If you are experiencing intense radiating pain down either leg, commonly referred to as sciatica, here is what I believe is the most efficient way to handle the injury. Often times, the pain will subside and you will be able to go about your normal life after a week on some Advil or Tylenol. But what happens when it doesn’t go away? Generally speaking, you will be thrown into a gauntlet of doctors, specialists, chiropractors, physical therapists, and anyone else that you believe has the answer to your problem.
I have been there. I know the pain you are in. Unless someone has been through this experience there is no way to properly describe the pain. Here is my best effort. An electrical sharp shooting pain that radiates down the leg, generally stopping behind the knee, but sometimes shooting down to the outside of the ankle. This pain pathway is consistent with L5-S1 herniation with nerve compression. 9/10 on the pain scale… with a 10/10 being burnt by a welding torch or boiling oil. See picture below for other pain pathways.
So if you are in this pain, how can you effectively and efficiently resolve it. Generally speaking, the herniation will need to be removed; however doctors will exhaust all options before opening you up. The microdiscectomy is an outpatient procedure that makes about a 4 cm incision, where the surgeon removes a portion of the disc where the herniation or bulge has occurred. This procedure will hopefully improve your condition by removing the disc material off of the nerve sending the pain signals throughout your body. So why did it take 5 years to get to this procedure.
I went to many world renowned specialists in Chicago, deducing that if I went to the “best” doctor I would get the best treatment. Wrong. I was moved through Rush and Northwestern like a Ford on an assembly line only to be dismissed and handed a script for some oral steroids or PT. Frustrated, I just gave up and tried to do core strengthening exercises, which helped sometimes. Then the pain progressed to the point where I could barely get out of bed, sit, or walk. It was a nightmare. I then went to a pain doctor that used epidural steroid injections combined with a potpourri of narcotics to help mitigate the pain. Still no help.
I then found a great pain doctor that understood my level of distress and fast tracked me to surgery. He tried a combination of injections and medications, and when that failed, I was under the knife within a month. So here are the cliff notes on how to get out of immense unrepairable nerve pain stemming from a herniated disc in the most efficient manner:
1. Go get an MRI
All doctors will need to see what is going on internally. Getting this done first will help save multiple unneeded visits to various doctors that will say that can’t do anything until there is an MRI to look at. Carry around a copy of that CD like it is your driver’s license.
2. Go to a Pain Specialist with strong credentials
Explain your level of pain and emphasize that you want to be fast tracked to a microdiscectomy procedure if he/she cannot provide relief.
3. Get multiple referrals of neurosurgeons and orthopedic surgeons from the Pain Specialist.
Line up appointments, don’t wait until after each appointment to move to the next doctor. I believe it is always best to get multiple opinions. I lined up multiple doctors in case any of the docs were dismissive like the ones that I encountered over my 5 year battle and would not proceed with the surgery.
4. Once comfortable with a doctor and you feel the procedure is right for you… Consider the benefits of getting it done. Studies show 90-95% effectiveness from the procedure. The microdiscectomy is minimally invasive, and you are pain free and walking the same day generally speaking.
I personally felt comfortable after the first Ortho I visited, and was in surgery within days. The recovery time is 10 weeks (no lifting, bending, or twisting) and PT begins at week 6. Listen to your body and take it easy.
The procedure does not fix back pain, dullness, or achyness. This procedure is used to get that sharp radiation nerve pain down the leg gone.
I am not a doctor, but I know there are thousands of people out there today that are going through that immense pain. If I can help one person get out of pain one day quicker… this post will have served its purpose.
In no way is this post any medical advice, it simply serves to help patients move through the process more efficiently. Only you and your selected doctors can make the determination of what treatment options are right for you. Hope this helps.
Patrick Draut
I also like young doctors from good schools. They are on top of their game, understand technology, and generally carry a more suitable bedside manner for those under 50.
Understanding these pain pathways is a good start towards resolution.
