How do you spell hell on Earth? P-a-i-n. What's a two word expression for pain? Pinched nerve. On Saturday, April 7, 2012, the long Easter weekend (Bad Saturday follows Good Friday?), I managed to pull a tendon out of place in my left shoulder, separate the two bones in my left forearm, the ulna and the radius, mess up both my left wrist and elbow and do some minor damage around the shoulder blade to my neck. I am now looking at months of healing which includes physiotherapy, keeping my shoulder taped up, both my wrist and elbow strapped and some support tapes on my left leg. I?m writing this as of week number seven. While I have now been back to work full days, my walking remains uncomfortable to the point where I restrict walking to going to my job and getting groceries. Taking a stroll around the block is still out of the question as it puts pressure on my upper body and my left shoulder doesn?t like it. Oh yeah, I am typing all this pretty much with one hand, my right hand.
I have said that if anybody could return me to the good health of Good Friday, just before Bad Saturday, I would pay them a grand. Oh hell, I'd pay them ten grand. My entire life has pretty much come to a dead halt as my health has become my number one priority and pain management has been my overriding concern.
And what was the cause of the worst physical trauma I have suffered in my entire life? Push-ups. If you are like me, it?s at this point your jaw drops and you exclaim, ?What!?!? I?ve been doing push-ups for fifty years. How could this happen?
Doing a push-up means putting the flat of your hand on the floor. When you do that, you bend your hand back stretching the tendons in your wrist. Sometimes, in order to make a push-up a little harder, I would do them with my hands closer together. Here we arrive at the perfect storm: a day off, more than the usual number of sets, my age and the accumulation of time. However, while this part of the story is startling, what comes after turns out to be perplexing.
I had what I thought to be a good Saturday: lots of exercise done in sets throughout the day, clean the apartment, get groceries, catch up on some private matters with email, blogging and such. On Sunday, I felt some pain but thought slashed hope this was due to "muscle burn", the good type of sore you get after working out. On Monday, I knew I had done something; I knew I had hurt myself. The shooting pain in my forearm was very reminiscent of the RSI (repetitive strain injury) I had suffered about 7 years ago so I immediately thought this was the same thing. I visited my doctor and he tested me. I could move my left arm in any one of a number of positions he instructed me to and I never felt any pain specifically from these movements. Nevertheless, I was feeling this throbbing pain in my forearm and the occasional tingling in my fingers. The two of us discussed RSI and he concurred that it seemed to be the likely cause. The conclusion was to proceed as I did before: don't use the arm and stick with just the right hand to do all computer work.
In retrospect, it's at this point my judgement was not just off but clouded by pain. I had concluded I would have to be patient, grit my teeth and try to ignore the pain and let my body heal. Pain though had turned into a 24 hour a day chore. While manageable with ibuprofen, it was pretty much constant. Usually sitting at home and not moving around lessened the discomfort which at times gave me the wrong idea I was getting better.
Over a four week period, I went back to visit my doctor a total of three times. Each time the conclusion was the same. I could move my arm around without any pain however I was constantly feeling pain. Okay, not excruciating pain but more of the dull background throbbing type punctuated by moments of sharp pain in my forearm. What was the cause? Other than patience and ibuprofen, my only other medication was a mild anti-inflammatory drug. During this time, I didn't do very much at all. While I did my job, sort of, I was expending all of my energy dealing with pain. I had the attention span of a mayfly as I would sit at home at my work desk for a few minutes then stand up to pace while holding my arm and saying, "Ow! Ow! Ow!"
In week four, I decided to work from home all week to further convalesce by not moving around too much. I had noted that walking exacerbated the pain.
And so, on the Friday, feeling a little better, I decided to wash my duvet and sweep out my apartment. As I said, I didn't do much of anything for 4 weeks. These simple tasks did involve me using my left arm to some extent and I ended up paying for it with the weekend from hell. Pain shot up and my suspicions, which had been growing for over a week, seem to be true. This wasn't RSI; I had done something to myself more dramatic but what?
