More MRIs Next Week - Hip And Lumbar Spine
Friday, October 16, 2015
First, let me thank those of you who have been there for me on this seemingly never ending quest for good health! If it weren't for all of you, I wouldn't be as hopeful as I am currently.
Now, down to brass tacks! Hubby went to the pain specialist with me this morning. He had two customer sites near by, so we went together. I told my doctor what the orthopedist said during my visit yesterday. I said that the knee's MRI showed a tiny meniscus tear but that the prosthetic looked close to perfect so the knee wasn't likely to be the source of my pain. Then, I discussed the fact that the orthopedist only used X-Rays of the hip to diagnose that there was no problem with the hip either. The X-Rays show no malformations or questionable areas in the hip. I was not happy that the orthopedist didn't pursue the hip more aggressively. He seemed to pin all of my issues on my lumbar spine and he commented about how out of shape my leg muscles are. Duh! I spent the last 5 months in bed with my legs elevated, when I wasn't as a doctor's appointment or at physical therapy! My orthopedist seemed glad to label my issues back related and hand me off to a pain specialist.
My pain doctor is super smart, gifted, funny and compassionate. He teaches neurology and other topics at one of the medical schools. He really knows the subject matter and how the body's nervous system works or doesn't work. He listened to what I had to say and asked me lots of questions. Some I could answer and some I couldn't answer. The tests/exam that my pain doctor did was quite different than what the orthopedist did. He had me stand on my toes and then stand on my heels (which I couldn't do with my left leg). He had me put the ankle of my left leg on my right knee, then he pushed down on my thigh (no pain with that one) He pressed on the bursa of both hips (sensitive on both sides). Finally he had me graphically trace on my own body, the route that my pain travels. He asked about my balance and foot drag and tripping. We discussed the way that my knee buckles and if my foot drags at the same time. He was very thorough in his exam.
Then, he sat down with me to talk about what he saw. He feels that I have two different problems. The most concerning, because of the fact that I have fallen a bunch of times, is the problem with the lower back. Since I was born with congenital spinal stenosis - a very small opening for my spinal cord inside my spinal vertebrae - I most likely also have very small openings for the nerves to branch out through to get to all of my body parts. If one or more of these nerve branches becomes inflamed, it rubs against the opening. He showed me a very cool model of the spine and showed me where it probably rubs. That nerve branch can't work properly and so my muscles appear weak and don't function appropriately. Thus, my knee buckles and I trip over my feet and fall.
Then, we discussed the second issue, which was the huge amounts of debilitating pain in my hip, thigh, groin, knee and the sciatic pain that goes down the outside of my leg and into my ankle. He feels that most if not all of my pain is coming from my hip. The most telling symptom is the groin pain that never seems to go away. That pain radiates across the thigh and down into the knee. It wakes me up every two hours at night and make walking, sitting, standing and even laying down uncomfortable.
We decided that I would have an MRI on both the lumbar spine (to rule out any recently developed abnormalities) as well as on my left hip. (To rule out recent injuries, growths, tears, breaks etc.). If there are no new abnormalities with the lumbar spine, he will treat the swollen nerve branch with a steroid injection to reduce the inflammation and promote healing. As for the hip, treatment will depend upon what shows up on the MRI. He may be able to inject the hip or he may be able to do a radio frequency ablation. He plans to do another ablation on my lumbar area as well as my cervical spine somewhere down the road.
I am thrilled that we have a plan for information gathering and treatment. I am now using a walker around the house to even out the pressure that I put on my shoulders. Using the walker should also encourage more even weight distribution as I walk and the walker is more stable and reduces my falling risk slightly. My two MRIs are scheduled for next Friday. I am feeling much more hopeful!