Back to my back..

It’s a cloudy, grey, drizzly day, I am full of cold, coughing and struggling to breathe through my nose, lacking both sleep and energy, unable to taste or smell; and yet today, I cannot feel anything, but gratitude. Today is my CES birthday, a two year anniversary since my life-changing emergency spinal surgery. CES stands for Cauda Equina Syndrome, induced by a spinal cord injury that can provoke paraplegia, or a range of mobility issues, affects bowel and bladder, and pretty much everything from the waist down. I’m often asked what caused my spinal cord injury, and the short answer is: ‘I’m not sure, but an accumulation of events led to a disc gradually slipping and impinging on the nerve root’, this is the long answer:

I didn’t get my CES from a dramatic, adrenalin fuelled accident such as skiing or sky-diving, I didn’t acquire it in the aftermath of some dreadful car crash or a freak disaster, or even in the noble act of pregnancy or giving birth, nope mine was a boring, gradual onset of increasingly worrying symptoms, as I stoically (but stupidly) persevered with a bad back, just living an independent life, persisting in thinking I was stronger than my reality.

Looking back, there were several signs that there was a problem, but it is only in hindsight that I have been able to connect the dots, and see the warnings too late for me. I suspect my journey from Greece to the UK in December 2014 started the problem. I had left Greece in my trusty, 18 year old, Ford Fiesta, ‘Rubini’; a lovely old lady with relatively low mileage for her age, but holes in the floor, a disconnected (faulty) heater, and inadequate windscreen wipers. She was perfect for the few miles drive from my island home to the beach, and a fortnightly trip across the mountains to the main town, for vet visits and provisions, yet I had taken my chances and pushed my luck taking her to Southern Italy, where I had intended to spend my first winter with Platonas, my stray dog puppy. However, the home (and associated car) in Italy didn’t work out, and I figured my best option was to stuff everything back in to the still sandy Rubini, with Platon curled up neatly on the passenger seat beside me, and drive as far as I could towards London; hoping that if I fell short, it would be close enough that someone would help me, without having to distress Platon with an experience as aircraft cargo.

We were driving through the most breathtaking scenery, but equally as terrifying, road out of Italy, which was loaded with heavy cargo lorries from the port of Genoa. The AutoFiori (Autostrada A10) passes through Liguria, across a steep and sprawling hillside, though a series of tunnels and viaducts, sometimes plunging you into echoing darkness for almost 2 km, before ejecting you onto vertiginous viaducts, precariously perched high above ravines in couloirs that stream to a sparkling sea; almost too beautiful to take your eyes off, except that the road is too narrow, too fast, too busy and wayyy too dangerous to take your eyes off either. As I carefully negotiated my way through the perilous barrage of trucks and juggernaut lorries, in my underpowered old lady of a car, I suddenly felt a stabbing in my heels, too intense to ignore. I suspected I had simply tied the laces of my trainers too tightly, but remember first struggling to untie them whilst driving, and having to pull over at a service station to loosen them. I must have stepped out of the car to stretch my legs, completely unaware that I was relieving the pressure on my spinal cord, caused by a seemingly innocuous seating position. Anyway, I carried on my journey, making it all the way back to London, having a fantastically, wonderful adventure on the way, and irritatingly tight shoe laces (or so I thought) completely unaware of the damage I was doing.

After a short winter period in London, I had resolved to sell my home of 20+ years there, looking for something more dog friendly to accommodate my darling, but decided to wait until after another summer in Greece, so I packed up the house to rent it for the interim. My back ached from carrying heavily laden boxes of books, clothes, kitchenware, everything, into the garage; but you know, it was just a bad back, so I kept going. It was a bitterly cold winter, as I walked Platon round the sprawling graveyard, with glittering frost and plumes of our warm breath in the biting cold air, and yet despite the sub-zero temperatures, I noticed one foot was always pleasantly warm as if I had a heating system in the sole of my right boot. It took me a while to address, as it didn’t hurt, in fact it was a lovely contrast to the blue, cold toes of my left foot. But, since I realised it was a neurological issue, I eventually presented it to my GP, who dismissed it with ‘well if it doesn’t hurt, why worry?’ and I foolishly left it at that.

