I have found myself revealing to my patients more often that I have had two spinal fusions and that I have significant daily pain and limitations. I used to be quite selective about when I would share this and at some point this year it started to become more of a part of how I practice medicine. It seems that prior to this year (and quite possibly 2015) I was still deluding myself into thinking and feeling that if I pretended to be in less distress on a day to day basis that my mind and body would follow suit. . . that I would be able to feel more normal more often than I do and thus be able to do ,with the same injuries, what I could do in my 30s. This used to work better than it has in recent years. The simple reason is twofold:
1) The non patient care demands of my chosen profession are larger. I find myself sitting in front of a computer clicking away due to governmental and insurance ‘rules’ and mandates that have close to zero benefit on the work I do in front of living people. One of my migraine triggers is sitting: in the car driving, at home too upright, at the office in my work chair, sitting in meetings or conferences. I simply will not compromise my work any more than I have by adding more non patient care computer work. I have also started to communicate more with patients (vent) about what we are being asked to do by people we do not technically work for. For example it takes 12-14 clicks on the computer to simply print out a Shingles vaccine prescription. Ridiculous.
2) I am feeling my own morbidity, recognizing it more realistically and feel VERY tired. Even the daily pain in my neck and back is wearing away what I consider life-years that I may have remaining. In addition in the past few years the migraines and headaches have really taken a toll much like concussions do (I have had 5 of those as well during my athletic endeavors). I don’t know if I am not as tough as I used to be or if what I am going through is a natural consequence of beating up my body with my work and training trying to stay in shape.
As a result my day to day life is a series of inefficient behaviors and maneuvers. Folding clothes to help my back at full time work spouse is torture. Sweeping the patio or indoors is another simple task that cannot perform without either a headache or stiff neck as a consequence. All of it is tending to lead me to being more angry, frustrated and negative. I am going to focus in these next two months on staying grateful, positive and thankful. It has worked for years and I hope to squeeze more functional time out of it.