My poor spine doc. "It says here on your chart I've seen you before," he says, searching my face for clues as to who I am. His patients are back patients, so they fall into two categories: they're fixed, or they're broken. The fixed ones like my friend Erika (who had two vertebra fused two years ago by this doc) are fixed. They never see him again. Erika has twinges of back pain but this past weekend she competed in a weightlifting competition, deadlifting more weight than you and I combined. She's fixed. Then there's the broken ones, folks who after surgery are injured still, and they see him once a month or twice a month for years and years. Me, I fall somewhere in between: the disk he fixed is OK, and the problems I have with it are related to scar tissue and nerve damage. I have four bad disks, though, and each is a different source of a different pain. A year and a half ago I saw my spine doc with a bad muscle pull and the beginnings of a herniation, and he passed me off to his pain management doc who insisted that the burning cramping stomach pains I got from celebrex were normal. I insisted that the holes in my stomach were abnormal, so I didn't see that guy again.
Between that visit and this, I had a pulled lumbar muscle shove up against some scar tissue. This would have been about eight months ago, and I saw my GP about it. This was right before a thing that I can't talk about happened at work, and I needed to be OK enough to fit in a small space for a very long time (as an aside, I sort of like the fact that I can't explain what that means, because it sounds way better when I make it all mysterious). She gave me ibuprofen (600mg), flexiril for sleep, and a 5mg 5 day supply of Norco. It took me wtwo weeks to recover.
I still had two days left when this last thing happened. I was getting off the couch on Easter Sunday, pondering my run that evening...I run ~3 miles a day, four to five days a week...and my back went pop and I dropped to the ground. Normally when my back goes, it takes a few minutes or hours to build up to OH SHIT, but this one was on me right away, hot iron needle in the nerve, my whole back whacked into an S-curve instantly. Monday I went to work for half a day. Tuesday I dug out my TENS unit and stayed at home. Wednesday I went to work, then to my spine doc.
When my back is really bad, my left hip juts out at an odd angle due to "reactive scoliosis", and my right foot splays out to the outside, and I limp, badly, since each step creates a spasm that may or may not become an earthquake of sympathetic spasms that may or may not make me pee myself as I fall down and pass out. So. There's that.
My new car is better than my old car for getting into and out of, except for the high seat bolsters...getting over them was gigantically painful. I limped to the doc's office, and limped around his waiting room...the waiting rooms of doctors who specialize in the spine have the very worst chairs ever made, and I could never understand that. Eventually they called me back, and the doctor opened with "it says here you've seen me before?"
"Yeah, you opened me up about three and a half or four years ago," I said, sort of chuckling. I'd had an X-ray between the waiting room and his office, and he looked through it and my MRI from 18 months ago. "Things look OK, how did it happen?" I explain the POP and the pain. "Well, that pop worries me. And your reactive scoliosis is really, very bad. Worst I've seen. But the X-ray looks fine, other than a little material around L5-S1..." and he trails off looking at the old MRI and the new X-Ray, overlaying them on an IBM display that was so goddamn pretty that the geek in me went all nuts despite my pain.
"Here's the deal, man," he says. He's always been very colloquial, which I love. "You're going to need to lose 50 pounds. You have four disks that are degenerating, three of which are fragile as hell, and one of which is probably herniated but isn't affecting the nerves in your legs or feet yet. The only way to fix it permanently is to replace all of it with titanium or lose 50 pounds."
There was other diagnostic stuff in there, making sure my nerves weren't impinged, making sure that it was just pain and not damage. Then he opened a web site and outlined how many calories I should be getting per day in order to safely lose 50 pounds in less than a year. He was happy I was jogging, he was happy about the 20 pounds I've lost since the start of the year, and he was happy that my diet is good food and not crap, but he wants me to treat my body like the machine it is.
"I like money," he says. "I could operate on you every year for the next five years, eventually you'd be OK for another ten or so years, but really if you want to change at all, you have to change your entire body."
Yeah, doc, no sweat.
I left there, limped to my car, drove to the pharmacy, paid my $50 for drugs, took a 10mg Norco, and pondered my weight. At 250 pounds, I am very heavy for my height (6 feet with my boots on), but I carry a lot of muscle. To my skeletal system, though, weight is weight. All of it is stress. So, how do I lose 1/5th my mass in less than a year? Diet, 60 minutes of exercise a day (at least 80 percent of it in aerobic stress at the very edge of what I can take), and the motivator that right his second is making my right side creep with tingling vines of white hot motherfucking pain.
You and me, we're going to try this.
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