The Puncture Chronicles - A Subdermal Saga

This is just a running diary of the skeptic-turned-believer’s introduction and experiences with acupuncture (hereinafter, ACP).

Tuesday, May 6, 2008 -

Went to the regular PPP (Pill Pushing Physician) yesterday.  Interesting thing.

When I did the two trips to the hospital with the pain way way out of control for hours on end, they said “Migraine”  I said “Bullshit”.  Why?  Because I had no aura, no nausea, no sensitivity to light… nothing that tells me it was a classical migraine like when I was a kid.

So yesterday my PPP mentions “migraine”.  I don’t use as many words as “bullshit” but tell him what I had observed.  The PPP, who is a great guy, looks at me yesterday like I am some sort of surprise excretion during an exam and combines it with that thousand-yard stare, and after a moment says “Well, there is a spectrum of migraines, and they don’t all have to be in the head.”

The lesson here is that you can have vascularization anywhere, and if it happens to be in the neck and spread out across the head, why then you have the recipe for pain.  Lots of it.  I asked if it had anything to do with the car accident and he said sure, any kind of stress or injury could set it off.

What could be, is that I have been experiencing a lower grade migraine nonstop for months, punctuated by screaming/crying/punching-things breakthrough agony or 1-3 days at a time of wishing I were dead, preferably by brand new (read: sharp) woodchipper.  How ’bout that?

So that could explain why painkillers only blunt the pain and not in a highly effective fashion at that.  The ACP would relax the muscles around said vascularization and relieve pain.

“What do you do for something like this?”, I asked my PPP.   He chirped brightly with a dazzling smile, “Imitrex.  Not long term, but it’ll tell us if we’re on the right track.”

The cost is unholy bordering on truly Satanic, with even the co-pay it was quite expensive, but on the other hand, how much are days on end being lost to pain worth?

We’ll soon see, as I am starting to notice the warning signs of one that will strike within the next 2-3 days and they are sufficiently strident that I can tell it will be a doozy.  I’ll keep you posted.

Wednesday, April 30, 2008 -

If I’m going to extoll the miracle of ACP, then it is only fair to use an openness policy which goes both ways. Today… eh… meh… feh… oh, I don’t know. Put simply, I hurt. Not a great day. But it would be unrealistic to assume every day would be a good day. I think it’s just something is out and I’m stiffened up from it. More tomorrow.

Tuesday, April 29, 2008 -

Le Porcupine did me again today (with the needles). Nothing you haven’t heard me describe before except for one little twist. Without warning, he came running at my head and in a giant underhand motion skewered me through the temple with a needle. If he was trying to pith me, it was a failure. If he was trying to cause me a huge amount of surprise and some pain, he succeeded. Did that in multiple places around my head. It’s distressing to have needles in your scalp.

Oh, remember how I estimated the needle diameter to be between 0.007″ and 0.010″? You don’t? Ok, fine, whatever, I measured one today with my calipers and came up with 0.0063″ … not a bad estimate by eye, for something so small. Your fingers can feel ridges and bumps and cracks to better than 0.001″ with practice, but gauging the diameter of something that small - use your eyes or an instrument, because your fingers will fool you.

Monday, April 28, 2008 -

Overdid it Saturday. Got the snowblower out and got it running. It hadn’t run all winter long because I forgot to summerize it. So I got in there and HOSED the float with carb cleaner and sprayed up the mower’s cloaca (there’s that word for you McGoo).

Pull-pull-pull-swear-pull-pull-pull-don’t swear (daughter watching)-pull-pull-pull-choke-pull-pull-choke-rrrrum-rumm-rumm-RRRRRRRRRMMMMM.

I couldn’t do that all winter because it was 5 degrees out, but butt was frozen to the patio, and I couldn’t feel my gas-drenched fingers. So I did the snowblowing the hard way. By hand. And it did not do my neck or back any favors.

Anyway, I felt good enough from Friday’s ACP visit with Le Porcupine I did a lot. More than I should have. But I enjoyed being USEFUL again! I have hope again. Yesterday and today, pain, bearable except at the very end of the work day. But I was USEFUL.

See the Porcupine tomorrow and see what else he’s got up his sleeve. He hasn’t yet told me to take two needles and call him in the morning, so I’m curious.

Friday, April 25, 2008 -

Saw Le Porcupine today. The visit was enhanced by having had a session with the pain psychologist the day before, where she spent some time with me in visualization. It is useful for misdirecting the body and getting it to relax in spite of itself. It can help reduce the pain that is there because of your tenseness, which is no small task, given that you are generally wound up so badly that all your sphincters are tight enough that you couldn’t drive a hatpin up your butt with a sledgehammer. I’m finding that the mind is a very crafty but very dumb thing at times. You can fool it into thinking a lot of things, which is probably how we get through life without screaming out the remainder of our existence.

