MRI Machines and Crumbly Bits

I am in my third month of sciatica pain, the kind that makes you consider stomach ulcerations by taking All Of The Ibuprofen In The House over the course of the last twelve weeks.  

After two or three urgent care appointments and an orthopaedic doctor visit, I saw my primary care doctor and asked her what I could do.  I am no longer able to walk normally, lay down or sit.  It is a bit ridiculous how stupid this pain is, if I sit (like right his very moment) it takes me quite a long time to get out of this position and fix my hip, leg and back so that I can move at a decent pace.  If I stay moving, I'm okay.  It is unrealistic to stand and pace every minute of the day so I do get "stuck" like this a few times a day, particularly when this happens:

The primary care physician sent me for an MRI on my lumbar and sacral spine, and it's just a mess.  I already knew I had some degeneration, but it's gotten worse and obviously now there's a nerve root issue.

Super!  GREAT!  Fun!  Love it.  The problem here is that I want my normal range of motion and movement back (HA HA) and without pain relief that works, this is impossible.  Taking NSAIDS after gastric bypass surgery is asking for a bloody ulcerated gut death and I'm currently risking it just to lay down at night. 

I am not writing this for pity - there's a million of you out there with similar conditions, and I was told "GO EXERCISE, THAT WILL FIX YOU!" and yes, please, I want to, but HOLY HELL.  Exercising by just picking up a toddler's thrown breakfast is like being stabbed in the asscheek.  Picking HIM up?  YEEEOUCH.  

Forget pants.  Socks?  Nope.  

"Degenerative disc disease L3-SL L4-5 broad-based central and posterior paracentral disc
protrusion with mild to moderate indentation on ventral thecal sac centrally and
bilaterally slightly greater on the left, with contact on the descending left L5 nerve
root in the lateral recess.
Central and right posterior paracentral L5-S1 disc protrusion with mild indentation on
ventral thecal sac centrally and eccentrically to the right.
Minor L3-4 midline disc protrusion.

On getting old.

As many of you -- I have had lower back pain for years, and in my normal Beth way I have ignored it or (...don't tell anyone!) medicated it with NSAIDS off and on, and heat, and exercise, and stretching.  AND GOD DAMN IT, IT HURTS.

Source - Healio 

NSAID use is contraindicated in gastric bypass patients as it can cause serious ulcers.  I started popping them like candy recently.  No. good.

The back pain comes  in cycles and never really goes away.  It gets to the point where I cannot ignore it and I am currently in a Flare Of I Cannot Sit Down Or Sleep Or Lay Down And Nothing Feels Right EXCEPT getting on my knees in 'downward dog' position.  When I describe it to other people they chime in with "Yep.  I live this." 

I had my husband take me to the urgent care MD on the weekend for X-Rays.  They show disc degeneration. No surprise. I suppose after ignoring it -- plus a few years of massive obesity, plus four pregnancies, losing all of the weight plus eating haphazardly and vitamin-deficiencies, it shouldn't be a surprise.  

Hooray.

I was prescribed an anti-epileptic drug instead of a pain-medicine, at my request because I do not want to be sedated, and that I am epileptic.  

Although as the doctor was describing the medication's side effects to me, he explained that it might cause "sedation, dizziness," and I stated, "... that it isn't like I do anything important anyway, I'm not using heavy machinery as it is."  

I do not know that he got my seizure humor. 

I don't feel much relief from a few days of this added medication -- and I do not feel that it will be of help to the pain, but there are more options.  I think that I will need to use exercise somehow, because this, just isn't working.  

I can't sit.  I can't sleep.  

I have a broken ass.  I. am. old.

Do you buy brand-names or generic?

When you go to the pharmacy or big-box retailer do you choose brand-name or off-brand generic over the counter medications and pills even with the same active ingredients?

This kind of thing enthralls me.  I love you NPR. 

Why do people choose what they choose when given the option of the same product in different packaging?  

Some of you are SO. INSISTENT. 

"I MUST HAVE THIS BRAND!"  

"It is the ONLY ONE!"

Don't EVEN bring it to crazy-town with mayonnaise.   But we're taking about medication today.

My line of thinking (...when making that choice in the aisle) goes to:

• Is is *exactly the same?*
• Does it have the same efficacy?
• Is the generic brand safe and effective?

When side-by-side store branded pills versus big brands aren't all that different, same active ingredients, similar labeling, the only thing that stands out to many of us is the pricing.  So why do you choose the more expensive product, if you do?

If I am being completely honest, I don't buy off-brand super inexpensive pills from big box retailers like Wal-Mart (...or a Dollar Store, shiver!) because quite frankly I am terrified at the potential of an eighty-eight cent price point and where THAT came from.  It's not that I am a brand snob, but just, no.  I read the packaging of every side-by-side product and if the ingredients match by percentage and you can see the source -- I do not mind paying less per pill.

I will admit for some things I have brandsnobbery  (...but even so much less lately and not really. I have even downgraded to generic huge tubs of coffee.  RIP Starbucks at home, entirely.  Thanks to blogging not being so, uh, lucrative, don't quit your dayjobs!)  But not for over the counter medications.  I bought approximately three boxes of generic gas medications, gut-fail medications and the like prior-to and during my trip to Portland last week because of desperation and it worked and kept me from ROTTING ON A PLANE THANK YOU VERY MUCH.

NPR -

Why does anyone buy Bayer aspirin — or Tylenol, or Advil — when, almost always, there's a bottle of cheaper generic pills, with the same active ingredient, sitting right next to the brand-name pills?

Matthew Gentzkow, an economist at the University of Chicago's Booth school, recently tried to answer this question. Along with a few colleagues, Gentzkow set out to test a hypothesis: Maybe people buy the brand-name pills because they just don't know that the generic version is basically the same thing.

"We came up with what is probably the simplest idea you've ever heard of," Gentzkow says. "Let's just look and see if people who are well-informed about these things still pay extra to buy brands."

In other words, do doctors, nurses and pharmacists pay extra for Tylenol instead of acetaminophen, or buy Advil instead of ibuprofen?

Gentzkow and his colleagues looked at a huge dataset of over 66 million shopping trips and found that, "lo and behold, nurses, doctors and pharmacists are much less likely to buy brands than average consumers," Gentzkow says. (Their findings are written up here.)

Pharmacists, for example, bought generics 90 percent of the time, compared with about 70 percent of the time for the overall population. "In a world where everyone was as well-informed as pharmacist or nurse, the market share of the brands would be much, much smaller than it is today," Gentzkow says.

I asked several people who had a bottle of Bayer or Tylenol or Advil at home why they'd bought the brand name. One guy told me he didn't want his wife to think he was cheap. A woman told me Bayer reminded her of her grandmother. Another guy, a lawyer, said he just didn't want to spend the time to figure it out, and decided it was worth the extra couple bucks to buy the brand.

In general, we often buy brands when we lack information — when, like that lawyer, we decide it's easier to spend the extra money rather than try to figure out what's what.

Jesse Shapiro, one of the co-authors of the headache paper, told me he buys Heinz ketchup rather than the generic brand. He likes Heinz. He thinks it's better than the generic, but he's not sure. "I couldn't promise that, if you blindfolded me, I could tell them apart," he says.

The Link between Acute Liver Failure and Bariatric Surgery

Tylenol, a no-no after gastric bypass?  Maybe.  Down the road, if confirmed in future large study -