The Doctor Drives a Subaru

A guy in a Subaru flagged me down while I commuted home on my bike the other day, yelling “Hey man! Hey!” Since typically getting yelled at on your bike by a driver isn’t the start of a good experience, I kept going. But he persisted, and I addressed him cautiously after he caught up to me with a light in downtown Salt Lake City. His message turned out to be a diagnosis: “Your bike seat’s too high.”
He had my attention. I had wondered the same thing recently after I adjusted my bike seat to fit my dad, who rode my bike when visiting from out of town. “Really? You think so?” “Definitely, I fit bikes for a living – it’s too high. Drop it an inch or two and it will be way easier on your joints.” I grabbed an Allen wrench after I got home, dropped the seat and rode to work the next day. My knee, which had been so sore for two months that I was unable to squat to pound tent stakes, immediately felt better. Two days later, two months of fairly chronic pain (I commute 35 miles per week) had disappeared, and I hadn’t even submitted a copay much less been exposed to damaging radiation, drugs or scary needles.
There’s a few lessons to be learned from this experience. The first: patients often have the means to heal themselves – a process that can range from eliminating potential causes of pain, changing diet or exercise habits, or, in this case, listening to a dude driving down the street in a Subaru.
I guess the other lessons learned are related to the first. Even though I’ve learned  from 20 years of managing back pain that I possess extraordinary, singular capabilities to heal myself, this simple solution still didn’t present itself as obvious until I had pedaled in pain through eight weeks of my summer.
The guy in the car reminded me that good health requires vigilance, faith in your own body and the open-mindedness to listen to a stranger on the street.

Fear Bee Gone

Fear of flying: One-time sting or lifetime allergy?

I stepped on one of these furry bees back in the early 80’s – got it stuck right between between two of my toes.  By the time I pried it out, it stung me something fierce. My foot got puffy and sore, but it turns out the worst was yet to come.

Less than an hour later I was at the emergency room having trouble breathing and experiencing the most piercing headache I’d felt. Bee allergy was the diagnosis, after a battery of tests detected a dangerous sensitivity.  The doctor gave me a kit with an epinephrine injection and told me I’d be carrying it around with me for the rest of my life, ready to jab the needle into my thigh in case another bee attacked.

It would be years before I was stung again, and thankfully, the allergic reaction never returned. But the fear remained. I refused to go outside in gym class at middle school, scared a bee would sting me. I was stung riding downhill on a couple of bike rides, and stopped nervously at the side of the trail to take my pulse and check my breathing. I even thought about my “allergy” the other day, when I brushed a nest with a broom and was stung in front of my house.

It took me years to realize that initial reaction was the extent of my bee allergy – although I still do carry Benadryl around just in case. Turns out you can grow out of a bee allergy.

Which brings me to my back, and the point of this post. I also think it’s possible to grow out of a back injury. For me, it required trusting that I wouldn’t hurt myself and getting on the bike, hitting the weights or jumping on the treadmill. In this way I learned, no matter how much my back ached, it always felt better after exercise.

I took this to heart Saturday morning, when I got up early after planning a 30-mile mountain bike ride. My back was sore because my knee had been bothering me – always a recipe for lower back ache in my body.

Five minutes in, cycling up a wildflower-covered ski slope in Park City, my back didn’t hurt anymore. And 25 miles later, even after I caught a handlebar on deadfall and took a tumble over my bars, it still felt fine.

Is There an App for That?

Believe it or not, Puff the Cat is here to help!

A spate of stories recently published on Post Traumatic Stress Disorder and recent war veterans focused on computer “apps” for managing stress. If I hadn’t thought long and hard about stress and its relationship to pain I might have dismissed these pieces as  lazy trend stories promoted by the makers of the software. Consider this telling quote from a 29-year-old reservist and medic, who has received counseling for her PTSD but also uses software on a tablet computer to help her log and manage stress. “I’m not going to lie,” the medic said. “When this came out we sort of wanted to slam it. But it surprised us and has been a phenomenal tool.” One of these apps allows vets to easily self-assess symptoms, gives instruction in muscle relaxation and breathing, and even displays a list of people to contact if things get overwhelming.

As someone who’s dug into the insidious relationship between stress and lower back pain, I wouldn’t go so far as to say the apps would “cure” PTSD, but I think it confirms the long-held belief that treating psychological issues can be a powerful tool in reducing pain – be it mental anguish or sciatica. After reading John Sarno’s books on pain management, and studies like this that draw a solid line between pet ownership and deaths by heart attack, I’m a firm believer that mood has a direct impact on how you physically feel. On a personal level, I can calm my back when it’s stiff by petting Puff the Cat, above (when he’s not acting crazy – he’s still a teenaged kitty!) – and I’ve had similar experiences with music. I thought about this connection the other day when I was walking around the block at work after writing on deadline for hours, clearing my head and working the kinks out of my back. A man – I’m pretty sure he was homeless – with a cane was leaning bent over on a fence, and I stopped and put my hand on his arm and asked him if he was OK. Surprised that I spoke to him, he said he was fine, and then, as I continued walking, he yelled out, “thank you for asking.” I felt glad that I did, and as that gratitude sunk in I felt my back release, as if this simple exchange did more for me than him.

