MRI Blues

Got pain?

For the last two months or so, I have been experiencing increasingly excruciating pain and numbness on my left arm, shoulder and back. Especially this month, there were daily occasions when I couldn’t even do any work with the computer. A few moments with my left hand on the keyboards and a piercing pain strikes my upper left extremities. For countless nights, I couldn’t sleep at all as it would be very painful after a minute or so just laying on my back in bed. I had to always move. The least pain I would feel sleeping face down which in a way relieved the “pressure” on my left shoulder and back.

I finally saw an orthopedic doctor at Capitol Medical Center (CMC) last May 17 with my wife accompanying me. It was a short consultation. The doctor’s diagnosis – cervical spondylosis.

Spondylosis is a medical condition signifying degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminae. In extreme cases, it may cause pressure on nerve roots with ensuing sensory and/or motor disturbances, such as pain, paresthesia, or muscle weakness in the limbs.

According to Wikipedia:

“When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel and/or bladder control. The patient may experience a phenomenon of shocks (paresthesia) in hands and legs because of nerve compression and lack of blood flow. If vertebrae of the neck are involved it is labelled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis.”

The doctor told me to have an MRI test which he believes is better than taking a regular X-ray test.

An MRI test. I’ve heard about it and have seen it on movies. But this is one test I haven’t taken.

By definition MRI refers to a magnetic resonance imaging (MRI) scan, a noninvasive method to create detailed pictures of the various parts of the body.

Unlike x-rays and computed tomographic (CT) scans, which use radiation, MRI uses powerful magnets and radio waves. I read somewhere that he magnetic field produced by an MRI is about 10 thousand times greater than the earth's. That’s a powerful set of magnets!

The magnetic field causes hydrogen atoms in the body to align in a certain way (identical to how the needle on a compass moves when you hold it near a magnet). When radio waves are sent toward the lined-up hydrogen atoms, they bounce back, and a computer records the signal. Different kinds of tissues emit back different signals.

There are two general types of MRI machines, the open and closed versions. A closed machine is smaller, has a narrow tube and is said to produce better images than the open type. An open MRI machine on the other hand, is open on three sides, making it more comfortable for the patient. However, the images are limited and are not as good since the magnets do not circle the whole body.

Open MRI machine

Not surprisingly, undergoing an MRI test entails a lot more money than having a regular X-ray test. Capitol Medical Center’s fee of 8,000 pesos for the MRI test I needed seemed to have already worked wonders in my body. I kept on telling my wife that my back has miraculously healed upon hearing the test fee!

Of course the pain didn’t go away. Sooner or later, I knew I had to get it to understand what was happening. It was a good thing that the hospital had a substantial discount for government employees due to their arrangement with GSIS. On the day I had my MRI test (May 27), I only paid 4,570 pesos. If there are medical findings, I could reimburse that amount with my office’s medical welfare fund.

The hospital had the open type MRI machine which I suppose lessened my chances of experiencing claustrophobia. But my MRI test wasn’t the longest 35 minutes of life because of fear of tight spaces. It was primarily because of the pain. I couldn’t move my body even if there was actually considerable space to move because that would ruin the image and we will have to do everything all over again.

A minute or so into the procedure, I was already experiencing piercing pain on my left back and shoulder coupled with widespread numbness over my left arm simply by lying down on my back. I tried to focus my mind on finishing the test, to bear the pain and to finish the test. I prayed a lot. At some point I thought I had already asked the intercession of all the saints in heaven and yet the test continued. It was the LONGEST 35 minutes of my life! I just thank God I was able to finish the test.

I got the results earlier today from Capitol Medical Center. Among the findings were:

· Alignment of my spine was normal

· The heights of the vertebral bodies and the intervertebral disks were well maintained

· The cervicomedullary junction and the spinal cord are normal

· There is no intraspinal or paraspinal mass lesion

I’m no medical doctor but all that pretty much sounds positive. However, there were other “impressions”:

Assymetric disk bulge, C5-C6, causing right-sided foraminal stenosis

Assymetric disk bulge, C6-C7, causing left-sided foraminal stenosis.

