"Why Don't They Believe Me??"

"Sure, your back hurts. Mine does too. Now get back to work!!"

Have you heard that when telling your supervisor that you can't go to work? I know I did, multiple times. You try, you really do try. You take a couple Advil, Motrin or Aleve, hoping that they'll take the edge off just enough to allow you to get out of bed, get dressed and head to the workplace. But it doesn't happen, does it? So why do those closest to us, either in our family or at work, think we're faking this horrible pain that back pain brings?

Let's go back to my first or second post for a moment. Eighty percent of adult Americans experience some form of back pain every year. Of that group, the cause for about 80% of them is muscular in nature. That means that they have strained or "pulled" a muscle in their backs. Most will see out a medical provider, as some of those injuries can producer a significant amount of pain. The "cure" most often recommended is 2-3 days of bed rest and moist heat, several times a day and a couple of OTC (Over the Counter) pain relievers, as needed. Additionally, after each heat treatment, perform some light stretching exercises. This will often help alleviate the pain and allow the muscles to loosen and not cramp up.

So what about the other 20%? If you're reading this blog, you're a member of this group like I am. Our pain is much deeper and much more difficult to ascertain and to cure. Some of us will never see a cure, only mitigation (a lessening of the pain level). This pain come from a skeletal deformation, either congenital or due to accidental injury, the causes parts of the body structure to impinge on a nerve or nerves. Often, this pain in debilitating and excruciating, needing medications much more powerful than an OTC and treatments much more elaborate than warm, moist heat, even surgery.

We've all seen scenes on television or perhaps in real life where someone has ridden a horse for the first time and dismount, rubbing their butts. However, if you've never ridden a horse, how can they explain to you what they feel so that you'll understand?

Luckily, I've been with the same PCP (primary care provider, whom I'll call, "Joe") since 1986. First his late father took care of me and when Dad retired, he took over. We've been family friends as well for all that time. And it actually was his father who was taking care of me when my disc first popped in 1992. So Joe knows all about my back pain. As a matter of fact, I even worked in Joe's office for almost 12 years as his Administrator and all during that time, I was only able to work part-time due to my pain.

For a long time, Joe tried to understand what I was going through. "Where was this pain" he asked. "How much does it hurt?" I explained until I was "blue in the face," and while he was very sympathetic, he never quite got it. I said to him, "You really can't appreciate this intractable pain unless you've had it." He agreed and we moved on.

However, just about two years ago, Joe experienced severe back pain. Pain that was so severe, there were days he couldn't make it to his office for his appointments. And that was very much uncharacteristic for him. As you can imagine, every time we saw each other, Joe wanted to know more and more about my pain and we'd discuss his symptoms. Finally, he reached a point and through a thorough exam by an excellent neurosurgeon, Joe was forced to undergo back surgery for a herniated disc.

He tolerated the procedure well and was hopefully on the road to recovery. He did well for several months. Then one day, while simply standing in the pool at his apartment complex, he experienced excruciating pain. The pain was so bad, he couldn't walk in the water. He sent someone up to his apartment to retrieve the walker he had used after his surgery and using that, he was just able to make it back upstairs and into bed.

Initially, he thought that it couldn't be related to his initial injury. It had to be something else, quite temporary and coincidental. As we've all heard, doctors make lousy patients. Joe was stubborn and pushed himself through the pain to get to the office to see his patients. Yet, after numerous injections and other minimally invasive procedures, another MRI showed that certain pieces of the original disc had not been seen (thus not removed) during the initial surgery. It was back to the surgical table for Joe.

I visited him in the hospital and I remember him finally caving in and admitting that he never had been truly able to comprehend the depth of my pain over all those years, until he experienced it himself. Thankfully this time, Joe has made a full recovery and is backing seeing zillions of patients every weekday, being the outstanding physician he is. And that's why your boss doesn't believe you when you complain about severe back pain. Unless that is, he/she saw you run over by the inebriated fork-lift driver and pinned to the bale of scrap paper.

However, it is imperative for you to know that you're not alone. Let me know what you think!

My Story

     Thanks for coming back to this new blog. As I promised in the opening page, I'm going to tell you how my story began and evolved. However, let's look at some basic facts. Here's a table from the American Academy of Pain Medicine:

Condition	Number of Sufferers	Source
Chronic Pain	100 million Americans	Institute of Medicine of The National Academies (2)
Diabetes	25.8 million Americans (diagnosed and estimated undiagnosed)	American Diabetes Association (3)
Coronary Heart Disease (heart attack and chest pain) Stroke	16.3 million Americans 7.0 million Americans	American Heart Association (4)
Cancer	11.9 million Americans	American Cancer Society (5)

(c) 2013 American Academy of Pain Web Site

As you can see, the number of people who complain of severe, chronic pain is greater than those who suffer from diabetes, Coronary Heart Disease (Heart Attack/Chest Pain), and cancer, combined! Additionally, a recent market research report indicates that more than 1.5 billion people worldwide suffer from chronic pain and that approximately 3- 4.5% of the global population suffers from neuropathic pain, with incidence rate increasing in complementary to age. (Global Industry Analysts, Inc. Report, January 10, 2011. http://www.prweb.com/pdfdownload/8052240.pdf. ) From these numbers, we know that we're not alone, even if, at times, we feel as though we are.

