Reader's story - Autumn 2002
	Learning to live again
Alison Hudson has triumphed over her back pain, regaining control over her life and preparing to take up challenges that we thought to be impossible.

My experience of back pain has been a long tough one. It is not something that will ever disappear, but something I have finally learnt to live with and to control in a way that allows me to do the things I always wanted.

I was a tall teenager and developed a slight scoliosis which was treated very conservatively by my doctors in South Africa. In October 1993, at the age of 17, I was involved in a car accident which left me with two compression fractures of the thoracic spine. I was discharged from hospital after three days with instructions of bed rest. After three months of this I was not much better. The scoliosis was worse and I only managed one day of school a week, if that. I ended up writing my final exams from home. I saw five different orthopaedic surgeons over a couple of months for their opinion. Four of them suggested surgery. We thought long and hard, and finally agreed to go ahead.

In April 1994, 1 went for surgery that involved the fusion of the vertebrae around the fractures, using bone taken from my hip. Two Harrington rods were the inserted on either side of my spine over 14 levels, leaving only two vertebrae free at the bottom of the spine. The rods were secured at the top with a hook system and at the bottom with two large screws.

The operation was extremely painful, and an experience I will never forget. I was in ITU for a couple of days and in hospital for almost three weeks. After a week I stood up for the first time (which was my most frightening moment). I had "grown" 2 inches with the straightening of my spine and my balance was completely out as my brain still had to adjust. For example, when I looked at my mom, I automatically looked where I would expect to see her eyes, only to find I now had to lower my gaze. I had to retrain many automated movements over the next few months as I was now rigid as a board. I had to roll in and out of bed, learn to walk, balance, sit and turning to look at someone was a whole new experience as I had to turn most of my body. There are so many things we take for granted, but try getting into a bath or getting dressed without moving your spine, it's quite a task, but this became my way of life for the next nine years.

When I left hospital I had no support, no physiotherapy or anything. My mother hired a private home nurse to help me round the house while she worked. I spent a lot of time lying in bed trying to subdue the pain with painkillers. I don't think I stopped taking painkillers over the next few years, it was the only the type and dosage that varied. After about eight months (spent mostly in bed I started going out to friends and on small shopping trips. Getting used to my new body was uncomfortable, both physically and psychologically, as I stood out like a sore thumb being so tall and so rigid.

Nevertheless I decided life had to go on somehow and just got on with it. Exactly a year after the operation, I stood up at a dinner party and felt something crack. My arms went numb and I felt a stabbing pain. A screw had broken from metal fatigue and I went in for surgery once more. They took the set of screws out, leaving the broken piece of a screw embedded in my vertebra - where it still is today. They replaced the screws with a set of hooks this time. My recovery from this surgery was fairly quick, but my confidence was damaged. My biggest fear was that of tripping or failing and causing something to break. I still get scared today if I don't have a very firm foothold.

In 1997 after my 21st birthday, I put myself to the ultimate test and moved, by myself, to the UK. I started work as a nanny looking after five children, probably not the best idea with a back like mine, but I was stubborn. I still had to take painkillers a lot and overtime my back got worse. I started getting sharp stabbing pains at the slightest wrong movement, so took more and more painkillers. By 1999 1 was desperate, so rather than waiting six months for an appointment, I saw a few private orthopaedic surgeons in the UK for their opinion. The pain was attributed to the rods being put into my back at the wrong angle and over too many unnecessary levels. Various options were discussed and I decided the best option was to remove the rods and to try rebuilding my back again. There was no guarantee from the surgeons it would be a success, but it was a chance I was willing to take since the only other option was to fuse mg whole spine. This would have included the two free vertebrae at the bottom which were very worn and damaged from bearing all the weight for so many years and which would result in even less flexibility and mobility. By this stage I had moved to London and went onto the waiting list at the Royal National Orthopaedic Hospital in Stanmore.

In January 2001 1 married my high school sweetheart who took me on a six week honeymoon around the world, despite mg pain. He was supportive and very encouraging, I even managed to go diving in Thailand with the help of an instructor who kitted me up while in the water, therefore never feeling the weight of the equipment. What an incredible day! That was my first taste of learning how to truly "live" with my problem. There were ways and means of doing a lot of things that don't seem possible with back pain.

