Monday, March 15, 2010

A shot in the ass

Not the metaphorical kind but the literal kind.

Today, my doctor decided to finally listen to me.

After asking me every week if was "80% better? 90% better?" I finally stopped him and said, "You KEEP ASKING ME THAT! I know you WANT ME to be 90% better - I do too - but I'm not and I don't see any point in lying about it."

That stopped him in his tracks. He ditched his rush-rush attitude, sat on the table and looked at me. I breathed a sigh of relief. Dude, I've been trying to tell you I AM NOT SIGNIFICANTLY BETTER!

I explained the process of how my PT had stopped my previous relief strategies in their tracks when she diagnosed me with the SI joint problem and how that had increased my pain and created new pains because now I no longer had my short-fix, self-help treatments. I told him that yes, indeed, some of that had subsided but the fact remains that I have so many different pains that fluctuate on a day-by-day, week-by-week basis, as well as the original pains I visited him with initially, that's hard to say exactly what percent better I am. Depending on what measure you're using I could actually say I'm WORSE!

His feeling was that I was somehow stuck. I've done so much, had so many different kinds of treatments (CONTINUE to have many different kinds of treatments) and, while I may be progressing, it definitely seems as though something is getting in the way of me making that switch into real recovery.

I was all, like, WELL YES! THAT'S WHY I'M HERE!

In all fairness, I'm a new patient to him. He's been dealing with me since Feb 1, I've been dealing with me and this hip thing since October '05.

So, we skipped the osteo manipulation for today, since I don't think all that cracking was helping anyway. Doc asked me where the majority of the pain seemed to start from, where the worst of it was and I pointed to my right butt cheek - for the anatomically correct, my piriformis area. It pretty much never stops aching, being sore, and/or burning. He pushed in there too and agreed that it definitely felt hard and tight. (Again, I'm all like, YES, THAT'S WHAT I SAID!)

Then he suggested a cortisone shot. At which point my hands began to sweat, I began to hyperventilate and I said something pathetic like "I don't do needles. I don't do needles!" Despite his assertion that I "wouldn't feel it" (when do you never not feel a needle piercing your skin!?) I was still mentally figuring out how to get out of there without getting stabbed. Yet, he made a good point: I've tried everything else and if I want to get better I need to try everything. It could be that I have a chronically tight piriformis muscle and no amount of therapy is going to release it. The cortisone shot could be just the thing to chill things out and allow other affected parts to release, heal, and get better.

I had to admit that he was right and, with Jamaica looming on the horizon, the prospect of some relief for my vacation without hours and hours of working out or icing, sounded very attractive. So, I just made the decision there and then to do it. JUST DO IT! No pontificating or working myself up, get that damn needle in my ass, stat!

As it goes, it didn't hurt that bad. It did hurt though. But, I've had worse. (Obvy... I've had a hip surgery and a c-section.)

Doc said that my SI ligament is VERY tight (pregnancy?) and that this could actually have more to do with my pain than any skeletal misalignment. (I like the sound of that.) So, we're going to see how these cortisone injections work and he's going to do some specific manipulation when I come back, just for the SI ligament. In the meantime, no PT, light stretching and rest for my poor sore butt.

Am I noticing any difference? Sure, in the department of less stiffness/aching but right now my butt is sore from the jab itself, so it might be a day or so before I feel the real benefit.

I also had another Alexander Technique appointment today. Despite my mixed feelings from the last one, I actually felt like we made progress today, finding some key elements to my posture puzzle. Pelvic floor muscles and illiopsoas need to be engaged. This totally connected for me because I've had problems with tightness in these places also. Engaging these areas immediately lifted me off my lower back, made me feel taller, and reduced my heel-fall impact while I was walking. Amazing! Everything started feeling much more natural!

We also practiced standing up, sitting down, bending over, and picking up weights using the same techinques and I immediately felt the difference, as opposed to my back taking the weight. Next appointment, in two weeks, we'll get into picking up less stable weights of like, oh, well, 20lbs. I wonder why....?

4 comments:

Urban Koda said...

Of all the shots I've had, I must admit that the flu shot in my butt, when I was still a wee lad, was likely the least painful of all. But that said, there's the indignity of bearing it first... I guess in your case, a cortisone shot to help that area, really couldn't have gone anywhere else.

Still pulling for you!!

e said...

Did he use an anesthetic with the shot? They way they did it in my hip was that they mixed the cortisone with an anesthetic, and then pushed thru a few drops, waited a few seconds, then did a little more, then waited a few seconds, then the rest. But as I said before, I think this is a good idea. Especially right before your vacation - you know you're in pain when you refer to your vacation as "looming ahead," right?

Keep us posted, want to know how the shot works for you.

MACMD said...

@Elena - no he did not use anesthetic but then it went right in my ass cheek vs. in my hip. I think that the more muscle and fat the area has, the less painful. I would imagine that, being closer to the joint itself, it would have been different. My doctor is actually unusual in that he does minor surgical procedures right there in his office, so he was very sure-handed and quick. He pushed my skin away from the area, and put the needle right into the muscle, which is amazingly less painful than it sounds. When he popped it out and did a second blast in an adjacent area and didn't pull the skin as tight, it was a bit more painful.

e said...

That makes sense. BTW, glad to hear that Alexander Technique is helping. I went to an orthopedist re my SI joint, and the guy was a jerk, not helpful, and basically was all, Alexander Technique doesn't exist, and don't waste your money. Whatever, dude, you did shit, and AT actually helped. So bite me.

Keep me posted on the cortisone. It's supposed to take a week or so to begin kicking in and then a month to take full effect. But if it doesn't, then my wild guess is that that's not where the cortisone needed to go. But I'm keeping my fingers crossed.

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