New Info, New Lens, New Story
This is the 9th extension article for my psychological memoir [ The Snowy Battlefield of Ohio ]. Some good news:
First, after a painstaking year of production, my audiobook is now published on various platforms, including Kobo, Google Play, Barnes & Noble, and Spotify.
Second, my official website (or author website, whatever) is open to the public now, with a couple of pages still being honed. From now on, I will send updates and news through my official newsletter (to subscribe, go to the bottom of my website), and Substack will mainly be used for blogging purposes, since I enjoy this platform.
In my book, I repeatedly mentioned my annoying musculoskeletal issues, which crippled me in terms of working and traveling. In Ohio, the main challenge was in the legs. I talked about overpronation in the foot, knee pain largely resulting from weak adductor muscles, as well as the occasional muscle spasm in the dominant calf, which prevented me from carrying heavy loads on my back or pushing a cart in a grocery store without discomfort. This history went from college through 2014, the last summer at Ohio State. The third condition, the haunting calf tightness, was slightly relieved after my leg length discrepancy was diagnosed in China in 2017. After that, I started to wear a new pair of customized orthotic inserts with additional corrections.
But the problem is only relieved, not eradicated. Over time, I started to develop heel pain on the left, which local doctors couldn’t solve. Through the years, I managed to train with several physical therapists from across the world on Zoom, because Smoke City, where I was stranded, is a fourth-tier city in China, where American-styled physical therapy was extremely hard to find on an outpatient basis. Still, PT training couldn’t eliminate the frequent tightness in my calf. Then I tried PRP (platelet-rich plasma) on some tendons, and it did help significantly. (God that was costly due to the high price of the container for centrifuging.) I was able to carry more weights without the need to use four-wheel carts all the time. But the triggered tightness was not eradicated yet. Neither was the heel pain, which would always come back after a whole-body infection, such as COVID-19. No PT, acupuncturists, or local orthopedic surgeons could explain why, and I swear they are all experienced clinicians.
Then last summer, after a rainstorm, I had an accident with my e-bike, which jerked my shoulder and hip. The symptoms didn’t disappear after a lot of treatment, but worsened during humid summer days: the left thigh often felt frozen while standing, cooking especially. So I went to get an MRI in a small hospital. Based on my asymmetrical symptoms, a senior doctor recommended a lumbar scan instead of a hip joint scan. They discovered 2 bulging discs. After I brought the new information to my American PT, she told me this new information could explain a lot of my past symptoms, from the heel pain to the weakness of the calf, to the frozen thigh (numbness in the IT band area). I was thus put on the Mackenzie extension program. From my support group, I also realized that the moving sensations in other sporadic pain regions were also referred pain. This rehab program was very intense and time-consuming, and it wasn’t enough. I also got spinal decompression therapy in the hospital for more targeted intervention until the discs were back in place on MRI. During that period, I came to realize that the disc bulge compressing the sciatic nerves might have something to do with the weird tightness, if not spasm, in my right calf, when my body is loaded. Remember this condition initially started in 2014. I used to focus on the calf only, but now I look at the radiculopathy instead. Long ago, a TCM doctor here ordered a CT scan for my lumbar area; in recent years, another TCM doctor ordered an x-ray for my lumbar region. Neither of these two approaches could provide sufficient information for the discs. People should reach their conclusion here. I normally see TCM as part of the conservative treatment program, and I have become more cautious about their diagnosis for serious musculoskeletal issues. Those who are aware they aren’t specialists for disc issues might not order the pricey tests for fear of a negative result.
As I said, the journey of recovery was very difficult. The low temperature in the winter and vibration from vehicles could trigger my radicular sensations (it felt like electric currents going down through the sciatic nerve). So I asked for more stability training programs for the lower back. ( I would highly recommend Brendan’s lowbackability channel if you have chronic back pain related to the discs. I actually purchased a Roman machine as he advocated. Note that I was able to use that machine many years ago in the gym. Meanwhile, if you are interested in online service from my PT, please contact me through email for referral. He’s really good.) Even today, I wouldn’t say the tissues have been 100% healed (unless regenerated through PRP, which I would save for the last resort). How can it be? The sciatic symptoms could date back to a decade ago, according to my book (see section 12.2). Chronic issues are not that easy to eliminate, even after you find the primary cause; the secondary and tertiary problems might be chronic too.
