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Fighting the Fight

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:29 AM in Back Surgery and Neck Surgery

My name is Josh and I am currently in recovery from an L4-S1 Fusion. I am 34 years old and I can tell you this surgery is by far the most difficult thing I have ever had to deal with. Since my operation about 8 weeks ago I have suffered from severe sleep deprivation. Tonight is particularly bad so I thought I'd share my story:

My back pain began when I was 22 years old. I was very much into weightlifting and injured myself hoisting up a 405 pound barbell. The exercise as I am sure some of you are familiar with is called the deadlift. My technique at the time was terrible and I performed no warm up. In other words, I was just asking for an injury. At that time in my life I just followed the older veterans in the gym without much thought. Because I was young and strong I never gave any thought to the consequences. In retrospect, I was quite foolish and my actions would initiate future years of back pain and turmoil.

The pain from the deadlift started the next day and I noticed that I had a tremendous amount of pressure above what seemed to be my tailbone. I didn't give it much thought because I thought it would go away. Eventually it did, but I was left with a dull, yet constant ache to the left of my lower back. I continued my daily activities and looked upon my lower back as more of an annoyance than a disability.

Over the years I would periodically injure my LB again doing either squats or the deadlift. It did not seem to matter that I had learned how to do these exercises correctly. It seemed that the initial trauma to myself at 22 had not been healed and the residual damage would be triggered now and again by these exercises. However, because these exercises were so productive in many ways I continued to do them. You see, they did not injure me for the most part unless I went incredibly heavy or had a lapse in form. In fact, I felt as if these movements did much for strengthening my LB and could be viewed as "injury proofing" tools.

Well, when I would occasionally re-injure myself the LB pain would be more pronounced and chronic. Despite these setbacks I continued to push through my LB problems and move on with my life. I was determined not to let my LB stop me from accomplishing my goals.

During this time I had begun to work as a personal trainer at several commercial gyms. I thoroughly enjoyed meeting new people and helping them to become healthier. I studied human anatomy, movement, exercise physiology, nutrition, stretching/yoga, sports psychology, and any other subject matter that I thought would help me to be a better teacher.

I was very strict with my clients so as to make safety a priority. My number one goal was to prevent injuries in any of my charges ...... especially their lower backs. Over the years I was able to successfully rehabilitate dozens of people - many with severe LB issues. Many of these people had failed to derive benefit from formal physical therapy. I was making a name for myself as a trainer, but was frustrated with my inability to fully rehabilitate myself. I had dropped the squatting and deadlifting at this time. Nevertheless, my back condition magnified and I decided to see a doctor about it for the first time when I was 29.

The doctor ordered an MRI and on my return visit said I had Degenerative Disk Disease. I was shocked that my image did not indicate something more substantial such as a herniated disk. He recommended physical therapy for me which I passed on because that was pretty much what I did for a living. I explained that my injury was not related to a muscular imbalance, poor flexibility, or postural problems. At that time I was a lean and athletic 6'1 165 pound man. I had a washboard stomach and clearly delineated para-spinal muscles. Didn't matter, the doctor said I needed to work on my "core" muscles. I explained to him that my muscles were strong, but some damage in my LB was preventing me from using them. I reiterated that my profession requires me to help people develop their "cores" and that I had rehabbed many people's LB injuries over the years. However, the programs I used to help others were failing me. If I did even light "core" exercises I would have back spasms and walk improperly for sometimes weeks at a time.

I never went back to him and would not reschedule a doctor's visit for about a year. By this time a doctor client of mine took an interest in helping me and suggested I see a popular University of Pittsburgh Neurosurgeon. With this doctor I had another MRI, multiple x-rays, a cat-scan, a bone-scan, a sonogram, and a fluroscopy. Potential diagnosis ranged from a slipped 12th rib that may be impinging on my intercostal nerve to an anomalous transverse process. Of course DDD was still in the mix and a possible calcification. In the end I saw a cardio-thoracic surgeon for the suspected "12th Rib Syndrome" and two other orthopedic doctors at the Cleveland Clinic. None of these doctors could figure out what was wrong with me. Other than degenerative conditions in my spine there was nothing they could identify as a pain origin.

