What is a diagnosis? According to Merriam-Webster Dictionary a diagnosis is:
the art or act of identifying a disease from its signs and symptoms:
investigation or analysis of the cause or nature of a condition, situation, or problem.
I have multiple diagnoses from active duty as well as a veteran.
What is chronic pain? According to John-Hopkins Medicine chronic pain is:
Pain starts in receptor nerve cells found beneath the skin and in organs throughout the body. When you are sick, injured, or have other type of problem, these receptor cells send messages along nerve pathways to the spinal cord, which then carries the message to the brain. Pain medicine reduces or blocks these messages before they reach the brain.
Pain can be anything from a slightly bothersome, such as a mild headache, to something excruciating and emergent, such as the chest pain that accompanies a heart attack, or pain of kidney stones. Pain can be acute, meaning new, subacute, lasting for a few weeks or months, and chronic, when it lasts for more than 3 months.
I have had pain in some areas for over 30 years.
What are symptoms? According to Oxford Languages symptoms are: a physical or mental feature which is regarded as indicating a condition of disease, particularly such a feature that is apparent to the patient.
According to the Overton Brooks V.A. Medical Center health professionals I have the diagnoses but the many symptoms don’t apply to me.
I remember visiting the Overton Brooks V.A. emergency room some time ago with excrutiating pain (mainly in my hips). The emergency room physician called neurosurgery about my conditions and told me that the neurosurgeon said, I should not have pain going down to my hips. WTF
Mr. Fobbs returns today after last being seen on October 4, 2022. He is beingseen status post right carpal tunnel release on August 16, 2022 with throbbingin the long finger of the right hand; however, he was having increased lowback and bilateral lower extremity pain, right greater than left, withradiation to the knees. I recommended a repeat lumbar MRI scan. This wasdone today at the VA.
He states his back pain is a pressure feeling which radiates into the hipsbilaterally, right greater than left, with radiation to the posterior kneesranging from a 5 to a 10. He has intermittent numbness, tingling, andweakness. He also has continuation of neck pain. He has had no treatment inthe last 6 months.
Current medications: Mr. Fobbs is provided a printed medicine reconciliation. He is asked toreview this for accuracy and notify Dr. D. of changes.
Physical exam:Manual testing of the motor groups of the lower extremities reveals noweakness. Sensation light touch and pinprick is intact left lowerextremities. Reflexes are trace at the knees and Achilles. Straight legraise are positive for muscle tightness.
Radiographic studies:Lumbar MRI scan from the VA on today’s date, October 18, 2022, shows mild L3-4stenosis, mild L4-5 stenosis with bilateral facet hypertrophy, and bilateralfacet hypertrophy at L5-S1.
Assessment:#1: M 51.16 L3-4 and L4-5 degenerative disc disease.#2: M 51.17 L5-S1 degenerative disc disease.
Plan:Although he has continued neck pain, his back pain is his current complaint.I will place a consult for bilateral facet joint blocks L3-4, L4-5, and L5-S1. He has not made an appointment for return evaluation but of asked that he call1 week postinjection to inform me of his progress at which point considerationfor further treatment for his back and/or neck including possible repeatcervical MRI scan can be considered.
I’ll let you be the judge and determine whether or not I COULD AT LEAST HAVE THE PAINS that I continue to complain about.
I don’t remember any mention of me supposing to make a post injection. I’m not denying it happen, I just don’t remember it.
FINDINGS: The cervical spine demonstrates normal alignment. Vertebral bodies are normal in height. There is a normal marrow signal pattern. Intervertebral disks are normal in height and signal intensity. The cervical spinal cord is normal in signal intensity. The craniocervical junction is intact. The included intracranial structures are grossly normal. The paraspinal soft tissues are normal. Evaluation of the individual levels demonstrates: C2-3: The thecal sac is patent. Uncovertebral joint hypertrophy causes mild right neural foraminal narrowing. C3-4: Small disc osteophyte complex narrows the thecal sac to 9 mm AP. Uncovertebral joint hypertrophy causes severe right and moderate left neural foraminal narrowing. C4-5: Small disc osteophyte complex contacts the bilateral descending C6 nerve roots and may be a source of radicular symptoms. The thecal sac is narrowed to 9 mm AP. Uncovertebral joint hypertrophy causes severe bilateral neural foraminal narrowing. C5-6: Small disc osteophyte complex with patent thecal sac. Uncovertebral joint hypertrophy causes severe right and mild left neural foraminal narrowing. C6-7: Small disc osteophyte complex with patent thecal sac. Uncovertebral joint hypertrophy and foraminal disc protrusions cause moderate bilateral neural foraminal narrowing. C7-T1: The thecal sac is patent. Facet hypertrophy causes mild right neural foraminal narrowing. Impression: Multilevel moderate and severe neural foraminal narrowing C3-C7. Primary Diagnostic Code: Minor Abnormality or Abn Prev Identified
07 Jun 2018 L SPINE– Report: 4 views of the lumbar spine, 4 views of each shoulder, frontal, lateral and sunrise views of the right knee. Indication: Pain, rule out DJD. Impression: Right knee: Unremarkable. Lumbar spine: Mild disc height loss at L3-4 with large marginal osteophytes. Right shoulder: Widening of the acromioclavicular joint is noted probably from prior injury. Minimal glenohumeral osteoarthritis. Left shoulder: Mild acromioclavicular osteoarthritis. Primary Diagnostic Code: Minor Abnormality or Abn Prev Identified.
I am really tired of having to take my precious time to keep doing stuff like this just to get proper treatment for my chronic pain and other things. Like I said, “You Be the Judge.”Fighting to try and get proper treatment from the Overton Brooks V.A. Medical Centern and this type of stuff (writing) is very stressful.
BUT IT’S EVEN MORE STRESSFUL AND DEPRESSING DEALING WITH THIS PAIN DAY AFTER DAY.