Me, tears streaming down my face, sobbing, as I stare at the stars: it’s just so beautiful
The medieval peasant I went back in time to give a bag of Doritos to, concerned: what terrible and powerful sorcerers they must have in your age, to be able to veil the vault of heaven itself from view, as you say
Me, sniffling: I didn’t realize, I can’t, it’s so much, I, I… are the chips good, at least?
Medieval peasant, trying to make me feel better: they’re… magical, strange traveler
actually im doing really well except for the fact that everything makes me sad and the things that dont make me sad make me angry. but other than that im fine
okay wait something about robert robertson just hit me.
maybe this mf doesn’t have a bed (besides the fact he threw his mattress in the dumpster to catch toxic) because sleeping on the wrong type of mattress hurts when you have chronic pain.
i was reading a post on the sciatica subreddit (lol what is my free time) where this person was basically like “am i trippin or do i feel better when i sleep on the floor?” and all the comments were like “yeah soft beds make my bones sit weird and makes me hurt more in the morning and i sleep like shit.”
my first thought was “hmm, i should try sleeping on the floor.” my second thought was “ROBERT.” it all makes sense.
like we literally aee him laying on the floor with beef in the game. i know it’s supposed to depict him being depressed (pants off, liquor bottle in hand) but like what if it also just feels good to him?
i've searched every combination of words imaginable and i still can't find that gif of the german star trek parody where gay spock is quickly drinking coffee and smoking freaking out PLEASE send it to me i need it urgently
So, you're writing fanfiction and your character has a fucked up back. Everyone has a little bit of back pain sometimes, but how does 'need surgery' back pain work? I'm using Robert Robertson Dispatch as a template here but feel free to use this on any characters you want to put in a jar and shake.
I can't speak to the nature of what Robert's exact spine damage is (although we all know he has some at least) but I assume his damage is probably chronic and lumbar, which is what I have, so I feel uniquely qualified to speak on this. Also, disclaimer: everyone has different experiences with this stuff so there's not really a right or wrong answer. Play around with it!
Think of chronic pain like a song that's playing in the background when you're trying to work. The song is always playing, or at the very least it always has the potential to be playing, and the volume changes. Most of the time it's at a low hum, constant and consistent, but you can tune it out well enough. It's not that you stop feeling the pain, but once you become familiar with it, it just turns into another one of the dozens of things you feel in and on your body.
The volume changes and fluxes constantly. When the volume is turned up you still have to ignore it, but it's much harder. It doesn't fade into the background as easily. This often makes you distracted and irritable because so much of your mental energy is being stolen by the pain. Occasionally the song is turned up so high that you can't think straight. This is a little more rare thankfully, but when it happens it sucks.
So.
What damage are we talking about, exactly?
Listen, I'm not a doctor, but I do have a truly insane quantity of pictures of CT and MRI scans, so take this with a grain of salt. Your back is made of vertebrae, right? Bones all stacked on top of each other. In between those are your spinal discs, little cushions between each vertebrae that keep the bones separate. Unfortunately those discs are very prone to wear and tear.
This is generally known as degenerative disc disease, a catch-all for the fact that as we age, our vertebrae work against these discs and wear them down. It is, unfortunately, inevitable, with age being the number one cause of disc degeneration. It’s far from the only cause, though; in fact, by the age of eighteen two of the discs in my back had basically disintegrated. This means that a few of my lumbar vertebrae (once again, bones) were grinding against each other for a couple of years. Obviously that hurts. I’ll get more into that later.
Risk is increased by an excess of physical exertion. If you move, so does your spine, shifting and rubbing. While this is natural, too much of anything is a bad thing. I assume that Robert in his years of workaholicism probably wore down the discs in his back a lot, most of this being in his lumbar (lower back, and the most common area for disc degeneration), although there was probably some amount of damage to his cervical spine (the spine in your neck).
The thing about degenerative disc disease is that it can take years for it to really become a problem worth addressing. In fact, basically everyone over the age of 40 has some level of disc degeneration as a natural consequence of aging. For most people, unless it becomes really severe and a detriment to their health, just focus on pain management.
So what does it actually feel like?
At first it's just an ache. It doesn't feel explicitly bad but it certainly doesn't feel good. It's weird.