With this information of disc bulge, I also learned from a TCM practitioner that viral infection can damage the nerve ending near the discs, and this will weaken my left leg through the motor nerve so the heel pain would recur. That’s why it’s crucial to treat infections at the early stage. I’ve never succeeded in that effort, unfortunately. I know many people who get their herniated discs diagnosed very late, but we should never lose hope.
Very sadly, not a single clinician I have met in the past decade has asked me to get a lumbar MRI, after I told them my long-term suffering. Some even wanted to perform surgery on my Achilles tendon without finding the root cause. They had all kinds of theories, but none was related to the bulging discs. I personally also agree it’s hard to detect it very early. Hindsight is 20/20. When people are given the information, things suddenly become so clear and straightforward. Everything makes sense now when we roll backward in time. But none of them was excellent at detective work before the info was presented by Mother Nature. I was saved by an accident caused by a summer rainstorm, and right before the rainstorm, I was getting PRP onto the tendons and the SI joint. It was very ironic. Fortunately, I am freer to travel now, and even hike on hills, as long as I tape my Achilles tendons before the trip. I can carry far more weight on my back, though I try not to do that without progressive training (which may take another few months). At this age, I don’t think the human body is designed to carry lots of weight on the back while traveling. We aren’t camels or donkeys. People should use tools to make life easier. Those who tell you otherwise are doing so for whatever reason.
Okay, if you remember, I have talked about podiatry in my book. After the discovery of my disc problem, how do I view the necessity of those orthotic inserts? And how do I view the PRP shots onto the tendons and joints? My answer is, I still believe those are helpful, despite the hassles. They have alleviated my symptoms before I discovered the disc problem. The lumbar extension exercises may have changed my spine and pelvis alignment, but the leg length discrepancy and the overpronation were both objective. And also, who told me to see a podiatrist? A foot/ankle surgeon recommended by a general medical website. They couldn’t detect the lumbar issue either. Nobody could. Nobody ever told me to see a spine specialist. No chiropractor can see your disc problem with the naked eye. You need an MRI scan. Do I want to always wear customized orthotic inserts? Hell no, but it’s also difficult to change back to a normal life. Adaptation always takes time and effort. How do I know that? Because I have gone through everything, every step, when starting to incorporate those as part of life, just like eyeglasses. Only people who suffer from the same problem understand the complexity, exhaustion, frustration, and compromises.
However, up to this point, one thing still hasn’t been addressed, following the logic I recounted: How did I get disc compression in 2014? Aging? Have I studied too hard since I was a kid? Frequent moving, as mentioned at the beginning of my book? Or the increased load on my back after I moved to the South Campus and started to carry my Toshiba and textbook inside my backpack?
I forgot one crucial event: I fell on the floor inside a condo in Upper Arlington, at the end of 2023 (section 6.4: Bad Omens). I was just picking up the key to the condo, and the snow melted when I walked into the living room with the AC still on. I slipped, and sat on my buttocks, using my left hand to support myself instinctively. For the wrist pain, I had PT for almost a year and two cortisone shots. Notice that my butts and my lumbar discs might have served as the cushion so that I didn’t get a pelvic fracture. (My tailbone did show a weird angle according to an x-ray in recent years.) Inertia during that fall could explain a lot of things. It’s plausible that the discs were compressed during that moment of impact, and slipped a little bit. With added stress the next summer, the disc eventually pinched into the nerve ending. The new pair of orthotic inserts realigned my spine so that the outward compression got more evenly distributed from right to left. Hence a year or two later, I started to get heel pain on the left, and the training result on my left calf couldn’t sustain over months.
The plausibility of my conjecture was validated by the spine specialist I work with. It is consistent with our impression that a big vertical injury like this can bring more damage to the spine than several years of cumulative loading. In retrospect, it’s a shame that we all focused on the symptomatic wrist too much and ignored the joints that bore the brunt of the accident. Of course, it’s all just post hoc analysis. No way to time travel and verify with an MRI. But I’m thankful that after becoming a memoirist, I have gained the ability to track down a lot of information stored in my brain, backward, layer by layer, like Windows File History. My brain has developed this inertia these days.
