Tuesday, December 16, 2008

FINALLY!!!!













So I finally got to take pics of my back. These pictures were taken today, so they are about 6 weeks post operation. Please ignore the mess in the background of the first pic. We really are working on getting this place cleaned up, but like I said there's a ton of work to be done.



The vertical incision on top is where the leads were placed. The horizontal incision on the bottom is where the battery pack is. As you can see it's stil slightly discolored. In person it looks kind of bruised.



I'm still working on getting my cell phone to hook up to my computer properly. If I ever get it to work I'll post the pics from right after I had the trial put in.

Saturday, December 13, 2008

The timing couldn't have been much worse...

Like I've said in previous posts, I'm so glad I went through with having the SCS implanted. It was one of the best decisions I've ever made. That having been said, the timing couldn't have been much worse.

My grandfather is dying of cancer. We thought he'd have more time, but it's not looking good now. He's on oxygen and pain killers constantly now, and hospice workers come in frequently to help him out. Of course it's important that I go visit him before he passes. The only problem is he lives about 5 hours (by car) from my husband and I. I simply can't ride in a car for that long of a time period.

We were going to visit him this weekend, but I don't think I'll make it. My husband says we can go up next weekend, but what if I can't ride in a car then, either? I don't think I'm going to be able to see him before he passes. It's heart-wrenching. My mom tells me not to worry about it, and that grandpa would understand, but that doesn't make me feel any better. This totally sucks.

Friday, December 12, 2008

Long time no post

I've been very busy lately, so I haven't had the time to post. We moved at the end of last month, and we haven't been able to get settled yet. This house is in total disarray, and needs to be cleaned before we can unpack anything. Once that's done, we need to start fixing it up to make it more livable. We'll get there, but it's going to take some time. I feel bad because I'm not really able to help out. Darn this SCS!

That's not to say I'm not glad I have it. I certainly am. It has been helping a lot with my pain. That's a wonderful feeling. Although my back is still pretty painful, I'm glad that I had the operation done. I know there will be an end to this pain, which I didn't know with the RSD.

I started back at work part-time on Monday. I work for 3 hours a day from the office, and then I come home and usually put in a few more hours. I have been working 7-9 hours a day most of the week. I think I've been overdoing it so yesterday I just came home and relaxed. I think I'll be doing the same again today. I've been taking 800 mg of Aleve (Sodium Naproxen) every 4-6 hours for the pain. It doesn't seem to be helping too much so I know I need to slow down a bit.

I've been playing with the stimulator settings a little. Most of the programs are pretty comfortable for me. I don't think I need to have them adjusted at this point.

The Representative from the company warned me that when I move I might feel sudden increases and decreases of the stimulation. For a while I didn't notice these changes, but just recently I started feeling them as I sit or stand, turn my head, or move in other normal ways. This is not going to go away, so I'll have to get used to it. I have to admit it is somewhat annoying, but I'm sure it won't take me long until I barely notice it is happening.

Saturday, November 29, 2008

The Great Exodus

We're moving today. It sucks because I can't bend, lift or twist. I've been trying to help out with packing, but I'm not much of a help. My husband will get worried about me after a few minutes and make me sit back down so I don't overdo it. That's certainly a good thing, but I feel bad for not being able to help more. We have until Monday to be out. Thank the lord for our friends and family who are helping us out. We really can't thank them enough.

My back seems to be healing well. I didn't think I would need a full month off of work, but I can see now that the doctor was right about that. It's almost been a month, and I'm just starting to get to the point of feeling like I could go back soon.

Well, here we go....

Sunday, November 23, 2008

The road to recovery continues

Today is 17 days post-op. I figured it was time for a new post updating my status.

My headache is fully gone now. It's such a relief. My back is still sore and I'm having trouble sitting or standing for extended periods of time. I may have overdone it a bit yesterday, so I've spent all day today laying on the couch. It's pretty sore right now. I can tell, however, that I am recovering. The scars also seem to be healing pretty well.

My RSD pain has increased a bit from the first week post-op, but it's still very low in comparison to the level it was at pre-op. I can't describe how it feels to finally be relieved of some of that pain. I've been walking (well kind of walking... the pain in my back doesn't allow for me to walk as easily as I did pre-RSD) without a limp since the surgery. It's amazing! I can only hope this trend continues.

