Dr L spent some time on my mid back this morning. In my updated I said it's "tight and feels kinked", and that when sleeping I wanted to "curl up and not stretch out". Same comments I made 2 years ago with Heather with my T7 and T8 fractures. Dr L said the same thing she did -- muscles are compensating, this time from the lumbar. After a few thumb-based tortures (good tortures though!) things certainly felt different, but by mid day my entire mid back was tired, cranky, not pained, but I kept wanting to rest and lean.
He didn't work on the hips, and once at work with a name I called WashU to start that process. I have the second MRI this Saturday. Clohisy was who Dr L recommended, but WashU is trying to divert me to Hunt or Prather. Need to look them up to learn more. Seems they were hung up on the "labrum tear" I mentioned even though I don't think that's the main reason I was being sent to Dr C? They will get the 2nd MRI results from MOBap, I've asked for the first MRI results to be forwarded,... next week they will review the reports and go from there.
How am I feeling? I'm adjusting to the extreme (for me!) reduction in activity. Since I'm walking from a distant-but-free parking spot I'm still logging 10K steps per day, and while it's uncomfortable I wouldn't call it painful. But it is unpleasant.
Thursday, April 27, 2017
Tuesday, April 25, 2017
MRI Results
Monday morning got the MRI, Tuesday morning the results.
Dr L commented on how my report went into a second page, he doesn't see that often. Over distance as usual.
First off -- no fractures seen, that's great news. What did they find? Time for some anatomy lessons!
"There is no acute fracture or osteonecrosis. Specifically, there is no stress fracture.
Surface coil imaging of the left hip demonstrates undersurface fraying and a nondisplaced tear of the anterosuperior labrum, noted on series 6 image 22. The direct superior labrum is intact and there is a large para-labral recess, noted on series 7 image 16. The anterior labrum is diminutive but not torn.
There is preservation of articular cartilage. The ligamentum teres is deficient. The iliofemoral ligament is intact.
The short external rotators are intact. The posterior footprint of the gluteus medius is maintained. There is chronic low-grade longitudinal stripping of the anterolateral footprint, series 4 image 17. The gluteus minimus demonstrates moderate tendinosis, with adjacent osseous remodeling, but without tear noted on series 7 image 17.
The iliopsoas tendon is not torn. There is not psoas bursitis. The direct and reflected heads of the rectus femoris are intact.
The fat planes surrounding the sciatic nerve are maintained. There is degeneration of the bilateral hamstring tendon origins.
Note is made of a partially imaged tear of the left adductor aponeurosis, series 4 image 27.
There is a small amount of fluid within the dependent portions of the pelvis, which may by physiologic.
Lower lumbar disc signal is preserved.
IMPRESSION:
MR left hip arthrogram demonstrates a focal tear of the anterosuperior labrum. Both the superior and direct anterior labrum are intact. Articular cartilage is maintained.
Note is made of a partially imaged tear of the left adductor aponeurosis, within the spectrum of a sports heria. Dedicated MRI imaging is offered as clinically indicated".
[and there are red spell check squiggles everywhere!]
So. For now. No SBR. Minimal walking. Unload as much as possible. Take the dog to the park, drive to work, and "pull all available strings" to see a recommended specialist at Wash U.
At the moment, I'm waiting on approval for the next MRI, and to hear again the name of the recommended hip surgeon.
Keeping calm.
And staring at the indicated images, wish I could see what they see, just so I could see it!
Dr L commented on how my report went into a second page, he doesn't see that often. Over distance as usual.
First off -- no fractures seen, that's great news. What did they find? Time for some anatomy lessons!
"There is no acute fracture or osteonecrosis. Specifically, there is no stress fracture.
Surface coil imaging of the left hip demonstrates undersurface fraying and a nondisplaced tear of the anterosuperior labrum, noted on series 6 image 22. The direct superior labrum is intact and there is a large para-labral recess, noted on series 7 image 16. The anterior labrum is diminutive but not torn.
There is preservation of articular cartilage. The ligamentum teres is deficient. The iliofemoral ligament is intact.
