What's up with my back?

Welcome to the newly named "L Word" blog. I'm not sure why I felt inspired to make the change except that during a brainstorm one night I found it to be particularly clever - that and I had been a little disenchanted with the name "Catboogie's Dream."

As most of you know, I have been experiencing leg/back issues for the last several months. Now that I have some answers about what is really going on, I wanted to fill you in more in-depth.

A herniated disc happens when part of the disc (in most cases already degenerated to some degree) pushes through the lining and, in my case, pushes on the sciatic nerve

First, to review, how the issue of how my herniated disc came to be:

• I have experienced lower back pain, with occasional flareups, for years (we're talking possibly since high school)
  
• For several years, I noticed what I thought was just a "tight hamstring" in my right leg, but really only during yoga was it noticeable.
  
• Last year, the issue became concerning enough for me to go to the doctor and pursue physical therapy (PT), but that fell through with a trip I had planned and other life stuff - and it eventually got better.
  
• April of 2011 - major flare-up; I wake up one morning and can barely walk, can't stand up straight for several days; eventually right foot becomes partially numb which prompts me to return to the doctor.
  
• Doctor does an xray, which is basically fine, and says my symptoms should go away with chiro and PT. I am loosely diagnosed as having "sciatica." I ask for an MRI but they say insurance won't approve it until I've tried the other things.
  
• My first step in recovery is to ice frequently, not exercise (which kills me), and I am officially banned from yoga for the forseeable future. Unfortunately, I can't take Advil or any NSAIDs because I am still on coumadin for my blood clot. I am finally cleared to start PT after a couple of months.
  
• After starting PT, I am improving. Yay!
  
• 3-4 weeks ago, I am standing at the sink and cough, and feel something happen in my lower back. At first it doesn't seem bad, but I now point to this as the straw that broke the camel's back.
• Things have been getting steadily worse since then. First back pain, then more leg pain: Now it hurts to stand for very long and sitting is also often uncomfortable. I am icing and taking Aleve like crazy.
• Finally return to my primary care doc and we decide to pursue the neurosurgical route, if nothing else than just to get a diagnosis.
• Neurosurgeon has me get an MRI, shows a large herniation. Brings me in and recommends trying local cortisone shots (also called epidural spinal injections) and then a revisit; says I am borderline for surgery. Gives me pain medicine. Tells me to stop PT, chiro, take it easy.

This is pretty much what my MRI looked like; a black disc means degeneration, lowest area (arrow) has a protrusion

That brings us up to now.

I liked the surgeon I went to see, who was recommended to me by my physical therapist (who I love, by the way) as the best guy in town. I was very glad that he wasn't trying to rush me into surgery. He understands it is a last resort, and that general anesthesia is especially hard on people with lung problems.

However, I am not feeling completely confident about the current plan because from what I have read about the steroid shots, there is such a varying degree of success. And sometimes they don't help at all! Not that I have anything better to suggest. [ I am so willied-out by the idea of a a spinal injection I haven't even been able to think about it, by the way. It's like flying. I just schedule it, then show up, and that is when I can start worrying. In this case, it will be Wednesday at about 2:30pm. :)]

There is a bit of a bright side here. I realized this week that this is really just a quality-of-life issue. I mean, sort of just. With my gallbladder issue, when I was facing surgery, there was a real risk to not doing anything. There was an added fear factor on top of the medical issue itself. However, there is no real danger that can come of this not being treated or getting worse besides pain and discomfort (as far as I know). This thing is going to heal on its own eventually, it just depends on how much time I can give it and how much help it needs.

Now, given that, with my CF, I need to be able to exercise (and, please universe, one day get back to yoga) and I will always be coughing, etc. And the fact that I don't like taking pain meds around the clock and being attached to an ice pack, there is an interest there to get this cleared up asap. I want to give this time, but it is hard to be patient when you are in pain.

Lastly, another bright spot. My lungs continue to be doing really awesome right now! (I actually have still been exercising a couple of days a week.) Possibly because of the new inhaled drug study I am participating in. Although that actually brings up another issue: in order to finish this drug study, I will need to hold off on surgery (I would think) until after it is completed, which is five weeks away. Hard to think of hobbling along like this for that much longer.

One step at a time. I go Wednesday for my injection, if that goes ok, I will get another one in two weeks and then go back to talk to the neurosurgeon. In the meantime, I am making a concerted effort to heal myself, and plan to read up a lot on all this stuff, and possibly pursue alternative treatments before surgery will really even be an option.