Back Dapped!

Sharon Jones - Umbria Jazz 2006

Sharon Jones was working as a prison guard at New York’s Riker’s Island prison in 1996  when a backup studio singing gig turned out to be her big break. When I saw her perform last Sunday with her band, the Dap Kings, at an outdoor amphitheater in Salt Lake City, she kicked off her high heels and danced the night away after a similarly hot set from opener Buckwheat Zydeco. Like the thousands of other people standing on the lawn on a beautiful summer night – armed with a cooler full of chilled white wine – I couldn’t help myself and danced right along with her. The next morning, when my 6-month-old woke me up before 7, I realized I’d be paying for my fun cavorting on an awkward, angled hillside when I felt a sharp ache in my lower back. Luckily 20 years of plying my back health hobby equipped me with the knowledge of what to do. I rode my bike to work, then walked to the gym and lifted free weights for an hour at lunch. The ache was still there when I got home, but after a night of rest and hydration, I got up the next morning feeling like a champ, and not regretting the incredible summer concert I’d indulged in. The lesson, learned the hard way after many failed attempts to “rest” my back after such an experience, may be counterintuitive to those just figuring out their back pain. But I’ve learned that exercise after pain will cut suffering time from weeks to days and from days to hours. I know, it’s counterintuitive – but so is a prison guard becoming a soul singer!

Cycle Out the Morning Kinks

Little Dell Reservoir from top of Emigration Canyon

This is the reward I received this morning 65 minutes after jumping on my road bike in Salt Lake City. Emigration Canyon, the final leg of the Mormon journey to Salt Lake City, transports riders out of the hot asphalt of the city up along a creek and into pine- and scrub-oak studded foothills of the Wasatch mountains. It’s also a great cure for a little morning backache, which I felt lifting my son out of his crib and changing his diaper at around 7 a.m. It’s common for me to wake up a little stiff in the morning, but long ago I discovered there’s nothing like a nice climb on the bike to work it out. On days that I work, I accomplish the same thing with my 3.5-mile commute, but the views are nowhere near as nice! Now I’m sitting here typing with no pain, and getting excited to take Finley on a hike into the next canyon south, Mill Creek. Yeah weekend in high summer in the Rockies!

Introducing…

Howdy! The name is Fin-Joe!

Hello! Wow, it’s been a while since I fired up the blog – apologies for being out of touch. As many of you know, I have a new member of my family to introduce – Finley Joseph Barker, aka “Fin-Joe”! He’s six months old and already long,  tall and getting heavy – 29 inches and 18 pounds, which brings me back to the subject of this blog (naturally) – my back. I spent months in the gym preparing for what every father I know said would be my greatest physical test. My regime consisted of three or four weight-lifting sessions per week and a mixture of power walking and biking (30-60 miles per week combined on average), as well as really watching my diet. The result, I dropped some weight and have emerged from the first six months of fatherhood stronger than I’ve been since college. More importantly, I haven’t had a significant back pain episode of any duration for more than a year! More later on this subject – there’s a lot of ground to cover, and my little buddy is getting up from his nap.

Falling for Opiates

Opiates for Back Pain Ups Risk of Falls

 

I’ve got a box in my closet with hundreds of pills prescribed by doctors for back pain – everything from opiates like Hydrocodone and Oxycontin to muscle relaxants like Flexoril and anti-inflammatories like Celebrex. While I do use them very infrequently to help me sleep or get on a plane when my back is in spasm, I can honestly say none of them work long-term.

In fact, I’ve come to the conclusion that prolonged use of drugs for back pain actually makes me feel worse, mostly because it robs me of the energy to walk and stretch and lift weights and just move around – all of the things that are critical to fighting pain. And while I imagine there are people worse off than me who need meds to just get through the day, I suspect many treated for simple, regional back pain end up spiraling into chronic illness because taking the drugs doesn’t do anything to fix the underlying problem.

So I was unsurprised to see a recent study focused on the use of opiate pain medication for non-cancer related pain (mostly back pain) in patients over 60 years old. The study, which included 2,300 people prescribed opiates for non-cancer pain for at least 90 days, found that the annual fracture rate – basically breaking bones by falling – more than doubled to 10 percent (from 4 percent) for those taking a dose of at least 50 milligrams of opiates per day, which the authors described as a “moderate” dose.

Not only did these patients fall and break a bone, the study reports that one-quarter of them ended up in a nursing home within a month of their fall.

For anyone who’s ever taken these powerful drugs, it’s pretty clear why people fall more when they’re drugged up: they make you dizzy – they totally sedate people to the point where they aren’t paying attention to what they’re doing. And taking them over a period of two months regularly, as those in the study did, basically rules out much exercise for all but the extremely motivated – that can’t be good for your balance either.