I just had my second visit with April Bernal, NP (Nurse Practitioner) at Scripps Green Hospital, Department of Pain Management. I had a lumbar injection six months ago that had not provided significant pain relief and asked if there was a chance a second time might have more positive results. She took considerable time showing me many views of my lumbar spine on the computer and educating me to what I was seeing. In the 3 years that I've been struggling with onset of lumbar and right hip pain, it was the first time a professional took the time to show me in detail how small the foramen are, the flattened discs, the scoliotic curve of my lumbar spine. It made a world of difference it helping me quickly decide my next step: forget another injection, since Pilates was already providing more benefit than any physical therapy had (she encouraged me to continue with Pilates, since the strengthening of the core muscles reduces pressure on the spine since when they are strong they support the spine). I will schedule an appointment with a spinal surgeon, which I had been opposed to even consider before. Injections are just short-term (up to six months) pain relief, but the degenerative process continues. (She said Pilates will reduce the progression of the degeneration.) She said I'll get an in-depth education of options, including possible relatively non-invasive procedures. April is an excellent listener and communicator and educator. And, she is genuinely compassionate!

Thanks again, April!