Tuesday, 4 August 2015

And Now for Something Completely Different....

 Having planned a full summer of activity at the beginning of the year I had clearly set myself up for a fall of a different kind.

 The spring had seen me get back underground again with a through trip from Bath Swallet to Rods Pot in Burrington Combe, my running was going well as I was going both further and faster and with the promise of good weather ahead I’d purchased my annual fishing rod licence and looked forward to peaceful days in the sun at Shakells lake relaxing and hopefully enjoying some good fishing.

But that was soon to change an old nemeses of mine was about to remind me that me was still there! Some of you may remember that at the back end of March we experienced a couple of periods of strong winds here in the UK. During one of these a small tree was blown over in our garden. Luckily the trunk had not snapped but it had fallen across the path to the garden shed. It was mid-week so I decided that I should move it out of the way to allow access until the weekend when I would put right Mother Nature’s mischievous actions. Big mistake! I gave the tree a shove to get it off the path and felt my back go. I had previously suffered with a prolapsed disc just prior to my de-bulking operation in 2012 and had a weakness there ever since.

As the days that followed went by it gradually got worse. At the weekend I was so bad that I managed to get an out of hour’s appointment on a Sunday to see a GP. She prescribed me painkillers and anti inflammatory pills to try and make things easier. I just about managed to go to work the following day but by the Tuesday the pain was so bad I could barely make it out of bed to the bath room. This time the GP came to me. He upped the pain killers to include 10 microgram per hour Buprenorphine patches as well as Gabapentin tablets.

 The following day things were even worse. I actually couldn’t get out of bed at all. A call to the 111 National health hotline saw an ambulance crew despatched to attend. When they arrive they were initially advising that it was a bad back and that there was not a lot they could do. At this point I was led in bed and the pain was manageable. They advised that they would get some Entonox in that would help with the pain and they would try and get me to the toilet but I should again take it up with my GP. With a few hefty pulls on the gas and with the effects kicking in I tried to stand at the side of the bed. The pain was worse than anything I have ever experienced. Even with all I have been through with the Pseudo. I managed to get to the end of the bed sucking on the gas so fast the valve couldn’t cope. Then the ambulance crew advised that the bottle was empty. They managed to get me back on to the bed and advised that they could see that I was in so much pain that they would have to take me in. They gave me some morphine and managed to get me into a wheelchair where I was carried down the stairs and into the Ambulance.

At South mead Hospitals A & E I was given more morphine. Once again led down on the trolley I was much more comfortable. I was given an MRI scan which showed a small prolapsed L5 S1 disc. The prolapsed disc was pressing on the nerves which was causing all of the pain and now the top of my right leg and half of my right foot was completely numb.

After a wait a doctor came in and advised that they would not be operating but could help.Another doctor from the neurosurgery team arrived and manipulated my back managed to get me stood up and walking and sent me home with some exercises.

And so commenced a miserable existence, I was only comfortable when I was either stood up or led down, I couldn’t sit at all. I would sleep all night OK, would get up and take a heap of tablets and pain killers, just about survive the drive to work where I would stand at my desk that had been raised up all day long. It got so bad that on the worse days I would go out to my car and lie on the back seat for an hour to ease the pain. I even did two meetings led on the floor! The journey home was excruciating, by three quarters of the way home I was in agony. One evening (Tracey’s birthday) I got in through the front door Tracey took one look at me and got my Dad to whisk me back out to A & E for the third time. The nurses on the admissions desk took one look at me and took me through there and then, another shot of morphine and the rest of Tracey’s birthday led on a trolley in A & E. By now the Buprenorphine patches had been increased to 35 micrograms per hour but just weren’t touching it. On this visit the MRI was not re done which probably would have changed the outcome of the evening’s events.

The following day the spinal assessment team called me, they had been trying to get me in front of the on-call neurosurgery team at Southmead but they had advised that because A & E had discharged me they didn’t consider me an urgent enough case to be seen that day.

I then saw the spinal assessment team again who arranged for a spinal root nerve block injection to be done. I was advised that there was a six week waiting list for the procedure. I simply couldn’t wait that long and managed to get the number for the admin desk to get onto the short notice cancellation list. I rang them the following day and my name was added.

I left it a few days and rang them again.

 “But your name has already been added Mr. Mason”
“Yep, I’m aware of that but was wondering if anything had come up?”
“No I’m afraid not”
“So is there such a thing as a same day cancellation list?”
“Well you would have to arrange to get here and someone to take you home as you won’t be able to drive”
“ I work a few minutes down the road so getting there is not an issue, I’m sure I can arrange a lift home at short notice”
“ OK hang on a minute let me take a look” rather abruptly....”Oh...hang on a minute...why wasn’t I told about this...can you do 9:30 tomorrow morning?”
“Yep, book me in. I’ll be there!”
It goes to show you just need to keep pushing!

So I had the procedure done the following morning. Basically the surgeon gives you a local anaesthetic and then injects a steroid and more anaesthetic into the area affected in the spine using an X ray machine to ensure that he is in the right area.
It didn’t work, in fact for me it made things worse.

I finally saw a consultant neurosurgeon just over a week later who advised I needed surgery, a L5 S1 micro discectomy. I agreed. A follow up MRI scan had revealed that the prolapsed disc had got considerably worse and was considered acute. Had this been done on my last visit to A & E I would probably been admitted.

Finally the procedure was carried out on the 24th July some four months after all the pain started. I was lucky, I was pushed through this stage quickly and the procedure was done at a private hospital. It was a short operation under general anaesthetic taking around one and a half hours in total and an overnight stay.
Three pieces of disc were removed, one of which had a piece of bone in it which was embedded in the nerve. It had caused superficial damage to the nerve itself and because the nerve had been stretched for so long there was some slack in it. It should however heal in the coming weeks and months.

Just over a week down the line and I’m feeling much better. Still the odd pain but it hasn’t been long since the op. I have plenty of restrictions in terms of lifting and exercise at present but I’m walking a couple of miles or so each day. I have follow up appointments with the consultant and Physiotherapist planned.
As far as Psuedomyxoma is concerned I have three things of interest!

August is raising awareness month for Psuedomyxoma Peritonei (PMP) with the Pseudomyxoma Survivor team  so please share this with as many people as possible. Two to three people per million per annum are diagnosed with this rare and devastating cancer. Because it’s so rare the patient often finds themselves being the expert when talking to GP’s as they have simply never heard of it. Exactly this happened to me on several occasions recently when talking to the doctors regarding my back in the story above. Some of whom I know then went away and looked it up and even read my blog! That’s why it’s important that we keep shouting about it as what chance does an un-diagnosed patient have when presenting to their GP with symptoms?

 At my work place we recently did a dress down day in aid of Basingstoke Hospitals Pseudomyxoma and colorectal cancer trust fund. On the last Friday of each month my colleagues all go to work in casual clothing and make a donation to a charity. Nisbets plc will then match the donation. We raised a fantastic £856 for the hospital! A great result that again helps raise awareness of this rare disease.

The final bit of news is that my annual CT scan date has come through in the post this week. So on September 11th I’ll be heading up to Basingstoke to spin the PMP wheel of fortune once again....

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