According to another report, approximately eighty-percent (80%) suffer from some form of neck or back pain every year. Of that number, approximately another eighty-percent (80%) suffer from a simple, yet painful, muscle strain or pull. However, it is the remaining twenty-percent (20%) of us who suffer from a more severe injury, that is skeletal in origin, where at least one of the discs that cushion the bones of the spine, from just below the skull to the tailbone, has been damaged and impinges on a nerve.

This pain is often caused by a traumatic accident, i.e. a fall, an auto collision, sports injury, etc. But, not always! And this is where my story begins:

It was Tuesday morning, September 12, 1992. I have been working for two years as the operations manager of a national promotional travel company. My duties consisted of about ninety-five percent (95%) desk duties and the rest was moving telephones and computers. Let me state that unequivocally, I did nothing the day before, that could be at fault for what I was about to experience.

The morning alarm went off and as I turned to get out of bed, I felt a sudden twinge in my lower back on the left side. Thinking that I probably slept in a queer position, I got up to get ready for work. But as I walked from the bed to the bathroom, that twinge was still there. It wasn't severe, but it was enough to keep my attention. After a shower and shave, I dressed and headed off to the office. However, when I went to sit down in my car (a Chevrolet Celebrity) that twinge became a true pain. On the so-undependable "pain scale" of 1-10, my twinge graduated from, perhaps a "2," to a "7" or "8."

When I arrived at the office, I gingerly got out of my car and headed inside. After getting through the basic morning tasks,  I called my chiropractor's office and set up an appointment near the end of the day. Dr. "L" was my second chiropractor in Florida and had worked closely with my first one. He had always done very well for me with the aches and pains I came in with, so there was no reason why I should not have had faith that he could mitigate this twinge.

Dr. "L" took me through a full exam to see if he could determine the cause of the pain. Then, I went through the regular modalities of electric stimulation, moist heat packs, ultrasound, and finally, his hands-on treatment. He was very gentle in the area of the pain so as not to aggravate whatever it was. I headed home thinking I was feeling a little bit better.

My assumption was incorrect. Not only did I still have the pain on Wednesday, but it was worse. Now I didn't have to wait to enter the car for the pain to be sharp and piercing; it was that way as I walked around. Thus, I saw my chiropractor again after work on Wednesday and again on Thursday. By this time, the pain was so bad that I did not go into work that day, so Dr. "L" was able to spend some more time with me. Unfortunately, it was all for naught.

"Stevie," he began, sitting across from me in the exam room. "We've gone as far as we can with chiropractic care and you're not showing any improvement and you always have, before this. We need to get you into regular medical care." That was one of the reasons why I liked Dr. "L" so much. He wasn't the type of chiropractor who made wild claims that chiropractic care could cure diseases, etc. He knew there were boundaries. I gave him the phone number of my primary care physician (PCP). He called him and explained his findings to him. By this time, I was bent over like a question mark and could hardly walk or even move.

When I arrived home, there was a message from my doctor for me to call him when I returned home. I did and he was kind enough to come over to my home after office hours and brought me a prescription of muscle relaxants. He also told me that he wanted me to have an MRI as soon as possible and would have his receptionist set it up for me. My doctor also helped me to get to my bed and told me to lay with my knees over a couple of pillows. This helps to open the spinal spaces and might help to alleviate some of the pain.

The next morning, (Friday) the receptionist called me and told me she was able to arrange the MRI for the following Monday. So, for the next three days, I was basically bedridden; I could only get up to use the lavatory or to eat. Other than that, I was in bed, flat on my back, with my legs over several pillows.

As it turned out, my attorney, who, along with his family, were close friends, came to my house on Monday to drive me the MRI. He had undergone back surgery just six months before the onset of my pain, so he knew exactly what I was going through, if my diagnosis with the MRI, matched his. At this point, I had only undergone one MRI prior to this and it wasn't the best medical experience I had.

Be that as it may, I had the test and as I exited the magnet room, the doctors were shaking their heads. My friend came over to tell me that there was no doubt that I was suffering from a herniated disc at level L4-L5. He said that he would arrange for me to see his neurosurgeon who had performed his surgery with great success. With that, he drove me home and set myself up to await my appointment with a neurosurgeon.

And I never was able to return to my work at the travel company, ever again.

Coming next: Meeting the man with the scalpel