Diagnostics (AKA The Inquisition Revisited)

Status:  The pain is now continuous, I mean relentless as in Good LORD, doesn’t this crap EVER stop?

“Nobody expects the Spanish Inquisition!” so says Monty Python. I say they’re right, especially when you are going for an appointment with a health CARE specialist.  In this regard, yeah… a hellish round of torture is kind of the last thing on your mind.  But let me back up a little first and tell you how I got myself into the “Den of Madness” in the first place.

APPOINTMENT #4 +

I was lying on the examination table in SPINE DOC’S office while we waited for the big man. Mom brought me here and although normally we can talk the paint off the walls, after a combined wait time of 2 and a half hours, the sanitary paper crinkling in my ear was the only sound in the room.  It had been over six months since my injury so according to SPINE DOC’S first assessment, my back is not getting better by itself.   Now is the time we discuss “workable solutions.”   Thankfully, though SPINE DOC is a spinal surgeon he doesn’t dive straight away into full-on scalpel land.  He wants to try the least invasive procedures first. One of those procedures was called I.D.E.T.:

I.D.E.T: Intradiscal Electrothermal* Therapy (IDET)

According to the website www.IDETprocedure.com , The Intradiscal Electrothermal Therapy or IDET procedure offers the following:

“For many patients, Intradiscal Electrothermal* Therapy (IDET) may offer significant relief from chronic discogenic lower back pain— 

Major steps in the procedure are: You are lightly sedated for relaxation.  With the aid of real-time x-ray imagery (video fluoroscopy), the doctor inserts a hollow needle into the damaged disc.  A small wire-like probe is then inserted into the needle and pushed very carefully until the heat-able tip is near the area of disc injury. It is this heat on the disc that provides the long-term therapeutic effects of the IDET procedure...

*Trademark of Smith & Nephew
This information intended for United States customers only Disclaimer, Copyright and Hyperlink notice - Current Share Price - Smith & Nephew Corporate | ©2007 Smith & Nephew.

DEFINITION in Laymen’s Terms:

Basically: It sounds like the procedure tries to seal up the disc by cauterizing it shut. That doesn’t sound too bad (why couldn't they just say that?).

BUT ( and it’s a big BUT)..  before we do anything further, we need to be prove to the insurance that SPINE DOC’S hunch is true; that the split disc is adding a significant amount to my pain therefore, if we intervene surgically NOW, there is a good chance we can reduce  most of the pain. To prove this to the insurance company’s satisfaction, I have to have an anesthesiologist perform a specific diagnostic test called a Discogramss. SPINE DOC briefly explained the procedure by saying they would inject the disc with dye and try to recreate the pain. Discs that weren't damaged aren't supposed to hurt, and discs that are "kinda dicey or completely wrecked" he said "that's supposed to hurt pretty bad" But it's only supposed to last for a second or two as they get the positive reading and then the pain backs off. So at LEAST I knew that much. It’s time for me to hit the “Google” train. Here’s some info on the test from the website www.neurosurgical.com

OK…I’m not generally a big whiney baby, but that doesn’t sound like a bowl full o’ fun. “Reproduce my pain?,” but, my pain doesn’t go anywhere, so-o-o-o why don’t they just take my word for it? But if it’s what I have to do to get this back o’ mine fixed and get back to work – bring it on!

Mom and I are on the way to the office of the anesthesiologist (aka “needle jockies” according to Spine Doc). The office is in a trendy neighborhood off a point jutting into the Pacific Ocean.  The parking lot is perfectly landscaped with 2 ½ year old house trees and perennials in three color combinations. The building continued the ‘pulled together’ appearance of the Needle  Jockey's professional palace of perfection.

Needle Jockey #1 was very proud of his place here and of his Discogram expertise. He explained highlights of the test and when the pain factor was brought up, he smoothly said, "Oh no! I don't believe in torturing people! That's not necessary. I put you under while we insert the needles and test, then wake you up after that's all over. No no no, I don't see the need for putting anyone through that." Seriously? Oh yes! No wonder everyone here is so shiny and pulled together. This guy RULES.

