Matt Cahill's blog
I had the pleasure of speaking with Richard Crouse for a nationally broadcast interview about Radioland. It was aired live last Saturday on NEWSTALK 1010, however now there is a permanent link, for anyone who would like to hear it. I really enjoyed the depth of our discussion and appreciated his attention to the mental health angle of the book.
As a therapist I’ve had the honour of sharing many a client’s experience during the COVID-19 pandemic gripping the world since early this year. It is one of those rare experiences in my profession where everyone — client, client’s friends/family, and therapist — are all in the same situation, facing the same invisible antagonist.
One thing which began to sink in for me, probably around August where most people, including myself, despite being able to enjoy the peak of summer and the freedom to leave our homes and workplaces, each day and each week seemed to be a repeat of the last one. At the worst of times it certainly felt this way to me: Groundhog Day without the humour or inevitable expectation that, whether we like it or not, credits will eventually roll. Even with the chaos of the American election and the clown shows of our respective provincial governments’ COVID preparations as distractions, it became clear to me that part of our misery was in the sense that time itself wasn’t moving despite us objectively knowing that it was. And while it might have seemed an interesting question to ponder theoretically back in August, now, in mid-November with the cold weather setting in and winter’s icy grasp not far from us, I think it’s important to share something: we have to make plans.
One thing I have both heard and repeatedly felt is that there is nothing to look forward to. Yes, there are a few vaccine candidates coming down the pipe, but I think it would be unwise for us to lull ourselves into believing that anyone who isn’t a frontline medical worker or resident of a long term care home is going to see a needle until at least next summer (please prove me wrong). Until then there is, in other words, no horizon line for us to align our sense of perspective, our direction. And so, to combat this sense that we are all floating in a timeless vacuum — and, most importantly, its ensuing depression and existential anxiety — I strongly recommend that we find ways to look forward to things, even if we have to search them out. This occurred to me when I’ve spoken with people who were moving, either because they were taking advantage of lower rent at another location, or just getting out of the city for better real estate options elsewhere. I found myself feeling jealous. I was jealous because I could see that for the next few weeks or months they could set their minds to the myriad of things-to-do and anticipate when you’re changing your place of primary residence: insurance, mail forwarding, organizing with a moving company, painting the kitchen, new mattress, reimagining the work/home space. They had, in other words, things both mentally substantial and hands-on practical to look forward to, which also happened to be novel and even open-ended (all the things you want to do before you move to a new location vs. all the things you actually have time to do). It didn’t need to be sexy, or even expensive. And I could see the relief that this presented for them.
So how can we transpose this upon our present moment, say, for the rest of us who don’t have the ability to make such a broad change in our lives? Here’s what I might suggest: look at your calendar and start to think of some thing or activity that will allow you to look forward, that you might feel engaged with, so that you can feel involved. I just received a Toronto District School Board guide in the mail, filled with online continuing education courses ranging from learning public speaking to cooking Afro-Cuban cuisine. Now, imagine enrolling in one of these courses and marking down six subsequent weeks’ worth of regularly-scheduled events where you get to look forward to learning something new — wouldn’t that add some structure to your seemingly structureless life? Books are flying off the shelves of many a book retailer — would a monthly online book club organized between you and some (carefully chosen) friends be a good idea? Maybe instead of shaking your fist at our hapless politicians on Twitter you could get involved in the organization and publicity of local community events, political or otherwise. Perhaps things like these would help us feel involved in a world where it’s hard to feel seen and heard because of all the sturm und drang around us.
I suppose what I’m suggesting is finding ways, big and small, to create a series of horizon lines for ourselves — individually and as a community — until the day comes when we will be able to safely walk out of our homes and see each other, and hold each other closely. I would like that as much as the next person, but until then I feel it’s important, from a mental health perspective, that we find ways to keep ourselves focused by finding (or creating) structure for ourselves.
So, according to the chiropractor I was referred to, I have an irritated disc [“subacute grade III mechanical low back (irritation of the L5/S1 disc, affecting the L5 nerve root on the left”)]. It’s nice having an answer. It’s also nice to hear that, contrary to what my impatience tells me, I’m doing very well (though I’d leave out the “…for your age” part, ahem). Basically, she said to keep doing what I’m doing and give it time.
The pulled Achilles is slowly healing. Ironically, though it didn’t stop me from running that 8K race, it does prevent me from doing my baguazhang forms due to the crouching stance required.
In the meantime, the weather is warming up, my winter coat is spending most of its time unused.
Again: give it time.
The short version: it turns out that what I have isn’t piriformis syndrome.
The long version is that if it were piriformis syndrome it would be gone by now. The pain has been alleviated greatly, but there is an odd pattern to the soreness, and overall it’s overstaying its welcome. I’m inclined to believe my TCM clinician when he suggests it’s a herniated lumbar disc. This would explain the prolonged condition, as well as how the pain is activated by any unhealthy sitting that messes with my spine’s alignment.