Frustrated and convinced that no one believed I had a legitimate LB problem I decided to give the doctors "a rest" for a while. During this time I continued to exercise as best I could. I tailored a program around my injury and bought any equipment I felt might help me recover from this chronic pain. I had started my own training business and had some of the best equipment around. I had machines that would work both the stomach and lower back muscles. Of course, these exercises continued to help my clients, but they would only exacerbate my symptoms.

In addition to my exercises, I sought out trigger point therapy, rolfing, deep tissue massage, chiropractic, inversion therapy, disk injections, anti-inflammatories, acupuncture, and anything else I could think of - nothing helped. I even tried just walking and yoga without my normal strength training. I couldn't seem to find an exercise modality that alleviated my pain.

My back took a turn for the worse at 32. I was doing a leg raise for my stomach and I felt "something click" in my LB. The pain was terrible and I was not able to walk very well. Every time I would extend my left leg to take a walking step there would be severe pain in my LB. It felt like there was a rope tied from my big toe to some nerve in my LB. Yet, I never really had sciatic pain in all of these years - my LB pain was more localized.

The fact that my LB pain was more localized concerned me. I always felt that if I had sciatic pain the MRI would have picked up a herniated disk. Then, with a clear cut diagnosis I could have undergone a disectomy. Unfortunately, because none of my imaging tests discovered anything, the doctors seemed rather dismissive. I have always felt that because I was young and in good shape the doctors did not believe that my pain was so severe - almost like some sort of reverse discrimination.

I would not see another doctor until I was 34. I saw an orthopedic doctor who looked at my x-ray and said that L5/S1 was collapsing and that this was the cause of my pain. He said that he believed when there was nothing left of the 5th lumbar disk that I would have complete pain relief. He said he suspected that within 5 years I would be fine. I asked him about a disk replacement and he said I was too young for that procedure. He said the replacement would not last 10 years before I'd need another one. My response was basically who cares. If a disk replacement ceased my pain for 10 years wouldn't it be worth it? Besides, in 10 years wouldn't technology and medical advancements provide replacements that could last 20 or even 30 years? He said if I went to enough surgeons that someone would do a fusion. I asked him if a fusion would help and he said he did not recommend it. When I asked him why he referenced adjacent segment disk disease and explained about other levels breaking down requiring more surgery in the future. When I asked him, despite the possibility of that happening, if he thought a fusion might help me with my back pain he did not give me an answer.

So, a couple months later I went for a 2nd opinion and that orthopedic doctor told me that with my history and no relief that yes, a fusion might help me a lot. I asked him if a fusion has helped people with just localized LB pain as opposed to sciatica and he said yes. The results are less predictable, but I think in your case it could help. He also said that if it didn't work I would probably be the same - no worse than I was pre-op.

Well, I am almost 2 months post-op and I am not very pleased to say the least. My pain is much worse than before surgery and I have to resume work. I have continued to pay all of my business overhead since my operation and cannot afford to take anymore time off. I do not feel ready at all to resume work, but I don't have any other options. I plan on instructing my clients verbally and do not intend to lift any objects.

I can say that my recent bout of insomnia has only added to the stress. Because I live alone in an apartment I have had to "weather the storm" with very little help from others. Trust me when I say I welcome any and all help!!! My journey alone through this ordeal is certainly not mentioned to brag to anyone. My story is not unlike many people on this forum and I sincerely empathize with others who are suffering. I believe that in my specific case I may have made the worst mistake of my life. I can sense myself spiraling down into a deep depression. I can only hope that with time I will slowly heal and then I can rehabilitate myself to some meaningful quality of life.

Thanks for listening,



  • First off let me welcome you to Spine-Health. Trust me when I tell you that you aren't alone anymore, at least not cyber-speaking. So many of us live with chronic pain caused by one thing or another and have understanding that outsiders simply can't.

    One thing that I noticed is that you continue to blame yourself over and over again. There comes a time when you must simply accept what has happened and move the focus to healing. My pain began when I was hit by a semi and while I still have anger and anxiety issues because of it I know that I can't heal unless my full attention is on the recovery and not the cause. You're practicing common sense in assuring that you won't make the same mistake again and that's all you can do.