That Monday, I woke up at 4am in excruciating pain. I saw my doctor at 11am and he sent me for an x-ray. Now the idea was to discover whether or not I had a pinched nerve in my neck but we still seemed to be working from the idea this was RSI. With the x-ray done, I went back to the office however with a certain desperation to ask everyone and try anything to get to the bottom of this mysterious pain.
A colleague recommended a kinesiologist slash sports medicine specialist saying he was something of a miracle worker. I may have been sceptical but at this stage I was so desperate, I would have tried a shaman.
Within five minutes, this gentleman seemed to know exactly what my problem was. However and here is the part that stunned me, he didn't just tell me a theory, he actually demonstrated he was right.
Landon gave me some strength tests. This involved putting my arm in various positions and he would push against my arm asking me to resist. He tested my left and right arms and I could easily feel how my left was very weak in comparison with my right.
First off, he told me about the tendon in my shoulder that connects to the bicep in the arm and that it was out of place. Digging into my shoulder, he told me to hold my breath then he pulled. Oddly enough, I didn't feel any pain. He retested my strength by asking me to hold my arm straight out but behind me at a 45 degree angle then resist as he pushed down. My strength had shot up a thousand percent. Oh my God, reseating the tendon in the proper place in the shoulder had put the working of my arm almost back to normal.
He examined my forearm and explained the separation of the ulna and the radius and the impact of this injury on the elbow and the wrist. Borrowing a chiropractic technique, he used a spring-loaded device called an activator on my elbow and wrist. He held this little gadget against each of my joints and pulled the handle. This tensed a spring which then released suddenly and gave a small but noticeable jolt to my joints. Apparently this movement repeated six or seven times, can literally jiggle the bones to get them back into their proper position.
I have little or no experience or knowledge about sports injuries or medicine in general; I have "suffered" from outstanding good health all my life. My questioning of this kinesiologist told me that while the human body is capable of all sorts of healing, some traumas it can't correct and instead, begins to adjust to them. The body can't reseat a bone so it will adjust to the bone being out of place.
Once again, the kinesiologist tested my strength. He asked me to hold my thumb and my pinkie together and he tried to separate them. Once again, I could feel my strength had shot up a thousand percent. I was flabbergasted.
As he laid out my plan of recovery strapping up my elbow and my wrist and printing out instructions for some isometrics exercises, I was upset at having wasted 4 weeks doing nothing because of an incorrect diagnosis for which I was in part responsible. I wondered just what I would have done if I had not had the good fortune of a colleague at work recommending this gentleman. How long would I have been running around looking for the answer to my dilemma? Because I had wasted 4 weeks, because I had run around for four weeks with things out of place, I wanted to be double sure; no triple sure, I was properly managing my recovery and so immediately booked to come back to this physio clinic on an almost daily basis.
Pinched Nerve: 24 hours of sheer, utter hell
While the above injuries were enough, it would seem the injuries extended into my shoulder all the way to my neck. This caused inflammation and the conjecture was that the pain I was feeling wasn't necessarily from my injuries per se but from a slightly pinched nerve in my neck. (Landon proved this by having me put my neck into certain positions and noting how the tingling in my left fingers increased.) One day after seeing the kinesiologist, my four weeks of neglect or misdiagnosis came to a head with 24 hours of absolute hell. For some inexplicable reason, my level of pain went through the roof. I spent the entire night pacing up and down in my apartment holding my arm and going, "Ow! Ow! Ow!" I would have gone to emergency but after calling a health service hot line, I realised there was nobody to deal with the cause of my problem. I'd sit around for hours waiting for help and in the end, somebody would merely fill me full of pain medication. Consequently, I waited it out until the following day so I could see somebody who was capable of doing something.
Question: How do you know you're really sick?
Answer: You're not bored.
Yep, you've got your head stuck in the toilet or your level of agony is nine point five on the Richter scale and you are not in the least bit thinking of watching TV, reading a book or looking at a magazine. Your brain is completely overwhelmed by messages coming in from all parts of your body saying, "I'm not happy" and it hasn't got a single second to be thinking, "There's nothing to do. I'm bored."
