Pain

    I don't know what started it. Lately, I'd been feeling well enough to join my shop's softball team. We weren't very good, but it was fun and it was exercise. I had been doing more bicycling with my sons and I had really started to get more serious with my photography. Work was satisfying and home was good. We had finally sold the other house so the dual mortgage baggage had been thrown to the curb. Why did my neck have to start hurting again?

    Four years ago, I was still in the Navy and living in Virginia. My ship had completed a shipyard refit and we were getting ready to go underway in preparation for deployment. It started as a mysterious weakness in my left arm. I had trouble lifting my towel in the morning. I could force myself to do it but it took an effort of concentration. Not normal for me, that's for sure. I had been riding the exercise bike in the ship's gym for a few months at that point and I was getting fit. I don't like the recumbant style of cycle, so I rode the upright with my body in a roadbike tuck, watching the TV and trying to keep my cadence up. My neck must have complained, but I never noticed.

    Some time passed and the weakness morphed into pain, radiating down my left arm through the tricep, across the hollow of the elbow and down to my index and middle fingers. I sought help at ship's medical, and the good doctor tried to help. After a few experiments with some mild pain reliever and nerve blocker, he decided I needed to seek some specialized help at the naval hospital. I had only been to Portsmouth Naval Hospital a couple times previously, once for some stitches and the other to visit a Sailor of mine. The increasingly debilitating pain in my arm and the path of numbness into my fingers told the neurologist what he needed to know. It appeared I had a pinched nerve from a collapsing disc in my neck.

    Some x-rays and an MRI later, we had some confirmation of the diagnosis. Told I had degenerative disc disease, I decided to not rush into surgery despite what my ship's doctor wanted, and I began several rounds of traction and physical therapy to try and relieve the pain in my arm. The neurologist also tried steroid injections into my disc twice. I also was on a high dosage of nerve blocker and narcotic pain reliever. None of this made my arm hurt less but by then I had transferred off the ship for medical reasons and my mom had come to help me with transportation and company since my wife and sons had their lives in Maryland. This extended time with my mom as an adult is one of the treasures of my lifetime.

    The neurosurgeon, arrogant and confident as surgeons usually are, seemed confident that surgery would eliminate the pain in my arm by lifting the disc pinching the nerve. The choice was between disc fusion and installing an artificial replacement disc. Fusion was tried and true, but also would reduce my range of motion. The Pretige disc was fairly new at the time but seemed promising and would allow my neck to turn and flex fully. I was not yet forty so the choice was easy. In April of 2009, with my wife at my side, I had the first surgery of my life and gained a stainless steel body part.

    The artificial disc did its job. After the normal healing and wound care, the pain in my arm did go away, leaving only the finger numbness from which I stiff suffer. A byproduct of the extended time the nerve was pinched, it may never fully recover. My neck muscles were tight but I assumed that would subside over time. I was able to slowly start living my life again, exercising more, sleeping in a bed instead of a chair, playing with my kids. I retired from the Navy, moved to Maryland with my family, and looked for work. I eventually started doing some business development work for a small defense contractor and I took some college classes at the local community college. My neck was doing okay but the stiffness and tightness in my neck never went away. I weaned myself off all the pain killers and nerve blockers, but I still needed 2400 mg a day of ibuprofen to keep the stiffness tolerable so I could work.

    Time went on, my mom passed away, and I had to empty out her house to settle the estate. I spent weeks unloading stuff from her house into dumpsters or into a truck to take to the scrap yard. My neck worked fine during all of that heavy labor, but the painful stiffness continued to be a bother. I needed the ibuprofen like clockwork or I would end up fatigued and drained like I had the flu. My neck would get tender and tight and the pain would get worse. I rarely felt any pain in my arm again, but my neck was a constant issue. At one point, my neck was so stiff my doctor tried giving me a muscle relaxer that ended up affecting my vision. He then prescribed twelve weeks of physical therapy, which did improve my range of motion and probably reduced the stiffness temporarily, but even continuing the exercises didn't let me eliminate the kidney-damaging daily overdose of ibuprofen.

    In 2011, we moved to Calvert County, MD, where I started my new job at Calvert Cliffs Nuclear Power Plant. Things went well at work, especially for the first year when I was in training most of the time. My neck grew stiff from the sedentary nature of classroom study, but nothing I wasn't used to by then. Unfortunately, training ended, which put me in the field (where I wanted to be) but my neck didn't like it. I felt well enough to bike and play first base, but it couldn't last. The stress of high heat and poor lighting combined with abnormal body positioning to put my neck under terrific strain, which I tolerated well some days and suffered in great pain on others. I also developed a new condition in my neck whereby I felt the need to pop my neck constantly. I could feel the vertebrae locking together and I seemed to need to pop them loose. This sometimes resulted in a strong tug down my spine. It also caused a metallic pinging sound inside my neck and head, which only I could hear but which was very real.

    My new family doctor again tried a new muscle relaxer which might have helped but also put me to sleep so it wasn't a viable solution. Heat also relieved some of the stiffness but only while it was applied. I missed enough work to need a Family Medical Leave Act and Disability case assignment. I had x-rays and another MRI done so I could see a neurosurgeon in Annapolis to make sure my artificial disc was still properly in place. He confirmed that it was and that I could see a chiropractor if I desired to, but he thought it might be a good idea to get a couple flexion x-rays to verify the disc flexibility, which I did, and to see a pain management doctor about a cortisone shot into the disc above the artificial one. I consulted with the pain doctor who prescribed yet another muscle relaxer, which seems to actually lessen the stiffness without knocking me out. The locking sensation didn't go away, so I agreed to return to the pain doctor for the spinal cortisone injection. I have been missing more work because of this again so I hope the injection and the muscle relaxer does the job long term.

    We'll see how it goes on Tuesday.