To Hell and Back

With 2009 being a bust musically because of my disc problem, I was determined to get back into gigging again in 2010. I took a job at Sofia's after New Year's with Eliot Zigmund and Ed Fuqua and it went really well. I felt very little, if any pain. But by the middle of February, my situation went from bad to worse. On a follow up gig with my old friend, Sylvia Cuenca, I needed to stretch out my arm every 10 min to avoid having my arm lock up. With top flight pianist Jill McCarron in the audience, I pressed myself to the limit and the problem probably escalated from there. Thankfully Jill sat in for two tunes, buying my aching arm a little recovery time.

My tricep, forearm and shoulder constantly throbbed when walking. Oddly, just having my hand in my pocket induced the worst paresthesia. One evening I suddenly couldn’t raise my arm at all. And in the morning it was the same. I couldn’t brush my teeth. I called the neurologist immediately who prescribed a pain killer and an oral steroid. The MRI taken put me through one of my most painful experiences ever. I couldn’t lie on my back without intense shoulder and arm pain and being locked in the claustrophobic MRI tube for 20 min only tested my will to bear the pain even further. After the MRI confirmed that spinal impingment was not the cause of the arm weakness, I started physical therapy. Thankfully, the strength came back to my arm. I started doing cervical traction and using my new cervical pillow. The idea behind traction is to stretch the vertebrae and relieve pressure off the nerve. Unfortunately, I think traction was a fatal mistake in my condition. My mind drifted back to one of the accupuncturists at the clinic who advised strongly against traction for herniated disc. (Damn! was he right? I thought). I woke up in the middle of the night and felt pain across my neck and shoulder with hot patches of edemic swelling down the spine, across the shoulder, down the ribcage, triceps, forearm and fingers. In the nights following, I was waking up in pain and swelling, making trips to the couch, but still not able to sleep. I tried sleeping semi-upright, on my back and on my side. But nothing worked. Everything felt so tender, soft pillows felt painful, like they were denting the back of my neck and head. The inside of my body felt like it was boiling and swelling.

At this point I was sleeping maybe 2 hours a night and getting really run down. At work I sat on the toilet just reflecting on my throbbing pain. It was almost to the point where I could faint but in a meditative state I tried to imagine pain as another sensation, like heat, trying to blot out the pain. That day I found a book online, Fix Your Own Pain Without Drugs or Surgery written by researcher and clinician, Dr. Jolie Bookspan. Her opinion is that correcting forward shoulder and forward head often solves the disc and pain problem; many of the medical conditions described in a typical MRI analysis such as herniation, cervical lordosis, and spondylosis can be irrelevant, once you learn to balance the weight of your head and square your shoulders properly underneath it. However I probably should've held off on these posture and stretch exercises until I was in a little less pain.

The next day I had an ache in the small of my back from Bookspan's recommended exercises. I had the uncomfortable feeling of being unable to support the weight of my own head! Eventually I ended up in the E/R at St. Luke’s Roosevelt. The hope was to get the pain injection recommended by the neurologist, but they wouldn’t do it. And I was still several days away from my pain management appointment. Instead the E/R doctor prescribed the painkiller, percocet. Percocet allowed me maybe an extra few hours of sleep but I would always awake at 3am with swelling and pain. This went on for several more days. On Monday I had the day off and strolled around the city on a sunny day. I was trying to stay positive, take vitamins (my friend Charles recommended magnesium malate and Vitamin D3) and got some exercise.

I was beginning to get confused. I was thinking in circles and losing the ability to make decisions: where to eat, where to buy water, whether to stay in the city or go back to Queens. I drank a lot of water but had no appetite whatsoever. I realized I had might've dropped 5 lbs that week. On the train people started looking at me funny. I probably looked like I was on drugs. When I got to Queens I ran into Duane Reade and bought myself a 6-pack of Ensure. Outside my fingers were fumbling as I broke open the pack and guzzled a bottle down. I thought maybe I should just sit and find a place outside to relax in the sun. But I realized I didn’t have the strength to carry the six pack to the park, so I got on the bus. I couldn’t get a seat so I stood. Somewhere in the middle of the bus ride, I found myself falling asleep standing. Finally I said to myself “Enough! Stop feeling sorry for yourself! Get a grip!” This actually stimulated my system a bit. I was happy I had that in me. When I got home I started exercising and doing stretches with renewed vigor. I felt really good with this new energized attitude. I lay myself down for a short nap late in the afternoon. But an hour later, I woke up with my armpit completely swollen up along with my neck, ribcage, arm and fingers. There were these little arthritic knots down my fingers. (So much for positive attitude). Later on in the evening I started developing this burning feeling on my left side. I never felt like this. As I researched the Internet I realized that the percocet was probably giving me an ulcer. All the previous nights I starting getting the feeling that my body was turning acidic. I couldn’t eat the meal cooked for me. I stuffed my face with lettuce and some simple pasta with some broccoli but I ate it without any feeling for appetite.

The night before pain management appointment a friend recommended that I go to the clinic crying in pain and go cold turkey on my meds so that they would give me the injection right away. Given percocet was killing me internally, I went ahead. That night I suffered incredibly. Hour after hour in pain. It felt like I was in drug withdrawal. Getting up and pacing, sitting on the couch, I was unable to relieve the pain or find a comfortable way to sit or lie down, stacking pillows everywhere. At around 5am I sat upright on the smaller couch, stacking pillows to my left and my right, behind my head and my feet. I was dying for sleep and was willing to try sleeping while sitting upright, but as I would doze off I could feel my head falling to the left, the right or in front of me, like a drug addict with the nods. The head nods were pulling on the disc, further irritating it which would wake me up in spasm. I was trapped in my own body! This is probably one of the most frightening experiences ever. Suicidal thoughts gripped me for the first time in my life. Because if you can’t walk, stand, sit or sleep, what else is there?

Miraculously, at 6am I suddenly fell into a deep sleep. I woke up (missed my physical therapy appt) and suddenly felt refreshed, and without pain. As if I had gone thru drug withdrawal and gotten to the other side. Now ironically I was pissed off, because the goal was to show up to the pain management clinic in pain so I’d get my shot! In the pain management office I was stretching myself out to induce some of the pain I had been feeling all these nights. When you fill out the chart you are supposed to rate your pain on a sliding scale. Me, I’m always trying to be honest about these things, but my wife looked at me with daggers. "Tell them you're in pain! They’ll never treat you!" She was right. As it turned out they scheduled my epidural steroid shot at the end of the week. The Saturday following it was miracle. Zero pain. However it was short lived. The pain returned in about a day. But not to the level it had been. More like how it was at different points last year - a somewhat annoying discomfort, but not life debilitating. Recently I got my second epidural and the effect was about 2 days. The one mistake you can make is pressing yourself too hard in the wake of the benefit from the shot.

In terms of the benefit, I had heard that epidural steroid shots are for the most part ineffective for the treatment of long-term pain. However, one of the doctors taking part in the injection procedure told me that in addition to calming down the nerve root, there is also the possibility (depending on the state of the herniation) that the herniation can resorb itself over time with the aid of the shot. That was new. I will be following up with this in a later blog.

Next Time: So IS There a Cure for Herniated Disc?