As I've written elsewhere, my entire life was upended on Saturday, April 7, 2012, when I sustained the worst physical trauma of my entire life. I am writing this in the middle of week number 12, coming up to three full months, and I am only now beginning to fully appreciate what has taken place and the true extent of my injury. I will be analysing all this for months if not years to come trying to understand the injury, the causes, the necessary remedial actions and what, if anything, may turn out to be a permanent problem I will be dealing with for the rest of my life. I will also be analysing my navigation of the health care system as I now wonder if I did a poor job of advocating for myself.
Recap
I overstretched the tendons in my left arm. I supposedly slightly separated the two bones of my forearm, the ulna and the radius, leaving the bones in my wrist out of place and the elbow slightly out of whack. I apparently unseated one branch of the upper bicep tendon, completely traumatized my rotator cuff (although I have not torn any of those tendons) never mind the entire shoulder and have caused some strain on the neck leaving a pinched C6 nerve probably due to a herniated cervical disk.
Due to the pinched nerve, I am feeling discomfort if not pain just about twenty-four by seven in my left arm. I can't walk without putting a strain on my upper body which in turn exacerbates the pinched nerve causing shooting pains in my left forearm and tingling and numbness in my left hand. When I walk, I bend my left arm and hold my left hand against the side of my neck as this elevated position seems to lessen the pinching of the nerve. When I sit, I ofttimes hold my left arm on top of my head while typing with just my right hand. Once again, the elevated arm supposedly opens the 5th and 6th vertebrae lessening the pressure on the nerve.
In a nutshell, life is not too good. Even though I am at work, my number one priority remains my health and pain management is my biggest concern. Yes, I have managed to go to the movies a few times recently but I'm sitting there constantly shifting around while I seek that elusive pain-free position. Other than that, I pretty much stay cooped up in my apartment. Taking a leisurely stroll around the block is a pleasure I have not had in three months as walking is at best uncomfortable and at worst painful.
Chronic pain
Over the years I have heard stories from colleagues, friends, and acquaintances and even from newspapers and online sources about chronic pain. Yes I heard the words but did I understand their meaning? Having never had the experience, did I grasp exactly what the words about the experience were telling me?
A couple of years ago, I did my first and (so far) only parachute jump. Like everybody else, I had seen parachute jumping in the movies and on TV. I had read articles written by those who had the experience. I had even had the opportunity to speak to people who had done it and who gave me a first-hand account of what it's about.
Nevertheless, my understanding of parachute jumping was merely "intellectual"; I didn't really understand what it all meant from a gut level. It wasn't until I was at an altitude of 13,500 feet (4,100 meters), strapped to my tandem jump instructor, watching the indicator lights over the open door go from red to yellow to green then tumbled out of the plane, the first plane I ever exited in my life which was not on the ground, that I really, really understood what parachuting meant. Oh, and what did it mean by the way? I would sum up the experience with two words, if you would be so kind as to excuse my French: "Holy c**p!!!"
However, over the years I've seen him and talked to him all without appreciating that sometimes while he's standing there talking to me, he's actually feeling pain. He's told me as such. Now I'm in the same position. I'll talk with you, smile at you, even crack jokes and yet the telltale sign is me holding my arm in a funny position as I attempt to lessen the pressure on my C6 nerve to lessen the tingling and numbness in my left hand and the sometimes shooting pain in my forearm. Okay, it's not excruciating pain as in I drop to my knees and start wailing for my mommy but it is a distracting, annoying and very bothersome pain that brings down your quality of life.
Last week, I stop to talk with another colleague who begins to tell me about how his day got off to a bad start because the muffler went on his car. As I stand there holding my arm up trying to stop the shooting pain in my forearm, he goes on about the dealership wanting thirteen hundred dollars to fix things and how he decided to drive his wife to work so he could take the car to Midas who said they could fix things for less than a hundred, and he was late getting to work, etc. etc. At some point, he stops, looks at me, looks at my arm, then says, "I'm sorry. I forgot you're hurting."
I smile then say, "Here's the deal. I'll trade you my shoulder for your muffler and I will throw in one thousand dollars cash."
We both laughed. Heck, I'll throw in two thousand dollars cash. Seriously.
I realise that just because I have a personal issue to deal with, it doesn't mean the rest of the world has come to a halt. Ha, like it would! In the past three months, I have visited my family doctor 5 times, seen both a chiropractor and a sports medicine specialist, plus visited 4 physiotherapists, a sports kinesiologist, and the Emergency ward of a local hospital. I have had almost a dozen physiotherapy sessions. And this isn't the end of it. Just yesterday, I had an EMG test.
Electromyography
Well now, isn't this one about as much fun as a barrel of monkeys: electrically shock me and stick needles into my muscles. What's next waterboarding? If you wanted me to talk, why not try the direct question? Geesh!
The purpose of this test is to verify the functioning of my nerves specifically looking for an impingement. First a doctor gives me the once over doing some physical tests. He has me put my arms and legs in certain positions then asks me to push back as he tries to move the body part. He notices how my left triceps is weak which is pretty obvious as I have just about not used my left arm for three months.
Secondly, a technician attaches some recording electrodes to my left hand then proceeds to zap me in various parts of my left arm. The idea is that the jolt travels up my arm to the neck then comes back down the arm to the hand where the electrodes record the activity. By the way, how about saying, "One... two... three..." instead of randomly sticking my finger in the light socket then flicking the switch? Okay, I'll live but I'm not lining up for a second turn on that merry-go-round.
