Saturday, July 27, 2013

A New Redo indeed...

The hubs developed a leak of spinal fluid at his surgical site. We took him back to see his Neurosurgeon and he was booked straight in for surgery. He was due to be back on the boat in 10 days time and the idea of going back under the knife got to him. When he was coming out of anesthesia, he couldn't use his legs. Naturally, I freaked out. I kept my composure for him, the PA kept checking and rechecking his legs. He wasn't even completely conscious yet. I had to explain to him, in his haze, that he was going back under because his legs weren't working. He didn't see me cry and he didn't hear my voice crack. They hit him some O2, some more versed and then wheeled him away. My hands were shaking and I nearly hyperventilated in the waiting room. I was still ok. I had to be because I had to make the hardest phone call of my life so far.

It was nearly 11PM in England, I had just called his Mum to tell her he was okay not even and hour before. I knew she had gone to bed with a clear head, knowing he was alright. Unfortunately, his Dad answered. That man hates me and I knew I'd woken him up. I asked, as clearly and calmly as I could to speak to his wife. I told her that the recovery team had come to get me and that her son had failed his neuro exams. I had to explain that he couldn't use his legs. I was mechanical and I relied on my training as a nurse to stay detached and deliver the news to a patient's family, but then she asked me how I was doing and I broke. I told her that I knew I couldn't care for him here and that I needed to think about long term plans. She's the only one in my husband's family that accepts that it wasn't my choice to leave England, but his. I told her I would keep her informed and that I needed to wait for the surgeon to come back out.

While I waited for the surgeon, I began looking at the cost of moving. I began looking at options. I began the dreary task of living in the worst case scenario. Then I learned something. I learned that while I'm here, looking to go back and restart nursing school and spend 4 years restudying to do something I'm only mildly interested in, I could spend 5 years studying to be a doctor in England. My first passion. Science. Medicine. I made my mind up. We WERE moving to England. I married my husband when I was 19, and I quit college for it because he was "non-taxable" due to his status working for the US Military. I followed him everywhere for nearly 10 years and because of that, all the financial stress falls on his shoulders. So I decided that if he comes out of this surgery with his legs working or not, we were going back to England. We were doing it right and I was going to medical school.

The surgeon came out and told me there was no obstruction, no pressure, no swelling, no damage to the nerves and that the nerve conduction tests went perfectly. He then asked me if it could be psychological. I said, "No, he's been calm, I don't see how it could have happened with him so sedated." But the Doctor said it does happen. I was so flustered and so focused on calling his mother and seeing him that I didn't think. In recovery, he was still failing his exams. High and barely conscious... he was still unable to respond to painful stimulus, he was unable to move his legs. I asked the nurses how his pedal pulses were, checked them myself. Checked capillary refill. Performs my own neural exams. I needed to make it real in my mind. The nurse stood beside me quietly and nodded as I pinched his nail bed, dug my nails into the soles of his feet, asked him to push and pull against my hands. The surgeon had come back to check on him again and watched me. I looked at them both and said, "He still has feeling though. I don't understand. It's like his brain has just turned his legs off." They both sort of shrug-nodded. The nurse must have thought I was going to cry or something and she shooed me out while they moved him from recovery to his room.

I called him Mum and explained that he passed the nerve conduction tests. The nerves were perfect. The paralysis was completely unexplainable. That we were going to have to sit it out and see how he is when he's more awake and able to understand things. I told her I would keep her posted and naturally we were both scared. I told her that I didn't care what he said, I was going to put my foot down about moving back to the UK. In the room, he was more with it. He asked if his Mum knew and I told him that she had been kept in the loop. He was confused, but not quite scared. That's when it really clicked. He such an outwardly stressed guy. He'd only had one episode of it before, but it was pretty severe. I went out to the Nurse's station and luckily his surgeon was there, wrapping up paperwork.

