . . but you can guess what it smelled like, yes?

My dad died in 2002; my mother was heartbroken and was convinced that she would spend the rest of her life alone. Joe was the love of her life. So when she became reacquainted with Dave, a friend of hers from high school, and they fell in love, she couldn’t have been more surprised. Dave is a wonderful man – a former math professor at Colorado College – and through Dave I have two new step-brothers, Bryan and Mark. Mark is my age, Bryan is three years younger. I can no longer claim to be the baby of the family!

Anyhow, so, yes, Thanksgiving. Because of our family history of amicable divorces, we all gather together, even though so-and-so is not married to so-and-so anymore, etcetera blah blah. We gathered at Doug’s house, as we’ve been doing for the past five years or so. He’s got a beautiful farmhouse out in Henderson, Colorado. Doug is a professional carpenter, so the woodwork in his home is stunning. I love going there just to see his beautiful work. Doug’s partner is Lois, and Doug’s sister Linda was also there, with her daughter Courtney and Courtney’s boyfriend Dane. Rima’s husband, Eddie, is a long-distance truck driver, and he was stuck in Phoenix for the holiday unfortunately, but his family made it to dinner. There was probably about twenty-five people total.

There was an enormous amount of food. I brought fingerling potatoes roasted in olive oil and whole garlic cloves, salt, pepper, and Penzey’s Mural of Flavor seasonings, and British mushy peas, made with baby peas, butter, crème fraiche, salt, and pepper. I used Nigella Lawson’s recipe (Nigella Lawson is my straight-girl crush, by the way) for the mushy peas.

I’ve blogged before about my gastric bypass and how I have to be careful about the types of foods that I eat because I can get dumping syndrome. OMG, I dumped about four times during Thanksgiving dinner. I totally did not control myself, so I would go from Hungry to Eating Now to Have Eaten Too Much to Dumping Now to Nauseated/Sleepy.

There was this wonderful brie – it had some kind of carmelized cranberries topping it, along with pecans, and it was just to die for. I absolutely must have the recipe. I also had Marsha’s ham salad, various crackers, a piece of fool’s toffee, and mushroom caps. By the time I got to the table  -- because these were just hor d’ouerves, mind  --  I was feeling totally dumpy; it was all I could do to not faceplant right there into the Hallmark turkey decor. I nodded off despite myself, chin to chest. Shawn nudged me under the table to keep me awake. It took about 30 minutes and two cups of coffee (of which I subsequently found out was decaf) until I felt normal again. So then it was time to fill my plate with dinner.

My mistake was the carmelized yams.

I got dumpy for the second time, and Shawn kicked me under the table for another 20 minutes. Then came dessert.

My mistake was the pecan pie.

This time I totally fell asleep, nauseated, at the table and Shawn couldn’t keep me awake no matter the amount of kicking. It took yet another 20 minutes plus 15 minutes in a rocking chair over by the fire until I felt normal again.

Then it was time for Bingo! Our family plays bingo every year at Thanksgiving and it’s terrific fun (I just sounded like a Dick and Jane reader there, didn’t I? How keen!). Everyone is required to bring 5-10 gifts wrapped in plain brown paper or newspaper, marked Woman, Man, Child, or Gender Neutral. This year I won a Christmas tea light lantern, a Santa Claus candy dish (CANDY! *is a zombie now*), and this fantastic clock made from an old CD – it’s totally Steampunky. Very cool. But my step-brother Mark won this amazing, giant stuffed chicken that was, like, the best thing ever, and Courtney won a replica of the leg lamp from A Christmas Story, so I can’t help but feel completely jealous. THE LEG LAMP! Ladies and gentlemen . . . THE LEG LAMP.

There is a can of Spam that has been making the rounds of the family for, oh, the past five or six years. It expired in 2007, that’s how old it is (and really, can Spam expire? You know that some s***’s old when SPAM expires). Yeah, it’s the family gag gift. I got the can of Spam in 2008; my step-brother Mark won it in 2009, but promptly gave it back to me for Christmas, so I’ve been the keeper of the Spam since 2008. UNTIL NOW! This year the Spam went to my step-brother Bryan, who was, I think, terribly disappointed to get the can of Spam. Not only is a can of Spam NOT the leg lamp, but it is also a can of TURKEY Spam, which is somehow even more vile than regular porky Spam.

For the record, I have never had Spam. Spam has never crossed my lips. Not holding the moral high ground, though, I admit that as a kid I used to love Underwood deviled ham and Vienna sausages, which is probably just as awful. Vienna sausages are, like, bologna with an extra odd flavor forced into a cylindrical shape. Speaking of sausages, have you ever noticed that Combos are the human form of Snausages?

And that, my friends, is the story of my Thanksgiving. Yes, I stole leftover pecan pie to bring home, and yes I obsessed about the pecan pie until it was all gone. You can take the fat off the girl, but you can’t take the fat girl out of the fat girl.

If you have read this far, I appreciate your attention to my long-winded family history and various anecdotes.

IT'S AMAZING WHAT SITTING ON FATG's ASS WILL DO

Fat At the Gym now weighs 206 pounds. This is totally legitimate because I weighed both times (216/206) at my doctor's office. I discontinued a medication that has weight gain as a side effect in September and I suspect my weight loss might be in part due to that. Also, well, I have been trying to watch what I eat. I'm not perfect (hello Starbucks and Taco Bell . . . OMG venti white chocolate mocha, iced, with whipped cream . . . that sucker has 762 calories in it, UGH). But, yeah, ten pounds down! Yippee ki-yay mother father!