But what happens on February 3rd?

The Patient Path

It's always February 2nd - ThisIsAuthentic.com

If, like me, you are a fan of redemption movies—and of Bill Murray—then today you tuned into AMC and watched Groundhog Day…again…and again…and again….


My favorite part of this time-warp movie comes near the end, when Phil (also the groundhog’s name) Connors finally gets it. He starts living in the ever-present moment, the only way we can experience earthbound time. Even before he learns how to escape from the time loop he’s caught in, he starts to accept his fate and begins learning how to live a perfect day that only infinite re-dos make possible.

But what is a “perfect” day, anyway? The message of the film is that this Scrooge-like guy becomes his best self through learning compassion for others—all with a comic and romantic twist (not unlike Bill’s other redemption movie from 1988, Scrooged). And his reward for living a perfect February 2nd is? Ta-da: February 3rd.

However, on the…

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Happy Thanksgiving 2016

freedom-from-want_norman-rockwell_1942

“Freedom from Want” – Norman Rockwell, 1942

Wishing everyone on “The Patient’s Path” a very happy and healthy holiday.

Courtesy of my husband, Farok Contractor, I share these interesting reflections on our national day of gratitude: Second Helping: Thanksgiving Day and Globalization, a refreshed version of his November 27, 2015 post.

The original post provides interesting historical perspectives and fun facts about Plimoth Colony and Plantation, an Amazing native American named Tisquantum (“Squanto”), and the Mexican origins of our favorite Thanksgiving entree: turkey.

All the best on this most grateful and gracious of American holidays.

Happy 3rd Anniversary, Patient Path!

The Patient Path began on November 9, 2013 . . .

3-forget-me-nots

. . . just 5 days after I was diagnosed with uterine (endometrial) cancer.


Three years later, I am grateful to be a cancer survivor. And I want to hear more women diagnosed with this disease say the same thing.

More than 60,000 American women will develop uterine (endometrial) cancer in 2016—and 10,000 of them will die of it. Most of this disease’s victims are over the age of 60, but it can strike women of any age.

Uterine cancer doesn’t get much media attention. And if women don’t learn to recognize the risk factors and symptoms,* and get timely, proper treatment, their lives may be compromised—and even shortened.

By raising awareness of this fourth most common cancer in United States women, and the most common gynecologic cancer, we can help stop this disease from killing the organ that gives us life.

The mission of our sister site, The Patient Path, is to provide informative and inspiring personal stories, supplemented with well-documented, highly reliable sources of information and support. Its goal is to educate, enlighten, encourage, and empower women to be full partners with their healthcare teams. .

Please visit often for exciting updates, including more stories of uterine cancer (read how mine began here), other stories of gynecologic and breast cancer (see Diane’s Story), new media content, webinars, and live events. Also see the stories on this site for additional healthcare stories and resources that help all patients navigate the healthcare system.

_______

*My only symptom was postmenopausal vaginal bleeding. Like the presidential election result of early today, November 9, 2016, uterine cancer blindsided me: I never saw it coming.


A Few Statistical Resources

American Cancer Society 

National Cancer Institute 

Centers for Disease Control and Prevention

Foundation for Women’s Cancer

Women’s Cancer Research

Reference: https://thepatientpath.net/2016/11/09/happy-3rd-anniversary-patient-path/

Chelsea’s Story: Spinal Surgeries for Scoliosis & Degenerative Disc Disease

Female Spine_Two-Thirds View_Blue

The following narrative comes from Chelsea Rubinstein, a young woman I met recently at a seminar. After hearing me mention that I had a website dedicated to telling personal healthcare stories complemented with resources and information to educate, empower, and encourage others on their own “patient path,” Chelsea shared her story with me. Then she offered to post it on this site in the hope that it would benefit others struggling with extensive spinal issues and back pain—and considering what to do about it. 

If you have spinal deformation or degenerative disc disease and are looking for information and support, you will find it here. In Chelsea’s words:

“After two years of physical deterioration, pain, and mental anguish, I finally had the surgery my doctor recommended—and it took away my pain. Afterward, he asked me to write this narrative, suggesting that if I could save even one person from the suffering I endured, it would make everything I went through worthwhile.”

Chelsea chose November 1, 2016 as the date to publish her story in part to commemorate the twenty-second anniversary of her first back surgery when she was eleven years old. And it was four years ago this month that she made a very difficult decision about a second procedure that would affect the rest of her life. Read on for the moving, inspiring story of perseverance, courage, and self-empowerment that led to freedom from agonizing back pain and disability.


INTERACTIVE POST: Highlighted/underscored text, images, and media contain links to reliable external resources. The stories, information, and resources on this site are intended to supplement—not replace—the advice of your clinical team.
Video Inspiration: Wean off of pain meds and rediscover the world.

Chelsea: Why I’m Sharing My Story

After my second spinal surgery four years ago, I met a lot of interesting and inspirational people at physical therapy. We swapped war stories—some of success, which could often be very encouraging, and some of disappointment, which could often be quite disheartening. We shared stories of woe, helped each other set goals, and sometimes just listened. We were part of a huge support system—even if we did not suffer from the same ailments, we all understood what it was like to live with pain.

One thing we often talked about was our relationships with our doctors. Most of us felt very close to the physicians and surgeons that took care of us. In talking to the people at physical therapy, I couldn’t help but compare the decisions they made in dealing with their medical conditions to my own choices. Did they do extensive research? Did they seek out reputable hospitals? How many doctors did they see for additional opinions? How did they go about choosing a surgeon?

For me, the research I did prior to surgery was both extensive and exhausting. The time and energy I put into educating myself and worrying about my situation was as tiring as living in pain every day. I will never forget the stress, dread, and mental anguish I experienced between the time I was diagnosed with degenerative disc disease and the time I—finally—had surgery. In the end, my efforts paid off—I chose a surgeon that cured me of my pain. Now, both my physical and mental stress are gone.

This narrative is dedicated to all the patients, family members, and friends of people who are suffering with severe pain. In sharing my experience, I hope I can help alleviate at least one other person’s stress. It is natural to be scared; and there is nothing wrong with doing research and asking as many questions as necessary until you are educated enough to make an informed decision—in fact, it’s the right thing to do.

I hope my story will inspire readers to get answers, seek multiple opinions, and take an active role in their healthcare decisions. Good luck, and don’t give up hope.

How My Life Was Affected—Two Years of Anguish Was Enough

It was November 2012—my friend’s birthday—and we were celebrating at the exclusive club inside Revel, then a brand-new casino in Atlantic City. We were with a large group of people, and rather than dancing and smiling and drinking, I was trying to hide from them so that no one would be concerned with me. I was tired of everyone being concerned with me—tired of the pain, tired of the shame, tired of the pity. I just wanted to be a normal twenty-nine-year-old out with her friends, partying.

