Questions About Spinal Stenosis

Back in 2008 I was having a lot of hip, back and leg pains and I had a MRI.  I thought I was going to need a hip replacement but the hip doctor said no, and sent me to another back specialist, one who specialized in pain management.  He told me I had arthritis in my L5 vertebra and physical therapy exercises would help.  They did.  I had to stop walking for exercise because it flared up my back and made my legs numb, but if I did my PT I could keep the pain under control.  In 2010 I went back to the doctor to ask if there was anything I could do to fix me so I could go back to walking for exercise.  He said no.  He then told me I had spinal stenosis and I should be prepared for a slow decline.  He said when things got very bad he could do nerve block shots, but I should put off thinking about surgery as long as possible.

Having the label “spinal stenosis” gave me something to research on the Internet, and generally I found the same recommendations to hold on off surgery for as long as possible – but with reasons why.  Many people ended up worse after surgery.  I even watched videos of surgical techniques for spinal stenosis.  Mucking around so close to the spine scares me.  By the way, how do surgeons know what they seeing, body parts aren’t color coded like in books and the old Illustrated Man model.

I decided to bide my time and see if new surgical techniques would be developed.  A few months ago I started seeing sites on the Internet advertising laparoscopic surgery that promised miracles for spinal stenosis sufferers, so I set up another appoint with my doctor.  I was hoping he’d have good news.  He said microsurgery was still surgery and warned me that a lot of places made a business off of selling procedures and they might not work for me.

The time I can spend standing and walking has greatly diminished.  I’m now down to 15-30 minutes.  My doctor said before I thought about surgery I needed to try a nerve block shot, but also said I was controlling my pain so well with PT that I could still put that off too.  I asked him if I could go back to walking after a shot, and he seemed iffy.  He thought a shot would extend my standing and walking time but it would wear off in months.  I asked him how they worked, and he said they reduced the inflammation in the nerves near the stenosis sites.

My doctor and internet sites warned not to do surgery until I was facing a quality of life issue.  That’s sort of vague.  I can go to work, but I can’t walk between buildings.  I can’t do much shopping.  I don’t want to go on vacations.  However, I’m a bookworm and TV watcher, so I’m reasonably comfortable for that.  I’m surviving without pain by walking a razor’s edge with physical therapy and not aggravating my back by standing or walking too long.  I could risk the surgery, but what if it causes permanent pain of another type?  Right now my feet and legs go numb and I have other weird sensations, and sometimes my back tightens, but I’m not suffering real pain.  I’ve been there, so I know.

If I had surgery how many holes, passages and paths would have to be widen?  And how long will it be before they fill in again?  I’m really fighting arthritis.  Are there ways to fight arthritis in general?

I also got to thinking about inflammation.  If steroids shots would reduce inflammation why wouldn’t other things do the same thing?

My doctor did tell me something that I totally wasn’t expecting but I should have.   He said arthritis was now affecting my L4 and L1 vertebras too.  So things were getting worse.  I didn’t ask, but did that mean I’d need multiple surgeries?

That’s the thing about this condition.  I have a hard time picturing it.  I haven’t seen the MRI or X-rays.  I have seen photos on the net but they aren’t me and they aren’t specific.  I would like to visualize how arthritis degenerates the spine.  I did find this at AAOS.org.  The caption said, “When we are young, disks have a high water content (left). As disks age and dry out, they may lose height or collapse (right). This puts pressure on the facet joints and may result in arthritis.”

This explanation doesn’t explain why steroid nerve blocks would help, but it makes me wonder if inversion tables would?  It also makes me wonder if there are diets to help stop the degeneration, or foods that make it worse.  I am overweight, so I also wonder if losing weight would help, I can’t imagine that it wouldn’t, but two doctors have said it wouldn’t.  The trouble is I’ve been trying to lose weight for half my life and haven’t succeeded.

I also wondered if chiropractic techniques would help.  Physical therapy exercises have saved me from years of pain.  I can limit the pain to almost nothing with daily exercises, and that might be the same as what a chiropractor could do.  The trouble is the arthritis is also building up deposits that squeeze the spine, and squeezes the nerves branching from the spine to my legs, which I don’t think would be reduced by manipulation or exercise, unless exercise reduces inflammation, or causes the nerves to rub against the arthritic growths and kept it from expanding.  But that’s just me wondering, I have no evidence of that.

But I do have a lot of questions, especially for people who have this condition.  I’d like to hear from people who have had surgery, of any type, and people who used chiropractors or other alternative medical techniques.  Do inversion tables help?  Got any diet tips?

I know I need to lose some weight to see if that can help.  I wish I could be as disciplined with my weight loss as I’ve been with my PT exercises.  I need a diet that is non-inflammatory in general, causes weight loss, and is anti-arthritic.  I bought a Bow-Flex to see if more exercise and stronger exercises would help.  All my life I ran or walked for exercise and I can do neither now.  I should swim, but that ain’t in the cards.

