Most paramedics have spinal trauma at the forefront of their mind whenever they run a trauma call.  I have recently found out that my back is broken.  And as you can imagine, being a paramedic who worries about spinal injuries, and discovering that I have had one for years has been a bit of a shock.

And now you are probably wondering how I broke my back, so I won’t leave you hanging.  When I was a child I was involved in a freak dodge ball accident.  This isn’t a joke.  I am being serious.

I was either in seventh or eight grade.  I can’t remember which.  We were playing a variant of the game called ‘Back Board Dodge’.  I won’t bore you with too many details, but there was a dead ball lying in our court.  There were only two or three boys left on our side of the court.  I really wanted that downed ball so that I could chuck it at someone and have a chance of throwing the winning ball.  Someone else on my team had the same idea.  We both ran for the ball and upon reaching it collided headlong into each other.  He was lower to the floor when we hit and stood up suddenly after reaching the ball.  This hit me at just the right moment and launched me into the air.  I fell from a height of about 6 feet in the air to the floor.  I fell flat on my back.

What came next was pain.  Real pain.  Pain like I have never felt before or since.  I am an atheist, but a shortcut to finding the words to describe this pain is to categorize it as “Old Testament Biblical Pain.”  As you might expect, I was unable to get up.  If you, dear reader, are a reasonable person you might think to yourself, “If I saw a young boy thrown into the air, land on his back, scream in pain, and then proceed to be unable to get off the floor, I would be concerned.  As a reasonable person, I would most definitely be concerned about this, and I would call for help and have the boy’s injuries assessed by a professional.”

Unfortunately, a reasonable person was not there.  The only adult present was our cro magnon redneck douchcanoe of a gym coach named Coach M.  There are many reasons to hate Coach M.  I have even started and stopped several blog posts about this man.  Why have I never published one?  Because every time I read my own work, I am unsatisfied with the results.  There is just no way for me to convey how stupid and worthless this man was.  There is also no way to convey how much I hate him.  So all attempts have failed me and I have never posted one.  Instead of letting words fail me yet again, I will just tell you what his actions were.  He rolled his eyes, slowly got up, walked across the gym floor, and stood over me.  He told me to get up and walk it off.  I told him I couldn’t.  He called me a pussy.  I told him I still couldn’t get up.  He had two other boys grab my arms and drag me off the court across the floor to the bleachers.  I laid there for the rest of the period unable to move.

I don’t think that one person in that gym considered for even a second that I was actually injured.  I am not sure why.  I never complained about anything.  In fact, I never really talked to anyone at all. Junior High was awkward for me, just like the rest of my childhood.  And to be honest I did not have one friend in that room.  And in the end, this is probably why it never occurred to anyone to attempt to help me.  No one there really gave a shit.

When the bell rang the coach slowly walked over to the bleachers, stood over me and said, “Are you going to continue being a pussy, or are you going to get up and go to your next class.”  A few of the other kids in the class laughed and called me a cry baby.

So I got up.  It was slow.  And it hurt.  But I got up went into the locker room, changed my clothes, and went to my next class.  I was late because I was walking so slowly, but I made it.

I went home and asked to see a doctor.  My parents didn’t honor my request for several days.  I had to pester them about it.  They told me, “I’m sure whatever you did hurt, but if you can walk on it there is no way you could have broken it.  So you are just going to have to take it easy for a few more days until it feels better.”

Over the next several days I complained enough until they arranged a doctor’s appointment for me.  I had to wait a couple of weeks until an appointment was available.  I told the doctor all about my accident.  He sat patiently listening to my story.  When I was finished he said, “Well…you’re walking around on it, so it can’t be broken.  We’ll try rotating some ice and heat to loosen the muscles up and you’ll feel better soon.”

That was about 28 years ago.  And my back still hurts.

But to be honest, after a few months it did feel better.  I learned to live with it.  At that time in my life I was very fit.  I lifted weights a lot and got tons of exercise.  After a while my muscles strengthened around the injury.  I also learned what aggravated my back and what to avoid.  But I was young and it didn’t stop me from doing stupid things.  I played soccer with that back.  I played football.  I wrecked a moped a couple of times.  I got in fights.  You name it, I did it.  And most of it hurt.

There is this weird bubble that exists around you if you say your back hurts.  So many people say their back hurts that people skim over it without caring.  I would often complain about it over the next few years to my parents.  This actually used to make my mother angry.  You see, she had suffered a real back injury.  She used to complain of back pain constantly.  When I was much younger she had surgery to repair a disc.  Recovery was slow for her.  I remember that my dad had a pool built in the back yard and claimed that it was tax deductible because of my mother’s back injury.  She also took a lot of pills for her back.  And knowing my mother, I sure most of them were pain pills of the ‘feel good’ variety.

But when I complained about my back I was told, “Now I don’t want to hear any more of that from you.  Your mother had a real back injury.  She needed surgery for it.  You’re young and strong.  There’s nothing wrong with you.  Now I don’t want to hear any more about this.  Just walk it off.  You’ll be fine.”

So for the next 28 years I learned to live with it.  As an adult I found that people cared even less when I mentioned it.  And there was a new problem.  My career.

Back injuries are the bane of everyEMSand fire service.  If you so much as mention back pain, many services look at you as a liability.  They see you as a potential money pit.  Who wants an employee on light duty drawing a check and not being productive?  And there has always been the problem that even though I have worked in healthcare for almost 20 years, I have never been well insured.  If you are an adult who works hard in a physical industry and relies on overtime, seeking treatment for an injured back is suicide.  High deductibles, apathetic doctors, and 40 hours of straight time each week is all that awaits you.  So for years I purposely hid the fact that I had back pain.  After I got married and had a child, it almost became imperative that no one found out about it because lost shifts and large bills would affect my family.

