It's all connected: Posture, Pain, Genetics, NSAIDs, and Stomach Problems

 I was fairly young when I started having health problems. One of them was headaches. I had severe headaches and then migraines starting when I was maybe 9. By the time I was in high school, headaches, constant infections, fatigue, and stomach problems caused me to miss over a month of class every single school year. One thing that helped quite a bit was Excedrin Migraine, a combination of ibuprofen and caffeine. I popped those things like candy. I bought them all the time, taking the maximum dose for weeks at a time. 

When I was a senior in high school I was diagnosed with my first ulcer and given Nexium. I was diagnosed with another ulcer when I was a freshman in college. 

I don't know why doctors never thought to connect my excessive usage of Excedrin Migraine to my ulcers. 

I've eaten all sorts of things since I discovered evolutionary medicine. Some of those things were not probably the best things to eat. And sometimes I've had stomach aches, but I've never gone back to my original horrible messed up state. 

Except once. I was backpacking through Europe with friends. Let's just say I didn't sleep so well and I also drank my fair share of brandy, mulled wine, and beer. I came down with what was probably strep throat, but the trip was almost over and I didn't know how I could get treated in a place like Budapest. So I took the max safe dosage of ibuprofen for over a week, all through Hungary and Austria. By the time I got back to home base in Sweden, I was having heartburn again. It took a long time for me to get rid of that. It was extremely unpleasant to say the least, requiring a strict elimination diet to fix.

And at that time I did my research and found that NSAIDs could damage the gut lining. Some studies have connected NSAIDS to impaired intestinal permeability in IBS patients. I stopped taking them. 

Last year I purchased 23andme for myself and then I also got my dad a kit for Christmas. I ran both of our outputs through Promethease, a cool open-source program I've blogged about before. One thing that I noticed this time was genoset 191, which is related to poor NSAID metabolism. Being super lucky, I have CYP2C8*3 from my father and CYP2C9*2 from my mother. Several studies have shown this genoset is associated with gastric bleeding. Now that's an acute symptom, but you have to wonder it can cause more subtle chronic stomach problems as well. 

Both my parents were taking NSAIDS at the time I realized this. Both have a history of stomach problems. My mother discontinued them on my advice and she said it helped. 

But when you stop taking NSAIDs, you realize how much our culture depends on them. Last year I messed up my knee while exercising and was kind of sore for a couple of days. I rarely resort to pain killers, but it was affecting my ability to concentrate. The office first aid kit only contained NSAIDs- aspirin, advil, etc. I walked to the drug store in pain and bought tylenol. It doesn't work as well for me as NSAIDs, but it worked OK.

But not being able to rely on pain relievers also forces you to address the real source of problems you might cover up otherwise. It seems like at least once a year, I get bad neck aches. Ususally it's after a big project when I sit hunched over for too long, even though I know it will have consequences. Unfortunate Even a standing desk doesn't fix this for me. Apparently I can hunch while standing.

Usually yoga helps it, but my regular yoga teacher moved away. When I went to another level 1 yoga class nearby, that teacher was really pushy about inversions. Now, I think inversions can be safe, but I don't think they are safe for beginners or people with certain structural issues at all. That's not the way the human body evolved to move and you really need to have good core strength and flexibility (the latter which I do not have) to do them safely. And of course my neck got worse after that class, to the point where I started to get headaches. 

And the 8 Steps to Pain-Free Back stuff only helps so much when it's that bad. I can't maintain the recommendations in the book if my muscles are cramped and miserable. So I decided to try other things. I went to the chiropractor next door to my office. Now I am suspicious of a lot of chiropractic stuff, but when my neck is in such a state, it really does seem to help and I can chose to ignore the office woo about food/vaccines/etc. Which is kind of hilarious given how pushy some chiropracters are about getting x-rays, which increase risk for several cancers. They had a video playing in the office of the latest place I went that was about chiropractic care having been around for 2000 years or something. I wondered how it was ever possible it existed before x-rays considering how annoyed they were with me when I said I wouldn't sign off on them. 

The other thing I didn't like about the chiropractic stuff is that I didn't feel it was fixing the root causes, just treating the symptoms and frustratingly when I brought that up to the chiropractor, they just said I needed to come in more. When I dialed back on my appointments because I was busy, the pain came back. 

I started seeing a rolfing professional on a whim. Rolfing was pretty interesting- is it almost like a massage, but one that tries to correct your structure by interrupting dysfunctional fascia. It provided me relief and the rolfer provided some insight into some of the everyday imbalances that seemed to plague me. I got the book she recommended, The New Rules of Posture by Mary Bond, which I'm currently in the middle of. 

It's truly an interesting book in how it points out the potential sources of problems. For example, I was under the impression that I was doing the right thing in terms of my shoes and walking. I walk a lot and I wear flexible thin-soled shoes. Earlier this year I started having some annoying heel pain on my right food. The exercises in the book pointed out that this is my dominant foot, so that makes sense. Or does it? Turns out that dominant doesn't mean what you think it means, the drive for the act of walking according to Bond should be the buttocks and ball/toes of the non-dominant foot, rather than the heel strike, which is how I was driving.

Also the Bond and Gokhale books both pointed out that the fact that my dress straps on many of the sleeveless dresses slipping is not just a minor annoyance, it reveals that my shoulders have become rounded over time, probably from a mixture of hunching (I often put my elbows on my desk and lean onto my hands) and letting my shoulder muscles atrophy. There is also just a host of interesting information about posture in the Bond book, particularly that about posture reflecting mood and social structure. If you think about this it makes sense. How many times have you seen a timid animal hunch down with you tried to pet them? Or cats arching their backs when trying to menace another cat? Or a guilty dog hunch and look down at the ground when confronted? In humans you start to notice this as well, seeing the introverted child or overworked programmer hunching? Perhaps this explains why various studies have tied unhappiness to back pain. They always frustrated me because some used them to imply that back pain is psychosomatic, but in my opinion it seems more likely that unhappiness and unhappy situations can lead to poor posture and also that pain from that can lead to further unhappiness.

So for the new year I plan on finishing the Bond book exercises. And I'd like to try out Feldenkrais and the Alexander technique. More Rolfing too with some gentle yoga, and occasional visits to the chiropractor just to release tension. And perhaps instead of doing group workouts, focus on my own weight training with my own deficits in mind. Any other suggestions?