I will begin this journey by sharing my SIJD story.
May 5,
2008: pain begins in late pregnancy – visit PCM (Primary Care Manager)
July 1,
2008: physical therapy
August 2008-early 2009: PCMs try oral medications,
no effect
January 2009: PCM
orders chiropractic consult, only for active duty military, so continue oral
med experimentation
June 2009: x-rays at army hospital, and MRI at civilian hospital. L4-L5, L5-S1
osteoarthritis and degenerative disc disease.
PCM wants to keep trying oral meds.
No effect.
August-September 2009: chiropractic (out of pocket) for
lumbar. No effect.
November 2009 – January 2010: two separate injections
(one in Nov, one in January) at pain management, both
times at L4-L5 & L5-S1. No effect.
February 2010: physical therapy begins for lumbar, no effect. PT
switches to treatment for SI Joint – first relief ever experienced. However, relief is minor and short-lived.
February 2010: PCM
orders MRI of hips – normal.
March-April 2010: chiropractic (out of pocket) for SI Joint –provides
minor, short-lived relief.
Late April 2010: third injection, in SI Joint as well as L4-L5.
No effect.
May 2010: buy inversion table per pain management
instructions, no relief – increased pain in right buttock when
inverted.
May
25, 2010: bone scan at Army
Hospital - normal
June 1,
2010: fourth injection,on right side of L4-L5. Minor relief of aching pain allowing sitting
for a little longer (still no standing or walking for any length of time),
relief lasted 2 weeks. No relief of
sharp pain in buttock.
June
29, 2010: orthopedic appointment. Opinion is also that it is SI Joint causing the
problem, with poor prognosis.
July 6,
2010: fifth injection, at S&W pain mgmt, in SI Joint –
numbing agent gave relief for 1.5 hours.
Medication changed from Gabapentin to Lyrica. Started sleeping on ice.
August
4, 2010: neurology appt. His physical exam indicated no nerve root damage,
but he wasn’t familiar with the treatments I asked about for SI Joint
Dysfunction. Did not offer any solutions
or treatments to try.
August
9, 2010: sixth injection, at S&W, this time a caudal
catheter in low back and another injection at SI Joint. 50% relief for the next two weeks. Ice sleeping reduced.
November
23, 2010: seventh injection series @ S&W: injections on the
right side of spine from L4 down to S2.
Diagnostic for RFA (Radiofrequency Ablation). 75% relief first day. Minor relief in the week following. Schedule RFA for Feb 2, but insurance denies
authorization. Resubmit RFA request, RFA
denied second time. Medication changed
back to Gabapentin from Lyrica, which had no effect.
February
22, 2011: same injections as Nov 2010, in addition to an SI
Joint injection. No significant relief. Pain continues to increase. Continue sleeping on ice or heat, depending
on how the pain responds.
March
15, 2011: Found a doctor familiar with SI Joint Fusion Surgery
in Tyler, TX
– Joseph Conflitti. Dr. Conflitti
performs examination and reviews case history and medical records. Confirms Sacroiliac Joint Dysfunction. Performs pre-op evaluation for SI Joint
Fusion surgery. RFA request resubmitted
again and denied again, appealed and denied a fourth time.
May
24, 2011: ninth injection series – 5 injections on
the side (branches) of L4 down to S2.
Additional injection in SI Joint.
Minor, short-term relief. Surgery request denied.
July
13, 2011:
Received fifth
and final denial letter for RFA procedure.
Proceed with surgery which was appealed and approved in June.
www.si-bone.com
for the procedure details.
Could not
bear weight for 6 weeks post-op.
August
19, 2011: Post-op exam in Tyler
with Dr. Conflitti. Pain still continues
but it is too early to call the surgery success or failure. Conflitti confirms that if my pain has not
improved by 6 months post-op, it very likely will never improve.
September
13, 2011: Tenth injection, @ S&W, this time in the
piriformis muscle for Piriformis Syndrome, a common problem alongside SI Joint
Dysfunction. Piriformis Syndrome causes
sciatic pain.
September
22, 2011: Post-op physical therapy evaluation. PT states recovery will be 2 – 3 years. Physical therapy begins on September 27.
September
27, 2011: PCM visit for walking cane prescription
November
10, 2011: Eleventh injection series @ S&W – branch block
right side of L4/L5 and S1. Relief of
pain for several hours (not of sciatic pain however). PT is continuing twice a week.
January 2012: Finally feel better post-op than pre-op. PT discontinued due to significant progress. No nerve pain, just muscle spasms.
March 6, 2012: Botox injection in piriformis at pain mgmt. 80% relief for 8 weeks. Discontinue all meds except Motrin and occasional Flexeril.
June 2012: Begin walking 1 mile several times weekly.
June 11, 2012: Botox injection in piriformis at pain mgmt. 80% relief.
July 2012: Pregnant. On Tylenol only at this point.
