I stepped out of the shower, shivering slightly on that cool Seattle August morning in 2015. As I reached up to grab my frayed towel, a knife pierced my lower back. I froze in mid-reach, and then slowly exhaled as I realized the pain had stopped. Please dear God don’t let it come back. My arm crept upward, removed the towel, and proceeded to cooperate with my other arm to dry me. I’m okay, I’m okay, I’m okay. It was just a fluke. Just a little spasm.
It’s incredible how well the brain can deny the fact that something physiologically significant must have happened. Excruciating spasms of pain aren’t normal, and for most of us they’re not a daily occurrence. But I convinced myself that I was fine, I hadn’t thrown my back out, I wouldn’t be down and out for three days like with my previous back injuries.
I had no more pain that day. Thank you, Lord. I didn’t have time for another down-on-the-couch-all-day-crab-walk-to-the-bathroom kind of back pain. I had grandchildren to babysit. I had scientific manuscripts to write, laundry to do. I had a work trip to Norway coming up. I had things to accomplish.
Plus, I didn’t get back pain anymore, not since I’d been through physical therapy several years before, and began working out with a trainer. Prior to that, my back “went out” on average every six months. Diligent with daily abdominal exercises, my most recent trainer told me that I had the strongest abdominal muscles of all her clients, including the women in their twenties who worked out to look good. So I knew it couldn’t be another back injury.
Another day passed without pain. I was okay.
Then it came back, just to the left of my spine at the top of my hip bone. Quick in and out like a shiv thrust so quickly no one could see the perpetrator. It struck when I reached for my face moisturizer, or when I cleaned my bifocals at the kitchen sink. It hit after I stooped to look for my grandson’s missing puzzle piece under the living room couch. One morning it happened several times in a row, taking my breath away, and forcing me to ask my husband to carry the cup of tea I’d just warmed in the microwave. As I reclined on the couch, Dr. Anne took over and deduced that this wasn’t a medical emergency since I had no neurological symptoms. Then Patient Anne said, But I’m in agony. I have to go to a real doctor.
So I saw my real doctor, a very knowledgeable internist whom I’d chosen because she’d trained in the same residency program I’d graduated from thirty years ago, and because she’d been a Chief Resident. Internists chosen to be Chief Resident at the end of the three-year program tend to be very smart. I wasn’t a Chief Resident.
“You don’t have neurological symptoms, and you haven’t blown a disc, so that’s good,” she said. “There’s no good reason to take X-rays, because it rarely changes the recommended treatment. You could just take a lot of ibuprofen, and then you wouldn’t have pain. But if you want to fix the underlying problem, you’re probably looking at some physical therapy.”
I chose the physical therapy. Once you get into your sixties, you start to think twice about the same medications you popped like candy when you were young. Ibuprofen increases risk for stomach bleeding and heart attacks, and the risk increases with age. The risk of physical therapy would be lower.
Through the first couple months of physical therapy, I continued to have pain, usually about one sharp dig a day. While I couldn’t pinpoint the particular movements that caused it, I did discern a temporal trend. The evil monster in my back was a morning creature. She struck early, then napped for the rest of the day. With some concentration on my morning activities, I realized that by 11 a.m. I was just about home-free. At last, I had something I could work with. I would be extra careful with my movements and posture in the morning, and live my life in the afternoon and evening.
I became three people. Morning Anne was the old woman who had physical limitations and needed caretaking. Afternoon Anne was young, energetic, and able to pick up grandchildren. And Evening Anne was the caretaker—she got things ready for Morning Anne. She moved items to the edges of counters, got out clothes for the morning, filled the tea kettle. She did this so that Morning Anne could perform her basic activities of daily living with minimal pain until her morning icing and exercise routine kicked in to appease the evil force living in her lower back.
Thinking as Caretaker Anne, it occurred to me that it would be nice to send messages to my future self. Many of us say we’d like to talk to our younger selves, tell them they’re doing just fine, or maybe chastise them for the mistakes they are about to make. But we don’t talk to our future selves. I’ve thought of some things I’d like to tell the older Anne:
Don’t be scammed: if a gravelly-voiced stranger calls saying he’s from the firefighter’s defense league, hang up immediately, just like you do now.
Don’t be a shut-in: elderly people with active social lives live longer and happier than recluses.
Watch your step: your weak bones are going to break if you fall. Your doctor can treat your bones, but you need to control things that can trip you up like throw rugs, loose slippers, and the old cat who thinks his needs supersede his owners’.
Enjoy life: stay in the present instead of ruing the past or worrying about the future.
My physical therapist made me change my life—how I sit, sleep, move, exercise—and luckily it worked. The evil monster in my back is dormant. But part of me still watches out for the older, vulnerable, lady within.