It is said that so-called cervical (neck) injuries usually result in full or partial tetraplegia (Quadriplegia). According to the Wikipedia article on spinal cord injury, one’s bodily functions retained, depending on the specific location and severity of trauma:

• Injuries at the C-1/C-2 levels will often result in loss of breathing, necessitating mechanical ventilators or phrenic nerve pacing.
• C3 vertebrae and above: Typically results in loss of diaphragm function, necessitating the use of a ventilator for breathing.
• C4 : Results in significant loss of function at the biceps and shoulders.
• C5 : Results in potential loss of function at the shoulders and biceps, and complete loss of function at the wrists and hands.
• C6 : Results in limited wrist control, and complete loss of hand function.
• C7 and T1 : Results in lack of dexterity in the hands and fingers, but allows for limited use of arms.

It is not only severe trauma that could cause spondylosis. Even simple reasons such as bad posture and other sources of what is termed as “repetitive strain injury” such as driving, traveling and working in front of computers without ergonomic care could also result in spondylosis. In my case, that seems to be the likely suspect.

I don’t know when I will visit the doctor again to show my MRI results. But I expect at the very least, a series of physical therapy sessions coming my way in the near future. One thing is for sure. I’m extra careful with my spine nowadays. I’m extra cautious that I don’t lose my footing on slippery tracks. No back breaking tasks for me unless truly necessary.

As far as the bad posture in front of the computer…now that’s something I still have to work out on.

Got my 1st pair of Reading Glasses!

Last weekend, I bought my first pair of prescription glasses from the Ideal Vision branch inside SM Fairview. It was actually reading glasses for my slightly deteriorating eyesight. I have been delaying this purchase for the last year or so for what seems to be inevitable as one grows older. Years of staying up late, reading against the light and not eating enough carrots I guess have finally caught up with me. I’m sure my diabetic condition has a lot to do with it too.

So with the eyeglass prescription I got from my ophthalmologist last January of this year, I sought remedy for my blurring vision.

At the eyeglass shop, the optometrist made me underwent basically the same procedures my ophthalmologist made me go through every visit. They used the phoropter to determine which lenses were best. Even as a kid, I always liked to have my visual acuity tested through Hermann Snellen’s classic letter chart. According to the Dictionary of Visual Science, visual acuity is the “acuteness or clearness of vision which is dependent on the sharpness of the retinal focus within the eye and the sensitivity of the interpretative faculty of the brain.”

According to Wikipedia:

In the term "20/20 vision", the numerator refers to the distance in feet between the subject and the chart. The denominator indicates the size of the letters, specifically it denotes the separation at which the lines that make up those letters would be separated by a visual angle of 1 arc minute, which for the lowest line that is read by an eye with no refractive error (or the errors corrected) is usually 20 feet. The metric equivalent is 6/6 vision where the distance is 6 metres. This means that at 20 feet or 6 metres, a typical human eye, able to separate 1 arc minute, can resolve lines with a spacing of about 1.75mm. 20/20 or 6/6 vision can be considered nominal performance for human distance vision; 20/40 or 6/12 vision can be considered half that acuity for distance vision and 20/10 or 6/3 vision would be twice normal acuity. ^[2] The 20/x number does not directly relate to the eyeglass prescription required to correct vision, because it does not specify the nature of the problem corrected by the lens, only the resulting performance. Instead an eye exam seeks to find the prescription that will provide at least 20/20 or 6/6 vision.^{[citation needed]}

If I remember it right, the good thing was I still had 20/20 vision. But my view of the chart became much sharper and better defined as a different set of lens were applied to my eyes.

This experience with corrective lenses widely broadened my knowledge with eye vision.

For instance, I realized that the prescription order consisted of all the specifications necessary to make the lens. Prescriptions generally include the power specifications of each lens (for each eye). Lenses come in positive (plus) and negative (minus) powers. Since a positive power lens will magnify an object and a negative power lens will minify it, it is very possible to tell whether a lens is positive or negative by simply looking through them.

Each power specification includes a spherical correction measured in so-called diopters. Convergent powers are positive (e.g., +4.00 D) and condense light to correct for farsightedness or to allow a person to read more comfortably. My eye doctor prescribed at the spherical column of my prescription + 1.50 for both my left (OS – Latin: oculus sinister) and my right (OD – Latin: oculus dexter) eyes. Divergent powers are negative (e.g., −3.75 D) and spread out light to correct for nearsightedness. If neither convergence nor divergence is required in the prescription, "plano" is used to denote a refractive power of zero.

In the late 90’s, I bought a pair of glasses with plano lenses. I just requested that it be UV coated because aside from its trendy look I used it while working in front of the computer. Long term exposure to UV-A radiation could damage the retina while massive exposure to UV-B radiation is said to increase the likelihood of cataracts.

