Monday, June 30, 2008

How to protect your low back/sanity when stuffed into a coach seat

Is it just me, or is travel becoming more undignified these days? Sky-high prices, mile-long lines, practically disrobing to pass through security, only to be stuffed, sardine-like, into tiny little seats for hours on end. Your surly attendant offers you a gastronomical Sophie's choice - gelatinous chicken, or fish pie? FISH. PIE. Two words never meant to be uttered together.

These days I fly on points, and a wing and a prayer. Yet I some how still ending up paying exorbitant fees in addition to surrendering all my points, and pray not just to arrive alive, but to be seated next to someone compact, quiet and... how does one say this delicately? Hygienic.

Travel is risky, people... you've got to look out for yourself and play the game right. But fear not, itinerant patients and friends, I've been there, done that, and lived to tell the tale and pass on the tips to you, so that I can write off my flight expenses.

First, choose your seats wisely. How? Aah... Truthfully, I am reluctant to share this secret, lest we are on the same flight and you score the better seat at my expense. But as a doctor I am obliged to help... so let this this be a testament to just how much I care. I use a site called 'seat guru' to look up the best seats - each is rated for comfort, proximity to the lavatories, leg room etc. I log on early and select strategically - in this case I chose a lovely second row coach seat with no seat in front of me. Now, I'm not a tall person by nature, but the extra room made all the difference. I could visit the facilities without disrupting my neighbours, I did not have the displeasure of a seat in front of me resting in my lap for 6 hours, and I was able to stretch as needed, see below. On the return flight I was less fortunate, crammed in a regular aisle seat with the common folk, having walked past empty first class pods that taunted me, making me wish I was really, really rich, or a pea.

B) Stretching is important to prevent stiffness from settling in, as well as to prevent deep vein thombosis (DVT - things are always much more ominous when known by an abbreviation). The dangers of DVT (blood clots developing usually in the legs) have been documented, and although this is more prevalent in certain populations, for example the elderly, people with blood clotting disorders or those who have had recent surgery, a few simple exercises can help reduce the risk. The important thing is to keep the blood moving - get up and walk around periodically, and flex and contract the calf muscles to pump the blood up from the lower legs. Just please, when doing so, try to avoid kicking the seat in front of you, especially when I'm in front of you. Yeah, I'm talking to you, 49C.

My favorite glute/lower back stretch is the figure four position: an ankle on the opposite knee, bend forward at the hips without rounding the low back. To stretch the neck, simple range of motion exercises will do (ear side to side, look over each shoulder, chin down, and then chin down to each side...), as well as shoulder shrugs. I suppose I'll have to upload some pictures. Give me some time, I'm still jet lagged. Check back here.

Or you could be like the contortionist I saw, doing the splits and what appeared to be a full yoga routine in the narrow space behind the last row of seats and the flight attendants' lounge (you know, the space with all the mysterious metal cabinets... where they prepare the fish pie!).

Finally, entertainment. This is the one area where airlines have improved dramatically. I suppose it is in keeping with the general decline of Americans' expectations and attention spans -"you can't just feed us crap, treat us poorly, cram us in and expect us to pay for for it... this is unaccept- hey, there's a TV screen 4 inches from my face! Sweet!" I don't generally watch much television, and I'm definitely dumber for having flown this trip, witness my viewing schedule:
  • I Am Legend (New York destroyed, featuring scary monster things. Actually loved this, was kept on the edge of my seat, made only possible by the extra leg room afforded to me)
  • p.s. I Love You (warning, if your emotions are running high for any reason, or if you are not a robot, you will cry. As in tears pouring down your face, sobbing hysterically, making people around you uneasy... please watch this film)
  • Cloverfield (New York destroyed, featuring scary monster things. I Am Legend without Will Smith)
  • The Savages (what the? I normally love Philip Seymour Hoffman, but this was booooring, I turned it off).
  • Then came TV, 'cause at this point I was too dumb to read... Arrested Development (Bob Loblaw... ha!), Flight of the Conchords (have you seen this yet? Brilliant!) and The Simpsons, an episode centered oddly enough around flying.
To reiterate, I don't watch much television any more, but I'm not so fancy that I can't appreciate a good Simpsons episode now and again. And I think Homer Simpson summed up the coach experience perfectly: when asked if there was any difference between flying in a private plane (or in this case, those fancy pods up front) and coach, he exclaims "are you kidding? It's the difference between champagne and carbonated pee."

