Thursday, February 07, 2008

Part I: Metamorphosis

It started innocently enough: a big Chicago snow storm followed by a period of relative warmth and rain, followed by the usual repeat of another anticipated eight inches of snow. Typical Chicago weather.

And I, being of unusual vim and vigor, set out to shovel the walk before work at the request of the Mrs. After all, 8 more inches on top of the slushy mix were to make for a hazardous path upon which to walk.

It was really heavy stuff. Not the usual fluffy white stuff. But the slushy/watery mixture was quickly moved off the walk since this had set back my usual before-work timing yesterday. I stood triumphant.

But there were a few last remnants of snow and slush that looked like they might represent a hazard. So I took one last past to clean those up, lifted the shovel only half-full of snow and, BLAM, a sudden piano-wire of sorts ruptured. I have no clue what it was, but there, standing on the sidewalk I was paralyzed with pain. It was like a 6,000 volt power line had attached to my lower back and sent it into uncontrollable spasm. I grabbed the nearby fence with my left hand and held the shovel handle with my right hand – not sure what to do next. Standing straight was not an option. Nor was twisting at all. My physician self thought: “Okay, I can still feel my legs. No real weakness. No radiculopathy. You should be okay. So walk.” Shuffling like a 90-year old with a walker in a torrential snow storm, I hobbled back to the house. Damn my back hurt.

I managed to get back to the house and first tried to lie on the floor.

Bad idea. I soon found that any attempts to right myself were met with remarkable spasms of pain. I could find a relatively comfortable position, but soon realized I could not lie there all day. So I log-rolled, flexed my knees just enough to rise to my hands and knees, then groveled back to a chair to plan my next move. Meanwhile, my back was still sending paroxysms of neuronal afferents to my cortex gleefully. Little bastards.

Now what? There I was, one hour before a full day of clinic was to start wondering what the heck do I do now? I mean what kind of idiot would do this to himself? Three surgeries tomorrow, weekend call this weekend. Back hurts like hell. And I’m unable to move except with remarkable discomfort. I have to get to clinic, I thought. My patients are probably already there.

My mind scrambled. I contemplated my next moves. I called my secretary to discuss the situation: perhaps reschedule folks? Have a colleague cover? Grin and bear it?

And then it dawned on me really why this was so terrifying:

A doctor had just become a patient and had to learn to negotiate their side of the health care system.

-Wes

11 comments:

Anonymous said...

get better soon.
i've had that sort of back discomfort since i was 20. no fun.
good luck.

Anonymous said...

I would recommend that you purchase one of the excellent back self-help books by Robin McKenzie. At least half of the morbidity from mechanical back pain is related to the panic people experience when they don't understand the problem and don't know what to do about it. I suspect that tens or hundreds of millions of healthcare dollars could be saved if more people learned about back pain and how to self-manage it rather than running to doctors or chiropractors and demanding MRI scans. Dr. McKenzie is a physical therapist from New Zealand who developed the "McKenzie Method" of rehabilitative exercises used by most PT's today. However, he clearly states in his books that anyone can do most of it themselves. Good luck.

rlbates said...

Hope you feel better soon. Keep moving, just do it slowly.

scalpel said...

A similar thing happened to me a while back. Physical therapy helped a lot. That's the only time in 12 years that I've missed a shift. It's just physically impossible to work like that. Even reaching for the telephone or TV remote on the other side of the couch was a difficult decision to make.

I hope you make a speedy recovery.

DrWes said...

Thanks to all.
Scalpel - made it to PT yesterday afternoon. Had massage and the muscle stim therapy - acutely it didn't feel much better. Sounds like our symptoms were nearly identical though - even needed to figure out how to get dressed - tough when you can't bend to reach your feet.

Gratefully, I was a quite bit better today - walking like I have a pole up my a** - but at least able to walk a bit. Aleve, rest, and ice: great combo.

feminizedwesternmale said...

Cha-ching.
Either collect on the exorbitant disability you pay for, or sue the city. You've won brother! Work on the tan and let us know once you get to the other side. V-I-C-T-O-R-Y!

DrWes said...

feminizedwesternmale-

Hmmmm. Cancun? Acapulco? Damn my back's really sore!

And the nerve of my city for not getting out early enough to shovel MY walks!

Heh.

Kb said...

Oh dear! I hope you feel better soon, Dr. Wes. Enjoy the PT and massages.

Now, I've spent enough time in the hospital cardiac unit to know that the nurses chuckle right before a snow storm. They nurses know their near empty floor before a storm will be filled with well meaning men who hefted too much heavy snow within 48 hours. The ER probably sees its fair share too.

I say hire a nice young man to come over and invest in rock salt next time!

JC said...

Pacing Clin Electrophysiol. 2007 Aug;30(8):1012-9.

Pacing Clin Electrophysiol. 2007 Sep;30(9):1149-57.

Get well soon.

patient x said...

I'm sorry about your accident, Dr. Wes, but it's interesting that you admit being "terrified" to walk in a patient's shoes. As I'm on the patient end of the spectrum, I'm curious what it is you fear.

DrWes said...

patient x-

Bureaucracy. Loss of control. Gettin' old.

That's enough to fear for a while...