"Conversion Disorder," I blurted out, and they looked at me confused.
"He has conversion disorder, he was only 0.5mg of lorazepam until a few months ago. He's only ever had one flair up before, it was a severe case of dysuria. It was so bad that they did a ureteroscopy on him to try and find the cause."
"I'd say this is his second episode then," the surgeon said.
Exactly! This isn't just idiopathic paralysis!"
"Hysterical Paralysis," his neurosurgeon and I both said together.
"My brother has very mild conversion disorder, but hysterical blindness, deafness and such are so rare," the Doctor said.
"I know, do you think we can try putting him back on the Ativan and see if that helps? He must have been worried about losing his job, his FMLA leave is up in a week, but he wasn't outwardly stressing about it. He must have already begun the episode, turning the mental stress to physical and the CSF repair just triggered it."
"Yes, I think that's a good idea. We'll get an MRI tomorrow to be safe, and try and get him into a Rehab place to get him moving again, if they'll take him. If not, we will discharge him."
"Push him out of the nest? Force him into reality again?"
"Yes, yes. If you're comfortable with that."
"I am. What choice do we have?"

I talked to him, made sure he got something to eat. Made endless cups of tea and when he was together enough, I approached the subject of moving to the UK. We had been saving up for a house, but, it wasn't logical to keep putting off my education and relying on just one earner. He's been to work in the Middle East, Africa, Mexico, all over Europe and I've quietly sat on the back burner. With him being in his early 30's and already having had back surgery as well, he needed to think of a career change, he needed to look at going back to University. It only took logic. If he couldn't get his legs back, we didn't have a choice. If he did get them working again, well, it was only until the next catastrophe. Plus, having made the decision that losing his offshore job didn't matter, it relieved the stress that caused the Conversion Episode in the first place.

I'm an autodidact. I had an abusive upbringing and I lived relatively close to a library. I also had a wonderful school librarian who would get me medical journals when I was very young. I would sneak off to the library when I was not much older than my son is now. Maybe 6 or 7 years old. I would read anything science I could get my hands on. I went through an AIDS phase, a Cancer phase, a Psychology phase. Books were my safe haven, they still are and I have ALWAYS had a passion for learning. I taught myself Basic and Visual Basic when I was 8 or 9, HTML was soon to follow. I also taught myself French at around 8 or 9, starting with an Atari program, then with help from the Library's endless supply of knowledge. I began hacking and cracking small things before I even knew what it was, computers were great, but medical science was always my favorite. The Librarians, at first, didn't think I could ever understand what I was reading, but left me alone. Then I just became part of the furniture. I used my knowledge of Ohio laws to terminate my Mom's custody as soon as I turned 12, and moved in with my Dad. Books were my power, but I never had the means to properly get into or through school.

I had a 4.0 when I was in nursing school. It was easy as breathing for me. Clinicals were heartwrenching, but I'm and empathetic person, so they came naturally as well. What didn't come natural was the constant fighting amongst the students. It was like a constant episode of Survivor, as if there were only a few spots to graduate with. The instructors started and encouraged the infighting. I was in a class full of "mean girls" several of which came smelling of booze and some would deliberately hurt the non-verbal patients. If anyone complained about this, they would find themselves locked out of the clinical site and would be counted absent. Two absences and you were excused from the program. I know this from experience. My Dad was diagnosed with late stage 3 melanoma before I applied to Nursing school. I was told the program was flexible and they understood I was caring for an ailing Father. Clinicals missed for that reason would be able to be made up. I missed one Clinical because he ripped his surgical drain out, I missed the next for turning a student in for breaking my patients finger to hear her cry and getting locked out. I got back in literally 1 minute past cut off and was sent packing. The dean told me I didn't belong in Nursing School because my "priorities were fucked up."

Anyway, getting back to my husband. They kept retesting his reflexes and his range of motion. The whole day ticked by. His feet were under the blanket and he only saw them when they were tested. A thought was brewing in my head, I couldn't figure out what, but it was there. We worked out a plan for moving. A fast plan, in case he couldn't walk again and a slow plan, in case he does. The nurses kept coming in to encourage him. They told us we were amazing because he was up and walking right after his initial surgery. They told us how amazing we are together, how well we work as a couple. They just wanted him up and moving. It's a small surgical center, with a very small patient to nurse ratio, so they really do get very attached to you there. They were all concerned, you could see their brows furrowed as they checked and rechecked his legs. They spoke only to me about his condition and we were selective about the narrative we wove for him. His Therapist called and said he didn't think he could help him anymore. He only knew of one Psychiatrist with any experience with Conversion Disorder and he would call her, but he told me to bear in mind that Hysterical Paralysis is extremely, extremely rare. This was going to be trial and error for all of us. Part of me (the nerd part) was a little excited. The wife part of me was scared.