Next time, I want champagne.

Tuesday, June 24, 2008

So long, farewell, auf wiedersehen...

Or rather, à bientôt!

I'm off for a jolly holiday. I shan't say where I'll be, except that they talk funny there, and I'm packing light.

I'd like to say that I'll be off studying brand new chiropractic techniques, learning the latest advancements in chiropractic technology... actually, what I'd really like to say is that I'll be sitting on a beach in Greece being hand-fed grapes by my very own Adonis. So let's just say that reality lies somewhere in the middle, between scholarly and sybaritic. I'll read a book in a Roman bath.

Assuming the locals have tapped into an electrical source and discovered the internets, I will do my best to update while I am gone, on things chiropractic and not. Possible topics include:
  • Is the sound of a spine 'cracking' different in a foreign language?
  • How to protect your low back when stuffed into an economy seat.
  • How to protect your sanity when stuffed into an economy seat.
  • Chiropractic abroad - different than chiropractic a-man?
I'll return after the long weekend, until then, Dr. Bain will be taking care of my patients. If you need to see him in my absence, rest assured you will be in good hands.

I wish everyone a safe and enjoyable long weekend!

Adieu, to yieu and yieu and yieu...

Saturday, June 21, 2008

The Power of Ow

So I've been reading Eckhart Tolle. In general I try to do whatever Oprah recommends, praise be she. But this guy - I'm just not sure. He writes about the power of now, coincidently the title of his book. His basic message seems to be: live in the moment. Granted I'm only 36 pages in at the moment, but I'm not sure what he is going to write about for 311 more pages! That's a lot of now... He claims the past and future don't exist, tells us to let go of the ego (now THERE is a complicated word... has Mr. Tolle read Ayn Rand?) and to think less.

This got me thinking (!) about pain perception. He spends many pages asking you to observe your thought process, to watch your mind think, to disassociate. I wonder if we can't do the same with pain - recognize that it is just that - a sensory perception. He writes that by dwelling on past pain (physical and emotional) we recreate and maintain that painful state.

Pain is emotional. Rare is the patient who will say 'it hurts, but it is just pain'. Pain is rarely 'just'; rather it is unfair, all-encompassing, and unique - no one else could possibly understand our particular pain. It can't be quantified, though we doctors try, asking you to rate it from 1 to 10 - but really, what does a 7 feel like? If my pain is an 8/10 and yours is a 4/10, do I hurt twice as much? What does pain FEEL like? Teenage boys, what with their fabulous communication skills sum it up best: "Derek, what does the pain feel like?" " hurts." Insightful. By definition pain is a subjective experience, though we don't usually remember that it is just that, an experience. It seems to be more of a state of being: we are IN pain.

I treat a psychologist with whom I have many interesting discussions about pain and perception and mind-body connections and disconnects. He mentioned that he was studying meditation, and that it has been noted that the brains and pain perception patterns of chronic pain patients are different than those of 'typical' people. We talk about 'body scanning' and meditation for these people. Basically, let's say your right knee hurts. A lot. You hurt and hurt and hurt, and your body is always very focussed on your pain. Nerves work on synaptic connections and demonstrate plasticity, that is to say that nerves can modify their firing patterns in response to repeated stimuli. In non-nerd language that is to say that your brain can change. So, think about knee pain knee pain knee pain... and the nerve pathways that convey information about knee pain become very active and easily activated. And since pain is just a nerve message, the message becomes more constant, more present. Your knee hurts ALL the time, it is all you think about, all you feel.

