Thursday, February 26, 2015

I Feel Better Now

Four weeks of up and down `pushing the pain threshold.'  What was a subjective level 9 pain four weeks ago is probably a solid subjective level 5.5 now. 
 
Objectively, as well, the level of pain is much reduced.  
 
"I Feel Better Now."  I actually was happy to read that a famous basketball star was going to be off the court for 10 weeks while a torn muscle and pinched nerve healed.  When the man with no shoes sees a man with no feet.  Always "compared to what?"
 
An important experience for an athlete of any age: 29 (basketball star) or 69 (me).
 
Many dimensions to such an experience.  From a greater and personal appreciation of the difficulties people with chronic pain have to deal with (your world gets smaller and smaller, hemmed in and smothered by pain).  To an intriguing learning process of anatomy, physiology and pharmacology.  Not to mention the varieties of positions in which one learns to sleep. 
 
--
 
Two weeks ago the central highland area of Arizona saw sunny days and warm weather.  The last week was cold (though nothing like the Midwest and east).  Coming our way for the next week is rain and cold. 
 
During the warm weather I was feeling sorry for myself while I couldn't train and struggled with the pain.  Now that I feel better it is good fortune that mother nature is enforcing the `no biking' rule.  A hedge against risking a too soon return to the rough and tumble of training. 
 
Instead I will be restricted to indoor activities, specifically the elliptical.  Aerobic effort and increased time on the machine.  Another two weeks and .... I hope for warmer weather.  Another two weeks and .... I hope to return to outdoor training on the bike. 
 
 

Wednesday, February 4, 2015

Radiculopathy - PINCHED NERVE

I think I'm correct in the identification of an overuse injury to the nerve exiting my C7 vertebra.  A pain that begins in the muscle near the scapula and extends and descends down the posterior of the arm to the little finger.  As it approaches the little finger the pain sensation changes to a pronounced tingling.  Things that can cause the Cervical Radiculopathy include ... uh huh ... rowing a boat.
 
It should have been enough that I sensed this pain two days and 30K meters before I stopped rowing. Too much is never enough. (So say the walking wounded).
 
The pain was very intense for a few days, resulting in loss of sleep and a fair amount of restricted upper body mobility.  The third day into this I started the NSAID ibuprofen.  200 mg every 6 or 8 hours at first.  Little improvement.  The fourth day I increased it to 400 mg every 6 to 8 hours. 
 
By the fifth day the intensity and sensitivity reduced significantly.  Thinking that the acute stage of the injury had passed I began working out on the elliptical, using my arms about half the time (30 minutes) with very little intensity.  On the sixth day the pain was almost entirely gone.  I felt fine lugging some groceries during the day.  In the evening, while sitting at my desk and leaning back in the chair I felt the return of the pain.  That night I was unable to sleep due to the pain and ache. 
 
At this point (day seven) I will be cutting back on the NSAID and will be seeing the doc.  I expect that I will get a cortisone shot and instructions to hold back on the elliptical and a return to household chores, etc.  Or, he may just slap me upside the head and tell me that my penance for `rowing through' is another week of agony. 
 
Pinched nerves are reported to take about 6 to 8 weeks to fully remediate.  Mortality does, in fact, suck.
 
UPDATE: Wednesday, Feb 5th.
 
Went to the doc this morning and he explained it to me in a way I can understand, so that I can manage my own responsibilities carefully.
 
 
When I overextended my reach on the indoor rower (erg) the peripheral nerve passing through the cervical (C7) vertebra was stressed over and over again. The repeated stress of that nerve (that goes down the posterior of the right arm to the little finger) resulted in an irritation and inflammation. The fibers of the nerve `complained' to their boss (central nervous system in the vertebrae), and the boss complained to what in most other people is their brain.
 
I, of course, being of the ultra-this-ultra-that mentality, interpreted all of the complaining as pissy little whining and ignored it. I punished the complainer with
more stress. 
 
I lost. 
 
Treatment?
  • Ibuprofen at levels that, temporarily, can be sustained by my system. (400 mg 3 x day) A small increase in blood pressure. Retention of water (weight gain). But it will reduce the inflammation (NSAID).
  • Treating my right arm and hand carefully. No heavy stresses. No lifting of weights, etc.
  • No extension of the neck (like when in slouching in a chair watching TV, or reading in bed).
  • Alternating application of hot and cold (no more than 20 minutes each) on area where the peripheral nerve exits C7 (right side).
  • A massage around the muscles in that area to relax them and loosen things.
  • It couldn't `hoit' if I stood under a hot shower and rotated my head and shoulders.
 
By the time I'm finished with this body I might actually learn something about how it works.
 
HERE is a really great little slide show that explains this common cause of such pain. Excellent and easily understood.