Tuesday, 12 June 2012

Health: You don't know what you've got till it's gone

In 1970, the Canadian singer song writer Joni Mitchell released "Big Yellow Taxi" which contained the telling line, "You don't know what you've got till it's gone." Yes, it is easy to take things for granted. This captures the idea of the centuries old proverb, "You never miss the water till the well runs dry." Day after day, some "thing" is just there like the sun or the moon and we become accustomed to it being there. However many things don't have the longevity of the sun and the moon and we can see those things come to an end and disappear and ofttimes it is not until something has disappeared that we may realize its value to us.

As I go through my various on-line contacts, email, Facebook, Twitter, blogs and even the news, I see the world spinning around. Mothers have posted pictures of their kids. People discuss their projects including vacations. A few talk about an evening out, a dinner at a restaurant or even something as simple as a walk in the park. Life is good.

In the past 9 weeks, I have visited my family doctor 5 times. I have pleaded with him for help and managed to get a referral to both a chiropractor and a sports medicine specialist. On my own, I have visited 4 physiotherapists, a sports kinesiologist, the Emergency ward of a local hospital and driven from Canada to the United States to pay out of my own pocket six hundred plus dollars to get a MRI. Why this desperation?

I will be analysing how I navigated the health care system for years to come with an objective of understanding just what I did wrong and in the future what I can do better to ensure my needs are met and not dismissed. After all these visits, I now understand the extent of my injury and have a course of action. Unfortunately, it took nine weeks of not knowing, confusion and unbelievable amounts of pain to be able to piece together what I would have hoped a medical professional would have told me in the beginning. Was it my fault because I didn't demand enough answers? Was I in so much pain that I did not comprehend what I was being told? Was I so disoriented that I simply didn't ask the right questions?

I now know that on Saturday, April 7, 2012, a series of exercises ended up being the straw that broke the camel's back, that is the sum total of my age, the decades of exercise, the stress of this particular day, who knows? The outcome was that I overstretched the tendons in my left arm. I slightly separated the two bones of the forearm, the ulna and radius, and slightly displaced the bones in my wrist and elbow. I unseated a tendon in my shoulder and completely overstressed my rotator cuff, the four groups of muscles and tendons which make up our shoulder.

All this manifested itself as pain in my forearm which was very similar to a repetitive stress injury I had several years ago. As a consequence, I thought my injury was simple. My family doctor gave me a test which seemed to indicate that my rotator cuff was intact which it was. However this test failed to indicate the extent of my injury. For four weeks, I followed my doctor's assessment and proceeded with idea that I had RSI in my forearm with no thought of the trauma suffered by the rotator cuff which extended to my neck. While my forearm was injured, much of the pain and the tingling and numbness of my left hand came from a pinched nerve in my neck, the C6. Instead of getting better after a couple of weeks as I expected, my condition seemed to worsen towards the 4 week mark which culminated with 24 hours of the most excruciating pain I have ever felt in my life.

The Grand Canyon and a pinched nerve
Years ago, the family visited Arizona and of course, we set aside the time to visit this natural wonder of the world. Before our departure, I read an article by a journalist who amusingly described how the canyon never disappoints. He said that people will tell you that a meal at such and such a restaurant is terrific. You may try out the restaurant and walk away thinking that it didn't quite live up to the word terrific. Somebody may tell you that a movie is really good but when you see it, it may not be quite as good as you would have expected. However, the journalist went on to say that no matter what he said, no matter how much he built up the Grand Canyon with adjectives such as spectacular or fantastic or unbelievable, you would never be let down when you eventually saw it. Why? No words adequately capture the grandeur of the Grand Canyon. Consequently no matter what the journalist writes or anybody says about the Grand Canyon, you will always be amazed when you see it for the first time. I am saying that based on experience because the Grand Canyon is a jaw-dropping sight.

I can say that a pinched nerve is exactly the same way. I can use the words excruciating or unbelievably painful or even utter hell but nothing I can say will prepare you for what you are going to feel. When I previously wrote about this, I wasn't kidding when I said that if anybody had told me at that moment I would feel that level of pain for the rest of my life, I would have asked to have been shot on the spot. Un-freakin' believable.

Are you having a nice day?
I don't consider myself a health nut per se but I do like to do what's necessary to keep myself in decent shape.

Two or three times a week I jog a route of 5.5 kilometers (3.4 miles) and occasionally, I push myself to do 10 km (6.2 mi). Right now, it is unpleasant to walk 4 blocks to go to the grocery store. Four measly blocks. I walk 6 blocks to go to work but I have to grit my teeth to do it. In other words, I have not had the simple pleasure of going for a stroll around the block because walking puts pressure on my upper body and of course on my left shoulder and I end up with either pain in my arm or tingling and numbness in my left hand. Okay, it's better now at the ninth week mark but I'm predicting it will take another couple of months before going for a stroll feels normal.

Whenever I do go out, I have to hold my left arm up to my chest. Somehow that lessens the pressure on the C6 nerve in my neck and lessens the tingling and numbness. Even when I sit at my desk, I mostly type with one hand while holding my left arm on top of my head. Yes, you heard me, on top of my head. Doctors know of this. Raising your arm spreads the 5th and 6th vertebrae in your neck and lessens any pressure on the C6 likely caused by inflammation.

