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Chronic Tonic: Adventures in Chronic Pain 7/2/09
Today’s Diary By: Stranded Wind
My life changed forever, Friday, May 13th of 1994, at 3:05 PM. We were turning left across Southwest Army Post Road in Des Moines, Iowa, when another Nissan Sentra, traveling at highway speed, struck our Sentra directly between the doors on the passenger side.
The other car had just got its brakes on and was traveling at perhaps 35 miles per hour when we were hit. I was sitting in the passenger seat and the windows on that side became a blizzard of broken glass. The impact moved the door post on my side in a good eight to ten inches. We spun around through the busy afternoon traffic without being hit again, then everything was still.
Once the dust settled I tried to draw a breath. And couldn’t. And tried again. And couldn’t ...
I sat for a long moment, stunned by the impact. I tried to draw a breath and found I couldn’t. I relaxed, tried again, and still couldn’t breathe. The fear washed over me; was I going to die right there? Finally the air came. I was in my mid twenties and still resilient. I crawled out through the broken window and waved off help. Forty five minutes later I was strapped to a board in an ambulance on my way for a CT scan, which found nothing.
Two weeks later I found the damage on my own. I buckled up, attached the rappelling rope, and stepped backwards off a 120’ bridge piling. I knew something was wrong right away – I couldn’t apply proper pressure pushing back with my right arm. Luckily someone else was already down so I had hands to belay me while I extracted myself from the situation. The next year I got a further evaluation and it was determined I’d lost a third of my strength and range of motion to the left – a whiplash injury.
Four years later I was struck from behind at 9:15 in the morning on a Houston on ramp near the Astros’ training field. The woman, Paula Smith, was on SR22 high risk insurance and had a history of drunk driving. She didn’t get the brakes on at all, striking me, pushing me into the back of a Houston police car, then ramming my rental car again. The hood of her Cadillac was folded double because the nose of her car went under the relatively high bumper on my rental Taurus. I probably could have walked away but being a bit wise to such things I accepted transport to Ben Taub General Hospital. They felt the need to get a urine sample from me "to check my kidneys for damage". I would have punched someone but I was in too much pain. Paula skated away without any charges despite likely having a couple of drinks of breakfast before hitting me.
The tendons in my right rotator cuff aren’t torn, but they’re not right. I can throw a ball about as far as my eight year old daughter. The disk in my neck at C5/C6 is slightly herniated – not enough for surgery, but enough that the muscles under my right shoulder are a constant knot. I was wearing a seat belt both times and I count myself very lucky, in spite of all the trouble these crashes have brought me.
I’ve tried a variety of things over the years to treat the pain associated with this injury with varying degrees of success.
The pain is nerve related rather than due to the muscles so your typical analgesics and anti-inflammatories can’t touch it. I did try both Celebrex and Vioxx, both of which I reacted to quite violently, and both of which got me hospital stays. I did a five year stint on a tiny dose of Elavil, an older tricyclic antidepressant and it made the situation bearable, but I felt like I was smoking dope on a nightly basis and I didn’t care for the constant fuzziness and weight gain.
I wore out my welcome with Elavil at age 35, developing the racing heart and other troubles associated with elderly users of the drug. I had to find something else to do.
I did have a good chiropractor at first, which helped with mobility, but I’m active and stretchy enough that I stopped needing it some years ago. I keep on it with a certain set of yoga stretches, things I do while just hanging around the office. I favor the right side and it’s funny to see how much more flexible that side is after ten years of effort.
Even with good habits and being in decent shape the pain was getting to me. I finally found a doctor that would do an epidural injection in the affected area. The first one was a treat – I got it, felt tremendous relief, and went back to work. I was a used telecom equipment dealer in those years and I bought quite the funny collection of stuff that day. Lesson learned – rent a movie or two before the epidural and go straight home after getting it. These were $300 out of pocket once or twice a year and they did the trick for a long time.
As I’ve diaried here before, I got Lyme some time in 2006 or 2007, it pretty much disabled me by the summer of 2007, and I only got back to work at the beginning of 2009. I’ve only had one epidural in that time, it’s been eighteen months, and I’m really paying for not having access.