Now let’s talk about the progress of my RSI recovery. In my book, this work-related injury was mentioned multiple times. My article How to Use Dragon to Control the Mouse is also related to that topic. Due to the high similarity between my RSI and the leg issues, in terms of the difficulty in unraveling the conundrum and finding a competent physical therapist, I will keep this part succinct.
Way back in 2017, the ergonomics specialist at UC Davis already told me that the cervical spine C6 might have an impact on my index finger (trigger finger), and the physical therapist at Kaiser Vacaville agreed with this idea. But we all know how difficult it is to get an MRI in the US, under an HMO health plan. Hehe.
Later in China, someone helped me get an opinion from a top hospital in Beijing, and they also confirmed that I should get a cervical MRI. Yes, they were right: I had disc herniation. The funny thing is, this guy referred me to an acupuncturist, who told me I might not need to treat the herniation. Why not? As I realized today, because (1) spinal decompression therapy is very expensive without insurance; (2) she is not in charge of that treatment; (3) she is a big fan of the fascia chain theory, and believes treating the fascia can substitute treating the disc herniation. Like many others, she doesn’t believe herniation should always be treated. But I already had symptoms that could directly map to a specific disc or nerve. Most people holding that opinion were from alternative medicine (in the Western sense), and they are right about it: even if your disc is back in space, the symptoms may not disappear completely. My RSI is multifactorial, although I believe disc compression to be the primary factor nowadays. In reality, I did things backward under incorrect advice, and therefore wasted a lot of time.
Over the years, I zigzagged through Structural Integration (helpful) and Alexander Technique (very helpful) until I found an experienced American PT who trained me remotely. It was a long journey month after month. You absolutely need hard and careful work to get better. Voice dictation cannot replace rehab because there are days your voice will stop working: think about laryngitis or acid reflux which damages your throat.
To address the remaining symptoms, I got PRP injections into the forearm and the upper back, based on the recommendations from someone in my support group. The hitch here was that the other patient in America only got a shot in the upper back, not the forearm, but the local surgeon who administered PRP to my body insisted on giving a shot in the forearm. 30% reduction of computer-related pain, I would say. He couldn’t understand that logic. I had to wait another year until the upper back felt very severe symptoms, and the second injection was highly effective in reducing my mouse-related problems, maybe another 30% down.
The remaining numbness when using the mouse can be clearly explained by the cervical disc compression (C5-6), and it was exacerbated by the vibration of a small e-vehicle I was driving last winter, similar to what happened to the lumbar discs. Hence I decided to get another cervical MRI after 5 years. Guess what? I had one more herniated disc. Now I have to take it seriously, against the acupuncturist’s dissuasion. I got the spinal decompression treatment for the neck with no regret, along with a more intensive stability drill. Both clinicians are male this time. The entire process was painstaking because I had to endure the bureaucracy and ideological attack from certain Chinese clinicians. Some clinicians trained in TCM really hate Western medicine, presumably due to their ignorance and ideological insecurity.
I do not aim for perfection in this recovery, but I am making solid progress year by year. With other health issues coming up, I can’t afford to prioritize physical therapy throughout the year.
I still recommend dictation in place of typing, when it comes to writing. As for using dictation for programming, I have reservations about it, but I have never been an enthusiast in programming languages. I had to learn many when I was in college and in academia.
Yes, I am going to tell you my latest life lessons: do not expect a generic TCM practitioner or PT or chiro to give you very accurate diagnoses in musculoskeletal issues. In many hospitals, PTs receive referrals from orthopedic surgeons or sports medicine doctors. Only well-rounded orthopedic surgeons can order MRI scans with confidence— what I have learned through years of observation. I’m not saying that healthcare structure is necessarily a good thing.
What kind of clinicians do I love or hate?
I love clinicians who directly offer their honest opinions, even when they turn out biased or simply wrong. I love clinicians who admit the limitations of their own skill set and ask me to seek a 2nd opinion from other experts. I don’t expect any person to be able to cure every problem I have. People are trained in different schools, and none of those is perfect.
