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Turning a Corner

Posted by: David Carroll

All’s been quiet on this front for a long time. I have spoken about how the Lord was healing me of a long term health problem with back pain culminating in having a tumor on my spinal cord in my neck discovered (revealed may be a better word ) and removed. This post will explain this period of quiet and the good news that came out of it but before I can explain the good news, I have to explain why I was so quiet.

Pre-Op MRI with TumorTake a look in the picture on the right of my pre-Op MRI. Can you see what is not supposed to be there? Look up and down the spinal cord coming off the base of the brain. About two thrids the way down is a blob which was pinching the spinal cord.

The surgery required removing the bones of my spinal column which surround and protect the spinal cord. This would give the surgeon access to the tumor on the cord. It was quite a delicate surgery to remove this mass which had attached itself to the spinal cord itself. The tricky part was that the tumor was the same texture and color as the nerve. Furthermore, the tumor had extended down one of the nerve roots going down to my left arm. This required removal of facet joint which keeps the vertabra from coming out of alignment. Without this joint, my neck would be easily broken. The solution here was to fuse the two vertabras together requiring rods and screws to hold it all together while the fusion takes place over the next year.

Post Op XrayThis is a an x-ray (not an MRI) showing the screws. You can see the rod and screws easily but also notice the missing spineous process bones. You can see two of them at the top of my neck (that’s my jaw on the upper right). Then they dissappear for the next five vertabra. These bones are part of the structure fo bones which surround and protect the spinal cord which sits just behind the spinal column of vertabra.  The vertabra are separated by discs forming a column which is the backbone of your body. The spinal cord, or main nerve, runs down just behind this backbone of vertabra and discs and is protected by the spineous process bones. As you can see, I don’t have those spineous process bones anymore. You can feel yours on your back. They are the bony things that stick out and make bumps on the skin down the middle of your back. I have a noticable flat spot on my neck now because those bones are missing. The back and neck muscles normally attach to Post Op Xraythese bones. I asked the surgeon where those muscles attach now and he said that he sewed the two sides together so that they now attach to opposing muscles groups rather than to a central bone.

The next xray on the right shows a frontal view and you can see the absence of these spineous process bones as the long oval darker shape in the middle of my neck just next to the screws. This was the cavity the surgeon made to gain wide open access to the spinal cord and the tumor.

I blogged my recovery from that surgery and how God was healing. The wonderful part was that the pain I had been dealing with in my back and my legs for three years was gone. So I have had two failed surgeries on my lower back and then a tumor which according to the doctors should have had nothing to do with my back pain. Healed! Right? Well, yes and not yet.

I realize that there are many stages of healing particularly when we talk of “complete healing.” What I did not realize several months ago was that although my pain was gone, my body had become dependent on pain killing drugs. I have been taking strong narcotics on a continual basis for over 18 months. I had figured out how to cope with the intestional problems that are typcally associated with opiods. But back last March, I started experiencing severe headaches that lasted 24–48 hours at a time, several times a week. Associated with this was dizziness and loss of appitite. Although I was experiencing no back pain I was having a very difficult time being productive even with simplest of mental activities. Furthermore, I went into a state of depression that was like a vice grip on my head. I am wondering if I wouldn’t rather go back to the back pain, at least I was able to accomplish some work. The worst part was this state of mind was affecting my spiritual well being.

I have wonderful news to report however, my headaches have been gone for several weeks now. I am exercising again, and my appitite has returned. Thank you Lord and thank all of you who were praying for me. Especially you Millie!

Now for the story of how this wonderful turn came about. I had convinced myself that the pain killers were a necessary part of my life since I still suffer from pretty bad arthritis in my left hip and left knee. Although I did not need the pain medication anymore for my low back or my shoulders (from the surgery on my neck), I still felt I needed it for my arthritis since it worked so well on that malady. I kept looking for some reason why my headaches started back last March. It seemed so drastic of a change from how well I had been doing during since January.

Post Op MRI showing SeromaIn March, I had another MRI on my neck done and discovered that I had a seroma which is a pocket of spinal fluid that had collected at the site of the surgery. In the picture, notice the white tube-like thing just to the right of the spinal cord. You can see that the spinal cord is much more relaxed than it was but that there is still some damage from where the tumor was. The white tube-like thing is where the surgeon had to remove so much bone that there was a cavity and although he tried to tighen the muscles up around there, it was impossible to completely fill the cavity with muscle tissue. Now the body abhors a vacuum so it will fill up with something.  Fluids are the easiest to fill such cavities and the nearest fluid in this case was spinal fluid. Such seromas are not uncommon and may or may not cause problems.

