So yesterday I had a follow-up appointment with the doctor for the sciatica. We also (all 3 of us) went in for a flu shot — rather, 3 flu shots — but that was just for convenience.

The doctor is a locum replacement for our family doctor, Dr. Izen. Dr. Izen’s on maternity leave right now (it’s a boy!). Anyway, the results of my x-ray were in. Mostly it revealed what I expected it to. Some deterioration in my spine (L4 and L5) and hips. Apparently there’s a bone spur on L5 too. None of this seemed to surprise or concern the doctor. Also revealed in the x-ray was “healed juvenile osteochondrosis”. The doctor said she didn’t know too much about what that was, and that she would have to look it up.
Frankly, she’s the doctor — I don’t know why she didn’t look it up before I came. Seems like that’s her job.

She expressed “surprise” since that wasn’t in the history that I gave her. I didn’t quite like the implication, but I told her it was news to me too. Anyway, *I* looked it up. It’s pretty generic term that covers a wide range of deterioration in the hips and spine as well as other areas. There are a number of “named” diseases that refer to specific types of juvenile osteochondrosis.

So, knowing nothing about this, I asked my mother about it. It turns out that I was diagnosed with Legg-Calvé-Perthes syndrome when I was 2 or 3. Apparently I was in for regular x-rays to monitor the problem. A short time later, however, I broke my leg. A lot of people have heard *that* story but I’ll save it until later for the blog. (On a side note, “blog” is not recognized by Firefox’s built-in dictionary. Weird.) Anyway, at the hospital, they told my parents that I didn’t have LCP syndrome, and apparently it was never thought of again, until today. LCP is a degenerative disease that causes damage to the femoral heads. Treatment seems to be leg braces and the avoidance of physical activity. Sounds pretty unpleasant.

At the age of 15 or 16 I began experiencing pain in my hips after periods of activity. It got reasonably bad at times … I recall getting into the Little Red Car while at university and having to lift my leg onto the clutch because of the pain. But at 15 or 16 this was pretty new, and pretty, um, irritating. My family doctor at the time didn’t have any idea what was going on, and I was sent to various specialists. I don’t recall the names, or the number of specialists. Eventually, I ended up at the Nova Scotia Rehab Centre in Halifax. I vaguely remember the situation … there was an older doctor and someone who I recognize now as probably a resident. Anyway, it was there that they told me that the problem was “antiverted femural heads”, a reasonably easy diagnosis in the mind of the doctor. I should mention that the “bedside manner” of this doctor was awful. I was alone at the time and the diagnosis was given pretty coldly. I was told that I would experience gradual but progressive degeneration of my hips, which would lead to problems with my back and knees. I was told that, at the time, I had the back of someone in their 30s. The only solution was surgery and, I was told, that was worse than the problem at that moment.

And that was it. There was no more. No suggestions on what to do to make life more comfortable, nothing about what to do about it, nothing at all in terms of offering support. Or hope for that matter.

Anyway, that explained the problem. I didn’t change my behaviour at the time, and in fact, I became more active. At university (I was 17 when I started at Dal) my activity level increased considerably. I started playing racquetball regularly, I was curling quite a bit in the winter, and generally involved in other physical activities. It wasn’t like I was playing football or anything, but still, it was more active than I had been at any other time in my life.

Now, some 15 years later, I can’t play racquetball or any other racket sports. It’s quite hard on my hips and knees.

But, I digress. The revelation that I had been diagnosed with this LCP syndrome as a young child, the hip problems I started experiencing as a teenager, and the back problems I’ve been experiencing recently suddenly clicked together. It seems obvious that it’s all inter-related. And, equally obvious, this has lead to seems to be osteoarthritis in the hips.
One of the questions I have though, is why has it taken *me* at the age of 32 to put this together? What happened when I was young? Was the hospital irresponsible at “undiagnosing” the original LCP determination? Why didn’t any of the doctors who looked at me when I was a teenager consider this option? How can an x-ray tech in BC make a reasonable diagnosis without the benefit of any of the history that others were privy to? Why didn’t the locum know what the x-ray tech was talking about, and put it together with what I thought were antiverted femural heads? Things seem pretty clear to me now, but what do I know, I’m not a doctor.

The locum recommended getting a CT scan as the next step. I’m not really sure what a CT scan will tell her (or Dr. Izen) other than confirming the extent of the degeneration. Given that the wait for a CT scan is on the order of months, I certainly hope that the sciatica will be resolved by then. Otherwise, I guess it’ll make a good picture for any pending surgery.

Meanwhile, I’ve been going to physio. I’ve been taught a small assortment of exercises, somewhat different than those I learned 5 years ago. I’ve been put on the rack three times now, and I bet there will be a fourth tomorrow. The rack, for those unfamiliar with such things, consists of a bed with two large leather straps. One strap goes around your chest, and is fastened to the head of the bed. The other strap goes around your hips, and is fastened to a machine. This machine pulls the lower strap in a controlled fashion, applying a certain amount of force for some period of time. My last session was 65 lbs, 40 seconds on, 10 seconds off (20 lbs) for 20 minutes. It’s uncomfortable but not painful. For everything I’ve read about sciatica, this is the typical treatment regime. Studies are inconclusive if it’s an effective treatment.

