I decided to use a benign floral image for this post rather than recycle one of my x-rays. That photo reminds me that there is truth, beauty, and comfort to be found in places outside myself. Right now I find little solace on the inside.
I am still contending with orthopedic pain that is trending toward chronic pain. More of my problems have been revealed through recent doctor visits. All of these issues are just different facets of the same stone, but the substance of this stone resists identification.
My lumbar spine issues were partially resolved through the L4/L5 fusion surgery I had back in March. When I look at my orthopedic visit summaries, I don’t like that diagnoses like “lumbar spinal stenosis” and “radiculopathy” are marked as resolved, as if my surgery totally alleviated those issues. In truth, the surgery repaired my worst disc space, but I have three more problematic discs. My MRI from December of last year revealed that I had four bulging or ruptured discs in my lumbar spine. The degree of deterioration between L4/L5 was far advanced compared to the other discs, so it was chosen for surgical intervention.
My recovery was progressing better than expected until August when the pain I used to feel while standing in place came roaring back worse than I’d ever felt in the past. This is admittedly a strange problem: when I am resting or walking quickly, the pain I feel is minimal or nonexistent. Moving slowly or standing in place becomes very painful within a couple minutes. We’ve all known the mental agony of waiting. It’s like this pain is that torment made physically manifest.
This disappointing development is odd considering that the serial x-rays after my fusion show that the area is healing and fusing well. My spinal surgeon referred me to another doctor in the orthopedic practice, one who focuses on hip and knee problems. The hip/knee doctor diagnosed me with (and this is a mouthful, admittedly) iliotibial band syndrome with sartorial strain. He prescribed physical therapy for this problem.
The exercises I learned in my PT sessions have helped resolve much of the tension I was feeling in my left leg, but my pain I feel while standing in place or walking slowly has not diminished.
I had a follow-up appointment with the hip/knee doctor today. He considered my complaints and carefully reviewed my pelvic x-rays. He told me that I have arthritis in my left sacroiliac joint, where my spine joins my pelvis. I’ve started a prednisone dose pack to reduce the inflammation in the joint. If these pills do not substantially reduce my pain, it is likely that I will get getting a cortisone shot directly in that joint (guided by x-ray for proper placement).
It so happens that the hip/knee doctor has also had spinal fusion surgery, and he told me that he also has arthritis in that joint and has had such injections twice. When he revealed this information to me, I silently wondered why he didn’t mention this history during my visit last month. It would have stopped me from dreadfully speculating that my pain while standing was due to another ruptured disc. Really, I spent too much time considering that lumbar degeneration could follow a trajectory similar to that archaic domino theory of communism.
Apparently, there is something of a domino issue going on with my arthritis. I have extensive arthritis in my lumbar spine. That my spinal arthritis has been developing silently and painlessly for years seems proof of divine mercy in my life. Now that this arthritis has spread to an adjacent joint, the pain at that spot definitely has volume.
All of this static has occupied much of my mental space lately. I suppose there is a bizarre happy medium of suffering. A life free of adversity would be tasteless, its beauty as shallow as a polyester pantsuit, pleasing and wrinkle-free only from a distance. There must be a point of saturation for pain. Once this point is crossed, there is no eloquence, poetry, or melody. Life condenses to necessity, and the challenge is to keep from turning inward, for that is where pain reigns as long as it rages.