A Few Small Answers - Yay!
Monday, May 06, 2019
Today, I saw my new pain management doctor. At first meeting, he appears to be a kind and gentle person. That's good news. He actually sat down in front of me and read my paperwork. He asked a couple of questions as he reviewed it and made some notations. Then he moved on to the MRI report. He asked me what trauma occurred resulting in my condition. I wasn't sure what to answer. Trauma? He laughed and told me he didn't do a very good job of asking. Then I was asked to tell him what kinds of active or repetitive things I do on a regular basis.
I told him about doing crafts, grading papers (25 years worth), Silver Sneakers, water aerobics etc. That is all I could think of that might be repetitive. Then he asked if I've fallen recently. Not including falling and breaking my vertebrae in January of 2018. The only thing I could think of was trying to hoist myself up into my BIL's truck (it's pretty high up). The doctor wasn't sure that would do it.
After reading the MRI report, the doctor looked up. He examined my wrist with all of the usual pressing and prodding. Then I moved my hand side to side and the right side made a loud crack. I asked if he heard the crack and he raised his eyebrows and said yes. I told him that my orthopedist tried to make it crack but it wouldn't. The doctor smiled and told me he certainly could hear it. I told him it would take a minute but I'd experience a crush of pain. True to my word, a minute later, there it was. He went back and looked at the MRI report again and asked me a few more questions. Then he tried to bend the wrist another way to see if I'd get another rush of pain. I didn't feel any additional pain.
I sat there as he was thinking over the information. When he looked up, I made the comment that there is a lot of little stuff going on as well as a few larger issues that need to be repaired. The doctor agreed. He explained that normally a collection of issues like mine are a result of some sort of trauma or injury. I voiced what I think are the issues, based upon me looking up a zillion of the things listed in the MRI report. He was pleasantly surprised. But...there is more to it than what I came away with. The reason he didn't add anything else is that the other issues have overlapping symptoms and represent a variety of possibilities. The pain doctor said that my orthopedist won't know exactly what the exact situation is, until he does the surgery.
Then I asked the question that has been bugging me for the last 3 months, "What is causing the crushing pain?" He explained to me that he can only tell me the most clear cut cause, since most of the the smaller issues are not exact at this point. When my wrist is at all stressed, moved around too much etc., the tendon on the outside of the wrist presses on the ulnar nerve. The nerve becomes inflamed and very irritated. There are other issues that occur at the same time and feed into the pain. (If only we knew what those are!) The end result can be very severe pain. (No kidding!) At last, some small answers!
The doctor and I worked on developing a treatment plan (for dealing with pain before my surgery) because just the nerve pain alone, can be so debilitating. My options are limited because of certain drug allergies. I must wear my brace continuously until surgery and no Silver Sneakers or very active activities where I need to use my hand to brace my body. We finally came up with a plan and he gave me some samples to try, along with 3 prescriptions.
I walked out of my appointment, a much happier camper and I felt a very short lived sense of relief. I dropped my stuff off at home and made the trek to the pharmacy. Then it all went downhill. Right off the bat, my prescription insurance doesn't want to cover 2 of the prescriptions. My pain doctor will have to fight with them. Ga-aaah! I hope my treatment plan won't be sent back to square one!