More ranting about pain, I’m afraid

So to follow on from The current state of pain, here’s where I stand now. I’ve been paddling for about an hour every 2nd or 3rd day. I’m not very fast, and the thermarest pad I’m using to protect my hip/butt makes me very unstable. I tried biking a few times and after the first one I felt great but after the second my butt was killing me for several days afterwards, so I probably won’t be doing that again. Too bad, because Towpath Bike finally got my gear indexing set up perfectly – it’s smoother shifting that when it was brand new.

Knees

Not much change here. I think I’m getting the “stabbing pain” more frequently, especially after paddling.

Ischial Tuberoscopy Area (aka “Butt pain”)

It got good enough that I was actually able to stand a trip up to Canada, by sitting in the passenger seat with the “sciatica pain” cushion and the seat reclined a lot to keep the weight off my butt. Unfortunately I tried cycling twice and now it feels pretty much the worst it’s ever been. Hopefully it will abate over the next few weeks again.

It’s very hard to remain upbeat about this pain. It’s still restricting my activities and enjoyment of life, and OTC Aleve and Tylenol aren’t really doing much. If I forget to take it for a couple of days, I notice the pain has gone from merely nearly unbearable to completely unbearable.

I really like my new primary care physician, but she seems to have seized upon the last conclusion from the doctor who did the pain stimulator implant test who suggested I should try the Mayo Clinic or the Cleveland Clinic. That seems like a real expensive roll of the dice. I’d have to spend some unknown amount of time away from home, and I don’t know how much or how little insurance would cover.

Tooth/Jaw Pain and Headaches

The tooth/jaw pain I reported last time has been pretty much cleared up. The dentist decided the antibiotic he was giving me wasn’t working, so he switched to something stronger. Almost immediately I got a big swelling on my jaw below a tooth two down from the one he’d started the root canal on. I got that tooth removed a day or two later. After the infection died down and I got the stitches out, the root canal was finished and in a few months they’ll implant a socket where the tooth was removed so I can get a replacement.

Meanwhile, in a quest to see why I’m having all these headaches, I got an MRI of my head which showed a very bright thing in one of my sinuses. It looked scary, but when I eventually got an appointment with an ENT he said it was just a mucosal accumulation cyst, and it was nothing to worry about. About 30-40% of people have one of these and most never know it.

But long before I got to see the ENT, the headaches went away on their own. It seemed to coincide with the progress of the antibiotics. They tell me it’s very rare for infection in the lower jaw to cause headaches, but it sure seems like it did.

Diabetes?

While I was dealing with all these other things, I got a blood test that showed that my A1C had gone from 5.7 last year to 10.7 this year. I’d had this year’s blood test done at a local blood lab that I’d only just discovered was near me and I was finding it hard to believe my A1C had gone so completely to hell in just a year, so I asked for a second test which I had done at the same lab I used last year. This time it was 11.1. That’s full blown diabetes. My doctor put me on insulin – at first slow acting stuff before bed, and later I was also put on fast acting stuff before each meal. What a pain.

When I got my gall bladder out they warned me that it might take a while for my digestion to accommodate the lack of a gall bladder. I wonder if that’s what caused the diabetes? I hope so, because it means it might go away again.

Also, I started noticing that I was rubbing my feet against each other, and it seemed like I was doing it because my feet were always freezing cold and the skin on my feet are always tingling. My doctor did some simple tests and says it’s not due to lack of circulation or lack of nerve sensitivity so it’s probably not due to the diabetes. But it’s still annoying.

The current state of pain

Let’s see where I currently stand.

Knee Pain

I’ve had knee pain since I was approximately 14 years old. It’s mostly a diffuse unlocalized pain that is usually moderate but sometimes gets worse. But the worst is this stabbing pain that feels like somebody going jabbing an ice pick under my knee caps. That doesn’t happen too often, thank goodness,

Back then, the usual doctor’s approach was “Take these anti-inflammatories and stay off it for a few months”, which I would do and then restart doing stuff and then it would flare up again. Sometimes they’d tell me to do some stretches and exercises to build up my quads. Never did much except make them hurt more. Over 40+ years I tried everything from physio to having an arthroscope shoved in there to acupuncture, and no physical cause or any form of relief was ever found. But in 40+ years, I’ve also made peace with the limitations it’s placed on me. Gave up running, orienteering, backpacking, canoe tripping, walking too far, and also got more aware of doing things that could hurt them, like sitting with my knees bent.

