Most of my readers are doubtless aware of my ongoing medical issues, including the removal of a kidney back in September, and your generous response to my appeal for funds to help pay for previous expenses plus what lies ahead. I'm very grateful to you all for your ongoing support.
I'm in the middle of a series of follow-up consultations on what the various tests have discovered. Briefly, my lower spine has deteriorated rather more than anticipated, partly due to the injury I suffered in 2004 and its treatment at that time, and partly due to my advancing age. There's no doubt that further surgery will be needed. One "side" of the medical fraternity thinks that it will be best to extend my existing spinal fusion to take in two adjacent vertebrae. The other "side" says that won't be enough, and instead wants to remove the existing fusion altogether and encase my lower (lumbar) spine in a sort of cage or mesh, supporting the whole thing in all directions. Both sides agree that surgery is necessary, but not what surgery, or how to go about it. Me, I'm the "piggy-in-the-middle", a playing-ground for neurosurgeons who are having a fine old time arguing with each other about what they (rather than I!) want to do next. It's . . . frustrating - and while all the arguing is going on, I'm paying for their discussions. That's even more frustrating!
There are trade-offs to be considered as well. It seems that whatever surgical solution is adopted, my lumbar vertebrae are likely to end up pretty solidly fixed together. That's going to make bending and twisting a lot harder than it already is (even though pain levels should improve). The mesh solution will be more restrictive than extending the fusion, but will offer greater long-term support. Which to choose, and why? I'm a layman. I can't answer that - but the doctors won't give me a single, straightforward answer. They simply tell me the alternatives, then say "It's up to you which one you want to choose." Since I'm not an expert, and I can't predict the future or its challenges, how am I supposed to know which to choose? I may as well glue some gears on my spine and call it steampunk!
So, here's what's going to happen over the next six months to a year.
- I'm going to work with a pain management specialist, a neurosurgeon (possibly more than one) and a neurologist, to try to pin down the best approach to solving my spinal problems and getting into the best shape I can for whatever lies ahead. In the short term, I may get a Spinal Cord Stimulation unit implanted in my back; that's currently (you should pardon the expression) under consideration.
- I'm going to try to get a lot fitter and lose a lot of weight. I'm going to find that very difficult, because my pain levels increase drastically when I exercise (even walking a short distance); hence the SCS unit and/or increased doses of analgesics (to be determined). It's a high priority. I'll probably follow Dr. Jason Fung's fasting protocol (adjusted to suit my needs) for several days each week, in an effort to speed up the weight loss, but that will have to be carefully monitored to see whether or not my medication doses need to be amended to compensate. If it's not one thing, it's another . . .
- I'll continue physical therapy and other exercises, so as to be in the best possible condition (which isn't saying much!) for whatever the surgeons may determine is the way forward.
Ongoing care at this level will continue to be a drain on the funds I've saved up (and you've donated) for hospital treatment, but it's unavoidable right now. As I recover from the loss of a kidney, I find I'm able to write more easily, so I'll try to get a new book (perhaps a new series?) out during 2026. God willing, that will help to fund more medical misadventures.
Thank you all for your prayers, support and understanding. I'll continue to "fight the good fight" as long and as hard as I can.
Peter
It sounds like quite an ordeal. I'm sorry for your situation but admire the lack of frustration with it. What cannot be remedied must be endured. I hope you are able to find an answer to which solution(s) to choose. God Bless You Sir. You have my positive thoughts for that.
ReplyDeletekeep a careful eye on what meds you take now that you down to one kidney. I am in the same boat. yeah, even walking around the damn supermarket kicks my ass these days. and only
ReplyDelete25 years ago I could still do a 2 mile run in less than 18 minutes. it was OTC meds that killed my one kidney by the way. yeah, they help a lot with the pain but the price was not worth it.
try to find some sort of middle ground with real pain meds with your doctor if you can.
these days, when it gets bad, I try yo lay down if I can and it "seems" to help.
at 70, everything is harder and takes longer no matter what. it time, you see it is the little battles that you can do or win. and getting cut on doesn't seem like a good idea to me anymore. but you may have better doctors than I have had in the past.
