Neck and Back Update

Exactly a week ago today I had my second nerve root block in my cervical spine. You may remember that before Christmas I had my first nerve root block, and at the time I was very concerned that the doctor had injected the medication in the wrong spot. It turned out, thankfully, that I was wrong, and the doctor did indeed block the right nerve, but I was so worried he had gotten it wrong that I didn't even think about whether or not the procedure actually worked as intended until two days later. When I reported in with the surgeon about the results all I could tell him was that for perhaps five days after the procedure I felt about 50% less pain, and then maybe 20% less pain for a few days after that. The surgeon told me that, based on my report, if he went ahead with the operation there was a good chance I would have 50% less pain as a result.

I told him I wanted to have another go at the nerve root block because I wasn't sure of the results, he agreed, and that is how I ended up getting another injection.

When I showed up at the pain management office last Monday, I told the doctor that I was there to verify the results of the last nerve root block because there is a possibility I might have surgery on my neck again, and I was looking for some reassurance. The doctor told me since that was the case, he would perform the block a little differently. He said instead of coming in between my shoulder blades and running a catheter up to the site and administering only steroids, (an anti-inflammatory,) he would come in through the side of my neck, and he would add an anesthesia along with the anti-inflammatory. He said doing that way would offer him more precision in getting the meds right on the nerve root that is giving me trouble, and the anesthesia would give instant results as far as my pain level was concerned.

Before we went into the operating room I was again offered an I.V. of sedatives. After the first go around I swore if I ever did this again I would take the I.V., but after learning the doctor was going to do the procedure without the use of a catheter I decided I would be OK without any sedation. So, off we went to do it again.

The second procedure wasn't as bad as the first. They had me lay on my left side, and strapped me to the bed. They told me to bend my knees a little, and to keep my right arm down along my side. After I was given a local anesthesia I never really felt much pain at all. The first time I had done this I momentarily felt a great deal of pain radiating from my neck down through my right arm when the catheter reached the nerve root. This time, however, all I felt was the slight pain you typically feel whenever a needle breaches the skin, and before I knew it the procedure was over and I was being helped off the bed.

The doctor told me that I should be feeling relief from my pain inside five minutes. We waited for a moment, and then he asked me how I felt. Believe it or not it can actually be kind of hard for me to tell whether or not I feel any difference in my level of pain. For one thing, my condition comes and goes; one day I may have a great deal of pain, and the next day not so much. That morning I was having pain, but while I sat in the waiting room my pain had subsided, so just before the procedure I wasn't in all that much pain.

Another problem is that pain is relative. My pain just before the procedure might be more than a normal person is used to, but since I regularly have a lot of pain, what I had that morning wasn't all that bad. In other words, after living with a lot of pain for a long while it gets a little tricky trying to discern between somewhat normal pain, and pain that indicates a serious problem.

My medications also are a factor. I take some very strong pain meds, and I have to take these meds regularly whether I have any significant pain or not. The reason for that of course is because I am taking narcotics, and your body doesn't like it much when you abruptly stop taking narcotics after you have been taking as much as I have for as long as I have. My first dose of the day is typically an hour before I get out of bed. That way I have a fresh dose of medication already in my bloodstream when I get up, and that makes the beginning of my day a lot smoother than if I were to take it just as I get out of bed. That morning I took my meds at around 6AM, so by 8:30 my pain was fairly well masked. The word "painkiller" is a misnomer because the medication never really eliminates, or "kills" the pain, it just changes the way the brain perceives pain. After the medication has worked it's magic I don't feel much pain, but I do feel what I can only describe as the shadow of the pain. In other words, I still feel something, but it just isn't all that painful.

Anyway, after thinking about it for a moment I was able to tell the doctor that my pain level did seem to drop, and in fact I felt like it had dropped significantly. It remained that way for maybe two hours or so. Since then I have enjoyed much less pain than what I have become accustomed to, so I guess it is time for the $64,000.00 question.

Do I want another surgery?