It is the day of the test. We go to pre-op and the trainee I.V. nurse keeps missing the mark the other one is pointing out to her (oh goodie. I'm the nursing crash dummy. Who's naughty list did I get stuck on?) I'm a good candidate for this though because my vein is as big as a house. We're done and now I wait. Kind of. I am itching... a lot. Aw, this can't be good. Now this is squeezing like a python.. ok color me done! Now the next 15 minutes I'm saying, OUTLOUD "Um excuse me? This feels wrong, is it? This kinda hurts, OK THIS PRESSURE IS GETTING VERY DIFFICULT TO WITHSTAAAA-A-A-A-A-AND,HELLO?? I'm not usually and wimp but..." "OHMYGAWD!" I hear from across the room and people in pooh bear scrubs come running, stethoscopes, rubber tubes, and tape rolls start being arranged above their necks mid run. Finally a shaky, squeaky voice is heard above the frey, "U-u-u-uh-h, Misssus Cook? I'm sorry-y-y-. You must have been moving around a lot, because SOMEHOW the IV line came out of your vein and.. was...(just above a whisper) pumping.fluid.under.your.arm's.skin.. (now so the world can hear, a throat clear) 'a-ah-hem' - BUT WE CAUGHT IT JUST IN TIME so it'll be fine!" as she busily re-arranged arm tape and avoided eye contact. I look down to see what appears to be a
"reverse Popeye." Now that the staff has got a line into SOMEWHERE, the head nurse reviews the procedure and near the end says, "now when all the needles are in place , that's when the doctor will wake you up to RE-CREATE THE PAIN!!!WHAT?!?!? He doesn't need to fuggin recreate it, IT didn't GO anywhere!!! Yes, oh yes, boys and girls, the Spanish Inquisition is still firmly in place because he WAKES YOU UP TO CAUSE YOU UNBELIEVEABLE PAIN . Where in Heaven's name is this NOT listed as torture??? Now I have to think on this while I'm trying to "just relax, Mrs. Cook (sheesh)"

THERE'S A LITTLE "THEY PUT YOU OUT SO IT'S A BETTER TEST" KIND OF INFO! and we haven't even GOTTEN to the actually test yet!

“We’re ready for the patient now,” I hear from the side door.  What happens if the patient isn’t ready for YOU yet?  Can I get a do-over on today, God?  ‘Cuz if there’s a line for that, Lord Puh-LEASE.. put my name on the list.

THE DISC-O-GRAM BEGINS

The orderlies begin wheeling me down the hall and the time for smart remarks, even to myself, is over.  Spine Doc said it would be painful – more so than I’m used to. The saving grace here will be in that it goes by quickly and then it’s over, right? PLUS the fact, that for pity sakes, I can’t sit and I feel pain ALL THE TIME!  If this is the test I need to have so they can find the exact problem and better yet, have proof of it to show the WC insurance company, then it’s worth it. 

So, “come on GRRRR-L” (as I tell my little ol self what to do) I’ve got to focus and concentrate now if I’m going to make it through this test.  Maybe if I think of it like a sparring match, it would help.  Like this: I know I’m going to get hit or kicked, potentially harder than I expect in a match… particularly if I am not familiar with my opponent. The key is to focus on my defense of the next blow and how I’ll make my opponent pay for it with my next offense. Even if it’s not the correct way to approach this test, it’s all I’ve got that even comes close, so I’m going with it.

I woke up to the most searing pain I had ever felt!  My skin felt like it was on fire; not just my back, but my arms, legs, fingers and toes.  I was sure that fire was dancing on every part of my body facing the air. I sucked in a breath and let out a scream on the exhale just to hear, “Stay still, Mrs. Cook” from the abyss behind me.  Oh yeah, that’s going to be fucking easy!  I felt as if I had absolutely no bearings because I awoke to this pain – This is supposed to be the “non-torture” he promised?!? What a …. “Aaaaaaaiiee, SHIT!” I screamed out again as the needles he so strategically placed through my spinal discs leeched out into my spinal cord and turned the nerves into hot pokers.

