This is practically what my body screamed to my brain when I saw the confirmed diagnosis and the X-ray slide of my lumbar area..

Anamnesis :
This semester rounds, I felt it's like a blessing that I got a lot of invitation to involve more deeply into practical medicine..

While most of medstudents face the same problems about being shunned away while doing thei practicals - I am blessed with a very dedicated attending, readily to teached us humble students, and a group of perky colleagues to keep me coming for more and more practicals.

5 sessions of practicals later, I learnt a lot more than I had than spending this past 3 years reading text book of surgery. There's the chance to scrub in, and my attending "little secret" on how to insert the Nasogastic tube more easily. And..uh..the screaming, purulent anaerobic ass...cant never forget about that (yes, a real ass...not an ass like..a person)

Anyway, on my 4th session, I was attending a non-stop practical for 16 hours (its that even worth an on call during residency)..where I stand on my poor feet for most of the days..and return to home hours later..when the inevitle happened..

Complaints :
I was back at home, planning to cook some chicken soup (for the body and the soul). I must be too tired to even concentrate on what I am doing when I try to lift something from the floor...

and...SNAP!!!

it felt like I was being shot at the back. For a moment, I almost scream..but managed to clench my teeth and just lay still on the bathroom floor (oh...so...Izzie)...Its so hurtful, I passed my screaming phase towards the giggling phase ..and my housemate thought I was crazy laughing by myself in the bathroom

I cant sit, and I cant lay..so I happened to stand for almost an hour in the middle of the hallway. Then, with good-humor, housemate managed to lay me down with the help of an iron board to keep my back straight. And, that night...i slept on an iron board ..which i think is kinda cool..haha

only that, the next morning..both of my legs tingle..and to my upmost upset, I couldnt feel my own finger on my right foot...shit!! its neurological!!

a reference to 2 rheumatologist later, they suspected a case of Osteoarthritis and presribe me with a handful of meds

Instrumental Examination:

I felt they almost kidding since in whole of my humble knowledge, I rarely meet an Osteoarthritis (OA) among young, healthy (dare I say), people...its more commonly known as the old-people disease..u know..combined that with tear n wear and bla bla bla...its like they're telling me I have gray hairs...

So, as just to comfort myself I consider herniated disk (as the symptoms is quite similar) and refer myself to a surgeon.

The surgeon (who happened to be my attending) directed me for a "free" lumbar x-ray (ugh..the enema the night before..undescribeable) - and yes, its free because he snatched some unused films, and ask for favors from the roentgenologist.

Then, a neuropathologist come to assist with the diagnosis...

5 doctors and an x-ray film later..my diagnosis was confirmed....I am an aging man

Treatment :
I was given a paravertebral injection of analgesic - which miracolously quickly, surpressed my pain ..but not for long..

a handful of meds was prescribed..which all amounted up to Rub 2300 (RM 300) !! it may seems like a small change for some of you..but for a medstudent living his ass in Volgograd solely on the scholar...its too much...so i picked up the cheapest myorelaxant and NSAIDS, and pass out the analgesic..thinking maybe a day or two later, the pain will go by itself, or I will be adapted to it.

Prognosis:

All the meds above, sadly does not heal the condition. It only control the symptoms from vaguely affecting my life. The process is irreversible, and there's a good chance it may recurs from time to time.

For work and career, sadly I had to think seriously to stop with the elective surgery practical. And more upsetting, I might have to let go of my ambition from being a surgeon..for good...( I recalled the time when I was a kid and wish I could be a pilot, only to be told NO by the optometrist who prescribed me an eyeglass 1 year later)

Epicrisis :

This is a rare case of 23-year old young, Asian male, with a confirmed diagnosis of OA in L4-L5-S1, with neurologic complication. Patient led a sedentary (but happy) life most of his lifetime, and once in a while enjoy swimming just for the sake of it. A higher-than-normal BMI and increase workload with monotonous work regime is believed to be the triggering factors for the OA to develop. An osteophytes compressing the nerve is believed to be the cause of pain and numbness, and might all well cause chronic pain in right leg. Management is by strikingly expensive and time-consuming meds. Prognosis is poor as the process is reversible (though liveable) and patient might need to seriously consider being a psychiatrist (read : quack) for his specialities

Disclaimer : I know most of all u juniors out there snatch my award-winning case history plan. But this POST isnt one of them..so, please, dont cut and paste this and send it to your Traumatology lecturer..that would be awful for both u and me