A Bit of a Nerve Root Block Update

This morning I had my second nerve root block procedure, only this time it was a little different

Last time the doctor ran a catheter from between my shoulder blade up to the C3-C4 area of my cervical spine where they then introduce some anti-inflammatory steroids directly on the nerve root. The idea was to reduce the swelling of the nerve that was causing my pain, and therefore positively identify the spot for a possible surgery in the future.

Because I was looking to verify the results of the last nerve root block, the doctor told me that this time around he was going to do a slightly different method that would be a little more precise, and that would give me immediate results. This time he injected the medications going in directly through the side of my neck, and along with the anti-inflammatory medicine he included an anesthesia that would literally numb the nerve thereby giving me immediate, if only temporary relief from the pain.

After the procedure I was wheeled into recovery, given a juice box of apple juice, and waited for the doctor to come check up on me. When he arrived he asked me how I felt, and I was happy to report that I did indeed feel less pain! It wasn't 100%, but it sure was damn close. He told me that the effects of the anesthesia would last about an hour, and then the anti-inflammatory meds would kick in anywhere from today until a few days later. At least we know for sure that the spot that is giving me so much grief is at C3-C4, and should I elect to go under the knife I have a good chance of finding permanent relief.

Now, you would think such a decision would be a no-brainer, but then again I bet you have never had a anterior cervical discectomy with fusion before, either. Let me tell you from first hand experience that is not a surgery you want to take lightly. It was incredibly painful, and the next three days I spent in the hospital were brutal. I couldn't swallow, eat, or talk, and I was terrified that I would drown in my own mucus should I fall asleep. I have a condition known as dysphagia, which is, simply put, a difficulty with swallowing. What I didn't know going into my last surgery was that this trouble, at least in my case, is brought on by an extra large piece of cartilage in my throat. We all have this particular piece of anatomy, but in my case it is abnormally large, so when they intubated me they ran into this piece of cartilage over, and aver again. It caused some swelling and irritation in my esophagus that prevented me from swallowing just about anything, including liquids. I tried to drink some water when I woke up from the anesthesia and the water literally bounced off the back of my throat and went up my nose.

Hopefully that won't happen again this time around because the doctor's will be aware of the problem, but as I said before, it is a very painful surgery, and I will need to overcome that fear of pain before I can commit to gong through with it.

Another difference between this surgery and the last is that last time I had the benefit of my wife staying with me in my hospital room 24 hours a day. At the time she worked at the hospital in the oncology wing admitting patients, so they bent the rules for her so she could sleep in the room with me. Should I go ahead with the surgery I am afraid having there with me won't be possible. I have hinted here on Athenamama before that my marriage sort of hit the skids a few months back, and while my former wife and I are amicable toward one another, I believe it would be asking a lot of her to stay with me like she did before.

The first time I had surgery I don't think I fully understood how had the recovery was going to be. I was pretty nonchalant about the whole affair right up to when they put me under, but when I woke up some three hours later I had a whole new perspective concerning neck surgery. I had initially told my wife she wouldn't have to stay with me in the hospital, but that first night after she fell asleep on the portable bed they provided for her I was very grateful she did. I honestly don't know what I will do this time around without someone there with me 24 hours a day. But, I guess that is what nurses are for.

In any case, we'll see how much relief this injection brings, and for how long it brings it over the next few days. Thanks again for all your kind words of support. It really does mean a bunch to me.

Back For More

Tomorrow morning at 8:30 I head on back to the Pain Management Specialist for another shot at the nerve root block procedure.

The reason for the second try is because I wasn't real sure of the results the first time around. I thought I felt some relief, but I wasn't absolutely sure, so after speaking with the neurosurgeon that might ultimately be the guy operating on me, I decided to have another go at it.

It isn't a very pleasant procedure, but I rather be sure of the results before making such an important decision regarding my health. Should I find significant relief from the nerve root block there is a very good chance I would equally, and permanently, benefit from surgery. However, if there isn't any real relief, then I face being on narcotics for the rest of my life.

I have pretty much exhausted all of my options when it comes to the problems with my cervical vertebrae, and my doctor and I agree that this nerve root block and possible surgery are my last hope in the quest of ridding myself of pain. I have tried physical therapy, the use of aTranscutaneous Electrical Nerve Stimulator, several types of medication, different holistic approaches, (including acupuncture,) and was once even offered to have a morphine pump installed inside my body that would keep a steady flow of medication to my spinal cord. I ultimately turned that solution down because no matter how much pain I might have, I don't think I have it that bad often enough to warrant such drastic measures.

