Out of Doors and Network

Out of Doors

I waited for temperatures to rise above freezing so I could ride outdoors today. I went out to get my bike and the water bottle I had left on my bike was hard as a rock.

Luckily, most of the ice on the roads and trails had melted. There were a few icy patches on the Mount Vernon Trail on the way up to the stone bridge from Alexandria so tomorrow morning’s bike commuters should be on the alert.

The ride went fine. I was a little underdressed though. After about 20 miles I started to think about the warmth of home and hearth and headed back from Alexandria. I stopped to buy some things at a drug store. I stood in line for about five minutes. My lower back started to ache. Can’t wait until I get that needle next week!

My wonky leg continues to wonk. No big surprise but I don’t need painkillers as long as I stay off of it. This is perfect weather for a walk in the woods too. Dang.

The irony of all this stenosis business is that about five years ago I decided to increase my hiking specifically to offset the osteoporosis that can set in when you do only non-weight-bearing exercise like bicycling. Damned if you do. Damned if you don’t.

I am happy with 27 pain free miles on the CrossCheck today. The next few days will be warmer so I’ll probably ramp up the distance. (I’m over 500 miles for the month as it is.)

Out of Network

The day after my MRI I received a document from my insurance company agreeing that the procedure was medically necessary and would be covered. (The MRI center had already been given the green light.) I have been getting emails and robocalls from my insurance company telling me that hospital MRI centers are often not regarded as in network. The insurance company told me that I “could save hundreds of dollars” if I went to another MRI facility.

Funny. The hospital MRI center told me I was covered and had to pay only a $100 co-pay.

After the third communication from the insurer I went on line to check things out. The insurer’s website clearly states that the MRI facility I went to was in network.

My guess is that other non-hospital MRI facilities charge the insurance company less. So they are trying to steer me to a place that saves them money. As long as I go to an approved facility, I pay $100. If they didn’t want me to go there, they should take it out of network or charge me a lower co-pay to go somewhere else.

Am I missing something?




Darth Stenosis, an MRI Report, and a Clarification

Bad Genes

“My father has it. I have it. My sister has it.”

Yesterday I was talked with my sister who is 2 1/2 years younger than me. She said she’s having back pain. She does not read my blog. I asked her to describe it.

Pain in the outside of her lower left leg. Pain when walking that is reduced when she leans forward or leans against something like a grocery cart. Pain that kicks in after about 50 yards. She can’t trust her left leg; it feels like it’s going to give out.

Gregor Mendel, phone home.

MRI Report

My MRI report confirms that my spine is FUBAR. Most of the pathology doesn’t seem to be causing me pain. I have moderate disc bulging and thinning here and there. And there is some stenosis in various places in my mid to upper spine. Mostly this seems to be the cause of mild discomfort as well as numbness in my feet and hands from time to time. My lower back gets achy when I stand or walk for long periods but muscle spasms are rare.

Near my 4th and 5th lumbar vertebrae, however, the report said:

There is severe left foraminal stenosis with indentation of exiting left L4 nerve root. The right foramen is moderately to severely stenotic with indentation of exiting right L4 nerve root.

This is consistent with my recent left leg problems. My guess is that’s where the epidural will go.

The same MRI center had a record of my 2014 scan. The report noted that a disc extrusion (i.e., bulge) found back then no longer exists. This is one reason why back patients are told to give it time. Many of these abnormalities resolve on their own, as did my 2014 problem.

A Clarification

In yesterday’s post, I described a conversation with my friend Julie who is a Rolfer. I may have given the impression that she is reckless or aggressive in her methods. If I did, I apologize to her and want to clarify.

Recapping: a Thai massage therapist skipped past my thighs when I indicated that the therapist had hit a sensitive nerve. What Julie meant when she said she’d “dig right in” to nerve pain was that ignoring the problem as the massage therapist did is unhelpful. The objective of massage is to grant short term relief and reduce tension. Oversimplifying, the objective of Rolfing (and for that matter Feldenkrais) is to reduce pain and stress in the long term by improving how body parts interact. Rolfing focuses on connective tissue called fascia that wraps around muscles and nerves. The end result should be pain and stress reduction on an on-going basis.

For now, I am focused on getting the offending nerve to calm down. Once I get the pain under control, I can consider how to deal with the situation longer term. My guess is that I’ll be doing some combination of yoga, PT, massage, Feldenkrais, and Rolfing.