Thursday, October 18, 2018

Hiatus

I apologize for the long hiatus in posting something here.  There have been two reasons for this; I will address the second reason in the next post.

There is a lesson in this, expecially for us "seasoned" sailors...  listen up:

I have had arthritis in my spine for a long time; I am no stranger to back pain.  In fact, I have had two spinal fusions already, L4/L5 and L3/L4.  So, the back pain I was experiencing early this summer was not a surprise, just a slight intensification of what I normally feel.  With one exception:  sitting down immediately relieved the pain.  Why is that unusual?  Well (putting on my engineering hat), sitting down should have made very little difference if the pain was arthritic - since L3-L5 were fixed in position, sitting down would have made no difference to L2 and above - sitting or standing L2 and above bear just about exactly the same weight.  It was a mystery - one which I solved with Excedrin, all thru June and July.

We spent an idyllic month aboard Eolian, living at anchor in the San Juan Islands, moving very little, reading, and crabbing.  Trips to shore were only determined by the longevity of the wine supply.  Excedrin continued to hold the back pain at bay.

In August, things began to change.  First, I noticed that I was walking kind of "flat-footed"...  that is, the forward part of my foot and toes were slapping onto the ground and providing very little "lift off" when walking.  This was accompanied by excruciatingly tight calf muscles.  Weird.

And then one day I was unable to board Eolian, except by crawling aboard on my hands and knees.  OK, something was definitely going on here.

I left the marina and camped out in my primary care doctor's office until they managed to squeeze me in - the doctor examined me and immediately ordered an MRI, which I got a day later.  While this was happening, I managed to score an appointment with my favorite neurosurgeon down in Seattle.  Total time duration from requesting an appointment with my primary care doctor to the neurosurgeon appointment: two weeks - a miracle.  He examined me and my MRI, said "Holy cow!" (well not exactly...), and scheduled me for surgery 2 weeks later, the first opening in his schedule.

In those intervening two weeks I essentially lost the remaining use of my legs completely.


The MRI and then later the surgery revealed a synovial cyst growing and squeezing my spinal cord.  There were actually two cysts; only one shows in the MRI slice above.  The neurosurgeon managed to dissect the cysts off of the sheath of my spinal cord without tearing it and letting my cerebral-spinal fluid leak out.  He also fused the L2/L3 joint which will prevent future formation of cysts, and finally he replaced the disk for good measure.

So,  No boating blogs posts - in fact, no posts at all.  But that is changing - I am getting better every day, tho it will still be a while before I can once again board Eolian.

It is too bad that it is far more difficult to search for causes of symptoms on the Internet than searching for symptoms of causes.  A search for synovial cysts will produce results showing exactly my symptoms.

Here are the learnings I have from this experience:
  • Do not ignore persistent spinal pain, or hide it from yourself using Excedrin.
  • Spinal pain is nothing to take lightly.  TV ads for various devices are all well and good.  BUT see a doctor, get an MRI, and see a neurosurgeon - let him recommend a device, if that is appropriate.  Uninformed self-care can lead to a wheelchair.
  • If I had had single-payer health care like my neighbor who has waited an entire year to get an appointment with his VA doctor, I would now be a paraplegic.
  • Do NOT put off dealing with back pain!  The best case is that you will live for years with pain while only delaying the inevitable.  That's the best case.  The worst case is that you will become permanently crippled.
  • This was my third spinal fusion and my fourth spinal surgery.  I can say with personal experience that recovery from the surgery will take less than a month (about 2.5 weeks in this latest case).  Recovery of function will take longer, depending on how long you lived with the pain before the surgery.  See, living with the pain will cause you to curtail activities, and hold yourself in distorted positions in order to minimize the pain.  It will take you longer to unlearn/relearn and rebuild unused muscles than to recover from the surgery.  How much longer?  Well, that depends on how long you lived with the pain and avoided the surgery.
And most of all...
  • Life is NOT a dress rehearsal.  If you want to cruise or live aboard, MAKE IT HAPPEN, NOW.  Don't put it off... You never know when it will suddenly not be possible for you...


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2 comments:

Unknown said...

Whoa, I happy to read this post! Happy that you are recovering! Agree and have to shake that finger at myself and make an appointment - not for back pain but other stuff.
Do all the after care, PT, exercises, etc. which are prescribed so that you regain or even improve beyond where you've been.

Take care, positive vibes and easy times sent over to you!!
Much love, --Heidi B.

Robert Salnick said...

Thanks so much Heidi!

Oh, I indeed intend to take full advantage of the after-care PT, but the Dr. wants me to wait until a month after surgery. In the mean time I am trying to make my walking look normal (forcing me to use muscles that have been basically disconnected for a coupe of months. Also, each time I go up a flight of stairs, it is just a little easier. So things are improving. Will I ski again? Too soon to tell.

And in the mean time, if you have medical issues yourself, I cannot stress strongly enough that you get them looked at by a professional. I wish that I had gone to the Dr. in June instead of September. Do it NOW! (Really what do you have to lose?)

Thanks for your care and love!
bob

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