One year gone

 In two days, I will have been working from home for a full year.

It's strange to think of all the things that I've grown accustomed to, in that year. No N Judah trains rumbling by, no lunches at work, no commute, making my own coffee, doing nothing, seeing nobody. I can't make myself participate in any of the online versions of the things I love, because... well, I don't know why. Honestly, staying home seems preferable to the disappointment of the pale shadow of what it was.

The question I posed in my second pandemic blog post was - what will be left when this is all over? So many of our favorite things have opened again only to re-close, and each time they do it wastes precious resources. How many times will they open and close, and will they ever open as they were, again?

And what am I going to be like? I feel like some sort of slug, like a potato. I can't get up the enthusiasm to get out of the house or go anywhere. Martin wants to make plans and I just can't get excited about anything. 

Part of this is that I'm still healing, I'm sure. I'm not back to 100% and I don't know when I will be. I honestly feel like I've been chasing 80% for weeks now, and not quite making it, but trying to get back to "normal" life again, whatever the hell that means, despite the pain and stiffness. My 3-month check in is on Monday and I'm terrified that they're going to tell me that the fusion isn't working, or that the third level we were supposed to do as an artificial disk has now failed and that's what's causing the pain. I don't know. I don't know. I'm scared. And I want so desperately to get back to "normal" even though there is no normal to get back to.

Some part of me has been observing with wry detachment as my brain... recovers... from all this pain. The silence that's rung in my head since May of 2017 (interspersed with gratingly loud loops of gratingly repetitive snippets of music) has been fading away. I thought it could've been that the breakup damaged my brain, because the rest of me felt weirdly physically fine but - what if it was the car crash? What if this degeneration started with whiplash in May of 2017 and took nearly two years to blossom into the first spasm (March 2019), and another 18 months to cause the second? I oscillate between dubious and angry that it could be true.

I'm angry at a lot of things right now. The housing market, politics that pits humans against their own interest, the pandemic, climate change. 

I would just like to go somewhere for awhile where I can make things and not be angry anymore, and not have to worry about how I'm going to get money or food or shelter or healthcare. I just want some sort of rest.

Get to work

Day two back to work and I'm exhausted already. I'm remembering how tired, burnt out, and discouraged I'd been at work before the Shoulder Thing and the Going Public Thing and the Neck Thing and the Acquisition. I realized that there's probably no future for me at this company because of a couple of people who've been quietly undermining me since I got there - and, hilariously, they picked today to show themselves. (But hey, at least I get a reasonable payout if I exercise my remaining options and GTFO?)

It's sort of a grim parallel with what's going on in politics now too. Biden is in, and has been working his ass off to start undoing the damage of the previous four years. And of course, the opposition is doing all the same dirty awful shit as they always have. We're right back to the stonewalling that they gave Obama, except now the economy is a farce and we're in the middle of a recession and a public health disaster while they're very suddenly concerned about the deficit. For fuck's sake. The Democratic Party needs to take no fucking prisoners.

The good news from today is that I'm feeling better, and better, and starting to really see the end of the tunnel with surgical recovery. Today, for the first time, the scar looked shorter, and less puffy. I can see the edges of the incision and see them starting to diminish. And I feel like my range of motion is starting to get better, bit by bit, even though the rest of me hurts like hell. I'm hoping to get back to yoga next week, even if it's modified.

And we're keeping up with the steady flow of houses on our radar, though none have been worth a look just yet, alas. And I apparently have good taste in condos, because the ones I favorite seem to flip to pending within 24 hours of my interest, siiiiiigh.

So, back to work.

Gratitude

 Wow, so, first week of 2021, really packing it in, huh? Only six days in and our first Doomscroll day of the year. I'm extremely thankful for a lot of things right now, and one of them is that I was still unambiguously on medical LOA while an armed mob signaled the end of our track record of "peaceful transfer of power" Democracy. 

I'm also grateful that, if it taught business people anything, when these doomscroll days happen there's no point in expecting anything to get fucking done; almost everyone I know who was trapped in view of screens reported that their bosses had given everyone a Mulligan for the day. Nobody can be expected to focus on work when History is happening - it's just been happening more and more frequently in the last year or so.

I'm grateful for the rain we've been having - mostly overnight, mostly in long slow downpours, mostly with sun breaking through in the afternoons. I have my fingers crossed that our aquifers recharge and the snowpack is deep and wet, and that the fire season gives us a bit of a reprieve in 2021. And I'm enjoying walking along the beach in the thin afternoon sunlight.

On Thursday, I logged in to work email for the first time since before my surgery, to request that we extend my LOA from the "best case" 4 week duration, to the full 6 weeks. It was *so* needed, and, looking back at my cuticles (which are picked and bloody) it was giving me a lot of anxiety apparently.

