Judith Fitzgerald, with "Emily" in her left hand
For the first time in my life, I don't have a leg to stand on (and, well, it sucks big-time).
Picture it: Beautiful June morning, sun peaking over view of pink-pearling, aqua-swirling lake from upstairs window, the world various, beautiful, new. I head for the stairs to make coffee. I put my left foot on the top stair. Fine. I put my right foot on the penultimate stair. Not fine. No leg there. (I just knew it would happen on these stairs. Thirteen of 'em. That's my unlucky number.) Halfway through freefall, brain clicks into action and remembers how to turn a plunge into a tumble. Still land hard and know one thing: This is not the coffee-pot station towards which I thought I had headed. Keerist. What the hell just happened? Think. Thinka thinka thinka.
Wait a minute. Blood? My face is pretty badly banged and bleeding. Ick. I check my osteoporotic bones and conclude no breaks; so, I try to stand. Good luck. I can see the telephone on top of the computer station and I cannot reach it. Oh, yes, I can. I crawl over and pull it down on top of me. Well, at least I can call someone. Who? Who would rise and shine at this ungawdly hour?
The pain. It needles up and down my right leg from my burning hip through my screaming knee through to my swelling foot. Unbearable. Cannot think about it. Breathe. Think about calling someone . . . Think about the dapplesun climbing the wall till I can make a phone call. When he answers, Butch says he will come and help. Oh, good. Now, I have to crawl to the entrance door and unlock it. Yay. It takes about half an hour, just in time to greet Butch.
"Jaysus, what happened to you? Get into a bar brawl?"
"Natch. You should see the other dame."
"Where's the 'phone? You need an ambulance."
"Correction. I need a coffee. No ambulance for me. Hate hospitals. MRSA! C difficile! Ugh!"
"Coffee won't cure this. You need to go to the hospital."
"If you make me a coffee, I'll go."
"Deal."
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Six weeks later, all I can say? I'm too damned young to feel this old, too independent to even contemplate spending the rest of my life in a wheelchair and, now, far too knowledgeable about lack of exercise and malnourishment's effects on the body (particularly a Celiac one), physiotherapy, writerly occupational hazards or how to negotiate stairs with the magic of technology to believe. I don't want to know this stuff. Especially not during these brutal times, well aware writerly organizations, in the fights of their lives, cannot spend time on issues of creator physical stictuitivity and good-practices vitality (thus, more than anything, I genuinely hope this PSA saves a few sedents - or, traditionally, sentients - more than a million howls a minute).
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"Hurtz, don't it?"
"Oh, yeah. Mega-Hurtz. Too much to communicate how much it does. Have a high pain threshold, too. Odd. Weather affects it hugely. Good news? I gained five pounds incarcerated at the North Bay General Hospital (Scollard Site). Great nurses. (Hiya, Dana: Got your Oz yet?) Hot orderlies. (Hello, Jeremy.) Hellarious roomie, Cecile, fresh from a wedding party, struck with strange chest jabs but still willing to learn dancing on the bed-table tricks from ringmaster yours truly despite same. We got called on the carpet. Seems our giggling and guffawing kinda kept the other patients awake since they all sleep at 8 p.m. Three. Two. One. Zonk!"
"Zat so?" Butch slightly raises one eyebrow under his Home-Hardware cap. "Well, I heard the entire area couldn't believe Jack Tennant delivered a perfect complementary dinner on the Jack Tennant Steakhouse with real china and cutlery the night before you got out of the other big house? Haha . . ."
". . . Don't give up your pay-job, Butchie Boyo."
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The pain subsides, somewhat, eventually. If patience is a victory, then the two weeks I clocked at the hospital did teach me a lot about nutrition, midnight fire alarms and, Dear Lard, how to hold my horses chomping at the bit to exit that germacious place ipso-quickso. Patients and caregivers work hard in their respective fields. Hell of a job. This patient has to conquer THE Triathlon before the PTB will allow me to go home; that is, the three legs of the test to see if you can manage on your own:
The bath-tub legover? Pfft! Pas de sweat. Got straight sixes. Hocking a whizz (or, more daintily, sitting upon a poor dame's throne and proving you can stand following the grand seating)? Piece o' cakewalk. Sixes across the board. The stairs? Another easy-peasy six, right? Wrong. The Russian judge, I think, purposely gave me 5.9 because I initially forgot, in my nervissment, holding a cane's counter-intuitive. You hold it on your good side. (Don't ask. Try it. You'll see why.) Anyway, bribed her; she took a ten-spot for perfekk sixes. Figures, eh? Got discharged right away.
