Archive for January, 2003

Adventures In Emergency Part 3

Nothing ever becomes real
till it is experienced
— even a proverb is no proverb to you
till your life has illustrated it.

John Keats (1795-1821), English poet

January 31. Friday.

Pain 9
Mobility 2

I awoke this morning to an eerily familiar situation. I was laid on my left side in a semi-foetal position and could sense the impending doom. It was not until I swung my legs over the edge of our exceptionally elevated bed and put some weight on my right leg that my heart sank. The pain, that excruciating nerve pain that is instantly unbearable shot from my back and out to the right portion of my thigh. Yesterday I had been feeling some degree of pain in the surgery site (a 4 or 5) but was under the assumption that it was static. Apparently this is not the case. I called my physio who instructed me to get myself to emergency and have the on-call doctor check it out. I also called my surgeon’s office in the hope of a little verbal direction however his office was closed until Monday. By this time, three hours had passed and the pain was increasing. Seeing no viable alternative I called Nicole and asked her to come and get me.

Without sounding too falsely complimentary, I don’t know what I would do without Nicole, she has never hesitated to do whatever necessary to help me through, never complained about being put in what is really a pretty crappy and emotionally demanding situation and best of all has never tried to hide her emotions regarding my situation. It is nice to see a brave face, but for me it is far more motivating and cathartic to see honest reactions to the ups and downs of my recovery. She has always shown immense strength of character and unwavering support, two things which have provided me with the emotional resolve to keep my head up and my attitude positive.

Upon my arrival I was once again immensely disappointed with the system in place for evaluating and processing incoming patients and was told to take a seat until I was called. I then learned that apparently the flu, a pulled muscle and a complaint of nausea and headache are more critical than a staff member returning after emergency surgery who is in immense pain, is losing all feeling in an extremity while standing in front of the triage desk and who is almost completely unresponsive to any stimulus from the hip down. I know it always seems more important that whatever anyone else has but I am at a loss to explain whatever ranking system they use to process incoming bodies. No wonder people call ambulances for every little thing, at least then they won’t be completely ignored. Luckily, as Nicole was returning from parking her car, she noticed my surgeon on his bike and accosted him with the news. His response though, was rather a let down I suppose. He told us that most likely it was just a disturbance of the scar tissue and because I have a “surprisingly mobile spine” for my size that he had expected some settling to occur. His solution was to fill me with narcotics and tell me to restrict myself to complete rest for the weekend.


So I took my Oxycocet and Nicole returned me to the couch, now in agony and rapidly losing faith once more in the medical community. The pain was now completely contained in my leg, not my back, but was just as intense as it had been pre-op.

We shall wait and see then won’t we?


I can’t make it all on my own,
no I know, I’m no superman.

Scrubs Theme Song

January 26. Sunday.

Pain 4
Mobility 6
Years 2
Love 10

Congratulations I think are due to the two of us, no only because we have survived ourselves and the massive changes we have both experienced within ourselves this year, but also because we have once again survived each other. We admit that we are not the easiest people to live with, and the longer time goes along, the more we realize that there are no two other people on this planet who could bear to put up with the two of us.

I shall revisit this page soon, but my condition currently makes typing extremely difficult and potentially harmful to me.

Nicole, I love you, I thank you, and I can’t imagine sharing my life, warts and all, with anyone else but you. Happy Anniversary!!!

Rocky Road

No man ever steps in the same river twice,
for it’s not the same river and he’s not the same man.

Heraclitus, Greek Philosopher

January 24. Friday.

Pain 4
Mobility 6

That is the thing about life, nothing is ever as straightforward as you wish it were, and despite your best efforts, something will always trip you up in the end. Maybe it is just to keep us on our toes, maybe it is because we as humans are intrinsically flawed and therefore our lives are modelled after that but whatever it is, I was a victim of it this week.