So I'm officially off work until January 26th, and friends, oh my god I need it so badly. I'm so grateful to have it and so grateful that I'm in a place in my life where it's available. 

And while I'm at it, let me say how grateful/angry I am about my health care coverage? As I'm tallying up the charges for medical services leading up to this, it's approaching $400k of billing. I hit my out-of-pocket maximum right before surgery so theoretically I'm not on the hook for any of that, but it's not clear that the individual providers won't come after me for the shortfall, which the imaging companies are already doing. I've been keeping all those charges on a single card since last year, just for tracking purposes, and it's already over $600 in post-insurance-settlement charges. Fuck those vultures. I'm scared.

Today was my one month check in, and now I get to track down and schedule the PT. The xray shows that my fusion is going well, and my doctor was shocked that I was still wearing the hard collar the whole time, and said to stop wearing it unless my neck feels tired or sore. I was worried about how puffy and lumpy the incision site is still, but I'm told that it actually looks great, and the level of puff I have is totally normal. 

My biggest question that I kept worrying about - what happened during the surgery that took an extra three hours has been answered. Apparently they didn't start the procedure until about 4, and I was held up an hour in the OR because there was no room in post-op yet. (The ICU bed shortage, and the extra-thorough cleaning of the rooms between patients has some knock-on effects.) Let me tell you folks, looking at the bill, that's like another $10k in anaesthesia drugs alone. The doctor also amusedly told me that it explains why Martin got an incredibly drugged out Laura call several hours earlier than expected; apparently the anaesthesia people get the task of monitoring/hanging out with the patient while the rest of the surgical team is dismissed, and they'll do puzzles and have whole conversations with you and put you on the phone with people if they're bored. 

And now... I want a nap.

Hello, 2021

It feels really surreal. Maybe that's the drugs?

Readers, I am here now to tell you that it was, in fact, the drugs. They are in fact both the solution and additional problems. This procedure has made what's already a rough and emotional time of year well-nigh unbearable. I've been see-sawing between totally fine and burn-your-life-down sobbingly depressed.

It turns out that tramadol has an SNRI in it, which is like an SSRI except that it also treats nerve pain apparently (which is good to do if you're treating chronic pain). I've struggled with, and mostly beaten, depression all my life. I've been passively suicidal on and off since I was 14 or so. My care team asked if I was currently on an SSRI but they did not ask about my mental health in any other way. Each time I've tried to taper off the tramadol, I've apparently been doing it wrong because I've had zero guidance from the team, and with zero guidance from the internet/community, because googling for this just nets you page after page of ads for rehab clinics. And each time I tried to taper, it's been like kicking the kid on the bike who's just taken off the training wheels. I felt like I've been barely staying astride.

And also the rest of the time, I feel entirely fine. Good, even.  We take nice long walks. We've cooked and built things and enjoyed the pleasant weather.

This is not to say I'm feeling totally great. I mean, I have intense and layered Strong Feelings about the state of my meat suit and how it's failing me, how ugly and lumpy and just overall gory the surgical site looks right now. But that's nothing next to the feeling like I've just come out from some sort of trance and found that I've been walking on knives for three weeks, and then effortlessly falling back into that trance. I cannot tell what's the drugs, and what's the continued conflicts in my relationship bubbling over; I can't tell what is forgivable and what's inevitable. 

And, for what it's worth, at least I can walk just fine, swallow fine, take all my vitamins again, shower, brush my hair and do a bunch of stuff okay again. I'm not off painkillers and not back to 100% yet and I don't know when I will be, but I'm no longer prevented from doing everyday tasks because of pain or stiffness, or lets be real here, fear. Though I'm also not yet off the opiods and thus not permitted to drive (which makes me feel surprisingly trapped), or alas, to drink. That latter has been a surprising ache for me, not because I particularly care about being drunk, but because I enjoy the sensory experience and traditions of cocktails so much. The fact that I feel sad about it makes me question if I have a problem? I don't think I do, or else I wouldn't have gone this long without any alcohol, right? 

I cannot wait to be out of this collar, to be able to drive myself places, and to have a nice nightcap before bed.

We dressed up for New Years Eve, because that's what you're supposed to do, even if you're just cooking and spending the evening at home on multiple Zoom calls with friends. And we took off my neck brace for a photo, so I could feel just the slightest bit normal for the first time in 17 days. 

So here I am. Don't tell my orthopedist.

T-plus three days

 It feels really surreal. Maybe that's the drugs?

