TMI time, but you'll thank me

You know your physical therapy on lower back pain is working when sex pain dramatically decreases.

Sex and Low Back Pain
Best and Worst Sex Positions for Back Pain

I've been in and out of physical therapy for low back pain for a couple of years, and this round is more fine tuning specific weak spots because I started getting shooting nerve pain down to my foot several months ago, on top of a few other new pains. It wasn't exactly back to the drawing board, but I'm evidently still doing something that triggers enough extra nerve compression at L5S1 that it felt like everything suddenly got way worse. Well, they say it's a little worse, but still manageable, and the two big things I'm working on now are being aware of what I'm doing so I avoid the trigger movements (no more picking up little kids, basically) and tightening up my core strength around the muscle areas allowing the compression to worsen. Some people have more damage than me and less pain, others have less damage and more pain, so low back pain is a very individual experience.

I bet a lot of you didn't know that sex pain can be caused by nerve compression in the lower back. Even if you have no other back or leg pain, whatever position or movements you're doing could be all it takes, and wham, it feels like someone ripped a new hole or a stab goes down your leg, or suddenly your hip locks up and you're beating out a charley horse in your glut.

When my lower back first flared back up again, I couldn't tell it was my back. I had nasty pain all around my pelvis and it kept feeling like I had a terrible bladder infection. Over time I've been checked and cleared for several things, including cancers and tumors. Nothing was ever wrong. It wasn't until I went to physical therapy and started core strength training that I could tell (feel) it actually started in my back. The nerve compression made that spot in my back feel numb. I could tell, though, that simple things like sitting or standing too long made all the other pain worse, and I had to learn all over how to properly stretch, move, and even walk.

Part of all that was sex pain, and it got pretty excruciating off and on. I could never tell when it would be bad, and it would hit so hard and fast in the middle of it that I'd double up in pain. I blamed it on aging, a mild cystocele that my gyno assured me wasn't a problem, hormones, fibromyalgia- but it always gets better with physical therapy for my lower back.

The L5S1 is the most common site for lower back pain because that joint connection takes the most weight, and the nerve there branches out in such a way that all kinds of weird sensations or pain or numbness can travel around in the oddest ways, even if you still seem to be fully functional and capable.

Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness (click)

"A syndrome in L5-S1 disc herniation with sexual and sphincter dysfunction without pain and muscle weakness was noted. We think that it is crucial for neurosurgeons to early realise that paralysis of the sphincter and sexual dysfunction are possible in patients with lumbar L5-S1 disc disease."

That basically means that sex pain and/or dysfunction might be a first warning sign of disc degeneration years ahead of disc damage showing up on x-rays or MRI. This goes for both men and women.

I can tell you from experience that pain meds and sitting around on a couch do NOT make this any better, even if the pain lessens. The only thing that has genuinely improved this kind of pain for me is core stretches and exercises specifically designed to strengthen the muscles that support the spine. (That is why it's called core.)

Even if you normally don't work out and hate exercise, you will love core if you spend a little time getting through the tough first day or week, and after that it becomes the tough first few minutes, and over time your body will almost beg you to do something core. Like hang a leg off a bed a certain way. I didn't know that was a core stretch that can relieve pressure right there on that spot, and after I've done the core stuff, which takes about 15-20 minutes if I do everything I'm told, the pain lessens quite dramatically, especially now that I've been using physical therapy somewhat regularly to control my pain. No pills I ever took made the pain lighten up like that, and I've taken handfuls of gigantic and very colorful pills in my life. I was even crippled for a couple of years because the pain was so bad. My worst year I thought I'd never be able to dress myself again.

Or have sex.

I'm having sex, guys.

mean is how I show my love

There's a new policy agreement I had to sign before my physical therapy assessment this time. They have so many no-shows and cancellations that they're losing a substantial amount of money flow, and THAT, my friends, is why insurance is so stupidly high. Don't blame it all on poor people and ERs. Blame the people who have insurance and medicare who are purposely noncompliant with care plans.

Physical therapy is hard work. It's not for the faint of heart. I've been there- in and out of wheelchairs, using a cane, needing a driver and assistance in and out of the shower, and help getting dressed. I know exactly what it feels like to be a burden and spiral down a black hole of hopelessness. I'm such a good friend with pain that I actually miss it when it's gone, because I almost get high off of it, even without meds.

