"It's Not Your Knee, It's Your Spine"

A Red Herring

Last weeks emergency visit to my Orthopedist was a visit full of questions, discussions, studying information not previously seen, and an ending diagnosis that was not what I hoped to hear, although I will reveal that I knew this was the root cause of this acute and severe nerve pain running down the anterior thigh.  

The best part of this:  I have a competent doctor, my questions are answered, and I know which direction I am heading.  It's always so freeing to know what exactly is the root of my pain.  We're not there yet, but I must say that I am quite impressed with this Orthopedic Surgeon.  

Another Red Herring in my life with this destroyed spine.  (*Red herring: noun, An English-language idiom that commonly refers to a type of logical fallacy in which a clue is intentionally or unintentionally misleading or distracting from the actual issue.)

First time an RH happened was 1996, year of my first Thoracic spinal surgery.  Something else was focused on, leading the physicians away from the cause and leaving me still suffering from the pain of the original issue while the Red Herring was taken care of.  

16 years later, this one is an interesting combination of an actual injury that could cause this type of pain, making it even more challenging to get to the root of the matter.  

I like docs who have recently been in training of sorts, whether it be a resident, etc., or a physician that has his entire career in front of him, excited, driven, actively determined to find what is wrong with his patients.  This doctor is one, very clear, and above all, he uses really great descriptive words when explaining something to me.  The kind of medical terms that aren't normally used in most physician/patient interactions.  I love it.  I learn so much, it's like a class mixed in with a visit.  I am looking up words after each visit!    

As he reviewed the standing Xrays that he ordered, I got out a copy of the most recent CT scan of my Thoracic spine, wanting to make sure that he had as much information as possible.  Although we were studying the knee, having that spine report was invaluable to the total patient view, a Holistic view.  

Then it was time to manipulate the knee joint.  After finding a spot that was extremely tender to palpation (that would later receive a Depomedrol injection) he asked me to lie down, supine with my legs straight out on the exam table.  I moved from sitting on the side of the table, and swung my legs around to lie down.  Oh.  Hold on!  Not happening.  I could not lower my torso and my leg at the same time.  I was stuck in a little 'v' shape, unable to move any more.

Severe, sudden pain shooting from my uppermost thigh down to the knee hit, the reason I was there a week early, not able to deal with it for another 7 days.  With my history of living with pain, this indicates an acute issue that demands immediate attention, for I am not one to run to the doc when it hurts.  This is that acute pain, nerve pain.  Stinging, it slams into your brain.  I can't help but think of James Franco in !27 Hours when he cuts the nerve in his arm.  It's the worst part of everything that had to be severed.  Nerve pain--The kind of pain that screams at you, shouts- and shouts loud, and you know you are not moving.  It burns, hits like an electrical jolt.  As I struggled just to get into position, I saw the doc watching it all, not helping me, just watching, and a look came over his face.  One of AHA!  The final question seemed to cap it all off for him, "Do you get numb in your leg below the knee, as in your feet?"  I answered "Yes, when I am driving", and that was that.

That's when I knew what I was going to hear, which direction this road will take me.  The good doc had a couple more positions he wanted me in that I just couldn't pull off, so the knee exam was cut a bit short.  He left to look again at the MRI of my knee, and also went in for a quick chat with his partner, a spine surgeon.  He asked me to walk out in the hallway so his partner could observe my strange, bent-over gait.  I can't stand up straight, it exacerbates the nerve pain to the inability to walk.

The diagnosis?  Suspect Sciatica with acute nerve compression, most likely in the upper Lumbar spine. Next stop is an L-spine MRI.  Last one I had was '02, it is basically a read of my Thoracic spine study, herniations, bulky osteophyte complexes, blah blah.  I am looking forward to seeing the changes over 11 years.

I am putting up my standing Xrays in the next post, which is already written and was ready to go, but that was before Ms. Screaming Nerve decided to speak up, helping us to get to the bottom of this, but really disrupting my writing groove, man.  ;)  

Gentle Hugs.......