At 9am, I started making phone calls. Keep in mind that I am in so much pain; I am desperate to try anything to alleviate my suffering. I had heard over the years of those who suffer from chronic pain and I began to wonder how they could possibly function at all. The pain is so distracting, you can't think. I still wonder how I managed to patiently converse with anyone while the voice in my head was screaming, "Gee-sus H kay rist!!!" If somebody had told me I would live the rest of my life with that level of chronic pain, I would have told them to shoot me on the spot.
At 10:15am, I spent an hour with a physiotherapist. I'm sure she is a nice lady but I went in with a level of pain of 85 out of a hundred and walked out with a level of pain of 85 out of a hundred. Massaging my shoulders, putting electrodes on my neck and acupuncture were all curious techniques for supposedly reducing pain but they didn't work one iota. While she massaged my neck I told her that under different circumstances, what she was doing would be pleasant but she wasn't doing anything to alleviate my suffering.
At 1pm I visited my family doctor. After telling him of what the kinesiologist had said and done and how the level of pain was off the charts, he managed to immediately get me an hour with a chiropractor. While this gentleman's technique was different, I walked out of the session with the same level of pain.
Conversations I had later with other people gave me some insight into how the body deals with pain. The brain can literally be overwhelmed by pain and shut it down. I began to wonder if the reason why I ofttimes thought I was feeling better as the day wore on wasn't because the pain went down but because my brain progressively shut it out.
Conversations I had later led me to believe I had overlooked the technique of icing my neck and shoulder to reduce inflammation. Surrounding tissues can put pressure on the nerve fibres and cause all sorts of pain. However, what's odd about this so-called pinched nerve is that you may not feel the pain where the nerve is actually pinched but elsewhere in the body. As I said, putting my neck in certain positions would increase the tingling in the fingers of my left hand.
Self-diagnosis: I'm an idiot
Because all my symptoms were very reminiscent of RSI (repetitive strain injury), I thought that's what I had. Because I could actually move my arm around without pain, I didn't think and my doctor didn't think there was anything else wrong. How influential was I in convincing my family doctor to go with a diagnosis of RSI instead of looking further?
Now that I've talked with the kinesiologist, I am now wondering if this RSI of 7 years ago wasn't RSI but an injury similar to this one. Over the past weeks, I have experienced some aches and pains in my right arm which makes me think I have probably injured my right arm but to a far lesser extent. After all, I am right handed and my right arm is stronger than my left so it stands to reason if anything was going to go first it would be the weaker arm, my left. I had the kinesiologist examine my right arm but he couldn't come to a definitive conclusion.
What if my colleague had not told me of this kinesiologist?
I don't want to think about this. I have no idea how much I would have bounced around from one expert to another before anybody managed to zero in on the actual problem. My family doctor didn't clue in. A physiotherapist didn't seem conversant with my problem. The chiropractor focused on what "he" thought was the issue. Only this kinesiologist, one expert out of four, immediately grasped what the cause of the problem was and had a plan of action. Why?
A discussion with my colleague revealed that this kinesiologist used to work in sports. He worked with professional athletes where injury meant doing what's necessary from a practical point of view to get them back in the game as quickly as possible. While I use the term kinesiologist, my colleague said this guy has borrowed from different sources: a little chiropractic technique, some physiotherapy and yes, kinesiology. He searches for the cause of the problem rather than focusing on the effect.
Lessons Learned What have I gotten out of this so far? I have discussed what happened with several people. I have talked with others who have visited this kinesiologist. I have talked about the idea of each of us dealing with our own health.
Health is everything
The old adage is true. Without health you have nothing, absolutely nothing. It doesn't matter if you've got wealth, fame or success. Without health you can't enjoy anything even the simple things like taking a walk around the block. (I miss that.)
