Update: Countdown to the New Year

Tuesday I was ready to sit down and blog about how great I was finally starting to feel. I had been at my desk catching up on claims and phone calls, not wearing the soft collar and enjoying a greater range of motion than I had since Tues last week. Somewhere around dark thirty the ibuprofen wore off. Back to the original pain level, no blogging today. Take 800 more mgs of kidney killers, turn on the heating pad and doze in the chair.

Wednesday morning I took my meds 1 hour before my first case, and felt well enough to assist with out wearing the collar. My next case wasn't scheduled until three hours later. The stiffness in my neck is just about gone. My range of motion is improving. The last thing that has been torturing me for the last 8 days and nights is the neuralgia on the right side of my neck from the occipital nerves. Each shooting, biting jolt of electric pain causes my neck to contract, my shoulders to scrunch up and my right eye to close as I hold my mouth in a twisted grimace. The neuralgia breaks through the ibuprofen after only 3-4 hours leaving me with 4-5 hours of suffering before I can re-dose. The Flexeril seems to have little or no effect on anything but my alertness. Neuralgia trumps Flexeril. I'm dropping Flexeril from my regime.

In final desperation I talked to one of the Anesthesiologists who also does pain clinic. I asked him how to go about setting up an appointment for an occipital nerve block at the clinic. He was going to give me the block right then and there in the OR, but we were at the hospital where I used to work and I was uncomfortable with that. If word got out (I'm sure there is at least one person there gunning for me) I might risk losing my privileges. He made some phone calls and learned that the doc who was on that day had already left the clinic but he could get me some samples to try for now. That was awesome, I told him, and while I was there I would go ahead and set up an appointment.

Got to the office and after some confusion, one of the women came out with a sample bottle of Lyrica. Sounds so cheerful doesn't it? Lyrica, like lyrical. I asked her how to go about setting up an appointment for pain clinic. She informed me that the clinic was closed from today until after Christmas! That's six more days of agony! I left feeling less than hopeful that this new med was going to solve anything, and headed out for my next case.

It was now 1400. My neck is screaming from the incessant, squeezing neuralgia. I put on my thyroid shield, the cervical collar my lead apron and scrub in. Fortunately this is a distal radius fx so we get to sit. The collar gives me somewhere to rest my head when my neck is tired of fighting. The crew makes fun of me of course. I tell them I thought I could pick up some sympathy dates. One of them suggest I decorate it for the holidays. I tell them it's getting embarrassing because of the food stains on it.

After the case, I was sitting in the doctor's lounge listening to my voice mail on speaker phone with my collar on and my head resting on a pillow on the back of the couch, holding the phone up at eye level when the surgeon I'd been working with stuck his head in the door. He told me that the ankle fx we are doing tomorrow is a simple one and if I was in pain, he could get by without me. I thanked him and told him it would depend on what this new drug does. I sat there for a minute contemplating my next move. I had full intentions of going to Trauma Grand Rounds tonight at 6 pm. It is only 3:30 and I'm in agony and I can't redose until 5 pm. I decide to go home and try the new drug.

I get home, feed the horses, get in the house and prepare my recliner for the evening. Heating pad, neck roll, warm fuzzy blanket, large tumbler of water, and bottles of pills. I had made the decision to sleep in the chair because while lying down on a pillow wasn't too uncomfortable, trying to turn over or get out of bed was. My chair will recline to almost horizontal, with a little pull on the armrests and a shift of weight and I am able to get up without straining my neck. I have had no appetite since this started which is good, cause I barely have any food in the house anyway. I get into my heavy sweats and settle into the chair. I pop a Lyrica and even though it is 1/2 an hour early for my ibuprofen, I pop four of them also. I hate loading up on ibuprofen and I try to keep my kidneys flushed.

