Thursday, October 1, 2020

October 1 – “The What and the So What …”

The neurosurgeon appointment has occurred.  We went in yesterday.  No problem getting Chris in with me.  In fact, they didn’t even have anyone manning the Covid Questions booth at the entrance to the clinic building.  We slipped right in and onto the elevator with no hindrance at all.  Too easy.  Once on the fifth floor we went right to the check-in desk.  No one was in the waiting room, either.  Seemed kind of eerie for an afternoon appointment.  Chris still dutifully searched for a set of two chairs together that didn’t have the “reserved seating” sign on them.  That’s how they are social distancing in the waiting room. 

 

 Before long the tech called my name and we were off, back into the abyss of exam rooms.  She sat us down and took my blood pressure.  But wait.  It was really high.  152/90.  That’s over the top.  My blood pressure has never been that high.  She took it again and it came down to the 140’s, a little better.  She wrote it off as being at the doctor’s office.  OK.  I’ll take that.

 

The chief resident came in first, as is their custom.  He called up my MRI on the computer and turned the screen so we could see it.  And it promptly went black.  He checked all the connections.  All seemed well.  The monitor simply indicated that it couldn’t find the computer.  He rebooted the computer.  Nothing.  Good thing they didn’t take his blood pressure about that time.  We finally just got up and changed rooms.  It didn’t take long for the nurse to pop her head in and be surprised by our presence.  She didn’t sound surprised to hear about the bad computer, though.  I was just glad I didn’t believe in bad omens, because this sure could have inspired concern about my back.  As it was, we just chuckled, and he continued on with the show.

 

So … the show.  I gotta say that seeing the picture of my back was pretty interesting.  Right up until he started showing me all the myriad of things wrong with it.  I felt like I was trapped in a kid’s toy that played “The Farmer in the Dell” over and over.  “A bulging disc here, arthritis there, bulging disc, bulging disc, everywhere a bulging disc.”  All up and down my spine I have bulging discs, even in the thoracic region.  Numerous places have significant narrowing of the area for the spinal cord to travel through.  The lumbar region has two pretty bad spots.  “But none of those are what we are looking at,” chirped Mr. Head Resident.  “It’s this one right here.”  He clicked on a few buttons until a second picture appeared.  “This is a detail of the T12-L1 disc.  It has clearly ruptured and is putting pressure on your spinal cord.”  Yup.  That was easy enough to see.  And from there he went into a discourse on exactly how they would go about doing the surgery to remove the portion of the disc that had blown inward when the explosion occurred.  Fascinating stuff.  Very intimidating, to be sure, but fascinating. 

 

As he talked the neurosurgeon arrived and took a seat across from us.  I appreciated the fact that he pulled his mask down under his chin so I could see his mouth when he talked.  I might actually be able to hear what he had to say.  He confirmed what Chief Resident had told us about the disc rupturing.  However, he wasn’t quite as concerned about pressure on my cord from it.  Yes, it was there, but there was still a tiny bit of room for the cord to do its thing, whatever that might be.  One thing he did explain to us was that because of the injury to that part of my back, the rest of the spine was doing its best to compensate, hence that bad lumbar area was hurting even more than usual.  That explained the uptick in pain in the regions below the actual rupture. 

 

But he could tell I was more interested in the “so what” part of the discussion.  What next?  What do we do about it?  So he smiled and began.  “I could do surgery and remove that piece of the disc.  I could.  In fact I want to, because it’s a really fun thing to do.  I could talk you into having the surgery right now.  Do I think you should have the surgery?  Not right now.  Rule of thumb …. If you are doing OK without surgery, don’t have surgery.  See, with back surgeries it’s like this.  You mess with one area, then the others have to compensate, aggravating them.  Then its another surgery, and before long you become an annuity for me and mine.  And after that you and Dr. Not Me are having yet another discussion about yet another surgery.”

 

Apparently, I still looked a little stunned by the whole thing.  He said, “You look a little doubtful.  Do you want me to say what I think?  Do you want me to tell you what we are going to do here?”  I didn’t answer, but that’s exactly what I wanted.  Fortunately, he continued, “Here’s what we’ll do.  Let’s wait three weeks.  Then you come back, and we’ll re-evaluate.  If it’s better or even the same, we’ll wait three more weeks.  If it gets worse before then, call me and we can proceed with the surgery.  There is no need to treat this like an emergency at this time.” 

 

Chris asked a few more questions.  And he reiterated that the restrictions were still in effect.  Ban on all heavy lifting, although he slipped and mentioned two gallons of milk.  That’s an increase over the half-gallon limit from last time.  When I pointed that out, he gave me a sideways glance as if to say, “You know what I mean.  Just don’t be stupid.” 

 

So I guess the visit was good news.  Sort of.  Frustrating, though.  No quick fix.  More damage than I knew about.  Live with the increased pain in the lumbar region as it figures out how to deal with the extra stress from its neighbor to the north.  Restrictions remain … forever.  Lifestyle change.  But we should still be able to travel.  Just have to pack lighter …

 

Isaiah 25:1 says, “Lord, you are my God; I will exalt you and praise your name, for in perfect faithfulness you have done wonderful things, things planned long ago.”

 

Father, thank you for the assurance from the doc yesterday.  He does inspire confidence.  Amen.

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