Begin Again

Whereas Natalie drew shapes and traced endless, winding paths, I can only spell. I write my name with hers, in cursive and in print. I describe the places we visit and how we feel when we leave. I learn by her breathing that she likes most the faraway foreign lands with long, unfamiliar spellings. And I conjugate the new words I learn, ‘J’adore, J’adore, J’adore.’

My new-kid-in-town crush passed away last week, just as I was getting ready for back surgery. I had written once about her, and I suppose had mentioned her out loud. My wife remembered me telling the story, how she had sat behind me in French class, drawing on my back with the end of a pen, and how the next quarter, when I was seated behind her, had demanded I do the same. I saw some brief announcement online, and searched her obituary. It was odd in that the photo shared with the obit was her high school photo, so there she was looking exactly as I remembered her the last time I saw her, over 25 years ago.

This back surgery has been years coming. I've typically avoided doctors, to the point where I hadn't realized my primary care physician left the country last year for Australia. He was my doctor for 10 years, maybe more. I think I saw him 3 or 4 times. Once for a broken leg. I've been dealing with lower back pain going back to 1999 or 2000, but last summer the episodic bouts took permanent residence, and by fall I was diagnosed with arthritis and set on a regimen of physical therapy. Ever since a new year's eve fishing trip, however, I have been disabled, to the point where I could not walk nor stand more than a few minutes.

Alex turned 40, and I surprised her with a first class flight to the Bellagio. But unable to follow her around the strip, we decided enough, and determined to see a specialist. I did slip in a ski trip to Mt. Bachelor, and while I was able to manage the slopes, each night was misery. The consulting doctor ordered an MRI. I have an extra, malformed vertebrae, the disc of which had collapsed and was situated on my sciatic nerve. He scheduled a TLIF procedure, where they lift the L6 off the S1, remove the disc, replace it with a bone-graft cage, bolt the vertebrae together and hope the whole thing fuses after 6 months.

Anyway, back to Natalie. I was able to get the story from the one person I still have contact with from my high school, who had been lifelong friends with Natalie. About 8 years ago, Natalie had gone in for a minor procedure, later became ill, fell and wound up in the hospital. Shortly thereafter, she had a series of strokes, which would leave her in a vegetative state. Her parents kept her on life support thereafter, praying I suppose for some miracle.

I am not going to get into the politics or religion of the matter, but I did make sure Alex knew exactly where to find my living will before going under the knife. Now that she knows, of course, I'm cautious about taking extra long naps after pissing her off. I'm no fool.

Minimally Invasive Transforaminal Lumbar Interbody Fusion

The first thing I noticed about the surgeon when he recommended surgery was his boots. And I noticed that every time I saw him, he had a different pair of very nice boots. I think when you are evaluating a surgeon, you should consider the following:

1. Recommendations from people you trust
2. Your gut instinct
3. The value of their footwear

Honorable mention: YELP (just kidding)

The boots thing is important, as I'll explain in a moment.

After recommending the surgery, I navigated our health care system, which primarily consists of insurance companies trying to get someone else to pay for the surgery your benefits cover. After two weeks, I gave up that the surgery would ever take place, and then got a phone call saying it was approved and could I come in next week. (BUT THAT'S TOO SOON, I almost said).

It almost was too soon. Fortunately, as my wife works in the health care system, she seems to understand it, and I was happy to turn this aspect of my life over to her. It was a little strange being her patient (she ran x-rays of me), and maybe it's always a little odd seeing your spouse in her work environment, being professional and knowledgeable and intimidating, and the whole time you're trying to remind yourself that this is the same person who watches reality television in sweat pants stolen from a homeless shelter.

It was almost too soon because I got sick. At first, I thought it was kidney stones. It was the same sort of convulsive, peristalsis that utterly paralyzes you and leaves fist prints in the linoleum. I'm still apologizing to the kids for the profanity. It was instead a bout of epididymitis, and absolutely, gut wrenching, nauseatingly brutal. I actually refused to go to the ER, but by the next day, my wife forced me to see a doctor, who put me on antibiotics and painkillers.

