Friday, May 20, 2011
My latest round of treatment began with cervical facet injections as the test for RF (Radiofrequency Ablation). The test was positive, meaning that there was some relief that tells the physician that the procedure will work effectively to reduce chronic pain. And although I have endured two other rounds of cervical facet injections before, this one was more difficult and worrisome. You see, this time the procedure was performed on C2 – C4 bilaterally.
I arrived at the surgery center one hour before my procedure so that paperwork is processed, vitals are taken, and I can be positioned and readied for the procedure in the outpatient surgical room. I am placed on the OR table, face down, and my skin is cleaned and prepped. Once my physician arrived, the fluoroscopy equipment is turned on and my spine comes to life on the monitor. My physician positions my neck and head in an attempt to locate the facet joints in my cervical spine.
The facet joints are real joints, responsible for motion or articulation. They can bend forward and backward. Each vertebra has two sets of facet joints; one pair faces upward, the other downward, forming a hinge-like joint at the back of the spine to connect the vertebrae together. There is synovial fluid and cartilage between each joint which acts as a cushion, assisting in all the twisting motions of the spine.
In my case, I have a C3-C4, C4-C5, C5-C6 three-level anterior and posterior fusion, which stops all motion of these joints. The movements of my neck are all produced from the joints located below and above the fusion, causing them to “wear out” at an alarming rate along with the threat produced by my osteoarthritis and degenerative disc disease. My facet joints rub against each other, bone to bone, with each movement of my head which makes driving, computer work, sitting, standing, walking, and even reading a book a painful challenge.
My skilled physician numbs the area before using a long needle to probe the space between the facet joints, taking extreme care to ensure that the spinal cord is not touched or damaged during the procedure. My doctor has difficulty getting into the joint on this day, and he hits the bone on two occasions while trying to inject into the C2 facet joints on both sides of my neck. The pain that I feel is something that I can’t describe, but I elected to do the procedure under a local anesthetic instead of light sedation or MAC anesthesia. I am having second thoughts about my decision. My physician asks me to open my mouth wide, then shut, then open again. My teeth are obstructing his view of the C2 facet joint. After a couple more attempts, the medication is finally injected into the joint, the procedure is over, and I am removed to the post op recovery room.
I am alright, although feeling very shaky. The first thing I do is thank God that I can feel my hands and toes, reassurance that all has gone well. Over the next couple of hours I notice that my pain level has decreased significantly. My constant ear, jaw, and back of the skull pains are better, but before I can get too excited over it, the pain returns and I caress my ice pack. I remind myself that this is only the test, not the treatment. RF is scheduled to occur in two weeks after a short recovery period. This will be the third time that I have had the RF procedure, but because of the difficulty obtaining access to my C2 facet joints, I am nervous.
At the end of the two week period, I report to the surgery center again and everything is repeated just like before. I opt out of the MAC anesthesia again, in favor of a local, however I begin to wonder if I am crazy. The facet joint injections take 5-10 minutes, but the RF procedure will take more than 20 minutes. Even so, this still is a very short period of time and I know that it is just better to skip the anesthesia unless absolutely necessary. After all, a radiofrequency nerve ablation is not as nasty as a colonoscopy!
After my skin is numbed, the RF needle or electrode is inserted. The electrode carries pulsed radiofrequency electric energy that will stun the nerves. The electrode is much larger than a regular needle and it does smart. The correct location is quickly found this time and my physician uses the pulses to twitch muscles and stimulate tingling sensations to assure that the needle is properly and precisely positioned next to the offending spinal nerve. Once confirmed, the nerve is “stunned” for 2 to 4 minutes before removing the electrode and proceeding to the next facet joint. Before long, the procedure is again over and I am whisked to recovery. I feel disoriented, dizzy, and more than a little unsure of myself as I am rolled onto my back to a new gurney. The room spins; vertigo is not fun, but slowly the spinning stops and I begin to feel more like myself. These vertiginous sensations are normal when RF is preformed on the cervical spine.
