So, I’ve often had a challenge with my lower back, particularly on my left side. The problem area is just above my hip, slightly around the back, somewhat adjacent to the small of my back, and a tad lower. Some of it is my weight, some is my posture, and some is a weak core. Regardless, it’s bothered me on and off for some 15-20 years. Often if I’m worried about doing X activity for health and fitness, my lower back worries me the most. Massage and chiro keep me upright, most of the time. Or I take something like Robaxecet when needed.
Last July, we went on a road trip through New England for 3-4 hours daily in the car. It bothered me a little, but we took a massage machine (two balls that pound on my spine) with us, BioFreeze, and a cushion for extra lumbar support if needed. Two days out of 14, it bothered me — one night at a hotel around day 10 or so and one night in Niagara Falls when we were walking over to a restaurant. That night, it was BAD on the way to the restaurant, but a Robaxecet pill later, and I was all good for the walk home.
In other words, it was controlled.
Until it wasn’t controlled
About five weeks ago, it started to nag at me. Biofreeze and muscle relaxant pills didn’t really help. I put up with it for two weeks, but it would twinge and spasm from time to time—just enough to be uncomfortable if I sat too long. I did back stretches, considered chiro, and finally went to get a massage.
The Registered Massage Therapist (RMT) was new to me, although I’ve seen her name at the clinic for a while. She met with me but didn’t want to treat me as she was afraid that whatever she loosened would / could cause more problems i.e., loosening areas that were actually protecting my back in compensation for whatever was going on. So, she insisted I see my regular doctor first and maybe get X-rays.
So off I trundled at the end of week 3 or so. He talked to me, did a basic exam, decided x-rays weren’t required unless physio didn’t fix me up, and off I went. Note that up until then, my pain was relatively under control. It might go to a 6/10 on a bad day, but that would be a quick twinge, not sustained pain.
On the Saturday and Sunday of that week (i.e., 1 and 2 days later), my back pain scale went to 10. I had some severe lockups, with the whole lower back engaged in a spasm, so much so that I actually screamed. I was even crying a couple of times when it didn’t subside. I needed to sit on the couch with a heating pad and couldn’t do much else. It was severe. But once I sat down, the pain would last maybe 20 seconds and then stop. Until I moved the wrong way.
I’m booked for a physio but that was week 6 (next week) to do the full intro appointment (1h). In the meantime, I saw another RMT in our orbit who is also an osteopath. I saw him Wed of week 4; my quads and hamstrings were SUPER tight, so he stretched and massaged until I could move again. Felt great. Lasted all day, and then on Thursday, I was twinging again. It was not like the previous weekend, but I still hit a 6-8 regularly until I sat down or relaxed my back somehow. The heat helped, but not as much as usual.
For Friday at 3:00, I had a massage booked with an RMT that I use regularly, as does Jacob. She’s awesome. I was really looking forward to the muscles releasing. Instead, I had a huge attack at 2:00, just as I was getting ready to see her.
For context, just before that, I finished work at about 1:45 p.m.; everything had been relatively fine all day. I had lunch; everything was good. When I went to the washroom, my back started to spasm. I stood up, and all hell broke loose in my lower back. Sitting or standing, I couldn’t get it to stop.
Under the heading of embarrassing, I had to call Andrea from upstairs to come help me, AND I even needed her to wipe my butt. I couldn’t bend to reach. Sigh. Cue the mental distress part. My pain scale reset so that I was now hitting 10/10 almost constantly. It wouldn’t stop.
I eventually made it up the stairs while she called an ambulance. It was the worst pain I had ever felt, and I wasn’t going to drive myself or take a taxi to the hospital in case I made it worse. But I wasn’t in a life-threatening situation, so I had to wait 3 hours for the ambulance to come. I finally stopped the pain on the couch with a heating pad, as long as I didn’t move. At 5:30 p.m., I had to go to the washroom again, and while it wasn’t fun getting there, the residual heat from the heating pad was keeping it loose. Until 10 minutes later when I tried to stand up again and it was pure torture. Andrea helped me again, including getting back to the couch. Twenty feet felt like 20 miles of torture. It took another 10 minutes for my back to calm down on the couch.
Enter the paramedics
So the paramedics arrived, checked heart and other vitals, all good. They gave me an option — go out on the gurney, which they thought would hurt a LOT, or power through it to walk to the ambulance. I powered through. Long, slow, and very painful. I’ve been in an ambulance not too long ago in tortoise years, and I know it feels like you’re riding in the back of an unaltered pickup truck. Very raw, little padding. I rode sitting up, holding on to some webbing beside me. Every rock, bump, turn, acceleration or deceleration I felt in my spine and lower back. I tried to chat the WHOLE way there to distract myself. My review? Twenty minutes, 1 star, would not recommend.
