I Wanna Be a Jalapeno!

For some bizarre reason, I planted twenty pepper plants – twenty! Last week, I decided to pickle some of my pepper crop. While happily attempting to say that silly tongue twister about Peter Piper’s pickled peppers, I carefully began to de-stem, de-seed, and slice my pretty crop of purple, white, and green peppers. Finally I was down to one last pepper – the jalapeno. I’d worked with jalapenos before, and they hadn’t burned my hands, so I was quite confident that I’d be fine.

I sliced the stem off the top of Mr. Jalapeno and the burning oils instantly burned my nostrils. Now, you’d think that would be enough to deter me and make me retrieve gloves, but I’m not that smart. I continue to slice and deseed the Jalapeno, only to feel the burn starting slowly on my hands. It didn’t take long for me to regret my decision to brave it out. My lungs were burning with each breath and my hands weren’t much better. To make things worse, at some point in time, I must have pushed the hair out of my face because my forehead and cheek were burning as well – OUCH!

No matter what I tried – water, soap, hand cleaner, nothing could help the burn that was stuck on my hands. I continued my pickling and canning in spite of the burn, which was getting worse by the minute, I couldn’t shake it! As I was trying to find something that would offer relief, I was thinking and decided that Christians should be a bit more like Jalapenos.

When we meet someone, especially non-Christians, we should leave a lasting impression on them. An impression that persistently continues to tug at their hearts, like Jalapeno oil on the skin. We have the Spirit living in us, and we shouldn’t hold Him in, but let His love shine through us in everything we do, and on to each person we come into contact with.

I pray I will be a little more like a Jalapeno each day. By the way, a product called Technu works to remove Jalapeno oils from your skin. It is marketed for poisen ivy/oak/sumac. Water just makes it worse. Just in case you decide to pick a peck of pickled peppers without gloves (I don’t recommend it).

Comfort from a Storm

One thing that I’ve been questioning recently is how God could have allowed all this pain to happen to me when so many people were praying for my surgery to go well and cure the pain.  A few days ago, God revealed a comforting analogy to me through nature that helped me understand a little bit of why.
Some days, the sun is hidden by many clouds.  Sometimes the rain pounds the earth, while thunder shakes the earth and lightning streaks across the sky.  This is not what we expected, not what we wanted, yet God remains in control.  The rain that drenches the ground also softens the seed coats to allow growth.  Without it, the seeds could not grow.  My life has seemed like a thunderstorm the past few months.   I often struggle to see how it is the answer to my prayers, but sometimes we need the stormy times for growth.  I pray that my heart would continue to be softened to hear His words and to grow closer to Him.

Absolutely Nothing

For the first time in a long time, I am doing nothing, not because I have to but because I can. Sure, I have a few things I could be doing, but they aren’t urgent and can wait. It seems bizarre that if something I want to do pops into my head, I have the energy to hop up and do it. It almost seems foolish to waste my energy on doing nothing, but I’m going to enjoy it while it lasts.

So, why don’t I have anything to do? Because my final papers are in, my final exams are over, and my year of college is complete. Well, I do have an online class to complete, but that isn’t due until mid-July, so I’m free! Free, that is, until I get home and I’m stuck in my room unpacking, but for now, I’m enjoying the freedom of doing nothing. Problem of doing nothing is that there is nothing to distract you from the pain either. In fact, all this rambling is my attempt to do something so I don’t have to think.

My dorm room is pretty empty, since I’ve packed and taken most of my stuff home last weekend and the weekend before. In fact, I have free time to do something fun, but nothing fun to do something with (except my lap top obviously). I just have some clothes and my school books left.

I must say, I’m fairly proud of myself for finishing this semester. It may be the longest, hardest, and most painful school term in my life. Since January, I have had two surgeries, two nerve blocks, and a three-week continuous epidural in addition to numerous drugs but still have managed to complete 22 credit hours of school work. Not only that, but I have managed to pull off good grades as well (I think I have all A’s except one or two B’s).