While I do some exercises every day, the weekends are my time to make up for my sedentary lifestyle. 150 sit-ups, 125 push-ups, some calisthenics and of course jogging. Right now, I am doing some very, very minor isometrics exercises given to me by a physiotherapist, exercises designed to slowly and I mean slowly redevelop my left shoulder. Bend my arm at the elbow at a ninety degree angle and push gently against the wall for 6 seconds. Pause 10 seconds then repeat. Do 6 sets. This targets the triceps muscle. In comparison to what I was doing before, this is peanuts. It is a reminder how low I've sunk.

Since I can't walk never mind jog, I have come up with an odd replacement I can do in my apartment. I march. Yep, I sort of march raising my legs more than normal for periods of ten to twenty minutes. Because I'm inside, I can hold my left arm over my head if the numbness or tingling gets bothersome. Okay, it may seem strange but imagine the looks I'd get if I did that outside: marching while holding my left arm on top of my head. At the moment this is the extent of my cardio workout. Imagine I could run 10 kilometers (6.2 mi) and am now reduced to this.

I have managed to get to the movies 3 times in the past few weeks but those are the only times I have been outside my apartment for anything recreational. Any outside activities have only involved a medical professional. And believe me; walking the fifteen blocks to the movie theatre is quite the chore. I wonder if anybody sitting behind me in the theatre finds it strange as I will sometimes sit with my left arm on top of my head.

For the past 10 weeks, I have slept on my right side, just my right side. I used to love to get between a pair of clean sheets and roll around enjoying my bed. Now I must carefully get in and out of bed and I can only lie on my left side. There is no rolling around; no enjoyment of clean sheets; there is just the search for a position where my left side doesn't hurt or feel tingly or numb.

Coughing and blowing my nose
Got something stuck in your throat? Cough. Feel the need? Blow your nose. Enjoy yourself.

I must cough and blow my nose lightly. Why? It tenses up my upper body and not only do I feel it in my shoulder, I can feel it in my left hand from this impingement on the C6 nerve in my neck. When I sneeze, I do my best to hold it back as I'm sure a full blown sneeze is going to have some unpleasant aftershocks.

My Attention Span
Pain is not very far away from my mind. I have had some excruciating moments in the past 9 weeks, especially the first 4 weeks ending with the pinched nerve episode. Since pain or discomfort is always present, I find I have a great deal of difficulty concentrating. My shoulder is uncomfortable, my left arm sometimes has sharp pains and my left hand will tingle or just go numb. This weighs on me constantly and I find myself very distracted by it. I get up frequently to pace up and down in my apartment and can't seem to work for extended periods of time.

Health is Everything
Having a nice day? Going for a walk? Jog through the park? Stroll down the street for a bite at the local café? All of that and more has been taken away from me. Health and nothing but health is my number priority in life. Pain management is at the forefront of every waking moment. While I think I now understand my injury and have had more than one professional assure me I will be able to regain my previous level of physical fitness, I realise that the year 2012 is now turned over completely to this one issue. Go on vacation? Read a best seller? Have a meal at that nice fancy restaurant down the street? Frankly, I don't care. Without my health I can't enjoy any of it. Without my health, I can't do any of it.

2012 is a Write-off
I expect the rest of the year is going to be devoted to getting myself put back together. I now realise that I'm lucky in the sense I don't require surgery. Some people detach their tendons from the bone and surgery is necessary to reattach them. Nevertheless, I have at least 6 months of recovery then I don't know how much time to slowly work up to where I was.

Living Alone and Fending for Yourself
I am realising that I'm lucky. Odd statement to make, eh? What if I had damaged my right arm to the extent I have damaged my left? Just how the heck would I get along?

In the last ten years of my father's life, he suffered from some mild seizures. After the death of his wife, my mother, he got a service called Life Line. Twice a day he had to push a button on a device hooked up to the telephone. If he failed to do so, the service would attempt to contact him by phone then escalate the call if it was unable to do so. Plus the service had a small device he wore around his neck which allowed him to push an emergency button if he got into trouble. When he finally had a heart attack, he was able to alert the service which called for an ambulance.

Final Word
The world continues to spin. People are walking, jogging, playing, and going about their daily lives. They are visiting restaurants, meeting one another, and enjoying themselves. They are all oblivious. They are healthy. For them, life goes on.

I have so many unanswered questions. Why did this happen? Will any of this be permanent? Will the tingling and numbness eventually go away? Will I once again attain my previous level of physical fitness? What can I do to ensure this never ever happens again?

You may think me morbid for bringing this up but I am trying to be funny. This coming October I will turn 60. My time is finite. Yes, all of our time is finite but I appreciate that finite to a 20 year old or 30 or 40 is not quite the same as 60. After all, I've jokingly said on more than one occasion, I can stop saying, "a hundred years from now it won't matter" and start saying "fifty years from now it won't matter."