What kind of clinicians do I hate? (Yes, I’m using this strong word, because their behavior pushes my buttons.) Those who call me faking it or call me psychosomatic, after I point out their treatment or advice is ineffective. These people like to be worshiped by ordinary citizens who don’t have deep biomedical knowledge. These people like to play the authority and are only open to positive feedback. They probably never do any follow-up with patients, whether it’s a hospital or a private clinic, not in a thousand years. They may know the limitations of their service, but they don’t want to give that away in front of me or their trainees. One can say they are egomaniac or narcissistic, but most probably, they’ve simply learned to gaslight patients like me. Medicine is a business in this objective world. Playing the authority benefits them more than admitting their misdiagnosis, I assume.
Regarding why such clinicians never hear negative feedback. Some people may say, for some clinicians, it’s because patients don’t want to hurt their feelings, knowing they are generally good people. That makes sense. Human nature. Here’s a cynical version of it: patients know that when you tell the clinician their treatment is ineffective, the clinician may get upset, so they won’t treat you again. First-hand experience. Patients in a small city have no choice but to hide it in order to maintain the relationship with the clinician.
Here’s something even more bitter. As mentioned above, every time I got a disc bulge or herniation in my MRI scan, some clinicians would tell me that I didn’t need to get the disc back in place. Their opinion works for some people but is refuted by my personal experience. The conservative treatment could never eradicate the problem; they may mask the problem temporarily until it stops working. Some surgeons can appear to be dismissive of your condition, even after you tell them your symptoms are clearly associated with the disc problem. Why? Because these surgeons know their hospital cannot offer conservative treatment like American-styled physical therapy, by which I mean doing a prescribed exercise program. Authorities don’t want to admit their own incapabilities or the lack of resources in their organization. Losing face means they will lose their business or their status. It doesn’t just damage their own reputation.
Wrong opinions as well as bureaucracy from clinicians can do a lot of harm to patients. Imagine a TCM doctor told senior patients that COVID-19 is just a flu so they don’t have to take it too seriously. Imagine a TCM doctor telling senior patients that vaccination was harmful to the body. Imagine those senior patients believing those opinions, and then dying of infection during the pandemic. Would the doctor take responsibility for that? Not in a thousand years. They would stick to the principle of self-preservation. In case of conflict, they would deny they had said anything, and their colleagues would have to testify in favor of this doctor. Or they could simply retire early or move to a different position. Sorry, am I talking about a real person? Hehe. By the way, the flu is also a serious health urgency nowadays. People can die because of it.
About Ohio? That was a student clinic with very limited resources, so I can’t blame them. They helped me as much as they could. How would you expect the PT in a student clinic to have seen many cases of herniated discs? Probably very rare. For a student clinic, that one comes with a physical therapy clinic, which is already amazing. How is that impossible? Because it’s Ohio State.
Again, I have to put the disclaimer here: my opinions are my own based on my complicated experiences. I cannot give medical advice to other patients, although it doesn’t mean they shouldn’t listen to my opinions. I tend to err on the side of caution and tend to see the long range, unlike most people living in a small town. Remember to see different types of experts, not just a second opinion from the same type of specialist belonging to the same cluster. I had to say that cruel fact: just like psychotherapy, there is only so much physical therapy can do. Sometimes you need cutting-edge techniques to undo the damage, when it comes to tissues like tendons, ligaments, and discs.
I hope my story can at least help some people deal with their chronic health problems. Filling up this story may not provide immediate solutions to my injuries, but the missing pieces, once identified, could bring me a lot of joy and serve as solemn reminders in life. There were lessons in dealing with people, or the bureaucracy; there are lessons in coping with the environment as well. One small example is that we should be wearing anti-slip shoes, whether we are young or old.
(June 10, 2025) There has been some new discovery about my leg length discrepancy. I will update here if there’s any turnaround. Remember in health care, there’s rarely any absolute right or wrong. If a clinician can reshape your body to make your life easier, definitely catch the opportunity. Theories should be used to guide holistic practice, instead of selling orthotics.
At the end of this post, I’d like to thank you for paying attention to my book project. Please go to my site and subscribe to the official newsletter if you are interested. Please share my book link(s) with people who you think may benefit from it. My future articles will be shorter, and more frequent, and the topics are going to get more psychological and potentially sensitive. In particular, some of my articles will benefit immigrants mostly.