“Is this the same pain you generally feel? Or different?” Holy crap people, this is the same pain like Hurricane Katrina and a summer breeze both involve wind..  “What the HELL do you mean – ‘Same pain’?” “Obviously, there’s more of it. I mean --TRY TO STAY STILL, MS COOK….” As apparently my sobbing was bobbing the “non-torturous” needles IN MY SPINE up and down. “I mean is it the same character of pain; Achy? Burning? Ho…” “YES! YES! JESUS HELP ME, YES!!!!!”  I just wanted him to stop whatever the hell he was doing there and go onto the next thing before I pass out. The pain was like someone had dropped Napalm charges in my spine while I was out and now I was burning alive from the inside out. Again, he pushed a needle deeper into the disc. “FU****!  (I screamed again with all my might) 

All I can see is white everywhere and the pain is worse than ever. I honestly feel like I have been struck by lightning and in the midst of it I have voices asking me “is this the pain you’ve had before? Achy? Burning?...” I have never felt my body screaming more in my life but Yeah, Buddy it’s fucking burning.  Now he moves to the next level – that was just the first in a series of four.  The next two were horrible, but not as extreme. The last, however, was just as brutal as the first. Plus it had the baggage of a lumbar spine now utterly racked with terror and pain.

&^&^&^&^&^&^&^&^&^&

Everyone has heard about, discussed and either lamented or lampooned the word “torture. Let’s discuss the idea of torture “My way”, that being if the actions match the words in the freaking Dictionary, it fits. Looking up a word’s definition is a lost art these days.  We’ll make the first stop at Webster’s own Medical Dictionary:

Definition of Torture (from Websters MEDICAL Dictionary)

Torture: An act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person, for a purpose such as obtaining information or a confession, punishment, intimidation or coercion, or for any reason based on discrimination of any kind. Survivors of torture often suffer from physical and psychological symptoms and disabilities. There may be specific forms of physical injury including broken bones, neurological damage, and musculoskeletal problems. Torture may results in psychological symptoms of depression (most common), post-traumatic stress disorder, marked sleep disturbances and alterations in self-perceptions together with feelings of powerlessness, fear, guilt and shame.

This statement comes from the medical profession’s very own dictionary.  They say that these are the definite after effects of having endured torture AND YET they do this to us every time they put us through another diabolical test or procedure.  Every time they leave a pain patient suffering with little or no pain meds because of an ARCHAIC belief that “opiates are always bad (you may get addicted, yada yada yada).  They are directly adding to the continued torture and /or after effects of the very patient they swore to help!  HOW DO WE NOT SEE THIS?!?!?!?! Or once we have seen it, how do we ever look away again?

I was told I had to lay flat for the next 24 -48 hours so that I minimize the risk of springing a leak in my spinal dura – the spinal wall that holds my central nervous system and the CSF or ‘Cerebral Spinal Fluid’. Here’s the catch that I apparently, not ‘they’, thought of. Before I get to LAY FLAT: I HAVE A BOUNCY 2- HOUR RIDE HOME IN A RENTED TANK!! When we tell the post-op team that, they have the nerve to look surprised, as if I lived in the Quizno’s next door.  I’m so mad and hurt and traumatized all I can think is “please stop these idiot’s babbling and get me the F-bomb OUTTA HERE!!!” as I hear, “oh. Well, uh… maybe she could sit really…oh. She doesn’t sit? How did she get here? .. ya.. I see…w…” going on behind me.  Apparently I am a magnet for sweet, dumbass hospital worker’s. Jeez! I must have been Eva Braun in a past life if my karma’s this bad.