CarolinaGurl's Butter Spray Diaries

No, I am not referring to the heart in my head that misses my husband (and man do I miss him) I am referring to my actual heart.

Most anyone who knows me knows I have had a rough year struggling with the recovery from my neck fusion surgery a year ago this March 12th (yeah!) and I am just recently back in the gym with any real level of commitment.  Since fat loss is at the top of my list right now and fitting into last years summer clothes is high on the list too, I figured I would go ahead and work on my cardio workout regmine (yes, inactivity breeds fat, in my case 14 pounds of it) and work in my resistance on a every other day basis seeing how my physiology reacts to each new addition to my schedule, so far so good with a group spasm here and there.

Anyhow, when I started back with the cardio two weeks ago I was praying I would make it through 20 minutes on the lowest setting. Progressively since then I have increased the time, the program and the resistance level.  So, now I am spend an entire 30 minute routine in the middle cardio range zone for my age (not in the lower fat loss range). I am completing the cross training hills program and I am now up to a level 5-6 in resistance!! 

What is completely weird is that I am sweating like a pig, which is actually a first for me. I read recently that peoples bodies change a bit metabolically each time they go under general anesthesia and since this was only the third time in my entire life (40 years now) that I had any sort of anesthesia I am wondering if that is why I am sweating so profusely now.  Well it really doesn’t matter because I am liking it. The great thing is that I am returning to my resting heart really quickly too for which I am grateful as heart disease runs in my fathers side of the family.  There is no heart issues of any kind on my moms side of my biology and I seem to trend healthwise more like her than him (thank you god!).

So…. now I am on the search for a workout computer and not just your average heart rate monitor. I want something that is geared more towards the cross training acpect rather than just cardio. I want to be able to occasionally do a resting phyiscal test as well as monitor when my body moves out of the fat burning realm and into the muscle burning stages during my workouts. I have been considering the Polar F40 or the Polar FT60 which are both compatible with the Polar Personal Trainer online training website. So if you have used either of these workout computers let me know as I am trying to make a decision on something that will be applicable to my training for a number of years in the future. I don’t want to "out grow" it like I did my little standard heart rate monitor I got four years ago.

So, as I said in the title of this blog "the heart remembers" and what a miracle it is too. Our bodies are amazing and their ability to remember a activity and adapt is a real testament to the belief system that there is an intellingent designer out there watching over us, and I would much rather belive that then believe that we are just biological happenstance.

My best to all, have a good workout and a great day!  ~Tyra

Yes you are some of the lucky few who will be able to see my new piece of permanent jewelry.  

This is way more constructive than a tattoo and this thing is like a naval ring times 1000! Not to mention exponentially more expensive to buy and more so yet to put in.  Believe you me you won’t be getting one of these on a whim on your next holiday vacation. (please don’t consider that a challenge).

But the sad thing about it is that no one barring Dr. Reuben and his OR staff gets to see it (   And as he broke it to me gently in our pre-op Q and A today the incision will be so small even he won’t be able to take a picture of it once it is in place. Bummer!

But that wasn’t the worst part of it. I was hoping that I would at LEAST have the opportunity to set off the beepers at the airport, but alas, no such luck.  

What I can tell you about it is that its 36 millimeters long about two centimeters wide with two long holes in it used to inject bone foam into the PEAK cage that will be taking the place of my discs. Then 6 screws hold everything in place and make the bond tight from front to back.

Now mind all of you that this is when my beautiful husband asked "do you have to drill pilot holes for those screws or do you just tap’em and Craftsman them into place?" I almost passed out. This just proves that no matter how cute you all think he is (and he is) that he is a MAN and he proved it for sure today.

Oh and by the way it is made 100% of titanium and I insisted that I at least get color choice on the screws, which just my luck are my favorite color, green!!

