It’s Been a While: Had a Laminectomy!

Wow. A long time. But, still many people reading since I have abandoned you. Sorry about that.

You see. I had big plans when I last posted. I was going to be an advocate for music festivals as a disabled person. I was going to out those who made it harder for disabled people to access music, and highlight those who helped and supported them. I was going to continue camping, endlessly, tirelessly refusing to give in to the pain and discomfort.

But, it didn’t happen. It was too ambitious. Because actually, as much as i loved it, my back pain and mobility deteriorated and I sort of stopped living. For a little while. I buried my head in the sand, again, about the longevity of what I know for sure now is degenerative disc disease and arthritis of the facet joints in my lumbar spine. And really, I am just not brave enough or strong enough or able to pretend my back pain is not there enough to be able to go to festivals as I would like no matter how fabulous the event organisers are. I attempted camping once this year, but due to a combination of shocking weather, mobility issues and air mattresses that keep deflating on me, it’s on the back burner. We might try once again. Hmm.

I think during my last rant or two I might have mentioned that I was waiting for an appointment to see a highly reputable Neurosurgeon at the National Hospital of Neurology and Neurosurgery. Well it did. I saw him, he was direct, honest, kind, and if I might say so, rather handsome to boot. He informed me that I have lumbar spinal stenosis due to the facet joints being little fuckers at TWO levels (it’s getting higher) – L4/L5 vertebra and L5/S1 vertebra. If you remember, my original problem was L5/S1 vertebra and was told I had a perfect spine if not for that injury. Well, that was bollocks! So, basically, along with a broad based disc bulge at L4/L5, and a thickened Ligamentum Flavem, which was helpfully pressing on the spinal cord, I had bone spurs growing into the channel where the sciatic nerve exits the spinal cord.

I had a laminectomy and decompression on the right side of L4/L5 and L5/S1 vertebra in January 2015 at NHNN, with the expectation of up to 50% overall pain relief, i.e. attempting to completely free the nerve and ease my sciatic pain, but not really being able to do much for the back pain without fusing my spine, which was given a 60/40 success rate so was dismissed for now. Initially the results were fabulous after the minor blip of a CSF leak; I could stand straighter, I could walk without a stumbling shuffling gait, I was able to walk without my lovely orange and black crutch for short walks on flat surfaces, and I felt I had, finally, turned a corner.

But no! Of course not! My pain levels went up, up up. My mood levels went down, down, down. I struggled with leg pain, back lock, constant muscle spasms from the base of my spine to my neck. I had trigger point injections which helped a lot (and four months later I am waiting for my 8 weeks review to see how these went) but wore off too quickly, I had acupuncture, which worked wonders for several days then back to epic spasms. Pain Clnic doctor and physiotherapist have both said I am impatient, have lots of muscle wastage, and to give it time, much, much more time, patience, effort. All of which I have been doing. I have slowed down as asked, but not stopped, and tried hard to be positive.

But it’s been 8 months since my laminectomy and decompression. 8 months of moving, walking (trying to get some distance but not happening), physio and i continue to struggle with standing for too long, walking, pretty much at all, and sitting for more than a few minutes. And now I am mostly back at the stuck bent over stage. I’ll take a photo of the  ‘old woman hunched over with a walking stick’ sign at Wembury Beach toilets to show you what I look like.

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Taking Control Back: The Expert Patients Programme

This week I have been pointed in the direction of the Expert Patients Programme which is a free self-management course run by volunteers who all have a chronic condition of some kind, for patients who have a chronic condition of any kind. It is a 6 week course of 2.5 hours per week in a group setting and provides structured support and real strategies for coping with the impact of chronic conditions, increasing confidence, learning coping strategies, dealing with relationships as well as meeting other people with chronic conditions.

The first person to tell me about the Expert Patients Programme was a friend via Facebook as I moaned about the length of wait for my various hospital appointments. Because I have moaned to everyone about it. A friend who has a chronic condition and said despite not completing the whole course, he found the sessions he attended useful in managing how he coped with coming to terms with his condition.

