Thursday, April 24, 2014

I Have a Ruptured Donut

Guys. Ready for another round of Julia wah-wah-wah? No? See ya'll tomorrow, then. on......

I have been in denial for the past six to eight months about this nagging back pain that turns into a numb right leg and foot after I walk it around. In defense of my denial, this showed up during a period when I was feeling crummy overall and wasn't doing a lot of walking around anyway. Then after my rituximab infusion and it's accompanying higher doses of prednisone, it all went away. Ahhhhhh. 

I forgot about it briefly until the pain and numbness returned as I tapered my prednisone dose. Rats. So during my last visit to Dr. Young Guy, I 'fessed up, and he ordered an x-ray of my back and made a referral to a physiatrist for me. 

What's a physiatrist? I asked suspiciously, thinking that the name sounded psychiatrist-y. 

"It's a physician that's received special training that combines orthopedics and neurology. They do lots of rehab work." Oh. Spiffy!

I received an appointment quickly, and last week met my very own physiatrist physician, who turned out to be even younger looking than Dr. Young Guy and equally nice. He listened carefully to my litany of symptoms, made a physical exam of my back and hips, then put me through a series of bizarre exercises to determine the type and extent of my issues. He made the mistake of asking the perfectly logical question, "How far can you walk before the numbness in your leg and foot begin?"

But since I was totally tired out from all that bending and stretching and walking tippy-toe, at that point the dreaded TIRED = STUPID factor came strongly into play. Um....I don't know. It doesn't seem like very far. I'm a really rotten distance estimator

He was a very patient young man. "Just try to describe the distance the best way that you can."

Well. You know when you go into one of those huge grocery stores? And you go in the door closest to the bakery? And then you go through the produce department and past the meat and dairy and end up by the frozen pies? 

He just looked at me. I couldn't read his expression.

You know. The pies in the frozen foods section. So it would be the distance from the parking lot, through the bakery and all the way to the frozen foods. I can't even do one whole lap around the grocery story periphery.

"O-kaaaaaaay," he said. 

We were silent for a brief period. I think he didn't quite know what to make of the information that I just given him. I was glad that he didn't do a facepalm or start to laugh. What a guy.

Then he gave me his opinion: "I think what you've got going here is a ruptured disk between two of the vertebrae of your back. It's most likely between the last of the lumbar vertebrae and the first of the sacral ones." He grabbed a plastic and rubber model of the spinal column complete with spinal cord, nerves, and a conveniently herniated disk. He bent the model spine as if it were a person hunching forward, and whoa! That little blue herniated disk bulged prominently to squeeze the nerve directly behind it. It was pretty gross, actually.  It looked kind of like this illustration from the Mayo Clinic, found here.

Here's how Mayo defines my back problem:
A herniated disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine. 
A spinal disk is a little like a jelly donut, with a softer center encased within a tougher exterior. Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer "jelly" pushes out through a crack in the tougher exterior. 
A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. Continue reading here
A jelly donut. I have a ruptured jelly donut. Hm.

I'm so pathetic. This knowledge made me want to immediately drive myself over to Krispy Kreme. But I didn't. Yay me! I would have patted myself on the back but that would have hurt.

He gave me some specific exercises to do, several postures to strictly avoid, talked about the use of heat and or ice, and made a return appointment for me. "Most people can heal these disk problems without surgery or injections. I'm hoping that you can too. But we'll keep a close eye on things to make sure," he said as he handed me a stack of papers that thankfully had all of the information written on them that we had just been discussing since I was still firmly in stupid-land at that point.

Good grief. Wouldn't you know this dumb stupid back thing had to show up just as my rituximab energy is beginning to kick in?

Does anyone have a ruptured jelly donut story with a happy ending to share? As in: their disk healed itself up just fine and dandy without surgery or injections?


I could really use one of those right now.


Betsi said...

Hi Julia! I had a herniated disk in my cervical spine years ago that was causing numbness, tingling and pain in my left arm and neck. Because I have MS, I thought that was the cause and didn't get it looked at right away. By the time I did, it was already starting to improve on its own. I went for PT, and the therapist said I was instinctively doing the "right" things--but added more exercises, like hanging my head off the side of the bed for several minutes. It did eventually heal completely and never came back. Good luck with yours!

annie said...

Hi Julia,

I had herniated discs with sciatica about 10 yrs. ago in L4-L5-S1 region. I went through about 9 months of osteopathy and when they couldn't do any more for me,many months of pysiotherapy at the hospital. For someone who thought she would remain a cripple, because I could not sit, stand, sleep, or do any movement as all would give me excruciating pain, I'm happy to be where I am today.

The good news is that you do get better with time, but it does take time. The body does heal itself, however you still have to be careful because any extra strain or bad movements will cause pain in that area.Don't have surgery unless it's your last resort as herniated disc comes back, so just take care of it with exercise with a specialist. Good luck.

ShEiLa said...

Oh dear... We have so much in common I surely hope I don't add this to the list anytime soon. I saw my rheumy today and I am sufficiently discouraged as it is. My issue is pain... All over pain. We are going to give Methotrexate a go... So now I can add blood draws every two months to my list of things to do while living an hour away from even a Quest Lab.... Good grief! Plus the desert summer has started sooner than I had hoped.... Actually my hope would be to have no summer at all. Wah.wah.wah.... Sheila style. ((hugs)) and good luck!

Anonymous said...

I've had a "bulging" disc just above my tailbone (see for various disc problems) for over 30 years, which flares up from time to time. I've had PT for it several times, so now when it starts, I put heat on it and use muscle relaxants that help. Last fall, when my usual treatment did not improve it, I saw the osteopath that practices with my primary care doctor. With just 2 visits, she had it feeling much better!