Photo 1: Herniated disc from Squidoo website
Photo 2: MRI of herniated disc from Peak Performance website

Roses are red, violets are blue

Roses are red

Violets are blue

Maybe if you've nothing nice to say

You're best off to wait and blog another day.

I'll admit this is how I've felt the last couple of weeks. When I recently told someone about my blog, I found myself saying, "I try not to write all about health stuff because I find it's kind of depressing and most people aren't really interested in reading about it." As soon as I said that I realized that my blog has been almost exclusively about my health adventures over the last year or so. (And that if someone didn't know me, they might think I was a total hypochondriac!) Which is not ideal, in my mind, but it really is the stuff I most enjoy writing about. It is therapeutic for me. So perhaps, in wanting to try to find a balance between keeping people informed and boring others to death, the thing to keep in mind is that my writing helps me. And maybe that is the purpose - I don't know.

In any case, in some ways it has been a hard couple of weeks. PT has dragged on helping only minimally while my leg has - for some reason - decided to start being in much more pain than ever before. Standing on it for even a minute or two will lead to pain sometimes so bad that it actually takes my breath away. Can you say not fun? The good thing is that as long as I stay moving, it is ok - took the dogs for a long walk downtown last night and it was basically fine. And, when I sit down, it almost instantly gets better, which I am also thankful for.

I had my initial visit at the neurosurgical doctor this week. I had zero nerve reflex on my right foot. I'm no doctor but that seems bad to me. The P.A., who I saw, said that means the problem is coming from the L5, the lowest vertibra. That there is something going on there affecting both the nerve signals and muscles in my leg and foot. Next step is an MRI. I had a horrible sinking feeling when I left the office. Like nothing good was going to come of all of this. Steroid injections? Surgery?? Not my idea of a good time. And by the way, why me?? With all this other shit I have to deal with.

But it is almost getting to the point where relief is welcome no matter the cost. I was thinking about how I used to be able to avoid irritating my leg during the first, I don't know, two years this was going on. But now, not so much - I can't avoid standing for god's sake! And when I think about the ways that it has changed the way I live my life, especially with exercise and yoga, well, let's just say that surgery (if an option) is no longer entirely out of the question. Which is a pretty huge thing for me to say. I really think that my goal of all this to to be pain free/minimal pain at least, to have greater range of movement, and to get back to yoga. Life just isn't the same without it.

In the meantime, I am (sometimes) barely getting by on Aleve, muscle relaxers and ice. I honestly don't know that the pills are doing any good. Oh, and my PT exercises. Still doing those. Sometimes they help. And others, like this morning, they seem to do nothing at all.

Drug Study: Even though I haven't been able to exercise my normal amount, I have seen my PFTs go up a little bit in this drug study I'm doing with a new inhaled antibiotic. I don't know if I am on the placebo or not. In any case, it is extremely awesome that even though the rest of me is sub-par that my lungs are totally hanging in there!!

Another great thing right now is that work is going awesome. I am busier and happier and more challenged than I ever have been. Also been doing a lot more writing and editing, which I enjoy (especially the editing.) I've been working more hours than usual and - being very conscious of getting enough rest at night - again, my body is holding up really well. And that's great.

Coming up: still waiting to see when a good time will be to go up north to see my new nephew Simon!! We are starting to think about planning some trips for next year. And, of course, hockey season is right around the corner. :)

Tonight we are going to celebrate my oldest friend Erica's birthday. Been looking forward to it all week!

Image taken from http://www.pictures-of-roses.com

A Change for First Friday

Our latest batch all ready for First Friday September

808 Soap has had First Friday, a downtown event during which art galleries stay open late and entice people in to browse with free wine and beer, on the third floor of a really old and quirky building downtown (Father & Son) for a year-and-a-half or so. We were all set for First Friday September with 25 new bars of soap and then... we found out that our normal place is still trying to resolve some issues before they can have big events again.

After a brief moment of panic, we decided to ask our friend who owns a bar downtown and, while 'selling bars in a bar' has a cute ring to it, we really weren't expecting much. It would be totally different than our normal crowd, would not get busy until later in the night after we were done, and who even carries cash anymore?

