Occam's Razor

I am not feeling too happy with physicians these days. Most specialists cannot see outside their own specialties. As for our general practitioners, they excel at treating the ordinary but often find themselves baffled by the mysterious, wherein they reach for their referral forms. This leaves us patients with more complicated medical problems often feeling desperate and depending on web sites for dubious guidance.

In 2004, I developed numbness and pain in my foot, which eventually spread to both feet. It was later followed by persistent tingling and burning on the back of my thighs when sitting. Since it started in my foot, I saw a podiatrist who stuck a needle full of steroids into my foot. When that did not work, he sent me to a neurologist and a vein specialist. The neurologist verified neuropathies. The vein specialist noticed my varicose veins and talked me into having the surface veins on my right leg removed. It was supposed to relieve the pressure on the nerves of the foot. Eventually I had tarsal tunnel surgery to treat a condition that apparently I never had. Thousands of dollars in co-pays alone were wasted. It looks like the real problems were upstream, but no one bothered to raise this is a possibility. I sure didn’t have a clue.

My primary care physician was baffled when I last saw him but when I told him I thought I had sciatica he gave me a list of referrals to more specialists. I haven’t reached the bottom of his list yet, which includes pain management specialists. I did see the orthopedist, who verified something I already knew from a previous MRI: my spine was fine. When I said I thought I had sciatica, he sent me to a chiropractor. There you can find me two to three mornings at week, generally at 7:30 AM getting traction on one of their VAX-D machines in my latest attempt to live something resembling a pain free life.

No pain, no gain. Traction is not necessarily painful, but it can be. However, it is uncomfortable. It has quickly risen on the list of things I would really prefer not to do. I would not be doing it at all if I did not feel desperate. Traction involves mounting a tight harness around my waist, lying down on the traction machine and letting the machine methodically pull me at sixty to eighty pounds, for ten cycles, while I hold on with my hands. I need to create space between my bones so things down there can move around. For a while, it made my breastbone hurt. It definitely makes my shoulder muscles hurt.

I have no idea whether this will work or not, but the chiropractor’s approach at least sounds logical. They took X-rays of my waist standing up and bending. When I bend, a space near my hipbone where the nerve to my right leg traverses is noticeably smaller than the one on the left side. The premise is that this is where my nerve impingement is occurring and is the root of my problem. Traction, ultrasound, low level electrical shocks to my lower back and right leg should allow my nerve to transmit data freely, making it go away in a couple of months. It’s like taking your foot off a hose. Or so they say.

It’s just a matter of getting a proper skeletal alignment, my chiropractors Dr. F. and Dr. R. assure me. They show me on my X-rays how one hipbone is slightly below the other. Get it and my spine in alignment so everything is aligned naturally again and I should get real relief. Alas, it’s not a simple thing to get your spine realigned. It means you have to become good friends with your chiropractors, a VAX-D machine, the youthful woman behind their counter and the women in the therapy rooms because you will be seeing all of them regularly. In fact, they may get more intimate with you than your spouse, as their soft hands slip ultrasound pads under your briefs and onto your buttocks. This part of the therapy happens after the traction when I am still trying to walk normally. I am still frequently moaning and feeling like a bat in sunshine because my head had been pushed inside the darkness of a U shaped pillow for twenty minutes. Otherwise, their hands might feel sensual. The electrical sparkly set of pads definitely gives you a tingly feeling; it needs to be “strong but comfortable” they tell me. I think I have some inkling of what it feels to be electrocuted. It would not be my preferred method of execution.

After all this therapy, you finally get to see the chiropractor. Typically, the most intimate I get with my doctor is when he puts his finger where the sun doesn’t shine during a physical. If you feel you are not getting intimate enough with your doctor, you definitely need to see your chiropractor. If they are not repeatedly violating your physical space, they are doing something wrong. Sometimes I figure I should be wrestling with them. Invariably you end up in some unnatural position with their breath close to your face, they push you sharply and some bone on your spine or hips cracks or shifts.

When I think of people with back problems, I think of obese people. Oddly, I have noticed few obese people at this chiropractic center. It’s full of very healthy looking people. Perhaps like me they ended up here in part by doing things “right”. I have been getting regular exercise for more than thirty years. I have run thousands of miles altogether, and pushed or pulled on innumerable weight machines. All of this was to stay healthy, but all that exercise turned out to have some unwelcome side effects on my body by perturbing my natural shape. It seems if you believe in exercise, you need to keep your chiropractor on your speed dial.

Yet I like my chiropractors perhaps because they are so un-physician like. So maybe this means I am starting to groove with the whole holistic medicine thing. Go see a physician and they will order tests and write prescriptions. It seems they cannot wait to get rid of you. Both my chiropractors are personable and don’t seem to be inordinately worried if you keep them a few extra minutes. They care about my problems and since you see them regularly they know you by name. Dr. R. can relate to my sciatica. He gave me his experience. “The pain was so bad I was screaming. I was living on Percocet.” Solution: months of traction and chiropractic care and it went away. “I am very hopeful for you”, he says as he had a 99.7% success rate when he worked for the military’s version of socialized medicine: Tri-care. He gave me his business card and wrote his cell phone number on it. “Call me anytime with any questions,” he says. I am not used to positive attention from doctors. Is he trying to help me, or pick me up, or both?

This is my first venture into holistic medicine. “Chiropractic first, drugs second, surgery last,” their sign says. I need to temporarily turn my spine into something more like jelly than a spine, and let things resettle into a more natural shape. To facilitate this, I must also take calcium supplements. Most importantly, I have to keep coming back, get more traction, have more sparkly things done on my spine, make more small talk with the Swedish therapist and give them a twenty-dollar co-pay. Then I stagger off to work where I periodically place ice bags under my thighs and in the small of my back to dull the chronic pain.

I obviously am not sure this chiropractor thing is going to work out, but I am hopeful. However many visits it takes, it will likely be a fraction of the cost of my two surgeries or the other specialists I saw who largely wasted my money and are causing our health insurance premiums to go through the roof. Time will tell, but I just wish I had been smart enough to start with the chiropractor. I might have removed years of pointless misery from my life.