So. Here I am. Mostly because I can’t go anywhere else but also because there is nowhere else in the world I would rather be. There’s something about mummy and daddy looking after you when you’re in that acts as chicken soup to the soul. Or a G&T to the liver… Perhaps if I go back to the beginning.
About 20 months ago I went to the doctors with pain in my back that was quite frankly becoming an irritating thorn in my life. Now bearing in mind that I have had back pain for about 10 years, this was nothing spectacular, however pain as always, is subjective and I was quite happy in my ignorance. Just exactly how happy I had been I wasn’t aware of until my bubble was well and truly burst.
Back pain can mean anything from a twinge when you twist or pull too far to a debilitating, crippling pain that controls your entire life. But both of these and every case in between all has one very common thing as a denominator; they’re all injuries you cannot see and therefore highly personal in how they affect individuals. For this reason the hospital pain scale of labelling a pain between 1 and 10 – 10 being the worst pain you could imagine and 1 being no pain at all – can be extremely informative but still dependent on the patient’s individual pain threshold and what they think the physician wants to hear at the time!
In my case, it has meant that since the age of 18, I just understood that everyone needed to stretch their back out, lie down on a hard wood floor for half an hour and in some cases had to wait for the spasms in my back to stop before I could sleep after a 12 hour shift in the pub. Thankfully there weren’t too many AFD’s in my life at that point; I eased my way into them later on. In other words, it just became an accepted part of my life and I got on despite it. Unfortunately as time passed this became getting on around it and finally became trying to go on in the face of it and in April 2010 after a particularly vigorous rugby season and an incident in the bar where my back seemed to cease up mid-shift, I decided to go and ask the doctor what he thought. As this was still part of the way through the rugby season, I decided to finish the last four games before going to get this checked out. Well, if he’d signed me off I wouldn’t have been able to play, at least my way I knew it was ok to continue through to the final!
In June, I discussed the bar incident with my friendly, albeit rather dry GP who suggested, because of the sudden onset that I go for an MRI to check for damage which, going through the wonders of the choose-and-book system only took about three weeks to come through and I went along to the very nice Sloane Hospital (Beckenham) where they scanned my back, played music too quietly in my ears and had little concerns with the fact their emergency button did not seem to be working. Not that I needed it especially but would have been nice to have the option! As the results would not be back into the GP’s for about 10 days, it seemed only to sensible to take my mind off things with a jaunt to Southwold on the Suffolk coast for the annual descent of about 1,000-1,500 rugby players for the beach touch sevens tournament. I wasn’t stupid though; I decided that it may be best to give my back a rest and stuck to the drinking team that year…
On the Monday I was off work to catch up on the weekend I couldn’t remember through the wonder that is Facebook pictures when I received a phone call from my doctor to discuss my results. This was odd because I was supposed to be ringing the surgery to find out the results and also I was not supposed to be able to get these until after Tuesday. Regardless of this my doctor told me that the reason I had been having so much trouble with it was because I had broken my back, and when I asked him if there was anything specific I should do with this, he told me ‘I should stop the rugby if I were you!’ [I told you he was a touch dry…]
We settled on a date later that week to discuss this new found injury and it was with a quiet joy that I informed my work, my team and anyone who had empathised in the last year with ‘ooh, I know just what you mean, my back is a bit sore too,’ about the results and then realised I couldn’t tell them anymore quite simply because I didn’t know it myself. So on visiting the doctors, the first thing I asked for was specifics and my doctor told me he didn’t really know but that he would refer me to kings neurosurgical team as soon as possible to get it all cleared up. This was on the 3rd August.
On the 3rd November, after 2 false starts, an appointment with the wrong department, the introduction of a private physician and a very angry letter to PALS, I met with Mr Bell, Neurosurgeon at Kings. By this time I was almost having apoplexy over what could be wrong, how much more damage I could be doing and just how broken my back truly was so I was a touch highly strung and he was rather more dismissive than was perhaps strictly necessary. It was, suffice to say, not the most congenial of meetings. But we rubbed along ok and by the time I left I knew pretty much what I had done and the physio I was to have to try to correct this without the need for surgery.
I had broken the transverse processes of the L5 (lumbar) vertebra. Which meant there was nothing pinning it to the muscles and it was wobbling about on its own, giving no though to the rest of the spinal column or the muscles that were having to overwork to compensate it. In short I had a selfish vertebra! This injury is commonly found in people who play sports, over extend their spines or play silly buggers with their backs. As I also found out that my spine was hyper mobile, I could quite feasibly be accused of all three.
I was told I should do six months of physio to try to alleviate the problems and given a follow-up appointment in April to assess my progress. Sound idea I thought, however in practise, what this actually meant was being prescribed a six week course of Pilates and then told to continue it for six months. I had just missed the start of a course so I was told to start with the next one. In January.
Two months into my physio stint having done nothing physical whatsoever – by this point I had given up rugby and the gym as the pain was inconsistent but insistent enough for not to want to aggravate it – I started my classes. Turned out they were a rolling class where you could step in at any time and start at the level you should be practising at. Now, not to boast but just being frank here, my core muscles have always been good. I did dance, gymnastics, athletics, swimming, netball and then rugby throughout my life and my core muscles have stayed in shape all the way through. I had little faith in this. However after my first hour-long session I was sweating, aching and knackered!