My drive back to Greece in April 2015 was in a car I bought ‘for Platon’, a Toyota Rav 4, with a much higher seating position, and much more room for my height, Platon, luggage, everything. We had a good journey down, apart from a strange bout of nausea and breathlessness, as I headed through the now familiar but no less intimidating deep tunnels through Liguria. I wondered whether it was purely psychological, but there was a lack of rationale to the feeling, I wasn’t afraid in my mind, despite my symptoms, which I eventually put down to an upset tummy, but I am now not so sure, and wonder whether somehow the duration of the journey, or even the memory of my stabbing heels was another unheeded warning.

My back was often a bit sore, I had packed up 20 years of accumulated living, well ok, ‘stuff’, into boxes, traipsed them down at least one, mostly two flights of stairs to the garage, then spent a week driving, and lived with a loving but stubborn dog of around 30+ Kg, whom I was often impatient enough to pick up, when his mood and mine differed, such as when he didn’t want to get in the car, and I did, for example. Then I found Leo (timid, terrified, and bearing the broken bones, bullets and many wounds of his abuse), and had two darling dogs to manage. They were absolutely fine most of the time, but Platon became reactive on the lead when I walked them together, I suspect in a protective manner of his much adored and fearful, little ‘brother’. I was probably a comical sight, walking along the curvaceous mountain roads, with Platon lunging and barking at anyone or any vehicle that approached us, as Leo hid nervously behind my legs, and leads tangled the three of us together. Fortunately they are quiet roads, but still, it wasn’t an easy walk for a bad back.

Then the storm came, we have some wonderfully dramatic electrical storms on the island, the thunder crashes (Zeus moving the furniture, as my dear friend Hilda quips), and lightening forks through pink and purple night skies. The rain relentlessly hammers on the glass balcony doors, and seeps through the cracks if we don’t secure the shutters, drumming on the roof and drenching absolutely everything! The electricity often fails, and we have to unplug the internet for fear of blowing the modem, so there’s little chance of anything other than watching the storm by candlelight, or sleeping. The dogs were excitable (Platon) and panicked (Leo), and as I was trying to keep them calm and hunker down for the night, I heard a faint scratching at the door, then mewing that grew with intensity. Dressed in my pyjamas, I manage to keep the dogs inside as I ventured out onto the step, finding a stray cat and her kitten, crying for mercy. My neighbours, the Russian ladies in the apartment below ours, were great cat lovers, and I remembered seeing a cat box on the wall of their patio. Thankfully, it was still there when I got soaked to the skin to fetch it, and after wrestling to keep the dogs inside and retrieve a dry towel for them to lie on, the cat and her kitten were keen to get in it. I struggled once more with the door, trying to keep the two dogs in as I brought in the cats; I lifted the not particularly heavy cat box, and felt a sharp stab in my lower back. It brought me to my knees, and as I knelt hunched over the crying kitten, with my wet hair plastered to my face, and rivulets running down my neck, on my knees, in the storm, on my doorstep, I did wonder how comical this painful story would be in the telling! I eventually managed to prize the door open, and slide the cat box inside, before crawling to bed, with Platon and Leo whimpering, seemingly sympathetic, as they settled beside me.

I spent about 3 weeks hardly moving from my bed, my Italian neighbours kindly took the dogs out for toilet walks every morning, my landlord gave them a quick walk some afternoons, and plentiful parcels of food arrived from friends and neighbours; such is the Greek virtue of philotomy, my back hurt like hell, but I was never hungry! The lovely local physiotherapist made house calls, and was reassured that the pain was only in my back and hadn’t radiated down my leg, and the doctor handed out pain-killers like sweeties.