The short external rotators are intact. The posterior footprint of the gluteus medius is maintained. There is chronic low-grade longitudinal stripping of the anterolateral footprint, series 4 image 17. The gluteus minimus demonstrates moderate tendinosis, with adjacent osseous remodeling, but without tear noted on series 7 image 17.
The iliopsoas tendon is not torn. There is not psoas bursitis. The direct and reflected heads of the rectus femoris are intact.
The fat planes surrounding the sciatic nerve are maintained. There is degeneration of the bilateral hamstring tendon origins.
Note is made of a partially imaged tear of the left adductor aponeurosis, series 4 image 27.
There is a small amount of fluid within the dependent portions of the pelvis, which may by physiologic.
Lower lumbar disc signal is preserved.
IMPRESSION:
MR left hip arthrogram demonstrates a focal tear of the anterosuperior labrum. Both the superior and direct anterior labrum are intact. Articular cartilage is maintained.
Note is made of a partially imaged tear of the left adductor aponeurosis, within the spectrum of a sports heria. Dedicated MRI imaging is offered as clinically indicated".
[and there are red spell check squiggles everywhere!]
So. For now. No SBR. Minimal walking. Unload as much as possible. Take the dog to the park, drive to work, and "pull all available strings" to see a recommended specialist at Wash U.
At the moment, I'm waiting on approval for the next MRI, and to hear again the name of the recommended hip surgeon.
Keeping calm.
And staring at the indicated images, wish I could see what they see, just so I could see it!
Sunday, April 23, 2017
Weekend of much discomfort
Nothing. Did nothing.
Worked Saturday, then errands.
Worked part of Sunday, an errand, got some mulch for the yard.
Absolutely beautiful weekend, lovely to be outside. My Thursday group was out biking Sunday, sooooo jealous but at the same time not so jealous as it would have been unhappy and uncomfortable.
Dr L explained it and it makes sense -- the muscles tightened up to buttress the injury, and he's loosening those muscles. That explains the rapid increase in pain and discomfort. Mostly feels like my hip is "out of place" and it needs to be "popped back".
Lots of mental exercises, even a low mass mediation! Telling myself ProYou style: This is a test, and how I handle this will determine the outcome. Took some time to understand maybe why this was "supposed to happen", as Tom would say. My body is talking, and I need to listen. I think that's why?
Worked Saturday, then errands.
Worked part of Sunday, an errand, got some mulch for the yard.
Absolutely beautiful weekend, lovely to be outside. My Thursday group was out biking Sunday, sooooo jealous but at the same time not so jealous as it would have been unhappy and uncomfortable.
Dr L explained it and it makes sense -- the muscles tightened up to buttress the injury, and he's loosening those muscles. That explains the rapid increase in pain and discomfort. Mostly feels like my hip is "out of place" and it needs to be "popped back".
Lots of mental exercises, even a low mass mediation! Telling myself ProYou style: This is a test, and how I handle this will determine the outcome. Took some time to understand maybe why this was "supposed to happen", as Tom would say. My body is talking, and I need to listen. I think that's why?
Thursday, April 20, 2017
3rd appt with Dr L; MRI scheduled; blog review; Confiteor
Today and yesterday -- BIKE COMMUTE 9.2 miles each day
At least I'm still biking. Today's appt opened up with him noting that I'm limping when I walk. So much for trying to walk normally. Then he said he's looked into the MRI, recommended a radiologist and site. Idea is that mobility is improved but pain is not. He thinks stress fracture, could also be soft tissue damage. Chicken and egg as to which might have come first, if both are there.
He said in "people like me" it takes a "massive dysfunction" before seeking help, because my "threshold is so high". He also expressed concern about my mental health, and I think he was only half joking. He was referring to me as a "100 miler", apparently I fall into that category!
With a skeletal model, he explained the probable sites for issue --femoral neck and upper femur bone. Under stress, the neck-to-bone area bears a lot of weight and can even flex. With my osteopenia and running, this area of bone is under a lot of stress.
He only worked on my back, notes it's getting better as measured by his straight edge. I swear he's taking up skin, damn that's painful. But no, just some pick spots afterwards! He said the fatigue I'm feeling in my back from carrying a backpack is due to load changes. Just reminds me too much of 2015 back problems.
MRI schedule for Monday morning, results Tuesday morning.
