I went to have another massage on Wednesday. My hamstrings have always been tight and I felt that they were a contributing factor to my poor back. I asked the masseur to concentrate on them but it turned out they weren't too bad. Some tightness in my gluteus minimus on the left and gluteus medius on the right, plus some tightness in my calves. Hmm.

I then went back to see Dr. G, the osteopath. He cracked me at L4 which allowed me to be more flexible. So far so good, but the underlying sharp right SIJ pain was still there. Then I mentioned my problem shoulder and he pressed it down sharply as I lay on my tummy. This enabled me a greater range of motion turning my head to the left. He then cracked my neck and the limited range of motion seemed to return. A bit nervewracking if you're not used to it, but it felt a bit looser. Trouble is, he's now away on holiday and won't be around for the rest of my stay in Melbourne. My wife's cousin's wife said he'd really helped her back and she was pretty much back to 100%.

On Thursday, I went for another massage concentrating on my lower back. This also wasn't too tight, surprisingly, but it helped a little. In the afternoon, I went to see the doctor at Metrospinal again - a year since my last visit. He explained the peripheral nerve stimulator to me.

It costs around AU$ 3k for a one-week trial and around AU$ 50k for the permanent implant with the best current technology - a rechargable battery with a remote control and various cables. The main cost is the AU$ 40k for the device itself. The wires lie about 1cm under the skin, running parallel to it. Once the trial device (larger than the permanent one) is in, I won't be able to shower. The technician will program the device with different programmes which I can then swap between myself according to how I feel. The doctor said he'd be hoping for ~ 70%+ improvement in the pain, but it could be as low as 20%. The device comes with a remote control so I can change the programme - think of it like a radio which has been tuned to preset channels out of a million possible combinations. During the trial period I will have to go in every two days for the doctor to fine-tune the programs. The trial implant is under sedation and I walk out the same day. The permanent implant involves an overnight stay at the Masada hospital in St Kilda East.

Quite apart from the expense, the main thing I need to figure out is how to make the time to have all these things done. Only two doctors in Australia do this operation - both at this clinic - and they both have an international conference to attend in USA next week. They also have plenty of other work so the number of slots is limited. It looks as though I may be able to do the trail by Sep. I will need 10 days in Melbourne for the trial and then 2 weeks for the real thing if I go ahead.

The doctor - let's call him Dr. H as I am losing track of all my doctors - said that he didn't believe in my "3% degree theory" and basically said that the peripheral nerve stimulator ("PNS") would just turn the pain off. This should allow me to exercise and strengthen my lower back (SIJ, presumably) so I might eventually get to the point where I don't need the device. He wasn't promising anything, but told me all the usual risks - infection and movement of the wires. Apparently until around 6 months ago, they found that the wires kept becoming uncoupled from the device (!) so I'm glad that's sorted out.

The PNS sits around 2cm under the skin. They'd stick it high up in my left buttock. It wouldn't be visible but if you pressed the area, you'd be able to feel it. It's about the size and shape of an egg but flat like an iPod. It's made of titanium and resin so "won't break" even if I fall over. Some airport security systems may turn it off, but I'd be given a letter to explain myself. I asked, "Is it like a pacemaker?" and they said, "Exactly". My sister's boyfriend who has a pacemaker warned me to watch out for supermarkets as well, which sometimes have detection devices at their doors now. In any event, I will be able to turn it on and off.

Recharging it involves plugging a recharger into a wall socket for a few hours. This can then be disconnected and held against my buttock parallel to the PNS for 4 hours to completely recharge the PNS. I forget how long the PNS lasts on one charge - a few days? Apparently it's not like a notebook battery which tends to shorten its life the more you use it.

I also met the device saleswoman - Ms P - who was very clear and said she'd be helping me tune the PNS if I went ahead. She'd also check whether anyone from her company could support me in Hong Kong. To her knowledge, no one in Hong Kong has such a device.

So the plan is:

(1) Check my insurance
(2) Schedule the trial
(3) See what support I can get in Hong Kong