You are done campaigning, time to face the facts. In a recent interview Mitt Romney is quoted as saying “I’m very sorry that we didn’t win,” he said on the call. “I know that you expected to win, we expected to win, we were disappointed with the result, we hadn’t anticipated it, and it was very close but close doesn’t count in this business.”
Losing EVERY battleground state except North Carolina was a horrendous loss. I’m not sure how to word this any differently; however, to call this close is the equivalent of a football game with the final score of 42-13, with the winning team out gaining the losing team 420 yards to 380 yards. Hopefully next election, now that the math light bulb turned on across the entire country, we can all remember how this game is scored. Electoral Votes.
Please review some past posts from early summer clarifying this point combined with a post from September 17th predicting the race exactly. 332-206.
I believe that I will now start to write about the fiscal cliff if you haven’t been bored to death yet.
Nate Silver projects that there is a 1.3% chance that there is an Electoral College tie in this year’s presidential race. Not that unlikely considering there are over a quadrillion combinations. Here is an excellent explainer video walking the viewer through the enormous mess that would ensue. The video leaves out the fact that the newly elected House of Representatives would actually be the ones voting, but other than that, great insight. Here is the most likely map of the tie and a link to the video.
I forgot to take into account that the left lights their hair on fire when things do not go their way. Opposed to defending their candidate like the right would… they dog pile on him in exchange for a week worth of news material. Mr. Obama did not have one negative sound byte and had a firm grip of policy as suspected. What appears to be the left’s main talking point is that they are upset that Mr. Obama did not call Mr. Romney out for flip flopping on positions or not being truthful and therefore he lost in a landslide. Add to that the loyal right that does not appear to be too concerned that Mr. Romney is moving to the center on policy and we see a small shift in polling in Mr. Romney’s favor. I have been calling for this shift to center from the Romney side for quite some time and am curious if the kick started too late or is perfectly timed.
With all polling data suggesting that President Obama will be reelected I look to analyze where Mr. Romney’s campaign strategy failed. His approach to the race was such, that he and his advisers believed they could simply take the opposite stance as the President and pull enough of the electorate. Critical error. First and foremost, this left Romney’s campaign fighting wars on too many fronts. He was left fighting against women’s health choices and the ACA (Obamacare). He had an arsenal of questionable fiscal policies that have failed in the past. Additionally, with the Ryan running mate selection, he then entered into the Ryan Budget and Medicare/Social Security debate. Add up women, elderly, uninsured Americans, and the middle-class and you will have a difficult time finding 50% or more importantly 270 Electoral College votes.
So how with all of this stacked up against him could he have ever stood a chance? Messaging. One simple message could have been pounded home. Opposed to counter attacking every move made by the current administration, he could have simply asked America “What is your house worth?”
In 1992 Carville coined the phrase “It’s the economy, stupid.” One message for a nation in recession. In 2004 “National Security”. One message for a nation under attack. In 2008 “Hope and Change” for Americans looking to be inspired. All three very different campaigns shared the same tactic. Keeping it simple and winning the race.
1 in 3 Americans are underwater on their mortgage. More importantly, some of the states that have been hit hardest happen to be battleground states. The two most critical states Ohio and Florida housing markets are still destroyed. Add to that, Nevada and Michigan and Mr.Romney could have set the cruise control on his way to the Oval Office.
Mr. Romney needed to brand himself as the man who was going to come in and clean up the housing mess. Once he earned the party’s nomination, he could have moved slightly to the center and laid out a comprehensive plan to restore home values across the country. He needed to use the RNC to talk to each person sitting in their living room about their home value. He needed to talk about how rents are on the rise. He needed to continually drive home that all of Obama’s housing policies have failed considerably since he has taken office.
This is the President’s Achilles heel. You’re not going to beat him on foreign policy, healthcare, food stamps, and macro- economics. He killed Bin Laden, no one’s life has changed for the worse since ACA was passed, food stamps actually drive GDP growth, and macro-economics are too complex for the average viewer at home.
