OK, I’m not talking about my drug problems. I’m talking about the terrible shape my body is in.

Now for the past year I’ve been suffering from either sciatica or piriformis syndrome (it makes no difference—either way, something is squishing my sciatic nerve.) Pain would suddenly get me, literally right in the ass, with some radiation down the leg, and even sometimes numbness and tingling. Nothing that some naproxen couldn’t take care of. Some weeks would be worse than others, but I didn’t really spend much time thinking about it.

In retrospect, I realize things have been slowly progressing for the worse.

Last week, I nearly fell down because of how much it hurt. I luckily was able to sit down in a controlled manner, but then I couldn’t get up again for several hours.

This is very bad.

I like to blame the fact that I bought a pair of shoes that were too big for me, and too damn heavy besides. This is roughly when I started having symptoms back in August of ‘06, and the symptoms got better once I dumped those shoes.

But most likely, this is just the end result of being way too sedentary, and being way too overweight. I mean way too overweight.

The sad irony is that now that I’m constantly in pain, I’m even less likely to want to exercise. I can’t even walk from one end of work to the other without having all the nerves in my right lower extremity feel like they’re shrieking in agony.

The slothful part of me just wants to get the decay and decline to get to the point. What’s the end point of all of this? Well, besides death. I mean, can you actually experience significant morbidity and even mortality from sciatica?

I mean, I guess I could just become even more and more unwilling to move. Eventually, my coronary arteries will narrow with cholesterol deposits, and then it’ll be the cath lab for me. Or v. fib arrest, dead on arrival, but I’m really trying to be more optimistic these days. I suppose this pain will encourage even worse body mechanics, making me prone to more injury.

I suppose I could become so sedentary that I end up with a DVT. Leading to a pulmonary embolism.

But as much as I whine about how sucky my life is, I really don’t want to undergo a steady, excruciatingly slow decline in function, only to be killed by something massive, sudden, and excruciatingly painful, like a heart attack or an embolism. (If I could choose my mechanism of death, it would be via respiratory arrest from morphine and/or benzodiazepine poisoning, preferrably in the setting of a hospital or even better, in the hands of hospice care, without having to get a plastic tube rammed down my throat, or getting my ribs cracked by overzealous interns, but I digress.)

So I’m actually looking into trying to get better. Literally one step at a time.

Sunday night, before I got on the freeway to drive back to San Diego, the pain was so distracting that I had to stop at a Ralphs and buy an ACE wrap. For some reason, wrapping it around my ankle really helped. (Although I suppose the 500 mg of naproxen and the 1250 mg of Tylenol probably played their part, too.)

I figured out that the pain in my right leg (if it isn’t a DVT) is probably a combination of things: the sciatic nerve pain and the sequelae of a couple of bad ankle sprains.

In high school my sophomore year (15 years ago!) I missed a little ledge and ended up twisting my ankle really bad. I mean, my leg and foot probably went at a 90° angle, except usually that part of the ankle doesn’t really move that way, or move at all, really. I was on crutches for a week. But I didn’t think about it again.

Then in July 2001, I sprained it again walking around NYC. I remember the pain being overwhelming. I almost blacked out (although a lot of that was probably because it was hot, I was dehydrated, and I was hypoglycemic or something.) That was probably one of the first times I remember being in so much pain that I wanted to throw up. But I managed to limp along. Again I didn’t think anything of it.

Most likely, I’ve seriously jacked up or even possibly completely torn my anterior talofibular ligament (ATFL), which happens to be the most common ligament injured in an ankle injury. Since I’m not athletic at all (although there was actually a very, very, very brief time in my life where I was actually running miles at a time), I never really noticed too much instability, although I did recognize that my ankle wasn’t as solid as it should be.

Well, apparently, it’s taken its toll. For the past few days, the area around my lateral malleolus (the outer knob of the ankle) has been aching, and getting worse with even just a little bit of walking, and I feel like I can’t put reliably put weight on this foot. My calf muscle is aching too, and I can feel my hamstrings atrophying.

I’ve heard quadriceps strengthening will help, but I can’t even imagine putting resistance on this leg at this point. Right now I’ve got both an ankle and a knee brace on. (While the ankle brace alone helped, the more I walked, the more I realized how weak my quads and my hamstrings are, and I felt pretty unsteady, and after a while, my knee started hurting too.)

Since I spend most of the time at work sitting down, I can barely tell if it’s helping. I’ve been having to park in the lot farthest from the clinic I’m rotating through right now, so the morning and the afternoon walk leave me aching and sweating. I guess the difference is that I can at least walk around the clinic without having to grit my teeth.

I’m being uncharacteristically optimistic. I’m hoping this is a sign that my limbs are starting to heal, and that as the days go by, it’ll get easier and easier to walk around like a normal person, and then I can start actually exercising.

It’s one thing to be fat and therefore unattractive to women. I’ve been dealing with this for a good decade or so now, so it doesn’t wound my psyche too badly. But it’s another level of awfulness to be fat and to be in physical pain because of being fat. Seriously. This sucks.

I mean, seriously, if I’m not going to get better, I wish someone would just put me down then, like a race horse that’s fit for the glue factory.