Anyway, visualization also helps you figure out what’s real and what is stuff that your sado-masochistic body decided to tack on for fun. My guess is that my past years of abusing my body with alcohol are catching up, and now my body is engaged in this passive/aggressive BS and trying to nip me in the ass every chance it gets. Paranoid, yes, perhaps. But it isn’t paranoia if your body really is out to get you.

So, I meet with Le Porcupine in his lair, and being the very nice guy that he is, he listened very intently to what I had to say (which is rare if you are talking about the Western medical profession). He told me to change into my shorts and said “We’re going to lay you out face up first today, and we might try to do those tendons again”. Here I voiced my concern that perhaps, after all, he had been with the CIA (see the entry for April 11). He laughed maniacally with this furtive/nervous glance and a hint of a facial tic. (actually all that was my hyperactive imagination in overdrive - he’s a very calm person)

So, again with the “Does it hurt when I do this?” routine. At one point there were three spots around the left shoulder where the pectoral starts to transition to the humerus where he said “Does this hurt” and kind of had to assume a yes based on my high-pitched grunt and sobbing. Surprisingly, he said “I’m not bearing down hard on those areas - it’s the same amount of pressure as everywhere else.” I’m thinking to myself that it can’t have been right, it felt like Gallagher had hit me with a huge ball-peen hammer in that really small area.

So… ankles, wrists, spot in the meaty area twixt the thumb and forefinger, gut, sides of the neck… everywhere. He walks out saying “Don’t get up and walk around, you’ll scare the other patients.”

What the hell was THAT supposed to mean? Ok, ok… Don’t ask.

Some indeterminate time later, perhaps years, he comes back in and pulls the needles and has me roll over. Same routine as before, poke, OW, poke, eh, poke, YIYIYIYI. Then he hit this one area that leads up to the neck from the shoulderblade area and HOLYJESUSMARYMOTHEROFGOD. Uh-uck-uh-huh-uh-grrrk-uh.

“Tender there?” he says. I would have thought that the sudden pain-induced vomiting would have been indicative of it being an outside the norm issue for me.

So when all was said and done, I got up and damn if I didn’t feel better than I had all week long.

I am now a converted true-believer in ACP.

I will probably get to sounding all righteous like a reformed whore about the whole thing, but I had been so disparaging about it for so many years that if others can potentially be helped by this they should waste no time in finding out. Western medicine had tried many things and though they were all doing the best they could and were all skilled and caring, something fundamental wasn’t getting addressed.

I went from a hard-boiled skeptic who was thinking “Sheee-it, I’ve got nothing to lose” to someone who has hope that full recovery is within his grasp.

At this moment I am still doped up but that is because the muscles that were so FUBAR’ed all this week and some peripheral ones hurt. The hurt won’t go away overnight, but he got them to relax, which is a miracle.

Tues/Wed/Thurs, April 22, 23, & 24, 2008 -

Life sucked. Spent three days trying to sleep off what was presumed to be a migraine but never did sleep it off, and no painkillers worked more than an hour or so. It was horrible. In retrospect, given the absence of light sensitivity, no aura preceding it, no nausea, and based on past experience, I don’t believe it was a migraine but rather something seriously out of whack and pinched in my neck. Godawful stuff, wouldn’t wish it on my worst enemy. Well, maybe a little.

OLDER STUFF - IN CHRONOLOGICAL ORDER

Monday, April 7, 2008 -

First visit. Lots of questions about past medical history, prior accidents (he needed to go get more paper ’cause he ran out - and you can stop laughing now Enas).

Finally it was time to really stick it to me, so to speak. Got undressed to a pair of shorts I brought with me. Sorry ladies, but I do not have Charlton Heston’s buns - best we nip that in the bud right now.

Laid face down on the table. The routine went a lot like this:

1. fingers walk down the spine, counting off vertebrae - no “eenie-meenie-minie-moe”, so it was in some small way encouraging
2. push extra hard to let you know that we have arrived. This is evidenced by the spasmodic twitching of the lower extremities and sudden loss of bladder control
3. request that the pincushion patient take a breath then let it out, and then slam that puppy home
4. repeat as often as desired, because after all, you just can’t have too much fun

Actually, most of the time you don’t even feel a gosh-darned thing. Butterfly burps are more forceful. Based on years of looking at small stuff (I design small mechanisms a lot as an engineer) I’d have to say that the needles are somewhere on the order of 0.007″ to 0.010″ in diameter but I’ll put a set of calipers on them next chance I get. Only occasionally was there a spot where it was uncomfortable and he was more than willing to reposition needles. Let’s put some perspective on this. A tattoo needle is a jackhammer to the ACP needle’s butterfly burp.

