Pins and needles

5
Jun
2010

Never led it be said that I am afraid to try new things. (Come to think of it, with my past, no one really says that about me. But still.) Having been gently cajoled by several people about it over the past few months as an alternative therapy to try to help deal with my shoulder issues, I decided to give acupuncture a shot. I had been thinking about it for a few weeks when as luck would have it, my friend Fabian had just recently started seeing someone for his stress and had wonderful things to report. I always prefer to have a recommendation before going to see someone, as the idea of randomly selecting someone out of a book or the internet makes me slightly queasy. So I took his card and called the guy a few days ago for an appointment today. I have to admit that everything from his cool demeanor to his office setup to his website to his very scientific way of presenting things put me quite at ease. Let’s face it, I am a westerner at heart, and being able to situate concepts in a method that involves logic, experiment, analysis, and verification (or at least the appearance of it) made me feel better. He asked me all manner of question about my life and habits, if I had been under any stress recently, etc. Then he poked and prodded around some of my muscle pain, taking note of various tender spots with a fascinating precision. For some reason I am not that clear on, he also examined my tongue (apparently the line running down the middle of it held some significance), and took my pulse on both wrists. We then went into the acupuncture room and I laid down on a table face up while he proceeded to stick very thin needles into me. He was constantly monitoring my response and asking questions about what I was feeling as each needle was inserted. Other than one minor flashpoint in my left hand, everything else went pretty smoothly. It was an odd sensation, very difficult to describe, as the needles went in. At some points a very slight sting, at others a light sensation of heat and at other points a sensation I can’t really find the words for, but not unpleasant and very slight. He left me alone for about 20 minutes and while I didn’t sleep, I was in a little bit of a trance laying there, pretty relaxed. He then came back in and started removing the needles one by one, and a large amount of blood started gushing out from every pore, spilling out onto the floor like the elevator scene in “The Shining”. Ok, I am totally joking, but just wanted to see if you were still reading. He took out the needles and then had me sit up and examined me again a little, and asked me how I felt. He asked me to stop weight lifting for a couple of weeks while we were pursuing treatment (at least my arms), and I agreed to that and made a couple more appointments. If there is no change by that time, I will probably give it up, but it can’t hurt to try. I left the place feeling a bit dreamy, but pretty good overall I have to say.

What you want to hear

28
Apr
2010

I have been thinking a lot the past few days about the placebo effect. It is a known fact that believing in something (especially a treatment related to one’s health) tends to make it much more effective, and ultimately real. It is also an unfortunate corollary of the placebo effect that if one tends to not believe in something, or to believe in a negative outcome, that too can become a self fulfilling prophecy. Ultimately, although our minds are not all powerful and cannot cure or worsen everything related to our health, what we believe about our state of being does have very significant health implications. These thoughts have occupied much of my thinking over the past few months as various health problems have presented themselves. These things are aided and abetted (or worsened) by various health care professionals, each with their own stake in the outcomes of their patients and what that means in terms of validating their own world views.

Let’s take the example of my shoulder injury. A few months ago (as many of you know) I started experiencing pain in my right shoulder and reduced range of motion. My doctor sent me to get MRIs which seemed to confirm some tears in the area, and then sent me to a specialist, Dr. Levy (who I had a rather awful visit with). Dr Levy (an orthopedic surgeon) minced no words with me, telling me that although I could try some other tactics like physical therapy, there was no getting around the fact that I would be needing surgery. He was an expert, this was his area of expertise, and that was that. I left somewhat disheartened (not to mention off-put by his bedside manner), but basically believing his analysis. I am not an expert, what did I know? Then again, I do know that when all one has is a hammer, every problem tends to look like a nail.

Over the past couple of months I have been too busy with moving and work projects to pursue any treatment, and my shoulder has gotten progressively worse. I finally decided a couple of weeks ago to make an appointment with a physical therapist, to see if I could at least have the pain abated a bit while I saved up money and courage for my inevitable operation. Something was slightly tugging me inside away from this decision, and there were competing voices in my head. A small “practical” voice in my head said why pay for something that won’t change the final outcome anyway, why not just schedule the surgery? Another voice, more feeble, held out hope that maybe I could avoid surgery after all, and what did I have to lose by at least meeting once with a physical therapist?

