Thursday, January 31, 2013

Cymbalta and the second subtalar fusion

It's been awhile since I've written anything on here, and that's because it's been awhile since I've been up to writing anything. Taking cymbalta really changed me, and not in a good way. Did it do what it was supposed to with taking care of the pain and pain-related depression? Yes. At what cost? Well, my mind. I felt very drunk every minute I was awake, completely disconnected from my body, had no motivation to do anything productive, got very obsessive about things I normally don't care that much about, had no appetite, and couldn't sleep. The only thing positive was becoming aware of the tension I carry in my left shoulder and jaw. I've had trouble with my left shoulder for a few years with strength training which I attributed to my right foot being damaged, but I'm beginning to think a bigger contributor was playing clarinet with high anxiety for 10 years and always holding my left arm and shoulder a little higher while practicing for hours as a time, which carried over into everyday life. The tension in my jaw is just from high anxiety. Now that I'm aware of it and consciously relaxing the tension in my shoulder and jaw, my overall anxiety level has gone down dramatically. I'm also internalizing a reminder when I'm out in public to keep my body relaxed when I start to feel anxiety taking over. That's the only positive thing I can take away from my experience with cymbalta.

The withdrawal was pure hell. I had severe headaches, horrific mood swings, nausea, vertigo, brain zaps when moving my eyes (neurons misfiring), sensitivity to light and sound, and basically felt like I'd lost my mind. It persisted for close to two months at varying degrees, the worst being in the first 3 weeks. I've never been happier to be off of a medication. I recently had coffee with a friend who hadn't seen me since I was on cymbalta, and the first thing she asked was what exactly I was on last time because I was flying high. I'm very glad to be in control of my body and thoughts again, even if some of the pain came back with it. Friends close to me have said that I just wasn't myself for those few months, and I can see it in pictures. My eyes were different and my expressions were vacant. I'm finally feeling like myself again. I'd forgotten how happy I usually am!

I had a subtalar joint fusion on January 16th on my left foot. My anxiety leading up to it was extremely high because of what had happened last time and not really knowing what had caused it. When I woke up from surgery, my doctor said that this fusion was even more complicated than the first (not reassuring!!) because the birth defect was more severe. Instead of the defect being a bar of bone connecting the calcaneus (heel bone) and talus (the bone above it), it was a much bigger block of bone that took an extra 30 minutes to remove from what he was anticipating. No artificial bone matrix was used in the joint this time, but he had plenty of my own bone to use and took a graft from the back of my calcaneus (heel) as well. After packing and aligning the joint, he drilled a large titanium screw through my heel that extends to the very top of my ankle. The hazy white part around the joint is where he removed the extra defective bone that was holding the joint together, essentially bone rubbing on bone with every step I took, a very painful arthritic condition. Before it would rain, the joint would throb as well. I've been living with a lot of pain for a long time and am glad the arthritis pain is gone.



Overall my experience has been extremely positive so far this time, while my whole body reacted badly to the fusion on the right foot. I was able to get myself out of the car, up the steps into the house and into my bed by myself immediately after the surgery. After the first one, I had to be half-carried for the first three days because I couldn't even get to the bathroom by myself. I was off of pain meds by the end of the first week this time, and I know I was on them for a few weeks last time. The best news is that while being casted, I could get my heel down to the casting stand both times while I was never able to the first time around from severe inflammation. The stitches came out a few days ago and everything is healing beautifully, while last time I had a large blister from the splint over the incision site that possibly contributed to the site opening later on. My body seems quite happy with the titanium and I'm feeling amazing overall. It's just an inconvenience that I can't put weight down for a few months. I'm using a bone growth stimulator every day for 30 minutes to help the bone fuse faster.

My first workout was one week post-op, a huge victory for me. Last time I couldn't move well enough to even think about it for several months from the complications. My right ankle hasn't been particularly happy with me because it's still full of scar tissue and I'm relying completely on it to get me around. I've refused using a wheelchair or electric carts in the stores this time, though I have a wheelchair in my garage just in case. I'm still taking anti-inflammatory supplements so the joint doesn't lock up too badly. I had stopped my supplements two weeks prior to surgery so my blood wouldn't be too thin and I felt like the tin man before he used the oil can. Very painful to walk.

Right now I'm eager to get back into the swing of things now that I'm feeling like a person again. I'm having a lot of fun modifying workouts so I can keep progressing as much as possible to be prepared for walking and full movement again. I never imagined I'd ever have to spend so much time being broken and finding ways to overcome it in my training sessions, but I hope to help others in a similar situation with my experience. Now that the worst has passed, I'm feeling up to the challenge.