You know what is not too complex? Asking someone if their mortgage exceeds their home value, asking someone if he/she has tried to modify a loan only to be turned away, asking if rent has gone up over the past 4 years? Obama could not beat him on this argument with numbers, and this argument alone could have changed who was playing offense and who was playing defense. This argument affects every voter and can actually be understood.
I suppose if a candidate and all of his advisers could not see this… maybe they do not belong in the White House after all. It’s pretty simple. Here’s your map you should have drawn up in March and you should have selected Rob Portman as a running mate to solidify it.
Couple of notes on the map. I gave the President the benefit of the doubt in Virginia, which most likely would not have gone his way if Romney were to win Ohio and Florida. Additionally, if Romney was to win Virginia coupled with Ohio and Florida, he wouldn’t need Michigan or Nevada. As you can see, it would have been very difficult to beat Romney with the strategy of hardest hit housing states.
It has been awhile since I have updated my results… and for good reason. Not much has changed, but we are seeing a shift in two states that could change the final tally with no substantial consequence to the general election (at this time). New Hampshire has had hints of red while North Carolina is turning blue reminiscent of the 2008 race that was decided by less than 20K votes in Obama’s favor in NC.
I am not going to have a knee jerk reaction and change my map based on these findings; however, after polling comes out after the first debate I will update the map if the trends continue.
Debate? I dislike the media’s talking heads that continually suggest Obama is not a good debater. No data suggests this to be the case… and data actually supports the contrary. Obama made significant gains pulling away from McCain in 08 after each debate and closed the gap on Hillary in the primaries following each debate. I also fail to recall a moment, debate or otherwise, that the POTUS has been stumped on policy including the time he took on a room of Republicans pushing for his healthcare reform. This one is for you mom 🙂
For someone who is not a good debater, he certainly has moved up the political ladder rather efficiently.
As always, thank you Dr. Wang for the data. Please visit his site for hard hitting statistical analysis. Amazing.
Via NFL.com… this looks eerily similar.
In Monday’s game between the Green Bay Packers and Seattle Seahawks, Seattle faced a 4th-and-10 from the Green Bay 24 with eight seconds remaining in the game.
Seattle quarterback Russell Wilson threw a pass into the end zone. Several players, including Seattle wide receiver Golden Tate and Green Bay safety M.D. Jennings, jumped into the air in an attempt to catch the ball.
While the ball is in the air, Tate can be seen shoving Green Bay cornerback Sam Shields to the ground. This should have been a penalty for offensive pass interference, which would have ended the game. It was not called and is not reviewable in instant replay.
When the players hit the ground in the end zone, the officials determined that both Tate and Jennings had possession of the ball. Under the rule for simultaneous catch, the ball belongs to Tate, the offensive player. The result of the play was a touchdown.
Replay Official Howard Slavin stopped the game for an instant replay review. The aspects of the play that were reviewable included if the ball hit the ground and who had possession of the ball. In the end zone, a ruling of a simultaneous catch is reviewable. That is not the case in the field of play, only in the end zone.
Referee Wayne Elliott determined that no indisputable visual evidence existed to overturn the call on the field, and as a result, the on-field ruling of touchdown stood. The NFL Officiating Department reviewed the video today and supports the decision not to overturn the on-field ruling following the instant replay review.
The result of the game is final.
Applicable rules to the play are as follows:
A player (or players) jumping in the air has not legally gained possession of the ball until he satisfies the elements of a catch listed here.
Rule 8, Section 1, Article 3 of the NFL Rule Book defines a catch:
A forward pass is complete (by the offense) or intercepted (by the defense) if a player, who is inbounds:
(a) secures control of the ball in his hands or arms prior to the ball touching the ground; and
(b) touches the ground inbounds with both feet or with any part of his body other than his hands; and
(c) maintains control of the ball long enough, after (a) and (b) have been fulfilled, to enable him to perform any act common to the game (i.e., maintaining control long enough to pitch it, pass it, advance with it, or avoid or ward off an opponent, etc.).
