ODI

Let's face it:  I'm a nerd. I'm a nerd in touch with her emotions and can express them. But I'm still a nerd. So when I...

Let's face it:  I'm a nerd.
I'm a nerd in touch with her emotions and can express them.
But I'm still a nerd.

So when I was up the other night (unable to find a comfortable position in which to sleep + mind preoccupied), I started researching lower back artificial disc replacement studies: the efficacy of multi-level disc replacement; post-op follow-ups in the 2-10 year ranges; comparison of different studies, etc.

A term kept on coming up — ODI — the Oswestry Disability Index.  The short questionnaire is designed to help doctors and researchers gauge where a person is in terms of their pain and how their pain affects their life.  The idea is that a doctor or researcher can ask these questions at various stages in a person's care (prior to surgery and at various post-op intervals) and compare as to whether there was an improvement.

There are 10 sections to the ODI questionnaire, with 6 possible answers in each section. Point values are assigned from 0 to 5 for each question depending on how the patient responds.  The sections are (1) Pain Intensity (2) Personal Care (3) Lifting (4) Walking (5) Sitting (6) Standing (7) Sleeping (8) Sex Life (if applicable) (9) Social Life (10) Traveling.  (Notice "Exercise" is not a category??)


The answers are then converted to a score and the score then determines the percent disability:
0% to 20% (minimal disability): Patients can cope with most activities of daily living. No treatment may be indicated except for suggestions on lifting, posture, physical fitness and diet. Patients with sedentary occupations (ex. secretaries) may experience more problems than others.
21%-40% (moderate disability): Patients may experience more pain and problems with sitting, lifting and standing. Travel and social life are more difficult. Patients may be off work. Personal care, sleeping and sexual activity may not be grossly affected. Conservative treatment may be sufficient. 
41%-60% (severe disability): Pain is a primary problem for these patients, but they may also be experiencing significant problems in travel, personal care, social life, sexual activity and sleep. A detailed evaluation is appropriate. 
61%-80% (crippled): Back pain has an impact on all aspects of daily living and work. Active treatment is required. 
81%-100%: These patients may be bed bound or exaggerating their symptoms. Careful evaluation is recommended.
If I were to take the test today, I would score a 46%.  This makes me sad.  I also realized when doing the test how much I've either had to give up (like playing softball/volleyball or volunteering at the animal shelter) or how much I avoid (dating) cause of my back. It makes me think of all the times I've turned down doing something I want to do (like going to museums) because I know how it'll affect me (walking on marble is the worst).

The questions also made me think of some stories that I've never told.  For instance, the travel section:
  •  I can travel anywhere without pain [0]
  •  I can travel anywhere but it gives me extra pain [1]
  •  Pain is bad but I manage journeys over two hours [2]
  •  Pain restricts me to journeys of less than one hour [3]
  •  Pain restricts me to short necessary journeys under 30 minutes [4]
  •  Pain prevents me from travelling except to receive treatment [5]
Since I have one of those "but you don't look sick/injured" injuries, I don't always get offered a seat on the bus or on the metro (I also feel weird asking for them).  The unexpected acceleration/deceleration of mass transit vehicles as well as their bad suspension often makes me clench my teeth in pain/discomfort.

In 2000, right after going to the ER for the first time for my back (and then being referred to an orthopedist who asked if I had too much rough sex), I went on Spring Break to Hawaii to visit my cousins.  On the leg from LAX to Hawaii, the flight attendant noticed that I kept shifting in my chair and asked me if I was comfortable.  I told her about my lower back pain.  She let me lie down in the bulkhead row.  What an angel. 

I wrote last week that this is "Not the Life I Want To Live" — it took doing this little exercise to actually see the day-to-day impact of my back injury versus feeling hopeless for the future.  This affects me now.   I'm glad I'm going to my doctor tomorrow morning.

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2 comments

  1. I struggle with chronic back pain as well so I can totally relate to how awful it is to live with pain that never gives you a break. I'm not a doctor but will tell you that taking fish oil (high EPA (for pain) instead of high DHA (for brain) made a huge difference in how well I can function with bulging discs. It takes about two weeks to kick in and if I go two days without my fish oil I can definitely tell it pain wise. Hope your doctor is helpful! Mine just want to give me pain meds and limited amounts of physical therapy (although stretch and yoga does help!).

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  2. @FitJournal -- I've read a lot about anti-inflammatory diets, and especially the role of Omega 3 Fatty acids. While I think an anti-inflammatory diet isn't a bad thing (it doesn't have any weird fad diet claims) and definitely worth trying overall, I think I'm past the stage where it can reverse the damage done (through trauma and genetics). My doctor understands that i want to be proactive and that one of my main focuses is the long-term strength and flexibility of my spine as well as preserving nerve function.

    That and I can only take fish oil at night. I get the worst fish oil burps.

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<3 Robby