Wednesday, December 23, 2015

My Dark Walk Into the Light

THOSE WHO KNEW ME AS A KID often laughed at my flat, spoon-shaped fingernails.  It seemed my normals were sometimes oddities only realized in the astonished faces of my friends.  In fact those funny nails were the first manifestation of an auto-immune condition that included arthritis. The wonderful thing about arthritis is that pushing through it and staying mobile can be the last word.  The very affliction that threatened to immobilize me instead mobilized me.  And so I mountain bike, I swim, I surf, I ski.  And until recently, I have managed to deftly play the hand that fate has dealt.  In fact, I was sometimes grateful for it.  Who would I be if arthritis were not nipping at my heels, keeping me fit?  But lately the battle has intensified.

In the middle of an arthritic flare-up over the past couple of months, I finally broke down, cried uncle, and visited a recommended chiropractor for some interim relief while the specialists at Penn finish their evaluations on me.  The first chiropractor last week adjusted my back, focusing on my neck (cervical spine).  It did not go well.  24 hours later I was completely unable to lie down and spent most of the night sitting on the edge of the bed, awake, in perpetual pain.  The next night I did something I really didn't want to.  I took codeine I had from a recent dental visit.  I was able to sleep most of the night, retaking the codeine when the pain woke me up at 3 AM.  It wasn't a perfect night but it was enough to find some REM.  Sleep was paramount - I simply could not endure another night of pain-driven insomnia.

So I went in today to a different chiropractor at the practice for a second adjustment.  He was a talking advertisement of his profession the entire time he was adjusting me.  I quickly learned the rule – he talked and I listened.  When at one point I dared to ask a question, he abruptly cut me off, not allowing me to finish asking it.  When he told the attending tech about my “PD,” I asked what PD stood for.  He told me it would take an hour to explain it and he was not about to start.  As he was applying the impulse gun on my knees, I wanted to tell him that my left knee had a pre-existing issue I thought he should know about, but was cut off before I could even start to form the sentence.  So I grit my teeth and let him continue.  When he finished, I thought I felt a bit more mobile but when I started pointing out a focal area of neck pain that still persisted, he again interrupted me and said almost rudely, “I do not want to hear about it."  He explained that the adjustment was over and any pain I felt was normal.  And that was that.

And so here I am tonight, having again taken my codeine, a heating pad under my neck, hoping I am not about to post this to the world in some drug-induced delirium I’ll regret tomorrow.  I wonder what the night will bring.  I am hoping to have turned a page with this.  Yet I am seriously regretting ever taking the chiropractic route.  I should have gotten up and walked out of there the first time he told me to be quiet.

As a health care practitioner, I cannot image dismissing what a patient/owner tells me.  Even dogs and cats can talk – one only needs to know how to listen.  Their “words” are in their body language.  In their voices.  In the whispered rhythm of their breathing.  In the way they hold their tail.  In a hundred physical signs you can discover in a good physical exam.  And almost always in their eyes.  So maybe I don’t understand chiropractic medicine.  I cannot imagine someone setting their hands on a patent's spine without discussing a medical history beyond perhaps reading some words jotted down from a previous doctor’s perspective.  Especially for a therapeutic discipline that claims to be holistic, it seems an incongruity to refuse to listen to the fears and concerns of those patients – to be content in a myopic focus on the bag of breathing bones lying on the table.  Medical history is almost always the most important part of any exam.  Am I missing something here?  Is this somehow not necessary for chiropractic medicine?

These are growth moments for me.  I can now understand a little more about the narrowing of the hallway some people walk, with pain painted upon one wall and the bliss of narcotic relief upon the other, with the lowering ceiling of insomnia crushing it all.  I saw my best friend step down that corridor and he never stepped out.  Twelve and a half years later I am still learning what I have been unable to fully imagine or understand.  I know so little about traveling down that hall of bad walls and crushing ceilings, but recently I have taken a few steps.

This message will have a happy ending.  I am truly confident that the future of my health is bright once the Penn-directed therapy is in place.  But I am all the more sensitive to those who do not have such a promising answer to their own dark walks.  I understand now more than ever the spiral of despair for those without choices.  It's a growth moment for me indeed.  But ultimately, being a vulnerable patient can make me a better listener.  A more understanding friend.  A more sensitive healer.  And I step out of this knowing how incredibly lucky I am.

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