I’ve known since I was a kid that getting old means breaking down physically, but I always pictured it happening fast.  I never pictured not being able to walk – I always pictured dying of a heart attack.  When I was at the Campbell Clinic I saw lots of people that looked much worse than me, some were in wheel chairs.  In recent years I’ve noticed old people having trouble walking, the ones with canes, or wheelchairs, or those little scooters.  I’ve seen a lot of people struggle just to go out to eat or or see a movie.  I suppose there are even more that stay at home.  There are millions of people worse off than me, and the thing is I need to pay attention to them, because they are my role models and trail blazers.

Unless I find a miracle cure, and I will try, I’m starting to see my future much differently than I ever imagined it.

JWH – 1/18/12

2012 New Year’s Resolutions: Becoming the Person I Want To Be

I turned 60 last year and my batting average for keeping new year’s resolutions is pretty close to .000 – but that doesn’t mean I won’t keep trying to become the person I think I should be.  This year I have more incentive than ever to change.  The question is whether or not I can find the discipline to live differently.  Few people ever choose to do the hard things in life.  Well that’s me, I always take the path of least resistance. 

As I’ve gotten older and my body has reacted strongly to different bad habits, I’ve learned that it’s better to listen to my body than suffer the consequences.  Pain and poor health has been my real incentive to change.

I have spinal stenosis and the amount of time I can stand or walk is dwindling.  I’m down to 15-30 minutes before my legs start going numb.  I weigh 237 pounds and need to loose 62 pounds to get to a normal BMI.  Losing weight won’t cure the spinal stenosis but it might reduce the strain of standing and walking.  Will this powerful negative incentive help me lose weight when I’ve always failed before? 

I do have some will power.  I became a vegetarian back in the 1960s.  I gave up caffeine because it helped with headaches, rosacea and just feeling better.  I’ve given up chocolate and fatty foods because it upsets my stomach.  I mostly drink water because of my bladder and kidneys protesting other drinks.  And I’ve given up eggs and junk food to help lower my cholesterol.    You’d think with all the foods I’ve given up for other health reasons I’d be losing weight, but I haven’t.  It’s uncanny – my body gets more efficient at processing food.

I also think about how I should be more charitable and giving.  I have a few problems but other people have a lot more problems and I feel guilty that I’m so lucky.  On all the nightly news programs they have been running stories about innovative charities.  I find that very inspiring.  I wondering if I can find a creative way to be more helpful.

Along with my need to lose body weight I wished I could lose clutter pounds.  This would be clutter that fills my house and office, and thought clutter crowding my brain, and activity clutter that wastes my time.  What I’d really love is the ability to focus on bigger projects and get them done rather than dissipating my life chasing after so many little things.

Finally, I want to be less verbose and more focused in my blogging.

Happy New Year

JWH 1/1/12

The Things I Should Be Doing

I tend to do whatever I feel like.

But then I’m sixty pounds overweight and my health is going down hill.  My house could use a good deal of renovation, and even though my yard guys keep my lawn close-clipped, it’s a green carpet of weeds.  I feel great relief when I see those shows about hoarders because it makes me feel clean and orderly in comparison.  I take a certain pride that I’m not an alcoholic like my parents but I have quite a reading addiction.  I wanted to be a writer, and although I can churn out the blog posts, I never write the fiction I constantly create in daydreams.

One of the biggest problems in my life is I’ve been reasonably happy and content – I think drive comes from dissatisfaction.  If it wasn’t for the guilt over being unproductive I could cruise to my deathbed with no regrets.  Yeah, that’s a pretty big exception though.

A friend of mine recently got some paid-for psychological advice which she shared with me for free.  She was told to picture herself dying comfortable, able to think clearly – and then asked to imagine what her regrets about leaving life would be.

Now that can be taken a number of ways.  There’s a difference between the fantasies that didn’t come true and the ambitions I gave up because of laziness.  Remember that movie about the bucket list – well how many people can die with the aid of a billionaire to finance an expensive life-improvement checklist?  I could say my life sucked because I didn’t become a rock star like Bob Dylan but is that fair when I can’t carry a tune and the only song I can remember the words to is “Happy Birthday” and I screw that up half the time.

Studies have shown that success is about 10,000 hours of practice, so should we all be regretful that we didn’t pick something and have applied ourselves diligently for three hours a day for ten years?

Maybe that psychiatrist meant something different.  Maybe he meant that people should regret not being nicer, or more generous, or more caring.  Many people believe a good life is based on how much you do for others and not what you do for yourself.  And to be honest, I’m a very selfish person.  I don’t feel too guilty though, I try to be a helpful person in my own way, and I give regularly to a number of charities, but the reality is I have no more talent for providing human comfort then I do music.

