Herniated Disc Update #4

I had an appointment with the PA, Kristen, at my pain doctor's office last week.  Jeff met me there and I am really glad he did because I'd forgotten a lot of the oddities that had happened in the seven weeks since my last visit.

He brought up my blue fingers and the auditory hallucinations, as he called them - I just said there was a party happening in my head.  Off and on, I could hear the murmur of a group of people talking but couldn't really make out any words - it was like they were at a party in the distance.  Yes I know that is weird but it only lasted for a few days and I think it probably was related to going off the Butrans pain patch.

I was nervous to tell Kristen about my decision to not get another epidural steroid injection since the last one didn't help at all - I stayed the same, pain-wise.  Well, I didn't need to be worried; she listened to me and agreed that another injection wasn't in order, whew!  I know everyone is really kind and caring at my pain management clinic, but I rarely challenge a doctor so this was hard for me to do.

Kristen was very thorough with going back through her notes, confirming pain levels over the last several months, and not only where I was hurting, but things like the pins and needles at my knee - did it wrap around the leg or was it only in the front?  Although it happens constantly, I didn't know - isn't that funny?  I got the answer a few minutes later when the pins and needles started again:  it's only on the front.  It happened off and on during the appointment and I was glad that Kristen could see the frequency and also how I wasn't doing anything when they began.  We went over my prescriptions; I was only on Gabapentin at that point.  Oh and four Aleve a day.  Even with that, I still hurt.

That was the talking part of the appointment; next I sat on the exam table while she tested my leg strength.  Then the fun began, with her pressing on my back to see where I hurt.  My back was barely an ouch, but when she got down to my hip area, or the sacrum as I have learned, there were a lot of ouches, especially on the left side.  Then there was more talking:  she suspected that the reason why the last injection didn't help was because the previous one had done the trick and the herniated disc and fragment had moved off of the nerve root.  So the injection did nothing because there was nothing to be done...in that area.

Jeff and I got an anatomy lesson at that point, where Kristen showed on a skeleton model the area that was hurting on me.  She explained that everything sort-of overlaps in the back and one issue can lead to another, and I was experiencing sacroiliac joint pain, or SI pain as it's commonly known.  The areas where I was still hurting (glute, groin, leg) can be caused by the SI, and she was pretty confident that was where my lasting pain was coming from.  Of course Jeff and I both said "wait, was there a herniated disc??" and she said yes, very much so, as shown on the MRI.  So while the herniated disc is under control (fingers crossed, PLEASE BE SO), now we can see that the SI joint is inflamed.

The treatment for this?  Taking Meloxicam, an anti-inflammatory drug, plus getting an injection in that joint.  Yes.  Another injection.  Yippee.  Obviously I am not thrilled about that because of how sick I got from my last steroid injection, but if this works I will be mostly pain free and that will be worth it.  The good thing about this is that if the injection doesn't work, there are alternatives, such as a plasma-rich injection - but that isn't covered by insurance so we might as well start with the one that is.  Hopefully the steroid injection will happen later this week; my doctor's schedule is pretty full plus he's on call at the hospital, so we'll see.

If it sounds like I'm throwing everything at this and hoping something sticks, I kind of am...with the advice of competent medical professionals, of course.  But I'm tired of hurting, I'm tired of not getting to do much because of the pain, and I'm tired of this dominating my life.

I'm still going to go to the neurosurgeon consultation appointment in September.  At this point I still want to hear what his take is on my injury and what he might recommend.  I don't think I need surgery but I'm not a doctor and I could be wrong - shocking, I know.