    The self-employed of the world are amazing. I owned a business for a long time and know how hard it is to take time off. Please don't overdo it though. Your clients will understand if you need to sit for awhile or even lie down. Do what is best for your healing FIRST. I know that with lower back surgeries that there is a strict no bending, lifting or twisting guideline and given what you do for a living that is going to be hard to follow. Ask your doc is a brace is a good idea to keep you on track while at work.

    Remember that we're here for you and are a post or PM away if you need anything. You don't need to feel alone in this journey any longer.


  • you know the commitment it took to train, the blood sweat and tears it took to change your body to where you wanted it to be and look, that doesnt change, your body and mind connected and adaptation happened.
    now when you fight this, remember your emotions and frustrations, they will help you when your get back to your feet and help others with their journey.
    i hope you find the way through, yoiu got the drive and determination, I think youll do fine,
    come by and see us and keep us up K?
    William Garza
    Spine-Health Mod

    Welcome to Spine-Health

  • I'm so sorry you've had such an ordeal. I know how frustrating and depressing all these limitations can be, especially if you are used to pushing yourself to the extreme. I would encourage you to consider some therapy for depression, for chronic pain depletes the brain of the feel happy chemicals and causes a chemical type of depression. I have suffered from this myself, and felt like it was my own weakness that caused the depression until my PM doctor talked to me about it. After several weeks on therapy, not only my mood, but my pain improved to a tolerable level. I hope you don't take offense, I really just want to help. I think it's worth talking about, at least with your doctor.

    Also, I agree with what you said about running your business. I, too, own a small business and my overhead doesn't really change when I'm not there working. It adds a tremendous amount of stress to your recovery. I hope that you have supportive friends and family like I do.

    Hang in there and I wish you a better tomorrow. Keep us posted of your progress. We want to support you through all of this.

  • Welcome and let me start by saying you are not alone in your fight. I too went to numerous Dr for 2 1/2 years for really painful lower back symptoms. Thought I was loosing my marbles casue no one could fine anything wrong. I too went through every test , treatment, therapy, accupuncture, drug therapy, injections. Finally went to a spine clinic 4 hours away and they found 3 torn discs. They wanted to do three level fusion. I got scared and went for second opinion. I had a two level discectomy and fusion on Dec 11. I know what you are dealing with. I have a small business and know what it is. Fusion is long and I am not yet able to bend lift twist or anything. I wont even start therapy for 6 to 8 weeks. Depression is something that will not help your healing. My adivce is to go and get some short term help from Dr. Back pain is the number 1 reason for depression, and I had to go on meds to keep going. It is not forever, just a way to be able to cope. I have pain, and am still on some fairly heavy meds. But everything is going the way it should, and when I went into this I was told it could take up to a year or more. Nerves were damaged and they are the slowest thing in body to heal. Keep your chin up. It will get better, and you need to allow yourself time to heal. You are early in your progress, I remember how I felt the same as you. It will get better. You just need to keep the fiath and do not over do it. You will sometimes feel like you take one step back for every 2 forward. It is normal to have good and bad days. But trust me, you are early in reocvery. Allow yourself time. Good Luck and if you want ant any time, to talk. PM Me. I will be here for ya!
  • You've gotten some good tips from others. I have a specific question: where is your pain now located? If you could go into more detail about the current location and type of pain, it would be useful.

    Are you on any meds for the pain? How did you decide on the surgeon who eventually did the fusion?

    Hope you are feeling a tad better today. The healing from fusion is a LONG process and takes a great deal of patience. Some people are lucky and find immediate relief, but it sure seems like the majority of us struggle for a long time on the road to recovery.
  • Sorry that you are in so pain. While I have never had a fusion and don't know the kind of pain you are in, I am empathize with you about being depressed due to chronic pain. Please get help for your depression. You may or may not need medication for it. Or you could be on antidepressant until your pain goes away.