Once I leave the surgery center with my ice pack, I am excited that the procedure is over and I am anticipating the rewards; decreased pain! The RF procedure went smoothly without complications or difficulties, unlike the facet joint injection. I am grateful that the ordeal is behind me and I know that I can just ride out the next few days of increased discomfort. To my surprise, the next few days pass quickly without much pain, just muscle soreness which is easily tolerated. I notice that the constant, horrible head pain at the very base of my skull is gone. I am overjoyed and happy about the instant, positive outcome. This is the first time that I find myself without this chronic pain from my never forgotten cervical fusions.
But within a couple of days, the pain begins to creep back as I slowly try to increase my activities. Driving or riding in the car becomes too painful. I can’t use my laptop or cook a meal. Sitting in a chair increases my pain level. Nothing has really changed. I believe the procedure has failed. So I restart my usual existence; 40 to 45 minutes of activity followed by 15 minutes of rest with ice packs applied to my neck. I limit my daily activities to reduce the horrific head pain and blinding headache. There are no tears. I do not cry.
I get angry and I allow my anger to rule every aspect of my life. I bark at my husband. I yell at the man who cuts our lawn. I sneer at the woman who is overlooking the coupons I have given her while I roll my eyes at my husband who begins to bag our groceries in paper bags. I hate paper bags. I walk away towards the car alone and I want to get in and drive away, forgetting my kind husband who is pushing the cart towards me. And then my anger begins to boil over and I scream at God. He has forgotten me. He hasn’t answered my one prayer that would be simple for the God of all creation. Heal me! Make this unending pain go away! Let this procedure work! I am tired of daily pain, and I am tired of living a limited existence. I want to look normal and wear normal clothes and shoes. I want to work and love life, but all I feel is anger. I forget that I spend part of my days encouraging others who I correspond with through social networks; telling them not to give up, showing them the love and grace of God in scriptures, and showing them the signs of God’s everlasting love and care that is all around us. Now all I can see is darkness, a blackness that swallows me whole. I have given up hope.
My husband tries to remind me of the Father’s sacrificial act; He gave up His only son so that my sins could be washed clean, but I sputter and grind my teeth as I say, “He doesn’t love me! He lets me suffer and it will never, ever end until I die! God doesn’t listen to me anymore, He is just sick of me and I have given up because God gave up on me!” My husband keeps trying. The more he tries to reach me, the angrier I become. I think that my husband doesn’t understand because he doesn’t cry out in pain like I do, and I don’t want him to find out what it is really like. No human deserves to live like this year after year. I skip church. It’s much too emotionally painful to go there. I can’t see God’s face right now.
Then I receive an email message from a new friend at a social network for those with invisible disease, My Invisible Disabilities Community. http://www.invisibledisabilitiescommunity.org/ She writes that God will use this to teach me something, reminding me that there is something to learn from all of this. She tells me that the enemy, Satan, does not waste time on those who are mediocre with God, they are easy prey. He tries to destroy the ones with the strongest relationships with the Lord because they are a threat to him. The enemy plants seeds of doubt in our thoughts when we have been knocked down. She encourages me not to let those little seeds take root and to stomp them out by speaking God’s Words, God’s promises. She tells me to use God’s gift wisely, and be patient because God will show His goodness. And she writes four words that make all the difference; “God has your back.”
I doubted that God was still listening to my prayers and He used a friend over the internet to talk directly to me. I know how much God loves me, but I couldn’t see anything through the disappointment and anger from the failed procedure. God restored my hope, my dreams, and my strength through a virtual friend. My anger dissipated. The shadows of darkness are gone as I speak His Holy Scriptures, and peace flows over my body, changing my color from red to yellow. I skip blue because the Lord forgave my weaknesses and tormented doubt with a warm embrace. I have returned home. I can wait. God’s love is eternal and I am priceless to him. He handles me with extreme care even when I deserved to be dropped. But instead, He marks me fragile for now, but just until I regain my strength.
My pain decreases along with my anger. The spasms in my muscles soften, then stop. I believe that my anger created more physical pain in my body than I should have ever endured. Maybe the effect of the RF procedure is just going to take a little longer this time and I was too impatient to wait until the nerve irritation from the “stun gun” stopped. I am taking my medication as prescribed as I wait for my supernatural healing from God, and I know that God has a higher purpose for my life than living a meager existence of chronic pain. I survived radiofrequency nerve ablation without any complications. I can survive the pain until it stops completely because God has my back.