Friday, May 30, 2008

I Feel Your Pain

I do.
Actually, worse than that (for me, at least), I feel MY pain.
And it hurts.
I've said it before - I'm no stranger to back pain. It is how I got into this profession in the first place (for the free care!) and although I manage quite well these days, I am still human (for now) and vulnerable to the same problems that plague you, the non-chiropractors. Patients often find this surprising, that their chiropractor should experience back pain. I suppose it is ironic (in the Alannis Morrisette incorrect usage of the word way), don'tcha think, or perhaps there is an element of shadenfreude involved - the chiropractor has back pain!!
But... ouch.

So what's an achy chiropractor to do? The first thing is to ice the injury. Ten minutes on, ten off, ten on again. The goal is to reduce inflammation - it is the key to most acute problems, and breaking this cycle is paramount. Whatever you do, don't heat a fresh injury! You wouldn't put heat on a sprained ankle - don't treat the back any differently. When in doubt, use ice. Some people find taking an anti-inflammatory helps, but this may not be appropriate for all people. Ice really is the safest anti-inflammatory, and natural substances such as ginger and bromelaine (from pineapples) can reduce inflammation too.

The next thing to do is to get care. Whatever care works for you - a massage, an adjustment, acupuncture... do something. The goal here is to prevent the compensation that your body will implement to guard the injured area. These things escalate - best to nip the problem in the bud. When people come to see me with a week-old injury, I not only have to deal with the original problem, but remove all the guarding and spasm that have built up since. ASAP is usually best.

Stretch the area, gently. Immediately stop any stretch that causes or increases pain especially sharp pain or leg pain. In the neck it may be best to avoid forcing the joints to move - focus on stretching the shoulders instead. Don't bounce into your stretches or force them - relax into the movement, use your breath. Stretch many, many times a day - hourly if possible. Once before bed is not going to be enough. Watch the video below - my basic emergency low back stretches. (oh, for crying out loud, I made an Oscar-worthy movie for you, and I can't upload) (Ok, praise be the internets, the video is now up... but the instructions are too small to read. Oh well. Just follow my lead, do what I do. Sorry about that!)

Finally, take deep breaths, relax, meditate a bit. Let your body heal, and know that this pain is temporary. Give your body the rest it needs.

I know personally that this last part is easier said than done. I tried to paint my porch on the weekend, and only got so far as stripping loose paint when this episode hit. Now my porch looks worse than when I started, I have to put my workouts on hold while I heal, and not to complain too much, but did I mention the pain? Poor me. I'm reminded of being in similar pain a few years back, and frankly it scares me a bit. Patience is not coming easily right now. Frustrating!!

But I'll try my best to relax. I'm going to ice the area and get adjusted by Dr. Bain. I'll make the time to see Lisa Quaning for some acupuncture, maybe get another massage. I'll opt for light yoga instead of push-ups, and well, I'll just have to deal with this minor, temporary set-back. I like to think that when my back is sore, it is just the universe giving me a refresher course in empathy, reminding me what it must be like to be a patient coming in, scared and in pain.

I know.

I'm feeling it too.

To all those suffering with me right now (and judging by my schedule lately, there are a lot of you!) hang in there... we'll get through this!

Saturday, May 24, 2008

Road Rage ( to protect your low back in a car!)

I am a good driver. Sure, I get a little distracted at times, what with phone calls and speed limits and music selection and other drivers... but I've mastered the basics and I know the deceleratrix from the velocitator. I'm accident free since the last one, and I think that record speaks for itself. More important, I'm a NICE driver. I don't rush since I'm always JUST on time anyway (depending on the grace period), I always signal, and I do the head bob AND the wave to thank people for letting me in front of them.

I am alarmed, however, at the way that human behaviour mutates when perched on four wheels - we become so brave and indignant! Cut someone off on foot and you'll likely hear 'hey! watch it!' (cut off someone's foot - whole different reaction). But behind a windshield, even the most mild-mannered kindergarten teacher is spewing profanities and cursing your existence. IT WAS MY TURN TO GO THROUGH THE STOP!!! STUPID &^#$*&%!!