Now, this stuck-struck proud owner of one walker (Wendell), two rollators (Scylla and Charybdis), two canes (Walt and Emily), a nifty bath chair complete with matching grab bars and a helluva thick envelope filled with everything I need to know and do for the next few decades (if I plan to live 'em on my own two feet), my best hope? No one else pays the physical price for a cerebral activity they cannot but do, for those elevating the objectives of the vocation - notwithstanding the current glut of "careerist" rubberneckers among us - above all else, for those (or most all of us) conscripted for life, whether we like it or not.
S'Okay. I'm already taking steps and making strides towards walking again. Already, I can sometimes stand without Walt's or Wendell's aid, can even take a few tentative yet independent unassisted walkies. First time I tried? Ka-thud. Now? I ace four or five upsy-turvy wobbles daily with a little help from available furniture.
Which explains this PSA. When we think of writers and occupational hazards, KIAs (Know-It-Alls) skim the surface. This N-KIA learned all this after the fact. It is my genuine hope that I help prevent at least one other sedent from a similar fate worse than fate. Natch, I start at the top, er, go to the source: The College of Physiotherapists of Ontario. Karin Micheelsen responds I ought to e-speak with Joanne Nesseth who firmly believes Jane Sleeth's the dame who can really set the record straight for all of us. She heads up the Optimal Performance Consultants in her managing-director capacity.
Bingo! After I tell her my predicament, she agrees to provide a wealth of information to help prevent stair-falling, floor-crawling and various off-shoots of pain related to neglecting one's bag of osteo-neuropathic bones and so forth. When I ask the author of numerous articles and a trio of books in the field, one a best-seller with Thompson Carswell, Sleeth replies there's plenty writers and other sentients can do to avoid, say, an atrophied (or disintegrated) Bursa muscle (which causes falls down 13 stairs). What other preventive or proactive measures should we who sit on our arses for a living take? Over to you, Managing Director Sleeth :).
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Judith Fitzgerald: Most writers do not know all the risks, perils and uglies of weakening bones and muscles as we age; would you mind describing these pitfalls and their consequences (plus, other factors that could further put writers in jeopardy, e.g., smoking, drinking, caffeine, etc.)?
Jane Sleeth: Writers, indeed many sentient and intellectually developed human beings, often neglect their health or, rather, let me put it this way: Many display their ignorance which, in its dictionary meaning, applies here. Once educated and trained, they are then enlightened, smarter and hopefully healthier from an ergonomic and well-being perspective. Since I am a writer, I well understand the imperative to sit, research, write, edit and repeat that process. There is some evidence that the more intellectually demanding - cognitive and mental demands being the technical terms - the task, the more statically writers tend to sit (mainly due to the assumed but incorrect notion that moving and changing one's posture will interrupt the writing process).
Contrary to such wrong thinking, ergonomic and human-factor research clearly shows that even with mentally demanding tasks, a change in posture, change in task and a full break from the work improves circulation to the muscles and tendons of the body as well as the brain. The better and more productive writers are, in fact, the ones who use what we call micro-breaks through the day. Positive by-products? Enhanced productivity and deadlines more likely to be met.
The Uglies to which you refer are collectively called Musculoskeletal Injury (MSI) and include the following I enumerate by how often a given MSI occurs in the writing profession as per Statistics Canada and Compensation Board statistics:
1. Low back pain
2. Right shoulder and neck discomfort (unless you're a southpaw)
3. Right elbow tendonitis or tennis elbow (ditto)
4. Carpal-tunnel syndrome (CTS), although low on the list in terms of frequency of incidence, is misreported in Canada as being more common than it is
5. De Quervain's is a tendonitis of the extensor tendons of the thumbs and is appearing more frequently as the use of Blackberries and cell-phone texting increases in length of time used and frequency of keystrokes.
