Fall Out

I saw my GP today. Or, rather, I saw the doctor he had filling in for him while he's on vacation or otherwise away from the office. She had me run through a series of tests to determine what may be going on with my back and, in the end, agreed that I am "MRI worthy." However, she also said that regardless of the MRI results, the immediate therapy will be the same and will probably do what is needed: stop the pain and strengthen the back.

As I said I would, I argued for the MRI anyway, saying that it can't hurt, it gives us new and better information, and, on the off chance that something serious happened, it will catch it and we can change course at that time. She agreed and wrote me the script. Now, the bad part: MRI availability is such that I probably won't be seen for three to six months. The joys of being in the Atlantic Provinces!

She was confused that the UC doctor gave me a script for Percocet for two reasons: 1. it doesn't treat potential (and most likely) nerve pain and 2. it is filtered through the liver, and I have a chronic liver condition. So she wrote me a script for both an anti-inflammatory and something to help with the nerve pain, which I will start taking tonight.

Her in-office tests showed that I don't appear to have any nerve damage. I'm to watch for incontinence and loss of muscle function and get to the ER immediately if either happens. That means the nerve has been damaged or pinched again, and the signals are not getting through to where they need to go. It also sort of confirms what was going on during the worst pain from a week ago, as I needed to use the bathroom much more often than I usually do (with large volume each time -- seemingly more than I had actually taken in) and I got to the point where my right leg would not support my weight at all. My nerve must have been under some serious stress at that time, so I'm glad my wife took me to the UC the next day.

I made yet another follow up appointment for November. Hopefully by then I will be back on my feet (literally and figuratively) and my normal doctor can suggest therapies and other regimens along with what I plan to ease back into doing (walking, riding my stationary bike, etc.). In the meantime, I need to avoid lifting and twisting, even after my back feels "fine," as I could re-injure it. I also need to be better about having assistance when I need to move something and not doing it on my own. I already have helpers/doers lined up for our upcoming heavy lifting needs, so that should work out.

Back Pain a Week Later

It is now September 11th, an auspicious day, and I am finally able to walk without too much effort and assistance. As long as I don't move around too much, lift anything heavy, or over-exert myself, my pain is minimal. However, I walk with a shuffle, as the pain is still there and my right leg doesn't want to take my weight as well as my left leg. At night, when I roll over, I am waking up and rolling slowly and carefully, due to the stabs of pain that still exist. Sitting in my work chair in the office is uncomfortable and I have to take frequent pauses to stretch and move so my back doesn't lock up and hurt worse when I finally do move.

All told, I hurt my back in the late afternoon of September 1st (around 4 pm) and I am only just starting to feel like I am getting back to normal on September 11th. That's 10 full days, plus a half of a day on the 1st itself. And that includes having the Percocet to take daily and being given 4 days of full rest from the doctor, during which I did next to nothing except sit or lie down and try not to move.

While I know spasming is occurring, and it is difficult for me to keep my back relaxed and loose throughout the day, I find it hard to believe that there is not some sort of underlying cause to this pain. Nearly every person who has had a similar situation happen to them has mentioned that they wound up having either a pinched nerve or some sort of back or disc trouble that needed further attention. In one case, it led to back surgery after years of trying to force her doctor to do the necessary tests to find out what the problem was. In most cases, it required at minimum physical therapy, massage, acupuncture, and/or chiropractic manipulation. In some cases, it has required changes to lifestyle, including one friend who had to get a standing desk at work and is still doing therapy over a year later.

I go to my family doctor tomorrow. Although I am obviously improving, I am going to press for an MRI so that we can definitively rule out or confirm disc issues and proceed with the proper course of action based on that conclusion. I still find it hard to believe that the urgent care doctor wouldn't have insisted on that being done at the time of my visit to rule out anything more severe. Maybe it is nothing -- maybe the MRI will show no damage and it truly is nothing more than severe spasms. Or maybe it will show the simplest form of damage, either a pinched nerve or a bulging disc, which typically require exercises and massage therapies to alleviate. Either way, I want to know.

This situation has driven home the point that I need to work on my weight and my core strength more consistently. I was to the point where I was using my stationary bicycle regularly, and was starting to see some results, when our basement flooded. That resulted in our workout equipment being put into a bin for over six weeks. I did continue to do walks, but walking is not very comfortable for me (rheumatoid arthritis), which is why I got the low-impact bicycle. Just as the situation started to turn around and we started moving our items back into the basement, I strained my back. So it has been since mid-June that I've used my bike. Once my back is to a point where I can walk and ride, I plan on pushing myself to improve my effort and get my endurance back up to a reasonable level (I still generally have my strength, what I lack is any endurance). This should help improve my weight, which will also help my back (as I carry nearly all of my extra weight on my belly).

What is frustrating me the most is that we are in the prime "John needs to do stuff" period of the year. There is wood that needs to be split. There is wood that needs to be ranked/stacked for winter. There is maintenance on the front porch needed. I need to take the AC out of the office window and store it. Even simple things have been affected: I haven't been able to stand well enough or long enough to help with dinner (usually one of my main tasks). We have new flooring coming soon, and I may not be able to move the furniture out of the way or back for when that is happening.

So, basically, during what is usually one of my busiest times around the house, I have been useless. My wife has had to do a lot more and she's got a lot of pressure on her from other sources (work, family, etc.) not to need my poor health and inability to help out adding more to her plate.