But it actually turned out really great! (Sadly, I got not a single picture.) Though the bar is the opposite of Father & Son in almost every way (3rd floor - basement; hot - cool; light - dark; cramped room - lots of space; limited alcohol selection - infinite choices of alcohol) somehow it worked. We sold 9 of our 25 bars in just over 2 hours of time, which is a good night for us.

So what is the future of 808 soap's First Friday? With the holiday season soon approaching, we definitely need to figure it out. Father & Son will likely remain a good place to sell during the rest of the month, but First Fridays there may never be the same.

Elaine and I at our display at Father & Son

Nephew!!!

Nate holding Simon

The big news around here is that my new nephew - Simon Delucia Smith - was born Monday morning, an entire month early! The good news is that his weight was fine and he was overall healthy; but they have kept him in the hospital this past week because of small issues that have cropped up. They are just being very precautious and hopefully he will be home soon!

Mom and I are trying to figure out when and the best way (fly or drive) to get up there and see him. Mom has continued to recover well from her hip replacement, but she still can't walk terribly long distances. So we will see. But we are both very anxious to get up there!

I had a really great visit up to the mountains for work this week. Four of us from our Durham office went up there and were shown around to some of our project sites in Hickory Nut Gorge (including Bat Cave - we felt the blow holes but couldn't actually go up to the entrance of the cave) and the Greater Roan Highlands (which was a trip up the marvelously beautiful Big Yellow Mountain.) We had great weather both days.

View from the top of Big Yellow

Those were the incredibly awesome extremely cool highlights from the week.

In less exciting news, my PT guy this week told me that he has done all he can do for me, and that it is time for me to see a back specialist (aka back surgeon) to get a full work-up, including an MRI. We were all (chiro, PT, GP, and I) hoping that it wouldn't come to this, that my issue would be able to be resolved with the combo of chiro, PT, and stretching/exercising I've been doing.

It's kind of funny to me because things would have never escalated to this point if it weren't for me getting a flare up a couple of weeks ago. (Pulled something in my back coughing.) I had been getting better, and I would have continued to get better and then go on my way; then at some point I would have gotten another flare up and had to start the whole process over again. So it is better that it happened now.

The years I've been dealing with this, the flare ups come and, ultimately, go. Last time I started PT, I went on vacation and had a course of IVs and by the end of that my leg was fine again. But this time is worse, I'm not sure why. And it has stumped the therapists. So stay tuned for the next chapter.

And as if I really needed something else to deal with, my skin has flared up with a strange rash. I'm not sure what caused it, but it is driving me sort of nuts. I am definitely thinking that if it isn't getting better soon I will need to see the doc or a derm doctor.

Lastly, here is a picture of me at UNC doing my first dose in a study for inhaled levofloxacin on Thursday. You all know how I am into documenting everything. :)

Figuring it out

Allergy testing

My goal for last weekend was to chill, chill, chill. And chill I did. It felt strange, but was very nice. :) Finished a book, napped, went to a movie, caught up on my trashy TV. I need to do that more often.

This week has, as usual, been go-go-go. The highlight of the week, appointment wise, was my allergy re-testing on Wednesday. We tested all 108 (a very auspicious number, no?) environmental and food allergens, and the only things I was allergic to was ragweed and...cats. Sadly. This is actually amazing, though, because when I was first tested in 2007 I was allergic to - seriously - the large majority of environmental allergens that we tested. This means that the allergy shots have been doing their job. Yay! We are going to beef up my serum for cats and ragweed and hope that will help me be able to cut back on my Prednisone dosage, which is now 10 mg per day.

My leg has continued to be bothersome and painful at times. My PT has been going along well but also feels like a bit of a crapshoot. I mean, on Saturday, after I've been going there for a month already, the therapist says to me, "I'm still trying to figure out just what's going on here." I know I have only seen her three times, but really?!? I go through 30 mins of 20-questions -"does this hurt?" "what is your pain level for this?" "if you do this, is it better or worse?" - I walk out feeling a bit better, but wondering why in the world it takes that much maneuvering just to feel a little bit better. It just doesn't seem fair. Actually, I am really frustrated and I hate it right now.

Onto merrier things: this weekend, our friend started refinishing our deck. So far, awesome! Can't wait to see the final result. Last night, Todd took me to a concert of a band he saw a bunch of times in the 90s but who hasn't played for a long time and I really enjoyed it. Today, Elaine and I made soap, working around her upstairs which has been inundated with stuff from her basement which flooded two weeks ago. It was good to make soap after so long of a break. Had some really cool ideas today. I'm lately feeling like such the 'ideas' person lately, and it is a role which I really like.