Eventually I started to feel more able, and regained mobility, enough to take the car for a service in preparation for my now delayed journey, back to London. I set out early, to avoid driving in the heat of the day, leaving the dogs at home with the balcony doors open so the air could circulate, and they could lie watching the sail boats bob along across the still blue sea below. It seemed strange to be completely alone without their constant endearing company, and I breathed in deeply the solitude of my journey, across dusty mountain roads, strewn with lazy goats that dawdled precariously along the cliff edges. Whenever I approach the place where I first found Platon, a remote road, far from any villages or habitation, my chest starts to tighten, and I experience an emotional reaction; sometimes tearful (that poor, sweet, soul, left to starve and suffer), sometimes angry (those bastard monsters that could perpetrate such an act of brutal cruelty) and that day was no different, except that it was cut short, by amazement, and another Puppy! Poppy (short for Penelope) as she became, was a few months old, skinny and cowering in the road when I saw her, I stopped the car, and cursing that for once I didn’t have any leads or even treats on me, approached her very slowly. I squatted a few metres from her, and let her draw near, which she did tentatively at first, before planting herself submissively between my knees. I gently stroked her dusty fur, feeling her skinny ribcage and spine too easily, noticing the wounds on her hind quarters, wondering what I was going to do; but knowing I couldn’t leave her abandoned here in this wilderness to starve to death. I stood and sighed, before talking gently to her as I slowly walked over to the car with her following, opened the boot, into which she jumped without waiting for me to ask or change my mind. So suddenly I had three dogs to take back to the UK, well 4 actually, as I had already agreed to take Dexter, another dog to a home I had found for him in Switzerland en route. And so I must add a car journey, mostly alone with 4 dogs, my luggage and a bad back, for a week across Europe to another thing I inflicted on my poor back, when it was already struggling.

Once back in the UK, I tried not to drive too much for a while, I was tired, my back was still sore, but the easiest way to walk three untrained dogs, is to take them to a secure paddock (20 minutes drive away), and let them chase each other around for an hour. It wasn’t ideal, but it was manageable. I started studying canine behaviour, and found it impossible to sit through the lectures, standing at the back of class trying to stretch out the odd feeling in my leg, and then grimacing as the sharp stabs returned, just before a trip to Athens for a wedding. I remember at the airport, wondering why I had even contemplated anything with a heel, as my grey suede knee high boots weren’t exactly towering, but they definitely had a heel.. so I purchased some foldable pumps in duty free, a little leopard print pair of salvation, worth every single penny!

I arrived in Athens to be greeted by an old friend, a gorgeous English girl from our modelling days, decades ago. She warned me she was struggling with a dodgy knee as she whisked me through the streets to her home, where we collapsed on the sofa, and I suddenly couldn’t get up again. Every time I moved the shooting pains attacked, but you know, I didn’t think it was anything serious (?!?). So the two of us managed, we hobbled around together, laughing at our predicament, and gritting our teeth as we stoically soldiered on. I attended the wedding, even managing to dance a little in my newly purchased pumps, but after the frivolity faced another 4 hours seated on an aeroplane back to London, which really added insult to injury, as far as my back was concerned, literally.

The next day, having missed my dogs desperately, I drove them to the paddock for a run, except that I started to feel light headed and nauseas as I joined the motorway, and as fought to keep panic at bay, suddenly realised I couldn’t feel or move my right leg. This is not a pleasing revelation, whilst driving in excess of the speed limit on the M1, and I quickly searched for a safe solution. Fortunately there was very little traffic about, so I headed over to the hard shoulder (emergency lane) and braked shakily with the handbrake. I struggled to get out of the car and stumbled to the barrier, where I leant over breathing deeply, focusing on the toes of my boots, trying to stop myself from fainting. Again the change of position must have removed the impingement from the nerve, as I realised as I got my breath back, that I had regained mobility, if not all of the feeling in my right leg again. I made it to safety, but the pain when seated was excruciating, as if the muscle in my right thigh was tensing involuntarily, and I had to stop every 5 minutes to stand and relieve the pain.

