A message of hope and wisdom for medical practitioners and people who suffer from chronic back pain.
I've lived with pain my entire life. As a young child it was at the hand of my father's brutality. Later it was emotional trauma throughout my years growing up until drugs and alcohol numbed me for a couple decades.
In my early twenties, when my first child was still a toddler, I began to suffer from chronic back pain. Here's where things get complicated. X-Rays and a mylogram showed nothing wrong in my spine. My doctor said the pain was all in my head and sent me to physical therapy and counseling.
Therapists recommended back strengthening exercises to increase blood flow and strengthen support muscles. I didn't do them. After frequent visits and complaints to my doctor, I was given pain medications, muscle relaxers and tranquilizers which did little except get me high. That helped me cope for awhile.
I didn't make the connection at the time, but the pain meds mixed with daily alcohol abuse affected my psyche. I became depressed, angry and sometimes suicidal. Counseling didn't help.
Ultimately, looking for relief from emotional and physical pain in my life, I made some really bad choices and foolish mistakes.
As the years went on, I was advised again and again to exercise, with emphasis on walking and core strengthening. Each time I would return to my therapist reporting no relief, seeking ever stronger pain medications. I never did the recommended exercises long enough to really know if they would help me.
Seeing with "mental corrective lenses" in hindsight, I realize now I wasn't looking for help. I was looking for a quick fix. I wanted a magic Genie who would grant me three wishes: a perfect marriage, no pain, and self confidence. That did not and was not going to happen.
In 1998 when I was finally diagnosed with degenerative disc disease and told surgery would bring relief, it was the victory I'd longed for. If there was something physically wrong, it could be fixed! I had high hopes - either I'd be cured of pain or die in surgery. To me, either was perfectly acceptable.
My surgeon recommended we try a minimally invasive laproscopic procedure first. Convinced it was a waste of time and money, I wanted him to do a more extensive procedure requiring the insertion of metal rods and pins in my spine. But he insisted on trying the other method first and as I predicted, there was no relief.
After a year in physical therapy without results, I went back under the knife for a life-changing procedure: laminectomy with fusion and instrumentation. I knew this was the answer for me. As I read the papers outlining the procedure and risks involved, I secretly hoped I'd die on the operating table, the only sure cure for my pain.
Somewhere deep down inside, I knew my pain wasn't caused by degenerative discs, arthritis or any other physiological condition. My physical pain was caused by emotional trauma which I pretended wasn't there. I was way too tough to buy into the victim game.
It was a ten and a half hour surgery during which my surgeon, the best in California, found arthritic bone spurs and removed them. He nicked a nerve and I was left permanently damaged and in chronic pain. I neither died nor found relief but instead was granted a lifelong companion. If misery loves company, her name is Anne. The two are now inseparable.
When I awoke from surgery, I couldn't move my left leg or right foot. The pain in my back and legs was excruciating. Through intense therapy, I regained some use of my leg and foot. The left thigh is largely controlled by my glut on that side and my other ankle is controlled by my right thigh. I still have a floppy foot - though I'm able to raise it considerably more than in the first year, I walk much like a marching horse and often trip myself when over tired.
In 2001 I had the instrumentation removed with a dim hope of some relief. Nada.
I'm left with a sensation like fire ants crawling over my feet, especially my left toes, particularly noticeable and irritating at bedtime when I'm laying still. During the day there are enough distractions to keep me from thinking about it all the time. However, the energy it takes to function with the weakness in my left thigh, right ankle, and constant pain drains me quickly. A few hours of doing the things I love most - photography, hiking, walking, gardening - leaves me utterly exhausted for days. As a consequence, I've been unable to work outside the home. Who would hire someone who works for a few hours then takes a break for a few days? On top of all of that, I developed fibro-myalgia, chronic fatigue, and severe allergies.
The nervous system is the communication line from your brain to your entire body so if a segment isn't getting all the information correctly, it can't relay it properly. I suppose it would be a little like trying to give instructions to a classroom with one's face in a fishbowl - filled with water.