It's so easy to take the whiny way out. I hurt. Yeah, join the club. I have a headache. My worst headache lasted 6 weeks and I got at most ten minutes of sleep at a time that entire time, because it was so bad I couldn't even lay down, so I hear ya. It's hard. So is having babies, and that's not stopping anybody. I can't do it. Then curl up and die, you big baby.

That's me talking to my head. I have said all the things everyone else has said. And then I kicked my butt and slammed my head into a wall and GOT TO WORK. I got pissed off enough to get up and do something about my whining.

It was hard believing I could do this. Every morning I had to actually literally SAY "I can do this." Sometimes it was just a whisper in my mind while I cried. Sometimes it was a hopeless defiant shout in the dark. But many times I really did say it out loud on my way in to physical therapy.

Yesterday was hard. I'm in a better place than I've been in years, but it was still hard getting through another assessment and core review. I'm not out of the woods. I can't just flop my body into a chair and pop pain pills when I sit too long. I can't be lazy without backsliding into more pain and disability and eventually major surgery. Yes, I can ask them to turn the pain off and risk paralysis and sepsis and a whole list of other possibilities in a 50/50 gamble, because that's what surgical pain management is. It doesn't fix anything. It actually harms the body even more so you just can't feel it. There's no guarantee how long it'll last, and once it's done you can't go back and undo it. I know too many people this has backfired on. It's way too easy to skip ahead to the last resort and then hear the horror stories- multiple procedures melting down into meth addiction trying to handle pain that simply can't be killed off. Procedures that went well but then catastrophic fail happened after a blood clot in the spine, making the disability so much worse than it was before. Pain being replaced with maddening numbness. Asking someone to cauterize a nerve is such a leap of faith, I can't imagine doing that unless I was ready to commit suicide anyway. My psychologist told me a few times I'm a cynic. That's putting it mildly. I look at it like this- if a surgeon tells me he won't do pain control on me even in radiology with a needle because my history contraindicates success (nice of him to be honest), then I'm going to find another way to live like this.

There is this wonderful program in place to help people who are sinking into quagmires of pain and disability. It's called physical therapy. It's there for just about everyone- medicare is very supportive, and most insurance plans will take the brunt of the cost. All it takes is a person telling their doctor they'd like some help with a specific pain- how to move correctly, how to strengthen that area, how to become more functional around the house. I can say from experience that it's like working miracles, but it takes participation. You can get a whole team of people in on it, and they'll all tell you the same thing- pain shots, PT, and even surgery all work better with regular stretching and exercise, and good nutrition and hydration. You wanna heal? Cut the crap. You don't make a car run better pouring sugar in the gas tank. You don't stick a cigarette in your dog's mouth. You don't give babies beer bottles. You don't pick a fantasy football player who doesn't make the workouts. The logic is sound. All we have to do is apply it.

Several years ago I made a decision. Do I want to LIVE? If I don't save myself, no one else has to. Get out there and GET TO WORK. It made differences nothing else ever did.

I went through a little backsliding the last 8 months, so I'm back in GET TO WORK mode. I'm slapping myself to get up and MOVE, I'm plugging my ears and singing lalalalala when my head whines that this is too hard, I'm gritting my teeth and psyching up and telling myself that actors and professional athletes are where they are because they were willing to work for it. There is nothing in this world saying a writer doesn't need that kind of one on one physical training, as well. Sitting in a chair writing words isn't easy. Anyone who thinks it's easy is an idiot.

I know I sound mean. Sometimes you gotta get mean if you wanna stick around longer for your family. Whining my way to an early grave is unacceptable to me. I've got things to do, people to meet, a world to change...

things that have dramatically impacted my depression and anxiety levels

I know this is going to sound crazy, but I'm a long-time depression survivor, and this is trew.

1- The sudden wheat allergy last year that had me in clinic and 2 ER visits and put me on prednisone for 17 days was a godsend. There's a rumor going around that wheat might be a big culprit in depression. After being completely wheat free for nearly a year now, I can totally vouch for that. I have no idea if it's related to the big Monsanto GMO wheat monopoly thing, but there seems to be some science developing behind it. The severe brain fog I lived with for years is mostly gone, although I still hit walls and have glitchy moments, my memory is getting better again, and my ability to deal with spontaneity and change (I have Aspergers) is getting better again. I don't seem to need as much shutdown time, and I seem more able to steer it now instead of caving to it. I'm not saying the original brain fail was caused by wheat, just that nerve healing (the brain is nerve central) seems to be going a lot faster without it.

