After two weeks on ibuprofen I was not getting significant relief. It worked better than the naprosyn, but it wasn't ending the situation. So I went back to the Ortho who prescribed me some prednisone. He and I had a long discussion about side effects and possible outcomes and agreed to give it a try. I got a pill pack with a six-day "supply" but with a complex timing and tapering dosage such that I took 6 pills the first day and one the last.
tl;dr, this shit is amazing. I can see why people get addicted (psychologically) to it. About half a day in I was whining about how my pain levels were back up because I cut out the ibu and about 1.5 days in I was like "holy shit I don't hurt that much anymore." The steroidal anti-inflammatory brought my pain levels down from baseline 4 with frequent 5-6 to baseline 2 with occasional 4-5. I was also (by day 3) hilariously wired.
No, I mean this was hilarious. I was PLANNING ALL THE THINGS at once and was semi-convinced I could pull them off even though it depended on just the right combination of... yeah, that. The jitters and slight inability to sleep were annoying but I wasn't sleeping much anyway, so who cares, right?
Sadly, as I tapered off the drug around day 5 the pain started coming back. I had a bad night and went back on the ibu. I need to have a conversation with the Ortho about what's the right way to manage this - I clearly got some substantial improvement with this medicine but it's also probably unsustainable. After a week on it I'm at a better baseline than I was before, so maybe we can do week-on/week-off or some other regime that'll slowly improve my quality of life without too many medical complications.
Meanwhile, I had my PT evaluation with Lahey. I'll just say up front that I don't like these guys. I wasn't super-happy with them last year except there was one woman there who was my New Best Friend because she could properly crack my back so I dealt with that. This new guy... well, he lectured me twice in the first ten minutes about my posture.
Dear Physical Therapist, You are not my mother. I spent decades hearing about my bad posture from my mother, and I no longer have to put up with it. I have shitty posture because I have spinal problems, which is what I'm here for. Deal with me on a helpful level or get out of my way. They also spent a lot of time giving me blah-blah about my arm problems, which I'm happy to have help with but is not the reason I'm there. Also, treating my preliminary diagnosis as a final diagnosis, and getting huffy about the fact that I'm getting an MRI somewhere else... yeah, the whole thing didn't go well. I've got two appointments with them and if things don't improve I'll go somewhere else for my PT.
So, about that diagnosis. I got a written version of the document I'd already seen with a hand-written annotation from the PA I saw at the start of this saying "significant arthritis in neck". No useful information about what that means, why that's related to the problems I'm having now, or what to do about it. She (the PA) seems to think the neurosurgeon will cover all that with me this week, so we'll see.
I did manage to get an MRI done Friday despite the snow, and I have two CDROMs in my possession. I need to figure out how to get the data into the Lahey system so the neuro and the PT can see it, and I need to have a conversation with the Ortho once he's reviewed it about what he thinks we ought to do.
This care coordination is complicated, and I've got something relatively simple. I can't imagine how people manage who have really serious things, or have things that make it hard for them to do their own care coordination.