'What do you mean chronic damage doesn't feel bad?' That's a fair question and it's one I don't really have an answer to. This started for me when I was pretty young (like, 10-12) so unfortunately I don't have very clear memories of what the onset was like, but I remember describing it as weird. It didn't hurt, it felt weird. It's like there's a zone of sensation, starting around the height where the hips dip in and going down to your ass. The truest word I can use to describe it is Uncomfortable. It aches and thrums like the hum of an AC. It tingles, almost.
Okay, what about when it starts getting worse, when it actually starts hurting in earnest? It's hard to draw a line between Uncomfortable and Pain. They hold elements of each other, they're inextricable, but it changes when the sensation starts feeling sharp. It graduates from that low thrum to a... louder thrum, I guess, and it's accompanied by that sharpness that we actually associate with pain. If you stretch by lifting your arms up, when you're relaxing there will be a quick, agonizing stabbing in the side of your spine. It lasts for only a few seconds but in the moment it's debilitating.
What's it like when the damage gets so bad the song gets deafening? The thrum is still there but it's all the way on max and it's accompanied by real pain. That zone of sensation tingles in a bad way and all the muscles in that area are tensed up which only makes it hurt worse. It's hard to think straight.
You don't actually feel it in your spine. That's why it's so weird and hard to explain. Hell, can you even feel your spine? Think about it. Think about where your spine is and try to feel it. You probably can't, or at least you can't feel it like you might expect to. That basically turns your spine into the Bermuda Triangle of pain. How do you know what you're feeling if you don't even know what you're feeling it from? That's why I described it as a zone of sensation. I'm not feeling it in my arm but I'm not feeling it as a rod of pain in my back, either. It's an extremely amorphous thing.
Your muscles hurt, too. They're strained and clenched because of the constant pain. I am woefully uninformed on muscle anatomy but at least in my experience, there's two long big muscles that run on either side on your spine and they require pretty frequent massaging to not ache so much. Your shoulders get pretty tense, too. Basically all the muscles on your back hate you.
Inflammation wants to kill you and your children. Whatever pain you feel now, inflammation makes it exponentially worse. Inflammation is when everything swells up, right? It takes up more space. Unfortunately your body only has so much space, meaning that once things swell they press down on nerves. You know how a pinched or compressed nerve is agony? Yeah, that's what inflammation is doing. In fact, for two months after my first surgery I had a hard time walking because the inflammation was pressing down on nerves and giving me terrible leg pain. On bad days I still get twinges, and this is a great way to force a mobility aid onto Robert. Diet is also a HUGE factor. Robert eats like shit, it's a lot of greasy hyperprocessed stuff, so that absolutely would make it worse.
Alright, how does this all work into a fic? Let's say we're writing in pre-canon where Robert has damage from being a workaholic and hasn't had surgery yet.
The tricky thing about chronic damage is that it isn't acute. It starts slowly and it's very easy to brush it off for years because it feels like just a minor discomfort. You just get so used to it that it's completely normal, it's a part of your life, and you don't even think about addressing it. I know this because it's exactly what I did. In fact, the only reason my damage was caught was because I made an offhanded comment to my doctor about 'the normal amount of back pain', at which point she side-eyed me and ordered an x-ray. I owe her my life. So, it's entirely probable that this, combined with the fact that Robert probably has a very high pain tolerance and is very stubborn, would never seek treatment and would likely already have some amount of damage by the time he crashes and ends up in a coma.
Sitting, standing, or lying down for extended periods of time hurts. The exact level of pain varies quite a bit depending on the situation but generally speaking the longer you stay still, the worse it gets. The onset and worsening of pain can be slowed with cushioning and support but unfortunately no pillow will delay the inevitable. If Robert is sitting in the mech for hours at a time, he's going to start hurting and it's only going to get worse until he can take a break and walk around. Even if he can take a break, that'll only offer a few minutes of relief if he just sits right back down and keeps on going. This goes double for if he's sitting at his desk, although I assume within canon by the time he's at SDN he's already had surgery.
You become prone to fidgeting. Motion is a temporary relief, it takes away that sharp jab for a couple of moments, and that’s a relief that you’ll spend every second of your day chasing. Shifting in your seat, standing up often, sitting down often, anything other than staying still.
Okay, so what's it like after surgery?
I assume that Robert had surgery after the crash so the coma gave him a break. I would write another six paragraphs about the entire process after surgery (lord knows I’m familiar with it), but I think the months in the coma allowed him to circumvent the worst of it. There are a few things, though.