People, why are we so angry? Why the need for asterisks* & ampersands? Why do we spread such negativity? Why do we become so self-righteous when automobiling that we are outraged when our fellow motorist makes an error? Especially, and this matters, one that DOESN'T HARM YOUR BODY OR YOUR VEHICLE?

I'd like to expound on this last point. Why do we get so mad at being 'almost hit'? Should we not instead thank our lucky stars/chosen deity that we were not, in fact, in a collision? Be grateful for intact reflexes and good road conditions? BUT SHE PULLED OUT AND WE BOTH HIT THE BRAKES HARD AND THEN NOTHING HAPPENED! Really, does this require an extension of the third metacarpal?

Since you are all dying to read my story: I'm driving north of Steeles, and since I misunderestimate the traffic in Northern Ontario, I'm of course late(ish. It is always relative). I attempt to make a right from a designated right exit lane, only to find that the road is closed (perhaps due to a snow storm? I was north of Hwy 7). I must get back into the flow of traffic heading north, so I signal and edge my way in. It gets a little fuzzy here, I don't recall cutting anyone off, certainly there were no screeching tires and I didn't see my life flash before me so I wasn't aware of a near collision - I was just trying to get back into the flow of traffic. I end up behind a car, who slows down to 40. In a 70 zone. Is she confused? Frightened? Is this the custom among the suburbanites? I muster up empathy and deliver respectful tiny toots of the horn to nudge her along. No, this is DELIBERATE. I'm being punished!! For... oh my goodness, does she think that my right hand lane diversion was an attempt to skirt traffic? I'm mortified! I pull around her (she is driving 40, people!) and we have a chance to chat at a light. I'll explain, she'll understand. Hell, if I wasn't late (and driving) we could become friends and laugh about it over drinks!

She is incensed, because I 'almost hit her'.
I don't even recall this near collision! I'm also amazed at the coincidence of (nearly!) running into Northern Ontario's best driver - what are her secrets for never having made a driving error herself? I explain what happened to the vigilante, and suggest that in the interest of preventing motor vehicle accidents, perhaps punishing me by driving 40km/hr was not so safe either, to which she replied, "I can do whatever I want".

And this, I think, is the lesson.

You most certainly can do whatever you want, Lady. We all can.
I want to be a calm, kind, albeit imperfect driver. I want to try to understand that the person who cut me off (insult of insults!) probably did it unintentionally. Maybe they were running late to a job interview, perhaps they just received bad news, or maybe they are just an a$$. But I want to be grateful for all the near-misses, and I want to try to be a more perfect person, if not a perfect driver.
You do whatever you want.

NOW that we all feel better! Let's talk about your lumbar spine while driving.
The secret is preserving the lumbar lordosis, the curve in the small of your back. Most car seats allow you to become 'C'-shaped, causing the low back muscles to tighten up, and putting your discs in a wedged and dangerous position. The solution is to maintain the normal curve - pump up your lumbar support if the car has it, use an ObusForme or other low back support, or in a pinch, put a small pillow or balled up t-shirt in the small of your low back. Also, remove your wallet from your back pocket - sitting on it can put pressure on the sciatic nerve and will unlevel your pelvis - sure to cause low back pain when driving.

Drive safely and NICELY, everyone!

*wonderful glyph, even better pluralized - say it!

Wednesday, May 21, 2008

A rant about IKEA and other crap.

I hate IKEA.

I must have low furniture esteem - I keep going back to this bad relationship. I look forward to a time in my life when I'll sever these Swedish ties, when I'll finally feel deserving of material more substantial than particle board, when I'll stand up and assert, "MY furniture will come PRE-ASSEMBLED!"

