Something has changed. Something is always changing. 

I woke up at 1am in the most excruciating pain I’ve been in since my diagnosis 16 months ago. How can that be possible? Answer: I’ve been masking the pain, and it’s been getting worse.

How did this happen?

It’s all related to the week in January when I felt like my spine was crumbling. My delayed pain upon standing had been getting worse over the previous month, and I had started to feel a “pulling” sensation in the left back side of my skull. As you may remember, a neck MRI and many doctors appointments later, my care team resolved that there was no surgical intervention needed. Yes, my spine is compressed in a few places, but it was a stable compression, not impinging on my spinal cord. I learned I was feeling a logical kind of pain, not a damaging sort.

I went to see a doctor at High Desert Sport and Spine, a clinic that specializes in non-surgical interventions, and we decided to try a nerve block in one of my compressed vertebrae to see if it would stop the delayed pain upon standing, which by this point had become a debilitating throbbing in my head and shoulders which lasted a full 10 seconds, 10 seconds after standing. The referring feeling of a pulling at the back of my skull, which I later recognized as a spasm, was a secondary pain, and an additional layer of the dreaded “p” word was caused by the constant bracing my neck and shoulders were doing to protect me. My body would brace for the throbbing before I stood up, while I stood up, and after I was already up. My neck and shoulders are almost constantly inflamed by this involuntary action, and I’ve been taking anti-inflammatories around the clock since then. 

Luckily, the ibuprofen stops the neck and shoulder soreness and the skull spasms. This makes sense if the spasm is caused by an inflamed nerve in my neck; the anti-inflammatory reduces the swelling, which reduces (or eliminates) the spasm for the duration of the med’s effectiveness. 

Nothing helps the delayed pain.

So, it wasn’t until the end of March that I was able to schedule the nerve block, and I had been coping just fine by taking mass quantities of ibuprofen over the previous months. But, the day came and the nerve block didn’t do anything. 

I had put a lot of hope into that block. 

I had rested my hopes and dreams on that block. 

I could take all the meds because I was getting the block, it would fix everything. 

I was even on the plane ride back home from helping my mom recover from a shoulder surgery when I watched a movie about a climber in Yosemite, and I felt so good that I knew I would thru-hike again. It was definitely possible! Two hours later, when the ibuprofen wore off: no way. There is no way I can hike again. 

The truth of what I had been blocking revealed that my “feel good” hours were an illusion. I was not better.

Ok, so the nerve block didn’t work. I have another appointment with the doctor today to see if there is anything else we can try, but in the meantime, the pain has been getting unbearable. How do I know? I had an appointment with my primary care doctor for my annual physical, and my blood test came back with high potassium levels. It was very easy to determine what was causing that…the handfuls of ibuprofen I was taking each day. Unfortunately, high potassium can lead to kidney damage, which can be very bad, so my primary care doc told me to ramp up the gabapentin (nerve pain medication) and decrease my ibuprofen use and to get my labs drawn in another week to see the difference (that’s today). Well shit.

The problem with gabapentin is the slow increase of dosage that you need to take to get up to full power. My ramping up of the drug would take weeks, meanwhile the reduction in vitamin I (yes, we thru-hikers refer to ibuprofen as a vitamin because we often take it daily) would have to start immediately.

I spent some serious time in the pain cave this week, and it soon became clear to me that things were much worse than in January. The pulling feeling is a sharp icepick stab to the head. The neck and shoulder throbbing is debilitating, and all combined together: I can no longer function without constant pain medication. Oh, and oxy doesn’t work on nerve pain, so that’s not even worth taking.

Last night I woke up for my nightly pee and was easily in the most pain I’ve been in since the cancer diagnosis. I was hit by a mack truck. My skull was on fire on the inside and out. I was a 7.5 on the scale of 1-10 on the pain scale. 

This is a now pain. My kidneys are a not now pain. I took the #&%^#& ibuprofen.

Where do we go from here? I have no idea, but I meet with the High Desert Sport and Spine doc later today, my oncologist and neck surgeon next week, and I am also getting an EEG test done for a neurologist appointment. I hope one of them can find something actionable to do because this isn’t sustainable. I can not live this way.

I was thinking I’d wait until I had a next step before writing all of this out. I don’t mean to scare anyone, but since this blog is for me, as a chronicle of what I’m going through, I’m choosing to publish this post when I’m crabby. When I’m exhausted, and my eyes are so tired they feel like sandpaper. I’m writing like I’m at the end of my wits, because that’s what I am.

None of this will ever be over. You don’t get to say “I’m all better now” with stage 4 cancer.

It won’t be over until I’m over, so this is just another chapter.