Back at work, once I had a break I called up this blog and searched on hip. I did this before with the left hip tag, this search expands it. I found -- to my complete surprise -- that this has been going on at least since LAST JUNE.
April 28th I noted left hip pain that I thought was due to a fall (but I didn't specify about the fall)
May 8th a fall onto a pile of rocks at the bottom of a hill at Greensfelder. Upper body bruising but severe bruising, swelling, and knots on left hip, quad and knee. Of course, I finished the last 19 miles, in extreme pain.
June 15th: noted left quad bone pain, kinda in the hip too, leg tight and sore, and for past few days it ached in bed. I stressed the ache aspect.
June 28th I called it a nagging niggle, comes and goes, easy to ignore
July 9th CMAR trail race 33 miles of hills, noted that left hip "talked" and "squawked" and felt weak
July 27th noted the popping in my hip, the first mention of it and said that it had been happening last week too
August 5th said the hip is 95-97% "great", but some left knee pain and tight calf.
Of course this continued into October, with the failure of my hip flexor at Farmdale and the R2T. The month of November was full rest, apparently not enough.
That this started last May or June oddly makes me feel better. I was so concerned that any diet or activities or anything since October was the problem. This tells me that no, this is a possible hold-over from a year ago when I was still taking Forteo and still healing. Is this a good thing? Or more denial?
I took a long walk today after lunch to get my mind cleared. I've been listening to (of all things) Catholic podcasts (only 2 months ago it was Buddhism, so maybe this isn't much of a stretch) and I keep hearing the words of the Confiteor in my head. I heard it last Sunday at church with Michelle, then again this morning in a podcast I started after leaving Dr L's office. The coincidence can't be ignored here.
I confess to almighty God and to you, my brothers and sisters, that I have greatly sinned, in my thoughts and in my words, in what I have done and in what I have failed to do, through my fault, through my fault, through my most grievous fault; therefore I ask blessed Mary ever-Virgin, all the Angels and Saints, and you, my brothers and sisters, to pray for me to the Lord our God.
Is this something I can add to my Songlist?
At least I'm still biking. Today's appt opened up with him noting that I'm limping when I walk. So much for trying to walk normally. Then he said he's looked into the MRI, recommended a radiologist and site. Idea is that mobility is improved but pain is not. He thinks stress fracture, could also be soft tissue damage. Chicken and egg as to which might have come first, if both are there.
He said in "people like me" it takes a "massive dysfunction" before seeking help, because my "threshold is so high". He also expressed concern about my mental health, and I think he was only half joking. He was referring to me as a "100 miler", apparently I fall into that category!
With a skeletal model, he explained the probable sites for issue --femoral neck and upper femur bone. Under stress, the neck-to-bone area bears a lot of weight and can even flex. With my osteopenia and running, this area of bone is under a lot of stress.
He only worked on my back, notes it's getting better as measured by his straight edge. I swear he's taking up skin, damn that's painful. But no, just some pick spots afterwards! He said the fatigue I'm feeling in my back from carrying a backpack is due to load changes. Just reminds me too much of 2015 back problems.
MRI schedule for Monday morning, results Tuesday morning.
Back at work, once I had a break I called up this blog and searched on hip. I did this before with the left hip tag, this search expands it. I found -- to my complete surprise -- that this has been going on at least since LAST JUNE.
April 28th I noted left hip pain that I thought was due to a fall (but I didn't specify about the fall)
May 8th a fall onto a pile of rocks at the bottom of a hill at Greensfelder. Upper body bruising but severe bruising, swelling, and knots on left hip, quad and knee. Of course, I finished the last 19 miles, in extreme pain.
June 15th: noted left quad bone pain, kinda in the hip too, leg tight and sore, and for past few days it ached in bed. I stressed the ache aspect.
June 28th I called it a nagging niggle, comes and goes, easy to ignore
July 9th CMAR trail race 33 miles of hills, noted that left hip "talked" and "squawked" and felt weak
July 27th noted the popping in my hip, the first mention of it and said that it had been happening last week too
August 5th said the hip is 95-97% "great", but some left knee pain and tight calf.
Of course this continued into October, with the failure of my hip flexor at Farmdale and the R2T. The month of November was full rest, apparently not enough.