Some doctors I talked to, not my surgeon, thought that this seroma could cause the headaches because of the hydrolic fluid connection through the spinal column to the brain. Any pumping of this fluid due to muscle movement or whatever would directly affect the brain since it too is encased in spinal fluid. My surgeon did not seem too worried about the seroma but he did say we’ll keep an eye on it since I have to have four more MRI’s done over the next three years to make sure the tumor does not return. The only complications he mentioned are infection and he did not seem to be too concerned about that. So the headaches were somewhat of a mystery but I became fixated that the seroma was the cuprit and was convinced that was my problem. I even contemplated more surgery to repair the seroma.

Meanwhile, in March, I was asking my surgeon to renew my prescription for pain killers while telling him how I felt they were really helping my arthritis problems and that I might need to continue to take them indefinately. He frowned at that suggestion but acquiesed. But then he decided to prescribe a new synthetic opoid which had just come out in a forumulation where you only had to take one pill a day. It was an extended release type of narcotic. So whereas I used to take the pills when I felt I needed one for pain, typically three a day, now I just took one every day in the morning whether I needed it or not. No pain ever, such bliss right? Not really. I began to realize that the pain killers were complicating my life because the associated constipation was getting more and more of a problem. Twice I tried to stop taking the pills for a couple of days and immediately would have severe flu-like withdrawal symptions accompanied by diarrea, not a pleasant situation. This is a classic case of drug dependancy. It is a physical dependancy not a psychological addicition. But I must say that the psychologal element still comes into play when you know what will happen if you stop taking the pills, withdrawals and exacerbated arthritis pain. Bottom line, the pain killers were starting to show their ugly side. They were wonderful and truly a blessing for a time but now they were definately a problem to be sovled.

Interestingly, although I had read about these drugs, I had never noticed some of the side effects mentioned in the pharmecutical litarature. I have always assumed that the endless lists of “Some patients may experience this that and the other” you see was just for those rare patient cases who were perhaps reporting these symptoms but were mistakenly assumed to be related to the drug. As far as I was concerned, such warnings were just a legal requirement for the drug companies. But then I read again where the opiods I was taking could cause headaches, dizziness and loss of appitite. All of a sudden it clicked. The headaches showed up only after I started taking the extended release pain killers in March. Now I had a huge reason to get off these pills at least long enough to determine whether they were the cause of my problems. So now the question became how to get through the withdrawals.  After consulting my surgeon I got a new prescription for normal pain killers (non extended release formulation) and I began to slowly cut down on the dosage. I worked my way down from 100% to 75%, 50%, 25% then 10% of the amount I was taking previously on a daily basis. I began to notice the headaches becomeing shorter, less intense and less frequent. Last Sunday, I decided to stop taking the pills completely.

Praise God, it has been four days now and I am completely off those narcotics with no severe headaches in two weeks! And all of the other symptoms are gone too. Last week, I returned to my personal trainer whom I had not seen in three years. I am lifting weights, walking and my outlook is fantastic.

So now I ask why did God allow me to go though all of these problems with depression and headaches? In retrospect I can say I really needed those pain meds over the last three years and I can thank God for that. But God knew I would become dependent on them and He had to allow me to discover what that was all about. If I had not been prescribed those one-a-day pills for pain, I might not have ever realized how detrimental that medicine could be over the long term. The last phase of my healing was to take me through a dark time so that I could see those last remaining problems which would have become demons had I not felt the need to fight them early on.

Thank you Lord for answering my prayers.

 

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Randy wrote:
Awesome post!

God's ways are so far beyond man's ability to comprehend. I look forward to that day when I can more fully understand the good that God brought from the many crosses He has asked me to endure. Praised be Jesus Christ, King of Endless Glory!
Millie Seatts wrote:
Our God is an AWESOME GOD. David dear heart, I am so happy to hear the great news. I knew in my heart, the next time you post in your blog, that it would be great news. My prayer was for you to not only be healed from the pain that you were going through but to be healed physically and mentally. Yes, your road to recovery was a test, but your love for God proved that you could stand the test. On our last conversation, I didn't like the part of you taking the pain medication so frequently so my prayer was that God would heal your mind and take away your need for those meds. I thank God for being with you every step on the way. Welcome back David, I love you dearly.
Dan Baker wrote:
I can empathize with your opiod issue. I am on Duragesic for severe chronic pain witch has disabled me from active churcch ministry. Anyway, I am in that class of people called opiod tolerant, that means all the normal ones have no effect at all. It helps with the pain but the side effects are something else. Right now the worse one is the auditory hallucinations. That means you hear sounds like one line from a song over and over and over. These are constant and starting to drive me nuts!

I am very glad you were able to get off yours so quickly. PTL

Please pray that I can get the spinal cord stimulator implant sooner than next fall. Waiting that long means I will not get off these narcotics until 2007. maybe?

Your post was an encouragement though. Thanks!
Dan Baker