Prayers for you. I have had a spinal stimulator since 2010 and is one of the few surgeries I have had that I am 100% grateful for and would do again if given the choice. I have known some who either did not like theirs or didn't get much relief, but I am happy and grateful that I have one. Note: While it has not done away with the pain and has not removed the need for pain meds, it has made the chronic pain manageable (even livable) and decreased the amount of pain meds thereby decreasing the side effects of those meds. Additionally, the new batteries, unlike the one I got in 2010 have the ability to be MRI friendly. I had the old one replaced last year and upgraded to the MRI friendly version.
ReplyDeleteI Highly recommend, though as with most things in life, your experience may differ, Prayers for Healing and relief from pain.
MSG Grumpy
Try asking the doctors what they'd do if they were in your situation. They often won't give their opinion due to malpractice concerns. However, sometimes if it's a "hypothetical" they will be more open. You might also ask your nurse which they'd choose if it were them. They see the results and know if one is better, but can't chime in (not a doctor). Ask them which they'd recommend to their dad if he were in your situation.
ReplyDelete-Texas Mike
Best wishes and God Speed your healing, Peter. I know from personal experience how frustrating it can be to be the medical guinea pig. Fortunately in my case things worked out relatively well (I'm still upright and breathing in any event.) Hope everything works out for you. I'm looking forward to more books at some point. ;-)
ReplyDeleteIf I may, the whole concept of eat less and move more is far too oversimplified. There's an enormous thing they're ignoring: you have an intricate system, what we engineers call a feedback and control system, that changes our metabolism. Calories In vs Calories Out (CICO - and pronounce that "psycho") ignores that entirely. The amount of calories you burn in any activity is variable, and amount you need to eat is also variable.
ReplyDeleteDr. Fung is one who is right more often than most. There are many now. Dr. Eric Westman is another. Gary Taubes isn't a doctor but is science writer that's worth reading. This one is an excerpt from a larger book of his that I read maybe 20 years ago.
Saying what to do to get around your body's control systems is more like what to do with your spine than saying "eat less and move more". It's complicated and two different doctors ("experts") can and will have different approaches. If you have diabetes, or other evidence your metabolism has been screwed up (or you're genetically challenged), I'd say to start looking into going Keto and combining that with fasting. Which is going to sound a lot like what Dr. Fung recommends. I've been keto since 2015 and low carb 20 years before that.
To me, it goes without saying that you can email me for more, and it's this screen name at Gmail.
Medically supervised water fasting is another, more radical possibility, which in your situation I would definitely consider. One question to investigate would be before or after any surgical procedure. I would think that given the potential for healing as well as weight loss, before might be better.
ReplyDeleteI went to school with the director of this center; he knew even then that this is what he wanted to do and is very focused and very knowledgeable. I haven't spoken with him since school, though.
The link to his facility: https://www.healthpromoting.com/
The link to his work in general:
https://www.truenorthhealthfoundation.org/
I can recommend the SCS based on the results achieved when my son received one to address pain in his lower leg due to a helicopter crash in Afghanistan. Once the stimulator was in place and tuned his pain went from a near constant 6 to 0-1. Prior to that he was on high doses of Pregabalin. His Pregabalin doses have been reduced in half and even when he happens to skip a dose (a frequent occurrence due to a TBI) he doesn't have an increase in pain.
ReplyDeleteSometime in the spring I'll be getting my spinal cord stimulator removed, the wires will stay but the unit will get removed.
ReplyDeleteStay away from the spinal cord stimulation crap.
ReplyDeleteTrust me, I know about lower back pain. I hurt my lower back in 1980 working on the dredges after Mt. St. Helens blew. I spent 5 years in pain. Went through 12 doctors and every test known to man at the time. Finally had a L5-S-1 fusion done in 85. They took a chuck of bone from my pelvis, broke it into pieces and stacked it around the L5-S1 vertebra. It took 2 years to heal and I was too young and active so it didn't heal right,.