I really wish I could have be more generous with my wife Susan, doing more things she likes to do, like going to baseball games or to bars on trivia night.  I just can’t though.  Baseball is boring, and I don’t like loud bars.  And I’m sure she feels bad about not liking the many things I like to do, like watching documentaries on cosmology or sitting around listening to jazz from 1959.

When it comes down to dealing with regret I think we need to be realistic.

I need to picture lying in my nursing home bed and think of things I should have done that I could have done.  And since I’m turning 60 in a couple of months, it should be things I could start doing right now.  Crying over my first six decades is pointless.  In all honesty, I can make a long list of things I wished I had done in those first sixty years and it would come down to a long list of “I wish I hadn’t been too chicken-shit to do X.”  But what’s the point of that, I have a timid omega male personality and that’s not going to change.

Sure I can think of a few things to wish for that might have been practical.  I wished I started caring for my teeth as a kid instead of waiting until I was in my forties.  I suppose I could have given up my favorite foods at 175 pounds instead of 235.  And if I had only maintained my exercise levels that I acquired in gym class in junior and senior high I could have been the person I always fantasized being.  Ha-ha.

See, that’s the thing about thinking about our dying regrets – it’s easy to make bucket lists, but it’s hard to judge who we really are.

I’ve known I should lose my extra pounds ever since I gained them.  I’ve always regretted them.  I’ve quit eating all my fun foods decades ago.  Other than forcing myself to live with constant craving, I don’t know what else to do.  And the same is true of having a beautifully decorated house and spiffy all grass lawn – I’d have to have a personality change.

I could write on my bucket list that life would have been great if I could have had sex with Catherine Zeta Jones or spent a year living in Paris writing a brilliant unforgettable novel.  But should I really downgrade my life on Earth because I didn’t?

At work people laugh at me because I all too often make references to things I read in books.  They say I shouldn’t read so much.  But, hey, I’m a bookworm.  That’s like telling a giraffe that he’d have a better life without that long neck.  Hell, when it comes down to it, I’m going to regret not reading more books, or listening to more music, or watching more documentaries, or all the other things I really love doing.

When I’m old and dying I’m going to regret losing my health and dying because I’ll have to stop doing what I’ve been doing my whole life, which is being me.

JWH – 8/7/11

Do Colds Get Stronger As We Get Older?

I have a mystery.  My annual colds are getting more debilitating each year.  I missed 5 work days with this cold, and I was sick on both connecting weekends too.  I still have nasty lingering symptoms.  This year was so bad that I’m freaked out about next year already.  Usually when I get a cold I’ll miss a couple days of work and get some reading done.  I didn’t even feel like reading this year. 

Why?  Here are some possibilities:

  • I’m getting older – is a cold harder to handle at 59 than 49 or 39?  How will they feel at 69, 79, 89?
  • I’ve been taking flu shots for the last three years, could this be a side-effect?
  • I’ve been living in a new (old) house and it has a new heating system – could that affect my system?
  • I’m exercising less because of a back problem – could reduce stamina hurt my ability to handle a cold?
  • Maybe I just hit a run of stronger cold strains and things will change?
  • Or is it only a matter of self-deception and the current infection is always the worse?

Looking back over my life I don’t remember colds being this unpleasant, but the one I’m getting over now has been a doozy.  And to be honest, after studying colds and flus, some of my memories of having the flu might actually have been a cold, so that I did have some bad colds when I was younger.

Wikipedia has a wonderful essay on the common cold.  It says the average adult gets 2-4 colds a year, and the average kid gets 6-12 cold infections annually.  It also says the average length of a cold is 7-10 days with some symptoms lasting up to 3 weeks.  Now that describe my “bad” colds.  And hell, I don’t ever remember having that many colds, either as an adult or a kid.  (If you do the math from Wikipedia, something sounds fishy though.  Some people must be sick all year round.)

I do think I’m on a four winter streak of ever worse colds, and I wonder why.

Under normal conditions having a cold wasn’t all that bad, I took off from work and read.  I’ve even thought  that a cold produces a nice high that’s perfect for rereading favorite novels and wallowing in nostalgia.  This year I couldn’t read.  I watched damn little TV.  I just tried to sleep as much as possible to escape the misery of the moment.  It’s been 12 days now, with the last three back at work.  I’m better, but I have a lingering hacking cough that scares my co-workers and keeps me up at night.  I’m still coughing up green pus, blowing out green snot (which is sometimes bloody), and if I leave my eyes shut for any length of time they will gum up with green goo. 

