Updates on hurting myself; new diagrams including referred pain, dermatomes, and flexion patterns

Straight-leg-testI tried increasing my hamstring stretch 3 days ago on June 18th, 2015 by about an inch. Typically, I place my leg on a surface that is 15 inches high, then a surface that is 16 inches high, and finally a surface that is about 17 inches high.

I’ve been doing that stretch for about 9 months now. I took a break after the Minkowsky doctor appointment that tore my back up again for a few months. Before that, I have been doing that stretch since about 2012.

When I fExercises for low back imageirst moved to San Diego, I could barely get my foot onto the 15 inches high surface. There was so much pulling on my right psoas. It took months before I could get it done comfortably. With the 17 inch high surface, I had a hard time actually lifting my leg up, I think my SI Joint was too rigid and immobile.

However, I’ve been stagnant for a few months now. So, I thought I would increase by about an inch, maybe 1/2 an inch. Basically, my fingertips usually rest at the top of my knee. On the right side I moved my fingertips to the middle of my knee cap. On the left side, I did the same.

I did this for a week with no problems.

Then those few days ago, I did it again. The right side is always way tighter than the left. So I kept the right side the same, but on the left side I moved my fingertips to just after my kneecap. I rested my weight on the leg.

I felt no pain at the time, I was actually quite cheerful I was making progress.Sciatica Pain

I woke up the next day and was like, ouch. This is going to be a bad pain day. But, I figured, no big deal, you did something slightly new that last week, you did everything right, if you have more pain, that’s just the way it is on the road to recovery.

Yeah, save for the fact that I’m experiencing pretty impressive nerve pain.

My right foot is equally numb and prickly. My right calf is very weak. I don’t feel like I can stand on it by itself for very long. There is also a weird, almost like constant charley horse in my right calf, which I realize is referred pain. When I lift my right leg, it stabs there. Not out, away from my body, but like a knee raise.

anterior_hip_muscles_Again, this seems highly unusual that that much pain would come from simply increasing a stretch, which I feel I did safely, by a half inch to an inch.

I’m so frustrated.

Therefore, I’m going to include some diagrams I spent looking at last night to figure out where my pain is coming from.

It is definitely L5-S1. Most of my pain is in the back side of my calf, on the lateral aspect of the right calf. The location on the foot seems to spread depending on, oh, who knows.

Here is also a good link from U.S. Agency for Health Care Policy and Research (1994).

On a side note, really? 1994? Couldn’t we have fixed back pain by now? Shouldn’t there be an injectable or something?

 

From that article, I found this diagram to be the most helpful …

 

Screen Shot 2015-06-21 at 10.32.12 AM

 

 

 

 

 

 

 

 

 

 

 

 

 

Here is another good article with a really good image. The article is basically a back pain guide

L4-S1 Pain distribution

 

 

 

 

 

Here is one final image that I really liked:

dermatomal map of nerve root distribution

 

 

 

 

 

 

 

 

Thanks for reading. I will still post on my physical therapy appointment later in the week.

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Madeline Fresco is a novelist who lives in San Diego. She is the author of CROSSED THE LINE, available for Kindle at Amazon.com, for Nook at Barnes & Noble, and as an ePub at other eBook retailers. You can also listen to her novel as a free, serialized audiobook atmadelinefresco.com. Her second book THE CHOICE, is available on Kindle at Amazon. Her third book ANGUISH, is available for Kindle at Amazon.com

 

Primary Doctor Appointment – Yup, I’m Worse

After about 5.5 weeks of continued, ongoing, non-improving back pain with new numbness and tingling, I went to see my primary care physician, JD. After explaining my symptoms to him, he decided to do a test. He pricked the sides of my legs to see if I was having any diminished sensation. Well, sadly, I was. He said that it was consistent with an increase in the amount of herniation at my disc site. I’m totally not happy about that. All of this increased pain from going to see a doctor so that maybe I could get better, and instead, I am worse off.

So uncool.

 

Therefore, my doctor is sending me to get another MRI. This time it is at a different campus, and the MRI machine is not as good. Oh, well. I have no idea how I am going to make it through the MRI with this worsening back pain. Honestly? It’s going to be terrible.

 

The other shitty thing is that it’s late in the day – 5:10pm. I don’t know how I am going to make it all the way through the day, trying to mitigate as much pain as possible, then drive there. Jeez, by the time I get there, I’m already going to be done.

 

Since the MRI is so late, I won’t have any results until probably Monday, probably late day at that as well, considering that any emergencies over the weekend will take priority.

