CHRONIC NERVE PAIN

 

Jesus, this is a bad few days of nerve pain in one spot. Today's worse and I'm aggravated. Nerves between L-3 to L-4, and L4-L5. My original point of injury over 45 years ago. 

I have all the Rxs I'm allotted today on board and they're doing a whole lot of nothing. 

 The TENS unit is on high, ice packs, a brace, and I'm grouchy as heck.

The dog keeps giving me her sad eyes look, wanting me to walk her around outside a few blocks or wrestle with her tugging on her toys, but not today.

I'd like to take a big nail, and hammer it right into the pinched nerve in retaliation, but that's plain crazy. 

Eventually, some part in the area will shift a centimeter or so and the pressure will move to another lumbar spot. Seems like the flexeril sometimes loosens up a muscle, allowing a shift of position. A guy from New York City didn't have any business riding bulls for recreation at age 20 while stationed at Camp Pendleton. We humans; we do foolish things. Serves me right.

On another topic, I got into this old novel from the 1950s, written by Truman Capote: Breakfast at Tiffany's. The man's writing is stunningly great. His characters are so well-defined and lively; their conversations realistic; and I'm halfway through it on my second reading day. 

THANK YOU TO VA HOSPITAL, LA JOLLA, CA

 

As a service-connected disabled Navy vet, I received excellent medical treatment yesterday during my visit to the hospital. I fear for the impending death of the Affordable Care Act.

There are MANY fewer employees nowadays working at the VA due to trump's consolidation of the money supply, but those who still work there are at the top of their games. Polite, professional, on-time, genial, helpful, and I am grateful to them.

Millions of Americans are worrying today about how they will be able to afford health care when Republicans strip them of it. Quality, affordable health care is a human right..

.

WHAT? Another surgery done. The VA got me good and removed a bad cancer deal--total thyroidectomy last week. ADD in more pain!

RODEO AND THE PAIN THAT COMES WITH AGING

     

THE ICE CHIPPER THAT STICKS INTO MY L3 - L4 NERVES

TWO SIDES OF THE LUMBAR SPINE TAKE TURNS STICKING IT TO ME. 

The right L3-L4 spot is my worst pain spot. My ice pick reference is a memory from childhood where there was an old cellar with some VERY old tool implements left by a previous seller. Think of a screwdriver with a rough wood handle, then 5 inches of thin steel with a tip sharpened by years of use actually chipping blocks of ice into smaller chunks. I guess this was before ice cube trays. I imagine a tool like that sticking into a nerve, a sensory nerve, nudging the nerve and poking in hard and persistently unannounced throughout the day. The stab prompts an immediate pain reflex that kicks my right leg out at the knee while jerking my head and upper torso backward. It's ridiculous! It scares the dog and annoys any person nearby.

This stabbing takes turns, switching back & forth multiple times during the day. It alternates sides. When the left side suffers, the right side gets a break. Vice versa, the right side prods the nerve, giving the left side pain relief. My right side is much worse than the left. Getting injured sitting on a bull when the chute gate opens puts the rider at a 50/50 chance of incurring an injury. On probably 2 out of 3 rides something gets injured, a muscle pulled, a bad bruising, etc. One Saturday morning in 1978, a certain bull threw me hard against a broken steel fence post and dislocated something in my right L3-4 area, about 3 inches to the right side of my spine; I get to think about it every day since I was about age 50. He busted a rib also on that same ride but that's no big deal.

The good thing about getting injured when you're young is that you heal up fast. What you don't know is that 30 years later the pain is gonna' come back and it's gonna' be there to stay. And this injury GROWS to affect lots of parts around it. An interesting aside to this bull wreck is that my right leg was out of whack for 2 days until something popped back into place. I sure wish I knew what it was but the physician on duty in the Navy Hospital ER that afternoon refused to give me an x-ray. Why not? He chewed me out because he had strong feelings that rodeo was cruelty to animals. 