I have been noticing the battery pack more and more as the days progress. In the beginning I barely even noticed it was there. Now it hurts when I lay back, or lean against anything that presses against the area. I know as I recover that pain will decrease as well.

Now to my sanity level.... I'm going crazy lying on my couch all day. I can't wait until I'm able to sit up long enough to get back to work. I'm going to talk to my boss about working from home starting tomorrow. I think if I have something to occupy my time a little bit it will help avoid my impending craziness.

Tuesday, November 18, 2008

For my good friend, Pat


It's been snowing here of late. I got up at about 5:00 this morning, and this is what it looked like outside my window. My good friend Pat rarely gets to see snow so I figured it might be a nice treat for her to see this, so this picture is for you, Pat. Please forgive the blurriness of the image. I'm still quite weak and my camera isn't the best.

Sunday, November 16, 2008

10 days down...

This is the first time I've been able to post since the surgery. It went well, and I am now the proud owner of a Spinal Cord Stimulator :)

There is good news and bad news associated with the latest surgery. We'll start with the good news, because I like to be optimistic. My pain levels are so low right now. I couldn't have imagined this kind of relief from the RSD pain. My pain level is down to about a 2 right now.

Then comes the bad news.... this is not meant to scare anyone away from SCS. I hope it will enlighten anyone considering a permanent implant, though. Keep in mind that everyone's experience will be different.

I didn't feel entirely prepared for the post-op experience. I knew it would be painful, but not as bad as it was. The first day I fainted from the pain twice. The doctor didn't warn us that this might be a problem, so the second time it happened (at 1:30 in the morning); my husband was on the phone to talk to my doctor. I have to admit this was terrifying. The doctor assured us that the fainting was due to the pain, and was nothing to worry about. I just needed someone with me 24/7.

By the afternoon following my operation, I was beginning to get sick from the Vicodin I had been put on. I was vomiting from it, but was unable to lift my head, so that was quite an experience. We called the doctor and asked what we should do, and he prescribed morphine to get me through the pain. Within a day I was vomiting from that as well, so I stopped taking the pain killers. That definitely was not conducive to pain relief.

3-4 days after the surgery my back started feeling a little better. The pain levels had gone down to a level I could at least tolerate. Then the headache started. The doctor says it may last from a few days to a few weeks. It’s still not gone, but I’m beginning to feel better.

My back is still sore. I can’t sit for very long before it gets too sore and I need to lie down. I can’t wait until this pain is gone. It shouldn’t be long now, although the doctor wants to write me an excuse from work for the next month. He said if I feel ready to go back sooner he can write me a release, and I’m sure that will happen.

So all that having been said, I feel the need to say that I do think it is well worth it. I’m ecstatic to be able to walk without a limp. It’s amazing. Before long I’ll be back to normal, but I won’ have to deal with the insane pain I was feeling before the operation. I can’t wait.

Thursday, November 6, 2008

Today's the day

I wanted to sleep in this morning, becuase of the whole no eating after midnight thing. At 3:30am the cat knocked a bunch of stuff over and scared the crap out of me.... I'm now fully awake.

I have to admit.... I'm terrified of the week ahead of me. I'm almost 100% sure it's going to be worth all the pain, but I'm definitely not looking forward to the next 7-10 days. I almost don't want to go through with it, but I'd never forgive myself if I didn't take this opportunity.

Wednesday, November 5, 2008

The day before D-day

So tomorrow is D-day. I went in for my appointment today. I decided on the rechargable battery. He told me that if I went with the nonrechargable I'd most likely only make it about 2 years before they would need to replace it, so yeah.

He explained the procedure to me, and then asked if I had any pain killers at home. I told him I have some Vicodin and he asked if I had enough to last a week. I told him I wasn't sure and he said I should check and let him know tomorrow when I get there if I need another perscription, because I will definitely need to take them for 7-10 days.... then he warned me that I will be in severe pain for at least 3-4 days after the surgery. Oh yay! This will be fun!

At least it's almost over, though. I can't wait for my pain levels to decrease again.