The next day, we had another problem. He's extremely claustrophobic and it was a closed MRI. So more sedatives. I went down with them. Still in my pajamas, sports bra, luckily. They began to put him in the machine and he began to panic. So I threw my glasses at the poor nurse and went in. I held his hand, then his head, then his leg. He trooped through it, I told him to close his eyes and he did okay. When they wheeled him back to his room, the bubbles in the back of my brain had finally formed into a cohesive idea. His feet were covered up. He could feel his legs but he wasn't connecting with them. "Stranger Danger," I explained to him when I unhooked and removed the airsocks, uncovered his feet and forced him to look at them.

I made him go through range of motion. I propped his legs up so his heels were off the bed and I forced him to look at how little his feet were actually moving. He was shocked and said he felt like they were moving more than that. Every circuit in the RoM's I forced him to push it harder, farther, hold it longer. Every time he tried to look away I made him watch his feet. I tried so hard to get him mad. He used to have such a quick temper, but he just wasn't getting mad. I needed him to feel something, anything. Push it! Pull up! You're NOT TRYING! Try harder! Stop babying yourself. This is fucking serious. We're getting discharged today. PUSH! Point your toes, Circles, circles! WATCH YOUR FEET! GET MAD!

The nurses were behind the privacy curtain that hung at the door of our suite. They peeked in, quietly and when the Hubs laid back, trying to give up, I looked and one and they nodded at me. He was moving more and more with every repetition. One dragged the PA in while I was yelling at him. He didn't notice the audience. I didn't let him look away from his feet. I told him I wasn't letting him see our son until he gave it everything he had. After a while, he decided to try and stand. When that proved to be a success, he decided to pee standing up. I stole a conversation with a nurse. I had to explain that I needed him to reestablish the connection with his legs and feet. I needed him to restore his "foot-eye" coordination and I wanted him to see how little he was actually moving his legs. Everyone kept his legs covered and I explained that I thought it was allowing him to distance himself even more from them, mentally. After a rest from his victory over the urinal, he sat in the recliner. He said his legs felt weak and rubbery, but he wanted to try a walk after a rest.

When he was ready, I held his arm and his hand. I allowed him to rest his hand on the hand rails, but not to use them. He went up the hall and back, made himself a cup of tea at the Keurig and sat back in the recliner. The nurses all cheered for him, just like when he did his victory lap after his discectomy. He announced he was ready to go home, he wanted to see our boy. I told him it wasn't happening until he did a whole lap around the floor without me supporting him and without the hand rails. I told him his leg were still strong, he'd only been laid up a day, and he had no logical excuse in the world to not use them. He reluctantly agreed. So after his cup of tea, we set off again. I held his hand loosely, and he did the whole lap.

So here I am, preparing for the UKCAT, the BMAT, picking out which Medical Schools in the UK to apply for and he's sitting across from me on Facebook. We both feel at peace with the decision. Would you care to guess the specialty I've chosen to pursue? Neuropsychiatry. .I really feel like if there's a switch in our brains powerful enough to paralyze us, imagine what it could do when used to heal us?

I'm aiming for Brighton and Sussex Medical School, my husband was born there and his parents live in Hastings. I'll apply for some schools in London as well, but, I am so in love with Brighton. It's such an amazing city. The only thing I have to overcome is that a long time ago, when I was in High School and suffering at the hands of some depraved individuals, my GPA suffered. I don't have the 3.5 they want, but, as a mature applicant with a background in the medical field, I'm hoping my UKCAT, life experience and passion makes up for it. I'm only 28, but sometimes, I feel like I've lived 100 lives.

