Comment by vrtx0 | Hacker News Reader

Comment by vrtx0 | Hacker News Reader

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I'm one of these missing men. I'm currently 35, and have been working as a software engineer since I was 19. Two years ago, I started experiencing excruciating, unrelenting low back pain that eventually required me to leave my job and go on long term disability.

I loved my job. I worked at MongoDB in Palo Alto for 3 years, contributing to the core database (C++) and designed a performance testing platform (among other things). It was a true pleasure to have worked with some extraordinarily brilliant people throughout my career. I biked ~5 miles to work from the house I shared with my partner in Atherton. Life was perfect.

I now live with my parents in Florida, and have symptoms that have progressed to what could be MS (I'm undergoing a complete work up at the Mayo Clinic in Jacksonville, FL).

Life sucks. I'm depressed, but who wouldn't be? I also take prescription pain medicine, which helps me get out of bed and shed some of the 105lbs I've gained since this started. Being 6'2" and 285lbs is depressing in it's own right.

That said, I want to stress two things:

1. Opioids are daemonized by the media, but there is no better option (aside from suicide). The implied correlation with pain medication in this article seems to reinforce the stigma I've been facing; that somehow I'm lazy, weak or an addict. But all I can offer is my word.

Like most people who enjoy software engineering, I gained immense gratification from solving difficult problems, learning new things, and completing a piece of software I'm proud of. Opioids don't replace that feeling (for me anyway). Nothing does. But the lesions on my brain make writing software effectively impossible.

2. Debilitating conditions predicate losing a job and starting pain medication. Maybe some people are just lazy and hate their jobs, but please don't punish me (and others like me) for it. Even if they're in the majority, please don't punish me. I suffer enough.

I went through something similar the past couple of years, and was letting my back determine job prospects (i.e. I didn't want to take a train downtown and walk five blocks to work, hell I didn't want to walk to the parking garage next to my building).

For me (and possibly only me, I don't know your situation), what worked better than anything was to start eating a keto (low carb, and incidentally no wheat) diet, which some attribute to having anti-inflammatory effects: http://www.wheatbellyblog.com/2012/01/low-back-pain-chiropra.... The pain went away very quickly (for me within a week of starting the diet) and I can walk normally again.

I'm not saying it will work for you, I don't know, but I've been on the diet for four months now, and the pain hasn't returned since. You might want to consider it. It significantly improved my life. I also lost 40lbs as well in that time period, with not a whole lot of exercise, which I'm hoping will help insure the pain doesn't come back in the future.

It's awful and it dictates your life when you have it, I know. I hope you figure out what's wrong and find something that works for you.

Also, if nothing else, I noticed that I could stay in the pool pretty much as long as I wanted when I had back pain, due to its buoyancy effect, so when I did have back pain, I got my exercise in by going to the pool regularly, and found relief from my pain while I was in there. You might want to consider that for weight loss as well.

If you are interested in keto, check out http://www.reddit.com/r/keto. It's a great source of information, motivation, and similar stories such as mine by real people, not paid endorsements.

Thanks for the suggestion. I've tried various diets, including Keto, LCHF, etc. I try to stick with LCHF just to slow down my weight gain, but it doesn't impact my pain or neurological symptoms.

For anybody else reading this I'm a similar situation, please do follow cableshaft's advice and try new diets. I also recommend physical therapy.

The cause(s) of MS and many similar diseases are not well understood. At all. FWIW, I lived a pretty healthy lifestyle before my symptoms started.

That's unfortunate that it didn't work for you. I'm glad to know you had given it a shot, though, so you at least know there's probably not a more natural fix for the problem. I really hope they find something and can give you something to ease your pain. Good luck.

When I went to physical therapy it consisted of them just teaching me stretches, all of which I could just find online. Is this the normal experience?

Good question. I can only share my personal experience; I've seen 5, but only 2 seemed to understand my pain and gave me exercises tailored to my needs (using elastic bands, aqua exercises, stretching, etc.). The standard for back pain seems to be core strengthening. I found aquatic exercises most helpful (and least painful) for that.

The best ones I've seen were both athletes who succumbed to back injuries. But there must be good PTs who learned by the book too... I hope.

I also went to a PT that specialized in low back pain & sciatica. Mine has finally gone away and the PT helped, but it has taken 1 year.

There was a study in the UK where 90% of back pain goes away in 1 year, so they advised against any surgery. Of course this was in the UK so they couldn't get surgery within a year.

Have you tried cbd oil or vaping?

CBD oil has a lot of promise. It doesn't get you "high", but acts much like an NSAID.

There is research suggesting medical marijuana is a good replacement for opioids, in some cases. Too bad FL isn't a state that gives you that option, so you could at least try it.

In CO, the deaths by opioids have gone down significantly.

I could not agree more. I had a medical marijuana note in CA, and it turned my stabbing pain into more of a pins-and-needles feeling (sorry, pain is difficult to describe in words). It also drastically reduced the tremor in my right hand.

But since moving to Florida, I have to take a drug test every month before my pain management doctor will prescribe anything. It's on the ballot in Florida next month.

I was one who called the other guy lazy. You are different, and I know there are many others who are in similar situations as yourself.

The current opiate epidemic and crackdown is also unfortunately affecting people like you, who are legitimately in pain.

I don't really have anything, besides saying that we as a society should do what we can to get you healthy, but I feel that when there's people who are healthy enough to train for the army, and mentally capable, and still refuse to do anything, that's when society in general starts feeling "why do we have welfare?" and, essentially, their behavior hurts those who actually need the help.

I wish you the best.

Thanks -- I genuinely appreciate your sentiment. As Sontag said:

"Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place."

Just as we don't like to think about dying, we don't like to think about getting sick. Fatigue, depression, pain, etc. -- they're all real, and can be completely debilitating. Nobody is immune. But sadly, people can indeed fake many of these symptoms; even the best MRIs and latest technology (like DaT scans) can't prove or disprove nearly as much as I thought before my first hand experience. That said, I don't _think_ that anybody faking a condition would subject themselves to as much radiation or spinal injections as a truly sick person would...

Anyway, you make a very valid point about what society sees, and their knee-jerk reaction. I felt this first hand when I moved from CA to FL (the former "pill mill capital of the US") nearly two years ago. Years before I moved back here, the state legislated limits on opioid prescriptions, and I had to reduce my dose when changing doctors. Did this legislation reduce opioid prescriptions in the state? yes. But heroin use has also skyrocketed. And legitimate patients are still suffering. But I digress... Thanks again for your comment.

There are non-opioid choices. Pick one. The opioids will ultimately kill you.

Ziconotide is a fine choice. It works better too. The only downside is that you can't take it in pill form.

There are non-opioid choices. I've been through every prescription oral medication. Some are worse than opioids. Gabapentin and its class make me incredibly nauseous before relieving pain. Most just don't touch it (some even started raising my AST and ALT).

That drug can't even be given by IV or IM, can it? I'm a candidate for the intrathecal pain pump, which looks to be the only way the drug you mentioned can be administered. But most doctors have suggested I wait for some clear answers before hooking a drug pump directly up to my spinal cord.

Thanks for mentioning this drug though. I'll ask my pain mgmt doctor about it.

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