 

Unfortunately, now we are talking surgery. Not that I am opposed to surgery, not at all. The only issue is, it will probably only fix the numbness and tingling. That’s why I was never a candidate before, because I didn’t have numbness and tingling.

 

I don’t even know what to think anymore.

 

The other awful thing was that when I asked my doctor how this impacted my long term health of my back, he said “you were going to always have problems before this, and now, yeah, you will always have problems.”

 

I don’t even know what that means.

 

I hate the idea that I’m always going to be in some type of pain. How has this happened? I mean, I know, but, how so bad?

Random Ramblings: Lots going on – failed doctor appointment, 2nd denial from social security

There has been a lot going on this last past week.

It started on Tuesday being contacted by MetLife to find out if I thought I could do any kind of work. There were a lot of questions about what I’ve tried so far and how I’ve been feeling for the last year. It was pretty emotional having to talk through how shitty my life has been the last year and a half. I actually cried on the phone. I couldn’t help it. I really wish things were different, and to try and explain yourself to someone was extremely emotional.

Then on Wednesday I decided to go see the new back D.O. again. Ultimately, I decided to try and see him again. One, I felt slightly pressured (by myself) from MetLife to have a follow-up with the guy. I just wasn’t sure since I have been in continuous, worse pain since the last time I saw him. Yet, I thought it would be good to actually find out what he was going to do for me, since I was in pain and all, I might as well find out at what cost.

The drive there is only two blocks away. It hurt so bad! A part of my back that had never hurt before, plus the annulus, and all of the lower back muscles. I had to try and hold myself up in the car just to take some of the edge off.

We made it there, and, thankfully, they whisked me right in. He asked me how I was doing, and I told him the truth — way worse. He decided that he wouldn’t do any manipulations that day and wait until I wasn’t so flared up. I have to tell you, I really, really appreciated that. I’m so flared up right now I could barely walk around the block. I asked him what he thought I should do in the mean time, and he suggested getting some cranial massage to try and relax my nervous system. I think as long as the people can come to my house, that would be in my best interest.

Today I was supposed to see that Dr House guy. Again, the office gave me the run-around. My appointment was originally scheduled for 2:00. It then got bumped to 3:00 and then 3:30. She was so bitchy with me on the phone and I just don’t want to suffer trying to drive there and find that I have to wait forever just to see him and be in severe pain tomorrow and, well, let’s be honest, for weeks upon weeks after.

I had a long conversation with my husband and we both agreed (which was really nice) that I wouldn’t go. He called the office and asked since I already had the time scheduled, if the doctor would call me for a consult — she didn’t even ask him, she just said no. I think, just after this last appointment and how bad my back hurts, I’m just not up to it. I keep trying and trying. When is enough enough? How many doctors do I have to see? I’ve seen 3 back doctors, 3 pain management, 6 different physical therapists, 2 different acupuncturists, a rheumatologist, my primary, my endocrinologist, a massage therapist, and a myofascial therapist.

I’m so frustrated by this last setback. It’s bad. It hurts when I lay down again. Walking is difficult. Stretches — forget stretches. I’ve had to lay down twice just to write this blog post.

I’ll check back in next Wednesday. That will be two weeks from onset of flare-up/setback. Man, I hope it is in between the car setback and the bike setback. 2 weeks for bike and 7 weeks for car. Although, I feel like it will be more like the car seeing as it was a similar motion — leaning back.

Annular Tear Doctor Appointments: A new doctor. Again. Again, No New Ideas And More Pain

IMG_0355I went to a new doctor yesterday. He is an osteopathic back doctor. The last time I went to see JD, my primary, I asked him, as a last result, was there ANYONE he could think of that I should see? He suggested this guy.

 

All in all, he was very thorough. He asked all the right questions, was on point, and really seemed to listen. I did forget about how to talk with a doctor though who is trying to put you through their exam. It’s hard because in my heart, I feel like I should be able to do all the motions he puts me through. It’s like I have a preexisting synapse that says, yes, he should be able to put my knee to my chest. Yet, I was briskly reminded when he just lifted my leg up in the air to “see” where and when it would hurt. I guess I wish they could just ask me first. Maybe say “how far can you lift your leg” instead of doing it. Doing it has caused me to be in a ton of pain yesterday and today. The problem is, these pains, don’t just last a few days. They last weeks.

 

I have to admit, I’m exhausted. I go see these doctors because we are hoping someone can help. That someone will have the answer. There are so many problems when I go see these doctors. One, I sort of still get my hopes up. That maybe, just maybe, he will have the answer. When they don’t, it’s so defeating. I begin to spiral all over again about how much I have lost in life. Everything. The ability to have kids. The ability to make a man happy. The ability to work. The ability to play with my nephew and niece. The ability to be a more happy and less stressed individual. The other problem is the pain. I am in so much pain right now. Standing hurts again. Yes, standing always hurts, but, now, immediately again. Laying hurts. I can’t get comfortable at night. This whole situation is intolerable.