For a few years after all this traumatic surgery I took several medications:
It took me six months to get off all of the drugs but once I did I've never looked back and never felt better (mentally.) I can live with the pain, lack of sleep and irritability far better than with the horrible sense of doom I had taking those drugs. I might add at this point that I have a liver disease so I have to be careful and cognizant of what my liver is processing as well.
Which brings me to mid-2009, left with permanent disabilities and learning to cope. A large part of this process is accepting my limitations and making the most of them.
One haunting discussion I had with my surgeon prior to the first operation keeps playing in my head like a rerun of a bad movie, in which he said, "you could probably wait another twenty years before having this surgery."
Another side effect of the nerve damage is weight gain. Because of the physical limitations and further degeneration (I've since had to have a hip replaced due to uneven gait wearing away the joint coupled with arthritis) I can't exercise as I'd like. No matter how much I watch what I eat, I've gotten flabby and thirty pounds overweight.
This article is written for the benefit of both doctors and patients alike. While the preamble is quite lengthy, it seemed necessary to draw a detailed picture of my situation to make clear some very important points:
Because surgery, under the best circumstances even with the best surgeon, is risky business. I was unstable with serious emotional trauma looking for answers and relief in all the wrong places. But no physician could read my mind. They rely heavily on what their patients tell them. Deluded people are very good telling people what they think they want to hear.
To the surgeon: Don't advise your patient to wait if they can wait. REFUSE to do surgery if it isn't life threatening. The surgery itself is life-threatening. Ask probing questions. Send them for a psychiatric evaluation to see if there isn't something troubling them that causes them to use pain either for attention, validation, or if they need a more rigorous course of physical and/or emotional therapies.
You cannot tell someone they're a hypochondriac - he or she must reach this conclusion on their own before they can get on the path to wellness. It requires a physician with sensitivity who can gently guide the person where they need to be. Use real stories. Relate a time when you felt there was something seriously wrong and learned otherwise. Put them in touch with others who have overcome debilitating emotional anxiety resulting in real physical pain. If the pain is genuinely caused by the spine's dysfunction but can be remedied with less traumatic and risky forms of therapy, by all means help that person get the the right kind.
To the person suffering from pain or degenerative disc disorder: Consider all the options and all the ramifications. Do the exercises. Do whatever it takes. If you think surgery will be the answer to all your problems, you probably need to see a psychiatrist or psychologist first. And above all, be honest with yourself.
To the insurance companies and policy writers, what you pay out in benefits for a person's long term rigorous physical therapy will be a pittance compared to the cost of surgery, not to mention a botched surgery that results in years of treatment.
If you've been told your X-Rays or MRI films show some bulging discs that "may be impinging on nerves," get a second and even third opinion. Nearly everyone on the planet over the age of thirty has some degeneration and bulging of disc material - that's a result of use, abuse and normal aging. Statistically, although many people have been diagnosed with the condition, the number of people who have no pain is equal to those who complain of pain.
The conclusion? Back pain may not be caused by bulging discs impinging on nerves. Most back pain is a result of weak muscles which spasm. This condition is easily remedied with exercise, specifically Pilates or core strengthening. See a physical therapist and/or chiropractor and do what you're told if you really want relief from pain.
If you're looking for attention and are willing to admit it, there are much better ways to get attention than by complaining. Join a theatre group or a writer's group or any kind of club. Get active in something. Volunteer for Habitat for Humanity or disaster relief. You'll feel good about yourself and people will love you for being a hero.
If you've been hearing that inner voice say your physical pain isn't real and you sincerely want to live a pain-free joyful life, please let me know. Let's try to get you the kind of help you really need, not unnecessary surgery or dangerous pharmaceuticals.
Here's to good health and happiness,
anne
I've lived with pain my entire life. As a young child it was at the hand of my father's brutality. Later it was emotional trauma throughout my years growing up until drugs and alcohol numbed me for a couple decades.
