Thursday, May 17, 2012

Every Pain Has A Cause

Last July I was preparing for a ultra marathon and was doing 40-50 km per week. I had never felt physically so strong before this and my legs were serving me like a rally car. Then suddenly one day, just like that, my right chest began to hurt while running. I could not get myself to complete the 15 km I had targeted for that session. The pain increased through the evening. By midnight, I felt pain with every breath that I took. And by next morning, I was completely immobile, in excruciating pain with the slightest of movement. The next few days I could not run, walk, sit, move my arms or even lie down in most positions. I was forced to breathing shallow and needed help to get out of bed.

I visited a doctor who first put me through a ultra-sound to rule out stones in the gall bladder. Nothing there. Then a physical exam and he concluded that this was a life long injury called costochondritis (a condition where your cartilage on ribs are inflamed). He sent me off with pain killers, saying that this is the only way to keep the inflammation and pain at bay; and that I have to avoid all things even remotely strenuous for my entire file. By following this, in one month my pain went down a notch - from excruciating to severe. I could hardly still do anything on my own. So I went to an orthopedic this time. Upon hearing my case, he seemed certain that I have bone cancer!! He got me to do a CT scan and full body bone scan. I was terrified but the reports ruled it out. However, it did show a healed fracture on my 7th anterior right rib. Now that explained the excruciating pain I had felt; but if it had healed why had the pain (though slightly less intense) had spread through my entire ribcage. And deep breathing still hurt a lot. So I was sent to a pulmonologist and he put me on steroids to get rid of the pain with some "heavy duty" medication. When even that didn't help, he suggested that I might have rheumatism. As you can imagine,  by now I was very irritable and used to end up crying at the smallest of things.

Anyway so I went to a rhuematalogist. And this time I didn't settle for anything less than the Head Of Department of one of the most reputed hospitals in the Philippines. After a physical check up and an interrogation, he prescribed 15 different tests, and said that he suspected vitamin D deficiency. He said this might explain a broken rib without any physical impact to that area. So after two weeks of tests, we gathered that his diagnosis was correct. I had a high risk vitamin D deficiency. Despite the high risk tag, I was happy! At least I now knew what the problem was. It took us 5 painful months to get to a start!!

Currently, I'm on an aggressive treatment to return to normalcy and my doc has promised that I will be able to run as much as I want to in 4-6 months.

Now, I'm not sharing all this to tell you about my miserable last 7 months or the incompetence of the doctors I met. Having grown up in India playing under the sun and now living in a sunny tropical island, with running for a hobby, I had never imagined I could be vitamin D deficient. And yet I was - is what I would like everyone to know. Most of us don't take our petty aches, muscle pulls and cramps, joint pains, and inflammations seriously. We should. And we should get it checked immediately.

Talking to people about this has helped me figure that I'm not the only one suffering from this deficiency; that there are plenty of people (especially women, in Philippines and India) who are sailing in the same boat. However, my doctor reassured me in his self styled humor - "it (vitamin D deficiency) is a wonderful problem. If attacked aggressively it disappears quickly."

About Vit D...and the lack of it -

Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones.The symptoms of this deficiency could be very subtle like tingling or numbing sensation on your face, cramps, body aches for no apparent reason, fatigue, irritability, depression. If you are a mother, then you need to be more wary of developing this deficiency. Vitamin D is critical to maintain normal blood levels of calcium and phosphorus.

And these are the main reasons for low levels of vitamin D:
    •    Lack of vitamin D in the diet, often in conjunction with inadequate sun exposure
    •    Inability to absorb vitamin D from the intestines
    •    Inability to process vitamin D due to kidney or liver disease
    •    Dark/brown skin
    •    Night-shifts and Lifestyle issues

Stay fit. Stay healthy :)