    I hope your doctor will find bette solution to your current problem. Or maybe go to another doctor.
  • Hi Josh, I am sorry to hear about your ordeal! I can't believe that it has gone on this long and you are still dealing with pain and more pain than before. I am almost 4 weeks post op from acdf c5-6-7 and feel a lot better but I am getting impatient with my recovery so I can only imagine how you feel. I am new to this message board stuff but if you just need someone to vent to pm me anytime. I also live alone so I know how hard it is when you are on your own. I do have some family to help so that makes it better but sometimes it is depressing to feel helpless and by yourself. Hope you get better.....hang in there.
  • Like many here have said, complete recovery can take up to 1.5 to 2 years. Once you reach the 2 yr mark, I think whatever recovery you have at that point is probably it. YOu have a long ways to go. Take whatever pain meds you need for now while you are healing. Are the pain meds not working? Do you need a better pain mgt doctor? With enough pain meds, you should be able to sleep at nights. All too often we have doctors who dont prescribe thr right medication or the right dosages.You;ll need pain meds for quite some time till recovery. FUsion is a long road to recovery. YOu had to do what you did, just as I knew I too had no choice as I was getting to the point of life not being worth living with my pain. DOnt regret taking action to fix the pain. 2 months is nothing when dealing with fusion.

    Good luck!
  • I appreciate the kind responses from everyone. To answer some questions:

    My current pain is still localized to my LB. Before my surgery I had constant pressure on my lower spine. It felt like I had someone standing on my LB all of the time. I also had pain to the left of my spine. After surgery the pain is in the same place, but worse. I now have pain on the right side too.

    I should probably mention that my left leg went numb about 6 weeks after surgery. The feeling is slowly coming back and is more concentrated in my foot and ankle now. Instead of complete numbness like before I have "pins and needles". Of course this is a little disconcerting because pre-surgery I had no sciatica. So, I can only assume that the surgery may have aggravated some nerves in my LB. I hope it goes away over time.

    Regarding pain meds, I stopped taking them about 10 days after my surgery. I had been sent home with Percocet and would take 20 to 30 mg a day (in the Hospital I had been on Dilaudid). I was having trouble going to the bathroom despite taking over the counter meds to combat this problem. I had not gone to the bathroom for about a week after my operation so I decided to come of the pain meds completely to try and rectify the problem. A day or two later I was able, with much effort, to resume going to the restroom. Another reason I have not been taking any pain meds is I am afraid of becoming addicted to them and I also want to feel what is going on in my body. After I stopped taking the percocets I was introduced to all kinds of new pain that had been absent before. I am certainly not a masochist, but I feel that the meds would mask my pain to the point that I might actually injure myself more. In other words, the meds might have created an illusion I was doing better than I really was and as a result I'd push myself in a potentially dangerous manner. Please keep in mind I am not against pain medications for people. These rationalizations were just my own "two cents" so to speak.

    The surgeon I chose was referred to me by a friend. He worked out of a well respected and well known Orthopedic practice in my city. My friend had cervical problems for years and like me was dismissed by many of the doctors. He had injured himself playing hockey many years before and had ongoing pain before this particular doctor operated on him. Before his operation he had seen maybe 5 or six different surgeons over a period of years. I thought if he helped my friend (who had complete pain relief from a 1 level cervical fusion/disectomy) that maybe he could help me.

    I appreciate the support and caring from everyone. I hope you are right and in a couple years my body will "stabilize" allowing me to have a drastic reduction in pain. Equally important is the ability to do basic activities such as laundry and grocery shopping which I am unable to do right now. I would like my body to have some level of function.

    As far as depression and therapy I value your insight and suggestions. It's interesting that you should mention this because years ago I was seeing a therapist and would only discuss my LB pain with him. He would always ask me if I wanted to discuss anything else with him such as work, family, or girls. I would always dismiss these topics and continue talking about my pain and the willingness to beat it. I would bring in anatomy coloring books and discuss theories I had about why my LB hurt so much. Eventually I stopped going because he told me that he did not feel equipped to deal with my specific situation. His reasoning was that someone with chronic pain needs more attention and I should seek help from a pain clinic. Despite what he said it helped me just to have an hour once a week to vent about my back. I think that frustrated him a lot.

