Monday, August 10, 2009

How I Spent My Friday

For those of you who haven't been reading this blog since its original inception (before the word "Returns" was tacked on), a little history: I have degenerative disk disease (and CF!). About seven years ago, my L5-S1 disk collapsed, and since then two more have collapsed.

Okay: science lesson time. Your vertebrae don't just sit on top of each other. They are cushioned by intervertebral disks--think of them as tough jelly donughts. The interior portion of the disk is called the nucleus pulposus and the thick outer layer is the annulus pulposus. Surrounding the disk is a layer of fatty tissue which my doctor calls dura matter. When you get a herniated disk, it's like squashing a jelly donught: the outer shell breaks, and some jelly squirts out. Every time you fall on your ass or hit a bump on a bike or slip on the ice, the force of that accident is absorbed by, basically, the annulus pulposus, which eventually cracks and breaks. In my case, the annulus pulposus broke real good, and gooey nucleus pulposus flowed out.

That's not so bad, right? Well, look at where the nucleus pulposus goes: right up against the spinal cord and/or nerve root. It's the latter in my case, which causes me pain down my right side (pelvis and lower). I have to be very careful not to further aggrevate the injury because the more jelly leaks out, the more pain I'm in. Well, I was sitting in my chair one day and coughed and BAM--that's all it took. Something slipped a little farther, and I was on the floor. My back doctor recommended a cortisone injection, which I'd never gotten before. He scheduled it for last Friday and that was basically the end of the discussion!

The procedure involves sticking a giant needle directly into the dura matter surrounding the disk and injecting a bunch of steroids in crystaline form that degrade over a 6-month period and, ideally, shrink up the disk and ease pressure off the nerve root. The doctor who actually performed the procedure was hopeful that the shrinking would "stick," effectively curing my L5-S1 herniation, though for how long nobody knows. I sure as hell need to stop lifting heavy things.

It's an interesting experience. The doctor numbed up my back with an injected agent (oh the brief, but intense burning!), then took a CAT scan of the target area. Using that CAT scan as a guide, he stuck a long needle into my back (couldn't feel anything except pressure), then took a CAT scan, then renegotiated the needle's trajectory, then another CAT nauseum. The whole time, I was just waiting for that needle to hit a nerve root (I'm a worrier) but nothing like that happened. The procedure was over before I knew it, and the only real discomfort was when the steroids were being pumped in, because it felt like my pelvis was being filled with something (it quickly dispursed). Then out came the needle and I was on my feet. Interestingly, when he got really close to the nerve root (necessarily), the areas where I normally experience pain felt tingley.

Side effects included ever so slight weakness in my feet, but I was otherwise fine. Walked out the door and went home. I even mowed the lawn even though I wasn't supposed to, and spent almost two hours hanging skulls on a cafe wall even though I probably wasn't supposed to. The pain gradually decreased over the weekend to the point where I'm fit as a fiddle today. Normally I'd be squirming in my chair right now but I'm in NO pain at all, which is kickass. It's hard to get used to--I keep feeling like I should be in pain, but I'm not.


Adam Pritchard said...

That's great that you're feeling well Zack!

Glendon Mellow said...

You are a brave guy, and it's great of you to put up a medical post so thoughtful and clear. You've done others who may need this procedure a service.

Glad you're well, Zach.

Sean Craven said...

Glad to hear things are working for you. I appreciate all the details, since I'm gonna have that procedure myself quite soon.

Best of luck with the back -- I hope the cure sticks.

Anonymous said...

Damn you basal vertebrates and your pulpy notochord. Damn you to heck!