It started off on Saturday as I went to sit down, the old familiar pain shot through my back, causing a great deal of initial surprise, and then an overwhelming tidal wave of anger. The pain was identical to the event pain I experienced whenever the herniated disc failed. Needless to say, this was a feeling I was hoping was a mere memory at this point. I stumbled to the couch and in-between breathing fits, spitting with anger and loathing and the odd bout of overwhelming self-pity I medicated myself and hoped for the best. The next day was surprisingly better. I was due to go to the physio and after a short discussion with her, she informed me that what had happened was a slight tear of the scar tissue that was forming which had in turn impacted the nerve, causing that all too familiar pain. I was eager to take her at her word and after some traction and some ultrasound treatments I went home feeling much more comforted and a little more confident.

The following day I was feeling much better, back on the road to full recovery or so I though. On the direction of my surgeon, I was trying to walk as much as possible and so I went to the store (about 100 meters down the street) and back without incident. However, the next day, which was now 3 days ago, I was suddenly unable to stand once again. I had gone from someone who had the appearance of magnificent recovery to the picture of pain and immobility. The pain this time was the feeling of having pulled a muscle in my back. The pain was not localized to the herniation site, but rather was from my mid back to my buttock on the right side. The result was an almost complete immobility of the lower back. This meant I was resigned to having to use my cane and several movements just to stand and the act had to be accomplished without any flexion of the back at all. This in itself is quite a feat, and anyone who has ever seen a VERY pregnant woman trying to stand from a low chair can imagine how I looked.

Discouraged is the penguin sitting atop the tip of the iceberg at this point. However, I was confident that the feeling was indeed muscular in nature and was most likely the result of an odd flex or compression while walking the day before. I was due back at the physio that day so I thought I would wait it out and see how I felt once I got there. Ha… not going to happen as they say. I was forced to cancel, not only because it was -20 and -35 with the wind chill, but also because there was no way I was going to be able to sit in my vehicle again. Was this back to square 1? That, indeed, was the question of the day. Call it blind faith, call it naïveté if you like, but I was almost sure that what I was experiencing was not in the order of magnitude that would require me taking any more drastic action than rest and medication. So, I once more chose the path of least activity and restricted myself to bed rest and chemicals while images of prosthetic discs and a second surgery bubbled slightly beneath the surface of my consciousness

As I awoke the next day, Thursday, I was pleased to find that the pain was reduced, the mobility was increased and most importantly that the pain was in the same place it had been the day before. I know by now that the most dangerous thing is when the pain starts to move around on me, and since it was a lesser degree of the same immobility, the light at the end of the tunnel once again beckoned me forth.

So I awoke this morning at 3:15 as usual, waiting for the Grocery Gateway guy to arrive between 6 and 7:30 roughly at the same place pain wise as I was just over a week ago. Although there is discomfort, there is no real pain to speak of, and although my mobility is still seriously lacking, I am able to once again reach my entire body while showering (there is a mental picture you won’t be able to banish for a while!)

These past few days have been critical in the judgment of my condition. I have learned that despite the surgery, that incandescent pain I feel on herniation may in fact not be gone forever as I had hoped. I also learned that the pain that followed was in fact muscular in nature, and that this description will help me to recognize that specific pain and to treat it with muscle relaxants, not anti-inflammatories.

There is one other thing too. Yesterday my cousin Kim turned 18. This is significant in so many ways for her, having recently found a decent chap to date, finally doing well in school and listing goals and ambitions as commonly as she used to list snowboarding tricks that she had learned behind the clubhouse with her pals. This age for Kim is significant I believe because she is finally starting to realize just what she is capable of achieving. I have not seen her in quite a while, but the brief talk I had with her a few weeks ago before my surgery revealed a much more mature and sensible young lady than I have ever seen before. 18 is a great age for so many people, I remember it was the time when I finally got a grasp on who it was I wanted to become, having been placed in boarding school and needing to fend for myself for the first time. But more than this age revealing her true character, I think it signifies something much more important, and that is the development into the woman we all believed for so long was hiding deep inside there somewhere. It is always fun to see kids grow up and change, but when it is someone so close to you and with so little experience as I have had, it is extra special to see her ready to take on the world. So Happy Birthday Kim, my little cousin, my 6′ tall 18 year old cousin, and although it is sad to see that little girl go, it is just as exciting to see the mature intelligent woman we all expected reveal herself to us at last.