    Thanks again,

  • Josh, I am nearly four months post-op but had a tremendous amount of work done, and am older (49). Listen, 2 months is very early in the game. You had muscles cut, nerves cut, tremendous violence done to your back. It will take time. Don't push too much. And at this point, don't worry about addiction, you aren't taking too much. STAY AHEAD of your pain--take pain meds early, before the pain becomes unmanageable. Use Colase or Senekot to help with the bathroom issue (or Miralax). If you can get pain under control, you will break the pain cycle, and start feeling better.
    Depression is normal when dealing with post-traumatic stress disorder, which is what all of us are dealing with after surgery, especially if we are still in pain, or worse pain. Discuss going on a mild anti-depressant, it MAKES A DIFFERENCE, even if just a little.
    Using modern meds to get you back on track and healed up is nothing to be ashamed of. And in a few more weeks, you will see the light at the end of the tunnel...
  • I agree with Dana that you should take your meds because I was told that prolonged pain would prolong recovery and it is beneficial in getting you on your feet again. I understand your concern about addiction, but if your are taking for pain only the chances are very slim. I also had L4-S1 fused last summer and understand what you're feeling. The pain is intense and recovery is long, and it takes a lot of patience and persistence. My case is different from yours because I was very deconditioned and led a sedentary lifestyle before my back went out and 2 discs were herniated. I didn't do anything, it just happened. Here I am a veteran of 2 surgeries, 3 years later and I still struggle with chronic back pain and permanent nerve damage. I know you can overcome this because you are a very fit and health individual. It is still early in the recovery process, but I think you'll do well in time so keep up the fight. Take care of yourself and I hope you progress each day :)
  • These things take alot of time to heal sometimes. Manage the pain the best you can for now and try and be patient. If after 4 months post op you are still feeling the same,...then get some answers. An xray/mri should be able to tell your surgeon if everything operatively went well. Nerves on the other hand, are tricky little bast*rds that heal on their own timetable. I'm dealing with that myself. Take it day by day and keep your spirits up. This to, will pass! This forum is full of many supportive people who will let you know you are not alone. They have great insight and will offer you as much help as they can. They really do care because they (we) are going through it also and can empathize with you. :)
  • Well, I see my surgeon in about 2 more weeks for my 3 month checkup. I assume he'll have x-rays taken to see if I am fusing yet.

    My surgeon has his patients wear an external hard brace for the first 3 months post-op. My brace actually had a leg attachment that made movement especially difficult. I found the brace helpful for about one month after the operation and then discontinued it's use. I removed the leg portion after one week and continued wearing the waist corset for another two. At that time I felt the brace was more of a diservice in my recovery than an aid.

    I know that use of an external brace after fusion surgery is an often debated topic. Before my surgery I extensively researched the use of such braces and found how many doctors do not believe they are necessary. The reason being that the core muscles become overly dependant on the brace and hence decondition over time.

    When I first got home from the hospital I was told I only had to wear my brace if I was leaving my apartment. I soon found how much harder my stomach and lower back muscles had to work just to stabilize me in an upright position. I decided then and there to stop using my brace as long as I maintained an upright position. In other words, I discontinued wearing my brace, but all of my actions were executed as if it was still on me (no BLT).

    As well, my surgeon doesn't allow physical therapy for the first 3 months (just walking). However, by week 5 I decided to "test" myself a little bit. One day, while in tremendous pain, I gently layed down on the floor and did some mild lower back stretches. I pulled one knee at a time to my chest and held for quite some time. Next, I pulled both knees into my chest making sure to be careful. My range of motion had, indeed, been compromised by the surgery and I could only get my knees so far. At that time I wasn't sure if my inflexibility was from the hardware or surgical inflammation/scar tissue. After the double knee to the chest stretch I gently rolled over onto my stomach and propped myself up onto my forearms. Consequently, putting a small arch in my lower back that I didn't think would be destructive to my fusion.

    Well, at about 10 weeks I have continued to carefully do these strecthes. Sometimes they are painful to do, but usually I feel BETTER after having done them. My instincts and body awareness tell me it is helping me to heal faster. I think the they have helped to stretch the surrounding musculature that had been damaged in the operation and to break up some scar tissue. Over the weeks I have regained some of my range of motion. I later added some hamstring, quadricep, calf, and hip flexor stretches which have helped to loosen me up even more.

    In the last week I have added pelvic bridges to my stretches while lying on the floor. I set a kitchen timer for 5 minutes and do them for that duration slowly. I make sure not to use momentum and I hold each repetition for several seconds at the top of the movement. These work the LB in a static contraction - meaning I am not arching or rounding the spine. I should mention that the stretches I chose were picked for the same reason - they allow little to no movement at the spine.