So you ready?? Here it is…….  Mine will be positioned on the bottom two vertebrae (not the one pictured but two more down)

NO PICTURE *lol*       spinal fusion hardware.jpg

On to the more serious note.  (okay serious but I tried to make it funny)

My surgery date is now for sure on March 12th at 3 pm EST and I will have an overnight stay that is unless I have problems swallowing which will land me one more night in the hospital on an IV of steroids for inflammation.   I happen to be a champion swallower (no laughs please) proven by my unforgiving love for brownies lately so I know I will be home on Thursday by closing time (mostly because there will be more brownies waiting at home for me).  There will also be a gym membership waiting for me too as I was just reminded by my husband.

The doctor said the following today:

1.     No work for at least the first week, this is non-negotiable.  

2.     After the first week I can do as much as I feel up to (I think I feel up to another brownie, be right back).

3.     I must wear the cervical collar for one entire week straight, except for sleeping (this poor doctor doesn’t understand that this was the contact sport that brought this about in the first place, actually it was my car accident.  Armin rolling over on my arm just brought it about more quickly).

4.     After the initial week of wearing the brace I should wear it anytime while working for the next 2 weeks (this ought to be interesting).

5.     I must also wear it anytime I am in a car driving or not for the following month.

6.     I must absolutely not drive for 10 days (as I could cause rubbernecking and thereby cause another accident) whether I am wearing my cervical brace or not, which I will because it is in the first ten days or rather refer to instruction 5.

7.     I am to wear the cervical brace not really to remind me of my physical limitations but for those around me.  Yes, this is to keep people from hugging me hard and then saying "so happy to see you made it through your surgery okay" afterwards which I am calling Reuben Spinal Specialists for another appointment.

8.     I will not have any pain in my arm and back anymore post surgery. So I will not be needing anymore Lyrica.  One word YEAH! Those $22.00 co-pays per week were beginning to hurt worse than my arm.

9.     I will only be losing approximately 10 to 15% of my lower neck range of motion, but more likely 5% because the injury is so low on my cervical spine. (this really makes me happy!!)

10.I am to have a good time watching movies and doing just about whatever I want in the week I have off (somehow I think sky diving is out and I know for sure driving myself to the sky diving place is too).

All kidding aside, as I have said before I appreciate all the wonderful support you ladies have given me over the past few weeks. I look forward to seeing you soon. Some of you sooner than others as I will need a ride to the movie theatre so you might as well come too.

My best to all of you, if you need anything from me or have any questions please don’t hesitate to give me a call, please. by day four I will be desperate for outside contact *lol*.

~Tyra

Hi everyone!

I have been wanting to write for quite awhile but haven’t had the ability to fit comfortly at the computer and gather my thoughts together enough to put into words what the last 14 weeks of my life have been like since the onset of my injury and the surgery to correct it.

Last week my beautifully supportive husband said in passing that he missed reading my body blogs and that I should get my thoughts together and start writing again because he was sure someone else out there was going through what I have and could either be a support to me or better yet I could be a lifeline to someone else. So, I decided that I would attack this story from the point at which I had my diagnosis and through to where I am now, nearing my release from PT sometime in July and looking forward to getting back to work someday soon.

I have decided to do this in three or four parts that way they are easy for you folks to read and digest and better yet easier for me to write as my body doesn’t tolerate sitting at the computer for as long as it takes me to write, rewrite and make any sense.

~Tyra aka CarolinaGurl

Well here I am 48 hours and counting till surgery time.  I am so anxious I could just scream.  I am so ready to be out of pain, I have never experienced anything as debilitating as nerve pain before in my life and I wouldn’t wish this on anyone not even my greatest enemy.  I am looking forward to having the feeling in my index finger back and being able to get through a day of work without having  to take half a Percocet every 6 hours. I am just joyful that I have good insurance thanks to my husband serving in the Marines making it possible for me to go to the best spine Doctor in the Southern region of the US.  I am also very greatful to my husbands command because they have given him the opportunity to stay home with me the first few days.  All the way around I am a very lucky girl.  I will write again post surgery and will post some pictures at that time although me in a cervical brace might just be more funny than pitiful.

Till then everyone, please stay healthy and lift big or go home!!

~Carolina Gurl aka Tyra

Well yesterday was a great day.  We (and I mean we) Me, Armin (my hubby) and Lee (my proxy mom) all had my pre-op appointment with Dr. Reuben. 

