Leigh Byford's back gave out when he was in transit in Singapore. He'd be in excruciating discomfort for more than 14 hours, after downing a slew of pain relievers.
Mr. Byford, his partner, and their two small children boarded a flight from South Australia bound for Germany in 2011.
They were on a family vacation to attend a friend's wedding, with hopes to explore old haunts in London. Yet, just hours into their journey, the then-34-year-back old's seized up - it was the debilitating agony he had been forced to deal in since his early twenties.
He had a locum doctor (in Singapore) bring me some painkillers and then he managed to 'get through to Heathrow, Mr. Byford, a nurse, explained to 9News.
As a result, he spent the whole flight in nine out of ten agonies. He wasn't crying, but he was on the verge of doing so.
He remembered sitting in the footwell of his economy seat, chugging a mixture of pills and alcohol in pursuit of relaxation. Nobody showed up.
He sat with my knees on the ground and my head on a cushion or something and he took, just to get through the ride, he paused to reflect.
It's a good thing he didn't die... he believes it's a 10- to 12-hour flight... he guessed he took maybe 18 tramadols, 10 Panadeine Forte, whiskey, whatever, he said.
He was just in excruciating agony.
Mr. Byford said that he was bedridden during the first two weeks of the family's trip after they landed in Germany. His grief was so serious that he will be unable to attend the ceremony.
This was terrible; my wife had to bear all the luggage, and we had two little children with us. It was a nightmare, he admitted.
The first symptom of discomfort
Mr. Byford was 24 years old and in his second year of nursing school when he experienced chronic lower back pain. After a day at the skatepark, he noticed his back give out, and it never healed.
At the moment, it was just intense discomfort in your lower back, he said. It's actually something akin to getting a rotting tooth or anything.
So, anytime you turn, you get this extremely intense agony, followed by a very nasty dull ache in your lower back, which is right at the base of my spine. He sought a series of therapies to relieve the chronic discomfort after several GP appointments with no definite diagnosis.
At first, he assumes you attempt rest. He must have sought pain relievers and anti-inflammatories, he said.
People only thought it was a disk thing because there's no good way to look at the amount of harm that's happened to someone's back and correctly estimate how much discomfort they'll be in. So staring at someone's CT scan and X-ray isn't really helpful.
Mr. Byford said he became very defensive of his back as a result of the pain, believing he had a technical deficiency.
He was really worried that it might worsen. As a result, he used to be unnecessarily defensive of my spine, he said.
They placed me on Pilates and conditioning programmes. He attempted physiotherapy, osteopathy, and so on. He used cold laser treatment and acupuncture in addition to general analgesics.
He said that the first four years of dealing with chronic pain were the most painful for him physically, in terms of exhaustion and a lack of optimism for his future.
One of the things he found tough at that age, and straight-up before he started getting stronger in my mid-30s... it was also about masculinity, he said.
Like if you went to Bunnings and tried to move something because he couldn't because he was afraid I'd injure me. As a result, I'd still end up asking my wife to bring stuff for me.
He recalled sitting in the car one day when he was in a lot of discomforts and all he could do was stay in the car. He was also along for the ride... and some man offered me this hiding when my wife was packing the car at the rear.
Mr. Byford claims that while severe back pain does not manifest itself suddenly, often people can't see something wrong with an individual.
A complicated ache
According to research published in August of last year by the Australian Institute of Health and Welfare, about 4 million individuals, or one of every six Australians, suffer from back pain.
More than 180,000 people were hospitalised with back pain in 2017-18.
Back pain was the second leading source of disease burden in 2015. It accounted for 4.1% of the overall disease burden in Australia.
Back pain, especially low back pain, is the most frequent chronic pain and the most burdensome, said Professor Lorimer Moseley, chair of Physiotherapy at the University of South Australia, to 9News.
This has the greatest societal effects due to the high cost of care. Back pain is a complicated condition. Back pain is caused by a variety of factors.
Professor Moseley, who is also the CEO of Pain Revolution, claimed that the most prevalent form of back pain that can be successfully handled is rotation and loading of the back, which is contrary to our current definition of back pain.
Many people equate back pain with a weak back, but our back is one of the most amazing body pieces. It's really strong, he said.
And it is fit for function, but we've continued to shift into this culture where we believe backs are bad because if we have back pain, it's because we have a weak back.
People want to improve their backs even though they are always nervous, because they are fearful of leaning over. The expectation that their back would crack in any way under loads they are already performing without realising is a popular trend in people with back pain.
According to Professor Moseley, there are two widespread misconceptions regarding back pain that make me insane.
The first, he said, is the all-too-common sticker on a slid disk.
The disk is the portion of the body that connects one vertebra to the next vertebra, because it's composed of ligament because cartilage, and it's so closely integrated with the vertebra that no one will ever have a disc slip, he said.
Looking at scans and having the disk in a new outline inspired the term. And it seems that something has leaked from the hand.
However, what has really occurred is that such ligaments have spread over time. And this is a natural aspect of the aging process. You can't even slip a disk.
He said that, in general, the most common misconception from someone who has had a scan of their back is that the scan findings reflect trauma.
Usually, they don't, he said.
They signify a shift in the back framework in order to help withstand loads of your life.
Because I've done a lot of manual and sports work, my vertebrae have shifted form to be thicker. They will be reported as anomalies if you take a scan of my back.
The medical condition
Mr. Byford found out about his illness during a chance conversation at work.
He'd just returned from a family vacation in Germany, and in an effort to discover solutions, he'd devoured whatever academic findings on persistent lower back pain he might find.
Since consulting with his prescribing physicians, he had a life-changing experience with one of the nephrologists he served with.
Mr. Byford was sent to a rheumatologist, who diagnosed him with ankylosing spondylitis, an autoimmune condition that may trigger any of the tiny vertebrae to fuse.
The only approach to cure my disorder is to work out, preferably aerobic exercise rather than affect exercise. Things like riding a bike, hiking, and just being fit, he said.
When necessary, he takes Panadol osteo and NSAIDs. Ultimately, what will be preferable is that these days, there are these specific drugs classified as biologic medications... However, the PBS (Pharmaceutical Benefits Scheme) criteria are very stringent, and he was unable to afford the drug.
Medication is out of control.
Mr. Byford said that the drug would cost him $400 a week, but just $8 a week on the PBS.
What surprises me is that there are many means of calculating the illness, he added.
How they (PBS) calculate that is by scaling the sum of damage to the spine and pelvis. He believes they will judge the level of bone shift with a simple x-ray.
So, they scale it from one to four, and four is someone that is wheelchair-bound who can't drive at all... So, aside from the infection, the other tissues ossify and become bone in ankylosing spondylitis... it essentially fuses it all together. He said that he is classified as a stage two and that he will like to be classified as a stage three in order to apply for the government benefit.
You'd be hard-pressed to function if you were in stage three. So it's a little strange to me that they wouldn't provide the drug to effectively slow the progress of having anyone working, he added.
Mr. Byford is still in chronic discomfort, but he is doing whatever he can to manage it.
I'm still in some kind of discomfort. It was even harder at the beginning. He was potentially in seven out of ten agonies all the time. Maybe it'll get down to five, and for what it's worth, it's now about a two, he stated.
I'm always cautious with how he raises objects, but knowing that it's an inflammatory back pain rather than a mechanical cause has opened me up physically to treat it a little differently.
So now, to be frank, he wants to do as best as he can.
