Sunday, March 12, 2017

On My Last Nerve

A couple of summers ago, I landed awkwardly while jumping into the pool. I had placed my hands on the deck, turned, and dropped down into the water, landing with my arms up in a sort of goalpost-stance. Perhaps my feet landed a little too squarely. Whatever it was, I assume I got what they call a "stinger" — a sharp jolt up my spine, flowering out beneath my shoulder blades, like burning electricity. I stood frozen for a moment like that until I caught my breath, then gingerly moved my arms and torso around to make sure everything was still functioning.

Ever since then, I've had some chronic soreness and weakness in that mid-back area. Still, it didn't prevent me from being physically active — I walk on the treadmill for a few miles at a stretch several times a week, I do a thrice-weekly routine of push-ups, pull-ups, chin-ups, sit-ups and dips, I hike most weekends, time and weather permitting, and I do up to an hour of yoga every day. I assumed a little nagging back pain was just one of the inevitabilities of middle age, possibly even a casualty of misdiagnosed-and-therefore-untreated rheumatoid arthritis from ages 28-31. Walk it off, champ.

Last week, on my way home, I started to feel some discomfort in my mid-back, which also made its presence felt in my stomach, in an almost-nauseated feeling. The pain increased steadily for the next half-hour or so, until it felt like my stomach was violently contracting. Then my arms and legs started to tingle and go slightly numb. When I stumbled in the door, the Lady of the House took one look at my chalk-white face, now streaming with cold sweat, and assumed I had food poisoning. I dropped to my arms and knees, groaning in pain, writhing around in an attempt to find some sort of posture to relieve the pressure, and, in between gasping for full breaths, managed to convey that no, it wasn't food poisoning, something was wrong with my back. After a few minutes with my back rounded and my chin tucked, I felt stable enough to make my way back to the car, where I re-assumed that posture in the back seat while she drove to the ER.

After two hours in the waiting room, and a further three waiting in a room to see a doctor, all spent leaning forward with a rounded back, the pain had largely subsided on its own. After an EKG, blood tests and a CT scan all came back with nothing to show, the doctor was left scratching his head and grasping at the straw of a possible gallbladder problem, which he conceded was very unlikely. He agreed with my suspicion that I had probably pinched a nerve, but there was little he could suggest. I arrived home at one a.m., no closer to a solution than I'd been eight hours earlier, though at least I knew I hadn't herniated a disk or something drastic like that.

The next day, I called a masseuse/physical therapist I've seen before and asked him his advice. He said the numbness and tingling definitely suggested a neural problem, not a muscular one, so a massage wouldn't help. He suggested a chiropractor, and when I said I didn't visit one, he recommended the one he works with. Now, I'm not exactly enamored of the wide variety of practices conventionally grouped together under the rubric of "alternative medicine" — like the related joke goes, there is no "Eastern medicine" or "Western medicine;" there's "medicine" and there's "stuff that hasn't been proven to work." I've been to chiropractors before, and while I have always thought, based on those experiences, that there certainly is a correlation between certain pains and the misalignment of vertebrae which can be relieved by manipulation of the spine, I didn't trust them much beyond that point. Some of them seem a little quackish when they try to pronounce on matters outside of their specialty, which I've heard them do often. In my experience — again, as someone who has spent a lot of time in doctor's offices dealing with autoimmune disorders — my "conventional" doctors were open-minded and well-informed while readily admitting when they didn't know something for sure, urging me to trust my own judgment. My chiropractors, in contrast, have seemed unprofessional in their scorn for "mainstream" medicine, while making sweeping judgments and proclamations on the efficacy of this or that treatment based on scant evidence. The last one I visited first suggested that rheumatoid arthritis wasn't really a disease, before later claiming that it was all caused by diet, and urging me to take various over-the-counter supplements. When I asked my rheumatologist about the diet and supplements, he said that there was a lot of smoke about those sorts of claims, no real fire, but if I noticed that eating something made me feel worse, I didn't need him to tell me to avoid it. As for the supplements, they were more for osteoarthritis, and wouldn't do much for me. I appreciated that sort of straightforward common sense. In my opinion, there's probably some sort of inferiority complex going on, where the alternative practitioners feel compelled to rush into the gap any time conventional medicine steps back and says "we don't know for sure", looking for any advantage they can get. Unfortunately, that kind of dogmatic certainty is a Pyrrhic victory at best.

Still, humbled by what was probably the most intense pain I've ever felt, I was willing to try just about anything, especially since the hospital wasn't offering anything beyond cortisone injections to the spine. It turned out that this chiropractor uses what's called the Gonstead method, which is much gentler than the usual kind — no twisting of the neck or hips. She had me sit on a stool while she rocked me very slightly from side to side, feeling along my spine from my sacrum to my neck for any misalignments. She identified three — in my right hip, my T6 vertebra, and my first rib, which was causing shoulder and neck pain. The adjustments were so mild, especially in the neck, that I could hardly believe anything had been done. One soft "pop" from the T6. The neck adjustment was me leaning my head back a bit while she pressed quickly but gently with the knife edge of her hand into my trapezius muscle. I barely felt the pressure, didn't feel anything change, but the difference has been astonishing. I could feel the positive effect in my hip while walking out of the office. You don't realize how much a chronic ache has been affecting you until it suddenly disappears. I still keep turning my head to the left just for the novelty of not feeling any pain along the left side of my neck and spine.

While reading up on the spine later, I learned, interestingly, that the T6 vertebra being close to the stomach, if injured, could cause heartburn, dyspepsia and indigestion. In hindsight, I realize that I came close to having similar problems on a few occasions, where I felt that same combination of back pain and nausea. In those instances, I had been able to move around and shift my posture before the nerve got terribly impinged, but there were a few times where I took some antacids, wondering if I had heartburn or something (I still don't know what heartburn actually feels like). I also recall that Kurt Cobain famously claimed that he started taking heroin because of a persistent stomach problem. In Michael Azerrad's biography of Nirvana, friends described Cobain as rolling on the floor in agony while dry retching, a condition that was recurrent enough to make him suicidal. He claimed that heroin cured him of this problem, but some of his skeptical friends, like Buzz Osbourne of the Melvins, argue that he never had a stomach problem to begin with, that it was just a typical junkie excuse for using drugs he'd always intended to use. But Azerrad's book also mentioned that not long before he finally did commit suicide, a doctor had diagnosed Cobain's ailment as a nerve problem related to his scoliosis. From this side of my trip to the ER, I look back on that old story with new appreciation — if I experienced excruciating pain like that on a regular basis with no apparent hope of relief, it might drive me out of my mind with desperation too. It's strange to ponder how Cobain's life might have been different, or longer, if only his spine had been straighter, and it's humbling to realize how easily any of us can be reduced to utter helplessness by our own skeleton and nervous system.