Tuesday, July 16, 2013

Back surgery hiatus

My husband had to get a discectomy on his L5/S1. Honestly, we didn't think he was going to get it in time, before his FMLA ran out. His company is fantastic, he's been on full pay this whole time, but the insurance company and our family Doctor really made a putz of the whole situation for the first 6 weeks or 7 weeks. Yay, America. Times like this I really miss living in the UK and I know he doesn't regret the decision to come back stateside, but I do. Him being British and me being a Yank, you'd think he would be the one missing England and the easy access to Europe. The access to healthcare and education. He prefers the congeniality of the people and the safety of America, it is a trade off and he has more faith in my country than I've had these last 10 years. While it's true, I'd never dream of sleeping with my doors and windows unlocked in England, I do have to worry about an accident or illness ruining our entire financial existences.

Anyway, about my running. I skipped my off day and decided to do a night run the night before my husband's surgery. We didn't have time to prepare for anything because he went in Wednesday and was in surgery Friday. Thursday was hellish. I only barely managed to squeeze in a run and my streets are so poorly lit, the sidewalks are lumpy, where there are sidewalks and about a half mile down the road is a not so great neighborhood. A half mile the other way is gated communities, Mercedes and BMW's, security guards, the whole she-bang. Thing is... I didn't realize the neighborhood gets not so great the other way.

I strapped my little lighted bracelet on, decided against my normal tuneage because this was around 11PM, and given the lack of street lights and the fact my dog is an unfortunate shade of black, I needed to be aware of cars, especially for her sake. I now know that I need more than the five minute brisk walk warm up, so I headed out, and about 10 minutes in, turned my workout on without music. Things were going well. I hadn't even worked up a sweat yet and a group of teenagers started following me. I'm still on week one. It was my last workout of week one and up to this point, for the past 5 years or so, I've been pretty sedentary. When I say I'm out of shape. I mean it. So I take a turn. The kids are getting a little closer and I'm listening. I'm on a walk interval. They take the turn. Gizmo, usually a laid back lady, began wumping. She's a talker, and the tone of her voice was worried. The boys were getting louder, closer and the hair on the back of my neck was standing up. I don't bring my taser running. My inhaler and phone is enough of a pain in the ass.

"Wump, wump, wuuummmmp."
"Shhh... s'ok, we have a run coming up. They won't follow us."
"Haaaarrrrruuummmp."
"Begin Jog."

So we did. It wasn't a scared, or desperate run. My phone was on speaker because I didn't want headphone impairing my hearing. So they may have heard it. I didn't want to appear nervous or worried about them in the least. I didn't want to give them what they wanted. I jogged lightly, Moe keeping pace, but still wumping in protest. I headed straight back home. I rounded another corner to put me on a straight shot to my road and I was so mad. If I didn't have Gizmo with me, I'd have turned around and confronted those kids. What kind of assholes get their jollies off on tormenting people? Fuck sake. Anyway, I ended my run 15 minutes into the program and it hurt. I hadn't even gotten warmed up completely. I didn't even get a sweat going and my legs KILLED. I knew that they wouldn't hurt if I could have just finished the run. So I came home, angry and fuming and poor Giz sensed it.

Anyway, the next morning, Sean got his back surgery. He's been in agony for months and months. They brought the versed in and I got to push it. The perks of being in the medical field! He was so high, I think the nurses took extra care to get him going just to hear him say goofy stuff with his accent. Seriously, I love Midazolam. I loved it when I was going in for my surgerys and I loved watching my husband get messed up on it before his. He did so much better coming out of anesthesia this time having had it before hand too. It could be too that the intense pain he'd lived with for so long was literally just gone after his surgery, but he didn't cry for no reason. He's a post-op crier, not so much with versed. He was like a new person without all that pain.

As you can imagine, I was on my feet or driving all day. I had to take my husband to the hospital, then take my son down 40 minutes South to my Dad. Then bust ass back up to see my hubs get high and sent off to the neuro-choppa and then I had to get our hospital room ready for him. We've spent a lot of time in hospitals, so we're pretty good at setting things up like home. Then I had to run out and meet the surgeon. After that, I paced around the room, learned paper quilling (I'm a compulsive crafter) and abused the hell out of the Keurig set up right outside our room.

