My cardiac health continues to improve. I had another appointment with my cardiologist on February 22, and he was quite pleased with my progress. The only change he made was to add one more medication that might further strengthen and support my heart. It’s basically an experiment to see if it helps, and to find out how well I tolerate it. (I can answer the second question now: after two weeks, I have noticed no side effects at all. But then, I have felt no side effects from any of my cardiac medications, and I’m on half a dozen of them now.) He also said that I will probably be ready to stop wearing a defibrillator fairly soon. My next cardiology appointment isn’t until April 26, so I assume I’ll be using it until then. It’s no great hardship.
But I did have a health setback in recent days that had nothing to do with my heart. It wasn’t life-threatening, either, but it sure was unpleasant and inconvenient. I had a flareup of lower back pain. This seems to happen to me about once a decade, or maybe a little more often, and it typically isn’t the result of a back injury. It just happens, for no apparent reason. And it doesn’t seem to be related to my age or my weight, because I can recall having one of these flareups when I was in college, at a time when I was still young and slim.
The discomfort built up rapidly over a couple of days, starting around Tuesday of last week (March 1). By Wednesday morning I was experiencing quite a bit of intermittent pain, but I was still functional. I had planned to take my old desktop computer to the Kramden Institute and donate it, something that I could only do on a Wednesday evening unless I wanted to take time off during a work day. So I was determined to complete that errand despite the pain. Picking up the computer and carrying it down the stairs to my car was not too bad, and driving was fine. When one of the Kramden volunteers offered to come out to my car and bring in the computer, I was happy to accept.
But things got worse that evening. The Kramden building is right next door to a Golden Corral restaurant, and I took the opportunity to eat supper there. I was doing OK during the meal, even though a buffet requires you to get up and move around much more than any other kind of restaurant. After the meal, I visited the men’s room and went into one of the stalls. When it was time to leave, I found the process of standing up, restoring my clothing to normal, and so forth to be agonizing. After washing my hands, I made my way slowly and painfully out to the parking lot. My gait was so stiff and slow that I thought I must look like Frankenstein’s monster shambling through the restaurant, but no one seemed to notice.
Once I got into my car, I was more or less comfortable. (Sitting or lying down doesn’t hurt. But standing and walking do.) I had planned to stop at a Walmart Neighborhood Market that was on my way home to pick up a couple of grocery items, and I decided to go through with it. I probably should have skipped that, but I was too stubborn. I managed to hobble through the store and collect the items I needed, leaning heavily on my shopping cart for support. As I approached the self-checkout, two of the employees saw that I was in distress and asked if I was all right. I explained what was happening and, after I scanned, bagged, and paid for my groceries, one of them offered to escort me to my car. I accepted with thanks, and managed to reach my car without incident. She put the groceries into the car for me and took care of returning the cart.
When I got home, I had to face the ordeal of climbing the stairs to my apartment. Since being discharged from the hospital, I had grown accustomed to traversing those stairs easily and effortlessly. Now it was like climbing a mountain again — not because of shortness of breath and fatigue, as it was in December, but just because it hurt so much. But I made it to the top, unlocked my door, and staggered inside. After putting away the groceries, I took my evening medication, added some pain reliever, and went to bed early.
Thursday morning was the low point. Getting out of bed took about half an hour and involved a great deal of pain. I found myself thinking that I might actually have to call 911 if I couldn’t even walk. But I wasn’t going to do that if I could avoid it. After using the shelving unit near my bed to slowly, gradually pull myself upright, I found that I could manage a shuffling walk. My first concern was, of course, to get to the bathroom. Second on my list was to make it to the door of my apartment and unbolt it, because if I did have to call 911, I wanted to make sure the EMTs could get in.
I was able to do both of those things, get some breakfast, and start my work day. Working was actually not a problem, because I do that sitting down, and sitting didn’t hurt. But the longer I sat in my comfy office chair, the more it would hurt when I stood up. So I made a point of getting up at least once per hour and hobbling around the apartment — going to the bathroom, getting another cup of coffee, or something like that. Standing and walking was still pretty awful.
In the past, I have dealt with these flareups by taking large doses of ibuprofen. It relieves the pain, but it also reduces the inflammation that’s causing the pain, and by using that medication, I have typically been able to clear up the problem in a few days. But now that option was off the table. When I left the hospital, my instructions had included a ban on ibuprofen or any of the other NSAIDs, like naproxen sodium. The only pain reliever available to me was acetaminophen, which I find to be less effective for pain, and worthless against inflammation. So on that Thursday morning, I called Cary Cardiology and spoke to a nurse. I described what I was experiencing and asked them to either give me permission to use ibuprofen or offer me an alternative medication that would do something about the inflammation.
The nurse talked to my cardiologist and called me back. They couldn’t let me use ibuprofen; in combination with one of my other medications, it could cause bleeding. And they don’t prescribe pain medications. She recommended that I call my primary care physician about that. So I did, talked to a nurse there, and she spoke to my physician, who prescribed cyclobenzeprine hydrochloride. It’s a muscle relaxant, not a pain reliever, but it seemed like a good idea to me, because I could tell my pain was being caused by muscle spasms in my lower back.
At my request, the prescription was sent to the pharmacy at the same Walmart Neighborhood Market where I had stopped for groceries the night before. But how would I get it? I was in no shape to navigate the stairs again. Up until this point, I hadn’t told any of my family what was happening, but it was clearly time to enlist someone to help. I called Ruth, and she immediately agreed to pick up the prescription and bring it to me when she got off work. When she arrived, she also took out my trash and insisted on preparing my supper and serving it to me. When she left, she took with her a package that needed to be dropped off at a FedEx store. (I am very grateful that she lives so close and is so willing to help when I need it.) After her departure, I took my muscle relaxant, ate supper, and went to bed early again.
On Friday morning, I didn’t notice any significant improvement. Getting out of bed was still an ordeal. But as the day progressed, I could tell the pain was gradually lessening. I continued taking the new medicine. With the arrival of Friday evening came the weekend, and I resolved to spend it resting and healing as much as I could. I spent Saturday and Sunday quietly at home, taking several naps during the day. Each time I slept, I woke up with less pain. By Monday morning, I was moving around the apartment much more easily. It still hurt, but in a more tolerable way.
It’s now Monday evening, and I’m nearly back to normal. There’s still a lot of stiffness when I get out of bed or stand up from a chair, and I’m still walking slowly and carefully, with some moaning and groaning. But I’m definitely on the mend. The Walmart pharmacy notified me that a refill of one of my prescriptions is ready, and I plan to go and pick it up myself tomorrow evening. That will be my first time venturing out of my apartment since last Wednesday, but I’m sure I’ll be up to it by then.
On Thursday evening, March 10, I am scheduled to have dinner with Bob and Miles. I don’t think I’ll have any difficulty keeping that appointment. I may not feel like going walking after dinner, but the meal itself, and the trip there and back, won’t be a problem.
It seems that I’ve weathered another storm. But it sure would be nice to have calm weather for a while.