The Good News

We have not lost faith,
but we have transferred it from God
to the medical profession.

George Bernard Shaw

January 14. Tuesday.

Pain 7
Mobility 4

The nurse really didn’t have to tell me that the skin had grown over the stitches and she was going to have to “dig in a bit” to get them out. She was amazed however that it had only been 2 weeks since the surgery, apparently I am a healer. I lay face down on the gurney, holding on to the headboard rails as she poked around, pulled and cut, all the time making small talk about how my surgery had been. Needless to say, since I had driven myself, hobbled from my car to the fracture clinic and stood around for half an hour waiting for the doctor to see me I wasn’t really in much of a conversation mood. Strangely, as she pulled each stitch from me, my mood seemed to magically improve. Nicole had promised to be there for emotional support, and didn’t even think it was gross that this woman was slicing and dicing me with a scalpel while pulling on my loose threads like an old pair of jeans. So they bandaged me up again and proceeded to parade me in front of the doctor, the physiotherapist and what seemed like anyone who wanted to poke their head around the curtain. It was all over in a flash, and we left with a referral to a physiotherapist in the medical building next door and an assurance that I could start walking gently, and that next week I could finally start to exercise again. (Of course, at this point I had no idea I would be back the next day to get the remaining stitch taken out… Unbelievable that someone could miss one, just unbelievable) Not that I was told I could hit the weights, but rather that I needed to start very light, make sure my back is supported and not to do any pulling exercises for the time being. I was also told that I would probably benefit from Electronic Muscle Stimulation or EMS in order to attempt to improve the atrophied muscle in my right leg which at this point is still all but useless when it comes to anything except a smooth level surface.

So I survived the journey into the snake pit, and although most people may have wanted to go and see their coworkers, there was no chance in hell that I was going to subject myself to being in the same department with those people until I was absolutely ready. Not necessarily because they are about as irritating as a weeping rash, but rather because I can’t muster the strength to explain to everyone over and over again how I am and what I am doing and when I will be back and so on and so on.. ugh.

I have to say also that it was great to see Nicole during the day again, and I know that it might sound strange to some that I miss her, it is true. There is a big difference between seeing someone at home after they have been working all day and you haven’t and struggling to work through the work week together, providing humour and strength to each other. I don’t miss work at all, but I miss working with Nicole every day. (That and the fact that I don’t trust her car in this snow we are having.)

Breaking The Fever

One small step for man
One giant leap for mankind

Neil Armstrong

First lunar landing, 1964

January 11. Saturday.

Pain 7
Mobility 5

I knew eventually I was going to have to force myself outside. Being cooped up even in the most luxurious and relaxing of surroundings does tend to fog one’s mind and debilitate one’s body. So I bundled myself up, taking at least 20 minutes to manage to dress myself, and took to the streets. Unfortunately, or maybe a well disguised blessing, we live close to a creek which means that all the sidewalks around here are either up or down in grade. The up proved to be no problem at all, but the down was a different story all together. I am glad I took one crutch with me “just in case” because without it I would still be standing in the snow at the corner of our street unable to make it down the grade without assistance. But all in all it was a wonderfully relieving experience. I was out for about 15 minutes, did a small circle around our little gated community and made it back in one piece. Lofty goals I know, but at this point, survival is my only driving force.

Adventures in Spinal Surgery

During your lifetime you will consume
approximately 60,000 lbs of food.
The equivalent of 6 elephants!

Liza Fromer, Breakfast Television, CITY TV

January 8. Wednesday.

Pain 8
Mobility 3

15 stitches, a 6″ incision. I feel like Frankenstein’s monster.