Rodeo? A fine traditional American pastime? Why, it's 'Americana!' I wonder what he thinks about baseball....

 

I Chickened Out of my 4th Spine Surgery! (It would have been my 4th.)

 

I already regret not going through with the ALIF procedure my great ortho surgeon wanted to perform.

A week before the schedule, with major concerns about pain Rx meds post-op, and a pharmacist again interfering with my prescriber's Rx, I didn't dare move ahead.

Why can't these 3rd party pretend doctors stay where they belong--I am speaking of pharmacists with no patient knowledge, with no patient best interests anywhere in their jaded brains.

Pharmacists--you are fungible--you are not providers. Follow orders. The academicians have issued a professional undergraduate degree--a 6-year program--and told you that you have a doctorate. It is not accurate. 

Now the physical therapist academics have followed suit and they call their graduates doctors, saying the physical therapist has a doctorate.

Good Lord! Face the facts of academic history. A bachelors degree is 4 years. Add 2 more years for a masters degree. Add 3 more years of study in which you present "new knowledge" in a subject, write a thesis--basically author a book, and defend & support your "new knowledge or patent addition to the existing body of knowledge before a board of your peers.

This fallacy must stop. Blocking the medication prescribed for a patient is NOT your role. Assisting insurance companies in blocking therapy should not be your role. Stay in your lane.

Not only did a retail pharmacist block post-op pain therapy with that being the sole cause of cancellation of a surgery to get 2 new metal lumbar discs. But this was the final step for me.

I was concurrently diagnosed with a new cancer which appears to require a head & neck surgeon. 

Also, the expectation of a 12-week recovery along with medication fears shut me down.

Don't get old....

** Three months update: The nerve is agonizing & infuriating. Why didn't I get that surgery done? I can be such a loser sometimes. 

I don't think it's the doctor...

 

To those readers who live with the invisible demon of pain, this is to you: Persevere.

Your repetitive routine attempts to mitigate your nerve pain with your ice packs, your TENS units, your supports, braces, and your 5 pillows that don't help much, but year after year you persist. GOOD! You haven't yielded yet to it. 

We have our daily nerve pain, our invisible 'steady state,' individual experiences that we endure. Your 'people' may very well think you are a whining, malingering, lazy waste of resources. We fellow dour waiting-room companions recognize it. You are among friends. 

I have had 4 good days. Less medicine. Gentle swims at the local beach. Some life in me!

Surgery in 3 weeks to replace 2 useless discs with titanium spacers is coming. I don't hope for pain elimination, but a reduction by half or more would be outstanding. 

The 'system' of monthly prescriptions and counting the hours between pills is an abomination for us. Long summer days mean more hours of pain while awake. Ask for assistance with breakthrough pain and you're suspect. Tread lightly. I don't think it's the doctor, but the system of fear that is institutional. 

I wish you strength.

  

    

CHRONIC PAIN: "Oh, Boy, what am I gonna' do?

 

Man, what am I going to do? 

Every day I find myself asking this question aloud, in my frustration and 'driving me crazy' endless pain. 

I wish someone could tell me my future, where this physical body of mine will lead me.

I understand how doctors get tired of hearing the same pain complaints; how people don't get better.

 Barring a miracle device or surgery that could restore a 67-year-old body to its age 40 status, I'm facing down serious practical issues with daily living. My nerves don't know that they are only supposed to hurt me to the point of 4 pills maximum per day. 

I started this post a week ago. Since then, there has been some grave input by a physician who is probably ready to push me off to something that is an oxymoron: "Pain Management."

This, should it occur; and I hope to hell some humanity prevails in the heart of my doctor, would be my third time being referred to the dreaded Pain Management Clinic. 

Whenever you hear the word "Management," you're in trouble.