Unfortunately in the mid to late 80s cross country ski racing was really becoming heavily biased towards skate-skiing, which was just terrible for my knees. I recently restarted skiing with several self-constraints: no skating, no skiing without groomed tracks, no racing, no more than 3 or 4 times a week. (I did 3 days in a row once and got stabbing pains in my knees afterwards.)

Ischial Tuberoscopy Area

This pain (aka “Butt pain”) came on about 2.5 years ago, and steadily got worse all through the 2021 kayak season. By April or May I was stopping in the middle of training paddles to stretch and rest my butt. By June, I was stopping frequently in the middle of races to lift my butt out of the seat. By the last race of the season, I got out of the boat and realized I would never paddle again that season. A month later I was on a long car ride (not driving) and it was so painful I was holding back the tears by the end of it. The pain was a major reason for retiring from work at the end of 2021.

This pain feels like it’s right on the “sit bones”. One of the many doctors or physical therapists I’ve seen in the last year and a bit explained just how complicated that area of your body is – as well as the sit bone (aka ischial tuberoscopy), there are bursae there, your sciatic nerve comes through and several muscles including the performis and quadrilateral femorus attach to your hip right there. It’s a very small area, near the surface and the pain level is directly related to how many hours and how hard it’s being pressed. Unfortunately because of all the things I’ve had to give up because of my knees, this pain has forced me to give up just about everything I planned to do in my retirement, like kayaking, cycling, traveling, visiting family, sitting at a computer, etc.

I’ve spent so much time in the last year seeing doctors and physical therapists and trying all kinds of diagnostic and therapeutic measures. Pretty much the last kick at the can was a spinal cord stimulator trial, but that failed. Nobody will give me any pain meds other than OTC Aleve and Tylenol, which do almost nothing (not nothing, just almost nothing). I’m kind of despairing right now.

Other Hip Pain

I haven’t actually been feeling for a while but I sometimes get an intense stabbing pain in one hip joint or the other. I started walking the dogs twice a day instead of once because walks seemed to help.

Tooth/Jaw Pain

Back in October or November, I had two fillings put in by a new (to me) dentist. He warned me that I had a filling there that was almost too large and I’d probably need a crown there sooner or later. One of those new fillings was painful right from the start – I hoping it would just sort itself out and it kind of did. The pain diminished but then recently got worse. The first thing they did was to correct my bite by reshaping the top of the filling, and that helped for a week or two, but then it got really, really painful on a Friday afternoon. So I suffered through a weekend and when I got back to the dentist he scheduled and then did a root canal (on the same day my stimulator trial was declared a failure, so it was a really great day, let me tell you.) It’s been getting better every day as the antibiotics take hold. But I’m also now painfully aware that I grind my teeth at night and clench them during the day if I’m not thinking about them. The dentist said they’re checking with the insurance company as to whether I’m eligible for a night guard.

Headaches

I get headaches nearly every day, and they often last all day. Sometimes I think they’re eye strain, but sometimes they wake me up in the middle of the night and then they’ll wreck my sleep and be with me half the day. I think at least the middle of the night ones are probably related to the teeth grinding. The day time ones might be as well or they might be eye strain. I’m thinking I might have to see my optometrist again to check my prescription.

Ear ache

I’m not sure why “headache” is one word but “ear ache” is two, but that’s the way it looks right to me.

I’ve fairly recently had a sort of hotness and ache in my left ear. That’s the same side as my painful tooth (and infection) so it might be related. It’s only a small inconvenience so I wouldn’t mention it except for the possible connection to the tooth.

Gross as this might sound, I produce a lot of ear wax. I had to buy a second set of AirPods because the first set got clogged with wax and I kind of broke something trying to clean the screens. Back when I worked at the Ministry of Transportation and Communications (the only place I ever worked that was so big and old-fashioned that they had a company nurse and doctor) the company doctor syringed out my ears once (after I got a complete blockage) and after 3 days of fruitless syringing suddenly this chunk of wax about the size of two joints of my pinky splashed down in one of those weird banana shaped basins doctors like. These days I use a paper clip that I’ve twisted to put a loop in the end to scoop out wax. I’m sure a doctor would scream if I showed them what I’m going but I’ve been doing it for years.

