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April 13th, 2005

cjsmith: (caduceus)
Wednesday, April 13th, 2005 11:56 am
1. No, we don't know why these nerves hurt. Sometimes trauma to an area (even long ago) can make the nerves more prone to getting wildly irritated. Sometimes stress is a factor. If I had back problems, she would suspect trouble at the nerve root that was affecting the ends. I have "vasospasm" in the small blood vessels of the area, and decreasing blood flow to the nerves can make them irritable. This is probably NOT a structural problem or a disease.

2. Yes, there is hope that I will run again. I have to take things very, very slowly though -- not just increasing my movement slowly and gradually, but being very gradual with applying or changing treatments.

I cried when she said there was hope.

3. Inflammation can cause purely mechanical problems. Often when they go in surgically to remove a nerve that's inflamed or has Morton's neuroma, they see that it has an inflamed bursa (sac of fluid, apparently) around it. I thought bursa were around ends of bones, and yeah that's the common understanding associated with the word "bursitis", but they can show up around nerves too. So perhaps inflammation is squeezing/pinching/rubbing the nerves in the area.

4. People's bodies do not, in general, "adjust" to anti-inflammatories like they do to narcotics. The doctor had no explanation for why I'm having rebound pain related to the anti-inflam. One thing we can try eventually is an anti-seizure drug that is frequently used for nerve pain. For now, we're switching me to a different anti-inflammatory and not doing too many things at once.

5. To learn more about a potential system-wide inflammation problem, see a rheumatologist. I told her I understand that I'm not presenting with the classic signs or symptoms of the big autoimmune diseases. She said this would be worth looking into just for peace of mind or for the sake of completeness.

6. Yes, the Myofascial Therapy Center sounds like a good idea. So does another thingy I can get at a physical therapy center in downtown San Jose (sigh): a machine of some kind that is designed to increase blood flow and calm down the "vasospasm".

So now I'm googling:

- An article on vasospasm in the brain, with some more general info. I've had no specific tests for this, but in an extremity like the foot, maybe it's easily observable by a trained physician. My feet ARE almost always cold, even when the rest of me is warm, so a circulatory problem is believable.
- Bursitis - indicates that "bursae" form in various places, not always on bone, and that different people have different numbers of them. This might explain one really really weird thing an ex-boyfriend of mine had on/in his wrist...
- Anti-seizure meds and nerve pain. Neurontin is the one Dr. O mentioned. Sadly, no anti-seizure medication is FAA-approved for pilots -- apparently regardless of whether or not I have seizures -- so trying this could mean I would never fly again.