Cassandra Malave

Background on the original injuries:
Everyone knows about the obvious casualties of war, but what they fail to recognize are the hidden victims.  My father served in the Pacific theatre during WWII in the Navy.  He was stationed on a submarine which was torpedoed and subsequently destroyed, leaving only three survivors.  Even though several years had passed by the time he wed my mother, he was still suffering from classic symptoms of Post Traumatic Stress Syndrome.  Of course, in 1945, they didn’t understand the real and long-lasting effects of war on the minds and emotions of human beings subjected to such horrific conditions.
After he returned from the war, he was what they called “a nervous wreck”.  He had become a chain smoker and he insisted on having a very quiet household.  That’s just not possible with two small children.  Having to deal with a strong-willed child such as myself was too much for him.  Consequently, one day when I was three years old, I had wet my pants for the umpteenth time, and it was just too much stress for my father. He promptly threw me to the floor and proceeded to strangle me.  I survived thanks to my mother intervening after I passed out.  I was black and blue from just above my chin down to the top of my chest.  But those were only the exterior signs of the damage done.  Unfortunately, he had succeeded in damaging my neck, to the extent that now my cervical spine curves in the opposite direction that God intended it to.  Over the years it has resulted in a variety of pains running down my shoulders, sharp, stabbing pains at the base of the back of my neck upon turning my head, and occasional migraines.  As I’m sure you can guess by now, my younger brother and I were raised in an abusive household, and pain has always been meaningless to both of us.  We both have a dangerously high threshold for pain tolerance.
My cervical vertebrae also display a narrowing of the disk, called “stenosis”, which is congenital.  My mother’s mother died when my mother was only 14 years old, and about the only thing she remembers about her mother was that her Dad used to constantly tell her, “Shh honey, Mommy’s laying down in the bedroom with one of those really bad headaches again.”  I’m grateful to God He released her from that body of pain as early as He did.  Glory to God for His unending mercy!
As I grew into my adult body, everything settled down, and even though my neck was far from “normal”, the grace of God was with me over the years, and I had only minimal trouble with it.
As far as my lower back is concerned, I injured that when I was 25 years old.  I lifted a box that was FAR too heavy for me.  Then, to set it down, I reached with the box, and twisted my back, and that was all she wrote!  My back “went out” and was never the same after that.  After struggling with it for 6 months, I finally capitulated to my husband and went to see a chiropractor.  Within a month he had me walking upright again, and within 3 months I was relatively free from pain and could resume my normal daily activities.  The lifestyle in Arizona is substantially different than it is in Indiana, and virtually everyone works out in a gym several times a week, and we go “mall walking” on the other days.  I was no exception, and over a period of 17 years I got into the best, most physically fit condition I had ever been in my life.  I was quite active, and I love the outdoors.
In Arizona, many people enjoy the great outdoors.  I loved camping on the Mogollon Rim, hiking the West Fork Trail in Sedona (a moderately easy hike, I assure you), swimming with friends, picnics and cookouts at the Estrella Mountain Park, horseback riding, site-seeing other, more remote parts of Arizona that most of the tourists don’t know exist, etc.  And now you will see how drastically my life has changed.