2- Regular zyrtec is making it possible for me to drive without delayed PTSD Tourette's behaviors, like tapping my steering wheel because I'm afraid to touch it, or not being able to stop blinking while I drive. I've discussed these anxiety behaviors with a psychologist, because they go back years. I've been rolling down all the windows in the coldest winters over severe claustrophobia while I'm driving, to the point of even pulling out of heavy traffic so I can exit my car before I have a meltdown. I've tried all kinds of meds (highway patrol has driven me home 'drunk' on meds in years past), and all kinds of behavior modification techniques, as you can imagine. (I trigger easily, thanks to being thrown out of a violently flipping vehicle, so it's amazing I drive at all, especially with the pain levels I've had through the years.) Last year I was COMMANDED to stay on zyrtec since my food reactions were going ridiculously more out of control, and I discovered that zyrtec crosses the brain barrier differently than other antihistamines and a regular dose has a very calming effect on me without making me sleepy. I've been able to drive like a normal person and have gotten through a whole winter and a very rainy spring and summer without having to emergency call family to talk me through driving home or constantly send update pix of where I am to facebook or twitter. After seeing such a huge change, I have to wonder how much of my severe anxiety had more to do with a continual overwhelming barrage of histamine reactions than anything. This is not true for everyone.
Cetirizine: actions on neurotransmitter receptors
The Zyrtec Effect
But this may be why it works for me. That's right, they're discovering anxiety (in some people) might be related to histamine over reaction.
Fibromyalgia Trial Shows Promise…For Chronic Fatigue Syndrome? Mast Cells and Ketiotifen in FM and ME/CFS

3- ASTYM treatments in physical therapy coupled with regular chiropractic adjustments have lowered the screaming pain levels on my nervous system more than anything else I've tried in years (and I've tried everything but surgery) and considering I've actually asked a dentist to do root canals on healthy teeth and sometimes think it would be lovely if someone would just severe my spinal cord in at least two places and put me in a wheelchair, my whole life turned around over this very simple technique. Lowering the pain levels dramatically lowered the stress on my nervous system, and that has made dealing with anxiety and depression much easier. There is nothing lovelier than physical therapy where you get one on one personal touch through massage and strength training, which has done me so much more good than medications. At first it was hard because I can't bear to be touched (super aspie + pain syndrome), but over time it became a real life saver. To give you context, it took four years to break through the nasty pain just under my skull because the scar tissue had grown so thick and was creating so much pressure and swelling around my cervical nerves that I couldn't even look up at the stars for years without nearly passing out. The scar tissue was the key- microfissure and slowly rebuild new more elastic tissues, and it works best with regular stretches and exercise. I'm actually sleeping nearly through the night now, after many years of not sleeping more than 2-4 hours through the night, even heavily medicated. More sleep and less pain eases anxiety levels.

I actually owned one of these.

4- I've noticed letting my glucose levels slip up (I'm diabetic) has an almost immediate effect on whether I go into a depression plunge, which is easily masked with meds and distractions that keep me from connecting those dots. Since I don't control with meds (my doctor pulled me off over med intolerance), I must be vigilant and aware of exactly what I'm eating all the time. Since I'm no longer on head meds, I've been able to see how immediate and drastic something as simple as snacking on a couple of cookies is when I haven't had any other food in several hours. My worst anxiety attacks used to come on mid-morning, and after I found out I'm diabetic, it was easy to see the pattern after a typical carby breakfast of cereal, pancakes, french toast, etc. If I don't want to blow the rest of my day on a sugar spike induced anxiety attack and then down a depression hole as my brain and body fold up trying to deal with that, I steer widely clear of anything carby before noon, and only sparingly the rest of the day. I wrote a post a few years ago, Holidays with Diabetes- Easier than You Think, in which I show how a person can still continue to have sweets all day in very small amounts as long as they avoid carb loading, but I've noticed since then that eating like that is like teasing depression all day long until it blows up into anxiety, so I've stopped doing it. If all you had to do to control your anxiety and depression was stop drinking soda and eating donuts and cake and french fries, would you do it? I've lost a sweet amount of weight over it, so I really don't miss 'comfort food' any more.

