It wasn't long before we were called back. Dr. R's assistant weighed me on the oldest looking scale I've ever seen. That didn't really surprise me, as I noticed a bona fide type writer in the office when I was there for my consultation. Hey, whatever works. Dr. R came in and introduced himself. He looked young. He is young. In fact, he's younger than I am. He asked that open-ended question of "So what's going on? Tell me about your pain." Well, first of all, Dr. R., it's interesting. Actually, I didn't say that. I explained, as best I could, the whole sordid tale. He had already been briefed by Dr. Houze and I believe had some communication with Dr. Kaeser's office. But he was very thorough in assessing my pain. He was so thorough he reminded me of one of some of my nursing students. They often go in to do their first head-to-toe assessment of a patient and they are so thorough. They don't want to miss a thing. He was just like that, and I appreciated it. I'm sure he'd been warned about the complexity of the case and perhaps even my persistence in wanting to find a cure.
He did the usual chiropractic assessment. It's strange to type that, as before all this started I had never really had any chiropractic care. And if you haven't, you're probably missing out. Anyway, the drill is basically that they check your spine, your neck, and then they zero in on the problem. They test the strength of your legs, and they ask if anything makes the pain worse. Some things did, on the right side. Certain ways he was stretching my leg back. He silently made notes, and then told me about the course of treatment he recommended. We would try some TENS (transcutaneous electric nerve stimulator) treatments, adjustments, and ART (Active Release Therapy). He's kind of a quiet one. I asked him about what he thought was going on--where's all the pain coming from, and what about all that rib pain I have? And why am I pretty much no better after the cortisone shots? He actually explained it really well. I have always referred to it as "ab" pain, and I had my injections done in the main ab muscle, the rectus abdominis. His assessment of me, though, revealed that my psoas is quite weak on the right, and there's a trigger point there. I had sort of thought something was up with my psoas through reading about trigger points, but was just so locked in on this being an abdominal muscle problem. I pointed to this hard ridge on the right side, where it hurts so much. "What is that?" I asked. "That's your psoas." Well, let me tell you, THAT'S where the problem is.
When he did passive stretching of it with his hand on it, it hurt like a mother deep in my abdomen. He explained that the psoas attaches to the ribs and the rectus abdominis. If in spasm, it pulls on them and causes pain there. The nerves between the ribs get involved, and the pain just spreads anywhere it can, including to the left side and up into my shoulders. As you can see in the picture below, the psoas is a thin muscle which runs sort of behind the rectus abdominis--it's a deep muscle that can be felt in the back and the abdomen--right where I have pain.
My right psoas is rock hard. I am not exaggerating. It's stiff as a board and it hurts when there's pressure applied directly to it. I know this because Dr. R did some ART on it. OUCH. But he was right on it. You know what this means, right? I need my psoas injected with cortisone, and not my abs. The psoas is in a serious state of spasm and inflammation. It's pulling on everything. But I can't have anymore injections until March 23. For now, I have to do my own trigger point therapy on it and see Drs. Houze and Russell a LOT. Even though I'm frustrated that I'm still hurting, I keep making baby steps forward. We've gone from having no idea what I have, knowing it's some kind of MPS, thinking it was purely abdominal MPS, to now knowing that it's likely quite isolated to the psoas. I can't wait to tell Dr. L so he can stick me with a bunch of 14 gauge needles there.
I've never had TENS therapy before. Dr. R hooked me up, turned up the juice, and told me to tell him when I could handle no more intensity. Well, I never got to that point (I'm used to this part of my body hurting all the time). He finally made the call to not increase the intensity anymore. He left the room and set the timer for 10 minutes. It was mild at first, kind of like tingles. Then, oh my word, it felt (and looked) like someone was kicking me in the side. It was unbelievable. I loved it. Beat that pain right out of me!
He also ordered an MRI, which I'm having on Monday. I can't wait to see the results of that. I don't see how it could be normal. After Dr. R was finished with me, we stopped by Indiana Running Company and Tim picked up the new NB Minimus trail shoes. Then we headed to the trail for 12 miles with dad, Wes, Scott, and Emily. Beautiful day for a trail run, and the trail was perfect--soft enough to feel great on your legs, but not so soft that you had to work too much harder. I didn't mind the hills. The county runs I've been doing are really paying off in that regard.
It still hurt. Especially in my ribs. It worsened in the last few miles, but even I couldn't help but enjoy myself. 20 tomorrow with Tim, Bill, and Kathy.
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