This is a long post describing something I’ve been going through for a couple of years now. It chronicles my experience with an injury and the pain that has remained because of it.
Let’s take a trip back in time to July 2012 when the simple act of zipping up a dress has changed my everyday life – and not for the better.
I was at my local Kohl’s shopping with my mom, something I typically do on the weekends. I found a dress that I liked and took it into the fitting room to try on. It had a zipper on my left hand side so I reach across my body with my right arm to zip it up. Let me pause her to explain that my chest is rather large so it’s not such an easy thing to reach across to zip something up. As I zipped it up I felt a strain and then tingling down my right arm but I disregarded it for the moment to admire myself in the mirror. The dress looked much better on the hanger than it did on me.
I left the fitting room and found my mom to whom I complained that my arm had been tingling and my side hurt. I assumed that I had pulled a muscle or at least strained one. Never being a sporty person I didn’t know what this felt like but I imagined that it felt like that. I turned to Facebook and Google to inquire about my pain. The pain eventually subsided enough that I didn’t think about it, but it did come back. It came back with such force that I couldn’t lift or even open doors with my right hand. At the time I was working as a receptionist and part of my job was to make coffee in the morning – this became a difficult task for me. Even writing tired my arm out. I had been dealing with the pain for Aleve/Motrin/Tylenol – anything that might help.
Years earlier I had been given a prescription for Tramadol for chronic upper back pain (without diagnosis). I took it very sparingly because it is a narcotic and very strong. Also, it did give me some side effects including making me drowsy. I usually only took it at night although it did cause me to wake up in the middle of the night and be wide awake for an hour or so. The pain during the summer and fall of 2012 got extreme enough that I started taking the Tramadol at work and working through the drowsiness. I was in a lot of pain.
I had started working as a receptionist in April 2012 so my health insurance kicked in around July or August. That is when I was finally able to go to see a doctor and inquire about my pain. I explained what had happened to her and she diagnosed it as costocondritis - an inflammation of the areas between the ribs. Thissounded possible so I took her advice of taking anti-inflammatories. I began taking the maximum dosage recommended from a prescription for Motrin. It did little to calm the pain. A sometime that fall I was in so much pain that Thomas couldn’t take it anymore. My usual relief of just laying my right side wasn’t doing much to help me and I had given up on taking Motrin since it didn’t help. Thomas grabbed my hand took me to Urgent Care.
Like most everyone, I had heard of doctor’s who really didn’t care but I hadn’t really ran across one to that point. This doctor made me feel so horrible I began sobbing uncontrollably (although I am a crier, a BIG crier). She also assumed that the reason for my pain was costocondritis and said that they couldn’t do x-rays because inflammation cannot be seen in x-rays. She then proceeded to accuse me of being there to get drugs. I told her, through my tears, that I didn’t come looking for something specific but anything that would relieve the pain I was in constantly. I left with nothing but a co-pay.
There was nothing I could do after that. The pain did begin to subside at some point and I took the Tramadol less frequently. Then, in the spring of 2013 I began to have more pain. I started working for the government and my insurance kicked in on March 1st. I immediately went to see my old doctor at Kaiser (which I hadn’t seen in about 2 years) and explained the situation to her. She also agreed that it was probably inflammation and that x-rays wouldn’t do anything. However she did tell me that if it got worse or changed to give her a call and she would order x-rays. I left pretty satisfied because the pain, while different, wasn’t affecting me AS much as it had been the previous year.
Then in May I began to get sharp pains right under my right breast. It felt as though I was being stabbed there. They were strong enough that my knees buckled – during work. My co-workers looked at me worried and it took me a minute to catch my breath to be able to explain what happened. I immediately e-mailed my doctor and explained what happened. The next day I got a call in the morning from the nurse telling me to come in for a same-day appointment. My doctor wasn’t available but I saw a back-up. Although she wasn’t sure what was wrong, she ordered the x-rays. After taking the x-rays that afternoon the technician told me it would probably not be until the following (it was ) because of Memorial Day. I was surprise to get a call the very next morning from the same nurse inquiring if I had had trauma to my right ribs – had I been in a car accident or a motorcycle accident – anything? I told her that I hadn’t. Nothing. No falling, accidents, and definitely no punching. She could not understand it…
I had THREE broken/cracked ribs! I began to cry when she told me this. I couldn’t keep the tears in. I had a diagnosis! There was a real REASON that I was in pain and I wasn’t making it up, which is something that I had begun to believe. I scared my co-workers who rushed to my cubicle to see what was going on.
The following few weeks consisted in repeated visits to different doctors. My doctor left Kaiser and I was left seeing duty doctors for the moment. I was given Norco for the pain and told to take it every 4 hours and in between to continue taking Motrin. I did this but the pain still wasn’t going away. The doctor’s couldn’t understand it and so they ordered a CT scan. The scan showed TWO additional cracked ribs. Now, I’m not great at math but that was WAY too many ribs to be cracked from no trauma. No one bought into the idea that it happened by zipping up a dress, but there was (is) no other explanation! I was finally referred to a pain management doctor when the internal medicine ones were unable to help me.
I went and saw a pain doctor that I had seen years before for my upper back pain. Dr. Miles is a very nice person. While I wouldn’t describe her as warm, she is very caring and interested in finding a diagnosis and solving it – not just giving me medication. Immediately she told me that the pain was not from the broken ribs, which by this point had begun to heal, but instead from the nerves that run from the spinal cord between the ribs. She explained to me that nerves don’t like to be touched and so when the ribs broke they didn’t like it and reacted. She likened it to when you hit your “funny bone”. The bone, of course, is not funny – instead what happens is that you hit the nerve that runs along your elbow and it causes a shock which induces the pain. There is nothing that can be done about this – no surgery or exercise. Only medicine. She told me that there were two medications that could help me, one stronger than the other. The stronger one – Lyrica – is not covered by insurance and could be costly. We went ahead and went with Gabapentin, the less strong, generic version. She placed me on a low-dose of it and said we would stagger it up as needed through the next few months.
To cut this very long story a bit shorter, I ended up on the highest dosage – 800mg three times a day. It was still not giving me enough relief so at my last appointment she told me to add the Tramadol at least twice a day and at bedtime as needed. The tramadol no longer makes me sleepy during the day, but it does continue to make me wake up at night.
I am still in pain as the medicine wears off and it’s almost time to take it again. I’m typically uncomfortable and fidgety. The worst part of it is that Dr. Miles thinks that this is permanent. You never know what will happen, but after the amount of time that has passed since the initial “injury” in July 2012 the fact that I’m still in so much pain indicates that the nerves will probably not heal anymore.
If you’ve read all of this – thank you!