Step with me into the WABAC Machine, all the way back to the year 2000. There I was, forced to sit in a chair, head down, for months, while my many eye surgeries healed. And when I at last returned to work, I found that it was suddenly Incredibly Painful to walk with my coworkers in the afternoon. It eventually disappeared, only to return every year or so. I saw the doctor about it twice in 2003, but the first time my regular doctor was out of town (and I like him better than his partner), and the second time he thought that it was probably my flat feet causing all the commotion.
Time passed. The pain and other symptoms came and went, and came again, and eventually I decided that I really had to go see him again. I called on Thursday: “He’s out tomorrow, would you like to see his partner that you don’t like as much?” “No, it’s him or nobody.” “All right, well, you’ll have to wait until Wednesday.”
So, I went in today, and to me, it was a little bit like an episode of House, M.D.:
“Doc, my foot hurts when I walk. I think I could stand on it all day, no problem, and I think that I could even walk a great distance, but if I try to push it just a little harder than some magic threshold, then my left foot starts to hurt, and pain radiates up the outside of my left leg, to maybe boot height. It seems to get worse when I weigh more, and better when I weigh less.”
At this point, I can see him thinking that he’s still got stuff left on his plate to rule out. I trot out the other interesting symptom: “When the bad thing starts to happen, and after it’s been going on for a while, I start having a lot of trouble lifting my foot. You know how, when you walk, you normally like to land first on your heel and kind of roll the foot onto the ground, to minimize the slamming. When the bad thing starts to happen, my foot eventually just starts slapping the pavement like a dead thing.”
“Ha!” [He is super-interested, now] “Does your foot tingle?”
“It tingles like anything!”
“Have you had any back pain?”
“No…” Wait, yes! Especially several weeks ago, but even now there’s a little pain, and a little on the left side, now that you mention it.
“I think you’ve got a back problem. That dropped foot is especially significant. I’ll have Michael come in and test you, and then we’ll probably want an X-ray.”
Michael comes in. He has a little machine with electrodes, one of which he attaches to my back. Then he starts holding an electrode to various parts of my good leg, and slowly cranking up the dial to increase the electricity. I’m supposed to tell him when I first feel it. When he gets to the lower left leg, it really obviously takes a lot longer for me to notice it. He retests that area several times.
Afterwards, grinning, he shows me the numbers: “Can you spot the problem?”
WHERE LEFT (BAD) LEG RIGHT (GOOD) LEG
Top 12 12
Upper Middle 14 14
Lower Middle 16 16
Lowest 60 16
Me: “Hey, what’s that 60 doing?”
“It was an 80 at first, but when I retested you, you got it twice in a row at 60, so I gave you a 60. That’s one irritated nerve. I’m not going to say you’ve got a problem with your back, but…you’ve got a problem with your back. We’re going to take an X-ray, now.”
A technician took a series of X-rays, and then the doctor came back to talk about it:
“You’ve got some bad discs, especially at L5 (you can see how this area doesn’t look so great on your X-ray, too). We can’t really tell from the X-ray how bad it is; we’d have to do an MRI to tell for sure. But the disc (or discs) are probably poking out from the spine, and pressing on a nerve that runs to your leg. The harder you exercise, the more the disc squozes out and presses on the nerve, causing pain, numbness, and that dropped foot. If it’s too bad, we’ll have to refer you to a surgeon for an operation. But if it’s less bad, then we might refer you to get a shot into the disc to reduce the swelling.
“But for now, since your problem is only intermittent, and only comes on if you exercise too hard, we might just treat it conservatively: get an Inversion Table, which allows you to lie down suspended from your ankles, to decompress your back, and I’m going to recommend a physical therapist to instruct you on some Yoga to strengthen your back muscles. And lose some weight!”
While this sounds like it’s going to be something of a pain, it is Extremely Satisfying to have a diagnosis that explains all the symptoms. And I badly frightened the X-ray tech, when he asked me, after having taken the first set of shots, “So why are you getting pictures of your back?” “Because my foot hurts!”