More on Piriformis Syndrome

I have now had two steroid injections into the piriformis. The first one was great and I felt normal for a short time. The second time, the radiologist managed to hit the sciatic nerve and that was a bit disastrous. I completely lost any feeling in my right leg. I couldn’t believe that the hospital let me go. They just told me  to be careful. But the leg wouldn’t take any weight and it felt like my knee was going to bend backwards…my husband had to get me out of the car and to the bottom of the stairs and he hurt his shoulder. I had to climb up the stairs on my bum and for the rest of the day, I had to ask for help to move. It was unbelievable.

The next morning there was still parts of my foot that were “frozen”. And the sciatic nerve was really irritated. Totally different. It took about a week for the irritation to go away but the piriformis is still hinkey although it is better. On Sunday Oct 11 the muscle went into spasm and would not stop. Horrible. The next day, the leg was so fatigued I couldn’t walk around the block. It’s coming and going which I’m grateful for. Before it was spasming all the time.

I saw Dr. Devonshire on Friday and she agreed that it was time to do the Botox. At least there will be a more lasting effect. I asked her what would happen if the nerve got hit again and she said that it would stop the pain fibers which is all right by me.

I have had tremendous relief from the lift in my shoe. I also had the left shoe built up all along the bottom. It is unbelievable what a difference this has made. Physio said that my leg length discrepancy was only seen on standing. Anyway, the lift puts me back in a more neutral alignment. That translates into less pain. All of a sudden I am standing straight. It’s so strange. I have exercises to do to strengthen the surrounding muscles (first stretched the piriformis but now it’s good). And we’re trying to move the ribs separate from the hips. I have been locked for a long, long time so even being able to do the side bend and move the ribs separately is a huge big deal. I”m just watching the end ranges of movement. Also strengthening proximal hamstrings. Amazing how those little things are so hard to do. One day I expect to get back on that reformer. I’m also doing the elliptical everyday or walking.

Still Doing Well

I feel quite fortunate to be able to say that even though the piriformis is still inflammed, I’m able to manage things. It is taking a little bit to get used to the new drug regime – cymbalta and nortriptyline – but I am getting  used to it. I really felt out of it for the first 5 weeks. The doctor told me to play around with the timing and I think that I have found a balance. I take the cymbalta at 1:30PM instead of at bedtime. I had a terrible time with my gut and pain which is what prompted the desire to change. That has been resolved and I am also no longer sleeping so much. I awake on my own between 6 and 7 which is my normal time.

Neuropathic Pain

I find it very interesting to see the pain managed so successfully with non-narcotic drugs. I’ve been in pain for years supposedly from my arthritis although my case is quite complicated. But isn’t everyone’s case different and complicated in other ways?

NSAIDs (non-steroidal anti-inflammatories) helped the pain but this was far from complete. And these types of drugs are not meant to be taken forever. The ideal case is that you get an acute inflammation from something eg spraining your ankle and you go on the NSAIDs for 10 days to aid with the healing.  Arthritis, however, is not an acute situation but rather is chronic. People go on the NSAIDs because of the pain and the drugs help to different degrees.Unless the patient is persistent about their level of pain, it often stops here. And the patients’ don’t know what is “normal” pain from arthritis. The one thing that they do know is they can’t manage many “normal” daily tasks and this can impact their quality of life (QOL) to varying degrees.

Around and Around We Go

Well, there is no shortage of changes, no shortage of frustrations and sometimes no shortage of hope. The most recent news is difficult to get through. The physicians are getting risky with their suggested treatments and I’m really having to decide just how much I am willing to gamble. I feel, after the hyperthermia trial in Holland, that I am done with the experiments.

Now I am at steroid injections and am stopping that unless they are done radiographically. I was a neurologist’s office last week and she gave me 6 injections trying to hit the piriformis muscle. I feel terrible now and over the last week it’s been hell. I was supposed to go today for a shot into my neck and begged off. She’s made an appointment to do a repeat one radiographically but this being Canada I have to wait a couple of months…She wants to do botox injections into the muscles. I am totally uncomfortable with that and want a second opinion.

Dr. Fernando Barinagarrementeria Aldatz in Queretaro, Mexico

Dr. Fernando Barinagarrementeria Aldatz is located in the Hospital Angeles de Queretaro.

I got in to see him in about one week. The visit was 800 pesos. He never once made me feel like I should leave. He chatted and asked me all kinds of questions.

Once you make the appointment send some info to him by email. Then phone to see if they got it.

I sent him reports and the hospital had a bit of a computer issue on that day but no one knew where it was.

The receptionists are nice. If you call they may tell you it is his personal email (which it is), so they can’t tell you whether the doctor has received or not.

Tell them to ask him or you’ll waste some time. You might have to phone back but it’s a much better way to get the most from your visit.

For sure, if you have had MRI’s done, bring the CDs.

And just so you know what he looks like I’ve attached a little picture. He is an absolute doll. And his English as good as mine.

Let me know if you need help or info.