I'll update as soon as possible after the surgery. It may take a while, though.

Tuesday, November 4, 2008

I got an appointment

The doctor's office called me today. They got approval from my insurance company to implant the permanent SCS :-D I have an appointment for this Thursday (as in the day after tomorrow). My doctor, the rep. from the company, and the surgical center all happened to have an open appointment, so they put me in.

When I had the trial removed, the doctor told me I would need to wait at least 3-4 weeks for the permanent. He said my back would need this amount of time to heal. It's only been 2 weeks. The receptionist said he gave it the okay, though.

I have a pre-op appointment with him tomorrow. I'm going to verify that the timing isn't an issue, becuase I have to admit I'm a little worried about it. He was very clear from day one what the time-frame would be.

I'm so excited. I can't wait until my pain levels go back down. These last 2 weeks have been terrible for my pain.

Monday, November 3, 2008

It's been a while

So I haven't posted in a while. I figured I might as well post an update. I’m still waiting for the doctor to call me back. They are waiting for approval for the permanent SCS from my insurance company. I'm waiting impatiently. I can't wait until I can finally get rid of this pain.

It has snowed on and off for about a week and a half now. In between days that it's snowing, it's between 50 and 70 degrees. The fluctuating weather is wreaking havoc on my leg. It hurts terribly right now.

The office is also very cold right now. It's a good thing I keep a blanket in my desk just in case I need to keep my leg warm. All I have to prop my leg up, however, is my trash can. It's not very friendly to my legs. That's something I'll have to continue working on.

I was thinking about how working is going to be during the 3 months that I have to keep my spine straight. My chair is not very conducive to having a straight spine. That's one of the main reasons I didn't work during the trial. It's a very comfy chair, but not if you need support for your back. I should probably start looking into finding a new chair tomorrow.

One last thing I need to address: Someone posted an anonymous comment to me asking for me to help them find a doctor in the Albany area. In case that poster is reading this, I wanted to let you know that I did try to contact you. I tried sending you emails from various accounts and all my emails were returned to me. If you are still looking for help, I can be reached at LMT at USARSD dot org. Email me and I will reply. Maybe it will work that way.

Thursday, October 23, 2008

Removal/The pain is back

One thing I learned through the trial: My posture sucks horribly. I need to work on that. The slightest of movements would change either where I felt the stimulation, or the strength of the stimulation. When I slouch (as I've been in the habit of doing my entire life), it increases the strength of the stimulation.

UGH! My doctor wasn't very gentle about the way he removed the sutures to remove the stimulator. He just took a needle and plucked at the sutures until they frayed and broke and then kind of just pulled them out. It wasn't the most pleasant of experiences.

He showed me the lead that was in my spine. I thought it was pretty cool. So my back hurts again, but only because of how the doctor pulled the sutures out. It didn't hurt at all when he actually pulled the lead out. After he removed the stimulator, we discussed having the permanent one implanted. My husband and I have decided that I'm definitely going to do it.

After that, my doctor left and the company rep came in. He showed me the battery and the remote that I will have, and explained the procedure to me. I'll be going in for the implant in about 4 weeks. It will be an outpatient procedure, so I will be able to have it in the same hospital as the trial.

They are going to make a small incision in my lower back and place the leads. They then fish wires down to another incision in my upper buttock (they will have to clear out some tissue there for this), where they will place the battery. They're going to use the x-rays from the trial placement to help them place the permanent stimulator, so it should be pretty easy to get it in the right spot.

I'm going to go with the rechargeable battery. That means they will have to open the incision in the buttock once every 6-10 years (according to the rep, with the settings I used it would most likely last 8 years) to replace the battery. He said unless there is a problem with the leads, they wll not reopen the incision in my lower back.

I left the office with a slight buzzing sensation in my leg still. It was about 40 degrees fahrenheit out, and the cold was definitely affecting my pain levels again. Within a few hours of being home my CRPS pain was back with a vengence. I can't wait until I have the permanent one implanted.

And so the trial comes to an end...

I'm having the stimulator removed today at 10:50. I have decided to go with ther permanent one. I've gotten some amazing relief over the last week, so I think it's worth it.

