In which I get shot in the butt

On Thursday DeLee came by my house in the morning and drove me over to the Spine and Pain center.  I'm not kidding about the name.

They're direct about the reason you're there.

The doctor, with the help of a heavily shielded nurse, used an xray machine to guide his needle deep into my right buttock, where he deposited about a grapefruit sized bolus of steroids.  Or possibly a tablespoon sized bolus.  It felt huge though.  I mean, right then it didn't because first he gave me a local anesthetic.  But when that wore off.. sitting was not so much of an option.  I stood a lot on Thursday.

As an aside, since the shot needed to go into my sacroiliac, my butt had to be bared.  But I didn't have to strip.  Shirt pulled up, pants pulled down.  It felt pretty illegitimate.  And then my doctor was cute.  Hi!  This is my butt.  Good gravy.  Could it get any more awkward?

I am uncertain if the shot is working the way it should.  My L5-S1 joint isn't so painful, but it had already become less painful after the brusque physical therapist showed me how to work on my tilted pelvis.  And now the sacroiliac joint feels like I got kicked in the butt.  Like I should be black and blue.  Just on my inside parts, though.  Apparently it takes some time for all that stuff to absorb and do whatever it's going to do.

My instructions were to rest on Thursday and apply ice every hour, which I did.  Friday I went to work like normal.  Saturday I went out to the park like I always do.  My instructions were not to increase activity, so I didn't.  I even did less mileage than the previous weekend.

Today I sent a note to a friend who has been down the steroid shot route before and knew what to expect.  "I feel like somebody pegged me in the butt with a softball," I wrote.  "Is that normal?"  She replied that I might need to be less active on it, and to try heat.  I wrote back "I was less active!  I mean, I only went 8 miles instead of 11.."

My friend says, "Uh, I think I see why you might be experiencing some pain still.."

I obviously don't have the first clue how to exercise in moderation.

Wednesday I go back to PT lady so she can evaluate my efforts.  She reminds me very much of some riding instructors I've met.  Very blunt, outspoken, and REALLY GOOD.  Unfortunately I couldn't completely keep up with her rapid fire blasting of anatomical descriptions and consequences of various problems, but I *did* get her to give me paperwork specifying precisely how the curative exercises are supposed to work.  I was very impressed with her insight and knowledge.  I love it when I meet people who are very good at what they do, especially when it's something that would be very difficult for me.  I can't look at a person and tell you much about how their body works.  She can look at me and visualize how my bones are connecting, and make the mental correction to how they should be connecting.  Just amazing.  I just nodded and tried to pay attention to what I needed to do to make it better.

I expect that both PT lady and my chiropractor will lecture me about not taking it easy enough while we're changing how my inner parts relate to each other.  Medical professionals get like that.  Like it's so easy being me?  You do not want to know what happens when I'm forced to not hike for a while.  *shudder*

In which I mention the things I had forgotten to tell you.

I just realized I never reported back on my new doc and ensuing activities.  New doc is kind of intense.  I didn't get through my laundry list, in large part because he lectured me for several years on all the bad things I had done to myself by taking so much Advil.  He launched into that lecture BECAUSE I asked what I could take that would be less bad for me, which I feel is an unfair reason to get lectured.  Obviously I realized it was unwise.

Anyway.

He also yelled at me for not having been in to see my ob/gyn recently enough.  When I called the ob/gyn afterward for an appointment, they couldn't get me in for NINE WEEKS.  There is a problem with this system.  I started surfing the web looking for other doctors, especially as my ob/gyn had also shut down their local office so I'd have to drive a good long way for my appointment.  The closest I found was actually around the corner from me, which was great!  And they had fantastic customer reviews.  But when I investigated further, I found that they had moved out of actual gynecology and into liposuction and vaginal cosmetic surgery.  If I want my thighs smoothed and my coochie tightened, they're the ones to go to.  For my annual pap smear, however, I have to look farther afield.  I still haven't found another alternative to the folks who moved and can't see me for months.

I brought up the whole "I feel sick if I eat gluten, but I tested negative for everything so the gastroenterologist told me NOT to avoid it" thing, and new doc agreed that the gastroenterologist was an idiot and told me to stay off gluten.  Which I was already doing.  I don't so much miss the crusty bread and the noodles, but it does make it a lot harder to go out to eat.  Or to buy foods without research.  I bought JD some bacon salt for Christmas, and not only does it not have bacon in it, but wheat is one of the first ingredients.  WTF, man?

Fortunately we have a variety of organic groceries in the area where it's reasonably easy to buy gluten free goods, and we have several nice restaurants with gluten free options.  But it's still kind of annoying.