This cabin fever is going to have to break soon, but meanwhile, here is an email I sent out o my co-workers to help them understand exactly what had happened to me and how I was. Rather than duplicate that effort, here it is:

I just wanted to drop a quick line to everyone to let you know what actually happened to me and how I am doing. I know a lot of you have asked Nicole how things are progressing, and I am grateful for the concern and the well wishes.As many of you know, I have had issues with a herniated disc in my lower back (L4) for many years now and have recently discovered medication that enabled me to reduce the time of recovery down to a couple of days. However, the recovery is contingent on absolute rest and careful monitoring of my situation. Unfortunately, the most recent episode was far more serious than usual due to the need for me to be mobile and active in order to resolve issues relating to my responsibilities at the hospital. What started out as a simple herniation of the disc creating pressure on the spinal nerves which causes an effect somewhat similar to Scoliosis (I am sure some of you have seen both Bob and I leaning over to one side as we walk during these painful episodes) developed into a severely displaced disc fragment that impacted the sciatic nerve. This caused excruciating pain down my right gluteus, into the quadriceps and terminating in the knee. When the cortisone injections into my spine did not help the situation, it was determined form both a CT and an MRI that surgery was going to be necessary to remove the portion of the annulus that was touching the nerve root. This was in preference to a discectomy that would have required removal of part of the nucleus of the disc in order to reduce the overall size of the disc. Most procedures that are available to patients with severe herniations are effective over time but require the procedure to be performed while the disc is healthy and normal. Even the newest and most promising procedure, referred to as “Percutaneous Microdecompressive endoscopic Spinal Discectomy with New laser Thermodiskoplasty for Non-Extruded Herniated Nucleus Polposus” as it’s name suggests requires that the disc be in a non-extruded state.So my options were limited, and under the trusted care of Dr. ******I went in for surgery on New Year’s Eve at 4pm.
Since the surgery, I am glad to report that the localized pain is gone both in the spine and the thigh. However, there is still pain in the knee and much of the strength in my upper leg is gone. I left the hospital on crutches, unable to support any weight on my right leg. I am happy to report that I am now able to support myself without the use of crutches, however I am unable to climb even the smallest of steps. Much of the loss of feeling in my leg has also returned, however from the top of the knee I still have little or no tactile sensation. It is normal for this numbness to remain up to 9 months after sciatic nerve injury, and from what I have read, it is normally 6 to 8 weeks before the pain is completely gone and normal strength returns.Since walking requires very little bending of the knee, I am able to walk without crutches for short distances (a hundred feet or so), however any incline or decline which requires strength from the quadriceps is impossible to negotiate without crutches.
I have a follow up with the doctor on the 14th of January which is 6 days from now and I am hoping that by that time I will be able to sit without pain and to walk without assistance. If that is the case, and I am given the all clear, I will return to work at that time.
Once again, I want to thank you all for your concern and hope that you all enjoyed a much better holiday season than Nicole and I were forced to endure.
Hope to see you all very soon,

Clarity Part II

You may also receive a telephone call where no one is on the other end.
It can be annoying and frightening.
These calls are often the result of something called “predictive dialing”.
Some telemarketing organizations use automatic dialers to place telephone calls or send faxes.
A “dead air” or “hang up” call will occur if a telemarketing representative
isn’t available when the call is answered.
Generally, companies allow sufficient time between calls for a representative to be available;
however, if the telemarketing representative is on another line
longer than expected, the result is “dead air”.

Telemarketing Factsheet


January 6. Monday.

Pain 8
Mobility 2

Although lacking any degree of clarity, I think that last entry appropriately captures the alarming speed with which life can turn around on you. I now spend my days on the couch recuperating, planning hardware projects and searching for bargains on Ebay. You can also tell that I am getting a little better since things other than my back are bothering me.

Telemarketers, specifically.


Did you do a search for the above number? If so, you are not alone. These people have been calling and hanging up (not an effective telemarketing method, FYI!) for weeks now and when I did a web search for them I was rewarded with the knowledge that they are in fact a telemarketing firm. If you call the number back they now have an answering machine which promises to remove you from their list. Right. I would recommend that you check out this page at the CRTC and take matters into your own hands.

