Tuesday 6 August 2019

Coping with chronic back pain

So how did my back pain journey start?  Back in 1988, I was run over by a driver who jumped the red lights at Burnt Oak Broadway. Anyone familiar with the junction, knows that there are three lanes on the Edgware Road, with the left one turning down the Watling. I was attempting to cross at 7.30am, to withdraw money from the ATM in the Nat West Bank on the corner of Stag Lane. There was a bus turning down the Watling in the left hand lane, and a green man saying safe to cross. I was in a hurry. As I got past the bus, I realised my mistake. A car was heading at speed, straight for me. As I recall, it was blue Ford Escort estate. They say that when you are about to die, time slows down and you get a moment of great clarity. I experienced this. Rather than being scared or frightened, I was actually quite pleased. I thought I'd be seeing my Dad soon, who had died the previous year. I also thought 'I never expected it to end like this'. Then I thought to myself, if I jump, maybe I might survive. So I jumped, the bonnet of the car smashed into my right thigh. My feet went through the car windscreen and I rolled over the roof, landing on the floor, breaking the little finger on my left hand. A group of horrified onlookers gathered. To their amazement, I jumped up and demanded that the bloke who had run me over, drive me immediately to casualty at Edgware General Hospital. He did this and was highly apologetic, explaining that he 'knew the sequence of the lights and didn't expect anyone to be crossing'.

I walked into casualty, head drenched in blood from cuts, to be greeted by a nurse telling me to sit down. I said 'I've just been run over, I am in total agony, I need some pain killers'. I then said I thought I was going to pass out. Immediately I was ushered through. By this time my thigh had swelled to twice its normal size, the pain was excruciating. I was given pethidine and sent for x-rays.

They X-Rayed my thigh, my head and my finger. The thighbone was fine, amazingly, although there was huge bruising. I couldn't walk, but they said  'you'll be fine in a month'. My head was also fine. The finger was broken in five places, but I was told that there isn't much to be done. As I was lying in bed, doped up to my eyeballs, being assessed by the doctors, the Police arrived. The driver had driven to Mill Hill Police station, admitted jumping the lights at 40mph and made a full statement. The Policeman asked if I wished to press charges. I said no, I was happy to be alive. The doctor queried the policeman. "Was he really doing 40mph?". The policeman said "that's what he told me and he had no reason to lie.". The doctor said "I've never seen anyone survive a crash at 40mph, let alone walkaway". This confirmed, in my doped up state, that I was blessed and lucky.

The timing was unfortunate, in extreme. The day before I'd left BT for a job at TSB in their IT department. I was due to start on Monday, ironically replacing a member of staff that had been run over. As I wasn't an employee, I would not be entitled to sick pay. At around 3pm, the doctor said I was OK to go home. I was issued with crutches and some codeine tablets. They said that there was nothing much to be done in hospital. My Brother came and drove me home. My then girlfriend (now wife) came down on the train from Manchester to look after me. Two weeks later, I struggled in to TSB at the Monument to start work, on crutches.

To be honest, I've not been the same since. At the time, I was in training to run a marathon. I could run 5km in around 17 minutes and played football twice a week. I found that when my leg could bear weight, I couldn't kick ball properly with my right foot and I couldn't run properly. An X-ray revealed my fibia had been broken. The pain in my thigh had masked this. As these recovered, I found I started getting lower back pain. The doctor explained that I'd taken a massive wallop and it was to be expected. It may take a year or two to subside, but stay active. I started doing Yoga, which seemed to help. After two years, the pain was no better, but I could cope. I saw Dominic Eglinton, the local Osteopath, who I found would alleviate the pain for a few days when it got bad. I saw the doctor several times. He'd say 'on a scale of 1-10' how bad would you say the pain is, with 1 being none and 10 being unbearable agony. Having experienced unbearable agony, I said 'It's 5 most of the time but 7 or 8 at its worst'. He asked 'How often is it that bad'. I'd say 'occasionally if something irritates it'.  So he'd say 'Take a paracetamol and keep moving'. I left it at that. One of the problems I have is that due to a stomach disorder, I can't take anti-inflammatory drugs such as neurofen, which is usually the recommended pain relief for such pain.