I am hopeful that my GP can help. Hopefully he will agree to the MRI. I assume he'll also provide me with some sort of therapy to help strengthen my back to resist this from happening in the future. For my part, I have firm plans to work out more regularly to build up my endurance, continue the plans to eat better to help lose weight (which should help my back as well), and move toward strengthening my core as I am able to do more. I have contacted friends who have offered to help with the wood, furniture moving, and a few other "John-tasks" around the house. And I hope to be able to start taking back some of my responsibilities around the house, like making dinner, soon, so I can relieve some of the pressure on my wife.

Back Pain

On the long weekend, my wife and I began the long process of recovery from our recent basement sewage flood. Servicemaster had finished most of its efforts to clean, repair, and recover the sheetrock, fiberglass insulation, etc., and had moved our vacated items back into the basement.

I went down on Sunday evening to assess the plan of action for Monday (my wife was away visiting some friends). As often happens, I started to move a little something, which led to moving a little something more, and next thing I knew, I had been down there for 90 minutes or more and had cleared a whole area. As one final act, I decided to lift a large bag filled with bathroom mats onto a spot in the downstairs closet. When I did, I felt a very tiny "pop" in my lower back and nearly fell to my knees from the pain that suddenly swept from my back through my legs.

I managed to hobble my way upstairs, grab the heating pad, and sit. I waited patiently for my wife to get home and didn't do much moving. She had to help me stand up and move into the bedroom that evening, as the pain was growing pretty bad.

Monday (the holiday) I could barely move. Any excess weight on my back at all, from trying to walk, standing up, and even some positions of sitting, caused intense pain. Any twisting and leaning also caused the pain. So Monday I spent most of the day in my comfy chair. I tried not to do much, rest it as much as I could, and withstand the pain. I finally took two Advil -- not even a dent in the pain. I then took a Motrin -- didn't even touch the pain. My wife went and spoke with a pharmacist an was given some Robaxin -- nothing, nada, zilch.

That night was horrible. I was in so much pain. On a scale of 1-10, it was 10. It was the most pain I have ever felt. At one point during the night, I had to use the bathroom. Even with my wife's help, I only made it about four small steps before the pain completely overwhelmed me. It was so intense that my entire body was sweating from those four steps enough that my sleeping attire was drenched through in seconds. I would have crumpled to my knees had my wife not been holding on to me for dear life. I was crying from the pain and starting to hyperventilate. Right then and there, we probably should have called an ambulance and gone to the ER. Instead, I peed into a cup my wife brought me and she folded me back into bed. I finally passed out for a couple of hours from about 5am to about 7:30am.

Tuesday morning we spoke with my mother in law (MIL), who is a nurse, and we all agreed I should go to either the ER or Urgent Care (UC). My MIL came down to help get me there, and off we went.

The UC had me go straight back to a stretcher. Soon enough, the doctor came. He jabbed a knuckle into my spine and didn't care how much he made me jump. He pronounced that I couldn't possibly have done anything structural to my body with what I described happening. He was going to give me a shot and a script and send me home. I had to ask him for an x-ray. When he got the x-ray back, he seemed surprised by the amount of spasm shown in them (it was straightening my spine). His goal seemed to be to get rid of me and make me my family doctor's problem, so he wrote a script for Percocet, a script for four days of bed rest, and sent me home.

What bothered me the most about this visit is that the doctor didn't want to look me in the eye, didn't want to do what, to me, seems like the bare minimum for someone presenting with unexplained and intense back pain (x-rays and an MRI), and didn't want to find the underlying cause. He just wanted me out of there. Not one person in the UC even glanced at my Medical Alert bracelet, no one seemed willing to pay attention to the medications I am on or care about the chronic conditions I have -- one of which is Rheumatoid Arthritis which, you know, just might be causing swelling in my spine? At the bare minimum, to find the source of the problem, it seems like a doctor should insist on an x-ray (for problems that could be detected there) and an MRI (for all the other problems that do not show up on x-ray or physical exam). Yet this doctor didn't want to do either and had to be persuaded to give me the x-ray!

Today is Thursday. I have been taking the Percocet, which makes me a bit loopy and groggy. It does not do much for the pain, but it makes me functionally able to move around, so I guess that is okay. I am staying off of it as much as I can and trying not to move around a great deal, but you use your back for everything.

Over the last few days, I have learned the pain is primarily on the right side of my spine and down my right leg. If I keep most of my weight off of that side of the body, the pain is much less than when using both legs or when I have to put weight on the right side (like while getting dressed, walking, etc.). I am spending most of my day in my comfy chair or in bed.

We also made a follow-up appointment with my GP. At that appointment, I am going to insist on an MRI, as a number of friends and colleagues have said that their bulging, herniated, or degenerating discs presented like my pain at first and it took weeks, months, and even years before they got an MRI and found the real problem and started to address it. And, since most of these types of issues do not show up via a physical exam nor on an x-ray, the MRI is the only way to find it. I have enough other issues that I will not stand for this to linger; if I need surgery or specialized treatment to fix this problem, I want to get to it now.

As we have our two cords of wood coming, more work in the basement, work coming for our living room and porch, and the rainy season almost upon us, I need to get healthy enough to start working again soon. But, being my back, I also don't want to screw it up in a permanent or chronic way. It will be a balancing act. Luckily, I have good friends who can likely help with the wood and furniture moving that will be needed.