But then I find myself in a warehouse drooling over things I can't pronounce, and I ration that it IS more affordable, and with the money I save, why I could afford a trip to Sweden! I oscillate between frugality and entitlement, quality versus quantity.

But today - assembling my new INGOL.F bench for the downstairs studio (rest there while waiting for your massage!) I may have hit a wall (with my fist. Do they sell drywall at IKEA?). It came with a chunk of (real!) wood already broken off. The one thing wouldn't fit properly into the other thing. It wobbles a bit. It rubbed against a wall, and since this real (!) wood has the consistency of sponge, it dented AND picked up paint. I hate my pretty new bench, and I spent the afternoon swearing in Swedish.

Perhaps the real reason I hate IKEA is that it seems to represent so much of what I hate about consumerism. Disposable, excess, mediocrity. And it really isn't that cheap! We have such low expectations, and that seems to be OK. It was broken right out of the box, but I couldn't be bothered to schlep it all the way back to North York to exchange it. The seams don't fit tight, but meh, it's fine. Remember growing up - how you probably lived with the same furniture for most of your life? Maybe some of it was handed down from your grandparents, and maybe it either became a family heirloom or ended up in your university apartment when your parents finally renovated after 20 years? What will you hand down to your children? Your Billy bookcase? This is becoming the way we operate. Disposable furniture, disposable clothing, disposable lives.

I have made some progress though. I splurged on a beautiful, real (!) wood, seats-12 and-will-last-me-forever French dining room table. It looks wonderful next to my particle board kitchen cabinets.

Draw ut hell-vetta, IKEA.

Oh. Since this blog is supposed to relate to things chiropractic... my back was totally sore from assembling my INGOLF.

Saturday, May 17, 2008

Can't hold me back

What is holding you back?
Is it your back?
*waits for laughter from wordplay enthusiasts to die down...*

I am a chiropractor who has suffered from back pain, who almost missed her own wedding due to a pinched nerve, and who has since developed an illicit and embarrassing crush on her neurosurgeon (I ♥ Dr. Tator!)

My x-rays are abysmal, my MRIs confound and astound the most erudite radiologist.

I'd bet dollars to donuts that your grandmother's L5/S1 disc is more intact than mine.

But I am not a victim, I do not accept a life sentence of pain and limitation, and lucky for me, structure does NOT always equal function.

Many people want to see the cause of their pain - they insist on x-rays and MRIs to determine the source, and are often disappointed when nothing is found. Surely there must be *something* there, it hurts! Likewise when that *something* is found, we are quick to do bad math: pain + arthritis = the arthritis in my spine makes me hurt. When we assume that structure (degenerated discs) equals function (low back pain) we set ourselves up as victims of an irreversible process, doomed to experience pain forever. So while I accept that my low back is my Achilles heel (what does that make my achilles tendon?), I don't accept forever.

Frankly, my lumbar spine does not look any better on x-ray than it did 3 years ago, when I experienced a level of pain I did not think was possible. Today I have the same low back, whole different outlook. I refuse to succumb to disc dictation, I will not be a victim. You will never hear me announce that I have a 'bad' back - my back is not bad, it is doing the best it can. It has different needs than yours. It is 'special'. It is mine!

I will kick and scream and punch and fight whatever tries to hold me back...

Wednesday, May 14, 2008

...with one eye open?

I'm often asked by patients 'how should I sleep'?
And I want to answer - soundly? Like a baby? Like a log? How should I know?

It is somewhat futile for your chiropractor (or anyone else for that matter!) to tell you how to sleep since your dozing body will do as it pleases. I will share with you some basic tips, but as is the rule with most activities between the sheets, what works for one person may not work for another. So figure out what works best for you.

