Showing posts with label exercise. Show all posts
Showing posts with label exercise. Show all posts

Wednesday, 2 March 2016

Story of Pain #1; Chronic Back Pain

I broke my sacrum in a freak accident at the age of 18. It took almost three months to heal during which I could not sit comfortably and often rode kneeling facing backwards in the seat to travel. I whined, griped about back pain and took pills and even non-prescription drugs.

Through the years, I also travelled, climbed mountains, Scuba dived, taught school, roller-bladed, skied and had adventures generally allowing the energy of youth to keep me moving. In 1975 using "Be Here Now" by Ram Das, I started doing yoga. Osteoarthritis developed in my knees starting in 1977.

In 1989, now 45 years old and still griping, I decided that I wanted to live longer with less pain. In May 1989, a physiotherapist started me onto an exercise program targeting my back. 

I found exercising to be boring so, in order to do it faithfully, I combined it with watching t-v. I became so accustomed to exercising in the living room that even our guests would be exposed to my routine. When I returned to the physiotherapist in September, 1990, I said “I feel better, I feel stronger, but my back still hurts a lot”. He poked me in my jelly-like soft abdomen. “What are you doing about these muscles?” he said. I replied, “I don’t like sit-ups”. There were a pile of non sit-up exercises for my core. As I faithfully continued adding the new exercises to the other, I experienced a pain-free week in April 1991, six months later.

It didn’t always remain pain free. I learned to change many of the ways that I did things – I changed position a lot, I stopped the car every hour on long trips, I put a foot bar in front of counters and desks, I lost ten pounds of weight, I used heat and saunas. I did not stop exercising – in fact, I added a yoga routine in order to increase both strength and flexibility. Sometimes I took naproxen, a non-steroidal pain and inflammation reliever. 

Osteoarthritis is a progressive disease and exercise didn’t “cure” it. Exercise does, however, make our bodies release endorphins which are natural pain-killers. This seems to be a good thing.

In November 2011, I fell on ice and severely jarred my pelvis and lower back. I struggled back to mobility with the help of my physician, the physiotherapist and a chiropractor. I had to severely modify the exercise program at first but by March 2012 I was well enough to go to Mali with a medical team. Unfortunately, I fell again on uneven pavement while running to avoid tanks during the military coup. When I eventually was able to walk and return to Canada, I made appointments with the physiotherapist, my physician, the back institute specialist, the chiropractor and a mental health counsellor (for PTSD prevention).

In May the back specialist insisted upon a back x-ray, reviewed it with me, emphasizing the deformities. The radiologist had read it as having “osteoporosis, severe osteoarthritis and a 60 degree roto-scoliosis”. In short, a very bad back. At that time, I was using two canes, doing modified exercises and, seeing myself as an invalid. He merely reinforced the importance of acknowledging that I had a severely misshapen back. The view from there was dismal. I was depressed.

A month later, my eldest daughter chided me when i was whining, “so which of these things is acute? Aren’t they all things that you have had for years?”
She was correct – in fact, the scoliosis had probably been present since my teens. 

At yoga in June, the instructor asked that each person “create an intention” for the class. I wanted to “see my back from the outside” and erase the vision of the x-ray. During that session, I was able to have a glimpse of a better back but only a glimpse. I had to consistently and mindfully re-envision my back.

Meanwhile I was learning more about backs. While I was recovering enough to fly home from Mali, my partner was collecting material about backs. A foot high stack of literature was sitting on the living room table. I found new and sometimes non-back exercises that helped backs. Stride – who knew that a long stride was hard on the back? – I modified my walking.  I became stronger and soon there was only one cane and then often none!

The real epiphany – and the reason that I’m writing this – came in the summer of 2015. I returned from seeing my family physician in Saskatoon. He had asked me how much pain I had – I had replied that it was almost always a 2/10, sometimes a 6/10, never 0/10.

Two out of ten all the time? This didn’t make sense. A re-set was in order. If I was always 2/10, then 2/10 was my zero. Using Melzack’s gate theory of pain, I reasoned that a person should be able to simply re-set the “gates”. While I could not change the abnormalities in my back, perhaps I could change my perception of the pain. In a sense that is what distraction, music, movement, and eating does to decrease awareness of pain. In this case, every time I became aware of the pain in my lower back I mentally “closed the gate” just above the painful area. At first this was quite tedious and took quite a bit of effort.  

But in fact, the process took less than six weeks! In mid September I realized that the gate seemed to be permanently closed. Most of the time, I had no pain. It was so hard to believe that I told no one. Today I remain free of that nagging low back pain that I have associated with my broken sacrum.

Not that I have quit exercising, weight control and all of the other good things including moving around – even at meetings, I get up and walk to the back of the room.

On my way through an airport months later, looking for something to read, I picked up Norman Doidge’s “The Brain’s Way of Healing”. Dr. Doidge explains how what I did works, not just for me but others as well! I heartily recommend it.

Friday, 4 April 2014

Coming Home from Elsewhere.....

The last two times that I came home from elsewhere, I was either copyediting or preparing something for the next departure. So I wasn’t really home. This time, I don’t have anything to prepare – my next departure is simply to be a doctor, I’ve had thirty years of practicing to be one, and like every other doctor I know, I would like to be the best that I can be, the challenge being that the horizon “fades forever and ever as I move”.

So home – with follow-ups from the trips to Ethiopia and to Banff to complete, to re-integrate my learnings and re-adjust the trajectory of the future.

Coming home is always a bit of a plunge.  There are huge differences between where I go and what home is – other places and experience collapse precipitously  – like feeling the cold water envelope your body as you dive into it. How do you compare city noise to nature’s silence?  The limited sky view under city lights to the depth of the stars in the heavens? Concrete and leashes to freely run dogs, cats and chickens?

Exotic foods? At the coop dinner, there were cabbage rolls and perogies with a traditional mushrooms sauce. I realized that I hadn’t had these foods for a long time and they are at least as exotic as some of the Ethiopian foods.

We’ve heard the saying: “Think Globally, Act locally”. I’ve been a bit remiss on the second half and a bit too much action in the global sphere.

When I travel, doing my yoga/physio exercises first thing in the morning anchors me. Often it becomes difficult to get that rhythm going at home – I seem to spend more time whining (not literally) and distracting myself first thing in the morning instead of just getting the job done. Perhaps I am experiencing a little rebelliousness over routine? I can do the exercises any time of the day – so I do, even they relieve pain for the rest of the day when they are done in the morning! Yup – this procrastination seems the sign of a whiner, desiring an trace of suffering, maintaining an element of masochism. I know that my days will become more settled when the routine gets back into the early morning.

In the distant past, Bill and I used to circle one another as he had to shrink to let me into the space and I had to become ready to accept his intimacy – I don’t mean physical intimacy because we’re more likely to jump onto one another like a dog onto a bone but the psychological space was often as much my difficulty in accepting the smaller circles of activity (and saying good to my recent experiences) as his ability to share. I cannot express how grateful I am for the home fires he keeps burning – the cooking and cleaning, the feeding of animals and the watering of plants. How fortunate I am to have such a home friend!

The dog. At first he is so appreciative of my return that he does everything I’ve ever taught him – as the days pass, he starts to behave more like a mischievous child than a trained six-year old dog.

The chickens. They don’t see me as anyone special – just a human that brings food and amusement. As they climb onto their roosts for the night, they purr.

When I get finished “coming home”, I’ll purr too.