CRPS My Journey - Chapter 1: The beginning

The hard reality

They say that sport is good for you. At school teachers encourage you to do at least a winter and summer sport. And in South Africa, like in many other countries I suppose, sport can become very competitive. But does anybody ever speak about the possible long term affects when you get older. You break your nose - "Nah you're fine" - but coach the blood is gushing - "That is nothing, you can hardly see it. Here let's just straighten your nose a bit and you'll be fine". You break your leg - "What are you lying on the ground for. Walk it off. I my day we broke something, you used it as an encouragement and finished the game first. Don't be such a woosh! Players these days are too soft" But coach the bone is sticking out - "Don't be ridiculous, that's just a scratch" 

But hey, fun is fun and if you're going to do sport you might as well go at it full throttle. Being adventurous I had my fair share of rock climbing, abseiling, kloofing, caving, kayaking - things that I am passionate about. At school I played some rugby, although tug-of-war was where I really excelled - probably because of my hard-headedness and refusal to give up. Being in adventure ministry for a number of years just fueled my passion. But nowadays this all seem so far behind me, as if in a faint memory. At times it feels like looking through a sheer curtain, standing on the sidelines as the world keep on moving forward.

For a number of years I have felt my neck becoming more and more problematic. Although I wrote it off as becoming overweight and unfit the last couple of years, there has always been that feeling of "what if" - "what if this was not just being unfit?, "what if there were bigger issues?" I mean at age 32 I already had my first neck operation - Thoracic Outlet Syndrome (TOS) the drs call it. My neck was a mess. The brachial plexus, which is a network of nerves that sends signals from the spinal cord to the shoulder, arm and hand were being compressed by the first rib and the clavicle - old sports injuries. It meant that a part of the bone were to be removed in order to decompress the nerves. 

 And for a couple of years after the operation my neck felt better. But then in January 2021,a lack of sleep due to a stiff and sore neck eventually drove me to see my specialist again. It felt like the TOS was acting up again. My right hand was turning numb at night and every morning I would wake up with pins and needles rising all the way into my shoulder and neck.  It was painful -  awkward - annoying. I thought after my neck operation the TOS was in remission, dealt with.

But that was just part of the problem. To top it off I had two new issues to deal with. On the one hand, a right knee that was creating excruciating pain whenever I had to bend down or stand up. On the other hand my right middle finger - locking, screaming and cursing in pain. Every morning I'd wake up to find my finger bent, locked. And every morning I had to pry it open with my left hand. Painful does not begin to describe it.

Running diagnostics

So I visited my shoulder specialist first. Maybe it was just the calcification in my shoulder that was back. I did have a shoulder operation 4 years ago so maybe it is the same problem. Nope! The dr did a sonar of the shoulder and found everything to be fine - "I think you need to go see your TOS specialist. It looks like the TOS is back". Oh no, not the TOS again. The last operation took me months to recover from.

At the Thoracic Surgeon he did more tests, sonars and scans. "Yes the TOS problem is still on the left side, although not as bad as it was on the right side, but the right side looks good. I think you need to see a surgeon at the Spine Centre. I think the problem lies with your spinal cord. I will also make an appointment with a Orthopaedic Surgeon to look at you knee and finger"

At this point I started to feel like a car having diagnostics done on it in the hope that that irritating idling problem can be resolved. But the pain was constantly nagging and the lack of sleep was making me more and more irritable, so I went to see the Spine Centre - "Mr Ritter, we have some not so good news and some good news. The not-so-good news - you have what we call Cervical Degenerative Disk Disease of the 3rd, 4th and 5th cervical disks. In layman's term, your disks are starting to disintegrate. The good news, we should be able to treat it conservatively, by sticking a needle in your disks - under anesthesia. You won't feel a thing. and then we monitor it over the next 3 years".  A rhizotomy they call it, a minimal invasive procedure where the pain signals get blocked, a conservative treatment in comparison to a disc replacement procedure. Okay that does not sound too bad, so lets do it.

At the Orthopaedic Surgeon's office there was no way of getting by with conservative therapy. My knee had a torn meniscus disk and ligaments. And the finger... A trigger finger.  This would mean operations for both, although in a surgeons scope of view quite common and minor procedures. Yea doc, tell that to my finger and knee - I don't think they will agree.

The Procedures

So in early February 2021 I first went for the Rhizotomy. It would take a couple of weeks to reach the full affect after the procedure was done. Meanwhile my operations, or rather operation, was scheduled for beginning March 2021 - a month after the rhizotomy. As I usually get very ill from anesthesia, I somehow managed to convince the doctor to operate both my knee and finger at the same time. In my mind this made total sense - both problems solved but only once being sick from the anesthetics. This was great. Yea sure it would be challenging for me afterwards, as both limbs are on the right side. And sure it might complicate the use of a crutch, but hey it sounded like a win-win and who wouldn't be up for such a challenge. Well apparently the doc was, as he quite happily agreed - we would sort out the details of using the crutch after the operation was done. 

 Apart from a few complications, the operations went well. But then came the week after the operation when it was time for the stitches to be removed and the start of Occupational therapy. And oh man, was I in for a surprise. As the cut on my hand where the operation was done was in such an awkward and sensitive area, some of the stitches were stuck and difficult and painful to remove. However there was no turning back and we had to push through the pain barrier. I think I felt a little bit of what a woman goes through during normal child birth, and I understood how they could go from being a angle to the devil himself from 0-60 seconds. It felt like the tissue was being ripped out of my hand. Sixty excruciating minutes later, the four stitches were out, but we were not out of the woods yet. Because what is life if not full of wonderful and exciting little events, and yes, you probably have guessed it - the next day, the wound on my hand burst open. You could see through the layers of fat and tissue. Now we were at a catch 22 as I had to continue with my hand exercises to regain and maintain the mobility of my hand, but now due to the open wound I had to take it easy with my hand so that I do not cause more damage. A major setback for my recovery. 

It took weeks for the wound to finally close up, and now came the hard part. As I am right handed, I had to teach myself since the operation to write and do everything with my left hand which in itself was very frustrating as everything took so much longer to accomplish. Now that the wound was closed, I felt like I was back in Grade R as I had to learn to use my right hand again. I had to learn to write again, painfully had to learn fine motors skills, things we take for granted like just holding a ball or squeezing it, picking stuff up, moving stuff, turning nuts and bolts, and the worst...bending my fingers.  I felt frustrated and depressed, irritated and angry as it felt like the progress I was making was way too slow. I had no strength in my hand, and trying to hold on to something without dropping it was almost impossible - it was like trying to lift a 1 ton wrecking ball by using just a chicken feather. I remember a couple months after the operation I had to change the sparkplugs on my wife's car. It took me almost 3 hours to change 4 sparkplugs, that were not even hidden, as I would keep dropping the spanner. And every single time when I finally did manage to hold on to the spanner, it became almost impossible to turn it as I had no strength and the pain were too much. I felt totally useless and depressed!

But the show must go on, an as they say, quitting is not an option. "Patience" the Dr said, i just need to be patient. The knee that initially seemed to be the bigger issue now took a backseat to the hand which was supposed to have been the minor issue. The healing he said can take up to 9 months for the mobility to come back, but he would make sure that I would have enough pain medication to get me through. And he did - not that the medication actually worked - but let's not jump ahead. That is a story for another day. Nothing could prepare me for what lay ahead as I have just entered through the door of the haunted house. 

So this is me.. I am JJ Ritter, a father, a husband, a survivor, a fighter, a CRPS warrior... Welcome to my journey!