Restless Leg Syndrome?

If you’d asked me five years ago about Restless Leg Syndrome, I’d say it was a made up thing to sell drugs. But sometime over the last few years I’ve found myself with my legs twitching without any reason. If I feel it coming and concentrate on it really hard, I can stop it, but only for as long as I concentrate. As soon as I go back to reading or whatever, it starts up. Slightly annoying.

To sum up

I don’t where I’m going forward from here. My therapist thinks the knee and butt pain are related to past trauma, which is why they’re not responding to treatments. But I’m not seeing any pain relief in therapy either. I keep asking him when I can expect any sort of change, and he just says it’ll happen when it happens.

But while I wait, I keep hoping for physical medicine to prevail. But I don’t see what I can do on that front. I’m also going to start pursuing “alternative medicine” for pain relief.

A weird thought

I had a weird thought the other night. There are a couple of programming tasks on my massive “to do” list that I figured I’d power through in the first few months of retirement before I started spending hours and hours alternating between training in my kayak and touring on bikes with my wife.

Well, life doesn’t always work out the way you intended and none of my todo items has been checked off because the pain that last year made it uncomfortable to sit for too long, and which was just on the “barely tolerable” end of things by the end of a normal length kayak race has now progressed to absolutely intolerable for even short stints at a desk chair or kayak. I’ve spent about 15 minutes total all winter in my erg, and haven’t even put my kayaks in the water. Normally by this time of the year I’d have 30 or 40 hours on the erg and about the same on the water. And I limit my sitting at my desk chair to short periods to deal with bills and paying taxes and the like. Even the library easy chairs are uncomfortable verging on painful these days.

But back to my weird thought. I have a new iPad. I can’t afford a new laptop. So I was thinking that for those programming tasks, what I might try is to install “code-server”, which is a hosted version of Visual Studio Code, on my linux server. This gives you the full power of a pretty extensive IDE available through an iPads web browser. I could try coding up one of those projects using that, maybe using the git integration to push the app to a free heroku instance for testing and debugging. I wonder if that’s doable?

Well, in order to find out, first I’d have to install code-server and make it available through my web server. Oh, what’s this, it appears you need to use nginx as your web server rather than Apache to do that. Well, no problem, I’ve been intending to make that switch to make it easier to use LetsEncrypt to put everything behind https like I should have years ago. Oh wait, one of my sites uses Perl fastcgi. Looks like there’s some extra hoops you have to jump through to configure that. And also convert all my .htacess files into clauses in the nginx configuration files.

Sigh, this is going to be a full in yak shaving exercise, isn’t it? I just wish the pain killers I take to be able to sleep at night didn’t leave me dizzy and disoriented all day, or that they actually killed the pain instead of just knocking me out.

Ending on a high note

Today I went into my place of work, and picked up all the stuff I’d left in and around my desk. Then I spent a few hours making sure none of my non-work info was left on my laptop, especially my password manager and iCloud account. Left my keyfob on my desk. Then I took my laptop to FedEx Office and sent it back to our head office in Connecticut. And that is it. Forty years of work as a professional computer programmer is over.

I counted it up a few months ago when I was writing my resignation letter, and I make it somewhere between 20 and 22 different jobs depending how you count it. That includes 1 month contracts and two 6 year long permanent jobs and everything in between. It doesn’t include two occasions where I was unemployed for several months in a row. Sometimes it sucked, sometimes it was great, but I’m never sorry that I chose this path.

Early on in the history of this blog, I started a series of “bad job experiences” posts. I stopped that after one of the people I’d mentioned in a post found the blog and disputed some of the things I said about it. I realized these posts might show up when I’m looking for work and potential employers Google my name and that might be harming me. I’d much rather they found my 100,000 plus Stackoverflow points or even my pathetic GitHub profile than that.

