10 Minutes of Nothing New

I was saving an update on my back until today, when I was supposed to have a wonderfully enlightening visit with my physiatrist.  Unfortunately, the words “enlightening” and “wonderful” could not be applied here today.

I have seen this doctor once before when I first had my MRI for the herniated disc.  She prescribed me some medicine and physical therapy.  She told me that if things did not progress well conservatively, I would have to start thinking about a steroid injection.  I have not seen this woman since and have worked solely with my physical therapist for the past many, many months.  I should note that I really love my PT and feel he is very helpful and encouraging.

The doctor, however… Not so much.  I spent ten minutes with her today.  Ten minutes in which she told me the following:

  • I could have re-herniated the disc a couple weeks ago. I could also just be one of those people who is prone to doing such things.
  • I should finish physical therapy. Despite my questions, she did not give me a time frame for this, only said that my PT would know when I should be done.
  • I don’t need another MRI because she would only need that if she were going to give me an injection or have a surgeon look at it. Neither of those things are necessary unless my leg pain gets worse.
  • If the pain in my leg gets worse or if I have another episode, I should call her.
  • Do not bend, twist, or lift things for six weeks.

My internal monologue:

  • I was already told that by your colleague at urgent care when it happened. Read charts much?
  • I have been in PT for a really long time now. A really long time.  And this still happened.
  • Thanks for not making me spend a whole load of money on a diagnostic tool for treatment that is not in consideration. This is not sarcasm.
  • If the pain gets worse or I have another episode, I am going to find another doctor.
  • Duh. Seriously and completely: duh.

I really appreciate the focus on conservative treatment.  I don’t want the shot or surgery.  I really just want to feel like I can do something to get better and protect myself against this happening again.  It’s frustrating to hear that I just need to keep doing what I’ve been doing and even then, it could just be for nothing and I could re-herniate again. Maybe another doctor wouldn’t tell me anything different.  The position I am in is just not the best one.

There is good news though!  Yesterday, my physical therapist told me I could start going on walks.  I did for about 30 minutes and added a little very slow, light jogging.  I had no problems with my back or legs during or after! I am really excited about that.  He also gave me the clear to at least walk the quarter marathon for Cap City.  I figure that in a month’s time, if things keep going well, I can probably run some of it.  Good news! Good news!

Post-Physical Therapy Back Update

I had my first physical therapy appointment this morning since my herniated disc “re-flare.”  When I walked in, I was apparently bent and shifted into a strange pose that when my PT mimicked it, I was horrified.  He immediately took me through preliminary movements to see my range of motion. I could lean forward pretty well, but I could not lean back at all without pain.

We went over to the wall and he had me stand a little away from it, lean on my left arm a little, and just “glide” myself against the wall.  I did this several times and it started to help almost immediately.  We varied it with leaning forward a little bit and working my way up to standing straight as I glided a few times in each position. It didn’t feel awesome, but every time I stepped away from the wall for him to check my alignment again, it was improved.  I could even start to lean backwards more.  We did a few other things, most of them didn’t feel very good, but I still felt like my ability to move around was improving and has improved a lot since Friday.

Back Care Notes

The session today was pretty short and ended with ice and instructions: I am to keep doing the glides in order to get myself into a more neutral position in my back.  If it doesn’t hurt, I can use the recumbent bike at the gym.  I can start with with 10-15 minutes, walk a little bit, and continue on if my back feels okay. I must use ice and the muscle relaxers would do me well at night since I can’t take them when I’m at work.

I cannot: run, jump, lift (including upper body lifts), twist, sit in a chair without back support, etc.

My PT said that it’s possible that once I am done with the steroids I am currently on, things could get worse again.  The steroids are taking care of the current inflammation, but it could just come back. He also thinks the doctor is probably going to want to go with a more “aggressive” treatment at this point.  He mentioned the shot, which he knows I am pretty against.  I don’t know what other options there are after that aside from surgery, which I am also not interested in either.  My doctor’s appointment is in the middle of being rescheduled, so we’ll see when that happens.

I have to say, I am pretty upset about this whole business.  I was doing so, so well. I was keeping to a good schedule of 3x a week strength training, 3x a week running.  My back was feeling good.  My ankle stopped hurting.  I was about to run over 6 miles for the first time ever!  Now, I can’t do any of that. I am going to try the bike tomorrow and see how it goes, keep up with my instructions, and all of that.