I began this post June 24th. Since then, in a mere week & 5 days, the country has been downsized--the federal government has been overtaken by a criminal regime, which appears to be intent on inflicting damage to social services. In this regard, we are in good hands--our own family hands--as we worked & saved & did not spend foolishly over 4 decades. There is insurance for health & retirement money. 

Below I have what I wrote 9 days ago:

          Again, this morning is one of these days. We just had the longest day of daylight yesterday--the summer solstice--and these days that go on and on until 8:30 pm are killers for folks like me who need to watch the clock to try to make the pain pills last. Too many waking hours.

The pills are not increased for the extra days of daylight. For a daily pain guy like me, for whom another spinal surgery is the next step, there are too many waking hours; therefore, I need more tablets for those extra hours. A doctor doesn't see the situation as I do. (Or you, possibly.)

Coming soon, in a couple of weeks at my next doctor appointment, I'm needing to request an increase. I'm a nervous wreck over this issue. Why should I have to be? My doctor has been great with me for permitting me medication, but he gets hassled by others who have no business intervening in my medical care. He has management people showing his names on "LISTS." Lists of prescribers whose patients may have over 8 Rx's per month, I'll speculate. The list that a patient does not want to be on is the list of patients who take 2 controlled substances daily! Ooohh...

That signifies nothing! Arbitrary lists dreamt up by young bureaucrats and doctors and pharmacists easily may damage the health care of our patients. I think that I'm on a couple of lists. I'm speculating.

Today is too much for me. I surely do NOT WANT a 4th spine surgery, but I can't exist like this: nerve pain with spasticity & now 'buckling' of the legs somewhat with the BIG spastic hot spots of the big nerves that exit my spinal cord at L-3 and L-4, then buzzing the sciatic nerves. 

I'm not special in any mode here in pain land. We know that many thousands of you exist like me--constantly dreading to be considered illegitimate or 'escalating.' The very nature of anatomy & physiology & orthopedic damage is thus.

Unfortunately for me, I have been visited by a recurrence of prostate cancer after 22 years clear. I also have growths in my thyroid gland that must be biopsied for a second time. Eight years ago, the biopsies were negative, although the liquid aspirated was colorless on one side and tea-colored on the other side. So, I have these 2 concerns weighing down my emotions. The option for the prostate cancer is "cryosurgery." I read about the details and that's just more than I'm able to absorb. 

What am I going to do?

 

 

Is there crying in pain management?

 I know there's no crying in baseball but occasionally there IS crying in the life of a pain person. This morning and now into early afternoon, I am beyond tolerating the customary daily frustration that accompanies my lumbar pain. I stay within the limit of allotted pain medication rather strictly. I am not a person who finds himself requesting 'early refills' on an opiate Rx.

As a retired pharmacist, I have years and years of that kind of situation, and I can assure the pain reader that there are countless jerkoffs, jerks, assholes, mean people, prescription police, 'fraidy cats, gossipers, nosy busybodies, and a myriad of workers in pharmacies and medical offices who derive some sort of self-gratification with finding a suspected 'red flag' in the course of receiving & processing a refill request for a controlled substance. 

Since this is my life with controlled substances inhabiting a small portion of it, but medications occupy a most critical component of my days and nights, I always aim to use less than the total quantity dispensed divided by the # of tablets allotted per day by the prescriber, yielding the quotient that is the 'days supply.'

The sadness dominated late this morning when my medication routine was ineffective in quenching or mitigating the burn of the deep persistent nerve pain which plays the role of my daily antagonist, forestalling my ability to live a normal healthy life in my retirement years.

Is weeping in pain crying? When one's eyes drip tears unintentionally without concomitant noises such as sobs or wails, is that crying? Was I crying for two hours this early afternoon before I went over my daily dosage of medicine to 'get the pain to stop?'

Maybe you have had this experience. It's not something that one can convey to the provider because the arena of prescribing is packed with doubt and disbelief. You would fight a losing battle. 

PAIN IS BACK. I AM SAD.

