Nurse on the Run

Apologizes for being the worst blogger known to man, but there’s only so much "Hey! My back still hurts!" things I can say without not even wanting to read my own writing.  (I’ve read my own race reports a million times…apparently I think that I’m just that entertaining.)  Anyway, since you’re all still reading (or pretending to), I figured a little update on my back would be nice.

My words can be boring, you can look at pictures instead.

I’ve always thought that I’m a fairly healthy person…never been overweight, always ate fairly healthy, never really needed to go to the doctor except for strep/ear infections when I was little, check-ups now and then, and physicals for high school.  ER visits include once for when I hyperventilated about a seventh grade science fair project (I’m a freak, true story), a migraine in eighth grade (passed out, vomiting, that was fun), mono in college (104.5 degree temperature?  oops), and vomiting my brains out in PA (I begged for Zofran, it was nice).

Needless to say, I’ve been lucky in the health department.  If you looked at my recent credit card statements, you would think otherwise.  Co-pays like crazy (those $30 add up quickly…), appointments all over the place.  It’s taught me a lesson in how difficult it can be for people to manage their healthcare, not to mention afford it.  And I barely have anything wrong with me!

I’m already way off topic, so let’s refocus.  (I’m on night shift, pardon the randomness.)  My back pain came back a few weeks ago after a month of pain free running, so back to the orthopedic surgeon I went.  She’s actually quite reasonable and asked me how I felt about possibly not running again, as the obvious solution to pain that only occurs when you run is to…not run.

Not to be dramatic, but I looked her in the eye (or her ear, I’m really bad at looking people in the eye) and told her that I can’t imagine not running for the rest of my life.  "Well then, let’s do the injections."  The next step in pain management here is epidural steroid injections.  While not a cure, they can certainly provide pain relief and anti-inflammatory action right in the source.  In my head, I find it hard to wrap my mind around the idea that my pain has come to something this invasive…nothing before has required me to sign a consent form!  Is running that important to me that I would let someone stick needles in my spine?

A running Susan is a happy Susan.

The short answer is…yes.  One of these days I’ll write a post on why I run, and what I told the doctor is true.  At 28, I simply cannot imagine not running for the rest of my life, so I’m willing to try more invasive procedures (which are actually quite safe, although not without potential risks) to try and get this moving again.  So the orthopedic surgeon recommended me to a pain management doctor.

Never in my life did I think that I would be seeing a pain management doctor.  However, since this back pain has been going on for over five months, apparently I fall into the category of "chronic back pain."  Well, that’s fun.  So I made the first appointment I could with this doctor, which was 9am on Monday.  At that point, it was after night shift and I was attempting to hold my eyes open with toothpicks.

The doctor seemed fairly nice, reviewed my history, my pain history, took my blood pressure and commented "119/79, is that high for you?  Are you nervous?" to which I replied that I’d had a lot of coffee (see also: night shift) and that maybe I was nervous about the man sticking needles in my spine.  (Also, that’s a pretty good blood pressure if you ask me…anyway.)  He explained further what is wrong with my back (bulging discs, annular tear…fail) and explained how the injections would help.  And how if they didn’t, maybe surgery would be an option.  Clearly a last option, as I really don’t want back surgery.

The problem with injections is that they don’t really fix the problem.  They might not help, they might help temporarily, they might help forever.  Studies produce mixed results.  The idea is that the steroids are localized and help reduce inflammation, which provides pain relief and may allow for healing.  So that’s nice.  I signed away my right to sue in case I’m paralyzed (the thought crossed my mind…), and headed to the procedure room.  On the way, he said he couldn’t quite read me, and I told him that I worked the night before and was tired.  Awesomeeee.  We chatted about the burn unit (he was a resident here back in the day) while I laid on a table awaiting NEEDLES IN MY SPINE.  (High fives for drama.)

Not my back.

The whole procedure took maybe ten minutes tops.  The procedure is x-ray guided, and the x-ray screen was right in front of my face, so I looked up to see a needle in my spine.  That’s cool.  A little marker on my back showed him where to go, and he injected some initial lidocaine as a numbing agent, followed by contrast to make sure he was in the right spot, followed by the steroids and lidocaine into my back.  I wiggled my toes the entire time to make sure they still moved (paranoid, much?) and soon enough a bandaid was on my back and I was on my way.  The pain was minimal, and all I felt was a little pressure in my right butt.  Can’t really complain.

The first question everyone has for me is, "Did it work??"  Well, I have no idea.  My back felt great yesterday as the lidocaine hadn’t worn off yet, but the pain is so random that it’s hard to tell if it worked.  He recommended trying to run on Wednesday or Thursday to see how it goes, although honestly I ran for twenty minutes pain-free the day before the injections, so who knows if I would have pain anyway.  I’m hoping it’s gone forever, but otherwise I have a follow up appointment two weeks after the initial one to see how it worked and maybe do another one.

Basically, I’m just hoping it goes away, although I know better than that.  I’ve been out of multiple races so far because of this pain (NYC Half, Boston Marathon), and I was supposed to run the San Francisco Marathon this coming Sunday to wrap up my time as an ambassador(post to come!), but I may be reserved to cheering like crazy.  People are starting to talk about training for the NYC Marathon, and I have no idea if I’ll be able to run that.  This has been an incredibly long, challenging process for me both mentally and physically, and I can only hope it will end soon.

I also feel quite silly complaining because I really don’t have it that bad.  The rest of my life isn’t affected by pain, although I do notice a twinge here or there at work.  It’s just hard because everyone looks at me (doctors included!) and says, "I can’t believe you of all people are having this problem."  Remember that whole thing about seemingly healthy?  Yep.  I know I’m lucky in the grand scheme of things, but fingers are double crossed hoping this injection works.  Or at least that the next one will.

Maybe one of these days I’ll have something exciting to add, but in the meantime, thanks for sticking around.