False Alarm

He believes his life is in shambles. He has been suffering from severe chronic low back pain since the mid-nineties. The stresses in his personal life are unimaginable. In December, he began suffering from debilitating radiculopathy in his left leg, making the simplest the task (i.e. standing up to go to the bathroom) excruciating. After 2 months of a meager existence, only able to lie in bed without severe discomfort, the patient underwent a lumbar laminectomy.

That was 7 weeks ago. After 4 weeks in short-term rehabilitation, he returned home, moving better than he had three months, but was still weak and very limited with his mobility. Last week, at 7:00 pm one evening, the patient called me in tears: while standing at his dresser, he looked over his left shoulder to look at the television and he began to experience a ‘new’ pain in his right buttock. “It’s a 12,” he told me (referring to the 1-10 pain scale, without my prompting him to do so). Fortunately, after an extra dose of pain medication, lying comfortably on his bed, and applying moist heat, the his symptoms quickly subsided.

When I saw him Wednesday, more that one week had past since the onset of pain in his low back and right buttock. He is moving better than he has since we met. He is now walking greater than 300 feet (consecutively) throughout the home with a rollator for support and he cried with joy at his last visit when he walked up/down the 4 steps in/out of the home for the 1st time (albeit slowly, while using a railing with 2 hands for support). When I entered his home, he was seated comfortably in his dining room chair, drinking his coffee and reading the sports page. His posture looked more comfortable than I had ever seen, however, his face looked forlorn.

“You won’t believe what happened yesterday… I felt so helpless… There was smoke in the basement, but I cannot go down there; there are just too many steps. I told her [his wife] to call the fire department…I couldn’t believe it…In 6 minutes, I had two fire engines, an ambulance, and 2 police cars outside of my house. The sirens were blaring and they had the lights on and everything.

The firemen walked into my house with axes and I thought to myself ‘Oh God, please don’t do too much damage.’ And wouldn’t you know, they came back out less than a minute later? It was my sump pump. The motor went on it. All they had to do was unplug it. Then, for the next 30-40 minutes, they all just hung out in my yard talking. All of ’em – the trucks, the ambulance, the cops – lights still flashing…the guys just standing in the yard and on the road talking and smoking. EVERY car that drove by was looking.

It was embarrassing. All I would have had to do was go downstairs and unplug it, but I couldn’t do anything.”

.    .    .    .

Thursday afternoon, about 30 hours after my last visit, he called again. I could hear the panic in his voice. The buttock pain was back again. He was crying.

He had been having his best day since surgery – he was up and moving around the house with his rollator until his weak left leg (persistent weakness since suffering radiculopathy in December) buckled beneath him. He did not fall, but in his effort to regain his balance, he had “tweaked” (his words, not mine) his buttock pain. He was in a panic.

“What the hell is wrong, Keith? What did I do to it?”

I replied, “Your sump pump just started smoking, that is all. The brain smelled smoke where there isn’t a fire, but decided to send 2 fire trucks, an ambulance, and some cops – sirens wailing and lights ablaze – you know, just in case. But – for now – what you need to understand is that to prevent yourself from falling when the knee buckled, you moved more quickly and with greater force through your back than you had done in a long time. The brain wasn’t ready for it and sounded the alarm. What I want you to do is go lay down like you did last week when you had the pain then. Watch the game and practice some of the deep breathing we have practiced. It worked then, it will work today too, it is just going to take a little time…the crew still has to hang out in the front yard, share some stories and smoke their cigarettes, but they will get in their vehicles and drive away soon enough.”

“Yeah, okay, ” he said, “That makes sense. But do they still have to keep the lights on, even if they know there is no fire?”

He got it! The tears had stopped. He was at ease. He had even cracked a little joke. I called the agency to notify them that there was a chance that he might call later in the evening with complaints of worsening pain, but I was optimistic that he was on his way to feeling better again.

When I visited yesterday, he was feeling better again and I wondered: Would he have felt better if he hadn’t called?

I’ll never know.

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3 thoughts on “False Alarm

  1. Pingback: Another Pain Metaphor | Forward Thinking PT

  2. Love this post, have shared with my team!

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