“Hon, you can’t sit there,” the bouncer said as he tapped me on the shoulder. I was sitting in my fancy dress and heels in the dirty stairwell. People were staring at me, pointing and laughing as they walked by.

“I’m not drunk,” I pleaded to the bouncer. “In fact, I just got here five minutes ago. I have back problems, and I just need to rest for a minute.”

“OK, that’s fine—but you can’t sit here,” he said, feigning a look of concern. I knew he didn’t believe me and that he thought I was thoroughly intoxicated.

I struggled back to my feet and found my brother and my friend Brittany. “You OK?” they asked simultaneously. They were already used to my back problems. After all, it was almost two years since my diagnosis. At this point, the pain was almost constant, and the length of time for which I could walk or stand was steadily decreasing, even when I wore my most comfortable sneakers.

“I’m OK,” I replied, trying to hide my agony. “I just need to sit.” We searched around the enormous club, but there were no seats. Finally, we found a couch, but it was in the VIP area—$1,300 for bottle service. I could feel the eyes of the bouncers burning into me. I was already on their radar, and they just needed an excuse to kick me out.

My brother, Brittany, and I went outside to the smoking area on the roof, the only place where we could find a place to sit. On this late night in November, the wind sliced through our entire bodies. I had no place to go—inside there was no place to sit, and outside we were tortured by sub-zero temperatures. Standing was no longer an option.

“I’m going back to the room,” I told them, unable to look either of them in the eye. “You guys stay here. I’ll be fine.” No matter how much I begged, they would not let me go alone. There was no way they would let me take a taxi back to Harrah’s, where we were staying, and then walk back to the room by myself when I could barely walk at all. I offered to reimburse them for the $40 cover charge to enter the club, but they refused. And by the time they returned after getting me back to the room, the line would be too long and they would never get back in. The shame was unbearable. We left without even saying goodbye to the birthday boy.

This was the deciding moment. I could not do this anymore. I had put it off long enough. I had suffered long enough. I had allowed my friends and family to endure my pain and suffering long enough. The quality of my life had deteriorated enough. I could no longer go out with friends, go shopping, dance, or even walk or stand for more than 5–10 minutes. How much I didn’t want to have yet another surgery on my spine no longer mattered. It had become a matter of necessity.

How It All Began—Scoliosis in Childhood

In 1994, when I was eleven, I needed surgery to fix severe scoliosis. My spine was shaped like the letter “S,” with a double curvature of 48 and 52 degrees (measured using the Cobb angle). At the time, my childhood innocence and ignorance were working in my favor. I was entering middle school, and my choices were, in my mind, simple: (1) wear a back brace and wait a few years for a surgery that was inevitable anyway, or (2) have the surgery and move on with my life with no bracing. My family did extensive research, including visiting five pediatric orthopedic surgeons in New Jersey, New York, and even Boston.

In the end, we chose surgery. My pediatric orthopedic surgeon, Dr. Samuel Laufer, did the procedure at Robert Wood Johnson in New Brunswick, NJ. He fused my spine from levels T3 (thoracic vertebra 3) to L3 (lumbar vertebra 3), placing bars, hooks, and rods in my spine to straighten it out.  I was out of school for a painful two months, but after recovery I was fine for the next 14 years!

(Click to view a video animation of scoliosis at Spine-health.com.)

(Click to view a video animation of scoliosis causes, symptoms, and treatments at SpineUniverse.com.)

(Click to view a video animation of spine anatomy at Spine-health.com.)

(Click to read more about two approaches to scoliosis surgery at Spine-health.com.)

(Click to read more about scoliosis surgery approaches and procedures at SpineUniverse.com.)

How It Started All Over Again—Sciatica and Worse in Young Adulthood

In my mid-twenties, I began to experience sciatica (nerve pain that ran down my leg). It began to affect my everyday life, and I started to feel depressed. I visited several doctors and had an MRI. Unfortunately, the MRI was inconclusive because the apparatus in my spine blocked the view. My doctors suggested core strengthening exercises and a strict diet. Having struggled with my weight my whole life, I was accustomed to doctors telling me this type of thing. So I went on a diet, and after losing only nine pounds, the sciatica disappeared—life was back to normal. (Click to view a video animation of sciatica at Spine-health.com.)

Two years later, I was down 40 pounds! I was working out six to seven days a week at the gym, doing Zumba®, salsa, and hip-hop classes. I was even going to get my license to become a Zumba instructor! I was looking and feeling the best I had in my life.

In the summer of 2010, when I was 27, I was on vacation in Aruba, shopping with my friends. All of a sudden, I felt the familiar twinge of pain down my leg. For anyone who has ever experienced sciatic pain, it is unmistakable. “How can this be?” I thought. “I’m in the best shape of my life!” I tried to ignore it for a few weeks, but I finally had to see a doctor.

The first doctor I visited was Dr. Steven Reich, an orthopedic surgeon in North Brunswick, NJ. My family trusted him because he had done my brother’s surgery for a bulging disc (following an accident) several years earlier. My brother’s surgery was done laparoscopically, and he was in and out of the hospital in one day and back to work in two weeks—problem solved. When my mother and I arrived at Dr. Reich’s office, I was calm and collected. I thought he would send me to physical therapy, and if that didn’t work, perhaps I would have to endure a laparoscopic outpatient surgery, like my brother. I could handle that—no big deal, especially after what I went through when I was eleven.

Dr. Reich diagnosed me with degenerative spondylolisthesis and arthritis. He explained that the cartilage between my vertebrae had deteriorated so that my discs were resting bone on bone. My disc had also shifted forward and was resting on my sciatic nerve, causing the pain. We knew it was pretty severe because I had pain all the way down my leg and pins and needles in my toes. In addition, my big toe had lost a significant amount of strength.

Spondylolisthesis Brochure Images

Spondylolisthesis Images – Click to Go to the Spine-health.com Brochure

(Click to read more about spondylolisthesis at Spine-health.com.)

(Click to view a video animation of degenerative spondylolisthesis at Spine-health.com.) 

(Click to view a video animation of spondylolisthesis symptoms and causes at Spine-health.com.)

He recommended spinal fusion surgery. They would place a spacer between my vertebrae and add some screws to hold it all in place. Then they would scrape out the arthritic bone and decompress the nerve. In order to do so, they would have to remove a piece of the apparatus that was already in my spine to gain access to the area. I would be out of work for approximately three to four months. It would take six months to a year to fully recover.

Spinal Fusion Brochure Images_Spine-health

Spinal Fusion Images – Click to Go to the Spine-health.com Brochure

(Click to read more about lumbar spinal fusion surgery at Spine-health.com.) 