Almost immediately after, and completely separately, a very close friend of mine emailed me to say she had actually spoken to the manager of the local Expert Patients Programme which is run from the local voluntary guild (of which my friend is the ACO), about my condition and also that I am a trained group facilitator myself. The coordinator has lent me the workbook so I could take a look at the course structure before deciding whether to do it or not and it looks well structured, thorough, and informative.

One of the things that appeals to me about the course is that it is run by fully trained volunteers with their own chronic conditions, and thus able to support from a personal understanding as well as being trained to facilitate learning in a group setting. I also like that it is in a group setting. There is going to be a wealth of knowledge, experience, information and support from this type of group, with people who know, who are there, who understand what it is like to never take a break from pain and who want to take control of their lives once again. I am already, ironically, a group facilitator in a cognitive psychology based area, which in essence is what self-management is but I work with people who are largely not ready to take control of their lives, and so know how important it is to be ready to do courses like this for them to succeed and the idea of being able to use my own experiences to share with others and help others has piqued my interest.

I am quite a thorough person when finding out about informative aspects of my condition – ways of coping, medical information about what is going on in my back, practical techniques, and medicines, but, what I am not so great at right now is emotionally coming to terms with the impact of chronic back pain so the support that a group like this can bring, and that I can bring to others appeals to me.

It’s funny because when I was first struggling with the pain and devastating impact of this condition, namely being told by an osteopath that I should not kayak again, he suggested cognitive therapy. But, he talked it up (or down) as being that much of my pain was psychological and that I needed to get to grips with it emotionally. My instant reaction was ‘fuck you I am not struggling emotionally’ and I walked about, did not return to see him again. To be fair, he was a tosser of the first order and did nothing practical after his initial correct diagnosis other than delay my treatment and make me feel like I should Just Get On with It.

I am not sure if it is me that has changed my own perspective in the last year, or that this course has been presented in a much better way, but, I like the idea of seeing myself as an Expert of my own condition, of taking control back, and so I am not seeing this like some counselling session to ‘come to terms’ with my condition, but one where I become myself again. Unlike those I work with, I am now ready to take control of my own destiny.

I have also read about being a volunteer myself, and yes I know, got to do the course first and learn to be that Expert myself before teaching others, but, I already want to be a volunteer. My friend clearly knows me well as she has already told the manager to expect me to end up as a volunteer!

So, I am going to find out when and where the next Expert Patients Programme is, sign myself up for it and I will post my progress on the course and any useful tips I learn on the way.

If you are interested in finding out about an Expert Patients Programme in your local area, you can either contact them via telephone or email, details on their website, or you can read more about it on the NHS website detailing specialist services available. 

It’s worth mentioning that there is also a specific Back Pain Management course run by the NHS, which I may be offered through the NHS hospital lead Pain Clinic, which will teaches specific skills relating to my back condition, but to use this as a tool alongside other treatment, and when I have more information about that I will post details. In addition to these courses there are other courses available for specific chronic conditions such as diabetes and arthritis.

The NHS 12 Week Wait.

There is a 12 week wait for the Pain clinic at my local hospital. That is, there are no appointments being offered as there are none available for the next 12 weeks, so I am somewhere quite a way down on the waiting list for appointments after that date. I take that to mean, the wait is in fact much longer than 12 weeks. I can travel for hours to another hospital, and have all my pain treatment at that hospital, and if I do that, I can have an appointment on 28th April 2013, but cannot then transfer to my local hospital when there is an appointment available.

The woman at the central referral unit that deal with referrals from GPs to the various hospital outpatient services in the South Devon area was very apologetic. She clearly has a lot of abuse from patients a lot of the time as I had to ask her to stop apologising. She said she felt terrible not being able to offer an appointment to the Pain Clinic to people who are clearly in a lot of pain. She advised me to ask my GP to write a letter stressing the level of pain I am in, but also gently suggested not to get my hopes up as, given that all the patients referred to the pain clinic are in fact in the same boat, they will all be doing the same thing.

She also told me, cautiously, that the 12-15 week wait I was told to expect for my neurosurgery consultant appointment date was overly optimistic. ‘sorry’ she said, again.