Arrival at the hospital showed 6-8 paramedic teams waiting with their patients for hand-off and a very busy ER. Since my problems weren’t life-threatening, they put me in a wheelchair, dumped me in the waiting room and went back to helping patients who really needed it. If I had known the ride in the ambulance would be so basic, I would have just taken a cab and hoped for the best. That isn’t really a fair assessment, as their main benefit besides transport was telling me what to do or how to move so I wouldn’t aggravate the situation.
I got to the ER just after 6:00, triaged at about 6:30, and then sat there in a wheelchair with my pain under control as long as I didn’t move too much. I had taken Robaxecet just before 6:00 at home. But if I stood up or moved too much, the spasms started up again.
I was alone, but I decided I needed an advocate if possible and called Andrea to join me if she was willing and able. Jacob was okay staying at home by himself, so she came. On the positive side, on Wednesday, I had ordered a wrap-around lifting belt/back brace, which arrived just as we were leaving in the ambulance. She brought it with her, and I put it on. Most of my discomfort when I moved went away. I could even stand up and take a few steps.
At 10:00, I had Andrea go tell the triage nurse my pain was increasing from sitting so long, and they said they’d bring me some pills. Two hours later, no pills, and I wanted to get myself out of a seated position. If necessary, I was willing to go home. Andrea went back over to see if there was someplace I could lie down to get the pressure off my spine, but they instead gave her Tylenol for me and a promise I would be seen very soon. “Very soon” turned out to be an hour to be escorted into the back to the secondary waiting room.
We found a place to sit; I even used the washroom on my own with the brace for support and didn’t die. I even managed to walk up and down a 30-foot space. But there were still 7 people ahead of me, apparently. I dozed off in the chair for 30m, but otherwise sat around until 3:00 a.m.. Nine hours after arriving at the hospital, I was going out of my mind. The pain was constant at this point and had risen from a constant 3-4 to a constant 6/10, and mentally I was done. I told Andrea, “I want to stay, but I can’t take this anymore. I need to lie down, or I’m going to lose it completely”.
The nurse agreed to put me in an exam room with an examining bed at least, that was at 3:05 or so, and I laid down on it. It took a bit to find a comfy position, but I slept for 45 minutes. Andrea was struggling too as there was no comfortable place for her. She had her head down on a hospital table. The doctor came in at 4:30 a.m. — 10.5 hours from arrival — and was very abrupt. It was clear that she thought I was wasting her time. I told her the pain was enough to make me scream, and my family doctor had told me if one of two things happened (spontaneous bowel release or increase in pain), I was to go to the ER. Hence, I was there.
She gave me some pain meds by IV and a muscle relaxant orally, and I went for X-rays around 5:30 a.m. The final result was that they showed nothing structural going on. They cut us loose at 7:30, home around 8:00 a.m. or so. It took roughly 14 hours to get a prescription for the pain that had me screaming at home originally. Sure, I got X-rays, pain meds, and a muscle relaxant by IV, which were worth it. And the prescriptions have worked well. But I don’t know that I would go again. I was literally losing my mind sitting there.
She gave me a prescription for five things, four of which were just over-the-counter, although two were prescription strength. The extra one was for reducing the muscle spasms. She told me to follow up with my regular doctor.
Not the best of headspaces
I was not in the best of headspaces for Saturday and Sunday. I’ll tell you, quite honestly, that if I had an off-switch during the worst of the pain on Friday, I’d likely be shut off now. I just needed it to stop. Fourteen hours at the hospital waiting for SOME sort of help did not improve my mood. I was ready to leave at midnight if they didn’t promise “soon,” I would have left at 3:00 a.m. if I couldn’t lie down. In pain with no help = go home now and curl up.
Which I did for the rest of the weekend.
My brain goes to the question, “Is this it? Is this what my life will come to?” I have no resilience for chronic intense pain, nor am I excited by the idea that I can’t sit at a computer for any length of time to write. My whole retirement plan revolves around the ability to do basic mobility and type at my computer. If I can’t, life really isn’t worth living for me.
