Comment by y-c-o-m-b | Hacker News Reader

Comment by y-c-o-m-b | Hacker News Reader

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> If you've ever known someone dealing with chronic pain, it can easily make you decide that you're better off dead than continuing to live

I'll confirm it for you right now. For me it's not just the back, it's areas along the entire spine. I've had spinal cord compression on my thoracic spine since late 2017 and nobody will touch it. My lumbar spine has many herniations and "schmorl's nodes" (where it's chipping away at the actual vertebrae) in addition to clamping my nerve roots shut. I had emergency surgery in my neck in early 2018. Prior to the thoracic spine injury, I was in the best shape of my life; very muscular and healthy with a 6-pack like you see in Luigi's pictures.

It's been an absolute miserable experience for the last 8 years. Being gaslighted by doctors before and after my surgery didn't help. Insurance tried to deny my emergency surgery at first despite the fact I lost all sensation from the neck down almost overnight. When you're dealing with trauma and the system works against you, very dark thoughts start to form. I'm not going to say I condone what Luigi did, but if you think people go through these events and don't think those thoughts on many occasions, you're so very wrong. There's a HUGE range of emotions that comes with it all. Suicide was definitely one of them for a long time as well. I have a wife and kids though and do not wish to burden them further by adding to the list of problems. They're the only things that's kept me going strong this whole time.

I'm sorry you've gone through that and I hope your condition improves. While I don't know the specifics of your case, in general there aren't a lot of real solid evidence-based medicine guidelines for treating back pain or injuries. Ask 10 different physicians and you'll get 10 different treatment plans. Surgery has made many patients worse in the long run. Obviously there are some traumatic injuries where emergency surgery is medically necessary, but for most patients the standard of care should be physical therapy first with surgery being a high-risk last resort.

https://peterattiamd.com/stuartmcgill/

You can't get approved for surgery without PT in many cases anyway, so by default, most people will have to undergo PT regardless. In a lot of cases, you still can't get surgery; insurance will request pain management via injections and stuff before approving surgery. In my case, I had to go through 6 weeks of PT, then insurance asked me to do another 6 weeks after the first 6 failed to produce benefits. PT accelerated my decline because they didn't understand the mechanics in my case, so it's not always beneficial either. Also some of those conservative treatments (injections) are still being denied by insurance. My dad recently went to get another series of injections and was denied because they didn't think it would be medically beneficial despite the fact that he improved significantly from the first set and it lasted over 6 months.

Unfortunately there's a huge variance in PT quality and skill levels, so just because 6 weeks of PT doesn't produce results doesn't necessarily mean that a different approach to PT wouldn't be better than surgery. Seriously, have you tried visiting a McGill Method Master Clinician? I would certainly try that before letting a surgeon cut on me. Watch the video I linked above and see if it might be relevant.

What sort of injections are you referring to? Corticosteroid injections can sometimes be helpful in the short term but clinical practice guidelines discourage prolonged use due to the risk of bone damage and other severe side effects. So insurers aren't necessarily wrong to deny payment for those.

Spinal problems are definitely on the list why seemingly "not terminally ill" people might want to take the option of euthanasia. Healthy imbeciles will scream with outrage "it's a sin, one must keep them alive at all costs" but that's because it's not them tortured 24/7 but other guy. And people are able to do monstrous things to other people without as much as loosing a night sleep.

Overall, the options for severe chronic pain are: heavy painkillers, physical therapy, wait-and-see (hope they improve) and if not ... dignified exit.

If they improve it takes years. And painkillers are ABSOLUTELY a must during that time but the innocent monsters (largely the rest of the population that is) will cry out "opioid addiction!!!", cut them off and sadistically (in their mind, gently) advise to get over it.

I have no words how much I despise this world. It's all fine and dandy until you lose your health, afterwards you really see it for how it is.

"The road to hell is paved with good intentions"

As I get older, I understand this phrase more and more.

I've learned that most people don't consider themselves to be "bad" or "malicious" overall. People will earnestly espouse opinions of arbitrary quality, with unknown justification and intent, and expect others to agree with them. They don't consider that they may be speaking out of severe lack of empathy or knowledge (Gell-Mann amnesia!). We're extremely limited and oftentimes we don't even recognize it.

I mean, prison might help take care of his back problem more than a health insurance company would.

> I've had spinal cord compression on my thoracic spine since late 2017 and nobody will touch it

Same here, except I’ve had it since ~2000 (mid-teenager). Anytime a suggested treatment makes it to insurance, they deny it because “it’s extremely uncommon for back problems of someone your age to be in the thoracic spine.” They’ll gladly pay for unnecessary surgeries on the lumbar, but refuse even many diagnostic attempts in the thoracic area.

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