Thursday, February 01, 2007

A Reader Asks About the Lower Back

Thinker 2
I got an e-mail yesterday from a reader who stumbled upon this blog while researching help for a herniated disc. Funny, since that is also how Le Doug found me over a year ago, and look how happy we are.
This new reader is about my age and doesn’t know anyone else with herniated disc issues. At least not anyone who’s under the age of 50. She wanted to know how I dealt with it. In order to help her, as well as other young-ish people with herniated discs, I am offering the following advice. Do with it what you will. It worked for me.

Stop, Collaborate and Listen:
You’re hurt. Accept it. It’s the reason why you can’t run eight miles anymore or why you’re being roused from sleep at 4:00 AM with lower back pain. It’s why your left leg tingles all the time and probably drags behind you when you walk. Your body is asking, nay, begging for help. Please heed the warning.

Seek Professional Help
The best thing your general practitioner can do is write you a referral for a neurologist, one that specializes in pain management. Herniated discs need to be managed and it is a multi-step process. Better get going. It may take a while.

More often than not the first step in diagnosing a herniated disc is getting an MRI. This is to assess exactly how bad it really is. In the wise words of my Dr. Boris, mine was “pretty bad.” I could have told him that even without having to deal with the MRI, but I guess for insurance purposes it all need to be documented. He sent me to physical therapy for a few weeks, which did little to alleviate my pain. I was still losing sleep and taking low-dose painkillers ad nauseum. Finally, after sitting in his office after not sleeping for about three days, Dr. Boris looked at me and said, “Okay, you want a shot? I’ll give you a shot.”

Get Ready for Some Drugs
When physical therapy and time don’t fix your disc, it’s time to turn to the wonderful world of pharmaceuticals. A common way of alleviating back pain is to inject cortisone directly into the disc, thus soothing the inflammation. It only takes about ten minutes and it pinches a bit, but whoever thought of sticking the drugs right into the spine is a genius. Within a few hours you’ll feel a difference. You may even have feeling back in your leg. Afterwards, go home and rest. There will be plenty of time for tom foolery once the disc is back to normal.

You will also likely be given some painkillers to take on a daily basis. No, you won’t be floating around in a Percocet-induced haze. You’re not that lucky. Instead, you’ll probably be given Ultracet, which is essentially a glorified aspirin. They work well, so keep them handy, especially if you want to exercise. If you are an extreme case, as I was, you may be given Lyrica. Stay away from Lyrica. It’s a narcotic, which taken in large doses will make you gain weight, no matter how closely you monitor your diet and exercise. I gained between 10 and 15 pounds while taking Lyrica for about four months.

Nice and Easy Does it Every Time
Just because you may have feeling in your leg and lower back again doesn’t mean you should start running half marathons. While you were dealing with your herniated disc your body probably atrophied a bit, and that’s fine. When you start working out again, take it easy, other wise you’re going to be back in the doctor’s office with needles in your spine again.

Just hours after I got my first shot I went an audition where I was tap dancing. I spent the summer whooping it up at weddings and bachelorette parties, doing the Horah in heels that even drag queens would have thought were a bit much. I ignored any advice about taking it easy and six months later I needed another shot. It took three shots before I realized my foolishness. I’m back to running four miles and doing yoga, but that’s after a long year of shots and painkillers that made me gain weight. So do as I say, not as I did.

Learn to Like Yoga
When you’re in the early stages of fixing a herniated disc, things like running and dancing are pretty much out. Not only are they bad for your back (not to sound like an old person) but they’re going to hurt. This is the point in the program where everyone will tell you to take up swimming. While swimming is no doubt good for building back muscles, it’s a very cumbersome activity, especially if you live in New York. Where are the pools in New York City? Between changing and swimming and showering again, it’s not the most practical activity you can choose. Swimming in the Hudson River is also pretty much out.

That said, get ye to a yoga class. And I mean a real yoga class, not some Saturday afternoon nonsense at the New York Sports Club. You need to start rebuilding your core muscles, the muscles that support your spine. That means your back and your abdominals. Yoga classes are cheap and you don’t have to get go all wacky and New Age to have it benefit you.

The Good News: You Probably Don’t Need Surgery
The last thing any reputable doctor wants to do is send you to have surgery for that disc. They would rather keep giving you shots and try different painkillers before sending you to the operating room. Back surgery is no joke and will have you out of commission for weeks, not to mention the months of physical therapy. Don’t get back surgery unless it’s absolutely a last resort. Most of the time you can find another way to deal with it.

In Conclusion…
The bottom line is that healing a herniated disc takes time. I slipped my disc in January of 2005 and it took a good year and a half before I was running four miles again. That’s low end for me, since in the summer of 2004 I was doing about 8 miles a day. But as my boyfriend always says, you only get one back, and it’s a pretty important part of your body, so you have to take care of it.
P.S I have no idea what is going on with the formatting today.