My painful friend

Just before Christmas, I slipped on some invisible ice and landed resoundingly on my left buttock, twisting my ankle as I fell. Initially, my concern was with my ankle, which, after a couple of weeks and daily applications of Ibuprofen gel returned to normal. At about the same time, I started to feel an ache in my left hip area, which over the weeks spread the full length of my left leg, in the process becoming very painful indeed.

So, I went to the doctor (by now about six weeks had elapsed since my fall) and she did some tests to establish that nothing had been broken in my leg or ankle. She suggested that I should see a physiotherapist, but as there was a 4 month waiting time, I'd be best to think about going private, which I duly did.

The physio did a much more thorough examination and prescribed some exercises. After a week doing these assiduously, there was no improvement so I returned. She did some more manipulation, during which it became clear that the site of pain was in my lower back. Throughout, the physio kept using the term 'referred pain', which means that the pain is displaced from the actual site of any injury. In this case, the sciatic nerve had been trapped somewhere as a result of the fall and the pain was referred throughout the length of the nerve down my left leg.

What I had become friends with was sciatica.

Continuing exercises -- including one with a tennis ball, obtained from a toy shop which, it turns out, supplies other invalids for the same purpose -- had no effect. So, I returned to the doctor. Not much joy.

My painful friend was now inhibiting any attempts at walking other than around the house. Curiously, though, I could cycle, which I continued to do on a daily basis. While cycling, my friend was just a background presence, but within yards of dismounting, sciatica returned with a vengeance as if reminding me that I should't have been fooled into thinking that my nagging companion had gone away.

By now I was getting more than a little fed up. So I went to a chiropractor. She carried out manipulation, confirming the main site of the pain, and plugged me into a machine which was to stimulate blood flow around the site. In addition, she prescribed the use of an ice pack to help reduce inflammation. And she suggested continuing some exercises and asking the doctor to prescribe an anti-inflammatory as well.

So, now into the third month since the fall, I was on a daily routine of pain killer (paracetamol, and at night a blend of this with codeine) and an anti-inflammatory (diclofenac). My twice weekly sessions with the chiropractor weren't having any noticeable effect, and, in fact, for the last session I was in considerable pain. At this point, the chiropractor more or less threw in towel and suggested that any further treatment be suspended until I had had a scan. (A private scan could be arranged for £200, which would also involve a trip to London -- not very practicable given my limited motility.)

By now I had asked my doctor to refer me to a specialist and, surprisingly, within a few days I had a call from the Nuffield hospital in Oxford to go there for an assessment,this being essentially a triage procedure to decide whether my case was serious enough to warrant a scan. (I had already had an X-ray, which simply revealed age related wear and tear.)

Getting to and from the hospital was in itself a bit of a problem, since I was still not able to walk very far. However, I drove to a park and ride car park nearer to Kidlington than Oxford and took a shuttle bus which plies a route from the car park to the Oxford hospitals, terminating at the one I was to attend. The bus journey took the best part of half an hour, during which I discovered that Oxford is not just the city of dreaming spires, but is also Hospital City.

At the hospital, a physiotherapist examined me and took a case history. The outcome of this is that I now have an appointment at the more convenient Royal Berks Hospital for a scan later this month -- four months to the day from my initial accident. She also suggested that I ask the doctor to prescribe a neuropathic drug to help sleep, and this was duly done so I have an addition to my drug routine.

Meanwhile, I saw the haematologist on 2nd April for my routine 6 month check up for Chronic Lymphocytic Leukemia (CLL), and he confirmed that I am still in remission (I had six months' chemotherapy a couple of years ago), but he was slightly concerned about one test result which suggested the liver was unhappy -- probably the result of the' cocktail of pain killers' I was on.

Great!

My son, on learning this, suggested milk thistle as a treatment for the liver. So I've added this to my daily intake.

Fortunately, the sciatic pain is abating, and yesterday I managed to walk in and out of town. This is no big deal, as the entire journey would be about half a mile, but it represents progress. However, my painful friend is still present and seems determined to ignore all hints that it's time to pack up and leave. I am confronted with a dilemma though over the scan: if my condition does improve radically, i don't think that a scan is justified. I'll have to ask the doctor for her advice on this.

This whole exercise has provided an insight into the limitations of the NHS. Whereas my diagnosis and treatment for CLL has been excellent, dealing with my present problem has shown that even before the various cuts and reorganisations that are to take place in the NHS, resources are restricted when it comes to dealing speedily with something like sciatica resulting from physical trauma. Going private is expensive and, indeed, prohibitive for anything involving either major or prolonged treatment. I have an awful feeling that the Coallition's NHS 'reform' will not, in fact, improve things and all of us are going to be haunted by painful friends that we can't afford to dislodge.