My Father's Aching Back (In Memoriam)

MY ACHING BACK!

By Bob Lucas

(published in TESA News, May 1983)

That was an expression used back in the days of World War II to express complete frustration, but it's now used to describe the physical condition of many human beings, myself included.

Last month's TESA-News informed its readers that I was in the hospital again, for the third time in a little more than a year, and wished me a speedy recovery. Thanks, I needed that. Now, a brief recap: my first visit to a hospital in March of 1982 was for the removal of two herniated disks; the second trip was suggested by a neurologist who attempted to alleviate some residual pain; the third confinement was in St. Louis University's Pain Management Program in a last-ditch effort to make me feel better. I emphasize "last-ditch" because a return trip to the surgeon who had performed my laminectomy elicited no promise of more relief through additional surgery and my family doctor informed me that I'd just have to "live with a little pain." (Unlike TV technicians, doctors don't have to guarantee their work for extended periods of time.)

By the time I got to my initial interview with the doctors at the Pain Management Program (PMP) my pain was excruciating, and after talking with them for over an hour I was convinced they wouldn't be able to help me, either. They told me that pain had taken over my entire body, a fact I already knew, and that they would try to get me to put it in the proper perspective. An internist checked out my body and pronounced that he thought that they could help me. That's all the encouragement I needed. In the back of my mind I still had the feeling that maybe they'd take some X-ray pictures and get me psyched up for more surgery that would really fix me up.

When I was informed as to what I should bring to the hospital I felt that they had confused me with some other patient: gym shoes and sweat clothes. Heck, I haven't had those items in about forty years, didn't they know I was practically a cripple? When they reassured me that I wouldn't just spend the day in bed in my pajamas, I figured that I'd better go shopping at a neighborhood discount store and get the latest fashions in exercise togs, still skeptical.

After I was admitted through Desloge Hospital, where I received the routine entrance examinations, I was ushered to my room in the Wohl Mental Health Building. This confirmed some of my deeper suspicions -- I'm a mental case. Very soon, though, I learned the wisdom of this location. It wasn't really structured like a hospital. Not one patient was bed-ridden, and all were granted a great deal of freedom. The PMP occupies a block of about nine rooms, only five of which are occupied. There is a lounge with refrigerator, sink and electric range, color TV, table, chairs, and a couch. One concession was made to hospital procedure in the form of a nurses' station which was headquarters for the full time nurse for the program. I hasten to point out that, while these R.N.'s routinely checked blood pressure, pulse, and temperature, they also encouraged the patients to do their "homework" in the evening.

Before any of the programs were entered into, each patient underwent a stress test in the cardiology department, wherein he operated a stationary bike or a treadmill to the point of physical fatigue, roughly that point at which the pulse rate was about twice the normal rate. Vital signs were constantly monitored during this test to make sure they didn’t hasten the patient’s demise.  At this point they knew the patient’s limits which they didn’t want to exceed in any of the exercise programs.

With the aid of a caliper they determined how much of my svelte body was excess baggage (fat) and how many pounds I would have to lose to achieve the perfect weight for my height. Try as I might, I was unable to convince them that I was not overweight but six inches short, but they put me on a weight-reduction diet anyway.

With these preliminary examinations completed, the patient is ready to enter the day-by-day routine. It goes like this:

0700 Rise and Shine - Blood pressure and temperature

0800 Breakfast

0830 Monday, Wednesday & Friday - visit with Internist

0900 Exercise Physiology (workout in gym)

1000 Biofeedback

1100 Occupational/Physical Therapy

1200 Lunch

1330 Group (air feelings with other patients - supervised)

1430 Physical Therapy

1600 Seminar (Learn about pain & stresses)

1730 Dinner (followed by 'homework,' visitors, etc.)

2230 M.A.S.H. (not compulsory) Bedtime optional

As I stated before, pain was ruling my body, and it was decided that my upper back pain was caused by muscle spasms caused by my "steeling" myself and stiffening my shoulders every time I got a twinge of pain from the lower back, which they told me I was entitled to have. Twice-a-day massages from the physical therapist helped work the kinks out of those shoulder muscles, to the point that they made a believer out of me - that pain receeded from a '5' on a scale of from ‘1’ - (discomfort) to '5' - (excrutiating pain) to a '0' - (no pain!!) Biofeedback helped to educate me in ways to relax those muscles so they don't spasm again; now, when I get the pain in the lower back, I'm supposed to relax the shoulders.

In brief, the whole PMP can be summed up in one word, ADAPT:

Acceptance of the pain which remains forever

Dealing with doctors, neither overusing or underusing

Aiming at reachable goals

Pacing activity level to avoid overdo-underdo cycle

Timing medication use to keep pain within manageable limits.

I've tried to sum up in a few words what I've learned in three weeks.  If you’d like to listen, I’ll happily tell you more, and reinforce my feelings at the same time.