I have spent the last 45years, as a mechanic, dealing with daily pain. Only to find out 2 years ago that the disc has been blown out there this whole time. I tried the steroid injection at $900 out of pocket and it worked great. For about 8 months. Now it is worse than ever. DO NOT, let them talk you into that stimulator!
I would go with whatever winds up giving you the most support so things don't move around and irritate the nerves around the area.
I literally feel your pain and hope the best for you.
Phil, AKA Bustednuckles
Peter, I know nothing about medical questions, so I shall not opine thereon. What I will suggest is that you take the funds that have accumulated in anticipation of surgery that has now been delayed and place them in some kind of interest-bearing or dividend-paying investment. Pick something safe. I like high rated municipal bonds myself...low yield, yes, but tax-free, or for something really safe, the humble CD. Let that money work rather than sitting idle; it sounds like you are facing a situation where every dollar counts. Of course, bear in mind that I know about as much about economics as I know about medicine....
ReplyDeleteI have had nerve ablation and a spinal cord stimulation unite. Neither worked. The two surgeons I have seen say I need to have 6 vertebrae fused in mu lower back. When I look at the peer reviewed studies (for what they are worth) https://pmc.ncbi.nlm.nih.gov/articles/PMC5685966/ it actually looks like a crap shoot if there will be any improvement or not. I am kicking the surgery can down the road as far as I possibly can. What has given me relief is losing weight (60 pounds so far) using a process similar to what Sig suggested above and a physical therapy technique called dry needling. Not pleasant by any means but it has lowered my pain levels so that I can be more active. The drawback is every ten days or so I go and get the dickens shocked out of my lower back. It is worth it. I wish you the very best. Something else that helps is staying positive and counting your blessings. EdC
ReplyDelete"I'm going to try to get a lot fitter and lose a lot of weight. I'm going to find that very difficult, because my pain levels increase drastically when I exercise (even walking a short distance)": Can you swim, or do water exercises?
ReplyDeleteOne more thing: I think, based on what I've seen of Dr. Goldhamer's work, that the loss of lean body mass with a supervised water fast may be less than what is typically seen with the the GLP-1 drugs. Loss of muscle tissue--itself a significant health risk--is a common concomitant of any rapid weight loss program. It can often be offset, but with appropriate nutrition (which can be difficult to do on the GLP-1 meds) as well as strength training at an intensity that you would probably not be able to undertake for some time after your procedure.
ReplyDeleteI pray for an excellent outcome for you. Pure self interest on my part, of course. I want you to keep writing so I can keep reading your work!
"Dr." Alan Goldhamer, the extended water fasting guy, has a lot of good to say about medically supervised fasting. I believe him when he speaks of its virtues.
ReplyDeleteHowever, he's a pure nutcase, like all vegans, when it comes to what you should eat when you are not fasting. And he doesn't decouple fasting from his vegetarian nonsense.
Vegetarianism(with B12 supplementation) is a sustainable diet that's less damaging than the Standard American Diet (SAD). But far more difficult than a pure carnivore diet, and somewhat more difficult than a hypercarnivore diet.
I second the recommendation for Fung, Westman, and Taubes. I would also add Dr. Boz, Dr. Berry, and Dr. Baker into the mix.
TLDR; : Do the water Fast. Do the sardine fast. Eat meat. Eat fat. Skip carbs.
Get the shots, radically lose weight, your pain will be quite manageable if not gone - Dallas anesthesia doc
ReplyDelete-Randale6-
ReplyDeleteI know you have a thing against medical tourism Mr. Grant but perhaps it's time to make use of it to get a second (and unshielded) opinion. You don't even need to hop onto a plane, find a well reputed foreign neurosurgeon (or practice group) and email them asking if they can take a look at your medical records, test results, and so forth and give you an opinion. Given that this would be an inherently foreign practitioner they are less likely to give you an opinion deliberately circumscribed to avoid malpractice suits.