So today the physical therapist recommended by Young Doctor Kildare saw me.
Much better than the “sports therapist” outfit across the parking lot from the Walgreen’s. Instead of a gymnasium full of clients besieging a couple of trained therapists and a bunch of not-too-bright assistants, this was one guy with his own office. He did have one assistant, who seemed to know what she was doing. And yeah, he was dealing with several patients at once, but at no time did I have to sit around for 20 or 30 minutes awaiting his attention.
But in the time department, he took the time to inquire in detail after the symptoms, to do an exam, and apparently to think about what he heard.
He agreed with YDK that whatever ails me is not “muscle spasms,” and he explained why he didn’t think so.
Hmmm… I seem not to have related the recent events here.
Backstory, then: After almost a year of back pain and foot pain, and after no visible improvement in the knee that I walloped two and a half months ago, I decided I needed to talk to someone who had more than 15 minutes scheduled to speak with patients. So I traipsed back out to the Mayo to see my doc of some 35 years.
He had me X-rayed and then, reading the radiologist’s report, said the X-rays showed some disk degeneration but not enough to cause significant back pain — and so he didn’t think the cause was a pinched nerve — and the knee didn’t seem to be seriously injured. He opined that the persistent pain is caused by “a muscle spasm condition” and prescribed a muscle relaxant, which proved impossible to get through Medicare Part D. After two more attempts, he finally came up with a drug I could afford out of pocket, cyclobenzaprine.
This dulled the pain a little, caused nightmares that verged on hallucination, and did nothing to eliminate the problem.
On reflection, “a muscle spasm condition” sounded kinda fishy — what kind of “muscle spasm” goes on for ten or twelve MONTHS, and if that’s what he thinks it is, why isn’t he testing me for MS, which in fact could cause something along those lines, or for diabetes, which can cause persistent lower-body pain? So I finally decided to try again with Young Dr. Kildare, who at least accepts Medicare.
After the usual brief interview, YDK begged to differ with the august opinions of the Mayo Clinic — he thinks it is a pinched nerve and advises the prescribed treatments are as follows, in this order:
1) Intensive physical therapy.
2) If this hasn’t worked after six weeks, epidural injection.
3) If that doesn’t work, do MRIs to determine a specific cause and attempt relief with surgery.
As for the knee, he believes the issue is prepatellar bursitis resulting from the fall I took, which would make some sense. If it doesn’t resolve over time, the course of treatment is exactly the same.
YDK is just a young fella on the run from patient to patient in a medical factory. However, to my ear he made a great deal more sense than the Honored and Elder M.D. This wouldn’t be the first time the Old Man has emitted a cattywampus diagnosis — years ago, when I was a bit younger than YDK, he tried to put me on beta blockers for the rest of my life, having decided I had a mitral valve prolapse. Before committing myself to permanent medicating, I asked my father’s cardiologist about it; he said if there was a valve prolapse (which he doubted), it was so minimal as to be virtually undetectable and I should ignore it unless I had some actual symptoms.
So…while Arizona sorely lacks top-quality medical care, the truth is, I’m no more star-struck by the Mayo name, despite their excellent hospital (one of the state’s few consistently rated excellent on a national basis), than by any other cluster of M.D.s around here. The Old Man’s theory didn’t hold water, the drug he prescribed did nothing more than briefly mask the pain, its maker specifically warned against its use for the elderly, and so I was willing to seek some other advice.
Hence, today’s physical therapist, whom Young Dr. Kildare recommended.
He scoffed at the “muscle spasm” theory. He explained the pain as a manifestation of compressed vertebrae brought on by the antic I got up to a year ago, which immediately preceded the symptoms. He decided the knee pain was unrelated to the back issue, and the heel pain may or may not be related to the back pain. In any event, said he, the first order of business was to address the back.
Damned if I know what he did, but whatever it was, it seems to have worked! He pushed on the back and pulled on the back in a way that felt a lot like a deep massage and that seemed reminiscent of chiropractic manipulation. When asked what exactly his procedure would do, he said the point was to “loosen up the joints,” whatever that means.
He recommended a half-dozen exercises, none of which caused any pain, unlike the other therapist’s contortions. By the time I walked out of his office, the back pain was almost gone, and the foot pain is significantly improved.
This evening when Cassie dragged me out the door to tromp around the block in search of cats, I was walking pretty much normally, something that hasn’t been so for months.
So what about the ginger snake oil I cooked up the other day?
Well, it did have a slight analgesic effect, so slight as probably to be wishful thinking. This evening I used some of it to stir-fry some shrimp with piles of onions, garlic, and Napa cabbage. Mighty good!
Probably the highest and best use of the stuff.