Finally the doctor comes back and puts needles connected to electrodes into the muscles of my forearm and by the thumb of my hand and listens to the audio interpretation of my muscles at rest and when contracted. What is this? Acupuncture with a computer?
Conclusion? I have a pinched nerve in my neck, the C6, more than likely caused by a herniated disk. It would seem that an MRI of my neck would be in order to confirm this diagnosis but the doctor warned me that this would be considered non critical and could take some time. Consequently, I decided to be pro-active and have signed up to go back to the States to pay for an MRI out of my own pocket.
Aside: I do not want me paying for an MRI in the States to be misconstrued as a criticism of the Canadian health care system or to be considered as an argument for a two tier health system. I would like to see sufficient investments in the system so that nobody would have to look elsewhere for supplemental services. I would like to come back and discuss this in more detail especially since Obamacare in the States is being vilified as a form of expensive socialized health insurance.
Postscript: June 22, 2012
I booked an MRI in the States for June 26. I just got a call from the hospital booking me for an MRI on the same day. Consequently, I cancelled my trip to the States and will proceed with the local MRI. Despite the doctor warning me about wait times for non critical scans, the "system" has come through.
Will the Cisco Kid ride again? Hell, right now I would be ecstatic to be able to stroll around the block without feeling tingling, numbness or pain. It's surprising how your expectations change. Jog? Exercise? Parachute out of a plane? I'd be grateful just to be able to walk comfortably. Yep, have almost everything taken away to appreciate the little things in life.
I certainly have a new understanding for what the other person may be feeling when they tell me they're suffering from chronic pain. Believe me, it sucks and it sucks royally. Yes, they may smile, they may laugh, and they may say some amusing things which will give you the impression that all is right with the world but don't be fooled. Everything may be all right in your world but everything is not all right in theirs.
Over the years I, like many people, have survived the ups and downs of living, the vagaries of life. I survived jumping out of an airplane and I will survive this. Things will be different but I will survive. I am going to be 60 years old later this year which means that statistically I have 20 to 25 years left. I'd like try to make them good ones.
Postscript
Throughout this little ordeal, I have had to smile as I have been reminded that while the modern age offers many wondrous things, it is obvious, sometimes painfully obvious, that we have a long way to go. Yes, there are doctors and medical science and pain killers and MRI scans, etc. but at the end of the day, I and everybody else involved is relying on my body to heal itself.
There's a scene in one of the episodes of Star Trek: The Next Generation where Dr. Beverly Crusher comes into Sickbay to find a sad-looking guy sitting on an examination table holding his arm in pain. He explains that he fell while mountain climbing on the Holodeck. Dr. Crusher pulls out some thingamajig with little flashing lights and waves it over the guy's arm. You hear a buzzing sound. The guy then moves his arm around tentatively obviously on the look-out for any pain. Feeling nothing, he bursts into a smile, hops off the table and with a wave of his hand exclaims "Thanks doc!" as he walks out the door.
I want one of those things.
References
my blog: Parachuting: If God had meant me to...
By the way and if you will excuse my French, do you know the saying "to be scared s**tless"? Well, I discovered it's not true. I think it took a full 24 hours after my jump before my sphincter unclenched.
Wikipedia: Electromyography
Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG is performed using an instrument called an electromyograph, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle cells when these cells are electrically or neurologically activated. The signals can be analyzed to detect medical abnormalities, activation level, recruitment order or to analyze the biomechanics of human or animal movement.
Free Online Medical Dictionary: Electromyography
During an EMG test, a fine needle is inserted into the muscle to be tested. This may cause some discomfort, similar to that of an injection. Recordings are made while the muscle is at rest, and then during the contraction. The person performing the test may move the limb being tested, and direct the patient to move it with various levels of force. The needle may be repositioned in the same muscle for further recording. Other muscles may be tested as well. A typical session lasts from 30-60 minutes.
A slightly different test, the nerve conduction velocity test, is often performed at the same time with the same equipment. In this test, stimulating and recording electrodes are used, and small electrical shocks are applied to measure the ability of the nerve to conduct electrical signals. This test may cause mild tingling and discomfort similar to a mild shock from static electricity. Evoked potentials may also be performed for additional diagnostic information. Nerve conduction velocity and evoked potential testing are especially helpful when pain or sensory complaints are more prominent than weakness.
Wikipedia: Spinal disc herniation
A spinal disc herniation is a medical condition affecting the spine due to trauma, lifting injuries, or idiopathic, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out beyond the damaged outer rings. Tears are almost always postero-lateral in nature owing to the presence of the posterior longitudinal ligament in the spinal canal. This tear in the disc ring may result in the release of inflammatory chemical mediators which may directly cause severe pain, even in the absence of nerve root compression.
Wikipedia: The Cisco Kid
The Cisco Kid refers to a character found in numerous film, radio, television and comic book series based on the fictional Western character created by O. Henry in his 1907 short story "The Caballero's Way", published in the collection Heart of the West. In movies and television, the Kid was depicted as a heroic Mexican caballero, even though he was originally a cruel outlaw.
my blog: Health: You don't know what you've got till it's gone
In 1970, the Canadian singer song writer Joni Mitchell released "Big Yellow Taxi" which contained the telling line, "You don't know what you've got till it's gone." Yes, it is easy to take things for granted. This captures the idea of the centuries old proverb, "You never miss the water till the well runs dry." Day after day, some "thing" is just there like the sun or the moon and we become accustomed to it being there. However many things don't have the longevity of the sun and the moon and we can see those things come to an end and disappear and ofttimes it is not until something has disappeared that we may realize its value to us.
2012-06-21
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