 

And yet, I have another appointment with this guy next week. Why? Because I still hope. I still dream maybe I will get better. I still struggle with the fact that most people get better. That only 10% of us don’t. I struggle with the fact that even though I didn’t have sciatica, which seems to be a worse condition, I don’t get to get better. The guy who drew my blood today (another issue, just routine maintenance), he said he had back pain with sciatica 16 years ago. He had surgery and now he is fine.

 

I’m not fine.

Random Ramblings: Changed the date of my doctor appointment and had a tweak from a bike

I finally just decided that I wanted to bump back my appointment with the doctor “House” type doctor until my husband can drive me. It’s just that … I’m a terror in the car. It’s just so painful to sit there. I get cranky that we aren’t making the lights fast enough. I also get cranky if you drive too fast because then I’m worried about stopping. Plus, my husband is used to how much pain that I am in. If the doctor office is taking too long to see me, he won’t hesitate to say something. I need that. I need someone to have my back. Not that my friend won’t … it’s just that with her there, I would be more likely to try and grin and bear it because I don’t want her to think I’m a baby. Plus, with my husband, if I can’t make it, I can’t make it. He will understand. If we have to abort mission on the way there, he will know why. He will know that I’m not being a baby. I need that kind of support, especially since I’m so nervous about this appointment.

Plus, I had a minor/moderate tweak this week.

Here’s what happened. I was doing slightly better! My stretches were going well. I was able to walk farther and with less difficulty. I was also able to stand at my work desk for longer and without too much pain. You know, the kind of pain where you can’t stop digging subconsciously at your back because it hurts so much?

So, because of this, I decided to get a stationary bike.

When I was doing better, at PT, I rode one. I thought, well, I’ve done it before, why not get one for the house?

Therefore, I went online and tried to find one. It’s hard in San Francisco because there really isn’t a place that has a large selection of bikes that you can try out. I did find Sports Authority and they had several bikes online, but only two in the store. My husband went to see the one I liked and he bought it. When it was delivered everything seemed fine. My husband was going out of town and wanted to see me ride it before he left. I’m only telling you this because it adds to why and how I hurt myself again. First off, it was late. I wasn’t thinking clearly, I was already spent from my whole day, and thus, I wasn’t really focused. Secondly, he was in a hurry because he needed to go to bed since he had to be up at 4:00am for an early 6:00am flight. Therefore, everything was kind of rushed.

I tried to lift my leg over the middle of the bike and it was quite high. Again, I didn’t feel anything tear or anything like that, but I knew it was too high (after the fact). We aborted mission and hoped that nothing would come of it.

Sure enough, the next day, the annular pain was back in full force. It was hard to sleep, hard to stand, and just generally more painful. As the days have gone by, about 6, it has sort of gotten worse. It’s almost like the annulus hurt, then it moved to the nearby muscles, and it just keeps spreading as each new muscle group gets more and more tired from compensating. Writing this blog now is difficult. I have a burning pain just over my right butt cheek where the butt meets the pelvis. That’s on top of the annular pain and the erector spinae muscles screaming at me.

I’m also telling you this to learn from my mistake. My husband and I made up some new rules.

– No new activities after 6.

– No being in a hurry.

– No rushing each other. If someone wants to talk it over again, so be it. Better to over analyze everything than to miss something.

– Go slow in case there is something that might have been missed.

Words to live by!

I’ll let you know how long this setback was/is. I was thinking about the setback with the car, thinking maybe it was three or 4 weeks … SEVEN! It was SEVEN weeks! That was a long time!

Oh, and if you are wondering why I didn’t just get the same bike from PT, it’s because that bike was $2000!

The internet is just so hard to gauge sometimes.

Best of luck to you all!

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Madeline Fresco is a novelist who lives in San Francisco. She is the author of CROSSED THE LINE, available for Kindle at Amazon.com, for Nook at Barnes & Noble, and as an ePub at other eBook retailers. You can also listen to her novel as a free, serialized audiobook at madelinefresco.com.

Random Ramblings: Ugh, in pain from driving in the car

Ugh. Another setback. I tried getting into my car in order to go to the doctors, but there was a small problem. My husband had driven someone to an event, and he had put the seat back a bit. Not a lot. Yet, just enough so that I arched my back subconsciously looking/feeling for the back of the seat.

