Beyond Black : Hilary Mantel

Struggling this week.  I know its only a few days post operation, but its awful being unable to do much at all.  So what is left? To forget about the untidy house and piles of 'must do' papers, and sit (or lay) down and give time over to a book.  I have had Beyond Black (2010) for a number of years. Not sure from where it came from or why, but I finally settled down to read it and was amazed at how it kept me from thinking of the dirt and papers piling up!
                                      
The Blurb: Alison Hart is a medium by trade: dead people talk to her, and she talks back. With her flat-eyed, flint-hearted sidekick, Colette, she tours the dormitory towns of London's orbital road, passing on messages from dead ancestors: 'Granny says she likes your new kitchen units.'  Alison's ability to communicate with spirits is a torment rather than a gift. Behind her plump, smiling and bland public persona is a desperate woman. She knows that the next life holds terrors that she must conceal from her clients. Her days and nights are haunted by the men she knew in her childhood, the thugs and petty criminals who preyed upon her hopeless, addled mother, Emmie. They infiltrate her house, her body and her soul; the more she tries to be rid of them, the stronger and nastier they become.

This tenth novel by Hilary Mantel, the critically acclaimed author of Giving Up the Ghost, is a witty and deeply sinister story of dark secrets and dark forces, set in an England that jumps at its own shadow, a country whose banal self-absorption is shot through by fear of the engulfing dark.

I couldn't have said it better myself!  If you have any interest in mediumship or hauntings you will love this book - especially if you have a dark sense of humour!

What Did I Have Done - Operation(s) - Lumbar Discetomy for Lumbar Disc Prolapse

The operation I had both times was a Lumbar Discetomy for Lumbar Disc Prolapse.

A Lumbar Disc Prolapse is usually confirmed by an MRI.  My consultant at Sheffield commented that mine was 'very impressive'.   He didn't mean this in a good way!

Each vertebral bone is separated by a inter-vertebral disc.  This disc acts like a pressure cushion.  It consists of a fibrous outside (annulus fibrosis) and a soft inside (nucleus pulposus). A lumbar disc prolapse (disc herniation / slipped disc) is where some of the central soft disc material has been pushed backwards through a weak area or tear in the outside fibrous part of the disc.  When this material touches or presses against one of the nerves (nerve roots) in the spine, pain down the leg (sciatica) results.

The majority of disc prolapses occur where there is already some weakening of the fibrous outside of the disc that is associated with wear and tear / degenerative changes in the spine. 

The main reason for offering surgery is to relieve severe radiating leg pain (sciatica).  Surgery does not benefit lower back pain. Surgery only takes the pressure off the compressed nerve root.

The operation is done under general anaesthetic and takes about an hour. The surgery is usually done through a cut about 5cm in length on your lower back.  After going between the muscles in your back, a small window, about 1cm in diameter is made into the spinal canal.  The offending disc material is removed as well as some adjacent disc material within the disc space.

A Lumbar Mictodiscectomy does not prevent the possibility of a future disc prolapse as not all the disc is removed due to increased risks of surgery. (injury to the abdominal blood vessels lying on the front of the spine).

Risks include deep venous thrombosis / pulmonary embolus (clot in leg/lung); hence the need to wear surgical stockings during the operation and for a time after the operation.    I was given a whole list of 'risks' to read about prior to surgery, but as I could not walk and was in a lot of pain, I felt the risks weren't significant enough to stop me having the operation!

Once home, I was advised to attend my GP surgery for removal of my staples at 10 days.  For the first 2 weeks following surgery, sitting should be minimised to essentials; such as toilet and eating.  Driving is considered inadvisable in the early weeks, even as a passenger.  However, exercise should be maintained, in particular walking.  Although not too much and watch your posture!!

'Discomfort' following surgery is common.  There are a variety of pain killers that can be taken.  Taking painkillers is preferable to letting any discomfort get bad and then having to control it, which will be more difficult.

If you are overweight (I am now!) you should consider losing weight as this will reduce the chances of spine wear and tear related problems I the future, including disc prolapse.

You will require 6 weeks off work (at least!).

Operation Number 2

All was going well.  I managed to go to my mums for Christmas Day and attend the Post Christmas party I had organised for the children.  Then I started walking.....  The first time I went out (17 days post op) I cried all the way back and did 0.71 miles in 22 minutes.  On New Years Day I managed 2.24 miles in 30mins.

Then over the weekend, I put the Christmas decorations away.  I went into the loft, and perhaps I should not have....as on the 6th January 2016 (Wednesday) I attended my GP with severe pain down my leg (again).  I asked if she could re-refer me to the Lincoln LCATS to be seen, but she said that as I was still under Sheffield I would have to see them!  She did give me some Tramadol for the pain though. On the Thursday I realised that actually I had lost all sensation in my foot.  I could not move it at all. I began to panic....

Luckily, on the Friday I had an appointment with the Physio at the LCATS service.  She took one look at my leg and called in the Consultant who confirmed I had 'Drop Foot'.  He was very concerned and ran Sheffield to try and speak to my consultant there.  Unfortunately, he had finished for the day/week.  The consultant told me to go to A&E.  We waited 3 hours in A&E to be told to just 'wait and see'...... 

Consequently, I rang Sheffield on Monday morning (Jan 11th).  They were able to bring my appointment forward 4 days and I was seen that evening.  Mr Zaki took one look and then sent me off for an MRI.  This time it was a full size MRI (not a mobile one) and so it was legs first and a lot less claustrophobic!  The MRI showed a small recurrent sided L4/5 disc prolapse.  In his letter to my GP he was rather scathing of Lincoln A&E!  His letter goes on to say My biggest issue here is that there has already been a 3/4 day delay and the chances of recovery of her footdrop are becoming slimmer......I am just worried that her footdrop is not going to recover but I will make sure that she has her surgery expedited in the next 2/3 days.....I will list her for a recurrent left L4/5 discectomy. 

Operation Number 2 was 14th January 2016.  This time I was lucky enough to have a single room.  We assumed that I would be allowed to go home about the same time as the last operation; which was just before lunch.  However, I was given antibiotics via a cannula in my arm and told I would be having three lots - the last one at 10pm.  From then on, I told anyone who would listen that IT'S MY BIRTHDAY!

The Physiotherapist was really good.  As my foot drop still seemed quite bad, she brought me not only a splint for my leg, but also a picker upper - so I can't say I didn't get any presents!  I know she asked someone about my antibiotics and when Mr Zaki's registar came, I asked him as well.  He said he would have a word with Mr Zaki.  It seemed they had only prescribed the antibiotics as it was my second operation in 4 weeks. 

There were tears.... That seemed to do the trick.  Mr Zaki arrived.  He seemed happy with the movement in my leg / foot and was happy to let me go.  He even wished me a Happy Birthday!