I struggled with "what if I'm doing the wrong thing" all the way up until I was signing the final consent to treatment, gowned and IV'd. Some part of me is still wondering that, but I realize that's because I'm in a new and different kind of pain so my instinct is to mentally downgrade the devil you know, so to speak. (Also say hello to the high res versions of my bone spurs. It looks like they’d been shopping at hot topic for punk spikes.)

Yeah, I'm in pain. It's to be expected really. I have six screws, a titanium plate, and two chunks of cadaver femur embedded in my neck now. (And a bunch of absorbable sutures)

It took three tries for them to seat the first IV, and once I had signed my consent to treatment, I asked for something for the anxiety. I'd been crying behind my mask on and off since arriving two hours early (as directed) and I was exhausted. My last memory was around 1pm, when of a member of the anaesthesia team holding a large slightly yellowed cylinder and tapping it into the hard-won IV port on top of my right hand. The surgery was scheduled for 12:23pm, to last for about 3.5 hours. 

I have some vague recollections of coming out of anaesthesia and talking to one of the surgical team about 18th century gelatin, and carnivorous plants, while they tried to stick a bedpan under me. I was lucid enough to know that wasn't going to work and ask for a catheter, which they were surprised by but assented to ("huh, she didn't even flinch"). I know I called Martin on a phone at some point but I can't remember a word of what I said to him. I woke up a second time in a recovery bed, some time around 9:45pm, visiting hours already over. 

Covid has been surging around the world recently, so it wasn't surprising to me that the promised orthopedic ICU bed didn't materialize immediately as I exited surgery. But hours passed, and more gurney beds with highly-drugged individuals started to collect in that room as no new beds became available. Around 12:30am the nurses came to shut down the recovery ward, so those of us still waiting were rolled back to the capacious pre-op ward, where we'd donned the gowns and IVs and done final signatures before our surgeries.  

So we waited. And waited. And had some jello and crackers, and water, and waited more. And some time around 4am, I started to feel nauseated. I had just undergone a blood draw (because I guess they have to do those every 6 hours or something for monitoring?) in my foot (because, as I found out later, literally every other part of my body that had accessible veins had been tapped) when I started to get tunnel vision and cold sweats. I woke up with a nurse screaming "help help" out into the ward, my toes curled over the bar at the end of my bed, another nurse holding me down as I arched, and a third working a suction tube into my mouth as I vomited and coughed. "Do you know where you are?!" "The hospital?" I coughed and choked as they sat me up, an expelled another liter of fluid (?!?!) before the nausea disappeared. I collapsed into bed as they stripped me and wiped me down, tucked me into a fresh gown and fresh socks and fresh blankets and put an anti-nausea patch behind my left ear. I slept under their watchful eyes, exhausted. 

And that's where I woke up again, about 11am, still not in my ICU bed, but in good spirits. I sat up, I got more blood drawn, they took my vitals, I started to eat again. My surgeon came around to look at me, and over the protests of the nurses got me up out of bed and into a chair to eat. A few minutes after he'd left, satisfied that I was mobile and on the mend, the tunnel vision came back. I had enough time to gasp "I'm blacking out" before it was on me again. I apparently had a vagal seizure that lasted about 8 seconds, scared the crap out of the nurses and the other patient still waiting for a bed, and knocked me off the chair. I got to use this super interesting device called a "Sara Stedy" to get from the floor back onto my bed, and the nurse who'd been looking after me the whole time sent a stream of almost-profanity into my surgeon's voicemail box. A few specialists visited while I was exhaustedly snoozing again, but after some tests we decided it wasn't an epileptic episode, but it could've been due to some of the many drugs they had me on. (My guess was gabapentin, and they said that was possible.) 

After those two episodes I guess I got a priority bump, because around 3pm an ICU bed came free for me and I left the pre-op corner with thanks for the nurse who'd been watching me like a hawk, and the other lady who was rooting for me.  The room was private, which surprised me, and had a great view of the trees of Mount Sutro. And after the loud, dim, busy corner of the pre-op ward, it was heavenly. After that I progressed fairly quickly - able to get out of bed, get to the restroom, and walk a bit with minimal assistance. Martin came to visit me, and I ordered dinner and snoozed a bit, then drifted off to sleep. Two more blood tests later, and an unknown number of shift changes and resident visits, I was ready to go home.

This is only day one home, but I can see this is going to be a long road. I already don't like this cervical collar, and I'm worried that it's also possibly too short for me. My hands, arms, and feet are covered in bruises from failed IV attempts, and I'm still picking ECG pad adhesive off my torso. My neck is bruised and slightly swollen, and I'm afraid to look at what's under the dressings. But I got to have a shower, and I put in my contact lenses, and that makes a huge difference to help me feel human again. I can't brush my own hair yet, and the drugs make me too woozy to walk far on my own, and swallowing is difficult and doesn't feel natural again yet. I'm still coughing up aspirated apple juice phlegm, apparently sleeping in the cervical collar makes me snore, and I've got some allergy/post-nasal drip/sinus infection thing cooking on top of it all. 