That this started last May or June oddly makes me feel better. I was so concerned that any diet or activities or anything since October was the problem. This tells me that no, this is a possible hold-over from a year ago when I was still taking Forteo and still healing. Is this a good thing? Or more denial?
I took a long walk today after lunch to get my mind cleared. I've been listening to (of all things) Catholic podcasts (only 2 months ago it was Buddhism, so maybe this isn't much of a stretch) and I keep hearing the words of the Confiteor in my head. I heard it last Sunday at church with Michelle, then again this morning in a podcast I started after leaving Dr L's office. The coincidence can't be ignored here.
Tuesday, April 18, 2017
2nd appt with Dr L
Nothing today, had to drive for appt and Puppy is at Big Shark. And I hurt.
Today -- I reported poor sleep as that was when the pain was worst. I was mildly limping, suffered on the dog walk, described a deep pain that seemed to be coming from the femur bone, a pain down the front hip/quads, and a 'kinked' feeling in my back over my left hip.
What he did -- the 'scraping' along the back (OMG it felt like skin was peeling up) and he commented on the gritty feeling. Camel-to-cat stretch with his fingers dug into my back (OMG again). But this is improving lumbar mobility as evidenced by photos.
On my right side, he worked on a lateral hip muscle while I slid/pulled my left knee up to my chest. "Very tight" he said. Then we worked on area of the hip inside the iliac crest -- I start with bent knee, then straighten it and flex backwards with the gluts. OMG again.
Initially he thought about a few treatments before an MRI. Today it sounded like he'd consider an MRI at the next appt on Thursday. His description -- new and different pains are expected as loads and unloads change with treatment. He said pains 'leftover' after treatments probably indicate another injury, he said stress fracture today but in previous appt also mentioned cartilage tear. So I guess more on Thursday.
Right now at work, it hurts to stand and walk, sitting doesn't hurt as much but after sitting isn't good either. I'm mildly limping. I skipped my afternoon walk, and I'm not looking forward to walking out to the truck.
Today -- I reported poor sleep as that was when the pain was worst. I was mildly limping, suffered on the dog walk, described a deep pain that seemed to be coming from the femur bone, a pain down the front hip/quads, and a 'kinked' feeling in my back over my left hip.
What he did -- the 'scraping' along the back (OMG it felt like skin was peeling up) and he commented on the gritty feeling. Camel-to-cat stretch with his fingers dug into my back (OMG again). But this is improving lumbar mobility as evidenced by photos.
On my right side, he worked on a lateral hip muscle while I slid/pulled my left knee up to my chest. "Very tight" he said. Then we worked on area of the hip inside the iliac crest -- I start with bent knee, then straighten it and flex backwards with the gluts. OMG again.
Initially he thought about a few treatments before an MRI. Today it sounded like he'd consider an MRI at the next appt on Thursday. His description -- new and different pains are expected as loads and unloads change with treatment. He said pains 'leftover' after treatments probably indicate another injury, he said stress fracture today but in previous appt also mentioned cartilage tear. So I guess more on Thursday.
Right now at work, it hurts to stand and walk, sitting doesn't hurt as much but after sitting isn't good either. I'm mildly limping. I skipped my afternoon walk, and I'm not looking forward to walking out to the truck.
Monday, April 17, 2017
Easter week summary
This will be a short blog book for 2017 unless things change. I left Thursday for home, came back Monday (yesterday). No running. No biking. Some walks, some playground play. I was in pain for most of the weekend. Sleeping was awful hard. Playground was OK as I was distracted by how weak my back felt playing.
Wish I had more to say!
Wish I had more to say!
Sunday, April 9, 2017
Time to get a biking over-use injury
Weds, Thurs, Fri: 9.2 miles a day BIKE COMMUTE
Saturday BIKE 27.3 miles in 2:15
Sunday BIKE 17.2 miles in unknown
A week of no running! And I don't feel too bad about it, I really miss it but at the same time it was so uncomfortable (and painful) that being "released" from it is helping me through it.