The buck stops here: I am responsible for me
I am the consumer. I must educate myself so I know what's going on. If I want to buy a car, I cannot, I should not rely on somebody else to make the decision for me. I must study cars in general, the various brands specifically and inform myself of all associated issues like warranty, service and financing.
The same is true for health care. I must become informed and knowledgeable. I must be prepared to intelligently discuss my health with a professional and I should not blindly accept whatever they may say. If I don't like the level of service for my car, I need to take it to another garage.
Family doctor = pain management
My doctor is a generalist; he is not a specialist. I would hope that his generalised knowledge would see him sending me off to the appropriate specialist for a more in-depth analysis but if I realise that pain management is probably his frontline defence against health issues, I may find myself masking the cause of my problem as opposed to finding it.
I must push but in order to push, I must be knowledgeable. Every year, I have an annual physical and cover the broader issues (see references below): my prostate and the dreaded DRE, a regular colonoscopy, macular degeneration and lutein supplements, Vitamin D, focal dystonia, diet, etc. I have now decided to make regular visits to this kinesiologist and his physiotherapy clinic for a different perspective on my physical health and my exercise routines.
The thigh bone is connected to the hip bone
During one of my visits to the clinic, I started asking questions about everything and one of the physiotherapists, Isaac got to talking about me jogging. We did some strength tests with me standing in various positions. He noticed my left arm was weak when I stood with my left foot forward.
Isaac discovered I had a bone out of place in my left ankle. He got it back in place and retested my strength. I could feel my strength shoot up a thousand percent. Amazing. This returns to the idea that if the body can't "fix" something, it will adjust to the injury but here injury doesn't necessarily mean something completely debilitating. For several years I had noted that during jogging I would something get a "kink" in my left ankle. I would have the same feeling you get when you misstep and twist your ankle, like you had sprained it. However, if I slowed down jogging, shook my foot and moved it around in a circular motion, I could always make the feeling go away. In other words, I hadn't really sprained my ankle; it was merely a temporary feeling of having sprained my ankle. Now I'm wondering if this was caused by this out of place bone in my ankle.
Push-ups
I'm not twenty years old. We may debate if I can take the same punishment and whether I can heal as fast or even if I am as flexible and limber. Whatever the case, this is a wake-up call to not blindly continue to do what I may have been doing without a problem out of dumb luck.
Landon's suggestion was for me to get push-up bars. This device consists of an upside down U. The two ends go on the floor and I grab a hold of the cross piece. This way my wrist in kept in alignment with my forearm and I am not bending my hand back stretching the tendon in my wrist. As soon as I am better and can attempt a push-up, I am certainly investing in that. A push-up is a wonderful exercise and I would hate to give them up.
Final Word Get up. Have a coffee. Plan my day: work, jogging, exercise, get groceries, go to the movies, think about what to do during the summer, think about what to do for vacation. In other words, get on with the rest of my life.
Get up. Wince. Take an ibuprofen. Have a coffee. Take an anti-inflammatory drug. Strap up the wrist. Strap up the elbow. Check the bandages on the shoulder and the leg; replace if necessary. Plan my day: move as little as possible. Try to be responsible enough to do a few isometric exercises. Realise groceries are low and start gritting my teeth about having to walk the six blocks, yes the six measly blocks, to the store. Other than physiotherapy and possibly work, I do not leave my apartment as it is still uncomfortable to walk. Besides, after a half block the fingers of my left hand start tingling and my forearm aches so I must hold my arm up in an odd position against my chest to reduce the pain. In other words, life has come to a dead halt. Life has become about health. Life is focused on healing.
There is no doubt about it; this is the worst physical trauma I have experienced in my life. Things are just humming along hunky dory when poof! It is all taken away in the twinkling of an eye. This is the end of week number seven and I am no longer taking ibuprofen on a regular basis. I am creaking around but instead of pain per se, I am feeling discomfort. Although I must be careful to not jump the gun. Once in a while a sudden twist or turn pulls something, causes some pain and makes me wince. I have managed to return to work but I am moving slowly. A week ago I did walk a mile to see the move The Avengers but other than groceries, the doctor and physio, that's the farthest I've gone for any recreational activity in 7 weeks.
