MRI followup - need some wisdom

So I had the followup with the orthopedist today, after December's MRI was interpreted as a nonunion. In the ten days since I got the result, I'd calmed down quite a bit, and was actually going to cancel the appointment. But I figured I could at least get the reassurance that there was nothing wrong with my fibula. And that's what I got - sort of. The whole visit was a LONG, awful, anxiety-provoking ordeal. I waited an hour and a half to been shown back to the exam room, where I waited another 45 minutes for the ortho, all the while fending off techs who said they never got my recent x-rays (from another hospital they don't like to communicate with) and needed to do some more. I kept declining. I was actually trying to stay calm by working on my SEP. Finally, I couldn't take any more and started to write a note for the doc, which is of course when he showed up. I needed to hear a positive assertion that the bone was fine - and he had a heck of a time delivering that. I kept asking and asking, and he kept wanting to talk about the age-related stuff that MIGHT be contributing to my pain. Finally he said, "You do NOT have a nonunion of the right fibula!" Then he said it was hard for him to contradict another doctor's opinion, because it went against his training. He said my ankle was right where it should be.
So why am I still incredibly tense and anxious? Because I carried away all the doubts created by this detailed look inside my 50-year-old foot (okay, a few more years than that, lol). The ortho really, really wanted to find a structural reason for my pain. Arthritis? Neuroma? Inflammation? I should have put my hands over my ears except for the part where he said the bone was fine. And the other part is doubt that my ankle really is fine. What if the doubt manifests itself into pain right there at the fib?
I don't know that I was wrong to get the MRI or to go to the followup. I just feel like the momentum I was carrying forward has come to screeching halt. Also, I'm supposed to go over the MRI results with my PT Wednesday. I don't think I want to have that conversation.
I could really use some perspective on this.

 

Hi birder,

I'm sorry for this difficult experience you had with the orthopedist. They have notoriously terrible bedside manner and empathy so i'm not surprised! So it's good that he isn't interpreting your result as a nonunion, to start- that is positive. But OF COURSE it is his job to try to find a structural cause of your pain! He is literally paid to do that and makes a living from it, he wouldn't even be thinking in terms of psychosomatic pain or neural pathways. Orthopedic docs really know nothing of this.

I don't think you were wrong to go to him, try to go easy on yourself! You got peace of mind that you don't actually have a nonunion and there is no other structural cause of your pain. If the orthopedic doc had to sit there and speculate...well...that tells you something.

I would caution you against having a conversation about the MRI with your PT if they are a pretty structurally focused practitioner. It might go similarly to how it was with your orthopedist. Do you still have goals you are working on with your PT? It might be tricky to continue trying to do PT if you no longer have a structural reason to do so and want to use TMS to treat this. Just some things to think about, feel free to message me if you want further PT insight

 

MindBodyPT, I think you're absolutely right - it WILL go exactly the same way. I've done PT faithfully for six months with decreasing returns. It's time to go solo. Thank you for your most excellent advice!

 

This is very true, and I hope this sinks in deeply!

 

Hi birder,

I totally get your frustration , fear around this whole medical search stuff.
Been there too with my foot The problem is you can totally get consumed by this. And even worse : medical specialist , pt are not very helpfull to say the least. And indeed : a specialist will be careful to say : your angle is fine : simply because you came to him with a painproblem. The mindstuff goes beyond him. You got green light on this now. A structural pt can make it worse i agree.
Start doing the tms program here and read on the forum. What helped me too was painsience. com (still does) to get some debunking on structural nonsense.
Let the pt help you with exersize and in the mean time do your tms ‘work’ ?
That’s my suggestion ..

 

As mentioned above the pain science website and articles are great.

 

These responses are truly helpful. After a miserable, anxious night, when I woke up this morning the world had righted itself, and I'm feeling the calm certainty about the TMS diagnosis and the confidence that I'm on the right path. Took my dog out, did a little jogging, didn't focus on the pain. One by one I'm going to starting dropping the the (crazy) things I do to control my pain, which to be honest serve to give structure to my day. And that, I think, is the crux of my anxiety: fear of emptiness. So more joy, more movement, more love, more realness. Less ice and Epsom salts!

