Tuesday, July 24, 2012

Pain managed?

Went to a smart and funny pain management specialist. He was very impressed with the comprehensive paperwork I'd completed (he shouldn't have been, I'm a social worker), and did some tests that had never been done before. He looked at how I walk -- apparently I don't use my toes enough -- palpated my sacroileac, which was very sore, and agreed with me that I don't need strengthening PT. I need to treat my poplitear tendinosis.

I wasn't surprised. Last month I went to a very snide orthopedist and told him I thought I had poplitear tendinitis. (Okay, so I was a little off. When you Google "popliteus tendonosis," you get no answers.)

"Do you know where the popliteus is?" Dr. Pompous asked pointedly.

If I didn't, how would I know to think there was something wrong with it?

I pointed to the tender spot behind my knee. My chiropractor had alerted me to it, saying it was spasming and could be causing the knee pain. But Dr. Pompous disagreed and prescribed strengthening PT for my patellofemoral syndrome. Which I knew from my brilliant chiropractor (who has by now helped me all he can) was not necessary. I spent a month doing quadricep strengthening exercises rigorously, and it did not help one bit. That led me to conclude that I did not have patellofemoral syndrome.

"I saw an orthopedist last year, who diagnosed me with patellofemoral syndrome," I said. "Also golfer's elbow. He gave me two sets of exercises, and I did all of them rigorously, twice a day. My elbow got better, my knees didn't. His diagnosis was wrong."

Never tell a surgeon that another surgeon was wrong.

"That doesn't mean the other orthopedist's diagnosis was wrong," said Dr. Pompous in baneful tones. "Up to 30% of patients don't recover. I'm prescribing strengthening exercises."

Jackass. So, a month later, I finally land in pain management, because the chiropractor can't help me any longer and doesn't know why I'm in so much pain. And I'm really hoping Dr. Dashing is right.

Dr. Dashing examined me with a fellow in the room, which was awesome, because he had to explain everything he was doing and why. Often when you're being examined the doctor pushes this and pokes that but doesn't give you a play-by-play, they just summarize at the end. This time I understood everything he was looking at and what it meant.

"Take off your shoes and walk down the hall," he said. I started down the hall. "Come back now." I turned around and came back. "Go back down the hall. You see?" he said to the fellow. "She's landing on the balls of her feet, not her toes."

Suddenly I felt very conscious of my toes. I generally only think of them when I'm getting a pedicure or have an ingrown toenail. It apparently affected my gait.

"Now she's landing on her toes," continued Dr. Dashing. We all laughed. It was cool; he wasn't making fun of me. After all, he respected my handy way with extensive paperwork and my comedic timing. Probably that is why I think he is funny.

So a few things. In addition to not utilizing my toes when I walk, my heels are drifting and my patellae are "tracking." This means that I am now supposed to imprison my feet in shoes with a closed heel, also known as a "heel counter." Which irritates me no end, as my favorite shoes are mules and my feet like the open air. And heels chafe. Feets don't fail me now? Too late.

Poplitear tendinosis is so rare that Dr. Dashing could not find its ICD-9 code for the PT referral, even after consulting the ICD database (which is proprietary) and Google. Which was also hilarious and felt kind of validating. There's a reason nobody knew what was wrong with me -- it's rare. Not that I'm honored. Although I might be if he publishes a journal article about me. So I'm going for PT, and I'm going back to Dr. Dash in a week for an injection to ease my excessively tender sacroiliac.

I'm not sure if my back hurts because I injured it in October 2000, I was hit by a car in October 2009, I have fibroids (5 days after the ultrasound I'm still bleeding; I'll see my gynecologist in two days, but the good news is that the fibroids haven't grown significantly, although that does make me wonder why I'm bleeding), or I have such a severe bladder infection that I have to take the vicious poison masquerading as an antibiotic, Bactrim. Never again. Today is my last day on it before I switch to Macrobid; I ache all over, my eyes are burning, and I feel feverish. Like the flu with no congestive symptoms.

But I trust Dr. Dashing, and I'm going to ask if any fellows want to sit in on the sacroiliac injection -- a procedure that apparently isn't done very often but Dr. Dashing thinks it should. Not because I'm an exhibitionist but because I like hearing the backstory.

It reminded me of my hospitalization after my suicide attempt. At another teaching hospital. I woke up from the coma with pneumonia, either acquired at the hospital or via aspiration. Med students trooped into my ICU room several times a day to listen to my lungs. One had trouble and said, "Can you take a deeper breath? I can't hear anything."

The last med student heard plenty, I wanted to say, but I obliged her.
Copyright (c) "Ayelet Survivor"

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