Hi, friends. Here’s another update on the current situation:

Mom’s sciatica pain increased so much that I took her back to her doctor again, right before New Year’s eve. The doc kindly increased her narcotic pain medicine dose to every four hours (rather than every six). Then he prescribed a walker for her, since walking is so painful and she’s so unsteady on her feet.

She absolutely hated that she had to get a walker. To her, it means “frail old lady.” Her doctor assured her that the walker was simply a tool to aid her mobility until her sciatica could be treated and relieved. It’s temporary, he said.

So we got the walker. It’s pretty darn nice—it has wheels, handbreaks and a seat. And to my delight, once she started using it, Mom’s attitude toward the walker did a 180. It makes moving much less painful for her, and she feels a lot more secure on her feet. (I’m relieved, too. I was so worried that she’d fall, and that I’d be unable to catch her in time or even injure her more trying to).

She gets exhausted very quickly when she’s up, so she appreciates the seat on the walker. She sits down at the sink to brush her teeth, fix her hair and put on makeup, all of which make her feel better. That walker has made a really big difference in her outlook.

Finally, it was time for Mom to see the pain specialist. He did an epidural lumbar injection of steroids in her low back yesterday, hoping to relieve her sciatica. As of this morning, nothing has changed—she’s still in great pain—but he warned us that it could take a few days before it takes effect. So we’re being patient and hopeful.

In the event that the injection doesn’t work, he said we should call him. And if she does experience improvement, but not a complete eradication of pain, then he’ll do another injection in two weeks.

And my bursitis hips?

Well, the lack of a parking space at the VA hospital nixed my opportunity to, once again, try steroid injections. Yep, you read that right: the lack of a parking space. I went to my appointment on Monday, only to find every parking lot surrounding the VA hospital facility completely full. There was no place to park, period, and there were so many people cruising the lots looking for spaces that the moment one opened, it was taken.

I ended up parking illegally in front of the physical therapy clinic, went inside and told them what was going on. I was already 20 minutes late at that point, so I didn’t have much hope that they’d still see me. They wouldn’t, and I understood why. Instead, they rescheduled my appointment for Jan. 24.

I was devastated about missing my appointment for such a stupid reason, but I’m over it. I’ve toughed it out this long, so I guess I can tough out another three weeks or so with seriously achy hips. And I have to admit that since the first round of steroid injections didn’t work, I don’t have a lot of faith in this second round. Still, it seems to be the only real possibility for relief.

On the bright side, the weather is simply gorgeous. We have bright sunshine, clear blue skies, and it’s snappy cool but not cold. I’m planning to take a short walk in a while, while Mom naps. The walk has to be short; I can’t walk or stand for long before my hips start killing me. But I really need the fresh air and a change of scenery.

I hope this post finds all of you feeling well and enjoying this first week of the New Year. While it has started out a bit grim for me, I have a feeling that 2011 will be a better year than 2010 was. Yep, I’m an optimist. I can’t help myself.

Wishing you a bright, sweet Year 2011. May it be filled with laughter and joy.

Post-Christmas, pre-New Year’s greetings to everyone! Thanks very much for your cheerful holiday wishes and encouragement. They made me smile.

In spite of the rapidly changing barometric pressure around here–raining and stormy for a day or two, then sunny and mild for the same period, over and over again–I’m feeling fairly well. My bursitis hips continue to hurt. My hands still ache and twinge at random. But overall, I’m good, and I’m looking forward to Jan. 3, when I’m having a do-over on those steroid injections. Fingers are crossed that this time they’ll do the trick and I can cross hip pain off my list.

Christmas was very quiet. Mom, with my support, decided to postpone the family dinner and holiday celebration until she’s feeling better. It would have completely exhausted her; she can only stand for a short time before the pain gets too intense, and she didn’t want to watch from the sidelines. We’ll get everyone together soon, with luck.

We saw her doctor on Christmas Eve for the results of her MRI. There’s nothing life-threatening going on in or around her lower spine, thank goodness, but the scan did show a couple of bulging discs, a few bone spurs and some degenerative arthritis damage–any or all of which might be aggravating her sciatic nerve.

Because her pain isn’t easing, and in fact is increasing, the doc upped the dosages on her nerve-pain med. And, he referred her to a pain specialist for a consultation and, if the specialist agrees, cortisone shots. Unfortunately, the first available appointment for that is Jan. 4 (though they promised me that if an earlier date opens due to a cancellation, they’ll call).