(Click to view a video animation of spinal fusion surgery for degenerative disc disease or spondylolisthesis at Spine-health.com.)

(Click to view a video animation of spinal fusion surgery at SpineUniverse.com.) 

A wave of emotions ran through me, including sadness, fear, self-loathing, self-pity, dread, and—most of all—anger. I was angry that I had to endure yet another surgery on my spine. Wasn’t one major surgery in a person’s life enough? I was most angry at Dr. Reich. I hated his diagnosis, and I felt his attitude was too nonchalant. He even cracked jokes and tried to make light of the subject. But to me, this was not in any way a laughing matter, and at the time I did not appreciate his bedside manner.

I felt like I was eleven years old again, back in the pediatric orthopedist’s office when my mom and I had first gotten the news that I needed surgery. Only this time, I was not armed with childhood innocence and naiveté. On the contrary, I had the painful memories and the experience of the first surgery working against me. There was no way I was having another procedure! Dr. Reich explained that waiting to have the surgery until I was ready was not physically damaging; however, the quality of my life would continue to deteriorate as the pain grew worse and worse over time. I was convinced that I could deal with it and left the office, determined not to have the procedure until I decided it was the right time.

How I Tried to Avoid the Inevitable . . . While Gathering Information

In the following months, I pursued several other opinions. I was looking for a quick fix. After all, before my brother’s laparoscopic surgery, several other doctors wanted to perform traditional surgery on him. It was Dr. Reich who offered him a less invasive option. If he could do this for my brother, surely he could do this for me! My faith in Dr. Reich’s recommended approach to my problem dwindled at this point, and I was determined to find another doctor who would offer other options.

I visited several other orthopedic surgeons in both New Jersey and New York City. The diagnoses were all the same, and all the doctors recommended spinal fusion surgery. However, they all had different methods and approaches. Dr. Reich had said he would go through the same incision in my back that was already there from the previous surgery. Dr. Darryl Antonacci, a nationally known spine specialist in Princeton, wanted to go in through my side. Dr. Russel Huang, an orthopedic spine surgeon at the Hospital for Special Surgery in New York, wanted to fuse two of my vertebrae instead of just one, going in through both my back and my abdomen. (This option frightened me.) I even spoke to a doctor in San Francisco who wanted to remove all the hardware in my back before the new spinal fusion. (This option really frightened me.)

All these differing opinions and approaches just increased my anxiety and stress levels. My hopes of finding a quick fix rapidly dissipated, and now all I wanted to do was to find two doctors to agree on how to approach the surgery. I felt like I carried a huge weight with me all the time. Everyone around me was like, “Just get the surgery!” They didn’t understand the implications the way I did. And I was a just fourth-grade teacher, not a medical expert; I felt completely ill-equipped to make the decision about which approach was the best. So I continued to ignore the problem.

And I continued to live my life to the fullest. Shortly after my initial visit with Dr. Reich, I got my license to teach Zumba. I gradually gained more and more of a following until I was teaching six to seven classes a week, with my class sizes averaging between 30 and 80 people. I taught at some of the best gyms in the area, did several Zumbathons for charity, and become a well-known and sought-after instructor. Mentally, I was feeling amazing! I had never thought I would enjoy exercise, never mind become an exercise instructor. I was continuing to improve my physique while motivating and inspiring others with stories of my weight loss journey and fitness goals.

Zumba

ZUMBA® is a registered trademark of Zumba Fitness, LLC.

But my body was suffering every day. At night, when I was teaching Zumba, the adrenaline carried me through the pain. But during the day, I was hardly able to perform my teaching duties. I tried my very best not to complain too much or allow my problems to affect others, and I continued to teach Zumba for a year. But I finally had to stop in May. Stopping Zumba was a last attempt to continue postponing the surgery. But for anyone who knew me, and understood how much Zumba meant to me, it was obvious that my pain levels were greater than I let on. If I was giving up Zumba, everyone knew it was a big deal.

After that, I still managed to lead a full social life, go on two international vacations, and have a relatively normal existence. But my back problems began to govern the things I would and wouldn’t do. Social situations in which I could not participate became more and more frequent as my pain continued to get worse. The last straw was the Atlantic City episode that I described at the beginning of this narrative, when I decided that it was, finally, time. But I still had not found two doctors to give me the same opinion as to which approach was best. I felt like I had been in limbo for the past two-and-a-half years, and I could not come up with the best means to a good end.

After stopping Zumba, I returned to physical therapy for core strengthening. Nick Maniscalco, my physical therapist at Twin Boro Physical Therapy in Edison, NJ, is, to this day, one of the most important and influential people in my life. He has been a tremendous source of knowledge, as well as emotional support. He had a history of back problems himself, and he had surgery at the age of 29 as well. He spoke very highly of his doctor, Dr. Michael Neuwirth, an orthopedic spine surgeon at New York Beth Israel, so I made an appointment to see him.

Dr. Neuwirth recommended fusing one of my vertebrae, but with both a posterior and anterior approach. He was a seasoned surgeon, and he knew most of the doctors I had already seen. This included Dr. Laufer, who had performed my scoliosis surgery, and Dr. Reich—who had been Dr. Neuwirth’s intern! Dr. Neuwirth raved about Dr. Reich’s abilities, giving him his highest recommendation and endorsement. I liked him a lot, and I left his office practically prepared to schedule surgery with him. But with a lot of coaxing, my mother eventually convinced me to visit Dr. Reich one more time to try to understand why he preferred just an anterior approach when Dr. Neuwirth recommended going in both posteriorly and anteriorly.

How I Finally Decided to Have Surgery—“Back” to the Future 

When I visited Dr. Reich again, I was in a very different frame of mind than when he first diagnosed me. I was mentally and physically prepared for surgery. However, I still had these unsettling feelings towards him. After all, he had been the bearer of bad news two years earlier. And I dreaded hearing his jokes and listening to his easy explanations of how he would literally dissect me. I cringed at the memories of him making light of the whole ordeal as if I were having a procedure as simple as getting a cavity filled. At least, that’s how I felt at the time, when I was under great stress.

When my mother and I arrived at Dr. Reich’s office, he greeted us both with warm, genuine hugs, as did various other familiar members of his staff. He explained his rationale to me and made me feel very comfortable with his recommendations. He was the same doctor I remembered, yet he seemed more patient and thorough in his explanations and answers to my countless questions. I was much more educated about the subject now, so the things that he said actually made sense to me.

All of a sudden, I realized that Dr. Reich’s nonchalance was not due to the fact that he didn’t understand the severity of the situation; rather, it was to keep me as calm as possible. And what I had perceived as an unusual bedside manner was really just his way of conveying confidence in his own abilities to fix my back, thereby making me feel confident in him. I knew that he was tailoring his surgical recommendations to me, Chelsea—the person, the teacher, the 29-year-old single girl who wanted a family and kids in the near future. I knew for sure that I was an individual to him, not just another name on a list. I scheduled surgery the next day.