It is a good thing that Lee and Armin remembered all the questions that we had come up with over the past week because as soon as Dr. Reuben came in the room I got a case of the stupids.  I mean I went BLANK!  I am so in awe of this man that I just drew complete zippo out of my head we he asked “do you have any questions?” 

Since I had a lot of time on my hands this week I did quite a bit of reading up on my new Doctor friend. 

Here are his stats:

MD at Johns Hopkins University (Americas first research University) in Baltimore MD.

Internship at the University of Chicago, Pritzker School of Medicine Chicago, IL.

Residency at the University of Chicago, Pritzker School of Medicine Chicago, IL.

Fellowship at Emory University Atlanta, GA

Clinical Instructor in Spine Surgery, Emory University

He specializes in minimally invasive cervical spine surgery

And he has invented a number of now commonly used surgical implants for both the lumbar and cervical spine areas.

Wow this guy is really good at what he does! And he happens to get rated as having the best bedside manner at Beaufort Memorial Hospital year after year.

So once I got my voice back after being completely dumbfounded by his level of kindness and willingness to explain everything to us in detail we got down to the really important questions.

1.        What will be my total loss of ROM? (Range of Motion)

According to Doctor Reuben I because of where on my neck my injury is and his recommendation of a double fusion ranging from C5 to C7 I would notice maybe a 10 to 15% loss of ROM.  In truth I would notice it very little because it is at the very base of my cervical spine.

2.       How long will the surgery be?

The surgery from start to finish should be about 3 hours total.

3.       When mounting the hardware on the vertebrae do you need to drill pilot holes? (this was my husband’s “tool time” question).

Yes, pilot holes are drilled to prevent cracking the vertebra.

4.       What is required for my post op healing time table?

The non-negotiable amount of time to be off from work or lifting of any kind in my case would be 7 to 10 days. During this time I will be fitted with a rigid cervical collar, this collar is to be worn a minimum amount of time of 8- 10 hours a day.  Most importantly it must be worn anytime while riding in a car for the next 30 days.  I will not be able to drive for the first 10 days anyway so I am good on that anyway but have to wear it driving or riding it doesn’t matter.

The Doctor ultimately said that the cervical collar is really more for my protection from other people rather than the other way around. It makes people aware that they need to be a bit more aware of their proximity to me and to make sure they don’t squeeze or jostle me too hard cause they could very well hurt me.

5.       So, what does this thing you’re going to put in look like?

Once the Doctor is inside and has removed the offending discs he will place in the voids a PEAK that is sized for that discs spot.  A PEAK is a cage like form that is made from poly ethylene (much like PVC *lol*) and looks like a small frame work of girders. Once these PEAK’s are in place the proper amount of torsion will be placed on my neck compressing the PEAK’s, then six pilot holes are drilled, two on each vertebra and then the titanium plate is affixed.  Once this second step is completed the Doctor will take a little bit of biological “foam” and inject it into the framework of the PEAK’s. Once they are filled properly the operation is done and out the front of my neck they come. 10 days later the PEAK’s will be filled in with bone that is of my own making thanks to the “bio foam”.

6.       Can I have a picture of my plate when it is in?

The Doctor said “no” not because of liability but because he does all this work through an incision on my neck no greater than an inch and half!! So it would be pretty hard to see.  But if you look in my photos section of this site you will find a mock up of the surgery I am about to have and I have to say it’s pretty cool because the screws are in my favorite color!!

7.       Will I set off the metal detectors at the Airport?

The Doctor says sadly “no” (I am so totally bummed, what is the use of having a hunk of metal in you if you can’t have any fun with it?

8.         When will I be able to get back into the gym?

I can be back in the gym within 2 weeks for cardio and anything having to do with my lower torso. Sadly I will not be back in the gym lifting upper body as if I wasn’t injured for sometime. Dr. Reuben thinks that it will be 4-6 weeks before I will be able to do any serious lifting in my shoulders because the spinal fusion is going to really piss off the top origination of my Traps which attach at the exact location of my surgery.

