Tuesday, March 3, 2015

Fix You Part II; Guest Blog by Melissa

Part II of the Fix You guest blog by Melissa, Nate’s wife. To read the first part, click here: http://nateruns.blogspot.com/2015/03/fix-you-part-i-guest-blog-by-melissa.html

“Difficult things take long time; impossible things, a little longer.” - Dr. Andre Jackson

While Nate and I were eager to move forward with surgery, the surgeon required we jump through many hoops. We had to prove that Nate’s symptoms were truly caused by his herniated disc. Nate had to undergo an EMG (electromyography), a test that should be reserved for places like Guantanamo Bay. During this test, a needle with an electrode in it is passed into various muscles. Once the needle penetrates the muscle the tester moves it around a bit to check for resting muscle activity. Then, the patient must contract that muscle as much as they can. Contracting a muscle when you have a needle electrode stuck in it sends the muscle into a massive cramp. Nate had to do this with pretty much every muscle in his right leg to trace his nerve issue back to the herniated disc in his spine.
Nate’s EMG clearly traced dysfunction in his lower leg back to the herniated disc. So surgery’s a go, right? Wrong. Next we had to try therapeutic/diagnostic cortisone injections. This is a series of ultrasound-guided injections into the herniated disc that are spaced out over a period of months. The injections usually alleviate symptoms, which confirms, prior to surgery, that the symptoms are truly caused by the disc. For some people the injections work so well that they do not require surgery at all.
Maybe we were being pessimistic, but Nate and I both knew the injections wouldn’t solve the loss of coordination problem; it seemed like a ridiculous hoop to have to jump through, not to mention very costly time-wise, but we hoped it would at least improve his symptoms a bit. The injections did help the sciatica he had but in the days following each injection Nate’s coordination got much worse. This only further convinced us that spine surgery would solve Nate’s injury once and for all. It might be a negative effect but the injections were clearly striking at the cause of the problem.
One year prior to the Olympic Trials in the marathon, Nate was ready for surgery. While every surgery carries risks, because Nate’s surgery was so non-traditional, there was an even longer list of risks and it was reiterated to us many times. The biggest risk was paralyzation. My parents begged me to not let Nate go through with the surgery. They couldn’t comprehend how a vibrant man who loved physical pursuits would risk becoming paralyzed just so he could return to the highest level of his sport. They said the risk wasn’t worth it. I remember nightly phone calls where each of them would beg and beg me to tell him not to go through with it. They told me if he became paralyzed during surgery he may not be able to cope with those ramifications. Why couldn’t he just be satisfied with his incredible accomplishments thus far and run recreationally instead?
I understood the risks and Nate understood the risks. I was scared. But Nate was determined to go through with the surgery, and I had done everything in my ability to secure the best surgeon possible for the job. Nate felt that without proceeding with surgery, he would always wonder if it might have fixed him, and he couldn’t live his life wondering that. He also worried about the problem progressing to the point he couldn’t run at all. He worried if by the time he reached middle age his leg would flop just with walking. If the surgery left him paralyzed, so be it. He knew, deep down, if he didn’t try to fix his leg now then the ability to use his leg would slowly be taken from him.
The day of the surgery I met with the anesthesiologist, explaining to him that Nate’s natural resting heart rate is 36 beats per minute. I would expect that to go even lower during surgery, so please don’t emergently stop the surgery because he looks like he’s about to flatline; that’s his normal. Nate was out just as soon as they hooked the IV up, and I had a couple of nervous hours to wait ahead of me. The plan that the surgeon had laid out for me a few weeks prior to the surgery was that Nate would be hospitalized at least overnight, and depending on how he recovered he could be kept in the hospital up to three days after his surgery.
I ate lunch slowly in the hospital cafeteria, wondering what exactly was happening in Nate’s surgery, hoping the surgeon didn’t have too much caffeine that day, and wondering how our lives would change for the better, or worse once the surgery was complete. I lingered in the cafeteria before going back up to the waiting room on the surgical floor. I knew this would be a day where time passed very slowly.