Two weeks later, on December 4, 2012, at age 29, I had my second spinal procedure at Robert Wood Johnson in New Brunswick, where I’d had my scoliosis surgery in 1994. The vertebrae at L4 and L5 (lumbar area) were fused, and this would limit my mobility—including teaching Zumba. But it would remove my pain.


Lumbar Spine Segments_L1 to L5

Lumbar Spine Anatomy – Image at Spine-health.com © Veritas Health, LLC

“Lumbar” is derived from the Latin word “lumbus,” meaning “lion.” And the lumbar spine is built for both power and flexibility—lifting, twisting, and bending.

The lumbar spine has several distinguishing characteristics:

  • The lower the vertebra is in the spinal column, the more weight it must bear. The five vertebrae of the lumbar spine (L1-L5) are the biggest unfused vertebrae in the spinal (vertebral) column, enabling them to support the weight of the entire torso.
  • The lumbar spine’s lowest two spinal segments, L4-L5 and L5-S1, which include the vertebrae and discs, bear the most weight and are therefore the most prone to degradation and injury.
  • The lumbar spine meets the sacrum (sacral region) at the lumbosacral joint (L5-S1). This joint allows for considerable rotation, so that the pelvis and hips may swing when walking and running. (Note: Chelsea may need to have this area fused in the future; see end of post.)

(Click to (1) read more about lumbar spine anatomy and pain

and (2) view a  lumbar spine anatomy video at Spine-health.com.)

(Click to view a video animation of lumbar fusion surgery for low back pain at SpineUniverse.com.)


When I woke up from surgery, I was in a lot of pain. I felt scared and sad. But I walked for the first time only six hours later, and all my pain from before surgery was completely gone! Of course I had post-surgical pain, but that was nothing compared to how I felt upon entering the hospital. I had mentally prepared to stay in the hospital for six days, but I was sent home on the fourth day. I felt like a huge weight had been lifted from my shoulders, and my thoughts were no longer focused on continuing to cope with the pain, but rather with what I could do once I was recovered. My state of limbo was finally over.

How My Life Has Changed—Living into the Future

It has been four years since my surgery, and my nerve pain is 100% gone. My recovery was not half as bad as I anticipated. I did physical therapy three times a week for about four months, I walked around my neighborhood for extra exercise, and I slowly started going back to the gym. I returned to work in about three months with no restrictions.

One side effect that I did not expect was the sheer gratitude that I felt. I was, and am, grateful to my friends and family for all the support they gave me before, during, and after surgery. I am no longer angry that I had to have surgery again; instead, I feel thankful that my problems were fixable with surgery. I am also grateful to have a great job and medical benefits that carried me through that time. I am eternally thankful that Nick was my physical therapist, for without his physical and mental support I do know how much longer it would have taken me to make the decision that ultimately gave me back my life.

And most importantly, I am thankful for Dr. Reich. The admiration and respect that I have for him is indescribable. I feel like my whole two-and-a-half-year journey started with and led me back to him. It makes me feel like everything happens for a reason, and things happened the way they were supposed to. The personal attention he gave me in terms of my diagnosis, my hospital stay, and my recovery were completely above and beyond my expectations. He has completely changed my life by fixing my back and removing this incredible mental anguish that I was carrying. I can actually say that, despite his unconventional manner, I love him. In fact, he asked me to write this narrative, suggesting that if I could save even one person from the suffering I endured, it would make everything I went through worthwhile.

Colorful Blue Heart

There are certain things that I am not allowed to do—high-diving into water, skydiving, tumbling, and any high-impact exercise—which, unfortunately, includes Zumba. I still feel a little stiff sometimes, and doing new things makes my muscles very sore. My back also gets tired very easily, and I try to avoid heavy lifting and excessive bending and twisting. But all this is a small price to pay to have my life back.

It is likely that I will need another fusion surgery in the future, probably L5-S1. (See the Spine-health.com information on lumbar spine anatomy above.) This thought undeniably scares me, but having Dr. Reich, Nick, and my family and friends in my corner makes it a little easier. If and when that time comes, I will not feel the need to seek out multiple opinions from other doctors. In my own time and when I am ready, I can say without hesitation that Dr. Reich will be the surgeon who will operate on me. He and his team will give me the best care I could ask for, and I will be confident in him and his recommendations.

Until then, you will find me living my life, pain-free and forever changed.

happy-spine-happy-life

Postscript

It has been a pleasure working with Chelsea on her story of spinal surgery and restored health. A vibrant, outgoing, enthusiastic person, Chelsea is obviously making the most of her pain-free life. Her regrets about post-surgical limitations are few because life is offering her so many more pathways to explore.

I share Chelsea and her doctor’s hopes that this narrative will benefit others considering what to do about severe back pain caused by degenerative disc disease. Please note that Chelsea and I are not offering medical advice to readers—individual patients must make their own informed decisions about their particular situations in conjunction with their healthcare practitioners.

To send Chelsea a comment or question, please use the Contact Form. Please also feel free to comment publicly below.

– Pamela Bond Contractor, Editor


Resources

Links Are Current as of November 1, 2016

The stories and resources on this site are intended to provide education, enlightenment, empowerment, and encouragement to inform your conversations with your healthcare team. They supplement—and do not replace—the advice of your clinicians.


Family Practice Notebook: Scoliosis: V. Measurement, Cobb Angle

Johns Hopkins Medicine: Scoliosis (includes comprehensive information, images, and video)

MedLinePlus: Spinal Fusion

National Institute of Arthritis and Musculoskeletal and Skin Diseases: Scoliosis (includes comprehensive information and schematic images)

National Scoliosis Foundation – (List of) Helpful Links (patient-led nonprofit organization)

SCI-Recovery.com: Anatomy of the Spinal Cord (spinal cord injury recovery site; includes anatomy)

Spine-health.com™

—Information

– Lumbar Spine Anatomy and Pain

– Lumbar Spinal Fusion Surgery

– Scoliosis Health Center

– Scoliosis: What You Need to Know

– Scoliosis Surgery

– Spondylolisthesis Health Center

—Images

– Spinal Fusion (Lumbar) Brochure

– Spondylolisthesis Brochure

—Videos

– Degenerative Spondylolisthesis Video

– Lumbar Spine Anatomy Video

– Sciatica Animated Video

– Scoliosis Animated Video

– Spine Anatomy Interactive Video

– Spine Fusion Surgery Video

– Spondylolisthesis Symptoms and Causes Video

SpineUniverse.com®

—Information

– Facts and FAQs About Sciatica, Low Back and Leg Pain

– Scoliosis Center

– Scoliosis Surgery: Approaches and Procedures

– Spondylolisthesis Center

—Videos

– Lumbar Fusion Animation

– Scoliosis Animation—Causes, Symptoms, and Treatments of Scoliosis

– Spinal Fusion Animation

WebMD

– Sciatica – Topic Overview

– Scoliosis Directory

– Spondylolisthesis – Topic Overview

Book: Zumba®: Ditch the Workout, Join the Party! The Zumba Weight Loss Program. By Beto Perez (creator of Zumba®) with Maggie Greenwood Robinson, Ph.D. New York: Wellness Central, Hachette Book Group, 2009.