Weirdly, even though I had fodder for that series even at the best jobs I had, I am hard pressed to find anything like that to write about my last job. I started at Skillsoft on 5 January 2020. By late March, we very quickly transitioned to working from home. Skillsoft management were great – one of the first things they did was immediately give us a day off to recover from the “stress” of the change. I’d had 7 years of previous experience with working from home and I thrive in that environment, but I took the day off, of course. They then put two weeks of “special leave” in our online time manager that we could take for COVID related emergencies, like providing support for sick family members or needing time to arrange things for your children. I think our sick leave was officially “use as much as you need, but we’ll probably need a doctors note if it drags on too long”.

I loved just about everything at this job. It was fast paced without being frenetic, you weren’t pressured to meet unreasonable deadlines, the tech stack was good, the other developers very approachable. Pat, the team leader was always willing to get on a slack call and walk you through any problems you had. Usually I tried to call my team mate Daquanne rather than Pat because Pat had so many other calls on his time and Daquanne was great at explaining things. I kind of hated sprint demo day, I did at my previous Agile jobs as well, but I got through them ok. And when we were in the office, Michelle would make cookies on demo day.

Other than the stress of demo day, the only nit I could pick was my co-worker Uyen who wore a lot of perfume. I’m over sensitive to perfume, and it would frequently make me sneeze even when she was at her desk and I was at mine. I bought a little USB powered fan to try to blow air towards her desk, and I guess it worked but I only had it for a week when we went to full work from home. Anybody need a cheap fan? She also had an accent which made it hard to understand her over Teams, so I didn’t go to her for help unless it was something where she was the subject matter expert, like our Fastly configuration.

We had a small team, and everybody got to work on front end and back end as per our own inclinations. Everybody had their areas of comfort but they also didn’t seem to mind if you picked up a story in their area or suggested a different approach in a code review. I can honestly say this was the best team I’ve ever been on – I’ve worked with other very smart very good programmers, but every other team had a person or two who you just hoped they’d go away and stop dragging down the rest of you. I’m hoping that doesn’t mean I was the drag.

I’ve been looking forward to retiring for a long time. I’m not going to stop programming – I’ve got a couple of projects I want to work on, and maybe I’ll do some bug fixing for open source projects. It sounds like log4j could use some help?

But also, I’ve been looking forward to having more time for paddling and biking. With more time to train, I was hoping I could try to do the Adirondak Canoe Classic. Unfortunately I’ve been having massive problems with pain in my hips and butt. This summer, I actually had to stop paddling during races to lift my butt out of the seat a few times to relieve the pain. And that pain has gotten worse over the last few months. I can’t paddle, or even sit in a car or a desk chair for more than 45 minutes without being in intense pain. In our recent trip to BC, there were several times I thought I was going to scream I was in so much pain. If I can’t find a solution for the pain, I’m not sure what I’m going to do.

That’s also going to impact my other major goal of retirement – traveling with Vicki. Again, I’m not looking forward to long car rides. Flying business class seems acceptable, especially those amazing pods we got on the flight home from BC. And let’s not even think about what the new COVID variant might mean to our booked Viking cruise.

So I guess task # 1 of the new year will be pounding the desk at my doctor until I get a solution to my pain problems or medication to manage them.

Cautiously optimistic on the pain front

This morning, the intense pain I had in the left hip is almost completely gone. I can sort of feel it lurking at the edge, but it’s not actually causing me any pain. The other, more familiar pain in the right hip has been fading slowly over the last two days and I think it will be away (on vacation) quite soon.

In much, much better news, my shoulder is doing better. A little while ago I blogged about how hopeless I felt because when I did my physio exercises, I’d be in pain for 3 or 4 days afterwards, which meant I wasn’t doing them often enough. A day or two later I saw my doctor and he did something where he had me lying down on my back and he reached under me and pushed his fingers into the base of my trapezius muscle and pushed down on my shoulder. That very day, I did my physio exercises and wasn’t in pain the next day. So I erged a bit that day, and I wasn’t sore the next day. So I did my physio, etc. After my business trip (where I didn’t do my physio or my erging, although I did try to stretch), the pain was starting to come back a bit, so my physiotherapist suggested that I just lie down on the floor with a tennis ball under my back, and relax and let my shoulder come back down to the floor. I’ve been doing that (although with a dog toy rather than a tennis ball, because that’s what I have to hand), and it helps a lot, although not as completely as what my doctor did. It might be time to start seeing a massage therapist again. But meanwhile, I’m erging!