However, I digress, as I wanted to point out a fact about my condition that is overlooked by most, myself included, but that is critical in any injury/recovery process. Imagine for a second the worst thing that someone could do to you within the realm of normality. By that I mean we are not talking about topics fit for Jerry Springer, but rather situations that everyday people would encounter. I have come to realize that the worst thing that you can do to another person within the confines of a relationship is risk your health. Be it refusing to go to the doctors office when you are obviously in need, or engaging in some activity that is damaging to yourself regardless of the consequences. There is nothing worse that seeing the person you love in pain. There is nothing quite like the feeling of powerlessness you experience when there is nothing that you can do to make things better. In addition, there is nothing that will inflame your anger and hostility more than the knowledge that the person is doing it to themselves.

So I need to apologize.

I can’t imagine anyone being as patient, as caring and as wonderful as Nicole has been through this episode. Not only that, but her patience throughout the past two years seeing me more often than not going from bad to worse all the while assuring her that it would be OK. I know I am not easy to argue with, that my flawless logic is crafted out of necessity rather than fact and that at times I can be stubborn. I also know that I must have caused her immeasurable heartache with my complaining, my bouts of gut wrenching pain where tears would flow freely down my face while I convinced myself that I knew what was best for me. Had I been in her position, I can’t say I would have been so patient or so forgiving. I remember how heart breaking it was to see her chipmunk cheeks after having her wisdom teeth out, her struggle to smile or even to open her mouth. It tore me up, and ever since I have had an overly protective feeling about her that I am sure at times is almost claustrophobic. However, Nicole and I are odd sorts, we spend 24/7 together and if we had the chance we would make it more. Our lives and psyches are so in tune with one another that sometimes it is hard to distinguish between our thought processes and even harder to try to conceal some truth or lie from one another. In fact, if you plug our birthdays in to a Biorhythm chart you will see that our cycles are almost identical, meaning our energies ebb and flow as one. All of this means only one thing, that any pain I am feeling will transpose itself onto her, and if you add that to the frustration of having to deal with an occasional stubborn ass then you end up with an emotional weight that I wouldn’t wish on anyone. I have said it again and again that I am astounded by her strength and her ability to empathize, but now I am simply in awe of her ability to stand up to a situation and a psychological battering that I am certain would have overwhelmed the vast majority of people.

I also need to say thank you.

Don’t get me wrong, it’s not as if I am an ungrateful; slob or some sadist whose purpose in life is to make others miserable, however, with what Nicole has had to put up with over the last few weeks my Tylenol 3/percocet/morphine induced slurrings of “I lurve you” and “Thank you I’m sorrysorrysorrythankyou” are most likely largely inadequate.

There are reparations to be made once the transformation into the unbroken man are complete and that is going to be a reward for us both in itself.

Thank you. I love you. I couldn’t have survived this nightmare without you by my side.


Damaged people are dangerous. They know they can survive.

Josephine Hart, Damage, Ch. 12

January 3. Friday.

Pain 9
Mobility 1

I struggled briefly with the confusion, the fog lifting rather more slowly than I would have liked and for a split second I was suspended in my own ethereal quasi-reality, no doubt a side effect of the narcotics. The room, a bland and flavourless kind of orange snapped into view, but still the logic of the situation evaded me. As I exhaled a seemingly endless breath, the incision reasserted itself at the front of my mind with blinding reality. I am certain that waking up in a hospital bed isn’t going to make it onto my top ten things to do first thing in any new year, at least not short term. In reality, the situation in which I found myself this January 1st may (I hope) prove to be the very best of all possible outcomes.