    In addition to these exercises I continue to walk which I find helpful. I might add the stationary bike one time a week in the future. I don't exercise everyday because I think doing so would impose on my healing. I much prefer to do my exercises 2 to 3 days a week with walking occuring everyday. Sometimes I force myself to walk up to my apartment rather than take the elevator (I live on the 7th floor) so my legs get some added tension beyond simply walking - it just depends how I feel that day.

    I have NOT executed a full squat or bent forward much at the waste since my surgery. I don't dare do these things until I am told that a solid fusion is occuring. I definitely feel like my lower back muscles could use some rounding, but that would be too dangerous right now. I hope in a few months I'll be able to touch my chest to my thighs while seated (like I'm trying to tie my shoes).

    I still cannot do my laundry or grocery shop for myself. I usually eat out so as to avoid lifting anything or having to carry items more than a few minutes. Driving resumed last week and has been somewhat challenging, but I am getting a little better each time.

    I am still having trouble sleeping (it is just before 5 AM here), but I push through. Sometimes Melatonin and Advil PM help, but it is inconsistent. After days of sleep deprivation I finally slept 17 hours last night! Starting work again last week should get me back on a routine in the near future. I worked about 25 hours and it was more difficult than I'd like to admit. If I want to keep my business I don't have much of a choice right now :)

    I took the advice of some fellow spine-healthers and made an appoinment with a psychologist. My 2nd appoinment is in about 4 hours - we'll see how it goes. He seems pretty cool and I think he cares.

    Thanks for the kind responses earlier and all of the support. For anyone reading this, I hope you continue to cope positively with your adversity and your pain is managed.

    Best Regards,


    *** BTW, my decision to deviate from some of my doctors orders was MY choice - good or bad. Do not look at my decsion as a blanket prescription to exercise prematurely or to not wear an external brace. Everyone is different and in my specific situation I felt these decisions would benefit ME. I think it is always better to err on the side of conservatism rather than take uneccessary risks.
  • dilaurodilauro ConnecticutPosts: 9,848
    Based on the information you have provided, I can picture what I have seen many times with people that are in the body training and physical therapy arenas.
    They look so deeply into what is wrong, why, studying charts, etc to find answers that sometimes they do not see what is there.
    It was good to see that you were determined to get some answers to your lower back problem. The Degenerate Disc Disease probably was no surprise. That just naturally occurs over time since it is basically the aging of the spine. There are a few ways that happens earlier in people and more severely. Trauma being one of them. I cant help but wonder if some of those earlier days in weight training that you did more to your spine that would just showed up.
    Having nerve pain after your surgery when you didnt have it before hand, could point to something happening during your surgery.
    As you have read , fusion can take time. You need to have patience and allow the body time to heal. One of those ways is the use of pain medications. When you are in pain, these medications help you so that your body isnt constantly combating high levels of pain. When it does that, it is more difficult to start the healing process.
    Like you indicated, it was your decision not to stay on with those pain medications. That is something I hear a lot from personal trainers and therapists. And their rationale is similar to yours, they didnt want to mask the problems.
    Two months post op is still so very early in the recovery process. Some folks can take a long time to heal, it is not that uncommon to hear about 12-18 months of recovery before things sort of get back into place.
    The question about using a brace or not is also a very
    delicate concern. For some patients, without it they will not only extend their recovery process but risk potentially new damage. Surgeons may differ on their views about braces, so its hard to say positively one way or the other.
    My brother has been a personal trainer for over 20 years and when he first had back problems, your story and his were almost identical. He fought back from using the pain medications and turned away physical therapy since he felt he could do it himself.
    Physical Therapy is a lot more than stretching and some basic strengthening. The other aspects such as heat/ice therapy, ultrasound, etc all help in the overall objective.
    You are still very young and hopefully the fact that you took good care of your body will help in the long run
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I appreciate your advice and concern. I plan on going to formal physical therapy in the near future to see what they can offer. I believe that some of the heat and massage type therapies can have value in my recovery. I would like to have some rolfing done in the future, but it would be too intensive right now. I believe the deep work on the muscle fascia could help in my recovery around the surgical site.

    I believe I speak for all of us, Ron, when I say how thankful we are for your guidance and support. I see you offer sound advice, help, and genuine empathy to all posters. It takes a lot of valuable time and energy to do this - I commend you :)

    Out of curiosity whatever became of your brother and his chronic back pain? Was your brother, with his training background, ever able to help with some of your pain?

    Best regards,

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