I’ve been spending way too much time thinking about what a test for quality of life would look like for me. Some sort of quantitative measurement. I keep thinking about a TV episode I saw. Maybe it was on Bones? Castle? Something where the dead guy of the week had been killed by a smart house that he had designed. It looked like someone had perhaps hacked it and killed him; in reality, spoiler alert, he knew his mental faculties were deteriorating, and he set an AI test for himself…every day, the house would give him a puzzle to solve. He was a scientist and mathematician, and he set it as a moderate-level puzzle, not genius-level or anything. If/when he couldn’t solve it, the house would kill him, as he programmed it to do. That episode resonated very strongly with me. I define myself very strongly by my mental faculties. If/when they diminish, what’s left will no longer be me, at least not by my standards.
Nevertheless, with the meds in my system, I managed to work half days from Monday to Wednesday this week. Did I mention that the end of the fiscal year is the worst time for me to be off work? My team has $3.5B in programming per year, and $2B of it goes out between January and March. I still have $750M to go. In addition, my team is working on a huge part of a very large report, and it is legislatively required to be finished by Tuesday next week in English and Friday in French to meet all the deadlines for a Ministerial release. Fun times. And yes, of course, my team can function without me. But it does that better when it’s planned rather than a sudden absence.
I’ve been taking the pills and wearing the brace all week. And to be honest, even with my mood dampened on the weekend, it’s been going pretty well. Even with the new scale for pain, nothing is going above a 6; even then, it’s only a twinge. Sure, I’m being REALLY careful to not aggravate it, but still, the brace and muscle relaxant are making a huge difference.
Reborn faith in healers
On Wednesday, I managed to see a resident at my doctor’s clinic. Honestly, it was a completely pleasant experience.
Over the last two years, Andrea, Jacob, and I have had a number of less-than-promising experiences with the health care system. Almost all of them involve situations where our family doctor is not “enough,” but it’s not quite “emergency care” either. Andrea’s bearing the brunt of many of them for herself and Jacob, as CHEO only lets one parent go in for the appointments. I chauffeur to the door; Andrea takes over from there.
This time, I arrived and managed to make it to the office after a long walk across a parking lot, down a hall, waiting about 10 minutes to check in, and then sitting for 2 minutes, all with relatively no pain other than a few twinges. I waited maybe 5 minutes, and the doctor called me in pretty much to the minute for my appointment, and you know what?
She was completely lovely. She had a positive attitude, was friendly, and took her time to explain things to me. I brought her up to speed on what I had experienced so far, and I told her I had three main questions, all of which seemed very logical to her. She answered them in turn.
First and foremost on my list was that if the hospital X-rays showed nothing, was there any additional follow-up needed? An MRI, maybe? Dr. Harper walked me through it, talking about the limited benefits of the various options and the low likelihood of finding anything if the X-rays didn’t show a structural problem. And that the solution would be the same anyway—likely physio, which I had already booked.
Second was the current mix of meds. I am on a proton pump inhibitor (PPI) already, and the doctor at the ER had prescribed me another (without checking the meds I was already on). I had already confirmed with my in-family pharmacist that they basically did the same thing, and I had decided not to switch over since there is a risk with stopping one that my stomach will rebound with a vengeance and give me reflux big-time. The doctor confirmed I could stick with the existing one. I could switch to the over-the-counter version for the others and use them as needed. Which left one (a back spasm reducer) that was set to run out after a week. She extended it by two weeks for now, and we’ll see how physio goes. We can revisit it in a few weeks if I need it longer.
Now, third on my list was what to do if/when I have a major attack again. Going to the ER was a waste of time and healthcare resources. But, unfortunately, there aren’t many good alternatives. I can take multiple inflammation reducers (mostly Ibuprofen and Acetominophen products), keep the brace on, and lie down immediately. Hopefully I’ll also have some stretches from the physiotherapist that could help in the moment. And if it happens again, I’ll have to bear through it and get a refill on the pure spasm reducer.
As I said, it was a very helpful session and a perfectly lovely experience. Unfortunately, the office I go to frowns on adopting residents who rotate in and out through their training. By the next time I go, she’ll likely be gone.
In the meantime, I’ve been able to write yesterday and today without too much aggravation, and I worked two full days this week, albeit a bit staggered for time. I haven’t gone into the office as I’m using the heating pad three to four times a day, and I can’t plug the heating pad in at my desk (without a risk of blowing a fuse or worse, apparently). I’m working from home for now. When I do go back, it will only be to the satellite office for a while, as my main office has way too long a hike from the parking lot to the actual office area; the local office is a much shorter walk.
In the meantime, onward!