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Thursday, January 23, 2014

Report from Doctor's Appointment

Here is a report from my doctor’s appointment concerning my back.  I am somewhat optimistic after the appointment.
The biggest thing causing the sciatic pain is what they call “foraminal narrowing.”  Bone spurs and ligaments that are thickened and enlarged because of the ongoing inflammation (arthritis) have caused the opening where the nerve exits the spinal canal (in this case, the sciatic nerve) to narrow and have pretty much pinched off the nerve on the left side, and moderately on the right side.  This is what is causing me all the pain.  The other issues I have (slippage in two vertebrae (spondylolisthesis) and bulging discs in three) have remained stable and have not worsened.  So that is good.  First we are going to try another epidural injection and see if I get some relief from that.  (To be honest, these injections have not helped me much in the past, but I am certainly willing to give it another try.)  If I do not get enough relief from that, there is a procedure they can do that will clean out the bone spurs and trim up the ligament so the foraminal opening is opened up.  This procedure will not keep me down nearly as long as some of the other things they may or may not have to do in the future, mainly a fusion.  I need to lose more weight for a fusion to be safe, and hopefully that will never have to happen.  I will continue with my weight loss efforts and hopefully there will be no further slippage or anything that could create the need for a fusion.
For some reason, after I got this news, I wanted to eat.  And I wanted to eat what I shouldn’t.  I think it’s because I knew I would not be having a fusion in the near future and I didn’t feel as urgent about getting weight off quickly.  I actually stopped at a convenience store and was going to get some donuts.  Then I remembered, I am getting off sugar and I “can’t have” that stuff.  So I started thinking of alternatives.  I was really hungry because I had not drank a shake yet this morning and it was 11:00 already.  (My shakes were not cold, so I hadn’t drank one yet.)  I ended up getting a little container of fresh fruit and ate that in the car.  So I did good with that.  When I got to the office, I drank a shake (I had one at work that was already cold).  Then a little while later, since it was lunchtime, I ate a 100-calorie pack of almonds.  I will probably drink another shake soon, since it is now 2:00.  There is no reason for me to vary my plan right now.  Fusion is not out of the question in the future, if the other treatments don’t help, so I need to keep my weight moving down.  Not to mention being ready for the wedding and reaching my ultimate goal.  So, onward I go.  I was kind of proud of myself.
I can’t find a definitive answer as to how long the recovery time is for this type of thing, but I know it will be shorter compared to the other.  So hopefully I can get back to walking and exercising again in the not-too-distant future.
My head is really hurting this afternoon.  I wish I could have the injection sooner and move on toward getting better, because sleeping in the chair continues to cause problems.  Ugh.  I just wish I had a solution.  I wish I could sleep on my stomach, but that also bothers my neck.  Sleeping on either side bothers my lower back.  Maybe I need to sleep standing up, lol.
I was just reading about losing weight as it relates to postmenopausal women.  It seems like it is so much harder than it used to be.  This article said that it really is not as related to menopause as it is to what we eat.  A diet composed of more fruits and vegetables and fish is recommended.  So tell me something I didn’t know.  I do know higher protein helps.  I think any supplementing of volume needs to be mostly fruits and vegetables.  Staying away from desserts and sugary drinks (sweets in general) was the biggest thing.  Another reason for me to stay away from sugar.  That’s what has always worked better for me.
I finally found a good thread talking about recovery from a foraminotomy.  The main person in the thread’s doctor told them to do nothing but rest (with some walking) for two weeks.  I also learned that often during these surgeries, the nerve will get irritated (and already is very irritated) by the surgeon having to work to get the opening free.  So I will likely continue to have sciatica for a while afterward (possibly months) while the nerve is settling down and healing, as well as regenerating.  Nerves heal very slowly.  Walking is encouraged often to help stretch the nerve and increase the blood supply to the area, which aids in healing.  I suspect that my nerve has been clinched for quite some time (my first MRI in 2011 showed that it was severely pinched and I suspect it had been that way for a while before then).  So I imagine this nerve is pretty angry.  But I handle pain pretty well, so as long as it is improving, slowly but surely, I will be fine.
My daughter made an omelet for dinner with eggs, sausage, onions, poblano peppers, spinach and cheese.  A little sriracha on top and some diced avocado finished it out.  Yum!  I didn't have my 3rd shake again today.  Just didn't get to it.  I finished the day with some SF hot chocolate.
I'd like to fast forward through the next 10 days, and the 10 days after that to see if this is going to work.  I just want to feel better.  I for sure want to be doing better by my daughter's wedding.  We can't have the Mother of the Bride limping down the aisle and crying.  The ceremony is outside and walking on uneven ground, particularly in dress shoes, is not something I look forward to in my current condition.
That's all for today.  Over and out.

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