update #8: the war on back pain

Time for another back pain update (and another cute cat picture). This time it's good news.

This week I went for a diagnostic procedure called lumbar medial branch block. The purpose is to determine if my pain is coming from any of the nerve branches coming off the facet joints in my spine. They inject an anesthetic around the nerve branches at several vertebra levels. If the pain stops, then my pain is coming from those joints and I'd be a candidate for radio frequency nerve ablation, which basically kills or "fries" the nerve. If the pain doesn't stop after the branch blocks, then that's not where it's coming from and there's no sense in trying the ablation.

So I went in for the procedure on Monday. It was pretty much the same as when I went for the epidural cortison injections: no NSAIDs for five days before the procedure and nothing to eat or drink four hours beforehand. I had to lay face-down on the table and they used fluoroscopy to guide the needles to the injection sites in real-time. A numbing agent was injected at each site and then they did eight injections–four on each side of the spine (L2 through L5). There was some discomfort, but it didn’t hurt anywhere near as much as the epidural cortisone injections I had earlier in the year. I was instructed to do home and do all the things that would normally aggravate my pain, which is easy since sitting is what causes it for me. That, and standing in one spot for more than 10 minutes or so. I was out of the office in 20 minutes, measured from the time they called me from the lobby to the time I left. I had to keep a pain log for five hours and report the level of pain and the percentage of improvement.

I sat at my home desk for FOUR HOURS mostly without back pain. That’s huge for me, because normally I'm starting to hurt after about 10 minutes or so. My hips and upper legs ached from sitting from so long, but there was almost no back pain. When I got up from my desk for the bathroom and a few other things, I actually felt the sciatic nerve pinching every time I took a step with my left leg, but didn’t feel all the other pain I normally feel. I guess the pain coming from the joints (and not knowing it) kind of skewed how I was feeling and I just assumed it was all from the pinched sciatic nerve. The anesthetic wore off by Tuesday night, which is what is supposed to happen, but it was a somewhat blissful couple of days!

I went into this without really any hope that it work since other things haven’t worked very well up until now. Well, it DID work! It also made me realize that I have pain not only from that sciatic nerve, but from the joints as well. Overall, I would estimate I got about a 75% reduction in pain.

I go back for my follow-up in a couple weeks, so I plan to tell them I want the ablation. I'm wondering, though:  how do they know which nerve to kill? They did eight injections spanning the L2 through L5, so how would they know which one to kill? Do they do another branch block procedure for only certain areas? Guess I'll find out in a couple weeks!

happy thanksgiving!

Happy Thanksgiving, everyone!

Aside from that, this post is an excuse to show off my contributions to today's meal:  pie and brownies!

This pie is one I've never made before and I got the recipe from the Pillsbury website.  Here's the recipe:  Almond Macaroon Cherry Pie. The only thing I did differently is I made the pie crust from scratch. (Yes, I'm showing off just a bit...) I can't comment on the taste since it just came out of the oven and is screaming hot. Plus, it's not for my house anyway. But really, how can one go wrong with cherry pie? Not possible!

I also made brownies from scratch. It's not difficult at all and really not much more effort than using a box mix.  I use the King Arthur Flour recipe, which you can find here (the newer version):  Ultimate Chewy Brownies. It's pretty much a no-fail recipe and the brownies are truly chewy with a crackly crust and they're not super sweet, which is why I like this recipe so much. This time I added 1/4 tsp of espresso powder to boost the chocolate flavor. It's not necessary and I normally don't add that, but I have a new canister of espresso powder and figured I'd try it out. It was a definitely a good call! The brownies had an even deeper chocolate flavor than usual.

A note about the brownie recipe linked above:  This is not the recipe I downloaded years ago. KAF has changed it a bit from what it used to be. Below is the actual recipe I use. The difference is that the newer recipe calls for a 9x9 pan instead of 8x8, "baking cocoa" instead of "cocoa powder" (I checked and they are actually the same thing), and adds the optional espresso powder. Also, I DO NOT use Hershey's Cocoa Powder for these brownies. I'm a total snob when it comes to cocoa powder for baking purposes. I find that Hershey's gives this particular brownie a different texture and it's not quite as chewy. I typically use Aristocrat cocoa powder made by Wilbur Chocolate.  It's a highly alkalized dark cocoa power with 22%-24% fat. I can only find it in-person at a particular candy store in Lancaster, PA, so I stock up when I visit my cousin. (You'll see at the link that it's sold in a 50 lb. bag, which is a bit too much for my needs!)  But if you want to buy online in a normal, home cook quantity, I found it on Amazon (of course!).  I also have used natural cocoa powder interchangeably and it worked perfectly fine.

The recipe below is the exact recipe that I use from the KAF website . You can see at the bottom it's from 2002--ancient times!


      King Arthur Flour's Ultimate Chewy Brownies

        3/4 cup unsweetened natural cocoa powder
        1 stick margarine, melted and cooled
        1/4 cup vegetable oil
        2 cups granulated sugar
        1 cup King Arthur Unbleached All-Purpose Flour
        3 eggs
        1 teaspoon vanilla (or coffee) extract

      Combine all ingredients in a bowl and mix well. Spread mixture in a
      greased 8 x 8-inch pan. Bake at 325°F for 35 to 40 minutes. Remove pan
      from oven and cool for at least 3 to 4 hours, or overnight, before cutting
      and serving.

      Copyright 2002, The King Arthur Flour Company. All rights reserved. KingArthurFlour.com

my latest tag sale finds

Twice a year the Stratford Cat Project, a cat rescue with which I volunteer and where most of my kitties have come from, holds a huge tag sale.  Proceeds go towards helping pay for medicals costs, supplies, etc.