In my early twenties, when my first child was still a toddler, I began to suffer from chronic back pain. Here's where things get complicated. X-Rays and a mylogram showed nothing wrong in my spine. My doctor said the pain was all in my head and sent me to physical therapy and counseling.
Therapists recommended back strengthening exercises to increase blood flow and strengthen support muscles. I didn't do them. After frequent visits and complaints to my doctor, I was given pain medications, muscle relaxers and tranquilizers which did little except get me high. That helped me cope for awhile.
I didn't make the connection at the time, but the pain meds mixed with daily alcohol abuse affected my psyche. I became depressed, angry and sometimes suicidal. Counseling didn't help.
Ultimately, looking for relief from emotional and physical pain in my life, I made some really bad choices and foolish mistakes.
As the years went on, I was advised again and again to exercise, with emphasis on walking and core strengthening. Each time I would return to my therapist reporting no relief, seeking ever stronger pain medications. I never did the recommended exercises long enough to really know if they would help me.
Seeing with "mental corrective lenses" in hindsight, I realize now I wasn't looking for help. I was looking for a quick fix. I wanted a magic Genie who would grant me three wishes: a perfect marriage, no pain, and self confidence. That did not and was not going to happen.
In 1998 when I was finally diagnosed with degenerative disc disease and told surgery would bring relief, it was the victory I'd longed for. If there was something physically wrong, it could be fixed! I had high hopes - either I'd be cured of pain or die in surgery. To me, either was perfectly acceptable.
My surgeon recommended we try a minimally invasive laproscopic procedure first. Convinced it was a waste of time and money, I wanted him to do a more extensive procedure requiring the insertion of metal rods and pins in my spine. But he insisted on trying the other method first and as I predicted, there was no relief.
After a year in physical therapy without results, I went back under the knife for a life-changing procedure: laminectomy with fusion and instrumentation. I knew this was the answer for me. As I read the papers outlining the procedure and risks involved, I secretly hoped I'd die on the operating table, the only sure cure for my pain.
Somewhere deep down inside, I knew my pain wasn't caused by degenerative discs, arthritis or any other physiological condition. My physical pain was caused by emotional trauma which I pretended wasn't there. I was way too tough to buy into the victim game.
It was a ten and a half hour surgery during which my surgeon, the best in California, found arthritic bone spurs and removed them. He nicked a nerve and I was left permanently damaged and in chronic pain. I neither died nor found relief but instead was granted a lifelong companion. If misery loves company, her name is Anne. The two are now inseparable.
When I awoke from surgery, I couldn't move my left leg or right foot. The pain in my back and legs was excruciating. Through intense therapy, I regained some use of my leg and foot. The left thigh is largely controlled by my glut on that side and my other ankle is controlled by my right thigh. I still have a floppy foot - though I'm able to raise it considerably more than in the first year, I walk much like a marching horse and often trip myself when over tired.
In 2001 I had the instrumentation removed with a dim hope of some relief. Nada.
I'm left with a sensation like fire ants crawling over my feet, especially my left toes, particularly noticeable and irritating at bedtime when I'm laying still. During the day there are enough distractions to keep me from thinking about it all the time. However, the energy it takes to function with the weakness in my left thigh, right ankle, and constant pain drains me quickly. A few hours of doing the things I love most - photography, hiking, walking, gardening - leaves me utterly exhausted for days. As a consequence, I've been unable to work outside the home. Who would hire someone who works for a few hours then takes a break for a few days? On top of all of that, I developed fibro-myalgia, chronic fatigue, and severe allergies.
The nervous system is the communication line from your brain to your entire body so if a segment isn't getting all the information correctly, it can't relay it properly. I suppose it would be a little like trying to give instructions to a classroom with one's face in a fishbowl - filled with water.
For a few years after all this traumatic surgery I took several medications:
- Neurontin for nerve pain (the wicked fire ants and stabbing pains in feet and legs)
- Percoset, a general narcotic pain reliever which always nauseated me
- Celexa or Paxil for depression (brought on by the Neurontin and constant nausea)
- Vioxx for arthritic pain in joints and muscles
- Welbutrin for focus because all the other meds kept me in a fog
It took me six months to get off all of the drugs but once I did I've never looked back and never felt better (mentally.) I can live with the pain, lack of sleep and irritability far better than with the horrible sense of doom I had taking those drugs. I might add at this point that I have a liver disease so I have to be careful and cognizant of what my liver is processing as well.
