It only hurts when I laugh; living with an injured back.

When I was a physiologist,  I used to ponder the cause of the sensations I felt in my body, the reactions of my gut, what is was about feeling sick that made me yawn or sweat, why a headache made he muscles on the back of my neck sore.  I even thought of writing a book of such observations, but like so many of my grand ideas, it ran into the sand trap of time and was forgotten. 

Now the pain protecting the healing bones in my back offers a whole new insight on life.  What I originally took for granted, didn’t think about, is suddenly, painfully brought to mind.  I have to be careful how I walk.  Keep the back straight, let the feet do the work, keep the head up, swing the arms for momentum but not too vigorously.  It’s amazing how much we use the trunk, the back, to add fluidity to our walking; the constant balances and adjustments that occur at every step.  All of these are now forbidden.  The back has to be locked rigid, the damage protected in a rigid case.

Lead off up the stairs with the left food not the right.  Any sudden movement with the right foot, brings on a spasm of pain that makes me cry out.  Use both arms to support when sitting up.  Don’t bend the back; reach down for things by using the knees.  Keep the back straight at all times. 

Breathe deeply and evenly and try not to cough. Coughing is so painful. The sharp contraction of diaphragm and intercostals jerks the wound, dislodging the broken ends of bone and creates an anguish of spasm.  A chest infection is the most dreaded complication of broken ribs.  Secretions collect in bruised tissues and can easily become infected.  The cells lining the bronchioles and bronchi have a carpet of cilia, tiny hairs that beat in waves wafting the secretions upwards.  But this ciliary escalator can only get secretions as far as the trachea, if that.  There they collect, tickle and have to be coughed up.  Try to suppress the cough reflex, grunt to move the collection and move the phlegm into the pharynx, from where it can be swallowed. 

Just as you use the knees to reach down, let your colon do most of the work in defaecation.  Learn to relax and take your time.  Think, evacuation – a bit of self hypnosis.  Imagine your gut like the M1 with the traffic flowing evenly smoothly.  Breathe deeply, allow your colon to ease, squeeze the plug of waste down until it is in the firing position.  Allow the sensation to build until, almost like orgasm, it demands release.  And then just a small graded increase in abdominal pressure will hopefully expel it all in one shot. 

Sorry to go on about it so much, but if you’ve hurt your back, constipation can become a real torture.  Take plenty of fibre, fruit, drink syrup of figs or prune juice, take a dose of lactulose every night, add a senna – do what it necessary to keep the contents of your colon soft, but not too much that they are liquid and urgent – you don’t want to be caught short.  Remember you can’t hurry, even if your bowel wants to.  Adjust the dose so your faeces are soft and pliable, then you can relax and let peristalsis do most of the work.  So  take your time. Remember, laxative and relaxation have the same derivation.  The ancients knew it.  So should we! 

But there is one thing you cannot always prevent.  It sneaks up on you when you are relaxed, catching you off guard, tearing into your back and causing the most intense spasms of pain.  That is emotion!  Not any emotion, but the sudden surges of anger and laughter. 

Emotion takes over the control we exert on our lives.  It demands expression, satisfaction.  Grievance, loss, depression can make it impossible to think of anything else.  The chemicals flood the brain, controlling our thoughts and movements, distracting, preoccupying,  obsessing with the same insistent thoughts. There can be no escape.  

The same happens with acute spasms of emotion.  The quick floods of chemical catch you unawares.  An attack of frustration while climbing the stairs can cause you to forget, lead off on the wrong foot, unlock and leave you hanging on, wracked  with the most intense pain.

And laughter, the repetitive contractions of intercostals, the inescapable build up of tension as you try to stop laughing, is murder. You can die laughing or it seems so.  The ridiculous can stab you in the back.  Avoid it at all cost.  Turn your face and your back to stone – for the time being anyway..