But then again he says, I am in much better shape already than most people he sees so I could surprise everyone and not need any physical therapy (I will take it if it is offerd tho) and be back in the gym within a very short time getting ready to have a good bikini season. However, because of the necessary healing that will be going on in my body he doesn’t see me competing again until next spring, mostly because I will need my nutrition to stay stable so I can heal properly so no cut diet for me this year.  I am fine with that I guess since I don’t have a choice.

So folks, we are now on the one week countdown to surgery day!  I found out at my pre-op appointment with the hospital that because I have had a staph infection in my leg within the last three years that I will have to bathe with some especially nasty soap and I cannot do the cleaning myself, someone else has to do it as to make sure I do not re-contaminate areas that have already been washed with this icky stuff. Anyhow, that is how I am.  I am presently working on no more than two clients a day and the rest I of the time I relax and trying not to piss off my neck by looking too far up or too far down.  I am still taking 75 mg of Lyrica a day and am told I will not need it following my surgery because the nerves will be completely freed of the discs herniations.

Well this has been a rather interesting week for your intrepid whoops injured fellow body blogger.  O have cried a lot, laughed a lot and even been surprised once this week so this is going to be an interesting post.

Monday I finally got my referral the orthopedic/spine doctor and called to make an appointment.  The receptionist asked me a few simple questions and then told me their next available appointment would be the 13^th of March.  I asked the receptionist Colleen to please put me on the list to fill in for any cancellations or no shows because I could be to their office in 20 minutes if I drove like Mario Andretti from Bluffton because I can’t go much longer with this pain. 

At the mention of pain Colleen got really serious and asked some pain related questions, how bad 1 – 10, stationary or radiating and etc.  Then she asked me to call the MRI place and have my radiology report faxed over and that was the end of that. I called Belfair MRI and had them fax the report over and less than an hour later I had a call back and an appointment the following day. When things happened that fast I said to her “well I guess I’m not an Epidural and Physical therapy candidate huh? No, she said you’re not you are a surgical candidate only. It seems that the Doctor had come into the lobby to use the copier looked at my report and wanted me in right away. SHIT SHIT SHIT SHIT SHIT!!

So I call my husband on the phone at work and start crying as soon as I heard his voice.  He gets me calmed down and I am finally able to get the whole story out and he said “good we’re going to get some answers and action even faster than you thought, be happy not sad.” I had clients that day so I had to buck up and keep a straight face till he got home but again fell apart as soon as he walked in the door.

Fast forward to the next morning and we are running all over the house getting ready to go to the Doctor’s office.  I decided to wear my favorite sweater (since it was chilly) and a body shaper so they could look at me without me having to get totally undressed. Then we had the breakfast rush and zoom zoom over to Beaufort and we’re sitting in the office.  I had a ton of paperwork for fill out (lordy did I ever) and then off to the exam room.

Today we met with Dr. Reuben’s PA Michelle and god almighty I like her a lot!  She explained everything in such detail to us and answered every question we had about how, where and when. Michelle also explained that they knew for sure that I had one badly ruptured at C6 & C7 I also had one that was very badly herniated at C5 & C6 as well.  Michelle said that it was very likely that since I already had one rupture that the Doctor would get in there and want to do a double fusion because there is little that can be done once a disc is badly herniated.  She said that he would look at all the films when he got in that afternoon from surgery and then call me (yeah right doctors’ actually calling patients these days).

So, after she told us about the necessity for the double fusion I got upset because I thought I hadn’t taken proper care of myself she walked out got all the MRI films, came back in and showed me my spine and that aside from the damage to not one but two of my disc’s I was a picture of spinal health. I had no spinal Stenosis, great bone density and in her opinion I had the spine of a 20 year old not a 40 year old and this damage was unquestionably caused by my car accident and not something I did to myself.

