LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Monday, May 24, 2010

More Borg than ever

Wires and medical tape wrap around my body, a Frankenstein mix of Egyptian mummification and Ivy climbing the walls of an old building.

Like Star Trek’s Borg characters, I am becoming more machine than man.

One machine pumps insulin into my body to keep me out of a coma. Another machine watches my blood sugar to make sure the first machine does not give me too little or too much insulin. A third machine is used to calibrate the second machine by drinking drops of blood several times per day. Lenses of polycarbonate help me to see, lenses implanted inside those lenses help me to read. High tech synthetic materials keep my blood pressure low, my cholesterol in the middle, and my thyroid right where it should be.

And now, a Transcutaneous Electrical Nerve Stimulator, or TENS, unit is pumping electricity into my back to scramble the nerve impulses that signal my brain that there is trouble.

So despite two rounds of therapeutic medical massage my lower back continues to get worse. Needless to say, I still need to get to the root cause of all of this. That is to say: what the fuck is causing all this pain?!

Pain exists for a reason. It is nature’s way of telling us something needs to be fixed. I’m not ignoring that, I’m waiting (not very patiently) for the first of what no doubt will be a long chain of medical appointments with assorted experts and imaging centers to try and find out what the problem is.

There is a background radiation of pain, like the radioactivity following a nuclear blast, that never really goes away. But if I shift my leg, even so much as moving my foot a few inches, explosions of pain radiate out of my back and throughout my body. Like getting hit by lightning. And when I try to stand up when I’ve been sitting for more than a few minutes the pain causes the lights to dim, like an electrical brown out. Maybe I’ll pass out. Maybe I won’t.

I can’t stand up totally straight until I can hobble to a wall and use it to pull myself upwards. Once standing straight, the pain returns to the back ground radiation.

What at first appeared to be a garden variety stress reaction is now looking like it might be something more sinister. Either that, or the Human Tumor bought a really good Voodoo doll on eBay.

So on top of muscle relaxants, I starting popping pain pills. Working my way up from over-the-counter to more powerful options. But the problem is by the time a med can out-shout this level of pain, you are so stoned you can’t function.

If you are going to sleep all the time, you might as well be dead.

But in the totally weird way my life tends to work (and this is why even though I rarely go to church I sure as heck believe in God), a technology I had never even heard of entered the scene. Here’s how it went down.

On one of the last days at the clinic before my medical leave, as I was hobbling around, one of the senior nurses said off hand, “Maybe one of those electrical thingies would help your back pain.” Before I had a chance to ask what an ‘electrical thingy’ was, I was distracted by some sort of blood sugar emergency with one of my patients and electrical thingies dropped from my brain until the first day of my leave when I checked my email.

One of the long list of messages was spam from American 3B Scientific, who I sometimes buy educational aids from. The subject line caught my eye. Break the pain cycle! Oh? Do tell…

So I opened the email and they were having a sale on electrical thingies. They are little boxes with wires and EKG-like pads. And they were called TENS units. Huh.

The science behind TENS seems sound, unlike the guy I met who was convinced that his colored-light device could lower blood sugar.

Nerves cells are what transmit feelings from just about everywhere in the body to our brains. Some single nerve cells can be up to four feet long. Wild! But all nerve cells, both short and long, use electrical impulses to transmit the sensations of hot, cold, pleasure, and pain. It’s a telegraph system on steroids.

The idea behind the TENS system is to introduce static that scrambles or blocks the transmission of the pain to the brain.

So to me, logically, this technology sounds at least plausible in that it makes at least theoretical physiologic sense. Use electricity to fuck with a part of your body that uses electricity.

I Googled around the internet and found that TENS has a mixed reputation both amongst patients and docs. I also found one clinical study that showed a significant pain reduction in about half the people studied, comparable to the reduction in pain seen by the members of the “medicated” arm of the study. Of course, the problem with studying pain is that you are studying something subjective.

You can’t measure pain. If you want to study how well a therapy helps blood pressure, blood sugar, or triglycerides—it’s easy-peasy. You can measure those things. Pain can only be reported, and no two people experience pain the same way.

I then booted up my telemedicine system and touched base with some other folks in the field. Most had a similar answer, they seem to help about half of people who try them. As the devices seem to hover around one hundred bucks for most models, it seemed to me it might be worth the risk.

One Endo I know said she’s even had good luck treating diabetic neuropathy with TENS units.

I told Debbie about TENS systems and she asked around at her clinic too. As it turns out, one of her co-workers had used one as part of her physical therapy post-op on a shoulder operation a few years back. The next day Debbie brought it home so we could do a one-rat clinical study. Yep. I’m the rat.

The following morning, I opened the case and pulled out a silver box about the size of a TV remote, cables, pads, 9-volt, batteries, and a manual. I opened the manual and the first thing my eyes happened upon was:

Stimulation delivered by this device may be sufficient to cause electrocution.

Oh grrrrrrrrreat.

Other things: don’t use it transcerebrally. That means if you have a head ache, don’t put a pad on each ear and run electricity through your head. It’ll scramble your brain.

Don’t use it if you have a pacemaker. Don’t use it if your are pregnant. Don’t use it in the shower. Don’t put it on so that the power flows front to back through your chest ‘cause then you’ve got a defibrillator on your hands. Well, I guess a fibrillator to be linguistically correct, as instead of fixing a cardiac arrhythmia you’d be creating one. Don’t flow through your neck or it will jack up your carotid sinus (just trust me on this one, jacking up your carotid sinus would ruin your day.)