I went back to my GP insisting on an MRI as quickly as possible, and endured the most painful car journey, lying agonizingly across the back seat, to get to the appointments. On receiving my results, the GP informed me that he would refer me to physiotherapy, despite having informed him of what I now know to be red flag symptoms, and I struggled through Christmas and New Year, with an irritatingly persistent urge to urinate, without passing much (neurogenic bladder), and what I thought was an upset tummy (impaired bowel control). Eventually, impatient with the GP’s tardy referral, I booked myself to see an osteopath locally, who took one look at my MRI, and recognised my symptoms, before sending me immediately to A&E (ER room), where I was operated on ASAP. (You can read that episode in my previous post: https://purenourishment.wordpress.com/2017/01/06/looking-back/) When I woke from surgery, my heels felt as if they were being stabbed with hot, sharp knives, which led me to discover that they are the site of the insertion for the affected nerves, suddenly the early warning signs made sense.

My outcome is incredibly lucky; I have almost full mobility, although two years later I am still working on building my core strength, and still can’t lift anything heavy, or even push a full supermarket trolley. Despite my initial fears, and necessity of a second emergency surgery, I am able to use the toilet normally, and don’t have to rely on the catheters, as I feared so dreadfully. Most of the saddle-numbness has disappeared, apart from a small area on my right thigh. The PTSD I suffered post-surgery, seems to have abated, I haven’t had a panic attack for at least 6 months, but I am still careful about driving on motorways, especially in the dark.

I know from the CES support forums that I am definitely one of the fortunate ones; many of my fellow sufferers have had to adjust to life in wheelchairs, or with walking frames and AFOs (Ankle Foot Orthosis – plastic supports). Many people with CES suffer with incontinence (both types), and rely on catheters and unpleasant evacuation techniques as part of their daily routines. Many people’s relationships fall apart, they lose their ability to work, and suffer with debilitating depression, and isolation, as a result of their CES. Whilst my surgery wasn’t life-changing in those ways, it has given me perspective, I no-longer strive to be fitter, faster, stronger in the gym; I am content to be able to walk the dogs and carry smaller hand bags. I’ve found a true appreciation for simple pleasures, and take time to reflect on my abilities, rather than dwell on my inabilities or failings. I am also acutely aware of an increased empathy for anyone that struggles with mobility issues, and hope that my increased awareness is reflected in increased kindness towards others.

So, a little back ache at the end of the day, is not something I can complain about, I might not be able to ski or ride horses again, but I can walk my dogs; and trust me, the little things really are the big things, sometimes we just need a little perspective! Please take care of yourselves, especially your backs, and if you have any suspicious symptoms, please insist on a thorough investigation, and don’t let doctors fob you off with their lack of concern or failure to take you seriously. Love & blessings, Hxx

{Photo: Rubini, with Platon and I on board, Greece 2014. Words, by me, Hayley Darby © 2018}

If you want to know more about CES here is a useful little video: http://www.spine-health.com/video/cauda-equina-syndrome-video

Back again..

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Photo via Pinterest

It’s a quiet wintry afternoon; I watch the sky bleed as the sun starts to set, with hues of orange and pink flaring beyond the silhouetted stark, bare, tree branches. A few geese ruffle their feathers and squawk half heartedly, and Platon, who’s snuggled against me, raises his head to check whether or not he needs to bark at them; and deciding not to, lowers his chin to rest on my leg again. He searches my face, as his expressive eyebrows bop about inquisitively; and I ruffle his voluptuous jowls, before stroking his velvety ears reassuringly. He sighs and we settle back into companionable silence; apart from the muttering geese, at the end of the garden.

We moved here a week ago, to a tastefully converted barn, on a working farm. It’s a temporary home, a stop gap in-between selling a property in London, our summer home in Greece, and an unknown future. It’s a haven for recuperation, a little time out from the normal stresses of life following an emergency surgery and a shock to the system. It’s my treat to myself as I digest and process a life-changing experience, and a peaceful place to heal and rehabilitate.