Cuidate mucho (take care)

Darlene

Dr. Fernando Barinagarrementeria Aldatz

fbarinaga@infosel.net.mx – Personal

01 442 192 3041 – Cell

442.192-3006 – Work

442.215-9977 – Móvil

Blvd B Quintana No. 141, Loma Dorada
Hospital Angeles de Queretaro
Queretaro, 76060 GTO
Mexico

Otra – Mapa

Nicest and Best Neurologist in Queretaro, Mexico

Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain

The complete article is free. It’s well worth visiting the link because there is also a 12 minute video explaining what the Alexander Technique is. I’ve posted the abstract below.

 http://www.bmj.com/cgi/content/full/337/aug19_2/a884

Published 19 August 2008, doi:10.1136/bmj.a884
Cite this as: BMJ 2008;337:a884

What’s Safe and What’s Not- Osteoporosis and Pilates Matwork

http://www.inneridea.com/library/pilates-osteoporosis-pilates-exercises-osteoporosis-exercises

Modifying Pilates for Clients With Osteoporosis

by Sherri R. Betz, PT

I’ve snipped this out of the article. The above link is well worth clicking. This is the BEST article on Pilates and Osteoporosis that I have seen.

 

<<snip>> What’s Safe and What’s Not 

Safe Pilates Mat Exercises

God Grant Me the Serenity to Accept the Things I Cannot Change

Life is a constantly changing canvas. We either adapt to the chances or we stay where we are. I’ve seen people that are bitter and angry. They can’t get past it and they put themselves into that scenario every single day. Not realizing that some changes have to come from within…

I had a support group back when the hospitals were notifying people that they had hepatitis C from the blood transfusion they had during surgery…I understand the anger- it was a part of me, too. But if you don’t let it go, you live and steep in that anger. It eats you up. No joy. So many other things to be thankful for. Children. Grandchildren. Life. Even in that moment of giving support, I met people that became lifelong friends. Special people I never would have met. I’m not saying that the anger has no place – it’s just not the place you want to stay.

For ten years, I suffered from hepatitis C. I choose the word suffered carefully. Everyday was a trial. Getting out bed was hard in the morning and sometimes wondered why I was getting up. I kept fighting. I was in clinical trials and spent three years taking drugs that may well have caused some of the problems I’m dealing with today. Nothing worked. Then I went to Holland and was accepted into a clincal study. It was a 7 hour surgery where a machine was used to heat your blood to exactly 41.8C. It caused the proteins in the immune system to unfold (from the heat) and then on the cooling refold back into their natural shape. The hypothesis was that the immune system was defunct. It no longer recognized the hepatitis C as an infection. After the surgery, it sure recognized it. And then I underwent high doses of chemotherapeutic drugs for 52 weeks. I needed blood transfusions (ironic, huh) and had to take shots to build my neutrophils- part of your white blood cells. I still have to take those shots. It was the worst year of my life. But I persisted where my family had doubts. I knew this might be my last chance to rid myself of this terrible disease.

Well it worked. That was in 2004. The hepatitis C is till undetectable. The odds on it returning now are very small. Every day is a good day compared to when I had the hepatitis C. But no one knows what caused my spinal degeneration. Advanced disc disease. Spinal Stenosis. Foraminal stenosis. Secondary scoliosis. Was the drugs? Was it the hyperthermia? Those are questions that can’t be answered…But I had MRIs from 2001 that showed normal degenerative changes for age. Now they read like a book. I have the spine of an 80 year old and the mind of 23 year old. I wouldn’t change anything. That’s how bad the hepatitis C was.

Now I sit before you having had three back surgeries. Being told that I move like a young person and my mind and body are not in sync. I’m used to fighting. Where does acceptance come into play? Do I accept this for my reality or do I continue to think that all will be normal one day? Am I keeping myself in this place the same way that the people did with hepatitis C? I don’t know the answer.

Maybe it’s a half way in between. I was born to fight. I was a blue baby back in 1954. Do learn to stop and accept the changes? I don’ t know….I just don’t know. God grant me the serenity to accept the things that I cannot change, the courage to change the things that I can and the wisdom to know the difference.

Muscle Database – sorted by muscle location

This is an incredible database of muscles and the nerves that innervate them. As a patient, it gives you a little more of idea of where the pain originates. For example, if the inside of your hip is sore and the pain radiates to the outside area of your knee, that follows the line of the Sartorius muscle. This muscle is innervated by the Femoral nerve at the root of L2, L3. This muscle functions to adduct the thigh (bring it in towards the midline), flexes the leg (brings it forward), and helps to rotate the leg medially (turn the leg inwards).

This database gives you all that information. YOU know what movements cause you pain. YOU know where you feel it. This doesn’t make any of physicians but when you are trying to tell your neurosurgeon where it hurts, it can help to isolate the area.

As a biologist, I am impressed with the amount of work that went into this table. It covers the whole body. In my earlier years, this would have been an invaluable study aid in human anatomy and the dissection lab.

Muscle Database – sorted by muscle location

Yoga Journal – Yoga Asana Columns – Easy Rider Asana Sequence

Yoga Journal – Yoga Asana Columns – Easy Rider Asana Sequence

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Check with your surgeon before doing any of these poses. The nice thing here is that there are photos of the all the poses.

A nice variety of assisted poses (using the wall or bolsters) for sciatica. Be careful with the Reclining Hand-to-Big-Toe Pose -variation 2. This is a twist even though you are using a chair and doing one leg at a time. The opposite hip cannot leave the mat. 

Extended Triangle pose and Extended Side Angle Pose are best done under supervision.

The Chair Twist should be approached with extreme caution. Do not force. Move within your limits. Dr. Guzman had me doing an exercise similar to this. I would try doing this standing first and reaching the crown of your head up as you turn. Lift up and out of your waist. You should not feel any discomfort.