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Re-evaluation

I have had my back re-evaluated by an orthopedic physician's assistant. I'm sad. I'm disappointed. This is what happened:

I already wrote about the original trauma in this post.

After my mission, I got another MRI and went back to physical therapy for a short time. My insurance screwed me over so I had to stop going to physical therapy, but it was good to get a refresher on my exercises. The diagnosis was the same.

Fast forward to today, coming up on 9 years from the initial trauma, the herniated discs. If I remember right, it was October 2010 that I started to have my sciatic pain. So it has been 9 years since I've been aware of this back problem. I still have pain after long, exerting days or activities. Going for a run or spending a day at the zoo or National Mall will cause pain in my leg and lower back. Sometimes I even get the ankle pain.

September 12, 2019. I went to see the orthopedic office here in Virginia for the first time. I had my original MRI images with me. I don't know where the second set are. I probably never got the disc. They were able to give me an x-ray right there in the office and make a preliminary assessment. The PA looked at it and told me everything looked fine. She said it looked like there might be some disc degeneration in the lower of the two discs, but overall she was optimistic of my condition. I could perform all the stretches she asked me to without pain. I asked her about restrictions and risks to my physical activities. She told me I don't have any. She said I could run a marathon if I wanted to, when I suggested that I know I can't do anything I want to without training. I was excited. Elated is probably a better word for it. I felt free. Mentally free. You see, just a few weeks before, I had a meltdown about my mental health and how I was feeling about our move. It clicked with me that most of my mental health has been related to this back trauma. I didn't have help healing mentally after the incident. I don't blame anyone for that, but everyone (including myself) was focusing on the physical recovery. To be told that I didn't have any restrictions or risks to any activity I want to do released me from the mental block that had been holding me back from living my life. I've been living cautiously, in fear of re-injury and the worst case scenario. I felt on top of the world with that news. I was free.

On the 16th, I took Biscuit for a run around the block. We live in a hilly area and the block is about a mile long round-trip. We didn't run the whole way, but when we weren't running (uphill), we were walking quickly. We did it in 20 minutes. I felt great. I dropped Biscuit off at home and went down to the gym to work out some more. I rode the stationary bike for at least half an hour and then lifted some free weights. I was elated that evening. I felt so good! The next two days I was incredibly stiff and hit with a cold, but I didn't care. I worked out for the first time in 9 years without holding back. I wasn't the least bit concerned during my workout.

On the 20th, I got my newest MRI. It was great. I wish it had been longer so I could have slept/rested longer. I like MRIs. They're soothing. They're quiet. I'm not expected or supposed to do anything other than lie still. It was great. It was a nice break from my daily responsibilities.

Today I had my follow-up appointment with the orthopedic office. The point of it being to see my new MRI and tell me how my back is really doing. No guessing. The PA was great at explaining the images to me. She showed me my healthy, hydrated discs. Then she showed me my degenerative, bulging discs. The ones that herniated 9 years ago. L4-L5 and L5-S1. The lower one is worse than the upper disc. I always knew that. The degenerative part didn't bother me as much as the bulging. I thought physical therapy would have helped my discs return to their former position and stop bulging. I guess I was wrong. I looked at the appointment summary at home to look up all the medical jargon and understand it better. I asked the PA about my restrictions and risks again. She wasn't as optimistic as the last visit, but she still said I don't have any restrictions. I asked her about hiking with R and softball. She said I really shouldn't be carrying R on my back. Softball is okay.

I'm really sad. I'm depressed by this outcome. I was really hoping to see a near perfectly healthy back. I wanted to be completely healthy. This is my life. I'm going to start physical therapy again for 6 weeks, twice a week. They'll give me home exercises that I need to do every day for the rest of my life. Every day, for the rest of my life. That is a depressing diagnosis. I'm trying to keep it from becoming another mental block. When she said that, I thought about my cane. I beat the crap out of it on the 14th and threw it away. It was the physical manifestation of my mental block. I beat it up and tossed it. I didn't want to see it again and have it prevent me from living my life fully. It was satisfying to see parts flying and then finally chuck it in the dumpster. I can't have that blocking me again. I don't want it to.

Hopefully I can get positive again after grieving this news. The physical therapy home stretches will be good to remind me to stay healthy, maintain a healthy weight, throughout my life. I guess this is my thorn in my side.

The orthopedic conclusion of my evaluation:
Mild degenerative disc bulging, spondylosis and minimal facet joint arthropathy at the lower lumbar levels resulting in mild central canal and right lateral recess stenosis at the L5-S1 level with possible impingement of the proximal right S1 nerve root, and very mild central canal and lateral recess stenosis at the L4-5 level without evidence of nerve root impingement.

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