Who said that CRPS ruins your life? I have overcame the pain and pressed on, even when others told me repeatedly to quit, to give up, to go home. I refused, pressed on, and emerged triumphant and I hope that this is an example to others. All of the long, sleepless nights (because of the pain or homework), the slow, painful typing, the excessive studying while in pain, all will have paid off if I learned something (I did) and if I grew closer to God (I did), and if I was able to make a change in others lives. I’d say it was a pretty successful semester, but I am glad it is complete, though I hate saying good bye to all my new friends.

Time to Play Catch Up

Has it really been a whole month since I last posted? It hardly seems that long, yet in some ways it seems like even longer. On April 16, I went to the hospital for an outpatient placement of an epidural line in my upper back. For three weeks, I would “enjoy” the blessings of a continuous epidural infusion of two medications made to scramble pain signals. I know this is a little confusing, but here is the information I’ve collected about them…

What is a continuous epidural infusion?
Just as an epidural is given to pregnant women during childbirth, it can also be used in the treatment of pain associated with chronic pain. Epidurals traditionally pump morphine for pain relief but are often combined with or exclusively a combination of analgesics (though this is “extra label usage” meaning it isn’t approved by the FDA for this use). Though it numbs pain, it isn’t supposed to affect sensory or motor nerves, meaning you can still feel and move, but don’t experience pain.

An epidural is performed by inserting a needle in the epidural space around the spine. A catheter is then fed into this space and the needle is removed, leaving the soft, flexible catheter in place. This is done with the aid of either an ultrasound or fluoroscopy to insure correct placement. Following the insertion of the catheter, a contrast (kind of like dye) is injected to be sure the medication will spread well and where the doctor wants it. The epidural line placement itself may be slightly painful when performed, as it involves inserting a long needle deep into the spine so it is usually done with sedation and local anesthetic. Even more painful is the “tunneling” done under the skin from the shoulder to ensure that the line is not accidently pulled out.

After the placement of the catheter, the line is hooked up to a pump which is attached to an I.V. bag containing the medication. A specific rate is set for the patient to receive through the catheter directly into the epidural space. If additional pain relief is needed, such as during physical therapy, a “bolus” rate is set allowing the patient to push a button to administer more medication.

How does this help CRPS patients?
Because pain signals to the pain are blocked for several weeks (as opposed to a few hours in a sympathetic nerve block), the brain is given time to “reset” the pain cycle. It also allows for a strenuous physical therapy program to take place, allowing the patient to work on range of motion, strength, and desensitization. Typically a very strenuous physical therapy schedule is worked out, often several hours every single day.

Like so many things with CRPS, little research has been done to prove whether continuous epidural infusions help or not. There is also much debate over which medications are best to use in the infusion, how long to leave it in, and even whether it works. There have been a few cases reported where an continuous epidural infusion cured CRPS (or at least put it into remission).

What about Amber’s personal experience?
I had a continuous epidural infusion at the cervical level (upper spine) for three weeks. The doctor used two different analgesics, and no opioids. Apparently, placing epidural lines in the cervical spine is much more difficult than the lumbar spine, which makes sense because the vertebrae are closer together and are thinner, making the epidural space smaller, which increases the risk of hitting the spinal cord. I completely trust my anesthesiologist who did the procedure, he is very experienced, probably one of the most experienced in the state for this type of procedure. I’m not sure I would even consider this at all unless I was very confident that the doctor doing the procedure knows what he is doing because it can be very dangerous if not done well.