It’ll be interesting, at any rate, to see what the physiotherapist says. Other than Tammy, she’s the only medical professional that has expressed a genuine interest in my difficulties. It seems to me that I will probably have to be much more dedicated in building up my core muscles and will have to stick to a specific exercise regime to strengthen the right muscles to reduce the rate of deterioration. Weight loss too, probably, but I’ve been pretty constant at my current weight and shedding more (I’ve dropped about 20 lbs from my worst while finishing up my thesis) won’t be easy.

Anyway, if you’re still reading this, wow!

OK. So, with the desktop computer running so well, any time I’ve been on the computer, I’ve been trying to work. If I’m not able to sit at the computer, then … well obviously I can’t blog.

So, I know I haven’t finished posting about the vacation. I’ll get another post out tonight and try to wrap it up early next week.

The sciatica: I’m not in any pain, but I’m still numb up and down my left leg, and half my left foot. I went for a little walk yesterday, and a bit of a longer one today. I’ve got a doctor’s appointment tomorrow and afterwards I hope to make it into work (by bus). Hopefully, with the doctor’s approval, I’ll commute by bus for a while into work and equally hopefully the sensation (and muscular control) will return to my leg.

The walk today involved taking Aidan down to the park to get some daylight pictures of him in his Monkey Costume. Being the experienced toddler he is, he walked all by himself down the hill and one block east to Oak Street before we put him in the stroller. He sure likes walking by himself and not so much in the stroller. Oh well.

We went down to Charleson Park and took some shots of him playing in the leaves. Sadly, we swept through the leaves first to make sure there were no needles. Oh well. Anyhow we got some nice shots. Here are a few, and more can be found in the Photo Barn.

Well, this isn’t a post I wanted to make. I haven’t written about the flight back from Halifax yet, but I need to talk about it briefly, here. Most of the flight was in the last row of seats, which, believe it or not, are more uncomfortable than the rest of the seats. Anyway, the relevance to this post is that by the time I got off the last leg in Vancouver, my hips and back were in quite a bit of pain. I didn’t think too much about it, but I probably should have taken extreme care moving our luggage around. But, it was the equivalent of 3:30 in the morning and thinking wasn’t the clearest.

Anyhow, the back pain was quite a bit better on Saturday, but things slowly went downhill. By Monday, I was pretty sore again, but I biked into work. For those about to say “That was stupid”, cycling is actually pretty easy on the back and joints in general.

Tuesday morning was Not Good. I got up, got myself upstairs, and promptly laid down on the couch. Over the next two hours, I got the cats fed and my email checked, but not much else. After considering my options, I couldn’t see how I could get myself to work. Sitting down was quite painful. Walking was difficult, and after walking from the kitchen to the living room, I needed to lay down again in order to relieve the pain.

Accepting the situation, I asked Gwen to make an appointment with the doctor, which was scheduled for the afternoon. I recognized the symptoms as quite similar to the sciatica I had in February of 2000 (and a small flair-up a year later). By the middle of the afternoon, however, I couldn’t stand without quite severe pain. Getting to the doctor’s (only a block away) was going to be a problem. Given the situation, I decided the ER was probably more appropriate — at least they’d be able to give me something for the pain.

So, Gwen loaded me into the truck (T’s mother, who works at the hospital came over to mind T and Aidan) and we drove the two blocks to the ER. I registered with Triage, and Gwen returned home to deal with T and Aidan. There were no strechers available, so I had to prop myself up against the security counter while waiting. After 10 or 15 minutes, Admitting called me over and I registered, more or less. After taking some details, my bloodpressure (160/100!), heart rate (99 bpm!) and temperature (37.9 C) the nurse took me (well, she lead, I shuffled. slowly.) down to Treatment, where they were able to let me lie on a gurney. Over the next 3 hours, a med student took my history and poked and prodded me. A brief visit from the “real” doctor resulted in what I already knew. Sciatica was back. He prescribed me some anti-inflammitories, pain killers, and another sort of drug that supposedly deals with inflammation of the nerve directly.

Note, that I was never actually given anything for the pain at the hospital.

Released, I shuffled back outside and Gwen came and picked me up (T had been picked up already).

So now I lie on my back, with a numb foot and no strength in my ankle in the left leg. Also, no ankle reflex. Pain down my left leg, and seemingly random muscle spasms in the leg. The back is mostly pain free, unless I do some bending. Walking is possible, but I’m not doing any hikes anytime soon. Sitting is still quite uncomfortable.

Past experience tells me that the meds will make things more comfortable over the next few days. The numbness and leg pains will resolve slowly over the next few weeks. The first time it took something like 5 or 6 weeks before I went back to “work” (grad school). I hope that things will be quicker this time. In the meantime, I’m setting myself up to be a telecommuter — work has backed up over the 2 week vacation, and there’s tonnes of things that need to be done. Fortunately, most things can be done either remotely or on the computer here.

Helping deal with Aidan, however, is going to be a challenge. Given I can’t pick him up, my usefulness is pretty low.

More updates to come.

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