From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Newsgroups: misc.handicap
Subject: Conservative treatment
Date: 28 Jul 92 17:12:47 GMT
Reply-To: Arthur.Saus@p160.f72.n376.z1.fidonet.org
Organization: FidoNet node 1:376/72.160 - Windows of the Worl, Columbia SC

Index Number: 23425

[This is from the Chronic Pain Conference]

Hello Linda!

17 Jul 92, Linda Cummings writes to Arthur Saus:

 >> Well, that is one possible explanation, but there are others that
 >> are equally possible if you understand the anatomy.  The L5-S1 and
 >> S1-S2 nerves pass through the L4-L5 spinal canal before they reach
 >> their respective levels.  It is certainly possible that a problem
 >> at the higher L4-L5 area can affect any nerves at a lower level.

 LC> So, this could explain my excrutiating tailbone pain, huh?  Possibly?

It possibly could, although there are many other possibilities
also.  Any set of symptoms can be associated with a number of
different medical problems. This is what is referred to as a
"differential diagnosis".  The challenge for the physician is to
figure out which problem a patient actually has, from the
constellation of symptoms that is presented.

 LC> But, it sure is hard to have chronic pain and be on any real
 LC> beneficial exercise program except to keep limbs limber.  For me, I can't
 LC> hardly stand to any type of real good exercise for weight loss. In fact, I
 LC> gained weight *after* the surgeries because I can't exercise.

Unfortunately this gets to be a vicious cycle, like so many other
disease problems.  Chronic pain is associated with being
overweight... patient doesn't get exercise because of the pain...
weight increases...pain increases...patient exercises less...etc.
Trying to break out of this cycle is difficult and requires a lot
of determination on the patient's part.  The problem with trying to
break this cycle is explained in the basic college psychology
courses... there are no immediate rewards for your efforts (ie
positive reinforcers), only the negative ones such as discomfort if
not outright PAIN.  The rewards for weight loss are there, but they
are long term.

Did you ever hear the old Kingston Trio song, "Desert Pete"?  The
setting of this ballad is that a man is wandering through the
desert, about to die of thirst when he runs across an old well that
has a bottle of water sitting beside it and a note from Desert
Pete.  The note states that there is a limitless amount of water
that will come from the pump, but to get it, the thirsty traveler
must first pour all the water from the bottle into the pump to
prime it.  The note states:

 You've got to prime the pump.
 You must have faith and believe.
 You've got to give of yourself
 before you're worthy to receive.
 Drink all the water you can hold,
 wash your face, cool your feet.
 But leave the bottle full for others.
           Thank you kindly,
           Desert Pete

Of course the ballad goes on to tell how sorely tempted the
traveler was to ignore the message and drink the water from the
bottle, but he had faith, followed the instructions, and indeed got
the pump working and was able to tap this limitless water supply.

Certainly you and others are not worrying about severe thirst in
the desert, but I think there's an important attitude expressed in
this ballad that will help in anything you are trying to
accomplish, even in the face of punishment or negative
reinforcers.

Arthur

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