My owie in Maui, or Denial is not a river in Egypt

It has been a long time coming. Approximately 10 years ago, at the tender age of 35, I saw my GP for severe back and leg pain. I had been building a shed in the garden and cleaning out our backyard pond. Both of these activities had involved some heavy lifting and lumbar flexion. 
“David,” said my GP, “It is normal at your age.” 

Up until that point, I thought of my GP as being a gentle and kind fellow. 

“That can’t be,” I replied in denial. “Nobody has ever said those words to me. I am not old enough for something to be ‘normal at my age,’” I said. 

I resisted the diagnosis, continued with my usual exercise and activities, and went for physiotherapy. After I developed a foot drop, it dawned on me that maybe I should heed my doctor’s advice. CT scanning confirmed lumbar disc disease with nerve root irritation. 

My kind and knowledgeable GP arranged for one of his anesthesiologist colleagues to inject drugs into my epidural space. Thanks to the accuracy of the diagnosis and of the anesthesiologist, I was put out of my misery. 

Life carried on as usual. I returned to jogging and gardening. Except for the occasional twinge of back pain, I was in good shape. In the last year, I even started going to the gym. Then came a family vacation to Hawaii during March of this year. It was great until I gave my younger son a piggyback ride one evening. The next morning, I bent over awkwardly to lace up my running shoes and felt a sharp pain in the top of my leg. The next day, the pain was also in my calf. 

Believing this to be muscular in origin, I persevered with jogging and working out. On our return home, I tried massage therapy, which did nothing for the pain. I paid a visit to my trusted physiotherapist. He told me that it sounded rather like disc disease again. 
“That can’t be,” I replied in denial (again). “The pain is in my pyriformis and plantaris muscles.”

My physiotherapist, Cliff, humor­ed me for the first visit. He treated my pyriformis and plantaris muscles. At my second visit, after I couldn’t change his mind, I wondered aloud if that would explain the numbness in my fifth toe and why the leg pain was worse when I coughed or sneezed. He smiled benevolently and suggested we try some traction.

I agreed, hoping that it would make me taller. After weeks of traction, I can safely say that I am still five feet short. However, my symptoms are improving somewhat with traction and IMS.  

For now, I avoid sitting, as this aggravates my symptoms. One of the benefits of this is that my patients think that I am in a hurry when they come to see me. They are used to me sitting down with them and striking a listening pose. Now they see me listening to them while standing. They interpret this as meaning that I am rushed. As a result, my appointments are virtually all on time now! 

I am looking forward to the accuracy of the anesthesiologist’s epidural needle in a couple of weeks’ time. Meantime, I am reminded daily that denial is not a river in Egypt, but the unhealthy way in which we cope with our problems. It is also the reason why we should all have a GP and not be treating ourselves.
—DBC

David B. Chapman, MBChB. My owie in Maui, or Denial is not a river in Egypt. BCMJ, Vol. 53, No. 6, July, August, 2011, Page(s) 257 - Editorials.



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