Tinnitus Awareness Week 2016 – May 16-20

Make Some Noise to Silence Tinnitus

Join the American Tinnitus Association In Raising Awareness about Tinnitus and Hyperacusis!

FOR IMMEDIATE RELEASE: May 13, 2016
Contact: Jennifer Born – jennifer@ata.org

Help Raise Awareness to Quiet Tinnitus During Tinnitus Awareness Week

 – ATA Challenge: Make the “Right Kind of Noise” About Tinnitus and Hyperacusis –

Portland, Ore. – The American Tinnitus Association (ATA) is challenging the tinnitus community to “Make Some Noise” about tinnitus and hyperacusis during National Tinnitus Awareness Week, May 16-20, 2016. Tinnitus, commonly referred to as “ringing in the ears” impacts up to 50 million people in the United States (U.S.) alone and has been the leading service-connected disability for veterans from all periods of service since 2009, accounting for 1.2 million veterans. Hyperacusis is a sensitivity to sound – sounds that are typically tolerated well by people who do not have hyperacusis – that can sometimes cause physical pain. Both conditions can be caused or exacerbated by exposure to environmental noise.

“Tinnitus and hyperacusis are real public health concerns that most people do not know about and unfortunately do not fully realize the devastating impacts these conditions can have until they develop them,” said Melanie West, Chair of ATA’s Board of Directors. “Tinnitus and hyperacusis can ruthlessly reduce an individual’s quality of life, leaving them socially isolated, anxious or depressed,” said West. “Because of the lack of general awareness about these conditions, this year during Tinnitus Awareness Week, we challenge all those with tinnitus and hyperacusis to ‘Make Some Noise’ and raise awareness of what it’s like to live with these conditions – tell your friends, co-workers and doctors,” West said.

According to the National Health and Nutrition Examination Survey (NHANES) conducted by the Centers for Disease Control (CDC), of the 50 million people in the United States with tinnitus 20 million are chronically affected, with disruptions in their sleep, concentration and mood, and in some cases impacting their ability to remain employed and even leave their homes for even short periods of time. These 20 million individuals are more likely to seek medical treatment for their condition.

ATA’s mission was recently updated to include hyperacusis because of the number of people with both of these conditions and the growing body of research demonstrating possible common mechanisms between the two. ATA also recently launched a new educational webinar series and during Tinnitus Awareness Week, ATA will broadcast a live webinar about Hyperacusis. Members of the public are invited to register for this webinar and learn more about Hyperacusis and how it relates to tinnitus. To learn more or register for this webinar, visit ATA.org.

While there is no quick solution to tinnitus, there are management strategies that can provide relief. The American Tinnitus Association has developed a Patient Roadmap on its newly redesigned website that can help patients navigate the sometimes confusing path of tinnitus treatment. In addition ATA can help people get connected with tinnitus health professionals who can help devise a customized management strategy.

During Tinnitus Awareness Week the American Tinnitus Association will be engaging the tinnitus community through Social Media on its Facebook and Twitter pages. Helpful information and articles about tinnitus treatments and research will be posted to these pages every day during Tinnitus Awareness Week. Visit Facebook.com/AmericanTinnitusAssociation to participate in this year’s national Tinnitus Awareness Week.

About the American Tinnitus Association

The American Tinnitus Association, headquartered in Portland, Ore., is the nation’s foremost organization committed to improving the lives of people with tinnitus and hyperacusis through education, advocacy and research toward a cure. For 45 years, ATA has helped patients understand and manage the “ringing in their ears” and raised resources to advance tinnitus research.  Since its founding in 1971, ATA has offered information, support, advice, and hope for people living with tinnitus, and has contributed over $6 million in “seed” funding to medical research projects focused on finding solutions for tinnitus and hyperacusis. For more information, please visit ATA.org.

But what happens on February 3rd?

A screengrab of a video by the tourism website of the state of Pennsylvania shows the groundhog Punxsutawney Phil being watched for signs of his shadow.

NPR reports on Punxsutawney Phil’s prediction of an early spring.

What’s my favorite holiday? After Thanksgiving, it’s . . . Groundhog Day. And if, like me, you’re a fan of redemption movies—and of Bill Murray—then today you watched Groundhog Day . . . again . . . and again. . . . 


It's always February 2nd - ThisIsAuthentic.com

Click to relive Bill Murray’s day . . . over . . . and over . . . and over. . . .

My favorite part of this perennial movie is near the end, when Phil—Connors, that is—finally gets it. He starts living—and giving—in the ever-present moment. He hasn’t yet escaped the never-explained time warp he has somehow found himself in; but in time (whatever that means), he accepts his fate and eventually lives a perfect day that only close to infinite re-dos could have made possible as he learns life’s most important lesson. And yet . . .

What is a “perfect” day? The message of the film is that this Scrooge-like guy learns about becoming his best self through genuine interest in and compassion for others—all with a comic and romantic twist (not unlike Bill’s other redemption movie, Scrooged).* His reward for a lesson well learned and a life well lived on February 2nd?

February 3rd.

But on the other side of the screen, we don’t get infinite re-dos. We ordinary mortals need to learn as we go through linear time, not when we’re stuck in an endless loop of it. So how do we learn to live a “perfect” day on February 3rd after learning the lessons of our own February 2nd? 

My personal February 2nd, so to speak, was actually on Valentine’s Day 2014. I underwent my last vaginal radiation treatment (brachytherapy) that day following a total hysterectomy for uterine cancer on December 13, 2013. And I was still in the “glow” of having survived a brush with mortality and having learned my lesson that all moments of life are precious and, in their own way, eternal. Or are they? This is a topic for another day, but perhaps all moments of time exist somewhere, in some treasure vault that we can revisit . . . and revisit . . . and revisit—if we learn the combination or find the key. So if the cosmos is filled with all the energy that has ever existed, why not make our contribution positive?