Anyway, I am just rambling on... over the next week or so I will be keeping close tabs on how much pain I am in, and for how long. Then I believe I will have enough data to decide what I want to do next.

As for tomorrow, after the procedure, I will be engaging in one of my favorite activities...

Yup, hanging with my crew, watching movies all day long.

In other health news,

Thalia is doing much better. Today she sneezed only once, and has been eating regularly. She has also been taking her meds like a good girl, and has been getting lots of rest.

Thalia and I would both like to thank everyone for their kind comments wishing her well. It really means a lot to both of us.

The Surgeon Calls

Earlier today I got a call from my prospective surgeon's office following up on the nerve root block procedure I suffered through endured just before Christmas. It went as I expected; the doctor wanted to know how much, if any, relief the procedure brought me, and I responded as best I could. It's difficult for me to judge such things because my perspective of my own pain level is skewed by modern pharmacology, but I told them that I think I felt perhaps 50% better after the procedure for about five days, and then maybe 20% better over the next few days after that, but then I was back at the same old level of pain as usual.

The office relayed the information to the surgeon, who in turn told them to tell me that the results mean there is a chance with surgery I could feel 50% better, but the decision to operate is of course up to me. I told the person who called, who's name is Jackie, by the way... a good omen there if I ever saw one, I told Jackie that I was hoping the surgeon would recommend another nerve root block. I told her that I wasn't real sure about how I felt afterwards because I had been so focused on the possibility that they had injected me at the wrong spot in my spine, and that I would have a better feel for my pain level if we were to do it again.

Jackie relayed that to the surgeon, and he thankfully agreed. So, because the first nerve root block was SO much fun, I have elected to do it again!

Go me.

Christmas, and Before

W ell, as I am sure all of you are aware, and other Christmas has come and gone. Despite some of the troubles I have been subjected to in the last few months of this year, (of which I vaguely hinted in my last post,) my Christmas turned out to be quite good this year, but then again, Christmas is good for me every year. I still live in the town where I grew up since 1966, and my folks are still with us, and are in great health. My sister, who also lives nearby, and I went over to the house my parents have lived in since 1967, and celebrated Christmas as we have for the last forty years. The only missing aspect of our traditional Christmas at home was my brother, but he lives in Washington state with his two daughters, so he decided to spend the holidays at home. Still, we had a great time, and it also served to remind me how incredibly lucky I am to have the family I do.

As I also mentioned in my last post, I did end up having the nerve root block procedure I wrote about back in October. Essentially I talked a little about my neck troubles, (or more specifically, my cervical spine troubles,) and how the UCLA doc suggested I have a nerve root block at the C3-C4 level of my spine.

Let's take a look inside of me, shall we? (I know we really don't need to, but I do so enjoy loking at pictures.)

Towards the center of the picture above you can see where my problem is. Remember this picture and try to visualize what I endured as I try my best to describe it.

The actual procedure was sort of a strange experience because when I left the office of the doctor who performed it, (it's an out patient procedure,) I was convinced he blocked the wrong nerve. Before he performed the nerve root block he spoke with me about my condition and my pain level. We talked about my surgery and at what level in my cervical spine that it dealt with, so as we walked into the operating room I was sure he knew what he was doing.

I was offered an IV with a sedative no less than three times by his staff, but I refused it each time. I equated the procedure with the cervical epidurals I had a few years ago. (Both are essentially the same thing; a needle is introduced into the area surrounding your spinal cord so that medication can be injected into the spinal cord fluid. Not so bad once you get used to the idea, really.) And while cervical epidurals are unpleasant, no sedation was offered by the hospital where I had them done, and therefore, I felt there would be no need for sedation during my nerve root block.