 March 1, 2025

My lumbar pain ride has roller-coasted a bit since my recent epidurals. From the peak of pain at the crest of the coaster, the pain vanished for 2 days as the coaster descended to earth level.

Today I rode back up to the top of the pain roller-coaster track and am back at the state where I typically am in my life.

To have had the 2 days free of the dominance of nerve compression at right L3 and L4 was unexpected and I am thankful for the doctor's skills.

Today is a bad day again, along with my TENS pads on high and the 4% lidocaine lotion rubbed into the areas. Ice packs are daily. I switch warm packs with fresh cold ones from the freezer throughout my days, all my days.

I'm convinced that small body parts move, shift around, pinch nerves and let off from a subtle movement of my muscles or body position, bending or twisting...

All my years of experience with this leads me to feel that increasing the space vertically between my lumbar disks via surgery is the sole way to give nerves space. The decompression of bad discs.

Such frustration is this 4-letter-word: pain.

Surgery it must be; and I loathe the idea of the surgery & hospital visit, with the week of anguish following the fusions, though I have 100% confidence in my surgeon.

This is repetitious. My regrets. 

Two Epidural Shots

 The day before yesterday I got two steroid epidurals in the right L3 and L4 spots. I had NO lumbar pain yesterday! So far today I have no lumbar pain. 

I have had at least 20 epidurals over several years and this is the true first time that I think they worked. I so so so do hope that this lack of pain continues. I love it. 

I swam in the beach yesterday--easy stuff--kicking on my back with fins--rehabbing the back little by little. No back problems at all in a vigorous swim through some rough surging waves. I walked back to the car straight up and pain free. I'll probably get in the water later today.

I don't know if this means that the needle and medicine landed in the exact nerve spots that needed to be treated. I do know that I had brief extreme nerve pain that radiated down my right leg when the 2 shots were being injected. I'm talking a few seconds of intensity, then back to okay. I always get the little bit of midazolam and fentanyl IV.  

I wonder if other patients have had that experience of the sensation that the doctor hit the best spot. Usually I have a sensation that the needle and medicine is in the general area.

Maybe the fluoroscopy view is better sometimes than others; maybe things shift around back there. Well, I'm sure that there IS shifting around because pain areas vary from hours to hours and from days to days.

Enough of my pain-free rambling.  

I am so angry today with these pinched up & compressed nerves in my spinal cord & the spinal offshoots from my lumbar back!

 I began this post February 6th and left it in 'draft' status. I'll return to publish it today, Saturday the 15th.

I took 4 days off from exercise due to my back killing me and driving me nutso. I don't want to get another fusion surgery, but I'm going to continue to go nuts with despair and depression, or give the surgery a shot, in the pursuit of substantial pain relief.

Pain really does ruin life. And it's invisible, save for an observable limp or leaning into a cane, or the grimaced distortion on the face of the victim.

It butts in on everything you are doing or want to do. It wears on the love and compassion of one's immediate family. Empathy of a family can only stretch so far. Easily ten years of observing the limitations of a broken person is far too long. It's not decent to ask family to tolerate being exposed to one's daily pill counting, always needing to pace out prescriptions so as not to be too much of a chronic bother to clinic staff and prescribers.

I feel badly every doggone day at home when I sit the day away trying to attain a partially comfortable position in a recliner chair. I am sorry that my family has to see me like this. Surely, they must want to holler at me to 'Shut the heck up; I can't stand your whining.'

I'm hurting severely today. I have the muscle relaxant, the anti-anxiety Rx, and the much-maligned opiate on board. Typically, they give me a couple of pain-free hours between doses. No, not pain free. Just pain-tolerable. That's every day! 

