What happens when the farmer gets injured…?

Early morning thoughts…

I like to write and document thoughts for several reasons. These include the possibility of helping someone else if they relate to what I am going through, and to reflect back on how I felt at this moment in time – thus gauging my improvement or decline, and so on. Today’s thoughts… What happens when the farmer gets injured or falls ill? Well, it seems complicated by the very nature of the farm itself. Caring for animals that are solely dependent on the farmer for their well-being means that there is no down time for recovery, unless others handle chores in their stead. Of course, others certainly CAN feed and water our critters, but there are extra little things farmers do to really care for them: special treats or attention, and even words of affirmation and love. If you think this is silly, then you’re not the kind of farmer I am, and you need read no further. Because the truth is, when the farmer is injured or sick, they feel that their farm may suffer, too. The farmer does not “call in sick” to anyone but themselves.

On our farm, I quite possibly bring these complications on myself, in the very ways that I prefer to handle chores. While my contractor husband seeks out tools and automation to help run things smoothly, I prefer to tackle most chores by hand. From using a broadfork to till the garden, to carrying fresh clean (and warm) water to the dairy goats, I like the close connection I feel with the land and the animals. So many early issues (health, nutritional needs, rising conflict within herds/flocks) are noticed and addressed well before they become a crisis, thus saving much time, energy, and frustration. Those early morning walks around the farm, coffee mug in hand, simply observing how all the animals and plants are doing, provide insight that may not occur if feeding & watering routines were all automated.

I understand and appreciate my husband’s efforts, as he does mine. I know that when he procures a tool (whether it’s a small device like a water trough float or a hopper feeder, or a big item like a firewood splitter or a tractor) he does so, in great part, to make farm chores easier. He notices, and is grateful for how hard I work, while kindly never noting the extra time that my hands-on approach borrows from domestic tasks. He supports the farm and our labor and inputs in his own way, and we all benefit from what we produce. But as I sit here this morning, chores all done in just an hour after dawn, coffee still in hand, I ponder the future of our farm. You see, as we age, injuries and illnesses seem to come faster, harder, and with more down time needed than when we were stronger, younger, and more resilient. While we aim to age in place, and age gracefully, we occasionally ask, “when will keeping up this farm be too much… what does retirement from homesteading look like?” And I find myself asking that more often lately.

In just a few days, I face a risky, but necessary, surgery on my spine. I am optimistic it will help me, but maybe it will not… I am also worried and fearful. Not only of the medical outcome, but for my farm and animals. There WILL be necessary down time for this recovery, and others WILL be caring for all things in my stead. The questions in my head range widely. Will the critters be well cared for? Will others be observant and address and intervene for those early concerns? If I don’t heal well, should we sell some? Likely enough, all will be just fine, and I’ll be feeling better than new in no time, but these questions swirl in my mind nonetheless.

Let’s talk a bit about pain. It’s like an awful emotion that you can’t convey to anyone else, so they can’t truly relate to how you feel, though they may sympathize or even empathize. Pain is so intrinsic and unique to each one that there can be no comparison to others’ pain. It can range from intermittent and bothersome, to unrelenting and debilitating. Pain is exhausting – physically and mentally. Pain can be deceivingly silent (I insist on suffering quietly) or excruciatingly loud (my husband hollers for the whole world to hear of his discomfort) or even stoic (like my son who sobs quietly.) And unless there is a grimace or tears, pain can even be invisible. It isn’t like a bandaged wound or a limp or a brace; it isn’t something we ask each other about. And often, it is not something we can claim to relate to, or even understand. Pain is insidious and an unpleasant sensory experience. Pain does cause incredible emotion.

