23 January 2010

A Pain in the Neck

Last November I was having some trouble with pain down my right arm. It was thought to be an impingement of the ulnar nerve and the cause seemed to be from poor posture (rounded shoulders, chin jutting forward). My doctor gave me prescriptions for a pain killer (hydrocodone), a muscle relaxant (cyclobenzaprine), and an anti-inflammatory (ibuprofen 800 mg), plus a referral to physical therapy (Community Rehab -- magnificent people!). I took the pain killer and muscle relaxant at night because they made me tired; I took the anti-inflammatory as directed and I did my exercises and monitored my posture. All healed.

This past Tuesday I woke in the morning with sharp pain in my right scapula that also went down my arm and into my hand. I figured I just slept wrong somehow and had impinged a different nerve. I did my exercises; I even went to my workout (we modified the workout to account for the pain and possible impingement). Tuesday night I just couldn't sleep because of the continued (and now worsened) pain. It seemed to be in the trapezius muscle and near the spine, but it radiated through the scapula and down through my elbow. I took one of the leftover hydrocodone from November around 10:30 p.m. No joy. I took another one around 1:00 a.m. and put some heat on the painful part.

On Wednesday morning I called in sick to the office, then called my doctor for an appointment.

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As an aside, I'd like to mention that I tried getting an appointment with a chiropractor. I called the place I'd gone to 2 years ago, the one that still sends emails to me on a regular (almost daily) basis. I said, "I'm in terrible pain. Can I get in to see someone this morning?" The guy who answered the phone hemmed and hawed, then said that they weren't seeing anyone until the afternoon. I hung up. Then I called a 2nd place which had been recommended by a friend. I said the same thing ("I'm in terrible pain; can I get in to see someone this morning?"). The lady who answered hemmed and hawed and said that the doctors were all preparing to go out of town. I told her that this was not my problem and I hung up. I called a third place, said the same thing, and the lady who answered hemmed and hawed and hemmed and hawed, so I finally hung up. Later that morning I happened to see my original chiropractor and when I told him I'd tried to get in that morning he said (with a huge grin of satisfaction), "Oh, yes, we had a seminar this morning! It was great!" They all are now on my list of places never to call if I have a problem. I'll be sending each one of them a letter of explanation of how they managed to lose a customer.
* * * * *

So, I got in to see my doctor at 10:00 a.m. He gave me new prescriptions for all of the above, plus another referral to Community Rehab for physical therapy. I got into Community Rehap at 1:00 p.m. for an appointment. As usual, they were wonderful -- moist heat packs, "E-STIM" and more exercises (these for median nerve impingement). And then I went to my part-time job. Wednesday night I did my exercises, took my meds, and went to sleep.

Thursday morning I had another session at Community Rehab before going to my full-time job. The therapeutic measures managed to keep the pain at bay until about 1:00 p.m. when it came back full force. I did my exercises to no avail. I spent the rest of the day just trying to manage the pain without drugs. After work I went to see the amazing J for some gratuitous massage.

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As an aside, the amazing J is a licensed massage therapist. He's serious about what he does. He doesn't need to burn incense or play new-age music while he works (you can do that yourself if you like, but it's not what he carries around in his massage therapy bag). He approaches his work as would a physical therapist. He keeps up on the latest information and techniques, and he's not swayed by a lot of psychobabble.
@ @ @ @ @

So, J did a bit of massage, and it helped until about 9:30 p.m. So, I did my exercises and took my meds, then I tried to sleep. No joy. I took another hydrocodone and added heat. No luck. I slept all of about 3 hours.

Friday morning I woke at 4:00 a.m. in pain. I let the dog out then went into the office (I just as well get paid, right?) and did the best I could to catch up on stuff. I called my doctor's office at 10:00 a.m. to let him know that the meds didn't seem to be working. The nurse (from my doc's office) called back to say that there was a prescription for a stronger pain medicine waiting for me at the office. So, I left work early, picked up the prescription, and then I went home. The new script (for oxycodone) helped me to sleep but it did nothing for the pain. I had a 3:00 p.m. appointment for more physical therapy. This is the first time that the therapy didn't work. I was in more pain when I left. So, I reported this to my doctor's office and was told they'd set up an appointment for an MRI.

And then I got a call from the nurse (Donna) at my doc's office. She said, "We can't get you scheduled for an MRI, so you should go to an emergency room and they'll get you jumped ahead of the line. If they have questions they can just call us."

OK. I went to one of the two hospitals she recommended. They did all of the paperwork, took me back to an exam room where I repeated all of the above (except for the asides). I was told, "I'm so sorry, but that's just not how it works. We can't give you anything stronger than they did, and we can't schedule an MRI." On top of that, I was seen by a PA (physician's assistant -- not a real doctor) who not only repeated that there was nothing they could do for me, but she said, "You have to give the therapy more time. We can't just schedule an MRI. I wouldn't do that anyway. I think this is all muscular, not nerve-related."

At this point I was ready to scream. But I didn't. I said that I just as well leave.

"Oh, no, we can still do something for the pain."

Huh? I thought you just said there was nothing you could do for me?!!!!!

They gave me an injection of something (it sounded like Deletol, but I know that's not right) and then a prescription for Valium because, in the opinion of the PA, the cyclobenzaprine was worthless as a muscle relaxant.

Whatever if was they injected me with took the edge off the pain but didn't take it away. It also made my head kind of fuzzy. At any rate, it wore off in 3 hours. I took one of the Valium as directed. It wore off in 6 hours. Now I'm awake and in pain, plus I have a migraine.

Is it healthcare reform that we need in this country, or is it communication reform? I can't believe the the odyssey I've been through in the past couple of days -- people who don't understand the words, "I'm in terrible pain and I need help;" nurses with the misguided notion that I'd get an MRI if I went to an ER; PAs who think they are gods -- and in the end I'm still in pain.

1 comment:

Ronald said...

Hey Jud,perhaps you should re-consider the chiropractor option(if you hadn't).It wouldn't hurt to do it at this point. You'll be fine. ron