So, I need to be patient. This is new territory for me.
The good news is that I was able to take part in the Spring Run-Off 8K in High Park — something I’d signed up for a couple of months ago. I was prepared to sit it out (albeit miserably), however I felt good enough to take part, so long as I kept my target limited to crossing the finish line vs achieving any particular run time. In the end I crushed my expectations and pulled off a solid performance for someone who hasn’t run in weeks (and didn’t injure anything in the process).
The bad news is that, the day before the race, I was stepping off a sidewalk to cross the street at a light when I pulled/tore something in the heel of my right foot. This would be the Achilles tendon. Luckily, as running goes, I’m not a heel-striker, so it didn’t bother me on race day (now that would have been a cruel reason to cancel). That said, I have yet another part of me to rehab.
I have this weird, recurring thing. It starts with a dull soreness in my left glute, kinda like someone kicked it the day before and it feels bruised. Then, in a day or so, an odd stiffness and soreness stretching from the glute all the way down the back of my left leg, going down to my ankle. Within a day or so it reaches the zenith of its pathology: pain.
Two weeks ago yesterday I tried getting out of bed. I swung my legs over to the side of the mattress, and between that everyday action and my feet touching the floor I became a crumbled mess, bent over in agony. I was in so much pain I was crying. I was unable to stand. I was unable to sit. I was unable to do anything without experiencing the sort of intense, unrelenting pain that makes you realize in seconds why anyone would unhesitatingly reach for opiates.
What I have goes by two names: pseudo sciatica, or piriformis syndrome. The sciatic nerve travels from the spine and down the leg where it provides sensation to the skin of the foot and the lower leg. Unlike classic sciatica which involves irritation of the nerve from the spine via a disc, what I got is caused by the irritation via the piriformis muscle — something you’ve likely never hear of, but it’s a band of muscle in the core of your glutes. If the piriformis is aggravated it can bother the sciatic nerve in a similar way to classic sciatica. [Update: please see the follow-up post]
I’ve described the pain to people as like having your hamstring replaced with razor wire. It’s actually worse, because of how the pain “glows” all through the leg. At its worst, the pain cuts through your thoughts, your feelings. It takes priority over everything. It doesn’t care if you are happy or if you had plans to go somewhere that day. I’m always humbled by how quickly physical pain cuts through everything, taking priority, and how it terrorizes me with its power. I end up impatient with others, downright angry 24/7. I catastrophize: this is never going to end, I’m going to be like this forever.
I can afford physiotherapy, which makes me lucky. I don’t have health benefits because I’m self-employed, so anything not covered by provincial health care comes out of my wallet. I immediately checked myself into a physio clinic and I remember being furious: this again. This being physio. Physiotherapy (and related physical therapies) is something I have a good deal of experience with and I never hesitate to recommend it to people; the irony is that when I find myself being forced to return to physio it feels as if I’ve failed at something. Something tells me I’ve been irresponsible, which is silly.
Piriformis syndrome can happen to people who sit a lot. While I’m one of the most physically active people I know (I walk to work every day, I go to the gym, I run, I practice baguazhang) my job as a psychotherapist means I’m sitting for an hour at a time. Piriformis syndrome also prefers distance runners, which makes me a prime candidate.
For the last two weeks I’ve been doing physio exercises three times a day, combined with visits to a clinic, combined with acupuncture and Chinese medicine. Progress was very, very slow. The last time I had this it lasted all of a week or so, and I was able to work it out on my own with stretching and massage. This time it’s been remarkably more painful and long-lasting.
Yesterday, on the two week anniversary of not being able to stand out of bed, it felt like something had subtly changed. My mobility felt more easy, I didn’t have the feeling like I couldn’t extend my lower leg when I was walking on the sidewalk doing errands. I stayed outside, pushing myself a little, forcing myself to stay active. Today, for the first time in many weeks (partly because of the terrible weather we’ve had) I was able to practice ba gua outside on our terrace. I nearly cried.
My relationship with physical exercise is a personal one. It allows me to connect with my body. It is embodied movement, whether it’s running a 10K circuit or doing ape offers fruit. I’ve gone two weeks without any chance of significant exercise, and so the things that gave me internal relief — running, baguazhang, gym — were off-limits, which in turn made me miserable, feeling imprisoned.
I suppose I’m sharing this because it’s important to take a moment to reflect on the relationship between body and mental health. How it directly affects my spirit. The pain is slowly receding, I have my mobility, and I know that soon I’m going to be able to run outside and feel better. But my experience pales beside anyone with chronic pain, and I am humbled when I consider anyone who has to go through life under such conditions, be they due to injury or living conditions. Not to mention the fact that, when this has passed, I will have spent hundreds of dollars on physical therapies that many cannot access.