Sound dangerous? Yeah, well so are automobiles, and we’ll let any idiot have one of those.

But when you are in pain, electrocution or heart attack seem like the least of your troubles. My main problem was the manual was very clear on where and how not to place the four pads, but was mum on the subject of where you should place them.

Place the pads on your body according to the location specified by your physician.

My physician is at her timeshare in Puerto Vallarta this week.

Back I went to the internet, where I found what I like to call “mass consensus” on the location of pads. That is to say, many websites were in agreement. Like a medieval army placing a city under siege, the pads surround the site of pain, the leads from one side of the machine at the top, the two pads that connect to the other side of the machine on the bottom. Make sure the positive leads are on one side and the negative leads on the other.

That makes the power flow across the lower spine. I was ready to go, with only one remaining problem. I can’t even stand, much less reach my own back. Lucky for me I have a wife.

When Deb got home from work she used a beard trimmer to shave the fine hairs off my lower back, stuck the pads on me, and after trying several different things, ran the wires down through my underwear, up my pants leg, through my shirt, and out to my belt.

Sitting at the kitchen table I put a fresh battery into the machine. Then, making sure both dials were off, I plugged in the leads. Two sets of deep brown eyes regarded me with unblinking curiosity. Deb and Rio looked on with interest, he a small clone of her, from his eyes, his hair, his skin, and the shape of his face exactly the same as hers.

I slowly turned one of the dials…

Slowly, starting at a tickle, I felt something in my lower back. As I turned the dial up more it went from a tickle to a vibrating sensation, like one of those massaging chairs. Higher still, and you get into pain similar to what it feels like to get a tattoo.

I turned it back down again.

“Well??” asks Debbie.

“Are you still in pain, Daddy?” asks Rio.

I set both dials to the maximum vibrating sensation and decide to test the system by trying to stand up. I start to rise with no difficulty and no pain and then ZAPPPPPPPPP!

Now, I’ve never touched my tongue to a bug zapper, but I imagine that the feeling would be similar.

I quickly yank the leads out of the top of the machine and shut it down. What the fuck?!

Deb pulls up my shirt to find out what happened. The cords where pulled as I stood up, unplugging them from the pads and letting the bare electrodes run across my naked skin.

Fourteen IV-3000 dressings later there is no chance that any of these wires is coming lose again. But at this point I’m disheartened. The pads are reusable, but not water proof. Even if the TENS is the perfect solution, Debbie would have to pull the pads off me every morning and get me rigged for the day once I was out of the shower.

But this is only a test, I tell myself. Let us see how things go.

So after about 24 hours, I can tell you that I’m one of the 50% that a TENS will work for. My back ground pain can be reduced to negligible by a very low setting. If I’m distracted and sitting comfortably I can completely shut it off and be fine. If I need to stand up, I crank it up to the tattoo setting for about 15 seconds and then I can stand, without using a wall to pull myself up. Once upright, I can reduce the TENS power to the level of the massaging chair, and can walk pain-free.

Now is this simply a case of hitting yourself in the head with a hammer so you can’t feel the pain in your foot? I don’t think so. First, consider that the tattoo-like pain is at the same site as the endogenous pain. And while the tattoo pain is sharper, it is more localized and lower down the pain scale.

Standing with the TENS turned off maxes out my pain, right off the scale. And it radiates outwards. It shoots up my back, down my legs, around my torso. It is an explosion of pain that takes time to fade away like the dust settling after a car bomb has gone off.

Standing with the TENS turned on still requires pain, but it is different. The pain is less, both in intensity and in the nature of how it feels. It is a sharp, rapid, tingling pain. Kinda like when your foot “goes to sleep.” And as soon as I’m upright, I can lower the setting, and the pain is gone.

I’m completely convinced, that for me at least, the TENS really does interrupt the pain signals between my back and my brain.

But the thought of all this long hook up process every morning had me really depressed. I went back to the internet to see if anyone made waterproof pads. I didn’t find that, but I did find several TENS “garments.” Think Velcro back-brace with built-in electrical pads. Rather than stick the pads on your body, you just strap on the brace in the morning and attach your TENS, and off you go.

There were a number of different ones to choose from, but I went with the “ReliaMed TENS Lower Back Pain Relief System.” RMTLBPRS for short. OK, I just made up that last part.

I whipped out my Mom’s credit card and ordered one from Health Products For You. It was $114.95 with free standard shipping. But I paid an extra $25.49 to get it here quickly.

It’s not here yet, so I can’t report on it, but my hope is that it will offer similar relief, especially with standing and sitting, without all the setup hassles with sticky stuff, running wires, and using medical tape.

So now I’m off to check the internet for a Star Trek convention near me. I’m thinking I might stand a good chance at winning the costume contest as a Diabetic Borg…

2 Comments:

Blogger Scott K. Johnson said...

I hate that you are in so much pain. I've never had an experience with back pain, but every single person I know that HAS had back pain say it is miserable. Sounds like it for you too.

I hope you're able to find some relief with the TENS system until you can get the root problem figured out.

12:54 PM  
Blogger Will said...

I can really relate to your back pain and have for the second time read Dr. Sarno's book, Healing Back Pain and recovered from debilitating pain. I highly recommend the book. Please visit www.joyfuldiabetic.com for my latest post on this subject. Here's wishing you a speedy return to zero pain.

8:37 AM  

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