A Twenty-Something in the Body of a Sixty-Something.

This is not about my gastro-intestinal issues (pun intended), because that's just graphic and gross. I am having a colonoscopy and a gastroscopy on the 27th of February. That's all I need to say about that.

No, this is about symptoms that strike a familiar chord for me. The timeline follows...

1994: I have a severe pinching pain in my back that renders me nearly immobile. I see a chiropractor, who does no x-rays and simply treats the pain-- poorly.

1998: The years have not been kind. I have lots of back, neck, shoulder, and arm pain, and frequent headaches. An MRI reveals two things: a ruptured disc between vertebrae C6 and C7 (in the neck or cervical spine) as well as a defect known as a Chiari I Malformation, which is present from birth but does not cause problems until adulthood, around the 30's or so. (In a Chiari malformation, the base of the brain is too large for the skull and begins to force its way through the foramen magnum, or the hole at the base of the skull, putting pressure on the spinal cord and restricting the flow of cerebral-spinal fluid. See picture at left.) The disc situation is the one that is urgent, so I have surgery to repair it. A small piece of my hipbone is removed and used as a spacer between the two vertebrae, as the disc is indeed ruptured and all but turned to dust by now. The piece of hipbone will fuse with the two vertebrae, creating one strong vertebrae. Success. Back pain gone. I am back to work in 5 weeks.

2001: I begin experiencing weird pains in my head when I laugh hard, cough, or even strain to have a BM. The pains feel like the flow of blood is being temporarily stopped somewhere on the top right side of the head. I nearly collapse during a performance of "Someone Who'll Watch Over Me," in which I am performing. The pain happens during the same scene at every performance of the show-- when I am excessively straining in a "fearful" moment of the script. My doctor suggests it's migraines and prescribes a variety of different medicines over a four-month period. The pains seem to come under control.

2003: I am having trouble swallowing. I must take small bites and chew my food excessively. I begin having the head pains again. I start to research Chiari Malformations and discover that many of my symptoms match up. I ask my doctor if he agrees, and he does. I see a neurosurgeon. In April, just 2 weeks before the opening of "A Chorus Line," of which I am the musical director and pianist (and sole accompanist mostly), I have brain surgery. In this procedure, the doctor removes a bit of the skull near the foramen magnum, allowing more room for the brain in an effort to improve the flow of cerebro-spinal fluid. My recovery takes longer than the week the surgeon predicted; fortunately, subsitute pianists are found for the show's opening weekend. I only miss about three weeks of work.

2005: I have lots of neck, back, shoulder and arm pain. The cervical-spinal fusion from 1998 has apparently failed-- the bones did not fuse. A second procedure is performed. This time a titanium plate is added to hold the two vertebrae and hipbone fragment together. This is followed by 6 weeks of physical therapy and the use of a bone-growth stimulator, which I wear twice a day and which uses electrical impulses to stimulate the fusion of the bones. I am off work for 8 weeks.

2008: The symptoms of both the spinal discomfort as well as the Chiari have all returned. I am having headaches, intra-cranial pressure in the back of my head, sore back, neck, right shoulder, right shoulder blade, and down the right arm. My doctor has ordered an MRI of the brain and the cervical spine-- with and without contrast dye.

Wailing and gnashing of teeth to follow.

Next up... job and hobby fun.