New doc gave me a referral for a local neurosurgeon because of my increasing back pain.  The old guys seemed fine but were a long drive, and wanted to refer me to other folks who were also a long drive and also not in my insurance plan.  So new neurosurgeon.  Although of course not so much neurosurgery is done there.  They really try to avoid cutting into people, because it's hazardous.  Both for the patient and for the doctor, when you consider lawsuits and etc.  They focus more on pain management.  If your pain can't be managed through braces and medications and physical therapy and who knows what else, THEN they consider surgery.  Which explains why they're changing the name of the office from having neurosurgery in it to having pain in it.

New neurosurgeon told me that he *does* think I can ride.  And I don't need a joint replacement.  He thinks the sacroiliac damage I took coming off of Pluto a few years ago is causing the pain in my lower back - although I feel it right in my spine, when he pokes and prods he finds pain only on the right side, not surrounding the whole joint.  And I don't have shooting pains or those awful electric nerve pains.  He also thinks that I have a short leg.  (Or a long one, if you prefer.)  Which explains why I can hike in the woods all day but two hours in a store kills me.  The uneven surfaces in the woods result in a different stride every time, so I'm not repeatedly torquing my pelvis the same way.  I'm having a scan to check my leg lengths, and also a visit to a physical therapist to do the same thing.  Fixing that problem might be as simple as putting a shim in one shoe.  To which I say "Hurrah!" but also "Why didn't we figure this out years ago?"

So we might have an easy fix for that, and I *might* be getting an injection into my sacroiliac to fix or at least bandaid my worst pain.  And he put me on Celebrex rather than Advil, which should be better for my insides.  So far it's been more effective at making me comfortable.

Neurosurgeon says I won't be able to ride completely without pain, but I don't expect that.  I just don't want to have to worry about crippling myself by riding.  Some pain is acceptable. 

I think that about covers it.  Now my GP and my dentist are in the same office park close to work and home, which is nice.  Neurosurgeon is in Bowie, which is close-ish.  All three are youngish black men which I find somewhat soothing.  Having grown up in PG County, as a white minority, I am not super comfortable with old male white doctors.  Technically my dentist isn't young anymore, but he was young when I started seeing him.  You just can't be intimidated by a kid in jeans and a tshirt.  (He dresses nicer now.)

In which my friends annoy me into making a decision

Apparently, I need to see some more doctors.  My loving, helpful, but annoying friends have been harping at me about stopping riding.  (Because I keep being generally miserable about it.)  "Just have spinal surgery" they say.  "I had three and I ride just fine."  I was feeling kind of bad, and kind of sad, and kind of mad.  Because what the hell do they know?  Have they been to the neurosurgeon with me?  Have they gasped in agonizing pain when the back stabs?  Have they suffered through hours of torture in the car because the back can't handle bumpy roads anymore?

But then I googled facet arthrosis surgery.  And also some other things.  Did you know they can pretty much replace a joint in your back?  Not stab it with iron bars so it never moves again, but actually replace it with something else that moves very much like a normal spine?  I watched videos of spines with hardware in them, bending all around.  And I thought about how nice it would be to have a functional back again.  And to be able to ride my horse.

Going by the video, they shave off the ends of your vertebrae and put new fake ends on.  And do something or other to the disk.  Trim it, or replace it, depending.  And they put some kind of miracle joint off to the side.

My mom's recovery from spinal surgery was fairly horrifying, so I'm not fooling myself that I would have a quick and/or easy recovery.  But if I got another, say, ten years of reasonably normal use, would that be worth a couple weeks of agony?  Maybe yes.  I mean, I got ten years of normal vision out of Lasik and that was worth it.  Plus in 10 years Pluto would be 23 and started to get slower.

I don't particularly want to go to the neurosurgeon all the way out in Annapolis, though.  It's not like there aren't doctors hiding in every crevice of Greenbelt.  I'd like to find somebody closer to home.  Especially as it seems likely that neurosurgical consulting is going to be a repeat thing for me.

First, though, I have a new patient appointment next week with a regular doc.  I actually like my old doc, but her office staff is horrendous.  Just to get test results I'd often have to call several times and finally drive over and stand in their office until they gave me the paper.  And they completely failed to get me authorizations for medical testing this year.  I finally paid out of pocket because I didn't have any more time or patience to screw around.  This doctor was recommended by a good friend, and she also vouched for the office staff.

I have made a list of my medications, and my various bizarre ailments (think zebras, doc.)  So I figure I'll go in there, smile, bombard him with all my weird health problems, show him my xrays, and ask for a referral to a neurosurgeon.  Piece of cake, right?

If this works out, and I do find a doc who can and will fix my back, and I endure PT and get better and can ride again, I'll have my friends to thank.  Thanks for being a pain, guys!  It was helpful.  Eventually.

:(

I am currently having a meltdown because the doctor's office has my MRI results, has promised to fax them, and has not in fact faxed them.  Talk amongst yourselves.