I don’t like to talk about my own pain. For over 30 years, I have developed, fine-tuned, and employed many coping techniques to help relieve or distract myself from pain. Even as a teen, my mother supported my holistic approach to mitigate my pain in the most natural way possible, and paid for numerous naturopathic and alternative medicine appointments and consultation. I have suffered from various physical pains all of my adult life, ranging from internal issues with my reproductive system (another story), to long-term dysfunction resulting from a motor vehicle collision (more on that later). Yet my body has served me well. I am strong and capable and carry on, proud of my endurance and ability to not let pain hold me back. This body has achieved great things, supported new life and been for the most part, fairly reliable. Obviously, I know my own body well, and I know when things are not right. As I mature, I heed the warning signs a little better. I stop working before exhaustion. I hydrate. I allow myself to rest. And just like I observe the changes in my garden, herds and flocks, I make note of concerning changes and try to address them. I strive for good health through prevention of illness and injury, and also through a lifestyle that includes fresh air, exercise and abundantly nourishing food.

Last spring, I took an ambulance ride to the ER, after enduring 12 long hours of the worst physical pain in my life. Pain worse than childbirth. Pain that stopped me from moving or thinking rationally. Later I learned that I was experiencing an acute diverticulitis attack from a severe infection. The treatment was swift and effective at resolving my pain and ill-health, and I now strive every day to ensure that I do not suffer a relapse. A year of good health ensued, and I was fit and vibrant, and supported both my son and husband during a winter of recovering from their own knee surgeries. I took care of most things on the farm for 6 straight months.

And then, several weeks ago, upper back pain that I have suffered with intermittently for over 20 years, suddenly became a new beastly sort of pain – unrelenting and all-consuming. The kind that you can not relieve, escape, or even sleep with. I was very concerned, but stoically carried on, performing most of my normal daily tasks. I made an appointment with a family physician, but it was weeks away. Though I tried to mitigate the pain, I became aware that this may be the kind of agony that people choose not to live with. In my small logging community, men younger than myself, who have injured themselves in the woods, have chosen to take their own life rather than live with relentless pain suffering. Was this that sort of pain?

I tried nearly everything to get relief. Hot water bottles, ice packs, flat on my back, slept in the reclining chair, stretches, got a massage, saw my chiropractor, used topical analgesics, and even took one of my husband’s leftover pain pills from his knee replacement surgery. But nothing eased the pain I couldn’t escape. A week after enduring more than I could stand, and increasingly suffering symptoms of sleep-deprivation, I lowered myself into the hot tub one weekend morning, prepared to bask in the comfort of hot water jets the rest of the day if need be. But just a few minutes in, and my pain became unbelievable. The word I used to describe it was “nuclear”. If you have children, you’ve likely seen the kids pain chart that ranges from 1-10 with various descriptive words and facial expressions, and so you will understand the saying, “my pain was off the chart.” Pain in my entire left side radiated into my arm, my back, my chest, and up into my jaw and ear. I began to shake with what felt like chills and muscle spasms. Except for not being short of breath, I had many symptoms of having a heart attack! Once out of the hot water, I seemed to relax a bit, but my husband took one look at me and rushed me to seek urgent care.

During the drive there, I faced one of my own, personal, worst fears – that I would be told there was nothing wrong with me, and that I was wasting my husband’s time on a perfectly good weekend spent in a medical crisis. After all, I have been known to not prioritize my own care or health needs in a timely manner; yet I decided that even if this acute attack was stress-induced or just some idiopathic or non-specific illness for which rest was the only remedy, I absolutely had to see a doctor! The wait was short, and the doctor assured me that I was not having a heart attack, but was in a pain crisis with high blood pressure from a suspected issue in my neck. Something was wrong in the range of motion tests she asked me to perform, and I didn’t understand why my head wouldn’t move to the left. Strangely, my neck didn’t really hurt, but the pain was radiating (known as referred pain) and concentrating itself into an area under my left shoulder blade. She prescribed me her “triple whammy” for spine pain – steroids, muscle relaxers and a narcotic, and ordered me to follow up with our family doctor right away.