It was a different sort of marathon for Nate and for me. I went back up to the waiting room and tried to read a book I brought with me, then I tried to read magazines, but mostly I sat there, my mind racing and concerned that the surgeon was accidentally severing nerves. I wondered if I had made the right choice by pushing for this surgery. I wondered if Nate truly understood the possible risks. I wondered if my parents were right, and if this surgery was just too risky without enough of an upside. It was too late now. I felt guilty. What had I driven him to do?
As slow as time was passing, I started to realize that we had gone beyond the expected amount of surgical time. I was so nervous and I didn’t want to be “that person” who nags the surgical staff, so I waiting over an hour after Nate’s surgery was supposed to be finished, before I slowly made my way up to the desk, nearly in tears and asked in a shaky voice, “My husband was supposed to be out of surgery over an hour ago. I don’t mind waiting. But I just want to know that he’s okay.” The woman at the desk told me she’d check with a nurse. When she returned she brought a nurse along with her who told me that Nate wasn’t waking up.
“He’s having a really hard time coming out of the anesthesia.” she said. “He just keeps falling back to sleep. Once he’s more awake I’ll come get you.”
This really didn’t quell any of my fears and instead made me more nervous that Nate was having some sort of anesthesia reaction. I waited another hour. Finally, the surgeon came into the waiting room.
“Melissa?” he called.
I ran to him. “How’d it go?” I blurted. The surgeon didn’t answer. He started to walk away and said over his shoulder, “Come with me.”
We walked down a corridor and I asked again, “How’d it go?” No answer. My face started to feel very hot and I felt like I was shaking uncontrollably. He ushered me into a private room.
“It was much worse than we thought” he said as soon as the door was closed.
“Oh my God.” I was ready to burst into tears. My worst fears had been realized.
“Yeah, there wasn’t any space at all for the nerves. No wonder he was having problems. I had to remove a ton of bone. So much more than I thought. It was way worse than what the MRI showed.” he said, rather matter of factly.
“So, he’s okay? He’s going to be able to run?” a glimmer of hope in me starting to shine once again.
“Oh of course! He’ll be fine. He’ll be sore for the next few weeks but make sure you get him up and walking around. He’ll be just fine.”
The surgeon brought me down to the post-op recovery unit and Nate was sitting up in a chair, wearing his USA warm-ups from the World Championships. He was doped and groggy and munching on graham crackers and sipping ginger ale.
“I feel really good” he said, “I can’t wait to go home!”
“You’ll be home soon enough,” I said, “But first you need to stay here for a while and recover.” I looked at the surgeon who was still lingering at the bedside. “Do you think he’ll be here just one night?” I asked.
“Oh no, not at all. You can take him home now if you’d like.”
I laughed, “Right. Sure thing. But when can he go home?”
The surgeon said, “No seriously, he can go home with you. You’re a nurse practitioner. You know what you need to do and what to look for. He’ll be much more comfortable at home. I think that’s the best place for him.”
I later found out that Nate had pre-arranged this. Nate hates hospitals; really, he has an irrational fear of them, so he spoke with the surgeon (unbeknownst to me) and convinced him to let him go home immediately following the surgery because I’m a healthcare professional and could take care of him. Because I was completely unaware of this, I didn’t take any additional time off from work. At the time, we lived in a third-floor apartment, basically an attic space of an old home. There would be no way that Nate would be able to make it up and down those flights of stairs immediately after surgery.

Before I could even protest, a smiling teenage girl with a wheelchair came to bring Nate down to the car. And a doped up Nate was looking at me and grinning from ear to ear. He was going home.

Keep tuning in to Nate's blog for the exciting conclusion of Fix You, out later this week!


danny said...

I feel like I'm part of your family. Melissa if Nurse practitioner doesn't workout, you surely have a career as a hollywood writer. If that's the case, I want to buy the rights to this upcoming Movie. One of the titles that comes to mind is..."The essence of faithfulness" . I read that somewhere, I just can't remember where. It seems to fit your love for Nate and Nate's resolve to comeback.

As for staying tuned, no need to ask, this is the best running blog on the web.

Scotty "PHAT" Graham said...

Wow, you have me hooked. I can't wait to see how he does in Boston.

MC said...

Great post!

Peter said...
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