Then you lay there with some really relaxing music in the background. First cycle was lots of needles in the mid and lower back. Don’t ask me why, but the heavy sensation and almost but not quite warm sensation I was feeling about ten to fifteen minutes into it was up in the shoulderblades and low neck region. I think I got a bit claustrophobic a few times but it was the kind that isn’t from being in a confined space but much like when I had a full-arm cast put on. It was the feeling of being stuck (pun not intended) there and unable to do anything… more of a case of my control-freak nature being balked. Years ago, the full-arm cast gave me fleeting impulses to chew either it or my arm off to be free of it.

After a half hour, the shrimp on the barbie got flipped (me) and he stuck me in a number of places up front - shoulder, what I think was the gut, maybe an odd leg or two, and the insides of my feet. Another 15 minutes went by.

Ok, that went well. What I noticed when leaving was that I was woozy and kind of almost disoriented - only, “how could you tell there was a difference?” you might ask. Go on, ask it. I’ll wait.

Got that out of your system? Good. Moving right along.

When I got back to work my thinking was really slow (a good metaphor would be “the unresponsive soft and mushy brakes of my mind were affecting performance going into mental turns”). The sensations at work might have been related to overindulgence in sniffing dry-erase markers, but you gotta calm down somehow. Otherwise I’m a man of few vices so cut me some slack, all right?

As of tonight, I officially feel like dogshit (MIL-D-6352-C, Type 2, Class IIIb). Interesting thing is that it is a general malaise that predominates, and yes, the usual core problem areas hurt and a bit more than average. But the nature of the pain is subtly different - AND - I now have greater range of motion but without a corresponding increase/penalty in the pain level usually associated with that motion.

I remain still critical and detached, yet I cannot deny that the procedure has elicited some changes. It is too early to qualify them as positive changes, I think. It would be jumping the gun to say that it was necessarily positive. An illustrative analogy would be to say that by taking arsenic, I see a change so it must mean that things are getting better. Well, no, change is not necessarily better, but it really depends upon the context. Too early to say whether our analogy uses arsenic or ibuprofen.

I am very very cautiously optimistic. Next visit is on Friday.

Tuesday, April 8, 2008 -

Ok, so last night sucked ass. Around 4am I dropped off to sleep. Woke up with an all-over feeling of a hangover, sore, and tender to the touch. Here’s the good part - still retaining the range of motion gain from yesterday. A little bit of pain crept back but hey it’s overall a good change. Not making plans just yet, but I’m looking forward to the chance at having a party to flush the damn things.

Wednesday, April 9, 2008 -

Well, Tuesday was kind of a pisser. Sore as hell but I’m told to expect that too, and that it isn’t unusual. It’s still better than the procedure last August shown in the pic below. After that procedure I was shuffling around like Tim Conway in the Carol Burnett Show when he played that little old man. I had my arm on my wife’s shoulder and she led me into McDonald’s. Got a LOT of stares but I said “Goddamnit, I’m GOING to walk in there and order my food like a *#(%#%* human being.” (and yes, those injections hurt like hell)

click on it for larger image…

Right now I’m medicated and hooked up to the TENS unit - makes for real twitchy muscles but I guess it just tires them out. I know it’s mixing two different things so it becomes hard to tell whether improvement comes from the TENS unit or the ‘puncture, but I’m not willing to be a guinea pig any more than I already am. Science will have to take a partial back seat.

Thursday, April 10, 2008 -

Well, the back and shoulderblades from the neck down are particularly tender, more so than usual - BUT - here’s the interesting part… the nasty vile ill-intentioned headaches (24/7) have tapered off to a background level that I can actually ignore if I’m busy. I mean, there’s still a headache there but it isn’t the chainsaw-through-the-skull-and-it-hasn’t-been-sharpened-lately kind of pain I’ve been living with. This is a had-a-sixpack-last-night kind of headache, which is sort of like the difference between The Rock in the movie Doom (post-infections) vs. Mr. Rogers. It’s all relative.

Friday, April 11, 2008 -

You’ve heard of a Century Ride, right? Where you get on your bike and pedal until you hit that magical 100 mile point and say to yourself “SELF… what sounds nice right now is a big dripping-with-condensation ice-filled ziploc bag for my nuts.” I did a full one two summers ago, got thirty miles through my second one last summer and then said “God, I’m not having fun, my neck is KILLING me.” I stopped at 52 miles. What a downer.