Which brings me to mid-2009, left with permanent disabilities and learning to cope. A large part of this process is accepting my limitations and making the most of them.
One haunting discussion I had with my surgeon prior to the first operation keeps playing in my head like a rerun of a bad movie, in which he said, "you could probably wait another twenty years before having this surgery."
Another side effect of the nerve damage is weight gain. Because of the physical limitations and further degeneration (I've since had to have a hip replaced due to uneven gait wearing away the joint coupled with arthritis) I can't exercise as I'd like. No matter how much I watch what I eat, I've gotten flabby and thirty pounds overweight.
This article is written for the benefit of both doctors and patients alike. While the preamble is quite lengthy, it seemed necessary to draw a detailed picture of my situation to make clear some very important points:
- Patients don't always (probably rarely) know what's best for them
- Patients in pain don't think very clearly
- Medical practitioners need to be more discerning when reading X-Ray, MRI or Mylogram films and help their patients make a wise decision.
- Careful psychological evaluations should be done on all patients considering risky surgeries
Because surgery, under the best circumstances even with the best surgeon, is risky business. I was unstable with serious emotional trauma looking for answers and relief in all the wrong places. But no physician could read my mind. They rely heavily on what their patients tell them. Deluded people are very good telling people what they think they want to hear.
To the surgeon: Don't advise your patient to wait if they can wait. REFUSE to do surgery if it isn't life threatening. The surgery itself is life-threatening. Ask probing questions. Send them for a psychiatric evaluation to see if there isn't something troubling them that causes them to use pain either for attention, validation, or if they need a more rigorous course of physical and/or emotional therapies.
You cannot tell someone they're a hypochondriac - he or she must reach this conclusion on their own before they can get on the path to wellness. It requires a physician with sensitivity who can gently guide the person where they need to be. Use real stories. Relate a time when you felt there was something seriously wrong and learned otherwise. Put them in touch with others who have overcome debilitating emotional anxiety resulting in real physical pain. If the pain is genuinely caused by the spine's dysfunction but can be remedied with less traumatic and risky forms of therapy, by all means help that person get the the right kind.
To the person suffering from pain or degenerative disc disorder: Consider all the options and all the ramifications. Do the exercises. Do whatever it takes. If you think surgery will be the answer to all your problems, you probably need to see a psychiatrist or psychologist first. And above all, be honest with yourself.
To the insurance companies and policy writers, what you pay out in benefits for a person's long term rigorous physical therapy will be a pittance compared to the cost of surgery, not to mention a botched surgery that results in years of treatment.
If you've been told your X-Rays or MRI films show some bulging discs that "may be impinging on nerves," get a second and even third opinion. Nearly everyone on the planet over the age of thirty has some degeneration and bulging of disc material - that's a result of use, abuse and normal aging. Statistically, although many people have been diagnosed with the condition, the number of people who have no pain is equal to those who complain of pain.
The conclusion? Back pain may not be caused by bulging discs impinging on nerves. Most back pain is a result of weak muscles which spasm. This condition is easily remedied with exercise, specifically Pilates or core strengthening. See a physical therapist and/or chiropractor and do what you're told if you really want relief from pain.
If you're looking for attention and are willing to admit it, there are much better ways to get attention than by complaining. Join a theatre group or a writer's group or any kind of club. Get active in something. Volunteer for Habitat for Humanity or disaster relief. You'll feel good about yourself and people will love you for being a hero.
If you've been hearing that inner voice say your physical pain isn't real and you sincerely want to live a pain-free joyful life, please let me know. Let's try to get you the kind of help you really need, not unnecessary surgery or dangerous pharmaceuticals.
Here's to good health and happiness,
anne
