L-5
Marina's cry for help produced three quite different results. Let's track them for a while. The key factor is known as "L-5". More on that in a moment.

1. Physiatrist. Dr. Deverin ordered a CT myelogram scan (happens next week), and meanwhile canceled Marina's two pain meds (Norco, Effexor) and substituted two others (Lortab, Trazadone). The early results: extreme nausea, and no change in pain. Marina hates nausea more than leg pain, sometimes. So, following a letter to Dr. D., as of this Tuesday afternoon, Marina is switched back to the original two.

2. Electrophysiologist. Referral from Dr. Null to Dr. Skomer, whose business card says he is a Diplomate of the American Board of Clinical Neurophysiology, and also of Psychiatry and Neurology. He's affiliated with California Pacific Medical Center, something entirely different from UCSF.

Marina saw him this afternoon. He made it clear from the outset that he is not a pain doctor; he figures out what is wrong, and it is up to others to deal with fixing it, and with the associated pain.

His diagnostic technique is called a Nerve Conduction Velocity Study. Electrodes are applied to the left leg, and a rather severe electrical shock is administered -- over and over and over, in different locations. Each shock causes the whole body to jerk dramatically. No fun to watch; much less fun to have it done. Each jolt yields a very complex computer picture, relating to nerve function.

Dr. Skomer said "This is a really complex situation." He says, "You're going to be a tough one to figure out -- but that's my job."

The problem, he says, is in the nerve called L-5, which is one of two nerves that make up the sciatic nerve, biggest nerve in the body, running from the spine down the leg into the toes. Although Dr. Skomer did not use the word "sciatica," it seems, from a quick Google search, that the term refers to a wide range of nerve-related leg pains.

What next? Dr. Skomer needs more information. He also did an electromyogram, which is a test of muscle function, done by inserting small needles into muscles, which transmit information to the computer when the muscles are at rest, mildly contracted, and extremely contracted.

He also needs blood chemistry information, so the lab was visited. We return for results next week. Dr. Skomer strongly recommends visiting the UCSF Pain Clinic.

3. Pain Clinic
This was Dr. Misakian's immediate thought, but then she decided to wait to see how things went with the physiatrist. But Marina, who continues to hurt pretty steadily, is asking Dr. M. for a referral to the Pain Clinic.

Well, at least things are moving. So is Marina. Yesterday she went down the forty wooden steps to the garden, because she had to see how her lilacs were doing. (They seem on the verge of blooming. Can Marina be far behind?)