Tuesday, August 22, 2017

That Butt sitting pain thing update

For over a year I have carried this special seat cushion around with me when I leave the house. No one has asked about it. One or two folks have. The rest are polite I guess, infirmity in others is so awkward, or they just don't care. Some people are nosey so you'd think, but no. — Originally  posted this on facebook in 2014, I have upgraded the cushion and still carry it wherever I go. — I was reminded of this last night when it came up in conversation.

I have blogged about this before but in the last few months much of the mental confusion has gone and with strict reduction in carbohydrates the mental fog has lifted too. Mostly. Depression? Meh. Less would be better but things are looking up. An updated review has been brewing in my head so here it is:

I have a pain at the location of my ischial tuberosity (sitz bones) the bones that support you when you sit. It feels like the gluteal muscles have no tone and just squish out of the way. But I stand and walk fairly well. Sometimes the pain starts right away but with physical therapy to build up the surrounding muscles and the special cushion I devised I can now go an hour or so, sometimes two, per day before pain starts to get too intense to think. Pain, anti-inflammatory or other medications have no effect on it.

I have brought this to the attention of a dozen doctors and others in the healthcare industry. None have offered a diagnosis or told me I was deluding myself. One pain specialist doctor did treat me with cortisone. It had no direct effect so we can rule out inflammation. I did experience a slight involuntary twisting sensation in my legs but the pain doc didn’t respond to my questions about this. The other medicos changed the subject to my damaged spine but gave no reason that just the gluteal muscles would be affected. A couple of neurology and ortho doctors have said they might consider doing and operation on my spine to repair crushed discs and impinged nerves if I lost 100 pounds. Then suggested that losing 100 pounds alone might relieve the symptoms. Likelihood the surgery would help were about 50/50 with worsening at about 25% probability. When pressed if that relief metric would include the butt thing they changed the subject.
Changing the subject seems to be the industry wide response.

This has left me, a non science guy, to come up with a hypothesis or three to explain the butt pain with no way to prove or disprove them.

I have neuropathy associated with diabetes. This started 16 yrs ago when I first was diagnosed with diabetes. It has gotten incrementally worse over those years; the trouble I have walking sometimes is probably linked to neuropathy. A variant called proximal neuropathy can effect larger muscle groups like in the buttocks. In a deep dive into medical surveys and studies all I came up with was essentially ‘Yeah it could happen’. No known cure. One of the Neurologists did what is called a ‘Nerve function test’ on me to document my neuropathy. He only spoke Italian so I am not sure what he found. I have come to know that few top level doctors choose to work in the bad air and cultural vacuum that is the southern valley of California. The ones that accept MediCal (medicaid) here are at the bottom of that barrel.

In 2004 I contracted to drive out to and around Wasco Ca. every night/365 for 6-8 hours starting at midnight. I took this contract because that is when the dizziness, dark depression and mental confusion started. I could function alright but the kind of consistency expected in more ‘interactive with other people’ kinds of work would not have worked. I wasn’t in the best place to do the physical lifting part of the job as smartly as I might have. The pickup I bought to do this had seats that were only a little softer than a wooden bench. There is a condition called weaver's bottom. Weavers got it in the old days from years of sitting in one place on wooden chairs. Athletes like cyclists get it too. They call it Ischial Bursitis and treat it as an inflammation caused by friction from using those tiny bike seats. I have established that what I have now is not inflammation but it may have started that way. There is also a tearing of those muscles that can occur from improper lifting. If you keep your back straight to protect your spine, tearing of those inflamed/damaged butt muscles can occur since they are taking so much of the load.

Besides decades of obesity the hard seats and too many hundreds of hours behind the wheel on too hard shocks are likely the cause of the compressed discs and arthritic lower spine that is the basis of why I was approved for social security disability.          

Add to this mix the drugs I starting taking around 1996 or 97. Statins. They are a point of much controversy. Many contend that the only documented good they do is possibly in helping a few percent of men under 70 who have already survived one heart attack. Other studies that are funded by the 35 billion dollar a year industry around this one class of drug are highly speculative. On the other side about 25% of people who take statin family drugs report adverse reactions and no lessening of heart disease risk. Diabetes and the mental confusion I experienced has been linked to statins in many peer reviewed studies but no definitive tests have been developed. Most common are complaints of muscle pain and damage. Ironically this can include the heart muscles.

The intended function of statins is to reduce cholesterol in the blood. The idea being that too much increases the risk of atherosclerosis blocking blood flow to the heart and brain. The myth that dietary cholesterol has an effect on serum cholesterol has been throughly debunked. Your body makes the cholesterol it needs. This means that the amount of cholesterol in your system is what is natural for you. Nature makes mistakes but not across the board and only after the industrial revolution. Cholesterol is part of every system of your body except your bones. Every nerve fiber relies on cholesterol for it’s functioning. The human brain is 60 percent fat, over 25 percent of that is cholesterol. Cholesterol is also a component of your muscles. It helps bind them together.
The real culprit in heart disease is stress and the cortisol your body produces in response. Too much cortisol too often damages the walls of your blood vessels. Cholesterol is the main patching material brought in to repair the holes. Much in modern society causes stress but it also drives productivity. You can avoid stress and most of the risk of heart disease through lifestyle changes. The main one being not participating in the rat race. Striving for that dream or even basic survival requires that you do. While I often have had high lipid levels shown in my blood tests; other tests like ultrasound imaging show little evidence of heart disease. I’ve been off statins since 2009. I meditate and have never sought wealth. The last 3.6 years of waiting on Soc Sec Disability and the 10 years working graveyard were quite stressful so guess I’ll have to see.  

This leads me to believe, granted with no actual tests or evidence, that the degradation that statins wrought on my brain and other systems likely is a contributor to the damage to my butt muscles. Either directly or indirectly.

Not knowing the pathology for sure is one level of disappointment. Not having any treatment for what has sidelined me from life these past years is a different level of disappointment. If only it were the only one.

Also found on web, but who the hell knows? I doubt that Medicare will pay for it:
Prolotherapy is one of the promising treatment for ischial tuberosity pain. In this treatment process dextrose solution is injected at the damaged tissue areas which then allow increasing fluid flow on those particular tissues and causes inflammation on those particular areas. It increases the blood flow and repairs the damaged part by boosting the immune system on those affected cells.

Stem Cell Therapy
Stem cell procedure produces mild inflammation on the affected ligaments to promote self-restoration of these tissues and reduce associated pain. Stem cells therapy promotes tissue healing by utilizing regenerative cells which obtain from patient’s own stem cells, just like natural process of our physiological system.

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