Friday was my first treatment with Dr L. Only 10 minutes?! For $87?! Oh boy. Hope insurance covers this. The first treatment was the lumbar, on hands and knees do the sway-back, then with this chisely-feeling tool he'd work the adhesions while I arched into cat stretch. OMG that did not feel good! I could feel the sandy grittiness that he attributed to the adhesions. Note to self -- don't eat too much before these appointments! Second was the hip, he tested my ROM before 3-4 treatment (via hand, no torture device), tested my ROM again and my knee slammed into my chest! Wow?! How long does that last, does it go away after a few days, will I notice anything else?
I did notice that my back was uncomfortable on the drive home and for most of the day. Mostly lumbar, not pain but an 'uncomfortable awareness'.
Saturday was a day of errands, so I packed up Puppy and a lock and a backpack to ride to the library, to Brentwood for WF, then almost made it to the GO! Expo (not enough time), then home to shower. TH and I were meeting today! The ride felt great -- granted it was slow with all the stops -- but that probably helped me in the end. I did the ride on a few dates and water. My energy was flagging at the end, but not really. My back was OK, the lumbar area was tight and I was aware of it.
Sunday was the GO! St Louis marathon, I walked Shoogs to the brewery to see TV at mile 7, walked her home, then grabbed my other Puppy to follow him around town with MP. Seemed there was a headwind in every direction. I'd eaten a fatty brekkie, picking at my pork stock bones, so I was full from 9am to 2pm, so another good ride "unfueled".
No pains afterwards, no problems, just lots of back tightness and awareness. Every now and then I get a tight feeling, zing, tired muscle feeling in my back. Hyper-aware? Or real symptoms?
This marks too one week into my SCD reset. All symptoms of the suspected histamine issue are cleared, I'm not acutely missing those foods (Kombucha, egg fluff, tomatoes, canned tomatoes). And I'm up to steamed carrot, green beans, zucchini, and radish for veggies. tried an orange this weekend. Citrus is a histamine food, so I kept it one dose. Also eating some cheese. No problems, except a lot of M3 unsatifaction feelings.
Saturday BIKE 27.3 miles in 2:15
Sunday BIKE 17.2 miles in unknown
A week of no running! And I don't feel too bad about it, I really miss it but at the same time it was so uncomfortable (and painful) that being "released" from it is helping me through it.
Friday was my first treatment with Dr L. Only 10 minutes?! For $87?! Oh boy. Hope insurance covers this. The first treatment was the lumbar, on hands and knees do the sway-back, then with this chisely-feeling tool he'd work the adhesions while I arched into cat stretch. OMG that did not feel good! I could feel the sandy grittiness that he attributed to the adhesions. Note to self -- don't eat too much before these appointments! Second was the hip, he tested my ROM before 3-4 treatment (via hand, no torture device), tested my ROM again and my knee slammed into my chest! Wow?! How long does that last, does it go away after a few days, will I notice anything else?
I did notice that my back was uncomfortable on the drive home and for most of the day. Mostly lumbar, not pain but an 'uncomfortable awareness'.
Saturday was a day of errands, so I packed up Puppy and a lock and a backpack to ride to the library, to Brentwood for WF, then almost made it to the GO! Expo (not enough time), then home to shower. TH and I were meeting today! The ride felt great -- granted it was slow with all the stops -- but that probably helped me in the end. I did the ride on a few dates and water. My energy was flagging at the end, but not really. My back was OK, the lumbar area was tight and I was aware of it.
Sunday was the GO! St Louis marathon, I walked Shoogs to the brewery to see TV at mile 7, walked her home, then grabbed my other Puppy to follow him around town with MP. Seemed there was a headwind in every direction. I'd eaten a fatty brekkie, picking at my pork stock bones, so I was full from 9am to 2pm, so another good ride "unfueled".
No pains afterwards, no problems, just lots of back tightness and awareness. Every now and then I get a tight feeling, zing, tired muscle feeling in my back. Hyper-aware? Or real symptoms?
This marks too one week into my SCD reset. All symptoms of the suspected histamine issue are cleared, I'm not acutely missing those foods (Kombucha, egg fluff, tomatoes, canned tomatoes). And I'm up to steamed carrot, green beans, zucchini, and radish for veggies. tried an orange this weekend. Citrus is a histamine food, so I kept it one dose. Also eating some cheese. No problems, except a lot of M3 unsatifaction feelings.
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