Thursday, July 7, 2011

Follow up and traffic fun

Todays adventures - ooh my ooh my ! It started with an appt with my Pain mngmt dr just for a normal fup nothing major - usually this occurs 1x a month per FDA guidelines on opioid prescribing rules. Not only do I end up stopping multiple times just to stand up for a couple minutes (about an hours drive) but the rest of the time I am trying to get comfortable bc of the fluid/swelling that has continued to hang around at my LP/laminotomy incision site - this fluid which fluctuates from very minor to more noticeable and more irritating when any type of pressure/touch is put on the area does increase and decrease in amount of fluid throughout the day sometimes correlating with a high pressure headache but most often is just there with no other symptoms other than it definitely aggravates the radiculopathic pain in low back/buttocks/L leg. I dont know if it is abnormal really or not since the fluid collection has been there since post-op and my Nrsgn is aware of it from even my 1st surgery fup 2 weeks post-op. I figure I see her in 2 weeks and since I dont have many symptoms headache related or atleast they are very fleating and the radicular pain is while very uncomfortable I dont think it is caused by the fluid colelction alone. I suspect the fluid will in time (hopefully! go down on its own - I had something similar with my 1st shunt placement also an LP shunt but that time it was more a golf ball size fluid collection that only grew and this is more a silly putty sized container and jello in consistency vs hard. So back to the appt - my Pain mgmnt dr and I agreed to try and switch around a coiple of my meds 1 at a time - right now if we can get insurance approvals we are going to switch from a schedule II opioid immediate release to a 1x 7 day release schedule III (less abuse potential thus the different rating) opioid if I can tolerate the patch system as I frequently react to most tapes/adhesives/patches (we previously tried both brand and generic fentanyl patch as well as various more localized patches such as lidoderm and flector). This med has less GI affects bc it is a patch system apparently and more targeted to certain receptors. I will also cont on a long acting 2x  daily opioid for now and this is less likely to change. We also are adding a topical gel lidocaine for the neuropathic pain and increased lyrica dose to calm down the nerve signals as this is a crucial time in nerve injury/repair healing to get on top of the nerve signals and make sure they do not become over-sensitive and overly active even after the injury has healed/when it heals in time. Later on we may add/switch out other meds. We also talked about the GI/Urology appts related to the nerve injury healing and whether or not I should see someone in private practice as this could be done sooner or wait but atleast for now i'll talk to my neurosurgoen first on the 21st as it seems more logical to keep all surgery related care at her hospital for communications purposes.
These arent very well but can see a bit of hte puffiness around the incision in the last 1-2

On the way home from this appt today I was about 20mins outside of milw on the interstate and about 5 miles from my exit to hwy 60 and I hear a loud noise which my heart skipped a beat and I immediately thought something hit my window. 1/2  a minute or more later it became quite apparent it wasnt my window  but instead my front passenger side tire was flat and I needed to pull off immediately. On this particular Interstate that was nothing short of scary sitting in the off-lane more in the gravel/grass praying for no idiots not paying attention and not on the road to not come by as I called my Dad who was close to an hour and a 1/2 away and then called my brother who was about 20mins away. Needless to say 45mins later and a few breathtaking - hair raising moments watching traffic as my brother changed my tire I was back on the road! YIKES! Thank you to my brother though im eternally grateful!!!

Tomorrow we are headed to Iola which is about 2 hour or 2 1/2 hours or so from where I live for a giant car show/swap meet which is something we do every year and always a nice time w/parents, sister and her husband along. and my mom, sister and split off for the better part of the day to do our own thing.

Take care - god bless,


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