Armin asked a lot of questions about how long would I been in rehab and how much range of motion I would be losing as a result of a double fusion. Michelle said that is it is usually a 10% loss of ROM per fusion, so I will lose 20% ROM in my lower neck which basically means I won’t be able to do the funky chicken dance anymore *lol* but I will be out of pain thank god. So off we go out to make appointments for surgery, pre op and etc and I am actually feeling much better about things and believe me any relief or elimination of this pain is just fine with me.

So fast forward to the next day (Thursday if you’re counting) and low and behold I get a call on the phone from Dr. Reuben himself!!  He tells me kindly that after considering all my MRI films and x-rays that he would like to proceed with a double fusion rather than the single because he believes in heading things off at the pass rather than going back into the spine again to remove a fusion plate and then have to put a larger one on to support a double.  I told him that I trusted him completely and that he is the professional and that what he says goes.  So now I have the pre-op blood work this afternoon and then my pre-op consult with the Doc this coming Tuesday and then my surgery on the following Wednesday the 12^th of March.

Post-op madness is I will be in a c-spine collar for 2 weeks and then I have to wear it anytime I am in a car, driving or not, for the month following the ten days. I cannot drive or work at all in those 14 days either so I am going to be just short of nuts by the end of those two weeks. People keep telling me they will come and get me and go to lunch or a movie so hopefully I will have SOME entertainment.

I will keep ya’ll posted in the days to come.

I have my pre-op consult with the Doctor on Tuesday the 3^rd so I will blog a bit about all that then. As of right now my pain level is at about a constant 7-8 since I cannot take any Motrin or Aleve two weeks prior to surgery, along with no caffeine either (this might kill me) but I do have the “good stuff” I just don’t like to take it because all it does is make me sleep and that is no fun.

Talk to you again soon, have a good weekend and be safe!

~Tyra

I had a reader write and ask if I was Tri-Care and had a referral now.  Here is the saga that I had to go through, don’t wince it does get better *lol* Now let me preface this story by telling you that when I was in San Diego I got the very best medical in a clinical type system that I have ever gotten in my life.  SDNMC was the absolute s**t!  They even did my knee surgery and did it beautifully.

But now we’re on the East coast on a small base with a tiny naval hospital with a lot of personnel and dependents so they are already out of their league to begin with because most would refer to it as being “an underserved area”.

Okay back to me.

Just before Christmas I threw my upper back out (it was my left Rhomboid again) and couldn’t move for the life of me. Went to BNMC ER and they took one look at me (didn’t touch me mind you) and prescribed 350 mg of Vicodin and 50 mg of Valium. Okay I am not a pill person so I called my sister a nurse told her what happened and she said Ice, heat, 800 mg of Motrin every six with a Prilosec a day and rest.  Wow can you believe that worked? No narcotics? Geez.

Fast forward to the LAST week of January.  My husband rolls over on my left arm in the night and I evidently pull and pull to get my arm out and finally really screw myself up because when I get up in the morning I am in PAIN! God awful grit your teeth, worse than childbirth pain.  So instead of driving all the way to BNMC ER we go to a wonderful local hospital ER (my sister works as a nurse here so I know it’s good) they run their hands all over me looking for swelling and decide they want to do an MRI but low a behold Tri-Care won’t clear it because it’s a weekend and I am not dying and can see my PCM the following week.  So frustrated they go the route of non-narcotic muscle relaxers, Motrin, rest, ice and heat alternating (this whole regimen is a real bi*ch when you’re a hair dresser let me tell you).

I was seen in the emergency room on the last Saturday of January for ten days I called and called to have a follow up appointment on the appointment line with my NH PCM and am told over and over she has no appointments available each day I ask for.  Finally I get so frustrated that I go to BNMC and present myself in the Dr’s office of my PCM demanding care and not really being all that nice about it at this point.  They say “who is your PCM Ma’am?” I say “Dr. ________” and the woman behind the counter says “Well she ain’t been here since the first week in November honey no wonder why you can’t get an appointment”. I about passed out right there.  So I ask to see anyone, saying I am in god awful pain for which I am taking only Motrin at this point and I feel like I am going to die crying every morning I get up. She replies “Sorry honey I don’t have anyone for you to see, Dr. _____’s replacement won’t be here for a couple months”.