They had me strip from the waist up, and then the doctor had me lay on an x-ray table face down, and then described what he was doing as we went along. He first wiped down my back with a cold liquid, and told me he was cleaning the site. Then, he covered my back with a sanitary, disposable cover of some sort, and told me he was covering the site to help keep it sterile. Next he said that I would feel a sharp pain as he administered the anesthesia. He said he would give me extra anesthesia since I declined the sedative, and then plunged the needle into the middle of my upper back. My UPPER back.

It was at that point I started wondering if the doctor knew what he was doing. I couldn't understand why he was anesthetizing me between my shoulder blades when the third and forth level of my cervical spine is way up in my neck, but I resolved myself to the idea that he is a doctor, after all, and does this procedure all of the time, so he MUST know what he is doing.

From that point on he never said another word, he just went on about his business. After the initial sharp pain of the anesthesia, I felt some pressure between my shoulders as the doctor utilized his Tuohy needle to gain access to my insides. Shortly after that I felt an incredible amount of pain that shot right up my spine, and down my right arm. It was NASTY, kids, but it only last a moment. Still, it was long enough for me to wish I had taken them up on that sedative offer.

After a little more finagling on the part of the doctor, and some more intense pain on the part of myself, we were soon finished and I was escorted to the recovery room where I was treated to a little juice box filled with, er, juice. Of all things.

I sat there in a mild state of shock still confused over whether or not the doctor got it right. I thought about our earlier conversation, and I believed going in that he was quite clear about where we all believed the source of my pain to be. However, I couldn't reconcile the location of the injection. Why the middle of the upper back? That's a long road to C3-C4. And why did I hear him tell his nurse something about T2-T3? I just couldn't understand why he injected me in my thoracic spine when my trouble emanates from the nerve roots in a part of my cervical spine. It just didn't make sense. The whole idea afterall was to directly bathe the nerve root at the C3-C4 level with medication, so just how was that accomplished from my thoracic spine?

I didn't go to work that day or the next because it felt like someone kicked me in the middle of my back. I spent those two days mulling over the procedure, and looking at the original order written by the UCLA doctor to see if somehow it could have been misinterpreted. Nope. It was written very well, and very clear.

You would have had to have been a moron to get it wrong. So why the middle of my upper back?

Though I couldn't understand how the doctor could have injected me in the wrong spot, I was firmly convinced he had. So utterly convinced, in fact, that I called my family practitioner and the surgeon at UCLA and left messages for them explaining my fears. I was so concerned about this that it distracted me from the real goal of the procedure; did it relieve my pain? Your brain can really do a number on you when it wants to, and even when it doesn't want to, and so
because I was so unfortunately focused on what I perceived to be a pretty major blunder, I totally ignored what the rest of my body was trying to tell me.

I went to work on the third day, and the first thing I saw on my desk was a fax from the doctor who performed the procedure. I picked up the fax, and began to read. I knew at once it was the report describing the procedure, and I was very curious to see what was in that report. As I read it, it all became very clear, and for those of you with any amount of medical background, it may have been clear earlier when I mentioned the needle the doctor used.

It turns out the reason the doctor injected me in the middle of my upper back wasn't because he was a quack, but because that was the site from which they ran the catheter up my spine!

Isn't that a riot?

They ran a catheter up my spine from T1-T2, allll the way up to C3-C4. To give you some idea of the distance that involves, remeber he started from the middle of my upper back, towards the middle of my shoulder blades. awell, from there he ran a tube up to about a spot in my cervical spine perpendicular to my jawbone. That's pretty damn far, and is something you damn well want to be sedated for!

After I finally understood what had happened, it finally dawned on me that I hadn't been experiencing all that much pain anymore. In fact, the only real pain I had was the after effects of the procedure, so I guess it worked! But my relief only lasted about a week, and then I started to feel the pain again. That's OK, though, because what we were really after was diagnosing the actual spot that is causing me pain. So,we might do the procedure again, which
believe it or not is what I am hoping for because the other alternative is operateing again, and cleaning out the area giving my nerve some room to move around. Since the last time somebody opened up my neck and shuffled my deck I woke up feeling like a million little rusty knives were digging into my neck and arm, you might be able to understand why I don't mind having another nerve root block first.

So, that's the nerve root block went. Not to bad all in all, but not all that much fun either. I need to contact the doctor at UCLA and tell him how I have been doing. He will most likely want me to make an appointment to see him again so we can discuss my options in greater detail.

