Wednesday, January 16, 2013

The Physiatrist

So, I went to see the Physiatrist on Monday.  A Physiatrist is someone who specializes in rehabilitative medicine and pain management.  She noted the arthritis on my MRI and performed several physical tests.  She attributes my pain to the significant arthritis in my lumbar spine.  She wants to inject my lumbar facet joints directly.

This is the end of the road for me, doctor-wise.  The Physiatrist, the Orthopedist, and my GI doctor have all said that my spinal degeneration is due to my IBD.  I am not a good surgical candidate. There is nothing they can do, other than manage my pain.

But, I'm unsure about having the injections.  They're going to cost a fortune, and many people say they didn't work for them.  The first injection they gave me sure didn't work, and I don't know if I want to take a chance on another.

Other than injections, all they can offer me is lidocaine patches, narcotics and topical anti-inflammatories.  I can't take oral anti-inflammatories, because of my IBD, Chiropractors have never helped, and I already do physical therapy.

This really sucks.  I won't lie, I've spent several days crying about it.  It's not fair.  I've got shit to do, I don't have time to be bothered by a bad back that's only going to get worse.  And I don't know what to do.  I don't know whether to spend a small fortune getting injections that may not work, or to just keep soldiering on and hoping the pain will subside.

I do know that crying doesn't work.  It just makes my eyes all puffy and then I look ugly.

I also know that I'm going to get Spider to PSG, whatever it takes.  I've come too far and I've done too much to give up now.  Besides, my back doesn't hurt when I ride.  It's the tacking up, mounting and dismounting that do me in.

When I ride, my horse lends me his body for a little while.  I get to trade in my battered, broken, aching body for his strong, supple one.  That's better than all the narcotics and injections in the world.



15 comments:

  1. I have no doubt that you will accomplish your goals with Spider - none whatsoever. I hope that a method of resolving your pain issues comes to light in the meantime...

    Weird coincidence - my brother got MRI results back today saying his lower back pain was probably related to some kind of IBD related issue. He can't take painkillers as he is a recovering addict.

    If you don't mind me asking, what's the connection between the two, and have you by chance looked into the effectiveness of acupuncture?

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    1. I don't mind you asking at all. I try to very open about my disease, because I know that many people who suffer from it feel embarrassed and awkward in talking about it. I want to normalize it.

      IBD is an auto-immune disease. The afflicted person's immune system attacks their own body, and destroys it. Nobody fully understands how or why this occurs, but about 1 in 6 people with IBD will develop arthritis in their spine. (I guess I should play the lottery, right?) The connection is poorly understood, but it is there.

      I don't like the narcotic painkillers. I try not to take them. They just make me sleepy. I've had good results with lidocaine patches and Voltaren gel (it's a topical NSAID that, in theory, doesn't effect people with IBD because it doesn't really get into the bloodstream). I've also seen some studies that suggest Celebrex (an NSAID) can be tolerated in IBD patients who are in remission. I'm going to try it, and I'll let you know how it goes.

      I am looking into acupuncture, but haven't tried it yet. It's hard to find an acupuncturist down here in nowheresville.

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    2. I forgot, I highly suggest the Specific Carbohydrate Diet for anyone suffering from IBD. It has changed my life. I don't think that it's a coincidence that I'm having more problems with my back now, during and after the holiday season when I've cheated on my diet.

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  2. Good luck with figuring out how best to treat your back. Injections are funny -- sometimes they work and sometimes they don't. My husband has had his knees injected; one knee it helped the other not so much. I have every confidence that you and Spider will get to PSG. You are an inspiration even if you don't feel like it; especially on those crying days. When I feel achy and whiney, I think of you and tell myself to buck up and get over it.

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    1. Aww, jeez... just when I was done crying....

      Thank you so much for your kind words. I really believe that dressage is for every horse and every rider. I write my journey down because I know that if I can do it, anyone can. Dressage is not some mystical ninja discipline. It is just training and learning. We can all do that!

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  3. Have to suggest acupuncture again. If you find a good acupuncturist it can really help--potentially both the IBD and the back pain itself.

    Hard to say about the injections. I too have heard mixed reviews. My knees were definitely helped with injections at first, but over time the treatments became less effective.

    Crying is good sometimes as it gets rid of tension and some of the frustration. Don't ever be ashamed to just feel sorry for yourself now and then. You deserve it.

    As for PSG....here's a plus. It's not as hard as it seems and Spider's training is not too far off that level. As long as you don't aspire to qualify for the Olympics or something, you can get the two of you there pretty quickly. Take the pressure off and just try some of the movements from the test. It's kind of fun seeing how well you can do and I'm sure it will help build your confidence and make it all feel better when you succeed. And, once you practice ride the test, you'll realize that it's not as big a deal as we all make it out to be. It will put your goal into perspective and give you a feel for what specific exercises you need to do to put the test into the competition arena.

    And...it may take your mind off of some of your worries...at least for a little while.

    Sending hugs. When winter's over, I'd be glad to come on down to give you some encouragement....

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    1. I'm looking into acupuncture. And I'm not looking to get to the Olympics. I'm looking to take him as far as I can, before I break down.

      I'd like very much for you to come down and give me some encouragement, but hopefully I'll be up to the Horse Park soon and you can cheer me on there!

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  4. So sorry to hear about your back!

    But, I'm sure you and Spider will make it to PSG.

    If it helps any, my sister also has back problems.

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    1. Thank you! It always helps to hear about others who are going through the same problems. Sometimes, when you're dealing with these things, it seems like the end of the world. But, then you hear about someone else who has the same issues and is able to get through it, and you think "Hey, I can do this, too".

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  5. Hugs to you. You're going to make it, if only because it pisses you off when doctors say you can't.

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    1. Hehe. Nobody tells me what I can't do!

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  6. I second Acupuncture and specifically Cupping. My BF has IBD and back pain and is an Endurance Athlete, the cupping worked very well for him, he still has pain and some IBD symptoms but they are more manageable. For my shoulder pain I have lidocaine patches and those things are awesome, that coupled with Physical Therapy exercises and TENs unite have helped reduce my need of the lidocaine patches.

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    1. I'm looking into acupuncture, just trying to find a reputable practitioner in my area.

      Love my lidocaine patches! I've also upped my yoga routine. Yoga has always helped me in the past, I'm hoping it will continue to help me align myself properly. And I'm following my SCD diet, no more cheating!

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  7. What can I say that everyone hasn't already. You'll make it with Spider because you want/need to. Acupuncture can works wonders for pain if you find the right one. My daughter has a bad back and neck and it really helped her. She also had developed very painful fibromyalgia from a nasty untreated case of Lyme's. And believe it or not she did so much research and came up with a a cure for herself so she has virtually no more pain. I don't know if it would work for you but she takes Bragg's Apple Cider Vinegar in a glass of warm water everyday with local honey.

    As for the shots I think it depends. Sometimes they work and sometimes not. My sister had really horrible arthritis in her neck and the shots helped her along with pain management.

    I think there is always room for hope. There are so many new innovative treatments for lots of diseases that in the future there will most likely be a treatment that works for you. In the meantime if you feel like crying, go ahead you deserve a pity party once in a while. It's not easy to live with pain.

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  8. This might be a silly suggestion, but have you tried essential oils? I know Young Living has a pain relief blend called PanAway (you can get it in a knock-off too) that apparently works pretty well. Worth a try?

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