Thursday, August 28, 2008

Nannie: Medical update

Today Nannie’s appointment with Dr. Munton was at 4:30, but she wanted to be there at 4:00. I pulled into the drive at 3:58 and she arrived about 4:10. They called her in right at 4:30. He had read her chart before entering the room and asked how she felt today. Answer, “Hurting”. It was 5:20 when we left and she did most of the talking about matters unrelated to health, but it makes her feel better to talk, which I hope this office understands by now. They had clearly had a long, perhaps difficult day, and were very tired, but listened to her until she really got off the subject. Dr. Munton reins her back in very nicely and helps her focus on the subject at hand. I’m so grateful to him for that.

His consensus is that the injections are only giving her short term relief now and are causing more side effects than long term benefits. The spine is such a mess, but from the previous success of the injections they know for sure that it is the L2 nerve that is causing her the most unbearable, burning pain down her right leg. He asked her which surgeons she had seen in town and completed paperwork to send to a new one, faxing records and test results. It may take up to 2 weeks to get the appointment when the Labor Day holiday is factored. The surgeon is Talmadge Trammell, a former violin student of mine, who is a neurosurgeon. Dr. Munton’s theory is that now that he knows the L2 nerve is the pain center, perhaps a disc can be removed that will alleviate the pressure on the nerve and the resulting pain.

This is how Dr. Munton narrowed the options:

  1. No longer having good long term results from injections, plus reacting to the cortisone
  2. Reactions to medications are unsatisfactory and complicated (Lyrica and Cymbalta did not work, causing some side effects. Pain patches unsuccessful and are very powerful medications which require careful withdrawal. Only med that gets results is hydrochodone, which is causing side effects such as loss of appetite, weight loss, sleeplessness. Keep taking the antidepressant.)
  3. Back brace may help by compressing the nerve into a comfortable position. He wrote a prescription for that.

Nannie really balked at the idea of surgery and began to voice many objections. He stopped her and asked first, if she objected to pain and suffering, then asked what she feared most about surgery. She began to cry and told him she feared losing her independence if surgery resulted in paralysis or further injury. He told her those are valid fears, but that her quality of life is pretty low now. He also told her he wished he had a magic pill, injection, or procedure that would take away all the pain and leave her happy, but he does not. I so appreciate his honesty and compassion toward her, and his willingness to continue trying to find a solution. He told her that when her body protests and she can’t move her body to help her get past the pain of missing Daddy, that she needs to use her mind. She cried more and explains that when she hurts really badly she can’t concentrate to crochet or remember what she reads.

Please pray for Dr. Trammell, for Nannie, and for pain free days and nights. She is very tired, and some of her strong will is broken. We’re giving thanks for Dr. Munton tonight.

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