A lifetime [of spinal injury]

short: eh, it's me flapping my gums about drugs and life in general.

So I have both kyphosis and scoliosis (curvature forward and laterally, respectively) of my lumbar spine. I owe both of these to auto accidents, although carrying some additional weight around my belt line has not helped things (the concussion I sustained in February has resulted, in a way rather opaque to me, in my losing around seventy pounds[!!]). This has, in a peculiar twist of fate, resulted in my becoming an inch shorter than I was in 1993 – when I got my first driver's license. I guess this sort of makes me smaller in several directions.

The mechanical damage is four fractured, in total, of five (six?) lumbar vertebrae. I am not especially hopeful about this condition. Looking forward, I am almost certainly going to have osteoarthritis and back pain for the rest of my life. Today, it's an effort to move around, stand, and even sit (I am getting my first hair cut this year because of the spine shenanigans this year, having been unable to sit in a chair until now).

I don't know what that means, medically. I am in fact a rather active dude when permitted to be. I quite frankly don't see much cessation in my normal activity, stupid or hazardous though it may be. Wife and I are presently in the market for a litre-sized sportbike (having borrowed the excellent and rather striking GSXR 1000 from a friend for two weeks, only to discover that while we can easily afford the bike, the insurance is on the order of $100/mo for both of us, who have "perfect" driving records), and if anything, I see that activity as increasing, rather than flagging at all.

The obvious concern to me is that, as I am just now easing into my thirties, that for the next seventy-or-more years, I will be using, and likely dependent upon, palliative care. The consequences of long-term opioid use vary by individual, and while I seem mostly not susceptible to too much physical addiction, I consider the usage of e.g., fentanyl to be crucial as an enabler for me to get out and do the things, including working, that I like to do. Doctors, of course, are not terribly thrilled about enabling somebody to use opioids long-term, especially if there is zero chance of the patient being rehabilitated. I suspect one or more of my doctors, in the next couple months, will set the tone of the coming decade and indeed the rest of my life. As I said, I am not hopeful. We frequently make exceptions with the very high dosage or potency of analgesics for patients who are terminal, but as I am obviously not terminal, and yet obviously substantially broken, I have no idea whatever how doctors will react to my condition. To be honest, even I don't really know how I feel about it. I don't like thinking about being dependent upon fentanyl patches for the rest of my life, but it hardly seems like a real problem if somebody cuts out all the red tape and suspicious faces that the drug comes with.

In a way, it's rather like accepting the responsibility of riding a motorcycle. I have in fact driven somewhat north of 140mph without a helmet on a slightly damp freeway, but for the most part, I very much behave, and in fact, drive more slowly and cautiously than anyone I know. The same is true of the drug: there is the opportunity, handed to you every day, to kill yourself if you screw around, but for the most part if you keep your eyes and ears open and use responsibly, there's little fuss.

People are astounded when I recall the number of broken bones I've had, dislocations, injuries in general, and how casual about it I am. I see it, perhaps foolishly, the way professional athletes approach injury. MotoGP riders are generally never at "100% health", as we've seen Dovizioso riding and winning with broken ankles. For my part, I am rarely ever uninjured. Whether through stupidity, clumsiness, stubbornness or hubris, I get injured. A lot. This has gotten one physician to ask for a bone density test, to see if perhaps I am just more fragile than the rest of you. That's actually rather perceptive, although I suspect I will again be shown to be "normal with a touch of stupidity." The one thing that leaves us with some question about bone density is the year of the yeast infection, in which I stayed on prednisone for what might have been four to six months. Again, I'm not sure even a declaration that I am far more likely to break a bone than others will actually slow my level of risk-taking behavior. Is that, itself, a disorder? Probably, but it's not one I care to be treated for. I am not the boy in the bubble, or the hemophiliac heir, hoping to propagate my legacy, genes, or anything so noble.

A friend of mine recently referred to me as "starting a, no shit, rocket science company." I am in fact doing that. Spun, my company, is sort of emerging this weekend. I will be looking to talk to people that think big and do things that may be perceived as stupid–getting into space with a turbojet comes to mind. It really is true, that ad astra per aspera business. I may have just stepped up the speed, risk, and pace to levels I hadn't reached in the past; what greater way to live, or die, than on a column of human will, reaching into the sky? It sounds melodramatic, but how could one possibly overstate the drama, passion, or single-mindedness that is clawing your way out of a gravity well? This is the stuff that kept folks like Einstein and Newton awake at night, to say nothing of von Braun.

I think I've previously stated that the status was situation normal, all fucked up. Today is not much different. Things are moving along with or without my input, and to quote another friend of mine, "where are we going? and what is this handbasket?" So, there's a fair amount of – to use the literal rather than vernacular meaning of the word – drama afoot, but this is hardly out of the ordinary. The dude abides.

At any rate, I wanted to update those who pay attention. I had a very bad day at physical therapy, as regards the back. I couldn't complete one of the series of stretches (of four or five), nor three of the exercises (of five), none of which had been a problem for me before. I had more pain today than I've had in a very long time, and to be perfectly honest, I don't think 75 mikes is actually doing the job with the fentanyl. I really don't. It's not "breakthrough pain" if it is static and in one location. My surgeon has talked about possibly going after these spinal "joints" that are, according to him, rather like fingers (broken a number of those so far, too). I think his plan of attack was to locally administer anti-inflammatories. This seems akin to the first treatment I had for the injury, and injection of Toradol, which, happily, worked (which is to say, made a positive impact on pain for a few hours, but not to go as far as saying it was panacea). The people at the hospital are concerned but cheerful in that way that people who work at hospitals are, telling me that everyone has bad days or bad weeks. They didn't seem to react to my stating a preference for "good" and "better" weeks, which is rather a disappointment. I don't recall when I see the surgeon again, but I may step up the pace if I continue to see as much pain as I did today, or the non-effectiveness of the fentanyl (today, "patch day," I feel approximately no effect from the patch).

I have no further trite quotes or allegory to add. The situation, fucked up as it is, is status quo.