good news..

The epidural L5-S1 shots are definitely working. I have virtually no sciatica now. Still occasional give outs of the right knee, but at much reduced frequency. My regular doc said give it a week to work and it has been that and a little more. So, I am happy. Doing regular stretches and abdominal strengthening now every morning. One side effect: last night I was awakened by a total charlie horsing of my left foot with the toes locked in the up position. Forcing them down with my right foot didn't work right away. I have had this happen rarely in the past.  Eventually the cramping stopped and I was able to return to sleep.

Long car rides are now easier but I'm not home free. I need to get out of the car on a regular basis. But getting to Colorado was much easier after the shots than it would have been before. And the wine fest was a blast.  Off to fish this week at Lake Powell.

MCL (mantle cell lymphoma, for those who forget) is currently in the rear view mirror. Here's hoping it stays there a long time.

Hey, hey, hey..

Well, my immediate impression is that the epidural shots have helped me. My sciatica is not noticeable this morning--we'll see about later on--and I seem to have greater flexibility. My knees are not giving out. The procedure was very out-patient like. Your own space to disrobe, vitals, visit from the doc, interminable waiting, the procedure, back to your space for stabilization, and then out of there. In at 2:30 out at 4:00 with apologies for the wait. Procedure maybe 15 min total. The procedure has allowed me to sort out the focus of different aches, the foot and hand neuropathy and the quiet insistence of an unrepaired inguinal hernia. If anything my lower back feels a bit more fragile, perhaps because things have loosened up down there. Full effects of the procedure are not supposed to be felt for 7-10 days, so I mustn't get ahead of myself.

Off to Grand Junction tomorrow for their annual wine festival, so we'll see how 6+ hrs in the car tests the lower back.

One down...

Read my MRI results earlier this morning. Severe degenerative disc disease. Has a kind of alliterative ring to it, right?. In essence, the pix in my lumbar region show the discs to be dried up ("dessicated"). Where my operation occurred 30+ yrs ago there is a "seroma" filling some of the space where half the disc was removed in what is called a hemi-laminectomy. A seroma is a mass consisting of blood and sera, a sort of self-contained tumor if I understand it correctly. There is no space between the vertebra there. There is very little between L4-5 as well.  When I read this I was amazed that I don't feel worse. When I had my hemi-laminectomy my pain was off the charts. An operation was absolutely necessary. Today I function with a little low level discomfort--except when my knees give way or I sit in a car for extended periods. In the latter case, my pain ratchets up to maybe 8 of 10. And I function with not being able to walk long distances. (Let's be honest here!) But it is also possible that some of my tiredness is due to living with--you guessed it--chronic pain.

A number of friends have had epidural injections for their back pain. Their results and their opinions of the docs who do them are all over the map. Mostly they are cynical. If I were to abstract a common outcome it would be this: good results on the first shot with diminishing returns with each shot thereafter.  Nevertheless, if such a course precludes or even postpones surgical procedures for a number of years, I'm for trying it.

The MRI procedure? Uncomfortable but necessary for the extra detail. Of course they couldn't get it done in one pass: the radiologist wanted more, specifically an inked one. So after 20 min back in I went with an injection, for another 7 min. Hopefully, there won't be another in my future for some time, as I barely fit in that tube now.

So it is onward to the epidural this afternoon....more afterward

Further considerations

One more night on the bandstand and that feature of my life recedes somewhat for another year. My preparations have paid off. I am getting through the gig with some (not much) chops left. The dinner-time thing I did 2 weeks ago went okay. We did it as a trio, guitar, drums, trumpet--no bass--and there were spaces where there should have been music. Oh well, you play the hand as dealt. The current dinner-show-dance has gone well for a couple other reasons too: the show isn't as demanding this year (blowing wise) and we are only doing one long set of dance music (leave 'em wanting more). My colleagues have been gracious in re my return. Ergo, tonight should go fine. It has been a blast as this activity recalls my early days and permits a sort of reliving without taking over my life. I always knew enough to keep my day gig, not to try to make a career of music, and my feelings about that still haven't changed. Today, my day job, is a lot easier (ha ha).

My big concern now has been--still is--my mobility. I worried initially about being able to get up and down from the bandstand. The major stairs thereto are, thankfully, railed, and I have been using those rails extensively. Then there are a couple unprotected steps in two sets to get to where the trumpets are seated. I am being really careful there also. We do have to get off the stand during the show. We wander the audience while playing Tuxedo Junction. Cornball, yes. Effective with the audience, yes. Why? I don't know. I have been able to do this but without much agility, which the 50 somethings in the band still have.

So to the main: Yesterday I met a new doc. He does backs and pain. He took a series of X-rays that I could see--he said we didn't need a radiologist to interpret and he was correct--showed no disk space between the L4-L5 area of the spine. I already have no disc space between L5 and S1 because that disc material was removed in a hemi-laminectomy some 30+ yrs ago. We are going to use a 3-pronged strategy that combines diagnosis and therapy. First, exercise: I have really felt considerable improvement in leg strength and function this past couple weeks because I have returned to doing my stretches and some core strengthening every day. (I have bagged my exercycle workouts until the show is completed.) (Above: L = lumbar; S = sacral areas of the spine). The good news is that my spine is fairly straight in the vertical dimension. Second, epidural injections of lydocaine and cortisone: The first will occur this coming Tuesday. For diagnostic purposes he will first do the L5 space since that is coincident with my sciatica which now radiates down the backs of both legs. He will next do the L4 space, if and only if, I don't get good (complete?) relief from the first injection. The L4 space pain--if there is such--is more coincident with radiation down the leg sides and fronts, which I don't chronically have.  His suspicion is that my knees suddenly buckling on me, is the body's response to sudden pain. Third, he will do electro-myography. This is essentially nerve function mapping via low level electrical stimulation. He believes he can sort out what I am feeling nerve-wise that is due to the recent (acute?) peripheral neuropathy as differentiated from what is happening (chronically, the sciatica) with my back. I have spoken with friends who have had the epidurals. The injections produce a variety of outcomes the most salient feature of which appears to be their variability. Some injections seem to last people (make them pain free) for more than a year, others just a few months. Still others, they do nothing for. They can done at the frequency of several per year. The doc is also prepared to go down the pain med route with increased doses of naproxen (prescription Alleve) as required. Oh, also he has ordered an MRI to further the diagnosis.

So, MRI Monday, epidural Tuesday, regular visit with my internist on Wednesday. Off to Colorado to sip wine, Thursday. I am one busy boy.  More sooner, than later....