...or you can have the pain treatment behind Curtain #4!
Marina's cry for help on dealing with the leg pain got three different kinds of answers from three different doctors, all arriving the same day.
First through the gate was the physiatrist (fizz-EYE-a-trist) who works with surgeon Dr. Hu. A physiatrist is an M.D. who specializes in long-term and chronic conditions, especially pain. Dr. Sibel (sih-BELL) Devirin (DEV-uh-rin) examined Marina this Tuesday morning. She quickly determined that the on-going leg pain is not CRPD (Complex Regional Pain Syndrome), formerly known as RSD. We're not sure what it means, but anyway it isn't.
However it may be a selective nervous block, which is treated with cortisone injections into the spinal region (if Marina is one of the 90% of cases where the hardware is not in the way). This will be determined by a specialized 'cat' scan called a CT myelogram, and that is scheduled for March 15th.
Meanwhile, Dr. Deviren has taken Marina off the Effexor medication (which seemed to work well for a short while) and put her on something new (for her) called Trazadone, which is also an anti-depressant that has the side effect of helping nerve pain.
After the March 15 lab test (unrelated to the myelogram), if the sodium level hasn't fallen, Dr. Deviren will put Marina on Neurontin. And for now, the Norco will be continued and possibly increased.
That's thing one.
Thing two is Dr. Null (remember him -- I checked and there actually is a website at www.DoctorVoid.com, but he's not a medical doctor) who checked in to say that he is mailing Marina a referral to a colleague at a different hospital, California Pacific, who is a neurologist and electrophysiolgist. We don't know what the latter does yet, or whether one might do this along with what the physiatrist recommends.
And thing three is Dr. Misakian checking in, to suggest that Marina visit the Pain Center at UCSF, which seems to be a separate entity there solely focused on baldness . . . no, actually, on pain; and Dr. M. also recommends increasing the dose of Effexor from 2 to 3 tablets a day (but Dr. D. has said to stop it entirely). Marina will have to figure out whom to tell or ask about what.
Meanwhile, Dr. D recommends lots of bed rest, with the left leg elevated so that it is higher than the heart, something Marina hasn't been told to do until now.
Posted by John Bear
at 2:35 PM PST