I'm so excited to have it removed, though. My back has gone from really painful to extremely itchy. I want to scratch it so bad, and in a few hours I may be able to do just that... and take a shower, which is really what I'm looking forward to.

Over the last week I have narrowed it down to 2-3 programs that I like. The company rep said I might not be able to fully narrow it down until after I've had the permanent for a while. I'm so excited at the thought of seeing permanent relief :-D

Monday, October 20, 2008

Day 4

Today is the fourth full day that I have had the stimulator. The RSD pain is still decreased :-D

My back pain is still pretty bad. I think I may have overdone it today. I was feeling somewhat better this morning, so my husband and I went to my office to pick up some work, an then went to visit his sister for a little bit. We were gone for a total of about 3 hours (although not continuous time). Sitting in the car for the hour-hour and a half was pretty bad, and then I had to sit on the edge of a chair for an hour, as well as stand for about 30 minutes.

The good part to all of this is that normally my RSD would have flared considerably by this point. Those pain levels are still quite low.

I hav been playing around with the settings on the stimulator. I really think this could help me.

Saturday, October 18, 2008

The operation

The pain in my back has subsided enough that I think I can post about the operation.

I got there at 1:00 PM on Thursday, October 16. I got there and they asked me to fill out a bunhc of paperwork about my health history, etc. I found that a bit wierd, since they had called me about all that stuff on Monday. I filled it out and handed it to the nurse who was to bring me back to my pre-op room.

We get into pre-op and she looks at my wirst and asks what I'm allergic to. I told her that I had seasonal and environmental allergies, but beyond that none. She asked a bunch of questions about allergies and then said "well they should have given you a blue wrist band instead of a red one." That kinda wierded me out too.

They got me all set up and my husband came in and stay with me while the doctors came in and explained the procedure. Come to find out they had my paperwork mixed up with someone else's so they had to have me re-sign a bunch of papers and fill them in again.

My husband left and they started wheeling me into the operating room. I have to admit I was terrified. I wasn't looking forward to the pain I knew I was going to have to endure. I get into the operating room and move over onto the operating table, face down. That's not the most comfortable position when you have an oxygen tube hanging out of your nose.

I remember the anesthesiologist putting some opaque, white fluid into my IV, and thinking "OUCH! couldn't you have pushed that in a bit slower?" and that is it. The next thing I remember the doctor was saying "That's the fastest this has ever gone" and the anesthesiologist assuring me that was a good thing. During the operation they gave me a light sedative and they woke me up and put me into a deeper sleep as needed. I was in that room for no more than 20 minutes, because 30 minutes after my husband walked out of the room they were calling him back in to sit with me.

Immediately I noticed that my RSD pain had decreased. My pain levels were about 60% less than they were when I went in to the pre-op room. The rep. from the stimulator company worked with me to find out which programs I should try over the week. I start playing with them, and recording what I like and dislike about each, on Monday.

So to the good news (keep in mind this is only after a couple of days):
I went in with CRPS pain that I rated at an 8-9/10. I came out with a pain level of 4/10.
I can touch my leg without causing myself any extra pain.
The color in my right leg has returned to normal.
The pain in my leg doesn't seem to increase with the cold.

I have pics of me pre-op and of my bandaging on my back. When I find the cable for my cell phone I'll post them here.

Friday, October 17, 2008

Post-op update

I'm home from the surgery. My back is really sore, so I'm not moving much. This post will be short as a result. The doctor said by Saturday night the soreness in my back should be gone, so I anxiously await Saturday night.

So far my RSD pain has decreased by about 50%. If this continues, I am going to have the permanant stimulator implanted.

I'll write more later.

Thursday, October 16, 2008

The big day

T-minus 5 hours and 30 minutes until I have to be at the office for my operation. I had my "last meal" last night. It was delicious. My husband made chicken breasts with bacon and melted cheese on it. Mmmmm.. soo good. I was allowed to eat until midnight last night and I can drink clear fluids (water, apple juice, black tea, or black coffee) until 10:00 this morning.