While on Honeymoon I got a call from my sister to say a letter had arrived confirming I had been booked into Stanmore in April, only a month after our return, I was excited and scared to death at the same time.

In April 2001 I underwent a very tricky five-hour long operation to remove the metalwork. I lost a lot of blood and had a few transfusions, but my surgeons were fantastic and the operation was a success. I recovered so well I only spent one night in ITU and although still on morphine for another week, the physiotherapist had me standing only three days after the operation. Each day after that I stood for slightly longer, then sat in a chair for a meal. A week later I was able to wash myself and another week later I could sit in a shower (with a little help).

Something was very different this time. I was surrounded by people offering support, doctors, physiotherapists, pain consultants, occupational therapists and more. To add to this I was determined to get a life back. I have dreams of skiing, riding a horse and getting a pilots licence.

I became pro-active in my recovery from the very beginning. It was not always easy, in fact it was often very frustrating and depressing for both myself, and those around me who also had to learn to live with my back pain/problems. Once at home I had to see a physiotherapist on a weekly basis. I made sure I got up early every morning. My husband made the bed and helped me dress which immediately made me feel better. I had breakfast sitting up and although I spent a lot of the first weeks lying down, I never got "into" bed, but lay on top with a throw for warmth. For snacks and lunch, everything was in the kitchen placed within reach, but I had to get up and walk to it. I got stronger every day, often in ways only I could notice.

Two months after I left the hospital I had a set back. I collapsed while speaking to a friend in her kitchen. The pain was excruciating, mostly referred pain into my hips and legs, I screamed at any attempt to move. This pain did not subside for a few weeks.

My back muscles were simply very conf used, after eight years of wastage, while the metal did all the work, they couldn't cope with my new movements and posture. My physiotherapy became more intensive. I now went three times a week with the biggest challenge getting into the cab to get me there and back.

I worked closely with my physiotherapist from this point on. I followed all my sessions through by exercising at home using a Swiss ball, sheets of prescribed exercises, books and a lot of heat therapy. Once the scar tissue had softene, and touch was more bearable, I started having a weekly massage at the beautician to keep the muscles relaxed for optimum results in my exercise regime. I started walking a few blocks on alternate days and then progressed to hydrotherapy. I later stopped shopping online and started going to the shops,just for small amounts at a time, something else my physio recommended.

My posture was difficult to maintain as my muscles were just too weak. My physiotherapist then introduced me to Pilates, which I tried and found very helpful to my core stability, I now practice wherever I am, whatever I am doing.

I worked very hard for a whole year, I literally watched the 'nonexistent' muscles growing in my once flat back and giving it shape. Exactly a year after my discharge from the hospital I was also discharged from physiotherapy, and the next day I took another major step in my recovery by accepting a part-time job at BackCare.

Going back to work was frightening. It took a bit of time for my confidence to come back to me and I had to learn how to pace myself in a very different routine from what I was used to, but with a little determination I managed to get it right. Getting out of the house twice a week did wonders for me, I was happier, felt more fulfilled and even more determined to remain pro active.

I still work hard at keeping my strength up and occasionally have to go back to a physiotherapist, but I am pleased to say that I no longer take any painkillers, only a herbal anti-inflammatory. The lesson I have learnt through all of this is that at the end of the day we need to help ourselves too. Physiotherapists, osteopaths, chiropractors etc. could only help me to a certain point and guide me in the right direction. The hardest work had to come from me. At the end of the day I was in the driving seat when it came to my successful recovery. With the right people around me I was able to make the right decisions and be taught how to help myself live as normal a life as possible.

In June this year I realised a dream. I went on a camping safari in Botswana. I slept on a mat on the floor, in a tent, in the wild. We went walking with a guide twice a day for at least two hours at a time. We tracked animals on foot, came face to face with buffalo, crocodiles and elephants, walked with giraffe and zebra, and tracked roaring lions. This would never have been possible if I had not learnt to truly "live" with my back pain.

I will never be completely pain free, but I can control it, continue to strengthen my muscles, stay active and achieve my dreams. As soon as I am strong enough to lift myself onto a horse I plan to take lessons, and this time next year I hope to do my private pilot's licence.