I rested for the rest of the weekend, and felt some relief from the muscle relaxer and the narcotic, but the steroid caused severe water retention and seemed to increase the pain in my shoulder exponentially. Still, I carried on, and even arrived at work on time on Monday (I had recently started a new job and felt that I should prove my reliability) but I did call my doctor first thing that morning. Amazingly, there was an immediate opening, and I rushed over to the clinic for a full exam and an X-ray, which revealed narrowing of all my neck vertebrae, likely causing spinal cord compression. The nurse reminded me that I had X-rays and an MRI for comparison from 6 years before when I was diagnosed with carpal tunnel, for which I underwent a simple surgery so I could continue to hand milk our goats.

We recalled those older images which showed bulging cervical disks (cushions between each neck vertebra) consistent with degenerative aging changes. But at this doctor visit, my blood pressure was still critically high, with my pain nearly completely unmanaged, as I had chosen to head to work without taking medication. I broke down with emotion, and the doctor ordered pain control and muscle relaxing injections, and called my husband to come get me, take me home, and have me rest for the remainder of the week. But I did not, as I felt I could not disappoint at my new job. I enjoyed the work very much, and the distraction from the joys (and challenges) of my job were a welcome distraction from my great discomfort. So my doctor changed the prescriptions, and increased the narcotic dosage, and I carried on. And sometime during all of this, my husband made me call my mother, who of course, because she is amazing, totally “has my back” through whatever I will endure.

With my pain still not relieved with the medication “triple whammy,” I was immediately ordered to receive a new MRI and referred to a neurosurgeon. Things escalated very quickly, and less than a week later I was diagnosed with herniated cervical (neck) discs, bone spurs, and such stenosis (constriction of my spinal cord) that I had developed cervical radiculopathy – where compressed nerves send waves and jolts of radiating pain through the upper body – from my neck to shoulders, arms, and fingers. Even worse, I was experiencing severe numbness and left side weakness to the point of stumbling and falls. I was dropping things, unable to carry much weight or even a coffee cup with my left hand, and a painful fall actually occurred at the neurology clinic when I was unable to get up onto the examination table.

The neurosurgeon performed a thorough exam, and we were both shocked to observe that the reflexes on the left side of my body were non-responsive, and that I was down to 10% strength (resistance) on my left side. The doctor went from my left side to my right, and back again, seemingly perplexed to not be able to elicit nerve responses. I laughed about it in my nervousness and confusion. But my doctor was not laughing, and instead was looking at me very seriously and with pity in his eyes. While unrelenting pain, numbness, and the inability to sleep were my primary complaints, the doctor expressed concern that permanent nerve damage was likely ongoing in that moment, and that conservative treatments were not an option if I were to retain the remaining function. He said it would be unethical of him to recommend anything short of emergency surgery to remedy my condition. What began as a short referral visit turned into nearly 4 hours of exams, counseling, and lab work, and by the end, I concurred with the doctor, that the risks of surgery (infection, spinal fluid leaks, even paralysis) were far less than losing function in half my body. The doctor said I was well on my way to experiencing additional issues (including with internal organs) if untreated; so he consulted with colleagues, and they cleared the schedule for me to have major surgery.

While he won’t know the extent of the damage and repair needed until surgery is underway, the least he is expecting to perform is a cervical discectomy (removing herniated disks in my neck between the vertebrae), and a posterior cervical foraminotomy & laminectomy – performed through a surgical incision in the back of my neck – enlarging the channels the nerves pass through in the vertebrae and removing parts of the vertebrate to decompress my spinal cord, with or without fusion or plates. The most he expects to do includes an anterior procedure (via the front of my neck), with bone spur removal and grafts from my own hip, but that comes with a longer hospital stay and recovery time. I am cautioned that additional surgeries may be needed.

While I was initially scheduled for surgery just 3 days after my neurology consult, insurance approval took a bit longer and I was rescheduled for surgery 7 days later. The extra time has provided more time to prepare myself, my family, and my farm, for my recovery time, but also more time to research the surgery and conclude that this is a realistic option. After 20 years of upper back pain, I never allowed myself to include narcotics in my tool kit for relief, and even these past weeks, the narcotics are not only NOT very effective at achieving pain control, but the side effects are quite unpleasant. I do not wish for a life spinning by on heavy pain killers or addiction, nor do I wish to become crippled, so I am willing to risk the surgery.