Nevertheless, the surgeon said I was still on. (On a positive note, all the illnesses forced me off of alcohol, cigars, supplements, ibuprofen, etc. - which are apparently taboo with the lumbar surgery route. I've been clean and sober for longer than I care to remember.)

Between prepping the house and buying a rollator (cherry red, soft top), bed-desk, shower stool, toilet seat elevator, and catching up on work, there really was absolutely no time to contemplate the surgery itself. When people talk about dying in your sleep, I think about general anesthesia. It's just sort of creepy. There's no dreaming, no time, just this abyss, and whenever you return from this place, you bring nothing with you. I did, for some reason, watch several videos of the TLIF procedure on Youtube, which is akin to watching plane crash videos prior to a cross-country flight.

Still, by Monday, when I had a serious of pre-op visits, I hadn't really thought about surgery. And to make matters worse (or better), my wife overslept the morning of my surgery, which means I was late, and when I'm late, I'm angry and irrational, and maybe she did it on purpose, because one moment I'm pissy and the very next, I'm getting hugs and kisses from her and my parents, and I'm sitting in a hospital bed talking with the surgeon.

And of course, he has on a different pair of boots. And instead of thinking about the fact that in a few minutes, I'm going to be floating in the abyss while this guy cuts open my spine, I can't help but be fascinated with the guy's shoes. So we talk about how he gets a custom pair made each year (he had once tried to get rhino skin boots, but yeah, no) and later on my wife comments that the guy has a reputation as being aloof and impersonal, but for some reason really opened up with me, and I'm like, TALK ABOUT A MAN'S SHOES.

I'm being wheeled through the surgery center, and there's people all around me, taking vitals, starting an IV, and this anesthesiologist puts a mask on me, saying, it's just a little oxygen, which is a lie, because that's the last thing I remember (IT WAS DRUGS).

When I woke up, my wife and mom came in and then the physical therapist, and they got me on my feet and walked me to the private recovery room, where I gorged on ice cream, soup and sprite for three or 4 hours. And then they said, 'WELP, TIME TO GO HOME.' So we went home that same day after back surgery. Science is amazing.

I wish I could say that the next day I was already back on the running trail, but between back spasms and gastrointestinal swelling, wound up in an ambulance. After a modification of the muscle relaxant, a bottle of magnesium citrate and a dose of suppositories/enemas (my wife and I will be divorcing upon my recovery unless I am allowed to get even), things were back to normal soon. I've walked a mile and a half each of the past two days.

Prior to the surgery, I kept telling myself to try and remember the pain that had brought me here. I can barely do so now. It's hard to describe what my life had become, my leg and back consumed my existence. At the end, it was impossible to sleep more than a few hours, and if I was lucky, I could find a position on my side, one leg curled up to my chest, where I could almost remember what it was like to feel nothing.

All of that is gone. I can almost imagine lacing up my running shoes again. Hiking. Standing up straight.

Two nights ago, my brother-in-law's mom passed away. I have been adopted into this particular family over the past 15 years, and they are dear. My brother-in-law shares a birthday weekend with my daughter, and we had just spent some time together in celebration. Alex was able to go to the hospital, though it's still difficult for me to get around. The 8 brothers and one sister were also faced with the prospect of keeping her alive artificially. They made the best call and are heartbroken.

It has been a strange year. In the process of reading through past blog posts looking for the piece I wrote about Natalie, I wound up seeing a glimpse of myself for a fairly long period. I had always thought that writing would help me grow, but in a lot of ways, it also kept me locked into being a particular person. It's hard to recognize that individual now. (For the record, I don't dislike him, and I think we often look back in judgment).

I have a few more days of recovery. And then I get to begin again.