For my reading glasses, my eye doctor prescribed clear, single vision lenses made of plastic material. I’m not sure so sure whether the lenses I got were plastic or glass but they were definitely clear and single vision. Single vision lenses have the same optical focal point or correction over the entire area of the lens. Other lens types include bi-focal, trifocal, progressive, adjustable focus or aspheric.

Another new thing I learned was the meaning of the acronym PD that you would probably see in an eyeglass prescription. PD stands for Pupillary Distance, sometimes also known as Interpupillary Distance (IPD). Basically it is the distance between pupils expressed in millimeters. It is often measured by the use of a pupilometer or by a classic ruler. PD measurements are said to be important in all spectacle dispensing. But I’m wondering why my previous PD was measured at 68 while in my latest prescription it was measured at 67. Does it actually change through the years?

At any rate, I’m now reaping the advantages of superb eyesight wearing my reading glasses when going through those fine print texts. Of course, I don’t wear it when I’m not reading anything close by as the lens was not meant for farther distances say more than a foot away from my eyes.

There is just one other procedure my eye doctor wants me to undergo due to my diabetes – a fluorescein angiogram. But that’s a topic for another post.

For now, I’m just thankful to God for my clearer eyesight!

Manifesto in Support of CFC-GK (Quezon City)

MANIFESTO IN SUPPORT OF CFC-GK (Quezon City)

To keep our spiritual essentials on a defined path and set the tone in support of CFC-GK, we state hereunder our perspective, beliefs and intentions:

1. We deeply value and acknowledge the pivotal role the Couples for Christ (CFC) has played in influencing our spiritual life: most importantly, as the avenue for personal and family renewal; and as the channel for God's work including Gawad Kalinga (GK) that led us to where we are now in our spiritual journey.

2. We retain our CFC identity. We do not intend to establish another community. We keep our covenant with God and continue to seek heightened spiritual involvement to deepen our faith, nurture hope and fulfill our purpose in CFC.

3. We are consistent with his Holiness Pope Benedict XVI's World Peace Message that religious freedom is the path to peace because this allows us to direct our personal and social life to God in whose light the identity, meaning and purpose of the person are fully understood. We aim to achieve authentic and vital human development.

4. We see Christian Faith in the light of the God who has a human face bearing in mind that each person remains unique and unrepeatable. We consistently seek Holy Spirit discernment in building up a social community in the spirit of respect for the common good.

5. We respond with boldness the call to choose a course of action that will restore us back to vibrant service in the CFC community. We choose Gawad Kalinga as our response to God's call to work with and for the poor in our journey of faith in the name of our Lord Jesus Christ. We embrace the values and ideals of GK. We firmly believe that GK through community and nation building is integral to missionary activities of the Catholic Church. Ultimately, it will fulfill the role of a powerful catalyst for innovative evangelization and world peace.

6. We strive to become “doers of the Word not hearers only” because “by works faith was made perfect”. We remain to shepherd the flock that God has entrusted to us being faithful to the truth and justice of the Gospel. We persevere to serve the least and last of our brethren.

7. We reject deliberate attempts to undermine GK's noble works by the distortion of truth and dissemination of inaccurate information aimed to discredit the prime movers of GK.

8. We trust that if our posture is contrary to the teachings of Jesus, then one should discard this manifesto completely! But if one finds that we are taking our stand upon the Holy Scripture, then let no fear keep him from threading with us the path of faith and obedience to the Word of God, in order that God's people here on earth be of one mind – one heart and that we in faith experience what He Himself has said, “Fear not, little flock, for it is your Father's good pleasure to give you the kingdom”.

9. We enjoin everyone, mindful of his personal convictions, who subscribes to the preceding statements to make a significant decision and strongly support the CFC-GK movement.

10. Lastly, we the undersigned come together in an expression of solidarity and reiterate to espouse the aspiration of CFC-GK. United in our belief in Jesus Christ our Lord of the One, Holy, Catholic, and Apostolic Church we uphold the unity of faith, love, hope and heroism in the pursuit of peace and holiness. Together, we stand behind this declaration in prayer and promise to combine forces and resources as we commit ourselves to participate in God's mission through CFC-GK.

We in CFC-GK, Q.C. continue to gather signatures and support for the movement with this concise manifesto so that brethren and critics alike would be truly informed of our position, beliefs and intentions.

May God bless us all!