Chapter 15: April 2008

If the month of March was like my dogs romping through the garden, April was like the Coney Island Cyclone. I had some symptom free mornings that teased me with the idea that the day would be a pain free one only to be followed by a thunderous crash of leg pain in the evening. I spent a lot of days in the fog of fatigue from too many nights of 4, 5, or 6 hours of sleep. I think I would trade pain for sleep. I think I would rather hurt than be so tired all the time. Of course, I may change my mind but that's the beauty of wishing for something you don't have.

Getting through a day feels like using a butter knife to saw through a 2 x4. Everything is hard. Everything is taxing. I can't think or read. I try to nap but my mind bumps and jumps around like monkeys in the jungle. I try to meditate - same thing. I think my mind wants to work, needs to work but just doesn't have the juice to keep anything going. A sputtering, chattering mind. Things that would not normally only mildly irritate me, piss me off. Things that would make me laugh, don't. About the only thing the seems to help is music. I listen to a lot of music. In the teeter-totter, walking with my dogs, just lying around. What would I do without an iPod? I feel like I should send Steve Jobs a thank you note.

I try not to drink more than about two cups of coffee a day even though some days I feel like I could just walk around with an I.V. drip of the stuff. Instead, and here's an interesting twist on handling things you don't like or, that bother you or, for that matter, pain, I try to just not fight the frustration of feeling so tired. I just try to accept it. I'm not very good at it though. I'm grumpy when I'm tired, terse,  and I find it incredibly difficult to mentally switch into a Zen Buddhist mindset of accepting the "now" even though to fight it is futile. I try to feel it, accept that what I am feeling is what I am, now, in this moment, but not what I will always be. The fear, and I'll bet a lot of people feel this way, is that by accepting something that frustrates you, you somehow are giving up or yielding to a lifetime of what you have in that moment- the very thing you don't want.  One of my teachers, Dale Goldstein, likes to say that suffering comes from failure to accept reality. I think he's right.

April 1-8, 2008
Sleeping averaged about 6 hours, and was interrupted by pain. Although the pain was less than the prior two months, it was still enough to prod me from sleep and force me up. I had some leg symptoms - numbness, pain, tingling - on and off through the week. The numbness freaks me out. It feels like I'm losing control of my leg.

I had a couple of days near the end of the week that surprised me with low to no pain - anywhere. And, on the 8th, I slept 7 hours - not straight through - but in total. This was a huge improvement but I still had low energy most of the day.

On the 1st, I had a follow-up consult with Christine - more on that in another chapter. The consult prior to this one, which I haven't published yet, was on March 12th. I've written about what happened in the consult but not about the details of what Christine examined / measured, why, what it meant, and how I felt about the info. So, that's coming up - sometime.

April 9-16, 2008
This week opened up with a very tough night: 4 hours of sleep with a lot of leg pain - like a 8/10 kind of leg pain. This level of pain really gets your attention. It's the Painster clawing and snapping, ripping and tearing his way up and down your leg. The Coney Island Cyclone. Just when I felt like I had made some real progress, my body crashed and along with it my head and my heart. The week didn't improve much. I averaged right around 5 hours of sleep a night. The Painster came back for a visit on the 11th dropping in around 6PM and staying for the evening like a guest who doesn't realize he should have left hours ago. But, I had also walked a lot that day - about 13 miles total. I usually walk 8-10 miles a day but I had a meeting - what I call a "walk and talk" that day. On the 14th, I woke up at 3AM with some mild leg pain - I call mild anything at a 3/10 or less - and was able to get back to sleep until 5AM when the pain returned and this time I had to get up. And, on the 16th, I ventured out for a real meeting where I actually had to sit down. I sat for 90 minutes - not continuously; I got up a few times - but had no residual symptoms from it. This was a major event but I didn't really trust that it would happen again or that I wouldn't have a visit from the Painster in a day or two. The week, overall was difficult with average pain levels around 5-6 / 10 and high levels of fatigue.

April 17 -24, 2008
Sleeping wasn't much better this week averaging about 6 hours a night but pain levels dropped to an average of 2.5 out of 10. I woke up on the 22nd with very low level of pain at 1/10, the kind you have to look around to find and by the end of the day, I had no symptoms. The next day was completely symptom free - April 23, 2008 - and on the 24th, I woke up to a symptom free morning.

But, the sleep issue persisted despite pain levels improving. Sometimes I'll wake up in the night, often because I'm uncomfortable, not what I would call "pain" but just stiff or maybe a really mild kind of soreness, and then it's off to the races with my mind like it shifts into a warp speed. Christine suggested that I try writing down things in my journal before I go to bed so I did. Nothing was in my head though. I was relaxed, not troubled by anything or at least anything new, and really just didn't have much to write about. Then, in the middle of the night, my brain suddenly turns on at full speed - like walking into a dark house and flipping one switch and the whole house lights up.  It's not that I gradually wake up. All of a sudden, I am wide awake. Mentally ready to run; physically ready to crawl.

April 25 - 30, 2008
I added sitting back into my life this week. The plan was to start with one hour a day and gradually increase it over the next several weeks paying close attention to my symptoms. I sat no more than two hours per day - total. This excluded any sitting I was already doing like driving to Sports Center. I used a 3 x 5 card and jotted down the time I sat doing anything. Two hours is not much time over the course of a day. But, I was happy to be doing it and didn't have symptoms. I learned that if I sat in a particular way, a specific posture, I could sit without any symptoms. I called it the "cello pose" because it reminded me of a cellist's position - minus the cello of course. You sit on the edge of the chair, legs apart with one foot slightly ahead of the other (the image is Paula Zahn playing cello). For clinicians, you'll recognize this position as an accentuated lumbar lordosis. This position reduces the amount of tension on the back side of my disc, where I injured it, but it also will increase pressure on the jopints of my spine. So, I can't or shouldn't sit like this for a long time.

I can also sit in my "second" office at home - where I have a bar with my Mac Air and my guitar stage stool set up. I can sit on the stool with my left side allowing the right side to be off and mostly straight. This shifts some of the load or force off the right side of my spine and allows me to carry some weight on the left leg and through my arms.

Pain levels averaged about 2.5 out of 10 but that was skewed by one day where my pain suddenly spiked. If I remove that day, the pain level was 1 out of 10 - a huge improvement in about ten weeks. I would like to also report improvement in my sleep but, as you might have guessed, it continued to plague me. I had two nights out of six that were fewer than five hours of sleep but, the good news, was that I also had four nights of seven or more hours of sleep. I started thinking that maybe the Coney Island Cyclone was coming to an end. And, on April 30th, 2008, I slept eight (8) hours! I hadn't slept eight hours in over a decade.

I continued my rehab at Sports Center and my visits with Trish throughout the month of April. You'll learn more about both soon.