Sunday, June 08, 2014

Life without a Tailbone

This isn't the best picture, but it was easy to find on the Internet. :)

Due to trauma to my coccyx over the past year, an orthopedic surgeon suggested that I have my tailbone removed. The procedure is called a coccygectomy. On Thursday, June 5, I had my coccyx removed.

Before I continue with my story, there are two important things that you should know. First, I can't sit down and type. This entire blog post is being dictated using Siri on my iPad. Second, while I'm not heavily medicated, I am medicated. So if some of the things I say sound strange, you can blame it on that.

The Injury

A little bit over a year ago, I went on a 44 mile bike ride. The bike ride was great. I went on the Murdoch Canal Trail. It was a beautiful day and my bike was pretty new. I pushed myself hard because I thought I could ride my bike for ever. I finally decided to turn around at mile 22. The following five or 6 miles were not too bad but I quickly became very tired. I also started feeling pains all over my body including my hips, my knees, my elbows, my hands and just about every other part of my body. I barely made it home, but I did make it home. My body felt exhausted. In fact, it felt more exhausted and more traumatized than I thought it should have felt.

The next day most of the pains were gone. But there were a few pains that still remained. For example, my tailbone hurt quite a bit. I also had some pains in my upper back. I went to my doctor and he suggested that I might have bruised my coccyx. He prescribed muscle relaxants. He said that these relaxants would help my tailbone fit back into the correct place and heal on its own. Sure enough, my tailbone pain went away after about two months. I hopped back on my bike and started riding to and from work once again during the fall semester.

By this time, I had learned two important things. First, cushioned bicycle seats are not good. You want most of your wait to be on your sit bones. If you have a cushioned seat, your sit bones will sink into the seat and the cushion will put pressure on your tailbone. Apparently, this is a common cause of tailbone pain in cyclists. Second, upon careful examination of my seat post and my seat, I recognized that the connection between the seat and the seatpost was wrong. It was slightly bent. The right side was a few millimeters shorter than the left side. I believe that this contributed to a repeated action that disturbed my coccyx and resulted in trauma. I do not know if this broke or bruised my tailbone. One thing that I do know, is that it greatly weakened the strength of my coccyx.

Now, let's fast-forward to January 2014. Remember, I had been riding my bike to and from work from September to December. I had replaced both my seatpost and my saddle. I really liked the new saddle that I bought. It was hard and my sit bones took most of the weight. One day during my commute, I must've hit a bump. I remember feeling excruciating pain that lasted all day long while at work. I figured I had just bruised my tailbone once again. I continued to ride my bike and didn't make any changes to my lifestyle. By March, the pain was too much. My doctor suggested that I get an X-ray to find out if there were any fractures. I postponed doing this as well. I was afraid that the x-rays would show a problem. I was even more afraid at the x-rays which show nothing. I really wanted to be pain-free. I wanted to ride my bike to and from work.

I had the x-rays made in April. My tailbone had been dislocated. The joint between two of the bones was completely gone. An orthopedic surgeon said that I could live with the pain, or have the tailbone surgically removed. I figured that if I'm going to live to be 137 years old, I should try to make sure that the next 103 years are relatively pain-free. I decided to have the procedure done.

The Surgery

I quickly began reading everything I could find about coccygectomies. The actual procedure is completed in 30 minutes. It's an outpatient surgery. But, the recovery time is estimated to be three months to a year long. I quickly realized that there were more horror stories of coccygectomies then there were upbeat positive reviews. Granted, about 90% of all those people who had the procedure done were happy with the procedure and had good results from the surgery.

I was very confused by one thing, though. The surgeon who did the procedure really did not have that much to say to me about the procedure. If I had only talked to him, I would've thought that this procedure was very simple and very successful. I later learned that he simply is a good surgeon. Many of the complications and problems that others had would not be an issue with him. He's a good surgeon. He has a lot of experience doing surgeries on the spine and removing tailbones. 

