Monday, April 11, 2011

Doctor Number 10

Throughout this process, I have seen 9 doctors/practitioners:

-a GP
-a Sports Medicine Specialist
-a GI Specialist
-4 Chiropractors
-1 PT
-an anesthesiologist/pain specialist

I have had an ultrasound, MRI, CT scan, HIDA scan, and a colonoscopy.  All of which have been unremarkable.  But my pain continues to be there.  So today I saw doctor number 10, a surgeon.  A good one.  And he doesn't think I need him.  He, too, thinks my problem is musculoskeletal.  That running (and anything involving impact) causes spasms in my abdominal muscles.  He is going to contact my pain management doctor and discuss me taking some systemic steroids, as well as some Neurontin.  He also thinks I need to take those and not run for 4-6 weeks.  I'm supposed to let my injury heal.  Even though that probably won't work (it may help, but won't fix it), as they all tell me that myofascial pain syndrome is not reversible.

But what is my injury?  It's not a torn or even a strained muscle (MRI ruled those out).  And which muscle is it?  It's deep in my abdomen, and high up under my rib cage.  It's somehow connected to my diaphragm.  I've injured my diaphragm?  What?  Basically, he is not willing to do an exploratory surgery.  I have nothing that would put me at risk for adhesions (no previous surgery), and no symptoms other than pain that increases with activity.  He did throw around the word fibromyalgia (though my pain doctor never has, and I think he would have by now).  He said I need a long period of rest, coupled with systemic anti-inflammatories, to let myself heal (as opposed to just treating symptoms).  It might help, but it's something I'm going to have to keep managing.

As I sat there, I wasn't really upset.  I do not want to have surgery just to have it.  I was (and still kind of am) just so convinced that something is VERY wrong inside of me.  I want whatever it is to come out.  But if there's nothing to come out...well, he's right, I don't need him.  The conversation involved talk of TENS units, how effective they are, etc.  And I began to realize "I am a chronic pain patient."  I am.  My pain can be treated, but it can't be fixed.  I actually feel relieved being able to admit that.  Every time I've had cortisone injections, I've been waiting for that pain free moment to come.  It hasn't.  And Dr. L told me it wouldn't, but I didn't believe him.  Now I do--and I realize I need to use the injections as a tool, not as a cure-all.

I am still going to meet with my OBGYN to talk about the possibility of endometriosis.  And I can't really tell you what I'm going to do beyond May 1.  I'm so emotionally drained that I may need the 6 weeks off anyway.  I also think "Well, fine, I'll just buy the best TENS on the market and keep on running."  The TENS makes it tolerable, but it doesn't make it good.  I miss good runs, and I don't know how to get them back.  At some point, I'm sure I'll finally break down and rest.  But I can't think about it right now.  I'm too geared up for my first marathon.

I had an appt. for cortisone injections on April 20th.  I changed it to April 25th.  I do seem to get some relief from the injections, but it's quite fleeting.  That is about as close as I can be injected to actual marathon day.  I hope it proves a good decision.  At this point, I'm just praying for a decent day pain-wise on May 1.  I'll be relatively rested from taper, so maybe that will help.

They tell me it's fine to keep on running in the TENS unit, and I guess there are worse things in life.  Also, on every TENS unit I've seen, it says "Do not use while exercising."  Oops.

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