Thus Far

Looking back, the first sign of my problems probably came a couple of weeks before we climbed Mount Kinabalu in September. I would experience a jabbing pain in the middle left of my torso. I'd experience it I think when I laughed and/or sneezed and/or took a very deep breath. I was worried it would get the better of me during the climb but I didnt experience it then. What I did experience was tiredness, within an hour of our ascent. I was clearly out of shape and resolved to get fit.

When I did experience it again, we went to see Dr. Tyrone Reyes. He poked at me (I dont think we did an x-ray) and said it didnt seem to be skeletal, just muscular and prescribed Arcoxia (I think).

The drugs worked and on my last two days on them, when I felt very good, I went to the gym. I believe it was a Monday and Tuesday. I considered Kinabalu a wake-up call and was determined to get fit. I do remember pounding the treadmill at least at one point.

I believe it was the very next night, Wednesday, when I walked home from work with significant pain in my heels. (In retrospect, I may have felt this pain in snatches in previous weeks, but attributed it to old shoes I made a mental note to change.) It felt like a condition that Bunny Fabella had (or has) so I called her once I got home, crosschecked the symptoms and added a new word to my vocabulary: plantar fasciitis.

(On Sunday, Oct. 25, I went back and forth to Los Banos for work and my back was feeling quite bad by the time we were on our way home. This may have been the night that, when I lay on my front for my now regular heating-pad treatment, I felt like my body was collapsing and cried out in pain and fear for Kat to help me turn on my back. I called in sick the next day. I was also out from Nov. 7 to 10.)

Within a few days, I was also experiencing pain in my right hip and my lower right back. As Dr. TR was away, we went to Makati Med rehab and saw Dr. Melissa Mercado on Nov. 16. She seemed to agree it was plantar fasciitis and seemed to say that the hip and back problems were a result of my ``compensating'' for the foot pain by walking in a way that strained my hip and back. She prescribed some therapy, mostly for the back, which I went through from Nov. 18 to Dec. 3.

When there was little or no improvement -- or my condition worsened in terms of having great difficulty getting out of bed, e.g. -- we saw Dr. George Canlas. The moment we saw him, he said what I had was pinched nerves, ordered an MRI, EMG and therapy. Before we left, I believe he had his therapists work on me and I felt some immediate relief.

The MRI was clear, the EMG showed five pinched nerves. I went for therapy in Makati because Dr. Canlas' clinic was in Alabang. I had at least 4 sessions from Dec. 7 to 14. Toward the end, I felt that the therapist had strained my hip flexors and so we decided to see Dr. Canlas again. After a short consult, his therapists worked on me again and relieved the hip flexor problem. They also seemed to better know what they were doing and so we decided to go to Alabang twice a week for therapy.

Therapy in Alabang (More than 6 sessions from Dec. 15 to Jan. 16) appeared to be effective on my back and legs, which appeared to have atrophied/weakened but which they were beginning to restrengthen. I was concerned, however, because the plantar fasciitis, which I thought had caused the other problems, remained, and could possibly cause the same or other problems in the future. From what I had read, many cases of plantar fasciitis run their course in about three months. My great fear then was that I was not one of the many.

And then, as January rolled along, the plantar fasciitis appeared to moderate significantly. I felt optimistic that it was fading.

If my memory is correct, I had my last therapy session on Sat., Jan. 16. I remember that because I had made a morning appointment which I had to move because we got an interview with Gilbert Teodoro. I moved the appointment to the afternoon. I remember the therapist was a bit aggressive with my feet, which is why for a while after that weekend, I attributed to her what I thought was a sprain.

In fact, I remember only feeling great pain the next night, during or after dinner with my family at a Japanese restaurant. That exacerbated things because we were sitting on the floor and it was an ordeal getting up. I thought maybe I wasnt ready to sit on floors yet. By the next day, there was very obvious swelling. When Kat said Maget F. was at our place, I rushed home for a free consult. She said it looked like a sprain, taught me how to bandage it and told me to elevate it and apply hot compresses.

After a day or so, it appeared to get better. On Jan. 21, I covered Noynoy Aquino's Makati Business Club speech at the Pen, spending most of the time on my feet. By that evening, it was worse than the previous day. I still thought it was a sprain that I hadnt given enough time to fully heal and so continued to bandage it and apply hot compresses.

During the last visit with Dr. Canlas, he asked me to get several blood tests to find out if my slow progress was the result of a certain condition, although he himself said he doubted it. I took the test -- for HLA-B27 -- which turned up positive, a strong sign I may have -- another new word -- ankylosing spondylitis. I saw Dr. Canlas again on Feb. 3 and he referred me to a rheumatologist Dr. Paolo Lorenzo, whom I saw on Feb. 5.

Dr. Lorenzo said based on my symptoms and my profile (young male), it seemed like AS. He prescribed a low, weekly dose of Methotrexate (7.5 mg a week) and two more weeks of Celebrex.

Feb. 19, Friday, was my last day on Celebrex. Feb. 22, Monday, we saw Dr. Tito Torralba. He ordered an x-ray and an MRI of the sacroiliac joints (an addendum if it was in my first MRI, a new MRI if not). He hardly looked at us as he asked questions and even less when we asked questions. He made me stand and poked my back in several places demanding ``does that hurt?, does that hurt?'' ``Not especially,'' I said at one point. ``What do you mean, not especially? Does it hurt or not?'' he said. ``It hurts because you're poking hard,'' I said.

On Tuesday my foot felt numb so I set the earliest appointment I could with Dr. Lorenzo (for Friday) and consulted Dr. Gerry Pedragosa after work. He didnt seem overly concerned and, thanks to Dr. Benjie Benitez, we got to see Dr. Lorenzo the next day, Wednesday, when he had no clinic. He prescribed Prednisone (2 tabs per day for 15 days, 1 tab per day for another 15 days). Scarily for me, he literally took a breath and started talking about Remicade (2-hour I.V. 8 times a year) and Enbrel (2 self injections per week). They're costly, and I'm scared to death of injections.

The steroids worked great on Thursday, my first full day on them; less so in the days since. Today and yesterday, my main pains are on my left heel (I'm not sure if it feels like plantar or something else) and my left ankle. The ankle is painful and sensitive.