PHYSICAL HEALTH

UPDATE Saturday December 4, 2021
WELCOME TO MY NEW NORMAL….

I’m getting a lot of my current circumstances out on my website today, and passing stuff along on Facebook. I believe I am the master of my own circumstances, which makes it easier to work and love. Our bodies and our minds are always changing…though at a certain point you realize it’s not getting better every day no matter how often you play the song to sing along. I have severe osteoarthritis and “lousy cartilage genetics.”
The last time we looked closely was before my below the left knee amputation in April 2018. Though I am being referred to most every bone and joint specialist for consultation, surgery is not at the top of my list, however I have a pinched nerve in my neck causing pain to run down my right arm like the mice ran down the clock. This pain is now added to the pinched sciatic nerve (yes, sciatica, the mice run down my crotch), and  you can literally hear and feel my bones klick klack when I’m being arranged on my back on the x-ray table. Just put those vertebrae anywhere you want them I said to the X-ray tech.

SO I am having my opioid  dose increased from 20 mgs a day to 30 mgs a day, in two grey 15 mg tablets. I am having to spend a few days “out of service” gettng used to my slight increase. Some context…the maximum daily dose in Canada once was 200 mgs, and is now 100mgs due to the opioid overdoses in the country. My increased dose takes me to 3o mgs, 30% of the maximum recommended dose.Also wheelchairs.

Take a look at this baby. Direct Mid-wheel Drive, mid-century modern Sea Foam colour if I can get it. I was not keen on the powered wheelchair. And I was right to expect I would get another round of why would you use one. “It” can’t be that bad.  That is why I have reprinted the bald facts below, my bones and joints are wrecked. The less gravity I expose my joints to,  the less pain I have. My wheelchair serves as a pain management technique as do my meds, my meditation, and the carers coming to the house to clean and fix our meals. I have been luck to meet and marry a disability rights advocate with MS who does not question if it hurts, how much it hurts, and if I lay perfectly still, well there would be less pain. I only mention the last because I was being written up for an MRI req and one of the questions was whether I could lie still for an hour! 🙂 Well yes, I’m pretty good at it, in fact I will be doing that exact thing in about 15 minutes. Wresting, I call it.

 

Victor Enns’ Report
Hip and Pelvis X-Ray, Foot/Ankle X-Ray IExam(s): RAD / FOOT ANKLE RT; PELVIS HIP RT Reason for Exam: PAIN TO RT HIP

EXAM TYPE:
C / T / L SPINES; PELVIS HIP RT; KNEE RT w SPEC VIEW; FOOT ANKLE RT

HISTORY:
BACK PAIN AND ARTHRITIS; PAIN TO RT HIP; ASSESS FOR ARTHRITIS; HX OF ANKLE FUSION WITH BROKEN SCREW

FINDINGS:
Cervical, thoracic and lumbar spine:

There is straightening of the normal cervical lordosis. This may be positional, reflect muscle spasm, or secondary to degenerative change. There is severe degenerative disc disease between C4 and C7. Moderate multilevel facet and uncovertebral osteoarthritis noted. There is mild degenerative anterolisthesis of C3 on C4. There is moderate to severe right foraminal stenosis at C4-5, C5-6 and C6-7, on the left at C3-4, with milder narrowing of lower left foramina. No fracture or destructive process.

Moderate lower thoracic degenerative disc disease noted. No thoracic compression fracture.

There is severe degenerative disc disease L1-2 and L5-S1. There is also L5

Printed by: Victor Irvin Enns on 23/11/21 at 5:13 pm from the Patient Portal

Page 1 of 3

                            Victor Enns' Report
                  Hip and Pelvis X-Ray, Foot/Ankle X-Ray

spondylolysis with grade 1-2 spondylolisthesis. Moderate facet osteoarthritis at multiple lower levels.

SUMMARY:

Page 2 of 3

1. Severe cervical spondylosis with moderate to severe foraminal stenosis, right greater than left.
2. Severe L1-2 and L5-S1 degenerative disc disease.
3. L5 spondylolysis with grade 1-2 spondylolisthesis. Milder degenerative disc disease elsewhere in the lumbar spine and in the lower thoracic spine.