I got my hair cut last night. I got 6-7" taken off. It's really short now, but I figured I might as well make my last shower for a week mean something. LOL! Sponge baths for me from here on out :-(

They want me to bring my inhaler in with me. I've been searching for it and I can't find it (like I told them, I haven't used it in months. I honestly think the last time I used it was last winter). I'll have to call in a few hours to find out what I should do. I'm pretty sure even if I found it it would be expired anyway.

ARGH! I'm so hungry (you know only because I can't eat)... more water for me.

Wednesday, October 15, 2008

Getting nervous...

I get the trial spinal cord stimulator inserted tomorrow. I'm starting to get really nervous. I found the spinal blocks to be incredibly painful. When I had the block in epidural form, it hurt the entire time it was in (come to find out they were pumping way too much medication into my spine at once). When I started seeing a pain doctor again, I swore I'd never get a block again. Now this?

I am extremely excited at the prospect of decreasing my long term pain levels, but the procedure itself scares the hell out of me. It's like my wedding. I couldn't wait to be my husband's wife, but the wedding itself terrified me.

The ends justifies the means...

Sunday, October 12, 2008

Walking is bad.... walking is bad....

My husband and I went to a beer festival with his friends yesterday. We were walking around for about 3 hours. I haven't done that in so long. It was tons of fun, but I forgot how much it would hurt. By the time we were 3 hours into it I had to sit down. We grabbed some food, sat and ate. The members of our group trickled in and out, getting themselves more beer smaples, but I just sat. After we ate, my husband decided it would be best for us to leave (I love how careful he is about my condition). By this time my pain level was really high again. I hope it calms down by tomorrow. The pain levels are still quite elevated. Hopefully by tomorrow morning they will have decreased some.

Friday, October 10, 2008

Work & Stimulator

I work full time. Normally this wouldn't be a big deal, but add in that I sleep an average of 2 hours a night (always in 10-20 minute increments) because of the pain, and you might begin to see why full-time employment is not an easy thing to endure when you suffer from CRPS. By the time I get home from an 8-hour day at work, I'm exhausted. I usually get home and crash on the couch until it's time to go to bed. By Friday I'm completely exhausted. I generally spend weekends crashing on the couch, trying to recoop from the work week.

Well, it's Friday. I made it through yet another week.

Next week I have my trial stimulator implanted. The stimulator is supposed to kind of confuse my brain. It will bombard my sympathetic nerves with electric pulses. The doctor says I will be exchanging the pain sensation to another, which I may or may not like, and will definitely need to ge used to. Nothing can be worse than the pain.

I'll update my progress here.

What is CRPS?

CRPS is complicated, and there's not much known about it. The symptoms will vary between people, and what works to treat one person will not work to help another.

CRPS was first discovered during the Civil War. Doctors on the field were faced with bullet wounds that, although healed, still caused soldiers severe, burning pain disproportional to the injury. It was originally termed Causalgia, meaning "burning pain." In fact, some still use this term today.

CRPS has gone through a number of name changes during it's history. Some of them include:
Complex Regional Pain Syndrome (CRPS Types I and II)
Reflex Sympathetic Dystrophy (RSD)
Reflex Sympathetic Dystrophy Syndrome (RSDS)
Causalgia
Sympathetic Maintained Pain Syndrome

CRPS is characterized by a burning pain that is dispropotional to the injury that caused it. The pain can be increased with stress, motion, touch (even the slightest touch can cause severe flare ups of CRPS), breezes, cold, etc.

Common symptoms of CRPS include, but are not limited to:
Burning and/or gripping pain
Skin changes (often the affected limb will because a deep red, blue, or purple color. Also, extremely dry, darker patches of skin often times crop up on the affected limb.)
Increased hair growth on the affected limb
Nails becomming brittle and breaking more easily
Limbs feeling cold to the touch
Changes in bone growth

Secondary symptoms include, but aren't limited to:
Depression
Insomnia

So what is causing the pain? This is a subject that's up for debate. One possible explanation is as follows: There are many types of nerves in the human body. Sympathetic nerves carry signals toward the brain, whereas somatic nerves carry signals away form the brain. My doctor explained it to me by saying that at some point the body gets confused. The Somatic nerves somehow get rewired and begin to send signals to the brain. The brain doesn't know how to comprehend these signals, so i translates them into pain. The sympathetic nerves then continue the pain cycle, and it never ends.

