Doctor Days, Part III [REVISED]

The Neurologist shows me a couple of well-worn pages out of some anatomy picture book. "You have degenerative disk disease," she starts, which makes sense because my first back MRI about nine years ago showed mild changes. She rattles off a couple of words which I don't know. I think she mentions spondylosis. "You have arthritis from here to here," she points to the top of the spine down to its bottom. She is convinced that the periodic nerve pain I've been experiencing, the reason why I returned to her practice back in August of 2016, is all due to what's going on with my spine. The pain is intense, but fortunately, it's brief, lasting for about an hour each day, and seemingly unrelated to the back pain I deal with. It's called paresthesia. I don't often complain about it because while it is torture, some of the worst pain I've ever felt, about the time I think I can't take anymore, it goes away on its own. Showering, for whatever reason (The Neurologist thinks it's because of the heat), makes it worse; so, I often just use a small towel in a bowl of water and soap, and clean myself up that way (of course, I'm forced to take showers multi-times per week anyway).

"Will the paresthesia ever go away?" I ask her while she's taking notes at her desk.

"No, but we can blunt the effect with medication." She lists a few drugs, asking me if I've ever taken any of them.

"I've taken Lyrica."

"I want to start you on Cymbalta, it will help with the neuropathy, but also has an antidepressant effect. So, we'll switch you from Lexapro to Cymbalta."

I pause at this, only because while I've been on the Lexapro, my depression has been at its lowest level for years. I can only recall a few short periods in my life when my illness was any better.

She draws a crude line in the form of a rollercoaster. "First, your mood might dip down like this, but then it should come back up. If you really feel like you're crashing, call me....Do you want to wait to see what Stanford says?"

"I think we should start immediately." I trust her, she's not a psychiatrist, but then again, she is very smart. Probably, short of a few physicians at Stanford, the most intelligent doctor I've had.