But what if we become disillusioned because we can’t unlock all the secrets of the universe? Such reflections brought me to the realization that, at least in human terms, the most important secret of life is the one Phil learns in the movie. And this thought took me back to the lyrics of the 1967 song by the Youngbloods, Get Together,” which may hold the deepest human secret:

You hold the key to love and fear
All in your trembling hand
Just one key unlocks them both
It’s there at your command

In an awesome and happy coincidence, when I wrote an earlier version of this post last year, a quick search for those lyrics took me to the February 3, 2015 page on the Huffington Post blog, “The Third Metric,” where that very song happened to be featured that day: Daily Meditation: Get Together.” Such coincidences seem to point to a cosmic connection, one that I don’t pretend to understand. Yet these occurrences whisper to me that perhaps we do hold a key that unlocks the secrets to at least our private universe.

In the afterglow of that “Whew! Narrow escape!” feeling post-op and post-radiation, I am still figuring out how to incorporate the lessons of my own February 2nd into my February 3rd. Learning how to do this will require me to be awake, aware, and appreciative during all the coming days until I run out of them. And it’s extremely hard.

Maybe tomorrow, on February 3rd, it will be enough for me to realize that aftermaths and interims are just as important as great events. Or maybe they are the great events. Life is still happening in an amazing way, even when we can’t quite feel the miracle of it after an emergency or a major event has melted into the rest of our experience.

Life transitions often feel shallow, muddy, confusing, unfocused, unimportant. But without the respite from urgency that we experience during exciting or traumatic times, we wouldn’t have the chance to dive deeper into our own being. These times spent in semi-mist may actually be mystical. Change is creative. So transition isn’t really a dark place to be feared or avoided, but a space offering a chance to learn and become your own next great thing. As earth transits around the sun, transition is how we experience time . . . and all the times of our lives.

Alone in my personal space, I will celebrate February 3rd, knowing that the ice crystals on the trees will become leaf buds . . . in time. I hope you will never be stuck on February 2nd and will have quietly wonderful February 3rds to look forward to for many years to come.


*And speaking of redemption stories . . .

Ghost of Christmas Past

Ghost of Christmas Present

Ghost of Christmas Yet to Come

A Christmas Carol_1843_30%

Happy New Year from “The Patient’s Path”

Blue Globe_Happy New Year 2016_Middle_Reduced

Dear Readers,

Thank all of you for following our sister site, The Patient Path, since its inception in November 2013, when I began my journey with Uterine (Endometrial) Cancer. That site is now dedicated to cancers, particularly those affecting women.

Please continue to visit this site, which covers a variety of health and healthcare topics, and our sister cancer site throughout 2016 for more information, insights, and inspiration for becoming the most important member of your healthcare team as you embark on your own journey with gynecologic cancer and with other challenges to your health and well-being.

As we say farewell to 2015, I wish all of you around the world the best of the rest of the holiday season and much HEALTH, happiness, and prosperity in the new year.

Pamela Bond Contractor


A Christmas Carol_1843_50% My favorite story, A CHRISTMAS CAROL, was published 172 years ago, on December 19, 1843. Click the book to view the only manuscript version of the novella, which is housed at the (J. Pierpont) Morgan Library & Museum in New York. Do take a look—it’s a treasure. And click these links to read my reflections of two years ago while undergoing treatment for Uterine (Endometrial) Cancer:
My Current Story, Update: Uterine (Endometrial) Cancer No More: Emotional Reflections in Blue Places –December 18, 2013
My Current Story, Update: Uterine-(Endometrial) Cancer No More: Lessons from the Ghost of Christmas Past –December 19, 2013
My Current Story, Update: Uterine (Endometrial) Cancer No More: Lessons from the Ghost of Christmas Present – December 24, 2013
My Current Story, Update: Uterine (Endometrial) & Skin Cancer No More: Lessons from the Ghost of Christmas Yet to Come – December 31, 2013

My Friend’s Story – Leukemia: Update on Her Family

Sandee & Mitch

SANDEE & MITCH KLINE

Last evening, as I was writing a fictional story based on my childhood, I received a long-distance telephone call from my real childhood friend’s daughter in Israel. She has kept in touch with me over the past five years since her mother, whom I had known since we were seven years old, died of leukemia in the fall of 2010. Each December 6, Sandee’s birthday, I post a remembrance of her, as I did again this year. Not that I need reminding . . . I don’t feel that Sandee ever left. She may be somewhere where we can’t hear her stories or her laughter, or benefit from her compassionate listening or offers of comfort; but I believe that everyone who was close to her can still feel her in their heart and soul. I can. And occasionally she even visits me in a dream. The only thing I don’t like about this is that I have to say goodbye again, and her presence in my slumbering brain reminds me that I could do nothing—absolutely nothing—to help her when she was so sick. That’s something I can’t forgive life for—not letting me do somethingF

After a minute or so of catch-up conversation on the phone last evening with Sandee’s daughter, I happened to ask about one of her brothers, who also had moved to Israel. After a silent pause, I heard the ominous words that the family had undergone yet another major shift: her brother had moved back home to Philadelphia to become the primary caregiver for their father. Mitch, who remained a warrior against leukemia and lymphoma—blood cancers that stole his wife, mother, and mother-in-law from him and from the people in their lives—is now fighting on his own behalf against stage 4 brain cancer. He is recovering from surgery, chemo, and radiation at home, cared for by his son and other close family members and friends.

This morning, I awoke to that heavy-hearted, semi-shocked feeling that stuns you back to the reality that an act of God or nature has just torn another hole through your world. I don’t have many details about Mitch at this point, but I am following updates on Facebook and remain in touch with several members of his and Sandee’s family. People local to the Philadelphia area may be interested in the “Lotsa Helping Hands” site—Pitch in for Mitch—which provides updates and information on how to give support (signup is required; mine is pending at this writing).

Links to leukemia and lymphoma sites are at the end of this post. In addition, people local to the area may be interested in the Philly-based Mark Roy Crespy Chapter of the City of Hope, organized by members of Sandee’s family in memory of her brother, who died at about age 11 from bone cancer.

In two days, on December 13, I will celebrate my second anniversary of being successfully treated for uterine cancer. On that day, Friday the 13th, 2013, I underwent a da Vinci robotic total hysterectomy, followed by vaginal radiation (brachytherapy). My recent checkup showed no evidence of recurrence, and I also just had a mammogram that was clear. (See complete information in Uterine Cancer: My Story & More.) I say this in humility and gratitude, even as I feel the pain of loss suffered by the family of my oldest and dearest friend (she still is).

Much progress has been made in treating cancer. But as my friend’s story shows, it is still leaving broken bodies, minds, and hearts in its wake. At the first sign that anything is wrong with your own or with a loved one’s health, please consult a medical practitioner. Early detection of this insidious disease may save your or your loved one’s life.


The following story was originally posted on December 6, 2013.