So, until next time, how about we close with a picture of Jackie, Angel, and Thalia all snuggled up with their daddy in his easy chair?

Yup. All in all, life is pretty good.

What's Going on in My Neck

Not too long ago, I wrote about my experience with pain killers. I am currently taking them as a result of a congenital problem in my cervical spine that has caused a sort of degenerative disk disease. In layman's terms, I was born with a bum set of vertebrae, and it's a real pain in the neck. (See how I did that? It's a play on words sort-of-thing because "a pain in the neck" is an old saying, but... ah, skip it.)

Anyway, by the Summer of 2003 my condition finally reached the point where my doctors were fearful that I could suffer a "catastrophic event" should I take a hit in the neck, be involved in a situation where my head would move violently in any direction putting more of a load on my neck than it was capable of handling. That could be anything from a roller coaster to an automobile accident. And so at the end of August of that same year I endured a form of surgery that the medical community lovingly refers to as "anterior cervical discectomy with fusion".

I call it "torture".

In any case, the surgery was considered a success by all involved because the surgeon was able to clear out the area of my cervical spine that posed the greatest threat to my general well being. However, there was some disappointment during my recovery because the pain I was experiencing that sent me to the doctors in the first place never went away. In fact, it got worse.

I continued with follow-up examinations with the surgeon for several months after the surgery, and, without going in to great detail, he ultimately decided that more surgery came with a greater risk to benefit ratio than he was comfortable with, so after his suspicions were confirmed by another neurological surgeon he referred me to at UCLA, he apologized that there wasn't more that he could do for me, and sent me back to my family practitioner.

I really don't blame him because I have what the medical community calls "dysphagia". I call it difficulty with swallowing. Essentially I have this over grown piece of cartilage in my throat that is somewhat larger than most people's. (Go me!) They found out about it during surgery when they had substantial difficulty intubating me. I found out about it when I woke up after surgery and couldn't swallow because my throat was all jacked-up from the surgical team trying to force a large tube down a small hole. (The catheter probably went better.) Because of this, and because of the scarring that occurs with any surgery, the surgeon didn't think it was a good idea to go back in.

Since then my family practitioner and I have tried just about everything modern medicine has to offer in the way of pain relief as it relates to nerve damage and the cervical spine. So far we haven't had much luck, and the only thing that brings me enough relief such that I am able to function as a normal human being is those ever so nasty pain killers. With out them, let me tell you, my life would be oh so very different. And even then I suffer a good portion of my day because pain killers never work as advertised. (Also, I figure at 6'2" and 240 pounds I am under medicated anyway.)

It wasn't so long ago that my family practitioner broke the news to me that it is quite possible I may be facing a lifetime of pain management through opiates. Since we have apparently exhausted every avenue known to exist, it seemed to me she just might be right. But then, my dad had back surgery.

The surgeon who did my dad's work is, by my father's estimation, a good egg, and an even better back cracker. My father, doing as father's do, talked with his doctor about my neck. Long story short, dad's surgeon looked at my last set of films, (MRI and X-ray,) and said, "I don't see why this can't be fixed. Tell your son to call UCLA, and ask to see either Dr. X, or Dr. Y"

My dad was so thrilled he called me from his doctor's parking lot.

I talked with my doctor, she pulled some strings, and I ended up back at UCLA just this past week. This has all been going on since last October. That is when my father first approached his back surgeon about looking over my films. The story behind what had to happen to get me into seeing the head of the UCLA Spine Center is a lengthy one, and I just didn't want to take the time to bore you with all those details, but I do want to say that without my dad's help, and without my own doctor acting above and beyond the call of duty, it never would have happened, and so those two people have my undying gratitude.

But, let's get to what happened at UCLA last week.

Back up to when I went to UCLA two years ago; I was given the brush off by the surgeon I saw. They had me dress out in an examination gown, but when the doctor came into the exam room all he did was pull two pieces of film from my MRI folder, looked them over until he was convinced that I was convinced he had given them a sincere once-over, and then told me that there wasn't much he could do for me. He said that while there was no doubt that I had degenerative disc disease, it wasn't any worse than perhaps 20% of the population walking around right now. The only difference between them and myself is that I know I have a problem
because of my history.

