Thoughts about a fall

monotonic

The Living Force
I had just gotten into the bathroom and was ready to let it rip and then - BOOOM!!

I had heard my mother moving around to get out of bed before, so I thought she must have fallen off the bed. After hearing her moaning, I decided I should postpone the call of nature.

She had fallen while walking, probably tripped on one of the many boxes piled around in our house.

After she regained her composure she didn't ask for anything right away. She has had back surgery to add titanium rods and only she really knows how she can move without causing even more pain. She manuevered around and got up herself. This happens occasionally, and while my brother usually tries to offer help, I've always taken the stance that if she needs something she will ask for it. I don't think I can really help her otherwise. She doesn't seem to like to ask for help, and she doesn't want to become dependent on anyone.

With me watching her, it seemed like it wasn't a bad injury and that she was dealing with it not much worse than a person with a badly stubbed toe. However she's repeatedly told us that she experiences a lot more pain than most people, which she has had to deal with since the surgery. She describes it like a nightmare, where the pain is unbearable but you think the pain will go a away in a week or a month. A month goes by and the pain is still overwhelming. It becomes 2 months, 6 months, and it never ends. At the time I didn't understand much, but I still remember when after 5 years she realized that the pain was finally manageable, she seemed to be healing, and there was a nice feeling.

Knowing this, I decided to forget what I thought I knew about how she experienced the fall. I didn't much expect from the outset to be able to help her any, and that is the pattern on all such occasions. So I just watched and remembered how I usually experience such falls.

Immediately I realized our experiences are very much different. I've always been resistant to bangs. Usually when I stub myself on something it will make a big noise and someone will ask me if I'm alright. Usually I hardly feel a thing, and rarely have a bruise unless I'm being particularly reckless. I've had a number of big bruises and I've had several mildly bad falls, but I'm 20 years old.

While I rarely get a slight bruise and more rarely, a stiff hurting joint, she seems to get a huge bruise, pain all over, and swelling. She asked for vitamin C and water, and limped back to the bed. She is coping, but I can tell the pain and shock is consuming half of her mental power.

She is doing her best to block out the pain. She gets a bag of green beans out of the freezer and asks me for a spoon. It confused me and I thought she intended to use it to ice the bruise, but she pauses, puts it back, and limps across the house to her computer desk to sit down. Then she curses herself for forgetting to get ice to put on it, so I go get the beans back. She had gotten the beans intending to eat them, but wasn't able to realize that she wanted to use them for her knee. After this she said it was having spasms, apparently another normal experience for her in this situation.

I was thinking there is so much difference between my experience and hers, easily describable, that others here might be able to point out underlying problems based on her symptoms.

Along with me and my brother she has been ketogenic for a year or more, although she is the least strict of all of us. When she goes into town she often brings back a large soda, potato chips and more recently, sandwitches from Subway. She's remarked on how great she has been since making the diet change. I noticed after all this time her muscle form seems to have completely changed; she has gotten leaner and more shapely, and her form seems younger and fit. She said the last time we moved house, she was laid up in bed for weeks. This time she was strong and had a lot of endurance (the boxes are everywhere because we just moved). I am always hopeful that the diet change will help her recover from problems with her soy allergy, and the occasional fall like this one. She is determined to have her "comfort" foods as well as ketosis, and excludes these foods whenever she feels she needs to heal. She likes this lifestyle and isn't open to suggestions, except maybe occasional supplements.

She says ever since the surgery she has been more coping than anything. She has never gotten back to her former speed - she reminisces about how she would simply get things done and go from one thing to the next in a marvellous flow. I think she is struggling to bring her experiences to a level where she can understand them. She is sometimes unattentive and forgetful (though many ordinary people are).

I diligently follow more than 30 webcomics every day, something I like to joke about to my friends, and I've seen many webcomic authors work on their comics through various medical emergencies. It has always struck me that the art style is always disturbed. I can look at a character and I can see all the curves seem wrong. In many cases the tone of the art also shifts, sometimes becoming strangely feminine and/or expressions becoming duller or sedated. Artists are so tuned into their drawing, so I think surgery and medical drugs must have a tremendous effect on one's perceptions, especially in certain cases like my mother.

So, how does this look to the network? What can you suggest?
 
Hi monotonic I don't get the point of your intervention. do you want to address something specific? It is not clear if she went to physiotherapy, what is the treatment recommended to her, is she falling because she has problem of equilibrium because her back issues? Why don't you take her to a doctor?
 
She makes all the decisions, I don't push her into anything. I'm just wondering of someone else has been in the same situation and can offer input. I think we can do better.
 
Well, I have never been in a such situation but I will do push (not obligate) her to get a medical diagnosis of their present state, in that way you can help and to know what to expect. Is her an old woman? can she fend by herself? does she depend on you?
 
She doesn't depend on me, and she's not old. She is past middle age but she has always looked much younger than she is, before the diet as well.

She is very wary of doctors and tries to handle almost everything on her own, taking advice from relatives and her own mother. But that does give me an idea! I can suggest she consult Psyche. She might be open to that. She and her mother are always looking for a new doctor.