Ta-ta!

Kitty week

The cat forever to be known as "kitty"

I had a pretty interesting week. Went to a Bulls game with some co-workers on Wednesday night - it was a perfect night for a ball game. Got some pool time in with my good friend on Thursday. We used to go a lot but this is the first time we've gone this summer. And yesterday I had a friend over and we grilled out pork chops (which turned out really well, not dry!) and then played a pretty intense strategy game at which I lost badly. But it was still fun. :)

I found a kitty on Sunday! She was a very friendly black cat who was so hot (it was 100-degrees out) that she was panting. She was also bald on her hind legs and rear end and had scabs around her neck, it turned out, from being allergic to fleas. I was worried about her and ended up taking her to the emergency vet.

$330 later she had been given fluids, de-flea'ed, her respirations were down, she tested negative for all communicable diseases, and they had given her shots of antibiotics and steroids. Long story short, it ended up that her owner was on vacation and she had escaped from her house. He got home two days later and they had a happy reunion. While it seemed he might not be taking the best care of her, the flea issue was recent and he'd been trying to get it under control, and the cat supposedly had a micro-chip since she doesn't keep collars on. So it was a happy ending.

I had a good session of PT on Monday, except that my leg tightness, which is the main symptom I've experienced since this has been going on for the last two years, doesn't really seem to be getting better. However, other good things are happening and in general I feel like I am progressing well. Then on Tuesday night I was standing at the sink coughing and irritated/reinjured the problem area in my back. At first it seemed minor, but it has turned into the same thing as before - really tight, keeps feeling like I need to stretch it but that doesn't really help, painful to turn certain ways. Ugh.

I was pretty much "over it" even right after that happened. As in, I'm tired of this messing up my life. So I went ahead with my elliptical that night - that was OK but probably wasn't great for it. Thursday I swam some laps at the pool, again, seemed OK. And Friday I was back at PT for my first "acute" visit since I started going. This morning it again feels tight and irritated. So I'm going to try to take it easy this weekend.

This week's appointments: (ha! I have so many appointments, I could probably have a category like this every week!)

• Monday, PT (above)
• Tuesday a.m., endocrinologist (diabetes): went well! A1C was 7.0 which is great, means my sugars have been under good control.
• Tuesday p.m., rheumatologist (allergy doc): I have been on allergy shots for 4 years now, and the Xolair shot for 3. The goal of these is to try and reduce the amount of steriods that I am on (both inhaled, Advair, and oral, Prednisone.) I have had a good year in terms of infection, but a bad year as far as Prednisone use. I am currently on the equivalent of 10mg a day, which is more than I want to be on. (5 would be ok.) So we decided to re-allergy test me. The thought being to see what I still react to even though I'm supposedly being treated for the things I am most allergic to. We are doing that on Wednesday and I am excited to see the results.
• Thursday - ok, this one was voluntary. I went to a screening visit for a clinical trial for a new inhaled antibiotic, levofloxacin. This is a drug that has been used for a long time in oral form, Levaquin, but the inhaled form is new. This is a stage II trial to test safety. If I get into the study, which I should, I will start it (or placebo) in two weeks. I will go back then, and then every two weeks for two months - the idea being that they follow me while I am on it and for the month afterward. To get into this trial, I have gone off my current regimen of inhaled antibiotics, and that is, fortunately, going very well.
• Friday - PT (above)

No big plans for the weekend, just going to take it easy.

Great Northern Adventure

My uncle Matt, Aunt Judy, me, Nathan and JoEllen

It's about time for some catching up here on Catboogie's Dream.

Basically things are going very well. I just got back from a wonderful vacation which I will tell you all about. And mom is doing ok despite a couple of setbacks. She had to go back in for surgery on July 14 to have her incision cleaned out. There appeared to be some infection at the surface, but the doctor wanted to confirm that it hadn't spread any deeper.

The post-surgery news was great - he had seen no indication of any infection, but he sent away some cultures anyway. However, when the cultures came back a few days later, they showed some mild staph. What was supposed to be a quick stay in the hospital ended up being four days. But she recovered well and was again back home.