Now the annular tear is on fire. I can’t sleep very well at night. My stretches are severely restricted. I had to cancel an appointment for tomorrow because I really don’t feel like I can tolerate sitting in the car for any amount of time.

I’m tired of all of these little setbacks. I’m tired of never being able to turn the corner. I’m tired of trying to keep my hopes up all time.

But, what can you do? I can’t give up. If I give up, then there definitely isn’t any hope.

So, I hope that things change soon. I really do hope.

I had my MRI

I’m tired and frustrated

I went to get my MRI today. Ugh.

Not. Good.

It started off fairly well. I did my stretches this morning and it went as well as any other morning over the last few days. The car ride was where I was a bit concerned. I have not sat for the last 5 weeks so this was the first time that I sat for any length of time, especially in a car. I did pretty well. It wasn’t until the last two minutes that I really started to get a bit anxious. However, I could see the hospital so that made me feel better. I’d say the ride was about 15 minutes?

I got there, and I have to say, I was a bit annoyed. They told me the appointment was at 9:00. Nope. It was actually at 9:15 and they were running about 15 minutes behind. Anyone with back pain knows that adding a half hour onto any event is brutal. I tried pacing the halls a bit. That seemed to help.

Here is where it got ugly. Laying down on the MRI bed was excruciating. It was so firm. I tried really hard to stay in the MRI the whole time, but I ultimately couldn’t do it. I just felt the L5-S1 annular tear area pulling. Then the throbbing began. Then my butt and leg started to hurt immensely. I started to cry a bit, trying to hold on. I just couldn’t do it.

I’m mostly frustrated because I feel like I should be doing better by now. I should be able to lay in a MRI machine. I could before. Maybe not well, but I made it through the entire exam. Why not this time?

I should be doing so much better. It’s been so long. I’m tired of my life passing me by. I wish there was something I could do!

Tomorrow is my appointment with the doctor to go over the findings. Hopefully we can come up with some kind of game plan.

4 weeks post set back. I’m sad

I’m sad

Saw my doctor today 4 weeks post setback. He didn’t look too thrilled to see me, which is rather irritating. Does he think that I really want to still be coming to the doctor?

I asked him to do another ultrasound on my back. It confirms that I still have a tear at the right erector spinae muscle. I asked if he thought it looked new? Or worse? He said that it just looks like a bit of a continuation of the previous muscle tear.

He recommended for that perhaps PRP in the future, thinking that the Prolotherapy wasn’t going to be enough to help solve that muscle tear. I asked him if he thought I was starting over from the beginning. He said no, but he wanted to really wait to give me a prognosis until we got a repeat MRI to see how the annular tear at L5-S1 was doing.

He was not a fan of getting facet joint injections of the L3-L5 area. He felt like the epidural steroid injections really didn’t help the first time around and that they probably wouldn’t help this time around either but that he didn’t want to make any recommendations until he got the results of the MRI.

He was not too geeked up on taking the Celebrex or doing Lidocaine patches during the day, thinking that the Lidocaine would mask the pain and that that would perhaps do more harm than good. He thought that it would be just fine to use them at night, and that it might help me with sleep.

As for physical therapy, he too, said no more.

Only other real thing that he said was absolutely no sitting and not a lot of standing, but that he wanted me to really keep moving. That’s a tough one. How am I supposed to keep moving and not stand and not sit? Ughh. And stairs are really not that successful, so how am I to get out of the house?

Overall, I am very, very stressed out, and not sure what to do. I mean, there really isn’t anything I can do. It’s hard. You want to be proactive in your recovery, and it’s more like just sitting (or not) around and waiting. I can’t cry myself to sleep every night. That’s not really helpful either.

Massive setback

Well, about a month ago, I was told that I would still be better by January 1. I have to say, I was actually starting to believe it. FOr the first time, I was able to sit longer, I was able to walk longer, and while I was out (standing) at a bar, I was able to last longer than I ever had before.

Sadly, I actually started to get a little bit of hope.

Then, again, my physical therapist did an exercise that ended by good luck streak and my chances for a recovery by January 1.

 

I don’t know what to do now. I’m at such a loss. It’s been 3 1/2 weeks since the injury and I am still severely limited. I look old after this year and a half. I feel like what a president looks like when they leave office. I look tired, my skin is splotchy, and I’m fat. I’m lonely, feel isolated, and don’t know what to do. Do I calm down — knowing that I will EVENTUALLY  get better? But, the truth is, I don’t know anymore. I actually started to have a bit of hope a month ago. Now I am down in the dumps again.

Any advice?