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Ice, Ice, Baby

This is the co-culprit in my back injury. The other culprit is myself.

This is the co-culprit in my back injury. The other culprit is myself.

There’s a quote I’ve posted the wall above my writing desk: “Even Thoreau stopped staring at the pond long enough to write a book.” It’s from Stephen King’s On Writing.

This past month I’ve had to adopt a paraphrase quote of my own: Even Stephen King stopped writing long enough to heal. Then he went back to work.”

As I remember King’s version of events in that same book, when he was hit by a van and badly injured he had to stop writing until he was pain-free enough to sit and type at a computer. Then, before he was even well enough to climb stairs, his wife set up a temporary writing desk downstairs and he took up his writing again as soon as he could.

At the end of April, I had a mishap while walking downstairs with my rambunctious dog and landed smack on the base of my spine. With other medical issues already compromising my back health, the pain was immediate and intense: I could feel muscles pulling and pulsating from the middle of my back to my butt, and a sharp, piercing pain at the base of my spine made the walk back to my apartment — with the dog in tow — slow and painful. I called a friend who arranged my ride to the emergency room.

I was told in the ER that I had suffered a fracture of the first lumbar vertebrae, but this turned out to be erroneous: I learned later from my primary physician that the radiologist had noticed what appeared to be a chronic, older fracture of that vertebrae. A subsequent visit to my Scoliosis specialist yielded a third opinion: there was no fracture, merely a “change” due to the slow “stable” progression of my Scoliosis. He pointed out that the locus of my pain was at the bottom of my spine, while the affected vertebrae was in the middle of my back.

What these opinions meant to me emotionally was the resurrection of an old resentment I have against the medical community: if they can’t see something they can fix immediately, whatever pain you’re in is “chronic.” From my point of view, if the pain is directly connected to an injurious accident and you can’t go more than a few hours without narcotics, you have acute pain. Muscle and nerve injuries don’t show up on x-rays, MRIs, or CT scans. But they’re there, and they’re real. The clinical evidence, unfortunately, is limited to the amount of pain you’re in.

Yet there’s a sound reason for a doctor’s reluctance to label pain by itself as an acute injury: the only therapeutic treatment they can offer is physical activity. At the same time, to keep the cycle of pain from interfering with activity, an acutely injured patient has to rest for the first few days. After 9 years in a back brace and three back injuries as an adult, I know that managing pain is more of an art than a science: you apply ice and heat and if those have limited or no effect you rest and/or take a pain pill. The idea is to prevent the onset of pain from triggering an inflammatory cycle that causes more pain and inflammation.

As I came to accept that I was in for yet another slow recovery from chronic pain, I set goals for getting back to my writing. If I could get through 8 hours of work, I would ice up and write for half an hour in the evening. Didn’t happen.

I told my writing coach I’d better write my half-hour in the morning before the daily grind set in to cause minor aches and pains throughout the day.

That didn’t happen either.

I failed my first physical therapy goal: mild stretching every day between the first and second appointments. Even though stretching made me feel better, it just didn’t happen. Slipped right through my fingers without much conscious thought on my part. Just like my writing was slipping through my fingers. I was demoralized and near tears after a painful PT session in which I discovered I could only bike 1.5 minutes before fatigue set in.

My PT pointedly told me that if I’d followed my stretching program, and then still felt fatigued, she would be concerned. But her diagnosis was sharp and direct: I was too inactive.

So I set out, half-subconsciously, to “prove” there was an acute injury by meeting her expectations and doing the stretching. Lo and behold, within two days, I was able to take the wedge pillows to raise my head and knees off the bed. I was able to climb out of bed in the morning and walk to the kitchen without pain in my hips and that lurching feeling in my lower back. After four days of stretching, I obtained a free trial pass to a gym and put in six minutes on a recumbent bike.

The empowerment of being able to affect my physical recovery led to some emotional recovery: I had to let go of my resentment of the medical system if I was going to get back to my writing. I had to stop feeling sorry for myself and let go of my passive “acceptance” of my disabilities. Coming from the inside track of mobility issues, I don’t entirely agree with the analogy that you have to “fight” physical pain; I happen to notice that people who champion this attitude are usually those who aren’t starting out with a mobility deficit.

What I do believe is that working through pain requires being emotionally and spiritually present, and letting go of resentments and fears that prevent you from safely and gently pushing limitations so that you can rebuild yourself.

Lo and behold, mere hours after coming to this realization in the middle of the night, I’ve put in 45 minutes and actually finished a piece of writing.

This injury may have torn me down physically, but it helped to rebuild and gain new strength spiritually and emotionally.

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