Using meditation and 'body scanning' techniques, you can change these pathways. Use plasticity to your advantage. Rewire your brain. Often done at the end of a yoga class, you focus your attention on different body parts, working your way up the body. When you focus on the ankle, you focus only on that joint. You feel the individual bones there, you send your breath there. You *see* your ankle, you feel the air on your ankle, and nothing else. Move on up, to the shins, to the knees. The important (and challenging) part of this is to observe and perceive, but not judge. When 'scanning' the knee, we might note that there is pain. That it throbs, that it feels heavy. Observing the sensation, but not emoting it. In other words, "the right knee hurts", not "my KNEE is KILLING ME!!!". Onward and upward, to the thigh and beyond.

By practicing sensing parts of the body other than the chronically painful knee, we start to deactivate the constant brain-knee pathway, and activate the brain-rest of the body pathways. It is new-agey, but it is also science. Living in the now means letting go of our pain, and when that is less possible, because hey - it hurts, noting it and moving on. Treating the cause of the pain and accepting that right now we need to deal with this situation, but not defining ourselves by it, or worrying about it.

Hmmm. Eckhart Tolle might be on to something. I'll finish reading the book ( of these days, I have been recently sidetracked by a book titled "Twinkie, Deconstructed", all about where each of the ingredients in a Twinkie comes from. The origins of high fructose corn syrup, polysorbate 60, modified corn starch. It is a fascinating, if not nerdy read.)... where was I... damn thought-tangents...

Gah. If anyone needs help staying in the 'now' it is I. But at least my knee doesn't hurt!

Tuesday, June 17, 2008

Penultimate Fighter

I'm not a violent person by nature. I'm more the 'make love not war' type, and I've been known to ask my boxing opponent if we can't just get along, and would they like a hug? In the words of Michael Jackson, I'm a lover, not a fighter. That, and ma ma se, ma ma sa, ma ma coo sa. True that.

So no one was more surprised than my husband when I came home and announced that I had found my true passion, and it was kickboxing. He has since joined me, and we are discovering what the angry and violent have known for some time - hitting things is fun. It is great for cardio-training, strength-building and aggression-releasing, and also builds up your self-esteem, a delicate structure that will be toppled when you actually WATCH yourself boxing on video.

Can you just imagine how intimidating I'd be in a real fight?!

Best of all, this workout really doesn't require much preparation or equipment. Boxing gloves help, but are not necessary. Boxing pads help, as do a punching bag of some sort, ours is named Jon. Again, not necessary. In fact, while on sabbatical this summer, my husband has been instructed to keep up his training by 'shadow boxing', basically hitting the air. Our trainer/punching bag gave us a CD of Bas Rutten, some big shot dutch fighter, calling out punch and kick combinations. It sounds pretty funny as is, but when I put it to music I realized just how out of touch I am with the typical Ultimate Fighter. Imagine an angry dutchman yelling out 'ONE! AND A FOUR! LEFT RIGHT LEFT HOOK! NOW THREE HOOKS!' to the following soundtrack:
  • Gonna Fly Now - Rocky theme (duh)
  • Gwen Stefani
  • Danger Zone - Top Gun Soundtrack (why is this on my itunes?)
  • Kung Fu Fighting
  • Gavin Creel - check him out!!
  • Physical - Olivia Newton John
  • Feist
  • Spice Girls - hugely popular with the mixed martial arts crowd
  • Rockit - Herbie Hancock - who doesn't love this song!

So you can see that I'm even less likely to be dee-jaying an Ultimate Fighter event than fighting in one. Which I have to admit, I considered when I learned that Amanda Lucas, daughter of George, had joined the women's MMA league. How cool is that?

Until I saw her photo... I'm sure she is a lovely lady outside the ring, but this is just not my style. There is blood on her face! And she is all sweaty! That outfit does nothing for her figure, and the fly-aways on her hair are giving me an anxiety attack. Frankly I'm already intimidated, and considering asking her if she would like a hug... after she cleans up, that is.