One of the things prescribed to combat Lyme and it’s side effects was hydroxychloroquinine. This is an anti-malarial and it is used to raise vacuole pH to flush out the bacteria, which may cyst up under pressure of antibiotics. It’s also used as an anit-inflammatory. I took this for ninety days as part of my treatment and only recently quit – the paranoia and vision troubles were bad enough, but when I started getting an irregular heartbeat I’d had enough. Notice the trend with prescribed drugs and nasty side effects?
I am not at all opposed to ‘alternative’ treatments, although the word offends me, as what that means is ‘not AMA/pharma company profit boosting’. I have tried in no particular order ...
Glucosamine and chondroitin. It got debunked in some ways a few years back and I never felt that much affect from it.
I did the Anti-Inflammatory Diet for a while and I like the effects, but I was already pretty healthy. I can’t tell all that much difference with fish oil, even the high purity stuff with lots of DHA/EPA.
SAM-e is pure magic if you don’t have any family history of manic behavior. I took 200mg and that was enough for me for quite a while, then I stopped when I got disabled and poor, and now I’m taking 800mg to counter joint pain associated with Lyme, which is quite evil in combination with the old injuries. I think about half of all depression cases in Europe are treated with this stuff – it’s a potent anti-depressant and liver detoxifier in addition to the affect it has on joints. The anti-depressant effects come on in about forty eight hours and there isn’t any detoxification period if you decide to stop taking it.
If I need a quick acting overall muscle relaxant I really like Kava Kava. There are some stories out there about liver toxicity but I think it’s big pharma propaganda – they checked something like 100,000 users and found six had died. But they were drunks (!) who were abusing the stuff(!) I had a bit of euphoria the first few times I took it but now it’s a simple muscle relaxant and little more. Get the capsules rather than the liquid – you’ll feel like you’ve given a goat a tongue bath if you get a taste of the stuff.
I recently tried Ashwagandha on the advice of a friend. This is good for kidneys (mine have cysts) and like every other Ayurvedic drug it has a raft of other benefits. It isn’t exhaustively studied since it can’t be patented but it strikes me as being very worthwhile for all sorts of aches and pains.
I used Tiger Balm topically on my shoulder for a long time and it’s OK. I really like the 0.1% Capsaicin creams, but you have to have a latex glove to apply them and woe unto you if you get any on your lips or in your eyes, which I manage to do pretty much every time I have it on.
I should say some words about not only what helps but WHO helps.
Chiropractors can be good ... or they can be a little dingy, which comes from being too focused on their specialty to the exclusion of other needed things.
I went to a pain specialist and it was a tremendous relief to get a treatment that really worked well. There is a price to be paid, at least the way I did it, but it was well worth the time and money.
I had an Ayurvedic doctor for a while and I wish I could find another one here. I had a customer herbal prescription and it was really slick, but I don’t recall the names of the things in it and the whole point to having a practitioner is that they know you and tune the prescription for your needs.
My yoga instructor was also an acupuncturist. This I strongly recommend – might seem like mumbo jumbo, but it works like crazy. I’ve got a western trained guy here now that I’ve just started seeing and at $40/visit that’s a screamin’ good deal for what he does for me. I was paying $75 in the big city.
Best of all, three of the seven years since I got divorced were spent with a massage therapist. The pain in my shoulder is the sort that responds to touch ... any touch, just someone laying their hands on the affect area, but to have someone who actually knew what she was doing was truly marvelous.
I have a copy of hypnotherapist Richard Bandler’s Convincing Comfort. This short audio CD can’t address the roots of pain, but it can put an end to the anxiety – pain is physical and mental in nature.
Along the same lines I’ve got to put a plug in for mindfulness meditation as a means to reduce the suffering one faces with chronic pain. Listening to the teachings of primarily Andrea Fella from Audio Dharma has been like adding an instrument panel for my body. I’m aware much sooner when something is bothering me and things are a lot less troublesome as I know they’re not forever.
If you’re facing chronic pain and reading this I hope I’ve provided some tidbit of information that’ll make your life easier.
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