Hunchback.

Having just been going to the PCP assigned to me at the time my insurance became active, I decided to follow the advice and recommendation of a friend and switch to the PCP at her office. She had had the similar experience of non or half diagnosis over the course of several years with little result, and said that this office was where she found doctors that would listen and take action. So I made the leap and I switched to an office much further from my apartment and made an appointment, X rays at the ready, to get my second opinion (since Professor Doctor hadn’t really given me… any opinion?)

I have no plans to abandon the original treatment plan. I do not want surgery, that would be shitty. But I wanted to make sure that I wasn’t going to hurt myself jumping straight into physical therapy without first making sure what exactly was wrong. I walked into the appointment with my new doctor still feeling completely confused about what my actual diagnosis was. The physical therapy referral from Professor Doctor, on the line labeled, “diagnosis”, had simply written “LBP” in large scrawl. I went in with the chief complaint of severe lower back pain and left with the diagnosis of… “lower back pain”? Great. Thanks for clearing that up.

A friend was kind enough to give me a ride to the new office since I’d never been to that part of town, and it is not what I would call an “easy” trip for a person in pain and in a back brace who needs a seat on the train. The office is underneath the Subway tracks, the walls are made of frosted windows, and there are chairs along those windows, facing the receptionists’ desk. This office, you can tell right away, is an osteopath’s office. An entire half of the office is dedicated to physical therapy suites, the other half, exam rooms.

I saw, let’s call her, Veronica, first. Veronica hung, rapt, but my every word. She seemed really concerned for my well being, and was receptive when I told her how much pain I was experiencing and how it manifested. She took pages of notes and showed me images of spines on her computer. She read the reports from my X rays and defined and illustrated for me what every single term meant. She told me what she thought my pain was and how she imagined it starting. She told me that I’d probably be given a stronger anti-inflammatory  (currently I an prescribed Naproxen), and that she was sending me to the physical medicine specialist and that after I saw that person I would probably be seeing a chiropractor. All in that same day.  I was later informed that Veronica could be slightly alarmist.

The physical medicine doctor, let’s call her Pam, asked me many of the same questions, looked over my  X ray reports with me, and then pulled up the images through the Lenox Hill Radiology website. She shuffled back and through the images a few times muttering “ok…. ok…” to herself every once in a while. She excused herself and came back with the director of the office, whom we’ll call Director Doctor.

Director Doctor sat and looked at the images, immediately muttering to himself, “kyphosis.” And going over the rest of the images. He explained to me, and showed me, what a “normal” spine looks like and how mine, instead, is shaped like a C. He let me know that whatever it was that was causing me the pain I’ve been experienced, has only been aggravated and intensified by the presence of kyphosis and the scoliosis I was previously diagnosed with, and had confirmed at this appointment.

He said my disc height wasn’t worrisome enough to warrant an MRI at this point, and seconded the opinion that careful and daily physical therapy would do me some serious good, if the X rays were any indication of the state of the bones. He confirmed that he believes I have spinal arthritis.

Still, there is nothing structurally worrisome about the bones themselves. There is no sign of deterioration or breakage, or mineralization. All of my pain, it is hypothesized, is soft tissue related (also nerve related, when in an exacerbation).

Things I noticed:

No one wants to tell me that I don’t need surgery.

For every doctor, there is a diagnosis. Sometimes they overlap. Sometimes they add new parts.

Things I was told:

“This is something you’ll feel your entire life.”

“This will be with you forever. There’s no fixing it.”

“This is probably what makes everything else worse.”

“You will have a pronounced curve and probably be bent over when you are 60 or 70 years old.”

I started to believe these doctors as the 4 hour appointment came to and end. It was the first time I had looked at the X rays with a doctor. It was the first time someone actually pointed to the areas of an image that helped to translate exactly what was happening. I was physically examined by 3 doctors, thoroughly and with care. I spoke up, I asked the same questions over and over again of each of the three doctors, and I didn’t stop until I felt like I had covered all I possibly could.

So, you know, all in all, it wasn’t great news. But it was good to know that I had covered my bases and found a place where the doctors listened to and answered my questions. So, onto physical therapy it is.