Once the Hubs was wheeled in, I was go-go-go again. He was on a drip, so he had to pee a lot. I don't like bothering the nurses, so, if they let me, I take over I&O. These nurses were super sweet and while they tried to make me sit my ass down, they knew they don't sit down in hospitals and there was no hope of me doing it either. He was peeing a lot, so I was up and down constantly, plus he wanted tea and water. Then I had to go let the dogs out. Later in the evening, I went to pick up dinner, got his some breezer cough drops for his intubation irritation, let the dogs out and got them bedded for the night and then headed back to the hospital for a shower.

That's when I noticed it. My feet were sore, which I expected, but they were swollen. I had edema in my lower legs, edema with slight pitting. I've NEVER had my feet or legs swell up. My skin was tight and it hurt to move my ankles. The pitting was what worried me. My sodium intake isn't high. I'm a vegetarian and I drink pretty much nothing but water. I can't drink carbonated anything because I'm on Topamax. Even when I was pregnant, I never had swollen ankles. The only thing different in my life right now is running. Even though I'm fat, my legs, especially my lower legs, have always been pretty muscular.

I didn't mention it because my the time I finished my shower, the hubs had gone from walking laps straight out of recovery to extremely nauseated, sweaty and in a lot of pain. It's expected though, the swelling from the surgery sets in and the drugs wear off. They tried Zofran, which didn't help, so they hit him with Phenergan and Dilaudid. He finally fell asleep around 3:30AM and I cautiously laid down. No sooner did the nurses clear out and I doze off, did I hear, "Babe? I have to pee." Le sigh. Thankfully the heavy painkillers were still fresh in his system and after peeing, I propped my feet up and we both slept.

The edema was much worse the next morning. I don't know if it's because I started and then prematurely stopped that run, which hurt so bad, or if it's just normal. I don't know if it's because I've gone from sedentary to working out or what it was, but the edema didn't go down until late Sunday. It hurt. I've had to keep walking because it's crucial to his recovery, but I haven't been able to run because he's a fall risk and isn't to be left alone. He feels great now, other than tenderness at the op site and in the suture line, but I still can't leave him alone until he's cleared. Just in case. We've been walking like crazy, so that's good... but he can't run. He wants to do Tough Mudder with me next year though, so hell yeah.

Tuesday, July 9, 2013

Off days?

After run number one on my Cto5K app, my ankles, shins and calves were sore. It was expected soreness, nothing unusual. My app has me warm up for 5 minutes with a brisk walk, then it has me jog and walk at intervals, followed by a cooldown walk. The idea is to increase jog times and decrease run times. This morning is my day off after my second workout. I have no soreness, which is surprising. I had a few down days after my first workout and I was so sore. The extended downtime wasn't from lack of motivation, but from rain and things going on at home. Anyway, after the first workout, I found myself unhappy that it was just my lower legs suffering. I ran through a program on my stationary bike to make my thighs feel like they'd gotten some love, they're a bigger problem than my calves. Today though, I feel no real soreness.

Am I supposed to be striving for post-workout pain? I feel like I let myself down by not being sore this morning. I struggled with anorexia in my early teens and I find I do tend to push things pretty far. So I'm sitting here pondering what to do with my off days. My abs need love and I adore pilates. I just don't have anywhere to do them. I refuse to plonk down in the living room and start doing the "seal" in front of my husband, because I wouldn't want to see my 200 pound butt rolling around and sweating, I definitely don't need him seeing that. He's on an off rotation from work so, it's not like I can wait until he goes to work to do it. He works overseas on 5 to 6 week stints.