I don't want to ever again waste 6 months recovering from such an injury, heck from any injury. This has been not just unpleasant but painful and frightening. I wouldn't wish a pinched nerve on my worst enemy. Yes, it is just that bad.

Good luck to us all. We never know what fate has in store for us. We never know when our number may be called.


References

FYI: This essay consists of approximately 2,500 words pretty much typed with just my right hand while holding my left hand on top of my head. Now picture that one. If that sounds bizarre, you have no idea of what a bizarre experience this has turned out to be. I hope you never have to go through this.

my blog: Joni Mitchell: Big Yellow Taxi
[music video, lyrics and notes]
Don't it always seem to go
That you don't know what you've got
Till it's gone
They paved paradise
And put up a parking lot


Answers.Com: You never miss the water till the well runs dry.
Manie wats [know] not quhairof [whereof] the wel sauris [tastes] quhill [until] it fall drie.
[a 1628 J. Carmichaell Proverbs in Scots no. 1140]


Wikipedia: Rotator cuff
In anatomy, the rotator cuff (or rotor cuff, sometimes called rotary cup) is a group of muscles and their tendons that act to stabilize the shoulder. The four muscles of the rotator cuff are over half of the seven scapulohumeral muscles. [The scapulohumeral muscles are a group of seven muscles that connect the humerus (bone of the upper arm) to the scapula (shoulder blade).]

my blog: Health: Life comes to a dead halt
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.

my blog: Living alone: the dangers of RSI
[Okay, so it turns out I didn't have RSI but the "Living Alone" part is still applicable!]
Ever notice how when you're really really sick you're not bored? You can lay there for hours even days in absolute and utter agony and watching TV is the last thing on your mind. Yes, that old mind is quite busy, thank you very much, having to deal with the sensory overload of the body's not too subtle message, "I'm in pain and I am none too pleased about it." Pain takes up a lot of your attention.

my blog: A hundred years from now it won't matter
The odd thought which had come to mind was that I no longer had to say one hundred years. At such an "advanced age" as being in my fifties, statistically I knew I would only live for probably another 30 or so years. After all, my father died just 2 days shy of 80. More than likely my genes will be like his, give or take a few years. ... I realized I could start saying, "It won't matter 50 years from now" or maybe "40 years from now".

Fiction: Mary Groans Then Dies
"I know my father who had some heart problems got himself hooked up with a telephone service called, if I remember correctly, Life Line." said Jake. "You apparently had to push a button every 12 hours and if you failed to do so, the service would check up on you, first by phoning you then by sending emergency services if there was no answer."

"Yeah, that would have been something," said Terry. "Unfortunately, in these circumstances, Mary only had her neighbours but in an apartment building, once you shut your door, you are pretty much on your own. You have little or no contact with your neighbours."

my blog: The Script: Live Like We're Dying
[music video, lyrics and notes]
You never know a good thing till it's gone
You never see a crash till it's head on
Why do we think we're right when we're dead wrong
You never know a good thing till it's gone


Yeah, we gotta start
Looking at the hands of the time we've been given
If this is all we got and we gotta start thinking
If every second counts on a clock that's ticking
Gotta live like we're dying


We only got 86,400 seconds in a day to
Turn it all around or to throw it all away
We gotta tell them that we love them
While we got the chance to say
Gotta live like we're dying


2012-06-12

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2 comments:

PollyAnna said...

I could relate to this post in many, many ways. As a result of cancer, I had fifteen surgeries on my upper body in six years, and all kinds of issues surrounding those surgeries that made it hard to lift my arm and painful to do even simple things. I learned how to live with pain for a very, very long time.

As someone who has made it through - I still have pain, but NOTHING like what it used to be - I will say this: the other side of pain is BEAUTIFUL. One day, you will wake up, and you will be in a fabulous mood, and you'll find yourself singing a little, and your coffee will taste so much better, and the colors will all be brighter, and then it will hit you: it doesn't hurt! And then every little thing seems more beautiful after that.

In my case, the first time I did downward dog in yoga when it didn't cause me to collapse or bring tears of pain to my eyes, I actually did weep, from gratitude.

I will hope that when your pain ends, that you will have the blessing of joy that brings. I will hope that when that happens, the colors of your world will seem brighter, too, and that you never forget how fortunate you are.

(PS At 30-40, I was well aware of my mortality, because I actively spent most of that decade trying not to die. You are fortunate to have reached your awareness of our finite time on earth later than I did. But I am fortunate, too, because for the rest of my life, I don't take life for granted, and often the mundane seems impossibly beautiful, simply because I'm there to experience it.)

BigLittleWolf said...

All I can say is... I'm sorry, and I empathize. Not sympathize; empathize. Having had a rotator cuff injury followed by complications and an MRI I had to pay out of pocket for, then physical therapy which worsened everything... let's just say, I get it.

As for pain? If necessary, we learn to live with it. On moderate days, we feel relieved. On not moderate days, everything is impacted. And then we feel immeasurably grateful that we are basically healthy and sound, and have made it this far in life in that state.

I hope you will heal well and thoroughly, and you're quite right - we take much for granted until we encounter something like this. Worsened, when dealing with it alone.

Sending, if you will allow, a virtual hug.