 SANDRA CRESPY KLINE

Sandee

 12-6-52 — 9-27-10

I met Sandee Crespy when we were both seven years old. We were in the same second-grade class at Ziegler Elementary School in Northeast Philadelphia. Although we had almost distinctly opposite personalities and, on the surface, not much in common, we nevertheless went through four schools together—after Ziegler it was Fels Junior High, Lincoln High, and La Salle College (now University), all in Philly. Our early careers also took roughly parallel paths—she was a legal secretary, I was a medical secretary. I was a bridesmaid at her wedding when she married her high school sweetheart, Mitch Kline, and she was the matron of honor at my wedding when I married my second husband, Farok Contractor, on December 7, 2003. After we graduated college—it took her 18 years of night school, me 11—she went on to become a CPA, and I became an editor-writer. Eighteen years may seem like a long time to go to college, but she and Mitch had three amazing children (Alyssa [Malka], Evan, and Jeffrey) while she also pursued her career and studied—and, of course, socialized with her many friends. (My son, Matt, was born about a year after I finally graduated while working full-time, so I had it a bit easier.)

This synopsis tells you very little about how and why we managed to retain a friendship over 50 years. To give you some idea of that relationship, you can read a brief remembrance I wrote about us in 2012 as an exercise for my writing group: An American Friendship—Associated Memory. In that mini-memoir, you’ll see that I mentioned my recently found sister, Vicki Sue, who was reunited with her maternal family 50 years after we were separated (read her story here). However, the connection is very important because just about a year after we found Vicki Sue, we lost Sandee to her deadly battle with leukemia. But not before the two of them had the chance to meet the previous October. Although Sandee had two lovely sisters, Ronnie and Jackie, you might have thought she’d found another one of her own. (She also had two brothers—Scott, who is doing well, and Mark, who died very young of bone cancer.) Of everyone I knew, she was the most thrilled that Vicki Sue had re-entered our lives—particularly because Vicki had been raised Jewish!

Sandee’s Jewish background was one of the things that had attracted me about her the most when we were young. She came from a big family—Ashkenazy on her mother’s side, Sephardic on her father’s. This mix of Russian and Spanish ancestry may be one of the primary reasons a bone-marrow donor could not be found to save Sandee’s life, despite her myriad of relatives on both sides. But my larger point is that I used to love going to Sandee’s house when we were kids because of all the people—all the life and love—I found there. My family is small and had an unhappier history, so I often took refuge in hers.

In October 2009, my family had its first reunion gathering to honor our finding Vicki Sue. This has evolved into an annual Oktoberfest celebration. But on this first occasion, Sandee joined us—you can see the joy on her face, drinking her last cup of tea in my home:

Sandee Holding Her Cup_October 2009

Sandee and I did share one final cup of tea—at her home in January 2010. She had recently returned from a trip to Israel, where she and Mitch had been visiting their daughter and her family, and thought she’d contracted some sort of bug. Each afternoon she developed a high fever and became very sleepy, so much so that she had to stop working. One snowy January afternoon, I went to see her and took with me a collection of unusual chocolate teas that someone had given me as a gift that I’d never opened. We cracked open the little canisters that day and enjoyed a cup of chocolate tea together. Although she didn’t drink out of “her” cup, which is at my house, looking at that cup brings back these powerful memories of those two last cups of tea we shared:

Sandee's Cup

I didn’t see Sandee again until August 15, 2010, just weeks before she passed. It wasn’t that I didn’t try—I emailed and called her family repeatedly trying to set up a time to visit. But she became sicker and weaker over the ensuing months and was in and out of hospitals, including Johns Hopkins—where our friend Sue and I went for our last girl-thing that August day. The three of us used to get together for our annual fall combined birthday dinner (my day is September 24, Sue’s is November 24, and Sandee’s, of course, was December 6). The last time I spoke with Sandee on the phone it was just a couple of days before my birthday, but she was too ill and too weak to realize it. On September 27, 2010, we got the word from her family that she’d passed away at the local hospital, which was her choice. She was surrounded by her loving family.

Her daughter, Malka, called me and asked me to be one of the pallbearers at her mother’s funeral. I’ve never before or since carried a burden that was so light in my hands and so heavy on my heart.

Click the heart image to read about its significance.

Sandee's Heart

Rest peacefully and as joyfully as you lived, my friend.

See more in Sandee’s memory here.

* * *

PLEASE SUPPORT THE EFFORT TO ERADICATE BLOOD CANCERS

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Thanksgiving Day and Globalization


© 2015 Prof. Farok J. Contractor, Rutgers University

“Freedom from Want” – Norman Rockwell, 1942

As Americans sit down to their Thanksgiving Day repasts each year, they are taught to recall the story of the “Pilgrim Fathers,” who in 1620 founded one of the first English settlements in North America at what was then Plimoth Colony in the State of Massachusetts. 

But the story of the English settlers seeking religious freedom in the New World was not, initially, one of gratitude. On arriving, they found nothing but “. . . a hideous & desolate wilderness, full of wilde beasts and wilde men.”[1] It was almost as if the settlers had landed on an unexplored frontier, like the Americans landing on a pristine moon more than three centuries later.

See the updated post: Second Helping, November 24, 2016


Early Globalization and the New World

Plimouth Plantation, Plymouth Mass

Recreation of Plimoth Colony, Plymouth, Massachusetts
See More at Plimouth Plantation

In fact, the very survival of Plimoth Colony, which evolved into the town of Plymouth, as well as the turkey that sits on the center of American tables on the fourth Thursday of each November, are testaments to more than a prior century’s globalization and trans-Atlantic travel. After 1492, when Cristoforo Colombo (re)discovered the Americas (the Norse had already settled in Canada around the year 1,000 under Lief Erikson), the Spanish and Portuguese had crossed the Atlantic thousands of times before the English settlers arrived in 1620; but they had concentrated mainly on the warmer and more fertile colonies in Mexico and Latin America. The English were left with the frigid, seemingly inhospitable remains—the North American forests, which appeared to have little economic value.

The Turkey
goulds turkey

Meleagris gallopavo mexicana–Ancestor of the North American Thanksgiving Bird

Most Americans at their Thanksgiving Day table do not realize that the large bird they are consuming is not native to America . . . and certainly not to Turkey. Its origin is Mexico, descended from a fowl that the Spanish exported to Europe a century before the English colony in the New World was established. By 1530, this bird could be found abundantly in European and British farms. However, in Europe it was confused with the guinea hen (an African fowl) that had previously been imported into Europe via Ottoman Turkey. Apparently, the taste, and the economics, of the Mexican bird were superior, and thus it displaced the African bird from European farms and tables. It is most likely that what Americans know today as the turkey is the Mexican bird, consumed by Europeans and then later re-imported back to North America on English ships. The Plimoth Colony settlers did hunt fowl, but if their catch included turkeys, it was the North American wild turkey (Meleagris Americana), not the Southern Mexican variety (Meleagris Mexicana)[2] that evolved into today’s turkey. (Of course,  today’s factory turkey is so genetically modified from its Mexican original that it is bland and likely much more tasteless, a far cry from its Mexican progenitor.)

