The nerve block is out of my system completely.
By now, I know the pattern well, the progression as the analgesic/steroid cocktail, injected into the nerve root between L3 and L4, fades and my autonomic nervous system restarts it’s infinite loop of misfires.
It starts with a twinge, a surge of pain. The lower fibula, about an inch and a half above the lateral malleolus. The surge grows into a zap. The zap is accompanied by a stab into the center of my ankle, right where the leg meets the foot. The zap grows into a strong blow, strong enough to take my breath away. The stab becomes a dagger, lodged. Then comes the dull ache up the inside of my ankle, inside the medial malleolus, stopping about halfway up my tibia. A tiny chainsaw across the outside of my heel. A white hot fire poker between my medial malleolus and my achilles tendon. Then, concurrently, the zip tie that cuts across the joint of my big toe, and the invisible fingers pulling at the top of my fibula.
I sometimes imagine my lower leg is on a giant’s buffalo wing platter. It’s spicy-hot, crispy-skinned, and dipped in cold bleu cheese dressing. And the giant picks up my leg and pulls my fibula away from the tibia and sucks the meat from between the bones. (Ironically, I have only ever eaten the part of chicken wings that look like miniature drumsticks; the two boned wings creep me out because of that weird meat between the bones.)
And when all the now all too familiar pain is fully firing, once the party really has really gotten started, my foot goes cold. Ice cold. It feels like it has been filled with sand. Cold, wet, gravelly sand from a northern California beach in the wintertime. It is difficult to move my foot and ankle. My foot feels heavy. My toe no longer lifts.
My skin turns a mottled grayish red color. My skin is shiny. And then the bees start stinging my leg. Not just one or two stray bees stinging in one or two places. There’s a swarming bee sting wedge. Just below my knee, extending medially and downward. The entire inside of my lower leg, down to my big toe, including the top and inside of my foot and ankle, but not including my second or other toes. Those lucky little devils are spared the wrath of a thousand non-existent bees.
Once the bees start stinging, I know what is coming imminently: the spasms and cramps. The spasms start as little twitches in my arch. A little shimmy in my calf. This is the stage where I am right now. The muscles in my foot are firing on their own. My big toe is pulling down and I am still unable to lift it up. It cramps and it hurts.
And I know what’s coming within the next day or two. And I know that from this point on, I have to closely, carefully monitor my activity. I have to time the amount of time I spend sitting, standing, moving.
The spasms aren’t just a case of the shakes. Every contraction sends an electric jolt up my leg and down into my foot. And with hundreds of contractions per minute… you get the idea.
And it’s funny. People always like to comment about my *mood*. In the days after my block: “it’s nice to see you in a good mood.” As the days pass, as the nerves return to their old tricks: “boy, are you in a baaaaaad moooooood!”
And it’s true. I am in a good mood after the block. Because I have some semblance of control over my lower leg, ankle, and foot. Because the knives and hot pokers have been removed, the tiny chainsaw stopped, the gunshot wound in my fibula healed, the cold sand drained, the bees stopped stinging, the electricity shut off, the aches are reduced, and there is no giant trying to pry apart my bones to get at the meat between my tibia and fibula. You’d be in a pretty good mood too.
And oh, jeez, you betcha you’d be in a bad mood too when it all comes back in full force.
The first time I went through it, it was a huge emotional roller coaster. The first relief of the CRPS-ity in over two years, since my accident, was pure elation. And Jesus, the let down, the depression, when it all came back after a few days…
Now that I am an old pro at these nerve blocks, I know not to be too happy. I allow myself to feel and enjoy the relief, but I know it will only last a few days. I dread that first surge. But I know it’s coming. And I know what will follow. And I know that this is the cycle that, like CRPS itself, is the infinite loop of my current life.
And this time around, I made a conscious effort to try to lop off the peaks and fill in the valleys. Yet, I still haven’t mastered maintaining a steady monotonous mood to placate the commenting onlookers and bystanders. Oh well. I can always try again next time.
So, yeah. There you have it. My nerve block is gone.