5- And that leads to small meals. Over time as I've fine tuned my metabolic and chemical default states, I've noticed that even when I watch the carbs, I feel much better through the night when I don't fill up on snacks in general before I go to bed. I've spent years waking up to full blown anxiety out of a dead sleep, and that lately seems to have gotten better all by itself just by not eating after 6 p.m. They say don't eat for a few hours before bed to avoid heartburn and GERD, but it also works for other problems, too. I've been through severe GERD, which can be dulled by continually eating or even just drinking milk, but when you add diabetes to that mix, you can get full blown heart racing in the middle of the night, and then doctors increase your blood pressure meds and put you on more anxiety pills, and as time goes on and on, you become high risk for sleep apnea and dying in your sleep from medication overdosing.
Anti-anxiety drugs, sleeping pills linked to risk of death
Popular sleep medications associated with increased risk of death
Anxiety attacks in your sleep are your body kicking in keeping you alive. If you are having anxiety attacks in your sleep, the fastest and most drastic change you can make is to stop eating before bed.

There are a lot of people on the webs describing their lives with some pretty nasty sounding anxiety and scary depression. I've been there. Years and years of it. I've been a pharmaceutical guinea pig, I know the walk in clinics and ERs like I know my own house, and my family is so good at automatically watching out for my triggers that I feel like I've really dragged their lives down sometimes. My body has become so over sensitive and hyper aware of every little bitty change inside and out that I only feel safe in my own home, and living like this is ridiculous. This has nothing to do with will power and mental illness, but living in a body that can't calm down because I've trained it for so many years to stay in fight or flight response. Well, it's starting to calm down now, and I'm loving it.

I discovered all these things accidentally. I don't think doctors have a big picture yet, but they're working on it. I grew up on homeopathy, and guys, it doesn't work. It's just training your nervous self to compulsively pop more pills or whatever. Discovering I'm allergic to chamomile tea was an eye opener, most people don't even think of that. Anyway, if you want to feel better, get better, have more control over the pain and depression and anxiety blowing up and shutting down your lives, do these things-

-Get a glucose meter and use it religiously if you are diabetic.
-Find a good chiropractor, AND talk to your doctor about physical therapy for the pains that ail you.
-Take advantage of your medicare (it pays for PT) and insurance (they pay, too, somewhat grudgingly, but beats having surgery, which should always be a last resort unless it's a medical emergency).
-Stop lying to yourself about it's ok if you have this bag of chips or that pint of ice cream.
-Reconsider using meds to slap bandaids over what you can be fixing yourself. I don't know about other diabetics, but I get nasty headaches when my high blood sugar comes down too fast, and since I'm allergic to tylenol, I monitor my carbs instead of popping pills.

And the biggest part of making a new Plan is
-TELL SOMEONE. Get other people in on the changes you're trying to make. You don't have a safety net if you don't tell anyone what you're doing. Or keep a journal, write it down, blog it, vlog it, share your experiments, then look back a year later and see if anything has improved.

There is no such thing as instant success. My brain crash was in 2004, my body crashed in 2007 between a slipped disc and a nasty CMV infection on top of undiagnosed diabetes. I made a PLAN in 2008-2009 because I honestly felt like I was dying and nothing was helping, and my life really started turning around in 2011. I finally broke free last year, healthiest I've been in over a decade, able to take care of myself and do my own shopping, control my own problems, but it took a plan with a set of long range goals, a team that included doctors, chiropractor, and psychologist, and my determination that I didn't want to die yet. I was so miserable and my life sucked so bad, and now it's all a nightmare I woke up from.

I was there. Fat, crippled, ugly, and a really scattered mess. Don't blow off what I'm saying.

If you knew you could save your life and be boinging around feeling good ten years down the road, would you do it?

Stop eating that crap. Decide what you want. Make a Plan. Write it down. Set goals. Tell someone. Create a team. Start a new habit of living better one small step at a time. In ten years you will feel better and look better and be glad you're still alive. Even if you still live with depression and anxiety, you might find it easing up because your body is doing better.

Most of all, stop kicking yourself. Doesn't matter over what. Self defeat is the fastest way to sink.

If you are also struggling with alcoholism, I wrote this.