Following the placement of the epidural line, I had excellent pain relief, in fact, nearly all my pain was gone, to the point I could completely ignore it most of the time. At first there was some difficulty in achieving pain relief without limiting my ability to use my arm. I did physical therapy every week day for 2 hours while the catheter was in place. Prior to the epidural, my hand strength was 20 lbs, after a week of therapy it was 50 lbs. I also noticed a significant change in range of motion, going from a very limited range of motion to full active range of motion within a few days. A week or so after the placement, the pain levels in my hand began to increase so the rate was adjusted, which caused some problems including hypotension, balance impairment, pupil dilation/constriction, and light-headedness as well as making me feel “out of it” and limiting motor control. I would wake up in the mornings and not be able to move my elbow or shoulder (but could move my wrist and fingers). The nurses worked very hard to balance offer pain relief and attempt to reduce side effects at the same time. I feel the epidural was beneficial in that it allowed me to participate in a strenuous physical therapy program, which has had lasting affects. Once removed however, the pain has returned, but I still have greater range of motion and strength than I did prior to it.

The other problem with my epidural was the pain it caused in my back and right shoulder (because it tunneled to the right to aim the catheter at the left arm. At first the pain was unbearable, but slowly grew better (with the help of more medication). The placement of the line was done with local anesthetic, but I wasn’t sedated. As the local anesthetic wore off, pain levels in the back increased within an expected range, but after a few days, sharp, stabbing pain gradually grew worse in the area surrounding catheter insertion site. The pain worsened to the point it was distracting and made it difficult to concentrate. I decided to continue to try to function with the pain, which was continuous, but varied in intensity. Over time, it began to have a deep ache as well. The pain has decreased some since the epidural was removed, but only after my doctor gave me two trigger point injections. Though the pain is bad, I don’t think it is the CRPS spreading because the pain is a little different. I’m doing physical therapy for my back/shoulder as well as my arm.

Any other questions? Just ask!

Who Can Do It?

In reflection over my last post, I’ve realized that I failed to mention another huge part of the realization my lack of participation in worship made me realize. God is worthy and I cannot give Him what He deserves. It doesn’t matter if you have one working arm or a hundred, as humans we simply cannot give Him what He deserves.

It isn’t something I am lacking solely because I cannot worship with the accompaniment of bass sounding music, but something we as a human race, as all creation, lacks. Sure we can sing Him pretty songs, help others, or even lead others to Him, but He is deserving of so much more.

This fact never came to me before, I don’t know if I’m just dense or if everyone is oblivious to the wonder of our God, but even when I served God with my whole heart and my whole healthy body, I could not give Him what He deserves.

If God did nothing, He would be worthy of praise beyond anything I can imagine.

This realization may give some the excuse that if we can’t do it all, we should do anything to worship Him, but that is so wrong. I will go on praising my God with my whole life, even if it causes me pain to do it because He is so worthy of my praise!

How Can I Say Thanks?

During worship this morning, I stood gritting my teeth and holding back tears, desperately clutching my arm to my body in an attempt to protect it from the low bass sound waves ricocheted around my body. For some reason, my arm responds to low sound waves the same way your arm might if it was placed in a pair of vice grips, then tightened. As painful as it was, it wasn’t the pain that finally caused the tears to roll down my face.

“How can I say thanks
For the things You have done for me,
Things so undeserved,
Yet You gave to prove Your love for me.”

Standing there with worshipers singing around me in reflection of God’s glory, I was hit with the realization that I could not worship with others due to my pain. How could I say thanks to Him for what He had done for me when I couldn’t bear the music accompaniment? I couldn’t give my God the praise He deserves because of my physical pain. The emotional pain that ran through my mind is incomparable to even the longing to sleep on my left side. How can I not worship my God? Why would He create a disease that would inhibit the worship of Him?

As tears rolled down my face, I realized that I was missing the point. Worship isn’t about singing a song, though in American churches, that seems to be the accepted norm. Worship is giving praise to God with my whole life!

“Just let me live my life,
Let it be pleasing, Lord, to Thee,
And if I gain any praise,
Let it go to Calvary.”

It is the things I do every day, the fact that I choose to get out of bed, tell God good morning, and hop out of bed eager to discover what He has in store for me is worship. When I choose the hard road of servanthood, sacrificing my best interests for others, that is worship. I don’t need a tolerant hand to worship, in fact, I don’t need a hand at all, I can worship God solely through my actions.