Things have progressed slowly although in the right direction since then. The unfortunate part is that mom developed an allergic reaction to the oral antibiotic they sent her home on, and she has been quite miserable dealing with that for the last couple of weeks.

Vacation:
I left on the 21st to drive to Cleveland. On Friday, my step-mom and I hit some of our usual second-hand spots, and then again on Saturday. We had amazing fresh fruit and corn, and went out for Thai food one night with the best coconut ice cream I've ever had (ok, you got me, the only coconut ice cream I've ever had. But it was delicious!!) Dad seemed to be doing pretty well; amazingly well despite the heat and humidity which are often treacherous for him to deal with considering his breathing problems.

This was my first time in Cleveland since my dad has been officially listed for lung transplant. I have to say, as relaxed as everyone there seems, it was a bit strange. There is that thought of 'what if' every time the phone rings. And there is a split reality in the sense that things could either go on as they are for as long as possible, or else that something will drastically and life-alteringly change - possibly at any moment. I hope the lungs come sooner rather than later.

After a couple of days, I headed to Michigan, first to visit an old friend and then onto my brother and his wife's new house in Mt. Pleasant. I have serious house envy of their turn-of-the century home, complete with gorgeous woodwork, beautiful hardwoods, plentiful working windows and lots and lots of space.

My brother's house

The next day, our uncle and aunt came up from Indiana to see the house, visit, and we had a small little baby shower during which we Skyped in dad & Mary Ann in Cleveland and mom in North Carolina.

In general, Mount Pleasant is a very cute and sleepy town. The downtown, while small, is thriving with shops, some galleries, a few restaurants, a yoga studio. It's about a 10 minute walk to downtown. There is a food co-op, a soda shop and a hardware store. Everyone was out enjoying the nice weather, but I can imagine the speed during winter is a lot slower.

I went back to Cleveland for a couple of days before returning home. I bought a beautiful cherry wood lingerie dresser that I had not been able to get out of my head since being there which *just* fit into my back seat. And then I got a crazy idea - instead of driving home Saturday, I would drive to my aunt's house in Pennsylvania, which I have been wanting to see since she moved there a couple of years ago, and then drive home from there on Sunday. The drive was very pretty, especially the last hour which was on a very windy, rolling and beautiful historic highway.

Scenery in rural Pennsylvania

It was nice seeing some more family and exploring a new place. It has been many years since I've driven on the Pennsylvania Turnpike, which my mom and I used to always take to visit family in NC and VA. The PA Turnpike is filled with 24-hour Starbucks (heaven!)

It was also nice to drive a different way home. Lord only knows how much I have driven I-77 in the last few years!

And then...I was home!!

Couple of quick updates from this week:

• My chiro said my back was doing very well and cringed when I told him I had driven almost 2,000 miles since I saw him last. He then said my back was doing especially well considering that!
• Had two more sessions of PT this week. I really like it. I am surprised how many yoga stretches are involved. The PT person reiterated how bad driving is on your back (but I was very conscientious of my posture) and gave me some special after-driving stretches to do.
• My lungs are beginning to feel a bit heavy from being off the inhaled antibiotics in preparation for a study for a new inhaled antibiotic. It isn't terrible, but it is noticeable. I now know the antibiotics do help (hard to tell when you are just on them continuously.) And it has really forced me to stay on top of my exercise, which is good.
• Had the much-anticipated hematology appointment on Thursday for the doc to weigh in on my stopping coumadin. GREAT NEWS - I AM OFF OF COUMADIN!! I am going to start on a daily low-dose aspirin, which should give me some protection from clot reformation. Overall, the appointment was great - great doctor (who, of course, my ever-awesome CF doctor had already prepped via emails back and forth). Bottom line is that he thinks my port will be fine. But if I do develop another clot, we have a plan for how to handle it. The not so good news is that the stenosis (narrowing) in my sub-clavian vein, which showed up on the ultrasound only after the clot had cleared, is scar tissue from all of the picc lines that I have had. So no more piccs or ports on the right side of my body. However, anything done on the left side should be fine. I have another whole side to mess up - yay!
• Lastly, the Cystic Dreams Fund, for which I sit on the Board, gave out our first four grants this week. I have to say I really enjoyed being a part of that process. It is great to know that we are helping to make peoples' lives a little bit easier. And I know that Paul, my friend who passed away and for whom the foundation was started, would be very very happy.