Today was a Century Needle Poke.

I was ready to come in today. Hurting again and wanted to see if Monday was a fluke or not. I’m still very objective/critical of the process and will be at every step.

I lie facedown on the table and the Porcupine says “Ok, put your legs up on these pillows because your feet have to be un-stressed for this one.” He grabs my heel and says to take a deep breath, let it out and he fires off a needle into my Achilles tendon on my right leg. He repeats it on the left. Two minutes go by and…

… here is where I’m going to get wigged out because I did then, too…

… and then all of the sudden I get this burning sensation at the base of my skull at the other end of my freakin’ body . Naively, I wait for the burning to die off or level off, and it keeps getting worse. Now it is like a really freakin’ deep sunburn that goes through to bone - that really bitchin’ tan that went wrong, you know? Then it starts really hurting. I said “Uh, this is like, uh, you know, really uncomfortable.” He says it is important to know exactly how I mean that.

Instead of telling the Porcupine what is going through my mind, which goes something like this: “Ok, it’s like you took sub-zero lighter fluid, pumped a bunch into the base of my skull and simultaneously heated it up with molten lead to the flash point and ignited it” - instead of that clever banter I say “It burns, base of my skull”, “Hurts,” and “Ow.” Brilliant responses on my part, just brilliant. Can’t figure out if I practiced to attain that kind of brilliance or whether I was just born gifted in that way.

He says “Ok, I’m going to take them out - they actually penetrate into the tendon a bit - and we’ll try another approach.”

(TO SELF: THEYDOWHAT??? WHATTHEHELLAREYOUTALKINABOUTDUDE?)

Right… so the needles are out, my neck is still burning like an LA wildfire, and I’m lying there wondering what kind of permanent nerve damage has to occur in order to feel that. He starts rubbing the area where it was burning and I couldn’t tell if it was getting better or not. Eventually it subsided. I’m not exaggerating - imagine running scalding hot tap water out of the faucet continually against the spot and you get the idea - just don’t stop for 3-4 minutes so you really get a chance to feel the love.

There’s fun lurking around every shadowed corner. We go into the “Poke the Patient Until He Screams” phase of the exercise. It consists of poking you in various places rather solidly and focusing on that location if the patient does indeed scream (hence the vivid description). Prevailing theory is that these loci of agony require puncturing.

Blade of the hands, all over the shoulders and shoulderblade areas, the kidneys, the sides, several times in the sides of the neck, base of the skull, etc. The Porcupine, who has an impeccable bedside manner, eventually stops (by design or because he ran out of needles, we’ll never know) and says “you look like a pincushion”. Oh yeah, now I’m relaxed. He’s noticed that we reached that goal and expresses his pleasure

Segue into the next act where once again one must lie still (so very very still), face down, punctured in a bazillion places, and try not to picture a well-filled balloon with lots of needles stuck in it. Other thoughts to avoid are “What if the building catches on fire?” and “If I try to scratch my buttocks will I drive one of these into a vital organ and leave me paralyzed and bleeding to death?” It also isn’t helpful to realize that there is a big lightning storm going on outside and that you have lots of little pointy pieces of metal sticking out of you. Wild packs of angry Chihuahuas represent a clear and present danger as well.

Several conclusions from today’s visit -

1. Horrific burning sensations in the neck can be derived from punctures in the Achilles
   
2. ACP can “unwind” things in your fascia and when it does, muscles can twitch violently and nonstop
3. Neck and shoulder issues can result in earaches. Don’t ask me how because I can’t explain it any better than #2 above, but it is true
4. Extreme lightheadedness can result from any and/or all ACP sessions
5. Ditto for nausea and the the more generalized “I Feel Like Dogshit” Quotient
6. If #1 is true, then we can make two guesses
   1. ACP isn’t necessarily proven, but there is evidence that it could be plausible
   2. Referred pain is a very real and potentially strong phenomenon
7. Western medicine has a lot of answers but it completely failed to explain several complaints I had that were addressed by ACP

Currently sitting in my comfy chair - you know what I mean - the chair that has a nice groove shaped just like your butt that is sensual and secure at the same time in spite of the layers of duct-tape holding it together. Feel kind of rotten at this moment but still have better range of motion that when I walked into the Porcupine’s Den this afternoon; Some pain is worse, others better - but overall, I am told that this is significant in that it shows that what I thought was wrong may not have been what was really wrong. Le Porcupine’s stance on this is that pain was being masked and/or spread around - sort of the physiological version of the shell game that Congress plays with taxes and social security in funding the entitlement mindset portion of the voting pool.

That’s all for now. More tomorrow.