I’m frustrated that she can’t be seen sooner. Even the increased pain med dosage isn’t relieving her pain. She hurts so much she stays on the sofa or in bed all the time, getting up only to use the bathroom. Each short trip is agonizing for her. She’s depressed and sometimes, seems hopeless. Though she tries to eat a little each time I bring her a meal or a snack, it’s a struggle for her.

I’m sure her doctor thinks I’m a terrible pest, but I’m calling him again today, hoping that at least there might be something else he can give her for the pain. I’m so worried about Mom.

I’d meant this post to be more cheerful, but I guess I haven’t been very successful. I do hope this finds you all feeling well.

Wishing everyone a warm and joyous holiday!

It’s a gray Winter Solstice day here in the Sierra foothills of Northern California, where I’m staying with my mother as she continues her battle with sciatica.

Yes, sciatica.

Last time I posted, mom had been diagnosed with a strained muscle in her low back. From the start, I was leery of that particular diagnosis; I couldn’t square it with the pain she described. It varied wildly in intensity and seemed to move from one side of her low back to the other. And it kept moving. As the weeks passed, the pain moved from her back down into the muscles of her bottom and then into her right thigh and calf.

In my own experience, the pain of a strained muscle doesn’t change locations. The muscle itself hurts. Sure, the pain might radiate or cause peripheral pain due to muscle fatigue, tightness and even spasms. But what Mom was experiencing didn’t square with that. A strained muscle in the back doesn’t cause intense, stabbing, burning pain in the lower leg. I wondered if she might have a pinched nerve somewhere.

My sister and I finally talked Mom into calling her doctor again. She was given an appointment that same day, and when she was called back to the exam room, we followed her like a couple of overgrown ducklings. As I mentioned in the previous post, my Mom is tough. She always minimizes her own discomfort, particularly to people outside the immediate family (she does it with us, too, but we’ve learned to call her bluff). But she’s also a bit forgetful these days. Jami and I wanted to make sure that her doctor had all the information we could give him.

It turned out that her doctor wasn’t there that day, so his nurse practitioner saw Mom. She listened carefully, perused Mom’s charts and asked questions. “Muscle strain” was the previous diagnosis, so she was working with that. Frustrated, I asked if a strained muscle in the back could telegraph severe pain into the thigh and calf.

She looked at Mom and asked her if it did that. Mom admitted it did. “Here, here and here?” the NP asked, touching the affected areas on Mom’s leg. “Yes,” said Mom.

It was as if a light bulb went on. “You have sciatica!” the NP exclaimed.

Heh. Nerve pain. I knew it.

You’ve probably heard of sciatica. It’s a pretty common ailment in the elderly population, caused by pressure and inflammation around the sciatic nerve, which is the largest nerve in the body. It runs from the spine down into the legs. Sciatica can be triggered by ordinary movements, like walking or reaching for something (a not particularly heavy something) overhead. The latter is how Mom’s case started. She was reaching up into a cabinet for her big wooden chest of silver place settings—and nearly dropped it when pain suddenly stabbed her in the low back.

Sciatica might be common, but don’t confuse “common” with “mild.” Sciatica can be horrifically painful and disabling. In my Mom’s case, it’s been both.

The doctor’s initial assessment was of a strained muscle because, at the time, that’s where the pain was. He’d ordered four weeks of physical therapy. As it turned out, the PT is also helpful for sciatica, so the NP told Mom to continue with it, but if she didn’t improve, to let her know and they’d order an MRI.

I learned a few things about Mom I didn’t know, that day.  One is that she has degenerative disk disease. Another is that she has a mildly herniated disk in her low back, and that’s probably what’s pressing on the sciatic nerve and causing the problem.

The other big thing I learned was that Mom has pernicious anemia—and she’s had it for some time. That was a jaw-dropper. The only reason I found out about that is that I tattled to the NP about how hard it was for my sister and I to get Mom to eat. We were very worried about it, and we knew Mom wouldn’t mention it herself.

Well. It turned out that she’d been diagnosed with pernicious anemia months ago, but she’d refused B12 injections because she didn’t want to have to drive up to the doc’s office once a week for them. He prescribed daily B12 tablets for her, instead. But Mom has only been taking them sporadically. She said she’d forgotten why she was supposed to take them. She’d entirely forgotten that she was seriously anemic.