At the start of the year, after struggling with niggling back issues, I unexpectedly underwent emergency spinal surgery. I had a herniated disc that was impinging on the nerve root for the whole lower body, called ‘Cauda Equina” as it resembles a horse’s tail. If you google ‘cauda equina syndrome’, you’ll see how dangerous and scary it is; all I knew was that the risks of my condition were immense (loss of lower body feeling & function), and that I had been naively ‘soldiering on’, (since my GP hadn’t been too alarmed at what I now know are classic ‘red flag’ symptoms), walking my dogs and lifting heavy cases. I am incredibly lucky that I didn’t do more damage. Eventually, I was fortunate that a well-informed osteopath sent me straight to A&E (Emergency room), and I was soon signing consent forms that acknowledged terrifying risks, before swiftly being whisked to theatre for intricate neurosurgery. It should be noted, that I have always had a fear of hospitals, and have been terrified of General anaesthesia, but the emotional roller coaster I rode in this instance elevated me to a surreal state, a strange mixture of denial and resignation, that fear was neatly sidelined to a manageable degree. An experience almost as if watching myself in this situation, disbelieving it was really happening, a bad dream I couldn’t wake up from; yet coupled with an acceptance that nothing I could do could change the course I was hurtling along. I guess at some point, I mentally handed over responsibility for my future mobility to my medical team and God, the Universe, a higher power; whatever you want to call it, the name is irrelevant, in times like this you find ‘something/someone’ to have internal conversations with.

I am incredibly blessed, my surgeons were skilled and my nurses compassionate, and after several successful operations I am able to walk unaided. I have some numbness and a little nerve damage, but these are small, manageable issues compared to the potential difficulties I could otherwise face. I have found an online community, a support group of CES patients, and am aware of how fortunate I am to be one of the lucky ones. I’m also aware of how brave so many people are, quietly battling such a debilitating, and often invisible condition, that spinal injuries present. I’ve come through the initial trauma, feeling extremely grateful, yet also suffered anxiety associated with the fragility and vulnerability. I think that previously being relatively fit and fiercely independent, I have found the contrasting lack of mobility and reliance on others, particularly frightening, and understanding the risks, worry that every twinge could be dreadfully damaging. However, I am having physiotherapy, and each day is a step forward, and I’m gaining strength and confidence with each one.

My best medicine has been my darling dogs, their caring cuddles and unwavering affection have been comforting and heart-warming. It’s very difficult to feel sorry for yourself when you feel such love and loyalty. They are also very motivating, I can’t wait to walk them, or even be able to drive them to the paddock to watch them run. I have however been very fortunate to have some wonderful help looking after them, and am very grateful for everyone who has taken care of them. It’s in times of crisis we really find out who our friends are, and I have been very blessed with lots of love and support too.

As I write, I hear footsteps on the gravel outside, and Platon’s ears prick up in anticipation, as KG, my friend and current carer, returns from a walk with Leo (my other dog). Once he is sure, Platon launches himself off my daybed, and stands expectantly at the door, his tail wagging forcefully, like a metronome; until he can contain himself no longer and jumps up, bracing himself with his paws on the door as he peeks out the window. This means that the peace
I needed to write is about to cease, since my boys, thrilled to be reunited after a whole heart-breaking hour, will play exuberantly and require my attention.

I just wanted to pop in here, and let you know what’s been happening, by way of introduction to my current situation, as suddenly I find myself with time, and lots of material for writing again. I feel as if I have missed chatting with old friends and have lots to catch up on; the arrival of Leo into our lives will be a chapter, as well as our journeying between London & Greece. There are stories to share about my injury and the beacons of light that shone in the darkest moments, the caring compassionate nurses, the bravery of fellow patients on my ward, and realisations about life’s unexpected twists and turns that may actually have been necessary in guiding us to where we are meant to be. Meanwhile, two young and lively dogs are calling me with their playful antics, so I hope you are all well and I’ll write again soon, I promise! Blessings & love, Hxx

{Photo ~Via pinterest, sadly uncredited, words ~by me, Hayley Darby ©2016}