Prom in the Balance

The past two weeks had been so exciting as my mom and I prepared for my senior year prom. I had bought a gorgeous, blue, strapless dress with silver neck lining, heels, clutch bag, and elegant earrings. I was sure I would look stunning when I walked into the event on the arm of my date, who would be in a black tux and matching blue tie.

A few days ago, those dreams fell apart in one fell swoop and I doubted I would be able to attend the prom, or even walk across the stage to receive my high school diploma a few weeks later.

Five weeks before I had slipped accidentally and injured my back muscles. In urgent care they reviewed the current medications I was on: Citalopram, for anxiety, and Focalin, for ADHD. Then I was prescribed a muscle relaxant (Cyclobenzaprine) for spasms, and an anti inflammatory (Celebrex) to reduce the swelling. Soon I was on the mend and not really thinking about my back anymore.

That didn’t last for long. One day I stood in chorus practice for over an hour and felt the pain in my back return with a vengeance. It hurt so badly I could hardly make it to my teacher to ask to sit down. I sat in the bleachers, without a back rest, and the pain kept biting harder into my lower back and when I drove home I was sweating. I called my parents from the car and they were prepared when I came home, with love and a dose of the muscle relaxant. I watched my mom’s worried face, and my dad’s usually abrupt mien turning soft.

The next days were in a fog. I went to school because in the morning it didn’t feel so bad. I have been brought up not to complain about aches and pains, and since my parents appeared sure the inflammation would settle and my back would mend, I forced myself through the days. Sitting in the uncomfortable school seats brought stinging aches, and walking between classes, with my bag and books in my arms, made each step an ordeal. My parents gave me muscle relaxants regularly and continued the anti inflammatory with the hope that I’d get back on the mend. My mom set an appointment with an orthopedic surgeon. Then I realized I had to press hard on my lower stomach to pee. We had an appointment with the doctor in a few days and as long as I could pee, my mom said, we could wait till we saw him. By now, the vision of the prom was distant and grey.

Then came the day in school when I could not stand it anymore. I knew we had an appointment with an orthopedic surgeon that afternoon, so I laid on the bed in the school infirmary in agony, waiting. Our imbecile nurse’s questions and comments did not help the feeling of nails stabbing my back. My mom called and asked if I could drive myself home and at that point I would have crawled to my car if I had to. I reached my house and sunk down in my chair. I was dizzy, disoriented and felt like I would vomit. Until then I know my parents never really understood the shape I was in. My parents laid me down in bed, dad gave me a dose of anti inflammatory and muscle relaxant, and my mom started looking more and more pale. She was bending over me checking my pulse.

The rest was a blur. I felt strong arms carry me out of my room and I remember laying in the ambulance. The strong men with the strong arms looked disturbed and from what I was told later they worked hard to get my pulse under control and my blood pressure down.

I Don’t Remember…

• I don’t remember arriving at the hospital.
• I don’t remember being undressed by the nurse and put in a hospital gown.
• I don’t remember being hooked up with IV and echo pads and a pressure cuff.
• I don’t remember my parents in the room while the doctor came in and poked at me and left.
• I don’t remember the nurse running back and forth.
• I don’t remember when they quickly drew blood.

The first thing I do remember is being so cold. So cold. I do remember my mom putting one blanket after another over me and still feeling cold. I do remember asking one of my parents – any one – to leave the room because it took to much effort to look at them both. I do remember the pain loosening up and beginning to feel like I was sinking. Relaxed. Calm. And so tired.

While I was sleeping, the doctor had walked in with an ER doctor’s usual flair, and determination to free the bed, and pronounced “All was well” and I could “Go home!!” They had not found any gases in my blood (don’t really know what they looked for) and, except for a low potassium level, I was “Good to go.” The prescription was to see a neurologist and a urologist. They returned my prescription bottles and on our way home we went. I cried at every turn, every speed bump, every pot hole and pains in my back radiated up to my neck. Mom had set a new appointment with the orthopedic surgeon who would now see us on an “ER basis” the next day. I continued to receive the anti inflammatory and the muscle relaxant, as well as the other medications I take daily to control my ADHD and anxiety.

The next day we sat in the orthopedic surgeon’s office at 8.00 am and I fell to the floor. The pain was excruciating. I could not move. They got me into an examination room and the doctor came surprisingly fast. A kind man with intelligent eyes who turned pale as he examined me. That much I could tell. I remember telling him I was hurting everywhere and when he asked me to lift my arms over my head I couldn’t. My muscles where stiff.

Again, I found myself at the ER, which happened to be across the street from his office. So there I was, in the same room as before in worse agony than I remember and delirious. Again an IV in my arm, and again some wonderful stuff to make me drowsy. I remember being rolled out and put on the MRI table and then slowly waking up. I had slept the entire time – for over 2 hours. Back in the room, I couldn’t understand why my mom’s face was green and she looked like she would faint, and my dad’s face was so grim. My parents kept looking at each other – long stares – I registered that. A man came in and said he needed to draw blood. I calmly said fine. I have no problems with that. He started poking at my hand and wrist and I could feel tears falling down my face. I was embarrassed. Because I don’t cry – ever!

Again. I was drowsy when the same doctor burst in the door with his brisk flair, announcing “Good news!” I could go home! The MRI showed there was nothing wrong with my spine, and the blood tests came up clear. The pain was under control, so it seemed (after all the pain reliever they had given me) so I stumbled out of the hospital. The doctor had, yet again, “prescribed” that I see a neurologist and a urologist on an “ER” basis immediately. Laying in the back of the car, I heard my mom frantically calling neurologists and getting the usual brush off. It didn’t matter that I just came out of ER. “The doctor doesn’t take ER patients. Call this number or that number.” And “I have pulled her record and I will put it on his desk. He will decide if he can see her or not. I will call you.” I still could not pee without pushing on my bladder so off we went to an amenable urologist who looked worried and repeated that we had to see a neurologist. He wanted me to have some procedures done ASAP which he knew the neurologist would order any way and they were scheduled.

Then came the magic moment. My dad asked the urologist if it was possible a muscle relaxant could cause this situation with the bladder. “It might,” he said. That night we stopped the muscle relaxant and the next day I could pee without pushing on my stomach.

Seeing the positive results from ceasing the muscle relaxant, my mom researched the interaction between the muscle relaxant and my other medications and, lo and behold, the muscle relaxant and my anxiety medication should NEVER be combined. NEVER. This interaction would lead to Serotonin Syndrome, a condition which causes severe muscle rigidity and can cause cardiac arrest. One doctor had prescribed the medication without checking for interactions, and three others had neglected checking – even though they were all told what medications I took.

It’s now day four after we stopped the muscle relaxant and we stopped the anxiety medication as well. Already I am up and about. I can sit in a chair to do my homework. Last night I could stand up and shower by myself. Yes, it hurt but at least I could do it. I’m going to the prom! For sure!