I typically stop by later in the day to help pack up and transport boxes back to the storage unit. Before doing so, I walk around to see what kinds of things I can buy. Typically I'm looking for cat-related items (surprised??), such as pictures and statues.  The statues I use as garden ornaments and grave markers for kitties that have crossed the Rainbow Bridge. I also like to put the statues on the landings outside my front, side and back doors--people need to know a crazy cat lady lives here. I also look for other decorative items that might be somewhat of an antique, but those are few and far between. I also grab books to put in my spare bedrooms for when people stay over. I don't know if they read them or not, but I'm prepared!

Our last tag sale was in September and these are the items I came home with. I haven't found spots for everything yet, but I'm working on it. The house is in a bit of disarray at the moment between laying down the new flooring, putting up the remaining curtains that I bought months ago, and cleaning up in general.

This one reminds me of my mom's cat, Missy. She was a tuxedo cat and kind of a crabby diva, but we loved her. I'm thinking I might re-frame this one, since I'm not thrilled with the frame itself.

This would probably look nice across from the front door, but I haven't decided yet.

This one is my favorite and it's pretty big, although you can't tell in this picture. But below you can see it in it's chosen spot.  I got the desk at the local antique store for a really good price. It's late 18th century/early 19th century. The primitive bowl on top is from the same store, and I got that for less than $10.00. Got the wooden spoons there, too. (I LOVE wooden spoons!)

life lately

Time for another update on life since I couldn't come up with anything interesting to post about.  I lasted posted a life update in July.

Cats

Leia had to go to the vet this week. She started showing signs of a urinary tract infection:  frequent litter box usage, only peeing a little each time, taking a long time in the box, licking. I brought her in and it turns out it's not a UTI. They think it's stress-related, but took a urine culture just in case. She has to have prescription food for awhile and we'll see how that goes. They're a little concerned because the original sample, the one they tested for infection, shows that her urine is a bit diluted. I'm hoping they don't say she has kidney disease. They gave her subcutaneous fluids and sent her home with pain medication. She stayed in the bedroom for awhile so I could monitor her litter box usage (with 11 cats, it's difficult to know who's doing what and when). She seems to be doing fine now. I haven't yet received the results of the culture, so I'm hoping nothing else comes up.

Car

Someone hit the back of my car in a parking lot and took off. I've had the car for less than a year, so I'm pretty annoyed. There goes my deductible! Since the paint is damaged, I had to fix it so it doesn't rust or get worse.  I don't understand why people do things like that. I'm guessing they know they won't get caught and are counting on the fact that it won't be noticed right away. And they're probably uninsured, unlicensed, or both. Anyway, it's fixed now. I guess the one bright spot is that the body shop washed my car, completely detailed the inside, and inflated my tires, which were a little low.

House

We're currently in the middle of putting down a vinyl plank floor in the family room. It wasn't planned. We just decided that since we had gotten rid of the couch and hadn't yet replaced it, why don't we tear up the (very) disgusting carpet and put down either laminate or vinyl?  So we ripped it up and, yes, it was really gross. I mean, I've got 11 cats and it's also a high-traffic area of the house. Bob has been working on laying the new floor down this week, but we'll probably spend part of the weekend finishing it up.

The hard part is working around the hatch in the floor, which is for the well. Yes, our well is under the family room. Our house was built in 1735 and the well was outside at that point. At some point in the early 1900s (we think), the family room was added. Rather than connect to the city water, the home owner decided to build an enclosure around the well and put a hatch in the floor so it can be accessed. Brilliant...not! Sure, it's cool to look at, but it's going to be REALLY expensive when the time comes to replace the well pump.

Here's the hatch in the floor.

And here's the well. Pretty amazing, isn't it? It's hard to believe this was dug almost 300 years ago with hand tools, and it's perfectly round. You can see how far down the water is. 

Back Pain

Last time I updated I mentioned that I wasn't doing anything else for awhile since I'd reached the limit of epidural cortisone shots I could have  in nine months. Now that summer is over, I've scheduled an appointment to see about getting them again. Even though they didn't last more than three weeks each time previously, it was still a great help when it came to sleeping.

Sleeping seems to be the biggest problem for me, mainly because, well, I need to sleep. When I'm sore from sitting (and sitting is the thing that causes most of the pain), I can just get up from my desk, the couch, whatever and walk around for awhile. I can't do that when I'm sleeping. I mean I could, but then it would take me awhile to fall back asleep and I'll end up more tired the next day. My standard practice at the moment is to take half a Tylenol PM and either one or two regular Tylenol at bedtime. I substitute half a Percocet for the Tylenol PM if I really need it, but I try not to do that since I sometimes feel hungover the next day. I'm getting really tired of taking pain medication every single night, so I'm thinking it's time to do the shots again, even if I only get limited relief. I'm also worried about my liver with all the acetaminophen, even though I take about half the daily maximum dosage. 

I'm trying to put off surgery until I get to the point where the pain stops me from doing certain things, like working out. I'm not at that point yet, though that could happen in the next year or two. 

Work

I mentioned in my last "life lately" post that my company was acquired. I've since learned that my job will end towards the end of February, so that means another job search. I'm actually not upset that I didn't get an offer from the acquiring company; I know many people that have worked there, and there's a reason they left.

It's a little too early to start searching, but I look everyday just to see what's out there...and there's not much. I'm thinking I may want to change industries, as I've been in the same one for 22 years, but that could mean a pay cut that I really can't afford right now. Lots of people have been telling me to "think outside the box" and that sounds good right about now. I'm someone who needs change, so going into another industry could be the shot of excitement I need, career-wise. It's scary, but exciting at the same time to think I could be doing something quite different this time next year.