Here's a list of the ergonomic hazards within the context of the workplace which may contribute to the development of such MSIs; each needs to occur in the writer's workplace or office in combinations before they present any sort of problem for the MSI system:
1. Non-neutral postures (or postures outside of the normal or resting postures each joint of the body finds most comfortable)
2. Force, surprisingly, tends not to be an issue in a writer's job unless they carry laptops and tonnes of research material around in a bag
3. Repetition occurs when the number of keystrokes or mouse clicks exceeds what the average human tendon or muscle is able to sustain. There are tools we use in our practice to calculate when these rates exceed what a person should perform on a day-to-day basis
4. Static loads at the muscles of the back, neck, shoulders and arms. This refers to what happens when a writer sits for long periods of time at the computer without taking micro-breaks and regular breaks in posture. The muscles will hold the joints of the back plus neck, legs and arms in place without movement occurring (which results in limited blood supply to the working muscles and leads to both fatigue and discomfort of these
5. Mechanical loads (which include writers leaning forearms onto the edges of their desks or onto those pads often used in tandem with mice. (These devices, sold as ergonomic, are anything but!) he writer leans the forearm onto the edge of their desk, or onto those pads often used in front of the mouse (they are sold as ergonomic but are anything but). Then, there's the incorrectly positioned chair-seat pan which places pressure at the back of the knees and could well cause compression to the soft tissues, wrist and leg nerves and tendons which, in turn, may negatively affect circulation (which could, in some cases, lead to the development of deep-vein thrombosis (DVT) in the legs)
6. Environmental factors such as low levels of light, distracting sounds and air quality all need to be scrupulously monitored.
[Hold on . . . This lefty's gotta take Charybdis for a walk :)! BRB!]
JF: Could you describe the worst-case patient you've treated? Is anyone's case truly hopeless? Are there ways, once afflicted, to return to a fully free-walking life?
JS: From where I sit as both an expert in Ergonomics and a physiotherapist, nobody is a lost cause (in particular if the MSI-related injuries are not chronic and if the writer is willing to make lifestyle changes, to use sound ergonomic principles, to become fit and to limit intake of coffee, cigarettes and alcohol, especially in combination).
Worst case? The male writer with an acute low-back injury accompanied by leg pain and change in sensation in the leg particularly with sitting. Experienced these symptoms for three months before I saw him in the clinic. The writer was provided with a program of exercise and postures to ensure his symptoms improved with respect to the leg in question; he invested in a proper chair with adjustability; and, he started to take daily micro-breaks every 30 minutes as well as proper breaks two-three times per day. Result? After two weeks on a comprehensive programme, the leg symptoms improved and, after two months, in our follow-ups, he happily reported no leg symptoms, periodic low-back discomfort and good control over various other items including sensation changes.
JF: What do you recommend writers do for mild-to-moderate pain in these situations? (I already know you have to elevate your feet when you sleep, say.)
JS: Ice. Pack ice when the MSI is acute (i.e., the first three days following an increase in symptoms). Plain old aspirin limits inflammation (as long as you are cleared to use ASA). Assume neutral and comfortable postures. After three days, commence or recommence your stretching program provided to you by your physiotherapist; recommence strengthening exercises such as Pilates or light weights. Notice that little to no emphasis is given to passive types of treatments such as bed rest, massage or acupuncture which, of course, can be used as well. HOWEVER, each writer still needs to adopt the ergonomic principles (including good seating from a reputable manufacturer of task chairs such as Knoll, Steelcase, Herman MIller, Teknion and Haworth, e.g.) outlined above and actively pursue an exercise-based programme developed for life over the long term.
JF: Are steroids the answer in some instances?
JS: Locally injected steroids are found, in the scientific literature, to be of limited to no application for these injuries. These injections, however, do present a risk for infection in the injection site and, if the patient's given repeated applications, that may weaken the tendon/ligaments at the joint.
JF: Is there anything else you believe I ought to include to educate writers about MSI afflictions and hazards they could potentially face?
JS: There is hope for writers despite the nature of the work and their propensity to not necessarily take care of their health (a generalization borne of observation and statistical review). Following the ergonomic, health and lifestyle recommendations can and will make a difference to the health of those who make a living writing.
I mean, even Gertrude Stein could have used a little more exercise!
JF: Touché! (And, yes, I will live to walk another day. Just watch me :).)
(Hat tips, Karin Micheelsen [Director of Communications, College of Physiotherapists of Ontario] Joanne Nesseth [Ontario Physiotherapy Association] Susan, Jack and Jack-Tennant Steakhouse Staff, St. Francis Woolger for the great coffee, SensMan PM for an incredibly generous gesture and gift of a well-loved mug above and beyond the call of beauty; but, most keenly, to Jane Sleeth [Managing Director, Optimal Performance Consultants] thank you so much.)
Contributing reviewer and "In Other Words" blogger Judith Fitzgerald, author of 30 works, lives in Northern Ontario's Almaguin Highlands.