We're all addicted to the thing that takes away the pain - How modern medicine has failed the First Responder.

I never wanted to get hurt on the job but had always envisioned it happening in some heroic way.  I saw myself showing off scars to a wide eyed audience whilst I recalled how I had just extricated the last preschooler when the car shifted or building flashed.  The reality was that my career was almost ended by a 165 pound panic attack patient that was sure he was dying.  As consummate professionals, we had offered to take him to the hospital for further evaluation, which he accepted.  The rescues we have in our department do not dump so the deck is ridiculously high.  As I went to load the patient into the back, the stretcher caught on the deck.  I arched my back to gain the extra couple of inches needed to push the stretcher into its cradle.

When people say they “heard a pop”, they are not exaggerating.  It felt like I had been stabbed in the back by an invisible assassin, leaving no visible mark.  In 39 years, I had never had a twinge in my back, no less an injury.  It took all my strength to assist my partner in removing the stretcher at the hospital and completing the transport.  The appropriate steps were taken to begin the Workman’s Comp process and I was told to report to the local urgent care clinic.  

After an x-ray and physical exam, I was offered a smorgasbord of pharmaceuticals, from opiate pain killers to steroidal anti-inflammatories.  Knowing that this was a traumatic injury, I tried to get the ball rolling on physical therapy but was told to report back to the clinic in three days.  Upon my return, I was greeted by a different PA who informed me that he would not authorize physical therapy and ordered me to take the meds.  Yes you heard me right, I was ordered to take drugs by a physician’s assistant at the clinic all local First Responder agencies use.  Needless to say, I don’t do well being told what to do by a medical professional that can’t even take care of his own health so I sought out the original doctor and finally got my referral for PT.

Trauma to the body is like trauma to a car.  The damage has to be addressed and the structure has to be rebuilt and strengthened.  I don’t know too many drivers that would be happy with a fresh coat of paint over a smashed up fender.  The human body is the same.  Prescribing medication as a long term fix to trauma is, in most cases, both ineffective and in my opinion, a violation of the Hippocratic oath.  “First do no harm” resonates deeply with me and my employer.  I have a set of protocols that dictate my medical choices for my patients.  If I deviate from these, I put the patient at risk for potential harm or even death.  So why doesn’t a fireman or police officer get this same courtesy extended to them?

I began the journey to heal myself without the chemicals that had been offered as my only solution.  I attended my first physical therapy session and was told the initial diagnosis was a type II tear to three of the ligaments connecting my L4 and L5 lumbar vertebrae.  This caused herniation of the discs and severe pain.  When I raised my leg in a prone position, my vertebra would actually rotate.  At this point, my son was 5 and mad about football (soccer for my American friends).  In an instant, I had gone from the cool dad who would kick a ball around the park with his son to a hobbling shadow of my former self.

You can’t describe what it is like to not be able to pick up your child.  I am a very hands on father and at five, my son loved to be picked up and flung around the room.  I couldn’t kick a ball, run, swim, do my martial arts, do a Crossfit workout or even make love to my wife.  Every type of movement was agony and it took its toll physically, mentally and emotionally.  The temptation to take the pills they had offered me was overwhelming.  Beer became an easy way of numbing the pain and helping me get to sleep but just felt even worse in the morning.  To add to this, I had been taken from my tribe, the job that I loved.  The ability to make a difference in someone else’s life was gone so this just added to a feeling of inadequacy.  I could feel myself slipping into some sort of depression, feeling emasculated by this inability to move as my body was designed.

I got pissed off.  Really bloody pissed off.  Firstly at myself for letting what ever weakness had caused this occur.  Secondly, at the awful lack of understanding and treatment options for a man who uses his body to put food on his family’s table.  This injury was legitimately threatening the two loves of my life; my family and being a firefighter.  I decided to devote every day to not only getting better but getting fitter and stronger that I was before.  I went to physical therapy four times a week, spending an hour and a half per session.  My fellow patients were elderly as Ocala has a large retirement community.  The physical therapist was not used to training occupational athletes so I had to help steer them in exercise choice.  The most basic of movements had become agony and it took going to a dark place to find the strength to push myself through the therapy.  

