Witness to Collapse

Most would believe that a twenty-eight year old would be too young to witness the decay and collapse of his once healthy body.  Yet, that is the process I am experiencing right now.  Each day I sense more movement in my spine and by night the pain in my back and neck overwhelms my desire and need to sleep to the point where I often find myself writing political or social commentary to pass the time and sooth my soul.  What I have not done yet, but hope to do now, is map this process and relate how it has felt along the way.  Few who know me are aware of this alternative reality I face almost every time it gets dark.  Fewer still realize how scary the nighttime is for me and how much I wish I did not have to face another one.  I welcome you to my reality and hope that what I tell you can answer questions some of you may have on why I feel compelled to write and what in my psychology is feeding often discordant actions or emotions that may make me socially uncomfortable.

                  

During my youth I developed what is called Pars Defect in my lower spine.  This is a defect where the bones in the spine do not connect to the other bones to which they are supposed to be attached.  Because of this misconnection my spine tends to have more flexibility than most other people’s.  This served me well in limbo competitions, but does not make for a solid bone structure as I begin to age.  What I did not realize is that this problem could stay hidden inside my back for my entire childhood, grudgingly exposing itself on rare occasions when I happened to overtax my vertebrae.  Throughout high school I pole vaulted, wrestled, weight lifted, and played soccer.  In college I added to these sports with ultimate frisbee, tai kwon do, and crew.  Overall, I was very athletic, in great shape, and slowly building up scar tissue in my lower spine where bone was supposed to have formed.  Every time I hit the ground, jolted my spine, or was thrown by someone I did a little more damage to an already weakened structure.  Eventually, this scar tissue began pressing on my sciatic nerve, causing me intermittent pain in my right hip that I associated with not stretching enough or periods of inactivity and muscle fatigue.  When this pain occurred I would merely stretch more and eventually it would go away.  In my junior year of college I had the worst spell of this pain where for about a month I lost most use of my right leg.  I went to the student health services at my school and was advised that I merely needed to stretch more.  As this confirmed what I already knew I just stretched more, the pain eventually went away, and I went on with my activities.

I stayed very active in sports throughout college and graduate school, but let myself slip away from such demanding physical performance when I took a desk job upon earning my graduate degree. I started to put on some weight and began noticing more soreness in my back and right hip, which I still attributed to inefficient stretching.  Long airplane rides endured with poor posture, non-ergonomically designed government office furniture, and a lack of knowledge about the hidden problem in my back led me to begin feeling pain at the base of my spine a few years ago.  I first noticed it on a very long flight to Norway when I could no longer sit in the airplane seat and had to stand several times during the flight.  I had never felt pain at the base of my spine before, but yet again I attributed it to not properly stretching and a lack of physical activity.  What followed this new pain was a period of harsh physical conditions that demanded a lot of work out of my back and legs as I traversed east Asia with a burden laden backpack and a curiosity for all the stair endowed sites of interest in the Middle Kingdom, the Kingdom of Champa, and Viet Nam.  Bearing that weight on my back as I ascended the steps to heaven or caught the sunset from the top of hills overlooking Angkor Wat sped up the process of deconstruction taking place within my lower spine.  As I wrote to most of you describing my journeys through Asia I was, unbeknownst to all of us, beginning my process of collapse.

Upon my return to the United States I returned to biking and was a proud new owner of a quality mountain bike on which I began training.  I only took it on relatively easy rides at first, figuring I would work my way up to learning how to properly mountain bike before I tackled the Moab.  Well, on one of these easy rides my front brakes caught before my back brakes as I was standing too high in the seat.  Such an improperly timed halt forced my entire body to fly off of the formerly quickly moving contraption and land me straight on my right knee into some very solid earth.  This was the most painful fall I have ever taken.  I was stunned and had to just sit and catch my breath for some time afterwards.  My knee was in severe pain, my helmet had a large gash in the side, and my ego, well, that still hasn’t recovered.  This accident and its associated pain stopped me from playing ultimate for several months because I could barely walk on the leg, let alone try to run on it.  In the first few days after the accident I went to the doctor (Kaiser) who merely offered me some crutches, a leg brace, an x-ray, and a wish of luck.  I demanded to see an orthopedist, but was disappointed when she merely told me to stay off the leg for six months to let it heal.  Not being satisfied with the care I was receiving I asked to have physical therapy, but was told that I did not need it.

Insistent that I receive physical therapy I took my problem to a doctor outside of my medical plan and a physical therapist who I paid for out of my own pocket.  They both provided me with some insight into my leg problem and some assistance in convincing Kaiser that physical therapy would be good for me.  When I finally was able to get Kaiser to agree to treat me (fully 8 months after injuring my leg) I was already feeling some back pain from having walked funny for such a long time.  At my first opportunity I ditched Kaiser for a real health plan and was lucky enough to find a doctor who was willing to work with me to find out the source of my enduring knee pain and my increasing back problems.  I tested with Rhumatologists, orthopedists, neurologists, and physical therapists, but my knee pains still would not go away and my back has continued to deteriorate.

Sometime over the past year, although I am not sure of the date, the pain in my back migrated from just within the base of my spine up to where my hips meet my back.  Through an MRI my neurologist has discovered that the disk between my L5S1 herniated, thus forcing the two vertebrae to rub against each other and pinch my sciatic nerve.  This explains my constant pain in the back of the right leg and why my right leg is so incredibly weak as compared to my left.  What this also means is that my left leg and the other disks in my back are compensating for this structural collapse and each in their own time will give out. 

That brings me to where I am today.  Every day now I feel more vertebrae moving in my back.  This means that my disks are becoming weaker.  As my right leg weakens and I continue to walk with a limp my back will continue to try to compensate, thus reducing its already minimized ability to hold me upright.  Core strengthening exercises and leg strengthening will slow this process, but once begun I cannot turn back the clock.  Eventually, I will lose feeling and the use of my legs, at which time my doctors will fuse my spine so that I may regain some mobility.  My future looks to be one of ever increasing disability permeated by surgeries and a hope for my current state of pain becoming so normal that I begin to believe that it has always been like this.

Each night I go to bed knowing that I won’t sleep through the night.  Prescribed drugs have helped ease some of the nighttime pain, but offer diminishing returns over time despite ever increasing doses.  It is ironic that when I’m conscious I can think about other things so that I don’t tend to notice the pain, but when I try to sleep and heal the pain becomes so overwhelming that I am forced to return to consciousness again in order to take my mind somewhere else.  I feel as if I have to avoid thinking about just one thing in order to accommodate the pain. 

Hopefully, some of you may have learned why I’ve been short tempered, emotionally variable, and psychologically disconnected in the recent past.  I offer you this information not to excuse myself or my actions, or to claim that they compare with real life and death problems many others face because of systemic rather than mere structural issues, but instead as a opening into my life and an understanding of my nights so that when you see me during the day you can recognize why I may be out of it.  I care about each of you enough to share what most would consider very personal information because I want you to share my life with me and understand me as best anyone who is not me can.