I'll stick with hitting people I know, and working on my patented 'LEFT, RIGHT, FLAIL ARMS, LEFT, GIGGLE' combination.

Thursday, June 12, 2008

My bad...

When my husband pointed out a grammatical error in my last post, my first thought was "that's unpossible". But, as usual, he was correct.

He is the kind of guy who within seconds of picking up a menu says, "I found two typos. They spelled zucchini wrong and put an extra g in the vegetable curry". I, on the other hand, am the kind of gal who within seconds of picking up a menu says, "do you want to share the sweet potato fries" and "why is our food taking so long to come!".

So I will correct and admit my transgression: using affect where effect should have been. Does this warrant a written, public apology? Could I not have just subtly fixed the error and moved on?


See, mistakes like these DRIVE ME NUTS. They represent laziness, carelessness, sloppiness, all the worst 'nesses. I worry about the next generation who consider texting to be sophisticated communication, & imho R lol-ing there way to inanity. We need to care about these things! If you made an error, like a typo, or (gasp!) misusing then and than, I would likely notice. I'd try not to judge you (hey, it happens to the best of us, see: affect/effect), but I'd notice.

So if you spot a mistake here, feel free to let me know. Gently, please.

We can all stand to be corrected now and then!

Monday, June 9, 2008

You are what you eat, Turkey.

It is said that you are what you eat. This makes sense, what else could you be? What you wear? What you do? What you think? You think therefore you are, or you are, therefore you eat?? Do we even think anymore about what we eat? What is the doc even talking about!?!

Food is our fuel, it is what nourishes us and becomes us, our substrate, substance and sustenance. Why then do people forget that just like a pill put in the mouth will have a profound effect on the body, the food we stuff in our maws also has profound (and often ROUND) effects on our bodies. Myself included... make no mistake, this is NOT simply a forum for me to preach. I need reminding of this as much as the next little piggy (particularly the one who ate roast beef...).

You see, I recently found myself in a carnivorous frenzy. Maybe it was the springtime call of the bbq, or the tantalizing sound of sizzling beef stimulating my ears and taste buds alike, but I could just not meet my meat needs. My blood thirst was relentless - burgers of all types (beef! lamb! duck!), kebabs both shish and not, makin' it bacon all the time!! If it once had a face, I wanted it seared and on my plate.

Sometime during this rapacious phase I tried to paint a porch and ended up in pain (my loyal readers will remember. I'm doing much better, thanks for asking.). Poor me and all that, but one night during my pity party a friend treated me to a cooking lesson at the Big Carrot. Salivating at the prospect of preparing some exotic organic beefy dish, imagine my disappointment when in front of me was a big gaudy bowl of... vegetables. You don't win friends with salad! The colours were blinding - red, orange, yellow, and so much green! We learned how to make vegetable soup, vegetable ragout (vegetable soup, less liquid) and veggie dip to dip our veggies in. It was a lovely class (thanks Lisa!) and I learned a lot of techniques that will be sure to remember the next time I order vegetable soup or veggie ragout or veggie dip.

But the best part, and the POINT of this post, is how I felt. BETTER. That night, my back hurt less. The next morning, I felt BETTER. Noticeably, significantly better. And since I'm no dummy, I thought... what did I do differently? The answer hit me like a sack of carrots - I inadvertently detoxed! Meat is highly inflammatory. It is known to exacerbate symptoms of arthritis and autoimmune diseases. Acute pain is largely due to inflammation. Those hippies had taught me a lesson (though sadly it wasn't 'how to prepare organic beef stroganoff') - it was time to step down from my post at the top of the food chain, as delicious as the view there was. Essentially, don't have a cow, man. (groan. sorry.)

