Trade-Off

So it's official.  Surgery.

 Adolescent. 
     A little over six years ago, I couldn't see doctor often because I lacked medical insurance.  Furthermore, the doctor I did see, along with my mother, always got mad at me for terrible posture.  I never understood why, but I just couldn't sit up.
     People would always say things about how my back curved when I sat on the ground.  It was something I was very self-conscious of, yet I thought it was terrible posture.  Mothers would notice and tell their children to straighten up.  Okay, so that happened last summer at Disney World, not when I was younger.  Or I didn't notice it as much when I was younger.
     I started feeling pain a little after I lost Mom.  I went to a chiropractor who told me, at 14, I had four curvatures in my back.  Scoliotic and Kyphotic curves.  And all of these vertebral subluxations, whatever that meant.  Clearly I couldn't afford the weekly visits, but I didn't mind.  He seemed too touchy anyway, and very creepy...and wore those weird Hawaiian shirts.  Again, I was young.  I'm not sure how I would have viewed him a little older.

High School Teen.
    I dropped a lot of weight extremely quickly with a lot of stressful events and very little food to survive on.  I learned to ration my food and somehow managed three meals a day, but I was still very, very thin in high school, over 50 pounds fewer than I am now.  I looked like an emaciated child from a third world country.  Therefore, my back was hardly an issue.  It wasn't heavy; and people didn't really notice, until I bent down to pick something up.  I did band; I did show choir. I was fine.
   Towards the end of my senior year, the pain started coming back.  I had trouble sitting up straight or sitting for more than half an hour.  I had trouble lifting my arms above my head.
   I visited a neuro/spinal surgeon.  He examined me, looked at my x-rays, and he diagnosed me with Degenerative Disc Disease.
   The more I read up on it, the more it hit me.  How did I get it so young?  I worked through it though and did all the physical therapy he prescribed, as well as his recommendations for swimming 45 minutes a day.

Early College Years.
    Freshman year of college.  Arrived much too quickly.  Went by even faster.  I spent long hours studying, hunched over the desk or on the floor.  I no longer had band or show choir to keep me active.  But somehow I managed to continue my physical therapy and exercise.  Swimming an hour, cardio an hour, stretches and ab work to keep my lower back strong, I managed it all.  But the pain just got worse.  I returned to the doctors.  This time, one at Duke hospital, a physiatrist.  This time, my curvature had increased to almost 80 degrees, around 79.6 and a little room for error.  He set up more formal physical therapy.
    I went back to him.  He sent me to a surgeon.  Dr. Fitch.  Clearly, surgeons don't have the best reputation for bedside manner, nor do they really give you a thorough understanding of how to approach your situation without surgery.  Be more active.  My eyes filled with tears.  Be more active?  On top of the three hours I was putting in a day?  That's it?  I guess deep down, I hoped for an answer to the pain.
    My primary care doctor told me, "Esha, you have to make this a priority in your life.  You know, for example, people with fibromyalgia spend a large majority of their life taking care of their chronic pain.  It's just something you have to learn to live with."
    I didn't know how to respond and left.
    At this point, all I wanted was a regular life.  I wanted to be a college student.  It was enough not having parents or a home.  It was enough with the PTSD symptoms and the other health problems.  Why did I have to make my back a priority?  I wanted to go to med school or dental school.  I wanted to learn and be able to perform to my full potential.  Yet, I was constantly being pulled back.

    On far too many meds, I was able to gain weight and look more healthy.  I started feeling better about how I looked, yet the curvature seemed to be more pronounced.  I noticed my clothes begin to look strange on.  Everything I tried on made my back look terrible.  Self-consciousness came back.
    Summer after Freshman year I added a new medication, the worst one, Effexor.  I lay in bed all day long and couldn't do a thing.  Immediately gained 30 pounds easily in fewer than two months.  I was crying all the time, sleeping all the time.  I think I got out of bed once a day...maybe a couple of hours.
    Sophomore Year of college arrived.  At this point the pain became unbearable.  I started feeling like someone was stabbing me all the time when I was sitting.  When I lay down, I felt shooting pain in my lower back because it wouldn't touch the bed.  Towards the end of the year, I got to the point where I just wanted to cry in every class because I was in intolerable pain.  I had been prescribed strong pain meds for years, but it wasn't helping at this point.  I went back to my physiatrist.  Rib damage.  (something very common with this condition.  At this point I was also diagnosed with Scheurmann's Disease.  And the lumbar degeneration, height loss, all that good stuff.  Mind you, I'm am 5' 11."  Maybe the height loss wasn't so bad.  haha. 
     He gave me an epidural steroid injection.  It didn't help immediately, but I noticed later that day, I started having chest pain.  It was a Wednesday.  Thursday it was worse.  My chest pain struck when I tried to work out.  I stopped and realized something was wrong.  I needed a few days off working out.  Friday the pain in my chest was worse than the pain in my back.  And by Sunday, I couldn't breathe or swallow.  The paramedics came, and took me to the emergency room.
   For about fifteen hours, I waited for results.  All kinds of tests, and nothing was found.  They discharged me around one in the morning.
   The next day I was called and told the residents misread my x-rays, and there was air escaping one of my lungs into the chest cavity.  Pneumomediastinum, they called it.
   The injection had punctured my lung.

    Plans put on hold, I finished classes and exams a little late.  Duke in Australia had to be put on hold.
   I spent the summer doing my dental internship.  Nine hours of standing did no good for my back.
The pain got worse and worse.  Nothing helped.  I tried it all (except never again will I get a steroid injection)..heating pads, icy-hot, pain meds, being active..or trying.
   It got harder and harder to be active.  And I've been the girl who can't sit down and watch TV.  I love dancing, running, exercising...
   My hours turned into fewer than ten minutes.  All I could last.  The good news: my pneumomediastinum had resolved.  

Now.  Junior Year.  
    At this point, I realized my focus was gone.  My studies were the last thing on my mind.  I couldn't read a paragraph and remember what it said.  Depression hit once again, along with panic attacks, and even worse pain.  I couldn't do a thing.  Oh, and I was only taking two classes as a medical underload.   I was beginning to doubt my own ability to be a student. 
     Someone suggested medical leave.  
     I requested to see a spinal surgeon again.  With the help of a couple of my other doctors, I was given an appointment with the head of the neurospinal surgery department at Duke.   
     Showing me cysts, worn out discs, Shmorl's nodes and a few other medical things, he agreed to give me surgery.  
     Mixed emotions.  What was I looking for?  At first, I was enthusiastic.  I could decrease the amount of pain I am in.  I could lessen the deformity.  I know... I'm self-conscious about it, while many people don't notice. 
    I am soon taking medical leave from here.  I don't know where I'm going or what this waiting time will be like...all I know is I struggle sitting, exercising, standing, and breathing...I just want my life back.
 
Reflecting.
    I began thinking of how different my life would be with my mother still here.  I wouldn't have health insurance, nor would I have thrown myself into my studies through highschool, and therefore, would not be here at Duke...  Duke has provided me with the healthcare I would have never gotten.  They have given me the security of never going hungry.  They have given me an environment full of people that touch my life in ways I could have never imagined.  Not that my mom never wanted to give me those things, but because of my father, she was never able to.  I've come to love Duke. 
     But all this for the most valuable person in my life.  My mom. 
 Some trade off, huh?