February 4th, 2006

Brad @ Burning Man

My Aching Back

The reason that the Current Mood field has been set to "Sore" since last Friday or so is that on last Friday afternoon the 27th, virtually without warning, my back started screaming in mortal agony. By last Friday night, it had reached the "torments of the damned" level, and the pain covered the entire area from the top of my left kidney in back to about two to four inches down the inside of my left thigh. Even with 2 off-brand Aleve every 8 hours, it felt (and still mostly feels) like I'm being kicked in the gonads approximately every one to two hours, with the pain made worse by any attempt to bend over or sit down. By the next morning, after a mostly sleepless night, I began to wonder if it was kidney stones, because according to the NIH web site, the area of pain for kidney stones exactly matched the area of pain on me.

I got in to see the doctor on Tuesday and got a $800+ abdominal CT scan late Tuesday afternoon, along with a dishonest prescription. (More on that in a minute.) By Wednesday morning, the CT scan confirmed that the doctor's guess (based on the urine workup) was right and my guess was wrong. He said it was just lower back pain. I insisted on further testing because nothing has happened to me that would explain any kind of a major back injury. The only thing I could think of was that my faithful (trash-dock road-killed) executive desk chair was finally losing its back support pins, the pins that held the back in place, and so I wasn't getting as much back support as I'm used to. But heck, both back in my rent-a-cop days and when I was working for The Company That Would Rather I Didn't Use Their Name, I sat in much worse chairs for longer at a stretch with fewer breaks, with nothing like this much pain. He, of course, asked if I'd been in any serious automobile accidents, and I said, no, none that I could remember.

Late Thursday afternoon, I had a flash of inspiration. Yes, I was in an accident. I'm such a dork that I'd forgotten it altogether, because it was such a minor accident, and because I experienced absolutely zero pain ... not just at the time, but any time since then. Some of you may remember it: back on November 18th I got run into, at about 5 mi/hr, by some senile blue-haired octogenarian who needed more than 5 minutes to react to the "sudden" shock of her foot having slipped off the brake pedal while parking. I escaped injury at the time by doing a rather acrobatic roll across her hood. The muscles that hurt now are exactly the muscles I would have over-extended doing that lean, jump, tuck, and roll. So the current working theory is that I received a very, very, very minor back injury a month and a half ago, that hadn't completely healed. I wouldn't have noticed, because I have a fairly high pain threshold and very little bodily awareness. Then when the back support on the chair I spend 8, 10 hours a day in started to fail, the chair exacerbated the back injury enough to start crippling spasms.

kukla_tko42 told me that I might have hidden long-term injuries, and that phobias about dealing with bureaucracy or not I should have gotten the driver's insurance information and demanded a police report. Learn from my mistake: Kukla is always right. Dammit. Anyway, I got the broken chair replaced; the new one, a $99 cloth-covered "manager chair" from Office Max (+$10 to extend the warranty on the casters and the fabric to 4 years, and as much as I use this chair, it was worth it) has even better lumbar support (but less padding overall) than my old faithful companion. Hopefully the back will just heal.

To my vast aggravation, the doctor sent me home with a very expensive and completely worthless placebo: nabumeton (the generic version of Relafen). I'd never heard of it, which I suspect is why he picked it. What I was lied to and told was that it was a combination pain killer and muscle relaxant. It being a new drug to me, I of course searched the online literature as soon as I got home with it, before I took even the first pill. What I failed to find puzzled me enough that I emailed a doctor friend of mine, who did some professional literature searches of her own. Relafen is by no means a muscle relaxant. It's just an NSAID, not significantly different from aspirin. It's not even as effective a pain killer as the 3 times cheaper over the counter drug I was already taking and tolerating well, the generic Aleve. I've scheduled a follow-up visit for this coming Tuesday, and I intend to have words about this. Not least of which I want to know, since he was (correctly, it turns out) so convinced it was spasming back muscles, why didn't he prescribe a muscle relaxant like his office told me told me he had?

Oh, but the CT scan turned up one thing that faintly amuses and faintly aggravates me. Way the holy heck back in 1989, at my pre-employment physical for The Conspiracy, the company-picked doctor said that I had a small hernia. So I asked my regular doctor about it, who checked and then said that the company's doctor was smoking crack. As I've had to change primary care physicians over the years, I kept asking about this, until something like 4 out of 5 doctors in a row said no, no hernia. So I stopped asking. What was the one thing that the CT scan did turn up? "Small right inguinal (groin) hernia." Upon viewing the CT scan, the doctor gave me the same advice that that first doctor gave me back in 1989, that it's so small that since it's not causing me any problems, it's not worth the risk of surgery to fix it.

So four doctors in the row, when specifically asked, failed to find a common health problem on me. Only one doctor I've visited in my entire life went to the trouble of doing a really good medical history on me, and that had more to do with the fact that she was a personal friend than anything professional (although I gather that she's that determined to extract a thorough medical history from all her patients, which is unsurprisingly why she finds and solves problems that no other doctor at her hospital finds). And my current doctor just sent me home with a bunch of $3/pill aspirin and lied to me about what it was supposed to do for me. So I asked my doctor friend, what is it that we Hickses are doing wrong, that this is the quality of health care we've all gotten, all the time, all the way back to when my parents were kids seventy years ago or more? Am I doing something wrong? She says no, it's the American health industry, which does everything it can to dis-incent any competent doctor from going into general medical practice, to all but force all the smarter ones to become specialists, and which then rigs its reimbursement schedules and industry-standard pricing models to a schedule of, ideally, no more than 5 minutes per patient visit. She says that her own father, a retired surgeon, can't find a good primary care physician. I'm a bit crabby about that. And I don't think it's just the shortness of sleep, my fear of disappointing my too-patient girlfriend by getting crippled up this early in the relationship, or the solid week of constant pain that flairs up into mortal agony every hour or so, talking here.