Saturday, April 12, 2008 -

Short update. Still a decent amount of pain, but ok with meds. I was told that pain might seem to move around as it became clearer what the underlying problems were. Indeed, I have a greater difficulty at present with garbage affecting me just below the neck right now. There were parts of today where if I had to sit any length of time in certain chairs (while making Pink Slime with my daughter - I’ll post the recipe) I had worsening pain and encroaching headache again. That is not the point to this post, however.

Prior to any treatment whatsoever, I was at best able to turn my head in 45-50 degrees either to the right or to the left. I was, with little or no discomfort in my neck, able to turn and look behind me, to the tune of 95-100 degrees, almost my full pre-accident range of travel.

I’m still going to be cautious, for two reasons…

1. Will this level of improvement last for more than a day?
2. Will the pain I am experiencing from pushing it too hard ten minutes ago also go away? (Might have tried too much too fast - not an isolated thing and it is actually part of my nature to “push it”)
3. I’m a very very stubborned skeptic - bulldoggishness is in an enginerd’s brains

Thursday, April 17, 2008 -

Refer to Saturday 12 entry. More of same except more pain, but I think maybe that is because I’m trying to do more. Am actually looking forward to being skewered by Le Porcupine. I still have great range of motion but the aches are still there and are not negligible by any stretch. Nice stabbing pains in the neck now and then. This is better in the sense that it is different. Don’t know if it is lifestyle better but it’s still early. I did give my daughter a piggyback ride on Monday. Paid for it - oh how I paid - but it was worth it and she grinned from ear to ear.

This better hurry up and heal soon because the weather is turning and my new bicycle from last year only has a little bit of miles on it. I want to RIDE. Life is too short to let this kind of shite rule it.

Friday, April 18, 2008 -

After much soul-searching, careful analysis, blindly grabbing for alternative explanations, I am forced to concede that in spite of my disbelief in ACP… there might be something to it.

I mean, think about it. You’re trained to trust Western medicine. You see it work time and time again. You go to school, your base knowledge is rooted in physics with real observable cause/effect, chemistry explains things in repeatable ways, great things are done by the Aristotelian methodology.

But then, along comes another idea, one that just rubs your fur the wrong way. It offends your sensibilities. It is a popcorn kernel’s shell wedged between teeth and gum. It is the persistent wedgie that you can’t address in the middle of your SAT testing

Ok, enough metaphors.

ACP… It is hard to believe in. It explains things in terms of fascia and body energy flow, and rarely if ever addresses the concept of nerves. It allows you to be poked in the Achilles tendon and feel like you are being reverse-garotted with a thin band of hot steel and does not engage in apologetics to explain mechanisms beyond the interlinking of fascia in the body. (Le Porcupine may want to beat me if I’m getting this wrong on details but I’m trying to do right by him)

So, by the time I went to see Le Porcupine this afternoon I was anxious. The char-his-head-off-with-the-needle-in-the-Achilles trick was definitely causing some anxiety. Plus, the headaches had come back by Wednesday all throbby and skull-gouging and bubbly - they are feisty headaches that enjoy a good laugh.

So again with the 300 needles. Le Porcupine stands back - not that I can see him when I’m face-down - and says “You look like a pincushion”. I said “Yep, that’s me… Sonic the Hedgehog”. Where did he stick me?

• The neck, both sides
• The base of the skull, two per side
• The back - all over the shoulderblade areas. Where’er I screamed, he struck, and I stopped counting how many times in that region
• What felt like my kidneys - one on each, I think
• The blades of my hands - one each
• The ankles - staying away from those Achilles (thank you God, thank you)
• The waist line, about two inches below the belt line

Again with the really woozy feeling afterwards. Again with the “I feel like yak snot” all-over feeling that I have come to associate with it being done with positive results.

Let me be abundantly clear: It has not solved the pain issues in the neck - YET. It has resulted in a 200% increase in range of motion. If it just takes a little longer to address the pain, I can be patient. Just getting rid of the ever-present evil spectre of a headache, then I am grateful beyond words.

I asked him if it would be possible to, within a month, get back on my bicycle and start training. He said he thought that it was do-able.

In July is the yearly One Helluva Ride in Chelsea, Michigan, and I look forward to it eagerly. I had to crap out at 52 miles last summer because I couldn’t take any more of the pain (a miracle I got that far, really) and it has eaten away at my soul like a black canker since then. What I set out to do, I do not like to be balked at. So this year, I HAVE to do it and will need to start training soon if I want to do it.

Here’s to hope. If you are dealing with chronic pain, take it from me, the absolute best test case - the confirmed skeptic, that it is worth trying.