See, we are what we eat. All that delicious, delicious meat was just adding fatty fuel to the fire, and the fire was getting too hot. So on what is a former carnivore to dine? Steamed bok choy. Brown rice. Salmon. Chick peas. Avocados. And when I do indulge (full disclosure: I am now on a dangerous ice cream kick. BUT: I've discovered a way to justify it - Kensington Market Organic Ice Cream, at Queen and Palmerston...) ... where was I... yes, when I do indulge, and I do, I try to make the more healthful choice. Organic, real foods win. Especially in flavours like vanilla cardamom and lavender blueberry. I'll be there every Sunday afternoon this summer...

Hippocrates said, "Let food be thy medicine, thy medicine shall be thy food".

Smart guy. Thou should listen to him.

Thursday, June 5, 2008

Why not?

Why did this happen, Doc? What is causing my pain?

Is it because I exercised/slept on the couch/went dancing in stilettos/exercised on the couch in stilettos?

The answer is: yes, all of the above, and then some. Truthfully, I usually won't know WHAT caused your pain because there is rarely ONE incident that caused it. The way you are today is the result of everything you have and have not done to date. That car accident in the early 90's that you didn't seek treatment for, the year you crashed on your friend's futon, the horrible chair at work, these matter. Yesterday's hard workout may have coincided with the onset of your current pain, but it was likely just the (wait for it...) straw that broke the camel's back.

It is ironic that we want so much to know why we hurt when we hurt, but care so little about our well-being when we are, well, well (actually, Alanis, it is less ironic than incongruous). One could argue that we want to know why so as to not do that again... but one would be wrong. Say I concur that your head is indeed sideways because you slept funny - now what, never sleep funny again? Or you postulate that you put your low back out driving to Buffalo for some last minute Tar-jay shopping - now what, no more bargain border shopping? Few of us when well want to know how to remain that way or become well-er (!). But the injured? They are suddenly VERY interested in injury prevention.

When someone has a heart attack, do we blame the last cheeseburger he ate (sob... if only he hadn't ordered the COMBO!!!)? We want to know the cause of our problem, the reason for our suffering, but really, we should be less concerned with the tipping point, and more focused on the process. Health and wellness are a journey, a culmination of choices and decisions over time. Where you are now is the result of where you have been, and all we can really do about it is deal with the present and choose to act right for the future.

Am I clear? I'll try to be less cryptic and more chiropractic.

Make good choices now. Take care of yourself now. See a chiropractor now, before you NEED to. It seems that the people who see me regularly, before they are in agony, have a lot less problems than those who wait. They hurt less frequently and less intensely. And when things do go awry, a pinch here, extra stress there, perhaps some bad luck mixed in with bad timing, the regular Joes get better faster.

They don't have to ask WHY they hurt, because the answer is 'sometimes it happens', and they are too busy getting better.

I don't even care what showed up on your x-ray (actually, I DO care - very much! Just not in the way you think). If you think a bit of arthritis on x-ray explains the pain you've had for 2 weeks, think again. It may contribute to your problem, but structure does NOT always equal function, and whatever shows up on radiograph likely predates your present complaint. It was there before you hurt, and will be there after.

So let's talk ergonomics and work on a stretching routine, and remember to book your follow-up visit. Let's worry less about what went wrong and focus more on how to fix it and then keep it from happening again. When you feel so great that you wonder WHY you are coming in, then I've done my job.

Monday, June 2, 2008

Happy Monday!

Some people don't like Mondays (The Boomtown Rats and The Bangles, to name a few). But perhaps our Monday-phobia is just a state of mind?
This morning is beautiful! A lovely, perfect spring day. I woke up feeling limber-er. When I looked out my window, I saw a Blue Jay (the bird, not Kelly Gruber - wouldn't that be weird though?). Then, another blue jay! Then, I kid you not, the blue jays kissed.
And I just knew it was going to be a great day.
And to top it off, all weekend I've been trying to think of a song... it has been eluding me - but on the way to work, I suddenly remembered it - how satisfying! (The song was Mad World, by Gary Jules, if you are interested).

Happy Monday, everyone!