This protracted affliction of ours is nothing less than torment. My personal lowlight is the compression on both sides of my L-3 and L-4 discs. Nerves that fire into causing stabbing spasms in the areas are routine with me. Primarily, my right side is most problematic, but my left side also gets its own time to torture me as well. Often the nerve pain is duller and pressuring me on both sides. When no medication combination touches it, I use TENS patches with some low voltage stuck on the areas to distract me. I use ice packs daily. I use elastic lumbar supports most of the day and evening but not at bedtime. Over the wide elastic support, I often strap on the hard post-op big lumbar support. I regularly slip an ice pack in under the supports. 

On a day like today, I get aggravated and start to think about punching walls. The frustration and anxiety that accompany nerve pain put me in an extremely foul loss of patience with the whole problem that rules my life.

Those of you with related issues with the endless nerve pain know what I write about. The dog wants to be walked but I may not be up for it for several days. An event or family gathering may be scheduled but I usually have to pass. Any thoughts of taking a long car ride somewhere I flat out avoid. 

I've written too much today, so I'll end it here.

***

I just heard dog barking and walked out to the backyard...we get coyotes roaming beyond our fence and they would eat a small dog like ours if they could in a minute. In the sky, just before 5:30 pm Pacific, I saw a second stage of another Spacex rocket zipping quietly very high across our sky; it must have launched from Vandenberg ten minutes ago. It has become a frequent event here.

CHRONIC PAIN -- It Never Stops

 I think the diagnosis of chronic pain, per the medical criteria, is pain lasting six weeks. I didn't just google it. I'm recalling the definition from reading over many years about it.

The meager definition leaves a great deal to be desired in support of the pain patient whose pain is lifelong.  Surely, the medical bureaucrats and academics and rule-making organizations could and should do a better job of categorizing patients.

Over years I have thought of my broken body parts--structural parts of the body--discs, bones, and nerves in endless possible scenarios.

I often think of an insect that one steps on. Maybe you hear a cracking sound but the insect escapes. It is certainly broken in some manner but gets away from you before you can finish it off. THEN I liken my body to the sturdy insect. I was stepped on, in a manner of speaking, and have had to persevere in living with my broken structural parts. These parts cannot be truly fixed and returned to 'factory condition.'

It has been a strong and depressing struggle with doctors, insurance barriers, referrals & prior authorizations to obtain treatments and injections, prescriptions & surgeries, support braces and official recognition of disabilities. Conservatively, the past fifteen years of my life have been dominated by these health matters. 

Why is this the norm? 

LUMBAR PAIN AFTER THE EXERCISE

 

I swam yesterday at the Oceanside Harbor Beach. Rehab kicking with fins while relaxing on my back. The water pressure pushing my body up facilitates the stretching and effectiveness forme. More importantly, I love cold beach water.

But I pay with increased lumbar pain the evening of the swim and more the following day, which is now, the 21st. 

The idea is that doing the exercise and physical therapy for rehabbing body areas will relieve pain and increase mobility. I'll buy into the increased mobility, but as for relieving pain...that's a big 'NO.' The strenuous exercise increases pain. 

 

I'm taking today off. I'll walk the dog tonight.

November 12, 2025

I'm reviewing this post and am so favorably taken with the beauty of our Oceanside beach in the photo. This is real. No people. I didn't wait for this scene. It's just that flat solitude of the beauty and calm of nature that I caught here. See the pier in the background minus the restaurant that burned down? That adds something to the shot. That is some perfect swimming water out there, right? How lucky are we!

Lumbar Pain

 While I rehab my neck after my second cervical fusion 4 months ago, I have been getting into the water at the Oceanside Harbor Beach, usually a mellow beach to play and kick.

Today I put the fins on again and, while lying on my back, worked on practicing my kicking to strengthen my low back. I need the second lumbar fusion, the L3 and L4. I already got the L5 to S-1 in 2014, I think it was.

I am working on getting approval to get more epidural shots soon in my L3 and L4 bilaterally. Tonight my lumbar is giving me lots of grief with mucho pain and some spasms. Thank goodness for my competent doctors at the VA system.

I wish that you fellow pain patients had the pain care that I have had over the many years.