“Squanto” and the Survival of Plimoth Colony

220px-Squantohowwellthecornprospered
Tisquantum (“Squanto”), Amazing Young Man of the Patuxet Tribe

Nine months after their arrival, more than half of the 102 individuals that disembarked from the Mayflower had perished of hunger and disease. The utterly unprepared and amateurish Pilgrims had arrived too late in the autumn of 1620 to plant crops, had underestimated the severity of the New England winter, and, to their surprise, found that their landing spot near the Cape Cod peninsula was unpopulated—so no human help or local advice was available. In another example of the effects of globalization, the Native American population in the area had been wiped out just a few years earlier through small pox and other diseases introduced by previously arriving English trading ships. One of these earlier ships in 1608 had sweetly proposed to exchange English metal goods for beaver and other animal skins, but then had captured and enslaved some of the natives and transported them to Europe.

One of them was a young man of the Patuxet tribe named Tisquantum (later shortened to Squanto), who was sold as a slave to Spanish Catholic priests for £20. Freed in 1612, Squanto traveled to England and lived in London for six years, with what must have been a wild hope of returning to his native village. In fact, it was not so improbable an aspiration because globalization was by then well established. Each year English trading ships would travel to New England to trade, pillage, and enslave. In 1618, Squanto’s English-language abilities and general acumen were noticed by an English ship captain who offered to take him back to New England in return for his translation and intermediary skills. Landing somewhere near the State of Maine, it took Squanto three years to walk his way south and find his native village (the place called Plimoth by the Pilgrims).

Squanto-Wampanoag

Squanto Greets the Surprised English Settlers

In the spring of 1621, as despair and death faced the weakened remaining English settlers, to their utter amazement a Native American speaking English, as well as the area’s Wampanoag language, stepped into their settlement, offering them friendship, advice on what crops to plant, and how to hunt and trap animals. More importantly, Squanto served as an ambassador or bridge to the area’s Narragansett and Wampanoag Indians, so that for a remarkable half century there was an uneasy peace between the English and the natives.

But by 1675, with more than 22,000 English immigrants, the natives realized they were being displaced from their own lands, and they launched an attack under the leadership of Metacom. This is sometimes described as the First Indian War. Of course, the locals were no match for English guns and growing numbers of colonists. The English presence in North America was by now an unassailable presence, whose later growth would populate the continent from “sea to shining sea.”

Thanksgiving Is as Much a Globalization Story as It Is an American One

Americans who enjoy their Thanksgiving repast are mostly oblivious of the fact that the story of the very founding of the United States is very much a story of globalization. Squanto’s trans-Atlantic journeys, his role in enabling the English bridgehead on the American continent, and the export and re-importation of the Mexican bird known to us as the turkey are vivid examples that globalization was commonplace—and even routine—by the 17th century.

++++++++++++++++++++++++++++++++++++

[1] From the diary of William Bradford (1590 – 1657), Governor of Plymouth Plantation Colony, Cape Cod, 1620: “A Hideous and Desolate Wilderness.” In History of Plymouth Plantation. In 1621, when only 50-odd half-starved survivors were left of the 102 that disembarked from the Mayflower, the word “governor” may have sounded far too grandiose a term. But with new annual arrivals, despite losses, the number of English grew to 180 by 1624, and had increased to over 1500 by 1650. (Patricia Scott Deetz and James Deetz, Population of Plymouth Town, Colony & County, 1620-1690.)
[2] John Bemelmans Marciano. On the origin of the species: Where did today’s bird come from? The answer may surprise you. Los Angeles Times, November 25, 2010.

Kitty Corner: More on Feline Toxoplasmosis

UPDATE ON MISTER C’s STORYMister C_Portrait_Lightened_2013_JBowman 


Last spring, I reported on my cat’s toxoplasmosisan insidious parasitic disease that causes neurological problems. (See the May 4 & May 5, 2015, posts.) To control his seizures, the vet put him on ¼ grain of phenobarbital (a barbiturate), which, tiny as it is, I split with a pill cutter, giving him half in the morning and half in the evening.

Unfortunately, on September 7 he had another seizure while on the medication, which was unexpected and dismaying. As before, he woke up from a sound sleep on the upper sofa cushion, falling onto the sofa seat and then jumping up and running around on the floor madly before falling on his side and seizing.

He recovered fairly quickly, within about 3 minutes or so, and I called the vet immediately to report the problem. I also complained that the pills were not cutting cleanly, causing a concern that he might not be getting his full dose. I took the pills (but not Mister C) into the vet’s office, and the tech checked them and so did the vet. Although they had the same problem cutting the pills, the vet advised me to just get another pill cutter, which I did, not completely happy with that recommendation. (I have now gone through three pill cutters.)

Things seemed to be under control until about two weeks ago. On November 4, he had yet another seizure, again waking from a sound sleep on the upper sofa cushion and falling onto the sofa seat. As before, he ran around on the floor wildly and then convulsed for about a minute. As the episode subsided, I called the vet and reported the seizure. By this time, the convulsion was over, and he was sitting up and seemed to be able to see and hear me, although the recovery took a minute or two longer than the last time. For a short while, he walked around in circles and then remained subdued for another few minutes. Then he was back to normal.

The vet said this could be caused by more neurological damage from the toxoplasmosis, or it could be something else, such as liver, kidney, or heart disease. Because his last blood test in the spring showed fairly normal kidney function, the vet advised me to double the dose to ¼ grain twice per day (a whole pill in the morning and a whole pill in the evening). His previous blood test showed that he was well within the therapeutic and nontoxic range of the medication, so I didn’t hesitate to give him the increased dosage (which also relieved me of worrying about splintered tablets). I put the pills in Greenies Pill Pockets®. I used to give him one in the morning with his dry food and then crush the other half of the pill into his wet food in the evening, but now he gets two Pill Pockets a day—and loves them. 

The vet further said that if the seizures were happening every three months or more, he wouldn’t be too concerned. But the last two occurred within two months of each other. If he has another seizure on the increased dosage, the vet wants to see him. (Another concern is that he may have a convulsion when I’m not there to see it.) I also watch him carefully to be sure he isn’t having any adverse effects of the increased medication—so far, I don’t see any.

Mister C_2015-11-16_Cropped

As I write this, he’s sleeping soundly on his cushion over my shoulder, snoring softly. At age 15, Mister C still has good quality of life despite his seizures (and former thyroid problem), so I’ll hang in with him as long as health and happiness are possible. 


FRESH STEP® CAT LITTER TOXOPLASMOSIS WARNING