Health update

 

The good news first:  thanks to a very competent and experienced pain management specialist, it looks as if the specific problem(s) with (or, rather, near) my lower spine have been nailed down at last, and a treatment path is opening up.

The bad news:  it's taken three years of visits to successive specialists such as neurosurgeons, neurologists, etc. to get here - and not one of those specialists identified, or even hinted at, the actual problem!

(Pause here while I spit in disgust, rinse my mouth out to get rid of the bitter taste, and catch my breath.)

OK.  As most readers will know, three years ago I began experiencing much worse pain than usual in my lower spine.  It had been painful since a severe injury back in 2004, followed by spinal fusion surgery, but it had settled down into a dull roar, with periodic episodes of greater pain.  The increased pain led me to ask for a referral to a neurosurgeon to figure out what was going on.  Over the next couple of years I saw two neurosurgical practices, one neurosurgeon, several radiologists, and some physical terrorists therapists.  They would all mutter about spinal deterioration above the site of the original fusion, but none would commit to what, precisely, needed to be done.  Instead, they kept referring me for additional CT scans and other investigations.  I came to the conclusion that they were reluctant to commit to surgical intervention because they couldn't precisely identify which vertebrae needed work.  If they operated, and I had to pay a great deal of money, but no improvement resulted, this would be problematic for them.

Earlier this year I asked my local physician to refer me to a pain management specialist.  I was popping Tramadol in multiples every day, and that's not sustainable in the long term.  She put me in touch with a fellow former South African, Dr. Theodoor Hancke, at Genesis Wellness and Pain in Wichita Falls.  I'm providing his name because he's a darned good doctor, and if you have severe pain problems and live within travel distance of Wichita Falls, I hope you'll contact him.  Tell him I said to call.

Dr. Hancke referred my CT scans to a top neurosurgeon in Dallas, who responded that in the absence of any certainty as to the precise location of the problem, he could not recommend spinal surgery at present.  Fair enough, I guess.  In the meanwhile, Dr. Hancke administered a Caudal Epidural Steroid Injection to try to reduce pain.  That worked for several weeks until the pain came back, so he repeated the process a second time, with similar results.

It was at this point that we heard from the neurosurgeon in Dallas.  Both Dr. Hancke and I were getting very frustrated at being unable to reduce the level of pain on a longer-term basis.  He suddenly asked me, "What about your sacroiliac?  Any problems there?"  I said that yes, I'd had a few, but...  Before I could go on, he made me take off my back support brace, turned me around, and stuck his fingers into the sacroiliac joints on both sides of my pelvis.  It hurt like hell, and I said so!  He grinned, and said that this opened up a whole new perspective on my problem.

I'm not a doctor, so I'll let Wikipedia summarize the problem:

• Sacroiliac joint
• Sacroiliac joint dysfunction
• Sacroiliitis
• Surgery for the dysfunctional sacroiliac joint

For a more authoritative (but still easy-to-understand) medical perspective, see "What to Know About Sacroiliac Joint Fusion".  It has a useful, informative video as well.

The infuriating thing is that my symptoms are an absolutely 100% fit with those described in the medical literature.  Why the heck couldn't all the so-called "medical professionals" who'd examined me and my CT scans have picked up on that?  I think it must be that they "locked in" on the fact that I'd had a previous fusion, and my current problems were in the same area as that previous site.  They couldn't look beyond the spine to consider other related issues - which makes me even more angry, because the medical literature indicates that well over 30% of those who undergo lumbar spinal fusion (as I did) subsequently experience sacroiliac problems.

Dr. Hancke, being a pain management specialist rather than a neurosurgeon, was able to "think outside the spine" (you should pardon the expression) and find a way forward.  I'm just sorry for three wasted years until I met up with him...  At any rate, last week he administered the first of what should be two, or at most three, steroid injections into both sacroiliac joints.  It's already had a dramatic effect on my pain levels, cutting them in half.  If, after it wears off, another injection has the same effect, that will probably be sufficient evidence to move forward with fusing both sacroiliac joints to provide long-term relief.  Not only will that be a less painful surgery than spinal fusion, but recovery time should be much shorter - and costs will be lower, too, which is a great help!

Anyway, that's how things stand at present.  I'm very pleased to be able to report what I think is significant progress.  God willing, and all other things being equal, by the middle of next year I might be in a much better position as far as my overall health and levels of pain are concerned.  There are, indeed, additional back problems that will probably require surgical attention in a few years, but that can be postponed until it's absolutely necessary.

Thanks again to all of you who've kept me in your prayers over this, and contributed to my fundraiser for related expenses.  I'm deeply grateful to you all.

Peter