It started about 3 weeks ago when I started to feel tightness and pain around my right lower back. This is a recurring event for me, seemingly every 6 months or so something happens to aggravate my L3 L4 disc making it herniate and pinch the nerve. The “event” is normally something like tying shoes, picking up my bags or some other mundane and definitely not typically dangerous activity. The result is a moment of excruciating pain followed by a list to one side and the spasming and involuntary contraction of various groups of muscles of my torso. The effect is one of Scoliosis, however the effect is largely temporary, cured by rest and lots of muscle relaxants. The inflammation of the nerve is treated by a very strong anti-inflammatory used to treat arthritis called Arthrotec, and usually I am up and about in a couple of days. Over time I have learned that indeed if I am not active almost immediately, my condition deteriorates until I am once again up and about. However, this time was different. There was no event to signify the start of the condition, just a nagging pain and dull ache around the usual region. I took the usual evasive steps but was surprised to find that no matter what I did, the condition worsened. The problem was not necessarily that I had done something significantly wrong to create this problem, but rather that in an attempt to stay active I was aggravating the problem. Couple this with an evening of standing in a cold server room with my boss who had called me in late one evening to fix a server issue and you have a recipe for disaster. After the evening fixing the problems that seemingly run rampant the second I am off site and assuring my boss that thanks to him I would not be returning to work that week, I was afraid that I had done too much. Little did I know just how far I had really gone. After 2 weeks of increasing pain, non-responsiveness to the medication and an increasing discomfort in my right thigh, I was becoming a pain in Nicole’s behind and she finally decided enough was enough and drove me to the emergency room. It wasn’t until I was in the car that I realized just how disabled I had become. Much like the boiling frog, I had adjusted magnificently to the pain and was unable to see that I was almost completely crippled. We saw the triage nurse, registered and then sat for 2 hours waiting for admission to the ambulatory area. Once there however, things sped up somewhat and 8 hours later (yes, I was being sarcastic) I was given 2 cortisone injections directly into my spine and several shots of Demerol to numb the pain. I was then taken to the CT room for a CT scan to determine the extent of the herniation. I was given the opportunity to stay for observation, but being less than thrilled with the treatment so far I decided home was the best idea. The decision to return home enabled me to relax (!) in familiar surroundings, but proved to be a critical error. On my way up from the basement, my leg gave out on me and I fell backwards into the handrail, trapping my leg through the open steps and cutting my knee in the process. This was the final sign that unlike my back episodes in the past, this was becoming critical.

Two days later, I was back in front of the triage nurse begging for someone to put me out of my misery.

This was where the true colours of the Canadian Health Care System really shone through. I have spent the last 5 years of my life committed to providing the best in security, speed and availability to the Clinical system at the hospital and hearing all about “patient care” and the need for prioritizing patient data but now I have to admit, my attitude is forever damaged. The nurse, the registration nurse and the ambulatory nurses and doctors failed to take a look at the visit form just 2 days prior. Although I told them many times when and why I had been there, their staunch refusal to pull the charts for the CT or the prognosis left me with a feeling of anger and neglect that I will remember for the rest of my life. I still, days later, find it hard to believe that the millions of dollars that the hospital has spent on the clinical system and training medical staff to use it that we may as well be using paper charts and pencils for all the good it does. I can’t even imagine how I would feel or how I would have been treated if I weren’t staff, and it is taking all my strength not to voice with great volume my displeasure with the system, the people in it and the brutal treatment that people must endure in order to get the care they need.

10 hours after being wheeled into emergency for the second time in two days, unable to walk, shaking with the pain and obviously under extreme duress I was admitted to the OR for surgery. I had been given Demerol, percocet, several muscle relaxants and some sublingual painkillers to enable me to withstand the pain of the MRI since having my legs straight caused intense burning from my thigh into my knee. I think of myself as having an extremely high pain threshold, since much of my life now involves managing pain of one kind or another but I was overcome by the intensity of the pain that seemed to localize over the interior cruciate area of my knee.

The pain was simply intolerable as I slipped away, breathing farewell into the plastic mask that covered my nose and mouth. It was 4pm, New Year’s Eve, a fitting end to what had started off as the Nightmare Before Christmas.

Several hours later, the herniated portion of the disc sat in a sample bottle by my bed, small victory over a piece of tissue that potentially has been the bane of my existence for the past the past 11 years. I squeezed the button to introduce another shot of Morphine into my IV and drifted off to sleep once again.