No bending, twisting, or lifting anything over ten pounds. Oftentimes the point of spine surgery is to fuse the vertebrae together, which sounds awful but it’s a hell of a lot better than more damage. For the first few months after surgery the primary goal is ensuring the success of the fusion. This means that you have a fuckton of physical restrictions, restrictions I’m almost positive that Robert doesn’t comply with (I will admit to pushing the envelope on this myself). A lot of these are weight restrictions, a certain amount you’re not supposed to lift basically ever again. Once again, we know for a fact Robert will ignore this, but it makes for great nagging material.
You can’t feel the hardware in your back but you can feel more stability. I’ve had a few people ask if I can feel the rods in my back or if I feel restricted at all. No, I don’t, but there is a difference. It’s not stiff or restrictive, it’s very comfortable, actually. You are sore for quite a while after getting a bunch of stuff screwed into your bones, though.
Inflammation wants to kill you and your children (part two, electric boogaloo). Your body is not happy with the fact that someone just cut and carved and drilled holes and stuck a bunch of new shit in there. For the first few months the inflammation is the worst while your body is trying to adjust to everything, and that’s when it hurts the worst. It does thankfully go down with time but it can take up to a year for the worst of the inflammation to go away.
Alright, we've got all of that. How do we address pain if we want to give our guy a break?
OTC painkillers are basically useless. It's not that the pain is so severe that OTC's won't do anything, it just doesn't work, period. Occasionally if I'm in a really bad spot and I'm getting desperate I'll try taking ibuprofen or something, but it has truly zero effect. If your Robert doesn't have prescription medication you could use this as an excuse for why he doesn't take medication, because this shit truly does nothing. The only OTC I've found any relief in is the combination of acetaminophen and ibuprofen which, fun fact, can be as effective as an opioid! Un-fun fact, doing this chronically will destroy your liver, so I keep my distance.
Okay, prescription medication! I'm not a pharmacist so please take this section with a grain of salt. The most common prescribed pain managements are painkillers (opioid and non-opioid) and muscle relaxers. A lot of people with chronic back pain take maintenance medication, meaning something they take every day around the same time to try and bring down the baseline level of pain, such as gabapentin. There's also medication for breakthrough pain, meaning that the normal regimen is falling short, which is generally where you have to break out the heavy stuff, like narcotics. I, personally, avoid these as much as I can, because they really fuck with my head. Like, staring into the void, takes a minute to string a sentence together level of fuckery. This is also a great excuse for why Robert may not want to take them. I usually stick to muscle relaxers which are extremely effective and don't make me a zombie.
Heat! Heat is our best friend. Hot baths, heating pads, etc, are very effective. Heat forces your muscles to relax and dilates your blood vessels, meaning more blood is flowing to the area. If I could walk around with a heating pad on my back, I would.
Laying on your side. Like I mentioned earlier, sitting and laying down can hurt, which is really really frustrating since chronic pain is also fatiguing. The most pain-friendly position I've found is lying on my side, but that doesn't get rid of the pain immediately. It usually takes a couple of minutes and some patience in this position to start getting any relief.
Motion is a maintenance and breakthrough medication. Shifting on your feet or side-to-side or standing up and walking is a very quick way to get relief although it doesn’t last very long, usually a few seconds or a couple of minutes. Exercise is a friend you have a complicated relationship with. You do need to move and it does help with pain management but you have to be very careful to not overdo it. Of course, Robert overdoes it.
TENS units! TENS stands for Transcutaneous Electrical Nerve Stimulation. It’s a little device with a bunch of wires connected to it, these wires being connected to a couple of little pads with sticky jelly on them. You stick the pads wherever your pain is the worst and turn it on, at which point it’s basically sending low-level electrical shocks to the area. It’s a very odd sensation but one that I personally find helpful. It feels like buzzing and while it doesn’t get rid of the pain by any means, the additional stimulation does help distract from it. If you’re familiar with the gate theory of pain, that’s what this is doing.
Massages and hot baths. These are great for relaxing the muscles in the affected area and helping with some of the inflammation. I often take hot baths with Epsom salt and I find some level of relief in it, although it really depends. I’m imagining Robert being forced into a nice, hot bath, and then getting a massage. He suffers so much, he deserves it.
And that’s pretty much it! I know this was very long but I really wanted you guys to have as much information as I could provide. I thought about adding another section on scars and wound care but I figure that’s it’s own thing. Once again, I’m not the primary authority on back problems! All of this is taken from my own personal experience and that doesn’t make anyone else’s experiences incorrect or less valid.
If you have any questions, I will answer! Hope this is helpful and make that man suffer!
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