Week 1 with My Disc

The numbness from the epidural lasted a few hours and then gradually wore off. It was abit weird to feel dense numbness down my legs. My legs gradually turned from rubber to more sure. Some stiffness returned and the sense that I could get in serious pain by moving the wrong way reared it's ugly head. However, even with those things, I was vertical again and so thankful.

Having spent my entire professional life in pain management, I knew there would be a few rules of the road:

1. No pain, no gain doesn't apply. While some bad science and superstition has led to the idea that patients with herniated or bulging discs should just return to all normal activities, I knew this was silly. For every tweak of the area (a position that caused severe pain or any sensation like cramping, weakness, tingling or even a funny feeling in my legs), I was causing a problem I would pay for by a longer recovery. The reason is that the small muscles that stabilize the back are also supplied by the same nerves I would be pissing off with these moves. This means that my ability to protect these nerves in the future (a job handled by these multifidus muscles), would be lessened. You can see these changes on MRI, as these multifidus muscles grow smaller and become less able to stabilize the spine.
2. Return to normal activities as quickly as possible. While this may sound contradictory, it isn't. In number 1 I presented the "Yin" rule, keep the area quiet. This is the Yang to rule number one's Yin. While it's true that I could piss off the nerves that hold the system together, I also had to prevent the secondary problems of muscle wasting and generalized deconditioning. This meant get moving as quickly as possible, hence the reason for my early epidural.

To summarize here, I had to allow the area healing and keep the nerve happy, while getting back in the saddle quickly. How did this work? Some examples:

-On day 3, i did 30 minutes on a StairMaster. When I noticed any sensation in my legs or the back spasm acting up (sure signs that the nerve was being irritated), I backed off.
-On day 4, I went back to a mild weight work-out and avoided carrying or lifting anything where my back was unsupported. Anytime I felt the tell tale signs of nerve irritation, I cut back.
-On day 5 I tried my usual hike/climb up a local mountain trail, but soon learned at even half speed, these climbing movements were causing some numbness in my legs. I bailed on the hike and spent an hour on my bike instead (this caused just some very light sensations).

For the first week, fatigue is my friend. I am very tired. This is likely because everything takes a bit more effort and I'm still dealing with some mild, chronic pain. I get to bed early every night.

I avoid all meds. I did take a few medications the first day, however, thanks to my epidural I don't need these. Regrettably, this is where so many of patients get hooked on narcotics. Without the luxury of prompt pain relief the first day, they take the only thing that works, narcotics.

My first week was a success, manageable pain, slow steps (I still get sharp pain if I move too fast in specific directions, sit too long, stand too long, or just stay in the same position for too long), and a rapid return to maybe 50% of my normal activities.