Author: Paul Tomblin

So to follow on from The current state of pain, here’s where I stand now. I’ve been paddling for about an hour every 2nd or 3rd day. I’m not very fast, and the thermarest pad I’m using to protect my hip/butt makes me very unstable. I tried biking a few times and after the first one I felt great but after the second my butt was killing me for several days afterwards, so I probably won’t be doing that again. Too bad, because Towpath Bike finally got my gear indexing set up perfectly – it’s smoother shifting that when it was brand new.

Knees

Not much change here. I think I’m getting the “stabbing pain” more frequently, especially after paddling.

Ischial Tuberoscopy Area (aka “Butt pain”)

It got good enough that I was actually able to stand a trip up to Canada, by sitting in the passenger seat with the “sciatica pain” cushion and the seat reclined a lot to keep the weight off my butt. Unfortunately I tried cycling twice and now it feels pretty much the worst it’s ever been. Hopefully it will abate over the next few weeks again.

It’s very hard to remain upbeat about this pain. It’s still restricting my activities and enjoyment of life, and OTC Aleve and Tylenol aren’t really doing much. If I forget to take it for a couple of days, I notice the pain has gone from merely nearly unbearable to completely unbearable.

I really like my new primary care physician, but she seems to have seized upon the last conclusion from the doctor who did the pain stimulator implant test who suggested I should try the Mayo Clinic or the Cleveland Clinic. That seems like a real expensive roll of the dice. I’d have to spend some unknown amount of time away from home, and I don’t know how much or how little insurance would cover.

Tooth/Jaw Pain and Headaches

The tooth/jaw pain I reported last time has been pretty much cleared up. The dentist decided the antibiotic he was giving me wasn’t working, so he switched to something stronger. Almost immediately I got a big swelling on my jaw below a tooth two down from the one he’d started the root canal on. I got that tooth removed a day or two later. After the infection died down and I got the stitches out, the root canal was finished and in a few months they’ll implant a socket where the tooth was removed so I can get a replacement.

Meanwhile, in a quest to see why I’m having all these headaches, I got an MRI of my head which showed a very bright thing in one of my sinuses. It looked scary, but when I eventually got an appointment with an ENT he said it was just a mucosal accumulation cyst, and it was nothing to worry about. About 30-40% of people have one of these and most never know it.

But long before I got to see the ENT, the headaches went away on their own. It seemed to coincide with the progress of the antibiotics. They tell me it’s very rare for infection in the lower jaw to cause headaches, but it sure seems like it did.

Diabetes?

While I was dealing with all these other things, I got a blood test that showed that my A1C had gone from 5.7 last year to 10.7 this year. I’d had this year’s blood test done at a local blood lab that I’d only just discovered was near me and I was finding it hard to believe my A1C had gone so completely to hell in just a year, so I asked for a second test which I had done at the same lab I used last year. This time it was 11.1. That’s full blown diabetes. My doctor put me on insulin – at first slow acting stuff before bed, and later I was also put on fast acting stuff before each meal. What a pain.

When I got my gall bladder out they warned me that it might take a while for my digestion to accommodate the lack of a gall bladder. I wonder if that’s what caused the diabetes? I hope so, because it means it might go away again.

Also, I started noticing that I was rubbing my feet against each other, and it seemed like I was doing it because my feet were always freezing cold and the skin on my feet are always tingling. My doctor did some simple tests and says it’s not due to lack of circulation or lack of nerve sensitivity so it’s probably not due to the diabetes. But it’s still annoying.

Let’s see where I currently stand.

Knee Pain

I’ve had knee pain since I was approximately 14 years old. It’s mostly a diffuse unlocalized pain that is usually moderate but sometimes gets worse. But the worst is this stabbing pain that feels like somebody going jabbing an ice pick under my knee caps. That doesn’t happen too often, thank goodness,

Back then, the usual doctor’s approach was “Take these anti-inflammatories and stay off it for a few months”, which I would do and then restart doing stuff and then it would flare up again. Sometimes they’d tell me to do some stretches and exercises to build up my quads. Never did much except make them hurt more. Over 40+ years I tried everything from physio to having an arthroscope shoved in there to acupuncture, and no physical cause or any form of relief was ever found. But in 40+ years, I’ve also made peace with the limitations it’s placed on me. Gave up running, orienteering, backpacking, canoe tripping, walking too far, and also got more aware of doing things that could hurt them, like sitting with my knees bent.

Unfortunately in the mid to late 80s cross country ski racing was really becoming heavily biased towards skate-skiing, which was just terrible for my knees. I recently restarted skiing with several self-constraints: no skating, no skiing without groomed tracks, no racing, no more than 3 or 4 times a week. (I did 3 days in a row once and got stabbing pains in my knees afterwards.)