My main concern is she just seems a bit zombie-like in general, and dissociated often. It seems she could be enjoying her life more.
 
Hi Monotonic,

To summarize your mother's current state:
- She is middle-aged, but apart from her back problem, seems quite healthy
- She has had back surgery a number of years ago (5 years?) and has experienced a chronic pain condition since then
- She seems to be dealing with this chronic pain condition quite well, given the circumstances
- She is partially on a ketogenic diet
- She doesn't want to be dependent on others

Let me address a few things:

Chronic back-pain after back surgery for back pain is unfortunately not that uncommon. In general surgeons tell their patients that in approx. 1/3 of the patients there is a huge benefit, in another 1/3 of patients there is little to no benefit, but no worsening either, and in another 1/3 of patients there is definitely some worsening, in a few massively so. Did the surgeon tell you mother something along these lines (numbers might have been slightly different)?

Now once you have had your surgery and things didn't improve or even worsened, you've got a problem. Often there is not much that you can do, because now you definitely have a mechanical problem, that might not have been around before. In rare cases another operation might fix the problem, but it is a situation of "diminishing returns" - the more you do surgically, the less likely you are to draw any benefit from it.

So the first station to go back to, if she wants to have another look (and she might already have done this unsuccessfully) is to go back to the surgeon, but be very wary of another intervention.

The next stop would be a chronic pain specialist, who might put her on some antidepressant to fight this chronic pain condition, or he might do other interventions. She would have to look at every one of them with care.

While she is partially on a ketogenic diet, she most likely is not in ketosis. I measure my ketone levels in the blood routinely and I can say that to remain in ketosis full-time is quite difficult. I personally seem to be very sensitive to proteins, so whenever I over-eat proteins just a littel bit - there goes my ketosis. On the other hand I am also not sure how far into ketosis one should be to reap the full benefits, The medical literature is full of suggestions, ranging from 1 - 4 mmol/l but usually doesn't give much reasons.

However one thing seems clear to me - cutting gluten would certainly benefit your mother's chronic pain condition (along with certain other measures, like FIR sauna, high-dose magnesium, careful physiotherapy, swimming etc), but as you mentioned in your post, you mother might not want to choose to go down the road of total gluten avoidance. Of course she is totally free to do what she wants and carrying the consequences of her actions. To get rid of soda also might enhance her well-being.

Another thing that comes into my mind is boron - as in borax. There was a recent flurry of articles under the heading of "The Borax Conspiracy" (see here) that describes boron as an adjunct to arthritis treatment. Now I haven't yet looked into that carefully enough to recommend - but you might want to do your own research and see what you come up with. I have tried borax a few times just to see what happens - not much, although it tastes horrible.

As to your situation, I think that you are having the right approach - offer help, but only answer to calls of help. Which is very hard to do, but a good exercise in internal vs external consideration.

Not sure if that post is any help to you, but I wish you and your mother all the best!
 
As nickelbleu writes:

"However one thing seems clear to me - cutting gluten would certainly benefit your mother's chronic pain condition (along with certain other measures, like FIR sauna, high-dose magnesium, careful physiotherapy, swimming etc), but as you mentioned in your post, you mother might not want to choose to go down the road of total gluten avoidance. "

I'm reading this passage and immediately I'm reminded of a schoolmate from way back who swims every single day to help with his back problem. It does him great good.
 
Thank you, that is very helpful.

She has been without gluten and processed food for a few months at a time at least I think. She complains about how disgusting it is to mix beef tallow into everything she eats. She has rarely been without dairy for long. I think she's experienced great benefits from the diet already, but she's decided to seek comfort foods as long as it doesn't cause her quite as much pain as she used to have.

It has been longer than 5 years since the surgery - that memory was pretty old. As I understand most of the pain is gone, but when she gets jostled it can really hurt. She says she was told her bones were crumbling as the doctors were working on her. She has been diagnosed with osteoporosis and fibromyalgia. She says she was in unbearable pain before the surgery and it was really her only option. Before the surgery she was in bed most of the time. She says she doesn't remember what the doctors told her, but as I understand her lungs were collapsing so she would not have lived much longer.

She is very cynical when it comes to doctors. It's unlikely she would take any prescribed pharmaceutical. The general stance is "why even bother".
 
monotonic said:
It has been longer than 5 years since the surgery - that memory was pretty old. As I understand most of the pain is gone, but when she gets jostled it can really hurt. She says she was told her bones were crumbling as the doctors were working on her. She has been diagnosed with osteoporosis and fibromyalgia. She says she was in unbearable pain before the surgery and it was really her only option. Before the surgery she was in bed most of the time. She says she doesn't remember what the doctors told her, but as I understand her lungs were collapsing so she would not have lived much longer.

The other thing to keep in mind is medical taping. It does help a lot in pain management, and it has had miraculous results in some people.

More info here:

http://cassiopaea.org/forum/index.php/topic,32114.msg434161.html#msg434161

and the techniques can be found here:

http://cassiopaea.org/forum/index.php/topic,17544.msg157927.html#msg157927

:)
 
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