I am hoping being able to bike will help my sanity. That’s the real problem.  I am so grumpy from pain and steroids and not being able to do the things I would normally.  Usually, if I was this grumpy, I could go for a run or go to the gym and work it out, so to speak.  With that not being an option, I just feel like I’m a pile of irritability and unhappiness. Strange how I never thought I’d run like I do now and now that I can’t run, things just aren’t as awesome.  In the little bit of time I’ve been running, it has become such a part of my life and my mental well-being, even.

While I don’t know if I will be able to run by the time the Cap City quarter comes around, the pacing requirement is pretty low, so I think I can at least walk it.  That’s my goal now: let’s just get to the point where 6.55 miles is something I can do in one way or another.

Disc Herniation, Take 2!

I know I have mentioned my herniated disc before, but for those not following along, here’s the story:

March 28, 2011 – I was deadlifting over 100lbs.  I came up wrong on the lift, felt a pop in my back, dropped the bar, and thought I was going to pass right out.  I could barely move, but luckily one of the trainers was nearby and helped me sit down. I couldn’t breathe very well and I was deathly pale, which made them think that my blood sugar dropped the minute the injury hit. One of the owners sat with me and iced my back for I am not sure how long.  Eventually, with the help of everyone and a very big stick they loaned me, I was able to drive myself home.  I had to re-ice my back just to get up the stairs to my apartment.  I have no idea how I did that because by the time I landed in bed, I could barely move.

Most of that week was an awful experience and the pain wasn’t something I’d ever felt before.  I am lucky that my friends are helpful and a couple of them came by those first few days to help with the cat, get meds, get food, etc. Not so lucky that it hurt so much to move that I almost passed out any time I had to get out of bed.

I was able to get along better as the week went on (I remember rejoicing when I could sleep on my side again), but it took a long time for the doctor to send me for my MRI.  I didn’t get that until part way through April of last year and then the appointment with the physiatrist didn’t take place until May.  By that point, I had made quite a bit of progress on my own, but still used a cane to walk at times to help me feel more stable on my feet with the leg pain and residual back pain I was experiencing.

L5-S1 herniated disc

From my MRI: To my untrained eye, this certainly looks like a disc popping out...

During the appointment with the physiatrist, she explained that I had a disc herniation at the L5-S1 (which is in your lower back).  The disc was pressing on a nerve, which was causing the sciatica in my leg, so she prescribed me a medication to help with that.  I was told about my options, which included an epidural steroid injection and physical therapy.  I chose to go with PT for the time being and only do the injection if it didn’t work.

Physical therapy started in June. I’ve been at it ever since with varying amounts of attendance. The main focus has been to develop my core muscles so that they could support my low back. I started back into the gym at some point and that’s when I started running due to lack of other possible activity (read: no heavy lifting).  I’ve been pretty regular in my activity level for the past couple of months. I finally felt like I was out of the woods and almost wondered why I was still in PT every other week.

Fast forward to two days ago. I had gone on a short run, come back and started to stretch.  I was about to go into one of the yoga poses that I do during stretching and that’s when it hit. I tried to stretch it out with things from PT. I applied ice pretty quickly and that seemed to help, but I could no longer stand up straight and the pain was intensifying.  I tried to call and talk to my physical therapist, but he was out of the office until Tuesday (incidentally when my next appointment with him is) and so they referred me to the orthopedic urgent care that they have.

I went in as soon as I realized that I wasn’t going to make it better on my own and that the pain was not subsiding. They asked some questions, did some quick tests, and told me that I had re-flared the disc. “Oh, yeah. This can just happen at any time now.  There might not seem to be any reason for it,” they said.  Great news, right? They did a thing on my legs that indicated that my nerve was being pushed on again.  I was given a prescription for steroids to help get the inflammation to go down, but I was told I could wait to use them since I could maybe wake up in the morning and feel better. They also gave me a muscle relaxer and told me not to return to work until Monday and to not do any heavy lifting.  I have to have a follow up with my physiatrist in a couple weeks and keep my PT appointment.

I am back to being friends with my cane.  My leg pain has only gotten worse in the last day, but I started the steroids yesterday morning. The back pain is nowhere near what it was the first time around and I’m thankful for that. My mobility really isn’t that bad and I can do most things, just uncomfortably. Yesterday was a big friend gathering and I had to leave not very far in because my leg pain was only getting worse and I couldn’t get comfortable. Ice and rest seem to be the biggest help and I’m hoping that the steroids will start working fast. I’m going to spend pretty much all day today resting so tomorrow at work won’t be a bad experience. I am anxiously awaiting my PT appointment to see what else I can be doing and I’m sure that I will get more info about the whys and hows of relapse.

Here’s to hoping this is the only relapse there is.