Testing My Limits

This past Friday I had yet another MRI on my lower back. I'm quite glad that MRI tubes don't trigger my claustrophobia (that has more to do with being restrained or in tight quarters with people). I've had enough of them (6?) to know what to expect and to just see it as noisy relaxation time.

The 5/11/2014 MRI radiology report read, in pertinent part:

L3-L4: Mild diffuse disc bulge/posterior disc protrusion. There is no significant spinal canal narrowing. There is no significant neural foraminal narrowing.

L4-L5: Mild posterior disc protrusion, with posterior annular tear. There is no significant spinal canal narrowing. There is mild bilateral facet arthropathy. There is mild bilateral neuroforaminal narrowing.

L5-S1: Mild L5 on S1 retrolisthesis with uncovering of the disc. There is no significant spinal canal narrowing. In combination with moderate facet arthropathy this contributes to moderate bilateral neuroforaminal narrowing.

IMPRESSION:

1. Mild L5 on S1 retrolisthesis with uncovering of the disc. In combination with moderate facet arthropathy this contributes to moderate bilateral neuroforaminal narrowing. There is no significant spinal canal narrowing.

2. Mild posterior disc protrusion, with posterior annular tear at L4-L5 causing no significant spinal canal narrowing.

3. Acute on chronic endplate degeneration changes at L5-S1.

*exhales* Okay, that was exhausting to type. I can't imagine what it's like to read if you've never read that before. One of the places I linked to, the Virginia Spine Institute, had a really good paragraph that I thought I'd share to help you all understand why all that mumbo jumbo above equates to pain (in addition to my most-read post about my back, "A Mile In Her Shoes"):

Just like other ligaments, the discs can be injured. The annulus can tear or rupture anywhere around the disc. If it tears and no disc material is ruptured, this is called an annular tear. The outer 1/3 of the disc’s annular ring is highly innervated with pain fibers. Thus, if a tear involves the outer 1/3 it may be extremely painful. This tear will heal with scar tissue over time but is more prone to future tears and injury. Studies also indicate that annular tears may lead to premature degeneration of the disc, endplates, and facet joints.

In comparison, the 2015 radiology report seems pretty tame to the 2014 report:

IMPRESSION: Relatively mild degenerative disc disease at L4-5 and particularly L5-S 1. No significant encroachment on neural structures is seen, Comparison with an outside study of 5/11/2014 shows no significant change.

I dunno, part of me wants to throttle these radiologists for saying that anything about my back pain is mild... but... moving on.

This past Monday I had my discogram. I'm going to annotate what I posted on my Facebook:

my actual discogram

I survived the discogram without fainting or cursing. Though I wanted to do both.

Intramuscular antibiotic in my butt hurt like a mofo.
[It still does even 2 days later.]
5 Novocaine needles on my skin
[This is so I wouldn't feel the introduction of the needles aimed straight at my discs]
4 needles introduced into my discs (L2-L3, L3-4, L4-5, L5-S1)
[left quite nice bruises]
Then one by one they introduce contrast dye and pressurized the disc until they reached my absolute pain threshold.
[I assume that they were measuring how much pressure they could put on my disc before I reached my pain threshold]
So I felt nerve pain radiating down my leg and then my back started spasming uncontrollably.
[It was like 7 years of pain compressed into 30 minutes.]
At one point it hurt so bad that I told him I didn't want to do it anymore but that I knew I had to
[The results would help pinpoint which discs were causing the most issues for me -- cause as is the FDA won't let me go 100% Bionic Woman.]
One disc hurt so bad that I cried out in pain and he asked me not to be so loud as to not disturb other patients. I said, "Respectfully, I am the only one getting a discogram. I am not concerned how they feel."
[I'm really proud that I didn't unleash every single curse that I knew at him. To be fair, though, I was screaming bloody murder. He offered to give me a towel to bite down on/yell into. Really? Thankfully, his assistant, Tia, just kept alternating between holding my hand and stroking my arm. She was amazing.]
When all was said and done I was in a ton of pain but could move around.
[Very slowly, couldn't stand up straight, and sitting was not fun]
Then we got a cab to go to the CT place. My dad told the driver to get me there expediently which was the worst idea ever. Accelerating/decelerating is bad on my back normally... but this was hell.
[Quicker isn't always better.]
CT was quick.
[Props to my technician who was sweet and kind]
I am home now. Took drugs. Got a Jack CAT scan.
[What a good kitteh -- he has rarely left my side these past few days]
Yay! I didn't faint. But that was horrible.
[I cannot emphasize that enough -- it was HORRIBLE.]

Unfortunately, I can't read the pressure charts that the discogram produced -- except to say that it did its job to cause pain. Though, I'm not entirely sure if I was able to separate out the pain that I felt going down my leg versus the pain of my entire back having spasms (they stopped once the needles were withdrawn). I knew going into it that the purpose of the test was to cause pain, but I was not prepared for what happened. I was in agony from the time he introduced the needles into my discs to the time he pulled them out. I think I was in too much pain to have my blood pressure drop (vasovagal response). My self-preservation instinct was to punch this guy in the taco.

I know this isn't the image that they are
interested in, but it's pretty interesting

In stark contrast, the CT was quick, easy, and painless. I loved that the technician (C/Kathy) even took the time to read how I hurt myself and asked questions about it. Many doctors haven't cared to ask. The same radiologist for the 2015 MRI completed the report for my CT exam:

l. Mild degeneration of the L3-4 and L4-S discs with some contrast material present in the anterior epidural spaces at both levels.

2. Contrast material in the left neural foramen at LS-S 1. This finding should be correlated with the patient's physical examination.

So, my discs are leaking, which they shouldn't. There was also another term that I need to ask Dr. O'Brien about -- "There appears to be some degeneration of the LS-S1 disc with a heterogeneous opacification of the disc seen particularly on the sagittal images."

My follow-up with my surgeon, Dr. O'Brien, is on Tuesday. Wish me luck.