So I go down to the Tri-care office and ask to change my PCM to an outside Doctor.  Tri-Care lady says “no problem we’ll get you a new doc right now, but you won’t be able to see them till after the first of March”.  At this point I don’t care I will do anything so I pick a Doctor after being on the phone with my sister the nurse telling her who is on the list. Then I go home and lie on the living room floor and cry because this my friends is the 10^th of February and I am not going to see a doctor for this till March. Never mind the fact that now ten days into this injury I can no longer feel my index finger, half the middle and half of the thumb web on my left hand, not to mention the pain that makes it feel like my muscles will explode and the bones are going to burst out of my skin at any moment.

So I go like this for another 10 days at which point I can’t take it anymore and call my best friend (also a nurse and a fellow military wife) for help and she says “call the patient advocate baby, she can do anything for you, Tri-Care bends at her will”. So I call the advocate and tell her what is happening and in the process burst into tears and can barely talk anymore because I am crying so hard with the on rush of so much frustration and pain.  Well my girlfriend wasn’t kidding. Thanks to this patient advocate it was now the 21st of February and I was in the doctor’s office of the doctor I chose two weeks ago being seen.

So we run through the battery of neurological tests, I am going to: press down on your arms, try to pull them apart out in front of you… etc. I walk out of the Doctors office with an Rx for two weeks of Lyrica free thanks to the manufacturer and a referral for an MRI which my sister is able to fast track for me because “she has people” and I am in two days later for that. 

And now you are up to date on this circus called Tri-care medicine.

Here is my soapbox moment:

It really makes me shake my head that there is ANYONE out there that wants the entire country to have to go through this kind of crap with a nationalized clinical health care program. You are more likely, like me, to fall through the cracks and not get any treatment for weeks when you are subject to a rotating clinical system.

Ask anyone in a rotating clinical setting like MediCal or better yet being in the VA medical system or at Walter Reed in DC while still on active duty what it is like to fight for every appointment, procedure or any ounce of help you get, throw on top of that the fact that you are also sick while you’re fighting for your medical needs. Oh and if you’re in a rural “underserved” area like we are here in South Carolina, plain and simple, you’re screwed because there is no doctor for you.

Our health care system in the US may be broken, but it can be fixed we don’t need to go to nationalized care for everyone, it’s not the answer.

Well they say that when you go looking for answers you will find them and in the meantime probably bang your head against a few walls and doors in the process.

First up, I have the slowest PCM office on the face of the earth.  We are talking two doctors in one office neither of which have a full patient list. They got the radiology results last Friday by the middle of the day and didn’t call me until 5:30 this evening to tell me that they will be referring me out. Can I get a hell yeah! thank god and pass the ammunition?

Don’t get me wrong, I am not calling my doctor a moron. I am just saying that if he were in this kind of pain, nerve pain mind you, the kind where it feels like your skin is melting off and your bones and joints may explode at any moment… you can count on the fact that he would be movin’ a lot faster than he is on my case.  I guess I should be grateful because at least I have medical insurance, but then again ours comes at the price of my husband having to be gone from me for 6 or 7 months at a time so I think it is a crap shoot on which is worse in my book.

So on to the dirt everyone wants to know instead of my rant is this. It appears and I truly mean that it appears on my MRI that I have a C-6 and C-7 impingement of the radial nerve branching to my left arm which is good because then I would really write and cut hair like a alcoholic with the morning shakes *lol*

So what is the resolution to all this? That is the 5 million dollar question. I will be seeing a spine specialist this week or early next week sometime.  As of right now the stated course of action for something this “minor” (to whom I don’t know) is either a corto-steroidal epidural and that’s it, or the combo of the epidural and physical therapy.  The latter is definitely what I am shooting for as any time in any gym is fine with me and if they can help me to strengthen the fine muscle grouping that will prevent this from happening again then Woooooooooooooooooooo Hoooooooooooooooooooooooooo!!!

So I will keep ya’ll posted on the info regarding my pain in the neck and no not my husband, at least this week.

Happiness is warm muscles!  ~Tyra