Yes I Do Have Back Pain In The Middle of My Back

Yesterday I went back to my pain management nurse practitioner yesterday. I felt like it was pulling teeth to get her to admit that there might be an additional source of pain in the thoracic area if my spine (that's the middle part - lumbar is the lower part, cervical is the upper part including your neck).

She saw my x-rays which my rheumatologist pointed out to me as showing possible sources of pain. She didn't think they could be causing that much pain. She did push on my back to see if it hurt (how thoughtful of her). She nearly pushed me across the room as she pressed on my spine. Yes it hurt. A lot.

Finally she agreed to recommend that I have an MRI on my spine to see if anything had changed in nearly 8 years. Its about time.

I keep saying I get new areas of pain and pain management seems to want to prescribe medication to me and give me injections. They never seem to want to look at the areas that might be causing pain. Whenever I say there is new pain, I get these responses "its your fibromyalgia in that area", "its referred pain from this other pain", "there isn't pain in that area".

I think that there is new pain obviously and finally they are going to look at what is going on in my back. At first the nurse practitioner wanted me to come back and see her after the MRI, but then she said I should see the doctor himself and see if he can do trigger point injections there to resolve the pain.

So now I have the date for my MRI (after Thanksgiving), do I want to call my pain management doctor or do I want to try a different pain management doctor to look at the results? A dilemma for sure.

In the meantime, I am sitting down because my back is hurting a lot in the middle where I have been telling them about.

Pain Management

There is a lot of information on pain management. I even have a pain management doctor. But what constitutes pain management? I have several prescriptions for pain management - patches, pills, etc. I go to the gym and exercise to help control my pain. I do regular stretching and exercises for pain management.

As you can see, pain management is not just about medication and injections. I want more than that. But I am not sure my doctor understands that. If I go to my pain management doctor and tell him my pain is acting up, he always tells me the same things:

• Don't sit around, get up and move.
• Here's more medication.

He never says lets take more pictures. Or 'let's see if there is anything else new'. Never. He just says here's more meds. Either shots or pills. I think I want more.

I did blog about this in a long day of doctor appointments. I saw his nurse practitioner about 2.5 weeks ago. All she did is order x-rays and upped my pills. My complaint is that I have new back pain higher up in my back. She is thinking fibromyalgia. I am thinking new issues. The x-ray did show some degeneration higher up in my back. I looked up what the x-ray showed and it has nothing exciting to say.

So why does my back hurt there? Fibromyalgia doesn't cut it for me. I know what fibromyalgia feels like. Trust me, I do. And my doctor and his nurse practitioner do not as they do not have it.

For the record the new x-rays were compared to my x-rays taken in December, 2008. That is the last time there were pictures taken of my back. It took an MRI then to tell us the whole story. I think I want an MRI to prove to me that there is nothing new going on. I think if you are being treated for something, you should get scans done periodically to make sure nothing is new.

I understand the over testing/over-diagnosis issues. I get that part. But since I was diagnosed with back issues in January 2009, I have been diagnosed with fibromyalgia, rheumatoid arthritis, have had several falls, and a few million other ailments.  Its not like my back pain has lessened in the intervening years. It has increased. You can't keep just upping the meds without further examining what is going on.

When I made my last appointment with the NP, I was told that my doctor has said that if one of his patients sees another back pain doctor, they can't go back and see him again. That's a bit to proprietary for me. I should be able to see another doctor in the department if I can't see him. Also, when I saw  his NP that is the second time in all these years that I haven't seen him. One other time, I saw his physicians assistant and that was years ago. I think I'm done.

I go back and see the NP next week. If she doesn't send me for an MRI or other scans, I think I will find a new pain management doctor.

The Political Season

We are far into the political season. I am just happy it will end in six or seven weeks. I don't know how soon it is and I don't really care. I just know the following:

• When voting for a candidate you are not voting for the best, you are voting for the least worst. This is especially true this year. No one is running around saying which candidate is better. They are only saying which candidate would be the least bad.
• We all have the opportunity to weigh in on election day by voting. I am not interested in discussing anything political and especially will not have any conversation with someone who doesn't vote.

That's it. You have time to educate yourself on the process and the issues now with enough weeks left to learn about them. So go forth and educate yourself and then make your choices (silently) and you have done your part.

