Sunday, August 29, 2010

Health Update

This is for those who are interested in what has been happening with my health as of late.
On March 24th, when I had an endoscopy to find out about my terrible bouts of nausea, they found I had a small gastric ulcer. The prescribed treatment was to get off my high-powered anti-inflammatory medication. The result has been devastating because the majority of my health problems are the result of inflammation. These are: rheumatoid arthritis which affects connective tissue, which is found between joints and surrounding some internal organs; osteoarthritis which affects most joints; fibromyalgia which affects muscles; neuropathy which affects many of my damaged nerves. The final result is that I'm restricted to living in my recliner, making me a shut-in.

My initial reaction was anger at God for allowing all this to happen. The mild depression I had had for months escalated to a clinical depression requiring medication which is helping. Over time my anger at God lessened (although I must admit it has never completely gone away), as I began to see that God allows this for a reason. In His sovereign wisdom He knows that this period away from what I was able to do is really for my good and His glory.

For the past several months I have not felt like doing very much, except to crochet, and not just any crochet but filet crochet. It is an old fashioned type of crocheting with thread rather than yarn. The results are a number of Christmas gifts for family and friends.

As my antidepressant has kicked in I've started to feel like doing more. One of my prayer partners suggested a small writer's group which meets at our home. This pushes me to write which has been a great encouragement. I've also been doing more reading of various books.

Being shut-in has contributed to my depression since I'm not able to make it to worship services at church. Praise God that my church broadcasts it's services via the internet every Sunday, and also enabled me to see some of the Hogue-Koop wedding in April, and the special concerts held there.

In May I had another endoscopy but the ulcer had not healed at all. It was a major disappointment. The GI doctor prescribed something to coat my stomach before each meal and an ulcer diet. Apparently this has worked since my latest endoscopy at the end of August shows considerable healing of the ulcer with just a short way to go. This was encouraging news for me. Praise God!

Starting at the end of May my original and still major chronic pain source became worse. This had been controlled by an annual nerve block, but now I had to call for it 4 months earlier than usual. (I suspect this is because of lack of the anti-inflammatory medication.) I also developed pain on standing and walking which I thought was connected to my original pain source. So I visited my pain doctor and he did my usual steroid epidural in May. It did not work. So another visit to my pain doctor in June resulted in an MRI being ordered, which I did not get until August 11th because of some exasperating mix up at my doctor's office. After the MRI I saw my pain doctor again to see what the next step would be.

First a lesson in how our spine is constructed for those who are not medical people: In all vertebrae (the bones that make up our spine) our spinal cord runs down the middle, protected by the bony processes (called facets) of the vertebrae. Off the spinal cord run nerves that mostly shoot out between each vertebrae. Also between the vertebrae are cushions called discs.
The first vertebrae are cervical; this is where our skull is attached. This is the one exception to the rule since there is very little cushion between each vertebrae, the nerves that come off the spinal cord run through neural foramen or holes in the vertebral bones.
Next are twelve T (thoracic) vertebrae.
Next are 5 L (lumbar) vertebrae.
Last are the S (sacral) vertebrae. These start out as individual vertebrae but by our late teens/early 20s they solidify together into a bony plate.

Some of the results of the MRI are expected:
They found the deviation of the lower spine which I've known about for over 30 years. There is no statistical data to back up blaming my back problems on its presence, which is why it is called a deviation and not a congenital defect.
They noted some “nonspecific edema of the posterior subcutaneous tissues” behind the lower vertebrae. This is probably due to inflammation, which is not a surprise since I've been off the one medication that kept this under control.

Other results of the MRI are more serious:
Starting at T12 and running down to L5 are minimally bulging discs and the facets show degenerative arthritic changes. This pretty much explains why standing and walking are so painful for me.
Most of the problems are between L4 and S1 --
The fat that surrounds the spinal cord has enlarged, compressing the cord and the nerves as they come out on each side. This is called epidural lipomatosis and is a side-effect of the steroids I have to take since my adrenal glands no longer work properly.
The disc bulging at L4-l5 is slightly worse than the rest of them, the facets show some enlargement (due to arthritic changes) resulting in a narrowing where the nerves come out from the spinal cord.

All of these problems explain much of the back and leg pain I've been experiencing. The treatment is now more complicated than what I used to get. It used to be treated easily by a single steroid epidural. But now I have to have two separate types of nerve blocks. The first is a different type of steroid epidural at L4-L5. The next will be three weeks later – a series of facet blocks higher up, probably between T12 down to L5. Praise God they put me out completely for all of these now.

I'd appreciate your prayers for all of this stuff. Pray for the pain doctors, that they will give me the right kind of blocks in the right areas and that they will work. Pray that I will learn to be content with whatever state the Lord puts me into, and that I will do the best I can with whatever capabilities I do have. It has been a long time since I've had this level of pain for this long – it is not easy. Those of you who have experienced chronic pain understand and I appreciate your thoughts and prayers.



1 comment:

Anonymous said...

Thanks be given to you allowing for regarding another prodigious article. Where else could anyone gross that kind of information in such a complete progress of writing? I have a conferral next week, and I am on the look seeking such information.