Pelvis and right hip:

There are bilateral total hip arthroplasties, with no osseous or hardware complication. Bony pelvis is intact. No significant SI joint arthropathy.

Right knee:

There is minor medial compartment joint space narrowing and marginal spurring. There is moderate to severe medial patellofemoral joint space loss with mild marginal spurring. Lateral compartment is preserved. No effusion, erosion or fracture.

SUMMARY:
Moderate to severe medial patellofemoral and minor medial femoral tibial OA.

Right foot and ankle:

They were is a lateral fibular plate and multiple screws with no hardware complication. The underlying fracture has healed. There is mild degenerative spurring at the margins of the intraosseous ligament and distal tibiofibular joint. There is also mild ankle joint OA, predominantly at the superolateral joint space.

Multiple orthopedic screws transfix the hindfoot. 1 of the navicular-talus screws is fractured. There is solid osseous union of the subtalar joint and talonavicular joint. Minor joint margin lipping evident at a few midfoot joints. There is fusion of the first IP joint. No erosive change. No acute fracture.

SUMMARY:
Extensive hindfoot fusion. 1 of the orthopedic screws is fractured. No acute

abnormality. Minimal to mild degenerative change at several sites with no erosive change.

Michael E Partrick MD,

Dictated by: Partrick,Michael E Transcribed by: IHSVC.TRAN Technologist: LEED21

Dictated Date: 16/11/21 1452 Transcribed Date: 16/11/21 1452 Signed Date: 16/11/21 1501

“Produced by Speech Recognition technology. If a clinically significant error is identified, please contact the Medical

Printed by: Victor Irvin Enns on 23/11/21 at 5:13 pm from the Patient Portal

 

UPDATE MARCH 27, 2018

Good news and bad news. My blood pressure is a low 110 over 70, not unusual in our family, my father and brother the exceptions. It seems I arrived at my GP’s with barely a pulse. The doc checked the pulse in my feet, including the one that will be sacrificed next Thursday, for the greater good of the rest of my body and my brain. All in order, if sluggish. “Haven’t had my afternoon coffee I says.”

Then he says, come up and I rolled my wheelchair next to his to look at the blood test results on the computer. I still  haven’t found my hearing aids. Way to many red highlights. My cholesterol has finally reached unacceptable levels (first time,  for everything) triglycerides also high, but at least this time I know it’s not my beverages. Sugar and uric acid good. The final blow was the pronouncement that my blood protein levels like albumin were too high. So much for cooking roasts I thought. Checking the Mayo Clinic site though I’ve learned
I’ve  just now checked the Mayo Clinic site too find some relief in

“A high-protein diet doesn’t cause high blood protein. High blood protein is not a specific disease or condition in itself. It’s usually a laboratory finding uncovered during the evaluation of a particular condition or symptom. For instance, although high blood protein is found in people who are dehydrated, the real problem is that the blood plasma is actually more concentrated.” So just another thing to watch and test. He prescribed a statin for my high cholesterol, taking my medication number into double digits.

Finally though, the concern remains with my irregular and incompetent heart, so more  ECG with echo (?) and more tests. I can’t imagine why it’s been left to the last weeks, and only with my prodding. So much for my bitch ‘n moan. Time to get back to make my place habitable for granddaughters!

March 20, 2018

Good news. I have no signs of scoliosis which runs in the family.  I am arthritic to various degrees in all my joints, but most painfully in my back, why it was checked. More about that later. The big news is my below the left knee amputation scheduled for April 5 th. Blood work tomorrow, pre-op physical next week. 

The 2015 ankle fusion didn’t take. One of  three failures of three hundred ankle fusions done by my foot surgeon. Too late to guarantee a succssful ankle replacement, while there is hope of a pain reduction, no guarantee following my amputation. I will get a prosthesis and learn to walk again.  I spend a lot of time in my wheelchair, or resting.    I am fundraising for an All Terrain Scooter, mentioned in my blog and on FaceBook. It has a degree of coolness that cannot be achieved with walkers or electric scooters. Donations welcome! 

The last entry was almost exactly a year ago. 

10:00 pm March 16, 2017; updated Friday March 17th from 8:45 to 10:00 a.m.