Running is it's own community. It has it's own culture and I don't know anything about it. I have a phone app, a slightly unwilling dog, thighs that rub together and a pair of shoes. Other than that, I'm pretty clueless. I know yesterday I spent so much effort talking myself into not quitting that I literally got lost. I also learned what getting warmed up really means and that's it. I know my body will tell me a lot, but I also know that there's wisdom out there from the people that's learned the hard lessons before me. I'm just embarrassed to even ask someone because if I say "I'm going to run a 5K in a few months," I get the most bizarre looks. I'm 5'2 and I wear somewhere between a 16 and an 18 pants. There's a roadblock when you're chunky, but honestly, you have to start somewhere. I put the weight on, I guess I have to do the time getting the weight off.

Monday, July 8, 2013

I am not a runner.

You don't notice getting fat. You get married. You get a dog. You have a baby. Somewhere in there, you get fat. Granted, not all of us get fat. I did. I'm fat. This isn't a fat shaming blog. I don't think this is going to be a running blog, or a vegetarian blog. This isn't a blog about severe asthma or weight loss. I highly doubt this is going to be a Mommy blog or a Dog lover's blog, but I'm all those things. This is just my journey to get myself back.

Of all the things I am, of all the mistakes I've made, the only one that haunts me is getting fat. It stares at me every day in the mirror and peeks up at me from the tag of my pants. Parts of me jiggle that never used to, part of me sweat that shouldn't. My husband loves me for me and he encourages me to do whatever is healthy, but he never fat shames me. I'm short, I have huge boobs and I now weigh just over 200 pounds.

I've always been asthmatic. I have a crazy amount of resentment towards my parents for it. They smoked around me, and when I say smoked... I mean chain-smoked. The walls of our home literally had tar trails dripping from them. I stunk of stale smoke and I lived in the ER. I have a burial plot paid for, because rather than smoke outside, they just bought the space in my Mom's family's area of the County cemetery and kept puffing. The Doctor's didn't expect me to survive childhood.

I accepted breathing problems as just par for the course. I pushed myself to the breaking point to keep up with my really active friends in high school. I brushed off the constant trips to the ER and learned to hide my symptoms. I put up a tough-girl facade and just dealt with it. Then I moved to Savannah, Georgia after school. After about a month, my best friend commented that she hadn't seen my inhaler since we had moved down there together. It hit me. I was running. I was breathing. I. Was. Breathing. It was bliss. Long story short. I met and married my husband and after 4 years of respiratory bliss, moved back to the Asthma trap, otherwise known as the Miami Valley.

So here I am. I'm swiftly approaching my 29th birthday, I have a five year old son and my ninth wedding anniversary is coming up. Plus... I'm fat. To make matters worse, I'm a fat vegetarian. I eat well, I watch my portions and I hardly ever snack. I do, however, take a crap-ton of steroids and live a pretty sedentary lifestyle. Steroids and couch-cruising do not a skinny person make.

Everyone has an "A-ha!" moment. Something that makes them change things. Mine was strange. I took my dogs to the vet and found out my seven year old Border Collie mix is 15 pounds overweight and is getting arthritis. I can totally let myself go, but not my dogs. So I researched and downloaded a couch to 5K app on my smartphone and I just completed workout number two.

I've already learned some lessons from this. Lesson one: I am NOT a runner. Not really a lesson, I knew this. Lesson two: Neither is my fattie dog. Lesson three: It hurts more getting going than it does to just do it. This one probably requires some explanation.

When I left this evening, my ankles and shins were killing me. They were burning and throbbing. I spent the first 3/4 of a mile talking myself into NOT turning around and going home. It seriously was agony. I made the decision with the pain in my shins to not actually do the running part of the program today. I power walked the whole thing. I didn't slow down, I kept a brisk pace and then I got lost. Seriously. I don't wear my glasses running and  I spent so much time arguing with myself over my shins, that I got lost. By the time I remembered I have Nav on my phone (which I actually use all the time for driving) the workout was pretty much done and I realized that the burning in my shins was gone. My muscles felt great and I was pretty happy. Gizmo, however, not so much. She was so done.

So, I guess, my advice for myself in the future, or anyone else out there NOT wanting to do their workouts today is to just work through the burn. It will go away and you'll feel great. My first 5K is in October. I'm hoping I have the tenacity to stick through this, because I really want to.