Current disabling conditions and how they came to be so:
As I aged, I had all the normal aches and pains other people have.  After living in the Sonoran Desert for 30 years, I met a wonderful Christian man in Indiana, we married, and I am now a “Hoosier in training”. :-))  Living in Indiana where we have a temperate climate, the rain and cold winters have taken somewhat of a toll on my body.  I have arthritis in my spine, shoulders, hands, and right hip.  But I was able to compensate for these minor annoyances by being able to sit at the computer most of the day to do my work.  When my back became stiff, I could stretch it out by taking a short walk.  When my legs ached, I could elevate them on a box I had hidden beneath my desk.  Not a big deal.
Then on August 29, 2006 I got what I believed was the stomach flu.  It changed my life forever.  I had a mild fever, vomiting, minor pain in my abdomen, all the classic symptoms.  I figured it would be gone in a day or two.  The next day it seemed worse instead of better, and I wasn’t sure what was going on.  I kept a close watch on my temperature, and it held steady at about 100 or 101 degrees.  The pain in my abdomen seemed to be increasing, but I figured something I had eaten just wasn’t agreeing with me, and I would probably feel better when it passed through my system.  By Thursday morning, August 31st, I was in some pain, but again, I felt it would pass in time.  I took my temperature though, and the thermometer read a whopping 104 degrees.  Time to go to the Doctor!  My husband made the appointment for me, and we got there within the hour.  The Doctor couldn’t see me right away, but his Nurse Practitioner could, and that was fine with me.  When she took my temp. she called Dr. Maddock for a consult from across the hall.  He gave me a shot of Demerol for the pain, and sent me to Porter Memorial Hospital for a Cat Scan of my abdomen.
Dr. Nemeth was the surgeon on call at the time, and when he reviewed the Cat Scan, he said that things were “so messed up in there” that he couldn’t tell what was wrong until he opened me up to look.  He also said I may come out of the surgery with a colostomy bag.  At this point, he just really couldn’t tell exactly what the problem was.
Three days later, I awoke out of a coma, on a respirator.  I learned that I had a perforated appendix, which had leaked toxins throughout my abdominal cavity.  They had to remove all my intestines, debreed them, flush my body cavity with antibiotics, wash my intestines with antibiotics, and put them all back into my body.  I had gone septic, they couldn’t keep my blood pressure up, and I had respiratory failure.  It took me four months to recover from the surgery, but during that time, I noticed my arthritis had become excessively painful, and my hair was falling out.
In October of 2006 I went to Dr. Maddock about it, and he explained to me that when the human body goes through a traumatic episode like this, it’s common for it to react as my body was reacting.  He said my hair would grow back in by spring of next year, and the arthritis pain would soon “calm down” and I could get back to my normal life.
Spring of 2007 came, and spring of 2007 went, and my hair had grown back in, but the pain in my back had only grown worse.  By this time, I no longer had a job, and consequently, no insurance.  I sought medical help from the North Shore Health Center.  They arranged a sliding fee schedule for me based on my husband’s income, which I could afford, and I was able to obtain my medications through Fagen Pharmacy through their Uninsured People Plan.  Dr. Girn, now my family Doctor, arranged a Cat Scan for me through the “Helping Hearts” Program at the Broadway Methodist Hospital.  I had to find out what was causing so very much pain in my lower back.  The Cat Scan showed lumbar spinal stenosis.  Well and good.  At least I had a name to go along with the pain.  At last my husband had irrefutable proof that there was, indeed, something horribly wrong with my back, which was causing me such grief.  It wasn’t my imagination, it wasn’t all in my head.  It wasn’t some sort of distorted attempt to get out of having to work the rest of my life.  I’ve always loved my work, for that matter.  I hold a Magna Cum Laude degree from Arizona State University in Education, majoring in Special Education, and I have loved working with the handicapped and mentally challenged for many years now.  I’ve always lived a very active and involved life, and I’ve always enjoyed my life at every stage of it.  But I knew I had to start facing this situation realistically.
I couldn’t even sit comfortably on our family sofa when I returned from the hospital, and we bought a special recliner just for me.  At this point in my life, I am truly living my life in my recliner.  But when I first began this journey, I had a lot of accommodations to make because of the pain and my lowered ability to stand, sit, or lift things.  They are as follows:

Pain Management Efforts
April 22, 2008

I have extreme difficulty rising from regular height chairs, a couch, or bed with pain in my back and legs, so:
In 2004 I placed bankers boxes filled with books beneath my bed instead of using the frame, because it raises the height of the bed by 4 more inches than normal.
I purchased 5 inch risers for my couch in 2004 to make it easier to rise up from..
I purchased and installed an 8 inch tall heightened toilet seat in 2004 for the same reason.
Since the autumn of 2006, I cannot walk or stand longer than 15 minutes without searing pain, so I purchased a walker with a seat in it so I could accompany my husband shopping at large “warehouse type” stores like Wal-Mart.  The walker also assists me in maintaining an upright posture while walking, instead of ending up bent over from the waist when the pain becomes too much to bear.
I purchased a recliner so I could elevate my legs, too.  I also had to put a lumbar support cushion behind my back when I sit in the recliner in order to sit comfortably.  I also learned that my knees have to be higher than my hips for me to get relief from the pain in my back.  I built a stanchion for my recliner within 2 days of purchasing the recliner, so I could rise from it with relative ease.
Because it causes pain in my back to pick something up from the floor, I purchased a long-armed “grabber” to assist me.
In the summer of 2007 I began to get headaches from the stenosis in my neck, even to the point of losing my vision for a second or two, so:
I stopped  reading for more than 5 minutes at a time, due to my neck being bent downwards and it causing me increased “headaches”.
I stopped crocheting for the same reason.
I stopped typing recipes on my computer for the same reason.
I stopped doing jigsaw puzzles for the same reason.
I stopped playing video games on my computer for the same reason.
To relieve the headaches, I lay back in my recliner, I draw the shades on the front windows, and place a lavender/sage scented cloth over my eyes (my efforts at aromatherapy).  It’s only truly effective if I fall asleep and nap for at least an hour, and, unfortunately, I have never been the type of person who could fall asleep during daylight hours, even as a child.
Dr. Girn prescribed Elavil (amatriptyline) for the headaches, but we have had to raise the dosage three times before any substantial relief was obtained.
By the autumn of 2007, my back deteriorated to the point where I can only stand or walk an average of about 5 minutes at a time.  When I had no choice but to continue to walk (for instance, being in a small store like Aldi or Strack’s), I break out in a cold sweat, my hands become clammy, and I become sick to my stomach, so:
My husband must accompany me now to both Aldi and Strack’s so he can push the cart while I carry the grocery list and use my walker to sit down from time to time during our shopping trip.
On April 5, 2007 I tried to pick up my walker and put it into the truck myself, without my husband’s help.  After a couple failed attempts, I got it into the truck.  Afterwards, I had sharp shooting pains up the right side of my neck and down my right arm.  I also had a very angry husband to contend with!  I have learned from this incident that I cannot put my walker into the truck alone.
I have placed an oak stool in my kitchen so I can take frequent  “sit down” breaks when I wash dishes, cook, pack my husband’s lunch, etc.
I have purchased a “shower chair”.  It’s the kind with a seat that slides across chrome rails into and out of the tub.  I sit on the chair outside of the tub, slide across into the tub, bring my legs into the tub one at a time from a secure, seated position, and stand up to begin my shower.  I wash my hair and then I have to sit down to alleviate the pain in my back.  I turn the water back on, finish my shower, and sit back down on the chair to slide out of the tub.  This has been quite helpful, in that I don’t have to ask my husband’s help to shower anymore.
I ask my husband to help me get dressed. He helps put my left sock on and get the left leg of my underwear and slacks on.  Then I can put them on the rest of the way and finish dressing.
On March 10, 2008 I went to a Pain Management doctor (Dr. Ungar) in Renssellear, IN who wanted me to get an EMG; since I have no insurance and no way to pay for his services now, I’ve got to wait to see whether or not I will qualify for Medicaid.  In the interim, he gave me a prescription for Zanaflex - 4 mg.  It reduced my pain by about 25%; while walking through Wal-Mart, I had to sit down twice, and while I broke out in a cold sweat from the pain, my hands didn’t get clammy, and I was able to make it back to our vehicle, although still in substantial pain.
I have pain in my back when I spend more than ½ an hour in bed, so I placed several pillows under my legs to provide elevation similar to the recliner, and so I get about 3-4 hours sleep in the bed each night.  When the discomfort in my back becomes too intolerable, I move to the recliner in the middle of the night and finish sleeping.  I’m already spending just about every waking moment in the recliner, and I really don’t want to start sleeping in it full time, too.
About the middle of March, 2008 I can no longer stand in church during the playing of the first two songs in the  praise and worship portion of the service.
As of March 31, 2008 I have restricted the times I ride in our family car (Chevy Malibu 4 door sedan).  It is painful for me to enter and exit our car due to the painful twisting strain on my lower back of getting in and out of it.  But it is still preferable to driving my Ford pickup, which rides rough and contributes to the pain in my neck, back, and head, as well as making my vision ‘blurry’ (well, wavy lines which obstruct my vision...not a good thing while driving).
Sunday April 6, 2008 - I began having sharp shooting pains down my right arm when I played my tambourine in church.  I have been playing the tambourine in church since 1974.  It is something I greatly enjoy, but it is beginning to look like I may have to give this up as well.  I also talked briefly to our Pastor about an alternative seating arrangement due to the hard wooden-backed pews causing me pain.
Monday April 7, 2008 - I have been resisting taking daily showers because it was so painful to bend my head backwards to get it under the showerhead (to shampoo my hair and take a shower), so I asked my landlord to install a handheld shower so I wouldn’t have to stand in the shower, and so I wouldn’t have to bend my neck backwards to shampoo with the old showerhead.
Tuesday April 8, 2008 - I had a talk with my Pastor about finding some sort of alternative seating arrangement for me because of my back pain.  There is a chair in the Associate Pastor’s office which I sit in when we pray which is padded on the back, and thickly padded on the seat.  He’s going to find another one for me that I can use to sit in the sanctuary during regular service times.
Sunday April 13, 2008 - For the third Sunday in a row I have had to sit through most of the service with my eyes closed.  About halfway through the past 3 services, I have had headaches due to the bright lighting and/or noise during the praise and worship portion of the Sunday service.  Closing my eyes helps alleviate the pain, although it doesn’t remove it completely; but I would say about 75% of it abates within the first ½ hour of keeping my eyes closed.
Tuesday April 22, 2008 - This past week I saw Dr. Girn again about the headaches; he wanted to do a CT scan on my head, but I can’t afford it.  He “upped” my pain meds to the maximun amount allowed.  After taking them for a few days, the headaches are held in check until later in the evening.  Unfortunately, the bright lights still give me headaches, so today I have purchased a wrap around type of light-blocking pair of dark glasses to wear while riding in the car/truck and in church.

