"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!

Where Does it All Begin? Or Does it?

Let's review the basic facts again:

In any given year:

• 80% of American adults with suffer back pain
• 80% of those people's pain will be muscular, meaning it's a simple pulled muscle that can often be treated with 2-3 days bed rest and warm, moist heat.
• The other 20% will suffer from neuro-skeletal injury, meaning actual damage to a disc or other part of the skeletal frame that impinges on a nerve causing severe pain

That's where I was starting in 1992 and still am today, March of 2015 and I have not had a day without serious pain in all that time. What puzzles me, as well as all my doctors, surgeons, therapists, etc., is why, if my injury occurred in 1978, did it take 14 years for my injury to manifest itself? I use the term, "puzzles" because no one has been able to answer that question. 

To briefly recap, in 1978, with about 10 months as a volunteer firefighter, my department sent me and a couple of other guys to the state fire college. I was enrolled in the state's basic firefighting skills course. It consisted in two days of classroom learning and then two days of live fireground skills. My buddy and I were split up into two different groups.

We had undergone good training back at our department, but this way, we'd have state certification. Of the five guys in my group, I was the only one who had some decent experience on the nozzle during actual fires, so I was placed at the end of the line in the live burn exercises.

The state had procured several ramshackle houses that were to be torn down anyway and we'd use those for the practice burns. We were paired up and the training officer had the building lit off and we went to work. Because I was the last one in the sequence, I didn't have my chance until the second day of the burns and I was the last one to go in for that day. My partner in this exercise was a young kid from a small town where he was a public safety officer. If you don't know that term, it's used for people hired to be both a police officer and a firefighter. They would patrol on their shifts, but also carry their bunker gear in their vehicle and respond on a working fire. He had never been in a real fire, never been on the nozzle, and only put on an SCBA in practice.

By the time my turn on the nozzle came, the insides of our building were pretty well burned through. Walls had holes, ceiling was coming down and loose boards were all over the place. I have this rookie behind me and, since this is the last burn of the program, they arced the entire place off! I was just cracking the nozzle open when a set of SCBA bells started to ring. No, not mine, my partner's, who is supposed to stand behind me taking the hose pressure off me. Instead, he drops the hose and starts to yell, "I'm outta air!! Outta air! I'm gonna die! I'm gonna die," and turns around and dives out the front door.

So here I am with 100psi at the tip and the training officer to my left at about 3-4 feet. If I drop the hose, he's a dead man! So, I tuck the hose between my arm and my side and try to knock down the fire that was directly in front of us. As I do, I work to close the bale slowly, but the pressure is still high and as I take a side-step, my left leg falls through a burned-out section of the floor. I collapse into the hole up to my crotch with my right leg curled up and I feel this explosion of pain in my left knee. (Did he say "knee?" I thought this was about a back injury!) Don't worry, it is.

Now I'm really up shit's creek. I've hurt my knee, I look like a little-person dressed as a firefighter and I'm trying to close down this nozzle before I let it go flying around the room. I finally manage to do so and take a breath. I close the nozzle and drop the hose. Still wearing my air-mask I begin yelling, "I'm hurt! I'm hurt!" 

For some reason, the officer thinks I'm saying, "I'm tired, I'm tired." We're both yelling at each other and not getting anywhere. I somehow manage to lift my damaged leg out of the hole and role over to grasp the edge of a wall. Favoring my left leg, I hobble over to the front door, tear my mask off and tried to walk out the door. One step and I fell over and down the three steps to the ground, where several firefighters were milling around. Next thing I know, someone is cutting up the left leg of my bunker pants and getting the SCBA and coat off me.

By this time, my left knee is the size of a seedless watermelon. I'm packaged up and shipped off to the local Emergency Room. X-rays were shot, however, even today, they don't serve injuries to cartilage and soft tissues well. I was placed in a knee immobilizer and sent back the the hotel with instructions to see my orthopedist upon my return to Greensboro.