People keep telling me to go to the doctor and get antibiotics.  Several people have said green is a sign of infection and I need antibiotics to fight it off.  I found this article that contradicts that.  And besides, I’m afraid of going to a doctor.  I picture her waiting room filled with sick people with even more germs to infect me.  And I’m also chicken about taking antibiotics.  I ended up in the emergency room in my twenties and I was told it was probably a reaction to penicillin. 

I’m a total wimp when it comes to getting sick.  If I can barely handle a cold now, how will the flu feel?  If my body can’t handle a common ailment how will it do if I have a heart attack, or pneumonia or cancer, or any of those other diseases old people get?  I need to build up some stamina if I’m going to even make it to my social security years.  It makes me wonder if God is getting me back for my skeptical life, or at least my body is getting me back for living a slothful, overweight life.  How can I redeem myself?

My friend Mike is four years younger than me, but when he had some health problems, he took control, lost weight, and is now running half marathons.  I need to make Mike my role model, but there’s one problem.  Mike has always been very disciplined and I’m not.  I’ve been trying to lose weight for twenty-five years and never have succeeded.  And that’s despite the fact that I’ve given up eating most of my favorite junk foods.

Be that as it may, I still need to work a little miracle of self-transformation on myself.  I just don’t know how.  I also feel that if I don’t find some method of aerobic exercise that my back can tolerate that my vitality and stamina is in a slow decline.  I bet next year’s cold will be even worse than this year’s cold.

JWH – 1/26/11

Vegan Diet Is Helping My Knees – Maybe

2010 has been a year of dealing with health problems for me.  I’m turning 59 next month, and this year I started feeling like I was really getting old.  For the past two years I’ve been on and off Zocor and Pravachol because my doctor wants to get my cholesterol down.  Concurrent with that I’ve been having back and leg trouble because of spinal stenosis.  I used to walk 2-3 miles a day for exercise, but now walking and standing compresses my spinal cord and makes my legs go numb.  So I’ve essentially stopped getting any good exercise except that do a lot of walking and stair climbing as part of my job – but even then, if I get too active at work my back and leg suffer.

I’ve tried the statins three times in the past two years, with each time me giving up because they make me feel like I’m sick all the time.  Plus they give me weird circulation problems that make my arms and legs go to sleep easily.  I was trying the statins again this summer because my doctor says I’m at high risk for a heart attack or stroke.

Even more of a bummer, this summer my knees started going out.  It really felt like I was getting old.  I could barely climb stairs going between floors at work, and I had to be very careful because it felt like my right knee was going to blow out on me.  I just assume this was part of getting old, maybe arthritis, because so many of my friends have bad knees.

By September 1st I had given up on the statins again.  I started reading about diets that might help with cholesterol and decided to try a vegan diet.  I’ve been a vegetarian for over forty years, so going vegan is like a health diet for vegetarians.  My doctor said if I lost weight my cholesterol numbers would go down.  So what the hell, I figure I would give it a try.

Now here’s the odd thing.  My knees have been getting better – much better.  The vegan diet can, if you choose the right foods, be an anti-inflammation diet.  Because I also quit the statins I don’t know they could have been making my knees go bad.  Two weeks after I stopped taking the drug I started feeling better in general, but I still had knee problems, and now almost four weeks after starting the vegan diet my knees feel much younger.

Can giving up eggs, milk, cheese and yogurt really have helped my knees?  I can’t say conclusively.  I’ve also been able to stop taking my diclofenac sodium anti-inflammation pills too, which is another clue that my diet is anti-inflammatory.  But I also have to consider that I’ve stopped eating so many sweets, and that might be anti-inflammatory too.

So as 2010 rushes to a close, I’m now feeling more like I did in 2008, which is reasonable good except for the spinal stenosis.  But that’s a physical problem, but one I can deal with by doing daily physical therapy exercises.

My doctor insisted I do a full checkup this week, and all the blood tests said I was doing great except for 161 LDL and 30 HDL.  I was particularly proud of my 117/68 blood pressure, which was 132/90 at my last checkup.  My doctor finally accepted I couldn’t handle statins and I told her I started the vegan diet.  Our goal is for me to get down to weighing 199 pounds in six months.  I’m at 229, down 5 pounds since I started the vegan diet about a month ago.

I already feel younger, like I’ve reversed a downhill slump in health.  That’s making me feel very positive about the diet.  Maybe if I can get down to 199 I’ll even feel younger still.  I’ll let you know.

What I’d like to know is how many things do I eat that makes me feel bad?  I have several friends that had horrible health problems until they discovered they were gluten intolerant and now they are dramatically better on a gluten free diet.  I remember back in my early 40s having painful prostrate problem that I eventually figured out was caused by the orange juice.  Decades ago I gave up caffeine because it was causing too many headaches.  And I know that wine and chocolate inflame my rosacea.  People talk all the time about good foods that make you healthy, but what are the good foods that make you unhealthy? 

JWH – 10/9/10