Update - long, sorry.
Quick History - gives you an idea of the state of medical care for back problems.
Drop back to early November: plenty of pain. Go over to The Cleveland Clinic Spine Institute, and meet with a Doctor Lynn Jedlicka. Tell her that I'm having tremendous low back pain; in fact, I have spasms while examines me. She orders x-rays of my thoracic pine. Refuses to consider that there's anything happening with the lumbar spine. Refuses to listen to my symptoms. Tells me all this pain is from DISH. Tells me, in no uncertain terms that I cannot see a chiropractor.
Gives me Rx for OxaProzin and Skelaxin.
Symptoms continue, deep tissue work is helping, but I get frustrated and meet with Doctor Livingston . Doc Livingston actually listens to all my symptoms, catalogs them, and begins diagnostic tests, including a muscle function test and lumbar spine x-rays. The x-rays show DISH has progressed; also show some potential issues with discs. One manual test, where I turn my left foot outward at the ankle, and attempt to hold it there against pressure, indicates a muscle function problem, which is typically a symptom of an impinged nerve at L5-S1.
Doc L. orders an MRI, to be conducted at Advantage Diagnostics . One of the staff radiologists reads the MRI, and determines that L2-L3 and L5-S1 are herniated, with nerve impingement at L5-S1; forgive my laziness, but MRI results are in the Taco truck, and I don't feel like walking outside to see which of the staff radiologists did the work. Perhaps later, when I go out to piss in the snow.
Doc L reads the MRI as well, and shows me where the impingement is located.
I kick around the idea of doing decompression. The big problem is that it's not covered by insurance, and I really wasn't prepared for a $6,000.00 outlay - that will put a crimp in the hookers-n-heroin budget for sure.
However: I'm tired of taking pain meds. I'm tired of being stuck at low weights in my events. I'm especially disappointed in myself because I can't effectively hike. Remember: I bought my house because of its location in the National Park, and its proximity to hiking trails. There's so many places that I love to hike, and have not been able to in 2+ years. It's beginning to impact who I am.
I've also tried PT, I've tried other less drastic chiropractic. I don't want to consider surgery.
I go to an MD for a second opinion, an MD who comes highly recommended, Dr.Hyo Kim in Warren, OH. During the initial consult, he takes a history, does some manual diagnostics, reviews a copy of the radiologist report, and schedules an EMG to determine specific nerve involvement. Rx for methyl-pred to help with the inflammation.
I then go for another opinion to Doctor DeMicco, who comes highly recommended by a couple buddies. He's pretty high up on the food chain at The Cleveland Clinic, in the Spine Institute.
His intern conducts a quick history and manual exam. He repeatedly ignores my symptoms involving leg and plantar fasciitis pain; keeps saying "Let's get back to the back pain. You've had back pain for 30 years." I keep telling him that this is different. He completely ignores my concerns about the manual diagnostic test for my foot, as well as my complaints about controlling that foot while hiking.
We reach an impass, with him suggesting that I take NSAIDs and do some PT, and that nothing else is going on.
He wisely leaves the exam room before I throttle his skinny little neck.
Dr. DeMicco enters, and he begins to listen to me. I emphatically (and I mean shout - and those of you who know me in person know what that means) that these symptoms are new, and that they impact my legs, and that I can't hike, and that I'm not taking the answer of NSAIDs. He explains that, in his read of the MRI, there is no nerve impingement from the disc herniation.
He thinks that what is going on is that the nerves are getting irritated where they exit the spine. He explains that they exit through two small holes, and those holes have probably closed up a bit with age, and the nerves rub against the walls when I stand.
Nonetheless, he RX's me gabapentin, we talk about PT, and schedule follow ups.
Which brings me up to Wednesday, 2/9, and the EMG with Dr. Kim. According to Dr. Kim, there is extensive nerve damage in the lower left leg - to the point where he doesn't understand how I am able to walk, and realizes that I'm fighting through some pain. Likewise, the upper left, in the region of the adductor, tests out badly.
Dr. Kim recommends immediate surgery to save the nerve. We discuss the decompression strategy, and he says that he doesn't understand how it works, but that it might work - he doesn't know. He also says that we can retake the EMG test in 2-3 months to see if there's any change.
For some reason, this news hit me hard, dropping me as sure as a cattle prod to my nuts, but without the tall blond dominatrix to lend some perspective to the pain.
Whew. That covers the various doctors, and outlines my overall strategy.
*
I just finished the 4th session of decompression.
The sessions go like this: laser treatment, then decompression, then laser treatment, then chiropractic adjustments - sometimes SI work, sometimes flexion-distraction. Sometimes have to hit things like the left ankle, which doesn't support me too well because of my missing muscle control.
I feel incredibly better. Today was a real turning point in how my back / hips / legs felt.
I was able to walk for 40 minutes, Average HR 130, with no pain. My dogs loved it. I loved it. I'm pain free after walking.
If anybody wants more details, feel free to PM me. Also, the above is cross-posted from my blog. I don't want to appear like I'm spamming this board, so I'm not posting a link. If you want that, just PM me.
Thanks for reading.
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