Ischial Tuberoscopy Area

This pain (aka “Butt pain”) came on about 2.5 years ago, and steadily got worse all through the 2021 kayak season. By April or May I was stopping in the middle of training paddles to stretch and rest my butt. By June, I was stopping frequently in the middle of races to lift my butt out of the seat. By the last race of the season, I got out of the boat and realized I would never paddle again that season. A month later I was on a long car ride (not driving) and it was so painful I was holding back the tears by the end of it. The pain was a major reason for retiring from work at the end of 2021.

This pain feels like it’s right on the “sit bones”. One of the many doctors or physical therapists I’ve seen in the last year and a bit explained just how complicated that area of your body is – as well as the sit bone (aka ischial tuberoscopy), there are bursae there, your sciatic nerve comes through and several muscles including the performis and quadrilateral femorus attach to your hip right there. It’s a very small area, near the surface and the pain level is directly related to how many hours and how hard it’s being pressed. Unfortunately because of all the things I’ve had to give up because of my knees, this pain has forced me to give up just about everything I planned to do in my retirement, like kayaking, cycling, traveling, visiting family, sitting at a computer, etc.

I’ve spent so much time in the last year seeing doctors and physical therapists and trying all kinds of diagnostic and therapeutic measures. Pretty much the last kick at the can was a spinal cord stimulator trial, but that failed. Nobody will give me any pain meds other than OTC Aleve and Tylenol, which do almost nothing (not nothing, just almost nothing). I’m kind of despairing right now.

Other Hip Pain

I haven’t actually been feeling for a while but I sometimes get an intense stabbing pain in one hip joint or the other. I started walking the dogs twice a day instead of once because walks seemed to help.

Tooth/Jaw Pain

Back in October or November, I had two fillings put in by a new (to me) dentist. He warned me that I had a filling there that was almost too large and I’d probably need a crown there sooner or later. One of those new fillings was painful right from the start – I hoping it would just sort itself out and it kind of did. The pain diminished but then recently got worse. The first thing they did was to correct my bite by reshaping the top of the filling, and that helped for a week or two, but then it got really, really painful on a Friday afternoon. So I suffered through a weekend and when I got back to the dentist he scheduled and then did a root canal (on the same day my stimulator trial was declared a failure, so it was a really great day, let me tell you.) It’s been getting better every day as the antibiotics take hold. But I’m also now painfully aware that I grind my teeth at night and clench them during the day if I’m not thinking about them. The dentist said they’re checking with the insurance company as to whether I’m eligible for a night guard.

Headaches

I get headaches nearly every day, and they often last all day. Sometimes I think they’re eye strain, but sometimes they wake me up in the middle of the night and then they’ll wreck my sleep and be with me half the day. I think at least the middle of the night ones are probably related to the teeth grinding. The day time ones might be as well or they might be eye strain. I’m thinking I might have to see my optometrist again to check my prescription.

Ear ache

I’m not sure why “headache” is one word but “ear ache” is two, but that’s the way it looks right to me.

I’ve fairly recently had a sort of hotness and ache in my left ear. That’s the same side as my painful tooth (and infection) so it might be related. It’s only a small inconvenience so I wouldn’t mention it except for the possible connection to the tooth.

Gross as this might sound, I produce a lot of ear wax. I had to buy a second set of AirPods because the first set got clogged with wax and I kind of broke something trying to clean the screens. Back when I worked at the Ministry of Transportation and Communications (the only place I ever worked that was so big and old-fashioned that they had a company nurse and doctor) the company doctor syringed out my ears once (after I got a complete blockage) and after 3 days of fruitless syringing suddenly this chunk of wax about the size of two joints of my pinky splashed down in one of those weird banana shaped basins doctors like. These days I use a paper clip that I’ve twisted to put a loop in the end to scoop out wax. I’m sure a doctor would scream if I showed them what I’m going but I’ve been doing it for years.

Restless Leg Syndrome?

If you’d asked me five years ago about Restless Leg Syndrome, I’d say it was a made up thing to sell drugs. But sometime over the last few years I’ve found myself with my legs twitching without any reason. If I feel it coming and concentrate on it really hard, I can stop it, but only for as long as I concentrate. As soon as I go back to reading or whatever, it starts up. Slightly annoying.

To sum up

I don’t where I’m going forward from here. My therapist thinks the knee and butt pain are related to past trauma, which is why they’re not responding to treatments. But I’m not seeing any pain relief in therapy either. I keep asking him when I can expect any sort of change, and he just says it’ll happen when it happens.

But while I wait, I keep hoping for physical medicine to prevail. But I don’t see what I can do on that front. I’m also going to start pursuing “alternative medicine” for pain relief.