I use this blog as a soap box to preach (ahem... to talk :-) about subjects that interest me.

Sunday, August 22, 2010

My back

During this month of August I haven’t been writing much. In particular, during the past week, I haven’t written at all. Now, for somebody who calls himself a writer, this is pretty bad. But when you have back problems and your doctor tells you that you shouldn’t be sitting, it’s kind of difficult to write. I do have a laptop and could have written while lying in bed, but it is easier said than done. The inspiration is just not there. Besides, I also have problems lying in bed.

With my back, it all started some decades ago, with crises of severe pain in the lumbar region. Initially, the crises resolved themselves after a few days of rest. Sometimes they were so bad that I couldn’t walk, but it only happened every few years... Then, about one and a half decades ago, I started taking medication to get back onto my feet more quickly. Till 2004, I only needed to take some Ibuprofen, available over the counter, for a week or so. In 2003, I started needing anti-inflammatory tablets, like Celebrex, to make the pain disappear. Then, in 2004, the pain lingered on, and I could only walk curved.

I tried acupuncture, but it didn’t have any effect. I had a CT-scan done, which involved dozens of X-rays. But the doctors didn’t really tell me anything worth remembering. I didn’t realise that the situation was quite serious. Towards the middle of 2004, I also started having pain in my shoulders. At times, I couldn’t even raise an arm or bend it backward. Perhaps it was a side effect of keeping a bad posture both sitting and standing. The best specialist I could find in Zurich told me that there was nothing he could do, except inject Cortisone into my “soft tissues” of the shoulders. I declined. I went to a physiotherapist and, slowly slowly, life returned to normal.

Last year, in 2009, the persistent pain came back, both in the back and in the shoulders. I discovered that after going to bed I couldn’t lie on my back, while in the morning I could. And after getting up in the morning I needed several minutes before I could bend without feeling a strong pain.

I consulted a Rheumatologist, who finally told me what’s wrong with me: I have a severe form of arthritis. Figure 1 is part of the positive of one of my X-rays. It shows a lateral view of my lumbar spine. The red circles show endplate osteophyte formations. Basically, it means that my spine has developed bridges connecting adjacent vertebrae. As a result, the flexibility of the spine is dramatically reduced. It wouldn’t be entirely correct to say that the vertebrae are fused, but you get the idea. Further, the blue circles show that the vertebrae are no longer aligned. Because of the misalignment, the backward arc of the lower region of my spine is more pronounced than it should. To compensate for that, I curve the middle section of my spine forward. This is why you see me curved.

Figure 1: X-ray

OK. I should lose weight and regain as much flexibility in my spine as possible, but several sessions of physiotherapy and exercises made at home have proven useless. Meanwhile, I have kept going with back and shoulder pain. I wake up at night a few times, but I seem to be getting enough rest. None of my two doctors has yet found a painkiller that has any effect. The rheumatologist prescribed Panadeine, which is a mix of Paracetamol and Codeine, without telling me that Codeine is actually addictive. It didn’t have an effect either. Good riddance.

I am sure that the pain I feel is nothing comparable to that felt by people with severe injuries or tumours, but it is strong enough to condition everything I do. I have to move slowly, cannot stoop for longer than a few seconds, find most chairs uncomfortable, etc., etc., etc. It is also very distractive and drains me of nervous energy, as everything I do requires more effort than it should.

At the beginning of August, on advice from a fellow writer, I went to see an Osteopath. These are doctors who specialise in manipulating the spine. While Chiropractors apply a significant amount of energy in their treatments, Osteopath are gentler. I know, I am also skeptical of people who practice so-called alternative medicine. But, at this stage, I don’t want to leave any stone unturned. After all, a super-physiotherapist might be able to help me.

It seems that he does help me, although it is too early to see significant results. He explained to me in a convincing way that I have to learn how to position myself and how to use my muscles in a different way if I want to see any improvement. He is also the one who told me that I should sit as little as possible.  Now I have raised my Mac so that I can type while standing, as shown in Figure 2.

 Figure 2: My desk

And as one cannot always remain standing, I have created a high seat by reducing the width of a saw horse and adding some upholstering, as shown in Figure 3. I can lean against it and almost sit on it (its height with upholstering and all is about 80cm).

Figure 3: My office chair

It is not an ideal solution, and I will have to work on it, but it’s a start...

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