I had two major concerns going into the surgery. First, for some reason IVs make me sick. I was so lucky to have such a nice nurse. Cherrelle talk to me about the IV and explained that there would not be a needle left in my arm. Instead it would just be the plastic catheter that was inserted into the vein. She did such a good job and I did not feel any pain and my arm did not become irritated following the insertion of the IV. Second, I really have a hard time waking up from anesthesia. I was lucky to have such a good anesthesiologist. I told him my concern, and at first he seemed like he didn't listen to it, or care about it, or think that it was important. Later, I found out that he gave me just enough anesthesia to do the procedure. Waking up was quite easy. I was quickly able to walk around and do everything that I needed to following the procedure.

The doctors and nurses had told me that the next few weeks weeks would be filled with pain similar to the pain that I had with the broken tailbone. I didn't really believe them. It turns out that it is similar pain. It wasn't until about a day later than I began to feel pain from the incision site. I also started having pains in the muscles in my lower and upper back.

The Recovery

So far, the recovery process has not been what I expected. I really thought I would feel miserable for the first two days after the surgery and up to the first three weeks following the surgery. To be fair, I think I was comparing it to the sickness I got in March. I was so sick for two weeks and was so miserable. For the most part, I feel happy. I'm really glad that I got the procedure done. Even though I still have the pain right now, I know that in the long term I'll be pain-free and able to ride my bike to and from work and for recreation.

There are a few things that I didn't expect. First of all, I thought I would be on pain medications for two or three days. The doctor said that it might be 2 to 3 weeks. Now, you have to remember, that much of the information I received was from personal accounts on the Internet. Even my doctor did not tell me very much before going into the procedure. I imagined that I wouldn't be able to sit for the first few days and that I would have difficulty sitting and standing for prolonged periods of time for the next three weeks. I did not anticipate difficulty in standing and walking during the first few days and weeks following the surgery. I can stand up for about 10 minutes before I start having intense lower back pain. Note, this is not pain from the incision site or where the tailbone used to be. It's actual pain in my lower back. I can walk for a little bit longer than I can stand. But once again the pain comes in the form of lower back cramping. 

I'm always hesitant about taking opiates. I know that they can be addictive and I also know that they can impair thinking and judgment. I was very concerned about what medication the doctor would prescribe for me. I did not like the way the medication made me feel the first time that I had opiates. This was a few years ago when I had a kidney stone. The medication was great for dealing with the pain but I did not like the way it made my head feel. This time around, the doctor gave me some opiates that don't seem as strong as the previous ones. While I do feel a little bit more relaxed I don't feel like my thinking or judgment is impaired. I also still have just a little bit of pain. I think the medication just takes the edge off. At first, I tried to take as little medication as possible. Even though I could take it every four hours, I tried to see if I could go 5, 6, 7, or eight hours without taking it. That ended yesterday morning. When I woke up at 6 AM to take my antibiotic I was in severe pain. To be honest, I felt like I was having kidney stones in both sides of my back. Plus my incision point hurt as well. Since then, I've been trying to take the pain medication every four hours. I'm not going to wake up in the middle of the night to take it though. So this morning, I was in quite a bit of pain before I took the pain medicine.

Today is the third day following the procedure. I'm really getting tired of laying in bed. I wish I could sit for a little bit longer, I wish I could walk a little longer, I wish I could stand a little longer. I don't have to teach until June 30. This is good news, because I believe I will probably have to be in bed up until June 30. I will try to sit occasionally. I'll try to stand occasionally. And I hope to go for walks every day. But, I think that minima lysing the pressure on the incision site will help it heal quickly.

The Conclusion

I know this has been a relatively boring blog post, but I'm glad I could get it written down.  I think my personality and attitude make it difficult to evaluate how hard or easy the recovery process will be. I'm still optimistic and am a very happy person. If you saw me, you'd see a smile on my face. But, I think that the road to recovery is going to be long and boring and painful.I appreciate all the help and all the prayers that have been offered for me.
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