When a player (or players) is going to the ground in the attempt to catch a pass, Rule 8, Section 1, Article 3, Item 1 states:
Player Going to the Ground. If a player goes to the ground in the act of catching a pass (with or without contact by an opponent), he must maintain control of the ball throughout the process of contacting the ground, whether in the field of play or the end zone. If he loses control of the ball, and the ball touches the ground before he regains control, the pass is incomplete. If he regains control prior to the ball touching the ground, the pass is complete.
Rule 8, Section 1, Article 3, Item 5 states:
Simultaneous Catch. If a pass is caught simultaneously by two eligible opponents, and both players retain it, the ball belongs to the passers. It is not a simultaneous catch if a player gains control first and an opponent subsequently gains joint control. If the ball is muffed after simultaneous touching by two such players, all the players of the passing team become eligible to catch the loose ball.
Maybe the people who get paid to analyze the game (The players and coaches, the analysts: Steve Young, Bill Simmons, Trent Dilfer, Rick Reilly, et al) should have a clearer understanding of the rule before weighing in. I hope this finds its way to them. Let’s review the rule:
Rule 8 – Section 3 – Article 1 – Item 5: Simultaneous Catch. If a pass is caught simultaneously by two eligible opponents, and both players retain it, the ball belongs to the passers. It is not a simultaneous catch if a player gains control first and an opponent subsequently gains joint control. If the ball is muffed after simultaneous touching by two such players, all the players of the passing team become eligible to catch the loose ball.
On the field, one ref saw it as a touchdown, the other saw it as an interception. Simultaneous catch.
So the argument then moves to the definition of control. Did Jennings clearly have control throughout?
“A player is in possession when he is in firm grip and control of the ball inbounds. To gain possession of a loose ball that has been caught, intercepted or recovered, a player must have complete control of the ball and have both feet completely on the ground inbounds or any other part of his body, other than his hands, on the ground inbounds. If the player loses the ball while simultaneously touching both feet or any other part of his body to the ground or if there is any doubt that the acts were simultaneous, there is no possession. This rule applies to the field of play and in the end zone.”
It also should be noted that Mike Tirico uses the exact word calling the catch a simultaneous catch during the live broadcast.
Enough with the witch hunt. The regular referees have made similar calls with similar consequences.
Not much has happened, except for Romney foreign policy behavior that further strengthens the likelihood of my electoral map coming to fruition. I have a hard time understanding the math his team conducted that has him winning an election based on far right policy. I thought by now he would have begun to move towards the center; however, with each move he keeps moving in the opposite direction. The voters he has secured are not going anywhere, the whole point is to attract the undecideds and Independents. Bizarre.
Additionally, I discovered this week that the folks at the University of Illinois also have a forecast model in play that has the likelihood of an Obama victory at 99.8% with 313.3 expected electoral votes (pictured above). I disagree with their map that has Virginia leaning red. I am not sure what polling suggests this to be the case. The latest Rasmussen has a 49% to 48% Obama lead in the state, with Rasmussen generally leaning a little to the right. On 9/16 PPP had a 49% to 45% advantage to Obama.
The markets have caught up somewhat on InTrade, with Obama trading up 10 points to 65 (still undervalued). Nate Silver has a 75% chance of Obama winning in November with a 90% likelihood of victory if the election was held today. Sam Wang over at Princeton shows a median electoral vote count at 313-225 favoring Obama. For me, no change… still calling a 332-206 race with the map staying the same for now.
If the election was held today, I believe that the map would play out like this. Barring economic catastrophe, I am having a difficult time believing the gap can be closed. Too many states to flip in 60 days. I think the VP debate is the last chance politically to close the margin without a major screw up from the Obama campaign. I also believe that this will look very similar to the map I put out as my final draft. Romney has to start dumping serious cash and spending a majority of his and Ryan’s time in: Wisconsin, Florida, Virginia, Colorado and Iowa.
Patrick Draut 