Thanks, but no thanks.

I felt very small, and I felt like I had just been called a hypochondriac. I got dressed, put my films back into my folder, went out into the waiting room, woke up my dad, told him we were leaving, and drove home.

Fast forward to last Wednesday. This time I was seen by not one, but TWO doctors, one of which was the man himself, Mr. Head of The UCLA Spine Center. After a thorough examination, and after a lengthy questioning about my medical history, and after looking at my films, what the Head of UCLA Spine Center told me is that he thinks a particular spot in my cervical spine located just above the site of my last operation, is the root of my pain problems. He said what he wants to do is to give me a root block exactly at that site, and if my pain goes away, then we know we have a winner. After the nerve block he said we would wait to see if the pain returns because sometimes all that is needed is a one time nerve block, and some patients never experience pain again. He said if the pain does come back we would just do another nerve block, and keep on like that for a while to see if that will work. If not, then at least we know exactly where to go when I have a second surgery.

For clarification, let's look at some pictures. (OK, I guess you don't really need any clarification, but I just LOVE looking at MRI's!)

This is just prior to my first surgery. The red numbers are my cervical vertebrae, and that thick gray line that runs almost vertically through the center of the picture is my spinal cord. If you look at the area of my spinal cord around the second vertebra you will notice some white around the gray spinal cord. That white is spinal fluid, and it should be like that all the way down your spine. You see in my case starting around my third vertebra, there is no more white. The reason is degenerative disk disease. The disks have broken down, or herniated, and are pressing on my spinal cord and the nerves that come off of it. I also have developed bone spurs, (osteophytes,) and looking at C-4 and C-5, the vertebra have actually shifted in relation to each other. Crazy, huh?

This MRI was just a few months after my operation. Looking pretty good all things considered. But if you look just aft of C-3 you will see another troubling area developing. There is some room, but it looked to me when I first saw it that I was in for more trouble. This is the MRI the first doctor at UCLA saw two years ago.

If you look closely at the forth fifth and sixth vertebrae you will see they look distorted. That is because they have been fused, and because there is a plate with six screws holding it all together.

This x-ray shows the plate and screws more clearly. I am actually facing the opposite direction, so the MRI's were of my lefts side, and this x-ray is of my right side. I uh, also have some gold teeth and a filling or two.

My most recent MRI. Now, before you say, "OH MY GOD, THERE IS NO ROOM FOR HIS SPINAL CORD AT ALL!!", let me assure you it isn't as bad as it looks. The surgeon marked my MRI with a sharpie just to show me what was going on in my neck when we visited him last week. It has narrowed, but it isn't that bad.

What has also occurred is my vertebrae have shifted again, but this time it is between C-3 and C-4. Also, the osteophytes are larger, and the disk is herniated. (It may have been herniated before, I am not real sure, and the doctor didn't say) This is where the doctor wants to block my nerves.

So, there ya have it, the Reader's Digest version of what's going on in my neck. Even with all that, I still work, and I still go to Disneyland,which I just did a couple of weeks ago, and you can bet I will be writing about soonish.

Painkillers Can Be of Some Good

This entry started off as a comment at my friend Fritz's blog, but it kinda got outta hand. Fritz recently wrote about his experience with the powerful painkiller that goes by the brand name, Norco. I have had a vast amount of experience with the drug myself, and with a number of painkillers in general, so I thought I would add my two cents. As I wrote, however, I found I had a lot more to say on the subject, and since I haven't addressed my own pain issues here for a while, I thought I would just turn my comment into a full blown post here instead.

For more background on my problems with my neck, feel free to check out past posts on the subject starting with this one, and continuing with this one, and this one, this one, this one, this one, this one, and this one. I usually don't like talking about this part of my life because frankly, I don't think it is that big a deal, and I don't always feel comfortable writing about it. But, this post of Fritz's sort of struck a chord with me. While I believe Fritz is right that painkillers such as Norco are addictive, and can be hell to get off of, I also feel they have their place in modern pharmacology.