 

I’m sort of in the same boat. Been having one sided lower back pain and leg pain for about 7 years. Finally had an MRI end of 2014 which showed a neuroma on a nerve near spine. First of all it was classed as incidental and not responsible for my pain then this was changed to that it was probably causing the pain. I have no traditional nerve pain, loss of reflex, strength, muscle tone nothing. I can hike and run and have no mobility problems...the only symptom is pain. I have a back scan every year now and the neuroma hasn’t changed at all in this period. By all accounts it’s probably been there all my life apparently so why it would suddenly become problematic when I turned 40 makes no sense. Half the consultants I see say it’s causing my pain and half say it isn’t and it’s best left alone. Ho hum.

 

I had so much explenations ‘ , i will not call them : diagnoses ! If they really don’t know : some feel the need to come up with ‘something ‘
(Read : painsience

The big problem back them for me as a desperate person was : i took those doctors remarks as the ‘truth ‘ instead of ‘guessing ‘
I wanted so hard to get a reason too so i wanted maybe to hear something : ‘nothing sounded pretty crazy !
Finally i realized they all guessed ‘something ‘ many times, they could not even agree on things , and it simply was impossible i had it all.
So then there came the option too : they also could be wrong ! All this searching only filled my head with fear

 

Yeah. I think for me you go through life expecting all these medical experts to have all the answers so when you have some condition that doesn’t fit neatly into a box you feel left high and dry.

I think the power of placebo and nocebo are important here. If you have faith and confidence in the message giver this helps hugely...conversely if you feel you are being fobbed off this can totally destroy confidence. The mixed messages of different diagnoses is probably the worse case scenario for the ‘typical’ TMS type.

 

Powerful to see this, allow feelings around it, explore this with compassion!

 

Huckleberry ,

You are so right about mixed messages being a nightmare for the Tms type
It was (and can still be ) a complete gestroy for my faith in the medical world. In fact it still is and that’s probably also not too good. Now bothered with some new pain and a recent comment from a pt made me angry at myself : why do i go there anyway ? and totally doubtfull about what she said (i know : pt is not a doctor but just saying .. ) then she finished with : it seems that you have little faith in your own body ‘ that was a good point, but i thought at the same time : ‘Well i do not gave a lot of faith in you Guys and girls anymore ‘
So this is not so positive i know , but it sadly comes from hearing so much nonsense for many years.

 

Reading this whole topic : one thing really stands out for me
‘Fear of emptyness’
That’s a big one i guess , also a hard one to explore .. Thanks

 

Lol..I know.

When my pain started about 5 years ago I trotted along to an osteopath. I knew it was a bad decision as I wouldn’t have any faith in them but just couldn’t help myself. Of course I got all the usual SI Joint and twisted pelvis diagnosis and she even seemed to take great delight in informing me that I could well end up in a wheelchair. It appears that all this could be avoided if I payed for 10 weekly sessions with her. I never went back there but she planted a huge nocebo in me.

 

You just dug up a bad memory for me,
went to a Chiro in the beginning who planed also the whole ‘twisted pelvis ‘ + therefor the si joint paint en
and specifik: the leg lenght difference stuf in my head. I still
had pain after several sessions.
After many other health proffesionals
i saw an orthopedic who said : you have a leg lenght difference : but its very common and no need to correct that.
She also said ‘there is no such thing as a twisted pelvis ‘ (she also was the only one who was brave enough to say : i do not know why you have pains )
One week later i saw a PT who said : Ofcourse there is such thing as a twisted pelvis , not saying you have that but it sure is possible .. ‘!

Long time after that my pain left (when i stopped seeing anyone and just tried to work on tms etc) but this nocebo is still with me. Lately have some neck pain etc: again on the same side ofvthe body and : bam : once again this ‘theory’ comes back to hount me
I should know better by now : but its hard

 

This all sounds familiar. I've spent a lot of money and consumed a lot of painkillers over the last 15 years. I cam across Dr Sarno's book on curing back pain and am 15 days into the programme. After reading about triggers, it would seem that recalling negative experiences with so-called professionals are triggers but it's hard to forget these phantoms which haunt us. Striving to be positive is obviously the goal. I find that hard, but can do it to a certain extent by exercising, swimming and running or walking in the open air.