When presented with the statistics, it is clear that not promptly treating the spinal cord compression could result in debilitation and physical handicap, yet the risks of complications in surgery are very slight, in a surgery that has been performed (and nearly perfected) since 1829. Thankfully, they now use anesthesia, and may wake me up to test reflexes mid-surgery (which I’m told I won’t remember) because 200 years ago, the operation was performed on patients fully awake to ensure that their spinal cord was still functioning. Still, I am making contingency plans in writing, and am talking with family & friends, to make my wishes clearly known about preferences for my own care and for that of the animals, if anything doesn’t go as expected.

Incidentally, my auto accident isn’t something I think or talk about much these days, though it certainly has been on my mind a lot lately. And ironically, the collision involved nothing else than a farmer, a truck & horse trailer, a dog, and a cherry pie. You really can’t make this stuff up! Here’s what happened that November morning back in 2001. I was on a rare day off work, a hardworking single mom, and had just dropped my son off to spend the weekend with his father. On my way to deliver a freshly baked cherry pie to a friend, I crested a small blind hill on a back country road, and to my horror, discovered a truck and dual axle horse trailer broadside in the road, blocking both lanes. The farmer’s truck had become stuck while pulling the horse trailer out of a pasture and he was trying to reposition it.

I was driving a brand new little pickup, at 50mph, and cresting that hill, I will never forget the things that went through my mind in the split-second I had before the collision. More of a triage of worst case scenarios, really. I noted a steep ditch on my side of the road, and the certainty of flipping or rolling my truck if I veered in that direction. I noted the horse trailer and decided I could not crash into it and injure any horses inside. I even saw a dog, sitting on the farmer’s lap as he was behind the wheel, and I just knew I couldn’t hit the truck. So in that moment, I opted to steer straight toward the trailer’s hitch and try to stop if possible. I locked the brakes, and moments later, the collision totaled both rigs.

In the end, my truck had 3 flat tires, the engine was nearly on my lap, my driver’s seat broke down flat, and I was trapped in a cab with doors that would not open, airbag dust choking me, and that damn cherry pie all over everything. The first responders were certain that pie was actually parts of my body. Life flight was called, but I refused transport. I was dating a local fireman who heard the call over the air and came to drive me to the hospital himself. And quite amazingly, I felt ok, though neck & back stiffness would creep up in the following days. The farmer was cited as the cause in the accident, as he had no flagger or flares to alert drivers while blocking the roadway. Investigators determined that I had just 70 feet of stopping distance to make that split-second decision about the location of the impact. My attorney secured a settlement for me that was supposed to provide care for the long term effects of the accident, but those funds were used up in the first few years for frequent chiropractic care, counseling, and expenses that came with single parenthood. I have had regular chiropractic care since, due to the loss of lordosis in my spine from the crash (the natural curvature of the back.)

Fast forward to the present, and my surgeon thinks the level of deterioration & degradation in my spine is very likely related to that accident. But as I said, this body has treated me well enough, and I look forward to giving it a fighting chance to support me another 46 years. After all, I still have a lot of life to live, and a lot of farming yet to come. I have just 3 more short days to get through, with no pain medications to help (the surgeon wants my tolerance restored so that post-op medications work well) and one more goat due with her kids tomorrow. Baby goats have been a very pleasant distraction from my agony lately.

Say a prayer for me, or send me your positive vibes, for I will undergo this alone, as visitors are not allowed to join me in the hospital. Please wish me well, and if things don’t go so well and I am no longer able to “be a farmer,” please give my animals a loving home.

Post-script: this long essay was started at 7am, but due to my inability to type very well right now, it has taken nearly 6 hours to complete (plus the time spent dashing to the hospital for my pre-surgical COVID test, because, you know… we’re still in pandemic times.) Ugh.

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