Spinal stenosis is a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. Spinal stenosis occurs most often in the lower back and the neck.mayoclinic.org
At five in the morning Friday, after an evening spent feasting with the same three people that I’ve been COVID quarantining with since March, them drinking champagne, me drinking water and hoping to be able to empty my bowels later (a generally empty hope as it was that night. Alcohol causes constipation, something on the avoid list for those of us who have issues with our guts) a late night spent watching television in an all-to-rare showing of familial appreciation, I was woken from a rather weird dream in which I could hear animal noises coming from a nearby set of bushes, only to discover that the weird noises were the Wife trying to get up off of the toilet and failing to be able to manage it, try as hard as she might.
Spinal stenosis has been having its way with her over the last few years, and it has caused her to become a frequent visitor to pain specialists as they try to address the various pain complaints (neck, back, feet, knees and legs) that seem to crop up at almost random times and places. The last visit to a pain doctor for treatment was a few days ago, and we thought she was heading into a more lengthy period of being free from the daily grinding pain that Spinal Stenosis inflicts on her.
With a little coaxing I was able to help her get moved into a chair in the next room, but it was clear to both of us in a very short time that we were going to have to transport her to the emergency room in order to get the problem diagnosed and addressed, because the pain that had started bothering her as she and the Daughter were preparing pies and cooking ham together was simply getting worse with time.
The problem she was having did not appear to be related to the recent treatments, but the only way to be sure was to bundle her up and take her to a doctor. So at six am amidst the Black Friday sale desperation visible at every shopping center we passed, I drove her to the ER of the hospital that we seem to be spending more and more time at these days.
With masks in place and temperature checks passed, we were ushered into a private space where the nurses and doctors popped in and out and over the next hour or so, until they finally agreed on the pain meds they wanted to try out. The problem here is that most of the pain meds that have been made available over the last few decades don’t seem to work well for the Wife, and most of them are also extremely addictive with some severe side-effects to boot. She has some preferences for older pain drugs, but those drugs are interdicted as barbiturates or some such, and so you have to pull teeth in order to get a doctor to prescribe you any of them. But those drugs do work, if you can get someone to give them to you. The emergency room doctors will not be doing this. They’ll try some other new drug, one that isn’t already deemed bad for some reason or other. It was a new drug, so we figured why not?
Then came the attempts to get an intravenous tap into the Wife’s veins. This is always a hit and miss process with her. Very few nurses seem to have the skill to get a needle in one of her veins. After a few tries the nurse dragged in an ultrasound machine specifically set up to help nurses with people like the Wife , people who don’t want to give up their secret blood supplies to interlopers like medical professionals. It was a cool gadget and with it she was able to hit a vein with the least amount of trouble I’ve ever seen in the many times I’ve watched them try to get a needle in that woman.
With the IV in place they could finally do the thing they wanted to do, and they gave her the pain medication she needed. Her blood pressure receded from the scary levels it had been at up to that point, and she finally started to doze off, only occasionally being woken by the alarms that seemed to go off every time she fell asleep. Heart rate too low, blood oxygen too low, whatever. After this had gone on for awhile, the nurses came back in and hooked her up with some oxygen and gave her a second shot, and at that point she actually slept for a bit.
Hours had passed by then. As I sat there in my mask trying not to touch anything other than my phone, I marveled at the hectic non-stop activity all around us. City hospitals are always a little busy, but I’ve never seen the kind of activity that was going on during that morning. Signs of the long pandemic we are suffering through were everywhere. Plastic sheeting hastily taped up to partition the various spaces that used to be simply curtained off. Masks, face shields and gloves were in place for every person who wandered in and out of the room, including the janitorial staff. The room next to the Wife’s was filled and vacated three times before we left there sometime around noon. Everyone looked tired and stressed, and I wondered if we really should be taking up these poor people’s times with some simple pain complaint that seemed almost trivial in that time and place.
The Wife was sleeping, which was all I really cared about. Sleeping, when she hadn’t been able to sleep at all before that point because of the constant pain. As I mentioned, they discharged her at about noon Friday. We got back to the house and got her into bed, and she promptly passed back out again. The pain doctors are all on holiday, of course. None of them will be available for consultation again until Monday. In the meantime she needs pain medication to keep the back pain to tolerable levels, and none of the pain meds that are commonly on offer do anything to help her with the pain she is experiencing. The ER doctors got her pain to recede enough that she has limited mobility again but they didn’t have any medication to send home with her.
The Wife has to be able to walk in order for her to to get around inside our house. It is an older two-story home, and it simply isn’t set up for wheelchairs or even a walker to work inside of it, even if she stays on the first floor. She can barely get around the house on crutches. Luckily we had some crutches that her father bought her after she injured her leg in high school and that we have never let go of since then. If we hadn’t had those crutches we would have had to call an ambulance to even get her to the ER in the first place, and she wouldn’t have made it back into the house when we were discharged and sent back home.
One good thing that the COVID pandemic has done is allow telemedicine to gain traction in society. Leaving the house is an invitation to get infected, and so talking to doctors via video chat makes it possible to see a doctor without having to sit next to sick people for several hours at a time. We managed to get a telemedicine appointment with or general practitioner on Saturday morning. That is the miracle of telemedicine. Seeing your GP for a few precious minutes on the weekend in order to get you some medicine that you need so that you can not be enduring constant pain for three days waiting for the specialist to get back to you about this problem that just might kill you with pain-induced stress. With the desired prescription winging its electronic way to the pharmacist, I can finally rest easy knowing that the Wife will not be in constant agony over this long weekend.
The insane war on drugs goes on, though, and its victims are people like the Wife who cannot get pain medication because every medication that works for her chronic pain is a medication that every doctor can get in trouble for prescribing too frequently. Pain doctors are the targets of convenience for these stupid government drug crackdowns because obviously you go to a pain doctor to get your pain meds. That is what a pain doctor is for. To help you alleviate your pain. Sometimes the drugs are required and when they are required that point in time has a two in seven chance of being on a day when the doctor will not be available to prescribe them, and no one is willing to go out on a limb and give pain meds to a patient that they don’t know personally, even when that person is in the kind of pain that registers as spikes in blood pressure. This situation is intolerable and has to change.
Pain management has to turn a corner and come to grips with the fact that pain meds are both required and potentially addictive, both at the same time. It is a juggling act that the medical establishment had better learn to master, and soon, if they want to head off the next oxycontin embarrassment. That debacle simply waits in the wings for the next corporation to see a chance to reap a profit from people who have pain and have the money to spend alleviating the pain. This problem is not going away because the problems with pain are not going away either. We are going to have to learn how to deal with this problem. The sooner the better.