By the way, Fritz, it's good to see you back blogging! And I love the new look as well. I imagine all that fancy artwork is you own? (Fritz is one of the most talented artists I have ever had the honor to know.)

In my case, drugs like Norco and Oxycontin are a godsend. I suffer from chronic neck and shoulder pain that radiates down my arms, and to my fingers, and I wouldn't be able to function at all if it weren't for these drugs. I have had this problem of and on for over twenty years, but just before, and ever since my neck operation in 2003, pain has become a part of my life. I now take two 80mg pills of Oxycontin a day, and two 10/325 Norco pills a day. I am what is known as “opiate tolerant”.

To me, there is a difference between being addicted, and being dependent. I am dependent on these drugs because without them I would be in debilitating pain for most of my day, and I certainly wouldn’t be able to work. Am I also addicted to them? No doubt, but which is worse, the pain, or an addiction to a drug that I need anyway?

My problem with the word "addiction" is that it implies the user has a problem controlling their intake of the drug. It also implies the person using the drug doesn't really need the drug other than because of their addiction, which many people would assume began because of recreational drug use. I might be addicted in the sense that my body would revolt should I suddenly stop using the drugs, but I am not addicted through any actions of my own.

There are times when I wonder if I actually need the drugs. I wonder if I were to not take painkillers, would I really be in that much pain. My conclusion is I would need to take them simply because I do still suffer from pain even though I do take such strong painkillers as Oxycontin and Norco daily. They simply are not sufficient when it comes to battling my pain. One of the biggest drawbacks of using narcotics for pain relief is that, when you first start, they work great, but as time goes on you need to take more and more to achieve the same level of pain relief. You finally top out at the highest dosage allowed, and from then on you really begin to understand what the term "pain management" means. The only drug that I have found so far that was able to knock out my pain all day was fentanyl, which comes in patch form, but the side effects make Oxycontin and Norco look like candy, and while it is supposed to last three days it starts to weaken after 1½.

The other reason I believe I would still have a lot of pain is because I have seen several different doctors, including the best pain specialist in the county, and many have agreed I need to be on pain medication. The pain specialist, while he has many different methods of treating pain, even recommended that I have a morphine pump implanted in my body so that morphine could be injected directly into my spinal column 24/7! He said he hadn’t seen a case as severe as mine in quite a while, and that he rarely goes straight for the morphine pump. He sent me home with a video tape that explained the whole procedure, and I decided I would rather take the pills than deal with that.

As far as I am concerned, the greatest drawback to taking these drugs is the stigma. I am uncomfortable telling other health professionals that I take these drugs because there is such a high rate of abuse, even by people who need them. I often feel I am being judged by other physicians even though in most cases none even so much as blink an eye when I tell them.

There is hope for me, however. I am scheduled to see the top neurosurgeon at the UCLA spine center this month. It has been a long process getting in to see this doctor, but between my physician, and my father’s back surgeon, and the person who handles my insurance case, I finally got an appointment. (Even the insurance company is on board with my condition. That should tell you something.)

My last operation was primarily to prevent any sort of cataclysmic event that would have resulted in a life in a wheelchair. This appointment is to see if there is something that can be done for the pain. My films, (x-rays, MRI's, CAT scans,) have been reviewed by a lot of doctors, and there has been a variety of opinions, but recently a local spine doctor, the one who operated on my dad, looked at my films and said he saw no reason why another operation couldn’t be successful, and he is the one that suggested UCLA.

I went to UCLA a few years ago, but the doctor that saw me was less than impressed with my condition. He said probably 20% of the population is walking around with as much stenosis in their neck as I am, but the difference is I know about mine. That guy hardly glanced at my films, and didn’t even exam me. I left feeling like he had just brushed me off.

I don’t know what the future holds for me, but if the operation works, if it even happens at all, then I will be looking at some sort of detox program. That’s fine with me. It’s tough dealing with pain, and taking these drugs. Some days I want to take more because I am in such horrible pain, but I can’t, so I just have to deal with it, even if I am at work or something of that nature.

The bottom line is, sure, these drugs are dangerous and very addictive, but in some cases they are also very necessary. Still, it would be nice to get off of them all together.