But here's to hoping that this pain subsides quickly, and I'm quickly back on my feet and better than I was before. I have a four week LOA from work, so it feels like most of what I need to do is sleep and drink water, and stay away from the surging coronavirus.

Oh, and alllllllll my Christmas shopping. x_x

Self-talk

T-minus three days to surgery. I keep waiting for some Sign(tm) that I'm doing the right thing, and in the absence of such I keep second- and third-guessing myself. I am in enough pain that I have lost the ability to reason about the pain; my brain keeps going back to the following: 1) Did I do enough to try to fix this without surgery? 2) Is my pain really *that* bad? Aren't there people worse off than me here? 3) Since this happened to me, don't I deserve to suffer? 4) What if it goes wrong?

As a mental health exercise, let me break this down for myself and see if it helps.

1) Yes. This first happened in March of 2019 and you toughed it out for a full month before seeking help, then you spent four more months getting back to 99% functionality, all without knowing that this was going to happen again. There were two more levels waiting to go. 

2) Yes, and this is bullshit medical-care-rationing thinking. You are in pain and thus you deserve treatment; you don't need to compare your pain to anyone else to justify getting it. You're having trouble with word-finding, you're having trouble with names, and focus and concentration are beyond you. These are all signs that things aren't going to get better on their own. Sure there are kids starving in Sudan or something, but nothing practical you can do is going to change that, and putting everyone else who suffers before your own care is not actually helping them or you. This is a trauma response. Putting others before yourself here will not make you a better person, win you approval or accolades from a distant theoretical authority.

3) No. This is the body you were granted for this incarnation. Part of the experience you're having is that of watching Time change it. Remember how you felt exactly this way when you got your first crown molar? How ashamed and grief-stricken you were that you couldn't keep your teeth in exactly the state they were when they first cut through your gums? And now it's nothing? You won't ever be the same, but Time was going to ensure that for you anyway. It's just not quite the not-the-same as you'd originally envisioned, and while it's natural given your upbringing to grieve that somewhat, don't let naturalistic fallacy swallow you whole. 

4) Even if it goes wrong, it will help. UCSF is world renowned for their Spine Center, and they're where everyone else goes when some other doctor fucks up their procedure. If Something Happens you'll be under the best possible care to correct it, even if it means more surgery. You're (relatively) young, with no serious underlying health conditions, and should heal quickly. You have a team of professionals on your side, and (gross that I have to write this, thanks 'Murica) the money to pay for their care. You've been in pain for about the same time that they expect you to need to get back to normal; that's more than enough time sacrificed on the altar of needless-pain.

This body is my vessel and I need to heave down occasionally. I will feel joy again, someday.

Real Fear

I am so scared.

After much wrangling with insurance, we're doing a 2-level fusion at UCSF. Anthem wouldn't approve a synthetic disc along with the fusion, so we're doing less to spare my mobility, on the promise they made that if I still have pain they'll approve a disc in a second operation. December 15th is my surgery day. That's a week away. I have an LOA set up with work. I have all the moving parts figured out and scheduling bits in place. And I am scared.

I am so scared I've been randomly breaking down into sobs, for minutes at a time. Hyperventilating, ugly cry, scared. Started turning on music when it happens so I don't freak out the downstairs neighbors. We're at four times today. Nothing like snapping-to and finding you've been sobbing on the kitchen floor in the middle of the day while your lunch cooks to make you doubt your own sanity.

What if I'm doing the wrong thing? What if it doesn't work? There's so much that's out of my hands.

I have never been scared on this animal, bodily level. I'm sitting in here piloting this meat suit through daily tasks while it shakes and sobs and I have to tell it to blink more so I can see what I'm trying to do and I am just... is this still a healthy level of compartmentalization? Am I doing this wrong? Is this breaking me? (Was I broken beforehand and just hadn't quite noticed?)

I'm reading through the pre-surgical instructions and putting them on the calendar and I can't stop crying. 

I can't imagine this hurting less. I am grieving the loss of my, I'll admit to this vanity, my pretty neck and collarbones. I'm scared that on top of this, it won't help - I'll still be in pain (in more, different pain) and will have to get a second surgery anyway. More scarring, more pain, more loss of the OEM parts I had.

And then some part of me recognizes that I am *in* pain right now, and despite my brain's insistence that I'm not in real pain, not really, I actually am, and that's why this (including the random crying jags) is happening and that's why I need this surgery. 

So I took one of my baby tramadol and I am going to go to sleep now.