I am so frustrated with the entire process this year, I am not interested in discussing it. I am not happy with how the campaigns have progressed so far that I just am going to ignore the whole thing and vote on election day.

I had thought I would watch the debate tonight and then thought not and then wasn't sure. Its supposed to be HHHUUUUGGGGEEE! But then the decision was taken away from me when I was scheduled for an MRI tonight at 930 PM. I will not be able to watch it. I need to leave here at 9 PM and then will be done around 1045 PM.  I still may DVR it so I can watch it another time. Decision made

I was thinking it was unusual that I could get an MRI on such short notice but I think I figured it out.

Politics over for me. Just go vote.

Not A Good Week Ahead

This coming week is going to be long, stressful, and sleep deprived. I don't know what I was thinking but I think the real answer is I wasn't thinking. This is my week:

• Saturday (today) - craft show where I will have a table all day
• Sunday: Lunch and dinner reservations with two different groups of people. Lunch at noon and an early dinner at 4 PM. 
• Monday: 930 PM MRI for my neck. I should be home by 11. I never stay up that late.
• Tuesday: Deep cleaning at the periodontist with novacaine. How fun! 
• Wednesday: The only good day because there is nothing on my calendar
• Thursday: Lunch plans with a friend. Sleep lab overnight to see if there is anything else wrong with me. This means another night of not enough sleep.
• Friday: Leave the sleep lab at 630 am and go directly to the gym.

What was I thinking? I don't know. I need to allow enough time for plenty of sleep each week. Monday morning I hope to sleep late. I also hope I can sleep in on Wednesday and Thursday since I will be up too late and do not expect enough sleep at the sleep lab.

My goals then for the week: focus on getting enough sleep and rest and pretend nothing will hurt. This is just a lot of poor planning on my part.

More Needles????

I hate needles. I really hate needles. If a needle is near me I can't look. If a needle is near anyone else, I leave the room. (Actually sewing needles and knitting needles are fine. Its those icky medical ones that cause me problems.)

Now it looks like more needles are in my future. Ick. Double ick!

Yesterday I went to see neurosurgery because of increasing pain in my neck. Real pain in my neck, not the literal kind. I do have to deal with the literal pains in the neck (like insurance companies, hospital billing departments, and poor bedside manners). Back in 2014, I was having problems with my right arm. I was sent to see a neurologist to see if there was something going on back in my brain to cause this. (A subtle way to see if there was a 'thingy' in my brain.)  There wasn't anything in my brain (except my brain) but there were disc protrusions and bone spurs on my neck.

Jump ahead 2.5 years later and I have increasing pain in my neck, shoulder, and arm. My primary care referred me back to neurosurgery. The neurosurgery physician's assistant said the following:

• Your body may reabsorb disc tissue but will not reabsorb bone so its not going away anytime soon, probably not ever.
• Physical therapy may help so we are going to try that.
• They want a new MRI of my neck (and brain) to get another picture of what's going on and see if there are any changes (read that as growth).
• The next step is needles in my neck sort of like what I get in my spine.

I am overjoyed. I can't wait. But I guess I have to realize that I can force myself to deal with needles if it means the pain might go away lessen. That is my dream actually for a pain free, healthy body. So I guess I have to stick with needles (that is such a bad pun I have to leave it even though its not what I meant to say. What I meant is I have to cope with needles.).

$1500 for an MRI

This was in the Boston Globe on June 12, 2015.

I had to post it. Too funny.  But not funny 'ha ha'.

Up before the birds

This morning I got up at the perky cheerful hour of 430am. And it was intentional. Why you say? Because I had an MRI of my elbow.

I always take the weird time MRIs. MRI machines need to run continuously because it takes too long to shut them down and bring them back up again. There are always appointments available in the middle of the night or on holidays. I once had an MRI on Easter Sunday. Easter isn't a big deal for us so I didn't mind.

I digress. This morning I was up before the birds. It was dark and quiet when I went out my door. The sun was just beginning to come up but I didn't get to see the sunrise. It was dark when I got there with just a hint of the coming day.

