Excerpts from the book: Jan Hnízdil – To My Sick People

PODZIM 2011 Kultura English
obálka čísla

We picked the following excerpt from the first part of the book entitled “Doctor’s Office Visits”. Later on we included some shorter quotes to further illustrate the author’s opinions and style.

The Case of a “Frozen Shoulder”
This term is used in medicine to refer to shoulder pains accompanied by limited mobility. The reason for this ailment is usually unclear, the treatment is slow and often unsuccessful. It is generally limited to taking pain pills, using various injections and different physical therapy procedures. Many patients suffer of this problem for most of their lives. What seems to be a difficult diagnostic problem for biological medicine can be explained by comprehensive medicine. The following example proves this point:

One day a petite woman of about 44 years of age came timidly into my office. In her eyes there was anxiety and stress from severe pain in her right shoulder. She was clearly afraid to move her arm even slightly. In a quiet voice she started to tell me about her difficulties. She has never been seriously ill in her life. Therefore she was very shocked about four months ago by a sudden pain that appeared while skiing in the mountains. She could not remember ever having any accident. She remembered that some pain first appeared while she carried her skis on her shoulder. In spite of the pain she continued her skiing for another week and then the pain was reduced for about a month. But it came back in full force after she had fallen. Even though she managed to break the fall somewhat, the blow seemed to have been transmitted to the sensitive shoulder. She tried to bear the pain for a week and then went to see the family doctor. He prescribed pain killers but they did not help much. The pain persisted and even the mobility became worse. After that she was examined by an orthopedic surgeon, she had x-rays, ultrasound, repeated injections of some corticoid mixture with anesthetics and electrotherapy. After some temporary relief her condition again got worse. All her treatments were ambulatory. She did not go on sick leave but kept on working.

I examined her shoulder thoroughly. Every slight touch caused her severe pain. Passive mobility was very limited while active mobility was practically almost zero. The diagnosis was clearly a frozen shoulder. Why was her previous treatment unsuccessful? I found the answer in her life story.

She has been working for fifteen years as a school teacher. She does not like her work and is not successful in managing her class. She comes home every day quite exhausted. But her duties are still not over. There is more at home – taking care of her daughter, preparing for the next day’s class, taking care of the house and garden. Everything rests on her shoulders. Her husband does not help, he has lots of worries with his business and has no time for his family.

The patient feels that everything lies on her and she can’t keep up with all the work. Since her childhood she has always loved sports, even a year ago she regularly played tennis, and did yoga. Now she has no time for any of it. Her physical condition worsened, and she gained ten kilograms. That does not help her mental well being either. She feels that she is in a state of constant stress. She often explodes in anger over trivialities and she sleeps poorly. On top of all that she now developed a problem with her shoulder. She did not want to go on a sick leave – there is nobody who could substitute for her. She tries to use her right arm as little as possible, but the pain is still very stressful. In the past she used to get some rest daily while walking her dog, but even that does not interest her any more. She had tears in her eyes when she told me how much she loved her dog – but she now has much difficulty to handle him. Her Belgian sheep dog weighs 35 kilograms, is not well trained, tends to run away and therefore has to be held on a leash. It is very hard to accomplish this with an aching shoulder.

The syndrome of a painful shoulder led to the patient’s life story which made it possible to understand the reasons for her problems and it explained why the previous treatments were unsuccessful. Her extended and one-sided workload in school and at home influenced her physical condition and mental health. Her fall while skiing and resulting injury to her shoulder was the last straw. The pain acted as a defense mechanism that was calling attention to overexertion and a warning against continuing. She remained a misunderstood patient by her physicians. Instead of creating conditions that would allow her some rest, her tenacious fight with pain persisted. Analgesics only helped the patient to continue for some time to strain the shoulder and thus to accelerate the worsening of her state. Continuing to walk her dog who was hard to handle only contributed to the problem.

When she came to my office she was on the verge of a physical and mental collapse. We quickly identified and clarified the relationships between her various difficulties. She willingly agreed to take a sick leave because of her debilitating condition. She will take a rest, will have her husband take care of the household and she will take good care of her right shoulder while carefully trying to exercise it. Movement will become the cure which will be applied in small doses several times a day so that it won’t cause any pain. She will stop taking analgesics. For a short time she will take lexaurin for dealing with anxiety and distress combined with shoulder massage, baths and Priessnitz wraps.

When she came for a checkup three weeks later she was almost pain free and the mobility of her shoulder improved with the treatment and was better than expected. Her sick leave ended after two weeks and she stopped taking lexaurin. She reorganized her life so that she now has more time for relaxation and she exercises regularly. I warned her not to be overly optimistic yet. If there is too much exertion or exposure to cold the ailment might return. Thanks to the fact that she understands where she had made a mistake and what her shoulder had tried to tell her, she has a good chance that the “frozen shoulder” syndrom will become only an unpleasant yet instructive episode in her life story.

* * *

Pain is not a disease. It is only a warning signal by which the body notifies us that we are doing something wrong. Instead of removing the reasons of illness we often heal the symptoms.

The present economic crisis is not financial. It is a crisis of values and behavior… We still believe in scientific progress. We hope that the crisis will go away and we will continue to live as we had lived before. That will not happen. As long as we do not change our values and our behavior some catastrophe is inevitable.

Laughter improves not only the immune system but it also has a beneficial effect upon the back, asthma, diseases of the heart, lungs, liver and the intestines. This was proven by research scientists at a medical school in Tokyo. They were trying to heal rheumatic patients by daily showing them animated cartoons. Blood tests that followed such projections showed a marked increase in the level of anti-inflammatory substances.

Sufficient sleep, good nourishment, varied exercise, good interpersonal relations, culture and love, they all influence a person’s health. Many of my patients are financially well of. They can afford a luxurious vacation, excellent food, very expensive fitness programs, yet they are still sick. They lack love. They don’t know how to give it or how to receive it.

Selected excerpts and following texts by Jarmila Lakosilová
Translated by Marie Dolanska

Vydavatelem Českého dialogu je Mezinárodní český klub

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