Now, we know better.

This is a tale of my mom, and of advances in research and medical treatment.

know better do better quote

Maya Angelou famously said, “Do the best you can until you know better.  Then when you know better, do better.”  This statement can be readily applied to scientific advances in patient care, and in the case of my mother, low back pain.

In the 1980s, when my brother and I were very young, my mom suffered from chronic low back pain.  There was no incident that started her pain, per se, but it was a dull ache that developed into chronic pain over the years.  She was diagnosed with “degenerative disc disease,” and in 1988 had aggressive back surgery, whereby the surgeon fused four of her five lumbar vertebrae together via screws and an eight-inch metal rod.  I have vague memories of visiting her in recovery in an Edmonton hospital, a few hour’s drive from our tiny prairie town of Hughenden, Alberta.  My nine-year-old brain didn’t hold on to many of the details, just that she was in a hospital bed, and I’d never seen my invincible mother, well, not invincible.

She recovered well, and her low back pain was a thing of the past through my ego-centric teenage and young adult years.  And while her history of back pain and surgery didn’t play a conscious role in my decision to become a chiropractor, the irony is not lost on me that I treat patients like her pre-surgical self every day.  I could have helped her, and let me boldly state that she might have avoided back surgery.  You see, she had no radiculopathy (pain down the leg due to pressure on a lumbar spinal nerve), no indicators of disc bulges or herniations, and she was only 38 years old, coincidentally the exact same age that I am now.

However, her back pain is back with a vengeance now, thirty years later.  It’s worsened over the last several years, and she now has trouble being on her feet or sitting for prolonged periods of time, and struggles to lift much more than her youngest 21-lb granddaughter. It’s affecting her quality of life, despite regular rehab exercises guided by yours truly, ergonomic modifications, and other conservative treatment measures.  The thing is, for the last thirty years, her body has compensated for the lack of movement through her lumbar spine, and the segments above and below her fusion now show advanced degeneration.  Her movement patterns have changed, her core muscles have changed, her biomechanics have changed.  Her spine does not move well, and as a cumulative result, she is in pain much of the time.

She’ll tell you she feels lucky.  Lucky that her pain was mostly gone for the last thirty years.  Lucky that the post-surgical ramifications haven’t affected her much until now.  But I’ll tell you that I wish she didn’t have chronic low back pain in the 1980s, because the conservative management today would be far different.

Why do I tell you this?  Because now, we know better.  Now, we do better.  And we are really good at treating low back pain.

lumbar fusion

This is similar to my mom’s spinal surgery in 1988, although four of her five lumbar vertebrae are involved.

*** As an aside, I never use the term “Degenerative Disc Disease” as a diagnosis because I think the term creates fear-mongering and patient helplessness.  Words spoken by a medical professional carry power, a power that I do not take lightly.  Improved semantics = improved patient outcomes.  And might I remind you that there is not always a correlation between clinic imaging results and a patient’s symptomatology…..

This has tipped my balance

My mama guilt has been running high as of late, pun intended.  You see, for the past three months, I’ve been focused on a lofty running goal: the Around the Bay 30K, a Southern Ontario pinnacle event in distance-running.  I’ve done the full 30km race only twice; once in 2004, with the youthful abilities of speed and recovery on my side, and once in 2008, as an under-trained newlywed, happy to be running alongside my husband.  Since then, running has been bumped down my priority list.

But now, two kids and a decade later, it’s been bumped back up.

My kids are a bit older, and we’re beyond the all-consuming baby/toddler stage, so I’ve had the time to rekindle my love affair with my sport.  For the last year, that’s meant mostly solo miles, with the highlight of one run per week with my dear Michaela.  Our ultimate goal is the 2019 New York City Marathon, but I felt my mid-week motivation waning as the cold weather and dark mornings descended upon us in the late Fall of 2017.  When my wheels came off in June last year, I knew things had to change if my New York dream was to come true.  So, in November, I joined a new training group, thanks to the advice of my friend Sarah.  And it’s been a game-changer.

This group does their long runs on Sunday mornings.  Although this is nothing new for me, the difference is that my long run used to hover around 15km, but for the past three months it’s been almost twice that.  More milage means more time required, and my quick-run-while-my-children sleep Sundays have been put aside for the last number of weeks; this has tipped my balance.

Balance is a fine line that I tiptoe along, often trading sleep for other priorities.  I’m sure many of you are in the same boat.   And so, with minimal family disruption, the bonus being other like-minded people who think it’s normal to get up before 5:00, my alarm clock rings at 4:45am on Tuesdays and Thursdays; my run is done and I’m back home before the rest of my house wakes.  The same can be said for my 6am 10k on Saturday mornings.  But as my Sunday group long runs have progressed in distance, I’ve had to rally my village.  My husband has been on his own for breakfast duty and hockey practices, for transporting kids and mobilizing sleepy children into cold vehicles.  My father-in-law has helped juggle back-to-back practices for two kids on two ends of the city and my neighbour has stepped in to carpool when other plans fell through.  The village for my children has become the village for me. It-Takes-a-Village-to-Raise-a-Child-6001

But there’s guilt.

Guilt at missing kid’s activities.  Guilt at putting it all on my husband’s shoulders.  Guilt at asking for help.  Guilt at doing something that’s all for me.

But there’s also joy.

Joy at doing something I love.  Joy at running times that seemed impossible only months ago.  Joy that my children see me value my health and my fitness and myself.

Joy that I didn’t quit when it GOT DAMN HARD.

Bring on the taper, let’s chase more joy.


This is my heart rate data from my last long run in this training cycle (33km).  Most of it was done in the pre-dawn darkness of Sunday morning.

Family Day: Road Trips and Memories

I’m tired today, guys.  If you live in Southern Ontario, you might be feeling it too, as the grey skies and downpours have turned our Winter wonderland into a soupy mess.  But the blue sky and sunshine of Spring is not far off, and I had a great run connors runnerswith my crew this morning that started my day off right (and wet)….

I hope you enjoyed your Family Day weekend, I had a sporty one, just the way I like ’em:

I’m at Burlington Sports & Spine Clinic until 2:30pm today.  See you there!