Unresolved Difficulties

I can’t carry more than about 5 lbs. without pain.

I can’t sit in our church pews without pain.

Exposure to daylight outdoors initiates a headache by the time I get home from a store, even though I wear “transition lenses” which turn dark in the sunlight.

I can’t sit outside for more than ½ hour at a time due to the “sunshine headaches”.

Riding in any vehicle causes pain in both my back and neck, resulting in headaches.

I can’t go to our friend’s home because I can’t climb more than one or two steps without being in severe pain.

I can’t stand in the foyer of our church and socialize with other members because of the pain while standing for more than 5 minutes.

I can’t vacuum because of the pain.

I can’t clean out my ‘fridge because of the pain of bending over for any length of time.

I can’t clean the front of my stove because of the pain of bending over.

I can’t clean my kitchen countertops as thoroughly as I would like because of the pain of standing more than about 5 minutes.

Laundry causes me pain, reaching down into the washer tub to retrieve the clean clothes and put them into the dryer.

Changing the bedding causes me pain with all the standing, walking and bending.

Lifting my walker into and out of the truck causes me pain, so my husband must do it for me, which means I can’t drive alone anywhere if I need to use my walker when I get to where I’m going.

I can’t use my computer without pain between my shoulder blades and headaches after 15-30 minutes.

I can’t sit at our kitchen table for meals because of the pain caused by low chairs and having to sit with a straight back.

I’m basically living my life in my recliner.  I eat, sleep part time, “watch” TV, listen to CD’s and spend quality time in prayer, all in the comfort of my recliner.  I highly resist leaving the house to go places with my husband, only because I know how much pain I will be in before too long; none of the pain relievers I am currently taking or have taken in the past (naproxin sodium, flexeril, skelaxin, zanaflex, meloxicam, amitriptylene) are able to cut through the searing pain I get in my back when I’ve been standing or walking too long.

And finally...I’m beginning to be in pain even while I’m sitting in my recliner.  There’s no rhyme nor reason to it; it erratically starts and stops for no apparent reason.  I need to find an effective pain reliever for both my lower back and the daily “headaches”.
**************************************************************

Today’s date is May 2, 2009.  Since I wrote the above, I have been approved for Medicaid in June of 2008 and have been able to receive some good health care.  A neurologist put me on Zonegran for the daily migraines, which, unfortunately, has diminished in its effectiveness.  The mixed blessing here is that the pain makes me sick to my stomach, and since December, 2008, I have lost 25 lbs.!  Every cloud has a silver lining.  A Pain Management Specialist tried an Epidural Block (unsuccessfully) and currently has me taking Tramadol, which does stop some of the nerve pain in my lower back, but is ineffective for the attendant muscular pain.
As for my pain from sitting in the pews in church, the Lord has found a remedy for that as well.  I only stay in the service for the first 20 minutes or so, just long enough for the ‘song service’ part.  During our Pastor’s preaching, I go to the back office and intercede in prayer for the ongoing service, where I can sit in a comfortable office chair. :-))
I came to Dr. Ungar because I’m one of those rare individuals who has two very serious problems.  Thanks be to the Lord our God, Dr. Ungar can address both the neurology aspect of my neck and head as well as dealing with the pain management for my lower back.  And it appears that I have been led to Dr. Ungar just in time, too!  The headaches are “pushing through” the 400 mg. of Zonegran I take daily, and the Tramadol just isn’t as effective as it used to be at reducing the pain in my lower back to an acceptable level.  I am beginning to experience pain in my sacral spine when I sit in my recliner for longer than ½ an hour, and if I can’t find solace in my recliner, well, I’m not sure just what we will have to do now.
Well, that’s my experience in a nutshell.  I hope it speaks to someone, somewhere, and I hope they realize that all is not lost.  Together, we WILL get through it.  There IS a light at the end of this very dark tunnel.  If there is anything I can do to help, please let Dr. Ungar know, and I would be glad to talk with you, ‘brainstorm’ with you for some practical solutions for helping you deal with your life given the type of pain you are in, or pray for you.  May the Lord bless and keep you.

Comments

[abercrombie and fitch]

I'm book-marking and will be tweeting this to my followers! Putting on Pandora bracelets uk will provide you with the customized feel along with each distinctive

style. hollister ukThe result is a gorgeous collection of Pandora jewellery uk that you can coordinate with each other

and with all of your other pieces.
abercrombie outletA woman is inseparable from jewellery. There is hardly any woman who can deny the attraction of the

glittering Pandora jewellery.
abercrombie and fitch ukPandora charms style is the look that many fashionable folks are targeting. All

Pandora jewellery is created with only the very best materials and top-quality engineering and design.
abercrombie and fitch online shop