I am glad that smaller voice won out. After getting some recommendations from friends, I went to go see a physical therapist yesterday, armed with my MRI report and various other documents related to my shoulder. He examined the report and told me that for my age it was not at all unusual to have some small tears reported, and that they bother some people and others not at all. He then gave me some motion and stress tests, and asked me what treatment I had been following up til now (essentially, none). He prescribed an anti-inflammatory to take for the next month, as well as an icing regime and physical therapy, which I will begin tomorrow. He told me based on the exam that surgery could probably be avoided, and that I should recover full use and strength with a couple of months’ treatment. I was thrilled.

Could this doctor be guilty of his own hammer and nail syndrome? Sure. Could this just be the response I want to believe? Sure as well. But as we know from the placebo effect, my chances of getting better are vastly improved by me believing it to be so. And avoiding the more radical and expensive option of surgery is a good way to go whenever possible. Western medicine, like the western mind, generally favors quick fixes (surgery) over gradual process (therapy). It prefers to see problems as discreet, not part of a system, and I can be guilty of this at times as well. Will this treatment route result in healing? We will see, but I feel a lot better about it in my head than I have in a long time, and that is a very important component of getting better.

I told you I was sick, III

2
Dec
2009

Don’t go sleep in a cabin in the woods of Tennessee and expect to come away unscathed.

Tennessee is where my months long nightmare of discomfort began. You may remember several months back I attended a family reunion, held in a rented cabin in the smokey mountains. Soon after coming back from that trip, I started having itching problems. As the weeks went by, they got worse and were pretty much all over my body, but especially inner thighs, buttocks, forearms, underarms, and many other places. The itching would subside in one area, only to move to another or reappear in that area a week or two later. I was going crazy and went to see a doctor. The first one I saw was a nurse practitioner. I duly recounted my trip to the woods, and she looked at my skin and decided that because she couldn’t see anything, I must have allergies of some sort and I  should try Claritin by day and Benydryl by night. This had absolutely no effect on the itching, but the Benydryl did make me very groggy. Not groggy enough to prevent me waking up with itching fits, however. Two weeks later I went to go see an actual doctor, and likewise recounted to him my family reunion trip to the south. I even asked him if I couldn’t have picked up something like scabies or lyme, having slept in the cabin and hiked in the mountains. He briefly looked at  my skin and said no, he was sure it wasn’t any of those. I probably just had dry skin and so he prescribed lotion to be used on my itchy areas, even though I told him my skin did not seem dry to me. Three weeks went by and my itching continued unabated. I went to go see the doctor a second time (my third medical visit about this) and told him that the itching was still very intense. He told me it was probably due to stress, at which point I said, “You can tell me it is all in my head if you want, but you sure as hell better prescribe something for my insanity then, because this is really driving me crazy.” I AGAIN relayed the story about Tennesee and he again poo-pooed it. I told him I was in intense discomfort and if he couldn’t help me, I needed to see someone else. He finally agreed to refer me to a dermatologist.

Today, two weeks after that last visit, I finally saw a dermatologist who examined me and gave a diagnosis fairly rapidly. I have scabies. While I am not thrilled to have scabies, I am thrilled that it is something diagnosed and treatable, and that I am not insane. And I have to admit, I am pretty pissed at all the people that told me that I had nothing, that it was all in my head, that I was stressed or something, all because they didn’t have the expertise to diagnose. Rather than admit they didn’t know, they foist the blame on the patient. It is way easier to just categorize all unknown ailments as hypochondria or stress than it is to actually make a thorough diagnosis.  I realize that many doctors are overworked and that a lot of patients are hypochondriacs, but you could at least run an analysis before dismissing something out of hand. ESPECIALLY when the patient himself suggested the (eventually correct) diagnosis. It also was more than a little depressing that several of my friends also suggested this was just stress, or something to be cured with a positive attitude or some alternative stress treatment. The only thing that was really stressing me out was having this untreatable itch. The upshot is, I know my body, I have been living in it a long time. I should trust my inner voice more. It really sucks when people who you go to don’t help, but apply their pre-conceived pet treatments or theories to something, rather than listening and examining and trying to see what is in front of them.

PS: Thanks for all the emails, but if it wasn’t clear from the above: YES, I now have the treatment and am starting it tonight!