The treatment would end with a 20 minute ice therapy, where I would sit and contemplated how the next time I would push even harder.  I would also try and figure out what went wrong.  How had I got hurt when on paper, I did everything right.  I found a chiropractor and paid out of pocket for treatment four times a week.  His initial assessment confirmed the damage in my back but also showed how I had developed an excessive curve in my spine.  The treatments began with an adjustment but were followed by 30 minutes of traction and exercises to begin to reverse the damage.  As I sat with my neck in traction, a video would play of a bloke doing what looked like a strange form of yoga.  One day, my chiropractor told me to find the routine on YouTube and do it every day before seeing him.

My progress had been painfully slow up to this point.  My back would start to feel a little better and I would begin to get encouraged.  The next morning, I would wake up, praying that the pain was gone, only to be greeted by the same burning pain.  Getting out of bed was an effort in itself and putting on my shoes was damn near comical.  I started to incorporate the video into my morning routine and was amazed that my back actually felt better after it.  The video was 12 minutes of Foundation Training, a back health routine developed by chiropractor Dr Eric Goodman to fix his own back.  He too had become so frustrated by the lack of options that he developed his own.  After a week, the progress was so good that I started doing it as part of my physical therapy and showed my therapist this incredible system.  My back got stronger and stronger and the pain got less every morning.

After 3 and a half months, I had strengthened my back to the point where the pain was gone and I could complete the tasks required of a fully functional firefighter.  Three months later, I competed in a 9/11 tribute charity event to honor the fallen, deadlifting 225 pounds for reps.  This wasn’t a superficial removal of pain, this was a legitimate fix to an injury that could have forced me to retire from the profession that I know I was born to do.  I managed to convince my department to send me to California and I became certified in Foundation Training.  Upon my return, I gave the class to every single firefighter in my department, giving them the tools to avoid the terrible journey I had been on. 

I had learned that this injury came from muscle imbalance placing the joints in biomechanically horrendous positions.  From sitting my entire life, my pelvis was tilted, my hamstrings and glutes were short and weak, my shoulders were rolled forward and my neck craned over my chest.  After six months, my posture had shifted completely and I was pain free.  I could squat properly, deadlift with good form and most of all, do anything a 5 year old asked me to do.  The journey has not stopped.  The anatomical damage will always be there, like a scar, so I have to work on my body like the athlete a first responder should be.  I sought out Julien Pineau of Strongfit to further challenge me, especially carrying the heavy loads a firefighter is required to do.  He found more imbalances and helped me further strengthen what was weak.

I can honestly say that I move better as a 42 year old man who got beat up in both firefighting and martial arts that my 21 year old former self.  The road the medical professionals I initially was sent to created a path to failure.  Without the exercises I used, my back would never have healed and the pain would always be with me.  The drugs they prescribed would be the “first one is free” slippery slope to opiate addiction.  In the 12 years of my career, only about 20% of the overdose deaths I ran on were from illegal street drugs.  The remaining 80% that tore the hearts out of the families were from pills prescribed by a physician, legally under our current “healthcare” system.  Now I’m not blaming all doctors but I am underlining the fact that the current system is not working and something needs to change.  I have brother firefighters that are addicts and some who died from this affliction.

As first responders, we need to understand that many injuries are treatable without medication or surgery.  This is a bitter pill to swallow as it requires patience.  The body is amazing but it needs time to heal.  You need to remove whatever imbalance caused the injury so it doesn’t happen again.  There’s no point going to a chiropractor if you’re not addressing the imbalance that caused the injury in the first place as it will merely repeat itself the moment it can.  We have to look at ourselves as athletes because we are.  Athletes have a team around them.  Nutritionists, trainers, chiropractors, coaches, and more.  If you cannot physically find these people then begin to educate yourself and become your own advocate.  Question everything you have been taught up to this point and start to see how it affect you personally.  If your doctor is morbidly obese, maybe he or she is not the best person for wellness advice.

William Osler said “one of the first duties of the physician is to educate the masses not to take medicine”.  Medicine certainly has its place and the drugs I carry on my engine can be extremely effective.  Medicine for chronic illness and injury, however, results in a lifetime dependency on chemicals.  In the realm of pain killers, this can lead to the destruction of families.  It’s time we started challenging this system as first responders.  When you get hurt, research how you can heal the injury without surgery or medication.  You’ll be surprise how many injuries can be healed without chemicals or traumatic surgery, getting bones glued together ensuring a lifetime of immobility and arthritis.  You are your own advocate and the more you understand about your own body and the treatments available, the more power you have over your own health.

Next week’s Podcast will feature Julien Pineau and Dr Eric Goodman will be on the show in January.  Please listen to these great teachers and begin the road to healing your injuries and preventing any future ones.

Take care out there brothers and sisters.