As it turns out, from 1978 through 1992, everyone involved, doctors, physical therapists, etc. all believed that the major injury I suffered was blowing out my left knee. The following December, I had the first of what wound up being five surgeries on that knee. However, throughout it all, we never suspected that there was another injury hiding somewhere in my lower lumbar spine.

Until one day in September 1992.....

It's Been a Long Time & I Have No Excuses!

If you had read my first several posts to this Blog, I humbly ask for your forgiveness. This subject is far too important for me to have left it wallow in the shadows. I'm very sorry. There are no excuses for me to offer other than a foolish error on my part. That's it. But now that I'm back here, I plan on making good and continuing the blog.

When I read over the last post I made in 2013, I have been in touch with my friend, "Fred" since that time. Fred has had a very painful and difficult time with his back injury. It cost him the job that he loved (a Florida deputy sheriff and K-9 officer) and hours and hours spent arguing with Worker's Compensation, having to hire an attorney, etc. And as bad as this sounds, it's all too common for those of us who have suffered severe back injuries. Fred faced one of the common arguments with his employer, he was milking a minor injury to get money from the county!  Yet, even providing hundreds of pages or medical documents from his doctor, from the Workman's Compensation doctor, as well as an independent third physician, the department fought with him at every turn. The MRI's and CAT scans meant nothing. Not even the fluoroscopic pictures taken during his surgery, were dismissed out of hand.

As I said, neither his injury nor his story, is unique. My situation back in 1992 did even last that long. The last day I was physically able to get out of bed and go to work was on September 15th. By mid-October, shortly after undergoing an MRI where it was determined that I had a significant herniation at L4-L5, the owner of the company where I had worked for over two years as the operations manager, sent me my check for September, hoping that I would feel better soon and good luck with my future. I could check back with him when I was able to return to work and he would be kind enough to see if there might be a position for me somewhere in the company.

What truly saved my ass was a disability policy I had purchased, against my judgement, mind you, when I was 30 years old. I figured that disability policies were for people on crutches, in wheelchairs, etc. I was an able-bodied young man, a volunteer firefighter/EMT. Why did I need this type of insurance? Who could have know that almost ten years later, that policy would help me continue to pay for a new home that I had purchased just two months earlier. Thus, if you're not too far into your journey with chronic pain, you may want follow-up with an insurance agent to see what you may be able to do to secure disability insurance.

Next: To Cut or Not To Cut - THAT is the Question!

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

Severe Neck & Neck Pain - What's Up?

     Most of us who suffer from severe back or neck pain can accurately pinpoint the date when "it" happened; the first day that the we lifted a heavy box, we were hit from behind in a traffic collision, we bent over the wrong way, etc. From that moment on, the pain has invaded not only our bodies, but every aspect of our lives.

     Hello and welcome. My name is Steve Greene and I have been enduring severe back pain since 1992. Over the last couple of months, I have met or spoken with the largest number of people in the shortest amount of time, all suffering from prolonged and intractable back pain. And from numerous news reports, there are thousands, if not, tens-of-thousands of us across this country, let alone the world! So, after several days of consideration, I decided to create this blog where anyone who is in the same "boat" can discuss his/her own situations and share the successes and the failures of the therapies, injections and procedures that they have been through.

     I am also researching the necessary tools and accessories it will take to begin a podcast to accompany and underscore this blog. I already have several volunteers who are willing to be interviewed for a podcast. Of course, both processes will be done with your privacy, first and foremost.

     I am sure that many of you are asking yourself, "What's in this for me?" What I hope to offer is a place where we can share our stories and see that we are not alone. When the news reports or newspaper articles decry that opioid medicines should be restricted only to patients with severe, cancer-related pain, we will discuss the matter here. When your Workmen's Compensation doctor tell you there is nothing else he/she can do for you, you can come here to here what other patients have done when the exact same thing happened to them.

     I have no doubt that we will laugh together and we will very likely cry together. However, the operative word is, "together." So please, give it a try, maybe even submit your own story. I will be adding my early experiences tomorrow. Till then, take a deep breath, curl your lips upward and

Smile...