Feet:
Right now: flurry of pins and needles, pain in left foot held at bay say 3 (From 1 to 10) by 10mgs of Percocet when I should have only taken 5mg. More pain today generally everywhere re weather change?
Last week: Left foot pain starts to return after cortisone shot. Figured this out by how I walked up the steps to the house. Back to one foot at time, dragging the left as before the shot. More pain at the front and back and on top of foot, also higher up on left side.
2 weeks ago: a pretty good week foot-wise. I started walking up the steps putting weight on alternate feet. What I had thought was a balance problem, or an icy step problem, had at its root my body’s desire to protect my left foot by not putting weight on it. Also my foot was usually straighter (noticed barefoot inside) to walk, rather than way duck walk, and often dragged.
Ankle injection3:weeks ago 24 hours after the shot all seemed to be well certainly ankle wise what hurt was the top of the foot, and higher up on the left side (top of fibula?). Hopeful.Analysis: three weeks exactly we’re back where we started with left foot,
Next steps: (ha).
*Orthopedic boots from the ground up. I am getting a lot of strange callous on my heels that could be walking/brace related. If my legs not quite the same length compensations can be made and the actual insoles could help with my stance and balance.
*If ankle replacement is a non-starter, I consider amputation as a good option.
It’s not the surgeries I mind to make good attempts to fix a bad ankle, but the amount of downtime after. I know about phantom pain. As it is, often I need to look at my feet to see if I’m wearing braces, shoes or socks. Is there also phantom neuropathy? After amputation I can look and see which foot I’m missing.

Knees:
More poly-neuropathic pain at nighttime, from toes to mid calf or knee. Not every night, no pattern.
I have experienced pain in different parts of my body in the last two weeks. Knees now usually at bedtime, not so unusual. Arthritic pain. Perhpas in sympathy with my sister who has knee replacement surgery scheduled for April 25, 2017. Update, my sister has recovered well and now in better shape than me or my brother who is recovering after a bad car accident. 

Torso/back 
Main pain-centre most days (today the left ankle wins). It runs across my back, kidney to kidney (just as locator, note) down my right side to my hip, dividing to my buttock and flank, and the other down the inside of my groin. CT Scan imaging shows considerable degeneration, loss of cartilage. My back has several issues related to my bad cartilage genetics. Problems include spondylolisthesis

Spondylos – vertebra; lysis – break; listhesis – slip.spondy

Spondylolisthesis is a condition that occurs when one vertebra slips forward over the vertebra below it. There are different types of spondylolisthesis – congenital spondylolisthesis, isthmic spondylolisthesis, dysplastic spondylolisthesis, degenerative spondylolisthesis and pathologic spondylolisthesis. This condition affects the lower vertebrae and is a painful condition.

(Wiki for spelling, and then the article seemed to cover many of my symptoms) Deterioration in enough places you’ll need to look at the report. The damage at L5 may be causing the biggest pain by pinching the nerve implicated in the pain location and  reduces my ability to sit for more than hour, which I prefer to do when I am writing. The spinal cord is shown to be ok.

Tests so far include blood-work, hands-on palpitation, xray, ct-scan and ultrasound, without finding my sugars or PSAs out of whack or locating kidney stones, gall stones or infection

Incompetent Heart ValveHeart:
Flutter now joined by diagnosed “incompetent heart.” ok incompetent heart valve.
Not much to do about either, but watch for changes. Taking 2.5 mg morning and again at night for 5mg of a Beta Blocker, Busperinol (?) and one baby ASA daily.

Hands and Elbows:

Hands a constant, sometimes easy to see with red knuckles, preferring exercises to gauntlets but use both. I usually can’t sit to type long enough for the gauntlet’s to give relief that they do over several hours, driving is the same. THEN Out of the blue, infuriating to wake up one morning with 6-7 pain in my damn elbows! Never before. Now sometimes I notice mild aches. Fri.March 17 2017.  The damn elbows again! Vicious! 

Current difficulties
My Dad lived to be 91 with all his original parts. The thought of living another 25 years with varying degrees of pain is daunting. And I don’t mean “aches and pains “ common to aging. I really had no idea what Chronic Pain was until it was happening to me.

 

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