Diagnosing.

When I blew my back out in 2006 it was a complete surprise. I was young and active with little family history of major back injuries. When I reached my apartment in Raleigh my husband (then boyfriend) Zack took me to urgent care. I distinctly remember how terrible that trip was. The car ride, the chairs in the waiting room that were too hard, the spasming muscles and what felt like patronizing staff made the whole ordeal terrible. I received my first-ever shot in the ass, a muscle relaxer that burned like hellfire. They felt so badly for me they let me sleep on a table for an hour before moving me to be x-rayed.

Here is the problem with back injuries: there are so many different kinds. Further, pain is subjective. So while two people may share a "pull" of the same muscle, one person may be able to keep working and living while another is crippled and in bed. This variance in pain tolerance also makes diagnosis difficult. After my x-ray showed I was "fine" I was diagnosed with a pulled muscle. This meant for months I took relaxers, got massages and took hot baths, hoping the muscle would heal and release. Instead these treatments only prolonged my injury by confusing my pain signals. It wasn't until several months later I went and had an MRI done. That was when I learned I had herniations in my L5 and S1 discs. Once diagnosed, my healing then seemed like a dream. Epidurals (steroids) and physical therapy and I felt good as new in just over a month.

My back began hurting again in November 2010. Whereas before I had a defining moment of injury (the sneeze) this time it was a slow process. Which really just means I had pain and ignored it. My understanding is that herniated discs never really heal on their own. Inflammation may disappear and back strength and flexibility help prevent and alleviate injury, but the risk of inflaming those discs is always there. I knew this and still did not pay attention when my back began to ache.

When I finally went for treatment I was often asked "what sparked this injury?" Originally I blamed an aggressive massage gone wrong. Later I blamed becoming active after a long period of being sedentary. I also blamed our bed, which was so old and concave that it really acted more as a hammock for Zack and I then any sort of supportive sleeping system. Really though what sparked my injury was carelessness. Even having a history of back injury I ignored those small twinges and aches. Those moments when you almost feel your back give out and then forget the weakness the next day. I thought I could diagnose myself and move on with my life.

When I finally admitted that maybe my body was hurting more than a simple strain it was really too late. However, I thought I knew how to fix it and went to the doctors who had helped me so much the first time. Like me, they thought that it would be an easy fix. After all, shots and physical therapy worked before, so it was safe to assume they would work the second time.

I want to take a moment to say that blame should not be placed on my doctors for any "failed" treatments. Like ignoring my body previously, I was also more than willing to just move through the treatments this time without asking questions. The doctors used my old diagnosis and old treatments. So when I actually felt physically worse after my first epidural it really threw me. Why would something that, in my memory was adequate, actually amplify and accelerate my pain and weakness? What we had ignored was the difference in pain this time. Before my lower back ached and spasmed. This time my right hip was excruciating and I had sciatic pain. In physical therapy I mentioned it and my therapist noticed they had only given me an injection in my L5. However, in 2006 I received shots in both L5 and S1. This is the price of not being a participant in healing. They are only allowed to do three injections...and I had just allowed one to be botched.

This was two times then where not paying attention had a heavy price. Diagnosis is difficult. Symptoms and pain are subjective. I try not to focus too hard on what-ifs. What if I had been more cautious in November, what if I had my back checked out when I initially had pain, what if I had asked what the treatments were going to be, what if... Hindsight allows indulging in scenarios where we are masters of our own fate and geniuses at life. In some of my darker moments that hindsight was a blanket, but really it may just be a lesson that I hope to god I've learned. It has certainly forced me into something I should have wanted in the first place, which is to be an active participant with my body. At the very least I understand much more the consequences of self-diagnosis and rushed treatments.