So now she’s getting a weekly B12 shot and taking the tablets daily. She’s also taking a narcotic analgesic for pain, and gabapentin at night, specifically for nerve pain.The NP suggested that she try to eat six mini-meals each day, focusing on proteins, and that she drink a half-cup of water every half hour. And she emphasized how important good nutrition is and how eating, even when Mom doesn’t feel like it, will help her body heal and get healthy again.

Unfortunately, Mom’s sciatica hasn’t improved in the two weeks since that appointment. She does specific exercises for it each day, but she’s basically bed-bound. The pain brings her to tears when she tries to get up in the morning and, while it’s sometimes milder during the day, it just keeps her down.  When she does get up, she gets weak, trembly and exhausted frighteningly fast.

I’ve talked to the doctor once more since, to ask if she could take her pain medication more than once every 12 hours and update him on her worrying fatigue. He increased the pain med dosage to one tablet every six hours and the gabipentin dosage, as well. And finally, he was very concerned that she isn’t improving. He told her to stop the PT. And he set up an appointment for an MRI.

Mom has that this afternoon. With luck, it will tell us more specifically what’s causing her sciatica to hang on so doggedly and allow the doctor to take more aggressive actions to relieve it. I’m glad. Just sorry she’s had to wait, and suffer, so long.

I’ve complained here, in the past, about not being able to find a job. But right now, I’m grateful that I don’t have one. Because my days and nights are free and my family can take care of themselves, I’ve basically moved in with Mom so I can take care of her. I prepare her food and wheedle her into eating those six small meals a day. I keep her water glass full and remind her to drink. I’m now in charge of making sure she takes all her meds each day and gets to the doc’s office once a week for that B12 shot.

And I’m always around to help her move, if she needs me, to encourage her when she gets frustrated and blue, and to laugh with her and keep her company. I’m so glad I can be here and that she doesn’t have to face this alone. I’m glad to be needed and pleased that I’m able to help.

My own health situation remains basically unchanged. The rheuma, thankfully, hasn’t been too bad; mostly just occasional twinges here and there, and stiffness and some low aching in my hands and wrists. The !#*!@ hip bursitis continues to hurt me, though.

Still, I’m mobile, strong, and feeling good overall. I have an appointment with the orthopedic physiatrist on Jan. 3 (finally! Yay!) and I’m hoping that if he decides to give me steroid injections again, perhaps he’ll give them in such a way that they’ll work this time. He may possibly also prescribe some PT. I’m all for it. I’m dreadfully tired of these aggravating, aching hips.

I probably won’t post again until after the holiday, so here’s wishing all of you a very Merry Christmas. May the day be filled with joy, warmth, fun and lots of laughter. Oh–and may it be pain-free. Yes.

Oh, it’s late.

Twelve-thirty ay-em. It’s been Monday for a half an hour and it’s raining outside, a constant pounding rain, a rain that gets you wet, fast, if you step out the door and away from eaves and porch-roofs and find yourself small and humanish and exposed to the low-hanging, streaming sky.

It’s Bremerhaven rain, I told my sister as we ran to my car for a trip to the local KFC, the only kind of supper food that sounded good to my Mom. She’s still suffering from that muscle she pulled in her low back several weeks ago. It’s wearing her down, the pain and the fatigue. And she won’t eat. “I’m not hungry,” she says. “Oh, I don’t really want anything. You girls go ahead, have something. Don’t worry about me.” So we suggested different foods. She’s always loved fried chicken; that actually raised something like interest. “That sounds good,” she said. So off we went, cold water sheeting down from the black night sky, to fetch hot fried chicken and mashed potatoes with gravy, and coleslaw.

She ate a drumstick and half each of the tiny portions of potatoes and coleslaw. And for dessert, a Reese’s chocolate peanut cluster.

“It feels better,” Mom says in answer to the question, “How’s your back feel?” But that’s always her answer. She got so tired this morning just taking a shower that when she was done, she put on fresh pajamas and snuggled down onto the sofa again, a heated rice-pack against the painful place. “I think its getting better. It’s not as bad as yesterday. It’s going away.”

