The next step…since the last step

I had another follow up appointment at Bone and Joint this week.  I am really getting sick of going and seeing them every couple of weeks.  This time was to talk about the effects of the steroid injection I got a week and a half ago.  I haven’t experienced the relief I had hoped from this treatment.  That sounds like a broken record.  This whole process has been less than I hoped. 

I talked with the doctor about the pain I was having.  We discussed the differences I experienced when I extended my back vs when I flexed my back.  Most of the pain I have right now is from bending.  The treatments up to this point have been geared toward pain during extension.  Does this mean that the treatments are working?  Does it mean that the core exercises I’m doing with PT are working?  Does it mean I just had a day when it hurt more to flex than to extend?  Who knows.

What I do know is that I still have pain.  The doctor is getting frustrated.  She pretty much told me that she thinks I should get a second opinion.  She knows I am frustrated and depressed and at my wits’ end.

We looked at the MRI images from back in May.  We talked about the torn annulus.  Her opinion is that the tear can be causing the pain when I bend forward.  The (conservative) treatment is to do an epidural.  The other treatment is spinal surgery.  She told me about her brother who is a spinal surgeon in Washington.  His patients are never allowed to run again.  I decided that spinal surgeons are the devil.

So, the next (last) treatment option that I have with this particular physician is to do an epidural injection on November 7th.  The process will be the same.  I’ll need a driver and I can’t eat or drink anything the morning of the procedure.  She will use a big needle, under X-ray guidance to get to the right area in my back (L5).  Here is an excellent website that explains the process of the epidural injection.  It will be a caudal injection, meaning that she will enter from the bottom-most portion of my spine.  My favorite part of this website is:

One study showed over 80% good to excellent results for caudal epidurals in managing back pain with or without disc herniation. These amazing results lasted for upwards of a year.

I hope that I fall into that 80%.  On a related note…is anyone available to take me to the appointment on the 7th?  My dad will be snowbird-ing in Texas by then.

I also talked with the doctor about my work restrictions.  She had written ‘moderate’ restrictions for me and my employer had been looking to get new, updated information from the doctor regarding my ability to perform my job.  I told the doc that I was able to do everything asked of me without violating the restrictions she had written.  So, she was able to return me to work without any restrictions…with the understanding that I am still going to be careful and not do anything that could cause pain or injury. 

The other thing we talked about was my running.  I told her that I was running a mile, slowly, most days of the week.  She seemed to think that this was fantastic.  That this was what I wanted.  I wanted to run.  I was reaching my goals.  I refrained from telling her what I really thought of her assessment.  Instead, I told her that I wanted to be able to train.  I wanted to really run.  She reminded me that running is putting a lot of pounding on my joints and my back.  But that she understands how much I want to be able to start training again. 

I am willing to adjust my expectations of my future performances.  I may never be able to qualify for Boston.  I may not be able to run a marathon a month.  I won’t be able to run seven days a week.  But I do want to be able to put in some quality training—speed work, intervals, long runs.  I want to be able to run a handful of half marathons a year and maybe one full marathon a year.  I feel like I still have PRs left in me.  I want to be able to work toward those goals.

In the meantime, she did say that I could increase my mileage by half a mile per day per week.  So, now that I have been running one mile a day for a while, I can take it up to a mile and a half.  Once I do that for a week or so, I can increase to two miles.  By then, it will be time for the injection. 

We are doing a family 5K Thursday evening.  There is a local Pumpkin Run.  Tim is thinking of shooting for a PR.  Jaden and I are going to run/walk it together.  At his pace, I shouldn’t be straining myself at all.  It is going to be nice to do an actual race, even if I won’t be racing it.  It is only my 2nd race of the year.  It will be Jaden’s 4th 5K of the year.  He is pretty excited.  I hope it doesn’t rain.  If it goes well, I may try to do another race with him in a couple weeks.  It is another local 5K we have done the last couple years.

Anyone else doing a Pumpkin Run?

Any experience with caudal epidurals?


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