Pilates turned out to be harder than I was anticipating but after the first week and a couple of practises at home, I got the hang of it and started to progress through the levels until the instructor was telling me the more advanced moves to do as I had already completed the lower ones. After my six weeks I continued with my exercises and waited for my appointment in April. However I was also still seeing the private surgeon Mr Chitnavis who had seen me when Kings had bodged my appointment as he had wanted to see me through the choose-and-book system and in March I had an epidural scheduled. Not the kind that numbs your lower body; that would be silly! This was one that injected steroid and local anaesthetic into the epidural space in my vertebrae looking to alleviate chronic pain. Unfortunately, the result was a week off work with the bruising and subsequent aggravated pain and then a return to the norm afterwards. Not deterred in any way, Mr Chitnavis cheerfully told me that it could take up to three attempts to help with an epidural so we should try again.
In the meantime, my appointment time with Mr Bell came and went due to some unexpected leave I got shunted – again – a month into the future and saw him in May, a week before my second epidural. At this point I was thinking of finding another way to go about this, through another surgeon, another hospital as I was fed up with the way Kings had been. But in this meeting, as though Mr Bell had sensed this, he was courteous, even kind and suggested the same path as the private doctor, arriving at the same conclusions and talking to me about the options open to me. The options though were pretty rubbish I have to say. They amounted to staying as I was with the pain under control using bupronorphine patches (opiate painkiller akin to morphine), not feeling able to act as I used to, continuing sport or moving without having to consider what repercussions it would have with every step, or surgery. The surgery was to fuse the L5 vertebra with the S1 in order to stabilise the whole thing and hopefully take some of the strain off the rest of my back. Simples!
My second epidural was a much greater success as they injected the mixture into the area where I felt more pain rather than the actual site of the injury which was a secondary pain site to me and this meant that I went back down to a few tramadol a day, off the patches all together and could for the majority of the day forget about the problem. This oddly, made me all the more determined to have the surgery as this was the feeling I wanted to aim for. If I needed to take a couple of pills a day and could then forget about it for the rest of the day I would be happy. It was also about this time that I decided once and for all not to go back to rugby, despite the surgeons’ assurances that my back would be as strong as someone who had never had this before. The chance of doing further damage to my back and the fact that I would be nervous going into tackles because of this would put me in greater danger on the pitch and would suck the fun out of the sport. It was kind of a miserable time with nothing to look forward to…
I got the date for my pre-assessment appointment on the 30th June at the hospital and they told me there the operation would be within the next 13-18 weeks which would place it around the end of August, beginning of September. This was not fine and dandy as this was the busiest time of year at my work, two months before my sister’s wedding and right when the hen do should have been taking place. So I did the only sensible thing I could have done. I delayed it. When you’ve been waiting for 14 months already, what’s another six months..?
I lasted the six months, epidural effects wearing off after about three of them, and the wedding was amazing. Still seeming to fight with the hospital every step of the way, I finally got my date on the 30th November and it was the 20st December 2011. In keeping with the problems I had had all the way through the first letter they sent me had the wrong date on it, prompting more panic as I only noticed this a week before the operation however once I arrived at the hospital on the 20th December, I was first into the operating theatre.
The operation to be performed was a minimally invasive Transforaminal Lumbar Interbody Fusion or a TLIF for short. The operation I was told went very smoothly but due to an oversight by the anaesthetist I was in a lot of pain afterwards as no one had looked at my – by now copious – notes, explaining the opiates I had been on for the last year and a half so the smaller amounts of morphine they were giving me for the pain were not having the effect they thought they would. Fortunately this only lasted the first 26 hours before a very nice member of the pain team came to see me and sort it out.
So I spent my 4 days in hospital, got my medication sorted, passed the physio tests of walking and going up the stairs and then just had to wait for a doctor who didn’t even know who I was to sign my discharge letter. Nope, I’m not exaggerating, the chap in question came straight over to the bed, ignoring me sitting in my cow print pyjamas and shook my mum’s hand asking her if she was felling well enough to go home, at which point I said that she probably was as she would be driving me… Still, a further two hours later I was allowed to leave the hospital, equipped with enough pills to sink the proverbial battleship but keep the crew stoned enough not to care, and we left for home.
The journey is probably one of those better off forgotten and so six days on it is a little hazy as I suppress the discomfort of getting lost in South East London and the feel of every speed bump on the way. But I was back for Christmas and all the festivities that entailed including the family interchanging visits and the over excitable dog who wasn’t allowed too close in case she knocked me over. I don’t think I have ever felt quite as weak and pathetic as I did that first day but I was just glad that the rooms didn’t smell of disinfectant and illness, the company was cheery and not verging on belligerent and I wasn’t poked and prodded six times a day. Simple wishes for Christmas but I had mine; I’d got home.
Over the next 5 days I read, walked a little and did little else in an effort not to exacerbate the pain I could feel waiting in the wings. After four days the staples came out which, as my back was still mostly numb, didn’t really feel like much but they were much larger than I thought they were going to be considering the width of the scars on my back and the amount of staple showing through. But that just about brings us up to date in why I am now sitting here, not really allowed out, not going anywhere and determined to use this time for as many of my goals as possible, this being the first; returning to writing.
It’s horrible to miss something without knowing precisely what it is you miss and if I’m honest I could have kept up with this myself but it somehow seems pointless keeping diary when so little happens in my days and journal of my thoughts and ideas sound so pretentious I’m not sure whether to laugh at myself or whether by doing so I could be construed as considering myself post-ironic… So instead I blog and here is where we start, and as that wily old Hatter said ‘when you get to the end; stop.’
And so I do.