There is a blessed two hours of almost total relief after dosing, and this is the only time I think I really sleep. The rest of the evening I float in and out of semi consciousness. Somewhere in time I awake and manage to stay alert long enough to watch Criminal Minds. I decide I better eat something so I make some toast. I let the dog out and drift off again. I wake up and the news is on. I can't remember if my dog is in or out so I get up to look and there he is waiting. I let him in, share the crust I saved for him and doze off again. Each time I wake, my heating pad with the built in safety switch, is off. I crank it back up, wrap my neck and whole head in it and doze off again. The next time I open my eyes David Letterman is on. I realize that I have a 730 start tomorrow and I have no alarm set. I reach for my cell phone and the TV remote. With some difficulty I set the sleep timer and the awake timer on the TV. I drift off. The pulsating neuralgia pain keeps me company all night, never letting me drift away completely, keeping me painfully aware of it's presence. The cat has been keeping my lap warm, the dog sleeping in the living room with me instead of on his own comfortable bed in the bedroom. I awake again and see that the TV is off. Good, the alarm should work. I can't remember what I did with the cell phone. I feel the neuralgia trying to grow stronger. I fantasize that the new drug may have reduced the severity but I am fooling my self. I open my eyes and I am aware that the light is changing beyond the curtains. I drift off again. I try to remember if I set the cell phone alarm. Drifting off again. Did I? That's okay,TV set to wake me up. In my haze I converse with myself trying to remember what time the sky gets light and wondering if I really did set any alarms when I jolt awake. I turn the TV on and check the display, 6:30! So much for the TV awake timer. I turn to look outside and it's snowing. I eject myself out of the chair and my neck punishes me instantly with a prolonged pulse of electric pain. The right occipital region of my neck spasms making it painful to hold my head up. I go to the bathroom and wash my face, brush my teeth, no time for make-up. My hair is is still in yesterday's braid and so it will stay. I throw on some clothes. I start to take a Lyrica but the precautions warn of possible dizziness and difficulty driving. Since I took the first one right before I started dozing, I'm not really sure how it did affect me. I decide with the snow, I'd better wait. I search for my cell phone and find it wedged between the chair cushions. I try to round up the dog to put him in the office with the doggie door. As I gather his meds, I look at the clock, it is almost 7 am. With snow, my commute will probably be a minimum of 45 minutes. If I was in my truck right now, I'd still be late and I'm at least 10-15 minutes away from leaving the driveway.

Admitting defeat, I call the surgery center and ask them to tell the Dr. that I am going to take him up on his offer and I won't be in this morning. I make some coffee, eat a blueberry fiber muffin and pop a Lyrica and 600 mg of ibuprofen. I'm going to keep the ibuprofen to 600 mg every six hours. Fourty five minutes later I feel great again. In fact I motor around and clean house a bit. The Lyrica does make me dizzy but not dangerously so. Although I was told to take it every eight hours, I think I will wait every 12 hrs. It's main target is fibromyalgia and the insert reads that most people feel some relief after one week. I think I cried when I read that. Here I was, practically crawling and begging for instant relief before I turn suicidal from pain, and bless him for giving me free samples but, after ONE WEEK!

I just want pain relief from the neuralgia until after January one. Then I am off to the neurosurgeon or a PM and R doctor. I'll sign up for my MRI, CT, XR anything you please. Just get me to the new year.

Ramona and Bongi, thank you both for your concern and checking in on me.

Bongi, I know this is nothing to fool around with. Since the irritation is with the occipital nerves and they arise from c-2, that is a dangerous level. What is that saying? C 4-5 stay alive? Something like that. Perhaps I had some intuitive foresight as to why I haven't been overly anxious to break my horses myself, and I know I shouldn't run anymore and have turned to hiking instead.

I have always had some sort of neck pain. This was chronic for about two months. While I'm sure the slipping on ice could have been a trigger, it was going to catch up to me eventually. You both know the position of your head while you operate. You both know which muscles ache after many hours in the OR. I'll get a fusion if it keeps me assisting, but I'll start with conservative treatment.