I have also heard theories relating to electrolyte balance in the body.

No matter what it is that's creating the pain, there is no physical reason for the pain to be there. It's a matter of the sympathetic nervous going haywire in some way.

Alternative Treatments

When the blocks stopped working and the epidural was out, we decided to see if holistic practices might help. We tried a number of them. The following are the most memorable:

I went to a Reflexologist for a period of time. She was great. The work she did not only helped a bit with the pain, my asthma, and allergies, but she also inspired me to get my massage therapy license (a license I hope to be able to use someday). I would recommend this treatment for a good number of conditions, but only if you can find a well trained, and licensed if that's required in your state, Reflexologist.

I also tried a therapy known as cold laser therapy. We kind of figured it was a crock to begin with, but ANYTHING to get rid of the pain. Well, I gave the therapist the benefit of the doubt for a number of treatments before deciding this wasn't for me, either.

Being a massage therapist, I learned the importance of meditation. Sometimes meditation will bring my pain level down. Sometimes it doesn't, but it always decreases my stress, which in turn helps with the pain.

The Early Treatments

We started off trying to control my pain with various anti-depressants and anti-seizure medications. I also started getting spinal blocks once a week. Neither seemed to help much.

We gave the blocks 2 months. The first block worked for a few days. It got rid of much of the pain. The second block worked for a slightly less period of time, and so it went until finally they stopped working. After the 3rd block that didn't work, it was time to move on to more drastic measures.

My doctor recommended an epidural with a stronger concoction of the spinal blocks. It was to be inserted, and then stay in my spine for a week. A few hours after I got home it had already broken. It broke, and I was brought to the ER 4 times before it was removed. I had the epidural placed on a Friday afternoon. By that Sunday my doctor had to remove it. They had too much fluid being pumped into my spine, and it couldn't all be absorbed so it was leaking back out the epidural site.

This was the point where my doctor said to me there was nothing he could do for me anymore. I was 17 years old, and any further treatments were unethical to perform on someone under the age of 18. He gave me a bunch of prescriptions and sent me on my way.

By the time I was 18, and had left for my first semester of college, I was taking 21 pills a day just to try and control the pain. It was too much and I gave up on them.

The beginning of the pain

The doctors aren't exactly sure how I ended up with CRPS. When I was in high school, I sprained my right ankle a number of times. The last time I inverted my ankle (rolled the foot inward), heard a loud pop, fell, and almost passed out from the pain. This was in May of 2001. By February of 2002 I was undergoing an arthroscopic surgery to remove soft tissue wedged in the right ankle joint. The debate is over whether it was the initial injury or the operation that caused my CRPS. The jury is out on this and may never return.

After the operation, I got an infection at the surgery site. The surgeon was slow to put me on anti-biotics, so that probably didn't help my situation. By the time they removed the cast, the infection was so bad I was put on a heavy course of anti-biotics to get rid of it.

I was slow to walk after the operation. The surgeon said there was no reason I shouldn't be able to walk 2 weeks afterwards. 2 months later he, myself, and my physical therapist were all baffled. Finally the surgeon sent me to a pain clinic. That is where I met the doctor who finally gave me a reason for the pain. He only needed to compare my right leg to my left for a few seconds before telling me he knew what the problem was.

It was a huge relief to finally get an answer. We were so hopeful. Little did we know that a diagnosis was only a small piece of the fight I had ahead of me.

To this day, on a good day I awake in the morning with a pain level of 6-7/10. On a bad day my pain levels will be as high as a 10/10. This pain level, however, can fluctuate by the second.

Intro to Me

This is my first ever blog, so bear with me. It might take a while to get used to this whole thing, and I can't promise I'll be very regular with my postings.

So why did I start a blog? I was diagnosed with a chronic pain condition known as Complex Regional Pain Syndrome (CRPS), or Reflex Sympathetic Dystrophy (Syndrome) (RSD(S)), in 2002. By the time I was diagnosed I was already in the final stages. I have been pretty bad about tracking my treatments (I used to have a notebook filled with pain levels, treatments, and just the entire saga in general, but it's MIA), and I figure this might help me do that. I would also like to help other people who may have the condition (and may or may not know they have it).