Stomach sleeping gets a bad rap for being hard on the back. This can be true, as this position forces the low back joints together. People with herniated discs might find that sleeping on their stomach offers relief though, since it puts the disc in a less herniated position. Stomach sleeping can be a pain in the neck - the head is forced to one side, putting excess pressure on these joints for an extended period of time. Excessive is relative though, and if you must sleep on your stomach this can be minimized by un-torquing your body (and accordingly, neck); try sleeping more 'semi-prone' - bring one knee up and end up sort of half on your side, half on your stomach. This can be helped by using pillows to prop yourself up.

Sleeping on your back is often 'best'. It opens up the joints in the lower back, which is great for anyone in acute low back pain - try also putting a pillow under your legs. This is also a great position to use an orthopedic neck pillow (the ones with the bump in them) - great for supporting the curve in your neck.

Side sleeping or fetal position is generally well-tolerated, especially if you are a fetus. Heh. This position, however, can be challenging for some women, especially the more curvaceous ones. Full hips mean that when lying on your side, your spine is actually NOT straight, though putting a pillow between your knees will align you better. Rotator cuff and hip problems also present a problem to the side sleeper, and it may be best to avoid the involved side. A pillow-top will help hips and shoulders sink into the mattress better, making side sleeping more tolerable.

As for mattress type, the best mattress is the one that feels comfortable. I prefer a coil mattress with a pillow-top. Firm is best, but don't confuse the cushion-y feeling of a pillow-top with softness. High coil count makes for a firm mattress. Spend good money on a mattress, but you don't need the most expensive one on the market either. Also - ditch the ancient mattress (or heaven forbid... futon!), irrespective of what you paid for it in 1992. 10 years seems to be the maximum life span of a bed.

Other than this, what can a chiropractor say? As anyone who has slept beside a tosser will attest, we move around in the night and rarely end up in the same position we started in. You can try to choose your ideal sleep positions based on your needs, but if you wake up facing a different direction, don't lose sleep over it (!). As long as you aren't waking up on the wrong side of the bed, things can't turn out so bad, can they.

Monday, May 5, 2008

Crazy is as crazy does...

I used to resent joggers. Their dedication, determination, the get-up-and-go they so obviously possessed reminded me how stuck I was. You see, I'm like many of you. I don't always make the best choices, I sometimes prefer reading a good book to working out. In fact it took some urging to drag me out of a recent particularly slothful period in my life. So I am especially proud of my present fitness and my ability to stick with it - because I know how easy it is to make excuses.

Three years ago I was recovering from surgery. I pushed myself to recover and did a good job of it, but I was left scared as well as scarred, and many of the physical activities I attempted left me tender and I retreated. When I finally decided to test and push my limits, to risk hurting a little bit for greater reward, I was shocked at what I could do.

See, we all have constraints imposed upon us. Time, budget, family obligations, work, natural abilities. I believe though, that it is a measure of the strength of our character to see how much we are willing to push the limits of these constraints. I had to acknowledge that my injury was no longer an excuse for inactivity. Can't jog? Discover something that you CAN do.

And so I swim. And box. And lift some weights. And I stretch a whole lot. I don't seem to stick with one thing, but I'm in the habit of always doing something. Who knows what I'll be doing next month, next fall, next year? And I'm proud of myself. And I write these notes and post these videos of me doing crazy things so that anyone checking in who might think "she's insane" will know that I'm not (well... maybe a little!), I'm like you, and if I can do spiderman push-ups (crazy!) and take video footage while holding plank pose when three years ago I thought I'd have a permanent limp and never be able to touch my toes (I don't and I can) then you can too. I'm just doing the best that I can - because for a long time I wasn't doing anything at all. The things I'm doing - they hurt like hell. No one said it was going to be easy. But I'm trying to stay focused and I can honestly say that I'm doing the best I can.

So let go of whatever is holding you back. Do what you have to do to make yourself whole again. Get moving, challenge and push yourself, open your mind, try something new. Accept what is right now, and work with what you've got. Give yourself allowance to be a little insane, and know that it will all be worth it in the end. If I can get through it, you can too.

Sunday, May 4, 2008

Hear the one about the chiropractor?!