In 2005, I was with a group of disabled people as part of the charity volunteering I undertake. A teenager with Downs syndrome in our group, who had a death wish, decided to throw himself in a river. I had to Rugby tackle him and drag him back, from the rivers edge. I really hurt my back. Following this, the pain was almost constantly a seven. I went again to see the doctor, who referred me to a specialist. An MRI was done and this revealed that when I'd been run over, I had suffered a stress fracture of the back on the L2 vertebrae. Where the fracture had healed, this had formed a nob that was pressing in the nerve. This explained the pain, the pins and needles and the numbness. I asked the consultant what could be done. He explained ' There is an operation. It would mean 12 weeks in bed, a 5-20% chance of paralysis and probably a 60% chance of fixing the problem'.  I was horrified. I'm self employed and can't afford such a break. So I asked 'what are the alternatives?'. He was rather surprised. He told me that everyone who he'd seen previously with such a problem was begging for the surgery, as they couldn't cope with the pain. I explained that whilst it was bad, I could live with it. He said 'Try physiotherapy, that may help manage it'. I contacted a family friend, Jill Dean, who is an excellent physio based in Mill Hill, who set me up with One of the physios who worked for her, Julie Gear. Julie looked at the MRI and said "Yeah, I can do something with that'.

She proceeded to make me sit on my knees (what in yoga is the pose of the child) and massaged my lower back for 15 minutes. I found it to be excruciatingly painful.  When I got up, I literally couldn't believe it. The pain had gone completely. For the first time in nearly 20 years I had no pain at all. It was like taking the best drug ever invented. Julie asked me how I was. I was elated. Then she gave me the bad news. 'You will be a Ok for a few days, but the pain will come back'. She then explained that we'd work out a way t manage it. I had 22 sessions in total. Each time the pattern would be repeated. No pain for a few days, then it would gradually come back. But with exercise, weight loss and Yoga, it was back to a constant 5. It was manageable.

Julie gave me a series of exercises that would to some degree relieve it when it started to creep up again. But the holy grain was a pain free existence. Sadly, the excellent Yoga teacher I had moved back to New Zealand and the gym I used closed. Whilst keeping the weight off is the best way to keep the back pain at bay, alcohol allows me to sleep. This tends to put the weight on. This is one of the dilemmas I face on a daily basis. If I could keep my weight at or below 14 stone, then it would be almost fine. Sadly that proves an ever more elusive dream. Last year, during the council election campaign, it got really bad. The worst thing is standing up, still. Talking to people on doorsteps for hours on end really irritates the problem. I found it had got unmanageable. I was advised to try acupuncture and recommended a clinic in Northwood. This managed to get things in check, and all of the walking actually brought the weight down. I've also found that regular Thai massage helps. I have one every couple of weeks at Siam Sanctuary in Mill Hill.

As I write this, the pain is at a 6 today. I will shortly go and do some exercises that will bring it back down to a 5. My wife has repeatedly asked why I don't start Yoga, but to be honest I've not found a local class doing Ashtanga Yoga to my taste. The consultant back in 2005 advised that I'd probably be back in a couple of years for the operation, as it would only get worse. The strategies I've developed have kept that at bay. I would definitely have an operation if it was a 95% chance of success and two weeks in bed. The odds aren't good enough to warrant it as described in 2005.

So my advice to anyone with the same dilemma. Try physio, listen to what they say. try non invasive complementary medicines and if they work, add them to your toolbox. In some ways, I am glad that my pain relief options are limited. My wife feels that red wine is worse than pharmaceutical pain killers. I disagree, but I try and have three days a week off the wine/ beer. I believe most pain is holistically manageable and that the NHS could save a lot of money if they invested more in physiotherapy and rehabilitation. All of the treatments I've had have been privately provided as the NHS just doesn't do such things. If I'd had the operation in 2005 and I'd lost use of my legs, how much would that have cost the NHS? When I hear about NHS budgets, I always wonder how much we waste because the NHS is only really good at acute care?

I'd be interested to hear of your experiences and ways to cope.

1 comment:

Mrs Angry said...

I sympathise, having problems with discs and a trapped nerve which causes continual numbness in my left leg and foot: again, they were not keen on operating mostly, I am guessing, because as with everything else budget restraints means non urgent ops are routinely discouraged. Walking helps usually but is sometimes painful and out of the question. Distraction is the only thing that works for a while. When the back is really bad, seeing an osteopath is a lifesaver. I highly recommend Christine Guerrier, in High Barnet.