She’s been saying that for nearly five weeks now. It’s not getting better. She’s been going twice a week to physical therapy for two weeks. She’s been to the doctor twice (the last time at my insistence), and the he took an x-ray, just to make sure she hadn’t broken something in there. She has osteoporosis; it’s possible. But there were no breaks, no fractures, no cracks or chips or shatters anywhere. Yet this persistent hurt, aggravated by a fall on the sore side when she caught her escaping cat as it darted down the driveway a few weeks after the original injury, just won’t heal. Since my sister arrived from New Mexico, she and I have been bullying Mom (gently, wheedling, not giving up) to call her doctor and see him yet again. To ask him to look a little harder. Because Mom isn’t bouncing back.

She’s a strong woman. Half-Finnish and stoic. I can remember very few times in my life that she’s been sick enough, with anything, to go to bed while the sun’s out. She’s always kept pain and discomfort to herself.  She’s always been a busy person, always in perpetual motion, rarely lighting anywhere, just small and slim and ramrod straight, always perfectly matched and coordinated and put together. Pajamas? In the daytime?

We’re worried about her. She’s weakening.

My own saga continues. My rheumatologist has referred me to an orthopedic physiatrist for the bursitis in my hips, suggesting more steroid injections given with a different technique and, perhaps, a series of physical therapy sessions. While I wait for that appointment (the VA will let me know when it is) I’ll just keep on keeping on, taking tramadol for the pain and being patient. As for the RA, my bloods looked great and the disease remains “under control” in spite of the constant pain in my hands. For the next six months I’ll be seeing the physiatrist instead of my rheumatologist. I’ll not see him again until May.

Well, then.

My sister was supposed to go back to Los Alamos on Tuesday, but she’s thinking about staying a few days past that, uneasy about leaving Mom when she’s still feeling so rough. I’m glad Jami is here. It’s been nice to have a co-conspirator and partner in crime, working to get Mom back on her feet. Mom listens to her; she always has. And she promised us tonight that she’ll call her doctor first thing in the morning.

So I’m going to shut down the computer now, turn off the light, and try to sleep as I toss from one achy hip to the other, listening to the North German rainstorm that has somehow found its way to the Northern California foothills. There’s work to do tomorrow. I’m not as stoic as my sweet Mom, even if her tough Finnish blood runs in my veins.

Thanks for listening.

Snowmelt rattles down the drainpipes. It drips off the clematis vine’s curlicue seed-pods and spade-like leaf-blades to zing-and-slide down my neck as I pass beneath the arbor. Melt-puddles wait for the unwary with a sudden splash of ice cold that soaks shoes and creeps northward up the socks, headed grimly for the knees.

The snow our rare November storm left behind is finally, finally melting away. It started yesterday as the temperature, following timidly behind the sun, inched its way through the middle of the 40s and touched 50 and, for the first time in twelve days, didn’t shrink back below freezing overnight.  I can walk outside in my normal, sensible shoes and leave my snowboots with the grippy soles inside the door. There’s no need to cast ice-melting grit before me, hoping to scare off a slip-and-fall just as a priest swings a censer of burning incense to ward off demons. A light breeze, chilly but cheerful, moves the long bell-chimes hanging from the eaves. They compose random melodies that escape and drift away.

Ask me: Do I love winter? Yes, I do, I do. But I’ll admit I’m glad this thick, icy, now elderly eight inches of snow will soon be nothing but a memory. With temps barely crossing 35 in the daytime and swooping down into the low 20s at night, the woodstove has been blazing 24-7 here at the Wren’s Nest. I’ve taken all the sweaters and long-sleeved turtlenecks out of storage and found my warmest socks. The menu each day has included hot cereal in the morning, nuked-to-steaming leftovers for lunch and thick, bubbling stews rich with vegetables and potatoes in the evening. I love all this stuff, but I’m relishing this lovely break in the ice, too. Solstice is still weeks away. There’s plenty of winter waiting in the wings.

I’m still gimping around with aching bursitis hips and stiff, twingy rheuma hands. My nights aren’t very restful, but I’m usually able to catch a short nap in the afternoon to make up for the lost sleep. (If there’s a reason to be grateful for unemployment, this is it.) My body has been uncomfortable, sometimes downright painful, but I’m in good spirits. This strange, early-season freeze has been chock-full of gifts, jewels in a winter palace. As long as I look for them, they’re there, ready to catch my breath in my throat and curl my lips into a smile.

