It’s a gray Winter Solstice day here in the Sierra foothills of Northern California, where I’m staying with my mother as she continues her battle with sciatica.
Last time I posted, mom had been diagnosed with a strained muscle in her low back. From the start, I was leery of that particular diagnosis; I couldn’t square it with the pain she described. It varied wildly in intensity and seemed to move from one side of her low back to the other. And it kept moving. As the weeks passed, the pain moved from her back down into the muscles of her bottom and then into her right thigh and calf.
In my own experience, the pain of a strained muscle doesn’t change locations. The muscle itself hurts. Sure, the pain might radiate or cause peripheral pain due to muscle fatigue, tightness and even spasms. But what Mom was experiencing didn’t square with that. A strained muscle in the back doesn’t cause intense, stabbing, burning pain in the lower leg. I wondered if she might have a pinched nerve somewhere.
My sister and I finally talked Mom into calling her doctor again. She was given an appointment that same day, and when she was called back to the exam room, we followed her like a couple of overgrown ducklings. As I mentioned in the previous post, my Mom is tough. She always minimizes her own discomfort, particularly to people outside the immediate family (she does it with us, too, but we’ve learned to call her bluff). But she’s also a bit forgetful these days. Jami and I wanted to make sure that her doctor had all the information we could give him.
It turned out that her doctor wasn’t there that day, so his nurse practitioner saw Mom. She listened carefully, perused Mom’s charts and asked questions. “Muscle strain” was the previous diagnosis, so she was working with that. Frustrated, I asked if a strained muscle in the back could telegraph severe pain into the thigh and calf.
She looked at Mom and asked her if it did that. Mom admitted it did. “Here, here and here?” the NP asked, touching the affected areas on Mom’s leg. “Yes,” said Mom.
It was as if a light bulb went on. “You have sciatica!” the NP exclaimed.
Heh. Nerve pain. I knew it.
You’ve probably heard of sciatica. It’s a pretty common ailment in the elderly population, caused by pressure and inflammation around the sciatic nerve, which is the largest nerve in the body. It runs from the spine down into the legs. Sciatica can be triggered by ordinary movements, like walking or reaching for something (a not particularly heavy something) overhead. The latter is how Mom’s case started. She was reaching up into a cabinet for her big wooden chest of silver place settings—and nearly dropped it when pain suddenly stabbed her in the low back.
Sciatica might be common, but don’t confuse “common” with “mild.” Sciatica can be horrifically painful and disabling. In my Mom’s case, it’s been both.
The doctor’s initial assessment was of a strained muscle because, at the time, that’s where the pain was. He’d ordered four weeks of physical therapy. As it turned out, the PT is also helpful for sciatica, so the NP told Mom to continue with it, but if she didn’t improve, to let her know and they’d order an MRI.
I learned a few things about Mom I didn’t know, that day. One is that she has degenerative disk disease. Another is that she has a mildly herniated disk in her low back, and that’s probably what’s pressing on the sciatic nerve and causing the problem.
The other big thing I learned was that Mom has pernicious anemia—and she’s had it for some time. That was a jaw-dropper. The only reason I found out about that is that I tattled to the NP about how hard it was for my sister and I to get Mom to eat. We were very worried about it, and we knew Mom wouldn’t mention it herself.
Well. It turned out that she’d been diagnosed with pernicious anemia months ago, but she’d refused B12 injections because she didn’t want to have to drive up to the doc’s office once a week for them. He prescribed daily B12 tablets for her, instead. But Mom has only been taking them sporadically. She said she’d forgotten why she was supposed to take them. She’d entirely forgotten that she was seriously anemic.
So now she’s getting a weekly B12 shot and taking the tablets daily. She’s also taking a narcotic analgesic for pain, and gabapentin at night, specifically for nerve pain.The NP suggested that she try to eat six mini-meals each day, focusing on proteins, and that she drink a half-cup of water every half hour. And she emphasized how important good nutrition is and how eating, even when Mom doesn’t feel like it, will help her body heal and get healthy again.
Unfortunately, Mom’s sciatica hasn’t improved in the two weeks since that appointment. She does specific exercises for it each day, but she’s basically bed-bound. The pain brings her to tears when she tries to get up in the morning and, while it’s sometimes milder during the day, it just keeps her down. When she does get up, she gets weak, trembly and exhausted frighteningly fast.
I’ve talked to the doctor once more since, to ask if she could take her pain medication more than once every 12 hours and update him on her worrying fatigue. He increased the pain med dosage to one tablet every six hours and the gabipentin dosage, as well. And finally, he was very concerned that she isn’t improving. He told her to stop the PT. And he set up an appointment for an MRI.
Mom has that this afternoon. With luck, it will tell us more specifically what’s causing her sciatica to hang on so doggedly and allow the doctor to take more aggressive actions to relieve it. I’m glad. Just sorry she’s had to wait, and suffer, so long.
I’ve complained here, in the past, about not being able to find a job. But right now, I’m grateful that I don’t have one. Because my days and nights are free and my family can take care of themselves, I’ve basically moved in with Mom so I can take care of her. I prepare her food and wheedle her into eating those six small meals a day. I keep her water glass full and remind her to drink. I’m now in charge of making sure she takes all her meds each day and gets to the doc’s office once a week for that B12 shot.
And I’m always around to help her move, if she needs me, to encourage her when she gets frustrated and blue, and to laugh with her and keep her company. I’m so glad I can be here and that she doesn’t have to face this alone. I’m glad to be needed and pleased that I’m able to help.
My own health situation remains basically unchanged. The rheuma, thankfully, hasn’t been too bad; mostly just occasional twinges here and there, and stiffness and some low aching in my hands and wrists. The !#*!@ hip bursitis continues to hurt me, though.
Still, I’m mobile, strong, and feeling good overall. I have an appointment with the orthopedic physiatrist on Jan. 3 (finally! Yay!) and I’m hoping that if he decides to give me steroid injections again, perhaps he’ll give them in such a way that they’ll work this time. He may possibly also prescribe some PT. I’m all for it. I’m dreadfully tired of these aggravating, aching hips.
I probably won’t post again until after the holiday, so here’s wishing all of you a very Merry Christmas. May the day be filled with joy, warmth, fun and lots of laughter. Oh–and may it be pain-free. Yes.