So anyway, I bet you are dying to hear about my elbow. This is the same elbow that had tennis elbow a couple years ago that came back again. I wear a splint often on my right hand because of the tennis elbow and arthritis. Recently I discovered I had a bunch of cysts on my elbow. My PCP and rheumatologist said to keep a eye on them and let them know if they get bigger or hurt.

Of course they got bigger and hurt, especially when they get squished. Note to self, don't squish the  whatevertheyares or they hurt for hours. But we don't know what they are. They could be cysts. They could be rheumatoid nodules as a side effect of my methotrexate. But cysts and nodules don't hurt when squished.

So the mystery looms. I had an x-ray earlier this week and had the MRI this morning. We should know results next week. This may mean changing my RA treatment... But if you have had breasts cancer you can't have a lot of the newer biologics. So the fun continues.

Now I might need to go to bed early to make up for getting up so early.

My husband thinks I should get to  name my  new ailment because its probably something weird. And with everything I have I should get to name something after me...

Caught up on my magazine reading

At the dentist office the other day, they were running a few minutes behind. I seized the opportunity to read the latest issue of People magazine - always full of intellectual discourse. I did learn that Lindsay Lohan has a girl friend. Do we care? Not really, but apparently her girlfriend is helping her clean up her life finally. What is she 22 and already done a few stints in rehab? (I think I have that right but maybe not.)

Yesterday I got to read another issue of People magazine from last fall - the one where Britney lost custody of her children - while waiting for the doctor. I don't think she has custody back. (Another 20-something who has already been through rehab. Grow up why don't you?)

Then due to the rain, I went to the gym instead of walking outside, and read my latest Newsweek and Business Week while on the treadmill. I also read Cosmopolitan Jan 2008 issue. It contained their annual astrology predictions for the year. Apparently 2008 is supposed to be a good year for me - well, I'm still waiting for the good part.

My new doctor was actually very nice and very thorough. She sent me for another MRI of the hemangioma on my liver in early September. It should be nice and stable and then I don't have to worry about it. On the good news, I don't have hemorrhoids. No, I have an anal fissure. What is that? Exactly what you think. And its a royal pain in the butt. I get lovely goo to put on it for a few weeks and if it doesn't suddenly decide to heal in the next few weeks, I get to go see a surgeon for more tests. (Gee, I can't wait.)

On the other hand, I can try stop taking prilosec for heartburn from my hiatal hernia. I would prefer not to take medication daily if I can get away with it. So we shall see what happens. Also, she thought the weird achy spots in my abdomen are not related to my digestive tract and probably muscular/skeletal. I will keep track of them and see what happens after surgery. They could just be related to my friendly little gall stone. (Perhaps I should name it - hmmm... I will think about it.)

Otherwise, today is just another boring day in my life. Walter's car is in the shop so he is taking my car. I am trapped at home with the cat and my computer so I will have to work all day and provide kitty treats at frequent intervals so I won't be pestered. Then I am meeting a friend for a walk - if it ever stops raining. Its another tropical summer in Boston. High's in the 60's and rain. We do get hot weather but not this week. (Wednesday's high I think was officially 69...) I've been wearing sweaters.

Got to meet lots of doctors

Yesterday I spent ALL day at Lahey. What fun. In the morning I had an EMG to find out about hopefully unrelated tingling in my left leg - probably caused by bursitis or a pinched nerve. However in view of everything else that is going on, I need to have a follow up bone scan next week to make sure.

Then we met with the surgeon, radiation oncologist, medical oncologist, and social worker. Apparently the good news is they caught it early, it is small, and is positive for estrogen and progesterone reception which means it should react well to hormone therapy. Also good news is they took off the damn itchy steri strips. Then the bad news. The MRI last week picked up a suspect area that is also located in my left breast which needs a further look so I have another ultrasound and possible needle biopsy tomorrow - which means more DAMN itchy steri strips. If that is positive, I am a candidate for a mastectomy instead of just a lumpectomy. I should know more late this week or early next week. I have since found out that MRIs show false positives - pick up something that isn't really there. I have already had two mammograms and an ultrasound that didn't show this so it is possible that it doesn't exist. Power of positive thinking here. Either way I go back to the surgeon on the 14th for decision time as well

More stress, more waiting. Desserts is stressed backwards - I don't really like dessert that much. What other junk foods spell something related backwards?