Am I lucky? There are so many questions to be answered. How long this will take to heal? Will the tingling in my fingers eventually disappear altogether? Do I have nerve damage? Will I be able to get back to the level of physical fitness I had before? Am I lucky? I once knew a guy whose car was broadsided. He spent two years in a body cast. Two years!!!
I have already consulted with this kinesiologist about my entire exercise routine. I can't afford to have my life stop dead in its tracks! I don't want to ever again make such a horrible mistake and have to pay for it in weeks or months. I am going to agonize over what I did or didn't do to cause this problem. I am going to agonize over what I did or didn't do to properly handle this problem. Whatever the case, I am certainly going to do my utmost to ensure this never happens again.
Health is truly everything.
References
Wikipedia: Perfect Storm
A "perfect storm" is an expression that describes an event where a rare combination of circumstances will aggravate a situation drastically. The term is also used to describe an actual phemonenon that happens to occur in such a confluence, resulting in an event of unusual magnitude.
Wikipedia: Pinched Nerve
A pinched nerve occurs when pressure is placed on a nerve, usually from swelling due to an injury or pregnancy. Nerve damage or pinched nerves are usually accompanied by pain, numbness, weakness, or paralysis. Patients may feel these symptoms in areas far from the actual site of damage, a phenomenon called referred pain. Referred pain occurs because when a nerve is damaged, signalling is defective from all parts of the area from which the nerve receives input, not just the site of the damage.
Wikipedia: Push-up
A push-up, or in British English a press-up, is a common calisthenics exercise performed in a prone position by raising and lowering the body using the arms. Push-ups exercise the pectoral muscles, triceps, and anterior deltoids, with ancillary benefits to the rest of the deltoids, serratus anterior, coracobrachialis and the midsection as a whole. Push-ups are a basic exercise used in civilian athletic training or physical education and commonly in military physical training.
Wikipedia: Knuckle push-ups
Another variation is to perform pushups on the knuckles of the fist, rather than with palms of the hands on the floor. This method is also commonly used in martial arts, such as Karate and Tae Kwon Do, and may be used in boxing training while wearing boxing gloves.
The intent, in addition to building strength and conditioning, is to toughen the knuckles, wrist, and forearm in the punching position. This variation also reduces the amount of strain in the wrist, compared to the typical "palms on floor" approach, and so it is sometimes used by those with wrist injuries. Such practitioners will usually perform their knuckle pushups on a padded floor or a rolled-up towel, unlike martial artists, who may do bare-knuckle pushups on hard floors.
Wikipedia: Activator technique
The Activator Method Chiropractic Technique is a chiropractic treatment method and device created by Dr. Arlan W. Fuhr as an alternative to manual manipulation of the spine and extremities. The device is categorized as a mechanical force manual assisted (MFMA) instrument which is generally regarded as a low-force chiropractic treatment technique. Activator Methods International, Ltd. (AMI) has been providing chiropractic care, resources and training since 1967. Founded on the principles of clinical research, AMI?s major contribution to chiropractic care is discovery and development of the Activator Method Chiropractic Technique and the associated Activator Adjusting Instruments.
Ya gotta take care of yourself!Living alone: the dangers of RSI
Jack Layton and Our Prostates
Gettin' old, man boobs and Vladimir Putin
An apple a day keeps the doctor at bay
Don't worry, be happy. You'll be healthier and live longer.
Codependency: we're in this together
Aspirin: good for what doesn't ail you
Vitamin D: the sunshine vitamin
Barb Tarbox (and my mother): bigger warnings on cigarettes
Macular Degenration: a problem I can't see
Where the sun don't shine: my colonoscopy
My Prostate: something near and dear to me
F*** Cancer
Living alone: the dangers of BPPV
Focal Dystonia: focal what?
Run for your lives! Literally.
Alcoholism: I'll drink to that!
Hot Dogs: Worth their weight in salt... literally!
2012-05-27
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