Determination, The Patient's Contribution to Wellness

May 31, 2008 - This months article is about determination and how important it is when one is ill and seeking diagnosis and treatment as well as in recovery. When I wrote my book, Contents under Pressure: One Man's Triumph over Chiari Syndrome, I used the word triumph because I truly believe that recovering from Chiari is a great personal triumph and sometimes not easily done. And, any significant triumph requires determination of the highest order. For me, recovering from Chiari was more difficult than graduating from college or finding a job. I couldn't think of anything more challenging that I had experienced personally. To me, even though I never served in the military or participated in a war, I imagine that beating Chiari is very much like facing a foreign enemy on the front line of battle. To win on the battle field, it takes the desire to live and a great deal of determination.

The topic of determination and its importance came to my mind while I was running my second ORRRC (Ohio River Road Runners' Club) marathon just this past March 30th in Xenia, Ohio. Contents under Pressure basically talks about my experience of going from marathon runner to wheel chair to marathon runner. The book ends with me completing the 2005 Air Force marathon following a long and difficult recovery from decompression. Following the Air Force marathon I ran three more, my first ORRRC marathon in Xenia, OH, one in Columbus, OH, and one in Athens, OH. While training for my second Columbus marathon, I injured my right Achilles tendon from overuse. The orthopedic surgeon characterized my injury as tendonosis as opposed to tendonitis with tendonosis meaning the accumulation of permanent micro scar tissue. The diagnosis was disheartening because I like to run and because I had come so far after Chiari. I couldn't believe that my heel was taking me down after Chiari couldn't. It seemed incredibly ironic.

I went to physical therapy which consisted of transdermal electrophoretic cortisone treatments, ultrasound treatments and lots of stretching. I maintained my cardiopulmonary condition as best I could by using a stationary bike being careful to flex my right ankle at a minimum. After a couple of months, I began to do some light jogging. I slowly increased my jogging while continuing to stretch and strengthen my right Achilles tendon. I slowed my pace by about 1 minute per mile and worked on my stamina. After a couple of months, I began to toy with the idea of running a marathon and devised a training schedule to ready myself for the 2008 ORRRC marathon in Xenia. Along the way, I caught the flu and then suffered from mid back spasms of unknown origin. I had my back problem checked and I was cleared of any disease (pleurisy, gall stones, etc.) or serious condition.

With all the road blocks, I was uncertain of my ability to complete the race. I decided to pace myself very carefully with the goal of finishing in 4 hours and 30 minutes. Conditions during the morning of the race were poor. It was about 39º F with a light drizzle and a steady strong wind. The first half of the race required running directly into the head wind. I knew that what I needed to finish was determination. After 10 miles of fighting the wind, I began to draw on my past experiences requiring determination. Determination is learned and remembering other instances of determination is helpful in applying it again. Naturally, I thought about my experience with Chiari and how difficult it was to run my first marathon after decompression. I carried that thought with me through the wind and even more so after mile 22 when my legs began to throb with each and every step. I completed the race 7 minutes ahead of my goal and I pondered about the true power of determination. Determination got me through the race with grace. It got me through all the road blocks I faced in getting there. It got me through finding a diagnosis, in finding treatment, and in recovering from decompression.

I receive many emails from other Chiari patients looking for help. I think a lot of these individuals have determination in the first place or they wouldn't have found and contacted me. I attempt to advise them as best I can clearly reminding them that I am not a physician and that they should always follow the advice and treatment plan of their physician. I always stress the importance of determination. Recovering from Chiari is very much like running a marathon with all sorts of road blocks thrown in the way. The patient must reach deep down into him/her self. Every time they turn around there will be an opportunity to stop pushing the envelope. Patients need to stay determined and resolve to find the right diagnosis and treatment and to stay on the road of recovery. There is an element of conquering Chiari that solely depends on self determination. It's the patient contribution to defeating Chiari. The doctors can not bring it to the table. Research is not going to bring it to the table. It's not easy but all too often it makes the difference between a good recovery and existing in an unproductive and disabled state.

Of course for some, whose condition is truly overwhelming, determination may not be enough but it's an important step and one worth taking for without it there can be no hope. For these unfortunate individuals no criticism should ever be leveled as long as they continue to try. Always remember, one is only a failure when he/she stops trying. Keep up the good fight or as our founding fathers would say, "stay the course".

Ed. Note: The opinions expressed above are solely those of the author. They do not represent the opinions of the editor, publisher, or this publication. Mr. D'Alonzo is not a medical doctor and does not give medical advice. Anyone with a medical problem is strongly encouraged to seek professional medical care.