There are many misconceptions about my profession. Since I aim to be educative, true to my doctor designation, I will gladly answer your chiropractic questions. Even the inane ones (contrary to popular belief, there ARE stupid questions!) - in fact, especially the inane ones. In my early years I was frustrated by chiropractic ignorance, and sought to convert the non-believers. But like a fine cheese, I've softened with age (ewww... that didn't even make sense, did it!?) and I no longer fight this good fight. Love your chiropractor? Tell me all about it, it warms my heart (especially when I'm your chiropractor!!). Open-minded but nervous? No problem - I'll be gentle! In pain but terrified of the 'crack'? I've got tons of tricks up my sleeve, and if the adjustment isn't your thing, we'll find something that works for you.

Ignorant and close-minded? Go ahead and hit me with your best... I'll answer you, but be prepared to either seriously back-up your statements, or to get a potentially sarcastic response to your question (I can't help it, sarcasm is my defense mechanism!). Like the gentleman at a party who asked me in all seriousness if it was in fact true that chiropractors do more harm than good. Really? All that school and money and time invested to dedicate myself to doing harm? Wouldn't that make the Hippocratic oath... hypocritical?

It interests me, however, why such chiropractic misinformation abounds.

I don't believe, as many patients think, that medical doctors are the problem. New med school graduates are learning more about complimentary and alternative therapies, and it is not uncommon to find us practicing alongside one another and referring patients. Some of the old-school docs might have other thoughts, but as I've noted, the halcyon days of 'Doctor Knows Best' are over. Patients are realizing that chiropractic works, and their physicians are learning to accept this and work together.

Often chiropractors are their own worst enemy. As a group we have trouble deciding what our scope of practice should be, and with such varied definitions of what we do, it is no wonder that confusion results. I remember this from my first experiences as a chiropractic patient - I had seen 3 different doctors and had 3 very different experiences. This is definitely a challenge for the profession: to be able to either clearly delineate our scope, or find a way to communicate to the public the different ways in which we practice, so that patients can get the type of care that they want.

I don't mind however, being poked fun at for my chosen profession. It IS funny, what I do. I push on your spine, it makes funny noises... aren't we all 5-year-olds at heart? I often subscribe to the philosophy that life is one big cosmic joke. We all need to lighten up, have a laugh, trust that the cosmos are playing recklessly with our fates and just roll with it. Chiropractors who take themselves too seriously - just like hairdressers, personal trainers, lawyers (ESPECIALLY lawyers!) and everyone else who does the same, deserve to be poked fun at now and again.

Luckily I love a good chiropractic joke.


Thursday, May 1, 2008


I love my job.
I often wonder if this is because I've truly found my calling, or because I'm the type of person to find happiness and meaning wherever I am. But what I do is a lot of who I am, and I can't imagine a different life than this one.

I always suspected I'd become some sort of doctor - I signed up for too many science classes in school and toed the line of nerd-dom too willingly to not acquire some letters after my name. (Interesting fact, etymologists, the word 'doctor' comes from the latin 'docere', meaning 'to teach', although somehow people confuse this noble word with 'someone who can prescribe me an antibiotic'. But I digress.)

I love being a chiropractor. I love that I earned my 'doctor of chiropractic' designation, but I am on a first name basis with most of my patients. I love that I am often a last resort - what an opportunity to really shine, when the 'typical' methods of rehabilitation have failed. I love proving chiropractic skeptics wrong. I love working with my hands, and I love making people feel and function better. This last point is the most powerful for me. I love when a patient returns to me and exclaims "doc, I don't know what you did, but I am SO much better!". You might not know 'what I did', but you've reminded me why I do it.

It is an awesome responsibility, this trust you place in me as your chiropractor, and I don't take it lightly. I'm honoured to doctor you, to teach you about your body, I feel privileged to help you reach your physical goals, I'm grateful for the opportunity to help heal you, and ultimately, I'm glad I know you.