Thankfully, for the last few years my job has been less physical.  I found myself in the classroom more often than on the street.  And when I accepted a job in organ procurement I thankfully spent most of my time at a desk when I first started.

But recently the game has changed.  Two things have created a situation that finally made me seek treatment.  A few months ago I started recovering tissue.  This got me away from my desk and standing for many hours on a tile floor, bending over at the waste in a sterile field where movement has been limited to the point where I am not even allowed to scratch an itch.  To be honest its not very physical, but it is exactly the kind of thing that hurts my back.  I would rather dead lift over 400 pounds and climb ten flights of stairs then bend over at the waste for a few hours.  The second thing that has compounded my situation is that good old fashioned middle aged arthritis has set in.  I have always been careful about bending over with my back, but now I don’t want to bend my knees either.  If I drop a pencil on the floor, there are very few options for me to get to it.  Consequently I often just walk away from things I have dropped.  I give up.

A few days ago it got so bad that my wife demanded that I go see our doctor.  I put it off as long as possible.  I didn’t think it would do any good.  No doctor has ever cared before.  But I had an episode the other day where I tried to get on my knees to pull some weeds out of the garden and I wound up in bed for two days.  So I went to my current primary care physician and made my complaint.  She asked a few questions, and patiently listened to my answers.  To my shock and amazement she ordered a series of x-rays and an MRI.  I wasn’t sure what to think.  I had been complaining of the same damn thing for over 25 years, and finally a doctor did something besides explain the fine art of rotating ice and heat.

So I went and had my tests.  A couple of days later the doctor called me on the phone.  Not one of her nurses.  She called me herself.

“Do you know you’re back is broken?”

“Well…no…but it doesn’t surprise me.  I bet it’s an old fused injury.”

“You’re right.  It is.  Some time in your life you cracked one, maybe two vertebra, and you have a terrible disc that is trying to herniated into you spinal canal.  I’m sending you to a neurosurgeon.”

A few days ago I had my appointment with him, and was able to add some bad news to the mix.

“Yep, at some time in the past you cracked your vertebra.  It shows up as an old stress fracture now.  And yep, that disc looks like crap.  That has to hurt too.  But what I am really concerned about is the amount of slippage L5 has.  This old fracture and bad disc have caused a lot of instability.  And when you lean forward this bone slides back and presses on your nerves.  I’m sure it is hurting you.  I bet you hate to bend over forward.”

But his idea of fixing it wasn’t pretty.  Here’s what he had to say about that:

“I could fix it with surgery, but I am not going to lie to you.  It’s invasive and you don’t want me to do it.  To fix this I would have to open you up, break this process off, remove this disc, fill the void with a bone graft, then try and stabilize the moving bone with screws and rods, then fuse the whole assembly together.  It would hurt.  It would be expensive.  You would be off work for a long time, and recovery would be hard.  This isn’t fun.  And I won’t lie to you, in the end this may be something you seek.  But we want to avoid it if at all possible.”

“Alright, so how do we avoid it?”

“Exercise.”

“That’s all you got?”

“Like I said, we want to avoid this kind of surgery.  You’re walking around, and it’s obvious that this doesn’t bother you all the time.  It would be irresponsible of me if we didn’t exhaust all other possibilities before I did all that to you.”

“What kind of exercises?”

“Swimming…yoga?”

“Really?”

“Yep.  And you need to hit it hard.  You basically have to strengthen the muscles around this injury so that you can hold that bone in place yourself.  If you can lose some weight and strengthen those muscles, you might feel a lot of relief.”

“And if I don’t?”

“Well, we’ll talk other options if this doesn’t work.  But you are going to try this first.”

So here I am.  I have a broken back, a slipped disc, and a bone that keeps slipping out of position, and the best avenue for treating it is to go exercise with it.  That sounds…really fucking fun.

My physical therapist gave me even more great news.  He was doing his first examination and started tapping various parts of my legs with a mallet.  He lingered at my left ankle, banging away at it like he was dissatisfied or had missed something.

“The doctor did that too.  I forgot to ask him why?  What’s going on down there?”

“You have permanent damage to these nerves.  There are no reflexes down here.  I didn’t see you limping.  Do you have trouble moving that foot?”

“Nope,”  I said and started rotating my ankle to prove it worked.  “I ride my bike to work everyday.”

“That’s really weird,” he said, “Most people with this problem drag their foot around or have drop-foot or something similar.  You don’t seem to be affected.”

He went on in more detail than my doctor to show how my back was broken.  He told me that one of the processes had most likely broken off and is free floating.  Since that anchor was taken away from my vertebra, it just floats around banging on nerves.  He said something about how weird it was that I was just walking around.  Then I told him that I played football, and was a fireman with this injury.  He looked at me like I was from Mars.

So he prescribed all of these exercises which I diligently do twice each day.  I spend about 45 minutes doing all these leg lifts and crunches in various directions and positions.  It’s kind of gross, but some of these exercises pop my bone out of place in a way that is audible to my wife and daughter.  I get the occasional, “Gross…was that your spine?!”

So here I am with very sore tummy and back muscles.  This was way beyond the workout that once gave me a six pack when I was younger.  So…what happens when you get a six pack under a layer of fat?  I may very well be able to tell you that soon.  I promise not to post pictures of that.

I will be writing more on my blog though.  I have had a lot of inspiration recently.  A few people have noticed that I have kind of disappeared from social media lately.  Nothing could be farther from the truth.  I post mostly on Google Plus now.  I have to admit that Facebook is so mundane that I just can’t bring myself to log in there anymore.  And Twitter is just too limiting and vast at the same time.  G+ is more my speed.  You should give it a try if you are bored with other venues.

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