The forecast is for rain, starting tomorrow and lasting through the weekend, with temperatures just high enough that it won’t convert to snow here at the alpine edge of the Sierras. I’m pleased. I’m picking my New Mexico sister up at the airport at noon tomorrow and taking her to my Mom’s house, an early Christmas surprise we concocted since Jami can’t be here for the holiday itself. On Saturday morning, I see my rheumatologist for my quarterly check-up. I’m curious to find out what he has up his sleeve for this maddening, painful, wearying bursitis and the aggravating rheuma pain in my hands and wrists. Nothing much, I’m afraid, but foolish optimist that I am, I remain hopeful.

May this find you warm, feeling well and enjoying the early gifts of the season. Thanks for dropping by.

We really do have much to be thankful for, don’t we. Here’s wishing all my friends in Blogworld a very, very Happy Thanksgiving. May your day be filled with much laughter, warmth and joy.

… because you may get it.

In the last post, regarding the snowfall that was imminent, I wrote “Bring it on” with blythe chutzpa. Heh:

A VIEW THROUGH the Japanese maple leaves just outside my kitchen window to the embankment, hedgerow and tall evergreens beyond after the first snowfall of the season.

ALTHOUGH I EXPECTED the snow, by the time it started it was dark and enough had built up on the driveway that I didn't feel like moving my car up to the street. "I don't have anywhere I need to go," I reasoned, backing myself up by remembering how long it takes the county to actually make it out to our little neighborhood in the wilds to plow. Even with the cars up on the street, I wouldn't be going anywhere for a while.

As I write this, approximately five inches of snow has fallen. And it’s falling still, a misty, sand-like snow topping the layers of heavier stuff from the night. Forecast is for more today and tomorrow. I’m planning a rich, hot lamb stew for supper tonight, thick with carrots, corn, green beans and potatoes. And for dessert? An apple crumble, warm from the oven.

FINNY McCOOL and PIB (Puss in Boots) take their job of keeping my legs warm seriously.

UPDATE: More snow. And comfort:

Mr. Stubbs is now an indoor cat. He seems to like it.

It’s snowing!

Sure, it’s not sticking to the ground yet, (it’s about 40 degrees out there) but soft, fat snowflakes are falling from the autumn night sky, building up on branches and leaves, roofs and fenceposts. Finny McCool is snugged between my calves, radiating heat beneath the thick comforter that covers both of us, and PIB is purring, tucked meatloaf-style into my side. The woodstove is crackling and glowing. I’m warm. Outside, it’s snowing.

If you’ve read Rheumablog for very long, you already know I’m a sucker for snow. I look forward to the first snowfall of each season and then to all the rest that come as autumn becomes winter and winter becomes early spring. I love the clean whiteness of new snow. I love the way it transforms the outside world into an intricately simple contrast of light and dark, and how it makes me grateful that I can be cozy and indoors. I love the soft quiet of snow, and how if it snows long enough to form an inches-thick blanket, it silences the continuous roar of traffic on the freeway a quarter-mile down the mountain from my house. When snow makes the world silent, it brings a curious peace to my heart. This, I think, is how the mountains are supposed to sound in winter. This is how they sounded a hundred years ago; five hundred years ago; five thousand years ago.

Last summer, Mr. Wren found cross-country skis for both of us through Freecycle. All we need are the proper footwear and warm outerwear to go with them, and we can ski this winter. I love cross-country skiing. I haven’t done it since I was in Germany, when I skied the Harz Mountains, but I feel confident that I can do it again if I start out slow and easy and build up strength over time. It’s a good motivation to take wee Finny out walking again and re-strengthen the muscles in my legs and hips. Bursitis and rheumatoid arthritis be damned. I skied in spite of severe, active rheuma-flares in Germany. I’m older now, and less fit than I was then, but I know I can do it again. Will I hurt afterward? Probably, but it will be worth it.

It’s inevitable that there will be times that I’ll get tired of snow before the winter ends. Usually, it happens when I’m forced to drive somewhere on snowy, slick, icy roads, or when I have to shovel a half ton of the stuff just to get to the woodpile. I only grumble a little, though. I like snow.

This is a La Nina winter, which usually means it will be a long, wet one. Last time we had a La Nina, we had a lot of snow, and it brought us snowstorms from November to May. It was unreal. Will it be that way this time? I don’t know, but I say “bring it on.”